Use Of The Pediatric Trauma Score To Triage Severity Of Childhood Injury

Trauma is the leading cause of pediatric mortality and morbidity in the United States, but there is no widely accepted trauma scoring criteria for the rapid triage of acute injuries in children. The objective of this study was to evaluate the association of the Pediatric Trauma Score (PTS) with central nervous system injury (CNS) and solid organ injury (SOI), subspecialist operative management, and emergency department (ED) disposition in pediatric trauma patients. Our hypothesis was that PTS would be adequately assosciated with these outcomes. We performed a retrospective review of the medical records of all patients less than 16 years of age evaluated for acute injuries in our Level I Pediatric Trauma Center from 1/2005-12/2011, excluding patients transferred from referring hospitals. Demographics, PTS criteria, and outcomes were abstracted. Receiver Operating Curve characteristics were performed to determine the predictive ability (AUC-Area under the Curve) of the PTS at detecting outcomes. Our results included 3,817 patients, the average age was 7.25 years; 66.1% were male; and 98.4% sustained blunt trauma. Mean PTS value was 10.0. PTS had an outstanding association with mortality (AUC: 0.996; SE: 0.001). PTS had an acceptable association with CNS injury (AUC: 0.750; SE: 0.029) and operative management including neurosurgery (AUC: 0.788; SE: 0.041), reconstructive surgery (AUC: 0.750; SE: 0.051), and pediatric surgery (AUC: 0.746; SE: 0.027). PTS had a poor association with solid organ injury (AUC: 0.572, SE: 0.038); operative management by orthopedic surgery (AUC: 0.565, SE: 0.014); and ED disposition including discharge to home (AUC: 0.641, SE: 0.009), admission to the intensive care unit (AUC: 0.689, SE: 0.017), and admission to the surgical ward (AUC: 0.667, SE: 0.018). In conclusion, PTS may be a useful means to triage acute injury in children and to predict likelihood of mortality, presence of CNS injury, and need for subspecialist surgical management

The relation of visual fixation and pursuit to posture in four month infants

The frozen posture of a young child as he visually attends to something of interest, or the very young infantTs wide open eyes and mouth as he fixes on a stimulus, illustrate dramatically the close relationship between the visual system and the total action system. The two appear to be inseparable and interdependent. When vision is impaired, control of posture may be impaired as evidenced by the typical delay in head righting in prone and all-fours postures of the blind infant. (Gesell and Amatruda, 1941; Gesell et al, 1949) In other children with severe visual impairment a peculiar head posture may be assumed in order to fix the eyes to receive the object stimulus on the most favorable part of the retina. (Gesell et al, 1949) Certain children with learning disabilities may also reflect visual problems either of oculomotor or perceptual causes in peculiar postures as they perform visuomotor tasks

Monitoring abundance of Carcinus maenas developmental stages in Seadrift Lagoon

Able to tolerate a wide range of habitats, temperatures, and salinities, Carcinus maenas thrives in much of its non-native range, out-competing native crabs for resources while diminishing food supplies for a variety of marine and estuarine organisms. In Seadrift Lagoon, a manmade inlet of Bolinas Lagoon in Marin County, California, green crabs comprise a significant portion of benthic fauna, and trapping efforts began in 2009 to eradicate them. We analyzed several years of trapping data to monitor demographic changes for this closed population, performed larvae and megalopae sampling with pot scrubbers, and counted eggs on ovigerous females captured in Seadrift Lagoon. Data records reveal a consistently decreasing population from 2009 to 2013, likely due to trapping efforts, followed by an enormous spike in 2014 and consequential crash in 2015. Increased proportions of smaller size classes (\u3c32 mm, 32-40 mm) may be associated with preceding years of increased proportions of gravid females. No larvae or megalopae were observed within the 115 samples taken over the course of 4 weeks in July 2015, and egg counts yielded an average of 30,000 eggs per female (average carapace width 49.5 mm). We conclude that larvae may be scarce as a result of predation, intraspecific competition for food or nursery habitats, early- or late-summer settlement, or some combination of these factors

Genesis lunar outpost: An evolutionary lunar habitat

Students at the University of Wisconsin-Milwaukee Department of Agriculture undertook a series of studies of lunar habitats during the 1989 to 1990 academic year. Undergraduate students from architecture and mechanical and structural engineering with backgrounds in interior design, biology and construction technology were involved in a seminar in the fall semester followed by a design studio in the spring. The studies resulted in three design alternatives for lunar habitation and an integrated design for an early stage lunar outpost

Impacts of ocean acidification on intertidal macroalgae and algivore preference

Ocean acidification, a facet of global climate change, has the potential to induce changes in marine macroalgae that modify their existing interactions with algivorous invertebrates. In this study, I examined the effects of elevated carbon dioxide (pCO2) on several species of intertidal macroalgae (Phaeophyta, Rhodophyta) and evaluated the present-day and predicted future preferences of algivores (Pugettia producta and Tegula funebralis) by assessing grazing rates on untreated algal tissue and on algae exposed to high-pCO2 seawater. Both red and brown algae grew faster in elevated pCO2 than in ambient seawater, and algae in intermediate pCO2 generated more new growth overall than those in highly elevated pCO2. The effect of pCO2 on the carbon and nitrogen contents of algae depended on species identity, and C:N ratios decreased slightly with increasing pCO2 for four of the five species studied. Total phenolic content in each alga was unaffected by pCO2 treatment, although similar (distinct) levels between untreated species became distinct (similar) when those same species were compared after high-pCO2 treatment. Algivores demonstrated contrasting responses to changes in their food sources; P. producta, a specialist crab grazer, did not modify its preference for the brown alga Egregia menziesii when offered high-pCO2 treated individuals, but the generalist snail T. funebralis adjusted its feeding behavior to choose algae with low phenolic contents, which created different patterns of preference for untreated and pCO2-treated algae. C:N ratios of algae did not appear to be a strong driver of preference for either grazer in feeding experiments. These results indicate that algae may be well-equipped to benefit from moderate increases in seawater pCO2, but they exhibit species-specific rates of growth and phenolic production, which in turn affect their appeal to a generalist algivore. Intertidal algal communities will therefore face altered patterns of predation under future ocean acidification conditions as generalist algivores adjust to new variation in algal palatability

Konjunkturschlaglicht: Geldpolitik deutlich expansiv

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Konjunkturschlaglicht: EZB-Leitzinsen unverändert

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