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This document is a position paper that provides updates to guidelines on lipid therapy in patients with diabetes mellitus. It emphasizes the importance of lipid therapy in reducing cardiovascular risk in patients with diabetes and provides recommendations for lipid diagnostics and treatment targets. The paper discusses various therapy strategies for lowering LDL cholesterol levels based on the patient's risk group, including the use of statins as the primary therapy and the addition of other lipid-lowering drugs if necessary. The document also highlights the importance of lifestyle measures and blood glucose control in the treatment of hypertriglyceridemia. Overall, it concludes that risk stratified patient-related LDL cholesterol reduction is an important part of diabetes therapy and can improve patient outcomes. [Extracted from the article]

Therapy of hypertension in patients with PAD In general, all patients with arterial hypertension benefit from a reduction in blood pressure [13], and patients with PAD (i. e., high-risk patients) in particular have an improved cardiovascular prognosis. This allows PCSK-9 inhibitors to be used in patients with progressive PAD on statin therapy or in patients with statin intolerance within the scope of the statutory health insurance funds' prescription ability and subject to the proviso of high therapy costs. Patients with diabetes have a 2 to 4-time higher risk of developing PAD than patients without diabetes. This position paper is based on the current German and international guideline recommendations [1][2][3] and serves as a short, clinically-oriented guideline for the diagnosis and treatment of patients with diabetes mellitus and peripheral arterial disease (PAD). [Extracted from the article]

Risk stratified patient-related LDL cholesterol reduction is an evidence-based integral part of diabetes therapy and can improve the clinical prognosis of our patients. For patients who meet the LDL cholesterol target but not the non-HDL cholesterol target, the non-HDL cholesterol level can be achieved by either lowering the triglyceride level (reduction of VLDL/remnant cholesterol) or further reducing the LDL cholesterol. The non-HDL cholesterol value (=total cholesterol minus HDL cholesterol) also approximately reflects this and includes VLDL cholesterol and remnant cholesterol in addition to LDL cholesterol. In normotriglyceridemia, the VLDL/remnant cholesterol concentration is<30 mg/dl (0.8 mmol/l) (which corresponds to a triglyceride value of approximately 150 mg/dl; 1.7 mmol/l), which is why non-HDL cholesterol target values are each 30 mg/dl (0.8 mmol/l) above the LDL cholesterol target value (Tab. [Extracted from the article]

Follicular unit excision (FUE) graft dissection has become the dominant method of donor harvesting globally, however, only a percentage of donor hair can be excised inside the safe donor area before visible donor thinning occurs. Compared to linear strip excision (LSE) where all follicular units inside the harvested ellipse of hair are used, FUE poses substantial limitations for lifetime graft yield and, therefore, cosmetic coverage in patients with advanced pattern hair loss. This paper reviews how combining the donor harvesting methods of FUE and LSE has been shown to optimize graft yield while minimizing the risk of donor depletion from overharvesting. It then describes a surgical technique called FUE-Linear Ellipse (FUE-LE) where FUE dissection of grafts inside a demarcated linear ellipse eliminates the need for a large dissection team which has posed a barrier for many new practices that offer both the donor harvesting methods. For practices that currently offer only FUE, the addition of the LSE method by the modified FUE-LE technique is possible without specialized staff training or associated equipment costs. In this paper, surgery practices that have adopted this technique will report on their experiences. Hair restoration surgeons are encouraged to provide both methods of donor harvesting (FUE and LSE using FUE-LE) in order to optimize graft yield for patients and avoid long-term donor depletion. Based on limited experience, it appears the technique of FUE-LE will help achieve this goal. [ABSTRACT FROM AUTHOR]

1 Endoscopic views in an elderly woman with melena showing: a a large ulcer with a visible vessel in the rectum; b a 2-cm square of synthetic paper that was found in the rectum after hemostasis had been achieved; c confirmation that hemostasis had been achieved the following day; d a detachable snare being used to change the foreign body into a cylindrical shape so that it can be safely removed from the rectum. An emergency lower gastrointestinal endoscopy revealed a large ulcer in the rectum and a visible vessel in the same area, which was bleeding (Fig. [Extracted from the article]

This document is an editorial celebrating the 50th anniversary of Seminars in Thrombosis and Hemostasis (STH), a medical journal that first published in 1974. The editorial discusses the various celebratory issues that have been published over the years, which contain historical content related to the fields of thrombosis and hemostasis. The document also mentions the republishing of highly cited and downloaded papers from STH, along with accompanying commentaries from experts in the respective fields. Additionally, the document provides a list of the 50 most highly downloaded papers from STH between 2014 and 2023. [Extracted from the article]

