Management and outcomes of traumatic hemothorax in children

Background: Adult guidelines for the management of traumatic hemothorax are well established; however, there have been no similar studies conducted in the pediatric population. The purpose of our study was to assess the management and outcomes of children with traumatic hemothorax. Materials and Methods: Following Institutional Review Board approval, we conducted a retrospective cross-sectional study of all trauma patients diagnosed with a hemothorax at a Level-1 pediatric trauma center from 2007 to 2012. Results: Forty-six children with hemothorax were identified, 23 from blunt mechanism and 23 from penetrating mechanism. The majority of children injured by penetrating mechanisms were treated with tube thoracostomy while the majority of blunt injury patients were observed (91.3% vs. 30.4% tube thoracostomy, penetrating vs. blunt, P = 0.00002). Among patients suffering from blunt mechanism, children who were managed with chest tubes had a greater volume of hemothorax than those who were observed. All children who were observed underwent serial chest radiographs demonstrating no progression and required no delayed procedures. Children with a hemothorax identified only by computed tomography, after negative plain radiograph, did not require intervention. No child developed a delayed empyema or fibrothorax. Conclusion: The data suggest that a small-volume hemothorax resulting from blunt mechanism may be safely observed without mandatory tube thoracostomy and with overall low complication rates

Scholar-activists in an expanding European food sovereignty movement

This article analyzes the roles, relations, and positions of scholar-activists in the European food sovereignty movement. In doing so, we document, make visible and question the political dimensions of researchers' participation in the movement. We argue that scholar-activists are part of the movement, but are distinct from the affected constituencies, put in place to ensure adequate representation of key movement actors. This is because scholar-activists lack a collective identity, have no processes to formulate collective demands, and no mechanisms for inter-researcher and researchers-movement communication. We reflect on whether and how scholar-activists could organize, and discuss possible pathways for a more cohesive and stronger researcher engagement in the movement.</p

A short-term multicenter analysis of radiolucent lines in a single uncemented rotating platform implant for total knee arthroplasty

BACKGROUND: Uncemented total knee arthroplasty is increasing as a potential solution for aseptic loosening via biologic fixation and to increase operative efficiency. However, postoperative radiolucent lines (RLLs) remain a concern for some clinicians. We report on a multicenter analysis of these RLLs over a 2-year period to identify their incidence, progression, and clinical significance. MATERIAL AND METHODS: Institutional review board approval was obtained for this retrospective, multicenter case series. A total of 312 patients treated with a single cruciate-retaining, fully porous coated femoral and tibial component design were included in the study. All patients were evaluated clinically and radiographically in the early postoperative period and at final follow-up (average 2.0 years). Average age of the study group was 58.2 years, and average body mass index was 30.7. Of the total, 66% were male, and 34% were female. Two independent surgeons evaluated the radiographs at the initial postoperative visit and at the most recent follow-up for RLLs. Knee Society Scores and range of motion (ROM) were collected at each visit. RESULTS: We identified RLLs in 25% of patients. All RLLs were less than 1 mm in size and located at the periphery of the tibial implant. None of the RLLs were progressive. At the final follow-up, compared with early postoperative imaging, no new RLLs were identified. Average ROM in flexion was 124 degrees, and the average Knee Society Scores at the most recent clinical follow-up was 96. CONCLUSION: RLLs are commonly seen following cementless TKA, most commonly underneath the tibial tray. Based on this data set, there does not appear to be progression of these RLLs with time, and they do not appear to have an effect on ROM or clinical outcome at 2 years

Statistical Modeling of the Default Mode Brain Network Reveals a Segregated Highway Structure

We investigate the functional organization of the Default Mode Network (DMN) – an important subnetwork within the brain associated with a wide range of higher-order cognitive functions. While past work has shown the whole-brain network of functional connectivity follows small-world organizational principles, subnetwork structure is less well understood. Current statistical tools, however, are not suited to quantifying the operating characteristics of functional networks as they often require threshold censoring of information and do not allow for inferential testing of the role that local processes play in determining network structure. Here, we develop the correlation Generalized Exponential Random Graph Model (cGERGM) – a statistical network model that uses local processes to capture the emergent structural properties of correlation networks without loss of information. Examining the DMN with the cGERGM, we show that, rather than demonstrating small-world properties, the DMN appears to be organized according to principles of a segregated highway – suggesting it is optimized for function-specific coordination between brain regions as opposed to information integration across the DMN. We further validate our findings through assessing the power and accuracy of the cGERGM on a testbed of simulated networks representing various commonly observed brain architectures

