Gangliosides for acute spinal cord injury.

BACKGROUND: Spinal cord injury (SCI) results in loss of feeling and movement. The consequences can be devastating for the patient and his or her carers. Global estimates of the number of new cases annually range from 15 to 40 per million. Leading causes of acute SCI are road traffic injury, violence, and injuries sustained in sports and other recreational activities. Care for people with SCI has improved, leading to an increase in survival rates. Attempts to improve patients' feeling and movement have involved the use of a wide range of treatments. Gangliosides are compounds that occur naturally in cell membranes. Laboratory studies have suggested they may have protective effects on nerves and even help them to re-grow. Clinical trials have taken place using gangliosides (usually GM1 ganglioside) for a number of neurological conditions. OBJECTIVES: To quantify the evidence for the effectiveness and safety of gangliosides when used to treat acute SCI. SEARCH STRATEGY: We searched the following databases to identify trials for inclusion: CENTRAL, MEDLINE, EMBASE, and the National Research Register. We also searched web-based trials registers, such as Current Controlled Trials. We approached the manufacturers of the most widely used ganglioside and researchers in this field to try to locate any unpublished data. SELECTION CRITERIA: Randomised controlled trials of any ganglioside versus controls, in patients with SCI. Outcome measures specified were: mortality, recovery of motor function, improvement in sensory measures, measures of functional activity, infections and any other adverse events. DATA COLLECTION AND ANALYSIS: Data were extracted from published studies and authors were contacted for further information. All data found was dichotomous and odds ratios (with 95% CIs) were calculated. A fixed-effects model was assumed. MAIN RESULTS: Two studies met the inclusion criteria. There were no deaths in one (n=37). In the other (n=760), there were slightly more deaths in the treatment group than in the control group; odds ratio 1.07 (0.57, 2.00 95%CI) - a result that can be explained by the play of chance. Methodological weaknesses regarding the collection and presentation of data from the two studies made it impossible to reach any conclusions regarding the effect of gangliosides on the other specified outcomes. AUTHORS' CONCLUSIONS: The evidence available does not support the use of ganglioside treatment to reduce the death rate in SCI patients. No evidence has yet emerged that ganglioside treatment improves recovery or quality of life in survivors

Fault slip-rate variations during crustal-scale strain localisation, central Italy

Rates of plate motion are generally uniform over 10–102 Myrs timescales. Faults between tectonic plates might, therefore, be expected to show temporally-uniform slip-rates if the same number of faults remain active. For an extending region of the Eurasia-Africa plate boundary, Italy, finite throw values (vertical component of the slip) for seismogenic normal faults are less than that predicted when recent throw-rates are extrapolated over the fault lifetimes. The effect correlates with distance from the fault system tips and demonstrates that the slip-rates on centrally-located faults have increased with time. Neighbouring normal faults were active in the Quaternary but show no signs of surface faulting during the latest Pleistocene to Holocene. Death of these faults has provided the extra strain per unit time to drive the increased slip-rates measured on other faults. Thus, fault interaction and death modify slip-rates and seismic hazards associated with plate tectonics

