Injury
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Traumatic injuries remain a leading cause of mortality across age groups. Despite advancements in medical care, addressing the broader determinants of health is essential. Social determinants of health (SDOH), including socioeconomic factors, play a crucial role in patient outcomes. The Social Vulnerability Index (SVI), developed by the CDC, integrates various indicators, providing a comprehensive framework for assessing community vulnerability. The objective of this study is to evaluate the connection between SVI and trauma patient outcomes. ⋯ In summary, these studies collectively demonstrate that there is a predictive value that SVI carries as it relates to trauma outcomes, underscoring that targeted interventions and policies to address social vulnerabilities can be done using this index. Further research is imperative to delve into the intricate interactions between SVI and specific trauma outcomes, considering demographic variations and exploring the potential implications for public health interventions.
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Randomized Controlled Trial Multicenter Study
Do the results of the OXYGEN trial change if analyzed as "as-treated?": A secondary analysis of the OXYGEN trial.
To determine if the results of the OXYGEN trial changed using an "as-treated" approach instead of the original "intention-to-treat" approach. The multi-center randomized controlled OXYGEN trial aimed to determine the effectiveness of high FiO2 in decreasing infection rates for high-risk tibial plateau, tibial pilon, and calcaneus fractures. ⋯ When re-analyzing based on which patients actually received high or control levels of perioperative oxygen fraction, the results are somewhat consistent with the original "intent-to-treat" analysis. Specifically, high perioperative oxygen lowered the risk of superficial SSI but did not affect deep infections.
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We aim to explore and target factors contributing to disparities in trauma-care outcomes between urban vs rural trauma centers including EMS protocols, trauma centers' (TC) distribution, infrastructure, and hospital resources. ⋯ Rural trauma patients often experience worse outcomes than their urban counterparts, possibly due to longer prehospital times, reduced TC access, and less specialized care. The designation of targeted Level III TCs in rural areas has been associated with improved outcomes. In contrast, unregulated TC expansion has not necessarily enhanced access or outcomes for rural patients.
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This review aims to provide a comprehensive overview of electric-scooter (E-Scooter) injuries by evaluating the incidence, common mechanisms of injury, clinical outcomes, associated costs, and effective interventions for injury prevention. ⋯ The incidence of E-Scooter related injuries rose significantly in recent years. These injuries typically result from falls and MVAs and are compounded by factors including limited helmet usage and riding while intoxicated. These contribute to the poorer clinical outcomes seen with E-Scooter injuries. However, there remains a significant paucity of literature focused on the outcomes of policies and interventions designed to reduce these injuries. Further investigation must address these gaps and discrepancies to inform future policies.
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During osteogenesis, a large number of bioactive molecules, macromolecules, cells, and cellular signals are activated to induce bone growth and development. The activation of molecular pathways leads to the occurrence of cellular events, ultimately resulting in observable changes. Therefore, in the studies of bone tissue engineering and regenerative medicine, it is essential to target fundamental events to exploit the mechanisms involved in osteogenesis. ⋯ A combination of sequential cascades takes place to drive the progression of osteogenesis. Also, the occurrence of these processes and, more generally, cellular and molecular processes related to osteogenesis necessitate the presence of transcription factors and their activity. The present review focuses on outlining several signaling pathways and transcription factors influencing the development of osteogenesis, and describes various methods of their manipulation to induce and enhance bone formation.