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Sample records for preload recruitable stroke

  1. Preload recruitable stroke work in the presence of intact cardiovascular reflexes in rats fed a diet high in unsaturated fats.

    Science.gov (United States)

    Trifunovic, B; Woodiwiss, A J; Norton, G R

    1995-01-15

    A decreased inotropic effect of myocardial beta receptor agonists in animals receiving diets high in unsaturated fats (UNSAT) has been demonstrated. The effect of an UNSAT diet on myocardial systolic performance under different loading conditions, in the presence of intact cardiovascular reflexes, has not been examined. We investigated the effect of an UNSAT diet on preload recruitable stroke work (SW) in the anaesthetised, open chest, ventilated rat. A control (CONTROL, 11% by energy), a high saturated fat (SAT, 37% by energy) and a high UNSAT (37% by energy) diet were fed to three groups of rats. At three months, systolic myocardial performance (stroke work: SW) at increasing left ventricular end diastolic pressures (LVEDP) was measured within a physiological preload range. There were no significant differences in either the slope or the intercept of the LVEDP/SW relation were found between the three diet groups. Systemic vascular resistance and heart rate decreased to the same extent in the three diet groups over the range of preloads examined. This occurred as a consequence of intact baroreceptor reflexes. Hence dietary modulation of unsaturated fats does not influence myocardial contraction over a wide range of physiological preloads in the presence of intact baroreceptor reflexes.

  2. Linearity of the Frank-Starling relationship in the intact heart: the concept of preload recruitable stroke work.

    Science.gov (United States)

    Glower, D D; Spratt, J A; Snow, N D; Kabas, J S; Davis, J W; Olsen, C O; Tyson, G S; Sabiston, D C; Rankin, J S

    1985-05-01

    The Frank-Starling relationship generally has been examined with filling pressure as the index of preload, resulting in a curvilinear function that plateaus at higher filling pressures. To investigate this relationship further in the intact heart, 32 dogs were chronically instrumented with left ventricular and pleural micromanometers and with regional (10 dogs) or global (22 dogs) ultrasonic dimension transducers. Seven days after implantation, left ventricular pressure and regional or global dimensions were recorded in the conscious state. After autonomic blockade, preload was varied by vena caval occlusion. Myocardial function was assessed by calculating regional or global stroke work, and preload was measured as end-diastolic segment length or chamber volume. The relationship between stroke work and either end-diastolic segment length or chamber volume (termed the preload recruitable stroke work relationship) was highly linear in every study (mean r = .97) and could be quantified by a slope (MW) and x-intercept (LW). Previous nonlinear relationships between stroke work and filling pressure seemed to reflect the exponential diastolic pressure-volume curve. Over the physiologic range of systolic arterial pressures produced by infusion of nitroprusside or phenylephrine, no significant change was observed in MW or LW in the normal dog. Calcium infusion increased both regional and global MW by 71 +/- 19% and 65 +/- 9%, respectively (p less than .02), with no significant change in LW. To normalize for ventricular geometry and heart rate, stroke work was computed from circumferential stress-strain data and converted to myocardial power output, which was then plotted against end-diastolic circumferential strain. This relationship also was highly linear, and the slope, Mmp (mW/cm3 of myocardium), is proposed as a potential measure of intrinsic myocardial performance independent of loading, geometry, and heart rate.

  3. Changes in Stroke Volume Induced by Lung Recruitment Maneuver Predict Fluid Responsiveness in Mechanically Ventilated Patients in the Operating Room.

    Science.gov (United States)

    Biais, Matthieu; Lanchon, Romain; Sesay, Musa; Le Gall, Lisa; Pereira, Bruno; Futier, Emmanuel; Nouette-Gaulain, Karine

    2017-02-01

    Lung recruitment maneuver induces a decrease in stroke volume, which is more pronounced in hypovolemic patients. The authors hypothesized that the magnitude of stroke volume reduction through lung recruitment maneuver could predict preload responsiveness. Twenty-eight mechanically ventilated patients with low tidal volume during general anesthesia were included. Heart rate, mean arterial pressure, stroke volume, and pulse pressure variations were recorded before lung recruitment maneuver (application of continuous positive airway pressure of 30 cm H2O for 30 s), during lung recruitment maneuver when stroke volume reached its minimal value, and before and after volume expansion (250 ml saline, 0.9%, infused during 10 min). Patients were considered as responders to fluid administration if stroke volume increased greater than or equal to 10%. Sixteen patients were responders. Lung recruitment maneuver induced a significant decrease in mean arterial pressure and stroke volume in both responders and nonresponders. Changes in stroke volume induced by lung recruitment maneuver were correlated with those induced by volume expansion (r = 0.56; P recruitment maneuver predicted fluid responsiveness with a sensitivity of 88% (95% CI, 62 to 98) and a specificity of 92% (95% CI, 62 to 99). Pulse pressure variations more than 6% before lung recruitment maneuver discriminated responders with a sensitivity of 69% (95% CI, 41 to 89) and a specificity of 75% (95% CI, 42 to 95). The area under receiver operating curves generated for changes in stroke volume induced by lung recruitment maneuver (0.96; 95% CI, 0.81 to 0.99) was significantly higher than that for pulse pressure variations (0.72; 95% CI, 0.52 to 0.88; P recruitment maneuver could predict preload responsiveness in mechanically ventilated patients in the operating room.

  4. Methods to improve patient recruitment and retention in stroke trials

    DEFF Research Database (Denmark)

    Berge, Eivind; Stapf, Christian; Al-Shahi Salman, Rustam

    2016-01-01

    Background: The success of randomized-controlled stroke trials is dependent on the recruitment and retention of a sufficient number of patients, but fewer than half of all trials meet their target number of patients. Methods: We performed a search and review of the literature, and conducted......, reimbursement for new interventions only within a study, and monetary incentives to institutions taking part in research (for recruitment); and involvement of patient groups, remote and central follow-up, use of mobile devices, and reminders to patients about their consent to participate (for retention...

  5. Trends in Recruitment Rates for Acute Stroke Trials, 1990-2014.

    Science.gov (United States)

    Feldman, William B; Kim, Anthony S; Chiong, Winston

    2017-03-01

    Slow recruitment in acute stroke trials hampers the evaluation of new therapies and delays the adoption of effective therapies into clinical practice. This systematic review evaluates whether recruitment efficiency and rates have increased in acute stroke trials from 1990 to 2014. Acute stroke trials from 2010 to 2014 were identified by a search of PubMed, Medline, the Cochrane Database of Research in Stroke, and the Stroke Trials Registry. These trials were compared to a previously published data set of trials conducted from 1990 to 2004. The median recruitment efficiency of trials from 1990 to 2004 was 0.41 participants/site/month compared with 0.26 participants/site/month from 2010 to 2014 (P=0.14). The median recruitment rate of trials from 1990 to 2004 was 26.8 participants/month compared with 19.0 participants/month from 2010 to 2014 (P=0.13). For acute stroke trials, neither recruitment efficiency nor recruitment rates have increased over the past 25 years and, if anything, have declined. © 2017 American Heart Association, Inc.

  6. Assessing altered motor unit recruitment patterns in paretic muscles of stroke survivors using surface electromyography

    Science.gov (United States)

    Hu, Xiaogang; Suresh, Aneesha K.; Rymer, William Z.; Suresh, Nina L.

    2015-12-01

    Objective. The advancement of surface electromyogram (sEMG) recording and signal processing techniques has allowed us to characterize the recruitment properties of a substantial population of motor units (MUs) non-invasively. Here we seek to determine whether MU recruitment properties are modified in paretic muscles of hemispheric stroke survivors. Approach. Using an advanced EMG sensor array, we recorded sEMG during isometric contractions of the first dorsal interosseous muscle over a range of contraction levels, from 20% to 60% of maximum, in both paretic and contralateral muscles of stroke survivors. Using MU decomposition techniques, MU action potential amplitudes and recruitment thresholds were derived for simultaneously activated MUs in each isometric contraction. Main results. Our results show a significant disruption of recruitment organization in paretic muscles, in that the size principle describing recruitment rank order was materially distorted. MUs were recruited over a very narrow force range with increasing force output, generating a strong clustering effect, when referenced to recruitment force magnitude. Such disturbances in MU properties also correlated well with the impairment of voluntary force generation. Significance. Our findings provide direct evidence regarding MU recruitment modifications in paretic muscles of stroke survivors, and suggest that these modifications may contribute to weakness for voluntary contractions.

  7. Preloaded Motorway Embankments

    DEFF Research Database (Denmark)

    Steenfelt, J. S.; Jørgensen, Mogens B.; Jørgensen, P. O.

    1999-01-01

    Road construction, particularly involving soft soil replacement, draws very heavily on the scarce resources of sand and gravel. One environmentally appealing alternative to complete soft soil replacement is preloading where the sand/gravel materials may be re-used along the road alignment...

  8. Preloaded Motorway Embankments

    DEFF Research Database (Denmark)

    Steenfelt, Jørgen S.; Jørgensen, Mogens B.; Jørgensen, P.O.

    Road construction, particularly involving soft soil replacement, draws very heavily on the scarce resources of sand and gravel. One environmentally appealing alternative to complete soft soil replacement is pre-loading where the sand/gravel materials may be re-used along the road alignment...

  9. Influence of Corticospinal Tracts from Higher Order Motor Cortices on Recruitment Curve Properties in Stroke

    Science.gov (United States)

    Potter-Baker, Kelsey A.; Varnerin, Nicole M.; Cunningham, David A.; Roelle, Sarah M.; Sankarasubramanian, Vishwanath; Bonnett, Corin E.; Machado, Andre G.; Conforto, Adriana B.; Sakaie, Ken; Plow, Ela B.

    2016-01-01

    Background: Recruitment curves (RCs) acquired using transcranial magnetic stimulation are commonly used in stroke to study physiologic functioning of corticospinal tracts (CST) from M1. However, it is unclear whether CSTs from higher motor cortices contribute as well. Objective: To explore whether integrity of CST from higher motor areas, besides M1, relates to CST functioning captured using RCs. Methods: RCs were acquired for a paretic hand muscle in patients with chronic stroke. Metrics describing gain and overall output of CST were collected. CST integrity was defined by diffusion tensor imaging. For CST emerging from M1 and higher motor areas, integrity (fractional anisotropy) was evaluated in the region of the posterior limb of the internal capsule, the length of CST and in the region of the stroke lesion. Results: We found that output and gain of RC was related to integrity along the length of CST emerging from higher motor cortices but not the M1. Conclusions: Our results suggest that RC parameters in chronic stroke infer function primarily of CST descending from the higher motor areas but not M1. RCs may thus serve as a simple, in-expensive means to assess re-mapping of alternate areas that is generally studied with resource-intensive neuroimaging in stroke. PMID:27013942

  10. Shoulder muscle recruitment patterns during a kayak stroke performed on a paddling ergometer.

    Science.gov (United States)

    Trevithick, Beverley A; Ginn, Karen A; Halaki, Mark; Balnave, Ronald

    2007-02-01

    Precise muscle co-ordination is required to maintain normal shoulder function and alterations in synchrony between shoulder muscles can result in loss of full range of movement and pain. Although shoulder pain in kayakers is high with 53% of elite international paddlers reporting shoulder injuries, little information is available regarding the pattern of shoulder muscle recruitment during paddling. The aim of this study was to investigate the normal recruitment pattern of shoulder muscles during the kayak stroke. Nine recreational paddlers without shoulder pain were examined. EMG data from eight shoulder muscles of the dominant arm were collected simultaneously with video data during simulated paddling on an ergometer. EMG data was normalized to time and peak amplitude. Intersubject consistency was evaluated using Pearson correlation analysis. The results of this study indicated a fair to high correlation in at least one phase of the kayak stroke in five of the muscles examined: upper trapezius, supraspinatus, latissimus dorsi, serratus anterior and rhomboid major. This normative data will enable comparisons with the shoulder muscle recruitment patterns in kayakers with shoulder pain in order to determine the role of altered motor control in the painful kayaking shoulder.

  11. Dynamic preload indicators fail to predict fluid responsiveness in open-chest conditions

    NARCIS (Netherlands)

    de Waal, Eric E. C.; Rex, Steffen; Kruitwagen, Cas L. J. J.; Kalkman, Cor J.; Buhre, Wolfgang F.

    2009-01-01

    Objective: Dynamic preload indicators like pulse pressure variation (PPV) and stroke volume variation (SVV) are increasingly being used for optimizing cardiac preload since they have been demonstrated to predict fluid responsiveness in a variety of perioperative settings. However, in open-chest cond

  12. Neutrophil recruitment to the brain in mouse and human ischemic stroke.

    Science.gov (United States)

    Perez-de-Puig, Isabel; Miró-Mur, Francesc; Ferrer-Ferrer, Maura; Gelpi, Ellen; Pedragosa, Jordi; Justicia, Carles; Urra, Xabier; Chamorro, Angel; Planas, Anna M

    2015-02-01

    Neutrophils are rapidly recruited in response to local tissue infection or inflammation. Stroke triggers a strong inflammatory reaction but the relevance of neutrophils in the ischemic brain is not fully understood, particularly in the absence of reperfusion. We investigated brain neutrophil recruitment in two murine models of permanent ischemia induced by either cauterization of the distal portion of the middle cerebral artery (c-MCAo) or intraluminal MCA occlusion (il-MCAo), and three fatal cases of human ischemic stroke. Flow cytometry analyses revealed progressive neutrophil recruitment after c-MCAo, lesser neutrophil recruitment following il-MCAo, and absence of neutrophils after sham operation. Confocal microscopy identified neutrophils in the leptomeninges from 6 h after the occlusion, in the cortical basal lamina and cortical Virchow-Robin spaces from 15 h, and also in the cortical brain parenchyma at 24 h. Neutrophils showed signs of activation including histone-3 citrullination, chromatin decondensation, and extracellular projection of DNA and histones suggestive of extracellular trap formation. Perivascular neutrophils were identified within the entire cortical infarction following c-MCAo. After il-MCAo, neutrophils prevailed in the margins but not the center of the cortical infarct, and were intraluminal and less abundant in the striatum. The lack of collaterals to the striatum and a collapsed pial anastomotic network due to brain edema in large hemispheric infarctions could impair neutrophil trafficking in this model. Neutrophil extravasation at the leptomeninges was also detected in the human tissue. We concluded that neutrophils extravasate from the leptomeningeal vessels and can eventually reach the brain in experimental animal models and humans with prolonged arterial occlusion.

  13. Monitoring preload performance

    Energy Technology Data Exchange (ETDEWEB)

    Russell, J.B.; Lawrence, C.A.; Paddock, M.W.; Ross, D.

    1999-07-01

    Reconstruction of State Highway 29 (STH 29) in north central Wisconsin was complicated by two separate deposits of compressible peat and organic silt within the highway right-of-way. The deposits ranged from about 3 to 11 meters in thickness over about 900 meters of the reconstruction alignment. Excavation and removal of the peat and organic silt was evaluated, but was determined to be cost prohibitive. Preloading was determined to be a cost effective and environmentally friendly solution, and was implemented at both deposits to induce the expected consolidation and long-term secondary compression of the final highway embankment and pavement sections. This paper presents the design, instrumentation, and rheological modeling procedures used to complete the project.

  14. DLC screw preload. Loosening prevention

    Directory of Open Access Journals (Sweden)

    Ivete Aparecida de Mattias Sartori

    2008-01-01

    Full Text Available The screw loosening is a reason to prosthetic rehabilitation failure. However, the DLC (Diamond-like carbon screw treatment lead thefriction decrease and sliding between the components, which increases the screw preload benefit and decreases the chance of looseningoccurrence. This case shows a clinical indication of the association of the correct preload applied and the DLC screw, which can be considered an optimized protocol to solve screw loosening recidivate of unitary prosthesis in anterior maxillary site.

  15. Update on the third international stroke trial (IST-3 of thrombolysis for acute ischaemic stroke and baseline features of the 3035 patients recruited

    Directory of Open Access Journals (Sweden)

    Sandercock Peter

    2011-11-01

    Full Text Available Abstract Background Intravenous recombinant tissue plasminogen activator (rtPA is approved in Europe for use in patients with acute ischaemic stroke who meet strictly defined criteria. IST-3 sought to improve the external validity and precision of the estimates of the overall treatment effects (efficacy and safety of rtPA in acute ischaemic stroke, and to determine whether a wider range of patients might benefit. Design International, multi-centre, prospective, randomized, open, blinded endpoint (PROBE trial of intravenous rtPA in acute ischaemic stroke. Suitable patients had to be assessed and able to start treatment within 6 hours of developing symptoms, and brain imaging must have excluded intracranial haemorrhage and stroke mimics. Results The initial pilot phase was double blind and then, on 01/08/2003, changed to an open design. Recruitment began on 05/05/2000 and closed on 31/07/2011, by which time 3035 patients had been included, only 61 (2% of whom met the criteria for the 2003 European approval for thrombolysis. 1617 patients were aged over 80 years at trial entry. The analysis plan will be finalised, without reference to the unblinded data, and published before the trial data are unblinded in early 2012. The main trial results will be presented at the European Stroke Conference in Lisbon in May 2012 with the aim to publish simultaneously in a peer-reviewed journal. The trial result will be presented in the context of an updated Cochrane systematic review. We also intend to include the trial data in an individual patient data meta-analysis of all the relevant randomised trials. Conclusion The data from the trial will: improve the external validity and precision of the estimates of the overall treatment effects (efficacy and safety of iv rtPA in acute ischaemic stroke; provide: new evidence on the balance of risk and benefit of intravenous rtPA among types of patients who do not clearly meet the terms of the current EU approval; and

  16. Stroke

    Science.gov (United States)

    ... rehabilitation helps individuals overcome disabilities that result from stroke damage. Drug therapy with blood thinners is the most common treatment for stroke. NIH: National Institute of Neurological Disorders and Stroke

  17. Prediction of fluid responsiveness by dynamic preload indices in patients undergoing major hepatic resection

    NARCIS (Netherlands)

    Vos, Jaap Jan; Kalmar, A.F.; Struys, Michel; Wietasch, Johann; Hendriks, Herman; Scheeren, Thomas

    2012-01-01

    Background and Goal of the Study:  Dynamic preload indices, based on the arterial pressure waveform (APW; semi-invasive) or on the plethysmographic waveform (PW; non-invasive) are increasingly used to assess fluid responsiveness. We compared the ability of the commercially available APW-based stroke

  18. Prediction of fluid responsiveness by dynamic preload indices in patients undergoing major hepatic resection

    NARCIS (Netherlands)

    Vos, J. J.; Kalmar, A.F.; Struys, M. M. R. F.; Wietasch, J. K. G.; Hendriks, H. G. D.; Scheeren, T. W. L.

    2012-01-01

    Background and Goal of the Study:  Dynamic preload indices, based on the arterial pressure waveform (APW; semi-invasive) or on the plethysmographic waveform (PW; non-invasive) are increasingly used to assess fluid responsiveness. We compared the ability of the commercially available APW-based stroke

  19. After-effects of peripheral neurostimulation on brain plasticity and ankle function in chronic stroke: The role of afferents recruited.

    Science.gov (United States)

    Beaulieu, Louis-David; Massé-Alarie, Hugo; Camiré-Bernier, Samuel; Ribot-Ciscar, Édith; Schneider, Cyril

    2017-09-01

    This study tested the after-effects of neuromuscular electrical stimulation (NMES), repetitive peripheral magnetic stimulation (rPMS) and muscle tendon vibration (VIB) on brain plasticity and sensorimotor impairments in chronic stroke to investigate whether different results could depend on the nature of afferents recruited by each technique. Fifteen people with chronic stroke participated in five sessions (one per week). Baseline measures were collected in session one, then, each participant received 4 randomly ordered interventions (NMES, rPMS, VIB and a 'control' intervention of exercises). Interventions were applied to the paretic ankle muscles and parameters of application were matched as closely as possible. Standardized clinical measures of the ankle function on the paretic side and transcranial magnetic stimulation (TMS) outcomes of both primary motor cortices (M1) were collected at pre- and post-application of each intervention. The ankle muscle strength was significantly improved by rPMS and VIB (P≤0.02). rPMS influenced M1 excitability (increase in the contralesional hemisphere, P=0.03) and inhibition (decrease in both hemispheres, P≤0.04). The group mean of a few clinical outcomes improved across sessions, i.e. independently of the order of interventions. Some TMS outcomes at baseline could predict the responsiveness to rPMS and VIB. This original study suggests that rPMS and VIB were efficient to drive M1 plasticity and sensorimotor improvements, likely via massive inflows of 'pure' proprioceptive information generated. Usefulness of some TMS outcomes to predict which intervention a patient could be more responsive to should be further tested in future studies. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Females have greater left ventricular twist mechanics than males during acute reductions to preload.

    Science.gov (United States)

    Williams, Alexandra M; Shave, Rob E; Stembridge, Mike; Eves, Neil D

    2016-07-01

    Compared to males, females have smaller left ventricular (LV) dimensions and volumes, higher ejection fractions (EF), and higher LV longitudinal and circumferential strain. LV twist mechanics determine ventricular function and are preload-dependent. Therefore, the sex differences in LV structure and myocardial function may result in different mechanics when preload is altered. This study investigated sex differences in LV mechanics during acute challenges to preload. With the use of conventional and speckle-tracking echocardiography, LV structure and function were assessed in 20 males (24 ± 6.2 yr) and 20 females (23 ± 3.1 yr) at baseline and during progressive levels of lower body negative pressure (LBNP). Fourteen participants (8 males, 6 females) were also assessed following a rapid infusion of saline. LV end-diastolic volume, end-systolic volume, stroke volume (SV), and EF were reduced in both groups during LBNP (P mechanics following saline infusion. Females have larger LV twist and a faster untwisting velocity than males during large reductions to preload, supporting that females have a greater reliance on LV twist mechanics to maintain SV during severe reductions to preload.

  1. Cardiac preload responsiveness in children with cardiovascular dysfunction or dilated cardiomyopathy: a multicenter observational study.

    Science.gov (United States)

    de la Oliva, Pedro; Menéndez-Suso, Juan J; Iglesias-Bouzas, Mabel; Álvarez-Rojas, Elena; González-Gómez, José M; Roselló, Patricia; Sánchez-Díaz, Juan I; Jaraba, Susana

    2015-01-01

    To characterize cardiac preload responsiveness in pediatric patients with cardiovascular dysfunction and dilated cardiomyopathy using global end-diastolic volume index, stroke volume index, cardiac index, and extravascular lung water index. Prospective multicenter observational study. Medical/surgical PICUs of seven Spanish University Medical Centers. Seventy-five pediatric patients (42 male, 33 female), median age 36 months (range, 1-207 mo), were divided into three groups: normal cardiovascular status, cardiovascular dysfunction, and dilated cardiomyopathy. All patients received hemodynamic monitoring with PiCCO2 (Pulsion Medical System SE, Munich, Germany). We evaluated 598 transpulmonary thermodilution sets of measurements. In 40 patients, stroke volume index, cardiac index, and global end-diastolic volume index were measured before and after 66 fluid challenges and loadings to test fluid responsiveness at different preload levels. Global end-diastolic volume versus predicted body surface area exhibits a power-law relationship: Global end-diastolic volume = 488.8·predicted body surface area (r = 0.93). Four levels of cardiac preload were established from the resulting "normal" global end-diastolic volume index (= 488.8·predicted body surface area). Stroke volume index and cardiac index versus global end-diastolic volume index/normal global end-diastolic volume index built using a linear mixed model analysis emulated Frank-Starling curves: in cardiovascular dysfunction group, stroke volume index (geometric mean [95% CI]) was 27 mL/m (24-31 mL/m) at "≤ 0.67 times normal global end-diastolic volume index," 37 mL/m (35-40 mL/m) at "> 0.67 ≤ 1.33 times normal global end-diastolic volume index" (Δ stroke volume index = 35%; p 1.33 ≤ 1.51 times normal global end-diastolic volume index" (Δ stroke volume index = 21%; p 1.51 times normal global end-diastolic volume index" (Δ stroke volume index = 4%; p = 1; area under the receiver

  2. Preloading of bolted connections in nuclear reactor component supports

    Energy Technology Data Exchange (ETDEWEB)

    Yahr, G T

    1984-10-01

    A number of failures of threaded fasteners in nuclear reactor component supports have been reported. Many of those failures were attributed to stress corrosion cracking. This report discusses how stress corrosion cracking can be avoided in bolting by controlling the maximum bolt preloads so that the sustained stresses in the bolts are below the level required to cause stress corrosion cracking. This is a basic departure from ordinary bolted joint design where the only limits on preload are on the minimum preload. Emphasis is placed on the importance of detailed analysis to determine the acceptable range of preload and the selection of a method for measuring the preload that is sufficiently accurate to ensure that the preload is actually within the acceptable range. Procedures for determining acceptable preload range are given, and the accuracy of various methods of measuring preload is discussed.

  3. Stroke

    Science.gov (United States)

    ... how to live with the effects of the stroke so you can be as independent as possible. It may include physical therapy, occupational therapy, speech therapy, and swallowing therapy.Your doctor will decide what kind of rehabilitation will be helpful for you. Rehabilitation can begin ...

  4. Effect of a preload force on anchor system frequency

    Institute of Scientific and Technical Information of China (English)

    Lu Aihong; Xu Jinhai; Liu Haishun

    2013-01-01

    The interrelationship between preload forces and natural frequencies of anchors was obtained from the structure of an anchor and its mechanical characteristics.We established a numerical model for the dynamic analysis of a bolt support system taking into consideration the working surroundings of the anchor.The natural frequency distribution of the system under various preload forces of the anchor was analyzed with ANSYS.Our results show that each order of the system frequency varied with an increase in preload forces.A single order frequency decreased with an increase in the preload force.A preload force affected low-order frequencies more than high-order frequencies.We obtained a functional relationship by fitting preload forces and fundamental frequencies,which was in agreement with our theoretical considerations.This study provides theoretical support for the detection of preload forces.

  5. Human neural progenitor cell engraftment increases neurogenesis and microglial recruitment in the brain of rats with stroke.

    Directory of Open Access Journals (Sweden)

    Zahra Hassani

    Full Text Available MAIN OBJECTIVES: Stem cell transplantation is to date one of the most promising therapies for chronic ischemic stroke. The human conditionally immortalised neural stem cell line, CTX0E03, has demonstrable efficacy in a rodent model of stroke and is currently in clinical trials. Nonetheless, the mechanisms by which it promotes brain repair are not fully characterised. This study investigated the cellular events occurring after CTX0E03 transplantation in the brains of rats that underwent ischemic stroke. METHODS: We focused on the endogenous proliferative activity of the host brain in response to cell transplantation and determined the identity of the proliferating cells using markers for young neurons (doublecortin, Dcx and microglia (CD11b. So as to determine the chronology of events occurring post-transplantation, we analysed the engrafted brains one week and four weeks post-transplantation. RESULTS: We observed a significantly greater endogenous proliferation in the striatum of ischemic brains receiving a CTX0E03 graft compared to vehicle-treated ischemic brains. A significant proportion of these proliferative cells were found to be Dcx+ striatal neuroblasts. Further, we describe an enhanced immune response after CTX0E03 engraftment, as shown by a significant increase of proliferating CD11b+ microglial cells. CONCLUSIONS: Our study demonstrates that few Dcx+ neuroblasts are proliferative in normal conditions, and that this population of proliferative neuroblasts is increased in response to stroke. We further show that CTX0E03 transplantation after stroke leads to the maintenance of this proliferative activity. Interestingly, the preservation of neuronal proliferative activity upon CTX0E03 transplantation is preceded and accompanied by a high rate of proliferating microglia. Our study suggests that microglia might mediate in part the effect of CTX0E03 transplantation on neuronal proliferation in ischemic stroke conditions.

  6. Nitroglycerin reduces augmentation index and central blood pressure independent of effects on cardiac preload

    Institute of Scientific and Technical Information of China (English)

    Mike; Saddon; Karen; McNeil; Philip; Chowienczyk

    2009-01-01

    Objective To determine whether reduction in central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-load or is due to arterial dilation. Methods We compared effects of NTG with those of lower body negative pressure (LBNP). Hemodynamic measurements were made at rest,during LBNP (10,20 and 30 mmHg,each for 15 min) and after NTG (10,30 and 100 μg/min,each dose for 15 min) in ten healthy volunteers. Cardiac pre-load,stroke volume and cardiac output w...

  7. Comparison of arterial pressure and plethysmographic waveform-based dynamic preload variables in assessing fluid responsiveness and dynamic arterial tone in patients undergoing major hepatic resection

    NARCIS (Netherlands)

    Vos, J. J.; Kalmar, A. F.; Struys, M. M. R. F.; Wietasch, J. K. G.; Hendriks, H. G. D.; Scheeren, T. W. L.

    2013-01-01

    Dynamic preload variables to predict fluid responsiveness are based either on the arterial pressure waveform (APW) or on the plethysmographic waveform (PW). We compared the ability of APW-based variations in stroke volume (SVV) and pulse pressure (PPV) and of PW-based plethysmographic variability in

  8. Comparison of arterial pressure and plethysmographic waveform-based dynamic preload variables in assessing fluid responsiveness and dynamic arterial tone in patients undergoing major hepatic resection

    NARCIS (Netherlands)

    Vos, J. J.; Kalmar, A. F.; Struys, M. M. R. F.; Wietasch, J. K. G.; Hendriks, H. G. D.; Scheeren, T. W. L.

    Dynamic preload variables to predict fluid responsiveness are based either on the arterial pressure waveform (APW) or on the plethysmographic waveform (PW). We compared the ability of APW-based variations in stroke volume (SVV) and pulse pressure (PPV) and of PW-based plethysmographic variability

  9. Comparison of arterial pressure and plethysmographic waveform-based dynamic preload variables in assessing fluid responsiveness and dynamic arterial tone in patients undergoing major hepatic resection

    NARCIS (Netherlands)

    Vos, J. J.; Kalmar, A. F.; Struys, M. M. R. F.; Wietasch, J. K. G.; Hendriks, H. G. D.; Scheeren, T. W. L.

    2013-01-01

    Dynamic preload variables to predict fluid responsiveness are based either on the arterial pressure waveform (APW) or on the plethysmographic waveform (PW). We compared the ability of APW-based variations in stroke volume (SVV) and pulse pressure (PPV) and of PW-based plethysmographic variability in

  10. Experimental study on bearing preload optimum of machine tool spindle

    Science.gov (United States)

    Xu, Tao; Xu, Guanghua; Zhang, Qin; Hua, Cheng; Zhang, Hu; Jiang, Kuosheng

    2012-05-01

    An experimental study is conducted to investigate the possibility and the effect of temperature rise and vibration level of bearing by adjusting axial preloads and radial loads in spindle bearing test rig. The shaft of the test rig is driven by a motorized high speed spindle at the range of 0~20000 rpm. The axial preloads and radial loads on bearings are controlled by using hydraulic pressure which can be adjusted automatically. Temperature rise and radial vibration of test bearings are measured by thermocouples and Polytec portable laser vibrometer PDV100. Experiment shows that the temperature rise of bearings is nonlinear varying with the increase of radial loads, but temperature rise almost increases linearly with the increase of axial preload and rotating speed. In this paper, an alternate axial preload is used for bearings. When the rotating speed passes through the critical speed of the shaft, axial preload of bearings will have a remarkable effect. The low preload could reduce bearing vibration and temperature rise for bearings as well. At the others speed, the high preload could improve the vibration performance of high speed spindle and the bearing temperature was lower than that of the constant pressure preload spindle.

  11. Variation in recruitment across sites in a consent-based clinical data registry: lessons from the Canadian Stroke Network

    Directory of Open Access Journals (Sweden)

    Richards Janice A

    2006-05-01

    Full Text Available Abstract Background In earlier work, we found important selection biases when we tried to obtain consent for participation in a national stroke registry. Recognizing that not all registries will be exempt from requiring consent for participation, we examine here in greater depth the reasons for the poor accrual of patients from a systems perspective with a view to obtaining as representative sample as possible. Methods We determined the percent of eligible patients who were approached to participate and, among those approached, the percent who actually consented to participate. In addition we examined the reasons why people were not approached or did not consent and the variation across sites in the percent of patients approached and consented. We also considered site variation in restrictions on the accrual and data collection process imposed by either the local research ethics board or the hospital. Results Seventy percent of stroke patients were approached, with wide variations in approach rates across sites (from: 41% to 86%, and considerable inter-site variation in hospital policies governing patient accrual. Chief reasons for not approaching were discharge or death before being approached for consent. Seventeen percent of those approached refused to participate (range: 5% to 75%. Finally, 11% of those approached did not participate due to language or communication difficulties. Conclusion We found wide variation in approach and agree rates across sites that were accounted for, in part, by different approaches to accrual and idiosyncratic policies of the hospitals. This wide variation in approach and agree rates raises important challenges for research ethics boards and data protection authorities in determining when to waive consent requirements, when to press for increased quality control, when to permit local adaptation of the consent process, and when to permit alternatives to individual express consent. We offer several suggestions for

  12. RV Myocardial Strain During Pre-Load Augmentation Is Associated With Exercise Capacity in Patients With Chronic HF.

    Science.gov (United States)

    Kusunose, Kenya; Yamada, Hirotsugu; Nishio, Susumu; Ishii, Ayumi; Hirata, Yukina; Seno, Hiromitsu; Saijo, Yoshihito; Ise, Takayuki; Yamaguchi, Koji; Yagi, Shusuke; Soeki, Takeshi; Wakatsuki, Tetsuzo; Sata, Masataka

    2017-07-13

    The aim of this study was to assess the relationship between right ventricular (RV) function during pre-load augmentation and exercise tolerance. Peak oxygen uptake (VO2) is a strong predictor of mortality in chronic heart failure. Cardiac function during pre-load augmentation is an important part of the phenomenon in the evaluation of exercise capacity. We prospectively performed echocardiographic studies in 68 chronic heart failure patients with cardiopulmonary exercise testing (mean age 60 ± 12 years; 69% male). After resting evaluations, echocardiographic parameters were repeated during leg positive pressure (LPP). Exercise capacity was assessed by peak VO2 in all patients (left ventricular ejection fraction: 43 ± 15%). Patients with severely reduced exercise capacity (peak VO2 <14 ml/kg/min) had significantly lower stroke volume index, left ventricular global longitudinal strain and RV strain and higher filling pressure (E/e' and pulmonary arterial systolic pressure) than the remainder. Stroke volume index (β = 0.49), global longitudinal strain (β = -0.61), E/e' (β = -0.32), pulmonary arterial systolic pressure (β = -0.57), and RV strain (β = -0.66) during LPP were independently correlated to peak VO2 (all p < 0.01). RV strain during LPP was the most powerful predictor in identifying patients with severely reduced exercise capacity (cut off value: -17%; sensitivity: 81%; specificity: 88%; areas under the curve: 0.88, p < 0.001) compared with other variables including resting parameters. RV strain during pre-load augmentation correlated independently to peak VO2 and was a powerful predictor in identifying patients with severely reduced exercise capacity. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  13. Investigation of multiple spindle characteristics under non-uniform bearing preload

    Directory of Open Access Journals (Sweden)

    Yanfei Zhang

    2016-02-01

    Full Text Available The non-uniform distribution load during machining and assembly process is crucial for spindle system, especially in complex working conditions. The conception of non-uniform preload adjustment approach was proposed and experimentally investigated in this article. Based on the mechanical equivalent principle, the non-uniform preload was theoretically transformed to the combination of uniform preload and an extra moment. Then, the non-uniform preload of rolling bearing was experimentally measured and analyzed via a spacer with 15-µm wear loss on the end face. The spindle performance factors, such as rotation accuracy, temperature rising, acceleration, and vibration, were all monitored. The rotation center of spindle was deviated in different non-uniform preload conditions. Meanwhile, the temperature and vibration performance of non-uniform preload are superior to those of uniform bearing preload.

  14. Effect of compressive follower preload on the flexion-extension response of the human lumbar spine.

    Science.gov (United States)

    Patwardhan, Avinash G; Havey, Robert M; Carandang, Gerard; Simonds, James; Voronov, Leonard I; Ghanayem, Alexander J; Meade, Kevin P; Gavin, Thomas M; Paxinos, Odysseas

    2003-05-01

    Traditional experimental methods are unable to study the kinematics of whole lumbar spine specimens under physiologic compressive preloads because the spine without active musculature buckles under just 120 N of vertical load. However, the lumbar spine can support a compressive load of physiologic magnitude (up to 1200 N) without collapsing if the load is applied along a follower load path. This study tested the hypothesis that the load-displacement response of the lumbar spine in flexion-extension is affected by the magnitude of the follower preload and the follower preload path. Twenty-one fresh human cadaveric lumbar spines were tested in flexion-extension under increasing compressive follower preload applied along two distinctly different optimized preload paths. The first (neutral) preload path was considered optimum if the specimen underwent the least angular change in its lordosis when the full range of preload (0-1200 N) was applied in its neutral posture. The second (flexed) preload path was optimized for an intermediate specimen posture between neutral and full flexion. A twofold increase in flexion stiffness occurred around the neutral posture as the preload was increased from 0 to 1200 N. The preload magnitude (400 N and larger) significantly affected the range of motion (ROM), with a 25% decrease at 1200 N preload applied along the neutral path. When the preload was applied along a path optimized for an intermediate forward-flexed posture, only a 15% decrease in ROM occurred at 1200 N. The results demonstrate that whole lumbar spine specimens can be subjected to compressive follower preloads of in vivo magnitudes while allowing physiologic mobility under flexion-extension moments. The optimized follower preload provides a method to simulate the resultant vector of the muscles that allow the spine to support physiologic compressive loads induced during flexion-extension activities.

  15. Pediatric Stroke

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... communicate with your child’s doctor. Symptoms of a Stroke Stroke is an injury to part of the ...

  16. Modelling and Estimation of Hammerstein System with Preload Nonlinearity

    Directory of Open Access Journals (Sweden)

    Khaled ELLEUCH

    2010-12-01

    Full Text Available This paper deals with modelling and parameter identification of nonlinear systems described by Hammerstein model having asymmetric static nonlinearities known as preload nonlinearity characteristic. The simultaneous use of both an easy decomposition technique and the generalized orthonormal bases leads to a particular form of Hammerstein model containing a minimal parameters number. The employ of orthonormal bases for the description of the linear dynamic block conducts to a linear regressor model, so that least squares techniques can be used for the parameter estimation. Singular Values Decomposition (SVD technique has been applied to separate the coupled parameters. To demonstrate the feasibility of the identification method, an illustrative example is included.

  17. Nitroglycerin reduces augmentation index and central blood pressure independent of effects on cardiac preload

    Institute of Scientific and Technical Information of China (English)

    Bao-min Liu; Xiao-lin Niu; Ben-yu Jiang; Mike Saddon; Karen McNeil; Philip Chowienczyk

    2009-01-01

    Objective To determine whether reduction In central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-lead or is due to arterial dilation. Methods We compared effects of NTG with these of lower body negative pressure (LBNP). Hemodyunmic measurements were made at rest, during LBNP (10, 20 and 30 mmHg, each for 15 min) and after NTG (10, 30 and 100μg/min, each dose for 15 min) in ten healthy volunteers. Cardiac pre-lead, stroke volume and cardiac output were assessed by echacardiography. Central pressure an mnentation and central systolic pressure were obtained by radial tonometry using a transfer function. Results LBNP (20 mmHg) and NTG (30μg/min) reduced pre-lead (as measured by the peak velocity of the S wave in the superior vena eava) to a similar degree [by (26. 8 ± 3.8) % and (23.9 ± 3. 4) %, respectively]. Compared to LBNP, NTG reduced systemic vascular resistance [by (32. 9 ± 7.5) %, p< 0. 01], decreased peripheral and central pressure augmentation [by (20. 8 ± 3. 4)% units and (12. 9±2. 9)% units, respectively, each P< 0. 01]. Conclusion These results suggest that a reduction in pre-load does not explain reduction in pressure augmentation and central systolic blood pressure by NTG and that these effects are mediated through arterial dilation.

  18. Stroke Treatments

    Science.gov (United States)

    ... T. Quiz 5 Things to Know About Stroke Stroke Treatment Stroke used to rank fourth in leading causes of ... type of treatment depends on the type of stroke. Ischemic stroke happens when a clot blocks a ...

  19. Semantic-preload video model based on VOP coding

    Science.gov (United States)

    Yang, Jianping; Zhang, Jie; Chen, Xiangjun

    2013-03-01

    In recent years, in order to reduce semantic gap which exists between high-level semantics and low-level features of video when the human understanding image or video, people mostly try the method of video annotation where in signal's downstream, namely further (again) attach labels to the content in video-database. Few people focus on the idea that: Use limited interaction and the means of comprehensive segmentation (including optical technologies) from the front-end of collection of video information (i.e. video camera), with video semantics analysis technology and corresponding concepts sets (i.e. ontology) which belong in a certain domain, as well as story shooting script and the task description of scene shooting etc; Apply different-level semantic descriptions to enrich the attributes of video object and the attributes of image region, then forms a new video model which is based on Video Object Plan (VOP) Coding. This model has potential intellectualized features, and carries a large amount of metadata, and embedded intermediate-level semantic concept into every object. This paper focuses on the latter, and presents a framework of a new video model. At present, this new video model is temporarily named "Video Model of Semantic-Preloaded or Semantic-Preload Video Model (simplified into VMoSP or SPVM)". This model mainly researches how to add labeling to video objects and image regions in real time, here video object and image region are usually used intermediate semantic labeling, and this work is placed on signal's upstream (i.e. video capture production stage). Because of the research needs, this paper also tries to analyses the hierarchic structure of video, and divides the hierarchic structure into nine hierarchy semantic levels, of course, this nine hierarchy only involved in video production process. In addition, the paper also point out that here semantic level tagging work (i.e. semantic preloading) only refers to the four middle-level semantic. All in

  20. Novel approach for determining the optimal axial preload of a simulating rotary table spindle system

    Institute of Scientific and Technical Information of China (English)

    SHAN Xiao-biao; XIE Tao; CHEN Wei-shan

    2007-01-01

    This paper presents a new theoretical model to determine the optimal axial preload ora spindle system, for challenging the traditional method which relies heavily on experience of engineers. The axial preloading stiffness was treated as the sum of the spindle modal stiffness and the framework elastic stiffness, based on a novel concept that magnitude of preloads can be controlled by measuring the resonant frequency of a spindle system. By employing an example of a certain type of aircraft simulating rotary table, the modal stiffness was measured on the Agilent 35670A Dynamic Signal Analyzer by experimental modal analysis. The equivalent elastic stiffness was simulated by both finite element analysis in ANSYS(R) and a curve fitting in MATLAB(R). Results showed that the static preloading stiffness of the spindle was 7.2125×107 N/m, and that the optimal preloading force was 120.0848 N. Practical application proved the feasibility of our method.

  1. Gasification of Nickel-Preloaded Oil Palm Biomass with Air

    Directory of Open Access Journals (Sweden)

    Syed Shatir A. Syed-Hassan

    2016-10-01

    Full Text Available This study experimentally investigates the gasification of nickel-preloaded oil palm biomass as an alternative catalytic approach to produce clean syngas. To eliminate the use of catalyst support, nickel was added directly to the oil palm mesocarp fiber via ion-exchange using an aqueous solution of nickel nitrate. Nickel species was found to disperse very well on the biomass at a nano-scale dispersion. The presence of the finely dispersed nickels on biomass enhanced syngas production and reduced tar content in the producer gas during the air gasification of biomass. It is believed that nickel particles attached on the biomass and its char promote the catalytic cracking of tar on their surface and supply free radicals to the gas phase to enhance the radical-driven gas-phase reactions for the reforming of high molecular weight hydrocarbons. The unconsumed nickel-containing char shows great potential to be re-utilised as a catalyst to further enhance the destruction of tar components in the secondary tar reduction process. Copyright © 2016 BCREC GROUP. All rights reserved Received: 12nd September 2015; Revised: 10th January 2016; Accepted:16th January 2016 How to Cite: Syed-Hassan, S.S.A., Nor-Azemi, S. (2016. Gasification of Nickel-Preloaded Oil Palm Biomass with Air. Bulletin of Chemical Reaction Engineering & Catalysis, 11 (3: 262-272 (doi:10.9767/bcrec.11.3.566.262-272 Permalink/DOI: http://doi.org/10.9767/bcrec.11.3.566.262-272

  2. Effect of cyclic torsional preloading on cyclic fatigue resistance of ProTaper Next and Mtwo nickel–titanium instruments

    Directory of Open Access Journals (Sweden)

    Eugenio Pedullà

    2015-06-01

    Conclusions: Torsional preloads reduced the cyclic fatigue resistance of M-wire and conventional (as ProTaper Next and Mtwo NiTi rotary instruments except for Mtwo with 25% or 50% of torsional preloading.

  3. In vitro axial preload application during spine flexibility testing: towards reduced apparatus-related artefacts.

    Science.gov (United States)

    Cripton, P A; Bruehlmann, S B; Orr, T E; Oxland, T R; Nolte, L P

    2000-12-01

    Presently, there is little consensus about how, or even if, axial preload should be incorporated in spine flexibility tests in order to simulate the compressive loads naturally present in vivo. Some preload application methods are suspected of producing unwanted "artefact" forces as the specimen rotates and, in doing so, influencing the resulting kinematics. The objective of this study was to quantitatively compare four distinct types of preload which have roots in contemporary experimental practice. The specific quantities compared were the reaction moments and forces resulting at the intervertebral disc and specimen kinematics. The preload types incorporated increasing amounts of caudal constraint on the preload application vector ranging from an unconstrained dead-load arrangement to an apparatus that allowed the vector to follow rotations of the specimen. Six human cadaveric spine segments were tested (1-L1/L2, 3-L2/L3, 1-L3/L4 and 1-L4/L5). Pure moments were applied to the specimens with each of the four different types of compressive preload. Kinematic response was measured using an opto-electronic motion analysis system. A six-axis load cell was used to measure reaction forces and moments. Artefact reaction moments and shear forces were significantly affected by preload application method and magnitude. Unconstrained preload methods produced high artefact moments and low artefact shear forces while more constrained methods did the opposite. A mechanical trade-off is suggested by our results, whereby unwanted moment can only be prevented at the cost of shear force production. When comparing spine flexibility studies, caution should be exercised to ensure preload was applied in a similar manner for all studies. Unwanted moments or forces induced as a result of preload application method may render the comparison of two seemingly similar studies inappropriate.

  4. Ischemic Stroke

    Science.gov (United States)

    ... fit. Learn more Survivors Just Experienced a Stroke Stroke Recovery Caregivers and Family Careliving Guide Careliving Community Stroke Support Groups Online Education Healthcare Professionals Join Us ...

  5. Combined and interactive effects of interference fit and preloads on composite joints

    Institute of Scientific and Technical Information of China (English)

    Liu Longquan; Zhang Junqi; Chen Kunkun; Wang Hai

    2014-01-01

    The combined and interactive effects of the bolt-hole fit conditions and the preloads of the fasteners on the load carrying capacity of single-lap composite-to-titanium bolted joints have been investigated both experimentally and numerically. Quasi-static tests of the hybrid joints with different fit conditions are implemented, and a three dimensional finite element progressive failure analysis model is proposed to predict the influences of the bolt-hole fit conditions and fastener’s pre-loads on the mechanical behaviors of the joints. Based on the experimental validated simulation method, a multi-factor, mixed levels orthogonal design table and the analysis of variance method are used to arrange the simulation conditions and to further study the interactive effects of preloads and fit conditions. Through the analysis of the results, for the researched double bolt, single-lap composite-titanium joints, it is found that:the effects of both the interference fit and the preloads change from positive into negative mode with the increase of the interference fit values or preload values; appropriate bolt-hole fit conditions and preloads can improve the bolt-hole contact conditions of the loaded joints, and then retard the fiber failures around the fastener holes, and increase the load carrying capacity of the joints eventually; the interactive effect of the bolt-hole interference fit conditions and preloads cannot be ignored and the parameters need to be considered together and synthetically as the joints are being optimized.

  6. Ischemic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually ... are at risk for having a more serious stroke. Symptoms of stroke are Sudden numbness or weakness ...

  7. Stroke - discharge

    Science.gov (United States)

    ... Know Stroke. Post-Stroke Rehabilitation. Updated September 2014. stroke.nih.gov/materials/rehabilitation.htm . Accessed July 22, 2016. The American Occupational Therapy Association. Recovering From Stroke. AOTA.org. 2013. www. ...

  8. Social Participation after Stroke: One-Year Follow-Up of Stroke Survivors in Nigeria

    OpenAIRE

    Grace O. Vincent-Onabajo

    2013-01-01

    Background. Stroke may negatively affect social participation in survivors. Aims. This study assessed the pattern of social participation in a sample of Nigerian stroke survivors across the first 12 months after stroke. Methods. Stroke survivors were consecutively recruited while on admission at a tertiary health institution. The London handicap scale was used to assess social participation at 1, 3, 6, 9, and 12 months at the homes of the stroke survivors. Overall and domain-specific patterns...

  9. Probability distribution of von Mises stress in the presence of pre-load.

    Energy Technology Data Exchange (ETDEWEB)

    Segalman, Daniel Joseph; Field, Richard V.,; Reese, Garth M.

    2013-04-01

    Random vibration under preload is important in multiple endeavors, including those involving launch and re-entry. There are some methods in the literature to begin to address this problem, but there is nothing that accommodates the existence of preloads and the necessity of making probabilistic statements about the stress levels likely to be encountered. An approach to achieve to this goal is presented along with several simple illustrations.

  10. Preloaded Motorway Embankments:an environmentally sound solution for soft soil areas

    OpenAIRE

    1999-01-01

    Road construction, particularly involving soft soil replacement, draws very heavily on the scarce resources of sand and gravel. One environmentally appealing alternative to complete soft soil replacement is preloading where the sand/gravel materials may be re-used along the road alignment. The paper describes the first application of the method for motorways in connection with the completion of the Danish motorway infrastructure. To validate the feasibility of preloading an instrumented test ...

  11. Calorie anticipation alters food intake after low-caloric not high-caloric preloads.

    Science.gov (United States)

    Hogenkamp, P S; Cedernaes, J; Chapman, C D; Vogel, H; Hjorth, O C; Zarei, S; Lundberg, L S; Brooks, S J; Dickson, S L; Benedict, C; Schiöth, H B

    2013-08-01

    Cognitive factors and anticipation are known to influence food intake. The current study examined the effect of anticipation and actual consumption of food on hormone (ghrelin, cortisol, and insulin) and glucose levels, appetite and ad libitum intake, to assess whether changes in hormone levels might explain the predicted differences in subsequent food intake. During four breakfast sessions, participants consumed a yogurt preload that was either low caloric (LC: 180 kcal/300 g) or high caloric (HC: 530 kcal/300 g) and was provided with either consistent or inconsistent calorie information (i.e., stating the caloric content of the preload was low or high). Appetite ratings and hormone and glucose levels were measured at baseline (t = 0), after providing the calorie information about the preload (t = 20), after consumption of the preload (t = 40), and just before ad libitum intake (t = 60). Ad libitum intake was lower after HC preloads (as compared to LC preloads; P Intake after LC preloads was higher when provided with (consistent) LC information (467±254 kcal) as compared to (inconsistent) HC information (346±210 kcal), but intake after the HC preloads did not depend on the information provided (LC information: 290±178 kcal, HC information: 333±179 kcal; caloric load*information P = 0.03). Hormone levels did not respond in an anticipatory manner, and the post-prandial responses depended on actual calories consumed. These results suggest that both cognitive and physiological information determine food intake. When actual caloric intake was sufficient to produce physiological satiety, cognitive factors played no role; however, when physiological satiety was limited, cognitively induced satiety reduced intake to comparable levels. Copyright © 2012 The Obesity Society.

  12. Influence of pre-load coefficient of TPJBs with even number pads on shaft lateral vibration

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    For a rotating machine with one or more tilting pad journal bearings (TPJBs), it is acommon state that pad-to-journal assembling clearances are uneven in one bearing, or inconsis-tent relationship of assembling clearances are encountered among all the bearings. Consideringthe structural characteristics of a TPJB, a concept named as "pad pair pre-load coefficient" corre-sponding to bearing pre-load coefficient is proposed. Firstly, the influence of bearing pre-load coef-ficient and pad pair pre-load coefficient on shaft vibration in a Jeffcot rotor is analyzed. Then takingNo.1 unit with two TPJBs in Guangzhou pumped storage power plant (GPSP) as an example, theinfluence of inconsistent relationship of the two bearing pre-load coefficients on shaft vibration isanalyzed. The results show that variety of one bearing pre-load coefficient will only influence vibra-tion amplitude, not involving the shape of shaft center orbit. But variety of one or more "pad pairpre-load coefficient" will influence not only vibration amplitude, but also the shape of orbit-whichwill be turned from a circle to an ellipse. By investigating variation characteristics of shape andvibration amplitude of orbits at the TPJBs, some theoretical bases will be supplied for diagnosingthe condition of the unit bearings.

  13. Noninvasively derived stroke volume variation by finger volume clamping can reliably predict fluid responsiveness

    NARCIS (Netherlands)

    Vos, Jaap Jan; Poterman, Marieke; Struys, Michel; Scheeren, Thomas; Kalmar, A.F.

    2013-01-01

    Background and Goal of Study:  Dynamic preload variables derived from the arterial pressure waveform have been shown to accurately predict fluid responsiveness in mechanically ventilated patients. One of these variables, stroke volume variation (SVV), can also be obtained noninvasively by the finger

  14. Preventing stroke

    Science.gov (United States)

    Stroke - prevention; CVA - prevention; cerebral vascular accident - prevention; TIA - prevention, transient ischemic attack - prevention ... something that increases your chance of having a stroke. You cannot change some risk factors for stroke. ...

  15. Stroke Rehabilitation

    Science.gov (United States)

    A stroke can cause lasting brain damage. People who survive a stroke need to relearn skills they lost because of ... them relearn those skills. The effects of a stroke depend on which area of the brain was ...

  16. Hemorrhagic Stroke

    Science.gov (United States)

    A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Hemorrhagic stroke is the less common type. It happens when ... an artery wall that breaks open. Symptoms of stroke are Sudden numbness or weakness of the face, ...

