Mount Auburn Hospital

Breastfeeding is a physiologically dynamic relationship between a mother and her child that is not replicated when an infant is fed expressed breastmilk, resulting in differences in health and developmental outcomes. However, pumping breastmilk is increasingly expected and normalized in many countries. It is also increasingly common in many countries for women to exclusively pump their milk and bottle-feed their infants without any direct breastfeeding. Alongside this, changes in language are being made with “breastfeeding” being replaced by “lactating” or “human milk feeding.” The trends in pumping and language marginalize the breastfeeding relationship and encourage treatment of women according to a male standard or patriarchy, to the detriment of women and children. The aim of this debate article is to discuss how lack of proper support for breastfeeding and workplaces assuming mother-infant separation encourage pumping over breastfeeding. This serves the corporate interests of breast pump manufacturers and the real or perceived corporate interests of employers, prioritizing profits ahead of the well-being of women and children. Normalization of pumping reduces expectations for proper breastfeeding support, adequate paid maternity leave, and workplace accommodations that allow for mother-infant proximity. Substituting “breastfeeding” with “lactating” or “human milk feeding” obscures the differences between breastfeeding and providing expressed breastmilk, undermining advocacy for breastfeeding support. A structural and social transformation that acknowledges the normativity of females is needed to uphold the rights and needs of women and children. This transformation values both women’s important reproductive work and their contributions to the workforce and society. Changes would include providing proper breastfeeding support at birth and thereafter, providing adequate paid maternity leave, reconfiguring workplace and childcare arrangements to better enable direct breastfeeding, and regulating marketing of breast pumps and commercial milk formula. Language should recognize the primacy of breastfeeding over “human milk feeding.” The normalization of pumping and “human milk feeding” is detrimental to women and children. “Breastfeeding” should be supported in practice and in language and in alignment with the human rights of women and children to breastfeed.

INTRODUCTION:Dengue has emerged as the most widespread and rapidly increasing vector-borne disease globally and is currently a global public health threat. Geographical, environmental, host and/or vector-specific factors can act as drivers of dengue epidemics globally. AREAS COVERED:The current dengue virus distribution and the geographical expansion of competent Aedes spp. vectors are reviewed. Recent advances in vaccine development and novel treatment options under evaluation are highlighted, including novel antivirals and monoclonal antibodies. EXPERT OPINION:Climate change and human-related factors are driving the global expansion of dengue risk, including in temperate regions. While licensed vaccines offer new prevention opportunities, limitations remain, especially for vulnerable populations. Continued research into effective antivirals and innovative vaccines is critical. A multidisciplinary approach integrating vector control, vaccination, and emerging therapies is essential to address the growing dengue burden in a warming world.

Psychological stress has been linked to the onset and course of autoimmune diseases. However, limited data exist regarding the relationship between pre-diagnosis stress exposure and subsequent disease course in systemic lupus erythematosus (SLE). We evaluated the association between psychological stress prior to SLE diagnosis and subsequent disease characteristics. We conducted a cross-sectional study of adults with SLE treated at a tertiary hospital between November 2019 and December 2022. Stress exposure during the two years preceding SLE diagnosis was assessed using the Holmes-Rahe Social Readjustment Rating Scale (life change units, LCU), and categorized as low (< 150), intermediate (150–299), or high (≥ 300). Data on clinical manifestations, comorbidities, disease activity patterns, patient-reported outcomes, and organ damage were collected. Associations between stress levels and outcomes were analyzed using logistic regression models. A total of 140 patients were included (90.7

Liquid biopsy now provides minimally invasive access to tumor-derived genomic and epigenetic information across the lung cancer continuum, and its clinical role continues to expand. This review examines that role across cancer detection (screening and diagnosis), treatment monitoring (advanced-disease genotyping, minimal residual disease (MRD) assessment, and resistance profiling at progression), and clinical outcome prediction. Plasma-based genotyping is now well established in advanced non-small cell lung cancer (NSCLC), while circulating tumor DNA (ctDNA)-based MRD detection in the curative-intent setting has accumulated a substantial evidence base over the past 5 years. Cell-free DNA (cfDNA) methylation, fragmentomics, and circulating tumor RNA (ctRNA) are emerging as complementary modalities, particularly when tumor shedding is low. We also consider concordance between liquid and tissue biopsies, the use of cerebrospinal fluid (CSF) ctDNA in central nervous system (CNS)-involved disease, and the practical issues of cost, reimbursement, and access that shape clinical adoption. The current state of the field can be framed across three tiers of evidence, with established applications, applications under prospective evaluation, and applications not yet ready for routine clinical use. No multi-cancer early detection (MCED) test has shown a mortality benefit to date, and ctDNA-guided treatment changes in metastatic disease still lack randomized overall-survival data.