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  1. Article ; Online: Lost in Translation: The Role of Interpreters on Labor and Delivery.

    Le Neveu, Margot / Berger, Zackary / Gross, Marielle

    Health equity

    2020  Volume 4, Issue 1, Page(s) 406–409

    Abstract: During the Coronavirus (COVID-19) pandemic, in-person interpreters have been deemed "nonessential," and thus eliminated to minimize viral exposure and conserve personal protective equipment. Considering alarming patterns of interpreter underuse, we ... ...

    Abstract During the Coronavirus (COVID-19) pandemic, in-person interpreters have been deemed "nonessential," and thus eliminated to minimize viral exposure and conserve personal protective equipment. Considering alarming patterns of interpreter underuse, we evaluate how substitution for remote modalities (telephone or video) may exacerbate existing inequalities for patients with limited English proficiency. The inherent intimacy, dynamic physicality, and cultural nuances of labor and delivery pose unique communication challenges. Using clinical scenarios, we illustrate the vital role interpreters have in providing accessible obstetric care. We argue that eliminating in-person interpreters in this setting is not justified by COVID-related harms given the potential to exacerbate underlying health disparities.
    Keywords covid19
    Language English
    Publishing date 2020-09-30
    Publishing country United States
    Document type Journal Article
    ISSN 2473-1242
    ISSN (online) 2473-1242
    DOI 10.1089/heq.2020.0016
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Impact of Obesity on Clinical and Financial Outcomes of Minimally Invasive Hysterectomy for Benign Conditions.

    Le Neveu, Margot / AlAshqar, Abdelrahman / Kohn, Jaden / Tambovtseva, Anastasia / Wang, Karen / Borahay, Mostafa

    Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC

    2022  Volume 44, Issue 9, Page(s) 953–959

    Abstract: Objective: To evaluate the effect of obesity on clinical and financial outcomes of minimally invasive hysterectomy METHODS: This was a retrospective cohort study of 5 affiliated hospitals. We obtained demographic, operative, and financial ... ...

    Abstract Objective: To evaluate the effect of obesity on clinical and financial outcomes of minimally invasive hysterectomy METHODS: This was a retrospective cohort study of 5 affiliated hospitals. We obtained demographic, operative, and financial characteristics to analyze the effects of obesity on outcomes, including operating room (OR) time, estimated blood loss (EBL), length of stay (LOS), adverse perioperative events, and hospital charges. Obesity was stratified by the following classes: no obesity (BMI <30 kg/m
    Results: A total of 2483 women underwent benign, minimally invasive hysterectomy. Laparoscopic was the most common approach (79.8%), followed by robotic (12.2%), and vaginal (8.0%). Mean BMI was 30.13 ± 6.99 kg/m
    Conclusion: Obesity appears to have a significant effect on clinical outcomes of benign hysterectomy that is approach-dependent and most notable among patients with class III obesity. BMI was not, however, a predictor of financial outcomes.
    MeSH term(s) Female ; Humans ; Hysterectomy/adverse effects ; Laparoscopy/adverse effects ; Length of Stay ; Obesity/complications ; Obesity/epidemiology ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Robotic Surgical Procedures/adverse effects
    Language English
    Publishing date 2022-05-20
    Publishing country Netherlands
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2171082-X
    ISSN 1701-2163
    ISSN 1701-2163
    DOI 10.1016/j.jogc.2022.04.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Patient caught breastfeeding and instructed to stop: an empirical ethics study on marijuana and lactation.

    Gross, Marielle S / Le Neveu, Margot / Milliken, Kara A / Beach, Mary Catherine

    Journal of cannabis research

    2022  Volume 4, Issue 1, Page(s) 20

    Abstract: Background: The US guidelines recommend avoiding marijuana during breastfeeding given concerns about infant's neurodevelopment. In this setting, some physicians and hospitals recommend against or prohibit breastfeeding when marijuana use is detected ... ...

