Early achievement of hemostasis defined by transfusion velocity: A possible mechanism for whole blood survival benefit.

Introduction: Whole blood resuscitation is associated with survival benefits in observational cohort studies. The mechanisms responsible for outcome benefits have not been adequately determined. We sought to characterize the achievement of hemostasis across patients receiving early whole blood versus component resuscitation.

Perspective: Challenges for Personalized Nutrition in the Current U.S. Regulatory Framework and Future Opportunities.

Personalized Nutrition (PN) aims to provide tailored dietary recommendations to improve a person's health outcomes by integrating a multitude of individual-level information and support desired behavior changes. The field is rapidly evolving with technological advances. As new biomarkers are discovered, wearables and other devices can now provide up-to-the-minute insights, and artificial intelligence (AI) and machine learning (ML) models support recommendations and lifestyle behavior change.

A Novel Fibrinolysis Resistance Capacity Assay Can Detect Fibrinolytic Phenotypes in Trauma Patients.

Background:  To evaluate residual fibrinolysis resistance activity (FRA) in plasma, a detergent-modified plasma clot lysis assay time (dPCLT) was established in which α2-antiplasmin (A2AP) and plasminogen activator inhibitor type 1 (PAI-1) are inactivated without impacting protease activity. We applied this novel assay to severely injured trauma patients' plasma.

Material And Methods:  Tissue-type plasminogen activator (tPA)-induced plasma clot lysis assays were conducted after detergents- (dPCLT) or vehicle- (sPCLT) treatment, and time to 50% clot lysis was measured ("transition midpoint", T ).

The tissue-plasminogen activator-challenged thromboelastography provides a comprehensive assessment of fibrinolysis in the severely injured.

Background: Tissue-plasminogen activator-challenged thromboelastography (tPA-TEG) predicts massive transfusion and mortality better than conventional rapid thromboelastography (rTEG), with little concordance between their lysis values (LY30). We hypothesized that the main fibrinolytic inhibitors plasminogen activator inhibitor-1 (PAI-1) and α-2 antiplasmin (A2AP), as well as markers of fibrinolytic activation (plasmin-antiplasmin [PAP], tPA-PAI-1 complex, tPA activity), would correlate more strongly with tPA-TEG versus rTEG LY30 and may explain the recent findings of four distinct fibrinolytic phenotypes in trauma based on these two TEG methodologies.

Methods: Adult trauma patients (n = 56) had tPA-TEG, rTEG, and plasma obtained on arrival to the emergency department with institutional review board approval.

Experiences of Gender-Diverse Youth Living With Chronic Pain.

Background: Although sex differences in pain are well documented, little is known regarding the relationship between gender and pain. Gender-diverse youth experience unique pain risk factors, including minority stress exposure, but are underrepresented in research.

Objective: Elicit experiences of gender-diverse youth who live with chronic pain.

Recommendations for Specialty Palliative APRN Graduate Education.

Background: Advanced practice registered nurses (APRNs) are essential to care for the growing number of individuals with advanced illness given the shortage of palliative care clinicians.

Problem: Graduate education for specialty practice palliative APRNs lacks consistency in structure, content, and standardization of specialty palliative APRN education.

Approach: A workgroup of expert palliative APRNs and graduate faculty conducted focused discussions and a literature review to develop consensus recommendations based on national palliative APRN competencies and aligned with the 8 core concepts of the AACN Essentials.

What is the impact of sports-related gambling advertising on gambling behaviour? A systematic review.

Background And Aims: Gambling is a public health issue and widespread advertising of gambling products may contribute to gambling harms. Sports-related gambling advertising includes advertising around sports games or for sports betting products. This review aimed to provide the most systematic and up-to-date review of the literature on the association between sports-related gambling advertising and gambling behaviour.

The Impact of "Close Margins" in HPV-Associated Oropharyngeal Squamous Cell Carcinoma Treated with TORS.

Objective: Margin distance is a significant prognosticator in oral cavity cancer but its role in HPV-related oropharyngeal squamous cell carcinoma [HPV(+)OPSCC] remains unclear. Here, we investigate the impact of margin distance on locoregional recurrence in HPV(+)OPSCC.

Study Design: This is a retrospective cohort study of surgically treated HPV(+)OPSCC patients.

The inability to predict futility in hemorrhaging trauma patients using 4-hour transfusion volumes and rates.

Background: Blood shortages and utilization stewardship have motivated the trauma community to evaluate futility cutoffs during massive transfusions (MTs). Recent single-center studies have confirmed meaningful survival in ultra-MT (≥20 U) and super-MT (≥50 U), while others advocate for earlier futility cut points. We sought to evaluate whether transfusion volume and intensity cut points could predict 100% mortality in a multicenter analysis.

Splenectomy versus angioembolization for severe splenic injuries in a national trauma registry: To save, or not to save, the spleen, that is the question.

Background: The use of angioembolization as a first approach for treating severe, blunt splenic injuries has increased recently, yet evidence showing its superiority to immediate splenectomy is lacking. We compared the prognosis of angioembolization versus splenectomy in patients presenting hemodynamically unstable with high-grade, image-confirmed, blunt splenic injuries in a nationally representative dataset.

Methods: We queried the 2017-2022 Trauma Quality Improvement Program database for adults with blunt splenic injury abbreviated injury scale = 4-5, with arrival systolic blood pressure <90 mm Hg, and treated with either angioembolization or splenectomy <6 hours of arrival after a computed tomography scan.

Machine Learning Prediction of Nitric Acid Extraction Behavior in PUREX Process.

