Ultrasound Identification of Retrobulbar Hematomas by Emergency Physicians in a Cadaveric Model

Introduction: Retrobulbar hemorrhage (RBH) is a rare complication of facial trauma that can lead to dangerous orbital compartment pressures and must be rapidly recognized to prevent permanent vision loss. Point-of-care ultrasound (POCUS) offers a rapid modality for evaluating a wide variety of ocular pathologies, and prior case reports demonstrate the ability of clinicians to recognize RBH using ultrasound. This study aimed to assess the ability of clinicians at various stages of training to identify a RBH using POCUS in a cadaveric model. Clinicians also were assessed for self-reported comfort using ultrasound for ocular pathology before and after the study.Methods: Participants included 17 physicians who evaluated 10 eyes (from five cadavers) that were independently randomized to have either a modeled RBH or no hemorrhage. Participants’ final diagnosis of each eye was recorded (RBH present or not), and participants also completed pre- and post-activity surveys.Results: The overall sensitivity and specificity to correctly diagnose retrobulbar fluid was 87% and 88%, respectively. Sensitivity and specificity were higher after excluding clinicians in their early phase of training. Additionally, self-reported comfort level with ocular ultrasound was significantly improved by this activity.Conclusion: Emergency physicians at a variety of training levels can correctly identify a cadaveric model of retrobulbar hemorrhage. Use of this cadaveric model can improve exposure of clinicians to the appearance of a rare but vision-threatening ocular pathology such as RBH

An Association of the Transgenerational Implications of Redlining and Obesity on Pediatric Type II Diabetes

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated that the presence of detracting neighborhood elements was strongly associated with food insecurity and perceived safety. Binary logistic regression analyses, controlling for sex, age, and race/ethnicity, showed a 23% (OR = 1.230; 95% CI, 1.151-1.315), 34.8% (OR = 1.348; 95% CI, 1.209-1.505), and 48.5% (OR = 1.485; 95% CI, 1.300-1.696) increase in odds of obesity in respondents who live in areas with one, two, and all three detracting elements, respectively. Controlling for the same variables and socioeconomic status, there was a 90.4% (OR = 1.904; 95% CI, 1.203-3.016) and 80.5% (OR = 1.805; 95 CI, 1.017-3.203) increase in odds of T2DM among those who resided in a neighborhood with two and all three detracting neighborhood elements, respectively. Predictors of T2DM were overweight/obese BMI, 12–17 years old, living with grandparents, food insecure, and living in a neighborhood with the presence of two detracting elements. Implications for positive social change include understanding the relationship between location, policy and health outcomes that can foster health equity and social justice

An Association of the Transgenerational Implications of Redlining and Obesity on Pediatric Type II Diabetes

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated that the presence of detracting neighborhood elements was strongly associated with food insecurity and perceived safety. Binary logistic regression analyses, controlling for sex, age, and race/ethnicity, showed a 23% (OR = 1.230; 95% CI, 1.151-1.315), 34.8% (OR = 1.348; 95% CI, 1.209-1.505), and 48.5% (OR = 1.485; 95% CI, 1.300-1.696) increase in odds of obesity in respondents who live in areas with one, two, and all three detracting elements, respectively. Controlling for the same variables and socioeconomic status, there was a 90.4% (OR = 1.904; 95% CI, 1.203-3.016) and 80.5% (OR = 1.805; 95 CI, 1.017-3.203) increase in odds of T2DM among those who resided in a neighborhood with two and all three detracting neighborhood elements, respectively. Predictors of T2DM were overweight/obese BMI, 12–17 years old, living with grandparents, food insecure, and living in a neighborhood with the presence of two detracting elements. Implications for positive social change include understanding the relationship between location, policy and health outcomes that can foster health equity and social justice

A Deeper Look at the New Milky Way Satellites: Sagittarius II, Reticulum II, Phoenix II, and Tucana III

We present deep Magellan/Megacam stellar photometry of four recently discovered faint Milky Way satellites: Sagittarius II (Sgr II), Reticulum II (Ret II), Phoenix II (Phe II), and Tucana III (Tuc III). Our photometry reaches ~2-3 magnitudes deeper than the discovery data, allowing us to revisit the properties of these new objects (e.g., distance, structural properties, luminosity measurements, and signs of tidal disturbance). The satellite color-magnitude diagrams show that they are all old (~13.5 Gyr) and metal-poor ([Fe/H]$\lesssim-2.2$). Sgr II is particularly interesting as it sits in an intermediate position between the loci of dwarf galaxies and globular clusters in the size-luminosity plane. The ensemble of its structural parameters is more consistent with a globular cluster classification, indicating that Sgr II is the most extended globular cluster in its luminosity range. The other three satellites land directly on the locus defined by Milky Way ultra-faint dwarf galaxies of similar luminosity. Ret II is the most elongated nearby dwarf galaxy currently known for its luminosity range. Our structural parameters for Phe II and Tuc III suggest that they are both dwarf galaxies. Tuc III is known to be associated with a stellar stream, which is clearly visible in our matched-filter stellar density map. The other satellites do not show any clear evidence of tidal stripping in the form of extensions or distortions. Finally, we also use archival HI data to place limits on the gas content of each object.Comment: Accepted for publication in ApJ. Minor updates to match accepted versio

Study of low-pass and high-pass RC filters by means of a circuit for signal superposition

