An Activation Failure: Factors Associated With Undertriage of Pediatric Major Trauma Victims.

Introduction: Undertriage of children contributes to poorer clinical outcomes. The objective of this study was to determine factors associated with undertriage of pediatric major trauma victims.

Methods: We performed a retrospective cross-sectional study of children (aged < 16 ys) using the 2021 American College of Surgeons National Trauma Data Bank.

Evaluation of a Large Language Model on the American Academy of Pediatrics' PREP Emergency Medicine Question Bank.

Background: Large language models (LLMs), including ChatGPT (Chat Generative Pretrained Transformer), a popular, publicly available LLM, represent an important innovation in the application of artificial intelligence. These systems generate relevant content by identifying patterns in large text datasets based on user input across various topics. We sought to evaluate the performance of ChatGPT in practice test questions designed to assess knowledge competency for pediatric emergency medicine (PEM).

Establishing thresholds for shock index in children to identify major trauma.

Background: An abnormal shock index (SI) is associated with greater injury severity among children with trauma. We sought to empirically-derive age-adjusted SI cutpoints associated with major trauma in children, and to compare the accuracy of these cutpoints to existing criteria for pediatric SI.

Methods: We performed a retrospective cohort study using the 2021 National Trauma Data Bank (NTDB) Participant Use File.

Corrigendum: Patients with juvenile idiopathic arthritis have decreased clonal diversity in the CD8 T cell repertoire response to influenza vaccination.

[This corrects the article DOI: 10.3389/fimmu.2024.

Patients with juvenile idiopathic arthritis have decreased clonal diversity in the CD8 T cell repertoire response to influenza vaccination.

Recurrent exposures to a pathogenic antigen remodel the CD8 T cell compartment and generate a functional memory repertoire that is polyclonal and complex. At the clonotype level, the response to the conserved influenza antigen, M1 has been well characterized in healthy individuals, but not in patients receiving immunosuppressive therapy or with aberrant immunity, such as those with juvenile idiopathic arthritis (JIA). Here we show that patients with JIA have a reduced number of M1 specific RS/RA clonotypes, indicating decreased clonal richness and, as a result, have lower repertoire diversity.

Centiles for the shock index among injured children in the prehospital setting.

Objective: The shock index (SI), the ratio of heart rate to systolic blood pressure, is a clinical tool for assessing injury severity. Age-adjusted SI models may improve predictive value for injured children in the out-of-hospital setting. We sought to characterize the proportion of children in the prehospital setting with an abnormal SI using established criteria, describe the age-based distribution of SI among injured children, and determine prehospital interventions by SI.

Comparison of Vital Sign Cutoffs to Identify Children With Major Trauma.

Importance: Vital signs are essential components in the triage of injured children. The Advanced Trauma Life Support (ATLS) and Pediatric Advanced Life Support (PALS) physiologic criteria are frequently used for trauma assessments.

Objective: To evaluate the performance of ATLS and PALS criteria vs empirically derived criteria for identifying major trauma in children.

Factors Associated with Pathway-Concordant Neuroimaging for Pediatric Ischemic Stroke.

Objective: To determine factors associated with magnetic resonance imaging (MRI) and noninvasive diagnostic angiography among children presenting to the emergency department (ED) with acute ischemic stroke.

Study Design: We performed a cross-sectional study using data from >50 US children's hospitals. We included children 29 days through 17 years old hospitalized from the ED with an International Classification of Diseases, Tenth Revision, Clinical Modification, diagnosis code for acute ischemic stroke between October 1, 2015, and November 30, 2022.

Myostatin and the Heart.

Myostatin (growth differentiation factor 8) is a member of the transforming growth factor-β superfamily. It is secreted mostly by skeletal muscles, although small amounts of myostatin are produced by the myocardium and the adipose tissue as well. Myostatin binds to activin IIB membrane receptors to activate the downstream intracellular canonical Smad2/Smad3 pathway, and additionally acts on non-Smad (non-canonical) pathways.

Injury patterns and mortality associated with near-hanging in children.

Background: The pathophysiology of near-hanging in children is different from that of adults due to anatomic, physiologic, and injury-related mechanisms, with evidence suggesting that blunt cerebrovascular injuries (BCVI) and cervical spine injuries (CSI) are uncommon. We sought to estimate the incidence of secondary injuries and their association with mortality in pediatric near-hanging victims.

Methods: We performed a retrospective observational study of children (≤17 years) with a diagnosis code for hanging between October 1, 2015 and February 28, 2023 who presented to one of 47 geographically diverse US children's hospitals.

Patrilocality and hunter-gatherer-related ancestry of populations in East-Central Europe during the Middle Bronze Age.

The demographic history of East-Central Europe after the Neolithic period remains poorly explored, despite this region being on the confluence of various ecological zones and cultural entities. Here, the descendants of societies associated with steppe pastoralists form Early Bronze Age were followed by Middle Bronze Age populations displaying unique characteristics. Particularly, the predominance of collective burials, the scale of which, was previously seen only in the Neolithic.

