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.

The HET (history, electrocardiogram, and troponin) score has low efficacy and negative predictive value in a multisite U.S. cohort study.

Introduction: The History, Electrocardiogram, and Troponin (HET) score is a simplified alternative to the HEART score for risk stratifying emergency department (ED) patients with chest pain. This study evaluates the safety and efficacy of the HET score for 30-day cardiac death or myocardial infarction (MI).

Methods: We conducted a secondary analysis of the STOP-CP multisite cohort study.

Vascular Closure Device versus Open Decannulation for Femoral Veno-Arterial Extracorporeal Membrane Oxygenation.

Background: Traditional decannulation of femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) involves femoral cutdown. Percutaneous methods have been developed, but data supporting their use is limited. We sought to compare the MANTA vascular closure device to open decannulation.

Use of Ex Situ Machine Perfusion for Liver Transplantation: The National Experience.

Background: Machine perfusion (MP) for liver transplantation has become more widespread in the United States, but national studies on this growing practice are lacking. We investigated national use and outcomes of MP for liver transplantation.

Methods: Adult (≥18 y) liver recipients transplanted between January 1, 2016 and September 30, 2023 in the United Network for Organ Sharing database were included.

Maternal Allergic Disease Phenotype and Infant Birth Season Influence the Human Milk Microbiome.

Early infancy is a critical period for immune development. In addition to being the primary food source during early infancy, human milk also provides multiple bioactive components that shape the infant gut microbiome and immune system and provides a constant source of exposure to maternal microbiota. Given the potential interplay between allergic diseases and the human microbiome, this study aimed to characterise the milk microbiome of allergic mothers.

Therapeutic potential of the flavonoid compound Licochalcone D in metabolic dysfunction-associated steatotic liver disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent chronic liver disease associated with type 2 diabetes, which doubles the risk of developing this condition. Various flavonoid compounds have a positive effect on lipid metabolism, inflammation, and insulin resistance and can contribute to slowing down the progression of MASLD. In the current study, we investigated the biological effects of Licochalcone D (Lico D), a flavonoid, in a metabolic disease model.

Equitable and effective clinical guidance development and dissemination: trauma aims to lead the way.

Thirty-four per cent of deaths among Americans aged 1-46 are due to injury, and many of these deaths could be prevented if all hospitals performed as well as the highest-performing hospitals. The Institute of Medicine and the National Academies of Science, Engineering and Medicine have called for learning health systems, with emphasis on clinical practice guidelines (CPGs) as a means of limiting preventable deaths. Reduction in mortality has been demonstrated when evidence-based trauma CPGs are adhered to; however, guidelines are variably updated, redundant, absent, inaccessible, or perceived as irrelevant.

Determining If Post-Injury Financial Distress Was Preexisting or Injury-Induced: A Prospective Cohort Study of Patients with Lower-Extremity Trauma.

Background: Previous research has estimated that over one-half of patients with orthopaedic trauma experience financial distress after the injury. However, it is unknown what proportion of patients lived under financial distress before the injury and, therefore, the causal effect of the injury on financial distress. This study examined changes in financial distress after the injury and factors associated with new post-injury financial distress.

Returning to Work is Associated with Higher Quality of Life: A LIMB-Q Analysis in Patients with Limb-Threatening Injuries.

Objectives: To identify clinical, demographic, and patient-reported outcomes (PROs) associated with return to work after lower extremity traumatic injury requiring amputation or limb salvage.

Methods: Design: Cross-sectional study.

Setting: Multi-center across 25 countries.

Comparative effectiveness of olodaterol/tiotropium and vilanterol/umeclidinium among COPD patients: a high-dimensional propensity score matched new user cohort study in a US Medicare population.

Background: Two long-acting muscarinic antagonist inhaler fixed dose combinations (olodaterol/tiotropium (OLO/TIO) and vilanterol/umeclidinium (VI/UMEC)) have once-a-day dosing for managing chronic obstructive pulmonary disease (COPD). This study aimed to compare clinical effectiveness of these inhalers in terms of ability to prevent severe COPD exacerbations in a United States Medicare population.

Research Design And Methods: Using nationally representative Medicare data (2013-2019), we employed a new user, active comparator design among beneficiaries aged 65 years and older with COPD.

Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.

Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.

Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.

Brown-Séquard syndrome after blunt cervical spine trauma in a patient with preinjury multilevel hemilaminectomies and OPLL: illustrative case.

Background: Brown-Séquard syndrome (BSS) is a rare neurological condition characterized by injury to one-half of the spinal cord. In the context of trauma, BSS is typically seen with penetrating injuries. Here, the authors present the unique case of a patient presenting with BSS after blunt trauma.

Depressive Symptoms in Adults with Autosomal Dominant Polycystic Kidney Disease.

Background: Individuals with autosomal dominant polycystic kidney disease (ADPKD) face mental health challenges linked to disease progression and its heritable nature. Prior studies reported mixed associations between depressive symptoms and ADPKD severity and progression. Here, we assessed depressive symptoms and disease severity over three years in ADPKD patients without end-stage kidney disease.

Artificial intelligence in emergency and trauma radiology: ASER AI/ML expert panel Delphi consensus statement on research guidelines, practices, and priorities.

Background: Emergency/trauma radiology artificial intelligence (AI) is maturing along all stages of technology readiness, with research and development (R&D) ranging from data curation and algorithm development to post-market monitoring and retraining.

Purpose: To develop an expert consensus document on best research practices and methodological priorities for emergency/trauma radiology AI.

