Impact of a Multiplex PCR Assay for Rapid Diagnosis and Antibiotic Utilization in Trauma Intensive Care Unit Patients with Ventilator-Acquired Pneumonia.

Ventilator-associated pneumonia (VAP) is a frequent complication in injured patients. Multiplex polymerase chain reaction (PCR) facilitates rapid identification of many respiratory pathogens prior to formal culture results. Our objective was to evaluate the effect of multiplex PCR implementation in a trauma intensive care unit (TICU) on antibiotic utilization and de-escalation.

Dual Functional Electroconductive Biofortified Electrospun Scaffold Functionalized With MWCNTs and Bacopa Monnieri for Accelerated Peripheral Nerve Regeneration.

Peripheral nerve injuries (PNIs) often lead to semi or complete loss of motor, sensory and autonomic functions. Although autografts are still the best option for PNI repair, their use is restricted due to the morbidity and availability of donor nerves. Because electrospun scaffolds may replicate the structure of native extracellular matrix (ECM), they provide a viable alternative.

A population-based cohort study of perinatal mental illness following traumatic brain injury.

Aims: To examine the risk of perinatal mental illness, including new diagnoses and recurrent use of mental healthcare, comparing women with and without traumatic brain injury (TBI), and to identify injury-related factors associated with these outcomes among women with TBI.

Methods: We conducted a population-based cohort study in Ontario, Canada, of all obstetrical deliveries to women in 2012-2021, excluding those with mental healthcare use in the year before conception. The cohort was stratified into women with no remote mental illness history (to identify new mental illness diagnoses between conception and 365 days postpartum) and those with a remote mental illness history (to identify recurrent illnesses).

The Psychobiological Toll of Chronic Conflict: Posttraumatic Stress Symptoms, Emotion Dysregulation, and Physiology in a Conflict-Exposed Community in South Sudan.

Background: Mass conflict and related displacement in South Sudan has created a significant mental health need, however extant research on the impact of conflict is limited among South Sudanese people and has predominantly relied on Western-developed self report measures.

Method: A total of 195 South Sudanese adults who work in both civil society and government leadership positions participated in a psychophysiological assessment of heart rate variability (HRV) and self-reported PTSD and emotion dysregulation symptoms to participation in the Trauma-Informed Community Empowerment (TICE) Framework, developed and implemented by the Global Trauma Project (GTP). We utilized measures of heart rate variability to determine parasympathetic activity, which may be associated with difficulties responding to stressors as well as long-term physical health morbidity and mortality.

Case series of high pressure paint injection injuries in single digits in a tertiary referral centre over a one year period.

High pressure injection injuries to upper extremities are largely rare occurrences. The direct and indirect effects of the injected substance can cause debilitating consequences for those affected and can lead to digit amputation. This case series includes three patients with high pressure injection injuries admitted to a single tertiary centre over one year.

Invasive ductal carcinoma at the site of a cosmetic nipple piercing.

We report a young female patient diagnosed with an invasive ductal carcinoma at the site of a prior cosmetic nipple piercing. She had no significant familial, genetic, or other carcinogenic risk factors to account for her presentation. A review of the literature confirms that trauma can occasionally be associated with invasive breast cancer, but such a connection has not previously been related to nipple piercing procedures.

Up IGF-I via high-toughness adaptive hydrogels for remodeling growth plate of children.

The growth plate is crucial for skeletal growth in children, but research on repairing growth plate damage and restoring growth is limited. Here, a high-toughness adaptive dual-crosslinked hydrogel is designed to mimic the growth plate's structure, supporting regeneration and bone growth. Composed of aldehyde-modified bacterial cellulose (DBNC), methacrylated gelatin (GelMA) and sodium alginate (Alg), the hydrogel is engineered through ionic bonding and Schiff base reactions, creating a macroporous structure.

Personal Protective Equipment Utilization and Determinant Factors Among Workers in Phibela Edible Oil Factory, West Gojjam, Ethiopia.

Background: An edible oil factory is a labor-intensive and technologically complex industry, with workers potentially exposed to a variety of dangers associated with such industries. Personal protective equipment is a universal, legal requirement, and an important strategy for preventing occupational injuries and illnesses caused by workplace hazards. However, such industries receive little attention, especially in Ethiopia.

Bilateral Lower Limb Injuries and the Need for Two Free Flaps: Simultaneous or Sequential.

