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The advent of ultra-minimally invasive endoscopic spine surgery, characterized by significantly reduced surgery times, minimal blood loss, and minimal tissue trauma, has precipitated a paradigm shift in the preoperative management of patients with cardiac disease undergoing elective spine procedures. This perspective article explores how these advancements have influenced the requirements for preoperative cardiac workups and the protocols surrounding the cessation of anticoagulation and antiplatelet therapies. Traditionally, extensive cardiac evaluations and the need to stop anticoagulation and antiplatelet agents have posed challenges, increasing the risk of cardiac events and delaying surgical interventions. However, the reduced invasiveness of endoscopic spine surgery presents a safer profile for patients with cardiac comorbidities, potentially minimizing the necessity for rigorous cardiac clearance and allowing for more flexible anticoagulation management. This perspective article synthesizes current research and clinical practices to provide a comprehensive overview of these evolving protocols. It also discusses the implications of these changes for patient safety, surgical outcomes, and overall healthcare efficiency. Finally, the article suggests directions for future research, emphasizing the need for updated guidelines that reflect the reduced perioperative risk associated with these innovative surgical techniques. This discussion is pivotal for primary care physicians, surgeons, cardiologists, and the broader medical community in optimizing care for this high-risk patient population.
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A key ambition in care studies has been to study care in practice and as practice. By turning towards practices, care studies has rendered visible and acknowledged important work that is not captured through looking at formal procedures or official and written materials, such as policy documents and medical protocols. In this literature, document materials and the written have often been seen as unable to demonstrate and address the 'specificities of care' (Mol et al., 2010, p. 9). We challenge this view by showing how pragmatically-oriented approaches can be extended to the procedural and formalized aspects of care practices. We draw upon fieldwork in the life sciences-comparative immunology-investigated through experiments on Atlantic cod (Gadus Morhua). How to care for fish is a contested domain; many uncertainties exist around how to care for fish so that legal requirements are met. We ask: How are existing legal and ethical principles and procedures put to work in cod immunology and animal research? By what document-practices and document-tools is care for cod in research negotiated and settled? How does the cod stand out as an object of care in the life sciences? Our article answers these questions by empirically teasing out how scientists navigate the terrain and arguing for the importance of bringing the document-based realities of animal research into analysis. We do this by delineating three different versions of care: procedural care, skilled care, and dispassionate care.
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The objective of the present study was to review the epidemiological and laboratory evidence on the role of aluminum (Al) exposure in the pathogenesis of cardiovascular diseases. Epidemiological data demonstrated an increased incidence of cardiovascular diseases (CVD), including hypertension and atherosclerosis in occupationally exposed subjects and hemodialysis patients. In addition, Al body burden was found to be elevated in patients with coronary heart disease, hypertension, and dyslipidemia. Laboratory studies demonstrated that Al exposure induced significant ultrastructural damage in the heart, resulting in electrocardiogram alterations in association with cardiomyocyte necrosis and apoptosis, inflammation, oxidative stress, inflammation, and mitochondrial dysfunction. In agreement with the epidemiological findings, laboratory data demonstrated dyslipidemia upon Al exposure, resulting from impaired hepatic lipid catabolism, as well as promotion of low-density lipoprotein oxidation. Al was also shown to inhibit paraoxonase 1 activity and to induce endothelial dysfunction and adhesion molecule expression, further promoting atherogenesis. The role of Al in hypertension was shown to be mediated by up-regulation of NADPH-oxidase, inhibition of nitric oxide bioavailability, and stimulation of renin-angiotensin-aldosterone system. It has been also demonstrated that Al exposure targets cerebral vasculature, which may be considered a link between Al exposure and cerebrovascular diseases. Findings from other tissues lend support that ferroptosis, pyroptosis, endoplasmic reticulum stress, and modulation of gut microbiome and metabolome are involved in the development of CVD upon Al exposure. A better understanding of the role of the cardiovascular system as a target for Al toxicity will be useful for risk assessment and the development of treatment and prevention strategies.
