Visual Field and Optical Coherence Tomography Parameters With and Without Positive Family History of Glaucoma.

BACKGROUND: To evaluate the Retinal Nerve Fiber Layer and Ganglion Cell Complex thickness using Spectral Domain Optical Coherence Tomography with and without positive family history of Primary Open Angle Glaucoma and its relation to visual field. METHODS: Total 120 eyes with each subjects with positive family history of Primary Open Angle Glaucoma (Group I, n=30) and healthy subjects without positive family history of Primary Open Angle Glaucoma (Group II, n=30) undergone complete ophthalmic evaluation with Retinal Nerve Fiber Layer, Ganglion Cell Complex and VF obtained from Spectral Domain Optical Coherence Tomography RTVue-100 and Humphrey visual field respectively .The measurements were analyzed and compared among two groups using independent-t test by using SPSS version 23.The relationship of Retinal Nerve Fiber Layer with visual field were evaluated with correlation analysis. RESULTS: There were 75 patients included in the study.nasal, temporal RNFL and average Ganglion Cell Complex was significantly lower and thinner in Group I with mean difference of -8.53±2.30 µm (p<0.001), -7.35±3.34 µm (p<0.001), -8.52±3.58µm (p<0.001),-11.87±2.24µm (p<0.001), -5.31±1.95µm (p<0.001) and -8.05±1.52µm (p<0.001) respectively. Correlation plot with Retinal Nerve Fiber Layer thickness as predictor of Mean Deviation and Pattern Standard Deviation indicated statistically significant degree of determination in Group I (r=0.455 and r=0.623, p<0.001 and p<0.001). CONCLUSIONS: The Optical Coherence Tomography and visual field Parameters are lower in group I and used as an early predictor, diagnosis, monitoring and management.

Cardiovascular Risk Factors Among First-Degree Relatives of Patients with Premature Cardiovascular Disease in Malta. Baseline Findings from the CRISO Project.

Purpose: A family history of premature atherosclerotic cardiovascular disease (ASCVD) confers a greater risk of developing ASCVD. However, the prevalence of ASCVD risk factors among asymptomatic Maltese adults with parental or fraternal history of premature ASCVD is unknown. The study aimed to evaluate and compare their risk with the general population. Patients and Methods: Posters to market the project were distributed in cardiac rehabilitation areas. Patients with premature cardiovascular disease facilitated recruitment by informing their relatives about the project. Medical doctors and cardiac rehabilitation nurses referred first-degree relatives. Posters were put up in community pharmacies, and an explanatory video clip was shared on social media for interested individuals to contact researchers. Those eligible were enrolled in a preventive cardiology lifestyle intervention. Their data were compared with the risk in the general population. Results: Many first-degree relatives had a suboptimal risk profile, with 60% (N = 89) having a total cholesterol level of >5.0 mmol/L; 54% having a low-density lipoprotein-cholesterol level of >3 mmol/L; 70.5% being overweight/obese, with 62% having a waist circumference greater than the recommended values; 34.8% having hypertension; 56.2% being inadequately adherent to the Mediterranean diet; 62% being underactive, with 18% being sedentary; and 25.8% being smokers. First-degree relatives had significantly higher proportions of underactive lifestyle (p = 0.00016), high body mass index (>25kg/m2) (p = 0.006), and systolic blood pressure (p = 0.001) than the general population, with 30% having metabolic syndrome. Conclusion: This study determined the prevalence of lifestyle, biochemical, physiological, and anthropometric cardiovascular risk factors among asymptomatic first-degree relatives of Maltese patients with premature ASCVD. First-degree relatives had considerable prevalences of an underactive lifestyle, hypertension, and obesity, suggesting better screening and early risk factor intervention are needed to modify their risk of ASCVD.

This study was done to evaluate factors that can increase the risk of heart disease in siblings and offspring of Maltese patients who developed atherosclerotic cardiovascular disease (ASCVD) at a young age. Relatives were invited to meetings during which a risk evaluation was performed. The researchers found that relatives had a high prevalence of cardiometabolic risk factors, meaning they were at increased risk of developing the disease. The researchers have concluded that reducing the risk of ASCVD in individuals at increased risk requires developing and testing potentially sustainable risk factor modification strategies.