This article is a commentary celebrating the 50th anniversary of Seminars in Thrombosis and Hemostasis (STH), a journal that first published in 1974. The commentary focuses on the historical significance of a paper titled "Description of an in vitro platelet function analyzer–PFA-100," which was published in a supplementary issue of STH in 1995 and is one of the most highly cited papers in the journal's history. The paper describes the PFA-100, an instrument that has since evolved into the PFA-200 and has been widely used for various purposes in the field of hemostasis. The commentary also mentions the impact of the PFA-100 on research and its potential applications in different areas, such as screening for von Willebrand disease and monitoring platelet function in animals. The article concludes by acknowledging the 30th anniversary of the PFA-100 in 2024 and its significant contributions to the hemostasis community. [Extracted from the article]

The article discusses the synthesis and catalytic properties of Donor-Acceptor Stenhouse Adducts (DASAs). DASAs are triene substances that can be prepared using specific reagents and conditions. The study explores the use of Lewis acids as catalysts for transforming DASAs into their ring isomers, and suggests potential applications as photosensors and Lewis acid sensors. The document provides detailed experimental procedures and results for the synthesis and characterization of various compounds, as well as a general procedure for the one-pot cyclization of DASAs. [Extracted from the article]

Background. Thieme Chemistry and the Editors of SYNTHESIS and SYNLETT present the 'SYNTHESIS/ SYNLETT Best Paper Awards'. These annual awards honor the authors of the best original research papers in each of the journals, considering their immediate impact on the field of chemical synthesis. Cathleen Crudden, Masakazu Nambo and their co-workers are the recipients of the SYNLETT Best Paper Award 2017. The work was a collaboration between Nagoya University in Japan and Queen's University in Canada. The authors are recognized for their work on the synthesis of tetraarylmethanes through a formal cross-dehydrogenative coupling of triarylmethanes with arenes, promoted by triflic acid. Benjamin List, Editor-in-Chief of SYNLETT, commented:"Nambo, Yim, Fowler, and Crudden have developed an elegant synthesis of tetraarylmethanes that involves an acid-catalyzed oxidative coupling of an arene with triarylmethanes, which became readily accessible in previous studies by the authors. The reaction proceeds via trityl-type cations and enables the formation of fascinating products, in which four different arenes are connected via a single stereogenic carbon atom." SYNFORM spoke with Masakazu Nambo and Cathleen Crudden, who were happy to share some background information regarding the prize-winning paper as well as current research activities ongoing in their groups. [ABSTRACT FROM AUTHOR]

This is a celebratory reprint of a historical paper published in STH in 1998. The original Abstract follows. The PFA-100 system is a platelet function analyzer designed to measure platelet-related primary hemostasis. The instrument uses two disposable cartridges: a collagen/epinephrine (CEPI) and a collagen/ADP (CADP) cartridge. Previous experience has shown that CEPI cartridges detect qualitative platelet defects, including acetylsalicylic acid (ASA)-induced abnormalities, while CADP cartridges detect only thrombocytopathies and not ASA use. In this seven-center trial, 206 healthy subjects and 176 persons with various platelet-related defects, including 127 ASA users, were studied. The platelet function status was determined by a platelet function test panel. Comparisons were made as to how well the defects were identified by the PFA-100 system and by platelet aggregometry. The reference intervals for both cartridges, testing the 206 healthy subjects, were similar to values described in smaller studies in the literature (mean closure time [CT] of 132 seconds for CEPI and 93 seconds for CADP). The use of different lot numbers of cartridges or duplicate versus singleton testing revealed no differences. Compared with the platelet function status, the PFA-100 system had a clinical sensitivity of 94.9% and a specificity of 88.8%. For aggregometry, a sensitivity of 94.3% and a specificity of 88.3% were obtained. These values are based on all 382 specimens. A separate analysis of sensitivity by type of platelet defect, ASA use versus congenital thrombocytopathies, revealed for the PFA-100 system a 94.5% sensitivity in identifying ASA users and a 95.9% sensitivity in identifying the other defects. For aggregometry, the values were 100% for ASA users and 79.6% for congenital defects. Analysis of concordance between the PFA-100 system and aggregometry revealed no difference in clinical sensitivity and specificity between the systems (p > 0.9999). The overall agreement was 87.5%, with a Kappa index of 0.751. The two tests are thus equivalent in their ability to identify normal and abnormal platelet defects. Testing 126 subjects who took 325 mg ASA revealed that the PFA-100 system (CEPI) was able to detect 71.7% of ASA-induced defects with a positive predictive value of 97.8%. The overall clinical accuracy of the system, calculated from the area under the receiver operating characteristic curve, was 0.977. The data suggest that the PFA-100 system is highly accurate in discriminating normal from abnormal platelet function. The ease of operation of the instrument makes it a useful tool to use in screening patients for platelet-related hemostasis defects. [ABSTRACT FROM AUTHOR]