  17. A technique for monitoring fast tuner piezoactuator preload forces for superconducting rf cavities

    Energy Technology Data Exchange (ETDEWEB)

    Pischalnikov, Y.; Branlard, J.; Carcagno, R.; Chase, B.; Edwards, H.; Orris, D.; Makulski, A.; McGee, M.; Nehring, R.; Poloubotko, V.; Sylvester, C.; /Fermilab

    2007-06-01

    The technology for mechanically compensating Lorentz Force detuning in superconducting RF cavities has already been developed at DESY. One technique is based on commercial piezoelectric actuators and was successfully demonstrated on TESLA cavities [1]. Piezo actuators for fast tuners can operate in a frequency range up to several kHz; however, it is very important to maintain a constant static force (preload) on the piezo actuator in the range of 10 to 50% of its specified blocking force. Determining the preload force during cool-down, warm-up, or re-tuning of the cavity is difficult without instrumentation, and exceeding the specified range can permanently damage the piezo stack. A technique based on strain gauge technology for superconducting magnets has been applied to fast tuners for monitoring the preload on the piezoelectric assembly. The design and testing of piezo actuator preload sensor technology is discussed. Results from measurements of preload sensors installed on the tuner of the Capture Cavity II (CCII)[2] tested at FNAL are presented. These results include measurements during cool-down, warmup, and cavity tuning along with dynamic Lorentz force compensation.

  18. EVALUATION OF TROQUE VS CLOSURE BOLT PRELOAD FOR A TYPICAL CONTAINMENT VESSEL UNDER SERVICE CONDITIONS

    Energy Technology Data Exchange (ETDEWEB)

    Smith, A.

    2010-02-16

    Radioactive material package containment vessels typically employ bolted closures of various configurations. Closure bolts must retain the lid of a package and must maintain required seal loads, while subjected to internal pressure, impact loads and vibration. The need for insuring that the specified preload is achieved in closure bolts for radioactive materials packagings has been a continual subject of concern for both designers and regulatory reviewers. The extensive literature on threaded fasteners provides sound guidance on design and torque specification for closure bolts. The literature also shows the uncertainty associated with use of torque to establish preload is typically between 10 and 35%. These studies have been performed under controlled, laboratory conditions. The ability to insure required preload in normal service is, consequently, an important question. The study described here investigated the relationship between indicated torque and resulting bolt load for a typical radioactive materials package closure using methods available under normal service conditions.

  19. The Influence of Preload on the Work of Angular Contact Ball Bearings

    Directory of Open Access Journals (Sweden)

    Kaczor Jarosław

    2016-09-01

    Full Text Available Optimum values of preload can be achieved in well-tried constructions and then applied in similar structures. For new structures, it is recommended to calculate the preload force and to test the correctness of calculation by means of experiments. In practice it may be necessary to introduce corrections, because not all real work parameters can be precisely known. Credibility of calculations depends, first of all, on the consistence between the assumptions concerning temperature conditions during work and elastic deformations of cooperating elements – first of all of a holder – and the real work conditions. The aim of the study is to determine how preload influences the work of a system of angular ball bearings, in relation to durability of bearing, moment of friction and rigidity of the bearing.

  20. Does fasting influence preload responsiveness in ASA 1 and 2 volunteers?

    Science.gov (United States)

    Alves, Daniel Rodrigues; Ribeiras, Regina

    Preoperative fasting was long regarded as an important cause of fluid depletion, leading to hemodynamic instability during surgery should replenishment is not promptly instituted. Lately, this traditional point of view has been progressively challenged, and a growing number of authors now propose a more restrictive approach to fluid management, although doubt remains as to the true hemodynamic influence of preoperative fasting. We designed an observational, analytic, prospective, longitudinal study in which 31 ASA 1 and ASA 2 volunteers underwent an echocardiographic examination both before and after a fasting period of at least 6hours (h). Data from both static and dynamic preload indices were obtained on both periods, and subsequently compared. Static preload indices exhibited a markedly variable behaviour with fasting. Dynamic indices, however, were far more consistent with one another, all pointing in the same direction, i.e., evidencing no statistically significant change with the fasting period. We also analysed the reliability of dynamic indices to respond to known, intentional preload changes. Aortic velocity time integral (VTI) variation with the passive leg raise manoeuvre was the only variable that proved to be sensitive enough to consistently signal the presence of preload variation. Fasting does not appear to cause a change in preload of conscious volunteers nor does it significantly alter their position in the Frank-Starling curve, even with longer fasting times than usually recommended. Transaortic VTI variation with the passive leg raise manoeuvre is the most robust dynamic index (of those studied) to evaluate preload responsiveness in spontaneously breathing patients. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  1. Neural responses to the mechanical parameters of a high velocity, low amplitude spinal manipulation: effect of preload parameters

    Science.gov (United States)

    Reed, William. R.; Long, Cynthia R.; Kawchuk, Gregory N.; Pickar, Joel G.

    2014-01-01

    Objective The purpose of this study was to determine how the preload that precedes a high velocity low amplitude spinal manipulation (HVLA-SM) affects muscle spindle input from lumbar paraspinal muscles both during and after the HVLA-SM. Methods Primary afferent activity from muscle spindles in lumbar paraspinal muscles were recorded from the L6 dorsal root in anesthetized cats. HVLA-SM of the L6 vertebra was preceded either by no preload or by systematic changes in the preload magnitude, duration, and the presence or absence of a downward incisural point (DIP). Immediate effects of preload on muscle spindle responses to the HVLA-SM were determined by comparing mean instantaneous discharge frequencies (MIF) during the HVLA-SM’s thrust phase with baseline. Longer lasting effects of preload on spindle responses to the HVLA-SM were determined by comparing MIF during slow ramp and hold movement of the L6 vertebra before and following the HVLA-SM. Results The smaller compared to the larger preload magnitude and the longer compared to the shorter preload duration significantly increased (P=0.02 and P=0.04) respectively) muscle spindle responses during the HVLA-SM thrust. The absence of preload had the greatest effect on the change in MIF. Interactions between preload magnitude, duration and DIP often produced statistically significant but arguably physiologically modest changes in the passive signaling properties of the muscle spindle following the manipulation. Conclusion Because preload parameters in this animal model were shown to affect neural responses to an HVLA-SM, preload characteristics should be taken into consideration when judging this intervention’s therapeutic benefit in both clinical efficacy studies and in clinical practice. PMID:24387888

  2. Whey protein preloads are more beneficial than soy protein preloads in regulating appetite, calorie intake, anthropometry, and body composition of overweight and obese men.

    Science.gov (United States)

    Tahavorgar, Atefeh; Vafa, Mohammadreza; Shidfar, Farzad; Gohari, Mahmoodreza; Heydari, Iraj

    2014-10-01

    High-protein diets exert beneficial effects on appetite, anthropometry, and body composition; however, the effects of protein preloads depend on the amount, type, and time of consumption. Therefore, we hypothesized that long-term supplemental preloads of whey protein concentrate (WPC) and soy protein isolate (SPI) consumed 30 minutes before the largest meal would decrease appetite, calorie intake (CI), and anthropometry and improve body composition in overweight and obese men in free-living conditions. The subjects included 45 men with a body mass index between 25 and 40 kg/m(2) and who were randomly allocated to either the WPC (n = 26) or SPI (n = 19) groups. For 12 weeks, the subjects consumed 65 g WPC or 60 g SPI that was dissolved in 500 mL water 30 minutes before their ad libitum lunch. Appetite, CI, anthropometry, and body composition were assessed before and after the study and biweekly throughout. After 12 weeks, mean changes between the groups were significant for appetite (P = .032), CI (P = .045), anthropometry (body weight [P = .008], body mass index [P = .006], and waist circumference), and body composition (body fat mass and lean muscle [P < .001]). Relative to baseline, within-group mean changes from WPC were significant for appetite, CI, anthropometry, and body composition (P < .001). In the SPI group, mean changes were significant, relative to baseline, for all variables except lean muscle (P = .37). According to this 12-week study, WPC preloads conducted 30 minutes prior to the ad libitum main meal exerted stronger beneficial effects than did SPI preloads on appetite, CI, anthropometry, and body composition of free-living overweight and obese men.

  3. Stroke Rehabilitation

    Science.gov (United States)

    ... or other long-term facility 15% die shortly after the stroke Approximately 14% of stroke survivors experience a second stroke in the first year following a stroke. Successful rehabilitation depends on: Amount of damage to the brain Skill on the part of ...

  4. Stimulation of Methanol Degradation in UASB Reactors: In Situ Versus Pre-Loading Cobalt on Anaerobic Granular Sludge

    NARCIS (Netherlands)

    Zandvoort, M.H.; Gieteling, J.; Lettinga, G.; Lens, P.N.L.

    2004-01-01

    The effect of pre-loading and in situ loading of cobalt onto a cobalt-limited granular sludge on the performance of methanol fed bioreactors was investigated. One upflow anaerobic sludge bed (UASB) reactor was inoculated with cobalt pre-loaded sludge (24h; 30degreesC; 1 mM CoCl2) and a second UASB w

  5. Stimulation of Methanol Degradation in UASB Reactors: In Situ Versus Pre-Loading Cobalt on Anaerobic Granular Sludge

    NARCIS (Netherlands)

    Zandvoort, M.H.; Gieteling, J.; Lettinga, G.; Lens, P.N.L.

    2004-01-01

    The effect of pre-loading and in situ loading of cobalt onto a cobalt-limited granular sludge on the performance of methanol fed bioreactors was investigated. One upflow anaerobic sludge bed (UASB) reactor was inoculated with cobalt pre-loaded sludge (24h; 30degreesC; 1 mM CoCl2) and a second UASB

  6. Dynamic Fracture Properties of Rocks Subjected to Static Pre-load Using Notched Semi-circular Bend Method

    Science.gov (United States)

    Chen, Rong; Li, Kang; Xia, Kaiwen; Lin, Yuliang; Yao, Wei; Lu, Fangyun

    2016-10-01

    A dynamic load superposed on a static pre-load is a key problem in deep underground rock engineering projects. Based on a modified split Hopkinson pressure bar test system, the notched semi-circular bend (NSCB) method is selected to investigate the fracture initiation toughness of rocks subjected to pre-load. In this study, a two-dimensional ANSYS finite element simulation model is developed to calculate the dimensionless stress intensity factor. Three groups of NSCB specimen are tested under a pre-load of 0, 37 and 74 % of the maximum static load and with the loading rate ranging from 0 to 60 GPa m1/2 s-1. The results show that under a given pre-load, the fracture initiation toughness of rock increases with the loading rate, resembling the typical rate dependence of materials. Furthermore, the dynamic rock fracture toughness decreases with the static pre-load at a given loading rate. The total fracture toughness, defined as the sum of the dynamic fracture toughness and initial stress intensity factor calculated from the pre-load, increases with the pre-load at a given loading rate. An empirical equation is used to represent the effect of loading rate and pre-load force, and the results show that this equation can depict the trend of the experimental data.

  7. pDC therapy induces recovery from EAE by recruiting endogenous pDC to sites of CNS inflammation

    DEFF Research Database (Denmark)

    Duraes, Fernanda V; Lippens, Carla; Steinbach, Karin;

    2016-01-01

    and is dependent on the subsequent and selective chemerin-mediated recruitment of endogenous pDCs to the CNS. The protective effect requires pDC pre-loading with myelin antigen, and is associated with the modulation of CNS-infiltrating pDC phenotype and inhibition of CNS encephalitogenic T cells. This study may...

  8. Diabetes and poor outcomes within 6 months after acute ischemic stroke: the China National Stroke Registry.

    Science.gov (United States)

    Jia, Qian; Zhao, Xingquan; Wang, Chunxue; Wang, Yilong; Yan, Yu; Li, Hao; Zhong, Liyong; Liu, Liping; Zheng, Huaguang; Zhou, Yong; Wang, Yongjun

    2011-10-01

    Diabetes mellitus (DM) is an independent risk factor for ischemic stroke. However, controversy exists with regard to the impact of DM on prognosis after ischemic stroke in the Chinese population. We investigated the associations between DM and death, dependency, and stroke recurrence in patients after ischemic stroke onset in a nationwide, prospective registry, the China National Stroke Registry. The China National Stroke Registry consecutively recruited patients hospitalized for acute ischemic stroke in 2007 to 2008 and who were prospectively followed up for clinical and functional outcomes (death, dependency, and stroke recurrence) at 3 and 6 months after disease onset. Multivariable logistic regression was performed to analyze the association between DM and stroke outcomes after adjusting for potential confounding including age, sex, National Institutes of Health Stroke Scale score, glucose level at admission, hypertension, coronary heart disease, smoking, urinary tract infection, and other factors. DM was identified in 3483 (27.0%) of stroke patients. Compared with stroke patients without DM, patients with DM had a significantly higher incidence of death or dependency and of recurrent stroke at 3 and 6 months after stroke onset. DM was an independent risk factor for death or dependency (adjusted odds ratio=1.23; 95% confidence interval, 1.10 to 1.37) in patients with ischemic stroke at 6 months after onset. DM independently predicted poor outcomes in Chinese patients after acute ischemic stroke.

  9. Effect of preload alternations on a new Doppler echocardiographic index of combined systolic and diastolic performance

    DEFF Research Database (Denmark)

    Møller, J E; Poulsen, S H; Egstrup, K

    1999-01-01

    The objective of the study was to assess the effect of preload alternations on a nongeometric Doppler index of combined systolic and diastolic myocardial performance (MPI). Doppler echocardiography was performed during Valsalva maneuver, passive leg lifting, and after sublingual administration of...

  10. Is the performance of acceleromyography improved with preload and normalization? A comparison with mechanomyography

    DEFF Research Database (Denmark)

    Claudius, Casper; Skovgaard, Lene Theil; Viby-Mogensen, Jørgen

    2009-01-01

    BACKGROUND: Many studies have indicated that acceleromyography and mechanomyography cannot be used interchangeably. To improve the agreement between the two methods, it has been suggested to use a preload and to refer all train-of-four (TOF) ratios to the control TOF (normalization) when using ac...

  11. A New Method of Combination of Electroosmosis, Vacuum and Surcharge Preloading for Soft Ground Improvement

    Institute of Scientific and Technical Information of China (English)

    刘汉龙; 崔允亮; 沈扬; 丁选明

    2014-01-01

    As-a-rapid-and-effective-ground-improvement-method-is-urgently-required-for-the-booming-land-reclamation-in-China’s-coastal-area,-this-study-proposes-a-new-combined-method-of-electroosmosis,-vacuum-preloading-and-surcharge-preloading.-A-new-type-of-electrical-prefabricated-vertical-drain-(ePVD)-and-a-new-electroosmotic-drainage-system-are-suggested-to-allow-the-application-of-the-new-method.-This-combined-method-is-then-field-tested-and-compared-with-the-conventional-vacuum-combined-with-surcharge-preloading-method.-The-monitoring-and-foundation-test-results-show-that-the-new-method-induces-a-settlement-20%larger-than-that-of-the-conventional-vacuum-combined-with-surcharge-preloading-method-in-the-same-treatment-period,-and-saves-approximately-half-of-the-treatment-time-compared-with-the-vacuum-combined-with-surcharge-preloading-method-according-to-the-finite-element-prediction-of-the-settlement.-The-proposed-method-also-increases-the-vane-shear-strength-of-the-soil-significantly.-The-bearing-capacity-of-the-ground-improved-by-use-of-the-new-proposed-method-raises-118%.-In-comparison,-there-is-only-a-75%rise-when-using-the-vacuum-combined-with-surcharge-preloading-method-during-the-same-reinforcement-period.-All-results-indicate-that-the-proposed-combined-method-is-effective-and-suitable-for-reinforcing-the-soft-clay-ground.-Besides,-the-voltage-applied-between-the-anode-and-cathode-increases-exponentially-versus-treatment-time-when-the-output-current-of-power-supplies-is-kept-constant.-Most-of-the-voltage-potential-in-electroosmosis-is-lost-at-electrodes,-leaving-smaller-than-50%-of-the-voltage-to-be-effectively-transmitted-into-the-soil.

  12. Know Stroke

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section Know Stroke Past Issues / Summer 2007 Table of Contents For ... D. Director, National Institute of Neurological Disorders and Stroke Photo courtesy of NIH/NINDS Welcome to this ...

  13. Stroke - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100218.htm Stroke - series—Part 1 To use the sharing features ... M. Editorial team. Related MedlinePlus Health Topics Ischemic Stroke A.D.A.M., Inc. is accredited by ...

  14. Stroke: Overview

    Science.gov (United States)

    ... NICHD Research Information Clinical Trials Resources and Publications Stroke: Overview Skip sharing on social media links Share this: Page Content Stroke is a leading cause of disability and death ...

  15. Recovering after stroke

    Science.gov (United States)

    Stroke rehabilitation; Cerebrovascular accident - rehabilitation; Recovery from stroke; Stroke - recovery; CVA - recovery ... WHERE TO LIVE AFTER A STROKE Most people will need stroke ... after they leave the hospital. Stroke rehab will help you ...

  16. Cryptogenic Stroke

    Directory of Open Access Journals (Sweden)

    Mohammad Saadatnia

    2017-02-01

    Full Text Available Cryptogenic stroke is defined as brain infarction that is not attributable to a source of definite embolism, large artery atherosclerosis, or small artery disease despite a thorough vascular, cardiac, and serologic evaluation. Despite many advances in our understanding of ischemic stroke, cryptogenic strokes remain a diagnostic and therapeutic challenge. The pathophysiology of cryptogenic stroke is likely various. Probable mechanisms include cardiac embolism secondary to occult paroxysmal atrial fibrillation, aortic atheromatous disease or other cardiac sources, paradoxical embolism from atrial septal abnormalities such as patent foramen ovale, hypercoagulable states, and preclinical or subclinical cerebrovascular disease.  Cryptogenic stroke is one-fourth among cerebral infarction, but most of them could be ascribed to embolic stroke. A significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging and improvement in our ability to detect paroxysmal atrial fibrillation in patients with cryptogenic stroke has strengthened the idea that these strokes are embolic in nature. a significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging.embolic stroke of undetermined sources(ESUS was planned for unifying embolic stroke of undetermined source.  The etiologies underlying ESUS included minor-risk potential cardioembolic sources, covert paroxysmal atrial fibrillation, cancer-associated coagulopathy and embolism, arteriogenic emboli, and paroxysmal embolism. Extensive evaluation including transesophageal echocardiography and cardiac monitoring for long time could identify the etiology of these patients. Therefore cryptogenic stroke is a diagnosis of exclusion. Compared with other stroke subtypes, cryptogenic stroke tends to have a better prognosis and lower long-term risk of recurrence.

  17. Potential Risk Analysis of Tailings Dam under Preloading Condition and Its Countermeasures

    Directory of Open Access Journals (Sweden)

    Shuren Wang

    2015-01-01

    Full Text Available It is very important for mine production safety to ensure the stability of the tailings dam. Taking a flatland tailings pond as the background, a threedimensional computational model was built based on a tailings dam under mullock heap preloading condition. Considering the current operating water level conditions, a liquid-solid coupling analysis of the model was conducted.The deformation characteristics of the tailings dam were revealed during successive preloading at the front of the dam. The safety factor and the potential slide face of the tailings dam were calculated under different conditions using the strength reduction method. The results show that the tailings dam in its current condition is basically stable, but if the mullock heap continues to be heightened, the tailings dam will become unstable. Therefore, in order to limit the height of the mullock heap, establishing a monitor and early warning mechanism are put forward to ensure mine production safety.

  18. Static Absolute Force Measurement for Preloaded Piezoelements Used for Active Lorentz Force Detuning System

    CERN Document Server

    Sekalski, S P; Sekalski, S P

    2004-01-01

    To reach high gradients in pulsed operation of superconducting (SC) cavities an active Lorentz force detuning compensation system is needed. For this system a piezoelement can be used as an actuator (other option is a magnetostrictive device). To guarantee the demanded lifetime of the active element, the proper preload force adjustment is necessary. To determine this parameter an absolute force sensor is needed which will be able to operate at cryogenic temperatures. Currently, there is no calibrated commercial available sensor, which will be able to measure the static force in such an environment. The authors propose to use a discovered phenomenon to estimate the preload force applied to the piezoelement. The principle of the proposed solution based on a shape of impedance curve, which changes with the value of applied force. Especially, the position of resonances are monitored. No need of specialized force sensor and measurement in-situ are additional advantages of proposed method.

  19. Automatic control of the preload in adaptive friction drives of chemical production machines

    Science.gov (United States)

    Balakin, P. D.

    2017-08-01

    Being based on the principle of providing the systems with adaptation property to the real parameters and operational condition, the energy effective mechanical system constructed on the base of friction gear with automated preload is offered and this allows keeping mechanical efficiency value adequate transforming drive path to in the terms of multimode operation. This is achieved by integrated control loop, operating on the basis of the laws of motion with the energy of the main power flow by changing automatically the kinematic dimension of the section and, hence, the value of preload in the friction contact. The given ratios of forces and deformations in the control loop are required at the stage of conceptual design to determine design dimensions of power transmission elements with new properties.

  20. Calorie Anticipation Alters Food Intake After Low-Caloric but Not High-Caloric Preloads

    OpenAIRE

    Hogenkamp, Pleunie; Cedernaes, Jonathan; Chapman, Colin; Vogel, Heike; Hjorth, Olof; Zarei, Sanaz; Lundberg, Lina; Brooks, Samantha; Dickson, Suzanne; Benedict, Christian; Schiöth, Helgi

    2013-01-01

    Objective Cognitive factors and anticipation are known to influence food intake. The current study examined the effect of anticipation and actual consumption of food on hormone (ghrelin, cortisol, and insulin) and glucose levels, appetite and ad libitum intake, to assess whether changes in hormone levels might explain the predicted differences in subsequent food intake. Design and Methods During four breakfast sessions, participants consumed a yogurt preload that was either low caloric (LC: 1...

  1. Deconstructing alcohol use on a night out in England: promotions, preloading and consumption.

    Science.gov (United States)

    McClatchley, Kirstie; Shorter, Gillian W; Chalmers, Jenny

    2014-07-01

    To examine alcohol consumed during a drinking event (a single drinking occasion) by those attending public house/on-trade establishments on nights with standard pricing and nights with promotional prices. Data (n = 425) were collected in an ecological momentary assessment over eight nights in two locations (Midlands and London) on both promotional and standard (Saturday) nights. Multiple regression was used to predict event alcohol consumption by sex, age, type of night, alcohol preloading behaviour, marital and employment status, education, Alcohol Use Disorders Identification Test alcohol consumption questions separately or total AUDIT-C and social group size. Mean (UK) units consumed were 11.8 (London) and 14.4 (Midlands). In London, consumption was similar on promotional and standard nights, but in the Midlands, standard night consumption was three units higher. Preloading was reported by 30%; more common on standard nights. Regression analyses revealed being male, preloading and past-year total AUDIT-C were associated with higher event consumption. However, when AUDIT-C questions were added separately, being a standard night was associated with increased event consumption and different AUDIT-C questions were significantly associated with event consumption in each location. Event consumption reflected heavy episodic drinking and was influenced by price. Promotional night consumption either matched standard Saturday night consumption or was slightly lower. In London, there was a significant preference for drinking at least one promotional beverage on promotional nights. On standard nights, consumption was over a wider range of venues, and preloading with off-trade alcohol was more likely. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  2. Comparison of colloid preload versus coload under low dose spinal anesthesia for cesarean delivery

    Science.gov (United States)

    Varshney, Rohit; Jain, Gaurav

    2013-01-01

    Background: Although fluid bolus is considered as a conventional prophylactic measure to prevent spinal-induced hypotension; vasopressors are nevertheless required. Low dose spinal anesthetics could markedly reduce such episodes of hypotension, by minimizing sympathetic blockade. Aims: We chose to compare the relative efficacy of colloid preload versus coload under low dose spinal anesthesia, for elective cesarean delivery. Settings and Design: A prospective, randomized, double-blinded study. Materials and Methods: In total, 42 parturients were randomized to receive a preload (Group P) of hydroxyl ethyl starch (10 ml/kg) over 20 min before initiation of low dose spinal anesthesia (hyperbaric bupivacaine 5.5 mg with fentanyl 25 μg) or coload (Group C) of an identical fluid over 5 min, starting at the time of identification of cerebrospinal fluid. Our primary outcome included hemodynamic parameters and the incidence of hypotension. The neonatal outcome and side-effects were also monitored. Statistical Analysis: Mann-Whitney U test and Fisher's exact/Chi-square test, whichever appropriate. A P < 0.05 was considered to be significant. Results: The incidence of hypotension was lower in Group P (10%) when compared with Group C (25%), though insignificant statistically. The hemodynamic parameters were better in Group P, though intergroup statistical differences were not observed. The time to the first episode of hypotension was longer in the Group P (17 min) as compared with Group C (14 min). No notable side-effects or adverse neonatal outcome was noted. Conclusion: Colloid preload has a clinical advantage over the coload strategy, in reducing hypotensive episodes under low dose spinal anesthesia. Preload is better under large hemodynamic fluctuations while coload is preferable for emergency scenarios. PMID:25885987

  3. Numerical Simulations on Buckling Failure of Preloaded Cylindrical Shell Irradiated by High Power Laser Beam

    Institute of Scientific and Technical Information of China (English)

    王吉; 王肖钧; 王峰; 赵凯

    2004-01-01

    With finite-element software ANSYS 7.0 and simple thermal-mechanical coupling constitutive relations,the buckling failure of preloaded cylindrical shell irradiated by high power laser beam was studied by numerical simulations. The buckling mode and buckling critical loading were analysed for different preloading conditions. The influence of laser intensity, beam irradiation time, preloading conditions and geometric parameters of cylindrical shell on the buckling mode were discussed. The numerical results show that: ① the buckling deformation of the cylindrical shell was concentrated in the area of laser spot and the radial buckling was the main buckling mode, ② a linear relationship between the buckling eigenvalue and the maximum temperature at the center of laser spot was approached, ③ the buckling failure of cylindrical shell was attributed to the coupling effect of the material softening and the radial deformation in the laser spot, and hence to raise the stiffness of the material would enhance the ability for anti-irradiation of structure substantially.

  4. The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery

    Science.gov (United States)

    Jones, Jason J; Chu, Jeffrey; Graham, Jacob; Zaluski, Serge; Rocha, Guillermo

    2016-01-01

    Purpose The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Methods Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. Results The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%–12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France). Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Conclusion Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity. PMID:27382245

  5. Kinesthetic taping improves walking function in patients with stroke

    DEFF Research Database (Denmark)

    Boeskov, Birgitte; Carver, Line Tornehøj; von Essen-Leise, Anders

    2014-01-01

    walking speed and clinical indices of spasticity in patients with stroke. METHODS: Thirty-two patients (9 women) receiving rehabilitation after stroke (average, 50 days since stroke) who had impaired walking ability were recruited. Primary outcome was maximal walking speed measured by the 10-meter walk...... be a valuable adjunct in physical therapy and rehabilitation of patients with stroke.......BACKGROUND: Stroke is an important cause of severe disability and impaired motor function. Treatment modalities that improve motor function in patients with stroke are needed. The objective of this study was to investigate the effect of kinesthetic taping of the anterior thigh and knee on maximal...

  6. The effect of preload/meal energy density on energy intake in a subsequent meal: A systematic review and meta-analysis.

    Science.gov (United States)

    Rouhani, Mohammad Hossein; Surkan, Pamela J; Azadbakht, Leila

    2017-08-01

    To conduct a systematic review and meta-analysis of the effects of preload/meal energy density on energy intake in a subsequent meal(s). Multiple databases were searched for studies published through December 2016 on the effects of preload/meal energy density on energy intake in a subsequent meal(s). We extracted information on mean energy intake in a subsequent meal(s) and on variables that could contribute to between-subject heterogeneity. Forty and Thirty nine eligible studies were identified for our systematic review and meta-analysis, respectively. The meta-analysis showed that preload/meal energy density did not affect energy intake in a subsequent meal(s) (95% CI:-21.21, 21.29). As heterogeneity was remarkable among studies, we stratified the studies by intervention type into "meal" or "preload" classifications. In the "preload" subgroup, studies used either fixed energy or fixed weight preloads. The results reveal that in comparison to a high energy-dense (HED) preload, consuming a low energy-dense (LED) preload with same weight resulted in higher energy intake in a subsequent meal (95% CI: 9.72, 56.19). On the other hand, decreased energy intake was observed after consuming an LED preload compared to after consumption of an HED preload with same energy content (95% CI: -138.71, -57.33). In the "meal" subgroup, studies were categorized by different subsequent meal (i.e., "afternoon or evening", "lunch" and "dinner or post-dinner"). Meta-analysis showed that an LED meal resulted in more energy intake only in afternoon or evening meals (95% CI: 14.82, 31.22). In summary, the current analysis revealed that we can restrict the energy intake by consuming an LED preload. Moreover, consuming an LED preload could favorably affect preload+meal energy intake. Copyright © 2016. Published by Elsevier Ltd.

  7. Atherosclerosis and Stroke

    Science.gov (United States)

    ... After Stroke Inspirational Stories Stroke Heroes Among Us Atherosclerosis and Stroke Updated:Oct 24,2016 Excerpted and ... cause difficulty walking and eventually gangrene. Stroke and atherosclerosis There are two types of ischemic stroke caused ...

  8. Outcomes of Descemet Stripping Endothelial Keratoplasty Using Eye Bank-Prepared Preloaded Grafts.

    Science.gov (United States)

    Palioura, Sotiria; Colby, Kathryn

    2017-01-01

    To evaluate the feasibility of Descemet stripping endothelial keratoplasty using grafts preloaded by an eye bank in a commercially available insertion device. In this retrospective case series, a series of 35 eyes in 34 consecutive patients who underwent Descemet stripping endothelial keratoplasty for Fuchs endothelial dystrophy or previously failed full-thickness grafts at a single tertiary care center from March 2013 to March 2014 was included. The donor tissue had undergone pre-lamellar dissection, trephination, and loading into EndoGlide Ultrathin inserters at the Lions Eye Institute for Transplant and Research (Tampa, FL) and was shipped overnight in Optisol GS to the surgeon (K.C.). Surgery was performed within 24 hours from tissue preparation and loading by the eye bank. Donor and recipient characteristics, endothelial cell density (ECD), best-corrected visual acuity, and central corneal thickness were recorded. The main outcome measures were intraoperative and postoperative complications and ECD loss at 3, 6, and 12 months. One primary graft failure (2.8%), 2 rebubblings (5.7%), and 1 graft rejection (2.8%) occurred. Mean preoperative donor ECD was 2821 ± 199 cells/mm. Six months postoperatively, the mean endothelial cell loss was 25.3% ± 17.2% (n = 32), which remained stable at 1 year (31.5% ± 17.9%, n = 32). Mean best-corrected visual acuity improved from 20/100 preoperatively to 20/25 at a mean follow-up of 1 year (n = 32). Mean central corneal thickness was reduced from 711 ± 110 μm to 638 ± 66 μm at the last follow-up visit. Donor graft tissue preloaded by an eye bank can be used successfully for endothelial keratoplasty. Preloading reduces intraoperative tissue manipulation.

  9. Sugar, perceived healthfulness, and satiety: When does a sugary preload lead people to eat more?

    Science.gov (United States)

    Mandel, Naomi; Brannon, Daniel

    2017-07-01

    In this research, we examine the interplay between physiological and psychological factors that determine whether the sugar level of a preload increases or decreases consumption on a subsequent snack-eating task. In study 1, participants who drank a high-sugar protein shake (which they believed to be healthy) consumed more subsequent snacks than participants who drank a low-sugar protein shake. Study 2 replicated these findings, but only when the shake was labeled as "healthy." When the shake was labeled as "indulgent," the effect was mitigated. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Should we stop using the determination of central venous pressure as a way to estimate cardiac preload?

    Science.gov (United States)

    Muñoz Nañez, Manuel Felipe

    2012-01-01

    Introduction: The determination of the values of central venous pressure has long been used as a guideline for volumetric therapy in the resuscitation of the critical patient, but the performance of such parameter is currently being questioned as an effective measurement of cardiac preload. This has aroused great interest in the search for more accurate parameters to determine cardiac preload and a patient's blood volume. Goals and Methods: Based on literature currently available, we aim to discuss the performance of central venous pressure as an effective parameter to determine cardiac preload. Results and Conclusion: Estimating variables such as end-diastolic ventricular area and global end-diastolic volume have a better performance than central venous pressure in determining cardiac preload. Despite the best performance of these devices, central venous pressure is still considered in our setting as the most practical and most commonly available way to assess the patient's preload. Only dynamic variables such as pulse pressure change are superior in determining an individual's blood volume. PMID:24893061

  11. How a Stroke Is Diagnosed

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... Diagnosis » How a Stroke is Diagnosed How a Stroke is Diagnosed How a Stroke is Diagnosed Lab ...

  12. USAR recruiting success factors

    OpenAIRE

    Thomas, George W.; Kocher, Kathryn M.; Gandolfo, Robin Ragsdale

    1987-01-01

    This study attempts to identify attributes associated with successful recruiters, to evaluate existing data on recruiter performance and characteristics, and to develop a model to aid in the selection of personnel who are likely to become successful recruiters. Conventional multivariate statistical techniques have not proved adequate in identifying successful recruiters, largely because of the absence of reliable and valid measures of recruiter success. This study applies a relatively new met...

  13. Challenges in recruitment, attendance and adherence of acute stroke survivors to a randomized trial in Brazil: a feasibility study Desafios no recrutamento, presença e adesão ao protocolo de intervenção em um ensaio controlado aleatorizado com sobreviventes de AVE agudo no Brasil: um estudo de viabilidade

    Directory of Open Access Journals (Sweden)

    Aline Scianni

    2012-02-01

    Full Text Available BACKGROUND: There is a high demand for stroke rehabilitation in the Brazilian public health system which should make undertaking clinical trials straightforward. OBJECTIVES: The aims of this study were to 1 determine the rate of recruitment of community-dwelling stroke survivors into a randomized trial of the effects of strength training in addition to task-specific gait training, 2 compare the effectiveness of various recruitment strategies on accrual rates, and 3 determine the attendance at training sessions and adherence to the intervention protocol. METHODS: Participants within six months of a stroke were screened for eligibility and invited to participate. Recruitment strategies were classified as advertisement or referral. The number of people who were screened, eligible and recruited for each strategy was recorded. Attendance at training sessions and adherence to the intervention protocol were recorded. RESULTS: Over the first 14 months, 150 stroke survivors were screened, 10 were recruited, and 35 (23% were eligible. Twenty-five of these patients (71% were unable to participate with lack of transport given as the most common reason. The most successful strategy was referral via hospital-based physical therapists (50%. Overall attendance was 72% with lack of transport being the most common reason for non-attendance. Overall adherence to the protocol was 97% with feeling unwell being the most common reason for non-adherence. CONCLUSIONS: Recruitment of stroke survivors was inefficient. Lack of transport was the most common barrier to participate in and attend training sessions. Funding for transport is essential to make carrying out trials in Brazil feasible. Trial Registration ACTRN12609000803291.CONTEXTUALIZAÇÃO: O sistema de saúde pública no Brasil apresenta uma alta demanda para a reabilitação de indivíduos após acidente vascular encefálico (AVE. Consequentemente, a condução de ensaios clínicos com essa população deveria

  14. Early clinical experience with a new preloaded one-piece intraocular lens in paediatric cataract surgery.

    Science.gov (United States)

    Gosling, D B; Chan, T K J

    2016-09-01

    PurposeTo report the clinical experience of using the Tecnis PCB00 (Abbott Medical Optics, Santa Ana, CA, USA) preloaded one-piece intraocular lens (IOL) in the setting of a tertiary referral centre for paediatric cataract.MethodsA retrospective case note review of all paediatric cataract surgeries using the Tecnis PCB00 IOL, at a single UK paediatric ophthalmology department.ResultsNine eyes in seven patients received the IOL between December 2014 and January 2016. All patients underwent lens aspiration and insertion of the IOL 'in the bag.' The indications for surgery included developmental cataract (8/9) and traumatic cataract (1/9). Mean age at the time of surgery was 7 years (range 2-14). The median improvement in logMAR best-corrected visual acuity was 0.475 (range 0.250-1.500). The mean follow-up duration was 5 months (range 1-13). No operative or post-operative complications occurred as a result of using the device.ConclusionThe Tecnis PCB00 preloaded IOL appears to be a safe and effective device in treating paediatric cataract.

  15. Quantification of the fungal fraction released from various preloaded fibrous filters during a simulated ventilation restart.

    Science.gov (United States)

    Morisseau, K; Joubert, A; Le Coq, L; Andres, Y

    2017-05-01

    This study aimed to demonstrate that particles, especially those associated with fungi, could be released from fibrous filters used in the air-handling unit (AHU) of heating, ventilation and air-conditioning (HVAC) systems during ventilation restarts. Quantification of the water retention capacity and SEM pictures of the filters was used to show the potential for fungal proliferation in unused or preloaded filters. Five fibrous filters with various particle collection efficiencies were studied: classes G4, M5, M6, F7, and combined F7 according to European standard EN779:2012. Filters were clogged with micronized rice particles containing the fungus Penicillium chrysogenum and then incubated for three weeks at 25°C and 90% relative humidity. The results indicated that the five clogged tested filters had various fungal growth capacities depending on their water retention capacity. Preloaded filters were subjected to a simulated ventilation restart in a controlled filtration device to quantify that the fraction of particles released was around 1% for the G4, 0.1% for the M5 and the M6, and 0.001% for the F7 and the combined F7 filter. The results indicate that the likelihood of fungal particle release by low efficiency filters is significantly higher than by high efficiency filters. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Boronophenylalanine uptake in C6 glioma model is dramatically increased by L-DOPA preloading

    Energy Technology Data Exchange (ETDEWEB)

    Capuani, S. [CNR-INFM SOFT, Department of Physics, Sapienza University of Rome, Piazzale Aldo Moro 2, Rome (Italy); Enrico Fermi Center, Compendio Viminale, Rome (Italy)], E-mail: silvia.capuani@roma1.infn.it; Gili, T. [CNR-INFM SOFT, Department of Physics, Sapienza University of Rome, Piazzale Aldo Moro 2, Rome (Italy); Enrico Fermi Center, Compendio Viminale, Rome (Italy); Bozzali, M. [Neuroimaging Laboratory, Santa Lucia Foundation, Via Ardeatina 306, Rome (Italy); Russo, S. [Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London (United Kingdom); Porcari, P. [CNR-INFM SOFT, Department of Physics, Sapienza University of Rome, Piazzale Aldo Moro 2, Rome (Italy); Cametti, C. [CNR-INFM SOFT, Department of Physics, Sapienza University of Rome, Piazzale Aldo Moro 2, Rome (Italy); Department of Physics, Sapienza University of Rome, Piazzale Aldo Moro 2, Rome (Italy); Muolo, M. [Department of Biological Science, University ' Rome III' , Viale G. Marconi 446, Rome (Italy); D' Amore, E. [Serv. Qual./Sicurezza Sperim. Anim., Istituto Superiore di Sanita, Rome (Italy); Maraviglia, B. [Enrico Fermi Center, Compendio Viminale, Rome (Italy); Neuroimaging Laboratory, Santa Lucia Foundation, Via Ardeatina 306, Rome (Italy); Lazzarino, G. [Laboratory of Biochemistry, Department of Chemical Sciences, University of Catania, Viale A. Doria 6, Catania (Italy); Pastore, F.S. [Department of Neuroscience, Institute of Neurosurgery, University ' Tor Vergata' , Via Montpellier 1, Rome (Italy)

    2009-07-15

    One of the main limitations for BNCT effectiveness is the insufficient intake of {sup 10}B nuclei within tumour cells. This work was aimed at investigating the use of L-DOPA as enhancer for boronophenylalanine (BPA) uptake in the C6 glioma model. The investigation was first performed in vitro, and then extended in vivo to the animal model. BPA accumulation in C6 glioma cells was assessed, using radiowave dielectric spectroscopy (RDS), with and without L-DOPA preloading. C6 glioma cells were also implanted in the brain of 25 rats, randomly assigned to two experimental branches: (1) intra-carotid BPA infusion; (2) intra-carotid BPA infusion after pre-treatment with L-DOPA, administrated 24 h before BPA infusion. All animals were sacrificed, and assessment of BPA concentrations in tumour tissue, normal brain, and blood samples was performed using high performance liquid chromatography (HPLC). L-DOPA preloading induced a massive increase of BPA concentration either in vitro on C6 glioma cells or in vivo in the animal model tumour. Moreover, no significant difference was found in the normal brain and blood samples between the two animal groups. This study suggests the potential use of L-DOPA as enhancer for BPA accumulation in malignant gliomas eligible for BNCT.

  17. Assessing cardiac preload by the Initial Systolic Time Interval obtained from impedance cardiography

    Directory of Open Access Journals (Sweden)

    Jan H Meijer

    2010-01-01

    Full Text Available The Initial Systolic Time Interval (ISTI, obtained from the electrocardiogram (ECG and impedance cardiogram (ICG, is considered to be a measure for the time delay between the electrical and mechanical activity of the heart and reflects an early active period of the cardiac cycle. The clinical relevance of this time interval is subject of study. This paper presents preliminary results of a pilot study investigating the use of ISTI in evaluating and predicting the circulatory response to fluid administration in patients after coronary artery bypass graft surgery, by comparing ISTI with cardiac output (CO responsiveness. Also the use of the pulse transit time (PTT, earlier recommended for this purpose, is investigated. The results show an inverse relationship between ISTI and CO at all moments of fluid administration and also an inverse relationship between the changes ΔISTI and ΔCO before and after full fluid administration. No relationships between PTT and CO or ΔPTT and ΔCO were found. It is concluded that ISTI is dependent upon preload, and that ISTI has the potential to be used as a clinical parameter assessing preload.

  18. Dynamic Measurement of Hemodynamic Parameters and Cardiac Preload in Adults with Dengue: A Prospective Observational Study.

    Directory of Open Access Journals (Sweden)

    Vipa Thanachartwet

    Full Text Available Few previous studies have monitored hemodynamic parameters to determine the physiological process of dengue or examined inferior vena cava (IVC parameters to assess cardiac preload during the clinical phase of dengue. From January 2013 to July 2015, we prospectively studied 162 hospitalized adults with confirmed dengue viral infection using non-invasive cardiac output monitoring and bedside ultrasonography to determine changes in hemodynamic and IVC parameters and identify the types of circulatory shock that occur in patients with dengue. Of 162 patients with dengue, 17 (10.5% experienced dengue shock and 145 (89.5% did not. In patients with shock, the mean arterial pressure was significantly lower on day 6 after fever onset (P = 0.045 and the pulse pressure was significantly lower between days 4 and 7 (P50% between days 4 and 5 (P<0.05. Hypovolemic shock was observed in 9 (52.9% patients and cardiogenic shock in 8 (47.1%, with a median (interquartile range time to shock onset of 6.0 (5.0-6.5 days after fever onset, which was the median day of defervescence. Intravascular hypovolemia occurred before defervescence, whereas myocardial dysfunction occurred on the day of defervescence until 2 weeks after fever onset. Hypovolemic shock and cardiogenic shock each occurred in approximately half of the patients with dengue shock. Therefore, dynamic measures to estimate changes in hemodynamic parameters and preload should be monitored to ensure adequate fluid therapy among patients with dengue, particularly patients with dengue shock.

  19. RECRUITMENT AND RECRUITMENT MODELS IN FISHERY SCIENCE

    Directory of Open Access Journals (Sweden)

    Merica Slišković

    2006-04-01

    Full Text Available Recruitment and growth of individuals bring the most to enlargement of fish stock biomass. Recruitment can be independent on stock size during the development of the fishery, but experience has showed that many fisheries have come to the point when recruitment decreases due to over fishing. Large parental stock does not give large number of juveniles because large number of individuals influences survival of juveniles (competition for food. In period between 1984 and 1987 this phenomenon was recorded in sardine population in the Adriatic Sea, when large biomass of parental stock resulted in twice less recruitment. In the period between 1993 and 2000 there was no significant recruitment of the sardine population in the Adriatic Sea and it reflected on biomass of the sardine. Large recruitment was recorded in 2001 and 2002. There are numerous mathematical models which give relation between stock and recruitment. Beverton–Holt’s and Ricker’s models are usually used. Beverton–Holt’s model assumes that recruitment depends on the density of population. Ricker’s model is based on assumption that all resources are evenly distributed among the individuals; therefore the rise in density causes the exhaustion of resources. This model is suitable for species as the sardine, which migrates in the breeding area.

  20. Numerical study on the influences of preload factor on the properties of three-lobe journal bearing

    Institute of Scientific and Technical Information of China (English)

    YAN Qing-hua; YAN Yong-ming; AN Qi

    2008-01-01

    The influences of preload factor on the characteristics of three-lobe journal beating, such as dimen-sionless load capacity, attitude angle, stiffness coefficients and damping coefficients, were studied by using the numerical calculation. And the influences of eccentricity ratio and wide-to-diameter ratio on the characteristics of journal bearing were investigated as well. The results show that with the increasing of preload factor, eccen-tricity ratio and wide-to-diameter ratio, the dimensionless load capacity and damping coefficients increase; meanwhile, the absolute value of stiffness coefficients increases;and with the increasing of preload factor and eccentricity ratio and the decreasing of wide-to-diameter ratio, the attitude angle decreases. The study offers theoretical base for engineering application of three-lobe journal bearing.

  1. Do stroke models model stroke?

    Directory of Open Access Journals (Sweden)

    Philipp Mergenthaler

    2012-11-01

    Full Text Available Stroke is one of the leading causes of death worldwide and the biggest reason for long-term disability. Basic research has formed the modern understanding of stroke pathophysiology, and has revealed important molecular, cellular and systemic mechanisms. However, despite decades of research, most translational stroke trials that aim to introduce basic research findings into clinical treatment strategies – most notably in the field of neuroprotection – have failed. Among other obstacles, poor methodological and statistical standards, negative publication bias, and incomplete preclinical testing have been proposed as ‘translational roadblocks’. In this article, we introduce the models commonly used in preclinical stroke research, discuss some of the causes of failed translational success and review potential remedies. We further introduce the concept of modeling ‘care’ of stroke patients, because current preclinical research models the disorder but does not model care or state-of-the-art clinical testing. Stringent statistical methods and controlled preclinical trials have been suggested to counteract weaknesses in preclinical research. We conclude that preclinical stroke research requires (1 appropriate modeling of the disorder, (2 appropriate modeling of the care of stroke patients and (3 an approach to preclinical testing that is similar to clinical testing, including Phase 3 randomized controlled preclinical trials as necessary additional steps before new therapies enter clinical testing.

  2. Effects of grapefruit, grapefruit juice and water preloads on energy balance, weight loss, body composition, and cardiometabolic risk in free-living obese adults

    Directory of Open Access Journals (Sweden)

    Niswender Kevin D

    2011-02-01

    Full Text Available Abstract Background Reducing dietary energy density has proven to be an effective strategy to reduce energy intakes and promote weight control. This effect appears most robust when a low energy dense preload is consumed before meals. Yet, much discussion continues regarding the optimal form of a preload. The purpose of the present study was to compare effects of a solid (grapefruit, liquid (grapefruit juice and water preload consumed prior to breakfast, lunch and dinner in the context of caloric restriction. Methods Eighty-five obese adults (BMI 30-39.9 were randomly assigned to (127 g grapefruit (GF, grapefruit juice (GFJ or water preload for 12 weeks after completing a 2-week caloric restriction phase. Preloads were matched for weight, calories, water content, and energy density. Weekly measures included blood pressure, weight, anthropometry and 24-hour dietary intakes. Resting energy expenditure, body composition, physical performance and cardiometabolic risk biomarkers were assessed. Results The total amount (grams of food consumed did not change over time. Yet, after preloads were combined with caloric restriction, average dietary energy density and total energy intakes decreased by 20-29% from baseline values. Subjects experienced 7.1% weight loss overall, with significant decreases in percentage body, trunk, android and gynoid fat, as well as waist circumferences (-4.5 cm. However, differences were not statistically significant among groups. Nevertheless, the amount and direction of change in serum HDL-cholesterol levels in GF (+6.2% and GFJ (+8.2% preload groups was significantly greater than water preload group (-3.7%. Conclusions These data indicate that incorporating consumption of a low energy dense dietary preload in a caloric restricted diet is a highly effective weight loss strategy. But, the form of the preload did not have differential effects on energy balance, weight loss or body composition. It is notable that subjects in GF

  3. The Stroke Outcomes Study 2 (SOS2: a prospective, analytic cohort study of depressive symptoms after stroke

    Directory of Open Access Journals (Sweden)

    Hewison Jenny

    2009-06-01

    Full Text Available Abstract Background Mood disorder is recognised as an important and common problem after stroke but little is known about the longer term effects of mood on functional outcomes. This protocol paper describes the Stroke Outcomes Study 2 (SOS2, a research study conducted in two large acute NHS Trusts in the North of England, which was designed to investigate the impact of early depressive symptoms on outcomes after an acute stroke. Methods and design SOS2 was a prospective cohort study that aimed to recruit patients in the first few weeks after a stroke, and to follow them up at regular intervals for one year thereafter in order to describe the trajectory of psychological symptoms and study their impact on physical functional recovery. Measures of mood and function were completed at baseline (approximately 3 weeks and at four follow-up time-points: approximately 9, 13, 26 and 52 weeks after the index stroke. Discussion Recruiting patients to research studies soon after an acute stroke is difficult. Mortality following stroke is approximately 30% and in the region of half the patients that survive the initial event are significantly disabled. Together these factors reduced the number of patients available to participate in SOS2 but once recruited to the study the drop-out rate was relatively low. During the recruitment period over 6000 admissions for stroke or query stroke were screened for eligibility. A cohort of 592 study participants was finally achieved.

  4. Preload-based starling-like control for rotary blood pumps: numerical comparison with pulsatility control and constant speed operation.

    Directory of Open Access Journals (Sweden)

    Mahdi Mansouri

    Full Text Available In this study, we evaluate a preload-based Starling-like controller for implantable rotary blood pumps (IRBPs using left ventricular end-diastolic pressure (PLVED as the feedback variable. Simulations are conducted using a validated mathematical model. The controller emulates the response of the natural left ventricle (LV to changes in PLVED. We report the performance of the preload-based Starling-like controller in comparison with our recently designed pulsatility controller and constant speed operation. In handling the transition from a baseline state to test states, which include vigorous exercise, blood loss and a major reduction in the LV contractility (LVC, the preload controller outperformed pulsatility control and constant speed operation in all three test scenarios. In exercise, preload-control achieved an increase of 54% in mean pump flow ([Formula: see text] with minimum loading on the LV, while pulsatility control achieved only a 5% increase in flow and a decrease in mean pump speed. In a hemorrhage scenario, the preload control maintained the greatest safety margin against LV suction. PLVED for the preload controller was 4.9 mmHg, compared with 0.4 mmHg for the pulsatility controller and 0.2 mmHg for the constant speed mode. This was associated with an adequate mean arterial pressure (MAP of 84 mmHg. In transition to low LVC, [Formula: see text] for preload control remained constant at 5.22 L/min with a PLVED of 8.0 mmHg. With regards to pulsatility control, [Formula: see text] fell to the nonviable level of 2.4 L/min with an associated PLVED of 16 mmHg and a MAP of 55 mmHg. Consequently, pulsatility control was deemed inferior to constant speed mode with a PLVED of 11 mmHg and a [Formula: see text] of 5.13 L/min in low LVC scenario. We conclude that pulsatility control imposes a danger to the patient in the severely reduced LVC scenario, which can be overcome by using a preload-based Starling-like control approach.

  5. DYNAMIC BUCKLING OF STATICALLY PRELOADED RING-STIFFENED CYLINDRICAL SHELLS UNDER AXIAL FLUID-SOLID IMPACT LOADING

    Institute of Scientific and Technical Information of China (English)

    Jiang Songqing; Li Yongchi; Hu Xiuzhang; Zheng Jijia

    2000-01-01

    The Initial Imperfection Amplified Criterion is applied to investigate the geometric nonlinear dynamic buckling of statically preloaded ring-stiffened cylindrical shells under axial fluid-solid impact. Tak ing account of the effects of large deformation and initial geometric imperfection, the governing equations are obtained by the Galerkin method and solved by the Runge-Kutta method. The effects of static preloading (uniform external radial pressure) on the buckling features and the load-carrying ability of ring-stiffened cy lindrical shells against axial impact are discussed.

  6. Extent of utilization of the Frank-Starling mechanism in conscious dogs. [preload effects on myocardial regulation

    Science.gov (United States)

    Boettcher, D. H.; Vatner, S. F.; Heyndrickx, G. R.; Braunwald, E.

    1978-01-01

    The left ventricular end-diastolic pressure-dimension relationships in conscious dogs were studied; the ventricle was stressed to its limit in terms of myocardial preload in order to assess the extent of use of the Frank-Starling mechanism under these conditions. The preload was increased through volume loading with saline infusions, the provocation of global myocardial ischemia by constriction of the left main coronary artery, and infusion of methoxamine. While left ventricular end-diastolic pressure increased substantially in the reclining conscious animals, the left ventricular end-diastolic diameter did not increase, suggesting a minimum role for the Frank-Starling mechanism in this case.

  7. E-recruitment

    DEFF Research Database (Denmark)

    Holm, Anna

    2012-01-01

    E-recruitment, also known as online or web-based recruitment, is little discussed in research from an organizational perspective. The purpose of this chapter is therefore to analyze and discuss the process of e-recruitment, its key constituents and organizing principles. In doing so I draw...... on the results of a qualitative study conducted in 2008-2009, and on data stemming from industrial reports, articles from practitioner magazines, and in-depth interviews. The chapter provides a summary of e-recruitment properties and a composite matrix of the overall elements of e-recruitment organizing. E-recruitment...

  8. Predicting sickness impact profile at six months after stroke: further results from the European multi-center CERISE study

    NARCIS (Netherlands)

    Stummer, C.A.; Verheyden, G.; Putman, K.; Jenni, W.; Schupp, W.; Wit, L. De

    2015-01-01

    PURPOSE: To develop prognostic models and equations for predicting participation at six months after stroke. METHODS: This European prospective cohort study recruited 532 consecutive patients from four rehabilitation centers. Participation was assessed at six months after stroke with the Sickness

  9. Driving After a Stroke

    Science.gov (United States)

    ... Inspirational Stories Stroke Heroes Among Us Driving After Stroke Updated:Jul 23,2015 Can I drive after ... more tips for daily living . Let's Talk About Stroke Fact Sheets Our stroke fact sheets cover treatments, ...