Association between pathological positivity rate of endometriosis, demographics, and concomitant gynecological conditions.

Background: To date, there remains a paucity of present-day literature on the topic of demographics and the biopsy-proven pathological positivity rate of endometriosis. Objective: The goal of this study was to explore the association between patients' demographics and other concomitant gynecological conditions or procedures and the pathological positivity rate of excision of endometriosis. Design: Retrospective cohort study. Methods: All women >18 years old who underwent laparoscopic surgery for endometriosis at a tertiary care hospital from October 2011 to October 2020. Women were classified into two groups: (1) Study group: women with >80% pathological positivity rate of endometriosis and (2) Control group: women with <80% pathological positivity rate. Results: A total of 401 women were included in the analysis. No difference was noted in the 80% pathological positivity rate based on body mass index [BMI; 68.7% in normal BMI versus 80% in underweight, versus 74.5% in overweight, and 74.1% in obese patients (p = 0.72)]. The percentage of patients reaching 80% pathological positivity of endometriosis was lower in women who had undergone previous laparoscopy for endometriosis compared to surgery naïve women (66.5% versus 76.5%, p = 0.03). In addition, a higher percentage of women who underwent concomitant hysterectomy (83.5% versus 68.8% for non-hysterectomy, p = 0.005) or bilateral oophorectomy (92.7% versus 70.0% for non-oophorectomy, p = 0.002) reached 80% pathological positivity. Women with an associated diagnosis of fibroids (79.7% versus 70.5%) or adenomyosis (76.4% versus 71.7%) were more likely to reach 80% pathological positivity compared to women without any other coexisting pathology; however, the observed differences were not statistically significant. After applying a log-binomial regression model, compared to White non-Hispanics, Hispanic patients were 30% less likely to reach 80% positivity (RR: 0.70, 95% CI: 0.49-1.02), although not statistically significant. Conclusion: No significant racial difference was found when comparing the rates of 80% pathological positivity of suspected endometriosis lesions among groups. Endometriosis pathological positivity rate was unaffected by patients' BMI and the presence of concomitant pathologies. In addition, prior laparoscopic surgery for endometriosis might cause tissue changes that result in a decrease in the observed pathological positivity rate of endometriosis lesions during subsequent surgeries.

Unravelling the maternal evolutionary history of the African leopard (Panthera pardus pardus).

The African leopard (Panthera pardus pardus) has lost a significant proportion of its historical range, notably in north-western Africa and South Africa. Recent studies have explored the genetic diversity and population structure of African leopards across the continent. A notable genetic observation is the presence of two divergent mitochondrial lineages, PAR-I and PAR-II. Both lineages appeared to be distributed widely, with PAR-II frequently found in southern Africa. Until now, no study has attempted to date the emergence of either lineage, assess haplotype distribution, or explore their evolutionary histories in any detail. To investigate these underappreciated questions, we compiled the largest and most geographically representative leopard data set of the mitochondrial NADH-5 gene to date. We combined samples (n = 33) collected in an altitudinal transect across the Mpumalanga province of South Africa, where two populations of leopard are known to be in genetic contact, with previously published sequences of African leopard (n = 211). We estimate that the maternal PAR-I and PAR-II lineages diverged approximately 0.7051 (0.4477-0.9632) million years ago (Ma). Through spatial and demographic analyses, we show that while PAR-I underwent a mid-Pleistocene population expansion resulting in several closely related haplotypes with little geographic structure across much of its range, PAR-II remained at constant size and may even have declined slightly in the last 0.1 Ma. The higher genetic drift experienced within PAR-II drove a greater degree of structure with little haplotype sharing and unique haplotypes in central Africa, the Cape, KwaZulu-Natal and the South African Highveld. The phylogeographic structure of PAR-II, with its increasing frequency southward and its exclusive occurrence in south-eastern South Africa, suggests that this lineage may have been isolated in South Africa during the mid-Pleistocene. This hypothesis is supported by historical changes in paleoclimate that promoted intense aridification around the Limpopo Basin between 1.0-0.6 Ma, potentially reducing gene flow and promoting genetic drift. Interestingly, we ascertained that the two nuclear DNA populations identified by a previous study as East and West Mpumalanga correspond to PAR-I and PAR-II, respectively, and that they have come into secondary contact in the Lowveld region of South Africa. Our results suggest a subdivision of African leopard mtDNA into two clades, with one occurring almost exclusively in South Africa, and we identify the potential environmental drivers of this observed structure. We caution that our results are based on a single mtDNA locus, but it nevertheless provides a hypothesis that can be further tested with a dense sample of nuclear DNA data, preferably whole genomes. If our interpretation holds true, it would provide the first genetic explanation for the smaller observed size of leopards at the southernmost end of their range in Africa.

