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The utility of computed tomography as a radiological investigation following multisystem trauma is already well established in current practice. This article examines the existing evidence and rationale behind the use of early computed tomography scanning in the management of the multisystem trauma patient, with a particular emphasis on the use of ‘whole body’ computed tomography scanning as a component of their initial management in the Emergency Department.The use of computed tomography has been shown to be superior to plain radiography for the detection of injuries in important body regions including the spine, thorax, abdomen and pelvis. Computed tomography scan of the head and cervical spine is also well established as the first investigation of choice for significant traumatic brain injury. The potential benefits of whole body computed tomography include reduced time to diagnosis and intervention, as well as significant improvements in clinical outcome and survival. Concerns regarding a whole body computed tomography approach relate to the increased ionising radiation dosage that patients will be exposed to, and perceived risks of the secondary transfer and scanning room environment itself. Potential barriers to the use of whole body computed tomography are also explored and discussed.This article also presents a proposed clinical algorithm derived from the results of a recent Delphi study into whole body computed tomography following blunt multitrauma, along with conclusions and recommendations from the subject matter panel review process. [ABSTRACT FROM PUBLISHER]

Objective: To investigate the association of whole-blood fatty acids and reported intakes of fats with risk of prostate cancer (PCa).Design: Case-control study of 209 men 40-80 years old with newly diagnosed, histologically confirmed prostate cancer and 226 cancer-free men attending the same urology clinics. Whole-blood fatty acid composition (mol%) was measured by gas chromatography and diet assessed by food frequency questionnaire.Results: High whole-blood oleic acid composition (tertile 3 vs. tertile 1: OR, 0.37; CI, 0.14-0.0.98) and moderate palmitic acid proportions (tertile 2: OR, 0.29; CI, 0.12-0.70) (tertile 3: OR, 0.53; CI, 0.19-1.54) were inversely related to risk of PCa, whereas men with high linolenic acid proportions were at increased likelihood of PCa (tertile 3 vs. tertile 1: OR, 2.06; 1.29-3.27). Blood myristic, stearic and palmitoleic acids were not associated with PCa. Higher intakes of dietary MUFA were inversely related to prostate cancer (tertile 3 vs. tertile 1: OR, 0.39; CI 0.16-0.92). The principal source of dietary MUFA was avocado intake. Dietary intakes of other fats were not associated with PCa.Conclusions: Whole-blood and dietary MUFA reduced the risk of prostate cancer. The association may be related to avocado intakes. High blood linolenic acid was directly related to prostate cancer. These associations warrant further investigation. [ABSTRACT FROM AUTHOR]

This article presents outcomes of the Smart Mothers Are Resisting Tobacco (S.M.A.R.T. Moms) project, a '5 A's'-based, best-practices intervention for prenatal smoking cessation targeting primarily pregnant WIC patients in Tennessee. Evidence-based training using '5 A's' materials were provided to health care providers. Providers in turn counseled patients on smoking cessation and provided individual cessation treatment plans with educational information and materials. At the conclusion of the 4-year project, 13,285 patients had received counseling and smoking cessation resources through the project. The overall success rate for participants who received counseling and agreed to use the self-help guide was 24.2% vs 20.9% for those who did not choose to use the self-help guide but did receive counseling, exceeding success rates previously found in similar settings. The outcomes of this project support research that even brief tobacco cessation counseling (5 to 15 min), delivered by trained providers and coupled with pregnancy-specific self-help materials, can increase cessation rates in women during pregnancy. Outcomes from this project also support that, when provided with adequate training and pregnancy-specific self-help materials, health care providers will more consistently counsel patients on smoking cessation during pregnancy. [ABSTRACT FROM AUTHOR]

