BACKGROUND:An acceptable algorithm for clearance of the cervical spine (C-spine) in the obtunded trauma patient remains controversial. Undetected C-spine injuries of an unstable nature can have ...devastating consequences. This has led to reluctance toward C-spine clearance in these patients.
OBJECTIVE:To objectify the accuracy of computed tomography (CT) scanning compared with dynamic radiographs within a well established C-spine clearance protocol in obtunded trauma patients at a level I trauma center.
METHODS:This was a prospective study of consecutive blunt trauma patients (18 years or older) admitted to a single institution between December 2004 and April 2008. To be eligible for study inclusion, patients must have undergone both a CT scan and dynamic plain radiographs of their C-spine as a part of their clearance process.
RESULTS:Among 402 patients, there was one injury missed on CT but detected by dynamic radiographs. This resulted in a percentage of missed injury of 0.25%. Subsequent independent review of the CT scan revealed that in fact pathologic changes were present on the scan indicative of the injury.
CONCLUSIONS:Our results indicate that CT of the C-spine is highly sensitive in detecting the vast majority (99.75%) of clinically significant C-spine injuries. We recommend that CT be used as the sole modality to radiographically clear the C-spine in obtunded trauma patients and do not support the use of flexion-extension radiographs as an ancillary diagnostic method.
Grass production provides Irish dairy farmers with a competitive advantage over many of their mainland European counterparts by providing a cheap feed source. The temperate climate in Ireland favours ...the production of grass, however production is highly seasonal with little growth over the winter period. This seasonal pattern of grass production in turn has resulted in predominantly spring calving dairy herds and has limited the development of the dairy product portfolio in Ireland which has created a reliance on dairy commodities. As Ireland exports approximately 80% of its dairy output, recent substantial increases in market price volatility has resulted in increased price volatility at farm level. The increased price volatility at market and farm level has been well documented; however the volatility of farm inputs has received little attention to date. In this paper the seasonal and volatile nature of grass production is presented and compared with other Irish crops. As Irish dairy and beef farmers expand production in the post quota environment the optimal use of grass as a feed source will be central to their competitive position. The volatile nature of this resource will require improved pasture management along with improved risk management tools. A number of possible tools are discussed in the latter part of this paper.
In order to promote sustainable and competitive ruminant production systems, the European Multisward project was aimed at improving farmer trust in grassland and grassland mixtures. A questionnaire ...on grassland functions was submitted in eight languages, in order to better understand the importance of grassland functions for all the stakeholders involved (farmers, policy decision-makers, researchers, farming advisors, students, teachers, private companies and NGOs). Over 2,000 replies were received. The 3 aspects of sustainability were classified as follows: Economic aspects > ecological aspects > social aspects, with varying results per country and type of stakeholder. Grassland functions are widely recognized and appreciated by all the players involved, emphasizing the importance of grassland in Europe.
Pour favoriser des systèmes de production de ruminants compétitifs et durables, le projet européen Multisward avait pour objectif d'améliorer la confiance des agriculteurs dans les prairies et mélanges prairiaux. Un questionnaire en 8 langues sur les fonctions des prairies a été proposé pour mieux connaître l'importance qu'elles revêtent auprès des différents acteurs concernés.La participation active de tous les acteurs concernés par les prairies (éleveurs, décideurs politiques, chercheurs, conseillers, étudiants, enseignants, entreprises et ONG) était un des objectifs clés du projet Multisward. Le questionnaire qui leur a été diffusé les interrogeait sur les fonctions des prairies. Près de 2 000 réponses ont été obtenues (principalement de Belgique, France, Irlande, Italie, Pays-Bas et Pologne). Interrogés sur l'importance des différents aspects de la durabilité, ces acteurs ont ainsi classé les 3 dimensions de la durabilité : économie > écologie > aspects sociaux, avec des variations selon le pays et le type d'enquêté. Les différentes fonctions des prairies sont largement reconnues et appréciées par tous les groupes d'acteurs, ce qui souligne l'importance des prairies en Europe.
