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Purpose The aim of this study was to determine the impact of age on patient-reported health-related quality of life (HRQoL) and the capacity to show resilience—i.e., the ability to adapt to stressful adverse events—after sustaining a polytrauma. Methods A cross-sectional multicenter cohort was conducted between 2013 and 2016 that included surviving polytrauma patients (ISS ≥ 16). HRQoL was obtained by the Short Musculoskeletal Function assessment and EuroQol (SMFA and EQ-5D-5L). The effect of age on HRQoL was tested with linear regression analysis. Next, the individual scores were compared with age- and sex-matched normative data to determine whether they showed resilience. Multivariate binary logistic regression was used to assess the effect of age on reaching the normative threshold of the surveys, correcting for several confounders. Results A total of 363 patients responded (57%). Overall, patients had a mean EQ-5D-5L score of 0.73. With higher age, scores on the SMFA subscales “upper extremity dysfunction,” “lower extremity dysfunction” and “daily activities” significantly dropped. Only 42% of patients were classified as being resilient, based on the EQ-5D-5L score. Patients aged 60–69 showed the highest resilience (56%), and those aged 80 + showed the lowest resilience (0%). Conclusion Sustaining a polytrauma leads to a serious decline in HRQoL. Aging is associated with a decline in the physical components of HRQoL. No clear relationship with age was seen on the non-physical components of quality of life. Octogenarians, and to a lesser extent septuagenarians and tricenarians, showed to be very vulnerable groups, with low rates of resilience after surviving a polytrauma.

We report on the development, characterization, and first application of a specialized resonance ionization laser ion source for high-resolution spectroscopy applications below usual hot cavity Doppler broadening limitations, for on-line experiments at CERN-ISOLDE. The new PI-LIST ion source comprises perpendicular laser/atom beam interaction in a radio-frequency quadrupole unit directly downstream the hot atomizer cavity. A spectral linewidth of 200–300MHz is demonstrated, with the potential to achieve below 100MHz. Compared to standard in-source laser ionization, the efficiency reduction factor ranges from a few 100 to above 1000. The implementation of this ion source concept at thick target radioactive ion beam facilities will greatly enhance capabilities for nuclear structure investigations without demanding dedicated experimental beam line setups, and will facilitate the delivery of isomer-pure beams to experimental stations.

International audience; In this paper we present the first high-resolution laser spectroscopy results obtained at the GISELE laser laboratory of the GANIL-SPIRAL2 facility, in preparation for the first experiments with the S$^3$-Low Energy Branch. Studies of neutron-deficient radioactive isotopes of erbium and tin represent the first physics cases to be studied at S$^3$. The measured isotope-shift and hyperfine structure data are presented for stable isotopes of these elements. The erbium isotopes were studied using the $4f^{12}6s^2$$^3H_6 \rightarrow 4f^{12}(^3 H)6s6p$$J = 5$ atomic transition (415 nm) and the tin isotopes were studied by the $5s^25p^2 (^3P_0) \rightarrow 5s^25p6s (^3P_1)$ atomic transition (286.4 nm), and are used as a benchmark of the laser setup. Additionally, the tin isotopes were studied by the $5s^25p6s (^3P_1) \rightarrow 5s^25p6p (^3P_2)$ atomic transition (811.6 nm), for which new isotope-shift data was obtained and the corresponding field-shift $F_{812}$ and mass-shift $M_{812}$ factors are presented.

