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On 7 September 1847, in Melbourne in the Port Phillip District of the Colony of New South Wales, David John Thomas (1813–1871) presented a paper, 'On the inhalation of the vapour of Æther, with cases', at an ordinary monthly meeting of the Port Phillip Medical Association. This is the earliest known presentation of a paper on etherisation in Australia. The partial publication of the manuscript in October 1847 in the Australian Medical Journal may have led to it being returned to Thomas in Melbourne. The handwritten manuscript is now preserved in the Medical History Museum, University of Melbourne, Melbourne, Victoria. A transcript of the complete manuscript is now recorded with relevant historical notes. [ABSTRACT FROM AUTHOR]

The Bündnis Junger Ärztinnen und Ärzte (BJÄ, Alliance of Young Physicians in Germany) has presented a position paper (PP) on Postgraduate Medical Education (PGME) against the background of an unfolding hospital reform in Germany, and they describe existing deficits of PGME in Germany. Based on this, demands were made of legislators, employers and medical associations which could result in a sweeping reformation of PGME. Hospital reforms can only be accomplished with well trained and motivated physicians. In this respect the BJÄ regards the reform of hospitals and the health-care system as a chance for a reform of PGME, which is long overdue. Legislative competence for PGME lies with the States of the Federal Republic of Germany and this warrants an adjustment of state medical association laws to accommodate the demands of the BJÄ. Generally PGME must be taken into consideration in all health-care legislation, in analogy to the meanwhile globally adopted principle of "Health in all Politics (HiAP)". The BJÄ has made every endeavour to produce this PP. The responsible stakeholders and actors in the health-care system would be well-advised to take the position paper seriously with a dwindling physician work force in hospitals and serious quality deficits in PGME. Hence, the BJÄ must be comprehensively supported. They need congenial partners to define the scientific foundation of all their demands, to test their application under real life conditions in hospital and outpatient care, to pursue research on the impact on patient care and on the intended transformation of the health-care system. This might best be accomplished by partnering with a scientific Association for Postgraduate Medical Education as has been the case in many countries for decades. [ABSTRACT FROM AUTHOR]

The current situation in Germany is characterised by significant differences between the two types of higher education institutions offering bachelor's degree programmes in midwifery at both universities of applied sciences and universities. These differences are noticeable in admission procedures, resource allocation, content focus and competence assessment at the respective institutions, which in turn result in heterogeneous study experiences. This article highlights the challenges currently facing bachelor degree programmes and the academic qualification of midwives, and identifies future requirements for the development of degree programmes in theory and practice as well as theory-practice transfer, and assessment formats. Furthermore, this article covers the content-related and structural-organisational requirements to develop in-depth academic skills grounded in theory teaching, the facilitation of clinical placements at an academic level, the training of qualified practical instructors and the development of applicable competence-based assessment formats, especially for the state exam. The development of a standardised, high-quality academic education for midwives in Germany requires networking of the different academic sites/locations to exchange experiences in teaching/learning and assessment formats. Furthermore, it can facilitate the development of a standardised competence-oriented model and core curriculum as well as the definition of quality criteria and standards for study programmes of midwifery science. The Midwifery Science Committee (AHW) in the DACH Assoviation for Medical Education (GMA) offers an optimal platform for cooperation between the different universities. The existing challenges for the further professional development of midwives can only be overcome by collaboration and pooled expertise. [ABSTRACT FROM AUTHOR]

The objective of academic training is to prepare midwives as independent healthcare professionals to make a substantial contribution to the healthcare of women in their reproductive years as well as to the health of their children and families. This article therefore describes the professional and educational requirements derived from the legal midwifery competencies within the new midwifery act. Furthermore, it identifies the conditions that need to be established to enable midwives in Germany to practise to their full scope in compliance with statutory responsibilities. Educational science, academic efforts, policymaking and accompanying research should work in synergy. This in turn enables midwives to achieve the maximum scope of their skills, with the objective of promoting physiological pregnancies and births. Consequently, it can strengthen early parenthood in alignment with the national health objectives of "health around childbirth". The academisation of the midwifery profession presents a profound opportunity for professional development in Germany. It is essential that midwives receive training based on the principles of educational science and care structures that are yet to be developed. This can enable them to perform within the wide range of their professional tasks to the highest standards, thereby ensuring the optimal care of their clients. Moreover, there is a chance to implement sustainable improvements in healthcare provision for women and their families during the reproductive phase and the period of parenthood in Germany. [ABSTRACT FROM AUTHOR]

