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Background: The most impactful research on pediatric type 1 diabetes (T1D) remains unknown. Objective: We aimed to evaluate the characteristics and impact of the 100 most-cited articles on pediatric T1D. Materials and Methods: Using a predefined bibliometric strategy, the Scopus database was searched for high-cited papers (HCPs) published from 2001 to 2020. Articles were evaluated for data on the publication year, countries, authors, journals, topics, and types. Social network analysis was performed to visualize the interaction among countries, organizations, and authors using VOSviewer software. Results: The top 100 HCPs received 390 to 4634 citations, averaging 773.5 citations per paper (CPP). The funded HCPs (n = 50) had a higher impact (CPP 791.5). The majority of HCPs (n = 83) were collaborative. Classifying by research type, 65 studies were clinical (n = 65), risk factors (n = 27), epidemiology (n = 26), pathophysiology (n = 16), treatment outcome (n = 13), genetics (n = 12), complications (n = 3), quality of life (n = 2), and prognosis (n = 1). The number of authors involved was 1,101, affiliated with 545 organizations in 27 countries; the USA (n = 64) and the UK (n = 24) were the most productive countries, whereas Australia and the UK were the most impactful. D.M. Nathan and J.M. Lawrence were the most prolific authors, while P. Raskin and J.M. Lachin were the most impactful. Conclusions: High-income countries such as the USA, UK, and Australia contribute significantly to high-impact pediatric T1D research. Funding and collaboration improve the impact of citations in publications. Less researched areas such as treatment outcomes, genetics, complications, quality of life, and prognosis should be the focus of future research on pediatric T1D. [ABSTRACT FROM AUTHOR]

The risk and outcome of deep vein thrombosis (DVT) in patients who sustained spinal cord injury (SCI) remain a challenge. We aimed to assess the incidence, risk, burden, and prophylaxis of DVT after SCI. Thirty-nine studies were identified from among 250 relevant articles based on firstly, broad criterion of DVT among SCI cases. secondly, "risk factors" impacting DVT, thirdly, published reports from apex bodies of global importance such as World Health Organization, Centre for disease control, Atlanta USA, and others were given due weightage for their authenticity. SCI is characterized by loss of motor, sensory, and autonomic function with partial or total damage of the anatomical structure leading to increased risk of thrombogenesis. SCIs present a higher risk of venous DVT constituting 9.7% of deaths in the 1st year of follow-up. Currently, prophylaxis with mechanical methods, vena cava filters and antithrombotic chemoprophylaxis in SCI are interventions for the management of DVT. DVT in SCI patients is not uncommon and needs a high index of suspicion and implementation of institutional prophylaxis protocol. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematological disease. There is an incidence. We aimed to evaluate the scientometrics characteristics of the scientific production on BPDCN between 2011 and 2020. METHODOLOGY: A cross-sectional and retrospective bibliometric study was performed. The search was executed in the Scopus database. Data were extracted based on a formula developed using thesaurus MeSH (Medline) and Emtree (Embase) terms. The retrieved papers received 11.2 citations per paper. Four of the ten most productive authors were from the United States. The institution with the highest impact (1064 citations) and the highest scientific output (46 papers) was the University of Texas MD Anderson Cancer Center (United States). RESULTS: The journal "Movement Disorders" rated first with 18 articles and 643 citations in terms of productivity and impact, and articles published in Q1 journals surpassed the remaining quartiles. The most cited articles had national collaboration. Conclusion the number of papers on BPDCN has been rising, yet journals with a higher quality tend to keep the similar publication rates, although they have shown a slight increase in the recent years. CONCLUSIONS: High-income countries' international collaboration is crucial for increasing publications impact; hence, greater collaborations between researchers and institutions from countries around the world are needed to expand knowledge on this subject. [ABSTRACT FROM AUTHOR]

Presents several abstracts of academic papers on health education in the United States. Includes `Human Doctoring: Bringing Authenticity to Our Care,' by Cathy Risdon and Lori Edey; `The Liberal Arts Physician,' by Gerard N. Burrow; `Community-Based Training in Family Medicine--a Different Paradigm,' by Bob Mash and Marietjie de Villiers.

The article presents a scientometric analysis for identifying major specialties of pharmacological research and the countries contributing the highest number of articles in pharmacology. According to the analysis, 1,471 research papers were published from 57 nations. The first nation with 30 percent score of total publications was the U.S. followed by Japan with 13 percent and Great Britain with 8.3 percent. About 37 nations published research papers on cellular and molecular pharmacology.

Objective: To identify and characterize the top-cited articles on idiopathic intracranial hypertension.Methods: We used "Web of Science database" to identify the top-cited articles published between the years of 1975-2017. The articles were evaluated using citation count and other factors that have an effect on the citation count.Results: The search yielded a total of 2,141 articles and the most frequently cited articles received between 58-476 citations. Most articles were published between the years 1990-1999. The most popular study design involved natural history studies. USA ranked first in productivity with 72 articles and the leading institution was University of Iowa. The journal "Neurology" published the greatest number of articles. In assessing the specialties, neurology contributed to 32% of top 100 articles. There was no correlation between the citation count and number of references, years since publication, number of authors, authors' H-index, and number of institutions that had collaborated. There were positive correlations between the citation count and journal impact factor, Scimago journal rank and journal source-normalized impact per paper values. While descriptive keywords were more frequent between 1980s and 1990s, keywords describing surgical management options such as "nerve sheath decompression" and "cerebrospinal-fluid diversion" were top-listed keywords after the year 2000.Conclusions: Our study can help researchers identify the most significant and impactful articles on idiopathic intracranial hypertension, as well as to provide insight into the most noteworthy scientific trends and to visualize future research needs of the topic. [ABSTRACT FROM AUTHOR]

