Requirement for urgent tracheal intubation after traumatic injury: a retrospective analysis of 11,010 patients in the Trauma Audit Research Network database.

Advanced airway management is a treatment priority in trauma care. It is likely that a proportion of patients who receive urgent airway management on arrival in the emergency department represent an unmet demand for airway intervention in the pre-hospital phase. This study aimed to investigate emergency airway practice in major trauma patients and establish any unmet demand in this patient group. A retrospective review of the Trauma Audit and Research Network database was performed to identify airway intervention(s) performed for patients admitted to major trauma centres in England from 01 April 2012 to 27 June 2016. In total, 11,010 patients had airway interventions: 4375 patients (43%) had their tracheas intubated in the pre-hospital setting compared with 5889 patients (57%) in the emergency department. Of the patients whose tracheas were intubated in the emergency department, this was done within 30 min of hospital arrival in 3264 patients (75%). Excluding tracheal intubation, 1593 patients had a pre-hospital airway intervention of which 881 (55%) subsequently had their trachea intubated in the emergency department; tracheal intubation was done within 30 min of arrival in the majority of these cases (805 patients (91%)). Over 70% of emergency department tracheal intubations in patients with traumatic injuries were performed within 30 min of hospital arrival; this suggests there may be an unmet demand in pre-hospital advanced airway management for trauma patients in England.

Advances in research on the impacts of anti-submarine sonar on beaked whales.

Mass stranding events (MSEs) of beaked whales (BWs) were extremely rare prior to the 1960s but increased markedly after the development of naval mid-frequency active sonar (MFAS). The temporal and spatial associations between atypical BW MSEs and naval exercises were first observed in the Canary Islands, Spain, in the mid-1980s. Further research on BWs stranded in association with naval exercises demonstrated pathological findings consistent with decompression sickness (DCS). A 2004 ban on MFASs around the Canary Islands successfully prevented additional BW MSEs in the region, but atypical MSEs have continued in other places of the world, especially in the Mediterranean Sea, with examined individuals showing DCS. A workshop held in Fuerteventura, Canary Islands, in September 2017 reviewed current knowledge on BW atypical MSEs associated with MFAS. Our review suggests that the effects of MFAS on BWs vary among individuals or populations, and predisposing factors may contribute to individual outcomes. Spatial management specific to BW habitat, such as the MFAS ban in the Canary Islands, has proven to be an effective mitigation tool and mitigation measures should be established in other areas taking into consideration known population-level information.

Effect of marine ambient in the production of pollutants from the pyrolysis and combustion of a mixture of plastic materials.

A mixture of polyethylene (PE), polyethylene-terephtalate (PET), polypropylene (PP) and Nylon was submerged in marine water during 12 moths. The chlorine content of these plastics was measured through the passing time. Thermobalance was used to look for differences in the thermal decomposition of the plastics during in that time interval. Degradation of PET, PP and Nylon produced changes in the weight loss curve, but behaviour of PE is confusing. Pyrolysis and combustion at 850 °C was finally performed to get knowledge of the possible differences in the emission of main gases, volatiles and semivolatiles including polycyclic aromatic hydrocarbons (PAHs), polychlorinated benzenes (ClBzs), polychlorinated phenols (ClPhs), polybrominated phenols (BrPhs), polychlorinated biphenyls (PCBs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs). Results show that the emission of chlorinated species is somewhat not affected by the chlorine content of the plastics mix. The production of PCBs and PCDD/Fs was very low, under 4 pg WHO-TEQ/g.

Maxillofacial injuries in patients with major trauma.

