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Equity, diversity, and inclusion (EDI) are essential for healthcare organizations since they allow for the development of programs and initiatives that bring together diverse perspectives and knowledge. Global multidisciplinary organizations, such as the Multinational Association for Supportive Care in Cancer (MASCC), need to understand the perspective of their members regarding EDI to identify opportunities to enhance diversity and inclusiveness and to better meet the needs of members from different backgrounds and resources. The MASCC Health Disparities Committee designed a survey to identify issues related to disparities faced by MASCC members when providing supportive care to patients with cancer and to examine the EDI landscape within the organization. Here, we report results related to EDI initiatives within the organization. Two-hundred and eighteen MASCC members responded to the survey (response rate 10.2%). The results indicated that respondents were generally satisfied with how MASCC manages leadership, membership, and organization-related EDI issues. Opportunities for improvement noted by respondents included developing strategies to foster a more diverse membership, improving communication regarding diversity in the organization, and increasing EDI content in educational sessions and publications. The results of this survey represent the first attempt at understanding how to improve EDI within MASCC and will be utilized to guide further initiatives and programs. [ABSTRACT FROM AUTHOR]

ABSTRACT Medical societies must maintain high standards of competence and quality when awarding specialist titles, defining the certification criteria, taking into account the needs and realities of the health system and medical practice.

Introduction. Linguistic expressions in a certain country, used in new or less developed sciences and professions, are commonly associated with difficulties due to the mother-tongue poverty. This also applies to the medical terminology. In modern Serbia, despite an eight-century-long hospital tradition, an institutional approach to the medical terminology was first established 180 years ago by the Society of Serbian Letters, founded in 1841, lasting until 1885. It was continued 30 years later by the Serbian Medical Society, founded in 1872. Society of Serbian Letters. The work of the Society of Serbian Letters on the Serbian language and terminology was very short, because Vuk Karadžić, among others, pointed out that the Society had to provide accurate and reliable terminology, which was not possible at the time. The work of Dr. Jovan Stejić and his translations of the books Macrobiotics and Anthropology are significant for medical terminology. Serbian Medical Society. Precisely set goals related to medical terminology and the preservation of the Serbian language in medicine were an integral part of the first Constitution of the Serbian Medical Society. However, during the continuous, 150-year- long work of the Society and the beginning of medical terminology standardization, for reasons still not explored, medical terminology has disappeared from its highest legal act, including the current Statute. Conclusion. Not even 180 years since the first short-term and 150 years since the long-term process of institutional approach to medical terminology was enough to develop and standardize medical terminology in modern Serbia. In order not to leave it to the arbitrariness of individuals, medical terminology must be a national strategy, such as, for example, the terminology of 33 professions in the Republic of Croatia called Croatian Professional Nomenclature [ABSTRACT FROM AUTHOR]

In response to increased focus on the issue of Assisted Dying (AD) in the UK due to the presentation of The Terminally Ill Adults (End of Life) Bill 2024-25 [1] and bills before parliaments in the Isle of Man, Guernsey and Scotland, the British Geriatric Society (BGS) recently developed a position statement opposing legalisation of AD in the UK [2]. We set out our key reasoning behind this position, namely the current adverse health and social care context and significant concern about whether effective safeguards can be created to protect older people with complex needs from undue harms. The BGS asks for improved, personalised, multidisciplinary care for older people at the end of their lives, including high-quality palliative and end-of-life care. It urges caution about legalisation and offers its expertise in any potential future shaping and implementation of AD legislation. This should include a conscience clause for professionals objecting to direct involvement. The main outcomes from a survey of member's opinions are also outlined [2]. The majority were against legalisation of AD; however, a significant minority were in favour, with some undecided. This diversity of opinion highlights a need for the Society to maintain balance and nuance on this difficult and emotive issue, warranting future BGS reviews if the relevant legislation changes., (© The Author(s) 2025. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

The Highlights Lecture, presented at the closing session of each SNMMI Annual Meeting, was originated and presented for more than 30 y by Henry N. Wagner, Jr., MD. Beginning in 2010, the duties of summarizing selected significant presentations at the meeting were divided annually among 4 distinguished nuclear and molecular medicine subject matter experts. The 2024 Highlights Lectures were delivered on June 11 at the SNMMI Annual Meeting in Toronto, Canada. Presented here is the lecture by Twyla Bartel, DO, MBA, from Global Advanced Imaging, PLLC (Little Rock, AR), who reviewed general clinical specialties topics from the meeting. Note that in the following presentation summary, numerals in brackets represent abstract numbers as published in The Journal of Nuclear Medicine (2024;65[suppl 2])., (© 2025 by the Society of Nuclear Medicine and Molecular Imaging.)

Professional medical societies are organizations consisting of health care professionals who share research, clinical, or social interests within a particular specialty or subspeciality of medicine. Professional societies offer members benefits including education, networking, research support, and opportunities for leadership and professional growth. These benefits can all contribute to improving a physician's proficiency in patient care, leadership, and academic pursuits. There is a paucity of information in the literature regarding strategies for successful professional society involvement and advancement. This study will provide a framework for successful professional society involvement for the early-career (<5 years in practice) orthopedic sports medicine surgeon., Competing Interests: Disclosure E.V. is on the editorial board of Arthroscopy; is a committee member of the Arthroscopy Association of North America, and performs unrelated consulting on shoulder arthroplasty for Exactech, outside the submitted work. T.S. is on the editorial board of Arthroscopy; is a committee member of the American Orthopaedic Society for Sports Medicine and American Academy of Orthopaedic Surgeons; performs unrelated consulting on shoulder arthroplasty for DJO Surgical; and is on the Social Media Board of the Arthroscopy Association of North America, outside the submitted work. C.D. has nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The 15th Annual Report from The Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support includes 29,634 continuous-flow left ventricular assist devices from the 10-year period between 2014 and 2024. The outcomes reported here demonstrate continued improved survival in the current era of fully magnetically levitated devices, with a significantly higher 1-year (85.7% vs 78.4%) and 5-year (59.7% vs 43.7%) survival than those receiving non-magnetically levitated devices. Magnetically levitated device recipients are experiencing a lower incidence of adverse events, including freedom from gastrointestinal bleeding (72.6%), device malfunction (82.9%), and stroke (86.7%) at 5 years. Additionally, a focus on a subgroup of patients younger than 50 years of age has demonstrated both superior outcomes in survival (91.6% survival at 1 year and 72.6% survival at 5 years) and decreased incidence of adverse events compared with older recipients. This younger cohort also demonstrated more tolerance to the characteristics of sex, race, ethnicity, and psychosocial indicators that are associated with worse outcomes after heart transplantation. Based upon these data, a potential net prolongation of life may be realized by considering prolonged left ventricular assist device support prior to heart transplantation in this population. These analyses provide preliminary data that could positively influence adoption of left ventricular assist device technology in groups previously not seen as candidates for this therapy, while providing a more responsible donor allocation strategy for advanced heart failure patients., Competing Interests: Disclosures Dan M. Meyer is on the clinical advisory board of PercAssist Corp. Aditi Nayak is on the clinical advisory board of PumpinHeart Limited, Ireland. Katherine L. Wood reports a relationship with Abbott that includes consulting or advisory. Sarah Schettle reports a relationship with the Medtronic Advisory Panel, and consulting with Abbott. James K. Kirklin discloses receiving partial salary support from the Society of Thoracic Surgeons (STS) as Director of the Data Center for STS Intermacs and being part owner and President of Kirklin Solutions, Inc., a University of Alabama at Birmingham (UAB) healthcare technology start-up company. Francis D. Pagani is a noncompensated ad-hoc scientific advisor for Abbott, Berlin Heals, FineHeart, and Medtronic, a non-compensated medical monitor for Abiomed, Scientific advisor for BrioHealth with travel compensation; and a member of the Data and Safety Monitoring Board (DSMB) for Carmat; and receives partial salary support from Blue Cross / Blue Shield of Michigan as Associate Director of the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative. Manreet K. Kanwar is on the Advisory Board for Abiomed, Abbott and CorWave, on CEC for BiVACOR, and a speaker for Abiomed. The other authors have no conflicts of interest to disclose., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Objective: To provide a set of living treatment recommendations that will give contemporary guidance on the management of patients with axial spondyloarthritis (axSpA) in Canada., Methods: The Spondyloarthritis Research Consortium of Canada (SPARCC), in conjunction with the Canadian Rheumatology Association, organized a treatment recommendations panel composed of rheumatologists, researchers, allied health professionals, and a patient advocate. A Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach was used, in which existing guidelines were adopted or adapted to a Canadian context. Recommendations were also placed in a health equity framework., Results: Fifty-six recommendations were made for patients with active axSpA, stable axSpA, active or stable axSpA, for comorbidities, and for assessment, screening, and imaging. Recommendations were also made for principles of management, disease monitoring, and ethical considerations., Conclusion: These living treatment recommendations will provide up-to-date guidance for the management of axSpA for Canadian practice. As part of the living model, they will be updated regularly as changes occur in the treatment landscape., (Copyright © 2024 by the Journal of Rheumatology.)

