Homeopathic treatment for prolonged postoperative coma: a case report.

PubMed

Vithoulkas, G; Văcăraș, V; Kavouras, J; Buzoianu, A D; Mărginean, M; Văcăraș, D; Cozma, S

2017-01-01

Coma is the state of unrousable unconsciousness. There are variations in the degree of coma and the findings and signs found on the patient's clinical examination depend on the underlying cause of the disorder. The Glasgow Coma scale evaluates the best motor, verbal and eye answers of the patient. A patient is considered to be in a coma if his Glasgow Coma Scale is below 8 points. The progress that we have made throughout the years has also led to complications that can culminate in a major catastrophe like death, permanent brain damage, coma. A study performed reached the conclusion that prior comorbidity, older age, intraoperative hypotension, and cardiovascular surgery may predispose patients to postoperative coma. The article presents a case of postoperative coma treated successfully with homeopathy. Although a rare complication, postoperative coma is a severe, death-leading condition, causing immense suffering on both the patient and the patient's family. A multidisciplinary and thorough approach is necessary for these patients, but even after a well-conducted therapy, this condition leads to the death of the patient.

Homeopathic treatment for prolonged postoperative coma: a case report

PubMed Central

Vithoulkas, G; Văcăraș, V; Kavouras, J; Buzoianu, AD; Mărginean, M; Văcăraș, D; Cozma, S

2017-01-01

Coma is the state of unrousable unconsciousness. There are variations in the degree of coma and the findings and signs found on the patient’s clinical examination depend on the underlying cause of the disorder. The Glasgow Coma scale evaluates the best motor, verbal and eye answers of the patient. A patient is considered to be in a coma if his Glasgow Coma Scale is below 8 points. The progress that we have made throughout the years has also led to complications that can culminate in a major catastrophe like death, permanent brain damage, coma. A study performed reached the conclusion that prior comorbidity, older age, intraoperative hypotension, and cardiovascular surgery may predispose patients to postoperative coma. The article presents a case of postoperative coma treated successfully with homeopathy. Although a rare complication, postoperative coma is a severe, death-leading condition, causing immense suffering on both the patient and the patient’s family. A multidisciplinary and thorough approach is necessary for these patients, but even after a well-conducted therapy, this condition leads to the death of the patient. PMID:28616086

The relationship between pneumonia and Glasgow coma scale assessment on acute stroke patients

NASA Astrophysics Data System (ADS)

Ritarwan, K.; Batubara, C. A.; Dhanu, R.

2018-03-01

Pneumonia is one of the most frequent medical complications of a stroke. Despite the well-documented association of a stroke associated infections with increased mortality and worse long-term outcome, on the other hand, the limited data available on independent predictors of pneumonia in acute stroke patients in an emergency unit. To determine the independentrelationship between pneumonia and Glasgow Coma Scale assessment on acute stroke patients. The cohort retrospective study observed 55 acute stroke patients who stayed in intensive care unit Adam Malik General Hospital from January until August 2017. Pneumonia was more frequent in patients with Ischemic stroke (OR 5.40; 95% CI: 1.28 – 6.40, p=0.003), higher National Institute of Health Stroke Scale (NIHSS) (p=0.014) and lower Glasgow Coma Scale (p=0.0001). Analysis multivariate logistic regression identified NIHSS as an independent of predictors of pneumonia (95% CI : 1.047 – 1.326, p=0.001). Pneumonia was associated with severity and type of stroke and length of hospital stay. The severity of the deficits evaluated by the NIHSS was shown to be the only independent risk factor for pneumonia in acute stroke patients.

Which clinical variable influences health-related quality of life the most after spontaneous subarachnoid hemorrhage? Hunt and Hess scale, Fisher score, World Federation of Neurosurgeons score, Brussels coma score, and Glasgow coma score compared.

PubMed

Kapapa, Thomas; Tjahjadi, Martin; König, Ralph; Wirtz, Christian Rainer; Woischneck, Dieter

2013-12-01

To determine the strength of the correlation between the Hunt and Hess scale, Fisher score, Brussels coma score, World Federation of Neurosurgeons score, and Glasgow coma score and health-related quality of life. Evaluable questionnaires from 236 patients (5.6 years [± standard deviation, 2.854 years] on average after hemorrhage) were included in the analysis. Quality of life was documented using the MOS-36 item short form health survey. Because of the ordinal nature of the variables, Kendall tau was used for calculation. Significance was established as P ≤ 0.05. Weak and very weak correlations were found in general (r ≤ 0.28). The strongest correlations were found between the Glasgow coma score and quality of life (r = 0.236, P = 0.0001). In particular, the "best verbal response" achieved the strongest correlations in the comparison, at r = 0.28/P = 0.0001. The Fisher score showed very weak correlations (r = -0.148/P = 0.012). The Brussels coma score (r = -0.216/P = 0.0001), Hunt and Hess scale (r = -0.197/P = 0.0001), and the World Federation of Neurosurgeons score (r = -0.185/P = 0.0001) revealed stronger correlations, especially in terms of the physical aspects of quality of life. The Glasgow coma scale revealed the strongest, and the Fisher score showed the weakest correlations. Thus the Fisher score, as an indicator of the severity of a hemorrhage, has little significance in terms of health-related quality of life. Copyright © 2013 Elsevier Inc. All rights reserved.

A Comparative Study of Glasgow Coma Scale and Full Outline of Unresponsiveness Scores for Predicting Long-Term Outcome After Brain Injury.

PubMed

McNett, Molly M; Amato, Shelly; Philippbar, Sue Ann

2016-01-01

The aim of this study was to compare predictive ability of hospital Glasgow Coma Scale (GCS) scores and scores obtained using a novel coma scoring tool (the Full Outline of Unresponsiveness [FOUR] scale) on long-term outcomes among patients with traumatic brain injury. Preliminary research of the FOUR scale suggests that it is comparable with GCS for predicting mortality and functional outcome at hospital discharge. No research has investigated relationships between coma scores and outcome 12 months postinjury. This is a prospective cohort study. Data were gathered on adult patients with traumatic brain injury admitted to urban level I trauma center. GCS and FOUR scores were assigned at 24 and 72 hours and at hospital discharge. Glasgow Outcome Scale scores were assigned at 6 and 12 months. The sample size was n = 107. Mean age was 53.5 (SD = ±21, range = 18-91) years. Spearman correlations were comparable and strongest among discharge GCS and FOUR scores and 12-month outcome (r = .73, p < .000; r = .72, p < .000). Multivariate regression models indicate that age and discharge GCS were the strongest predictors of outcome. Areas under the curve were similar for GCS and FOUR scores, with discharge scores occupying the largest areas. GCS and FOUR scores were comparable in bivariate associations with long-term outcome. Discharge coma scores performed best for both tools, with GCS discharge scores predictive in multivariate models.

Prognostic value of EEG in different etiological types of coma.

PubMed

Khaburzania, M; Beridze, M

2013-06-01

Study aimed at evaluation of prognostic value of standard EEG in different etiology of coma and the influence of etiological factor on the EEG patterns and coma outcome. Totally 175 coma patients were investigated. Patients were evaluated by Glasgow Coma Scale (GCS), clinically and by 16 channel electroencephalography. Auditory evoked potentials studied by EEG -regime for evoked potentials in patients with vegetative state (VS). Patients divided in 8 groups according to coma etiology. All patients were studied for photoreaction, brainstem reflexes, localization of sound and pain, length of coma state and outcome. Brain injury visualized by conventional CT. Outcome defined as death, VS, recovery with disability and without disability. Disability was rated by Disability Rating Scale (DRS). Recovered patients assessed by Mini Mental State Examination (MMSE) scale. Statistics performed by SPSS-11.0. From 175 coma patients 55 patients died, 23 patients found in VS, 97 patients recovered with and without disability. In all etiological groups of coma the background EEG patterns were established. Correspondence analysis of all investigated factors revealed that sound localization had the significant association with EEG delta and theta rhythms and with recovery from coma state (Chi-sqr. =31.10493; p= 0.000001). Among 23 VS patients 9 patients had the signs of MCS and showed the long latency waves (p300) after binaural stimulation. The high amplitude theta frequencies in frontal and temporal lobes significantly correlated with prolongation of latency of cognitive evoked potentials (r=+0.47; p<0.01). Etiological factor had the significant effect on EEG patterns' association with coma outcome only in hemorrhagic and traumatic coma (chi-sqr.=12.95; p<0.005; chi-sqr.=7.92; p<0.03 respectively). Significant correlations established between the delta and theta EEG patterns and coma outcome. Low amplitude decreased power delta and theta frequencies correlated with SND in survived

Right median nerve electrical stimulation for acute traumatic coma (the Asia Coma Electrical Stimulation trial): study protocol for a randomised controlled trial.

PubMed

Wu, Xiang; Zhang, Chao; Feng, Junfeng; Mao, Qing; Gao, Guoyi; Jiang, Jiyao

2017-07-10

Traumatic brain injury (TBI) has become the most common cause of death and disability in persons between 15 and 30 years of age, and about 10-15% of patients affected by TBI will end up in a coma. Coma caused by TBI presents a significant challenge to neuroscientists. Right median nerve electrical stimulation has been reported as a simple, inexpensive, non-invasive technique to speed recovery and improve outcomes for traumatic comatose patients. This multicentre, prospective, randomised (1:1) controlled trial aims to demonstrate the efficacy and safety of electrical right median nerve stimulation (RMNS) in both accelerating emergence from coma and promoting long-term outcomes. This trial aims to enrol 380 TBI comatose patients to partake in either an electrical stimulation group or a non-stimulation group. Patients assigned to the stimulation group will receive RMNS in addition to standard treatment at an amplitude of 15-20 mA with a pulse width of 300 μs at 40 Hz ON for 20 s and OFF for 40 s. The electrical treatment will last for 8 h per day for 2 weeks. The primary endpoint will be the percentage of patients regaining consciousness 6 months after injury. The secondary endpoints will be Extended Glasgow Outcome Scale, Coma Recovery Scale-Revised and Disability Rating Scale scores at 28 days, 3 months and 6 months after injury; Glasgow Coma Scale, Glasgow Coma Scale Motor Part and Full Outline of Unresponsiveness scale scores on day 1 and day 7 after enrolment and 28 days, 3 months and 6 months after injury; duration of unconsciousness and mechanical ventilation; length of intensive care unit and hospital stays; and incidence of adverse events. Right median nerve electrical stimulation has been used as a safe, inexpensive, non-invasive therapy for neuroresuscitation of coma patients for more than two decades, yet no trial has robustly proven the efficacy and safety of this treatment. The Asia Coma Electrical Stimulation (ACES) trial has the

Assessment of nociception and pain in participants with unresponsive or minimally conscious state after acquired brain injury: the relationship between the Coma Recovery Scale-Revised and the Nociception Coma Scale-Revised.

PubMed

Chatelle, Camille; Hauger, Solveig L; Martial, Charlotte; Becker, Frank; Eifert, Bernd; Boering, Dana; Giacino, Joseph T; Laureys, Steven; Løvstad, Marianne; Maurer-Karattup, Petra

2018-04-10

Investigate the relationship between consciousness and nociceptive responsiveness (i.e., Nociception Coma Scale-Revised [NCS-R]), examine the suitability of the NCS-R for assessing nociception in participants with disorders of consciousness (DoC) and replicate previous findings on psychometric properties of the scale. We prospectively assessed consciousness with the Coma Recovery Scale-Revised (CRS-R). Responses during baseline, non-noxious and noxious stimulations were scored with the NCS-R, CRS-R oromotor and motor subscales. Specialized DoC program and university hospitals. Eighty-five participants diagnosed with DoCs. Correlation between CRS-R total scores and CRS-R and NCS-R (sub)scores to noxious stimulation, proportion of grimace and/or cry in participants with minimally consciousness (MCS) and unresponsive wakefulness syndrome (UWS) during non-noxious and noxious conditions. Not applicable RESULTS: CRS-R total scores correlated with NCS-R total scores and subscores. CRS-R motor subscale correlated with NCS-R total scores and motor subscale and CRS-R oromotor subscale correlated with NCS-R total scores, as well as verbal and facial expression. There was a difference between participants with UWS and MCS in the proportion of grimace and/or crying during the noxious condition. We replicated previous findings on psychometric properties of the scale, but found a different score as the best threshold for nociception. We report a strong relationship between responsiveness to nociception and the level of consciousness. The NCS-R seems to offer a valuable tool to assess nociception in an efficient manner, but additional studies are needed to allow recommendations for clinical assessment of subjective pain experience. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Another collision for the Coma cluster

NASA Technical Reports Server (NTRS)

Vikhlinin, A.; Forman, W.; Jones, C.

1996-01-01

The wavelet transform analysis of the Rosat position sensitive proportional counter (PSPC) images of the Coma cluster are presented. The analysis shows, on small scales, a substructure dominated by two extended sources surrounding the two bright clusters NGC 4874 and NGC 4889. On scales of about 2 arcmin to 3 arcmin, the analysis reveals a tail of X-ray emission originating near the cluster center, curving to the south and east for approximately 25 arcmin and ending near the galaxy NGC 4911. The results are interpreted in terms of a merger of a group, having a core mass of approximately 10(exp 13) solar mass, with the main body of the Coma cluster.

The portrayal of coma in contemporary motion pictures.

PubMed

Wijdicks, Eelco F M; Wijdicks, Coen A

2006-05-09

Coma has been a theme of screenplays in motion pictures, but there is no information about its accuracy. The authors reviewed 30 movies from 1970 to 2004 with actors depicting prolonged coma. Accurate depiction of comatose patients was defined by appearance, the complexity of care, accurate cause of coma and probability of awakening, and appropriate compassionate discussion between the physician and family members. Twenty-two key scenes from 17 movies were rated for accuracy by a panel of neurointensivists and neuroscience nurses and then were shown to 72 nonmedical viewers. Accuracy of the scenes was assessed using a Likert Scale. Coma was most often caused by motor vehicle accidents or violence (63%). The time in a comatose state varied from days to 10 years. Awakening occurred in 18 of 30 motion pictures (60%). Awakening was sudden with cognition intact, even after prolonged time in a coma. Actors personified "Sleeping Beauty" (eyes closed, beautifully groomed). Physicians appeared as caricatures. Only two movies had a reasonable accurate representation (Dream Life of Angels and Reversal of Fortune). The majority of the surveyed viewers identified inaccuracy of representation of coma, awakenings, and conversations on the experience of being in a coma, except in 8 of the 22 scenes (36%). Twenty-eight of the 72 viewers (39%) could potentially allow these scenes to influence decisions in real life. Misrepresentation of coma and awakening was common in motion pictures and impacted on the public perception of coma. Neurologic advice regarding prolonged coma is needed.

Gait and Glasgow Coma Scale scores can predict functional recovery in patients with traumatic brain injury☆

PubMed Central

Bilgin, Sevil; Guclu-Gunduz, Arzu; Oruckaptan, Hakan; Kose, Nezire; Celik, Bülent

2012-01-01

Fifty-one patients with mild (n = 14), moderate (n = 10) and severe traumatic brain injury (n = 27) received early rehabilitation. Level of consciousness was evaluated using the Glasgow Coma Score. Functional level was determined using the Glasgow Outcome Score, whilst mobility was evaluated using the Mobility Scale for Acute Stroke. Activities of daily living were assessed using the Barthel Index. Following Bobath neurodevelopmental therapy, the level of consciousness was significantly improved in patients with moderate and severe traumatic brain injury, but was not greatly influenced in patients with mild traumatic brain injury. Mobility and functional level were significantly improved in patients with mild, moderate and severe traumatic brain injury. Gait recovery was more obvious in patients with mild traumatic brain injury than in patients with moderate and severe traumatic brain injury. Activities of daily living showed an improvement but this was insignificant except for patients with severe traumatic brain injury. Nevertheless, complete recovery was not acquired at discharge. Multiple regression analysis showed that gait and Glasgow Coma Scale scores can be considered predictors of functional outcomes following traumatic brain injury. PMID:25624828

[Myxedema coma].

PubMed

Rizzo, Leonardo F L; Mana, Daniela L; Bruno, Oscar D; Wartofsky, Leonard

2017-01-01

Hypothyroidism is a frequently diagnosed and simply treated disease. If not recognised, however, in time it may develop into the most severe manifestation of hypothyroidism known as myxedema coma. The term "myxedema coma" is generally seen as misleading since most patients do not initially present in a coma. The typical progression is lethargy evolving into stupor and, eventually, into coma with respiratory failure and hypothermia. It mainly affects elderly women, often occurring in winter and is relatively rare. It can be considered a form of decompensated hypothyroidism often triggered by a variety of non-thyroid conditions or diseases provoking an extremely severe condition of multiple system failure with lethal consequences unless an early diagnosis is made and an aggressive treatment is administered.

EEG and Coma.

PubMed

Ardeshna, Nikesh I

2016-03-01

Coma is defined as a state of extreme unresponsiveness, in which a person exhibits no voluntary movement or behavior even to painful stimuli. The utilization of EEG for patients in coma has increased dramatically over the last few years. In fact, many institutions have set protocols for continuous EEG (cEEG) monitoring for patients in coma due to potential causes such as subarachnoid hemorrhage or cardiac arrest. Consequently, EEG plays an important role in diagnosis, managenent, and in some cases even prognosis of coma patients.

Large-scale dust jets in the coma of 67P/Churyumov-Gerasimenko as seen by the OSIRIS instrument onboard Rosetta

NASA Astrophysics Data System (ADS)

Lara, L. M.; Lowry, S.; Vincent, J.-B.; Gutiérrez, P. J.; Rożek, A.; La Forgia, F.; Oklay, N.; Sierks, H.; Barbieri, C.; Lamy, P. L.; Rodrigo, R.; Koschny, D.; Rickman, H.; Keller, H. U.; Agarwal, J.; Auger, A.-T.; A'Hearn, M. F.; Barucci, M. A.; Bertaux, J.-L.; Bertini, I.; Besse, S.; Bodewits, D.; Cremonese, G.; Davidsson, B.; Da Deppo, V.; Debei, S.; De Cecco, M.; El-Maarry, M. R.; Ferri, F.; Fornasier, S.; Fulle, M.; Groussin, O.; Gutiérrez-Marques, P.; Güttler, C.; Hviid, S. F.; Ip, W.-H.; Jorda, L.; Knollenberg, J.; Kovacs, G.; Kramm, J.-R.; Kührt, E.; Küppers, M.; Lazzarin, M.; Lin, Z.-Y.; López-Moreno, J. J.; Magrin, S.; Marzari, F.; Michalik, H.; Moissl-Fraund, R.; Moreno, F.; Mottola, S.; Naletto, G.; Pajola, M.; Pommerol, A.; Thomas, N.; Sabau, M. D.; Tubiana, C.

2015-11-01

Context. During the most recent perihelion passage in 2009 of comet 67P/Churyumov-Gerasimenko (67P), ground-based observations showed an anisotropic dust coma where jet-like features were detected at ~ 1.3 AU from the Sun. The current perihelion passage is exceptional as the Rosetta spacecraft is monitoring the nucleus activity since March 2014, when a clear dust coma was already surrounding the nucleus at 4.3 AU from the Sun. Subsequently, the OSIRIS camera also witnessed an outburst in activity between April 27 and 30, and since mid-July, the dust coma at rh ~ 3.7-3.6 AU preperihelion is clearly non-isotropic, pointing to the existence of dust jet-like features. Aims: We aim to ascertain on the nucleus surface the origin of the dust jet-like features detected as early as in mid-July 2014. This will help to establish how the localized comet nucleus activity compares with that seen in previous apparitions and will also help following its evolution as the comet approaches its perihelion, at which phase most of the jets were detected from ground-based observations. Determining these areas also allows locating them in regions on the nucleus with spectroscopic or geomorphological distinct characteristics. Methods: Three series of dust images of comet 67P obtained with the Wide Angle Camera (WAC) of the OSIRIS instrument onboard the Rosetta spacecraft were processed with different enhancement techniques. This was made to clearly show the existence of jet-like features in the dust coma, whose appearance toward the observer changed as a result of the rotation of the comet nucleus and of the changing observing geometry from the spacecraft. The position angles of these features in the coma together with information on the observing geometry, nucleus shape, and rotation, allowed us to determine the most likely locations on the nucleus surface where the jets originate from. Results: Geometrical tracing of jet sources indicates that the activity of the nucleus of 67P gave rise

The coma cluster after lunch: Has a galaxcy group passed through the cluster core?

NASA Technical Reports Server (NTRS)

Burns, Jack O.; Roettiger, Kurt; Ledlow, Michael; Klypin, Anatoly

1994-01-01

We propose that the Coma cluster has recently undergone a collision with the NGC 4839 galaxy group. The ROSAT X-ray morphology, the Coma radio halo, the presence of poststarburst galaxies in the bridge between Coma and NGC 4839, the usually high velocity dispersion for the NGC 4839 group, and the position of a large-scale galaxy filament to the NE of Coma are all used to argue that the NGC 4839 group passed through the core of Coma approximately 2 Gyr ago. We present a new Hydro/N-body simulation of the merger between a galaxy group and a rich cluster that reproduces many of the observed X-ray and optical properties of Coma/NGC 4839.

Ultraviolet and optical view of galaxies in the Coma Supercluster

NASA Astrophysics Data System (ADS)

Mahajan, Smriti; Singh, Ankit; Shobhana, Devika

2018-05-01

The Coma supercluster (100h-1Mpc) offers an unprecedented contiguous range of environments in the nearby Universe. In this paper we present a catalogue of spectroscopically confirmed galaxies in the Coma supercluster detected in the ultraviolet (UV) wavebands. We use the arsenal of UV and optical data for galaxies in the Coma supercluster covering ˜500 square degrees on the sky to study their photometric and spectroscopic properties as a function of environment at various scales. We identify the different components of the cosmic-web: large-scale filaments and voids using Discrete Persistent Structures Extractor, and groups and clusters using Hierarchical Density-based spatial clustering of applications with noise, respectively. We find that in the Coma supercluster the median emission in Hα inclines, while the g - r and FUV - NUV colours of galaxies become bluer moving further away from the spine of the filaments out to a radius of ˜1 Mpc. On the other hand, an opposite trend is observed as the distance between the galaxy and centre of the nearest cluster or group decreases. Our analysis supports the hypothesis that properties of galaxies are not just defined by its stellar mass and large-scale density, but also by the environmental processes resulting due to the intrafilament medium whose role in accelerating galaxy transformations needs to be investigated thoroughly using multi-wavelength data.

EEG in connection with coma.

PubMed

Wilson, John A; Nordal, Helge J

2013-01-08

Coma is a dynamic condition that may have various causes. Important changes may take place rapidly, often with consequences for treatment. The purpose of this article is to provide a brief overview of EEG patterns in comas with various causes, and indicate how EEG contributes in an assessment of the prognosis for coma patients. The article is based on many years of clinical and research-based experience of EEG used for patients in coma. A self-built reference database was supplemented by searches for relevant articles in PubMed. EEG reveals immediate changes in coma, and can provide early information on cause and prognosis. It is the only diagnostic tool for detecting a non-convulsive epileptic status. Locked-in- syndrome may be overseen without EEG. Repeated EEG scans increase diagnostic certainty and make it possible to monitor the development of coma. EEG reflects brain function continuously and therefore holds a key place in the assessment and treatment of coma.

Functional coma.

PubMed

Ludwig, L; McWhirter, L; Williams, S; Derry, C; Stone, J

2016-01-01

Functional coma - here defined as a prolonged motionless dissociative attack with absent or reduced response to external stimuli - is a relatively rare presentation. In this chapter we examine a wide range of terms used to describe states of unresponsiveness in which psychologic factors are relevant to etiology, such as depressive stupor, catatonia, nonepileptic "pseudostatus," and factitious disorders, and discuss the place of functional or psychogenic coma among these. Historically, diagnosis of functional coma has sometimes been reached after prolonged investigation and exclusion of other diagnoses. However, as is the case with other functional disorders, diagnosis should preferably be made on the basis of positive findings that provide evidence of inconsistency between an apparent comatose state and normal waking nervous system functioning. In our review of physical signs, we find some evidence for the presence of firm resistance to eye opening as reasonably sensitive and specific for functional coma, as well as the eye gaze sign, in which patients tend to look to the ground when turned on to one side. Noxious stimuli such as Harvey's sign (application of high-frequency vibrating tuning fork to the nasal mucosa) can also be helpful, although patients with this disorder are often remarkably unresponsive to usually painful stimuli, particularly as more commonly applied using sternal or nail bed pressure. The use of repeated painful stimuli is therefore not recommended. We also discuss the role of general anesthesia and other physiologic triggers to functional coma. © 2016 Elsevier B.V. All rights reserved.

SOCCER: Comet Coma Sample Return Mission

NASA Technical Reports Server (NTRS)

Albee, A. L.; Uesugi, K. T.; Tsou, Peter

1994-01-01

Comets, being considered the most primitive bodies in the solar system, command the highest priority among solar system objects for studying solar nebula evolution and the evolution of life through biogenic elements and compounds. Sample Of Comet Coma Earth Return (SOCCER), a joint effort between NASA and the Institute of Space and Astronautical Science (ISAS) in Japan, has two primary science objectives: (1) the imaging of the comet nucleus and (2) the return to Earth of samples of volatile species and intact dust. This effort makes use of the unique strengths and capabilities of both countries in realizing this important quest for the return of samples from a comet. This paper presents an overview of SOCCER's science payloads, engineering flight system, and its mission operations.

Long-term outcomes after immediate aortic repair for acute type A aortic dissection complicated by coma.

PubMed

Tsukube, Takuro; Haraguchi, Tomonori; Okada, Yasushi; Matsukawa, Ritsu; Kozawa, Shuichi; Ogawa, Kyoichi; Okita, Yutaka

2014-09-01

The management of acute type A aortic dissection complicated by coma remains controversial. We previously reported an excellent rate of recovery of consciousness provided aortic repair was performed within 5 hours of the onset of symptoms. This study evaluates the early and long-term outcomes using this approach. Between August 2003 and July 2013, of the 241 patients with acute type A aortic dissection brought to the Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, 30 (12.4%) presented with coma; Glasgow Coma Scale was less than 11 on arrival. Surgery was performed in 186 patients, including 27 (14.5%) who were comatose. Twenty-four comatose patients underwent successful aortic repair immediately (immediate group). Their mean age was 71.0 ± 11.1 years, Glasgow Coma Scale was 6.5 ± 2.4, and prevalence of carotid dissection was 79%. For brain protection, deep hypothermia with antegrade cerebral perfusion was used, and postoperative induced hypothermia was performed. Neurologic evaluations were performed using the Glasgow Coma Scale, National Institutes of Health Stroke Scale, and modified Rankin Scale. In the immediate group, the time from the onset of symptoms to arrival in the operating theater was 222 ± 86 minutes. Hospital mortality was 12.5%. Full recovery of consciousness was achieved in 79% of patients in up to 30 days. Postoperative Glasgow Coma Scale and National Institutes of Health Stroke Scale improved significantly when compared with the preoperative score (P < .05), and postoperative activities of daily living independence (modified Rankin Scale <3) was achieved in 50% of patients. The mean follow-up period was 56.5 months, and the cumulative survival was 48.2% after 10 years. Cox proportional hazards regression analysis indicated that immediate repair (hazard ratio, 4.3; P = .007) was the only significant predictor of postoperative survival over a 5-year period. The early and long-term outcomes as a result of immediate aortic

Anions in Cometary Comae

NASA Technical Reports Server (NTRS)

Charnley, Steven B.

2011-01-01

The presence of negative ions (anions) in cometary comae is known from Giotto mass spectrometry of IP/Halley. The anions 0-, OH-, C-, CH- and CN- have been detected, as well as unidentified anions with masses 22-65 and 85-110 amu (Chaizy et al. 1991). Organic molecular anions are known to have a significant impact on the charge balance of interstellar clouds and circumstellar envelopes and have been shown to act as catalysts for the gas-phase synthesis of larger hydrocarbon molecules in the ISM, but their importance in cometary comae has not yet been explored. We present details of the first attempt to model the chemistry of anions in cometary comae. Based on the combined chemical and hydro dynamical model of Rodgers & Charnley (2002), we investigate the role of large carbon-chain anions in cometary coma chemistry. We calculate the effects of these anions on coma thermodynamics, charge balance and examine their impact on molecule formation.

[Prognostic value of EEG in acute posttraumatic coma (author's transl)].

PubMed

Walser, H; Friedli, W; Glinz, W

1981-12-01

To evaluate the prognostic power of a single EEG-record, the recordings of 50 patients with posttraumatic coma performed within 48 hours after the injury were compared with the outcome after 6 months. A 5-point scale comprising 2 EEG-patterns being notorious for their dismal prognostic significance (suppression bursts, alpha-coma) and changes of vigilance were used as a mean of visual assessment of the recordings. In 24 out of the 28 patients with a bad outcome, the EEG had shown the patterns of category I, II and III (suppression bursts, alpha coma, no changes of vigilance). Of the 22 patients with a good outcome, the EEG had been classified as IV or V (clearly discernible changes of vigilance, sleep patterns). Further findings of particular dismal prognostic significance were focal epileptic discharges, as 9 out of the 11 patients with this EEG pattern had not survived the posttraumatic coma for more than 6 months.

Chemical Recycling of HCN in Cometary Comae

NASA Astrophysics Data System (ADS)

Boice, Daniel C.; Kawakita, Hideyo; Shinnaka, Yoshiharu; Mumma, Michael J.; Kobayashi, Hitomi; Ogawa, Sayuri

2014-11-01

Modeling is essential to understand the important physical and chemical processes that occur in cometary comae, especially the relationship between putative parent and daughter molecules, such as, HCN and CN. Photochemistry is a major source of ions and electrons that further initiate key gas-phase reactions, contributing to the plethora of molecules and atoms observed in comets. The effects of photoelectrons that interact via impacts are important to the overall excitation and dissociation processes in the inner coma. We consider the relevant processes in the collision-dominated, inner coma of a comet within a global modeling framework to understand observations of HCN and CN. The CN source(s) must be able to produce highly collimated jets, be consistent with the observed CN parent scale length, and have a production rate consistent with the observed CN production. HCN fulfills these conditions in some comets (e.g., 1P/Halley, Hale-Bopp) while it does not in others (e.g., 8P/Tuttle, 6P/d’Arrest, 73P/S-W3, 2P/Encke, 9P/Temple 1 and C/2007 W1).We investigate the chemistry of HCN with our chemical kinetics coma model including a network with other possible CN parents, as well as a dust component that may be a potential source of CN. It is seen that the major destruction pathways of HCN are via photo dissociation (into H and CN) and protonation with water group ions - primarily H3O+. We point out the intriguing “recycling” of HCN via protonation reactions with H3O+, H2O+, OH+, and subsequent dissociative recombination. It seems that HCN molecules observed in the coma can consist of those initially released from the nucleus and those that are freshly formed at different locations in the coma via these protonation/dissociation reactions. We will investigate implications for reconciling discrepancies between observations of HCN and CN in cometary comae.Acknowledgements: We appreciate support from the NSF Planetary Astronomy Program. This program is partially

Compressed spectral arrays of patients with fulminant hepatic failure in hepatic coma undergoing liver transplantation.

PubMed

Takeichi, Takayuki; Asonuma, Katsuhiro; Kim, Ildeok; Inomata, Yukihiro; Kasahara, Mureo; Ohwada, Susumu; Morishita, Yasuo; Tanaka, Koichi

2002-08-01

Assessing the coma status of patients with fulminant hepatic failure (FHF) is important for determining the reversibility of brain damage and for properly timing liver transplantation. The compressed spectral array (CSA) method is a frequency analysis technique that processes electroencephalogram signals by computer to facilitate on-line interpretation. This method has been used to monitor the consciousness levels of neurointensive care unit patients. In this study, we determined whether CSA could be used to assess the coma status of patients with FHF, and whether CSA provided information that was useful in deciding when to proceed with liver transplantation. CSA recording was carried out in 17 FHF patients with encephalopathy (coma grade III-IV) who underwent living-related liver transplantation between August 1997 and May 1999. Recording was performed with a Neuromonitor OEE-72044 (NIHON KOHDEN, Osaka, Japan) every 24 h before and after transplantation, until the patients regained consciousness. The CSAs of healthy controls were distributed almost equally between 0 and 16 Hz. The CSAs of FHF patients in hepatic coma were classified into three patterns. Eight of the 17 patients showed very prominent slow waves of about 2 Hz (group A), and seven patients showed strongly suppressed rapid waves between 8 and 16 Hz (group B). The remaining two patients showed CSA patterns that were similar to those of healthy controls, even though these patients were comatose (group C). Abnormal CSA patterns were observed in 15 of the 17 patients (88%). Group B patients seemed to have higher coma grades than did group A patients. Sixteen patients underwent liver transplantation, completely recovered from hepatic encephalopathy, and subsequently showed CSA patterns similar to those of healthy controls. One patient died without regaining consciousness. These results suggest that CSA is useful in assessing the coma status of FHF patients and in evaluating electrophysiological recovery

The relation between persistent coma and brain ischemia after severe brain injury.

PubMed

Cheng, Quan; Jiang, Bing; Xi, Jian; Li, Zhen Yan; Liu, Jin Fang; Wang, Jun Yu

2013-12-01

To investigate the relation between brain ischemia and persistent vegetative state after severe traumatic brain injury. The 66 patients with severe brain injury were divided into two groups: The persistent coma group (coma duration ≥10 d) included 51 patients who had an admission Glasgow Coma Scale (GCS) of 5-8 and were unconscious for more than 10 d. There were 15 patients in the control group, their admission GCS was 5-8, and were unconscious for less than 10 d. The brain areas, including frontal, parietal, temporal, occipital lobes and thalamus, were measured by Single Photon Emission Computed Tomography (SPECT). In the first SPECT scan, multiple areas of cerebral ischemia were documented in all patients in both groups, whereas bilateral thalamic ischemia were presented in all patients in the persistent coma group and were absented in the control group. In the second SPECT scan taken during the period of analepsia, with an indication that unilateral thalamic ischemia were persisted in 28 of 41 patients in persistent coma group(28/41,68.29%). Persistent coma after severe brain injury is associated with bilateral thalamic ischemia.

Validation of the Italian version of the Coma Recovery Scale-Revised (CRS-R).

PubMed

Sacco, Simona; Altobelli, Emma; Pistarini, Caterina; Cerone, Davide; Cazzulani, Benedetta; Carolei, Antonio

2011-01-01

To validate the Italian version of the Coma Recovery Scale-Revised (CRS-R). Two observers applied the Italian version of the CRS-R to selected patients. On day 1, observer A and B independently scored each patient; the comparison of their observations was used to evaluate inter-observer agreement. On day 2, observer A completed a second evaluation and the comparison of this observation with that obtained on day 1 by the same observer was used to evaluate test-re-test agreement. For each evaluation, also diagnostic impression (vegetative state/minimally conscious state) was reported. Thirty-eight patients were evaluated (mean age ± SD, 58.9 ± 13.8 years). Inter-observer (ρ = 0.81; p < 0.001) as well as test-re-test agreement (ρ = 0.97; p < 0.001) for the total score was high. Inter-observer agreement was excellent for the communication sub-scale, good for the auditory, visual and motor sub-scales and moderate for the oromotor/verbal and arousal sub-scales. Test-re-test agreement was excellent for the visual, motor, oromotor/verbal and communication sub-scales, good for the auditory sub-scale and moderate for the arousal sub-scale. When considering the diagnostic impression, inter-observer agreement was good (κ = 0.75; p < 0.001) and test-re-test agreement was excellent (κ = 0.92; p < 0.001). The Italian version of the CRS-R can be administered reliably and can be also employed to discriminate patients in vegetative and in minimally conscious state.

Sensitivity and Specificity of the Coma Recovery Scale--Revised Total Score in Detection of Conscious Awareness.

PubMed

Bodien, Yelena G; Carlowicz, Cecilia A; Chatelle, Camille; Giacino, Joseph T

2016-03-01

To describe the sensitivity and specificity of Coma Recovery Scale-Revised (CRS-R) total scores in detecting conscious awareness. Data were retrospectively extracted from the medical records of patients enrolled in a specialized disorders of consciousness (DOC) program. Sensitivity and specificity analyses were completed using CRS-R-derived diagnoses of minimally conscious state (MCS) or emerged from minimally conscious state (EMCS) as the reference standard for conscious awareness and the total CRS-R score as the test criterion. A receiver operating characteristic curve was constructed to demonstrate the optimal CRS-R total cutoff score for maximizing sensitivity and specificity. Specialized DOC program. Patients enrolled in the DOC program (N=252, 157 men; mean age, 49y; mean time from injury, 48d; traumatic etiology, n=127; nontraumatic etiology, n=125; diagnosis of coma or vegetative state, n=70; diagnosis of MCS or EMCS, n=182). Not applicable. Sensitivity and specificity of CRS-R total scores in detecting conscious awareness. A CRS-R total score of 10 or higher yielded a sensitivity of .78 for correct identification of patients in MCS or EMCS, and a specificity of 1.00 for correct identification of patients who did not meet criteria for either of these diagnoses (ie, were diagnosed with vegetative state or coma). The area under the curve in the receiver operating characteristic curve analysis is .98. A total CRS-R score of 10 or higher provides strong evidence of conscious awareness but resulted in a false-negative diagnostic error in 22% of patients who demonstrated conscious awareness based on CRS-R diagnostic criteria. A cutoff score of 8 provides the best balance between sensitivity and specificity, accurately classifying 93% of cases. The optimal total score cutoff will vary depending on the user's objective. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The outskirts of the Coma cluster

NASA Astrophysics Data System (ADS)

Gavazzi, Giuseppe

Evolved Coma-like clusters of galaxies are constituted of relaxed cores composed of ''old'' early-type galaxies, embedded in large-scale structures, mostly constituted of unevolved (late-type) systems. According to the hierarchical theory of cluster formation the central regions are being fed with unevolved, low-mass systems infalling from the surroundings that are gradually transformed into elliptical/S0 galaxies by tidal galaxy-galaxy and galaxy-cluster interactions, taking place at some boundary distance. The Coma cluster, the most studied of all local clusters, provides us with the ideal test-bed for such an evolutionary study because of the completeness of the photometric and kinematic information already at hands. The field of view of the planned GALEX observations is not big enough to include the boundary interface where most transformations processes are expected to take place, including the truncation of the current star formation. We propose to complete the outskirt of Coma with an additional corona of 11 GALEX imaging fields of 1500 sec exposure each, matching the deepness (UV_{AB}=23.5 mag) of the fields observed in guarantee time. Given the priority of the target, we also propose one optional Central pointing that includes one bright star marginally exceeding the detector brightness limit.

The child in coma

NASA Technical Reports Server (NTRS)

Lewinn, E. B.

1978-01-01

Children in coma continue to pose medical, social, economic, ethical, moral, and legal problems. Modern life-support technology has aggravated these problems. Coma is viewed as a pathological state of unconsciousness from which the patient has not achieved arousal, and which calls for vigorous action to help him regain consciousness. There are two variables that have an especially important bearing on the ability to achieve arousal. These are: the character of the brain injury that caused the coma, and environmental factors that affect the patient after the injury.

A Dozen New Galaxies Caught in the Act: Gas Stripping and Extended Emission Line Regions in the Coma Cluster

NASA Astrophysics Data System (ADS)

Yagi, Masafumi; Yoshida, Michitoshi; Komiyama, Yutaka; Kashikawa, Nobunari; Furusawa, Hisanori; Okamura, Sadanori; Graham, Alister W.; Miller, Neal A.; Carter, David; Mobasher, Bahram; Jogee, Shardha

2010-12-01

We present images of extended Hα clouds associated with 14 member galaxies in the Coma cluster obtained from deep narrowband imaging observations with the Suprime-Cam at the Subaru Telescope. The parent galaxies of the extended Hα clouds are distributed farther than 0.2 Mpc from the peak of the X-ray emission of the cluster. Most of the galaxies are bluer than g - r ≈ 0.5 and they account for 57% of the blue (g - r < 0.5) bright (r < 17.8 mag) galaxies in the central region of the Coma cluster. They reside near the red- and blueshifted edges of the radial velocity distribution of Coma cluster member galaxies. Our findings suggest that most of the parent galaxies were recently captured by the Coma cluster potential and are now infalling toward the cluster center with their disk gas being stripped off and producing the observed Hα clouds. Based on data collected at the Subaru Telescope, which is operated by the National Astronomical Observatory of Japan.

Predictive Utility of the Total Glasgow Coma Scale Versus the Motor Component of the Glasgow Coma Scale for Identification of Patients With Serious Traumatic Injuries.

PubMed

Chou, Roger; Totten, Annette M; Carney, Nancy; Dandy, Spencer; Fu, Rongwei; Grusing, Sara; Pappas, Miranda; Wasson, Ngoc; Newgard, Craig D

2017-08-01

The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care. Ovid MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Health and Psychosocial Instruments, and the Cochrane databases were searched through June 2016 for English-language cohort studies. We included studies that compared the area under the receiver operating characteristic curve (AUROC) of the tGCS versus the mGCS or Simplified Motor Scale assessed in the field or shortly after arrival in the emergency department for predicting the outcomes described above. Meta-analyses were performed with a random-effects model, and subgroup and sensitivity analyses were conducted. We included 18 head-to-head studies of predictive utility (n=1,703,388). For inhospital mortality, the tGCS was associated with slightly greater discrimination than the mGCS (pooled mean difference in [AUROC] 0.015; 95% confidence interval [CI] 0.009 to 0.022; I 2 =85%; 12 studies) or the Simplified Motor Scale (pooled mean difference in AUROC 0.030; 95% CI 0.024 to 0.036; I 2 =0%; 5 studies). The tGCS was also associated with greater discrimination than the mGCS or Simplified Motor Scale for nonmortality outcomes (differences in AUROC from 0.03 to 0.05). Findings were robust in subgroup and sensitivity analyses. The tGCS is associated with slightly greater discrimination than the mGCS or Simplified Motor Scale for identifying severe trauma. The small differences in discrimination are likely to be

Energy expenditure during barbiturate coma.

PubMed

Ashcraft, Christine M; Frankenfield, David C

2013-10-01

Barbiturate coma may have a significant effect on metabolic rate, but the phenomenon is not extensively studied. The primary purpose of the current study was to compare the metabolic rate of general critical care patients with those requiring barbiturate coma. A secondary purpose was to evaluate the accuracy of the Penn State prediction equation between these 2 groups of patients. Indirect calorimetry was used to measure the resting metabolic rate of mechanically ventilated, critically ill patients in a barbiturate coma and those of similar height, weight, and age but not in a barbiturate coma. Measurements of resting metabolic rate were compared with predictions using the Penn State equation accounting for body size, body temperature, and minute ventilation. The barbiturate coma group had a lower resting metabolic rate than the control group that remained lower even after adjustment for predicted healthy metabolic rate and maximum body temperature (1859 ± 290 vs 2037 ± 289 kcal/d, P = .020). When minute ventilation was also included in the analysis, the resting metabolic rate between the groups became statistically insignificant (1929 ± 229 vs 2023 ± 226 kcal/d, P = .142). The Penn State equation, which uses these variables, was accurate in 73% of the control patients and also the barbiturate coma patients. Resting metabolic rate is moderately reduced in barbiturate coma, but the decrease is out of proportion with changes in body temperature. However, if both body temperature and minute ventilation are considered, then the change is predictable.

Development of an objective tool for the diagnosis of myxedema coma.

PubMed

Chiong, Yien V; Bammerlin, Elaine; Mariash, Cary N

2015-09-01

Myxedema coma, a rare entity, with a reported 25%-65% mortality had no objective criteria for making the diagnosis when we began our study. We developed an objective screening tool for myxedema coma to more easily identify patients and examine the best treatment method in future prospective studies to reduce the mortality of this entity. We conducted a retrospective chart review to find all patients aged ≥18 years admitted with myxedema coma from January 1, 2005 through June 13, 2010 at Indiana University Health Methodist Hospital. On the basis of both our retrospective chart review and on literature accounts, we identified 6 criteria to diagnose myxedema coma. We identified 10 patients initially diagnosed with myxedema coma and established a control group consisting of 13 patients identified with altered mental status and increased thyroid-stimulating hormone (TSH) levels. The 6 variables we created for the screening tool were heart rate, temperature, Glasgow coma scale, TSH, free thyroxine, and precipitating factors. The screening tool has a sensitivity and specificity of about 80%. We ran a logistic regression model using the 10 study patients and 13 controls with the 6 variables. No variables alone significantly contributed to the model. However, the overall model was highly significant (P = 0.012), providing strong support for a scoring system that uses these variables simultaneously. This screening tool enables physicians to rapidly diagnose myxedema coma to expedite treatment. A more refined diagnostic tool may be used in future clinical studies designed to determine the optimal treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Near-death experiences in non-life-threatening events and coma of different etiologies.

PubMed

Charland-Verville, Vanessa; Jourdan, Jean-Pierre; Thonnard, Marie; Ledoux, Didier; Donneau, Anne-Francoise; Quertemont, Etienne; Laureys, Steven

2014-01-01

Near death experiences (NDEs) are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have attempted to associate the experiences' intensity and content to etiology. This retrospective investigation assessed the intensity and the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., "NDE-like" experience) or after a pathological coma (i.e., "real NDE") and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE scale. From our 190 reports who met the criteria for NDE (i.e., Greyson NDE scale total score >7/32), intensity (i.e., Greyson NDE scale total score) and content (i.e., Greyson NDE scale features) did not differ between "NDE-like" (n = 50) and "real NDE" (n = 140) groups, nor within the "real NDE" group depending on the cause of coma (anoxic/traumatic/other). The most frequently reported feature was peacefulness (89-93%). Only 2 patients (1%) recounted a negative experience. The overall NDE core features' frequencies were higher in our retrospective anoxic cohort when compared to historical published prospective data. It appears that "real NDEs" after coma of different etiologies are similar to "NDE-like" experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have experienced a different content compared to the prospective experiencers.

Reliability and diagnostic characteristics of the JFK coma recovery scale-revised: exploring the influence of rater's level of experience.

PubMed

Løvstad, Marianne; Frøslie, Kathrine F; Giacino, Joseph T; Skandsen, Toril; Anke, Audny; Schanke, Anne-Kristine

2010-01-01

To confirm the reliability and diagnostic validity of the JFK Coma Recovery Scale-Revised (CRS-R) across raters with varying levels of experience. Thirty-one patients with disorders of consciousness were recruited from 6 Norwegian hospitals. CRS-R and the Disability Rating Scale. Reliability measures were good for the CRS-R total scores and moderate to good for its subscales. Diagnostic agreement among examiners was good. Raters' experience with the CRS-R favorably influenced reliability. Sensitivity and specificity analyses demonstrated better detection of patients in minimally conscious state on the CRS-R relative to the Disability Rating Scale. The CRS-R is a reliable tool for diagnosing vegetative state and minimally conscious state. Raters' level of experience influences the reliability of the CRS-R scores.

Thermodynamics of the Coma Cluster Outskirts

NASA Astrophysics Data System (ADS)

Simionescu, A.; Werner, N.; Urban, O.; Allen, S. W.; Fabian, A. C.; Mantz, A.; Matsushita, K.; Nulsen, P. E. J.; Sanders, J. S.; Sasaki, T.; Sato, T.; Takei, Y.; Walker, S. A.

2013-09-01

We present results from a large mosaic of Suzaku observations of the Coma Cluster, the nearest and X-ray brightest hot (~8 keV), dynamically active, non-cool core system, focusing on the thermodynamic properties of the intracluster medium on large scales. For azimuths not aligned with an infalling subcluster toward the southwest, our measured temperature and X-ray brightness profiles exhibit broadly consistent radial trends, with the temperature decreasing from about 8.5 keV at the cluster center to about 2 keV at a radius of 2 Mpc, which is the edge of our detection limit. The southwest merger significantly boosts the surface brightness, allowing us to detect X-ray emission out to ~2.2 Mpc along this direction. Apart from the southwestern infalling subcluster, the surface brightness profiles show multiple edges around radii of 30-40 arcmin. The azimuthally averaged temperature profile, as well as the deprojected density and pressure profiles, all show a sharp drop consistent with an outwardly-propagating shock front located at 40 arcmin, corresponding to the outermost edge of the giant radio halo observed at 352 MHz with the Westerbork Synthesis Radio Telescope. The shock front may be powering this radio emission. A clear entropy excess inside of r 500 reflects the violent merging events linked with these morphological features. Beyond r 500, the entropy profiles of the Coma Cluster along the relatively relaxed directions are consistent with the power-law behavior expected from simple models of gravitational large-scale structure formation. The pressure is also in agreement at these radii with the expected values measured from Sunyaev-Zel'dovich data from the Planck satellite. However, due to the large uncertainties associated with the Coma Cluster measurements, we cannot yet exclude an entropy flattening in this system consistent with that seen in more relaxed cool core clusters.

The distribution of early- and late-type galaxies in the Coma cluster

NASA Technical Reports Server (NTRS)

Doi, M.; Fukugita, M.; Okamura, S.; Turner, E. L.

1995-01-01

The spatial distribution and the morohology-density relation of Coma cluster galaxies are studied using a new homogeneous photmetric sample of 450 galaxies down to B = 16.0 mag with quantitative morphology classification. The sample covers a wide area (10 deg X 10 deg), extending well beyond the Coma cluster. Morphological classifications into early- (E+SO) and late-(S) type galaxies are made by an automated algorithm using simple photometric parameters, with which the misclassification rate is expected to be approximately 10% with respect to early and late types given in the Third Reference Catalogue of Bright Galaxies. The flattened distribution of Coma cluster galaxies, as noted in previous studies, is most conspicuously seen if the early-type galaxies are selected. Early-type galaxies are distributed in a thick filament extended from the NE to the WSW direction that delineates a part of large-scale structure. Spiral galaxies show a distribution with a modest density gradient toward the cluster center; at least bright spiral galaxies are present close to the center of the Coma cluster. We also examine the morphology-density relation for the Coma cluster including its surrounding regions.

Postoperative myxoedema coma.

PubMed

James, Robert; James, Jessie; Vij, Amarjit Singh; Vij, Kamaljeet Kaur

2014-02-13

Hypothyroidism is a commonly diagnosed endocrine disorder in medicine. Hyponatraemia is reported in up to 10% of hypothyroid patients, although it is usually mild and rarely causes symptoms. Myxoedema coma is a rare manifestation of hypothyroidism and it can be lethal if it goes undiagnosed and untreated. Our patient presented with an acute manifestation of probable long-standing, but undiagnosed, hypothyroidism. She was asymptomatic but when subjected to surgery (identifiable stress factor) it precipitated as myxoedema coma. Stressful situations such as surgery or infection are the usual precipitating factors for myxoedema coma. The patient responded well to treatment with levothyroxin, 0.9% saline infusion and other general supportive measures. Judicious use of intravenous saline to correct hyponatraemia is important. Correction with 3% normal saline should be carried out with great caution, as rapid correction with 3% normal saline can lead to central pontine demyelination.

Postoperative myxoedema coma

PubMed Central

James, Robert; James, Jessie; Vij, Amarjit Singh; Vij, Kamaljeet Kaur

2014-01-01

Hypothyroidism is a commonly diagnosed endocrine disorder in medicine. Hyponatraemia is reported in up to 10% of hypothyroid patients, although it is usually mild and rarely causes symptoms. Myxoedema coma is a rare manifestation of hypothyroidism and it can be lethal if it goes undiagnosed and untreated. Our patient presented with an acute manifestation of probable long-standing, but undiagnosed, hypothyroidism. She was asymptomatic but when subjected to surgery (identifiable stress factor) it precipitated as myxoedema coma. Stressful situations such as surgery or infection are the usual precipitating factors for myxoedema coma. The patient responded well to treatment with levothyroxin, 0.9% saline infusion and other general supportive measures. Judicious use of intravenous saline to correct hyponatraemia is important. Correction with 3% normal saline should be carried out with great caution, as rapid correction with 3% normal saline can lead to central pontine demyelination. PMID:24526192

[Coma in France today].

PubMed

Do, Chung Hi

2015-01-01

Comas result from acute life-threatening neurological failure. To understand coma, it is firstly necessary to define it, to cite the aetiologies and their epidemiology and to describe the chronic disorders of consciousness. It is also important to address the challenges and principles of treatment during the acute phase. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

ULTRA-COMPACT DWARFS IN THE COMA CLUSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chiboucas, Kristin; Tully, R. Brent; Marzke, R. O.

2011-08-20

We have undertaken a spectroscopic search for ultra-compact dwarf galaxies (UCDs) in the dense core of the dynamically evolved, massive Coma cluster as part of the Hubble Space Telescope/Advanced Camera for Surveys (HST/ACS) Coma Cluster Treasury Survey. UCD candidates were initially chosen based on color, magnitude, degree of resolution within the ACS images, and the known properties of Fornax and Virgo UCDs. Follow-up spectroscopy with Keck/Low-Resolution Imaging Spectrometer confirmed 27 candidates as members of the Coma cluster, a success rate >60% for targeted objects brighter than M{sub R} = -12. Another 14 candidates may also prove to be Coma members,more » but low signal-to-noise spectra prevent definitive conclusions. An investigation of the properties and distribution of the Coma UCDs finds these objects to be very similar to UCDs discovered in other environments. The Coma UCDs tend to be clustered around giant galaxies in the cluster core and have colors/metallicity that correlate with the host galaxy. With properties and a distribution similar to that of the Coma cluster globular cluster population, we find strong support for a star cluster origin for the majority of the Coma UCDs. However, a few UCDs appear to have stellar population or structural properties which differentiate them from the old star cluster populations found in the Coma cluster, perhaps indicating that UCDs may form through multiple formation channels.« less

Characterization of the warm-hot intergalactic medium near the Coma cluster through high-resolution spectroscopy of X Comae

NASA Astrophysics Data System (ADS)

Bonamente, M.; Ahoranta, J.; Tilton, E.; Tempel, E.; Morandi, A.

2017-08-01

We have analysed all available archival XMM-Newton observations of X Comae, a bright X-ray quasar behind the Coma cluster, to study the properties of the warm-hot intergalactic medium (WHIM) in the vicinity of the nearest massive galaxy cluster. The reflection grating spectrometer observations confirm the possible presence of a Ne ix K α absorption line at the redshift of Coma, although with a limited statistical significance. This analysis is therefore in line with the earlier analysis by Takei et al. based on a sub-set of these data. Its large column density and optical depth, however, point to implausible conditions for the absorbing medium, thereby casting serious doubts to its reality. Chandra has never observed X Comae and therefore cannot provide additional information on this source. We combine upper limits to the presence of other X-ray absorption lines (notably from O vii and O viii) at the redshift of Coma with positive measurements of the soft excess emission from Coma measured by ROSAT (Bonamente et al.). The combination of emission from warm-hot gas at kT ˜ 1/4 keV and upper limits from absorption lines provide useful constraints on the density and the sightline length of the putative WHIM towards Coma. We conclude that the putative warm-hot medium towards Coma is consistent with expected properties, with a baryon overdensity δb ≥ 10 and a sightline extent of order of tens of Mpc.

Myxedema coma.

PubMed

Wartofsky, Leonard

2006-12-01

Myxedema coma is the term given to the most severe presentation of profound hypothyroidism and is often fatal in spite of therapy. Decompensation of the hypothyroid patient into a coma may be precipitated by a number of drugs, systemic illnesses (eg, pneumonia), and other causes. It typically presents in older women in the winter months and is associated with signs of hypothyroidism, hypothermia, hyponatremia, hypercarbia, and hypoxemia. Treatment must be initiated promptly in an intensive care unit setting. Although thyroid hormone therapy is critical to survival, it remains uncertain whether it should be administered as thyroxine, triiodothyronine, or both. Adjunctive measures, such as ventilation, warming, fluids, antibiotics, pressors, and corticosteroids, may be essential for survival.

Pain assessment with the revised nociception coma scale and outcomes of patients with unresponsive wakefulness syndrome: results from a pilot study.

PubMed

Bagnato, Sergio; Boccagni, Cristina; Sant'Angelo, Antonino; Alito, Angelo; Galardi, Giuseppe

2018-06-01

The aim of this study was to evaluate whether standardized responses to nociceptive pain, assessed with the revised Nociception Coma Scale (NCS-R), were correlated with the outcomes of patients with unresponsive wakefulness syndrome (UWS) 6 months after admission to a rehabilitation department. We recruited 24 consecutive patients with UWS. Patients' consciousness levels were assessed with the revised Coma Recovery Scale (CRS-R) at admission and 6 months later, and their CRS-R scores were correlated with the NCS-R scores at admission. Ten of the 24 patients with UWS recovered consciousness after 6 months. The NCS-R score at admission was correlated with the CRS-R score at admission (P = 0.02), but not after 6 months (P = 0.6). Patients with and without consciousness improvement after 6 months showed no significant difference in the NCS-R total score and sub-scores at admission (P values > 0.05). In conclusion, the correlation between NCS-R and CRS-R scores at admission suggests that the standardized assessment of pain parallels patients' levels of consciousness, and may be helpful in the clinical evaluation of patients with UWS. Pain response assessed with the NCS-R was not related to the 6-month outcomes of patients with UWS.

Myxedema coma: diagnosis and treatment.

PubMed

Wall, C R

2000-12-01

Myxedema coma, the extreme manifestation of hypothyroidism, is an uncommon but potentially lethal condition. Patients with hypothyroidism may exhibit a number of physiologic alterations to compensate for the lack of thyroid hormone. If these homeostatic mechanisms are overwhelmed by factors such as infection, the patient may decompensate into myxedema coma. Patients with hypothyroidism typically have a history of fatigue, weight gain, constipation and cold intolerance. Physicians should include hypothyroidism in the differential diagnosis of every patient with hyponatremia. Patients with suspected myxedema coma should be admitted to an intensive care unit for vigorous pulmonary and cardiovascular support. Most authorities recommend treatment with intravenous levothyroxine (T4) as opposed to intravenous liothyronine (T3). Hydrocortisone should be administered until coexisting adrenal insufficiency is ruled out. Family physicians are in an important position to prevent myxedema coma by maintaining a high level of suspicion for hypothyroidism.

Near-death experiences in non-life-threatening events and coma of different etiologies

PubMed Central

Charland-Verville, Vanessa; Jourdan, Jean-Pierre; Thonnard, Marie; Ledoux, Didier; Donneau, Anne-Francoise; Quertemont, Etienne; Laureys, Steven

2014-01-01

Background: Near death experiences (NDEs) are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have attempted to associate the experiences' intensity and content to etiology. Methods: This retrospective investigation assessed the intensity and the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., “NDE-like” experience) or after a pathological coma (i.e., “real NDE”) and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE scale. Results: From our 190 reports who met the criteria for NDE (i.e., Greyson NDE scale total score >7/32), intensity (i.e., Greyson NDE scale total score) and content (i.e., Greyson NDE scale features) did not differ between “NDE-like” (n = 50) and “real NDE” (n = 140) groups, nor within the “real NDE” group depending on the cause of coma (anoxic/traumatic/other). The most frequently reported feature was peacefulness (89–93%). Only 2 patients (1%) recounted a negative experience. The overall NDE core features' frequencies were higher in our retrospective anoxic cohort when compared to historical published prospective data. Conclusions: It appears that “real NDEs” after coma of different etiologies are similar to “NDE-like” experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have

Preliminary Evidence for a Virial Shock around the Coma Galaxy Cluster

NASA Astrophysics Data System (ADS)

Keshet, Uri; Kushnir, Doron; Loeb, Abraham; Waxman, Eli

2017-08-01

Galaxy clusters, the largest gravitationally bound objects in the universe, are thought to grow by accreting mass from their surroundings through large-scale virial shocks. Due to electron acceleration in such a shock, it should appear as a γ-ray, hard X-ray, and radio ring, elongated toward the large-scale filaments feeding the cluster, coincident with a cutoff in the thermal Sunyaev-Zel’dovich (SZ) signal. However, no such signature was found until now, and the very existence of cluster virial shocks has remained a theory. We find preliminary evidence for a large γ-ray ring of ˜ 5 {Mpc} minor axis around the Coma cluster, elongated toward the large-scale filament connecting Coma and Abell 1367, detected at the nominal 2.7σ confidence level (5.1σ using control signal simulations). The γ-ray ring correlates both with a synchrotron signal and with the SZ cutoff, but not with Galactic tracers. The γ-ray and radio signatures agree with analytic and numerical predictions if the shock deposits ˜ 1 % of the thermal energy in relativistic electrons over a Hubble time and ˜ 1 % in magnetic fields. The implied inverse Compton and synchrotron cumulative emission from similar shocks can contribute significantly to the diffuse extragalactic γ-ray and low-frequency radio backgrounds. Our results, if confirmed, reveal the prolate structure of the hot gas in Coma, the feeding pattern of the cluster, and properties of the surrounding large-scale voids and filaments. The anticipated detection of such shocks around other clusters would provide a powerful new cosmological probe.

[Brain function recovery after prolonged posttraumatic coma].

PubMed

Klimash, A V; Zhanaidarov, Z S

2016-01-01

To explore the characteristics of brain function recovery in patients after prolonged posttraumatic coma and with long-unconscious states. Eighty-seven patients after prolonged posttraumatic coma were followed-up for two years. An analysis of a clinical/neurological picture after a prolonged episode of coma was based on the dynamics of vital functions, neurological status and patient's reactions to external stimuli. Based on the dynamics of the clinical/neurological picture that shows the recovery of functions of the certain brain areas, three stages of brain function recovery after a prolonged episode of coma were singled out: brain stem areas, diencephalic areas and telencephalic areas. These functional/anatomic areas of brain function recovery after prolonged coma were compared to the present classifications.

Neurotrauma pediatric scales

PubMed Central

Alexandru, Vlad Ciurea; Aurelia, Mihaela Sandu; Mihai, Popescu; Stefan, Mircea Iencean; Bogdan, Davidescu

2008-01-01

Cranial traumas have different particularities in infants, toddlers, preschool child, school child and teenagers. The assessment of these cases must be individualized according to age. It is completely different in children that in adults. Trauma scales, very useful in grading the severity and predicting outcome in traumatic brain injury, used in adults must be adapted in children. Children have age-related specificity and anatomic particularities, for each of this period of development. Neurotrauma scales, specific for infants and children, such as Pediatric Coma Scale, Children’s Coma Score, Trauma Infant Neurological Score, Glasgow Coma Scale, Liege Scale are reviewed, as well as neurotrauma outcome scales, like Glasgow Outcome Scale, modified Rankin score, KOSCHI score and Barthel Index. The authors present these scales in an exhaustive manner for thoroughgoing pediatric neurotrauma standards. PMID:20108520

THERMODYNAMICS OF THE COMA CLUSTER OUTSKIRTS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Simionescu, A.; Werner, N.; Urban, O.

2013-09-20

We present results from a large mosaic of Suzaku observations of the Coma Cluster, the nearest and X-ray brightest hot ({approx}8 keV), dynamically active, non-cool core system, focusing on the thermodynamic properties of the intracluster medium on large scales. For azimuths not aligned with an infalling subcluster toward the southwest, our measured temperature and X-ray brightness profiles exhibit broadly consistent radial trends, with the temperature decreasing from about 8.5 keV at the cluster center to about 2 keV at a radius of 2 Mpc, which is the edge of our detection limit. The southwest merger significantly boosts the surface brightness,more » allowing us to detect X-ray emission out to {approx}2.2 Mpc along this direction. Apart from the southwestern infalling subcluster, the surface brightness profiles show multiple edges around radii of 30-40 arcmin. The azimuthally averaged temperature profile, as well as the deprojected density and pressure profiles, all show a sharp drop consistent with an outwardly-propagating shock front located at 40 arcmin, corresponding to the outermost edge of the giant radio halo observed at 352 MHz with the Westerbork Synthesis Radio Telescope. The shock front may be powering this radio emission. A clear entropy excess inside of r{sub 500} reflects the violent merging events linked with these morphological features. Beyond r{sub 500}, the entropy profiles of the Coma Cluster along the relatively relaxed directions are consistent with the power-law behavior expected from simple models of gravitational large-scale structure formation. The pressure is also in agreement at these radii with the expected values measured from Sunyaev-Zel'dovich data from the Planck satellite. However, due to the large uncertainties associated with the Coma Cluster measurements, we cannot yet exclude an entropy flattening in this system consistent with that seen in more relaxed cool core clusters.« less

Modeling the coma of 2060 Chiron

NASA Technical Reports Server (NTRS)

Boice, D. C.; Konno, I.; Stern, S. Alan; Huebner, W. F.

1991-01-01

Observations of comet-like activity and a resolved coma have established that 2060 Chiron is a comet. Determinations of its radius range from 65 to 200 km. This unusually large size for a comet suggests that the atmosphere of Chiron is intermediate to the tightly bound, thin atmospheres typical of planets and satellite and the greatly extended atmospheres in free expansion typical of cometary comae. Under certain conditions it may gravitationally bind an atmosphere that is thick compared to its size, while a significant amount of gas escapes to an extensive exosphere. These attributes coupled with reports of sporadic outbursts at large heliocentric distances and the identification of CN in the coma make Chiron a challenging object to model. Simple models of gas production and the dusty coma were recently presented but a general concensus on many basic features has not emerged. Development was begun on a more complete coma model of Chiron. The objectives are to report progress on this model and give the preliminary results for understanding Chiron.

Acute Kidney Injury as a Risk Factor for Delirium and Coma during Critical Illness.

PubMed

Siew, Edward D; Fissell, William H; Tripp, Christina M; Blume, Jeffrey D; Wilson, Matthew D; Clark, Amanda J; Vincz, Andrew J; Ely, E Wesley; Pandharipande, Pratik P; Girard, Timothy D

2017-06-15

Acute kidney injury may contribute to distant organ dysfunction. Few studies have examined kidney injury as a risk factor for delirium and coma. To examine whether acute kidney injury is associated with delirium and coma in critically ill adults. In a prospective cohort study of intensive care unit patients with respiratory failure and/or shock, we examined the association between acute kidney injury and daily mental status using multinomial transition models adjusting for demographics, nonrenal organ failure, sepsis, prior mental status, and sedative exposure. Acute kidney injury was characterized daily using the difference between baseline and peak serum creatinine and staged according to Kidney Disease Improving Global Outcomes criteria. Mental status (normal vs. delirium vs. coma) was assessed daily with the Confusion Assessment Method for the ICU and Richmond Agitation-Sedation Scale. Among 466 patients, stage 2 acute kidney injury was a risk factor for delirium (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.07-2.26) and coma (OR, 2.04; 95% CI, 1.25-3.34) as was stage 3 injury (OR for delirium, 2.56; 95% CI, 1.57-4.16) (OR for coma, 3.34; 95% CI, 1.85-6.03). Daily peak serum creatinine (adjusted for baseline) values were also associated with delirium (OR, 1.35; 95% CI, 1.18-1.55) and coma (OR, 1.44; 95% CI, 1.20-1.74). Renal replacement therapy modified the association between stage 3 acute kidney injury and daily peak serum creatinine and both delirium and coma. Acute kidney injury is a risk factor for delirium and coma during critical illness.

Initial Diagnosis and Management of Coma.

PubMed

Traub, Stephen J; Wijdicks, Eelco F

2016-11-01

Coma represents a true medical emergency. Drug intoxications are a leading cause of coma; however, other metabolic disturbances and traumatic brain injury are also common causes. The general emergency department approach begins with stabilization of airway, breathing, and circulation, followed by a thorough physical examination to generate a limited differential diagnosis that is then refined by focused testing. Definitive treatment is ultimately disease-specific. This article presents an overview of the pathophysiology, causes, examination, and treatment of coma. Copyright © 2016 Elsevier Inc. All rights reserved.

[Myxedema coma. A case reported].

PubMed

Rebollo-Gómez, Héctor

2010-01-01

Myxedema coma is a life-threatening condition; it is a complication of untreated hypothyroidism and an endocrine emergency. Most patients are elderly women with a previous history of long-standing hypothyroidism which presents during the winter. The myxedema coma has an insidious onset and it is very rare; its recognition can be quite difficult. Once suspected, treatment can be lifesaving and should be start promptly in anticipation of confirmation of the diagnosis by laboratory test. The mortality rate is high. I presented a case of an old woman with myxedema coma with an undiagnosed hypothyroidism, with altered mental status, normal temperature, pneumonia, hyponatremia and high level of creatine phosphokinase, who presented in the emergency room.

Myxoedema coma presenting in status epilepticus.

PubMed Central

Woods, K. L.; Holmes, G. K.

1977-01-01

A 71-year-old woman with myxoedema coma presenting in status epilepticus is reported. Although this complication of myxoedema coma is considered to be fatal the patient described responded dramatically to treatment and remains in good health. PMID:876913

The Enigmatic (Almost) Dark Galaxy Coma P: The Atomic Interstellar Medium

NASA Astrophysics Data System (ADS)

Ball, Catherine; Cannon, John M.; Leisman, Lukas; Adams, Elizabeth A. K.; Haynes, Martha P.; Józsa, Gyula I. G.; McQuinn, Kristen B. W.; Salzer, John J.; Brunker, Samantha; Giovanelli, Riccardo; Hallenbeck, Gregory; Janesh, William; Janowiecki, Steven; Jones, Michael G.; Rhode, Katherine L.

2018-02-01

We present new high-resolution H I spectral line imaging of Coma P, the brightest H I source in the system HI 1232+20. This galaxy with extremely low surface brightness was first identified in the ALFALFA survey as an “(Almost) Dark” object: a clearly extragalactic H I source with no obvious optical counterpart in existing optical survey data (although faint ultraviolet emission was detected in archival GALEX imaging). Using a combination of data from the Westerbork Synthesis Radio Telescope and the Karl G. Jansky Very Large Array, we investigate the H I morphology and kinematics at a variety of physical scales. The H I morphology is irregular, reaching only moderate maxima in mass surface density (peak {σ }{{H}{{I}}}∼ 10 {M}ȯ pc‑2). Gas of lower surface brightness extends to large radial distances, with the H I diameter measured at 4.0 ± 0.2 kpc inside the 1 {M}ȯ pc‑2 level. We quantify the relationships between mass surface density of H I gas and star formation on timescales of ∼100–200 Myr as traced by GALEX far-ultraviolet emission. While Coma P has regions of dense H I gas reaching the {N}{{H}{{I}}}={10}21 cm‑2 level typically associated with ongoing star formation, it lacks massive star formation as traced by Hα emission. The H I kinematics are extremely complex: a simple model of a rotating disk cannot describe the H I gas in Coma P. Using spatially resolved position–velocity analysis we identify two nearly perpendicular axes of projected rotation that we interpret as either the collision of two H I disks or a significant infall event. Similarly, three-dimensional modeling of the H I dynamics provides a best fit with two H I components. Coma P is just consistent (within 3σ) with the known {M}{{H}{{I}}}{--}{D}{{H}{{I}}} scaling relation. It is either too large for its H I mass, has too low an H I mass for its H I size, or the two H I components artificially extend its H I size. Coma P lies within the empirical scatter at the faint end

The Three Sources of Gas in the Comae of Comets

NASA Technical Reports Server (NTRS)

Huebner, W. F.

1995-01-01

Surface water ice on a comet nucleus is the major source of coma gas. Dust, entrained by coma gas, fragments and vaporizes, forming a second, distributed source of coma gas constituents. Ice species more volatile than water ice below the surface of the nucleus are a third source of coma gas. Vapors from these ices, produced by heat penetrating into the nucleus, diffuse through pores outward into the coma. The second and third sources provide minor, but sometimes easily detectible, gaseous species in the coma. We present mixing ratios of observed minor coma constituents relative to water vapor as a function of heliocentric and cometocentric distances and compare these ratios with model predictions, assuming the sources of the minor species are either coma dust or volatile ices in the nucleus.

Myxedema coma.

PubMed

Kwaku, Maxwell P; Burman, Kenneth D

2007-01-01

Untreated or unrecognized hypothyroidism may progress to severe decompensated hypothyroidism or myxedema coma. Relatively few cases are reported in the literature since the first case was apparently reported from the St. Thomas Hospital in London in 1879. The paucity of cases may be due to either underreporting or improvement in the diagnosis and treatment of uncomplicated hypothyroidism. However, despite the ready availability of sensitive thyrotropin assays, the recognition and treatment of myxedema coma remains a challenge. Although thyroid hormone treatment is highly effective when combined with ventilatory and hemodynamic support in the intensive care unit setting, controversies abound on the optimal and most effective choice of thyroid hormone preparation: thyroxine and triiodothyronine and in what amount. Accumulated evidence now shows that proper use of either thyroxine alone or in combination with triiodothyronine may be effective therapy.

2012/13 abnormal cold winter in Japan associated with Large-scale Atmospheric Circulation and Local Sea Surface Temperature over the Sea of Japan

NASA Astrophysics Data System (ADS)

Ando, Y.; Ogi, M.; Tachibana, Y.

2013-12-01

On Japan, wintertime cold wave has social, economic, psychological and political impacts because of the lack of atomic power stations in the era of post Fukushima world. The colder winter is the more electricity is needed. Wintertime weather of Japan and its prediction has come under the world spotlight. The winter of 2012/13 in Japan was abnormally cold, and such a cold winter has persisted for 3 years. Wintertime climate of Japan is governed by some dominant modes of the large-scale atmospheric circulations. Yasunaka and Hanawa (2008) demonstrated that the two dominant modes - Arctic Oscillation (AO) and Western Pacific (WP) pattern - account for about 65% of the interannual variation of the wintertime mean surface air temperature of Japan. A negative AO brings about cold winter in Japan. In addition, a negative WP also brings about cold winter in Japan. Looking back to the winter of 2012/13, both the negative AO and negative WP continued from October through December. If the previous studies were correct, it would have been extremely very cold from October through December. In fact, in December, in accordance with previous studies, it was colder than normal. Contrary to the expectation, in October and November, it was, however, warmer than normal. This discrepancy signifies that an additional hidden circumstance that heats Japan overwhelms these large-scale atmospheric circulations that cool Japan. In this study, we therefore seek an additional cause of wintertime climate of Japan particularly focusing 2012 as well as the AO and WP. We found that anomalously warm oceanic temperature surrounding Japan overwhelmed influences of the AO or WP. Unlike the inland climate, the island climate can be strongly influenced by surrounding ocean temperature, suggesting that large-scale atmospheric patterns alone do not determine the climate of islands. (a) Time series of a 5-day running mean AO index (blue) as defined by Ogi et al., (2004), who called it the SVNAM index. For

Rapid reduction of acute subdural hematoma and redistribution of hematoma: case report.

