Changes in cerebral compartmental compliances during mild hypocapnia in patients with traumatic brain injury.

The benefit of induced hyperventilation for intracranial pressure (ICP) control after severe traumatic brain injury (TBI) is controversial. In this study, we investigated the impact of early and sustained hyperventilation on compliances of the cerebral arteries and of the cerebrospinal (CSF) compartment during mild hyperventilation in severe TBI patients. We included 27 severe TBI patients (mean 39.5 ± 3.4 years, 6 women) in whom an increase in ventilation (20% increase in respiratory minute volume) was performed during 50 min as part of a standard clinical CO(2) reactivity test. Using a new mathematical model, cerebral arterial compliance (Ca) and CSF compartment compliance (Ci) were calculated based on the analysis of ICP, arterial blood pressure, and cerebral blood flow velocity waveforms. Hyperventilation initially induced a reduction in ICP (17.5 ± 6.6 vs. 13.9 ± 6.2 mmHg; p < 0.001), which correlated with an increase in Ci (r(2) = 0.213; p = 0.015). Concomitantly, the reduction in cerebral blood flow velocities (CBFV, 74.6 ± 27.0 vs. 62.9 ± 22.9 cm/sec; p < 0.001) marginally correlated with the reduction in Ca (r(2) = 0.209; p = 0.017). During sustained hyperventilation, ICP increased (13.9 ± 6.2 vs. 15.3 ± 6.4 mmHg; p < 0.001), which correlated with a reduction in Ci (r(2) = 0.297; p = 0.003), but no significant changes in Ca were found during that period. The early reduction in Ca persisted irrespective of the duration of hyperventilation, which may contribute to the lack of clinical benefit of hyperventilation after TBI. Further studies are needed to determine whether monitoring of arterial and CSF compartment compliances may detect and prevent an adverse ischemic event during hyperventilation.

Helicopter rescue operations involving winching of an emergency physician.

OBJECTIVE: We sought to study the epidemiologic and medical aspects of alpine helicopter rescue operations involving the winching of an emergency physician to the victim. METHODS: We retrospectively reviewed the medical and operational reports of a single helicopter-based emergency medical service. Data from 1 January 2003 to 31 December 2008 were analysed. RESULTS: A total of 921 patients were identified, with a male:female ratio of 2:1. There were 56 (6%) patients aged 15 or under. The median time from emergency call to helicopter take-off was 7 min (IQR = 5-10 min). 840 (91%) patients suffered from trauma-related injuries, with falls from heights during sports activities the most frequent event. The most common injuries involved the legs (246 or 27%), head (175 or 19%), upper limbs (117 or 13%), spine (108 or 12%), and femur (66 or 7%). Only 81 (9%) victims suffered from a medical emergency, but these cases were, when compared to the trauma victims, significantly more severe according to the NACA index (p<0.001). Overall, 246 (27%) patients had a severe injury or illness, namely, a potential or overt vital threat (NACA score between 4 and 6). A total of 478 (52%) patients required administration of major analgesics: fentanyl (443 patients or 48%), ketamine (42 patients or 5%) or morphine (7 patients or 1%). The mean dose of fentanyl was 188 micrograms (range 25-750, SD 127). Major medical interventions such as administration of vasoactive drugs, intravenous perfusions of more than 1000 ml of fluids, ventilation or intubation were performed on 39 (4%) patients. CONCLUSIONS: The severity of the patients' injuries or illnesses along with the high proportion of medical procedures performed directly on-site validates emergency physician winching for advanced life support procedures and analgesia.

Dictionnaire alphabético-méthodique des cérémonies et des rites sacrés.... tome 15 / par M. l'abbé Boissonnet, ... ; publié par M. l'abbé Migne, ...

Collection : Encyclopédie théologique... ; 15-17

Dictionnaire alphabético-méthodique des cérémonies et des rites sacrés.... tome 16 / par M. l'abbé Boissonnet, ... ; publié par M. l'abbé Migne, ...

Collection : Encyclopédie théologique... ; 15-17

Dictionnaire alphabético-méthodique des cérémonies et des rites sacrés.... tome 17 / par M. l'abbé Boissonnet, ... ; publié par M. l'abbé Migne, ...

Collection : Encyclopédie théologique... ; 15-17

Real-time tree-foliage surface estimation using a ground laser scanner

The optimization of most pesticide and fertilizer applications is based on overall grove conditions. In this work we measurements. Recently, Wei [9, 10] used a terrestrial propose a measurement system based on a ground laser scanner to LIDAR to measure tree height, width and volume developing estimate the volume of the trees and then extrapolate their foliage a set of experiments to evaluate the repeatability and surface in real-time. Tests with pear trees demonstrated that the accuracy of the measurements, obtaining a coefficient of relation between the volume and the foliage can be interpreted as variation of 5.4% and a relative error of 4.4% in the linear with a coefficient of correlation (R) of 0.81 and the foliar estimation of the volume but without real-time capabilities. surface can be estimated with an average error less than 5 %.