The National Cancer Database (NCDB) collects data from approximately 1,500 Commission on Cancer (CoC) facilities and represent 73.7% of newly diagnosed cancers nationwide. The American College of Surgeons Cancer Program developed it first annual report from the NCDB 2021 participant user file reporting new observations and recent trends of cancer diagnoses, patient demographics, and treatments as well as an in-depth report on treatment and outcomes in breast, pancreas, and colon cancers. Of the 1,328,131 cancers diagnosed in 2021 at 1,281 reporting CoC hospitals, one-fifth continue to be female breast cancer. In 2021, the NCDB's 5 most common adult cancers were breast, prostate, lung, colon, and melanoma and varied by patient sex. Use of neoadjuvant systemic therapy increased in recent years in pancreas, breast, and urinary bladder cancer, although a slight decrease in pancreas and breast cancer was observed in 2021. Breast cancer has high survival rates, especially in lower-stage disease and estrogen receptor-positive/human epidermal growth factor receptor 2-negative disease. There is increase in neoadjuvant systemic therapy use, especially in human epidermal growth factor receptor 2-positive disease and estrogen receptor-negative disease. Colon cancer presents most commonly as stage III or II with a primary in the cecum or ascending colon in 38.9%. The majority are microsatellite instability stable, Kirsten rat sarcoma viral oncogene homologue normal, and CEA positive. Survival is most dependent on stage but also associated with microsatellite instability stability, abnormal Kirsten rat sarcoma viral oncogene homologue, and positive CEA. Pancreatic cancer presents with stage IV disease in nearly half, although an increase in stage I disease is seen. The most common location is pancreatic head. Survival is relatively low and most dependent on stage., (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Review the subsequent impact of recommendations made by the 2004 American Surgical Association Blue Ribbon Committee (BRC I) Report on Surgical Education., Background: Current leaders of the American College of Surgeons and the American Surgical Association convened an expert panel to review the impact of the BRC I report and make recommendations for future improvements in surgical education., Methods: BRC I members reviewed the 2004 recommendations in light of the current status of surgical education., Results: Some of the recommendations of BRC I have gained traction and have been implemented. There is a well-organized national curriculum and numerous educational offerings. There has been greater emphasis on preparing faculty to teach, and there are ample opportunities for professional advancement as an educator. The number of residents has grown, although not at a pace to meet the country's needs either by total number or geographic distribution. The number of women in the profession has increased. There is greater awareness and attention to resident (and faculty) well-being. The anticipated radical change in the educational scheme has not been adopted. Training in surgical research still depends on the resources and interests of individual programs. Financing student and graduate medical education remains a challenge., Conclusions: The medical landscape has changed considerably since BRC I published its findings in 2005. A contemporary assessment of surgical education and training is needed to meet the future needs of the profession and our patients., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction and Objectives: The development of specific heart failure (HF) units has improved the management of patients with this disease due to improved organization and resource management. The Spanish Society of Cardiology (SEC) has defined 3 types of HF units (community, specialized, and advanced) based on their complexity and service portfolio. Our aim was to compare the characteristics, treatment, and outcomes of patients with HF according to the type of unit., Methods: We analyzed data from the SEC-Excelente-IC quality accreditation program registry, with 1716 patients consecutively included in two 1-month cutoffs (March and October) from 2019 to 2021 by 45 SEC-accredited HF units. We compared the characteristics, treatment and 1-year outcomes between the 3 types of units., Results: Of the 1716 patients, 13.2% were treated in community units, 65.9% in specialized units, and 20.9% in advanced units. The rates of mortality (27.5 vs 15.5/100 patients-year; P<.001), admissions for HF (39.7 vs 29.2/100 patients-year; P=.019), total decompensations (56.1 vs 40.5/100 patients-year; P=.003), and combined death/admission for HF (45.2 vs 31.4/100 patients-year; P=.005) were higher in community units than in specialized/advanced units. Follow-up in a community unit was an independent predictor of higher mortality and admissions at 1 year., Conclusions: Compared with follow-up by more specialized units, follow-up in a community unit was associated with a higher decompensation rate and increased 1-year mortality., (Copyright © 2024 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Physician involvement in political advocacy has become increasingly important in recent years. This study aims to explore the types of involvement and barriers to involvement in political advocacy among American Shoulder and Elbow Surgeons (ASES) members, identify issues considered most important by ASES members, and assess demographic factors that might correlate with involvement in political advocacy efforts among ASES members., Methods: This survey was conducted by the ASES Political Advocacy Committee over a 2-week period in June 2021. The survey collected demographic information including sex, ethnicity, years in practice, practice type, political affiliation, and level of current involvement in political advocacy. Additional questions consisted of thoughts regarding current health care policy issues and the role of the American Academy of Orthopaedic Surgeons/ASES regarding such policy issues., Results: We received 297 responses for a total response rate of 27%. Of those who responded, 24.6% identified as Democrat, 33% identified as Republican, and 42.4% identified as Independent. There was no difference in political affiliation between membership groups. Physician Reimbursement (82%), Medical Liability Reform (50%), and Physician Ownership (50%) were the most important issues identified among respondents. Physician Ownership, Physician Reimbursement and Graduate Medical Education and Student Loan Reform were most important to those in early practice, while Quality and Research was most important to those with greater than 25 years of practice experience., Conclusion: There is strong agreement among surgeons regarding the most important political advocacy issues. The efforts of the American Academy of Orthopaedic Surgeons and ASES should focus on these areas. Additionally, the vast majority of respondents felt that advocacy efforts had a positive impact on patients and surgeons., (Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Objective: The American Medical Informatics Association (AMIA) Task Force on Diversity, Equity, and Inclusion (DEI) was established to address systemic racism and health disparities in biomedical and health informatics, aligning with AMIA's mission to transform healthcare. AMIA's DEI initiatives were spurred by member voices responding to police brutality and COVID-19's impact on Black/African American communities., Materials and Methods: The Task Force, consisting of 20 members across 3 groups aligned with AMIA's 2020-2025 Strategic Plan, met biweekly to develop DEI recommendations with the help of 16 additional volunteers. These recommendations were reviewed, prioritized, and presented to the AMIA Board of Directors for approval., Results: In 9 months, the Task Force (1) created a logic model to support workforce diversity and raise AMIA's DEI awareness, (2) conducted an environmental scan of other associations' DEI activities, (3) developed a DEI framework for AMIA meetings, (4) gathered member feedback, (5) cultivated DEI educational resources, (6) created a Board nominations and diversity session, (7) reviewed the Board's Strategic Planning for DEI alignment, (8) led a program to increase diversity at the 2020 AMIA Virtual Annual Symposium, and (9) standardized socially-assigned race and ethnicity data collection., Discussion: The Task Force proposed actionable recommendations that focused on AMIA's role in addressing systemic racism and health equity, helping the organization understand its member diversity., Conclusion: This work supported marginalized groups, broadened the research agenda, and positioned AMIA as a DEI leader while reinforcing the need for ongoing transformation within informatics., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association.)