Carpal tunnel syndrome (CTS) is a disease caused by compression of the median nerve passing through the wrist. Patients suffer from severe pain and paresthesis in the median nerve. Compression of the median nerve occurs, with prolonged working on keyboards (computer or laptop or music players) being one of the reasons along with others such as diabetes or rheumatoid arthritis. CTS research holds great promise for the patients as well as doctors for better medical treatment. The study has been carried out with an objective to analyze research progress based on the literature published on CTS during the last 35 years. The retrospective study has been carried out from the data indexed in SCOPUS multidisciplinary database from 1983 to 2017 (35 years). The study involves analysis of publication trends in terms of total articles, productive countries, institutions, journals, productive authors, most cited articles along with impact in terms of citation and h-Index. The SCOPUS database yielded 13187 articles during the study period. These articles were analyzed further for interpreting results. In the last 35 years, the number of scientific publications on CTS has been increasing with an annual growth rate of 9.86% per year. USA has been the most productive country. Literature pertaining to females is more than clinical studies involving males. [ABSTRACT FROM AUTHOR]

Background: The number of times a research work gets cited by another article is one of the article-level metrics for assessing the quality of a research publication. Citation analysis by bibliometric review has been performed in several disciplines. The current study was aimed to systematically review the literature available on pediatric inguinal hernia since 1960 in terms of the 25 most cited articles in this field and analyze the bibliometric variables author and organizational collaborative patterns. Methods: Thomson Reuters Web of Science citation indexing database and research platform were used to retrieve the most cited articles in pediatric inguinal hernia (PIH) using appropriate search strings. The characteristics (name of authors, the total number of authors, the title of publication, journal of publication, year of publication, etc.) of the 25 top-cited articles were recorded. Specific bibliographical parameters were derived and analyzed. Visualization maps were generated using VOSviewer software. Results: The analysis revealed that the Journal of Pediatric Surgery was leading the choice of journal for publication. While most of the publications originated from the United States of America, Schier was the most influential author. Five of the eight top-productive authors are also the most connected. Conclusion: Articles on laparoscopic repair in PIH have been heavily cited. Following the United States of America, Turkey stands out as the topmost productive country in PIH. The publications on PIH show that "collaboration" is the bridging force between productivity and influence on the academic community. [ABSTRACT FROM AUTHOR]

Tricuspid regurgitation (TR) is a common finding. Any changes to the components of the tricuspid valve (TV), such as the tricuspid annulus, valve leaflets, papillary muscles, and chordae tendinae can lead to TR. This valvular disease has recently sparked interest after it was long forgotten. This paper examines the anatomy of the TV, etiology of TR, and critically appraises the diagnostic methods used to assess the TV and the current medical treatment options for TR. This paper aims to give a detailed review of TR in hopes that more research will be conducted to help better assess patients with tricuspid regurgitation. [ABSTRACT FROM AUTHOR]

Chinese medicine has a long history in the United States, dating back to its colonial period and extending up to the present. This essay focuses on the earliest generation of practitioners of traditional Chinese medicine in the United States. Although acupuncture is the modality most commonly associated with Chinese medicine in today's medical marketplace, up until the 1970s, Chinese healers in the United States typically specialized in herbalism. Well before mass emigration from China to the United States began, Chinese material medica crossed the oceans, in both directions: Chinese medicinal teas and herbs came west while Appalachian ginseng went east. Beginning in the 1850s, Chinese immigrants came to the United States and transplanted their health practices, sometimes quite literally by propagating medicinal plants in their adopted home. Over time, Chinese doctors learned how to sell their services to non-Chinese patients by presenting herbalism as "nature's remedies.". [ABSTRACT FROM AUTHOR]

Background: To estimate the pooled odds of oral contraceptive pills consumption (OCPs) use as well as pregnancy history and multiple sclerosis (MS) risk. Methods: We systematically searched PubMed, Embase, Scopus, Web of Science, Google scholar, and gray literature including references of the references as well as conference papers. The search strategy in PubMed was ((Oral contraceptive pills) OR OCP) AND (Multiple Sclerosis OR Sclerosis, Multiple) OR Sclerosis, Disseminated) OR Disseminated Sclerosis) OR MS (Multiple Sclerosis)) OR Multiple Sclerosis, Acute Fulminating) AND (gravidity) OR (pregnancy). Results: Four studies were included. The pooled odds of developing MS in women with pregnancy history compared with nulligravid women was 0.64 (95%CI = 0.53 - 0.78) (I² = 0, P = 0.5), which means that pregnancy reduces the risk of MS by 36%. The pooled odds of OCP consumption and risk of MS were 1.09 (95% CI = 0.67 - 1.76). By comparing the pooled odds of OCP consumption and risk of MS according to the country of the origin, we found that the pooled odds in Iranian studies was 1.03 (95% CI = 0.31 - 3.45) and the pooled OR in studies that were conducted in the United States was 1.13 (95% CI = 0.65 - 1.98), which showed that the country of the origin was not the cause of heterogeneity. Conclusions: The results of this systematic review show that pregnancy history is a protective factor for MS development, whereas OCP use has no significant effect. [ABSTRACT FROM AUTHOR]

Perinatal mental health is a complex and multifaceted area influenced by various psychosocial risk factors that impact the well-being of individuals during pregnancy and the postpartum period. This article provides insight into the intricacies of perinatal mental health challenges, emphasizing the importance of comprehensive support systems. It highlights prominent risk factors, including exposure to stressful life events, strained marital relationships, inadequate social support, lower socioeconomic status, single marital status, unwanted pregnancies, obstetrical stressors, and infant temperament. The article discusses various psychosocial interventions, including psychoeducation, cognitive restructuring, problem-solving techniques, behavioral activation, and befriending. It also emphasizes the importance of specialized care for women experiencing postpartum psychosis. The National Institute of Mental Health and Neurosciences-Mother-Baby Unit Model, a multidisciplinary approach to perinatal mental health care, is explored, highlighting its comprehensive psychosocial assessment and tailored interventions. The article emphasizes the need to focus on psychosocial risk factors and culturally sensitive interventions in perinatal mental health care. [ABSTRACT FROM AUTHOR]