    Abstract Background: The US guidelines recommend avoiding marijuana during breastfeeding given concerns about infant's neurodevelopment. In this setting, some physicians and hospitals recommend against or prohibit breastfeeding when marijuana use is detected during pregnancy. However, breastfeeding is beneficial for infants and women, and stigmatization of substance use in pregnancy has been historically linked to punitive approaches with a disproportionate impact on minority populations. We advance an empirically informed ethical analysis of this issue.
    Methods: First, we performed a retrospective cross-sectional qualitative study of prenatal and postpartum records from a random sample of 150 women delivered in an academic hospital system in 2017 to provide evidence and context regarding breastfeeding management in relation to marijuana use. We then perform a scoping literature review on infant risks from breastmilk marijuana exposure and risks associated with not breastfeeding for infants and women. Finally, we analyze this issue vis-a-vis ethical principles of beneficence, autonomy, and justice.
    Results: (1) Medical records reveal punitive language pertaining to the medicinal use of marijuana in pregnancy and misinterpretation of national guidelines, e.g., "patient caught breastfeeding and instructed to stop." (2) Though there are plausible neurodevelopmental harms from breastmilk exposure to THC, evidence of infant effects from breastmilk exposure to marijuana is limited and largely confounded by concomitant pregnancy exposure and undisclosed exposures. By contrast, health benefits of breastfeeding for women and infants are well-established, as are harms of forgoing breastfeeding. (3) Discouraging breastfeeding for women with marijuana use in pregnancy contradicts beneficence, as it neglects women's health considerations and incorrectly assumes that risks exceed benefits for infants. Restrictive hospital practices (e.g., withholding lactation support) compromise maternal autonomy and exploit power asymmetry between birthing persons and institutions, particularly when compulsory toxicology screening prompts child welfare investigations. Finally, recommending against breastfeeding during prenatal care and imposing restrictions during postpartum hospitalization may exacerbate racial disparities in breastfeeding and related health outcomes.
    Conclusions: Policy interpretations which discourage rather than encourage breastfeeding among women who use of marijuana may cause net harm, compromise autonomy, and disproportionately threaten health and wellbeing of underserved women and infants.
    Language English
    Publishing date 2022-04-12
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2522-5782
    ISSN (online) 2522-5782
    DOI 10.1186/s42238-022-00127-y
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  4. Article ; Online: Laparoscopic administration of bupivacaine at the uterosacral ligaments during benign laparoscopic and robotic hysterectomy: a randomized controlled trial.

    Frost, Anja S / Kohn, Jaden R / Le Neveu, Margot / Brah, Tara / Okonkwo, Obianuju / Borahay, Mostafa A / Wu, Harold / Simpson, Khara / Patzkowsky, Kristin E / Wang, Karen C

    American journal of obstetrics and gynecology

    2023  Volume 229, Issue 5, Page(s) 526.e1–526.e14

    Abstract: Background: Postoperative pain continues to be an undermanaged part of the surgical experience. Multimodal analgesia has been adopted in response to the opioid epidemic, but opioid prescribing practices remain high after minimally invasive hysterectomy. ...

