The impact of a register on the management of neonatal cooling in Switzerland.

BACKGROUND Therapeutic hypothermia following hypoxic ischaemic encephalopathy in term infants was introduced into Switzerland in 2005. Initial documentation of perinatal and resuscitation details was poor and neuromonitoring insufficient. In 2011, a National Asphyxia and Cooling Register was introduced. AIMS To compare management of cooled infants before and after introduction of the register concerning documentation, neuromonitoring, cooling methods and evaluation of temperature variability between cooling methods. STUDY DESIGN Data of cooled infants before the register was in place (first time period: 2005-2010) and afterwards (second time period: 2011-2012) was collected with a case report form. RESULTS 150 infants were cooled during the first time period and 97 during the second time period. Most infants were cooled passively or passively with gel packs during both time periods (82% in 2005-2010 vs 70% in 2011-2012), however more infants were cooled actively during the second time period (18% versus 30%). Overall there was a significant reduction in temperature variability (p < 0.001) comparing the two time periods. A significantly higher proportion of temperature measurements within target temperature range (72% versus 77%, p < 0.001), fewer temperature measurements above (24% versus 7%, p < 0.001) and more temperatures below target range (4% versus 16%, p < 0.001) were recorded during the second time period. Neuromonitoring improved after introduction of the cooling register. CONCLUSION Management of infants with HIE improved since introducing the register. Temperature variability was reduced, more temperature measurements in the target range and fewer temperature measurements above target range were observed. Neuromonitoring has improved, however imaging should be performed more often.

Ion channel macromolecular complexes in cardiomyocytes: roles in sudden cardiac death.

The movement of ions across specific channels embedded on the membrane of individual cardiomyocytes is crucial for the generation and propagation of the cardiac electric impulse. Emerging evidence over the past 20 years strongly suggests that the normal electric function of the heart is the result of dynamic interactions of membrane ion channels working in an orchestrated fashion as part of complex molecular networks. Such networks work together with exquisite temporal precision to generate each action potential and contraction. Macromolecular complexes play crucial roles in transcription, translation, oligomerization, trafficking, membrane retention, glycosylation, post-translational modification, turnover, function, and degradation of all cardiac ion channels known to date. In addition, the accurate timing of each cardiac beat and contraction demands, a comparable precision on the assembly and organizations of sodium, calcium, and potassium channel complexes within specific subcellular microdomains, where physical proximity allows for prompt and efficient interaction. This review article, part of the Compendium on Sudden Cardiac Death, discusses the major issues related to the role of ion channel macromolecular assemblies in normal cardiac electric function and the mechanisms of arrhythmias leading to sudden cardiac death. It provides an idea of how these issues are being addressed in the laboratory and in the clinic, which important questions remain unanswered, and what future research will be needed to improve knowledge and advance therapy.

A Muddy Mystery: What's Causing Sudden Vegetation Dieback in Connecticut's Marshes?

Some of Connecticut's salt marshes are experiencing unprecedented sudden vegetation dieback, leaving bare mud where Spartina grass used to grow. In a Sea Grant project, Dr. Wade Elmer has investigated possible causes.

Bankruptcy Costs, Liability Dollarization, and Vulnerability to Sudden Stops

Emerging market countries that have improved institutions and attained intermediate levels of institutional quality have experienced severe financial crises following capital flow reversals. However, there is also evidence that countries with strong institutions and deep capital markets are less affected by external shocks. We reconcile these two observations using a calibrated DSGE model that extends the financial accelerator framework developed in Bernanke, Gertler, and Gilchrist (1999). The model captures financial market institutional quality with creditors. ability to recover assets from bankrupt firms. Bankruptcy costs affect vulnerability to sudden stops directly but also indirectly by affecting the degree of liability dollarization. Simulations reveal an inverted U-shaped relationship between bankruptcy recovery rates and the output loss following sudden stops. We provide empirical evidence that this non-linear relationship exists.

Assessing maintenance of evaporative cooling systems in Legionellosis outbreaks

Evaporative cooling systems continue to be associated with outbreaks of Legionnaires’ disease despite widely available maintenance guidelines intended to reduce these outbreaks. Yet, the guidelines vary widely regarding the recommendations that are made to maintain evaporative cooling systems and it is unclear whether guidelines were in place or, if they were, whether they were being followed when the outbreaks of Legionnaires’ disease occurred. Thus, this study was designed to conduct two systematic reviews of (1) evaporative cooling system maintenance guidelines; and (2) published Legionnaires’ disease outbreaks. For each maintenance guideline identified in the systematic review, recommended maintenance practices were abstracted and similarities and/or differences in the reported recommendations were assessed. Following the systematic review of outbreak investigations that meet the inclusion criteria established for the study, information about the state of the evaporative cooling system during the outbreak investigation was abstracted to summarize, when reported, which maintenance practices were implemented. As expected, the recommended maintenance procedures varied greatly across the guidelines and were not always specific. Overall, the outbreak investigations tended to report similar maintenance issues that were unclear in the maintenance guidelines. Generally, these maintenance issues were biocide use, microbiological testing, frequency of general inspections, and protocols and frequency of total system cleanings. The role in which non-standardized and generalized maintenance guidelines plays in the continued association between Legionnaires’ disease and evaporative cooling systems is still not fully understood. However, this study suggests that more specific and standardized maintenance guidelines, that have been scientifically established to be effective in controlling Legionella bacteria, are needed and then these guidelines must be properly implemented in order to help reduce further Legionnaires’ disease outbreaks associated with evaporative cooling systems.^