Methods: A Delphi consensus exercise was conducted by the ASER AI/ML expert panel between 2022-2024.

Comprehensive Analysis Reveals No Significant Correlation Between p16/CDKN2A Expression and Treatment Outcomes in Laryngeal Squamous Cell Carcinoma.

Background: The p16/CDKN2A protein is being explored as an independent prognostic marker in laryngeal cancer, with studies suggesting that p16-positive patients may have a better prognosis. While its role is well-established in oropharyngeal squamous cell carcinoma (OPSCC) related to HPV, ongoing research indicates its potential prognostic value in laryngeal cancer, even in HPV-negative cases.

Methods: In this study, we investigated the association between survival outcomes and p16 expression in a cohort of 310 laryngeal cancer patients from the Cancer Genome Atlas (TCGA) Program and the University of Maryland Medical Center (UMMC).

Severe pulmonary hypertension in chronic obstructive pulmonary disease - From clinical perspective to histological evidence.

Severe pulmonary hypertension (PH) in chronic obstructive pulmonary disease (COPD) is currently defined by an elevated mean pulmonary arterial pressure and strongly elevated pulmonary vascular resistance >5 wood units. Clinically, these patients show a male predominance, and usually present with very severe dyspnea, severe hypoxemia, strongly decreased exercise capacity and poor prognosis, even though the clinical picture is frequently associated with less severe airflow obstruction. Explanted lung samples of patients with COPD and severe PH show severe remodeling of small pulmonary arterioles, predominantly in the intima and media of the vessels.

Community-Engaged Insights: Understanding the Housing Needs of Rural Caregivers During Hospital Treatment.

Purpose: This study explored the experiences of rural caregivers who require temporary housing during hospital treatment when healthcare is not available in their home communities. Understanding these experiences can identify challenges and inform solutions for improving rural access to healthcare.

Methods: We conducted a community-engaged qualitative study using semi-structured interviews with caregivers who stayed at a healthcare hospitality house in Charlotte, NC.

Self-Reported Cervical Cancer Screening Uptake Among Women of Reproductive Age in Zambia: Evidence from the 2021 Zambia Population-Based HIV Impact Assessment (ZAMPHIA) Survey.

Background: Despite Zambia implementing the World Health Organisation's (WHO) tri-pillar cervical cancer prevention goals 90-70-90 Prevent, Screen, and Treat, cervical cancer claims 2000 lives annually and reigns as the most common cancer among women, especially those living with HIV (WLHIV). Our study describes the national uptake of screening and treatment from the ZAMPHIA 2021 survey.

Methods: Utilising a two-stage cluster sampling approach, the study included participants aged 15 years and older across Zambia's ten provinces.

Delusional Unreality and Predictive Processing.

Background: Phenomenological psychopathologists have recently highlighted how people with delusions experience multiple realities (delusional and non-delusional) and have suggested this double bookkeeping cannot be explained via predictive processing. Here, we present data from Kamin blocking and extinction learning that show how predictive processing might, in principle, explain a pervasive sense of dual reality.

Methods: This cross-sectional study involved three participant groups: patients with schizophrenia (SZ; n=42), healthy participants with elevated esoteric beliefs (EEB; clairaudient psychics; n=31), and heathy controls (with neither illness nor significant delusional ideation, n=62).

Management of pleural effusion in mechanically ventilated critically ill patients: A systematic review and guideline.

Background: Mechanically ventilated critically ill patients often develop pleural effusions, which may impact lung compliance and expansion. This systematic review explores the management of pleural effusion in the critically ill population.

Methods: A comprehensive literature search was performed.

Clinical and biochemical footprints of inherited metabolic diseases: XVII. Dysmorphisms.

Dysmorphisms, or physical abnormalities in appearance, can vary in frequency and severity among individuals with inherited metabolic disorders (IMD). The prevalence of dysmorphisms in these disorders can range from rare occurrences to more common features, depending on the specific disorder and its genetic characteristics. It is important to note that not all individuals with IMDs will exhibit dysmorphic features, and the presence of such features may vary widely among different types of metabolic disorders.

Dual Psychosocial Screening of the Adolescent Patient by Implementing the SEEK Teen Questionnaire.

Objective: This study introduces the SEEK Teen Questionnaire, expanding the Safe Environment for Every Kid (SEEK) approach to include adolescent perspectives alongside caregiver responses for dual psychosocial screening. The objective of this study aims to triangulate adolescent responses with those of their caregivers to demonstrate the benefits of dual psychosocial screening.

Methods: The SEEK Teen Questionnaire was developed by integrating input from primary care and adolescent medicine professionals, national experts, and adolescent stakeholders.

The role of the psychedelic experience in psilocybin treatment for treatment-resistant depression.

Objective: To determine the relationships between psilocybin dose, psychedelic experiences, and therapeutic outcome in treatment-resistant depression.

Methods: For treatment-resistant depression, 233 participants received a single dose of 25, 10, or 1 mg of COMP360 psilocybin (a proprietary, pharmaceutical-grade synthesized psilocybin formulation, developed by the sponsor, Compass Pathfinder Ltd.) with psychological support.

A Systematic Review of Human Paenibacillus Infections and Comparison of Adult and Pediatric Cases.

Background: Neonatal infections due to Paenibacillus species have increasingly been reported over the last few years.

Methods: We performed a structured literature review of human Paenibacillus infections in pediatric and adult patients to compare the epidemiology of infections between these distinct patient populations.

Results: Forty reports describing 177 infections were included.