Evidence-based guidelines for bleeding in trauma patients: where do we go from here?

The development of evidence-based guidelines has gained popularity as a strategy to reduce variation in practice and to orient clinical care around documentable best practices. Based on available data, the new European guidelines for the management of bleeding in the trauma patient do deliver a number of sound recommendations. However, some issues remain controversial and, like many guidelines, the actual translation of these evidence-based recommendations into routine clinical practice protocols continues to leave opportunity for variation. Nevertheless, this consensus guideline provides an excellent starting point. As evidence continues to accumulate, future iterations should provide greater specificity and move us closer to the definitive best practice

Manufacturing and Testing of Ceramic Based Hybrid Composites with Various Fibers, Matrix Systems, and Processing Conditions.

M.S. Thesis. University of Hawaiʻi at Mānoa 2018

The spectrum of Platonic graphs over finite fields

AbstractWe give a decomposition theorem for Platonic graphs over finite fields and use this to determine the spectrum of these graphs. We also derive estimates for the isoperimetric numbers of the graphs

Macroeconomic trends and practice models impacting acute care surgery

Acute care surgery (ACS) diagnoses are responsible for approximately a quarter of the costs of inpatient care in the US government, and individuals will be responsible for a larger share of the costs of this healthcare as the population ages. ACS as a specialty thus has the opportunity to meet a significant healthcare need, and by optimizing care delivery models do so in a way that improves both quality and value. ACS practice models that have maintained or added emergency general surgery (EGS) and even elective surgery have realized more operative case volume and surgeon satisfaction. However, vulnerabilities exist in the ACS model. Payer mix in a practice varies by geography and distribution of EGS, trauma, critical care, and elective surgery. Critical care codes constitute approximately 25% of all billing by acute care surgeons, so even small changes in reimbursement in critical care can have significant impact on professional revenue. Staffing an ACS practice can be challenging depending on reimbursement and due to uneven geographic distribution of available surgeons. Empowered by an understanding of economics, using team-oriented leadership inherent to trauma surgeons, and in partnership with healthcare organizations and regulatory bodies, ACS surgeons are positioned to significantly influence the future of healthcare in the USA

Fluorescent Polystyrene Films for the Detection of Volatile Organic Compounds Using the Twisted Intramolecular Charge Transfer Mechanism

Thin films of styrene copolymers containing fluorescent molecular rotors were demonstrated to be strongly sensitive to volatile organic compounds (VOCs). Styrene copolymers of 2-[4-vinyl(1,1'-biphenyl)-4'-yl]-cyanovinyljulolidine (JCBF) were prepared with different P(STY-co-JCBF)(m) compositions (m% = 0.10-1.00) and molecular weights of about 12,000 g/mol. Methanol solutions of JCBF were not emissive due to the formation of the typical twisted intramolecular charge transfer (TICT) state at low viscosity regime, which formation was effectively hampered by adding progressive amounts of glycerol. The sensing performances of the spin-coated copolymer films (thickness of about 4 µm) demonstrated significant vapochromism when exposed to VOCs characterized by high vapour pressure and favourable interaction with the polymer matrix such as THF, CHCl₃ and CH₂Cl₂. The vapochromic response was also reversible and reproducible after successive exposure cycles, whereas the fluorescence variation scaled linearly with VOC concentration, thus suggesting future applications as VOC optical sensors

Zero Textbook Cost Syllabus for COM 3078 (Group Communication)

This course focuses on small-group communication in private, public, and business settings. Topics include types and functions of groups, group-communication theory, issues of power and trust in group communication, effective communication in face-to-face and virtual teams, group conflict, group cohesiveness and team-building, and communication strategies for collaborative problem-solving and decision-making. The format of the course is designed so you will have the opportunity to develop and practice your group communication skills. Therefore, the goal is to provide you with new perspectives on the process of group and team communication, as well as increased options for communicating effectively in group and team settings. You will take part in student-facilitated discussion, group/team interaction and projects, lectures, and individual assignments. This course relies heavily on self-initiated learning and is enhanced by group interaction and personal reflection

LEADERSHIP CONCERNS: DISCURSIVE FRAMING WITHIN THE DISENGAGEMENT/GROWTH PHASE OF A SMALL BUSINESS

Small businesses are an integral part of the U.S. workforce. Leaders of small businesses are often presented with opportunities to communicate the changes and transitions that occur as a small business grows. This research assesses the process of leader sensegiving and employee sensemaking through the use of framing as a discursive resource within the context of a small business. A qualitative approach, capturing 27 in-depth interviews assesses the framing-to-sensemaking overlap in a small business setting. Results indicate that framing and sensemaking unfold as a process: either as a harmonious framing-to-sensemaking outcome or a discordant framing-to-sensemaking outcome

Imidazole-Fused Enediynes by Selective C5–C4 Alkynylations of 4,5-Dibromoimidazoles

An efficient synthesis of symmetrical 1,2-disubstituted 4,5-dialkynylimidazoles by Sonogashira alkynylation of the corresponding 4,5-dibromo derivatives was developed. Moreover, through a careful tuning of the palladium ligand, unsymmetrical 1,2-disusbtituted 4,5-dialkynylimidazoles were also prepared through a regioselective C5 alkynylation of 4,5-dibromoimidazoles, followed by a second alkynylation involving the 4-bromo derivatives so obtained. This interesting class of imidazole-fused enediynes is also able to give thermal Bergman cycloaromatization (BC), as proved by DSC experiments

Vapochromic features of new luminogens based on julolidine-containing styrene copolymers

We report on vapochromic films suitable for detecting volatile organic compounds (VOCs), based on new polystyrene copolymers containing julolidine fluorescent molecular rotors (JCAEM). Poly(styrene-co-hydroxyethylmethacrylate) copolymers functionalized with cyanovinyl-julolidine moieties of different compositions were prepared, (P(STY-co-JCAEM)(m) with m = 0.06-0.61). The sensing performance of the spin-coated copolymer films demonstrated significant vapochromism when exposed to VOCs characterized by high vapour pressure and a favourable interaction with the polymer matrix, such as Et2O and CH2Cl2. It is worth mentioning that the fluorescence decrease rate was 7 times faster than that of previously investigated julolidine-based fluorescent molecular rotors dispersed in PS films. This phenomenon was attributed to the better control of the JCAEM moiety distribution in the polymer matrix conferred by the covalent approach, combined with a minimal film thickness of 4 microns. These factors, in concert, strongly accelerate the deactivation pathways of the JCAEM units in the presence of VOCs which interact well. Overall, the present results support the use of julolidine-enriched styrene copolymers as effective chromogenic materials suitable for the fast detection of VOCs