Emergency department and inpatient interhospital transfers for patients with status epilepticus.

Objective: Interhospital transfers for status epilepticus (SE) are common, and some are avoidable and likely lower yield. The use of interhospital transfer may differ in emergency department (ED) and inpatient settings, which contend with differing clinical resources and financial incentives. However, transfer from these two settings is understudied, leaving gaps in our ability to improve the hospital experience, cost, and triage for this neurologic emergency.

Injectable Estradiol Use in Transgender and Gender-Diverse Individuals in the U.S.: A Multicenter Retrospective Study.

Context: Guidelines for use of injectable estradiol esters (valerate [EV] and cypionate [EC]) among transgender and gender diverse (TGD) individuals designated male at birth vary considerably, with many providers noting supraphysiologic serum estradiol concentrations based on current dosing recommendations.

Objectives: 1. Determine dose of injectable estradiol (subcutaneous [SC] and intramuscular [IM]) needed to reach guideline-recommended estradiol concentrations for TGD adults using EC/EV.

Long-term neurobehavioral and neuroimaging outcomes in athletes with prior concussion(s) and head impact exposure.

The long-term health of former athletes with a history of multiple concussions and/or repetitive head impact (RHI) exposure has been of growing interest among the public. The true proportion of dementia cases attributable to neurotrauma and the neurobehavioral profile/sequelae of multiple concussion and RHI exposure among athletes has been difficult to determine. Across three exposure paradigms (i.

Protocol for a 1-year randomised, controlled, parallel group, open-label trial on the effects and feasibility of time-restricted eating in individuals with type 2 diabetes- The Restricted Eating Time in the Treatment of Type 2 Diabetes (RESET2) trial.

Aim: Time-restricted eating (TRE) limits the time for food intake to typically 6-10 h/day without other dietary restrictions. The aim of the RESET2 (the REStricted Eating Time in the treatment of type 2 diabetes) trial is to investigate the effects on glycaemic control (HbA) and the feasibility of a 1-year TRE intervention in individuals with overweight/obesity and type 2 diabetes. The aim of the present paper is to describe the protocol for the RESET2 trial.

Intra-Individual Stable Isotope Variation Tracks Brazilian Contemporary Dietary and Nutritional Transition.

Introduction: Contemporary dietary and nutritional transitions are commonplace, but difficult to study directly. In Brazil, and Latin America, this generalized process, leading to current obesity and malnutrition problems, started more than four decades ago. Although body weight and food availability are used to measure changes, not much information on food consumption and nutrition exist.

Current Burden of Lean Metabolic Dysfunction-Associated Steatotic Liver Disease Among US Adults, 2017-2023.

Our study investigated the prevalence of lean steatotic liver disease (SLD) and its subcategories, including metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction-related and alcohol-related SLD (MetALD), and alcohol-related liver disease (ALD) among lean adults in the US. Analysing data from 2965 lean adults (≥ 18 years) from the National Health and Nutrition Examination Survey (2017-2023), we found the age-adjusted prevalence of lean SLD to be 12.8%.

Segregation in hospital care for Medicare beneficiaries by race and ethnicity and dual-eligible status from 2013 to 2021.

Objective: To examine the extent of segregation between hospitals for Medicare beneficiaries by race, ethnicity, and dual-eligible status over time.

Data Sources And Study Setting: We used Medicare inpatient hospital provider data for fee-for-service (FFS) beneficiaries, and the Dartmouth Atlas of Health Care from 2013 to 2021 nationwide, for hospital referral regions (HRRs), and for and hospital service areas (HSAs).

Study Design: We conducted time trend analysis with dissimilarity indices (DIs) for Black (DI-Black), Hispanic (DI-Hispanic), non-White (including Black, Hispanic, and other non-White) (DI-non-White), and dual-eligible (DI-Dual) beneficiaries.

Adjuvant Chemotherapy Is Associated With Prolonged Survival Time in Small-Breed Dogs Undergoing Amputation for Appendicular Osteosarcoma.