Endovascular stent grafting (EVSG) is a minimally invasive alternative to open repair of thoracic aortic aneurysms. It is useful in the treatment of thoracic aneurysms, dissections, and ruptures. Currently, the incidence of thoracic aortic aneurysms is 6:100,000 people. Comorbidities often include hypertension, coronary artery disease, chronic obstructive pulmonary disease, peripheral vascular disease, and cerebrovascular disease, and there often is a history of smoking. Without surgical intervention, a high risk of mortality exists, primarily due to aneurysm rupture. Due to the complexity of performing open surgical repair of the thoracic aorta and its associated morbidities such as paraplegia, renal failure, stroke, and prolonged ventilator support, new approaches to thoracic aneurysm repair are being investigated. When compared with open repair, stent grafting is a palliative rather than a curative treatment, and the risk of aneurysmal rupture still exists. This article describes a patient who underwent EVSG who had a history of abdominal aortic aneurysm repair and a known bovine arch. [ABSTRACT FROM AUTHOR]

The so-called Hippocratic injunction to do no harm has been an axiom central to clinical pharmacology and to the education of medical and graduate students. With the recent reexamination of the nature and magnitude of adverse reactions to drugs, the purposes of this research and review were to discover the origin of this unique Latin expression. It has been reported that the author was neither Hippocrates nor Galen. Searches of writings back to the Middle Ages have uncovered the appearance of the axiom as expressed in English, coupled with its unique Latin, in 1860, with attribution to the English physician, Thomas Sydenham. Commonly used in the late 1800s into the early decades of the 1900s, it was nearly exclusively transmitted orally; it rarely appeared in print in the early 20th century. Its applicability and limitations as a guide to the ethical practice of medicine and pharmacological research are discussed. Despite insufficiencies, it remains a potent reminder that every medical and pharmacological decision carries the potential for harm. [ABSTRACT FROM AUTHOR]

We have performed a 4-year prospective surveillance for Pseudomonas aeruginosa cross-infection at a large regional adult cystic fibrosis center. Despite purpose-built facilities in a new building and the practice of strict hygiene, P. aeruginosa cross-infection has continued. In contrast, individuals segregated from the cohort of patients with chronic P. aeruginosa infection but who attend the same center have not acquired infection with transmissible P. aeruginosa strains. Simple infection control measures alone do not prevent the spread of transmissible P. aeruginosa strains between individuals with cystic fibrosis. However, in our clinic patient segregation effectively controlled spread of such strains. [ABSTRACT FROM AUTHOR]

Objective: To find a parameter that would discriminate between the patients with idiopathic interstitial pneumonia who survived to undergo transplantation and those who died while waiting to undergo transplantation.Methods: A retrospective review was performed of all lung transplant referrals for idiopathic interstitial pneumonia that were listed with United Network for Organ Sharing at the University of California San Diego from January 1990 to February 1999. Of the 331 patients who were listed, 48 met the eligibility criteria. Patient demographics, radiographic studies, pathology reports, and the results of resting and exercise cardiopulmonary function tests were recorded from each patient's chart. Patients were divided into the following two groups: those patients who survived until transplantation and those still waiting were classified as "alive"; and those patients who died before undergoing transplantation were classified as "deceased."Results: Forty-three of 48 patients had a pathologic diagnosis. The cohort included 25 patients with usual interstitial pneumonitis, 3 patients with nonspecific interstitial pneumonitis, 1 patient with desquamative interstitial pneumonitis, and 14 patients with interstitial lung disease of unknown etiology. The only significant difference between the two groups was resting PaO(2) (p = 0.035). A stepwise multivariate analysis demonstrated that PaO(2) and FEV(1)/FVC ratio were significantly associated with survival (hazards ratio, 1.06; confidence interval, 0.99 to 1.13; p = 0.019).Conclusions: A survival analysis using PaO(2) and FEV(1)/FVC ratio values proved to be statistically significant, but a prospective trial is needed to determine the clinical relevance of these parameters for predicting survival in patients with idiopathic interstitial pneumonia. [ABSTRACT FROM AUTHOR]

Minority and majority influence were studied simultaneously within the context of freely interacting groups. It was hypothesized that minorities would act as a rein, reducing the degree of polarization in majority members' attitudes. The direction and magnitude of attitude change on a social issue in unanimous groups were compared to those of groups with either one or two minority members. In addition, the secondary effects of minority influence on cognitive processes, predicted by Nemeth (1986), were assessed using two thought listing tasks-one involving an issue discussed by the group and a second involving an issue that was not previously discussed. Results supported the 'minority as a rein' analogy as well as the predictions made by Nemeth. However, it appears that minority influence manifests itself differently depending on whether or not individual members have to defend their position during group interaction. [ABSTRACT FROM AUTHOR]

