High-frequency pCO2 and ancillary data were recorded for seven years during the first deployment of a CARbon Interface OCean Atmosphere (CARIOCA) sensor in the surface waters of a temperate coastal ...ecosystem, the Bay of Brest, which is impacted by both coastal (via estuaries) and oceanic (North Atlantic via the Iroise Sea) water inputs. The CARIOCA sensor proved to be an excellent tool to constrain the high pCO2 variability in such dynamic coastal ecosystem. Biological processes (e.g. pelagic photosynthesis/respiration) were the main drivers of the seasonal and diurnal pCO2 dynamics throughout seven years of observations. Autotrophic processes were responsible for abrupt pCO2 drawdown of 100 to 200 mu atm in spring. During the spring bloom, diurnal variations were driven by diel biological cycle. The average daily drawdown due to autotrophy (observed during highest daily PAR) was equivalent to 10 to 60% of the total pCO2 drawdown observed every year during the spring season. From late summer to fall, heterotrophic processes increased pCO2 in the surface water of the Bay back to the pre-bloom level. The average daily increase due to heterotrophy (observed during lowest daily PAR) corresponded to 10 to 70% of the total pCO2 increase observed every year during the late summer to fall period. Air-sea CO2 fluxes estimates based on hourly, daily and monthly calculations showed that careful consideration of the diurnal variability was needed to accurately estimate air-sea CO2 fluxes in the Bay of Brest. Sampling only during daytime or night-time would induce 8 to 36% error on monthly air-sea CO2 fluxes. This would in turn reverse the direction of the fluxes at annual level for the Bay. The annual emissions of CO2 from the surface waters of the Bay to the atmosphere showed relatively low inter-annual variations with an average of +0.7+/-0.4molCm-2yr super(-1) computed for the study period. Further, air-sea CO2 fluxes computed for the adjacent inner-estuaries and Iroise Sea for an annual cycle were +17+/-3molCm-2yr super(-1) and -0.2+/-0.2molCm-2yr super(-1), respectively. The spatial gradient showed a clear pattern from strong source to sink of CO2, from the inner-estuaries to the open oceanic waters of the North Atlantic. We suggest that semi-enclosed Bays act as buffers for sea to air emissions of CO2 from inner estuaries to adjacent costal seas.
High-frequency pCO
2 and ancillary data were recorded for seven years during the first deployment of a CARbon Interface OCean Atmosphere (CARIOCA) sensor in the surface waters of a temperate coastal ...ecosystem, the Bay of Brest, which is impacted by both coastal (via estuaries) and oceanic (North Atlantic via the Iroise Sea) water inputs. The CARIOCA sensor proved to be an excellent tool to constrain the high pCO
2 variability in such dynamic coastal ecosystem. Biological processes (e.g. pelagic photosynthesis/respiration) were the main drivers of the seasonal and diurnal pCO
2 dynamics throughout seven years of observations. Autotrophic processes were responsible for abrupt pCO
2 drawdown of 100 to 200
μatm in spring. During the spring bloom, diurnal variations were driven by diel biological cycle. The average daily drawdown due to autotrophy (observed during highest daily PAR) was equivalent to 10 to 60% of the total pCO
2 drawdown observed every year during the spring season. From late summer to fall, heterotrophic processes increased pCO
2 in the surface water of the Bay back to the pre-bloom level. The average daily increase due to heterotrophy (observed during lowest daily PAR) corresponded to 10 to 70% of the total pCO
2 increase observed every year during the late summer to fall period. Air–sea CO
2 fluxes estimates based on hourly, daily and monthly calculations showed that careful consideration of the diurnal variability was needed to accurately estimate air–sea CO
2 fluxes in the Bay of Brest. Sampling only during daytime or night-time would induce 8 to 36% error on monthly air–sea CO
2 fluxes. This would in turn reverse the direction of the fluxes at annual level for the Bay. The annual emissions of CO
2 from the surface waters of the Bay to the atmosphere showed relatively low inter-annual variations with an average of +
0.7
±
0.4
mol
C
m
−2
yr
−
1
computed for the study period. Further, air–sea CO
2 fluxes computed for the adjacent inner-estuaries and Iroise Sea for an annual cycle were +
17
±
3
mol
C
m
−2
yr
−
1
and −
0.2
±
0.2
mol
C
m
−2
yr
−
1
, respectively. The spatial gradient showed a clear pattern from strong source to sink of CO
2, from the inner-estuaries to the open oceanic waters of the North Atlantic. We suggest that semi-enclosed Bays act as buffers for sea to air emissions of CO
2 from inner estuaries to adjacent costal seas.
► We assessed pCO
2 dynamics from diurnal to inter-annual level in the Bay of Brest. ► Pelagic biological processes controlled pCO
2 dynamics from spring to fall. ► Integrating pCO
2 diurnal variability is imperative for air–sea CO
2 fluxes estimates. ► Bays act as buffers for sea to air CO
2 emissions from estuaries to coastal seas.
We evaluate the accuracy of F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET) for staging and management of renal cell carcinoma.
FDG-PET was performed in 25 patients with known or ...suspected primary renal tumors and/or metastatic disease and compared with conventional imaging techniques, including computerized tomography (CT). Histopathological confirmation was obtained in 18 patients and confirmation of the disease was by followup in the remainder. The impact of FDG-PET on disease management was also assessed.