The World Health Organization reveals that pediatric burns represent a large portion of burns globally (61). Increases in survival rates have guided clinical and research focus on physical, psychological, and social outcomes. Research on other childhood illnesses has shown the efficacy of social support throughout recovery. In the pediatric burn literature, studies have shown the efficacy of burn camps for promoting positive interactions among survivors, learning coping skills, and facilitating socialization and reintegration. However, few studies have focused on the benefits of peer support for pediatric burn survivors and their caregivers in the inpatient and outpatient phases of recovery. This descriptive paper identifies options for building resilience for pediatric burn survivors through peer support in the inpatient and outpatient phases of recovery. The authors discuss options for providing peer support during the coronavirus disease 2019 pandemic on the pediatric intensive care unit, general pediatric floor, and outpatient setting. [ABSTRACT FROM AUTHOR]

Background The aim of this study is to investigate the different approaches to thermal challenges, both cold and warm, used in dynamic infrared thermography for reconstructive surgery, and explore whether it affects the success of preoperative perforator mapping. Methods Literature was collected from Ovid Medline, Embase, PubMed, and Cochrane. The references of the full-text articles located from the original search were also appraised. Thirteen articles were extracted for the final qualitative analysis. A systematic review was then conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results Thirteen articles looked at a cold challenge, which included airflow cooling, direct contact cooling, and evaporation-based cooling. Two articles investigated warm challenges. One paper used no challenge, suggesting it unnecessary with a highly sensitive camera. All cold challenges were positively supported by a high level of flap perfusion success and/or a high level of correlation with other forms of investigation. Conclusion Cold challenges were overall superior to no challenge and warm challenges; however, this conclusion is limited by the small participant size, the possibility of detection bias, and poor methodology detailing. Airflow cooling—specifically, using a desktop fan to blow air for 2 minutes—was noted to likely cause the least discomfort due to a low cooling capacity yet simultaneously maintain effectiveness and allow for a uniform cooling application. Warm challenges showed less conclusive results and were restricted by lack of studies. This topic would benefit from larger scale studies that compare multiple approaches while using standardized equipment to eliminate confounding factors. [ABSTRACT FROM AUTHOR]

This article explores the use of thioether-containing ligands in catalysis applications. Thioether ligands, which contain a sulfur atom, have traditionally been less considered due to their lower donor and acceptor character compared to phosphorus ligands. However, ligands with a low degree of oxidation and a combination of sulfur with another heteroatom have shown promise in generating interesting catalysts. The article provides examples of enantioselective and non-enantioselective reactions using thioether ligands and discusses the advantages of combining sulfur with another heteroatom. The paper is organized based on the type of heteroatom that accompanies the thioether function, such as phosphorus and nitrogen. Various catalytic systems involving thioether ligands for different organic transformations are discussed, including dihydroboration, cyclopropanation, silyl-hydrogen insertion, C-H functionalization, and C-H alkenylation. The ligands play a crucial role in enhancing the activity and selectivity of the catalysts, and they have been successfully applied to a wide range of substrates. Mechanistic studies have provided insights into the reaction pathways and the role of the ligands in facilitating the transformations. The article highlights the potential of thioether-functionalized ligands in metal-catalyzed reactions and suggests a promising future for sulfur in catalysis. [Extracted from the article]

Seminars in Thrombosis and Hemostasis (STH) celebrates 50 years of publishing in 2024. To celebrate this landmark event, STH is republishing some archival material. This manuscript represents the second most highly cited paper ever published in STH. The manuscript published without an abstract, and essentially represented a State of the Art Review on the bleeding time, a relatively invasive procedure that required an incision on the skin or earlobe of a patient, and timing how long it took for the incision to stop bleeding. The bleeding time test was first described in 1901 by the French physician Milian, who presented three studies of bleeding from stab wounds made in the fingertips of healthy and diseased subjects. In 1910, Duke observed the duration of bleeding from small incisions of the ear lobe, and pointed out that the duration of bleeding was increased in instances of reduced platelet counts. The test was subsequently repeatedly modified, and numerous variants of the test, including semiautomated methods, were described by several workers. The most frequently utilised test reflected one described by Ivy and coworkers, who shifted the location of the incision to the volar aspect of the forearm and applied a blood pressure cuff to the arm to maintain a standard venous pressure. The bleeding time has been proposed for use as a diagnostic test for platelet-related bleeding disorders, a measure of efficacy in various forms of therapy, and as a prognosticator of abnormal bleeding. The authors to the current review reevaluated the bleeding time literature using methods to assess the performance of the test in 1990, locating 862 printed documents that discussed the bleeding time, the majority in peer-reviewed professional journals. As this is a republication of archival material, transformed into a modern format, we apologise in advance for any errors introduced during this transformation. [ABSTRACT FROM AUTHOR]

