Recurrent Lumbar Disk Herniation and Revision Surgery Rates After Single-Level Lumbar Microdiscectomy in the Military Population.

Background: Lumbar microdiscectomy remains the most commonly performed surgical procedure for symptomatic lumbar disk herniation (LDH). Despite advances in surgical techniques, recurrent LDH (rLDH) ranges from 5% to 24%, representing the most common cause of surgical failure and revision surgery. Optimal treatment of reherniation remains controversial.

Rhabdoid Tumor of the Kidney and Soft Tissues: Results from National Wilms Tumor Study-5 and Children's Oncology Group Study AREN0321.

Purpose: National Wilms Tumor Study-5 (NWTS-5) and AREN0321 evaluated the outcomes of children with rhabdoid tumor of the kidney (RTK) and malignant rhabdoid tumor of soft tissues (MRT).

Patients And Methods: Eligible patients with RTK were enrolled prospectively on NWTS-5 (1995-2002) and treated with carboplatin and etoposide alternating with cyclophosphamide (Regimen RTK). Patients with RTK or MRT were enrolled on AREN0321 (2005-2012) and received vincristine, doxorubicin, and cyclophosphamide alternating with carboplatin, cyclophosphamide, and etoposide (Regimens UH-1 or dose-reduced Revised UH-1).

Establishing an immune correlate of protection for Nipah virus in nonhuman primates.

The limited but recurrent outbreaks of the zoonotic Nipah virus (NiV) infection in humans, its high fatality rate, and the potential virus transmission from human to human make NiV a concerning threat with pandemic potential. There are no licensed vaccines to prevent infection and disease. A recombinant Hendra virus soluble G glycoprotein vaccine (HeV-sG-V) candidate was recently tested in a Phase I clinical trial.

Updates in Human Papillomavirus Vaccination to Improve Medical Readiness in Active Duty Service Members.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is associated with the development of genital warts, precancerous lesions, and cancers of the oropharynx, anus, penis, vulva, vagina, and cervix. HPV-associated diseases are preventable through vaccination. An Australian nationwide vaccination program will effectively eliminate cervical cancer as a public health concern by the year 2035.

Quantifying the Impact of Sustained Acceleration on Critical Care Transport Medical Equipment.

Introduction: Military and commercial stakeholders are investing to explore the use of hypersonic aircraft and orbital spacecraft to transport cargo, medical supplies, passengers, and casualties. These vehicle platforms require periods of sustained acceleration, but to date, these dynamic forces have not been comprehensively considered in the environment of critical care patient movement because injured patients and advanced aeromedical evacuation (AE) equipment are rarely subjected to these conditions. While military AE equipment does undergo crash hazard acceleration testing, equipment functionality during or after sustained acceleration remains to be evaluated.

An electrolyte disturbance masquerading as a panic attack.

Because proton pump inhibitors (PPIs) are so commonly used, their safety and potential adverse reactions often are not considered. This article describes a patient whose paresthesias and severe muscle cramps were attributed to panic attacks but actually were caused by hypocalcemia secondary to PPI-induced hypomagnesemia. This case serves as a reminder that PPIs should be used cautiously and appropriately with consideration for regular monitoring of electrolytes and vitamin B12.

Hosts and vectors of scrub typhus in Chile: epidemiological study and molecular analyses of Orientia infection in rodents and rodent-associated mites.

Candidatus Orientia chiloensis causes scrub typhus over a wide geographical range in southern Chile. The life cycle, including vectors and reservoirs of this novel rickettsial pathogen, is incompletely understood. We analyzed rodent tissue and rodent-associated mite samples collected during a field study in six localities on Chiloé Island, where human scrub typhus cases have occurred.

The clinically relevant MEK inhibitor mirdametinib combined with D-cycloserine and prediction error disrupts fear memory in PTSD models.

This study establishes mirdametinib as the first MEK inhibitor that can undergo clinical development for psychiatric indications such as post-traumatic stress disorder (PTSD). PTSD is characterized by persistent traumatic memories with limited effective treatment options. A body of evidence suggests that memory storage is dynamic and constantly updated through post-retrieval modification a process termed reconsolidation.

Gathering Validity Evidence for the Bushmaster Assessment Tool.

Introduction: The education of military medical providers typically relies on assessments with established passing parameters to help ensure individuals are equipped to care for those in harm's way. Evaluations of medical knowledge are often provided by governing bodies and are supported by strong validity evidence. In contrast, assessing an individual's leadership skills presents a challenge, as tools with robust validity evidence for leadership evaluation are not yet as widely available as clinical assessment tools.

