Early Surgery for Traumatic Spinal Cord Injury: Where Are We Now?

Study Design: Narrative review. Objective: There is a strong biological rationale to perform early decompression after traumatic spinal cord injury (SCI). With an enlarging clinical evidence base, most spine surgeons internationally now favor early decompression for the majority of SCI patients; however, a number of pertinent questions remain surrounding this therapy. Methods: A narrative review evaluating the status of early surgery for SCI. In particular, we addressed the following questions: (1) Which patients stand to benefit most from early surgery? 2) What is the most appropriate time threshold defining early surgery? Results: Although heterogeneity exists, the evidence generally seems to support early surgery. While the best evidence exists for cervical SCI, there is insufficient data to support a differential effect for early surgery depending on neurological level or injury severity. When comparing thresholds to define early versus late surgery-including a later threshold (48-72 hours), an earlier threshold (24 hours), and an ultra-early threshold (8-12 hours)-the 2 earlier time points seem to be associated with the greatest potential for improved outcomes. However, existing prehospital and hospital logistics pose barriers to early surgery in a significant proportion of patients. An overview of recommendations from the recent AOSpine guidelines is provided. Conclusion: In spite of increasing acceptance of early surgery post SCI, further research is needed to (1) identify subgroups of patients who stand to derive particular benefit-in particular to develop more evidence-based approaches for central cord syndrome and (2) investigate the efficacy and feasibility of ultra-early surgery targeting more aggressive timelines

Prevalence and associated harm of engagement in self-Asphyxial behaviours ('choking game') in young people:A systematic review

OBJECTIVE: To assess the prevalence of engagement in self-asphyxial (risk-taking) behaviour (SAB) (‘choking game’) and associated morbidity and mortality in children and young people up to age 20. DESIGN: Systematic literature review. SEARCH STRATEGY: Electronic database search of MEDLINE, Embase, PsycINFO, CINAHL, PubMed, Web of Science Core Collection, BIOSIS citation index and the Cochrane register with no language or date limits applied. References of key papers were reviewed, and experts were contacted to identify additional relevant papers. ELIGIBILITY CRITERIA: Systematic reviews, cross-sectional, cohort and case–control studies, and case reports examining SAB with regard to individuals aged 0–20 years, without explicitly stated autoerotic, suicidal or self-harm intentions were included. RESULTS: Thirty-six relevant studies were identified, and SAB was reported in 10 countries. In North America, France and Colombia, awareness of SAB ranged from 36% to 91% across studies/settings, and the median lifetime prevalence of engagement in SAB was 7.4%. Six studies identified the potential for SAB to be associated with engagement in other risk behaviours. Ninety-nine fatal cases were reported. Of the 24 cases described in detail, most occurred when individuals engaged in SAB alone and used a ligature. CONCLUSIONS: The current evidence on SAB among young people is limited, and stems predominantly from North America and France. Awareness of SAB among young people is high, and engagement varies by setting. Further research is needed to understand the level of risk and harm associated with SAB, and to determine the appropriate public health response

Infrared spectroscopy of cataclysmic variables: III. Dwarf novae below the period gap and novalike variables

We present K-band spectra of the short-period dwarf novae YZ Cnc, LY Hya, BK Lyn, T Leo, SW UMa and WZ Sge, the novalike variables DW UMa, V1315 Aql, RW Tri, VY Scl, UU Aqr and GP Com, and a series of field dwarf stars with spectral types ranging from K2-M6. The spectra of the dwarf novae are dominated by emission lines of HI and HeI. The large velocity and equivalent widths of these lines, in conjunction with the fact that the lines are double-peaked in the highest inclination systems, indicate an accretion disc origin. In the case of YZ Cnc and T Leo, for which we obtained time-resolved data covering a complete orbital cycle, the emission lines show modulations in their equivalent widths which are most probably associated with the bright spot (the region where the gas stream collides with the accretion disc). There are no clear detections of the secondary star in any of the dwarf novae below the period gap, yielding upper limits of 10-30% for the contribution of the secondary star to the observed K-band flux. In conjunction with the K-band magnitudes of the dwarf novae, we use the derived secondary star contributions to calculate lower limits to the distances to these systems. The spectra of the novalike variables are dominated by broad, single-peaked emission lines of HI and HeI - even the eclipsing systems we observed do not show the double-peaked profiles predicted by standard accretion disc theory. With the exception of RW Tri, which exhibits NaI, CaI and 12CO absorption features consistent with a M0V secondary contributing 65% of the observed K-band flux, we find no evidence for the secondary star in any of the novalike variables. The implications of this result are discussed.Comment: 13 pages, 5 figures, to appear in MNRA

