Identification of hematomas in mild traumatic brain injury using an index of quantitative brain electrical activity

Rapid identification of traumatic intracranial hematomas following closed head injury represents a significant health care need because of the potentially life-threatening risk they present. This study demonstrates the clinical utility of an index of brain electrical activity used to identify intracranial hematomas in traumatic brain injury (TBI) presenting to the emergency department (ED). Brain electrical activity was recorded from a limited montage located on the forehead of 394 closed head injured patients who were referred for CT scans as part of their standard ED assessment. A total of 116 of these patients were found to be CT positive (CT+), of which 46 patients with traumatic intracranial hematomas (CT+) were identified for study. A total of 278 patients were found to be CT negative (CT−) and were used as controls. CT scans were subjected to quanitative measurements of volume of blood and distance of bleed from recording electrodes by blinded independent experts, implementing a validated method for hematoma measurement. Using an algorithm based on brain electrical activity developed on a large independent cohort of TBI patients and controls (TBI-Index), patients were classified as either positive or negative for structural brain injury. Sensitivity to hematomas was found to be 95.7% (95% CI=85.2, 99.5), specificity was 43.9% (95% CI=38.0, 49.9). There was no significant relationship between the TBI-Index and distance of the bleed from recording sites (F=0.044, p=0.833), or volume of blood measured F=0.179, p=0.674). Results of this study are a validation and extension of previously published retrospective findings in an independent population, and provide evidence that a TBI-Index for structural brain injury is a highly sensitive measure for the detection of potentially life-threatening traumatic intracranial hematomas, and could contribute to the rapid, quantitative evaluation and treatment of such patients

A Database of Cepheid Distance Moduli and TRGB, GCLF, PNLF and SBF Data Useful for Distance Determinations

We present a compilation of Cepheid distance moduli and data for four secondary distance indicators that employ stars in the old stellar populations: the planetary nebula luminosity function (PNLF), the globular cluster luminosity function (GCLF), the tip of the red giant branch (TRGB), and the surface brightness fluctuation (SBF) method. The database includes all data published as of July 15, 1999. The main strength of this compilation resides in all data being on a consistent and homogeneous system: all Cepheid distances are derived using the same calibration of the period-luminosity relation, the treatment of errors is consistent for all indicators, measurements which are not considered reliable are excluded. As such, the database is ideal for inter-comparing any of the distance indicators considered, or for deriving a Cepheid calibration to any secondary distance indicator. Specifically, the database includes: 1) Cepheid distances, extinctions and metallicities; 2) apparent magnitudes of the PNLF cutoff; 3) apparent magnitudes and colors of the turnover of the GCLF (both in the V- and B-bands); 4) apparent magnitudes of the TRGB (in the I-band) and V-I colors at and 0.5 magnitudes fainter than the TRGB; 5) apparent surface brightness fluctuation magnitudes I, K', K_short, and using the F814W filter with the HST/WFPC2. In addition, for every galaxy in the database we give reddening estimates from DIRBE/IRAS as well as HI maps, J2000 coordinates, Hubble and T-type morphological classification, apparent total magnitude in B, and systemic velocity. (Abridged)Comment: Accepted for publication in the Astrophysical Journal Supplement Series. Because of space limitations, the figures included are low resolution bitmap images. Original figures can be found at http://www.astro.ucla.edu/~laura/pub.ht

The HST Key Project on the Extragalactic Distance Scale XXV. A Recalibration of Cepheid Distances to Type Ia Supernovae and the Value of the Hubble Constant

