Glioblastoma multiforme (GBM) is known for its dismal prognosis, though its dependence on patients' readily available RBCs parameters is not fully established. In this work, 170 GBM patients, diagnosed and treated in Soroka University Medical Center (SUMC) over the last 12 years were retrospectively inspected for their survival dependency on pre-operative RBCs parameters. Besides KPS and tumor resection supplemented by oncological treatment, age under 70 (HR = 0.4, 95% CI 0.24-0.65, p = 0.00073), low hemoglobin level (HR = 1.79, 95% CI 1.06-2.99, p = 0.031), and Red Cell Distribution Width (RDW) <14% (HR = 0.57, 95% CI 0.37-0.88, p = 0.018) were found to be prognostic of patients' overall survival in multivariate analysis, accounting for a false discovery rate of < 5% due to multiple hypothesis testing. According to these results, a stratification tree was made, from which a favorable route highlighted a subgroup of nearly 30% of the cohorts' patients whose median overall survival was 21.1 months (95% CI 16.2-27.2)-higher than the established chemo-radiation standard first-line treatment regimen overall median survival average of about 15 months. The beneficial or detrimental effect of RBCs parameters on GBM prognosis and its possible causes is discussed. Keywords: glioblastoma multiforme (GBM), hemoglobin, RDW (red cell distribution width), prognostic factors, overall survival KEY POINTS-GBM resection followed by oncological treatment of patients under the age of 70 with normal hemoglobin level and RDW < 14% enhance patients' survival.-Measures aimed to normalize hemoglobin levels and RDW prior to surgical intervention may be useful in order to improve GBM patients' prognosis.

IntroductionThe challenging environment of prehospital casualty care demands providers to make prompt decisions and to engage in lifesaving interventions, occasionally without them being adequately experienced. Telementoring based on augmented reality (AR) devices has the potential to decrease the decision time and minimise the distance gap between an experienced consultant and the first responder. The purpose of this study was to determine whether telementoring with AR glasses would affect chest thoracotomy performance and self-confidence of inexperienced trainees.MethodsTwo groups of inexperienced medical students performed a chest thoracotomy in an ex vivo pig model. While one group was mentored remotely using HoloLens AR glasses, the second performed the procedure independently. An observer assessed the trainees’ performance. In addition, trainees and mentors evaluated their own performance.ResultsQuality of performance was found to be superior with remote guidance, without significant prolongation of the procedure (492 s vs 496 s, p=0.943). Moreover, sense of self-confidence among participant was substantially improved in the telementoring group in which 100% of the participants believed the procedure was successful compared with 40% in the control group (p=0.035).ConclusionAR devices may have a role in future prehospital telementoring systems, to provide accessible consultation for first responders, and could thus positively affect the provider's confidence in decision-making, enhance procedure performance and ultimately improve patient prognosis. That being said, future studies are required to estimate full potential of this technology and additional adjustments are necessary for maximal optimisation and implementation in the field of prehospital care.

<b><i>Background:</i></b> In the absence of universal screening for congenital cytomegalovirus (cCMV) infection, the aim of this study was to assess the outcomes of a targeted screening protocol based on maternal and neonatal risk indicators. <b><i>Methods:</i></b> The medical records of 2,623 neonates born in our maternal hospital between June 2016 and December 2018 and screened for cCMV infection were reviewed. Among those of the included neonates, the records of 380 CMV-negative and 19 CMV-positive neonates were randomly assigned to obtain additional comparative data. <b><i>Results:</i></b> During the study period, a total of 63 neonates were identified as positive for cCMV, comprising 0.2% of the total birth cohort (63/28,982) and 2.4% of all neonates screened for cCMV (63/2,623). The comparative data analysis showed that suspected or confirmed CMV infection during pregnancy, maternal age, and maternal diabetes mellitus were found to be significantly associated with a positive cCMV diagnosis. Although symmetric small for gestational age and hearing screening failure contributed to the detection of some of the CMV-positive infants, these factors were not specific to this group. The results of the logistic regression model showed that the only factor that was significantly associated with an increased risk for a cCMV diagnosis was maternal serology suspected of CMV infection during pregnancy, with a regression coefficient estimate of 2.657 (adjusted <i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> A targeted neonatal screening protocol based on multiple maternal and neonatal risk indicators is feasible but provides limited information. Our study emphasizes the importance of universal neonatal screening for the detection of neonates with cCMV.

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OBJECTIVE:To evaluate adverse perinatal outcomes among women whose pregnancies were complicated with placental abruption, accompanied by hypertensive disorders of pregnancy. STUDY DESIGN: A retrospective population-based cohort study of pregnancy and perinatal outcomes among women complicated with placental abruption, was conducted. A comparison was made between patients with (study group) and without (comparison group) hypertensive disorders of pregnancy (essential hypertension, gestational hypertension, and preeclampsia toxemia (PET)). Demographic, clinical, and obstetric characteristics were recorded, and pregnancy complications and adverse perinatal outcomes were compared between the groups. Univariate analysis was followed by a multivariate analysis to control for confounders. A p-value of < 0.05 was considered statistically significant. RESULTS: During the study period, of 1,588 pregnancies that were complicated with placental abruption, 218 (13.7%) suffered from hypertensive disorders. A higher rate of antepartum fetal death (APD) was noted among those complicated with placental abruption accompanied by hypertensive disorders. Additionally, preterm birth, nulliparity, lower mean birth weight, and small for gestational age (SGA) neonates were more common in the study group. Finally, women in the study group were more likely to need blood transfusion.In multivariate analyses, hypertensive disorders of pregnancy were found to be independently associated with preterm delivery (OR 1.54, 95% CI 1.14-2.08, p¼0.001) intrauterine growth restriction (OR 3.57, 95% CI 1.42-9.01, p< 0.01) and APD (OR 2.70, 95% CI 1.83-3.99, p< 0.001) in women with placental abruption. CONCLUSION: Among pregnancies complicated with placental abruption hypertensive disorders of pregnancy were significantly associated with a higher incidence of preterm delivery, intrauterine growth restriction, and APD than women with placental abruption without hypertensive disorders. This information contributes to a deeper understanding of the clinical implications of placental abruption in patients with hypertensive disorders of pregnancy.