Inhaled nitric oxide for high-altitude pulmonary edema

BACKGROUND. Pulmonary hypertension is a hallmark of high-altitude pulmonary edema and may contribute to its pathogenesis. When administered by inhalation, nitric oxide, an endothelium-derived relaxing factor, attenuates the pulmonary vasoconstriction produced by short-term hypoxia. METHODS. We studied the effects of inhaled nitric oxide on pulmonary-artery pressure and arterial oxygenation in 18 mountaineers prone to high-altitude pulmonary edema and 18 mountaineers resistant to this condition in a high altitude laboratory (altitude, 4559 m). We also obtained lung-perfusion scans before and during nitric oxide inhalation to gain further insight into the mechanism of action of nitric oxide. RESULTS. In the high-altitude laboratory, subjects prone to high-altitude pulmonary edema had more pronounced pulmonary hypertension and hypoxemia than subjects resistant to high-altitude pulmonary edema. Arterial oxygen saturation was inversely related to the severity of pulmonary hypertension (r=-0.50, P=0.002). In subjects prone to high-altitude pulmonary edema, the inhalation of nitric oxide (40 ppm for 15 minutes) produced a decrease in mean (+/-SD) systolic pulmonary-artery pressure that was three times larger than the decrease in subjects resistant to such edema (25.9+/-8.9 vs. 8.7+/-4.8 mm Hg, P<0.001). Inhaled nitric oxide improved arterial oxygenation in the 10 subjects who had radiographic evidence of pulmonary edema (arterial oxygen saturation increased from 67+/-10 to 73+/-12 percent, P=0.047), whereas it worsened oxygenation in subjects resistant to high-altitude pulmonary edema. The nitric oxide-induced improvement in arterial oxygenation in subjects with high-altitude pulmonary edema was accompanied by a shift in blood flow in the lung away from edematous segments and toward nonedematous segments. CONCLUSIONS. The inhalation of nitric oxide improves arterial oxygenation in high-altitude pulmonary edema, and this beneficial effect may be related to its favorable action on the distribution of blood flow in the lungs. A defect in nitric nitric oxide synthesis may contribute to high-altitude pulmonary edema

Scaling in Numerical Simulations of Domain Walls

We study the evolution of domain wall networks appearing after phase transitions in the early Universe. They exhibit interesting dynamical scaling behaviour which is not yet well understood, and are also simple models for the more phenomenologically acceptable string networks. We have run numerical simulations in two- and three-dimensional lattices of sizes up to 4096^3. The theoretically predicted scaling solution for the wall area density A ~ 1/t is supported by the simulation results, while no evidence of a logarithmic correction reported in previous studies could be found. The energy loss mechanism appears to be direct radiation, rather than the formation and collapse of closed loops or spheres. We discuss the implications for the evolution of string networks.Comment: 7pp RevTeX, 9 eps files (including six 220kB ones

Cosmic microwave background and large scale structure limits on the interaction between dark matter and baryons

We study the effect on the cosmic microwave background (CMB) anisotropy and large scale structure (LSS) power spectrum of a scattering interaction between cold dark matter and baryons. This scattering alters the CMB anisotropy and LSS spectrum through momentum transfer between the cold dark matter particles and the baryons. We find that current CMB observations can put an upper limit on the scattering cross section which is comparable with or slightly stronger than previous disk heating constraints at masses greater than 1 GeV, and much stronger at smaller masses. When large-scale structure constraints are added to the CMB limits, our constraint is more stringent than this previous limit at all masses. In particular, a dark matter-baryon scattering cross section comparable to the ``Spergel-Steinhardt'' cross section is ruled out for dark matter mass greater than 1 GeV.Comment: 8 pages, 2 figures, use RevTeX4, submitted to PRD replaced with revised versio