Seit Jahren nimmt die Nutzung von elektrisch unterstutzten Fahrradern (Pedelecs, im Volksmund „E-Bikes“) in Deutschland zu. Hierdurch steigt auch die Anzahl (schwer) verletzter und verstorbener Pedelec-Fahrer. Im klinischen Alltag entsteht der Verdacht, dass Pedelec-Fahrer bei Unfallen haufiger schwerer verletzt werden als konventionelle Fahrradfahrer. Analyse der Morbiditat und Mortalitat durch Unfalle von Pedelec-Fahrern im Vergleich zu konventionellen Fahrradfahrern in einem uberregionalen Traumazentrum im Traumanetzwerk Oldenburg-Ostfriesland. Prospektive Kohortenstudie mit Erhebung von Daten von 59 Pedelec-Fahrern und 164 konventionellen Fahrradfahrern nach Unfallen mit Vorstellung in der Notaufnahme und Klinik fur Unfallchirurgie, Orthopadie und Sporttraumatologie des Evangelischen Krankenhauses Oldenburg in der Periode vom 01.03.2017 bis zum 01.03.2019. Das Durchschnittsalter von Pedelec-Fahrern und konventionellen Fahrradfahrern unterschied sich signifikant mit 62 bzw. 48 Jahren. Pedelec-Fahrer sind haufiger vorerkrankt als konventionelle Radfahrer und werden bei Unfallen signifikant schwerer verletzt. Hierbei liegt der durchschnittliche ISS bei 5,2 im Vergleich zu 3,4. Die Sterberate von Pedelec-Fahrern unterscheidet sich nicht von der konventioneller Radfahrer. Pedelec-Fahrer bilden im Vergleich zum durchschnittlichen Fahrradfahrer eine besondere Risikogruppe. Sie werden bei Unfallen signifikant schwerer verletzt als konventionelle Fahrradfahrer. Aufgrund der demografischen Entwicklung mit steigendem Durchschnittsalter und Multimorbiditat von Verkehrsteilnehmern sowie der stetig wachsenden Verkaufszahlen von Pedelecs ist mit einer Zunahme schwerer Pedelec-Unfalle zu rechnen. Auf Pedelec-Nutzer gerichtete Masnahmen zu Unfall- und Verletzungspravention (wie z. B. Helm tragen, Pedelec-Kurse o. A.) sollten gefordert werden. In der Notfallmedizin sollten Pedelec-Nutzer besondere Aufmerksamkeit und aggressive Diagnostik erfahren. Niedrigschwellig sollte ein interdisziplinares Initialassessment der Patienten erfolgen (Schockraummanagement).

Thermo-mechanical effects due to changes in the ambient temperature on the shop floor and internal heat sources caused by the manufacturing process significantly contribute to the geometric deviations of a machine tool and therefore, the geometric deviations of the manufactured workpiece. Minimizing these thermally induced geometric deviations is worthwhile since the requested tolerances of machined workpieces become continually smaller nowadays. To investigate the overall deformations of a machine tool structure due to variations in ambient temperature the geometric errors of a five-axis machine tool at different ambient temperatures by means of a portable climate simulation chamber are systematically mapped. While positioning and squareness errors of the linear axes are significantly influenced by the ambient temperature, straightness as well as rotational errors were less sensitive to temperature effects. For the investigated machine tool errors of the two rotational axes are negligible due to an active cooling of these axes. Through numerical error compensation of the linear axes, the geometric errors of the investigated machine tool can be reduced up to 80%. Finally, an outlook how a temperature-dependent compensation could be derived from previously measured compensation fields at discrete temperatures and afterwards applied on-the-fly during manufacturing is given.

The novel and sensitive In-Gas Laser Ionization Spectroscopy (IGLIS) technique enables high-precision laser spectroscopy of the heaviest elements and isotopes very far from stability that are produced in fusion-evaporation reactions at in-flight separators. Powerful and dedicated laser systems are required in these facilities to realize in-gas jet laser spectroscopy with optimal spectral resolution and efficiency. The performance with respect to the requirements for IGLIS studies at the low energy front-end of the Super Separator Spectrometer (S3) at GANIL, France, of Dye and Ti:sapphire laser systems is investigated. In addition, a number of specific experimental cases on key isotopes of the elements Ag, Sn, Ac, and No are discussed in detail. The novel and sensitive In-Gas Laser Ionization Spectroscopy (IGLIS) technique enables high-precision laser spectroscopy of the heaviest elements and isotopes very far from stability that are produced in fusion-evaporation reactions at in-flight separators. Powerful and dedicated laser systems are required in these facilities to realize in-gas jet laser spectroscopy with optimal spectral resolution and efficiency. The performance with respect to the requirements for IGLIS studies at the low energy front-end of the Super Separator Spectrometer (S3) at GANIL, France, of Dye and Ti:sapphire laser systems is investigated. In addition, a number of specific experimental cases on key isotopes of the elements Ag, Sn, Ac, and No are discussed in detail. ispartof: Nuclear Instruments & Methods In Physics Research Section B-Beam Interactions With Materials And Atoms vol:463 pages:86-95 status: published