Objective: This document purpose is to create an evidence-based position statement on the role of metformin therapy in pregnancy complicated by obesity, gestational diabetes (GDM), type 2 diabetes mellitus (T2DM), polycystic ovary syndrome (PCOS) and in women undergoing assisted reproductive technology (ART). Methods: A comprehensive review of international diabetes guidelines and a search of medical literature was performed to identify studies presenting data on the use of metformin in pregnancy. The document was approved by the councils of the two scientific societies. Results: In condition affecting the fertility, as PCOS, metformin use in pre-conception or early in pregnancy may be beneficial for clinical pregnancy, even in ART treatment, and in obese-PCOS women may reduce preterm delivery. In obese women, even in the presence of GDM or T2DM, metformin use in pregnancy is associated with a lower gestational weight gain. In pregnancy complicated by diabetes (GDM or T2DM), metformin improves maternal glycemic control and may reduce insulin dose. Neonatal and infant outcomes related to metformin exposure in utero are lacking. Metformin use in women with GDM or T2DM is associated with lower birth weight. However, an increased tendency to overweight–obesity has been observed in children, later in life. Conclusions: Metformin may represent a therapeutic option in selected women with obesity, PCOS, GDM, T2DM, and in women undergoing ART. However, more research is required specifically on the long-term effects of in utero exposition to metformin. [ABSTRACT FROM AUTHOR]

Background: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. Methods: This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. Results: Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20–107) depending on the initial surgeon's experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon's proficiency. Conclusions: Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) is coming into the field of nuclear medicine, and it is likely here to stay. As a society, EANM can and must play a central role in the use of AI in nuclear medicine. In this position paper, the EANM explains the preconditions for the implementation of AI in NM and takes position. [ABSTRACT FROM AUTHOR]

ChatGPT, a chatbot released by OpenAI in November 2022, has rocked academia with its capacity to generate papers "good enough" for academic journals. Major journals such as Nature and professional societies such as the World Association of Medical Editors have moved fast to issue policies to ban or curb AI-written papers. Amid the flurry of policy initiatives, one important challenge seems to be overlooked: AI-generated papers are not easily discernible to the human eye, and we lack the right tools to implement the policies. Without such tools, the well-intentioned policies are likely to remain on paper. [ABSTRACT FROM AUTHOR]

While we have the tools to achieve this goal, the persistent barriers to healthcare services experienced by too many individuals will need to be addressed to make significant progress and improve the health and quality of life of all people with human immunodeficiency virus (HIV). The necessary structural changes require actions by federal, state, and local policymakers and range from ensuring universal access to healthcare services to optimizing care delivery to ensuring a robust and diverse infectious diseases and HIV workforce. In this article, we outlines 10 key principles for policy reforms that, if advanced, would make ending the HIV epidemic in the United States possible and could have much more far-reaching effects in improving the health of our nation. [ABSTRACT FROM AUTHOR]

Aim: The paper presents a bibliometric analysisis of high-cited papers (HCPs) on Covid-19 published during 2019-2021. The study provides evidence on current research trends in the subject, identifies influential countries, organizations, research papers and journals on Covid-19 research. The study evaluates publication and citation performance of highly-cited papers and maps network interactions amongst the key global players using VOSviewer software. Materials and Methods: The data for the study was sourced from Web of Science for the period 2019-2021. Results: The USA, China and the UK dominate global Covid-19 research in terms of research productivity. In terms of citation performance China leads the tally with the USA at the second position. The USA, China and the UK account for a 88% share of total HCPs in the subject. The study identified top eleven centers of excellence based on the criteria of most productivity as well as most-cited organizations. New England Journal of Medicine, Lancet, JAMA - Journal of the American Medical Association, Science and Nature are the most favoured journals for publishing HCPs. The relationship networks of most productive countries, organizations, and keywords are also given in the paper. [ABSTRACT FROM AUTHOR]

