Incidence of Guillain-Barre syndrome among patients with Campylobacter infection: A general practice research database study

The association between Campylobacter infection and subsequent Guillain-Barre syndrome (GBS) has been well documented. To date, however, there exists no direct estimate of the incidence of GBS among patients with Campylobacter infection. Using the General Practice Research Database, we estimate the incidence of GBS in a cohort of patients presenting with Campylobacter enteritis to be 1.17/1000 person-years, a rate 77 times greater than that in the general population. The probability that an individual who develops Campylobacter enteritis will also develop GBS during the subsequent 2-month period is < 2/10,000

Variations in the slope of the resolved star-forming main sequence: A tool for constraining the mass of star-forming regions

The correlation between galaxies' integrated stellar masses and star formation rates (the 'star formation main sequence', SFMS) is a well-established scaling relation. Recently, surveys have found a relationship between the star formation rate (SFR) and stellar mass surface densities on kpc and sub-kpc scales (the 'resolved SFMS', rSFMS). In this work, we demonstrate that the rSFMS emerges naturally in Feedback In Realistic Environments 2 (FIRE-2) zoom-in simulations of Milky Way-mass galaxies. We make SFR and stellar mass maps of the simulated galaxies at a variety of spatial resolutions and star formation averaging time-scales and fit the rSFMS using multiple methods from the literature. While the absolute value of the SFMS slope (αMS) depends on the fitting method, the slope is steeper for longer star formation time-scales and lower spatial resolutions regardless of the fitting method employed. We present a toy model that quantitatively captures the dependence of the simulated galaxies' αMS on spatial resolution and use it to illustrate how this dependence can be used to constrain the characteristic mass of star-forming clumps

What drives the evolution of gas kinematics in star-forming galaxies?

One important result from recent large integral field spectrograph (IFS) surveys is that the intrinsic velocity dispersion of galaxies traced by star-forming gas increases with redshift. Massive, rotation-dominated discs are already in place at z ∼ 2, but they are dynamically hotter than spiral galaxies in the local Universe. Although several plausible mechanisms for this elevated velocity dispersion (e.g. star formation feedback, elevated gas supply, or more frequent galaxy interactions) have been proposed, the fundamental driver of the velocity dispersion enhancement at high redshift remains unclear. We investigate the origin of this kinematic evolution using a suite of cosmological simulations from the FIRE (Feedback In Realistic Environments) project. Although IFS surveys generally cover a wider range of stellar masses than in these simulations, the simulated galaxies show trends between intrinsic velocity dispersion (σ intr ), SFR, and z in agreement with observations. In both observations and simulations, galaxies on the star-forming main sequence have median σ intr values that increase from z ∼ 0 to z ∼ 1–1.5, but this increasing trend is less evident at higher redshift. In the FIRE simulations, σ intr can vary significantly on time-scales of 100 Myr. These variations closely mirror the time evolution of the SFR and gas inflow rate (M gas ). By cross-correlating pairs of σ intr, M gas, and SFR, we show that increased gas inflow leads to subsequent enhanced star formation, and enhancements in σ intr tend to temporally coincide with increases in M gas and SFR

The ISM properties and gas kinematics of a redshift 3 massive dusty star-forming galaxy

We present CO (J = 1 → 0; 3 → 2; 5 → 4; 10 → 9) and 1.2 kpc resolution [C II] line observations of the dusty star-forming galaxy (SFG) HXMM05—carried out with the Karl G. Jansky Very Large Array, the Combined Array for Research in Millimeter-wave Astronomy, the Plateau de Bure Interferometer, and the Atacama Large Millimeter/submillimeter Array, measuring an unambiguous redshift of z = 2.9850 ± 0.0009. We find that HXMM05 is a hyperluminous infrared galaxy (LIR = (4 ± 1) × 1013 Le) with a total molecular gas mass of (2.1 ± 0.7) × 1011(aCO/0.8) Me. The CO (J = 1 → 0) and [C II] emission are extended over ∼9 kpc in diameter, and the CO line FWHM exceeds 1100 km s−1 . The [C II] emission shows a monotonic velocity gradient consistent with a disk, with a maximum rotation velocity of vc = 616 ± 100 km s−1 and a dynamical mass of (7.7 ± 3.1) × 1011 Me. We find a star formation rate of 2900- + 595 750 Me yr−1 . HXMM05 is thus among the most intensely SFGs known at high redshift. Photodissociation region modeling suggests physical conditions similar to nearby SFGs, showing extended star formation, which is consistent with our finding that the gas emission and dust emission are cospatial. Its molecular gas excitation resembles the local major merger Arp 220. The broad CO and [C II] lines and a pair of compact dust nuclei suggest the presence of a late-stage major merger at the center of the extended disk, again reminiscent of Arp 220. The observed gas kinematics and conditions, together with the presence of a companion and the pair of nuclei, suggest that HXMM05 is experiencing multiple mergers as a part of the evolution

