State-Level Helmet Use Laws, Helmet Use, and Head Injuries in EMS Patients Involved in Motorcycle Collisions.

Objectives: Motorcycle helmets save lives and reduce serious injury after motorcycle collisions (MCC). In 2022, 18 states had laws requiring helmet use by motorcyclists aged ≥21 years. Our objective was to compare helmet use and head trauma in emergency medical services (EMS) patients involved in MCC in states with and without helmet use laws.

What Is Truly Informed Consent in Medical Practice and What Has the Perception of Risk Got to Do with It?

Making decisions about risk, describing and appropriately explaining risk in medical practice is complex for patients and professionals. In this paper, we investigate how the concept of consent is practiced differently in the UK and Norway and discuss pros and cons of the chosen approaches from a patient safety culture perspective. We argue that consent is a fundamental part of the safety culture and influence on health system functioning and patient and staff safety.

Lactams Exhibit Potent Antifungal Activity Against Monospecies and Multispecies Interkingdom Biofilms on a Novel Hydrogel Skin Model.

Infections of intact and damaged skin barriers and keratin are frequently associated with complex biofilm communities containing bacteria and fungi, yet there are limited options for successful management. This study intended to focus on the utility of some novel proprietary lactam molecules, quorum sensing (QS)-derived halogenated furanones, which act to block the QS pathway, against key fungal pathogens of the skin (Candida albicans, Malassezia furfur and Microsporum gypseum). Moreover, we aimed to assess how these actives performed against complex interkingdom biofilms in a clinically relevant model.

Prognostic Value of Serum Bilirubin in Aneurysmal Subarachnoid Hemorrhage Patients.

Background: Bilirubin plays a crucial role in the pathophysiological processes of strokes. However, the relationship between serum bilirubin levels and the prognosis of aneurysmal subarachnoid hemorrhage (aSAH) remains unexplored. This study aims to investigate the association between serum bilirubin levels and the mortality rate of aSAH patients.

An Atypical Case of Marchiafava-Bignami Disease in a Young Chronic Alcoholic: Challenges in Diagnosis and Prognosis.

A 27-year-old male patient with chronic alcohol use disorder was diagnosed with Marchiafava-Bignami disease (MBD) after experiencing an episode of unconsciousness. MRI scans revealed lesions in the corpus callosum and adjacent white matter. Despite prompt initiation of intensive treatment with high-dose thiamine and corticosteroids, the patient only partially recovered, remaining disoriented and exhibiting persistent neurological deficits during follow-up.

Preliminary feasibility and efficacy of a brief behavioural treatment for insomnia after acquired brain injury: A case series.

Insomnia after acquired brain injury (ABI) is common and can negatively impact an individual's rehabilitation, recovery, and quality of life. The present study investigated the feasibility and preliminary efficacy of a Brief Behavioural Treatment for Insomnia (BBTI) in a community sample following ABI. Ten participants were recruited.

Investigation of the association between therapeutic effectiveness of anamorelin and Glasgow prognostic score in patients with cancer cachexia: a competing risk analysis.

Anamorelin, a highly selective ghrelin receptor agonist, enhances appetite and increases lean body mass in patients with cancer cachexia. However, the predictors of its therapeutic effectiveness are uncertain. This study aimed to investigate the association between the Glasgow prognostic score (GPS), used for classifying the severity of cancer cachexia, the therapeutic effectiveness of anamorelin, and the feasibility of early treatment based on cancer types.

Pterional vs. mini-pterional craniotomy for intracranial aneurysms: a systematic review and meta-analysis.

The mini-pterional craniotomy (mPT) was designed to be a minimally invasive alternative to the standard pterional (PT) approach. However, it remains unclear which technique produces better results. Thus, we aimed to perform a meta-analysis comparing functional, surgical, and aesthetic outcomes between mPT and PT in intracranial aneurysms.

Prebiotic RNA self-assembling and the origin of life: Mechanistic and molecular modeling rationale for explaining the prebiotic origin and replication of RNA.