  To determine the choice of flap cover for patients presenting with bilateral lower limb trauma requiring free flap cover and to derive a step-wise guide to the planning of bilateral lower limb free flaps.  This was a retrospective study of patients over a 20 year period from 2000 to 2020 who presented with bilateral lower limb defects following trauma and were managed with two free flaps for wound cover, done either simultaneously or sequentially in the same admission.  Of the 11 cases with 22 defects, there were 3 re-explorations with 1 flap loss managed with delayed fasciocutaneous flap cover.

Burn inhalation injury and intubation with dexamethasone-eluting endotracheal tubes modulate local microbiome and alter airway inflammation.

Background: Inhalation injuries, caused by exposure to extreme heat and chemical irritants, lead to complications with speaking, swallowing, and breathing. This study investigates the effects of thermal injury and endotracheal tube (ETT) placement on the airway microbiome and inflammatory response. A secondary aim is to assess the impact of localized dexamethasone delivery via a drug-eluting ETT to reduce laryngeal scarring.

Assessment of radiation knowledge among medical personnel in nuclear emergency preparedness: a cross-sectional study.

Background: Radiation literacy, encompassing the understanding of basic principles, applications, risks, and protective measures related to ionizing radiation, is critical for medical personnel working in jobs that involve the use of radioactive materials or medical imaging. In the context of nuclear emergency preparedness, the level of radiation knowledge among healthcare professionals-such as doctors, nurses, and radiographers-directly influences the effectiveness and safety of emergency responses. This study aims to address this gap by evaluating the radiation knowledge of medical personnel and identifying areas for improvement in profession-specific training programs.

Medical validity and layperson interpretation of emergency visit recommendations by the GPT model: A cross-sectional study.

Aim: In Japan, emergency ambulance dispatches involve minor cases requiring outpatient services, emphasizing the need for improved public guidance regarding emergency care. This study evaluated both the medical plausibility of the GPT model in aiding laypersons to determine the need for emergency medical care and the laypersons' interpretations of its outputs.

Methods: This cross-sectional study was conducted from December 10, 2023, to March 7, 2024.

Differential expression of plasma extracellular vesicles microRNAs and exploration of their association with bone metabolism in childhood trauma participants treated in a psychosomatic clinic.

Introduction: Early life stress (ELS) impacts neurotransmitters and cell communication, potentially disrupting neurological and physiological processes. Recently, ELS has been implicated in impaired bone metabolism, with extracellular vesicles (EVs) and their cargo, microRNAs (miRNAs), might affecting this process. This research aimed to elucidate the association between childhood trauma, a specific form of ELS, and bone metabolism through studying miRNA in EVs within three steps: firstly, examining alterations of EV miRNAs between ELS and controls, secondly analyzing associations between altered EV miRNAs and bone markers, and thirdly exploring the target gene prediction and enrichment pathways of altered EV miRNAs.

Fostering engagement using a wearable for self-tracking assisted psychotherapy with refugees diagnosed with complex PTSD: a feasibility pilot study.

Background: To address the unique challenges faced by refugees diagnosed with complex post-traumatic stress disorder (CPTSD), psychotherapy needs to be personalized. The integration of self-tracking instruments into therapy offers a promising approach to personalizing treatment. This feasibility pilot study develops and explores a preliminary self-tracking assisted treatment concept using a wearable self-tracking instrument called the One Button Tracker (OBT).

Endoscopic Vacuum Therapy for the Treatment of Atrial Fibrillation Ablation-Induced Esophageal Perforation.

Esophageal thermal injury from atrial fibrillation ablation is not uncommon; however, full-thickness perforation is rare. Such injuries are often treated with surgical revision, stent placement, or medical management. Endoscopic vacuum therapy is a novel and emerging technique to repair transmural gastrointestinal defects; however, its use in the management of esophageal thermal ulceration and perforation after a cardiac ablation procedure is limited.

Clinical Outcomes of Intramedullary Kirschner Wire Fixation for Unstable Radius and Ulna Fractures in Children: A Prospective Study in Yemen.

Background: Forearm fractures are among the most common pediatric injuries, and unstable fractures often require surgical intervention. Intramedullary Kirchner wire (K-wire) fixation has emerged as a minimally invasive treatment option, offering advantages such as reduced soft tissue damage and shorter hospital stays. This study evaluated the clinical outcomes of K-wire fixation for unstable radius and ulna fractures in children.

Global, regional, and national burden of tobacco-related neurological disorders from 1990 to 2021: Trends and future projections.

Introduction: Tobacco use is as a major public health concern around the world, adversely impacting quality of life. Our study aims to analyze the trends in the burden of tobacco-related neurological disorders (ND) at global, regional, and national levels from 1990 to 2021, as well as potential future trends.

