Characterizing Limb Loss and Absence in Military Health System Beneficiaries: Demographics, Causes, and Trends (2005-2023).

Introduction: An estimated 5.6 million individuals in the U.S.

Development of a multiplex serological assay to detect immunoreactivity against a novel in military working dogs.

pose a significant health risk to military working dogs (MWDs), and these zoonotic organisms may also cause disease in humans. According to the U.S.

Recalibrating Self-Assessment: Navigating Imposter Syndrome Through Metacognitive Reflection.

Background: Accurate self-assessment is foundational for life-long learning, professional development and patient safety, yet many learners struggle to develop this fundamental skill. Even skilled self-assessors-or savvy calibrators-may sometimes struggle with self-assessment accuracy, particularly during professional transitions and challenges. This study explored the metacognitive processes employed by high-performing physicians to maintain or recalibrate accurate self-assessment across diverse professional contexts.

Ten-Year Trends in Digital Rectal Exam Results and Prostate Cancer Detection: Insights from the PLCO Trial.

Objective: Digital Rectal Examination (DRE) remains an important preventive measure in primary care settings, but a single screening may produce false positives. We sought to explore the trend of abnormal DRE (suspicious and non-suspicious) findings in men with and without prostate cancer.

Methods: We utilized data on 34,756 men (1,713 Black and 33,043 White) from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.

Improved injury detection through harmonizing multi-site neuroimaging data after experimental TBI: a Translational Outcomes Project in Neurotrauma consortium study.

Multi-site neuroimaging studies have become increasingly common in order to generate larger samples of reproducible data to answer questions associated with smaller effect sizes. The data harmonization model NeuroCombat has been shown to remove site effects introduced by differences in site-related technical variance while maintaining group differences, yet its effect on improving statistical power in pre-clinical models of CNS disease is unclear. The present study examined fractional anisotropy data computed from diffusion weighted imaging data at 3 and 30 days post-controlled cortical impact injury from 184 adult rats across four sites as part of the Translational-Outcome-Project-in-Neurotrauma (TOP-NT) Consortium.

Expulsion rates 12 months after early versus interval postpartum intrauterine device placement: a randomized trial.

Objective: The early postpartum period, 2 to 4 weeks postpartum, is an optimal time for intrauterine device (IUD) initiation; placement can be co-located with early postpartum or infant visits. We aimed to compare expulsion rates at 12 months postpartum for IUDs placed early compared to the standard interval 6-week visit.

Study Design: This is a randomized controlled trial conducted at four U.

Integrating Gait Analysis Systems in Clinical Rehabilitation Settings for Individuals With Lower Limb Amputation: A Narrative Review.

A primary goal of rehabilitative care for individuals with lower limb amputation (LLA) is to restore safe, effective gait. Traditional gait analysis, both observational and quantitative, assesses gait deviations in individuals with LLA to inform clinical management. Observational gait analysis performed in clinical settings can be highly subjective, whereas quantitative gait analysis is often costly, time-consuming, and therefore impractical to perform in point-of-care clinical settings.

Correction: Integrating Gait Analysis Systems in Clinical Rehabilitation Settings for Individuals With Lower Limb Amputation: A Narrative Review.

[This corrects the article DOI: 10.7759/cureus.91030.

The Need to Incorporate Post-Acute Care Entities Into the National Disaster Medical System.

The National Disaster Medical System (NDMS) is critical to healthcare preparedness and response in the United States but currently has limited capacity for handling large-scale mass-casualty surge events. Crises, such as the COVID-19 pandemic, have shown how quickly the US healthcare system can become overwhelmed, necessitating novel solutions for handling a large-scale influx of patients. This paper proposes the inclusion of post-acute care (PAC) entities, which provide long-term care rehabilitation and short-stay subacute rehabilitation support rather than acute or critical care, into the NDMS as one solution to increase its capacity during mass-casualty surges.

