Does confidence mirror competence? Outcomes following Stop the Bleed® training among lay community members.

Aim: To evaluate and compare pre- and post-STB training outcomes of bleeding control knowledge, willingness to act and confidence in doing so.

Background: Stop the Bleed® (STB) training improves trainees' willingness to intervene in pre-hospital bleeding emergencies and confidence in doing so, but few studies report associated knowledge-based outcomes.

Methods: A cross-sectional, observational study was performed using a pre-/post-test approach.

Positron stopping in multilayer materials.

Positron annihilation spectroscopy provides a sensitive toolset for defect characterization. In beam based studies of single-layer targets, the form of implantation profiles is well established, depending on the kinetic energy and angle of incident positrons relative to the target surface and the density and average atomic number of the target. For multilayer systems, the difference in density and across the layers makes derivation of an analytical form difficult.

Esophageal Siderosis: An Unusual Complication of Oral Iron Therapy.

Iron is the most common nutritional deficiency encountered in the United States, with over 15% of Americans using some form of daily oral iron supplementation. Although commonly associated with minor gastrointestinal side effects, severe gastrointestinal complications are rare. Direct cytotoxic mucosal damage and subsequent ulcer formation have rarely been reported.

Postoperative Medial Gutter Impingement Following Primary Total Ankle Arthroplasty: A Retrospective Case-Control Study.

Background: Medial gutter impingement may compromise the results of an otherwise well-fixed total ankle arthroplasty (TAA), but no previous study has assessed predisposing factors. This case-control study sought to investigate potential risk factors and the role of talar component downsizing in decreasing medial impingement.

Methods: A retrospective case-control study with 149 patients was performed.

Cancer incidence in male and female Canadian Armed Forces personnel and Veterans enrolled between 1976 and 2016: a retrospective population-based cohort study.

Objectives: To describe rates of overall and type-specific primary cancers in Canadian Armed Forces (CAF) personnel and Veterans with a first enrolment in the CAF between 1976 and 2016, with comparisons to the Canadian general population (CGP).

Methods: This retrospective cohort study linked CAF administrative data to national cancer registries. Primary cancer diagnoses were ascertained from 1976 to 2017.

A Longitudinal Study of Reading and Mental Health Development in Children With Reported Ear and Hearing Difficulties.

Purpose: Reported ear and hearing difficulties (rEHD) are known to be associated with reading difficulties as well as mental health problems. In this study, we aim to examine the relationship between reading and mental health in children with rEHD.

Method: In this study, we used structural equation modeling to measure the strength of longitudinal relationships between reading and mental health-related variables in children with rEHD-aged 5-11 years-in four large longitudinal databases from the United Kingdom ( = 5,254), the United States (s = 1,541 and 6,401), and Australia ( = 2,272).

A Soil Monitoring Law for Europe.

Over 60% of European soils are unhealthy according to the Soil Mission board estimates and the indicators presented in the European Union (EU) Soil degradation dashboard. The situation may worsen if no policy interventions are taken. The unsustainable use of natural resources, in particular the degradation of soils, precipitates biodiversity loss, exacerbated by the climate crisis.

Don't ignore the tough questions: A qualitative investigation into occupational stressors impacting veterinarians' mental health.

Objective: To explore Canadian clinical veterinarians' perspectives of occupational stressors. Although extant research has emphasized quantitative reporting of workplace stressors in veterinary medicine, a qualitative approach can lend depth and context.

Procedure: One-on-one interviews were conducted with 25 veterinarians at the 2016 Canadian Veterinary Medical Association Conference.

Perspectives on the sustainment of a healthy vending initiative in a university setting: a reflexive thematic analysis.

The World Health Organization recommends countries adopt policies that encourage the creation of healthier food retail. In Australia, some organisations have created enforceable regulation for healthier food retail in settings under their contractual control. While progressive for public health, little evidence exists on the characteristics of individuals and organisations influencing sustainment of such initiatives.

Assessing the impact of a mandatory calorie labelling policy in out-of-home food outlets in England on consumer behaviour: a natural experimental study.

Background: Out-of-home (OOH) food tends to be energy-dense and nutrient-poor. In response, England implemented a mandatory calorie labelling policy in the OOH sector. We evaluated changes in consumer behaviours after the policy was implemented in April 2022.

An Emergency Department Virtual Observation Unit Fall Prevention Program: A Pilot Acceptability Study.

Background Falls are a leading cause of unintentional death among adults aged 65 and above and are associated with significant injuries and healthcare costs. Older adults frequently present to the emergency department (ED) for falls. However, ED clinicians rarely focus on preventing future falls, given the lack of time and resources.

The SIMCA Study Protocol: Factors influencing the implementation of the Midwifery Continuity of Carer (MCoC) model of care in NHS maternity care in England: A mixed methods cross case analysis involving clinicians, women and policy makers.

Background: During pregnancy, labour and early motherhood, most women in the UK receive care from different midwives. NHS policy change in England sought to introduce a model of care whereby each woman is cared for by the same midwife throughout antenatal, intrapartum and postnatal periods, supported by a small team of midwives to cover off-duty periods. This model is called the Midwifery Continuity of Carer (MCoC).

Impact of Outpatient Palliative Care Services on Resource Utilization and Cost Management in a Capitated Medicare Population.

The integration of palliative care into the U.S. health care system has grown significantly, with outpatient palliative care services (OPCSs) playing an increasingly vital role in managing patients with serious illnesses.

Pseudoaneurysm of a Venous Coronary Bypass Graft Repaired With Covered Stents.