  10. Stroke (For Kids)

    Science.gov (United States)

    ... de los dientes Video: Getting an X-ray Stroke KidsHealth > For Kids > Stroke Print A A A ... get help quickly. continue What Happens During a Stroke? A stroke usually happens suddenly, and a person ...

  11. Stroke (For Kids)

    Science.gov (United States)

    ... Emergency Room? What Happens in the Operating Room? Stroke KidsHealth > For Kids > Stroke A A A What's ... get help quickly. continue What Happens During a Stroke? A stroke usually happens suddenly, and a person ...

  12. E-recruitment

    DEFF Research Database (Denmark)

    Holm, Anna B.

    2012-01-01

    Up to now, there has been little research on the impact of e-recruitment on the recruitment process as a whole. The present study fills part of this gap by investigating the effect of e-recruitment on the design of the recruitment process. Three explorative case studies were carried out in three...... large organisations in Denmark in 2008-2010. The findings indicate that e-recruitment transforms the traditional recruitment process into a time- and space-independent, collaborative hiring process. The most significant changes are recorded in the sequence and increased divisibility of main recruitment...... tasks and subtasks. For management, the main task is now that of communicating with candidates. In addition, a new on-going task of maintaining a corporate career website has become an integral part of the new recruitment process. The new design is presented in the following, and its implications...

  13. Influence of mass moment of inertia on normal modes of preloaded solar array mast

    Science.gov (United States)

    Armand, Sasan C.; Lin, Paul

    1992-01-01

    Earth-orbiting spacecraft often contain solar arrays or antennas supported by a preloaded mast. Because of weight and cost considerations, the structures supporting the spacecraft appendages are extremely light and flexible; therefore, it is vital to investigate the influence of all physical and structural parameters that may influence the dynamic behavior of the overall structure. The study primarily focuses on the mast for the space station solar arrays, but the formulations and the techniques developed in this study apply to any large and flexible mast in zero gravity. Furthermore, to determine the influence on the circular frequencies, the mass moment of inertia of the mast was incorporated into the governing equation of motion for bending. A finite element technique (MSC/NASTRAN) was used to verify the formulation. Results indicate that when the mast is relatively flexible and long, the mass moment inertia influences the circular frequencies.

  14. Clues to occult cancer in patients with ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Suk Jae Kim

    Full Text Available BACKGROUND: We hypothesized that hidden malignancy could be detected in patients with cryptogenic stroke without active cancer when they showed the distinctive characteristics of cancer-related stroke. METHODS AND FINDINGS: Among 2,562 consecutive patients with acute ischemic stroke, patients with cryptogenic stroke were analyzed and categorized into two groups according to the presence of active cancer: cryptogenic stroke with active cancer (cancer-related stroke, CA-stroke group and without active cancer (CR-stroke group. Patients with active lung cancer without stroke were also recruited for comparison purposes (CA-control. Clinical factors, lesion patterns on diffusion-weighted MRI (DWI, and laboratory findings were analyzed among groups. A total of 348 patients with cryptogenic stroke were enrolled in this study. Among them, 71 (20.4% patients had active cancer at the time of stroke. The D-dimer levels were significantly higher in patients with CA-stroke than those with CR-stroke or CA-control (both p<0.001. Regarding lesion patterns, patients with CA-stroke mostly had multiple lesions in multiple vascular territories, while more than 80% of patients with CR-stroke had single/multiple lesions in a single vascular territory (P<0.001. D-dimer levels (OR 1.11 per 1 µg/mL increase; 95% CI 1.06-1.15; P<0.001 and DWI lesion patterns (OR 7.13; 95% CI 3.42-14.87; P<0.001 were independently associated with CA-stroke. Workup for hidden malignancy was performed during hospitalization in 10 patients who showed elevated D-dimer levels and multiple infarcts involving multiple vascular territories but had no known cancer, and it revealed hidden malignancies in all the patients. CONCLUSION: Patients with CA-stroke have distinctive D-dimer levels and lesion patterns. These characteristics can serve as clues to occult cancer in patients with cryptogenic stroke.

  15. A Comparison of Mixed-Method Cooling Interventions on Preloaded Running Performance in the Heat.

    Science.gov (United States)

    Stevens, Christopher J; Bennett, Kyle J M; Sculley, Dean V; Callister, Robin; Taylor, Lee; Dascombe, Ben J

    2017-03-01

    Stevens, CJ, Bennett, KJM, Sculley, DV, Callister, R, Taylor, L, and Dascombe, BJ. A comparison of mixed-method cooling interventions on preloaded running performance in the heat. J Strength Cond Res 31(3): 620-629, 2017-The purpose of this investigation was to assess the effect of combining practical methods to cool the body on endurance running performance and physiology in the heat. Eleven trained male runners completed 4 randomized, preloaded running time trials (20 minutes at 70% V[Combining Dot Above]O2max and a 3 km time trial) on a nonmotorized treadmill in the heat (33° C). Trials consisted of precooling by combined cold-water immersion and ice slurry ingestion (PRE), midcooling by combined facial water spray and menthol mouth rinse (MID), a combination of all methods (ALL), and control (CON). Performance time was significantly faster in MID (13.7 ± 1.2 minutes; p < 0.01) and ALL (13.7 ± 1.4 minutes; p = 0.04) but not PRE (13.9 ± 1.4 minutes; p = 0.24) when compared with CON (14.2 ± 1.2 minutes). Precooling significantly reduced rectal temperature (initially by 0.5 ± 0.2° C), mean skin temperature, heart rate and sweat rate, and increased iEMG activity, whereas midcooling significantly increased expired air volume and respiratory exchange ratio compared with control. Significant decreases in forehead temperature, thermal sensation, and postexercise blood prolactin concentration were observed in all conditions compared with control. Performance was improved with midcooling, whereas precooling had little or no influence. Midcooling may have improved performance through an attenuated inhibitory psychophysiological and endocrine response to the heat.

  16. Efficacy of Sealing Agents on Preload Maintenance of Screw-Retained Implant-Supported Prostheses.

    Science.gov (United States)

    Seloto, Camila Berbel; Strazzi Sahyon, Henrico Badaoui; Dos Santos, Paulo Henrique; Delben, Juliana Aparecida; Assunção, Wirley Gonçalves

    2017-09-22

    The aim of this study was to evaluate the effect of sealing agents on preload maintenance of screw joints. A total of four groups (n = 10 in each group) of abutment/implant systems, including external hexagon implants and antirotational UCLA abutments with a metallic collar in cobalt-chromium alloy, were assessed. In the control group (CG), no sealing agent was used at the abutment screw/implant interface. In the other groups, three different sealing agents were used at the abutment screw/implant interface: anaerobic sealing agent for medium torque (ASMT), anaerobic sealing agent for high torque (ASHT), and cyanoacrylate-based bonding agent (CYAB). All abutments were attached to the implants at 32 ± 1 N.cm. After 48 ± 2 hours of initial tightening, loosing torque (detorque) was measured using a digital torque wrench. Data were analyzed using Shapiro-Wilk, Wilcoxon, and Kruskal-Wallis tests, at 5% level of significance. In the CG and ASMT groups, detorque was lower than the insertion torque (24.6 ± 1.5 N.cm and 24.3 ± 1.1 N.cm, respectively). In the ASHT and CYAB groups, mean detorque increased in comparison to the insertion torque (51.0 ± 7.4 N.cm and 47.7 ± 15.1 N.cm, respectively). The ASHT was more efficient than the other sealing agents, increasing the remaining preload (detorque value) 58.88%. Although the cyanoacrylate-based bonding agent also generated high detorque values, the high standard deviation suggested its lower reliability.

  17. The influence of isometric preload on power expressed during bench press in strength-trained men.

    Science.gov (United States)

    Bartolomei, Sandro; Fukuda, David H; Hoffman, Jay R; Stout, Jeffrey R; Merni, Franco

    2017-03-01

    The purpose of this study was to compare the power expressed during the bench press exercise in resistance-trained men following different pre-activation conditions. Twenty-two trained men (age 24.1 ± 1.7 years, height 178.6 ± 6.1 cm, body mass 81.1 ± 10.6 kg) completed a maximal effort bench press (1-RM) test (100.0 kg ± 8.1 kg). In a subsequent assessment, each participant performed concentric bench press movements with loads of 20%, 30%, 40% and 50% of their 1-RM preceded by either a concentric contraction (CC), a low isometric preload (LIP; 70% 1-RM) or a high isometric preload (HIP; 100% 1-RM) conditions. All movements were performed in a Smith machine with a settable quick-release device. Participants performed all three conditions in randomized fashion. Results indicated that power outputs during the bench press exercise following HIP were significantly (p < 0.05) greater than CC at 20% 1-RM (+9%), 30% 1-RM (+16%) and 40% 1-RM (+14%), and LIP at 20% 1-RM (+4%), 30% 1-RM (+20%) and 40% 1-RM (+15%). No differences were found between conditions at 50% 1-RM. Area under the force-power curve with HIP was greater (p < 0.05) than with CC and LIP. In conclusion, results of this study indicate that the use of a HIP (100% 1-RM) in trained participants results in significantly greater power output during the concentric phase of a multi-joint exercise when compared to standard concentric movement.

  18. Preload-based Starling-like control of rotary blood pumps: An in-vitro evaluation

    Science.gov (United States)

    Gregory, Shaun D.; Salamonsen, Robert F.; Lovell, Nigel H.; Stevens, Michael C.; Pauls, Jo P.; Akmeliawati, Rini; Lim, Einly

    2017-01-01

    Due to a shortage of donor hearts, rotary left ventricular assist devices (LVADs) are used to provide mechanical circulatory support. To address the preload insensitivity of the constant speed controller (CSC) used in conventional LVADs, we developed a preload-based Starling-like controller (SLC). The SLC emulates the Starling law of the heart to maintain mean pump flow (QP¯) with respect to mean left ventricular end diastolic pressure (PLVEDm) as the feedback signal. The SLC and CSC were compared using a mock circulation loop to assess their capacity to increase cardiac output during mild exercise while avoiding ventricular suction (marked by a negative PLVEDm) and maintaining circulatory stability during blood loss and severe reductions in left ventricular contractility (LVC). The root mean squared hemodynamic deviation (RMSHD) metric was used to assess the clinical acceptability of each controller based on pre-defined hemodynamic limits. We also compared the in-silico results from our previously published paper with our in-vitro outcomes. In the exercise simulation, the SLC increased QP¯ by 37%, compared to only 17% with the CSC. During blood loss, the SLC maintained a better safety margin against left ventricular suction with PLVEDm of 2.7 mmHg compared to -0.1 mmHg for CSC. A transition to reduced LVC resulted in decreased mean arterial pressure (MAP) and QP¯ with CSC, whilst the SLC maintained MAP and QP¯. The results were associated with a much lower RMSHD value with SLC (70.3%) compared to CSC (225.5%), demonstrating improved capacity of the SLC to compensate for the varying cardiac demand during profound circulatory changes. In-vitro and in-silico results demonstrated similar trends to the simulated changes in patient state however the magnitude of hemodynamic changes were different, thus justifying the progression to in-vitro evaluation. PMID:28212401

  19. Impact of implementing evidence-based acute stroke interventions on survival: the South London Stroke Register.

    Directory of Open Access Journals (Sweden)

    Juliet Addo

    Full Text Available BACKGROUND: Studies examining the impact of organised acute stroke care interventions on survival in subgroups of stroke patients remain limited. AIMS: This study examined the effects of a range of evidence-based interventions of acute stroke care on one year survival post-stroke and determined the size of the effect across different socio-demographic and clinical subgroups of patients. METHODS: Data on 4026 patients with a first-ever stroke recruited to the population-based South London Stroke Register between 1995 and 2010 were used. In uni-variable analyses, one year cumulative survival rates in socio-demographic groups and by care received was determined. Survival functions were compared using Log-rank tests. Multivariable Cox models were used to test for interactions between components of care and age group, sex, ethnic group, social class, stroke subtype and level of consciousness. RESULTS: 1949 (56.4% patients were admitted to a stroke unit. Patients managed on a stroke unit, those with deficits receiving specific rehabilitation therapies and those with ischaemic stroke subtype receiving aspirin in the acute phase had better one year survival compared to those who did not receive these interventions. The greatest reduction in the hazards of death among patients treated on a stroke unit were in the youngest patients aged <65 years, (HR 0.39; 95% CI: 0.25-0.62, and those with reduced levels of consciousness, GCS <9, (HR: 0.44; CI: 0.33-0.58. CONCLUSIONS: There was evidence of better one year survival in patients receiving specific acute interventions after stroke with a significantly greater effect in stroke subgroups, suggesting the possibility of re-organising stroke services to ensure that the most appropriate care is made accessible to patients likely to derive the most benefits from such interventions.

  20. The Recruitment Process:

    DEFF Research Database (Denmark)

    Holm, Anna

    The aim of this research was to determine whether the introduction of e-recruitment has an impact on the process and underlying tasks, subtasks and activities of recruitment. Three large organizations with well-established e-recruitment practices were included in the study. The three case studies......, which were carried out in Denmark in 2008-2009 using qualitative research methods, revealed changes in the sequence, divisibility and repetitiveness of a number of recruitment tasks and subtasks. The new recruitment process design was identified and presented in the paper. The study concluded...

  1. Echocardiographic Measures of Diastolic Function Are Preload Dependent during Triggered Positive Pressure Ventilation: A Controlled Crossover Study in Healthy Subjects

    Directory of Open Access Journals (Sweden)

    Peter Juhl-Olsen

    2012-01-01

    Full Text Available Background. The use of echocardiography in intensive care settings impacts decision making. A prerequisite for the use of echocardiography is relative resistance to changes in volume status and levels of positive pressure ventilation (PPV. Studies on indices of diastolic function report conflicting results with regard to dependence on volume status. Evidence is scarce on PPV. Methods. Ten healthy subjects were exposed to 6 levels of positive end-expiratory pressure (PEEP and pressure support (PS following a baseline reading. All ventilator settings were performed at three positions: horizontal, reverse-Trendelenburg, and Trendelenburg. Echocardiography was performed throughout. Results. During spontaneous breathing, early diastolic transmitral velocity ( changed with positioning (, whereas early diastolic velocity of the mitral annulus ( was independent (. With PPV, and proved preload dependent (. Increases in PEEP, PS, or a combination influenced and in reverse-Trendelenburg- and horizontal positions, but not in the Trendelenburg position. Discussion. The change towards preload dependency of with PPV suggests that PPV increases myocardial preload sensitivity. The susceptibility of and to preload changes during PPV discourages their use in settings of volume shifts or during changes in ventilator settings. Conclusion. Positioning and PPV affect and .

  2. Trunk response to sudden forward perturbations - effects of preload and sudden load magnitudes, posture and abdominal antagonistic activation.

    Science.gov (United States)

    Shahvarpour, Ali; Shirazi-Adl, Aboulfazl; Mecheri, Hakim; Larivière, Christian

    2014-06-01

    Unexpected loading of the spine is a risk factor for low back pain. The trunk neuromuscular and kinematics responses are likely influenced by the perturbation itself as well as initial trunk conditions. The effect of four parameters (preload, sudden load, initial trunk flexed posture, initial abdominal antagonistic activity) on trunk kinematics and back muscles reflex response were evaluated. Twelve asymptomatic subjects participated in sudden forward perturbation tests under six distinct conditions. Preload did not change the reflexive response of back muscles and the trunk displacement; while peak trunk velocity and acceleration as well as the relative load peak decreased. Sudden load increased reflex response of muscles, trunk kinematics and loading variables. When the trunk was initially flexed, back muscles latency was delayed, trunk velocity and acceleration increased; however, reflex amplitude and relative trunk displacement remained unchanged. Abdominal antagonistic preactivation increased reflexive response of muscles but kinematics variables were not affected. Preload, initial flexed posture and abdominal muscles preactivation increased back muscles preactivity. Both velocity and acceleration peaks of the trunk movement decreased with preload despite greater total load. In contrast, they increased in the initial flexed posture and to some extent when abdominal muscles were preactivated demonstrating the distinct effects of pre-perturbation variables on trunk kinematics and risk of injury. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Risk factors for stress in children after parental stroke

    NARCIS (Netherlands)

    Sieh, D.S.; Meijer, A.M.; Visser-Meily, J.M.

    2010-01-01

    Objectives: To assess risk factors for stress in children 3 years after parental stroke. Participants: Questionnaires were filled in by 44 children aged 7-18 years, parents who suffered a stroke and healthy spouses from 29 families recruited in 9 participating rehabilitation centers across the

  4. Health-Related Quality of Life in the Family Caregivers of Stroke Survivors

    Science.gov (United States)

    Chen, Yangkun

    2010-01-01

    The objective of this cross-sectional study was to identify the factors associated with health-related quality of life (HRQOL) of family caregivers of Chinese stroke patients. One hundred and twenty-three stroke patients consecutively admitted to a stroke clinic and their 123 family caregivers were recruited. The caregivers' HRQOLs were assessed…

  5. Health-Related Quality of Life in the Family Caregivers of Stroke Survivors

    Science.gov (United States)

    Chen, Yangkun

    2010-01-01

    The objective of this cross-sectional study was to identify the factors associated with health-related quality of life (HRQOL) of family caregivers of Chinese stroke patients. One hundred and twenty-three stroke patients consecutively admitted to a stroke clinic and their 123 family caregivers were recruited. The caregivers' HRQOLs were assessed…

  6. Acute antithrombotic treatment of ischemic stroke.

    Science.gov (United States)

    Alderazi, Yazan J; Grotta, James C

    2014-05-01

    Antithrombotic medication is a cornerstone of acute ischemic stroke treatment and secondary prevention. The efficacy of thrombolysis with alteplase in acute stroke has been demonstrated in several clinical trials. This safe and costeffective therapy has transformed the practice of stroke care and has led to subsequent trials of other antithrombotic medications for treatment of ischemic stroke in the acute phase. These antithrombotics include thrombolytic, antiplatelet and anticoagulant agents. While, no other medication has yet demonstrated adequate efficacy, our current and evolving understanding of infarct expansion, ischemic penumbra, collateral circulation and the blood brain barrier is allowing testing of antithrombotic medications tailored to individual patient pathophysiology in clinical trials. This understanding accompanies developments in neuroimaging and organization of stroke care that allow for wide-spread recruitment in these trials. Alteplase remains the mainstay treatment of arterial acute ischemic stroke; however, anticoagulation is the standard therapy for cerebral venous sinus thrombosis. Antithrombotic use in acute stroke, arterial and venous, has demonstrated efficacy but leaves many questions unanswered. This patient population is a fertile ground for novel research, especially as it relates to; combination antithrombotic therapy, combination of pharmacological and mechanical thrombolysis, and the transition to secondary prevention. Here we review the current antithrombotics in the acute phase of ischemic stroke highlighting the evidence-base and areas of uncertainty.

  7. Mixed Stroke

    Institute of Scientific and Technical Information of China (English)

    HuangRuxun(黄如训); Zeng Jinsheng(曾进胜)

    2000-01-01

    Purpose To summarize the chnical, autoptic and animal experimental dala of stroke, propose the concept of mixed stroke (MS) and demonstrate the enoiogy, pathogenesis, clinical mainfestations, prophylaxis and treatment of MS Background At present. stroke still is classified in the national and international academic fields as two main groups: hemorrhage and ischema In fact, thc cerebral vascular disease with hemorrhage forus and ischema focus at the same time is not rare moreover, this type of stroke has special etiology, pathogenesis and clinical manifestations. But it is always made a main dagnosis and neglected the other nature of coexistent focus on either clinical or pathological diagnosis according to traditional classification of stroke Data sources and methods Mort of pablished originsl articles about MS in our department and laboralory wcre reviewed. Resulta The clinical autoptic and animal experimental dats all prcved that hemorrhage and infarction could occur in the course of a stroke simultaneously or in suecession during a short time, which demonstrated the existence of MS It was found clinically that MS patients all had the hustory of hypcrtension and in the autoptic data the MS patients dying of stroke all had typical hypertensive changes in the heart and kidney. and had hypertensive arteriosclerosis in the cerebral arteriole and small artery. MS was cas lily thdueed in stroke-prone renovascular hypertensivc rats This kind of rats are free from genetic deficiency and arc not affected by senile factor, so their cerebral vascular foci are mainly induced by the single factor -hypertension. TThese indicate definitely that hypertensive cerebral vascular lesion is the basis inducing MS. The main lesions of hypertensive cerebral arteriole and small artery were hyalinosis and fibrinoid of the walls, and the formation of microaneurysms or hyperplasla of iniernal and external layers The math lcsions of hypertensive cerebral capillaries were increasing vascular

  8. Recovery After Stroke: Recurrent Stroke

    Science.gov (United States)

    ... cholesterol or are overweight. If you are at risk for high blood pressure, ask your doctor how to manage it more ... feel fine. Medicines Medicine may help reduce stroke risk. In addition to those that treat high blood pressure, drugs are also available to control high cholesterol ...

  9. Effects of a Protein Preload on Gastric Emptying, Glycemia, and Gut Hormones After a Carbohydrate Meal in Diet-Controlled Type 2 Diabetes

    OpenAIRE

    Ma, Jing; Stevens, Julie E.; Cukier, Kimberly; Maddox, Anne F.; Wishart, Judith M.; Jones, Karen L.; Clifton, Peter M.; Horowitz, Michael; Rayner, Christopher K.

    2009-01-01

    OBJECTIVE We evaluated whether a whey preload could slow gastric emptying, stimulate incretin hormones, and attenuate postprandial glycemia in type 2 diabetes. RESEARCH DESIGN AND METHODS Eight type 2 diabetic patients ingested 350 ml beef soup 30 min before a potato meal; 55 g whey was added to either the soup (whey preload) or potato (whey in meal) or no whey was given. RESULTS Gastric emptying was slowest after the whey preload (P < 0.0005). The incremental area under the blood glucose cur...

  10. Stress Corrosion Cracking of X80 Pipeline Steel in Near-Neutral pH Environment under Constant Load Tests with and without Preload

    Institute of Scientific and Technical Information of China (English)

    Y.Z. Jia; J.Q. Wang; E.H. Han; W. Ke1

    2011-01-01

    Constant load tests in NS4 solution purged with N2-5%CO2 gas mixture were conducted on American Petroleum Institute (API) X80 pipeline steel applied in the 2nd West-East (;as Pipeline project with and without preload. The results show that cracks could initiate and propagate in X80 pipeline steel in near-neutral pH environment under a constant load condition. The life of crack initiation and propagation increased with decreasing applied stress. Preload did not change its corrosion behavior obviously. However, preload reduced the time for crack initiation.

  11. Stroke awareness in Denmark

    DEFF Research Database (Denmark)

    Truelsen, Thomas; Krarup, Lars-Henrik

    2010-01-01

    This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke....

  12. Stroke awareness in Denmark

    DEFF Research Database (Denmark)

    Truelsen, Thomas; Krarup, Lars-Henrik

    2010-01-01

    This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke....

  13. Fluid loading and norepinephrine infusion mask the left ventricular preload decrease induced by pleural effusion.

    Science.gov (United States)

    Wemmelund, Kristian Borup; Ringgård, Viktor Kromann; Vistisen, Simon Tilma; Hyldebrandt, Janus Adler; Sloth, Erik; Juhl-Olsen, Peter

    2017-09-11

    Pleural effusion (PLE) may lead to low blood pressure and reduced cardiac output. Low blood pressure and reduced cardiac output are often treated with fluid loading and vasopressors. This study aimed to determine the impact of fluid loading and norepinephrine infusion on physiologic determinants of cardiac function obtained by ultrasonography during PLE. In this randomised, blinded, controlled laboratory study, 30 piglets (21.9 ± 1.3 kg) had bilateral PLE (75 mL/kg) induced. Subsequently, the piglets were randomised to intervention as follows: fluid loading (80 mL/kg/h for 1.5 h, n = 12), norepinephrine infusion (0.01, 0.03, 0.05, 0.1, 0.2 and 0.3 μg/kg/min (15 min each, n = 12)) or control (n = 6). Main outcome was left ventricular preload measured as left ventricular end-diastolic area. Secondary endpoints included contractility and afterload as well as global measures of circulation. All endpoints were assessed with echocardiography and invasive pressure-flow measurements. PLE decreased left ventricular end-diastolic area, mean arterial pressure and cardiac output (p values  0.05) to baseline. Left ventricular contractility increased with norepinephrine infusion (p = 0.002), but was not affected by fluid loading (p = 0.903). Afterload increased in both active groups (p values > 0.001). Overall, inferior vena cava distensibility remained unchanged during intervention (p values ≥ 0.085). Evacuation of PLE caused numerical increases in left ventricular end-diastolic area, but only significantly so in controls (p = 0.006). PLE significantly reduced left ventricular preload. Both fluid and norepinephrine treatment reverted this effect and normalised global haemodynamic parameters. Inferior vena cava distensibility remained unchanged. The haemodynamic significance of PLE may be underestimated during fluid or norepinephrine administration, potentially masking the presence of PLE.

  14. [Hippocampal stroke].

    Science.gov (United States)

    Rollnik, J D; Traitel, B; Dietrich, B; Lenz, O

    2015-02-01

    Unilateral cerebral ischemia of the hippocampus is very rare. This paper reviews the literature and presents the case of a 59-year-old woman with an amnestic syndrome due to a left hippocampal stroke. The patient suffered from retrograde amnesia which was most severe over the 2 days prior to presenting and a slight anterograde amnesia. In addition, a verbal memory disorder was confirmed 1 week after admission by neurological tests. As risk factors, arterial hypertension and a relative hyper-beta lipoproteinemia were found. This case shows that unilateral amnestic stroke, e.g. in the hippocampus region, may be the cause of an amnestic syndrome and should be included in the differential diagnostics.

  15. Multiple Strokes

    Directory of Open Access Journals (Sweden)

    Obododimma Oha

    2008-12-01

    Full Text Available This poem playfully addresses the slippery nature of linguistic signification, employing humour and sarcasm in presenting a wide range of human experience. It ironical twists -- and "strokes" (read ambiguously as both a giving a punishment and erotic pleasuring -- move from the naming of location through international discourse of capital to the crumbling relationships between nation states. It reading of the signs of language is tied to the unease and fracture in cultural and political experience.

  16. Sex Differences in Stroke Subtypes, Severity, Risk Factors, and Outcomes Among Elderly Patients with Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Changshen eYu

    2015-09-01

    Full Text Available Background: Although the age-specific incidence and mortality of stroke is higher among men, stroke has a greater clinical effect on women. However, the sex differences in stroke among elderly patients are unknown. Therefore, we aimed to assess the sex differences in stroke among elderly stroke patients.Methods: Between 2005 and 2013, we recruited 1,484 consecutive acute ischemic stroke patients (≥75 years old from a specialized neurology hospital in Tianjin, China. Information regarding their stroke subtypes, severity, risk factors, and outcomes at 3 and 12 months after stroke were recorded.Results: Comparing with men, women had a significantly higher prevalence of severe stroke (17.20% vs. 12.54%, hypertension (76.42% vs. 66.39%, dyslipidemias (30.35% vs. 22.76%, and obesity (18.40% vs. 9.32%, P < 0.05. Comparing with women, men had a significantly higher prevalence of intracranial artery stenosis (23.11% vs. 17.45%, current smoking (29.60% vs. 13.05%, and alcohol consumption (12.15% vs. 0.47%, P < 0.05. Moreover, dependency was more common among women at 3 and 12 months after stroke, although the sex difference disappeared after adjusting for stroke subtypes, severity, and risk factors. Conclusions: Elderly women with acute ischemic stroke had more severe stroke status and worse outcomes at 3 and 12 months after stroke. Thus, elderly female post-acute ischemic stroke patients are a crucial population that should be assisted with controlling their risk factors for stroke and changing their lifestyle.

  17. Preload Analysis of Screw Bolt Joints on the First Wall Graphite Tiles in EAST

    Institute of Scientific and Technical Information of China (English)

    曹磊; 宋云涛

    2012-01-01

    The first wall in the Experimental Advanced Superconducting Tokamak (EAST) used graphite tiles to withstand high thermal energy. The graphite tiles are mounted on the heat sink using screw bolts which have been preloaded to produce a clamp force. The clamp force is very important to keep the graphite tiles tightly on the surface of the heat sink so that the heat flux crosses this contacting surface in a small thermal resistor. Without the clamp force, the small gap between the graphite tiles and the heat sink will make it impossible for thermal power to be carried away by cooling water. Some bolts may even fall off with the loss of clamp force. From the mathematical models, the loss process of the clamp force has been studied. Research results explain how the different thermal expansions of three members of the screw joint makes the clamp force decrease to zero under temperature rise and external force, and how the stiffness affects the relation between the clamp force and temperature. The research also gives the critical temperature at which the clamp force can remain above zero. Analysis results indicate that the current screw joints are almost destined to lose their clamp force during the running time of EAST, so the bolt joints should be redesigned in order to improve its reliability.

  18. National Stroke Association

    Science.gov (United States)

    ... Virginia Washington West Virginia Wisconsin Wyoming Go National Stroke Association Our mission is to reduce the incidence ... and support for all impacted by stroke. Understanding stroke and the recovery journey can be overwhelming, but ...

  19. Two Kinds of Stroke

    Science.gov (United States)

    ... Issue Past Issues Special Section Two Kinds of Stroke Past Issues / Summer 2007 Table of Contents For ... are often a warning sign for future strokes. Stroke Can Affect Anyone Award-winning actress Julie Harris ...

  20. Healthy Living after Stroke

    Science.gov (United States)

    ... Stories Stroke Heroes Among Us Healthy Living After Stroke Nutrition Good nutrition is one way to reduce ... look to maintain health and wellness. Subscribe to Stroke Connection Get quarterly digital issues plus our monthly ...

  1. The "Know Stroke" Campaign

    Science.gov (United States)

    ... Current Issue Past Issues Special Section The "Know Stroke" Campaign Past Issues / Summer 2007 Table of Contents ... campaign for the U.S. Hispanic community. 1 Know Stroke A stroke occurs when the blood supply to ...

  2. Stroke - risk factors

    Science.gov (United States)

    ... Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Functional Genomics and Translational Biology; Council on Hypertension. Guidelines for the primary prevention of stroke: a ...

  3. Finite Element Analysis on the Pre-load Structures of the Central Solenoid for the HT-7U Device

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The central solenoid is an important part of the HT-7U device. In this paper, the computational analysis of the stress and the displacement on the pre-load structures of the central solenoid have been made by the finite element analysis system COSMOS/M2.0 under room and/or operating temperature. According to the analytical results, the clip aprons and compression plates are all satisfied with safety design criteria.

  4. Acute effect of alginate-based preload on satiety feelings, energy intake, and gastric emptying rate in healthy subjects.

    Science.gov (United States)

    Georg Jensen, Morten; Kristensen, Mette; Belza, Anita; Knudsen, Jes C; Astrup, Arne

    2012-09-01

    Viscous dietary fibers such as sodium alginate extracted from brown seaweed have received much attention lately for their potential role in energy regulation through the inhibition of energy intake and increase of satiety feelings. The aim of our study was to investigate the effect on postprandial satiety feelings, energy intake, and gastric emptying rate (GER), by the paracetamol method, of two different volumes of an alginate-based preload in normal-weight subjects. In a four-way placebo-controlled, double-blind, crossover trial, 20 subjects (age: 25.9 ± 3.4 years; BMI: 23.5 ± 1.7 kg/m(2)) were randomly assigned to receive a 3% preload concentration of either low volume (LV; 9.9 g alginate in 330 ml) or high volume (HV; 15.0 g alginate in 500 ml) alginate-based beverage, or an iso-volume placebo beverage. The preloads were ingested 30 min before a fixed breakfast and again before an ad libitum lunch. Consumption of LV-alginate preload induced a significantly lower (8.0%) energy intake than the placebo beverage (P = 0.040) at the following lunch meal, without differences in satiety feelings or paracetamol concentrations. The HV alginate significantly increased satiety feelings (P = 0.038), reduced hunger (P = 0.042) and the feeling of prospective food consumption (P = 0.027), and reduced area under the curve (iAUC) paracetamol concentrations compared to the placebo (P = 0.05). However, only a 5.5% reduction in energy intake was observed for HV alginate (P = 0.20). Although they are somewhat contradictory, our results suggest that alginate consumption does affect satiety feelings and energy intake. However, further investigation on the volume of alginate administered is needed before inferring that this fiber has a possible role in short-term energy regulation.

  5. A dynamic model of the windlass mechanism of the foot: evidence for early stance phase preloading of the plantar aponeurosis.

    Science.gov (United States)

    Caravaggi, Paolo; Pataky, Todd; Goulermas, John Y; Savage, Russel; Crompton, Robin

    2009-08-01

    In the present study we have estimated the temporal elongation of the plantar aponeurosis (PA) during normal walking using a subject-specific multi-segment rigid-body model of the foot. As previous studies have suggested that muscular forces at the ankle can pre-load the PA prior to heel-strike, the main purpose of the current study was to test, through modelling, whether there is any tension present in the PA during early stance phase. Reflective markers were attached to bony landmarks to track the kinematics of the calcaneus, metatarsus and toes during barefoot walking. Ultrasonography measurements were performed on three subjects to determine both the location of the origin of the PA on the plantar aspect of the calcaneus, and the radii of the metatarsal heads. Starting with the foot in a neutral, unloaded position, inverse kinematics allowed calculation of the tension in the five slips of the PA during the whole duration of the stance phase. The results show that the PA experienced tension significantly above rest during early stance phase in all subjects (P<0.01), thus providing support for the PA-preloading hypothesis. The amount of preloading and the maximum elongation of the slips of the PA decreased from medial to lateral. The mean maximum tension exerted by the PA was 1.5 BW (body weight) over the three subjects.

  6. Rotordynamic Evaluation of Full Scale Rotor on Tilting Pad Bearings with 0.1 and 0.3 Preload

    Directory of Open Access Journals (Sweden)

    Weimin Wang

    2014-01-01

    Full Text Available A system identification method for rotating machinery stability evaluation is investigated based on sine sweep excitation testing with electromagnetic actuator. The traditional MIMO FRF is transformed into dFRF from real number field to complex field with a transformation matrix, eliminating the influence of forward and backward modal overlap and providing higher accuracy to identify rotor’s first forward modal parameters using the rational polynomial method. The modal parameters are acquired for stability estimation. Furthermore, two sets of bearing with preloads of 0.1 and 0.3 under both load-on-pad (LOP and load-between-pad (LBP conditions are investigated. The effects of oil inlet pressure (1.0 bar–1.75 bar and temperature (43°C–51°C on the stability of rotor are investigated in detail. Results indicate that the stability of rotor will be improved by increasing the oil inlet temperature and pressure. It is found that the rotor is more stable on bearing with 0.1 preload than that of 0.3 preload. Load-on-pad provides more damping to rotor than load-between-pad. The method and outcomes of this paper can provide both theory basis and technology foundation for improving the rotor stability of centrifugal compressors.

  7. An analytical solution for two-dimensional vacuum preloading combined with electro-osmosis consolidation using EKG electrodes.

    Science.gov (United States)

    Shen, Yang; Qiu, Chenchen; Li, Yande; Shi, Wen; Rui, Xiaoxi

    2017-01-01

    China is a country with vast territory, but economic development and population growth have reduced the usable land resources in recent years. Therefore, reclamation by pumping and filling is carried out in eastern coastal regions of China in order to meet the needs of urbanization. However, large areas of reclaimed land need rapid drainage consolidation treatment. Based on past researches on how to improve the treatment efficiency of soft clay using vacuum preloading combined with electro-osmosis, a two-dimensional drainage plane model was proposed according to the Terzaghi and Esrig consolidation theory. However, the analytical solution using two-dimensional plane model was never involved. Current analytical solutions can't have a thorough theoretical analysis of practical engineering and give relevant guidance. Considering the smearing effect and the rectangle arrangement pattern, an analytical solution is derived to describe the behavior of pore-water and the consolidation process by using EKG (electro-kinetic geo synthetics) materials. The functions of EKG materials include drainage, electric conduction and corrosion resistance. Comparison with test results is carried out to verify the analytical solution. It is found that the measured value is larger than the applied vacuum degree because of the stacking effect of the vacuum preloading and electro-osmosis. The trends of the mean measured value and the mean analytical value processes are comparable. Therefore, the consolidation model can accurately assess the change in pore-water pressure and the consolidation process during vacuum preloading combined with electro-osmosis.

  8. Exploring molecular sieve capabilities of activated carbon fibers to reduce the impact of NOM preloading on trichloroethylene adsorption.

    Science.gov (United States)

    Karanfil, Tanju; Dastgheib, Seyed A; Mauldin, Dina

    2006-02-15

    Adsorption of trichloroethylene (TCE) by two activated carbon fibers (ACFs) and two granular activated carbons (GACs) preloaded with hydrophobic and transphilic fractions of natural organic matter (NOM) was examined. ACF10, the most microporous activated carbon used in this study, had over 90% of its pore volume in pores smaller than 10 A. It also had the highest volume in pores 5-8 A, which is the optimum pore size region for TCE adsorption, among the four activated carbons. Adsorption of NOM fractions by ACF10 was, in general, negligible. Therefore, ACF10, functioning as a molecular sieve during preloading, exhibited the least NOM uptake for each fraction, and subsequently the highest TCE adsorption. The other three sorbents had wider pore size distributions, including high volumes in pores larger than 10 A, where NOM molecules can adsorb. As a result, they showed a higher degree of uptake for all NOM fractions, and subsequently lower adsorption capacities for TCE, as compared to ACF10. The results obtained in this study showed that understanding the interplay between the optimum pore size region for the adsorption of target synthetic organic contaminant (SOC) and the pore size region for the adsorption of NOM molecules is important for controlling NOM-SOC competitions. Experiments with different NOM fractions indicated that the degree of NOM loading is important in terms of preloading effects; however the waythatthe carbon pores are filled and loaded by different NOM fractions can be different and may create an additional negative impact on TCE adsorption.

  9. Recent advances in TeleStroke: a systematic review on applications in prehospital management and Stroke Unit treatment or TeleStroke networking in developing countries.

    Science.gov (United States)

    Hubert, Gordian J; Müller-Barna, Peter; Audebert, Heinrich J

    2014-12-01

    TeleStroke has become an increasing means to overcome shortage of stroke expertise in underserved areas. This rapidly growing field has triggered a large amount of publications in recent years. We aimed to analyze recent advances in the field of telemedicine for acute stroke, with main focus on prehospital management, Stroke Unit treatment and network implementations in developing countries. Out of 260 articles, 25 were selected for this systematic review: 9 regarding prehospital management, 14 regarding Stroke Unit treatment and 2 describing a network in developing countries. Prehospital management showed that stroke recognition can start at the dispatch emergency call, important clinical information can be electronically transmitted to hospitals before admission and even acute treatment such as thrombolysis can be initiated in the prehospital field if ambulances are equipped with CT scan and point-of-care laboratory. Articles on remote clinical examination, telemedical imaging interpretation, trial recruitment and cost-effectiveness described various aspects of Stroke Unit treatment within TeleStroke networks, underlining reliability, safety and cost savings of these systems of care. Only one network was described to have been implemented in a developing/emerging nation. TeleStroke is a growing field expanding its focus to a broader spectrum of stroke care. It still seems to be underused, particularly in developing countries.

  10. Recruiter Selection Model

    Science.gov (United States)

    2006-05-01

    interests include feature selection, statistical learning, multivariate statistics, market research, and classification. He may be contacted at...current youth market , and reducing barriers to Army enlistment. Part of the Army Recruiting Initiatives was the creation of a recruiter selection...Selection Model DevelPed by the Openuier Reseach Crate of E...lneSstm Erapseeeng Depce-teo, WViitd Ntt. siliec Academy, NW..t Point, 271 Weau/’itt 21M

  11. Sex Disparities in Stroke

    DEFF Research Database (Denmark)

    Dehlendorff, Christian; Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2015-01-01

    BACKGROUND: Uncertainty remains about whether stroke affects men and women similarly. We studied differences between men and women with regard to stroke severity and survival. METHODS AND RESULTS: We used the Danish Stroke Registry, with information on all hospital admissions for stroke in Denmark...... between 2003 and 2012 (N=79 617), and the Danish Register of Causes of Death. Information was available on age, sex, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk profile. We studied only deaths due to the index stroke, with the assumption that death...... reported on death certificates as due to stroke was related to the index stroke if death occurred within the first week or month after stroke. Multivariate Cox regression analysis and multiple imputation were applied. Stroke was the cause of death for 4373 and 5512 of the 79 617 patients within 1 week (5...

  12. Prevention Of Stroke

    Directory of Open Access Journals (Sweden)

    Nagaraja D

    2005-01-01

    Full Text Available Stroke is an important cause for neurological morbidity and mortality. Prevention of ischemic stroke involves identification and prevention of risk factors and optimal use of pharmacotherapy. Risk factors have been classified as modifiable and non-modifiable; control of modifiable factors should prevent stroke occurrence. Stroke prevention has been described at three levels: primary, secondary and tertiary. Prolonged hypertension increases an individual′s risk for developing fatal or nonfatal stroke by three times and its control has been shown to prevent stroke. Diabetes mellitus is an important cause for microangiopathy and predisposes to stroke. Statin trials have shown significant reduction in stroke in those who were treated with statins. Stroke risk can be reduced by avoiding tobacco use, control of obesity and avoiding sedentary life style. Anti platelet medications are effective for secondary prevention of stroke. Educating society regarding modifiable risk factors and optimal use of pharmacotherapy form the cornerstone for the prevention of stroke.

  13. Electronic Recruitment at CERN

    CERN Multimedia

    2004-01-01

    The Human Resources Department switches to electronic recruitment. From now on whenever you are involved in a recruitment action you will receive an e-mail giving you access to a Web folder. Inside you will find a shortlist of applications drawn up by the Human Resources Department. This will allow you to consult the folder, at the same time as everyone else involved in the recruitment process, for the vacancy you are interested in. This new electronic recruitment system, known as e-RT, will be introduced in a presentation given at 10 a.m. on 11 February in the Main Auditorium. Implemented by AIS (Administrative Information Services) and the Human Resources Department, e-RT will cover vacancies open in all of CERN's recruitment programmes. The electronic application system was initially made available to technical students in July 2003. By December it was extended to summer students, fellows, associates and Local Staff. Geraldine Ballet from the Recruitment Service prefers e-RT to mountains of paper! The Hu...

  14. Spontaneous Low Frequency Oscillations in Acute Ischemic Stroke

    DEFF Research Database (Denmark)

    Phillip, Dorte; Schytz, Henrik Winther; Iversen, Helle Klingenberg

    2014-01-01

    patients admitted to the stroke unit with symptoms of ischemic stroke. 11/29 patients received thrombolytic therapy. NIRS examination was conducted 2 days (median time) from stroke onset. NIRS optodes were placed on each side of the head with a 3 cm source-detector distance. Using transfer function.......09-0.11 Hz range are affected by changes in cerebral autoregulation (CA), which is altered following stroke. We examined oxyHb LFOs at bed-side as a marker of CA in the subacute phase in stroke patients with or without recombinant tissue plasminogen activator thrombolytic therapy. Methods: We recruited 29...... analysis, inter-hemispheric phase shift and amplitude ratio of the oxyHb oscillations in the 0.09-0.11 Hz range were assessed. Results: The correlation between NIHSS scores at admission and oxyHb parameters revealed a significant positive correlation between stroke severity at admission and inter...

  15. Does Antiplatelet Therapy during Bridging Thrombolysis Increase Rates of Intracerebral Hemorrhage in Stroke Patients?

    Science.gov (United States)

    Broeg-Morvay, Anne; Mordasini, Pasquale; Slezak, Agnieszka; Liesirova, Kai; Meisterernst, Julia; Schroth, Gerhard; Arnold, Marcel; Jung, Simon; Mattle, Heinrich P; Gralla, Jan; Fischer, Urs

    2017-01-01

    Symptomatic intracerebral hemorrhage (sICH) after bridging thrombolysis for acute ischemic stroke is a devastating complication. We aimed to assess whether the additional administration of aspirin during endovascular intervention increases bleeding rates. We retrospectively compared bleeding complications and outcome in stroke patients who received bridging thrombolysis with (tPA+ASA) and without (tPA-ASA) aspirin during endovascular intervention between November 2008 and March 2014. Furthermore, we analyzed bleeding complications and outcome in antiplatelet naïve patients with those with prior or acute antiplatelet therapy. Baseline characteristics, previous medication, and dosage of rtPA did not differ between 50 tPA+ASA (39 aspirin naïve, 11 preloaded) and 181 tPA-ASA patients (p>0.05). tPA+ASA patients had more often internal carotid artery (ICA) occlusion (p0.1). There were no differences in bleeding complications and mortality among 112 bridging patients with antiplatelet therapy (62 preloaded, 39 acute administration, 11 both) and 117 antiplatelet naïve patients. In a logistic regression analysis, aspirin administration during endovascular procedure was not a predictor of sICH. Antiplatelet therapy before or during bridging thrombolysis in patients with acute ischemic stroke did not increase the risk of bleeding complications and had no impact on outcome. This finding has to be confirmed in larger studies.

  16. Vascular cognitive disorders and depression after first-ever stroke: the Fogarty-Mexico Stroke Cohort.

    Science.gov (United States)

    Arauz, Antonio; Rodríguez-Agudelo, Yaneth; Sosa, Ana Luisa; Chávez, Mireya; Paz, Francisco; González, Margarita; Coral, Juliana; Díaz-Olavarrieta, Claudia; Román, Gustavo C

    2014-01-01

    memory in 49%, language in 38%, perception in 36%, and attention in 38%. Executive dysfunction occurred in 36% of non-demented subjects, 65% of them with mild-moderate deficits in daily living activities. Female gender (p ≤ 0.054), older age (mean age 65.6 years vs. 49.3, p Mexico cohort recruited relatively young acute stroke patients, compared with other Mexican stroke cohorts. PSD and VCI occurred frequently but prevalence of VaD (12%) was lower than expected. A high prevalence of treatable stroke risk factors suggests that preventive interventions are advisable. © 2014 S. Karger AG, Basel.

  17. European Stroke Organisation (ESO) guidelines for the management of temperature in patients with acute ischemic stroke.

    Science.gov (United States)

    Ntaios, George; Dziedzic, Tomasz; Michel, Patrik; Papavasileiou, Vasileios; Petersson, Jesper; Staykov, Dimitre; Thomas, Brenda; Steiner, Thorsten

    2015-08-01

    Hyperthermia is a frequent complication in patients with acute ischemic stroke. On the other hand, therapeutically induced hypothermia has shown promising potential in animal models of focal cerebral ischemia. This Guideline Document presents the European Stroke Organisation guidelines for the management of temperature in patients with acute ischemic stroke. A multidisciplinary group identified related questions and developed its recommendations based on evidence from randomized controlled trials elaborating the Grading of Recommendations Assessment, Development, and Evaluation approach. This Guideline Document was reviewed within the European Stroke Organisation and externally and was approved by the European Stroke Organisation Guidelines Committee and the European Stroke Organisation Executive Committee. We found low-quality evidence, and therefore, we cannot make any recommendation for treating hyperthermia as a means to improve functional outcome and/or survival in patients with acute ischemic stroke and hyperthermia; moderate evidence to suggest against routine prevention of hyperthermia with antipyretics as a means to improve functional outcome and/or survival in patients with acute ischemic stroke and normothermia; very low-quality evidence to suggest against routine induction of hypothermia as a means to improve functional outcome and/or survival in patients with acute ischemic stroke. The currently available data about the management of temperature in patients with acute ischemic stroke are limited, and the strengths of the recommendations are therefore weak. We call for new randomized controlled trials as well as recruitment of eligible patients to ongoing randomized controlled trials to allow for better-informed recommendations in the future. © 2015 World Stroke Organization.

  18. Effects of preload 4 repetition maximum on 100-m sprint times in collegiate women.

    Science.gov (United States)

    Linder, Elizabeth E; Prins, Jan H; Murata, Nathan M; Derenne, Coop; Morgan, Charles F; Solomon, John R

    2010-05-01

    The purpose of this study was to determine the effects of postactivation potentiation (PAP) on track-sprint performance after a preload set of 4 repetition maximum (4RM) parallel back half-squat exercises in collegiate women. All subjects (n = 12) participated in 2 testing sessions over a 3-week period. During the first testing session, subjects performed the Controlled protocol consisting of a 4-minute standardized warm-up, followed by a 4-minute active rest, a 100-m track sprint, a second 4-minute active rest, finalized with a second 100-m sprint. The second testing session, the Treatment protocol, consisted of a 4-minute standardized warm-up, followed by 4-minute active rest, sprint, a second 4-minute active rest, a warm-up of 4RM parallel back half-squat, a third 9-minute active rest, finalized with a second sprint. The results indicated that there was a significant improvement of 0.19 seconds (p sprint was preceded by a 4RM back-squat protocol during Treatment. The standardized effect size, d, was 0.82, indicating a large effect size. Additionally, the results indicated that it would be expected that mean sprint times would increase 0.04-0.34 seconds (p 0.05). The findings suggest that performing a 4RM parallel back half-squat warm-up before a track sprint will have a positive PAP affect on decreased track-sprint times. Track coaches, looking for the "competitive edge" (PAP effect) may re-warm up their sprinters during meets.

  19. Epilepsy after stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Høgenhaven, H; Thage, O

    1987-01-01

    Development of epilepsy was studied prospectively in a group of 77 consecutive stroke patients. Included were stroke patients less than 75 years old admitted within the first 3 days after the stroke. Excluded were patients with subarachnoid hemorrhage, vertebrobasilar stroke, and patients...

  20. Stroke: First Aid

    Science.gov (United States)

    First aid Stroke: First aid Stroke: First aid By Mayo Clinic Staff A stroke occurs when there's bleeding into your brain or when normal blood flow to ... next several hours. Seek immediate medical assistance. A stroke is a true emergency. The sooner treatment is ...

  1. Leukocytosis in acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H

    1999-01-01

    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...

  2. Evaluation of stroke services in Anglia stroke clinical network to examine the variation in acute services and stroke outcomes

    Directory of Open Access Journals (Sweden)

    George Abraham

    2011-02-01

    Full Text Available Abstract Background Stroke is the third leading cause of death in developed countries and the leading cause of long-term disability worldwide. A series of national stroke audits in the UK highlighted the differences in stroke care between hospitals. The study aims to describe variation in outcomes following stroke and to identify the characteristics of services that are associated with better outcomes, after accounting for case mix differences and individual prognostic factors. Methods/Design We will conduct a cohort study in eight acute NHS trusts within East of England, with at least one year of follow-up after stroke. The study population will be a systematically selected representative sample of patients admitted with stroke during the study period, recruited within each hospital. We will collect individual patient data on prognostic characteristics, health care received, outcomes and costs of care and we will also record relevant characteristics of each provider organisation. The determinants of one year outcome including patient reported outcome will be assessed statistically with proportional hazards regression models. Self (or proxy completed EuroQol (EQ-5D questionnaires will measure quality of life at baseline and follow-up for cost utility analyses. Discussion This study will provide observational data about health service factors associated with variations in patient outcomes and health care costs following hospital admission for acute stroke. This will form the basis for future RCTs by identifying promising health service interventions, assessing the feasibility of recruiting and following up trial patients, and provide evidence about frequency and variances in outcomes, and intra-cluster correlation of outcomes, for sample size calculations. The results will inform clinicians, public, service providers, commissioners and policy makers to drive further improvement in health services which will bring direct benefit to the patients.

  3. Adapting the Home After a Stroke

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... after a Stroke Adapting the Home after a Stroke Caregiver Introduction What is Aphasia? Stroke Recovery Guides ...

  4. Recruitment of general practices

    DEFF Research Database (Denmark)

    Riis, Allan; Jensen, Cathrine Elgaard; Maindal, Helle Terkildsen;

    2016-01-01

    Introduction: Health service research often involves the active participation of healthcare professionals. However, their ability and commitment to research varies. This can cause recruitment difficulties and thereby prolong the study period and inflate budgets. Solberg has identified seven R......, which was fewer than planned (100 practices). In this evaluation, five of Solberg’s seven R-factors were successfully addressed and two factors were not. The need to involve (reciprocity) end users in the development of new software and the amount of time needed to conduct recruitment (resolution) were...

  5. Pre-meal video game playing and a glucose preload suppress food intake in normal weight boys.

    Science.gov (United States)

    Branton, Alyson; Akhavan, Tina; Gladanac, Branka; Pollard, Damion; Welch, Jo; Rossiter, Melissa; Bellissimo, Nick

    2014-12-01

    Increased food intake (FI) during television viewing has been reported in children, but it is unknown if this occurs following pre-meal video game playing (VGP). The objective was to determine the effect of pre-meal VGP for 30 min on subjective appetite and emotions, and FI in normal weight (NW) boys after a glucose or control preload. On four test mornings, NW boys (n = 19) received equally sweetened preloads of a non-caloric sucralose control or 50 g glucose in 250 mL of water, with or without VGP for 30 min. Food intake from an ad libitum pizza meal was measured immediately after. Subjective appetite was measured at 0, 15, 30, and 60 min. Subjective emotions were determined by visual analog scale at baseline and immediately before lunch. Both VGP (p = 0.023) and glucose (p decreased FI by 59 and 170 kcal, respectively. Subjective average appetite increased to 30 min (p = 0.003), but was lower after glucose (p = 0.01) in both the VGP and no-VGP conditions compared with the control. Frustration and aggression scores increased after VGP (p <0.05), but did not correlate with FI. However, baseline and pre-meal happiness and excitement scores were inversely associated with FI. In conclusion, both pre-meal VGP and the glucose preload suppressed FI, supporting the roles of both physiologic and environmental factors in the regulation of short-term FI in 9- to 14-year-old NW boys.

  6. Effect of Preload Alterations on Left Ventricular Systolic Parameters Including Speckle-Tracking Echocardiography Radial Strain During General Anesthesia.

