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The purpose of this study was to evaluate readily accessible U.S. based online physical therapy protocols for open and endoscopic hip abductor repairs and to assess the variability in post-operative rehabilitation protocols. Online physical therapy protocols from U.S. based orthopaedic institutions for gluteus medius/minimus repair were collected using a web-based query utilizing search terms "hip abductor repair rehabilitation protocol" and "gluteus repair rehabilitation protocol." Published protocols from both Electronic Residency Application Service (ERAS) academic orthopaedic surgery programs and private groups were collected. All publicly available protocols were included. Protocols were analyzed using a standardized spreadsheet to assess rehabilitation components and timelines. Descriptive statistics (median values, percentages, ranges) were calculated. 54 rehabilitation protocols were assessed, including 22 (41%) from ERAS-affiliated academic programs or associated physicians. Postoperative weight-bearing was addressed in 53/54 (98%) protocols, with 41 (77%) recommending toe-touch/touchdown/flat-foot/20-lb weightbearing. Median duration of restricted weight-bearing was 6 weeks (range, 2-8 weeks). Regarding range of motion restrictions, 37 (69%) protocols limited hip flexion to 90°, 42 (78%) advised against passive adduction past neutral, and 49 (91%) against active abduction. Bracing was recommended in 30 (56%) protocols, with 25 (83%) lacking brace specification and only 5 (17%) recommending an abduction brace. Return-to-sport timelines were included in 19 (35%) protocols, with a median 16 weeks (range 12-24). Functional testing was mentioned in 22 (41%) protocols, though tests and criteria varied. Substantial variability exists in the composition and timing of rehabilitation protocols following hip abductor tendon repair. A majority of protocols advised limited weight bearing for the first 6 weeks after surgery and avoidance of active hip abduction and passive hip adduction, however there was wide variation in the recommendations regarding brace use, strengthening progressions, the role of functional testing, and the timeline for return to activity and sport.

Market authorization applications that do not obtain authorization after CHMP review, whether through a formal negative opinion or pre-opinion withdrawal, remain poorly characterized at a systems level, despite substantial strategic, and commercial implications for applicants, and the broader impact on public-health. We conducted a retrospective descriptive analysis of 47 Article 8[3] new marketing authorization applications (MAAs) evaluated by the CHMP between 2021 and 2025, comprising 16 applications with a formal negative CHMP opinion and 31 withdrawn applications with an underlying negative benefit-risk assessment. Public assessment documents were reviewed, and documented CHMP concerns were scored across four predefined domains: CMC, non-clinical, clinical, and regulatory/procedural, including subsequent secondary sub-categorization to allow for more detail. Procedural timelines, re-examination outcomes, and multi-domain co-occurrence patterns were also summarized. Findings were summarized descriptively using counts, percentages, and procedural-duration comparisons. Withdrawn and refused MAAs showed comparable product profiles and similar rates of orphan designation. Withdrawals occurred throughout all phases of the assessment procedure, reflecting different points at which applicants considered continuation no longer viable. Across both cohorts, procedural timelines frequently exceeded theoretical EMA benchmarks, with the excess concentrated in clock-stop phases. Clinical concerns were the most frequently documented domain, observed in 16/16 refused applications (100%) and 28/31 withdrawals (90%). Within the clinical domain, the secondary categories study-design concerns and insufficient evidence of efficacy were the most common findings and frequently co-occurred. Compared with refusals, withdrawals showed a broader deficiency profile, more often involving multiple domains, particularly CMC and regulatory/procedural concerns in addition to clinical deficiencies. These observations suggest that unsuccessful outcomes in this cohort were commonly associated with limitations in evidence generation, dossier readiness, and alignment between regulatory pathway and evidence maturity. Earlier cross-domain readiness assessment may help applicants identify major unresolved deficiencies before or during CHMP review.