Venous thromboembolism (VTE) is a main contributor to morbidity and mortality in cancer patients. Biomarkers with the potential to predict cancer-associated VTE are continually sought. Of these, markers of thrombin generation present a likely option. The present systematic review examines the ability of three widely used biomarkers of thrombin generation: prothrombin fragment 1.2 (F1.2), thrombin-antithrombin complex (TAT), and ex vivo thrombin generation, to predict VTE in both solid and hematologic adult cancer patients. Relevant studies were identified in the PubMed and Embase databases, and the review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Each study was evaluated using the quality assessment tool from the National Heart, Lung, and Blood Institute. The review protocol was published on PROSPERO with identifier CRD42022362339. In total, 24 papers were included in the review: 11 reporting data on F1.2, 9 on TAT, and 12 on ex vivo thrombin generation. The quality ratings of the included studies varied from good (n = 13), fair (n = 8), to poor (n = 3) with a high heterogenicity. However, F1.2, TAT complex, and ex vivo thrombin generation were all found to be associated with the development of VTE. This association was most pronounced for F1.2. Furthermore, the determination of F1.2 was able to improve the precision of several established risk assessment scores. In conclusion, markers of thrombin generation were found to be elevated in cancer patients with VTE, and particularly, F1.2 was found to be a promising predictor of cancer-associated VTE. [ABSTRACT FROM AUTHOR]

Core outcome sets (COSs) provide a mechanism to guide researchers and clinicians when deciding which outcomes to report in research related to a specific clinical condition or intervention. The intention behind creating a COS for a specific condition is to improve the reporting of important and meaningful outcomes, thus enhancing the relevance of research. Additionally, a COS helps facilitate comparison of outcomes between different clinical studies and reduces research waste. In this paper, we discuss the availability of COSs in the field of pediatric general surgery. We provide an overview of the methodologies used to develop a COS, including common pitfalls, and finally, we discuss COS uptake and implementation. An understanding of all these aspects is important for researchers considering developing a new COS and for those reading research where a COS has been developed or used within a study. Failure to adequately appreciate the nuances of COS development, in particular, risks fundamental flaws that may jeopardize COS validity and subsequently hinder COS uptake and implementation. [ABSTRACT FROM AUTHOR]

This paper presented a national register for esophageal atresia (EA) started in January 2008. We report our experience about the conception of this database and its coordination. Data management and data quality are also detailed. In 2023, more than 2,500 patients with EA are included. Prevalence of EA in France was calculated at 1.8/10,000 live birth. Main clinical results are listed with scientific publications issued directly from the register. [ABSTRACT FROM AUTHOR]

American Indians and Alaska Natives (AI/AN) are the Indigenous peoples of the United States. According to the U.S. Census Bureau, approximately 9.7 million people self-identified as AI/AN (alone or in combination with other races), representing 2.9% of the total U.S. population. These people represent diverse groups of discrete Tribes, each with their language, culture, and geographic home. As part of the conquest and settlement of North America, some Indigenous peoples signed treaties with the U.S. government, surrendering their lands in return for various government commitments, including health care. The Indian Health Service (IHS) was born out of these agreements. The IHS is an agency in the U.S. Department of Health and Human Services under the U.S. Public Health Service. The IHS provides a comprehensive health service delivery system for approximately 2.7 million AI/AN who belong to 574 federally recognized Tribes/nations in 37 states. The aim of this paper is to make recommendations regarding the initiation of sustainable neurology care in marginalized or underserved populations by reviewing 40 years of neurology care provision within the IHS. We will discuss (1) the IHS, (2) neurological care provided within the IHS, including midlevel provider extension of neurology care and traditional medical care, and (3) select neurological diagnoses within AI/AN populations. Marginalized populations, including those in the United States that are rural, remote, or low socioeconomic status, lack access to specialty neurology care. This includes many AI/AN. The IHS has developed novel solutions to promote specialty care, including neurology. Notably, initial IHS investments in full-time neurology providers have led to more robust neurology care, often receiving attention from university programs. This suggests that an initial investment in stable on-site full-time neurology services provides a path to potential sustainable care for marginalized populations. [ABSTRACT FROM AUTHOR]