Efecto del nitrato de potasio, fosfato de potasio y ethephon en la inducción floral de la feijoa o goiabeira serrana (Acca sellowiana [O. Berg] Burret)

El ensayo se llevó a cabo en la finca El Cortijo (La Vega, Cundinamarca, Colombia [04°55'N y 74°18'W], 2350 m altitud, 17°C temperatura media, 1423 mm precipitación anual, 85% humedad relativa, 1377 horas brillo solar/año). Se utilizaron árboles de feijoa o goiabeira serrana de seis años, Clon 41 ('Quimba'), evaluando fertilizantes foliares KNO3 (Nitrato de Potasio 13-0-46® 1%, 1,5% y 2%) y KH2PO4 (fosfato de potasio; Cosmofoliar 0-32-43®; 0,5%, 0,75% y 1,0%) y la fitohormona ethephon (Ethrel® 48 SL; 100, 150 y 200 mg L-1). Se determinaron el número de botones florales inducidos, flores formadas, además, el porcentaje de flores formadas y nivel de eficacia de los productos inductores. El KH2PO4 al 0,5% obtuvo resultados favorables en cada una de las variables evaluadas, comparado con el 0,75% y 1% del mismo producto y, sin embargo hubo un alto número de flores inducidas y formadas, no se presentaron diferencias significativas con el testigo. Ethephon a 150 mg L-1 en la inducción de botones florales y a 100 mg L-1 en la de formación de flores mostró resultados favorables, pero tampoco pudo superar el testigo por falta de significancia. La respuesta generada por KNO3 mostró una baja inducción de botones florales, y una eficacia negativa en la proporción de flores formadas; asimismo fitotoxicidad, cuando se emplearon concentraciones al 2% de este producto.

Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants.

BACKGROUND: Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. METHODS: We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m(2) [underweight], 18·5 kg/m(2) to <20 kg/m(2), 20 kg/m(2) to <25 kg/m(2), 25 kg/m(2) to <30 kg/m(2), 30 kg/m(2) to <35 kg/m(2), 35 kg/m(2) to <40 kg/m(2), ≥40 kg/m(2) [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. FINDINGS: We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m(2) (95% credible interval 21·3-22·1) in 1975 to 24·2 kg/m(2) (24·0-24·4) in 2014 in men, and from 22·1 kg/m(2) (21·7-22·5) in 1975 to 24·4 kg/m(2) (24·2-24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m(2) in central Africa and south Asia to 29·2 kg/m(2) (28·6-29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m(2) (21·4-22·3) in south Asia to 32·2 kg/m(2) (31·5-32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5-17·4) to 8·8% (7·4-10·3) in men and from 14·6% (11·6-17·9) to 9·7% (8·3-11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8-29·2) in men and 24·0% (18·9-29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4-4·1) in 1975 to 10·8% (9·7-12·0) in 2014 in men, and from 6·4% (5·1-7·8) to 14·9% (13·6-16·1) in women. 2·3% (2·0-2·7) of the world's men and 5·0% (4·4-5·6) of women were severely obese (ie, have BMI ≥35 kg/m(2)). Globally, prevalence of morbid obesity was 0·64% (0·46-0·86) in men and 1·6% (1·3-1·9) in women. INTERPRETATION: If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world's poorest regions, especially in south Asia. FUNDING: Wellcome Trust, Grand Challenges Canada.

L’obra de Guillaume de Machaut en el Manuscrit Mòdena, Biblioteca Estense, a.M.5.24

Entre finals del segle XIV i principis del XV es data la redacció del Manuscrit Mòdena, Biblioteca Estense, .M.5.24, un dels principals manuscrits del moment que han arribat als nostres dies, essent un element culminant pel que fa a penetració de l’art polifònic francès a la Itàlia d’inicis del ‘400. En ell es copien quatre peces de Guillaume de Machaut i l’únic poema de l’autor francès musicat per un altre compositor. En els treballs sobre el manuscrit molt sovint s’obvien aquestes quatre peces, i l’estudi sobre Machaut es fa quasi exclusivament des de les fonts franceses. Aquest treball pretén respondre, sobretot, a dues preguntes: Què ens poden explicar aquestes peces sobre el procés d’afrancesament de la música italiana? Què ens poden explicar sobre la difusió de l’obra de Machaut pel vell continent?

De summo bono Democriti

Invocatio: Q.F.F.Q.S.