University of Mississippi Medical Center

To examine the risk of hospital readmission after an index hospitalization for TBI in older adults. Using data from the Atherosclerosis Risk in Communities (ARIC) study, we used propensity score matching of individuals with an index TBI-related hospitalization to individuals with (1) non-TBI hospitalizations (primary analysis) and (2) orthopedic injury hospitalizations (secondary analysis). The rate of all-cause hospital readmission was estimated using adjusted Fine-Gray proportional hazards regression models within strata defined by time since hospitalization. Follow-up extended from the date of index hospitalization after study enrollment (1987-1989) through December 31, 2019. Six hundred sixty-seven participants with an index TBI-related hospitalization were matched using propensity scores with replacement with a ratio of 1:4-2668 participants with non-TBI-related hospitalizations and 1:3 with 2001 participants with orthopedic injury-related hospitalizations. Median age was 68 years (IQR = 46-95) at index hospitalization. Compared to participants with an index non-TBI-related hospitalization, readmission rates were lower among participants with an index TBI-related hospitalization (HR = 0.80, 95% CI = 0.74, 0.87) over a median follow-up of 2.7 years, although similar readmission rates were observed within the first year of follow-up (HR = 1.03, 95% CI = 0.88, 1.21). Rates of hospital readmission among persons with an index TBI-related hospitalization were similarly decreased compared with persons with an orthopedic injury-related hospitalization (HR = 0.78, 95% CI = 0.72, 0.85) over a median follow-up of 3.1 years. Among community-dwelling older adults with a TBI-related hospitalization, rates of hospital readmission were similar to individuals hospitalized for a non-TBI cause in the first year, but lower subsequently. Targeted interventions in the first year post-hospitalization may be most beneficial for reducing readmissions among individuals with TBI.

In pediatric inpatient settings, there has been an increase in patients with mental health problems who display aggressive behavior toward staff. The aim of this project was to prevent aggression in patients in a pediatric inpatient unit through the promotion of best practices. The project was guided by the JBI Model of Evidence-Based Health care and the JBI Evidence Implementation Framework. An audit and feedback strategy was used, with baseline and follow-up audits conducted. Eight evidence-based practices were used for the audit criteria. Strategies to improve compliance with best practices were implemented following the baseline audit. A follow-up audit was conducted to measure any changes in clinical practice. Gaps between evidence and practice were identified for three of the audit criteria. Barriers included the lack of a policy for preventing or managing aggressive behavior in patients, the lack of a process to identify triggers of aggressive behavior, and inconsistent use of the aggression prevention care plan in the electronic health record. To address these barriers, the project team created a unit protocol, or written guidance, for preventing aggressive behavior, implemented a process to document triggers, and developed a general aggression care plan in the electronic health record. Overall compliance with evidence-based practices increased from 30% to 34%. This evidence implementation project used a clinical audit process, which led to a small overall improvement in compliance with evidence-based practices. This project has a potential long-term benefit, with staff being better prepared to prevent aggressive outbursts in patients in the general pediatric unit. However, further work is required to continue improving compliance with evidence-based practices. http://links.lww.com/IJEBH/A358.

The health and well-being of young adult building artisans are germane because of their critical role in infrastructure development. There is a perceived increase and paucity of studies regarding young adult building artisans' involvement in illicit substances, which threatens the achievement of Sustainable Development Goals (SDGs) 3 and 8. This study investigated the underlying causes and recommended feasible measures to prevent or mitigate the use of illicit substances among young adult artisans on construction sites in Nigeria, and, by extension, to improve the achievement of Goals 3 and 8. This research employs a face-to-face interview to collect data in Lagos and Abuja, Nigeria. Findings reveal that there is a prevalent issue of increasing young adult building artisans' illicit substance intake on building sites. This poses a significant threat to occupational health (SDG 3) and workplace safety (SDG 8). Findings also identified 17 underlying causes, including a lack of awareness among artisans, a low educational background and lax safety and management policies. This research contributes to the existing literature on preventing or mitigating illicit substance use among young adult building artisans. It also recognises that preventive or mitigative measures can be useful for mental health stability and, by extension, for achieving the SDGs.