You have to control your emotions and take action? Here are 10 way to smooth out rocky situations. [ABSTRACT FROM AUTHOR]

Background and Purpose: Men believe they are perceived as unfit for nursing. No scales exist to measure perceptions of men's fitness for nursing. Additionally, women have been largely excluded from this area of inquiry. This study's purpose was to develop and test the psychometric properties of the Fitness in Nursing Scale for Men. Methods: Six hundred thirty-five nurses participated. Scale development entailed concept clarification, item development, and scale testing. Results: Confirmatory factor analysis suggested a two-factor structure (F1: nursing fitness and F2: strengths of men in nursing) which demonstrated good model fit, root mean square error of approximation = 0.059, 90% CI (0.056, 0.063), standardized root mean square residual = 0.055, comparative fit index = 0.932, Tucker-Lewis index = 0.927, and ω t = 0.98. Invariance held. Latent means were not significantly different for women ( M = 5.90) compared with men ( M = 5.92). Conclusions: Findings suggest men are perceived as fit for nursing, but results are inconsistent with men's qualitative experiences. Future research should attempt to reconcile the disagreement. Findings can inform cultural awareness strategies in the workplace and classroom., (© Copyright 2024 Springer Publishing Company, LLC.)

Highly pathogenic Burkholderia pseudomallei is the causative agent of melioidosis, a neglected tropical disease endemic in Southeast Asian tropical region. This bacterium encompasses diverse virulence factors which further undergo dynamic gene-expression flux as it transits through distinct environmental niches within the host which may lead to manifestation of differential clinical symptoms. B. pseudomallei, is classified as a Tier 1 select agent in the United States and regarded as a risk group 3 organism in India with the potential to be used as bioweapon. Considering these facts, it is vital to uncover both physiological and genetic heterogeneity of B. pseudomallei, particularly to identify any novel virulence factors that may contribute to pathogenicity. B. pseudomallei strain CM000113 was isolated from a clinical case in India, characterized it for its physiological, biochemical, and prominently genetic traits through WGS. It has a type 2 morphotype with faster doubling time and high biofilm producing capacity as compared to Pseudomonas aeruginosa. The genome size is 7.3 Mbp and it is phylogenetically close to B. pseudomallei strain Mahidol 1106a and Burkholderia mallei Turkey 2. We observed genetic heterogeneity, as key virulence factors that were identified shows sequence dissimilarity with reference strains. Additionally, presence of genomic islands, harbouring two virulence factors, GmhA and GmhB2, associated with pathogenesis indicates possibility of horizontal gene transfer. These results emphasize the need for an extensive study focusing the genome of B. pseudomallei and its associated heterogeneity, to identify molecular biomarkers aiding to develop point-of-care diagnostic kits for early diagnosis of melioidosis., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Sudden cardiac arrest (SCA) is the leading cause of sudden death in athletes during high-level, organised sport. Patient-related and event-related factors provide an opportunity for rapid intervention and the potential for high survival rates. The aim of this consensus was to develop a best-practice guideline for dedicated field-of-play medical teams responding to SCA during an organised sporting event. A task-and-finish group from Resuscitation Council UK identified a stakeholder group of relevant experts and cardiac arrest survivors in March and April 2022. Together, they developed a best-practice guideline using the best available evidence. A public consultation period further refined the guideline before it was finalised in December 2023. Any sudden collapse, without rapid recovery during sporting activity, should be considered an SCA until proven otherwise. Field-of-play medical teams should be empowered to access the collapsed athlete as soon as possible and perform initial essential interventions in situ. This includes a suggested minimum of three cycles of cardiopulmonary resuscitation and defibrillation in persistent shockable rhythms while other aspects of advanced life support are initiated. There should be careful organisation and practice of the medical response, including plans to transport athletes to dedicated facilities for definitive medical care. This best-practice guideline complements, rather than supersedes, existing resuscitation guidelines. It provides a clear approach to how to best treat an athlete with SCA and how to organise the medical response so treatments are