Physical literacy (PL) has emerged as an important framework for understanding children's and adolescents' motivation, confidence, physical competence, knowledge, and engagement in lifelong physical activity. Although youth physical literacy research has expanded rapidly, limited bibliometric evidence has systematically mapped its global development, intellectual structure, and emerging thematic trends. This study aimed to examine the evolution of youth physical literacy research from 2000 to 2025 and identify major research themes, collaboration patterns, and emerging directions. A bibliometric analysis was conducted using records retrieved from the Web of Science Core Collection and Scopus databases within a multi-database validation framework. After data cleaning, deduplication, and exclusion of records outside the study period, 856 publications published between 2000 and 2025 were included. Bibliometrix, VOSviewer, and CiteSpace were used to examine publication trends, collaboration networks, influential contributors, keyword co-occurrence patterns, thematic clusters, timeline evolution, and burst keywords. Youth physical literacy research showed a sustained increase in publications, particularly after 2015. Canada, Australia, China, the United States, and the United Kingdom were among the most productive countries. Keyword and cluster analyses identified major themes related to physical education, motor competence, physical activity, physical competence, assessment and validation, fitness, health literacy, and public health. Timeline and burst analyses further suggested increasing attention to psychological, educational, and well-being-related themes within the youth physical literacy literature. Cross-database comparison showed consistent patterns in publication trends, leading contributors, and core thematic structures, supporting the robustness of the identified research patterns. This study provides a systematic and validated mapping of the global research landscape of youth physical literacy from 2000 to 2025. The findings suggest that youth physical literacy research has expanded from physical education, motor competence, and assessment-oriented topics toward broader educational, psychosocial, and health-related themes. These results offer a knowledge map for researchers, educators, and policymakers interested in advancing youth physical literacy in educational contexts and supporting holistic student development.

Increased cannabis use in young adults may influence brain health and neurodevelopment. In the context of chronic HIV-associated neuroinflammation, however, mild cannabis use may attenuate negative outcomes through anti-inflammatory effects. More frequent cannabis use may remain deleterious to both young adults with HIV (YWH) and without HIV (YWoH). We explored cross-sectional associations between cannabis use frequency and cognitive performance in YWH and YWoH. Participants aged 18-24 included 38 YWH and 61 YWoH (32% White) who completed cognitive tests of verbal memory, processing speed, working memory, executive functions, and overall fluid cognition. Timeline follow-back interviews assessed days of cannabis use (past 30, 180 and 365 days). Primary analyses focused on 30-day use, categorized as: no use, mild/moderate (1-<5 days used/week) and heavy (&#x2265;5 days used/week). Generalized estimating equations modeled associations of HIV, cannabis use category, and their interaction with cognitive outcomes; trend analyses used cannabis frequency as a continuous variable. Due to group differences in proportion of females, sex differences could not be addressed. YWH had worse performance than YWoH in fluid cognition, memory, processing speed, and executive functioning. Adjusting for HIV status, heavy 30-day use, versus no use, was associated with worse performance on fluid cognition, immediate and delayed word list recall, processing speed and executive functions. Relative to mild/moderate use, heavy use was associated with worse immediate and delayed story recall and executive functions. Results were similar for 180- and 365-day use. Interactions between HIV status and 30-day cannabis use category were not significant, although exploratory analyses employing cannabis use as a continuous measure suggested a linear relationship for YWoH of greater use with worse cognitive performance, while for YWH, non-linear relationships suggested better performance with mild/moderate use on some memory and executive functioning measures. These results suggest ongoing heavy cannabis use is associated with worse cognitive performance among young adults. For YWH, however, mild to moderate levels of cannabis use may have a protective effect possibly through altering chronic neuroinflammation, although causality cannot be determined in this cross-sectional study. Understanding differential, population-specific effects of cannabis use frequency may be important in setting use guidelines.