To establish a consensus on the definition and management of idiopathic gastroparesis, international experts (selected by neurogastroenterology and motility societies and initiated by the Rome Foundation) devised 144 statements using the Delphi method, with at least 80% agreement required. This consensus defined idiopathic gastroparesis as the presence of symptoms associated with delayed gastric emptying in the absence of mechanical obstruction. Nausea and vomiting were identified as cardinal symptoms. Frequently co-existing symptoms are early satiation and postprandial fullness. Diagnosis requires the presence of these symptoms alongside delayed gastric emptying, measured by a 4 h scintigraphy or gastric emptying breath test of a mixed composition meal in the absence of mechanical obstruction. Therapeutic options with proven efficacy were sparse. Dietary adjustments, nutritional support (per guidelines from the European Society for Clinical Nutrition and Metabolism for substantial weight loss or intractable vomiting), and opioid cessation were recommended by a consensus opinion. Antiemetic and prokinetic agents were also considered potentially beneficial. This consensus offers a global perspective on idiopathic gastroparesis., Competing Interests: Declaration of interests JT has given scientific advice to Aclipse, Adare, AlfaSigma, Bayer, Clasado, Danone, Falk, FitForMe, Ironwood, Kyowa Kirin, Menarini, Promed, Ricordati, Takeda, Truvion, Tsumura, and Zeria Pharmaceuticals; has received financial research support from Biohit, Kiowa Kirin, ProMed, Sofar, and Takeda; and has served on the speaker bureau for Abbott, Bio-Codex, Mayoly, Menarini, ProMed, Schwabe, Takeda, and Truvion Pharmaceuticals. BEL is on scientific advisory boards for Ironwood, Salix, Takeda, and Sanofi. VS is a consultant or speaker for AlfaSigma, Bayer, Coloplast, and Metagenics. HM has received speaking fees from Takeda, Viatris, EA Pharma, and Astra. GG has served as a consultant or speaker for Laborie, Medtronic, Kyowa Kirin, Lilly, and Enterra Medical. GO’G is a director and shareholder of Insides Company and Alimetry and holds patents and other intellectual property in the fields of gastrointestinal electrophysiology and neuromodulation (US11712566B2; US20230083795A1). BM has participated in the advisory board and received grant support from Atmo, and grant support from Takeda, Medtronic, and the Gastroparesis Consortium (NIDDK NIH UO1 grant). LN is a consultant for Enterra Medical, Ardelyx, Phathom, Evoke, and Takeda. All other authors have no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Food security exists when all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their dietary needs for an active and healthy life. While there is a lengthy body of literature examining food insecurity among children, food insecurity among adolescents and young adults (AYAs) has been relatively understudied. The literature demonstrates that AYAs experiencing food insecurity have poorer physical, mental, and psychosocial health outcomes than their peers, which may persist into adulthood. As AYAs reach reproductive maturity, those experiencing food insecurity are more likely to have children who are also poorly nourished, perpetuating intergenerational poor nutrition and its associated health and socioeconomic costs. In this position paper, Society for Adolescent Health and Medicine (SAHM) recommends actions that healthcare professionals can take to achieve a goal of universal food security among AYAs. As SAHM strives to promote the optimal health of AYAs around the world, the positions in this paper affirm SAHM's commitment to promoting food security for all AYAs., (Copyright © 2024 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: The American Neurogastroenterology and Motility Society Gastroparesis Cardinal Symptom Index-Daily Diary (ANMS GCSI-DD) is a patient-reported outcome (PRO) instrument for gastroparesis. This study evaluated the psychometric properties of the ANMS GCSI-DD and determined a meaningful change threshold using the data from a phase 2b trial in adults with moderate-to-severe idiopathic or diabetic gastroparesis (DG)., Methods: The psychometric properties of ANMS GCSI-DD were analyzed using other clinician- and patient-reported outcomes from 242 patients during the 12-week trial. Trial exit interviews were conducted in a cohort of 32 patients to capture their perspectives on meaningful change from the trial., Results: ANMS GCSI-DD demonstrated good performance: unidimensionality scores exhibited good fit; internal consistency reliability was >0.70; test-retest reliability was above 0.90, and convergent validity showed strong correlations (0.70-0.90) with overall severity rating and moderate correlations (0.30-0.70) with other outcomes. ANMS GCSI-DD scores discriminated among groups with varying severity of gastroparesis symptoms in known-groups validity (p < 0.001) and were responsive to symptom improvement. Triangulation of the quantitative anchor-based estimates of 0.9-1.4 category points as a meaningful change in the ANMS GCSI-DD composite score, and the qualitative exit interview findings of 0.5-1.5 as meaningful change, supports a one-point change on a five-point scale (0-4) as the meaningful change threshold., Conclusion: The ANMS GCSI-DD is a reliable and valid PRO instrument to employ in clinical development for patients with moderate-to-severe idiopathic or DG, and a one-point score change in the ANMS GCSI-DD composite score is recommended as a meaningful change threshold of symptom change., (© 2024 John Wiley & Sons Ltd.)

Background: The Society of Thoracic Surgeons Adult Cardiac Surgery Database (STS ACSD) was expanded in 2017 to include more granular detail on thoracic aortic surgeries. We describe the first validated risk model in thoracic aortic surgery from the STS ACSD., Methods: The study population consisted of patients undergoing nonemergent isolated ascending aortic aneurysm repair by open or clamped distal anastomoses, including those requiring aortic root or valve replacement. Model outcomes included operative mortality, 30-day major morbidity (cardiac reoperation, deep sternal wound infection, stroke, prolonged ventilation, renal failure), and a composite of both. To select the predictors, univariate associations and clinical face validity of models were examined. Models were evaluated by their ability to distinguish between patients with and without specific outcomes (discrimination) and their predictive accuracy (calibration)., Results: Between 2017 and 2021, 24,051 eligible patients underwent ascending aortic aneurysm surgery at 905 hospitals. Procedures included 8913 aortic root replacements, 2135 valve-sparing root replacements, 7545 ascending aortic replacements with aortic valve replacement, and 5458 ascending aortic replacements. Circulatory arrest was performed in 7316 (30.4%) cases. Operative mortality was 1.9%, and 12.2% of patients experienced major morbidity including 2.4% incidence of stroke. The adjusted C statistics for the model were 0.74, 0.67, and 0.67 for mortality, morbidity, and the composite, respectively. Previous stroke and circulatory arrest were associated with new stroke. Genetic aortopathy was associated with less mortality., Conclusions: A new STS ACSD risk model to predict mortality and morbidity after ascending aneurysm surgery has been developed, and predictors of better and worse outcomes have been identified., Competing Interests: Disclosures Nimesh Desai reports a relationship with W. L. Gore & Associates Inc that includes: consulting or advisory; with Terumo Medical Corp that includes: consulting or advisory; with Artivion, Inc that includes: consulting or advisory; with Edwards Lifesciences Corporation that includes: consulting or advisory; and with Baxter International Inc that includes: consulting or advisory. Hiroo Takayama reports a relationship with Edwards Lifesciences which includes consulting and advisory and W.L. Gore which includes consulting and advisory. Eric Roselli reports a relationship with Artivion, Inc that includes: consulting or advisory and a licensing agreement; with Cook Medical Inc that includes: consulting or advisory; with Edwards Lifesciences Corporation that includes: consulting or advisory; with W. L. Gore & Associates Inc that includes: consulting or advisory; with Medtronic that includes: consulting or advisory; with JenaValve Technology Inc that includes: speaking and lecture fees; with LifeNet Inc that includes: speaking and lecture fees; and with Terumo Aortic that includes: speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Study Design: Retrospective registry analysis., Objective: To examine predictions of individual Scoliosis Research Society-22r (SRS-22r) questions one year after surgery for adolescent idiopathic scoliosis (AIS)., Summary of Background Data: A precision-medicine approach to AIS surgery will inform patients of the likelihood of achieving particular results from surgery, specifically individual responses to the SRS-22r questionnaire., Methods: A multicenter AIS registry was queried for surgical AIS patients treated between 2002 and 2020. Preoperative data collected included standard demographic data, deformity descriptive data, and SRS-22r scores. Postoperative one-year SRS-22r scores were modeled using ordinal logistic regression. The highest probability was the most likely response. Model performance was examined by c-statistics, where c >0.8 was considered excellent. Ceiling effects were measured by the proportion of patients reporting "5" to each question., Results: A total of 3251 patients contributed data to the study; mean age 14.4 (±2.2) years, female 2631 (81%), major thoracic coronal curve 53°, mean lumbar 41°. C-statistic values ranged from 0.6 (poor) to 0.8 (excellent), evidence of varied predictive capabilities. Q17 ("days off work/school," c = 0.84, ceiling achieved 75%) and Q15 ("financial difficulties," c = 0.86, ceiling achieved 82%) had the greatest predictive capabilities while Q11 ("pain medication," c=0.73, ceiling achieved 67%), Q10 ("appearance," c=0.72, ceiling achieved 35%), and Q19 ("attractive," c=0.69, ceiling achieved 37%) performed poorly., Conclusions: Prediction of individual SRS-22r item responses, perhaps most germane to AIS treatment, was poor. The prediction of less relevant outcomes, where ceiling effects are present, was greater as the models chose "5" for all responses. These ceiling effects may limit discrimination and hamper efforts at personalized outcome predictions., Level of Evidence: Level 3., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The knowledge of pericardial diseases has now improved, including prospective and retrospective cohort studies focusing on the pathogenesis, diagnosis, treatment, and outcomes. The complex interplay between genetic predisposition (especially for autoinflammatory conditions), inflammation, and autoimmunity is now known to trigger recurrences of pericarditis. Moreover, diagnostic capabilities have improved with the implementation of multimodality imaging, particularly cardiac magnetic resonance (CMR), to detect and monitor pericardial inflammation, to allow diagnosis in more complicated cases, and tailor the duration of therapy based on objective parameters. A new class of drugs, the anti-IL-1 agents, have been introduced for patients with an inflammatory phenotype of presentation, and not responding to conventional anti-inflammatory therapies, including NSAID, colchicine, and corticosteroids. At present, the clinical management of pericardial diseases is definitely on the road of evidence-based medicine with new ongoing European guidelines focusing on the spectrum of inflammatory myocardial and pericardial syndromes., (Copyright © 2024 Italian Federation of Cardiology - I.F.C. All rights reserved.)

Purpose: To evaluate the representation of women as speakers at U.S. radiology annual scientific meetings (ASM)., Methods: This retrospective study analyzed speaker demographic data from the Society of Interventional Radiology (SIR) and American Roentgen Ray Society (ARRS) ASM between 2019 and 2022. Speaker gender was identified through publicly available profiles, and the percentage of female speakers was calculated for each year. Statistical significance of trends was determined using chi-squared tests, and linear regression analysis was employed to assess trends and to predict future representation., Results: At the SIR ASM, female representation increased from 20.0 % (67 of 334 speakers) in 2019 to 26.5 % (90 of 340 speakers) in 2022. Chi-squared tests showed a statistically significant increase when adjusted for the percentage of female membership. At the ARRS ASM, female representation fluctuated, dropping from 36.6 % (104 of 284 speakers) in 2019 to 17.7 % (43 of 243 speakers) in 2020, then rising to 48.5 % (190 of 392 speakers) in 2022. A chi-squared test revealed significant variation in female representation across the years (p < 0.0001)., Conclusion: While both ASM showed an overall positive trend in female speaker representation, SIR demonstrated consistent increases, whereas ARRS exhibited significant fluctuations. Continued efforts in advocacy and targeted interventions are needed to sustain progress and address the gender gap in radiology., (Copyright © 2024. Published by Elsevier Inc.)

