Emergency Bleeding Control Interventions After Immediate Total-Body CT Scans in Trauma Patients

Background: Immediate total-body CT (iTBCT) is often used for screening of potential severely injured patients. Patients requiring emergency bleeding control interventions benefit from fast and optimal trauma screening. The aim of this study was to assess whether an initial trauma assessment with iTBCT is associated with lower mortality in patients requiring emergency bleeding control interventions. Methods: In the REACT-2 trial, patients who sustained major trauma were randomized for iTBCT or for conventional imaging and selective CT scanning (standard workup; STWU) in five trauma centers. Patients who underwent emergency bleeding control interventions following their initial trauma assessment with iTBCT were compared for mortality and clinically relevant time intervals to patients that underwent the initial trauma assessment with the STWU. Results: In the REACT-2 trial, 1083 patients were enrolled of which 172

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

On the generation of mean fields by small-scale electron magnetohydrodynamics turbulence

The problem of the generation of mean magnetic fields by small-scale turbulence within the framework of electron magnetohydrodynamics (EMHD) is considered. Two EMHD models are investigated, a two and one-half dimensional (2½D) model in which the magnetic field has all three spatial components but, due to a strong external field, depends only on two coordinates, and a fully three-dimensional (3D) model with an imposed stationary and homogeneous magnetic field. It is shown that in the case of 2½D turbulence two possible mechanisms are responsible for the generation of mean magnetic fields. The first one is similar to the a-effect in the MHD dynamo problem and is due to a nonzero helicity of the turbulence. The second one is related to the anisotropy of the turbulence, which can give rise to negative dissipation (resistivity, viscosity) of the mean field. The influence of electron inertia on the above effects is analyzed. Inertia results in a qualitative modification of the helicity effects and may lead to a change in sign of the turbulent viscosity. The criteria for the generation of mean magnetic fields are obtained. In the case of the 3D model, the generation of large-scale helicons by the small-scale helicon turbulence is studied within the framework of the adiabatic approximation. A closed set of equations for the evolution of both the magnetic field of the large-scale helicon and of the generalized action of the small-scale turbulence is obtained. The criterion for the resonant instability of a large-scale helicon due to its interaction with small-scale helicon turbulence is obtained

On self-induced transparency in laser-plasma interactions

We study fully relativistic nonlinear one-dimensional equations describing steady-state solutions for an electromagnetic wave interacting with a plasma in the self-induced transparency regime. In addition to the well-known solution that corresponds to the transmission of the electromagnetic wave into plasma, another steady-state solution is shown to exist in a certain range of amplitudes of the wave. The latter solution corresponds to total reflection of the incident wave. The coexistence of the two solutions indicates the possibility of hysteretic behavior in the self-induced transparency