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Aterosclerosis , Enfermedades Cardiovasculares , Dislipidemias , Hipertensión , Humanos , Enfermedades Cardiovasculares/inducido químicamente , Enfermedades Cardiovasculares/epidemiología , Aluminio/toxicidad , Hipertensión/metabolismo , Estrés Oxidativo , Aterosclerosis/etiología , InflamaciónRESUMEN
Endocannabinoids were implicated in a variety of pathological conditions including anxiety and are considered promising new targets for anxiolytic drug development. The optimism concerning the potentials of this system for anxiolysis is probably justified. However, the complexity of the mechanisms affected by endocannabinoids, and discrepant findings obtained with various experimental approaches makes the interpretation of research results difficult. Here, we review the anxiety-related effects of the three main interventions used to study the endocannabinoid system: pharmacological agents active at endocannabinoid-binding sites present on both the cell membrane and in the cytoplasm, genetic manipulations targeting cannabinoid receptors, and function-enhancers represented by inhibitors of endocannabinoid degradation and transport. Binding-site ligands provide inconsistent findings probably because they activate a multitude of mechanisms concomitantly. More robust findings were obtained with genetic manipulations and particularly with function enhancers, which heighten ongoing endocannabinoid activation rather than affecting all mechanisms indiscriminately. The enhancement of ongoing activity appears to ameliorate stress-induced anxiety without consistent effects on anxiety in general. Limited evidence suggests that this effect is achieved by promoting active coping styles in critical situations. These findings suggest that the functional enhancement of endocannabinoid signaling is a promising drug development target for stress-related anxiety disorders.
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Cannabinoides , Humanos , Cannabinoides/farmacología , Cannabinoides/uso terapéutico , Endocannabinoides/metabolismo , Moduladores de Receptores de Cannabinoides/metabolismo , Ansiedad/tratamiento farmacológico , Trastornos de Ansiedad , Receptores de Cannabinoides/metabolismo , Adaptación PsicológicaRESUMEN
Pest ants are known for their damage to biodiversity, harm to agriculture, and negative impact on human welfare. Ants thrive when environmental opportunities arise, becoming pests and/or invading non-native areas. As social insects, they are extremely difficult to control using sustainable methods like biological control. The latter, although safer to the environment, acts slowly allowing the ants to use their individual and social defenses. Among biocontrol agents, fungal pathogens were proposed as promising, however, it is difficult to ascertain their success when the bibliography has not been reviewed and condensed. Therefore, this paper is the first in performing such task by analyzing publications mainly from 2000 to 2022 about the control of pest ants by fungi. From 85 publications selected, 77% corresponded to laboratory studies. Beauveria and Metarhizium were the genera most used in laboratory and field studies. Most of them included Acromyrmex and Atta leaf-cutter ants (LCA), and Solenopsis fire ants. From laboratory experiments, we evaluated how ant net mortality was affected by ant and fungal species, and also by origin, concentration, and inoculation technique of the fungal strains tested. Beauveria bassiana and Metarhizium anisopliae produced the greatest mortality, along with the inoculation spray technique and fungal strains collected from ants. There was a positive relationship between ant mortality and fungal concentration only for those studies which evaluated more than one concentration. Twenty field experimental studies were found, covering 13 pest species, mainly LCA and Solenopsis invicta. Only B. bassiana was tested on Solenopsis, M. anisopliae was mostly used for Acromyrmex, and M. anisopliae or Trichoderma were mainly used with Atta species. The median control field efficiency varied from 20% to 85% for different fungi and ant genera. When grouping all fungal species together, the median control efficiency seemed to be better for Acromyrmex (67%) than for Atta and Solenopsis (both 43%). Our review shows that, at this stage of knowledge, it is very difficult to extrapolate any result. We offer suggestions to improve and standardize laboratory and field experimental studies in order to advance more efficiently in the fungal control of pest ants.
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Stormwater is a vital resource and dynamic driver of terrestrial ecosystem processes. However, processes controlling interactions during and shortly after storms are often poorly seen and poorly sensed when direct observations are substituted with technological ones. We discuss how human observations complement technological ones and the benefits of scientists spending more time in the storm. Human observation can reveal ephemeral storm-related phenomena such as biogeochemical hot moments, organismal responses, and sedimentary processes that can then be explored in greater resolution using sensors and virtual experiments. Storm-related phenomena trigger lasting, oversized impacts on hydrologic and biogeochemical processes, organismal traits or functions, and ecosystem services at all scales. We provide examples of phenomena in forests, across disciplines and scales, that have been overlooked in past research to inspire mindful, holistic observation of ecosystems during storms. We conclude that technological observations alone are insufficient to trace the process complexity and unpredictability of fleeting biogeochemical or ecological events without the shower thoughts produced by scientists' human sensory and cognitive systems during storms.
