COMMENTARY DISCLOSURES Authors and DisclosuresAuthors Noelle LoConte, MD Associate Professor of Medicine; Faculty Member, Division of Hematology, Medical Oncology, and Palliative Care; Director of Outreach, UW Carbone Cancer Center; University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Disclosure: Noelle LoConte, MD, has disclosed the following relevant financial relationships:Received research funding from: Exact SciencesReceived compensation from: National Cancer Institute as a monograph reviewer Kristine E. Torres-Lockhart, MD Assistant Professor of General Internal Medicine and Psychiatry, Albert Einstein College of Medicine; Director, Addiction Medicine Fellowship, Montefiore Einstein; Founding Director, Addiction Consult Service, Weiler Hospital; Bronx, New York Disclosure: Kristine E. Torres-Lockhart, MD, has disclosed no relevant financial relationships. Nathaniel Chin, MD Associate Professor, Department of Medicine, Division of Geriatrics and Gerontology; Associate Program Director, UW Health Memory Clinic; Medical Director, Wisconsin Alzheimer's Disease Research Study; Medical Director, Wisconsin Registry for Alzheimer's Prevention Study; Medical Director, ADRC Consortium for Clarity in ADRD Research Through Imaging (CLARiTI), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Disclosure: Nathaniel Chin, MD, has disclosed the following relevant financial relationships:Serve(d) as a consultant or advisor for: New Amsterdam Pharma Inc (1-day advisory panel, July 2023); Eli Lilly Inc (2-day advisory panel, January 2025)Serve(d) as a volunteer board member for: Medical and Scientific Board, Wisconsin Alzheimer's Association; Alzheimer's Foundation of America | May 27, 2025 Disclosure: Noelle LoConte, MD, has disclosed the following relevant financial relationships:Received research funding from: Exact SciencesReceived compensation from: National Cancer Institute as a monograph reviewer Disclosure: Kristine E. Torres-Lockhart, MD, has disclosed no relevant financial relationships. Disclosure: Nathaniel Chin, MD, has disclosed the following relevant financial relationships:Serve(d) as a consultant or advisor for: New Amsterdam Pharma Inc (1-day advisory panel, July 2023); Eli Lilly Inc (2-day advisory panel, January 2025)Serve(d) as a volunteer board member for: Medical and Scientific Board, Wisconsin Alzheimer's Association; Alzheimer's Foundation of America Dr LoConte spotlights emerging research that now ties alcohol to cancers beyond the well-known “big seven,” including prostate, pancreatic, and stomach cancers. Despite this growing evidence, many physicians still don't ask patients about alcohol use. She urges clinicians — especially oncologists — to normalize these conversations in everyday care, provide nonstigmatizing support, and acknowledge how deeply embedded drinking is in social norms. It's a call to action to reframe alcohol as a critical lifestyle factor in cancer care. — WATCH NOW for exclusive insights and the latest on mastering medical school. Any views expressed above are the author's own and do not necessarily reflect the views of WebMD/Medscape or its affiliates.

