:root{--paper: #f5ecd6;--paper-soft: #f0e6c9;--paper-deep: #e8dcba;--ink: #1a1513;--ink-soft: #2a2320;--ink-muted: #5a4f47;--ink-light: #8a7d72;--nejm-red: #9a1e2a;--nejm-red-deep: #7a1520;--rule: 1px solid var(--ink);--rule-hair: 1px solid rgba(26, 21, 19, .25);--rule-light: 1px solid rgba(26, 21, 19, .15);--serif: "EB Garamond", "Times New Roman", Georgia, serif;--sans: "IBM Plex Sans", -apple-system, system-ui, sans-serif;--mono: "IBM Plex Mono", ui-monospace, monospace;--measure: 34rem}*,*:before,*:after{box-sizing:border-box;margin:0;padding:0}html{scroll-behavior:smooth}body{font-family:var(--serif);font-size:19px;line-height:1.55;color:var(--ink);background:var(--paper);-webkit-font-smoothing:antialiased;text-rendering:optimizeLegibility;font-feature-settings:"kern","liga","onum"}h1,h2,h3,h4{font-family:var(--serif);font-weight:500;line-height:1.1;letter-spacing:-.005em}h2{font-size:clamp(2rem,4vw,3.25rem)}h3{font-size:clamp(1.4rem,2.2vw,1.85rem)}.smallcaps{font-family:var(--sans);font-size:.72rem;font-weight:500;letter-spacing:.15em;text-transform:uppercase;color:var(--ink)}.smallcaps--red{color:var(--nejm-red)}.smallcaps--muted{color:var(--ink-muted)}.btn{padding:.9rem 1.85rem;text-decoration:none;font-family:var(--sans);font-size:.78rem;font-weight:500;letter-spacing:.12em;text-transform:uppercase;transition:all .2s;display:inline-block;border:1px solid transparent;white-space:nowrap}.btn-primary{background:var(--nejm-red);color:var(--paper)}.btn-primary:hover{background:var(--nejm-red-deep)}.btn-ghost{color:var(--ink);border-color:var(--ink)}.btn-ghost:hover{background:var(--ink);color:var(--paper)}.specialty-link{font-family:var(--sans);font-size:.72rem;font-weight:500;letter-spacing:.12em;text-transform:uppercase;color:var(--ink);text-decoration:none;border-bottom:1px solid var(--nejm-red);padding-bottom:2px;transition:color .2s}.specialty-link:hover{color:var(--nejm-red)}.container{max-width:1280px;margin:0 auto;padding:0 2.5rem}.container-wide{max-width:1440px;margin:0 auto;padding:0 2.5rem}@media(max-width:768px){.container,.container-wide{padding:0 1.25rem}}.section-marker{display:flex;justify-content:center;align-items:center;gap:1rem;padding:1.5rem 0;border-top:var(--rule-light);border-bottom:var(--rule-light);margin-bottom:4rem}.section-marker-rule{width:3rem;height:1px;background:var(--ink)}.topstrip{background:var(--paper);padding:.9rem 0;border-bottom:var(--rule-hair);font-family:var(--sans);font-size:.78rem;color:var(--ink-muted)}.topstrip-inner{display:flex;justify-content:space-between;align-items:center;gap:2rem;flex-wrap:wrap}.topstrip-contact{display:flex;gap:2rem;flex-wrap:wrap;align-items:center}.topstrip-contact a{color:var(--ink);text-decoration:none}.topstrip-contact a:hover{color:var(--nejm-red)}.topstrip-lang{display:flex;gap:1rem}.topstrip-lang a{color:var(--ink-muted);text-decoration:none;font-size:.7rem;letter-spacing:.12em;text-transform:uppercase;font-weight:500}.topstrip-lang a.active{color:var(--nejm-red)}@media(max-width:600px){.topstrip-address{display:none}.topstrip-contact{gap:1rem}}.masthead{background:#f5ecd6f5;backdrop-filter:blur(8px);border-bottom:var(--rule-hair);position:sticky;top:0;z-index:50}.masthead-inner{display:flex;justify-content:space-between;align-items:center;padding:1.25rem 0;gap:2rem}.logo-link{display:flex;align-items:center;text-decoration:none;flex-shrink:0}.logo-img{height:36px;width:auto;transition:opacity .2s;display:block}.logo-link:hover .logo-img{opacity:.85}.nav-wrap{display:flex;align-items:center;gap:2rem}.nav-links{display:flex;gap:2rem;list-style:none;align-items:center;font-family:var(--sans);font-size:.9rem;font-weight:500}.nav-links a{color:var(--ink);text-decoration:none;transition:color .2s}.nav-links