    Science.gov (United States)

    Weber, Ulrike; Base, Eva; Ristl, Robin; Mora, Bruno

    2015-08-01

    Frequently used parameters for evaluation of left ventricular systolic function are load-sensitive. However, the impact of preload alterations on speckle-tracking echocardiographic parameters during anesthesia has not been validated. Therefore, two-dimensional (2D) speckle-tracking echocardiography radial strain (RS) was assessed during general anesthesia, simulating 3 different preload conditions. Single-center prospective observational study. University hospital. Thirty-three patients with normal left ventricular systolic function undergoing major surgery. Transgastric views of the midpapillary level of the left ventricle were acquired at 3 different positions. Fractional shortening (FS), fractional area change (FAC), and 2D speckle-tracking echocardiography RS were analyzed in the transgastric midpapillary view. Considerable correlation above 0.5 was found for FAC and FS in the zero and Trendelenburg positions (r = 0.629, r = 0.587), and for RS and FAC in the anti-Trendelenburg position (r = 0.518). In the repeated-measures analysis, significant differences among the values measured at the 3 positions were found for FAC and FS. For FAC, there were differences up to 2.8 percentage points between the anti-Trendelenburg position and the other 2 positions. For FS, only the difference between position zero and anti-Trendelenburg was significant, with an observed change of 1.66. Two-dimensional RS was not significantly different at all positions, with observed changes below 1 percentage point. Alterations in preload did not result in clinically relevant changes of RS, FS, or FAC. Observed changes for RS were smallest; however, the variation of RS was larger than that of FS or FAC. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Direct Laryngoscopy and Endotracheal Intubation Complicated by Anterior Tracheal Laceration Secondary to Protrusion of Preloaded Endotracheal Tube Stylet.

    Science.gov (United States)

    Warner, Matthew A; Fox, Jonathan F

    2016-02-15

    Tracheal wall disruption is a rare complication of endotracheal intubation, typically occurring in the posterior (membranous) trachea lacking cartilaginous support. We present the case of a 68-year-old man who developed an anterior tracheal tear after routine endotracheal intubation, most likely occurring secondary to protrusion of a factory-preloaded stylet beyond the distal orifice of the endotracheal tube. Tracheal disruption should be considered in any patient with subcutaneous emphysema and respiratory distress after tracheal extubation and confirmed with bronchoscopy. Conservative management may be appropriate for those with small tears, hemodynamic stability, and the ability to isolate the tear from positive pressure ventilation.

  8. FE-MODELLING OF A CONTACT LAYER BETWEEN ELEMENTS JOINED IN PRELOADED BOLTED CONNECTIONS FOR THE OPERATIONAL CONDITION

    Directory of Open Access Journals (Sweden)

    Rafał Grzejda

    2014-11-01

    Full Text Available Modelling and calculations of a contact layer between elements joined in a preloaded bolted connection for the operational condition are presented. The physical model of the bolted connection is based on a flexible flange element that is joined with a rigid support by means of the no-bolt model (at the assembly stage or the rigid body bolt model (at the operational stage. The contact layer between joined elements is described as the nonlinear Winkler model. The contact joint model considering an experimental normal elastic characteristic is presented. Examples of normal contact pressure and normal contact deformations distributions are contained.

  9. E-recruitment

    DEFF Research Database (Denmark)

    Holm, Anna

    2012-01-01

    -recruitment is viewed as a case of virtual organizing- the organization of processes and activities which, via technology and human agents, facilitate time- and space-independent interaction and collaboration. In closure I offer a brief discussion of implications of the findings for HR managers and professionals...

  10. Recruitment. Hello, goodbye.

    Science.gov (United States)

    Moore, Alison

    2008-07-10

    The UK is "moving to a policy of self-sufficiency" according to the Department of Health. The numbers of new overseas entrants into healthcare, including doctors, nurses and midwives has slumped. Several other countries, including Canada, the US and Australia, are aggressively recruiting from overseas, including from the UK. There is an increasing perception the UK does not want overseas staff.

  11. [Recruitment in presbycusis].

    Science.gov (United States)

    Sánchez Legaza, E; Ciges Juan, M; González Pérez, M; Miranda Caravallo, J I

    2006-01-01

    Presbycusis is characterised by a sensorineural hearing loss, mainly in high frequencies, symmetrical and progressive and poor understanding. Recuritment, typical in cochlear hearing loss, would be present in cases of sensorial presbycusis which runs mainly in cochlear pathologies. We analyse variables and their possible interrelations with recruitment in 241 presbycusic patients.

  12. Neurogenesis in Stroke Recovery.

    Science.gov (United States)

    Koh, Seong-Ho; Park, Hyun-Hee

    2017-02-01

    Stroke, resulting from limited blood flow to the brain, is one of the most important causes of morbidity and mortality worldwide. Stroke is classified as ischemic, due to lack of blood flow, or hemorrhagic, due to bleeding. Because 87 % of strokes are classified as ischemic, this type will be the predominant focus of this review. Except for thrombolytic therapy, there is no established treatment to reduce the neurological deficits caused by ischemic stroke. Therefore, it is necessary to develop new therapeutic strategies designed to improve neurological functions after ischemic stroke. Recently, therapies to enhance neurogenesis after ischemic stroke have been investigated. However, these approaches have not led to successful clinical outcomes. This review addresses the pathophysiology of stroke, neurogenesis after stroke, and how to stimulate these processes based on the current literature. Finally, ongoing clinical trials to improve neurological functions after stroke by enhancing neurogenesis are discussed in this review.

  13. An evaluation of screening measures for cognitive impairment after stroke

    OpenAIRE

    Blake, Holly; McKinney, Michelle; Treece, Karen; Lee, Elizabeth; Lincoln, Nadina B.

    2002-01-01

    Objectives: to assess the sensitivity and specificity of a screening battery for detecting cognitive impairment after stroke. Design: a randomized controlled trial. Methods: stroke patients were recruited from hospitals in three centres. Patients were screened for cognitive impairment on the Mini‐Mental State Examination, the Sheffield Screening Test for Acquired Language Disorders and Raven's Coloured Progressive Matrices and received a further battery of assessments of cognitive f...

  14. Stroke and High Blood Pressure

    Science.gov (United States)

    ... More How High Blood Pressure Can Lead to Stroke Updated:Dec 2,2016 Stroke and high blood ... Changes That Matter • Find Tools & Resources Show Your Stroke Support! Show your stroke support with our new ...

  15. Difficulty Swallowing After Stroke (Dysphagia)

    Science.gov (United States)

    ... Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August ...

  16. [Stroke and aging].

    Science.gov (United States)

    Ly, J; Maquet, P

    2014-01-01

    Stroke risk increases with aging and one third of ischemic strokes occurs in very elderly (> or = 80 years). These are responsible of two thirds of the overall stroke-related morbi-mortality. Stroke in very elderly differs from younger individuals by sex ratio (more women), risk factors (more atrial fibrillation and hypertension) and usually a worse functional outcome. Very elderly are likely to benefit from stroke unit care and early revascularisation treatments although they have historically been excluded from this urgent management. These issues are likely to worsen in the future with the increasing impact of stroke on our aging societies.

  17. Participation in Complex and Social Everyday Activities Six Years after Stroke: Predictors for Return to Pre-Stroke Level.

    Directory of Open Access Journals (Sweden)

    Avvai Singam

    Full Text Available Long-term disability following stroke can lead to participation restrictions in complex and social everyday activities, yet information is lacking on to what extent stroke survivors return to their pre-stroke levels of participation.The objectives of this study were to investigate the level of participation in complex and social everyday activities 6 years after stroke, to compare this with pre-stroke participation and to identify predictors of returning to pre-stroke levels of participation.All patients admitted to Karolinska University Hospital's stroke units during a 1-year period were eligible to participate and 349 patients were recruited. Assessments were made at base-line, 3 months and 6 years using self-reported outcome measures. Participation was assessed using the Frenchay Activities Index (FAI. The 6-year score for each participant was compared to the pre-stroke score, both for the total score and for each domain (domestic chores, leisure/work and outdoor activities. Predictors of having the same or better level of participation at 6 years were identified using logistic regression.At 6 years, 121 participants were followed up, 166 were deceased, 44 declined to take part and 18 could not be traced. At 6 years 84% could be described as active (FAI≥15. The same level of participation or better than pre-stroke was found in 35% of participants, in 65% the level was lower. Similar predictors were identified for achieving the same or better level of participation at 6 years for FAI total and the three domains; ability to walk without aids and a lower age at stroke onset, and perceived mobility, participation and recovery at 3 months.Six years after stroke, 35% of participants had the same or better level of participation as pre-stroke. Rehabilitation after stroke to improve walking ability and participation might improve long-term participation in complex and social everyday activities.

  18. MEAN PLATELET VOLUME AND RISK OF THROMBOTIC STROKE

    Directory of Open Access Journals (Sweden)

    Prasantha Kumar Thankappan

    2017-07-01

    Full Text Available BACKGROUND Stroke is a major cause of long term morbidity and mortality. Several factors are known to increase the liability to stroke. Platelets play a crucial role in the pathogenesis of atherosclerotic complications, contributing to thrombus formation. Platelet size (mean platelet volume, MPV is a marker and possible determinant of platelet function, large platelets being potentially more reactive. Hence an attempt has-been made to study the association if any between mean platelet volume and thrombotic stroke. The aim of this study was to determine whether an association exists between Mean Platelet Volume (MPV and thrombotic stroke. MATERIALS AND METHODS The study is a case control study and data was collected at Government Medical College Hospital, Kottayam, Kerala a tertiary care referral centre. The study was carried out among fifty patients diagnosed with thrombotic stroke and presenting to the hospital within forty eight hours of onset of symptoms. Fifty age group and sex matched controls were also recruited. Mean platelet volume was obtained using a SYSMEX automated analyser. RESULTS This study has shown a statistically significant relation between mean platelet volume and risk of thrombotic stroke but no statistically significant correlation between clinical severity of stroke and mean platelet volume. CONCLUSION This study has shown an elevation of MPV in acute phase of thrombotic stroke. Platelet mass was found to be more or less a constant. This study did not find a statistically significant correlation between clinical severity of stroke and mean platelet volume.

  19. Factors associated with strain in informal caregivers of stroke patients.

    Science.gov (United States)

    Hung, Jen-Wen; Huang, Yu-Ching; Chen, Jin-Hua; Liao, Li-Na; Lin, Chun-Ju; Chuo, Chia-Ying; Chang, Ku-Chou

    2012-01-01

    Stroke is one of the most prevalent causes of adult disability and handicap. Informal caregivers play an important role in poststroke care. However, informal caregivers may experience strain, which threatens the recovery of stroke subjects. This study aimed to describe changes in strain experienced by informal caregivers from 3 to 6 months after the stroke, and identify the predicting factors. We recruited pairs of inpatients with ischemic stroke and informal caregivers from a tertiary referral hospital and interviewed them at 3 and 6 months after the stroke. Caregiver strain was evaluated using the Caregiver Strain Index (CSI), with a CSI ≥ 7 indicating considerable caregiver strain. Various factors associated with caregiver strain were analyzed using generalized estimating equations. Eighty-nine stroke patients and caregivers completed the study. Considerable strain was reported in 46% and 43% of the caregivers at the 3rd and 6th month, respectively. Patient factors such as severe disabilities (Barthel Index ≤ 60), poor cognition (Mini-Mental State Examination ≤ 23), depression (Beck Depression Inventory [BDI] ≥ 10), and recurrent stroke were predictors for caregiver strain. Caregiver factors, such as changed employment status, help from formal caregivers, and depression (BDI ≥ 10) were also associated with considerable caregiver strain. Nearly 50% of caregivers experienced considerable strain. Interventions aimed at reducing the caregivers' strain should focus on enhancing the functional and emotional status of stroke subjects, prevention of recurrent stroke, and efficient management of depression symptoms in caregivers.

  20. An automated method to control preload by compensation for stress relaxation in spontaneously contracting, isometric rat mesenteric lymphatics.

    Science.gov (United States)

    Davis, Michael J; Lane, Megan M; Scallan, Joshua P; Gashev, Anatoliy A; Zawieja, David C

    2007-08-01

    Our objective was to devise a system to automatically correct for stress relaxation of isometric rat mesenteric lymphatics (90-120 microm, ID). Stress relaxation is a particular problem in isometric studies of highly distensible vessels and is evident as a time-dependent, secondary decline in force after an abrupt length increase. Because the phasic contraction pattern of lymphatics is exquisitely sensitive to changes in preload, stress relaxation makes stable contraction patterns difficult to achieve and analyze. A DMT wire myograph was modified to accommodate an Inchworm piezo stack in series with a standard micrometer drive to permit automated control of vessel caliber/force. The force output of the myograph was digitized and computer algorithms were devised to servo control force by changing vessel diameter. The system was tested on passive lymphatics, passive small veins, and lymphatics exhibiting spontaneous force transients. The software was designed to temporarily disable servo control during a spontaneous force transient. For both active and passive lymphatics, stable preloads were very well maintained, indicating that the system was adequately compensating for stress relaxation. The method works well with isometric rat mesenteric lymphatics without disturbing spontaneous activity. It should be applicable to arterial, venous, and lymphatic vessels (80-500 microm in diameter) isolated from other tissues and species.

  1. Outsourcing of labour recruitment

    OpenAIRE

    Gemrich, Jan

    2008-01-01

    The aim of the project is to introduce the reader to the world of possibilities, advantages and disadvantages of current outsourcing, to highlight the factors limiting the use of outsourcing and the risks. Practical example then tries to introduce the reader to the creation and the process of the outsourcing relationship and to define the benefits and limitations resulting from the outsourcing of labour recruitment as part of personnel work.

  2. Impaired glucose regulation predicted 1-year mortality of Chinese patients with ischemic stroke: data from abnormal glucose regulation in patients with acute stroke across China.

    Science.gov (United States)

    Jia, Qian; Liu, Gaifen; Zheng, Huaguang; Zhao, Xingquan; Wang, Chunxue; Wang, Yilong; Liu, Liping; Wang, Yongjun

    2014-05-01

    It remains uncertain if impaired glucose regulation (IGR) as a predictor for stroke outcomes. This study aimed at observing the effect of IGR on the 1-year outcomes in Chinese patients with ischemic stroke. Patients with acute ischemic stroke were recruited consecutively in multihospitals across China. Oral glucose tolerance test was performed to identify IGR. Cox proportion hazard model was performed to investigate the effect of IGR on 1-year mortality or stroke recurrence in patients with ischemic stroke. The study recruited 2639 patients with ischemic stroke. IGR was shown as an independent risk factor for the mortality of patients with ischemic stroke (hazard ratio [95% confidence interval], 3.088 [1.386-6.884]; P=0.006). However, IGR showed no significant effects on the dependency or stroke recurrence of patients (P=0.540 and 0.618, respectively). IGR was an independent predictor for the mortality of patients with ischemic stroke. IGR should be highlighted and intervened actively in the patients with ischemic stroke.

  3. Heart and Stroke Encyclopedia

    Science.gov (United States)

    ... Venous Thromboembolism Aortic Aneurysm More The Heart and Stroke Encyclopedia Click a letter below to get a ... dozens of cardiovascular terms from our Heart and Stroke Encyclopedia and get links to in-depth information. ...

  4. Stroke Trials Registry

    Science.gov (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Trials Registry Clinical Trials Interventions Conditions Sponsors ... a clinical trial near you Welcome to the Stroke Trials Registry Our registry of clinical trials in ...

  5. Stroke Fact Sheet

    Science.gov (United States)

    ... tells you to. Return to top Does taking birth control pills increase my risk for stroke? Taking birth ... your vagina Return to top Does using the birth control patch increase my risk for stroke? The patch ...

  6. Stroke Connection Magazine

    Science.gov (United States)

    ... reason to live a longer, healthier life. These stroke survivors, caregivers and others share their 'whys'. We'd love ... let us know! Main Menu Survival Journeys For Caregivers Tips and ... Stroke Association. All rights reserved. | Privacy Policy

  7. Perinatal and Childhood Stroke

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-03-01

    Full Text Available The epidemiology, risk factors, outcome and prognosis of perinatal and childhood stroke were reviewed at a workshop sponsored by the National Institute of Neurological Disorders and Stroke in Bethesda, MD, on Sept 18 and 19, 2000.

  8. Analog-Computer Investigation of Effects of Friction and Preload on the Dynamic Longitudinal Characteristics of a Pilot-Airplane Combination

    Science.gov (United States)

    Crane, Harold L.

    1961-01-01

    With an electric analog computer, an investigation has been made of the effects of control frictions and preloads on the transient longitudinal response of a fighter airplane during abrupt small attitude corrections. The simulation included the airplane dynamics, powered control system, feel system, and a simple linearized pseudopilot. Control frictions at the stick pivot and at the servo valve as well as preloads of the stick and valve were considered individually and in combinations. It is believed that the results which are presented in the form of time histories and vector diagrams present a more detailed illustration of the effects of stray forces and compensating forces in the longitudinal control system than has previously been available. Consistent with the results of previous studies, the present results show that any of these four friction and preload forces caused some deterioration of the response. However, even a small amount of valve friction caused an oscillatory pitching response during which the phasing of the valve friction was such that it caused energy to be fed into the pitching oscillation of the air-plane. Of the other friction and preload forces which were considered, it was found that stick preload was close to 180 deg. out of phase with valve friction and thus could compensate in large measure for valve friction as long as the cycling of the stick encompassed the trim point. Either stick friction or valve preload provided a smaller stabilizing effect primarily through a reduction in the amplitude of the resultant force vector acting on the control system. Some data were obtained on the effects of friction when the damping or inertia of the control system or the pilot lag was varied.

  9. Dysphagia in acute stroke: Correlation with stroke subtype, vascular territory and in-hospital respiratory morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Sundar Uma

    2008-01-01

    Full Text Available Aims: The study aimed at correlation of post-stroke dysphagia with area and volume of infarct/ bleed, and with subsequent in-hospital respiratory morbidity and mortality. Materials and Methods: 50 patients of acute stroke were serially recruited. Standard Staff swallowing assessment was performed within 24 hours of admission along with pulse oximetry. Ischemic strokes were classified as per OCPS registry. In-hospital respiratory morbidity and mortality, mode of nutrition and disability status at discharge were noted. Results: 21/50 (42% patients had post-stroke dysphagia during their hospital course. Among infarcts, Total Anterior Circulation Infarcts (TACI had 100% incidence of dysphagia, followed by Partial Anterior Circulation Infarcts (PACI-36%, Posterior Circulation infarcts (POCI-33%, and Lacunar infarcts (LACI-18%. 67% of hemorrhages had post-stroke dysphagia. Staff swallowing assessment had a sensitivity and specificity of 75% and 73% respy., for predicting respiratory morbidity. The corresponding figures for Pulse oximetry were 79% and 91%.

  10. Dizziness in stroke

    OpenAIRE

    M V Zamergrad

    2015-01-01

    Differential diagnosis of new-onset acute vestibular vertigo is chiefly made between vestibular neuronitis and stroke. Dizziness in stroke is usually accompanied by other focal neurological symptoms of brainstem and cerebellar involvement. However, stroke may appear as isolated vestibular vertigo in some cases. An analysis of history data and the results of neurovestibular examination and brain magnetic resonance imaging allows stroke to be diagnosed in patients with acute isolated dizziness....

  11. Genetics of stroke

    OpenAIRE

    Guo, Jin-Min; Liu, Ai-Jun; Su, Ding-Feng

    2010-01-01

    Stroke is the second most common cause of death and the most common cause of disability in developed countries. Stroke is a multi-factorial disease caused by a combination of environmental and genetic factors. Numerous epidemiologic studies have documented a significant genetic component in the occurrence of strokes. Genes encoding products involved in lipid metabolism, thrombosis, and inflammation are believed to be potential genetic factors for stroke. Although a large group of candidate ge...

  12. Post-Stroke Rehabilitation

    Science.gov (United States)

    ... PDF (704 kb) » Spanish Version » Order Materials » Post-Stroke Rehabilitation In the United States more than 700,000 ... best possible long-term outcome. What is post-stroke rehabilitation? Rehabilitation helps stroke survivors relearn skills that are ...

  13. Recruitment Practices And Institutional Change

    DEFF Research Database (Denmark)

    Holm, Anna; Ulhøi, John Parm

    as a theoretical lens in order to understand how shared rules, norms and beliefs guide recruitment professionals in their choice of recruitment tactics and ways of performing recruitment tasks. Our findings suggest that recruitment practices have been strongly influenced by changes in the labour market, technology......Up to now, there has been little research on recruitment practices from an organizational perspective, and in part it lags behind practice. This paper attempts to rectify this by studying recent changes in the recruitment practices of Danish organizations. We employ new institutional theory......, and individuals’ social cognition. Among other things, this is reflected in the use of online recruitment and employer branding. The study concludes that the recruitment field has transformed and reviewed its practices due to institutional changes in how individuals search for employment and expect to be hired....

  14. Recruitment Requires an Informed Public

    Science.gov (United States)

    Boucher, Leon

    1975-01-01

    The personal approach of the Ohio Recruitment Commission for Agricultural Education has been very effective in recruiting potential vocational agriculture teachers from junior and senior high school classes. (EA)

  15. Cerebral microbleeds and suicidality in stroke.

    Science.gov (United States)

    Tang, Wai Kwong; Chen, Yang Kun; Liang, Hua Jun; Chu, Winnie C W; Mok, Vincent C T; Ungvari, Gabor S; Wong, Ka Sing

    2012-01-01

    Cerebral microbleeds (CMBs) are common in stroke survivors. The clinical significance of CMBs in the development of suicidality (SI) following stroke is unknown. This study examined the association between SI and CMBs. The aim of the study reported here was to determine the relationship between CMBs and SI in ischemic stroke survivors. A cohort of 367 patients with acute ischemic stroke admitted to the stroke unit of a university-affiliated regional hospital in Hong Kong was recruited. SI was assessed with the geriatric mental state examination at three months following the subjects' index stroke. Depressive symptoms were assessed using the geriatric depression scale (GDS). A qualified psychiatrist administered the Chinese version of the Structured Clinical Interview for DSM-IV to diagnose depressive disorders. The presence and location of CMBs were evaluated with magnetic resonance imaging (MRI). Compared with the non-SI patients, SI patients were more likely to have CMBs in any brain region (36.6% vs. 20.2%, p = 0.017), specifically more lobar (29.3% vs. 13.5%, p = 0.008) and thalamic CMBs (19.5% vs. 7.5%, p = 0.018). Presence of CMBs (odds ratio was 2.5, p = 0.026) and lobar CMBs (odds ratio 2.6, p = 0.034) were independent predictors of SI in the multivariate analysis. The results suggest that lobar CMBs may play roles in the development of SI. The importance of CMBs in the pathogenesis of SI in stroke survivors warrants further investigation. Copyright © 2012 The Academy of Psychosomatic Medicine. All rights reserved.

  16. Epigenetics in Stroke Recovery

    Science.gov (United States)

    Kassis, Haifa; Shehadah, Amjad; Chopp, Michael; Zhang, Zheng Gang

    2017-01-01

    Abstract: While the death rate from stroke has continually decreased due to interventions in the hyperacute stage of the disease, long-term disability and institutionalization have become common sequelae in the aftermath of stroke. Therefore, identification of new molecular pathways that could be targeted to improve neurological recovery among survivors of stroke is crucial. Epigenetic mechanisms such as post-translational modifications of histone proteins and microRNAs have recently emerged as key regulators of the enhanced plasticity observed during repair processes after stroke. In this review, we highlight the recent advancements in the evolving field of epigenetics in stroke recovery. PMID:28264471

  17. Psychoneuroimmunology of stroke.

    Science.gov (United States)

    Skinner, Robert; Georgiou, Rachel; Thornton, Peter; Rothwell, Nancy

    2009-05-01

    Stroke is the major cause of disability in the Western world and is the third greatest cause of death, but there are no widely effective treatments to prevent the devastating effects of stroke. Extensive and growing evidence implicates inflammatory and immune processes in the occurrence of stroke and particularly in the subsequent injury. Several inflammatory mediators have been identified in the pathogenesis of stroke including specific cytokines, adhesion molecules, matrix metalloproteinases, and eicosanoids. An early clinical trial suggests that inhibiting interleukin-1 may be of benefit in the treatment of acute stroke.

  18. The Need for Perceptive Recruiters

    Science.gov (United States)

    Kidd, M. C.

    1971-01-01

    Recruiters are crucial to their employers, especially with regard to the recruitment of highly paid technical and engineering candidates. A poor recruiter can fail by not having the ability to judge personality traits and spot the things that will spell success for the new hire and his company. (Author)

  19. 10 Ways to Recruit Teachers.

    Science.gov (United States)

    Stewart, Daisy

    1999-01-01

    Suggestions for recruiting teachers are as follow: talk to teens, recruit from within, involve counselors, target uncertain students, network, build relationships with tech prep, enlist military personnel, recruit extension agents, contact outplacement and employment services, and use distance-learning methods. (JOW)

  20. 10 Ways to Recruit Teachers.

    Science.gov (United States)

    Stewart, Daisy

    1999-01-01

    Suggestions for recruiting teachers are as follow: talk to teens, recruit from within, involve counselors, target uncertain students, network, build relationships with tech prep, enlist military personnel, recruit extension agents, contact outplacement and employment services, and use distance-learning methods. (JOW)

  1. Clinical Epidemiology Of Stroke

    Directory of Open Access Journals (Sweden)

    Nagaraja D

    2005-01-01

    Full Text Available Stroke is a huge public health problem because of its high morbidity and disability. The epidemiology of stroke is of relevance to construct practical paradigms to tackle this major health issue in the community. Recent data have shown that about 72-86% of strokes are ischemic, 9-18% are due to hemorrhage (intracerebral of subarachnoid and the rest are undefined. The risk factors for stroke are multiple and combined. At present, stroke is no more considered as unavoidable and untreatable. It is an emergency and specialized units and teams improve outcome and lower costs. Death related to stroke is declining in many countries and in both sexes. This decrease in multifactorial. The detection and more effective treatment of hypertension may play an important factor, as well as the improved medical care and improvement in diagnostic procedures. While stroke incidence appears stable and stroke mortality is slowly declining, the absolute magnitude of stroke is likely to grow over the next 30 years. as the population ages, the absolute number of stroke victims and demands on healthcare and other support systems is likely to increase substantially in the future. Keeping this in perspective, this chapter shall focus on the epidemiology of stroke in the world and in Indian, in particular.

  2. Registration of acute stroke

    DEFF Research Database (Denmark)

    Wildenschild, Cathrine; Mehnert, Frank; Thomsen, Reimar Wernich

    2013-01-01

    BACKGROUND: The validity of the registration of patients in stroke-specific registries has seldom been investigated, nor compared with administrative hospital discharge registries. The objective of this study was to examine the validity of the registration of patients in a stroke-specific registry...... (The Danish Stroke Registry [DSR]) and a hospital discharge registry (The Danish National Patient Registry [DNRP]). METHODS: Assuming that all patients with stroke were registered in either the DSR, DNRP or both, we first identified a sample of 75 patients registered with stroke in 2009; 25 patients...... in the DSR, 25 patients in the DNRP, and 25 patients registered in both data sources. Using the medical record as a gold standard, we then estimated the sensitivity and positive predictive value of a stroke diagnosis in the DSR and the DNRP. Secondly, we reviewed 160 medical records for all potential stroke...

  3. Sleep and Stroke

    Directory of Open Access Journals (Sweden)

    M V Padma Srivastav

    2014-03-01

    Full Text Available Circadian variations in conjunction with sleep-related heart rhythm changes and sleepdisordered breathing (SDB are contributing risk factors for stroke. Strong scientificevidence now exists indicating that SDB contributes to systemic hypertension, aprominent risk factor for stroke, and compelling circumstantial evidence is presentsuggesting that SDB raises the risk for development of stroke through other circulatorymechanisms as well. Preliminary evidence indicates that post-stroke patients have ahigher prevalence of SDB, which is likely to compromise their rehabilitation outcomes.Since SDB is modifiable with the application of CPAP and other treatment modalities,there is practical value in investigating patients at risk of stroke or post stroke forpresence of SDB. Successful application of CPAP or BiPAP therapy may improve theoutcome in both instances.Key words : Sleep, Stroke, SDB, CPAP

  4. The relationship between stroke survivors' perceived identity and mood, self-esteem and quality of life.

    Science.gov (United States)

    Lapadatu, Irina; Morris, Reg

    2017-01-11

    To examine change in identity after stroke and to elucidate its relationship with mood and quality of life. To test Higgins' theory of the impact of identity (self-discrepancy) on anxiety and depression. To examine the role of self-esteem in mediating the relationship between identity and outcomes. Sixty-five community-living first-time stroke survivors, mean age 61.58 and time since stroke 5.60 years, were recruited from stroke charities. A cross-sectional study used the Head Injury Semantic Differential Scale, the Hospital Anxiety and Depression Scale, the Rosenberg Self-Esteem Scale, the Stroke-Specific Quality of Life Questionnaire (adapted) and the Barthel Index. Identity was rated more negatively after stroke than before (t(64) = 6.46, p self-esteem (r = -.48, p self-esteem (β = .30, p self-esteem are associated with important outcomes for stroke survivors.

  5. Changes of resting cerebral activities in subacute ischemic stroke patients

    Directory of Open Access Journals (Sweden)

    Ping Wu

    2015-01-01

    Full Text Available This study aimed to detect the difference in resting cerebral activities between ischemic stroke patients and healthy participants, define the abnormal site, and provide new evidence for pathological mechanisms, clinical diagnosis, prognosis prediction and efficacy evaluation of ischemic stroke. At present, the majority of functional magnetic resonance imaging studies focus on the motor dysfunction and the acute stage of ischemic stroke. This study recruited 15 right-handed ischemic stroke patients at subacute stage (15 days to 11.5 weeks and 15 age-matched healthy participants. A resting-state functional magnetic resonance imaging scan was performed on each subject to detect cerebral activity. Regional homogeneity analysis was used to investigate the difference in cerebral activities between ischemic stroke patients and healthy participants. The results showed that the ischemic stroke patients had lower regional homogeneity in anterior cingulate and left cerebrum and higher regional homogeneity in cerebellum, left precuneus and left frontal lobe, compared with healthy participants. The experimental findings demonstrate that the areas in which regional homogeneity was different between ischemic stroke patients and healthy participants are in the cerebellum, left precuneus, left triangle inferior frontal gyrus, left inferior temporal gyrus and anterior cingulate. These locations, related to the motor, sensory and emotion areas, are likely potential targets for the neural regeneration of subacute ischemic stroke patients.

  6. Changes of resting cerebral activities in subacute ischemic stroke patients

    Institute of Scientific and Technical Information of China (English)

    Ping Wu; Fang Zeng; Yong-xin Li; Bai-li Yu; Li-hua Qiu; Wei Qin; Ji Li; Yu-mei Zhou; Fan-rong Liang

    2015-01-01

    This study aimed to detect the difference in resting cerebral activities between ischemic stroke pa-tients and healthy participants, deifne the abnormal site, and provide new evidence for pathological mechanisms, clinical diagnosis, prognosis prediction and efifcacy evaluation of ischemic stroke. At present, the majority of functional magnetic resonance imaging studies focus on the motor dysfunc-tion and the acute stage of ischemic stroke. This study recruited 15 right-handed ischemic stroke patients at subacute stage (15 days to 11.5 weeks) and 15 age-matched healthy participants. A rest-ing-state functional magnetic resonance imaging scan was performed on each subject to detect cerebral activity. Regional homogeneity analysis was used to investigate the difference in cerebral activities between ischemic stroke patients and healthy participants. The results showed that the ischemic stroke patients had lower regional homogeneity in anterior cingulate and left cerebrum and higher regional homogeneity in cerebellum, left precuneus and left frontal lobe, compared with healthy participants. The experimental ifndings demonstrate that the areas in which regional homogeneity was different between ischemic stroke patients and healthy participants are in the cerebellum, left precuneus, left triangle inferior frontal gyrus, left inferior temporal gyrus and anterior cingulate. These locations, related to the motor, sensory and emotion areas, are likely po-tential targets for the neural regeneration of subacute ischemic stroke patients.

  7. Design, Assembly and Preloading of Ball Bearings for Space Applications- Lessons Learned and Guidelines for Future Success

    Science.gov (United States)

    Videra, E.; Lebreton, C.; Lewis, S. D.; Gaillard, L.

    2013-09-01

    The use of ball bearings in the space industry is commonplace, with a broad range of applications from the most precise pointing mechanisms to extreme long -life and performance-demanding reaction wheels and simpler single-shot devices where precision, performance and life may be less difficult to achieve. Though most application developments are ultimately successful, the lessons learned from the incorrect implementation of ball bearings are, usually for understandable commercial reasons, not widely distributed - but often extremely valuable for industry.The organizations contributing to this paper have an unprecedentedly clear view of numerous spacecraft applications, both successful and otherwise, together with many years of experience in design, handling, lubricating, preloading and testing ball bearings for space applications.In order to help the space community to avoid design or handling errors in future, ESA has mandated bearing manufacturer ADR, and the European Space Tribology Laboratory (ESTL) to create a useful guideline which summarises both best practice and a distillation of the lessons learned from many programs.This paper presents a selection of the more valuable and generally applicable lessons learned by these organizations in the last 30-40 years together with an overview of the recently published guideline document itself [1] which embodies this experience and contains recommendations concerning ball bearing selection, design and conceptual rules and recommendations for assembly, preloading and verification testing.The novelty of this paper comes from the broad range of experiences and applications, both good and bad that the organisations concerned have observed and the publication (for the first time) of guidelines for use by the space mechanisms community in Europe.

  8. A new nonlinear dynamic model of the rotor-bearing system considering preload and varying contact angle of the bearing

    Science.gov (United States)

    Zhang, Xuening; Han, Qinkai; Peng, Zhike; Chu, Fulei

    2015-05-01

    A great deal of research work has been done on the dynamic behaviors of the rotor-bearing system. However, the important effects of load and variation of contact angle on the bearing performance have not been focused on sufficiently. In this paper, a five-degree-of-freedom load distribution model is set up considering the bearing preload and the loads due to the rotor imbalance. Utilizing this model, the variation of the bearing contact angle is investigated thoroughly. The comparisons of the obtained contact angle against the results from literature validate that the proposed load distribution model is effective. With this model, the static ball deformations are obtained considering variation of the contact angle. Through resolving the dynamic displacements of the rotor, the dynamic ball deformations could also be obtained. Then the total restoring forces and moments of the bearings could be formulated. By introducing these nonlinear forces and moments into the rotating system, a new dynamic model considering the preload and the variation of contact angle is set up. The present analyses indicate that the bearing contact angle will be changed remarkably with the effect of bearing load. The deflection vibration of the rotor-bearing system will be underestimated without considering the varying contact angle. With the effect of varying contact angle, the ball passage frequency and its combinations with the shaft rotating frequency become more noticeable. The main resonance regions for the rotor-bearing system shift to the lower speed ranges when the variation of contact angle is taken into account.

  9. The effect of maintaining a constant preload or a constant degree of thumb abduction on the isometric twitch force of the thumb

    NARCIS (Netherlands)

    van Santen, G; Wierda, JMKH

    Objective. To investigate the effects of maintaining a constant preload and of maintaining a constant degree of thumb abduction on the isometric twitch force during mechanomyography of the thumb, we monitored neuromuscular function in patients anaesthetized without the use of a neuromuscular

  10. Research of Preloading Method for Axial Piston Pump with Swash Plate%斜盘式轴向柱塞泵预紧方式研究

    Institute of Scientific and Technical Information of China (English)

    张伟; 吉利科; 朱琳

    2015-01-01

    在斜盘式轴向柱塞泵中,通常采用弹簧对缸体与配油盘进行中心预紧,产生的预压力压紧保持架使柱塞与滑靴回程。目前常见为碟形弹簧及普通螺旋形弹簧,该文对两种弹簧进行比较,同时对使用上述两种弹簧的几种典型中心弹簧预紧方式进行比较、分析,给出在不同场合建议选用的预紧方式。%In general, the cylinder and valve plate is preloaded by spring in axial piston pump with swash plate. Meanwhile the spring can preload the retainer to make the piston and piston shoe back to the swash plate. The structure is widely used in axial piston pump. At present, the disk spring and coil spring are used often. In this paper, several typical preloading methods with the two types of spring above are dis-cussed and analyzed, and the proper preloading method is suggested in different specific applications.

  11. Increase in twitch force of the adductor pollicis muscle with stabilized preload at constant thumb abduction before and after administration of muscle relaxant

    NARCIS (Netherlands)

    van Santen, G; Wierda, JMKH; Fidler, [No Value

    1999-01-01

    Objective. To determine whether the twitch force of the adductor pollicis remains stable when 0.1 Hz single twitch stimulation is started after stabilization of the thumb preload at a constant degree of thumb abduction; also to study any possible increase in twitch force before the onset of and afte

  12. Recruiting in remote locations

    Energy Technology Data Exchange (ETDEWEB)

    Ionel, C. [Enerflex Systems Ltd., Calgary, AB (Canada)

    2006-07-01

    This presentation provided details of Enerflex, a leading supplier of products and services to the oil and gas industry, and outlined their personnel hiring policies. Enerflex's core values include community involvement and divisional logo branding. The extensive training that is provided places an emphasis on employee empowerment. The company also places an emphasis on employee safety, diversity, and team building. Competitive salaries are offered along with generous equipment allowances and a flexible benefits program. Benefits include travel and overtime rates; health benefits; retirement savings; scholarship programs; career opportunities; and apprenticeship programs. External technical training is provided. An employee referral program has been developed, and the company's recruitment program also advertises in remote newspapers to develop career streams within remote communities. tabs., figs.

  13. eHealth recruitment challenges.

    Science.gov (United States)

    Thompson, Debbe; Canada, Ashanti; Bhatt, Riddhi; Davis, Jennifer; Plesko, Lisa; Baranowski, Tom; Cullen, Karen; Zakeri, Issa

    2006-11-01

    Little is known about effective eHealth recruitment methods. This paper presents recruitment challenges associated with enrolling African-American girls aged 8-10 years in an eHealth obesity prevention program, their effect on the recruitment plan, and potential implications for eHealth research. Although the initial recruitment strategy was literature-informed, it failed to enroll the desired number of girls within a reasonable time period. Therefore, the recruitment strategy was reformulated to incorporate principles of social marketing and traditional marketing techniques. The resulting plan included both targeted, highly specific strategies (e.g., selected churches), and more broad-based approaches (e.g., media exposure, mass mailings, radio advertisements). The revised plan enabled recruitment goals to be attained. Media appeared to be particularly effective at reaching the intended audience. Future research should identify the most effective recruitment strategies for reaching potential eHealth audiences.

  14. Implications of the center of rotation concept for the reconstruction of anterior column lordosis and axial preloads in spinal deformity surgery.

    Science.gov (United States)

    Koller, Heiko; Mayer, Michael; Zenner, Juliane; Resch, Herbert; Niederberger, Alfred; Fierlbeck, Johann; Hitzl, Wolfgang; Acosta, Frank L

    2012-07-01

    In thoracolumbar deformity surgery, anterior-only approaches are used for reconstruction of anterior column failures. It is generally advised that vertebral body replacements (VBRs) should be preloaded by compression. However, little is known regarding the impact of different techniques for generation of preloads and which surgical principle is best for restoration of lordosis. Therefore, the authors analyzed the effect of different surgical techniques to restore spinal alignment and lordosis as well as the ability to generate axial preloads on VBRs in anterior column reconstructions. The authors performed a laboratory study using 7 fresh-frozen specimens (from T-3 to S-1) to assess the ability for lordosis reconstruction of 5 techniques and their potential for increasing preloads on a modified distractable VBR in a 1-level thoracolumbar corpectomy. The testing protocol was as follows: 1) Radiographs of specimens were obtained. 2) A 1-level corpectomy was performed. 3) In alternating order, lordosis was applied using 1 of the 5 techniques. Then, preloads during insertion and after relaxation using the modified distractable VBR were assessed using a miniature load-cell incorporated in the modified distractable VBR. The modified distractable VBR was inserted into the corpectomy defect after lordosis was applied using 1) a lamina spreader; 2) the modified distractable VBR only; 3) the ArcoFix System (an angular stable plate system enabling in situ reduction); 4) a lordosizer (a customized instrument enabling reduction while replicating the intervertebral center of rotation [COR] according to the COR method); and 5) a lordosizer and top-loading screws ([LZ+TLS], distraction with the lordosizer applied on a 5.5-mm rod linked to 2 top-loading pedicle screws inserted laterally into the vertebra). Changes in the regional kyphosis angle were assessed radiographically using the Cobb method. The bone mineral density of specimens was 0.72 ± 22.6 g/cm(2). The maximum regional

  15. Sequential strokes in a hyperacute stroke unit.

    Science.gov (United States)

    Ganesalingam, Jeban; Buddha, Sandeep; Carlton-Jones, Anoma L; Nicholas, Richard

    2014-08-01

    Vasculitis is a rare, but treatable condition that can present to hyperacute stroke units. Thrombolysis does not treat the underlying pathology, and a rapidly evolving clinical picture drives clinical decision often before all the investigation results are available.

  16. Brain activation is related to smoothness of upper limb movements after stroke

    NARCIS (Netherlands)

    Buma, Floor E.; van Kordelaar, Joost; Raemaekers, Matthijs; van Wegen, Erwin E H; Ramsey, Nick F.; Kwakkel, Gert

    2016-01-01

    It is unclear whether additionally recruited sensorimotor areas in the ipsilesional and contralesional hemisphere and the cerebellum can compensate for lost neuronal functions after stroke. The objective of this study was to investigate how increased recruitment of secondary sensorimotor areas is

  17. Blood Pressure Control: Stroke and Stroke Prevention

    Directory of Open Access Journals (Sweden)

    Hans-Christoph Diener

    2005-03-01

    Full Text Available Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention.All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention.Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences.The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.

  18. From Traditional Recruiting To E-Recruiting in Public Organizations

    Directory of Open Access Journals (Sweden)

    ARTENE Adela Suzana

    2013-05-01

    Full Text Available Recruiting is the activity that determines, in quantitative and qualitative terms, the structure of the sample of people from which the selection will be made for a specific position and / or public office, for a position that is already created in the organizational structure. The recruitment process is triggered when in the organizational structure of public institutions appear new functions or positions, or when the existing ones become vacant through retirement, death, transfer or dismissal. E-Recruiting represents the process through which the personnel is recruited using electronic resources.

  19. Validation of Siriraj Stroke Score in southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Chukwuonye II

    2015-10-01

    Full Text Available Innocent Ijezie Chukwuonye,1 Kenneth Arinze Ohagwu,2 Enoch Ogbonnaya Uche,3,4 Abali Chuku,5 Rowland Ihezuo Nwanke,2 Christopher Chukwuemeka Ohagwu,6 Ignatius U Ezeani,7 Collins Ogbonna Nwabuko,8 Martin Anazodo Nnoli,9 Efosa Oviasu,4,10 Okechukwu Samuel Ogah4,11 1Division of Nephrology, 2Division of Neurology, Department of Internal Medicine, Federal Medical Centre, Umuahia, Nigeria; 3Division of Neurosurgery, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria; 4Federal Medical Centre, Umuahia, Nigeria; 5Department of Ophthalmology, Federal Medical Centre, Umuahia, Nigeria; 6Department of Radiography, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria; 7Division of Endocrinology, Department of Internal Medicine, Federal Medical Centre, Umuahia, Nigeria; 8Department of Hematology, Federal Medical Centre, Umuahia, Nigeria; 9Department of Anatomical Pathology, University of Calabar, Calabar, Nigeria; 10Division of Nephrology, Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Nigeria; 11Division of Cardiology, University College Hospital Ibadan, Ibadan, Nigeria Abstract: The aim of the study is to validate the use of Siriraj Stroke Score (SSS in the diagnosis of acute hemorrhagic and acute ischemic stroke in southeast Nigeria. This was a prospective study on validity of SSS in the diagnosis of stroke types in southeast Nigeria. Subjects diagnosed with stroke for whom brain computerized tomography (CT scan was performed on admission were recruited during the study period. SSS was calculated for each subject, and the SSS diagnosis was compared with brain CT scan-based diagnosis. A total of 2,307 patients were admitted in the hospital medical wards during the study period, of whom 360 (15.6% were stroke patients and of these, 113 (31.4% adult subjects met the inclusion criteria. The mean age of the subjects was 66.5±2.6 years. The mean interval between ictus and presentation was 2

  20. Genetics of ischaemic stroke.

    Science.gov (United States)

    Sharma, Pankaj; Yadav, Sunaina; Meschia, James F

    2013-12-01

    Recent advances in genomics and statistical computation have allowed us to begin addressing the genetic basis of stroke at a molecular level. These advances are at the cusp of making important changes to clinical practice of some monogenic forms of stroke and, in the future, are likely to revolutionise the care provided to these patients. In this review we summarise the state of knowledge in ischaemic stroke genetics particularly in the context of how a practicing clinician can best use this knowledge.

  1. Acute stroke imaging research roadmap

    NARCIS (Netherlands)

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Koehrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Warach, Steven

    2008-01-01

    The recent "Advanced Neuroimaging for Acute Stroke Treatment" meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (

  2. Heart Disease and Stroke Prevention

    Science.gov (United States)

    ... Heart Health and Stroke Heart disease and stroke prevention Related information Learn more about healthy eating and ... top More information on Heart disease and stroke prevention Read more from womenshealth.gov A Lifetime of ...

  3. STROKE PREVENTION IN HYPERTENSIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    S. Y. Martsevich

    2006-01-01

    Full Text Available Importance of the stroke as one of the main reason of population mortality and invalidity is considered. Stroke risk factors including arterial hypertension are described. The main pharmacotherapy ways of primary and secondary stroke prevention are discussed.

  4. Nutrition and stroke

    National Research Council Canada - National Science Library

    Huang, Chen Ya

    2007-01-01

    ..., Homocysteinemia, and alcohol are the most significant modifiable risk factors of stroke. Of these, hypertension, diabetes, smoking, hyperlipidemia, homocysteinemia and alcoholism are obviously affected by lifestyle and nutrition...

  5. Determining the Feasibility of Ambulance-Based Randomised Controlled Trials in Patients with Ultra-Acute Stroke: Study Protocol for the “Rapid Intervention with GTN in Hypertensive Stroke Trial” (RIGHT, ISRCTN66434824)

    National Research Council Canada - National Science Library

    Ankolekar, Sandeep; Sare, Gillian; Geeganage, Chamila; Fuller, Michael; Stokes, Lynn; Sprigg, Nikola; Parry, Ruth; Siriwardena, A. Niroshan; Bath, Philip M. W

    2012-01-01

    .... No completed randomised controlled trials of ambulance-based treatment for acute stroke have been reported in the UK, and the practicalities of recruiting, consenting, and treating patients are unknown. Methods...

  6. Determining the Feasibility of Ambulance-Based Randomised Controlled Trials in Patients with Ultra-Acute Stroke: Study Protocol for the "Rapid Intervention with GTN in Hypertensive Stroke Trial" (RIGHT, ISRCTN66434824)

    National Research Council Canada - National Science Library

    Ankolekar, Sandeep; Sare, Gillian; Geeganage, Chamila; Fuller, Michael; Stokes, Lynn; Sprigg, Nikola; Parry, Ruth; Siriwardena, A Niroshan; Bath, Philip M W

    2012-01-01

    .... No completed randomised controlled trials of ambulance-based treatment for acute stroke have been reported in the UK, and the practicalities of recruiting, consenting, and treating patients are unknown. Methods...

  7. The mirror neuron system in post-stroke rehabilitation

    Science.gov (United States)

    2013-01-01

    Different treatments for stroke patients have been proposed; among them the mirror therapy and motion imagery lead to functional recovery by providing a cortical reorganization. Up today the basic concepts of the current literature on mirror neurons and the major findings regarding the use of mirror therapy and motor imagery as potential tools to promote reorganization and functional recovery in post-stroke patients. Bibliographic research was conducted based on publications over the past thirteen years written in English in the databases Scielo, Pubmed/MEDLINE, ISI Web of Knowledge. The studies showed how the interaction among vision, proprioception and motor commands promotes the recruitment of mirror neurons, thus providing cortical reorganization and functional recovery of post-stroke patients. We conclude that the experimental advances on Mirror Neurons will bring new rational therapeutic approaches to post-stroke rehabilitation. PMID:24134862

  8. Body Mass Index and Stroke

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2013-01-01

    Although obesity is associated with excess mortality and morbidity, mortality is lower in obese than in normal weight stroke patients (the obesity paradox). Studies now indicate that obesity is not associated with increased risk of recurrent stroke in the years after first stroke. We studied...... the association between body mass index (BMI) and stroke patient's risk of having a history of previous stroke (recurrent stroke)....

  9. Spontaneous ischaemic stroke in dogs

    DEFF Research Database (Denmark)

    Gredal, Hanne Birgit; Skerritt, G. C.; Gideon, P.

    2013-01-01

    Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.......Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms....

  10. Thrombophilia risk is not increased in children after perinatal stroke.

    Science.gov (United States)

    Curtis, Colleen; Mineyko, Aleksandra; Massicotte, Patricia; Leaker, Michael; Jiang, Xiu Yan; Floer, Amalia; Kirton, Adam

    2017-03-03

    Perinatal stroke causes cerebral palsy and lifelong disability. Specific diseases are definable but mechanisms are poorly understood. Evidence suggests possible associations between arterial perinatal stroke and prothrombotic disorders but population-based, controlled, disease-specific studies are limited. Understanding thrombophilia in perinatal stroke informs pathogenesis models and clinical management. We conducted a population-based, prospective, case-control study to determine the association of specific perinatal stroke diseases with known thrombophilias. Children with idiopathic, MRI-classified neonatal arterial ischemic stroke (NAIS), arterial presumed perinatal ischemic stroke (APPIS), or fetal periventricular venous infarction (PVI) were recruited. Standardized thrombophilia evaluations were performed after 12 months of age on stroke cases and controls including quantified protein C and S, antithrombin, factors VIII/IX/XI, fibrinogen, lipoprotein(a), homocysteine, lupus anticoagulant, anticardiolipin antibodies and genotyping of factor V Leiden (FVL), factor II G20210A (FII), and MTHFR C677T. A total of 212 children were studied: 46 NAIS, 34 APPIS, 55 PVI, and 77 controls (53% male, median 4.8 years). Of 14 parameters, no differences were observed in 12 including all common thrombophilias. Mean prothrombin time was shorter in arterial strokes (p<0.001). Rates of antiphospholipid antibodies were low, comparable to controls, and resolved on repeat testing. FVL and FII rates were comparable to population norms. Total number of possible abnormalities did not differ between cases and controls. Our prospective, population-based, controlled, disease-specific study suggests minimal association between perinatal stroke and thrombophilia. This does not exclude the possibility of disordered coagulation at the time of stroke but suggests testing in childhood is not indicated.

  11. Psychosocial Outcomes in StrokE: the POISE observational stroke study protocol

    Directory of Open Access Journals (Sweden)

    Jan Stephen

    2009-06-01

    Full Text Available Abstract Background Each year, approximately 12,000 Australians of working age survive a stroke. As a group, younger stroke survivors have less physical impairment and lower mortality after stroke compared with older survivors; however, the psychosocial and economic consequences are potentially substantial. Most of these younger stroke survivors have responsibility for generating an income or providing family care and indicate that their primary objective is to return to work. However, effective vocational rehabilitation strategies to increase the proportion of younger stroke survivors able to return to work, and information on the key target areas for those strategies, are currently lacking. Methods/Design This multi-centre, three year cohort study will recruit a representative sample of younger ( Discussion The study is designed to identify targets for rehabilitation-, social- and medical-intervention strategies that promote and maintain healthy ageing in people with cardiovascular and mental health conditions, two of the seven Australian national health priority areas. This will rectify the paucity of information internationally around optimal clinical practice and social policy in this area.

  12. Elevated Troponin Level with Negative Outcome Was Found in Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Buse Hasırcı

    2013-01-01

    Full Text Available Background. Troponin increment is a highly sensitive and specific marker of myocardial necrosis. The reason of high troponin levels in acute stroke is not clear. The aim of this study was to identify the relationships between cardiac troponin-I (cTnI level and stroke. Methods. This study recruited 868 patients who were admitted to Istanbul Medeniyet University due to acute ischemic stroke, and the diagnosis was confirmed by diffusion magnetic resonance imaging. The patients with the causes increasing troponin level were excluded from the study. A total of 239 patients were finally included in the study. Clinics were evaluated by the modified Rankin Scale (mRS and the National Institutes of Health Stroke Scale (NIHSS. Results. Serum level of troponin was higher in ischemic stroke patients with anterior circulation involvement in comparison to posterior involvement or hemorrhagic stroke (. Higher troponin levels related to increased stroke scale scores at discharge in ischemic stroke (. The level of cTnI was correlated with stroke scale scores at both admission and discharge in posterior stroke patients (. Conclusion. cTnI is a highly specific and sensitive marker of myocardial damage, and its elevation was associated with more severe neurological deficits in acute ischemic stroke.

  13. Preventable Pediatric Stroke via Vaccination?

    OpenAIRE

    Press, Craig A.; Wainwright, Mark S

    2015-01-01

    Investigators from the Vascular Effects of Infection in Pediatric Stroke (VIPS) group studied the risk of arterial ischemic stroke (AIS) associated with minor infection and routine childhood vaccinations.

  14. Secondary Stroke Prevention in Cryptogenic Stroke and Embolic Stroke of Undetermined Source (ESUS).

    Science.gov (United States)

    Diener, Hans-Christoph; Bernstein, Richard; Hart, Robert

    2017-09-01

    The purpose of the study was to review the literature on cryptogenic stroke and embolic stroke of undetermined stroke (ESUS). Cryptogenic stroke according to TOAST criteria is a stroke which is not due to cardiogenic embolism, small vessel disease with lacunes or large vessel disease of brain supplying arteries. In the context of secondary stroke prevention studies, cryptogenic stroke is not operationally defined. The new concept of "embolic stroke of undetermined source" (ESUS) provides an operational definition. ESUS is diagnosed as a non-lacunar stroke on cerebral imaging and exclusion of large vessel atherosclerosis by CTA, MRA or ultrasound. Cardiogenic embolism is made less likely by ECG monitoring and echocardiography. At present, aspirin is used for secondary stroke prevention in patients with cryptogenic stroke. Based on the construct that ESUS might be caused by undetected atrial fibrillation or other embolic mechanisms, ongoing randomised secondary stroke prevention trials are comparing non-vitamin K oral anticoagulants (NOACs) with aspirin.