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The article concerns the mechatronic design and experimental investigations of the HUBO automated human body scanning system. Functional problems that should be solved by using the developed scanning system are defined. These include reducing the number of sensors used while eliminating the need to rotate a human and ensuring the automation of the scanning process. Research problems that should be the subject of experimental research are defined. The current state of the art in the field of systems and techniques for scanning the human figure is described. The functional and technical assumptions for the HUBO scanning system are formulated. The mechanical design of the scanner, the hardware and information system architectures as well as the user's mobile application are presented. The method of operation of the scanning system and its innovative features are discussed. It is demonstrated that the developed solution of the scanning system allows the identified problems to be overcome. The methodology of the experimental research of the scanning system based on the photogrammetry technique is described. The results of laboratory studies with the use of dummies and experimental research with human participation are presented. The scope of the research carried out allows answers to the identified research problems related to the scanning of the human figure using the photogrammetry technique to be obtained. As part of laboratory tests using a measuring dummy, a mean error of 0.65 mm and standard deviation of the mean of 0.65 mm were obtained for the best scanner configuration. Research with human participation was carried out for the scanner version, in which the scanning time was 30 s, with the possibility of its reduction to 15 s. The results of studies using realistic dummies and with human participation were compared using the root mean square error parameter (RMSE) provided by the AliceVision framework, which was available for all analyzed objects. As a result, it was observed that these results are comparable, i.e., the RMSE parameter is equal to about 1 px.
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Cuerpo Humano , Aplicaciones Móviles , Humanos , Imagenología Tridimensional/métodos , Fotogrametría/métodos , AutomatizaciónRESUMEN
Some fungus-farming ambrosia beetles rely on multiple nutritional cultivars (Ascomycota: Ophiostomatales and/or yeasts) that seem to change in relative abundance over time. The succession of these fungi could benefit beetle hosts by optimal consumption of the substrate and extended longevity of the nest. However, abundances of fungal cultivars and other symbionts are poorly known and their culture-independent quantification over development has been studied in only a single species. Here, for the first time, we compared the diversity and succession of both fungal and bacterial communities of fungus gardens in the fruit-tree pinhole borer, Xyleborinus saxesenii, from field and laboratory nests over time. By amplicon sequencing of probed fungus gardens of both nest types at three development phases we showed an extreme reduction of diversity in both bacterial and fungal symbionts in laboratory nests. Furthermore, we observed a general transition from nutritional to non-beneficial fungal symbionts during beetle development. While one known nutritional mutualist, Raffaelea canadensis, was occurring more or less stable over time, the second mutualist R. sulphurea was dominating young nests and decreased in abundance at the expense of other secondary fungi. The quicker the succession proceeded, the slower offspring beetles developed, suggesting a negative role of these secondary symbionts. Finally, we found signs of transgenerational costs of late dispersal for daughters, possibly as early dispersers transmitted and started their own nests with less of the non-beneficial taxa. Future studies should focus on the functional roles of the few bacterial taxa that were present in both field and laboratory nests.
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Global salinization of freshwaters is adversely affecting biotic communities and ecosystem processes. We reviewed six decades (1960-2020) of literature published on animal responses to increased salinities across different taxonomic and ecological contexts and identified knowledge gaps. From 585 journal articles, we characterized 5924 responses of mollusks, crustaceans, zooplankton, non-arthropod invertebrates (NAI), insects, fishes, and amphibians to salinization. Insects and fishes were the most studied taxa; Na+ and Cl- were the most studied ions-. Collectively, concentrations of the ions examined typically spanned five orders of magnitude. Species' invasiveness was a key motivation for studying mollusks, crustaceans, and fishes; threats of urbanization and road salts were key motivations for studying NAI, zooplankton, and amphibians. Laboratory studies were more common than field studies for most taxa. Focal life stages in laboratory studies varied widely but juveniles and adults were represented similarly in field studies. Studies of mollusks, NAI, and crustacean focused on adults; studies of zooplankton, insects, fishes, and amphibians focused on juveniles. Organismal- and population-level responses measuring solute uptake, internal chemistry, body condition, or ion concentrations predominated laboratory studies; population- and assemblage-level responses measuring abundance, spatial distribution, or assemblage composition predominated field studies. Negative responses to salinization predominated but positive and unimodal responses were apparent across all taxa and organizational levels. Key topics for further research include a) salinity responses by more taxa, b) responses to especially toxic ions (i.e., potassium, bicarbonate, sulfate, magnesium), c) mechanisms causing positive and unimodal responses, d) traits underpinning responses, e) effects transcending organizational levels, f) ion-specific response thresholds, and g) interactions between salinity and other stressors. Our review suggests inter-taxa variation in sensitivity to salinization reflects occurrence of certain biological traits, including gill-breathing, semi-permeable skin, multiple life stages, and limited mobility. We propose a traits-based framework to predict salinization sensitivity from shared traits. This evolutionary approach could inform management aimed at preventing or reducing adverse impacts of freshwater salinization.