Sudden Infant Death disparities: A systematic review on health education and policy recommendations for decreasing Sudden Infant Death in the African-American community

Objective: To perform a systematic review of the literature on SIDS and SUID deaths concentrated in the African-American community, describe health education and policy recommendations and recommend a new approach that may aid in decreasing the disparity of infant mortality in the African-American community. ^ Methods: The PubMed database was systematically searched to identify relevant articles for final review and analysis. Using the CASP 2006 system to critique literature, twelve articles were found that met inclusion and exclusion criteria. ^ Results: Evidence in the literature confirmed there was a current disparity among African Americans' infant mortality rates in comparison to other US ethnic groups. The underlying reasons for these disparities included the following maternal and infant characteristics: mothers younger than eighteen, having more than one live infant, having a high school education or less, never been married, and have infants born preterm or with low birth weight. Maternal smoking, substance abuse, and breastfeeding did not have a significant impact on infant sleep environments among African Americans. ^ Conclusion: Tailored health education programs at the community level, better access to pre-pregnancy and prenatal care, and increased maternal perception of risk that is relevant to the infants sleeping environment are all possible solutions that may decrease African American infant mortality rates.^

Effect of Date of Planting on Soybean Sudden Death Syndrome

The objectives of this project was to study the effect of planting date on the onset of soybean sudden death syndrome (SDS). It is believed, that avoiding planting soybeans into wet cold soil may delay or lower the severity of SDS. Planting date for soybeans is important and can have a large effect on yield potential.

Global cooling during the Eocene Oligocene Transition

About 34 million years ago, Earth's climate shifted from a relatively ice-free world to one with glacial conditions on Antarctica characterized by substantial ice sheets. How Earth's temperature changed during this climate transition remains poorly understood, and evidence for Northern Hemisphere polar ice is controversial. Here, we report proxy records of sea surface temperatures from multiple ocean localities and show that the high-latitude temperature decrease was substantial and heterogeneous. High-latitude (45 degrees to 70 degrees in both hemispheres) temperatures before the climate transition were ~20°C and cooled an average of ~5°C. Our results, combined with ocean and ice-sheet model simulations and benthic oxygen isotope records, indicate that Northern Hemisphere glaciation was not required to accommodate the magnitude of continental ice growth during this time.

(Table 3) Run conditions and phase relations and proportions during cooling rate experiments on ODP Interval 163-989B-10R-7,55-59

Equilibrium melting and controlled cooling experiments were undertaken to constrain the crystallization and cooling histories of tholeiitic basalts recovered by the Ocean Drilling Program drilling of Site 989 on the Southeast Greenland continental margin. Isothermal experiments conducted at 1 atm. and at the fayalite-magnetite-quartz buffer using lava sample Section 163-989B-10R-7 yielded the equilibrium appearance sequence with decreasing temperature: olivine at 1184 ± 2ºC; plagioclase at 1177ºC ± 5ºC; augite at 1167 ± 5ºC; and pigeonite at 1113 ± 12ºC. In controlled cooling experiments using the same starting composition and cooling rates between 10ºC/hr and 2000ºC/hr, we find a significant temperature delay in the crystallization of olivine, plagioclase, and augite (relative to the equilibrium appearance temperature); pigeonite does not form under any dynamic crystallization conditions. Olivine exhibits the largest suppression in appearance temperature (e.g., 30º for 10ºC/hr and >190º at 100ºC/hr), while plagioclase shows the smallest (~10ºC at 10ºC/hr; 30ºC at 100ºC/hr, and ~80ºC at 1000ºC/hr). These results are in marked contrast to those obtained on lunar basalts, which generally show a large suppression of plagioclase crystallization and modest suppression of olivine crystallization with an increased cooling rate. The results we report agree well with the petrography of lavas recovered from Site 989. Furthermore, the textural analysis of run products, representing a large range of cooling rates and quench temperatures (1150ºC to 1000ºC), provide a framework for evaluating cooling conditions necessary for glass formation, rates of plagioclase growth, and kinetic factors governing plagioclase growth morphology. Specifically, we use these insights to interpret the textural and mineralogical features of the unusual compound flow recovered at Site 989. We concluded from the analysis that this flow most likely records multiple breakouts from a distal tube at an abrupt break in slope, possibly a fault scarp, resulting in the formation of a lava fan delta. This interpretation implies that normal faulting of the oldest lava sequences (lower and, possibly, middle series) preceded eruption of Site 989 lavas.