History of Eugenics in Otorhinolaryngology: Ernst Rüdin and the International Eugenics Network.

Introduction The early geneticist and psychiatrist Ernst Rüdin (1874-1952) became one of the key figures in the eugenics movement and in the German health system of the Nazi era. His connections in the international eugenics network have played an important role in the history of eugenics. Objective To discuss the connections between Ernst Rüdin's scientific group in Munich and Otmar von Verschuer's group in Frankfurt during the Nazi era. Methods Otorhinolaryngological materials from Ernst Rüdin's former private library are presented, and they show Rüdin's deep involvement in the international eugenics network. These materials provide insights into early medical genetics in otorhinolaryngology. Results One result of the present study is that eugenics groups from Munich, Frankfurt, and New York certainly influenced one another in the field of otorhinolaryngology. Karlheinz Idelberger and Josef Mengele were two scientists who performed hereditary research on orofacial clefts. Later, Mengele became deeply involved in Nazi medical crimes. His former work on orofacial clefts clearly had, to some extent, an influence on subsequent studies. Conclusion An international eugenics network already existed before 1933. However, it becomes clear that the weaknesses of many early genetic studies did not enable its authors to draw firm scientific conclusions, suggesting that scientists lacked an accurate concept of the genetic causes of most illnesses.

The conflicts of Ray Adams and Joe Foley with Abe Baker: The neurology and neuropathology of liver failure (1949-1963) and the founding of the American Academy of Neurology (1948).

This article examines disagreements among three giants of twentieth-century American neurology: Raymond Adams, Joseph Foley, and Abraham Baker. The disagreements Adams and Foley had with Baker concerned two issues: (1) the neurologic and neuropathological manifestations of liver failure with hepatic encephalopathy as expounded from the late 1940s to the early 1960s, and (2) the founding of the American Academy of Neurology in 1948 as an inclusive medical society under the principal leadership of Baker. The conflicts are examined from transcribed meeting debates (1949-1963), salient original publications (1949-1963), public addresses of protagonists touching on these issues (1971, 1984), and oral histories and less formal interviews of the protagonists and their associates (1979-2014). Contributing to these conflicts were contrasting personalities and outlooks on American neurology in the mid-twentieth century. Adams and Foley prevailed with their characterization of the neurologic and neuropathologic features of liver failure, whereas Baker triumphed with the need for and importance of an inclusive neurological society that would develop continuing medical education for neurologists at a national level, garner federal financial support for neurology training programs, and facilitate the development of neurology as a strong, independent medical discipline in the United States.

The Impact of Formal Education, Specialized Training, and Offense Type on Perceptions of Employability: Can Bias Toward Hiring a Person With a Criminal History Be Mitigated?

Though hesitations to hire formerly incarcerated individuals are often related to assumptions about a person's dangerousness, there remain legitimate reasons, such as limited formal education and basic skills, that prevent returning residents from finding work. Previous research suggests that hiring decisions are confounded by offense type, even if an employer would otherwise consider a person with a criminal history. Thus, it is unclear whether returning residents' level of education or training can mitigate barriers related to their offense history. Using hypothetical case vignettes of a formerly incarcerated job applicant, this study examined whether hiring decisions were influenced by education and offense type. A between-subjects design with a sample of 223 individuals recruited via MTurk was conducted. Results of this study were largely consistent with prior research suggesting that criminal history presents an obstacle when trying to obtain employment. Implications and future directions are provided in the discussion.