Artificial intelligence has the potential to rapidly transform exercise prescription and coaching through machine learning, deep learning, and large language models. However, there is a disconnect between peer-reviewed evidence and real-world deployment in commercial platforms. This narrative review evaluated recent literature (2023-2025) assessing data-driven programming approaches for exercise prescription. Articles were identified across four themes in exercise programming: data integration on wearables and sensors, predictive modeling, chatbots and virtual coaches, and general-use large language models. Current evidence demonstrates the feasibility of artificial intelligence for activity recognition, workload estimation, and short-term performance prediction. However, significant gaps remain in evaluating closed-loop adaptive programming, downstream behavioral outcomes, and long-term effectiveness. Industry systems integrate multimodal data and continuously evolve, operating largely without formal validation. Advancement requires translational research models that bridge academic rigor with industry implementation timelines, prioritize transparency and human-in-the-loop frameworks, and evaluate artificial intelligence as a tool to augment rather than replace professional exercise prescription.

Malaria transmission relies on sporozoite formation in the mosquito midgut and subsequent salivary gland (SG) invasion. Despite their importance, the cell biology of these processes remains poorly understood. We apply mosquito tissue ultrastructure expansion microscopy (MoTissU-ExM), which physically expands infected mosquito tissues while preserving host and parasite ultrastructure. MoTissU-ExM reveals parasite structures and organelles, including features previously seen only by electron microscopy and novel structures not observed before. We use MoTissU-ExM to investigate sporozoite formation and SG invasion, focusing on rhoptries-secretory organelles critical for host cell invasion. We establish a timeline for rhoptry biogenesis, show that two rhoptries are consumed during SG invasion, and provide the first evidence that rhoptry pairs are specialized for different invasion events. We further characterize RON11 as the first protein involved in sporozoite rhoptry biogenesis; its disruption produces sporozoites that specifically fail to invade SG epithelial cells, blocking parasite transmission.

The Edge On-Edge Off (EO-EO) hypothesis posits that poor sleep quality leads to low daytime arousal, which individuals may combat with caffeine use later in the day (i.e., Edge-On). Greater caffeine use then leads to higher arousal in the evening, which individuals may take advantage of or combat by drinking alcohol (i.e., Edge-Off). Heavy drinking, in turn, disrupts sleep (potentially adding hangover effects to daytime fatigue) and continues the cycle, particularly in the absence of structural barriers to drinking. The current study examines the behavioral predictions of an EO-EO cycle of alcohol use in which poor sleep quality predicts next-day caffeine use and, in turn, later day drinking. Drinking behaviors then perpetuate this cycle across days through the disruption of sleep. Data came from a 10-day timeline follow-back survey completed by 1496 college students (aged 18-28; 61% female-identifying; 15% African American, 65% White, 12% Asian, 5% multi-racial, and less than 3% American Indian or Pacific Islander). We estimated Latent Curve Models with Structured Residuals to examine within-person links and serially mediated effects involving poor sleep quality, caffeine and alcohol use, and next night's poor sleep quality, differentiating between cycles occurring during the week versus the college weekend. We also tested the same cycle with napping duration, rather than caffeine use, as the within-day mediator. Findings supported the behavioral predictions of the EO-EO cycle linking poor sleep quality and greater subsequent caffeine and alcohol use, forming a recurring cycle. Evidence for this cycle was limited to the college weekend. Napping duration did not mediate the association between poor sleep quality and greater drinking. The EO-EO cycle was supported primarily during the college weekend. These findings offer a promising proof of concept regarding the EO-EO cycle and point to several future directions for research.

