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.

Pseudo-endocrine Disorders: Recognition, Management, and Action.

"Pseudo-endocrine disorders" refer to proposed conditions that have never been scientifically proven to exist but, due to widespread misinformation available on the internet and other media, are relatively commonly diagnosed and treated with equally unproven and sometimes dangerous treatments. Adrenal fatigue is a nonexistent condition that supposedly results from adrenal exhaustion and atrophy due to chronic stress and has been promoted as a potential explanation for a variety of symptoms. Testing consists of nonvalidated online surveys and salivary cortisol profiles while treatment is not evidence-based at best and can be dangerous.

A Novel Machine Learning Model to Predict Revision ACL Reconstruction Failure in the MARS Cohort.

Background: As machine learning becomes increasingly utilized in orthopaedic clinical research, the application of machine learning methodology to cohort data from the Multicenter ACL Revision Study (MARS) presents a valuable opportunity to translate data into patient-specific insights.

Purpose: To apply novel machine learning methodology to MARS cohort data to determine a predictive model of revision anterior cruciate ligament reconstruction (rACLR) graft failure and features most predictive of failure.

Study Design: Cohort study; Level of evidence, 3.

microRNAs in congenital diaphragmatic hernia: insights into prenatal and perinatal biomarkers and altered molecular pathways.

Background: Congenital diaphragmatic hernia (CDH) is characterized by a diaphragmatic defect, leading to herniation of abdominal organs into the chest, lung compression, and impaired lung development, often resulting in pulmonary hypertension and lung hypoplasia. Prenatal imaging techniques like ultrasound and MRI provide anatomical predictors of outcomes, but their limitations necessitate novel biomarkers for better prognostic accuracy.

Objective: This study aims to identify unique circulating maternal, fetal, and neonatal microRNAs (miRNAs) that can distinguish CDH pregnancies from healthy controls and assess their potential as markers of disease severity.

Surgical Predictors of Clinical Outcome 6 Years After Revision ACL Reconstruction.

Background: Revision anterior cruciate ligament (ACL) reconstruction has been documented to have inferior outcomes compared with primary ACL reconstruction. The reasons why remain unknown.

Purpose: To determine whether surgical factors performed at the time of revision ACL reconstruction can influence a patient's outcome at 6-year follow-up.

Requirement for Fucosyltransferase 2 in Allergic Airway Hyperreactivity and Mucus Obstruction.

Mucus hypersecretion is an important pathological problem in respiratory diseases. Mucus accumulates in the airways of people with asthma, and it contributes to airflow limitation by forming plugs that occlude airways. Current treatments have minimal effects on mucus or its chief components, the polymeric mucin glycoproteins MUC5AC and MUC5B.

Variability in youth coach concussion education requirements across states.

Background: Youth sports coaches play a critical role in proper concussion recognition and management, reinforcing the need for coach concussion education. As of 2021, most states have statutory and policy measures mandating concussion education for coaches. In practice, these mandates have been enacted through state legislatures and their respective youth sport governing bodies.

Taking a Team Approach: Keep up with the EHR with a Training and Optimization Program.

Objectives: This study aimed to describe the current landscape of electronic health record (EHR) training and optimization programs (ETOPs) and their impact on healthcare workers' (HCWs) experience with the EHR.

Methods: A 72-question electronic survey was developed and distributed to healthcare organization (HCO) leaders in clinical informatics through various channels such as national informatics conferences, social media, and email distribution lists of vendors and informatics associations. The survey collected data on the characteristics, resourcing, approach, and outcomes of ETOPs.

Area-Level Social Deprivation and Cytomegalovirus Seropositivity at the Time of Solid Organ Transplant.

Importance: Cytomegalovirus (CMV) is associated with significant morbidity and mortality in solid organ transplant (SOT) recipients. The risk factors for CMV seropositivity in SOT recipients, including area-level social deprivation in the US, have not been fully characterized.

Objective: To (1) evaluate CMV seroprevalence, (2) assess the recipient characteristics associated with CMV seropositivity, and (3) assess the association of area-level social deprivation index (SDI) scores with pretransplant CMV serostatus.

Variability in forced expiratory volume in 1 s in children with symptomatically well-controlled asthma.

Aims: Spirometry is used by many clinicians to monitor asthma in children but relatively little is understood about its variability over time. The aim of this study was to determine the variability of forced expiratory volume in 1 s (FEV in children with symptomatically well-controlled asthma by applying three different methods of expressing change in FEV over 3-month intervals.

Methods: Data from five longitudinal studies of children with asthma which measured FEV at 3-month intervals over 6 or 12 months were used.

World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guidelines update - XVI - Nutritional management of cow's milk allergy.

Cow's milk allergy (CMA) is one of the most common presentations of food allergy in early childhood. Management of CMA involves individualized avoidance of cow's milk and other mammalian milk and foods containing these. Optimal elimination of cow's milk avoidance includes: label reading; information about safe and nutritious substitute foods; appropriate choice of infant formula or a plant-based food; establishing tolerance to baked milk and monitoring nutritional intake and growth.

Celiac disease in North America: What is the current practice of pediatric gastroenterology providers?

Objectives: While guidelines exist for the diagnosis and management of pediatric celiac disease (CeD), current practices in North America are not well-described. This study aimed to explore current practice patterns to identify gaps and direct future clinical, training and research initiatives.

Methods: A 23-item survey designed by the Celiac Disease Special Interest Group was distributed electronically to its members.

What works in implementing shared medical appointments for patients with diabetes in primary care to enhance reach: a qualitative comparative analysis from the Invested in Diabetes study.

Background: Diabetes is a serious public health problem affecting 37.3 million Americans. Diabetes shared medical appointments (SMAs) are an effective strategy for providing diabetes self-management support and education in primary care.

Higher prenatal anxiety predicts lower neonatal hair cortisol.

Background: Prenatal glucocorticoids are one of the most widely proposed prenatal programming mechanisms, yet few studies exist that measure fetal cortisol via neonatal hair. Neonatal hair provides a window into the fetal experience and represents cortisol accumulation in the third trimester of pregnancy. In the current study, we test the links between two types of anxiety over the course of gestation (pregnancy-related anxiety and general anxiety) with neonatal hair cortisol.