Adjuvant chemotherapy is a well-established treatment for large-breed dogs with appendicular osteosarcoma; however, it is unclear if it improves outcomes in small-breed dogs due to limited focused studies. This retrospective study aimed to investigate the oncologic outcomes of dogs weighting less than 15 kg with appendicular osteosarcoma that underwent curative resection with or without postoperative adjuvant chemotherapy. Endpoints were time to distant progression (TTDP) and overall survival (OS).

No Difference in External Rotation Loss After Isolated Bankart Repair, Remplissage, or Latarjet: A Systematic Review and Meta-analysis.

Background: Despite the effectiveness of remplissage in reducing instability recurrence, debate remains about the loss of external rotation (ER) after this procedure.

Purpose: To compare the loss of ER after primary isolated arthroscopic Bankart repair alone (BR), Bankart with remplissage (REMP), and Latarjet (LAT) procedures.

Study Design: Meta-analysis; Level of evidence, 3.

Longitudinal analysis of anthropometric measures over 5 years in patients with Friedreich ataxia in the EFACTS natural history study.

Background: Friedreich ataxia is a rare neurodegenerative disorder caused by frataxin deficiency. Both underweight and overweight occur in mitochondrial disorders, each with adverse health outcomes. We investigated the longitudinal evolution of anthropometric abnormalities in Friedreich ataxia and the hypothesis that both weight loss and weight gain are associated with faster disease progression.

Evaluating the impact of severe hypoglycaemia definition wording on severe hypoglycaemia history assessment.

Aim: Several wordings of the definition of severe hypoglycaemia (SH) exist. This study aims to evaluate how different SH definition wordings affect SH history assessment.

Methods: In this cross-sectional study, surveys were emailed to registrants of the T1D Exchange, a U.

Knotless Versus Knotted Suture Anchors for Labral Repair of the Hip: A Systematic Review of Clinical and Biomechanical Outcomes.

Background: Arthroscopic labral repair of the hip is successfully performed with increasing frequency using either knotless or knotted suture anchors, each with its own risks and benefits.

Purpose: To examine biomechanical and clinical outcomes for labral repair of the hip based on the use of knotted or knotless suture anchors.

Study Design: Systematic review; Level of evidence, 4.

Pre-disability resilience and well-being following the onset of functional impairments.

Objectives: Tested the prospective relationship of a resilient personality prototype determined prior to disability onset to well-being among persons with and without debilitating functional impairments nine to 10 years later. A resilient profile was expected to predict well-being through its beneficial associations with positive affect, perceived control and social support.

Design: Longitudinal, prospective observation study.

Arthroscopy Is at Least as Effective as Arthrotomy for Treatment of Septic Arthritis in Adults: A Systematic Review of Large and Intermediate Joints.

Background: Surgical options for septic arthritis include open arthrotomy or an arthroscopic procedure. The optimal surgical technique remains a matter of debate as acceptable results have been reported for both.

Purpose: To evaluate the efficacy of arthroscopy versus arthrotomy for the treatment of septic arthritis in large and intermediate-sized joints.

Clinical characteristics associated with cervical hydrated nucleus pulposus extrusion in dogs.

Background: Clinical characteristics of cervical hydrated nucleus pulposus extrusion (HNPE) in dogs compared to other causes of cervical myelopathy are not well described.

Hypothesis/objectives: To evaluate for clinical characteristics and mechanical ventilation likelihood associated with HNPE compared to other causes of cervical myelopathy.

Animals: Three hundred seventy-seven client-owned dogs from 2010 to 2022.

Gemcitabine and docetaxel for high-risk non-muscle-invasive bladder cancer: EuroGemDoce group results.

Objective: To evaluate the oncological efficacy and safety of sequential intravesical gemcitabine/docetaxel (Gem/Doce) therapy in a European cohort of patients with high-risk and very-high-risk non-muscle-invasive bladder cancer (NMIBC) after previous Bacillus Calmette-Guérin (BCG) treatment.