Size structure, age, and growth of the blue shark, Prionace glauca (Linnaeus, 1758) in southern Brazil.

The blue shark is a highly migratory species with a worldwide distribution, making it susceptible to multiple fishing fleets across the globe. In southern Brazil, it is an important target, comprising up to 40% of the total biomass landed by the commercial surface longline fleet. This study aims to contribute to a better understanding of how the species uses the region and to update its life-history information available for future assessments. Over five consecutive years (2018-2022) of landings and onboard monitoring, we gathered size data and vertebral samples to describe the species size composition in the region, as well as its seasonal and interannual variability and to update estimated life-history parameters. The results showed that southern Brazil is mainly inhabited by large juvenile males that arrive during winter (July-September) and stay until spring (October-December), when their frequency decreases. Small adult males are present throughout the year but in higher frequencies during summer. A small number of adult females are present with higher frequencies during spring and summer, which decreases during the austral autumn and winter. Some variability in the presence of each life stage was observed among years. The estimated life-history parameters were as follows: L∞: 255.02 cm fork length (FL), k: 0.20, L0:35.68 cm FL for males; L∞: 246.47 cm FL, k: 0.23, L0:36.77 cm FL for females; and L∞: 269.58 cm FL, k: 0.18, L0:36.19 cm FL for pooled sexes. However, the estimated values must be cautiously interpreted, as the obtained samples cannot be construed as representative of the entire harvested stock due to the lack of consistent presence of some life stages in the study region.

The natural history of celiac artery aneurysms.

OBJECTIVES: The goal of this study was to document the natural history of celiac artery aneurysms (CAAs). BACKGROUND: Celiac artery aneurysms are rare. Existing literature is skewed towards outcomes after intervention of large, symptomatic aneurysms but the behavior of untreated CAAs is poorly understood. METHODS: This is a single institution, retrospective analysis of patients with CAA diagnosed by CT imaging (2015-2019) identified through an institutional radiology database. Radiologic, demographic, and follow-up data were analyzed. The primary endpoint was the mean growth rate of CAAs. RESULTS: Of the 76 patients included, 86.8% were men with a mean age at presentation of 69.8 years. The mean CAA diameter on index imaging was 15.4 +/- 3.8 mm (range, 7-30 mm). All were classified as true aneurysms and 76.3% were saccular. All patients had clinical follow-up with mean follow-up 31.2 months +/- 21.6 months. No patient developed symptoms or rupture. The mean radiological follow-up among 45 patients was 25.2 +/- 16.8 months. Over this period, 16 CAAs (35.6%) enlarged, while 29 (64.4%) remained stable. One patient (1.3%) underwent intervention for increasing size in the setting of a chronic dissection. On multivariate analysis, age <70 was significantly associated with increased risk of aneurysm growth. CONCLUSIONS: In this institutional review of patients with CAAs, the majority of aneurysms remained stable in size, with no patients developing symptoms or rupture over clinical follow-up. Given the observed benign behavior of these aneurysms, guidelines that suggest conservative management of CAAs less than 2 cm seems appropriate.

Clinical course of patients with conservatively managed cerebral cavernous malformations.

INTRODUCTION: There is uncertainty whether patients with a cerebral cavernous malformation (CCM) should undergo conservative or surgical treatment, resulting in practice variation among hospitals. Our objective was to report clinical outcomes of patients with primarily conservatively managed CCMs. PATIENTS AND METHODS: This single-center cohort study included consecutive adult CCM patients, diagnosed in 2000-2023, who underwent conservative management as primary treatment strategy. Data were extracted from medical records, and we systematically conducted telephone and questionnaire follow-up. Functional status was assessed on the modified Rankin Scale (mRS). RESULTS: Of 345 patients, we included 265 patients with a CCM (median age 46 years; 45% male). At baseline, 131 (49%) patients presented with symptomatic hemorrhage (SH), and 134 (51%) with other symptoms or asymptomatically. During 58 months (IQR 35-94) median follow-up, 51 (19%) patients experienced a SH, 33 (12%) a seizure, and 13 (5%) focal neurological deficits. Fourteen (5%) patients underwent intervention (surgery n = 11, radiosurgery n = 4). Presentation with SH was associated with higher annual bleeding rates (6.0% vs 1.5%, p < 0.001), and higher cumulative 5-/10-year bleeding risks (31%/41% vs 7%, p < 0.001). Brainstem CCM was associated with higher cumulative 5-/10-year bleeding risks (27%/38% vs 17%/21%, p = 0.038). Nineteen (7%) patients died; two (0.8%) directly attributable to CCM. Of 246 surviving patients, 205 (83%) completed the questionnaire. At follow-up, 172/224 (77%) patients were functionally independent (mRS score ⩽2). DISCUSSION AND CONCLUSION: The majority of conservatively managed CCM patients remained free of a SH during follow-up. Few patients required intervention, and death attributable to the CCM was rare. These data may help patient counseling and treatment decisions.