Follicular unit grafts can be harvested using two methods: strip follicular unit transplantation and follicular unit excision. Each method can generate outstanding results, but both are uniquely different with respect to the advantages and disadvantages they offer. Devising a sound surgical plan is instrumental to assure that a patient's short-term and long-term goals can be met, but creating the best plan possible for the graft harvest process is not straightforward. This paper will review the various advantages and disadvantages of each graft harvest method, along with their short-term and long-term ramifications, so as to provide insight into the process by which a sound surgical plan can be developed for any patient seeking surgical hair restoration. [ABSTRACT FROM AUTHOR]

The purpose of this analysis is to assess the use of machine learning (ML) algorithms in the prediction of postoperative outcomes, including complications, recurrence, and death in transsphenoidal surgery. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed all papers that used at least one ML algorithm to predict outcomes after transsphenoidal surgery. We searched Scopus, PubMed, and Web of Science databases for studies published prior to May 12, 2021. We identified 13 studies enrolling 5,048 patients. We extracted the general characteristics of each study; the sensitivity, specificity, area under the curve (AUC) of the ML models developed as well as the features identified as important by the ML models. We identified 12 studies with 5,048 patients that included ML algorithms for adenomas, three with 1807 patients specifically for acromegaly, and five with 2105 patients specifically for Cushing's disease. Nearly all were single-institution studies. The studies used a heterogeneous mix of ML algorithms and features to build predictive models. All papers reported an AUC greater than 0.7, which indicates clinical utility. ML algorithms have the potential to predict postoperative outcomes of transsphenoidal surgery and can improve patient care. Ensemble algorithms and neural networks were often top performers when compared with other ML algorithms. Biochemical and preoperative features were most likely to be selected as important by ML models. Inexplicability remains a challenge, but algorithms such as local interpretable model–agnostic explanation or Shapley value can increase explainability of ML algorithms. Our analysis shows that ML algorithms have the potential to greatly assist surgeons in clinical decision making. [ABSTRACT FROM AUTHOR]

Seminars in Thrombosis and Hemostasis (STH) is celebrating its 50th anniversary in 2024. The journal has published two celebratory issues in 2022 and 2023, and a third historical paper compilation is currently being prepared. Some senior editors are retiring, but new senior editors have been promoted to fill the vacancies. The journal's Impact Factor has fluctuated over the years, with a peak in 2021 due to highly cited COVID-19-related papers. Future topics for the journal include bleeding disorders, laboratory diagnostics, and thrombotic disorders. The focus on COVID-19 will shift to long-term consequences and post-acute sequelae. [Extracted from the article]

Objective The objective of this paper was to describe peri-procedural events and complications of infants requiring laser photocoagulation for retinopathy of prematurity (ROP) in a level IV neonatal intensive care unit. Study Design A retrospective chart review was performed of neonates requiring ROP exams from January 2017 to August 2020. Baseline maternal and neonatal characteristics, ROP exam findings, and associated treatment were analyzed. Group characteristics were compared based on the need for laser photocoagulation. Subgroup analysis of the laser group including respiratory outcomes, cardiorespiratory index (CRI) scores, and pain scores was also performed. Results Neonatal and maternal characteristics in the laser (n = 27) and non-laser (n = 172) groups were assessed. Of the 81.5% (22/27) that required re-intubation for laser, 36% (8/22) had >1 intubation and 18% (4/22) had >1 extubation attempt. The average duration of intubation following laser was 2.46 ± 7.13 days, with 40% (9/22) needing peri-extubation steroids and 18% (4/22) racemic epinephrine to facilitate extubation. Mean total respiratory support time post-laser was 8.65 ± 15.23 days. Mean neonatal pain, agitation, and sedation scores after laser were zero immediately after the procedure, 0.09 ± 0.33 at 12 hours, 0.11 ± 0.47 at 24 hours, and 0.11 ± 0.51 at 48 hours. The mean CRI scores were 1 ± 0 immediately after the procedure, 1.17 ± 0.4 at 12 hours, 1.41 ± 0.20 at 24 hours, and 1 ± 0 at 48 hours. Conclusion Nearly all infants undergoing laser photocoagulation for ROP in our cohort required intubation and continued respiratory support. Despite stability during the procedure, complications from intubation were common. Key Points Routine intubation for laser is associated with complications. Need for post-procedural respiratory support is common. Avoiding intubation may mitigate these neonatal complications. [ABSTRACT FROM AUTHOR]

