Characterizing the automatic radon flux transfer standard system Autoflux: laboratory calibration and field experiments

High-quality, long-term measurements of terrestrial trace gas emissions are important for investigations of atmospheric, geophysical and biological processes to help mitigate climate change and protect the environment and the health of citizens. High-frequency terrestrial fluxes of the radioactive noble gas 222Rn, in particular, are useful for validating radon flux maps and used to evaluate the performance of regional atmospheric models, to improve greenhouse gas emission inventories (by the radon tracer method) and to determine radon priority areas for radiation protection goals. A new automatic radon flux system (Autoflux) was developed as a transfer standard (TS) to assist with establishing a traceability chain for field-based radon flux measurements. The operational characteristics and features of the system were optimized based on a literature review of existing flux measurement systems. To characterize and calibrate Autoflux, a bespoke radon exhalation bed (EB) facility was also constructed with the intended purpose of providing a constant radon exhalation under a specific set of controlled laboratory conditions. The calibrated Autoflux was then used to transfer the derived calibration to a second continuous radon flux system under laboratory conditions; both instruments were then tested in the field and compared with modeled fluxes. This paper presents (i) a literature review of state-of-the-art radon flux systems and EB facilities; (ii) the design, characterization and calibration of a reference radon EB facility; (iii) the design, characterization and calibration of the Autoflux system; (iv) the calibration of a second radon flux system (INTE_Flux) using the EB and Autoflux, with a total uncertainty of 9 % (k = 1) for an average radon flux of ∼ 1800 mBq m−2 s−1 under controlled laboratory conditions; and (v)​​​​​​​ an example application of the calibrated TS and INTE_Flux systems for in situ radon flux measurements, which are then compared with simulated radon fluxes. Calibration of the TS under different environmental conditions and at lower reference fluxes will be the subject of a separate future investigation.</p

Municipal mortality due to thyroid cancer in Spain

BACKGROUND: Thyroid cancer is a tumor with a low but growing incidence in Spain. This study sought to depict its spatial municipal mortality pattern, using the classic model proposed by Besag, York and Mollié. METHODS: It was possible to compile and ascertain the posterior distribution of relative risk on the basis of a single Bayesian spatial model covering all of Spain's 8077 municipal areas. Maps were plotted depicting standardized mortality ratios, smoothed relative risk (RR) estimates, and the posterior probability that RR > 1. RESULTS: From 1989 to 1998 a total of 2,538 thyroid cancer deaths were registered in 1,041 municipalities. The highest relative risks were mostly situated in the Canary Islands, the province of Lugo, the east of La Coruña (Corunna) and western areas of Asturias and Orense. CONCLUSION: The observed mortality pattern coincides with areas in Spain where goiter has been declared endemic. The higher frequency in these same areas of undifferentiated, more aggressive carcinomas could be reflected in the mortality figures. Other unknown genetic or environmental factors could also play a role in the etiology of this tumor

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts

Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24&nbsp;h. In both studies, patients were followed for outcome until death, hospital discharge or for 60&nbsp;days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24&nbsp;h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (&gt; 29 cmH2O) and driving pressure (&gt; 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (&gt; 8&nbsp;ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure &gt; 29 cmH2O and driving pressure &gt; 14 cmH2O on the first day of mechanical ventilation but not tidal volume &gt; 8&nbsp;ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies

Two significant experiences related to radon in a high risk area in Spain

Radon is a natural radioactive gas and it is currently accepted as being responsible for lung cancer in some cases. One of the most important sources of indoor radon is from the soil. The radium content of soil is also a very important factor to be taken into account. The natural radiation map of Spain (MARNA) classifies the country into three regions with different levels of natural gamma radiation. There are some areas in Spain with high levels of natural radiation one of those is the province of Salamanca. Western part of this province presents a population of 20 000 inhabitants and 7% of the houses have an indoor radon concentration above 400 Bqźm–3. In this high risk area, the village of Villar de la Yegua is of special interest: 11% of the houses in this village have an indoor radon level below 400 Bqźm–3, 89 per cent have above 400 Bqźm–3 and 71 per cent of the houses have a radon concentration above 1000 Bqźm–3. An old uranium mine site close to this village has been selected for the construction of an experimental pilot house. It is a two story house located in the place with a very high 226Ra concentration in soil. Radon in soil at 1 m depth has an average level of 250 kBqźm–3. We present in this work the characteristics of the experimental unit located in this high risk area and we describe the zone where one of the Spanish villages with the highest radon concentration is located. This is a very interesting place for further research on indoor radon concentration and it is a unique opportunity of testing radon monitors, radon passive detectors and remedial actions for the mitigation of radon in real conditions. It is common to carry out intercomparison exercises under laboratory conditions. Nonetheless, it is not so common to develop these exercises in real conditions as we have in the experimental unit we present here. We offer in this work the possibility for other research groups of testing their equipments in this unit and we also show the evolution of the works carried out in the locality of Villar de la Yegua