Large Scale Pressure Fluctuations and Sunyaev-Zel'dovich Effect

The Sunyaev-Zel'dovich (SZ) effect associated with pressure fluctuations of the large scale structure gas distribution will be probed with current and upcoming wide-field small angular scale cosmic microwave background experiments. We study the generation of pressure fluctuations by baryons which are present in virialized dark matter halos and by baryons present in small overdensities. For collapsed halos, assuming the gas distribution is in hydrostatic equilibrium with matter density distribution, we predict the pressure power spectrum and bispectrum associated with the large scale structure gas distribution by extending the dark matter halo approach which describes the density field in terms of correlations between and within halos. The projected pressure power spectrum allows a determination of the resulting SZ power spectrum due to virialized structures. The unshocked photoionized baryons present in smaller overdensities trace the Jeans-scale smoothed dark matter distribution. They provide a lower limit to the SZ effect due to large scale structure in the absence of massive collapsed halos. We extend our calculations to discuss higher order statistics, such as bispectrum and skewness in SZ data. The SZ-weak lensing cross-correlation is suggested as a probe of correlations between dark matter and baryon density fields, while the probability distribution functions of peak statistics of SZ halos in wide field CMB data can be used as a probe of cosmology and non-Gaussian evolution of large scale structure pressure fluctuations.Comment: 16 pages, 9 figures; Revised with expanded discussions. Phys. Rev. D. (in press

Reconstructing the properties of dark energy from recent observations

We explore the properties of dark energy from recent observational data, including the Gold Sne Ia, the baryonic acoustic oscillation peak from SDSS, the CMB shift parameter from WMAP3, the X-ray gas mass fraction in cluster and the Hubble parameter versus redshift. The $\Lambda CDM$ model with curvature and two parameterized dark energy models are studied. For the $\Lambda CDM$ model, we find that the flat universe is consistent with observations at the $1\sigma$ confidence level and a closed universe is slightly favored by these data. For two parameterized dark energy models, with the prior given on the present matter density, $\Omega_{m0}$, with $\Omega_{m0}=0.24$, $\Omega_{m0}=0.28$ and $\Omega_{m0}=0.32$, our result seems to suggest that the trend of $\Omega_{m0}$ dependence for an evolving dark energy from a combination of the observational data sets is model-dependent.Comment: 16 pages, 15 figures, To appear in JCA

New approaches to measuring anthelminthic drug efficacy: parasitological responses of childhood schistosome infections to treatment with praziquantel

By 2020, the global health community aims to control and eliminate human helminthiases, including schistosomiasis in selected African countries, principally by preventive chemotherapy (PCT) through mass drug administration (MDA) of anthelminthics. Quantitative monitoring of anthelminthic responses is crucial for promptly detecting changes in efficacy, potentially indicative of emerging drug resistance. Statistical models offer a powerful means to delineate and compare efficacy among individuals, among groups of individuals and among populations.; We illustrate a variety of statistical frameworks that offer different levels of inference by analysing data from nine previous studies on egg counts collected from African children before and after administration of praziquantel.; We quantify responses to praziquantel as egg reduction rates (ERRs), using different frameworks to estimate ERRs among population strata, as average responses, and within strata, as individual responses. We compare our model-based average ERRs to corresponding model-free estimates, using as reference the World Health Organization (WHO) 90 % threshold of optimal efficacy. We estimate distributions of individual responses and summarize the variation among these responses as the fraction of ERRs falling below the WHO threshold.; Generic models for evaluating responses to anthelminthics deepen our understanding of variation among populations, sub-populations and individuals. We discuss the future application of statistical modelling approaches for monitoring and evaluation of PCT programmes targeting human helminthiases in the context of the WHO 2020 control and elimination goals

Prevalence and predictors for homo- and heterosubtypic antibodies against influenza a virus