Adaptation and evaluation of a mechanistic grass growth simulation model for grass-based systems Hurtado-Uria, Cristina; Hennessy, Deirdre; Delaby, Luc ...
The Role of Grasslands in a Green Future Threats and Perspectives in Less Favoured Areas. (18)2013; 17th Symposium of the European Grassland Federation (EGF), Akureyri, ISL, 2013-06-23-2013-06-26, 201-203,
2013
Conference Proceeding
An accurate grass growth model would be a valuable tool in anticipating grass growth and grass utilization at farm level. Ideally, a grass growth simulation model must be accurate, dynamic, use ...realistic input parameters and incorporate meteorological data. The objective of this study was to parameterize the grass growth model developed by Jouven et al. (2006) to increase its accuracy of grass growth simulation in the south of Ireland. The model was parameterized using an optimization technique where a number of the parameters in themodel were optimized with the objective function of minimizing the root mean square error (RMSE). Both meteorological and grass growth data for the period 2005 to 2009 were included in the optimization process. During validation the Jouven Model was compared to the Adapted Model. RMSE was reduced from 20.45 kg DM ha-1 day-1 with the Jouven Model to 14.62 kg DM ha-1 day-1 with the Adapted Model. MSPE was reduced from 476 to 183. The proposed changes to the Jouven Model improved grass growth simulation in the south ofIreland. The adapted version of the Jouven Model can be used for grass growth simulation ; albeit without perfect simulation.
Adaptation and evaluation of a mechanistic grass growth simulation model for grass-based systems Hurtado-Uria, Cristina; Hennessy, Deirdre; Delaby, Luc ...
The Role of Grasslands in a Green Future Threats and Perspectives in Less Favoured Areas. (18)2013; 17th Symposium of the European Grassland Federation (EGF), Akureyri, ISL, 2013-06-23-2013-06-26, 201-203,
2013
Conference Proceeding
An accurate grass growth model would be a valuable tool in anticipating grass growth and grass utilization at farm level. Ideally, a grass growth simulation model must be accurate, dynamic, use ...realistic input parameters and incorporate meteorological data. The objective of this study was to parameterize the grass growth model developed by Jouven et al. (2006) to increase its accuracy of grass growth simulation in the south of Ireland. The model was parameterized using an optimization technique where a number of the parameters in themodel were optimized with the objective function of minimizing the root mean square error (RMSE). Both meteorological and grass growth data for the period 2005 to 2009 were included in the optimization process. During validation the Jouven Model was compared to the Adapted Model. RMSE was reduced from 20.45 kg DM ha-1 day-1 with the Jouven Model to 14.62 kg DM ha-1 day-1 with the Adapted Model. MSPE was reduced from 476 to 183. The proposed changes to the Jouven Model improved grass growth simulation in the south ofIreland. The adapted version of the Jouven Model can be used for grass growth simulation ; albeit without perfect simulation.
A 63-year-old man underwent endoscopic evaluation of the rectal stump for rectal bleeding and suffered a massive cerebral air embolism with severe neurological impairment and subsequent death. The ...patient underwent a Hartmann's procedure 9 month previously for ischaemic bowel and was noted to have portal hypertension at laparotomy. We hypothesise that air entered the venous plexus around rectum and entered the azygos vein via a porto-systemic shunt and travelled retrogradely via the superior vena cava to the venous sinuses of the brain.
The European project Multisward aims to increase reliance on grasslands and on multi-species swards for competitive and sustainable ruminant production systems. This contributes to food security and ...enhanced environmental goods. As part of Multisward, an inventory was made of requirements and expectations of stakeholders with respect to the multi-functionality of grasslands in EU countries. The traditional foursome of primary producer, policy maker, research and advice were identified as the most important stakeholders, followedby non-governmental organisations (NGOs) (nature, environment), education and industry. A first international stakeholder consultation revealed the appreciation of current and future functions of grasslands in Europe. In general the economic functions of grasslands, mainly feed for herbivores, were considered the most important. Stakeholders expected this to remain unchanged in future. Environmental functions of grasslands were placed second : water quality and quantity, adaptation to climate change, mitigation and biodiversity. Finally, social services were mentioned.
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