Compressible laminar streaks with wall suction

Peer reviewedPublisher PD

Implementation of Pediatric Emergency Care Applied Research Network (PECARN) guidelines for traumatic brain injury in a rural tertiary care center

Objectives: To evaluate changes in imaging practices for pediatric head trauma following publication of the Pediatric Emergency Care Applied Research Network (PECARN) guidelines, explore areas for quality improvement regarding neuroradiology referrals. We also sought to determine the prevalence of incidental findings discovered on CTs attained for minor head trauma and ascertain disposition in these cases. Methods: This retrospective study was conducted at a rural academic center and included 156 children who received CTs for head trauma between 2005 and 2015. Subjects were divided into two groups: pre-PECARN publication and post-PECARN publication. Electronic medical records were reviewed to determine whether or not head CTs were obtained according to PECARN guidelines. The proportion of scanned cases and incidental findings in each group were then compared. Results: Significantly more subjects met PECARN criteria for head CT during the pre-PECARN period (67.1% vs 50.6%, p=0.04). Among those who met PECARN criteria, severe mechanism of injury was the most common criterion met in both groups (43.8% pre-PECARN and 26.5% post-PECARN). Nine (5.7%) subjects had incidental findings (similar for both study periods), of which three prompted additional diagnostic testing or invasive intervention. Among those who did not meet PECARN criteria, the most common mechanism of injury was fall (\u3c 3 feet). Conclusions: Implementation of PECARN guidelines at our center remained limited in the five years after publication of this practice guide. Clinically insignificant incidental findings were often detected and may heighten patient anxiety

A dynamical model of a GRID market

We discuss potential market mechanisms for the GRID. A complete dynamical model of a GRID market is defined with three types of agents. Providers, middlemen and users exchange universal GRID computing units (GCUs) at varying prices. Providers and middlemen have strategies aimed at maximizing profit while users are 'satisficing' agents, and only change their behavior if the service they receive is sufficiently poor or overpriced. Preliminary results from a multi-agent numerical simulation of the market model shows that the distribution of price changes has a power law tail.Comment: 4 pages, 3 figure

Meeting India’s future water needs: policy options

River basinsWater shortageWater transferGroundwater irrigationWater productivity