  15. Recruit and ADVANCE

    Science.gov (United States)

    Rosser, Sue V.

    2007-04-01

    Beginning in 2001, the National Science Foundation launched the ADVANCE Initiative, which has now awarded more than 70 million to some thirty institutions for transformations to advance women. Results of studies on how to attract and retain women students and faculty underpinned our ADVANCE Institutional Transformation grant funded by the NSF for 3.7 million for five years, beginning in 2001. As co-principal investigator on this grant, I insured that this research informed the five major threads of the grant: 1) Four termed ADVANCE professors to mentor junior women faculty in each college; 2) Collection of MIT-Report-like data indicators to assess whether advancement of women really occurs during and after the institutional transformation undertaken through ADVANCE; 3) Family-friendly policies and practices to stop the tenure clock and provide active service, modified duties, lactation stations and day care; 4) Mini-retreats to facilitate access for tenure-track women faculty to male decision-makers and administrators for informal conversations and discussion on topics important to women faculty; 5) Removal of subtle gender, racial, and other biases in promotion and tenure. The dynamic changes resulting from the grant in quality of mentoring, new understanding of promotion and tenure, numbers of women retained and given endowed chairs, and emergence of new family friendly policies gave me hope for genuine diversification of leadership in science and technology. As the grant funding ends, the absence of NSF prestige and monitoring, coupled with a change in academic leadership at the top, provide new challenges for institutionalization, recruitment, and advancement of women into leadership positions in science and engineering.

  16. Self-perceived psychological stress and ischemic stroke: a case-control study

    Directory of Open Access Journals (Sweden)

    Blomstrand Christian

    2009-10-01

    Full Text Available Abstract Background A growing body of evidence suggests that psychological stress contributes to coronary artery disease. However, associations between stress and stroke are less clear. In this study, we investigated the possible association between ischemic stroke and self-perceived psychological stress, as measured by a single-item questionnaire, previously reported to be associated with myocardial infarction. Methods In the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS, 600 consecutive patients with acute ischemic stroke (aged 18 to 69 years and 600 age-matched and sex-matched population controls were recruited. Ischemic stroke subtype was determined according to Trial of Org 10172 in Acute Stroke Treatment (TOAST criteria. Self-perceived psychological stress preceding stroke was assessed retrospectively using a single-item questionnaire. Results Permanent self-perceived psychological stress during the last year or longer was independently associated with overall ischemic stroke (multivariate adjusted odds ratio (OR 3.49, 95% confidence interval (CI 2.06 to 5.93. Analyses by stroke subtype showed that this association was present for large vessel disease (OR 3.91, 95% CI 1.58 to 9.67, small vessel disease (OR 3.20, 95% CI 1.64 to 6.24, and cryptogenic stroke (OR 4.03, 95% CI 2.34 to 6.95, but not for cardioembolic stroke (OR 1.48, 95% CI 0.64 to 3.39. Conclusion In this case-control study, we found an independent association between self-perceived psychological stress and ischemic stroke. A novel finding was that this association differed by ischemic stroke subtype. Our results emphasize the need for further prospective studies addressing the potential role for psychological stress as a risk factor for ischemic stroke. In such studies ischemic stroke subtypes should be taken into consideration.

  17. Preload dependence of new Doppler techniques limits their utility for left ventricular diastolic function assessment in hemodialysis patients.

    Science.gov (United States)

    Ie, Eric H Y; Vletter, Wim B; ten Cate, Folkert J; Nette, Robert W; Weimar, Willem; Roelandt, Jos R T C; Zietse, Robert

    2003-07-01

    Left ventricular (LV) hypertrophy leads to diastolic dysfunction. Standard Doppler transmitral and pulmonary vein (PV) flow velocity measurements are preload dependent. New techniques such as mitral annulus velocity by Doppler tissue imaging (DTI) and LV inflow propagation velocity measured from color M-mode have been proposed as relatively preload-independent measurements of diastolic function. These parameters were studied before and after hemodialysis (HD) with ultrafiltration to test their potential advantage for LV diastolic function assessment in HD patients. Ten patients (seven with LV hypertrophy) underwent Doppler echocardiography 1 h before, 1 h after, and 1 d after HD. Early (E) and atrial (A) peak transmitral flow velocities, peak PV systolic (s) and diastolic (d) flow velocities, peak e and a mitral annulus velocities in DTI, and early diastolic LV flow propagation velocity (V(p)) were measured. In all patients, the E/A ratio after HD (0.54; 0.37 to 1.02) was lower (P < 0.01) than before HD (0.77; 0.60 to 1.34). E decreased (P < 0.01), whereas A did not. PV s/d after HD (2.15; 1.08 to 3.90) was higher (P < 0.01) than before HD (1.80; 1.25 to 2.68). Tissue e/a after HD (0.40; 0.26 to 0.96) was lower (P < 0.01) than before HD (0.56; 0.40 to 1.05). Tissue e decreased (P < 0.02), whereas a did not. V(p) after HD (30 cm/s; 16 to 47 cm/s) was lower (P < 0.01) than before HD (45 cm/s; 32 to 60 cm/s). Twenty-four hours after the initial measurements values for E/A (0.59; 0.37 to 1.23), PV s/d (1.85; 1.07 to 3.38), e/a (0.41; 0.27 to 1.06), and V(p) (28 cm/s; 23 to 33 cm/s) were similar as those taken 1 h after HD. It is concluded that, even when using the newer Doppler techniques DTI and color M-mode, pseudonormalization, which was due to volume overload before HD, resulted in underestimation of the degree of diastolic dysfunction. Therefore, the advantage of these techniques over conventional parameters for the assessment of LV diastolic function in HD

  18. Virtual reality for stroke rehabilitation.

    Science.gov (United States)

    Laver, Kate E; George, Stacey; Thomas, Susie; Deutsch, Judith E; Crotty, Maria

    2015-02-12

    Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation. In particular, commercial gaming consoles have been rapidly adopted in clinical settings. This is an update of a Cochrane Review published in 2011. To determine the efficacy of virtual reality compared with an alternative intervention or no intervention on upper limb function and activity. To determine the efficacy of virtual reality compared with an alternative intervention or no intervention on: gait and balance activity, global motor function, cognitive function, activity limitation, participation restriction and quality of life, voxels or regions of interest identified via imaging, and adverse events. Additionally, we aimed to comment on the feasibility of virtual reality for use with stroke patients by reporting on patient eligibility criteria and recruitment. We searched the Cochrane Stroke Group Trials Register (October 2013), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2013, Issue 11), MEDLINE (1950 to November 2013), EMBASE (1980 to November 2013) and seven additional databases. We also searched trials registries and reference lists. Randomised and quasi-randomised trials of virtual reality ("an advanced form of human-computer interface that allows the user to 'interact' with and become 'immersed' in a computer-generated environment in a naturalistic fashion") in adults after stroke. The primary outcome of interest was upper limb function and activity. Secondary outcomes included gait and balance function and activity, and global motor function. Two review authors independently selected trials based on pre-defined inclusion criteria, extracted data and assessed risk of bias. A third review author moderated disagreements when required. The authors contacted investigators to obtain missing information. We included 37 trials that involved 1019 participants. Study sample sizes were generally small and interventions

  19. Use of Occupational Performance Coaching for stroke survivors (OPC-Stroke in late rehabilitation: A descriptive case study

    Directory of Open Access Journals (Sweden)

    Danika Belliveau

    2016-04-01

    Full Text Available Background: Stroke is a leading cause of disability in adults. Following stroke, 60% of people report needing help with everyday activities, and 80% report having very few meaningful activities. These restrictions often continue for years. This study explored the efficacy of Occupational Performance Coaching for stroke survivors (OPC-Stroke on the participation level of adults in the later stage of stroke rehabilitation. Method: A descriptive case study design was used. One participant in the later stages of rehabilitation was recruited. Outcome measures for participation, goal performance and satisfaction, and emotional well-being were administered pre and postintervention to observe for direction of change. A semi-structured interview was carried out postintervention to explore the participant’s experiences of the intervention. Results: The participant who took part in the study reported improvement with his goal performance and satisfaction. However, the level of participation did not improve and emotional well-being decreased. Qualitative data revealed an appreciation of the intervention and a recommendation of the intervention for others. Conclusion: OPC-Stroke was valued by the participant and shows promise for improving goal performance and satisfaction. Further research is necessary to determine the potential efficacy of OPC-Stroke in later stages of rehabilitation.

  20. 6 CFR 17.310 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Recruitment. 17.310 Section 17.310 Domestic... in Admission and Recruitment Prohibited § 17.310 Recruitment. (a) Nondiscriminatory recruitment. A... recruitment and admission of students. A recipient may be required to undertake additional recruitment efforts...

  1. 40 CFR 5.310 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Recruitment. 5.310 Section 5.310... in Admission and Recruitment Prohibited § 5.310 Recruitment. (a) Nondiscriminatory recruitment. A... recruitment and admission of students. A recipient may be required to undertake additional recruitment efforts...

  2. 14 CFR 1253.310 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Recruitment. 1253.310 Section 1253.310... in Admission and Recruitment Prohibited § 1253.310 Recruitment. (a) Nondiscriminatory recruitment. A... recruitment and admission of students. A recipient may be required to undertake additional recruitment efforts...

  3. 43 CFR 41.310 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Recruitment. 41.310 Section 41.310 Public... in Admission and Recruitment Prohibited § 41.310 Recruitment. (a) Nondiscriminatory recruitment. A... recruitment and admission of students. A recipient may be required to undertake additional recruitment efforts...

  4. 41 CFR 101-4.310 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Recruitment. 101-4.310... Admission and Recruitment Prohibited § 101-4.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient... recruitment and admission of students. A recipient may be required to undertake additional recruitment efforts...

  5. 28 CFR 54.310 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Recruitment. 54.310 Section 54.310... in Admission and Recruitment Prohibited § 54.310 Recruitment. (a) Nondiscriminatory recruitment. A... recruitment and admission of students. A recipient may be required to undertake additional recruitment efforts...

  6. 15 CFR 8a.310 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Recruitment. 8a.310 Section 8a.310... in Admission and Recruitment Prohibited § 8a.310 Recruitment. (a) Nondiscriminatory recruitment. A... recruitment and admission of students. A recipient may be required to undertake additional recruitment efforts...

  7. Diversity employment and recruitment sources

    Energy Technology Data Exchange (ETDEWEB)

    1994-08-01

    Effective human resources management has been identified as one of four critical success factors in the Department of Energy Strategic Plan. The Plan states relative to this factor: ``The Department seeks greater alignment of resources with agency priorities and increased diversification of the workforce, including gender, ethnicity, age, and skills. This diversification will bring new thinking and perspectives that heretofore have not had a voice in departmental decision-making.`` This Guide has been developed as a key tool to assist Department of Energy management and administrative staff in achieving Goal 2 of this critical success factor, which is to ``Ensure a diverse and talented workforce.`` There are numerous sources from which to recruit minorities, women and persons with disabilities. Applying creativity and proactive effort, using traditional and non-traditional approaches, and reaching out to various professional, academic and social communities will increase the reservoir of qualified candidates from which to make selections. In addition, outreach initiatives will undoubtedly yield further benefits such as a richer cultural understanding and diversity awareness. The resource listings presented in this Guide are offered to encourage active participation in the diversity recruitment process. This Guide contains resource listings by state for organizations in the following categories: (1) African American Recruitment Sources; (2) Asian American/Pacific Islander Recruitment Sources; (3) Hispanic Recruitment Sources; (4) Native American/Alaskan Native Recruitment Sources; (5) Persons with Disabilities Recruitment Sources; and (6) Women Recruitment Sources.

  8. Recruiting and Supporting Latino Volunteers.

    Science.gov (United States)

    Hobbs, Beverly B.

    This booklet is intended to help volunteer recruiters better understand characteristics of the Latino community that might impact volunteering. It also suggests strategies or steps to use in successfully recruiting and supporting Latino volunteers. Information is based on a study of Latinos and volunteerism conducted in Oregon in 1999. The…

  9. Recruiting and Supporting Latino Volunteers.

    Science.gov (United States)

    Hobbs, Beverly B.

    This booklet is intended to help volunteer recruiters better understand characteristics of the Latino community that might impact volunteering. It also suggests strategies or steps to use in successfully recruiting and supporting Latino volunteers. Information is based on a study of Latinos and volunteerism conducted in Oregon in 1999. The…

  10. Three Keys to Better Recruiting

    Science.gov (United States)

    Brazington, Alicia

    2012-01-01

    Recruitment is an expensive business: In 2010-2011, the median cost to recruit an undergraduate was $2,185 among private colleges and universities, according to Noel-Levitz, an enrollment management consultancy. In these tough fiscal times, admissions departments are under pressure to keep those costs down even as they pursue higher enrollment and…

  11. The Optimal Golf Stroke

    DEFF Research Database (Denmark)

    Buchinger, Mikael; Durigen, Susan; Dahl, Johan Rambech

    2006-01-01

    The paper presents a preliminary investigation into aspects of the game of golf. A series of models is proposed for the golf stroke, the momentum transfer between club and ball and the flight of the ball.Numerical and asymptotic solutions are presented reproducing many of the features observed...... in the golf stroke of a professional golfer....

  12. Relational Processing Following Stroke

    Science.gov (United States)

    Andrews, Glenda; Halford, Graeme S.; Shum, David; Maujean, Annick; Chappell, Mark; Birney, Damian

    2013-01-01

    The research examined relational processing following stroke. Stroke patients (14 with frontal, 30 with non-frontal lesions) and 41 matched controls completed four relational processing tasks: sentence comprehension, Latin square matrix completion, modified Dimensional Change Card Sorting, and n-back. Each task included items at two or three…

  13. Strokes (For Parents)

    Science.gov (United States)

    ... the brain that's affected and the amount of damage the stroke causes. More likely, a parent first notices changes ... rehabilitation and therapy. previous continue Complications The brain damage that occurs during a stroke can cause a number of other problems that ...

  14. GANGGUAN MOOD PADA STROKE

    Directory of Open Access Journals (Sweden)

    Gabriella Tantular

    2015-10-01

    Full Text Available Stroke adalah salah satu sindrom neurologi yang dapat menimbulkan kecacatan dalam kehidupanmanusia. Salah  satu gejala yang dapat  timbul  setelah  seseorang  terkena  stroke adalah gangguanmood. Gangguan mood berhubungan dengan disabilitas fisik, beratnya stroke dan gangguan kognitif.Gangguan mood yang ditemukan pada stroke adalah depresi, gangguan afektif bipolar dan mania.Gambaran  gejala  berhubungan dengan  lesi  anatomis  stroke. Terapi  yang diberikan dapat  berupafarmakologis, psikoterapi, dan rehabilitasi. [MEDICINA 2015;46:33-36].Stroke is one of neurology syndrome that cause disability in human life. One of the symptoms thatappear after stroke was mood disorder. Mood disorder were related to physical disability, severity ofstroke  and  cognitive  dysfunction. Mood  disorder  found  in  stroke was  depression,  affective  bipolardisorder, and mania. Symptoms were associated with anatomical lesion. Treatment for this disorderare pharmacologic treatment, psychotherapy, and rehabilitation. [MEDICINA 2015;46:33-36].

  15. The Danish Stroke Registry

    DEFF Research Database (Denmark)

    Johnsen, Søren Paaske; Ingeman, Annette; Hundborg, Heidi Holmager

    2016-01-01

    AIM OF DATABASE: The aim of the Danish Stroke Registry is to monitor and improve the quality of care among all patients with acute stroke and transient ischemic attack (TIA) treated at Danish hospitals. STUDY POPULATION: All patients with acute stroke (from 2003) or TIA (from 2013) treated...... at Danish hospitals. Reporting is mandatory by law for all hospital departments treating these patients. The registry included >130,000 events by the end of 2014, including 10,822 strokes and 4,227 TIAs registered in 2014. MAIN VARIABLES: The registry holds prospectively collected data on key processes...... of care, mainly covering the early phase after stroke, including data on time of delivery of the processes and the eligibility of the individual patients for each process. The data are used for assessing 18 process indicators reflecting recommendations in the national clinical guidelines for patients...

  16. Stroke risk factors among participants of a world stroke day ...

    African Journals Online (AJOL)

    2015-04-20

    Apr 20, 2015 ... stroke day awareness program in an urban area of Nigeria. Community ... of ischemic stroke was 1.64 in obese versus healthy subjects and 1.22 in .... Acute stroke mortality at Lagos University Teaching Hospital‑A five ... A review of stroke admissions at a tertiary hospital in rural Southwestern. Nigeria.

  17. Neural recruitment associated with anomia treatment in aphasia.

    Science.gov (United States)

    Fridriksson, Julius; Morrow-Odom, Leigh; Moser, Dana; Fridriksson, Astrid; Baylis, Gordon

    2006-09-01

    The purpose of this study was to investigate changes in the spatial distribution of cortical activity associated with anomia treatment in three persons with aphasia. Participants underwent three fMRI sessions before and after a period of intensive language treatment focused on object naming. The results revealed bilateral hemispheric recruitment associated with improved ability to name items targeted in treatment. This is the first study to employ multiple pre- and post-treatment fMRI sessions in the study of treatment-induced recovery from aphasia and has implications for future studies of brain plasticity in stroke.

  18. Stroke and Women

    Directory of Open Access Journals (Sweden)

    Gülçin Benbir

    2013-12-01

    Full Text Available OBJECTIVE: We aimed to investigate the differences in vascular risk factor and etiology of stroke in two sexes. METHODS: We reviewed the medical files of 2798 patients being followed-up in our Stroke Clinic between the years 1996-2011. The stroke subtypes and risk factors were recorded on the basis of clinical data, physical and neurological examinations, and neuroimaging findings. Data were collected in SPSS 11.5 system and Pearson chi-square and Mann-Whitney U tests were used for statistical analysis. RESULTS: Of a total of 2798 patients, 2564 patients (91,6% had ischemic stroke, and 234 of them (8,4% had hemorrhagic stroke. The mean follow-up duration was 50.2+42.7 months. Of whole study population, 1289 patients were women (46%, 1509 of them were men (54%. The analysis of stroke subtypes showed that the most common subtype was stroke of unknown etiology in both sexes. Following this, the most common subtype was atherothrombotic stroke in men, and cardioembolic stroke in women. Coronary heart disease was more common in men, while atrial fibrillation and other rhythm anomalies were more common in women. Smoking and alcohol consumption were more common in men. CONCLUSION: Our study showed that there are major differences in stroke subtypes and vascular risk factors. Better knowledge of these differences, as well as influencing factors, is of crucial value – in addition to the need of hormonal changes, pregnancy and depression to be better identified in women – for both primary and secondary prevention.

  19. Design of a cluster-randomized minority recruitment trial: RECRUIT.

    Science.gov (United States)

    Tilley, Barbara C; Mainous, Arch G; Smith, Daniel W; McKee, M Diane; Amorrortu, Rossybelle P; Alvidrez, Jennifer; Diaz, Vanessa; Ford, Marvella E; Fernandez, Maria E; Hauser, Robert A; Singer, Carlos; Landa, Veronica; Trevino, Aron; DeSantis, Stacia M; Zhang, Yefei; Daniels, Elvan; Tabor, Derrick; Vernon, Sally W

    2017-06-01

    Racial/ethnic minority groups remain underrepresented in clinical trials. Many strategies to increase minority recruitment focus on minority communities and emphasize common diseases such as hypertension. Scant literature focuses on minority recruitment to trials of less common conditions, often conducted in specialty clinics and dependent on physician referrals. We identified trust/mistrust of specialist physician investigators and institutions conducting medical research and consequent participant reluctance to participate in clinical trials as key-shared barriers across racial/ethnic groups. We developed a trust-based continuous quality improvement intervention to build trust between specialist physician investigators and community minority-serving physicians and ultimately potential trial participants. To avoid the inherent biases of non-randomized studies, we evaluated the intervention in the national Randomized Recruitment Intervention Trial (RECRUIT). This report presents the design of RECRUIT. Specialty clinic follow-up continues through April 2017. We hypothesized that specialist physician investigators and coordinators trained in the trust-based continuous quality improvement intervention would enroll a greater proportion of minority participants in their specialty clinics than specialist physician investigators in control specialty clinics. Specialty clinic was the unit of randomization. Using continuous quality improvement, the specialist physician investigators and coordinators tailored recruitment approaches to their specialty clinic characteristics and populations. Primary analyses were adjusted for clustering by specialty clinic within parent trial and matching covariates. RECRUIT was implemented in four multi-site clinical trials (parent trials) supported by three National Institutes of Health institutes and included 50 associated specialty clinics from these parent trials. Using current data, we have 88% power or greater to detect a 0.15 or

  20. Preloading with L-BPA, L-tyrosine and L-DOPA enhances the uptake of [(18)F]FBPA in human and mouse tumour cell lines.

    Science.gov (United States)

    Wingelhofer, Bettina; Kreis, Katharina; Mairinger, Severin; Muchitsch, Viktoria; Stanek, Johann; Wanek, Thomas; Langer, Oliver; Kuntner, Claudia

    2016-12-01

    Aim of this study was to investigate if cellular [(18)F]FBPA uptake can be increased upon preloading with amino acids. [(18)F]FBPA uptake was assessed in HuH-7, CaCo-2 and B16-F1 cells pretreated with different concentrations or incubation times of L-BPA, L-tyrosine or L-DOPA. Without preloading, highest uptake of [(18)F]FBPA was observed in B16-F1 cells, followed by CaCo-2 cells and HuH-7 cells. In all cell lines higher [(18)F]FBPA accumulation (up to 1.65-fold) was obtained with increasing L-BPA, L-DOPA and L-tyrosine concentrations.

  1. Effect of Right Insular Involvement on Death and Functional Outcome After Acute Ischemic Stroke in the IST-3 Trial (Third International Stroke Trial).

    Science.gov (United States)

    Sposato, Luciano A; Cohen, Geoffrey; Wardlaw, Joanna M; Sandercock, Peter; Lindley, Richard I; Hachinski, Vladimir

    2016-12-01

    In patients with acute ischemic stroke, whether involvement of the insular cortex influences outcome is controversial. Much of the apparent adverse outcome may relate to such strokes usually being severe. We examined the influence of right and left insular involvement on stroke outcomes among patients from the IST-3 study (Third International Stroke Trial) who had visible ischemic stroke on neuroimaging. We used multiple logistic regression to compare outcomes of left versus right insular and noninsular strokes across strata of stroke severity, on death, proportion dead or dependent, and level of disability (ordinalized Oxford Handicap Score) at 6 months, with adjustment for the effects of age, lesion size, and presence of atrial fibrillation. Of 3035 patients recruited, 2099 had visible ischemic strokes limited to a single hemisphere on computed tomography/magnetic resonance scans. Of these, 566 and 714 had infarction of right and left insula. Six months after randomization, right insular involvement was associated with increased odds of death when compared with noninsular strokes on the left side (adjusted odds ratio, 1.83; 95% confidence interval, 1.33-2.52), whereas the adjusted odds ratio comparing mortality after insular versus noninsular strokes on the left side was not significant. Among mild/moderate strokes, outcomes for right insular involvement were worse than for left insular, but among more severe strokes, the difference in outcomes was less substantial. We found an association between right insular involvement and higher odds of death and worse functional outcome. The difference between right- and left-sided insular lesions on outcomes seemed to be most evident for mild/moderate strokes. URL: http://www.isrctn.com. Unique identifier: ISRCTN25765518. © 2016 American Heart Association, Inc.

  2. Prevention of altered hemodynamics after spinal anesthesia: A comparison of volume preloading with tetrastarch, succinylated gelatin and ringer lactate solution for the patients undergoing lower segment caesarean section

    Directory of Open Access Journals (Sweden)

    Tapobrata Mitra

    2014-01-01

    Full Text Available Background: Spinal anesthesia has replaced general anesthesia in obstetric practice. Hemodynamic instability is a common, but preventable complication of spinal anesthesia. Preloading the circulation with intravenous fluids is considered a safe and effective method of preventing hypotension following spinal anesthesia. We had conducted a study to compare the hemodynamic stability after volume preloading with either Ringer′s lactate (RL or tetrastarch hydroxyethyl starch (HES or succinylated gelatin (SG in the patients undergoing cesarean section under spinal anesthesia. Materials and Methods: It was a prospective, double-blinded and randomized controlled study. Ninety six ASA-I healthy, nonlaboring parturients were randomly divided in 3 groups HES, SG, RL (n = 32 each and received 10 ml/kg HES 130/0.4; 10 ml/kg SG (4% modified fluid gelatin and 20 ml/kg RL respectively prior to SA scheduled for cesarean section. Heart rate, blood pressure (BP, oxygen saturation was measured. Results: The fall in systolic blood pressure (SBP (<100 mm Hg noted among 5 (15.63%, 12 (37.5% and 14 (43.75% parturients in groups HES, SG, RL respectively. Vasopressor (phenylephrine was used to treat hypotension when SBP <90 mm Hg. Both the results and APGAR scores were comparable in all the groups. Lower preloading volume and less intra-operative vasopressor requirement was noted in HES group for maintaining BP though it has no clinical significance. Conclusion: RL which is cheap, physiological and widely available crystalloid can preload effectively and maintain hemodynamic stability well in cesarean section and any remnant hypotension can easily be manageable with vasopressor.

  3. Shot peening under preloading conditions. Influence on residual stress state and fatigue of components. Festigkeitsstrahlen unter Vorspannung. Auswirkung auf Eigenspannungszustand und Schwingfestigkeit von Bauteilen

    Energy Technology Data Exchange (ETDEWEB)

    Engelmohr, F. (BMW AG, Muenchen (Germany). Hauptabteilung Betriebsfestigkeit); Fiedler, B. (BMW AG, Muenchen (Germany). Hauptabteilung Betriebsfestigkeit)

    1994-10-01

    Lightweight construction of vehicles supports saving of energy. The service life and fatigue strength of certain car components can be improved by shot peening under preloading conditions. Simultaneously the scattering may be reduced. This enables to reduce the weight of those components. This paper deals with the reasons for increasing the fatigue strength and decreasing of its scattering as well as the influence of parameters on these properties for the examples of piston rods and barrel springs. (orig.)

  4. Risks for Heart Disease & Stroke

    Science.gov (United States)

    ... for Heart Disease & Stroke Risks for Heart Disease & Stroke About 1.5 million heart attacks and strokes happen every year in the United States. You ... some of your risks for heart disease and stroke, but you can manage many of your risks ...

  5. Third European Stroke Science Workshop

    NARCIS (Netherlands)

    Dichgans, Martin; Planas, Anna M.; Biessels, Geert Jan; van der Worp, Bart; Sudlow, Cathie; Norrving, B.; Lees, Kennedy; Mattle, Heinrich P.

    2016-01-01

    Lake Eibsee, Garmisch-Partenkirchen, November 19 to 21, 2015: The European Stroke Organization convened >120 stroke experts from 27 countries to discuss latest results and hot topics in clinical, translational, and basic stroke research. Since its inception in 2011, the European Stroke Science

  6. Human Resources Marketing and Recruiting: Essentials of Digital Recruiting

    CERN Document Server

    Purvis, James

    2016-01-01

    This chapter will cover digital recruitment from its definition thru to its history in recruitment and trends. The subject itself could cover an entire book or an entire module at university, so this chapter will broadly touch upon the key elements and considerations. Under cultural perspective, the recruitment life cycle will be broken down into its individual parts, and digital solutions will be examined for each individual part of the process together with the impact this has on the knowledge and challenges for the manager and team. The economic perspective will assist in prioritizing initiatives and building a business case for the introduction of digital recruiting solutions. The risk perspective will raise awareness of the potential pitfalls and the operational perspective on the key considerations for a successful implementation. Finally, the key messages of this chapter are summarized in the Do’s and Don’ts.

  7. In vivo release by vagal stimulation of L-/sup 3/Hglutamic acid in the nucleus tractus solitarius preloaded with L-/sup 3/Hglutamine

    Energy Technology Data Exchange (ETDEWEB)

    Granata, A.R.; Sved, A.F.; Reis, D.J.

    1984-01-01

    In anesthetized and paralyzed rats, using a push-pull perfusion technique, we examined the effect of bilateral vagal stimulation on the release of L-/sup 3/Hglutamic acid (L-/sup 3/HGlu) from the nucleus tractus solitarius (NTS), after preloading the tissue either with L-/sup 3/HGlu or L-/sup 3/Hglutamine (L-/sup 3/HGln). Vagal stimulation sufficient to produce a maximum fall of arterial pressure (AP) evoked release of L-/sup 3/HGlu from the NTS when the tissue was preloaded with either /sup 3/H-Glu or /sup 3/H-Gln, and of D-/sup 3/Haspartic acid (D-/sup 3/HAsp) when this stable Glu analogue was used to preloaded with either /sup 3/H-Glu or /sup 3/H-Gln, and of D-/sup 3/H precursor L-Gln is a good marker of the releasable pool of L-Glu in vivo and are consistent with the hypothesis that L-/sup 3/HGlu is a neurotransmitter in the NTS, mediating the vasodepressor response from cardiopulmonary mechanoreceptors.

  8. Sales Training for Army Recruiter Success: Interviews with Excellent Recruiters

    Science.gov (United States)

    1987-11-01

    merit of an expert modeling system of the skills and strategies used by excel- lent Army recruiters. Neurolinguistic programming (NLP) was used as the...7. AUTHOR(&) 8. CONTRACT OR GRANT NUMBER(s) Steven R. Frieman 9. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ELEMENT. PROJECT, TASK U.S...Recruiting 2M AUSTIRACT (rcnttm ame r orw am nssry i Identify by block number) s-This report describes a program of research on communication strategies and

  9. Navy Enlisted Recruiting: Alternatives for Improving Recruiter Productivity

    Science.gov (United States)

    2013-03-01

    screening process and understanding the differences in cognitive ability, the different cultures of each rating, and their correlation to recruiting...process and understanding the differences in cognitive ability, the different cultures of each rating, and their correlation to recruiting performance...of the seven months that it took to complete this research. A special Bravo Zulu to my advisors, Professor Jeremy Arkes, Professor Steve Mehay, and

  10. Dizziness in stroke

    Directory of Open Access Journals (Sweden)

    M. V. Zamergrad

    2015-01-01

    Full Text Available Differential diagnosis of new-onset acute vestibular vertigo is chiefly made between vestibular neuronitis and stroke. Dizziness in stroke is usually accompanied by other focal neurological symptoms of brainstem and cerebellar involvement. However, stroke may appear as isolated vestibular vertigo in some cases. An analysis of history data and the results of neurovestibular examination and brain magnetic resonance imaging allows stroke to be diagnosed in patients with acute isolated dizziness. The treatment of patients with stroke-induced dizziness involves a wide range of medications for the reduction of the degree of dizziness and unsteadiness and for the secondary prevention of stroke. Vestibular rehabilitation is an important component of treatment. The paper describes an observation of a patient with poorly controlled hypertension, who developed new-onset acute systemic dizziness. Vestibular neuronitis might be presumed to be a peripheral cause of vestibular disorders, by taking into account the absence of additional obvious neurological symptoms (such as pareses, defective sensation, diplopia, etc. and the nature of nystagmus. However, intention tremor in fingernose and heel-knee tests on the left side, a negative Halmagyi test, and results of Romberg’s test could suggest that stroke was a cause ofdizziness.

  11. Imaging acute ischemic stroke.

    Science.gov (United States)

    González, R Gilberto; Schwamm, Lee H

    2016-01-01

    Acute ischemic stroke is common and often treatable, but treatment requires reliable information on the state of the brain that may be provided by modern neuroimaging. Critical information includes: the presence of hemorrhage; the site of arterial occlusion; the size of the early infarct "core"; and the size of underperfused, potentially threatened brain parenchyma, commonly referred to as the "penumbra." In this chapter we review the major determinants of outcomes in ischemic stroke patients, and the clinical value of various advanced computed tomography and magnetic resonance imaging methods that may provide key physiologic information in these patients. The focus is on major strokes due to occlusions of large arteries of the anterior circulation, the most common cause of a severe stroke syndrome. The current evidence-based approach to imaging the acute stroke patient at the Massachusetts General Hospital is presented, which is applicable for all stroke types. We conclude with new information on time and stroke evolution that imaging has revealed, and how it may open the possibilities of treating many more patients. © 2016 Elsevier B.V. All rights reserved.

  12. Communication in conversation in stroke patients.

    Science.gov (United States)

    Rousseaux, Marc; Daveluy, Walter; Kozlowski, Odile

    2010-07-01

    In stroke patients, it has been suggested that communication disorders could result from lexical and syntactic disorders in left hemisphere lesions and from pragmatics problems in right lesions. However, we have little information on patient behaviour in dyadic communication, especially in conversation. Here, we analyzed the various processes participating in communication difficulties at the rehabilitation phase (1-6 months) post-stroke, in order to define the main mechanisms of verbal and non-verbal communication (VC, NVC) disorders and their relationship with aphasic disorders. Sixty-three patients were recruited, who belonged to six groups, with left or right cortico-sub-cortical (L-CSC, R-CSC) or sub-cortical (L-SC, R-SC), frontal (Fro) or posterior fossa (PF) lesions. They were compared with an equivalent control group (gender, age, education level). We used the Lille Communication Test, which comprises three parts: participation to communication (greeting, attention, engagement), verbal communication (verbal comprehension, speech outflow, intelligibility, word production, syntax, verbal pragmatics and verbal feedback) and non-verbal communication (understanding gestures, affective expressivity, producing gestures, pragmatics and feedback). We also used the Functional Communication Profile and the Boston Diagnostic Aphasia Examination (BDAE). Decrease in participation was found in L-CSC, R-CSC and Fro patients. Verbal communication was essentially disrupted in L-SCS and L-SC groups, including by verbal pragmatic disorders, and to a lesser degree in frontal patients. Nonverbal communication was mainly affected in R-CSC patients, especially by pragmatic difficulties. L-CSC patients showed an increase in gesture production, compensating for aphasia. In conclusion, communication disorders were relatively complex and could not be summarised by syntactical and lexical difficulties in left stroke and pragmatic problems in right stroke. The former also showed severe

  13. Characteristics of Neuromuscular Control of the Scapula after Stroke: A First Exploration

    Science.gov (United States)

    De Baets, Liesbet; Jaspers, Ellen; Janssens, Luc; Van Deun, Sara

    2014-01-01

    This study aimed to characterize scapular muscle timing in stroke patients with and without shoulder pain. Muscle activity of upper trapezius, lower trapezius, serratus anterior, infraspinatus, and anterior deltoid (AD) was measured (Delsys Trigno surface EMG system, USA) in 14 healthy controls (dominant side) and 30 stroke patients (hemiplegic side) of whom 10 had impingement-like shoulder pain. Participants performed 45° and full range anteflexion, in two load conditions. The impact of group, anteflexion height, load condition, and muscle was assessed for onset and offset of the different muscles relative to the onset and offset of AD, using a 3 (group) × 2 (height) × 2 (load) × 4 (muscle) mixed model design. Recruitment patterns were additionally described. Across all load conditions and groups, serratus anterior had a significantly earlier onset and, together with lower trapezius, a significantly later offset in 45° compared to full range anteflexion tasks (p < 0.001). In stroke patients without pain, lower trapezius had furthermore a significantly earlier onset in comparison to stroke patients with shoulder pain (all tasks, p = 0.04). Serratus anterior also showed a significantly earlier offset in stroke patients with shoulder pain in comparison to controls (p = 0.01) and stroke patients without pain (p < 0.001). Analysis of muscle recruitment patterns indicated that for full range tasks, stroke patients without pain used early and prolonged activity of infraspinatus. In stroke patients with shoulder pain, recruitment patterns were characterized by delayed activation and early inactivity of serratus anterior. These timing results can serve as a reference frame for scapular muscle timing post-stroke, and when designing upper limb treatment protocols and clinical guidelines for shoulder pain after stroke. PMID:25477805

  14. Characteristics of neuromuscular control of the scapula after stroke: a first exploration

    Directory of Open Access Journals (Sweden)

    Liesbet eDe Baets

    2014-11-01

    Full Text Available This study aimed to characterize scapular muscle timing in stroke patients with and without shoulder pain. Muscle activity of upper trapezius, lower trapezius, serratus anterior, infraspinatus and anterior deltoid was measured (Delsys Trigno surface EMG system, US in 14 healthy controls (dominant side and 30 stroke patients (hemiplegic side of whom 10 had impingement-like shoulder pain. Participants performed 45° and full range anteflexion, in two load conditions. The impact of group, anteflexion height, load condition and muscle was assessed for onset and offset of the different muscles relative to the onset and offset of anterior deltoid, using a 3 (group* 2 (height* 2 (load* 4 (muscle mixed model design. Recruitment patterns were additionally described. Across all load conditions and groups, serratus anterior had a significantly earlier onset and, together with lower trapezius, a significantly later offset in 45° compared to full range anteflexion tasks (p<.001. In stroke patients without pain, lower trapezius had furthermore a significantly earlier onset in comparison to stroke patients with shoulder pain (all tasks, p=.04. Serratus anterior also showed a significantly earlier offset in stroke patients with shoulder pain in comparison to controls (p=.01 and stroke patients without pain (p<.001. Analysis of muscle recruitment patterns indicated that for full range tasks, stroke patients without pain used early and prolonged activity of infraspinatus. In stroke patients with shoulder pain, recruitment patterns were characterized by delayed activation and early inactivity of serratus anterior. These timing results can serve as a reference frame for scapular muscle timing post-stroke, and when designing upper limb treatment protocols and clinical guidelines for shoulder pain after stroke.

  15. Hyponatremia in stroke

    Directory of Open Access Journals (Sweden)

    Sheikh Saleem

    2014-01-01

    Full Text Available Introduction: Hyponatremia is a common electrolyte disorder encountered in patients of neurological disorders which is usually either due to inappropriate secretion of Antidiuretic hormone (SIADH or cerebral salt wasting syndrome (CSWS. We conducted this study in a tertiary care hospital to determine the incidence and etiology of hyponatremia in patients of stroke admitted in the hospital. Materials and Methods: It was a prospective study done over a period of two years that included established cases of stroke diagnosed on the basis of clinical history, examination and neuroimaging. 1000 stoke patients were evaluated for hyponatremia (serum sodium <130 meq/l. The data was analysed using Chi-square test using SPSS (Statistical package for social science software. Results: Out of 1000 patients, 353 patients had hyponatremia. Out of this 353 patients, 238 (67% had SIADH and 115 (33% had CSWS. SIADH was seen in 83 patients who had ischemic stroke and 155 patients of hemorrhagic stroke. CSWS was found in 38 patients with ischemic stroke and 77 patients with hemorrhagic stroke. Statistical analysis revealed that hyponatremia significantly affects the outcome of stroke especially when it is due to CSWS rather than SIADH. Conclusion: Incidence of hyponatremia in our study population was 35%. In patients of hyponatremia 67% were having SIADH and 33% were having CSWS. Overall hyponatremia affected the outcome of stroke especially when caused by CSWS. Therefore close monitoring of serum sodium must be done in all patients who are admitted with stroke and efforts must be made to determine the cause of hyponatremia, in order to properly manage such patients thereby decreasing the mortality rate.

  16. Hyponatremia in stroke

    Science.gov (United States)

    Saleem, Sheikh; Yousuf, Irfan; Gul, Azhara; Gupta, Satish; Verma, Sawan

    2014-01-01

    Introduction: Hyponatremia is a common electrolyte disorder encountered in patients of neurological disorders which is usually either due to inappropriate secretion of Antidiuretic hormone (SIADH) or cerebral salt wasting syndrome (CSWS). We conducted this study in a tertiary care hospital to determine the incidence and etiology of hyponatremia in patients of stroke admitted in the hospital. Materials and Methods: It was a prospective study done over a period of two years that included established cases of stroke diagnosed on the basis of clinical history, examination and neuroimaging. 1000 stoke patients were evaluated for hyponatremia (serum sodium <130 meq/l). The data was analysed using Chi-square test using SPSS (Statistical package for social science) software. Results: Out of 1000 patients, 353 patients had hyponatremia. Out of this 353 patients, 238 (67%) had SIADH and 115 (33%) had CSWS. SIADH was seen in 83 patients who had ischemic stroke and 155 patients of hemorrhagic stroke. CSWS was found in 38 patients with ischemic stroke and 77 patients with hemorrhagic stroke. Statistical analysis revealed that hyponatremia significantly affects the outcome of stroke especially when it is due to CSWS rather than SIADH. Conclusion: Incidence of hyponatremia in our study population was 35%. In patients of hyponatremia 67% were having SIADH and 33% were having CSWS. Overall hyponatremia affected the outcome of stroke especially when caused by CSWS. Therefore close monitoring of serum sodium must be done in all patients who are admitted with stroke and efforts must be made to determine the cause of hyponatremia, in order to properly manage such patients thereby decreasing the mortality rate. PMID:24753660

  17. Regular group exercise is associated with improved mood but not quality of life following stroke

    Directory of Open Access Journals (Sweden)

    Michelle N. McDonnell

    2014-03-01

    Full Text Available Purpose. People with stroke living in the community have an increased prevalence of depression and lower quality of life than healthy older adults. This cross-sectional observational study investigated whether participation in regular exercise was associated with improved mood and quality of life.Methods. We recruited three groups of community dwelling participants: 13 healthy older adults, 17 adults post-stroke who regularly participated in group exercise at a community fitness facility and 10 adults post-stroke who did not regularly exercise. We measured mood using the Depression, Anxiety, Stress Scale (DASS and quality of life using the Assessment of Quality of Life (AQoL scale.Results. Levels of stress and depression were significantly greater in the people with stroke who did not undertake regular exercise (p = 0.004 and p = 0.004 respectively, although this group had more recent strokes (p < 0.001. Both stroke groups had lower quality of life scores (p = 0.04 than the healthy adults.Conclusions. This small, community-based study confirms that people following stroke report poorer quality of life than stroke-free individuals. However, those who exercise regularly have significantly lower stress and depression compared to stroke survivors who do not. Future research should focus on the precise type and amount of exercise capable of improving mood following stroke.

  18. The experience of living with stroke in low urban and rural socioeconomic areas of South Africa

    Directory of Open Access Journals (Sweden)

    M. Maleka

    2012-12-01

    Full Text Available The effects of stroke on stroke survivors are profound and affecttheir quality of life. The aim of this study was to establish the experience of peopleliving with stroke in low socioeconomic urban and rural areas of South Africa.A qualitative study using semi-structured interviews was used to collect data.Participants were identified from stroke registers and recruited from PHC clinicsin Soweto, Gauteng and Limpopo provinces. Participants had to have had a stroke,be above the age of 18 and had lived in the community six months to a year followingtheir stroke. The researcher or research assistant conducted the interviews ofparticipants who had had strokes as well as their caregivers in the home language of the participants. The interviewswere audio taped, transcribed and translated into English. A thematic content analysis was done.Thirty two participants were interviewed, 13 from Soweto, Gauteng, and 19 from rural Limpopo provinces. Theresults suggest that the sudden, overwhelming transformation as a result of a stroke forms a background for loss ofcommunity mobility, social isolation, role reversal within the family and community, loss of role within the family andcommunity, loss of meaningful activities of daily living, loss of hope and threat to livelihood amongst stroke survivorsliving in low socioeconomic areas of South Africa.An overwhelming picture of despondency was found, with few positive stories told in both settings. The themesidentified from the interviews reflected the experience and issues that a patient with stroke has to deal with in lowsocioeconomic areas of South Africa.

  19. Regular group exercise is associated with improved mood but not quality of life following stroke.

    Science.gov (United States)

    McDonnell, Michelle N; Mackintosh, Shylie F; Hillier, Susan L; Bryan, Janet

    2014-01-01

    Purpose. People with stroke living in the community have an increased prevalence of depression and lower quality of life than healthy older adults. This cross-sectional observational study investigated whether participation in regular exercise was associated with improved mood and quality of life. Methods. We recruited three groups of community dwelling participants: 13 healthy older adults, 17 adults post-stroke who regularly participated in group exercise at a community fitness facility and 10 adults post-stroke who did not regularly exercise. We measured mood using the Depression, Anxiety, Stress Scale (DASS) and quality of life using the Assessment of Quality of Life (AQoL) scale. Results. Levels of stress and depression were significantly greater in the people with stroke who did not undertake regular exercise (p = 0.004 and p = 0.004 respectively), although this group had more recent strokes (p < 0.001). Both stroke groups had lower quality of life scores (p = 0.04) than the healthy adults. Conclusions. This small, community-based study confirms that people following stroke report poorer quality of life than stroke-free individuals. However, those who exercise regularly have significantly lower stress and depression compared to stroke survivors who do not. Future research should focus on the precise type and amount of exercise capable of improving mood following stroke.

  20. Cortisol levels and the severity and outcomes of acute stroke: a systematic review.

    Science.gov (United States)

    Barugh, Amanda Jayne; Gray, Paul; Shenkin, Susan Deborah; MacLullich, Alasdair Maurice Joseph; Mead, Gillian Elizabeth

    2014-03-01

    Studies in non-stroke patients have shown an association between dysregulation of the hypothalamic-pituitary-adrenal axis and morbidity and mortality. We conducted a systematic review to evaluate cortisol levels in acute stroke and their associations with outcome. We searched MEDLINE and EMBASE for articles up to April 2013 and PsychINFO for articles up to July 2013, using the keywords "cortisol" and "stroke" and associated terms or synonyms. We included studies published in peer-reviewed journals that recruited 10 or more participants and measured cortisol at least once in the first year following stroke. Data were extracted regarding cortisol levels, including changes over time and their relationship to stroke severity, and outcome. Of 11,240 abstracts, 101 full texts were obtained and 48 fulfilled our inclusion criteria. Cortisol levels were high in the first week after stroke in the majority of studies (26 studies, n = 1,340). Higher cortisol was associated with dependency (8/11 studies, n = 822), delirium (5/6 studies, n = 269) depression (3/5 studies n = 117) and mortality (8/10 studies, n = 856). Five studies adjusted for stroke severity; one found an association between higher cortisol and dependency, and three found an association between higher cortisol and mortality. Cortisol levels are high for at least 7 days after stroke. Elevated cortisol after stroke is associated with dependency, morbidity, and mortality; however, there is insufficient evidence to conclude that these relationships are independent of stroke severity.

  1. Stroke patients with a past history of cancer are at increased risk of recurrent stroke and cardiovascular mortality.

    Directory of Open Access Journals (Sweden)

    Kui-Kai Lau

    Full Text Available BACKGROUND AND PURPOSE: Cancer patients are at increased risk of cardiovascular and cerebrovascular events. It is unclear whether cancer confers any additional risk for recurrent stroke or cardiovascular mortality after stroke. METHODS: This was a single center, observational study of 1,105 consecutive Chinese ischemic stroke patients recruited from a large stroke rehabilitation unit based in Hong Kong. We sought to determine whether patients with cancer are at higher risk of recurrent stroke and cardiovascular mortality. RESULTS: Amongst 1,105 patients, 58 patients (5.2% had cancer, of whom 74% were in remission. After a mean follow-up of 76 ± 18 months, 241 patients developed a recurrent stroke: 22 in patients with cancer (38%, annual incidence 13.94%/year, substantially more than those without cancer (21%, 4.65%/year (p<0.01. In a Cox regression model, cancer, age and atrial fibrillation were the 3 independent predictors of recurrent stroke with a hazard ratio (HR of 2.42 (95% confidence interval (CI: 1.54-3.80, 1.01 (1.00-1.03 and 1.35 (1.01-1.82 respectively. Likewise, patients with cancer had a higher cardiovascular mortality compared with those without cancer (4.30%/year vs. 2.35%/year, p = 0.08. In Cox regression analysis, cancer (HR: 2.08, 95% CI: 1.08-4.02, age (HR: 1.04, 95% CI 1.02-1.06, heart failure (HR: 3.06, 95% CI 1.72-5.47 and significant carotid atherosclerosis (HR: 1.55, 95% CI 1.02-2.36 were independent predictors for cardiovascular mortality. CONCLUSIONS: Stroke patients with a past history of cancer are at increased risk of recurrent stroke and cardiovascular mortality.

  2. Hearing Characteristics of Stroke Patients: Prevalence and Characteristics of Hearing Impairment and Auditory Processing Disorders in Stroke Patients.

    Science.gov (United States)

    Koohi, Nehzat; Vickers, Deborah A; Lakshmanan, Rahul; Chandrashekar, Hoskote; Werring, David J; Warren, Jason D; Bamiou, Doris-Eva

    2017-06-01

    Stroke survivors may suffer from a range of hearing impairments that may restrict their participation in postacute rehabilitation programs. Hearing impairment may have a significant impact on listening, linguistic skills, and overall communication of the affected stroke patient. However, no studies sought to systematically characterize auditory function of stroke patients in detail, to establish the different types of hearing impairments in this cohort of patients. Such information would be clinically useful in understanding and addressing the hearing needs of stroke survivors. The present study aimed to characterize and classify the hearing impairments, using a detailed audiological assessment test battery, in order to determine the level of clinical need and inform appropriate rehabilitation for this patient population. A case-control study. Forty-two recruited stroke patients who were discharged from a stroke unit and 40 control participants matched for age. All participants underwent pure-tone audiometry and immittance measurements including acoustic reflex threshold, transient-evoked otoacoustic emissions, auditory-evoked brainstem response, and a central auditory processing assessment battery, performed in a single session. Hearing impairments were classified as peripheral hearing loss (cochlear and neural type), central auditory processing disorder (CAPD), and as a combination of CAPD and peripheral hearing loss. Overall mean hearing thresholds were not significantly different between the control and stroke groups. The most common type of hearing impairment in stroke patients was the combination type, "peripheral and CAPD," in the 61- to 80-yr-old subgroup (in 55%), and auditory processing deficits in 18- to 60-yr-olds (in 40%), which were both significantly higher than in controls. This is the first study to examine hearing function in detail in stroke patients. Given the importance of hearing for the efficiency of communication, it is essential to identify

  3. [Obesity Paradox and Stroke].

    Science.gov (United States)

    Baumgartner, Ralf; Oesch, Lisa; Sarikaya, Hakan

    2016-07-06

    The obesity paradox suggests that overweight and obese patients of older age may have higher survival rates after stroke as compared to normalweight patients. However, the results need a cautious interpretation due to selection bias, treatment bias and different patients’ characteristics. Moreover, randomized studies that prove a benefit of weight reduction are still lacking. As obesity is an independet risk factor for stroke, weight reduction should still be recommended in overweight patients. Randomized-controlled studies are needed to prove the effect of weight reduction on morbidity and mortality after stroke.

  4. Sleep and Stroke.

    Science.gov (United States)

    Mims, Kimberly Nicole; Kirsch, Douglas

    2016-03-01

    Evidence increasingly suggests sleep disorders are associated with higher risk of cardiovascular events, including stroke. Strong data correlate untreated sleep apnea with poorer stroke outcomes and more recent evidence implicates sleep disruption as a possible etiology for increased cerebrovascular events. Also, sleep duration may affect incidence of cardiovascular events. In addition, sleep-disordered breathing, insomnia, restless legs syndrome, and parasomnias can occur as a result of cerebrovascular events. Treatment of sleep disorders improve sleep-related symptoms and may also improve stroke recovery and risk of future events.

  5. Strokes in mitochondrial diseases

    Directory of Open Access Journals (Sweden)

    N V Pizova

    2012-01-01

    Full Text Available It is suggested that mitochondrial diseases might be identified in 22—33% of cryptogenic stroke cases in young subjects. The incidence of mitochondrial disorders in patients with stroke is unknown; it is 0.8 to 7.2% according to the data of some authors. The paper gives data on the prevalence, pathogenesis, and clinical manifestations of mitochondrial diseases, such as mitochondrial encephalopathy, lactic acidosis, and stroke-like syndrome (MELAS and insulin-like episodes; myoclonic epilepsy and ragged-red fibers (MERRF syndrome, and Kearns-Sayre syndrome (sporadic multisystem mitochondrial pathology.

  6. Organisational change, job strain and increased risk of stroke? A pilot study.

    Science.gov (United States)

    Medin, Jennie; Ekberg, Kerstin; Nordlund, Anders; Eklund, Jörgen

    2008-01-01

    The objective of this pilot study was to explore whether organisational change and work-related stress, as measured by the Job Content Questionnaire, were associated with first-ever stroke among working people aged 30-65. In a case-control study a total of 65 consecutive cases, aged 30-65 years of age, with first-ever stroke were recruited from four hospitals in Sweden during 2000-2002. During the same period, 103 random population controls in the same age interval were recruited. Data on job-related stress and traditional medical risk factors were collected by a questionnaire. In the multivariate analyses, organisational change (OR 3.38) increased the likelihood of stroke, while experiencing an active job (OR 0.37) decreased the likelihood of stroke. Regarding risk factors outside work, age (OR 1.11), low physical activity (OR 5.21), low education (OR 2.48) and family history of stroke (OR 2.59) were associated with increased likelihood of stroke. This study suggests an association between organisational change, work-related stress and stroke. The likelihood of stroke was lower for people in active job situations.

  7. Information networks and worker recruitment

    NARCIS (Netherlands)

    Schram, A.; Brandts, J.; Gërxhani, K.