The guidelines, published in ASH's peer-reviewed journal Blood Advances, were developed by an expert panel following a rigorous review process. They aim to improve health outcomes by providing evidence-based recommendations for managing VTE in children. Specifically, this recommendation advises clinicians to consider dabigatran or rivaroxaban over therapies such as low molecular weight heparin and vitamin k antagonist. "These evidence-based guidelines are a key resource for clinicians to improve the quality of care for this vulnerable population," said Belinda R. Avalos, MD, ASH president. Collaborating with ASH on these updated pediatric VTE guidelines reflects the ISTH's commitment to ensuring that children affected by VTE receive the most effective, evidence-based care. It's critical that we continue advancing research and education in this area to support better outcomes for young patients worldwide." VTE sometimes manifests as deep vein thrombosis, when a blood clot forms in the deep veins, or pulmonary embolism, when a blood clot blocks an artery in the lung. Although the incidence of VTE in children at a population level is very low, it is higher in children who are hospitalized and can be life-threatening. "Thrombosis in children is an increasingly common complication in children with complex illnesses and conditions and, if not managed well, can impact long-term outcomes for these patients," said Paul Monagle, MD, MBBS, MSc, a pediatric hematologist and professor of pediatrics at the University of Melbourne and chair of the ASH ISTH Guidelines on Treatment of Pediatric VTE. "The care of children is important, and parents should know that there is a body of evidence that supports their child's treatment options." Rui Tostoes, Chief Technology Officer at ImmuneBridge, shares how his team is redefining preclinical development and large-scale manufacturing for allogeneic cell therapies. Advancing GPCR drug discovery with fragment screening using GCI technology Evotec's insights into GPCRs and waveRAPID technology reveal new opportunities in drug discovery, focusing on orphan receptors and innovative screening methods. News-Medical.Net provides this medical information service in accordance with these terms and conditions. Please note that medical information found on this website is designed to support, not to replace the relationship between patient and physician/doctor and the medical advice they may provide. Hi, I'm Azthena, you can trust me to find commercial scientific answers from News-Medical.net. Registered members can chat with Azthena, request quotations, download pdf's, brochures and subscribe to our related newsletter content. A few things you need to know before we start. While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles. Please do not ask questions that use sensitive or confidential information.

As part of a $93 million grant package, the Cancer Prevention and Research Institute of Texas, known for funding groundbreaking projects, has awarded the University of Houston $3 million to set up a Cancer Immunotherapy Biomarker Core. This state-of-the-art facility will offer researchers in Texas the most comprehensive targeted proteomic cancer biomarker screens currently feasible, particularly in the field of cancer biology and immunotherapy. UH CIBC will be the first such facility in Texas to offer targeted proteomics, which is the technology that makes it possible to study thousands of proteins at once and will offer its services at a minimized cost partly subsidized by CPRIT funding. All of these will lead to reduced cancer associated morbidity and mortality." "Cancer immunotherapy is experiencing a meteoric rise, and this new chapter in oncology demands a new array of biomarkers, including blood and tissue biomarkers that predict who might respond best to immunotherapy, and biomarkers that help researchers identify the best targets for immunotherapy," said Mohan. To meet these needs the CIBC will offer four unique platforms that include a 11,000- plex targeted proteomic screen that allows 11,000 specific proteins to be screened in any single body fluid sample, representing the largest proteomic coverage possible, as well as 21,000-plex protein array platform that allows scientists to assess the specificity of autoantibodies/ligands against the entire human proteome. To offer targeted exploratory proteomic technologies for protein biomarker discovery To offer targeted exploratory technologies for identifying novel autoantibodies, neoantigens and binding ligands To educate and promote the adoption of contemporary proteomic technologies among Texas researchers Mohan, an MD/PhD, has over two decades of expertise in engineering diagnostic arrays and using the platforms offered and is a member of the UH Drug Discovery Institute. He has reported novel biomarkers for colorectal, bladder, prostate, stomach and pancreatic cancers. She directs the Drug Discovery Institute Immunology Core, with more than 100 UH faculty members. Peng has long-standing expertise in immunoassays and has led projects on T cell-mediated anti-tumor immune response pathways using genetic screens and preclinical models. All CPRIT grant applications undergo rigorous, independent, unbiased, merit-based peer review. Rui Tostoes, Chief Technology Officer at ImmuneBridge, shares how his team is redefining preclinical development and large-scale manufacturing for allogeneic cell therapies. Advancing GPCR drug discovery with fragment screening using GCI technology News-Medical.Net provides this medical information service in accordance with these terms and conditions. Please note that medical information found on this website is designed to support, not to replace the relationship between patient and physician/doctor and the medical advice they may provide. Hi, I'm Azthena, you can trust me to find commercial scientific answers from News-Medical.net. Registered members can chat with Azthena, request quotations, download pdf's, brochures and subscribe to our related newsletter content. A few things you need to know before we start. While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles. Please do not ask questions that use sensitive or confidential information.