Background and objective Extra-articular fractures of the proximal third of the tibia are technically demanding injuries due to the complex deforming muscular forces and frequently compromised soft tissue envelope. The optimal treatment strategy for this fracture subtype remains unsettled, particularly regarding the choice between minimally invasive percutaneous plate osteosynthesis (MIPPO) and intramedullary interlocking nailing (IMILN). This study was undertaken to compare these two treatment modalities and determine their relative effectiveness. Methods A single-center, prospective, comparative study employing alternating allocation was conducted at IMS and SUM Hospital, Bhubaneswar, with patient recruitment carried out from September 2024 to February 2025, and final clinical and functional follow-up at 12 months completed by March 2026. Fifty-two adults aged 20-60 years with AO/OTA 41A2 fractures, including Gustilo-Anderson grade I and II open injuries, were sequentially allocated to either MIPPO (n = 26) or IMILN (n = 26). The primary outcomes included time to radiological union and 12-month functional assessment using the Knee Society Score (KSS), Lower Extremity Functional Scale (LEFS), and Johner and Wruhs grading scale. Continuous variables were compared using the independent-samples t-test, while categorical variables were analyzed using the chi-square or Fisher's exact test as appropriate. Statistical analyses were performed using IBM SPSS Statistics version 21.0 (IBM Corp., Armonk, NY). Results Forty-six patients completed the one-year follow-up (MIPPO, n = 24; IMILN, n = 22). Mean radiological union time was 16.1 weeks (MIPPO) versus 16.9 weeks (IMILN) (mean difference: -0.8 weeks, 95% CI: -4.0 to 2.4; p = 0.62). Final union rates were 23/24 (95.8%) and 21/22 (95.5%), respectively. Malreduction > 5&#xb0; occurred in 4/26 (15.4%, MIPPO) and 5/26 (19.2%, IMILN) (p = 0.71). Mean KSS was 80.2 versus 80.8 (mean difference: -0.6, 95% CI: -7.0 to 5.8; p = 0.85), and mean LEFS was 65.2 versus 67.3 (mean difference: -2.1, 95% CI: -6.6 to 2.4; p = 0.35). Excellent or good Johner and Wruhs grades were achieved in 18/24 (75.0%, MIPPO) and 18/22 (81.8%, IMILN). Partial weight-bearing was initiated earlier in the IMILN group (two to three postoperative days vs. three to four weeks; p < 0.001). Intraoperative adjuncts were required in 13/26 (50.0%) of IMILN versus 3/26 (11.5%) of MIPPO procedures (p = 0.005). Conclusions Within the limitations of this small, single-center cohort study, MIPPO and IMILN demonstrated comparable union rates and one-year functional outcomes for AO/OTA 41A2 fractures. IMILN facilitated earlier mobilization but necessitated adjunct procedures more frequently and was associated with anterior knee pain. MIPPO was associated with minimal knee-related morbidity, albeit with a more gradual rehabilitation timeline. Implant selection should therefore be guided by fracture morphology, soft-tissue condition, and locally available instrumentation rather than an absolute preference for either construct.

Adolescence is a critical developmental period marked by heightened vulnerability to initiating substance use, with long-term implications for health and behavior. Nicotine, alcohol, and cannabis are the most commonly used substances among adolescents. Their use often co-occurs but few studies have described or quantified the patterns and doses of substance co-use in this vulnerable population. We used data from six waves of the Adolescent Brain Cognitive Development study. Substance use was measured through a web-based timeline followback interview, and outcomes are operationalized into substance use quantity (in standard units), single use, and co-use (use of two substances on the same day) of alcohol, cannabis, and nicotine. Group differences of average dose in standard units between single use and co-use for each substance class were analyzed using linear mixed-effects modeling in years 4-6. The average dose of nicotine was significantly higher when co-used with alcohol (4.32; 95% confidence interval [CI]: 2.55-6.09; p < .001) or when co-used with cannabis (4.41; 95% CI: 2.76-6.05; p < .001) in year 6; nicotine trends were similar in years four and five. In year 6, the average dose of alcohol was higher when co-used with cannabis (1.87; 95% CI: 0.37-3.36; p = .004) or co-used with nicotine (1.64; 95% CI: 0.06-3.22; p = .03) compared to single use of alcohol. The average dose of cannabis was not significantly different when used singularly or co-used with either alcohol or nicotine in our study years. During adolescence, the co-use of substances (namely alcohol and nicotine) may lead to higher average doses compared to single-substance use.

