Biomechanics of the Toddler Head During Low-height Falls: An Anthropomorphic Dummy Analysis Laboratory Investigation

OBJECT Falls are the most common environmental setting for closed head injuries in children between 2 and 4 years of age. The authors previously found that toddlers had fewer skull fractures and scalp/facial soft-tissue injuries, and more frequent altered mental status than infants for the same low-height falls (≤3 ft). METHODS To identify potential age-dependent mechanical load factors that may be responsible for these clinical findings, the authors created an instrumented dummy representing an 18-month-old child using published toddler anthropometry and mechanical properties of the skull and neck, and they measured peak angular acceleration during low-height falls (1, 2, and 3 ft) onto carpet pad and concrete. They compared these results from occiput-first impacts to previously obtained values measured in a 6-week-old infant dummy. RESULTS Peak angular acceleration of the toddler dummy head was largest in the sagittal and horizontal directions and increased significantly (around 2-fold) with fall height between 1 and 2 ft. Impacts onto concrete produced larger peak angular accelerations and smaller impact durations than those onto carpet pad. When compared with previously measured infant drops, toddler head accelerations were more than double those of the infant from the same height onto the same surface, likely contributing to the higher incidence of loss of consciousness reported in toddlers. Furthermore, the toddler impact forces were larger than those in the infant, but because of the thicker toddler skull, the risk of skull fracture from low-height falls is likely lower in toddlers compared with infants. CONCLUSIONS If similar fracture limits and brain tissue injury thresholds between infants and toddlers are assumed, it is expected that for impact events, the toddler is likely less vulnerable to skull fracture but more vulnerable to neurological impairment compared with the infant

Biomechanics of Toddler Head During Low-height Falls: An Anthorpomorphic Dummy Analysis

Object. Falls are the most common environmental setting for closed head injuries in children between 2 and 4 years of age. The authors previously found that toddlers had fewer skull fractures and scalp/facial soft-tissue injuries, and more frequent altered mental status than infants for the same low-height falls (≤ 3 ft). Methods. To identify potential age-dependent mechanical load factors that may be responsible for these clinical findings, the authors created an instrumented dummy representing an 18-month-old child using published toddler anthropometry and mechanical properties of the skull and neck, and they measured peak angular acceleration during low-height falls (1, 2, and 3 ft) onto carpet pad and concrete. They compared these results from occiput-first impacts to previously obtained values measured in a 6-week-old infant dummy. Results. Peak angular acceleration of the toddler dummy head was largest in the sagittal and horizontal directions and increased significantly (around 2-fold) with fall height between 1 and 2 ft. Impacts onto concrete produced larger peak angular accelerations and smaller impact durations than those onto carpet pad. When compared with previously measured infant drops, toddler head accelerations were more than double those of the infant from the same height onto the same surface, likely contributing to the higher incidence of loss of consciousness reported in toddlers. Furthermore, the toddler impact forces were larger than those in the infant, but because of the thicker toddler skull, the risk of skull fracture from low-height falls is likely lower in toddlers compared with infants. Conclusions. If similar fracture limits and brain tissue injury thresholds between infants and toddlers are assumed, it is expected that for impact events, the toddler is likely less vulnerable to skull fracture but more vulnerable to neurological impairment compared with the infant

Influence of Age and Fall Type on Head Injuries in Infants and Toddlers

Age-based differences in fall type and neuroanatomy in infants and toddlers may affect clinical presentations and injury patterns. Objective Our goal is to understand the influence of fall type and age on injuries to help guide clinical evaluation. Design/Setting/Participants Retrospectively, 285 children 0–48 months with accidental head injury from a fall and brain imaging between 2000 and 2006 were categorized by age (infan ≤ 1 year and toddler = 1–4 years) and fall type: low (≤3 ft), intermediate (\u3e3 andft), high height falls (≥10 ft) and stair falls. Outcome Measures Clinical manifestations were noted and head injuries separated into primary (bleeding) and secondary (hypoxia, edema). The influence of age and fall type on head injuries sustained was evaluated. Results Injury patterns in children scores, infants sustained more skull fractures than toddlers (71% vs. 39%). Of children with skull fractures, 11% had no evidence of scalp/facial soft tissue swelling. Of the patients with primary intracranial injury, 30% had no skull fracture and 8% had neither skull fracture nor cranial soft tissue injury. Low height falls resulted in primary intracranial injury without soft tissue or skull injury in infants (6%) and toddlers (16%). Conclusions Within a given fall type, age-related differences in injuries exist between infants and toddlers. When interpreting a fall history, clinicians must consider the fall type and influence of age on resulting injury. For young children, intracranial injury is not always accompanied by external manifestations of their injury

Embracing aporia: exploring arts-based methods, pain, “playfulness,” and improvisation in research on gender and social violence