Ion sources exploiting laser resonance ionization offer efficient and element-selective radioactive ion beam production at the leading isotope separation on-line facilities worldwide. Most commonly, laser resonance ionization takes place inside a resistively heated atomizer tube directly coupled to the production target, where the element of interest is evaporated and provided as atomic vapor. While naturally the majority of atoms is ionized inside this hot cavity, a fraction of the neutrals effuses towards the high voltage beam extraction system of the subsequent mass separator. We report on several systematic investigations on this phenomenon regarding its significance and implications on the operation of resonance ionization laser ion sources. Experiments suggest a less sharply directed atom cone than expected from theoretical model, up to a lateral opening angle of 45°. Inside the tubular volume defined by the laser beam diameter around the central axis behind the source exit, more than 90% of potentially ionizable atoms are found within the first 2 cm. Geometrical constraints for the construction of devices based on ionization in the effusing atom beam directly downstream of the hot cavity are derived, and causes for cross-mass beam contamination are identified. Counter measures using laser repetition rate synchronized beam gating by fast electrostatic beam deflection to overcome these problems are presented.

Objective:To evaluate the impact of the COVID-19 pandemic on the outcome of major trauma patients in the Netherlands. Summary Background Data:Major trauma patients highly rely on immediate access to specialized services, including ICUs, shortages caused by the impact of the COVID-19 pandemic may influence their outcome. Methods:A multi-center observational cohort study, based on the Dutch National Trauma Registry was performed. Characteristics, resource usage, and outcome of major trauma patients (injury severity score ≥16) treated at all trauma-receiving hospitals during the first COVID-19 peak (March 23 through May 10) were compared with those treated from the same period in 2018 and 2019 (reference period).Results:During the peak period, 520 major trauma patients were admitted, versus 570 on average in the pre-COVID-19 years. Significantly fewer patients were admitted to ICU facilities during the peak than during the reference period (49.6% vs 55.8%; P=0.016). Patients with less severe traumatic brain injuries in particular were less often admitted to the ICU during the peak (40.5% vs 52.5%; P=0.005). Moreover, this subgroup showed an increased mortality compared to the reference period (13.5% vs 7.7%; P=0.044). These results were confirmed using multivariable logistic regression analyses. In addition, a significant increase in observed versus predicted mortality was recorded for patients who had a priori predicted mortality of 50% to 75% (P=0.012). Conclusions:The COVID-19 peak had an adverse effect on trauma care as major trauma patients were less often admitted to ICU and specifically those with minor through moderate brain injury had higher mortality rates.

Background Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time. Methods All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS. Results The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC. Conclusion Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital.

The European Physical Society Conference on High Energy Physics, Online conference, jointly organized by Universität Hamburg and the research center DESY; he European Physical Society Conference on High Energy Physics (EPS-HEP2021) 398, 4 pp. (2022). doi:10.22323/1.398.0211, Published by Sissa Medialab Trieste, Italy

Purpose Thoracic trauma accounts for 25–50% of posttraumatic mortality. Data on epidemiology of thoracic trauma in Scandinavia and risk factors for mortality are scarce. This study aims to provide an overview of epidemiology, clinical events and risk factors for mortality of patients with severe thoracic injuries. Methods A retrospective study including adult thoracic trauma patients with abbreviated injury scale ≥ 3, between 2009 and 2018 at Haukeland University Hospital was performed. Subgroup analyses were performed for specific patient groups: (1) isolated thoracic trauma, (2) polytrauma without Traumatic Brain Injury (TBI) and (3) polytrauma with TBI. Logistic regression analyses were applied to find risk factors for 30-days mortality. Age, sex, comorbidity polypharmacy score (CPS), trauma and injury severity score (TRISS) and comprehensive complication index (CI) were included in the final model. Results Data of 514 patients were analyzed, of which 60 (12%) patients died. Median (IQR) injury severity score (ISS) was 17 (13–27). Data of 463 patients, of which 39 patients died (8%), were included in multivariate analyses. Female sex odds ratio (OR) (2.7, p = 0.04), CPS > 9 (OR 4.8; p = 0.01), TRISS ≤ 50% (OR 44; p p Conclusion Comorbidities and associated pharmacotherapies, TRISS, female sex, and complications during admission predict in-hospital mortality after thoracic trauma. Current findings might help to recognize patients at risk of an adverse outcome, and thereby prevent complications. Trial registration: retrospectively registered The regional committees for medical and health research ethics file number is 2017/293.

