Differences in content of care and outcomes between a clinical practice guideline adherent program and usual care for patellofemoral pain: A retrospective pilot study.

Background: Patellofemoral pain (PFP) is a common knee condition in young and active individuals that is managed with highly variable treatment strategies.

Objective: To determine whether the length, number of visits, and content of physical therapy care for patients with PFP differ between a Clinical Practice Guidelines (CPG) adherent program and usual care. Additionally, the percentage of patients reporting clinically important improvements in patient-reported outcomes in each group was evaluated as an exploratory aim.

Education Research: Utilization of Simulation in Residency Programs: A Survey of Adult Neurology Residency Program Directors.

Background And Objectives: Previous research has demonstrated that simulation-based medical education (SBME) can improve neurology trainees' confidence, knowledge, and competence. However, a general needs assessment and review of current SBME used within neurology are needed to guide SBME curriculum development. The objective of this study was to describe the current use of SBME in resident education and to assess perceived barriers to expanding SBME interventions.

Inequities in Physical Therapy Receipt of US Service Members and Veterans With Low Back Pain.

Objective: To investigate inequities in time to physical therapy (PT) for patients with low back pain (LBP).

Design: Retrospective observational study using data from the Department of Defense and Veterans Health Administration clinical and administrative data repositories derived from medical records, claims, and enrolment data.

Setting: Military Health System, Veterans Health Administration, and civilian health care facilities.

A Multidisciplinary Approach to Navigating Variants of Uncertain Significance in Sudden Infant Deaths: A Case Report of 2 Siblings With an SCN10A VUS.

The sudden death of a previously healthy infant is a devastating event for a family-the death of 2 even more unimaginable. Prior to the debunking of Meadow's law, a legal concept attributing multiple unexplained infant deaths to Munchausen by proxy, these events could lead to the wrongful prosecution of those who had lost their children to "sudden unexpected infant death (SUID)." Today, these cases, wherein multiple infants within one family pass inexplicably, raise suspicion for a possible genetic cause and point toward a need for postmortem genetic testing.

Quantifying the Diagnostic Utility of Baseline Testing in Concussion Management: An Analysis of Collegiate Athletes From the NCAA-DoD CARE Consortium Dataset.

Background: Although preseason baseline testing is a commonly recommended part of the concussion management process, its "value-added" contribution to the diagnosis of acute concussion compared with normative reference values remains in question.

Purpose: This research aimed to evaluate the diagnostic benefits of baseline testing in acute concussion assessment compared with normative reference values and characterize the athletes who receive the most diagnostic utility from baseline testing.

Study Design: Cohort study (Diagnosis); Level of evidence, 2.

Psilocybin: From Psychiatric Pariah to Perceived Panacea.

Objective: The authors critically examine the evidence base for psilocybin administered with psychological support/therapy (PST) in the treatment of psychiatric disorders and offer practical recommendations to guide future research endeavors.

Methods: PubMed was searched for English-language articles from January 1998 to November 2023, using the search term "psilocybin." A total of 1,449 articles were identified and screened through titles and abstracts.

Early Care of Polytraumatized Patients: A Framework for Orthopaedic Surgeons.

The role of orthopaedic surgeons during trauma activations is vague and often underused. Advanced trauma life support (ATLS) is a training program and framework for performing initial life- and limb-threatening interventions. ATLS was created by Dr.

Moving Past the Status Quo: Redefining the Feedback Landscape for Junior Clinician-Educator Career Development.

This perspective piece addresses the challenges junior clinician-educators face as they navigate career development within academic medical centers. In addition to understanding local promotion and tenure processes and seeking mentorship, we argue that faculty feedback is an often neglected, but essential, component in clinician-educator development. We repurpose and use the MISCA model-Message, Implementation, Student, Context, and Agents-as a framework to better understand and improve feedback for faculty.

Time between pancreatic cancer diagnosis and treatment initiation and survival in the U.S. Military Health System.

Background: Pancreatic cancer has a high case fatality and treatment is known to improve survival. It is unknown whether the time between diagnosis and treatment initiation (time-to-treatment) is related to survival. Access to medical care may influence both treatment receipt and timing.

Relugolix reduces leiomyoma extracellular matrix production via the TGF β pathway.

Objective: To determine if the oral GnRH antagonist relugolix affects leiomyoma extracellular matrix production through the TGF β pathway DESIGN: Laboratory Study SUBJECTS: None.

Intervention: Exposure of human leiomyoma cells to TGF β and/or relugolix MAIN OUTCOME MEASURES: Production of TGF β, pSMAD2/3, SMAD2/3, COL1A1, FN1 and VCAN in treated and untreated leiomyoma cells RESULTS: TGF β3 production was decreased at 24 hours with relugolix at 10nM (0.80 + 0.

radiosensitivity and Mn antioxidant content: antigenic preservation and pathobiology.

The bacterium responsible for Lyme disease, , accumulates high levels of manganese without iron and possesses a polyploid genome, characteristics suggesting potential extreme resistance to radiation. Contrary to expectations, we report that wild-type B31 cells are radiosensitive, with a gamma-radiation survival limit for 10 wild-type cells of <1 kGy. Thus, we explored radiosensitivity through electron paramagnetic resonance (EPR) spectroscopy by quantitating the fraction of Mn present as antioxidant Mn metabolite complexes (H-Mn).