PubMed

Watanabe, Arata; Omata, Tomohiro; Kinouchi, Hiroyuki

2010-01-01

An 88-year-old woman presented with acute subdural hematoma (ASDH) which showed rapid resolution on computed tomography (CT) and magnetic resonance (MR) imaging. She was transferred to our hospital after falling out of bed. On admission, she was comatose with Japan Coma Scale score of 200 and Glasgow Coma Scale score of E1V1M2. Brain CT showed a thick left frontotemporal ASDH. Conservative treatment consisted of 200 ml of glycerol administered intravenously twice a day, and maintenance in the approximately 20 degree head-up position to reduce intracranial pressure. Three days later, her consciousness recovered to Japan Coma Scale score of 30 and Glasgow Coma Scale score of E2V4M5. CT showed obvious reduction of the hematoma without brain or scalp swelling. Spinal MR imaging detected no redistribution of hematoma to the spine. The present case illustrates that rapid spontaneous reduction of ASDH may occur by redistribution of hematoma, mainly to the supratentorial subdural space because of brain atrophy.

The reliability of the Glasgow Coma Scale: a systematic review.

PubMed

Reith, Florence C M; Van den Brande, Ruben; Synnot, Anneliese; Gruen, Russell; Maas, Andrew I R

2016-01-01

The Glasgow Coma Scale (GCS) provides a structured method for assessment of the level of consciousness. Its derived sum score is applied in research and adopted in intensive care unit scoring systems. Controversy exists on the reliability of the GCS. The aim of this systematic review was to summarize evidence on the reliability of the GCS. A literature search was undertaken in MEDLINE, EMBASE and CINAHL. Observational studies that assessed the reliability of the GCS, expressed by a statistical measure, were included. Methodological quality was evaluated with the consensus-based standards for the selection of health measurement instruments checklist and its influence on results considered. Reliability estimates were synthesized narratively. We identified 52 relevant studies that showed significant heterogeneity in the type of reliability estimates used, patients studied, setting and characteristics of observers. Methodological quality was good (n = 7), fair (n = 18) or poor (n = 27). In good quality studies, kappa values were ≥0.6 in 85%, and all intraclass correlation coefficients indicated excellent reliability. Poor quality studies showed lower reliability estimates. Reliability for the GCS components was higher than for the sum score. Factors that may influence reliability include education and training, the level of consciousness and type of stimuli used. Only 13% of studies were of good quality and inconsistency in reported reliability estimates was found. Although the reliability was adequate in good quality studies, further improvement is desirable. From a methodological perspective, the quality of reliability studies needs to be improved. From a clinical perspective, a renewed focus on training/education and standardization of assessment is required.

The origin of low mass particles within and beyond the dust coma envelopes of Comet Halley

NASA Technical Reports Server (NTRS)

Simpson, J. A.; Rabinowitz, D.; Tuzzolino, A. J.; Ksanfomality, L. V.; Sagdeev, R. Z.

1987-01-01

Measurements from the Dust Counter and Mass Analyzer (DUCMA) instruments on VEGA-1 and -2 revealed unexpected fluxes of low mass (up to 10 to the minus 13th power g) dust particles at very great distances from the nucleus (300,000 to 600,000 km). These particles are detected in clusters (10 sec duration), preceded and followed by relatively long time intervals during which no dust is detected. This cluster phenomenon also occurs inside the envelope boundaries. Clusters of low mass particles are intermixed with the overall dust distribution throughout the coma. The clusters account for many of the short-term small-scale intensity enhancements previously ascribed to microjets in the coma. The origin of these clusters appears to be emission from the nucleus of large conglomerates which disintegrate in the coma to yield clusters of discrete, small particles continuing outward to the distant coma.

Chemical and Hydrodynamical Models of Cometary Comae

NASA Technical Reports Server (NTRS)

Charnley, Steven

2012-01-01

Multi-fluid modelling of the outflowing gases which sublimate from cometary nuclei as they approach the Sun is necessary for understanding the important physical and chemical processes occurring in this complex plasma. Coma chemistry models can be employed to interpret observational data and to ultimately determine chemical composition and structure of the nuclear ices and dust. We describe a combined chemical and hydrodynamical model [1] in which differential equations for the chemical abundances and the energy balance are solved as a function of distance from the cometary nucleus. The presence of negative ions (anions) in cometary comae is known from Giotto mass spectrometry of 1P/Halley. The anions O(-), OH(-), C(-), CH(-) and CN(-) have been detected, as well as unidentified anions with masses 22-65 and 85-110 amu [2]. Organic molecular anions such as C4H(-) and C6H(-) are known to have a significant impact on the charge balance of interstellar clouds and circumstellar envelopes and have been shown to act as catalysts for the gas-phase synthesis of larger hydrocarbon molecules in the ISM, but their importance in cometary comae has not yet been fully explored. We present details of new models for the chemistry of cometary comae that include atomic and molecular anions and calculate the impact of these anions on the coma physics and chemistry af the coma.

Observational data needs useful for modeling the coma

NASA Technical Reports Server (NTRS)

Huebner, W. F.; Giguere, P. T.

1981-01-01

A computer model of comet comae is described; results from assumed composition of frozen gases are summarized and compared to coma observations. Restrictions on relative abundance of some frozen constituents are illustrated. Modeling, when tightly coupled to observational data, can be important for comprehensive analysis of observations, for predicting undetected molecular species and for improved understanding of coma and nucleus. To accomplish this, total gas production rates and relative elemental abundances of H:C:N:O:S are needed as a function of heliocentric distance of the comet. Also needed are relative column densitites and column density profiles with well defined diaphragm range and pointing position on the coma. Production rates are less desirable since they are model dependent. Total number (or upper limits) of molecules in the coma and analysis of unidentified spectral lines are needed also.

Coma Recovery Scale-Revised: evidentiary support for hierarchical grading of level of consciousness.

PubMed

Gerrard, Paul; Zafonte, Ross; Giacino, Joseph T

2014-12-01

To investigate the neurobehavioral pattern of recovery of consciousness as reflected by performance on the subscales of the Coma Recovery Scale-Revised (CRS-R). Retrospective item response theory (IRT) and factor analysis. Inpatient rehabilitation facilities. Rehabilitation inpatients (N=180) with posttraumatic disturbance in consciousness who participated in a double-blinded, randomized, controlled drug trial. Not applicable. Scores on CRS-R subscales. The CRS-R was found to fit factor analytic models adhering to the assumptions of unidimensionality and monotonicity. In addition, subscales were mutually independent based on residual correlations. Nonparametric IRT reaffirmed the finding of monotonicity. A highly constrained confirmatory factor analysis model, which imposed equal factor loadings on all items, was found to fit the data well and was used to estimate a 1-parameter IRT model. This study provides evidence of the unidimensionality of the CRS-R and supports the hierarchical structure of the CRS-R subscales, suggesting that it is an effective tool for establishing diagnosis and monitoring recovery of consciousness after severe traumatic brain injury. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

[Thyroid Storm and Myxedema Coma].

PubMed

Milkau, Malte; Sayk, Friedhelm

2018-03-01

Thyroid storm and myxedema coma are the most severe clinical forms of thyroid dysfunction. While both hyper- and hypothyroidsm are common diseases, thyroid storm and myxedema coma are rare. Due to their unspecific signs and symptoms they are often difficult to diagnose. Both disorders are medical emergencies, which still show a significant mortality. The following article summarizes diagnostic tools and treatment options for these disorders. © Georg Thieme Verlag KG Stuttgart · New York.

Myxedema coma after esophagectomy.

PubMed

Yuan, Yong; Hu, Yang; Xie, Tianpeng; Zhao, Yongfan

2010-07-01

For most patients with esophageal cancer, esophagectomy is an effective therapy. Perioperative management is critical for clinical outcomes after the operation. Great efforts should be made to avoid postoperative complications. We report myxedema coma, an emergency condition caused by severe hypothyroidism, after a patient underwent esophagectomy for esophageal cancer. The patient was successfully treated with intravenous levothyroxine. We strongly recommend that physicians test the thyroid hormone levels in patients with risk factors. If myxedema coma occurs, immediate use of intravenous levothyroxine is effective for this lethal complication. Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Models for Cometary Comae Containing Negative Ions

NASA Technical Reports Server (NTRS)

Cordiner, M. A.; Charnley, S. B.

2012-01-01

The presence of negative ions (anions) in cometary comae is known from Giotto mass spectrometry of IP/Halley. The anions O(-), OH(-), C(-), CH(-) and CN(-) have been detected, as well as unidentified anions with masses 22-65 and 85-110 amu [I]. Organic molecular anions such as C4H(-) and C6H(-) are known to have a significant impact on the charge balance of interstellar clouds and circumstellar envelopes and have been shown to act as catalysts for the gas phase synthesis of larger hydrocarbon molecules in the ISM, but their importance in cometary comae has not yet been fully explored. We present details of our new models for the chemistry of cometary comae that include atomic and molecular anions. We calculate the impact of these anions on the charge balance and examine their importance for cometary coma chemistry.

The Spinning Corona of FK Comae

NASA Astrophysics Data System (ADS)

Kashyap, Vinay

2010-09-01

FK Comae is an ultra-fast rotating, single yellow giant, product of a recent W UMa merger. Extraordinary levels of FUV and X-ray emission rate FK Comae a coronal powerhouse on par with the most extreme of the better known activity heavyweights: short-period RS CVn binaries. As a single star, FK Comae has clear advantages as a laboratory for exploring the outer limits of magnetospheric activity among the coronal cool stars. FK Comae has a long history of attention at optical and X-ray wavelengths, thanks to its generously spotted surface, and proclivity to flare regularly at high energies. FUSE discovered ultra-broad, redshifted profiles of OVI and CIII, but unfortunately the singular observation could not be repeated, thanks to the satellite's flaky attitude system. The remarkable FUV spectrum was taken just a few months before STIS failed in 2004, so there was no opportunity to turn the more powerful gaze of Hubble to the task. Now, finally, the amazing sensitivity of Cosmic Origins Spectrograph can be brought to bear: a single orbit can capture an FUV spectrum of FK Comae with S/N at instrumental limits for bright lines, and digging down to faint FeXXI 1354 {bridge to the coordinated Chandra HETGS pointing we are carrying out}.We will trace how the bright FUV regions relate spatially to the photospheric dark spots, to inform ideas of coronal structure and heating in these advanced objects. We will probe whether a global magnetosphere exists, and whether the field lines are loaded with hot coronal gas {>10 MK}, as well as the cooler 0.3 MK material already suggested by highly broadened FUSE OVI. Further, we will test whether the striking 100 km/s redshifts of the FUV lines, and similar shifts seen in NeX by Chandra HETGS, are caused by persistent coronal flows {outflows, perhaps implicated in magnetic braking; or inflows, like "coronal rain" on the Sun}. Our method is to exploit, on the one hand, emission-line "Doppler imaging," whereby bright surface regions are

Variation in Risk-Standardized Mortality of Stroke among Hospitals in Japan.

PubMed

Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

2015-01-01

Despite recent advances in care, stroke remains a life-threatening disease. Little is known about current hospital mortality with stroke and how it varies by hospital in a national clinical setting in Japan. Using the Diagnosis Procedure Combination database (a national inpatient database in Japan), we identified patients aged ≥ 20 years who were admitted to the hospital with a primary diagnosis of stroke within 3 days of stroke onset from April 2012 to March 2013. We constructed a multivariable logistic regression model to predict in-hospital death for each patient with patient-level factors, including age, sex, type of stroke, Japan Coma Scale, and modified Rankin Scale. We defined risk-standardized mortality ratio as the ratio of the actual number of in-hospital deaths to the expected number of such deaths for each hospital. A hospital-level multivariable linear regression was modeled to analyze the association between risk-standardized mortality ratio and hospital-level factors. We performed a patient-level Cox regression analysis to examine the association of in-hospital death with both patient-level and hospital-level factors. Of 176,753 eligible patients from 894 hospitals, overall in-hospital mortality was 10.8%. The risk-standardized mortality ratio for stroke varied widely among the hospitals; the proportions of hospitals with risk-standardized mortality ratio categories of ≤ 0.50, 0.51-1.00, 1.01-1.50, 1.51-2.00, and >2.00 were 3.9%, 47.9%, 41.4%, 5.2%, and 1.5%, respectively. Academic status, presence of a stroke care unit, higher hospital volume and availability of endovascular therapy had a significantly lower risk-standardized mortality ratio; distance from the patient's residence to the hospital was not associated with the risk-standardized mortality ratio. Our results suggest that stroke-ready hospitals play an important role in improving stroke mortality in Japan.

Myxedema coma leading to respiratory depression in a dog.

PubMed

Atkinson, Kathryn; Aubert, Isabelle

2004-04-01

A 10-year-old, intact male, cocker spaniel was presented with hypothermia, without shivering, and progressive stupor leading to coma. Myxedema coma, potentially precipitated by diuretic therapy, was tentatively diagnosed and treatment initiated, but progressive respiratory depression led to the decision to euthanize. Postmortem findings supported the diagnosis of myxedema coma.

Long-lasting functional disabilities in patients who recover from coma after cardiac operations.

PubMed

Rodriguez, Rosendo A; Nair, Shona; Bussière, Miguel; Nathan, Howard J

2013-03-01

Uncertainty regarding the long-term functional outcome of patients who awaken from coma after cardiac operations is difficult for families and physicians and may delay rehabilitation. We studied the long-term functional status of these patients to determine if duration of coma predicted outcome. We followed 71 patients who underwent cardiac operations; recovered their ability to respond to verbal commands after coma associated with postoperative stroke, encephalopathy, and/or seizures; and were discharged from the hospital. The Glasgow Outcome Scale Extended (GOSE) was used to assess functional disability 2 to 4 years after discharge. Outcomes were classified as favorable (GOSE scores 7 and 8) and unfavorable (GOSE scores 1-6). Of 71 patients identified, 39 were interviewed, 15 died, 1 refused to be interviewed, and 16 were lost to follow-up. Of the 54 patients with completed GOSE evaluations, only 15 (28%) had favorable outcomes. Among patients with unfavorable outcomes, 15 (28%) died, 14 (26%) survived with moderate disabilities, and 10 (18%) had severe disabilities. Factors associated with unfavorable outcomes were increases in duration of coma (p = 0.007), time in intensive care (p = 0.006), length of hospitalization (p = 0.004), and postoperative serum creatine kinase levels (p = 0.006). Only duration of coma was an independent predictor of unfavorable outcome (odds ratio [OR], 1.25; 95% confidence interval [CI], 1.008-1.537; p = 0.042). Patients with durations of coma greater than 4 days were more likely to have unfavorable outcomes (OR, 5.1; 95% CI, 1.3-21.3; p = 0.02). Two thirds of comatose patients who survived to discharge after cardiac operations had unfavorable long-term functional outcomes. A longer duration of unconsciousness is a predictor of unfavorable outcome. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Myxedema coma leading to respiratory depression in a dog

PubMed Central

2004-01-01

Abstract A 10-year-old, intact male, cocker spaniel was presented with hypothermia, without shivering, and progressive stupor leading to coma. Myxedema coma, potentially precipitated by diuretic therapy, was tentatively diagnosed and treatment initiated, but progressive respiratory depression led to the decision to euthanize. Postmortem findings supported the diagnosis of myxedema coma. PMID:15144105

[Thyrotoxic storm and myxedema coma].

PubMed

Takasu, N

1999-08-01

Thyrotoxic or hyperthyroid storm is a grave, life-threatening, but relatively infrequent medical emergency. Immediate causes of death in this emergency are severe hyperpyrexia and pulmonary edema associated with arrhythmias, shock, and coma. This emergency is found in Graves' patients most frequently. Myxedema coma is an emergency clinical state caused by severe deficiency of thyroid hormones. This crisis represents the extreme expression of hypothyroidism. While it is quite useful to elicit a history of previous hypothyroidism, thyroid surgery, or radioactive iodine treatment, it is not obtainable.

Poor outcome prediction by burst suppression ratio in adults with post-anoxic coma without hypothermia.

PubMed

Yang, Qinglin; Su, Yingying; Hussain, Mohammed; Chen, Weibi; Ye, Hong; Gao, Daiquan; Tian, Fei

2014-05-01

Burst suppression ratio (BSR) is a quantitative electroencephalography (qEEG) parameter. The purpose of our study was to compare the accuracy of BSR when compared to other EEG parameters in predicting poor outcomes in adults who sustained post-anoxic coma while not being subjected to therapeutic hypothermia. EEG was registered and recorded at least once within 7 days of post-anoxic coma onset. Electrodes were placed according to the international 10-20 system, using a 16-channel layout. Each EEG expert scored raw EEG using a grading scale adapted from Young and scored amplitude-integrated electroencephalography tracings, in addition to obtaining qEEG parameters defined as BSR with a defined threshold. Glasgow outcome scales of 1 and 2 at 3 months, determined by two blinded neurologists, were defined as poor outcome. Sixty patients with Glasgow coma scale score of 8 or less after anoxic accident were included. The sensitivity (97.1%), specificity (73.3%), positive predictive value (82.5%), and negative prediction value (95.0%) of BSR in predicting poor outcome were higher than other EEG variables. BSR1 and BSR2 were reliable in predicting death (area under the curve > 0.8, P < 0.05), with the respective cutoff points being 39.8% and 61.6%. BSR1 was reliable in predicting poor outcome (area under the curve  =  0.820, P < 0.05) with a cutoff point of 23.9%. BSR1 was also an independent predictor of increased risk of death (odds ratio  =  1.042, 95% confidence intervals: 1.012-1.073, P  =  0.006). BSR may be a better predictor in prognosticating poor outcomes in patients with post-anoxic coma who do not undergo therapeutic hypothermia when compared to other qEEG parameters.

Jet morphology and coma analysis of comet 103P/Hartley 2

NASA Astrophysics Data System (ADS)

Vaughan, Charles M.

In 2010, comet 103P/Hartley 2 was observed pre- and post-perihelion using the George and Cynthia Mitchell Integral Field Spectrometer on the 2.7-m telescope at McDonald Observatory in Texas. Data for gaseous radicals C2, C3, CH, CN, and NH2 were collected over six nights from 15 July to 10 November. The spectral data were used to create coma maps for each of the observed species, and the maps were processed using radial and azimuthal mean division techniques to create enhanced images of the coma, revealing subtle morphological features. 340 enhanced coma images were created for each observation and species. Visual inspection reveals that the coma is heterogeneous between the five detected radicals, and statistical analyses verify this result. To compliment the ongoing investigation of Hartley 2 as studied by the EPOXI flyby mission, findings from other researchers (Belton et al., 2012; Syal et al., 2012; and Thomas et al., 2012) are used to characterize the nucleus spin state and identify dust jet locations on the nucleus. With rotational period measurements from EPOXI, dust jet vectors on the nucleus surface are rotated to relevant observation times in November to compare the computed jet directions with the radical densities in the coma. Dust jet sites on the smaller nucleus lobe show a stronger correlation with high radical concentrations than the dust sites on the larger nucleus lobe. Production rates for potential parentage of radical species are calculated using the radial outflow Haser model (Haser, 1957), which are compared to mixing ratios relative to water from separate campaigns to constrain parentage. NH3 is likely the sole producer of NH2, whereas CN may be produced from a combination of HCN, C2N2, and CH3CN. Traditional parentage of C2, C3, and CH do not yield acceptable fits or suitable mixing ratios with the Haser model, and it is possible that extended coma ices having relatively short scale lengths greatly contribute to production of these

Validation of an Interview-Based Rating Scale Developed in Japan for Pervasive Developmental Disorders

ERIC Educational Resources Information Center

Ito, Hiroyuki; Tani, Iori; Yukihiro, Ryoji; Adachi, Jun; Hara, Koichi; Ogasawara, Megumi; Inoue, Masahiko; Kamio, Yoko; Nakamura, Kazuhiko; Uchiyama, Tokio; Ichikawa, Hironobu; Sugiyama, Toshiro; Hagiwara, Taku; Tsujii, Masatsugu

2012-01-01

The pervasive developmental disorders (PDDs) Autism Society Japan Rating Scale (PARS), an interview-based instrument for evaluating PDDs, has been developed in Japan with the aim of providing a method that (1) can be used to evaluate PDD symptoms and related support needs and (2) is simpler and easier than the currently used "gold…

Coma measurement by transmission image sensor with a PSM

NASA Astrophysics Data System (ADS)

Wang, Fan; Wang, Xiangzhao; Ma, Mingying; Zhang, Dongqing; Shi, Weijie; Hu, Jianming

2005-01-01

As feature size decreases, especially with the use of resolution enhancement technique such as off axis illumination and phase shifting mask, fast and accurate in-situ measurement of coma has become very important in improving the performance of modern lithographic tools. The measurement of coma can be achieved by the transmission image sensor, which is an aerial image measurement device. The coma can be determined by measuring the positions of the aerial image at multiple illumination settings. In the present paper, we improve the measurement accuracy of the above technique with an alternating phase shifting mask. Using the scalar diffraction theory, we analyze the effect of coma on the aerial image. To analyze the effect of the alternating phase shifting mask, we compare the pupil filling of the mark used in the above technique with that of the phase-shifted mark used in the new technique. We calculate the coma-induced image displacements of the marks at multiple partial coherence and NA settings, using the PROLITH simulation program. The simulation results show that the accuracy of coma measurement can increase approximately 20 percent using the alternating phase shifting mask.

Which EEG patterns in coma are nonconvulsive status epilepticus?

PubMed

Trinka, Eugen; Leitinger, Markus

2015-08-01

Nonconvulsive status epilepticus (NCSE) is common in patients with coma with a prevalence between 5% and 48%. Patients in deep coma may exhibit epileptiform EEG patterns, such as generalized periodic spikes, and there is an ongoing debate about the relationship of these patterns and NCSE. The purposes of this review are (i) to discuss the various EEG patterns found in coma, its fluctuations, and transitions and (ii) to propose modified criteria for NCSE in coma. Classical coma patterns such as diffuse polymorphic delta activity, spindle coma, alpha/theta coma, low output voltage, or burst suppression do not reflect NCSE. Any ictal patterns with a typical spatiotemporal evolution or epileptiform discharges faster than 2.5 Hz in a comatose patient reflect nonconvulsive seizures or NCSE and should be treated. Generalized periodic diacharges or lateralized periodic discharges (GPDs/LPDs) with a frequency of less than 2.5 Hz or rhythmic discharges (RDs) faster than 0.5 Hz are the borderland of NCSE in coma. In these cases, at least one of the additional criteria is needed to diagnose NCSE (a) subtle clinical ictal phenomena, (b) typical spatiotemporal evolution, or (c) response to antiepileptic drug treatment. There is currently no consensus about how long these patterns must be present to qualify for NCSE, and the distinction from nonconvulsive seizures in patients with critical illness or in comatose patients seems arbitrary. The Salzburg Consensus Criteria for NCSE [1] have been modified according to the Standardized Terminology of the American Clinical Neurophysiology Society [2] and validated in three different cohorts, with a sensitivity of 97.2%, a specificity of 95.9%, and a diagnostic accuracy of 96.3% in patients with clinical signs of NCSE. Their diagnostic utility in different cohorts with patients in deep coma has to be studied in the future. This article is part of a Special Issue entitled "Status Epilepticus". Copyright © 2015. Published by Elsevier Inc.

New red jewels in Coma Berenices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Terrien, Ryan C.; Mahadevan, Suvrath; Deshpande, Rohit

2014-02-20

We have used Sloan Digital Sky Survey-III (SDSS-III) Apache Point Observatory Galactic Evolution Experiment (APOGEE) radial velocity observations in the near-infrared H-band to explore the membership of the nearby (86.7 ± 0.9 pc) open cluster Coma Berenices (Melotte 111), concentrating on the poorly populated low-mass end of the main sequence. Using SDSS-III APOGEE radial velocity measurements, we confirm the membership of eight K/M dwarf members, providing the first confirmed low-mass members of the Coma Berenices cluster. Using R ∼ 2000 spectra from IRTF-SpeX, we confirm the independently luminosity classes of these targets, and find their metallicities to be consistent withmore » the known solar mean metallicity of Coma Berenices and of M dwarfs in the solar neighborhood. In addition, the APOGEE spectra have enabled measurement of vsin i for each target and detection for the first time of the low-mass secondary components of the known binary systems Melotte 111 102 and Melotte 111 120, as well as identification of the previously unknown binary system 2MASS J12214070+2707510. Finally, we use Kilodegree Extremely Little Telescope photometry to measure photometric variability and rotation periods for a subset of the Coma Berenices members.« less

Myxedema coma in a patient with Down's syndrome.

PubMed

Bansal, Darpan; Nanda, Ashish; Gupta, Ekta; Croker, Mary; Williams, Misty L; Bacchus, Amy; Simmons, Debra; Erbland, Marcia

2006-11-01

hyroid dysfunction is common in Down's syndrome, most common being hypothyroidism. Longstanding, untreated hypothyroidism can lead to myxedema coma. Here we report a patient with Down's syndrome who presented with myxedema coma. The three essential elements for the diagnosis of myxedema coma include altered mental status, defective thermoregulation and a precipitating event or illness; all of these were present in our patient. Also, very high TSH, low T3 and T4, and the rapid response to the treatment with levothyroxine confirmed the diagnosis. Patients with Down's syndrome should have regular screening for thyroid dysfunction.

Glasgow Coma Scale and Outcomes after Structural Traumatic Head Injury in Early Childhood

PubMed Central

Heather, Natasha L.; Derraik, José G. B.; Beca, John; Hofman, Paul L.; Dansey, Rangi; Hamill, James; Cutfield, Wayne S.

2013-01-01

Objective To assess the association of the Glasgow Coma Scale (GCS) with radiological evidence of head injury (the Abbreviated Injury Scale for the head region, AIS-HR) in young children hospitalized with traumatic head injury (THI), and the predictive value of GCS and AIS-HR scores for long-term impairment. Methods Our study involved a 10-year retrospective review of a database encompassing all patients admitted to Starship Children’s Hospital (Auckland, New Zealand, 2000–2010) with THI. Results We studied 619 children aged <5 years at the time of THI, with long-term outcome data available for 161 subjects. Both GCS and AIS-HR scores were predictive of length of intensive care unit and hospital stay (all p<0.001). GCS was correlated with AIS-HR (ρ=-0.46; p<0.001), although mild GCS scores (13–15) commonly under-estimated the severity of radiological injury: 42% of children with mild GCS scores had serious–critical THI (AIS-HR 3–5). Increasingly severe GCS or AIS-HR scores were both associated with a greater likelihood of long-term impairment (neurological disability, residual problems, and educational support). However, long-term impairment was also relatively common in children with mild GCS scores paired with structural THI more severe than a simple linear skull fracture. Conclusion Severe GCS scores will identify most cases of severe radiological injury in early childhood, and are good predictors of poor long-term outcome. However, young children admitted to hospital with structural THI and mild GCS scores have an appreciable risk of long-term disability, and also warrant long-term follow-up. PMID:24312648

Burst Suppression on Processed Electroencephalography as a Predictor of Post-Coma Delirium in Mechanically Ventilated ICU Patients

PubMed Central

Andresen, Jennifer M.; Girard, Timothy D.; Pandharipande, Pratik P.; Davidson, Mario A.; Ely, E. Wesley; Watson, Paula L.

2015-01-01

Objectives Many patients, due to a combination of illness and sedatives, spend a considerable amount of time in a comatose state that can include time in burst suppression. We sought to determine if burst suppression measured by processed electroencephalography (pEEG) during coma in sedative-exposed patients is a predictor of post-coma delirium during critical illness. Design Observational convenience sample cohort Setting Medical and surgical ICUs in a tertiary care medical center Patients Cohort of 124 mechanically ventilated ICU patients Measurements and Main Results Depth of sedation was monitored twice daily using the Richmond Agitation-Sedation Scale and continuously monitored by pEEG. When non-comatose, patients were assessed for delirium twice daily using Confusion Assessment Method for the ICU (CAM-ICU). Multiple logistic regression and Cox proportional hazards regression were used to assess associations between time in burst suppression and both incidence and time to resolution of delirium, respectively, adjusting for time in deep sedation and a principal component score consisting of APACHE II score and cumulative doses of sedatives while comatose. Of the 124 patients enrolled and monitored, 55 patients either never had coma or never emerged from coma yielding 69 patients for whom we performed these analyses; 42 of these 69 (61%) had post-coma delirium. Most patients had burst-suppression during coma, though often short-lived [ median (intraquartile range) time in burst suppression, 6.4 (1-58) minutes]. After adjusting for covariates, even this short time in burst suppression independently predicted a higher incidence of post-coma delirium [odds ratio 4.16; 95% confidence interval (CI) 1.27-13.62; p=0.02] and a lower likelihood (delayed) resolution of delirium (hazard ratio 0.78; 95% CI 0.53-0.98; p=0.04). Conclusions Time in burst suppression during coma, as measured by processed EEG, was an independent predictor of incidence and time to resolution of

FK Comae, King of Spin: the Movie

NASA Astrophysics Data System (ADS)

Ayres, Thomas

2010-09-01

FK Comae is an ultra-fast rotating, single yellow giant, product of a recent W UMa merger. Extraordinary levels of FUV and X-ray emission rate FK Comae a coronal powerhouse on par with the most extreme of the better known activity heavyweights: short-period RS CVn binaries. As a single star, FK Comae has clear advantages as a laboratory for exploring the outer limits of magnetospheric activity among the coronal cool stars. FK Comae has a long history of attention at optical and X-ray wavelengths, thanks to its generously spotted surface, and proclivity to flare regularly at high energies. FUSE discovered ultra-broad, redshifted profiles of O VI and C III, but unfortunately the singular observation could not be repeated, thanks to the satellite's flaky attitude system. The remarkable FUV spectrum was taken just a few months before STIS failed in 2004, so there was no opportunity to turn the more powerful gaze of Hubble to the task. Now, finally, the amazing sensitivity of Cosmic Origins Spectrograph can be brought to bear: a single orbit can capture an FUV spectrum of FK Comae with S/N at instrumental limits for bright lines, and digging down to faint Fe XXI 1354 {bridge to the coordinated Chandra HETGS pointing we also are proposing}.We will trace how the bright FUV regions relate spatially to the photospheric dark spots, to inform ideas of coronal structure and heating in these advanced objects. We will probe whether a global magnetosphere exists, and whether the field lines are loaded with hot coronal gas {>10 MK}, as well as the cooler 0.3 MK material already suggested by highly broadened FUSE O VI. Further, we will test whether the striking 100 km/s redshifts of the FUV lines, and similar shifts seen in Ne X by Chandra HETGS, are caused by a massive coronal outflow {perhaps implicated in magnetic braking}. Our method is to exploit, on the one hand, emission-line "Doppler imaging," whereby bright surface regions are mapped onto specific locations in the global

A CO2-rich coma model applied to the neutral coma of Comet West

NASA Technical Reports Server (NTRS)

Mitchell, G. F.; Swift, M. B.; Huntress, W. T.

1982-01-01

Models of the cometary coma in which the dominant volatile is CO2 have been constructed for a range of heliocentric distances. Model coma abundances of C2, C3, and CN are compared with the abundances observed in Comet West and are found to be in good agreement. Furthermore, the variation with heliocentric distance of C2, C3, and CN model abundances agree well with the observed variation in Comet West. The present work lends detailed support to a previous suggestion that a substance more volatile than water, such as CO2, controls the evaporation of the nucleus of Comet West. The implications for cometary formation are briefly discussed.

Clinical, Radiologic, and Legal Significance of "Extensor Response" in Posttraumatic Coma.

PubMed

Firsching, Raimund; Woischneck, Dieter; Langejürgen, Alexander; Parreidt, Andreas; Bondar, Imre; Skalej, Martin; Röhl, Friedrich; Voellger, Benjamin

2015-11-01

The timely detection of neurologic deterioration can be critical for the survival of a neurosurgical patient following head injury. Because little reliable evidence is available on the prognostic value of the clinical sign "extensor response" in comatose posttraumatic patients, we investigated the correlation of this clinical sign with outcome and with early radiologic findings from magnetic resonance imaging (MRI). This retrospective analysis of prospectively obtained data included 157 patients who had remained in a coma for a minimum of 24 hours after traumatic brain injury. All patients received a 1.5-T MRI within 10 days (median: 2 days) of the injury. The correlations between clinical findings 12 and 24 hours after the injury-in particular, extensor response and pupillary function, MRI findings, and outcome after 1 year-were investigated. Statistical analysis included contingency tables, Fisher exact test, odds ratios (ORs) with confidence intervals (CIs), and weighted κ values. There were 48 patients with extensor response within the first 24 hours after the injury. Patients with extensor response (World Federation of Neurosurgical Societies coma grade III) statistically were significantly more likely to harbor MRI lesions in the brainstem when compared with patients in a coma who had no further deficiencies (coma grade I; p = 0.0004 by Fisher exact test, OR 10.8 with 95% CI, 2.7-42.5) and patients with unilateral loss of pupil function (coma grade II; p = 0.0187, OR 2.8 with 95% CI, 1.2-6.5). The correlation of brainstem lesions as found by MRI and outcome according to the Glasgow Outcome Scale after 1 year was also highly significant (p ≤ 0.016). The correlation of extensor response and loss of pupil function with an unfavorable outcome and with brainstem lesions revealed by MRI is highly significant. Their sudden onset may be associated with the sudden onset of brainstem dysfunction and should therefore be regarded as one of the most

Myxedema Coma.

PubMed

Munir, Atif

2018-01-01

Myxedema may be the first presentation of patients with undiagnosed hypothyroidism. Definitive management is with thyroid hormone but supportive measures, identification and treatment of precipitating factors in an appropriately safe environment are vital. There is no consensus about preferred thyroid hormone regimen. Corticosteroid therapy is given until adrenal insufficiency has been excluded. We present here a case of seventy-four years old woman of myxodema coma.

Observing RAM Pressure Stripping and Morphological Transformation in the Coma Cluster

NASA Astrophysics Data System (ADS)

Gregg, Michael; West, Michael

2017-07-01

The two largest spirals in the Coma cluster, NGC4911 and NGC4921, are being vigorously ram-pressure stripped by the hot intracluster medium. Our HST ACS and WFC3 images have revealed galactic scale shock fronts, giant "Pillars of Creation", rivulets of dust, and spatially coherent star formation in these grand design spirals. We have now obtained HST WFC3 imaging of five additional large Coma spirals to search for and investigate the effects of ram pressure stripping across the wider cluster environment. The results are equally spectacular as the first two examples. The geometry of the interactions in some cases allows an estimation of the various time scales involved, including gas flows out of the disk leading to creation of the ICM, and the attendant triggered star formation in the galaxy disks. The global star formation patterns yield insights into the spatial and temporal ISM-ICM interactions driving cluster galaxy evolution and ultimately transforming morphologies from spiral to S0. These processes were much more common in the early Universe when the intergalactic and intracluster components were initially created from stripping and destruction of member galaxies.

Coma cluster of galaxies

NASA Technical Reports Server (NTRS)

1999-01-01

Atlas Image mosaic, covering 34' x 34' on the sky, of the Coma cluster, aka Abell 1656. This is a particularly rich cluster of individual galaxies (over 1000 members), most prominently the two giant ellipticals, NGC 4874 (right) and NGC 4889 (left). The remaining members are mostly smaller ellipticals, but spiral galaxies are also evident in the 2MASS image. The cluster is seen toward the constellation Coma Berenices, but is actually at a distance of about 100 Mpc (330 million light years, or a redshift of 0.023) from us. At this distance, the cluster is in what is known as the 'Hubble flow,' or the overall expansion of the Universe. As such, astronomers can measure the Hubble Constant, or the universal expansion rate, based on the distance to this cluster. Large, rich clusters, such as Coma, allow astronomers to measure the 'missing mass,' i.e., the matter in the cluster that we cannot see, since it gravitationally influences the motions of the member galaxies within the cluster. The near-infrared maps the overall luminous mass content of the member galaxies, since the light at these wavelengths is dominated by the more numerous older stellar populations. Galaxies, as seen by 2MASS, look fairly smooth and homogeneous, as can be seen from the Hubble 'tuning fork' diagram of near-infrared galaxy morphology. Image mosaic by S. Van Dyk (IPAC).

Myxedema coma with cardiac tamponade and severe cardiomyopathy.

PubMed

Majid-Moosa, Abdulla; Schussler, Jeffrey M; Mora, Adan

2015-10-01

Myxedema coma is an infrequent but potentially fatal complication of hypothyroidism. We present a rare case of previously undiagnosed hypothyroidism presenting in cardiogenic shock from pericardial tamponade and depressed myocardial contractility in myxedema coma. Here, we focus on cardiovascular complications associated with the condition.

A Dusty Coma Model of Comet Hyakutake

NASA Astrophysics Data System (ADS)

Boice, D. C.; Benkhoff, J.

1996-09-01

We present a multifluid, hydrodynamic model for the gas, dust, and plasma flow in a cometary coma appropriate for Comet Hyakutake. The model accounts for three sources of gas release: sublimation from surface ices, transport of gas from subsurface regions through the surface, and release of gas from dust in the coma. The simulations are based on a spherically symmetric neutral coma model with detailed photo and gas-phase chemistry and dust entrainment by the gas. The model includes a separate energy balance for the electrons, separate flow of the neutral gas, fast neutral atomic and molecular hydrogen, and dust entrainment with fragmentation. The simulations allow a study of how certain features of a cometary coma, e.g., spatial distributions of gas-phase species and dust of various sizes, change with heliocentric distance. Special attention is given to observations of hydrocarbon and sulphur species. In comparison with observations, the model can be used to characterize the environment surrounding Hyakutake and aid in assimilating a variety of diverse observations of this bright comet. A complete description of the model and more extensive results with comparisons to observations where possible will be presented.

Diagnosis of reversible causes of coma.

PubMed

Edlow, Jonathan A; Rabinstein, Alejandro; Traub, Stephen J; Wijdicks, Eelco F M

2014-12-06

Because coma has many causes, physicians must develop a structured, algorithmic approach to diagnose and treat reversible causes rapidly. The three main mechanisms of coma are structural brain lesions, diffuse neuronal dysfunction, and, rarely, psychiatric causes. The first priority is to stabilise the patient by treatment of life-threatening conditions, then to use the history, physical examination, and laboratory findings to identify structural causes and diagnose treatable disorders. Some patients have a clear diagnosis. In those who do not, the first decision is whether brain imaging is needed. Imaging should be done in post-traumatic coma or when structural brain lesions are probable or possible causes. Patients who do not undergo imaging should be reassessed regularly. If CT is non-diagnostic, a checklist should be used use to indicate whether advanced imaging is needed or evidence is present of a treatable poisoning or infection, seizures including non-convulsive status epilepticus, endocrinopathy, or thiamine deficiency. Copyright © 2014 Elsevier Ltd. All rights reserved.

The effects of hypoglycemic and alcoholic coma on the blood-brain barrier permeability

PubMed Central

Yorulmaz, Hatice; Seker, Fatma Burcu; Oztas, Baria

2011-01-01

In this investigation, the effects of hypoglycemic coma and alcoholic coma on the blood-brain barrier (BBB) permeability have been compared. Female adult Wistar albino rats weighing 180-230 g were divided into three groups: Control group (n=8), Alcoholic Coma Group (n=18), and Hypoglycemic Coma group (n=12). The animals went into coma approximately 3-4 hours after insulin administration and 3-5 minutes after alcohol administration. Evans blue (4mL/kg) was injected intravenously as BBB tracer. It was observed that the alcoholic coma did not significantly increase the BBB permeability in any of the brain regions when compared to control group. Changes in BBB permeability were significantly increased by the hypoglycemic coma in comparison to the control group values (p<0.01). Our findings suggest that hypoglycemic and alcoholic coma have different effects on the BBB permeability depending on the energy metabolism. PMID:21619558

THE HST/ACS COMA CLUSTER SURVEY. VIII. BARRED DISK GALAXIES IN THE CORE OF THE COMA CLUSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marinova, Irina; Jogee, Shardha; Weinzirl, Tim

2012-02-20

We use high-resolution ({approx}0.''1) F814W Advanced Camera for Surveys (ACS) images from the Hubble Space Telescope ACS Treasury survey of the Coma cluster at z {approx} 0.02 to study bars in massive disk galaxies (S0s), as well as low-mass dwarf galaxies in the core of the Coma cluster, the densest environment in the nearby universe. Our study helps to constrain the evolution of bars and disks in dense environments and provides a comparison point for studies in lower density environments and at higher redshifts. Our results are: (1) we characterize the fraction and properties of bars in a sample ofmore » 32 bright (M{sub V} {approx}< -18, M{sub *} > 10{sup 9.5} M{sub Sun }) S0 galaxies, which dominate the population of massive disk galaxies in the Coma core. We find that the measurement of a bar fraction among S0 galaxies must be handled with special care due to the difficulty in separating unbarred S0s from ellipticals, and the potential dilution of the bar signature by light from a relatively large, bright bulge. The results depend sensitively on the method used: the bar fraction for bright S0s in the Coma core is 50% {+-} 11%, 65% {+-} 11%, and 60% {+-} 11% based on three methods of bar detection, namely, strict ellipse fit criteria, relaxed ellipse fit criteria, and visual classification. (2) We compare the S0 bar fraction across different environments (the Coma core, A901/902, and Virgo) adopting the critical step of using matched samples and matched methods in order to ensure robust comparisons. We find that the bar fraction among bright S0 galaxies does not show a statistically significant variation (within the error bars of {+-}11%) across environments which span two orders of magnitude in galaxy number density (n {approx} 300-10,000 galaxies Mpc{sup -3}) and include rich and poor clusters, such as the core of Coma, the A901/902 cluster, and Virgo. We speculate that the bar fraction among S0s is not significantly enhanced in rich clusters compared to

A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS).

PubMed

Dixit, Siddharth; Dutta, Manoj Kumar; Namdeo, Mayank

2015-05-01

Myxedema coma or hypothyroid crisis is an endocrine emergency and needs ICU management. Neuroleptic malignant syndrome (NMS) is another medical emergency which needs high degree of clinical suspicion else mortality can be high. There is a paradox in co existence of myxedema coma and NMS. While one is hypometabolic state another is hypermetabolic state and both can be precipitated by antipsychotics use. Hypothermia and flaccidity commonly expected in myxedema coma may mask fever and rigidity of classical NMS contributing to diagnostic problem and treatment delay. Scientific literature on coexistance of myxedema coma and NMS is sparse. We hereby report first case with coexisting myxedema coma and NMS in a patient of schizophrenia treated with antipsychotic, where classical symptoms of NMS were masked by myxedema coma. Prompt diagnosis and effective management by a team resulted in favourable outcome in our patient. This case is reported to alert intensive care physicians to atypical manifestations of NMS in presence of hypothyroidism.

A Rare Case of Myxedema Coma with Neuroleptic Malignant Syndrome (NMS)

PubMed Central

Dutta, Manoj Kumar; Namdeo, Mayank

2015-01-01

Myxedema coma or hypothyroid crisis is an endocrine emergency and needs ICU management. Neuroleptic malignant syndrome (NMS) is another medical emergency which needs high degree of clinical suspicion else mortality can be high. There is a paradox in co existence of myxedema coma and NMS. While one is hypometabolic state another is hypermetabolic state and both can be precipitated by antipsychotics use. Hypothermia and flaccidity commonly expected in myxedema coma may mask fever and rigidity of classical NMS contributing to diagnostic problem and treatment delay. Scientific literature on coexistance of myxedema coma and NMS is sparse. We hereby report first case with coexisting myxedema coma and NMS in a patient of schizophrenia treated with antipsychotic, where classical symptoms of NMS were masked by myxedema coma. Prompt diagnosis and effective management by a team resulted in favourable outcome in our patient. This case is reported to alert intensive care physicians to atypical manifestations of NMS in presence of hypothyroidism. PMID:26155541

Thyroid gland disorder emergencies: thyroid storm and myxedema coma.

PubMed

Hampton, Jessica

2013-01-01

Although thyroid dysfunction will develop in more than 12% of the US population during their lifetimes, true thyroid emergencies are rare. Thyroid storm and myxedema coma are endocrine emergencies resulting from thyroid hormone dysregulation, usually coupled with an acute illness as a precipitant. Careful assessment of risk and rapid action, once danger is identified, are essential for limiting morbidity and mortality related to thyroid storm and myxedema coma. This article reviews which patients are at risk, explains thyroid storm and myxedema coma, and describes pharmacological treatment and supportive cares.

Coma Patient Monitoring System Using Image Processing

NASA Astrophysics Data System (ADS)

Sankalp, Meenu

2011-12-01

COMA PATIENT MONITORING SYSTEM provides high quality healthcare services in the near future. To provide more convenient and comprehensive medical monitoring in big hospitals since it is tough job for medical personnel to monitor each patient for 24 hours.. The latest development in patient monitoring system can be used in Intensive Care Unit (ICU), Critical Care Unit (CCU), and Emergency Rooms of hospital. During treatment, the patient monitor is continuously monitoring the coma patient to transmit the important information. Also in the emergency cases, doctor are able to monitor patient condition efficiently to reduce time consumption, thus it provides more effective healthcare system. So due to importance of patient monitoring system, the continuous monitoring of the coma patient can be simplified. This paper investigates about the effects seen in the patient using "Coma Patient Monitoring System" which is a very advanced product related to physical changes in body movement of the patient and gives Warning in form of alarm and display on the LCD in less than one second time. It also passes a sms to a person sitting at the distant place if there exists any movement in any body part of the patient. The model for the system uses Keil software for the software implementation of the developed system.

Influence of coma aberration on aperture averaged scintillations in oceanic turbulence

NASA Astrophysics Data System (ADS)

Luo, Yujuan; Ji, Xiaoling; Yu, Hong

2018-01-01

The influence of coma aberration on aperture averaged scintillations in oceanic turbulence is studied in detail by using the numerical simulation method. In general, in weak oceanic turbulence, the aperture averaged scintillation can be effectively suppressed by means of the coma aberration, and the aperture averaged scintillation decreases as the coma aberration coefficient increases. However, in moderate and strong oceanic turbulence the influence of coma aberration on aperture averaged scintillations can be ignored. In addition, the aperture averaged scintillation dominated by salinity-induced turbulence is larger than that dominated by temperature-induced turbulence. In particular, it is shown that for coma-aberrated Gaussian beams, the behavior of aperture averaged scintillation index is quite different from the behavior of point scintillation index, and the aperture averaged scintillation index is more suitable for characterizing scintillations in practice.

MAPPING THE GAS TURBULENCE IN THE COMA CLUSTER: PREDICTIONS FOR ASTRO-H

DOE Office of Scientific and Technical Information (OSTI.GOV)

ZuHone, J. A.; Markevitch, M.; Zhuravleva, I.

2016-02-01

Astro-H will be able for the first time to map gas velocities and detect turbulence in galaxy clusters. One of the best targets for turbulence studies is the Coma cluster, due to its proximity, absence of a cool core, and lack of a central active galactic nucleus. To determine what constraints Astro-H will be able to place on the Coma velocity field, we construct simulated maps of the projected gas velocity and compute the second-order structure function, an analog of the velocity power spectrum. We vary the injection scale, dissipation scale, slope, and normalization of the turbulent power spectrum, andmore » apply measurement errors and finite sampling to the velocity field. We find that even with sparse coverage of the cluster, Astro-H will be able to measure the Mach number and the injection scale of the turbulent power spectrum—the quantities determining the energy flux down the turbulent cascade and the diffusion rate for everything that is advected by the gas (metals, cosmic rays, etc.). Astro-H will not be sensitive to the dissipation scale or the slope of the power spectrum in its inertial range, unless they are outside physically motivated intervals. We give the expected confidence intervals for the injection scale and the normalization of the power spectrum for a number of possible pointing configurations, combining the structure function and velocity dispersion data. Importantly, we also determine that measurement errors on the line shift will bias the velocity structure function upward, and show how to correct this bias.« less

Mapping the Gas Turbulence in the Coma Cluster: Predictions for Astro-H

NASA Technical Reports Server (NTRS)

ZuHone, J. A.; Markevitch, M.; Zhuravleva, I.

2016-01-01

Astro-H will be able for the first time to map gas velocities and detect turbulence in galaxy clusters. One of the best targets for turbulence studies is the Coma cluster, due to its proximity, absence of a cool core, and lack of a central active galactic nucleus. To determine what constraints Astro-H will be able to place on the Coma velocity field, we construct simulated maps of the projected gas velocity and compute the second-order structure function, an analog of the velocity power spectrum. We vary the injection scale, dissipation scale, slope, and normalization of the turbulent power spectrum, and apply measurement errors and finite sampling to the velocity field. We find that even with sparse coverage of the cluster, Astro-H will be able to measure the Mach number and the injection scale of the turbulent power spectrum-the quantities determining the energy flux down the turbulent cascade and the diffusion rate for everything that is advected by the gas (metals, cosmic rays, etc.). Astro-H will not be sensitive to the dissipation scale or the slope of the power spectrum in its inertial range, unless they are outside physically motivated intervals. We give the expected confidence intervals for the injection scale and the normalization of the power spectrum for a number of possible pointing configurations, combining the structure function and velocity dispersion data. Importantly, we also determine that measurement errors on the line shift will bias the velocity structure function upward, and show how to correct this bias.

ROSAT observations of Coma Cluster galaxies

NASA Technical Reports Server (NTRS)

Dow, K. L.; White, S. D. M.

1995-01-01

The approximately 86 ks ROSAT Position Sensitive Proportional Counter (PSPC) image of the Coma Cluster is deeper than any previous X-ray observation of a galaxy cluster. We search for X-ray emission from 35 individual galaxies in a magnitude-limited sample, all of which lie within 20 arcmins of the optical axis in at least one of the four Coma pointings. We detect seven galaxies in the 0.4-2.4 keV band at a significance level exceeding 3 sigma, and a further four at above 2 sigma. Although we can set only upper limits on the individual flux from each of the other galaxies, we are able to measure their mean flux by stacking the observations. The X-ray luminosities of the seven detections range from 6.2 x 10(exp 40) to 1.5 x 10(exp 42) ergs/s (0.4-2.4 keV for H(sub 0) = 50 km/s/Mpc). For galaxies with a blue absolute magnitude of about -21 we find a mean X-ray luminosity of 1.3 x 10(exp 40) ergs/s. The ratio of X-ray to optical luminosity is substantially smaller for such subjects than for the brightest galaxies in the cluster. The X-ray luminosities of the four brightest galaxies are ill-defined, however, because of ambiguity in distinguishing galaxy emission from cluster emission. Each object appears to be related to significant structure in the diffuse intracluster medium. We also investigate emission in the softer 0.2-0.4 keV band where detections are less significant because of the higher background, and we discuss the properties of a number of interesting individual sources. The X-ray luminosities of the Coma galaxies are similar to those of galaxies in the Virgo Cluster and in other regions with relatively low galaxy density. We conclude that large-scale environmental effects do not significantly enhance or suppress the average X-ray emission from galaxies, but that individual objects vary in luminosity substantially in a way which may depend on the detailed history of their environment.

Coma cluster of galaxies

NASA Image and Video Library

1999-12-02

Atlas Image mosaic, covering 34 x 34 on the sky, of the Coma cluster, aka Abell 1656. This is a particularly rich cluster of individual galaxies over 1000 members, most prominently the two giant ellipticals, NGC 4874 right and NGC 4889 left.

Gas Dynamics and Kinetics in the Cometary Coma: Theory and Observations

NASA Technical Reports Server (NTRS)

Combi, Michael R.; Harris, Walter M.; Smyth, William H.

2005-01-01

Our ability to describe the physical state of the expanding coma affects fundamental areas of cometary study both directly and indirectly. In order to convert measured abundances of gas species in the coma to gas production rates, models for the distribution and kinematics of gas species in the coma are required. Conversely, many different types of observations, together with laboratory data and theory, are still required to determine coma model attributes and parameters. Accurate relative and absolute gas production rates and their variations with time and from comet to comet are crucial to our basic understanding of the composition and structure of cometary nuclei and their place in the solar system. We review the gas dynamics and kinetics of cometary comae from both theoretical and observational perspectives, which are important for understanding the wide variety of physical conditions that are encountered.

Coma blisters in children: case report and review of the literature.

PubMed

Bosco, Laura; Schena, Donatella; Colato, Chiara; Biban, Paolo; Girolomoni, Giampiero

2013-12-01

Coma-induced blisters is a rare condition associated with prolonged impairment of conscious level, which is relatively well-known in adults following overdose with barbiturates. However, it has been very rarely described in children. A case of coma-bullae occurring in an 11-year-old child with meningoencephalitis is herein reported. The bullous lesions occurred on the limbs and trunks, and evolved into necrotic ulcers in a few days. No correlation with any drug overdosage was found. A skin biopsy revealed epidermal and eccrine sweat gland necrosis with abundant neutrophils, and thrombosis of the vessels in the lower dermis. A comprehensive review of the literature showed that only 5 cases of coma-bullae in children have been published so far. Coma blistering resolves spontaneously within days or weeks. Diagnosis of coma-bullae may require careful clinical-pathologic correlation to exclude other blistering diseases in children.

Fulminant hyperammonaemia induced by thiopental coma in rats.

PubMed

Ivnitsky, Jury Ju; Rejniuk, Vladimir L; Schäfer, Timur V; Malakhovsky, Vladimir N

2006-07-25

Fulminant hyperammonaemia as a threshold effect of coma-inducing dose of sodium thiopental has been revealed in rats. Blood ammonia content increased progressively after the introduction of 1.0 LD(50) (but not 0.8 LD(50)) of sodium thiopental three times in 3h and five times in 18h. The urinary ammonia excretion was not impaired while the volatilization of ammoniac from the body of ST-treated rats was higher, giving evidence of the augmentation of ammonia production. Blood urea increased by one third despite of insignificant alterations of haematocrit and blood creatinine. Ammonia hyperproduction in the digestive tract could result from gastrointestinal stasis, which has been verified by roentgenography and confirmed by correlation of hyperammonaemia with the stool retardation. In thiopental coma rats the slope of a dose-dependent increase of the blood ammonia and the blood urea after the intraperitoneal injection of ammonium acetate did not exceed that in intact animals. So the ammonia hyperproduction in the digestive tract could be the main contributing cause of fulminant hyperammonaemia in rats with thiopental coma and thus be involved into pathogenesis of the coma.

Glasgow Coma Scale and Its Components on Admission: Are They Valuable Prognostic Tools in Acute Mixed Drug Poisoning?

PubMed Central

Eizadi Mood, N.; Sabzghabaee, A. M.; Yadegarfar, Gh.; Yaraghi, A.; Ramazani Chaleshtori, M.

2011-01-01

Introduction. The verbal, eye, and motor components of Glasgow coma scale (GCS) may be influenced by poisoned patients' behavior in an attempted suicide. So, the values of admission GCS and its components for outcomes prediction in mixed drugs poisoning were investigated. Materials and Methods. A followup study data was performed on patients with mixed drugs poisoning. Outcomes were recorded as without complications and with complications. Discrimination was evaluated by calculating the area under the receiver operating characteristic curves (AUC). Results. There was a significant difference between the mean value of each component of GCS as well as the total GCS between patients with and without complication. Discrimination was best for GCS (AUC: 0.933 ± 0.020) and verbal (0.932 ± 0.021), followed by motor (0.911 ± 0.025), then eye (0.89 ± 0.028). Conclusions. Admission GCS and its components seem to be valuable in outcome prediction of patients with mixed drug poisoning. PMID:21559299

Factors Influencing the Reliability of the Glasgow Coma Scale: A Systematic Review.

PubMed

Reith, Florence Cm; Synnot, Anneliese; van den Brande, Ruben; Gruen, Russell L; Maas, Andrew Ir

2017-06-01

The Glasgow Coma Scale (GCS) characterizes patients with diminished consciousness. In a recent systematic review, we found overall adequate reliability across different clinical settings, but reliability estimates varied considerably between studies, and methodological quality of studies was overall poor. Identifying and understanding factors that can affect its reliability is important, in order to promote high standards for clinical use of the GCS. The aim of this systematic review was to identify factors that influence reliability and to provide an evidence base for promoting consistent and reliable application of the GCS. A comprehensive literature search was undertaken in MEDLINE, EMBASE, and CINAHL from 1974 to July 2016. Studies assessing the reliability of the GCS in adults or describing any factor that influences reliability were included. Two reviewers independently screened citations, selected full texts, and undertook data extraction and critical appraisal. Methodological quality of studies was evaluated with the consensus-based standards for the selection of health measurement instruments checklist. Data were synthesized narratively and presented in tables. Forty-one studies were included for analysis. Factors identified that may influence reliability are education and training, the level of consciousness, and type of stimuli used. Conflicting results were found for experience of the observer, the pathology causing the reduced consciousness, and intubation/sedation. No clear influence was found for the professional background of observers. Reliability of the GCS is influenced by multiple factors and as such is context dependent. This review points to the potential for improvement from training and education and standardization of assessment methods, for which recommendations are presented. Copyright © 2017 by the Congress of Neurological Surgeons.

Dynamic molecular oxygen production in cometary comae.

PubMed

Yao, Yunxi; Giapis, Konstantinos P

2017-05-08

Abundant molecular oxygen was discovered in the coma of comet 67P/Churyumov-Gerasimenko. Its origin was ascribed to primordial gaseous O 2 incorporated into the nucleus during the comet's formation. This thesis was put forward after discounting several O 2 production mechanisms in comets, including photolysis and radiolysis of water, solar wind-surface interactions and gas-phase collisions. Here we report an original Eley-Rideal reaction mechanism, which permits direct O 2 formation in single collisions of energetic water ions with oxidized cometary surface analogues. The reaction proceeds by H 2 O + abstracting a surface O-atom, then forming an excited precursor state, which dissociates to produce O 2 - . Subsequent photo-detachment leads to molecular O 2 , whose presence in the coma may thus be linked directly to water molecules and their interaction with the solar wind. This abiotic O 2 production mechanism is consistent with reported trends in the 67P coma and raises awareness of the role of energetic negative ions in comets.

Dynamic molecular oxygen production in cometary comae

NASA Astrophysics Data System (ADS)

Yao, Yunxi; Giapis, Konstantinos P.

2017-05-01

Abundant molecular oxygen was discovered in the coma of comet 67P/Churyumov-Gerasimenko. Its origin was ascribed to primordial gaseous O2 incorporated into the nucleus during the comet's formation. This thesis was put forward after discounting several O2 production mechanisms in comets, including photolysis and radiolysis of water, solar wind-surface interactions and gas-phase collisions. Here we report an original Eley-Rideal reaction mechanism, which permits direct O2 formation in single collisions of energetic water ions with oxidized cometary surface analogues. The reaction proceeds by H2O+ abstracting a surface O-atom, then forming an excited precursor state, which dissociates to produce O2-. Subsequent photo-detachment leads to molecular O2, whose presence in the coma may thus be linked directly to water molecules and their interaction with the solar wind. This abiotic O2 production mechanism is consistent with reported trends in the 67P coma and raises awareness of the role of energetic negative ions in comets.

An Atypical Case of Myxedema Coma with Concomitant Nonconvulsive Seizure.

PubMed

Patel, Pratik; Bekkerman, Mikhael; Varallo-Rodriguez, Cristina; Rampersaud, Rajendra

2016-01-01

Hypothyroidism is a prevalent condition in the general population that is treatable with appropriately dosed thyroid hormone replacement medication. Infrequently, patients will present with myxedema coma, characterized by hypothermia, hypotension, bradycardia, and altered mental status in the setting of severe hypothyroidism. Myxedema coma has also been known to manifest in a number of unusual and dangerous forms. Here, we present the case of a woman we diagnosed with an uncharacteristic expression of myxedema coma and nonconvulsive seizure complicated by a right middle cerebral artery infarct.

An Atypical Case of Myxedema Coma with Concomitant Nonconvulsive Seizure

PubMed Central

Patel, Pratik; Varallo-Rodriguez, Cristina

2016-01-01

Hypothyroidism is a prevalent condition in the general population that is treatable with appropriately dosed thyroid hormone replacement medication. Infrequently, patients will present with myxedema coma, characterized by hypothermia, hypotension, bradycardia, and altered mental status in the setting of severe hypothyroidism. Myxedema coma has also been known to manifest in a number of unusual and dangerous forms. Here, we present the case of a woman we diagnosed with an uncharacteristic expression of myxedema coma and nonconvulsive seizure complicated by a right middle cerebral artery infarct. PMID:27872766

Capturing the Coma

NASA Technical Reports Server (NTRS)

2005-01-01

This image shows comet Tempel 1, as seen by the Deep Impact spacecraft on June 21, 2005. It was taken using the clear filter of the spacecraft's medium resolution imager camera. The spacecraft was 11,564,081.7 kilometers (7,185,920 miles) away from the comet. Twelve images were combined together, and a logarithmic stretch was applied to enhance the coma of the comet.

Bacteriology of aspiration pneumonia in patients with acute coma.

PubMed

Lauterbach, Enise; Voss, Frederik; Gerigk, Roland; Lauterbach, Michael

2014-12-01

Loss of protective airway reflexes in patients with acute coma puts these patients at risk of aspiration pneumonia complicating the course of the primary disease. Available data vary considerably with regard to bacteriology, role of anaerobic bacteria, and antibiotic treatment. Our objective was to research the bacteriology of aspiration pneumonia in acute coma patients who were not pre-treated with antibiotics or hospitalized within 30 days prior to the event. We prospectively analyzed 127 patient records from adult patients admitted, intubated and ventilated to a tertiary medical intensive care unit with acute coma. Bacteriology and antibiotic resistance testing from tracheal aspirate sampled within 24 h after admission, blood cultures, ICU scores (APACHE II, SOFA), hematology, and clinical chemistry were assessed. Patients were followed up until death or hospital discharge. The majority of patients with acute coma suffered from acute cardiovascular disorders, predominantly myocardial infarction, followed by poisonings, and coma of unknown cause. In a majority of our patients, microaspiration resulted in overt infection. Most frequently S. aureus, H. influenzae, and S. pneumoniae were isolated. Anaerobic bacteria (Bacteroides spec., Fusobacteria, Prevotella spec.) were isolated from tracheal aspirate in a minority of patients, and predominantly as part of a mixed infection. Antibiotic monotherapy with a 2nd generation cephalosporin, or a 3rd generation gyrase inhibitor, was most effective in our patients regardless of the presence of anaerobic bacteria.

Incidence, predictors and outcomes of postoperative coma: an observational study of 858,606 patients.

PubMed

Newman, Jessica; Blake, Kathryn; Fennema, Jordan; Harris, David; Shanks, Amy; Avidan, Michael S; Kelz, Max B; Mashour, George A

2013-08-01

Coma is a state of profound unresponsiveness that can occur as a serious perioperative complication. The study of risk factors for, and sequelae of, postoperative coma has been limited due to the rarity of the event. To determine the incidence, risk factors and impact of postoperative coma in a large patient population. Observational study using a prospectively gathered national dataset. Data from 858 606 patients were analysed. The incidence of postoperative coma of more than 24-h duration was identified. Logistic regression was used to identify independent predictors and develop a risk model of postoperative coma in derivation and validation cohorts; 30-day mortality was also analysed. The incidence of postoperative coma was 0.06%. Multivariate analysis revealed the following independent predictors: liver disease, systemic sepsis, age at least 63 years, renal disease, emergency operation, cardiac disease, hypertension, prior neurological disease, diabetes mellitus and BMI 25 to 29.99 kg m (protective). These predictors were incorporated into a risk index classification; odds ratios for postoperative coma increased from 2.5 with one risk factor to 18.4 with three. Coma was associated with 74.2% all-cause mortality; coma associated with cardiac arrest had a 1.9-fold higher mortality. This is the largest study of postoperative coma ever reported and will be useful for determining risk of coma of more than 24 h duration when evaluating an unresponsive patient following surgery. Data on prognosis will aid medical and ethical decision-making for the comatose surgical patient.

Severe angioedema in myxedema coma: a difficult airway in a rare endocrine emergency.

PubMed

Lee, Christopher H; Wira, Charles R

2009-10-01

Myxedema coma is the most lethal manifestation of hypothyroidism. It is a true medical emergency and can result in profound hemodynamic instability and airway compromise. Myxedema coma currently remains a diagnostic challenge due to the rarity of cases seen today, and failure to promptly initiate therapy with replacement thyroid hormone can be fatal. As thyroid hormone therapy can take days or weeks to reverse the manifestations of myxedema coma, interim supportive therapy is critical while awaiting clinical improvement. Some patients will require endotracheal intubation in the emergency department (ED), and physicians should be aware that unanticipated posterior pharyngeal edema in myxedema coma could severely complicate airway management. Although mechanical ventilation is a well-described adjunctive therapy for myxedema coma, reports of the potential difficulty in securing a definitive airway in these patients are rare. We describe a case of an unidentified woman who presented to the ED with myxedema coma requiring urgent endotracheal intubation and was found to have extensive posterior pharyngeal angioedema inconsistent with her relatively benign external examination. This case highlights the typical features of myxedema coma and discusses our necessity for a rescue device in definitive endotracheal tube placement. Emergency physicians should anticipate a potentially difficult airway in all myxedema coma patients regardless of the degree of external facial edema present.

Between My Body and My "Dead Body": Narratives of Coma.

PubMed

Meoded Danon, Limor

2016-01-01

This article is based on narrative research that focuses on corporeal experience during coma and during the rehabilitation process. Seventeen participants from different areas of Israel who had been in various kinds of coma states reveal what the corporeal experience of coma is. The participants are divided into three types of narrative protagonists--"dead-alive," "rational," and "emissaries." Each of the participants redefined the boundaries of the body, especially in cases when they spoke of experiences they did not understand as corporeal, for example, out-of-body experiences, near-death experiences, or experiences of being between the earthly and unearthly. Their struggle to find suitable words to tell their coma stories emphasizes these boundaries between experiencing and telling, which crossed the normative discursive border of the medical establishment and illustrates the ambiguous nature of human existence. © The Author(s) 2015.

The relation between Glasgow Coma Scale score and later cerebral atrophy in paediatric traumatic brain injury.

PubMed

Ghosh, Alokananda; Wilde, Elisabeth A; Hunter, Jill V; Bigler, Erin D; Chu, Zili; Li, Xiaoqi; Vasquez, Ana C; Menefee, Deleene; Yallampalli, Ragini; Levin, Harvey S

2009-03-01

To examine initial Glasgow Coma Scale (GCS) score and its relationship with later cerebral atrophy in children with traumatic brain injury (TBI) using Quantitative Magnetic Resonance Imaging (QMRI) at 4 months post-injury. It was hypothesized that a lower GCS score would predict later generalized atrophy. As a guide in assessing paediatric TBI patients, the probability of developing chronic cerebral atrophy was determined based on the initial GCS score. The probability model used data from 45 paediatric patients (mean age = 13.6) with mild-to-severe TBI and 41 paediatric (mean age = 12.4) orthopaedically-injured children. This study found a 24% increase in the odds of developing an abnormal ventricle-to-brain ratio (VBR) and a 27% increase in the odds of developing reduced white matter percentage on neuroimaging with each numerical drop in GCS score. Logistic regression models with cut-offs determined by normative QMRI data confirmed that a lower initial GCS score predicts later atrophy. GCS is a commonly used measure of injury severity. It has proven to be a prognostic indicator of cognitive recovery and functional outcome and is also predictive of later parenchymal change.

Memory disorder related to coma duration after head injury.

PubMed Central

Vilkki, J; Poropudas, K; Servo, A

1988-01-01

The relationship of memory and intelligence test performances to coma duration was studied in 51 head injured patients who had not been operated on for intracranial haematoma. Memory defect was related to coma duration, and was not secondary to impaired perceptual or conceptual analysis of the material to be remembered. PMID:3236022

Map-based trigonometric parallaxes of open clusters: Coma

NASA Technical Reports Server (NTRS)

Gatewood, George

1995-01-01

This is the fourth study in a series to determine the direct trigonometric parallaxes of four of the nearest open star clusters, the Hyades, the Pleiades, the Praesepe, and the nearby cluster in Coma (Gatewood et al. 1990; Gatewood et al. 1992); Gatewood & Kiewiet de Jonge 1994). The results for the open star cluster in Coma are compared with those of the other three clusters, and the members are found to be significantly subluminous. The trigonometric parallax of the cluster is estimated from that of three members studied with the Multichannel Astrometric Photometer (MAP) at the Thaw Refractor of the University of Pittsburgh's Allegheny Observatory. The weighted mean parallax of the cluster is +13.53 +/- 0.54 mass (0.00054 min), corresponding to a distance modulus of 4.34 +/- 0.09 mag. The U-B excess of the Coma cluster members may be used to adjust the observed absolute magnitudes and the B-V measurements as suggested by Sandage & Eggen (1959). The agreement obtained in this manner suggests that, like subdwarf stars, the stars of the Coma cluster appear subluminous because of line blanketing. One of the three members observed in this study was recognized as a member by its parallax and is the faintest known member of the cluster.

Map-based trigonometric parallaxes of open clusters: Coma

NASA Astrophysics Data System (ADS)

Gatewood, George

1995-06-01

This is the fourth study in a series to determine the direct trigonometric parallaxes of four of the nearest open star clusters, the Hyades, the Pleiades, the Praesepe, and the nearby cluster in Coma (Gatewood et al. 1990; Gatewood et al. 1992); Gatewood & Kiewiet de Jonge 1994). The results for the open star cluster in Coma are compared with those of the other three clusters, and the members are found to be significantly subluminous. The trigonometric parallax of the cluster is estimated from that of three members studied with the Multichannel Astrometric Photometer (MAP) at the Thaw Refractor of the University of Pittsburgh's Allegheny Observatory. The weighted mean parallax of the cluster is +13.53 +/- 0.54 mass (0.00054 min), corresponding to a distance modulus of 4.34 +/- 0.09 mag. The U-B excess of the Coma cluster members may be used to adjust the observed absolute magnitudes and the B-V measurements as suggested by Sandage & Eggen (1959). The agreement obtained in this manner suggests that, like subdwarf stars, the stars of the Coma cluster appear subluminous because of line blanketing. One of the three members observed in this study was recognized as a member by its parallax and is the faintest known member of the cluster.

Contemporary approach to neurologic prognostication of coma after cardiac arrest.

PubMed

Ben-Hamouda, Nawfel; Taccone, Fabio S; Rossetti, Andrea O; Oddo, Mauro

2014-11-01

Coma after cardiac arrest (CA) is an important cause of admission to the ICU. Prognosis of post-CA coma has significantly improved over the past decade, particularly because of aggressive postresuscitation care and the use of therapeutic targeted temperature management (TTM). TTM and sedatives used to maintain controlled cooling might delay neurologic reflexes and reduce the accuracy of clinical examination. In the early ICU phase, patients' good recovery may often be indistinguishable (based on neurologic examination alone) from patients who eventually will have a poor prognosis. Prognostication of post-CA coma, therefore, has evolved toward a multimodal approach that combines neurologic examination with EEG and evoked potentials. Blood biomarkers (eg, neuron-specific enolase [NSE] and soluble 100-β protein) are useful complements for coma prognostication; however, results vary among commercial laboratory assays, and applying one single cutoff level (eg, > 33 μg/L for NSE) for poor prognostication is not recommended. Neuroimaging, mainly diffusion MRI, is emerging as a promising tool for prognostication, but its precise role needs further study before it can be widely used. This multimodal approach might reduce false-positive rates of poor prognosis, thereby providing optimal prognostication of comatose CA survivors. The aim of this review is to summarize studies and the principal tools presently available for outcome prediction and to describe a practical approach to the multimodal prognostication of coma after CA, with a particular focus on neuromonitoring tools. We also propose an algorithm for the optimal use of such multimodal tools during the early ICU phase of post-CA coma.

Chemistry in the Dusty Coma of Comet Hale-Bopp

NASA Astrophysics Data System (ADS)

Boice, D. C.; Cochran, A. L.; Disanti, M. A.; Huebner, W. F.

1998-09-01

Recent progress on a multifluid, hydrodynamic model is presented for the dusty gas flow in the inner coma of comet Hale-Bopp at several heliocentric distances. The simulations are based on a 1-D neutral coma model with detailed photo and gas-phase chemistry and dust entrainment by the gas, a separate energy balance for the electrons, separate flow of the neutral gas, fast neutral atomic and molecular hydrogen, and dust entrainment with fragmentation. The model accounts for three sources of gas release: sublimation from surface ices, transport of gas from subsurface regions through the surface, and release of gas from dust in the coma. This permits a consistent study of the importance and strength of each possible source for a variety of gas-phase species. The simulations allow a study of the changes with heliocentric distance of features within a cometary coma, e.g., spatial distributions of gas-phase species and dust of various sizes and the velocity and temperature profiles. In particular, the model is used to probe spatial distributions of gas-phase species (e.g., CN, CH, C_3, C_2, HCN, HNC, CO) and dust, and the velocity and temperature structure to understand the complex gas-phase chemistry that occurs in the inner coma. Comparisons with observations are made where available to characterize the environment surrounding comet Hale-Bopp and to aid in assimilating a variety of diverse observations of this unique comet.

The Coma Cluster Luminosity Function from Ultraviolet to Near-Infrared

NASA Astrophysics Data System (ADS)

Andreon, S.; Cuillandre, J.-C.; Pello, R.

The Coma cluster luminosity function (LF) from ultraviolet (2000 AA ) to the near-infrared (H band) is summarized. In the UV the LF is very steep, much steeper than in the optical. The steep Coma UV LF implies that faint and bright galaxies give similar contributions to the total UV flux and to the total metal production rate. The ComaUV LF is dominated in number and luminosity by blue galaxies, which are often faint in the optical. Therefore the Coma UV LF is dominated by star forming galaxies, not by massive and large galaxies. The optical Coma LF is relatively steep (alpha=-1.4) over the 11 magnitudes sampled, but its slope and shape depend on considered filter and magnitude. We found a clear steeping of the FL going from B to R bands, indicative of the presence of a large number of red dwarfs, as faint as three bright globular clusters. Furthermore, using Hubble Space Telescope images, we discover that blends of globular clusters, not resolved in individual components due to seeing, look like dwarf galaxies when observed from the ground and are numerous and bright. The existence of these fake extended sources increases the steepness of the LF at faint magnitudes, if not deal on. This concern affects previous deep probing of the luminosity function, but not the present work. The near-infrared LF wa s computed on a near-infrared selected sample of galaxies which photometry is complete down to the typical dwarf (M* +5) luminosity. The Coma LF can be described by a Schechter function with intermediate slope (alpha sim-1.3), plus a dip at MH~-22 mag. The shape of the Coma LF in H band is quite similar to th e one found in the B band. The similarity of the LF in the optical and H bands implies that in the central region of Coma there is no new population of galaxies which is too faint to be observed in the optical band (because dust enshrouded, for instance), down to the magnitudes of dwarfs. The exponential cut of the LF at the bright end is in good agreement with

Jet Morphology and Coma Analysis of Comet 103P/Hartley 2

NASA Astrophysics Data System (ADS)

Vaughan, Charles M.; Pierce, Donna M.; Cochran, Anita L.

