EMS Pediatric Trauma Transport: Do Disparities Exist?

Introduction: Trauma is the leading cause of disability and death among children in the United States. Optimal outcomes are achieved at pediatric trauma centers (PTCs), which are specialized to address the unique needs of this population. Disparities in trauma have been reported, affecting optimal delivery of care.

Diagnostic and prognostic value of quantitative cardiac magnetic resonance imaging biomarkers in systemic lupus erythematosus: a systematic review and meta-analysis.

Objectives: The aim of this study was to compare CMR imaging biomarkers between SLE patients and matched controls.

Materials And Methods: Electronic databases were systematically searched from inception until November 2023. All studies reporting CMR imaging data in SLE patients were included.

Interleukin-1α release during necrotic-like cell death generates myeloid-driven immunosuppression that restricts anti-tumor immunity.

Necroptosis can promote antigen-specific immune responses, suggesting induced necroptosis as a therapeutic approach for cancer. Here we sought to determine the mechanism of immune activation but found the necroptosis mediators RIPK3 and MLKL dispensable for tumor growth in genetic and implantable models of breast or lung cancer. Surprisingly, inducing necroptosis within established breast tumors generates a myeloid suppressive microenvironment that inhibits T cell function, promotes tumor growth, and reduces survival.

Pre-hospital Tourniquet Use in Adolescent and Pediatric Traumatic Hemorrhage: A National Study.

Background: Tourniquet placement (TP) is a crucial intervention to control hemorrhage, but limited literature exists for use in children. This study aimed to evaluate the effectiveness of tourniquet application by different providers (Emergency Medical Services (EMS), first responder (FR), and bystanders), hypothesizing equivalent impact on outcomes for pediatric trauma patients for all providers.

Methods: Data from the National EMS Information Systems (NEMSIS) 2017-2020 was used to examine patients 0-19 years old and assess the outcomes of tourniquet application.

Primary central nervous system germ cell tumors in Central America and the Caribbean Region: an AHOPCA 20-year experience.

Background: Primary central nervous system germ cell tumors (GCT) are rare neoplasms in pediatrics. Treatment depends on the histological subtype and extent of the disease. Overall survival (OS) is above 90% for germinomas and 70%-80% for nongerminomatous GCT (NGGCT) in high-income countries (HIC) while data are usually lacking for patients in Low-Middle Income country (LMIC).

Further characterisation of late somatosensory evoked potentials using electroencephalogram and magnetoencephalogram source imaging.

Beside the well-documented involvement of secondary somatosensory area, the cortical network underlying late somatosensory evoked potentials (P60/N60 and P100/N100) is still unknown. Electroencephalogram and magnetoencephalogram source imaging were performed to further investigate the origin of the brain cortical areas involved in late somatosensory evoked potentials, using sensory inputs of different strengths and by testing the correlation between cortical sources. Simultaneous high-density electroencephalograms and magnetoencephalograms were performed in 19 participants, and electrical stimulation was applied to the median nerve (wrist level) at intensity between 1.

Variability in Standardized Mortality Rates Among Pediatric Traumatic Brain Injury Patients: A Comparative Analysis of Trauma Centers.

Introduction: Traumatic brain injury (TBI) causes significant morbidity and mortality in pediatric patients and care is highly variable. Standardized mortality ratio (SMR) summarizes the mortality rate of a specific center relative to the expected rates across all centers, adjusted for case-mix. This study aimed to evaluate variations in SMRs among pediatric trauma centers for TBI.

Four-dimensional flow cardiovascular magnetic resonance aortic cross-sectional pressure changes and their associations with flow patterns in health and ascending thoracic aortic aneurysm.

Background: Ascending thoracic aortic aneurysm (ATAA) is a silent and threatening dilation of the ascending aorta (AscAo). Maximal aortic diameter which is currently used for ATAA patients management and surgery planning has been shown to inadequately characterize risk of dissection in a large proportion of patients. Our aim was to propose a comprehensive quantitative evaluation of aortic morphology and pressure-flow-wall associations from four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) data in healthy aging and in patients with ATAA.

