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.

Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.

Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.

Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.

Supporting Children's Mental Health Needs in Disasters.

Public health emergencies, including climate-related and manmade disasters such as active shooter incidents, occur regularly in the United States. A comprehensive approach is needed to ensure that children's mental health needs are adequately addressed following disasters. This article summarizes the latest evidence on how health systems can effectively address children's unique developmental, social, emotional, and behavioral needs in the context of disasters.

Enhanced sensitivity of TAPscan v4 enables comprehensive analysis of streptophyte transcription factor evolution.

Transcription-associated proteins (TAPs) fulfill multiple functions in regulatory and developmental processes and display lineage-specific evolution. TAPscan is a comprehensive and highly reliable tool for genome-wide TAP annotation via domain profiles. Here, we present TAPscan v4, including an updated web interface (https://tapscan.

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.

Prevalence and Outcomes of Chronic Kidney Disease-Associated Pruritus: International Results from Peritoneal Dialysis Outcomes and Practice Patterns Study.

Key Points: CKD-associated pruritus is highly prevalent among peritoneal dialysis patients. Pruritus is associated with reduced health-related quality of life, and the composite of mortality and transfer to hemodialysis for peritoneal dialysis patients. Efforts to better identify and manage pruritus in this population are needed.

Harmonic and Subharmonic RF Injection Locking of THz Metasurface Quantum-Cascade VECSEL.

Harmonic and subharmonic RF injection locking is demonstrated in a terahertz (THz) quantum-cascade vertical-external-cavity surface-emitting laser (QC-VECSEL). By tuning the RF injection frequency around integer multiples and submultiples of the cavity round-trip frequency, different harmonic and subharmonic orders can be excited in the same device. Modulation-dependent behavior of the device has been studied with recorded lasing spectral broadening and locking bandwidths in each case.

Structural variation in the pangenome of wild and domesticated barley.

Pangenomes are collections of annotated genome sequences of multiple individuals of a species. The structural variants uncovered by these datasets are a major asset to genetic analysis in crop plants. Here we report a pangenome of barley comprising long-read sequence assemblies of 76 wild and domesticated genomes and short-read sequence data of 1,315 genotypes.

Inclusion of Veterans Health Administration hospitals in Centers for Medicare & Medicaid Services Overall Hospital Quality Star Ratings.

Background/objective: The Centers for Medicare & Medicaid Services (CMS) Overall Hospital Quality Star Rating, established in 2016, is a summary of publicly available quality information for acute care hospitals. In July 2023, Veterans Health Administration (VHA) hospitals became eligible to receive a CMS Overall Hospital Quality Star Rating for the first time. Our objective was to compare performance in quality ratings among VHA and non-VHA hospitals.

Outcomes and physiologic responses associated with ketamine administration after traumatic brain injury in the United States and Canada: a retrospective analysis.

Purpose: Ketamine has historically been contraindicated in traumatic brain injury (TBI) due to concern for raising intracranial pressure. However, it is increasingly being used in TBI due to the favorable respiratory and hemodynamic properties. To date, no studies have evaluated whether ketamine administered in subjects with TBI is associated with patient survival or disability.

Prehospital Delta Shock Index Predicts Mortality and Need for Life Saving Interventions in Trauma Patients.

Objectives: The delta shock index (ΔSI), defined as the change in shock index (SI) over time, is associated with hospital morbidity and mortality, but prehospital studies about ΔSI are limited. We investigate the association of prehospital ΔSI with mortality and resource utilization, hypothesizing that increases in SI among field trauma patients are associated with increased mortality and blood product transfusion.

Methods: We performed a multicenter, retrospective, observational study from the Linking Investigators in Trauma and Emergency Services (LITES) network.

A framework for developing a real-time lake phytoplankton forecasting system to support water quality management in the face of global change.

Phytoplankton blooms create harmful toxins, scums, and taste and odor compounds and thus pose a major risk to drinking water safety. Climate and land use change are increasing the frequency and severity of blooms, motivating the development of new approaches for preemptive, rather than reactive, water management. While several real-time phytoplankton forecasts have been developed to date, none are both automated and quantify uncertainty in their predictions, which is critical for manager use.

Global Challenges After a Global Challenge: Lessons Learned from the COVID-19 Pandemic.

Coronavirus disease 2019 (COVID-19) has affected not only individual lives but also the world and global systems, both natural and human-made. Besides millions of deaths and environmental challenges, the rapid spread of the infection and its very high socioeconomic impact have affected healthcare, economic status and wealth, and mental health across the globe. To better appreciate the pandemic's influence, multidisciplinary and interdisciplinary approaches are needed.

Diagnostic Performance of GFAP, UCH-L1, and MAP-2 Within 30 and 60 Minutes of Traumatic Brain Injury.

Importance: Data on the performance of traumatic brain injury (TBI) biomarkers within minutes of injury are lacking.

Objectives: To examine the performance of glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and microtubule-associated protein 2 (MAP-2) within 30 and 60 minutes of TBI in identifying intracranial lesions on computed tomography (CT) scan, need for neurosurgical intervention (NSI), and clinically important early outcomes (CIEO).

Design, Setting, And Participants: This cohort study is a biomarker analysis of a multicenter prehospital TBI cohort from the Prehospital Tranexamic Acid Use for TBI clinical trial conducted across 20 centers and 39 emergency medical systems in North America from May 2015 to March 2017.

Association of emergency department characteristics with presence of recommended pediatric-specific behavioral health policies.

Objectives: In the United States, pediatric emergency department (ED) visits for behavioral health (BH) are increasing. We sought to determine ED-level characteristics associated with having recommended BH-related policies.

Methods: We conducted a retrospective serial cross-sectional study of National Pediatric Readiness Project assessments administered to US EDs in 2013 and 2021.

Biobased Self-Healing Thin Film Coatings Based on Poly (Itaconic Acid Esters).

Paper used for packaging applications is often coated with thin polymer coatings to improve the properties, like printability and barrier properties, respectively. Today, these coatings are still often based on petroleum-based polymers. In this study, the fabrication of biobased thin film coatings is described.

The rs2046210 Polymorphism Is Associated with Endometriosis Risk and Elevated Estrogen Receptor 1 Expression in the Eutopic Endometrium of Women with the Disease.

In this focused genetic case-control study, we analyzed two functional single-nucleotide variants (SNVs) associated with breast cancer risk (rs2046210, rs9383590) and one risk SNV for an implantation defect and infertility (rs9340799) for their association with endometriosis susceptibility, progression and gene regulation in endometriosis patients. The rs2046210, rs9383590 and rs9340799 SNVs were genotyped in 153 endometriosis patients and 87 control subjects with Caucasian ancestry. We analyzed the association of all SNVs with endometriosis susceptibility in all patients and in subgroups and assessed the concordance between the SNVs.

Antithrombin III Levels and Outcomes Among Patients With Trauma.

Importance: Patients with trauma exhibit a complex balance of coagulopathy manifested by both bleeding and thrombosis. Antithrombin III is a plasma protein that functions as an important regulator of coagulation. Previous studies have found a high incidence of antithrombin III deficiency among patients with trauma.

Quality Measurement in Oncology: Time to Take the Next Step!

Oncology is a complex clinical specialty often requiring the close interaction of teams of different medical specialists for a successful outcome. The field is rapidly evolving scientifically, with successive discoveries of oncologic driver mutations soon followed by therapeutic agents able to interrupt the neoplastic process. Unfortunately, objective quality measurement demonstrates that many patients are not receiving optimal care, from diagnostic accuracy, therapeutic, or end-of-life perspectives.