Minor head injury in anticoagulated patients: Outcomes and analysis of clinical predictors. A prospective study.

BACKGROUND: The optimal management of patients taking oral anticoagulants who experience minor head injury (MHI) is unclear. The availability of validated protocols and reliable predictors of prognosis would be of great benefit. We investigated clinical factors as predictors of clinical outcomes and intracranial injury (ICI). METHODS: We conducted a single-cohort, prospective, observational study in an ED. Our structured clinical pathway included a first head CT scan, 24 h observation and a second CT scan. The primary outcome was the occurrence of MHI-related death or re-admission to ED at day +30. The secondary outcome was the rate of delayed ICI (dICI), defined as second positive CT scan after a first negative CT scan. We assessed some clinical predictors derived from guidelines and clinical prediction rules as potential risk factors for the outcomes. RESULTS: 450 patients with a negative first CT scan who underwent a second CT scan composed our 'study population'. The rate of the primary outcome was 4%. The rate of the secondary outcome was 4.7%. Upon univariate and multivariate analysis no statistically significant predictors for the outcomes were found. CONCLUSIONS: Previous retrospective studies showed a lot of negative predictive factors for anticoagulated patients suffering a minor head injury. In our prospective study no clinical factors emerged as predictors of poor clinical outcomes and dICI. So, even if we confirmed a low rate of adverse outcomes, the best management of these patients in ED remains not so clear and future trials are needed.

Correction of the VIR-visible dataset from the Dawn mission at Vesta.

This work describes the correction method applied to the dataset acquired at the asteroid (4) Vesta by the visible channel of the visible and infrared mapping spectrometer. The rising detector temperature during data acquisitions in the visible wavelengths leads to a spectral slope increase over the whole spectral range. This limits the accuracy of the studies of the Vesta surface in this wavelength range. Here, we detail an empirical method to correct for the visible detector temperature dependency while taking into account the specificity of the Vesta dataset.

Correction of the VIR-visible data set from the Dawn mission.

Data acquired at Ceres by the visible channel of the Visible and InfraRed mapping spectrometer (VIR) on board the NASA Dawn spacecraft are affected by the temperatures of both the visible (VIS) and the infrared (IR) sensors, which are, respectively, a charged coupled device and a HgCdTe array. The variations of the visible channel temperatures measured during the sessions of acquisitions are correlated with the variations in the spectral slope and shape for all the mission phases. The IR channel temperature is more stable during the acquisitions; nonetheless, it is characterized by a bimodal distribution whether the cryocooler (and, therefore, the IR channel) is used or not during the visible channel operations. When the infrared channel temperature is high (175 K, i.e., not in use and with the cryocooler off), an additional negative slope and a distortion are observed in the spectra of the visible channel. We developed an empirical correction based on a reference spectrum for the whole dataset; it is designed to correct the two issues related to the sensor temperatures that we have identified. The reference spectrum is calculated to be representative of the global Ceres' surface. It is also made of the data acquired when the visible and infrared channel temperatures are equal to the ones measured during an observation of the Arcturus star by VIR, which is consistent with several ground-based observations. The developed correction allows reliable analysis and mapping to be performed by minimizing the artifacts induced by fluctuations of the VIS temperature. Thanks to this correction, a direct comparison between different mission phases during which the VIR experienced different visible and infrared channel temperatures is now possible.

Localized aliphatic organic material on the surface of Ceres.

Organic compounds occur in some chondritic meteorites, and their signatures on solar system bodies have been sought for decades. Spectral signatures of organics have not been unambiguously identified on the surfaces of asteroids, whereas they have been detected on cometary nuclei. Data returned by the Visible and InfraRed Mapping Spectrometer on board the Dawn spacecraft show a clear detection of an organic absorption feature at 3.4 micrometers on dwarf planet Ceres. This signature is characteristic of aliphatic organic matter and is mainly localized on a broad region of ~1000 square kilometers close to the ~50-kilometer Ernutet crater. The combined presence on Ceres of ammonia-bearing hydrated minerals, water ice, carbonates, salts, and organic material indicates a very complex chemical environment, suggesting favorable environments to prebiotic chemistry.