Objectives: The revised European Society of Musculoskeletal Radiology (ESSR) consensus guidelines on soft tissue tumor imaging represent an update of 2015 after technical advancements, further insights into specific entities, and revised World Health Organization (2020) and AJCC (2017) classifications. This second of three papers covers algorithms once histology is confirmed: (1) standardized whole-body staging, (2) special algorithms for non-malignant entities, and (3) multiplicity, genetic tumor syndromes, and pitfalls., Materials and Methods: A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries. Statements that had undergone interdisciplinary revision were scored online by the level of agreement (0 to 10) during two iterative rounds, that could result in 'group consensus', 'group agreement', or 'lack of agreement'., Results: The three sections contain 24 statements with comments. Group consensus was reached in 95.8% and group agreement in 4.2%. For whole-body staging, pulmonary MDCT should be performed in all high-grade sarcomas. Whole-body MRI is preferred for staging bone metastasis, with [ 18 F]FDG-PET/CT as an alternative modality in PET-avid tumors. Patients with alveolar soft part sarcoma, clear cell sarcoma, and angiosarcoma should be screened for brain metastases. Special algorithms are recommended for entities such as rhabdomyosarcoma, extraskeletal Ewing sarcoma, myxoid liposarcoma, and neurofibromatosis type 1 associated malignant peripheral nerve sheath tumors. Satisfaction of search should be avoided in potential multiplicity., Conclusion: Standardized whole-body staging includes pulmonary MDCT in all high-grade sarcomas; entity-dependent modifications and specific algorithms are recommended for sarcomas and non-malignant soft tissue tumors., Clinical Relevance Statement: These updated ESSR soft tissue tumor imaging guidelines aim to provide support in decision-making, helping to avoid common pitfalls, by providing general and entity-specific algorithms, techniques, and reporting recommendations for whole-body staging in sarcoma and non-malignant soft tissue tumors., Key Points: An early, accurate, diagnosis is crucial for the prognosis of patients with soft tissue tumors. These updated guidelines provide best practice expert consensus for standardized imaging algorithms, techniques, and reporting. Standardization can improve the comparability examinations and provide databases for large data analysis., Competing Interests: Compliance with ethical standards. Guarantor: The scientific guarantor of this publication is Univ.-Prof. Priv.-Doz. Dr. I.M.N.H. Conflict of interest: A.B. is a member of the European Radiology Editorial Board. He has not taken part in the review or selection process of this article. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry: No complex statistical methods were necessary for this paper. Informed consent: Written informed consent was not required for this study because patients were not involved. Ethical approval: Institutional Review Board approval was not required because patients were not involved. Study subjects or cohorts overlap: Study subjects or cohorts have not been previously reported. Methodology: Expert consensus is performed by a Delphi process Perspective: not applicable Study design: not applicable Location: multicentre study, (© 2024. The Author(s).)

The Society for Adolescent Health and Medicine and the International Association for Adolescent Health recognize that climate change impacts multiple dimensions of health and well-being for adolescents and young adults. According to the World Health Organization, climate change is one of the top 10 health threats facing humanity. No aspect of adolescent health is spared from the consequences of climate change: food and housing insecurity, heat-related morbidity and mortality, water-borne diseases, infectious diseases, including sexually transmitted infections and HIV, mental health disorders, gender-based violence, conflict, internal displacement, and migration are all impacted. Vulnerable populations, such as adolescents and young adults, and those living in lower- to middle-income countries and environmental justice communities, are the ones whose health will be most affected. The Society for Adolescent Health and Medicine and the International Association for Adolescent Health call for urgent action in alignment with the United Nations Sustainable Development Goals and the Convention on the Rights of the Child to avert the irreversible consequences of climate change. Health professionals and health-care organizations can and should help lead global climate action along with youth, supporting mitigation and adaptation strategies that protect young people. Adolescent health professionals and organizations must advocate for climate justice and equitable resources, urge health systems to mitigate their adverse impacts on the environment, advocate for health organizations to focus on green investments, be leaders in climate education of the next generation of adolescent health professionals, and focus research on equitable strategies to reduce climate harms., (Copyright © 2024 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

A recent American College of Obstetricians and Gynecologists Clinical Practice Update continues to recommend targeted (as opposed to universal) screening for pregestational diabetes, no longer recommends screening for early gestational diabetes mellitus (GDM), and provides updated guidelines for immediate postpartum testing for diabetes in patients with GDM. Here, we present data that the targeted screening paradigm, which has repeatedly been shown to fail in practice because of its complexity, no longer makes sense in the context of the high and rising prevalence of diabetes and diabetic risk factors, and we argue that the time has come for universal early pregnancy screening for pregestational diabetes. Furthermore, the recommendation against early screening for GDM is based on 2021 U.S. Preventive Services Task Force guidance, which in turn is based almost entirely on a single underpowered study that excluded individuals at highest risk and does not account for more recent research showing benefits of early diagnosis and treatment. Universal early pregnancy screening for pregestational diabetes may also help to identify patients at risk who will benefit from early GDM diagnosis and treatment and may provide rationale for prioritizing postpartum diabetes testing., Competing Interests: Financial Disclosure The authors did not report any potential conflicts of interest., (Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

The Society of Radiologists in Ultrasound convened a multisociety panel to develop a first-trimester US lexicon based on scientific evidence, societal guidelines, and expert consensus that would be appropriate for imagers, clinicians, and patients. Through a modified Delphi process with consensus of at least 80%, agreement was reached for preferred terms, synonyms, and terms to avoid. An intrauterine pregnancy (IUP) is defined as a pregnancy implanted in a normal location within the uterus. In contrast, an ectopic pregnancy (EP) is any pregnancy implanted in an abnormal location, whether extrauterine or intrauterine, thus categorizing cesarean scar implantations as EPs. The term pregnancy of unknown location is used in the setting of a pregnant patient without evidence of a definite or probable IUP or EP at transvaginal US. Since cardiac development is a gradual process and cardiac chambers are not fully formed in the first trimester, the term cardiac activity is recommended in lieu of 'heart motion' or 'heartbeat.' The terms 'living' and 'viable' should also be avoided in the first trimester. 'Pregnancy failure' is replaced by early pregnancy loss (EPL). When paired with various modifiers, EPL is used to describe a pregnancy in the first trimester that may or will not progress, is in the process of expulsion, or has either incompletely or completely passed., Competing Interests: Disclosures of conflicts of interest S.K.R. Book royalties from Elsevier. M.M.H. Payment for lectures, travel, or visiting professorship from Massachusetts General Hospital/Brigham Women’s Hospital, University of Toronto, McMaster University, World Class CME, and Hoag Medical Group; section editor for RadioGraphics. P.M.D. No relevant relationships. M.C.F. Payment for panel discussion from GE HealthCare. A. Kennedy Royalties and writer’s fees from Elsevier; honoraria from World Class CME and University of California Davis; support for travel from the RSNA; secretary of the Society of Radiologists in Ultrasound. R.A. No relevant relationships. K.B. Patents planned, issued, or pending with Kristyn Brandi MD MPH LLC. L.D. No relevant relationships. S.K.H. Grants from the National Center for Advancing Translational Sciences at the National Institutes of Health; payment for presentations from Organon; payment for expert testimony from Huff Powell Bailey; support for attending meeting from the American College of Obstetricians and Gynecologists (ACOG); section secretary of the Pennsylvania ACOG. A. Kamaya Book royalties from Elsevier. A. Koyama No relevant relationships. P.C.L. Honoraria for editor role from RoshReview (now Blueprint); support to attend meeting from Individuals with Intellectual or Development Disability Engaged, Aligned and Leading project workgroup funded by the Patient-Centered Outcomes Research Institute; secretary-treasurer of the New York Chapter of the American College of Emergency Physicians and past chair of the American College of Emergency Physicians Emergency Ultrasound Section. K.E.M. No relevant relationships. T.M. Book royalties from Elsevier. S.G.O. No relevant relationships. K.O. No relevant relationships. R.S. Honoraria and support for travel to meetings from World Class CME. S.S. Grants from the National Institutes of Health, AbbVie, and Organon. L.M.S. No relevant relationships., (Copyright © 2024 Elsevier Inc., RSNA. Published by Elsevier Inc. All rights reserved.)