Background Before the advent of antenatal steroids, early non-invasive respiratory support (NIV), and intratracheal surfactant, antenatal terbutaline was also used to improve lung compliance and reduce the incidence of respiratory distress syndrome (RDS). Objectives The objective of this paper was to study the association between antenatal terbutaline and endotracheal intubation (ET) within the first 24 hours of life, RDS, bronchopulmonary dysplasia (BPD), and intraventricular hemorrhage (IVH) in infants with the gestational age (GA) of <32 weeks, and to study the association between antenatal terbutaline, and ET or NIV within the first 24 hours of life, and RDS in infants with the GA of 32 to 36 weeks. Method This was a retrospective medical record review of preterm infants delivered at a single tertiary care center from October 2016 to December 2020. Multivariable logistic regression was used to explore the association between antenatal terbutaline and neonatal respiratory support. Result 1,794 infants were included, 234 (13.0%) had the GA of <32 weeks and 1,560 (86.9%) had the GA of 32 to 36 weeks. Antenatal terbutaline, corticosteroid, or both agents were administered in 561 (31.3%), 1,461 (81.4%), and 555 (30.9%), respectively. Antenatal terbutaline was significantly associated with a reduction in ET (adjusted odds ratio [aOR] = 0.40, 95% confident interval [CI] 0.19–0.82, p = 0.012) in infants with the GA of <32 weeks, but not in infants with the GA of 32–36 weeks. Antenatal terbutaline was not associated with RDS or BPD but was significantly associated with a reduction in grade III-IV IVH (aOR 0.11, CI 0.01–0.98; p = 0.048), in infants with the GA of <32 weeks. Conclusion In a state-of-the-art neonatal care setting, antenatal terbutaline was associated with a reduction in ET during the first 24 hours in infants with the GA of <32 weeks. The use of antenatal terbutaline to improve acute neonatal respiratory outcomes merits reconsideration. Key Points The neonatal respiratory benefits of antenatal terbutaline in the era of antenatal corticosteroids were uncertain. Terbutaline is associated with a reduction in endotracheal intubation in a modern care setting. The role of terbutaline, and potentially other betamimetics, to improve neonatal respiratory outcomes merits reconsideration. [ABSTRACT FROM AUTHOR]

Objectives Group prenatal care models were initially designed for women with medically low-risk pregnancies, and early outcome data focused on these patient populations. Pregnancy outcome data for women with medically high-risk pregnancies participating in group prenatal care is needed to guide clinical practice. This study compares rates of preterm birth, low birth weight, and neonatal intensive care unit admissions among women with medical risk for poor birth outcomes who receive group versus individual prenatal care. Study Design This retrospective cohort study uses vital statistics data to compare pregnancy outcomes for women from 21 obstetric practices participating in a statewide expansion project of group prenatal care. The study population for this paper included women with pregestational or gestational hypertension, pregestational or gestational diabetes, and high body mass index (BMI > 45 kg/m 2). Patients were matched using propensity scoring, and outcomes were compared using logistic regression. Two levels of treatment exposure based on group visit attendance were evaluated for women in group care: any exposure (one or more groups) or minimum threshold (five or more groups). Results Participation in group prenatal care at either treatment exposure level was associated with a lower risk of neonatal intensive care unit (NICU) admissions (10.2 group vs. 13.8% individual care, odds ratio [OR] = 0.708, p < 0.001). Participating in the minimum threshold of groups (five or more sessions) was associated with reduced risk of preterm birth (11.4% group vs. 18.4% individual care, OR = 0.569, p < 0.001) and NICU admissions (8.4% group vs. 15.9% individual care, OR = 0.483, p < 0.001). No differences in birth weight were observed. Conclusion This study provides preliminary evidence that women who have or develop common medical conditions during pregnancy are not at greater risk for preterm birth, low birth weight, or NICU admissions if they participate in group prenatal care. Practices who routinely exclude patients with these conditions from group participation should reconsider increasing inclusivity of their groups. Key Points This study compares outcomes for women who receive group versus individual prenatal care The study population was limited to women with diabetes, hypertension, and/or high BMI. Group participants did not have higher rates of preterm birth, low birth weight, or NICU admissions. [ABSTRACT FROM AUTHOR]

The latest issue of Seminars in Thrombosis and Hemostasis (STH) is a compilation of articles covering various topics related to thrombosis and bleeding. It includes reviews on neonates with intrauterine growth restriction, pediatric presentations of the antiphospholipid syndrome, genetic variations in tissue factor-dependent disease, heterozygous factor XIII deficiency, and the use of global hemostasis assays in patients with myeloproliferative neoplasms. The document also features reviews on the role of CD36 in platelet activation, laser-induced blood coagulation in surgery, detecting blood clots in ECMO circuits, post-COVID venous thrombosis, and the effects of SARS-CoV-2 spike protein variants on platelets. Commentaries on various topics and the republishing of historical papers are also included. [Extracted from the article]