Seasonal exposure of carbon dioxide ice on the nucleus of comet 67P/Churyumov-Gerasimenko.

Carbon dioxide (CO2) is one of the most abundant species in cometary nuclei, but because of its high volatility, CO2 ice is generally only found beneath the surface. We report the infrared spectroscopic identification of a CO2 ice-rich surface area located in the Anhur region of comet 67P/Churyumov-Gerasimenko. Spectral modeling shows that about 0.1% of the 80- by 60-meter area is CO2 ice. This exposed ice was observed a short time after the comet exited local winter; following the increased illumination, the CO2 ice completely disappeared over about 3 weeks. We estimate the mass of the sublimated CO2 ice and the depth of the eroded surface layer. We interpret the presence of CO2 ice as the result of the extreme seasonal changes induced by the rotation and orbit of the comet.

Distribution of phyllosilicates on the surface of Ceres.

The dwarf planet Ceres is known to host phyllosilicate minerals at its surface, but their distribution and origin have not previously been determined. We used the spectrometer onboard the Dawn spacecraft to map their spatial distribution on the basis of diagnostic absorption features in the visible and near-infrared spectral range (0.25 to 5.0 micrometers). We found that magnesium- and ammonium-bearing minerals are ubiquitous across the surface. Variations in the strength of the absorption features are spatially correlated and indicate considerable variability in the relative abundance of the phyllosilicates, although their composition is fairly uniform. These data, along with the distinctive spectral properties of Ceres relative to other asteroids and carbonaceous meteorites, indicate that the phyllosilicates were formed endogenously by a globally widespread and extensive alteration process.

Bright carbonate deposits as evidence of aqueous alteration on (1) Ceres.

The typically dark surface of the dwarf planet Ceres is punctuated by areas of much higher albedo, most prominently in the Occator crater. These small bright areas have been tentatively interpreted as containing a large amount of hydrated magnesium sulfate, in contrast to the average surface, which is a mixture of low-albedo materials and magnesium phyllosilicates, ammoniated phyllosilicates and carbonates. Here we report high spatial and spectral resolution near-infrared observations of the bright areas in the Occator crater on Ceres. Spectra of these bright areas are consistent with a large amount of sodium carbonate, constituting the most concentrated known extraterrestrial occurrence of carbonate on kilometre-wide scales in the Solar System. The carbonates are mixed with a dark component and small amounts of phyllosilicates, as well as ammonium carbonate or ammonium chloride. Some of these compounds have also been detected in the plume of Saturn's sixth-largest moon Enceladus. The compounds are endogenous and we propose that they are the solid residue of crystallization of brines and entrained altered solids that reached the surface from below. The heat source may have been transient (triggered by impact heating). Alternatively, internal temperatures may be above the eutectic temperature of subsurface brines, in which case fluids may exist at depth on Ceres today.

Exposed water ice on the nucleus of comet 67P/Churyumov-Gerasimenko.

Although water vapour is the main species observed in the coma of comet 67P/Churyumov-Gerasimenko and water is the major constituent of cometary nuclei, limited evidence for exposed water-ice regions on the surface of the nucleus has been found so far. The absence of large regions of exposed water ice seems a common finding on the surfaces of many of the comets observed so far. The nucleus of 67P/Churyumov-Gerasimenko appears to be fairly uniformly coated with dark, dehydrated, refractory and organic-rich material. Here we report the identification at infrared wavelengths of water ice on two debris falls in the Imhotep region of the nucleus. The ice has been exposed on the walls of elevated structures and at the base of the walls. A quantitative derivation of the abundance of ice in these regions indicates the presence of millimetre-sized pure water-ice grains, considerably larger than in all previous observations. Although micrometre-sized water-ice grains are the usual result of vapour recondensation in ice-free layers, the occurrence of millimetre-sized grains of pure ice as observed in the Imhotep debris falls is best explained by grain growth by vapour diffusion in ice-rich layers, or by sintering. As a consequence of these processes, the nucleus can develop an extended and complex coating in which the outer dehydrated crust is superimposed on layers enriched in water ice. The stratigraphy observed on 67P/Churyumov-Gerasimenko is therefore the result of evolutionary processes affecting the uppermost metres of the nucleus and does not necessarily require a global layering to have occurred at the time of the comet's formation.