Disease and non-battle injury incidence rate trends in the US military, 2010-2021.

Introduction: This study's purpose was to analyse disease and non-battle injury (DNBI) incidence trends in US military personnel from 2010 to 2021 to understand implications for medical readiness.

Methods: A retrospective cohort of deidentified DNBI cases was developed from the person-event data environment for all military personnel between 2010 and 2021. Chronic and acute conditions were identified using the clinical classification software for categorising International Classification of Disease-9-Clinical Modification (ICD-9-CM) codes and clinical classification software refined for categorising ICD-10-CM codes.

Physical confinement and phagocytic uptake induce persistent cell migration.

Physical confinement is not routinely considered as a factor that influences phagocytosis, which is typically investigated using unconfined in vitro assays. BV2 microglia-like cells were used to interrogate the impact of confinement on IgG-mediated phagocytosis side by side with unconfined cells. Confinement acted as a potent phagocytic driver, greatly increasing the fraction of phagocytic cells in the population compared to the unconfined setting.

Validity of Novel Classification of Patient Safety and Patient-Centered Outcomes.

Objectives: To validate and assess the interrater agreement on a novel classification system for reporting adverse events.

Methods: A cross-sectional review of adverse events recorded from 2019 to 2023 of 211 patient cases within the Department of Otolaryngology-Head and Neck Surgery at a tertiary care center. Three raters (one attending and two resident physicians) were recruited to classify these cases according to two classification systems, Clavien Dindo Classification (CDC) and the new classification system, Quality Improvement Classification System (QICS).

Activities of ISO Working Group 18: Biological and Physical Retrospective Dosimetry.

Biological and physical retrospective dosimetry for ionizing radiation exposure is a rapidly growing field, and several methods for performing biological and physical retrospective dosimetry have been developed to provide absorbed dose estimates for individuals after occupational, accidental, intentional, and incidental exposures to ionizing radiation. In large-scale radiological/nuclear incidents, multiple retrospective dosimetry laboratories from several countries may be involved in providing timely dose estimates for effective medical management of several thousand exposed individuals. In such scenarios, the harmonization of methods among participating laboratories is crucial for consistency in data analysis, dose estimation, and medical decision-making.

Process-Oriented Analysis of Knowledge Construction in Problem-Based Learning: A Systematic Review of Health Professions Education in Literature.

Problem-Based Learning (PBL) is widely implemented in health professions education (HPE). Small-group knowledge construction plays an essential role in trainees' learning from PBL tutorials. However, there is a dearth of systematic reviews to unpack the black box of the PBL knowledge construction process.

The Family Wellness Program: a bench to bedside translation of behavioral and social science research into a clinical program for intimate partners of warfighters following traumatic brain injury.

This report details a bench to bedside translation of behavioral and social science research into a clinical program as a result of a collaboration between two United States Defense Health Agency Centers of Excellence for warfighter traumatic brain injury (TBI) and brain health. Identifying a gap in health-related quality of life (HRQOL) measures, our team instigated a 7-year multisite effort to validate and develop generic and caregiver specific HRQOL domains for family members of warfighters and civilians with a TBI using state-of-the-science measurement development standards; the measurement system. The TBI-CareQOL was integrated into the Defense and Veterans Brain Injury Center-Traumatic Brain Injury Center of Excellence designed to address four elements in a Congressional mandate (NDAA FY2007 Sec721 Public Law 109-364).

In-vivo evaluation of vitamin E loaded muscle void fillers for the provisional treatment of volumetric muscle loss.

Objective: This study investigates the therapeutic potential of α-tocopherol (Vitamin E, VitE), delivered locally via a polyethylene glycol (PEG) hydrogel serving as a muscle void filler (MVF), for the acute treatment of volumetric muscle loss (VML) in a rat model. The primary goal was to determine if VitE, a reactive oxygen species scavenger, could exert antioxidant effects at the VML site and thereby improve the recovery of adjacent muscle tissue over a four-week period.

