UNASSIGNED: While the provision of unapproved regenerative medicine has been problematic worldwide, few studies have examined the implementation status of regenerative medicine (RM) in the specific field. This study aimed to determine the current status of therapy and clinical research in the obstetrics and gynecology (OBGYN) in Japan under the Act on the Safety of Regenerative Medicine (RM Act).
UNASSIGNED: Detailed data were extracted from publicly available websites provided by the Ministry of Health, Labour, and Welfare. We extracted descriptive details, including risk classification of the RM Act, modality, target disease, locality, institution, and administration route. For therapy, the price for each modality was evaluated.
UNASSIGNED: The total number of therapeutic provision plans in OBGYN (1.9% of RM in Japan) are classified as Class II (moderate) risk. Most were administered in clinics in urban areas for treating endometrial or ovarian infertility by locally administering platelet-rich plasma (PRP) or autologous mesenchymal stem cells (MSCs). The price using MSCs is approximately eight times more expensive that of those involving PRP (1832.1 ± 1139.8 vs 240.8 ± 106.5 thousand yen, p < 0.0001). Regarding research, four plans (2.2%) were submitted to target implantation failure and advanced gynecological cancer using autologous lymphocytes, dendritic cells, or MSCs.
UNASSIGNED: The RM Act permits knowledge of the current status of regenerative medicine even for unapproved uses in a specific clinical field. The study findings shall prompt a worldwide discussion regarding the required regulations for therapy and clinical research of RM.

Autism in Systemic Group Psychotherapy: \"Strong Together\" a Care Model for Children and Adolescents from Practice Awareness of people with autism in our society is constantly increasing. Nevertheless, ambiguities and caution in dealing with autistic clients are still tangible. Due to the growing demand, there is a shortage of care for clients on the autism spectrum. This applies in particular to group therapy services in German-speaking countries. However, the international AWMF guidelines state that group therapy is the therapy method of choice for children and adolescents with autistic perception. In order to counteract this gap in care, this article presents a systemic group therapy for autistic people. It explains the extent to which the systemic approach in combination with a multimodal approach is a beneficial approach. It also highlights the importance of expanding the range of care services, interdisciplinary cooperation, and exchange. The compatibility of practice and research in systemic psychotherapy will be explained, teamwork in private practice will be emphasized, therapeutic experiences will be shared and an outlook on ongoing evaluation research will be presented.
Zusammenfassung Die Sensibilität für Menschen mit Autismus in unserer Gesellschaft nimmt stetig zu. Dennoch sind weiterhin Unklarheiten und Vorsicht im Umgang mit autistischen Klient:innen fassbar. Durch die wachsende Nachfrage existiert eine Versorgungsknappheit für Klient:innen im Autismus-Spektrum. Insbesondere betrifft dies gruppentherapeutische Angebote im deutschsprachigen Raum. Den internationalen Leitlinien der AWMF ist jedoch zu entnehmen, dass Gruppentherapie für Kinder und Jugendliche mit Autismus die Therapiemethode der ersten Wahl darstellt. Um dieser Versorgungslücke entgegenzuwirken, wird in diesem Artikel eine systemische Gruppentherapie für autistische Menschen vorgestellt. Es wird erläutert, inwiefern die systemische Haltung in Kombination mit einem multimodalen Ansatz einen gewinnbringenden Zugang darstellt. Zudem wird die Wichtigkeit der Erweiterung von Versorgungsangeboten, interdisziplinären Zusammenarbeit und Austausches aufgezeigt. Es wird die Vereinbarkeit von Praxis und Forschung in der systemischen Psychotherapie erläutert, Teamarbeit im niedergelassenen Bereich hervorgehoben, therapeutische Erfahrungen geteilt und ein Ausblick über die laufende Evaluationsforschung präsentiert.