Although there has been a lot of research focused on the effect of war on child refugees, along with those impacted directly, there are no recent studies comparing these two groups side‑by‑side. In this paper, we review psychiatric comorbidities associated with children (defined as 17‑year‑olds and younger) exposed to war, with an additional emphasis on approaches to treatment. In addition, we aim to understand these children’s thoughts and insights into their situation(s). We will do so by presenting narratives given by close relatives of (1) two children currently in Ukraine in the midst of the war, (2) another young Ukrainian child war refugee who was able to recently leave the country, and (3) an adult and his experiences of being a war refugee and then resettling in the United States as a child. We never know when or where a war will begin. It is important that we have mental health professionals that can help children through the current and unexpected adversities that arise with war and displacement. These children need assistance with their uncertainties about the future and the risk of disruption of peace or comfort. Moreover, mental health disparities are substantial amongst children exposed to the traumas associated with war, and treatment is limited. We share this research to encourage mental health professionals to seek understanding of the impact the current war is having on Ukrainian youth. It is our hope that, with presenting these narrative accounts, mental health providers will gain a deeper understanding of what these children are encountering and will become prepared to support them and their mental health. [ABSTRACT FROM AUTHOR]

Background: Smile esthetics can be subjective. This study aims to assess the effect of culture/geographic location on judging smile esthetics by comparing the perception of smile characteristics between American laypersons (Western culture) and Iranians (Eastern). Materials and Methods: One hundred residents from each country were recruited for this analytical cross-sectional study. A frontal picture of a posed smile with standard norms which are mentioned in the Contemporary Orthodontics textbook by William R. Proffit was selected. Adobe Photoshop 7 was used to alter midline diastema, gingival display (GD), maxillary midline-to-face discrepancy, buccal corridor (BC), and smile arc. Images were given to groups to determine the most attractive and acceptable smile. Data were analyzed by Chi-square, Mann-Whitney, and Spearman correlation coefficient in SPSS-22 (α = 0.05). Results: Americans were less critical in judging diastema (P < 0.001), GD (P = 0.013), and BC (P = 0.004) for smile attractiveness than Iranians. No difference was between the two groups in choosing the acceptability threshold and determining the most attractive smile except for BC (P = 0.002). Conclusion: Overall, Americans were more tolerant of variations in smile characteristics than Iranians. Both groups agreed on most smiles. Therefore, it seems that it is reasonable to use similar standards for smile characteristics while considering the small differences. [ABSTRACT FROM AUTHOR]

Medical professionals face high stress due to the type of work they do and the prolonged working hours. Frequent burnout results due to the challenging nature of their work. Added to the stress of work, malpractice lawsuits add to their burden. In India, most doctors work in compromised settings with poor infrastructure and manpower but are expected to follow the best practices. In court, they are judged with the Bolam and Bolitho tests being essential considerations. Several tragic incidents have been reported, including depression, anger issues, and even suicide deaths of healthcare professionals (HCPs) after accusations of negligence and subsequent inquiry. Such incidents demonstrate the multitude of challenges an HCP faces in day-to-day practice. It is crucial to find ways to tackle these problems and enhance the capacity of HCP to handle such demanding circumstances. Malpractice litigation can significantly impact the mental health of HCPs. It is common to experience emotional turmoil when faced with a lawsuit. Second victim syndrome (SVS) is a term used to describe a set of symptoms experienced by HCPs who make an error leading to injury to a patient. However, it also happens if he is traumatized by the consequences of violence during healthcare services or a lawsuit or defamation article in newspaper/social media. Following a litigation crisis in their career, many HCPs go through various stages of grief, including shock, denial, anger, bargaining, depression, and acceptance. At times, death by suicide of the HCPs is well known. SVS is known to profoundly affect the personal, family, economic, professional (defensive practice), and social life of HCPs. HCPs should accept the allegations of negligence as an occupational hazard and prepare for the eventual litigation at least once in a lifetime by knowing about the medical laws, HCP's rights, becoming aware of the emotional turmoil of the lawsuit, preparing to cope with the lawsuit, and seeking help from colleagues and indemnity insurance. Frequent training of the HCPs is strongly recommended to know about the changing laws and also to undergo periodic professional competence enhancement to reduce the incidents of errors amounting to medical negligence. Medical and hospital administration should debrief after any incident and conduct internal investigations to identify systemic flaws and prevent future recurrence, resolve issues within their control at their level, and manage media (mainstream and social media) appropriately. If established, a reporting system with online and offline services will ease the internal administrative investigation process and take appropriate, timely actions. During the crisis, HCPs should have adequate and appropriate insurance or indemnity coverage and mental health support systems. [ABSTRACT FROM AUTHOR]

In addition to the expensive and lengthy process of developing a new medicine, the attrition rate in clinical research was on the rise, resulting in stagnation in the development of new compounds. As a consequence to this, the US Food and Drug Administration released a critical path initiative document in 2004, highlighting the need for developing innovative trial designs. One of the innovations suggested the use of adaptive designs for clinical trials. Thus, post critical path initiative, there is a growing interest in using adaptive designs for the development of pharmaceutical products. Adaptive designs are expected to have great potential to reduce the number of patients and duration of trial and to have relatively less exposure to new drug. Adaptive designs are not new in the sense that the task of interim analysis (IA)/review of the accumulated data used in adaptive designs existed in the past too. However, such reviews/ analyses of accumulated data were not necessarily planned at the stage of planning clinical trial and the methods used were not necessarily compliant with clinical trial process. The Bayesian approach commonly used in adaptive designs was developed by Thomas Bayes in the 18th century, about hundred years prior to the development of modern statistical methods by the father of modern statistics, Sir Ronald A. Fisher, but the complexity involved in Bayesian approach prevented its use in real life practice. The advances in the field of computer and information technology over the last three to four decades has changed the scenario and the Bayesian techniques are being used in adaptive designs in addition to other sequential methods used in IA. This paper attempts to describe the various adaptive designs in clinical trial and views of stakeholders about feasibility of using them, without going into mathematical complexities. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to assess and compare the occlusal contacts in dentate and edentulous patients wearing complete denture with varying head posture. Materials and Methods: Ad hoc sampling of 30 subjects (15 dentate and 15 edentulous) based on inclusion and exclusion criteria was done. Subjects were divided into two groups: dentate and edentulous. Each group was further divided into two subgroups based on two head postures-upright 90° and ventroflexed 30°. For recording of every posture, a new sensor was used, and the subject was asked to clench on the sensor in maximum intercuspation position at the two head postures. Results: Data were summarized as mean ± standard error and compared by Student's t-test using SPSS software (windows version 17.0 IBM corporation, New York, USA). A statistically significant correlation between head posture and contact area was found in dentate and denture wearers, i.e., tooth contact area varies with head posture. Conclusion: It was concluded that the occlusal contacts vary at different head posture in dentate as well as in denture wearers. With ventroflexion, the number of tooth contact decreased as compared to upright-erect position in both groups. Clinical implication - since the number of tooth contacts varies with varying head postures, it is recommended that the balancing of the contacts should be done at varying head postures. [ABSTRACT FROM AUTHOR]