The European physical journal / D 76(10), 190 (2022). doi:10.1140/epjd/s10053-022-00510-7, Published by Springer, Heidelberg

Contains fulltext : 288470.pdf (Publisher’s version ) (Closed access) OBJECTIVE: We aimed to investigate the prevalence and characteristics of non-accidental trauma (NAT) in children with polytrauma treated at level-I trauma centres (TC). SUMMARY OF BACKGROUND: Data 6-10% Of children who present at the emergency department with injuries, sustain polytrauma. Polytrauma may result from either accidental (AT) or NAT, i.e. inflicted or neglect. The prevalence of NAT among children with polytrauma is currently unclear. METHODS: This is a retrospective study that included children (0-18 years) with an Injury Severity Score >15, who presented at one of the 11 Level-I trauma centers (TC) in the Netherlands between January 1, 2010 and January 1, 2016. Outcomes were classified based on the conclusions of the Child Abuse and Neglect-team. Cases in which conclusions were unavailable and there was no clear accidental cause of injuries were reviewed by an expert panel. RESULTS: The study included 1623 children, 1452 (89%) were classified as AT, 171 (11%) as NAT; 39 (2,4%) inflicted and 132 (8,1%) neglect. Of pre-school aged children (

Purpose The aim of this study was to compare the pre-hospital treatment of major trauma patients with similar injury patterns in Germany and the Netherlands. Patients and methods This matched-pairs analysis is based on the TraumaRegister DGU (R). The authors compared major trauma patients (ISS >= 16) from 2009 to 2015 treated in Dutch and German Level 1 trauma centers (TC). Endpoints were the pre-hospital times and interventions performed until hospital admission. Additional endpoints included hospital mortality, 24-h mortality and standardized mortality ratio (SMR) which was calculated using the Revised Injury Severity Classification, version II (RISC II). Patients were matched by age, gender, injury pattern, vital status on-scene and involvement into a traffic accident. Three subgroups were formed according to the mode of transportation and level of care provided during transport: Ambulance/Physician, Helicopter/Physician and Ambulance/Emergency Medical Technician. Results Patients were matched into 1094 pairs. German patients arrived at the TC after a mean pre-hospital time of 65.6 (+/- 29.6) min while Dutch patients arrived after 61.4 (+/- 28.7) min. Pre-hospital intubation rate was slightly higher in the Netherlands (44.1% GER vs 50.5% NL). Chest tubes were placed in 3.0% of German patients and 8.3% of Dutch patients. 63.5% of the German patients received analgesia/sedation which was below the rate of Dutch patients (71.1%). The hospital mortality was for 17.6% for German patients and 19.8% for Dutch patients. The SMR was about 1.0 for both groups. Conclusion Multiple differences and some similarities in the treatment of major trauma patients with similar injury patterns were found but no clinically relevant differences in the chosen outcome parameters could be observed.

Objectives The objectives of this study were to gather an expert opinion survey and to evaluate the suitability of summarized indications and interventions for DCO. Background The indications to perform temporary surgery in musculoskeletal injuries may vary during the hospitalization and have not been defined. We performed a literature review and an expert opinion survey about the indications for damage control orthopaedics (DCO). Methods Part I: A literature review was performed on the basis of the PubMed library search. Publications were screened for damage control interventions in the following anatomic regions: "Spine", "Pelvis", "Extremities" and "Soft Tissues". A standardized questionnaire was developed including a list of damage control interventions and associated indications. Part II: Development of the expert opinion survey: experienced trauma and orthopaedic surgeons participated in the consensus process. Results Part I: A total of 646 references were obtained on the basis of the MeSH terms search. 74 manuscripts were included. Part II: Twelve experts in the field of polytrauma management met at three consensus meetings. We identified 12 interventions and 79 indications for DCO. In spinal trauma, percutaneous interventions were determined beneficial. Traction was considered harmful. For isolated injuries, a new terminology should be used: "MusculoSkeletal Temporary Surgery". Conclusion This review demonstrates a detailed description of the management consensus for abbreviated musculoskeletal surgeries. It was consented that early fixation is crucial for all major fractures, and certain indications for DCO were dropped. Authors propose a distinct terminology to separate local (MuST surgery) versus systemic (polytrauma: DCO) scenarios.