Mass and Angular Momentum in General Relativity

We present an introduction to mass and angular momentum in General Relativity. After briefly reviewing energy-momentum for matter fields, first in the flat Minkowski case (Special Relativity) and then in curved spacetimes with or without symmetries, we focus on the discussion of energy-momentum for the gravitational field. We illustrate the difficulties rooted in the Equivalence Principle for defining a local energy-momentum density for the gravitational field. This leads to the understanding of gravitational energy-momentum and angular momentum as non-local observables that make sense, at best, for extended domains of spacetime. After introducing Komar quantities associated with spacetime symmetries, it is shown how total energy-momentum can be unambiguously defined for isolated systems, providing fundamental tests for the internal consistency of General Relativity as well as setting the conceptual basis for the understanding of energy loss by gravitational radiation. Finally, several attempts to formulate quasi-local notions of mass and angular momentum associated with extended but finite spacetime domains are presented, together with some illustrations of the relations between total and quasi-local quantities in the particular context of black hole spacetimes. This article is not intended to be a rigorous and exhaustive review of the subject, but rather an invitation to the topic for non-experts. In this sense we follow essentially the expositions in Szabados 2004, Gourgoulhon 2007, Poisson 2004 and Wald 84, and refer the reader interested in further developments to the existing literature, in particular to the excellent and comprehensive review by Szabados (2004).Comment: 41 pages. Notes based on the lecture given at the C.N.R.S. "School on Mass" (June 2008) in Orleans, France. To appear as proceedings in the book "Mass and Motion in General Relativity", eds. L. Blanchet, A. Spallicci and B. Whiting. Some comments and references added

Pressure balance in the multiphase ISM of cosmologically simulated disc galaxies

Pressure balance plays a central role in models of the interstellar medium (ISM), but whether and how pressure balance is realized in a realistic multiphase ISM is not yet well understood. We address this question by using a set of FIRE-2 cosmological zoom-in simulations of Milky Way-mass disc galaxies, in which a multiphase ISM is self-consistently shaped by gravity, cooling, and stellar feedback. We analyse how gravity determines the vertical pressure profile as well as how the total ISM pressure is partitioned between different phases and components (thermal, dispersion/turbulence, and bulk flows). We show that, on average and consistent with previous more idealized simulations, the total ISM pressure balances the weight of the overlying gas. Deviations from vertical pressure balance increase with increasing galactocentric radius and with decreasing averaging scale. The different phases are in rough total pressure equilibrium with one another, but with large deviations from thermal pressure equilibrium owing to kinetic support in the cold and warm phases, which dominate the total pressure near the mid-plane. Bulk flows (e.g. inflows and fountains) are important at a few disc scale heights, while thermal pressure from hot gas dominates at larger heights. Overall, the total mid-plane pressure is well-predicted by the weight of the disc gas and we show that it also scales linearly with the star formation rate surface density (ςSFR). These results support the notion that the Kennicutt-Schmidt relation arises because ςSFR and the gas surface density (ςg) are connected via the ISM mid-plane pressure

Rehabilitation Enablement in Chronic Heart Failure—a facilitated self-care rehabilitation intervention in patients with heart failure with preserved ejection fraction (REACH-HFpEF) and their caregivers:rationale and protocol for a single-centre pilot randomised controlled trial