Clinical practice guidelines provide a framework against which quality of care is measured. Recommendations contained within guidelines are used for decision-making not only within the clinical domain but also other related issues within the health systems. As such the use of research evidence for formulating recommendations contained in a guideline is a global standard to ensure guideline quality. The paper briefly reviews how the need for and use of evidence in guideline development shaped up historically and then provides an overview of the four typologies of guideline development mechanisms at the country level. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to estimate the predictors, associations, and outcomes of COVID-19-associated pulmonary disease (CAPA) in the United States. STUDY DESIGN AND METHODS: This retrospective cohort study was performed by using the National Inpatient Sample Database 2020 to identify coronavirus disease 2019 (COVID-19) and CAPA hospitalizations. Baseline variables and outcomes were compared between COVID-19 hospitalizations without aspergillosis and those with aspergillosis. These variables were then used to perform an adjusted analysis for obtaining predictors and factors associated with CAPA and its inhospital mortality. RESULTS: Of the 1,020,880 hospitalizations identified with the principal diagnosis of COVID-19, CAPA was identified in 1510 (0.1%) hospitalizations. The CAPA cohort consisted of a higher proportion of males (58%) as well as racial and ethnic minorities (Hispanics, Blacks, and others [including Asian or Pacific islanders, native Americans]). Inhospital mortality was significantly higher (47.35% vs. 10.87%, P < 0.001), the average length of stay was longer (27.61 vs. 7.29 days, P < 0.001), and the mean cost per hospitalization was higher ($121,560 vs. $18,423, P < 0.001) in the CAPA group compared to COVID-19 without aspergillosis. History of solid organ transplant, chronic obstructive pulmonary disease, and venous thromboembolism were associated with higher odds of CAPA among other factors. The use of invasive mechanical ventilation (adjusted odds ratio [aOR] 6.24, P < 0.001), acute kidney injury (aOR 2.02, P = 0.028), and septic shock (aOR 2.07, P = 0.018) were associated with higher inhospital mortality in the CAPA cohort. CONCLUSION: While CAPA is an infrequent complication during hospitalizations for COVID-19, it significantly increases all-cause mortality, prolongs hospital stays, and leads to higher hospital expenses compared to COVID-19 cases without aspergillosis. [ABSTRACT FROM AUTHOR]

Clinical trials that allow significant heterogeneity of population or interventions often result in uncertain outcomes. In this paper, we review the outcomes of five recent trials of endovascular interventions in acute ischemic stroke in the context of the neutral results of previous large clinical trials on the subject. [ABSTRACT FROM AUTHOR]

Huge cost pressures and the need to drive faster approvals has driven a technology transformation in the clinical trial (CT) industry. The CT industry is thus leveraging mobile data, cloud computing, social media, robotic automation, and electronic source to drive efficiencies in a big way. Outsourcing of clinical operations support services to technology companies with a clinical edge is gaining tremendous importance. This paper provides an overview of current technology trends, applicable Food and Drug Administration (FDA) guidelines, basic challenges that the pharma industry is facing in trying to implement such changes and its shift towards outsourcing these services to enable it to focus on site operations. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to identify recent research trends on diabetic macular edema (DME) and focus on publications from different countries, institutions, and authors. Methods: We retrieved and analyzed data from January 1, 2003 to December 31, 2022 on the DME research field from the Web of Science Core Collection (WoSCC) database. Microsoft Excel and VOSviewer were applied to perform visualization analysis and evaluate the trends. Results: A total of 4482 publications were identified, and the annual global publications increased steadily, from 36 to 390, during this period. The United States (1339 publications, 71,754 citations), Johns Hopkins University (176 publications, 17,015 citations), and Bressler NM (76 publications, 9621 citations) were the most influential and productive countries, institutions, and authors, respectively. The top 100 keywords were classified into five clusters: (1) therapy and adverse effects of DME; (2) clinical biomarkers of DME; (3) mechanistic research on DME; (4) improving bioavailability and efficacy; and (5) early diagnosis of diabetic complications. "Diabetic macular edema," "retinopathy," "ranibizumab," and "optical coherence tomography angiography" were the most frequent keywords. Regarding the average appearing years (AAYs) of the keywords, "deep learning" (AAY:2020.83), "optical coherence tomography angiography" (AAY:2019.59), "intravitreal Aflibercept" (AAY:2019.29), and "dexamethasone implant" (AAY:2019.20) were recognized as the hotspots of the DME research area in the short run. Conclusion: In the past two decades, the United States was in master status in DME research. Although intravitreal drug injection has been the mainstream therapy for a long time, the effectiveness of different drugs, such as dexamethasone, new solutions for drug delivery, such as intravitreal implantation, and more accurate tools for the classification and follow-up of DME patients, such as deep learning systems, are still research hotspots. [ABSTRACT FROM AUTHOR]

