Therapeutic hypothermia, still "too cool to be true?"

Therapeutic hypothermia, an intervention reducing core body temperature below 35 degrees Celsius, has gained popularity in the management of acute brain injury after a series of small clinical trials in patients following cardiac arrest, stroke and traumatic brain injury. This article reviews the evidence relating to therapeutic hypothermia as an intervention in acute injury

Developing a Prognostic Model for Traumatic Brain Injury—A Missed Opportunity?

Peter Andrews and Neil Young discuss the implications of a study involving the development and validation of new prognostic models for traumatic brain injury

Randomised trial of glutamine, selenium, or both, to supplement parenteral nutrition for critically ill patients

Peer reviewedPublisher PD

Deformation of the Pacific/North America plate boundary at Queen Charlotte Fault : the possible role of rheology

Published 2018. This article is a U.S. Government work and is in the public domain in the USA. The definitive version was published in Journal of Geophysical Research: Solid Earth 123 (2018): 4223-4242, doi:10.1002/2017JB014770.The Pacific/North America (PA/NA) plate boundary between Vancouver Island and Alaska is similar to the PA/NA boundary in California in its kinematic history and the rate and azimuth of current relative motion, yet their deformation styles are distinct. The California plate boundary shows a broad zone of parallel strike slip and thrust faults and folds, whereas the 49‐mm/yr PA/NA relative plate motion in Canada and Alaska is centered on a single, narrow, continuous ~900‐km‐long fault, the Queen Charlotte Fault (QCF). Using gravity analysis, we propose that this plate boundary is centered on the continent/ocean boundary (COB), an unusual location for continental transform faults because plate boundaries typically localize within the continental lithosphere, which is weaker. Because the COB is a boundary between materials of contrasting elastic properties, once a fault is established there, it will probably remain stable. We propose that deformation progressively shifted to the COB in the wake of Yakutat terrane's northward motion along the margin. Minor convergence across the plate boundary is probably accommodated by fault reactivation on Pacific crust and by an eastward dipping QCF. Underthrusting of Pacific slab under Haida Gwaii occurs at convergence angles >14°–15° and may have been responsible for the emergence of the archipelago. The calculated slab entry dip (5°–8°) suggests that the slab probably does not extend into the asthenosphere. The PA/NA plate boundary at the QCF can serve as a structurally simple site to investigate the impact of rheology and composition on crustal deformation and the initiation of slab underthrusting

Multipartite quantum entanglement evolution in photosynthetic complexes

We investigate the evolution of entanglement in the Fenna-Matthew-Olson (FMO) complex based on simulations using the scaled hierarchical equations of motion approach. We examine the role of entanglement in the FMO complex by direct computation of the convex roof. We use monogamy to give a lower bound for entanglement and obtain an upper bound from the evaluation of the convex roof. Examination of bipartite measures for all possible bipartitions provides a complete picture of the multipartite entanglement. Our results support the hypothesis that entanglement is maximum primary along the two distinct electronic energy transfer pathways. In addition, we note that the structure of multipartite entanglement is quite simple, suggesting that there are constraints on the mixed state entanglement beyond those due to monogamy. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4742333

Linear modeling of possible mechanisms for parkinson tremor generation

The power of Parkinson tremor is expressed in terms of possibly changed frequency response functions between relevant variables in the neuromuscular system. The derivation starts out from a linear loopless equivalent model of mechanisms for general tremor generation. Hypothetical changes in this model from the substrate of the disease are indicated, and possible ones are inferred from literature about experiments on patients. The result indicates that in these patients tremor appears to have been generated in loops, which did not include the brain area which in surgery usually is inactivated. For some patients in the literature, these loops could involve muscle length receptors, the static sensitivity of which may have been enlarged by pathological brain activity

Interaction between allelic variations in vitamin D receptor and retinoid X receptor genes on metabolic traits

BACKGROUND: Low vitamin D status has been shown to be a risk factor for several metabolic traits such as obesity, diabetes and cardiovascular disease. The biological actions of 1, 25-dihydroxyvitamin D, are mediated through the vitamin D receptor (VDR), which heterodimerizes with retinoid X receptor, gamma (RXRG). Hence, we examined the potential interactions between the tagging polymorphisms in the VDR (22 tag SNPs) and RXRG (23 tag SNPs) genes on metabolic outcomes such as body mass index, waist circumference, waist-hip ratio (WHR), high- and low-density lipoprotein (LDL) cholesterols, serum triglycerides, systolic and diastolic blood pressures and glycated haemoglobin in the 1958 British Birth Cohort (1958BC, up to n = 5,231). We used Multifactor- dimensionality reduction (MDR) program as a non-parametric test to examine for potential interactions between the VDR and RXRG gene polymorphisms in the 1958BC. We used the data from Northern Finland Birth Cohort 1966 (NFBC66, up to n = 5,316) and Twins UK (up to n = 3,943) to replicate our initial findings from 1958BC. RESULTS: After Bonferroni correction, the joint-likelihood ratio test suggested interactions on serum triglycerides (4 SNP - SNP pairs), LDL cholesterol (2 SNP - SNP pairs) and WHR (1 SNP - SNP pair) in the 1958BC. MDR permutation model testing analysis showed one two-way and one three-way interaction to be statistically significant on serum triglycerides in the 1958BC. In meta-analysis of results from two replication cohorts (NFBC66 and Twins UK, total n = 8,183), none of the interactions remained after correction for multiple testing (Pinteraction >0.17). CONCLUSIONS: Our results did not provide strong evidence for interactions between allelic variations in VDR and RXRG genes on metabolic outcomes; however, further replication studies on large samples are needed to confirm our findings