Of the 17 patients with known or suspected primary tumors FDG-PET was true positive in 15, true negative in 1 and false-negative in 1. Comparative CT was true positive in 16 patients and false-positive in 1. The accuracy of FDG-PET and CT was similar (94%). All patients would have undergone radical nephrectomy after conventional imaging findings but FDG-PET results altered treatment decisions for 6 (35%), of whom 3 underwent partial nephrectomy and 3 avoided surgery due to confirmation of benign pathology or detection of unsuspected metastatic disease. Of the 8 cases referred for evaluation of local recurrence and/or metastatic disease FDG-PET changed treatment decisions in 4 (50%), with disease up staged in 3 and recurrence excluded in 1. Compared with CT, FDG-PET was able to detect local recurrence and distant metastases more accurately and differentiated recurrence from radiation necrosis.
FDG-PET accurately detected local disease spread and metastatic disease in patients with renal cell carcinoma and altered treatment in 40%. FDG-PET may have a role in the diagnostic evaluation of patients with renal cell carcinoma preoperatively and staging of metastatic disease.
Abstract
Using patent-based indicators, this paper aims to explain the extent to which the production of innovation is globalized. First, it provides evidence—over time, across countries and across ...industrial sectors—on the patterns in international technological collaboration and in cross-border ownership of innovation. Second, a fractional logit model is estimated for a unique panel dataset covering patent information for 21 industries in 29 countries in the period 1980–2005. The results show that countries tend to be more globalized in industrial sectors in which they are less technologically specialized. It suggests that globalization of innovation is a means of acquiring competences abroad that are lacking at home, rather than a way to exploit home technological strengths. The empirical findings also indicate that the intensity of globalization of innovation is higher in multidisciplinary country–industry pairs and in those which compete internationally in trade.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Cementless primary total hip arthroplasty (THA) is associated with risks of bleeding and thromboembolism. Anticoagulants are effective as venous thromboprophylaxis, but with an increased risk of ...bleeding. Tranexamic acid (TXA) is an efficient antifibrinolytic agent, but the mode and timing of its administration remain controversial. This study aimed to determine whether two intravenous (IV) TXA regimens (a three-hour two-dose (short-TXA) and 11-hour four-dose (long-TXA)) were more effective than placebo in reducing perioperative real blood loss (RBL, between baseline and day 3 postoperatively) in patients undergoing THA who receive rivaroxaban as thromboprophylaxis. The secondary aim was to assess the non-inferiority of the reduction of blood loss of the short protocol versus the long protocol.
A multicentre, prospective, randomized, double-blind, placebo-controlled trial was undertaken involving 229 patients undergoing primary cementless THA using a posterior approach, whose extended rivaroxaban thromboprophylaxis started on the day of surgery. There were 98 male and 131 female patients, with a mean age of 65.5 years (32 to 91). The primary outcome, perioperative RBL, was evaluated at 72 hours postoperatively. The efficacy of short- and long-TXA protocols in the reduction of perioperative RBL was compared with a placebo group.
TXA significantly reduced perioperative blood loss compared with placebo (p < 0.001); the mean differences were 525.3 ml (short-TXA vs placebo) and 550.1 ml (long-TXA vs placebo). No venous or arterial thromboembolic complications were reported. The upper boundary of the 95% confidence interval, when comparing short and long protocols, was below the pre-specified margin of non-inferiority (p = 0.027).
In patients undergoing primary cementless THA, using a posterior approach, who are treated with rivaroxaban for thromboembolic prophylaxis, short- and long-TXA IV protocols are significantly more effective than placebo in reducing perioperative RBL, without any thromboembolic complications. Non-inferiority of a short- versus a long-TXA protocol in reducing perioperative RBL was supported in a secondary analysis.
Emergency Intubation in Covid-19 Herzog, Nicolas; Giacardi, Christophe; Danguy des Déserts, Marc ...
The New England journal of medicine,
05/2021, Letnik:
384, Številka:
19
Journal Article
Recenzirano
Odprti dostop
To the Editor:
The video by Shrestha et al. (Feb. 18 issue)
1
shows a method for emergency intubation in a patient with Covid-19 that includes the use of a negative-pressure isolation room. This ...measure was initially recommended to prevent hospital-acquired infections. However, negative air pressure in rooms in the intensive care unit could increase the risk of invasive pulmonary aspergillosis,
2
which has been reported in 10 to 30% of patients with Covid-19 in the intensive care unit.
3
Positive-pressure isolation rooms are used to reduce the risk of invasive pulmonary aspergillosis in immunocompromised patients, but their use is not suitable for . . .
Recent advances on trauma management from the prehospital setting to in hospital care led to a better surviving severe trauma rate. Mortality from exsanguination remains the first preventable ...mortality. Damage-control resuscitation and surgery are evolving and thus some promising concepts are developing. Transfusion toolkit is brought on the prehospital scene while temporary bridge to hemostasis may be helpful. Panel transfusion products allow an individualized ratio assumed by fresh frozen or lyophilized plasma, fresh or cold-stored whole blood, fibrinogen, four-factor prothrombin complex concentrates. Growing interest is raising in whole blood transfusion, resuscitative endovascular balloon occlusion of the aorta use, hybrid emergency room, viscoelastic hemostatic assays to improve patient outcomes. Microcirculation, traumatic endotheliopathy, organ failures and secondary immunosuppression are point out since late deaths are increasing and may deserve specific treatment.As each trauma patient follows his own course over the following days after trauma, trauma management may be seen through successive, temporal, and individualized aims.
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