Prospective multi-centre analysis of rural trauma team development training for medical trainees and traffic law enforcement professionals in Uganda: an interrupted time series study.

Background: Research shows that trauma team formation could potentially improve effectiveness of injury care in rural settings. The aim of this study was to determine the feasibility of rural trauma team training amongst medical trainees and traffic law enforcement professionals in Uganda.

Methods: Prospective multi-centre interrupted time series analysis of an interventional training based on the 4th edition of rural trauma team development course of the American College of Surgeons.

Health system financing fragmentation and maternal mortality transition in Mexico, 2000-2022.

Objective: To analyze the temporal and territorial relationship between health system financing fragmentation and maternal mortality in the last two decades in Mexico.

Methods: We conducted an ecological-longitudinal study of the maternal mortality ratio (MMR) in the 32 states of Mexico during the period 2000-2022. Annual MMRs were estimated at the national and state levels according to health insurance.

Engaging Patients in Discussions About Medication Deprescribing.

Background: Deprescribing, intentional medication discontinuation or dose reduction, can reduce potentially inappropriate medication use and medication-related harms. Engaging patients in deprescribing discussions may increase likelihood of deprescribing and promote shared decision-making.

Objective: To examine the impact of patient-directed educational brochures on patient engagement and deprescribing discussions with primary care providers (PCPs).

Engineering synthetic signaling receptors to enable erythropoietin-free erythropoiesis.

Blood transfusion plays a vital role in modern medicine, but frequent shortages occur. Ex vivo manufacturing of red blood cells (RBCs) from universal donor cells offers a potential solution, yet the high cost of recombinant cytokines remains a barrier. Erythropoietin (EPO) signaling is crucial for RBC development, and EPO is among the most expensive media components.

Is there a mental health diagnostic crisis in primary care? Current research practices in global mental health cannot answer that question.

In low- and middle-income countries, fewer than 1 in 10 people with mental health conditions are estimated to be accurately diagnosed in primary care. This is despite more than 90 countries providing mental health training for primary healthcare workers in the past two decades. The lack of accurate diagnoses is a major bottleneck to reducing the global mental health treatment gap.

Currently Available Radiology-Specific Reporting Guidelines.

The aim of this paper is to contextualize and review reporting guidelines available at the EQUATOR Network that are most relevant to radiology-specific investigations. Eight EQUATOR Network reporting guidelines for the clinical area of radiology, not including the subspecialized areas of imaging of the cardiovascular, neurologic, and oncologic diseases are reviewed and discussed. The reporting guidelines are for diagnostic and therapeutic clinical research.

Starfield's 4Cs of NCD management in primary healthcare: a conceptual framework development from a case study of 19 countries.

Introduction: Faced with a backdrop of an increasing chronic disease burden from an ageing global population compounded with rising healthcare costs, health systems are required to implement cost-effective, safe and equitable care through efficient service delivery models. One approach to achieving this is through Starfield's 4Cs of primary healthcare (PHC), which delineates the key attributes of a high-performing PHC system that upholds the pillars of care coordination, first contact of care, continuity of care and comprehensive care. Therefore, this study aims to explore and elucidate the key themes and subthemes related to and extending beyond Starfield's 4Cs of PHC by integrating findings from a comprehensive literature review and a qualitative study.

Changes in Out-of-Pocket Drug Expenditures Among Medicare Beneficiaries with Dementia Under the Inflation Reduction Act: A Simulation Study.

Objectives: We investigated how the Inflation Reduction Act (IRA) Medicare Part D benefit redesign may reduce out-of-pocket (OOP) drug expenditures for Medicare beneficiaries with dementia. Methods Design Utilizing data from the Health and Retirement Study (HRS) linked with Medicare claims, we simulated post-redesign OOP drug spending by applying the 2025 prescription drug cost-sharing rules to each beneficiary's pre-redesign Part D medication utilization data for 2016, adjusting for inflation. Participants Our study population comprised HRS respondents aged 65 and older in 2016, enrolled in Medicare fee-for-service, with at least one Part D drug claim in 2016, and diagnosed with dementia between 2000 and 2016 (n=1,677).

National Survey of Lung Cancer Screening Eligibility in United States Veterans.