Combining laser spectroscopy in a Versatile Arc Discharge and Laser Ion Source, with Penning-trap mass spectrometry at the CERN-ISOLDE facility, this work reports on mean-square charge radii of neutron-rich mercury isotopes across the $N = 126$ shell closure, the electromagnetic moments of $^{207}$Hg and more precise mass values of $^{206-208}$Hg. The odd-even staggering (OES) of the mean square charge radii and the kink at $N = 126$ are analyzed within the framework of covariant density functional theory (CDFT), with comparisons between different functionals to investigate the dependence of the results on the underlying single-particle structure. The observed features are defined predominantly in the particle-hole channel in CDFT, since both are present in the calculations without pairing. However, the magnitude of the kink is still affected by the occupation of the $1i_{11/2}$ and $2g_{9/2}$ orbitals with a dependence on the relative energies as well as pairing., 20 pages, 12 figures, Phys. Rev. C in press

Description, Quasi non-desctructive actinide isotope detection and imaging on the 100nm scale advances single particle nuclear forensics., Micrometer-sized pollutant particles are of highest concern in environmental and life sciences, cosmochemistry, and forensics. From their composition, detailed information on origin and potential risks to human health or environment is obtained. We combine secondary ion mass spectrometry with resonant laser ionization to selectively examine elemental and isotopic composition of individual particles at submicrometer spatial resolution. Avoiding any chemical sample preparation, isobaric interferences are suppressed by five orders of magnitude. In contrast to most mass spectrometric techniques, only negligible mass is consumed, leaving the particle intact for further studies. Identification of actinide elements and their isotopes on a Chernobyl hot particle, including 242mAm at ultratrace levels, proved the performance. Beyond that, the technique is applicable to almost all elements and opens up previously unexplored scientific applications.

Thoracic trauma accounts for 25-50% of posttraumatic mortality. Data on epidemiology of thoracic trauma in Scandinavia and risk factors for mortality are scarce. This study aims to provide an overview of epidemiology, clinical events and risk factors for mortality of patients with severe thoracic injuries.A retrospective study including adult thoracic trauma patients with abbreviated injury scale ≥ 3, between 2009 and 2018 at Haukeland University Hospital was performed. Subgroup analyses were performed for specific patient groups: (1) isolated thoracic trauma, (2) polytrauma without Traumatic Brain Injury (TBI) and (3) polytrauma with TBI. Logistic regression analyses were applied to find risk factors for 30-days mortality. Age, sex, comorbidity polypharmacy score (CPS), trauma and injury severity score (TRISS) and comprehensive complication index (CI) were included in the final model.Data of 514 patients were analyzed, of which 60 (12%) patients died. Median (IQR) injury severity score (ISS) was 17 (13-27). Data of 463 patients, of which 39 patients died (8%), were included in multivariate analyses. Female sex odds ratio (OR) (2.7, p = 0.04), CPS 9 (OR 4.8; p = 0.01), TRISS ≤ 50% (OR 44; p 0.001) and CI ≥ 30 (OR 12.5, p 0.001) were significant risk factors for mortality. Subgroup analyses did not demonstrate other risk factors.Comorbidities and associated pharmacotherapies, TRISS, female sex, and complications during admission predict in-hospital mortality after thoracic trauma. Current findings might help to recognize patients at risk of an adverse outcome, and thereby prevent complications.RETROSPECTIVELY REGISTERED: The regional committees for medical and health research ethics file number is 2017/293.

Laser resonance ionization at the RISIKO 30 kV mass separator has been used to produce isotopically and isobarically pure and well quantified

