Association Between Disability and Life Satisfaction, Participation, and Psychological Health: A Traumatic Brain Injury Model Systems Study.

Background And Objectives: Moderate-to-severe traumatic brain injury (TBI) can result in disability across physical, social, and cognitive domains. The Glasgow Outcome Scale-Extended (GOSE), which evaluates global function, is the most frequently used TBI outcome measure. However, the GOSE may not capture all domains of recovery.

Progesterone for Traumatic Brain Injury, Experimental Clinical Treatment III Trial Revisited: Objective Classification of Traumatic Brain Injury With Brain Imaging Segmentation and Biomarker Levels.

Objective: This post hoc study of the Progesterone for Traumatic Brain Injury, Experimental Clinical Treatment (ProTECT) III trial investigates whether improving traumatic brain injury (TBI) classification, using serum biomarkers (glial fibrillary acidic protein [GFAP] and ubiquitin carboxyl-terminal esterase L1 [UCH-L1]) and algorithmically assessed total lesion volume, could identify a subset of responders to progesterone treatment, beyond broad measures like the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale-Extended (GOS-E), which may fail to capture subtle changes in TBI recovery.

Design: Brain lesion volumes on CT scans were quantified using Brain Lesion Analysis and Segmentation Tool for CT. Patients were classified into true-positive and true-negative groups based on an optimization scheme to determine a threshold that maximizes agreement between radiological assessment and objectively measured lesion volume.

Mortality rate and predictors among stroke patients in the public hospitals in Harari region, Eastern Ethiopia.

Stroke is a major cause of death and disability worldwide, yet there is limited information on the mortality rate and its predictors in Eastern Ethiopia. This lack of evidence is particularly significant, as hospitals in the Harari region provide the majority of healthcare services for stroke and chronic diseases. Therefore, our objective is to assess the mortality rate and predictors among stroke patients in the public hospitals in Harari.

Trends In Reported Outcomes For Growth Hormone Therapy In Children With Growth Hormone Deficiency.

Objective: To understand the frequency and trends in reported outcomes of safety and effectiveness for recombinant human growth hormone (rhGH) therapy for growth hormone deficiency (GHD) in childhood.

Methods: A systematic review was performed in seven English and Chinese language databases. Eligibility criteria included all studies published between 2003 and 2022, with participants who started rhGH before the age of 16 years for GHD.

Economic burden and cost-effectiveness of treatments for open tibia fractures in Malawi: Economic analysis of a multicentre prospective cohort study.

Background: Open tibia fractures result in substantial lifelong disability for patients, and are expensive to treat. As the injury typically affects young working men, the societal costs from open tibia fractures are likely to also be high in low income countries, but remain largely unknown. We therefore investigated the overall societal costs and cost-effectiveness of different orthopaedic treatments at one year following an open tibia fracture in Malawi.

One Chance to Get it Right: Exploring Perspectives and Experiences in Care Home Discharge Decision-Making in the Acute Hospital.

Background: Discharge from acute hospital to new care home is a complex and life changing process often involving several key stakeholders in decision-making such as the older person, their significant person and members of the multidisciplinary team. There is limited research exploring the perspectives of these stakeholders, including factors that influence decision-making and how this is communicated.

Objective: This study explored how decisions are made to discharge older people directly from hospital to care home, considering the perspectives and experiences of those involved.

trials in ocular drug development: a new frontier in ophthalmology.

Introduction: In silico trials represent an unprecedented opportunity for ocular drug development. These trials not only promise significant reductions in costs and development timelines but also meaningful improvements in both patient safety and compliance.

Areas Covered: This critical perspective gives discussion to the value of in silico trials for novel ocular drug discovery and development.

Management of abdominal gunshot injuries: Surgical intervention or conservative follow-up? A single-center experience.

Background: This study aims to retrospectively evaluate treatment approaches and clinical outcomes in patients with penetrating abdominal trauma caused by gunshot injuries-one of the most complex and controversial areas in trauma surgery.

Methods: A total of 101 patients diagnosed and treated for penetrating abdominal trauma due to gunshot injuries between 2015 and 2025 were included in the study. Demographic data (age and sex); vital signs at admission to the emergency department (blood pressure, pulse, respiratory rate, body temperature); level of consciousness (Glasgow Coma Scale); hemodynamic status (stability/instability, need for fluid or inotropic support); intra-abdominal (liver, spleen, small intestine, colon, etc.

Characterization and Application of Novel Exercise Recovery Patterns That Reflect Cardiac Performance: A Substudy of the SEQUOIA-HCM Trial.

Background: Post-exercise oxygen uptake recovery (VORec) is slow in advanced heart failure. We sought to establish easily derived VORec measures and evaluate their cardiospecificity and prognostic relevance in patients with dyspnea on exertion. We further sought to determine VORec modifiability proportional to changes in cardiac function with disease-specific treatment of obstructive hypertrophic cardiomyopathy.

Expanding the fluorescence toolkit: molecular design, synthesis and biological application of unnatural amino acids.

Fluorescence imaging has become an indispensable tool in modern biology, enabling the visualisation of dynamic molecular processes with spatial and temporal precision. Traditional strategies rely heavily on the conjugation of large, extrinsic fluorophores, such as green fluorscent protein or organic dyes, through linkers to proteins or peptides of interest. While sometimes effective, these bulky labels can interfere with native protein structure, function, and interactions, limiting their utility in studying sensitive or compact biological systems.

The unexploited potential of data systems tracking medicines utilization: an opportunity to improve access to oncology combination therapies.

Background: While progress has been made in oncology treatments, including the introduction of combination therapies, barriers affect patient access. There are approaches that could improve access including combination-specific pricing that allow the price to reflect whether a product is used in monotherapy or in combination. The feasibility of this solution requires data on the utilization of combination therapies.