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Ecosistema , Motivación , Animales , Agua Dulce/química , Invertebrados , Sales (Química) , Zooplancton/fisiología , Peces , Insectos , SalinidadRESUMEN
The aim of this work is to delineate the odyssey of parenteral nutrition (noun number: 01.080), which is also called intravenous nutrition. Robert Elman (a surgeon) administered fibrinogen hydrolysate intravenously to dogs and observed the positive nitrogen balance in 1937. Corresponding report about this clinical research was published later on. Oscar Schuberth (a surgeon) and Arvid Wretlind (an internist) developed the soybean oil emulsion with good tolerability and infused a mixture of glucose, amino acids and fat emulsion into patients for the first time. Stanley Dudrick (a surgeon) carried out laboratory studies, such as infusion of 30% glucose through the central vein, selection of materials for silicone rubber catheter, monitoring of nitrogen balance, and so on. He validated that the growth and development of beagle could be supported with parenteral nutrition. Douglas Wilmore (a surgeon) applied parenteral nutrition to a baby girl with congenital stenosis of alimentary tract and thus initially validated the effectiveness of parenteral nutrition in human after 18 months' observation. All mentioned above are landmarks in the history of parenteral nutrition.The development of it is a rugged but interesting journey parenteral nutrition, exemplifying the general principles and methodology of scientific researches. Fifty-six years passing by since the commencement, now, it is time to march into Phase 3 translational (T3) research for parenteral nutrition. T3 clinical researches in parenteral and enteral nutrition is now in the ascendant in China. By looking back at the odyssey, we would like to highlight the necessity of incessant optimization and standardization of parenteral and enteral nutrition practice, to eventually achieve the rational use of nutrition support therapy and bring about patient benefits.
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The presence of cyanotoxins and its bioaccumulation in the food chain is an increasingly common problem worldwide. Despite the toxic effects produced by Anatoxin-a (ATX-a), this neurotoxin has been less studied compared to microcystins (MCs) and cylindrospermopsin (CYN). Studies conducted under laboratory conditions are of particular interest because these provide information which are directly related to the effects produced by the toxin. Currently, the World Health Organization (WHO) considers the ATX-a toxicological database inadequate to support the publication of a formal guideline reference value. Therefore, the aim of the present work is to compile all of the in vitro and in vivo toxicological studies performed so far and to identify potential data gaps. Results show that the number of reports is increasing in recent years. However, more in vitro studies are needed, mainly in standardized neuronal cell lines. Regarding in vivo studies, very few of them reflect conditions occurring in nature and further studies with longer periods of oral exposure would be of interest. Moreover, additional toxicological aspects of great interest such as mutagenicity, genotoxicity, immunotoxicity and alteration of hormonal balance need to be studied in depth.