Background: The effectiveness of trivalent influenza vaccination has been confirmed in several studies. To date, it is not known whether repeated exposure and vaccination to influenza promote production of cross-reactive anti-bodies. Furthermore, how strains encountered earlier in life imprint the immune response is currently poorly understood. Methods: To determine the prevalence for human homo- and heterosubtypic antibody responses, we scruti-nized serum samples from 305 healthy volunteers for hemagglutinin-binding and -neutralizing antibodies against several strains and subtypes of influenza A. Statistical analyses were then performed to establish the association of measured values with potential predictors. Results: It was found that vaccination not only promoted higher binding and neutralizing antibody titers to homosubtypic in fluenza isolates but also increased heterosubtypic human immune responses. Both binding and neutralizing antibody titers in relation with age of the donors mirrored the course of the different influenza strain circulation during the last century. Advanced age appeared to be of advantage for both binding and neutralizing titers to most subtypes. In contrast, the first virus subtype encountered was found to imprint to some degree subsequent antibody responses. Antibodies to recent strains, however, primarily seemed to be promoted by vaccination. Conclusions: We provide evidence that vaccinations stimulate both homo- and heterosubtypic immune responses in young and middle-aged as well as more senior individuals. Our analyses suggest that influenza vaccinations not only prevent infection against currently circulating strains but can also stimulate broader humoral immune responses that potentially attenuate infections with zoonotic or antigenically shifted strains

Probing Unstable Massive Neutrinos with Current Cosmic Microwave Background Observations

The pattern of anisotropies in the Cosmic Microwave Background depends upon the masses and lifetimes of the three neutrino species. A neutrino species of mass greater than 10 eV with lifetime between 10^{13} sec and 10^{17} sec leaves a very distinct signature (due to the integrated Sachs-Wolfe effect): the anisotropies at large angles are predicted to be comparable to those on degree scales. Present data exclude such a possibility and hence this region of parameter space. For $m_\nu \simeq 30$ eV, $\tau \simeq 10^{13}$ sec, we find an interesting possibility: the Integrated Sachs Wolfe peak produced by the decaying neutrino in low-$\Omega$ models mimics the acoustic peak expected in an $\Omega = 1$ model.Comment: 5 pages, 4 figure

EUV Spectra of the Full Solar Disk: Analysis and Results of the Cosmic Hot Interstellar Plasma Spectrometer (CHIPS)

We analyze EUV spectra of the full solar disk from the Cosmic Hot Interstellar Plasma Spectrometer (CHIPS) spanning a period of two years. The observations were obtained via a fortuitous off-axis light path in the 140 -- 270 Angstrom passband. The general appearance of the spectra remained relatively stable over the two-year time period, but did show significant variations of up to 25% between two sets of Fe lines that show peak emission at 1 MK and 2 MK. The variations occur at a measured period of 27.2 days and are caused by regions of hotter and cooler plasma rotating into, and out of, the field of view. The CHIANTI spectral code is employed to determine plasma temperatures, densities, and emission measures. A set of five isothermal plasmas fit the full disk spectra well. A 1 -- 2 MK plasma of Fe contributes 85% of the total emission in the CHIPS passband. The standard Differential Emission Measures (DEMs) supplied with the CHIANTI package do not fit the CHIPS spectra well as they over-predict emission at temperatures below log(T) = 6.0 and above log(T) = 6.3. The results are important for cross-calibrating TIMED, SORCE, SOHO/EIT, and CDS/GIS, as well as the recently launched Solar Dynamics Observatory.Comment: 27 Pages, 13 Figure

Is the Internet a useful and relevant source for health and health care information retrieval for German cardiothoracic patients? First results from a prospective survey among 255 Patients at a German cardiothoracic surgical clinic

BACKGROUND: It is not clear how prevalent Internet use among cardiopathic patients in Germany is and what impact it has on the health care utilisation. We measured the extent of Internet use among cardiopathic patients and examined the effects that Internet use has on users' knowledge about their cardiac disease, health care matters and their use of the health care system. METHODS: We conducted a prospective survey among 255 cardiopathic patients at a German university hospital. RESULTS: Forty seven respondents (18 %) used the internet and 8,8 % (n = 23) went online more than 20 hours per month. The most frequent reason for not using the internet was disinterest (52,3 %). Fourteen patients (5,4 %) searched for specific disease-related information and valued the retrieved information on an analogous scale (1 = not relevant, 5 = very relevant) on median with 4,0. Internet use is age and education dependent. Only 36 (14,1 %) respondents found the internet useful, whereas the vast majority would not use it. Electronic scheduling for ambulatory visits or postoperative telemedical monitoring were rather disapproved. CONCLUSION: We conclude that Internet use is infrequent among our study population and the search for relevant health and disease related information is not well established