    2007-01-01

    This paper studies experimentally how the existence of social information networks affects the ways in which firms recruit new personnel. Through such networks firms learn about prospective employees' performance in previous jobs. Assuming individualistic preferences social networks are predicted no

  8. Recruiting for Prior Service Market

    Science.gov (United States)

    2008-06-01

    perceptions, expectations and issues for re-enlistment • Develop potential marketing and advertising tactics and strategies targeted to the defined...01 JUN 2008 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Recruiting for Prior Service Market 5a. CONTRACT NUMBER 5b. GRANT...Command First Handshake to First Unit of Assignment An Army of One Proud to Be e e to Serve Recruiting for Prior Service Market MAJ Eric Givens / MAJ Brian

  9. World Stroke Organization global stroke services guidelines and action plan.

    Science.gov (United States)

    Lindsay, Patrice; Furie, Karen L; Davis, Stephen M; Donnan, Geoffrey A; Norrving, Bo

    2014-10-01

    Every two seconds, someone across the globe suffers a symptomatic stroke. 'Silent' cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention, acute stroke management, and stroke recovery. The current challenge lies in implementing these interventions, particularly in regions with high incidences of stroke and limited healthcare resources. The Global Stroke Services Action Plan was conceived as a tool to identifying key elements in stroke care across a continuum of health models. At the minimal level of resource availability, stroke care delivery is based at a local clinic staffed predominantly by non-physicians. In this environment, laboratory tests and diagnostic studies are scarce, and much of the emphasis is placed on bedside clinical skills, teaching, and prevention. The essential services level offers access to a CT scan, physicians, and the potential for acute thrombolytic therapy, however stroke expertise may still be difficult to access. At the advanced stroke services level, multidisciplinary stroke expertise, multimodal imaging, and comprehensive therapies are available. A national plan for stroke care should incorporate local and regional strengths and build upon them. This clinical practice guideline is a synopsis of the core recommendations and quality indicators adapted from ten high quality multinational stroke guidelines. It can be used to establish the current level of stroke services, target goals for expanding stroke resources, and ensuring that all stages of stroke care are being adequately addressed, even at the advanced stroke services level. This document is a start, but there is more to be done

  10. Approximately determining preloading duration considering creep%考虑蠕变时预压期的近似确定方法

    Institute of Scientific and Technical Information of China (English)

    胡亚元

    2012-01-01

    As the secondary consolidation settlement was not taken into account in classical preloading theory and the flaw sometimes happened that the critical consolidation degree was bigger than 100% considering secondary consolidation settlement in Johnson's method, an approximate formula of preloading duration under a single-stage sudden loading was proposed. During the derivation of this approximate formula, Bjerrum's equal-time creep diagram and Yin-Graham equivalent-time rheological model are used and Zeng Guo-xi's approximate formula of consolidation degree is employed. So the approximate formula can be able to avoid the flaw of Johnson's method, and analyze the effects of soft subsoil's consolidation coefficient, creep coefficient, swelling index, surcharge pressure ratio, allowable post-construction settlement and preconsolidation time on preloading duration. Research results show that when surcharge pressure ratio is relatively smaller, preloading duration decays with the power growth of surcharge pressure ratio. An increase in surcharge pressure ratio can obviously make preloading duration short. When surcharge pressure ratio become bigger, preloading duration slowly decays with the growth of surcharge pressure ratio. An increase in surcharge pressure ratio can only make preloading duration a little decrease.%针对经典预压理论无法考虑次固结沉降以及考虑次固结沉降的Johnson法有时会出现临界固结度超过100%的错误,提出预压荷载一次骤然施加完毕后预压持续时间的近似计算公式.在推导该近似公式过程中,利用Bjerrum等时蠕变图和Yin-Graham等效时间线流变模型,采用曾国熙近似固结度计算公式,因此该近似公式能够克服Johnson法的缺陷,分析软基固结系数、蠕变系数、回弹指数、超固结比、工后允许沉降和预固结时间对预压工期的影响.研究表明:当预压超载较小时,预压持续时间随着超载比的增加呈幂函数趋势减少,

  11. Radixin expression in microglia after cortical stroke lesion.

    Science.gov (United States)

    Persson, Åsa; Osman, Ahmed; Bolouri, Hayde; Mallard, Carina; Kuhn, H Georg

    2013-05-01

    Stroke induces extensive tissue remodeling, resulting in the activation of several cell types in the brain as well as recruitment of blood-borne leucocytes. Radixin is part of a cytoskeleton linker protein family with the ability to connect transmembrane proteins to the actin cytoskeleton, promoting cell functions involving a dynamic cytoskeleton such as morphological changes, cell division and migration which are common events of different cell types after stroke. In the healthy adult brain radixin is expressed in Olig2(+) cells throughout the brain and in neural progenitor cells in the subventricular zone. In the current study, we detected a 2.5 fold increase in the number of radixin positive cells in the peri-infarct cortex two weeks after the induction of cortical stroke by photothrombosis. Similarly, the number of Olig2(+) cells increased in the peri-infarct area after stroke; however, the number of radixin(+)/Olig2(+) cells was unchanged. Neural progenitor cells maintained radixin expression on their route to the infarct. More surprising however, was the expression of radixin in activated microglia in the peri-infarct cortex. Seventy percent of Iba1(+) cells expressed radixin after stroke, a population which was not present in the control brain. Furthermore, activation of radixin was predominantly detected in the peri-infarct region of oligodendrocyte progenitors and microglia. The specific location of radixin(+) cells in the peri-infarct region and in microglia suggests a role for radixin in microglial activation after stroke.

  12. Computed tomography to estimate cardiac preload and extravascular lung water. A retrospective analysis in critically ill patients

    Directory of Open Access Journals (Sweden)

    Schmid Roland M

    2011-05-01

    Full Text Available Abstract Background In critically ill patients intravascular volume status and pulmonary edema need to be quantified as soon as possible. Many critically ill patients undergo a computed tomography (CT-scan of the thorax after admission to the intensive care unit (ICU. This study investigates whether CT-based estimation of cardiac preload and pulmonary hydration can accurately assess volume status and can contribute to an early estimation of hemodynamics. Methods Thirty medical ICU patients. Global end-diastolic volume index (GEDVI and extravascular lung water index (EVLWI were assessed using transpulmonary thermodilution (TPTD serving as reference method (with established GEDVI/EVLWI normal values. Central venous pressure (CVP was determined. CT-based estimation of GEDVI/EVLWI/CVP by two different radiologists (R1, R2 without analyzing software. Primary endpoint: predictive capabilities of CT-based estimation of GEDVI/EVLWI/CVP compared to TPTD and measured CVP. Secondary endpoint: interobserver correlation and agreement between R1 and R2. Results Accuracy of CT-estimation of GEDVI ( 800 mL/m2 was 33%(R1/27%(R2. For R1 and R2 sensitivity for diagnosis of low GEDVI (2 was 0% (specificity 100%. Sensitivity for prediction of elevated GEDVI (> 800 mL/m2 was 86%(R1/57%(R2 with a specificity of 57%(R1/39%(R2 (positive predictive value 38%(R1/22%(R2; negative predictive value 93%(R1/75%(R2. Estimated CT-GEDVI and TPTD-GEDVI were significantly different showing an overestimation of GEDVI by the radiologists (R1: mean difference ± standard error (SE: 191 ± 30 mL/m2, p 2, p 10 mL/kg was 30% for R1 and 40% for R2. CT-EVLWI and TPTD-EVLWI were significantly different (R1: mean difference ± SE: 3.3 ± 1.2 mL/kg, p = 0.013; R2: mean difference ± SE: 2.8 ± 1.1 mL/kg, p = 0.021. Again ccc was low with -0.02 (R1; 95% CI: -0.20 to +0.13, BCF = 0.44 and +0.14 (R2; 95% CI: -0.05 to +0.32, BCF = 0.53. GEDVI, EVLWI and CVP estimations of R1 and R2 showed a poor

  13. 45 CFR 86.23 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Recruitment. 86.23 Section 86.23 Public Welfare... in Admission and Recruitment Prohibited § 86.23 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which this subpart applies shall not discriminate on the basis of sex in the recruitment and...

  14. 22 CFR 146.310 - Recruitment.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Recruitment. 146.310 Section 146.310 Foreign... Recruitment Prohibited § 146.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 146.300 through 146.310 apply shall not discriminate on the basis of sex in the recruitment and admission...

  15. 49 CFR 25.310 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Recruitment. 25.310 Section 25.310 Transportation... Recruitment Prohibited § 25.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 25.300 through 25.310 apply shall not discriminate on the basis of sex in the recruitment and admission of...

  16. 22 CFR 229.310 - Recruitment.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Recruitment. 229.310 Section 229.310 Foreign... and Recruitment Prohibited § 229.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 229.300 through 229.310 apply shall not discriminate on the basis of sex in the recruitment and...

  17. 10 CFR 1042.310 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Recruitment. 1042.310 Section 1042.310 Energy DEPARTMENT... Recruitment Prohibited § 1042.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 1042.300 through 1042.310 apply shall not discriminate on the basis of sex in the recruitment and admission...

  18. Cost of stroke

    DEFF Research Database (Denmark)

    Jennum, Poul; Iversen, Helle K; Ibsen, Rikke

    2015-01-01

    BACKGROUND: To estimate the direct and indirect costs of stroke in patients and their partners. DESCRIPTION: Direct and indirect costs were calculated using records from the Danish National Patient Registry from 93,047 ischemic, 26,012 hemorrhagic and 128,824 unspecified stroke patients...... and compared with 364,433, 103,741 and 500,490 matched controls, respectively. RESULTS: Independent of age and gender, stroke patients had significantly higher rates of mortality, health-related contacts, medication use and lower employment, lower income and higher social-transfer payments than controls....... The attributable cost of direct net health care costs after the stroke (general practitioner services, hospital services, and medication) and indirect costs (loss of labor market income) were €10,720, €8,205 and €7,377 for patients, and €989, €1,544 and €1.645 for their partners, over and above that of controls...

  19. A Stroke of Language

    Science.gov (United States)

    Blaisdell, Bob

    2011-01-01

    The author reflects on foreign-language learning by his EFL students as well as his own foreign-language learning. He concludes by musing on the possible and fantastical devastation on language-ability wrought by strokes.

  20. Comparative study of NMP-preloaded and dip-loaded membranes for guided bone regeneration of rabbit cranial defects.

    Science.gov (United States)

    Karfeld-Sulzer, Lindsay S; Ghayor, Chafik; Siegenthaler, Barbara; Gjoksi, Bebeka; Pohjonen, Timo H; Weber, Franz E

    2017-02-01

    Guided bone regeneration (GBR) has been utilized for several decades for the healing of cranio-maxillofacial bone defects and, particularly in the dental field, by creating space with a barrier membrane to exclude soft tissue and encourage bone growth in the membrane-protected volume. Although the first membranes were non-resorbable, a new generation of GBR membranes aims to biodegrade and provide bioactivity for better overall results. The Inion GTR™ poly(lactide-co-glycolide) (PLGA) membrane is not only resorbable but also bioactive, since it includes N-methylpyrrolidone (NMP), which has been shown to promote bone regeneration. In this study, the effects of loading different amounts of NMP onto the membrane through chemical vapour deposition or dipping have been explored. In vitro release demonstrated that lower levels of NMP led to lower NMP concentrations and slower release, based on total NMP loaded in the membrane. The dipped membrane released almost all of the NMP within 15 min, leading to a high NMP concentration. For the in vivo studies in rabbits, 6 mm calvarial defects were created and left untreated or covered with an ePTFE membrane or PLGA membranes dipped in, or preloaded with, NMP. Evaluation of the bony regeneration revealed that the barrier membranes improved bony healing and that a decrease in NMP content improved the performance. Overall, we have demonstrated the potential of these PLGA membranes with a more favourable NMP release profile and the significance of exploring the effect of NMP on these PLGA membranes with regard to bone ingrowth. Copyright © 2014 John Wiley & Sons, Ltd.

  1. The impact of a pre-loaded multi-ingredient performance supplement on muscle soreness and performance following downhill running.

    Science.gov (United States)

    Ormsbee, Michael J; Ward, Emery G; Bach, Christopher W; Arciero, Paul J; McKune, Andrew J; Panton, Lynn B

    2015-01-01

    The effects of multi-ingredient performance supplements (MIPS) on perceived soreness, strength, flexibility and vertical jump performance following eccentric exercise are unknown. The purpose of this study was to determine the impact of MIPS (NO-Shotgun®) pre-loaded 4 weeks prior to a single bout of downhill running (DHR) on muscle soreness and performance. Trained male runners (n = 20) were stratified by VO2max, strength, and lean mass into two groups; MIPS (n = 10) ingested one serving daily of NO-Shotgun® for 28 days and 30 min prior to all post-testing visits, Control (CON; n = 10) consumed an isocaloric maltodextrin placebo in an identical manner as MIPS. Perceived soreness and performance measurements (strength, flexibility, and jump height) were tested on 6 occasions; 28 days prior to DHR, immediately before DHR (PRE), immediately post (POST) DHR, 24, 48, and 72 hr post-DHR. Perceived soreness significantly increased (p < 0.05) post DHR compared to PRE at all time-points, with no difference between groups. Creatine kinase (CK) and lactate dehydrogenase (LDH) increased over time (p < 0.001) with no group x time interactions (p = 0.236 and p = 0.535, respectively). Significant time effects were measured for strength (p = 0.001), flexibility (p = 0.025) and vertical jump (p < 0.001). There were no group x time interactions for any performance measurements. Consumption of MIPS for 4 weeks prior to a single bout of DHR did not affect perceived soreness, muscle damage, strength, flexibility, or jump performance compared to an isocaloric placebo in trained male runners following a single bout of DHR.

  2. A method for the production of cryopreserved aliquots of antigen-preloaded, mature dendritic cells ready for clinical use.

    Science.gov (United States)

    Feuerstein, B; Berger, T G; Maczek, C; Röder, C; Schreiner, D; Hirsch, U; Haendle, I; Leisgang, W; Glaser, A; Kuss, O; Diepgen, T L; Schuler, G; Schuler-Thurner, B

    2000-11-01

    Dendritic cells (DC) are increasingly used as a vaccine. Unfortunately, a satisfactory cryopreservation of DC in the absence of FCS is not yet available, so that laborious repeated generation of DC from fresh blood or frozen peripheral blood mononuclear cells for each vaccination has been required to date. We now aimed at developing an effective cryopreservation method, and by testing several variables found that it was crucial to combine the most advantageous maturation stimulus with an improved freezing procedure. We generated monocyte-derived DC from leukapheresis products by using GM-CSF and IL-4 and showed that amongst several known maturation stimuli the cocktail consisting of TNF-alpha+IL-1 beta+IL-6+PGE(2) achieved the highest survival of mature DC. We then systematically explored cryopreservation conditions, and found that freezing matured DC at 1 degrees C/min in pure autologous serum+10% DMSO+5% glucose at a cell density of 10x10(6) DC/ml gave the best results. Using this approach 85-100% of the frozen DC could be recovered in a viable state after thawing (Table 1). The morphology, phenotype, survival as well as functional properties (allogeneic mixed leukocyte reaction, induction of influenza matrix or melan A peptide-specific cytotoxic T cells) of these thawed DC were equivalent to freshly prepared ones. The addition of CD40L or TRANCE/RANKL further improved DC survival. Importantly, we demonstrate that DC can effectively be loaded with antigens (such as Tetanus Toxoid, influenza matrix and melan A peptides) before cryopreservation so that it is now possible to generate antigen-preloaded, frozen DC aliquots that after thawing can be used right away. This is an important advance as both the generation of a standardized DC vaccine under GMP conditions and the carrying out of clinical trials are greatly facilitated.

  3. Examination of motor unit control properties in stroke survivors using surface EMG decomposition: a preliminary report.

    Science.gov (United States)

    Suresh, Nina; Li, Xiaoyan; Zhou, Ping; Rymer, William Zev

    2011-01-01

    The objective of this pilot study was to examine alterations in motor unit (MU) control properties, (i.e. MU recruitment and firing rate) after stroke utilizing a recently developed high-yield surface electromyogram (EMG) decomposition technique. Two stroke subjects participated in this study. A sensor array was used to record surface EMG signals from the first dorsal interosseous (FDI) muscle during voluntary isometric contraction at varying force levels. The recording was performed in both paretic and contralateral muscles using a matched force protocol. Single motor unit activity was extracted using the surface EMG decomposition software from Delsys Inc. The results from the two stroke subjects indicate a reduction in the mean motor unit firing rate and a compression of motor unit recruitment range in paretic muscle as compared with the contralateral muscles. These findings provide further evidence of spinal motoneuron involvement after a hemispheric brain lesion, and help us to understand the complex origins of stroke induced muscle weakness.

  4. Endocarditis and stroke.

    Science.gov (United States)

    Grecu, Nicolae; Tiu, Cristina; Terecoasa, Elena; Bajenaru, Ovidiu

    2014-12-01

    Endocarditis is an important, although less common, cause of cerebral embolism. All forms of endocarditis share an initial common pathophysiologic pathway, best illustrated by the non-bacterial thrombotic form, but also a final potential for embolization. Stroke associated with endocarditis has signifficant mortality and morbidity rates, especially due to the frequent concomitant multiple sites of brain embolization. In this article we aim to briefly review endocarditis with a focus on stroke as a complication, while also presenting case correlates from our department.

  5. Brain modulation by event-related desynchronization (ERD) guided neurofeedback: toward a new therapy in acute stroke

    NARCIS (Netherlands)

    Tangwiriyasakul, Chayanin

    2014-01-01

    Motor imagery (MI) therapy is suggested to assist motor (re)learning during stroke rehabilitation. During MI training, part of motor neurons is being recruited similar to motor execution. Repetitive recruitment of motor neurons through mental training leads to enhancement and/or restoration of conne

  6. Functional Exercise and Physical Fitness Post Stroke: The Importance of Exercise Maintenance for Motor Control and Physical Fitness after Stroke

    Directory of Open Access Journals (Sweden)

    Birgitta Langhammer

    2012-01-01

    Full Text Available It is argued that all stroke patients, indifferent of disability, have the same possibility to improve with training. The aim of the study was to follow and register functional improvements in two groups with different functional capacities at baseline for a period of 36 months. Stroke patients were recruited and divided into groups related to their functional status at baseline. During the acute rehabilitation, both groups received functional task-oriented training, followed by regular self- or therapeutic driven training the first year after stroke and varied exercise patterns the following 24 months. The participants were tested on admission, and at three, six, twelve, and thirty-six months after the onset of stroke. Both groups improved functional activity up to six months which then stabilized up to twelve months to decline somewhat at thirty-six months after stroke. Change scores indicate a greater potential for rehabilitation in the MAS ≤35 in relation to group MAS >35 although the functional capacity was higher in the latter. This indicates the importance of maintaining exercise and training for all persons after stroke.

  7. Nursing care for stroke patients

    DEFF Research Database (Denmark)

    Tulek, Zeliha; Poulsen, Ingrid; Gillis, Katrin

    2017-01-01

    AIMS AND OBJECTIVES: To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies (ESS) 2006, and to examine to what extent the ESS have been implemented in stroke care nursing in Europe. BACKGROUND: Stroke is a leading cause of death...... comprising 61 questions based on the ESS and scientific evidence in nursing practice was distributed to representatives of the European Association of Neuroscience Nurses, who sent the questionnaire to nurses active in stroke care. The questionnaire covered the following areas of stroke care: Organization...... of stroke services, Management of acute stroke and prevention including basic care and nursing, and Secondary prevention. RESULTS: Ninety-two nurses in stroke care in 11 European countries participated in the survey. Within the first 48 hours after stroke onset, 95% monitor patients regularly, 94% start...

  8. Stroke-related stigma among West Africans: Patterns and predictors.

    Science.gov (United States)

    Sarfo, Fred Stephen; Nichols, Michelle; Qanungo, Suparna; Teklehaimanot, Abeba; Singh, Arti; Mensah, Nathaniel; Saulson, Raelle; Gebregziabher, Mulugeta; Ezinne, Uvere; Owolabi, Mayowa; Jenkins, Carolyn; Ovbiagele, Bruce

    2017-04-15

    Disability-adjusted life-years lost after stroke in Low & Middle-Income Countries (LMICs) is almost seven times those lost in High-income countries. Although individuals living with chronic neurological and mental disorders are prone to stigma, there is a striking paucity of literature on stroke-related stigma particularly from LMICs. To assess the prevalence, severity, determinants and psycho-social consequences of stigma among LMIC stroke survivors. Between November 2015 and February 2016, we conducted a cross-sectional survey of 200 consecutive stroke survivors attending a neurology clinic in a tertiary medical center in Ghana. The validated 8-Item Stigma Scale for Chronic Illness (SSCI-8) questionnaire was administered to study participants to assess internalized and enacted domains of stigma at the personal dimension with further adaptation to capture family and community stigma experienced by stroke participants. Responses on the SSCI-8 were scored from 1 to 5 for each item, where 1=never, 2=rarely, 3=sometimes, 4=often and 5=always with a score range of 8-40. Demographic and clinical data on stroke type and severity as well as depression and Health-Related Quality of Life indicators were also collected. Predictors of stroke-related stigma were assessed using Linear Models (GLM) via Proc GENMOD in SAS 9.4. 105 (52.5%) subjects recruited were males and the mean±SD age of stroke survivors in this survey was 62.0±14.4years. Mean SSCI-8 score was highest for personal stigma (13.7±5.7), which was significantly higher than family stigma (11.9±4.6; p=0.0005) and social/community stigma (11.4±4.4; pstigma. A graded increase in scores on the Geriatric Depression Scale and Centre for Epidemiological Studies-Depression scale was observed across the three categories. Living in an urban setting was associated with higher SSCI-8 scores. Moreover, stroke subjects with more severe post-stroke residual symptom deficits reported a significantly higher frequency of stigma

  9. Associations between working memory, health literacy, and recall of the signs of stroke among older adults.

    Science.gov (United States)

    Ganzer, Christine A; Insel, Kathleen C; Ritter, Leslie S

    2012-10-01

    Stroke remains a major cause of mortality and disability among older adults. Although early treatment after stroke is known to reduce both mortality and disability, the first step in seeking early treatment is dependent on the rapid recognition of the signs of stroke. Recall of the signs of stroke may be dependent on factors that exist before the stroke itself. Although it is known that both working memory and health literacy decline with advancing age, these factors have not been thoroughly examined with respect to recall of the signs of stroke. Therefore, the purpose of the current study was to investigate associations between working memory, health literacy, and recall of the signs of stroke among older adults. Community dwelling older adults (≥65 years of age) were recruited from two senior centers. Fifty-six participants meeting inclusion criteria provided demographic and health information and were asked to read a public service brochure listing the five warning signs of stroke. Working memory was then assessed using the Wechsler Adult Intelligence Scale 3rd Edition Working Memory Index. Health literacy was assessed by the Short Test of Functional Health Literacy in Adults. Participants' recall of the five warning signs of stroke was evaluated. The mean age was 80.4 years. The mean number of the signs of stroke recalled was 2.9 ± 1.33. Working memory and health literacy were positively correlated with recall of the signs of stroke (r = .38, p recall. There was no statistically significant interaction between working memory and health literacy. Findings from this study indicate that working memory and health literacy were associated with successful recall of the warning signs of stroke in older adults. Further studies are needed to determine if programs that include cognitive and literacy assessments could identify older adults who need additional support to learn and recall the signs of stroke.

  10. Tumour targeting and radiation dose of radioimmunotherapy with {sup 90}Y-rituximab in CD20+ B-cell lymphoma as predicted by {sup 89}Zr-rituximab immuno-PET: impact of preloading with unlabelled rituximab

    Energy Technology Data Exchange (ETDEWEB)

    Muylle, Kristoff [Vrije Universiteit Brussel, MIMA Research Group, Brussels (Belgium); Universite Libre de Bruxelles, Department of Nuclear Medicine, Jules Bordet Institute, Brussels (Belgium); Flamen, Patrick; Guiot, Thomas; Ghanem, Ghanem; Meuleman, Nathalie; Bourgeois, Pierre; Vanderlinden, Bruno; Vaes, Melanie; Bron, Dominique [Universite Libre de Bruxelles, Jules Bordet Institute, Brussels (Belgium); Vugts, Danielle J.; Dongen, Guus A.M.S. van [VU University Medical Centre, Amsterdam (Netherlands); Everaert, Hendrik [Vrije Universiteit Brussel, UZ Brussel, Brussels (Belgium); Vrije Universiteit Brussel, MIMA Research Group, Brussels (Belgium)

    2015-07-15

    To compare using immuno-PET/CT the distribution of {sup 89}Zr-labelled rituximab without and with a preload of unlabelled rituximab to assess the impact of preloading with unlabelled rituximab on tumour targeting and radiation dose of subsequent radioimmunotherapy with {sup 90}Y-labelled rituximab in CD20+ B-cell lymphoma. Five patients with CD20+ B-cell lymphoma and progressive disease were prospectively enrolled. All patients underwent three study phases: initial dosimetric phase with baseline {sup 89}Zr-rituximab PET/CT imaging without a cold preload, followed 3 weeks later by a second dosimetric phase with administration of a standard preload (250 mg/m{sup 2}) of unlabelled rituximab followed by injection of {sup 89}Zr-rituximab, and a therapeutic phase 1 week later with administration of unlabelled rituximab followed by {sup 90}Y-rituximab. PET/CT imaging and tracer uptake by organs and lesions were assessed. With a cold rituximab preload, the calculated whole-body dose of {sup 90}Y-rituximab was similar (mean 0.87 mSv/MBq, range 0.82-0.99 mSv/MBq) in all patients. Without a preload, an increase in whole-body dose of 59 % and 87 % was noted in two patients with preserved circulating CD20+ B cells. This increase in radiation dose was primarily due to a 12.4-fold to 15-fold higher dose to the spleen without a preload. No significant change in whole-body dose was noted in the three other patients with B-cell depletion. Without a preload, consistently higher tumour uptake was noticed in patients with B-cell depletion. Administration of the standard preload of unlabelled rituximab impairs radioconjugate tumour targeting in the majority of patients eligible for radioimmunotherapy, that is patients previously treated with rituximab-containing therapeutic regimens. This common practice may need to be reconsidered and further evaluated as the rationale for this high preload has its origin in the ''prerituximab era''. (orig.)

  11. MRI Biomarkers for Hand-Motor Outcome Prediction and Therapy Monitoring following Stroke

    OpenAIRE

    Horn, U; Grothe., M; Lotze, M.

    2016-01-01

    Several biomarkers have been identified which enable a considerable prediction of hand-motor outcome after cerebral damage already in the subacute stage after stroke. We here review the value of MRI biomarkers in the evaluation of corticospinal integrity and functional recruitment of motor resources. Many of the functional imaging parameters are not feasible early after stroke or for patients with high impairment and low compliance. Whereas functional connectivity parameters have demonstrated...

  12. Stroke risk perception among participants of a stroke awareness campaign

    Directory of Open Access Journals (Sweden)

    Heuschmann Peter U

    2007-03-01

    Full Text Available Abstract Background Subjective risk factor perception is an important component of the motivation to change unhealthy life styles. While prior studies assessed cardiovascular risk factor knowledge, little is known about determinants of the individual perception of stroke risk. Methods Survey by mailed questionnaire among 1483 participants of a prior public stroke campaign in Germany. Participants had been informed about their individual stroke risk based on the Framingham stroke risk score. Stroke risk factor knowledge, perception of lifetime stroke risk and risk factor status were included in the questionnaire, and the determinants of good risk factor knowledge and high stroke risk perception were identified using logistic regression models. Results Overall stroke risk factor knowledge was good with 67–96% of the participants recognizing established risk factors. The two exceptions were diabetes (recognized by 49% and myocardial infarction (57%. Knowledge of a specific factor was superior among those affected by it. 13% of all participants considered themselves of having a high stroke risk, 55% indicated a moderate risk. All major risk factors contributed significantly to the perception of being at high stroke risk, but the effects of age, sex and education were non-significant. Poor self-rated health was additionally associated with high individual stroke risk perception. Conclusion Stroke risk factor knowledge was high in this study. The self perception of an increased stroke risk was associated with established risk factors as well as low perception of general health.

  13. Interventional neuroradiology of stroke, still not dead

    Institute of Scientific and Technical Information of China (English)

    Vitor; Mendes; Pereira; Karl-Olof; Lvblad

    2013-01-01

    Since the National Institute of Neurological Disorders and Stroke trial,intravenous thrombolysis has been gaining wide acceptance as the modality of treatment for acute embolic stroke,with a current therapeutic window of up to 4.5 h.Both imaging[with either magnetic resonance imaging(MRI)or computed tomography(CT)]and interventional techniques(thrombolysis and/or thrombectomy)have since improved and provided us with additional imaging of the penumbra using CT or MRI and more advanced thrombolysis or thrombectomy strategies that have been embraced in many centers dealing with patients with acute cerebral ischemia.These techniques,however,have come under scrutiny due to their accrued healthcare costs and have been questioned following major recent studies.These studies basically showed that interventional techniques were not superior to the traditional intravenous thrombolysis techniques and that penumbra imaging could not determine what patients would benefit from more aggressive(i.e.,interventional)treatment.We discuss this in the light of the latest developments in both diagnostic and interventional neuroradiology and point out why further studies are needed in order to define the right choices for patients with acute stroke.Indeed,these studies were in part conducted with suboptimal patient recruitment strategies and did not always use the latest interventional techniques available today.So,while these studies may have raised some relevant questions,at the same time,definitive answers have not been given,in our opinion.

  14. Interventional neuroradiology of stroke, still not dead.

    Science.gov (United States)

    Pereira, Vitor Mendes; Lövblad, Karl-Olof

    2013-12-28

    Since the National Institute of Neurological Disorders and Stroke trial, intravenous thrombolysis has been gaining wide acceptance as the modality of treatment for acute embolic stroke, with a current therapeutic window of up to 4.5 h. Both imaging [with either magnetic resonance imaging (MRI) or computed tomography (CT)] and interventional techniques (thrombolysis and/or thrombectomy) have since improved and provided us with additional imaging of the penumbra using CT or MRI and more advanced thrombolysis or thrombectomy strategies that have been embraced in many centers dealing with patients with acute cerebral ischemia. These techniques, however, have come under scrutiny due to their accrued healthcare costs and have been questioned following major recent studies. These studies basically showed that interventional techniques were not superior to the traditional intravenous thrombolysis techniques and that penumbra imaging could not determine what patients would benefit from more aggressive (i.e., interventional) treatment. We discuss this in the light of the latest developments in both diagnostic and interventional neuroradiology and point out why further studies are needed in order to define the right choices for patients with acute stroke. Indeed, these studies were in part conducted with suboptimal patient recruitment strategies and did not always use the latest interventional techniques available today. So, while these studies may have raised some relevant questions, at the same time, definitive answers have not been given, in our opinion.

  15. Relearning the Basics: Rehabilitation after a Stroke

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Stroke Rehabilitation Relearning the Basics: Rehabilitation After a Stroke Past ... to help them recover successfully. What is post-stroke rehabilitation? Rehab helps stroke survivors relearn skills lost to ...

  16. Optimal sequence timing of CT angiography and perfusion CT in patients with stroke

    Energy Technology Data Exchange (ETDEWEB)

    Morhard, D., E-mail: morhard@nrad.de [Institute of Clinical Radiology, University of Munich, Munich (Germany); Institute of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Klinikum Muenchen-Harlaching, Munich (Germany); Wirth, C.D. [Institute of Clinical Radiology, University of Munich, Munich (Germany); Department of General Internal Medicine, University Hospital Inselspital, University of Bern, Bern (Switzerland); Reiser, M.F. [Institute of Clinical Radiology, University of Munich, Munich (Germany); Schulte-Altedorneburg, G. [Institute of Diagnostic and Interventional Radiology, Neuroradiology and Nuclear Medicine, Klinikum Muenchen-Harlaching, Munich (Germany); Ertl-Wagner, B. [Institute of Clinical Radiology, University of Munich, Munich (Germany)

    2013-06-15

    Objective: Standard stroke CT protocols start with non-enhanced CT followed by perfusion-CT (PCT) and end with CTA. We aimed to evaluate the influence of the sequence of PCT and CTA on quantitative perfusion parameters, venous contrast enhancement and examination time to save critical time in the therapeutic window in stroke patients. Methods and materials: Stroke CT data sets of 85 patients, 47 patients with CTA before PCT (group A) and 38 with CTA after PCT (group B) were retrospectively analyzed by two experienced neuroradiologists. Parameter maps of cerebral blood flow, cerebral blood volume, time to peak and mean transit time and contrast enhancements (arterial and venous) were compared. Results: Both readers rated contrast of brain-supplying arteries to be equal in both groups (p = 0.55 (intracranial) and p = 0.73 (extracranial)) although the extent of venous superimposition of the ICA was rated higher in group B (p = 0.04). Quantitative perfusion parameters did not significantly differ between the groups (all p > 0.18), while the extent of venous superimposition of the ICA was rated higher in group B (p = 0.04). The time to complete the diagnostic CT examination was significantly shorter for group A (p < 0.01). Conclusion: Performing CTA directly after NECT has no significant effect on PCT parameters and avoids venous preloading in CTA, while examination times were significantly shorter.

  17. Spatial synchrony in cisco recruitment

    Science.gov (United States)

    Myers, Jared T.; Yule, Daniel L.; Jones, Michael L.; Ahrenstorff, Tyler D.; Hrabik, Thomas R.; Claramunt, Randall M.; Ebener, Mark P.; Berglund, Eric K.

    2015-01-01

    We examined the spatial scale of recruitment variability for disparate cisco (Coregonus artedi) populations in the Great Lakes (n = 8) and Minnesota inland lakes (n = 4). We found that the scale of synchrony was approximately 400 km when all available data were utilized; much greater than the 50-km scale suggested for freshwater fish populations in an earlier global analysis. The presence of recruitment synchrony between Great Lakes and inland lake cisco populations supports the hypothesis that synchronicity is driven by climate and not dispersal. We also found synchrony in larval densities among three Lake Superior populations separated by 25–275 km, which further supports the hypothesis that broad-scale climatic factors are the cause of spatial synchrony. Among several candidate climate variables measured during the period of larval cisco emergence, maximum wind speeds exhibited the most similar spatial scale of synchrony to that observed for cisco. Other factors, such as average water temperatures, exhibited synchrony on broader spatial scales, which suggests they could also be contributing to recruitment synchrony. Our results provide evidence that abiotic factors can induce synchronous patterns of recruitment for populations of cisco inhabiting waters across a broad geographic range, and show that broad-scale synchrony of recruitment can occur in freshwater fish populations as well as those from marine systems.

  18. The influence of neighborhood unemployment on mortality after stroke.

    Science.gov (United States)

    Unrath, Michael; Wellmann, Jürgen; Diederichs, Claudia; Binse, Lisa; Kalic, Marianne; Heuschmann, Peter Ulrich; Berger, Klaus

    2014-07-01

    Few studies have investigated the impact of neighborhood characteristics on mortality after stroke. Aim of our study was to analyze the influence of district unemployment as indicator of neighborhood socioeconomic status (SES-NH) on poststroke mortality, and to compare these results with the mortality in the underlying general population. Our analyses involve 2 prospective cohort studies from the city of Dortmund, Germany. In the Dortmund Stroke Register (DOST), consecutive stroke patients (N=1883) were recruited from acute care hospitals. In the Dortmund Health Study (DHS), a random general population sample was drawn (n=2291; response rate 66.9%). Vital status was ascertained in the city's registration office and information on district unemployment was obtained from the city's statistical office. We performed multilevel survival analyses to examine the association between district unemployment and mortality. The association between neighborhood unemployment and mortality was weak and not statistically significant in the stroke cohort. Only stroke patients exposed to the highest district unemployment (fourth quartile) had slightly higher mortality risks. In the general population sample, higher district unemployment was significantly associated with higher mortality following a social gradient. After adjustment for education, health-related behavior and morbidity was made the strength of this association decreased. The impact of SES-NH on mortality was different for stroke patients and the general population. Differences in the association between SES-NH and mortality may be partly explained by disease-related characteristics of the stroke cohort such as homogeneous lifestyles, similar morbidity profiles, medical factors, and old age. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  19. Neuroimaging of young adults with stroke in Ilorin Nigeria.

    Science.gov (United States)

    Oyinloye, Olalekan; Nzeh, Donald; Adesiyun, Olusola; Ibrahim, Mohammed; Akande, Halimat; Sanya, Emmanuel

    2015-01-01

    Stroke in young adults is relatively uncommon. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most valuable tools for the diagnosis of stroke. Recent data on stroke in young adults in Nigeria is sparse. The aim of this study is to document the imaging pattern in young patients aged 15-45 years with suspected cerebrovascular accidents (CVA) in the Nigerian environment. This was a retrospective study of 69 patients aged 15-45 years, with clinical diagnosis of stroke, referred for neuro-imaging, from October 2008 to November 2013. All patients with the clinical diagnosis of stroke within this age group were recruited into the study. Images were obtained from a four slice channel general electric CT machine and a 0.2 Tesla Siemens Magnetom Concerto MRI scanner. A total of 69 patients (44 males and 25 females) were studied. Sixty out of 69 (87.0%) patients were accurately diagnosed with CVA, with 9 (13.0) cases of misdiagnoses. A total of 21 (35%) out of the 60 cases confirmed on imaging had intracerebral hemorrhage (ICH), 10 (16.7%) had subarachnoid hemorrhage (SAH) and 29 (48.3%) had cerebral infarct (CI). Hypertension was the common risk factor for all stroke subtypes. The most common location for ICH, was the basal ganglia in 8 (38.8%), while the commonest pattern for CI, was lacunar infarct in the basal ganglia (51.7%). The incidence of hemorrhagic CVA (ICH and SAH combined) was slightly higher than ischemic CVA in this study. Lacunar infarcts in the basal ganglia and also ICH in the basal ganglia were the most common patterns, both are strongly linked to hypertension. A diagnostic protocol of stroke in young adults, to include neuroimaging and other ancillary investigations is advocated for stroke in young adults as some of the etiologies are treatable.

  20. Stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Freedman, Ben; Potpara, Tatjana S; Lip, Gregory Y H

    2016-01-01

    Atrial fibrillation is found in a third of all ischaemic strokes, even more after post-stroke atrial fibrillation monitoring. Data from stroke registries show that both unknown and untreated or under treated atrial fibrillation is responsible for most of these strokes, which are often fatal...... or debilitating. Most could be prevented if efforts were directed towards detection of atrial fibrillation before stroke occurs, through screening or case finding, and treatment of all patients with atrial fibrillation at increased risk of stroke with well-controlled vitamin K antagonists or non-vitamin K...

  1. Understanding Millennials to Improve Recruiting Efficiency

    Science.gov (United States)

    2011-03-24

    to the authors of Generations at Work, when recruiting Millennials one must “be tolerant of their “swiss cheese scheduling”-an hour or two here, a...Recruiting Command, Recruiting Operations, 4-3. 32 Ibid., 6-4. 33 U.S. Army Recruiting Command, The Recruiter Handbook , United States Army Recruiting...6-1. 35 U.S. Army Recruiting Command, The Recruiter Handbook , 1-3. 36 Lynn C. Lancaster and David Stillman, When Generations Collide: Who They Ar

  2. Risk factors for medical complications of acute hemorrhagic stroke

    Institute of Scientific and Technical Information of China (English)

    Jangala Mohan Sidhartha; Aravinda Reddy Purma; Nagaswaram Krupa Sagar; Marri Prabhu Teja; Meda Venkata subbaiah; Muniswami Purushothaman

    2015-01-01

    Objective: To assess the risk factors leading to medical complications of hemorrhagic stroke. Methods: We conducted an observational study in neurology, emergency and general medicine wards at a tertiary care teaching hospital in Kadapa. We recruited hemorrhagic stroke patients, and excluded the patients have evidence of trauma or brain tumor as the cause of hemorrhage. We observed the subjects throughout their hospital stay to assess the risk factors and complications. Results: During period of 12 months, 288 subjects included in the study, 89% of them identified at least 1 prespecified risk factor for their admission in hospital and 75% of them experienced at least 1 prespecified complication during their stay in hospital. Around 47% of subjects deceased, among which 64% were females. Conclusions: Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality rate was more when compared to males.

  3. Integrin Regulation during Leukocyte Recruitment.

    Science.gov (United States)

    Herter, Jan; Zarbock, Alexander

    2013-05-01

    Integrins are recognized as vital players in leukocyte recruitment. Integrin malfunction causes severe disease patterns characterized by the inability to fight pathogens. Although inflammatory reactions are beneficial and necessary for host defense, these reactions have to be controlled to prevent tissue destruction and harmful sequelae. In this review, we discuss the different signaling pathways leading to the change of integrin adhesiveness in neutrophils, monocytes, and lymphocytes. We thereby focus on the importance of integrin activation for the different steps of the leukocyte recruitment cascade, including rolling, adhesion, postadhesion strengthening, intravascular crawling, and transmigration, as each step necessitates the proper functioning of a distinct set of integrin molecules that has to be activated specifically. Additionally, we discuss endogenous mechanisms that balance and counteract integrin activation and limit leukocyte recruitment at the site of inflammation. Further insight into these complex mechanisms may provide new approaches for developing new anti-inflammatory therapies.

  4. Uncover the recruiter in you!

    CERN Multimedia

    2013-01-01

    2013 saw the launch of the one-day training course "Selecting the best person for CERN". So far, 10 courses have taken place and over 100 participants have taken part in this interactive, hands on experience.   The course has been met with much enthusiasm and positive feedback, with participants not only feeling better prepared and organised for the recruitment boards, but also equipped with concrete tools on how to prepare and conduct an effective selection interview. Following on from this success, further sessions are planned in 2014: we look forward to welcoming recruiting supervisors and board members who are likely to take part in a recruitment process, whether for LD or LD2IC, and who are interested in finding out more about how to get the most out of this important process! To enrol to this course, please follow this link: "Selecting the best person for CERN".

  5. Human development recruiting and selection

    Directory of Open Access Journals (Sweden)

    Maksimović Marijana

    2002-01-01

    Full Text Available Along with the development of trends towards internationalization and globalization, human resource management and, especially, international human resource management, attracted overall theoretical and practical interest. International environment is complex, made of numerous elements like social organization, laws, education, values and attitudes, religion language, politics, material and technological culture. In multicultural environment, strategic activities could be multiplied through economical political, cultural, social and technological spheres of action, making the recruitment, selection and successful resource allocation in the international human resource management a real challenge for top management. In international human resource management practice, several approaches to the recruitment have differentiated, playing the key roles in hiring talented individuals and retaining efficient workforce KW resources, labor force, recruiting, managers, education

  6. Microvascular Recruitment in Insulin Resistance

    DEFF Research Database (Denmark)

    Sjøberg, Kim Anker

    In this PhD work a new method for measuring microvascular recruitment was developed and evaluated, using continues real-time imaging of contrast enhanced ultrasound. Gas-filled microbubbles were infused intravenously and by taking advantage of the echogenic properties of the microbubbles the reso......In this PhD work a new method for measuring microvascular recruitment was developed and evaluated, using continues real-time imaging of contrast enhanced ultrasound. Gas-filled microbubbles were infused intravenously and by taking advantage of the echogenic properties of the microbubbles...... hormone glucagon-like-peptide-1 (GLP-1) in the microcirculation. Glucagon-like-peptide-1 analogs are drugs used for treatments of insulin resistance and type 2 diabetes but the vascular effects of GLP-1 in vivo are elusive. Here it was shown that GLP-1 rapidly increased the microvascular recruitment...

  7. Microvascular Recruitment in Insulin Resistance

    DEFF Research Database (Denmark)

    Sjøberg, Kim Anker

    the resonating sound from the microbubbles in the systemic circulation were recorded for determination of microvascular recruitment in designated muscle segments. Results showed that microvascular recruitment increased with insulin stimulation by ~30% in rats and ~40% in humans (study I). Furthermore......, it was observed that muscle contractions increased muscle perfusion rapidly by 3-4 fold and by 1-2 fold compared to basal and insulin, respectively, in both rat and human skeletal muscle (study I). The real-time contrast-enhanced ultrasound method was applied to investigate the vaso-active effect of the incretin...... hormone glucagon-like-peptide-1 (GLP-1) in the microcirculation. Glucagon-like-peptide-1 analogs are drugs used for treatments of insulin resistance and type 2 diabetes but the vascular effects of GLP-1 in vivo are elusive. Here it was shown that GLP-1 rapidly increased the microvascular recruitment...

  8. Mini-Stroke vs. Regular Stroke: What's the Difference?

    Science.gov (United States)

    ... How is a ministroke different from a regular stroke? Answers from Jerry W. Swanson, M.D. When ... brain, spinal cord or retina, which may cause stroke-like symptoms but does not damage brain cells ...

  9. Code stroke in Asturias.

    Science.gov (United States)

    Benavente, L; Villanueva, M J; Vega, P; Casado, I; Vidal, J A; Castaño, B; Amorín, M; de la Vega, V; Santos, H; Trigo, A; Gómez, M B; Larrosa, D; Temprano, T; González, M; Murias, E; Calleja, S

    2016-04-01

    Intravenous thrombolysis with alteplase is an effective treatment for ischaemic stroke when applied during the first 4.5 hours, but less than 15% of patients have access to this technique. Mechanical thrombectomy is more frequently able to recanalise proximal occlusions in large vessels, but the infrastructure it requires makes it even less available. We describe the implementation of code stroke in Asturias, as well as the process of adapting various existing resources for urgent stroke care in the region. By considering these resources, and the demographic and geographic circumstances of our region, we examine ways of reorganising the code stroke protocol that would optimise treatment times and provide the most appropriate treatment for each patient. We distributed the 8 health districts in Asturias so as to permit referral of candidates for reperfusion therapies to either of the 2 hospitals with 24-hour stroke units and on-call neurologists and providing IV fibrinolysis. Hospitals were assigned according to proximity and stroke severity; the most severe cases were immediately referred to the hospital with on-call interventional neurology care. Patient triage was provided by pre-hospital emergency services according to the NIHSS score. Modifications to code stroke in Asturias have allowed us to apply reperfusion therapies with good results, while emphasising equitable care and managing the severity-time ratio to offer the best and safest treatment for each patient as soon as possible. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  10. The Fangshan/Family-based Ischemic Stroke Study In China (FISSIC protocol

    Directory of Open Access Journals (Sweden)

    Chen Dafang

    2007-09-01

    Full Text Available Abstract Background The exact etiology of ischemic stroke remains unclear, because multiple genetic predispositions and environmental risk factors may be involved, and their interactions dictate the complexity. Family-based studies provide unique features in design, while they are currently underrepresented for studies of ischemic stroke in developing countries. The Fangshan/Family-based Ischemic Stroke Study In China (FISSIC program aims to conduct a genetic pedigree study of ischemic stroke in rural communities of China. Methods/Design The pedigrees of ischemic stroke with clear documentation are recruited by using the proband-initiated contact method, based on the stroke registry in hospital and communities. Blood samples and detailed information of pedigrees are collected through the health care network in the rural area, and prospective follow-up of the pedigrees cohort is scheduled. Complementary strategies of both family-based design and matched case-spousal control design are used, and comprehensive statistical methods will be implemented to ascertain potential complex genetic and environmental factors and their interactions as well. Discussion This study is complementary to other genetic pedigree studies of ischemic stroke, such as the Siblings With Ischemic Stroke Study (SWISS, which are established in developed countries. We describe the protocol of this family-based genetic epidemiological study that may be used as a new practical guideline and research paradigm in developing countries and facilitate initiatives of stroke study for international collaborations.

  11. Do recruitment ties affect wages?

    DEFF Research Database (Denmark)

    Larsen, Anna Folke; Rand, John; Torm, Nina Elisabeth

    This paper examines the extent to which recruitment ties affect individual wage outcomes in small and medium scale manufacturing firms. Based on a unique matched employer-employee dataset from Vietnam we find that there is a significant positive wage premium associated with obtaining a job through...... an informal contact, when controlling for standard determinants of wage compensation. Moreover, we show that the mechanism through which informal contacts affect wages depends on the type of recruitment tie used. The findings are robust across location, firm size categories and different worker types....

  12. Stroke risk perception among participants of a stroke awareness campaign

    OpenAIRE

    Heuschmann Peter U; Heidrich Jan; Kraywinkel Klaus; Wagner Markus; Berger Klaus

    2007-01-01

    Abstract Background Subjective risk factor perception is an important component of the motivation to change unhealthy life styles. While prior studies assessed cardiovascular risk factor knowledge, little is known about determinants of the individual perception of stroke risk. Methods Survey by mailed questionnaire among 1483 participants of a prior public stroke campaign in Germany. Participants had been informed about their individual stroke risk based on the Framingham stroke risk score. S...

  13. Mortality, Recurrence, and Dependency Rates Are Higher after Acute Ischemic Stroke in Elderly Patients with Diabetes Compared to Younger Patients.

    Science.gov (United States)

    Long, Xue; Lou, Yongzhong; Gu, Hongfei; Guo, Xiaofei; Wang, Tao; Zhu, Yanxia; Zhao, Wenjuan; Ning, Xianjia; Li, Bin; Wang, Jinghua; An, Zhongping

    2016-01-01

    Stroke has a greater effect on the elderly than on younger patients. However, the long-term outcomes associated with stroke among elderly patients with diabetes are unknown. We aimed to assess the differences in long-term outcomes between young and elderly stroke patients with diabetes. A total of 3,615 acute ischemic stroke patients with diabetes were recruited for this study between 2006 and 2014. Outcomes at 12 and 36 months after stroke (including mortality, recurrence, and dependency) were compared between younger (age alcohol consumers. Mortality, dependency, and recurrence rates at 12 months after stroke were 19.0, 48.5, and 20.9% in the elderly group and 7.4, 30.9, and 15.4% in the younger group, respectively (all P dependency, and recurrence rates at 12 and 36 months after stroke were significantly higher in the elderly group than in the younger group after adjusting for stroke subtypes, stroke severity, and risk factors. Odds ratios (95% confidence interval) at 12 and 36 months after stroke were 2.18 (1.64-2.89) and 3.10 (2.35-4.08), respectively, for mortality, all P dependency, all P dependency after stroke.

  14. Acupuncture Modulates the Functional Connectivity of the Default Mode Network in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Yong Zhang

    2014-01-01

    Full Text Available Abundant evidence from previous fMRI studies on acupuncture has revealed significant modulatory effects at widespread brain regions. However, few reports on the modulation to the default mode network (DMN of stroke patients have been investigated in the field of acupuncture. To study the modulatory effects of acupuncture on the DMN of stroke patients, eight right hemispheric infarction and stable ischemic stroke patients and ten healthy subjects were recruited to undergo resting state fMRI scanning before and after acupuncture stimulation. Functional connectivity analysis was applied with the bilateral posterior cingulate cortices chosen as the seed regions. The main finding demonstrated that the interregional interactions between the ACC and PCC especially enhanced after acupuncture at GB34 in stroke patients, compared with healthy controls. The results indicated that the possible mechanisms of the modulatory effects of acupuncture on the DMN of stroke patients could be interpreted in terms of cognitive ability and motor function recovery.

  15. Alexia for Braille following bilateral occipital stroke in an early blind woman.

    Science.gov (United States)

    Hamilton, R; Keenan, J P; Catala, M; Pascual-Leone, A

    2000-02-07

    Recent functional imaging and neurophysiologic studies indicate that the occipital cortex may play a role in Braille reading in congenitally and early blind subjects. We report on a woman blind from birth who sustained bilateral occipital damage following an ischemic stroke. Prior to the stroke, the patient was a proficient Braille reader. Following the stroke, she was no longer able to read Braille yet her somatosensory perception appeared otherwise to be unchanged. This case supports the emerging evidence for the recruitment of striate and prestriate cortex for Braille reading in early blind subjects.

  16. From stroke unit care to stroke care unit

    NARCIS (Netherlands)

    De Keyser, J; Sulter, G.

    1999-01-01

    In some stroke units continuous monitoring of blood pressure, electrocardiogram, body temperature, and oxygen saturation has become an integral part of the management of acute stroke. In addition, regular measurements of blood glucose are performed. Stroke units equipped with such monitoring facilit

  17. An Economic Evaluation Comparing Stroke Telemedicine to Conventional Stroke Medicine

    Science.gov (United States)

    Budhram, Stanley Chandra

    2011-01-01

    Stroke is not only a serious medical problem, but it also poses an enormous economic burden on society. Stroke ranks the third as the leading cause of death in the United States behind heart disease and cancer. The survivors of stroke suffer from various degrees of long-term disability which create a severe financial burden on society. University…

  18. From stroke unit care to stroke care unit

    NARCIS (Netherlands)

    De Keyser, J; Sulter, G.

    1999-01-01

    In some stroke units continuous monitoring of blood pressure, electrocardiogram, body temperature, and oxygen saturation has become an integral part of the management of acute stroke. In addition, regular measurements of blood glucose are performed. Stroke units equipped with such monitoring

  19. Choral singing therapy following stroke or Parkinson's disease: an exploration of participants' experiences.

    Science.gov (United States)

    Fogg-Rogers, Laura; Buetow, Stephen; Talmage, Alison; McCann, Clare M; Leão, Sylvia H S; Tippett, Lynette; Leung, Joan; McPherson, Kathryn M; Purdy, Suzanne C

    2016-01-01

    People with stroke or Parkinson's disease (PD) live with reduced mood, social participation and quality of life (QOL). Communication difficulties affect 90% of people with PD (dysarthria) and over 33% of people with stroke (aphasia). These consequences are disabling in many ways. However, as singing is typically still possible, its therapeutic use is of increasing interest. This article explores the experiences of and factors influencing participation in choral singing therapy (CST) by people with stroke or PD and their significant others. Participants (eight people with stroke, six with PD) were recruited from a community music therapy choir running CST. Significant others (seven for stroke, two for PD) were also recruited. Supported communication methods were used as needed to undertake semi-structured interviews (total N = 23). Thematic analysis indicated participants had many unmet needs associated with their condition, which motivated them to explore self-management options. CST participation was described as an enjoyable social activity, and participation was perceived as improving mood, language, breathing and voice. Choral singing was perceived by people with stroke and PD to help them self-manage some of the consequences of their condition, including social isolation, low mood and communication difficulties. Choral singing therapy (CST) is sought out by people with stroke and PD to help self-manage symptoms of their condition. Participation is perceived as an enjoyable activity which improves mood, voice and language symptoms. CST may enable access to specialist music therapy and speech language therapy protocols within community frameworks.

  20. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... busting” drug. The drug must be given soon after a stroke to be effective. Subsequent treatment for stroke includes medications and physical therapy, as well as surgery to repair the damage. Meal planning and physical activity may be part ...

  1. Hispanics and Heart Disease, Stroke

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Hispanics and Heart Disease, Stroke Updated:Aug 30,2016 Heart disease is the No. 1 killer for all Americans and stroke is the fifth leading cause of death. Hispanics ...

  2. Diabetes, Heart Disease, and Stroke

    Science.gov (United States)

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes, Heart Disease, and Stroke Having diabetes means that ... help to stop. What is the link between diabetes, heart disease, and stroke? Over time, high blood ...