The aim of the study was to investigate the relationship between VEGF-460C/T polymorphism and susceptibility to diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) by meta-analysis. A comprehensive search was conducted across six databases until September 2023 to identify studies examining the association between VEGF-460C/T polymorphism and susceptibility to DR. Data process was performed by Stata 15.0 software. Eight studies were included, involving 1463 patients with DR. In the overall analysis, the difference was statistically significant only in the homozygous model (CC vs. TT: OR=1.86, p=0.048). A subgroup analysis of 6 papers with genotype frequency satisfying HWE in the control group indicated significant differences among the allele (C vs. T: OR=1.34, p=0.037), recessive (CC vs. CT+TT: OR=1.96, p=0.022) and homozygous (CC vs. TT: OR=2.28, p=0.015) models. However, in the dominant and heterozygous models, the difference was not statistically significant. The sensitivity of the HWE-based subgroup analysis showed that the conclusions in other gene models except the heterozygote model were not robust. This meta-analysis indicated that VEGF-460C/T gene polymorphism is associated with susceptibility to DR in T2DM. Allele C and genotype CC at the VEGF-460C/T locus are associated with an increased risk of DR in T2DM. However, considering that the results are not robust, more trials involving more rigorous design are needed to verify the findings of this review in the future. [ABSTRACT FROM AUTHOR]

Online self-diagnosis of psychiatric disorders by the general public is increasing. The reasons for the increase include the expansion of Internet technologies and the use of social media, the rapid growth of direct-to-consumer e-commerce in healthcare, and the increased emphasis on patient involvement in decision making. The publicity given to artificial intelligence (AI) has also contributed to the increased use of online screening tools by the general public. This paper aims to review factors contributing to the expansion of online self-diagnosis by the general public, and discuss both the risks and benefits of online self-diagnosis of psychiatric disorders. A narrative review was performed with examples obtained from the scientific literature and commercial articles written for the general public. Online self-diagnosis of psychiatric disorders is growing rapidly. Some people with a positive result on a screening tool will seek professional help. However, there are many potential risks for patients who self-diagnose, including an incorrect or dangerous diagnosis, increased patient anxiety about the diagnosis, obtaining unfiltered advice on social media, using the self-diagnosis to self-treat, including online purchase of medications without a prescription, and technical issues including the loss of privacy. Physicians need to be aware of the increase in self-diagnosis by the general public and the potential risks, both medical and technical. Psychiatrists must recognize that the general public is often unaware of the challenging medical and technical issues involved in the diagnosis of a mental disorder, and be ready to treat patients who have already obtained an online self-diagnosis. [ABSTRACT FROM AUTHOR]

Seminars in Thrombosis and Hemostasis (STH) celebrates 50 years of publishing in 2024. To celebrate this landmark event, STH is republishing some archival material. This manuscript represents the first full paper ever published in STH. The manuscript published without an abstract, and essentially covered in considerable detail the molecular structure of fibrinogen, as was known at that time. Fittingly, it covers some historical perspectives, the physicochemical properties and structure of fibrinogen across several species of animals (including humans) and its transformation into fibrin. We hope the readers of STH enjoy this journey into the past. This manuscript is accompanied by a Commentary that reflects on this past, as well as the journey towards contemporary understanding of the molecular structure of fibrinogen. As this is a republication of archival material, transformed into a modern format, we apologise in advance for any errors introduced during this transformation. [ABSTRACT FROM AUTHOR]

Limb amputations can be devastating and significantly affect an individual's independence, leading to functional and psychosocial challenges in nearly 2 million people in the United States alone. Over the past decade, robotic devices driven by neural signals such as neuroprostheses have shown great potential to restore the lost function of limbs, allowing amputees to regain movement and sensation. However, current neuroprosthetic interfaces have challenges in both signal quality and long-term stability. To overcome these limitations and work toward creating bionic limbs, the Neuromuscular Laboratory at University of Michigan Plastic Surgery has developed the Regenerative Peripheral Nerve Interface (RPNI). This surgical construct embeds a transected peripheral nerve into a free muscle graft, effectively amplifying small peripheral nerve signals to provide enhanced control signals for a neuroprosthetic limb. Furthermore, the RPNI has the potential to provide sensory feedback to the user and facilitate neuroprosthesis embodiment. This review focuses on the animal studies and clinical trials of the RPNI to recapitulate the promising trajectory toward neurobionics where the boundary between an artificial device and the human body becomes indistinct. This paper also sheds light on the prospects of the improvement and dissemination of the RPNI technology. [ABSTRACT FROM AUTHOR]

This article examines the factors that predict academic career paths among neurosurgery residents who completed a skull-base (SB) fellowship. The study collected data on 81 neurosurgery residents who pursued a SB fellowship from 2018 to 2023. The results showed that academic SB neurosurgeons tended to publish more papers, resulting in a higher h-index, than their nonacademic colleagues before and during their residency. Academic surgeons also typically began publishing on topics within SB surgery earlier in their training compared to nonacademic surgeons. This suggests the importance of early mentoring from a SB neurosurgeon during residency. [Extracted from the article]