Hypertension is responsible for more than two million deaths due to cardiovascular disease annually in Latin America (LATAM), of which one million occurs before 70 years of age. Hypertension is the main risk factor for cardiovascular morbidity and mortality, affecting between 20 and 40% of LATAM adults. Since the publication of the 2017 LASH hypertension guidelines, reports from different LATAM countries have confirmed the burden of hypertension on cardiovascular disease events and mortality in the region. Many studies in the region have reported and emphasized the dramatically insufficient blood pressure control. The extremely low rates of awareness, treatment, and control of hypertension, particularly in patients with metabolic disorders, is a recognized severe problem in LATAM. Earlier implementation of antihypertensive interventions and management of all cardiovascular risk factors is the recognized best strategy to improve the natural history of cardiovascular disease in LATAM. The 2024 LASH guidelines have been developed by a large group of experts from internal medicine, cardiology, nephrology, endocrinology, general medicine, geriatrics, pharmacology, and epidemiology of different countries of LATAM and Europe. A careful search for novel studies on hypertension and related diseases in LATAM, together with the new evidence that emerged since the 2017 LASH guidelines, support all statements and recommendations. This update aims to provide clear, concise, accessible, and useful recommendations for health professionals to improve awareness, treatment, and control of hypertension and associated cardiovascular risk factors in the region., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Orthopedic advocacy is an indispensable tool for surgeons to help shape health care policies and address the mounting challenges they face in providing quality care to patients and maintaining a sustainable practice. Health care advocacy embodies a commitment to fair health care access and provider autonomy, employs diverse strategies to amplify patient and doctor voices, and advances public health imperatives. Orthopedic advocacy confronts a myriad of legislative challenges specific to the orthopedic specialty, from reimbursement complexities to regulatory burdens. This necessitates strategic alliances and grassroots engagement to effectuate meaningful change. By fostering public awareness and legislative engagement, individual surgeons can drive transformative reforms, ensuring orthopedic practice aligns with patient needs and advances health care impartiality. The American Academy of Orthopaedic Surgeons advocacy program along with its subspecialty affiliates, such as the American Shoulder and Elbow Surgeons political advocacy committee, have a structured approach to advocacy comprising government relations, grassroots mobilization, and educational initiatives. This review explores the basis of health care advocacy including the structure of the American Academy of Orthopaedic Surgeons advocacy program. In addition to highlighting key legislative issues facing front-line orthopedic surgeons, this manuscript provides some provisional insights on how individual surgeons can engage in orthopedic advocacy to drive positive change., (Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Japanese patients with polycystic ovary syndrome (PCOS) exhibit distinct body type characteristics, such that the rate of overweight/obese women is remarkably low. In addition, hyperandrogenism is relatively rare among Japanese PCOS patients. Therefore, these factors are considered in PCOS diagnostic criteria used in Japan. Diagnostic criteria for PCOS were recently revised by the Japan Society of Obstetrics and Gynecology based on a nationwide survey of PCOS and released on December 5, 2023 (JSOG2024). JSOG2024 criteria diagnosed PCOS according to the following three items: (1) irregular menstrual cycle/chronic anovulation, (2) polycystic ovarian morphology or elevated serum anti-Müllerian hormone (AMH) level, and (3) hyperandrogenism or high luteinizing hormone. The presence of all three items is required to diagnose PCOS, after excluding other diseases with symptoms similar to PCOS. We also established AMH cut-off values by age and a system for evaluating ovarian findings useful for both the JSOG2024 and Rotterdam criteria. We anticipate that the JSOG2024 criteria with cut-off values will enhance the treatment of Japanese patients with PCOS and those of other ethnicities with low obesity and hirsutism., (© 2024 Japan Society of Obstetrics and Gynecology.)

Background: The scientific debate concerning clinical, translational and surgical aspects of iNPH could still be limited in respect to the incidence of this condition. The aim of this paper is to systematically assess the extent of the debate on INPH in the context of the congresses of the relevant medical and scientific societies in our Country., Methods: We thoroughly examined the websites and scientific programs of 12 leading scientific societies linked to medical specialities involved in diagnosis and management of INPH, among which the neurological, neurosurgical, neurophysiological, rehabilitation medicine and urologic societies. The amount of time (in hours) was examined in a time span of events which took place between 2019 and 2023., Results: Notably, across 4 years (2019-2023), a total of 7 out of 12 (58.3%) of the aforementioned leading scientific societies dedicated a total of zero minutes to the topic "iNPH", two further societies hosted talks for a total of less than one hours concerning such condition. The amount of time dedicated to giant intracranial aneurysms and vestibular schwannomas was in respect to the incidence of the conditions, significantly longer than the time spent debating on iNPH., Conclusions: The results demonstrates that in our country, despite the high and increasing incidence of INPH, the awareness raised on the topic could still be limited, especially compared to other, significantly rarer intracranial conditions such as giant intracranial aneurysms and vestibular schwannomas., (Copyright © 2024 Sociedad Española de Neurocirugía. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: This report evaluates rheumatologists' stated adherence to and agreement with the 2020 American College of Rheumatology (ACR) Guideline for the Management of Gout., Methods: A 57-item questionnaire was administered to a sample of US rheumatologists. Stated adherence scores were based on several guideline recommendations reported to be followed by rheumatologists in practice, whereas stated agreement scores were based on whether respondents always followed the recommendations., Results: All 201 rheumatologists approached completed the questionnaire. The mean overall stated adherence score was 11.5 (maximum 15), whereas the mean overall stated agreement score was 7.7 (maximum 14). Less experienced rheumatologists (≤ 8 yrs; n = 49) were likely to claim adherence to more individual ACR recommendations than those with more experience (> 8 yrs; n = 152; mean stated adherence score: 12.3 vs 11.3; P ≤ 0.05). Rheumatologists who claimed to see ≤ 75 patients with gout in 6 months (n = 66) had a mean stated adherence score of 12.1 vs 11.2 for those who claimed to have seen > 75 patients ( P ≤ 0.05). Approximately 78% of rheumatologists claimed to follow the guideline for initiating urate-lowering therapy (ULT), and 89% were likely to prescribe allopurinol as a first-line ULT. Claimed adherence to recommendations for dosing was lower (febuxostat: 43%; allopurinol: 39%). Rheumatologists from academic settings were more likely to prescribe an interleukin-1 inhibitor for gout flares., Conclusion: The self-reported practice of the surveyed US rheumatologists was generally concordant with the 2020 ACR Guideline for the Management of Gout. However, there were gaps in guideline knowledge and stated adherence among rheumatologists, mainly concerning the dosing of treatment regimens., (Copyright © 2024 by the Journal of Rheumatology.)

Aim: To provide information including the trend of gynecological malignancies in Japan, we hereby present the Annual Patient Report for 2021 and the Annual Treatment Report for 2016, on the outcomes of patients who started treatment in 2016., Methods: The Japan Society of Obstetrics and Gynecology maintains an annual tumor registry, where information on gynecological malignancies from various participating institutions is gathered. The data of patients whose treatment with gynecologic malignancies was initiated in 2021 were analyzed retrospectively. Survival of the patients who started treatment with cervical, endometrial, and ovarian cancer in 2016 was analyzed by using the Kaplan-Meier, log-rank, and Wilcoxson tests., Results: Treatment was initiated in 2021 for 8006 patients with cervical cancer, 13 912 with endometrial cancer, 8337 with ovarian, tubal, and peritoneal cancer, 2375 with ovarian borderline tumors, and with the others (226 vulvar cancer, 161 vaginal cancer, 437 uterine sarcoma, 47 uterine adenosarcoma, 160 trophoblastic diseases). This clinicopathological information was summarized as the Patient Annual Report. The 5-year survival rates of the patients with cervical cancer were 92.3%, 77.0%, 56.1%, and 30.3% for stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with endometrial cancer were 94.1%, 88.8%, 71.2%, and 24.5% for stages I, II, III, and IV, respectively. The 5-year survival rates for the patients with ovarian cancer (surface epithelial-stromal tumors) were 91.3%, 78.8%, 54.3%, and 36.8% for stages I, II, III, and IV, respectively., Conclusion: The annual tumor report is an important survey that provides knowledge on gynecological malignancy trends in Japan., (© 2024 Japan Society of Obstetrics and Gynecology.)