Advances in the Treatment of Congenital Infiltrating Lipomatosis of the Face: The Role of PIK3CA Mutations and Microvascular Reconstruction.

Congenital infiltrating lipomatosis of the face is a rare aggressive-benign disorder characterized by progressive hemifacial overgrowth and complex, often asymmetrical, facial differences. Recently linked with the PIK3CA-Related Overgrowth Spectrum, it arises from mosaic mutations in the PIK3CA gene. Treatment, largely supportive and tailored to individual clinical presentations, requires a multidisciplinary approach.

Diffuse Axonal and Vascular Pathology in the Gyrencephalic Brain after High-Energy Blunt Injury: Clinicopathological Correlations Involving the Brainstem.

Traumatic brain injury (TBI) after high-energy, behind helmet blunt trauma (BHBT) is an important but poorly understood clinical entity often associated with apnea and death in humans. In this study, we use a swine model of high-energy BHBT to characterize key neuropathologies and their association with acute respiratory decompensation. Animals with either stable or critical vital signs were euthanized within 4 h after injury for neuropathological assessment, with emphasis on axonal and vascular pathologies in the brainstem.

Access to care and the Hispanic paradox among Hispanic patients with hepatocellular carcinoma.

Purpose: Despite the disproportionate impact of hepatocellular carcinoma (HCC) on Hispanic patients, reported outcomes are limited, particularly among subpopulations. Our study aimed to evaluate outcomes in access to care and survival among racial and ethnic Hispanic subpopulations.

Methods: The National Cancer Database was utilized to identify patients diagnosed with HCC between 2004 and 2020.

Risk for exertional heat illness among US army enlistees: climate indexes, intrinsic factors and their interactions.

Objectives: To characterise intrinsic and extrinsic (climatic) risks for mild and severe exertional heat illness (EHI) among first-year army enlistees.

Methods: We examined 337 786 soldiers who enlisted between 2012 and 2019. Survival models were used to predict incident EHI from intrinsic factors (demographics, healthcare utilisation, chronic conditions, body mass index (BMI), Army Physical Fitness Test (APFT), upper/lower respiratory tract infections (URTI and LRTI), skin and soft-tissue infections (SSTI), extrinsic factors (geographical region, daily mean Universal Thermal Climate Index (UTCI), wet bulb globe temperature (WBGT)) and interactions.

Heterozygous UBR5 variants result in a neurodevelopmental syndrome with developmental delay, autism, and intellectual disability.

E3 ubiquitin ligases have been linked to developmental diseases including autism, Angelman syndrome (UBE3A), and Johanson-Blizzard syndrome (JBS) (UBR1). Here, we report variants in the E3 ligase UBR5 in 29 individuals presenting with a neurodevelopmental syndrome that includes developmental delay, autism, intellectual disability, epilepsy, movement disorders, and/or genital anomalies. Their phenotype is distinct from JBS due to the absence of exocrine pancreatic insufficiency and the presence of autism, epilepsy, and, in some probands, a movement disorder.

I'm Getting a Migraine: A Comparative Evaluation of Patient and Clinician Interpretations of Migraine Symptoms.

Patients and providers vary in how they describe common otolaryngology-related complaints. These differences can lead to miscommunication and frustration that may affect patient outcomes and satisfaction. The aim of this cross-sectional survey-based study was to explore the differences in migraine symptom selection by otolaryngology patients and clinicians.

Menopausal hormone therapy use among active duty service women.

Objective: Menopausal hormone therapy (HT) has been shown to be effective in alleviating symptoms of menopause. While previous literature has described the frequency of HT use for the relief of menopausal symptoms in both the general and veteran female populations, there is currently no literature describing this frequency within the female active duty population. This study aims to address this gap in knowledge by conducting a retrospective cross-sectional study of HT receipt in active duty service women (ADSW) ages 45 to 64 during fiscal years (FYs) 2018 to 2022.

A review of long-term outcomes of repetitive concussive and subconcussive blast exposures in the military and limitations of the literature.

The purpose of this review is to summarize the long-term cognitive, psychological, fluid biomarker, and neuroimaging outcomes following repetitive concussive and subconcussive blast exposures sustained through a military career. A review of the literature was conducted, with 450 manuscripts originally identified and 44 manuscripts ultimately included in the review. The most robust studies investigating how repetitive concussive and subconcussive exposures related to cognitive performance suggest there is no meaningful impact.

MRSA Cellulitis with Orbital and Retinal Abscesses Resulting in Lemierre Syndrome Following Eyebrow Piercing.

We describe a case of orbital cellulitis with abscess formation following eyebrow piercing complicated by internal jugular vein thrombosis and subretinal abscesses requiring enucleation with orbital abscess drainage. The popularity of body piercing is increasing and physicians should be familiar with the possibility and management of vision-threatening complications of facial piercing. Following left eyebrow piercing, a 20-year-old female experienced increasing periorbital swelling, erythema, chemosis, orbital pain, decreased vision, and concomitant fever, chills, and rhinorrhea.