Nutritional support for head-injured patients

Copyright John Wiley & Sons. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2004, Issue 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.’ Perel, P. , Yanagawa, T. , Bunn, F. , Roberts, I. , Wentz, R. and Pierro, A. Nutritional support for head-injured patients. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD001530. DOI: 10.1002/14651858.CD001530.pub2Background: Head injury increases the body's metabolic responses, and therefore nutritional demands. Provision of an adequate supply of nutrients is associated with improved outcome. The best route for administering nutrition (parenterally (TPN) or enterally (EN)), and the best timing of administration (for example, early versus late) of nutrients needs to be established. Objectives: To quantify the effect on mortality and morbidity of alternative strategies of providing nutritional support following head injury. Search strategy: Trials were identified by computerised searches of the Cochrane Injuries Group specialised register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, National Research Register, Web of Science and other electronic trials registers. Reference lists of trials and review articles were checked. The searches were last updated in July 2006. Selection criteria: Randomised controlled trials of timing or route of nutritional support following acute traumatic brain injury. Data collection and analysis: Two authors independently abstracted data and assessed trial quality. Information was collected on death, disability, and incidence of infection. If trial quality was unclear, or if there were missing outcome data, trialists were contacted in an attempt to get further information. Main results: A total of 11 trials were included. Seven trials addressed the timing of support (early versus delayed), data on mortality were obtained for all seven trials (284 participants). The relative risk (RR) for death with early nutritional support was 0.67 (95% CI 0.41 to 1.07). Data on disability were available for three trials. The RR for death or disability at the end of follow-up was 0.75 (95% CI 0.50 to 1.11). Seven trials compared parenteral versus enteral nutrition. Because early support often involves parenteral nutrition, three of the trials are also included in the previous analyses. Five trials (207 participants) reported mortality. The RR for mortality at the end of follow-up period was 0.66 (0.41 to 1.07). Two trials provided data on death and disability. The RR was 0.69 (95% Cl 0.40 to 1.19). One trial compared gastric versus jejunal enteral nutrition, there were no deaths and the RR was not estimable. Authors' conclusions: This review suggests that early feeding may be associated with a trend towards better outcomes in terms of survival and disability. Further trials are required. These trials should report not only nutritional outcomes but also the effect on death and disability.Peer reviewe

Self-consistent simulations of a von K\'arm\'an type dynamo in a spherical domain with metallic walls

We have performed numerical simulations of boundary-driven dynamos using a three-dimensional non-linear magnetohydrodynamical model in a spherical shell geometry. A conducting fluid of magnetic Prandtl number Pm=0.01 is driven into motion by the counter-rotation of the two hemispheric walls. The resulting flow is of von K\'arm\'an type, consisting of a layer of zonal velocity close to the outer wall and a secondary meridional circulation. Above a certain forcing threshold, the mean flow is unstable to non-axisymmetric motions within an equatorial belt. For fixed forcing above this threshold, we have studied the dynamo properties of this flow. The presence of a conducting outer wall is essential to the existence of a dynamo at these parameters. We have therefore studied the effect of changing the material parameters of the wall (magnetic permeability, electrical conductivity, and thickness) on the dynamo. In common with previous studies, we find that dynamos are obtained only when either the conductivity or the permeability is sufficiently large. However, we find that the effect of these two parameters on the dynamo process are different and can even compete to the detriment of the dynamo. Our self-consistent approach allow us to analyze in detail the dynamo feedback loop. The dynamos we obtain are typically dominated by an axisymmetric toroidal magnetic field and an axial dipole component. We show that the ability of the outer shear layer to produce a strong toroidal field depends critically on the presence of a conducting outer wall, which shields the fluid from the vacuum outside. The generation of the axisymmetric poloidal field, on the other hand, occurs in the equatorial belt and does not depend on the wall properties.Comment: accepted for publication in Physical Review

Pion electromagnetic form factor at spacelike momenta

A novel method is employed to compute the pion electromagnetic form factor, F_\pi(Q^2), on the entire domain of spacelike momentum transfer using the Dyson-Schwinger equation (DSE) framework in quantum chromodynamics (QCD). The DSE architecture unifies this prediction with that of the pion's valence-quark parton distribution amplitude (PDA). Using this PDA, the leading-order, leading-twist perturbative QCD result for Q^2 F_\pi(Q^2) underestimates the full computation by just 15% on Q^2>~8GeV^2, in stark contrast with the result obtained using the asymptotic PDA. The analysis shows that hard contributions to the pion form factor dominate for Q^2>~8GeV^2 but, even so, the magnitude of Q^2 F_\pi(Q^2) reflects the scale of dynamical chiral symmetry breaking, a pivotal emergent phenomenon in the Standard Model.Comment: 5 pages, 2 figures. To appear in Phys. Rev. Let