Warming alters life-history traits and competition in a phage community.

Host-parasite interactions are highly susceptible to changes in temperature due to mismatches in species thermal responses. In nature, parasites often exist in communities, and responses to temperature are expected to vary between host-parasite pairs. Temperature change thus has consequences for both host-parasite dynamics and parasite-parasite interactions. Here, we investigate the impact of warming (37°C, 40°C, and 42°C) on parasite life-history traits and competition using the opportunistic bacterial pathogen Pseudomonas aeruginosa (host) and a panel of three genetically diverse lytic bacteriophages (parasites). We show that phages vary in their responses to temperature. While 37°C and 40°C did not have a major effect on phage infectivity, infection by two phages was restricted at 42°C. This outcome was attributed to disruption of different phage life-history traits including host attachment and replication inside hosts. Furthermore, we show that temperature mediates competition between phages by altering their competitiveness. These results highlight phage trait variation across thermal regimes with the potential to drive community dynamics. Our results have important implications for eukaryotic viromes and the design of phage cocktail therapies.IMPORTANCEMammalian hosts often elevate their body temperatures through fevers to restrict the growth of bacterial infections. However, the extent to which fever temperatures affect the communities of phages with the ability to parasitize those bacteria remains unclear. In this study, we investigate the impact of warming across a fever temperature range (37°C, 40°C, and 42°C) on phage life-history traits and competition using a bacterium (host) and bacteriophage (parasite) system. We show that phages vary in their responses to temperature due to disruption of different phage life-history traits. Furthermore, we show that temperature can alter phage competitiveness and shape phage-phage competition outcomes. These results suggest that fever temperatures have the potential to restrict phage infectivity and drive phage community dynamics. We discuss implications for the role of temperature in shaping host-parasite interactions more widely.

The transition of general practice into an academic discipline: tracing the origins through the first four professors in general practice/family medicine.

Being the 'mother' of most clinical specialties, general practice is as old as medicine itself. However, as a recognized academic discipline within medical schools, general practice has a relatively short life span. A decisive step forward was taken in 1956 when the University of Edinburgh established its Department of General Practice, and appointed the world's inaugural professor in the field in 1963. During the 1960s, the pioneering move in Edinburgh was followed by universities in the Netherlands (University of Utrecht), Canada (Western University, Ontario), and Norway (University of Oslo), marking the beginning of global academic recognition for general practice/family medicine. Despite its critical role in healthcare, the academic evolution of general practice has been sparingly documented, with a notable absence of comprehensive accounts detailing its integration into medical schools as an independent discipline with university departments and academic professors. Last year (2023) marked the 60th anniversary of Dr. Richard Scott's historic appointment as the first professor of General Practice/Family Medicine. Through the lens of the first four professors appointed between 1963 and 1969, we explore the 'birth' of general practice to become an academic discipline. In most western countries of today, general practice has become a recognized medical discipline and an important part of the medical education. But many places, this development is lagging behind. The global shaping of general practice into an academic discipline is therefore definitively not completed.

Early adversity and sexual diversity: the importance of self-reported and neurobiological sexual reward sensitivity.