Major trauma is an important cause of mortality and morbidity worldwide. Mortality is high with rates over 10% commonly reported. We studied the epidemiology and aetiology of maxillofacial injuries in patients who presented with major trauma as recorded nationally by retrospectively analysing the database of the Trauma Audit Research Network from 2001 to 2015. All patients who had major trauma with associated maxillofacial injuries were included in the analysis. Of 104645 patients recorded as having had major trauma during the study period, 22148 (21.2%) had an associated maxillofacial injury. Most of them were male (74.2%), and the type of injury was usually blunt (97.5%). Road traffic collisions were the most common mechanism (44.1%), followed by falls of less than 2m (21.6%). An associated serious head injury was more common in those who had a facial injury (81% compared with 60.6%, p<0.0001). Nearly all the facial injuries (94%) were minor, or moderately severe. Maxillofacial injuries commonly present with major trauma but are rarely severe. A maxillofacial injury may indicate an increased likelihood of an associated head injury.

Improved outcomes for hepatic trauma in England and Wales over a decade of trauma and hepatobiliary surgery centralisation.

BACKGROUND: Over the last decade trauma services have undergone a reconfiguration in England and Wales. The objective is to describe the epidemiology, management and outcomes for liver trauma over this period and examine factors predicting survival. METHODS: Patients sustaining hepatic trauma were identified using the Trauma Audit and Research Network database. Demographics, management and outcomes were assessed between January 2005 and December 2014 and analysed over five, 2-year study periods. Independent predictor variables for the outcome of liver trauma were analysed using multiple logistic regression. RESULTS: 4368 Patients sustained hepatic trauma (with known outcome) between January 2005 and December 2014. Median age was 34 years (interquartile range 23-49). 81% were due to blunt and 19% to penetrating trauma. Road traffic collisions were the main mechanism of injury (58.2%). 241 patients (5.5%) underwent liver-specific surgery. The overall 30-day mortality rate was 16.4%. Improvements were seen in early consultant input, frequency and timing of computed tomography (CT) scanning, use of tranexamic acid and 30-day mortality over the five time periods. Being treated in a unit with an on-site HPB service increased the odds of survival (odds ratio 3.5, 95% confidence intervals 2.7-4.5). CONCLUSIONS: Our study has shown that being treated in a unit with an on-site HPB service increased the odds of survival. Further evaluation of the benefits of trauma and HPB surgery centralisation is warranted.

Pollutant content in marine debris and characterization by thermal decomposition.

Marine debris (MDs) produces a wide variety of negative environmental, economic, safety, health and cultural impacts. Most marine litter has a very low decomposition rate (plastics), leading to a gradual accumulation in the coastal and marine environment. Characterization of the MDs has been done in terms of their pollutant content: PAHs, ClBzs, ClPhs, BrPhs, PCDD/Fs and PCBs. The results show that MDs is not a very contaminated waste. Also, thermal decomposition of MDs materials has been studied in a thermobalance at different atmospheres and heating rates. Below 400-500K, the atmosphere does not affect the thermal degradation of the mentioned waste. However, at temperatures between 500 and 800K the presence of oxygen accelerates the decomposition. Also, a kinetic model is proposed for the combustion of the MDs, and the decomposition is compared with that of their main constituents, i.e., polyethylene (PE), polystyrene (PS), polypropylene (PP), nylon and polyethylene-terephthalate (PET).

Análisis de la radiactividad en aguas del Balneario de San Nicolás (Almería) / Radioactivity analysis of San Nicolás Spa water

Se ha realizado el estudio radiológico del agua del manantial del Balneario de San Nicolás en la provincia de Almería. Este estudio ha consistido en la determinación cuantitativa de los radionucleidos naturales más importantes desde el punto de vista de la protección radiológica existentes en las aguas del balneario. La medida del contenido radiactivo de las aguas constituye un tema cuyo estudio resulta de gran interés. Las aguas con elementos radiactivos disueltos pueden producir, como consecuencia directa de su consumo, dosis de irradiación interna tanto por ingestión como por inhalación de estos elementos. Debido a esto es necesario, en algunos casos, proceder al análisis y posterior evaluación de la dosis asociada a este consumo (AU)