Implementation of a Novel Patient Decision Aid for Women with Elevated Breast Cancer Risk Who Are Considering MRI Screening: A Pilot Study.

Purpose: To determine the feasibility and acceptability of using a patient decision aid (DA) for women with elevated breast cancer risk who are considering MRI screening.

Methods: This pilot study employed a mixed methods design to develop, modify, and test an interactive DA. The DA was administered among a consecutive patient sample with an estimated Tyrer-Cuzick v.

The Comparative Bioavailability of Fluticasone and Azelastine Delivered as a Single Fixed Dose Combination (MP-AzeFlu) in Comparison to Two Different Formulations of Azelastine and Fluticasone Propionate Following Intranasal Administration in Healthy Chinese Volunteers.

Objective: Two studies (Study I and Study II) were conducted in healthy Chinese volunteers to confirm that there was no pharmacokinetic drug interaction between AZE and FLU in MP-AzeFlu. The secondary objective was to evaluate the pharmacokinetic parameters of MP-AzeFlu compared with the commercially available mono-components.

Methods: Both studies were a randomized, open-label, three-period, six-sequence, single-dose cross-over trial (William's design) conducted at Beijing Hospital (Beijing, China) in September and October of 2019 in 30 healthy adult male and female volunteers.

Assessing the mobility of Bronze Age societies in East-Central Europe. A strontium and oxygen isotope perspective on two archaeological sites.

European Bronze Age societies are generally characterised by increased mobility and the application of isotopic methods to archaeology has allowed the rate and range of human travels to be quantified. However, little is known about the mobility of the people inhabiting East-Central Europe in the late Early and Middle Bronze Age (1950-1250 BC) whose primary subsistence strategy was herding supported by crop cultivation. This paper presents the results of strontium (87Sr/86Sr) and oxygen (δ18O) isotope analyses in the enamel of people buried in collective graves at the cemeteries in Gustorzyn and Żerniki Górne.

Endogenous and Exogenous Antioxidants in Skeletal Muscle Fatigue Development during Exercise.

Muscle fatigue is defined as a decrease in maximal force or power generated in response to contractile activity, and it is a risk factor for the development of musculoskeletal injuries. One of the many stressors imposed on skeletal muscle through exercise is the increased production of reactive oxygen species (ROS) and reactive nitrogen species (RNS), which intensifies as a function of exercise intensity and duration. Exposure to ROS/RNS can affect Na/K-ATPase activity, intramyofibrillar calcium turnover and sensitivity, and actin-myosin kinetics to reduce muscle force production.

A Method of Damage Detection Efficiency Enhancement of PZT Sensor Networks under Influence of Environmental and Operational Conditions.

Two performance parameters are particularly important for the assessment of structural health monitoring (SHM) systems, i.e., their damage detection capabilities and risk of false positive indications due to varying environmental and operational conditions (EOCs).

Endothelial lipase: regulation and biological function.

Endothelial lipase is synthetized almost exclusively in endothelial cells and then fixed on the luminal surface of the endothelium by means of heparan sulphate proteoglycans. The enzyme is expressed in the endothelium of nearly all tissues and the degree of expression is higher in richly vascularized tissues than in the less vascularized ones. The endothelial lipase expression in tissues is upregulated by shear and cyclic stress, angiotensin II and hypertension.

Racial and Ethnic Disparities in Emergency Department Wait Times for Children: Analysis of a Nationally Representative Sample.

Objective: To evaluate the association of race and ethnicity with wait times for children in US emergency departments (ED).

Methods: We performed a cross-sectional study of ED encounters of children (<18 years) from 2014 to 2019 using a multistage survey of nonfederal US ED encounters. Our primary variable of interest was composite race and ethnicity: non-Hispanic White (NHW), non-Hispanic Black, Hispanic, and all others.

Role of cross-reactivity in cellular immune targeting of influenza A M1 variant peptide epitopes.

The immunologic significance of cross-reactivity of TCR recognition of peptide:MHC complexes is still poorly understood. We have described TCR cross-reactivity in a system involving polyclonal CD8 T cell recognition of the well characterized influenza viral M1 epitope. While M1 is generally conserved between influenza A isolates, error-prone transcription generates stable variant RNA during infection which could act as novel epitopes.

Autoreactive CD8 T cells in NOD mice exhibit phenotypic heterogeneity but restricted TCR gene usage.

Type 1 diabetes (T1D) is an autoimmune disorder defined by CD8 T cell-mediated destruction of pancreatic β cells. We have previously shown that diabetogenic CD8 T cells in the islets of non-obese diabetic mice are phenotypically heterogeneous, but clonal heterogeneity remains relatively unexplored. Here, we use paired single-cell RNA and T-cell receptor sequencing (scRNA-seq and scTCR-seq) to characterize autoreactive CD8 T cells from the islets and spleens of non-obese diabetic mice.

Fuzzy-Logic-Based Recommendation System for Processing in Condition Monitoring.

The development of a machine's condition monitoring system is often a challenging task. This process requires the collection of a sufficiently large dataset on signals from machine operation, context information related to the operation conditions, and the diagnosis experience. The two referred problems are today relatively easy to solve.