Introduction: A scientometric analysis was conducted to characterize the global research publications in extrahepatic portal venous obstruction (EHPVO), and state-of-the-art visualization graphics were generated to provide insight into specific bibliometric variables. Materials and Methods: The Web of Science database was accessed for research productivity and bibliometric variables of countries, institutions, authors, journals, and content analysis of top-20 cited documents were performed. Collaborative networks and co-occurrence of keywords map were generated using VOSviewer software. Results: Two hundred and sixteen records were retrieved with an annual growth rate of 2.53%. India is the leading country in productivity (n = 4339), followed by the USA and China. Post Graduate Institute of Medical Education and Research, Chandigarh, was the top productive institute. Sarin SK was the most prolific author, having the highest citations received and h-index. The hotspot topics were "portal hypertension," "cirrhosis," "children," "biliopathy/cholangiopathy," "liver fibrosis," and "liver transplantation" as per keyword co-occurrence networking. J Gastroenterol Hepatol had the most publications of EHPVO research as well the h-index. Regarding collaborative network mapping, the USA and Primignani M were the significant nodes among country and author, respectively. Conclusion: EHPVO research publication volume is low but is gradually progressing with dominant contributions from Indian institutes and authors. Most highly cited articles are of low level of evidence, and multi-institutional collaborative research can be the way forward. [ABSTRACT FROM AUTHOR]

BACKGROUND: Maternal death generates a great impact on public health, and it is recognized that its main cause is postpartum hemorrhage (PPH). Therefore, the objective was to analyze the bibliometric profile of the world scientific production on maternal mortality due to PPH. MATERIALS AND METHODS: Bibliometric study that included original articles indexed in Scopus, identified by means of a search strategy that included MESH terms and logical operators. Bibliometric indicators were estimated with the SciVal tool, and the VOSwiever program was used for co-occurrence networks by key terms and co-authorship by country. RESULTS: There has been an increase in the number of publications in the past 5 years. Regarding co-occurrence, the most frequent terms were "postpartum hemorrhage" and "maternal mortality." The United States and the United Kingdom are positioned as those with the highest density of publications; in addition, Australia evidences collaboration with Canada and South Korea. Publications with national collaboration were more frequent (36%). BMC Pregnancy and Childbirth is the most productive journal, although BJOG: An International Journal of Obstetrics and Gynecology has a higher normalized impact. The authors with the highest scientific output belong to an institution in the Netherlands. Vrije Universiteit Amsterdam and Leiden University are the most productive. CONCLUSION: Scientific activity on maternal mortality due to PPH is increasing and its main means of dissemination are high-impact journals. National collaboration was more frequent, with the active participation of authors and institutions from the Netherlands and the United States. [ABSTRACT FROM AUTHOR]

Electronic health records (EHRs) have emerged as a major topic in health care and are central to the federal government's strategy for transforming healthcare delivery in the United States. Recent federal actions that aim to promote the use of EHRs promise to have significant implications for laboratories and for pathology practices. Under the HITECH (Health Information Technology Economic and Clinical Health) Act, an EHR incentive program has been established through which individual physicians and hospitals can qualify to receive incentive payments if they achieve "meaningful use" of "certified" EHR technology. The rule also establishes payment penalties in future years for eligible providers who have not met the requirements for meaningful use of EHRs. Meaningful use must be achieved using EHR technology that has been certified in accordance with functional and technical criteria that are set forth a regulation that parallels the meaningful use criteria in the incentive program. These actions and regulations are important to laboratories and pathologists for a number of reasons. Several of the criteria and requirements in the meaningful use rules and EHR certification criteria relate directly or indirectly to laboratory testing and laboratory information management, and future stage requirements are expected to impact the laboratory as well. Furthermore, as EHR uptake expands, there will be greater expectations for electronic interchange of laboratory information and laboratory information system (LIS)-EHR interfaces. Laboratories will need to be aware of the technical, operational, and business challenges that they may face as expectations for LIS-EHR increase. This paper reviews the important recent federal efforts aimed at accelerating EHR use, including the incentive program for EHR meaningful use, provider eligibility, and EHR certification criteria, from a perspective of their relevance for laboratories and pathology practices. [ABSTRACT FROM AUTHOR]

During the last decade, despite increased investment in drug research and development related activity, stagnation in new drug discovery has been documented. Despite a 70% increase in investment in research and development-related activities, a 40% fall in launch of new chemical entities was seen during 1994-2004. A steep rise in the attrition rate of drug development has complicated the matter. Rising cost and increased attrition rates proved major barriers to investment in higher risk drugs or in therapies for uncommon diseases or diseases that predominantly afflict the poor. This prompted Food and Drug Administration (FDA) to highlight this problem in a 2004 white paper classified as "Critical Path Initiative" (CPI) and to initiate steps to target stagnation and rise in attrition rates. Many new drug development projects have started worldwide taking cue from CPI; adopting microdosing, adaptive designs and taking advantage of newly developed biomarkers under the CPI. This review discusses the various strategies adopted under CPI to decrease attrition rate and stagnation of new drug development, and the challenges and controversies associated with CPI. [ABSTRACT FROM AUTHOR]

Currently, there are more than 445,000 veterans receiving compensation for hearing loss associated with military service, and 395,000 receiving compensation for service-related tinnitus. In addition to compensation payments, service-related hearing disorders cost the US Department of Veterans Affairs in terms of provision of hearing aids, hearing aid-related services, and clinical services at its 220 facilities nationwide. It is imperative that hearing conservation among military personnel and veterans be addressed. In this paper, we describe the rationale for and the development of a multimedia Hearing Loss Prevention Program aimed at preventing the progression of hearing loss among veterans associated with social, recreational, and nonmilitary occupational noise exposure. The program was developed based on the principles outlined in the Health Belief Model of Rosenstock (1966) and the Health Promotion Model of Pender et al. (2002). [ABSTRACT FROM AUTHOR]