This article explores the role of play and playfulness—as both methodological and analytical tools—in research on social violence. While play may seem antithetical to both discussions on methods and to studying social violence, we found that actually paying attention to such elements was in fact very productive. This article draws on a series of participatory workshops that engaged theater, dance, and comedy, which were held in Sierra Leone in 2021 that explored various social dimensions of sexual and gender-based violence in rural communities. The “fun” components that are so frequently dismissed in favor of more flat and binary research helped us better understand the complex, and often painful, emotions of women in these communities. We pay particular attention to how singing, which was not originally part of the research plan, became critical to engaging these women on discussions of social violence. We argue that researchers should be more aware and open to the prospects that “play,” “fun,” and improvisation have to offer in research processes, and how such components can themselves be absolutely critical to how we conduct and analyze research, as well as engage with participants, even in relation to sensitive subject matter. Le présent article s'intéresse au rôle du jeu et de la gaieté, à la fois en tant qu'outils méthodologiques et analytiques, dans la recherche sur la violence sociale. Alors que le jeu peut paraître antithétique par rapport aux discussions sur les méthodes et l’étude de la violence sociale, nous avons observé qu'il était finalement très productif de s'y intéresser. Cet article se fonde sur une série d'ateliers participatifs impliquant le théâtre, la danse et l'humour, qui se sont déroulés en Sierra Leone en 2021. Ils traitaient de plusieurs dimensions sociales de la violence sexuelle et fondée sur le genre au sein des communautés rurales. Les composantes « amusantes », si souvent balayées en faveur de recherches plus monotones et binaires, nous ont permis de mieux comprendre les émotions complexes, et souvent douloureuses, des femmes de ces communautés. Nous nous sommes notamment attardés sur la façon dont le chant, qui ne faisait initialement pas partie du programme de recherche, s'est révélé essentiel pour entrer en communication avec ces femmes au sujet des violences sociales. Nous soutenons que les chercheurs devraient être plus conscients des possibilités offertes par le « jeu », l’« amusement » et l'improvisation dans le cadre des procédés de recherche, et ouverts à celles-ci. Ces composantes peuvent en fait se révéler tout à fait essentielles dans la conduite et l'analyse de recherches, mais aussi pour s'adresser aux participants, même quand il s'agit de sujets sensibles. Este artículo analiza el papel del juego y la capacidad para jugar como herramientas metodológicas y analíticas en la investigación sobre la violencia social. Si bien el juego puede parecer antitético en el marco tanto de las discusiones sobre los métodos como del estudio de la violencia social, hemos descubierto que prestar atención a estos elementos es, de hecho, muy productivo. Este artículo se basa en una serie de talleres participativos que se celebraron en Sierra Leona en 2021, en los que se utilizó el teatro, la danza y la comedia y en los que se exploraron diversas dimensiones sociales de la violencia sexual y de género en las comunidades rurales. Los componentes «divertidos», que tan frecuentemente se descartan en favor de una investigación más plana y binaria, nos ayudaron a comprender mejor las complejas, y a menudo dolorosas, emociones de las mujeres de estas comunidades. Prestamos especial atención a cómo el canto, que en un principio no formaba parte del plan de investigación, se convirtió en algo fundamental para involucrar a estas mujeres en los debates sobre la violencia social. Sostenemos que los investigadores deberían ser más conscientes y estar más abiertos a las perspectivas que ofrecen el «juego», la «diversión» y la improvisación en los procesos de investigación, y cómo estos componentes pueden ser en sí mismos absolutamente críticos para la forma en que realizamos y analizamos la investigación, así como para relacionarnos con los participantes, incluso en relación con temas delicados

Planetary Candidates Observed by Kepler, III: Analysis of the First 16 Months of Data

New transiting planet candidates are identified in sixteen months (May 2009 - September 2010) of data from the Kepler spacecraft. Nearly five thousand periodic transit-like signals are vetted against astrophysical and instrumental false positives yielding 1,091 viable new planet candidates, bringing the total count up to over 2,300. Improved vetting metrics are employed, contributing to higher catalog reliability. Most notable is the noise-weighted robust averaging of multi-quarter photo-center offsets derived from difference image analysis which identifies likely background eclipsing binaries. Twenty-two months of photometry are used for the purpose of characterizing each of the new candidates. Ephemerides (transit epoch, T_0, and orbital period, P) are tabulated as well as the products of light curve modeling: reduced radius (Rp/R*), reduced semi-major axis (d/R*), and impact parameter (b). The largest fractional increases are seen for the smallest planet candidates (197% for candidates smaller than 2Re compared to 52% for candidates larger than 2Re) and those at longer orbital periods (123% for candidates outside of 50-day orbits versus 85% for candidates inside of 50-day orbits). The gains are larger than expected from increasing the observing window from thirteen months (Quarter 1-- Quarter 5) to sixteen months (Quarter 1 -- Quarter 6). This demonstrates the benefit of continued development of pipeline analysis software. The fraction of all host stars with multiple candidates has grown from 17% to 20%, and the paucity of short-period giant planets in multiple systems is still evident. The progression toward smaller planets at longer orbital periods with each new catalog release suggests that Earth-size planets in the Habitable Zone are forthcoming if, indeed, such planets are abundant.Comment: Submitted to ApJS. Machine-readable tables are available at http://kepler.nasa.gov, http://archive.stsci.edu/kepler/results.html, and the NASA Exoplanet Archiv

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Probiotic Bacteria Induce a ‘Glow of Health’

Radiant skin and hair are universally recognized as indications of good health. However, this ‘glow of health’ display remains poorly understood. We found that feeding of probiotic bacteria to aged mice induced integumentary changes mimicking peak health and reproductive fitness characteristic of much younger animals. Eating probiotic yogurt triggered epithelial follicular anagen-phase shift with sebocytogenesis resulting in thick lustrous fur due to a bacteria-triggered interleukin-10-dependent mechanism. Aged male animals eating probiotics exhibited increased subcuticular folliculogenesis, when compared with matched controls, yielding luxuriant fur only in probiotic-fed subjects. Female animals displayed probiotic-induced hyperacidity coinciding with shinier hair, a feature that also aligns with fertility in human females. Together these data provide insights into mammalian evolution and novel strategies for integumentary health