Predicting blunt cerebrovascular injury in pediatric trauma: Validation of the Utah Score

Risk factors for blunt cerebrovascular injury (BCVI) may differ between children and adults, suggesting that children at low risk for BCVI after trauma receive unnecessary computed tomography angiography (CTA) and high-dose radiation. We previously developed a score for predicting pediatric BCVI based on retrospective cohort analysis. Our objective is to externally validate this prediction score with a retrospective multi-institutional cohort. We included patients who underwent CTA for traumatic cranial injury at four pediatric Level I trauma centers. Each patient in the validation cohort was scored using the “Utah Score” and classified as high or low risk. Before analysis, we defined a misclassification rate <25% as validating the Utah Score. Six hundred forty-five patients (mean age 8.6 ± 5.4 years; 63.4% males) underwent screening for BCVI via CTA. The validation cohort was 411 patients from three sites compared with the training cohort of 234 patients. Twenty-two BCVIs (5.4%) were identified in the validation cohort. The Utah Score was significantly associated with BCVIs in the validation cohort (odds ratio 8.1 [3.3, 19.8], p < 0.001) and discriminated well in the validation cohort (area under the curve 72%). When the Utah Score was applied to the validation cohort, the sensitivity was 59%, specificity was 85%, positive predictive value was 18%, and negative predictive value was 97%. The Utah Score misclassified 16.6% of patients in the validation cohort. The Utah Score for predicting BCVI in pediatric trauma patients was validated with a low misclassification rate using a large, independent, multicenter cohort. Its implementation in the clinical setting may reduce the use of CTA in low-risk patients

Groundwater Flow Demonstration Model Activities for Grades 6-12

This set of activities is designed to use a demonstration model available through the Uath County Cooperative Extension Services or from Project WET. They demonstrate such concepts as aquifers, groundwater flow, water table, the relationship between groundwater and surface water, recharge, and others. A glossary and standards correlations to the Utah Core Curriculum for Science are included. The physical model can be obtained through the Utah County Cooperative Extension Service, the Utah Water Resources Education Program, or for sale from Project WET (Water Education for Teachers). Educational levels: High school, Middle school

Symmetric measures via moments

Algebraic tools in statistics have recently been receiving special attention and a number of interactions between algebraic geometry and computational statistics have been rapidly developing. This paper presents another such connection, namely, one between probabilistic models invariant under a finite group of (non-singular) linear transformations and polynomials invariant under the same group. Two specific aspects of the connection are discussed: generalization of the (uniqueness part of the multivariate) problem of moments and log-linear, or toric, modeling by expansion of invariant terms. A distribution of minuscule subimages extracted from a large database of natural images is analyzed to illustrate the above concepts.Comment: Published in at http://dx.doi.org/10.3150/07-BEJ6144 the Bernoulli (http://isi.cbs.nl/bernoulli/) by the International Statistical Institute/Bernoulli Society (http://isi.cbs.nl/BS/bshome.htm

A Balanced Energy Plan for the Interior West

Describes a Balanced Energy Plan for the Interior West region of Arizona, New Mexico, Nevada, Utah, Colorado, Wyoming and Montana. Part of the Hewlett Foundation Energy Series

Trade-Off Time: How Four States Continue to Deliver

Highlights performance measures used in Indiana, Maryland, Utah, and Virginia to ensure results-driven budgeting by defining goals, assessing priorities and trade-offs, targeting cuts with precision, and creating a culture of results-focused budgeting

The Massachusetts and Utah Health Insurance Exchanges: Lessons Learned

Examines the quality and choice of plans, affordability, and ease of enrollment in existing state-run exchanges. Outlines lessons learned, including the need for ongoing refinement, consideration of broader market interactions, and public outreach

Increased risk for other cancers in individuals with Ewing sarcoma and their relatives.

BackgroundThere are few reports of the association of other cancers with Ewing sarcoma in patients and their relatives. We use a resource combining statewide genealogy and cancer reporting to provide unbiased risks.MethodsUsing a combined genealogy of 2.3 million Utah individuals and the Utah Cancer Registry (UCR), relative risks (RRs) for cancers of other sites were estimated in 143 Ewing sarcoma patients using a Cox proportional hazards model with matched controls; however, risks in relatives were estimated using internal cohort-specific cancer rates in first-, second-, and third-degree relatives.ResultsCancers of three sites (breast, brain, complex genotype/karyotype sarcoma) were observed in excess in Ewing sarcoma patients. No Ewing sarcoma patients were identified among first-, second-, or third-degree relatives of Ewing sarcoma patients. Significantly increased risk for brain, lung/bronchus, female genital, and prostate cancer was observed in first-degree relatives. Significantly increased risks were observed in second-degree relatives for breast cancer, nonmelanoma eye cancer, malignant peripheral nerve sheath cancer, non-Hodgkin lymphoma, and translocation sarcomas. Significantly increased risks for stomach cancer, prostate cancer, and acute lymphocytic leukemia were observed in third-degree relatives.ConclusionsThis analysis of risk for cancer among Ewing sarcoma patients and their relatives indicates evidence for some increased cancer predisposition in this population which can be used to individualize consideration of potential treatment of patients and screening of patients and relatives