a:hover{color:var(--nejm-red)}.nav-cta{padding:.6rem 1.15rem;background:var(--nejm-red);color:var(--paper)!important;text-decoration:none;font-family:var(--sans);font-size:.78rem;font-weight:500;letter-spacing:.1em;text-transform:uppercase;transition:background .2s;white-space:nowrap}.nav-cta:hover{background:var(--nejm-red-deep)}.mobile-menu-btn{display:none;flex-direction:column;justify-content:center;gap:5px;width:32px;height:32px;background:none;border:none;cursor:pointer;padding:4px;flex-shrink:0}.mobile-menu-btn span{display:block;width:100%;height:2px;background:var(--ink);transition:all .25s}@media(max-width:1000px){.nav-links{display:none}.mobile-menu-btn{display:flex}.nav-cta{display:none}}@media(max-width:480px){.logo-img{height:28px}}.mobile-nav{position:fixed;inset:0;background:var(--paper);z-index:200;transform:translate(100%);transition:transform .3s cubic-bezier(.4,0,.2,1);overflow-y:auto}.mobile-nav.open{transform:translate(0)}.mobile-nav-inner{padding:1.5rem 1.5rem 3rem;min-height:100%;display:flex;flex-direction:column}.mobile-nav-header{display:flex;justify-content:space-between;align-items:center;padding-bottom:2rem;border-bottom:var(--rule-hair);margin-bottom:2rem}.mobile-nav-close{background:none;border:1px solid var(--ink);width:36px;height:36px;display:flex;align-items:center;justify-content:center;cursor:pointer;font-family:var(--sans);font-size:1rem;color:var(--ink)}.mobile-nav-links{list-style:none;margin-bottom:2.5rem}.mobile-nav-links li{border-bottom:var(--rule-hair)}.mobile-nav-links a{display:block;padding:1.1rem 0;font-family:var(--sans);font-size:1.1rem;font-weight:500;color:var(--ink);text-decoration:none;transition:color .2s}.mobile-nav-links a:hover{color:var(--nejm-red)}.mobile-nav-cta{display:block;text-align:center;margin-bottom:2.5rem;padding:1rem}.mobile-nav-contact{display:flex;flex-direction:column;gap:.75rem;margin-top:auto;padding-top:2rem;border-top:var(--rule-hair)}.mobile-nav-contact a{font-family:var(--sans);font-size:.85rem;color:var(--ink-muted);text-decoration:none}.footer{background:var(--paper);color:var(--ink);padding:5rem 0 2rem;border-top:var(--rule)}.footer-grid{display:grid;grid-template-columns:1.5fr 1fr 1fr 1fr 1fr;gap:2.5rem;margin-bottom:4rem}@media(max-width:1100px){.footer-grid{grid-template-columns:1.5fr 1fr 1fr;gap:2.5rem 2rem}}@media(max-width:700px){.footer-grid{grid-template-columns:1fr 1fr;gap:2rem}}@media(max-width:480px){.footer-grid{grid-template-columns:1fr}}.footer-brand img{height:40px;width:auto;margin-bottom:1.25rem;display:block}.footer-brand p{font-size:1rem;line-height:1.55;max-width:22rem;color:var(--ink-muted)}.footer h4{font-family:var(--sans);font-size:.72rem;font-weight:500;letter-spacing:.15em;text-transform:uppercase;color:var(--nejm-red);margin-bottom:1.25rem}.footer ul{list-style:none}.footer li{margin-bottom:.65rem}.footer a{color:var(--ink);text-decoration:none;font-size:.95rem;transition:color .2s;display:inline-flex;align-items:center;gap:.55rem}.footer a:hover{color:var(--nejm-red)}.footer-icon{display:inline-flex;width:14px;height:14px;color:var(--nejm-red);flex-shrink:0}.footer-icon svg{width:100%;height:100%}.footer-bottom{padding-top:2rem;border-top:var(--rule-hair);display:flex;justify-content:space-between;flex-wrap:wrap;gap:1rem;font-family:var(--sans);font-size:.72rem;letter-spacing:.12em;text-transform:uppercase;color:var(--ink-muted);font-weight:500}.running-feet{padding:2.5rem 0;border-top:var(--rule);border-bottom:var(--rule);background:var(--paper);font-family:var(--sans);font-size:.72rem;letter-spacing:.14em;text-transform:uppercase;color:var(--ink-muted);font-weight:500;text-align:center}.running-feet span:after{content:" · ";margin:0 .35rem;color:var(--ink-light)}.running-feet span:last-child:after{content:""}