Radio activity analysis of San Nicolás Spa water was carried out by the CIEMAT Laboratory of Environmental Radioactivity. With this aim the most important natural radionuclides were determined in water from spring water. The measurement and knowledge of radioactivity level in water is an interesting and convenient topic. The consumption of water which has dissolved some radionuclides could lead to internal irradiation both by ingestion and by inhalation. Therefore it is necessary, in some cases, to determine the water radioactivity level in order to assess the dose (AU)

Análisis de la radiactividad en aguas del Balneario de Villavieja (Castellón) / Radioactivity analysis of Villavieja Spa water

Se ha realizado el estudio radiológico del agua del manantial del Balneario de Villavieja en la provincia de Castellón. Este estudio ha consistido en la determinación cuantitativa de los radionucleidos naturales más importantes desde el punto de vista de la protección radiológica existentes en las aguas del balneario. La medida del contenido radiactivo de las aguas constituye un tema cuyo estudio resulta de gran interés. Las aguas con elementos radiactivos disueltos pueden producir, como consecuencia directa de su consumo, dosis de irradiación interna tanto por ingestión como por inhalación de estos elementos. Debido a esto es necesario, en algunos casos, proceder al análisis y posterior evaluación de la dosis asociada a este consumo (AU)

Radio activity analysis of Villavieja Spa water was carried out by the CIEMAT Laboratory of Environmental Radioactivity. With this aim the most important natural radionuclides were determined in water from spring water. The measurement and knowledge of radioactivity level in water is an interesting and convenient topic. The consumption of water which has dissolved some radionuclides could lead to internal irradiation both by ingestion and by inhalation. Therefore it is necessary, in some cases, to determine the water radioactivity level in order to assess the dose (AU)

Análisis de la radiactividad en aguas del balneario / Radioactivity analysis of spa water

Se ha realizado el estudio radiológico del agua del manantial del Balneario de Olmedo en la provincia de Valladolid. Este estudio ha consistido en la determinación cuantitativa de los radionucleidos naturales más importantes desde el punto de vista de la protección radiológica existentes en las aguas del balneario. La medida del contenido radiactivo de las aguas constituye un tema cuyo estudio resulta de gran interés. Las aguas con elementos radiactivos disueltos pueden producir, como consecuencia directa de su consumo, dosis de irradiación interna tanto por ingestión como por inhalación de estos elementos. Debido a esto es necesario, en algunos casos, proceder al análisis y posterior evaluación de la dosis asociada a este consumo

Radioactivity analysis of Olmedo Spa water was carried out by the CIEMAT Laboratory of Environmental Radioactivity. With this aim the most important natural radionuclides were determined in water from spring water. The measurement and knowledge of radioactivity level in water is an interesting and convenient topic. The consumption of water which has dissolved some radionuclides could lead to internal irradiation both by ingestion and by inhalation. Therefore it is necessary, in some cases, to determine the water radioactivity level in order to assess the dose

Cardiotrophin 1 protects beta cells from apoptosis and prevents streptozotocin-induced diabetes in a mouse model.

AIMS/HYPOTHESIS: Cardiotrophin 1 (CT-1) is a recently described cytokine originally isolated from the heart where it has been shown to play an important role in apoptotic protection of cardiomyocytes and heart hypertrophy. Its beneficial properties have also been described in other organs such as liver and neuromuscular tissue. In the present study, we investigated whether CT-1 can confer protection against pro-apoptotic stimuli in pancreatic beta cells, and its role in insulin secretion and diabetes development. METHODS: The effects of CT-1 on apoptosis and function were studied using MIN6B1 cells and freshly isolated murine pancreatic islets. The impact on the development of diabetes was evaluated in Ct1-null (Ct1 (-/-)) mice (the gene Ct1 is also known as Ctf1) using two streptozotocin (STZ)-induced models of diabetes. RESULTS: CT-1 has a protective effect in MIN6B1 cells and murine islets under the pro-apoptotic stimulus of serum deprivation, which correlates with the expression of B cell lymphoma-extra large, or following exposure to a mixture of cytokines. In addition, CT-1 enhances glucose-stimulated insulin secretion in MIN6B1 cells and this was repressed by inhibitors of phospholipase C. Furthermore, Ct1 (-/-) mice were more prone to develop diabetes, and their glucose tolerance test showed impaired plasma glucose clearance which correlated with decreased pancreatic insulin secretion. CONCLUSIONS/INTERPRETATION: The results obtained from both in vitro and in vivo experiments show that CT-1 improves beta cell function and survival, and protects mice against STZ-induced diabetes.