Background and Aims: Training in interventional endoscopy is offered by nonaccredited advanced endoscopy fellowship programs (AEFPs). The number of these programs has increased dramatically with a concurrent increase in the breadth and complexity of interventional endoscopy procedures. Accreditation is governed by competency-based education, yet what constitutes a "high-quality" nonaccredited AEFP has not been defined. Using an evidence-based consensus process, we aimed to establish standards for AEFPs., Methods: The RAND UCLA appropriateness method, a well-described modified Delphi process to develop quality indicators, was used. A task force established by the American Society for Gastrointestinal Endoscopy drafted potential quality indicators (structure, process, and outcome) in 6 categories: activity preceding training; structure of AEFPs; training in ERCP, EUS, and EMR; and luminal stent placement. Three rounds of iterative feedback from 20 experts were conducted. Round 0 involved discussion of project details. In round 1, experts independently ranked proposed quality indicators on a 9-point interval scale ranging from highly inappropriate (1) to highly appropriate (9). Next, proposed quality indicators were discussed and reworded in a group meeting followed by round 2, in which experts independently reranked proposed quality indicators and provided benchmarks (when applicable). The median score for each quality indicator was calculated. Mean absolute deviation from the median was calculated, and appropriateness of potential quality indicators was assessed using the BIOMED concerted action on appropriateness definition, P value method, and interpercentile range adjusted for symmetry definition. A quality indicator was deemed appropriate if the median score was ≥7 and met criteria for appropriateness using all 3 defined statistical methods., Results: Of 89 proposed quality indicators, 37 statements met criteria as appropriate for a quality indicator (activity preceding training, 2; structure of AEFPs, 10; training in ERCP, 7; training in EUS, 8; training in EMR, 7; luminal stent placement, 3). Minimum thresholds were defined for 19 relevant quality indicators for number of trainers, procedures during fellowship, and procedures before assessment of competence. Among the final appropriate quality indicators were that all trainees should undergo qualitative and quantitative competence assessments using validated tools at least quarterly with documented feedback throughout the training period and that trainees should track outcomes and relevant quality metrics for specific procedures., Conclusions: This consensus process using validated methodology established standards for an AEFP in an effort to ensure adequate training in the most commonly taught interventional endoscopic procedures (ERCP, EUS, EMR, and luminal stent placement) during fellowship. An important component of an AEFP is the use of competency-based assessments that are compliant with the Accreditation Council for Graduate Medical Education's Next Accreditation System, with the goal of ensuring that trainees achieve specific milestones in their progression to achieving cognitive and technical competency., Competing Interests: Disclosure The following authors disclosed financial relationships: G. A. Cote: Consultant for Interpace Diagnostics and Olympus Corporation; research support from Abbvie Pharmaceuticals. R. N. Keswani: Consultant for Medtronic and Boston Scientific. R. H. Yadlapati: Consultant for Medtronic, Phathom Pharmaceuticals, and StatLinkMD; research support from Ironwood Pharmaceuticals; advisory board with stock options in RJS Mediagnostix. T. M. Berzin: Consultant for Medtronic, Boston Scientific, Wision AI, Magentiq Eye, and RSIP Vision. P. Chahal: Consultant for Boston Scientific and Medtronic. J. Cohen: Consultant for Olympus America and Micro-Tech; stock owner in GI Windows, Virtual Health Partners, and Rom-Tech; owner of MD Medical Navigators. W. J. Coyle: Speaker for Abbvie, Pharm and Regeneron, and Pharm D. Early: Scientific advisory board for Guardant Health. N. M. Guda: Consultant for Boston Scientific and Hemostasis Inc LLC; speaker for Lupin Pharmaceuticals, India. S. Inamdar: Consultant for Pentax Medical. E. J. Shin: Consultant for Boston Scientific. U. D. Siddiqui: Consultant and speaker for Olympus, Boston Scientific, ConMed, Medtronic, and Cook Medical; research support from Olympus and Boston Scientific. All other authors disclosed no financial relationships., (Copyright © 2025 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Background: Structured preparation is necessary to conduct quality improvement (QI) strategies that are relevant to the problem, feasible, appropriately resourced, and potentially effective. Recent work suggests that improvement efforts are suboptimally conducted. Our goal was to determine how well preparation for surgical QI is undertaken, including detailing the problem, setting project goals, and planning an intervention., Study Design: This retrospective cross-sectional study included QI efforts submitted in 2019 to the American College of Surgeons (ACS) during review for accreditation across 5 ACS Quality Programs: Children's Surgery Verification, the Commission on Cancer, the MBSAQIP, the National Accreditation Program for Breast Centers, and the Trauma Verification Program. Projects were scored for alignment with three components of the preconduct phase of the ACS Quality Framework: problem detailing, goal specification, and strategic planning., Results: A total of 242 projects satisfied inclusion criteria and were scored. Most projects in the final cohort were from MBSAQIP (36%), Commission on Cancer (31%), or National Accreditation Program for Breast Centers (29%) programs. The average overall preconduct score was 52% (SD 17). On average, projects performed best in the "goal specification" component (65%, SD 27), followed by "problem detailing" (52%, SD 16), and "strategic planning" (44%, SD 25). Within these components, identification of possible limitations (5%) and consideration of contextual issues (12%) were among the least frequently reported items., Conclusions: Thorough planning is a critical component of effective QI, and our study reflects significant opportunity for its improvement. The ACS Quality Framework may serve as a guide to improve QI planning, thereby promoting efficiency and effectiveness of these efforts., (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)

The ARS brain committee recommends that vorasidenib may be appropriate for recurrent or residual IDH-mutant grade 2 oligodendroglioma or astrocytoma. Vorasidenib is usually not appropriate for completely resected grade 2 oligodendroglioma or astrocytoma, any grade 3 oligodendroglioma or astrocytoma, or combined with radiotherapy and/or chemotherapy for any grade 2-3 glioma., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Dr. McClelland receives research funding from the National Institutes of Health (National Cancer for Advancing Translational Sciences), University Hospitals Minority Faculty Career Development Award, the Robert Winn Diversity in Clinical Trials Career Development Award (sponsored by the Bristol Myers Squibb Foundation), the Case Comprehensive Cancer Center Accelerator Pilot Project Award, the Gilead Sciences Research Scholars Program in Solid Tumors Award, the Radiation Oncology Institute, and the Susan G Komen Career Catalyst Research Grant. Dr. Wang reports grants from Genentech and Varian, royalties from Wolters Kluwer, consulting fees from AbbVie, Cancer Panels, Elekta, Merck, RTOG Foundation, and Iylon Precision, honoraria from Cancer Panels, DSMB/Advisory participation with Iylon Precision, and stock or options from Doximity, outside of the submitted work. Dr. McGranahan reports clinical Trial Support (institutional) from Servier (I.R.I.S.), Biomimetix, Denovo Biopharma, Biohaven pharmaceuticals, Chimerix, Novocure, Vigeo and Consulting/Advisory Board: Servier (I.R.I.S.). Dr. Eric Lehrer is on the Advisory Board for Servier Pharmaceuticals (all funds paid to Mayo Clinic). Dr. Palmer is a consultant for Servier (not in scope of work) and consultant for Icotec and Novocure. All remaining authors have declared no conflicts of interest.]., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Recently, there has been an increase in the representation of women within the cardiothoracic surgery workforce, with discussions about gender equity garnering interest. We sought to identify whether this increase is accompanied by commensurate selection for representation at national meetings., Methods: Online archives of The Society of Thoracic Surgeons (STS) Annual Meetings were reviewed from 2015 to 2024. Data regarding the moderator's gender were abstracted. The gender distribution of moderators across the various session categories was surveyed, and subgroup analyses were performed., Results: During the years of study, the STS Annual Meeting Taskforce selected 983 moderators to participate in the conference, including 218 women. The representation of women moderators demonstrated a favorable, upward trend. In 2015, 12.1% of moderators were women, with a consistent rate from 2015 to 2018. There was a noticeable rise in invited women moderators in 2019, with 25.4% of moderators being women. This proportion increased to 36.9% women in 2024. General Thoracic sessions have consistently included a greater percentage of women moderators compared with other sessions. Other topic areas, such as Education and Quality Improvement and Critical Care, transitioned to greater representation of women in recent years., Conclusions: There has been an increase over time in women moderators selected for participation in the STS Annual Meeting, with progress in gender diversity seen in most session types. Although the overall proportion of women within cardiothoracic surgery remains low, the STS has increasingly worked toward encouraging inclusivity. Efforts to further support well-rounded representation are of important benefit., Competing Interests: Disclosures Neel Chudgar reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory. Mara Antonoff reports a relationship with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory; and with Merck & Co Inc that includes: consulting or advisory. Brendon Stiles reports a relationship with Gala Therapeutics that includes: consulting or advisory; with AstraZeneca Pharmaceuticals LP that includes: consulting or advisory; with Bristol-Myers Squibb Co that includes: consulting or advisory; with Bristol-Myers Squibb Foundation that includes: consulting or advisory; with Pfizer Inc that includes: consulting or advisory; with Genentech Inc that includes: consulting or advisory; with Lung Cancer Research Foundation that includes: consulting or advisory; with Medtronic Inc that includes: consulting or advisory; and with Arcus Biosciences Inc that includes: consulting or advisory. The other authors have no conflicts of interest to disclose. Declaration of Generative AI and AI-Assisted Technologies During the preparation of this work the authors used ChatGPT to proofread the text. After using this tool/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication., (Published by Elsevier Inc.)

Introduction: In light of the lack of diversity in academic medicine leadership, diversity-related, student-led national medical organizations (NMOs) provide a space for solace and reprieve among common peers while providing an opportunity to develop leadership competencies in a supportive environment. Despite the impact NMOs have had on cultivating generations of leaders in medicine, trainees may not identify opportunities for leadership development that are transferable to future careers in academic medicine., Methods: We designed and implemented a dynamic 60-minute workshop with an interactive PowerPoint presentation, author-owned video testimonials (from past student leaders of NMOs), two case presentations, and reflection exercises. We assessed learner self-perceived confidence via workshop surveys. The target audience of this module was medical trainees, including medical students, residents, and fellows., Results: Forty-three workshop attendees across three sites submitted partial or complete survey evaluations. Respondents included medical students (77%), with the remainder self-identified as either postbaccalaureate students, residents/fellows, academic faculty, or physicians. A comparison of pre- and postresponses showed a statistically significant increase in confidence in addressing each of the four educational objectives. Participants felt the case presentations offered relevant applicable examples., Discussion: For many trainees, the role that diversity-related NMOs play in developing leadership competencies may be unclear and not articulated in traditional medical curricula. In this module, we provide examples of how NMOs facilitate leadership development and may encourage our diverse trainees to eventually become academic faculty., (© 2024 Brutus et al.)

