Concomitant trauma of brain and upper cervical spine: lessons in injury patterns and outcomes

Purpose: The literature on concomitant traumatic brain injury (TBI) and traumatic spinal injury is sparse and a few, if any, studies focus on concomitant TBI and associated upper cervical injury. The objective of this study was to fill this gap and to define demographics, patterns of injury, and clinical data of this specific population. Methods: Records of patients admitted at a single trauma centre with the main diagnosis of TBI and concomitant C0-C1-C2 injury (upper cervical spine) were identified and reviewed. Demographics, clinical, and radiological variables were analyzed and compared to those of patients with TBI and: (i) C3-C7 injury (lower cervical spine); (ii) any other part of the spine other than C1-C2 injury (non-upper cervical); (iii) T1-L5 injury (thoracolumbar). Results: 1545 patients were admitted with TBI and an associated C1-C2 injury was found in 22 (1.4%). The mean age was 64 years, and 54.5% were females. Females had a higher rate of concomitant upper cervical injury (p = 0.046 vs non-upper cervical; p = 0.050 vs thoracolumbar). Patients with an upper cervical injury were significantly older (p = 0.034 vs lower cervical; p = 0.030 vs non-upper cervical). Patients older than 55 years old had higher odds of an upper cervical injury when compared to the other groups (OR = 2.75). The main mechanism of trauma was road accidents (RAs) (10/22; 45.5%) All pedestrian injuries occurred in the upper cervical injured group (p = 0.015). ICU length of stay was longer for patients with an upper cervical injury (p = 0.018). Four patients died in the upper cervical injury group (18.2%), and no death occurred in other comparator groups (p = 0.003). Conclusions: The rate of concomitant cranial and upper cervical spine injury was 1.4%. Risk factors were female gender, age ≥ 55, and pedestrians. RAs were the most common mechanism of injury. There was an association between the upper cervical injury group and longer ICU stay as well as higher mortality rates. Increased understanding of the pattern of concomitant craniospinal injury can help guide comprehensive diagnosis, avoid missed injuries, and appropriate treatment

Protocolo para avaliação do estoque de carbono e de nitrogênio do solo em sistemas florestais - Projeto Saltus.

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Monitoramento dos fluxos de gases de efeito estufa de plantio de pinus e mata nativa, Rio Negrinho, SC.

Resumo

L'importanza ecologica e fitoalimurgica dei prati ricchi di specie del Trentino

Il cambiamento del sistema foraggero-zootecnico, da estensivo a intensivo, ha determinato la progressiva sostituzione del letame con il liquame. L’uso del liquame come fertilizzante riduce l’oligotrofia del suolo e porta alla banalizzazione delle fitocenosi erbacee. Nell’ambito del progetto Bioagrimont sono state indagate con metodo floristico-vegetazionale e statistico 25 fitocenosi (plots 5m x 5m) prato-pascolive a diversa gestione e quota altimetrica delle valli di Fiemme, di Fassa e Passo di Lavazè. I risultati confermano la correlazione negativa tra ricchezza floristica (S) e apporto di nutrienti (N) ed evidenziano una sensibile perdita del valore naturalistico per i prati del fondovalle. Si dimostra inoltre che le praterie a maggior ricchezza floristica, legate a ridotto o nullo apporto di nutrienti, funzionano da serbatoio di specie potenzialmente utili anche a livello alimentare e officinal

Effects of mixing state on optical and radiative properties of black carbon in the European Arctic

Atmospheric aging promotes internal mixing of black carbon (BC), leading to an enhancement of light absorption and radiative forcing. The relationship between BC mixing state and consequent absorption enhancement was never estimated for BC found in the Arctic region. In the present work, we aim to quantify the absorption enhancement and its impact on radiative forcing as a function of microphysical properties and mixing state of BC observed in situ at the Zeppelin Arctic station (78°&thinsp;N) in the spring of 2012 during the CLIMSLIP (Climate impacts of short-lived pollutants in the polar region) project.Single-particle soot photometer (SP2) measurements showed a mean mass concentration of refractory black carbon (rBC) of 39&thinsp;ng&thinsp;m−3, while the rBC mass size distribution was of lognormal shape, peaking at an rBC mass-equivalent diameter (DrBC) of around 240&thinsp;nm. On average, the number fraction of particles containing a BC core with DrBC&gt;80&thinsp;nm was less than 5&thinsp;% in the size range (overall optical particle diameter) from 150 to 500&thinsp;nm. The BC cores were internally mixed with other particulate matter. The median coating thickness of BC cores with 220&thinsp;nm&thinsp;&lt;&thinsp;DrBC&lt; 260&thinsp;nm was 52&thinsp;nm, resulting in a core–shell diameter ratio of 1.4, assuming a coated sphere morphology. Combining the aerosol absorption coefficient observed with an Aethalometer and the rBC mass concentration from the SP2, a mass absorption cross section (MAC) of 9.8&thinsp;m2&thinsp;g−1 was inferred at a wavelength of 550 nm. Consistent with direct observation, a similar MAC value (8.4&thinsp;m2&thinsp;g−1 at 550&thinsp;nm) was obtained indirectly by using Mie theory and assuming a coated-sphere morphology with the BC mixing state constrained from the SP2 measurements. According to these calculations, the lensing effect is estimated to cause a 54&thinsp;% enhancement of the MAC compared to that of bare BC particles with equal BC core size distribution. Finally, the ARTDECO radiative transfer model was used to estimate the sensitivity of the radiative balance to changes in light absorption by BC as a result of a varying degree of internal mixing at constant total BC mass. The clear-sky noontime aerosol radiative forcing over a surface with an assumed wavelength-dependent albedo of 0.76–0.89 decreased, when ignoring the absorption enhancement, by −0.12&thinsp;W&thinsp;m−2 compared to the base case scenario, which was constrained with mean observed aerosol properties for the Zeppelin site in Arctic spring. The exact magnitude of this forcing difference scales with environmental conditions such as the aerosol optical depth, solar zenith angle and surface albedo. Nevertheless, our investigation suggests that the absorption enhancement due to internal mixing of BC, which is a systematic effect, should be considered for quantifying the aerosol radiative forcing in the Arctic region.</p