delivered effectively and optimise outcomes., Competing Interests: Competing interests: Author affiliations are listed in the acknowledgements. In addition, the following authors report these conflicts of interest: JAD is editor-in-chief of BJSM., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Aprostocetus hagenowii (Ratzeburg) is a parasitoid wasp that parasitizes the oothecae of peridomestic pest cockroaches. A. hagenowii has been used in integrated pest management (IPM) programs for cockroach control but little is known about how this parasitoid responds to the insecticides commonly used for cockroach management. Five insecticidal gel bait products containing indoxacarb, clothianidin, fipronil, dinotefuran, or abamectin B1 were tested for their toxicity towards A. hagenowii and the American cockroach, Periplaneta americana (L.; Blattodea: Blattidae), a host of A. hagenowii and a common pest. All baits were tested as fresh and 1-d aged deposits. Indoxacarb was the only active ingredient that did not cause significant (P < 0.05) A. hagenowii mortality compared to the control in both the fresh and aged gel experiments (Median survival time [MST]s: 168 h fresh, 72 h aged). Clothianidin caused the lowest A. hagenowii MSTs across experiments (24 h, fresh and aged). All baits caused significant P. americana mortality as fresh and 1-d aged deposits (P < 0.05). Indoxacarb appears most compatible with A. hagenowii in cockroach IPM., (© The Author(s) 2024. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Algal physiological ecology on submarine groundwater discharge (SGD) influenced reefs is likely shaped by intermittent, tidally-driven estuarine conditions that occur with SGD fluxes of fresh-to-brackish groundwater from the subterranean estuary to reef ecosystems. SGD is a common inconspicuous feature worldwide on reefs of basaltic high islands and continental margins. Yet, SGD-driven dynamics of algal physiology are not well understood. To understand how invasive species have physiologically outcompeted native species on many SGD-influenced reefs, physiology in tissue water potential (TWP) regulation, photosynthesis, nitrogen storage, and cellular anatomy were measured across a gradient of SGD-influence, for four Rhodophyte species. Compared with non-SGD conditions, SGD was associated with higher TWP, larger medulla cells with thinner walls, and thinner cortical cell walls for two invasives, Gracilaria salicornia and Acanthophora spicifera, higher photosynthetic rates in G. salicornia, greater nitrogen concentration for A. spicifera and G. salicornia, and increased δ 15 N ratios for A. spicifera, G. salicornia, and native Laurencia dendroidea. Distinct physiological strategies were measured for the two invasive species across the gradient of SGD-influence, and for L. dendroidea and Gracilaria perplexa offshore. This study illuminates species-specific physiological response, and how introduced opportunistic species may outcompete native species under conditions of SGD., (© 2024. The Author(s).)

The MiniMUGA genotyping array is a popular tool for genetic quality control of laboratory mice and genotyping samples from most experimental crosses involving laboratory strains, particularly for reduced complexity crosses. The content of the production version of the MiniMUGA array is fixed; however, there is the opportunity to improve the array's performance and the associated report's usefulness by leveraging thousands of samples genotyped since the initial description of MiniMUGA. Here, we report our efforts to update and improve marker annotation, increase the number and the reliability of the consensus genotypes for classical inbred strains and substrains, and increase the number of constructs reliably detected with MiniMUGA. In addition, we have implemented key changes in the informatics pipeline to identify and quantify the contribution of specific genetic backgrounds to the makeup of a given sample, remove arbitrary thresholds, include the Y Chromosome and mitochondrial genome in the ideogram, and improve robust detection of the presence of commercially available substrains based on diagnostic alleles. Finally, we have updated the layout of the report to simplify the interpretation and completeness of the analysis and added a section summarizing the ideogram in table format. These changes will be of general interest to the mouse research community and will be instrumental in our goal of improving the rigor and reproducibility of mouse-based biomedical research., Competing Interests: Conflicts of interest The authors have no conflict of interest to declare. None of the authors have a financial relationship with Neogen Inc. apart from the service contracts listed above., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Genetics Society of America.)