Apresentamos nesse trabalho, um experimento realizado nos Laboratórios didáticos do Instituto de Física da USP, relacionado ao estudo do funcionamento de filtros RC para baixas e altas freqüências. Para tal, foi especialmente projetado um circuito que efetua a superposição de um sinal gerado internamente, a uma onda senoidal externa. Várias situações experimentais podem ser geradas, por meio da variação da freqüência, tanto do sinal interno quanto da onda senoidal externa. Um estudo das componentes de freqüência de Fourier é também realizado para se estabelecer os parâmetros de funcionamento dos filtros. O funcionamento dos circuitos como integradores e diferenciadores também é explorado. Os estudantes são, portanto, levados a compreender a eficácia desses filtros mais simples, dependendo das freqüências dos sinais de entrada e correspondentes componentes de Fourier, e das freqüências de corte estabelecidas.In this work we present an experiment performed in the undergraduate laboratories at the University of São Paulo Physics Institute. It is related to the study of low-pass and high-pass RC filters. For this purpose, we designed and constructed a circuit for the superposition of an internally generated signal and an external sinusoidal signal. An investigation of the Fourier frequency components is also performed in order to establish working parameters for the RC filters. The operation of the circuits as integrators and differentiators is also explored. The students are therefore led to understand how efficient these circuits can be depending on the frequency and Fourier components of the entrance signals, as well as the cutoff frequencies previously defined

A Bayes linear Bayes method for estimation of correlated event rates

Typically, full Bayesian estimation of correlated event rates can be computationally challenging since estimators are intractable. When estimation of event rates represents one activity within a larger modeling process, there is an incentive to develop more efficient inference than provided by a full Bayesian model. We develop a new subjective inference method for correlated event rates based on a Bayes linear Bayes model under the assumption that events are generated from a homogeneous Poisson process. To reduce the elicitation burden we introduce homogenization factors to the model and, as an alternative to a subjective prior, an empirical method using the method of moments is developed. Inference under the new method is compared against estimates obtained under a full Bayesian model, which takes a multivariate gamma prior, where the predictive and posterior distributions are derived in terms of well-known functions. The mathematical properties of both models are presented. A simulation study shows that the Bayes linear Bayes inference method and the full Bayesian model provide equally reliable estimates. An illustrative example, motivated by a problem of estimating correlated event rates across different users in a simple supply chain, shows how ignoring the correlation leads to biased estimation of event rates

Signatures of Tidal Disruption in Ultra-Faint Dwarf Galaxies: A Combined HST, Gaia, and MMT/Hectochelle Study of Leo V

The ultra-faint dwarf galaxy Leo V has shown both photometric overdensities and kinematic members at large radii, along with a tentative kinematic gradient, suggesting that it may have undergone a close encounter with the Milky Way. We investigate these signs of disruption through a combination of i) high-precision photometry obtained with the Hubble Space Telescope (HST), ii) two epochs of stellar spectra obtained with the Hectochelle Spectrograph on the MMT, and iii) measurements from the Gaia mission. Using the HST data, we examine one of the reported stream-like overdensities at large radii, and conclude that it is not a true stellar stream, but instead a clump of foreground stars and background galaxies. Our spectroscopic analysis shows that one known member star is likely a binary, and challenges the membership status of three others, including two distant candidates that had formerly provided evidence for overall stellar mass loss. We also find evidence that the proposed kinematic gradient across Leo V might be due to small number statistics. We update the systemic proper motion of Leo V, finding $(\mu_\alpha \cos\delta, \mu_\delta)= (0.009\pm0.560$, $-0.777\pm0.314)$ mas yr$^{-1}$, which is consistent with its reported orbit that did not put Leo V at risk of being disturbed by the Milky Way. These findings remove most of the observational clues that suggested Leo V was disrupting, however, we also find new plausible member stars, two of which are located >5 half-light radii from the main body. These stars require further investigation. Therefore, the nature of Leo V still remains an open question.Comment: Higher resolution figures are available upon request. Submitted to the Ap

Functional coexistence of twin arsenic resistance systems in Pseudomonas putida KT2440

The genome of the soil bacterium Pseudomonas putida KT2440 bears two virtually identical arsRBCH operons putatively encoding resistance to inorganic arsenic species. Single and double chromosomal deletions in each of these ars clusters of this bacterium were tested for arsenic sensitivity and found that the contribution of each operon to the resistance to the metalloid was not additive, as either cluster sufficed to endow cells with high-level resistance. However, otherwise identical traits linked to each of the ars sites diverged when temperature was decreased. Growth of the various mutants at 15°C (instead of the standard 30°C for P. putida) uncovered that ars2 affords a much higher resistance to As (III) than the ars1 counterpart. Reverse transcription polymerase chain reaction of arsB1 and arsB2 genes as well as lacZ fusions to the Pars1 and Pars2 promoters traced the difference to variations in transcription of the corresponding gene sets at each temperature. Functional redundancy may thus be selected as a stable condition - rather than just as transient state - if it affords one key activity to be expressed under a wider range of physicochemical settings. This seems to provide a straightforward solution to regulatory problems in environmental bacteria that thrive under changing scenarios.This study was supported by the BIO program of the Spanish Ministry of Economy and Competitiveness (MINECO), the ST-FLOW and ARISYS Contracts of the EU, the ERANET-IB Program and the PROMT Project of the Autonomous Community of Madrid.Peer reviewe