Materials And Methods: Data were retrospectively collected from 95 patients with NMIBC, treated with Gem/Doce at 12 European centres between 2021 and 2024. Patients previously treated with BCG who had completed a full induction course and received at least one follow-up evaluation were included.

Kotter's change management approach to transforming oral healthcare delivery: A case study.

Introduction: Despite progress in research and technological advancements, the delivery of oral health care continues to be plagued by disparities in accessibility and affordability. Dental caries and periodontal disease remain major issues, and new challenges such as socioeconomic disparities and emerging public health dangers also contribute to the complexity of the issue. To address these challenges, dental education and oral healthcare delivery must shift their focus from disease treatment to disease prevention and health promotion.

Rural nonprofit hospital community benefit and financial assistance spending: A call for greater reporting transparency.

Purpose: US nonprofit hospitals must provide community benefits including financial assistance to be tax-exempt. Rural residents particularly benefit from financial assistance because they have higher medical debt on average. The Internal Revenue Service allows nonprofit hospitals that are members of health systems to report expenditures for their entire system (group returns) rather than for individual hospitals.

Are gender traits and stereotypes associated with stress and burnout among midlife women?

Women experience greater stress and burnout compared to men, particularly at midlife, when gender role expectations may contribute to experiencing stress and burnout. To date, researchers have not empirically examined the associations between gender traits and stereotypes, stress, and burnout among midlife women. Gendered traits and stereotypes were assessed via self-reported questionnaires, along with perceived stress and burnout.

The Role of Exosomes in Medical Dermatology: Literature Review and Update.

Background: Exosomes are extracellular vesicles, composed of a phospholipid bilayer, that are primarily derived from stem cells. The contents of exosomes can be incorporated into the tissue in which they are introduced, which presents a unique therapeutic option.

Aims: Exosomes have been investigated as a treatment for a number of medical ailments, but the literature supporting these indications is inconclusive.

The pleiotropic effects of PCSK9 in cardiovascular diseases beyond cholesterol metabolism.

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality globally, with elevated low-density lipoprotein cholesterol (LDL-C) levels being a major risk factor. Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a critical role in regulating LDL-C levels by promoting the degradation of hepatic low-density lipoprotein receptors (LDLR) responsible for clearing LDL-C from the circulation. PCSK9 inhibitors are novel lipid-modifying agents that have demonstrated remarkable efficacy in reducing plasma LDL-C levels and decreasing the incidence of CVD.

Posttraumatic Stress Disorder and Weight Loss in Male and Female Active-duty Service Members: A Weight Management Study.

Background: Overweight and obesity are critical public health concerns with relevance to U.S. military personnel, as active duty service members must meet physical fitness and body composition standards.

Best Practice Recommendations for Endometrial Intraepithelial Neoplasia/Atypical Endometrial Hyperplasia in the Military Health System.

Endometrial cancer is the most prevalent gynecologic cancer in the United States and has rising incidence and mortality. Endometrial intraepithelial neoplasia or atypical endometrial hyperplasia (EIN-AEH), a precancerous neoplasm, is surgically managed with hysterectomy in patients who have completed childbearing because of risk of progression to cancer. Concurrent endometrial carcinoma (EC) is also present on hysterectomy specimens in up to 50% of cases.

The Impact of Critical Speed and Lean Body Mass on Load Carriage Performance for Army Reserve Officers' Training Corps Cadets.

Introduction: Load carriage is an inherent part of tactical operations. Critical speed (CS) has been associated with technical and combat-specific performance measures (e.g.

Battlefield Acupuncture Does Not Provide Additional Improvement in Pain When Combined With Standard Physical Therapy After Shoulder Surgery: A Randomized Clinical Trial.

Introduction: Shoulder stabilization surgery is common among military personnel, causing severe acute postoperative pain that may contribute to the development of chronic pain, thereby reducing military readiness. Battlefield Acupuncture (BFA) has shown promise as a non-pharmaceutical intervention for acute postoperative pain. The purpose of this study was to determine the effectiveness of BFA combined with standard physical therapy on pain, self-reported mood, self-reported improvement, and medication use in patients after shoulder stabilization surgery.