Introduction: Hip fracture surgery is among the most performed surgical procedures in elderly patients. Mortality rates are high, however, and patients often fail to live independently following a hip fracture. To improve outcome, multidisciplinary care pathways have been initiated, but longer-term results are lacking. Aim of this study was to compare functional outcome and living situation six months after hip fracture treatment with and without a care pathway.Patients and methods: A multicentre prospective controlled trial was conducted with three hospitals: in one hospital patients were treated with a care pathway, in the other hospitals patients received usual care. All patients aged >= 60 years witha hipfracture were asked to participate. Besides basic characteristics, health-related quality of life (EQ-5D) and performance scores of activities of daily living (Katz Index and Lawton IADL) were assessed. Differences in scores were analysed using linear regression. Propensity score adjustment was used to correct for differences between the care pathway and the usual care group. Missing data were imputed.Results: No differences in rate of return to prefracture ADL level were found between patients in the care pathway group and the usual care group. The percentage of participants in the same situation as before the fracture was the same in both treatment groups (81%). There were no significant differences in quality of life, activities of daily living or mortality (15% vs 10%, p = 0.17), but hospital stay in the care pathway group was significantly shorter (median 7 vs 10 days). Discussion: Treatment of elderly patients with a hip fracture is commonly organised in care pathways. Although short-term advantages are reported, positive effects on longer-term functional results could not be proven in our study. This study confirmed a shorter hospital stay in the care pathway group, which potentially may lead to a reduction in costs.Conclusions: Functional outcome and living situation six months after a hip fracture is the same for patients treated with or without a care pathway. (C) 2021 The Author(s). Published by Elsevier Ltd.

The Gothenburg ANion Detector for Affinity measurements by Laser PHotodetachment (GANDALPH) has recently been built for measurements of electron affinities (EA) of radioisotopes. A first measurement campaign is aimed towards the determination of the EA of astatine, the rarest naturally occurring element on earth. In this work we present several upgrades of GANDALPH which have been implemented in order to facilitate EA measurements of radioisotopes where only low intensity ion beams (< 1pA) can be produced.

BACKGROUND: Pelvic ring injuries are serious injuries, often associated with substantial morbidity and mortality rates. The long-term consequences of these injuries might affect the patients' personal life. Our aim was to assess the long-term effects of pelvic ring injuries on physical functioning and quality of life (QoL) using validated patient-reported outcome measures (PROMs) and comparing these results to normative data from the general population.PATIENTS AND METHODS: A retrospective cohort study was conducted on adults treated for pelvic ring injuries between 2007 and 2016. Demographics, fracture type, injury mechanism, treatment and complications were recorded. PROMs questionnaires concerning physical functioning (SMFA) and quality of life (EQ-5D) were used. Patients were divided according to their age (18-30, 31-64, 65 and older) and fracture type (Tile/AO type A, B or C). Differences in SMFA and EQ-5D scores of the operatively and non-operatively treated patients and between the study population and general population were analyzed.RESULTS: A total of 413 patients were identified of which 279 were eligible for follow-up. One-hundred and ninety-two (69%) patients responded with a mean follow-up of 4.4 years. Patients reported a median score of 13.9 on the SMFA function index, 16.7 on the bother index, 12.5 on the lower extremity, 18.8 on the activities of daily living and 23.4 on the emotion subscale. A median EQ-5D score of 0.8 was reported. There was no difference in physical functioning and QoL between operatively and non-operatively treated patients. Comparison of these results to normative data of the general population revealed a significant (P CONCLUSION: Long-term physical functioning and QoL in patients who had sustained a pelvic ring injury seems fair, although significantly decreased in comparison with their peers from the general population.

Resonance ionization mass spectrometry is an efficient tool to detect minute amounts of long-lived radio-isotopes in environmental samples. Applying resonant excitation and ionization with pulsed laser radiation within a hot cavity atomizer enables the sensitive detection and precise quantification of long-lived actinide isotopes. Due to the inherently element selective ionization process, this method ensures ultimate suppression of contaminations from other elements and molecules. The characterization of in-source resonance ionization of the actinide elements U, Th, Np, and Am using a compact quadrupole mass spectrometer (QMS) setup are discussed.

The development of a highly efficient resonance ionization scheme for lutetium is presented. A laser ion source, based on the all-solid-state Titanium:sapphire laser system, was used at the 30 keV RISIKO off-line mass separator to characterize different possible optical excitation schemes in respect to their ionization efficiency. The developed laser resonance ionization scheme can be directly applied to the use at radioactive ion beam facilities, e. g. at the CERN-MEDICIS facility, for large-scale production of medical radioisotopes.