    Abstract Background: Postoperative pain continues to be an undermanaged part of the surgical experience. Multimodal analgesia has been adopted in response to the opioid epidemic, but opioid prescribing practices remain high after minimally invasive hysterectomy. Novel adjuvant opioid-sparing analgesia to optimize acute postoperative pain control is crucial in preventing chronic pain and minimizing opioid usage.
    Objective: This study aimed to determine the effect of direct laparoscopic uterosacral bupivacaine administration on opioid usage and postoperative pain in patients undergoing benign minimally invasive (laparoscopic and robotic) hysterectomy.
    Study design: This was a single-blinded, triple-arm, randomized controlled trial at an academic medical center between March 15, 2021, and April 8, 2022. The inclusion criteria were patients aged >18 years undergoing benign laparoscopic or robotic hysterectomy. The exclusion criteria were non-English-speaking patients, patients with an allergy to bupivacaine or actively using opioid medications, patients undergoing transversus abdominis plane block, and patients undergoing supracervical hysterectomy or combination cases with other surgical services. Patients were randomized in a 1:1:1 fashion to the following uterosacral administration before colpotomy: no administration, 20 mL of normal saline, or 20 mL of 0.25% bupivacaine. All patients received incisional infiltration with 10 mL of 0.25% bupivacaine. The primary outcome was 24-hour oral morphine equivalent usage (postoperative day 0 and postoperative day 1). The secondary outcomes were total oral morphine equivalent usage in 7 days, last day of oral morphine equivalent usage, numeric pain scores from the universal pain assessment tool, and return of bowel function. Patients reported postoperative pain scores, total opioid consumption, and return of bowel function via Qualtrics surveys. Patient and surgical characteristics and primary and secondary outcomes were compared using chi-square analysis and 1-way analysis of variance. Multiple linear regression was used to identify predictors of opioid use in the first 24 hours after surgery and total opioid use in the 7 days after surgery.
    Results: Of 518 hysterectomies screened, 410 (79%) were eligible, 215 (52%) agreed to participate, and 180 were ultimately included in the final analysis after accounting for dropout. Most hysterectomies (70%) were performed laparoscopically, and the remainder were performed robotically. Most hysterectomies (94%) were outpatient. Patients randomized to bupivacaine had higher rates of former and current tobacco use, and patients randomized to the no-administration group had higher rates of previous surgery. There was no difference in first 24-hour oral morphine equivalent use among the groups (P=.10). Moreover, there was no difference in numeric pain scores (although a trend toward significance in discharge pain scores in the bupivacaine group), total 7-day oral morphine equivalent use, day of last opioid use, or return of bowel function among the groups (P>.05 for all). The predictors of increased 24-hour opioid usage among all patients included only increased postanesthesia care unit oral morphine equivalent usage. The predictors of 7-day opioid usage among all patients included concurrent tobacco use and mood disorder, history of previous laparoscopy, estimated blood loss of >200 mL, and increased oral morphine equivalent usage in the postanesthesia care unit.
    Conclusion: Laparoscopic uterosacral administration of bupivacaine at the time of minimally invasive hysterectomy did not result in decreased opioid usage or change in numeric pain scores.
    MeSH term(s) Female ; Humans ; Bupivacaine/therapeutic use ; Analgesics, Opioid/therapeutic use ; Anesthetics, Local/therapeutic use ; Robotic Surgical Procedures ; Pain Measurement ; Practice Patterns, Physicians' ; Pain, Postoperative/prevention & control ; Hysterectomy/adverse effects ; Laparoscopy/adverse effects ; Morphine ; Abdominal Muscles
    Chemical Substances Bupivacaine (Y8335394RO) ; Analgesics, Opioid ; Anesthetics, Local ; Morphine (76I7G6D29C)
    Language English
    Publishing date 2023-07-31
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 80016-8
    ISSN 1097-6868 ; 0002-9378
    ISSN (online) 1097-6868
    ISSN 0002-9378
    DOI 10.1016/j.ajog.2023.07.047
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    In stock of ZB MED Cologne/Königswinter

    Um I Zs.152: Show issues Location:
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  5. Article ; Online: Creation and Implementation of Virtual Urogynecology Patient Cases for Medical Student Education.

    Kikuchi, Jacqueline Y / Le Neveu, Margot / Arnold, Shannon / Offnick, Austin / Muñiz, Keila S / Pandya, Prerna / Feroz, Rehan / Long, Jaime B / Ledebur, Lindsay R / Patterson, Danielle / Chen, Chi Chiung Grace

    MedEdPORTAL : the journal of teaching and learning resources

    2022  Volume 18, Page(s) 11259

    Abstract: Introduction: Urogynecologic disorders are highly prevalent, and many physicians across various specialties will encounter and care for patients with pelvic floor disorders. Yet most medical students have had limited to no experience in diagnosing and ... ...

    Abstract Introduction: Urogynecologic disorders are highly prevalent, and many physicians across various specialties will encounter and care for patients with pelvic floor disorders. Yet most medical students have had limited to no experience in diagnosing and managing pelvic floor disorders, resulting in a gap in clinical education.
    Methods: Three virtual and interactive urogynecologic patient cases were developed on an e-learning platform with an overall goal of increasing clinical exposure to various pelvic floor disorders. The cases were integrated into the medical student obstetrics and gynecology clerkship during the 2020-2021 academic year (
    Results: Twenty-one students (52%) completed the survey. Ninety percent (
    Discussion: Our findings suggest that these interactive virtual patient cases are an acceptable, valuable, and effective tool for learners. Utilizing the cases can help mitigate existing disparities in exposure to pelvic floor disorders both highlighted by and preceding the COVID-19 pandemic.
    MeSH term(s) COVID-19/epidemiology ; Female ; Gynecology/education ; Humans ; Pandemics ; Pelvic Floor Disorders ; Pregnancy ; Students, Medical
    Language English
    Publishing date 2022-05-27
    Publishing country United States
    Document type Journal Article
    ISSN 2374-8265
    ISSN (online) 2374-8265
    DOI 10.15766/mep_2374-8265.11259
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  6. Article ; Online: Creation and Implementation of Virtual Urogynecology Patient Cases for Medical Student Education

    Jacqueline Y. Kikuchi / Margot Le Neveu / Shannon Arnold / Austin Offnick / Keila S. Muñiz / Prerna Pandya / Rehan Feroz / Jaime B. Long / Lindsay R. Ledebur / Danielle Patterson / Chi Chiung Grace Chen

    MedEdPORTAL, Vol

    2022  Volume 18

    Abstract: Introduction Urogynecologic disorders are highly prevalent, and many physicians across various specialties will encounter and care for patients with pelvic floor disorders. Yet most medical students have had limited to no experience in diagnosing and ... ...