Plutonium uranium reduction extraction (PUREX) is a liquid-liquid extraction process used to recover plutonium (Pu) and uranium (U) from irradiated uranium fuel for various nuclear-related applications. Despite extensive efforts, quantitative prediction of liquid-liquid extraction parameters, i.e.

Prevalence of Neurodiversity in a UK High Secure Psychiatric Hospital Cohort: A Records Study.

Background: The term neurodiversity is an umbrella term for any atypical pattern of cognitive ability, including but not confined to neurodevelopmental disorders. Research suggests that several neurodivergent conditions are overrepresented in offender populations, with a recent survey suggesting that over half of those coming into contact with the criminal justice system may have a neurodivergent condition. Considerable effort has been invested in trying to divert people with such conditions out of long-stay hospitals, but nevertheless, a few studies in secure hospitals suggest that while prevalence in hospitals may be lower than in prisons, it is high relative to the general population.

How I diagnose high-grade B-cell lymphoma.

Objectives: High-grade B-cell lymphoma (HGBL), introduced in the 2016 World Health Organization (WHO) revised fourth edition classification, included cases defined by MYC and BCL2 and/or BCL6 rearrangements or by high-grade morphology. Diagnostic criteria and nomenclature for these lymphomas were refined in the 2022 WHO fifth edition (WHO-5) classification and International Consensus Classification (ICC). This review describes our approach to the diagnosis of HGBL.

Investigating the Role of Primary Cilia and Bone Morphogenetic Protein Signaling in Periodontal Ligament Response to Orthodontic Strain In Vivo and In Vitro: A Pilot Study.

Periodontal ligament (PDL) cells are crucial for mechanosensation and mechanotransduction within the PDL, yet the role of primary cilia in orthodontic force transmission has not been examined. While bone morphogenetic protein (BMP) signaling significantly influences ciliary function, its effect on cellular responses to mechanical stress has not been investigated. This study aims to investigate whether primary cilia and BMP signaling are involved in the periodontal ligament's response to orthodontic tooth movement and the resultant mechanical strain.

PAG orchestrates T cell immune synapse function by binding to actin.

Unlabelled: Many immunotherapies impact T cell function by impacting the immune synapse. While immunotherapy is extremely successful in some patients, in many others, it fails to help or causes complications, including immune-related adverse events. Phosphoprotein Associated with Glycosphingolipid Rich Microdomains 1 (PAG) is a transmembrane scaffold protein with importance in T cell signaling.

National Trends and Benchmarks for Operative Time and Hospital Length of Stay in Parotidectomies.

Objective: The extent of parotidectomy for benign tumors has de-escalated in the United States. We aim to define modern benchmarks for operative time and hospital length of stay (LOS) in parotidectomy and identify risk factors that may prolong these benchmarks.

Study Design: This is a retrospective cross-sectional study of all adults who underwent parotidectomy for a primary parotid neoplasm between January 2011 and December 2021 using the American College of Surgeons National Surgical Quality Improvement Program database.

PARTIAL OCCLUSION, LESS AKI: AN AORTA REGISTRY ANALYSIS OF PREBOA-PRO.

Background: Noncompressible torso hemorrhage remains a leading cause of potentially preventable deaths. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has emerged as an adjunct temporizing hemorrhage control. The complete occlusion strategy with the ER-REBOA catheter can cause distal ischemia when used for longer than 30 min.

Wavelength-dependent intersystem crossing dynamics of phenolic carbonyls in wildfire emissions.

Quantum chemical calculations were employed to construct Jablonski diagrams for a series of phenolic carbonyls, including vanillin, iso-vanillin, 4-hydroxybenzaldehyde, syringaldehyde, and coniferyl aldehyde. These molecules can enter the Earth's atmosphere from forest fire emissions and participate in photochemical reactions within the atmospheric condensed phase, including cloud and fog droplets and aqueous aerosol particles. This photochemistry alters the composition of light-absorbing organic content, or brown carbon, in droplets and particles through the formation and destruction of key chromophores.

Motivators and barriers to exercise in college students compared to faculty and staff.

: Compare the barriers and motivators to exercise in faculty/staff compared to students. : Students and faculty/staff who were enrolled or employed at a college in Pennsylvania were emailed a link to a 91-question online Qualtrics survey. : The survey collected demographic information as well as physical activity habits and included the Barriers to Being Active Questionnaire, Motivations for Physical Activities Measure, and Behavioral Regulation in Exercise Questionnaire.

Evolution of whole blood trauma resuscitation in childbearing age females: practice patterns and trends.

Background: The use of low titer group O whole blood (LTOWB) for resuscitation of patients with traumatic hemorrhage is becoming increasingly common. Practices regarding the administration of RhD-positive LTOWB to childbearing age females (CBAFs) vary between institutions due to concerns about RhD alloimmunization. This study examined practices related to LTOWB transfusion as they pertain to age and sex.

Predictors of Length of Physical Therapy Care for Infants With Congenital Torticollis.

Purpose: This study explored whether the type of torticollis, amount of tummy time or container time, participant age at examination, and Alberta Infant Motor Scales score influence the length of physical therapy care for infants with torticollis.

Methods: Data for 149 participants were extracted from medical records for infants with torticollis who received care between November 2018 and November 2021.

Results: Statistically significant correlations were found between length of care (LOC) and torticollis type, age at examination, active range of motion rotation deficit, and passive range of motion rotation deficit.

Developing a modern radiotherapy department in a rural hospital in Cameroon: The Mbingo experience.

Although radiotherapy is critical for cancer cure and palliation, access to such expensive and sophisticated technology is very limited in low- and middle-income countries (LMIC). Cancer incidence in Africa is currently 1.5 million case per year, thus urgent and innovative solutions are required to build necessary infrastructure needed to address this global health challenge.