2017-12-01

Spectral data for the coma of Hartley 2 were acquired across four nights in late 2010 using an integral field spectrometer at McDonald Observatory. For the 30 observations during these four nights, we detected five radical species in the coma: C2, C3, CH, CN, and NH2. Using division by azimuthal mean and division by radial profile, we enhanced 150 images of the coma to reveal subtle coma structure. These images revealed noticeable temporal evolution and spatial variations between species. To quantify the observed variation between species, we partitioned the coma and used analysis of variance (ANOVA) techniques to provide a statistical basis for heterogeneity. Nearly every ANOVA test indicated a spatially diverse distribution in the coma when considering all species collectively. To examine the temporal behavior, we used the works by Belton et al., Thomas et al., and Bruck Syal et al. to predict nucleus orientation and active jet directions at our observation times. Several of these reported jet sites correlated to high radical concentrations, and the sites on the smaller lobe are more closely associated with high radical concentrations. Lastly, we provide constraints for the suspect parent molecules of the detected radicals, and we propose that photolysis reactions occurring at or near extended icy grains are a source for the more enigmatic radicals, such as C3.

Glasgow Coma Scale score, mortality, and functional outcome in head-injured patients.

PubMed

Udekwu, Pascal; Kromhout-Schiro, Sharon; Vaslef, Steven; Baker, Christopher; Oller, Dale

2004-05-01

Preresuscitation Glasgow Coma Scale (P-GCS) score is frequently obtained in injured patients and incorporated into mortality prediction. Data on functional outcome in head injury is sparse. A large group of patients with head injuries was analyzed to assess relationships between P-GCS score, mortality, and functional outcome as measured by the Functional Independence Measure (FIM). Records for patients with International Classification of Diseases, Ninth Revision diagnosis codes indicating head injury in a statewide trauma registry between 1994 and 2002 were selected. P-GCS score, mortality, and FIM score at hospital discharge were integrated and analyzed. Of 138,750 patients, 22,924 patients were used for the mortality study and 7,150 patients for the FIM study. A good correlation exists between P-GCS score and FIM, as determined by rank correlation coefficients, whereas mortality falls steeply between a P-GCS score of 3 and a P-GCS score of 7 followed by a shallow fall. Although P-GCS score is related to mortality in head-injured patients, its relationship is nonlinear, which casts doubt on its use as a continuous measure or an equivalent set of categorical measures incorporated into outcome prediction models. The average FIM scores indicate substantial likelihood of good outcomes in survivors with low P-GCS scores, further complicating the use of the P-GCS score in the prediction of poor outcome at the time of initial patient evaluation. Although the P-GCS score is related to functional outcome as measured by the FIM score and mortality in head injury, current mortality prediction models may need to be modified to account for the nonlinear relationship between P-GCS score and mortality. The P-GCS score is not a good clinical tool for outcome prediction in individual head-injured patients, given the variability in mortality rates and functional outcomes at all scores.

Neural signature of coma revealed by posteromedial cortex connection density analysis.

PubMed

Malagurski, Briguita; Péran, Patrice; Sarton, Benjamine; Riu, Beatrice; Gonzalez, Leslie; Vardon-Bounes, Fanny; Seguin, Thierry; Geeraerts, Thomas; Fourcade, Olivier; de Pasquale, Francesco; Silva, Stein

2017-01-01

Posteromedial cortex (PMC) is a highly segregated and dynamic core, which appears to play a critical role in internally/externally directed cognitive processes, including conscious awareness. Nevertheless, neuroimaging studies on acquired disorders of consciousness, have traditionally explored PMC as a homogenous and indivisible structure. We suggest that a fine-grained description of intrinsic PMC topology during coma, could expand our understanding about how this cortical hub contributes to consciousness generation and maintain, and could permit the identification of specific markers related to brain injury mechanism and useful for neurological prognostication. To explore this, we used a recently developed voxel-based unbiased approach, named functional connectivity density (CD). We compared 27 comatose patients (15 traumatic and 12 anoxic), to 14 age-matched healthy controls. The patients' outcome was assessed 3 months later using Coma Recovery Scale-Revised (CRS-R). A complex pattern of decreased and increased connections was observed, suggesting a network imbalance between internal/external processing systems, within PMC during coma. The number of PMC voxels with hypo-CD positive correlation showed a significant negative association with the CRS-R score, notwithstanding aetiology. Traumatic injury specifically appeared to be associated with a greater prevalence of hyper-connected (negative correlation) voxels, which was inversely associated with patient neurological outcome. A logistic regression model using the number of hypo-CD positive and hyper-CD negative correlations, accurately permitted patient's outcome prediction (AUC = 0.906, 95%IC = 0.795-1). These points might reflect adaptive plasticity mechanism and pave the way for innovative prognosis and therapeutics methods.

Predictors of Stroke and Coma After Neurosurgery: An ACS-NSQIP Analysis.

PubMed

Larsen, Alexandra M G; Cote, David J; Karhade, Aditya V; Smith, Timothy R

2016-09-01

The American College of Surgeons National Surgical Quality Improvement Program database aims to reduce 30-day postoperative complications. Reduction of postoperative stroke and coma can decrease length and cost of hospitalization, improve patient functional status, and decrease morbidity and mortality. We performed a search of the American College of Surgeons National Surgical Quality Improvement Program database for all patients from 2006 to 2013 undergoing an operation with a surgeon whose primary specialty was neurologic surgery. Of 94,546 neurosurgical patients reported, there were 687 (0.73%) cases of postoperative stroke and coma. The annual rate of coma longer than 24 hours decreased from 0.90% in 2006 to 0.002% in 2013 (P < 0.001), and the annual rate of stroke decreased from 1.2% in 2006 to 0.5% in 2013 (P = 0.013). Multivariate analysis showed that inpatient status (P = 0.001; odds ratio [OR], 30.3), age (P = 0.005; OR, 1.012), history of diabetes (P = 0.017; OR, 1.515), ventilator dependence (P < 0.001; OR, 4.379), impaired sensorium (P < 0.001; OR, 2.314), history of coma longer than 24 hours (P < 0.001; OR, 2.655), hemiparesis (P = 0.022; OR, 1.492), cerebrovascular accident/stroke with neurologic deficit (P < 0.001; OR, 2.091), cerebrovascular accident/stroke without neurologic deficit (P = 0.001; OR, 2.44), and tumor involving central nervous system (P < 0.001; OR, 2.928) are significant risk factors for developing postneurosurgical stroke and coma. The rate of postneurosurgical stroke decreased from 1.2% in 2006 to 0.5% in 2013 and the rate of postneurosurgical coma greater than 24 hours decreased from 0.9% in 2006 to 0.002% in 2013. Ten risk factors for developing postneurosurgical stroke and coma were identified using multivariable analysis. These risk factors should be assessed preoperatively and incorporated into clinical decision making so that individuals who are at higher risk for the development of stroke and coma can be appropriately

Myxedema coma in a patient with subclinical hypothyroidism.

PubMed

Mallipedhi, Akhila; Vali, Hamza; Okosieme, Onyebuchi

2011-01-01

Myxedema coma is the extreme manifestation of hypothyroidism, typically seen in patients with severe biochemical hypothyroidism. Its occurrence in association with subclinical hypothyroidism is extremely unusual. We describe a patient with subclinical hypothyroidism who developed clinical manifestations of myxedema coma. A 47-year-old woman presented to our endocrine clinic with complaints of fatigue and biochemical findings of subclinical hypothyroidism. She was started on treatment with thyroxine (T4) but remained unwell and was later admitted to hospital with hormone profile showing persisting subclinical hypothyroidism (elevated thyrotropin and normal free T4 [FT4] and free triiodothyronine [FT3]): FT4 10.7 pmol/L (reference range 10.3-24.5), FT3 2.7 pmol/L (reference range 2.67-7.03), and thyrotropin 6.09 mU/L (reference range 0.4-4.0). She subsequently developed hypothermia (temperature 33.2°C), circulatory collapse, and coma. Biochemical profile showed hyponatremia, elevated creatinine phosphokinase, metabolic acidosis, and renal failure. An echocardiogram revealed a moderate-sized pericardial effusion. We diagnosed myxedema coma and started treatment with intravenous T3. She responded dramatically with improvement in level of consciousness and normalization of metabolic parameters. We found no explanation other than hypothyroidism to account for the presentation. Adrenocorticotrophic hormone (ACTH) stimulation tests excluded adrenal insufficiency, and serum gonadotrophins were within the normal reference range. FT4 estimation by equilibrium dialysis excluded analytical interference, and molecular analysis for the thyroid hormone receptor β gene associated with thyroid hormone resistance was negative. To the best of our knowledge this is the first report of myxedema coma in a patient with subclinical hypothyroidism. The reason for normal thyroid hormone levels is unclear but may reflect deviation from a higher pre-morbid set-point. The case

Effect of the Modified Glasgow Coma Scale Score Criteria for Mild Traumatic Brain Injury on Mortality Prediction: Comparing Classic and Modified Glasgow Coma Scale Score Model Scores of 13

PubMed Central

Mena, Jorge Humberto; Sanchez, Alvaro Ignacio; Rubiano, Andres M.; Peitzman, Andrew B.; Sperry, Jason L.; Gutierrez, Maria Isabel; Puyana, Juan Carlos

2011-01-01

Objective The Glasgow Coma Scale (GCS) classifies Traumatic Brain Injuries (TBI) as Mild (14–15); Moderate (9–13) or Severe (3–8). The ATLS modified this classification so that a GCS score of 13 is categorized as mild TBI. We investigated the effect of this modification on mortality prediction, comparing patients with a GCS of 13 classified as moderate TBI (Classic Model) to patients with GCS of 13 classified as mild TBI (Modified Model). Methods We selected adult TBI patients from the Pennsylvania Outcome Study database (PTOS). Logistic regressions adjusting for age, sex, cause, severity, trauma center level, comorbidities, and isolated TBI were performed. A second evaluation included the time trend of mortality. A third evaluation also included hypothermia, hypotension, mechanical ventilation, screening for drugs, and severity of TBI. Discrimination of the models was evaluated using the area under receiver operating characteristic curve (AUC). Calibration was evaluated using the Hoslmer-Lemershow goodness of fit (GOF) test. Results In the first evaluation, the AUCs were 0.922 (95 %CI, 0.917–0.926) and 0.908 (95 %CI, 0.903–0.912) for classic and modified models, respectively. Both models showed poor calibration (p<0.001). In the third evaluation, the AUCs were 0.946 (95 %CI, 0.943 – 0.949) and 0.938 (95 %CI, 0.934 –0.940) for the classic and modified models, respectively, with improvements in calibration (p=0.30 and p=0.02 for the classic and modified models, respectively). Conclusion The lack of overlap between ROC curves of both models reveals a statistically significant difference in their ability to predict mortality. The classic model demonstrated better GOF than the modified model. A GCS of 13 classified as moderate TBI in a multivariate logistic regression model performed better than a GCS of 13 classified as mild. PMID:22071923

[Interobserver reliability of the Glasgow coma scale in critically ill patients with neurological and/or neurosurgical disease].

PubMed

Sánchez-Sánchez, M M; Sánchez-Izquierdo, R; Sánchez-Muñoz, E I; Martínez-Yegles, I; Fraile-Gamo, M P; Arias-Rivera, S

2014-01-01

The Glasgow coma scale (GCS) is a common tool used for neurological assessment of critically ill patients. Despite its widespread use, the GCS has some limitations, as sometimes different observers may value differently the same response. To evaluate the interobserver agreement, among intensive care nurses with a minimum of 3 years experience, both in the overall estimate of GCS and for each of its components. Prospective observational study including 110 neurological and/or neurosurgical patients conducted in a critical care unit of 18 beds, from October 2010 until December 2012. Registered variables: Demographic characteristics, reason for admission, overall GCS and its components. The neurological evaluation was conducted by a minimum of 3 nurses. One of them applied an algorithm and consensual assessment technique and all, independently, valued response to stimuli. Interobserver agreement was measured using the intraclass correlation coefficient (ICC) for a confidence interval (CI) of 95%. The study was approved by the Ethics Committee for Clinical Trails. The intraclass correlation coefficient (confident interval) for scale was: Overall GCS: 0.989 (0.985-0.992); ocular response: 0.981 (0.974-0.986); verbal response: 0.971 (0.960-0.979); motor response: 0.987 (0.982-0.991). In our cohort of patients we observed a high level of consistency in the application of both the GCS as in each of its components. Copyright © 2013 Elsevier España, S.L. y SEEIUC. All rights reserved.

The present status of xeroderma pigmentosum in Japan and a tentative severity classification scale.

PubMed

Nakano, Eiji; Masaki, Taro; Kanda, Fumio; Ono, Ryusuke; Takeuchi, Seiji; Moriwaki, Shinichi; Nishigori, Chikako

2016-08-01

Xeroderma pigmentosum (XP) is a rare autosomal recessive hereditary disease. Patients with XP have severe hypersensitivity to sunlight, resulting in skin cancers, and some patients have neurological symptoms. In Japan, XP complementation group A (XP-A) is the most common form, and it is associated with severe neurological symptoms. We performed a nationwide survey on XP to determine the present status of XP in Japan. The distribution of complementation groups in Japan was considerably different from that in other countries, but there was a higher frequency in group A and the variant type, which is similar to previous reports in Japan. Basal cell carcinoma was the most frequent skin cancer that patients with XP developed, followed by squamous cell carcinoma and malignant melanoma. The frequency of these skin cancers in patients with XP-A has decreased, and these skin cancers have been occurring in much older people than those previously observed. Diagnosing XP in patients at younger ages seems to encourage patients and their parents to use sun protection, which helps prevent skin cancer. We also created a tentative scale for classifying the severity of XP, and we evaluated the neurological symptoms of XP-A using this severity scale. Our classification correlated well with patients' age, suggesting that it may be useful and feasible in clinical practice to assess the progression of symptoms of each patient with XP and evaluate the effects of treatment in the future. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Coma Associated with Microscopy-Diagnosed Plasmodium vivax: A Prospective Study in Papua, Indonesia

PubMed Central

Hardianto, Setiawan O.; Tjitra, Emiliana; Kenangalem, Enny; Sugiarto, Paulus; Price, Ric N.; Anstey, Nicholas M.

2011-01-01

Background Coma complicates Plasmodium falciparum infection but is uncommonly associated with P. vivax. Most series of vivax coma have been retrospective and have not utilized molecular methods to exclude mixed infections with P. falciparum. Methods We prospectively enrolled patients hospitalized in Timika, Indonesia, with a Glasgow Coma Score (GCS) ≤10 and P. vivax monoinfection on initial microscopy over a four year period. Hematological, biochemical, serological, radiological and cerebrospinal fluid (CSF) examinations were performed to identify other causes of coma. Repeat microscopy, antigen detection and polymerase chain reaction (PCR) were performed to exclude infections with other Plasmodium species. Results Of 24 patients fulfilling enrolment criteria, 5 had clear evidence for other non-malarial etiologies. PCR demonstrated 10 mixed infections and 3 P. falciparum monoinfections. 6 (25%) patients had vivax monoinfection and no apparent alternative cause, with a median GCS of 9 (range 8–10) and a median coma duration of 42 (range 36–48) hours. CSF leukocyte counts were <10/ul (n = 3); 2 of the 3 patients without CSF examination recovered with antimalarial therapy alone. One patient had a tremor on discharge consistent with a post-malarial neurological syndrome. No patient had other organ dysfunction. The only death was associated with pure P. falciparum infection by PCR. Vivax monoinfection-associated risk of coma was estimated at 1 in 29,486 clinical vivax infections with no deaths. In comparison, the risk of falciparum-associated coma was estimated at 1 in 1,276 clinical infections with an 18.5% mortality rate. Conclusions P. vivax-associated coma is rare, occurring 23 times less frequently than that seen with falciparum malaria, and is associated with a high proportion of non-malarial causes and mixed infections using PCR. The pathogenesis of coma associated with vivax malaria, particularly the role of comorbidities, is uncertain and requires

Comet coma sample return instrument

NASA Technical Reports Server (NTRS)

Albee, A. L.; Brownlee, Don E.; Burnett, Donald S.; Tsou, Peter; Uesugi, K. T.

1994-01-01

The sample collection technology and instrument concept for the Sample of Comet Coma Earth Return Mission (SOCCER) are described. The scientific goals of this Flyby Sample Return are to return to coma dust and volatile samples from a known comet source, which will permit accurate elemental and isotopic measurements for thousands of individual solid particles and volatiles, detailed analysis of the dust structure, morphology, and mineralogy of the intact samples, and identification of the biogenic elements or compounds in the solid and volatile samples. Having these intact samples, morphologic, petrographic, and phase structural features can be determined. Information on dust particle size, shape, and density can be ascertained by analyzing penetration holes and tracks in the capture medium. Time and spatial data of dust capture will provide understanding of the flux dynamics of the coma and the jets. Additional information will include the identification of cosmic ray tracks in the cometary grains, which can provide a particle's process history and perhaps even the age of the comet. The measurements will be made with the same equipment used for studying micrometeorites for decades past; hence, the results can be directly compared without extrapolation or modification. The data will provide a powerful and direct technique for comparing the cometary samples with all known types of meteorites and interplanetary dust. This sample collection system will provide the first sample return from a specifically identified primitive body and will allow, for the first time, a direct method of matching meteoritic materials captured on Earth with known parent bodies.

Using the abbreviated injury severity and Glasgow Coma Scale scores to predict 2-week mortality after traumatic brain injury.

PubMed

Timmons, Shelly D; Bee, Tiffany; Webb, Sharon; Diaz-Arrastia, Ramon R; Hesdorffer, Dale

2011-11-01

Prediction of outcome after traumatic brain injury (TBI) remains elusive. We tested the use of a single hospital Glasgow Coma Scale (GCS) Score, GCS Motor Score, and the Head component of the Abbreviated Injury Scale (AIS) Score to predict 2-week cumulative mortality in a large cohort of TBI patients admitted to the eight U.S. Level I trauma centers in the TBI Clinical Trials Network. Data on 2,808 TBI patients were entered into a centralized database. These TBI patients were categorized as severe (GCS score, 3-8), moderate (9-12), or complicated mild (13-15 with positive computed tomography findings). Intubation and chemical paralysis were recorded. The cumulative incidence of mortality in the first 2 weeks after head injury was calculated using Kaplan-Meier survival analysis. Cox proportional hazards regression was used to estimate the magnitude of the risk for 2-week mortality. Two-week cumulative mortality was independently predicted by GCS, GCS Motor Score, and Head AIS. GCS Severity Category and GCS Motor Score were stronger predictors of 2-week mortality than Head AIS. There was also an independent effect of age (<60 vs. ≥60) on mortality after controlling for both GCS and Head AIS Scores. Anatomic and physiologic scales are useful in the prediction of mortality after TBI. We did not demonstrate any added benefit to combining the total GCS or GCS Motor Scores with the Head AIS Score in the short-term prediction of death after TBI.

[The coma awakening unit, between intensive care and rehabilitation].

PubMed

Mimouni, Arnaud

2015-01-01

After intensive care and before classic neurological rehabilitation is possible, patients in an altered state of consciousness are cared for at early stages in so-called coma awakening units. The care involves, on the one hand, the complex support of the patient's awakening from coma as a neurological and existential process, and on the other, support for their families. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Immediate coma and poor outcome in subarachnoid haemorrhage are independently associated with an aneurysmal origin.

PubMed

Tsermoulas, Georgios; Flett, Lisa; Gregson, Barbara; Mitchell, Patrick

2013-08-01

Subarachnoid haemorrhage (SAH) may present with coma and this is known to be associated with aneurysmal origin and blood load. Aneurysmal origin is associated with increased blood load and existing data do not allow us to determine if the association between coma and aneurysmal SAH is wholly due to blood load or if aneurysmal origin has an additional independent effect. The objective of our study is to find if an aneurysmal origin is a predictor of acute onset of coma independent of blood load. A series of consecutive patients with spontaneous SAH were divided into two groups: aneurysmal (aSAH) and non-aneurysmal--angiographically negative SAH (naSAH). Blood load was quantified so that the effect of aneurysmal origin could be resolved from the effect of the amount of blood spilled. Non-parametric regression was used to relate blood load to coma and poor outcome rates for aneurysmal bleeds. We analysed a total of 421 patients presenting during the period 2009-2011. Ninety aneurysmal cases presented with coma, seventy immediately in the early phase and seven shortly after rebleeding. None of the naSAH cases presented with immediate coma and 1 developed delayed coma. Delayed coma was associated with acute hydrocephalus in both groups. Aneurysmal origin was found to be an independent determinant of immediate coma (p=0.02) and poor outcome (p<0.001). Immediate coma and poor outcome in SAH are associated with an aneurysmal origin and do not characterize naSAH. Copyright © 2013 Elsevier B.V. All rights reserved.

PCA/HEXTE Observations of Coma and A2319

NASA Technical Reports Server (NTRS)

Rephaeli, Yoel

1998-01-01

The Coma cluster was observed in 1996 for 90 ks by the PCA and HEXTE instruments aboard the RXTE satellite, the first simultaneous, pointing measurement of Coma in the broad, 2-250 keV, energy band. The high sensitivity achieved during this long observation allows precise determination of the spectrum. Our analysis of the measurements clearly indicates that in addition to the main thermal emission from hot intracluster gas at kT=7.5 keV, a second spectral component is required to best-fit the data. If thermal, it can be described with a temperature of 4.7 keV contributing about 20% of the total flux. The additional spectral component can also be described by a power-law, possibly due to Compton scattering of relativistic electrons by the CMB. This interpretation is based on the diffuse radio synchrotron emission, which has a spectral index of 2.34, within the range allowed by fits to the RXTE spectral data. A Compton origin of the measured nonthermal component would imply that the volume-averaged magnetic field in the central region of Coma is B =0.2 micro-Gauss, a value deduced directly from the radio and X-ray measurements (and thus free of the usual assumption of energy equipartition). Barring the presence of unknown systematic errors in the RXTE source or background measurements, our spectral analysis yields considerable evidence for Compton X-ray emission in the Coma cluster.

A human brain network derived from coma-causing brainstem lesions.

PubMed

Fischer, David B; Boes, Aaron D; Demertzi, Athena; Evrard, Henry C; Laureys, Steven; Edlow, Brian L; Liu, Hesheng; Saper, Clifford B; Pascual-Leone, Alvaro; Fox, Michael D; Geerling, Joel C

2016-12-06

To characterize a brainstem location specific to coma-causing lesions, and its functional connectivity network. We compared 12 coma-causing brainstem lesions to 24 control brainstem lesions using voxel-based lesion-symptom mapping in a case-control design to identify a site significantly associated with coma. We next used resting-state functional connectivity from a healthy cohort to identify a network of regions functionally connected to this brainstem site. We further investigated the cortical regions of this network by comparing their spatial topography to that of known networks and by evaluating their functional connectivity in patients with disorders of consciousness. A small region in the rostral dorsolateral pontine tegmentum was significantly associated with coma-causing lesions. In healthy adults, this brainstem site was functionally connected to the ventral anterior insula (AI) and pregenual anterior cingulate cortex (pACC). These cortical areas aligned poorly with previously defined resting-state networks, better matching the distribution of von Economo neurons. Finally, connectivity between the AI and pACC was disrupted in patients with disorders of consciousness, and to a greater degree than other brain networks. Injury to a small region in the pontine tegmentum is significantly associated with coma. This brainstem site is functionally connected to 2 cortical regions, the AI and pACC, which become disconnected in disorders of consciousness. This network of brain regions may have a role in the maintenance of human consciousness. © 2016 American Academy of Neurology.

A human brain network derived from coma-causing brainstem lesions

PubMed Central

Boes, Aaron D.; Demertzi, Athena; Evrard, Henry C.; Laureys, Steven; Edlow, Brian L.; Liu, Hesheng; Saper, Clifford B.; Pascual-Leone, Alvaro; Geerling, Joel C.

2016-01-01

Objective: To characterize a brainstem location specific to coma-causing lesions, and its functional connectivity network. Methods: We compared 12 coma-causing brainstem lesions to 24 control brainstem lesions using voxel-based lesion-symptom mapping in a case-control design to identify a site significantly associated with coma. We next used resting-state functional connectivity from a healthy cohort to identify a network of regions functionally connected to this brainstem site. We further investigated the cortical regions of this network by comparing their spatial topography to that of known networks and by evaluating their functional connectivity in patients with disorders of consciousness. Results: A small region in the rostral dorsolateral pontine tegmentum was significantly associated with coma-causing lesions. In healthy adults, this brainstem site was functionally connected to the ventral anterior insula (AI) and pregenual anterior cingulate cortex (pACC). These cortical areas aligned poorly with previously defined resting-state networks, better matching the distribution of von Economo neurons. Finally, connectivity between the AI and pACC was disrupted in patients with disorders of consciousness, and to a greater degree than other brain networks. Conclusions: Injury to a small region in the pontine tegmentum is significantly associated with coma. This brainstem site is functionally connected to 2 cortical regions, the AI and pACC, which become disconnected in disorders of consciousness. This network of brain regions may have a role in the maintenance of human consciousness. PMID:27815400

Diagnosis of myxedema coma complicated by renal failure: a case report.

PubMed

Takamura, Akiteru; Sangen, Ryusho; Furumura, Yoshiki; Usuda, Daisuke; Kasamaki, Yuji; Kanda, Tsugiyasu

2017-04-01

Myxedema coma, caused by severe lack of thyroid hormone, is characterized by deterioration of mental status, hypothermia, hypotension, hyponatremia, and hypoventilation. We describe an 84-year-old woman who presented with renal failure and new onset severe hypothyroidism leading to challenges in the recognition of myxedema coma.

Time variability and heterogeneity in the coma of 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Hässig, M.; Altwegg, K.; Balsiger, H.; Bar-Nun, A.; Berthelier, J. J.; Bieler, A.; Bochsler, P.; Briois, C.; Calmonte, U.; Combi, M.; De Keyser, J.; Eberhardt, P.; Fiethe, B.; Fuselier, S. A.; Galand, M.; Gasc, S.; Gombosi, T. I.; Hansen, K. C.; Jäckel, A.; Keller, H. U.; Kopp, E.; Korth, A.; Kührt, E.; Le Roy, L.; Mall, U.; Marty, B.; Mousis, O.; Neefs, E.; Owen, T.; Rème, H.; Rubin, M.; Sémon, T.; Tornow, C.; Tzou, C.-Y.; Waite, J. H.; Wurz, P.

2015-01-01

Comets contain the best-preserved material from the beginning of our planetary system. Their nuclei and comae composition reveal clues about physical and chemical conditions during the early solar system when comets formed. ROSINA (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) onboard the Rosetta spacecraft has measured the coma composition of comet 67P/Churyumov-Gerasimenko with well-sampled time resolution per rotation. Measurements were made over many comet rotation periods and a wide range of latitudes. These measurements show large fluctuations in composition in a heterogeneous coma that has diurnal and possibly seasonal variations in the major outgassing species: water, carbon monoxide, and carbon dioxide. These results indicate a complex coma-nucleus relationship where seasonal variations may be driven by temperature differences just below the comet surface.

Development of the Career Anchors Scale among Occupational Health Nurses in Japan

PubMed Central

Kubo, Yoshiko; Hatono, Yoko; Kubo, Tomohide; Shimamoto, Satoko; Nakatani, Junko; Burgel, Barbara J.

2016-01-01

Objectives: This study aimed to develop the Career Anchors Scale among Occupational Health Nurses (CASOHN) and evaluate its reliability and validity. Methods: Scale items were developed through a qualitative inductive analysis of interview data, and items were revised following an examination of content validity by experts and occupational health nurses (OHNs), resulting in a provisional scale of 41 items. A total of 745 OHNs (response rate 45.2%) affiliated with the Japan Society for Occupational Health participated in the self-administered questionnaire survey. Results: Two items were deleted based on item-total correlations. Factor analysis was then conducted on the remaining 39 items to examine construct validity. An exploratory factor analysis with a main factor method and promax rotation resulted in the extraction of six factors. The variance contribution ratios of the six factors were 37.45, 7.01, 5.86, 4.95, 4.16, and 3.19%. The cumulative contribution ratio was 62.62%. The factors were named as follows: Demonstrating expertise and considering position in work (Factor 1); Management skills for effective work (Factor 2); Supporting health improvement in groups and organizations (Factor 3); Providing employee-focused support (Factor 4); Collaborating with occupational health team members and personnel (Factor 5); and Compatibility of work and private life (Factor 6). The confidence coefficient determined by the split-half method was 0.85. Cronbach's alpha coefficient for the overall scale was 0.95, whereas those of the six subscales were 0.88, 0.90, 0.91, 0.80, 0.85, and 0.79, respectively. Conclusions: CASOHN was found to be valid and reliable for measuring career anchors among OHNs in Japan. PMID:27725484

Development of the Career Anchors Scale among Occupational Health Nurses in Japan.

PubMed

Kubo, Yoshiko; Hatono, Yoko; Kubo, Tomohide; Shimamoto, Satoko; Nakatani, Junko; Burgel, Barbara J

2016-11-29

This study aimed to develop the Career Anchors Scale among Occupational Health Nurses (CASOHN) and evaluate its reliability and validity. Scale items were developed through a qualitative inductive analysis of interview data, and items were revised following an examination of content validity by experts and occupational health nurses (OHNs), resulting in a provisional scale of 41 items. A total of 745 OHNs (response rate 45.2%) affiliated with the Japan Society for Occupational Health participated in the self-administered questionnaire survey. Two items were deleted based on item-total correlations. Factor analysis was then conducted on the remaining 39 items to examine construct validity. An exploratory factor analysis with a main factor method and promax rotation resulted in the extraction of six factors. The variance contribution ratios of the six factors were 37.45, 7.01, 5.86, 4.95, 4.16, and 3.19%. The cumulative contribution ratio was 62.62%. The factors were named as follows: Demonstrating expertise and considering position in work (Factor 1); Management skills for effective work (Factor 2); Supporting health improvement in groups and organizations (Factor 3); Providing employee-focused support (Factor 4); Collaborating with occupational health team members and personnel (Factor 5); and Compatibility of work and private life (Factor 6). The confidence coefficient determined by the split-half method was 0.85. Cronbach's alpha coefficient for the overall scale was 0.95, whereas those of the six subscales were 0.88, 0.90, 0.91, 0.80, 0.85, and 0.79, respectively. CASOHN was found to be valid and reliable for measuring career anchors among OHNs in Japan.

Alpha coma in an adolescent with diabetic ketoacidosis.

PubMed

Ostojic, Slavica; Vukovic, Rade; Milenkovic, Tatjana; Mitrovic, Katarina; Djuric, Milena; Nikolic, Ljubica

2017-01-01

Ostojic S, Vukovic R, Milenkovic T, Mitrovic K, Djuric M, Nikolic L. Alpha coma in an adolescent with diabetic ketoacidosis. Turk J Pediatr 2017; 59: 318-321. This is the first report of alpha coma (AC) caused by brain edema in a patient with diabetic ketoacidosis (DKA). A previously healthy 15-year-old girl was admitted to the intensive care unit due to altered state of consciousness during the course of treatment for DKA. Patient was in a coma, intubated and had tachycardia with poor peripheral perfusion. Results of laboratory analyses indicated severe DKA and computed tomography scan indicated diffuse brain edema. The EEG pattern showed uniform alpha activity. Treatment with intravenous fluids, insulin and mannitol was started. Patient`s state of consciousness gradually improved and on the third day she was extubated. On the fifth day, her neurologic status and EEG findings were completely normal with no residual neurological deficits. In conclusion, although AC is associated with a high fatality rate, favorable outcome can be achieved with prompt recognition and treatment of cerebral edema in pediatric patients with DKA.

Status epilepticus caused by a myxoedema coma.

PubMed

Jansen, H J; Doebé, S R Oedit; Louwerse, E S; van der Linden, J C; Netten, P M

2006-06-01

The case of a 63-year-old woman who presented with status epilepticus, coma and hypoventilation is reported. A primary neurological cause was considered. Hypothermia led to further investigations and a diagnosis of severe hypothyroidism. The neurological complications of hyperthyriodism include alteration in mental status with slowness, decreased concentration and lethargy, headache, cranial nerve palsies, dysarthria, hoarseness, myopathy, neuropathy, reflex changes, ataxia, and psychotic episodes. Our patient suffered from a rare consequence of severe hypothyroidism presenting with status epilepticus and she died despite treatment. To our knowledge this is the second patient to be reported with myxoedema coma with this kind of presentation. Despite therapeutic options, there is a high mortality rate.

Recovery of Patients with Pure Diffuse Axonal Injury Who Remained in a Coma for 6 Hours or More.

PubMed

Almeida Vieira, Rita de Cássia; Paiva, Wellingson Silva; de Oliveira, Daniel Vieira; de Paula Guirado, Vinícius Monteiro; Caetano Lança, Ellen de Fátima; de Sousa, Regina Márcia Cardoso

2018-01-01

Diffuse axonal injury (DAI) is a traumatic brain injury and one of the most common causes of unfavorable outcome and death. The aim of this study was to investigate the recovery of patients with pure DAI who remained in a coma for 6 hours or longer after brain injury. This was a follow-up study of 75 patients diagnosed with pure DAI, aged 18-60 years, with a Glasgow Coma Scale score ≤8 at hospital admission. Patient data were collected at hospital admission, hospital discharge, and 3 and 6 months after DAI. Recovery was assessed by score changes in the Katz Index of Independence in Activities of Daily Living and Extended Glasgow Outcome Scale. The percentage of patients in a coma for 6-24 hours, >24 hours without brainstem signs, and >24 hours with brainstem signs was 42.7%, 20%, and 37.3%, respectively. The 6-month mortality rate was 32.0%, and the mean Extended Glasgow Outcome Scale score among survivors decreased from 3.8 at discharge (SD = 1.2) to 2.1 at 3 months (SD = 1.6) and 1.2 at 6 months (SD = 1.6). The mean Katz Index of Independence in Activities of Daily Living scores were 8.5 (SD = 5.5), 3.5 (SD = 5.8), and 1.8 (SD = 4.5) at discharge and 3 and 6 months after trauma, respectively. Statistically significant differences were observed among the 3 evaluation periods. Mortality was high among patients with DAI, but almost all survivors had favorable outcomes at 6 months. Functional improvement was more pronounced in the first 3 months. Copyright © 2017. Published by Elsevier Inc.

Split high-dose oral levothyroxine treatment as a successful therapy option in myxedema coma.

PubMed

Charoensri, Suranut; Sriphrapradang, Chutintorn; Nimitphong, Hataikarn

2017-10-01

High-dose intravenous thyroxine (T4) is the preferable treatment for myxedema coma. We describe the clinical course of a 69-year-old man who presented with myxedema coma and received oral levothyroxine (LT4) therapy (1 mg) in a split dose. This suggests split high-dose oral LT4 as a therapeutic option in myxedema coma.

Analysis of Risk Factors for Hypoglycemic Coma in 194 Patients with Type 2 Diabetes

PubMed Central

Lu, Zefen; Liu, Jianfeng; He, Qing; Chakraborty, Anindita; Zhu, Tiehong

2017-01-01

Background The present study was conducted to analyze possible risk factors in patients with type 2 diabetes who are in hypoglycemic coma. Material/Methods A total of 194 patients with type 2 diabetic hypoglycemic coma who were admitted to our hospital between January 2010 and January 2016 were included. The patients were all in coma on admission, and their blood glucose levels were lower than 2.8 mmol/L. None of the patients had type I diabetes, specific types of diabetes, or gestational diabetes. Multiple linear regression analysis was used to determine possible factors associated with hypoglycemic coma. Results Among the patients, 82 were male and 112 were female (mean age, 66.88±10.62 years). In addition, 72 patients lived in urban areas and 122 lived in rural areas. Occurrence of hypoglycemic coma was correlated with difference between urban and rural residence, glycosylated hemoglobin (HbA1c) level, combined hypertension, and combined neural complications. Self-purchased drugs resulted in significantly lower blood glucose level at the onset of hypoglycemic coma than insulin, secretagogue, or non-secretagogue drugs. Blood glucose level at onset was correlated with season. Patients living in rural areas or with combined macrovascular or microvascular complications had prolonged hospital stay and poor prognosis. Conclusions Our results demonstrate that rural residence, higher HbA1c level, combined hypertension, and combined neural complications increase the incidence of hypoglycemic coma. Use of self-purchased drugs and colder seasons may result in lower blood glucose levels in patients with hypoglycemic coma. PMID:29180613

Reestablishment of ion homeostasis during chill-coma recovery in the cricket Gryllus pennsylvanicus

PubMed Central

MacMillan, Heath A.; Williams, Caroline M.; Staples, James F.; Sinclair, Brent J.

2012-01-01

The time required to recover from cold-induced paralysis (chill-coma) is a common measure of insect cold tolerance used to test central questions in thermal biology and predict the effects of climate change on insect populations. The onset of chill-coma in the fall field cricket (Gryllus pennsylvanicus, Orthoptera: Gryllidae) is accompanied by a progressive drift of Na+ and water from the hemolymph to the gut, but the physiological mechanisms underlying recovery from chill-coma are not understood for any insect. Using a combination of gravimetric methods and atomic absorption spectroscopy, we demonstrate that recovery from chill-coma involves a reestablishment of hemolymph ion content and volume driven by removal of Na+ and water from the gut. Recovery is associated with a transient elevation of metabolic rate, the time span of which increases with increasing cold exposure duration and closely matches the duration of complete osmotic recovery. Thus, complete recovery from chill-coma is metabolically costly and encompasses a longer period than is required for the recovery of muscle potentials and movement. These findings provide evidence that physiological mechanisms of hemolymph ion content and volume regulation, such as ion-motive ATPase activity, are instrumental in chill-coma recovery and may underlie natural variation in insect cold tolerance. PMID:23184963

Coma morphology of comet 67P controlled by insolation over irregular nucleus

NASA Astrophysics Data System (ADS)

Shi, X.; Hu, X.; Mottola, S.; Sierks, H.; Keller, H. U.; Rose, M.; Güttler, C.; Fulle, M.; Fornasier, S.; Agarwal, J.; Pajola, M.; Tubiana, C.; Bodewits, D.; Barbieri, C.; Lamy, P. L.; Rodrigo, R.; Koschny, D.; Barucci, M. A.; Bertaux, J.-L.; Bertini, I.; Boudreault, S.; Cremonese, G.; Da Deppo, V.; Davidsson, B.; Debei, S.; De Cecco, M.; Deller, J.; Groussin, O.; Gutiérrez, P. J.; Hviid, S. F.; Ip, W.-H.; Jorda, L.; Knollenberg, J.; Kovacs, G.; Kramm, J.-R.; Kührt, E.; Küppers, M.; Lara, L. M.; Lazzarin, M.; Lopez-Moreno, J. J.; Marzari, F.; Naletto, G.; Oklay, N.; Toth, I.; Vincent, J.-B.

2018-05-01

While the structural complexity of cometary comae is already recognizable from telescopic observations1, the innermost region, within a few radii of the nucleus, was not resolved until spacecraft exploration became a reality2,3. The dust coma displays jet-like features of enhanced brightness superposed on a diffuse background1,4,5. Some features can be traced to specific areas on the nucleus, and result conceivably from locally enhanced outgassing and/or dust emission6-8. However, diffuse or even uniform activity over topographic concavity can converge to produce jet-like features9,10. Therefore, linking observed coma morphology to the distribution of activity on the nucleus is difficult11,12. Here, we study the emergence of dust activity at sunrise on comet 67P/Churyumov-Gerasimenko using high-resolution, stereo images from the OSIRIS camera onboard the Rosetta spacecraft, where the sources and formation of the jet-like features are resolved. We perform numerical simulations to show that the ambient dust coma is driven by pervasive but non-uniform water outgassing from the homogeneous surface layer. Physical collimations of gas and dust flows occur at local maxima of insolation and also via topographic focusing. Coma structures are projected to exhibit jet-like features that vary with the perspective of the observer. For an irregular comet such as 67P/Churyumov-Gerasimenko, near-nucleus coma structures can be concealed in the shadow of the nucleus, which further complicates the picture.

Abundant molecular oxygen in the coma of comet 67P/Churyumov-Gerasimenko.

PubMed

Bieler, A; Altwegg, K; Balsiger, H; Bar-Nun, A; Berthelier, J-J; Bochsler, P; Briois, C; Calmonte, U; Combi, M; De Keyser, J; van Dishoeck, E F; Fiethe, B; Fuselier, S A; Gasc, S; Gombosi, T I; Hansen, K C; Hässig, M; Jäckel, A; Kopp, E; Korth, A; Le Roy, L; Mall, U; Maggiolo, R; Marty, B; Mousis, O; Owen, T; Rème, H; Rubin, M; Sémon, T; Tzou, C-Y; Waite, J H; Walsh, C; Wurz, P

2015-10-29

The composition of the neutral gas comas of most comets is dominated by H2O, CO and CO2, typically comprising as much as 95 per cent of the total gas density. In addition, cometary comas have been found to contain a rich array of other molecules, including sulfuric compounds and complex hydrocarbons. Molecular oxygen (O2), however, despite its detection on other icy bodies such as the moons of Jupiter and Saturn, has remained undetected in cometary comas. Here we report in situ measurement of O2 in the coma of comet 67P/Churyumov-Gerasimenko, with local abundances ranging from one per cent to ten per cent relative to H2O and with a mean value of 3.80 ± 0.85 per cent. Our observations indicate that the O2/H2O ratio is isotropic in the coma and does not change systematically with heliocentric distance. This suggests that primordial O2 was incorporated into the nucleus during the comet's formation, which is unexpected given the low upper limits from remote sensing observations. Current Solar System formation models do not predict conditions that would allow this to occur.

Epidemiology and prognosis of coma in daytime television dramas

PubMed Central

Casarett, David; Fishman, Jessica M; MacMoran, Holly Jo; Pickard, Amy; Asch, David A

2005-01-01

Objective To determine how soap operas portray, and possibly misrepresent, the likelihood of recovery for patients in coma. Design Retrospective cohort study. Setting Nine soap operas in the United States reviewed between 1 January 1995 and 15 May 2005. Subjects 64 characters who experienced a period of unconsciousness lasting at least 24 hours. Their final status at the end of the follow-up period was compared with pooled data from a meta-analysis. Results Comas lasted a median of 13 days (interquartile range 7-25 days). Fifty seven (89%) patients recovered fully, five (8%) died, and two (3%) remained in a vegetative state. Mortality for non-traumatic and traumatic coma was significantly lower than would be predicted from the meta-analysis data (non-traumatic 4% v 53%; traumatic 6% v 67%; Fisher's exact test both P < 0.001). On the day that patients regained consciousness, most (49/57; 86%) had no evidence of limited function, cognitive deficit, or residual disability needing rehabilitation. Compared with meta-analysis data, patients in this sample had a much better than expected chance of returning to normal function (non-traumatic 91% v 1%; traumatic 89% v 7%; both P < 0.001). Conclusions The portrayal of coma in soap operas is overly optimistic. Although these programmes are presented as fiction, they may contribute to unrealistic expectations of recovery. PMID:16373744

Dwarf galaxies in the coma cluster: Star formation properties and evolution

NASA Astrophysics Data System (ADS)

Hammer, Derek M.

The infall regions of galaxy clusters are unique laboratories for studying the impact of environment on galaxy evolution. This intermediate region links the low-density field environment and the dense core of the cluster, and is thought to host recently accreted galaxies whose star formation is being quenched by external processes associated with the cluster. In this dissertation, we measure the star formation properties of galaxies at the infall region of the nearby rich cluster of galaxies, Coma. We rely primarily on Ultraviolet (UV) data owing to its sensitivity to recent star formation and we place more emphasis on the properties of dwarf galaxies. Dwarf galaxies are good tracers of external processes in clusters but their evolution is poorly constrained as they are intrinsically faint and hence more challenging to detect. We make use of deep GALEX far-UV and near-UV observations at the infall region of the Coma cluster. This area of the cluster has supporting photometric coverage at optical and IR wavelengths in addition to optical spectroscopic data that includes deep redshift coverage of dwarf galaxies in Coma. Our GALEX observations were the deepest exposures taken for a local galaxy cluster. The depth of these images required alternative data analysis techniques to overcome systematic effects that limit the default GALEX pipeline analysis. Specifically, we used a deblending method that improved detection efficiency by a factor of ˜2 and allowed reliable photometry a few magnitudes deeper than the pipeline catalog. We performed deep measurements of the total UV galaxy counts in our field that were used to measure the source confusion limit for crowded GALEX fields. The star formation properties of Coma members were studied for galaxies that span from starbursts to passive galaxies. Star-forming galaxies in Coma tend to have lower specific star formation rates, on average, as compared to field galaxies. We show that the majority of these galaxies are likely

Spectroscopic Investigations of Fragment Species in the Coma

NASA Technical Reports Server (NTRS)

Feldman, Paul D.; Cochran, Anita L.; Combi, Michael R.

2004-01-01

The content of the gaseous coma of a comet is dominated by fragment species produced by photolysis of the parent molecules issuing directly from the icy nucleus of the comet. Spectroscopy of these species provides complementary information on the physical state of the coma to that obtained from observations of the parent species. Extraction of physical parameters requires detailed molecular and atomic data together with reliable high-resolution spectra and absolute fluxes of the primary source of excitation, the Sun. The large database of observations, dating back more than a century, provides a means to assess the chemical and evolutionary diversity of comets.

Dark energy and the structure of the Coma cluster of galaxies

NASA Astrophysics Data System (ADS)

Chernin, A. D.; Bisnovatyi-Kogan, G. S.; Teerikorpi, P.; Valtonen, M. J.; Byrd, G. G.; Merafina, M.

2013-05-01

Context. We consider the Coma cluster of galaxies as a gravitationally bound physical system embedded in the perfectly uniform static dark energy background as implied by ΛCDM cosmology. Aims: We ask if the density of dark energy is high enough to affect the structure of a large and rich cluster of galaxies. Methods: We base our work on recent observational data on the Coma cluster, and apply our theory of local dynamical effects of dark energy, including the zero-gravity radius RZG of the local force field as the key parameter. Results: 1) Three masses are defined that characterize the structure of a regular cluster: the matter mass MM, the dark-energy effective mass MDE (<0), and the gravitating mass MG (=MM + MDE). 2) A new matter-density profile is suggested that reproduces the observational data well for the Coma cluster in the radius range from 1.4 Mpc to 14 Mpc and takes the dark energy background into account. 3) Using this profile, we calculate upper limits for the total size of the Coma cluster, R ≤ RZG ≈ 20 Mpc, and its total matter mass, MM ≲ MM(RZG) = 6.2 × 1015 M⊙. Conclusions: The dark energy antigravity affects the structure of the Coma cluster strongly at large radii R ≳ 14 Mpc and should be considered when its total mass is derived.

Postoperative Conversion Disorder in Elderly Oral Cancer Patient.

PubMed

Yakushiji, Takashi; Hayashi, Kamichika; Morikawa, Takamichi; Migita, Masashi; Ogane, Satoru; Muramatsu, Kyotaro; Kamio, Takashi; Shibahara, Takahiko; Takano, Nobuo

2016-01-01

Conversion disorder is a condition in which psychological stress in response to difficult situations manifests as physical symptoms. Here, we report a case of postoperative coma due to conversion disorder in an elderly oral cancer patient. An 82-year-old woman was referred to Tokyo Dental College Chiba Hospital with a mass lesion on the tongue. A biopsy revealed a well-differentiated squamous cell carcinoma. Surgical treatment was performed for the tongue carcinoma and tracheotomy for management of the airway. On postoperative day 5, the patient exhibited loss of consciousness (Glasgow Coma Scale: E1, VT, M1; Japan Coma Scale: III-300). The patient's vital signs were all normal, as were the results of a full blood count, brain-CT, MRI, and MRA. Only the arm dropping test was positive. Therefore, the cause of the coma was diagnosed as conversion disorder. Seven hours later, the patient showed a complete recovery.

VizieR Online Data Catalog: ETGs sample for the Coma cluster (Riguccini+, 2015)

NASA Astrophysics Data System (ADS)

Riguccini, L.; Temi, P.; Amblard, A.; Fanelli, M.; Brighenti, F.

2017-10-01

For the Coma Cluster, we utilize the work of Mahajan et al. (2010, J/MNRAS/404/1745) to build our ETG sample. Mahajan et al. (2010, J/MNRAS/404/1745) used a combination of MIPS 24 μm observations and SDSS photometry and spectra to investigate the star formation history of galaxies in the Coma supercluster. All of their galaxies from the SDSS data in the Coma supercluster region are brighter than r~17.77, the completeness limit of the SDSS spectroscopic galaxy catalog. Their 24 μm fluxes are obtained from archival data covering 2x2 deg2 for Coma Cluster. Our final sample of 124 sources is composed of 49 ellipticals and 75 lenticulars. (1 data file).

Amiodarone-induced myxoedema coma.

PubMed

Hassan, Syed; Ayoub, Walaa; Hassan, Mona; Wisgerhof, Max

2014-04-12

A 62-year-old man was found to have bradycardia, hypothermia and respiratory failure 3 weeks after initiation of amiodarone therapy for atrial fibrillation. Thyroid-stimulating hormone was found to be 168 μIU/mL (nl. 0.3-5 μIU/mL) and free thyroxine (FT4) was <0.2 ng/dL (nl. 0.8-1.8 ng/dL). He received intravenous fluids, vasopressor therapy and stress dose steroids; he was intubated and admitted to the intensive care unit. He received 500 μg of intravenous levothyroxine in the first 18 h of therapy, and 150 µg intravenous daily thereafter. Haemodynamic improvement, along with complete recovery of mental status, occurred after 48 h. Twelve hours after the initiation of therapy, FT4 was 0.96 ng/dL. The patient was maintained on levothyroxine 175 (g POorally daily. A thyroid ultrasound showed diffuse heterogeneity. The 24 hour excretion of iodine was 3657 (mcg (25-756 ( mcg). The only two cases of amiodarone-induced myxoedema coma in the literature report patient death despite supportive therapy and thyroid hormone replacement. This case represents the most thoroughly investigated case of amiodarone-induced myxoedema coma with a history significant for subclinical thyroid disease.

Millennial-scale variability in vegetation records from the East Asian Islands: Taiwan, Japan and Sakhalin

NASA Astrophysics Data System (ADS)

Takahara, Hikaru; Igarashi, Yaeko; Hayashi, Ryoma; Kumon, Fujio; Liew, Ping-Mei; Yamamoto, Masanobu; Kawai, Sayuri; Oba, Tadamichi; Irino, Tomohisa

2010-10-01

High-resolution pollen records from Taiwan, Japan and Sakhalin document regional vegetation changes during Dansgaard-Oeschger (D-O) cycles during the last glacial. During the period from the cold phase (GS 18/19) to warm phase (D-O 19), the biome shift from temperate conifer forest to cold/cool conifer forest in Japan and from subtropical forest to temperate deciduous/conifer forest in Taiwan. The vegetation in D-O 17, cool mixed forest in central Japan, temperate deciduous broadleaf forest in western Japan and subtropical forest in Taiwan, indicates warm condition but not wet in all area. These vegetation changes lead to biome shift from MIS (Marine Isotope Stage) 4 to MIS 3. The abundance of Cryptomeria japonica and Fagus crenata in D-O 12 and D-O 8 indicates wet conditions brought by the strong summer monsoon through the Islands and high snowfall brought by the inflow of the Tsushima Warm Current into the Sea of Japan. The registration of other D-O warming events in MIS 3, although reflected by shifts in the abundance of key species, is not sufficient to produce changes in biomes. Development of cold deciduous forest in HS (Heinrich events) 1 in Sakhalin, Hokkaido and central Japan was conspicuous and was much larger than that in YD. Vegetation response in YD was small scale and within the same biome in the East Asian Islands. In D-O 1 at the termination of the last glacial, the same taxa that developed in the early Holocene, cold evergreen needleleaf trees in northern region, temperate deciduous broadleaf trees in central and western Japan, and warm-temperate evergreen trees in Taiwan, increased.

[The myxoedema coma exists, we met it].

PubMed

Fritsch, N; Tran-Van, D; Dardare, E; Gentile, A; Deroudilhe, G; Fontaine, B

2007-09-01

The myxoedema coma corresponds to the ultimate evolution of a hypothyroidism and is characterized by a major deficit in thyroid hormones responsible for a collapse of the metabolism. The preventive and curative treatment is based on the administration of thyroid hormones, whose benefits are opposed to the cardiovascular risks related to an iatrogenic hyperthyroidism for patients often old with cardiopathy. We report the case of a 92-year-old patient with unbalanced hypothyroidism and chronic cardiac deficiency, who presented a myxoedema coma in the postoperative period of an urgent digestive surgery. This observation illustrates the difficulties in treating patients with unbalanced hypothyroidism following emergency surgery, in the absence of consensus on the type and the amounts of thyroid hormones substitution.

[Hysterical pseudo-coma: A case report].

PubMed

Chouaib, N; Chouaib, H; Belyamani, L; Otheman, Y; Bichra, M Z

2015-09-01

Hysterical pseudo-coma corresponds to a state of clinical sleep with contrasting waking electroencephalogram. It can last several hours or even several days in the absence of an underlying organic disease. In psychiatry, this disorder is currently part of the "dissociative disorder not otherwise specified". Through this case report, we describe the evolution of a hysterical pseudo-coma that lasted four days in a 28-year-old man. The normality of biological, radiological and electroencephalographic assessments, and responsiveness of the patient during the implementation of a nasogastric tube, led us to suspect a mental origin. An adapted psychiatric care allowed the patient to recover his autonomy after three days of hospitalization. This had prevented the escalation of explorations and invasive treatments. However, the search for organic comorbidity and its management remains a priority. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Origins of ultra-diffuse galaxies in the Coma cluster - II. Constraints from their stellar populations

NASA Astrophysics Data System (ADS)

Ferré-Mateu, Anna; Alabi, Adebusola; Forbes, Duncan A.; Romanowsky, Aaron J.; Brodie, Jean; Pandya, Viraj; Martín-Navarro, Ignacio; Bellstedt, Sabine; Wasserman, Asher; Stone, Maria B.; Okabe, Nobuhiro

2018-06-01

In this second paper of the series we study, with new Keck/DEIMOS spectra, the stellar populations of seven spectroscopically confirmed ultra-diffuse galaxies (UDGs) in the Coma cluster. We find intermediate to old ages (˜ 7 Gyr), low metallicities ([Z/H]˜ - 0.7 dex) and mostly super-solar abundance patterns ([Mg/Fe] ˜ 0.13 dex). These properties are similar to those of low-luminosity (dwarf) galaxies inhabiting the same area in the cluster and are mostly consistent with being the continuity of the stellar mass scaling relations of more massive galaxies. These UDGs' star formation histories imply a relatively recent infall into the Coma cluster, consistent with the theoretical predictions for a dwarf-like origin. However, considering the scatter in the resulting properties and including other UDGs in Coma, together with the results from the velocity phase-space study of the Paper I in this series, a mixed-bag of origins is needed to explain the nature of all UDGs. Our results thus reinforce a scenario in which many UDGs are field dwarfs that become quenched through their later infall onto cluster environments, whereas some UDGs could be be genuine primordial galaxies that failed to develop due to an early quenching phase. The unknown proportion of dwarf-like to primordial-like UDGs leaves the enigma of the nature of UDGs still open.

Automated EEG entropy measurements in coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state

PubMed Central

Gosseries, Olivia; Schnakers, Caroline; Ledoux, Didier; Vanhaudenhuyse, Audrey; Bruno, Marie-Aurélie; Demertzi, Athéna; Noirhomme, Quentin; Lehembre, Rémy; Damas, Pierre; Goldman, Serge; Peeters, Erika; Moonen, Gustave; Laureys, Steven

Summary Monitoring the level of consciousness in brain-injured patients with disorders of consciousness is crucial as it provides diagnostic and prognostic information. Behavioral assessment remains the gold standard for assessing consciousness but previous studies have shown a high rate of misdiagnosis. This study aimed to investigate the usefulness of electroencephalography (EEG) entropy measurements in differentiating unconscious (coma or vegetative) from minimally conscious patients. Left fronto-temporal EEG recordings (10-minute resting state epochs) were prospectively obtained in 56 patients and 16 age-matched healthy volunteers. Patients were assessed in the acute (≤1 month post-injury; n=29) or chronic (>1 month post-injury; n=27) stage. The etiology was traumatic in 23 patients. Automated online EEG entropy calculations (providing an arbitrary value ranging from 0 to 91) were compared with behavioral assessments (Coma Recovery Scale-Revised) and outcome. EEG entropy correlated with Coma Recovery Scale total scores (r=0.49). Mean EEG entropy values were higher in minimally conscious (73±19; mean and standard deviation) than in vegetative/unresponsive wakefulness syndrome patients (45±28). Receiver operating characteristic analysis revealed an entropy cut-off value of 52 differentiating acute unconscious from minimally conscious patients (sensitivity 89% and specificity 90%). In chronic patients, entropy measurements offered no reliable diagnostic information. EEG entropy measurements did not allow prediction of outcome. User-independent time-frequency balanced spectral EEG entropy measurements seem to constitute an interesting diagnostic – albeit not prognostic – tool for assessing neural network complexity in disorders of consciousness in the acute setting. Future studies are needed before using this tool in routine clinical practice, and these should seek to improve automated EEG quantification paradigms in order to reduce the remaining false

[Acute encephalopathy caused by cyanogenic fungi in 2004, and magic mushroom regulation in Japan].

PubMed

Gonmori, Kunio; Yokoyama, Kazumasa

2009-03-01

Two topics, related to mushroom poisoning of recent interest in Japan, have been presented. In autumn 2004, 59 cases of acute encephalopathy were reported across 9 prefectures in Japan (24 from Akita Prefecture with 8 deaths; age 48-93, average 70; female 14, male 10). Of 24 cases, 20 had kidney dysfunction. Four poisoned subjects showed no kidney trouble. Of the 24 poisoning cases, 23 people ate Pleurocybella porrigens, and one ate Grifola frondosa. The latter subject (female, late 40's) was receiving dialysis for more than 35 years. In August, she felt dizziness, headache and tinnitus. She visited hospital and asked to stay there. In the hospital she ate 5g of stewed G. frondosa and 10g of the same fungus boiled with chicken and taro on different days. Fourteen to 18 days after the eatings, she developed cramps and lost consciousness, and fell into a coma. Her cramp and coma continued for about 10 days almost until her death. Her symptoms caused by G. frondosa were similar to those observed for the above 23 cases of P. porrigens ingestion. Therefore, we concluded that encephalopathy experienced in Akita Prefecture caused by was the cyanogenic fungi such as P. porrigens , G. frondosa, Pleurotus eringii etc. Although the amounts of mushrooms eaten by poisoned subjects were not so clear, we estimated that the amounts of hydrogen cyanide (HCN) taken into human bodies exceeded the detoxication limit of HCN, resulting in HCN poisoning. However, it has not been proved that the encephalopathy is directly or indirectly caused by the HCN poisoning. Many typhoons came across Japan and landed 10 times in 2004, and mushroom size was larger than usual one, and HCN contents in fruit-bodies seemed to be increased especially in the late-stage of their growth. Thirteen species of magic mushrooms were prohibited by the law from 2002 in Japan. They include Copelandia (Panaeolus) cyanescens, Panaeolus papilionaceus, Panaeolus sphinctrinus, Panaeolus subbalteatus, Psilocybe argentipes

VizieR Online Data Catalog: HST/ACS Coma Cluster Survey. VI. (den Brok+, 2011)

NASA Astrophysics Data System (ADS)

den Brok, M.; Peletier, R. F.; Valentijn, E. A.; Balcells, M.; Carter, D.; Erwin, P.; Ferguson, H. C.; Goudfrooij, P.; Graham, A. W.; Hammer, D.; Lucey, J. R.; Trentham, N.; Guzman, R.; Hoyos, C.; Verdoes Kleijn, G.; Jogee, S.; Karick, A. M.; Marinova, I.; Mouhcine, M.; Weinzirl, T.

2018-01-01

We have used the data from the HST/ACS Coma Cluster Survey, a deep two-passband imaging survey of the Coma cluster. A full description of the observations and data reduction can be found in Paper I (Carter et al., 2008ApJS..176..424C). We have derived colour gradients for a sample of confirmed or very likely Coma cluster members. (2 data files).

The Complex Outgassing of Comets and the Resulting Coma, a Direct Simulation Monte-Carlo Approach

NASA Astrophysics Data System (ADS)

Fougere, Nicolas

During its journey, when a comet gets within a few astronomical units of the Sun, solar heating liberates gases and dust from its icy nucleus forming a rarefied cometary atmosphere, the so-called coma. This tenuous atmosphere can expand to distances up to millions of kilometers representing orders of magnitude larger than the nucleus size. Most of the practical cases of coma studies involve the consideration of rarefied gas flows under non-LTE conditions where the hydrodynamics approach is not valid. Then, the use of kinetic methods is required to properly study the physics of the cometary coma. The Direct Simulation Monte-Carlo (DSMC) method is the method of choice to solve the Boltzmann equation, giving the opportunity to study the cometary atmosphere from the inner coma where collisions dominate and is in thermodynamic equilibrium to the outer coma where densities are lower and free flow conditions are verified. While previous studies of the coma used direct sublimation from the nucleus for spherically symmetric 1D models, or 2D models with a day/night asymmetry, recent observations of comets showed the existence of local small source areas such as jets, and extended sources via sublimating icy grains, that must be included into cometary models for a realistic representation of the physics of the coma. In this work, we present, for the first time, 1D, 2D, and 3D models that can take into account the full effects of conditions with more complex sources of gas with jets and/or icy grains. Moreover, an innovative work in a full 3D description of the cometary coma using a kinetic method with a realistic nucleus and outgassing is demonstrated. While most of the physical models used in this study had already been developed, they are included in one self-consistent coma model for the first time. The inclusion of complex cometary outgassing processes represents the state-of-the-art of cometary coma modeling. This provides invaluable information about the coma by

Therapeutic burst-suppression coma in pediatric febrile refractory status epilepticus.

PubMed

Lin, Jainn-Jim; Chou, Cheng-Che; Lan, Shih-Yun; Hsiao, Hsiang-Ju; Wang, Yu; Chan, Oi-Wa; Hsia, Shao-Hsuan; Wang, Huei-Shyong; Lin, Kuang-Lin

2017-09-01

Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013. The clinical characteristics were analyzed. Thirty-five patients (23 boys; age range: 1-18years) were enrolled, of whom 28 (80%) developed super-refractory status epilepticus. All of the patients received the continuous administration of intravenous antiepileptic drugs for febrile refractory status epilepticus, and 26 (74.3%) achieved therapeutic burst-suppression coma. All of the patients received mechanical ventilatory support, and 26 (74.3%) received inotropic agents. Eight (22.9%) patients died within 1month. The neurologically functional outcomes at 6months were good in six (27.3%) of the 22 survivors, of whom two returned to clinical baseline. The patients with therapeutic burst-suppression coma were significantly associated with hemodynamic support than the patients with electrographic seizures control (p=0.03), and had a trend of higher 1-month mortality rate, worse 6months outcomes, and a longer duration of hospitalization. Our results suggest that therapeutic burst-suppression coma to treat febrile refractory status epilepticus may lead to an increased risk of hemodynamic instability and a trend of worse outcomes. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Hco+ in the Coma of Comet Hale-Bopp

NASA Astrophysics Data System (ADS)

Lovell, A. J.; Schloerb, F. P.; Bergin, E. A.; Dickens, J. E.; De Vries, C. H.; Senay, M. C.; Irvine, W. M.

1997-05-01

Maps of comet C/1995 O1 (Hale-Bopp) in the millimeter-wave emission of the ion HCO^+ revealed a local minimum near the nucleus position, with a maximum about 100,000 km in the antisolar direction. These observed features of the HCO^+ emission require a low abundance of HCO^+ due to enhanced destruction in the inner coma of the comet, within a region of low electron temperature (T_e). To set constraints on the formation of HCO^+ in the coma, as well as the location and magnitude of the transition to higher T_e, the data are compared with the results of ion-molecule chemistry models.

HCO+ in the coma of comet Hale-Bopp

NASA Technical Reports Server (NTRS)

Lovell, A. J.; Schloerb, F. P.; Bergin, E. A.; Dickens, J. E.; Devries, C. H.; Senay, M. C.; Irvine, W. M.; Ferris, J. P. (Principal Investigator)

1997-01-01

Maps of comet C/1995 O1 (Hale-Bopp) in the millimeter-wave emission of the ion HCO+ revealed a local minimum near the nucleus position, with a maximum about 100,000 km in the antisolar direction. These observed features of the HCO+ emission require a low abundance of HCO+ due to enhanced destruction in the inner coma of the comet, within a region of low electron temperature (Te). To set constraints on the formation of HCO+ in the coma, as well as the location and magnitude of the transition to higher Te, the data are compared with the results of ion-molecule chemistry models.

Chemical Recycling of Molecules in Cometary Comae

NASA Astrophysics Data System (ADS)

Boice, Daniel C.; Kawakita, Hideyo; Shinnaka, Yoshiharu; Kobayashi, Hitomi

2015-08-01

Modeling is essential to understand the important physical and chemical processes that occur in cometary comae, especially the relationship between native and sibling molecules, such as, HCN and CN. Photochemistry is a major source of ions and electrons that further initiate key gas-phase reactions, leading to the plethora of molecules and atoms observed in comets. The effects of photoelectrons that react via impacts are important to the overall ionization in the inner coma. We have found that many molecules undergo protonation reactions with primarily water, followed by electron recombination resulting in the original molecules in a vibrationally excited state. These excited molecules spontaneously emit photons back to the ground state. We identify this series of reactions as chemical “recycling.” We discuss the importance of this mechanism for HCN, NH3, and water in comets. We also identify other relevant processes in the collision-dominated, inner coma of a comet within a global modeling framework to better understand observations and in situ measurements of cometary species, especially relationships between native and sibling molecules for the Rosetta Mission to Comet 67P/Churyumov-Gerasimenko.Acknowledgements: We appreciate support from the NSF Planetary Astronomy Program under Grant No. 0908529. This program is partially supported by the MEXT Supported Program for the Strategic Research Foundation at Private Universities, 2014-2018.

[Thyroid emergencies : Thyroid storm and myxedema coma].

PubMed

Spitzweg, C; Reincke, M; Gärtner, R

2017-10-01

Thyroid emergencies are rare life-threatening endocrine conditions resulting from either decompensated thyrotoxicosis (thyroid storm) or severe thyroid hormone deficiency (myxedema coma). Both conditions develop out of a long-standing undiagnosed or untreated hyper- or hypothyroidism, respectively, precipitated by an acute stress-associated event, such as infection, trauma, or surgery. Cardinal features of thyroid storm are myasthenia, cardiovascular symptoms, in particular tachycardia, as well as hyperthermia and central nervous system dysfunction. The diagnosis is made based on clinical criteria only as thyroid hormone measurements do not differentiate between thyroid storm and uncomplicated hyperthyroidism. In addition to critical care measures therapy focusses on inhibition of thyroid hormone synthesis and secretion (antithyroid drugs, perchlorate, Lugol's solution, cholestyramine, thyroidectomy) as well as inhibition of thyroid hormone effects in the periphery (β-blocker, glucocorticoids).Cardinal symptoms of myxedema coma are hypothermia, decreased mental status, and hypoventilation with risk of pneumonia and hyponatremia. The diagnosis is also purely based on clinical criteria as measurements of thyroid hormone levels do not differ between uncomplicated severe hypothyroidism and myxedema coma. In addition to substitution of thyroid hormones and glucocorticoids, therapy focusses on critical care measures to treat hypoventilation and hypercapnia, correction of hyponatremia and hypothermia.Survival of both thyroid emergencies can only be optimized by early diagnosis based on clinical criteria and prompt initiation of multimodal therapy including supportive measures and treatment of the precipitating event.

Prediction of Recovery from Coma After CPR

MedlinePlus

... to pain. There is good evidence* that myoclonus status epilepticus within the first day after CPR accurately predicts poor recovery from coma. Myoclonus status epilepticus is a constant twitching of muscles, including the ...

A diagnostic scoring system for myxedema coma.

PubMed

Popoveniuc, Geanina; Chandra, Tanu; Sud, Anchal; Sharma, Meeta; Blackman, Marc R; Burman, Kenneth D; Mete, Mihriye; Desale, Sameer; Wartofsky, Leonard

2014-08-01

To develop diagnostic criteria for myxedema coma (MC), a decompensated state of extreme hypothyroidism with a high mortality rate if untreated, in order to facilitate its early recognition and treatment. The frequencies of characteristics associated with MC were assessed retrospectively in patients from our institutions in order to derive a semiquantitative diagnostic point scale that was further applied on selected patients whose data were retrieved from the literature. Logistic regression analysis was used to test the predictive power of the score. Receiver operating characteristic (ROC) curve analysis was performed to test the discriminative power of the score. Of the 21 patients examined, 7 were reclassified as not having MC (non-MC), and they were used as controls. The scoring system included a composite of alterations of thermoregulatory, central nervous, cardiovascular, gastrointestinal, and metabolic systems, and presence or absence of a precipitating event. All 14 of our MC patients had a score of ≥60, whereas 6 of 7 non-MC patients had scores of 25 to 50. A total of 16 of 22 MC patients whose data were retrieved from the literature had a score ≥60, and 6 of 22 of these patients scored between 45 and 55. The odds ratio per each score unit increase as a continuum was 1.09 (95% confidence interval [CI], 1.01 to 1.16; P = .019); a score of 60 identified coma, with an odds ratio of 1.22. The area under the ROC curve was 0.88 (95% CI, 0.65 to 1.00), and the score of 60 had 100% sensitivity and 85.71% specificity. A score ≥60 in the proposed scoring system is potentially diagnostic for MC, whereas scores between 45 and 59 could classify patients at risk for MC.

These are two images of the inner coma of Comet Hyakutake

NASA Technical Reports Server (NTRS)

2002-01-01

These are two images of the inner coma of Comet Hyakutake made on April 3 and 4, 1996, using the NASA Hubble Space Telescope Wide Field Planetary Camera 2 (WFPC2). The first one, shown in red, was taken through a narrow-band red filter that shows only sunlight scattered by dust particles in the inner coma of the comet. The second one, shown in blue was taken with an ultraviolet 'Woods' filter image that shows the distribution of scattered ultraviolet radiation from hydrogen atoms in the inner coma. The coma is the head or dusty-gas atmosphere of a comet. The square field of view is 14,000 km on a side and the sun is toward the upper right corner of the image. Hydrogen atoms represent the most abundant gas in the whole coma of the comet. They are produced when solar ultraviolet light breaks up molecules of water, the major constitutent of the nucleus of the comet. These images were taken as part of an observing program to study water photochemistry in comets. Measurements of hydrogen (H) and hydroxyl (OH) in the coma (or atmosphere) of Comet Hyakutake were also made using the Goddard High Resolution Spectrograph (GHRS) and the Faint Object Spectrograph (FOS). A self-consistent analysis of all the data shows that the water production rate of the comet was between 7 and 8 tons per second on the April 3 and 4. A theoretical model was used in the analysis which accounts for the detailed physics and chemistry of the photochemical destruction of the water, the production of the H and OH, and their expansion in the coma (or atmosphere) of the comet. The model matched the velocity measurements of hydrogen atoms made using the high spectral resolution capabilities of the GHRS instrument. The importance of such a detailed model is that is permits the accurate calculation of the production rate of water from observations of H and OH. The inner yellow region near the center of the red dust image is dominated by the contribution from the dust which shows sunward directed spiral

Modeling the Thermodynamic Properties of the Inner Comae of Comets

NASA Astrophysics Data System (ADS)

Boice, Daniel C.

2017-10-01

Introduction: Modeling is central to understand the important properties of the cometary environment. We have developed a comet model, SUISEI, that self-consistently includes the relevant physicochemical processes within a global modeling framework, from the porous subsurface layers of the nucleus to the interaction with the solar wind. Our goal is to gain valuable insights into the intrinsic properties of cometary nuclei so we can better understand observations and in situ measurements. SUISEI includes a multifluid, reactive gas dynamics simulation of the dusty coma (ComChem) and a suite of other coupled numerical simulations. This model has been successfully applied to a variety of comets in previous studies over the past three decades. We present results from a quantitative study of the thermodynamic properties and chemistry of cometary comae as a function of cometocentric and heliocentric distance to aid in interpretation of observations and in situ measurements of comets.Results and Discussion: ComChem solves the fluid dynamic equations for the mass, momentum, and energy of three neutral fluids (H, H2, and the heavier bulk fluid), ions, and electrons. In the inner coma, the gas expands, cools, accelerates, and undergoes many photolytic and gas-phase chemical reactions tracking hundreds of sibling species. The code handles the transition to free molecular flow and describes the spatial distribution of species in the coma of a comet. Variations of neutral gas temperature and velocity with cometocentric distance and heliocentric distance for a comet approaching the Sun from 2.5 to 0.3 AU are presented. Large increases in the gas temperatures (>400 K) due to photolytic heating in the coma within ~0.5 AU are noted, with dramatic effects on the chemistry, optical depth, and other coma properties. Results are compared to observations when available.Conclusions: SUISEI has proven to be a unique and valuable model to understand the relevant physical processes and

Ram Pressure Stripping and Morphological Transformation in the Coma Cluster

NASA Astrophysics Data System (ADS)

Gregg, Michael; West, Michael

2017-01-01

The two largest spiral galaxies in the Coma cluster, NGC4911 and NGC4921, exhibit signs of being vigorously ram-pressure stripped by the hot intracluster medium. HST ACS and WFC3 images have revealed galactic scale shock fronts, giant "Pillars of Creation", rivulets of dust, and spatially coherent star formation in these grand design spirals. All evidence points to these galaxies being stressed by a global external source which can only be the hot intracluster medium (ICM). Inspired by these examples, we have obtained HST WFC3 imaging of five additional large spirals to search for and investigate the effects of ram pressure stripping across the wider Coma cluster. The results are equally spectacular as the first two examples. The geometry of the interactions in some cases allows us to estimate the various time scales involved, including gas flows out of the disk leading to creation of the ICM, and the attendant triggered star formation in the galaxy disks. The global star formation patterns and wholesale tidal stripping of matter yield insights into the spatial and temporal ISM-ICM interactions driving the evolution of galaxies in clusters and ultimately transforming their morphologies from spiral to S0. These processes, much more common in the early Universe, led to the wholesale morphological transformation of Hubble types during the assembly of rich clusters, when the intergalactic populations and hot ICM were first being created and laid down from such stripping and destruction of their member galaxies.We also report on two instrumental aspects of WFC3: 1) using the filter pair F350LP and F600LP to create an extremely broad pseudo Blue-Red color to achieve the greatest observing efficiency with HST, and 2) a WFC3 CCD effect which leads to apparent quantization of background counts, making automatic sky determination challenging when using drizzlepac routines.