Modelling phenolic and technological maturities of grapes by means of the multivariate relation between organoleptic and physicochemical properties.

The ripeness of grapes at the harvest time is one of the most important parameters for obtaining high quality red wines. Traditionally the decision of harvesting is to be taken only after analysing sugar concentration, titratable acidity and pH of the grape juice (technological maturity). However, these parameters only provide information about the pulp ripeness and overlook the real degree of skins and seeds maturities (phenolic maturity). Both maturities, technological and phenolic, are not simultaneously reached, on the contrary they tend to separate depending on several factors: grape variety, cultivar, adverse weather conditions, soil, water availability and cultural practices. Besides, this divergence is increasing as a consequence of the climate change (larger quantities of CO(2), less rain, and higher temperatures). 247 samples collected in vineyards representative of the qualified designation of origin Rioja from 2007 to 2011 have been analysed. Samples contain the four grape varieties usual in the elaboration of Rioja wines ('tempranillo', 'garnacha', 'mazuelo' and 'graciano'). The present study is the first systematic investigation on the maturity of grapes that includes the organoleptic evaluation of the degree of grapes maturity (sugars/acidity maturity, aromatic maturity of the pulp, aromatic maturity of the skins and tannins maturity) together with the values of the physicochemical parameters (probable alcohol degree, total acidity, pH, malic acid, K, total index polyphenolics, anthocyans, absorbances at 420, 520 and 620 nm, colour index and tartaric acid) determined over the same samples. A varimax rotation of the latent variables of a PLS model between the physicochemical variables and the mean of four sensory variables allows identifying both maturities. Besides, the position of the samples in the first plane defines the effect that the different factors exert on both phenolic and technological maturities.

EGFR signaling upregulates expression of microsomal prostaglandin E synthase-1 in cancer cells leading to enhanced tumorigenicity.

In this report we describe the contribution of prostaglandin E(2) (PGE(2)) derived from the inducible microsomal PGE-synthase type-1 (mPGES-1) to the epidermal growth factor receptor (EGFR) oncogenic drive in tumor epithelial cells and in tumor-bearing mice. EGFR stimulation upregulated expression of mPGES-1 in HT-29, A431 and A549 cancer cells. Egr-1, a transcription factor induced by EGF, mediated this response. The Egr-1 rise provoked the overexpression of mPGES-1 messenger and protein, and enhanced PGE(2) formation. These changes were suppressed either by silencing Egr-1, or by upstream blockade of EGFR or ERK1/2 signals. Further, in a clonogenic assay on tumor cells, EGF induced a florid tumorigenic phenotype, which regressed when mPGES-1 was silenced or knocked down. EGF-induced mPGES-1 overexpression in epithelial cell reduced E-cadherin expression, whereas enhancing that of vimentin, suggesting an incipient mesenchymal phenotype. Additionally, inhibiting the EGFR in mice bearing the A431 tumor, the mPGES-1 expression and the tumor growth, exhibited a parallel decline. In conclusion, these findings provide novel evidence that a tight cooperation between the EGF/EGFR and mPGES-1 leads to a significant tumorigenic gain in epithelial cells, and provide clues for controlling the vicious association.

Evaluation of CdZnTe as neutron detector around medical accelerators.