Work shows that sexually-diverse individuals face high rates of early life adversity and in turn increased engagement in behavioral outcomes traditionally associated with adversity, such as sexual risk taking. Recent theoretical work suggests that these associations may be attributable to heightened sexual reward sensitivity among adversity-exposed women. We aimed to test these claims using a combination of self-report and EEG measures to test the relationship between early adversity, sexual reward sensitivity (both self-reported and EEG measured) and sexual risk taking in a sexually diverse sample of cis-gender women (N = 208) (Mage = 27.17, SD = 6.36). Results showed that childhood SES predicted self-reported sexual reward sensitivity which in turn predicted numbers of male and female sexual partners. In contrast we found that perceived childhood unpredictability predicted neurobiological sexual reward sensitivity as measured by EEG which in turn predicted male sexual partner number. The results presented here provide support for the notion that heightened sexual reward sensitivity may be a pathway through which early life adversity augments future sexual behavior, and underscores the importance of including greater attention to the dynamics of pleasure and reward in sexual health promotion.

Impact of time-history terms on reservoir dynamics and prediction accuracy in echo state networks.

The echo state network (ESN) is an excellent machine learning model for processing time-series data. This model, utilising the response of a recurrent neural network, called a reservoir, to input signals, achieves high training efficiency. Introducing time-history terms into the neuron model of the reservoir is known to improve the time-series prediction performance of ESN, yet the reasons for this improvement have not been quantitatively explained in terms of reservoir dynamics characteristics. Therefore, we hypothesised that the performance enhancement brought about by time-history terms could be explained by delay capacity, a recently proposed metric for assessing the memory performance of reservoirs. To test this hypothesis, we conducted comparative experiments using ESN models with time-history terms, namely leaky integrator ESNs (LI-ESN) and chaotic echo state networks (ChESN). The results suggest that compared with ESNs without time-history terms, the reservoir dynamics of LI-ESN and ChESN can maintain diversity and stability while possessing higher delay capacity, leading to their superior performance. Explaining ESN performance through dynamical metrics are crucial for evaluating the numerous ESN architectures recently proposed from a general perspective and for the development of more sophisticated architectures, and this study contributes to such efforts.

Morphological disparity and structural performance of the dromaeosaurid skull informs ecology and evolutionary history.

Non-avialan theropod dinosaurs had diverse ecologies and varied skull morphologies. Previous studies of theropod cranial morphology mostly focused on higher-level taxa or characteristics associated with herbivory. To better understand morphological disparity and function within carnivorous theropod families, here we focus on the Dromaeosauridae, 'raptors' traditionally seen as agile carnivorous hunters.We applied 2D geometric morphometrics to quantify skull shape, performed mechanical advantage analysis to assess the efficiency of bite force transfer, and performed finite element analysis to examine strain distribution in the skull during biting. We find that dromaeosaurid skull morphology was less disparate than most non-avialan theropod groups. Their skulls show a continuum of form between those that are tall and short and those that are flat and long. We hypothesise that this narrower morphological disparity indicates developmental constraint on skull shape, as observed in some mammalian families. Mechanical advantage indicates that Dromaeosaurus albertensis and Deinonychus antirrhopus were adapted for relatively high bite forces, while Halszkaraptor escuilliei was adapted for high bite speed, and other dromaeosaurids for intermediate bite forces and speeds. Finite element analysis indicates regions of high strain are consistent within dromaeosaurid families but differ between them. Average strain levels do not follow any phylogenetic pattern, possibly due to ecological convergence between distantly-related taxa.Combining our new morphofunctional data with a re-evaluation of previous evidence, we find piscivorous reconstructions of Halszkaraptor escuilliei to be unlikely, and instead suggest an invertivorous diet and possible adaptations for feeding in murky water or other low-visibility conditions. We support Deinonychus antirrhopus as being adapted for taking large vertebrate prey, but we find that its skull is relatively less resistant to bite forces than other dromaeosaurids. Given the recovery of high bite force resistance for Velociraptor mongoliensis, which is believed to have regularly engaged in scavenging behaviour, we suggest that higher bite force resistance in a dromaeosaurid taxon may reflect a greater reliance on scavenging rather than fresh kills.Comparisons to the troodontid Gobivenator mongoliensis suggest that a gracile rostrum like that of Velociraptor mongoliensis is ancestral to their closest common ancestor (Deinonychosauria) and the robust rostra of Dromaeosaurus albertensis and Deinonychus antirrhopus are a derived condition. Gobivenator mongoliensis also displays a higher jaw mechanical advantage and lower resistance to bite force than the examined dromaeosaurids, but given the hypothesised ecological divergence of troodontids from dromaeosaurids it is unclear which group, if either, represents the ancestral condition. Future work extending sampling to troodontids would therefore be invaluable and provide much needed context to the origin of skull form and function in early birds. This study illustrates how skull shape and functional metrics can discern non-avialan theropod ecology at lower taxonomic levels and identify variants of carnivorous feeding.

Leonard Rowntree, Louis Wilson, Fielding Garrison, and the origins of teaching medical history at the Mayo Clinic.

A visiting surgeon described his disappointment with an aspect of the Mayo Clinic in 1914, stating that there was "the almost lack of anything that could be dignified by the term 'lecture.'" One year later, the Mayo Foundation for Medical Education and Research was founded. By 1917, the foundation declared history of medicine a graduate-level subject, and history of medicine questions were included in final oral examinations. In 1920 and 1921, lectures were given on historical topics; however, these lectures petered out, and there were no historical lectures in the official curriculum of 1923 or 1924. Enter Leonard Rowntree, who in 1926 proposed a lecture series on the history of medicine. Rowntree wrote to Fielding Garrison in early 1927 to ask for assistance selecting speakers. The two men corresponded and developed a list of eminent medical historians to invite, including Sir Charles Ballance, William Welch, and Garrison himself. These lectures served to enrich the greater Midwestern medical community as well thanks to Louis Wilson. Then head of the Mayo Foundation, Wilson wrote to nearby institutions to create a lecture circuit for speakers who traveled to the Mayo Clinic. Ultimately, the lectures were published as a book in 1933.

Understanding South Korean women workers' career transition experiences: using the career decision tree model.

Introduction: Relatively little research has explored non-Western women workers and their career transitions within their unique cultural contexts. Thus, more context-sensitive approaches to women's career trajectories are needed. Methods: Based on Bian and Wang's Career Decision Tree Model (2019) as a conceptual framework, the reasons for South Korean women workers' career transitions and influencing factors were explored using a qualitative approach with in-depth interviews with 35 South Korean women workers at various career stages. Results and Discussion: Their main motive of career transitions was difficulty maintaining their physical and mental health, which stemmed from their demanding work life. A typical issue, the burden of child rearing and family responsibilities, was also reported, but it was not the primary reason for their career transitions. Instead, the women workers often mentioned these responsibilities along with other reasons. Other reasons were unresolved career interests and expectations associated with their lack of career goals and preparation prior to joining the labor market. These factors led to significant changes in women's values and priorities along their career path, which finally triggered a decision to make a career transition. South Korean socio-cultural characteristics embedded in the South Korean women's personal and organizational lives provide insights on how to interpret the findings. Although on the surface some of our findings appeared to confirm previous studies on women's career transitions in Western-based literature, noteworthy differences were discovered when delving deeper into women's career transitions in the South Korean context.

60 Years of the 3Rs symposium: Lessons learned and the road ahead.

When The Principles of Humane Experimental Technique was published in 1959, authors William Russell and Rex Burch had a modest goal: to make researchers think about what they were doing in the laboratory - and to do it more humanely. Sixty years later, their groundbreaking book was celebrated for inspiring a revolution in science and launching a new field: The 3Rs of alternatives to animal experimentation. On November 22, 2019, some pioneering and leading scientists and researchers in the field gathered at the Johns Hopkins Bloomberg School of Public Health in Bal-timore for the 60 Years of the 3Rs Symposium: Lessons Learned and the Road Ahead. The event was sponsored by the Johns Hopkins Center for Alternatives to Animal Testing (CAAT), the Foundation for Chemistry Research and Initiatives, the Alternative Research & Development Foundation (ARDF), the American Cleaning Institute (ACI), the International Fragrance Association (IFRA), the Institute for In Vitro Sciences (IIVS), John "Jack" R. Fowle III, and the Society of Toxicology (SoT). Fourteen pres-entations shared the history behind the groundbreaking publication, international efforts to achieve its aims, stumbling blocks to progress, as well as remarkable achievements. The day was a tribute to Russell and Burch, and a testament to what is possible when people from many walks of life - science, government, and industry - work toward a common goal.

