Hypothermia for perinatal asphyxial encephalopathy. A Swiss survey of opinion, practice and cerebral investigations

BACKGROUND: Perinatal asphyxial encephalopathy occurs in 1-per 1000 live births and is associated with high mortality and morbidity. Therapeutic hypothermia increases intact survival and improves neurodevelopmental outcome in survivors.AIMS: To evaluate (i) the opinion and practice of therapeutic hypothermia as a therapy for moderate to severe perinatal asphyxial encephalopathy amongst Swiss neonatologists and paediatric intensive care specialists, (ii) the current clinical management of infants with perinatal asphyxial encephalopathy and (iii) the need for a national perinatal asphyxia and therapeutic hypothermia registry.METHODS: Two web-based questionnaires were sent to 18 senior staff physicians within the Swiss Neonatal Network.RESULTS: Therapeutic hypothermia was considered effective by all responders, however only 11 of 18 units provided therapeutic hypothermia. Cooling was initiated during transfer and performed passively in 82% of centres with a target rectal temperature of 33-34 degrees C. Most units ventilated infants with perinatal asphyxial encephalopathy if clinically indicated and 73% of responders gave analgesia routinely to cooled infants. Neuromonitoring included continuous amplitude integrated EEG (aEEG) and EEG. Neuroimaging included cranial ultrasound (cUS), magnetic resonance imaging (MRI) and computed tomography (CT). Sixty-seven percent of units treating infants with perinatal asphyxial encephalopathy performed MRI routinely. All heads of departments questioned indicated that a "Swiss National Asphyxia and Cooling Registry" is needed.CONCLUSIONS: In Switzerland, access to therapeutic hypothermia is widespread and Swiss neonatologists believe that therapeutic hypothermia for perinatal asphyxia is effective. National cooling protocols are needed for the management of infants with perinatal asphyxial encephalopathy in order to ensure safe cooling, appropriate monitoring, imaging and follow-up assessment. A national registry is needed to collect data on diagnosis, treatment, adverse events and outcome

Random-Matrix Theory of Quantum Size Effects on Nuclear Magnetic Resonance in Metal Particles

The distribution function of the local density of states is computed exactly for the Wigner-Dyson ensemble of random Hamiltonians. In the absence of time-reversal symmetry, precise agreement is obtained with the "supersymmetry" theory by Efetov and Prigodin of the NMR lineshape in disordered metal particles. Upon breaking time-reversal symmetry, the variance of the Knight shift in the smallest particles is reduced by a universal factor of 2/3. ***To be published in Physical Review B.****Comment: 4 pages, REVTeX-3.0, 1 postscript figure, INLO-PUB-940819; [2017: figure included in text

Physics in Riemann's mathematical papers

Riemann's mathematical papers contain many ideas that arise from physics, and some of them are motivated by problems from physics. In fact, it is not easy to separate Riemann's ideas in mathematics from those in physics. Furthermore, Riemann's philosophical ideas are often in the background of his work on science. The aim of this chapter is to give an overview of Riemann's mathematical results based on physical reasoning or motivated by physics. We also elaborate on the relation with philosophy. While we discuss some of Riemann's philosophical points of view, we review some ideas on the same subjects emitted by Riemann's predecessors, and in particular Greek philosophers, mainly the pre-socratics and Aristotle. The final version of this paper will appear in the book: From Riemann to differential geometry and relativity (L. Ji, A. Papadopoulos and S. Yamada, ed.) Berlin: Springer, 2017

Stage progression and neurological symptoms in Trypanosoma brucei rhodesiense sleeping sickness: role of the CNS inflammatory response

