Surgical Management of Penetrating Carotid Artery Injury: Preoperative Level of Consciousness Does Matter.

Background: The optimal surgical management of penetrating carotid artery injuries (PCAIs) remains controversial. This study aimed to examine the association between operative techniques for PCAI and the incidence of stroke.

Study Design: This retrospective cohort study used the American College of Surgeons TQIP (2016 to 2021) database.

Building Geriatric Trauma Programs in Resource-Constrained Environments: Trauma Quality Improvement Program Guideline Implementation at Two Safety Net Hospitals in Southern California.

To improve care of geriatric trauma patients, the American College of Surgeons (ACS) Trauma Quality Improvement Program (TQIP) updated guidelines in 2021. Amid geriatrician shortages in Southern California, 2 Los Angeles County safety net hospitals were tasked with creating a strategy to meet geriatric trauma guidelines despite constrained resources. All trauma patients ≥ 60 years admitted to a safety net hospital in Southern California were enrolled without exclusions (August 2022-April 2023).

Thoracic irrigation for prevention of secondary intervention after thoracostomy tube drainage for hemothorax: A Western Trauma Association multicenter study.

Background: Retained hemothorax (rHTX) requiring intervention occurs in up to 20% of patients who undergo chest tube (TT) placement for a hemothorax (HTX). Thoracic irrigation at the time of TT placement decreases the need for secondary intervention in this patient group but those findings are limited because of the single-center design. A multicenter study was conducted to evaluate the effectiveness of thoracic irrigation.

Non-Binary Trauma Patients: Delineating a Vulnerable, At-Risk Population.

Introduction: An increasing proportion of the population identifies as non-binary. This marginalized group may be at differential risk for trauma compared to those who identify as male or female, but physical trauma among non-binary patients has not yet been examined at a national level.

Methods: All patients aged ≥ 16 years in the National Trauma Data Bank were included (2021-2022).

Physiologic parameters and radiologic findings can predict pulmonary complications and guide management in traumatic rib fractures.

Background: Traumatic rib fracture is associated with a high morbidity rate and identifying patients at risk of developing pulmonary complications (PC) can guide management and potentially decrease unnecessary intensive care admissions. Therefore, we sought to assess and compare the utility of a physiologic parameter, vital capacity (VC), with the admission radiologic findings (RibScore) in predicting PC in patients with rib fractures.

Methods: This is a single-center retrospective review (2015-2018) of all adult (≥18 years) patients admitted to a Level I trauma center with traumatic rib fracture.

Repeated boat noise exposure damages inner ear sensory hair cells and decreases hearing sensitivity in Atlantic croaker (Micropogonias undulatus).

Anthropogenic noise is becoming a major underwater pollutant because of rapidly increasing boat traffic worldwide. But its impact on aquatic organisms remains largely unknown. Previous studies have focused mainly on high-frequency and impulsive noises (i.

Trauma surgeon-performed peripheral arterial repairs are associated with equivalent outcomes when compared with vascular surgeons.

Background: Civilian extremity trauma with vascular injury carries a significant risk of morbidity, limb loss, and mortality. We aim to describe the trends in extremity vascular injury repair and compare outcomes between trauma and vascular surgeons.

Methods: We performed a single-center retrospective review of patients 18 years or older with extremity vascular injury requiring surgical intervention between January 2009 and December 2019.

Use of regional analgesia and risk of delirium in older adults with multiple rib fractures: An Eastern Association for the Surgery of Trauma multicenter study.

Background: Single-center data demonstrates that regional analgesia (RA) techniques are associated with reduced risk of delirium in older patients with multiple rib fractures. We hypothesized that a similar effect between RA and delirium would be identified in a larger cohort of patients from multiple level I trauma centers.

Methods: Retrospective data from seven level I trauma centers were collected for intensive care unit (ICU) patients 65 years or older with ≥3 rib fractures from January 2012 to December 2016.

