Accuracy, reliability, and utility of the extended focused assessment with sonography in trauma examination in the setting of thoracic gunshot wounds.

Background: The extended focused assessment with sonography in trauma (eFAST) examination includes additional thoracic views beyond the standard focused assessment with sonography in trauma examination. Its validation has predominantly been conducted in blunt trauma cases. Our aim was to evaluate the eFAST examination in a targeted population with penetrating thoracic trauma.

Syntheses of Structurally Complex Marine Cyclopropyl-Diterpenoids: Peyssonnoside A and Its Aglycon.

Peyssonnoside A is a marine-derived sulfated diterpenoid glucoside featuring a remarkable 5/6/3/6 tetracyclic skeleton with a highly substituted cyclopropane ring deeply embedded in its structure. Herein, we report on the full development of the first total synthesis of this natural product and its aglycon, peyssonnosol. Through the experimental evaluation of a series of synthetic strategies, including utilization of Ohloff-Rautenstrauch cycloisomerization and C-H allylation, we identified a concise, efficient, and highly diastereoselective route.

The viral serpin SPI-1 directly inhibits the host cell serine protease FAM111A.

The host-range mutant of rabbitpox virus (RPXV) with a deletion in the gene encoding the serpin serine protease inhibitor 1 (SPI-1) fails to replicate efficiently in restrictive host cells. Depletion of the host cell serine protease FAM111A restores viral replication in these cells, suggesting that SPI-1 targets FAM111A to facilitate infection. However, direct evidence of SPI-1 inhibiting FAM111A has been lacking.

Combination of deep learning reconstruction and quantification for dynamic contrast-enhanced (DCE) MRI.

Dynamic contrast-enhanced (DCE) MRI is an important imaging tool for evaluating tumor vascularity that can lead to improved characterization of tumor extent and heterogeneity, and for early assessment of treatment response. However, clinical adoption of quantitative DCE-MRI remains limited due to challenges in acquisition and quantification performance, and lack of automated tools. This study presents an end-to-end deep learning pipeline that exploits a novel deep reconstruction network called DCE-Movienet with a previously developed deep quantification network called DCE-Qnet for fast and quantitative DCE-MRI.

Bail Out Procedures in Acute Cholecystitis: Risk Factors and Optimal Approach.

Background: For difficult cholecystectomies, bail out procedures (BOP) are performed to mitigate risk of patient harm.

Objective: This study sought to identify risk factors for BOP for acute cholecystitis and to compare outcomes by type of BOP performed. Patients with acute cholecystitis who underwent cholecystectomy were included (2020-2022).

Hyperfibrinolysis: a crucial phenotypic abnormality of posttraumatic fibrinolytic dysfunction.

Background: Traumatic fibrinolytic dysfunction is often categorized into 3 phenotypes based on the result of thromboelastography (TEG) lysis at 30 minutes (LY30): fibrinolysis shutdown, physiologic fibrinolysis, and hyperfibrinolysis. However, the molecular pathophysiology of fibrinolytic dysfunction and the association with clinical outcomes have not been fully evaluated.

Objectives: To assess whether posttraumatic fibrinolysis phenotypes identified by TEG correlate with levels of key fibrinolysis-related serum markers and with risk of mortality and hospital complications.

Venous thromboembolism chemoprophylaxis after severe polytrauma: timing and type of prophylaxis matter.

In this review, we provide recommendations as well as summarize available data on the optimal time to initiate venous thromboembolism chemoprophylaxis after severe trauma. A general approach to the severe polytrauma patient is provided as well as in-depth reviews of three high-risk injury subgroups: patients with traumatic brain injury, solid organ injury, and pelvic fractures.

Sex-based utilization and outcomes of cold-stored whole blood for trauma resuscitation: Analysis of a prospective multicenter study.

Background: Resuscitation with cold-stored whole blood (WB) has outcome benefits, but benefits varied by patient sex is unknown. There are also concerns about alloimmunization risk for premenopausal females given WB, leading to some protocols excluding this cohort. We sought to analyze WB utilization, outcomes, and disparities by patient sex.

Outcomes Following Surgical and Nonsurgical Treatment for Uncomplicated Appendicitis in Older Adults.

Importance: The optimal treatment of acute uncomplicated appendicitis in older adults with frailty is not defined.

Objective: To examine outcomes associated with treatment strategies for acute uncomplicated appendicitis in older adults with or without frailty.

Design, Setting, And Participants: This retrospective cohort study used National Inpatient Sample data from adults 65 years or older with a diagnosis of uncomplicated appendicitis from January 1, 2016, to December 31, 2018.

The influence of the interventionalist's sex on the outcome and complications of transbronchial lung cryobiopsy.

Background: To date there are no data on sex aspects evaluating outcomes of interventional pneumology (IP). Our aim was to investigate sex differences in transbronchial lung cryobiopsy (TBLC) outcomes in the diagnosis of interstitial lung disease (ILD).

Methods: All consecutive (TBLC)s performed for ILD evaluation between Nov 17 and Dec 21 at a tertiary referral center for ILDs and IP were analyzed.

Unhoused and Injured: Injury Characteristics and Outcomes in Unhoused Trauma Patients.

Introduction: The unhoused population is known to be at high risk for traumatic injury. However, there are scarce data regarding injury patterns and outcomes for this patient group. This study aims to investigate any differences in injury characteristics and hospital outcomes between unhoused and housed patients presenting with traumatic injuries.

Photoacoustic Quantification of Tissue Oxygenation Using Conditional Invertible Neural Networks.

Intelligent systems in interventional healthcare depend on the reliable perception of the environment. In this context, photoacoustic tomography (PAT) has emerged as a non-invasive, functional imaging modality with great clinical potential. Current research focuses on converting the high-dimensional, not human-interpretable spectral data into the underlying functional information, specifically the blood oxygenation.

An Abdominal Seat Belt Sign is Associated With Similar Incidence of Hollow Viscus Injury but Increased In-Hospital Mortality in Older Adult Trauma Patients: A PCSA Multicenter Study.

Background: The abdominal seat belt sign (SBS) is associated with an increased risk of hollow viscus injury (HVI). Older age is associated with worse outcomes in trauma patients. Thus, older trauma patients ≥65 years of age (OTPs) may be at an increased risk of HVI with abdominal SBS.

Bile Duct Injuries During Urgent Cholecystectomy at a Safety Net Teaching Hospital: Attending Experience and Time of Day May Matter.

Bile duct injury (BDI) is one of the most severe complications during cholecystectomy. Early identification of risk factors for BDI may permit risk reduction strategies and inform patient consent. This study aimed to define patient, provider, and systemic factors associated with BDI; BDI incidence; and short-term outcomes of BDI after urgent cholecystectomy.