Asymmetric Spherical Coupled Escape Probability: Model and Results for Optically Thick Cometary Comae

NASA Astrophysics Data System (ADS)

Gersch, Alan; A'Hearn, M. F.

2012-05-01

We have adapted the Coupled Escape Probability method of radiative transfer calculations for use in asymmetrical spherical situations and applied it to modeling molecular emission spectra of potentially optically thick cometary comae. Recent space missions (e.g. Deep Impact & EPOXI) have provided spectra from comets of unprecedented spatial resolution of the regions of the coma near the nucleus, where the coma may be optically thick. Currently active missions (e.g. Rosetta) and hopefully more in the future will continue the trend and demonstrate the need for better modeling of comae with optical depth effects included. Here we present a brief description of our model and results of interest for cometary studies, especially for space based observations. Although primarily motivated by the need for comet modeling, our (asymmetric spherical) radiative transfer model could be used for studying other astrophysical phenomena as well.

Diagnostic Simulations of the Lunar Exosphere using Coma and Tail

NASA Astrophysics Data System (ADS)

Lee, Dong Wook; Kim, Sang J.

2017-10-01

The characteristics of the lunar exosphere can be constrained by comparing simulated models with observational data of the coma and tail (Lee et al., JGR, 2011); and thus far a few independent approaches on this issue have been performed and presented in the literature. Since there are two-different observational constraints for the lunar exosphere, it is interesting to find the best exospheric model that can account for the observed characteristics of the coma and tail. Considering various initial conditions of different sources and space weather, we present preliminary time-dependent simulations between the initial and final stages of the development of the lunar tail. Based on an updated 3-D model, we are planning to conduct numerous simulations to constrain the best model parameters from the coma images obtained from coronagraph observations supported by a NASA monitoring program (Morgan, Killen, and Potter, AGU, 2015) and future tail data.

Spatial variation in automated burst suppression detection in pharmacologically induced coma.

PubMed

An, Jingzhi; Jonnalagadda, Durga; Moura, Valdery; Purdon, Patrick L; Brown, Emery N; Westover, M Brandon

2015-01-01

Burst suppression is actively studied as a control signal to guide anesthetic dosing in patients undergoing medically induced coma. The ability to automatically identify periods of EEG suppression and compactly summarize the depth of coma using the burst suppression probability (BSP) is crucial to effective and safe monitoring and control of medical coma. Current literature however does not explicitly account for the potential variation in burst suppression parameters across different scalp locations. In this study we analyzed standard 19-channel EEG recordings from 8 patients with refractory status epilepticus who underwent pharmacologically induced burst suppression as medical treatment for refractory seizures. We found that although burst suppression is generally considered a global phenomenon, BSP obtained using a previously validated algorithm varies systematically across different channels. A global representation of information from individual channels is proposed that takes into account the burst suppression characteristics recorded at multiple electrodes. BSP computed from this representative burst suppression pattern may be more resilient to noise and a better representation of the brain state of patients. Multichannel data integration may enhance the reliability of estimates of the depth of medical coma.

Amiodarone-induced myxoedema coma

PubMed Central

Hassan, Syed; Ayoub, Walaa; Hassan, Mona; Wisgerhof, Max

2014-01-01

A 62-year-old man was found to have bradycardia, hypothermia and respiratory failure 3 weeks after initiation of amiodarone therapy for atrial fibrillation. Thyroid-stimulating hormone was found to be 168 μIU/mL (nl. 0.3–5 μIU/mL) and free thyroxine (FT4) was <0.2 ng/dL (nl. 0.8–1.8 ng/dL). He received intravenous fluids, vasopressor therapy and stress dose steroids; he was intubated and admitted to the intensive care unit. He received 500 μg of intravenous levothyroxine in the first 18 h of therapy, and 150 µg intravenous daily thereafter. Haemodynamic improvement, along with complete recovery of mental status, occurred after 48 h. Twelve hours after the initiation of therapy, FT4 was 0.96 ng/dL. The patient was maintained on levothyroxine 175 (g POorally daily. A thyroid ultrasound showed diffuse heterogeneity. The 24 hour excretion of iodine was 3657 (mcg (25–756 ( mcg). The only two cases of amiodarone-induced myxoedema coma in the literature report patient death despite supportive therapy and thyroid hormone replacement. This case represents the most thoroughly investigated case of amiodarone-induced myxoedema coma with a history significant for subclinical thyroid disease. PMID:24729111

The effect of brain death and coma on gastric myoelectrical activity.

PubMed

Bor, Canan; Bordin, Dmitry; Demirag, Kubilay; Uyar, Mehmet

2016-05-01

Gastrointestinal motility problems and delayed gastric emptying in patients admitted to intensive care units are important because they can contribute to different problems. Herein we aimed to measure the changes in gastric myoelectrical activity with electrogastrography (EGG) following brain death (BD) and compare the results to those from patients in a deep coma without BD. Fifteen patients with BD and nine in a deep coma with a Glasgow Coma Score from 3 to 8 were included. An enteral nutrition solution was given via a nasogastric tube between 45 min of fasting and the postprandial periods. The mean dominant frequency (MnDF), normal gastric slow wave ratio (%), tachygastria and bradygastria (%), power ratio (PR: dominant power after test meal/fasting), and dominant frequency instability coefficient were evaluated. The median of MnDF was determined 3.20±0.6 (BD) vs 3.05±0.5 (control), p>0.05. Patients with BD displayed tachygastria, particularly during the fasting state, with this disturbance decreasing during the postprandial period (from 41% to 15%). However, none of the differences between the groups were statistically significant. PR was pathologic in 4/15 (26.7%) patients in the BD group and 4/9 (44.4%) patients in the control group (p=0.288). Patients with coma or BD bouth might have gastric myoelectrical activity disturbances. BD does not show more severe disturbance than coma wihouth BD. EGG might be useful as a non-invasive and easy-to-use technology; however, it needs further improvement.

Coma of modified Gregorian and Cassegrainian mirror systems

NASA Technical Reports Server (NTRS)

Jones, R. T.

1976-01-01

The equivalence of the classical Newtonian, Cassegrainian, and Gregorian mirror systems with respect to the first two Seidel aberrations is rederived by means of a simple congruence. The effects of arbitrary small modifications of the two mirror systems are then studied and general formulas are derived for the effects of such modifications on the spherical aberration and coma. Spherical aberration is corrected to the third order if the amount of glass removed from one surface is replaced at the corresponding zone of the other surface. Modifications in which one surface is made spherical while the other is adjusted to eliminate spherical aberration result in large increases of coma for systems having the usual amplifying ratios.

Morfología de la Coma del Cometa Hale - Bopp

NASA Astrophysics Data System (ADS)

Gil-Hutton, R.; Caballero, M.; Coldwell, G.; Cañada, M.; Godoy, G.; Trozzo, C.; Gómez, G.

Para lograr comprender plenamente los procesos físicos que se desarrollan en los núcleos cometarios y obtener un modelo que explique, no sólo su actividad, sino también sus efectos sobre la coma, es necesario obtener información detallada para el mayor número de cometas posible, siendo las características más interesantes para estudiar la ubicación de las regiones activas, la presencia de jets, las tasas de producción de gas y polvo y la interacción de la coma con el viento solar. En la actualidad, con técnicas de procesamiento de imágenes y tecnología CCD se pueden obtener este tipo de datos para cometas que ingresan al sistema solar interior y estudiar, de esta manera, la morfología de sus comas, tratando de correlacionar la actividad detectada con algún modelo teórico. En este trabajo se presenta un estudio parcial de la actividad desarrollada por el cometa Hale-Bopp, y sus efectos sobre la morfología de su coma, desde agosto de 1995 hasta la fecha en base a imágenes adquiridas con el telescopio de 0.76 m. de la Estación Astronómica Dr. Carlos Ulrrico Cesco.

The Large-Grained Dust Coma of 174P/Echeclus

NASA Technical Reports Server (NTRS)

Bauer, James M.; Choi, Young-Jun; Weissman, Paul R.; Stansberry, John A.; Fernandez, Yanga R.; Roe, Henry G.; Buratti, Bonnie J.; Sung, Hyun-Il

2008-01-01

On 2005 December 30, Y.-J. Choi and P. R. Weissman discovered that the formerly dormant Centaur 2000 EC98 was in strong outburst. Previous observations by P. Rousselot et al. spanning a 3-year period indicated a lack of coma down to the 27 mag arcsec 2 level.We present Spitzer Space Telescope MIPS observations of this newly active Centaur--now known as 174P/Echeclus (2000 EC98)--or 60558 Echeclus--taken in 2006 late February. The images show strong signal at both the 24 and 70 micron bands and reveal an extended coma about 2' in diameter. Analyses yield estimates of the coma signal contribution that are in excess of 90% of the total signal in the 24 micron band. Dust production estimates ranging from 1.7-4 x 10(exp 2) kg/s are on the order of 30 times that seen in other Centaurs. Simultaneous visible-wavelength observations were also obtained with Palomar Observatory's 200-inch telescope, the 1.8-m Vatican Advanced Technology Telescope, the Bohyunsan Optical Astronomy Observatory (BOAO) 1.8-m telescope, and Table Mountain Observatory's 0.6-m telescope, revealing a coma morphology nearly identical to the mid-IR observations. The grain size distribution derived from the data yields a log particle mass power-law with slope parameter (alpha) = -0.87 +/- 0.07, and is consistent with steady cometary-activity, such as that observed during the Stardust spacecraft's encounter at 81P/Wild 2, and not with an impact driven event, such as that caused by the Deep Impact experiment.

Hypothyroidism and myxedema coma.

PubMed

Finora, Kevin; Greco, Deborah

2007-01-01

Hypothyroidism is a common endocrinopathy in dogs but is rare in cats. Lymphocytic thyroiditis and idiopathic thyroid atrophy are common causes of this condition. Specific thyroid function tests, in conjunction with clinical signs and physical examination findings, are used to help confirm a diagnosis of hypothyroidism. This disease can be managed with synthetic hormone supplementation and has an excellent prognosis. Myxedema coma is a rare and potentially fatal manifestation of severe hypothyroidism that can be successfully treated using intravenous levothyroxine.

Severe oligozoospermia in a patient with myxedema coma.

PubMed

Komiya, Akira; Watanabe, Akihiko; Kawauchi, Yoko; Takano, Atsuko; Fuse, Hideki

2012-10-01

A case of severe oligozoospermia with myxedema coma is herein presented. The patient was referred to a male infertility clinic with a 5-year history of primary infertility. Decreased serum testosterone and elevated serum prolactin without abnormal MRI findings in the hypothalamus, and decreased semen volume and sperm motility were noted. A GnRH test revealed a decreased luteinizing hormone response, whereas the HCG test showed a normal testosterone increase. Because a urinalysis after ejaculation indicated retrograde ejaculation, imipramine administration was started. However, the semen quality deteriorated, so the patient was referred to an ART clinic. Twenty-one months from the initial visit, the patient developed a loss of consciousness and edema due to myxedema coma, a life-threatening state of hypothyroidism. The patient recovered after 1 month of thyroid hormone replacement therapy (HRT) with corticosteroids. Three months after the myxedema coma, a semen analysis showed a decreased semen volume (0.2 mL) and severe oligozoospermia (two spermatozoa/ejaculate). Elevated prolactin and decreased testosterone levels were still present. These parameters gradually improved after restoration of euthyroidism by HRT. In conclusion, physicians should confirm the thyroid function in the management of male infertility, especially in patients with elevated prolactin levels.

Streaming Clumps Ejection Model and the Heterogeneous Inner Coma of Comet Wild 2

NASA Technical Reports Server (NTRS)

Clark, B. C.; Economou, T. E.; Green, S. F.; Sandford, S. A.; Zolensky, M. E.

2004-01-01

The conventional concept of cometary comae is that they are dominated by fine particulates released individually by sublimation of surface volatiles and subsequent entrainment in the near-surface gas. It has long been recognized that such particulates could be relatively large, with early estimates that objects perhaps up to one meter in size may be levitated from the surface of the typical cometary nucleus. However, the general uniformity and small average particulate size of observed comae and the relatively smooth, monotonic increases and decreases in particle density during the Giotto flythrough of comet Halley s coma in 1986 reinforced the view that the bulk of the particles are released at the surface, are fine-sized and inert. Jets have been interpreted as geometrically constrained release of these particulates. With major heterogeneities observed during the recent flythrough of the inner coma of comet Wild 2, these views deserve reconsideration.

Deep UV Luminosity Functions at the Infall Region of the Coma Cluster

NASA Technical Reports Server (NTRS)

Hammer, D. M.; Hornschemeier, A. E.; Salim, S.; Smith, R.; Jenkins, L.; Mobasher, B.; Miller, N.; Ferguson, H.

2011-01-01

We have used deep GALEX observations at the infall region of the Coma cluster to measure the faintest UV luminosity functions (LFs) presented for a rich galaxy cluster thus far. The Coma UV LFs are measured to M(sub uv) = -10.5 in the GALEX FUV and NUV bands, or 3.5 mag fainter than previous studies, and reach the dwarf early-type galaxy population in Coma for the first time. The Schechter faint-end slopes (alpha approximately equal to -1.39 in both GALEX bands) are shallower than reported in previous Coma UV LF studies owing to a flatter LF at faint magnitudes. A Gaussian-plus-Schechter model provides a slightly better parametrization of the UV LFs resulting in a faint-end slope of alpha approximately equal to -1.15 in both GALEX bands. The two-component model gives faint-end slopes shallower than alpha = -1 (a turnover) for the LFs constructed separately for passive and star forming galaxies. The UV LFs for star forming galaxies show a turnover at M(sub UV) approximately equal to -14 owing to a deficit of dwarf star forming galaxies in Coma with stellar masses below M(sub *) = 10(sup 8) solar mass. A similar turnover is identified in recent UV LFs measured for the Virgo cluster suggesting this may be a common feature of local galaxy clusters, whereas the field UV LFs continue to rise at faint magnitudes. We did not identify an excess of passive galaxies as would be expected if the missing dwarf star forming galaxies were quenched inside the cluster. In fact, the LFs for both dwarf passive and star forming galaxies show the same turnover at faint magnitudes. We discuss the possible origin of the missing dwarf star forming galaxies in Coma and their expected properties based on comparisons to local field galaxies.

Radical formation in the coma from photodissociation of ice grains

NASA Technical Reports Server (NTRS)

Jackson, William M.; Gerth, Christopher

1990-01-01

Long ago visual observations of comets suggested that there are jets in comets but it has only been recently that A'Hearn et al. have proven that some of these jets are due to emission from the CN radical. Recent studies in the lab have shown that CN radicals can be ejected directly into the gas phase from the photolysis of frozen vapors if the parent molecular has been excited to repulsive excited state. This later observation suggests that the jets that have been observed may be due to photodissociation of icy grains in the coma. A theory of radical formation from icy grains is presented. It is shown that direct formation of free radicals in the coma is an effective way to produce radicals from icy grains in the coma. The model predicts that icy grains could produce from 6 to 800,000 OH radicals/s per grain depending upon whether the radius of the grain is 0.3 to 100 micron.

EEG as an Indicator of Cerebral Functioning in Postanoxic Coma.

PubMed

Juan, Elsa; Kaplan, Peter W; Oddo, Mauro; Rossetti, Andrea O

2015-12-01

Postanoxic coma after cardiac arrest is one of the most serious acute cerebral conditions and a frequent cause of admission to critical care units. Given substantial improvement of outcome over the recent years, a reliable and timely assessment of clinical evolution and prognosis is essential in this context, but may be challenging. In addition to the classic neurologic examination, EEG is increasingly emerging as an important tool to assess cerebral functions noninvasively. Although targeted temperature management and related sedation may delay clinical assessment, EEG provides accurate prognostic information in the early phase of coma. Here, the most frequently encountered EEG patterns in postanoxic coma are summarized and their relations with outcome prediction are discussed. This article also addresses the influence of targeted temperature management on brain signals and the implication of the evolution of EEG patterns over time. Finally, the article ends with a view of the future prospects for EEG in postanoxic management and prognostication.

Prediction of cognitive outcome based on the progression of auditory discrimination during coma.

PubMed

Juan, Elsa; De Lucia, Marzia; Tzovara, Athina; Beaud, Valérie; Oddo, Mauro; Clarke, Stephanie; Rossetti, Andrea O

2016-09-01

To date, no clinical test is able to predict cognitive and functional outcome of cardiac arrest survivors. Improvement of auditory discrimination in acute coma indicates survival with high specificity. Whether the degree of this improvement is indicative of recovery remains unknown. Here we investigated if progression of auditory discrimination can predict cognitive and functional outcome. We prospectively recorded electroencephalography responses to auditory stimuli of post-anoxic comatose patients on the first and second day after admission. For each recording, auditory discrimination was quantified and its evolution over the two recordings was used to classify survivors as "predicted" when it increased vs. "other" if not. Cognitive functions were tested on awakening and functional outcome was assessed at 3 months using the Cerebral Performance Categories (CPC) scale. Thirty-two patients were included, 14 "predicted survivors" and 18 "other survivors". "Predicted survivors" were more likely to recover basic cognitive functions shortly after awakening (ability to follow a standardized neuropsychological battery: 86% vs. 44%; p=0.03 (Fisher)) and to show a very good functional outcome at 3 months (CPC 1: 86% vs. 33%; p=0.004 (Fisher)). Moreover, progression of auditory discrimination during coma was strongly correlated with cognitive performance on awakening (phonemic verbal fluency: rs=0.48; p=0.009 (Spearman)). Progression of auditory discrimination during coma provides early indication of future recovery of cognitive functions. The degree of improvement is informative of the degree of functional impairment. If confirmed in a larger cohort, this test would be the first to predict detailed outcome at the single-patient level. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does Scale of Public Hospitals Affect Bargaining Power? Evidence From Japan

PubMed Central

Noto, Konosuke; Kojo, Takao; Innami, Ichiro

2017-01-01

Background: Many of public hospitals in Japan have had a deficit for a long time. Japanese local governments have been encouraging public hospitals to use group purchasing of drugs to benefit from the economies of scale, and increase their bargaining power for obtaining discounts in drug purchasing, thus improving their financial situation. In this study, we empirically investigate whether or not the scale of public hospitals actually affects their bargaining power. Methods: Using micro-level panel data on public hospitals, we examine the effect of the scale of public hospitals (in terms of the number of occupancy beds) on drug purchasing efficiency (DPE) (the average discount rate in purchasing drugs) as a proxy variable of the bargaining power. Additionally, we evaluate the effect of the presence or absence of management responsibility in public hospital for economic efficiency as the proxy variable of an economic incentive and its interaction with the hospital scales on the bargaining power. In the estimations, we use the fixed effects model to control the heterogeneity of each hospital in order to estimate reliable parameters. Results: The scale of public hospitals does not positively correlate with bargaining power, whereas the management responsibility for economic efficiency does. Additionally, scale does not interact with management responsibility. Conclusion: Giving management responsibility for economic efficiency to public hospitals is a more reliable way of gaining bargaining power in drug purchasing, rather than promoting the increase in scale of these public hospitals. PMID:29172376

Chemistry in cometary comae

NASA Technical Reports Server (NTRS)

Irvine, W. M.; Dickens, J. E.; Lovell, A. J.; Schloerb, F. P.; Senay, M.; Bergin, E. A.; Jewitt, D.; Matthews, H. E.

1998-01-01

Significant gas-phase chemistry occurs in the comae of bright comets, as is demonstrated here for the case of Comet Hale-Bopp. The abundance ratio of the two isomers, hydrogen cyanide and hydrogen isocyanide, is shown to vary with heliocentric distance in a way that is consistent with production of HNC by ion-molecule chemistry initiated by the photoionization of water. Likewise, the first maps of emission from HCO+ show an abundance and an extended distribution that are consistent with the same chemical model.

Diagnostic utility of flumazenil in coma with suspected poisoning: a double blind, randomised controlled study.

PubMed Central

Höjer, J; Baehrendtz, S; Matell, G; Gustafsson, L L

1990-01-01

OBJECTIVE--To assess the diagnostic value and safety of the benzodiazepine antagonist flumazenil in patients with coma of unclear origin with suspected poisoning. DESIGN--Double blind, placebo controlled, randomised study. SETTING--Intensive care unit at a major teaching hospital. PATIENTS--105 Unconscious adults admitted consecutively with suspected drug overdosage during 18 months from a total of 362 cases of poisoning. Exclusion criteria were pregnancy, epilepsy, obvious poisoning with drugs identified unequivocally from information from relatives or others as other than benzodiazepines, and coma score greater than 10 on a scale graded from 4 to 20. Patients were allocated randomly to receive flumazenil (21 men and 32 women) or placebo (25 men and 27 women). INTERVENTIONS--Intravenous injection of flumazenil (10 ml, 0.1 mg/ml) or placebo (10 ml vehicle alone) given double blind over three minutes. MAIN OUTCOME MEASURES--Serum and urine concentrations of benzodiazepines, antidepressants, and several other agents; blood gas tensions; standardised evaluation on admission and five minutes after the injection by means of coma scale score and urgent diagnostic or therapeutic interventions indicated according to the history and clinical examination; standardised interview after the injection to try to ascertain further information; and adverse reactions. RESULTS--Benzodiazepines were found in the serum in 36 of the 53 patients in the flumazenil group and in 37 of the 52 who received placebo. The average coma scale score increased significantly after injection in the flumazenil group (6.4 v 12.1, p less than 0.001) but not in the placebo group. In the flumazenil group several interventions were rendered unnecessary by the injection: gastric lavage and urinary catheterisation (19 patients each), intubation (21), artificial ventilation and computed tomography of the brain (three patients each), blood culture and lumbar puncture (one patient each), and

Nonpolytropic model for the Coma Cluster

NASA Technical Reports Server (NTRS)

Fusco-Femiano, R.; Hughes, John P.

1994-01-01

In this article we demonstrate, for the first time, how a physically motivated static model for both the gas and galaxies in the Coma Cluster of galaxies can jointly fit all available X-ray and optical imaging and spectroscopic data. The principal assumption of this nonpolytropic model (Cavaliere & Fusco-Femiano 1981, hereafter CFF), is that the intracluster gas temperature is proportional to the square of the galaxy velocity dispersion everywhere throughout the cluster; no other assumption about the gas temperature distribution is required. After demonstrating that the CFF nonpolytropic model is an adequate representation of the gas and galaxy distributions, the radial velocity dispersion profile, and the gas temperature distribution, we derive the following information about the Coma Cluster: 1. The central temperature is about 9 keV and the central density is 2.8 x 10(exp -3)/cm(exp 3) for the X-ray emitting plasma; 2. The binding mass of the cluster is approximately 2 x 10(exp 15) solar mass within 5 Mpc for (H(sub 0) = 50 km/sec/Mpc), with a mass-to-light ratio of approximately 160 solar mass/solar luminosity; 3. The contribution of the gas to the total virial mass increases with distance from the cluster center, and we estimate that this ratio is no greater than approximately 50% within 5 Mpc. The ability of the CFF nonpolytropic model to describe the current X-ray and optical data for the Coma Cluster suggests that a significant fraction of the thermal energy contained in the hot gas in this as well as other rich galaxy clusters may have come from the interaction between the galaxies and the ambient cluster medium. interaction between the galaxies and the ambient cluster medium.

Application of Early Nutrition Support in Neurosurgical Coma Patients.

PubMed

Ren, Guoqin

2015-12-01

The present study was conducted to investigate the clinical efficacy of early parenteral and enteral nutrition (PN + EN) support in neurosurgical coma patients. Eighty cases of neurosurgical coma patients were randomly divided into intervention group and control group. The intervention group received early PN + EN support, and the control group received only total enteral nutritional (TEN) support. The levels of hemoglobin (HGB), serum albumin (ALB), prealbumin (PA), and retinol-binding protein (RBP) in two groups on days 1, 10, and 20 were observed. The incidences of pneumonia, stress ulcer, abnormal liver function, abdominal distension, and diarrhea between two groups were also compared. Results found that, on day 10, compared with the control group, the levels of HGB, PA, and RBP in the intervention group were significantly increased (P < 0.05). On day 20, ALB in the intervention group significantly increased (P < 0.05), and the incidences of pneumonia, abdominal distension, and diarrhea in the intervention group were significantly lower than those in the control group (P < 0.05). Compared with only TEN support, early PN + EN support can obviously improve the nutritional status of neurosurgical coma patients and reduce the occurrence of complications.

Factor structure and sex differences on the Wechsler Preschool and Primary Scale of Intelligence in China, Japan and United States.

PubMed

Liu, Jianghong; Lynn, Richard

2011-08-01

This study presents data on the factor structure of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and sex and cultural differences in WPPSI test scores among 5- and 6-year-olds from China, Japan, and the United States. Results show the presence of a verbal and nonverbal factor structure across all three countries. Sex differences on the 10 subtests were generally consistent, with a male advantage on a subtest of spatial abilities (Mazes). Males in the Chinese sample obtained significantly higher Full Scale IQ scores than females and had lower variability in their test scores. These observations were not present in the Japan and United States samples. Mean Full Scale IQ score in the Chinese sample was 104.1, representing a 4-point increase from 1988 to 2004.

Cometary science. Time variability and heterogeneity in the coma of 67P/Churyumov-Gerasimenko.

PubMed

Hässig, M; Altwegg, K; Balsiger, H; Bar-Nun, A; Berthelier, J J; Bieler, A; Bochsler, P; Briois, C; Calmonte, U; Combi, M; De Keyser, J; Eberhardt, P; Fiethe, B; Fuselier, S A; Galand, M; Gasc, S; Gombosi, T I; Hansen, K C; Jäckel, A; Keller, H U; Kopp, E; Korth, A; Kührt, E; Le Roy, L; Mall, U; Marty, B; Mousis, O; Neefs, E; Owen, T; Rème, H; Rubin, M; Sémon, T; Tornow, C; Tzou, C-Y; Waite, J H; Wurz, P

2015-01-23

Comets contain the best-preserved material from the beginning of our planetary system. Their nuclei and comae composition reveal clues about physical and chemical conditions during the early solar system when comets formed. ROSINA (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) onboard the Rosetta spacecraft has measured the coma composition of comet 67P/Churyumov-Gerasimenko with well-sampled time resolution per rotation. Measurements were made over many comet rotation periods and a wide range of latitudes. These measurements show large fluctuations in composition in a heterogeneous coma that has diurnal and possibly seasonal variations in the major outgassing species: water, carbon monoxide, and carbon dioxide. These results indicate a complex coma-nucleus relationship where seasonal variations may be driven by temperature differences just below the comet surface. Copyright © 2015, American Association for the Advancement of Science.

Period change of a contact binary system RW Comae Berenices

NASA Astrophysics Data System (ADS)

Maithong, Wiraporn; Phao-ai, Parinda

2017-08-01

In this work, we studied about the period change of a contact binary system RW Comae Berenices. The binary system was observed on March 9th, 2016 by the 105 mm diameter of a refraction telescope with the DSLR digital camera at the Regional Observatory for the Public Nakhon Ratchasima, Thailand. The photometry used the IRIS program. The period change was analyzed by used the O-C diagram. The result shows that the period of the RW Comae Berenices is increasing with 1.89×10-3 seconds/year.

Childhood acute non-traumatic coma: aetiology and challenges in management in resource-poor countries of Africa and Asia.

PubMed

Gwer, Samson; Chacha, Clifford; Newton, Charles R; Idro, Richard

2013-08-01

This review examines the best available evidence on the aetiology of childhood acute non-traumatic coma in resource-poor countries (RPCs), discusses the challenges associated with management, and explores strategies to address them. Publications in English and French which reported on studies on the aetiology of childhood non-traumatic coma in RPCs are reviewed. Primarily, the MEDLINE database was searched using the keywords coma, unconsciousness, causality, aetiology, child, malaria cerebral, meningitis, encephalitis, Africa, Asia, and developing countries. 14 records were identified for inclusion in the review. Cerebral malaria (CM) was the commonest cause of childhood coma in most of the studies conducted in Africa. Acute bacterial meningitis (ABM) was the second most common known cause of coma in seven of the African studies. Of the studies in Asia, encephalitides were the commonest cause of coma in two studies in India, and ABM was the commonest cause of coma in Pakistan. Streptococcus pneumoniae was the most commonly isolated organism in ABM. Japanese encephalitis, dengue fever and enteroviruses were the viral agents most commonly isolated. Accurate diagnosis of the aetiology of childhood coma in RPCs is complicated by overlap in clinical presentation, limited diagnostic resources, disease endemicity and co-morbidity. For improved outcomes, studies are needed to further elucidate the aetiology of childhood coma in RPCs, explore simple and practical diagnostic tools, and investigate the most appropriate specific and supportive interventions to manage and prevent infectious encephalopathies.

A Study of the Effects of Faint Dust Comae on the Spectra of Asteroids

NASA Astrophysics Data System (ADS)

Rondón, E.; Carvano, J.; Lorenz-Martins, S.

2017-09-01

The presence of dust comae on asteroids and centaurs is a phenomenon that became accepted in the last decades and which challenges the traditional definitions of asteroids and comets. A possible way of improving the chances of discovery of Active Asteroids is to use large multi-colour surveys or catalogs, like SDSS Moving Object Catalog. In this work we analyze the effects of faint dust comae on asteroid spectra and then use it to investigate the effects that a faint dust comae would have over the spectrum, magnitude, and radial profile of asteroids.

Repeatability of the Dust and Gas Morphological Structures in the Coma of Comet

NASA Astrophysics Data System (ADS)

Lejoly, Cassandra; Samarasinha, N. H.; Ojha, L.; Schleicher, D. G.

2013-10-01

Comet 1P/Halley is the most famous comet in history and has been observed for over two millennia, making it one of the most extensively studied comets. The morphology in the coma of comet 1P/Halley originates due to the activity at the nucleus and could be used as a probe of the nuclear rotation and the activity. We will present the results from a study summarizing the evolution of coma morphology of comet 1P/Halley observed from ground between October 1985 and June 1986. The results to be presented include analysis of dust features as well as gas (CN) features in the coma and comparisons will be made between their spatial and temporal evolution. About 80 CN images and 300 continuum images from the Small Bodies Node of the NASA Planetary Data System were analyzed using image enhancement techniques that were not available n the 1980s. This enables us to see coma structure never observed before in comet 1P/Halley. Because of the comet's proximity to Earth, most of our best signal-to-noise images were taken in the March-April interval of 1986. Despite the limited coverage of preceding and following months, there is a sufficient number of images to monitor morphological evolution over many months. The initial synodic periods as a function of time used to phase the images together were extrapolated from the lightcurves of the active coma (Schleicher et al. 1990, AJ, 100, 896-912). We will present the periods of repeatability of individual coma features measured using the position angle at different spatial distances from the nucleus in adjacent cycles. Separate features appear to have slightly different periods of repeatability, perhaps depending on the corresponding source regions on the nucleus and/or projection effects. The periods of repeatability of coma morphologies will be presented as a function of time from the perihelion. These results will ultimately be used in detailed modeling of the coma morphologies of comet 1P/Halley over the 1985-1986 apparition in

Soft X-ray excess in the Coma cluster from a Cosmic Axion Background

DOE Office of Scientific and Technical Information (OSTI.GOV)

Angus, Stephen; Conlon, Joseph P.; Marsh, M.C. David

2014-09-01

We show that the soft X-ray excess in the Coma cluster can be explained by a cosmic background of relativistic axion-like particles (ALPs) converting into photons in the cluster magnetic field. We provide a detailed self-contained review of the cluster soft X-ray excess, the proposed astrophysical explanations and the problems they face, and explain how a 0.1- 1 keV axion background naturally arises at reheating in many string theory models of the early universe. We study the morphology of the soft excess by numerically propagating axions through stochastic, multi-scale magnetic field models that are consistent with observations of Faraday rotation measuresmore » from Coma. By comparing to ROSAT observations of the 0.2- 0.4 keV soft excess, we find that the overall excess luminosity is easily reproduced for g{sub aγγ} ∼ 2 × 10{sup -13} Ge {sup -1}. The resulting morphology is highly sensitive to the magnetic field power spectrum. For Gaussian magnetic field models, the observed soft excess morphology prefers magnetic field spectra with most power in coherence lengths on O(3 kpc) scales over those with most power on O(12 kpc) scales. Within this scenario, we bound the mean energy of the axion background to 50 eV∼< ( E{sub a} ) ∼< 250 eV, the axion mass to m{sub a} ∼< 10{sup -12} eV, and derive a lower bound on the axion-photon coupling g{sub aγγ} ∼> √(0.5/Δ N{sub eff}) 1.4 × 10{sup -13} Ge {sup -1}.« less

A brain-machine interface for control of medically-induced coma.

PubMed

Shanechi, Maryam M; Chemali, Jessica J; Liberman, Max; Solt, Ken; Brown, Emery N

2013-10-01

Medically-induced coma is a drug-induced state of profound brain inactivation and unconsciousness used to treat refractory intracranial hypertension and to manage treatment-resistant epilepsy. The state of coma is achieved by continually monitoring the patient's brain activity with an electroencephalogram (EEG) and manually titrating the anesthetic infusion rate to maintain a specified level of burst suppression, an EEG marker of profound brain inactivation in which bursts of electrical activity alternate with periods of quiescence or suppression. The medical coma is often required for several days. A more rational approach would be to implement a brain-machine interface (BMI) that monitors the EEG and adjusts the anesthetic infusion rate in real time to maintain the specified target level of burst suppression. We used a stochastic control framework to develop a BMI to control medically-induced coma in a rodent model. The BMI controlled an EEG-guided closed-loop infusion of the anesthetic propofol to maintain precisely specified dynamic target levels of burst suppression. We used as the control signal the burst suppression probability (BSP), the brain's instantaneous probability of being in the suppressed state. We characterized the EEG response to propofol using a two-dimensional linear compartment model and estimated the model parameters specific to each animal prior to initiating control. We derived a recursive Bayesian binary filter algorithm to compute the BSP from the EEG and controllers using a linear-quadratic-regulator and a model-predictive control strategy. Both controllers used the estimated BSP as feedback. The BMI accurately controlled burst suppression in individual rodents across dynamic target trajectories, and enabled prompt transitions between target levels while avoiding both undershoot and overshoot. The median performance error for the BMI was 3.6%, the median bias was -1.4% and the overall posterior probability of reliable control was 1 (95

Population size estimation of men who have sex with men through the network scale-up method in Japan.

PubMed

Ezoe, Satoshi; Morooka, Takeo; Noda, Tatsuya; Sabin, Miriam Lewis; Koike, Soichi

2012-01-01

Men who have sex with men (MSM) are one of the groups most at risk for HIV infection in Japan. However, size estimates of MSM populations have not been conducted with sufficient frequency and rigor because of the difficulty, high cost and stigma associated with reaching such populations. This study examined an innovative and simple method for estimating the size of the MSM population in Japan. We combined an internet survey with the network scale-up method, a social network method for estimating the size of hard-to-reach populations, for the first time in Japan. An internet survey was conducted among 1,500 internet users who registered with a nationwide internet-research agency. The survey participants were asked how many members of particular groups with known population sizes (firepersons, police officers, and military personnel) they knew as acquaintances. The participants were also asked to identify the number of their acquaintances whom they understood to be MSM. Using these survey results with the network scale-up method, the personal network size and MSM population size were estimated. The personal network size was estimated to be 363.5 regardless of the sex of the acquaintances and 174.0 for only male acquaintances. The estimated MSM prevalence among the total male population in Japan was 0.0402% without adjustment, and 2.87% after adjusting for the transmission error of MSM. The estimated personal network size and MSM prevalence seen in this study were comparable to those from previous survey results based on the direct-estimation method. Estimating population sizes through combining an internet survey with the network scale-up method appeared to be an effective method from the perspectives of rapidity, simplicity, and low cost as compared with more-conventional methods.

Population Size Estimation of Men Who Have Sex with Men through the Network Scale-Up Method in Japan

PubMed Central

Ezoe, Satoshi; Morooka, Takeo; Noda, Tatsuya; Sabin, Miriam Lewis; Koike, Soichi

2012-01-01

Background Men who have sex with men (MSM) are one of the groups most at risk for HIV infection in Japan. However, size estimates of MSM populations have not been conducted with sufficient frequency and rigor because of the difficulty, high cost and stigma associated with reaching such populations. This study examined an innovative and simple method for estimating the size of the MSM population in Japan. We combined an internet survey with the network scale-up method, a social network method for estimating the size of hard-to-reach populations, for the first time in Japan. Methods and Findings An internet survey was conducted among 1,500 internet users who registered with a nationwide internet-research agency. The survey participants were asked how many members of particular groups with known population sizes (firepersons, police officers, and military personnel) they knew as acquaintances. The participants were also asked to identify the number of their acquaintances whom they understood to be MSM. Using these survey results with the network scale-up method, the personal network size and MSM population size were estimated. The personal network size was estimated to be 363.5 regardless of the sex of the acquaintances and 174.0 for only male acquaintances. The estimated MSM prevalence among the total male population in Japan was 0.0402% without adjustment, and 2.87% after adjusting for the transmission error of MSM. Conclusions The estimated personal network size and MSM prevalence seen in this study were comparable to those from previous survey results based on the direct-estimation method. Estimating population sizes through combining an internet survey with the network scale-up method appeared to be an effective method from the perspectives of rapidity, simplicity, and low cost as compared with more-conventional methods. PMID:22563366

Hyperosmolar diabetic non-ketotic coma, hyperkalaemia and an unusual near death experience.

PubMed

Ting, J Y

2001-03-01

Generally, cardiac arrest due to pulseless electrical activity has a poor outcome, except when reversible factors such as acute hyperkalaemia are identified and managed early. Hyperosmolar diabetic non-ketotic coma may lead to acute hyperkalaemia. Hyperosmolar diabetic non-ketotic coma is a metabolic emergency usually seen in elderly non-insulin dependent diabetics, characterized by severe hyperglycaemia, volume depletion, altered consciousness, confusion and less frequently neurological deficit. Cerebrovascular accident or transient ischaemic attack may be mistakenly diagnosed, particularly if the patient has no history of diabetes mellitus. Delays in diagnosis and management of glycaemic emergencies presenting as a constellation of neurological abnormalities can be avoided by routine early measurement of blood glucose. Hyperosmolar diabetic non-ketotic coma should be considered in any patient with altered consciousness or neurologic deficit in conjunction with hyperglycaemia. As hyperosmolar diabetic non-ketotic coma results in severe fluid depletion, electrolyte disturbance, profound hyperglycaemia and an altered mental state, the guiding principles of therapy include aggressive rehydration, insulin therapy, correction of electrolyte abnormalities and treatment of any underlying illnesses. Treatment of acute hyperkalaemia includes calcium ions, insulin with dextrose, salbutamol and haemodialysis.

[Myxedema coma as a rare differential diagnosis of severe consciousness disturbance].

PubMed

Kollmar, R; Schellinger, P D; Bardutzky, J; Meisel, F; Schwaninger, M

2002-12-01

Myxedema coma is a rare and life-threatening complication of untreated hypothyroidism. Therefore, it must be part of the differential diagnosis in comatose patients. We report one patient who presented with CO(2) narcosis,hypothermia, bradycardia,hyporeflexia, tetraparesis, ascitis, pleural effusions, and heart insufficiency. Examination of the CSF, cranial CT, MRI, and MR angiography were normal. In suspicion of myxedema coma,the patient was treated with high dose L-thyroxine and hydrocortisone for preventing secondary adrenal insufficiency. A fast clinical recovery, decreased T4 (7.2 ng/l) and T3 (0.93 ng/l), and increased TSH (20.19 mU/l) together with the following anamnesis of radio iodine therapy and insufficient thyroxine intake confirmed the diagnosis. In conclusion, treatment of the myxedema coma must be started as soon as the laboratory results are confirmatory, since its course depends on the time of initiation of treatment.

Hypoplastic anaemia complicating myxoedema coma.

PubMed

Song, S H; McCallum, C J; Campbell, I W

1998-10-01

The case of a 68 year old women presenting in myxoedema coma is described. She was found to be anaemic with a haemoglobin of 8.2 g/dl. Further investigations showed a pancytopenia and a hypoplastic anaemia confirmed by bone marrow. The patient recovered and became euthyroid following initial treatment with intravenous tri-iodothyronine (T3) and later oral thyroxine (T4) replacement with resolution of pancytopenia and return of bone marrow to normal.

The Blue Coma: The Role of Methylene Blue in Unexplained Coma After Cardiac Surgery.

PubMed

Martino, Enrico Antonio; Winterton, Dario; Nardelli, Pasquale; Pasin, Laura; Calabrò, Maria Grazia; Bove, Tiziana; Fanelli, Giovanna; Zangrillo, Alberto; Landoni, Giovanni

2016-04-01

Methylene blue commonly is used as a dye or an antidote, but also can be used off label as a vasopressor. Serotonin toxicity is a potentially lethal and often misdiagnosed condition that can result from drug interaction. Mild serotonin toxicity previously was reported in settings in which methylene blue was used as a dye. The authors report 3 cases of life-threatening serotonin toxicity in patients undergoing chronic selective serotonin reuptake inhibitor (SSRI) therapy who also underwent cardiac surgery and received methylene blue to treat vasoplegic syndrome. An observational study. A cardiothoracic intensive care unit (ICU) in a teaching hospital. Three patients who received methylene blue after cardiac surgery, later discovered to be undergoing chronic SSRI therapy. None. All 3 patients received high doses of fentanyl during general anesthesia. They all developed vasoplegic syndrome and consequently were given methylene blue in the ICU. All 3 patients developed serotonin toxicity, including coma, after this administration and diagnostic tests were negative for acute intracranial pathology. Coma lasted between 1 and 5 days. Two patients were discharged from the ICU shortly after awakening, whereas the third patient experienced a complicated postoperative course for concomitant refractory low-cardiac-output syndrome. Patients undergoing chronic SSRI therapy should not be administered methylene blue to treat vasoplegic syndrome. Copyright © 2016 Elsevier Inc. All rights reserved.

Monte Carlo Particle Trajectory Models for Neutral Cometary Gases. II. The Spatial Morphology of the Lyman-Alpha Coma

NASA Astrophysics Data System (ADS)

Combi, Michael R.; Smyth, William H.

1988-04-01

The Monte Carlo particle-trajectory model (MCPTM) developed in Paper 1 is applied to explain the observed morphology of the spatially extended Lyα comae of comets. The physical processes and assumptions used in the model as they relate to the photodissociation of H2O and OH and the solar radiation pressure acceleration are presented herein. For this first application, the rocket and Skylab images of the Lyα coma of comet Kohoutek were chosen for study. The self-consistent modeling analysis of these data consisted of two parts. The first part entailed using a steady state spherically symmetric inner coma MCPTM coupled with a simple gas-dynamic model to calculate the physical development of the coma, i.e., the dependence of coma temperature and outflow speed on radial distance to the center of the nucleus, as a function of the (time) heliocentric distance of the comet. The inner coma MCPTM was used to calculate correctly the photo-chemical heating of the coma due to the partial collisional thermalization of the hot hydrogen atoms produced in the photodissociation of water molecules. In the second part of the analysis the results from the first part were used in a fully time-dependent and three-dimensional extended coma MCPTM which includes the explicit calculation of partial thermalization of the H atoms by multiple collisions with coma molecules. The same physical model yielded very good matches between the modeled Lycα isophotes and those observed in both of the two very different images of comet Kohoutek. The production rate was varied in time as implied by the shape of the visual light curve. All other physical parameters were varied only according to their naturally expected heliocentric distance and velocity dependencies. The complete physical description of the inner coma provided by the coupled gas-dynamic/MCPTM calculation was needed to obtain a good fit to the data. The correct inner coma description is important since it provides not only the initial

Hall effect in the coma of 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Huang, Z.; Tóth, G.; Gombosi, T. I.; Jia, X.; Combi, M. R.; Hansen, K. C.; Fougere, N.; Shou, Y.; Tenishev, V.; Altwegg, K.; Rubin, M.

2018-04-01

Magnetohydrodynamics simulations have been carried out in studying the solar wind and cometary plasma interactions for decades. Various plasma boundaries have been simulated and compared well with observations for comet 1P/Halley. The Rosetta mission, which studies comet 67P/Churyumov-Gerasimenko, challenges our understanding of the solar wind and comet interactions. The Rosetta Plasma Consortium observed regions of very weak magnetic field outside the predicted diamagnetic cavity. In this paper, we simulate the inner coma with the Hall magnetohydrodynamics equations and show that the Hall effect is important in the inner coma environment. The magnetic field topology becomes complex and magnetic reconnection occurs on the dayside when the Hall effect is taken into account. The magnetic reconnection on the dayside can generate weak magnetic field regions outside the global diamagnetic cavity, which may explain the Rosetta Plasma Consortium observations. We conclude that the substantial change in the inner coma environment is due to the fact that the ion inertial length (or gyro radius) is not much smaller than the size of the diamagnetic cavity.

DEEP ULTRAVIOLET LUMINOSITY FUNCTIONS AT THE INFALL REGION OF THE COMA CLUSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hammer, D. M.; Hornschemeier, A. E.; Jenkins, L.

2012-02-01

We have used deep GALEX observations at the infall region of the Coma cluster to measure the faintest ultraviolet (UV) luminosity functions (LFs) presented for a rich galaxy cluster thus far. The Coma UV LFs are measured to M{sub UV} = -10.5 in the GALEX FUV and NUV bands, or 3.5 mag fainter than previous studies, and reach the dwarf early-type galaxy population in Coma for the first time. The Schechter faint-end slopes ({alpha} Almost-Equal-To -1.39 in both GALEX bands) are shallower than reported in previous Coma UV LF studies owing to a flatter LF at faint magnitudes. A Gaussian-plus-Schechtermore » model provides a slightly better parameterization of the UV LFs resulting in a faint-end slope of {alpha} Almost-Equal-To -1.15 in both GALEX bands. The two-component model gives faint-end slopes shallower than {alpha} = -1 (a turnover) for the LFs constructed separately for passive and star-forming galaxies. The UV LFs for star-forming galaxies show a turnover at M{sub UV} Almost-Equal-To -14 owing to a deficit of dwarf star-forming galaxies in Coma with stellar masses below M{sub *} = 10{sup 8} M{sub Sun }. A similar turnover is identified in recent UV LFs measured for the Virgo cluster suggesting this may be a common feature of local galaxy clusters, whereas the field UV LFs continue to rise at faint magnitudes. We did not identify an excess of passive galaxies as would be expected if the missing dwarf star-forming galaxies were quenched inside the cluster. In fact, the LFs for both dwarf passive and star-forming galaxies show the same turnover at faint magnitudes. We discuss the possible origin of the missing dwarf star-forming galaxies in Coma and their expected properties based on comparisons to local field galaxies.« less

Assessment of refractive astigmatism and simulated therapeutic refractive surgery strategies in coma-like-aberrations-dominant corneal optics.

PubMed

Zhou, Wen; Stojanovic, Aleksandar; Utheim, Tor Paaske

2016-01-01

The aim of the study is to raise the awareness of the influence of coma-like higher-order aberrations (HOAs) on power and orientation of refractive astigmatism (RA) and to explore how to account for that influence in the planning of topography-guided refractive surgery in eyes with coma-like-aberrations-dominant corneal optics. Eleven eyes with coma-like-aberrations-dominant corneal optics and with low lenticular astigmatism (LA) were selected for astigmatism analysis and for treatment simulations with topography-guided custom ablation. Vector analysis was used to evaluate the contribution of coma-like corneal HOAs to RA. Two different strategies were used for simulated treatments aiming to regularize irregular corneal optics: With both strategies correction of anterior corneal surface irregularities (corneal HOAs) were intended. Correction of total corneal astigmatism (TCA) and RA was intended as well with strategies 1 and 2, respectively. Axis of discrepant astigmatism (RA minus TCA minus LA) correlated strongly with axis of coma. Vertical coma influenced RA by canceling the effect of the with-the-rule astigmatism and increasing the effect of the against-the-rule astigmatism. After simulated correction of anterior corneal HOAs along with TCA and RA (strategies 1 and 2), only a small amount of anterior corneal astigmatism (ACA) and no TCA remained after strategy 1, while considerable amount of ACA and TCA remained after strategy 2. Coma-like corneal aberrations seem to contribute a considerable astigmatic component to RA in eyes with coma-like-aberrations dominant corneal optics. If topography-guided ablation is programmed to correct the corneal HOAs and RA, the astigmatic component caused by the coma-like corneal HOAs will be treated twice and will result in induced astigmatism. Disregarding RA and treating TCA along with the corneal HOAs is recommended instead.

Accuracy of self-reported length of coma and posttraumatic amnesia in persons with medically verified traumatic brain injury.

PubMed

Sherer, Mark; Sander, Angelle M; Maestas, Kacey Little; Pastorek, Nicholas J; Nick, Todd G; Li, Jingyun

2015-04-01

To determine the accuracy of self-reported length of coma and posttraumatic amnesia (PTA) in persons with medically verified traumatic brain injury (TBI) and to investigate factors that affect self-report of length of coma and PTA duration. Prospective cohort study. Specialized rehabilitation center with inpatient and outpatient programs. Persons (N=242) with medically verified TBI who were identified from a registry of persons who had previously participated in TBI-related research. Not applicable. Self-reported length of coma and self-reported PTA duration. Review of medical records revealed that the mean medically documented length of coma and PTA duration was 6.9±12 and 19.2±22 days, respectively, and the mean self-reported length of coma and PTA duration was 16.7±22 and 106±194 days, respectively. The average discrepancy between self-report and medical record for length of coma and PTA duration was 8.2±21 and 64±176 days, respectively. Multivariable regression models revealed that time since injury, performance on cognitive tests, and medical record values were associated with self-reported values for both length of coma and PTA duration. In this investigation, persons with medically verified TBI showed poor accuracy in their self-report of length of coma and PTA duration. Discrepancies were large enough to affect injury severity classification. Caution should be exercised when considering self-report of length of coma and PTA duration. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Inter-rater reliability of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in critically ill patients: a prospective observational study

PubMed Central

2010-01-01

Introduction The Glasgow Coma Scale (GCS) is the most widely used scoring system for comatose patients in intensive care. Limitations of the GCS include the impossibility to assess the verbal score in intubated or aphasic patients, and an inconsistent inter-rater reliability. The FOUR (Full Outline of UnResponsiveness) score, a new coma scale not reliant on verbal response, was recently proposed. The aim of the present study was to compare the inter-rater reliability of the GCS and the FOUR score among unselected patients in general critical care. A further aim was to compare the inter-rater reliability of neurologists with that of intensive care unit (ICU) staff. Methods In this prospective observational study, scoring of GCS and FOUR score was performed by neurologists and ICU staff on 267 consecutive patients admitted to intensive care. Results In a total of 437 pair wise ratings the exact inter-rater agreement for the GCS was 71%, and for the FOUR score 82% (P = 0.0016); the inter-rater agreement within a range of ± 1 score point for the GCS was 90%, and for the FOUR score 92% (P = ns.). The exact inter-rater agreement among neurologists was superior to that among ICU staff for the FOUR score (87% vs. 79%, P = 0.04) but not for the GCS (73% vs. 73%). Neurologists and ICU staff did not significantly differ in the inter-rater agreement within a range of ± 1 score point for both GCS (88% vs. 93%) and the FOUR score (91% vs. 88%). Conclusions The FOUR score performed better than the GCS for exact inter-rater agreement, but not for the clinically more relevant agreement within the range of ± 1 score point. Though neurologists outperformed ICU staff with regard to exact inter-rater agreement, the inter-rater agreement of ICU staff within the clinically more relevant range of ± 1 score point equalled that of the neurologists. The small advantage in inter-rater reliability of the FOUR score is most likely insufficient to replace the GCS, a score with a long

High resolution integral-field spectroscopy of gas and ion distributions in the coma of Comet C/2012 S1 ISON

NASA Astrophysics Data System (ADS)

Schmidt, Carl

2016-02-01

Neutral and ion species in cometary comae exhibit significant differences in their spatial distributions. These distributions reflect the combined effects of sublimation, ion pickup, collisions, solar radiation pressure, photolysis scale lengths of any parent molecules, and photolysis of the species of interest. An image-slicer spectrograph (R ∼ 20,000) is used here to measure C2, NH2, Na, and H2O+ emission lines in Comet C/2012 S1 ISON's coma within a narrow spectral window spanning 5868-5926 Å. These species are mapped over a 1.6 × 2.7 arcmin field made up of 240 individual spectra. While prior cometary observations have found that peak column densities of these species appear either sunward or anti-sunward, ISON's coma was elongated several thousand kilometers along an axis perpendicular to its motion and the sunward vector. The peak brightness of each species was located within 5000 km of the dusty continuum concentration. ISON's water ion tail appeared distinctly broader than the neutral Na tail and no evidence is seen for an extended source of Na by dissociative recombination of a molecular ion. The Na D2/D1 ratio in the head is 1.49 ± 0.06 despite being optically thin, increasing to 1.93 ± 0.07 in the tail. The dust distribution falls off less steeply than the canonical inverse with distance from the nucleus and C2 and NH2 scale lengths indicate an extended source, possibly due to nucleus fragmentation.

Perioperative management of a patient with myxedema coma and septicemic shock.

PubMed

Baduni, Neha; Sinha, Sunil Kumar; Sanwal, Manoj K

2012-10-01

Myxedema coma is a life-threatening but uncommon complication of long-standing, neglected hypothyroidism. It was first reported by Ord in 1879. Till date only around 200 cases have been reported in literature. The incidence in European countries is 0.22 per million per year. No epidemiological data is available from the Indian subcontinent. We are reporting the case of an elderly lady who went into life-threatening myxedema coma along with septicemic shock, and was successfully treated with oral thyroxine.

Mortality prediction of head Abbreviated Injury Score and Glasgow Coma Scale: analysis of 7,764 head injuries.

PubMed

Demetriades, Demetrios; Kuncir, Eric; Murray, James; Velmahos, George C; Rhee, Peter; Chan, Linda

2004-08-01

We assessed the prognostic value and limitations of Glasgow Coma Scale (GCS) and head Abbreviated Injury Score (AIS) and correlated head AIS with GCS. We studied 7,764 patients with head injuries. Bivariate analysis was performed to examine the relationship of GCS, head AIS, age, gender, and mechanism of injury with mortality. Stepwise logistic regression analysis was used to identify the independent risk factors associated with mortality. The overall mortality in the group of head injury patients with no other major extracranial injuries and no hypotension on admission was 9.3%. Logistic regression analysis identified head AIS, GCS, age, and mechanism of injury as significant independent risk factors of death. The prognostic value of GCS and head AIS was significantly affected by the mechanism of injury and the age of the patient. Patients with similar GCS or head AIS but different mechanisms of injury or ages had significantly different outcomes. The adjusted odds ratio of death in penetrating trauma was 5.2 (3.9, 7.0), p < 0.0001, and in the age group > or = 55 years the adjusted odds ratio was 3.4 (2.6, 4.6), p < 0.0001. There was no correlation between head AIS and GCS (correlation coefficient -0.31). Mechanism of injury and age have a major effect in the predictive value of GCS and head AIS. There is no good correlation between GCS and head AIS.

Extreme hyperphosphatemia and hypocalcemic coma associated with phosphate enema.

PubMed

Hsu, Heng Jung; Wu, Mai-Szu

2008-01-01

Fleet enema (sodium phosphate, C.B. Fleet Co., Inc., Lynchburg, Virginia) is widely used for bowel preparation or constipation relief in the hospital and over the counter. The potential risks, including hyperphosphatemia and hypocalcemic coma should be kept in mind of primary care physician. The patients with older age, bowel obstruction, small intestinal disorders, poor gut motility, and renal disease are contraindicated or should be administered with caution. We present a patient with old age and chronic renal failure who developed severe hyperphosphatemia and hypocalcemic tetany with coma after sodium phosphate enema. We recommend the use of alternative enema preparations, such as simple tap water or saline solution enemas, which can prevent fatal complications in high risk patients.

Complete recovery after severe myxoedema coma complicated by status epilepticus

PubMed Central

Fjølner, Jesper; Søndergaard, Esben; Kampmann, Ulla; Nielsen, Søren

2015-01-01

We report a case of life-threatening myxoedema presenting with hypothermia, hypotension, bradycardia, pericardial effusion and deep coma. The condition was complicated by prolonged status epilepticus. The optimal treatment strategy has been debated over the years and the literature is briefly reviewed. Treatment with l-thyroxine (LT4) monotherapy without initial loading dose and with no l-triiodothyronine (LT3) treatment was successful with full recovery after hospitalisation for more than a month. Myxoedema coma is a rare, reversible condition with a high mortality and should be considered as a differential diagnosis in medical emergencies. PMID:25809434

Complete recovery after severe myxoedema coma complicated by status epilepticus.

PubMed

Fjølner, Jesper; Søndergaard, Esben; Kampmann, Ulla; Nielsen, Søren

2015-03-25

We report a case of life-threatening myxoedema presenting with hypothermia, hypotension, bradycardia, pericardial effusion and deep coma. The condition was complicated by prolonged status epilepticus. The optimal treatment strategy has been debated over the years and the literature is briefly reviewed. Treatment with l-thyroxine (LT4) monotherapy without initial loading dose and with no l-triiodothyronine (LT3) treatment was successful with full recovery after hospitalisation for more than a month. Myxoedema coma is a rare, reversible condition with a high mortality and should be considered as a differential diagnosis in medical emergencies. 2015 BMJ Publishing Group Ltd.

The Dependence of the Circumnuclear Coma Structure on the Properties of the Nucleus. IV. Structure of the Night-Side Gas Coma of a Strongly Sublimating Nucleus

NASA Astrophysics Data System (ADS)

Crifo, J. F.; Rodionov, A. V.

2000-12-01

The structure of the nightside coma in the vicinity of a strongly active comet nucleus of pure ice is investigated by solving gasdynamic equations for the flow of water vapour sublimated from—or condensed onto—the nucleus surface. To guarantee the physical validity of the solution, both Euler and Navier-Stokes Equations are solved, and the solutions are compared. A spherical nucleus is considered first and then a triaxial ellipsoidal nucleus. The results show that (1) a fluid coma of significant extent and very complicated physical structure is formed; (2) for low heat conduction transfer across the nucleus from the dayside to the nightside surface, a narrow conical weak shock appears near to the antisolar axis; the whole nightside surface acts as a cold trap for the vapor, part of which recondenses onto it; (3) for intermediate heat conduction, part of the nightside surface becomes weakly sublimating, and a different weak shock pattern is formed; and (4) at high heat conduction, the whole nightside surface is weakly sublimating, and the resulting flow pattern becomes similar to that existing in a coma formed by diffusion from the nucleus interior (see Crifo, Rodionov and Bockelée-Morvan, 1999, Icarus138, 83-106). The results are compared to related model results by other authors, and a discussion is made of their relevance to the 1996 observation of the near-nucleus nightside coma of Comet C/1996 B2 Hyakutake.

Disconnection of the Ascending Arousal System in Traumatic Coma

PubMed Central

Edlow, Brian L.; Haynes, Robin L.; Takahashi, Emi; Klein, Joshua P.; Cummings, Peter; Benner, Thomas; Greer, David M.; Greenberg, Steven M.; Wu, Ona; Kinney, Hannah C.; Folkerth, Rebecca D.

2013-01-01

Traumatic coma is associated with disruption of axonal pathways throughout the brain but the specific pathways involved in humans are incompletely understood. In this study, we used high angular resolution diffusion imaging (HARDI) to map the connectivity of axonal pathways that mediate the 2 critical components of consciousness – arousal and awareness – in the postmortem brain of a 62-year-old woman with acute traumatic coma and in 2 control brains. HARDI tractography guided tissue sampling in the neuropathological analysis. HARDI tractography demonstrated complete disruption of white matter pathways connecting brainstem arousal nuclei to the basal forebrain and thalamic intralaminar and reticular nuclei. In contrast, hemispheric arousal pathways connecting the thalamus and basal forebrain to the cerebral cortex were only partially disrupted, as were the cortical “awareness pathways.” Neuropathologic examination, which utilized β-amyloid precursor protein and fractin immunomarkers, revealed axonal injury in the white matter of the brainstem and cerebral hemispheres that corresponded to sites of HARDI tract disruption. Axonal injury was also present within the grey matter of the hypothalamus, thalamus, basal forebrain, and cerebral cortex. We propose that traumatic coma may be a subcortical disconnection syndrome related to the disconnection of specific brainstem arousal nuclei from the thalamus and basal forebrain. PMID:23656993

Cometary coma chemical composition (C4) mission. [Abstract only

NASA Technical Reports Server (NTRS)

Carle, G. C.; Clark, B. C.; Niemann, H. B.; Alexander, M.; Knocke, P. C.; O'Hara, B. J.

1994-01-01

Cometary missions are of enormous fundamental importance for many different space science disciplines, including exobiology. Comets are presumed relics of the earliest, most primitive material in the solar nebula and are related to the planetesimals. They undoubtedly provided a general enrichment of volatiles to the inner solar system (contributing to atmospheres and oceans) and may have been key to the origin of life. A Discovery class, comet rendezvous mission, the Cometary Coma Chemical Composition (C4) Mission, was selected for further study by NASA earlier this year. The C4 Mission is a highly focused and usefully-limited subset of the Cometary Rendezvous Asteroid Flyby (CRAF) Mission, concentrating exclusively on measurements which will lead to an understanding of the chemical composition and make-up of the cometary nucleus. The scientific goals of the Cometary Coma Chemical Composition (C4) Mission are to rendezvous with a short-period comet and (1) to determine the elemental, chemical, and isotopic composition of the nucleus and (2) to characterize the chemical and isotopic nature of its atmosphere. Further, it is a goal to obtain preliminary data on the development of the coma (dust and gas composition) as a function of time and orbital position.

[No relationship between blood type and personality: evidence from large-scale surveys in Japan and the US].

PubMed

Nawata, Kengo

2014-06-01

Despite the widespread popular belief in Japan about a relationship between personality and ABO blood type, this association has not been empirically substantiated. This study provides more robust evidence that there is no relationship between blood type and personality, through a secondary analysis of large-scale survey data. Recent data (after 2000) were collected using large-scale random sampling from over 10,000 people in total from both Japan and the US. Effect sizes were calculated. Japanese datasets from 2004 (N = 2,878-2,938), and 2,005 (N = 3,618-3,692) as well as one dataset from the US in 2004 (N = 3,037-3,092) were used. In all the datasets, 65 of 68 items yielded non-significant differences between blood groups. Effect sizes (eta2) were less than .003. This means that blood type explained less than 0.3% of the total variance in personality. These results show the non-relevance of blood type for personality.

Music therapy for coma patients: preliminary results.

PubMed

Sun, J; Chen, W

2015-04-01

The application of quantitative EEG (δ+θ/α+β value) and GCS value to evaluate the role of music therapy for traumatic brain injury coma patients. Forty patients of traumatic brain injury coma were selected to meet the inclusion criteria. Twenty cases were selected for the rehabilitation, neurology and neurosurgery ward, whose families could actively cooperate with, and the patients could receive a long-term fixed nursing staff with formal music therapy (music group). Twenty cases were in the intensive care unit of the rehabilitation, neurology and neurosurgery ward. Their families members cooperated poorly, had often changing nursing staff, and without a formal music therapy (control group). After a one monthe follow up, the GCS value and quantitative EEG (δ+θ/α+β value) were compared between the two groups. Between the two groups, except for the presence or absence of formal music therapy, the rest of treatment had no significant difference and was matched by age, gender, and injury types. In 40 cases of traumatic brain injury patients, the GCS value increased in the music group after treatment when compared to the control group. The difference between the two groups was significant (p < 0.05). The quantitative EEG value (δ+θ/α+β value) of music group values were decreased after treatment, and the difference was significant compared with the control group (p < 0.05). Through the quantitative EEG (δ+θ/α+β value) and the GCS observation score, music therapy in patients with craniocerebral trauma coma has obviously an effect on promoting to regain consciousness. The quantitative EEG (δ+θ/α+β value) can be used as an objective index to evaluate the state of brain function.

Severe congestive heart failure patient on amiodarone presenting with myxedemic coma: a case report.

PubMed

Shaheen, Mazen

2009-01-01

This is a case report of myxedema coma secondary to amiodarone-induced hypothyroidism in a patient with severe congestive heart failure (CHF). To our knowledge and after reviewing the literature there is one case report of myxedema coma during long term amiodarone therapy. Myxedema coma is a life threatening condition that carries a mortality reaching as high as 20% with treatment. The condition is treated with intravenous thyroxine (T4) or intravenous tri-iodo-thyronine (T3). Patients with CHF on amiodarone may suffer serious morbidity and mortality from hypothyroidism, and thus may deserve closer follow up for thyroid stimulating hormone (TSH) levels. This case report carries an important clinical application given the frequent usage of amiodarone among CHF patients. The myriad clinical presentation of myxedema coma and its serious morbidity and mortality stresses the need to suspect this clinical syndrome among CHF patients presenting with hypotension, weakness or other unexplained symptoms.

'Is she alive? Is she dead?' Representations of chronic disorders of consciousness in Douglas Coupland's Girlfriend in a Coma.

PubMed

Colbeck, Matthew

2016-09-01

Depictions of coma have come to dominate literary and filmic texts over the last half century, a phenomenon coinciding with advancements in medical technology that have led to remarkable increases in the survival rates of patients with chronic disorders of consciousness. Authors of coma fiction are preoccupied with the imagined subjective experience of coma, often creating complex, dream-like worlds from which the protagonist must escape if survival is to be achieved. However, such representations appear to conflict with medical case studies and patient narratives that reveal that most often survivors of coma have no recollection of the coma itself. Providing a close reading of Douglas Coupland's Girlfriend in a Coma (1998) against the context of medical literature and diagnoses, this article examines how the coma patient is represented, often depicting the realities of a prolonged vegetative state, in contrast with other popular representations of coma. It explores how the author develops a work of 'fantastic' fiction (a genre defined by the structuralist critic Tzvetan Todorov), using the condition of coma as a metaphor for a postmodern existential crisis, while simultaneously employing mimetic techniques that raise important medical, ethical and philosophical questions surrounding the ontological status of the comatose patient. It is argued that coma fiction, even in its misrepresentation of the condition, can help us to engage with and interrogate how we think about chronic disorders of consciousness, thereby providing a valuable insight into our attitudes towards illness and mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Solar-insolation-induced changes in the coma morphology of comet 67P/Churyumov-Gerasimenko. Optical monitoring with the Nordic Optical Telescope

NASA Astrophysics Data System (ADS)

Zaprudin, B.; Lehto, H. J.; Nilsson, K.; Somero, A.; Pursimo, T.; Snodgrass, C.; Schulz, R.

2017-07-01

Context. 67P/Churyumov-Gerasimenko (67P/C-G) is a short-period Jupiter family comet with an orbital period of 6.55 yr. Being the target comet of ESA's Rosetta mission, 67P/C-G has become one of the most intensively studied minor bodies of the solar system. The Rosetta Orbiter and the Philae Lander have brought us unique information about the structure and activity of the comet nucleus, as well as its activity along the orbit, composition of gas, and dust particles emitted into the coma. However, as Rosetta stayed in very close proximity to the cometary nucleus (less than 500 km with a few short excursions reaching up to 1500 km), it could not see the global picture of a coma at the scales reachable by telescopic observations (103 - 105 km). Aims: In this work we aim to connect in-situ observations made by Rosetta with the morphological evolution of the coma structures monitored by the ground-based observations. In particular, we concentrate on causal relationships between the coma morphology and evolution observed with the Nordic Optical Telescope (NOT) in the Canary Islands, and the seasonal changes of the insolation and the activity of the comet observed by the Rosetta instruments. Methods: Comet 67P/C-G was monitored with the NOT in imaging mode in two colors. Imaging optical observations were performed roughly on a weekly basis, which provides good coverage of short- and long-term variability. With the three dimensional modeling of the coma produced by active regions on the southern hemisphere, we aim to qualify the observed morphology by connecting it to the activity observed by Rosetta. Results: During our monitoring program, we detected major changes in the coma morphology of comet 67P/C-G. These were long-term and long-lasting changes. They do not represent any sudden outburst or short transient event, but are connected to seasonal changes of the surface insolation and the emergence of new active regions on the irregular shaped comet nucleus. We have also

[Myxedema coma in a patient with type 1 neurofibromatosis: rare association].

PubMed

Sasazawa, Denise Tieko; Tsukumo, Daniela Miti; Lalli, Cristina Alba

2013-12-01

Myxedema coma, a rare but fatal emergency, is an extreme expression of hypothyroidism. We describe a 51-year-old male patient who has discontinued hypothyroidism treatment 10 months earlier and developed lethargy, edema, and cold intolerance symptoms. He also had a previous diagnosis of neurofibromatosis. After admission, he progressed to respiratory insufficiency and coma. The prompt recognition of the condition, thyroid hormone replacement, and management of the complications (hypoventilation, cardiogenic shock associated with swinging heart, adrenal and renal insufficiency and sepsis), resulted in a favorable evolution.

MMN and novelty P3 in coma and other altered states of consciousness: a review.

PubMed

Morlet, Dominique; Fischer, Catherine

2014-07-01

In recent decades, there has been a growing interest in the assessment of patients in altered states of consciousness. There is a need for accurate and early prediction of awakening and recovery from coma. Neurophysiological assessment of coma was once restricted to brainstem auditory and primary cortex somatosensory evoked potentials elicited in the 30 ms range, which have both shown good predictive value for poor coma outcome only. In this paper, we review how passive auditory oddball paradigms including deviant and novel sounds have proved their efficiency in assessing brain function at a higher level, without requiring the patient's active involvement, thus providing an enhanced tool for the prediction of coma outcome. The presence of an MMN in response to deviant stimuli highlights preserved automatic sensory memory processes. Recorded during coma, MMN has shown high specificity as a predictor of recovery of consciousness. The presence of a novelty P3 in response to the subject's own first name presented as a novel (rare) stimulus has shown a good correlation with coma awakening. There is now a growing interest in the search for markers of consciousness, if there are any, in unresponsive patients (chronic vegetative or minimally conscious states). We discuss the different ERP patterns observed in these patients. The presence of novelty P3, including parietal components and possibly followed by a late parietal positivity, raises the possibility that some awareness processes are at work in these unresponsive patients.

MMN and Novelty P3 in Coma and Other Altered States of Consciousness: A Review

PubMed Central

Morlet, Dominique; Fischer, Catherine

2014-01-01

In recent decades, there has been a growing interest in the assessment of patients in altered states of consciousness. There is a need for accurate and early prediction of awakening and recovery from coma. Neurophysiological assessment of coma was once restricted to brainstem auditory and primary cortex somatosensory evoked potentials elicited in the thirty millisecond range, which have both shown good predictive value for poor coma outcome only. In this paper, we review how passive auditory oddball paradigms including deviant and novel sounds have proved their efficiency in assessing brain function at a higher level, without requiring the patient’s active involvement, thus providing an enhanced tool for the prediction of coma outcome. The presence of an MMN in response to deviant stimuli highlights preserved automatic sensory memory processes. Recorded during coma, MMN has shown high specificity as a predictor of recovery of consciousness. The presence of a novelty P3 in response to the subject’s own first name presented as a novel (rare) stimulus has shown a good correlation with coma awakening. There is now a growing interest in the search for markers of consciousness, if there are any, in unresponsive patients (chronic vegetative or minimally conscious states). We discuss the different ERP patterns observed in these patients. The presence of novelty P3, including parietal components and possibly followed by a late parietal positivity, raises the possibility that some awareness processes are at work in these unresponsive patients. PMID:24281786

Origins of ultra-diffuse galaxies in the Coma cluster - I. Constraints from velocity phase-space

NASA Astrophysics Data System (ADS)

Alabi, Adebusola; Ferré-Mateu, Anna; Romanowsky, Aaron J.; Brodie, Jean; Forbes, Duncan A.; Wasserman, Asher; Bellstedt, Sabine; Martín-Navarro, Ignacio; Pandya, Viraj; Stone, Maria B.; Okabe, Nobuhiro

2018-06-01

We use Keck/DEIMOS spectroscopy to confirm the cluster membership of 16 ultra-diffuse galaxies (UDGs) in the Coma cluster, bringing the total number of spectroscopically confirmed UDGs from the Yagi et al. (Y16) catalog to 25. We also identify a new cluster background UDG, confirming that most (˜95 per cent) of the UDGs in the Y16 catalog belong to the Coma cluster. In this pilot study of Coma UDGs in velocity phase-space, we find evidence of a diverse origin for Coma cluster UDGs, similar to normal dwarf galaxies. Some UDGs in our sample are consistent with being late infalls into the cluster environment while some may have been in the cluster for ≥8 Gyr. The late infallen UDGs have higher absolute relative line-of-sight velocities, bluer optical colors, and within the projected cluster core, are smaller in size, compared to the early infalls. The early infall UDGs, which may also have formed in-situ, have been in the cluster environment for as long as the most luminous galaxies in the Coma cluster and they may be failed galaxies which experienced star formation quenching at earlier epochs.

Prognosis of patients in coma after acute subdural hematoma due to ruptured intracranial aneurysm.

PubMed

Torné, Ramon; Rodríguez-Hernández, Ana; Romero-Chala, Fabián; Arikan, Fuat; Vilalta, Jordi; Sahuquillo, Juan

2016-04-01

Acute subdural hematomas (aSDH) secondary to intracranial aneurysm rupture are rare. Most patients present with coma and their functional prognosis has been classically considered to be very poor. Previous studies mixed good-grade and poor-grade patients and reported variable outcomes. We reviewed our experience by focusing on patients in coma only and hypothesized that aSDH might worsen initial mortality but not long-term functional outcome. Between 2005 and 2013, 440 subarachnoid hemorrhage (SAH) patients were admitted to our center. Nineteen (4.3%) were found to have an associated aSDH and 13 (2.9%) of these presented with coma. Their prospectively collected clinical and outcome data were reviewed and compared with that of 104 SAH patients without aSDH who presented with coma during the same period. Median aSDH thickness was 10mm. Four patients presented with an associated aneurysmal cortical laceration and only one had good recovery. Overall, we observed good long-term outcomes in both SAH patients in coma with aSDH and those without aSDH (38.5% versus 26.4%). Associated aSDH does not appear to indicate a poorer long-term functional prognosis in SAH patients presenting with coma. Anisocoria and brain herniation are observed in patients with aSDH thicknesses that are smaller than those observed in trauma patients. Despite a high initial mortality, early surgery to remove the aSDH results in a good outcome in over 60% of survivors. Aneurysmal cortical laceration appears to be an independent entity which shows a poorer prognosis than other types of aneurysmal aSDH. Copyright © 2015 Elsevier Ltd. All rights reserved.

Prolonged dystonic reaction to chlorpromazine in myxoedema coma.

PubMed Central

Wood, G. M.; Waters, A. K.

1980-01-01

A case of myxoedema coma is reported where the administration of chlorpromazine resulted in a prolonged dystonic reaction. A similar challenge with a butyrophenone when the patient was on thyroxine caused a similar but much abbreviated response. PMID:7393810

The fragmentation of dust in the innermost comae of comets: Possible evidence from ground-based images

NASA Technical Reports Server (NTRS)

Combi, Michael R.

1994-01-01

Dust particles when released from the nucleus of a comet are entrained in the expanding gas flow created by the vaporization of ices (mainly water ice). Traditional approaches to dusty-gas dynamics in the inner comae of comets consider there to be an initial distribution of dust particle sizes which do not fragment or evaporate. The standard Finson-Probstein model (and subsequent variations) yields a one-to-one-to-one correspondence between the size of a dust particle, its terminal velocity owing to gas drag, and its radiation pressure acceleration which creates the notable cometary dust tail. The comparison of a newly developed dust coma model shows that the typical elongated shapes of isophotes in the dust comae of comets on the scale of greater than 10(exp 4) km from the nucleus requires that the one-to-one-to-one relationship between particle size, terminal velocity and radiation pressure acceleration cannot in general be correct. There must be a broad range of particles including those having a small velocity but large radiation pressure acceleration in order to explain the elongated shape. A straightforward way to create such a distribution is if particle fragmentation, or some combination of fragmentation with vaporization, routinely occurs within and/or just outside of the dusty-gas dynamic acceleration region (i.e., up to several hundred km). In this way initially large particles, which are accelerated to fairly slow velocities by gas-drag, fragment to form small particles which still move slowly but are subject to a relatively large radiation pressure acceleration. Fragmentation has already been suggested as one possible interpretation for the flattened gradient in the spatial profiles of dust extracted from Giotto images of Comet Halley. Grain vaporization has been suggested as a possible spatially extended source of coma gases. The general elongated isophote shapes seen in ground-based images for many years represents another possible signature of

Therapeutic options to enhance coma arousal after traumatic brain injury: state of the art of current treatments to improve coma recovery.

PubMed

Cossu, Giulia

2014-04-01

Traumatic brain injury is a leading cause of death and disability. Optimizing the recovery from coma is a priority in seeking to improve patients' functional outcomes. Standards of care have not been established: pharmacological interventions, right median nerve and sensory stimulation, dorsal column stimulation (DCS), deep brain stimulation, transcranial magnetic stimulation, hyperbaric oxygen therapy and cell transplantation have all been utilized with contrasting results. The aim of this review is to clarify the indications for the various techniques and to guide the clinical practice towards an earlier coma arousal. A systematic bibliographic search was undertaken using the principal search engines (Pubmed, Embase, Ovid and Cochrane databases) to locate the most pertinent studies. Traumatic injury is a highly individualized process, and subsequent impairments are dependent on multiple factors: this heterogeneity influences and determines therapeutic responses to the various interventions.

Isolation and characterization of acid-soluble collagen from the scales of marine fishes from Japan and Vietnam.

PubMed

Minh Thuy, Le Thi; Okazaki, Emiko; Osako, Kazufumi

2014-04-15

Acid-soluble collagen (ASC) was successfully extracted from the scales of lizard fish (Saurida spp.) and horse mackerel (Trachurus japonicus) from Japan and Vietnam and grey mullet (Mugil cephalis), flying fish (Cypselurus melanurus) and yellowback seabream (Dentex tumifrons) from Japan. ASC yields were about 0.43-1.5% (on a dry weight basis), depending on the species. The SDS-PAGE profile showed that the ASCs were type I collagens, and consisted of two different α chains, α1 and α2, as well as a β component. ASC of horse mackerel from Vietnam contained a higher imino acid level than that from Japan. ASC denaturation temperature (Td) ranged from 26 to 29 °C, depending on fish species and imino acid content (p<0.01). Maximal solubility of individual collagens was observed at pHs 1-3. Collagen solubility decreased sharply at NaCl concentrations >0.4M, regardless of fish type. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Translation and Validation of the FOUR Scale for Children and its Use as Outcome Predictor: A Pilot Study].

PubMed

Ferreira, Sofia Simões; Meireles, Daniel; Pinto, Alexandra; Abecasis, Francisco

2017-09-29

The Full Outline of UnResponsiveness - FOUR scale has been previously validated to assess impaired consciousness in the adult population. The aim of this study is the translation into Portuguese and validation of the FOUR scale in the pediatric population. The study also compares the FOUR scale and Glasgow coma scale score ratings and the clinical outcome of patients hospitalized in Pediatric Intensive Care Units. This study prospectively rated patients admitted to the Pediatric Intensive Care Units with impaired consciousness during one year. Both scales were applied daily to patients by three types of examiners: intensivists, residents and nurses, from the moment of admission until clinical discharge. Neurological sequelae was evaluated using the King's Outcome Scale for Childhood Head Injury - KOSCHI. Twenty seven patients between one and 17 years of age were included. Both scales are reliable and inter-rater reliability was greater for the FOUR score. Glasgow coma scale showed a minimum score in eight evaluations, whereas the FOUR scale obtained the minimum score in only two of these evaluations. In both scales there was a strong association between the admission score and the patient's outcome (area under curve FOUR = 0.939, versus Glasgow coma scale = 0.925). The FOUR scale provides more neurological information than Glasgow coma scale in patients with impaired consciousness and has prognostic interest. The FOUR scale can be applied in patients admitted with impaired consciousness in Pediatric Intensive Care Units. We think that a multicenter study would be very beneficial for confirming and generalizing these results.

DARK MATTER SUBHALOS AND THE X-RAY MORPHOLOGY OF THE COMA CLUSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andrade-Santos, Felipe; Nulsen, Paul E. J.; Kraft, Ralph P.

2013-04-01

Structure formation models predict that clusters of galaxies contain numerous massive subhalos. The gravity of a subhalo in a cluster compresses the surrounding intracluster gas and enhances its X-ray emission. We present a simple model, which treats subhalos as slow moving and gasless, for computing this effect. Recent weak lensing measurements by Okabe et al. have determined masses of {approx}10{sup 13} M{sub Sun} for three mass concentrations projected within 300 kpc of the center of the Coma Cluster, two of which are centered on the giant elliptical galaxies NGC 4889 and NGC 4874. Adopting a smooth spheroidal {beta}-model for themore » gas distribution in the unperturbed cluster, we model the effect of these subhalos on the X-ray morphology of the Coma Cluster, comparing our results to Chandra and XMM-Newton X-ray data. The agreement between the models and the X-ray morphology of the central Coma Cluster is striking. With subhalo parameters from the lensing measurements, the distances of the three subhalos from the Coma Cluster midplane along our line of sight are all tightly constrained. Using the model to fit the subhalo masses for NGC 4889 and NGC 4874 gives 9.1 Multiplication-Sign 10{sup 12} M{sub Sun} and 7.6 Multiplication-Sign 10{sup 12} M{sub Sun }, respectively, in good agreement with the lensing masses. These results lend strong support to the argument that NGC 4889 and NGC 4874 are each associated with a subhalo that resides near the center of the Coma Cluster. In addition to constraining the masses and 3-d location of subhalos, the X-ray data show promise as a means of probing the structure of central subhalos.« less

A study to explore nurses' knowledge in using the Glasgow Coma Scale in an acute care hospital.

PubMed

Mattar, Ihsan; Liaw, Sok Ying; Chan, Moon Fai

2013-10-01

The Glasgow Coma Scale (GCS) is a neurological instrument, which measures the "depth and duration of impaired consciousness." The appeal of the GCS lies in its applicability in a wide variety of clinical situations as well as its ease of use by a range of healthcare staff. However, the GCS is not without its weaknesses and limitations. Its ease of use opens it up to misinterpretation and misapplication. Despite the propensity for incorrect assessment, the GCS remains in use in the clinical setting and enjoys an "unwarranted and privileged position." This creates an issue to patient care as the GCS is an important instrument in communicating an accurate assessment of the patient's condition between clinical staff. The aim of this study was to investigate nurses' knowledge in using the GCS and the demographic factors influencing knowledge of the GCS. This is a correlational observational study conducted in one acute care hospital in Singapore. The participants were registered nurses involving in bedside nursing care. A self-administered questionnaire was provided to the participants via ward managers. The quantitative responses were collated and analyzed using SPSS 16.0. Type of clinical discipline (i.e., neuroscience, general medicine, and neurointensive care unit; beta = 0.51, p < .001) and the length of experience in a neuroscience setting (beta = 0.22, p = .005) were significant in determining a nurses' knowledge of the GCS. Nurses in the neonatal intensive care unit scored the highest mean scores (12.7), whereas nurses from the general medicine wards scored the lowest mean scores (9.7). Nurses who worked in a neuroscience setting for 6 years or more scored higher mean scores (11.9) on the knowledge scale, whereas nurses who worked in a neuroscience setting for less than a year scored lower mean scores (10.0). Educational interventions and guidelines in performing GCS assessment are suggested to maintain and improve knowledge in performing the GCS.

Comet 81p/Wild 2: The Updated Stardust Coma Dust Fluence Measurement for Smaller (Sub 10-Micrometre) Particles

NASA Technical Reports Server (NTRS)

Price, M. C.; Kearsley, A. T.; Burchell, M. J.; Horz, Friedrich; Cole, M. J.

2009-01-01

Micrometre and smaller scale dust within cometary comae can be observed by telescopic remote sensing spectroscopy [1] and the particle size and abundance can be measured by in situ spacecraft impact detectors [2]. Initial interpretation of the samples returned from comet 81P/Wild 2 by the Stardust spacecraft [3] appears to show that very fine dust contributes not only a small fraction of the solid mass, but is also relatively sparse [4], with a low negative power function describing grain size distribution, contrasting with an apparent abundance indicated by the on-board Dust Flux Monitor Instrument (DFMI) [5] operational during the encounter. For particles above 10 m diameter there is good correspondence between results from the DFMI and the particle size inferred from experimental calibration [6] of measured aerogel track and aluminium foil crater dimensions (as seen in Figure 4 of [4]). However, divergence between data-sets becomes apparent at smaller sizes, especially submicrometre, where the returned sample data are based upon location and measurement of tiny craters found by electron microscopy of Al foils. Here effects of detection efficiency tail-off at each search magnification can be seen in the down-scale flattening of each scale component, but are reliably compensated by sensible extrapolation between segments. There is also no evidence of malfunction in the operation of DFMI during passage through the coma (S. Green, personal comm.), so can the two data sets be reconciled?

X ray archeology in the Coma cluster

NASA Technical Reports Server (NTRS)

White, Simon D. M.; Briel, Ulrich G.; Henry, J. Patrick

1993-01-01

Images of X-ray emission from hot gas within the Coma cluster of galaxies are presented. These maps, made with the Rosat satellite, have high signal to noise ratio and allow cluster structure to be analyzed in unprecedented detail. They show greater structural irregularity than could be anticipated from earlier observations of Coma. Emission is detected from a number of bright cluster galaxies in addition to the two known previously. In four cases there is evidence that these galaxies lie at the center of an extended subconcentration within the cluster, possibly the remnant of their associated groups. For at least two galaxies the images show direct evidence for ongoing disruption of their gaseous atmosphere. The luminosity associated with these galaxies is comparable to that detected around similar ellipticals in much poorer environments. Emission is easily detected and appears to become more regular at large radii. The data show that this archetype of a rich and regular galaxy cluster was formed by the merging of several distinct subunits which are not yet fully destroyed.

Using an integral-field unit spectrograph to study radical species in cometary coma

NASA Astrophysics Data System (ADS)

Lewis, Benjamin; Pierce, Donna M.; Vaughan, Charles M.; Cochran, Anita

2015-01-01

We have observed several comets using an integral-field unit spectrograph (the George and Cynthia Mitchell Spectrograph) on the 2.7m Harlan J. Smith telescope at McDonald Observatory. Full-coma spectroscopic images were obtained for various radical species (C2, C3, CN, NH2). Various coma enhancements were used to identify and characterize coma morphological features. The azimuthal average profiles and the Haser model were used to determine production rates and possible parent molecules. Here, we present the work completed to date, and we compare our results to other comet taxonomic surveys. This work was funded by the National Science Foundation Graduate K-12 (GK-12) STEM Fellows program (Award No. DGE-0947419), NASA's Planetary Atmospheres program (Award No. NNX14AH18G), and the Fund for Astrophysical Research, Inc.

Using an integral-field unit spectrograph to study radical species in cometary coma

NASA Astrophysics Data System (ADS)

Lewis, Benjamin; Pierce, Donna; Cochran, Anita; Vaughan, Charles

2014-11-01

We have observed several comets using an integral-field unit spectrograph (the George and Cynthia Mitchell Spectrograph) on the 2.7m Harlan J. Smith telescope at McDonald Observatory. Full-coma spectroscopic images were obtained for various radical species (C2, C3, CN, NH2). Various coma enhancements were used to identify and characterize coma morphological features. The azimuthal average profiles and the Haser model were used to determine production rates and possible parent molecules. Here, we present the work completed to date, and we compare our results to other comet taxonomic surveys. This work was funded by the National Science Foundation Graduate K-12 (GK-12) STEM Fellows program (Award No. DGE-0947419), NASA’s Planetary Atmospheres program (Award No. NNX14AH18G), and the Fund for Astrophysical Research, Inc.

Modeling of the illumination driven coma of 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Bieler, André

2015-04-01

In this paper we present results modeling 67P/Churyumov-Gerasimenko's (C-G) neutral coma properties observed by the Rosetta ROSINA experiment with 3 different model approaches. The basic assumption for all models is the idea that the out-gassing properties of C-G are mainly illumination driven. With this assumption all models are capable of reproducing most features in the neutral coma signature as detected by the ROSINA-COPS instrument over several months. The models include the realistic shape model of the nucleus to calculate the illumination conditions over time which are used to define the boundary conditions for the hydrodynamic (BATS-R-US code) and the Direct Simulation Monte Carlo (AMPS code) simulations. The third model finally computes the projection of the total illumination on the comet surface towards the spacecraft. Our results indicate that at large heliocentric distances (3.5 to 2.8 AU) most gas coma structures observed by the in-situ instruments can be explained by uniformly distributed activity regions spread over the whole nucleus surface.

Dwarfs in Coma Cluster

NASA Technical Reports Server (NTRS)

2007-01-01

[figure removed for brevity, see original site] Click on image for larger poster version

This false-color mosaic of the central region of the Coma cluster combines infrared and visible-light images to reveal thousands of faint objects (green). Follow-up observations showed that many of these objects, which appear here as faint green smudges, are dwarf galaxies belonging to the cluster. Two large elliptical galaxies, NGC 4889 and NGC 4874, dominate the cluster's center. The mosaic combines visible-light data from the Sloan Digital Sky Survey (color coded blue) with long- and short-wavelength infrared views (red and green, respectively) from NASA's Spitzer Space Telescope.

Myxedema coma associated with combination aripiprazole and sertraline therapy.

PubMed

Church, Chelsea O; Callen, Erin C

2009-12-01

To describe a case of myxedema coma (MC) associated with combination aripiprazole and sertraline therapy. A 41-year-old male presented to the emergency department with confusion, right-sided numbness and tingling, slurred speech, dizziness, and facial edema. His blood pressure was 160/113 mm Hg, with a pulse of 56 beats/min and temperature of 35.4 degrees C. Initial abnormal laboratory values included creatine kinase (CK) 439 U/L; serum creatinine 1.6 mg/dL; aspartate aminotransferase 85 U/L; and alanine aminotransferase 35 U/L. Repeat cardiac markers revealed an elevated CK level of 3573 U/L with a CK-MB of 24 ng/mL. Thyroid function tests showed thyroid-stimulating hormone 126.4 microIU/mL and free thyroxine 0.29 ng/dL. Home medications of unknown duration were sertraline 200 mg and aripiprazole 20 mg daily. He was admitted to the intensive care unit and initially treated with intravenous levothyroxine and dexamethasone. By hospital day 4, the patient was clinically stable and discharged to home. Myxedema coma, the most significant form of hypothyroidism (HT), is a rare but potentially fatal condition. The known precipitating causes of MC were ruled out in this patient, which left his home medications as the likely cause. Cases of HT caused by certain atypical antipsychotics and antidepressants are found in the literature, but none was reported with aripiprazole therapy. There are also no reported cases of sertraline or aripiprazole inducing MC. Use of the Naranjo probability scale indicates that the combination of aripiprazole and sertraline was a probable inducer of MC in this patient. Due to the widespread use of psychotropic medications, clinicians should be reminded of the rare, yet life-threatening, occurrence of MC when treating patients, especially with combination therapies such as sertraline and aripiprazole.

The Nature and Origin of UCDs in the Coma Cluster

NASA Astrophysics Data System (ADS)

Chiboucas, Kristin; Tully, R. Brent; Madrid, Juan; Phillipps, Steven; Carter, David; Peng, Eric

2018-01-01

UCDs are super massive star clusters found largely in dense regions but have also been found around individual galaxies and in smaller groups. Their origin is still under debate but currently favored scenarios include formation as giant star clusters, either as the brightest globular clusters or through mergers of super star clusters, themselves formed during major galaxy mergers, or as remnant nuclei from tidal stripping of nucleated dwarf ellipticals. Establishing the nature of these enigmatic objects has important implications for our understanding of star formation, star cluster formation, the missing satellite problem, and galaxy evolution. We are attempting to disentangle these competing formation scenarios with a large survey of UCDs in the Coma cluster. Using ACS two-passband imaging from the HST/ACS Coma Cluster Treasury Survey, we are using colors and sizes to identify the UCD cluster members. With a large size limited sample of the UCD population within the core region of the Coma cluster, we are investigating the population size, properties, and spatial distribution, and comparing that with the Coma globular cluster and nuclear star cluster populations to discriminate between the threshing and globular cluster scenarios. In previous work, we had found a possible correlation of UCD colors with host galaxy and a possible excess of UCDs around a non-central giant galaxy with an unusually large globular cluster population, both suggestive of a globular cluster origin. With a larger sample size and additional imaging fields that encompass the regions around these giant galaxies, we have found that the color correlation with host persists and the giant galaxy with unusually large globular cluster population does appear to host a large UCD population as well. We present the current status of the survey.

Comet 67P/Churyumov-Gerasimenko during the Rosetta mission: numerical simulation of dusty gas coma

NASA Astrophysics Data System (ADS)

Tenishev, Valeriy; Combi, Michael; Rubin, Martin; Hansen, Kenneth; Gombosi, Tamas

The Rosetta spacecraft is en route to comet 67P/Churyumov-Gerasimenko for a rendezvous, landing, and extensive orbital phase beginning in 2014. Having a limited amount of information regarding its coma, interpretation of measurements and safety consideration of the spacecraft will require modeling of the comet's environment. Such models should be able to simulate both the gas and dust phases of the coma as well as the interaction between them in a self-consistent manner. The relevant physical processes in the coma include photolytic reactions and interaction with the nucleus for the gas phase and drag by the gas, gravity of the nucleus, solar gravity and radiation pressure, and charging by the ambient plasma for the dust phase. Developing of such modeling capabilities will be able to link measurements obtained by different instruments onboard of spacecraft. Some examples of cometary comae simulations can be found in [1-3]. In this work we present our kinetic model of a dusty gas coma [4] with results of its application to the case of comet Churyumov-Gerasimenko at conditions corresponding to some stages the during the Rosetta mission. Based on the surface properties and local production rates obtained by MIRO, RSI and VIRTIS the model will be able to propagate the injected gas and dust into the coma linking the measurements to those obtained by ALICE, MIDAS and ROSINA for the gas phase and COSIMA and GIADA for the dust phase of the coma. A simultaneous simulation of the major components of the multi-phase coma will allow us to link observations of the gas and dust phases. In this work we present results of a numerical study of neutral/ionized multispecies gaseous and electrically charged dust environment of the comet Churyumov-Gerasimenko at a helio-centric distance of 1.3 AU. The simulation is performed in fully 3D geometry with a realistic nucleus model that describes its topological features and source distribution. Both, neutral and ionized components of the

Particle Sizes in the Coma of Comet 45P/Honda-Mrkos-Pajdušáková from Arecibo Radar Observations

NASA Astrophysics Data System (ADS)

Springmann, Alessondra; Howell, Ellen S.; Harmon, John K.; Lejoly, Cassandra; Rivera-Valentin, Edgard G.; Virkki, Anne; Zambrano-Marin, Luisa F.; Taylor, Patrick A.; Harris, Walter M.; Mueller, Beatrice E. A.; Samarasinha, Nalin H.; Rodriguez Sanchez-Vahamonde, Carolina

2017-10-01

Radar observations of cometary comae can provide information about not only the cross-section of the coma, but also constraints on the particle sizes comprising the coma. Harmon et al. (2011) described analysis of radar observations of comet 103P/Hartley 2 to constrain the sizes of its coma particles, as well as modeling to analyze the particle velocity distribution in the coma and orientation with respect to the sun. Arecibo Observatory planetary radar system observations of comet 45P/Honda-Mrkos-Pajdušáková were obtained 9-16 February 2017 by transmitting a continuous wave of polarized radio waves at the comet. By examining the polarization ratios of the returned signal (whether it has the same sense or opposite sense of the transmitted signal), we can look for non-zero same sense polarization signal. Detectable same sense signal indicates the presence of particles with sizes larger than the Rayleigh transition size criteria, a = λ/2π ≈ 2 cm (for the Arecibo wavelength of 12.6 cm).The observations show strong opposite sense signal return from the comet nucleus, as well as a larger ‘skirt’ of surrounding grains in the coma. Preliminary analysis of this data indicates at least a weak same sense polarized signal, implying a population of grains larger than 2 cm in the coma. The sizes of particles in the coma, compared with the area of the coma, can help us constrain the minimum mass for particles at the Rayleigh size limit in the 45P coma. Further, a detectable grain halo of large particles around 45P would imply significant lofting of grains from the comet nucleus.ReferencesHarmon, John K., et al. "Radar observations of comet 103P/Hartley 2." The Astrophysical Journal Letters 734.1 (2011): L2.

Jet Morphology and Coma Analysis of 103P/Hartley 2: Temporal Evolution and Interspecies Comparisons

NASA Astrophysics Data System (ADS)

Vaughan, Charles M.; Pierce, Donna M.; Cochran, Anita L.

2014-11-01

We present our results on an expanded study of the jet and coma behavior of comet 103P/Hartley 2 (a continuation of original results presented in Vaughan et al. 2012). We observed Hartley 2 pre- and post-perihelion in 2010 using the George and Cynthia Mitchell Spectrograph on the 2.7 m telescope at McDonald Observatory. Data for CN, C2, C3, CH, and NH2 were collected over six nights from 15 July to 10 November. The spectral data were used to create coma maps for each of the observed species, and the maps were processed using radial and azimuthal division techniques to create enhanced images of the coma to examine coma morphological features. To compliment the ongoing investigation of Hartley 2 as studied by the EPOXI flyby mission, we use findings from other researchers (Belton et al. 2012; Syal et al. 2012; Thomas et al. 2012) to identify dust jet locations on the nucleus and compare the computed jet directions to the radical densities in the coma at our observation times. We also calculate production rates and mixing ratios with water for suspected parent species. This work was funded by the National Science Foundation Graduate K-12 (GK-12) STEM Fellows program (Award No. DGE-0947419) and NASA’s Planetary Atmospheres program (Award No. NNX14AH18G).

A Giant Warm Baryonic Halo for the Coma Cluster

NASA Technical Reports Server (NTRS)

Bonamente, Max; Lieu, Richard; Joy, Marshall K.; Six, N. Frank (Technical Monitor)

2002-01-01

Several deep PSPC observations of the Coma cluster unveil a very large-scale halo of soft X-ray emission, substantially in excess of the well know radiation from the hot intra-cluster medium. The excess emission, previously reported in the central cluster regions through lower-sensitivity EUVE and ROSAT data, is now evident out to a radius of 2.5 Mpc, demonstrating that the soft excess radiation from clusters is a phenomenon of cosmological significance. The spectrum at these large radii cannot be modeled non-thermally, but is consistent with the original scenario of thermal emission at warm temperatures. The mass of this plasma is at least on par with that of the hot X-ray emitting plasma, and significantly more massive if the plasma resides in low-density filamentary structures. Thus the data lend vital support to current theories of cosmic evolution, which predict greater than 50 percent by mass of today's baryons reside in warm-hot filaments converging at clusters of galaxies.

Thermal instability in the inner coma of a comet

NASA Technical Reports Server (NTRS)

Milikh, G. M.; Sharma, A. S.

1995-01-01

The spacecraft and ground based observations of comet Halley inner coma showed a localized ion density depletion region whose origin is not well understood. Although it has been linked to a thermal instability associated with negative ions, the photodetachment lifetime of negative ions (approximately 1 sec) is too short compared to the electron attachment time scale (approximately 100 sec) for this process to have a significant effect. A mechanism for the ion density depletion based on the thermal instability of the cometary plasma due to the excitation of rotational and vibrational levels of water molecules is proposed. The electron energy losses due to these processes peak near 4000 K (0.36 eV) and at temperatures higher than this value a localized cooling leads to further cooling (thermal instability) due to the increased radiation loss. The resulting increase in recombination leads to an ion density depletion and the estimates for this depletion at comet Halley agree with the observations.

Dust in Cometary Comae: Present Understanding of the Structure and Composition of Dust Particles

NASA Technical Reports Server (NTRS)

Levasseur-Regourd, A. C.; Zolensky, M.; Lasue, J.

2007-01-01

In situ probing of a very few cometary comae has shown that dust particles present a low albedo and a low density, and that they consist of both rocky material and refractory organics. Remote observations of solar light scattered by cometary dust provide information on the properties of dust particles in the coma of a larger set of comets. The observations of the linear polarization in the coma indicate that the dust particles are irregular, with a size greater (on the average) than about one micron. Besides, they suggest, through numerical and experimental simulations, that both compact grains and fluffy aggregates (with a power law of the size distribution in the -2.6 to -3 range), and both rather transparent silicates and absorbing organics are present in the coma. Recent analysis of the cometary dust samples collected by the Stardust mission provide a unique ground truth and confirm, for comet 81P/Wild 2, the results from remote sensing observations. Future space missions to comets should, in the next decade, lead to a more precise characterization of the structure and composition of cometary dust particles.

Tertiary evolution of the Shimanto belt (Japan): A large-scale collision in Early Miocene

NASA Astrophysics Data System (ADS)

Raimbourg, Hugues; Famin, Vincent; Palazzin, Giulia; Yamaguchi, Asuka; Augier, Romain

2017-07-01

To decipher the Miocene evolution of the Shimanto belt of southwestern Japan, structural and paleothermal studies were carried out in the western area of Shikoku Island. All units constituting the belt, both in its Cretaceous and Tertiary domains, are in average strongly dipping to the NW or SE, while shortening directions deduced from fault kinematics are consistently orientated NNW-SSE. Peak paleotemperatures estimated with Raman spectra of organic matter increase strongly across the southern, Tertiary portion of the belt, in tandem with the development of a steeply dipping metamorphic cleavage. Near the southern tip of Ashizuri Peninsula, the unconformity between accreted strata and fore-arc basin, present along the whole belt, corresponds to a large paleotemperature gap, supporting the occurrence of a major collision in Early Miocene. This tectonic event occurred before the magmatic event that affected the whole belt at 15 Ma. The associated shortening was accommodated in two opposite modes, either localized on regional-scale faults such as the Nobeoka Tectonic Line in Kyushu or distributed through the whole belt as in Shikoku. The reappraisal of this collision leads to reinterpret large-scale seismic refraction profiles of the margins, where the unit underlying the modern accretionary prism is now attributed to an older package of deformed and accreted sedimentary units belonging to the Shimanto belt. When integrated into reconstructions of Philippine Sea Plate motion, the collision corresponds to the oblique collision of a paleo Izu-Bonin-Mariana Arc with Japan in Early Miocene.

Near-UV OH Prompt Emission in the Innermost Coma of 103P/Hartley 2

NASA Astrophysics Data System (ADS)

La Forgia, Fiorangela; Bodewits, Dennis; A'Hearn, Michael F.; Protopapa, Silvia; Kelley, Michael S. P.; Sunshine, Jessica; Feaga, Lori; Farnham, Tony

2017-11-01

The Deep Impact spacecraft flyby of comet 103P/Hartley 2 occurred on 2010 November 4, 1 week after perihelion with a closest approach (CA) distance of about 700 km. We used narrowband images obtained by the Medium Resolution Imager on board the spacecraft to study the gas and dust in the innermost coma. We derived an overall dust reddening of 15%/100 nm between 345 and 749 nm and identified a blue enhancement in the dust coma in the sunward direction within 5 km from the nucleus, which we interpret as a localized enrichment in water ice. OH column density maps show an anti-sunward enhancement throughout the encounter, except for the highest-resolution images, acquired at CA, where a radial jet becomes visible in the innermost coma, extending up to 12 km from the nucleus. The OH distribution in the inner coma is very different from that expected for a fragment species. Instead, it correlates well with the water vapor map derived by the HRI-IR instrument on board Deep Impact. Radial profiles of the OH column density and derived water production rates show an excess of OH emission during CA that cannot be explained with pure fluorescence. We attribute this excess to a prompt emission process where photodissociation of H2O directly produces excited OH*(A 2Σ+) radicals. Our observations provide the first direct imaging of near-UV prompt emission of OH. We therefore suggest the use of a dedicated filter centered at 318.8 nm to directly trace the water in the coma of comets.

Negative Ion Chemistry in the Coma of Comet 1P/Halley

NASA Technical Reports Server (NTRS)

Cordiner, M. A.; Charnley, S. B.

2012-01-01

Negative ions (anions) were identified in the coma of comet 1P/Halley from in-situ measurements performed by the Giotto spacecraft in 1986. These anions were detected with masses in the range 7-110 amu, but with insufficient mass resolution to permit unambiguous identification. We present details of a new chemical-hydrodynamic model for the coma of comet Halley that includes - for the first time - atomic and molecular anions, in addition to a comprehensive hydrocarbon chemistry. Anion number densities arc calculated as a function of radius in the coma, and compared with the Giotto results. Important anion production mechanisms arc found to include radiative electron attachment, polar photodissociation, dissociative electron attachment, and proton transfer. The polyyne anions C4H(-) and C6H(-) arc found to be likely candidates to explain the Giotto anion mass spectrum in the range 49-73 amu. Thc CN(-) anion probably makes a significant contribution to the mass spectrum at 26 amu. Larger carbon-chain anions such as C8H(1) can explain the peak near 100 amu provided there is a source of large carbon-chain-bearing molecules from the cometary nucleus.

A SUZAKU SEARCH FOR NONTHERMAL EMISSION AT HARD X-RAY ENERGIES IN THE COMA CLUSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wik, Daniel R.; Sarazin, Craig L.; Finoguenov, Alexis

2009-05-10

The brightest cluster radio halo known resides in the Coma cluster of galaxies. The relativistic electrons producing this diffuse synchrotron emission should also produce inverse Compton emission that becomes competitive with thermal emission from the intracluster medium (ICM) at hard X-ray energies. Thus far, claimed detections of this emission in Coma are controversial. We present a Suzaku HXD-PIN observation of the Coma cluster in order to nail down its nonthermal hard X-ray content. The contribution of thermal emission to the HXD-PIN spectrum is constrained by simultaneously fitting thermal and nonthermal models to it and a spatially equivalent spectrum derived frommore » an XMM-Newton mosaic of the Coma field. We fail to find statistically significant evidence for nonthermal emission in the spectra which are better described by only a single- or multitemperature model for the ICM. Including systematic uncertainties, we derive a 90% upper limit on the flux of nonthermal emission of 6.0 x 10{sup -12} erg s{sup -1} cm{sup -2} (20-80 keV, for {gamma} = 2.0), which implies a lower limit on the cluster-averaged magnetic field of B>0.15 {mu}G. Our flux upper limit is 2.5 times lower than the detected nonthermal flux from RXTE and BeppoSAX. However, if the nonthermal hard X-ray emission in Coma is more spatially extended than the observed radio halo, the Suzaku HXD-PIN may miss some fraction of the emission. A detailed investigation indicates that {approx}50%-67% of the emission might go undetected, which could make our limit consistent with that of Rephaeli and Gruber and Fusco-Femiano et al. The thermal interpretation of the hard Coma spectrum is consistent with recent analyses of INTEGRAL and Swift data.« less

Modeling Coma Gas Jets in Comet Hale-Bopp

NASA Technical Reports Server (NTRS)

Lederer, S. M.; Campins, H.

2001-01-01

We present an analysis of OH, CN, and C2 jets observed in Comet Hale-Bopp. The relative contributions from and composition of the coma gas sources, and the parameters describing the active areas responsible for the gas jets will be discussed. Additional information is contained in the original extended abstract.

The HST/ACS Coma Cluster Survey. II. Data Description and Source Catalogs

NASA Technical Reports Server (NTRS)

Hammer, Derek; Kleijn, Gijs Verdoes; Hoyos, Carlos; Den Brok, Mark; Balcells, Marc; Ferguson, Henry C.; Goudfrooij, Paul; Carter, David; Guzman, Rafael; Peletier, Reynier F.;

Amiodarone induced myxedema coma: Two case reports and literature review.

PubMed

Hawatmeh, Amer; Thawabi, Mohammad; Abuarqoub, Ahmad; Shamoon, Fayez

2018-05-21

Amiodarone is a benzofuran derivative that contains 37% iodine by weight and is structurally similar to the thyroid hormones. Amiodarone has a complex effect on the thyroid gland, ranging from abnormalities of thyroid function tests to overt thyroid dysfunction, with either thyrotoxicosis or hypothyroidism. Myxedema coma secondary to amiodarone use has been rarely reported in the literature. Our two case reports are an add on to the literature, and illustrate that amiodarone is an important cause of thyroid dysfunction including hypothyroidism and myxedema coma. Hence, healthcare providers should have a high index of suspicion for these conditions while treating patients who are taking amiodarone therapy as early recognition and management are essential to optimize outcomes. Copyright © 2018 Elsevier Inc. All rights reserved.

X-ray archaeology in the Coma cluster

NASA Technical Reports Server (NTRS)

White, Simon D. M.; Briel, Ulrich G.; Henry, J. P.

1993-01-01

We present images of X-ray emission from hot gas within the Coma cluster of galaxies. These maps, made with the ROSAT satellite, have much higher SNR than any previous X-ray image of a galaxy cluster, and allow cluster structure to be analyzed in unprecedented detail. They show greater structural irregularity than might have been anticipated from earlier observations of Coma. Emission is detected from a number of bright cluster galaxies in addition to the two known previously. In four cases, there is evidence that these galaxies lie at the center of an extended subconcentration within the cluster, possibly the remnant of their associated groups. For at least two galaxies, the images show direct evidence for ongoing disruption of their gaseous atmosphere. The luminosity associated with these galaxies is comparable to that detected around similar ellipticals in much poorer environments. Emission is easily detected to the limit of our field, about 1 deg from the cluster center, and appears to become more regular at large radii. The data show clearly that this archetype of a rich and regular galaxy cluster was, in fact, formed by the merging of several distinct subunits which are not yet fully destroyed.

Predictors of outcome in myxoedema coma: a study from a tertiary care centre.

PubMed

Dutta, Pinaki; Bhansali, Anil; Masoodi, Shriq Rashid; Bhadada, Sanjay; Sharma, Navneet; Rajput, Rajesh

2008-01-01

With the easy availability of thyroid hormone assays, thyroid disorders are now recognised even in a subclinical state. However, patients are still seen with advanced manifestations of the disease, particularly in developing countries. This observational study analysed the predictors of outcome in patients with myxoedema coma and tested the validity of different modules to define morbidity and mortality in these patients. Twenty-three consecutive patients with myxoedema coma who presented from January 1999 to August 2006 were studied. The thyroid function test and random serum cortisol were measured in all patients at the time of admission. Patients were given oral or intravenous (i.v.) thyroxine with intention to treat with the latter according to availability. Various modules that predict outcome, including Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score, were analysed. SOFA score was repeated every 2 days until the time of discharge or demise. Twenty-three patients (20 women; 87%) of 59.5 +/- 14.4 years of age (range, 30 to 89 years) were seen during the study period. Nine (39%) patients were diagnosed with hypothyroidism for the first time at the time of presentation of myxoedema coma, whereas 14 (70%) were diagnosed with hypothyroidism previously. However, the treatment defaulters presented early to the hospital and had more severe manifestations than de novo subjects. Nineteen (82%) had thyroprivic (primary) and 4 (17%) had trophoprivic (secondary) hypothyroidism. Fifteen (65%) patients presented in the winter and in 17 (74%) sepsis was the major accompanying comorbidity. Twelve (52%) had a history of diuretic use, thereby delaying the initial diagnosis. Patients who received oral L-thyroxine had no difference in outcome from those receiving i.v. thyroxine. Twelve (52%) subjects died and sepsis was the predominant cause of death. Various predictors of mortality

Predictors of outcome in myxoedema coma: a study from a tertiary care centre

PubMed Central

Dutta, Pinaki; Bhansali, Anil; Masoodi, Shriq Rashid; Bhadada, Sanjay; Sharma, Navneet; Rajput, Rajesh

2008-01-01

Background With the easy availability of thyroid hormone assays, thyroid disorders are now recognised even in a subclinical state. However, patients are still seen with advanced manifestations of the disease, particularly in developing countries. This observational study analysed the predictors of outcome in patients with myxoedema coma and tested the validity of different modules to define morbidity and mortality in these patients. Methods Twenty-three consecutive patients with myxoedema coma who presented from January 1999 to August 2006 were studied. The thyroid function test and random serum cortisol were measured in all patients at the time of admission. Patients were given oral or intravenous (IV) thyroxine with intention to treat with the latter according to availability. Various modules that predict outcome, including Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score, were analysed. SOFA score was repeated every 2 days until the time of discharge or demise. Results Twenty-three patients (20 women; 87%) of 59.5 ± 14.4 years of age (range, 30 to 89 years) were seen during the study period. Nine (39%) patients were diagnosed with hypothyroidism for the first time at the time of presentation of myxoedema coma, whereas 14 (70%) were diagnosed with hypothyroidism previously. However, the treatment defaulters presented early to the hospital and had more severe manifestations than de novo subjects. Nineteen (82%) had thyroprivic (primary) and 4 (17%) had trophoprivic (secondary) hypothyroidism. Fifteen (65%) patients presented in the winter and in 17 (74%) sepsis was the major accompanying comorbidity. Twelve (52%) had a history of diuretic use, thereby delaying the initial diagnosis. Patients who received oral L-thyroxine had no difference in outcome from those receiving IV thyroxine. Twelve (52%) subjects died and sepsis was the predominant cause of death. Various

Children's Perceived Competence Scale: Reference values in Japan.

PubMed

Nagai, Yukiyo; Nomura, Kayo; Nagata, Masako; Ohgi, Shohei; Iwasa, Mitsuji

2015-12-01

To support children with chronic diseases, reference values to measure developmental changes in self-perception and self-esteem are considered a useful yardstick. To develop reference values to measure self-perceived competence and self-esteem in Japanese children, the Children's Perceived Competence Scale (CPCS) was administered to 768 children of elementary school grade 1 (6 years) to grade 6 (11 years) at four public schools in Japan, from November to December 2012. After excluding 74 with chronic diseases and/or incomplete responses, 694 children were included. CPCS measures children's self-perceived competence in cognitive, social, physical domains, and general self-worth, namely self-esteem. There was a tendency for scores of cognitive and general self-worth to decrease with increasing grade. Scores among grade 5 respondents were significantly lower than those among grade 4 respondents for both social and physical domains. Scores among boys and girls differed significantly, with boys scoring higher for physical domain in grades 3 and 6 and for general self-worth domain in grade 6. The CPCS reference values to measure self-perceived competence and self-esteem in Japanese children were developed in this study. These reference values are useful to inform practitioners supporting children with psychological or psychiatric problems or those with chronic diseases. © The Author(s) 2014.

Coma dust scattering concepts applied to the Rosetta mission

NASA Astrophysics Data System (ADS)

Fink, Uwe; Rinaldi, Giovanna

2015-09-01

This paper describes basic concepts, as well as providing a framework, for the interpretation of the light scattered by the dust in a cometary coma as observed by instruments on a spacecraft such as Rosetta. It is shown that the expected optical depths are small enough that single scattering can be applied. Each of the quantities that contribute to the scattered intensity is discussed in detail. Using optical constants of the likely coma dust constituents, olivine, pyroxene and carbon, the scattering properties of the dust are calculated. For the resulting observable scattering intensities several particle size distributions are considered, a simple power law, power laws with a small particle cut off and a log-normal distributions with various parameters. Within the context of a simple outflow model, the standard definition of Afρ for a circular observing aperture is expanded to an equivalent Afρ for an annulus and specific line-of-sight observation. The resulting equivalence between the observed intensity and Afρ is used to predict observable intensities for 67P/Churyumov-Gerasimenko at the spacecraft encounter near 3.3 AU and near perihelion at 1.3 AU. This is done by normalizing particle production rates of various size distributions to agree with observed ground based Afρ values. Various geometries for the column densities in a cometary coma are considered. The calculations for a simple outflow model are compared with more elaborate Direct Simulation Monte Carlo Calculation (DSMC) models to define the limits of applicability of the simpler analytical approach. Thus our analytical approach can be applied to the majority of the Rosetta coma observations, particularly beyond several nuclear radii where the dust is no longer in a collisional environment, without recourse to computer intensive DSMC calculations for specific cases. In addition to a spherically symmetric 1-dimensional approach we investigate column densities for the 2-dimensional DSMC model on the

A preliminary model of the coma of 2060 Chiron

NASA Technical Reports Server (NTRS)

Boice, Daniel C.; Konno, I.; Stern, S. Alan; Huebner, Walter F.

1992-01-01

We have included gravity in our fluid dynamic model with chemical kinetics of dusty comet comae and applied it with two dust sizes to 2060 Chiron. A progress report on the model and preliminary results concerning gas/dust dynamics and chemistry is given.

Human Brain Activity Patterns beyond the Isoelectric Line of Extreme Deep Coma

PubMed Central

Kroeger, Daniel; Florea, Bogdan; Amzica, Florin

2013-01-01

The electroencephalogram (EEG) reflects brain electrical activity. A flat (isoelectric) EEG, which is usually recorded during very deep coma, is considered to be a turning point between a living brain and a deceased brain. Therefore the isoelectric EEG constitutes, together with evidence of irreversible structural brain damage, one of the criteria for the assessment of brain death. In this study we use EEG recordings for humans on the one hand, and on the other hand double simultaneous intracellular recordings in the cortex and hippocampus, combined with EEG, in cats. They serve to demonstrate that a novel brain phenomenon is observable in both humans and animals during coma that is deeper than the one reflected by the isoelectric EEG, and that this state is characterized by brain activity generated within the hippocampal formation. This new state was induced either by medication applied to postanoxic coma (in human) or by application of high doses of anesthesia (isoflurane in animals) leading to an EEG activity of quasi-rhythmic sharp waves which henceforth we propose to call ν-complexes (Nu-complexes). Using simultaneous intracellular recordings in vivo in the cortex and hippocampus (especially in the CA3 region) we demonstrate that ν-complexes arise in the hippocampus and are subsequently transmitted to the cortex. The genesis of a hippocampal ν-complex depends upon another hippocampal activity, known as ripple activity, which is not overtly detectable at the cortical level. Based on our observations, we propose a scenario of how self-oscillations in hippocampal neurons can lead to a whole brain phenomenon during coma. PMID:24058669

Myxedema Coma with Reversible Cardiopulmonary Failure: a Rare Entity in 21St Century.

PubMed

Dhakal, Prajwal; Pant, Manisha; Acharya, Pranab Sharma; Dahal, Sumit; Bhatt, Vijaya Raj

2015-09-01

Myxedema coma, a rare entity in 21st century in developed nations, is a decompensated phase of hypothyroidism with high mortality rates. We describe a young woman with myxedema, who developed respiratory failure, congestive heart failure and significant pericardial effusion, some of the uncommon manifestations. Decreased cardiac contractility can result in cardiomyopathy and heart failure. As illustrated by this case, myxedema can also result in significant pericardial effusion due to increased vascular permeability. Myxedema can further be complicated by alveolar hypoventilation and respiratory failure secondary to the lack of central drive as well as respiratory muscle weakness. Prompt therapy with thyroid hormone replacement, glucocorticoid therapy, aggressive supportive care and management of the precipitating event can save lives and reverse the cardiopulmonary symptoms, as in our patient. Hence, physicians should have a high index of suspicion for myxedema coma in patients with unexplained cardiopulmonary failure. Our report is, therefore, aimed at bringing awareness about the rare but fatal manifestations of myxedema coma.

The kinetics and dynamics of the coma of Halley's comet

NASA Technical Reports Server (NTRS)

Combi, Michael R.

1994-01-01

This grant to the University of Michigan supported the efforts of Michael R. Combi to serve as a co-investigator in collaboration with a larger effort by the principal investigator, William Smyth of Atmospheric and Environmental Research, Inc. The overall objective of this project was to analyze in a self-consistent manner unique optical O((sup 1)D) and NH2 ultra-high resolution line profile data of excellent quality and other supporting lower-resolution spectral data for the coma of comet P/Halley by using highly developed and physically-based cometary coma models in order to determine and explain in terms of physical processes the actual dynamics and photochemical kinetics that occur in the coma. The justification for this work is that it provides a valuable and underlying physical base from which to interpret significantly different types of coma observations in a self-consistent manner and hence bring into agreement (or avoid) apparent inconsistencies that arise from non-physically based interpretations. The level of effort for the Michigan component amounted to less than three person-months over a planned period of three years. The period had been extended at no extra cost to four years because the Michigan grant and the AER contract did not have coincident time periods. An effort of somewhat larger scope was undertaken by the PI. The importance of the O((sup 1)D) profiles is that they provide a direct trace of the water distribution in comets. The line profile shape is produced by the convolution of the outflow velocity and thermal dispersion of the parent water molecules with the photokinetic ejection of the oxygen atoms upon photodissociation of the parent water molecules. Our understanding of the NH2 and its precursor ammonia are important for comet-to-comet composition variations as they relate to the cosmo-chemistry of the early solar nebula. Modeling of the distribution of NH2 is necessary in order to infer the ammonia production rates from NH2

Phase Synchronization in Electroencephalographic Recordings Prognosticates Outcome in Paediatric Coma

PubMed Central

Nenadovic, Vera; Perez Velazquez, Jose Luis; Hutchison, James Saunders

2014-01-01

Brain injury from trauma, cardiac arrest or stroke is the most important cause of death and acquired disability in the paediatric population. Due to the lifetime impact of brain injury, there is a need for methods to stratify patient risk and ultimately predict outcome. Early prognosis is fundamental to the implementation of interventions to improve recovery, but no clinical model as yet exists. Healthy physiology is associated with a relative high variability of physiologic signals in organ systems. This was first evaluated in heart rate variability research. Brain variability can be quantified through electroencephalographic (EEG) phase synchrony. We hypothesised that variability in brain signals from EEG recordings would correlate with patient outcome after brain injury. Lower variability in EEG phase synchronization, would be associated with poor patient prognosis. A retrospective study, spanning 10 years (2000–2010) analysed the scalp EEGs of children aged 1 month to 17 years in coma (Glasgow Coma Scale, GCS, <8) admitted to the paediatric critical care unit (PCCU) following brain injury from TBI, cardiac arrest or stroke. Phase synchrony of the EEGs was evaluated using the Hilbert transform and the variability of the phase synchrony calculated. Outcome was evaluated using the 6 point Paediatric Performance Category Score (PCPC) based on chart review at the time of hospital discharge. Outcome was dichotomized to good outcome (PCPC score 1 to 3) and poor outcome (PCPC score 4 to 6). Children who had a poor outcome following brain injury secondary to cardiac arrest, TBI or stroke, had a higher magnitude of synchrony (R index), a lower spatial complexity of the synchrony patterns and a lower temporal variability of the synchrony index values at 15 Hz when compared to those patients with a good outcome. PMID:24752289

Near-UV OH Prompt Emission in the Innermost Coma of 103P/Hartley 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

La Forgia, Fiorangela; Bodewits, Dennis; A’Hearn, Michael F.

The Deep Impact spacecraft flyby of comet 103P/Hartley 2 occurred on 2010 November 4, 1 week after perihelion with a closest approach (CA) distance of about 700 km. We used narrowband images obtained by the Medium Resolution Imager on board the spacecraft to study the gas and dust in the innermost coma. We derived an overall dust reddening of 15%/100 nm between 345 and 749 nm and identified a blue enhancement in the dust coma in the sunward direction within 5 km from the nucleus, which we interpret as a localized enrichment in water ice. OH column density maps show an anti-sunwardmore » enhancement throughout the encounter, except for the highest-resolution images, acquired at CA, where a radial jet becomes visible in the innermost coma, extending up to 12 km from the nucleus. The OH distribution in the inner coma is very different from that expected for a fragment species. Instead, it correlates well with the water vapor map derived by the HRI-IR instrument on board Deep Impact . Radial profiles of the OH column density and derived water production rates show an excess of OH emission during CA that cannot be explained with pure fluorescence. We attribute this excess to a prompt emission process where photodissociation of H{sub 2}O directly produces excited OH*( A {sup 2}Σ{sup +}) radicals. Our observations provide the first direct imaging of near-UV prompt emission of OH. We therefore suggest the use of a dedicated filter centered at 318.8 nm to directly trace the water in the coma of comets.« less

Balance of corneal horizontal coma by internal optics in eyes with intraocular artificial lenses: evidence of a passive mechanism.

PubMed

Marcos, Susana; Rosales, Patricia; Llorente, Lourdes; Barbero, Sergio; Jiménez-Alfaro, I

2008-01-01

It is well known that the aberrations of the cornea are partially compensated by the aberrations of the internal optics of the eye (primarily the crystalline lens) in young subjects. This effect has been found not only for the spherical aberration, but also for horizontal coma. It has been debated whether the compensation of horizontal coma is the result of passive mechanism [Artal, P., Benito, A., & Tabernero, J. (2006). The human eye is an example of robust optical design. Journal of Vision, 6 (1), 1-7] or through an active developmental feedback process [Kelly, J. E., Mihashi, T., & Howland, H. C. (2004). Compensation of corneal horizontal/vertical astigmatism, lateral coma, and spherical aberration by internal optics of the eye. Journal of Vision, 4 (4), 262-271]. In this study we investigate the active or passive nature of the horizontal coma compensation using eyes with artificial lenses, where no active developmental process can be present. We measured total and corneal aberrations, and lens tilt and decentration in a group of 38 eyes implanted with two types of intraocular lenses designed to compensate the corneal spherical aberration of the average population. We found that spherical aberration was compensated by 66%, and horizontal coma by 87% on average. The spherical aberration is not compensated at an individual level, but horizontal coma is compensated individually (coefficients of correlation corneal/internal aberration: -0.946, p<0.0001). The fact that corneal (but not total) horizontal coma is highly correlated with angle lamda (computed from the shift of the 1st Purkinje image from the pupil center, for foveal fixation) indicates that the compensation arises primarily from the geometrical configuration of the eye (which generates horizontal coma of opposite signs in the cornea and internal optics). The amount and direction of tilts and misalignments of the lens are comparable to those found in young eyes, and on average tend to compensate (rather

Sudden cardiac arrest as a rare presentation of myxedema coma: case report.

PubMed

Salhan, Divya; Sapkota, Deepak; Verma, Prakash; Kandel, Saroj; Abdulfattah, Omar; Lixon, Antony; Zwenge, Deribe; Schmidt, Frances

2017-01-01

Myxedema coma is a decompensated hypothyroidism which occurs due to long-standing, undiagnosed, or untreated hypothyroidism. Untreated hypothyroidism is known to affect almost all organs including the heart. It is associated with a decrease in cardiac output, stroke volume due to decreased myocardial contractility, and an increase in systemic vascular resistance. It can cause cardiac arrhythmias and the most commonly seen conduction abnormalities are sinus bradycardia, heart block, ventricular tachycardia, and torsade de pointes. The authors report a case of an elderly man who presented with sudden cardiac arrest and myxedema coma and who was successfully revived.

Emergency department outpatient treatment of alcohol-intoxicated bicyclists increases the cost of medical care in Japan

PubMed Central

Yamauchi, Sunao; Mizobe, Michiko; Nakashima, Yoshiyuki; Takahashi, Jin; Funakoshi, Hiraku; Urayama, Kevin Y.; Ohde, Sachiko; Takahashi, Osamu; Shiga, Takashi

2017-01-01

Riding a bicycle under the influence of alcohol is illegal in Japan. Nevertheless, intoxicated bicyclists are frequently treated at hospital emergency departments for bicycle-related injuries. This patient population usually requires more hospital resources, even for relatively minor injuries. Therefore, we hypothesized that bicycle-related crashes involving bicyclists under the influence of alcohol cost more to treat than those that do not involve alcohol intoxication. The aim of the present study was to examine the costs associated with bicycle-related minor injuries and alcohol intoxication of the bicyclist. The study was conducted at the Tokyo Bay Urayasu Ichikawa Medical Center Emergency Department, Japan. All minor bicycle crashes involving 217 individuals aged ≥20 years treated from September 1, 2012 to August 31, 2013 were included in the analysis of data obtained from medical records. Variables included alcohol intoxication, sex, age, collision with a motor vehicle, Glasgow Coma Scale, injury severity score (ISS), laboratory tests, treatment of wounds, number of X-ray images, number of computed tomography scans, and medical costs. Multiple linear regression analysis was performed to evaluate the association between alcohol intoxication and medical costs. Seventy (32%) patients consumed alcohol, and the median medical cost was 253 USD (interquartile range [IQR], 164–330). Multivariable analysis showed that alcohol intoxication was independently associated with higher medical costs (p = 0.030, adjusted R-square value = 0.55). These findings support our hypothesis and should encourage authorities to implement comprehensive measures to prohibit bicycling under the influence of alcohol to prevent injuries and to reduce medical costs. PMID:28329002

Jet Morphology and Coma Analysis of 103P/Hartley 2

NASA Astrophysics Data System (ADS)

Vaughan, Charles; Pierce, D.; Dorman, G.; Cochran, A.

2012-10-01

We have observed comet 103P/Hartley 2 using the George and Cynthia Mitchell Spectrograph (formerly VIRUS-P) on the 2.7 m telescope at McDonald Observatory (Hill et al. 2008). Data for CN, C2, C3, and NH2 were collected over six nights from 2010 July 15 to November 10. The data were processed to form images of the coma for each of the observed species. We have performed azimuthal average division on each of the coma images to examine jet morphology and have investigated the nature of the production of the radical species using our modified vectorial model (Ihalawela et al. 2011). This work enhances the ongoing investigation of the chemistry and outgassing behavior of Hartley 2 as studied by the EPOXI flyby mission.

Post-coma persons with multiple disabilities use assistive technology for their leisure engagement and communication.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Oliva, Doretta; Buonocunto, Francesca; Sacco, Valentina; D'Amico, Fiora; Navarro, Jorge; Lanzilotti, Crocifissa; De Tommaso, Marina; Megna, Marisa

2014-01-01

Interventions for post-coma persons, who have emerged from a minimally conscious state but present with extensive neuro-motor impairment and lack of or minimal verbal skills, need to promote occupation and communication through the use of assistive technology. These two studies were aimed at assessing two technology-aided programs to promote leisure engagement and communication for three post-coma participants with multiple disabilities. Study I assessed a program to allow a woman and a man with extensive neuro-motor impairment and lack of speech to switch on music and videos, make requests to caregivers, and send messages to (communicate with) relevant partners and receive messages from those partners. Study II assessed a program to allow a post-coma woman with extensive motor impairment and reduced verbal behavior to activate music, videos and requests, send and receive messages, and make telephone calls. Data showed that both programs were successful. The participants of Study I managed leisure engagement, requests, as well as text messaging. The participant of Study II showed consistent leisure engagement, text messaging, and telephone calls. Assistive technology can be profitably used to provide post-coma persons with multiple disabilities relevant leisure and communication opportunities.

Two-dimensional molecular line transfer for a cometary coma

NASA Astrophysics Data System (ADS)

Szutowicz, S.

2017-09-01

In the proposed axisymmetric model of the cometary coma the gas density profile is described by an angular density function. Three methods for treating two-dimensional radiative transfer are compared: the Large Velocity Gradient (LVG) (the Sobolev method), Accelerated Lambda Iteration (ALI) and accelerated Monte Carlo (MC).

Routine intracranial pressure monitoring in acute coma.

PubMed

Forsyth, Rob J; Raper, Joseph; Todhunter, Emma

2015-11-02

; range 22 to 44), and all had severe traumatic brain injury, mostly due to traffic incidents. All were receiving care within intensive care units (ICUs) at one of six hospitals in either Bolivia or Ecuador. Investigators followed up 92% of participants for six months or until death. The trial excluded patients with a Glasgow Coma Score (GCS) less than three and fixed dilated pupils on admission on the basis that they had sustained brain injury of an unsalvageable severity.The study compared people managed using either an intracranial monitor or non-invasive monitoring (imaging and clinical examination) to identify potentially harmful raised intracranial pressure. Both study groups used imaging and clinical examination measures.Mortality at six months was 56/144 (39%) in the ICP-monitored group and 67/153 (44%) in the non-invasive group.Unfavourable outcome (defined as death or moderate to severe disability at six months) as assessed by the extended Glasgow Outcome Scale (GOS-E) was 80/144 (56%) in the ICP-monitored group and 93/153 (61%) in the non-invasive group.Six percent of participants in the ICP monitoring group had complications related to the monitoring, none of which met criteria for being a serious adverse event. There were no complications relating to the non-invasive group.Other complications and adverse events were comparable between treatment groups, 70/157 (45%) in the ICP-monitored group and 76/167 (46%) in the non-invasive group.Late mortality in both the monitored and non-invasive groups was high, with 35% of deaths occurring > 14 days after injury. The authors comment that this high late mortality may reflect inadequacies in post-ICU services for disabled survivors requiring specialist rehabilitation care. The data from the single RCT studying the role of routine ICP monitoring in acute traumatic coma fails to provide evidence to support the intervention.Research in this area is complicated by the fact that RCTs necessarily assess the combined impact

Myxoedema coma in the setting of hyperglycaemic hyperosmolar state.

PubMed

Spyridoulias, Alexander; Riaz, Muhammad Shakeel

2016-01-11

Decompensated hypothyroidism is a rare endocrine emergency but a differential that should be considered in patients presenting critically unwell with systemic illness. We report a case of myxoedema coma in a woman presenting with respiratory failure, hypotension, hypothermia and a reduced level of consciousness, all of which are poor prognostic features in decompensated hypothyroidism. The patient was admitted to critical care for mechanical ventilation and cardiovascular support and treated with a combination of insulin, liothyronine and levothyroxine, making a good recovery. We wanted to highlight this case of myxoedema coma occurring in the context of a hyperglycaemic hyperosmolar state (HHS), as the former condition is normally associated with hypoglycaemia, hyponatraemia and hypo-osmolality. Decompensated hypothyroidism should be considered in presentations of HHS as well as with other metabolic derangements, as delays in thyroid hormone replacement are associated with poorer outcomes. It has multisystem effects challenging its recognition and we discuss potential complications and their management. 2016 BMJ Publishing Group Ltd.

Myxoedema coma in the setting of hyperglycaemic hyperosmolar state

PubMed Central

Spyridoulias, Alexander; Riaz, Muhammad Shakeel

2016-01-01

Decompensated hypothyroidism is a rare endocrine emergency but a differential that should be considered in patients presenting critically unwell with systemic illness. We report a case of myxoedema coma in a woman presenting with respiratory failure, hypotension, hypothermia and a reduced level of consciousness, all of which are poor prognostic features in decompensated hypothyroidism. The patient was admitted to critical care for mechanical ventilation and cardiovascular support and treated with a combination of insulin, liothyronine and levothyroxine, making a good recovery. We wanted to highlight this case of myxoedema coma occurring in the context of a hyperglycaemic hyperosmolar state (HHS), as the former condition is normally associated with hypoglycaemia, hyponatraemia and hypo-osmolality. Decompensated hypothyroidism should be considered in presentations of HHS as well as with other metabolic derangements, as delays in thyroid hormone replacement are associated with poorer outcomes. It has multisystem effects challenging its recognition and we discuss potential complications and their management. PMID:26759401

Analysis of hydrogen H-alpha observations of the coma of Comet P/Halley

NASA Technical Reports Server (NTRS)

Smyth, William H.; Marconi, M. L.; Scherb, Frank; Roesler, Fred L.

1993-01-01

The Monte Carlo Particle Trajectory Model of Combi and Smyth (1988) is used here to analyze observations of the H-alpha coma of Comet Halley. The solar excitation mechanism for the H-alpha emissions line is described. The H2O production rates derived for the H-alpha brightness measurements are shown to be very consistent with the H2O production rates determined from other Comet Halley observations of the H, O, and OH comae. Revised H2O production rates determined from 6300 A brightness measurements are presented.

Challenges in the Management of a Patient with Myxoedema Coma in Ghana: A Case Report.

PubMed

Akpalu, Josephine; Atiase, Yacoba; Yorke, Ernest; Fiscian, Henrietta; Kootin-Sanwu, Cecilia; Akpalu, Albert

2017-03-01

Myxoedema coma is a rare life-threatening disease, and it is essential that it is managed appropriately to reduce the associated high mortality. However, in the setting where efficient healthcare delivery is hampered by inadequacies, the management of such cases may pose a significant challenge. We present the case of a middle-aged woman diagnosed with myxoedema coma and severe hyponatremia. The case report highlights some of the challenges that may be encountered during the management of myxoedema coma in similar settings and outlines the management strategies undertaken to overcome them in the absence of national guidelines. It also brings to the fore the need for clinicians to look out for clinical features suggestive of hypothyroidism particularly among high risk individuals for early diagnosis and treatment. None declared.

FORTY-SEVEN MILKY WAY-SIZED, EXTREMELY DIFFUSE GALAXIES IN THE COMA CLUSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Van Dokkum, Pieter G.; Merritt, Allison; Geha, Marla

2015-01-10

We report the discovery of 47 low surface brightness objects in deep images of a 3° × 3° field centered on the Coma cluster, obtained with the Dragonfly Telephoto Array. The objects have central surface brightness μ(g, 0) ranging from 24-26 mag arcsec{sup –2} and effective radii r {sub eff} = 3''-10'', as measured from archival Canada-France-Hawaii Telescope images. From their spatial distribution we infer that most or all of the objects are galaxies in the Coma cluster. This relatively large distance is surprising as it implies that the galaxies are very large: with r {sub eff} = 1.5-4.6 kpcmore » their sizes are similar to those of L {sub *} galaxies even though their median stellar mass is only ∼6 × 10{sup 7} M {sub ☉}. The galaxies are relatively red and round, with (g – i) = 0.8 and (b/a) = 0.74. One of the 47 galaxies is fortuitously covered by a deep Hubble Space Telescope Advanced Camera for Surveys (ACS) observation. The ACS imaging shows a large spheroidal object with a central surface brightness μ{sub 475} = 25.8 mag arcsec{sup –2}, a Sérsic index n = 0.6, and an effective radius of 7'', corresponding to 3.4 kpc at the distance of Coma. The galaxy is not resolved into stars, consistent with expectations for a Coma cluster object. We speculate that these ''ultra-diffuse galaxies'' may have lost their gas supply at early times, possibly resulting in very high dark matter fractions.« less

Evidence for methane and ammonia in the coma of comet P/Halley

NASA Technical Reports Server (NTRS)

Allen, M.; Delitsky, M.; Huntress, W.; Yung, Y.; Ip, W.-H.

1987-01-01

Methane and ammonia abundances in the coma of Halley are derived from Giotto ion mass spectrometer data using an Eulerian model of chemical and physical processes inside the contact surface to simulate Giotto high-intensity spectrometer ion mass spectral data for mass-to-charge ratios (m/q) from 15 to 19. The ratio m/q = 19/18 as a function of distance from the nucleus is not reproduced by a model for a pure water coma. It is necessary to include the presence of NH3, and uniquely NH3, in coma gases in order to explain the data. A ratio of production rates Q(NH3)/Q(H2O) = 0.01 = 0.02 results in model values approximating the Giotto data. Methane is identified as the most probable source of the distinct peak at m/q = 15. The observations are fit best with Q(CH4)/Q(Q2O) = 0.02. The chemical composition of the comet nucleus implied by these production rate ratios is unlike that of the outer planets. On the other hand, there are also significant differences from observations of gas phase interstellar material.

S-net project: Construction of large scale seafloor observatory network for tsunamis and earthquakes in Japan

NASA Astrophysics Data System (ADS)

Mochizuki, M.; Kanazawa, T.; Uehira, K.; Shimbo, T.; Shiomi, K.; Kunugi, T.; Aoi, S.; Matsumoto, T.; Sekiguchi, S.; Yamamoto, N.; Takahashi, N.; Shinohara, M.; Yamada, T.

2016-12-01

National Research Institute for Earth Science and Disaster Resilience ( NIED ) has launched the project of constructing an observatory network for tsunamis and earthquakes on the seafloor. The observatory network was named "S-net, Seafloor Observation Network for Earthquakes and Tsunamis along the Japan Trench". The S-net consists of 150 seafloor observatories which are connected in line with submarine optical cables. The total length of submarine optical cable is about 5,700 km. The S-net system extends along Kuril and Japan trenches around Japan islands from north to south covering the area between southeast off island of Hokkaido and off the Boso Peninsula, Chiba Prefecture. The project has been financially supported by MEXT Japan. An observatory package is 34cm in diameter and 226cm long. Each observatory equips two units of a high sensitive water-depth sensor as a tsunami meter and four sets of three-component seismometers. The water-depth sensor has measurement resolution of sub-centimeter level. Combination of multiple seismometers secures wide dynamic range and robustness of the observation that are needed for early earthquake warning. The S-net is composed of six segment networks that consists of about 25 observatories and 800-1,600km length submarine optical cable. Five of six segment networks except the one covering the outer rise area of the Japan Trench has been already installed. The data from the observatories on those five segment networks are being transferred to the data center at NIED on a real-time basis, and then verification of data integrity are being carried out at the present moment. Installation of the last segment network of the S-net, that is, the outer rise one is scheduled to be finished within FY2016. Full-scale operation of the S-net will start at FY2017. We will report construction and operation of the S-net submarine cable system as well as the outline of the obtained data in this presentation.

A Massive Warm Baryonic Halo in the Coma Cluster

NASA Technical Reports Server (NTRS)

Bonamente, Massimiliano; Joy, Marshall K.; Lieu, Richard

2003-01-01

Several deep PSPC observations of the Coma Cluster reveal a very large scale halo of soft X-ray emission, substantially in excess of the well-known radiation from the hot intracluster medium. The excess emission, previously reported in the central region of the cluster using lower sensitivity Extreme Ultraviolet Explorer (EUVE) and ROSAT data, is now evident out to a radius of 2.6 Mpc, demonstrating that the soft excess radiation from clusters is a phenomenon of cosmological significance. The X-ray spectrum at these large radii cannot be modeled nonthermally but is consistent with the original scenario of thermal emission from warm gas at approx. 10(exp 6) K. The mass of the warm gas is on par with that of the hot X-ray-emitting plasma and significantly more massive if the warm gas resides in low-density filamentary structures. Thus, the data lend vital support to current theories of cosmic evolution, which predict that at low redshift approx. 30%-40% of the baryons reside in warm filaments converging at clusters of galaxies.

Formation of C3 and C2 in Cometary Comae

NASA Astrophysics Data System (ADS)

Hölscher, Alexander

2015-03-01

Comets are remnants from the Solar System formation. They reside at large distances from the Sun and are believed to store deep freeze imprints of the chemical and physical conditions at the time the Solar System formed. The main ice component of a comet is H2O followed by CO and CO2 with additional small amounts of molecules with varying complexity. Comets also contain large amounts of dust. If a comet approaches the Sun the ices begin to sublimate giving rise to the cometary coma. The molecules producing the coma can be observed in the infrared, the radio wavelength range and at optical wavelengths. To constrain the formation of the Solar System, models require knowledge of the composition for a statistically significant number of comets. This favors optical observations of e.g. C3 (tricarbon) and C2 (dicarbon) since these species allow observations even of relatively faint comets and do not require space missions (infrared observations). However, one has to link these observed photodissociation product species (daughter species) to the molecules that originally sublimated from the comet nucleus surface, i.e. the so-called parent molecules, as e.g. C2H2 (acetylene) for C2. However, for C3 no parent molecules have been identified so far. This thesis investigates the formation of C3 and C2 radicals in cometary comae due to photodissociation of observed and in the literature proposed hydrocarbon parent molecules. For this purpose a one-dimensional multi-fluid coma chemistry model has been improved and applied. This work added new photo reactions to the model, updated the hydrocarbon photo rate coefficients and quantified their uncertainty. A sensitivity analysis has been carried out to determine the reactions whose uncertainty most affect the model output uncertainty. Special attention should be paid to these so-called key reactions in future laboratory experiments and quantum chemical computations to reduce the model output uncertainty more effectively. This will

A Case of Myxedema Coma Presenting as a Brain Stem Infarct in a 74-Year-Old Korean Woman

PubMed Central

Ahn, Ji Yun; Kwon, Hyuk-Sool; Ahn, Hee Chol

2010-01-01

Myxedema coma is the extreme form of untreated hypothyroidism. In reality, few patients present comatose with severe myxedema. We describe a patient with myxedema coma which was initially misdiagnosed as a brain stem infarct. She presented to the hospital with alteration of the mental status, generalized edema, hypothermia, hypoventilation, and hypotension. Initially her brain stem reflexes were absent. After respiratory and circulatory support, her neurologic status was not improved soon. The diagnosis of myxedema coma was often missed or delayed due to various clinical findings and concomitant medical condition and precipitating factors. It is more difficult to diagnose when a patient has no medical history of hypothyroidism. A high index of clinical suspicion can make a timely diagnosis and initiate appropriate treatment. We report this case to alert clinicians considering diagnosis of myxedema coma in patients with severe decompensated metabolic state including mental change. PMID:20808690

A case of myxedema coma presenting as a brain stem infarct in a 74-year-old Korean woman.

PubMed

Ahn, Ji Yun; Kwon, Hyuk-Sool; Ahn, Hee Chol; Sohn, You Dong

2010-09-01

Myxedema coma is the extreme form of untreated hypothyroidism. In reality, few patients present comatose with severe myxedema. We describe a patient with myxedema coma which was initially misdiagnosed as a brain stem infarct. She presented to the hospital with alteration of the mental status, generalized edema, hypothermia, hypoventilation, and hypotension. Initially her brain stem reflexes were absent. After respiratory and circulatory support, her neurologic status was not improved soon. The diagnosis of myxedema coma was often missed or delayed due to various clinical findings and concomitant medical condition and precipitating factors. It is more difficult to diagnose when a patient has no medical history of hypothyroidism. A high index of clinical suspicion can make a timely diagnosis and initiate appropriate treatment. We report this case to alert clinicians considering diagnosis of myxedema coma in patients with severe decompensated metabolic state including mental change.

Coma Morphology Due to an Extended Active Region and Implications for the Spin State of Comet Hale-Bopp

NASA Technical Reports Server (NTRS)

Samarasinha, Nalin H.

2000-01-01

We show that the circular character of continuum structures observed in the coma of comet Hale-Bopp around the perihelion passage is most likely due to a dust jet from a large extended active region on the surface. Coma morphology due to a wide jet is different from that due to a narrow jet. The latter shows foreshortening effects due to observing geometry, wider jet produces more circular features. This circularization effect provides a self-consistent explanation for the evolution of near-perihelion coma morphology. No changes in the direction of the rotational angular momentum vector are required during this period in contrast to the models of Schleicher et al. This circularization effect also enables us to produce near-circular coma features in the S-E quadrant during 1997 late February and therefore questions the basic premise on which Sekanina bases his morphological arguments for a gravitationally bound satellite nucleus.

Abnormal intra-aural pressure waves associated with death in African children with acute nontraumatic coma.

PubMed

Gwer, Samson; Kazungu, Michael; Chengo, Eddie; Ohuma, Eric O; Idro, Richard; Birch, Tony; Marchbanks, Robert; Kirkham, Fenella J; Newton, Charles R

2015-07-01

We explored the relationship between tympanic membrane displacement (TMD) measurements, a tool to monitor intracranial pressure noninvasively, and clinical features and death in children with acute coma in Kilifi, Kenya. Between November 2007 and September 2009, we made serial TMD measurements and clinical observations on children with acute coma (Blantyre coma score (BCS) ≤ 2) on the pediatric high dependency unit of Kilifi District Hospital, and on well children presenting to the hospital's outpatient department for routine follow-up. We examined middle ear function using tympanometry and measured cardiac pulse (CPA) and respiratory pulse pressure amplitudes (RPA) using the TMD analyzer. We recruited 75 children (32 (43%) females; median age 3.3 (IQR: 2.0, 4.3) years). Twenty-one (28%) children died. Higher TMD measurements predicted death. Adjusting for diagnosis, every 50 nl rise in both semirecumbent and recumbent CPA was associated with increased odds of death associated with intracranial herniation (OR: 1.61, 95% confidence interval (CI): 1.07, 2.41; P = 0.02 and OR: 1.35, 95% CI: 1.10, 1.66; P ≤ 0.01 respectively). Raised TMD pulse pressure measurements are associated with death and may be useful in detecting and monitoring risk of intracranial herniation and intracranial pressure in childhood coma.

Polyuria, acidosis, and coma following massive ibuprofen ingestion.

PubMed

Levine, Michael; Khurana, Amandeep; Ruha, Anne-Michelle

2010-09-01

Ibuprofen was the first over-the-counter nonsteroidal anti-inflammatory drug available in the United States. Despite being a common agent of ingestion, significant toxicity in overdose is rare. We report a case of a massive ibuprofen ingestion who developed polyuria, acidosis, and coma but survived, despite having a serum ibuprofen concentration greater than previous fatal cases. A 19-year-old man ingested 90 g (1,200 mg/kg) ibuprofen. He was initially awake and alert, but his level of consciousness deteriorated over several hours. Seven hours following the ingestion, he was intubated and mechanically ventilated secondary to loss of airway reflexes. He developed a lactic acidosis and polyuria, which lasted for nearly 24 h. His serum creatinine peaked at 1.12 mg/dL. An ibuprofen level drawn 7 h postingestion was 739.2 mg/L (therapeutic 5-49 mg/L). We describe a case of a massive ibuprofen overdose characterized by metabolic acidosis, coma, and a state of high urine output who survived with aggressive supportive care. This case is unique in several ways. First, ibuprofen levels this high have only rarely been described. Second, polyuria is very poorly described following ibuprofen ingestions.

Prognostic and diagnostic value of EEG signal coupling measures in coma.