  3. Preventable Pediatric Stroke via Vaccination?

    Directory of Open Access Journals (Sweden)

    Craig A. Press

    2015-11-01

    Full Text Available Investigators from the Vascular Effects of Infection in Pediatric Stroke (VIPS group studied the risk of arterial ischemic stroke (AIS associated with minor infection and routine childhood vaccinations.

  4. Let's Talk about Ischemic Stroke

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Let's Talk About Ischemic Stroke Updated:Dec 9,2015 The majority of strokes ... Should I Limit Sodium? How Do I Understand "Nutrition Facts" Labels? How Can I Quit Smoking? How ...

  5. Heart Disease and Stroke Statistics

    Science.gov (United States)

    ... Media for Heart.org Heart and Stroke Association Statistics Banner 1 - Stats white banner Each year, the ... health and disease in the population. Heart & Stroke Statistics FAQs What is Prevalence? Prevalence is an estimate ...

  6. Stroke rehabilitation and discharge planning.

    Science.gov (United States)

    Kerr, Peter

    Nurses play a pivotal role in the rehabilitation and discharge planning process of patients who have had a stroke. The nurse's role in the wider stroke multidisciplinary team is complex and diverse and, as such, stroke nurses may find it hard to describe their role and how it fits into the rehabilitation and discharge planning process. A definition of the stroke nurse role in prominent publications such as those of the Scottish Intercollegiate Guidelines Network and the Royal College of Physicians is lacking. This article emphasises the role of the stroke nurse in the rehabilitation and discharge planning process in the stroke unit, while highlighting the complexity, diversity and importance of this role in providing holistic care and support for patients who have survived a stroke. The author draws on his clinical experience of stroke nursing practice in primary, secondary and tertiary care in west central Scotland.

  7. Research on Reinforcement Depth for Foundation Treatment by Vacuum Preloading%真空预压地基处理的加固深度研究

    Institute of Scientific and Technical Information of China (English)

    吴迪; 孙田

    2011-01-01

    With the development of economy in coastal areas, the requirement of soft-soil treatment is much larger. As vacuum preloading has greater advantage for the soft-soil treatment, so it is widely used. But the research on the influencing depth of the vacuum preloading is little, and there is no definite conclusion. Here, the stressing conditions of soil are analyzed from microcosm and macrocosm based on 3-dimensional consolidation. The difference of vacuum pressure causes much deeper influence. Combined with engineering examples, the conclusion is got that the influencing depth of the vacuum preloading could reach to the end of plastic drainage board by analysing the monitoring data.%随着沿海经济的发展,软土处理的需求加大,真空预压处理软土有着比较大的优势,被广泛运用。但在真空预压的影响深度方面,目前学术界研究的较少,没有给出一个明确的结论。文章从土体三维固结出发,分析土体受力不但在微观上的等向受力,在宏观上受到真空压力差的影响,而且真空压力差增加了真空度的影响深度。同时结合工程实例,分析现场监测数据,得出真空预压影响深度可以达到排水板底部。

  8. Educational approach on stroke training in Europe.

    Science.gov (United States)

    Corea, F; Gunther, A; Kwan, J; Petzold, A; Debette, S; Sessa, M; Silvestrelli, G; Parnetti, L; Tambasco, N

    2006-01-01

    According to the European Stroke Initiative (EUSI), stroke care is best delivered within a stroke unit by a specialized multidisciplinary stroke team led by stroke specialists. At present, there is no guideline or consensus regarding training requirements or clinical standards that stroke specialists should achieve. It is envisaged that stroke specialists in training would need to acquire adequate knowledge and competency across three major areas of stroke care: acute stroke, stroke rehabilitation, and stroke prevention. With an EUSI document, the European Association of Young Neurologists and Trainees Stroke Subspeciality Group aims to promote discussion on the many aspects of stroke training and the requirements to be a stroke specialist in the European community. The ultimate purpose is to agree on common standards to promote good clinical care and effective stroke prevention across Europe. In the future, this may be translated into better patient outcome and a reduction in the global burden of this condition.

  9. 考虑摩擦特性时过盈量对轴承预紧力的影响%Influence of interference on bearing preload considering frictional properties

    Institute of Scientific and Technical Information of China (English)

    宁峰平; 姚建涛; 安静涛; 孙锟; 赵永生

    2015-01-01

    针对航天机构中轴承轴向预紧力精确确定的问题,基于静力学和弹性力学,在考虑配合尺寸、摩擦特性的基础上,研究了轴承预紧力与拧紧力矩的关系.利用锁紧螺母拧紧力矩与轴向力的关系,确定施加于轴承上的轴向力;根据摩擦力与摩擦特性及装配尺寸的关系,分析摩擦力对轴向力的截留作用;通过轴承力平衡方程组,对实际预紧力进行理论分析.文中研究了配合尺寸及摩擦特性对预紧力的影响,揭示了不同装配下预紧力随拧紧力矩的变化规律.研究结果表明:对轴承71807C预紧力结果进行分析,发现相同拧紧力矩下,过盈量增0.5μm,轴向力中约有123 N的力被截留;且摩擦系数增加0.05,轴向力截留率增大约13%.过盈量越大,轴承与主轴间摩擦力对轴向力的截留作用越大,预紧力对应的拧紧力矩越大;相比加热炉加热,油槽加热降低了配合区域的摩擦系数,加载相同的拧紧力矩时使轴承预紧力较大.经试验验证,该理论分析可以确定施加的预紧力,又可以提高装配质量.该研究建立预紧力测量的理论计算模型,并可用此模型较精确地确定预紧力,为轴承预紧力设计和装配提供参考.%Bearings are a necessary part of mechanism, and have been widely used in various mechanical systems, such as agricultural machinery, engineering machinery, precision machinery, aerospace machinery. The preload of bearings affects bearing stiffness, rotating precision and service life. Meanwhile, precise determination of bearing preload is the guarantee for the high-precision bearing support system. Related determining preloads have already been analyzed, but the literatures don't consider the interception of friction at fitting area. Space bearing works in space environment, and it is essential to accurately determine the preload. If the initial preload is not selected appropriately or accurately, the changes of preload induced by

  10. The Recruitment Process with Negrophilism

    Science.gov (United States)

    Anderson, Alvin Frederick

    1975-01-01

    Author suggests certain cultural aspects essential to be considered by counselors in vocational guidance of blacks, means of recruiting black graduates, and approaches for disseminating information about jobs among blacks: peer counseling, unstructured group discussions, sociodrama and black career conferences. Recommends employment of black…

  11. Recruiting and Retaining Summer Staff.

    Science.gov (United States)

    Crossen, Brian; Yerkes, Rita

    1998-01-01

    Recruiting of camp staff is challenged by economic and workplace restructuring, including business downsizing, part-time and temporary employment patterns, and generational attitude changes. Strategies for hiring and retaining staff include knowing what college-age workers want, marketing benefits, adopting new business strategies, and empowering…

  12. Gender bias in academic recruitment

    DEFF Research Database (Denmark)

    Abramo, Giovanni; D’Angelo, Ciriaco Andrea; Rosati, Francesco

    2016-01-01

    It is well known that women are underrepresented in the academic systems of many countries. Gender discrimination is one of the factors that could contribute to this phenomenon. This study considers a recent national academic recruitment campaign in Italy, examining whether women are subject to m...

  13. Do recruitment ties affect wages?

    DEFF Research Database (Denmark)

    Larsen, Anna Folke; Rand, John; Torm, Nina Elisabeth

    This paper examines the extent to which recruitment ties affect individual wage outcomes in small and medium scale manufacturing firms. Based on a unique matched employer-employee dataset from Vietnam we find that there is a significant positive wage premium associated with obtaining a job through...

  14. Predatory journals recruit fake editor

    OpenAIRE

    Sorokowski, Piotr; Kulczycki, Emanuel; Sorokowska, Agnieszka; Pisanski, Kasia

    2017-01-01

    This article is freely available online at http://www.nature.com/news/predatory-journals-recruit-fake-editor-1.21662 An investigation finds that dozens of academic titles offered ‘Dr Fraud’ — a sham, unqualified scientist — a place on their editorial board. Katarzyna Pisanski and colleagues report.

  15. Stroke literacy in Singapore: data from a survey of public housing estate residents.

    Science.gov (United States)

    Lim, Weiyen; Chuang, Ding Fang; Chue, Koy Min; Lee, Damian Z; Leong, Nicholas J; Ng, Zhi Guang; Peng, Kailing; Shen, Xiayan; Tham, Ye Ni; Wang, Kangjie; De Silva, Deidre Anne

    2014-09-01

    Knowledge of stroke symptoms is associated with seeking medical attention early, and knowledge of risk factors is an essential factor in stroke prevention. In this study, we evaluated the level of stroke literacy in Singapore. A cross-sectional study of Singapore citizens and permanent residents aged 21 years and above was conducted in a public housing estate. Participants were randomly sampled using multi-stage stratified sampling. Assessment of awareness of stroke symptoms and risk factors was performed using open-ended questions. In total, 687 respondents were recruited, with a response rate of 69.7%. Overall, 52.4% of respondents identified the brain as the source of pathology, and 47.6% could cite at least 1 of the 3 FAST symptoms (facial droop, arm weakness and speech difficulty), while 40% could name 2 or more of 7 established risk factors for stroke (high blood pressure, high cholesterol, cigarette smoking, diabetes mellitus, older age, previous heart attacks and stroke). Respondents at higher risk of stroke (older individuals and those with stroke risk factors) did not have greater awareness of stroke symptoms and risk factors. The majority of respondents reported they would seek immediate medical care if they experienced stroke symptoms. Only 59.4% knew the emergency ambulance service telephone number. In a sample of Singaporean adults residing in a public housing estate, we found evidence of poor stroke literacy, highlighting the need for comprehensive population-based education efforts. There is a role for opportunistic education among those at higher risk of stroke.

  16. Dysphagia and nutritional status at the time of hospital admission for ischemic stroke.

    Science.gov (United States)

    Crary, Michael A; Carnaby-Mann, Giselle D; Miller, Leslie; Antonios, Nader; Silliman, Scott

    2006-01-01

    Dysphagia and poor nutritional status occur frequently after stroke; however, potential associations between them are unknown. We evaluated potential associations between dysphagia and poor nutritional status in patients with acute ischemic stroke. Potential associations between these outcomes and more global stroke severity measures were also assessed. In all, 76 patients with acute ischemic stroke were recruited on admission to the dedicated stroke department of an academic medical center. All patients were assessed with a clinical swallowing evaluation, Functional Oral Intake Scale, Mini Nutritional Assessment, body mass index, percent body fat, National Institutes of Health Stroke Scale, modified Rankin Scale, and modified Barthel Index. Associations were evaluated among dysphagia, nutrition, and stroke severity measures. On clinical examination 52.6% of study patients demonstrated dysphagia and 26.3% were identified with poor nutritional status. Dysphagia, based on clinical assessment, was associated with stroke severity (National Institutes of Health Stroke Scale, odds ratio [OR] 4.6, 95% confidence interval [CI] 1.6-13.1; modified Rankin Scale, OR 12.3, 95% CI 3.2-47.4) and with functional oral intake (OR 29.2, 95% CI 8.4-101.8), but not with measures of nutritional status (Mini Nutritional Assessment, OR 1.0, 95% CI 0.4-2.8). Nutritional measures did not correlate with swallowing or stroke severity measures. Dysphagia and poor nutritional status are prevalent in patients with acute ischemic stroke, however, they are not associated with each other at the time of hospital admission. Furthermore, dysphagia, but not nutritional status, is associated with stroke severity measures.

  17. SAR: Stroke Authorship Recognition

    KAUST Repository

    Shaheen, Sara

    2015-10-15

    Are simple strokes unique to the artist or designer who renders them? If so, can this idea be used to identify authorship or to classify artistic drawings? Also, could training methods be devised to develop particular styles? To answer these questions, we propose the Stroke Authorship Recognition (SAR) approach, a novel method that distinguishes the authorship of 2D digitized drawings. SAR converts a drawing into a histogram of stroke attributes that is discriminative of authorship. We provide extensive classification experiments on a large variety of data sets, which validate SAR\\'s ability to distinguish unique authorship of artists and designers. We also demonstrate the usefulness of SAR in several applications including the detection of fraudulent sketches, the training and monitoring of artists in learning a particular new style and the first quantitative way to measure the quality of automatic sketch synthesis tools. © 2015 The Eurographics Association and John Wiley & Sons Ltd.

  18. Stroke and Episodic Memory Disorders

    Science.gov (United States)

    Lim, Chun; Alexander, Michael P.

    2009-01-01

    Memory impairments are common after stroke, and the anatomical basis for impairments may be quite variable. To determine the range of stroke-related memory impairment, we identified all case reports and group studies through the Medline database and the Science Citation Index. There is no hypothesis about memory that is unique to stroke, but there…

  19. Recovery of gait after stroke

    NARCIS (Netherlands)

    Kollen, B.J.

    2006-01-01

    In the Netherlands annually about 30,000 people suffer a stroke for the first time. One third of these stroke patients die within the first year, while 41% experience long term disabilities. This makes stroke a major disease in medical and in socio-economic terms. Not just on society but also, and f

  20. Recovery of gait after stroke

    NARCIS (Netherlands)

    Kollen, B.J.

    2006-01-01

    Revised edition of the digital PhD thesis, 14-03-2006 In the Netherlands annually about 30,000 people suffer a stroke for the first time. One third of these stroke patients die within the first year, while 41% experience long term disabilities. This makes stroke a major disease in medical and in soc

  1. Personal accounts of stroke experiences

    NARCIS (Netherlands)

    Wachters-Kaufmann, CSM

    2000-01-01

    As there appeared to be a need for personal accounts of stroke experiences, a book called "Speaking about Stroke" was written for stroke patients and their caregivers. For the past two years, a questionnaire was sent to the people who had ordered the book, to gain an insight into the characteristics

  2. Personal accounts of stroke experiences

    NARCIS (Netherlands)

    Wachters-Kaufmann, CSM

    2000-01-01

    As there appeared to be a need for personal accounts of stroke experiences, a book called "Speaking about Stroke" was written for stroke patients and their caregivers. For the past two years, a questionnaire was sent to the people who had ordered the book, to gain an insight into the characteristics

  3. Recovery of gait after stroke

    NARCIS (Netherlands)

    Kollen, B.J.

    Revised edition of the digital PhD thesis, 14-03-2006 In the Netherlands annually about 30,000 people suffer a stroke for the first time. One third of these stroke patients die within the first year, while 41% experience long term disabilities. This makes stroke a major disease in medical and in

  4. Recovery of gait after stroke

    NARCIS (Netherlands)

    Kollen, B.J.

    2006-01-01

    In the Netherlands annually about 30,000 people suffer a stroke for the first time. One third of these stroke patients die within the first year, while 41% experience long term disabilities. This makes stroke a major disease in medical and in socio-economic terms. Not just on society but also, and

  5. Extending the Query Language of a Data Warehouse for Patient Recruitment.

    Science.gov (United States)

    Dietrich, Georg; Ertl, Maximilian; Fette, Georg; Kaspar, Mathias; Krebs, Jonathan; Mackenrodt, Daniel; Störk, Stefan; Puppe, Frank

    2017-01-01

    Patient recruitment for clinical trials is a laborious task, as many texts have to be screened. Usually, this work is done manually and takes a lot of time. We have developed a system that automates the screening process. Besides standard keyword queries, the query language supports extraction of numbers, time-spans and negations. In a feasibility study for patient recruitment from a stroke unit with 40 patients, we achieved encouraging extraction rates above 95% for numbers and negations and ca. 86% for time spans.

  6. 29 CFR 36.510 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Recruitment. 36.510 Section 36.510 Labor Office of the... Activities Prohibited § 36.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has...

  7. 44 CFR 19.510 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Recruitment. 19.510 Section... Programs or Activities Prohibited § 19.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a...

  8. 24 CFR 3.510 - Recruitment.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Recruitment. 3.510 Section 3.510... Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found to be presently...

  9. 22 CFR 146.510 - Recruitment.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Recruitment. 146.510 Section 146.510 Foreign... Education Programs or Activities Prohibited § 146.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees...

  10. 10 CFR 1042.510 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Recruitment. 1042.510 Section 1042.510 Energy DEPARTMENT... Education Programs or Activities Prohibited § 1042.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees...

  11. 36 CFR 1211.510 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Recruitment. 1211.510 Section... Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found to be presently...

  12. 45 CFR 618.310 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Recruitment. 618.310 Section 618.310 Public... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 618.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 618.300 through 618.310 apply shall not discriminate on the...

  13. 44 CFR 19.310 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Recruitment. 19.310 Section... RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 19.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 19.300 through 19...

  14. 38 CFR 23.510 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Recruitment. 23.510... Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found to be presently...

  15. 10 CFR 5.510 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Recruitment. 5.510 Section 5.510 Energy NUCLEAR REGULATORY... Prohibited § 5.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found...

  16. 36 CFR 1211.310 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Recruitment. 1211.310 Section... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1211.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 1211.300 through 1211.310 apply shall not discriminate on the...

  17. 13 CFR 113.510 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Recruitment. 113.510 Section 113... Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found to be presently...

  18. 13 CFR 113.310 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Recruitment. 113.310 Section 113... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 113.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 113.300 through 113.310 apply shall not discriminate on the...

  19. 43 CFR 41.510 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Recruitment. 41.510 Section 41.510 Public... in Employment in Education Programs or Activities Prohibited § 41.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment...

  20. 22 CFR 229.510 - Recruitment.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Recruitment. 229.510 Section 229.510 Foreign... in Education Programs or Activities Prohibited § 229.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring...

  1. 10 CFR 5.310 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Recruitment. 5.310 Section 5.310 Energy NUCLEAR REGULATORY... FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 5.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 5.300 through 5.310 apply shall not...

  2. 7 CFR 15a.23 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Recruitment. 15a.23 Section 15a.23 Agriculture Office... FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 15a.23 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which this subpart applies shall...

  3. 45 CFR 2555.510 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Recruitment. 2555.510 Section 2555.510 Public... Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found to be presently...

  4. 20 CFR 656.21 - Supervised recruitment.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Supervised recruitment. 656.21 Section 656.21... Supervised recruitment. (a) Supervised recruitment. Where the Certifying Officer determines it appropriate, post-filing supervised recruitment may be required of the employer for the pending application or...

  5. 14 CFR 1253.510 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Recruitment. 1253.510 Section 1253.510... in Employment in Education Programs or Activities Prohibited § 1253.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment...

  6. 45 CFR 2555.310 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Recruitment. 2555.310 Section 2555.310 Public... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 2555.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 2555.300 through 2555.310 apply shall not discriminate on the...

  7. 28 CFR 54.510 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Recruitment. 54.510 Section 54.510... in Employment in Education Programs or Activities Prohibited § 54.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment...

  8. 32 CFR 196.510 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Recruitment. 196.510 Section 196.510 National... Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found to be presently...

  9. 41 CFR 101-4.510 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Recruitment. 101-4.510... Employment in Education Programs or Activities Prohibited § 101-4.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring...

  10. 29 CFR 36.310 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Recruitment. 36.310 Section 36.310 Labor Office of the... FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 36.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 36.300 through 36.310...

  11. 24 CFR 3.310 - Recruitment.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Recruitment. 3.310 Section 3.310... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 3.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 3.300 through 3.310 apply shall not discriminate on the basis...

  12. 32 CFR 196.310 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Recruitment. 196.310 Section 196.310 National... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 196.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 196.300 through 196.310 apply shall not discriminate on the...

  13. 49 CFR 25.510 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Recruitment. 25.510 Section 25.510 Transportation... Education Programs or Activities Prohibited § 25.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees...

  14. 15 CFR 8a.510 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Recruitment. 8a.510 Section 8a.510... in Employment in Education Programs or Activities Prohibited § 8a.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment...

  15. 18 CFR 1317.310 - Recruitment.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Recruitment. 1317.310... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1317.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 1317.300 through 1317.310 apply shall not discriminate on the...

  16. 20 CFR 655.30 - Supervised recruitment.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Supervised recruitment. 655.30 Section 655.30... Workers) § 655.30 Supervised recruitment. (a) Supervised recruitment. Where an employer is found to have... failed to adequately conduct recruitment activities or failed in any obligation of this part, the CO may...

  17. 6 CFR 17.510 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Recruitment. 17.510 Section 17.510 Domestic... in Employment in Education Programs or Activities Prohibited § 17.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment...

  18. 34 CFR 106.23 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Recruitment. 106.23 Section 106.23 Education... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 106.23 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which this subpart applies shall not discriminate on the basis of sex...

  19. 45 CFR 618.510 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Recruitment. 618.510 Section 618.510 Public... Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found to be presently...

  20. 18 CFR 1317.510 - Recruitment.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Recruitment. 1317.510... Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found to be presently...

  1. 45 CFR 83.12 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Recruitment. 83.12 Section 83.12 Public Welfare... § 83.12 Recruitment. (a) Comparable recruitment. A federally supported entity shall, with respect to... demonstrate that such action is part of a recruitment program which does not have the effect of discriminating...

  2. 7 CFR 15a.53 - Recruitment.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Recruitment. 15a.53 Section 15a.53 Agriculture Office... Activities Prohibited § 15a.53 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has...

  3. 34 CFR 106.53 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Recruitment. 106.53 Section 106.53 Education... Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment and hiring of employees. Where a recipient has been found to be presently...

  4. 31 CFR 28.510 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Recruitment. 28.510 Section 28.510... Basis of Sex in Employment in Education Programs or Activities Prohibited § 28.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment...

  5. 40 CFR 5.510 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Recruitment. 5.510 Section 5.510... in Employment in Education Programs or Activities Prohibited § 5.510 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment...

  6. 31 CFR 28.310 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Recruitment. 28.310 Section 28.310... Basis of Sex in Admission and Recruitment Prohibited § 28.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 28.300 through 28.310 apply shall not discriminate on the basis of sex in...

  7. 45 CFR 86.53 - Recruitment.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Recruitment. 86.53 Section 86.53 Public Welfare... in Employment in Education Programs or Activities Prohibited § 86.53 Recruitment. (a) Nondiscriminatory recruitment and hiring. A recipient shall not discriminate on the basis of sex in the recruitment...

  8. 38 CFR 23.310 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Recruitment. 23.310... Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 23.310 Recruitment. (a) Nondiscriminatory recruitment. A recipient to which §§ 23.300 through 23.310 apply shall not discriminate on the...

  9. International Student Recruitment: Trends and Challenges

    Science.gov (United States)

    Falcone, Santa

    2017-01-01

    This paper provides a review of current trends in international student recruitment. Focusing specifically on recruitment of Chinese students, important aspects of China's educational system relevant to recruitment are presented. Barriers to Chinese student recruitment are then discussed. Successful, employed, international graduates validate…

  10. 20 CFR 655.205 - Recruitment period.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Recruitment period. 655.205 Section 655.205... Agricultural Employment § 655.205 Recruitment period. (a) If the OFLC Administrator determines that the... respect to the recruitment of U.S. workers. (c) By the 60th day of the recruitment period, or 20 days...

  11. Endocarditis and Stroke

    Science.gov (United States)

    GRECU, Nicolae; TIU, Cristina; TERECOASA, Elena; BAJENARU, Ovidiu

    2014-01-01

    Endocarditis is an important, although less common, cause of cerebral embolism. All forms of endocarditis share an initial common pathophysiologic pathway, best illustrated by the non-bacterial thrombotic form, but also a final potential for embolization. Stroke associated with endocarditis has signifficant mortality and morbidity rates, especially due to the frequent concomitant multiple sites of brain embolization. In this article we aim to briefly review endocarditis with a focus on stroke as a complication, while also presenting case correlates from our department. PMID:25705308

  12. Physical factors associated with fatigue after stroke: an exploratory study.

    Science.gov (United States)

    Hoang, Chi Lan Nguyen; Salle, Jean-Yves; Mandigout, Stéphane; Hamonet, Julia; Macian-Montoro, Francisco; Daviet, Jean-Christophe

    2012-01-01

    To look for a relationship between physical fatigue and physical parameters in patients at least 3 months post stroke. We conducted a prospective cross-sectional study of 32 poststroke patients (average duration of stroke 40 months) who were recruited among in- and outpatients followed by the Department of Physical and Rehabilitation Medicine of a university hospital. Fatigue was defined as a Fatigue Severity Scale (FSS) score of 4 or more. The parameters studied were age, sex, time since stroke, Demeurisse Motor Index, Barthel Index score, new Functional Ambulation Category, Berg Balance Scale, 10-meter walk test, 6-minute walk test, Dijon Physical Activity Score, Montgomery and Asberg Depression Rating Scale, Epworth Sleepiness Scale, presence of pain, and length and area of the center of pressure displacement obtained posturographically. Two-thirds of patients (65.6%) were fatigued. The mean FSS score was 4.3 ± 1.8. Fatigue was not associated with the physical parameters studied; notably, there was no correlation with motor impairment, autonomy and walking capacity, or balance and physical activity. However, after multivariate analysis, we found an association between physical fatigue and time since the occurrence of stroke (P = .05). Our study revealed a relationship between pain and physical fatigue, as reported by 2 other studies. Poststroke fatigue management should include appropriate pain management. Further studies are necessary to determine the causes of physical fatigue after stroke.

  13. Inflammation without neuronal death triggers striatal neurogenesis comparable to stroke.

    Science.gov (United States)

    Chapman, Katie Z; Ge, Ruimin; Monni, Emanuela; Tatarishvili, Jemal; Ahlenius, Henrik; Arvidsson, Andreas; Ekdahl, Christine T; Lindvall, Olle; Kokaia, Zaal

    2015-11-01

    Ischemic stroke triggers neurogenesis from neural stem/progenitor cells (NSPCs) in the subventricular zone (SVZ) and migration of newly formed neuroblasts toward the damaged striatum where they differentiate to mature neurons. Whether it is the injury per se or the associated inflammation that gives rise to this endogenous neurogenic response is unknown. Here we showed that inflammation without corresponding neuronal loss caused by intrastriatal lipopolysaccharide (LPS) injection leads to striatal neurogenesis in rats comparable to that after a 30 min middle cerebral artery occlusion, as characterized by striatal DCX+ neuroblast recruitment and mature NeuN+/BrdU+ neuron formation. Using global gene expression analysis, changes in several factors that could potentially regulate striatal neurogenesis were identified in microglia sorted from SVZ and striatum of LPS-injected and stroke-subjected rats. Among the upregulated factors, one chemokine, CXCL13, was found to promote neuroblast migration from neonatal mouse SVZ explants in vitro. However, neuroblast migration to the striatum was not affected in constitutive CXCL13 receptor CXCR5(-/-) mice subjected to stroke. Infarct volume and pro-inflammatory M1 microglia/macrophage density were increased in CXCR5(-/-) mice, suggesting that microglia-derived CXCL13, acting through CXCR5, might be involved in neuroprotection following stroke. Our findings raise the possibility that the inflammation accompanying an ischemic insult is the major inducer of striatal neurogenesis after stroke.

  14. Ultrasonographic Findings in Hemiplegic Knees of Stroke Patients

    Directory of Open Access Journals (Sweden)

    Chao-Pin Yang

    2005-02-01

    Full Text Available Clinical and radiologic asymmetric arthritic differences between paralyzed and nonparalyzed limbs of stroke patients have been reported. Arthritic pathology aggravates motor dysfunction and compromises rehabilitation. Musculoskeletal ultrasonography plays an important role in showing soft tissue and the articular cartilage of the knee. Fifty-nine patients with either ischemic or hemorrhagic stroke-induced right or left hemiplegia were recruited to evaluate soft-tissue and intra-articular cartilage changes in hemiplegic knees of stroke patients using ultrasonography. An additional 15 subjects (30 knees without knee disease or a history of knee trauma or surgery were used as controls. There were significant differences in suprapatellar effusion and patellar tendinitis between hemiplegic and nonhemiplegic knees. Suprapatellar effusion and pes anserinus tendinitis were correlated with Brunnstrom stage. The length of time since stroke onset was not significantly correlated with positive ultrasonographic findings in hemiplegic knees. In conclusion, ultrasonography is useful for detecting periarticular soft-tissue changes and intra-articular lesions in hemiplegic knees of stroke patients.

  15. Incidence of Stroke in Young Adults: A Review

    Directory of Open Access Journals (Sweden)

    Carmine Marini

    2011-01-01

    Full Text Available Introduction. Stroke in the young may have a dramatic impact on the quality of life in survivors. This study was aimed to evaluate incidence of first-ever stroke in the young by means of a systematic review. Materials and Methods. All papers on incidence of stroke in the young published after 1980, were identified by electronic search of Medline and manual search of reference lists. Only studies recruiting subjects under 44 years of age and with a lower age limit not higher than 20 years were included. Incidence rates were standardized to the 2000 European population according to the direct method. Poisson regression analysis was used to compare studies. Results. 29 studies including 3548 participants were identified. Incidence rates, after excluding a few outliers, ranged between 8.63 and 19.12 for crude rates and between 8.70 and 21.02 for standardized rates. Heterogeneity among studies was statistically significant but improved after excluding 4 studies. Few studies reported the proportions of stroke subtypes. Conclusions. Stroke in subjects under 45 years of age is not such a rare disease and requires specific preventive programs.

  16. Family History in Young Patients With Stroke.

    Science.gov (United States)

    Thijs, Vincent; Grittner, Ulrike; Dichgans, Martin; Enzinger, Christian; Fazekas, Franz; Giese, Anne-Katrin; Kessler, Christof; Kolodny, Edwin; Kropp, Peter; Martus, Peter; Norrving, Bo; Ringelstein, Erich Bernd; Rothwell, Peter M; Schmidt, Reinhold; Tanislav, Christian; Tatlisumak, Turgut; von Sarnowski, Bettina; Rolfs, Arndt

    2015-07-01

    Family history of stroke is an established risk factor for stroke. We evaluated whether family history of stroke predisposed to certain stroke subtypes and whether it differed by sex in young patients with stroke. We used data from the Stroke in Fabry Patients study, a large prospective, hospital-based, screening study for Fabry disease in young patients (aged stroke in whom cardiovascular risk factors and family history of stroke were obtained and detailed stroke subtyping was performed. A family history of stroke was present in 1578 of 4232 transient ischemic attack and ischemic stroke patients (37.3%). Female patients more often had a history of stroke in the maternal lineage (P=0.027) than in the paternal lineage. There was no association with stroke subtype according to Trial of Org 10172 in Acute Stroke Treatment nor with the presence of white matter disease on brain imaging. Patients with dissection less frequently reported a family history of stroke (30.4% versus 36.3%; P=0.018). Patients with a parental history of stroke more commonly had siblings with stroke (3.6% versus 2.6%; P=0.047). Although present in about a third of patients, a family history of stroke is not specifically related to stroke pathogenic subtypes in patients with young stroke. Young women with stroke more often report stroke in the maternal lineage. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583. © 2015 American Heart Association, Inc.

  17. Means for load variation during echocardiographic assessment of the Frank-Starling relationship.

    Science.gov (United States)

    Atkins, B Z; Silvestry, S C; Davis, J W; Kisslo, J A; Glower, D D

    1999-10-01

    Because minimally invasive methods of preload variation are not validated for load-insensitive indexes of cardiac performance, intravenous nitroglycerin (NTG), phenylephrine, and saline solution (VOL) boluses were used in blocked and intact autonomic states to alter load and were compared with vena caval occlusion in the assessment of preload recruitable stroke work relationships between stroke work and left ventricular end-diastolic volume in dogs. In both autonomic states NTG and VOL produced comparable linear relationships. NTG and saline solution were combined with noninvasive measurements of left ventricular pressure and volume to construct echocardiographic relationships between stroke work and left ventricular end-diastolic cross-sectional area; NTG produced linear relationships similar to vena caval occlusion. Therefore NTG and VOL reliably alter load in constructing preload recruitable stroke work relationships, and NTG may be used with noninvasive measurements to provide load-insensitive estimates of cardiac function in a minimally invasive manner.

  18. Navigating stroke care: the experiences of younger stroke survivors.

    Science.gov (United States)

    Sadler, Euan; Daniel, Katie; Wolfe, Charles D A; McKevitt, Christopher

    2014-01-01

    Although stroke is associated with ageing, a significant proportion of strokes occur in younger people. Younger stroke survivors have experienced care available as inappropriate to their needs. However, insufficient attention has been paid to how the social context shapes their experiences of care. We investigated this question with younger stroke survivors in Greater London, UK. We conducted in-depth interviews with individuals aged between 24 and 62 years. Interviews were analysed thematically, with interpretation informed by Bourdieu's concepts of field, capital and habitus. In the acute care setting it was implicit for participants that expertise and guidance was to be prioritised and largely this was reported as what was received. Individuals' cultural capital shaped expectations to access information, but health care professionals' symbolic capital meant they controlled its provision. After discharge, professional guidance was still looked for, but many felt it was limited or unavailable. It was here that participants' social, cultural and economic capital became more important in experiences of care. The field of stroke shaped younger stroke survivors' experiences of care. Navigating stroke care was contingent on accessing different forms of capital. Differences in access to these resources influenced longer term adjustment after stroke. Stroke care can be conceptualised as a temporal field of social activity and relationships which shapes variations in experiences of care among younger stroke survivors, and differences in expectations of support at different time points after stroke. On entering the field of stroke participants reported needing health care professional guidance and expertise to manage the acute event, yet difficulties accessing information in hospital limited the agency of some individuals wanting to take an active role in their recovery. After discharge from hospital variations in experiences of care among participants were more evident

  19. Proportional Motor Recovery After Stroke: Implications for Trial Design.

    Science.gov (United States)

    Stinear, Cathy M; Byblow, Winston D; Ackerley, Suzanne J; Smith, Marie-Claire; Borges, Victor M; Barber, P Alan

    2017-03-01

    Recovery of upper-limb motor impairment after first-ever ischemic stroke is proportional to the degree of initial impairment in patients with a functional corticospinal tract (CST). This study aimed to investigate whether proportional recovery occurs in a more clinically relevant sample including patients with intracerebral hemorrhage and previous stroke. Patients with upper-limb weakness were assessed 3 days and 3 months poststroke with the Fugl-Meyer scale. Transcranial magnetic stimulation was used to test CST function, and patients were dichotomized according to the presence of motor evoked potentials in the paretic wrist extensors. Linear regression modeling of Δ Fugl-Meyer score between 3 days and 3 months was performed, with predictors including initial impairment (66 - baseline Fugl-Meyer score), age, sex, stroke type, previous stroke, comorbidities, and upper-limb therapy dose. One hundred ninety-two patients were recruited, and 157 completed 3-month follow-up. Patients with a functional CST made a proportional recovery of 63% (95% confidence interval, 55%-70%) of initial motor impairment. The recovery of patients without a functional CST was not proportional to initial impairment and was reduced by greater CST damage. Recovery of motor impairment in patients with intact CST is proportional to initial impairment and unaffected by previous stroke, type of stroke, or upper-limb therapy dose. Novel interventions that interact with the neurobiological mechanisms of recovery are needed. The generalizability of proportional recovery is such that patients with intracerebral hemorrhage and previous stroke may usefully be included in interventional rehabilitation trials. URL: http://www.anzctr.org.au. Unique identifier: ANZCTR12611000755932. © 2017 American Heart Association, Inc.

  20. An EMG-driven exoskeleton hand robotic training device on chronic stroke subjects: task training system for stroke rehabilitation.

    Science.gov (United States)

    Ho, N S K; Tong, K Y; Hu, X L; Fung, K L; Wei, X J; Rong, W; Susanto, E A

    2011-01-01

    An exoskeleton hand robotic training device is specially designed for persons after stroke to provide training on their impaired hand by using an exoskeleton robotic hand which is actively driven by their own muscle signals. It detects the stroke person's intention using his/her surface electromyography (EMG) signals from the hemiplegic side and assists in hand opening or hand closing functional tasks. The robotic system is made up of an embedded controller and a robotic hand module which can be adjusted to fit for different finger length. Eight chronic stroke subjects had been recruited to evaluate the effects of this device. The preliminary results showed significant improvement in hand functions (ARAT) and upper limb functions (FMA) after 20 sessions of robot-assisted hand functions task training. With the use of this light and portable robotic device, stroke patients can now practice more easily for the opening and closing of their hands at their own will, and handle functional daily living tasks at ease. A video is included together with this paper to give a demonstration of the hand robotic system on chronic stroke subjects and it will be presented in the conference.

  1. Long term ingestion of a preload containing fructo-oligosaccharide or guar gum decreases fat mass but not food intake in mice.

    Science.gov (United States)

    Hadri, Zouheyr; Chaumontet, Catherine; Fromentin, Gilles; Even, Patrick C; Darcel, Nicolas; Bouras, Abdelkader Dilmi; Tomé, Daniel; Rasoamanana, Rojo

    2015-08-01

    Fermentable dietary fibre such as fructo-oligosaccharide and viscous dietary fibers such as guar gum and alginate affect energy homeostasis. The goal of this study was to compare the impact of long term intake of these three dietary fibers on food intake, meal pattern, body weight and fat accumulation in mice. Over a period of 3weeks, the mice were fed daily with a preload containing 32mg of fructo-oligosaccharide or alginate or 13mg of guar gum. Food intake and body weight were monitored weekly, while meal patterns, adiposity and the expression of hypothalamic neuropeptide genes were evaluated at the end of the study period. The 3 dietary fibers produced a similar decrease in total daily food intake (14 to 22%) at the end of the first week, and this effect disappeared over time. The 3 dietary fibers induced a slight variation in satiation parameters. Body weight and expression of hypothalamic neuropeptide genes were not affected by any of the treatment. Preload of fructo-oligosaccharide and guar gum induced a similar and substantial decrease in the development of adiposity (17% and 14%, respectively), while alginate had no effect. Our results demonstrate mainly that the inhibitory effect of dietary fiber on food intake is lost over time, and that guar gum limits fat storage.

  2. Numerical Study Of The Effects Of Preloading, Axial Loading And Concrete Shrinkage On Reinforced Concrete Elements Strengthened By Concrete Layers And Jackets

    Science.gov (United States)

    Lampropoulos, A. P.; Dritsos, S. E.

    2008-07-01

    In this study, the technique of seismic strengthening existing reinforced concrete columns and beams using additional concrete layers and jackets is examined. The finite element method and the finite element program ATENA is used in this investigation. When a reinforced jacket or layer is being constructed around a column it is already preloaded due to existing service loads. This effect has been examined for different values of the axial load normalized to the strengthened column. The techniques of strengthening with a concrete jacket or a reinforced concrete layer on the compressive side of the column are examined. Another phenomenon that is examined in this study is the shrinkage of the new concrete of an additional layer used to strengthen an existing member. For this investigation, a simply supported beam with an additional reinforced concrete layer on the tensile side is examined. The results demonstrate that the effect of preloading is important when a reinforced concrete layer is being used with shear connectors between the old and the new reinforcement. It was also found that the shrinkage of the new concrete reduces the strength of the strengthened beam and induces an initial sliding between the old and the new concrete.

  3. Sex and acute stroke presentation.

    Science.gov (United States)

    Labiche, Lise A; Chan, Wenyaw; Saldin, Kamaldeen R; Morgenstern, Lewis B

    2002-11-01

    We determine whether a sex difference exists for acute stroke emergency department presentation. The TLL Temple Foundation Stroke Project is a prospective observational study of acute stroke management that identified 1,189 validated strokes in nonurban community EDs from February 1998 to March 2000. Structured interview of the patient and the person with the patient at symptom onset identified the symptom or symptoms that prompted the patient to seek medical attention. Interview data were available for 1,124 (94%) patients. A physician blinded to sex classified the reported symptoms into 14 categories. Nontraditional stroke symptoms were reported by 28% of women and 19% of men (odds ratio 1.62; 95% confidence interval 1.2 to 2.2). Nontraditional stroke symptoms, pain (men 8%, women 12%) and change in level of consciousness (men 12%, women 17%), were more often reported by women. Traditional stroke symptoms, imbalance (men 20%, women 15%) and hemiparesis (men 24%, women 19%), were reported more frequently by men. Trends were also found for women to present with nonneurologic symptoms (men 17%, women 21%) and men to present with gait abnormalities (men 11%, women 8%). There was no sex difference in the mean number of symptoms reported by an individual patient. This study suggests that a sex difference exists in reporting of acute stroke symptoms. Women with validated strokes present more frequently with nontraditional stroke symptoms than men. Recognition of this difference might yield faster evaluation and management of female patients with acute stroke eligible for acute therapies.

  4. Stroke while jogging.

    OpenAIRE

    Kelly, W F; Roussak, J.

    1980-01-01

    Jogging is a form of physical exercise that has stimulated the imagination of the public as shown by recent appearance of its own journal (Jogging Magazine, Editor J. Bryant). We wish to report the unusual complication of an acute stroke sustained during jogging.

  5. Ischemic strokes and migraine

    Energy Technology Data Exchange (ETDEWEB)

    Bousser, M.G.; Baron, J.C.; Chiras, J.

    1985-11-01

    Lasting neurological deficits, though most infrequent, do occur in migrainous subjects and are well documented by clinical angiographic computed tomographic (CT scan) and even pathological studies. However the mechanism of cerebral ischemia in migraine remains widely unknown and the precise role of migraine in the pathogenesis of ischemic strokes is still debated. (orig./MG).

  6. Heart Disease and Stroke

    Centers for Disease Control (CDC) Podcasts

    2013-09-03

    In this podcast, Dr. Tom Frieden, CDC Director, discusses the number one killer in the United States - heart disease and stroke.  Created: 9/3/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/6/2014.

  7. Stroke? Localized, otogenic meningitis!

    DEFF Research Database (Denmark)

    Ingolfsdottir, Harpa Maria; Thomasen, Per Caye

    2011-01-01

    We report the case of a patient admitted with aphasia, treated for a stroke. Subsequently, it was revealed that the symptoms were caused by complicated otitis media with localized meningitis. This case draws attention to the possible intracranial spread of infection when neurological symptoms occur...

  8. Neurorehabilitation after Stroke

    Directory of Open Access Journals (Sweden)

    Rüdiger J. Seitz

    2013-08-01

    Full Text Available Recovery from ischaemic stroke is determined in the acute phase by the lesion impact of ischaemia and subsequently, by functional and structural network changes in the spared brain tissue. Neurorehabilitation supports the restitution of function using repetitive, learning-based and, more recently, technology-based training strategies.

  9. Burden of stroke in Malaysia.

    Science.gov (United States)

    Loo, Keat Wei; Gan, Siew Hua

    2012-02-01

    Stroke is one of the top five leading causes of death and one of the top 10 causes for hospitalization in Malaysia. Stroke is also in the top five diseases with the greatest burden of disease, based on disability-adjusted life years. However, prospective studies on stroke in Malaysia are limited. To date, neither the prevalence of stroke nor its incidence nationally has been recorded. Hypertension is the major risk factor for stroke. The mean age of stroke patients in Malaysia is between 54.5 and 62.6 years. Traditional medicine is commonly practiced. With the increasing number of stroke cases annually, more government and nongovernment organizations should be involved in primary and secondary prevention strategies.

  10. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature...... is directly related to stroke severity and outcome, and fever after stroke is associated with substantial increases in morbidity and mortality. Normalisation of temperature in acute stroke by antipyretics is generally recommended, although there is no direct evidence to support this treatment. Despite its...... obvious therapeutic potential, hypothermia as a form of neuroprotection for stroke has been investigated in only a few very small studies. Therapeutic hypothermia is feasible in acute stroke but owing to serious side-effects--such as hypotension, cardiac arrhythmia, and pneumonia--it is still thought...

  11. A recruiting failure turned success

    Directory of Open Access Journals (Sweden)

    Smith Roger

    2008-03-01

    Full Text Available Abstract Background This paper describes an attempt that was made to recruit child-bearing women into a nutrition-based research study and the knowledge that was gained when this approach was unsuccessful. The Assessment Before Children Develop Obesity Study was a cross-sectional survey which planned to follow-up women and children who had previously been, or were currently enrolled in the Mathematical Model of Pregnancy Study. Methods Ethics approval was sought and obtained over an eight month period. After just six weeks it was obvious that our research objectives were not achievable because of an inadequate response rate (10%. This led to a review of the recruiting methodology as well as all written materials provided to potential participants. Advice was sought from those with expertise in the design of large public health campaigns and literature was consulted to refine our recruitment strategy. Results In subsequent redevelopment, the Assessment Before Children Develop Obesity Study was merged with the Mathematical Model of Pregnancy Study to become what is now known as the Women and Their Children's Health Study. Consent rates improved from 10% and 35% in the Assessment Before Children Develop Obesity and Mathematical Model of Pregnancy studies respectively, to 61% in the Women and Their Children's Health Study (chi square test, p Conclusion By sharing our experience we aim to assist other researcher in avoiding the same pitfalls and offer effective strategies for improving response rates.

  12. International nurse recruitment in India.

    Science.gov (United States)

    Khadria, Binod

    2007-06-01

    This paper describes the practice of international recruitment of Indian nurses in the model of a "business process outsourcing" of comprehensive training-cum-recruitment-cum-placement for popular destinations like the United Kingdom and United States through an agency system that has acquired growing intensity in India. Despite the extremely low nurse to population ratio in India, hospital managers in India are not concerned about the growing exodus of nurses to other countries. In fact, they are actively joining forces with profitable commercial ventures that operate as both training and recruiting agencies. Most of this activity is concentrated in Delhi, Bangalore, and Kochi. Gaps in data on nursing education, employment, and migration, as well as nonstandardization of definitions of "registered nurse," impair the analysis of international migration of nurses from India, making it difficult to assess the impact of migration on vacancy rates. One thing is clear, however, the chain of commercial interests that facilitate nurse migration is increasingly well organized and profitable, making the future growth of this business a certainty.

  13. Periodic Limb Movements and White Matter Hyperintensities in First-Ever Minor Stroke or High-Risk Transient Ischemic Attack.

    Science.gov (United States)

    Boulos, Mark I; Murray, Brian J; Muir, Ryan T; Gao, Fuqiang; Szilagyi, Gregory M; Huroy, Menal; Kiss, Alexander; Walters, Arthur S; Black, Sandra E; Lim, Andrew S; Swartz, Richard H

    2017-03-01

    Emerging evidence suggests that periodic limb movements (PLMs) may contribute to the development of cerebrovascular disease. White matter hyperintensities (WMHs), a widely accepted biomarker for cerebral small vessel disease, are associated with incident stroke and death. We evaluated the association between increased PLM indices and WMH burden in patients presenting with stroke or transient ischemic attack (TIA), while controlling for vascular risk factors and stroke severity. Thirty patients presenting within 2 weeks of a first-ever minor stroke or high-risk TIA were prospectively recruited. PLM severity was measured with polysomnography. WMH burden was quantified using the Age Related White Matter Changes (ARWMC) scale based on neuroimaging. Partial Spearman's rank-order correlations and multiple linear regression models tested the association between WMH burden and PLM severity. Greater WMH burden was correlated with elevated PLM index and stroke volume. Partial Spearman's rank-order correlations demonstrated that the relationship between WMH burden and PLM index persisted despite controlling for vascular risk factors. Multivariate linear regression models revealed that PLM index was a significant predictor of an elevated ARWMC score while controlling for age, stroke volume, stroke severity, hypertension, and apnea-hypopnea index. The quantity of PLMs was associated with WMH burden in patients with first-ever minor stroke or TIA. PLMs may be a risk factor for or marker of WMH burden, even after considering vascular risk factors and stroke severity. These results invite further investigation of PLMs as a potentially useful target to reduce WMH and stroke burden.

  14. Rehabilitating the Stroke Collection

    Directory of Open Access Journals (Sweden)

    Mary Grimmond

    2006-06-01

    Full Text Available Objective The aim of this project was to complete an analysis of monograph and audiovisual items held in the Central Coast Health Service (CCHS Libraries and containing information relevant to the treatment of acute stroke. Acute stroke is treated by multidisciplinary teams of clinicians based at two hospitals within the CCHS. The adequacy of the library collection was measured by subject coverage and age. Methods The methodology used consisted of three main steps: a literature review; design, administration, and analysis of a questionnaire to members of the CCHS Acute Stroke Team; and an analysis of the libraries’ collections. The research project utilised project management methodology and an evidence based librarianship framework. Results The questionnaire revealed that electronic resources were by far the most frequently used by participants, followed in order by print journals, books, interlibrary loan articles, and audiovisual items. Collection analysis demonstrated that the monograph and audiovisual collections were adequate in both scope and currency to support the information needs of Acute Stroke Team members, with the exception of resources to support patient education. Conclusion The researchers developed recommendations for future collection development in the area of acute stroke resources. Conducting this project within the evidence based librarianship framework helped to develop library staff members’ confidence in their ability to make future collection development decisions, informed by the target group’s information needs and preferences. The collection analysis methodology was designed to be replicated, and new specialist groups within the client base of the library will be targeted to repeat the collection analysis process.

  15. Increased Incidence of Interatrial Block in Younger Adults with Cryptogenic Stroke and Patent Foramen Ovale

    Directory of Open Access Journals (Sweden)

    P.E. Cotter

    2011-04-01

    Full Text Available Background: Stroke is often unexplained in younger adults, although it is often associated with a patent foramen ovale (PFO. The reason for the association is not fully explained, and mechanisms other than paradoxical embolism may be involved. Young stroke patients with PFO have more atrial vulnerability than those without PFO. It is plausible that stretching of the interatrial septum may disrupt the interatrial conduction pathways causing interatrial block (IAB. IAB is associated with atrial fibrillation, dysfunctional left atria and stroke. Methods: Electrocardiogram (ECG characteristics of prospectively recruited young patients (≤55 years of age with unexplained stroke (TOAST and A-S-C-O were compared with control data. All stroke cases underwent bubble contrast transthoracic and transoesophageal echography. IAB was defined as a P-wave duration of ≧110 ms. ECG data were converted to electronic format and analysed in a blind manner. Results: Fifty-five patients and 23 datasets were analysed. Patients with unexplained stroke had longer P-wave duration (p = 0.013 and a greater prevalence of IAB (p = 0.02 than healthy controls. Case status was an independent predictor of P-wave duration in a significant multivariate model. There was a significant increase in the proportion of cases with a PFO with IAB compared with cases without PFO and with controls (p = 0.005. Conclusions: Young patients with unexplained stroke, particularly those with PFO, exhibit abnormal atrial electrical characteristics suggesting atrial arrhythmia or atrial dysfunction as a possible mechanism of stroke.

  16. Knowledge of Stroke Risk Factors among Stroke Survivors in Nigeria

    Directory of Open Access Journals (Sweden)

    Grace Vincent-Onabajo

    2016-01-01

    Full Text Available Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke—whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk factor was assessed using open-ended questionnaire. Data were treated with descriptive statistics and logistic regression analysis. Results. Sixty-nine stroke survivors (male = 72.5%; mean ± SD age = 49.7±10.6 years participated in the study. Thirty-four (49.4% participants had knowledge of stroke risk factors. Only educational level was significantly associated with knowledge and participants with tertiary educational qualification were about 48 times (odds ratio = 48.5; CI = 7.6–309.8; P<0.0001 more likely to be knowledgeable than those with no education. Conclusion. Less than half of the participants had knowledge of stroke risk factors. Participants with tertiary education were significantly more knowledgeable than those with lower educational qualifications. Effective means of educating stroke survivors on stroke risk factors should be identified and adopted.

  17. Outcome Determinants of Stroke in a Brazilian Primary Stroke Center

    Directory of Open Access Journals (Sweden)

    Gustavo W. Kuster

    2014-01-01

    Full Text Available Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in São Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS, transient ischemic attack (TIA, and intracerebral hemorrhage (ICH admitted at “Hospital Paulistano,” São Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with 66.8±15.7 years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil.

  18. Understanding Stroke - Know Stroke • Know the Signs • Act in Time

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section Understanding Stroke Know Stroke • Know the Signs • Act in Time Past Issues / ... Julie Harris, and motivational speaker David Layton. Preventing Stroke "Until I had my stroke, I didn't ...

  19. Autologous Mesenchymal Stem Cells in Chronic Stroke

    Directory of Open Access Journals (Sweden)

    Ashu Bhasin

    2011-12-01

    Full Text Available Background: Cell transplantation is a ‘hype and hope’ in the current scenario. It is in the early stage of development with promises to restore function in chronic diseases. Mesenchymal stem cell (MSC transplantation in stroke patients has shown significant improvement by reducing clinical and functional deficits. They are feasible and multipotent and have homing characteristics. This study evaluates the safety, feasibility and efficacy of autologous MSC transplantation in patients with chronic stroke using clinical scores and functional imaging (blood oxygen level-dependent and diffusion tensor imaging techniques. Methods: Twelve chronic stroke patients were recruited; inclusion criteria were stroke lasting 3 months to 1 year, motor strength of hand muscles of at least 2, and NIHSS of 4–15, and patients had to be conscious and able to comprehend. Fugl Meyer (FM, modified Barthel index (mBI, MRC, Ashworth tone grade scale scores and functional imaging scans were assessed at baseline, and after 8 and 24 weeks. Bone marrow was aspirated under aseptic conditions and expansion of MSC took 3 weeks with animal serum-free media (Stem Pro SFM. Six patients were administered a mean of 50–60 × 106 cells i.v. followed by 8 weeks of physiotherapy. Six patients served as controls. This was a non-randomized experimental controlled trial. Results: Clinical and radiological scanning was normal for the stem cell group patients. There was no mortality or cell-related adverse reaction. The laboratory tests on days 1, 3, 5 and 7 were also normal in the MSC group till the last follow-up. The FM and mBI showed a modest increase in the stem cell group compared to controls. There was an increased number of cluster activation of Brodmann areas BA 4 and BA 6 after stem cell infusion compared to controls, indicating neural plasticity. Conclusion: MSC therapy aiming to restore function in stroke is safe and feasible. Further randomized controlled trials are needed

  20. Organizational issues in stroke treatment: The Swiss paradigm - Stroke units

    Directory of Open Access Journals (Sweden)

    Georgios K Matis

    2013-01-01

    Full Text Available Stroke represents the leading cause of acquired disability in adults and poses a tremendous socioeconomic burden both on patients and the society. In this sense, prompt diagnosis and urgent treatment are needed in order to radically reduce the devastating consequences of this disease. Herein the authors present the new guidelines recently adopted by the Swiss Stroke Society concerning the establishment of stroke units. Standardized treatment and allocation protocols along with an acute rehabilitation concept seem to be the core of the Swiss stroke management system. Coordinated multidisciplinary care provided by specialized medical, nursing and therapy staff is of utmost importance for achieving a significant dependency and death reduction. It is believed that the implementation of these guidelines in the stroke care system would be beneficial not only for the stroke patients, but also for the health system.