Objective: To assess test–retest reliability, construct validity and responsiveness of the Dutch Short Musculoskeletal Function Assessment (SMFA-NL) in patients who sustained acute physical trauma. Design: A longitudinal cohort study. Setting: A level 1 trauma center in The Netherlands. Subjects: Patients who required hospital admission after sustaining an acute physical trauma. Intervention: Patients completed the SMFA-NL at six weeks, eight weeks and six months post-injury. Main measure: The measures used were The Dutch Short Musculoskeletal Function Assessment. Test–retest reliability (between six and eight weeks post-injury) using intraclass correlation coefficients, the smallest detectable change and Bland and Altman plots. Construct validity (six weeks post-injury) and responsiveness (between six weeks and six months post-injury) were evaluated using the hypothesis testing method. Results: A total of 248 patients (mean age: 46.5, SD: 13.4) participated, 145 patients completed the retest questionnaires (eight weeks) and 160 patients completed the responsiveness questionnaires (six months). The intraclass correlation coefficients indicated good to excellent reliability on all subscales (0.80 to 0.98). The smallest detectable change was 17.4 for the Upper Extremity Dysfunction subscale, 11.0 for the Lower Extremity Dysfunction subscales, 13.9 for the Problems with Daily Activities subscale and 16.5 for the Mental and Emotional Problems subscale. At group level, the smallest detectable change ranged from 1.48 to 1.96. A total of 86% of the construct validity hypotheses and 79% of the responsiveness hypotheses were confirmed. Conclusion: This study showed that the SMFA-NL has good to excellent reliability, sufficient construct validity and is able to detect change in physical function over time.

Purpose The section for the skeletal trauma and sport's injuries of the European Society for Trauma and Emergency Surgery (ESTES) appointed a task force group to reach a consensus among European countries on proximal humeral fractures. Material/Methods The task force group organized several consensus meetings until a paper with final recommendations was confirmed during the ESTES Executive Board meeting in Berlin on 25 October 2018. Conclusion The Recommendations compare conservative and four possible operative treatment options (ORIF, nailing, hemi- and total reverse arthroplasty) and enable the smallest common denominator for the surgical treatment among ESTES members.

BACKGROUNDThe Berlin polytrauma definition (BPD) was established to identify multiple injury patients with a high risk of mortality. The definition includes injuries with an Abbreviated Injury Scale score of >= 3 in >= 2 body regions (2AIS >= 3) combined with the presence of >= 1 physiological risk factors (PRFs). The PRFs are based on age, Glasgow Coma Scale, hypotension, acidosis, and coagulopathy at specific cutoff values. This study evaluates and compares the BPD with two other multiple injury definitions used to identify patients with high resource utilization and mortality risk, using data from the Dutch National Trauma Register (DNTR). METHODSThe evaluation was performed based on 2015 to 2018 DNTR data. First, patient characteristics for 2AIS >= 3, Injury Severity Score (ISS) of >= 16, and BPD patients were compared. Second, the PRFs prevalence and odds ratios of mortality for 2AIS >= 3 patients were compared with those from the Deutsche Gesellschaft fur Unfallchirurgie Trauma Register. Subsequently, the association between PRF and mortality was assessed for 2AIS >= 3-DNTR patients and compared with those with an ISS of >= 16. RESULTSThe DNTR recorded 300,649 acute trauma admissions. A total of 15,711 patients sustained an ISS of >= 16, and 6,263 patients had suffered a 2AIS >= 3 injury. All individual PRFs were associated with a mortality of >30% in 2AIS >= 3-DNTR patients. The increase in PRFs was associated with a significant increase in mortality for both 2AIS >= 3 and ISS >= 16 patients. A total of 4,264 patients met the BPDs criteria. Overall mortality (27.2%), intensive care unit admission (71.2%), and length of stay were the highest for the BPD group. CONCLUSIONThis study confirms that the BPD identifies high-risk patients in a population-based registry. The addition of PRFs to the anatomical injury scores improves the identification of severely injured patients with a high risk of mortality. Compared with the ISS >= 16 and 2AIS >= 3 multiple injury definitions, the BPD showed to improve the accuracy of capturing patients with a high medical resource need and mortality rate.