Artifacts reduction in VIR/Dawn data.

Remote sensing images are generally affected by different types of noise that degrade the quality of the spectral data (i.e., stripes and spikes). Hyperspectral images returned by a Visible and InfraRed (VIR) spectrometer onboard the NASA Dawn mission exhibit residual systematic artifacts. VIR is an imaging spectrometer coupling high spectral and spatial resolutions in the visible and infrared spectral domain (0.25-5.0 µm). VIR data present one type of noise that may mask or distort real features (i.e., spikes and stripes), which may lead to misinterpretation of the surface composition. This paper presents a technique for the minimization of artifacts in VIR data that include a new instrument response function combining ground and in-flight radiometric measurements, correction of spectral spikes, odd-even band effects, systematic vertical stripes, high-frequency noise, and comparison with ground telescopic spectra of Vesta and Ceres. We developed a correction of artifacts in a two steps process: creation of the artifacts matrix and application of the same matrix to the VIR dataset. In the approach presented here, a polynomial function is used to fit the high frequency variations. After applying these corrections, the resulting spectra show improvements of the quality of the data. The new calibrated data enhance the significance of results from the spectral analysis of Vesta and Ceres.

Ammoniated phyllosilicates with a likely outer Solar System origin on (1) Ceres.

Studies of the dwarf planet (1) Ceres using ground-based and orbiting telescopes have concluded that its closest meteoritic analogues are the volatile-rich CI and CM carbonaceous chondrites. Water in clay minerals, ammoniated phyllosilicates, or a mixture of Mg(OH)2 (brucite), Mg2CO3 and iron-rich serpentine have all been proposed to exist on the surface. In particular, brucite has been suggested from analysis of the mid-infrared spectrum of Ceres. But the lack of spectral data across telluric absorption bands in the wavelength region 2.5 to 2.9 micrometres--where the OH stretching vibration and the H2O bending overtone are found--has precluded definitive identifications. In addition, water vapour around Ceres has recently been reported, possibly originating from localized sources. Here we report spectra of Ceres from 0.4 to 5 micrometres acquired at distances from ~82,000 to 4,300 kilometres from the surface. Our measurements indicate widespread ammoniated phyllosilicates across the surface, but no detectable water ice. Ammonia, accreted either as organic matter or as ice, may have reacted with phyllosilicates on Ceres during differentiation. This suggests that material from the outer Solar System was incorporated into Ceres, either during its formation at great heliocentric distance or by incorporation of material transported into the main asteroid belt.

The diurnal cycle of water ice on comet 67P/Churyumov-Gerasimenko.

Observations of cometary nuclei have revealed a very limited amount of surface water ice, which is insufficient to explain the observed water outgassing. This was clearly demonstrated on comet 9P/Tempel 1, where the dust jets (driven by volatiles) were only partially correlated with the exposed ice regions. The observations of 67P/Churyumov-Gerasimenko have revealed that activity has a diurnal variation in intensity arising from changing insolation conditions. It was previously concluded that water vapour was generated in ice-rich subsurface layers with a transport mechanism linked to solar illumination, but that has not hitherto been observed. Periodic condensations of water vapour very close to, or on, the surface were suggested to explain short-lived outbursts seen near sunrise on comet 9P/Tempel 1. Here we report observations of water ice on the surface of comet 67P/Churyumov-Gerasimenko, appearing and disappearing in a cyclic pattern that follows local illumination conditions, providing a source of localized activity. This water cycle appears to be an important process in the evolution of the comet, leading to cyclical modification of the relative abundance of water ice on its surface.