  1. Etiologic Ischemic Stroke Phenotypes in the NINDS Stroke Genetics Network

    Science.gov (United States)

    Ay, Hakan; Arsava, Ethem Murat; Andsberg, Gunnar; Benner, Thomas; Brown, Robert D.; Chapman, Sherita N.; Cole, John W.; Delavaran, Hossein; Dichgans, Martin; Engström, Gunnar; Giralt-Steinhauer, Eva; Grewal, Raji P.; Gwinn, Katrina; Jern, Christina; Jimenez-Conde, Jordi; Jood, Katarina; Katsnelson, Michael; Kissela, Brett; Kittner, Steven J.; Kleindorfer, Dawn O.; Labovitz, Daniel L.; Lanfranconi, Silvia; Lee, Jin-Moo; Lehm, Manuel; Lemmens, Robin; Levi, Chris; Li, Linxin; Lindgren, Arne; Markus, Hugh S.; McArdle, Patrick F.; Melander, Olle; Norrving, Bo; Peddareddygari, Leema Reddy; Pedersén, Annie; Pera, Joanna; Rannikmäe, Kristiina; Rexrode, Kathryn M.; Rhodes, David; Rich, Stephen S.; Roquer, Jaume; Rosand, Jonathan; Rothwell, Peter M.; Rundek, Tatjana; Sacco, Ralph L.; Schmidt, Reinhold; Schürks, Markus; Seiler, Stephan; Sharma, Pankaj; Slowik, Agnieszka; Sudlow, Cathie; Thijs, Vincent; Woodfield, Rebecca; Worrall, Bradford B.; Meschia, James F.

    2014-01-01

    Background and Purpose NINDS Stroke Genetics Network (SiGN) is an international consortium of ischemic stroke studies that aims to generate high quality phenotype data to identify the genetic basis of etiologic stroke subtypes. This analysis characterizes the etiopathogenetic basis of ischemic stroke and reliability of stroke classification in the consortium. Methods Fifty-two trained and certified adjudicators determined both phenotypic (abnormal test findings categorized in major etiologic groups without weighting towards the most likely cause) and causative ischemic stroke subtypes in 16,954 subjects with imaging-confirmed ischemic stroke from 12 US studies and 11 studies from 8 European countries using the web-based Causative Classification of Stroke System. Classification reliability was assessed with blinded re-adjudication of 1509 randomly selected cases. Results The distribution of etiologic categories varied by study, age, sex, and race (pstroke etiology (phenotypic subtype) were classified into the same final causative category with high confidence. There was good agreement for both causative (kappa 0.72, 95%CI:0.69-0.75) and phenotypic classifications (kappa 0.73, 95%CI:0.70-0.75). Conclusions This study demonstrates that etiologic subtypes can be determined with good reliability in studies that include investigators with different expertise and background, institutions with different stroke evaluation protocols and geographic location, and patient populations with different epidemiological characteristics. The discordance between phenotypic and causative stroke subtypes highlights the fact that the presence of an abnormality in a stroke patient does not necessarily mean that it is the cause of stroke. PMID:25378430

  2. Guidelines for acute ischemic stroke treatment: part II: stroke treatment

    Directory of Open Access Journals (Sweden)

    Sheila Cristina Ouriques Martins

    2012-11-01

    Full Text Available The second part of these Guidelines covers the topics of antiplatelet, anticoagulant, and statin therapy in acute ischemic stroke, reperfusion therapy, and classification of Stroke Centers. Information on the classes and levels of evidence used in this guideline is provided in Part I. A translated version of the Guidelines is available from the Brazilian Stroke Society website (www.sbdcv.com.br.

  3. Evaluation of the Recognition of Stroke in the Emergency Room (ROSIER scale in Chinese patients in Hong Kong.

    Directory of Open Access Journals (Sweden)

    Hui-lin Jiang

    Full Text Available BACKGROUND AND PURPOSE: The objective of this study was to determine the performance of the Recognition Of Stroke In the Emergency Room (ROSIER scale in risk-stratifying Chinese patients with suspected stroke in Hong Kong. METHODS: This was a prospective cohort study in an urban academic emergency department (ED over a 7-month period. Patients over 18 years of age with suspected stroke were recruited between June 2011 and December 2011. ROSIER scale assessment was performed in the ED triage area. Logistic regression analysis was used to estimate the impacts of diagnostic variables, including ROSIER scale, past history and ED characteristics. FINDINGS: 715 suspected stroke patients were recruited for assessment, of whom 371 (52% had acute cerebrovascular disease (302 ischaemic strokes, 24 transient ischaemic attacks (TIA, 45 intracerebral haemorrhages, and 344 (48% had other illnesses i.e. stroke mimics. Common stroke mimics were spinal neuropathy, dementia, labyrinthitis and sepsis. The suggested cut-off score of>0 for the ROSIER scale for stroke diagnosis gave a sensitivity of 87% (95%CI 83-90, a specificity of 41% (95%CI 36-47, a positive predictive value of 62% (95%CI 57-66, and a negative predictive value of 75% (95%CI 68-81, and the AUC was 0.723. The overall accuracy at cut off>0 was 65% i.e. (323+141/715. INTERPRETATION: The ROSIER scale was not as effective at differentiating acute stroke from stroke mimics in Chinese patients in Hong Kong as it was in the original studies, primarily due to a much lower specificity. If the ROSIER scale is to be clinically useful in Chinese suspected stroke patients, it requires further refinement.

  4. 染料预负载树脂对Cu(Ⅱ)的吸附作用特性%ADSORPTION OF Cu(H) ON DYE-PRELOADED RESIN

    Institute of Scientific and Technical Information of China (English)

    凌晨; 刘福强; 陈泰鹏; 龙超; 吴秋原; 李爱民

    2013-01-01

    通过预负载实验,研究了染料预负载超高交联吸附树脂NDA-150对Cu(Ⅱ)的作用持性.研究结果表明,NDA-150负载酸性蓝29的能力很强,但对Cu(U)吸附极弱.预负载酸性蓝29显著提高了NDA-150对Cu(Ⅱ)的吸附能力,而且随染料负载量的增加,Cu(Ⅱ)的吸附量呈阶段性的线性增长,单位增长倍率先增后降呈现两个阶段.FT-IR和XPS的表征结果显示,固相上染料分子中磺酸基、氨基及羟基参与了对Cu(Ⅱ)的吸附,这为染料预负载增强了树脂对Cu(Ⅱ)的吸附亲和力提供了直接证据.通过Ca(Ⅱ)屏蔽位点实验,表明固相中染料分子主要为Cu(Ⅱ)的吸附提供离子交换位点,此外还提供部分螯合位点.由此可见,超高交联吸附树脂NDA-150有可能同时去除废水中染料及共存重金属离子.%The influence of dye preloaded on the adsorption of Cu(Ⅱ) with hypercrosslinked polymeric resin NDA-150 was studied. Acid Blue 29 preloaded markedly enhanced the adsorption capacity of Cu(Ⅱ) on the resin. With the increase of preloading concentration, the adsorption capacity of Cu(Ⅱ) presented a periodically linear growth, while the enhancement amount contributed by per mole AB (ER) increased first and decreased afterwards. Based on the experimental results of FT-IR and XPS, the adsorption of Cu(Ⅱ) was improved by the interaction of Cu(Ⅱ) with -SOaNa, -NH2, and -OH group in the adsorbed dye molecules. The inside enhancement mechanisms were also examined by performing sites pre-shielding experiment and the results demonstrated that interactions between Cu(Ⅱ) and AB were composed of both ion exchange and coordination. NDA-15 resin can simultaneously remove dye and heavy metal ions from wastewater.

  5. Hemichorea after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Sadullah Saglam

    2016-03-01

    Full Text Available The deterioration of the balance between direct and indirect ways in the basal ganglia causes chorea. The lesions of contralateral basal ganglia, thalamus or the connection of them all together are responsible for this. Chorea can be observed during the course of metabolic and vascular diseases, neurodegenerative or hereditary diseases. Hyperkinetic movement disorders after acute ischemic stroke are reported as rare; however, hemichorea is the most frequent developing disorder of hyperkinetic movement as a result of cerebrovascular disease. In this case report, we presented two case who applied us with choreiform movements in his left half of the body after acute thalamic stroke. [Cukurova Med J 2016; 41(0.100: 29-32

  6. Brand Caliphate and recruitment between the genders

    OpenAIRE

    Monroe, Brandi Lynn Evans

    2016-01-01

    Approved for public release; distribution is unlimited Since the declaration of the Islamic State (IS) in 2014, men and women have been recruited to join the Caliphate in numbers surpassing those recruited by al Qaida. This variance in recruitment volume is likely attributable to the online propaganda campaign, Brand Caliphate. This thesis looks at the recruitment of women and asks if Brand Caliphate specifically targets females with its messaging, and if so, is the messaging effective? Ba...

  7. Plasma cytokines in acute stroke

    DEFF Research Database (Denmark)

    Christensen, Hanne Krarup; Boysen, Gudrun; Christensen, Erik

    2011-01-01

    GOALS: The aim of this study was to test the relations between plasma cytokines and the clinical characteristics, course, and risk factors in acute stroke. PATIENTS AND METHODS: The analysis was based on 179 patients with acute stroke included within 24 hours of stroke onset. On inclusion and 3...... measured by enzyme-linked immunoassay (ELISA). FINDINGS: The levels of most cytokines were significantly different in acute stroke from the levels 3 months later; but only IL-10 was positively associated with stroke severity. C-reactive protein and white blood cell count were positively associated...... with the cytokine response. CONCLUSIONS: We found a substantial overall cytokine reaction that reflected the stroke incident. However, these results do not, at present, suggest a potential for clinical use, as they do not seem to add to the information obtained from the clinical workup of the individual patient....

  8. Pathogenic mechanisms following ischemic stroke.

    Science.gov (United States)

    Khoshnam, Seyed Esmaeil; Winlow, William; Farzaneh, Maryam; Farbood, Yaghoob; Moghaddam, Hadi Fathi

    2017-07-01

    Stroke is the second most common cause of death and the leading cause of disability worldwide. Brain injury following stroke results from a complex series of pathophysiological events including excitotoxicity, oxidative and nitrative stress, inflammation, and apoptosis. Moreover, there is a mechanistic link between brain ischemia, innate and adaptive immune cells, intracranial atherosclerosis, and also the gut microbiota in modifying the cerebral responses to ischemic insult. There are very few treatments for stroke injuries, partly owing to an incomplete understanding of the diverse cellular and molecular changes that occur following ischemic stroke and that are responsible for neuronal death. Experimental discoveries have begun to define the cellular and molecular mechanisms involved in stroke injury, leading to the development of numerous agents that target various injury pathways. In the present article, we review the underlying pathophysiology of ischemic stroke and reveal the intertwined pathways that are promising therapeutic targets.

  9. Danger signals in stroke.

    Science.gov (United States)

    Gelderblom, Mathias; Sobey, Christopher G; Kleinschnitz, Christoph; Magnus, Tim

    2015-11-01

    Danger molecules are the first signals released from dying tissue after stroke. These danger signals bind to receptors on immune cells that will result in their activation and the release of inflammatory and neurotoxic mediators, resulting in amplification of the immune response and subsequent enlargement of the damaged brain volume. The release of danger signals is a central event that leads to a multitude of signals and cascades in the affected and neighbouring tissue, therefore providing a potential target for therapy.

  10. [Mitochondrial diseases and stroke].

    Science.gov (United States)

    Irimia, P; Oliveros-Cid, A; Martínez-Vila, E

    1998-04-01

    We review the mitochondrial diseases in which cerebrovascular changes are seen, such as the MERRF syndrome (myoclonic epilepsy and ragged red fibers) or the Kearns-Sayre syndrome (progressive external ophthalmoplegia, retinitis pigmentaria, cerebellar disorders and disorders of cardiac conduction), focusing on the syndrome involving mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS). We consider the different clinical aspects, diagnostic methods, pathophysiological mechanisms of the cerebrovascular involvement as well as therapeutic approaches.

  11. Chloride channels in stroke

    Institute of Scientific and Technical Information of China (English)

    Ya-ping ZHANG; Hao ZHANG; Dayue Darrel DUAN

    2013-01-01

    Vascular remodeling of cerebral arterioles,including proliferation,migration,and apoptosis of vascular smooth muscle cells (VSMCs),is the major cause of changes in the cross-sectional area and diameter of the arteries and sudden interruption of blood flow or hemorrhage in the brain,ie,stroke.Accumulating evidence strongly supports an important role for chloride (Clˉ) channels in vascular remodeling and stroke.At least three Clˉ channel genes are expressed in VSMCs:1) the TMEM16A (or Ano1),which may encode the calcium-activated Clˉ channels (CACCs); 2) the CLC-3 Clˉ channel and Clˉ/H+ antiporter,which is closely related to the volume-regulated Clˉ channels (VRCCs); and 3) the cystic fibrosis transmembrane conductance regulator (CFTR),which encodes the PKA-and PKC-activated Clˉ channels.Activation of the CACCs by agonist-induced increase in intracellular Ca2+ causes membrane depolarization,vasoconstriction,and inhibition of VSMC proliferation.Activation of VRCCs by cell volume increase or membrane stretch promotes the production of reactive oxygen species,induces proliferation and inhibits apoptosis of VSMCs.Activation of CFTR inhibits oxidative stress and may prevent the development of hypertension.In addition,Clˉ current mediated by gammaaminobutyric acid (GABA) receptor has also been implicated a role in ischemic neuron death.This review focuses on the functional roles of Clˉ channels in the development of stroke and provides a perspective on the future directions for research and the potential to develop Clˉ channels as new targets for the prevention and treatment of stroke.

  12. Does the Inclusion of Virtual Reality Games within Conventional Rehabilitation Enhance Balance Retraining after a Recent Episode of Stroke?

    OpenAIRE

    Rajaratnam, B. S.; J. Gui KaiEn; Lee JiaLin, K.; Kwek SweeSin; Sim FenRu, S.; Lee Enting; Ang YiHsia, E.; Ng KeatHwee; Su Yunfeng; Woo YingHowe, W.; Teo SiaoTing, S.

    2013-01-01

    This randomised controlled and double-blinded pilot study evaluated if interactive virtual reality balance related games integrated within conventional rehabilitation sessions resulted in more superior retraining of dynamic balance compared to CR after stroke. 19 subjects diagnosed with a recent episode of stroke were recruited from a local rehabilitation hospital and randomly assigned to either a control or an experimental group. Subjects in the control groups underwent 60 minutes of convent...

  13. Does the Inclusion of Virtual Reality Games within Conventional Rehabilitation Enhance Balance Retraining after a Recent Episode of Stroke?

    OpenAIRE

    B. S. Rajaratnam; Gui KaiEn, J.; Lee JiaLin, K.; Kwek SweeSin; Sim FenRu, S.; Lee Enting; Ang YiHsia, E.; Ng KeatHwee; Su Yunfeng; Woo YingHowe, W.; S. Teo SiaoTing

    2013-01-01

    This randomised controlled and double-blinded pilot study evaluated if interactive virtual reality balance related games integrated within conventional rehabilitation sessions resulted in more superior retraining of dynamic balance compared to CR after stroke. 19 subjects diagnosed with a recent episode of stroke were recruited from a local rehabilitation hospital and randomly assigned to either a control or an experimental group. Subjects in the control groups underwent 60 minutes of convent...

  14. A single bout of high-intensity interval training improves motor skill retention in individuals with stroke

    DEFF Research Database (Denmark)

    Nepveu, Jean-Francois; Thiel, Alexander; Tang, Ada

    2017-01-01

    intensity is sufficient to induce neuroplastic changes and improve motor skill retention in patients with chronic stroke. METHODS: Twenty-two patients with different levels of motor impairment were recruited. On the first session, the effects of a maximal graded exercise test on corticospinal...... exercise test triggers only modest neuroplastic changes in patients with chronic stroke. However, a single bout of high-intensity interval training performed immediately after motor practice improves skill retention, which could potentially accelerate motor recovery in these individuals....

  15. Khat and stroke

    Directory of Open Access Journals (Sweden)

    Sanjay V Kulkarni

    2012-01-01

    Full Text Available Khat chewing, though a tradition followed majorly in African countries, has of late spread widely across the globe due to faster transport systems and advanced preservation techniques. Many complications such as psychosis, arterial hypertension, angina pectoris, and myocardial infarction have been reported in connection to khat abuse. We present a case of a young man who presented with acute onset left-sided weakness. He was a known khat addict for over three decades. A diagnosis of left hemiplegia due to right middle cerebral artery infarction was established. Detailed evaluation revealed no significant underlying cause for stroke. Since the main central nervous system effects of khat are comparable with those of amphetamines and there are established reports of stroke in amphetamine abuse, the former was assumed to be the etiological factor. The patient was discontinued from taking khat and was managed conservatively. The subject showed significant recovery with no further complications or similar episodes during follow-up. To the best of our knowledge, this is the second case of stroke associated with khat. Since the management is essentially conservative, a vigilant history eliciting of khat abuse in prevalent countries would cut down unnecessary healthcare costs.

  16. Calorie restriction and stroke

    Directory of Open Access Journals (Sweden)

    Manzanero Silvia

    2011-09-01

    Full Text Available Abstract Stroke, a major cause of disability and mortality in the elderly, occurs when a cerebral blood vessel is occluded or ruptured, resulting in ischemic damage and death of brain cells. The injury mechanism involves metabolic and oxidative stress, excitotoxicity, apoptosis and inflammatory processes, including activation of glial cells and infiltration of leukocytes. In animal models, dietary energy restriction, by daily calorie reduction (CR or intermittent fasting (IF, extends lifespan and decreases the development of age-related diseases. Dietary energy restriction may also benefit neurons, as suggested by experimental evidence showing that CR and IF protect neurons against degeneration in animal models. Recent findings by our group and others suggest the possibility that dietary energy restriction may protect against stroke induced brain injury, in part by inducing the expression of neurotrophic factors, such as brain-derived neurotrophic factor (BDNF and basic fibroblast growth factor (bFGF; protein chaperones, including heat shock protein 70 (Hsp70 and glucose regulated protein 78 (GRP78; antioxidant enzymes, such as superoxide dismutases (SOD and heme oxygenase-1 (HO-1, silent information regulator T1 (SIRT1, uncoupling proteins and anti-inflammatory cytokines. This article discusses the protective mechanisms activated by dietary energy restriction in ischemic stroke.

  17. Neuroprotection In Acute Stroke

    Directory of Open Access Journals (Sweden)

    Ali Amini Harandi

    2017-02-01

    Full Text Available Stroke is the leading cause of adult disability and remains the third most common cause of death in industrialized nations. The concept of neuroprotection mainly came from the studies of the pathology and pathophysiology of ischemic brain injury. Greater understanding of the pathophysiology of neuronal damage in ischemic stroke has generated interest in neuroprotection as a management strategy. Neuroprotective agents in stroke treatment, have generated long-term interest that have the potential to preserve brain tissue and improve overall outcome. One arm of neuroprotective agents limits acute injury to neurons in the ischemic penumbra. Many of these agents modulate neuronal receptors to reduce release of excitatory neurotransmitters, which contribute to early neuronal injury. Other neuroprotective agents prevent potentially detrimental events associated with return of blood flow. Returning blood contains leukocytes that may occlude small vessels and release toxic products. In fact they should act targeting excitotoxicity, oxidative and nitrosative stress, and inflammation. The past few decades have produced a plethora of negative neuroprotective trial results. The questions of feasibility and practicability cannot be resolved simultaneously. In the future, optimal therapy may be achieved by combining neuroprotective agents with complementary mechanisms. Relevant areas of interest include the search for safe and effective treatment strategies that combine neuroprotection reperfusion, better use of advanced brain imaging for patient selection, and wider implementation of prehospital conducted clinical trials.

  18. 28 CFR 345.31 - Recruitment.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Recruitment. 345.31 Section 345.31 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT OF JUSTICE FEDERAL PRISON INDUSTRIES (FPI) INMATE WORK PROGRAMS Recruitment and Hiring Practices § 345.31 Recruitment. Inmate workers for...

  19. Faculty Recruitment in an Era of Change

    Science.gov (United States)

    Levine, Marilyn; Schimpf, Martin

    2010-01-01

    Faculty recruitment is a challenge for administration and departments, especially in an era of change in the academy. This article builds on information from an interactive conference panel session that focused on faculty recruitment best practices. The article addresses faculty recruitment strategies that focus on the optimization of search…

  20. 5 CFR 330.402 - Direct recruitment.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Direct recruitment. 330.402 Section 330.402 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Positions Restricted to Preference Eligibles § 330.402 Direct recruitment...

  1. The Effects of Incentives on Recruiter Productivity

    Science.gov (United States)

    2014-03-01

    recruiter. (after Samuelson , Kraus, Reese, Moskowitz, 2006, p. 13). ...................................................................................3...sailors to volunteer for recruiting duty. However, these incentives lack the endurance to successively motivate recruiters. Samuelson et al.’s (2006...productivity between 12 and 18 months ( Samuelson , Kraus, Reese, & Moskowitz, 2006). The drop-off in productivity after their peak (with usually more than half

  2. Stroke and Native Hawaiians/Pacific Islanders

    Science.gov (United States)

    ... Population Profiles > Native Hawaiian/Other Pacific Islander > Stroke Stroke and Native Hawaiians/Pacific Islanders Native Hawaiians/Pacific ... non-Hispanic white adults to die from a stroke in 2010. In general, Native Hawaiian/Pacific Islander ...

  3. What Are the Warning Signs of Stroke?

    Science.gov (United States)

    ... Cardiovascular Conditions What Are the Warning Signs of Stroke? Brain tissue affected by blockage Stroke is the fifth leading cause of death in ... over 55 years old have more chance of stroke, and the risk gets greater as you get ...

  4. Cost and Outcome in Pediatric Ischemic Stroke.

    Science.gov (United States)

    Hamilton, William; Huang, Haijuan; Seiber, Eric; Lo, Warren

    2015-10-01

    The cost of childhood stroke receives little notice. The authors examined potential drivers of cost and outcome to test whether (1) neonatal strokes cost less than childhood strokes, (2) associated diseases influence cost, (3) arterial ischemic stroke is more costly than sinovenous thrombosis, and (4) cost correlates with outcome. The authors reviewed records of 111 children who sustained arterial ischemic stroke or sinovenous thrombosis between 2005 and 2010 to identify costs for the following year. They assessed outcomes in 46 with the Recovery and Recurrence Questionnaire and the Pediatric Quality of Life Inventory. Neonatal strokes cost less than childhood stroke. Strokes associated with congenital heart disease or vasculopathy cost the most, while perinatal or idiopathic strokes cost the least. Higher costs are correlated with worse impairment and poorer quality of life. Stroke etiology significantly influences the cost of pediatric stroke. Future cost-benefit studies must consider etiology when estimating the incremental costs associated with stroke.

  5. Recovery After Stroke: Managing Life at Home

    Science.gov (United States)

    ... and adaptable clothing. You can find them on Internet sites and at health supply stores. Check out ... your local stroke association.  Subscribe to Stroke Smart magazine at www.stroke.org to view the latest ...

  6. Let's Talk about Stroke and Aphasia

    Science.gov (United States)

    ... get Stroke Connection magazine, a free magazine for stroke survivors and caregivers at strokeconnection.org . Connect with others sharing similar journeys with stroke by joining our Support Network at strokeassociation.org/ ...

  7. Guide to Choosing Stroke Rehabilitation Services

    Science.gov (United States)

    National Stroke Association’s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you:  Re-learn basic skills such ...

  8. REHABILITATION SERVICES FOR PERSONS AFFECTED BY STROKE IN JORDAN

    Directory of Open Access Journals (Sweden)

    Ann Moore

    2011-05-01

    Full Text Available The purpose of this study was to explore the perceptions stroke survivors have of the rehabilitation services received by them in the Jordanian community. A secondary aim was to explore the impact of culture on providing appropriate services for stroke survivors.Eighteen stroke survivors were recruited from an outpatient stroke rehabilitation programme. All 18 participants had been discharged from hospital for between one and six months. Semi-structured interviews were performed, either in the physiotherapy outpatient clinic where the affected person was attending a clinic or in their homes. Transcription of interviews carried out in Arabic and thematic analysis was also carried out in that language by transcribers who were fluent in Arabic and English, using a back-translation method. Necessary measures were taken to ensure the accuracy, reliability and validity of the data collection and analysis. Following thematic analysis, themes arising out of the data included physiotherapy and occupational therapy support in the community, out-patient rehabilitation clinic services, community clinic services and support from families, friends and neighbours. Participants expressed satisfaction with their therapists, but there were large areas of unmet rehabilitation need for stroke survivors in the Jordanian community such as a limited availability of occupational therapy services, insufficient amount of therapy services and poor medical support.   This study presents a unique contribution to knowledge relating to the experiences of stroke survivors in a developing country, and also shows how care systems are very dependent on cultural contexts, cultural beliefs and practises.DOI 10.5463/DCID.v22i1.18

  9. Cerebrogenic tachyarrhythmia in acute stroke

    Directory of Open Access Journals (Sweden)

    A S Praveen Kumar

    2012-01-01

    Full Text Available The electrocardiac abnormalities following acute stroke are frequent and seen in both ischemic and hemorrhagic stroke. The changes seen in electrocardiogram (ECG consist of repolarization abnormalities such as ST elevation, ST depression, negative T waves, and QT prolongation. Among tachyarrhythmias, atrial fibrillation is the most common and occurrence of focal atrial tachycardia is very rare though any cardiac arrhythmias can follow acute stroke. We report a case of focal atrial tachycardia following acute ischemic stroke in 50-year-old female without structural heart disease, and their mechanisms and clinical implications.

  10. [Pregnancy and acute ischemic stroke].

    Science.gov (United States)

    Bereczki, Dániel

    2016-05-15

    Pregnancy-related ischemic strokes play an important role in both maternal and fetal morbidity and mortality. Changes in hemostaseology and hemodynamics as well as risk factors related to or independent from pregnancy contribute to the increased stroke-risk during gestation and the puerperium. Potential teratogenic effects make diagnostics, acute therapy and prevention challenging. Because randomized, controlled trials are not available, a multicenter registry of patients with gestational stroke would be desirable. Until definite guidelines emerge, management of acute ischemic stroke during pregnancy remains individual, involving experts and weighing the risks and benefits.

  11. Reducing Haemorrhagic Transformation after Thrombolysis for Stroke: A Strategy Utilising Minocycline

    Directory of Open Access Journals (Sweden)

    David J. Blacker

    2013-01-01

    Full Text Available Haemorrhagic transformation (HT of recently ischaemic brain is a feared complication of thrombolytic therapy that may be caused or compounded by ischaemia-induced activation of matrix metalloproteinases (MMPs. The tetracycline antibiotic minocycline inhibits matrix MMPs and reduces macroscopic HT in rodents with stroke treated with tissue plasminogen activator (tPA. The West Australian Intravenous Minocycline and TPA Stroke Study (WAIMATSS aims to determine the safety and efficacy of adding minocycline to tPA in acute ischaemic stroke. The WAIMATSS is a multicentre, prospective, and randomised pilot study of intravenous minocycline, 200 mg 12 hourly for 5 doses, compared with standard care, in patients with ischaemic stroke treated with intravenous tPA. The primary endpoint is HT diagnosed by brain CT and MRI. Secondary endpoints include clinical outcome measures. Some illustrative cases from the early recruitment phase of this study will be presented, and future perspectives will be discussed.

  12. Neurological deterioration in the acute phase of minor ischemic stroke is an independent predictor of poor outcomes at 1 year: results from the China National Stroke Registry (CNSR)

    Institute of Scientific and Technical Information of China (English)

    JU Yi; ZHAO Xing-quan; WANG Chun-xue; WANG Yi-long; LIU Gai-fen; WANG Yong-jun

    2013-01-01

    Background The risk of clinical deterioration still exists in the acute phase despite the fact that patients with minor stroke may display less severe symptoms.The impact of this clinical deterioration on long-term outcomes is unknown.We characterized the clinical features of neurological deterioration (ND) in the acute phase of minor ischemic stroke (MIS) and investigated its impact on mid-and long-term outcomes.Methods This was a multi-centered,prospective clinical study involving patients with MIS (the National Institutes of Health Stroke Scale,NIHSS <3) recruited from the China National Stroke Registry.Patients were included who had been hospitalized within 24 hours of stroke onset.Baseline characteristics,complication rates during hospitalization,etiology of stroke,as well as 3-,6-,and 12-month post-stroke outcomes were compared between patients with and without ND during the acute phase.Results A number of 368 (15.2%) out of 2424 patients included in the study exhibited ND in the acute phase.Compared to patients without ND,patients with ND had longer hospital stay,increased rate of baseline diabetes,and multiple complications.Multivariate Logistic regression indicated that ND in acute phase was an independent factor predictive of increased dependence (adjusted odds ratio =5.20,95% Cl,3.51-7.70,P <0.001) at 12-month post-stroke.Conclusions The risk of ND in the acute phase is high in patients with MIS.ND in the acute phase is an independent predictor for poor outcomes at 12 months post-stroke onset.

  13. Stroke genetics: a review and update.

    OpenAIRE

    Lindgren, Arne

    2014-01-01

    Stroke genetics includes several topics of clinical interest, including (1) molecular genetic variations affecting risk of monogenic stroke syndromes; (2) molecular genetic variations affecting risk of common stroke syndromes, sometimes with specific effects on risk of specific main types of stroke or subtypes of ischemic and hemorrhagic stroke; (3) genetics of conditions associated with stroke risk e.g. white matter hyperintensities, atrial fibrillation and hypertension; (4) hereditary cause...

  14. Peak plasma interleukin-6 and other peripheral markers of inflammation in the first week of ischaemic stroke correlate with brain infarct volume, stroke severity and long-term outcome

    Directory of Open Access Journals (Sweden)

    del Zoppo Gregory J

    2004-01-01

    Full Text Available Abstract Background Cerebral ischaemia initiates an inflammatory response in the brain and periphery. We assessed the relationship between peak values of plasma interleukin-6 (IL-6 in the first week after ischaemic stroke, with measures of stroke severity and outcome. Methods Thirty-seven patients with ischaemic stroke were prospectively recruited. Plasma IL-6, and other markers of peripheral inflammation, were measured at pre-determined timepoints in the first week after stroke onset. Primary analyses were the association between peak plasma IL-6 concentration with both modified Rankin score (mRS at 3 months and computed tomography (CT brain infarct volume. Results Peak plasma IL-6 concentration correlated significantly (p Conclusions These data provide evidence that the magnitude of the peripheral inflammatory response is related to the severity of acute ischaemic stroke, and clinical outcome.

  15. Mechanism Study of Port Soft Base Reinforced by Vacuum Preloading%真空预压加固港口软土地基的机理研究

    Institute of Scientific and Technical Information of China (English)

    邵旭

    2015-01-01

    自Kjellman于1952年提出真空预压加固软地基以来,真空预压技术在加固软土地基方面得到广泛应用,但对加固机理仍然有不同的见解。本文结合工程监测资料,对天津某港口软土地基加固区的水势的变化、加固前后总应力变化以及真空卸载之后的地表沉降进行分析,得出负压固结理论可以较好的解释真空预压机理,但对卸压后地表继续沉降这一现象却无法很好解释,这一现象值得进一步探究。%Vacuum preloading reinforcement of soft base has been developed and widely used since the technique was put forward by Kjellman in 1952, but there are still various explanations for the mechanism of reinforcement. Relevant monitoring data was used to analyze the changes of water potential, total stress variation before and after consolidation, and surface settlement after vacuum unloading in a soft base reinforced zone of Tianjin port. The research results showed that negative pressure consolidation theory explained vacuum preloading mechanism well, but the theory did not support the phenomena of surface continuous settlement after unloading, which required further study.

  16. Participation in Leisure Activity and Exercise of Chronic Stroke Survivors Using Community-Based Rehabilitation Services in Seongnam City

    Science.gov (United States)

    Yi, Tae Im; Lee, Ko Eun; Ha, Seung A

    2015-01-01

    Objective To clarify how participation in leisure activities and exercise by chronic stroke survivors differs before and after a stroke. Methods Sixty chronic stroke survivors receiving community-based rehabilitation services from a health center in Seongnam City were recruited. They completed a questionnaire survey regarding their demographic characteristics and accompanying diseases, and on the status of their leisure activities and exercise. In addition, their level of function (Korean version of Modified Barthel Index score), risk of depression (Beck Depression Inventory), and quality of life (SF-8) were measured. Results After their stroke, most of the respondents had not returned to their pre-stroke levels of leisure activity participation. The reported number of leisure activities declined from a mean of 3.9 activities before stroke to 1.9 activities post-stroke. In addition, many participants became home-bound, sedentary, and non-social after their stroke. The most common barriers to participation in leisure activities were weakness and poor balance, lack of transportation, and cost. The respondents reported a mean daily time spent on exercise of 2.6±1.3 hours. Pain was the most common barrier to exercise participation. Conclusion Chronic stroke survivors need information on leisure activities and appropriate pain management. PMID:25932420

  17. Interactive Voice Response-An Innovative Approach to Post-Stroke Depression Self-Management Support.

    Science.gov (United States)

    Skolarus, Lesli E; Piette, John D; Pfeiffer, Paul N; Williams, Linda S; Mackey, Jason; Hughes, Rebecca; Morgenstern, Lewis B

    2017-02-01

    Automated interactive voice response (IVR) call systems can provide systematic monitoring and self-management support to depressed patients, but it is unknown if stroke patients are able and willing to engage in IVR interactions. We sought to assess the feasibility and acceptability of IVR as an adjunct to post-stroke depression follow-up care. The CarePartner program is a mobile health program designed to optimize depression self-management, facilitate social support from a caregiver, and strengthen connections between stroke survivors and primary care providers (PCPs). Ischemic stroke patients and an informal caregiver, if available, were recruited during the patient's acute stroke hospitalization or follow-up appointment. The CarePartner program was activated in patients with depressive symptoms during their stroke hospitalization or follow-up. The 3-month intervention consisted of weekly IVR calls monitoring both depressive symptoms and medication adherence along with tailored suggestions for depressive symptom self-management. After each completed IVR call, informal caregivers were automatically updated, and, if needed, the subject's PCP was notified. Of the 56 stroke patients who enrolled, depressive symptoms were identified in 13 (23 %) subjects. Subjects completed 74 % of the weekly IVR assessments. A total of six subjects did not complete the outcome assessment, including two non-study-related deaths. PCPs were notified five times, including two times for suicidal ideation and three times for medication non-adherence. Stroke patients with depressive symptoms were able to engage in an IVR call system. Future studies are needed to explore the efficacy of an IVR approach for post-stroke self-management and monitoring of stroke-related outcomes.

  18. The effect of health education on Taiwanese hypertensive patients' knowledge and cognition of stroke.

    Science.gov (United States)

    Tang, Yu-Hsuan; Hung, Chich-Hsiu; Chen, Hsing-Mei; Lin, Tsung-Hsien; Liu, Yi

    2015-04-01

    Hypertension is a risk factor for stroke. Increasing patient knowledge and cognition about stroke among hypertensive patients is essential. To explore the effect of a health education intervention on the knowledge and cognition of stroke in hypertensive patients. A quasi-experimental design was used with 103 patients with hypertension. The sample was recruited from a cardiologist's outpatient office at a medical center in Kaohsiung city, southern Taiwan. Half the patients (experimental group, n = 52) received health education, whereas the others received only conventional general outpatient care (control group, n = 51). All patients underwent a pretest followed by posttests at 4 and 8 weeks after the intervention. A stroke knowledge scale and stroke cognition scale were used for data collection. The experimental group scored significantly higher than the control group in level of knowledge and cognition of stroke. This study supports that a health education CD-ROM and printed information provided in the outpatient clinical improves knowledge of and cognition of stroke among hypertensive patients. In outpatient clinical practice, nurses can help improve patients' knowledge and cognition of the risks of stroke by playing the health education CD-ROM and providing printed information during the patients' wait time before appointments. Further studies with a longer follow-up (6 months or 1 year) are needed to evaluate the long-term effects of health education on stroke knowledge and cognition among patients with hypertension. An outpatient health education program using a CD-ROM and printed information for hypertensive patients can improve the patients' knowledge and cognition of stroke. © 2015 Sigma Theta Tau International.

  19. Transient ischemic attack and acute ischemic stroke: associations with retinal microvascular signs.

    Science.gov (United States)

    Wang, Jie Jin; Baker, Michelle L; Hand, Peter J; Hankey, Graeme J; Lindley, Richard I; Rochtchina, Elena; Wong, Tien Y; Liew, Gerald; Mitchell, Paul

    2011-02-01

    Small vessel disease plays a role in cerebral events. We aimed to investigate the prevalence and patterns of retinal microvascular signs (surrogates for cerebral small vessel disease) among patients with transient ischemic attack (TIA) or acute stroke and population control subjects. Patients with TIA or acute stroke aged ≥49 years admitted to hospitals in Melbourne and Sydney, Australia, were recruited to the Multi-Centre Retina and Stroke Study (n=693, 2005 to 2007). Control subjects were Blue Mountains Eye Study participants aged ≥49 years without TIAs or stroke (n=3384, 1992 to 1994, west of Sydney). TIA, ischemic stroke, or primary intracerebral hemorrhage was classified using standardized neurological assessments, including neuroimaging. Retinal microvascular signs (retinopathy, focal arteriolar narrowing, arteriovenous nicking, enhanced arteriolar light reflex) were assessed from retinal photographs masked to clinical information. Patients with TIA or acute stroke were older than control subjects and more likely to have stroke risk factors. After adjustment for study site and known risk factors, all retinal microvascular signs were more common in patients with TIA or acute stroke than in control subjects (OR, 1.9 to 8.7; Pischemic stroke had similar prevalences of nondiabetic retinopathy (26.9% versus 29.5%; OR, 0.8; 95% CI, 0.5 to 1.6), diabetic retinopathy (55.5% versus 50.0%; OR, 1.3; 95% CI, 0.4 to 3.6), focal arteriolar narrowing (15.6% versus 18.4%; OR, 0.8; 95% CI, 0.4 to 1.5), and arteriovenous nicking (23.0% versus 17.8%; OR, 1.4; 95% CI, 0.7 to 2.7). Patients with TIA and acute stroke may share similar risk factors or pathogenic mechanisms.

  20. Effect of in-hospital medical complications on case fatality post-acute ischemic stroke: data from the China National Stroke Registry

    Institute of Scientific and Technical Information of China (English)

    WANG Peng-lian; CHEN Sheng-yun; CHEN Qi-dong; QU Hui; LU Jing-jing; ZHANG Jing; MA Rui-hua; ZHANG Yu-mei; WANG Yong-jun; ZHAO Xing-quan; YANG Zhong-hua; WANG An-xin; WANG Chun-xue; LIU Li-ping; WANG Yi-long; WANG Xin-gao; JU Yi

    2012-01-01

    Background In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset.However,few studies from China have reported the effect of these complications on the mortality of patients with acute ischemic stroke.In this prospective work,the China National Stroke Registry Study,we investigated the effect of medical complications on the case fatality of patients with acute ischemic stroke.Methods From September 2007 to August 2008,we prospectively obtained the data of patients with acute stroke from 132 clinical centers in China.Medical complications,case fatality and other information recorded at baseline,during hospitalisation,and at 3,6,and 12 months after stroke onset.Multivariable Logistic regression was performed to analyze the effect of medical complications on the case fatality of patients with acute ischemic stroke.Results There were 39741 patients screened,14526 patients with acute ischemic stroke recruited,and 11560 ischemic stroke patients without missing data identified during the 12-month follow-up.Of the 11560 ischemic patients,15.8% (1826)had in-hospital medical complications.The most common complication was pneumonia (1373;11.9% of patients),followed by urinary tract infection and gastrointestinal bleeding.In comparison with patients without complications,stroke patients with complications had a significantly higher risk of death during their hospitalization,and at 3,6 and 12 months post-stroke.Having any one in-hospital medical complication was an independent risk factor for death in patients with acute ischemic stroke during hospital period (adjusted OR=6.946;95% CI 5.181 to 9.314),at 3 months (adjusted OR=3.843;95% Cl 3.221 to 4.584),6 months (adjusted OR=3.492;95% CI 2.970 to 4.106),and 12 months (adjusted OR=3.511;95% Cl 3.021 to 4.080).Having multiple complications strongly increased the death risk of patients.Conclusion Short-term and long-term outcomes of acute stroke patients

  1. Construction Technologies of Vacuum Preloading Foundation Treatment in Tianjin Port%浅析天津港真空预压法地基处理的主要施工技术

    Institute of Scientific and Technical Information of China (English)

    刘云杰

    2012-01-01

    Based on vacuum preloading soft foundation treatment technologies usually used in Tianjin Port, we emphasize conventional vacuum preloading method and the construction technologies of straight-line vacuum preloading soft foundation treatment, analyze the reason why the expected effect has not been reached in the construction of vacuum preloading soft foundation treatment, propose the detailed resolution and relevant technical measures against the above case, which will provide the reference for similar soft foundation treatment construction.%基于目前天津港常用的真空预压软土地基处理技术,介绍常规真空预压法与直排式真空预压法软土地基处理的施工工艺,着重分析真空预压软土地基处理施工过程中未达预期效果的原因,有针对性地提出解决办法和相应的技术措施,可为类似软土地基处理工程的施工提供参考.

  2. Study status of vacuum preloading soft-soil foundation reinforcing theory and technology%真空预压软土地基加固理论和技术研究现状

    Institute of Scientific and Technical Information of China (English)

    王成保; 苌宽; 张玉国

    2016-01-01

    The paper introduces basic working principles of vacuum preloading method,discusses research status of vacuum preloading soft-soil foundation reinforcing theory and construction technology,analyzes problems existing in vacuum preloading soft-soil foundation construction,and finally points out that:the combination of vacuum preloading technology,monitoring technology and information constructing technology will be good for realizing whole-process construction monitoring,so as to improve social and economic benefits of the project.%介绍了真空预压法的基本工作原理,论述了真空预压软土地基加固理论及施工工艺的研究现状,分析了真空预压软土地基施工中存在的问题,指出将真空预压工艺、监测技术与信息化施工技术相结合,有助于实现施工过程的全面监测,从而提高工程的社会经济效益.

  3. Improving quality and outcomes of stroke care in hospitals: Protocol and statistical analysis plan for the Stroke123 implementation study.

    Science.gov (United States)

    Cadilhac, Dominique A; Andrew, Nadine E; Kilkenny, Monique F; Hill, Kelvin; Grabsch, Brenda; Lannin, Natasha A; Thrift, Amanda G; Anderson, Craig S; Donnan, Geoffrey A; Middleton, Sandy; Grimley, Rohan

    2017-01-01

    Rationale The effectiveness of clinician-focused interventions to improve stroke care is uncertain. Aims To determine whether an organizational intervention can improve the quality of stroke care over usual care. Sample size estimates To detect an absolute 10% difference in overall performance (composite outcome), a minimum of 21 hospitals and 843 patients per group was determined. Methods and design Before and after controlled design in hospitals in Queensland, Australia. Intervention Externally facilitated program (StrokeLink) using outreach workshops incorporating clinical performance feedback, patient outcomes (survival, quality of life at 90-180 days), local barrier assessments to best practice care, action planning, and ongoing support. Descriptive and multivariable analyses adjusted for patient correlations by hospital (intention-to-treat method). Context Concurrent implementation of financial incentives to increase stroke unit access and use of the Australian Stroke Clinical Registry for performance monitoring. Study outcome(s) Primary outcome: net change in composite score (i.e. total number of process indicators achieved divided by the sum of eligible indicators for each cohort). change in individual indicators, change in composite score comparing hospitals that did or did not develop action plans (per-protocol analysis), impact on 90-180-day health outcomes. Sensitivity analyses: hospital self-rated status, alternate cross-sectional audit data (Stroke Foundation). To account for temporal effects, comparison of Queensland hospital performance relative to other Australian hospitals will also be undertaken. Discussion Twenty-one hospitals were recruited; however, one was unable to participate within the study time frame. Workshops were held between 11 March 2014 and 7 November 2014. Data are ready for analysis.

  4. Gender bias in academic recruitment

    DEFF Research Database (Denmark)

    Abramo, Giovanni; D’Angelo, Ciriaco Andrea; Rosati, Francesco

    2016-01-01

    It is well known that women are underrepresented in the academic systems of many countries. Gender discrimination is one of the factors that could contribute to this phenomenon. This study considers a recent national academic recruitment campaign in Italy, examining whether women are subject...... to more or less bias than men. The findings show that no gender-related differences occur among the candidates who benefit from positive bias, while among those candidates affected by negative bias, the incidence of women is lower than that of men. Among the factors that determine success in a competition...... for an academic position, the number of the applicant’s career years in the same university as the committee members assumes greater weight for male candidates than for females. Being of the same gender as the committee president is also a factor that assumes greater weight for male applicants. On the other hand...

  5. Effect analysis of a soft ground reinforced by a combined vacuum preloading and pneumatic fracturing method%劈裂真空法加固软土地基的效果分析

    Institute of Scientific and Technical Information of China (English)

    章定文; 韩文君; 刘松玉; 杜广印

    2012-01-01

    To overcome the problems of traditional vacuum preloading method, vacuum preloading and pneumatic fracturing are combined to reinforce the performance of ground improvement. The mechanism and construction procedures of the combined method are introduced firstly. The reinforcement effect of the combined method is validated through a pilot highway embankment on soft clay in Jiangsu, China. Comparing to the traditional vacuum preloading method, the combined vacuum preloading and pneumatic fracturing method would enhance the transfer efficiency of vacuum into deep soil layers and accelerate the dissipation of excess pore water pressure. Therefore, the strength increase of soft soil layers improved by the combined method is much larger than that of ground reinforced by the traditional vacuum preloading method. The combined method also can reduce the construction period than the traditional vacuum preloading method. The test results of cone penetration tests and engineering properties tests of soft soils also indicate the superior of the combined vacuum preloading and pneumatic fracturing method.%针对常规真空预压法加固软土地基中存在的问题,介绍了最新研制开发的气压劈裂真空预压法及其施工工艺,并通过现场试验段测试结果分析了劈裂真空法加固软土地基的效果.测试结果表明,较常规真空预压法而言,劈裂真空法可以提高真空荷载向深层土体中的传递效率和加速超静孔隙水压力的消散,既可改善深层软土的加固效果又可加速地基固结,缩短工程工期;劈裂真空法加固地基的沉降效率大于常规真空预压法处理地基,沉降易于收敛,有利于工后沉降的控制.通过加固前后孔压静力触探试验测试结果对比和取样室内试验土性参数变化分析,论证了劈裂真空法加固深层软土地基的有效性和优越性.

  6. Functional magnetic resonance imaging study on dysphagia after unilateral hemispheric stroke: a preliminary study.

    Science.gov (United States)

    Li, S; Luo, C; Yu, B; Yan, B; Gong, Q; He, C; He, L; Huang, X; Yao, D; Lui, S; Tang, H; Chen, Q; Zeng, Y; Zhou, D

    2009-12-01

    Swallowing dysfunction is common and disabling after acute stroke; however, the mechanism of dysphagia or recovery of swallowing from dysphagia remains uncertain. The purpose of this study was to explore cerebral activation of swallowing in dysphagia using functional MRI (fMRI) to compare the functional anatomy of swallowing in unilateral hemispheric stroke patients and healthy adults. In total, five left hemispheric stroke patients with dysphagia, five right hemispheric stroke patients with dysphagia and 10 healthy controls were examined with event related fMRI while laryngeal swallow related movements were recorded. Data were processed using the general linear model. A multifocal cerebral representation of swallowing was identified predominantly in the left hemisphere, in a bilateral and asymmetrical manner. Cerebral activation during swallowing tasks was localised to the precentral, postcentral and anterior cingulate gyri, insula and thalamus in all groups. Activation of volitional swallowing in dysphagic unilateral hemispheric stroke patients might require reorganisation of the dominant hemispheric motor cortex, or a compensatory shift in activation to unaffected areas of the hemisphere. The results indicate that unilateral stroke of either cerebral hemisphere can produce dysphagia. Effective recovery is associated with cerebral activation related to cortical swallowing representation in the compensating or recruited areas of the intact hemisphere. Functional MRI is a useful method for exploring the spatial localisation of changes in neuronal activity during tasks that may be related to recovery. Therefore, the subsequent information gleaned from changes in neural plasticity could be useful for assessing the prognosis of dysphagic stroke.

  7. Neuroprotection for Ischemic Stroke: Moving Past Shortcomings and Identifying Promising Directions

    Directory of Open Access Journals (Sweden)

    Jason D. Huber

    2013-01-01

    Full Text Available The translation of neuroprotective agents for ischemic stroke from bench-to-bedside has largely failed to produce improved treatments since the development of tissue plasminogen activator (tPA. One possible reason for lack of translation is the failure to acknowledge the greatest risk factor for stroke, age, and other common comorbidities such as hypertension, obesity, and diabetes that are associated with stroke. In this review, we highlight both mechanisms of studying these factors and results of those that have been addressed. We also discuss the potential role of other lifestyle factors associated with an increased stroke risk such as sleep fragmentation and/or deprivation. Furthermore, many proposed therapeutic agents have targeted molecular mechanisms occurring soon after the onset of ischemia despite data indicating delayed patient presentation following ischemic stroke. Modulating inflammation has been identified as a promising therapeutic avenue consistent with preliminary success of ongoing clinical trials for anti-inflammatory compounds such as minocycline. We review the role of inflammation in stroke and in particular, the role of inflammatory cell recruitment and macrophage phenotype in the inflammatory process. Emerging evidence indicates an increasing role of neuro-immune crosstalk, which has led to increased interest in identification of peripheral biomarkers indicative of neural injury. It is our hope that identification and investigation of factors influencing stroke pathophysiology may lead to improved therapeutics.

  8. Social competence following pediatric stroke: contributions of brain insult and family environment.

    Science.gov (United States)

    Anderson, Vicki; Gomes, Alison; Greenham, Mardee; Hearps, Stephen; Gordon, Anne; Rinehart, Nicole; Gonzalez, Linda; Yeates, Keith Owen; Hajek, Christine A; Lo, Warren; Mackay, Mark

    2014-01-01

    Limited information is available regarding predictors of psychosocial difficulties in children following stroke. This study aimed to (i) compare social competence of children with arterial ischemic stroke (AIS) to those with chronic illness and healthy controls and (ii) investigate the contribution of stroke pathology, neurological outcome and environment. Thirty-six children with AIS > 12 months prior to recruitment were compared with children with chronic illness (asthma) (n = 15) and healthy controls (n = 43). Children underwent intellectual assessment, and children and parents completed questionnaires to assess social competence. Children with AIS underwent MRI scan and neurological evaluation. Child AIS was associated with poorer social adjustment and participation, and children with AIS were rated as having more social problems than controls. Lesion volume was not associated with social outcome, but subcortical stroke was linked to reduced social participation and younger stroke onset predicted better social interaction and higher self-esteem. Family function was the sole predictor of social adjustment. Findings highlight the risk of social impairment following pediatric stroke, with both stroke and environmental factors influencing children's social competence in the chronic stages of recovery. They indicate the potential for intervention targeting support at the family level.

  9. Brain Symmetry Index in Healthy and Stroke Patients for Assessment and Prognosis

    Directory of Open Access Journals (Sweden)

    Andrei Agius Anastasi

    2017-01-01

    Full Text Available Objective. Quantitative neurophysiological signal parameters are of value in predicting motor recovery after stroke. The novel role of EEG-derived brain symmetry index for motor function prognostication in the subacute phase after stroke is explored. Methods. Ten male stroke patients and ten matched healthy controls were recruited. Motor function was first assessed clinically using the MRC score, its derivative Motricity Index, and the Fugl–Meyer assessment score. EEG was subsequently recorded first with subjects at rest and then during hand grasping motions, triggered by visual cues. Brain symmetry index (BSI was used to identify the differences in EEG-quantified interhemispheric cortical power asymmetry observable in healthy versus cortical and subcortical stroke patients. Subsequently, any correlation between BSI and motor function was explored. Results. BSI was found to be significantly higher in stroke subjects compared to healthy controls (p=0.023. The difference in BSI was more pronounced in the cortical stroke subgroup (p=0.016. BSI showed only a mild general decrease on repeated monthly recording. Notably, a statistically significant correlation was observed between early BSI and Fugl–Meyer score later in recovery (p<0.050. Conclusions. Brain symmetry index is increased in the subacute poststroke phase and correlates with motor function 1-2 months after stroke.

  10. Kinesthetic taping improves walking function in patients with stroke: a pilot cohort study.

    Science.gov (United States)

    Boeskov, Birgitte; Carver, Line Tornehøj; von Essen-Leise, Anders; Henriksen, Marius

    2014-01-01

    Stroke is an important cause of severe disability and impaired motor function. Treatment modalities that improve motor function in patients with stroke are needed. The objective of this study was to investigate the effect of kinesthetic taping of the anterior thigh and knee on maximal walking speed and clinical indices of spasticity in patients with stroke. Thirty-two patients (9 women) receiving rehabilitation after stroke (average, 50 days since stroke) who had impaired walking ability were recruited. Primary outcome was maximal walking speed measured by the 10-meter walk test. Secondary outcomes were number of steps taken during the test and clinical signs of spasticity measured by the Tardieu Scale. Tests were conducted before and immediately after application of kinesthetic tape to the anterior thigh and knee of the paretic lower limb. After application of the tape, the maximal walking speed increased, on average, by 0.08 m/s (95% CI, 0.04 to 0.12; P stroke. Such a positive effect on motor function could be a valuable adjunct in physical therapy and rehabilitation of patients with stroke.

  11. Long-term impact of stroke on patients' health-related quality of life.

    Science.gov (United States)

    De Wit, Liesbet; Theuns, Peter; