Effect of Pre-Hospital Intubation in Patients with Severe Traumatic Brain Injury on Outcome: A Prospective Cohort Study.

Secondary injuries are associated with bad outcomes in the case of severe traumatic brain injury (sTBI). Patients with a Glasgow Coma Scale (GCS) < 9 should undergo pre-hospital intubation (PHI). There is controversy about whether PHI is beneficial. The aim of this study was to estimate the effect of PHI in patients after sTBI. A multicenter, prospective cohort study was performed in Switzerland, including 832 adults with sTBI. Outcomes were death and impaired consciousness at 14 days. Associations between risk factors and outcomes were assessed with univariate and multivariate Cox models for survival, and univariate and multivariate regression models for impaired consciousness. Potential risk factors were age, GCS on scene, pupil reaction, Injury Severity Score (ISS), PHI, oxygen administration, and type of admission to trauma center. Age, GCS on scene < 9, abnormal pupil reaction and ISS ≥ 25 were associated with mortality. GCS < 9 and ISS ≥ 25 were correlated with impaired consciousness. PHI was overall not associated with short-term mortality and consciousness. However, there was a significative interaction with PHI and major trauma. PHI improves outcome from patients with sTBI and an ISS ≥ 25

Characterization and dating of coastal deposits of NW Portugal (Minho - Neiva area): a record of climate, eustasy and crustal uplift during the Quaternary

This study presents the characterization and numerical dating of Quaternary coastal deposits of NW Portugal, located between the mouths of the Minho and Neiva rivers. They record continental (small alluvial fans and streams) and transitional (aeolian dunes, interdune ponds, estuary, sandy and gravelly beaches) paleoenvironments. Quartz and K-feldspar optically stimulated luminescence (OSL) dating is employed as well as AMS C-14 dating. A staircase of coastal terraces (abrasion shore platforms) was identified (altimetry, a.s.l.) and ascribed to the following probable Marine Isotope Stages (MIS): T1 - 20-18 m (MIS11); T2 - ca. 13 m (MIS9); T3 - 9.3-7.3 m (MIS7); T4 - 5.5-4.5 m (MIS5); T5 - 3.5-2.0 m (MIS5). The terraces have some preserved sedimentary facies that includes coeval beach sediments on the lowest four. A late Pleistocene to Holocene sedimentary cover comprises four sub-units: a) the lower sub-unit, corresponding to ferruginous stream deposits and aeolian dunes dated ca. 67-61 ka (MIS4), probably related with sub-humid to arid mid-cold conditions; b) on the slopes, the lower sub-unit is overlapped by sandy-silty colluvium and sandy alluvial deposits dated ca. 56-28 ka (MIS3) and probably reflecting cold/mid-cold and wet/dry climate conditions; c) this sub-unit is topped by soliflucted lobes and sandy-silty/silty deposits recording cold and dry climate dated 20-13 ka (MIS2), and d) a top subunit dated to 16-18th century, recording Little Ice Age events, consisting of fluvial sediments coeval with temperate climate evolving to aeolian dunes from the Maunder Minimum (cold windy dry conditions).Portuguese Foundation for Science and Technology (FCT) - grant SFRH/BD/16438/2004 - project PTDC/GEO-GEO/2860/2012 - Sabbatical Leave Grant ref. SFRH/BSAB/1289/2012 - Research also has been supported by both Aarhus University and Risø DTU (Denmark

The Eastern Lower Tagus Valley Fault Zone in central Portugal : active faulting in a low-deformation region within a major river environment

Active faulting in the Lower Tagus Valley, Central Portugal, poses a significant seismic hazard that is not well understood. Although the area has been affected by damaging earthquakes during historical times, only recently has definitive evidence of Quaternary surface faulting been found along the western side of the Tagus River. The location, geometry and kinematics of active faults along the eastern side of the Tagus valley have not been previously studied. We present the first results of mapping and paleoseismic analysis of the eastern strand of the Lower Tagus Valley Fault Zone (LTVFZ). Geomorphological, paleoseismological, and seismic reflection studies indicate that the Eastern LTVFZ is a left-lateral strike-slip fault. The detailed mapping of geomorphic features and studies in two paleoseismic trenches show that surface fault rupture has occurred at least six times during the past 10 ka. The river offsets indicate a minimum slip rate on the order of 0.14–0.24 mm/yr for the fault zone. Fault trace mapping, geomorphic analysis, and paleoseismic studies suggest a maximum magnitude for the Eastern LTVFZ of Mw ~ 7.3 with a recurrence interval for surface ruptures ~ 1.7 ka. At least two events occurred after 1175 ± 95 cal yr BP. Single-event displacements are unlikely to be resolved in the paleoseismic trenches, thus our observations most probably represent the minimum number of events identified in the trenches

Biodiversity increases and decreases ecosystem stability

International audienc

New data on the chronology of the Vale do Forno sedimentary sequence (Lower Tejo River terrace staircase) and its relevance as a fluvial archive of the Middle Pleistocene in western Iberia

The Vale do Forno archaeological sites (Alpiar\ue7a, central Portugal) document the earliest human occupation in the Lower Tejo River, well established in geomorphological and environmental terms, within the Middle Pleistocene. In a staircase of six fluvial terraces, the Palaeolithic sites were found on the T4 terrace (\ufe24 m, above river bed) which is made of a basal Lower Gravels unit (LG) and an overlying Upper Sands unit (US). Geomorphological mapping, coupled with lithostratigraphy, sedimentology and luminescence dating (quartz-OSL and K-feldspar post-IRIR290) were used in this study. The oldest artefacts found in the LG unit show crude bifacial forms that can be attributed to the Acheulian. In contrast, the US unit has archaeological sites stratigraphically documenting successive phases of an evolved Acheulian. Luminescence dating and correlation with the Marine Isotopic Stages suggest that the LG unit has a probable age of ca. 335 to 325 ka and the US unit an age of ca. 325 to 155 ka. This is in contrast to previous interpretations ascribing this terrace (and lithic industries) to the Last Interglacial and early phases of the Last Glacial. The VF3 site (Milharos), containing Micoquian (Final Acheulian) industries (with fine and elaborated bifaces), found in a stratigraphic level located between the T4 terrace deposits and a colluvium associated with Late Pleistocene aeolian sands, is younger than 155 ka but much older than 32 ka

Traitement des gonalgies en antalgie interventionnelle [Interventional pain management for knee pain.]

Arthritis is the main cause of knee pain among adults over 50 years old. Prosthetic surgery is the ultimate treatment, however percutaneous interventional pain management is a good alternative treatment for patients who are not eligible for an operation or for those who experiment persistent pain after surgery. Intra-articular corticosteroids or hyaluronic acid injections have a mild effect which is limited in time. Nerve ablation treatment using radiofrequency or cryotherapy may have longer lasting analgesic effects superior than 6 months. Finally, regenerative medicine, meaning platelet-rich plasma or mesenchymal stem cells, seems a very promising treatment by improving pain and mobility for a longer period