The Need for Near-Earth Multi-Spacecraft Heliospheric Measurements and an Explorer Mission to Investigate Interplanetary Structures and Transients in the Near-Earth Heliosphere.

Based on decades of single-spacecraft measurements near 1 au as well as data from heliospheric and planetary missions, multi-spacecraft simultaneous measurements in the inner heliosphere on separations of 0.05-0.2 au are required to close existing gaps in our knowledge of solar wind structures, transients, and energetic particles, especially coronal mass ejections (CMEs), stream interaction regions (SIRs), high speed solar wind streams (HSS), and energetic storm particle (ESP) events.

ACR Appropriateness Criteria® Head Trauma: 2021 Update.

Head trauma (ie, head injury) is a significant public health concern and is a leading cause of morbidity and mortality in children and young adults. Neuroimaging plays an important role in the management of head and brain injury, which can be separated into acute (0-7 days), subacute (<3 months), then chronic (>3 months) phases. Over 75% of acute head trauma is classified as mild, of which over 75% have a normal Glasgow Coma Scale score of 15, therefore clinical practice guidelines universally recommend selective CT scanning in this patient population, which is often based on clinical decision rules.

The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist.

With the emergence of work-related musculoskeletal disorders and the associated high cost of injured workers, physical therapists are in a unique position to help employers manage these concerns through multidisciplinary injury prevention programs, education, ergonomics, on-site treatment, and return to work programs. The purpose of this paper, through a review of the literature, is to describe the effect that workplace injuries have on employees and the economic burden on employers. Furthermore, this paper will highlight the effectiveness a physical therapist can have in the occupational health setting as part of a multidisciplinary team on ergonomics, employee health, prevention of work-related musculoskeletal disorders, return to work programs, and on-site treatment interventions, such as therapeutic exercise and manual intervention.

Neurosurgical Coverage for Emergency and Trauma Call.

Traditionally, neurosurgeons have responded to calls to treat new patients or address emergent, acute neurosurgical pathology in the hospitals they staff as part of their duty to the medical profession and community. Due to increasing financial pressures placed upon neurosurgical practice from hospitals and regulatory mandates, remuneration for neurosurgeon availability to serve on trauma call has become more frequent and is increasingly seen as essential. In this study, we present the first peer-review published survey of neurosurgical emergency and trauma call coverage patterns, scope, schedules, compensation, liability exposure, and call cessation.

Factors associated with burnout among US neurosurgery residents: a nationwide survey.

OBJECTIVEExcessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, burnout has garnered much attention in recent years. Using a national survey, the authors formally evaluated burnout among neurosurgery trainees.

ACR Appropriateness Criteria Head Trauma.

Neuroimaging plays an important role in the management of head trauma. Several guidelines have been published for identifying which patients can avoid neuroimaging. Noncontrast head CT is the most appropriate initial examination in patients with minor or mild acute closed head injury who require neuroimaging as well as patients with moderate to severe acute closed head injury.

Orbital invasion by ACTH-secreting pituitary adenomas.

Orbital invasion by pituitary tumors is rare. To the best of the authors' knowledge, adrenocorticotrophin (ACTH)-secreting pituitary tumors with orbital invasion have not been described in MEDLINE indexed literature. The authors report 2 cases of ACTH-secreting tumors with orbital invasion.

Expert credibility in climate change.

Although preliminary estimates from published literature and expert surveys suggest striking agreement among climate scientists on the tenets of anthropogenic climate change (ACC), the American public expresses substantial doubt about both the anthropogenic cause and the level of scientific agreement underpinning ACC. A broad analysis of the climate scientist community itself, the distribution of credibility of dissenting researchers relative to agreeing researchers, and the level of agreement among top climate experts has not been conducted and would inform future ACC discussions. Here, we use an extensive dataset of 1,372 climate researchers and their publication and citation data to show that (i) 97-98% of the climate researchers most actively publishing in the field surveyed here support the tenets of ACC outlined by the Intergovernmental Panel on Climate Change, and (ii) the relative climate expertise and scientific prominence of the researchers unconvinced of ACC are substantially below that of the convinced researchers.

Incidence of unsuspected blunt carotid artery injury.

Objective: This study attempts to document the incidence of unsuspected blunt carotid artery injury (BCI) in a prospective series of consecutive blunt trauma patients undergoing angiographic evaluation of the aorta. Previous studies have included mainly patients who became symptomatic from BCI, thus documenting a "detected incidence."

