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S.B. is a 1717-year-old man who lost control of his sport utility vehicle and struck a tree. Witnesses reported he was not restrained, and his face hit the windshield on impact. When paramedics arrived, S.B. was responsive but confused, had significant facial swelling, and complained of pain in his right wrist and left forearm. The paramedics initiated cervical spine precautions, strapped him to a backboard, started oxygen at 15 L/min15 \mathrm{~L} / \mathrm{min} via a nonrebreather mask, and started a 16 -gauge IV with 0.9%0.9 \% normal saline. His vital signs were 120/75,125,36120 / 75,125,36, and SaO294%\mathrm{SaO}_2 94 \%. On arrival to the local emergency department (ED) 5 minutes later, his VS were 110/62110/62, 110110 regular, 2828 to 3232 and shallow, and SaO299%\mathrm{SaO}_2 99 \%. An additional 16-gauge IV was inserted and the following labs were drawn: CBC, type and crossmatch, complete metabolic panel, PT/ PTT INR, and alcohol level. The trauma physician completed a head-to-toe assessment and found the following:

Physician Note

Obeys commands, responds to voice but not oriented to time or place. Generalized facial edema with full-thickness 22-cm cheek laceration and bilateral mandibular depressed fractures. Blood behind left tympanic membrane, edema with slight discoloration over left mastoid process. Clear drainage coming from the left nare. Mid to upper chest contusions without crepitus, breath sounds clear. Abdomen slightly firm but not tender. Catheterized for 500500 mL clear yellow urine; negative for blood, glucose, ketones. Positive deformity of right wrist and diffuse tenderness of left lower forearm.

What are the symptoms of a posterior fossa fracture (fracture of temporal petrous bone), and how does it compare to a BSF?

Question

Many observational studies conclude that low-fat diets protect against cancer and cardiovascular "events" (heart attacks, stroke, and so forth). Experimental results, however, are generally negative. In 2006, the Women's Health Initiative (WHI) published its results. This was a large-scale randomized trial on women who had reached menopause. As one part of the study, 48,835 women were randomized: 19,541 were assigned to the treatment group and put on a low-fat diet. The other 29,294 women were assigned to the control group and ate as they normally would. Subjects were followed for 8 years. Among other things, the investigators found that 1,357 women on the low-fat diet experienced at least one cardiovascular event, compared to 2,088 in the control group. can the difference between the two groups be explained by chance? What do you conclude about the effect of the low-fat diet?

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1,357 of the 19,541 women in the treatment group had at least one cardiovascular event, while 2,088 of the 29,294 women in the control group had at least one cardiovascular event.

Percentage A=1357195410.0694=6.94%Percentage B=2088292940.0713=7.13%Sample size A=19,541Sample size B=29,294\begin{align*} \text{Percentage A}&=\frac{1357}{19541}\approx 0.0694=6.94\% \\ \text{Percentage B}&=\frac{2088}{29294}\approx 0.0713=7.13\% \\ \text{Sample size A}&=19,541 \\ \text{Sample size B}&=29,294 \end{align*}

The box corresponding treatment group contains a ticket per woman in the treatment group, where the value on the ticket is a 1 when she had a cardiovascular event and otherwise the value on the ticket is 0. The box corresponding to the control group contains a ticket per woman in the control group, where the value on the ticket is a 1 when she had a cardiovascular and otherwise the value on the ticket is 0.

The null hypothesis states that the two boxes contains have the same percentage, while the alternative hypothesis states that the percentages are different.

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