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Is There a Need for Abdominal CT Scan in Trauma Patients With a Low-Risk Mechanism of Injury and Normal Vital Signs?
Background Clinically significant injuries are often missed in trauma patients with low-risk mechanisms of injury and lack of \"red flags,\" such as abnormal vital signs. The purpose of this retrospective analysis was to evaluate the efficacy of computed axial tomography (CT) for identifying occult injuries in a high-volume trauma center. Methods Records from our institutional trauma registry were retrospectively extracted, examining encounters from January 2015 to October 2019. Those patients between the ages of 18 and 65 who were referred to the trauma team with a CT scan of the abdomen and had low-risk mechanisms of injury, a Glasgow Coma Scale (GCS) score of 15, and normal vital signs at presentation were included. Patients in the lowest trauma categorization (Level Three, Consult) met the study definition for the low-risk mechanism of injury. Demographic and clinical data were abstracted for all patients. For this analysis, patients were divided into two groups based on age (18 - 40 years or 40 - 65 years). Injuries found on CT, their clinical significance, and the likelihood of being missed without CT were determined. Results Of 2,103 blunt trauma patients that received a CT scan of the abdomen from January 2015 to October 2019, 134/2,103 (6.4%) met the inclusion criteria (mean age: 44.6 years; 72.3% male). Patients between the ages of 40 and 65 years comprised 61.2% (82/134) of the study population. Of the included patients, 17.2% (23/134) had at least one acute traumatic injury identified after CT imaging of the torso. Occult injuries found on CT included rib fracture with associated lung injuries (10/23, 43.5%), splenic laceration (4/23, 17.4%), liver laceration (3/23, 13.0%), gluteal hematoma with active bleeding (1/23, 4.3%), sternal fractures (3/23, 13.0%), and thoracic or lumbar spine fractures (2/23, 8.7%). An independent review of the medical records determined that 9.0% (12/134) of these patients had traumatic injuries that would have been missed based on clinical examination without CT. Conclusions Based on our experience, utilizing CT imaging of at least the abdomen as a routine screening measure for all trauma consults - even low-risk patients with normal vital signs - can rapidly and accurately identify clinically significant injuries that would have been otherwise missed in a notable portion of the population.
Journal Article
Mind the gap: technology, millennial leadership and the cross-generational workforce
It comes as no surprise that different generations respond to and utilise emerging technology in vastly different ways. However as more Millennials take on leadership positions within academic libraries, their attitudes towards and uses of technology may bring conflicting expectations for leadership to the forefront. What are the generational traits and motivations of the Millennial and how will they manifest themselves as a style of leadership? What are some areas of tension arising from Millennial leadership and technology utilisation, and what steps can the Millennial leader take to alleviate such tension? Written by a Millennial who became a Dean of University Libraries at the age of 29, this article explores the challenges faced by the Millennial leader and the inherent opportunities for growth at both the personal and the organisational levels.
Journal Article
Academic Libraries and High-Impact Practices for Student Retention: Library Deans’ Perspectives
Numerous studies on retention have highlighted the role of student engagement in influencing students’ withdrawal decisions. This study seeks to address how academic libraries affect student retention by examining the perception of academic library deans or directors on the alignment between library services and resources with ten nationally validated high-impact practices (HIPs). This study used a survey distributed to the academic library deans and directors of public master’s universities in the United States. A positive correlation was found between library instruction, library facilities, and library collections with each of the HIPs.
Journal Article
Overlap, overdetermination, and the necessity of origin
Proponents of the necessity of material origins hold roughly that an entity’s originating matter could not have been radically different from its actual originating matter. Sungil Han defends the considerably stronger position that an entity’s originating matter could not have been at all different from its actual originating matter. I raise some worries for Han’s key premise as it pertains to biological origins, and discuss certain methodological limitations of Han’s project as it pertains to the origins of artifacts.
Journal Article
Examining information exchange and virtual communities: an emergent framework
Purpose - The purpose of this paper is to present an emergent conceptual framework for examining virtual communities.Design methdodology approach - Established theories and models of community, social networks, information exchange, and information sharing behaviours are explored with the goal of determining their usefulness in conceptualising virtual communities.Findings - Explored theories and models are inter-related and expanded to form a tiered conceptual framework for examining virtual communities. This framework also acknowledges the affective contexts in which virtual communities operate.Practical implications - The presented conceptual framework may inform information professionals tasked with creating, maintaining, and improving corporate, educational, research, and other information systems. It may also be of use to researchers who seek to build theory that attempts to explain phenomena observable in virtual communities.Originality value - In contrast to models and frameworks which focus on analysing individual components and attributes of virtual communities, the presented framework provides a holistic starting point for understanding inter-related structural, cognitive, behavioural and affective dimensions of online communities
Journal Article
The role of informal communication in building shared understanding of non-functional requirements in remote continuous software engineering
Building a shared understanding of non-functional requirements (NFRs) is a known but understudied challenge in requirements engineering, primarily in organizations that adopt continuous software engineering (CSE) practices. During the peak of the COVID-19 pandemic, many CSE organizations complied with working remotely due to the imposed health restrictions; many organizations continue to work remotely while implementing business processes to facilitate team communication and productivity. In remote CSE organizations, managing NFRs becomes more challenging due to the limitations of team communication. While previous research has identified the factors that lead to a lack of shared understanding of NFRs in CSE, we still have a significant gap in understanding how CSE organizations, particularly in remote work, build a shared understanding of NFRs. We conduct a 6-month ethnography-informed case study of a remote CSE organization. We identify a number of practices for building a shared understanding of NFRs, such as validating NFRs through feedback. We also studied the practices of remote collaboration and in particular, the use and affordances offered by the collaborative workspace Gather that the organization used for remote interaction; our findings suggest that it allows for informal communications instrumental for building shared understanding. In addition, we describe the limitations to building a shared understanding of NFRs in the organization, such as gaps in communication and the limited understanding of customer context. Furthermore, we conducted further interviews to validate our findings for relevance and to gain additional insights into the shared understanding of NFRs within the organization. As actionable insights, we discuss our findings in light of proactive practices that represent opportunities for software organizations to invest in building a shared understanding of NFRs in their development.