The heart failure epidemic is growing and its prevention, in order to reduce associated hospital readmission rates and its clinical and economic burden, is a key issue in modern cardiovascular medicine. The present position paper aims to provide practical evidence-based information to support the implementation of effective preventive measures. After reviewing the most common risk factors, an overview of the population attributable risks in different continents is presented, to identify potentially effective opportunities for prevention and to inform preventive strategies. Finally, potential interventions that have been proposed and have been shown to be effective in preventing heart failure are listed. [ABSTRACT FROM AUTHOR]

In September 1847, David John Thomas read a paper on etherisation at a monthly meeting of the Port Phillip Medical Association. Thomas' paper is the earliest known presentation of a paper on etherisation in the Australian colonies. Almost half of Thomas' 27-page manuscript was published in October 1847 in the Australian Medical Journal. The original manuscript was acquired at an unknown date by the Medical Society of Victoria. Although a full transcript of the manuscript was published in 1933, the original manuscript of Dr Thomas remained unknown to anaesthesia historians and is now held by the Medical History Museum, University of Melbourne. [ABSTRACT FROM AUTHOR]

Purpose: To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. Methods: Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary societies to contribute to this document. Evidence is based on systematic reviews, consensus-based position statements, and expert opinion. Results: Twenty-four sections on HNC-specific OD topics. Conclusion: This European White Paper summarizes current best practice on management of OD in HNC, providing recommendations to support patients and health professionals. The body of literature and its level of evidence on diagnostics and treatment for OD in HNC remain poor. This is in the context of an expected increase in the prevalence of OD due to HNC in the near future. Contributing factors to increased prevalence include aging of our European population (including HNC patients) and an increase in human papillomavirus (HPV) related cancer, despite the introduction of HPV vaccination in various countries. We recommend timely implementation of OD screening in HNC patients while emphasizing the need for robust scientific research on the treatment of OD in HNC. Meanwhile, its management remains a challenge for European professional associations and policymakers. [ABSTRACT FROM AUTHOR]

Genetic cardiomyopathies are disorders of the cardiac muscle, most often explained by pathogenic mutations in genes encoding sarcomere, cytoskeleton, or ion channel proteins. Clinical phenotypes such as heart failure and arrhythmia are classically treated with generic drugs, but aetiology-specific and targeted treatments are lacking. As a result, cardiomyopathies still present a major burden to society, and affect many young and older patients. The Translational Committee of the Heart Failure Association (HFA) and the Working Group of Myocardial Function of the European Society of Cardiology (ESC) organized a workshop to discuss recent advances in molecular and physiological studies of various forms of cardiomyopathies. The study of cardiomyopathies has intensified after several new study setups became available, such as induced pluripotent stem cells, three-dimensional printing of cells, use of scaffolds and engineered heart tissue, with convincing human validation studies. Furthermore, our knowledge on the consequences of mutated proteins has deepened, with relevance for cellular homeostasis, protein quality control and toxicity, often specific to particular cardiomyopathies, with precise effects explaining the aberrations. This has opened up new avenues to treat cardiomyopathies, using contemporary techniques from the molecular toolbox, such as gene editing and repair using CRISPR-Cas9 techniques, antisense therapies, novel designer drugs, and RNA therapies. In this article, we discuss the connection between biology and diverse clinical presentation, as well as promising new medications and therapeutic avenues, which may be instrumental to come to precision medicine of genetic cardiomyopathies. [ABSTRACT FROM AUTHOR]

In light of the accumulating evidence for survival benefit coming from the use of macrolides for community-acquired pneumonia (CAP), a group of experts from the field of internal medicine and infectious diseases frame a position statement on the use of macrolides for the management of bacterial CAP and for infection by the novel coronavirus (COVID-19). The statement is framed taking into consideration existing publications and own research experience. The main content of this statement is that the combination of one β-lactam and a macrolide should be the first treatment of choice for patients with severe bacterial CAP. Severity is assessed as scoring 2 or more points on the CURB65 scoring system of severity or as pneumonia severity index III to V or C-reactive protein more than 150 mg/l; the suggested macrolide is either azithromycin or clarithromycin. The experts also suggest that in COVID-19 pneumonia, the combination of one β-lactam and a macrolide should be reserved only when there is strong suspicion of bacterial co-infection. [ABSTRACT FROM AUTHOR]

