Organizational Engagement: One State's Experience With Invigorating Affiliate Membership and Building a Sustainable Fundraising Model.

Over the last 6 years, the Pennsylvania Affiliate of the American College of Nurse-Midwives has worked to meet the needs of its diverse membership and increase the capacity of the affiliate board by taking a series of strategic steps. This article details the key components of this journey, which has culminated in a successful annual conference with over $118,000 in net revenue to help meet affiliate goals, including pursuing midwifery modernization legislation for Pennsylvania and an increase in our affiliate membership by almost 100 individuals. The annual conference, Midwifery Forward, which completed its fifth year in 2023, has also given our community of midwives a yearly reason to gather and reconnect, celebrate accomplishments, welcome new graduates, and make plans for the year ahead.

Term prelabor rupture of membranes: immediate induction is the optimal management.

Term prelabor rupture of membranes, defined as rupture of membranes before the onset of labor at ≥37 weeks of gestation, is a common obstetrical event occurring in 8% of pregnancies. However, most relevant guidelines are inconclusive regarding the management of this condition and the optimal timing of induction of labor. Here, we present evidence from randomized controlled trials and a recent meta-analysis indicating that an immediate induction of labor in term premature rupture of membranes is associated with several maternal and neonatal benefits compared with expectant management, without increasing the risk of cesarean delivery.

An Unfortunate Cause of Chronic Nausea and Vomiting: Mitochondrial Neurogastrointestinal Encephalomyopathy (MNGIE).

We present a unique case of a 24-year-old male who was admitted for intractable nausea, emesis, weight loss, and abdominal discomfort. The patient underwent an extensive workup and was diagnosed with mitochondrial neurogastrointestinal encephalopathy. Early diagnosis is critical to proper management of this disease process.

The impact of double-blind peer review on gender bias in scientific publishing: a systematic review.

Objective: Gender-based bias during journal peer review can lead to publication biases and perpetuate gender inequality in science. Double-blind peer review, in which the names of authors and reviewers are masked, may present an opportunity for scientific literature to increase equity and reduce gender-based biases. This systematic review of studies evaluates the impact of double-blind vs single-blind peer review on the publication rates by perceived author gender.

Evidence-based labor management: second stage of labor (part 4).

Several interventions during the second stage of labor have been identified and investigated. Prophylactic intrapartum betamimetics should be avoided, as their usage is associated with an increase in operative vaginal deliveries. Women without epidural anesthesia are recommended to give birth in any upright or lateral position.

Cervical ripening with laminaria tents prior to second trimester induction of labor.

Background: Induction abortion in the second trimester may be favored in some instances, such as in women with compounding medical conditions or when skilled providers are not available. Various methods of pre-induction cervical preparation have been used to shorten the length of induction and decrease the risk of complications. The benefits of cervical preparation with laminaria before D&E have been well studied, but the benefits of laminaria before medical induction are less clear.

A comparative study of PCS and PAM50 prostate cancer classification schemes.

Background: Two prostate cancer (PC) classification methods based on transcriptome profiles, a de novo method referred to as the "Prostate Cancer Classification System" (PCS) and a variation of the established PAM50 breast cancer algorithm, were recently proposed. Both studies concluded that most human PC can be assigned to one of three tumor subtypes, two categorized as luminal and one as basal, suggesting the two methods reflect consistency in underlying biology. Despite the similarity, differences and commonalities between the two classification methods have not yet been reported.

Evidence-based labor management: first stage of labor (part 3).

There are several interventions during the first stage of labor that have been studied. Vaginal disinfection with chlorhexidine cannot be recommended. Intrapartum antibiotic prophylaxis is recommended for group B streptococcus-positive women.

Evidence-based labor management: induction of labor (part 2).

Induction of labor is indicated for many obstetrical, maternal, and fetal indications. Induction can be offered for pregnancy at 39 weeks' gestation. No prediction method is considered sensitive or specific enough to determine the incidence of cesarean delivery after induction.

Transvaginal ultrasound training for the obstetrics and gynecology resident: A multisite randomized controlled trial of educational DVD.

Purpose: Residents in obstetrics and gynecology are deemed to be proficient in transvaginal ultrasound (TVUS) upon graduation, although TVUS education in residency is not standardized. The objective of this study is to assess for improvement in TVUS knowledge among residents after viewing an educational DVD.