This article draws on our doctoral research to explore ideas of structural mirroring between queer and chronically ill lifecourses, examining how our 'queer' bodies challenge normative constructions of time, future, and family. Grounded in scholarship on queer and crip temporalities, and informed by our own insider perspectives, we use our lived experience to show how such bodies might deviate from societal norms and temporal regulations around productivity, reproduction, and maturity. Building on traditions that extend 'queerness' beyond sexual identity, we position it as a critical lens for interrogating normative social structures. By reclaiming queerness as 'crookedness', we use auto/biographical narratives to illustrate how embodied experiences challenge reproductive futures and societal expectations. Focusing on temporal disruptions-such as recognition and visibility (diagnosis and coming out), maturity (leaving home and potential of marriage), and the future (e.g. reproduction)-we trace how 'crooked lifecourses' diverge from normative timelines. By placing the experiences of a woman in her twenties with chronic illnesses alongside those of a gay man in his thirties navigating Confucianist reproductive expectations, we highlight the exclusionary effects of chrononormativity. Our 'crooked lifecourse' concept aims to expand 'queer' and 'crip' as frameworks for understanding lives beyond normative expectations, while demonstrating how deviations from dominant temporalities generate alternative forms of care, intimacy, and resistance.

Post-treatment transitions after active cancer care often lack clear ownership, timelines and closure rules, shifting coordination work onto survivors and staff. We aimed to identify how these failures arise and to co-design a handover standard for post-treatment survivorship care. In a two-stage qualitative study, Stage A involved semi-structured interviews with survivors and professionals (n&#x2009;=&#x2009;65) across head and neck, colorectal and gastrointestinal stromal tumour pathways; Stage B comprised four co-design workshops (n&#x2009;=&#x2009;21). We identified a mechanism we term mirrored burden, in which routine letters and electronic records fail to make responsibility explicit and both survivors and staff end up chasing care. Co-design produced a four-component handover standard centred on accountable correspondence, a clinically senior survivorship lead practitioner with delegated authority, clinic-based resolution capacity, and equity safeguards for non-digital access and communication needs, plus four equity-stratified audit-ready feasibility indicators for service-level evaluation.

Evaluation of medical education is essential for ensuring the quality of health professional training. However, conventional evaluation approaches often lack objectivity, scalability, and longitudinal assessment capacity. Virtual reality (VR) and artificial intelligence (AI) are increasingly integrated into medical education, yet their application in educational evaluation has not been systematically characterized. To examine research trends, thematic evolution, and emerging directions in VR- and AI-enabled medical education evaluation, a bibliometric analysis was conducted. Publications indexed in the Web of Science Core Collection between January 1, 2015, and December 31, 2025, were retrieved using predefined search terms related to VR, AI, medical education, and evaluation. Eligible English-language articles and reviews were analyzed using CiteSpace (version 6.4.R2). Annual publication and citation trends, country collaboration patterns, and cited journals were assessed. Research themes and frontiers were examined through keyword co-occurrence, clustering, burst detection, and timeline analyses. A total of 695 publications were included. Annual publications and citations increased steadily, with accelerated growth after 2020. The United States, Germany, China, England, and Canada produced the highest number of publications, whereas Belgium, Egypt, Sweden, Singapore, and Switzerland demonstrated high collaboration centrality. Influential cited journals were concentrated in medical education and simulation-based training domains. Keyword analyses identified major themes including surgical education, VR simulation, clinical reasoning, decision support, and residency and undergraduate education. Burst and timeline analyses indicated a progression from early simulation-based skill validation toward learner-centered performance evaluation and, more recently, quality-oriented and curriculum-level assessment. Research on VR- and AI-enabled medical education evaluation has expanded rapidly and evolved from technical skill assessment toward comprehensive, competency-oriented, and quality-focused evaluation. These findings highlight the growing role of emerging technologies in shaping future global medical education evaluation frameworks.