The human otolithic system (utricle and saccule), housed within the bony vestibule of the inner ear, establishes our sense of balance in conjunction with the semicircular canals. Yet, while the morphological evolution of the semicircular canals is actively explored, comparative morphological analyses of the otolithic system are lacking. This is regrettable because functional links with head orientation suggest the otolithic system could be used to track postural change throughout human evolution and across primates more broadly. In this context, we present the first analysis of the evolution of the human otolithic system within an anthropoid primate setting. Using the vestibule as a morphological proxy for the utricle and saccule, we compare humans to 13 other extant anthropoid species, and use phylogenetically-informed methods to find correlations with body size, endocranial flexion, and head-neck posture. Our results, obtained through micro-CT of 136 inner ears, reveal two major evolutionary transitions in hominoids, leading to distinctive vestibular morphology in humans, characterized by otolithic morphology resembling squirrel monkeys (possibly due to reversal), with a pronounced supraovalic fossa. Finally, we find a positional signal embedded in the anthropoid bony vestibule, providing the foundation to further explore the evolution of human head-neck posture using inner ear morphology., (© 2024. The Author(s).)

Background: Rapid public defibrillation with automated external defibrillators (AEDs) is critical to improving out-of-hospital cardiac arrest survival. Concerns about AED theft and vandalism have led to implementing security measures, including locked cabinets. This scoping review, conducted as part of the evidence review for the International Liaison Committee on Resuscitation, explores the impact of securing AEDs in locked cabinets., Methods: Searches of Medline, Embase, Cochrane, CINAHL (from database inception to 25/5/2024) and Google Scholar (first 200 articles). Studies of any type or design, published with an English abstract, examining the impact of locked AED cabinets were included. The included studies were grouped by outcomes, and an iterative narrative synthesis was performed., Results: We screened 2,096 titles and found 10 relevant studies: 8 observational studies (4 published as conference abstracts) and 2 simulation studies. No study reported patient outcomes. Studies reported data on between 36 and 31,938 AEDs. Most studies reported low rates (<2%) of theft/missing/vandalism, including AEDs that were accessible 24/7. The only study comparing unlocked and locked cabinets showed minimal difference in theft and vandalism rates (0.3% vs. 0.1%). Two simulation studies showed significantly slower AED retrieval when additional security measures, included locked cabinets, were used. A survey of first responders reported half (25/50) were injured while accessing an AED that required breaking glass to access., Conclusion: The limited literature suggests that vandalism and the loss of AEDs are rare and occur in locked and unlocked cabinets. Research on this topic is needed that focuses on real-life retrieval and patient outcomes., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. GDP is Editor-in-Chief and JEB is an Associate Editor of Resusciation Plus., (© 2024 The Author(s).)

A significant source of risk for neurodevelopmental disorders (NDDs), including intellectual disability (ID) and autism spectrum disorder (ASD), lies in genes located on the X chromosome. Males can be particularly vulnerable to X-linked variation because of hemizygosity, and male-specific segregation in pedigrees has guided earlier gene discovery for X-linked recessive conditions. More recently, X-linked disorders disproportionally affecting females, with complex inheritance patterns and/or presenting with sex differences, have surfaced. Here, we discuss the genetics and neurobiology of X-linked genes that are paradigmatic to understand NDDs in females. Integrating genetic, clinical, and functional data will be key to understand how X-linked variation contributes to the risk architecture of NDDs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: Examine the cardiovascular, muscular function, cognitive, and neural plastic responses to determine the safety and effectiveness of acute Intermittent hypoxia (AIH) at a low, high, and control fractional inspired oxygen (FiO 2 ) dosage METHODS: Thirteen human participants performed 30-min of AIH in 60-s intervals at FiO2's of 0.21 (AIH 21 ), 0.15 (AIH 15 ), and 0.09 (AIH 9 ). Heart rate variability (root mean squared of successive differences; RMSSD), heart rate, oxygen saturation (SpO2), blood pressure, muscular strength, neuromuscular activation, cerebral hemodynamic responses, cognition, symptomology, and brain-derived neurotrophic factor (BDNF) responses were measured before (Pre-AIH), after (post-AIH), and at 20-min of recovery (Recovery-AIH) RESULTS: There were no differences between AIH protocols for heart rate, RMSSD, blood pressure, or SpO2. Muscular strength improved Post-AIH for AIH 15 (10 %) and AIH 9 (14 %) and remained elevated (6 %) at Recovery-AIH. Neuromuscular activation increased Pre-AIH to Post-AIH for AIH15 (10 %) and AIH 9 (11 %). Cerebral hemodynamic responses were not impacted between conditions. Both AIH 15 and AIH9 increased BDNF Post-AIH (62 %) and Recovery-AIH (63 %) CONCLUSION: Acute intermittent hypoxia is generally safe and effective at producing neural plastic responses, but further examination of co-occurring cardiovascular diseases is needed. This study provides safety focused findings which will widen the adoption and refinement of AIH protocols., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

