Abstract. The neutron time-of-flight facility n TOF features a white neutron source produced by spallation through 20 GeV/c protons impinging on a lead target. The facility, aiming primarily at the measurement of neutron-induced reaction cross sections, was operating at CERN between 2001 and 2004, and then underwent a major upgrade in 2008. This paper presents in detail all the characteristics of the new neutron beam in the currently available configurations, which correspond to two different collimation systems and two choices of neutron moderator. The characteristics discussed include the intensity and energy dependence of the neutron flux, the spatial profile of the beam, the in-beam background components and the energy resolution/broadening. The discussion of these features is based on dedicated measurements and Monte Carlo simulations, and includes estimations of the systematic uncertainties of the mentioned quantities.
The 63 Niðn; Þ cross section has been measured for the first time at the neutron time-of-flight facility n_TOF at CERN from thermal neutron energies up to 200 keV. In total, capture kernels of 12 (new)
BACKGROUND:The purpose of the current study was to investigate the effect of early adrenergic hyperactivity as manifested by prehospital (emergency medical service [EMS]) hypertension on outcomes of traumatic brain injury (TBI) patients and to develop a prognostic model of the presence of TBI based on EMS and admission (emergency department [ED]) hypertension.
METHODS:This study is a retrospective review of the 2007 to 2008 National Trauma Data Bank including blunt trauma patients 15 years or older with available EMS and ED vital signs. Patients with head Abbreviated Injury Scale (AIS) score of 3 or greater were selected, and mortality was examined within EMS systolic blood pressure (SBP) groups: lower than 100 mm Hg, 110 mm Hg to 150 mm Hg, 160 mm Hg to 180 mm Hg, and 190 mm Hg to 230 mm Hg. A forward logistic regression model including the EMS heart rate, EMS SBP, EMS Glasgow Coma Scale (GCS) score, ED heart rate, and ED SBP was used to identify predictors of a TBI in patients with ED GCS score of less than or equal to 8, 9 to 13, and 14 to 15.
RESULTS:For the 5-year study period, 315,242 patients met inclusion criteria. Adjusted odds for mortality increased in a stepwise fashion with increasing EMS SBP compared with patients with normal EMS SBP (adjusted odds ratio [95% confidence interval], 1.33 [1.22Y1.44], p G 0.001, for EMS SBP of 160Y180 mm Hg and 1.97 [1.76Y2.21], p G 0.001, for EMS SBP of 190Y230 mm Hg).A 7-point scoring system was developed for each ED GCS score group to predict the presence of a TBI. EMS SBP of greater than 150 mm Hg and ED SBP of greater than 150 mm Hg were both predictive of the presence of a TBI in patients with ED GCS score of 8 or less and in patients with ED GCS score of 9 to 13 or 14 to 15, respectively.
CONCLUSION:Prehospital hypertension in TBI is associated with a higher mortality risk. Early hypertension in the prehospital setting and at admission can be used to predict the presence of such injuries. These findings may have important early triage and treatment implications. (J Trauma Acute Care Surg. 2014;77: 592Y598.
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