Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.

Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.

Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.

Ocular Biomechanical Responses to Long-Duration Spaceflight.

To assess the impact of microgravity exposure on ocular rigidity (OR), intraocular pressure (IOP), and ocular pulse amplitude (OPA) following long-term space missions. OR was evaluated using optical coherence tomography (OCT) and deep learning-based choroid segmentation. IOP and OPA were measured with the PASCAL Dynamic Contour Tonometer (DCT).

Trauma video review analysis: Increased provider movement impedes trauma team performance.

Introduction: Trauma team performance, measured by the non-technical skills scale T-NOTECHS, has been shown to impact patient outcomes. We assess how personnel movements affect non-technical skills and time of resuscitation(TOR) using trauma video review.

Methods: A prospective study of blunt and/or penetrating trauma activations recorded between May and November 2023 ​at a Level-I trauma center.

Development of a Whey Protein Recovery Process Using Sugar Kelp ( Extracts.

Whey is the largest waste product of the cheese-making industry and the current methods of extracting the nutrients from it are costly and inefficient. This study assessed the feasibility of using crude polysaccharides to flocculate proteins from liquid whey waste. The flocculants used were a sugar kelp ( extract, as well as commercial seaweed polysaccharides, alginate and k-carrageenan, to recover proteins from the liquid whey waste.

Trauma video review through the legal lens: Improving care while minimizing risk.

Video-based platforms have emerged as a transformative force in the field of trauma surgery. Despite its potential, the adoption of trauma video review (TVR) faces challenges. In this review, we describe the use of TVR and examine medicolegal issues pertaining to spoliation, patient privacy, and consent.

Defining characteristics of categorical general surgery resident lateral transfers.

Background: Few studies describe rationales for intraspecialty ('lateral') general surgery (GS) resident program transfers.

Objective: We aimed to describe the key features of GS residency programs reporting lateral transfers, to characterize reasons behind transfer events, and to compare transferring resident skill sets against their new institutional peers.

Methods: A survey was administered in October 2020 to capture program features and demographic information of residents who transferred into or out of a GS residency program during a 5-year period.

A randomized phase 2b trial examined the effects of the glucagon-like peptide-1 and glucagon receptor agonist cotadutide on kidney outcomes in patients with diabetic kidney disease.

Cotadutide is a glucagon-like peptide-1 (GLP-1) and glucagon receptor agonist that may improve kidney function in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). In this phase 2b study, patients with T2D and CKD (estimated glomerular filtration rate [eGFR] of 20 or more and under 90 mL/min per 1.73 m and urinary albumin-to-creatinine ratio [UACR] over 50 mg/g) were randomized 1:1:1:1:1 to 26 weeks' treatment with standard of care plus subcutaneous cotadutide uptitrated to 100, 300, or 600 μg, or placebo daily (double-blind), or the GLP-1 agonist semaglutide 1 mg once weekly (open-label).

Mind the GAHP: A novel protocol for improved vascular access in the hypotensive patient.

Background: Obtaining intravenous access in hypotensive patients is challenging and may critically delay resuscitation. The Graduated Vascular Access for Hypotensive Patient (GAHP) protocol leverages intraosseous fluid boluses to specifically dilate proximal veins. This study aims to evaluate the efficacy of GAHP in maximizing venous targets through early distal intraosseous access and a small fluid bolus.

Liner orientation change of dual mobility cup determined via 3D ultrasound imaging and motion analysis: A cadaver study.

Background: A mobile polyethylene liner enables the dual mobility cup (DMC) to contribute to restoring hip joint range-of-motion, decreasing wear and increasing implant stability. However, more data is required on how liner orientation changes with hip joint movement. As a first step towards better understanding liner orientation change in vivo, this cadaver study focuses on quantifying DMC liner orientation change after different hip passive movements, using ultrasound imaging and motion analysis.

A comparison of outcomes including bile duct injury of subtotal cholecystectomy versus open total cholecystectomy as bailout procedures for severe cholecystitis: A multicenter real-world study.

Background: Dense inflammation obscuring the hepatocystic anatomy can hinder the ability to perform a safe standard laparoscopic cholecystectomy in severe cholecystitis, requiring use of a bailout procedure. We compared clinical outcomes of laparoscopic and open subtotal cholecystectomy against the traditional standard of open total cholecystectomy to identify the optimal bailout strategy for the difficult gallbladder.

Methods: A multicenter, multinational retrospective cohort study of patients who underwent bailout procedures for severe cholecystitis.

