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Firearm injuries are the leading cause of death among children aged 0 to 17 years in the United States. This study examines the factors associated with recurrent firearm injury among children who presented with a nonfatal firearm injury in the St. Louis, Missouri, region. Visual Abstract. Factors Associated With Recurrent Pediatric Firearm Injury: Firearm injuries are the leading cause of death among children aged 0 to 17 years in the United States. This study examines the factors associated with recurrent firearm injury among children who presented with a nonfatal firearm injury in the St. Louis, Missouri, region. Background: Firearm injuries are the leading cause of death among children aged 0 to 17 years in the United States. Objective: To examine the factors associated with recurrent firearm injury among children who presented with acute (index) nonfatal firearm injury in the St. Louis region. Design: Multicenter, observational, cohort study. Setting: 2 adult and 2 pediatric level I trauma hospitals in St. Louis, Missouri. Participants: Pediatric patients aged 0 to 17 years presenting with an index firearm injury between 2010 and 2019. Measurements: From the St. Louis Region-Wide Hospital-Based Violence Intervention Program Data Repository, we collected data on firearm-injured patient demographics, hospital and diagnostic information, health insurance status, and mortality. The Social Vulnerability Index was used to characterize the social vulnerability of the census tracts of patients' residences. Analysis included descriptive statistics and time-to-event analyses estimating the cumulative incidence of experiencing a recurrent firearm injury. Results: During the 10-year study period, 1340 children presented with an index firearm injury. Most patients were Black (87%), non-Hispanic (99%), male (84%), and between the ages of 15 and 17 years (67%). The estimated risk for firearm reinjury was 6% at 1 year and 14% at 5 years after initial injury. Male children and those seen at an adult hospital were at increased risk for reinjury. Limitation: Our data set does not account for injuries occurring outside of the study period and for reinjuries presenting to nonstudy hospitals. Conclusion: Children who experience an initial firearm injury are at high risk for experiencing a recurrent firearm injury. Interventions are needed to reduce reinjury and address inequities in the demographic and clinical profiles within this cohort of children. Primary Funding Source: National Institutes of Health. [ABSTRACT FROM AUTHOR]

Background: Lateral lumbar interbody fusion (LLIF) is commonly used to address various lumbar pathologies. LLIF using the prone transpsoas (PTP) approach has several potential advantages, allowing simultaneous access to the anterior and posterior columns of the spine. The aim of this study was to report the 1-year outcomes of LLIF via PTP. Methods: This is a retrospective review of 97 consecutive patients who underwent LLIF via PTP. Radiographic parameters, including lumbar-lordosis, segmental-lordosis, anterior disc height, and posterior disc height, were measured on preoperative, initial-postoperative, and 1-year postoperative imaging. Patient-reported outcomes measures, including Oswestry Disability Index, visual analog scale (VAS), pain EQ5D, and postoperative complications, were reviewed. Results: Ninety-seven consecutive patients underwent 161 levels of LLIF. Fifty-seven percent underwent 1-level LLIF, 30% 2-level LLIF, 6% 3-level LLIF, and 7% 4-level LLIF. The most common level was L4 to L5 (35%), followed by L3 to L4 (33%), L2 to L3 (21%), and L1 to L2 (11%). Significant improvements were noted at initial and 1-year postoperative periods in lumbar-lordosis (2° ± 10°, P = 0.049; 3° ± 9°, P = 0.005), segmental-lordosis (6° ± 5°, P < 0.001; 5° ± 5°, P < 0.001), anterior disc height (8 mm ± 4 mm, P < 0.001; 7 mm ± 4 mm, P < 0.001), and posterior disc height (3 mm ± 2 mm, P < 0.001; 3 mm ± 2 mm, P < 0.001). Significant improvements were seen in Oswestry Disability Index at 6 weeks (P = 0.002), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively; pain EQ5D at 6 weeks (P < 0.001), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively; and leg and back visual analog scale at 2 weeks (P < 0.001), 6 months (P < 0.001), and 1 year (P < 0.001) postoperatively. The average length of stay was 2.5 days, and the most common complications were ipsilateral hip flexor pain (46%), weakness (59%), and contralateral hip flexor pain (29%). Conclusion: PTP is a novel way of performing LLIF. These 1-year data support that PTP is an effective, safe, and viable approach with similar patient-reported outcome measures and complications profiles as LLIF performed in the lateral decubitus position. [ABSTRACT FROM AUTHOR]