Factors Influencing Compliance to Follow-up Visits in Orthopaedic Surgery.

Background: Orthopaedic procedures require postoperative follow-up to maximize recovery. Missed appointments and noncompliance can result in complications and increased healthcare costs. This study investigates the relationship between patient postoperative visit attendance and the distance traveled to receive care.

Multilevel testing of constraints induced by structural equation modeling in fMRI effective connectivity analysis: A proof of concept.

In functional MRI (fMRI), effective connectivity analysis aims at inferring the causal influences that brain regions exert on one another. A common method for this type of analysis is structural equation modeling (SEM). We here propose a novel method to test the validity of a given model of structural equation.

Outcomes of Threaded Intramedullary Headless Nail Fixation for Metacarpal Fractures.

Metacarpal fractures are common and may require operative treatment; however, there is no gold standard fixation technique. K-wires are used for simplicity and flexibility but require immobilization and can lead to complications. Dorsal plating provides greater stability than K-wires but is subject to its own limitations.

Effect of sonification types in upper-limb movement: a quantitative and qualitative study in hemiparetic and healthy participants.

Background: Movement sonification, the use of real-time auditory feedback linked to movement parameters, have been proposed to support rehabilitation. Nevertheless, if promising results have been reported, the effect of the type of sound used has not been studied systematically. The aim of this study was to investigate in a single session the effect of different types of sonification both quantitatively and qualitatively on patients with acquired brain lesions and healthy participants.

First case report of a perinatally HIV-infected infant with HIV resistance to dolutegravir associated with tenofovir/lamivudine/dolutegravir use in mothers.

Perinatally HIV-infected infants can be infected with a drug-resistant virus or select for drug resistance by exposure to sub-therapeutic levels of maternal antiretroviral drugs present in breastmilk or from sub-therapeutic infant prophylaxis. We report a case of dolutegravir resistance detected in a treatment-naive perinatally HIV-infected infant whose mother was receiving tenofovir/lamivudine/dolutegravir. This case was detected during a national survey of HIV drug resistance in Haiti amongst infants testing positive for HIV through the national early infant diagnosis program between April 2020 and March 2021.

Developmental changes in exploration resemble stochastic optimization.

Human development is often described as a 'cooling off' process, analogous to stochastic optimization algorithms that implement a gradual reduction in randomness over time. Yet there is ambiguity in how to interpret this analogy, due to a lack of concrete empirical comparisons. Using data from n = 281 participants ages 5 to 55, we show that cooling off does not only apply to the single dimension of randomness.

Value of aortic volumes assessed by automated segmentation of 3D MRI data in patients with thoracic aortic dilatation: A case-control study.

Purpose: The purpose of this study was to investigate the benefit of aortic volumes compared to diameters or cross-sectional areas on three-dimensional (3D) magnetic resonance imaging (MRI) in discriminating between patients with dilated aorta and matched controls.

Materials And Methods: Sixty-two patients (47 men and 15 women; median age, 66 years; age range: 33-86 years) with tricuspid aortic valve and ascending thoracic aorta aneurysm (TAV-ATAA) and 43 patients (35 men and 8 women; median age, 51 years; age range: 17-76 years) with bicuspid aortic valve and dilated ascending aorta (BAV) were studied. One group of 54 controls matched for age and sex to patients with TAV-ATAA (39 men and 15 women; median age, 68 years; age range: 33-81 years) and one group of 42 controls matched for age and sex to patients with BAV (34 men and 8 women; median age, 50 years; age range: 17-77 years) were identified.

Feasibility of a New Regional Myocardial Strain Parameter for the Detection of Wall Motion Abnormalities in Arrhythmogenic Right Ventricular Cardiomyopathy.

Purpose: To evaluate a cardiac MRI feature tracking (FT)-derived parameter that combines right ventricular (RV) longitudinal and radial motions in detecting arrhythmogenic right ventricular cardiomyopathy (ARVC).

