The Use of Ultrasound as an Adjunct to X-Ray For the Localization and Removal of Soft Tissue Foreign Bodies in an Urgent Care Setting

Embedded soft tissue foreign bodies are common complaints of patients presenting to rural urgent care centers. The removal of soft tissue foreign bodies present challenges for the healthcare provider when objects are radiolucent and cannot be identified on readily available diagnostic imaging modalities such as plain radiographs (X-rays). Ultrasound has been introduced in the literature as a useful adjunct to X-rays for the localization and removal of soft tissue foreign bodies. The purpose of this research utilization project was to report the use of bedside ultrasound by healthcare providers as an adjunct to X-ray for the localization and removal of foreign bodies in soft tissue wounds among patients presenting to an urgent care setting. A total of 45 patients\u27 medical records were selected for this retrospective chart review. Patients\u27 ages ranged from two to 88 years with a mean age of 39 years. The selected patients in the chart review underwent soft tissue foreign body removal with the use of X-ray alone (N=24), ultrasound and X-ray (N=8), and without the use of X-ray or ultrasound (N=13). Medical records of the three groups of patients were compared for the following variables: time from the onset of the foreign body removal procedure to patient discharge; the location of the foreign body and time of removal to discharge; and types of foreign body material and time for removal to discharge. X-ray alone detected 10 of 24 soft tissue foreign bodies with a removal time to patient discharge of 22 minutes. X-ray and ultrasound in parallel detected all 8 soft tissue foreign bodies with a removal time to patient discharge of 19 minutes. Without diagnostic imaging 13 soft tissue foreign bodies were detected with blind probing by the provider with a removal time to patient discharge of 16 minutes. Pertinent comparisons also yielded pain as the most common presenting symptom associated with an embedded soft tissue foreign body while the finger was the most commonly affected anatomical location. Wooden foreign body material required the greatest extraction time compared to metal and glass. In this research utilization project, the implementation of ultrasound as an adjunct to X-ray for the localization and removal of soft tissue foreign bodies had favorable outcomes when used to remove both radiolucent and radiopaque objects compared to X-ray alone in the urgent care setting

Comment on "Evidence for dark matter in the inner Milky Way"

This is a brief rebuttal to arXiv:1502.03821, which claims to provide the first observational proof of dark matter interior to the solar circle. We point out that this result is not new, and can be traced back at least a quarter century.Comment: 3 pages, 2 figures. In this version we add a figure from a 1998 paper that shows the same result that arXiv:1502.03821 claims to be novel. We also add a short note rebutting arXiv:1503.08784 which was written in response to the first versio

A case study in leveraging strategic partnerships through trust-based philanthropy

This practice note highlights a case study of leveraging strategic partnerships through trust-based philanthropy, a set of practices rooted in values, relationship building, mutual learning, and equity. It describes the motivations, planning, and execution of a symposium organized by, and held for, a Foundation and four of its grantees. The symposium led to the development of sustained pathways between and among the partners, resulting in productive collaborations and shared projects. This case study is shared to illustrate the argument that it is the responsibility of funders, and certainly in their self-interest, to eliminate competition between organizations to whom they provide financial resources and support. By facilitating trust and collaboration, funders are uniquely positioned to foster collective, higher-impact work. © 2024 The Authors. Journal of Philanthropy and Marketing published by John Wiley & Sons Ltd

Effect of Population III Multiplicity on Dark Star Formation

We numerically study the mutual interaction between dark matter (DM) and Population III (Pop III) stellar systems in order to explore the possibility of Pop III dark stars within this physical scenario. We perform a cosmological simulation, initialized at z ~ 100, which follows the evolution of gas and DM. We analyze the formation of the first minihalo at z ~ 20 and the subsequent collapse of the gas to densities of 10^12 cm^-3. We then use this simulation to initialize a set of smaller-scale `cut-out' simulations in which we further refine the DM to have spatial resolution similar to that of the gas. We test multiple DM density profiles, and we employ the sink particle method to represent the accreting star-forming region. We find that, for a range of DM configurations, the motion of the Pop III star-disk system serves to separate the positions of the protostars with respect to the DM density peak, such that there is insufficient DM to influence the formation and evolution of the protostars for more than ~ 5000 years. In addition, the star-disk system causes gravitational scattering of the central DM to lower densities, further decreasing the influence of DM over time. Any DM-powered phase of Pop III stars will thus be very short-lived for the typical multiple system, and DM will not serve to significantly prolong the life of Pop III stars.Comment: 16 pages, 11 figures, to appear in MNRA

The Formation of the First Massive Black Holes

Supermassive black holes (SMBHs) are common in local galactic nuclei, and SMBHs as massive as several billion solar masses already exist at redshift z=6. These earliest SMBHs may grow by the combination of radiation-pressure-limited accretion and mergers of stellar-mass seed BHs, left behind by the first generation of metal-free stars, or may be formed by more rapid direct collapse of gas in rare special environments where dense gas can accumulate without first fragmenting into stars. This chapter offers a review of these two competing scenarios, as well as some more exotic alternative ideas. It also briefly discusses how the different models may be distinguished in the future by observations with JWST, (e)LISA and other instruments.Comment: 47 pages with 306 references; this review is a chapter in "The First Galaxies - Theoretical Predictions and Observational Clues", Springer Astrophysics and Space Science Library, Eds. T. Wiklind, V. Bromm & B. Mobasher, in pres

Galaxy Formation Theory

We review the current theory of how galaxies form within the cosmological framework provided by the cold dark matter paradigm for structure formation. Beginning with the pre-galactic evolution of baryonic material we describe the analytical and numerical understanding of how baryons condense into galaxies, what determines the structure of those galaxies and how internal and external processes (including star formation, merging, active galactic nuclei etc.) determine their gross properties and evolution. Throughout, we highlight successes and failings of current galaxy formation theory. We include a review of computational implementations of galaxy formation theory and assess their ability to provide reliable modelling of this complex phenomenon. We finish with a discussion of several "hot topics" in contemporary galaxy formation theory and assess future directions for this field.Comment: 58 pages, to appear in Physics Reports. This version includes minor corrections and a handful of additional reference

Dental biofilm: ecological interactions in health and disease.