Methods: During a 22-month period, all patients undergoing angiographic evaluation of the aorta after blunt trauma who were not felt to be at increased risk for BCI were included in the screening protocol.

Magnetic resonance imaging: utilization in the management of central nervous system trauma.

Objective: To determine the availability, use, and perceived value of magnetic resonance imaging (MR) in the management of acute central nervous system (CNS) trauma in United States Level I (or equivalent) trauma centers (TCs).

Design, Materials, And Methods: One hundred sixty-nine American College of Surgeons, state or locally designated Level I (or equivalent) TCs were identified using compiled lists and telephone contacts. Surveys about MR use in CNS trauma were mailed to each institution.

Mild traumatic brain injuries in low-risk trauma patients.

Background: Moderate or severe traumatic brain injury (TBI) resulting from cranial trauma is usually easily recognizable. Mild TBI (MTBI), however, may escape detection at presentation because of delayed symptoms and the absence of radiographic abnormalities. Despite its subtle or delayed presentation, the spectrum of symptoms often experienced after MTBI, collectively referred to as "postconcussive syndrome," may cause serious psychosocial dysfunction.

Spine and spinal cord injuries in downhill skiers.

Spine and spinal cord injuries are the most debilitating and costly of serious injuries sustained by downhill skiers. We present a series of 126 skiers with spine and spinal cord injuries drawn from 636 consecutive injured skiers evaluated at one center over an 11-year period. The incidence of spinal injury was very low (0.

Severe snowboarding injuries.

Thirty-seven consecutive patients with severe snowboard-related injuries (defined by referral to a Level I trauma centre) were reviewed. The type and mechanism of each injury were examined and found to be similar to those reported for skiers. Mild closed head injuries were common (54 per cent).

Rhabdomyolysis following spinal cord injury: case report.

Rhabdomyolysis is commonly seen in association with multisystem trauma. We report an unexpected case of rhabdomyolysis and subsequent renal insufficiency after spinal cord injury unassociated with acute muscular injury. Immobilization, in conjunction with mild systemic hypoperfusion, was the suspected cause.

Traumatic brain injury associated with an intradiploic epidermoid cyst: case report.

We present a case of an intradiploic epidermoid cyst with an unusual complication. After a minor fall, a patient with a large right parietal epidermoid suffered a traumatic brain injury caused by the transfer of the force of the fall through the cyst contents to the brain and by transdural herniation of the cyst contents into brain parenchyma. Elective resection of intradiploic epidermoids associated with large bony defects is recommended to avoid this apparently rare but potentially dangerous complication of an otherwise benign condition.

Elevated intracranial pressure masks hemorrhagic hypotension in a canine model.

Previous clinical studies of blunt trauma patients with severe brain injuries have demonstrated that emergency department vital signs failed to consistently identify life-threatening abdominal injury. One hypothesis to explain this is that bradycardia and systemic hypertension from brainstem injury (the Cushing response) may mask the tachycardia and hypotension ordinarily manifested by hemorrhagic hypovolemia. This would result in inappropriately normal or near-normal emergency department vital signs for otherwise clinically apparent hypovolemia.

Intracranial malignant germ cell tumor and the Klinefelter syndrome. Case report and review of the literature.

A case of intracranial mixed malignant germ cell tumor (GCT) in a patient with the Klinefelter syndrome (KS) is reported. Extragonadal GCTs, including those of intracranial origin, have previously been noted in KS patients. A review of the English literature suggests that although this phenomenon is rare, there appears to be more than a coincidental relationship between GCTs and a 47,XXY karyotype.

Early definitive abdominal evaluation in the triage of unconscious normotensive blunt trauma patients.

The need for simultaneous diagnosis and treatment of life-threatening intracranial mass lesions and intra-abdominal injury results in controversy over the appropriate triage of unconscious blunt trauma patients with stable vital signs. To aid in early decisions for these patients, a retrospective analysis of 290 patients with Glasgow Coma Scale (GCS) scores < or = 8 and systolic blood pressures (SBP) > 90 mm Hg was undertaken. The hypothesis of this study was that life-threatening abdominal injury frequently occurs in these patients and injuries cannot be consistently identified from vital signs alone.

The effectiveness of cosmetic products in alleviating a range of skin dryness conditions as determined by clinical and instrumental techniques.

Synopsis A vast array of cosmetic products are used routinely by consumers to alleviate a range of skin care problems. Consumer concern ranges from age-associated skin changes to complexion (e.g.