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Toxinas Bacterianas , Toxinas Bacterianas/toxicidad , Tropanos/toxicidad , Microcistinas/toxicidad , Neurotoxinas , Mutágenos/toxicidadRESUMEN
OBJECTIVES: To develop a risk of bias tool for pre-clinical dental materials research studies that aims to support reporting of future investigations and improve assessment in systematic reviews. METHODS: A four-stage process following EQUATOR network recommendations was followed, which included project launch, literature review, Delphi process and the tool finalization. With the support of the European Federation of Conservative Dentistry (EFCD) and the Dental Materials Group of the International Association for Dental Research (DMG-IADR), a total of 26 expert stakeholders were included in the development and Delphi vote of the initial proposal. The proposal was built using data gathered from the literature review stage. During this stage, recent systematic reviews featuring dental materials research, and risk of bias tools found in the literature were comprehensively scanned for bias sources. The experts thus reached a consensus for the items, domains and judgement related to the tool, allowing a detailed guide for each item and corresponding signalling questions. RESULTS: The tool features nine items in total, spread between 4 domains, pertaining to the following types of bias: bias related to planning and allocation (D1), specimen preparation (D2), outcome assessment (D3) and data treatment and outcome reporting (D4). RoBDEMAT, as presented, features signalling questions and a guide that can be used for RoB judgement. Its use as a checklist is preferred over a final summary score. CONCLUSION: RoBDEMAT is the first risk of bias tool for pre-clinical dental materials research, supported and developed by a broad group of expert stakeholders in the field, validating its future use. CLINICAL SIGNIFICANCE: This new tool will contribute the study field by improving the scientific quality and rigour of dental materials research studies and their systematic reviews. Such studies are the foundation and support of future clinical research and evidence-based decisions.
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Lista de Verificación , Publicaciones , Revisiones Sistemáticas como Asunto , Sesgo , Materiales DentalesRESUMEN
Taking as a point of departure the role that the category of frailty increasingly plays in the classification, sorting and management of ageing populations in contemporary societies, this paper focuses on the crafting and validation of mouse models of frailty. The paper suggests that such models embody therapeutic and techno-economic expectations of ageing research, particularly as these are re-invigorated by current attempts to manipulate or eradicate cell senescence. The paper brings together critical gerontology, social studies of science and more-than-human anthropology to contextualise and analyse ethnographic data collected during fieldwork in a biology of ageing laboratory. The paper proposes that to build a mouse model of frailty, researchers need to learn to 'think like a mouse', provisionally taking the animal's point of view, to then efface that link and reconfigure the scientific chain of reference that enables translation between humans and mouse models of frailty.
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Fragilidad , Geriatría , Envejecimiento , Animales , Antropología Cultural , Humanos , RatonesRESUMEN
BACKGROUND: Computed tomography of the abdomen (CT) is used as the gold standard for detecting solid organ injuries (SOI) after blunt abdominal trauma (BAT). However, patient selection for CT is still controversial due to its potential risks. In this study, we aimed to investigate the usefulness of laboratory tests in the detection or exclusion of SOI in pediatric patients evaluated in the emergency department due to BAT. METHODS: The study was planned as a prospective, observational study and was conducted in the emergency department of a university hospital between February 2018 and February 2019. Patients under the age of 18 who were evaluated for BAT in the emergency department were included in the study. In the study, the diagnostic value of abnormal laboratory tests in detecting SOI was calculated by accepting CT results as the gold standard. RESULTS: Of the 323 patients included in the study, 118 (36%) were male. There were 283 patients who underwent CT. SOI was detected in 18 (6%) patients. Abnormal alanine aminotransferase, aspartate aminotransferase, amylase and lipase tests were found to be statistically significant in predicting SOI (p < 0.05). However, none of the tests were found to have sufficient sensitivity and specificity. Hemoglobin, hematocrit, lactate and base excess values were not found to be statistically significant in predicting SOI (p > 0.005). CONCLUSIONS: The hematologic laboratory tests are insufficient to rule out solid organ injury in pediatric patient with BAT.
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Traumatismos Abdominales , Heridas no Penetrantes , Traumatismos Abdominales/diagnóstico por imagen , Niño , Femenino , Humanos , Masculino , Estudios Prospectivos , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Heridas no Penetrantes/diagnósticoRESUMEN
Around the turn of the twentieth century, microbiologists in Western Europe and North America began to organize centralized collections of microbial cultures. Collectors published lists of the strains they cultured, offering to send duplicates to colleagues near and far. This essay explores the history of microbial culture collections through two cases: Johanna Westerdijk's collection of phytopathogenic fungi in the Netherlands and Ernst Georg Pringsheim's collection of single-celled algae at the German University in Prague. Historians of science have tended to look at twentieth-century biological specimen collections as either repositories of communal research materials or storehouses of economically important biological variation. An examination of Westerdijk's and Pringsheim's collections illustrates how collectors, researchers, and patrons ascribed different kinds of value to collections featuring distinctive microbial life forms. This essay argues that characteristics of cultivated microorganisms, such as a fungus's propensity to infect crops or an alga's amenability to experimentation, shaped the trajectories of Westerdijk's and Pringsheim's collections as these collectors developed relationships with colleagues and patrons. Letters between Westerdijk and Pringsheim open a window onto divergences in their approaches to collecting cultures, while also shedding light on the aspirational internationality of the collections that resulted.