PubMed

Zubler, Frederic; Koenig, Christa; Steimer, Andreas; Jakob, Stephan M; Schindler, Kaspar A; Gast, Heidemarie

2016-08-01

Our aim was to assess the diagnostic and predictive value of several quantitative EEG (qEEG) analysis methods in comatose patients. In 79 patients, coupling between EEG signals on the left-right (inter-hemispheric) axis and on the anterior-posterior (intra-hemispheric) axis was measured with four synchronization measures: relative delta power asymmetry, cross-correlation, symbolic mutual information and transfer entropy directionality. Results were compared with etiology of coma and clinical outcome. Using cross-validation, the predictive value of measure combinations was assessed with a Bayes classifier with mixture of Gaussians. Five of eight measures showed a statistically significant difference between patients grouped according to outcome; one measure revealed differences in patients grouped according to the etiology. Interestingly, a high level of synchrony between the left and right hemisphere was associated with mortality on intensive care unit, whereas higher synchrony between anterior and posterior brain regions was associated with survival. The combination with the best predictive value reached an area-under the curve of 0.875 (for patients with post anoxic encephalopathy: 0.946). EEG synchronization measures can contribute to clinical assessment, and provide new approaches for understanding the pathophysiology of coma. Prognostication in coma remains a challenging task. qEEG could improve current multi-modal approaches. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Production, Outflow Velocity, and Radial Distribution of H2O and OH in the Coma of Comet C/1995 O1 [Hale-Bopp] from Wide Field Imaging of OH

NASA Technical Reports Server (NTRS)

Harris, Walter M.; Scherb, Frank; Mierkiewicz, Edwin; Oliverson, Ronald; Morgenthaler, Jeffrey

2003-01-01

Observations of OH are a useful proxy of the water production rate (Q(sub H2O)) and outflow velocity (V(sub out)) in comets. From wide field images taken on 03/28/1997 and 04/08/1997 that capture the entire scale length of the OH coma of comet C/1995 O1 (Hale-Bopp), we obtain Q(sub H2O) from the model-independent method of aperture summation. With an adaptive ring summation algorithm, we extract the radial brightness distribution of OH 0-0 band emission out to cometocentric distances of up to 10(exp 6) km, both as azimuthal averages and in quadrants covering different position angles relative to the comet-Sun line. These profiles are fit using both fixed and variable velocity 2-component spherical expansion models to estimate V(sub OH) with increasing distance from the nucleus. The OH coma of Hale-Bopp was more spatially extended than previous comets, and this extension is best matched by a variable acceleration of H2O and OH that acted across the entire coma, but was strongest within 1-2 x 10(exp 4) km from the nucleus. Our models indicate that V(sub OH) at the edge of our detectable field of view (10(exp 6) km) was approx. 2-3 times greater in Hale-Bopp than for a 1P/Halley-class comet at 1 AU, which is consistent with the results of more sophisticated gas-kinetic models, extrapolation from previous observations of OH in comets with Q(sub H2O) greater than 10(exp 29)/s , and direct radio measurements of the outer coma Hale-Bopp OH velocity. The most probable source of this acceleration is thermalization of the excess energy of dissociation of H2O and OH over an extended collisional coma. When the coma is broken down by quadrants in position angle, we find an azimuthal asymmetry in the radial distribution that is characterized by an increase in the spatial extent of OH in the region between the orbit-trailing and anti-sunward directions. Model fits specific to this area and comparison with radio OH measurements suggest greater acceleration here, with V(sub OH

Coma in fatal adult human malaria is not caused by cerebral oedema

PubMed Central

2011-01-01

Background The role of brain oedema in the pathophysiology of cerebral malaria is controversial. Coma associated with severe Plasmodium falciparum malaria is multifactorial, but associated with histological evidence of parasitized erythrocyte sequestration and resultant microvascular congestion in cerebral vessels. To determine whether these changes cause breakdown of the blood-brain barrier and resultant perivascular or parenchymal cerebral oedema, histology, immunohistochemistry and image analysis were used to define the prevalence of histological patterns of oedema and the expression of specific molecular pathways involved in water balance in the brain in adults with fatal falciparum malaria. Methods The brains of 20 adult Vietnamese patients who died of severe malaria were examined for evidence of disrupted vascular integrity. Immunohistochemistry and image analysis was performed on brainstem sections for activation of the vascular endothelial growth factor (VEGF) receptor 2 and expression of the aquaporin 4 (AQP4) water channel protein. Fibrinogen immunostaining was assessed as evidence of blood-brain barrier leakage and perivascular oedema formation. Correlations were performed with clinical, biochemical and neuropathological parameters of severe malaria infection. Results The presence of oedema, plasma protein leakage and evidence of VEGF signalling were heterogeneous in fatal falciparum malaria and did not correlate with pre-mortem coma. Differences in vascular integrity were observed between brain regions with the greatest prevalence of disruption in the brainstem, compared to the cortex or midbrain. There was a statistically non-significant trend towards higher AQP4 staining in the brainstem of cases that presented with coma (P = .02). Conclusions Histological evidence of cerebral oedema or immunohistochemical evidence of localised loss of vascular integrity did not correlate with the occurrence of pre-mortem coma in adults with fatal falciparum malaria

Coma in fatal adult human malaria is not caused by cerebral oedema.

PubMed

Medana, Isabelle M; Day, Nicholas P J; Sachanonta, Navakanit; Mai, Nguyen T H; Dondorp, Arjen M; Pongponratn, Emsri; Hien, Tran T; White, Nicholas J; Turner, Gareth D H

2011-09-17

The role of brain oedema in the pathophysiology of cerebral malaria is controversial. Coma associated with severe Plasmodium falciparum malaria is multifactorial, but associated with histological evidence of parasitized erythrocyte sequestration and resultant microvascular congestion in cerebral vessels. To determine whether these changes cause breakdown of the blood-brain barrier and resultant perivascular or parenchymal cerebral oedema, histology, immunohistochemistry and image analysis were used to define the prevalence of histological patterns of oedema and the expression of specific molecular pathways involved in water balance in the brain in adults with fatal falciparum malaria. The brains of 20 adult Vietnamese patients who died of severe malaria were examined for evidence of disrupted vascular integrity. Immunohistochemistry and image analysis was performed on brainstem sections for activation of the vascular endothelial growth factor (VEGF) receptor 2 and expression of the aquaporin 4 (AQP4) water channel protein. Fibrinogen immunostaining was assessed as evidence of blood-brain barrier leakage and perivascular oedema formation. Correlations were performed with clinical, biochemical and neuropathological parameters of severe malaria infection. The presence of oedema, plasma protein leakage and evidence of VEGF signalling were heterogeneous in fatal falciparum malaria and did not correlate with pre-mortem coma. Differences in vascular integrity were observed between brain regions with the greatest prevalence of disruption in the brainstem, compared to the cortex or midbrain. There was a statistically non-significant trend towards higher AQP4 staining in the brainstem of cases that presented with coma (P = .02). Histological evidence of cerebral oedema or immunohistochemical evidence of localised loss of vascular integrity did not correlate with the occurrence of pre-mortem coma in adults with fatal falciparum malaria. Enhanced expression of AQP4 water

VizieR Online Data Catalog: Coma clusters and filaments galaxies FIR survey (Fuller+, 2016)

NASA Astrophysics Data System (ADS)

Fuller, C.; Davies, J. I.; Smith, M. W. L.; Valiante, E.; Eales, S.; Bourne, N.; Dunne, L.; Dye, S.; Furlanetto, C.; Ibar, E.; Ivison, R.; Maddox, S.; Sansom, A.; Michalowski, M. J.; Davis, T.

2017-05-01

We have undertaken a Herschel FIR survey of the Coma cluster and the galaxy filament it resides within. Our survey covers an area of ~150 deg2 observed in five bands at 100, 160, 250, 350 and 500um. We have used the SDSS spectroscopic survey to define an area and redshift selected sample of 744 Coma cluster galaxies - the CCC. For comparison, we also define in a similar way a sample of 951 galaxies in the connecting filament - the CFC. (2 data files).

The Radio Luminosity Function and Galaxy Evolution in the Coma Cluster

NASA Technical Reports Server (NTRS)

Miller, Neal A.; Hornschemeier, Ann E.; Mabasher, Bahram; Brudgesm Terrry J.; Hudson, Michael J.; Marzke, Ronald O.; Smith, Russell J.

2008-01-01

We investigate the radio luminosity function and radio source population for two fields within the Coma cluster of galaxies, with the fields centered on the cluster core and southwest infall region and each covering about half a square degree. Using VLA data with a typical rms sensitivity of 28 (mu)Jy per 4.4" beam, we identify 249 radio sources with optical counterparts brighter than r = 22 (equivalent to M(sub r) = -13 for cluster member galaxies). Comprehensive optical spectroscopy identifies 38 of these as members of the Coma cluster, evenly split between sources powered by an active nucleus and sources powered by active star formation. The radio-detected star-forming galaxies are restricted to radio luminosities between about 10(exp 21) and 10(exp 22) W/Hz, an interesting result given that star formation dominates field radio luminosity functions below about 10(exp 23) W/Hz. The majority of the radio-detected star-forming galaxies have characteristics of starbursts, including high specific star formation rates and optical spectra with strong emission lines. In conjunction with prior studies on post-starburst galaxies within the Coma cluster, this is consistent with a picture in which late-type galaxies entering Coma undergo a starburst prior to a rapid cessation of star formation. Optically bright elliptical galaxies (Mr less than or equals -20.5) make the largest contribution to the radio luminosity function at both the high (> approx. 3x10(exp 22) W/Hz) and low (< approx. 10(exp 21) W/Hz) ends. Through a stacking analysis of these optically-bright ellipticals we find that they continue to harbor radio sources down to luminosities as faint as 3x10(exp 19) W/Hz. However, contrary to published results for the Virgo cluster we find no evidence for the existence of a population of optically faint (M(sub r) approx. equals -14) dwarf ellipticals hosting strong radio AGN.

Intranasal post-cardiac arrest treatment with orexin-A facilitates arousal from coma and ameliorates neuroinflammation.

PubMed

Modi, Hiren R; Wang, Qihong; Gd, Sahithi; Sherman, David; Greenwald, Elliot; Savonenko, Alena V; Geocadin, Romergryko G; Thakor, Nitish V

2017-01-01

deficit scale score (NDS). Our results indicate that intranasal delivery of ORXA post-CA has an anti-inflammatory effect and accelerates cortical EEG and behavioral recovery. Beneficial outcomes from intranasal ORXA treatment lay the groundwork for therapeutic clinical approach to treating post-CA coma.

External Validation of the PECARN Head Trauma Prediction Rules in Japan.

PubMed

Ide, Kentaro; Uematsu, Satoko; Tetsuhara, Kenichi; Yoshimura, Satoshi; Kato, Takahiro; Kobayashi, Tohru

2017-03-01

The Pediatric Emergency Care Applied Research Network (PECARN) head trauma prediction rules are used to assist computed tomography (CT) decision-making for children with minor head trauma. Although the PECARN rules have been validated in North America and Europe, they have not yet been validated in Asia. In Japan, there are no clinical decision rules for children with minor head trauma. The rate of head CT for children with minor head trauma in Japan is high since CT is widely accessible across the country. The objective of this study was to evaluate the diagnostic accuracy of the PECARN rules for identifying clinically important traumatic brain injuries (ciTBI) in children with minor head trauma in Japan. We conducted a retrospective cohort study at a tertiary care pediatric hospital in Japan (30,000 patients/year). We enrolled all children younger than 18 years with minor head trauma (Glasgow Coma Scale ≥ 14) who presented to the emergency department within 24 hours of their injury between January and December 2013. We retrospectively classified the children into three risk categories according to the PECARN rules. The PECARN rules were considered negative when children were classified into the very-low-risk category. The primary outcome was considered positive when a child had ciTBI defined as head injury resulting in death, neurosurgery, intubation for > 24 hours, or hospital admission ≥ 2 nights with evidence of TBI on CT. Among 2,208 children included in the study, 24 (1.1%) had ciTBI. Sensitivities and specificities of the PECARN rules to predict ciTBI were 85.7% (12/14; 95% confidence interval [CI] = 57.2 to 98.2) and 73.5% (572/778; 95% CI = 70.3 to 76.6), respectively, for children < 2 years old, and 100% (10/10; 95% CI = 58.7 to 100) and 73.5% (1033/1406; 95% CI = 71.0 to 75.7) for children ≥ 2 years old, respectively. There were 10 cases of physically abused children < 2 years old, and six (60%) of them had ciTBI. Also, two cases of

SUZAKU OBSERVATIONS OF SUBHALOS IN THE COMA CLUSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sasaki, Toru; Matsushita, Kyoko; Sato, Kosuke

2015-06-10

We observed three massive subhalos in the Coma cluster with Suzaku. These subhalos, labeled “ID 1,” “ID 2,” and “ID 32,” were detected with a weak-lensing survey using Subaru/Suprime-Cam, and are located at the projected distances of 1.4 r{sub 500}, 1.2 r{sub 500}, and 1.6 r{sub 500} from the center of the Coma cluster, respectively. The subhalo “ID 1” has a compact X-ray excess emission close to the center of the weak-lensing mass contour, and the gas mass to weak-lensing mass ratio is about 0.001. The temperature of the emission is about 3 keV, which is slightly lower than thatmore » of the surrounding intracluster medium (ICM) and that expected for the temperature versus mass relation of clusters of galaxies. The subhalo “ID 32” shows an excess emission whose peak is shifted toward the opposite direction from the center of the Coma cluster. The gas mass to weak-lensing mass ratio is also about 0.001, which is significantly smaller than regular galaxy groups. The temperature of the excess is about 0.5 keV and significantly lower than that of the surrounding ICM and far from the temperature versus mass relation of clusters. However, there is no significant excess X-ray emission in the “ID 2” subhalo. Assuming an infall velocity of about 2000 km s{sup −1}, at the border of the excess X-ray emission, the ram pressures for “ID 1” and “ID 32” are comparable to the gravitational restoring force per area. We also studied the effect of the Kelvin–Helmholtz instability to strip the gas. Although we found X-ray clumps associated with the weak-lensing subhalos, their X-ray luminosities are much lower than the total ICM luminosity in the cluster outskirts.« less

Intravenous administration of levothyroxine for treatment of suspected myxedema coma complicated by severe hypothermia in a dog.

PubMed

Henik, R A; Dixon, R M

2000-03-01

A 7-year-old male English Coonhound with suspected myxedema coma complicated by severe hypothermia and metabolic abnormalities was treated with a combination of active external and core rewarming techniques, i.v. and oral administration of levothyroxine, supplemental oxygen, and administration of fluids (0.9% NaCl solution). Myxedema coma develops as a consequence of severe hypothyroidism and is characterized by a hypometabolic, stuporous state. Myxedema coma is associated with a high mortality rate, and most reported cases have involved Doberman Pinschers. Intravenous administration of levothyroxine can be used successfully in combination with oral administration to restore normal metabolic function and assist in warming and thermoregulation, although dosages should be conservative to avoid adverse cardiovascular effects.

DNA Data Bank of Japan (DDBJ) for genome scale research in life science

PubMed Central

Tateno, Y.; Imanishi, T.; Miyazaki, S.; Fukami-Kobayashi, K.; Saitou, N.; Sugawara, H.; Gojobori, T.

2002-01-01

The DNA Data Bank of Japan (DDBJ, http://www.ddbj.nig.ac.jp) has made an effort to collect as much data as possible mainly from Japanese researchers. The increase rates of the data we collected, annotated and released to the public in the past year are 43% for the number of entries and 52% for the number of bases. The increase rates are accelerated even after the human genome was sequenced, because sequencing technology has been remarkably advanced and simplified, and research in life science has been shifted from the gene scale to the genome scale. In addition, we have developed the Genome Information Broker (GIB, http://gib.genes.nig.ac.jp) that now includes more than 50 complete microbial genome and Arabidopsis genome data. We have also developed a database of the human genome, the Human Genomics Studio (HGS, http://studio.nig.ac.jp). HGS provides one with a set of sequences being as continuous as possible in any one of the 24 chromosomes. Both GIB and HGS have been updated incorporating newly available data and retrieval tools. PMID:11752245

Underestimation of Microearthquake Size by the Magnitude Scale of the Japan Meteorological Agency: Influence on Earthquake Statistics

NASA Astrophysics Data System (ADS)

Uchide, Takahiko; Imanishi, Kazutoshi

2018-01-01

Magnitude scales based on the amplitude of seismic waves, including the Japan Meteorological Agency magnitude scale (Mj), are commonly used in routine processes. The moment magnitude scale (Mw), however, is more physics based and is able to evaluate any type and size of earthquake. This paper addresses the relation between Mj and Mw for microearthquakes. The relative moment magnitudes among earthquakes are well constrained by multiple spectral ratio analyses. The results for the events in the Fukushima Hamadori and northern Ibaraki prefecture areas of Japan imply that Mj is significantly and systematically smaller than Mw for microearthquakes. The Mj-Mw curve has slopes of 1/2 and 1 for small and large values of Mj, respectively; for example, Mj = 1.0 corresponds to Mw = 2.0. A simple numerical simulation implies that this is due to anelastic attenuation and the recording using a finite sampling interval. The underestimation affects earthquake statistics. The completeness magnitude, Mc, for magnitudes lower than which the magnitude-frequency distribution deviates from the Gutenberg-Richter law, is effectively lower for Mw than that for Mj, by taking into account the systematic difference between Mj and Mw. The b values of the Gutenberg-Richter law are larger for Mw than for Mj. As the b values for Mj and Mw are well correlated, qualitative argument using b values is not affected. While the estimated b values for Mj are below 1.5, those for Mw often exceed 1.5. This may affect the physical implication of the seismicity.

Hubble Sees 'Island Universe' in the Coma Cluster

NASA Image and Video Library

2017-12-08

NASA image release August 10, 2010 A long-exposure Hubble Space Telescope image shows a majestic face-on spiral galaxy located deep within the Coma Cluster of galaxies, which lies 320 million light-years away in the northern constellation Coma Berenices. The galaxy, known as NGC 4911, contains rich lanes of dust and gas near its center. These are silhouetted against glowing newborn star clusters and iridescent pink clouds of hydrogen, the existence of which indicates ongoing star formation. Hubble has also captured the outer spiral arms of NGC 4911, along with thousands of other galaxies of varying sizes. The high resolution of Hubble's cameras, paired with considerably long exposures, made it possible to observe these faint details. NGC 4911 and other spirals near the center of the cluster are being transformed by the gravitational tug of their neighbors. In the case of NGC 4911, wispy arcs of the galaxy's outer spiral arms are being pulled and distorted by forces from a companion galaxy (NGC 4911A), to the upper right. The resultant stripped material will eventually be dispersed throughout the core of the Coma Cluster, where it will fuel the intergalactic populations of stars and star clusters. The Coma Cluster is home to almost 1,000 galaxies, making it one of the densest collections of galaxies in the nearby universe. It continues to transform galaxies at the present epoch, due to the interactions of close-proximity galaxy systems within the dense cluster. Vigorous star formation is triggered in such collisions. Galaxies in this cluster are so densely packed that they undergo frequent interactions and collisions. When galaxies of nearly equal masses merge, they form elliptical galaxies. Merging is more likely to occur in the center of the cluster where the density of galaxies is higher, giving rise to more elliptical galaxies. This natural-color Hubble image, which combines data obtained in 2006, 2007, and 2009 from the Wide Field Planetary Camera 2 and the

Article 31(b) Triggers - The COMA Misfires

DTIC Science & Technology

1994-03-01

under Article 31 to the effect that he need not be a witness against himself.31 9 The court’s final appeal to Miranda rationale came in the form of a...the suspect will be irrelevant.49’ Thus the test will avoid any appeal to emotion or false perception. What factors should the court examine? The...history of the UCMJ, the United States Court of Military Appeals (COMA) has struggled to develop and maintain a coherent analysis of the triggering

The relationships of a rationality/antiemotionality personality scale to mortalities of cancer and cardiovascular disease in a community population in Japan.

PubMed

Hirokawa, Kumi; Nagata, Chisato; Takatsuka, Naoyoshi; Shimizu, Hiroyuki

2004-01-01

Grossarth-Maticek et al. reported that an individual's level on a rationality/antiemotionality (R/A) personality was strongly predictive of cancer, ischemic heart disease and stroke mortality. To investigate the relationships of an individual's level on the R/A personality to cancer and cardiovascular disease mortality in Japan, we conducted a population-based cohort study. A self-administered questionnaire was distributed to 36990 Japanese residents in September 1992. The response rate was 90.3%. Data from 13226 males and 14880 females were analyzed. Dates and causes of death through December 31, 1999 were obtained for deceased participants. The results from multivariate hazard ratios (HRs) revealed that males scoring in the middle level compared to those scoring in the lower level of the R/A personality scale decreased their risk of death from cancer and cardiovascular diseases after controlling for covariates. The level on the R/A personality scale may affect mortality from cancer and cardiovascular diseases differently in Japan.

Production, Outflow Velocity, and Radial Distribution of H2O and OH in the Coma of Comet C/1995 O1 [Hale-Bopp] from Wide Field Imaging of OH

NASA Technical Reports Server (NTRS)

Harris, Walter M.; Scherb, Frank; Mierkiewicz, Edwin; Oliversen, Ronald; Morgenthaler, Jeffrey

2001-01-01

Observations of OH are a useful proxy of the water production rate (Q(sub H2O)) and outflow velocity (V(sub out)) in comets. We use wide field images taken on 03/28/1997 and 04/08/1997 that capture the entire scale length of the OH coma of comet C/1995O1 (Hale-Bopp) to obtain Q(sub H2O) from the model-independent method of aperture summation. We also extract the radial brightness profile of OH 3080 angstroms out to cometocentric distances of up to 10(exp 6) km using an adaptive ring summation algorithm. Radial profiles are obtained as azimuthal averages and in quadrants covering different position angles relative to the comet-Sun line. These profiles are fit using both fixed and variable velocity two-component spherical expansion models to determine VOH with increasing distance from the nucleus. The OH coma of Hale-Bopp was more spatially extended than in previous comets, and this extension is best matched by a variable acceleration of H2O and OH that acted across the entire coma, but was strongest within 1-2 x 10(exp 4) km from the nucleus. This acceleration led to VOH at 10(exp 6) km that was 2-3 times greater than that obtained from a 1P/Halleytype comet at 1 AU, a result that is consistent with gas-kinetic models, extrapolation from previous observations of OH in comets with Q(sub H2O) > 10(exp 29)/s, and radio measurements of the outer coma Hale-Bopp OH velocity profile. When the coma is broken down by quadrant, we find an azimuthal asymmetry in the radial distribution that is characterized by an increase in the spatial extent of OH in the region between the orbit-trailing and anti-sunward directions. Model fits to this area and comparison with radio OH measurements suggest greater acceleration in this region, with VOH UP to 1.5 times greater at 10(exp 6) km radial distance than elsewhere in the coma.

The dust distribution within the inner coma of comet P/Halley 1982i - Encounter by Giotto's impact detectors

NASA Technical Reports Server (NTRS)

Mcdonnell, J. A. M.; Evans, G. C.; Evans, S. T.; Alexander, W. M.; Burton, W. M.; Firth, J. G.; Bussoletti, E.; Grard, R. J. L.; Hanner, M. S.; Sekanina, Z.

1987-01-01

Analyses are presented of Giotto's Dust Impact Detection System experiment measurements of dust grains incident on the Giotto dust shield along its trajectory through the coma of comet P/Halley on March 13 and 14, 1986. Ground-based CCD imagery of the inner coma dust continuum at the time of the encounter are used to derive the area of grains intercepted by Giotto. Data obtained at large masses show clear evidence of a decrease in the mass distribution index at these masses within the coma; it is shown that such a value of the mass index can furnish sufficient mass for consistency with an observed deceleration.

Testing a generalized cubic Galileon gravity model with the Coma Cluster

DOE Office of Scientific and Technical Information (OSTI.GOV)

Terukina, Ayumu; Yamamoto, Kazuhiro; Okabe, Nobuhiro

2015-10-01

We obtain a constraint on the parameters of a generalized cubic Galileon gravity model exhibiting the Vainshtein mechanism by using multi-wavelength observations of the Coma Cluster. The generalized cubic Galileon model is characterized by three parameters of the turning scale associated with the Vainshtein mechanism, and the amplitude of modifying a gravitational potential and a lensing potential. X-ray and Sunyaev-Zel'dovich (SZ) observations of the intra-cluster medium are sensitive to the gravitational potential, while the weak-lensing (WL) measurement is specified by the lensing potential. A joint fit of a complementary multi-wavelength dataset of X-ray, SZ and WL measurements enables us tomore » simultaneously constrain these three parameters of the generalized cubic Galileon model for the first time. We also find a degeneracy between the cluster mass parameters and the gravitational modification parameters, which is influential in the limit of the weak screening of the fifth force.« less

Evolution of H2O related species in the neutral coma of 67P

NASA Astrophysics Data System (ADS)

Bieler, A. M.; Altwegg, K.; Balsiger, H. R.; Bar-Nun, A.; Berthelier, J. J.; Bochsler, P. A.; Briois, C.; Calmonte, U.; Combi, M. R.; De Keyser, J.; van Dishoeck, E.; Fiethe, B.; Fuselier, S. A.; Gasc, S.; Gombosi, T. I.; Hansen, K. C.; Hässig, M.; Jäckel, A.; Kopp, E.; Korth, A.; Le Roy, L.; Mall, U.; Maggiolo, R.; Marty, B.; Mousis, O.; Owen, T. C.; Reme, H.; Rubin, M.; Sémon, T.; Tzou, C. Y.; Waite, J. H., Jr.; Walsh, C.; Wurz, P.

2015-12-01

The ROSINA-DFMS mass spectrometer has been probing the coma of 67Psince the spacecraft arrived at the comet in August 2014.The acquired data set covers a large range of viewing geometries forthe ever changing conditions of 67P along its journey to pericenter. With the high temporal resolutionof ROSINA-DFMS we are able to examine diurnal and seasonal changesof different species in the gaseous coma.Large scale heterogeneities in the coma have been reported since the very first measurements of the neutral inventory at 67P.Many of the minor species are seen to follow one of the major compounds,H2O, CO or CO2.In this paper we will present the latest results on H2O related species.We will discuss the possible trapping/building mechanisms responsible for these species and why it is different from other species such asCO, N2 or CO2. Acknowledgements:Work at the University of Michigan was funded by NASA contract JPL-1266313.Work at UoB was funded by the State of Bern, the Swiss National Science Foundationand the European Space Agency PRODEX Program. Work at MPS was funded by the Max-Planck Society and BMWI contract 50QP1302. Work at Southwest Research institute was supported by subcontract #1496541 from the Jet Propulsion Laboratory. Work at BIRA-IASB was supported by the Belgian Science Policy Office via PRODEX/ROSINA PEA 90020. This work has been carried out thanks to the support of the A*MIDEX project (n° ANR-11-IDEX-0001-02) funded by the « Investissements d'Avenir » French Government program, managed by the French National Research Agency (ANR). This work was supported by CNES grants at IRAP, LATMOS, LPC2E, UTINAM, CRPG, and by the European Research Council (grant no. 267255 to B. Marty). A. Bar-Nun thanks the Ministry of Science and the Israel Space agency. Work by JHW at Southwest Research Institute was funded by the NASA JPL subcontract NAS703001TONMO710889. EvD and CW are supported by A-ERC grant 291141 CHEMPLAN and an NWO Veni award. We acknowledge herewith the

ALP conversion and the soft X-ray excess in the outskirts of the Coma cluster

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kraljic, David; Rummel, Markus; Conlon, Joseph P., E-mail: David.Kraljic@physics.ox.ac.uk, E-mail: Markus.Rummel@physics.ox.ac.uk, E-mail: j.conlon1@physics.ox.ac.uk

2015-01-01

It was recently found that the soft X-ray excess in the center of the Coma cluster can be fitted by conversion of axion-like-particles (ALPs) of a cosmic axion background (CAB) to photons. We extend this analysis to the outskirts of Coma, including regions up to 5 Mpc from the center of the cluster. We extract the excess soft X-ray flux from ROSAT All-Sky Survey data and compare it to the expected flux from ALP to photon conversion of a CAB. The soft X-ray excess both in the center and the outskirts of Coma can be simultaneously fitted by ALP tomore » photon conversion of a CAB. Given the uncertainties of the cluster magnetic field in the outskirts we constrain the parameter space of the CAB. In particular, an upper limit on the CAB mean energy and a range of allowed ALP-photon couplings are derived.« less

Regional and transported aerosols during DRAGON-Japan experiment

NASA Astrophysics Data System (ADS)

Sano, I.; Holben, B. N.; Mukai, S.; Nakata, M.; Nakaguchi, Y.; Sugimoto, N.; Hatakeyama, S.; Nishizawa, T.; Takamura, T.; Takemura, T.; Yonemitsu, M.; Fujito, T.; Schafer, J.; Eck, T. F.; Sorokin, M.; Kenny, P.; Goto, M.; Hiraki, T.; Iguchi, N.; Kouzai, K.; KUJI, M.; Muramatsu, K.; Okada, Y.; Sadanaga, Y.; Tohno, S.; Toyazaki, Y.; Yamamoto, K.

2013-12-01

Aerosol properties over Japan have been monitored by AERONET sun / sky photometers since 2000. These measurements provides us with long term information of local aerosols, which are influenced by transported aerosols, such as Asian dusts or anthropogenic pollutants due to rapid increasing of energy consumption in Asian countries. A new aerosol monitoring experiment, Distributed Regional Aerosol Gridded Observation Networks (DRAGON) - Japan is operated in spring of 2012. The main instrument of DRAGON network is AERONET sun/sky radiometers. Some of them are sparsely set along the Japanese coast and some others make a dense network in Osaka, which is the second-largest city in Japan and famous for manufacturing town. Several 2ch NIES-LIDAR systems are also co-located with AERONET instrument to monitor Asian dusts throughout the campaign. The objects of Dragon-Japan are to characterize local aerosols as well as transported ones from the continent of China, and to acquire the detailed aerosol information for validating satellite data with high resolved spatial scale. This work presents the comprehensive results of aerosol properties with respect to regional- and/or transported- scale during DRAGON-Japan experiments.

Prospective Cohort Study Evaluating the Prognostic Value of Simple EEG Parameters in Postanoxic Coma.

PubMed

Azabou, Eric; Fischer, Catherine; Mauguiere, François; Vaugier, Isabelle; Annane, Djillali; Sharshar, Tarek; Lofaso, Fréderic

2016-01-01

We prospectively studied early bedside standard EEG characteristics in 61 acute postanoxic coma patients. Five simple EEG features, namely, isoelectric, discontinuous, nonreactive to intense auditory and nociceptive stimuli, dominant delta frequency, and occurrence of paroxysms were classified yes or no. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC) of each of these variables for predicting an unfavorable outcome, defined as death, persistent vegetative state, minimally conscious state, or severe neurological disability, as assessed 1 year after coma onset were computed as well as Synek's score. The outcome was unfavorable in 56 (91.8%) patients. Sensitivity, specificity, PPV, NPV, and AUC of nonreactive EEG for predicting an unfavorable outcome were 84%, 80%, 98%, 31%, and 0.82, respectively; and were all very close to the ones of Synek score>3, which were 82%, 80%, 98%, 29%, and 0.81, respectively. Specificities for predicting an unfavorable outcome were 100% for isoelectric, discontinuous, or dominant delta activity EEG. These 3 last features were constantly associated to unfavorable outcome. Absent EEG reactivity strongly predicted an unfavorable outcome in postanoxic coma, and performed as accurate as a Synek score>3. Analyzing characteristics of some simple EEG features may easily help nonneurophysiologist physicians to investigate prognostic issue of postanoxic coma patient. In this study (a) discontinuous, isoelectric, or delta-dominant EEG were constantly associated with unfavorable outcome and (b) nonreactive EEG performed prognostic as accurate as a Synek score>3. © EEG and Clinical Neuroscience Society (ECNS) 2015.

Electronics manufacturing and assembly in Japan

NASA Technical Reports Server (NTRS)

Kukowski, John A.; Boulton, William R.

1995-01-01

In the consumer electronics industry, precision processing technology is the basis for enhancing product functions and for minimizing components and end products. Throughout Japan, manufacturing technology is seen as critical to the production and assembly of advanced products. While its population has increased less than 30 percent over twenty-five years, Japan's gross national product has increase thirtyfold; this growth has resulted in large part from rapid replacement of manual operations with innovative, high-speed, large-scale, continuously running, complex machines that process a growing number of miniaturized components. The JTEC panel found that introduction of next-generation electronics products in Japan goes hand-in-hand with introduction of new and improved production equipment. In the panel's judgment, Japan's advanced process technologies and equipment development and its highly automated factories are crucial elements of its domination of the consumer electronics marketplace - and Japan's expertise in manufacturing consumer electronics products gives it potentially unapproachable process expertise in all electronics markets.

Effectiveness of influenza vaccination for children in Japan: Four-year observational study using a large-scale claims database.

PubMed

Shibata, Natsumi; Kimura, Shinya; Hoshino, Takahiro; Takeuchi, Masato; Urushihara, Hisashi

2018-05-11

To date, few large-scale comparative effectiveness studies of influenza vaccination have been conducted in Japan, since marketing authorization for influenza vaccines in Japan has been granted based only on the results of seroconversion and safety in small-sized populations in clinical trial phases not on the vaccine effectiveness. We evaluated the clinical effectiveness of influenza vaccination for children aged 1-15 years in Japan throughout four influenza seasons from 2010 to 2014 in the real world setting. We conducted a cohort study using a large-scale claims database for employee health care insurance plans covering more than 3 million people, including enrollees and their dependents. Vaccination status was identified using plan records for the influenza vaccination subsidies. The effectiveness of influenza vaccination in preventing influenza and its complications was evaluated. To control confounding related to influenza vaccination, odds ratios (OR) were calculated by applying a doubly robust method using the propensity score for vaccination. Total study population throughout the four consecutive influenza seasons was over 116,000. Vaccination rate was higher in younger children and in the recent influenza seasons. Throughout the four seasons, the estimated ORs for influenza onset were statistically significant and ranged from 0.797 to 0.894 after doubly robust adjustment. On age stratification, significant ORs were observed in younger children. Additionally, ORs for influenza complication outcomes, such as pneumonia, hospitalization with influenza and respiratory tract diseases, were significantly reduced, except for hospitalization with influenza in the 2010/2011 and 2012/2013 seasons. We confirmed the clinical effectiveness of influenza vaccination in children aged 1-15 years from the 2010/2011 to 2013/2014 influenza seasons. Influenza vaccine significantly prevented the onset of influenza and was effective in reducing its secondary complications

Electron Impact Studies Relevant to Rosetta Coma Measurements of 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Bodewits, D.; Feldman, P. D.; Matejčík, Š.; Országh, J.; Durian, M.

2017-12-01

Auroral emission from electron impact processes can provide a remote window on the physical properties of plasma and neutral gases surrounding small bodies (Galand & Chakrabarti, 2002; Roth et al. 2014). Surprisingly, Rosetta found that outside 2 AU pre-perihelion, atomic and molecular emission features in the inner coma were predominantly caused by dissociative electron impact excitation (Feldman et al. 2015). When the comet came within 2 au of the Sun, fluorescent emission became the dominant process, as water densities in the inner coma could effectively cool the electron population below the appearance energy of the relevant electron impact dissociative excitation processes (Bodewits et al. 2016). Further quantitative interpretation of the Alice and OSIRIS images of the coma is by limited excitation cross sections measured of electron impact reactions with the gases present in cometary comae, including H2O, CO2, CO, O2, and HCN. We will present the first results of a series of experiments dedicated to investigate the emission features seen by the instruments on board Rosetta. The experimental set up is located at the Comenius University in Bratislava, Slovakia, and consists of a crossed-beam configuration combining an electron monochromator and a gas beam (Danko et al. 2013). The electron induced emission spectra are measured using a Czerny-Turner optical monochromator provides a spectral resolution of 0.3 nm FWHM and is equipped with a photomultiplier sensitive between 185 and 710 nm. References: Bodewits, D. et al. The Astronomical Journal 152, 130 (2016). Danko, M. et al. J. Phys. B 46, 045203 (2013). Feldman, P. D. et al. Astron. Astroph. 583, A8 (2015). Galand, M. & Chakrabarti, S. Geophysical Monograph 130. Ed. Michael Mendillo 130, 55- (2002). Roth, L., Saur, J., Retherford, K. D., Strobel, D. F. & Feldman, P. D. Science (2014). doi:10.1126/science.1247051

Analysis of the ROSINA/COPS end-of-mission measurements of the coma of comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Tenishev, Valeriy; Combi, Michael R.; Fougere, Nicolas; Rubin, Martin; Tzou, Chia-Yu; Shou, Yinsi; Gombosi, T. I.; Altwegg, Kathrin; Huang, Zhenguang; Toth, Gabor; Hansen, Kenneth C.

2017-10-01

A cometary coma is a unique phenomenon in the Solar system that represents an example of a planetary atmosphere influenced by little or no gravity. Due to the negligible gravity of a comet’s nucleus, a coma has a characteristic size that exceeds that of the nucleus itself by many orders of magnitude. An extended dusty gas cloud that forms a coma is affected mainly by molecular collisions, radiative cooling, and photolytic, charge-exchange, and impact-ionization reactions.Such an environment has been extensively observed during the recent Rosetta mission, which was the first mission that escorts a comet along its way through the Solar system for an extended amount of time with the main scientific objectives of characterizing comet’s nucleus, determining the surface composition, and studying the comet’s activity development.The ROSINA (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) Comet Pressure Sensor (COPS) onboard the Rosetta spacecraft has performed one of the most exciting observations of the innermost coma during the spacecraft descend maneuver during the last ten hours of the mission when the random and outflow directed pressures in the coma have been measured all the way down to the comet’s surface. Performed at such close proximity to the nucleus, these observations can help to characterize effects due to topological features and/or the gas local conditions at the surface of the nucleus.The major focus of the presented study is analyzing of the end-of-mission pressure measurements by the ROSINA/COPS instrument. Because the coma at a heliocentric distance of 3.8 AU was in a collisionless regime, it can be described by solving the Liouville equation, as we have done in our analysis. We have used the SHAP5 nucleus model to account for the topology of the volatile source. Spacecraft trajectory and the instrument pointing with respect to the comet’s nucleus have been obtained with the SPICE library. Here, we present results of our analysis

Reversible coma and Duret hemorrhage after intracranial hypotension from remote lumbar spine surgery: case report.

PubMed

Bonow, Robert H; Bales, James W; Morton, Ryan P; Levitt, Michael R; Zhang, Fangyi

2016-03-01

Intracranial hypotension is a rare condition caused by spontaneous or iatrogenic CSF leaks that alter normal CSF dynamics. Symptoms range from mild headaches to transtentorial herniation, coma, and death. Duret hemorrhages have been reported to occur in some patients with this condition and are traditionally believed to be associated with a poor neurological outcome. A 73-year-old man with a remote history of spinal fusion presented with syncope and was found to have small subdural hematomas on head CT studies. He was managed nonoperatively and discharged with a Glasgow Coma Scale score of 15, only to return 3 days later with obtundation, fixed downward gaze, anisocoria, and absent cranial nerve reflexes. A CT scan showed Duret hemorrhages and subtle enlargement of the subdural hematomas, though the hematomas remained too small to account for his poor clinical condition. Magnetic resonance imaging of the spine revealed a large lumbar pseudomeningocele in the area of prior fusion. His condition dramatically improved when he was placed in the Trendelenburg position and underwent repair of the pseudomeningocele. He was kept flat for 7 days and was ultimately discharged in good condition. On long-term follow-up, his only identifiable deficit was diplopia due to an internuclear ophthalmoplegia. Intracranial hypotension is a rare condition that can cause profound morbidity, including tonsillar herniation and brainstem hemorrhage. With proper identification and treatment of the CSF leak, patients can make functional recoveries.

Predictors of outcome in myxoedema coma

PubMed Central

Beynon, Jennifer; Akhtar, Simeen; Kearney, Tara

2008-01-01

Myxoedema coma is a rare and life-threatening illness the outcome of which has not been robustly studied in large numbers, partly due to its low incidence. Dutta and colleagues have explored outcome predictors in a developing country where access to thyroid function tests is more limited than in the Western world. Cardiovascular instability, reduced consciousness, persistent hypothermia, and sepsis all contributed to a poorer outcome, as has been demonstrated before, but a generic outcome predictor model was shown to be useful in this group of patients. Unfortunately, this observational study was unable to show differences in outcome based on replacement treatment methods and the mortality remains at 40%. PMID:18254932

Predictors of outcome in myxoedema coma.

PubMed

Beynon, Jennifer; Akhtar, Simeen; Kearney, Tara

2008-01-01

Myxoedema coma is a rare and life-threatening illness the outcome of which has not been robustly studied in large numbers, partly due to its low incidence. Dutta and colleagues have explored outcome predictors in a developing country where access to thyroid function tests is more limited than in the Western world. Cardiovascular instability, reduced consciousness, persistent hypothermia, and sepsis all contributed to a poorer outcome, as has been demonstrated before, but a generic outcome predictor model was shown to be useful in this group of patients. Unfortunately, this observational study was unable to show differences in outcome based on replacement treatment methods and the mortality remains at 40%.

Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study.

PubMed

Malaguarnera, Mariano; Risino, Corrado; Cammalleri, Lisa; Malaguarnera, Lucia; Astuto, Marinella; Vecchio, Ignazio; Rampello, Liborio

2009-07-01

Our earlier study has demonstrated that the administration of L-acetylcarnitine (LAC) improves neurological symptoms and serum parameters in hepatic coma. The aim of this work has been to evaluate the efficacy of the LAC and branched chain amino acids (BCAA) versus BCAA, administered in intravenous infusion, in patients with cirrhotic hepatic coma. Forty-eight highly selected patients were enrolled in the study and, after randomization, received blindly LAC+BCAA (n=24) versus BCAA (n=24). The two groups were similar in age, sex, pathogenesis of cirrhosis, and severity of liver disease. The comparison between values before and after LAC planned treatment showed statistical significant differences in neurological findings, evaluated by the Glasgow Scale, ammonia serum levels, blood urea nitrogen, and EEG. After 60 min of the study period, the LAC+BCAA treated patients compared with BCCA treated showed a significant decrease of ammonia serum levels: 41.20 versus 10.40 mumol P<0.05. After 1 day of the study period, the LAC+BCAA treated patients compared with BCCA treated patients showed a significant increase of Glasgow's score: 3.60 versus 1.50 score P<0.05; a significant decrease of ammonia serum levels: 63.30 versus 27.00 mumol P<0.01; a significant improvement of EEG cps/s: 2.70 versus 0.6 P<0.001. No side-effects were observed in our study series. Our study demonstrated that the administration of BCAA supplemented with LAC might improve neurological symptoms and serum ammonium levels in selected cirrhotic patients with hepatic coma.

Synergism of isothermal regimen and sodium succinate in experimental therapy of barbiturate coma.

PubMed

Reinyuk, V L; Shefer, T V; Ivnitskii, Yu Yu

2006-07-01

In rats with experimental thiopental coma rectal temperature decreased by 9.4 degrees C, oxygen consumption 5-fold, and arteriovenous Po(2)gradient decreased 2-fold within 3 h; CO(2)accumulated in the blood and mixed type acidosis developed. Administration of sodium succinate under these conditions increased arteriovenous Po(2)gradient and reduced manifestations of metabolic acidosis. Maintenance of normal body temperature (warming) corrected primarily manifestations of respiratory acidosis. Each therapeutic agent reduced inhibition of O(2)consumption by 1/4; animal survival tended to increase from 42 to 50%. Combined use of these treatments potentiated the antiacidotic effect and increased survival to 92%. The authors conclude that hypothermia inhibits the therapeutic effect of succinate in barbiturate coma.

Myxedema coma: A case report of pediatric emergency care.

PubMed

Zhu, Yueniu; Qiu, Wenjuan; Deng, Mengyan; Zhu, Xiaodong

2017-05-01

Myxedema coma (MC) is extremely rare but lethal in pediatric patients with hypothyroidism leading to altered mental status and hypothermia. But there is no clinical guideline for such cases. A 6-year-old Chinese girl presented with coma and hypothermia preceded by pneumonia. Her lab results were: free thyroxin (T4) 4.18 pmol/L and thyroid-stimulating hormone (TSH) > 150 μIU/mL with extremely elevated anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin. Pneumonia, mild pleural, and pericardial effusion were seen on computed tomographic (CT) scan. MC, autoimmune hypothyroidism, pneumonia and sepsis were diagnosed. Gastric levothyroxine, intravenous dexamethasone and antibiotics were administered. Her consciousness was restored and temperature returned to normal 2 days after starting levothyroxine. She was discharged two weeks later. MC is rare but may be the initial presentation in pediatric patients with prolonged untreated hypothyroidism. Autoimmune thyroiditis could cause hypothyroidism in children. MC should be suspected in pediatric patients with altered mental status, hypothermia and cardiovascular instability. Treatment with 100 mg/m of gastric levothyroxine is an option for pediatric patients with MC.

Small-scale spatial variation in near-surface turbidites around the JFAST site near the Japan Trench

NASA Astrophysics Data System (ADS)

Yoshikawa, Shuro; Kanamatsu, Toshiya; Kasaya, Takafumi

2016-03-01

This paper aims to improve our understanding of the depositional processes associated with turbidites related to recent earthquake events. A series of short sediment cores (ca. 20-30 cm long) were recovered from the landward slope of the Japan Trench around JFAST (Japan Trench Fast Drilling Project) site C0019 by a remotely operated vehicle, KAIKO 7000 II, and the sample sites were accurately located using an LBL (long base line) acoustic navigation system. The properties of the cores were analyzed using visual observations, soft X-ray radiographs, smear slides, measurement of anisotropy of magnetic susceptibility, and analysis of radioactive elements (134Cs, 137Cs, and excess 210Pb). For the first time, small-scale (ca. 200-1000 m) spatial variations in recent earthquake-triggered deep-sea turbidites, the formation of which was probably linked to the 2011 Tohoku-oki earthquake, are described. We also examine the submarine landslide that probably generated the sediment unit below the turbidites, which is thought to be an important process in the study area. The spatial distribution and characteristics of the near-surface seismoturbidite obtained immediately after the earthquake, presented here, will enable precise calibration of offshore evidence of recent earthquakes, and thus facilitate the use of the sedimentary archive for paleoseismic interpretations. Furthermore, although sampling for turbidite seismology on steep slopes has not been widely performed previously, our results suggest that the recent event deposits may be continuously tracked from the slope to the basin using a combination of the present sampling method and conventional large-scale investigation techniques.

Rosetta/Alice Measurements of Atomic and Molecular Abundances in the Coma of 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Vervack, R. J., Jr.; Weaver, H. A., Jr.; Knight, M. M.; Feldman, P.; Stern, A.; Parker, J. W.; Feaga, L. M.; Steffl, A.; Bertaux, J. L.; A'Hearn, M. F.; Keeney, B. A.

2017-12-01

During the Rosetta orbital phase from August 2014 through September 2016, the Alice far-ultraviolet (FUV) imaging spectrograph routinely monitored the FUV emission from the coma of 67P/Churyumov-Gerasimenko (67P). These data, spanning 700-2050 Å, provide both spatial and temporal information on the evolution of the coma composition throughout the encounter. Emissions from hydrogen (Lyman beta at 1025 Å), oxygen (1304 Å triplet, 1356 Å), sulfur (1429 Å and 1479 Å multiplets, 1814 Å triplet), and carbon (1561 Å, 1657 Å) were regularly observed, as well as emission from the CO Fourth Positive and Cameron bands. We present a preliminary analysis of these emissions with a focus on the abundances in the coma and a mapping of the temporal and spatial variations. Both short-term (days) and long-term (months) variations will be discussed in the context of rotational and seasonal timeframes. We also present ratios among various species with the goal of identifying the dominant processes at work in the coma as a function of time. Rosetta is an ESA mission with contributions from its member states and NASA. The Alice team acknowledges continuing support from NASA's Jet Propulsion Laboratory through contract 1336850 to the Southwest Research Institute. RJV's work was supported by a subcontract from Southwest Research Institute to the Johns Hopkins University Applied Physics Laboratory.

Interaction between Meso-scale Eddies and Sub-polar Front in the East (Japan) Sea based on ARGO, AVHRR, and Numerical Model

NASA Astrophysics Data System (ADS)

Ro, Y.; Kim, E.

2008-12-01

The East (Japan) Sea is drawing keen international attentions from broad spectrum of groups such as scientists, diplomats, and defense officers for its geopolitical situation, peculiar scientific assets recognized as miniature ocean. From physical oceanographic aspect, it is very rich with many features such as basin-wide circulation pattern, boundary currents, sub-polar front, meso-scale eddy activities and deep water formation. The circulation pattern in the East (Japan) Sea has been of major interests for its peculiar gyre, a western boundary current and its separation that resembles the currents such as Kuroshio and Gulf Stream. In relation to the gyre system in the East Sea, the formation of the East Korea Warm Current (EKWC) has brought up with many numerical experiments. Numerical experiments suggested a new idea to explain the formation of the EKWC in that the potential energy supply into the Ulleung Basin (UB) from the meso-scale eddy is a key process. This is closely linked with the baroclinic instability and the meandering of offshore component of Tsushima Warm Current. The UB has drawn attentions for its role of the formation of two major boundary currents, EKWC, North Korea Warm Current (NKCC), their interaction with the mesoscale UWE, watermass exchange between the Northern Japan Basin and UB. Numerical experiments along with hydrographic and other satellite datasets such as AVHRR, altimeter and ARGO profiles have been analyzed to understand the formation of the UWE. We found that the influence of the bottom topography and frictional forcing against lateral boundary are all closely associated with the sub-polar front. Meandering of the axis of the sub-polar front is closely linked with the separation point of the EKWC, Ulleung Warm Eddy, and other small and meso-scale eddies on the sub-polar front. These will be demonstrated with results of the numerical modeling experiments and animation movie will be presented.

Which score should be used in intubated patients’ Glasgow coma scale or full outline of unresponsiveness?

PubMed Central

Gorji, Mohammad Ali Heidari; Gorji, Ali Morad Heidari; Hosseini, Seyed Hossein

2015-01-01

Background and Aims: Today Glasgow coma scale (GCS) is the most well-known and common score for evaluation of the level of consciousness and outcome predict after traumatic brain injuries in the world. Regarding to some advantages of the full outline of unresponsiveness (FOUR) score over GCS in intubated patients, we’re going to compare the precision of these two scores in predicting the outcome predict in intubated patients. Methods: This research was a diagnostic-based study, which was conducted prospectively on 80 patients with Traumatic brain injury who were intubated and admitted to Intensive Care Unit (ICU) of Educational Hospitals of Mazandaran University of Medical Science during February 2013 to August 2013. The scores of FOUR and GCS were measured by the researcher in the first 24 h of admission in ICU. The information's recorded in the check list including the mortality rate of early and late inside of the hospital interred to excel. The findings were analyzed using SPSS software, through descriptive statistics and regression logistic. Results: The results showed of 80 patients 21 patients (20%) were female and 59 patients (80%) were male. The age average of the samples was 33.80 ± 12.60 ranging from 16 to 60 years old. 21 patients (26.2%) died during treatment. Of 21 patients, 15 patients died during first 14 days (18.7%) and 6 patients died after 14 years (7.5%). The area under curve (AUC) of FOUR score in early mortality was 0.90 (C1 = 0.95, 0.88–0.90). The amount AUC for GCS was 0.80 (C1 = 0.95, 0.78–0.84), which in delayed mortality it was ordered as 0.86 (C1 = 0.95, 0.84–0.90) and 0.89 (C1 = 0.95, 0.78–0.88). Conclusion: The research results indicated that FOUR score is more exact and more practical in intubated patients regarding lack of verbal response factor in early mortality prediction in GCS. Hence, it is recommended for health professionals to use the FOUR score to predict the early outcome of intubated patients with traumatic

Modelling of the inner gas and dust coma of comet 67P/Churyumov-Gerasimenko using ROSINA/COPS and OSIRIS data - First results

NASA Astrophysics Data System (ADS)

Marschall, R.; Su, C. C.; Liao, Y.; Thomas, N.; Wu, J. S.; Altwegg, K.; Sierks, H.; Ip, W.-H.; Keller, H. U.; Knollenberg, J.; Kührt, E.; Lai, I. L.; Rubin, M.; Skorov, Y.; Jorda, L.; Preusker, F.; Scholten, F.; Gicquel, A.; Gracia-Berná, A.; Naletto, G.

2015-10-01

The physics of the outflow above the surface of comets is somewhat complex. Ice sublimating into vacuum forms a non-equilibrium boundary layer, the "Knudsen layer" (Kn-layer), with a scale height of #20 mean free paths. If the production rate is low, the Kn-layer becomes infinitely thick and the velocity distribution function (VDF) remains strongly non-Maxwellian. Thus our preferred method for gas dynamics simulations of the coma is Direct Simulation Monte Carlo DSMC. Here we report on the first results of models of the outflow from the Rosetta target, comet67P/Churyumov-Gerasimenko (C-G). Our aims are to (1) determine the gas flow-field of H2O and CO2 in the innermost coma and compare the results to the in-situ measurements of the ROSINA/COPS instrument (2) produce artificial images of the dust brightnesses that can be compared to the OSIRIS cameras. The comparison with ROSINA/COPS and OSIRIS data help to constrain the initial conditions of the simulations and thus yield information on the surface processes.

Galaxy Interactions, Tidal Debris, and the Origin of Intracluster Light in the Coma Cluster

NASA Astrophysics Data System (ADS)

Gregg, Michael

1999-07-01

We propose to obtain deep WFPC2 and parallel STIS images of low surface brightness tidal debris that we have recently discovered in the Coma cluster; the material is being stripped from its parent galaxy and added to the general cluster background. These images will enable direct study of the brightest blue and red supergiants, globular clusters, and star forming regions which may be present, or will place strong limits on the numbers of such objects and any recent star formation. We also propose similar observations of the parent spiral, NGC4911, in the core of Coma; it is losing its ISM to the hot cluster gas and as well as the low surface brightness tidal debris. By imaging this galaxy, we will get a high resolution look at the interaction between the galaxy and interstellar medium, as well as any ram-pressure induced star formation. The tidal features in Coma appear to be adding material to the background light and cD galaxy envelopes at a significant rate; determining the nature of the added stellar population and the interactions which produce it are critical to understanding the formation and evolution of cD galaxies and clusters.

Large-Scale Earthquake Countermeasures Act and the Earthquake Prediction Council in Japan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rikitake, T.

1979-08-07

The Large-Scale Earthquake Countermeasures Act was enacted in Japan in December 1978. This act aims at mitigating earthquake hazards by designating an area to be an area under intensified measures against earthquake disaster, such designation being based on long-term earthquake prediction information, and by issuing an earthquake warnings statement based on imminent prediction information, when possible. In an emergency case as defined by the law, the prime minister will be empowered to take various actions which cannot be taken at ordinary times. For instance, he may ask the Self-Defense Force to come into the earthquake-threatened area before the earthquake occurrence.more » A Prediction Council has been formed in order to evaluate premonitory effects that might be observed over the Tokai area, which was designated an area under intensified measures against earthquake disaster some time in June 1979. An extremely dense observation network has been constructed over the area.« less

Coma measurement by use of an alternating phase-shifting mask mark with a specific phase width

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qiu Zicheng; Wang Xiangzhao; Yuan Qiongyan

2009-01-10

The correlation between the coma sensitivity of the alternating phase-shifting mask (Alt-PSM) mark and the mark's structure is studied based on the Hopkins theory of partially coherent imaging and positive resist optical lithography (PROLITH) simulation. It is found that an optimized Alt-PSM mark with its phase width being two-thirds its pitch has a higher sensitivity to coma than Alt-PSM marks with the same pitch and the different phase widths. The pitch of the Alt-PSM mark is also optimized by PROLITH simulation, and the structure of p=1.92{lambda}/NA and pw=2p/3 proves to be with the highest sensitivity. The optimized Alt-PSM mark ismore » used as a measurement mark to retrieve coma aberration from the projection optics in lithographic tools. In comparison with an ordinary Alt-PSM mark with its phase width being a half its pitch, the measurement accuracies of Z7 and Z14 apparently increase.« less

[Euthanasia of patients in coma vigil. Results on German medical staff attitudes].

PubMed

Böttger-Kessler, G; Beine, K H

2007-07-01

An examination was made concerning doctors' and nursing staff's attitudes towards active euthanasia of patients suffering from coma vigil (2652 doctors and 5785 nursing staff were interviewed). This investigation made clear that most of the persons asked about this group of patients voted for a change in German laws following the Dutch example. There were noticeable differences observed between the professional groups. A majority (64.79%) were convinced that under certain circumstances it is justified to end intentionally the life of persons in a coma vigil. Of the nursing staff, 70.38% were in favour of this attitude, and 51.53% of the doctors share this opinion. Certain groups supported the question of active euthanasia more clearly than others. These were young participants in the investigation, first-time employees, nondenominational interviewees, those who are dissatisfied with their job situation, who are from the newly-formed German states, and who are divorced. The attitudes expressed by all these people originate in many different motives: thoughts about the patients, aspects concerning jobs, and personal aspects had an influence on results of the investigation. This single investigation which was restricted to patients suffering from coma vigil and to employees of the public health service, does not prove that the total population has generally changed its attitude toward active euthanasia. It is impossible to justify the necessity of new laws about euthanasia based on the above results.

Survival rate and expression of Heat-shock protein 70 and Frost genes after temperature stress in Drosophila melanogaster lines that are selected for recovery time from temperature coma.

PubMed

Udaka, Hiroko; Ueda, Chiaki; Goto, Shin G

2010-12-01

In this study, we investigated the physiological mechanisms underlying temperature tolerance using Drosophila melanogaster lines with rapid, intermediate, or slow recovery from heat or chill coma that were established by artificial selection or by free recombination without selection. Specifically, we focused on the relationships among their recovery from heat or chill coma, survival after severe heat or cold, and survival enhanced by rapid cold hardening (RCH) or heat hardening. The recovery time from heat coma was not related to the survival rate after severe heat. The line with rapid recovery from chill coma showed a higher survival rate after severe cold exposure, and therefore the same mechanisms are likely to underlie these phenotypes. The recovery time from chill coma and survival rate after severe cold were unrelated to RCH-enhanced survival. We also examined the expression of two genes, Heat-shock protein 70 (Hsp70) and Frost, in these lines to understand the contribution of these stress-inducible genes to intraspecific variation in recovery from temperature coma. The line showing rapid recovery from heat coma did not exhibit higher expression of Hsp70 and Frost. In addition, Hsp70 and Frost transcription levels were not correlated with the recovery time from chill coma. Thus, Hsp70 and Frost transcriptional regulation was not involved in the intraspecific variation in recovery from temperature coma. Copyright © 2010 Elsevier Ltd. All rights reserved.

End-of-mission ROSINA/COPS measurements as a probe of the innermost coma of comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Tenishev, V.; Fougere, N.; Rubin, M.; Tzou, C. Y.; Combi, M. R.; Altwegg, K.; Gombosi, T. I.; Shou, Y.; Huang, Z.; Hansen, K. C.; Toth, G.

2017-12-01

A cometary coma is a unique phenomenon in the Solar system that represents an example of a planetary atmosphere influenced by little or no gravity. Due to the negligible gravity of a comet's nucleus, a coma has a characteristic size that exceeds that of the nucleus itself by many orders of magnitude. An extended dusty gas cloud that forms a coma is affected mainly by molecular collisions, radiative cooling, and photolytic, charge-exchange, and impact-ionization reactions. Such an environment has been extensively observed during the recent Rosetta mission, which was the first mission that escorts a comet along its way through the Solar system for an extended amount of time with the main scientific objectives of characterizing comet's nucleus, determining the surface composition, and studying the comet's activity development. The ROSINA (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) Comet Pressure Sensor (COPS) onboard the Rosetta spacecraft has performed one of the most exciting observations of the innermost coma during the spacecraft descend maneuver during the last ten hours of the mission when the random and outflow directed pressures in the coma have been measured all the way down to the comet's surface. Performed at such close proximity to the nucleus, these observations can help to characterize effects due to topological features and/or the gas local conditions at the surface of the nucleus. The major focus of the presented study is analyzing of the end-of-mission pressure measurements by the ROSINA/COPS instrument. Because the coma at a heliocentric distance of 3.8 AU was in a collisionless regime, it can be described by solving the Liouville equation, as we have done in our analysis. We have used the SHAP5 nucleus model to account for the topology of the volatile source. Spacecraft trajectory and the instrument pointing with respect to the comet's nucleus have been obtained with the SPICE library. Here, we present results of our analysis and

The Distance to the Coma Cluster from the Tully--Fisher Relation

NASA Astrophysics Data System (ADS)

Herter, T.; Vogt, N. P.; Haynes, M. P.; Giovanelli, R.

1993-12-01

As part of a survey to determine the distances to nearby (z < .04) Abell clusters via application of the Tully--Fisher (TF) relation, we have obtained 21 cm HI line widths, optical rotation curves and photometric I--band CCD images of galaxies within and near the Coma cluster. Because spiral galaxies within the cluster itself are HI deficient and thus are detected marginally or not at all in HI, distance determinations using only the radio TF relation exclude true cluster members. Our sample includes eight HI deficient galaxies within 1.5 degrees of the cluster center, for which optical velocity widths are derived from their Hα and [NII] rotation curves. The 21 cm line widths have been extracted using a new algorithm designed to optimize the measurement for TF applications, taking into account the effects of spectral resolution and smoothing. The optical width is constructed from the velocity histogram, and is therefore a global value akin to the HI width. A correction for turbulent broadening of the HI is derived from comparison of the optical and HI widths. Using a combined sample of 260 galaxies in 11 clusters and an additional 30 field objects at comparable distances, we have performed a calibration of the radio and optical analogs of the TF relation. Preliminary results show a clear linear relationship with a small offset between optical and radio widths, and good agreement in deriving Tully--Fisher distances to clusters. Our Coma sample consists of 28 galaxies with optical widths and 42 with HI line widths, with an overlapping set of 20 galaxies. We will present the data on the Coma cluster, and discuss the results of our analysis.

Chorea--an unusual manifestation in a woman recovering from myxedema coma.

PubMed

Yu, Catherine H Y; Stovel, Rebecca; Fox, Susan

2012-01-01

To report a case of reversible chorea in a woman with myxedema coma. We describe the clinical course, imaging findings, and laboratory test results of a patient who initially presented with myxedema coma and then developed reversible chorea upon treatment. A 33-year-old woman with a known history of primary hypothyroidism presented with a 3-week history of lethargy, progressing to a precipitous decline in consciousness that required intubation. Physical examination revealed concurrent hypothermia and bradycardia. Laboratory investigations demonstrated a thyrotropin concentration greater than 100 mIU/L, a free triiodothyronine concentration of 1.9 pg/mL, and a free thyroxine concentration of 0.24 ng/dL, but no other metabolic abnormalities. She was treated with intravenous levothyroxine therapy on the first 2 days of hospital admission (200 mcg and 250 mcg, respectively). On day 2, she was obeying commands and she was extubated. She began exhibiting choreiform movements. Thyroid function test results revealed a normal free thyroxine concentration (1.10 ng/dL), but an elevated thyrotropin concentration (40.98 mIU/L) and a low free triiodothyronine concentration (1.9 pg/mL). Findings from computed tomography and magnetic resonance imaging of her brain and analysis of cerebrospinal fluid were normal. Her regimen was transitioned to oral levothyroxine, 88 mcg daily, and by day 4, her choreiform movements ceased. Neurologic manifestations of hypothyroidism include psychomotor slowing, memory deficits, and dementia, with myxedema coma at the extreme of this spectrum. Although chorea is a rare manifestation of hyperthyroidism, this is the first report of a patient with acquired, reversible choreiform movement disorder while still being severely hypothyroid and treated with levothyroxine.

The near-infrared Tully-Fisher relation - A preliminary study of the Coma and Abell 400 clusters

NASA Technical Reports Server (NTRS)

Guhathakurta, Puragra; Bernstein, Gary; Raychaudhury, Somak; Haynes, Martha; Giovanelli, Riccardo; Herter, Terry; Vogt, Nicole

1993-01-01

We have started a large project to study the NIR Tully-Fisher (TF) relation using H- and I-band surface photometry of spiral galaxies. A preliminary study of 20 spirals in the Coma and Abell 400 clusters is presented. The NIR images have been used to derive accurate inclinations and total magnitudes, and rotational linewidths are measured from high-quality 21-cm Arecibo data. The scatter in the Coma TF plot is found to be 0.19 mag in the H band and 0.20 mag in the I band for a set of 13 galaxies, if we assume that they are all at the same distance. The deviation of the Coma galaxies from the best-fit Tully-Fisher relation is correlated with their redshift, indicating that some of the galaxies are not bound to the cluster. Indeed, if we treat all the galaxies in the Coma sample as undergoing free Hubble expansion, the TF scatter drops to 0.12 and 0.13 mag for the H- and I-band datasets, respectively. The Abell 400 sample is best fit by a common distance model, yielding a scatter of 0.12 mag for seven galaxies in H using a fixed TF slope. We are in the process of studying cluster and field spirals out to about 10,000 km/s in order to calibrate the NIR TF relation and will apply it to more nearby galaxies to measure the peculiar velocity field in the local universe.

Numerical simulations of the radiance from the limb measurements of dusty coma of the Comet 67P/Churyumov Gerasimenko

NASA Astrophysics Data System (ADS)

Błęcka, M. I.; Rinaldi, G.; Fink, U.; Capacioni, F.; Tozzi, G. P.

2013-09-01

The work we present deals with the spectrometric measurements of the VIRTIS instrument part of the payload of the Rosetta mission to the Comet 67P/Churyumov-Gerasimenko. This spectrometer will monitor (VIRTIS M channel: 0.25μm - 0.98μm; Δκ=20cm-1 ; 0.980 - 5.0 μm; Δκ=5cm-1; VIRTIS H channel: 2.0 μm- 5.0 μm ; Δκ=5cm-1) the nucleus and the coma in order to provide a picture of coma's composition, the production of gas and dust, and the structure and variation of mineralogy of the nucleus surface. The dust is an important constituent of cometary environment and is always present on the surface of the nucleus and in the coma. The cometary spectra are strongly affected by the processes taking place in the coma and by the structure, composition and the spatial distribution of cometary solid particles. The particles of the dust, illuminated by solar light, scatter, absorb and emit radiation. The reflected and emitted radiation are transmitted through the coma region before being collected by instruments such as VIRTIS. The reflection, absorption, scattering, and emission processes in the coma depend on the Comet-Sun geometry. In the VIRTIS team we have initiated and effort to simulate the dust radiance using several radiative transfer models (see Rinaldi et al, this issue). In the present paper, which is the continuation of our previous works (e.g. AGU fall meeting 2011, EGU 2012, EPSC2012 -abstracts), we are mainly concentrated on the influence of optical parameters of dust on spectra we expect from the VIRTIS/Rosetta measurements. To this purposes the equation of radiative transfer in limb geometry through the assembly of various dust grains and gases is solved. The number density distribution of the dust grains around the coma and their size distribution are drawn from recent theoretical models (e.g.Tenishev et.al.2011). A few phenomenological scattering phase functions are taken into account. We have assumed in the simulation the presence on the surface of

L-Band RFI in Japan

NASA Technical Reports Server (NTRS)

Soldo, Yan; de Matthaeis, Paolo; Le Vine, David M.

2016-01-01

In recent years, three instruments have been launched into orbit with the aim of producing global maps of sea surface salinity and soil moisture using the 1400-1427 MHz band: SMOS, Aquarius and SMAP. Although this frequency band is allocated to passive measurements only, RFI (Radio-Frequency Interference) is present in the data of all three missions. On a global scale, the three sensors have observed approximately the same distribution of RFI. Japan is an important exception that has implications for the design of RFI detection algorithms. RFI in Japan is caused by a large number of emitters belonging to the same system (TV receivers) and for this reason some traditional RFI detection strategies detect little to no RFI over Japan. The study of this case has led to an improvement of the approach to detect RFI in Aquarius data.

Characteristics of perceived parenting styles in Japan using the EMBU scale.

PubMed

Someya, T; Uehara, T; Kadowaki, M; Tang, S W; Takahashi, S

1999-10-01

The EMBU (Egna Minnen av Barndoms Uppfostran) is a self-report questionnaire for the assessment of one's memory of parental rearing experiences. We are interested in using this scale to determine the characteristics of perceived parenting styles in Japan. The study subjects consisted of 1320 healthy Japanese volunteers, comprising 687 males (52%) and 633 females (48%). We investigated the relationship between demographics and the EMBU scale. ANCOVA revealed that the subject's gender had a significant effect on paternal rejection scores (male > female), and both gender and birth-order position had significant effects on emotional warmth scores for both parents (female > male, and only-child > middle or last-born child). Birth-order position had significant effects on maternal over-protection, with the highest score being that of only children, and on the aspect of favouritism (favouring subjects), scores for both parents were highest from the last-born children. Rejection scores for the mother were significantly higher than those for the father from female subjects. Among both male and female subjects, emotional warmth scores and overprotection scores for the mother were significantly higher than those for the father. Among male subjects, scores for the mother on favouritism of the subject were significantly higher than those for the father. On the other hand, among female subjects, scores for the father on favouritism of the subject were higher than scores for the mother. Our results suggest that parenting styles have significant interrelationships with the gender and birth-order position of the subject.

Active music therapy in the rehabilitation of severe brain injured patients during coma recovery.

PubMed

Formisano, R; Vinicola, V; Penta, F; Matteis, M; Brunelli, S; Weckel, J W

2001-01-01

Active improvised music therapy may offer an adjuvant from of treatment in the early rehabilitation of severe brain-injured patients. Active music therapy consists of musical improvisation between patient and therapist by singing or by playing different musical instruments, according to the vital functions, the neurological conditions and the motor abilities of the patients. We studied 34 severe brain-injured patients with a mean coma duration of 52 days +/- 37.21 and a mean interval from coma onset to the beginning of rehabilitation of 154 days on average. Our preliminary results show a significant improvement of the collaboration of the severe brain-injured patients and a reduction of undesired behaviours such as inertia (reduced psychomotor initiative) or psychomotor agitation.

Myxedema coma of both primary and secondary origin, with non-classic presentation and extremely elevated creatine kinase.

PubMed

Benvenga, S; Squadrito, S; Saporito, F; Cimino, A; Arrigo, F; Trimarchi, F

2000-09-01

Myxedema coma is a rare, often fatal endocrine emergency that concerns elderly patients with long-standing primary hypothyroidism; myxedema coma of central origin is exceedingly rare. Here, we report a 37-year-old woman in whom classical symptoms of hypothyroidism had been absent. Six years earlier, she had severe obstetric hemorrhage and, shortly after, two subsequent episodes of pericardial effusion. On the day of admission, pericardiocentesis was performed for the third episode of pericardial effusion. Because of the subsequent grave arrhythmias and unconsciousness, she was transferred to our ICU. Prior to the endocrine consultation, a silent myocardial infarction had been suspected, based on the extremely high serum levels of creatine kinase (CK) and isoenzyme CK-MB. However, based on thyroid sonography, pituitary computed tomography, elevated titers of antithyroid antibodies and pituitary stimulation tests, the final diagnosis was myxedema coma of dual origin: an atrophic variant of Hashimoto's thyroiditis and post-necrotic pituitary atrophy (Sheehan syndrome). Substitutive therapy caused a prompt clinical amelioration and normalization of CK levels. Our patient is the first case of myxedema coma of double etiology, and illustrates how its presentation deviates markedly from the one endocrinologists and physicians at ICU are prepared to encounter. In addition, cardiac problems as those of our patient should not discourage from substitutive treatment (using L-thyroxine and the gastrointestinal route of absorption), if the age is relatively low.

Japan.

PubMed

1987-02-01

Japan is composed of 4 main islands and more than 3900 smaller islands and has 317.7 persons/square kilometer. This makes it one of the most densely populated nations in the world. Religion is an important force in the life of the Japanese and most consider themselves Buddhists. Schooling is free through junior high but 90% of Japanese students complete high school. In fact, Japan enjoys one of the highest literacy rates in the world. There are over 178 newspapers and 3500 magazines published in Japan and the number of new book titles issued each year is greater than that in the US. Since WW1, Japan expanded its influence in Asia and its holdings in the Pacific. However, as a direct result of WW2, Japan lost all of its overseas possessions and was able to retain only its own islands. Since 1952, Japan has been ruled by conservative governments which cooperate closely with the West. Great economic growth has come since the post-treaty period. Japan as a constitutional monarchy operates within the framework of a constitution which became effective in May 1947. Executive power is vested in a cabinet which includes the prime minister and the ministers of state. Japan is one of the most politically stable of the postwar democracies and the Liberal Democratic Party is representative of Japanese moderate conservatism. The economy of Japan is strong and growing. With few resources, there is only 19% of Japanese land suitable for cultivation. Its exports earn only about 19% of the country's gross national product. More than 59 million workers comprise Japan's labor force, 40% of whom are women. Japan and the US are strongly linked trading partners and after Canada, Japan is the largest trading partner of the US. Foreign policy since 1952 has fostered close cooperation with the West and Japan is vitally interested in good relations with its neighbors. Relations with the Soviet Union are not close although Japan is attempting to improve the situation. US policy is based on

Deep Galex Observations of the Coma Cluster: Source Catalog and Galaxy Counts

NASA Technical Reports Server (NTRS)

Hammer, D.; Hornschemeier, A. E.; Mobasher, B.; Miller, N.; Smith, R.; Arnouts, S.; Milliard, B.; Jenkins, L.

2010-01-01

We present a source catalog from deep 26 ks GALEX observations of the Coma cluster in the far-UV (FUV; 1530 Angstroms) and near-UV (NUV; 2310 Angstroms) wavebands. The observed field is centered 0.9 deg. (1.6 Mpc) south-west of the Coma core, and has full optical photometric coverage by SDSS and spectroscopic coverage to r-21. The catalog consists of 9700 galaxies with GALEX and SDSS photometry, including 242 spectroscopically-confirmed Coma member galaxies that range from giant spirals and elliptical galaxies to dwarf irregular and early-type galaxies. The full multi-wavelength catalog (cluster plus background galaxies) is 80% complete to NUV=23 and FUV=23.5, and has a limiting depth at NUV=24.5 and FUV=25.0 which corresponds to a star formation rate of 10(exp -3) solar mass yr(sup -1) at the distance of Coma. The GALEX images presented here are very deep and include detections of many resolved cluster members superposed on a dense field of unresolved background galaxies. This required a two-fold approach to generating a source catalog: we used a Bayesian deblending algorithm to measure faint and compact sources (using SDSS coordinates as a position prior), and used the GALEX pipeline catalog for bright and/or extended objects. We performed simulations to assess the importance of systematic effects (e.g. object blends, source confusion, Eddington Bias) that influence source detection and photometry when using both methods. The Bayesian deblending method roughly doubles the number of source detections and provides reliable photometry to a few magnitudes deeper than the GALEX pipeline catalog. This method is also free from source confusion over the UV magnitude range studied here: conversely, we estimate that the GALEX pipeline catalogs are confusion limited at NUV approximately 23 and FUV approximately 24. We have measured the total UV galaxy counts using our catalog and report a 50% excess of counts across FUV=22-23.5 and NUV=21.5-23 relative to previous GALEX

Effects of Large-Scale Releases on the Genetic Structure of Red Sea Bream (Pagrus major, Temminck et Schlegel) Populations in Japan.

PubMed

Blanco Gonzalez, Enrique; Aritaki, Masato; Knutsen, Halvor; Taniguchi, Nobuhiko

2015-01-01

Large-scale hatchery releases are carried out for many marine fish species worldwide; nevertheless, the long-term effects of this practice on the genetic structure of natural populations remains unclear. The lack of knowledge is especially evident when independent stock enhancement programs are conducted simultaneously on the same species at different geographical locations, as occurs with red sea bream (Pagrus major, Temminck et Schlegel) in Japan. In this study, we examined the putative effects of intensive offspring releases on the genetic structure of red sea bream populations along the Japanese archipelago by genotyping 848 fish at fifteen microsatellite loci. Our results suggests weak but consistent patterns of genetic divergence (F(ST) = 0.002, p < 0.001). Red sea bream in Japan appeared spatially structured with several patches of distinct allelic composition, which corresponded to areas receiving an important influx of fish of hatchery origin, either released intentionally or from unintentional escapees from aquaculture operations. In addition to impacts upon local populations inhabiting semi-enclosed embayments, large-scale releases (either intentionally or from unintentional escapes) appeared also to have perturbed genetic structure in open areas. Hence, results of the present study suggest that independent large-scale marine stock enhancement programs conducted simultaneously on one species at different geographical locations may compromise native genetic structure and lead to patchy patterns in population genetic structure.

Economic evaluation of decompressive craniectomy versus barbiturate coma for refractory intracranial hypertension following traumatic brain injury.

PubMed

Alali, Aziz S; Naimark, David M J; Wilson, Jefferson R; Fowler, Robert A; Scales, Damon C; Golan, Eyal; Mainprize, Todd G; Ray, Joel G; Nathens, Avery B

2014-10-01

Decompressive craniectomy and barbiturate coma are often used as second-tier strategies when intracranial hypertension following severe traumatic brain injury is refractory to first-line treatments. Uncertainty surrounds the decision to choose either treatment option. We investigated which strategy is more economically attractive in this context. We performed a cost-utility analysis. A Markov Monte Carlo microsimulation model with a life-long time horizon was created to compare quality-adjusted survival and cost of the two treatment strategies, from the perspective of healthcare payer. Model parameters were estimated from the literature. Two-dimensional simulation was used to incorporate parameter uncertainty into the model. Value of information analysis was conducted to identify major drivers of decision uncertainty and focus future research. Trauma centers in the United States. Base case was a population of patients (mean age = 25 yr) who developed refractory intracranial hypertension following traumatic brain injury. We compared two treatment strategies: decompressive craniectomy and barbiturate coma. Decompressive craniectomy was associated with an average gain of 1.5 quality-adjusted life years relative to barbiturate coma, with an incremental cost-effectiveness ratio of $9,565/quality-adjusted life year gained. Decompressive craniectomy resulted in a greater quality-adjusted life expectancy 86% of the time and was more cost-effective than barbiturate coma in 78% of cases if our willingness-to-pay threshold is $50,000/quality-adjusted life year and 82% of cases at a threshold of $100,000/quality-adjusted life year. At older age, decompressive craniectomy continued to increase survival but at higher cost (incremental cost-effectiveness ratio = $197,906/quality-adjusted life year at mean age = 85 yr). Based on available evidence, decompressive craniectomy for the treatment of refractory intracranial hypertension following traumatic brain injury provides better

Extending technology-aided leisure and communication programs to persons with spinal cord injury and post-coma multiple disabilities.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; Ricciuti, Riccardo A; Trignani, Roberto; Oliva, Doretta; Signorino, Mario; D'Amico, Fiora; Sasanelli, Giovanni

2015-01-01

These two studies extended technology-aided programs to promote leisure and communication opportunities to a man with cervical spinal cord injury and a post-coma man with multiple disabilities. The studies involved the use of ABAB designs, in which A and B represented baseline and intervention phases, respectively. The programs focused on enabling the participants to activate songs, videos, requests, text messages, and telephone calls. These options were presented on a computer screen and activated through a small pressure microswitch by the man with spinal cord injury and a special touch screen by the post-coma man. To help the latter participant, who had no verbal skills, with requests and telephone calls, series of words and phrases were made available that he could activate in those situations. Data showed that both participants were successful in managing the programs arranged for them. The man with spinal cord injury activated mean frequencies of above five options per 10-min session. The post-coma man activated mean frequencies of about 12 options per 20-min session. Technology-aided programs for promoting leisure and communication opportunities might be successfully tailored to persons with spinal cord injury and persons with post-coma multiple disabilities. Implications for Rehabilitation Technology-aided programs may be critical to enable persons with pervasive motor impairment to engage in leisure activities and communication events independently. Persons with spinal cord injury, post-coma extended brain damage, and forms of neurodegenerative disease, such as amyotrophic lateral sclerosis, may benefit from those programs. The programs could be adapted to the participants' characteristics, both in terms of technology and contents, so as to improve their overall impact on the participants' functioning and general mood.

A Chemical Model of the Coma of Comet C/2009 P1 (Garradd)

NASA Astrophysics Data System (ADS)

Boice, Daniel C.; Kawakita, H.; Kobayashi, H.; Naka, C.; Phelps, L.

2012-10-01

Modeling is essential to understand the important physical and chemical processes that occur in cometary comae. Photochemistry is a major source of ions and electrons that further initiate key gas-phase reactions, leading to the plethora of molecules and atoms observed in comets. The effects of photoelectrons that react via impacts are important to the overall ionization. We identify the relevant processes within a global modeling framework to understand simultaneous observations in the visible and near-IR of Comet C/2009 (Garradd) and to provide valuable insights into the intrinsic properties of its nucleus. Details of these processes are presented in the collision-dominated, inner coma of the comet to evaluate the relative chemical pathways and the relationship between parent and sibling molecules. Acknowledgements: We appreciate support from the NSF Planetary Astronomy Program.

Modeling of the VIRTIS-M Observations of the Coma of Comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Fougere, Nicolas; Combi, Michael R.; Tenishev, Valeriy; Bieler, Andre; Migliorini, Alessandra; Piccioni, Giuseppe; Capaccioni, Fabrizio; Filacchione, Gianrico; Toth, Gabor; Huang, Zhenguang; Gombosi, Tamas; Hansen, Kenneth; Bockelee-Morvan, Dominique; Debout, Vincent; Erard, Stephane; Leyrat, Cedric; Fink, Uwe; Rubin, Martin; Altwegg, Kathrin; Tzou, Chia-Yu; Le Roy, Lena; Calmonte, Ursina; Berthelier, Jean-Jacques; Reme, Henri; Hassig, Myrtha; Fuselier, Stephen; Fiethe, Bjorn; De Keyser, Johan

2015-11-01

The recent images of the inner coma of 67P/Churyumov-Gerasimenko (CG) made by the infrared channel of the VIRTIS-M instrument on board the Rosetta spacecraft show the gas distribution as it expands in the coma (Migliorini et al. 2015, DPS abstract).Since VIRTIS is a remote sensing instrument, a proper modeling of these observations requires the computation of the full coma of comet CG, which necessitates the use of a kinetic approach due to the rather low gas densities. Hence, we apply a Direct Simulation Monde Carlo (DSMC) method to solve the Boltzmann equation and describe CG’s coma from the nucleus surface up to a few hundreds of kilometers. The model uses the SHAP5 nucleus shape model from the OSIRIS team. The gas flux distribution takes into account solar illumination, including self-shadowing. The local activity at the surface of the nucleus is given by spherical harmonics expansion reproducing best the ROSINA-DFMS data. The densities from the DSMC model outputs are then integrated along the line-of-sight to create synthetic images that are directly comparable with the VIRTIS-M column density measurements.The good agreement between the observations and the model illustrates our continuously improving understanding of the physics of the coma of comet CG.AcknowledgementsWork at UofM was supported by contracts JPL#1266313, JPL#1266314 and NASA grant NNX09AB59G. Work at UoB was funded by the State of Bern, the Swiss National Science Foundation and by the European Space Agency PRODEX Program. Work at Southwest Research institute was supported by subcontract #1496541 from the JPL. Work at BIRA-IASB was supported by the Belgian Science Policy Office via PRODEX/ROSINA PEA 90020. The authors would like to thank ASI, CNES, DLR, NASA for supporting this research. VIRTIS was built by a consortium formed by Italy, France and Germany, under the scientific responsibility of the IAPS of INAF, which guides also the scientific operations. The consortium includes also the

Japan.

PubMed

1989-02-01

Japan consists of 3900 islands and lies off the east coast of Asia. Even though Japan is one of the most densely populated nations in the world, its growth rate has stabilized at .5%. 94% of all children go to senior high school and almost 90% finish. Responsibility for the sick, aged, and infirmed is changing from the family and private sector to government. Japan was founded in 600 BC and its 1st capital was in Nara (710-1867). The Portuguese, the 1st Westerners to make contact with Japan in 1542, opened trade which lasted until the mid 17th century. US Navy Commodore Matthew Perry forced Japan to reopen in 1854. Following wars with China and Russia in the late 1800s and early 1900s respectively, Japan took part in World Wars I and II. In between these wars Japan invaded Manchuria and China. The US dropped an atomic bomb on Hiroshima and Nagasaki and the Japanese surrendered in September, 1945 ending World War II (WWII). Following, WWII, the Allied Powers guided Japan's establishment as a nonthreatening nation and a democratic parliamentary government (a constitutional monarchy) with a limited defense force. Japan remains one of the most politically stable of all postwar democracies. The Liberal Democratic Party's Noboru Takeshita became prime minister in 1987. Japan has limited natural resources and only 19% of the land is arable. Japanese ingenuity and skill combine to produce one of the highest per hectare crop yields in the world. Japan is a major economic power, and its and the US economies are becoming more interdependent. Its exports, making up only 13% of the gross national product, mainly go to Canada and the US. Many in the US are concerned, however, with the trade deficit with Japan and are seeking ways to make trade more equitable. Japan wishes to maintain good relations with its Asian neighbors and other nations. The US and Japan enjoy a strong, productive relationship.

Intubation is not a marker for coma after in-hospital cardiac arrest: A retrospective study.

PubMed

Berg, Katherine M; Grossestreuer, Anne V; Uber, Amy; Patel, Parth V; Donnino, Michael W

2017-10-01

In-hospital cardiac arrest (IHCA) strikes over 200,000 people in the United States annually. Targeted temperature management (TTM) is considered beneficial in other settings, but there is no prospective data for IHCA. Recent work on TTM and IHCA found an association between TTM and worse outcome. However, the authors used intubation as a marker for coma to determine eligibility for TTM. The validity of this approach is unexplored. Retrospective, single center study of adult patients with IHCA occurring in an intensive care unit, intubated prior to or during the event, or immediately after ROSC. We evaluated the percentage of patients documented as comatose after arrest, defined as Glasgow Comas Score (GCS) <8 for the primary analysis. We also evaluated the difference in hospital survival in patients with GCS <8 versus ≥8. Two sensitivity analyses using different methods for defining coma using post-ROSC GCS were conducted. 29/102 (28%) intubated patients had a post-ROSC GCS≥8, and 22 (22%) were documented as following commands. Survival in patients with GCS≥8 vs.<8 was 62% (18/29) vs. 37% (27/73) in unadjusted analysis (p=0.02). The adjusted odds ratio for survival to hospital discharge was 3.81 (95%CI: 1.37-10.61, p=0.01). Results were similar in both sensitivity analyses. Intubation prior to or during IHCA was not a valid marker of coma after ROSC. Post-ROSC mental status was associated with hospital survival, and thus could be an important confounder when conducting observational studies on the association of TTM with outcomes in this patient population. Copyright © 2017 Elsevier B.V. All rights reserved.

[Spanish versions of the Simplified Motor Score and the Glasgow Coma Scale in out-of-hospital treatment of head injury in adults: a preliminary study of each scale's ability to predict adverse events].

PubMed

Roca, Guillem; Mayol, Sergi; García, Esteban; Casajuana, Edgar; Quintana, Salvador

2015-06-01

To determine the ability of the modified (Spanish) version of the Simplified Motor Score (mSMS) to predict adverse events during hospitalization and to compare its predictive ability to that of the Glasgow Coma Scale (GCS) in adults with head injuries treated outside the hospital. Observational study of retrospective cohorts including all patients over the age of 14 years attended for head injuries occurring within 24 hours of treatment by an advanced life-support unit staffed by nurses between May 1, 2013, and May 1, 2014. The mSMS was a translation of the English original, created through a process of discussions of direct and back translations to arrive at consensus. Out-of-hospital patient records were searched to find GCS and mSMS scores. To predict the ability of each scale to predict brain injuries, neurosurgery, intubation, and/or inhospital death, we calculated the area under the receiving operator characteristic curves (AUCs). Of the total of 115 head-injury patients attended, 64 met the inclusion criteria. The mean (SD) age was 47 (24) years. Twelve (18.8%) patients developed some form of adverse event during hospitalization; 91.6% had brain damage, 58.3% required intubation, 8.3% required surgery, and 41.6% died. The AUC for the GCS was 0.907 (95% CI, 0.81-1.00; P<.001); the AUC for the mSMS was 0.796 (95% CI, 0.64-0.95; P=.001). Although the ability of the mSMS to predict in-hospital adverse outcomes is good, it is inferior to the GCS in adults with head injuries attended outside the hospital.

Heart failure presenting as myxedema coma: case report and review article.

PubMed

Chaudhari, Dhara; Gangadharan, Venkat; Forrest, Terry

2013-05-01

Hypothyroidism is a common medical problem easily treated when diagnosed but requiring regular follow-up and patient medication compliance. At times, this diagnosis can go untreated resulting in the development of severe consequences such as Myxedema Coma. Of all the clinical symptoms, cardiovascular manifestations tend to be especially severe and often life threatening.

Heart failure presenting as myxedema coma: case report and review article.

PubMed

Chaudhari, Dhara; Gangadharan, Venkat; Forrest, Terry

2014-02-01

Hypothyroidism is a common medical problem easily treated when diagnosed but requiring regular follow-up and patient medication compliance. At times, this diagnosis can go untreated resulting in the development of severe consequences such as Myxedema Coma. Of all the clinical symptoms, cardiovascular manifestations tend to be especially severe and often life threatening.

MAPPING THE RELEASE OF VOLATILES IN THE INNER COMAE OF COMETS C/2012 F6 (LEMMON) AND C/2012 S1 (ISON) USING THE ATACAMA LARGE MILLIMETER/SUBMILLIMETER ARRAY

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cordiner, M. A.; Milam, S. N.; Mumma, M. J.

2014-09-01

Results are presented from the first cometary observations using the Atacama Large Millimeter/Submillimeter Array (ALMA), including measurements of the spatially resolved distributions of HCN, HNC, H{sub 2}CO, and dust within the comae of two comets: C/2012 F6 (Lemmon) and C/2012 S1 (ISON), observed at heliocentric distances of 1.5 AU and 0.54 AU, respectively. These observations (with angular resolution ≈0.''5), reveal an unprecedented level of detail in the distributions of these fundamental cometary molecules, and demonstrate the power of ALMA for quantitative measurements of the distributions of molecules and dust in the inner comae of typical bright comets. In both comets, HCN ismore » found to originate from (or within a few hundred kilometers of) the nucleus, with a spatial distribution largely consistent with spherically symmetric, uniform outflow. By contrast, the HNC distributions are clumpy and asymmetrical, with peaks at cometocentric radii ∼500-1000 km, consistent with release of HNC in collimated outflow(s). Compared to HCN, the H{sub 2}CO distribution in comet Lemmon is very extended. The interferometric visibility amplitudes are consistent with coma production of H{sub 2}CO and HNC from unidentified precursor material(s) in both comets. Adopting a Haser model, the H{sub 2}CO parent scale length is found to be a few thousand kilometers in Lemmon and only a few hundred kilometers in ISON, consistent with the destruction of the precursor by photolysis or thermal degradation at a rate that scales in proportion to the solar radiation flux.« less

Isothermality of the gas in the Coma cluster

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hughes, J.P.; Yamashita, K.; Okumura, Y.

1988-04-01

The high-quality X-ray spectrum of the Coma cluster observed by the Japanese satelite Tenma in conjunction with imaging data from the Einstein Observatory was used to explore the temperature distribution of the cluster gas. It is found that pure polytropic models are inadequate to describe this temperature distribution. Instead, a hybrid model is proposed consisting of a central isothermal region surrounded by a polytropic distribution. It is shown that as much as 75 percent of the global emission may come from the isothermal component. 30 references.

Factors predisposing to coma and delirium: fentanyl and midazolam exposure; CYP3A5, ABCB1, and ABCG2 genetic polymorphisms; and inflammatory factors.

PubMed

Skrobik, Yoanna; Leger, Caroline; Cossette, Mariève; Michaud, Veronique; Turgeon, Jacques

2013-04-01

Delirium and sedative-induced coma are described as incremental manifestations of cerebral dysfunction. Both may be associated with sedative or opiate doses and pharmacokinetic or pharmacogenetic variables, such as drug plasma levels (exposure), drug metabolism, and/or their transport across the blood-brain barrier. To compare biological and drug treatment characteristics in patients with coma and/or delirium while in the ICU. In 99 patients receiving IV fentanyl, midazolam, or both, we evaluated drug doses, covariates likely to influence drug effects (age, body mass index, and renal and hepatic dysfunction); delirium risk factors; concomitant administration of CYP3A and P-glycoprotein substrates/inhibitors; ABCB1, ABCG2, and CYP3A5 genetic polymorphisms; and fentanyl and midazolam plasma levels. Delirium and coma were evaluated daily. In patients with only coma (n=15), only delirium (n=7), and neither ever (n=14), we measured plasma levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-1RA, IL-6, IL-8, IL-10, IL-17,macrophage inflammatory protein-1β, and monocyte chemotactic protein-1. Time to first coma was associated with fentanyl and midazolam doses (p=0.03 and p=0.01, respectively). The number of days in coma was associated with the number of days of coadministration of CYP3A inhibitors (r=0.30; p=0.006). Plasma levels of fentanyl were higher in patients with clinical coma (3.7±4.7 vs. 2.0±1.8 ng/mL, p=0.0001) as were midazolam plasma levels (1050±2232 vs. 168±249 ng/mL, p=0.0001). Delirium occurrence was unrelated to midazolam administration, cumulative doses, or serum levels. Days with delirium were associated with days of coadministration of P-glycoprotein inhibitor (r=0.35; p=0.0004). Delirious patients had higher levels of the inflammatory mediator IL-6 than comatose patients (129.3 vs. 35.0 pg/mL, p=0.05). Coma is associated with fentanyl and midazolam exposure; delirium is unrelated to midazolam and may be linked to inflammatory status

How does information influence hope in family members of traumatic coma patients in intensive care unit?

PubMed

Verhaeghe, Sofie T L; van Zuuren, Florence J; Defloor, Tom; Duijnstee, Mia S H; Grypdonck, Mieke H F

2007-08-01

To assess the interplay between hope and the information provided by health care professionals. Earlier research learned that hope is crucial for relatives of traumatic coma patients. Also it has been reported that the need for information is extremely important for relatives of critically ill patients. A qualitative approach according to the 'grounded theory' method with constant comparison was used. We held 24 in-depth interviews with 22 family members of 16 patients with traumatic coma. Data processing and data analysis took place in a cyclic process wherein the induction of themes was alternated by confrontation with new material. Family members of traumatic coma patients want information that is as accurate as possible, provided by doctors and nurses in an understandable manner and leaving room for hope. At first, family members can do no more than passively absorb the information they receive. After some time, they actively start working with information and learn what to build their hope on. In this way, concrete hope evolves and seems to be strongly determined by information. Information that is more positive than warranted is not appreciated at all. It leads to false hope and once its real nature becomes apparent, to increased distress and loss of trust in the professionals. The process of hope is crucial in coping with traumatic coma and information can facilitate this process. If professionals, especially nurses, keep the process in mind that family members go through in handling information, they can not only facilitate this process but also help them to establish realistic hope.

A NuSTAR observation of the center of the Coma Cluster

DOE PAGES

Gastaldello, Fabio; Wik, Daniel R.; Molendi, S.; ...

2015-02-20

We present the results of a 55 ks NuSTAR observation of the core of the Coma Cluster. The global spectrum can be explained by thermal gas emission, with a conservative 90% upper limit to non-thermal inverse Compton (IC) emission of 5.1 × 10 –12 erg cm –2 s –1 in a 12' × 12' field of view. The brightness of the thermal component in this central region does not allow more stringent upper limits on the IC component when compared with non-imaging instruments with much larger fields of view where claims of detections have been made. Future mosaic NuSTAR observationsmore » of Coma will further address this issue. In addition, the temperature map shows a relatively uniform temperature distribution with a gradient from the hot northwest side to the cooler southeast, in agreement with previous measurements. The temperature determination is robust given the flat effective area and low background in the 3-20 keV band, making NuSTAR an ideal instrument to measure high temperatures in the intracluster medium.« less

Spectroscopic studies of the molecular parentage of radical species in cometary comae

NASA Astrophysics Data System (ADS)

Lewis, Benjamin; Pierce, Donna; Cochran, Anita

2015-11-01

We have observed several comets using an integral-field unit spectrograph (the George and Cynthia Mitchell Spectrograph) on the 2.7m Harlan J. Smith telescope at McDonald Observatory. Full-coma spectroscopic images were obtained for various radical species (C2, C3, CH, CN, NH2). By constructing azimuthal average profiles from the full-coma spectroscopic images we can test Haser model parameters with our observations. The Haser model was used to determine production rates and possible parent lifetimes that would be consistent with the model. By iterating through a large range of possible parents lifetimes, we can see what range of values in which the Haser model is consistent with observations. Also, this type of analysis gives us perspective on how sensitive the model's fit quality is to changes in parent lifetimes. Here, we present the work completed to date, and we compare our results to other comet taxonomic surveys.

Brain MRS glutamine as a biomarker to guide therapy of hyperammonemic coma.

PubMed

O'Donnell-Luria, Anne H; Lin, Alexander P; Merugumala, Sai K; Rohr, Frances; Waisbren, Susan E; Lynch, Rebecca; Tchekmedyian, Vatche; Goldberg, Aaron D; Bellinger, Andrew; McFaline-Figueroa, J Ricardo; Simon, Tracey; Gershanik, Esteban F; Levy, Bruce D; Cohen, David E; Samuels, Martin A; Berry, Gerard T; Frank, Natasha Y

2017-05-01

Acute idiopathic hyperammonemia in an adult patient is a life-threatening condition often resulting in a rapid progression to irreversible cerebral edema and death. While ammonia-scavenging therapies lower blood ammonia levels, in comparison, clearance of waste nitrogen from the brain may be delayed. Therefore, we used magnetic resonance spectroscopy (MRS) to monitor cerebral glutamine levels, the major reservoir of ammonia, in a gastric bypass patient with hyperammonemic coma undergoing therapy with N-carbamoyl glutamate and the ammonia-scavenging agents, sodium phenylacetate and sodium benzoate. Improvement in mental status mirrored brain glutamine levels, as coma persisted for 48h after plasma ammonia normalized. We hypothesize that the slower clearance for brain glutamine levels accounts for the delay in improvement following initiation of treatment in cases of chronic hyperammonemia. We propose MRS to monitor brain glutamine as a noninvasive approach to be utilized for diagnostic and therapeutic monitoring purposes in adult patients presenting with idiopathic hyperammonemia. Copyright © 2017 Elsevier Inc. All rights reserved.

Testing chameleon gravity with the Coma cluster

DOE Office of Scientific and Technical Information (OSTI.GOV)

Terukina, Ayumu; Yamamoto, Kazuhiro; Lombriser, Lucas

2014-04-01

We propose a novel method to test the gravitational interactions in the outskirts of galaxy clusters. When gravity is modified, this is typically accompanied by the introduction of an additional scalar degree of freedom, which mediates an attractive fifth force. The presence of an extra gravitational coupling, however, is tightly constrained by local measurements. In chameleon modifications of gravity, local tests can be evaded by employing a screening mechanism that suppresses the fifth force in dense environments. While the chameleon field may be screened in the interior of the cluster, its outer region can still be affected by the extramore » force, introducing a deviation between the hydrostatic and lensing mass of the cluster. Thus, the chameleon modification can be tested by combining the gas and lensing measurements of the cluster. We demonstrate the operability of our method with the Coma cluster, for which both a lensing measurement and gas observations from the X-ray surface brightness, the X-ray temperature, and the Sunyaev-Zel'dovich effect are available. Using the joint observational data set, we perform a Markov chain Monte Carlo analysis of the parameter space describing the different profiles in both the Newtonian and chameleon scenarios. We report competitive constraints on the chameleon field amplitude and its coupling strength to matter. In the case of f(R) gravity, corresponding to a specific choice of the coupling, we find an upper bound on the background field amplitude of |f{sub R0}| < 6 × 10{sup −5}, which is currently the tightest constraint on cosmological scales.« less

Post-anoxic quantitative MRI changes may predict emergence from coma and functional outcomes at discharge.

PubMed

Reynolds, Alexandra S; Guo, Xiaotao; Matthews, Elizabeth; Brodie, Daniel; Rabbani, Leroy E; Roh, David J; Park, Soojin; Claassen, Jan; Elkind, Mitchell S V; Zhao, Binsheng; Agarwal, Sachin

2017-08-01

Traditional predictors of neurological prognosis after cardiac arrest are unreliable after targeted temperature management. Absence of pupillary reflexes remains a reliable predictor of poor outcome. Diffusion-weighted imaging has emerged as a potential predictor of recovery, and here we compare imaging characteristics to pupillary exam. We identified 69 patients who had MRIs within seven days of arrest and used a semi-automated algorithm to perform quantitative volumetric analysis of apparent diffusion coefficient (ADC) sequences at various thresholds. Area under receiver operating characteristic curves (ROC-AUC) were estimated to compare predictive values of quantitative MRI with pupillary exam at days 3, 5 and 7 post-arrest, for persistence of coma and functional outcomes at discharge. Cerebral Performance Category scores of 3-4 were considered poor outcome. Excluding patients where life support was withdrawn, ≥2.8% diffusion restriction of the entire brain at an ADC of ≤650×10 -6 m 2 /s was 100% specific and 68% sensitive for failure to wake up from coma before discharge. The ROC-AUC of ADC changes at ≤450×10 -6 mm 2 /s and ≤650×10 -6 mm 2 /s were significantly superior in predicting failure to wake up from coma compared to bilateral absence of pupillary reflexes. Among survivors, >0.01% of diffusion restriction of the entire brain at an ADC ≤450×10 -6 m 2 /s was 100% specific and 46% sensitive for poor functional outcome at discharge. The ROC curve predicting poor functional outcome at ADC ≤450×10 -6 mm 2 /s had an AUC of 0.737 (0.574-0.899, p=0.04). Post-anoxic diffusion changes using quantitative brain MRI may aid in predicting persistent coma and poor functional outcomes at hospital discharge. Copyright © 2017 Elsevier B.V. All rights reserved.

Prognostic accuracy of five simple scales in childhood bacterial meningitis.

PubMed

Pelkonen, Tuula; Roine, Irmeli; Monteiro, Lurdes; Cruzeiro, Manuel Leite; Pitkäranta, Anne; Kataja, Matti; Peltola, Heikki

2012-08-01

In childhood acute bacterial meningitis, the level of consciousness, measured with the Glasgow coma scale (GCS) or the Blantyre coma scale (BCS), is the most important predictor of outcome. The Herson-Todd scale (HTS) was developed for Haemophilus influenzae meningitis. Our objective was to identify prognostic factors, to form a simple scale, and to compare the predictive accuracy of these scales. Seven hundred and twenty-three children with bacterial meningitis in Luanda were scored by GCS, BCS, and HTS. The simple Luanda scale (SLS), based on our entire database, comprised domestic electricity, days of illness, convulsions, consciousness, and dyspnoea at presentation. The Bayesian Luanda scale (BLS) added blood glucose concentration. The accuracy of the 5 scales was determined for 491 children without an underlying condition, against the outcomes of death, severe neurological sequelae or death, or a poor outcome (severe neurological sequelae, death, or deafness), at hospital discharge. The highest accuracy was achieved with the BLS, whose area under the curve (AUC) for death was 0.83, for severe neurological sequelae or death was 0.84, and for poor outcome was 0.82. Overall, the AUCs for SLS were ≥0.79, for GCS were ≥0.76, for BCS were ≥0.74, and for HTS were ≥0.68. Adding laboratory parameters to a simple scoring system, such as the SLS, improves the prognostic accuracy only little in bacterial meningitis.

The Japan Medical Association's disaster preparedness: lessons from the Great East Japan Earthquake and Tsunami.

PubMed

Ishii, Masami; Nagata, Takashi

2013-10-01

A complex disaster, the Great East Japan Earthquake of March 11, 2011, consisted of a large-scale earthquake, tsunami, and nuclear accident, resulting in more than 15 000 fatalities, injuries, and missing persons and damage over a 500-km area. The entire Japanese public was profoundly affected by "3/11." The risk of radiation exposure initially delayed the medical response, prolonging the recovery efforts. Japan's representative medical organization, the Japan Medical Association (JMA), began dispatching Japan Medical Association Teams (JMATs) to affected areas beginning March 15, 2011. About 1400 JMATs comprising nearly 5500 health workers were launched. The JMA coordinated JMAT operations and cooperated in conducting postmortem examination, transporting large quantities of medical supplies, and establishing a multiorganizational council to provide health assistance to disaster survivors. Importantly, these response efforts contributed to the complete recovery of the health care system in affected areas within 3 months, and by July 15, 2011, JMATs were withdrawn. Subsequently, JMATs II have been providing long-term continuing medical support to disaster-affected areas. However, Japan is at great risk for future natural disasters because of its Pacific Rim location. Also, its rapidly aging population, uneven distribution of and shortage of medical resources in regional communities, and an overburdened public health insurance system highlight the need for a highly prepared and effective disaster response system.

Food deprivation and prior anoxic coma have opposite effects on the activity of a visual interneuron in the locust.

PubMed

Cross, Kevin P; Britton, Samantha; Mangulins, Rebecca; Money, Tomas G A; Robertson, R Meldrum

2017-04-01

We compared how different metabolic stressors, anoxic coma and food deprivation, affected signaling in neural tissue. We used the locust's Descending Contralateral Movement Detector (DCMD) interneuron because its large axon, high firing frequencies, and rapid conduction velocity make it energetically expensive. We exposed locusts to a 30min anoxic coma or 1day of food deprivation and found contrasting effects on signaling within the axon. After a prior anoxic coma, the DCMD fired fewer high-frequency (>200Hz) action potentials (APs) (Control: 12.4±1.6; Coma: 6.3±0.9) with a reduction in axonal conduction velocity (CV) at all frequencies (∼4-8%) when presented with a standard looming visual stimulus. Prior anoxic coma was also associated with a loss of supernormal conduction by reducing both the number of supernormal APs and the firing frequency with the highest CV. Initially, food deprivation caused a significant increase in the number of low- and high-frequency APs with no differences observed in CV. After controlling for isolation, food deprivation resulted in an increase in high-frequency APs (>200Hz: Control: 17.1±1.7; Food-deprived: 19.9±1.3) and an increase in relative conduction velocity for frequencies >150Hz (∼2%). Action potentials of food-deprived animals had a smaller half-width (Control: 0.45±0.02ms; Food-deprived: 0.40±0.01ms) and decay time (Control: 0.62±0.03ms; Food-deprived: 0.54±0.02ms). Our data indicate that the effects of metabolic stress on neural signaling can be stressor-dependent. Copyright © 2017 Elsevier Ltd. All rights reserved.

Japan’s Nuclear Future: Policy Debate, Prospects, and U.S. Interests

DTIC Science & Technology

2008-05-09

raised in particular over the construction of an industrial- scale reprocessing facility in Japan,. Additionally, fast breeder reactors also produce more...Nuclear Fuel Cycle Engineering Laboratories. 10 A fast breeder reactor is a fast neutron reactor that produces more plutonium than it consumes, which can...Japan Nuclear Fuel Limited (JNFL) has built and is currently running active testing on a large - scale commercial reprocessing plant at Rokkasho-mura

Urologic cancer in Japan: role of Japan at the frontier of issues in Asia.

PubMed

Akaza, Hideyuki

2016-01-01

The characteristics of urological cancer in Japan can be summarized in the following points. (i) As the onset of this type of cancer is typically seen in elderly patients, it is becoming a major social issue in Japan that has already become an aging society. (ii) Many diverse treatment methods are available and a response is required that prioritizes quality of life. (iii) Although vigorous research and development efforts into new drugs are being carried out on a global level, resulting in beneficial medical agents becoming more readily available, unless concepts relating to cost vs. effectiveness are further developed and there is a real risk that medical systems and structures in their current form will become unsustainable. (iv) Although at the current point there are no original large-scale clinical trials being conducted in Asia, Japan has a wealth of experience of participating in many international joint clinical trials and it is therefore an urgent and pressing challenge to organize joint clinical trials in Asia and amass a body of knowledge that is unique to Asia. In view of this current situation and given Japan's position at the frontier of issues, it is important for Japan to take the initiative in Asia in cooperating with other Asian nations in efforts to resolve and overcome various challenges. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The etiology and outcome of non-traumatic coma in critical care: a systematic review.

PubMed

Horsting, Marlene Wb B; Franken, Mira D; Meulenbelt, Jan; van Klei, Wilton A; de Lange, Dylan W

2015-04-29

Non-traumatic coma (NTC) is a serious condition requiring swift medical or surgical decision making upon arrival at the emergency department. Knowledge of the most frequent etiologies of NTC and associated mortality might improve the management of these patients. Here, we present the results of a systematic literature search on the etiologies and prognosis of NTC. Two reviewers independently performed a systematic literature search in the Pubmed, Embase and Cochrane databases with subsequent reference and citation checking. Inclusion criteria were retrospective or prospective observational studies on NTC, which reported on etiologies and prognostic information of patients admitted to the emergency department or intensive care unit. Eventually, 14 studies with enough data on NTC, were selected for this systematic literature review. The most common causes of NTC were stroke (6-54%), post-anoxic coma (3-42%), poisoning (<1-39%) and metabolic causes (1-29%). NTC was also often caused by infections, especially in African studies affecting 10-51% of patients. The NTC mortality rate ranged from 25 to 87% and the mortality rate continued to increase long after the event had occurred. Also, 5-25% of patients remained moderately-severely disabled or in permanent vegetative state. The mortality was highest for stroke (60-95%) and post-anoxic coma (54-89%) and lowest for poisoning (0-39%) and epilepsy (0-10%). NTC represents a challenge to the emergency and the critical care physicians with an important mortality and moderate-severe disability rate. Even though, included studies were very heterogeneous, the most common causes of NTC are stroke, post anoxic, poisoning and various metabolic etiologies. The best outcome is achieved for patients with poisoning and epilepsy, while the worst outcome was seen in patients with stroke and post-anoxic coma. Adequate knowledge of the most common causes of NTC and prioritizing the causes by mortality ensures a swift and adequate work

[Arreflexic coma and MELAS syndrome].

PubMed

Muñoz-Guillén, N; León-López, R; Ferrer-Higueras, M J; Vargas-Vaserot, F J; Dueñas-Jurado, J M

2009-01-01

MELAS is a progressive neurodegenerative and fatal disease characterized by mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes. It is the result of a mitochondrial DNA mutation. Although the incidence of MELAS is currently unknown, it is suspected that approximately 1 out of every 5,000 persons world-wide have some type of defect in mitochondrial DNA. Cardinal clinical features observed in more than 90% of the patients include severe headache that may be associated with stroke-like episodes, seizures and the onset of symptoms before the age of 40 years. Diagnosis is established through genetic test or by with muscle biopsies that reveal the presence of ragged-red fibers. Prognosis is poor, with death at an early age. In this article, we present the clinical case of a 31-year old women diagnosed of MELAS syndrome who was admitted to the Intensive Care Unit of our hospital with arreflexic coma.

Brain Connectivity in Pathological and Pharmacological Coma

PubMed Central

Noirhomme, Quentin; Soddu, Andrea; Lehembre, Rémy; Vanhaudenhuyse, Audrey; Boveroux, Pierre; Boly, Mélanie; Laureys, Steven

2010-01-01

Recent studies in patients with disorders of consciousness (DOC) tend to support the view that awareness is not related to activity in a single brain region but to thalamo-cortical connectivity in the frontoparietal network. Functional neuroimaging studies have shown preserved albeit disconnected low-level cortical activation in response to external stimulation in patients in a “vegetative state” or unresponsive wakefulness syndrome. While activation of these “primary” sensory cortices does not necessarily reflect conscious awareness, activation in higher-order associative cortices in minimally conscious state patients seems to herald some residual perceptual awareness. PET studies have identified a metabolic dysfunction in a widespread frontoparietal “global neuronal workspace” in DOC patients including the midline default mode network (“intrinsic” system) and the lateral frontoparietal cortices or “extrinsic system.” Recent studies have investigated the relation of awareness to the functional connectivity within intrinsic and extrinsic networks, and with the thalami in both pathological and pharmacological coma. In brain damaged patients, connectivity in all default network areas was found to be non-linearly correlated with the degree of clinical consciousness impairment, ranging from healthy controls and locked-in syndrome to minimally conscious, vegetative, coma, and brain dead patients. Anesthesia-induced loss of consciousness was also shown to correlate with a global decrease in cortico-cortical and thalamo-cortical connectivity in both intrinsic and extrinsic networks, but not in auditory, or visual networks. In anesthesia, unconsciousness was also associated with a loss of cross-modal interactions between networks. These results suggest that conscious awareness critically depends on the functional integrity of thalamo-cortical and cortico-cortical frontoparietal connectivity within and between “intrinsic” and “extrinsic” brain

CT-angiography source images indicate less fatal outcome despite coma of patients in the Basilar Artery International Cooperation Study.

PubMed

Pallesen, Lars P; Khomenko, Andrei; Dzialowski, Imanuel; Barlinn, Jessica; Barlinn, Kristian; Zerna, Charlotte; van der Hoeven, Erik Jrj; Algra, Ale; Kapelle, L Jaap; Michel, Patrik; Bodechtel, Ulf; Demchuk, Andrew M; Schonewille, Wouter; Puetz, Volker

2017-02-01

Background Coma is associated with poor outcome in patients with basilar artery occlusion. Aims We sought to assess whether the posterior circulation Acute Stroke Prognosis Early CT Score and the Pons-Midbrain Index applied to CT angiography source images predict the outcome of comatose patients in the Basilar Artery International Cooperation Study. Methods Basilar Artery International Cooperation Study was a prospective, observational registry of patients with acute basilar artery occlusion with 48 recruiting centers worldwide. We applied posterior circulation Acute Stroke Prognosis Early CT Score and Pons-Midbrain Index to CT angiography source images of Basilar Artery International Cooperation Study patients who presented with coma. We calculated adjusted risk ratios to assess the association of dichotomized posterior circulation Acute Stroke Prognosis Early CT Score (≥8 vs. <8) and Pons-Midbrain Index (<3 vs. ≥3) with mortality and favourable outcome (modified Rankin Scale score 0-3) at one month. Results Of 619 patients in the Basilar Artery International Cooperation Study registry, CT angiography source images were available for review in 158 patients. Among these, 78 patients (49%) presented with coma. Compared to non-comatose patients, comatose patients were more likely to die (risk ratios 2.34; CI 95% 1.56-3.52) and less likely to have a favourable outcome (risk ratios 0.44; CI 95% 0.24-0.80). Among comatose patients, a Pons-Midbrain Index < 3 was related to reduced mortality (adjusted RR 0.66; 95% CI 0.46-0.96), but not to favourable outcome (adjusted RR 1.19; 95% CI 0.39-3.62). Posterior circulation Acute Stroke Prognosis Early CT Score dichotomized at ≥ 8 vs. <8 was not significantly associated with death (adjusted RR 0.70; 95% CI 0.46-1.05). Conclusion In comatose patients with basilar artery occlusion, the extent of brainstem ischemia appears to be related to mortality but not to favourable outcome.

Modeling Cometary Coma with a Three Dimensional, Anisotropic Multiple Scattering Distributed Processing Code

NASA Technical Reports Server (NTRS)

Luchini, Chris B.

1997-01-01

Development of camera and instrument simulations for space exploration requires the development of scientifically accurate models of the objects to be studied. Several planned cometary missions have prompted the development of a three dimensional, multi-spectral, anisotropic multiple scattering model of cometary coma.

VizieR Online Data Catalog: Subaru-UDGs in the Coma cluster (Yagi+, 2016)

NASA Astrophysics Data System (ADS)

Yagi, M.; Koda, J.; Komiyama, Y.; Yamanoi, H.

2016-10-01

We retrieved a wide W-C-RC band (R-band) survey of the Coma cluster of Suprime-Cam from the Subaru public archive (SMOKA; Baba et al. 2002ASPC..281..298B) between 2011 Mar 02 and 2011 Apr 01. (1 data file).

EEG dynamical correlates of focal and diffuse causes of coma.

PubMed

Kafashan, MohammadMehdi; Ryu, Shoko; Hargis, Mitchell J; Laurido-Soto, Osvaldo; Roberts, Debra E; Thontakudi, Akshay; Eisenman, Lawrence; Kummer, Terrance T; Ching, ShiNung

2017-11-15

Rapidly determining the causes of a depressed level of consciousness (DLOC) including coma is a common clinical challenge. Quantitative analysis of the electroencephalogram (EEG) has the potential to improve DLOC assessment by providing readily deployable, temporally detailed characterization of brain activity in such patients. While used commonly for seizure detection, EEG-based assessment of DLOC etiology is less well-established. As a first step towards etiological diagnosis, we sought to distinguish focal and diffuse causes of DLOC through assessment of temporal dynamics within EEG signals. We retrospectively analyzed EEG recordings from 40 patients with DLOC with consensus focal or diffuse culprit pathology. For each recording, we performed a suite of time-series analyses, then used a statistical framework to identify which analyses (features) could be used to distinguish between focal and diffuse cases. Using cross-validation approaches, we identified several spectral and non-spectral EEG features that were significantly different between DLOC patients with focal vs. diffuse etiologies, enabling EEG-based classification with an accuracy of 76%. Our findings suggest that DLOC due to focal vs. diffuse injuries differ along several electrophysiological parameters. These results may form the basis of future classification strategies for DLOC and coma that are more etiologically-specific and therefore therapeutically-relevant.

Evidence of Absence of Tidal Features in the Outskirts of Ultra Diffuse Galaxies in the Coma Cluster

NASA Astrophysics Data System (ADS)

Mowla, Lamiya; van Dokkum, Pieter; Merritt, Allison; Abraham, Roberto; Yagi, Masafumi; Koda, Jin

2017-12-01

We study the presence of tidal features associated with ultra diffuse galaxies (UDGs) in galaxy clusters. Specifically, we stack deep Subaru images of UDGs in the Coma cluster to determine whether they show position angle twists at large radii. Selecting galaxies with central surface brightness μ (g,0)> 24 magarcsec-2 and projected half-light radius {r}e> 1.5 {kpc}, we identify 287 UDGs in the Yagi et al. catalog of low surface brightness Coma objects. The UDGs have apparent spheroidal shapes with median Sérsic index < n> =0.8 and median axis ratio < b/a> =0.7. The images are processed by masking all background objects and rotating to align the major axis before stacking them in bins of properties such as axis ratio, angle of major axis with respect to the cluster center, and separation from cluster center. Our image stacks reach further than 7 kpc (≳4r e). Analysis of the isophotes of the stacks reveals that the ellipticity remains constant up to the last measured point, which means that the individual galaxies have a non-varying position angle and axis ratio and show no evidence for tidal disruption out to ˜ 4{r}e. We demonstrate this explicitly by comparing our stacks with stacks of model UDGs with and without tidal features in their outskirts. We infer that the average tidal radius of the Coma UDGs is >7 kpc and estimate that the average dark matter fraction within the tidal radius of the UDGs inhabiting the innermost 0.5 Mpc of Coma is >99%.

Hyperammonemic coma after craniotomy: Hepatic encephalopathy from upper gastrointestinal hemorrhage or valproate side effect?: Case report and literature review.

PubMed

Guo, Xiaopeng; Wei, Junji; Gao, Lu; Xing, Bing; Xu, Zhiqin

2017-04-01

Postoperative coma is not uncommon in patients after craniotomy. It generally presents as mental state changes and is usually caused by intracranial hematoma, brain edema, or swelling. Hyperammonemia can also result in postoperative coma; however, it is rarely recognized as a potential cause in coma patients. Hyperammonemic coma is determined through a complicated differential diagnosis, and although it can also be induced as a side effect of valproate (VPA), this cause is frequently unrecognized or confused with upper gastrointestinal hemorrhage (UGH)-induced hepatic encephalopathy. We herein present a case of valproate-induced hyperammonemic encephalopathy (VHE) to illustrate the rarity of such cases and emphasize the importance of correct diagnosis and proper treatment. A 61-year-old woman with meningioma was admitted into our hospital. Radical resection of the tumor was performed, and the patient recovered well as expected. After administration of valproate for 7 days, the patient was suddenly found in a deep coma, and her mental state deteriorated rapidly. The diagnoses of hepatic encephalopathy was confirmed. However, whether it origins from upper gastrointestinal hemorrhage or valproate side effect is uncertain. The patient's condition fluctuated without improvement during the subsequent 3 days under the treatment of reducing ammonia. With the discontinuation of valproate treatment, the patient regained complete consciousness within 48 hours, and her blood ammonia decreased to the normal range within 4 days. VHE is a rare but serious complication in patients after craniotomy and is diagnosed by mental state changes and elevated blood ammonia. Thus, the regular perioperative administration of VPA, which is frequently neglected as a cause of VHE, should be emphasized. In addition, excluding UGH prior to providing a diagnosis and immediately discontinuing VPA administration are recommended.

Inclusion of Highest Glasgow Coma Scale Motor Component Score in Mortality Risk Adjustment for Benchmarking of Trauma Center Performance.

PubMed

Gomez, David; Byrne, James P; Alali, Aziz S; Xiong, Wei; Hoeft, Chris; Neal, Melanie; Subacius, Harris; Nathens, Avery B

2017-12-01

The Glasgow Coma Scale (GCS) is the most widely used measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor component (mGCS) score is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS score in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including the highest mGCS score on the performance of risk-adjustment models and subsequent external benchmarking results. Data were derived from the Trauma Quality Improvement Program analytic dataset (January 2014 through March 2015) and were limited to the severe TBI cohort (16 years or older, isolated head injury, GCS ≤8). Risk-adjustment models were created that varied in the mGCS covariates only (initial score, highest score, or both initial and highest mGCS scores). Model performance and fit, as well as external benchmarking results, were compared. There were 6,553 patients with severe TBI across 231 trauma centers included. Initial and highest mGCS scores were different in 47% of patients (n = 3,097). Model performance and fit improved when both initial and highest mGCS scores were included, as evidenced by improved C-statistic, Akaike Information Criterion, and adjusted R-squared values. Three-quarters of centers changed their adjusted odds ratio decile, 2.6% of centers changed outlier status, and 45% of centers exhibited a ≥0.5-SD change in the odds ratio of death after including highest mGCS score in the model. This study supports the concept that additional clinical information has the potential to not only improve the performance of current risk-adjustment models, but can also have a meaningful impact on external benchmarking strategies. Highest mGCS score is a good potential candidate for inclusion in additional models. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Canadian CT head rule and New Orleans Criteria in mild traumatic brain injury: comparison at a tertiary referral hospital in Japan.

PubMed

Mata-Mbemba, Daddy; Mugikura, Shunji; Nakagawa, Atsuhiro; Murata, Takaki; Kato, Yumiko; Tatewaki, Yasuko; Takase, Kei; Kushimoto, Shigeki; Tominaga, Teiji; Takahashi, Shoki

2016-01-01

We compared Canadian computed tomography (CT) head rule (CCHR) and New Orleans Criteria (NOC) in predicting important CT findings in patients with mild traumatic brain injury (TBI). We included 142 consecutive patients with mild TBI [Glasgow coma scale (GCS) 13-15] who showed at least one of the risk factors stated in the CCHR or the NOC. We introduced two scores: a Canadian from the CCHR and a New Orleans from the NOC. A patient's score represented a sum of the number of positive items. We examined the relationship between scores or items and the presence of important CT findings. Only the Canadian was significantly associated with important CT findings in multivariate analyses and showed higher area under the receiver operating characteristic curve (AUC) either in all 142 patients (GCS 13-15: P = 0.0130; AUC = 0.69) or in the 67 with a GCS = 15 (P = 0.0128, AUC = 0.73). Of items, ">60 years" or "≥65 years" included in either guideline was the strongest predictor of important CT finding, followed by "GCS < 15 after 2 h" included only in the CCHR. In a tertiary referral hospital in Japan, CCHR had higher performance than the NOC in predicting important CT findings.

Hematin and propranolol in acute intermittent porphyria. Full recovery from quadriplegic coma and respiratory failure.

PubMed

Brezis, M; Ghanem, J; Weiler-Ravell, D; Epstein, O; Morris, D

1979-01-01

The authors present a case of acute intermittent porphyria (AIP) in an almost fatal relapse with quadriplegia, bulbar paralysis and coma. Intravenous hematin produced an immediate arousal from coma and allowed a gradual resumption of bulbar and autonomic functions. Persistent tachycardia and hypertension necessitated huge doses of intravenous propranolol. Both hematin and propranolol administrations were followed by a remarkable decrease in urinary amino-levulinic acid and porphobilinogen excretion. Nevertheless, after the acute stage, the patient was left with a severe generalized muscle wasting. After 7 months of intensive physical therapy, complete recovery of all neuromuscular functions was achieved. The modern aspects of the management of AIP are presented; the efficacy and the limits of hematin and propranolol therapy are discussed.

A NuSTAR OBSERVATION OF THE CENTER OF THE COMA CLUSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gastaldello, Fabio; Molendi, S.; Wik, Daniel R.

2015-02-20

We present the results of a 55 ks NuSTAR observation of the core of the Coma Cluster. The global spectrum can be explained by thermal gas emission, with a conservative 90% upper limit to non-thermal inverse Compton (IC) emission of 5.1 × 10{sup –12} erg cm{sup –2} s{sup –1} in a 12' × 12' field of view. The brightness of the thermal component in this central region does not allow more stringent upper limits on the IC component when compared with non-imaging instruments with much larger fields of view where claims of detections have been made. Future mosaic NuSTAR observations ofmore » Coma will further address this issue. The temperature map shows a relatively uniform temperature distribution with a gradient from the hot northwest side to the cooler southeast, in agreement with previous measurements. The temperature determination is robust given the flat effective area and low background in the 3-20 keV band, making NuSTAR an ideal instrument to measure high temperatures in the intracluster medium.« less

Radio-Observaciones del OH EN la Coma del Cometa Halley Desde EL Hemisferio Sur

NASA Astrophysics Data System (ADS)

Silva, A. M.; Bajaja, E.; Morras, R.; Cersosimo, J. C.; Martin, M. C.; Arnal, E. M.; Poppel, W. G. L.; Colomb, F. R.; Mazzaro, J.; Olalde, J. C.; Boriakoff, V.; Mirabel, I. F.

1987-05-01

Se utilizó una antena de 30 metros del Instituto Argentino de Radioastronomía para observaciones diarias Cf ebrero a abril de 1986) de la transición en 1667 MHz ( λ = 18 cm) del OH en la coma del cometa Halley. De las observaciones realizadas se concluye: 1) El número promedio de moléculas de OH en la coma durante 37 días de observación fue de (8.9±3.5)x1034 moléculas, lo que implica una tasa de producción promedio de OH de 1.8x1029 moléculas seg-1 y consecuentemente una pérdida de masa promedio de 17±6 toneladas seg-1 . Este valor está de acuerdo con las mediciones realizadas por las sondas Vega y Giotto. 2) El monitoreo desde el lAR revela la existencia de variaciones bruscas en los flujos de absorción del OH. Estas variaciones son consistentes con los modelos que representan la producción gaseosa a partir de ejecciones y/o desprendimientos discretos de materia congelada del núcleo. 3) Las variaciones en la densidad de flujo son consistentes con las estimaciones de los tiem- pos de vida medios del H2O y del OH en presencia del campo de radiación solar. 4) Se encuentra una correlación entre la intensidad del flujo absorbido y anisotropías en Ia dinamica de la coma.

Usefulness of the abbreviated injury score and the injury severity score in comparison to the Glasgow Coma Scale in predicting outcome after traumatic brain injury.

PubMed

Foreman, Brandon P; Caesar, R Ruth; Parks, Jennifer; Madden, Christopher; Gentilello, Larry M; Shafi, Shahid; Carlile, Mary C; Harper, Caryn R; Diaz-Arrastia, Ramon R

2007-04-01

Assessment of injury severity is important in the management of patients with brain trauma. We aimed to analyze the usefulness of the head abbreviated injury score (AIS), the injury severity score (ISS), and the Glasgow Coma Scale (GCS) as measures of injury severity and predictors of outcome after traumatic brain injury (TBI). Data were prospectively collected from 410 patients with TBI. AIS, ISS, and GCS were recorded at admission. Subjects' outcomes after TBI were measured using the Glasgow Outcome Scale (GOS-E) at 12 months postinjury. Uni- and multivariate analyses were performed. Outcome information was obtained from 270 patients (66%). ISS was the best predictor of GOS-E (rs = -0.341, p < 0.001), followed by GCS score (rs = 0.227, p < 0.001), and head AIS (rs = -0.222, p < 0.001). When considered in combination, GCS score and ISS modestly improved the correlation with GOS-E (R = 0.335, p < 0.001). The combination of GCS score and head AIS had a similar effect (R = 0.275, p < 0.001). Correlations were stronger from patients 8). GCS score, AIS, and ISS are weakly correlated with 12-month outcome. However, anatomic measures modestly outperform GCS as predictors of GOS-E. The combination of GCS and AIS/ISS correlate with outcome better than do any of the three measures alone. Results support the addition of anatomic measures such as AIS and ISS in clinical studies of TBI. Additionally, most of the variance in outcome is not accounted for by currently available measures of injury severity.

GLOBULAR CLUSTERS AND SPUR CLUSTERS IN NGC 4921, THE BRIGHTEST SPIRAL GALAXY IN THE COMA CLUSTER

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Myung Gyoon; Jang, In Sung, E-mail: mglee@astro.snu.ac.kr, E-mail: isjang@astro.snu.ac.kr

2016-03-01

We resolve a significant fraction of globular clusters (GCs) in NGC 4921, the brightest spiral galaxy in the Coma cluster. We also find a number of extended bright star clusters (star complexes) in the spur region of the arms. The latter are much brighter and bluer than those in the normal star-forming region, being as massive as 3 × 10{sup 5} M{sub ⊙}. The color distribution of the GCs in this galaxy is found to be bimodal. The turnover magnitudes of the luminosity functions of the blue (metal-poor) GCs (0.70 < (V − I) ≤ 1.05) in the halo are estimated V(max) = 27.11 ± 0.09 mag and I(max) = 26.21 ± 0.11 mag.more » We obtain similar values for NGC 4923, a companion S0 galaxy, and two Coma cD galaxies (NGC 4874 and NGC 4889). The mean value for the turnover magnitudes of these four galaxies is I(max) = 26.25 ± 0.03 mag. Adopting M{sub I} (max) = −8.56 ± 0.09 mag for the metal-poor GCs, we determine the mean distance to the four Coma galaxies to be 91 ± 4 Mpc. Combining this with the Coma radial velocity, we derive a value of the Hubble constant, H{sub 0} = 77.9 ± 3.6 km s{sup −1} Mpc{sup −1}. We estimate the GC specific frequency of NGC 4921 to be S{sub N} = 1.29 ± 0.25, close to the values for early-type galaxies. This indicates that NGC 4921 is in the transition phase to S0s.« less

Aerobraking strategies for the sample of comet coma earth return mission

NASA Astrophysics Data System (ADS)

Abe, Takashi; Kawaguchi, Jun'ichiro; Uesugi, Kuninori; Yen, Chen-Wan L.

The results of a study to the validate the applicability of the aerobraking concept to the SOCCER (sample of comet coma earth return) mission using a six-DOF computer simulation of the aerobraking process are presented. The SOCCER spacecraft and the aerobraking scenario and power supply problem are briefly described. Results are presented for the spin effect, payload exposure problem, and sun angle effect.

Aerobraking strategies for the sample of comet coma earth return mission

NASA Technical Reports Server (NTRS)

Abe, Takashi; Kawaguchi, Jun'ichiro; Uesugi, Kuninori; Yen, Chen-Wan L.

1990-01-01

The results of a study to the validate the applicability of the aerobraking concept to the SOCCER (sample of comet coma earth return) mission using a six-DOF computer simulation of the aerobraking process are presented. The SOCCER spacecraft and the aerobraking scenario and power supply problem are briefly described. Results are presented for the spin effect, payload exposure problem, and sun angle effect.

An Application of Hydraulic Tomography to a Large-Scale Fractured Granite Site, Mizunami, Japan.

PubMed

Zha, Yuanyuan; Yeh, Tian-Chyi J; Illman, Walter A; Tanaka, Tatsuya; Bruines, Patrick; Onoe, Hironori; Saegusa, Hiromitsu; Mao, Deqiang; Takeuchi, Shinji; Wen, Jet-Chau

2016-11-01

While hydraulic tomography (HT) is a mature aquifer characterization technology, its applications to characterize hydrogeology of kilometer-scale fault and fracture zones are rare. This paper sequentially analyzes datasets from two new pumping tests as well as those from two previous pumping tests analyzed by Illman et al. (2009) at a fractured granite site in Mizunami, Japan. Results of this analysis show that datasets from two previous pumping tests at one side of a fault zone as used in the previous study led to inaccurate mapping of fracture and fault zones. Inclusion of the datasets from the two new pumping tests (one of which was conducted on the other side of the fault) yields locations of the fault zone consistent with those based on geological mapping. The new datasets also produce a detailed image of the irregular fault zone, which is not available from geological investigation alone and the previous study. As a result, we conclude that if prior knowledge about geological structures at a field site is considered during the design of HT surveys, valuable non-redundant datasets about the fracture and fault zones can be collected. Only with these non-redundant data sets, can HT then be a viable and robust tool for delineating fracture and fault distributions over kilometer scales, even when only a limited number of boreholes are available. In essence, this paper proves that HT is a new tool for geologists, geophysicists, and engineers for mapping large-scale fracture and fault zone distributions. © 2016, National Ground Water Association.

Dwarf Galaxies in the Coma Cluster. II. Photometry and Analysis

NASA Astrophysics Data System (ADS)

Secker, J.; Harris, W. E.; Plummer, J. D.

1997-12-01

We use the data set derived in our previous paper (Secker & Harris 1997) to study the dwarf galaxy population in the central =~ 700 arcmin(2) of the Coma cluster, the majority of which are early-type dwarf elliptical (dE) galaxies. Analysis of the statistically-decontaminated dE galaxy sequence in the color-magnitude diagram reveals that the mean dE color at R = 18.0 mag is (B-R) =~ 1.4 mag, but that a highly significant trend of color with magnitude exists (Delta (B-R)/Delta R = -0.056+/-0.002 mag) in the sense that fainter dEs are bluer and thus presumably more metal-poor. The mean color of the faintest dEs in our sample is (B-R) =~ 1.15 mag, consistent with a color measurement of the diffuse intracluster light in the Coma core. This intracluster light could then have originated from the tidal disruption of faint dEs in the cluster core. The total galaxy luminosity function (LF) is well modeled as the sum of a log-normal distribution for the giant galaxies, and a Schechter function for the dE galaxies with a faint-end slope alpha = -1.41+/-0.05. This value of alpha is consistent with those measured for the Virgo and Fornax clusters. The spatial distribution of the faint dE galaxies (19.0 < R <= 22.5 mag) is well fit by a standard King model with a central surface density of Sigma_0 = 1.17 dEs arcmin(-2) and a core radius R_c = 22.15 arcmin ( =~ 0.46h(-1) Mpc). This core is significantly larger than the R_c = 13.71 arcmin ( =~ 0.29h(-1) Mpc) found for the cluster giants and the brighter dEs (R <= 19.0 mag), again consistent with the idea that faint dEs in the dense core have been disrupted. Finally, we find that most dEs belong to the general Coma cluster potential rather than as satellites of individual giant galaxies: An analysis of the number counts around 10 cluster giants reveals that they each have on average 4+/- 1 dE companions within a projected radius of 13.9h(-1) kpc. (SECTION: Galaxies)

KECK/LRIS SPECTROSCOPIC CONFIRMATION OF COMA CLUSTER DWARF GALAXY MEMBERSHIP ASSIGNMENTS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chiboucas, Kristin; Tully, R. Brent; Marzke, Ronald O.

2010-11-01

Keck/LRIS multi-object spectroscopy has been carried out on 140 of some of the lowest and highest surface brightness faint (19 < R < 22) dwarf galaxy candidates in the core region of the Coma Cluster. These spectra are used to measure redshifts and establish membership for these faint dwarf populations. The primary goal of the low surface brightness sample is to test our ability to use morphological and surface brightness criteria to distinguish between Coma Cluster members and background galaxies using high resolution Hubble Space Telescope/Advanced Camera for Surveys images. Candidates were rated as expected members, uncertain, or expected background.more » From 93 spectra, 51 dwarf galaxy members and 20 background galaxies are identified. Our morphological membership estimation success rate is {approx}100% for objects expected to be members and better than {approx}90% for galaxies expected to be in the background. We confirm that low surface brightness is a very good indicator of cluster membership. High surface brightness galaxies are almost always background with confusion arising only from the cases of the rare compact elliptical (cE) galaxies. The more problematic cases occur at intermediate surface brightness. Many of these galaxies are given uncertain membership ratings, and these were found to be members about half of the time. Including color information will improve membership determination but will fail for some of the same objects that are already misidentified when using only surface brightness and morphology criteria. cE galaxies with B-V colors {approx}0.2 mag redward of the red sequence in particular require spectroscopic follow up. In a sample of 47 high surface brightness, ultracompact dwarf candidates, 19 objects have redshifts which place them in the Coma Cluster, while another 6 have questionable redshift measurements but may also prove to be members. Redshift measurements are presented and the use of indirect means for establishing cluster

Complete paralytic botulism mimicking a deep coma in a child.

PubMed

Azapağası, Ebru; Kendirli, Tanıl; Öz-Tuncer, Gökçen; Albayrak, Pelin; Teber, Serap; Deda, Gülhis

2017-01-01

Botulism is a rare cause of neuroparalysis. Delay in diagnosis and treatment exerts adverse impact on mortality and morbidity. We report a child with complete flaccid paralysis followed by progression to coma-like consciousness. The patient required mechanical ventilation. As serological tests could not be performed, detailed history and physical examinations led to the suspicion of botulism, and repetitive nerve stimulation tests supported the diagnosis. Botulinum antitoxin was administered. The patient`s neuromuscular function improved rapidly.

Hematoma Shape, Hematoma Size, Glasgow Coma Scale Score and ICH Score: Which Predicts the 30-Day Mortality Better for Intracerebral Hematoma?

PubMed Central

Wang, Chih-Wei; Liu, Yi-Jui; Lee, Yi-Hsiung; Hueng, Dueng-Yuan; Fan, Hueng-Chuen; Yang, Fu-Chi; Hsueh, Chun-Jen; Kao, Hung-Wen; Juan, Chun-Jung; Hsu, Hsian-He

2014-01-01

Purpose To investigate the performance of hematoma shape, hematoma size, Glasgow coma scale (GCS) score, and intracerebral hematoma (ICH) score in predicting the 30-day mortality for ICH patients. To examine the influence of the estimation error of hematoma size on the prediction of 30-day mortality. Materials and Methods This retrospective study, approved by a local institutional review board with written informed consent waived, recruited 106 patients diagnosed as ICH by non-enhanced computed tomography study. The hemorrhagic shape, hematoma size measured by computer-assisted volumetric analysis (CAVA) and estimated by ABC/2 formula, ICH score and GCS score was examined. The predicting performance of 30-day mortality of the aforementioned variables was evaluated. Statistical analysis was performed using Kolmogorov-Smirnov tests, paired t test, nonparametric test, linear regression analysis, and binary logistic regression. The receiver operating characteristics curves were plotted and areas under curve (AUC) were calculated for 30-day mortality. A P value less than 0.05 was considered as statistically significant. Results The overall 30-day mortality rate was 15.1% of ICH patients. The hematoma shape, hematoma size, ICH score, and GCS score all significantly predict the 30-day mortality for ICH patients, with an AUC of 0.692 (P = 0.0018), 0.715 (P = 0.0008) (by ABC/2) to 0.738 (P = 0.0002) (by CAVA), 0.877 (P<0.0001) (by ABC/2) to 0.882 (P<0.0001) (by CAVA), and 0.912 (P<0.0001), respectively. Conclusion Our study shows that hematoma shape, hematoma size, ICH scores and GCS score all significantly predict the 30-day mortality in an increasing order of AUC. The effect of overestimation of hematoma size by ABC/2 formula in predicting the 30-day mortality could be remedied by using ICH score. PMID:25029592

Coma of unknown origin in the emergency department: implementation of an in-house management routine.

PubMed

Braun, Mischa; Schmidt, Wolf Ulrich; Möckel, Martin; Römer, Michael; Ploner, Christoph J; Lindner, Tobias

2016-04-27

Coma of unknown origin is an emergency caused by a variety of possibly life-threatening pathologies. Although lethality is high, there are currently no generally accepted management guidelines. We implemented a new interdisciplinary standard operating procedure (SOP) for patients presenting with non-traumatic coma of unknown origin. It includes a new in-house triage process, a new alert call, a new composition of the clinical response team and a new management algorithm (altogether termed "coma alarm"). It is triggered by two simple criteria to be checked with out-of-hospital emergency response teams before the patient arrives. A neurologist in collaboration with an internal specialist leads the in-hospital team. Collaboration with anaesthesiology, trauma surgery and neurosurgery is organised along structured pathways that include standardised laboratory tests and imaging. Patients were prospectively enrolled. We calculated response times as well as sensitivity and false positive rates, thus proportions of over- and undertriaged patients, as quality measures for the implementation in the SOP. During 24 months after implementation, we identified 325 eligible patients. Sensitivity was 60 % initially (months 1-4), then fluctuated between 84 and 94 % (months 5-24). Overtriage never exceeded 15 % and undertriage could be kept low at a maximum of 11 % after a learning period. We achieved a median door-to-CT time of 20 minutes. 85 % of patients needed subsequent ICU treatment, 40 % of which required specialised neuro-ICUs. Our results indicate that our new simple in-house triage criteria may be sufficient to identify eligible patients before arrival. We aimed at ensuring the fastest possible proceedings given high portions of underlying time-sensitive neurological and medical pathologies while using all available resources as purposefully as possible. Our SOP may provide an appropriate tool for efficient management of patients with non-traumatic coma. Our results

Correlation of generation interval and scale of large-scale submarine landslides using 3D seismic data off Shimokita Peninsula, Northeast Japan

NASA Astrophysics Data System (ADS)

Nakamura, Yuki; Ashi, Juichiro; Morita, Sumito

2016-04-01

To clarify timing and scale of past submarine landslides is important to understand formation processes of the landslides. The study area is in a part of continental slope of the Japan Trench, where a number of large-scale submarine landslide (slump) deposits have been identified in Pliocene and Quaternary formations by analysing METI's 3D seismic data "Sanrikuoki 3D" off Shimokita Peninsula (Morita et al., 2011). As structural features, swarm of parallel dikes which are likely dewatering paths formed accompanying the slumping deformation, and slip directions are basically perpendicular to the parallel dikes. Therefore, parallel dikes are good indicator for estimation of slip directions. Slip direction of each slide was determined one kilometre grid in the survey area of 40 km x 20 km. The remarkable slip direction varies from Pliocene to Quaternary in the survey area. Parallel dike structure is also available for the distinguishment of the slump deposit and normal deposit on time slice images. By tracing outline of slump deposits at each depth, we identified general morphology of the overall slump deposits, and calculated the volume of the extracted slump deposits so as to estimate the scale of each event. We investigated temporal and spatial variation of depositional pattern of the slump deposits. Calculating the generation interval of the slumps, some periodicity is likely recognized, especially large slump do not occur in succession. Additionally, examining the relationship of the cumulative volume and the generation interval, certain correlation is observed in Pliocene and Quaternary. Key words: submarine landslides, 3D seismic data, Shimokita Peninsula

Cometary Matter Analyser (COMA/CRAF)

NASA Technical Reports Server (NTRS)

Buechler, K.; Igenbergs, E.; Klein, J. W.; Krueger, F. R.; Kuczera, H.; Morfill, G.; Palme, H.; Roessler, K.; Weishaupt, U.; Zerrull, R.;

Hypoxic coma as a strategy to survive inundation in a salt-marsh inhabiting spider

PubMed Central

Pétillon, Julien; Montaigne, William; Renault, David

2009-01-01

Spiders constitute a major arthropod group in regularly inundated habitats. Some species survive a flooding period under water. We compared survival during both submersion and a recovery period after submersion, in three stenotopic lycosids: two salt-marsh species Arctosa fulvolineata and Pardosa purbeckensis, and a forest spider Pardosa lugubris. Both activity and survival rates were determined under controlled laboratory conditions by individually surveying 120 females kept submerged in sea water. We found significant differences between the three species, with the two salt-marsh spiders exhibiting higher survival abilities. To our knowledge, this study reports for the first time the existence of a hypoxic coma caused by submersion, which is most pronounced in A. fulvolineata, the salt-marsh spider known to overcome tidal inundation under water. Its ability to fall into that coma can therefore be considered a physiological adaptation to its regularly inundated habitat. PMID:19411268

A New 3D Multi-fluid Model: A Study of Kinetic Effects and Variations of Physical Conditions in the Cometary Coma

NASA Astrophysics Data System (ADS)

Shou, Y.; Combi, M.; Toth, G.; Tenishev, V.; Fougere, N.; Jia, X.; Rubin, M.; Huang, Z.; Hansen, K.; Gombosi, T.; Bieler, A.

2016-12-01

Physics-based numerical coma models are desirable whether to interpret the spacecraft observations of the inner coma or to compare with the ground-based observations of the outer coma. In this work, we develop a multi-neutral-fluid model based on the BATS-R-US code of the University of Michigan, which is capable of computing both the inner and outer coma and simulating time-variable phenomena. It treats H2O, OH, H2, O, and H as separate fluids and each fluid has its own velocity and temperature, with collisions coupling all fluids together. The self-consistent collisional interactions decrease the velocity differences, re-distribute the excess energy deposited by chemical reactions among all species, and account for the varying heating efficiency under various physical conditions. Recognizing that the fluid approach has limitations in capturing all of the correct physics for certain applications, especially for very low density environment, we applied our multi-fluid coma model to comet 67P/Churyumov-Gerasimenko at various heliocentric distances and demonstrated that it yields comparable results to the Direct Simulation Monte Carlo (DSMC) model, which is based on a kinetic approach that is valid under these conditions. Therefore, our model may be a powerful alternative to the particle-based model, especially for some computationally intensive simulations. In addition, by running the model with several combinations of production rates and heliocentric distances, we characterize the cometary H2O expansion speeds and demonstrate the nonlinear dependencies of production rate and heliocentric distance. Our results are also compared to previous modeling work and remote observations, which serve as further validation of our model.

CONSTRAINTS ON COSMIC RAYS, MAGNETIC FIELDS, AND DARK MATTER FROM GAMMA-RAY OBSERVATIONS OF THE COMA CLUSTER OF GALAXIES WITH VERITAS AND FERMI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arlen, T.; Aune, T.; Bouvier, A.

2012-10-01

Observations of radio halos and relics in galaxy clusters indicate efficient electron acceleration. Protons should likewise be accelerated and, on account of weak energy losses, can accumulate, suggesting that clusters may also be sources of very high energy (VHE; E > 100 GeV) gamma-ray emission. We report here on VHE gamma-ray observations of the Coma galaxy cluster with the VERITAS array of imaging Cerenkov telescopes, with complementing Fermi Large Area Telescope observations at GeV energies. No significant gamma-ray emission from the Coma Cluster was detected. Integral flux upper limits at the 99% confidence level were measured to be on themore » order of (2-5) Multiplication-Sign 10{sup -8} photons m {sup -2} s {sup -1} (VERITAS, >220 GeV) and {approx}2 Multiplication-Sign 10{sup -6} photons m {sup -2} s {sup -1} (Fermi, 1-3 GeV), respectively. We use the gamma-ray upper limits to constrain cosmic rays (CRs) and magnetic fields in Coma. Using an analytical approach, the CR-to-thermal pressure ratio is constrained to be <16% from VERITAS data and <1.7% from Fermi data (averaged within the virial radius). These upper limits are starting to constrain the CR physics in self-consistent cosmological cluster simulations and cap the maximum CR acceleration efficiency at structure formation shocks to be <50%. Alternatively, this may argue for non-negligible CR transport processes such as CR streaming and diffusion into the outer cluster regions. Assuming that the radio-emitting electrons of the Coma halo result from hadronic CR interactions, the observations imply a lower limit on the central magnetic field in Coma of {approx}(2-5.5) {mu}G, depending on the radial magnetic field profile and on the gamma-ray spectral index. Since these values are below those inferred by Faraday rotation measurements in Coma (for most of the parameter space), this renders the hadronic model a very plausible explanation of the Coma radio halo. Finally, since galaxy clusters are dark

Constraints on Cosmic Rays, Magnetic Fields, and Dark Matter from Gamma-ray Observations of the Coma Cluster of Galaxies with VERITAS and FERMI

NASA Technical Reports Server (NTRS)

Arlen, T.; Aune, T.; Beilicke, M.; Benbow, W.; Bouvier, A.; Buckley, J. H.; Bugaev, V.; Byrum, K.; Cannon, A.; Cesarini, A.;

Marked EEG worsening following Levetiracetam overdose: How a pharmacological issue can confound coma prognosis.