Managing career transitions in the profession of acute care surgery.

Career shifts are a naturally occurring part of the trauma and acute care surgeon's profession. These transitions may occur at various timepoints throughout a surgeon's career and each has their own specific challenges. Finding a good fit for your first job is critical for ensuring success as an early career surgeon.

Tibiofemoral Slip Velocity in Total Knee Arthroplasty is Design-Invariant but Activity-Dependent.

Tibiofemoral slip velocity is a key contributor to total knee arthroplasty (TKA) component wear, yet few studies have evaluated this quantity in vivo. The aim of the present study was to measure and compare tibiofemoral slip velocities in 3 TKA designs for a range of daily activities. Mobile biplane X-ray imaging was used to measure 6-degree-of-freedom tibiofemoral kinematics and the locations of articular contact in 75 patients implanted with a posterior-stabilized, cruciate-retaining, or medial-stabilized design while each patient performed level walking, step up, step down, sit-to-stand, and stand-to-sit.

Teamwork matters: The association between nontechnical skills and cardiac arrest in trauma patients presenting with hypotension.

Background: The impact of trauma team dynamics on outcomes in injured patients is not completely understood. We sought to evaluate the association between trauma team function, as measured by a modified Trauma Non-Technical Skills assessment, and cardiac arrest in hypotensive trauma patients. We hypothesized that better team function is associated with a decreased probability of developing cardiac arrest.

Percutaneous thoracostomy with thoracic lavage for traumatic hemothorax: a performance improvement initiative.

Objectives: Percutaneously placed small-bore (14 Fr) catheters and pleural lavage have emerged independently as innovative approaches to hemothorax management. This report describes techniques for combining percutaneous thoracostomy with pleural lavage and presents results from a performance improvement series of patients managed with percutaneous thoracostomy with immediate lavage.

Methods: This was a prospective performance improvement series of patients treated at a level 1 trauma center with percutaneous thoracostomy and immediate lavage between April 2021 and May 2023.

Agreement between a markerless and a marker-based motion capture systems for balance related quantities.

Balance studies usually focus on quantities describing the global body motion. Assessing such quantities using classical marker-based approach can be tedious and modify the participant's behaviour. The recent development of markerless motion capture methods could bypass the issues related to the use of markers.

The ALOG domain defines a family of plant-specific transcription factors acting during Arabidopsis flower development.

The ALOG (Arabidopsis LIGHT-DEPENDENT SHORT HYPOCOTYLS 1 (LSH1) and Oryza G1) proteins are conserved plant-specific Transcription Factors (TFs). They play critical roles in the development of various plant organs (meristems, inflorescences, floral organs, and nodules) from bryophytes to higher flowering plants. Despite the fact that the first members of this family were originally discovered in Arabidopsis, their role in this model plant has remained poorly characterized.

Handoffs and transitions of care: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma.

Background: The Joint Commission reports that at least half of communication breakdowns occur during handovers or transitions of care. There is no consensus on how best to approach the transfer of care within acute care surgery (ACS). We conduct a systematic review and meta-analysis of the current data on handoffs and transitions of care in ACS patients and evaluate the impact of standardization and formalized communication processes.

A Velocity Stretch Reflex Threshold Based on Muscle-Tendon Unit Peak Acceleration to Detect Possible Occurrences of Spasticity during Gait in Children with Cerebral Palsy.

Spasticity might affect gait in children with cerebral palsy. Quantifying its occurrence during locomotion is challenging. One approach is to determine kinematic stretch reflex thresholds, usually on the velocity, during passive assessment and to search for their exceedance during gait.

Primary Repair Versus Resection for AAST Grade I and II Colon Injuries: Does the Type of Repair Matter?

Introduction: The management of traumatic colon injuries has evolved over the past two decades. Recent evidence suggests that primary repair or resection over colostomy may decrease morbidity and mortality. Data comparing patients undergoing primary repair versus resection are lacking.

Reliability of the safety threats and adverse events in trauma (STAT) taxonomy using trauma video review.

Purpose: The STAT (Safety Threats and Adverse Events in Trauma) taxonomy was developed through expert consensus, and groups 65 identified trauma resuscitation adverse events (AEs) into nine distinct categories. It provides a framework for standardized analysis of trauma resuscitations and creates a foundation for targeted quality improvement and patient safety initiatives. This study aims to evaluate the reliability of the STAT taxonomy in identifying AEs during video-recorded trauma resuscitations.