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Hongos , Plantas , Europa (Continente) , Humanos , Países Bajos , América del NorteRESUMEN
AIM: The aim of this paper is to present recommendations from an international workshop which evaluated the methodology and reporting of caries diagnostic studies. As a unique feature, this type of studies is focused on caries lesion detection and assessment, and many of them are carried out in vitro, because of the possibility of histological validation of the whole caries spectrum. This feature is not well covered in the existing reporting STARD guideline within the EQUATOR Network. PARTICIPANTS AND METHODS: An international working group of 13 cariology researchers was formed. The STARD checklist was reviewed and modified for caries detection and diagnosis purposes, in a three-step process of evaluation, consensual modification, and delivery during three 2-day workshops over 18 months. Special attention was paid to reporting requirements of caries studies that solely focus on reliability. RESULTS: The STARD checklist was modified in 14/30 items, with an emphasis on issues of sample selection (tooth selection in in vitro studies), blinding, and detailed reporting of results. CONCLUSION: Following STARCARDDS (STAndard Reporting of CAries Detection and Diagnostic Studies) is expected to result in complete reporting of study design and methodology in future caries diagnosis and detection experiments both in vivo and in vitro, thus allowing for better comparability of studies and higher quality of systematic reviews. CLINICAL RELEVANCE: Standardization of caries diagnostic studies leads to a better comparability among future studies, both in vivo and in vitro.
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Susceptibilidad a Caries Dentarias , Caries Dental , Lista de Verificación , Caries Dental/diagnóstico , Humanos , Reproducibilidad de los Resultados , Proyectos de Investigación , Revisiones Sistemáticas como AsuntoRESUMEN
Caries diagnostic studies differ with respect to their design, included patients/tooth samples, use of diagnostic and reference methods, calibration, blinding and data reporting. Such heterogeneity makes comparisons between studies difficult and could represent a substantial risk of bias (RoB) when it is not identified. Therefore, the present report aims to describe the development and background of a RoB assessment tool for caries diagnostic studies. The expert group developed and agreed to use a RoB assessment tool during three workshops. Here, existing instruments (e.g., QUADAS 2 and the Joanna Briggs Institute Reviewers' Manual) influenced the hierarchy and phrasing of the signalling questions that were adapted to the specific dental purpose. The tailored RoB assessment tool that was created consists of 16 signalling questions that are organized in four domains. This tool considers the selection/spectrum bias (1), the bias of the index (2) and reference tests (3), and the bias of the study flow and data analysis (4) and can be downloaded from the journal website. This paper explores possible sources of heterogeneity and bias in caries diagnostic studies and summarizes the relevant methodological aspects.
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Inherited bone marrow failure syndromes are a group of genetic disorders associated with bone marrow production defects resulting in single or multiple cytopenias. Many of these disorders predispose the patient to hematologic and nonhematologic malignancies, requiring life-long follow-up. A positive family history of hematologic disorders or malignancies is frequent, as these disorders commonly run in families, and selection of family members as potential bone marrow donors should be performed with caution to avoid transplanting potentially defective stem cells. This review highlights the most common genetic disorders associated with bone marrow failure.
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Enfermedades de la Médula Ósea , Neoplasias , Biología , Enfermedades de la Médula Ósea/diagnóstico , Enfermedades de la Médula Ósea/genética , Trastornos de Fallo de la Médula Ósea , Síndromes Congénitos de Insuficiencia de la Médula Ósea , HumanosRESUMEN
Although both laboratory and field studies are needed to effectively assess effects and risk of contaminants to free-living organisms, the limitations of each must be understood. The objectives of this paper are to examine information on field studies of reproductive effects of perfluorinated substances (PFASs) on bird populations, discuss the differences among field studies, and then place those results in context with laboratory studies. Hypotheses to explain the divergences between field studies and between laboratory and field studies will be discussed. Those differences include mixture issues, misattribution of the mechanism or the specific PFAS causing impairments, as well as other possible reasons. Finally, suggestions to better link laboratory and field studies will be presented. Integr Environ Assess Manag 2021;17:690-696. Published 2021. This article is a US Government work and is in the public domain in the USA.