Examining the Discrepancy between Subjective Cognitive Complaints and Processing Speed Performance in Military Personnel with Traumatic Brain Injury.

Objective: To examine correlates of the discrepancy between subjective cognitive complaints and processing speed performance in a sample of military personnel with and without traumatic brain injury (TBI).

Method: About 235 U.S.

Barriers for Responding to Pediatric Out-of-Hospital Cardiac Arrest During Emergency Medical Calls: A Qualitative Study.

Background: Rapid recognition of pediatric out-of-hospital cardiac arrest (POHCA) is a critical component to prompt initiation of bystander interventions. We aimed to investigate barriers for responding to POHCA during emergency medical calls.

Methods And Results: We included all POHCA calls (aged 0-18 years) from the emergency dispatch center in the Capital Region of Denmark between 2018 and 2021 and excluded POHCAs with no resuscitation order, found dead, where trained health professionals were on site, or where there was no possibility for initiation of cardiopulmonary resuscitation.

Genotype-phenotype associations in individuals with Diamond Blackfan anaemia.

Introduction: Diamond Blackfan anaemia (DBA) is a rare disorder characterized by failure of red blood cell production, congenital abnormalities and cancer predisposition, primarily caused by pathogenic germline variants in genes encoding ribosomal proteins.

Methods: We conducted a genotype-phenotype and outcome study of 121 patients with DBA spanning the 20-year history of the National Cancer Institute's Inherited Bone Marrow Failure Syndromes study. Patient phenotypes were compared by large versus small ribosomal protein genes, across genes with >5 cases (, , and ) and by type of pathogenic variants (hypomorphic versus null, large deletions versus others).

Reviewing the Impacts of Natural and Technological Disasters on the End-Stage Kidney Disease Community.

The impact and severity of natural disasters and hazards have been increasing in the United States and throughout the world. With our mounting reliance and dependence on technology in our industrialized society, technological disasters also have become more commonplace. Although disasters may occur with little to no warning, these risks are felt to be acceptable despite their ability to impact large populations.

Incidence of Alpha-Gal IgE Sensitization in 3000 Military Personnel, Assessing Sex, Race, Installation, and Occupational Impacts.

: IgE to galactose-alpha-1,3-galactose (alpha-gal) is associated with (lone star tick) bites, accounting for the regional distribution of the alpha-gal syndrome (AGS). Longitudinal studies describing risk factors for incident alpha-gal sensitization are lacking. The objective of this project was to assess the incidence of alpha-gal IgE seroconversion and identify associated demographic, occupational, and geographical risk factors among US military personnel.

Role of Annexin 7 (ANXA7) as a Tumor Suppressor and a Regulator of Drug Resistance in Thyroid Cancer.

Thyroid cancer is the most common endocrine malignancy in the United States, with an overall favorable prognosis. However, some patients experience poor outcomes due to the development of resistance to conventional therapies. Genetic alterations, including mutations in BRAF, Met, and p53, play critical roles in thyroid cancer progression, with the BRAF V600E mutation detected in over 60% of cases.

Associations between phenotypes of childhood and adolescent obesity and incident hypertension in young adulthood.

Objectives: We investigated whether empirically derived childhood obesity phenotypes were differentially associated with risk of hypertension in young adulthood, and whether these associations differed by sex.

Methods: Data came from 11,404 participants in the Growing Up Today Study, a prospective cohort study in the US established in 1996. We used a childhood obesity phenotype variable that was previously empirically derived using latent class analysis.

Effects of national health benefits expansion policy on out-of-pocket payments and utilization of patients with four major catastrophic diseases.

Background: As South Korea achieved universal health care (UHC) in 1989, patients' access to low-cost health services has highly increased. However, as liability for high-cost procedures is still high, patients' accessibility to high-cost services is has been limited. For this reason, the Korean government has implemented an initiative of the "Mid-term Health Benefits Security Plan" to expand the health benefits coverage since 2005.

Alzheimer's Disease Sequencing Project Release 4 Whole Genome Sequencing Dataset.

The Alzheimer's Disease Sequencing Project (ADSP) is a national initiative to understand the genetic architecture of Alzheimer's Disease and Related Dementias (AD/ADRD) by sequencing whole genomes of affected participants and age-matched cognitive controls from diverse populations. The Genome Center for Alzheimer's Disease (GCAD) processed whole-genome sequencing data from 36,361 ADSP participants, including 35,014 genetically unique participants of which 45% are from non-European ancestry, across 17 cohorts in 14 countries in this fourth release (R4). This sequencing effort identified 387 million bi-allelic variants, 42 million short insertions/deletions, and 2.