S-MTC

Language processing involves the rapid interaction of multiple brain regions. The study of its neurophysiological bases would therefore benefit from neuroimaging techniques combining both good spatial and good temporal resolution. Here we use the event-related optical signal (EROS), a recently developed imaging method, to reveal rapid interactions between left superior/middle temporal cortices (S/MTC) and inferior frontal cortices (IFC) during the processing of semantically or syntactically anomalous sentences. Participants were presented with sentences of these types intermixed with nonanomalous control sentences and were required to judge their acceptability. ERPs were recorded simultaneously with EROS and showed the typical activities that are elicited when processing anomalous stimuli: the N400 and the P600 for semantic and syntactic anomalies, respectively. The EROS response to semantically anomalous words showed increased activity in the S/MTC (corresponding in time with the N400), followed by IFC activity. Syntactically anomalous words evoked a similar sequence, with a temporal-lobe EROS response (corresponding in time with the P600), followed by frontal activity. However, the S/MTC activity corresponding to a semantic anomaly was more ventral than that corresponding to a syntactic anomaly. These data suggest that activation related to anomaly processing in sentences proceeds from temporal to frontal brain regions for both semantic and syntactic anomalies. This first EROS study investigating language processing shows that EROS can be used to image rapid interactions across cortical areas.

Background:Management of pelvic fracture associated haemorrhage is often complex with high morbidity and mortality rates. Different treatment options are used to control bleeding with an on-going discussion in the trauma community regarding the best management algorithm.Main body:Recent studies have shown trans-arterial embolisation (TAE) to be a safe and effective technique to control pelvic fracture associated haemorrhage. Computed tomography (CT) evidence of active bleeding, haemodynamic instability, and pelvic fracture patterns are amongst important indicators for TAE.Conclusion:Herein, we aim to provide a comprehensive literature review of the effectiveness of TAE in controlling haemorrhage secondary to pelvic fracture according to the indications, technique and embolic agents, and outcomes, whilst incorporating our Level 1 major trauma centre's (MTC) results between 2014-2017.

Objective:We aimed to compare adolescent mortality rates between different types of major trauma centre (MTC or level 1; adult, children's and mixed).Methods:Data were obtained from TARN (Trauma Audit Research Network) from English sites over a 6-year period (2012-2018), with adolescence defined as 10-24.99 years. Results are presented using descriptive statistics. Patient characteristics were compared using the Kruskal-Wallis test with Dunn's post-hoc analysis for pairwise comparison and χ2test for categorical variables.Results:21 033 cases met inclusion criteria. Trauma-related 30-day crude mortality rates by MTC type were 2.5% (children's), 4.4% (mixed) and 4.9% (adult). Logistic regression accounting for injury severity, mechanism of injury, physiological parameters and 'hospital ID', resulted in adjusted odds of mortality of 2.41 (95% CI 1.31 to 4.43; p=0.005) and 1.85 (95% CI 1.03 to 3.35; p=0.041) in adult and mixed MTCs, respectively when compared with children's MTCs. In three subgroup analyses the same trend was noted. In adolescents aged 14-17.99 years old, those managed in a children's MTC had the lowest mortality rate at 2.5%, compared with 4.9% in adult MTCs and 4.4% in mixed MTCs (no statistical difference between children's and mixed). In cases of major trauma (Injury Severity Score >15) the adjusted odds of mortality were also greater in the mixed and adult MTC groups when compared with the children's MTC. Median length of stay (LoS) and intensive care unit LoS were comparable for all MTC types. Patients managed in children's MTCs were less likely to have a CT scan (46.2% vs 62.8% mixed vs 64% adult).Conclusions:Children's MTC have lower crude and adjusted 30-day mortality rates for adolescent trauma. Further research is required in this field to identify the factors that may have influenced these findings.