A one-year study in healthy women who were also consistently cycling every 21-36 days and had normal ovulation, showed that it is usual to experience mild breast tenderness and swelling before the next period. Breast tenderness and swelling are common concerns associated with the menstrual cycle. However, little research previously has indicated how or if these breast symptoms are linked with ovulation. "Previous research has not clarified if breast tenderness and swelling, that may be experienced before menstruation, are part of a 'premenstrual syndrome' (PMS) and thus a problem and abnormal, or are something that is to be expected," said Dr. Azita Goshtasebi, a family physician, and co-author who helped design the study. "Our study evaluated the experiences of 53 healthy women over the course of a year and found that minimal breast swelling and breast tenderness usually occurred before flow in regular, ovulatory menstrual cycles," reported the lead researcher, Dr. Mary Wood. She began this work as a medical student and is currently an internal medicine resident at the University of British Columbia. Dr. Sonia Shirin, co-author and UBC Centre for Menstrual Cycle and Ovulation research associate, explained: "Breast symptoms-including whether or not there was any breast tenderness and the breasts changed in size-were recorded daily in the Menstrual Cycle Diary©. Also, ovulation or egg release was confirmed using the validated Quantitative Basal Temperature© analysis in these community women over an average of 13 cycles each." This is the first longitudinal study to characterize breast experiences with confirmed ovulation. We were surprised to find that women actually had more breast tenderness and swelling when they had normal ovulation, compared to ovulatory disturbed cycles with short luteal phases (<10 days) or anovulation (no ovulation)." "There are possible long-term health consequences associated with disturbed ovulation within normal cycles including bone loss and risk for earlier heart attacks." "Note that the relationship of breast tenderness and swelling with normally ovulatory cycles was only possible to show when we examined the experiences of all 53 women in 491 ovulatory cycles versus the 199 with ovulatory disturbances. "That may be because we had fewer normally ovulatory cycles." This study included 53 women, ages 20-41, with menstrual cycle data from an average of 13 cycles each. Results showed that the median breast tenderness on a 0-4 scale was 1.4, and the change in breast size from usual on a 1-5 scale, where three represents no change, was 4. Breast tenderness and swelling experiences related to menstrual cycles and ovulation in healthy premenopausal women: Secondary analysis of the 1-year “Prospective Ovulation Cohort.” PLOS One. Rui Tostoes, Chief Technology Officer at ImmuneBridge, shares how his team is redefining preclinical development and large-scale manufacturing for allogeneic cell therapies. Advancing GPCR drug discovery with fragment screening using GCI technology News-Medical.Net provides this medical information service in accordance with these terms and conditions. Please note that medical information found on this website is designed to support, not to replace the relationship between patient and physician/doctor and the medical advice they may provide. Hi, I'm Azthena, you can trust me to find commercial scientific answers from News-Medical.net. Registered members can chat with Azthena, request quotations, download pdf's, brochures and subscribe to our related newsletter content. A few things you need to know before we start. While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles. Please do not ask questions that use sensitive or confidential information.