BACKGROUND: The oral microbiome is diverse and exists as multispecies microbial communities on oral surfaces in structurally and functionally organized biofilms. AIM: To describe the network of microbial interactions (both synergistic and antagonistic) occurring within these biofilms and assess their role in oral health and dental disease. METHODS: PubMed database was searched for studies on microbial ecological interactions in dental biofilms. The search results did not lend themselves to systematic review and have been summarized in a narrative review instead. RESULTS: Five hundred and forty-seven original research articles and 212 reviews were identified. The majority (86%) of research articles addressed bacterial-bacterial interactions, while inter-kingdom microbial interactions were the least studied. The interactions included physical and nutritional synergistic associations, antagonism, cell-to-cell communication and gene transfer. CONCLUSIONS: Oral microbial communities display emergent properties that cannot be inferred from studies of single species. Individual organisms grow in environments they would not tolerate in pure culture. The networks of multiple synergistic and antagonistic interactions generate microbial inter-dependencies and give biofilms a resilience to minor environmental perturbations, and this contributes to oral health. If key environmental pressures exceed thresholds associated with health, then the competitiveness among oral microorganisms is altered and dysbiosis can occur, increasing the risk of dental disease

Hydrologic controls on basin-scale distribution of benthic invertebrates

Streamflow variability is a major determinant of basin-scale distributions of benthic invertebrates. Here we present a novel procedure based on a probabilistic approach aiming at a spatially explicit quantitative assessment of benthic invertebrate abundance as derived from near-bed flow variability. Although the proposed approach neglects ecological determinants other than hydraulic ones, it is nevertheless relevant in view of its implications on the predictability of basin-scale patterns of organisms. In the present context, aquatic invertebrates are considered, given that they are widely employed as sensitive indicators of fluvial ecosystem health and human-induced perturbations. Moving from the analytical characterization of site-specific probability distribution functions of streamflow and bottom shear stress, we achieve a spatial extension to an entire stream network. Bottom shear stress distributions, coupled with habitat suitability curves derived from field studies, are used to produce maps of invertebrate suitability to shear stress conditions. Therefore, the proposed framework allows one to inspect the possible impacts on river ecology of human-induced perturbations of streamflow variability. We apply this framework to an Austrian river network for which rainfall and streamflow time series, river network hydraulic properties, and local information on invertebrate abundance for a limited number of sites are available. A comparison between observed species density versus modeled suitability to shear stress is also presented. Although the proposed strategy focuses on a single controlling factor and thus represents an ecological minimal model, it allows derivation of important implications for water resource management and fluvial ecosystem protection. Key Points Hydrologic variability is a major control of invertebrate habitat suitability New analytical basin-scale approach for pdfs of ecohydrological key features Austrian river basin used for ecohydrological data-model compariso

Reducing the Effects of Aging on Cognition with Therapeutic Intervention of an Oral multi‐Nutrient combination (REACTION): Study Design and Baseline Results

Background Alzheimer’s Disease (AD) is the most common cause of dementia, and the risk of developing AD increases with age. Age‐related cognitive decline (ARCD) refers to the cognitive changes that can occur in individuals because of aging. Research suggests that the underlying mechanism behind ARCD is a loss of synaptic plasticity and altered dendritic spine morphology. Similarly, the cognitive changes in AD are also thought to arise from impaired synaptic plasticity and dendritic spine loss. Souvenaid, contains a specific combination of precursors and cofactors for phospholipid biosynthesis, and has shown beneficial effects on memory, cognition, and brain atrophy in prodromal AD. In addition, data from this previous study imply a stronger effect would be expected in participants at earlier stages of prodromal AD. To test the effect of Souvenaid in ARCD, the REACTION (Reducing the Effects of Aging on Cognition with Therapeutic Intervention of an Oral multi‐Nutrient combination) pilot study was developed. Method REACTION1 is a 6‐month single‐center randomized, double‐blind placebo‐controlled pilot clinical trial. The study factors in local COVID‐19 restrictions and is conducted fully virtually. Participants will be aged 55‐89 with ARCD, and screened and randomized to the oral multi‐nutrient combination (Souvenaid) or placebo on a 1:1 basis. The main outcome of this trial is feasibility (recruitment rate and time, adherence rate and retention rate). Other outcomes include memory (e.g. Ray Verbal Learning Task), cognition (e.g. Oral Trail Making Test), and quality of life (e.g. Amsterdam IADL Questionnaire) outcome measures. Result Of 141 inquiries over 7 months, 60 eligible participants were recruited. 54 were successfully screened for randomization. As of 3 Feb 2022, 47 participants have been randomized to placebo or Souvenaid (6 are awaiting randomization, 1 withdrew prior to randomization.) Detailed baseline characteristics of the study population will be presented at the meeting, including descriptive statistics on demographics and the inclusion criteria such as the RBANS, MoCA and SCD 9‐item brief screening tool score. Conclusion With the rapidly growing prevalence of ARCD and limited pharmacological curative treatment options currently available, nutritional interventions may potentially play an important role to prevent or delay the onset of ARCD. 1. Clinicaltrial.gov identifier: NCT0414762