The mean-square charge radii of $^{207,208}$Hg ($Z=80, N=127,128$) have been studied for the first time and those of $^{202,203,206}$Hg ($N=122,123,126$) remeasured by the application of in-source resonance-ionization laser spectroscopy at ISOLDE (CERN). The characteristic \textit{kink} in the charge radii at the $N=126$ neutron shell closure has been revealed, providing the first information on its behavior below the $Z=82$ proton shell closure. A theoretical analysis has been performed within relativistic Hartree-Bogoliubov and non-relativistic Hartree-Fock-Bogoliubov approaches, considering both the new mercury results and existing lead data. Contrary to previous interpretations, it is demonstrated that both the kink at $N=126$ and the odd-even staggering (OES) in its vicinity can be described predominately at the mean-field level, and that pairing does not need to play a crucial role in their origin. A new OES mechanism is suggested, related to the staggering in the occupation of the different neutron orbitals in odd- and even-$A$ nuclei, facilitated by particle-vibration coupling for odd-$A$ nuclei.

Isotope shifts of $^{223-226,228}$Ra$^{19}$F were measured for different vibrational levels in the electronic transition $A^{2}{}{\Pi}_{1/2}\leftarrow X^{2}{}{\Sigma}^{+}$. The observed isotope shifts demonstrate the particularly high sensitivity of radium monofluoride to nuclear size effects, offering a stringent test of models describing the electronic density within the radium nucleus. Ab initio quantum chemical calculations are in excellent agreement with experimental observations. These results highlight some of the unique opportunities that short-lived molecules could offer in nuclear structure and in fundamental symmetry studies., Comment: The paper was accepted for publication as a Letter in Physical Review Letters

The CERN-MEDICIS facility aims to produce emerging medical radionuclides for the theranostics approach in nuclear medicine with mass separation of ion beams. To enhance the radioisotope yield and purity of collected samples, the resonance ionization laser ion source MELISSA was constructed, and provided the first laser ions at the facility in 2019. Several operational tests were accomplished to investigate its performance in preparation for the upcoming production of terbium radioisotopes, which are of particular interest for medical applications. © 2020, The Author(s). KU Leuven Horizon 2020: 642889 MEDICIS-PROMED 05P12UMCIA, 05P15UMCIA Open Access funding provided by Projekt DEAL. We would like to acknowledge the help and assistance from the whole MEDICIS collaboration; from CERN-ISOLDE Technical and Physical groups. This research project has been supported by a Marie Skłodowska-Curie Innovative Training Network Fellowship of the European Commission’s Horizon 2020 Programme under contract number 642889 MEDICIS-PROMED; by the German Federal Ministry of Education and Research under the consecutive projects 05P12UMCIA and 05P15UMCIA; by the Research Foundation Flanders FWO (Belgium) and by a KU Leuven START grant.

Laser resonance ionization at the RISIKO 30 kV mass separator has been used to produce isotopically and isobarically pure and well quantified 222Rn emanation standards. Based upon laser-spectroscopic preparation studies, ion implantation into aluminum and tungsten targets has been carried out, providing overall implantation efficiencies of 40% up to 60%. The absolute implanted activity of 226Ra was determined by the technique of defined solid-angle α-particle spectrometry, where excellent energy resolution was observed. The 222Rn emanation coefficient of the produced targets was studied using α-particle and γ-ray spectrometry, and yielded results between 0.23 and 0.34, with relative uncertainty on the order of 1%. No dependence exceeding a 1% change of the emanation on humidity could be identified in the range of 15 %rH to 75 %rH, whereas there were hints of a slight correlation between the emanation and temperature. Additionally, and as expected, the emanation coefficient was found to be dependent on the target material as well as the implanted dose. © 2021

The goal for the ECHo experiment is the determination of the effective electron neutrino mass by analyzing the electron capture (EC) spectrum of $^{163}$Ho. Metallic magnetic calorimeters enclosing $^{163}$Ho, achieved very good performance to conduct such an experiment. During the first phase of the experiment, ECHo-1k, the detector production and the implantation process of high purity $^{163}$Ho have been optimized. Large detector arrays have been developed, featuring energy resolution below 5eV and activity of about 1Bq per pixel. High statistics and high resolution $^{163}$Ho spectra have been acquired and analyzed in light of new theoretical description of the spectral shape, considering the independently determined Q$_{\mathrm{EC}}$-value, and a dedicated background model. In this contribution, we present preliminary results obtained in the first phase of ECHo. At the same time, we discuss the necessary upgrades towards the second phase of the experiment, ECHo-100k.