A specific group of nerve cells in the brain stem appears to control how semaglutide affects appetite and weight – without causing nausea. Semaglutide belongs to a group of drugs called GLP-1R agonists and has been shown to effectively reduce food intake and body weight. The drug is already well established as part of the treatment for obesity and type 2 diabetes, but can cause side effects such as nausea and muscle loss. In a new study, researchers at the Sahlgrenska Academy at the University of Gothenburg have shown that it is possible to distinguish the nerve cells in the brain that control the beneficial effects – such as reduced food intake and fat loss – from those that contribute to side effects. They tracked which nerve cells were activated by the drug and were then able to stimulate these cells – without administering the drug itself. The result was that the mice ate less and lost weight, just as they did when treated with semaglutide. When these nerve cells were killed, the drug's effect on appetite and fat loss instead decreased significantly. However, side effects such as nausea and muscle loss remained. This suggests that these nerve cells control the beneficial effects of semaglutide. We have therefore identified a specific group of nerve cells that is necessary for the effects that semaglutide has on weight and appetite, but which does not appear to contribute to any significant extent to side effects such as nausea. If we can target the treatment there, we may be able to maintain the positive effects while reducing side effects." For the researchers, the result is not only an early step toward potentially improved treatment, it also provides new knowledge about how semaglutide works in the brain. It is important to understand how these drugs actually work. Semaglutide effects on energy balance are mediated by Adcyap1+ neurons in the dorsal vagal complex. Rui Tostoes, Chief Technology Officer at ImmuneBridge, shares how his team is redefining preclinical development and large-scale manufacturing for allogeneic cell therapies. Advancing GPCR drug discovery with fragment screening using GCI technology Evotec's insights into GPCRs and waveRAPID technology reveal new opportunities in drug discovery, focusing on orphan receptors and innovative screening methods. Discover how hot melt extrusion supports polypharmacy reduction and novel therapies for stroke and snakebite with expert insights. News-Medical.Net provides this medical information service in accordance with these terms and conditions. Please note that medical information found on this website is designed to support, not to replace the relationship between patient and physician/doctor and the medical advice they may provide. Hi, I'm Azthena, you can trust me to find commercial scientific answers from News-Medical.net. Registered members can chat with Azthena, request quotations, download pdf's, brochures and subscribe to our related newsletter content. A few things you need to know before we start. Please check the box above to proceed. While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles. Please do not ask questions that use sensitive or confidential information.

The American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) published the new Clinical Practice Guideline (CPG): Surgical Management of Chronic Rhinosinusitis today in Otolaryngology–Head and Neck Surgery. Chronic rhinosinusitis (CRS) affects 11.6% of adults and prompts 4.1 million annual ambulatory visits. Chronic rhinosinusitis doesn't just affect the nose-it can influence a person's general life. Patients can struggle with poor sleep, brain fog, depression, anxiety, and reduced productivity that ripples through their relationships and work or school performance." Jennifer J. Shin, MD, SM, Chair of the CPG Guideline Development Group Patients with CRS face daily challenges that deserve our full attention and comprehensive care. This CPG provides the guidance for developing the needed care pathways for patients who may undergo surgery for CRS, based on current best evidence, such as systematic reviews, meta-analyses, and randomized control trials, as well as observational studies when these were more apt for specific clinical research questions." Some people with chronic sinus problems need surgery when medications alone don't provide enough relief. For certain types of sinus disease, having surgery sooner can help prevent worsening symptoms and reduce pain. Surgery works especially well for people who have fungal infections or nasal polyps (small growths), since these conditions often don't respond well to medication alone. Surgery may also help people whose sinus problems cause frequent infections, ongoing symptoms, or make other conditions like asthma worse. This CPG provides proven, research-based recommendations for the best ways to treat chronic sinus problems. Specifically, through 11 evidence-based key action statements, it covers the main surgery and additional treatments that might be needed, as well as follow-up procedures when necessary. The goal is to ensure patients receive excellent care before, during, and after their sinus surgery, while making sure doctors clearly explain treatment options and involve patients in making informed decisions about their care. The guideline development group consisted of 18 panel members representing experts in specialties/subspecialities encompassing rhinology, comprehensive otolaryngology, otolaryngic allergy, otorhinolaryngological advanced practice provision, as well as a consumer representative. Rui Tostoes, Chief Technology Officer at ImmuneBridge, shares how his team is redefining preclinical development and large-scale manufacturing for allogeneic cell therapies. Advancing GPCR drug discovery with fragment screening using GCI technology News-Medical.Net provides this medical information service in accordance with these terms and conditions. Please note that medical information found on this website is designed to support, not to replace the relationship between patient and physician/doctor and the medical advice they may provide. Hi, I'm Azthena, you can trust me to find commercial scientific answers from News-Medical.net. Registered members can chat with Azthena, request quotations, download pdf's, brochures and subscribe to our related newsletter content. A few things you need to know before we start. While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles. Please do not ask questions that use sensitive or confidential information.