    Abstract Introduction Urogynecologic disorders are highly prevalent, and many physicians across various specialties will encounter and care for patients with pelvic floor disorders. Yet most medical students have had limited to no experience in diagnosing and managing pelvic floor disorders, resulting in a gap in clinical education. Methods Three virtual and interactive urogynecologic patient cases were developed on an e-learning platform with an overall goal of increasing clinical exposure to various pelvic floor disorders. The cases were integrated into the medical student obstetrics and gynecology clerkship during the 2020–2021 academic year (n = 40). Participants provided feedback regarding usability, acceptability, and educational value of the cases. Results Twenty-one students (52%) completed the survey. Ninety percent (n = 19) agreed or strongly agreed that they were satisfied with the cases, and 71% (n = 15) agreed or strongly agreed that they would recommend the virtual patient cases to other students. All students (n = 21) felt that the format was easy to use and reported that the cases were appropriate for their level of learning. Most students felt that the cases increased or significantly increased their confidence regarding nonsurgical and surgical management options for pelvic floor disorders. Discussion Our findings suggest that these interactive virtual patient cases are an acceptable, valuable, and effective tool for learners. Utilizing the cases can help mitigate existing disparities in exposure to pelvic floor disorders both highlighted by and preceding the COVID-19 pandemic.
    Keywords Pelvic Floor Disorders ; Pelvic Organ Prolapse ; Urinary Incontinence ; OB/GYN ; Online/Distance Learning ; Urology ; Medicine (General) ; R5-920 ; Education ; L
    Subject code 150
    Language English
    Publishing date 2022-05-01T00:00:00Z
    Publisher Association of American Medical Colleges
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Double-strand break repair assays determine pathway choice and structure of gene conversion events in Drosophila melanogaster.

    Do, Anthony T / Brooks, Joseph T / Le Neveu, Margot K / LaRocque, Jeannine R

    G3 (Bethesda, Md.)

    2014  Volume 4, Issue 3, Page(s) 425–432

    Abstract: Double-strand breaks (DSBs) must be accurately and efficiently repaired to maintain genome integrity. Depending on the organism receiving the break, the genomic location of the DSB, and the cell-cycle phase in which it occurs, a DSB can be repaired by ... ...

    Abstract Double-strand breaks (DSBs) must be accurately and efficiently repaired to maintain genome integrity. Depending on the organism receiving the break, the genomic location of the DSB, and the cell-cycle phase in which it occurs, a DSB can be repaired by homologous recombination (HR), nonhomologous end-joining (NHEJ), or single-strand annealing (SSA). Two novel DSB repair assays were developed to determine the contributions of these repair pathways and to finely resolve repair event structures in Drosophila melanogaster. Rad51-dependent homologous recombination is the preferred DSB repair pathway in mitotically dividing cells, and the pathway choice between HR and SSA occurs after end resection and before Rad51-dependent strand invasion. HR events are associated with long gene conversion tracts and are both bidirectional and unidirectional, consistent with repair via the synthesis-dependent strand annealing pathway. Additionally, HR between diverged sequences is suppressed in Drosophila, similar to levels reported in human cells. Junction analyses of rare NHEJ events reveal that canonical NHEJ is utilized in this system.
    MeSH term(s) Animals ; Caenorhabditis elegans Proteins/genetics ; Caenorhabditis elegans Proteins/metabolism ; DNA Breaks, Double-Stranded ; DNA End-Joining Repair ; DNA Repair ; Drosophila melanogaster/genetics ; Genome ; Homologous Recombination ; Rad51 Recombinase/genetics ; Rad51 Recombinase/metabolism
    Chemical Substances Caenorhabditis elegans Proteins ; Rad51 Recombinase (EC 2.7.7.-) ; rad-51 protein, C elegans (EC 2.7.7.-)
    Language English
    Publishing date 2014-03-20
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2629978-1
    ISSN 2160-1836 ; 2160-1836
    ISSN (online) 2160-1836
    ISSN 2160-1836
    DOI 10.1534/g3.113.010074
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