Constraints on the magnitude and patterns of ocean cooling at the Last Glacial Maximum - Supplementary material

Observation-based reconstructions of sea surface temperature from relatively stable periods in the past, such as the Last Glacial Maximum, represent an important means of constraining climate sensitivity and evaluating model simulations. The first quantitative global reconstruction of sea surface temperatures during the Last Glacial Maximum was developed by the Climate Long-Range Investigation, Mapping and Prediction (CLIMAP) project in the 1970s and 1980s. Since that time, several shortcomings of that earlier effort have become apparent. Here we present an updated synthesis of sea surface temperatures during the Last Glacial Maximum, rigorously defined as the period between 23 and 19 thousand years before present, from the Multiproxy Approach for the Reconstruction of the Glacial Ocean Surface (MARGO) project. We integrate microfossil and geochemical reconstructions of surface temperatures and include assessments of the reliability of individual records. Our reconstruction reveals the presence of large longitudinal gradients in sea surface temperature in all of the ocean basins, in contrast to the simulations of the Last Glacial Maximum climate available at present.

Onset of long-term cooling of Greenland near the Eocene-Oligocene boundary as revealed by branched tetraether lipids

The Eocene-Oligocene (E-O) boundary interval is considered to be one of the major transitions in Earth's climate, witnessing the first major expansion of the East Antarctic Ice Sheet. However, the extent of the associated climatic cooling, especially for high northern latitude continental landmasses, is poorly constrained. In this study we reconstruct the first mean annual air temperature (MAAT) for the Greenland landmass during the late Eocene and early Oligocene by applying a new proxy based on the distribution of branched tetraether lipids derived from soil bacteria preserved in a marine sediment core from the Greenland Basin. The temperature estimates are compared with a composite continental temperature record based on bio-climatic analysis of pollen assemblages. Both proxies reveal comparable late Eocene MAATs of ~13-15 °C and a gradual long-term cooling of ~3-5 °C starting near the E-O boundary. These data are in agreement with other MAAT reconstructions from northern midlatitude continents and suggest a general cooling of the Northern Hemisphere during the E-O transition.

Response of marine palynomorphs to Neogene climate cooling in the Iceland Sea, ODP Hole 151-907A

The present study on ODP Leg 151 Hole 907A combines a detailed analysis of marine palynomorphs (dinoflagellate cysts, prasinophytes, and acritarchs) and a low-resolution alkenone-based sea-surface temperature (SST) record for the interval between 14.5 and 2.5 Ma, and allows to investigate the relationship between palynomorph assemblages and the paleoenvironmental evolution of the Iceland Sea. A high marine productivity is indicated in the Middle Miocene, and palynomorphs and SSTs both mirror the subsequent long-term Neogene climate deterioration. The diverse Middle Miocene palynomorph assemblages clearly diminish towards the impoverished assemblages of the Late Pliocene; parallel with a somewhat gradual decrease of SSTs being as high as 20 °C at ~13.5 Ma to around 8 °C at ~3 Ma. Superimposed, palynomorph assemblages not only reflect Middle to Late Miocene climate variability partly coinciding with the short-lived global Miocene isotope events (Mi-events), but also the initiation of a proto-thermohaline circulation across the Middle Miocene Climate Transition, which led to increased meridionality in the Nordic Seas. Last occurrences of species cluster during three events in the Late Miocene to Early Pliocene and are ascribed to the progressive strengthening and freshening of the proto-East Greenland Current towards modern conditions. A significant high latitude cooling between 6.5 and 6 Ma is depicted by the supraregional "Decahedrella event" coeval with lowest Miocene productivity and a SST decline. In the Early Pliocene, a transient warming is accompanied by surface water stratification and increased productivity that likely reflects a high latitude response to the global biogenic bloom. The succeeding crash in palynomorph accumulation, and a subsequent interval virtually barren of marine palynomorphs may be attributed to enhanced bottom water oxygenation and substantial sea ice cover, and indicates that conditions seriously affecting marine productivity in the Iceland Sea were already established well before the marked expansion of the Greenland Ice Sheet at 3.3 Ma.