Abstract: In 2003, the Institute of Medicine noted the need to improve workforce diversity. The American Society of Hematology (ASH) responded by developing the Minority Recruitment Initiative (MRI) to recruit diverse physicians/scientists into hematology. We evaluated the outcomes of the program. From 2004 to 2022, there were 405 awardees. Compared with national estimates, MRI awardees were less likely to discontinue their degree programs. MRI graduate student awardees had 0% attrition (97.5% confidence interval [CI], 10.6), whereas the national minority graduate student attrition was 36%. Medical student awardees had 2.2% (95% CI, 0.61-5.6) attrition, compared with the minority medical school attrition of 5.6%. Awardees were more likely than expected to pursue hematology-oncology (5.7% minority national estimate) because 14.4% (95% CI, 8.1-23.0) of medical student awardees and 88.5% (95% CI, 70.0-97.6) of early career awardees remain in the field. ASH has developed a successful program, but continued efforts are needed to advance equity in hematology., (© 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)

This joint position statement (JPS) on immersion pulmonary oedema (IPO) and diving is the product of a workshop held at the 52nd Annual Scientific Meeting of the South Pacific Underwater Medicine Society (SPUMS) from 12-17 May 2024, and consultation with the United Kingdom Diving Medical Committee (UKDMC), three members of which attended the meeting. The JPS is a consensus of experts with relevant evidence cited where available. The statement reviews the nomenclature, pathophysiology, risk factors, clinical features, prehospital treatment, investigation of and the fitness for future compressed gas diving following an episode of IPO. Immersion pulmonary oedema is a life-threatening illness that requires emergency management as described in this statement. A diver with previous suspected or confirmed IPO should consult a medical practitioner experienced in diving medicine. The SPUMS and the UKDMC strongly advise against further compressed gas diving if an individual has experienced an episode of IPO., Competing Interests: Dr Turner acts as a consultant and proctor for St Jude Medical, Medtronic and Edwards Lifesciences, as a consultant and lecturer for Gore Medical and performs PFO closures on private patients. The other authors declare that they have no conflicts of interest. Professor Mitchell is the editor of Diving and Hyperbaric Medicine Journal, but as a societal consensus guideline this manuscript was not subject to peer review and a resulting publication decision. No external funding was declared., (Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.)

This paediatric diving position statement was developed from a targeted workshop at the 51st Annual Scientific Meeting of the South Pacific Underwater Medicine Society (SPUMS) on 8 June 2023. It highlights the factors that SPUMS regards as important when undertaking health risk assessments for diving by children and adolescents (defined as aged 10 to 15 years). Health risk assessments for diving should be performed by doctors who are trained in diving medicine and who are familiar with the specific risks which result from breathing compressed gas in the aquatic environment. Undertaking a diver health risk assessment of children and adolescents requires a detailed history (including medical, mental health, psychological maturity), a comprehensive diver medical physical examination and evaluation of all relevant investigations to exclude unacceptable risks. In addition, assessment of the individual's motivation to dive and reported in-water capability should occur, whilst engaging with their parent /guardian and instructor, where appropriate, to ensure that safety for the child is optimised. The guideline applies to all compressed air diving including scuba and surface supply diving provided in open and contained bodies of water., Competing Interests: No conflicts of interest were declared., (Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.)

Aims: Diabetes mellitus (diabetes) is common amongst patients with non-ST-segment elevation myocardial infarction (NSTEMI). We describe presentation, care, and outcomes of patients admitted with NSTEMI by diabetes status., Methods and Results: Prospective cohort study including 2928 patients (1104 with prior diabetes, 1824 without) admitted to hospital with NSTEMI from 287 centres in 59 countries. Quality of care was evaluated based on 12 guideline-recommended care interventions. Outcomes included in-hospital acute heart failure, cardiogenic shock, repeat myocardial infarction, stroke/transient ischaemic attack (TIA), BARC Type ≥ 3 bleeding and death, as well as 30-day mortality. Patients with diabetes had higher comorbidity burden and more frequently presented with Killip Class II-IV heart failure (10.2% vs. 3.7%, P < 0.001), haemodynamic instability (7.1% vs. 3.7%, P < 0.001), and ongoing chest pain (43.1% vs. 37.0%, P < 0.001), than those without diabetes. Overall, care quality received was similar by diabetes status (60.0% vs. 60.5% received ≥ 80% of eligible care interventions, P = 0.786), but patients with diabetes experienced higher rates of in-hospital acute heart failure (15.3% vs. 6.8% P < 0.001), cardiogenic shock (4.5% vs. 2.5%, P = 0.002), stroke/TIA (2.0% vs. 0.8%, P = 0.006), and death (2.5% vs. 1.4%, P = 0.022), and higher 30-day mortality (3.3% vs. 2.0%, P = 0.025). Of NSTEMI with diabetes, only 1.9% and 9.0% received prescription for glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors, respectively, on discharge, and only 45.9% were referred for cardiac rehabilitation., Conclusion: NSTEMI patients with diabetes, compared with those without, present more clinically unwell and have worse outcomes despite receiving equal quality of care. Prescription of cardiovascular-protective glycaemic agents is an actionable target to reduce risk of further events., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Aims: To develop a suite of quality indicators (QIs) for the evaluation of the care and outcomes for adults undergoing transcatheter aortic valve implantation (TAVI)., Methods and Results: We followed the European Society of Cardiology (ESC) methodology for the development of QIs. Key domains were identified by constructing a conceptual framework for the delivery of TAVI care. A list of candidate QIs was developed by conducting a systematic review of the literature. A modified Delphi method was then used to select the final set of QIs. Finally, we mapped the QIs to the EuroHeart (European Unified Registries on Heart Care Evaluation and Randomized Trials) data standards for TAVI to ascertain the extent to which the EuroHeart TAVI registry captures information to calculate the QIs. We formed an international group of experts in quality improvement and TAVI, including representatives from the European Association of Percutaneous Cardiovascular Interventions, the European Association of Cardiovascular Imaging, and the Association of Cardiovascular Nursing and Allied Professions. In total, 27 QIs were selected across 8 domains of TAVI care, comprising 22 main (81%) and 5 secondary (19%) QIs. Of these, 19/27 (70%) are now being utilized in the EuroHeart TAVI registry., Conclusion: We present the 2023 ESC QIs for TAVI, developed using a standard methodology and in collaboration with ESC Associations. The EuroHeart TAVI registry allows calculation of the majority of the QIs, which may be used for benchmarking care and quality improvement initiatives., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

In December 2023, the Trauma Professional Committee of the American Society of Surgeons officially released the seventh edition of "Resources for Optimal Care of the Injured Patient (2022 Stan-dards)". Compared to the sixth edition of the standards, the main updated content of the seventh edition includes ten aspects: (1) trauma centers need to meet new personnel configuration and qualification requirements, (2) trauma centers need to develop more structured and effective trauma treatment effectiveness improvement and patient safety plans, (3) trauma centers need to develop data quality plans, (4) trauma centers need to develop new diagnosis and treatment plans for specific patients, (5) trauma centers need to have new professional knowledge, (6) trauma centers need to meet new response time and resource availability standards, (7) trauma centers need to meet new academic and scientific requirements, (8) tertiary trauma centers need corresponding qualification certificates if providing neurological trauma treatment, (9) new requirements for pediatric trauma centers, (10) the fourth level trauma center standards. The research literature published by scholars in the field of trauma in the past decade has provided sufficient evidence-based medicine evidence for updating content. The article introduces and analyzes the updates in the seventh edition standards in light of the available evidence.

Background: Sudden cardiac death (SCD) is a major concern in patients with hypertrophic cardiomyopathy (HCM). The American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) have different guidelines for SCD risk stratification. Their comparative performance in diverse populations remains uncertain., Objective: Evaluate the performance of the 2020 ACC/AHA and 2014 ESC guidelines for SCD stratification in a Brazilian cohort with HCM., Methods: This retrospective cohort study included patients diagnosed with HCM who were followed in a dedicated clinic at a tertiary hospital in Brazil. The primary outcome was SCD, aborted cardiac arrest due to ventricular fibrillation (VF), sustained ventricular tachycardia (SVT), an episode of VF or SVT, or appropriate ICD therapy. Risk prediction models were assessed using the C-index., Results: A total of 187 patients were included, with a mean follow-up of 8.3 years. The 2020 ACC/AHA guidelines classified 106 (56%) patients as high-risk for SCD, while the 2014 ESC guidelines identified 54 (29%). The primary outcome occurred in 12% of the high-risk group identified by the ACC/AHA guidelines and 13% of the high-risk group identified by the ESC guidelines. Both guidelines showed low discriminatory power for SCD risk in this Brazilian cohort, with AUC values of 0.634 and 0.581 for the ACC/AHA and ESC guidelines, respectively., Conclusions: The 2020 ACC/AHA and 2014 ESC guidelines have limitations in predicting SCD events and defining ICD indications in Brazilian HCM patients. Further studies are needed to refine risk stratification and optimize SCD prevention in this population., Competing Interests: All authors declare that there are no conflicts of interest related to this study. We have no financial or personal relationships with any entities that could have influenced the work reported in this paper. Specifically, no author has shareholding in or has received grants, consultancy fees, or any other form of compensation from companies whose products are featured in this manuscript or that manufacture competing products. This statement is made in accordance with the requirements of the European Journal of Heart Failure and the ICMJE Conflicts of Interest disclosure form. Each author has submitted a completed disclosure form along with this submission., (Copyright: © 2024 The Author(s).)