Cepheid-based distances to seven Type Ia supernovae (SNe)-host galaxies have been derived using the standard HST Key Project on the Extragalactic Distance Scale pipeline. For the first time, this allows for a transparent comparison of data accumulated as part of three different HST projects, the Key Project, the Sandage et al. Type Ia SNe program, and the Tanvir et al. Leo I Group study. Re-analyzing the Tanvir et al. galaxy and six Sandage et al. galaxies we find a mean (weighted) offset in true distance moduli of 0.12+/-0.07 mag -- i.e., 6% in linear distance -- in the sense of reducing the distance scale, or increasing H0. Adopting the reddening-corrected Hubble relations of Suntzeff et al. (1999), tied to a zero point based upon SNe~1990N, 1981B, 1998bu, 1989B, 1972E and 1960F and the photometric calibration of Hill et al. (1998), leads to a Hubble constant of H0=68+/-2(random)+/-5(systematic) km/s/Mpc. Adopting the Kennicutt et al. (1998) Cepheid period-luminosity-metallicity dependency decreases the inferred H0 by 4%. The H0 result from Type Ia SNe is now in good agreement, to within their respective uncertainties, with that from the Tully-Fisher and surface brightness fluctuation relations.Comment: Accepted for publication in The Astrophysical Journal. 62 pages, LaTeX, 9 Postscript figures. Also available at http://casa.colorado.edu/~bgibson/publications.htm

The HST Key Project on the Extragalactic Distance Scale. XXVIII. Combining the Constraints on the Hubble Constant

Since the launch of the Hubble Space Telescope nine years ago, Cepheid distances to 25 galaxies have been determined for the purpose of calibrating secondary distance indicators. A variety of these can now be calibrated, and the accompanying papers by Sakai, Kelson, Ferrarese, and Gibson employ the full set of 25 galaxies to consider the Tully-Fisher relation, the fundamental plane of elliptical galaxies, Type Ia supernovae, and surface brightness fluctuations. When calibrated with Cepheid distances, each of these methods yields a measurement of the Hubble constant and a corresponding measurement uncertainty. We combine these measurements in this paper, together with a model of the velocity field, to yield the best available estimate of the value of H_0 within the range of these secondary distance indicators and its uncertainty. The result is H_0 = 71 +/- 6 km/sec/Mpc. The largest contributor to the uncertainty of this 67% confidence level result is the distance of the Large Magellanic Cloud, which has been assumed to be 50 +/- 3 kpc

The Extragalactic Distance Scale Key Project XXVII. A Derivation of the Hubble Constant Using the Fundamental Plane and Dn-Sigma Relations in Leo I, Virgo, and Fornax

Using published photometry and spectroscopy, we construct the fundamental plane and D_n-Sigma relations in Leo I, Virgo and Fornax. The published Cepheid P-L relations to spirals in these clusters fixes the relation between angular size and metric distance for both the fundamental plane and D_n-Sigma relations. Using the locally calibrated fundamental plane, we infer distances to a sample of clusters with a mean redshift of cz \approx 6000 \kms, and derive a value of H_0=78+- 5+- 9 km/s/Mpc (random, systematic) for the local expansion rate. This value includes a correction for depth effects in the Cepheid distances to the nearby clusters, which decreased the deduced value of the expansion rate by 5% +- 5%. If one further adopts the metallicity correction to the Cepheid PL relation, as derived by the Key Project, the value of the Hubble constant would decrease by a further 6%+- 4%. These two sources of systematic error, when combined with a +- 6% error due to the uncertainty in the distance to the Large Magellanic Cloud, a +- 4% error due to uncertainties in the WFPC2 calibration, and several small sources of uncertainty in the fundamental plane analysis, combine to yield a total systematic uncertainty of +- 11%. We find that the values obtained using either the CMB, or a flow-field model, for the reference frame of the distant clusters, agree to within 1%. The Dn-Sigma relation also produces similar results, as expected from the correlated nature of the two scaling relations. A complete discussion of the sources of random and systematic error in this determination of the Hubble constant is also given, in order to facilitate comparison with the other secondary indicators being used by the Key Project.Comment: 21 pages, 3 figures, Accepted for publication in Ap

Early inflammatory cytokine expression in cerebrospinal fluid of patients with spontaneous intraventricular hemorrhage