Recurring outbursts of the supernova impostor AT 2016blu in NGC 4559

We present the first photometric analysis of the supernova (SN) impostor AT 2016blu in NGC 4559. This transient was discovered by the Lick Observatory Supernova Search in 2012 and has continued its outbursts since then. Optical and infrared photometry of AT 2016blu reveals at least 19 outbursts in 2012-2022. Similar photometry from 1999-2009 shows no outbursts, indicating that the star was relatively stable in the decade before discovery. Archival {\it Hubble Space Telescope} observations suggest that the progenitor had a minimum initial mass of $M >= 33$ M$_{\odot}$ and a luminosity of $L >= 10^{5.7}$ L$_{\odot}$. AT 2016blu's outbursts show irregular variability with multiple closely spaced peaks having typical amplitudes of 1-2 mag and durations of 1-4 weeks. While individual outbursts have irregular light curves, concentrations of these peaks recur with a period of $\sim 113 \pm 2$ d. Based on this period, we predict times for upcoming outbursts in 2023 and 2024. AT 2016blu shares similarities with SN 2000ch in NGC 3432, where outbursts may arise from periastron encounters in an eccentric binary containing a luminous blue variable (LBV). We propose that AT 2016blu's outbursts are also driven by interactions that intensify around periastron in an eccentric system. Intrinsic variability of the LBV-like primary star may cause different intensity and duration of binary interaction at each periastron passage. AT 2016blu also resembles the periastron encounters of $\eta$ Carinae prior to its Great Eruption and the erratic pre-SN eruptions of SN 2009ip. This similarity and the onset of eruptions in the past decade hint that AT 2016blu may also be headed for a catastrophe, making it a target of great interest.Comment: 18 pages, 14 figures, 6 tables, MNRAS Accepte

PneuMum: Impact from a randomised controlled trial of maternal 23-valent pneumococcal polysaccharide vaccination on middle ear disease amongst Indigenous infants, Northern Territory, Australia

BackgroundWe assessed maternal 23-valent pneumococcal polysaccharide (23vPPV) vaccine efficacy (VE) against middle ear disease and pneumococcal carriage amongst Australian Indigenous infants.MethodsIn an open label, allocation concealed, outcome-assessor blinded, community stratified, randomised controlled trial, healthy pregnant Indigenous women aged 17–39 years in the Northern Territory of Australia received the 23vPPV (1:1:1) at: 30–36 weeks gestation, birth, or were unvaccinated (ClinicalTrials.gov NCT00714064). Co-primary outcomes were the point prevalences of infant middle ear disease and 23vPPV-type carriage at age 7 months.ResultsThe consent rate was 50% (313/632). Among 227 eligible participants randomised, retention rates were 86% (66/77) controls; 89% (67/75) pregnancy vaccinees; 88% (66/75) birth vaccinees. At infant age 7 months, ear disease prevalence was: 71% (47/66) controls, 63% (42/67) pregnancy vaccinees, 76% (50/66) birth vaccinees; and 23vPPV-type carriage was: 26% (17/66) controls, 18% (12/67) pregnancy vaccinees, 18% (12/66) birth vaccinees. For pregnancy vaccinees, VE was 12% (95% CI −12% to 31%) against infant ear disease and 30% (95% CI −34% to 64%) against 23vPPV-type carriage. In a post-hoc analysis, VE against infant ear disease concurrent with carriage of 23vPPV or related types was 51% (95% CI −2% to 76%). There were no serious adverse effects following receipt of the 23vPPV in pregnancy or at birth.ConclusionsIn a high risk population, our study was unable to demonstrate efficacy of 23vPPV in pregnancy against the co-primary outcomes of either all-cause infant ear disease or 23vPPV-type nasopharyngeal carriage at age 7 months. Efficacy against ear disease concurrent with carriage of vaccine-related serotypes (a more specific outcome) suggests 23vPPV in pregnancy may complement childhood pneumococcal vaccination programs