Purpose in Life After Brain Injury: Expanding the Focus and Impact of Interdisciplinary Rehabilitation.

Purpose: Traumatic brain injury (TBI) is a life-altering event that can abruptly and drastically derail an individual's expected life trajectory. While some adults who have sustained a TBI go on to make a full recovery, many live with persisting disability many years postinjury. Helping patients adjust to and flourish with disability that may persist should be as much a part of rehabilitative practice as addressing impairment, activity, and participation-level changes after TBI.

Downstaging of hepatocellular carcinoma before liver transplantation: Results from a national multi-center prospective cohort study.

Background Aims: Patients with hepatocellular carcinoma (HCC) meeting UNOS-downstaging (DS) criteria have excellent post-liver transplantation (LT) outcomes. Studies on HCC beyond UNOS-DS criteria ("All-comers" (AC)) have been limited by small sample size and short follow-up time, prompting this analysis.

Approach Results: 326 patients meeting UNOS-DS and 190 meeting AC criteria from 9 LT centers across 5 UNOS regions were enrolled from 2015 to 2023 and prospectively followed.

Rib and Sternum Nonunions: Diagnosis and Treatment and Awareness of Other Potential Posttraumatic Pathology.

As the operative management of acute, chest wall, skeletal injury escalates throughout the world, it has become commonplace for patients with posttraumatic conditions to present with clinical reconstructive challenges as well. In addition, it is becoming clear that rib nonunions are not rare, likely more than 5% of rib fractures. No subspecialty is better equipped to address such painful conditions than orthopaedic surgery.

Best Available Outcomes Evidence Informing Standard of Care.

Although nonoperative management is the mainstay for rib fracture treatment, surgical stabilization of rib fractures is becoming more common. Recently, the number of high-quality studies on management of rib fractures has also increased. The primary purpose of this review is to analyze the currently available prospective randomized studies on the management of rib fractures.

Discussion of Surgical Indications: The Black, White, and Gray.

Chest wall trauma is rapidly evolving and now represents a multidisciplinary field with incredible growth in research and surgical intervention; however, even with more than 800 publications on chest wall trauma to date, surgical indications are not black and white. Injury patterns need to be better defined and outcome measurements need to evolve for accurate longer term functional assessment of patients if this field of surgery is to move beyond historical indications for operative intervention. This essay will communicate what is known about operative indications in a way that stratifies the need for surgery.

Dorsal hippocampus represents locations to avoid as well as locations to approach during approach-avoidance conflict.

Worrying about perceived threats is a hallmark of multiple psychological disorders including anxiety. This concern about future events is particularly important when an individual is faced with an approach-avoidance conflict. Potential goals to approach are known to be represented in the dorsal hippocampus during theta cycles.

Cognitive impairment caused by compromised hepatic ketogenesis is prevented by endurance exercise.

Extensive research has demonstrated endurance exercise to be neuroprotective. Whether these neuroprotective benefits are mediated, in part, by hepatic ketone production remains unclear. To investigate the role of hepatic ketone production on brain health during exercise, healthy 6-month-old female rats underwent viral knockdown of the rate-limiting enzyme in the liver that catalyses the first reaction in ketogenesis: 3-hydroxymethylglutaryl-CoA synthase 2 (HMGCS2).

Impaired hydrogen sulfide biosynthesis underlies eccentric contraction-induced force loss in dystrophin-deficient skeletal muscle.

Eccentric contraction- (ECC) induced force loss is a hallmark of murine dystrophin-deficient (mdx) skeletal muscle that is used to assess efficacy of potential therapies for Duchenne muscular dystrophy. While virtually all key proteins involved in muscle contraction have been implicated in ECC force loss, a unifying mechanism that orchestrates force loss across such diverse molecular targets has not been identified. We showed that correcting defective hydrogen sulfide (H2S) signaling in mdx muscle prevented ECC force loss.

Double kissing crush versus culotte for bifurcation percutaneous coronary interventions: insights from the PROGRESS-BIFURCATION registry.

Background: Upfront 2-stent techniques are often used in bifurcation percutaneous coronary interventions (PCI), but there is controversy about optimal strategy selection.