Introduction: Lung cancer screening is underutilized, especially in rural areas where lung cancer mortality is high. Approximately 11.2% of the United States (US) population over age 50 meet the United States Preventive Services Task Force (USPSTF) 2021 lung cancer screening eligibility criteria; the proportion of eligible Veterans is unknown.

What happens after menopause? (WHAM): A prospective controlled study of cognition 24 months after premenopausal risk-reducing salpingo-oophorectomy.

Objective: Women with BRCA1/2 pathogenic variants considering risk-reducing bilateral oophorectomy (RRSO) may be concerned about potential effects of surgical menopause on cognition. Whether RRSO affects cognition and whether hormone therapy (HT) modifies this effect remains uncertain. This study aimed to prospectively measure the effect of premenopausal RRSO on cognition and the modifying effects of HT up to 24 months.

A call to action for disrupting microaggressions, improving interprofessional collaboration, and optimizing outcomes: Nurse leaders have a role.

Background: Microaggressions are pervasive in clinical and academic environments, often unnoticed by those unaware of the privileges and power dynamics tied to socially constructed hierarchies. These subtle manifestations of bias and prejudice are typically directed toward historically marginalized individuals and groups (HMIGs), contributing to a toxic culture that undermines interprofessional communication, collaboration, and healthcare delivery.

Purpose: This article aims to explore the concept of microaggressions and their impact on healthcare environments.

Oral Regimens for Rifampin-Resistant, Fluoroquinolone-Susceptible Tuberculosis.

Background: For decades, poor treatment options and low-quality evidence plagued care for patients with rifampin-resistant tuberculosis. The advent of new drugs to treat tuberculosis and enhanced funding now permit randomized, controlled trials of shortened-duration, all-oral treatments for rifampin-resistant tuberculosis.

Methods: We conducted a phase 3, multinational, open-label, randomized, controlled noninferiority trial to compare standard therapy for treatment of fluoroquinolone-susceptible, rifampin-resistant tuberculosis with five 9-month oral regimens that included various combinations of bedaquiline (B), delamanid (D), linezolid (L), levofloxacin (Lfx) or moxifloxacin (M), clofazimine (C), and pyrazinamide (Z).

Natural Language Processing Identifies Under-Documentation of Symptoms in Patients on Hemodialysis.

Background: Patients on hemodialysis (HD) have a high burden of emotional and physical symptoms. These symptoms are often under-recognized. NLP can be used to identify patient symptoms from the EHR.

Revolutionising Osseous Biopsy: The Impact of Artificial Intelligence in the Era of Personalised Medicine.

In a rapidly evolving healthcare environment, artificial intelligence (AI) is transforming diagnostic techniques and personalised medicine. This is also seen in osseous biopsies. AI applications in radiomics, histopathology, predictive modelling, biopsy navigation, and interdisciplinary communication are reshaping how bone biopsies are conducted and interpreted.

Implicit and Explicit Race and Weight Biases Among Physician Assistant Preceptors and Trainees.

Introduction: As new equity, diversity, and inclusion programs emerge in physician assistant/associate (PA) education, there is a need to assess baseline levels of implicit and explicit biases among PA preceptors' and trainees. The objectives of this study were (1) to measure implicit and explicit race (Black/White) and weight (fat/thin) biases among PA preceptors and trainees and (2) to identify potential gaps in PA preceptor and trainee education.

Methods: This is a cross-sectional study of PA preceptors and trainees from one program operating in several US states; implicit and explicit race and antifat biases and receipt of prior education were measured.

Developing an Intervention to Enhance Aging in Place for Older Veterans Living in Permanent Supportive Housing.

Background And Objectives: The Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program provides rental subsidies, case management, and supportive services to Veterans who are currently or formerly homeless, 77% of whom are ages ≥50. Few interventions have been developed to address the needs of older Veterans in HUD-VASH.

Research Design And Methods: We conducted a 2-stage study to inform the development of an intervention to promote aging in place in HUD-VASH.

"It's that feeling that you can't get away": Motherhood, gender inequality and the stress process during extreme events.

The impacts of extreme events can intersect with pre-disaster systemic inequalities and deficiencies, exacerbating distress. This paper contributes to the existing literature by exploring the psychosocial processes through which stressors become traumatic during an extreme event. It does so by focusing on how mothers of children and/or adolescents in the United Kingdom experienced the COVID-19 pandemic.