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UNASSIGNED: The transition from residency training into practice is associated with increasing risks of litigation, burnout, and stress. Yet, we know very little about how best to prepare graduates for the full scope of independent practice, beyond ensuring clinical competence. Thus, we explored the transition to independent practice (TTP) experiences of recent Obstetrics and Gynaecology graduates to understand potential gaps in their perceived readiness for practice.
UNASSIGNED: Using constructivist grounded theory, we conducted semi-structured interviews with 20 Obstetricians/Gynaecologists who graduated from nine Canadian residency programs within the last five years. Iterative data collection and analysis led to the development of key themes.
UNASSIGNED: Five key themes encompassed different practice gaps experienced by participants throughout their transition. These practice gaps fit into five competency domains: providing clinical care, such as managing unfamiliar low-risk ambulatory presentations; navigating logistics, such as triaging referrals; managing administration, such as hiring or firing support staff; reclaiming personhood, such as boundary-setting between work and home; and bearing ultimate responsibility, such as navigating patient complaints. Mitigating factors were found to widen or narrow the extent to which new graduates experienced a practice gap. There was a shared sense among participants that some practice gaps were impossible to resolve during training.
UNASSIGNED: Existing practice gaps are multi-dimensional and perhaps not realistically addressed during residency. Instead, TTP mentorship and training opportunities must extend beyond residency to ensure that new graduates are equipped for the full breadth of independent practice.
UNASSIGNED: Le passage de la résidence à la pratique est associé à des risques croissants de litiges, d\'épuisement professionnel et de stress. Pourtant, nous savons très peu de choses sur la meilleure façon de préparer les diplômés à l\'ensemble du champ d’application d’une pratique indépendante, au-delà de veiller à la compétence clinique. Nous avons donc exploré les expériences de transition vers la pratique indépendante de récents diplômés en obstétrique et gynécologie afin de comprendre les lacunes potentielles dans leur perception de leur préparation à la pratique.
UNASSIGNED: En utilisant la théorie constructiviste ancrée, nous avons mené des entrevues semi-structurées avec 20 obstétriciens et gynécologues diplômés de neuf programmes de résidence canadiens au cours des cinq dernières années. La collecte et l\'analyse itératives des données ont permis de dégager des thèmes clés.
UNASSIGNED: Cinq thèmes clés englobaient différentes lacunes dans la pratique rencontrées par les participants tout au long de leur transition. Ces lacunes s\'inscrivent dans cinq domaines de compétences : la prestation de soins cliniques, comme la gestion de modes de présentation ambulatoires peu familiers et à faible risque; la gestion de la logistique, comme le triage des demandes de consultation; la gestion de l\'administration, comme l\'embauche ou le licenciement du personnel de soutien; la récupération de l\'identité personnelle, comme l\'établissement de limites entre le travail et la maison; ainsi que le fait d’assumer la responsabilité ultime, comme la gestion des plaintes des patients. On a constaté que certains facteurs accroissaient ou réduisaient la la perception des nouveaux diplômés d’une lacune dans leur pratique. Les participants étaient tous d\'avis qu\'il était impossible de combler certaines lacunes dans la pratique au cours de la formation.
UNASSIGNED: Les lacunes existantes dans la pratique sont multidimensionnelles et ne peuvent peut-être pas être comblées de manière réaliste pendant la résidence. Les possibilités de mentorat et de formation en ce qui a trait à la transition vers la pratique doivent plutôt s\'étendre au-delà de la résidence afin de veiller à ce que les nouveaux diplômés soient préparés à tous les aspects d’une pratique indépendante.

Over the course of the past twenty years, private equity (PE) has played a role in acquiring medical practices, hospitals, and nursing homes. More recently, PE has taken a greater interest in acquiring dental practices, but few data exist about the scope of PE activity within dentistry. We analyzed dentist provider data for the period 2015-21 to examine trends in PE acquisition of dental practices. The percentage of dentists affiliated with PE increased from 6.6 percent in 2015 to 12.8 percent in 2021. During this period, PE affiliation increased particularly among larger dental practices and among dental specialists such as endodontists, oral surgeons, and pediatric dentists. PE-affiliated dental practices were more likely to participate in Medicaid than practices not affiliated with PE. Future research should investigate whether PE\'s role in dentistry affects the affordability and quality of dental services.

OBJECTIVE: The neuroradiology job market is constantly changing along with the skill sets needed by fellowship graduates to participate successfully in the job market. This study aimed to establish a baseline of employer requirements in the neuroradiology job market within the study timeframe.
METHODS: The American Society of Neuroradiology and American College of Radiology job boards were queried for neuroradiology positions between August 12, 2022, and December 31, 2022. The positions and requirements were categorized into academic versus private practice, general diagnostic radiology, full-subspecialized neuroradiology, hybrid remote/onsite, outpatient, inpatient/emergency, general interventional radiology procedures, and neuroradiology procedures. Exclusion criteria included neurointerventional only, remote-only, pediatric-only, no preference for neuroradiology, and duplicate posts within and between the job boards.
RESULTS: Of 1777 total job posts, 179 were neuroradiology-specific and the remainder were general. Of the 179 neuroradiology-specific jobs, 55 neuroradiology jobs were academic and 124 jobs were private practice. A higher proportion of private practice jobs required general diagnostic interpretations (83% versus 26%), a higher proportion of academic jobs required neuroradiology procedures (56% versus 31%), and a higher proportion of private practice jobs required general interventional radiology procedures (22% versus 0%). Thirty-nine percent of all neuroradiology-specific onsite jobs required neuroradiology procedures, and 15% required general interventional radiology procedures.
CONCLUSIONS: Because there was a sizable difference between general radiology and procedure requirements between academic and private practice positions, tailoring fellowship training for career aspirations of neuroradiology fellows should be considered to adapt to the skills needed for the evolving job market. In the queried timeframe, 61% of neuroradiology-specific onsite jobs did not have a specific procedure skill requirement for job applicants. This article serves as a single snapshot of the job market and its requirements for neuroradiologists, to aid in planning training to meet the needs of employers.