Journal Article
32 Determining the feeding value of corn gluten feed relative to corn when supplemented to beef calves grazed on stockpiled tall fescue pastures
This experiment compared the performance response of supplementing corn gluten feed (CGF) or corn to calves grazing stockpiled tall fescue pastures over a 70-d period. Forty-four Angus x Simmental calves (238 ± 4 kg) were stratified across 6 treatments by BW and sex in a 2 x 3 factorial arrangement. Calves were supplemented cracked corn (n = 16) or CGF (n = 18). Calves were housed in 2 pastures and supplemented individually using the SmartFeed Pro feeding system, with all treatments represented in each pasture. Supplement DMI was programmed at 0.59, 0.87, or 1.13% BW. Calves which failed to train to the feeding system (n = 10) were treated as an un-supplemented control. Weight and flesh condition score (FCS) were recorded every 14-d, and ultrasound 12th rib fat thickness (FT) was measured on d 0 and 70. Data were analyzed with PROC GLM in SAS with supplement type as a main effect, sex as a fixed effect, and group as a random effect. Individual supplement DMI was included in the model as a covariate rather than a main effect due to high variation. Significance was defined at P ≤ 0.05 and means were separated using LSD. Initial BW, FCS, and FT were similar (P ≥ 0.12) among treatments. No differences (P ≥ 0.25) were observed in supplement DMI throughout the experiment. No differences (P ≥ 0.64) were observed in ADG and supplement G:F through 14 d. Through d 28 to 70, CGF-fed calves had greater (P ≤ 0.03) ADG and supplement G:F relative to corn-fed calves. Final FCS was greater (P < 0.01) for CGF-supplemented calves relative to those supplemented corn, though FT was not different (P = 0.87). These data indicate that supplementing CGF rather than corn yields a greater performance response in beef calves grazing stockpiled tall fescue.
Journal Article
Determining the feeding value of corn gluten feed relative to corn when supplemented to beef calves grazed on stockpiled tall fescue pastures
This experiment compared the performance response of supplementing corn gluten feed (CGF) or corn to calves grazing stockpiled tall fescue pastures over a 70-d period. Forty-four Angus x Simmental calves (238 ± 4 kg) were stratified across 6 treatments by BW and sex in a 2 x 3 factorial arrangement. Calves were supplemented cracked corn (n = 16) or CGF (n = 18). Calves were housed in 2 pastures and supplemented individually using the SmartFeed Pro feeding system, with all treatments represented in each pasture. Supplement DMI was programmed at 0.59, 0.87, or 1.13% BW Calves which failed to train to the feeding system (n = 10) were treated as an un-supplemented control. Weight and flesh condition score (FCS) were recorded every 14-d, and ultrasound 12th rib fat thickness (FT) was measured on d 0 and 70. Data were analyzed with PROC GLM in SAS with supplement type as a main effect, sex as a fixed effect, and group as a random effect. Individual supplement DMI was included in the model as a covariate rather than a main effect due to high variation. Significance was defined at P < 0.05 and means were separated using LSD. Initial BW, FCS, and FT were similar (P > 0.12) among treatments. No differences (P > 0.25) were observed in supplement DMI throughout the experiment. No differences (P > 0.64) were observed in ADG and supplement G:F through 14 d. Through d 28 to 70, CGF-fed calves had greater (P < 0.03) ADG and supplement G:F relative to corn-fed calves. Final FCS was greater (P < 0.01) for CGF-supplemented calves relative to those supplemented corn, though FT was not different (P = 0.87). These data indicate that supplementing CGF rather than corn yields a greater performance response in beef calves grazing stockpiled tall fescue.
Journal Article
Structured and Target-Specific Development of Cortico-Cortical Connectivity in the Mouse Visual Cortex
The mammalian cortex exhibits highly stereotyped long-range connectivity, yet the developmental principles that specify precise cortico-cortical projection patterns remain poorly defined. Two dominant models propose that target specificity arises either from early inter-regional exuberant outgrowth followed by pruning, or through initially directed axonal targeting. To resolve this, we systematically mapped the postnatal development of V1 cortico-cortical projection neurons (CCPNs) to eleven higher visual areas (HVAs) in mice using rapid and complementary retrograde, anterograde, and single-cell tracing methods. We found that V1→HVA connectivity develops via spatiotemporally staggered axon extension and pruning programs, aligned with target position along the medial-lateral axis. Reciprocal HVA→V1 feedback emerges concurrently and is refined over time, yielding gradually aligned bidirectional connectivity. Notably, both multiplexed retrograde tracing and MAPseq-based single-cell profiling revealed that individual V1 neurons initialize and retain specific projection motifs with limited variation over development, arguing against global exuberance followed by selective, inter-areal pruning. Instead, our findings support a directed guidance model, in which distinct V1 CCPN subtypes establish selective projection patterns early, followed by local, target-dependent refinement. This structured yet heterogeneous developmental strategy provides an anatomical framework for how precise long-range cortical networks emerge.
V1→HVA connections form via directed axonal targeting, establishing motifs early with little variationMedial targets are innervated earlier and refine gradually, lateral targets later and rapidlyFeedforward and feedback V1-HVA circuits emerge concurrentlyBidirectional like-to-like V1-HVA connectivity refines across development.
Journal Article