Scientists have unearthed surprising details about how our bodies handle insulin – the hormone that plays a crucial role in regulating blood sugar and developing diabetes. In a new paper in the scientific journal Cell, researchers from the University of Copenhagen found that all individuals have unique and varying degrees of insulin resistance at the molecular level. The discovery of this 'molecular fingerprint' for insulin sensitivity challenges the traditional binary classification of people as being either healthy or living with type 2 diabetes. Our study highlights the need to move beyond separating people into two boxes and recognize individual variation." Atul Deshmukh, Associate Professor from the Novo Nordisk Foundation Center for Basic Metabolic Research, CBMR, University of Copenhagen The breakthrough was made using cutting-edge protein analysis, known as proteomics, to study how insulin affects muscle tissue. This approach enabled the team to map molecular changes in muscle biopsies from over 120 individuals. Their analyses revealed that certain proteins change consistently as insulin resistance develops. These molecular signatures could help identify people at risk earlier than current clinical methods allow – even before symptoms appear. "By learning more about the molecular signatures of insulin resistance, we're building the foundation for precision medicine in type 2 diabetes tailored to each patient. Our research is a big step in that direction," adds Anna Krook, Professor at Karolinska Institutet and co-lead author of the study. In addition, the researchers were able to use these molecular fingerprints to precisely predict how well the body handles insulin. "When we combine this deep, clinical data with the molecular signatures of insulin resistance, we suddenly understand a lot more about people's insulin resistance that we can use to design precision medicine," says Jeppe Kjærgaard Northcote, first author of the study and researcher at CBMR. Personalized molecular signatures of insulin resistance and type 2 diabetes. Rui Tostoes, Chief Technology Officer at ImmuneBridge, shares how his team is redefining preclinical development and large-scale manufacturing for allogeneic cell therapies. Advancing GPCR drug discovery with fragment screening using GCI technology Evotec's insights into GPCRs and waveRAPID technology reveal new opportunities in drug discovery, focusing on orphan receptors and innovative screening methods. News-Medical.Net provides this medical information service in accordance with these terms and conditions. Please note that medical information found on this website is designed to support, not to replace the relationship between patient and physician/doctor and the medical advice they may provide. Hi, I'm Azthena, you can trust me to find commercial scientific answers from News-Medical.net. Registered members can chat with Azthena, request quotations, download pdf's, brochures and subscribe to our related newsletter content. A few things you need to know before we start. While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles. Please do not ask questions that use sensitive or confidential information.

In a world first, Canadian scientists at the CRCHUM, the hospital research centre affiliated with Université de Montréal, have identified microRNA able to protect small blood vessels and support kidney function after severe injury. For the four million people diagnosed with chronic renal failure in Canada-and millions more abroad-this scientific advancement could have a major impact on early diagnosis and prevention of the disease. Previously, there was no known reliable biomarker for evaluating the health of these capillaries and for developing targeted approaches to preserve kidney function. UdeM medical professors Marie-Josée Hébert and Héloïse Cardinal, holders of the Shire Chair in Nephrology, Renal Transplantation and Regeneration, co-authored the study with Hébert's research associate Francis Migneault. Kidney injuries, caused by the temporary interruption and restoration of blood flow, can lead to a decrease in the number of small blood vessels, seriously disrupting kidney function. "Using this biomarker, a test could be developed to evaluate the status of the small blood vessels much earlier," she said. "Doctors in hospitals could then better evaluate the microvascular health of higher-risk patients. "These could include elderly patients or those undergoing surgeries during which blood flow is temporarily stopped, as is the case for organ transplants or cardiovascular interventions." "We first observed fluctuating levels of miR-423-5p microRNA in the blood of mice with acute kidney injuries," said Migneault, the study's first author. Thanks to this biomarker, clinical teams could confirm whether their interventions improve or diminish the health of small blood vessels. "But what's really incredible is that by injecting this microRNA into mice with kidney injuries, we were able to preserve the small blood vessels and limit the damage done to the kidneys," said Migneault. In terms of prevention, a test based on this miR-423-5p