In recent years, a great interest has been focused on the prebiotic origin of nucleic acids and life on Earth. An attractive idea is that life was initially based on an autocatalytic and autoreplicative RNA (the RNA-world). RNA duplexes are right-handed helical chains with antiparallel orientation, but the rationale for these features is not yet known.

Impact of diabetes mellitus on coronary artery plaque characteristics and outcomes in the SCOT-HEART trial.

Background: Diabetes mellitus is an established cardiovascular risk factor. We assessed the impact of diabetes mellitus on quantitative plaque and long-term outcomes in patients with and without diabetes mellitus in the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.

Methods: Coronary artery calcium (CAC) was assessed on non-contrast computed tomography (CT).

Diabetic foot ulcer photography study: a study within a trial to assess the reliability of two-dimensional (2D) photography for the assessment of ulcer healing in patients with diabetes-related foot ulcers-protocol paper.

Background: The primary endpoint in diabetes-related foot ulcer (DFU) trials is often time to healing, defined as complete re-epithelialisation with absence of drainage, requiring clinical expert assessment as the gold standard. Central blinded photograph review for confirmation of healing is increasingly being undertaken for internal validity. The Diabetic Foot Ulcer Photography study aims to determine the agreement between blinded independent review panel members for assessing ulcer healing status in patients with DFUs.

Gaps in knowledge and management of iron deficiency in heart failure: a nationwide survey of cardiologists in China.

Background: Heart failure (HF) guidelines recommend routine testing for iron deficiency (ID) and, for those with ID, intravenous iron if the left ventricular ejection fraction is <50%. Guideline adherence to these recommendations by cardiologists in China is unknown.

Methods And Results: An independent academic web-based survey was designed and distributed via social networks to cardiologists across China.

Induction of macrophage efferocytosis in pancreatic cancer via PI3Kγ inhibition and radiotherapy promotes tumour control.

Background: The immune suppression mechanisms in pancreatic ductal adenocarcinoma (PDAC) remain unknown, but preclinical studies have implicated macrophage-mediated immune tolerance. Hence, pathways that regulate macrophage phenotype are of strategic interest, with reprogramming strategies focusing on inhibitors of phosphoinositide 3-kinase-gamma (PI3Kγ) due to restricted immune cell expression. Inhibition of PI3Kγ alone is ineffective in PDAC, despite increased infiltration of CD8+ T cells.

Advantages of disposable portable endoscope in removing thalamic hematoma via the superior parietal lobule.

Objectives: Thalamic hematoma patients present with diverse clinical conditions, and treatment approaches vary widely. Currently, the use of disposable portable endoscope surgery has been rapidly adopted in many hospitals, but outcomes can vary significantly. Surgical approaches and techniques for thalamic hematoma often reference those used for basal ganglia hemorrhage, but their effectiveness remains uncertain.

Evaluating student understanding of pharmacodynamics core concepts.

Pharmacodynamics is an essential subdiscipline of pharmacology that underpins safe and effective prescribing and therapeutic decision-making, as well as drug discovery and development. The exponential increase in the number of therapeutic drugs has prompted members of the pharmacology educator community to question existing pharmacology curricula focused on individual drugs and move toward a curriculum focused on conceptual understanding. A first step towards conceptual understanding is to establish what students currently know about pharmacodynamic core concepts.

The impact of new-onset atrial fibrillation in the setting of acute coronary syndrome.

Approximately 10 % of patients who have suffered from myocardial infarction develop new-onset atrial fibrillation (AF). Coronary artery disease implicating atrial branches has been associated with AF. The following variables have been associated with new-onset AF in the setting of acute coronary syndrome: older age, history of hypertension, history of angina, history of stroke, chronic renal failure, body mass index, no statin use, worse nutritional status, worse Killip class, admission heart rate ≥ 85 bpm, complete atrioventricular block, Glasgow prognostic score, Syntax score, CHEST score > 3, PRECISE-DAPT score ≥ 25, left ventricular ejection fraction ≤40 %, increased left atrial diameter, E/E' ratio > 12, epicardial fat tissue thickness, and thrombolysis in myocardial infarction flow < 3.