This is the final version of the article. Available from the publisher via the DOI in this record.INTRODUCTION: The Rehabilitation EnAblement in CHronic Heart Failure in patients with Heart Failure (HF) with preserved ejection fraction (REACH-HFpEF) pilot trial is part of a research programme designed to develop and evaluate a facilitated, home-based, self-help rehabilitation intervention to improve self-care and quality of life (QoL) in heart failure patients and their caregivers. We will assess the feasibility of a definitive trial of the REACH-HF intervention in patients with HFpEF and their caregivers. The impact of the REACH-HF intervention on echocardiographic outcomes and bloodborne biomarkers will also be assessed. METHODS AND ANALYSIS: A single-centre parallel two-group randomised controlled trial (RCT) with 1:1 individual allocation to the REACH-HF intervention plus usual care (intervention) or usual care alone (control) in 50 HFpEF patients and their caregivers. The REACH-HF intervention comprises a REACH-HF manual with supplementary tools, delivered by trained facilitators over 12 weeks. A mixed methods approach will be used to assess estimation of recruitment and retention rates; fidelity of REACH-HF manual delivery; identification of barriers to participation and adherence to the intervention and study protocol; feasibility of data collection and outcome burden. We will assess the variance in study outcomes to inform a definitive study sample size and assess methods for the collection of resource use and intervention delivery cost data to develop the cost-effectiveness analyses framework for any future trial. Patient outcomes collected at baseline, 4 and 6 months include QoL, psychological well-being, exercise capacity, physical activity and HF-related hospitalisation. Caregiver outcomes will also be assessed, and a substudy will evaluate impact of the REACH-HF manual on resting global cardiovascular function and bloodborne biomarkers in HFpEF patients. ETHICS AND DISSEMINATION: The study is approved by the East of Scotland Research Ethics Service (Ref: 15/ES/0036). Findings will be disseminated via journals and presentations to clinicians, commissioners and service users. TRIAL REGISTRATION NUMBER: ISRCTN78539530; Pre-results .This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-1210-12004). NB, CA, CJG and RST are also supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula at the Royal Devon and Exeter NHS Foundation Trust; KJ by CLAHRC West Midlands and SS by CLAHRC East-Midlands. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Healt

Guillain-Barré Syndrome and Preceding Infection with Campylobacter, Influenza and Epstein-Barr Virus in the General Practice Research Database

BACKGROUND: A number of infectious agents have previously been suggested as risk factors for the development of Guillain-Barré syndrome (GBS), but robust epidemiologic evidence for these associations is lacking. METHODS AND FINDINGS: We conducted a nested case-control study using data from the United Kingdom General Practice Research Database between 1991 and 2001. Controls were matched to cases on general practice clinic, sex, year of birth and date of outcome diagnosis in their matched case. We found positive associations between GBS and infection with Campylobacter, Epstein-Barr virus and influenza-like illness in the previous two months, as well as evidence of a protective effect of influenza vaccination. After correction for under-ascertainment of Campylobacter infection, the excess risk of GBS following Campylobacter enteritis was 60-fold and 20% of GBS cases were attributable to this pathogen. CONCLUSIONS: Our findings indicate a far greater excess risk of GBS among Campylobacter enteritis patients than previously reported by retrospective serological studies. In addition, they confirm previously suggested associations between infection due to Epstein-Barr virus infection and influenza-like illness and GBS. Finally, we report evidence of a protective effect of influenza vaccination on GBS risk, which may be mediated through protection against influenza disease, or result from a lower likelihood of vaccination among those with recent infection. Cohort studies of GBS incidence in this population would help to clarify the burden of GBS due to influenza, and any potential protective effect of influenza vaccination

The Cost of Sex: Quantifying Energetic Investment in Gamete Production by Males and Females

The relative energetic investment in reproduction between the sexes forms the basis of sexual selection and life history theories in evolutionary biology. It is often assumed that males invest considerably less in gametes than females, but quantifying the energetic cost of gamete production in both sexes has remained a difficult challenge. For a broad diversity of species (invertebrates, reptiles, amphibians, fishes, birds, and mammals), we compared the cost of gamete production between the sexes in terms of the investment in gonad tissue and the rate of gamete biomass production. Investment in gonad biomass was nearly proportional to body mass in both sexes, but gamete biomass production rate was approximately two to four orders of magnitude higher in females. In both males and females, gamete biomass production rate increased with organism mass as a power law, much like individual metabolic rate. This suggests that whole-organism energetics may act as a primary constraint on gamete production among species. Residual variation in sperm production rate was positively correlated with relative testes size. Together, these results suggest that understanding the heterogeneity in rates of gamete production among species requires joint consideration of the effects of gonad mass and metabolism