Measuring neutron capture cross sections of radioactive nuclei: From activations at the FZK Van de Graaff to direct neutron captures in inverse kinematics with a storage ring at TRIUMF.

Measuring neutron capture cross sections of radioactive nuclei is a crucial step towards a better understanding of the origin of the elements heavier than iron. For decades, the precise measurement of direct neutron capture cross sections in the "stellar" energy range (eV up to a few MeV) was limited to stable and longer-lived nuclei that could be provided as physical samples and then irradiated with neutrons. New experimental methods are now being developed to extend these direct measurements towards shorter-lived radioactive nuclei (t1/2< 1 y). One project in this direction is a low-energy heavy-ion storage ring coupled to the ISAC facility at TRIUMF, Canada's accelerator laboratory in Vancouver BC, which has a compact neutron source in the ring matrix. Such a pioneering facility could be built within the next 10 years and store a wide range of radioactive ions provided directly from the existing ISOL facility, allowing for the first time to carry out direct neutron capture measurements on short-lived isotopes in inverse kinematics.

Pulmonary Hygiene Protocol Reduces Incidence of Lobar Collapse in Severe Traumatic Brain Injury.

Background Traumatic brain injury (TBI) is a common cause of death among injured patients. In addition to neurologic sequelae which may increase mortality risk, trauma patients suffering severe TBI (Glasgow Coma Score≤8) have a predilection for pulmonary complications. We have previously demonstrated that patients with severe TBI who were intubated and mechanically ventilated are at greater risk of radiographic pulmonary lobar collapse that necessitates advanced directional suctioning and/or bronchoscopy. We sought to minimize the potentially deleterious effects of such lobar collapse by using a standardized pulmonary hygiene protocol. Methods We performed a retrospective comparison of lobar collapse incidence among three groups over 21 months: patients without severe TBI who were intubated and mechanically ventilated for greater than 24 hours (i.e. "NO TBI"); patients with severe TBI who were intubated and mechanically ventilated for greater than 24 hours who were not treated with a standardized pulmonary hygiene protocol (i.e. historical "CONTROL"); and patients with severe TBI who were intubated and mechanically ventilated for greater than 24 hours and who were treated with a standardized pulmonary hygiene protocol (i.e. "HYGIENE"). Our analysis excluded patients who had any significant neck injury as we had previously found that pulmonary complications are increased in this subpopulation. Results We reviewed the charts of 310 trauma patients (NO TBI = 104, CONTROL = 101, HYGIENE = 105) and analyzed demographics, injury severity and outcomes, including the incidence of pulmonary lobar collapse. Pulmonary hygiene protocol demonstrated a significant reduction in the incidence of lobar collapse among the HYGIENE group compared to CONTROL, approximating the incidence among patients with no TBI (11% vs 27% vs 10%, respectively, p = 0.0009). No significant difference was noted in ventilator days, intensive care unit length of stay, hospital length of stay, mortality, nor incidence of pneumonia.  Conclusion High-risk TBI patients have a predilection towards the development of pulmonary lobar collapse, which can be significantly reduced by the use of a standardized pulmonary hygiene protocol.