Outcomes in patients with gunshot wounds to the brain.

Introduction:Gunshot wounds to the brain (GSWB) confer high lethality and uncertain recovery. It is unclear which patients benefit from aggressive resuscitation, and furthermore whether patients with GSWB undergoing cardiopulmonary resuscitation (CPR) have potential for survival or organ donation. Therefore, we sought to determine the rates of survival and organ donation, as well as identify factors associated with both outcomes in patients with GSWB undergoing CPR. Methods:We performed a retrospective, multicenter study at 25 US trauma centers including dates between June 1, 2011 and December 31, 2017. Patients were included if they suffered isolated GSWB and required CPR at a referring hospital, in the field, or in the trauma resuscitation room. Patients were excluded for significant torso or extremity injuries, or if pregnant. Binomial regression models were used to determine predictors of survival/organ donation. Results:825 patients met study criteria; the majority were male (87.6%) with a mean age of 36.5 years. Most (67%) underwent CPR in the field and 2.1% (n=17) survived to discharge. Of the non-survivors, 17.5% (n=141) were considered eligible donors, with a donation rate of 58.9% (n=83) in this group. Regression models found several predictors of survival. Hormone replacement was predictive of both survival and organ donation. Conclusion:We found that GSWB requiring CPR during trauma resuscitation was associated with a 2.1% survival rate and overall organ donation rate of 10.3%. Several factors appear to be favorably associated with survival, although predictions are uncertain due to the low number of survivors in this patient population. Hormone replacement was predictive of both survival and organ donation. These results are a starting point for determining appropriate treatment algorithms for this devastating clinical condition. Level of evidence:Level II

Haze in Pluto's atmosphere: Results from SOFIA and ground-based observations of the 2015 June 29 Pluto occultation

On UT 29 June 2015, the occultation by Pluto of a bright star (r′ = 11.9) was observed from the Stratospheric Observatory for Infrared Astronomy (SOFIA) and several ground-based stations in New Zealand and Australia. Pre-event astrometry allowed for an in-flight update to the SOFIA team with the result that SOFIA was deep within the central flash zone (~22 km from center). Analysis of the combined data leads to the result that Pluto's middle atmosphere is essentially unchanged from 2011 and 2013 (Person et al. 2013; Bosh et al. 2015); there has been no significant expansion or contraction of the atmosphere. Additionally, our multi-wavelength observations allow us to conclude that a haze component in the atmosphere is required to reproduce the light curves obtained. This haze scenario has implications for understanding the photochemistry of Pluto's atmosphere

TRIO OF STELLAR OCCULTATIONS BY PLUTO ONE YEAR PRIOR TO NEW HORIZONS' ARRIVAL

We observed occultations by Pluto during a predicted series of events in 2014 July with the 1 m telescope of the Mt. John Observatory in New Zealand. The predictions were based on updated astrometry obtained in the previous months at the USNO, CTIO, and Lowell Observatories. We successfully detected occultations by Pluto of an R = 18 mag star on July 23 (14:23:32 ± 00:00:04 UTC to 14:25:30 ± 00:00:04 UTC), with a drop of 75% of the unocculted stellar signal, and of an R = 17 star on July 24 (11:41:30 ± 00:00:08 UTC to 11:43:28 ± 00:00:08 UTC), with a drop of 80% of the unocculted stellar signal, both with 20 s exposures with our frame-transfer Portable Occultation, Eclipse, and Transit System. Since Pluto had a geocentric velocity of 22.51 km s[superscript −1] on July 23 and 22.35 km s[superscript −1] on July 24, these intervals yield limits on the chord lengths (surface and lower atmosphere) of 2700 ± 130 km and 2640 ± 250 km, respectively, indicating that the events were near central, and therefore provide astrometric constraints on the prediction method. Our coordinated observations with the 4 m AAT in Australia on July 23 and the 6.5 m Magellan/Clay on Las Campanas, the 4.1 m Southern Astrophysical Research Telescope on Cerro Pachön, the 2.5 m DuPont on Las Campanas (LCO), the 0.6 m SARA-South on Cerro Tololo of the Southeastern Association for Research in Astronomy (SARA), the MPI/ESO 2.2 m on La Silla, and the 0.45 m Cerro Calán telescope and 0.36 telescope in Constitución in Chile on July 27 and 31, which would have provided higher-cadence observations for studies of Pluto's atmosphere, were largely foiled by clouds, but led to detection with the LCO Magellan/Clay and DuPont Telescopes on July 31 of the grazing occultation of a previously unknown 15th-magnitude star, completing the trio of occultations successfully observed and reported in this paper.National Research Foundation (South Africa

Pluto Occultation on 2015 June 29 UTC With Central Flash and Atmospheric Spikes Just Before the New Horizons Flyby

We observed the occultation by Pluto of a 12th magnitude star, one of the two brightest occultation stars ever in our dozen years of continual monitoring of Pluto's atmosphere through such studies, on 2015 June 29 UTC. At the Univ. of Canterbury Mt. John Observatory (New Zealand), under clear skies throughout, we used a POETS frame-transfer CCD at 10 Hz with GPS timing on the 1-m McLellan telescope as well as an infrared camera on an 0.6-m telescope and three-color photometry at a slower cadence on a second 0.6-m telescope. At the Auckland Observatory, we used a POETS and a PICO on 0.5-m and 0.4-m telescopes, with 0.4 s and 2 s cadences, respectively, obtaining ingress observations before clouds moved in. The Mt. John light curves show a central flash, indicating that we were close to the center of the occultation path. Analysis of our light curves show that Pluto's atmosphere remains robust. The presence of spikes at both sites in the egress and ingress shows atmospheric layering. We coordinated our observations with aircraft observations (Bosh et al., 2017) with the Stratospheric Observatory for Infrared Astronomy (SOFIA). Our chords helped constrain the path across Pluto that SOFIA saw. Our ground-based and airborne stellar-occultation effort came only just over two weeks of Earth days and two Pluto days before the flyby of NASA's New Horizons spacecraft