Methods: We performed a secondary dataset analysis for the assessment of mortality and disability-adjusted life years (DALYs) using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, to explore the burden of tobacco-related ND.

My Week of Denial and Disorientation: A Lived Experience Narrative of a Stay in a Psychiatric Emergency Department.

Background: Psychiatric emergency departments (EDs) are common settings in which patients receive crisis care, yet their experiences in these environments remain understudied.

Aim: This lived experience narrative recounts the first author's week-long stay in a psychiatric ED, providing insight into the experiences and challenges of inpatient psychiatric care.

Methods: The first author used a narrative approach to develop a series of vignettes that captured significant moments of her inpatient experience.

Smoking and Elevated Preneoadjuvant Chemoradiotherapy Serum Carcinoembryonic Antigen Levels Are Associated With High Tumor Regression Grade and Poor Survival in Patients With Locally Advanced Rectal Cancer.

Neoadjuvant chemoradiotherapy (NACRT) is the standard treatment for patients with locally advanced rectal cancer (LARC). Tumor regression grade (TRG) is an essential prognostic factor in determining treatment efficacy. However, the potential factors influencing TRG in patients with rectal cancer who have received NACRT have not been investigated.

Complication and Revision Rate in Complex Intraarticular Calcaneal Fractures: Extended Lateral vs Sinus Tarsi Approach.

Background: Adequate surgical treatment of intra-articular calcaneal fractures is challenging. Current clinical evidence on the superiority of either the extended lateral approach (ELA) or the sinus tarsi approach (STA) and their impact on radiologic and functional outcome remains inconclusive, and studies are characterized by low case numbers and short follow-up periods. We hypothesized that using STA would lead to fewer complications and revisions, without impairing fracture reduction or short- to midterm outcome.

Foot Malalignment and Proximal Fifth Metatarsal Fractures.

Background: Proximal fifth metatarsal fractures are common injuries that are classified into 3 zones according to their anatomical localization. While zone 1 and 2 fractures typically are traumatic, zone 3 fractures may be linked to foot alignment abnormalities, such as hindfoot varus and metatarsus adductus. The aim of the study was to explore the association between hindfoot alignment and different fracture zones, as well as the relationship between traumatic and atraumatic fracture origin and foot alignment.

A Comparative Analysis of Revision Rates in Surgical Treatments for Lumbar Isthmic Spondylolisthesis.

Study DesignRetrospective Cohort Study.ObjectiveIsthmic spondylolisthesis is frequently encountered in spine surgical practice, though there is a significant variation in surgical management strategies. We sought to evaluate revision rates between patients who underwent anterior-approach lumbar interbody fusion (ALIF) alone, posterolateral fusion (PLF) alone, PLIF/TLIF, and ALIF+PSF.

Current concepts in arthroscopic rotator cuff repair.

Rotator cuff repair has experience great development, transitioning from open surgical techniques to minimally invasive arthroscopic methods. This review explores its historical development, current repair techniques, biomechanical considerations, and advances in materials and biological augmentation. It also addresses strategies for managing partial-thickness and massive tears, compares single-row and double-row repairs, and highlights the importance of individualized postoperative rehabilitation.

Outcomes of footprint medialization and bone marrow stimulation in chronic retracted rotator cuff tears.

Background: This study compared the clinical and radiological outcomes of chronic retracted rotator cuff tears where complete footprint coverage cannot be achieved, using two treatments: footprint medialization with bone marrow stimulation and conventional incomplete repair.

Methods: This retrospective study included 87 patients who underwent arthroscopic rotator cuff repair with incomplete footprint coverage. The included patients were divided into group 1 (54 patients with footprint medialization and bone marrow stimulation) and group 2 (33 patients with conventional repair).

Does Topical Steroid Use Increase the Risk for Subsequent Tympanoplasty?

Objectives: Although the current data support the notion that combination therapy of topical steroids with antibiotics is a safe, and often superior, option for suppurative otitis media when compared to topical antibiotics alone, little is known about the impact of topical steroids on tympanic membrane (TM) healing and risk of residual perforation. This study aims to describe the long-term impact the addition of topical steroids to antibiotics has on TM healing, as measured by rates of subsequent tympanoplasty.

Methods: Electronic health records were queried using TriNetX Research Network to construct cohorts of adult patients with "infected" TM perforation (ICD-10 code H66) and "noninfected" TM perforation (ICD-10 code H72).