Bowel Ischemia Score Predicts Early Operation in Patients With Adhesive Small Bowel Obstruction.

Background: Nonoperative management of adhesive small bowel obstruction (SBO) is successful in up to 80% of patients. Current recommendations advocate for computed tomography (CT) scan in all patients with SBO to supplement surgical decision-making. The hypothesis of this study was that cumulative findings on CT would predict the need for operative intervention in the setting of SBO.

Politics, water management and infrastructure.

While modern water management has been central to the achievement of a range of beneficial social outcomes, it has increasingly drawn criticism for its disconnection from democratic decision-making, hindering efforts to develop more resilient systems. This paper examines how an experiment with more resilient water infrastructure politicized centralized water management focusing, in particular, on a stormwater re-use 'third-pipe' system at a large residential development in Auckland, New Zealand. Through analysis of resident and expert views on safety, cost and security, the paper attends (1) to the ways in which techno-managerial water management was contested and, thus, politicized through the implementation of the third pipe, and (2) how the mobilization of techno-managerial discourses by water management authorities delegitimized the third-pipe system, rendering it ultimately inoperable.

Ketamine infusion for pain control in elderly patients with multiple rib fractures: Results of a randomized controlled trial.

Background: Rib fractures are associated with increased mortality, particularly in the elderly. While opiate-based pain regimens remain the cornerstone of rib fracture management, issues related to opioids have driven research into alternative analgesics. Adjunctive ketamine use in lieu of opioids continues to increase but little evidence exists to support its efficacy or safety within the elderly trauma population.

Observing pneumothoraces: The 35-millimeter rule is safe for both blunt and penetrating chest trauma.

Background: As more pneumothoraxes (PTX) are being identified on chest computed tomography (CT), the empiric trigger for tube thoracostomy (TT) versus observation remains unclear. We hypothesized that PTX measuring 35 mm or less on chest CT can be safely observed in both penetrating and blunt trauma mechanisms.

Methods: A retrospective review was conducted of all patients diagnosed with PTX by chest CT between January 2011 and December 2016.

Relative size variation of the otoliths, swim bladder, and Weberian apparatus structures in piranhas and pacus (Characiformes: Serrasalmidae) with different ecologies and its implications for the detection of sound stimuli.

The Weberian apparatus of otophysan fishes confers acute hearing that is hypothesized to allow these fishes to assess the environment and to find food resources. The otophysan family Serrasalmidae (piranhas and pacus) includes species known to feed on falling fruits and seeds (frugivore/granivores) that splash in rivers, herbivorous species associated with torrents and rapids (rheophiles), and carnivores that feed aggressively within shoals. Relevant sound stimuli may vary among these ecological groups and hearing may be tuned to different cues among species.

Guidance on Lu-DOTATATE Peptide Receptor Radionuclide Therapy from the Experience of a Single Nuclear Medicine Division.

Lu-DOTATATE is a radiolabeled somatostatin analog that has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors in adults.

Hearing capacities and morphology of the auditory system in Serrasalmidae (Teleostei: Otophysi).

Like all otophysan fishes, serrasalmids (piranhas and relatives) possess a Weberian apparatus that improves their hearing capacities. We compared the hearing abilities among eight species of serrasalmids having different life-history traits: herbivorous vs. carnivorous and vocal vs.

Operative team communication during simulated emergencies: Too busy to respond?

Background: Ineffective communication among members of a multidisciplinary team is associated with operative error and failure to rescue. We sought to measure operative team communication in a simulated emergency using an established communication framework called "closed loop communication." We hypothesized that communication directed at a specific recipient would be more likely to elicit a check back or closed loop response and that this relationship would vary with changes in patients' clinical status.

Unusual sound production mechanism in the triggerfish Rhinecanthus aculeatus (Balistidae).

The ability to produce sound has been known for decades in Balistidae. Sounds of many species have been recorded and a variety of sound-producing mechanisms have been proposed, including teeth stridulation, collision of the buccal teeth and movements of the fins. The best-supported hypothesis involves movements of the pectoral fin against the lateral part of the swimbladder, called a drumming membrane.