Abstract: Incidental findings in diagnostic imaging are common, but follow-up recommendations often lack consistency. The Society of Radiologists in Ultrasound (SRU) issued guidelines in 2021 for managing incidentally detected gallbladder polyps, aiming to balance follow-up with avoiding overtreatment. There is variable adherence to these guidelines in radiology reports, however, which makes it difficult for the clinician to pursue appropriate follow-up for the patient. The purpose of this project is to test the feasibility of a Large Language Model (LLM)-based tool to incorporate SRU guidelines into radiology reports. Additionally, we propose a framework for closely integrating societal follow-up recommendations into radiology reports, using this tool as an example.Following institutional review board approval, we retrospectively reviewed gallbladder ultrasound examinations performed on adult ED patients in 2022. Data on patient demographics and radiology report content were collected. Using the 2021 SRU guidelines, we developed an interactive tool employing a retriever-augmented generator (RAG) and prompt engineering. A board-certified radiologist tested the accuracy, whereas a board-certified emergency medicine physician assessed the clarity and consistency of the recommendations.The interactive tool, GB-PRL, outperformed leading closed-source and open-source LLMs, achieving 100% accuracy in risk categorization and follow-up recommendations on hypothetical user queries (P < 0.001). The tool also showed superior accuracy compared to radiology reports on retrospective data (P = 0.04). Although GB-PRL demonstrated greater clarity and consistency, the improvement from the radiology reports was not statistically significant (P = 0.22). Further work is needed for prospective testing of GB-PRL before integrating it into clinical practice., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose of Review: Since the publication of the 2019 American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network (ACR/SAA/SPARTAN) treatment recommendations for ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (axSpA), new evidence has emerged that necessitates a revision of the ACR/SAA/SPARTAN clinical practice guideline (CPG)., Recent Findings: An online survey was conducted among SPARTAN members prior to the 2024 Annual Meeting, with 81 members participating. A majority (62%) expressed a preference for treating axSpA as a single entity in the updated CPG, eliminating the distinction between AS and nonradiographic axSpA. Updating the recommendations on pharmacotherapy was considered the top priority, followed by revising recommendations on disease activity monitoring and biosimilar use. Over half of the respondents (58%) rated the 2019 CPG as no more than moderately user-friendly. Key areas for improvement include outdated content, lack of quick reference materials, complex flow charts, and inadequate visual aids. The survey results indicate strong support among SPARTAN members for treating axSpA as a single entity in the forthcoming update of the ACR/SAA/SPARTAN CPG. Additionally, there is demand for a more user-friendly guideline document., Competing Interests: Declarations. Ethics Approval and Consent to Participate: This article does not contain any studies with human or animal subperformed by any of the authors. Competing Interests: J.E. is on the board of directors of SPARTAN., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose of Review: To summarize selected late-breaking science on cardiovascular disease (CVD) prevention presented at the 2024 European Society of Cardiology (ESC) Congress., Recent Findings: Key studies from the 2024 ESC Congress highlight advances in (CVD) management. Apolipoprotein A-1 infusions reduced risk in acute myocardial infarction patients with high LDL cholesterol. Plozasiran cut triglycerides and apolipoprotein C-III levels, lowering pancreatitis risk. A 14-year study linked smoking among youth to cardiac abnormalities. Baseline hsCRP, LDL-C, and Lp(a) were strong predictors of 30-year outcomes in women. Alternative LDL-lowering strategies matched high-intensity statins in effectiveness of LDL-C lowering and reduced diabetes risk. Early combination lipid lowering therapy improved outcomes post-myocardial infarction. Nordic and Mediterranean diets were linked to lower atherosclerotic CVD risk. The findings from the 2024 ESC Congress highlight significant advancements in CVD prevention, including novel lipid-lowering therapies, biomarker-based risk prediction, and lifestyle interventions. These studies underscore the importance of early and personalized treatment strategies to mitigate long-term cardiovascular risk., Competing Interests: Declarations. Competing Interests: Dr. Virani is a Section Editor for the Springer journals Current Atherosclerosis Reports and Current Cardiology Reports. Dr. Slipczuk has received consulting honorarium from Amgen and Philips, participated in the advisory board for Bristol-Myers-Squib, and serves as site PI for V-INITIATE and Ocean(a) trials. The other authors declare that they have no conflict of interest. Financial Declarations. Dr. Virani is supported by the Department of Veterans Affairs, NIH, NIHR UK, Tahir, and Jooma Family Foundation. Dr. Slipczuk has received institutional grants from Amgen and Philips. Human and Animal Rights and Informed Consent: This article does not contain any studies with human participants or animals performed by any of the authors., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Importance: Pediatric patients with complex medical problems benefit from pediatric sub-specialty care; however, a significant proportion of children live greater than 80 mi. away from pediatric sub-specialty care., Objective: To identify current knowledge gaps and outline concrete next steps to make progress on issues that have persistently challenged the pediatric nephrology workforce., Evidence Review: Workforce Summit 2.0 employed the round table format and methodology for consensus building using adapted Delphi principles. Content domains were identified via input from the ASPN Workforce Committee, the ASPN's 2023 Strategic Plan survey, the ASPN's Pediatric Nephrology Division Directors survey, and ongoing feedback from ASPN members. Working groups met prior to the Summit to conduct an organized literature review and establish key questions to be addressed. The Summit was held in-person in November 2023. During the Summit, work groups presented their preliminary findings, and the at-large group developed the key action statements and future directions., Findings: A holistic appraisal of the effort required to cover inpatient and outpatient sub-specialty care will help define faculty effort and time distribution. Most pediatric nephrologists practice in academic settings, so work beyond clinical care including education, research, advocacy, and administrative/service tasks may form a substantial amount of a faculty member's time and effort. An academic relative value unit (RVU) may assist in creating a more inclusive assessment of their contributions to their academic practice. Pediatric sub-specialties, such as nephrology, contribute to the clinical mission and care of their institutions beyond their direct billable RVUs. Advocacy throughout the field of pediatrics is necessary in order for reimbursement of pediatric sub-specialist care to accurately reflect the time and effort required to address complex care needs. Flexible, individualized training pathways may improve recruitment into sub-specialty fields such as nephrology., Conclusions and Relevance: The workforce crisis facing the pediatric nephrology field is echoed throughout many pediatric sub-specialties. Efforts to improve recruitment, retention, and reimbursement are necessary to improve the care delivered to pediatric patients., (© 2024. The Author(s).)

Background: Contemporary national outcomes of open and endovascular aortic repair for descending thoracic aortic aneurysms (DTAAs) and thoracoabdominal aortic aneurysms (TAAAs) are unclear. This study evaluated this issue by using The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD)., Methods: From July 1, 2017 to June 30, 2022, study investigators identified 3522 adults who underwent planned DTAA repair (open, 328; endovascular, 1895) or TAAA repair (open, 870; endovascular, 429), after excluding ascending aorta or aortic arch aneurysms (zone 0, 1, or 2), interventions with a proximal extent in zone 0 or zone 1, juxtarenal or infrarenal aortic interventions, hybrid procedures, aortic trauma, and aortic infection., Results: Most DTAA interventions (85.2%) were endovascular repairs, whereas most TAAA interventions were open repairs (66.9%). For DTAA interventions, the operative mortality, permanent stroke rate, and rate of spinal cord injury were 4.2%, 3.8%, and 2.4% for endovascular repairs and 9.2%, 8.5%, and 4.6% for open repairs, respectively (all P < .05). For TAAA interventions, the operative mortality, permanent stroke rate, and rate of spinal cord injury were 6.5%, 2.1%, and 3.0% for endovascular repairs and 11.7%, 6.0%, and 12.2% for open repairs, respectively (all P < .05). Increasing annual open TAAA repair volume was associated with lower odds of experiencing the composite of operative mortality, permanent stroke, or spinal cord injury., Conclusions: On the basis of STS ACSD data, endovascular repair was the predominant approach for treating DTAA, whereas most patients undergoing TAAA interventions had an open surgical repair. Outcome differences between open and endovascular approaches may be related to patient selection. Increasing center experience with open TAAA repair is associated with improved outcomes., Competing Interests: Disclosures The authors have no conflicts of interest to disclose., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

This paper describes the use of digital solutions to improve the care of trauma patients in Germany. The focus is on the trauma networks of the German Society for Trauma Surgery (Deutsche Gesellschaft für Unfallchirurgie, DGU). The use of digital solutions includes quality assurance through the TraumaRegister, which enables comprehensive data analysis as well as preregistration and resource utilization through programs such as the interdisciplinary proof of treatment IVENA eHealth, Rescuetrack and Rescue-Net. In addition, Predictive Hospital Resource Planning is presented, which optimizes resource forecasting using artificial intelligence (AI). Telemedical services such as Medgate and teleradiology solutions (Nexus/Chili) offer additional support, especially in rural areas. The paper shows how the digitalization of medical care is crucial to improving the efficiency and quality of treatment of trauma patients. In addition, the paper shows possible developments in the field of clinical decision making through AI., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: W. Lehmann, S. Blaschke, U. Schweigkofler und C. Spering geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)