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Exploring the stochastic intricacies of bone microstructure is a promising way to make progress on the practical issue of bone fracture. This study investigates the fracture of human complete ribs subjected to bending and using acoustic emission (AE) for microfailure detection. As the strain increases, the number of AE signals per unit of time rises until, beyond a certain threshold, an avalanche of signals occurs, indicating the aggregation of numerous microfailures into a macroscopic fracture. Since microfailures appear randomly throughout the bending test, and given the lack of a deterministic law and the random nature of microfailures during the bending test, we opted to develop a stochastic model to account for their occurrence within the irregular and random microstructure of the cortical bone. Notable discoveries encompass the significant correlation between adjusted parameters of the stochastic model and the total number of microfailures with anthropometric variables such as age and body mass index (BMI). The progression of microfailures with strain is significantly more pronounced with age and BMI, as measured by the rate of bone deterioration. In addition, the rate of microfailures is significantly impacted by BMI alone. It is also observed that the average energy of the identified AE events adheres to a precisely defined Pareto distribution for every specimen, with the principal exponent exhibiting a significant correlation with anthropometric variables. From a mathematical standpoint, the model can be described as a double Cox stochastic and explosive (coxplosive process) model. This further provides insight into the reason why the ribs of older individuals are considerably less resilient than those of younger individuals, breaking under a considerably lower maximum strain ( ε max ). [ABSTRACT FROM AUTHOR]

Purpose: Respiratory support is the mainstay for the management of patients with pulmonary contusion following blunt chest trauma. In patients not requiring immediate intubation and ventilation, the optimal respiratory management strategy is not clear. This systematic review and meta-analysis aimed to determine the efficacy of non-invasive ventilation (NIV), as compared to traditional respiratory support strategies (i.e., high-flow facemask oxygen or pre-emptive intubation and ventilation), in adult patients with blunt chest trauma. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing NIV to traditional forms of respiratory support (i.e., facemask oxygen or intubation and ventilation) in an adult trauma population. For each eligible trial, we extracted the outcomes of all-cause mortality, length of intensive care unit (ICU) stay, length of hospital stay, and pneumonia. Results: We identified 643 citations, selected 17 for full-text evaluation, and identified three eligible RCTs. Patients receiving NIV had a non-significant reduction in the risk of death (OR 0.55; 95 % CI 0.18-1.70; I = 0 %), but significant reductions in length of ICU stay (mean difference −2.45 days; 95 % CI −4.27 to −0.63; I = 66 %), length of hospital stay (mean difference −4.60 days; 95 % CI −8.81 to −0.39; I = 85 %), and risk of pneumonia (OR 0.20; 95 % CI 0.09-0.47; I = 0 %). Conclusion: This meta-analysis suggests that NIV is superior to both high-flow facemask oxygen or pre-emptive intubation and ventilation in patients with blunt chest trauma who have no contraindication to NIV. [ABSTRACT FROM AUTHOR]

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