Nanoparticle delivery to tumors remains inefficient, with current nanomedicines achieving only 0.7% injected dose per gram (ID/g) of tumor tissue due to uncontrolled protein corona formation that redirects nanoparticles away from target sites. We engineered biomimetic protein coronas to control nanoparticle–protein interactions and enhance tumor targeting. Competitive binding studies using NMR spectroscopy revealed that transferrin (Tf) and fibronectin (Fn) outcompete albumin (BSA) and immunoglobulin G (IgG) for 15 nm gold nanoparticle surfaces, establishing a binding hierarchy that enables predictable corona composition. Precoating nanoparticles with a four-protein combination (BSA+Tf+Fn+IgG) created coronas that achieved a balance between cancer cell uptake and reduced macrophage uptake in vitro. When administered to tumor-bearing mice, these engineered coronas achieved 13 ppm/g tumor accumulation (equivalent to 4% ID/g), representing 6.5-fold improvement over bare nanoparticles and 2.6-fold improvement over PEGylated formulations. Proteomics analysis of secondary coronas formed in human serum revealed that engineered nanoparticles selectively recruit transport and adhesion proteins while limiting immune recognition signatures. The preformed coronas maintained targeting protein retention and reduced complement binding compared to controls. Circular dichroism confirmed minimal protein structural perturbation, preserving receptor-binding functionality for active targeting. The strategy harnesses natural protein adsorption processes to create ″smart″ biological interfaces that simultaneously evade immune clearance and promote tumor cell recognition through transferrin receptor and integrin-mediated pathways. This approach demonstrates the feasibility of treating the corona as a programmable interface, addressing delivery limitations that have hindered clinical translation of cancer nanomedicines.

Begin as you mean to go on." 1 This timeless advice, often given to new physicians as they start residency, applies just as well to the launch of an academic career.The transition from clinician or resident to faculty member can feel exhilarating but also disorienting: Expectations are high, roadmaps are vague, and the hidden curriculum of academia often seems accessible only to insiders.The New Faculty Guide to Academic Family Medicine steps into this gap with a clear purpose to orient, equip, and encourage early career faculty in family medicine.Created by the Society of Teachers of Family Medicine Faculty Development and New Faculty Collaboratives, the book reflects the expertise of its editorial team: family medicine educators who serve as program directors, fellowship directors, and academic leaders.Their lived experience in guiding and mentoring new faculty gives the text both authority and empathy.Each chapter is organized around "the basics," "what you need to know," and "what you need to do," supported by timelines, barriers, and resources.This modular design makes the book highly usable and easy to reference.Early chapters address academic roles, balancing clinical duties with scholarship, and understanding promotion pathways.Later sections move into curriculum design, assessment, leadership, and career growth.Scholarship is framed broadly and inclusively, recognizing contributions such as quality improvement, case reports, and educational innovations alongside traditional research.This validation of diverse scholarly output is particularly encouraging for family medicine faculty, many of whom balance heavy clinical loads with academic work.The guide also highlights advising and service, reframing them as opportunities to strengthen identity and community rather than as distractions from scholarship.One of the book's most valuable contributions is its treatment of mentorship.Rather than suggesting reliance on a single mentor, the authors encourage building a portfolio of guides who collectively provide a foundation for growth.This model reflects best practices in faculty development and offers a realistic approach for sustaining long-term success.The text also acknowledges the hidden curriculum of academic medicine.It addresses unspoken expectations around authorship, committee work, and professional visibility, offering scripts and strategies to navigate these realities with confidence.The tone is consistently supportive, striking a balance between encouragement and practicality.The guide's strengths lie in its usability and family medicine specific context.Its scannable format, barrier-mitigation tips, and curated resources make it easy to apply in daily work.Examples rooted in continuity clinic, resident education, and community engagement enhance credibility and resonance.Still, the book is not without limitations.The first two chapters, while rich, are relatively dense and may be challenging entry points for new readers.Reordering the material to begin with topics most relevant to early faculty could improve flow.