Background: Human African trypanosomiasis progresses from an early (hemolymphatic) stage, through CNS invasion to the late (meningoencephalitic) stage. In experimental infections disease progression is associated with neuroinflammatory responses and neurological symptoms, but this concept requires evaluation in African trypanosomiasis patients, where correct diagnosis of the disease stage is of critical therapeutic importance. Methodology/Principal Findings: This was a retrospective study on a cohort of 115 T.b.rhodesiense HAT patients recruited in Eastern Uganda. Paired plasma and CSF samples allowed the measurement of peripheral and CNS immunoglobulin and of CSF cytokine synthesis. Cytokine and immunoglobulin expression were evaluated in relation to disease duration, stage progression and neurological symptoms. Neurological symptoms were not related to stage progression (with the exception of moderate coma). Increases in CNS immunoglobulin, IL-10 and TNF-α synthesis were associated with stage progression and were mirrored by a reduction in TGF-β levels in the CSF. There were no significant associations between CNS immunoglobulin and cytokine production and neurological signs of disease with the exception of moderate coma cases. Within the study group we identified diagnostically early stage cases with no CSF pleocytosis but intrathecal immunoglobulin synthesis and diagnostically late stage cases with marginal CSF pleocytosis and no detectable trypanosomes in the CSF. Conclusions: Our results demonstrate that there is not a direct linkage between stage progression, neurological signs of infection and neuroinflammatory responses in rhodesiense HAT. Neurological signs are observed in both early and late stages, and while intrathecal immunoglobulin synthesis is associated with neurological signs, these are also observed in cases lacking a CNS inflammatory response. While there is an increase in inflammatory cytokine production with stage progression, this is paralleled by increases in CSF IL-10. As stage diagnostics, the CSF immunoglobulins and cytokines studied do not have sufficient sensitivity to be of clinical value

Instantaneous Shape Sampling - a model for the γ\gamma-absorption cross section of transitional nuclei

The influence of the quadrupole shape fluctuations on the dipole vibrations in transitional nuclei is investigated in the framework of the Instantaneous Shape Sampling Model, which combines the Interacting Boson Model for the slow collective quadrupole motion with the Random Phase Approximation for the rapid dipole vibrations. Coupling to the complex background configurations is taken into account by folding the results with a Lorentzian with an energy dependent width. The low-energy energy portion of the $\gamma$- absorption cross section, which is important for photo-nuclear processes, is studied for the isotopic series of Kr, Xe, Ba, and Sm. The experimental cross sections are well reproduced. The low-energy cross section is determined by the Landau fragmentation of the dipole strength and its redistribution caused by the shape fluctuations. Collisional damping only wipes out fluctuations of the absorption cross section, generating the smooth energy dependence observed in experiment. In the case of semi-magic nuclei, shallow pygmy resonances are found in agreement with experiment

Transition to superfluid turbulence governed by an intrinsic parameter

Hydrodynamic flow in both classical and quantum fluids can be either laminar or turbulent. To describe the latter, vortices in turbulent flow are modelled with stable vortex filaments. While this is an idealization in classical fluids, vortices are real topologically stable quantized objects in superfluids. Thus superfluid turbulence is thought to hold the key to new understanding on turbulence in general. The fermion superfluid 3He offers further possibilities owing to a large variation in its hydrodynamic characteristics over the experimentally accessible temperatures. While studying the hydrodynamics of the B phase of superfluid 3He, we discovered a sharp transition at 0.60Tc between two regimes, with regular behaviour at high-temperatures and turbulence at low-temperatures. Unlike in classical fluids, this transition is insensitive to velocity and occurs at a temperature where the dissipative vortex damping drops below a critical limit. This discovery resolves the conflict between existing high- and low-temperature measurements in 3He-B: At high temperatures in rotating flow a vortex loop injected into superflow has been observed to expand monotonically to a single rectilinear vortex line, while at very low temperatures a tangled network of quantized vortex lines can be generated in a quiescent bath with a vibrating wire. The solution of this conflict reveals a new intrinsic criterion for the existence of superfluid turbulence.Comment: Revtex file; 5 pages, 2 figure

Cultivation-independent methods applied to the microbial prospection of oil and gas in soil from a sedimentary basin in Brazil

The upper parts of oil field structures may leak gas which is supposed to be indirectly detected by the soil bacterial populations. Such microorganisms are capable of consuming this gas, supporting the Microbial Prospection of Oil and Gas (MPOG) methodology. The goal of the present work was to characterize microbial communities involved in short-chain alkane metabolism, namely methane, ethane and propane, in samples from a petroliferous (P) soil through clone libraries of the 16S rRNA gene of the Domains Bacteria and Archaea and the catabolic gene coding for the soluble di-iron monooxygenase (SDIMO) enzyme alpha subunit. The microbial community presented high abundance of the bacterial phylum Actinobacteria, which represented 53% of total clones, and the Crenarchaeota group I.1b from the Archaea Domain. The analysis of the catabolic genes revealed the occurrence of seven Operational Protein Families (OPF) and higher richness (Chao = 7; Ace = 7.5) and diversity (Shannon = 1.09) in P soil when compared with a non-petroliferous (Np) soil (Chao = 2; Ace = 0, Shannon = 0.44). Clones related to the ethene monooxygenase (EtnC) and methane monooxygenase (MmoX) coding genes occurred only in P soil, which also presented higher levels of methane and lower levels of ethane and propane, revealed by short-chain hydrocarbon measures. Real-time PCR results suggested that the SDIMO genes occur in very low abundance in the soil samples under study. Further investigations on SDIMOs genes in natural environments are necessary to unravel their still uncharted diversity and to provide reliable tools for the prospection of degrading populations