Internationally, 20th century medical education concentrated on equipping new graduates with technical skills and pushing the frontiers of technological sciences to extend and enhance life in ways unimaginable in previous decades. In the 21st century, health services are expected to be characterized not by the ''fix-up-when-things-go-wrong'' type of care that 20th century physicians have become so good at, but by preventive care that can obviate much of the need for these fix-up services. Enabling doctors to deal with the different health care needs of future patients will require a values shift in medical education. The United States leads the world in per capita health care expenditure yet trails in many important measures of health status. It epitomizes many elements of both the good and the bad in current medical education that may be less obvious in other countries that are less wealthy, less technologically oriented, and less committed to individual freedoms. In this paper we use the US as a case study to argue the need for a fundamental shift in values away from the 20th century emphasis on disease, specialization and treatment, and towards health, generalization and prevention. We draw on data from the National Ambulatory Medical Care Survey to compare roles of primary care physicians and other office-based medical specialties in delivering preventive health care. We also estimate the cost of providing preventive care in terms of physician time. Finally, we contemplate how medical education values must change in the US and other countries if 21st century physicians are to be prepared to meet the health care needs of their communities. [ABSTRACT FROM AUTHOR]

Purpose: The Keeping Families Healthy (KFH) program at the University of Florida College of Medicine is a new community-based course designed to improve physician-patient relationships. This paper describes the experience of the first-year medical students' home visits, which were developed to foster health promotion and disease prevention. Approach: This two-semester course offers first-year medical students the opportunity to integrate prevention, service, and humanism into the established educational curriculum. During the course the learners have opportunities to interact with families who have volunteered to serve in partnership with the College of Medicine faculty as community lay teachers. The program provides a valuable service to the participating families by helping them identify useful community resources, and by formulating healthy care plans for prevention of illness and stabilization of chronic illness. Conclusions: Community-based learning and home visits expose students to personal travails (e.g. lack of financial resources) in a way that cannot be addressed in traditional settings. This exposure may involve students in community-building strategies that can assist not only individual patients, but also communities. Additionally, home visits provide an opportunity for pre-clinical students to have an active rather than passive role in their education. [ABSTRACT FROM AUTHOR]

Introduction: The problem of counterfeiting of drugs is assuming alarming proportions and is getting difficult to combat due to its trans-national character. It is undermining the faith of people on health care system. Therefore, there is a need to adopt zero tolerance approach to combat the problem. The Way Forward: There are many solutions available which are being adopted in piece meal manner by individual manufacturers. However, for wholesalers and resellers it is getting difficult to maintain multiple solutions. Therefore, there is a need to adopt a unified solution preferably with the help of the government. Conclusions: This paper discusses the available solutions, their shortcomings and proposes a comprehensive solution where at each level in the supply chain the authenticity is verified preferable linking it with Unique identification. [ABSTRACT FROM AUTHOR]

Heart failure (HF) is characterized by high symptom burden including, but not limited to fatigue, dyspnea, and edema. Up to 21.5% of HF patients experience significant depressive symptoms, much higher than 7.1% in adults without HF. Diet, metabolites, and other inflammatory mechanisms have gained notable attention in recent studies for contributions to symptoms in HF. Symptoms for black adults (B/As) with HF are often influenced by lifestyle factors, which may influence their higher mortality rates; few studies address these factors. Distinguishing the links between key elements with diet, inflammation, and symptoms may bring clarity for new dietary strategies in HF clinical care. The purpose of this integrative review is to examine the existing literature regarding relationships among physiologic pathways in HF along with physical and emotional symptoms in the context of inflammation, dietary intake, tumor necrosis factor-alpha (TNF-α), a biomarker of inflammation, and trimethylamine-N-Oxide (TMAO). Based on available evidence, inflammation may be a key link between physical symptoms, diet, depression, TMAO, and TNF-α in persons with HF and warrants further examination to clarify pathological links to solidify evidence for better guidance with dietary modifications. The literature reviewed in this study demonstrates that more work is needed to examine dietary planning, social support, and differences between men and women in the B/A community. Results of this literature review call attention to the essential, personalized care needs related to symptom monitoring and dietary planning which is expected to decrease symptom burden in the HF population. [ABSTRACT FROM AUTHOR]

The article explores the potential use of dexmedetomidine in pediatric cardiac anesthesia. Dexmedetomidine is not yet approved by the U.S. Food and Drug Administration for use in pediatric patients, although several papers describe its use in pediatric patients in operating room, in catheterization laboratory, in magnetic resonance imaging (MRI) suits and in intensive care units (ICU). It cites several studies which indicate cardiovascular and neuroprotective properties of this drug.

Chinese medicine is growing rapidly in the United States both as a field of research and in the daily treatment of illnesses. The popularity of Chinese medicine, particularly acupuncture, as a healing mechanism demonstrates American people's positive experience with Chinese medicine and their embracing it as an alternative to the mainstream Western biomedicine. Chinese medicine is an important part of the Alternative and Complementary Medicine or Integrated Medicine in the United States health system. It is increasingly used and covered by health insurance. Although Chinese medicine has been in the United States since colonial times, it was discriminated against by local authorities. However, things began to change in the 1970s when individual states gradually passed laws to legalize the practice of acupuncture as a healing mechanism. American public interest in Chinese medicine, particularly acupuncture, was aroused by the media's report of the "magic" power of acupuncture during President Nixon's visit to China. Non-Asians studied acupuncture in the following decades, which contributed to the establishment of acupuncture as a profession in the American health system. The history of Chinese medicine in the United States illustrates that Chinese and Asian immigrants promoted Chinese medicine in the communities, while Chinese American medical scientists who were trained in biomedicine played an important role in shaping the biomedical method of acupuncture research. This article investigates the changes of Chinese medicine in the United States, with a focus on acupuncture. Situating the discussion in a larger context of social and cultural changes, this study examines the contributions of Chinese immigrants and the popularity of acupuncture in the United States. It analyzes the development of acupuncture practice and research, the professional training in Chinese medicine, and American people's interest in using Chinese medicine as a reliable healing mechanism to many health problems, including chronic pain, cancer, and drug addictions. [ABSTRACT FROM AUTHOR]

Patient portals allow patients to access their personal health information. The 21st Century Cures Act in the United States sought to eliminate ‘information blocking’, requiring timely release upon request of electronic health information including diagnostic test results. Some health systems, including the one in the present study, chose a systematic switch to immediate release of all or nearly all diagnostic test results to patient portals as part of compliance with the Cures Act. Our primary objective was to study changes in the time to view test results by patients before and after implementation of Cures Act-related changes. This retrospective pre-post study included data from two 10-month time periods before and after implementation of Cures Act-related changes at an academic medical center. The study included all patients (adult and pediatric) with diagnostic testing (laboratory and imaging) performed in the outpatient, inpatient, or emergency department settings. Between February 9, 2020 and December 9, 2021, there was a total of 3 809 397 diagnostic tests from 204 605 unique patients (3 320 423 tests for adult patients; 488 974 for pediatric patients). Overall, 56.5% (115 627) of patients were female, 84.1% (172 048) white, and 96.5% (197 517) preferred English as primary language. The odds of viewing test results within 1 and 30 days after portal release increased monthly throughout both time periods before and after the Cures Act for all patients. The rate of increase was significantly higher after implementation only in the subgroup of tests belonging to adult patients with active MyChart accounts. Immediate release shifted a higher proportion of result/report release to weekends (3.2% pre-Cures vs 15.3% post-Cures), although patient viewing patterns by day of week and time of day were similar before and after immediate release changes. The switch to immediate release of diagnostic test results to the patient portal resulted in a higher fraction of results viewed within 1 day across outpatient, inpatient, and emergency department settings. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has created public health crisis and economic instability globally. However, the pandemic and the nationwide lockdown have a significant impact on the psychosocial status, emotional state, relationships of individuals, family, and community. Families were facing challenges due to lockdown and will do their best to develop adaptive behavior for attaining self-stability. The present study helps to understand the effect of lockdown on family well-being and the shift of intrafamilial relationships during the lockdown. Subjects and Methods: A cross-sectional study was done in an urban area of Kakinada from April to June 2020. A convenient sample of 300 families was selected by systematic random method. One parent and one adolescent child from each family, a total of 600 study participants were included under the study. Data were collected using a semi-structured questionnaire, entered in Microsoft Excel and analyzed using IBM SPSS. The mean, frequencies, proportion, and Chi-square test were used to analyze data. Results: Adaptability has increased during lockdown by sharing of household work, from 3% before to 91.7%. 97.3% were happy spending time with family members. Communication and satisfaction have increased by a decrease in conflicts, from 19.7% to 7% during the lockdown. Only 3.08% of adults were facing either physical or verbal abuse. Conclusions: During the lockdown period, the family members spent quality time together acquired new skills, and conflicts among them were reduced. Domestic violence is low in this particular study area and familial bonding is high. [ABSTRACT FROM AUTHOR]

Focuses on the need to devote time, effort and deep reflection on articles dealing with important topics such as health education in the United States. Misconception on speed reading as valuable reading; Relevance of producing articles on themes of community-oriented education and problem-based learning; Importance of health professions education periodicals.

Chinese medicine originated in China and has taken root all over the world. In the United States, Chinese medicine belongs to the category of complementary and alternative medicine and has a history of over 50 years as a recognized profession. The education of Chinese medicine is undoubtedly the foundation for the development and growth of Chinese medicine practice. In this article, we briefly introduced the history of acupuncture profession and its development in the United States. Pacific College of Health and Science New York and Eastern School of Acupuncture and Traditional Medicine were discussed and analyzed. This article aims to discuss two examples of acupuncture schools in the United States to provide an overview of the history and current development of Chinese medicine education in the United States. [ABSTRACT FROM AUTHOR]

Medicine operates within the world views of the culture that it serves, and the widespread Chinese diaspora has carried medical practices with it. The resulting creolization takes shape at the borders of intersecting cultures in a distinct form of integration. This article explores the intersections of integration relative to the spread of Chinese medicine in the United States in practical, cognitive, and theoretical terms. This article could be a reference to practitioners, academics, and policymakers in the areas of integrative and Chinese medicine. [ABSTRACT FROM AUTHOR]

Background: Ambulatory training is an integral component of internal medicine residency programs, yet details regarding operational processes in resident continuity clinics remain limited. Methods: We surveyed a convenience sample of medical directors of residency practices between 2015 and 2019 (n = 222) to describe and share operational and scheduling processes in internal medicine resident continuity clinics in the US. Results: Among residency practices, support for the medical director role ranged substantially, but was most commonly reported at 11%-20% full-time-equivalent support. By the end of the survey period, the majority of programs (65.1%) reported obtaining patient-centered medical home (PCMH) certification (level 1-3). For new patient appointments, 34.9% of programs reported a 1-7 day wait and 25.8% reported an 8-14 day wait. Wait times for new appointments were generally shorter for PCMH certified practices (P = 0.029). No-show rates were most commonly 26%-50% for new patients and 11%-25% for established patients. Most programs reported that interns see 3-4 patients per ½-day and senior residents see 5-6 patients per ½-day. Most interns and residents maintain a panel size of 51-120 patients. Discussion: Creating high-performing residency clinics requires a focus on core building blocks and operational processes. Based on the survey results and consensus opinion, we provide five summary recommendations related to (1) support for the medical director leadership role, (2) patient-centered and coordinated models of care, (3) support for patient scheduling, (4) recommended visit lengths, and (5) ancillary support, such as social work. [ABSTRACT FROM AUTHOR]

Background Day-case thyroid surgery is practiced in some centers mainly in the United States. Potential life-threatening complications make surgeons apprehensive. Data published mainly from the American centers suggest that the approach is clearly feasible and the outcomes are encouraging. Patients and methods The study is a case series that was conducted on 75 participants who were indicated for thyroid surgery. Data were collected prospectively at Cairo University Hospitals from June 2018 to February 2019. Patients, fulfilling inclusion criteria, had their surgery and were discharged on the same day, only if the discharge criteria were met. Results Ten (13%) out of 75 patients fulfilling the discharge criteria refused to leave the hospital due to anxiety. Four patients were not eligible for the same-day discharge due to operative complications. 61 patients (81%) were patients were discharged safely and were contacted the next day for follow-up. Around 20% of those who were safely discharged on the day of surgery were not satisfied by the service. Conclusion With proper patient selection, day-case thyroidectomy is safe and applicable in the Egyptian health service. Awareness campaigns, supporting day-case surgery, are needed to increase public acceptance. [ABSTRACT FROM AUTHOR]

A calendar of events related to sexually transmitted diseases in the U.S. from October 2007 to March 2008 is presented which include 31st National Conference of Indian Association for the Study of Sexually Transmitted Diseases and AIDS, 15th International Union against Sexually Transmitted Infections (IUSTI) - Asia Pacific (AP) congress, and HIV Congress 2008.