During the first years of the Royal Society's existence, a whole network of natural philosophical exchanges was set up between the Fellows and foreign gentlemen interested in the study of nature. From the exchanges with Italy, medicine appears to be one of the major topics of interest; and a series of medical papers based on Italian researches appear in the Society's journal, the Philosophical Transactions (PT). This article is a linguistic and socio-historical analysis of 25 medical papers published in the PT in the first fifty years of its existence. The selected articles were either translations of Italian writings or reports of Italian research. The purpose of the study is: (1) to illustrate from a linguistic and socio-cultural point of view the nature of Italian medical contributions to the early PT; and (2) to investigate Anglo-Italian relations through the Royal Society's medical interaction with Italians by analysing the PT articles and further contextual resources from a critical perspective. [ABSTRACT FROM AUTHOR]

A position paper (PP) should establish a unified voice in areas where controversy occurs based upon multiple practices and/or therapeutic choices. Typically, a position paper should elucidate the knowledge gap, followed by an evidence-based review of options, leading to an "endorsed position." A position paper should represent more than the opinion or consensus of the authors but should present current opinions and practices supported by the World Society of Emergency Surgery (WSES). Accordingly, position papers should require the approval of an expert group of WSES and in parallel be presented at an annual meeting prior to submission for publication. It is important that a unified approach for drafting of position papers be established and endorsed by WSES in order to establish credibility and prevent misunderstandings during a smooth transition to publication. The purpose of this article is to suggest a uniform process for the development of WSES guidelines. [ABSTRACT FROM AUTHOR]

Background: 5-Fluorouracil (FU) is one of the most commonly used cytostatic drugs in the systemic treatment of cancer. Treatment with FU may cause severe or life-threatening side effects and the treatment-related mortality rate is 0.2–1.0%. Summary: Among other risk factors associated with increased toxicity, a genetic deficiency in dihydropyrimidine dehydrogenase (DPD), an enzyme responsible for the metabolism of FU, is well known. This is due to variants in the DPD gene (DPYD). Up to 9% of European patients carry a DPD gene variant that decreases enzyme activity, and DPD is completely lacking in approximately 0.5% of patients. Here we describe the clinical and genetic background and summarize recommendations for the genetic testing and tailoring of treatment with 5-FU derivatives. The statement was developed as a consensus statement organized by the German Society for Hematology and Medical Oncology in cooperation with 13 medical associations from Austria, Germany, and Switzerland. Key Messages: (i) Patients should be tested for the 4 most common genetic DPYD variants before treatment with drugs containing FU. (ii) Testing forms the basis for a differentiated, risk-adapted algorithm with recommendations for treatment with FU-containing drugs. (iii) Testing may optionally be supplemented by therapeutic drug monitoring. [ABSTRACT FROM AUTHOR]

Objectives: This document provides an English translation of the Israeli Joint Commission's national guidelines for triaging severely ill patients during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Four subcommittees of medical, legal, ethical-social, and religious experts developed the general principles and practical medical criteria for triaging scarce life-saving resources. Results: The guidelines provide an overview of general principles as well as pragmatic medical criteria and a practical triage protocol to be followed should the healthcare system be overwhelmed due to COVID-19. Issues covered include triggers for activating the guidelines, guiding ethical, legal, and religious principles, equity in access, fair distribution, transparency, consistency, palliation, medical policy prioritization, problem-solving mechanisms, and public trust. Conclusions: The Israeli consensus document and pragmatic medical triage protocol offer a societal and medical roadmap for allocating scarce resources during the COVID-19 pandemic or other disasters. [ABSTRACT FROM AUTHOR]

COVID-19 disease is characterized by serious clinical manifestations which could require urgent hospitalization. Prolonged hospitalization, with catabolism and immobilization, induces a decrease in weight and muscle mass which can result in sarcopenia, a condition that impairs respiratory and cardiac function, worsening the prognosis. In this scenario there is an urgent need of nutritional indications aimed to prevent or contrast hospital malnutrition by improving the patient's response to therapy and to facilitate healthcare professionals in managing nutritional interventions on patients, reducing their already high workload due to the state of emergency. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges faced by the Journal of the American Veterinary Medical Association (JAVMA) in paper production due to labor strikes and supply chain shortages.