We investigated cerebrospinal fluid (CSF) expression of inflammatory cytokines and their relationship with spontaneous intracerebral and intraventricular hemorrhage (ICH, IVH) and perihematomal edema (PHE) volumes in patients with acute IVH. Twenty-eight adults with IVH requiring external ventricular drainage for obstructive hydrocephalus had cerebrospinal fluid (CSF) collected for up to 10 days and had levels of interleukin-1α (IL-1α), IL-1β, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNFα), and C-C motif chemokine ligand CCL2 measured using enzyme-linked immunosorbent assay. Median [IQR] ICH and IVH volumes at baseline (T0) were 19.8 [5.8–48.8] and 14.3 [5.3–38] mL respectively. Mean levels of IL-1β, IL-6, IL-10, TNF-α, and CCL2 peaked early compared to day 9–10 (p < 0.05) and decreased across subsequent time periods. Levels of IL-1β, IL-6, IL-8, IL-10, and CCL2 had positive correlations with IVH volume at days 3–8 whereas positive correlations with ICH volume occurred earlier at day 1–2. Significant correlations were found with PHE volume for IL-6, IL-10 and CCL2 at day 1–2 and with relative PHE at days 7–8 or 9–10 for IL-1β, IL-6, IL-8, and IL-10. Time trends of CSF cytokines support experimental data suggesting association of cerebral inflammatory responses with ICH/IVH severity. Pro-inflammatory markers are potential targets for injury reduction

The HST Key Project on the Extragalactic Distance Scale. XXII. The Discovery of Cepheids in NGC 1326-A

We report on the detection of Cepheids and the first distance measurement to the spiral galaxy NGC 1326-A, a member of the Fornax cluster of galaxies. We have employed data obtained with the Wide Field and Planetary Camera 2 on board the Hubble Space Telescope. Over a 49 day interval, a total of twelve V-band (F555W) and eight I-band (F814W) epochs of observation were obtained. Two photometric reduction packages, ALLFRAME and DoPHOT, have been employed to obtain photometry measures from the three Wide Field CCDs. Variability analysis yields a total of 17 Cepheids in common with both photometry datasets, with periods ranging between 10 and 50 days. Of these 14 Cepheids with high-quality lightcurves are used to fit the V and I period-luminosity relations and derive apparent distance moduli, assuming a Large Magellanic Cloud distance modulus (m-M) (LMC) = 18.50 +- 0.10 mag and color excess E(B-V) = 0.10 mag. Assuming A(V)/E(V-I) = 2.45, the DoPHOT data yield a true distance modulus to NGC 1326-A of (m-M)_0 = 31.36 +- 0.17 (random) +- 0.13 (systematic) mag, corresponding to a distance of 18.7 \pm 1.5 (random) \pm 1.2 (systematic) Mpc. The derived distance to NGC 1326-A is in good agreement with the distance derived previously to NGC 1365, another spiral galaxy member of the Fornax cluster. However the distances to both galaxies are significantly lower than to NGC 1425, a third Cepheid calibrator in the outer parts of the cluster.Comment: 33 pages A gzipped tar file containing 12 figures can be obtained from http://www.ipac.caltech.edu/H0kp/n1326a/n1326a.htm

The Hubble Space Telescope Extragalactic Distance Scale Key Project XXIII. The Discovery of Cepheids In NGC 3319

The distance to NGC 3319 has been determined from Cepheid variable stars as part of the Hubble Space Telescope Key Project on the Extragalactic Distance Scale. Thirteen and four epochs of observations, using filters F555W (V) and F814W (I) respectively, were made with the Wide Field Planetary Camera 2. Thirty-three Cepheid variables between periods of 8 and 47 days were discovered. Adopting a Large Magellanic Cloud distance modulus of 18.50 +- 0.10 mag and extinction of E(V-I)=0.13 mag, a true reddening-corrected distance modulus (based on an analysis employing the ALLFRAME software package) of 30.78 +- 0.14 (random) +- 0.10 (systematic) mag and the extinction of E(V-I) = 0.06 mag were determined for NGC 3319. This galaxy is the last galaxy observed for the HST H0 Key Project.Comment: 22 pages. A gzipped tar file containing 16 figures can be obtained from http://www.ipac.caltech.edu/H0kp/n3319/n3319.htm