Global trends and correlates of covid-19 vaccination hesitancy: Findings from the icare study

The success of large-scale COVID-19 vaccination campaigns is contingent upon people being willing to receive the vaccine. Our study explored COVID-19 vaccine hesitancy and its correlates in eight different countries around the globe. We analyzed convenience sample data collected between March 2020 and January 2021 as part of the iCARE cross-sectional study. Univariate and multivariate statistical analyses were conducted to explore the correlates of vaccine hesitancy. We included 32,028 participants from eight countries, and observed that 27% of the participants exhibited vaccine hesitancy, with increases over time. France reported the highest level of hesitancy (47.3%) and Brazil reported the lowest (9.6%). Women, younger individuals (≤29 years), people living in rural areas, and those with a lower perceived income were more likely to be hesitant. People who previously received an influenza vaccine were 70% less likely to report COVID-19 vaccine hesitancy. We observed that people reporting greater COVID-19 health concerns were less likely to be hesitant, whereas people with higher personal financial concerns were more likely to be hesitant. Our findings indicate that there is substantial vaccine hesitancy in several countries, with cross-national differences in the magnitude and direction of the trend. Vaccination communication initiatives should target hesitant individuals (women, younger adults, people with lower incomes and those living in rural areas), and should highlight the immediate health, social and economic benefits of vaccination across these settings. Country-level analyses are warranted to understand the complex psychological, socio-environmental, and cultural factors associated with vaccine hesitancy

Calculation of AGARD Wing 445.6 Flutter Using Navier-Stokes Aerodynamics

An unsteady, 3D, implicit upwind Euler/Navier-Stokes algorithm is here used to compute the flutter characteristics of Wing 445.6, the AGARD standard aeroelastic configuration for dynamic response, with a view to the discrepancy between Euler characteristics and experimental data. Attention is given to effects of fluid viscosity, structural damping, and number of structural model nodes. The flutter characteristics of the wing are determined using these unsteady generalized aerodynamic forces in a traditional V-g analysis. The V-g analysis indicates that fluid viscosity has a significant effect on the supersonic flutter boundary for this wing

Transformational Leadership and Incivility: A Multilevel and Longitudinal Test

This research examines group-level perceptions of transformational leadership (TFL) as negative longitudinal predictors of witnessing person-related (e.g., insults/affronts) and work-related (e.g., negation/intentional work overload) acts of incivility at work. Witnessing workplace incivility was also postulated to negatively predict employee need satisfaction. Data were collected among production employees in different Canadian plants of a major manufacturing company (N = 344) who worked for 42 different managers (Mgroup size= 9.76). Two waves of data collection occurred 1 year apart. Results from multilevel analyses showed that workgroups where managers were perceived to engage in more frequent TFL behaviors reported reduced levels of person- and work-related incivility 1 year later. However, group-level incivility did not predict change in group-level need satisfaction 1 year later. At the individual level, results showed that witnessing higher levels of person-related incivility than one’s colleagues predicted reduced satisfaction of the need for relatedness 1 year later. These longitudinal findings build upon previous literature by identifying TFL as a potential managerial strategy to reduce incivility in workgroups over time. They also show that mere exposure to workplace misbehavior still affects employees’ adjustment, suggesting that every effort to reduce deviance in workplaces is worthwhile

Characterization of growth and metabolism of the haloalkaliphile Natronomonas pharaonis

Natronomonas pharaonis is an archaeon adapted to two extreme conditions: high salt concentration and alkaline pH. It has become one of the model organisms for the study of extremophilic life. Here, we present a genome-scale, manually curated metabolic reconstruction for the microorganism. The reconstruction itself represents a knowledge base of the haloalkaliphile's metabolism and, as such, would greatly assist further investigations on archaeal pathways. In addition, we experimentally determined several parameters relevant to growth, including a characterization of the biomass composition and a quantification of carbon and oxygen consumption. Using the metabolic reconstruction and the experimental data, we formulated a constraints-based model which we used to analyze the behavior of the archaeon when grown on a single carbon source. Results of the analysis include the finding that Natronomonas pharaonis, when grown aerobically on acetate, uses a carbon to oxygen consumption ratio that is theoretically near-optimal with respect to growth and energy production. This supports the hypothesis that, under simple conditions, the microorganism optimizes its metabolism with respect to the two objectives. We also found that the archaeon has a very low carbon efficiency of only about 35%. This inefficiency is probably due to a very low P/O ratio as well as to the other difficulties posed by its extreme environment