Miniaturized Ultraviolet Imager Phase III

This document details the work to date, June 9, 2020, done by the Cal Poly Mechanical Engineering senior project team, Miniaturized Ultraviolet Imager: Phase III (MUVI III), sponsored by the University of California, Berkeley – Space Sciences Laboratory (UCB SSL). MUVI III is the third senior project team of an ongoing design, MUVI: the prototype of a 2U sized CubeSat intended to capture aurora images in the ionosphere. The first team, MUVI I, finished development of the UV imager. The second team, MUVI II, designed the mirror mounting and deployable door mechanisms. The goal of MUVI phase III is to design, manufacture, and test MUVI’s 2U sized instrumentation frame, Photek UV camera mounting flexure, and ground support test fixture modeled after a P-POD. The instrumentation frame serves as an optical alignment datum, provides structural integrity, and dampens vibrations for the satellite. The instrumentation frame must survive launch and the thermal vacuum of space, have minimal mass, and comply with budgetary needs. Furthermore, the instrumentation frame shall fulfill the 2U size specification as detailed by CubeSat. Using FEA (Finite Element Analysis), the effects of vibrational loads will be modeled and accounted for. During launch, the instruments within the frame will face dynamic motion, risking failure of electronics, mechanical yielding, and overall mission demise. Boundary conditions will be replicated on ground by mimicking the mass of the Photek on the mounting flexure and by inserting the instrumentation frame into a replica P-Pod (Poly-Picosatellite) OGODS (On Ground Orbital Deployer Simulator) before beginning vibration testing. Once modeling has provided adequate confidence in the design, UCB SSL will manufacture the designed prototype components, and the assembled prototype will undergo vibration testing at Cal Poly. Ultimately, the mission of this project is to qualify the MUVI instrumentation frame for a TRL 6 rating from NASA. The main body of this document includes an introduction to the project, background information, project objectives, preliminary research and documentation, initial design ideas and concepts, final design, manufacturing plans, design verification plans, sponsor wants and needs, details about project management, Quality Function Development (QFD), and a project Gantt chart

The Quiescent Spectrum of the AM CVn star CP Eri

We used the 6.5m MMT to obtain a spectrum of the AM CVn star CP Eri in quiescence. The spectrum is dominated by He I emission lines, which are clearly double peaked with a peak-to-peak separation of ~1900 km/s. The spectrum is similar to that of the longer period AM CVn systems GP Com and CE 315, linking the short and the long period AM CVn systems. In contrast with GP Com and CE 315, the spectrum of CP Eri does not show a central 'spike' in the line profiles, but it does show lines of SiII in emission. The presence of these lines indicates that the material being transferred is of higher metallicity than in GP Com and CE 315, which, combined with the low proper motion of the system, probably excludes a halo origin of the progenitor of CP Eri. We constrain the primary mass to M_1>0.27 M_sun and the orbital inclination to 33 degr < i < 80 degr. The presence of the He I lines in emission opens up the possibility for phase resolved spectroscopic studies which allows a determination of the system parameters and a detailed study of helium accretion disks under highly varying circumstances.Comment: 12 pages, 2 figures, accepted for publication in ApJ Letter

Mapping the contribution of Allied Health Professions to the wider public health workforce : a rapid review of evidence-based interventions

Objectives: The objective was to identify a selection of the best examples of the public health contributions by Allied Health Professionals (AHPs) in order to encourage a wider awareness and participation from that workforce to public health practice. Study design: A mapping exercise was used to identify evidence-based interventions that could lead to health improvements across a population. Methods: A rapid review was undertaken to identify evidence, followed by a survey of Allied Health Profession (AHP) practitioners and an expert panel consensus method to select the examples of AHP public health interventions. Results: Nine evidence-based interventions are identified and selected as examples of current AHP good practice. These examples represent a contribution to public health and include screening interventions, secondary prevention and risk management. Conclusions: This study contributes to a strategy for AHPs in public health by appraising the effectiveness and impact of some exemplar AHP practices that contribute to health improvement. There is a need for AHPs to measure the impact of their interventions and to demonstrate evidence of outcomes at population level. Keywords: allied health professions; Applied Health Professionals; evidence-based practice; health improvement; public health; rapid revie