Hydrostatic pressure does not cause detectable changes to survival of human retinal ganglion

Purpose: Elevated intraocular pressure (IOP) is a major risk factor for glaucoma. One consequence of raised IOP is that ocular tissues are subjected to increased hydrostatic pressure (HP). The effect of raised HP on stress pathway signaling and retinal ganglion cell (RGC) survival in the human retina was investigated. Methods: A chamber was designed to expose cells to increased HP (constant and fluctuating). Accurate pressure control (10-100mmHg) was achieved using mass flow controllers. Human organotypic retinal cultures (HORCs) from donor eyes (<24h post mortem) were cultured in serum-free DMEM/HamF12. Increased HP was compared to simulated ischemia (oxygen glucose deprivation, OGD). Cell death and apoptosis were measured by LDH and TUNEL assays, RGC marker expression by qRT-PCR (THY-1) and RGC number by immunohistochemistry (NeuN). Activated p38 and JNK were detected by Western blot. Results: Exposure of HORCs to constant (60mmHg) or fluctuating (10-100mmHg; 1 cycle/min) pressure for 24 or 48h caused no loss of structural integrity, LDH release, decrease in RGC marker expression (THY-1) or loss of RGCs compared with controls. In addition, there was no increase in TUNEL-positive NeuN-labelled cells at either time-point indicating no increase in apoptosis of RGCs. OGD increased apoptosis, reduced RGC marker expression and RGC number and caused elevated LDH release at 24h. p38 and JNK phosphorylation remained unchanged in HORCs exposed to fluctuating pressure (10-100mmHg; 1 cycle/min) for 15, 30, 60 and 90min durations, whereas OGD (3h) increased activation of p38 and JNK, remaining elevated for 90min post-OGD. Conclusions: Directly applied HP had no detectable impact on RGC survival and stress-signalling in HORCs. Simulated ischemia, however, activated stress pathways and caused RGC death. These results show that direct HP does not cause degeneration of RGCs in the ex vivo human retina

Monodromy--like Relations for Finite Loop Amplitudes

We investigate the existence of relations for finite one-loop amplitudes in Yang-Mills theory. Using a diagrammatic formalism and a remarkable connection between tree and loop level, we deduce sequences of amplitude relations for any number of external legs.Comment: 24 pages, 6 figures, v2 typos corrected, reference adde

Temporal Patterns in Perchlorate, Thiocyanate, and Iodide Excretion in Human Milk

BACKGROUND: Perchlorate and thiocyanate interfere with iodide uptake at the sodium–iodide symporter and are potential disruptors of thyroid hormone synthesis. Perchlorate is a common contaminant of water, food, and human milk. Although it is known that iodide undergoes significant diurnal variations in serum and urinary excretion, less is known about diurnal variations of milk iodide levels. OBJECTIVES: Variability in perchlorate and thiocyanate excretion in human milk has not been examined. Our objective was to determine variability of perchlorate, thiocyanate, and iodide in serially collected samples of human milk. METHODS: Ten lactating women were asked to collect six milk samples on each of 3 days. As an alternative, subjects were asked to collect as many milk samples as comfortably possible over 3 days. Samples were analyzed for perchlorate, iodide, and thiocyanate by ion chromatography coupled with mass spectrometry. RESULTS: Individual perchlorate, iodide, and thiocyanate levels varied significantly over time; there was also considerable variation among individuals. The iodide range, mean ± SD, and median for all samples (n = 108) were 3.1–334 μg/L, 87.9 ± 80.9 μg/L, and 55.2 μg/L, respectively. The range, mean ± SD, and median of perchlorate in all samples (n = 147) were 0.5–39.5 μg/L, 5.8 ± 6.2 μg/L, and 4.0 μg/L. The range, mean ± SD, and median of thiocyanate in all samples (n = 117) were 0.4 –228.3 μg/L, 35.6 ± 57.9 μg/L, and 5.6 μg/L. The data are not symmetrically distributed; the mean is higher than the median in all cases. CONCLUSIONS: Iodine intake may be inadequate in a significant fraction of this study population. Perchlorate and thiocyanate appear to be common in human milk. The role of these chemicals in reducing breast milk iodide is in need of further investigation