William Russell and Rex Burch published their book The Principles of Humane Experimental Technique in 1959. The book encouraged researchers to replace animal experiments where it was possible, to refine experiments with animals in order to reduce their suffering, and to reduce the number of animals that had to be used for experiments to the minimum. Sixty years later, a group of pioneering and leading scientists and researchers in the field gathered to share how the publi­cation came about and how the vision inspired international collaborations and successes on many different levels including new laws. The paper includes an overview of important milestones in the history of alternatives to animal experimentation.

Lorenz Fries on the defense of Avicenna, the prince of physicians: Addressed to the medics of Germany (1530).

During the 14th century CE, a pivotal shift took place in the world of medicine as its epicenter transitioned from the Middle East to Europe. The emergence of the European Renaissance sparked skepticism regarding the significance of Avicenna's contributions to the advancement of medicine. This paper explores how the rise of secularization and the Renaissance in Europe marked significant cultural transformations, fostering the spread of literacy. These societal shifts influenced the trajectory of medical thought, and Avicenna's "Canon of Medicine" received both praise and condemnation amidst the evolving intellectual landscape. In this context, Lorenz Fries composed his "Defense of Avicenna," a testament to his profound admiration for Avicenna's legacy. This paper presents an English translation of Fries' 1530 work, and introduces Fries and Avicenna's "Canon," contextualizing Fries' defense within the broader rejection of Arab-language medical texts in the 16th century. It also explores Avicenna's influence on European medicine and anatomy during the Renaissance and highlights the enduring relevance of his contributions to the annals of science. Fries' defense underscores Avicenna's methodological acumen and emphasizes the importance of a robust theoretical foundation in medical practice. Avicenna's integration of Aristotelianism with Platonism highlighted the necessity of a rigorous method informed by theory in medical analysis. Fries' defense remains relevant today, particularly in advocating for systematic medical analysis against subjective approaches. Avicenna's medical philosophy seems nested within a larger, hopeful attempt to resolve the tensions between science or naturalism and religion or spiritualism. The rejection of Avicenna reflects broader conflicts between Aristotelian and Neoplatonic traditions, suggesting a complex interplay of secularization and theological influences in shaping medical thought during the Renaissance.

The Evolution of Genetic Testing from Focused Testing to Panel Testing and from Patient Focused to Population Testing: Are We There Yet?

The field of cancer genetics has evolved significantly over the past 30 years. Genetic testing has become less expensive and more comprehensive which has changed practice patterns. It is no longer necessary to restrict testing to those with the highest likelihood of testing positive. In addition, we have learned that the criteria developed to determine who has the highest likelihood of testing positive are neither sensitive nor specific. As a result, the field is moving from testing only the highest risk patients identified based on testing criteria to testing all cancer patients. This requires new service delivery models where testing can be mainstreamed into oncology clinics and posttest genetic counseling can be provided to individuals who test positive and those with concerning personal or family histories who test negative. The use of videos, testing kiosks, chatbots, and genetic counseling assistants have been employed to help facilitate testing at a larger scale and have good patient uptake and satisfaction. While testing is important for cancer patients as it may impact their treatment, future cancer risks, and family member's cancer risks, it is unfortunate that their cancer could not be prevented in the first place. Population testing for all adults would be a strategy to identify individuals with adult-onset diseases before they develop cancer in an attempt to prevent it entirely. A few research studies (Healthy Nevada and MyCode) have offered population testing for the three Centers for Disease Control and Prevention Tier 1 conditions: hereditary breast and ovarian cancer syndrome, Lynch syndrome, and familial hypercholesterolemia finding a prevalence of 1 in 70 individuals in the general population. We anticipate that testing for all cancer patients and the general population will continue to increase over the next 20 years and the genetics community needs to help lead the way to ensure this happens in a responsible manner.