Racial justice movements sparked by police killings of Black and Brown persons have led to a reassessment of the role of policing in America. This has promoted important conversations about how best to improve public safety and design law enforcement practices that are equitable and just across communities. A component of this conversation is addressing stress and trauma faced by police as a routine part of their duties, as it can affect the quality of policing. Job-related stress and trauma experienced by police officers are an international phenomenon, yet underexplored areas in social work research and practice. Police officers experience high levels of stress from routine exposure to traumatic situations, leading to high rates of post-traumatic stress disorder, substance use, and depression. Officers who are actively experiencing symptoms of stress and trauma are more likely to engage in misconduct, including the unnecessary use of force. This study explores the stress and trauma-related experiences of police officers. We conducted one-on-one, semi-structured interviews with 23 officers from an urban police department in St Louis, Missouri. Analysis of interviews addressed three areas: (1) stress and trauma experiences associated with police work, (2) negative effects of stress and trauma on officers, and (3) factors impacting officer access to treatment. We conclude that social work can contribute to improved policing outcomes by helping officers address their job-related stress and trauma through engaged research and practice. [ABSTRACT FROM AUTHOR]

BACKGROUND: Distinguishing between cervical nerve root and intrinsic shoulder pathology can be a difficult task given the overlapping and often coexisting symptoms. OBJECTIVE: The objective of this study was to highlight the often-complicated presentation of these symptoms and the subsequent potential for delay in care regarding this subset of patients. METHODS: A total of 9 patients, managed by one of two different surgeons, were identified with a history of C5 nerve root palsy. A chart review was conducted, and the following information was recorded: presenting complaint, time from symptom onset to diagnosis, time from symptom onset to presentation to a spine surgeon, first specialist seen for symptoms, non-spinal advanced imaging and treatment conducted before diagnosis, preoperative and postoperative exam, time to recovery, and type of surgery. RESULTS: We observed an average time from onset of symptoms to presentation to a spine surgeon to be 31.6 weeks. These patients' time to full recovery after cervical decompression was 15 weeks. CONCLUSION: : We observed a critical delay to presentation in this series of patients with C5 nerve palsy. C5 nerve palsy should remain an elemental part of the differential diagnosis in the setting of any shoulder or neck pain presenting with weakness. [ABSTRACT FROM AUTHOR]

The translation elongation factor eEF1A promotes protein synthesis. Its methylation by METTL13 increases its activity, supporting tumor growth. However, in some cancers, a high abundance of eEF1A isoforms is associated with a good prognosis. Here, we found that eEF1A2 exhibited oncogenic or tumor-suppressor functions depending on its interaction with METTL13 or the phosphatase PTEN, respectively. METTL13 and PTEN competed for interaction with eEF1A2 in the same structural domain. PTEN-bound eEF1A2 promoted the ubiquitination and degradation of the mitosis-promoting Aurora kinase A in the S and G2 phases of the cell cycle. eEF1A2 bridged the interactions between the SKP1-CUL1-FBXW7 (SCF) ubiquitin ligase complex, the kinase GSK3β, and Aurora-A, thereby facilitating the phosphorylation of Aurora-A in a degron site that was recognized by FBXW7. Genetic ablation of Eef1a2 or Pten in mice resulted in a greater abundance of Aurora-A and increased cell cycling in mammary tumors, which was corroborated in breast cancer tissues from patients. Reactivating this pathway using fimepinostat, which relieves inhibitory signaling directed at PTEN and increases FBXW7 expression, combined with inhibiting Aurora-A with alisertib, suppressed breast cancer cell proliferation in culture and tumor growth in vivo. The findings demonstrate a therapeutically exploitable, tumor-suppressive role for eEF1A2 in breast cancer. Editor's summary: Isoforms of the protein synthesis factor eEF1A can either promote or suppress tumor growth. Treekitkarnmongkol et al. found that eEF1A2 teams up with the tumor suppressor PTEN to repress cell cycling. The interaction between eEF1A2 and PTEN resulted in the assembly of a complex of the kinase GSK3β, the mitotic kinase Aurora-A, and the ubiquitin ligase complex SCF in the pre-mitotic phases of the cell cycle. Phosphorylation at a specific site by GSK3β marked Aurora-A for degradation by the SCF complex, reducing progression through mitosis. Accordingly, Aurora-A was more stable and abundant in PTEN-deficient breast cancers, which showed increased proliferation. A two-drug combination that derepressed PTEN and inhibited Aurora-A suppressed tumor growth in mice, suggesting a potential treatment strategy for patients with PTEN-deficient breast tumors. —Leslie K. Ferrarelli [ABSTRACT FROM AUTHOR]