microRNA could be useful for patients with cardiac failure, pulmonary failure or certain neurodegenerative diseases. "For these medical conditions, the loss of small blood vessels plays a key role, because of the association with normal or accelerated aging," said Hébert. "Our discovery could, therefore, have a significant impact on the health of all Canadians." For those with pulmonary failure, several research projects are in progress under Emmanuelle Brochiero, a researcher and head of the Immunopathology research theme at the CRCHUM. It may also be possible, using the CHUM's biological material biobank, to determine if existing medications, administered after a kidney transplant to treat another issue, impact small blood vessel health, added Hébert. Endothelial extracellular vesicle miR-423-5p regulates microvascular homeostasis and renal function after ischemia-reperfusion injury. Rui Tostoes, Chief Technology Officer at ImmuneBridge, shares how his team is redefining preclinical development and large-scale manufacturing for allogeneic cell therapies. Advancing GPCR drug discovery with fragment screening using GCI technology Evotec's insights into GPCRs and waveRAPID technology reveal new opportunities in drug discovery, focusing on orphan receptors and innovative screening methods. News-Medical.Net provides this medical information service in accordance with these terms and conditions. Please note that medical information found on this website is designed to support, not to replace the relationship between patient and physician/doctor and the medical advice they may provide. Hi, I'm Azthena, you can trust me to find commercial scientific answers from News-Medical.net. Registered members can chat with Azthena, request quotations, download pdf's, brochures and subscribe to our related newsletter content. A few things you need to know before we start. While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles. Please do not ask questions that use sensitive or confidential information.

MINNEAPOLIS — Risk for venous thromboembolism (VTE) appears substantially greater in patients with placenta accrete than in other pregnant patients, found a small single-center study presented at the American College of Obstetricians and Gynecologists (ACOG) 2025 Annual Meeting. Despite the institution having created a specific protocol — a VTE bundle — for patients with placenta accreta, only about one in five patients with placenta accreta received the complete bundle, reported Rinat Tal, of the University of Michigan Medical School, Ann Arbor, Michigan, and colleagues. “Patients with placenta accreta spectrum are at risk for massive hemorrhage, need for blood transfusion, massive transfusion, long operating times, general anesthesia, and ICU stay, all of which increased patients' risk for VTE beyond the preexisting elevated risk in pregnancy,” the authors wrote. Yet, guidelines do not exist regarding the optimal VTE prophylaxis for patients with placenta accreta, they noted. So, the researchers assessed the effectiveness of a VTE bundle developed at their institution for reducing risk for VTE in patients with placenta accreta. The authors analyzed retrospective data on all scheduled cesarean hysterectomies performed for suspected placenta accreta, excluding patients with cancer and those with incomplete 6-week postpartum data. They identified 90 patients who met their criteria and found that only 22.2% had received the complete VTE bundle. Incidence of VTE was 2.2% in the cohort: One patient who received the complete bundle and one who did not (P = .34). The researchers noted, however, that the incidence of VTE was 18 times higher in this cohort than in pregnant patients generally. However, the other 71.4% were missing anywhere from one to three components, including 5.7% who received no prophylactic anticoagulation. Also, more of the women receiving an incomplete bundle had a previous C section (92.9%) than those who received the full bundle (80%). Median blood loss was greater in those who received an incomplete bundle (2500 mL) than those who received the full bundle (1600 mL), and more women receiving an incomplete bundle (21.4%) had a packed red blood cell transfusion than those who received the full bundle (5%). Alison G. Cahill, MD, associate dean of translational research and professor of women's health at The University of Texas at Austin Dell Medical School, told Medscape Medical News that the findings here need to be interpreted cautiously given that it's such a small study and results are only currently available in the poster. This study “raises the question as to whether or not this group [those with placenta accreta] should be considered separately” in seeking more ways to prevent VTE, she said. “Just the idea of thinking about VTE risk — that there are differences, and what they look like, and how we might approach them differently — is an important investigative lane, especially because a lot of the data that we have for VTE primary prevention is from outside of the obstetric literature,” Cahill said. No external funding or disclosures from the authors were reported.