The prognostic value of injury severity, location of event, and age at injury in pediatric traumatic head injuries

Jonas G Halldorsson1, Kjell M Flekkoy2, Gudmundur B Arnkelsson3, Kristinn Tomasson4, Kristinn R Gudmundsson5, Eirikur Orn Arnarson1,61Psychological Health Services, Landspitali University Hospital, Reykjavik, Iceland; 2Department of Psychology, University of Oslo, and Department of Geriatric Medicine, Ulleval University Hospital, Oslo, Norway; 3Department of Psychology, University of Iceland, Reykjavik, Iceland; 4Administration of Occupational Safety and Health, Reykjavik, Iceland; 5Department of Neurosurgery, Landspitali University Hospital, Reykjavik, Iceland; 6Faculty of Medicine, University of Iceland, Reykjavik, IcelandAims: To estimate the prognostic value of injury severity, location of event, and demographic parameters, for symptoms of pediatric traumatic head injury (THI) 4 years later.Methods: Data were collected prospectively from Reykjavik City Hospital on all patients age 0–19 years, diagnosed with THI (n = 408) during one year. Information was collected on patient demographics, location of traumatic event, cause of injury, injury severity, and ICD-9 diagnosis. Injury severity was estimated according to the Head Injury Severity Scale (HISS). Four years post-injury, a questionnaire on late symptoms attributed to the THI was sent.Results: Symptoms reported were more common among patients with moderate/severe THI than among others (p < 0.001). The event location had prognostic value (p < 0.05). Overall, 72% of patients with moderate/severe motor vehicle-related THI reported symptoms. There was a curvilinear age effect (p < 0.05). Symptoms were least frequent in the youngest age group, 0–4 years, and most frequent in the age group 5–14 years. Gender and urban/rural residence were not significantly related to symptoms.Conclusions: Motor vehicle related moderate/severe THI resulted in a high rate of late symptoms. Location had a prognostic value. Patients with motor vehicle-related THI need special consideration regardless of injury severity.Keywords: follow-up, pediatric, symptoms, traumatic head injur

Urban–rural differences in pediatric traumatic head injuries: A prospective nationwide study

Jonas G Halldorsson1, Kjell M Flekkoy2, Kristinn R Gudmundsson3, Gudmundur B Arnkelsson4, Eirikur Orn Arnarson1,51Psychological Health Services, Landspitali University Hospital, Reykjavik, Iceland; 2Department of Psychology, University of Oslo, Oslo, Norway; 3Department of Neurosurgery, Landspitali University Hospital, Reykjavik, Iceland; 4Faculty of Social Science, University of Iceland, Reykjavik, Iceland; 5Faculty of Medicine, University of Iceland, Reykjavik, IcelandAims: To estimate differences in the incidence of recorded traumatic head injuries by gender, age, severity, and geographical area.Methods: The study was prospective and nationwide. Data were collected from all hospitals, emergency units and healthcare centers in Iceland regarding all Icelandic children and adolescents 0–19 years old consecutively diagnosed with traumatic head injuries (N = 550) during a one-year period.Results: Annual incidence of minimal, mild, moderate/severe, and fatal head injuries (ICD-9 850–854) was 6.41 per 1000, with 95% confi dence interval (CI) 5.9, 7.0. Annual incidence of minimal head injuries (ICD-9 850) treated at emergency units was 4.65 (CI 4.2, 5.1) per 1000, mild head injuries admitted to hospital (ICD-9 850) was 1.50 (CI 1.3, 1.8) per 1000, and moderate/severe nonfatal injuries (ICD-9 851–854) was 0.21 (CI 0.1, 0.3) per 1000. Death rate was 0.05 (CI 0.0, 0.1) per 1000. Young children were at greater risk of sustaining minimal head injuries than older ones. Boys were at greater risk than girls were. In rural areas, incidence of recorded minimal head injuries was low.Conclusions: Use of nationwide estimate of the incidence of pediatric head injury shows important differences between urban and rural areas as well as between different age groups.Keywords: incidence, nationwide, pediatric, prospective, traumatic head injuries, urban-rural difference

Average seasonal changes in chlorophyll a in Icelandic waters

The standard algorithms used to derive sea surface chlorophyll a concentration from remotely sensed ocean colour data are based almost entirely on the measurements of surface water samples collected in open sea (case 1) waters which cover ~60% of the worlds oceans, where strong correlations between reflectance and chlorophyll concentration have been found. However, satellite chlorophyll data for waters outside the defined case 1 areas, but derived using standard calibrations, are frequently used without reference to local in situ measurements and despite well-known factors likely to lead to inaccuracy. In Icelandic waters, multiannual averages of 8-d composites of SeaWiFS chlorophyll concentration accounted for just 20% of the variance in a multiannual dataset of in situ chlorophyll a measurements. Nevertheless, applying penalized regression spline methodology to model the spatial and temporal patterns of in situ measurements, using satellite chlorophyll as one of the predictor variables, improved the correlation considerably. Day number, representing seasonal variation, accounted for substantial deviation between SeaWiFS and in situ estimates of surface chlorophyll. The final model, using bottom depth and bearing to the sampling location as well as the two variables mentioned above, explained 49% of the variance in the fitting dataset