There is limited information regarding the use of dried capillary blood spots collected on a filter paper (FP) to test for islet cell antibodies. The aim of this study was to validate the use of dried capillary blood spots collected on a FP for the analysis of islet cell antibodies. FP eluates were tested using both single and combined assay for antibodies to glutamic acid decarboxylase (GADA) and/or to the protein tyrosine phosphatase like IA-2 (IA-2A), and a single assay for antibodies to insulin (IAA). The results were compared with those of serum assays. Ninety-one subjects were studied. Forty had Type 1 diabetes mellitus (T1DM) and 51 were first-degree relatives (FDR) of patients with T1DM. The GADA and IA-2A were measured by radio-binding assays, which utilize 35S-labeled GAD65 and IA-2. IAA was measured by a microtiter plate assay using 125I-labeled insulin. Twenty-six of those with T1DM (65%) and 5 of the FDRs (10%) had at least 1 positive test on the single serum assays. The FP combi-assay for GADA and IA-2A had 97.8% concordance rate when compared with serum single assays for GADA and IA-2A. The concordance rate for individual assays were 96.7% for GADA, and 100% for both IA-2A and IAA There was significant correlation of the antibody levels between FP and serum specimen for all 3 antibodies. We conclude that antibody screening performed using dried capillary blood spots collected on a FP correlates well with serum assays, and provides an easy alternative for population screening. [ABSTRACT FROM AUTHOR]

Endoscopic endonasal surgery of the skull base (EESSB) is now well established as an alternate surgical technique/approach for the treatment of skull base pathology but is not universally practiced at all institutions that perform skull base surgery. Skull base surgeons are encouraged to share the white paper with coders and insurance companies to promote improved understanding and better coding practices. [Extracted from the article]

Despite the public health benefits of cycling in the general population, mental health issues may be evident in high-performance and elite-level competitive domains. With prominent riders disclosing their experiences with psychiatric symptoms, distinctive socioenvironmental factors could exacerbate psychopathological vulnerabilities. This suggests a need for greater mental health awareness amongst stakeholders, supplemented by actions from international and national federations and regulators. To synthesise relevant observations about psychiatric concerns in high-performance and elite-level cycling, we conducted a keyword search of articles in APA PsycINFO, PubMed, and Scopus based on specified exclusion criteria. Thirteen papers were identified that examined mental health issues in high-performance and/or elite-level cycling per classifications from the World Health Organization's International Classification of Diseases 11th Revision. A large proportion of articles illustrated eating disorder symptomatology, but others discussed attention deficit/hyperactivity disorder, anxiety disorder, depression, sleep wake disorders, and substance use disorder. Existing literature underlines important considerations for all stakeholders within the cycling community around mental health initiatives and care provisions, which are currently lacking across the sport. Such programmes could incorporate consensus statements, psychiatric screening, psychoeducation, stigma-reducing policies, and athlete advocacy. These can help mitigate socioenvironmental risk factors and prioritise athlete wellbeing over performance-centred motivations. [ABSTRACT FROM AUTHOR]

Background Nutritional management of children and adolescents with severe neurological impairment (SNI) is challenging. A web-based survey was distributed to identify the present situation and the knowledge of the involved medical professionals in Germany. Methods The survey was created with LimeSurvey, and access data were distributed by several medical societies. Eighty-three questions covered four topics: "general information," "gastro- and jejunostomy procedure," "handling of gastrostomies and feeding tubes," and "nutritional management and follow-up of children and adolescents with SNI." A descriptive analysis was performed with Microsoft Excel. Results A total of 156 participated (65 completed and 91 partially), 27% being pediatric gastroenterologists, 23% pediatric neurologists, and 10% pediatric surgeons. The most common indications for gastrostomy and tube feeding were oropharyngeal dysfunction and failure to thrive. Many patients were still underweight after some months of enteral feeding. The procedure of gastrostomy and handling recommendations varied broadly. Frequently, standard operating procedures (SOPs) and written local guidelines did not exist, and there was a considerable request for training. Only 53% of participants were aware of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition position paper published in 2017, even fewer (38%) followed the guidelines. The recommended measures to assess a nutritional status were often not respected. Conclusion Nutritional management of children and adolescents with SNI in Germany is still strongly deficient. Despite the international guideline of 2017, few colleagues are aware of and adhere to the recommendations. This could be improved by interdisciplinary teaching and evaluation of the reasons for noncompliance. The procedure of gastrostomy and the patients' follow-up vary widely. Therefore, modified SOPs should be developed. [ABSTRACT FROM AUTHOR]