This study performed an in-depth investigation into the myeloid cellular landscape in the synovium of patients with rheumatoid arthritis (RA), "individuals at risk" of RA, and healthy controls (HC). Flow cytometric analysis demonstrated the presence of a CD40-expressing CD206 + CD163 + macrophage population dominating the inflamed RA synovium, associated with disease activity and treatment response. In-depth RNA sequencing and metabolic analysis demonstrated that this macrophage population is transcriptionally distinct, displaying unique inflammatory and tissue-resident gene signatures, has a stable bioenergetic profile, and regulates stromal cell responses. Single-cell RNA sequencing profiling of 67,908 RA and HC synovial tissue cells identified nine transcriptionally distinct macrophage clusters. IL-1B + CCL20 + and SPP1 + MT2A + are the principal macrophage clusters in RA synovium, displaying heightened CD40 gene expression, capable of shaping stromal cell responses, and are importantly enriched before disease onset. Combined, these findings identify the presence of an early pathogenic myeloid signature that shapes the RA joint microenvironment and represents a unique opportunity for early diagnosis and therapeutic intervention.

Aim: To identify Attributes, Characteristics and Demonstrations of nursing practice from both nurses' and people perspectives in today's healthcare environments. A secondary aim was to identify relevant differences between female and male nurses in the context of ACDs., Design: This systematic review was informed by the Joanna Briggs Institute Convergent Integrated Approach to Mixed Study Systematic Reviews., Methods: The search included articles ranging from the years 2000 to 2023 across 10 electronic databases and multiple grey literature outlets. McMaster critical review forms and the Mixed Methods Appraisal Tool were used to appraise article quality. The Convergent Integrated Approach to Mixed Study Systematic Reviews was used to guide data synthesis., Results: Twenty articles were included in this review, 13 qualitative, five quantitative and two mixed-methods studies. Three themes emerged, including knowledge, practice skills and interpersonal relationships. Differences in Attributes, Characteristics and Demonstrations of professional practice between women and men in nursing were also explored., Conclusion: Findings suggest that evolving healthcare environments challenge nurses to remain focused on patient-centred and compassionate care. The review also supports nurses caring in a manner that empowers people, increases well-being, and reduces suffering., Impact: Identified characteristics and attributes of nursing practice, including emphasis on continuous learning, interpersonal relationships and compassion, have a profound impact on nursing. Nurses should remain adaptable, compassionate and patient-focused in an ever-evolving healthcare environment. These foundational care principles are necessary for improving patient outcomes, enhancing trust between people and healthcare providers, and increasing inclusivity and diversity in the nursing workforce., Wider Global Community: Nurses worldwide should strive to embody these attributes to provide high-quality, patient-centred care in an inclusive environment in today's demanding healthcare environment. Gender-specific differences in the perception and expression of professional Attributes, Characteristics and Demonstrations can inform inclusion and diversity efforts in the workplace., Reporting Method: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines., Patient or Public Contribution: No Patient or Public Contribution., (© 2024 John Wiley & Sons Ltd.)