Advancement in utilization of magnetic resonance imaging and biomarkers in the understanding of schizophrenia.

Historically, psychiatric diagnoses have been made based on patient's reported symptoms applying the criteria from diagnostic and statistical manual of mental disorders. The utilization of neuroimaging or biomarkers to make the diagnosis and manage psychiatric disorders remains a distant goal. There have been several studies that examine brain imaging in psychiatric disorders, but more work is needed to elucidate the complexities of the human brain.

Treatment of Inpatient Opioid Withdrawal with Short-Acting Full Agonist Opioids at a Safety-Net Hospital.

Background: Fentanyl use leads to increased opioid tolerance in people with opioid use disorder, complicating management of opioid withdrawal syndrome. While accepted as gold standard, methadone and buprenorphine may be insufficient to treat acute opioid withdrawal. Short-acting full agonist opioids (SAFAO) may improve treatment in the acute care setting.

Priority Clinical Actions for Outpatient Management of Nonhospitalized Traumatic Brain Injury.

Outpatient care following nonhospitalized traumatic brain injury (TBI) is variable, and often sparse. The National Academies of Sciences, Engineering, and Medicine's 2022 report on highlighted the need to improve the consistency and quality of TBI care in the community. In response, the present study aimed to identify existing evidence-based guidance and specific clinical actions over the days to months following nonhospitalized TBI that should be prioritized for implementation in primary care.

The inability to predict futility in hemorrhaging trauma patients using 4-hour transfusion volumes and rates.

Background: Blood shortages and utilization stewardship have motivated the trauma community to evaluate futility cutoffs during massive transfusions (MTs). Recent single-center studies have confirmed meaningful survival in ultra-MT (≥20 U) and super-MT (≥50 U), while others advocate for earlier futility cut points. We sought to evaluate whether transfusion volume and intensity cut points could predict 100% mortality in a multicenter analysis.

Research progress on digestive disorders following traumatic brain injury.

Traumatic brain injury (TBI) is a prevalent disease that poses a significant threat to global public health. Digestive dysfunction, as a common complication, is of particular importance to understand its pathogenesis, diagnostic criteria, and relevant treatment strategies. TBI can affect digestive function through inflammatory immune responses, the enteric nervous system, and hormonal levels.

Neural Network and Logistic Regression Models Based on Ultrasound Radiomics and Clinical-Pathological Features to Predict Occult Level II Lymph Node Metastasis in Papillary Thyroid Carcinoma.

Rationale And Objectives: Papillary thyroid carcinoma (PTC) often metastasizes to lateral cervical lymph nodes, especially in level II. This study aims to develop predictive models to identify level II lymph node metastasis (LNM), guiding selective neck dissection (SND) to minimize unnecessary surgery and morbidity in low-risk patients.

Methods: A retrospective cohort of 313 PTC patients who underwent modified radical neck dissection (MRND) between October 2020 and January 2023 was analyzed.

Multifaceted roles of IL-17 in bone and tendon health.

The interleukin-17 (IL-17) family, encompassing IL-17A to IL-17F, plays pivotal roles across various biomedical fields. IL-17A, a prominent cytokine, has garnered significant attention. However, the pathological effects of IL-17 can often be unpredictable.

Splenectomy versus angioembolization for severe splenic injuries in a national trauma registry: To save, or not to save, the spleen, that is the question.

Background: The use of angioembolization as a first approach for treating severe, blunt splenic injuries has increased recently, yet evidence showing its superiority to immediate splenectomy is lacking. We compared the prognosis of angioembolization versus splenectomy in patients presenting hemodynamically unstable with high-grade, image-confirmed, blunt splenic injuries in a nationally representative dataset.

Methods: We queried the 2017-2022 Trauma Quality Improvement Program database for adults with blunt splenic injury abbreviated injury scale = 4-5, with arrival systolic blood pressure <90 mm Hg, and treated with either angioembolization or splenectomy <6 hours of arrival after a computed tomography scan.

Altered thrombin generation with prothrombin complex concentrate is not detected by viscoelastic testing: an in vitro study.

Background: Bleeding guidelines currently recommend use of viscoelastic testing (VET) to direct haemostatic resuscitation in severe haemorrhage. However, VET-derived parameters of clot initiation, such as clotting time (CT) and activated clotting time (ACT), might not adequately reflect a clinically relevant interaction of procoagulant and anticoagulant activity, as revealed by thrombin generation assays. The aim of this study was to evaluate the ability of CT and ACT to indicate thrombin generation activity.

Implementation Strategies and Ergonomic Factors in Robot-assisted Microsurgery.

Robot-assisted surgery represents a significant innovation in reconstructive microsurgery, providing enhanced precision and reduced surgeon fatigue. This study examines the integration of robotic assistance in a series of 85 consecutive robot-assisted microsurgical (RAMS) operations. It aims to evaluate changes in the integration of RAMS during the implementation phase in a single institution.