Methods: This is a multisite prospective randomized controlled trial using an educational DVD ("Gynecology: Beginners Only"), compared to routine education.

Long-acting reversible contraception in adolescents in Sub-Saharan Africa: evidence from demographic and health surveys.

Objective: To explore (1) long-acting reversible contraception (LARC) use and (2) future contraceptive preferences in Sub-Saharan African adolescents as undesired pregnancies in Sub-Saharan African adolescents are associated with significant maternal/neonatal morbidity.

Methods: Nationally-representative Demographic and Health Surveys (USAID) obtained informed consent and interviewed 45,054 adolescents, including 19,561 (43.4% of total) sexually active adolescents (aged 15-19) from 18 least developed Sub-Saharan African nations regarding contraception (years 2005-2011, response rate 89.

Safety and Efficacy of Exenatide Once Weekly Plus Dapagliflozin Once Daily Versus Exenatide or Dapagliflozin Alone in Patients With Type 2 Diabetes Inadequately Controlled With Metformin Monotherapy: 52-Week Results of the DURATION-8 Randomized Controlled Trial.

Objective: Among patients with type 2 diabetes uncontrolled with metformin, exenatide once weekly (QW) plus dapagliflozin combination produced greater reductions in glycemia, weight, and systolic blood pressure (SBP) at 28 weeks than exenatide QW or dapagliflozin alone (DURATION-8). Here, we investigated the safety and maintenance of efficacy at 52 weeks, after a 24-week extension.

Research Design And Methods: This phase 3, multicenter, double-blind study randomized adults with type 2 diabetes (with glycated hemoglobin [HbA] 8.

Opioid Utilization by Pregnant Women with Sickle Cell Disease and the Risk of Neonatal Abstinence Syndrome.

Background: Pregnant women with sickle cell disease (SCD) are at increased risk of maternal and fetal complications. There are limited data on the outcome of the treatment of VOCs with opioids in relation to neonatal complications during pregnancy.

Methods: This is a retrospective cohort study of women with SCD from January 1999 to December 2008.

An expert consensus for the management of chronic hepatitis B in Asian Americans.

Background: Hepatitis B virus (HBV) infection is common with major clinical consequences. In Asian Americans, the HBsAg carrier rate ranges from 2% to 16% which approximates the rates from their countries of origin. Similarly, HBV is the most important cause of cirrhosis, hepatocellular carcinoma (HCC) and liver related deaths in HBsAg positive Asians worldwide.

Common error pathways seen in the RO-ILS data that demonstrate opportunities for improving treatment safety.

Purpose: The Radiation Oncology Incident Learning System (RO-ILS) receives event reports from facilities across the country. This effort extracted common error pathways seen in the data. These pathways, expressed as fault trees, demonstrate the need for, and opportunities for, preventing these errors and/or limiting their propagation to treatment.

Adjuvant Sunitinib in High-Risk Patients with Uveal Melanoma: Comparison with Institutional Controls.

Purpose: To compare overall survival in high-risk patients with primary uveal melanoma who received adjuvant sunitinib with institutional controls.

Design: Retrospective cohort.

Participants: Selection criteria were (1) monosomy 3 and 8q amplification by cytogenetic or DecisionDx-UM Class 2 and (2) monosomy 3 and large tumor size (T3-4 by American Joint Committee on Cancer classification).

Results of a curtailed randomized controlled trial, evaluating the efficacy and safety of azimilide in patients with implantable cardioverter-defibrillators: The SHIELD-2 trial.

Background: Frequent hospital attendances in patients with implantable cardioverter-defibrillators (ICDs) result in significant morbidity and health care costs. Current drugs to reduce ICD shocks and hospital visits have limited efficacy and considerable toxicity. We evaluated the efficacy and safety of azimilide, a novel oral class III antiarrhythmic, for use in ICD patients.

Endothelium in the pharyngeal arches 3, 4 and 6 is derived from the second heart field.

Oxygenated blood from the heart is directed into the systemic circulation through the aortic arch arteries (AAAs). The AAAs arise by remodeling of three symmetrical pairs of pharyngeal arch arteries (PAAs), which connect the heart with the paired dorsal aortae at mid-gestation. Aberrant PAA formation results in defects frequently observed in patients with lethal congenital heart disease.