A 71-year-old man with remote coronary bypass surgery presented for evaluation of intermittent pulsatile bleeding from a sternal wound and received a diagnosis of ruptured saphenous vein graft, which was managed with covered stent placement. This case highlights a nonsurgical management approach for this potentially fatal complication.

The effect of sarcopenic obesity on knee biomechanics in individuals with end-stage knee osteoarthritis.

Background: It is unclear how knee biomechanics in individuals with Sarcopenic Obesity and osteoarthritis (OA-SO) affect ambulation relative to those with knee osteoarthritis (OA) without SO. The primary objective of this study was to compare the knee kinematics and spatio-temporal gait parameters during treadmill walking using simulated terrain modifications in individuals with end-stage knee OA awaiting total knee arthroplasty (TKA) with SO and obesity (OA-SO group) versus those with knee OA without SO (OA group).

Methods: We performed a cross-sectional analysis of individuals with knee OA (with or without SO) awaiting TKA.

Impact of perceived attending consistency on general surgery resident feedback satisfaction in a national sample.

Introduction: We aim to determine whether general surgery residents' feedback satisfaction relates to number of attendings providing consistent feedback.

Methods: In January 2023, residents were surveyed about feedback perceptions post in-training exam. Respondents selected how many attendings gave consistent feedback, with those selecting 0-25 ​% or 76-100 ​% grouped as low-percentage (LP) or high-percentage (HP).

Predicting Cow's Milk Challenge Outcomes in Children: Multivariate Analysis of Clinical Predictors.

Introduction: Oral food challenges are the gold standard for diagnosis and reactivity thresholds but are resource-intensive and high-risk for reactions. Limited data on factors associated with increased risk of positive oral food challenges exist. We aimed to assess factors associated with positive oral food challenges and create a model to predict cow milk oral food challenge outcomes.

Food Insecurity and Clinical Outcomes in Surgical Trauma Patients.

Importance: Food insecurity, which is the lack of consistent access to sufficient and nutritious food, impacts over 1.3 billion individuals worldwide. The impact of food insecurity on primary care and medical subspecialties is recognized, but its influence on surgical outcomes remains underexplored.

The Use of an OSCE With a Standardized Patient Actor to Assess Professionalism and Communication for the Oral Certifying Examination: The Initial Experience of the American Board of Urology.

Purpose: Promotion of professionalism/communication (P/C) is a strategic initiative within the American Board of Medical Specialties; however, reliable assessment of this competency in the certification process is lacking. In this article, we present the findings of the American Board of Urology's P/C objective structured clinical examination (OSCE), which was implemented on the 2023 and 2024 certifying examinations.

Methods: The certifying examination was administered to 694 candidates (335 in 2023 and 359 in 2024).

The Relationship Between Tensor Fascia Latae and Gluteus Maximus Has the Potential to Indicate Early Intra-articular and Degenerative Pathologies of the Femoral-Acetabular Joint: A Narrative Review.

Unlabelled: Intra-articular and degenerative hip pathologies have become common place with the number of total hip replacements rising year on year in the United Kingdom (UK). Pathology is identified by clinicians using special tests which are researched maneuvers used by clinicians to rule in or rule out specific musculoskeletal pathologies. Special tests used for hip pathology usually have high specificity to exclude degenerative and intraarticular pathology but vary in sensitivity.

Proof of concept pilot study to assess the utility of magnetic resonance extra-cellular volume quantification to diagnose advanced liver disease in people with Cystic Fibrosis.

Background: Current diagnostic tools are limited in their ability to diagnose cystic fibrosis liver disease (CFLD) as disease is often focal in nature. Magnetic resonance extracellular volume quantification (MRI ECV) in the liver may have diagnostic utility in CFLD as a more selective liver volume is assessed and can be performed using equipment readily available in clinical practice on a standard MRI protocol.

Methods: Healthy volunteers (HV), CF participants with no liver disease (CF-noLD) and CF participants with cirrhosis (CF-C) aged 18 years and above had MRI ECV measured using a 3T Siemens scanner.

Feasibility and Safety of Peptide Receptor Radionuclide Therapy With 177Lu-DOTATATE for Neuroendocrine Tumor in a Patient With Sickle Cell Anemia.

A 56-year-old woman with sickle cell anemia (SCA) and metastatic neuroendocrine tumor refractory to somatostatin analog received 4 cycles of peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE. The treatment schedule was delayed by multiple episodes of hospitalizations related to underlying SCA. PRRT was well-tolerated with stable renal, hematologic, and liver lab parameters.

A pan-gene catalogue of Asian cultivated rice.

The rice genome underpins fundamental research and breeding, but the Nipponbare (japonica) reference does not fully encompass the genetic diversity of Asian rice. To address this gap, the Rice Population Reference Panel (RPRP) was developed, comprising high-quality assemblies of 16 rice cultivars to represent , , , and varietal groups. The RPRP has been consistently annotated, supported by extensive experimental data and here we report the computational assignment, characterization and dissemination of stably identified pan-genes.

Physiological Resilience: What Is It and How Might It Be Trained?

Physiological resilience has recently been recognized as an additional factor that influences endurance exercise performance. It has thus been incorporated into a modified, contemporary version of "the Joyner model" which acknowledges that start-line values of V̇Omax, efficiency or economy, and metabolic thresholds are prone to deterioration, often with appreciable interindividual variability, during prolonged endurance exercise. The physiological underpinnings of resilience are elusive and sports physiologists are presently concerned with developing practical testing protocols which reflect an athlete's resilience characteristics.