The prognostic value of injury severity, location of event, and age at injury in pediatric traumatic head injuries. Neuropsychiatric Disease and Treatment

Aims: To estimate the prognostic value of injury severity, location of event, and demographic parameters, for symptoms of pediatric traumatic head injury (THI) 4 years later. Methods: Data were collected prospectively from Reykjavik City Hospital on all patients age 0-19 years, diagnosed with THI (n = 408) during one year. Information was collected on patient demographics, location of traumatic event, cause of injury, injury severity, and ICD-9 diagnosis. Injury severity was estimated according to the Head Injury Severity Scale (HISS). Four years post-injury, a questionnaire on late symptoms attributed to the THI was sent. Results: Symptoms reported were more common among patients with moderate/severe THI than among others (p Ͻ 0.001). The event location had prognostic value (p Ͻ 0.05). Overall, 72% of patients with moderate/severe motor vehicle-related THI reported symptoms. There was a curvilinear age effect (p Ͻ 0.05). Symptoms were least frequent in the youngest age group, 0-4 years, and most frequent in the age group 5-14 years. Gender and urban/rural residence were not signifi cantly related to symptoms. Conclusions: Motor vehicle related moderate/severe THI resulted in a high rate of late symptoms. Location had a prognostic value. Patients with motor vehicle-related THI need special consideration regardless of injury severity

Observational evidence linking ocean sulfur compounds to atmospheric dimethyl sulfide during Icelandic Sea phytoplankton blooms

In two Icelandic Sea spring blooms (May 2018 and 2019) in the North Atlantic Ocean (62.9-68.0 degrees N, 9.0-28.0 degrees W), chlorophyll -a and dimethylsulfoniopropionate (DMSP) concentrations and DMSP lyase activity (the DMSP-to-dimethyl sul-fide (DMS) conversion efficiency) were measured at 67 stations, and the hourly atmospheric DMS mixing ratios were con-currently measured only in May 2019 at Storhofdi on Heimaey Island, located south of Iceland (63.4 degrees N, 20.3 degrees W). The ocean parameters for biology (i.e., chlorophyll -a, DMSP, and DMSP lyase activity) were broadly associated in distribution; however, the statistical significance of the association differed among four ocean domains and also between 2018 and 2019. Specifically, the widespread dominance of Phaeocystis, coccolithophores, and dinoflagellates (all rich in DMSP and high in DMSP lyase activity) across the study area is a compelling indication that variations in DMSP-rich phytoplankton were likely a main cause of the variations in statistical significance. For all the ocean domains defined here, we found that the DMS production capacity (calculated using the exposures of air masses to ocean biology prior to their arrivals at Heimaey and the atmospheric DMS mixing ratios of those air masses at Heimaey) was surprisingly consistent with in situ ocean S data (i.e., DMSP and DMSP lyase activity). Our study shows that the proposed computational approach en-abled the detection of changes in DMS production and emission in association with changes in ocean primary producers.11Nsciescopu

A global dataset of photosynthesis-irradiance parameters for marine phytoplankton

The MAPPS global database of photosynthesis-irradiance (P-E) parameters consists of over 5000 P-E experiments that provides information on the spatio-temporal variability in the two P-E parameters (the assimilation number, and the initial slope) that are fundamental inputs for models of marine primary production that use chlorophyll as the state variable. The experiments were carried out by an international group of research scientists to examine the basin-scale variability in the photophysiological response of marine phytoplankton over a range of oceanic regimes (from the oligotrophic gyres to productive shelf systems) and covers several decades. These data can be used to improve the assignment of P-E parameters in the estimation of marine primary production using satellite data

A variant of the gene encoding leukotriene A4 hydrolase confers ethnicity-specific risk of myocardial infarction.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldVariants of the gene ALOX5AP (also known as FLAP) encoding arachidonate 5-lipoxygenase activating protein are known to be associated with risk of myocardial infarction. Here we show that a haplotype (HapK) spanning the LTA4H gene encoding leukotriene A4 hydrolase, a protein in the same biochemical pathway as ALOX5AP, confers modest risk of myocardial infarction in an Icelandic cohort. Measurements of leukotriene B4 (LTB4) production suggest that this risk is mediated through upregulation of the leukotriene pathway. Three cohorts from the United States also show that HapK confers a modest relative risk (1.16) in European Americans, but it confers a threefold larger risk in African Americans. About 27% of the European American controls carried at least one copy of HapK, as compared with only 6% of African American controls. Our analyses indicate that HapK is very rare in Africa and that its occurrence in African Americans is due to European admixture. Interactions with other genetic or environmental risk factors that are more common in African Americans are likely to account for the greater relative risk conferred by HapK in this group