Results: The MVF successfully increased VitE levels in the muscle throughout the implantation period.

3D-Printed Biocompatible Frames for Electrospun Nanofiber Membranes: An Enabling Biofabrication Technology for Three-Dimensional Tissue Models and Engineered Cell Culture Platforms.

Electrospun nanofiber membranes (ESNFMs) are exceptional biomaterials for tissue engineering, closely mimicking the native extracellular matrix. However, their inherent fragility poses significant handling, processing, and integration challenges, limiting their widespread application in advanced 3D tissue models and biofabricated devices. This study introduces a novel and on-mat framing technique utilizing extrusion-based printing of a UV-curable biocompatible resin (Biotough D90 MF) to create rigid, integrated support structures directly on chitosan-polyethylene oxide (PEO) ESNFMs.

RNA Sequencing on Muscle Biopsies from Exertional Rhabdomyolysis Patients Revealed Down-Regulation of Mitochondrial Function and Enhancement of Extracellular Matrix Composition.

Background/objective: Exertional rhabdomyolysis (ER) is primarily driven by mechanical stress on muscles during strenuous or unaccustomed exercise, often exacerbated by environmental factors like heat and dehydration. While the general cellular pathway involving energy depletion and calcium overload is understood in horse ER models, the underlying mechanisms specific to the ER are not universally known within humans. This study aimed to evaluate whether patients with ER exhibited transcriptional signatures that were significantly different from those of healthy individuals.

Neutrophil Gelatinase-Associated Lipocalin: A Shared Early Biomarker of Remote Organ Dysfunction in Blast-Induced Extremity Trauma.

Polytrauma is a critical global health concern characterized by immune dysregulation and a high risk of multiple organ dysfunction syndrome (MODS). Early molecular mechanisms linking trauma severity to organ injury are poorly understood. We used two rat blast-polytrauma models: a tourniquet-induced ischemia/reperfusion injury (tIRI) model and a non-ischemia/reperfusion injury (non-IRI) model.

User experience and hemostatic efficacy: Comparative analysis of commercial agents in junctional and hepatic hemorrhage models.

Background/objectives: Hemorrhage is associated with most preventable combat-related deaths. Management of non-compressible truncal and junctional hemorrhage remains challenging, especially with prolonged evacuations. This study evaluated the efficacy of commercial topical hemostatic agents in uncontrolled hemorrhage models under coagulopathic conditions, examining differences based on applicator experience.

New Approaches to Investigate Novel Agents in Ewing Sarcoma: A Report From the Children's Oncology Group Bone Tumor Committee.

Outcomes for relapsed Ewing sarcoma remain consistently poor. Continued efforts to consider creative new approaches for the treatment of relapsed Ewing sarcoma are needed. The Children's Oncology Group Bone Tumor Committee convened a New Strategies for Ewing Sarcoma Task Force to systematically evaluate agents for inclusion in future Phase II or III clinical trials for relapsed Ewing sarcoma.

The Effect of Experimentally Induced Cognitive Fatigue on Energy Intake Among Youth With and Without Recent Reported Dietary Restraint.

Objective: Resource-based models of self-regulation posit that cognitive fatigue, or the depletion of cognitive resources, may be an impetus for self-regulatory difficulties, including overeating. Studies of adults indicate that cognitive fatigue may increase energy intake only among adults who report engaging in dietary restraint (DR). The current study examined if DR similarly moderates the effects of cognitive fatigue on energy intake in youth.

Evaluating the muscularity-oriented eating test: Factor structure and psychometric properties among university athletes and across sexes.

Objective: The Muscularity-Oriented Eating Test (MOET) was developed to measure muscularity-oriented eating pathology among young men; however, this construct is relevant across sexes and may be particularly applicable to athletes. Thus, this study sought to validate the MOET among male and female athletes and non-athletes.

Methods: Students (N = 2189) from three U.