Variation in swim bladder drumming sounds from three doradid catfish species with similar sonic morphologies.

A variety of teleost fishes produce sounds for communication by vibrating the swim bladder with fast contracting muscles. Doradid catfishes have an elastic spring apparatus (ESA) for sound production. Contractions of the ESA protractor muscle pull the anterior transverse process of the 4th vertebra or Müllerian ramus (MR) to expand the swim bladder and elasticity of the MR returns the swim bladder to the resting state.

Diversity and evolution of sound production in the social behavior of Chaetodon butterflyfishes.

Fish produce context-specific sounds during social communication, but it is not known how acoustic behaviors have evolved in relation to specializations of the auditory system. Butterflyfishes (family Chaetodontidae) have a well-defined phylogeny and produce pulsed communication sounds during social interactions on coral reefs. Recent work indicates that two sound production mechanisms exist in the bannerfish clade and that other mechanisms are used in the Chaetodon clade, which is distinguished by an auditory specialization, the laterophysic connection (LC).

Sound pressure enhances the hearing sensitivity of Chaetodon butterflyfishes on noisy coral reefs.

Butterflyfishes are conspicuous members of coral reefs that communicate with acoustic signals during social interactions with mates and other conspecifics. Members of the genus Chaetodon have a laterophysic connection (LC) - a unique association of anterior swim bladder horns and the cranial lateral line - but the action of the LC system on auditory sensitivity is unexplored. Here, we show in baseline auditory evoked potential threshold experiments that Forcipiger flavissimus (which lacks swim bladder horns and LC) is sensitive to sound tones from 100 Hz up to 1000 Hz, and that thresholds for three species of Chaetodon are 10-15 dB lower, with extended hearing ranges up to 1700-2000 Hz.

Sound production to electric discharge: sonic muscle evolution in progress in Synodontis spp. catfishes (Mochokidae).

Elucidating the origins of complex biological structures has been one of the major challenges of evolutionary studies. Within vertebrates, the capacity to produce regular coordinated electric organ discharges (EODs) has evolved independently in different fish lineages. Intermediate stages, however, are not known.

A superfast muscle in the complex sonic apparatus of Ophidion rochei (Ophidiiformes): histological and physiological approaches.

In teleosts, superfast muscles are generally associated with the swimbladder wall, whose vibrations result in sound production. In Ophidion rochei, three pairs of muscles were named 'sonic' because their contractions affect swimbladder position: the dorsal sonic muscle (DSM), the intermediate sonic muscle (ISM), and the ventral sonic muscle (VSM). These muscles were investigated thanks to electron microscopy and electromyography in order to determine their function in sound production.

Modifications in call characteristics and sonic apparatus morphology during puberty in Ophidion rochei (Actinopterygii: Ophidiidae).

Juveniles, females, and males of Ophidion rochei share similar external morphology, probably because they are mainly active in the dark, which reduces the role of visual cues. Their internal sonic apparatuses, however, are complex: three pairs of sonic muscles, and highly modified vertebrae and ribs are involved in sound production. The sonic apparatus of males differs from juveniles and females in having larger swimbladder plates (modified ribs associate with the swimbladder wall) and sonic muscles, a modified swimbladder shape and a mineralized structure called the "rocker bone" in front of the swimbladder.

Sound production mechanism in Gobius paganellus (Gobiidae).

Gobiidae, the largest fish family (>1500 species), has species from at least 10 genera that produce sounds for communication. Studies focused on goby sound production mechanisms have suggested that sounds are produced by the forcible ejection of water through small apertures in the opercles (hydrodynamic mechanism). The present study was a multidisciplinary investigation (morphology, muscle histology, high-speed video, sound analysis and electromyography) of the sound emission mechanism in Gobius paganellus, which produces both pulsed and tonal calls.