Respiratory syncytial virus (RSV) inflicts severe illness and courses of infections not only in neonates, infants, and young children, but also causes significant morbidity and mortality in older adults and in people with immunosuppression, hemato-oncologic disease, chronic lung disease, or cardiovascular disease. In June and August 2023, effective vaccines against RSV were approved for the first time by the European Medicines Agency (EMA) for the EU. The respective pivotal studies showed a very high efficacy of the vaccine in preventing severe RSV-associated respiratory infections. At this point, use of the respective vaccines is restricted to persons aged 60 years or older, according to the registration studies. We therefore recommend use of the vaccination in persons aged 60 years or older. In addition, we recommend use of the vaccination in adults of any age with severe pulmonary or cardiovascular pre-existing conditions, as well as in adults with significant immune compromise, after individual consultation with the treating physician. Cost coverage can be applied for individually with the responsible health insurance company. [ABSTRACT FROM AUTHOR]

Background: Covid-19 pandemic had been a disastrous catastrophe on human race affecting different groups of population differently. Pregnancy is a condition which too has been affected by Covid-19. The present study aims to examine the research productivity of Covid-19 and pregnancy. Methods: Keywords pertaining to "Covid-19" and "Pregnancy" were used in search string in Scopus database for the period 2020-21. Data regarding publications growth, productive countries, authors and institutions, high cited papers and significant keywords was retrieved to analyze results. Results: The search retrieved 2945 global publications for the period 2020-21. The USA, UK and China were the most productive countries (with 28.96%, 11.27% and 9.3% global share) on "Covid-19 and Pregnancy". The 613 organizations and 953 authors participated in global research on the subject, with top 20 most productive organizations and authors contributing 26.38% and 9.68% global publication share and 53.64% and 38.53% global citation share respectively. Huazhong University of Science and Technology, China, Tongji Medical College, China and Harvard Medical School, USA were the most productive organizations (with 68, 64 and 52 publications) and Huazhong University of Science and Technology, China (45.88 and 2.12), Tongji Medical College, China (44.96 and 2.08) and University of Health Sciences, Turkey (22.38 and 1.03) led the world as most impactful organizations in terms of citation impact and relative citation index. A Khalil (23 papers), C. Gyamfi-Bannerman (19 papers) and D. Goffman and I.C. Poon (17 papers each) were the most productive authors and H. Yang (197.4 and 4.66), l. Feng (105.12 and 2.5) and D.A. Schwartz (74.82 and 1.77) were the most impactful authors. American Journal of Obstetrics and Gynecology (94 papers), International Journal of Obstetrics and Gynecology (85 papers) and European Journal of Obstetrics and Gynecology and Reproductive Biology (66 papers) were the most productive journals in global research on "Covid-19 and Pregnancy". JAMA-Journal of the American Medical Association (45.52), Acta Obstetricia et Gynecologica Scandinavica (34.22) and Ultrasound in Obstetrics and Gynecology (25.95) were leading most impactful journals. The 61 (2.07%) out of 2945 global publications on "Covid-19 and Pregnancy" registered 102 to 1571 citations per paper and they together received 14620 citations averaging 239.67 citations per paper. These 61 publications are assumed as high cited publications and involve 153 authors, 116 organizations and published in 43 journals. [ABSTRACT FROM AUTHOR]

The advent of electronic medical records brought image filing systems to many hospitals, as well as electronic endoscopic medical records. However, data integration among multiple different vendors has not yet been accomplished. We start the Japan Endoscopic Database ( JED) Project endorsed by Japan Gastroenterological Endoscopy Society ( JGES) from January 2015. The purposes of this project are as follows: (i) developing the world's largest endoscopic database generated from daily use of the reporting system; (ii) capturing the actual performance of endoscopic practice in Japan; and (iii) standardizing the terminology and fundamental items for registry of clinical studies. Moreover, the JED project has the potential to automatically collect data about adverse events, competency and evaluation of residents, and actual numbers of procedures on a nationwide scale, certification for the specialty board system, and so on. We believe that this design paper will be helpful not only for future nationwide research but also for international research ( UMIN000016093). [ABSTRACT FROM AUTHOR]