Chronic d-galactose (d-gal) injection is an experimental model of accelerated aging in rodents. However, the cardiovascular phenotypes of this model have been poorly characterized, especially as they relate to sex differences. The goal of this study was to investigate the cardiovascular effects of chronic d-gal injection in male and female C57BL/6 mice and the impact of HO-1 induction or inhibition in this model. Forty-eight 8-week-old male and female C57BL/6 mice were divided randomly into four groups (n = 6): control, d-gal, d-gal + CoPP, and d-gal + ZnBG. Body weight, echocardiography, blood pressure measurement, Doppler ultrasound, echoMRI, micro-CT, histopathology, and protein analysis were performed. Our results show a strong sexual dimorphism in the cardiovascular effects of d-gal treatment and the effects of HO-1 induction or inhibition. Male mice were found to be more prone to systolic dysfunction and oxidative stress upon d-gal treatment and benefited more from the protective effects of HO-1 induction. Female mice were found to be protected from the cardiac effects of d-gal treatment yet were more prone to the effects of HO-1 inhibition. Our results demonstrate a sexually dimorphic response to the cardiovascular effects of d-gal treatment and alterations in HO-1.

Military personnel and veterans exposed to blast overpressure waves frequently report vestibular symptoms, including dizziness, vertigo, and imbalance. Although blast exposure is known to disrupt vestibular function, how vestibular deficits develop over time, particularly at the level of vestibular afferent signaling, remains unclear. In this study, we used an ear-blast model to investigate the early injury responses and progression of vestibular deficits following a single, moderate-intensity blast exposure (20 PSI) in male and female Long-Evans rats. Vestibular function was assessed using single-unit recordings from vestibular afferents and vestibulo-ocular reflex (VOR) testing. Blast exposure produced progressive changes in vestibular afferent activity in both male and female rats. In males, spontaneous firing rates remained unchanged, whereas females showed a reduction at 1day and 14days post-blast. In both sexes, firing irregularity increased, and a greater proportion of afferents became less responsive to head rotation and translation. Although gains and phases of the remaining canal and otolith afferents were preserved, response distortion increased following blast exposure, indicating reduced precision of vestibular afferents' encoding of head movement. Despite the impairments in vestibular nerve activity, steady-state rotational and translational VOR gains remained largely unchanged, with only moderate phase changes up to 56days post-blast. However, a subset of animals exhibited reduced step rotationalVOR gains and earlier quick phase responses following blast exposure. Morphological analysis revealed stereocilia damage, significant loss of saccular hair cells, and astrocytic activation in the central vestibular nuclei. Together, these findings indicate that blast-induced vestibular injury involves both peripheral and central components, with progressive changes in vestibular afferent activity that could influence sensory inputs to the CNS.

HIV is a retrovirus affecting the body's immune system. People living with HIV (PWH) aged ≥45 have a higher risk of atherosclerotic cardiovascular disease (ASCVD). Statins are generally recommended for PWH with a 10-year ASCVD risk of ≥5%. This project aimed to promote evidence-based practices (EBPs) regarding statin-prescribing for eligible PWH in an outpatient specialty clinic. Guided by the JBI Evidence Implementation Framework, two EBPs for increasing statin-prescribing were used as audit criteria: (1) use of a validated tool to estimate ASCVD risk and (2) presence of an alert for clinicians in the electronic health record (EHR) for positive screenings. To determine compliance with EBPs, a baseline audit was completed via EHR reviews. Then, barriers to compliance were identified and strategies to improve compliance were implemented. A follow-up audit was conducted to measure changes in compliance with best practices. The baseline audit revealed 56% and 0% compliance with the two EBPs, respectively. Barriers to compliance included the absence of a standardized process for estimating patients' CVD risk and clinicians often being unaware of patients' statin eligibility. Strategies to improve EBP compliance included using a "Smart Phrase" to automatically insert a calculation of the 10-year ASCVD risk score into the EHR and placing a statin eligibility notification into eligible patients' EHRs. The follow-up audit indicated a decrease in compliance for Criterion 1 (56% to 52%) but an increase of 100% for Criterion 2. The project objective was partially met, but interventions were impractical for sustainability. Prescribing practices among nurse practitioners and medical doctors should be explored, as differences in prescribing habits were noticeable. http://links.lww.com/IJEBH/A516.