An Analysis of 24-Hour Survival Based on Arrival by Atypical Ground Transport Versus Ground Emergency Medical Services.

Objectives: Studies comparing police, privately owned vehicle (POV), and ground Emergency Medical Services (GEMS) trauma transports reveal mixed results. It remains unclear whether using nonstandard transport methods may be beneficial in the setting of certain injuries. We sought to determine 24-h survival after transport by police or POV when compared to GEMS.

Best Practices for Delivering Neoadjuvant Therapy in Pancreatic Ductal Adenocarcinoma.

Importance: Neoadjuvant therapy (NT) is an increasingly used treatment strategy for patients with localized pancreatic ductal adenocarcinoma (PDAC). Little research has been conducted on cancer care delivery during NT, and the standards for optimal delivery of NT have not been defined.

Objective: To develop consensus best practices for delivering NT to patients with localized PDAC.

Accelerated initiation of antiretroviral therapy by virtual health in service members newly diagnosed with HIV infection.

Objectives: Delays in HIV antiretroviral therapy (ART) have been associated with HIV disease progression and forward transmission. We evaluated the effectiveness of an accelerated ART virtual protocol (VP) for active duty (AD) members with incident HIV diagnosis.

Methods: Under the traditional protocol (TP), service members stationed worldwide were evaluated in-person at Brooke Army Medical Center (BAMC) and received comprehensive HIV care.

Protective effect of Apelin-13 on oxygen and glucose deprivation induced-damage in retinal ganglion cells cultured in vitro.

Ischemic-anoxic injury plays an important role in the pathophysiology of diabetes retinopathy, optic neuropathy, even glaucoma and other ocular diseases. It may ultimately cause damage to neuronal death like retinal ganglion cells (RGCs) and subsequent visual loss. RGCs are essential elements of the retina and optic nerve that are crucial to visual formation.

Socioecological drivers of burnout - a mixed methods study of military health providers.

Introduction: Health provider burnout is highly prevalent (28-51%) in the US and may contribute to a projected national health provider shortage by 2030. The Socioecological Model (SEM) is a proven conceptual framework used to identify influencing factors and design relevant solutions to improve health outcomes across multiple ecological levels. This study applied the SEM to identify modifiable drivers and solutions of burnout across multiple levels among US Military health providers.

The Utility of Whole Body Computed Tomography in Trauma Activations and the Impact of Incidental Findings on Patient Management: A Review.

Traumatic injury remains a leading cause of death globally, necessitating rapid and accurate diagnostic tools in emergency settings. Whole-body computed tomography (WBCT) has emerged as an increasingly utilized component in trauma care due to its speed and diagnostic precision. This review summarizes current data on the impact of WBCT on trauma mortality and examines the frequency and clinical implications of incidental findings (IFs).

DOES WHOLE BLOOD RESUSCITATION INCREASE RISK FOR VENOUS THROMBOEMBOLISM IN TRAUMA PATIENTS? A COMPARISON OF WHOLE BLOOD VS COMPONENT THERAPY IN 3468 PATIENTS.

Background: Whole blood (WB) resuscitation has been shown to provide mortality benefit. However, the impact of whole blood transfusions on the risk of venous thromboembolism (VTE) remains unclear. We sought to compare the VTE risk in patients resuscitated with WB vs component therapy (COMP).

Advancements and challenges of R-loops in cancers: Biological insights and future directions.

R-loops involve in various biological processes under human normal physiological conditions. Disruption of R-loops can lead to disease onset and affect the progression of illnesses, particularly in cancers. Herein, we summarized and discussed the regulative networks, phenotypes and future directions of R-loops in cancers.

Perceived barriers and facilitators to implementation of injury prevention programs in the military: Feedback from inside the trenches.

Background: Musculoskeletal injuries enact a substantial burden in military settings, incurring high costs, long-term disability, and impacting military readiness. This has led to a prioritization of injury prevention programs. Understanding the challenges faced by those trying to implement these programs could help standardize and better inform future efforts.

Injuries Associated With Mandated Wear of Body Armor in Iraq.

Introduction: Protective ballistic body armor (BA) may be needed during certain threat postures while deployed. This requirement often adds between 35 and 45lbs of extra weight carried by the service member (SM) for multiple hours during the day. The physical toll of that extra weight and the effect it may have on deployed medical resources has not been clearly characterized in the literature.

Predicting deep infection in pilon and tibial plateau fractures: a secondary analysis of the VANCO and OXYGEN trials.

Objectives: To develop and validate a prediction model for a deep surgical site infection (SSI) after fixation of a tibial plateau or pilon fracture.

Design: Pooled data from 2 randomized trials (VANCO and OXYGEN).

Setting: Fifty-two US trauma centers.

Enteral Resuscitation: A Field-Expedient Treatment Strategy for Burn Shock during Wartime and in Other Austere Settings.

Burn injuries are a constant threat in war. Aspects of the modern battlefield increase the risk of burn injuries and pose challenges for early treatment. The initial resuscitation of a severely burn-injured patient often exceeds the resources available in front-line medical facilities.

Extracorporeal Organ Support for Burn-Injured Patients.

As mortality relating to severe acute burn injury improves, patients are surviving longer into the critical care phase, which is commonly complicated by multisystem organ failure. Extracorporeal organ support (ECOS) represents a set of potential therapeutic technologies for managing patients with organ-specific complications. This article provides a comprehensive review of the existing literature, focusing on the use of continuous kidney replacement therapy, extracorporeal membrane oxygenation, extracorporeal carbon dioxide removal, and extracorporeal blood purification.

Diagnosis and Treatment of Infections in the Burn Patient.

Infection is very common in burn patients because they lose the primary barrier from microorganism invasion, the skin. While there are attempts to prevent infections, topical antimicrobials and systemic prophylaxis tend to lead to more resistant organisms. After the initial resuscitation, the most common cause of death is from sepsis and multiple organ dysfunction syndrome.