Abuse was identified in 48% of children less than 18months with humeral fractures. Among those with femoral fractures, abuse was diagnosed in 34% and 25% of children aged less than 12 and 18months, respectively. Among children who were not in an independently verified incident, the authors strongly recommend routine evaluation for child abuse, including specialty child abuse consultation, for 1) children aged less than 3years old presenting with rib fractures and 2) children aged less than 18months presenting with humeral or femoral fractures (Level of Evidence III Review).Among children who were not in an independently verified incident, the authors strongly recommend routine evaluation for child abuse, including specialty child abuse consultation, for 1) children aged less than 3 years old presenting with rib fractures and 2) children aged less than 18 months presenting with humeral or femoral fractures (Level of Evidence III Review). Medullary rim sign (MRS) refers to a hyperechoic line in the renal medulla, reported on ultrasound examination (US) in both dogs and cats with and without kidney disease (KD). To describe the different aspects of MRS in cats and to assess its association with KD. Cats that underwent US examination, with MRS (study group) with and without KD and without MRS with and without KD (control groups). Retrospective case-control study cats with MRS, with or without KD (rim sign groups) and cats without MRS, with or without KD (control groups). Ultrasonographic images were blindly reviewed with attention given to the thickness and margins of the MRS recorded. Eighty-four cats with MRS were included and 60 cats recruited for each control group. The MRS had 2 distinct aspects a thin hyperechoic line with well-defined margins (MRS-line) in 50/84 cats (59%) and a thick hyperechoic band with ill-defined margins (MRS-band) in 34/84 cats (41%). Twenty of 50 (40%) cats with MRS-line and 25/34 (74%) of cats with MRS-band had KD. The frequency of MRS-line was higher in cats without KD, whereas the presence of MRS-band was more frequent in cats with KD (P = .003). A thick hyperechoic ill-defined band (for which the term medullary band sign is proposed) was more frequently associated with KD, whereas a thin hyperechoic well-defined line (true MRS) may be seen in cats with or without KD.A thick hyperechoic ill-defined band (for which the term medullary band sign is proposed) was more frequently associated with KD, whereas a thin hyperechoic well-defined line (true MRS) may be seen in cats with or without KD.Arc (activity-regulated cytoskeleton-associated protein) is posited as a critical regulator of long-term synaptic plasticity at excitatory synapses, including long-term potentiation, long-term depression, inverse synaptic tagging and homoeostatic scaling, with pivotal roles in memory and postnatal cortical development. However, the mechanisms underlying the bidirectional regulation of synaptic strength are poorly understood. Here we review evidence from different plasticity paradigms, highlight outstanding issues and discuss stimulus-specific mechanisms that dictate Arc function. We propose a model in which Arc bidirectionally controls synaptic strength by coordinate regulation of AMPA-type glutamate receptor (AMPAR) trafficking and actin cytoskeletal dynamics in dendritic spines. Key to this model, Arc is proposed to function as an activity-dependent regulator of AMPAR lateral membrane diffusion and trapping at synapses. To evaluate the common carotid stiffness via echo tracking in patients with hypertension and acute aortic dissection (AD) and to investigate the independent predictors for the occurrence of AD in hypertensive (HP) patients. Fifty HP patients complicated by acute AD (AD group), 50 HP patients without AD (HP group), and 50 age-matched healthy volunteers (control group) were enrolled to assess the common carotid stiffness index (β), single-point pulsed wave velocity (PWVβ), and arterial compliance (AC) via echo tracking. The intima-media thickness, diameter, β and PWVβ of the common carotid artery (CCA) in the AD group were significantly higher than those in the HP and control groups, whereas AC in the AD group was significantly lower (P < .05). In a multivariate logistic regression analysis, the systolic blood pressure (SBP; odds ratio [OR], 2.316; 95% confidence interval [CI], 2.033-2.563; P < .001), β (OR, 2.140; 95% CI, 1.931-2.367; P < .001), PWVβ (OR, 1.212; 95% CI, 1.004-1.397; P = .023), and AC (OR, 0.565; 95% CI, 0.339-0.654; P < .001) were significantly related to the occurrence of AD in HP patients. The area under the curve values for the AC, SBP, β, and PWVβ were 0.822, 0.806, 0.778, and 0.741, respectively, and the area under the curve was up to 0.943 when these parameters were combined. The compliance of the CCA decreased, and the stiffness of the CCA increased significantly in HP patients complicated by AD. Tacrolimus The AC, β, and PWVβ of the CCA, together with the SBP, were independent predictors of the occurrence of AD in HP patients.The compliance of the CCA decreased, and the stiffness of the CCA increased significantly in HP patients complicated by AD. The AC, β, and PWVβ of the CCA, together with the SBP, were independent predictors of the occurrence of AD in HP patients. Hemorrhagic shock is the leading cause of survivable death in trauma patients and recent literature has focused on resuscitation strategies including transfusing low-titer group O whole blood (LTOWB). Debate remains regarding whether leukocyte reduced (LR) whole blood is of clinical benefit or detriment to patients requiring massive transfusion. This study compares survival outcomes between LR-LTOWB and non-LR LTOWB. The objective of this prospective, observational study was to detect any difference in 24-hour survival between patients receiving LR-LTOWB and non-LR LTOWB during their massive transfusion activation. Secondary objectives were to report any difference in ICU LOS, ventilation days, in-hospital survival, and hospital LOS. Data collected included patient sex, age, mechanism of injury, Injury Severity Score (ISS), Trauma Injury Severity Score (TRISS), cause of death, and number of LTOWB transfused. A total of 167 patients received 271 LTOWB transfusions. There were 97 patients that received 168 units of LR-LTOWB while 70 patients received 103 units of non-LR LTOWB.