Sapropel cycles in the Mediterranean Sea

Water column stratification increased at climatic transitions from cold to warm periods during the late Quaternary and led to anoxic conditions and sapropel formation in the deep eastern Mediterranean basins. High-resolution data sets on sea-surface temperatures (SST) (estimated from UK'37 indices) and d18O of planktonic foraminifer calcite (d18Ofc) across late Pleistocene sapropel intervals show that d18Ofc decreased (between 1 and 4.6 per mil) and SST increased (between 0.7° and 6.7°C). Maximal d18Oseawater depletion of eastern Mediterranean surface waters at the transition is between 0.5 and 3.0 per mil, and in all but one case exceeded the depletion seen in a western Mediterranean core. The depletion in d18Oseawater is most pronounced at sapropel bases, in agreement with an initial sudden input of monsoon-derived freshwater. Most sapropels coincide with warming trends of SST. The density decrease by initial freshwater input and continued warming of the sea surface pooled fresh water in the surface layer and prohibited deep convection down to ageing deep water emplaced during cold and arid glacial conditions. An exception to this pattern is "glacial" sapropel S6; its largest d18Oseawater depletion (3 per mil) is almost matched by the depletion in the western Mediterranean Sea, and it is accompanied by surface water cooling following an initially rapid warming phase. A second period of significant isotopic depletion is in isotope stage 6 at the 150 kyr insolation maximum. While not expressed as a sapropel due to cold SST, it is in accord with a strengthened monsoon in the southern catchment.

Paleocene radiolarian distribution and biostratigraphy from offshore eastern New Zealand

A 100-m-thick Paleocene sequence of mainly pelagic sediments at ODP Site 1121, on the eastern flanks of the Campbell Plateau, contains few to common radiolarians of relatively low diversity in the lower 40 m (Early to early Late Paleocene) and abundant, diverse radiolarian assemblages in the upper 60 m (mid-Late Paleocene). The 150 taxa recorded from the entire Paleocene interval are thought to under-represent the actual species diversity by at least one half as many morphotypes have not been differentiated below the level of genus. Assemblages in the lower 40 m are similar to those described from onland New Zealand and DSDP Site 208 (northern Lord Howe Rise); they are correlated with South Pacific radiolarian zones RP4 and RP5. Assemblages in the upper 60 m differ from other known Late Paleocene assemblages in the great abundance of plagiacanthids and cycladophorids. Similarities are noted with later Cenozoic cool-water assemblages. This upper interval is correlated with South Pacific zone RP6, as revised herein, based on comparison with faunas from Site 208 and Marlborough, New Zealand. The interval is also correlated with the upper part of North Atlantic zone RP6 (RP6b-c) based on the presence of Aspis velutochlamydosaurus, Plectodiscus circularis and Pterocodon poculum. Other species, such as Buryella tetradica and Buryella pentadica, are valuable for local correlation but exhibit considerable diachroneity between the Pacific, Indian and Atlantic Oceans. An age model for the Paleocene interval at Site 1121, based on well-constrained nannofossil and radiolarian datums, indicates that the rate of compacted sediment accumulation doubles from 15 to 30 mm/ka at the RP5/RP6 zonal boundary. In large part this is due to a sudden and pronounced increase in accumulation rates for all siliceous fossils; radiolarians and larger diatoms increase from <100 to >10 000 specimens/cm2/ka. This apparent increase in biosiliceous productivity is age-equivalent to a mid-Paleocene cooling event (57-59 Ma) identified from global stable isotope records that is associated with the heaviest delta13C values for the entire Cenozoic.

Planktic foraminiferal turnover across the Paleocene-Eocene transition in the Bay of Biscay, North Atlantic

Planktic foraminifera across the Paleocene-Eocene transition at DSDP Site 401 indicate that the benthic foraminiferal mass extinction occurred within Subzone P 6a of Berggren and Miller (1988), or PS of Berggren et al. (1995) and coincident with a sudden 2.0? excursion in 6r3C values. The benthic foraminiferal extinction event (BFEE) and Sr3C excursion was accompanied by a planktic foraminiferal turnover marked by an influx of warm water species (Morozovella and Acarinina), a decrease in cooler water species (Subbotina), a sudden short-term increase in low oxygen tolerant taxa (Chiloguembelina), and no significant species extinctions. These faunal changes suggest climatic warming, expansion of the oxygen minimum zone, and a well stratified ocean water column. Oxygen isotope data of the surface dweller M. subbotina suggest climate warming beginning with a gradual 0.5? decrease in delta180 in the 175 cm preceding the benthic foraminiferal extinction event followed by a sudden decrease of 1? (4°C) at the BFEE. The delta13C excursion occurred over 27 cm of sediment and, assuming constant sediment accumulation rates, represents a maximum of 23 ka. Recovery to pre-excursion delta13C values occurs within 172 cm, or about 144 ka. Climate cooling begins in Subzone P 6c as indicated by an increase in cooler water subbotinids and acarininids with rounded chambers and a decrease in warm water morozovellids.