Materials And Methods: Patients with ARVC ( = 47; median age, 46 [IQR, 30-52] years; 31 men) were compared with controls ( = 39; median age, 46 [IQR, 33-53] years; 23 men) and separated into two groups based on fulfillment of major structural 2020 International criteria. Cine data from 1.

Brain Metabolic Alterations in Seropositive Autoimmune Encephalitis: An F-FDG PET Study.

Introduction: Autoimmune encephalitis (AE) diagnosis and follow-up remain challenging. Brain F-fluoro-deoxy-glucose positron emission tomography (FDG PET) has shown promising results in AE. Our aim was to investigate FDG PET alterations in AE, according to antibody subtype.

Resistance levels to non-nucleoside reverse transcriptase inhibitors among pregnant women with recent HIV infection in Malawi.

Background: Information on HIV drug resistance (HIVDR) prevalence in people newly diagnosed with HIV is limited. We implemented a cross-sectional study to estimate HIVDR prevalence among pregnant women recently infected with HIV in Malawi.

Methods: The HIVDR study was nested within a routine antenatal clinic (ANC) sentinel surveillance survey.

Epidemiology of HIV drug resistance in low- and middle-income countries and WHO global strategy to monitor its emergence.

Purpose Of Review: This review summarises the latest information of the epidemiology of HIV drug resistance (HIVDR) in low- and middle-income countries and the updated WHO global strategy for HIVDR surveillance and monitoring.

Recent Findings: Finding from recent national-representative surveys show a rise in pretreatment drug resistance (PDR) to reverse transcriptase inhibitors and especially to the class of nonnucleoside reverse transcriptase inhibitors. Levels of PDR are especially high in infants <18 months and adults reporting prior exposure to antiretrovirals.

HIV drug resistance in persons initiating or reinitiating first-line antiretroviral therapy in Paraguay: Results of a National Patient Survey.

Human immunodeficiency virus (HIV) drug resistance increases mortality and morbidity and antiretroviral therapy (ART) costs. We describe Paraguay's first nationally representative survey on pretreatment drug resistance (PDR) conducted among persons who initiated or reinitiated ART in 2019. ​​​​We conducted a cross-sectional survey of antiretroviral (ARV) drug resistance in Paraguay in 2019.

Measurement of the Spectral Efficiency of a Heterogeneous Network Architecture of the NG-PON Type for a Quasilinear Propagation Regime.

The objective of future optical fiber networks is to provide an efficient infrastructure capable of supporting an increasing and variable number of data traffic generated by the diversification of applications with different speed requirements that the current legacy Line Speed networks Single Line Rate (SLR), with predefined modulation formats, cannot supply, because they do not offer enough flexibility to meet the requirements of the demands with such a wide range of granularities. Therefore, next-generation optical networks will be highly heterogeneous in nature, incorporating mixed modulation formats and Mixed Line Rates (MLR). In this work, an analysis of the measurement of the spectral efficiency of a heterogeneous network architecture of the next-generation passive optical network (NG-PON) type is reported for a quasilinear propagation regime through the use of the equation adapted from Shannon's information theory and developed by the group from the GNTT Research of the University of Cauca, where it was found that it is better to transmit channels of 10 Gbps and 40 Gbps with robust modulations in MLR networks to make an improvement in the spectral efficiency of the network, achieving the same amount of information in a smaller bandwidth or more information in the same bandwidth.

Pretreatment Human Immunodeficiency Virus (HIV) Drug Resistance Among Treatment-Naive Infants Newly Diagnosed With HIV in 2016 in Namibia: Results of a Nationally Representative Study.

Background: The World Health Organization (WHO) recommends routine surveillance of pretreatment human immunodeficiency virus (HIV) drug resistance (HIVDR) in children <18 months of age diagnosed with HIV through early infant diagnosis (EID). In 2016, 262 children <18 months of age were diagnosed with HIV in Namibia through EID. Levels of HIVDR in this population are unknown.