Cometary science. The organic-rich surface of comet 67P/Churyumov-Gerasimenko as seen by VIRTIS/Rosetta.

The VIRTIS (Visible, Infrared and Thermal Imaging Spectrometer) instrument on board the Rosetta spacecraft has provided evidence of carbon-bearing compounds on the nucleus of the comet 67P/Churyumov-Gerasimenko. The very low reflectance of the nucleus (normal albedo of 0.060 ± 0.003 at 0.55 micrometers), the spectral slopes in visible and infrared ranges (5 to 25 and 1.5 to 5% kÅ(-1)), and the broad absorption feature in the 2.9-to-3.6-micrometer range present across the entire illuminated surface are compatible with opaque minerals associated with nonvolatile organic macromolecular materials: a complex mixture of various types of carbon-hydrogen and/or oxygen-hydrogen chemical groups, with little contribution of nitrogen-hydrogen groups. In active areas, the changes in spectral slope and absorption feature width may suggest small amounts of water-ice. However, no ice-rich patches are observed, indicating a generally dehydrated nature for the surface currently illuminated by the Sun.

Ethanol in biological fluids: headspace GC measurement.

The present study evaluates the suitability of headspace gas chromatography (GC) with a capillary column as a method for determining the ethanol content in different biological fluids. This procedure allows the use of headspace GC not only as a reference method but also in routine diagnostics and monitoring work. The recent literature reviewed reports no standardized methodology that is at the same time suitable for ethanol determination in all routinely available biological fluids (blood, serum, plasma, urine, and saliva). The proposed procedure seems to be a good solution to the problem. The reproducibility study for the biological fluids tested resulted in coefficients of variation that ranged from 0.8 to 2.9% and recoveries that averaged 99%. Linearity was verified in the range of 0.01-20 g/L of ethanol in aqueous solutions. Sensitivity was determined to be 0.01 g/L. Ethanol measurement by this method is easy, simple, and highly reliable, and only a small sample volume (0.1 mL) is required. An internal standard and sample manipulation are not necessary. The obtained results suggest that the use of headspace GC could be extended from confirmatory analyses to routine application in many biomedical fields.

[Nutritional studies in a commune of Lazio. Anthropometric data and food consumption in childhood]. / Indagine nutrizionale in un comune del Lazio. Dati antropometrici e consumi alimentari in età scolare.

The present study concerns with anthropometric and nutritional data collected in the school population of a small rural town in Lazio. We studied 368 school-children of both sexes, belonging to the following age groups: from 7 to 8 years, 9 to 10 years, 11 to 12 years, 13 to 14 years. The technique of evaluation of obesity used in this paper is: weight 20% higher than the height-adjusted figure according to NCHS's curves and triceps skinfold higher than 90 degrees centile according to Tanner's curves. Dietary intake was assessed by a "24 hour-recall" on three consecutive days one of which of holiday. The prevalence of obesity is 17.7%. In all the age groups daily caloric intake is adjusted to that recommended by Italian 1987 Larn. On the other hand the single nutrient's assumption shows important differences from Larn. Particularly in all the age groups daily protein intake is high (14.6%-15.8% of the energy in a day), with an increased animal-vegetable protein ratio (1.5-2.1). Dietary lipids are higher than 35.9% of day's energy (35.9%-39.5%); the polyunsaturated/saturated fatty acids ratio is low (0.3-0.5). Cholesterol in the diet (231-347 mg/day) exceeds the level recommended. The daily intake of total carbohydrates (45.3%-48.5%) is low. Crude fiber intake increases with age from 2.8 g to 4.5 g/day. There is no statistical difference between obese and not obese subjects for what concerns energy intake or single nutrient's assumption.(ABSTRACT TRUNCATED AT 250 WORDS)