Trends in Emergency Neurosurgical Workload: Evidence From a Tertiary Center.

Background Emergency neurosurgical referrals are a leading driver of on-call workload and unplanned admissions. Tracking their volume and case-mix supports safe staffing, imaging capacity, and bed planning across regional networks. The study included all emergency referrals made to the department between 2020 and 2022.

Effect of resistance exercise on body composition, muscle strength and cardiometabolic health during dietary weight loss in people living with overweight or obesity: a systematic review and meta-analysis.

Background: The prevalence of obesity has tripled over the past 35 years. Although caloric restriction reduces body fat, lean tissue is also lost. Resistance exercise may mitigate these effects.

Predicting 28-day mortality for patients with acute anterior circulation large vessel occlusion stroke following endovascular treatment in neurology intensive care units.

Background: The clinical utility of the National Institutes of Health Stroke Scale, Glasgow Coma Scale, and modified Rankin Scale scores in predicting prognosis is well established. However, whether the Acute Physiology and Chronic Health Evaluation System II (APACHE II) score can predict mortality in patients with large vessel occlusion stroke (LVOS) admitted to the neurology intensive care unit (NICU) following endovascular treatment (EVT) remains unclear. This study aims to evaluate the ability of the APACHE II score to predict mortality in post-EVT LVOS patients admitted to the NICU.

Management of posttraumatic refractory paroxysmal sympathetic hyperactivity with bromocriptine: a case report.

This case report describes a unique instance of refractory paroxysmal sympathetic hyperactivity (PSH) in a 19-year-old woman following a traumatic brain injury sustained in a motorcycle accident. The patient presented in a semicomatose state with a Glasgow Coma Scale score of 3 (E1, VT, M2), a significant left frontotemporal subdural hematoma, and a midline shift that necessitated emergency craniectomy and hematoma evacuation. Postoperatively, she developed recurrent episodes of hyperthermia, tachycardia, hypertension, tachypnea, diaphoresis, rigidity, and eyeball deviation triggered by non-noxious stimuli.

Correlation of base deficit and age shock index with in-hospital mortality in geriatric major trauma patients: a 1-year retrospective study at a single level I trauma center in Indonesia.

Purpose: Base deficit (BD) and age shock index have been utilized as an indicator of resuscitation adequacy and a predictor of poor outcomes in trauma cases, respectively. However, evidence regarding their correlation with in-hospital mortality among geriatric major trauma patients remains scarce in the literature.

Methods: This analytical observational study employed a retrospective cohort design involving 82 geriatric major trauma patients treated at our institution between November 2023 and November 2024.

Ethnic differences in protein biomarkers of peripartum cardiomyopathy: a proteomic study on the EORP cohort.

Aims: The diagnosis of peripartum cardiomyopathy (PPCM) is often delayed due to the absence of disease-specific biomarkers. Recently, serum proteins-QSOX1, adiponectin (ADIPOQ) and ITIH3-have shown potential for improving diagnostic accuracy, especially when used with NT-proBNP. However, the influence of ethnicity on their expression remains unclear.

Density-dependent network structuring within and across wild animal systems.

Theory predicts that high population density leads to more strongly connected spatial and social networks, but how local density drives individuals' positions within their networks is unclear. This gap reduces our ability to understand and predict density-dependent processes. Here we show that density drives greater network connectedness at the scale of individuals within wild animal populations.

Clinical and radiological outcome after microsurgical management of ruptured and unruptured brain arteriovenous malformations.

The treatment of unruptured & ruptured AVMs remains controversial. Microsurgical resection of the AVM offers the higher cure rate, but the associated morbidity and mortality may exceed that of the AVM's natural history. Single center retrospective cohort study of 120 consecutive patients harboring intracranial AVM operated on between January 2010 and June 2023.

Visible-Light-Promoted Hydroxyalkylation of Heterocycles with α-Oxocarboxylic Acids.

We herein report the Minisci-type redox-neutral decarboxylative hydroxyalkylation of heteroarenes under photocatalyst- and transition-metal-free conditions. This methodology tolerates various functional groups that can be subsequently elaborated. Upon absorption of photons, the excited state of the α-oxocarboxylic acid forms an acyl radical, which adds to the protonated heteroarene to give the desired product after a spin center shift (SCS), reduction, and deprotonation.

Targeting the zinc metalloprotease gp63 of Leishmania for vaccine design and new drug discovery using immunoinformatics, molecular docking and molecular dynamics simulation studies.

Leishmaniasis is a vector-borne parasitic disease caused by Leishmania spp., for which there is no vaccine and an urgent need for better drugs. The zinc metalloprotease gp63 of Leishmania has been identified as an antigenic structure for vaccine design and a promising target for new antileishmanial agents.

Experiences of Adult Informal Caregivers in Palliative Care Provision for Persons with Advanced Cancer: A Meta-synthesis.

Context: Cancer diagnoses are increasing in Sub-Saharan Africa. Diagnoses often occur at a late stage in the disease, hampering the timely initiation of palliative care. The lack of formalised palliative care provision in the region results in informal caregivers assuming most of the caregiving roles for patients.

Global Outcomes Across 20 Years After Inpatient Rehabilitation for Traumatic Brain Injury.

Objective: To explore and visually display differences in the distribution of the Glasgow Outcome Scale - Extended (GOS-E) over time after traumatic brain injury (TBI), focusing on variations in outcome distributions based on GOS-E at Year 1 postinjury and age at injury.

Setting: Community.

Participants: 14 010 individuals who received inpatient rehabilitation in the TBI Model Systems.