Methods: The authors examined the clinical and angiographic characteristics and long-term outcomes of 232 bifurcation PCIs that were performed using the double kissing (DK) crush or culotte technique in 216 patients between 2014 and 2023 using data from the Prospective Global Registry for the Study of Bifurcation Lesion Interventions (NCT05100992). The inverse probability of treatment weighted (IPTW) Cox proportional hazards model was used to assess long-term outcomes.

Use of the Ostial Flash balloon in aorto-ostial chronic total occlusion percutaneous coronary intervention.

Background: The use of the Ostial Flash balloon (Ostial Corporation) has received limited study in aorto-ostial chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI).

Methods: The authors evaluated the outcomes of Ostial Flash balloon use in a large CTO-PCI registry (PROGRESS-CTO, NCT02061436).

Results: The Ostial Flash balloon was used in 54 of 907 aorto-ostial CTO PCIs in 905 patients (6.

Screening for Osteoporosis to Prevent Fractures: A Systematic Evidence Review for the US Preventive Services Task Force.

Importance: Fragility fractures result in significant morbidity.

Objective: To review evidence on osteoporosis screening to inform the US Preventive Services Task Force.

Data Sources: PubMed, Embase, Cochrane Library, and trial registries through January 9, 2024; references, experts, and literature surveillance through July 31, 2024.

Cancer Incidence in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) - The Onco-SOL Ancillary Study.

Background: Few studies have examined how cancer incidence varies by country of origin among United States Hispanic/Latino adults. Herein, we describe the incidence rates of cancer overall and for screen-detectable, tobacco-related, and obesity-related cancers among 16,415 participants in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), an ongoing population-based cohort study of Hispanic/Latino adults from diverse backgrounds.

Methods: Cohort participant records were linked to the state cancer registries in New York, Florida, California, and Illinois to ascertain cancer incidence from baseline (2008-2011) through 2021.

Pulmonary granuloma formation during latent infection in C3HeB/FeJ mice involves progression through three immunological phases.

is a fungal pathogen that can cause lethal disease in immunocompromised patients. Immunocompetent host immune responses, such as formation of pulmonary granulomas, control the infection and prevent disseminated disease. Little is known about the immunological conditions establishing the latent infection granuloma in the lungs.

SPLASH Into Fitness: A Swimming-Based Pilot Intervention to Promote Healthful Identities and Behaviors Among Preadolescent Girls.

Background: Girls' physical activity and healthful eating behaviors decline throughout adolescence. These trajectories may be linked to the underdevelopment of exercise and healthful eater identities. Youth programs might consider prioritizing identity development as an innovative health promotion strategy, especially during the formative preadolescent life stage.

Systematic Review and Meta-Analysis of the Super High-Pressure Balloon (SIS-OPN) for Percutaneous Coronary Intervention.

Introduction: The super high-pressure NC balloon (OPN NC; SIS Medical AG, Winterthur, Switzerland) is increasingly used in percutaneous coronary intervention (PCI). We performed a systematic review and meta-analysis of its efficacy and safety.

Methods: A systematic review was conducted using PubMed and the Cochrane Library to identify studies using the OPN NC balloon in PCI.

Managing the work of living with heart failure: a qualitative study using the cumulative complexity model from Southeastern Minnesota.

Objective: Patients with heart failure (HF) perform a variety of self-care activities to control symptoms and minimise the risk of HF decompensations. The objective of this study was to understand how patients build capacity and manage the work of living with HF.

Design: A qualitative study using semi-structured telephone interviews.

Structural insights into binding-site access and ligand recognition by human ABCB1.

ABCB1 is a broad-spectrum efflux pump central to cellular drug handling and multidrug resistance in humans. However, how it is able to recognize and transport a wide range of diverse substrates remains poorly understood. Here we present cryo-EM structures of lipid-embedded human ABCB1 in conformationally distinct apo-, substrate-bound, inhibitor-bound, and nucleotide-trapped states at 3.

Lifetime risk and projected burden of dementia.

Understanding the lifetime risk of dementia can inform public health planning and improve patient engagement in prevention. Using data from a community-based, prospective cohort study (n = 15,043; 26.9% Black race, 55.