PubMed

Bouchier, Baptiste; Demarquay, Geneviève; Guérin, Claude; André-Obadia, Nathalie; Gobert, Florent

2017-01-01

Levetiracetam is an anti-epileptic drug commonly used in intensive care when seizure is suspected as a possible cause of coma. We propose to question the cofounding effect of Levetiracetam during the prognostication process in a case of anoxic coma. We report the story of a young woman presenting a comatose state following a hypoxic cardiac arrest. After a first EEG presenting an intermediate EEG pattern, a seizure suspicion led to prescribe Levetiracetam. The EEG showed then the appearance of burst suppression, which was compatible with a very severe pattern of post-anoxic coma. This aggravation was in fact related to an overdose of Levetiracetam (the only medication introduced recently) and was reversible after Levetiracetam cessation. The increased plasmatic dosages of Levetiracetam confirming this overdose could have been favoured by a moderate reduction of renal clearance, previously underestimated because of a low body-weight. This EEG dynamic was unexpected under Levetiracetam and could sign a functional instability after anoxia. Burst suppression is classically observed with high doses of anaesthetics, but is not expected after a minor anti-epileptic drug. This report proposes that Levetiracetam tolerance might not be straightforward after brain lesions and engages us to avoid confounding factors during the awakening prognostication, which is mainly based on the severity of the EEG. Hence, prognosis should not be decided on an isolated parameter, especially if the dynamic is atypical after a new prescription, even for well-known drugs. For any suspicion, the drug's dosage and replacement should be managed before any premature care's withdrawal. Copyright © 2016 Elsevier B.V. All rights reserved.

A Two-Center Validation of "Patient Does Not Follow Commands" and Three Other Simplified Measures to Replace the Glasgow Coma Scale for Field Trauma Triage.

PubMed

Hopkins, Emily; Green, Steven M; Kiemeney, Michael; Haukoos, Jason S

2018-05-02

Out-of-hospital personnel worldwide calculate the 13-point Glasgow Coma Scale (GCS) score as a routine part of field trauma triage. We wish to independently validate a simpler binary assessment to replace the GCS for this task. We analyzed trauma center registries from Loma Linda University Health (2003 to 2015) and Denver Health Medical Center (2009 to 2015) to compare the binary assessment "patient does not follow commands" (ie, GCS motor score <6) with GCS score less than or equal to 13 for the prediction of 5 trauma outcomes: emergency intubation, clinically significant brain injury, need for neurosurgical intervention, Injury Severity Score greater than 15, and mortality. As a secondary analysis, we similarly evaluated 3 other measures simpler than the GCS: GCS motor score less than 5, Simplified Motor Score, and the "alert, voice, pain, unresponsive" scale. In this analysis of 47,973 trauma patients, we found that the binary assessment "patient does not follow commands" was essentially identical to GCS score less than or equal to 13 for the prediction of all 5 trauma outcomes, with slightly superior positive likelihood ratios (eg, those for mortality 2.37 versus 2.13) offsetting slightly inferior negative ones (eg, those for mortality 0.25 versus 0.24) and its graphic depiction of sensitivity versus specificity superimposing the GCS prediction curve. We found similar results for the 3 other simplified measures. In this 2-center external validation, we confirmed that a simple binary assessment-"patient does not follow commands"-could effectively replace the more complicated GCS for field trauma triage. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

A comparison of the diagnostic power of the Full Outline of Unresponsiveness scale and the Glasgow coma scale in the discharge outcome prediction of patients with traumatic brain injury admitted to the intensive care unit

PubMed Central

Gorji, Mohammad Ali Heidari; Hoseini, Seyed Hosein; Gholipur, Afshin; Mohammadpur, Reza Ali

2014-01-01

Background and Aim: This study aimed to determine whether the Full Outline of Unresponsiveness (FOUR) score is an accurate predictorof discharge outcome in traumatic brain injury (TBI) patients and to compare its performanceto Glasgow coma scale (GCS). Materials and Methods: Thisis diagnostic study conducted prospectively on 53 TBI patients admitted to ICU of education hospitals of Medical Science University of Mazandaran during February 2013 to June 2013. Data collection was done with a checklist including biographic, clinical information and outcome. The FOUR score and GCS were determined by the researcher in the first 24 hours. Outcomes considered as in-hospital mortality and poor neurologic outcome (Glasgow Outcome Scale (GOS) 1-3) in discharge time from the hospital. Results: In terms of predictive power for in-hospital mortality, the area under the receiver operating characteristic (ROC) curve was 0/92 (95% CI. 0/81-0/97) for FOUR score and 0/96 (95% CI. 0/87-0/99) for GCS. In terms of predictive power of poor neurologic outcome, the area under the ROC curve was 0/95 (95% CI. 0/86-0/99) for FOUR score and 0/90 (95% CI.0/79-0/96) for GCS as evidenced by GOS 1-3. The cut-off of 6 showed sensitivity and specificity of total four score predicting poor outcome at 0/86 and 0/87 while the cut-off of 4 showed the value of in hospital mortality at 0/90 and 0/90. The total GCS score showed sensitivity and specificity 0/100 and 0/61 at cut-off 7 in predicting poor outcome while in predicting mortality at cut-off of 4 this range was 0/100 and 0/92. Conclusion: The FOUR score is an accurate predictor of discharge outcome in TBI patients. Thus, researchers recommend for therapeutic Schematizationto use in neurosurgical patients at admission day. PMID:24843331

A Cluster Of Activities On Coma From The Hubble Space Telescope, StarDate, And McDonald Observatory

NASA Astrophysics Data System (ADS)

Hemenway, Mary Kay; Jogee, S.; Fricke, K.; Preston, S.

2011-01-01

With a goal of providing a vast audience of students, teachers, the general public, and Spanish-speakers with activities to learn about research on the Coma cluster of galaxies based on the HST ACS Treasury survey of Coma, McDonald Observatory used a many-faceted approach. Since this research offered an unprecedented legacy dataset, part of the challenge was to convey the importance of this project to a diverse audience. The methodology was to create different products for different (overlapping) audiences. Five radio programs were produced in English and Spanish for distribution on over 500 radio stations in the US and Mexico with a listening audience of over 2 million; in addition to the radio listeners, there were over 13,000 downloads of the English scripts and almost 6000 of the Spanish. Images were prepared for use in the StarDate Online Astronomy Picture of the Week, for ViewSpace (used in museums), and for the StarDate/Universo Teacher Guide. A high-school level activity on the Coma Cluster was prepared and distributed both on-line and in an upgraded printed version of the StarDate/Universo Teacher Guide. This guide has been distributed to over 1700 teachers nationally. A YouTube video about careers and research in astronomy using the Coma cluster as an example was produced. Just as the activities were varied, so were the evaluation methods. This material is based upon work supported by the National Aeronautics and Space Administration under Grant/Contract/Agreement No. HST-EO-10861.35-A issued through the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS5-26555.

Gas Distributions in Comet ISON’s Coma: Concurrent Integral-Field Spectroscopy and Narrow-band Imaging.

NASA Astrophysics Data System (ADS)

Schmidt, Carl; Johnson, Robert E.; Baumgardner, Jeffrey; Mendillo, Michael

2014-11-01

At a solar distance of 0.44 AU, Oort cloud comet C/2012 S1 (ISON) exhibited an outburst phase that was observed by small telescopes at the McDonald Observatory. In conjunction with narrow-band (14Å) imaging over a wide-field, an image-slicer spectrograph ( 20,000) simultaneously measured the spatial distribution of ISON’s coma over a 1.6 x 2.7 arcminute field made up of 246 individual spectra. More than fifty emission lines from C2, NH2, CO, H2O+ and Na were observed within a single Echelle order spanning 5868Å to 5930Å. Spatial reconstructions of these species reveal that ISON’s coma was quite elongated several thousand km along the axis perpendicular to its motion. The ion tail appeared distinctly broader than the neutral Na tail, providing strong evidence that Na in the coma did not originate by dissociative recombination of a sodium bearing molecular ion. Production rates increased from 1.6 ± 0.3 x 1023 to 5.8 ± 1 x 1023 Na atoms/s within 24 hours, outgassing much less than comparable comets relative to ISON’s water production. The anti-sunward Na tail was imaged >106 km from the nucleus. Its distribution indicates origins both near the nucleus and in the dust tail, with the ratio of these Na sources varying on hourly timescales due to outburst activity.

[Rare consciousness disturbances in toxicological practice: akinetic mutism, somnambulism, locked-in syndrome, and psychogenic coma].

PubMed

Ciszowski, Krzysztof; Mietka-Ciszowska, Aneta

2013-01-01

The toxicity of xenobiotics can result inrare disorders of consciousness, such as akinetic mutism and somnambulism as well as syndromes mimicking consciousness disturbances, such as locked-in syndrome and psychogenic coma. Akinetic mutism is a condition characterized by a lack of spontaneous movements and little or no vocalization. Somnambulism include performing of complex motor activity in an automatic manner during deep sleep, without any awareness of its execution. The locked-in syndrome is a state with quadriplegia coexisting with cranial nerves palsies and mutism, but with fully preserved consciousness. Psychogenic coma is a condition in which the patient has preserved level of consciousness and awareness, but does not communicate with theenvironment and does not exhibit the external manifestations of consciousness. This paper presents the etiology, clinical characteristics, as well as diagnostic and therapeutic issues for the above syndromes.

Pre- and Post-equinox ROSINA production rates calculated using a realistic empirical coma model derived from AMPS-DSMC simulations of comet 67P/Churyumov-Gerasimenko

NASA Astrophysics Data System (ADS)

Hansen, Kenneth; Altwegg, Kathrin; Berthelier, Jean-Jacques; Bieler, Andre; Calmonte, Ursina; Combi, Michael; De Keyser, Johan; Fiethe, Björn; Fougere, Nicolas; Fuselier, Stephen; Gombosi, Tamas; Hässig, Myrtha; Huang, Zhenguang; Le Roy, Lena; Rubin, Martin; Tenishev, Valeriy; Toth, Gabor; Tzou, Chia-Yu

2016-04-01

We have previously used results from the AMPS DSMC (Adaptive Mesh Particle Simulator Direct Simulation Monte Carlo) model to create an empirical model of the near comet coma (<400 km) of comet 67P for the pre-equinox orbit of comet 67P/Churyumov-Gerasimenko. In this work we extend the empirical model to the post-equinox, post-perihelion time period. In addition, we extend the coma model to significantly further from the comet (~100,000-1,000,000 km). The empirical model characterizes the neutral coma in a comet centered, sun fixed reference frame as a function of heliocentric distance, radial distance from the comet, local time and declination. Furthermore, we have generalized the model beyond application to 67P by replacing the heliocentric distance parameterizations and mapping them to production rates. Using this method, the model become significantly more general and can be applied to any comet. The model is a significant improvement over simpler empirical models, such as the Haser model. For 67P, the DSMC results are, of course, a more accurate representation of the coma at any given time, but the advantage of a mean state, empirical model is the ease and speed of use. One application of the empirical model is to de-trend the spacecraft motion from the ROSINA COPS and DFMS data (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis, Comet Pressure Sensor, Double Focusing Mass Spectrometer). The ROSINA instrument measures the neutral coma density at a single point and the measured value is influenced by the location of the spacecraft relative to the comet and the comet-sun line. Using the empirical coma model we can correct for the position of the spacecraft and compute a total production rate based on the single point measurement. In this presentation we will present the coma production rate as a function of heliocentric distance both pre- and post-equinox and perihelion.

DRY MERGER RATE AND POST-MERGER FRACTION IN THE COMA CLUSTER CORE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cordero, Juan P.; Campusano, Luis E.; Haines, Christopher P.

2016-01-20

We evaluate the dry merger activity in the Coma cluster, using a spectroscopically complete sample of 70 red-sequence (RS) galaxies, most of which (∼75%) are located within 0.2R{sub 200} (∼0.5 Mpc) from the cluster center, with data from the Coma Treasury Survey obtained with the Hubble Space Telescope. The fraction of close galaxy pairs in the sample is the proxy employed for the estimation of the merger activity. We identify 5 pairs and 1 triplet, enclosing a total of 13 galaxies, based on limits on projected separation and line-of-sight velocity difference. Of these systems, none show signs of ongoing interaction,more » and therefore we do not find any true mergers in our sample. This negative result sets a 1σ upper limit of 1.5% per Gyr for the major dry merger rate, consistent with the low rates expected in present-day clusters. Detailed examination of the images of all the RS galaxies in the sample reveals only one with low surface brightness features identifiable as the remnant of a past merger or interaction, implying a post-merger fraction below 2%.« less

Automated surface photometry for the Coma Cluster galaxies: The catalog

NASA Technical Reports Server (NTRS)

Doi, M.; Fukugita, M.; Okamura, S.; Tarusawa, K.

1995-01-01

A homogeneous photometry catalog is presented for 450 galaxies with B(sub 25.5) less than or equal to 16 mag located in the 9.8 deg x 9.8 deg region centered on the Coma Cluster. The catalog is based on photographic photometry using an automated surface photometry software for data reduction applied to B-band Schmidt plates. The catalog provides accurate positions, isophotal and total magnitudes, major and minor axes, and a few other photometric parameters including rudimentary morphology (early of late type).

Status of liquid metal fast breeder reactor fuel development in Japan

NASA Astrophysics Data System (ADS)

Katsuragawa, M.; Kashihara, H.; Akebi, M.

1993-09-01

The mixed-oxide fuel technology for a liquid metal fast breeder reactor (LMFBR) in Japan is progressing toward commercial deployment of LMFBR. Based on accumulated experience in Joyo and Monju fuel development, efforts for large scale LMFBR fuel development are devoted to improved irradiation performance, reliability and economy. This paper summarizes accomplishments, current activities and future plans for LMFBR fuel development in Japan.

HUT observations of carbon monoxide in the coma of Comet Levy (1990c)

NASA Technical Reports Server (NTRS)

Feldman, P. D.; Davidsen, A. F.; Blair, W. P.; Bowers, C. W.; Dixon, W. V.; Durrance, S. T.; Henry, R. C.; Kriss, G. A.; Kruk, J.; Moos, H. W.

1991-01-01

Observations of comet Levy (1990c) were made with the Hopkins Ultraviolet Telescope during the Astro-1 Space Shuttle mission on 10 Dec. 1990. The spectrum, covering the wavelength range 415 to 1850 A at a spectral emission of 3 A (in first order), shows the presence of carbon monoxide and atomic hydrogen, carbon, and sulfur in the coma. Aside from H I Lyman-beta, no cometary features are detected below 1200 A, although cometary O I and O II would be masked by the same emissions present in the day airglow spectrum. The 9.4 x 116 arcsec aperture corresponds to 12,000 x 148,000 km at the comet. The derived production rate of CO relative to water, 0.13 + or - 0.02, compared with the same ratio derived from IUE observations (made in Sep. 1990) which sample a much smaller region of the coma, 0.04 + or - 0.01, suggests the presence of an extended source of CO, as was found in comet Halley. Upper limits on Ne and Ar abundance are within an order of magnitude or solar abundances.

A Comparison of the Near-Infrared Spectral Features of Early-Type Galaxies in the Virgo and Coma Clusters

NASA Astrophysics Data System (ADS)

Houdashelt, M. L.

1992-05-01

Initial results are presented from an examination of near-infrared spectra (6800 - 9200 Angstroms) of 34 early-type galaxies - 17 in the Virgo cluster, 10 in the Coma cluster and seven field members. It has previously been speculated that E/S0 galaxies of similar luminosity in the Virgo and Coma clusters have different red stellar populations. To explore this possibility, pseudo-equivalent widths of a number of near-IR spectral features have been measured. The important features studied include the TiO bands near 7100, 7890, 8197, 8500 and 8950 Angstroms, which are mainly produced by the late-type stars whose flux contributes only about 10-20\\ the near-IR. The strengths of the Ca triplet (8498, 8542, 8662 Angstroms) and Na I doublet (8183, 8195 Angstroms) are also measured, since these features are affected by the relative contribution of dwarf stars to the red light. Although the main focus of this work is the search for spectral differences among the Coma, Virgo and field E/S0 populations, each subgroup of galaxies (and the sample as a whole) are also examined for correlations among the feature strengths, galaxy color and luminosity.

Comet 209P/LINEAR's Very Close Approach to Earth: Probing the Inner-Coma Physical Environment and Volatile Composition

NASA Astrophysics Data System (ADS)

Bonev, Boncho P.; DiSanti, Michael; Mumma, Michael; Gibb, Erika; Villanueva, Geronimo; Paganini, Lucas; Combi, Michael; Magee-Sauer, Karen

2014-02-01

Using NIRSPEC at Keck 2 we propose spatially-resolved high- resolution spectroscopic observations of H_2O emission in the coma of the Jupiter-family comet 209P/LINEAR. The exceptionally small geocentric distance - 0.06 AU - will afford very high spatial resolution. Using long-slit spectroscopy we will measure the spatial variation of the temperature and column density of water, providing a very rare direct quantitative view of the physical state in the innermost region of a cometary atmosphere, within 50-100 km from the nucleus. To maximize the science return, we will also measure the abundances of CH_3OH and C_2H_6 simultaneously with H_2O. Only one instrument setting is required for our entire investigation, thereby optimizing observing efficiency. Our proposed study targets improved understanding of the near-nucleus coma physics, and of the primary volatile composition of Jupiter-family comets, a dynamical group which remains underrepresented in modern taxonomical studies. In addition, this project will provide a context for interpreting results from the Rosetta mission, and also a test of state-of-the-art physical models of the coma.

Intellectual Assessment of Children and Youth in Japan: Past, Present, and Future

ERIC Educational Resources Information Center

Ishikuma, Toshinori; Matsuda, Osamu; Fujita, Kazuhiro; Ueno, Kazuhiko

2016-01-01

This article briefly reviews the history of intellectual assessment with children and youth in Japan, as well as current practices and future directions. The history of intelligence test use in Japan began in the early 20th century. Since the 21st century, three major intelligence tests, namely, the Wechsler Intelligence Scales, the Kaufman…

Study of the coma of comet 67P/Churyumov-Gerasimenko based on the ROSINA/RTOF instrument onboard Rosetta

NASA Astrophysics Data System (ADS)

Hoang, M.; Garnier, P.; Rème, H.; Altwegg, K.; Balsiger, H.; Calmonte, U.; Fiethe, B.; Galli, A.; Gasc, S.; Jäckel, A.; Mall, U.; Le Roy, L.; Rubin, M.; Tzou, C.-Y.; Waite, J. H.; Wurz, P.

2015-10-01

The Rosetta ESA mission investigates the environment of the comet 67P / Churyumov- Gerasimenko since August 2014. Among the experiments onboard the satellite, the ROSINA experiment (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis) includes two mass spectrometers (DFMS and RTOF) to analyze the composition of neutrals and ions, and an instrument (COPS) to monitor the density and velocity of neutrals in the coma [1]. We will here analyze and discuss the data of the ROSINA/RTOF instrument during the comet escort phase. A detailed description of the main volatiles (H2O, CO2, CO) dynamics and of the heterogeneities of the coma will be provided.

Modeling of the Inner Coma of Comet 67P/Churyumov-Gerasimenko Constrained by VIRTIS and ROSINA Observations

NASA Astrophysics Data System (ADS)

Fougere, N.; Combi, M. R.; Tenishev, V.; Bieler, A. M.; Migliorini, A.; Bockelée-Morvan, D.; Toth, G.; Huang, Z.; Gombosi, T. I.; Hansen, K. C.; Capaccioni, F.; Filacchione, G.; Piccioni, G.; Debout, V.; Erard, S.; Leyrat, C.; Fink, U.; Rubin, M.; Altwegg, K.; Tzou, C. Y.; Le Roy, L.; Calmonte, U.; Berthelier, J. J.; Rème, H.; Hässig, M.; Fuselier, S. A.; Fiethe, B.; De Keyser, J.

2015-12-01

As it orbits around comet 67P/Churyumov-Gerasimenko (CG), the Rosetta spacecraft acquires more information about its main target. The numerous observations made at various geometries and at different times enable a good spatial and temporal coverage of the evolution of CG's cometary coma. However, the question regarding the link between the coma measurements and the nucleus activity remains relatively open notably due to gas expansion and strong kinetic effects in the comet's rarefied atmosphere. In this work, we use coma observations made by the ROSINA-DFMS instrument to constrain the activity at the surface of the nucleus. The distribution of the H2O and CO2 outgassing is described with the use of spherical harmonics. The coordinates in the orthogonal system represented by the spherical harmonics are computed using a least squared method, minimizing the sum of the square residuals between an analytical coma model and the DFMS data. Then, the previously deduced activity distributions are used in a Direct Simulation Monte Carlo (DSMC) model to compute a full description of the H2O and CO2 coma of comet CG from the nucleus' surface up to several hundreds of kilometers. The DSMC outputs are used to create synthetic images, which can be directly compared with VIRTIS measurements. The good agreement between the VIRTIS observations and the DSMC model, itself constrained with ROSINA data, provides a compelling juxtaposition of the measurements from these two instruments. Acknowledgements Work at UofM was supported by contracts JPL#1266313, JPL#1266314 and NASA grant NNX09AB59G. Work at UoB was funded by the State of Bern, the Swiss National Science Foundation and by the ESA PRODEX Program. Work at Southwest Research institute was supported by subcontract #1496541 from the JPL. Work at BIRA-IASB was supported by the Belgian Science Policy Office via PRODEX/ROSINA PEA 90020. The authors would like to thank ASI, CNES, DLR, NASA for supporting this research. VIRTIS was built

The distribution of gas and ions in the inner coma of 67P/Churyumov-Gerasimenko between 3 AU before and after its perihelion

NASA Astrophysics Data System (ADS)

Bodewits, Dennis; Lara, Luisa; La Forgia, Fiorangela; A'Hearn, Michael F.; Knollenberg, Jörg; Lazzarin, Monica; Li, Zhong-Yi; Osiris Team

2016-10-01

Rosetta explored a regime not accessible before: the inner coma of a low-activity comet at a large range of heliocentric distances. The Wide Angle Camera (WAC) of the OSIRIS instrument on board the Rosetta spacecraft is equipped with several narrowband filters that are centered on the emission lines and bands of various molecules and ions. These filters center on fragment species that are relatively bright and that have been used for numerous comet studies from the ground (e.g. A'Hearn et al. 1995). Surprisingly, we found that outside 2 AU pre-perihelion, the emission in the filters was dominated by emission from dissociative electron impact excitation (Bodewits et al. 2016). Closer to perihelion, higher gas densities reduced electron temperatures in the inner coma and photo-processes drove much if not most of the emission from the comet. Our observations allowed us to study changes in the physical environment of the inner coma, and Rosetta's excursions as far as 1000 km from the surface allowed us to study different regions of the coma.In this contribution, we will summarize the results of our OSIRIS observations from approximately 3 AU before to 3 AU after perihelion.

Effect of Memantine on Serum Levels of Neuron-Specific Enolase and on the Glasgow Coma Scale in Patients With Moderate Traumatic Brain Injury.

PubMed

Mokhtari, Majid; Nayeb-Aghaei, Hossein; Kouchek, Mehran; Miri, Mir Mohammad; Goharani, Reza; Amoozandeh, Arash; Akhavan Salamat, Sina; Sistanizad, Mohammad

2018-01-01

Traumatic brain injury (TBI) is a major cause of disability and death globally. Despite significant progress in neuromonitoring and neuroprotection, pharmacological interventions have failed to generate favorable results. We examined the effect of memantine on serum levels of neuron-specific enolase (NSE), a marker of neuronal damage, and the Glasgow Coma Scale (GCS) in patients with moderate TBI. Patients were randomly assigned to the control group (who received standard TBI management) and the treatment group (who, alongside their standard management, received enteral memantine 30 mg twice daily for 7 days). Patients' clinical data, GCS, findings of head computed tomography, and serum NSE levels were collected during the study. Forty-one patients were randomized into the control and treatment groups, 19 and 22 patients respectively. Baseline characteristics and serum NSE levels were not significantly different between the 2 groups. The mean serum NSE levels for the memantine and the control groups on day 3 were 7.95 ± 2.86 and 12.33 ± 7.09 ng/mL, respectively (P = .05), and on day 7 were 5.03 ± 3.25 and 10.04 ± 5.72 ng/mL, respectively (P = .003). The mean GCS on day 3 was 12.3 ± 2.0 and 10.9 ± 1.9 in the memantine and control groups, respectively (P = .03). Serum NSE levels and GCS changes were negatively correlated (r = -0.368, P = .02). Patients with moderate TBI who received memantine had significantly reduced serum NSE levels by day 7 and marked improvement in their GCS scores on day 3 of the study. © 2017, The American College of Clinical Pharmacology.

Fatal coma in a young adult due to late-onset urea cycle deficiency presenting with a prolonged seizure: a case report.

PubMed

Alameri, Majid; Shakra, Mustafa; Alsaadi, Taoufik

2015-11-23

Unexplained hyperammonemic coma in adults can be a medical dilemma in the absence of triggering factors and known comorbidities. Ornithine transcarbamylase deficiency presents most commonly with hyperammonemic coma. Although a rare disorder, ornithine transcarbamylase deficiency is the most common of the urea cycle disorders, which can occur both in children, and less commonly, in adults. The urea cycle disorder is usually acquired as an X-linked trait, and very rarely, similar to our reported case, may be acquired as a "new" mutation. Mutations that lead to later-onset presentations may lead to life-threatening disease and may be unrecognized, particularly when the first clinical symptoms occur in adulthood. We report the case of a previously healthy 17-year-old white man who developed a prolonged seizure and a rapid decline in mental status leading to coma over a 3-day period. Analysis of the OTC gene showed a 119G variant, which was identified in exon 2 of the OTC gene by sequencing. A diagnosis of ornithine transcarbamylase deficiency should be considered in adult patients who present with unexplained hyperammonemic coma and for all adult patients presenting with cryptogenic new-onset seizure and laboratory finding of elevated blood ammonia levels. This reported case highlights the importance of early recognition of this potentially reversible cause of life-threatening encephalopathy, as timely recognition and appropriate treatment can be lifesaving.

Evolution of near UV Halley's spectrum in the inner coma

NASA Technical Reports Server (NTRS)

Rousselot, Phillippe; Clairemidi, Jacques; Vernotte, F.; Moreels, Guy

1992-01-01

A direct way to observe the photodissociation of water vapor in a cometary coma is to detect the OH prompt emission. This emission is shifted of delta lambda = 4 nm with respect to the OH 309 nm fluorescence band. The extended data set obtained with the three-channel spectrometer on-board Vega 2 reveals at short distance of the nucleus (i.e., less than 600 km) an excess of emission on the right wing of the OH band which may be interpreted as being mainly due to prompt emission.

Hyperosmolar nonketotic coma precipitated by lithium-induced nephrogenic diabetes insipidus.

PubMed Central

Azam, H.; Newton, R. W.; Morris, A. D.; Thompson, C. J.

1998-01-01

A 45-year-old man, with a 10-year history of manic depression treated with lithium, was admitted with hyperosmolar, nonketotic coma. He gave a five-year history of polyuria and polydipsia, during which time urinalysis had been negative for glucose. After recovery from hyperglycaemia, he remained polyuric despite normal blood glucose concentrations; water deprivation testing indicated nephrogenic diabetes insipidus, likely to be lithium-induced. We hypothesize that when this man developed type 2 diabetes, chronic polyuria due to nephrogenic diabetes insipidus was sufficient to precipitate hyperosmolar dehydration. PMID:9538487

The Impact of Sika Deer on Vegetation in Japan: Setting Management Priorities on a National Scale

NASA Astrophysics Data System (ADS)

Ohashi, Haruka; Yoshikawa, Masato; Oono, Keiichi; Tanaka, Norihisa; Hatase, Yoriko; Murakami, Yuhide

2014-09-01

Irreversible shifts in ecosystems caused by large herbivores are becoming widespread around the world. We analyzed data derived from the 2009-2010 Sika Deer Impact Survey, which assessed the geographical distribution of deer impacts on vegetation through a questionnaire, on a scale of 5-km grid-cells. Our aim was to identify areas facing irreversible ecosystem shifts caused by deer overpopulation and in need of management prioritization. Our results demonstrated that the areas with heavy impacts on vegetation were widely distributed across Japan from north to south and from the coastal to the alpine areas. Grid-cells with heavy impacts are especially expanding in the southwestern part of the Pacific side of Japan. The intensity of deer impacts was explained by four factors: (1) the number of 5-km grid-cells with sika deer in neighboring 5 km-grid-cells in 1978 and 2003, (2) the year sika deer were first recorded in a grid-cell, (3) the number of months in which maximum snow depth exceeded 50 cm, and (4) the proportion of urban areas in a particular grid-cell. Based on our model, areas with long-persistent deer populations, short snow periods, and fewer urban areas were predicted to be the most vulnerable to deer impact. Although many areas matching these criteria already have heavy deer impact, there are some areas that remain only slightly impacted. These areas may need to be designated as having high management priority because of the possibility of a rapid intensification of deer impact.

The impact of Sika deer on vegetation in Japan: setting management priorities on a national scale.

PubMed

Ohashi, Haruka; Yoshikawa, Masato; Oono, Keiichi; Tanaka, Norihisa; Hatase, Yoriko; Murakami, Yuhide

2014-09-01

Irreversible shifts in ecosystems caused by large herbivores are becoming widespread around the world. We analyzed data derived from the 2009-2010 Sika Deer Impact Survey, which assessed the geographical distribution of deer impacts on vegetation through a questionnaire, on a scale of 5-km grid-cells. Our aim was to identify areas facing irreversible ecosystem shifts caused by deer overpopulation and in need of management prioritization. Our results demonstrated that the areas with heavy impacts on vegetation were widely distributed across Japan from north to south and from the coastal to the alpine areas. Grid-cells with heavy impacts are especially expanding in the southwestern part of the Pacific side of Japan. The intensity of deer impacts was explained by four factors: (1) the number of 5-km grid-cells with sika deer in neighboring 5 km-grid-cells in 1978 and 2003, (2) the year sika deer were first recorded in a grid-cell, (3) the number of months in which maximum snow depth exceeded 50 cm, and (4) the proportion of urban areas in a particular grid-cell. Based on our model, areas with long-persistent deer populations, short snow periods, and fewer urban areas were predicted to be the most vulnerable to deer impact. Although many areas matching these criteria already have heavy deer impact, there are some areas that remain only slightly impacted. These areas may need to be designated as having high management priority because of the possibility of a rapid intensification of deer impact.

Child Development and Childcare in Japan

ERIC Educational Resources Information Center

Anme, Tokie; Segal, Uma A.

2010-01-01

With increasing numbers of women joining the workforce, there is a need for quality childcare. This project, conducted in Japan and using a large number of participants, sought to standardize an evaluation scale to measure the development of children. The development of children under six years of age (N = 22,819) who are enrolled in childcare…

Immediate and Long-Term Outcome of Acute H2S Intoxication Induced Coma in Unanesthetized Rats: Effects of Methylene Blue

PubMed Central

Sonobe, Takashi; Chenuel, Bruno; Cooper, Timothy K.; Haouzi, Philippe

2015-01-01

Background Acute hydrogen sulfide (H2S) poisoning produces a coma, the outcome of which ranges from full recovery to severe neurological deficits. The aim of our study was to 1- describe the immediate and long-term neurological effects following H2S-induced coma in un-anesthetized rats, and 2- determine the potential benefit of methylene blue (MB), a compound we previously found to counteract acute sulfide cardiac toxicity. Methods NaHS was administered IP in un-sedated rats to produce a coma (n = 34). One minute into coma, the rats received MB (4 mg/kg IV) or saline. The surviving rats were followed clinically and assigned to Morris water maze (MWM) and open field testing then sacrificed at day 7. Results Sixty percent of the non-treated comatose rats died by pulseless electrical activity. Nine percent recovered with neurological deficits requiring euthanasia, their brain examination revealed major neuronal necrosis of the superficial and middle layers of the cerebral cortex and the posterior thalamus, with variable necrosis of the caudate putamen, but no lesions of the hippocampus or the cerebellum, in contrast to the typical distribution of post-ischemic lesions. The remaining animals displayed, on average, a significantly less effective search strategy than the control rats (n = 21) during MWM testing. Meanwhile, 75% of rats that received MB survived and could perform the MWM test (P<0.05 vs non-treated animals). The treated animals displayed a significantly higher occurrence of spatial search than the non-treated animals. However, a similar proportion of cortical necrosis was observed in both groups, with a milder clinical presentation following MB. Conclusion In conclusion, in rats surviving H2S induced coma, spatial search patterns were used less frequently than in control animals. A small percentage of rats presented necrotic neuronal lesions, which distribution differed from post-ischemic lesions. MB dramatically improved the immediate survival and spatial

Immediate and Long-Term Outcome of Acute H2S Intoxication Induced Coma in Unanesthetized Rats: Effects of Methylene Blue.

PubMed

Sonobe, Takashi; Chenuel, Bruno; Cooper, Timothy K; Haouzi, Philippe

2015-01-01

Acute hydrogen sulfide (H2S) poisoning produces a coma, the outcome of which ranges from full recovery to severe neurological deficits. The aim of our study was to 1--describe the immediate and long-term neurological effects following H2S-induced coma in un-anesthetized rats, and 2--determine the potential benefit of methylene blue (MB), a compound we previously found to counteract acute sulfide cardiac toxicity. NaHS was administered IP in un-sedated rats to produce a coma (n = 34). One minute into coma, the rats received MB (4 mg/kg i.v.) or saline. The surviving rats were followed clinically and assigned to Morris water maze (MWM) and open field testing then sacrificed at day 7. Sixty percent of the non-treated comatose rats died by pulseless electrical activity. Nine percent recovered with neurological deficits requiring euthanasia, their brain examination revealed major neuronal necrosis of the superficial and middle layers of the cerebral cortex and the posterior thalamus, with variable necrosis of the caudate putamen, but no lesions of the hippocampus or the cerebellum, in contrast to the typical distribution of post-ischemic lesions. The remaining animals displayed, on average, a significantly less effective search strategy than the control rats (n = 21) during MWM testing. Meanwhile, 75% of rats that received MB survived and could perform the MWM test (P<0.05 vs non-treated animals). The treated animals displayed a significantly higher occurrence of spatial search than the non-treated animals. However, a similar proportion of cortical necrosis was observed in both groups, with a milder clinical presentation following MB. In conclusion, in rats surviving H2S induced coma, spatial search patterns were used less frequently than in control animals. A small percentage of rats presented necrotic neuronal lesions, which distribution differed from post-ischemic lesions. MB dramatically improved the immediate survival and spatial search strategy in the surviving

Communication Opportunities via Special Messaging Technology for Two Post-Coma Persons with Multiple Disabilities

ERIC Educational Resources Information Center

Lancioni, Giulio E.; O'Reilly, Mark F.; Singh, Nirbhay N.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Colonna, Fabio; Navarro, Jorge; Lanzilotti, Crocifissa; de Pace, Claudia; Megna, Marisa; Oliva, Doretta

2011-01-01

This study extended the assessment of a special messaging technology with two additional post-coma adults who had emerged from a minimally conscious state, but showed multiple disabilities including profound motor and communication impairments. For each participant, the study involved an ABAB design, in which the A represented baseline phases and…

Time-dependent evolution of the near nuclear coma of cometary nuclei during their rotational motion

NASA Astrophysics Data System (ADS)

Szego, K.; Crifo, J.-F.; Fulle, M.; Rodionov, A. V.

2003-04-01

The new physical model of Rodionov et al. (Planetary and Space Sci., 50, 983, 2002) that describes the cometary activity based on a 3-d collisional gas dynamical model has been successfully applied to account for the dust features observed by the cameras flying onboard of the VEGA and Giotto probes during the encounter with comet Halley. This indicates, in particular, that these structures are dominantly controlled by the nucleus topography. An upgraded version of this model has been recently developed and is being applied to the vast body of data gathered in 1986 on comet Halley. This new version is tridimensional as previously, and, in addition, time-dependent. This allows the exact, self-consistent computation of the whole coma structure (primary and daughter molecules, dust), allowing to study its dependence upon nucleus shape, composition, and rotation. The results presented here assume that the coma is formed by solar-driven sublimation of a homogeneous dusty-ice nucleus with shape and rotational state derived for P/Halley. The results are, however, of quite general significance -- in particular they remain valid for different shapes and for inhomogeneous nucleus. This presentation focuses on the time dependence of the dust and gas features obtained around the nucleus. Movies will summarize the results of the calculations exhibiting the time development of the dust and gas coma and its relation to the surface orography for a rotating nucleus. The effect of nucleus activity on its rotational motion, and possible constraints hampering the observation of the activity will be also analyzed.

The globular cluster systems of 54 Coma ultra-diffuse galaxies: statistical constraints from HST data

NASA Astrophysics Data System (ADS)

Amorisco, N. C.; Monachesi, A.; Agnello, A.; White, S. D. M.

2018-04-01

We use data from the HST Coma Cluster Treasury program to assess the richness of the globular cluster systems (GCSs) of 54 Coma ultra-diffuse galaxies (UDGs), 18 of which have a half-light radius exceeding 1.5 kpc. We use a hierarchical Bayesian method tested on a large number of mock data sets to account consistently for the high and spatially varying background counts in Coma. These include both background galaxies and intra-cluster globular clusters (ICGCs), which are disentangled from the population of member globular clusters (GCs) in a probabilistic fashion. We find no candidate for a GCS as rich as that of the Milky Way, our sample has GCSs typical of dwarf galaxies. For the standard relation between GCS richness and halo mass, 33 galaxies have a virial mass Mvir ≤ 1011 M⊙ at 90 per cent probability. Only three have Mvir > 1011 M⊙ with the same confidence. The mean colour and spread in colour of the UDG GCs are indistinguishable from those of the abundant population of ICGCs. The majority of UDGs in our sample are consistent with the relation between stellar mass and GC richness of `normal' dwarf galaxies. Nine systems, however, display GCSs that are richer by a factor of 3 or more (at 90 per cent probability). Six of these have sizes ≲1.4 kpc. Our results imply that the physical mechanisms responsible for the extended size of the UDGs and for the enhanced GC richness of some cluster dwarfs are at most weakly correlated.

Efficacy of Intravenous Haloperidol on the duration of Delirium and Coma in Critically Ill Patients (Hope-ICU): a Randomised, Placebo-Controlled Trial

PubMed Central

Page, Valerie J; Ely, E Wesley; Gates, Simon; Zhao, Xiao Bei; Alce, Timothy; Shintani, Ayumi; Jackson, Jim; Perkins, Gavin D; McAuley, Daniel F

2016-01-01

Background Delirium is frequently diagnosed in critically ill patients and is associated with poor clinical outcomes. Haloperidol is the most commonly used drug for delirium despite little evidence of its effectiveness. The aim of this study was to establish whether early treatment with haloperidol would decrease the time that survivors of critical illness spent in delirium or in coma. Methods We did this double-blind, placebo-controlled randomised trial in a general adult intensive care unit (ICU). Critically ill patients (≥18 years) needing mechanical ventilation within 72 of admission were enrolled. Patients were randomised (by an independent nurse, in 1:1 ratio, with permuted block size of four and six, using a centralised, secure web-based randomisation service) to receive haloperidol 2·5mgs or 0·9% saline placebo intravenously every 8 h irrespective of coma or delirium status. Study drug was discontinued on ICU discharge, once delirium-free and coma-free for 2 consecutive days, or after a maximum of 14 days treatment, which ever came first. Delirium was assessed using the confusion assessment method - for the ICU (CAM-ICU). The primary outcome was delirium-free and coma-free days, defined as the number of days in the first 14 days after randomisation during which the patient was alive without delirium and not in coma from any cause. Patients who died within the 14-day study period were recorded as having 0 days free of delirium and coma. ICU clinical and research staff and patients were masked to treatment throughout the study. Analyses were by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Registry, number ISRCTN83567338. Findings 142 patients were randomised, 141 were included in the final analysis (71 haloperidol, 70 placebo). Patients in the haloperidol group spent about the same number of days alive, without delirium, and without coma as did patients in the placebo group (median 5 days [IQR 0

Coma, Hyperthermia and Bleeding Associated with Massive LSD Overdose

PubMed Central

Klock, John C.; Boerner, Udo; Becker, Charles E.

1974-01-01

Eight patients were seen within 15 minutes of intranasal self-administration of large amounts of pure D-lysergic acid diethylamide (LSD) tartrate powder. Emesis and collapse occurred along with signs of sympathetic overactivity, hyperthermia, coma and respiratory arrest. Mild generalized bleeding occurred in several patients and evidence of platelet dysfunction was present in all. Serum and gastric concentrations of LSD tartrate ranged from 2.1 to 26 nanograms per ml and 1,000 to 7,000 μg per 100 ml, respectively. With supportive care, all patients recovered. Massive LSD overdose in man is life-threatening and produces striking and distinctive manifestations. ImagesFigure 1. PMID:4816396

Combining DSMC Simulations and ROSINA/COPS Data of Comet 67P/Churyumov-Gerasimenko to Develop a Realistic Empirical Coma Model and to Determine Accurate Production Rates

NASA Astrophysics Data System (ADS)

Hansen, K. C.; Fougere, N.; Bieler, A. M.; Altwegg, K.; Combi, M. R.; Gombosi, T. I.; Huang, Z.; Rubin, M.; Tenishev, V.; Toth, G.; Tzou, C. Y.

2015-12-01

We have previously published results from the AMPS DSMC (Adaptive Mesh Particle Simulator Direct Simulation Monte Carlo) model and its characterization of the neutral coma of comet 67P/Churyumov-Gerasimenko through detailed comparison with data collected by the ROSINA/COPS (Rosetta Orbiter Spectrometer for Ion and Neutral Analysis/COmet Pressure Sensor) instrument aboard the Rosetta spacecraft [Bieler, 2015]. Results from these DSMC models have been used to create an empirical model of the near comet coma (<200 km) of comet 67P. The empirical model characterizes the neutral coma in a comet centered, sun fixed reference frame as a function of heliocentric distance, radial distance from the comet, local time and declination. The model is a significant improvement over more simple empirical models, such as the Haser model. While the DSMC results are a more accurate representation of the coma at any given time, the advantage of a mean state, empirical model is the ease and speed of use. One use of such an empirical model is in the calculation of a total cometary coma production rate from the ROSINA/COPS data. The COPS data are in situ measurements of gas density and velocity along the ROSETTA spacecraft track. Converting the measured neutral density into a production rate requires knowledge of the neutral gas distribution in the coma. Our empirical model provides this information and therefore allows us to correct for the spacecraft location to calculate a production rate as a function of heliocentric distance. We will present the full empirical model as well as the calculated neutral production rate for the period of August 2014 - August 2015 (perihelion).

An adaptive and generalizable closed-loop system for control of medically induced coma and other states of anesthesia

NASA Astrophysics Data System (ADS)

Yang, Yuxiao; Shanechi, Maryam M.

2016-12-01

Objective. Design of closed-loop anesthetic delivery (CLAD) systems is an important topic, particularly for medically induced coma, which needs to be maintained for long periods. Current CLADs for medically induced coma require a separate offline experiment for model parameter estimation, which causes interruption in treatment and is difficult to perform. Also, CLADs may exhibit bias due to inherent time-variation and non-stationarity, and may have large infusion rate variations at steady state. Finally, current CLADs lack theoretical performance guarantees. We develop the first adaptive CLAD for medically induced coma, which addresses these limitations. Further, we extend our adaptive system to be generalizable to other states of anesthesia. Approach. We designed general parametric pharmacodynamic, pharmacokinetic and neural observation models with associated guidelines, and derived a novel adaptive controller. We further penalized large steady-state drug infusion rate variations in the controller. We derived theoretical guarantees that the adaptive system has zero steady-state bias. Using simulations that resembled real time-varying and noisy environments, we tested the closed-loop system for control of two different anesthetic states, burst suppression in medically induced coma and unconsciousness in general anesthesia. Main results. In 1200 simulations, the adaptive system achieved precise control of both anesthetic states despite non-stationarity, time-variation, noise, and no initial parameter knowledge. In both cases, the adaptive system performed close to a baseline system that knew the parameters exactly. In contrast, a non-adaptive system resulted in large steady-state bias and error. The adaptive system also resulted in significantly smaller steady-state infusion rate variations compared to prior systems. Significance. These results have significant implications for clinically viable CLAD design for a wide range of anesthetic states, with potential cost

An adaptive and generalizable closed-loop system for control of medically induced coma and other states of anesthesia.

PubMed

Yang, Yuxiao; Shanechi, Maryam M

2016-12-01

Design of closed-loop anesthetic delivery (CLAD) systems is an important topic, particularly for medically induced coma, which needs to be maintained for long periods. Current CLADs for medically induced coma require a separate offline experiment for model parameter estimation, which causes interruption in treatment and is difficult to perform. Also, CLADs may exhibit bias due to inherent time-variation and non-stationarity, and may have large infusion rate variations at steady state. Finally, current CLADs lack theoretical performance guarantees. We develop the first adaptive CLAD for medically induced coma, which addresses these limitations. Further, we extend our adaptive system to be generalizable to other states of anesthesia. We designed general parametric pharmacodynamic, pharmacokinetic and neural observation models with associated guidelines, and derived a novel adaptive controller. We further penalized large steady-state drug infusion rate variations in the controller. We derived theoretical guarantees that the adaptive system has zero steady-state bias. Using simulations that resembled real time-varying and noisy environments, we tested the closed-loop system for control of two different anesthetic states, burst suppression in medically induced coma and unconsciousness in general anesthesia. In 1200 simulations, the adaptive system achieved precise control of both anesthetic states despite non-stationarity, time-variation, noise, and no initial parameter knowledge. In both cases, the adaptive system performed close to a baseline system that knew the parameters exactly. In contrast, a non-adaptive system resulted in large steady-state bias and error. The adaptive system also resulted in significantly smaller steady-state infusion rate variations compared to prior systems. These results have significant implications for clinically viable CLAD design for a wide range of anesthetic states, with potential cost-saving and therapeutic benefits.

Recent activities of the physical society of Japan and the Japan society of applied physics gender equality promotion committees

NASA Astrophysics Data System (ADS)

Kaki, K.; Okiharu, F.; Tajima, S.; Takayama, H.; Watanabe, M. O.

2013-03-01

The results of a 2007 large-scale survey of gender equality in scientific and technological professions in Japan are reported. The activities of two Japanese physics societies in the three years since the 3rd IUPAP International Conference on Women in Physics was held in 2008 are reported.

Prescription patterns and trends in anti-rheumatic drug use based on a large-scale claims database in Japan.

PubMed

Katada, Hirotaka; Yukawa, Naoichiro; Urushihara, Hisashi; Tanaka, Shiro; Mimori, Tsuneyo; Kawakami, Koji

2015-05-01

This drug utilization study aimed to investigate prescription patterns and trends for anti-rheumatic drug use in Japanese patients with rheumatoid arthritis (RA), clarifying if patients with RA in Japan are being treated according to EULAR recommendations and ACR guidelines. We used a large-scale claims database consisting of the medical claims of employee health insurance recipients, which included approximately one million insured people. The claims data for incident 5,126 patients with diagnosis codes of RA between January 1, 2005 and October 31, 2011 were analyzed. The number of patients who received disease modifying anti-rheumatic drugs (DMARDs) including biologics as initial therapy was 629 (12.3 %), while the others received non-DMARD therapy only. During the study period, use of methotrexate (MTX) and biologics as first-line drugs increased from 1.9 to 8.0 % and from 0 to 1.6 %, respectively (p < 0.001 for both), while that of non-steroidal anti-inflammatory drugs (NSAIDs) decreased (p = 0.004). Time from first RA diagnosis to the start of treatment with DMARDs decreased significantly from 2005 to 2010. These findings suggest that many early RA patients in Japan do not yet receive aggressive treatment, albeit that this prescribing practice has gradually changed to better comply with clinical recommendations. The current, obsolete Japanese RA guidelines require urgent updating to reflect the most recent knowledge and care with effective treatment modalities.

Observation of a rapid decrease in the brightness of the coma of 2060 Chiron in 1990 January

NASA Technical Reports Server (NTRS)

Buratti, Bonnie J.; Dunbar, R. Scott

1991-01-01

Photometric observations of 2060 Chiron in the V and R filters were obtained with the 1.5-m telescope on Palomar Mountain during a 7-hr period on January 20, 1990 (UT). A general decrease of about 10 percent in integrated brightness occurred in both filters. No color dependence to the decrease was observed. A small (about 0.02 mag) rotational light curve, far smaller than the 0.09 mag (peak-to-peak) one observed by Bus et al. (1989) is superposed on the general decrease. On January 29, 1990, Luu and Jewitt (1990) observed an impulsive brightening of Chiron of approximately the same magnitude and time scale as the presently observed decrease in brightness. The combined results provide evidence that Chiron is currently exhibiting short-term fluctuations in the brightness of its coma, in addition to its well-established general decrease in brightness.

Observation of a rapid decrease in the brightness of the coma of 2060 Chiron in 1990 January

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buratti, B.J.; Dunbar, R.S.

Photometric observations of 2060 Chiron in the V and R filters were obtained with the 1.5-m telescope on Palomar Mountain during a 7-hr period on January 20, 1990 (UT). A general decrease of about 10 percent in integrated brightness occurred in both filters. No color dependence to the decrease was observed. A small (about 0.02 mag) rotational light curve, far smaller than the 0.09 mag (peak-to-peak) one observed by Bus et al. (1989) is superposed on the general decrease. On January 29, 1990, Luu and Jewitt (1990) observed an impulsive brightening of Chiron of approximately the same magnitude and timemore » scale as the presently observed decrease in brightness. The combined results provide evidence that Chiron is currently exhibiting short-term fluctuations in the brightness of its coma, in addition to its well-established general decrease in brightness. 14 refs.« less

Physical process in the coma of comet 67P derived from narrowband imaging of fragment species

NASA Astrophysics Data System (ADS)

Perez Lopez, F.; Küppers, M.; Marín-Yaseli de la Parra, J.; Besse, S.; Moissl, R.

2017-09-01

During the rendezvous of the Rosetta spacecraft with comet 67P/Churyumov-Gerasimenko, the OSIRIS scientific cameras monitored the near-nucleus gas environment in various narrow-band filters, observing various fragment species. It turned out that the excitation processes in the innermost coma are significantly different from the overall coma, as observed from the ground [1]. In particular, some of the observed emissions of fragments (daughter molecules) are created by direct dissociation of parent molecules, and in those cases the spatial distribution of the emission directly maps the distribution of parent molecules. We investigate the evolution of the brightness and distribution of the emissions over time to improve our understanding of the underlying emission mechanisms and to derive the spatial distribution of H2O and CO2. The outcome will provide constraints on the homogeneity of the cometary nucleus.

Japanese as a Second Language Assessment in Japan: Current Issues and Future Directions

ERIC Educational Resources Information Center

Hatasa, Yukiko; Watanabe, Tomoko

2017-01-01

This article reviews assessment practices of Japanese as a second language as taught in Japan since the 1980s. It begins with an explanation of the social and political conditions that have impacted assessment practices in Japan and then addresses current assessment practices and issues. This analysis first examines large-scale tests developed in…

Japan.

ERIC Educational Resources Information Center

Geiger, Rita; And Others

The document offers practical and motivating techniques for studying Japan. Dedicated to promoting global awareness, separate sections discuss Japan's geography, history, culture, education, government, economics, energy, transportation, and communication. Each section presents a topical overview; suggested classroom activities; and easily…

A comparison of the near-infrared spectral features of early-type galaxies in the Coma Cluster, the Virgo cluster and the field

NASA Technical Reports Server (NTRS)

Houdashelt, Mark L.; Frogel, Jay A.

1993-01-01

Earlier researchers derived the relative distance between the Coma and Virgo clusters from color-magnitude relations of the early-type galaxies in each cluster. They found that the derived distance was color-dependent and concluded that the galaxies of similar luminosity in the two clusters differ in their red stellar populations. More recently, the color-dependence of the Coma-Virgo distance modulus has been called into question. However, because these two clusters differ so dramatically in their morphologies and kinematics, it is plausible that the star formation histories of the member galaxies also differed. If the conclusions of earlier researchers are indeed correct, then some signature of the resulting stellar population differences should appear in the near-infrared and/or infrared light of the respective galaxies. We have collected near-infrared spectra of 17 Virgo and 10 Coma early-type galaxies; this sample spans about four magnitudes in luminosity in each cluster. Seven field E/S0 galaxies have been observed for comparison. Pseudo-equivalent widths have been measured for all of the field galaxies, all but one of the Virgo members, and five of the Coma galaxies. The features examined are sensitive to the temperature, metallicity, and surface gravity of the reddest stars. A preliminary analysis of these spectral features has been performed, and, with a few notable exceptions, the measured pseudo-equivalent widths agree well with previously published values.

Correlates of depressive symptoms among workers in small- and medium-scale manufacturing enterprises in Japan.

PubMed

Ikeda, Tomoko; Nakata, Akinori; Takahashi, Masaya; Hojou, Minoru; Haratani, Takashi; Nishikido, Noriko; Kamibeppu, Kiyoko

2009-01-01

Although the relationship between job stress and depressive symptoms has been well documented among workers in large scale enterprises, the situation in small- and medium-scale enterprises (SMEs) is not fully understood. To clarify the factors associated with depressive symptoms in SMEs in Japan. 1,516 male and 738 female Japanese workers at SMEs were surveyed using a self-administered questionnaire. We applied hierarchical multiple linear regression with depressive symptoms (Center for Epidemiologic Studies Depressive Symptoms Scale) as the dependent variable, and (1) Individual, (2) Lifestyle, (3) Job stressors, and (4) SME unique factors as independent variables entered in 4 steps. Analyses were stratified by sex due to large differences in stress scores and demographic variables. Perceived lack of understanding from others with regard to health was the strongest factor associated with increased depressive symptoms (BETA=0.29 in males and 0.28 in females). Higher intragroup conflict (BETA=0.15 in males and 0.09 in females), perceived job future ambiguity (BETA=0.09 in males and 0.11 in females), higher quantitative workload (BETA=0.06 in males and 0.10 in females), and being an employer or a member of the employer's family (BETA=0.06 in males and 0.10 in females) were additional factors associated with high depressive symptoms. Economic concern, being single, cigarette smoking, shorter sleep duration, and skill underutilization were male specific, while younger age and lower social support at work were female specific factors significantly associated with increased depressive symptoms. These data suggest that poor mental health may be prevented by creating a workplace climate which focuses on the high value of the health of fellow workers.

Studies of cluster X-ray sources, energy spectra for the Perseus, Virgo, and Coma clusters

NASA Technical Reports Server (NTRS)

Kellogg, E.; Baldwin, J. R.; Koch, D.

1975-01-01

Final Uhuru X-ray differential-energy spectra are presented for the Perseus, Virgo, and Coma clusters. Power-law and isothermal bremsstrahlung model spectra with low-energy cutoffs are given, and the energy-dependent Gaunt factor is calculated for the bremsstrahlung. The spectra, which are best fits to the Uhuru data between 2 and 10 keV, are compared with previous observations of these sources in the energy range from 0.1 to 100 keV. The problem of parameter estimation is discussed, error bars with 68% confidence are given for the independently determined slope and cutoff parameters, and the 68% confidence limits are plotted for the fitted spectral functions. The data for Perseus above 20 keV marginally favor the bremsstrahlung fit, those for Virgo between 0.25 and 1.0 keV clearly favor that curve, and those for Coma indicate a low-energy turnover or cutoff. Implications of such a cutoff are briefly discussed.

Dust grains in the coma of 67P/Churyumov-Gerasimenko - link with surface properties and cometary activity

NASA Astrophysics Data System (ADS)

Capria, M. T.; Ivanovski, S.; Zakharov, W.; Capaccioni, F.; Filacchione, G.; De Sanctis, M. C.; Rotundi, A.; Della Corte, V.; Longobardo, A.; Palomba, E.; Colangeli, L.; Bockelee-Morvan, D.; Erard, S.; Leyrat, C.

2016-11-01

The imaging spectrometer VIRTIS and the dust analyzer GIADA, onboard Rosetta, made an extensive observation of the dust particles in the coma of the comet 67P/Churyumov-Gerasimenko. From the analysis of GIADA data, two different kind of particles have been revealed, compact and fluffy with different compositions and dynamical properties. Compact particles are characterized by densities of about 10E3 kg/m3, while fluffy particles have an almost fractal nature, with densities less than 1 kg/m3. In this work we present the initial results of a model linking the dust flux distribution, as obtained from a theoretical thermal nucleus model, with a model describing the dynamics of aspherical grains in the coma. The results are discussed in the context of the latest observations from VIRTIS and GIADA instruments. The 2D nucleus thermal model, when applied to the real shape of the comet, provides the size distribution and physical properties of the emitted grains at different times and location on the surface. The thermal model can simulate grains of various size distribution, composition and physical properties. This information is used as an input for the dust dynamical model that follows the emitted particles in the coma. The main source of heating is the solar illumination. In the dust dynamical model, the grain trajectory of emitted particles remains in a plane perpendicular to the rotational axis and the direction of illumination is taken to be in the same plane (i.e. does not cause transversal forces). The dust particles are assumed to be isothermal convex bodies and temperature changes only induce modest changes in the aerodynamic force (twice higher temperature changes aerodynamic force less than 30%). This study reviews the theoretical values at which temperature difference starts to play a role on the dynamics. We discuss to what extent the particle's temperature affects the terminal velocities of the dust grains in the 67P coma in dependence on their mass and

Dust grains in the coma of 67P/Churyumov-Gerasimenko - link with surface properties and cometary activity

NASA Astrophysics Data System (ADS)

Capria, Maria Teresa; Ivanovski, Stavro; Zakharov, Vladimir; Capaccioni, Fabrizio; Filacchione, Gianrico; De Sanctis, Maria Cristina; rotundi, alessandra; della corte, vincenzo; Longobardo, Andrea; Palomba, Ernesto; colangeli, luigi; Bockelee-Morvan, Dominique; Érard, Stéphane; Leyrat, Cedric; VIRTIS, GIADA

2016-10-01

The imaging spectrometer VIRTIS and the dust analyzer GIADA, onboard Rosetta, made an extensive observation of the dust particles in the coma of the comet 67P/Churyumov-Gerasimenko. From the analysis of GIADA data, two different kind of particles have been revealed, compact and fluffy with different compositions and dynamical properties. Compact particles are characterized by densities of about 103 kg/m3, while fluffy particles have an almost fractal nature, with densities less than 1 kg/m3.In this work we present the initial results of a model linking the dust flux distribution, as obtained from a theoretical thermal nucleus model, with a model describing the dynamics of aspherical grains in the coma. The results are discussed in the context of the latest observations from VIRTIS and GIADA instruments.The 2D nucleus thermal model, when applied to the real shape of the comet, provides the size distribution and physical properties of the emitted grains at different times and location on the surface. The thermal model can simulate grains of various size distribution, composition and physical properties. This information is used as an input for the dust dynamical model that follows the emitted particles in the coma. The main source of heating is the solar illumination. In the dust dynamical model, the grain trajectory of emitted particles remains in a plane perpendicular to the rotational axis and the direction of illumination is taken to be in the same plane (i.e. does not cause transversal forces). The dust particles are assumed to be isothermal convex bodies and temperature changes only induce modest changes in the aerodynamic force (twice higher temperature changes aerodynamic force less than ~30%). This study reviews the theoretical values at which temperature difference starts to play a role on the dynamics. We discuss to what extent the particle's temperature affects the terminal velocities of the dust grains in the 67P coma in dependence on their mass and

Study and application of molluscicides in Japan*

PubMed Central

Komiya, Yoshitaka

1961-01-01

For several years after the First World War calcium oxide was the main compound used in the control of Oncomelania nosophora in Japan. This was generally replaced in 1944 by calcium cyanamide; since 1952 the prefectural authorities in areas of endemic bilharziasis have increasingly turned to the use of sodium pentachlorophenate as the molluscicide of choice. Applied at a rate of 5 g per m2, this compound has been found to kill 70%-80% of snails per application. Laboratory and field experiments with calcium-arsenic compounds have been conducted in Japan and have indicated that these products have a relatively high molluscicidal effect; they have, however, not been used on a wide scale for snail control. PMID:14458130

Robust control of burst suppression for medical coma

NASA Astrophysics Data System (ADS)

Westover, M. Brandon; Kim, Seong-Eun; Ching, ShiNung; Purdon, Patrick L.; Brown, Emery N.

2015-08-01

Objective. Medical coma is an anesthetic-induced state of brain inactivation, manifest in the electroencephalogram by burst suppression. Feedback control can be used to regulate burst suppression, however, previous designs have not been robust. Robust control design is critical under real-world operating conditions, subject to substantial pharmacokinetic and pharmacodynamic parameter uncertainty and unpredictable external disturbances. We sought to develop a robust closed-loop anesthesia delivery (CLAD) system to control medical coma. Approach. We developed a robust CLAD system to control the burst suppression probability (BSP). We developed a novel BSP tracking algorithm based on realistic models of propofol pharmacokinetics and pharmacodynamics. We also developed a practical method for estimating patient-specific pharmacodynamics parameters. Finally, we synthesized a robust proportional integral controller. Using a factorial design spanning patient age, mass, height, and gender, we tested whether the system performed within clinically acceptable limits. Throughout all experiments we subjected the system to disturbances, simulating treatment of refractory status epilepticus in a real-world intensive care unit environment. Main results. In 5400 simulations, CLAD behavior remained within specifications. Transient behavior after a step in target BSP from 0.2 to 0.8 exhibited a rise time (the median (min, max)) of 1.4 [1.1, 1.9] min; settling time, 7.8 [4.2, 9.0] min; and percent overshoot of 9.6 [2.3, 10.8]%. Under steady state conditions the CLAD system exhibited a median error of 0.1 [-0.5, 0.9]%; inaccuracy of 1.8 [0.9, 3.4]%; oscillation index of 1.8 [0.9, 3.4]%; and maximum instantaneous propofol dose of 4.3 [2.1, 10.5] mg kg-1. The maximum hourly propofol dose was 4.3 [2.1, 10.3] mg kg-1 h-1. Performance fell within clinically acceptable limits for all measures. Significance. A CLAD system designed using robust control theory achieves clinically acceptable

Robust control of burst suppression for medical coma

PubMed Central

Westover, M Brandon; Kim, Seong-Eun; Ching, ShiNung; Purdon, Patrick L; Brown, Emery N

2015-01-01

Objective Medical coma is an anesthetic-induced state of brain inactivation, manifest in the electroencephalogram by burst suppression. Feedback control can be used to regulate burst suppression, however, previous designs have not been robust. Robust control design is critical under real-world operating conditions, subject to substantial pharmacokinetic and pharmacodynamic parameter uncertainty and unpredictable external disturbances. We sought to develop a robust closed-loop anesthesia delivery (CLAD) system to control medical coma. Approach We developed a robust CLAD system to control the burst suppression probability (BSP). We developed a novel BSP tracking algorithm based on realistic models of propofol pharmacokinetics and pharmacodynamics. We also developed a practical method for estimating patient-specific pharmacodynamics parameters. Finally, we synthesized a robust proportional integral controller. Using a factorial design spanning patient age, mass, height, and gender, we tested whether the system performed within clinically acceptable limits. Throughout all experiments we subjected the system to disturbances, simulating treatment of refractory status epilepticus in a real-world intensive care unit environment. Main results In 5400 simulations, CLAD behavior remained within specifications. Transient behavior after a step in target BSP from 0.2 to 0.8 exhibited a rise time (the median (min, max)) of 1.4 [1.1, 1.9] min; settling time, 7.8 [4.2, 9.0] min; and percent overshoot of 9.6 [2.3, 10.8]%. Under steady state conditions the CLAD system exhibited a median error of 0.1 [−0.5, 0.9]%; inaccuracy of 1.8 [0.9, 3.4]%; oscillation index of 1.8 [0.9, 3.4]%; and maximum instantaneous propofol dose of 4.3 [2.1, 10.5] mg kg−1. The maximum hourly propofol dose was 4.3 [2.1, 10.3] mg kg−1 h−1. Performance fell within clinically acceptable limits for all measures. Significance A CLAD system designed using robust control theory achieves clinically acceptable

A new 3D multi-fluid model: a study of kinetic effects and variations of physical conditions in the cometary coma

NASA Astrophysics Data System (ADS)

Shou, Yinsi; Combi, Michael R.; Toth, Gabor; Huang, Zhenguang; Jia, Xianzhe; Fougere, Nicolas; Tenishev, Valeriy; Gombosi, T. I.; Hansen, Kenneth C.; Bieler, Andre

2016-10-01

Physics-based numerical coma models are desirable whether to interpret the spacecraft observations of the inner coma or to compare with the ground-based observations of the outer coma. In this work, we develop a multi-neutral-fluid model based on BATS-R-US in the University of Michigan's SWMF (Space Weather Modeling Framework), which is capable of computing both the inner and the outer coma and simulating time-variable phenomena. It treats H2O, OH, H2, O, and H as separate fluids and each fluid has its own velocity and temperature, with collisions coupling all fluids together. The self-consistent collisional interactions decrease the velocity differences, re-distribute the excess energy deposited by chemical reactions among all species, and account for the varying heating efficiency under various physical conditions. Recognizing that the fluid approach has limitations in capturing all of the correct physics for certain applications, especially for very low density environment, we applied our multi-fluid coma model to comet 67P/Churyumov-Gerasimenko (CG) at various heliocentric distances and demonstrated that it is able to yield comparable results as the Direct Simulation Monte Carlo (DSMC) model, which is based on a kinetic approach that is valid under these conditions. Therefore, our model may be a powerful alternative to the particle-based model, especially for some computationally intensive simulations. In addition, by running the model with several combinations of production rates and heliocentric distances, we can characterize the cometary H2O expansion speeds and demonstrate the nonlinear effect of production rates or photochemical heating. Our results are also compared to previous modeling work (e.g., Bockelee-Morvan & Crovisier 1987) and remote observations (e.g., Tseng et al. 2007), which serve as further validation of our model. This work has been partially supported by grant NNX14AG84G from the NASA Planetary Atmospheres Program, and US Rosetta contracts

Summer outbursts in the coma of 67P/Churyumov-Gerasimenko as observed by VIRTIS-M

NASA Astrophysics Data System (ADS)

Rinaldi, G.; Bockelee-Morvan, D.; Ciarniello, M.; Tozzi, G. P.; Capaccioni, F.; Filacchione, G.; Fink, U.; Doose, L.; Raponi, A.; Capria, M. T.; Erard, S.; Leyrat, C.; Longobardo, A.; Taylor, F.

2017-09-01

In this work, we present an analysis of the outbursts observed by VIRTIS-M for the dates of August 10, September 13 and 14 2015, when the comet was at heliocentric distances of -1.2 AU (inbound) to 1.3 AU (outbound), 2 day before and one month after the perihelion passage respectively. They are characterized by a sudden and short increase of the dust emission, from localized areas with variable degree of collimation, followed by a sweet decrease of activity. The lifetime is between 5 and 15 minutes and the corresponding radiance at 0.55 μm is typically of the order of 10-2 - 1 Watt/m2/str/μm, i.e. 10-20 times larger than the surrounding coma. VIRTIS-M identified 2 main dust plumes morphologies associated to these events: a narrow jet and a broad plumes. We found clear evidence of different colour values in the ouburst with respect to the surrounding coma. This implies that we observed dust with different physical characteristics both in the structures and in the coma. The comparison between IR (VIRTIS-H) and VIS (VIRTISM) observations allows to derive the projected velocity of the small dust grain obtaining 23 -40 m/s. It is also possible to estimate the total mass loss in the outburst, by converting the radiance over an image to a dust cross section, and then to mass assuming a dust size distribution with a power law index of -3. For September 14 large event we estimated a total ejected dust mass of few tens tons as found by Vincent et al. 2016.

Exocomet Orbit Fitting: Accelerating Coma Absorption During Transits of β Pictoris

NASA Astrophysics Data System (ADS)

Kennedy, Grant M.

2018-06-01

Comets are a remarkable feature in our night sky, visible on their passage through the inner Solar system as the Sun's energy sublimates ices and liberates surface material, generating beautiful comae, dust, and ion tails. Comets are also thought to orbit other stars, and are the most promising interpretation of sporadic absorption features (i.e. transits) seen in spectra of stars such as β Pictoris and 49 Ceti. These "exocomets" are thought to form and evolve in the same way as in the Solar system, and as in the Solar system we may gain insight into their origins by deriving their orbits. In the case of β Pictoris, orbits have been estimated indirectly, using the radial velocity of the absorption features coupled with a physical evaporation model to estimate the stellocentric distance at transit dtr. Here, we note that the inferred dtr imply that some absorption signatures should accelerate over several hours, and show that this acceleration is indeed seen in HARPS spectra. This new constraint means that orbital characteristics can be obtained directly, and the pericentre distance and longitude constrained when parabolic orbits are assumed. The results from fitting orbits to 12 accelerating features, and a handful of non-accelerating ones, are in broad agreement with previous estimates based on an evaporation model, thereby providing some validation of the exocomet hypothesis. A prediction of the evaporation model, that coma absorption is deeper for more distant transits, is also seen here.

Ultraviolet and visible variability of the coma of Comet Levy (1990c)

NASA Technical Reports Server (NTRS)

Feldman, P. D.; Budzien, S. A.; Festou, M. C.; A'Hearn, M. F.; Tozzi, G. P.

1992-01-01

A visible lightcurve of Comet Levy obtained with the IUE Fine Error Sensor has revealed short-term coma variability. A production-rate source function is derivable from these data which implies a nucleus exhibiting hemispherically asymmetric activity. The ratio of gas-to-dust-production rates is also noted to exhibit asymmetry. The low dust-outflow velocity derived from observations, at about 200 m/sec, indicates a distribution that is rich in large, 3-10 micron particles.

Tracking the recovery of consciousness from coma

PubMed Central

Laureys, Steven; Boly, Mélanie; Maquet, Pierre

2006-01-01

Predicting the chances of recovery of consciousness and communication in patients who survive their coma but transit in a vegetative state or minimally conscious state (MCS) remains a major challenge for their medical caregivers. Very few studies have examined the slow neuronal changes underlying functional recovery of consciousness from severe chronic brain damage. A case study in this issue of the JCI reports an extraordinary recovery of functional verbal communication and motor function in a patient who remained in MCS for 19 years (see the related article beginning on page 2005). Diffusion tensor MRI showed increased fractional anisotropy (assumed to reflect myelinated fiber density) in posteromedial cortices, encompassing cuneus and precuneus. These same areas showed increased glucose metabolism as studied by PET scanning, likely reflecting the neuronal regrowth paralleling the patient’s clinical recovery. This case shows that old dogmas need to be oppugned, as recovery with meaningful reduction in disability continued in this case for nearly 2 decades after extremely severe traumatic brain injury. PMID:16823480

[Post-traumatic coma and pre-traumatic memory].

PubMed

Malacrida, R; Piazza, J; Abraham, G

1990-01-01

Instead of thinking that it is impossible to enter in the internal world of a comatose patient, we are now put before a new and encouraging prospective, that of the possibility, even though minimal, of influencing the vital residual organisation of the patient and to induce him perhaps to accept again external stimulations, which previously were too intense. As loss of conscience often causes loss of memory, our intention was to examine the problem of memory loss in comatose patients after accidents. The analysis of 50 questionnaires distributed to trauma-patients awakening from a comatose state and interviews give clear indications that: 1) the patients remember absolutely nothing during the time of the coma; 2) in the majority of cases (34) the patients remember in the moment preceding the accident a clear autodestructive tendency especially if they were the cause of the accident; and 3) almost all patients (41) agree to have benefited greatly from the trauma itself and from its memory.

Factors associated with mortality of patients with myxoedema coma: prospective study in 11 cases treated in a single institution.

PubMed

Rodríguez, I; Fluiters, E; Pérez-Méndez, L F; Luna, R; Páramo, C; García-Mayor, R V

2004-02-01

This study was carried out to investigate the clinical and biochemical factors which might be of importance in predicting the outcome of patients with myxoedema coma. Eleven patients (ten female) aged 68.1+/-19.5 years attended our institution over a period of 18 years. Glasgow and APACHE II scores and serum free thyroxine and TSH were measured in all the patients on entry. Patients were selected at random to be treated with two different regimens of l-thyroxine. Four patients died with the mortality rate being 36.4%. The patients in coma at entry had significantly higher mortality rates than those with minor degrees of consciousness (75% vs 14.3% respectively, P=0.04). The surviving patients had significantly higher Glasgow scores than those who died (11.85+/-2.3 vs 5.25+/-2.2 respectively, P<0.001). Comparison of the mean values of APACHE II scores between the surviving group and those who died was significantly different (18.0+/-2.08 vs 31.5+/-2.08 respectively, P<0.0001). The degree of consciousness, the Glasgow score and the severity of the illness measured by APACHE II score on entry were the main factors that determined the post-treatment outcome of patients with myxoedema coma.

Subaru Weak-lensing Survey of Dark Matter Subhalos in the Coma Cluster: Subhalo Mass Function and Statistical Properties

NASA Astrophysics Data System (ADS)

Okabe, Nobuhiro; Futamase, Toshifumi; Kajisawa, Masaru; Kuroshima, Risa

2014-04-01

We present a 4 deg2 weak gravitational lensing survey of subhalos in the very nearby Coma cluster using the Subaru/Suprime-Cam. The large apparent size of cluster subhalos allows us to measure the mass of 32 subhalos detected in a model-independent manner, down to the order of 10-3 of the virial mass of the cluster. Weak-lensing mass measurements of these shear-selected subhalos enable us to investigate subhalo properties and the correlation between subhalo masses and galaxy luminosities for the first time. The mean distortion profiles stacked over subhalos show a sharply truncated feature which is well-fitted by a Navarro-Frenk-White (NFW) mass model with the truncation radius, as expected due to tidal destruction by the main cluster. We also found that subhalo masses, truncation radii, and mass-to-light ratios decrease toward the cluster center. The subhalo mass function, dn/dln M sub, in the range of 2 orders of magnitude in mass, is well described by a single power law or a Schechter function. Best-fit power indices of 1.09^{+0.42}_{-0.32} for the former model and 0.99_{-0.23}^{+0.34} for the latter, are in remarkable agreement with slopes of ~0.9-1.0 predicted by the cold dark matter paradigm. The tangential distortion signals in the radial range of 0.02-2 h -1 Mpc from the cluster center show a complex structure which is well described by a composition of three mass components of subhalos, the NFW mass distribution as a smooth component of the main cluster, and a lensing model from a large scale structure behind the cluster. Although the lensing signals are 1 order of magnitude lower than those for clusters at z ~ 0.2, the total signal-to-noise ratio, S/N = 13.3, is comparable, or higher, because the enormous number of background source galaxies compensates for the low lensing efficiency of the nearby cluster. Based on data collected from the Subaru Telescope and obtained from SMOKA, operated by the Astronomy Data Center, National Astronomical Observatory of