The operation of electron linear accelerators (LINACs) and cyclotrons can produce a mixed gamma-neutron field composed of energetic neutrons coming directly from the source and scattered lower energy neutrons. The thermal neutron detection properties of a non-moderated coplanar-grid CdZnTe (CZT) gamma-ray detector close to an 18 MV electron LINAC and an 18 MeV proton cyclotron producing the radioisotope (18)F for positron emission tomography are investigated. The two accelerators are operated at conditions producing similar thermal neutron fluence rates of the order of 10(4) cm(-2) s(-1) at the measurement locations. The counting efficiency of the CZT detector using the prompt 558 keV photopeak following (113)Cd thermal neutron capture is evaluated and a good neutron detection performance is found at the two installations.

Nuevos mecanismos en la defensa natural del hígado frente a la lesión / No disponible

No disponible

Correlation between external exposure and activity in patients undergoing 131I thyroid cancer therapy.

The uptake and clearance of 131I activity for inpatients undergoing cancer therapy were determined from routine external dose survey measurements. A bi-exponential behavior was found, with the two time constants representing the iodine dynamics in the thyroid on one hand and in the rest of the body on the other. The external dose at 1 m from the patient was correlated to the activity in the thyroid remnant and inside the body, the averaged value being 52.8 +/- 11.4 microSv GBq(-1) h(-1). The temporal evolution of activity in the body, the urinary system and the thyroid remnant area were determined taking into account the clearance from thyroid and whole body (effective retention constants averages 0.23 +/- 0.14 d(-1) and 1.46 +/- 0.34 d(-1)) and the uptake in thyroid (3.15 +/- 3.36%). Applications of this study in the public and environmental radiation protection areas are presented.

Calibration of a portable HPGe detector using MCNP code for the determination of 137Cs in soils.

In situ gamma spectrometry provides a fast method to determine (137)Cs inventories in soils. To improve the accuracy of the estimates, one can use not only the information on the photopeak count rates but also on the peak to forward-scatter ratios. Before applying this procedure to field measurements, a calibration including several experimental simulations must be carried out in the laboratory. In this paper it is shown that Monte Carlo methods are a valuable tool to minimize the number of experimental measurements needed for the calibration.

Artificial neural networks technology for neutron spectrometry and dosimetry.

Artificial Neural Network Technology has been applied to unfold neutron spectra and to calculate 13 dosimetric quantities using seven count rates from a Bonner Sphere Spectrometer with a (6)LiI(Eu). Two different networks, one for spectrometry and another for dosimetry, were designed. To train and test both networks, 177 neutron spectra from the IAEA compilation were utilised. Spectra were re-binned into 31 energy groups, and the dosimetric quantities were calculated using the MCNP code and the fluence-to-dose conversion coefficients from ICRP 74. Neutron spectra and UTA4 response matrix were used to calculate the expected count rates in the Bonner spectrometer. Spectra and H(10) of (239)PuBe and (241)AmBe were experimentally obtained and compared with those determined with the artificial neural networks.

Campos neutrónicos producidos por un acelerador lineal para radioterapia / Neutron fields produced by linear accelerator for radiotherapy

Mediante una serie de medidas y cálculos Monte Carlo se han determinado las características dosimétricas y los espectros de los fotoneutrones que se producen en torno a un acelerador lineal para radioterapia de 18 MV. Las medidas se realizaron con dosímetros termoluminiscentes TLD 600 y TLD 700 que se expusieron desnudos y emparedados con Cd, así como dentro de una esfera de parafina y dentro de esferas Bonner.

Measurements and Monte Carlo calculations has been utilized to determine the dosimetric features as well as the neutron spectra of photoneutrons produced around an 18 MV linear accelerator for radiotherapy. Measurementes were carried out with bare and Cd covered thermolumiscent dosimeters, TLD600 and TLD700, as well as inside a paraffine moderator. TLD pairs were also utilized as thermal neutrons inside a Bonner sphere spectrometer.