Cyclin-dependent kinase inhibitor ( cki-1 ) is associated with cell cycle arrest and cellular quiescence. In Caenorhabditis elegans , glia-to-neuron transdifferentiation of the phasmid socket 1 (PHso1) glia into the phasmid D (PHD) neuron has been previously described across larval stages. Here, we report the post-hatching timeline of PHso1-to-PHD remodeling within L4 substages, including the loss of glial socket morphology and the acquisition of neuronal features well into adulthood. We find that cki-1 expression decreases across L4 substages between 40-50 hours post-hatching in males, while cki-1 remains robustly expressed in hermaphrodite PHso1 cells. Across L3, L4, and adulthood, PHso1 cell proportions change consistently.

Uncontrolled hemorrhage remains a leading cause of early, potentially preventable death following traumatic injury. Contemporary multicenter data continue to demonstrate that fatalities from hemorrhagic shock cluster within the first hours after injury, reinforcing the operational principle that the critical timeline is from point of injury to initiation of hemostatic resuscitation rather than time to hospital arrival. Ongoing armed conflict, including the war in Ukraine, as well as broader preparedness for future disasters and mass casualty events, underscores the need for evidence-based, practical strategies to reduce preventable morbidity and mortality. Panel discussion and supporting documents underscore that forward resuscitation must be feasible for protocol-based teams in austere environments: early blood where possible, ideally low-titer O whole blood, plasma-based bridging strategies (including spray- or freeze-dried plasma, which is rapidly becoming available and very new to the prehospital paradigm) when blood logistics are constrained, and mandatory early adjuncts, tranexamic acid and calcium, embedded into simple, auditable pathways. This synthesis integrates the panel's "good, bad, and hard realities" from the audience discussion and proposes practical next steps for scalable clinical governance in the prehospital space in Ukraine under ongoing conflict constraints.

Neuroblastoma is the most frequent extracranial solid tumor of young children and demonstrates a wide range of biological behavior, from spontaneous regression to highly aggressive metastatic disease. Recent advances in genomics, epigenetics, tumor microenvironment biology, and multi-omics technologies have greatly enhanced understanding of neuroblastoma pathogenesis and enabled the development of precision diagnostic and prognostic approaches. This review examines current evidence for molecular and cellular mechanisms underlying neuroblastoma initiation, progression, and therapeutic resistance, with a focus on MYCN amplification, ALK pathway dysregulation, chromosomal instability, telomere maintenance mechanisms, epigenetic remodeling, and neural crest developmental biology. This review primarily emphasizes that these characteristics should be interpreted within a unified developmental framework. In this context, age serves more as an indicator of the differentiation status of the sympathoadrenal progenitor pool rather than merely a timeline for the accumulation of somatic mutations. This viewpoint connects the epigenetic, genetic, and clinical aspects of the disease, providing insight into its distinctive range of behaviors, from spontaneous regression in infants to fatal progression in older children. The promising role of integrative diagnostic platforms - such as genomic profiling, liquid biopsy, radiomics, metabolomics, single-cell sequencing, and artificial intelligence-aided imaging approaches - in early detection and disease characterization is explored in detail. The evaluation of both existing and emerging prognostic models involves a critical analysis of molecular biomarkers, tumor microenvironment signatures, circulating tumor DNA, immune profiling, and machine-learning-based stratification systems. Additionally, the translational potential of systems biology approaches is examined, along with future directions for integrating multi-omics data into clinically relevant precision oncology frameworks. Integrative approaches are collectively reshaping neuroblastoma research by connecting molecular pathogenesis with advanced diagnostic and prognostic tools. These developments are expected to facilitate enhanced risk-adapted therapeutic strategies, personalized medicine, and ultimately, improved survival rates in children with neuroblastoma.