The author reflects on the difficulty faced by medical professionals in the U.S. for adopting guidelines for blood transfusion practices in medical system that affects patient's health . Topics discussed includes resistance to modify current practices related to blood transfusion, hospitals themselves setting guidelines if a patient will receive transfusion and measurement of hemoglobin levels before transfusion. [ABSTRACT FROM AUTHOR]

Background: This study discerns surgeons' attitudes and practices in the determination of heart valve replacement for patients with infectious endocarditis (IE) due to intravenous drug use (IVDU). We aimed to identify the factors contributing to surgeons' decision-making process for initial and recurrent surgical heart valves and the availability of institutional guidance. Methods: An IRB-approved, anonymous mixed-methods, open survey instrument was designed and validated with 24 questions. A convenience sample of cardiothoracic surgeons in the United States and globally resulted in a total of 220 study participants with 176 completing every question on the survey. Results: A cluster analysis revealed that although surgeons can be divided into subgroups based on their previous experience with valve replacements, these groups are not perfectly homogenous, and the number of identified clusters is dependent on technique used. Analysis of variance revealed the variables that most clearly divided the surgeons into subgroups were, in order of importance, years of practice, number of valve replacements, and geography. Conclusions: Our analysis showed heterogeneity among cardiothoracic surgeons regarding how they make clinical decisions regarding re-operative valve replacement related to IE-IVDU. Therefore, an opportunity exists for interprofessional teams to develop comprehensive guidelines to decrease variability in surgical decision-making regarding valve replacement associated with IE-IVDU. [ABSTRACT FROM AUTHOR]

As the US health-care system continues on a path toward greater patient and provider dissatisfaction and decreasing access to primary health services, there is a growing need for leadership among tomorrow's health professionals. Students of today must acquire the skills to lead the United States toward solutions that will offer universal access and eliminate disparities. As examined in the US, there are two main modes for students to learn these meaningful skills; curriculum- and institution-based leadership development and organiz ation-based leadership development. In this paper we review these two methods from an American perspective and discuss ways that educational institutions can support student leadership development. In addition, we address ways in which non-governmental organiz ations can provide opportunities to foster student leadership. Lastly, we offer recommendations for US policy change at institutional, local, state, and national levels to help achieve the goals stated above. [ABSTRACT FROM AUTHOR]

Because much of health professions education in the US is publicly financed, the actions of politicians have profound effects on the organization of health professions education. The success of health professions education programs, therefore, depends in part on the ability of educators to advocate for change in the legislature. Successful legislative advocacy requires a general understanding of the legislative process and the needs of politicians combined with effective communications strategy. The tools of individual legislative advocacy include position papers, letter writing, politician meetings and visits, and using the media. Professional associations advocate on behalf of their members through coalitions, key contact programs, grassroots campaigns, and lobbyists. Successful legislative advocacy depends on credibility and the development of long-term relationships with members of the legislature. The process of legislative advocacy is straightforward and should be viewed as an integral part of health professions education. [ABSTRACT FROM AUTHOR]

There is growing interest and investment in health-related collaboration in the United States. In an environment characterized by increasingly complex health problems, substantial resource constraints, and a fragmented health system, public and private organiz ations as well as communities are recognizing that most objectives related to health and health care cannot be achieved by any single person or organiz ation working alone. Partnerships that bring together diverse people and organiz ations have the potential for developing new and creative ways of dealing with today's turbulent environment. Despite its potential advantages, collaboration also presents daunting challenges. Further, documenting the effectiveness of partnerships in improving health and well-being has been difficult. Given the significant difficulties of collaboration and the lack of evidence of its effectiveness, questioning whether the investment in health partnerships is justified seems reasonable. In this paper we address this question by illustrating the connective power of collaboration. We describe how collaboration, by connecting individual-level services, broadening community involvement in population-based health strategies, and linking individual-level services and population-based strategies, can improve the health of communities. We then discuss activities that could assist partnerships in reaching their collaborative potential and conclude by presenting the most compelling reasons for pursuing collaboration. [ABSTRACT FROM AUTHOR]

This study explores American patients' understanding of traditional Chinese medicine (TCM) in the late 19th century by referring to letters from American patients recorded in The Science of Oriental Medicine, written by Tan Fuyuan (谭富园), a Chinese medicine doctor working in the United States in the late Qing dynasty. Identifying a focus on significant effects, pulse diagnosis, herbal teas, dietary control, and long-term treatment, the results also discussed the differences between TCM and Western medicine in simple terms to show that the "ideological" spread of TCM was based on its curative effect. However, the "theoretical" spread of TCM requires more of intercultural exchanges. [ABSTRACT FROM AUTHOR]

American ginseng (Panax Quinquefolium L), also known as Xi Yang Shen (西洋参 Radix Panacis Quinquefolii), is indigenous to the United States and Canada. Its discovery in the 1700s paved the way for international trade, which boosted the economy of the New World and helped build commercial ties between the US and China. Due to its therapeutic effects, the demand for American ginseng grew steadily, eventually causing the volume of wild ginseng to dwindle. As a result, laws and regulations were introduced requiring farmers and exporters to engage in harvesting practices that would preserve wild American ginseng. Nowadays, wild American ginseng is considered an endangered and protected species. This article discusses the history, properties, and applications of American ginseng to optimize its use and protection. [ABSTRACT FROM AUTHOR]