British Society of Gastroenterology National Evaluation of Colonoscopy Quality: Findings from the National Endoscopy Database.

Background And Aims: Analysis of national colonoscopy quality using automatically uploaded data from a national database, including exploring performance variation.

Methods: Data on all colonoscopies performed in the UK 01/03/2019-29/02/2020 and recorded in the National Endoscopy Database were analysed. Unadjusted key performance indicators were calculated and proportions of endoscopists achieving national standards were determined.

Maintenance treatment with vedolizumab in paediatric inflammatory bowel disease (VEDOKIDS): 54-week outcomes of a multicentre, prospective, cohort study.

Background: Infliximab and adalimumab are the only biologics thus far approved for paediatric patients with inflammatory bowel disease (IBD), so other biologics, such as vedolizumab, are prescribed off-label. Despite its frequent use, prospective data for vedolizumab treatment in children are available only for short-term induction outcomes. We aimed to evaluate the long-term efficacy and safety of maintenance therapy with vedolizumab in paediatric patients with IBD.

Finite-time H output synchronization for DCRDNNs with multiple delayed and adaptive output couplings.

This work concentrates on solving the finite-time H output synchronization (FTHOS) issue of directed coupled reaction-diffusion neural networks (DCRDNNs) with multiple delayed and adaptive output couplings in the presence of external disturbances. Based on the output information, an adaptive law to adjust output coupling weights and a controller are respectively developed to ensure that the DCRDNNs achieve FTHOS. Then, in the special case of no external disturbances, a corollary on the finite-time output synchronization (FTOS) of the DCRDNNs with multiple delayed and adaptive output couplings is provided.

Standardized Outcomes for Randomized Controlled Trials Targeting Early Interventions in Patients With Moderate-to-Severe Traumatic Brain Injury: Protocol for the Development of a Core Outcome Set.

Background: : With more than 60 million new cases around the world each year, traumatic brain injury (TBI) causes substantial mortality and morbidity. Managing TBI is a major human, social, and economic concern. In the last 20 years, there has been an increase in clinical trials in neurocritical care, leading mostly to negative results.

Frozen Section Doughnuts Obtained with a 5 mm Stapling Device Improve Outcomes in Laparoscopic Endorectal Pull-Throughs for Hirschsprung's Disease.

A primary pull-through for Hirschsprung's disease (HD) requires confirmation of normal ganglionic bowel by intraoperative biopsies to determine the level of resection. Despite this, aganglionic bowel that is not fully resected (so-called "transition zone pull-throughs") is reported in 15%-19% of patients. We hypothesize that this may result from insufficient biopsies sent for intraoperative diagnosis.

Quantity of Caloric Support After Pediatric Severe Traumatic Brain Injury: Description of Associated Outcomes in a Single Retrospective Center Cohort, 2010-2022.

Objectives: To examine the relationship between adequacy of caloric nutritional support during the first week after severe traumatic brain injury (TBI) and outcome.

Design: Single-center retrospective cohort, 2010-2022.

Setting: Tertiary care children's hospital with a level 1 trauma center.

Machine Learning Approach for Sepsis Risk Assessment in Ischemic Stroke Patients.

Background: Ischemic stroke is a critical neurological condition, with infection representing a significant aspect of its clinical management. Sepsis, a life-threatening organ dysfunction resulting from infection, is among the most dangerous complications in the intensive care unit (ICU). Currently, no model exists to predict the onset of sepsis in ischemic stroke patients.

Gonadal function and pathology in 17beta-HSD 3 and 5alpha-reductase deficiency.

Objective: 17β-Hydroxysteroid dehydrogenase 3 deficiency (17β-HSDD) and 5α-reductase type 2 deficiency (5α-RD) are rare 46,XY differences of sex development (DSD). This study aims to enlarge the limited knowledge on long-term gonadal function and gonadal pathology in these conditions.

Design: Retrospective multicentre cohort study.