Ring Fixator Bone Transport is Associated With Fewer Unplanned Major Reoperations than Masquelet in the Treatment of Segmental Bone Defects of the Tibia.

Objective: To determine whether bone transport or Masquelet results in higher rates of major unplanned reoperations for the treatment of segmental tibial bone defects ≥4 cm in length.

Methods: Design: Retrospective cohort.

Setting: Level I trauma center.

Combined Effects of Oxandrolone and Exercise on Muscle Recovery in Rats with Severe Burn and Hindlimb Unloading.

Background: Loss of muscle mass and strength in patients who have experienced severe burns is dramatic and associated with subsequent functional impairment. Past work has shown that exercise and oxandrolone, an anabolic steroid, individually improve muscle function and muscle mass in severely burned patients. This study aims to evaluate the effect of oxandrolone treatment combined with resistance exercise on muscle atrophy and investigate the protein synthesis and mitochondrial biogenesis pathways in a hindlimb suspension model.

INCREASED CITRULLINATED HISTONE H3 LEVELS AND ACCELERATED THROMBIN KINETICS IN TRAUMA PATIENTS WHO DEVELOP VENOUS THROMBOEMBOLISM.

Background: Neutrophil extracellular traps (NETs), and its formation and release, known as NETosis, may play a role in the initiation of thrombin generation (TG) in trauma. The objective of this study was to assess whether trauma patients, who develop symptomatic venous thromboembolism (VTE), have increased levels of plasma citrullinated histone H3 (CitH3) and accelerated TG kinetics.

Methods: Patients presenting to a Level I Trauma Center as trauma activations had samples collected within 12 hours of time of injury (TOI), alongside healthy volunteers (HV).

A systematic review and meta-analysis of radiation exposure in spinal surgeries: Comparing C-Arm, CT navigation, and O-Arm techniques.

Introduction: Advanced imaging techniques, such as C-arm fluoroscopy, O-arm, and CT navigation, are integral to achieving precision in orthopedic surgeries. However, these technologies also expose patients, surgeons, and operating room staff to varying levels of radiation. This systematic review and meta-analysis evaluate the radiation exposure (RE) associated with these imaging modalities and their impact on surgical outcomes.

Nicorandil Ameliorates Depression-Like Behaviors After Traumatic Brain Injury by Suppressing Ferroptosis Through the SLC7A11/GPX4 Axis in the Hippocampus.

Introduction: Depression is a prevalent and significant psychological consequence of traumatic brain injury (TBI). Ferroptosis, an iron-dependent form of regulated cell death, exacerbates the neurological damage associated with TBI. This study investigates whether nicorandil, a potassium channel opener with nitrate-like properties known for its antioxidative and neuroprotective effects, can mitigate depression-like behaviors following TBI by modulating ferroptosis.

Application of rapid genotyping of Warfarin individualized pharmacogenetic variants in Warfarin therapy.

Warfarin is the most widely used oral anticoagulant in clinical practice. The cytochrome P450 2C9 (CYP2C9), vitamin K epoxide reductase complex 1 (VKORC1), and cytochrome P450 4F2 (CYP4F2) genotypes are associated with warfarin dose requirements in China. Accurate genotyping is vital for obtaining reliable genotype-guided warfarin dosing information.

Surveillance for surgical site infections developed during hospital stay & after discharge: A multicentric study.

Background & objectives Surgical site infections (SSIs) are among the most prevalent healthcare-associated infections (HCAIs). They cause significant morbidity, leading to excess health expenditures and increased length of hospital stay. Despite a high population burden, data on post-discharge SSIs is lacking from low-and middle-income countries (LMICs).

Risk factors for dysphagia after traumatic cervical spinal cord injury: A retrospective study.

Objective: The pathophysiological mechanisms of dysphagia in individuals with traumatic cervical spinal cord injury (SCI) are not well understood yet. Several risk factors for developing dysphagia after SCI were postulated including mechanical ventilation, tracheostomy, age, female sex, anterior surgical approach, SCI severity, and multi-level spinal fusion. This study aimed to identify risk factors for dysphagia in individuals who sustained traumatic cervical SCI.

Risk of venous thromboembolic complications in pregnant trauma patients: A matched cohort study.

Background: Trauma and pregnancy are both risk factors for venous thromboembolism (VTE). We hypothesized that pregnant blunt trauma patients would have a higher incidence of VTE complications compared with matched nonpregnant females.

Methods: We conducted a retrospective cohort study using National Trauma Data Bank data from 2017 to 2022.

Impact of Surgical Timing on Postoperative Complications Following Open Reduction Internal Fixation of Mandibular Fractures.

Purpose: The mandible is the second most fractured facial bone. The timing of open reduction internal fixation (ORIF) has been a subject of debate for decades. The authors sought to investigate the association between the timing of ORIF and the incidence of postoperative complications.