Swordfish bill injury involving abdomen and vertebral column: case report and review

<p>Abstract</p> <p>Background</p> <p>Penetrating injuries of the abdomen and spinal canal that involve organic material of animal origin are extremely rare and derive from domestic and wild animal attacks or fish attacks.</p> <p>Case presentation</p> <p>In this case report we present the unique, as far as the literature is concerned, unprovoked woman's injury to the abdomen by a swordfish. There are only four cases of swordfish attacks on humans in the literature - one resulted to thoracic trauma, two to head trauma and one to knee trauma, one of which was fatal - none of which were unprovoked. Three victims were professional or amateur fishermen whereas in the last reported case the victim was a bather as in our case. Our case is the only case where organic debris of animal's origin remained in the spinal canal after penetrating trauma.</p> <p>Conclusions</p> <p>Although much has been written about the management of penetrating abdominal and spinal cord trauma, controversy remains about the optimal management. Moreover, there is little experience in the management of patients with such spinal injuries, due to the fact that such cases are extremely rare. In this report we focus on the patient's treatment with regard to abdominal and spinal trauma and present a review of the literature.</p

90Y-clivatuzumab tetraxetan with or without low-dose gemcitabine: A phase Ib study in patients with metastatic pancreatic cancer after two or more prior therapies

AbstractBackgroundFor patients with metastatic pancreatic adenocarcinoma, there are no approved or established treatments beyond the 2nd line. A Phase Ib study of fractionated radioimmunotherapy was undertaken in this setting, administering 90Y-clivatuzumab tetraxetan (yttrium-90-radiolabelled humanised antibody targeting pancreatic adenocarcinoma mucin) with or without low radiosensitising doses of gemcitabine.MethodsFifty-eight patients with three (2–7) median prior treatments were treated on Arm A (N=29, 90Y-clivatuzumab tetraxetan, weekly 6.5mCi/m2doses×3, plus gemcitabine, weekly 200mg/m2 doses×4 starting 1week earlier) or Arm B (N=29, 90Y-clivatuzumab tetraxetan alone, weekly 6.5mCi/m2doses×3), repeating cycles after 4-week delays. Safety was the primary endpoint; efficacy was also evaluated.ResultsCytopaenias (predominantly transient thrombocytopenia) were the only significant toxicities. Fifty-three patients (27 Arm A, 26 Arm B, 91% overall) completed ⩾1 full treatment cycles, with 23 (12 Arm A, 11 Arm B; 40%) receiving multiple cycles, including seven (6 Arm A, 1 Arm B; 12%) given 3–9 cycles. Two patients in Arm A had partial responses by RECIST criteria. Kaplan–Meier overall survival (OS) appeared improved in Arm A versus B (hazard ratio [HR] 0.55, 95% CI: 0.29–0.86; P=0.017, log-rank) and the median OS for Arm A versus Arm B increased to 7.9 versus 3.4months with multiple cycles (HR 0.32, P=0.004), including three patients in Arm A surviving >1year.ConclusionsClinical studies of 90Y-clivatuzumab tetraxetan combined with low-dose gemcitabine appear feasible in metastatic pancreatic cancer patients beyond 2nd line and a Phase III trial of this combination is now underway in this setting

Dry matter losses and methane emissions during wood chip storage: the impact on full life cycle greenhouse gas savings of short rotation coppice willow for heat

A life cycle assessment (LCA) approach was used to examine the greenhouse gas (GHG) emissions and energy balance of short rotation coppice (SRC) willow for heat production. The modelled supply chain includes cutting multiplication, site establishment, maintenance, harvesting, storage, transport and combustion. The relative impacts of dry matter losses and methane emissions from chip storage were examined from a LCA perspective, comparing the GHG emissions from the SRC supply chain with those of natural gas for heat generation. The results show that SRC generally provides very high GHG emission savings of over 90 %. The LCA model estimates that a 1, 10 and 20 % loss of dry matter during storage causes a 1, 6 and 11 % increase in GHG emissions per MWh. The GHG emission results are extremely sensitive to emissions of methane from the wood chip stack: If 1 % of the carbon within the stack undergoes anaerobic decomposition to methane, then the GHG emissions per MWh are tripled. There are some uncertainties in the LCA results, regarding the true formation of methane in wood chip stacks, non-CO2 emissions from combustion, N2O emissions from leaf fall and the extent of carbon sequestered under the crop, and these all contribute a large proportion of the life cycle GHG emissions from cultivation of the cro

A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

Harvesting of southern Piedmont’s orchards pruning residues: evaluations of biomass production and harvesting losses

In recent years, there has been an increasing interest in respect to all farming residues, including orchard pruning residues. The masses and dimensional characteristics of branches pruned, depend on several factors such as fruit variety, active strength plant, training systems, intensity and periodicity pruning. Many studies were done to fix this type of biomass availability, however they’re not up-to-date, and usually they are lacking of accurate surveys. A detailed knowledge of current pruning biomass availability, both qualitative and quantitative, is also necessary for the evaluation of the economic sustainability of their energetic exploitation. In this context, in order to provide an assessment of the real chain potential of energy renewable production, from Cuneo territory pruning residues, a research was conducted on two different orchards species Actinidia (Kiwi tree) and Malus (Apple tree) pruned in two different ways: “traditional system” and “taille longue system”. For each species, pruning residues amount were quantified together with their diameter. The surveys were performed at least on four half trees placed on the same row spacing with three randomized replications in the crop. The amount of pruning residues were determined by a dynamometer (precision 0.02N) whereas the diameter of individual cut-off branches has been detected at the base of the same using a twentieths calliper. Subsequently were performed pruning residues windrowing by rotating rake and the harvest of the same by fixed chamber round baler suitably modified. At the end of these operations have been determined harvesting losses with the same methodology used for the initial quantification of residues. The first result shows that with the “traditional pruning system” the biomass average availability is of 2.5t DM ha–1 and 3.0t DM ha–1, respectively for kiwi tree and apple tree. For the latter, the average values are significantly lower 0.5t DM ha–1 with “taille longue” pruning system. The harvesting losses have been nearly 19% in kiwi tree and 16% for apple tree (from 95% to 11% according to the variety). In both crops the variation of harvester losses are due mainly to the size and conformation (straight) of pruned branches