Implementing Food as Medicine During COVID-19: Produce Prescriptions and Integrative Group Medical Visits in Federally Qualified Health Centers.

Background: Food as Medicine is a rapidly developing area of health care in the United States, aimed at concurrently addressing nutrition-sensitive chronic conditions and food and nutrition insecurity. Recipe4Health (R4H) is a Food as Medicine program with an integrative health equity focus. It provides prescriptions for locally grown produce ('Food Farmacy') with or without integrative group medical visits, alongside training for clinic staff.

Exploring Skin Tone Diversity in a Plastic Surgery Resident Education Curriculum.

Gaps remain in surgical education regarding the representation of skin tone diversity. To improve equity and prevent misdiagnosis leading to worsened health outcomes, efforts must be made to ensure educational photographs are representative of the diverse patient populations plastic surgery residents will be treated in their future practices. Four study investigators examined 96 h of recorded lecture seminars from a Canadian plastic surgery resident education curriculum from May 2020 to December 2021.

The promise of community-driven preprints in ecology and evolution.

Publishing preprints is quickly becoming commonplace in ecology and evolutionary biology. Preprints can facilitate the rapid sharing of scientific knowledge establishing precedence and enabling feedback from the research community before peer review. Yet, significant barriers to preprint use exist, including language barriers, a lack of understanding about the benefits of preprints and a lack of diversity in the types of research outputs accepted (e.

Long COVID and its risk factors in migrants: a nationwide register study from Sweden.

Background: Many studies have found more severe COVID-19 outcomes in migrants and ethnic minorities throughout the COVID-19 pandemic, while recent evidence also suggests higher risk of longer-term consequences. We studied the risk of a long COVID diagnosis among adult residents in Sweden, dependent on country of birth and accounting for known risk factors for long COVID.

Methods: We used linked Swedish administrative registers between March 1, 2020 and April 1, 2023, to estimate the risk of a long COVID diagnosis in the adult population that had a confirmed COVID-19 infection.

Screening high-risk Veterans for cirrhosis: taking a stepwise population health approach.

Background: Because cirrhosis is often unrecognized, we aimed to develop a stepwise screening algorithm for cirrhosis in the Veterans Health Administration (VHA) and assess this approach's feasibility and acceptability.

Methods: VHA hepatology clinicians ("champions") were invited to participate in a pilot program from June 2020 to October 2022. The VHA Corporate Data Warehouse was queried to identify Veterans with possible undiagnosed cirrhosis using Fibrosis-4 (FIB-4) ≥ 3.

Interleukin-17: A pleiotropic cytokine implicated in inflammatory, infectious, and malignant disorders.

IL-17A, referred to as IL-17, is the founding member of a family of pro-inflammatory cytokines, including IL-17B, IL-17C, IL-17D, IL-17E (or IL-25), and IL-17F, which act via receptors IL-17RA to IL-17RE, and elicit potent cellular responses that impact diverse diseases. IL-17's interactions with various cytokines include forming a heterodimer with IL-17F and being stimulated by IL-23's activation of Th17 cells, which can lead to inflammation and autoimmunity. IL-17 is implicated in infectious diseases and inflammatory disorders such as rheumatoid arthritis and psoriasis, promoting neutrophil recruitment and anti-bacterial immunity, but potentially exacerbating fungal and viral infections, revealing its dual role as protective and pathologic.

Value Propositions for Digital Shared Medication Plans to Boost Patient-Health Care Professional Partnerships: Co-Design Study.

Background: Health authorities worldwide have invested in digital technologies to establish robust information exchange systems for improving the safety and efficiency of medication management. Nevertheless, inaccurate medication lists and information gaps are common, particularly during care transitions, leading to avoidable harm, inefficiencies, and increased costs. Besides fragmented health care processes, the inconsistent incorporation of patient-driven changes contributes to these problems.

One-Year Real-World Outcomes of Ab-Externo Gel Stent Placement From the EXPAND Study.

Prcis: In the real-world, retrospective, EXPAND study of consecutive adults with glaucoma, ab-externo gel stent implantation effectively lowered intraocular pressure (34%) and the medication burden (61%), with transient/self-resolving hypotony as the most frequent adverse event (28%).

Purpose: To assess effectiveness and safety of ab-externo gel stent (GS) implantation in glaucoma.

Methods: Multicenter, real-world, retrospective study.