Qualitative inquiry is central to nursing and health research, yet many established analytic approaches require substantial time and expertise. These demands can pose challenges for researchers working within constrained timelines and multidisciplinary teams. RRITA, a Rapid, Reflexive, Integrated approach to Thematic Analysis, was developed to address the persistent tension between rigour and feasibility. To introduce RRITA as a reflexive qualitative analysis method, providing a theoretically grounded and practically actionable guide to its implementation. Methodological paper outlining the conceptual foundations, analytic workflow, and applied features of RRITA, illustrated with data from a study on gratitude in palliative care. RRITA comprises seven steps organised around an alternating expand-compress cadence. In steps 1 and 2, researchers formulate a paradigm-aligned research question and define domains to populate the initial structure of the RRITA matrix, the method's central analytic instrument, maintaining a direct line of sight between raw data and analytic output while preserving subtle meanings and complexity. Researchers generate raw data in step 3 and refine them in step 4. Steps 5 and 6 shift to line-by-line inductive coding grounded in participants' accounts, iterative theme construction supported by theme warrants, and active engagement with analytic tensions and discordance. Step 7 culminates in a coherent narrative that integrates thematic articulation and interpretation, illustrative data, the reflexive pivot, and scholarly literature. Throughout the research journey, RRITA supports the systematic scrutiny of researcher subjectivity through the embedded practices of reflexive anchoring and notes. RRITA supports rigorous qualitative analysis through a structured workflow that synthesises key features of reflexive thematic analysis and rapid qualitative approaches. It introduces three integrative analytic innovations: embedded, situated reflexive practices, systematic engagement with discordant data and analytic tensions, and a versioned matrix trail documenting the analytic process from the initial reflexive anchor to final theme construction. RRITA proposes that rigour and accessibility are complementary when supported by thoughtful methodological design. It offers a theoretically grounded approach to qualitative inquiry that fosters interpretive depth while accommodating the practical constraints of nursing and health research. RRITA is particularly suited for clinical inquiry, teaching, and student supervision. Its versioned matrix trail renders analytic reasoning visible and discussable at each step, supporting the development of interpretive competence and the timely generation of high-quality evidence to inform contemporary nursing practice and policy.

Based on data from the U.S. Department of Defense Joint Trauma Registry, the Joint Trauma System has developed clinical practice guidelines for combat casualty care (CCC). As future high-intensity conflicts are likely to involve multinational operations, interoperability with allied nations-whose trauma systems may differ from established U.S. practices-is essential. This study aimed to compare key characteristics of French and U.S. military trauma systems to anticipate interoperability in CCC. This retrospective observational study included all U.S. and French service members (SMs) who sustained a severe battle injury requiring intensive care unit admission between 2009 and 2022. Demographics, prehospital management, and in-hospital interventions, including transfusions and tranexamic acid administration, were analyzed. A total of 734 U.S. and 98 French SMs met inclusion criteria. Most U.S. casualties occurred in Afghanistan (96.3%), whereas French casualties were mainly engaged in Africa after 2013 (51.0%). U.S. SMs sustained more improvised explosive device-related injuries (54.3% vs. 33.7%, P&#x2009;<&#x2009;.001) and fewer penetrating injuries (68.1% vs. 84.7%, P&#x2009;<&#x2009;.001) than French SMs. French SMs were more frequently managed by a prehospital physician (80.6% vs. 53.1%), received more prehospital transfusions (16.3% vs. 7.9%, P&#x2009;=&#x2009;.005), and more tranexamic acid (28.6% vs. 7.9%, P&#x2009;<&#x2009;.001). Median transport time from point of injury to surgical care was longer for French SMs (120 vs. 50 minutes). Both trauma systems emphasize early prehospital transfusion. Key differences include mechanisms of injury, the presence of a physician in prehospital teams, early tranexamic acid use, and evacuation timelines. Enhancing interoperability will require strengthened international data sharing, harmonization of competencies, and sustained collaboration in CCC.