BACKGROUND: Nail excisions are indicated for onychocryptosis and nail spicules. They are technically demanding and require a refined skill set. We aimed to characterize practice patterns of US providers performing nail excisions.
METHODS: We conducted a retrospective analysis of Medicare provider use and payment data, part D, for all claims of partial or complete nail/nail matrix excision with/without nail plate removal/destruction (current procedural terminology code 11750). High performers were defined as providers performing annual nail excisions 2 standard deviations above the mean. We analyzed demographic risk factors for nail excision high performers, including practice location, years of experience, household median income, practice type, and provider gender. Statistical analysis was conducted in SAS v9.4, with values of P < .05 considered statistically significant.
RESULTS: Providers (n = 32,279) and high performers (n = 942) performed mean 34.7 and 173 nail excisions annually. Unsurprisingly, podiatrists constituted 99.7% of all nail excision performers. Providers in the South versus Midwest and Northeast were more often nail excision high performers (odds ratio [OR], 1.95; P < .0001, and OR, 1.46; P < .0001). Solo versus group practitioners were more likely, respectively, to be nail excision high performers (OR, 2.15; P < .0001). With linear regression analysis, for every 10-year increase in years of provider experience, there was an increase of 1.2 nail excisions annually per provider (P < .0001). For every $100,000 increase in household median income of practice location, there was a decrease of 9.9 nail excisions annually per provider.
CONCLUSIONS: Southern podiatrists, podiatrists with more years of experience, solo practitioners, and those practicing in regions with lower household median incomes were more likely to perform higher numbers of nail excisions. Identifying performance trends among podiatrists can help podiatrists understand how their performance of nail excisions compares to other podiatrists across the country.

Over the past century, family physicians have moved from small independently owned practices, many of them solo, to being employed by large hospital systems, corporate entities, or health systems. Today, almost three-quarters of all physicians are employed and the highest percentage of employed physicians are family physicians.This essay contrasts the elements of independent practice with employed practice as part of what has been lost in the past half century, but what might be regained if physicians demanded more autonomy and control over their practices.

BACKGROUND: Periodontitis is one of the most prevalent oral diseases with significant implications for systemic health. This study aims to explore themes influencing successful long-term outcomes in periodontal treatment through a historical lens, focusing on various factors influencing the longevity of periodontal health and dentition stability.
METHODS: Utilizing an inductive qualitative thematic analysis approach, this study utilized a retrospective chart review of 19 patient records spanning, on average, 40 years.
RESULTS: Four major themes contributing to periodontal stability were identified: (1) adequate patient plaque control; (2) regular periodontal maintenance; (3) collaboration between hygienists and periodontists; and (4) the application of various periodontist/dentist-performed procedures.
CONCLUSIONS: Current findings underscore the importance of these factors in preserving patients\' periodontal health by emphasizing conservative treatment approaches in the maintenance and retention of the natural dentition.
CONCLUSIONS: Adequate patient plaque control is essential for maintaining a patient\'s periodontal health and dentition long-term. A regular periodontal maintenance schedule should be assigned and modified as necessary for each individual patient\'s care. Collaborative care with hygienist colleagues and ensuring there are flexible treatment options for patients can lead to successful treatment outcomes when hygiene alone is not sufficient.
CONCLUSIONS: Periodontitis is a widespread oral disease with significant systemic health implications. This study examined patient records to identify factors contributing to long-term periodontal stability and maintenance of teeth. By analyzing 19 patient charts over an average of 40 years using a qualitative approach, four key themes were identified in successful patient treatments: effective patient plaque control, regular periodontal maintenance, collaboration between dental hygienists and periodontists, and the addition of other approaches by periodontists and dentists when necessary. The study underscores the importance of these factors in preserving periodontal health and retaining natural teeth with conservative treatment approaches. This research highlights the critical role of sustained, multifaceted dental care and professional collaboration in achieving successful long-term oral and systemic health outcomes.

Owning and operating an Office-Based Lab (OBL) creates a unique career, combining the privilege of practicing Interventional Radiology (IR) with the creativity and excitement of running a complex business. No business is more complicated than the American Healthcare system, with a combination of necessary operational systems, government and commercial reimbursement, local and national regulations, an ever-changing landscape, and various patient populations; the business is always shifting. No field is as complex and exciting as Interventional Radiology, with advanced clinical and technical expertise, device development, rocedural ingenuity, and the ability to solve complex medical problems with elegant solutions. A sole owner and operator in an OBL has full autotomy, and thus full responsibility for the medical and business aspects of the practice.