Pion distribution amplitude from lattice-QCD

A method is explained through which a pointwise accurate approximation to the pion's valence-quark distribution amplitude (PDA) may be obtained from a limited number of moments. In connection with the single nontrivial moment accessible in contemporary simulations of lattice-regularised quantum chromodynamics (QCD), the method yields a PDA that is a broad concave function whose pointwise form agrees with that predicted by Dyson-Schwinger equation analyses of the pion. Under leading-order evolution, the PDA remains broad to energy scales in excess of 100 GeV, a feature which signals persistence of the influence of dynamical chiral symmetry breaking. Consequently, the asymptotic distribution, \phi_\pi^asy(x), is a poor approximation to the pion's PDA at all such scales that are either currently accessible or foreseeable in experiments on pion elastic and transition form factors. Thus, related expectations based on \phi_\pi^asy(x) should be revised.Comment: 5 pages, 2 figure

X-Ray Observations of Black Widow Pulsars

We describe the first X-ray observations of five short orbital period ($P_B < 1$ day), $\gamma$-ray emitting, binary millisecond pulsars. Four of these, PSRs J0023+0923, J1124$-$3653, J1810+1744, and J2256$-$1024 are `black-widow' pulsars, with degenerate companions of mass $\ll0.1 M_{\odot}$, three of which exhibit radio eclipses. The fifth source, PSR J2215+5135, is an eclipsing `redback' with a near Roche-lobe filling $\sim$0.2 solar mass non-degenerate companion. Data were taken using the \textit{Chandra X-Ray Observatory} and covered a full binary orbit for each pulsar. Two pulsars, PSRs J2215+5135 and J2256$-$1024, show significant orbital variability while PSR J1124$-$3653 shows marginal orbital variability. The lightcurves for these three pulsars have X-ray flux minima coinciding with the phases of the radio eclipses. This phenomenon is consistent with an intrabinary shock emission interpretation for the X-rays. The other two pulsars, PSRs J0023+0923 and J1810+1744, are fainter and do not demonstrate variability at a level we can detect in these data. All five spectra are fit with three separate models: a power-law model, a blackbody model, and a combined model with both power-law and blackbody components. The preferred spectral fits yield power-law indices that range from 1.3 to 3.2 and blackbody temperatures in the hundreds of eV. The spectrum for PSR J2215+5135 shows a significant hard X-ray component, with a large number of counts above 2 keV, which is additional evidence for the presence of intrabinary shock emission and is similar to what has been detected in the low-mass X-ray binary to millisecond pulsar transition object PSR J1023+0038.Comment: 8 pages, 6 figures, 2 tables, submitted to Ap

Scald risk in social housing can be reduced through thermostatic control system without increasing Legionella risk: a cluster randomised trial.

OBJECTIVE: To quantify the effects of a thermostatic control system in social (public) housing on the prevalence of dangerous (>60°C) water temperatures and on fuel consumption. DESIGN: Pair-matched double-blind cluster randomised controlled trial. SETTING: Social housing in a deprived inner-London borough. PARTICIPANTS: 150 households recruited as clusters from 22 social housing estates. Four small estates were combined into two clusters (resulting in a total of 10 pairs of clusters). INTERVENTION: Social housing estate boiler houses were randomised to a thermostatic control sterilisation programme (heating water to 65°C during 00:00-06:00 h and to 50°C from 06:00 to 00:00 h daily) or to standard control (constant temperature 65°C). MAIN OUTCOME MEASURES: Water temperature over 60°C ('dangerous') after running taps for 1 min and daily fuel consumption (cubic feet of gas). RESULTS: 10 clusters (80 households) were allocated to the sterilisation programme and 10 clusters (70 households) to control, of which 73 and 67 households, respectively, were analysed. Prevalence of dangerous (>60°C) hot water temperatures at 1 min was significantly reduced with the sterilisation programme (mean of cluster prevalence 1% in sterilisation programme group vs 34% in control group; absolute difference 33%, 95% CI 12% to 54%; p=0.006). Prevalence of high (>55°C) hot water temperatures at 1 min was significantly reduced (31% sterilisation vs 59% control; absolute difference 28%, 95% CI 9% to 47%; p=0.009). Gas consumption per day reduced more in the control group than in the sterilisation programme group, although not statistically significantly (p=0.125). CONCLUSIONS: The thermostatic control with daily sterilisation was effective in capping hot water temperatures and therefore reduced scald risk. Although expected to save energy, fuel consumption was increased relative to the control group. Trial registration ClinicalTrials.gov ID: NCT00874692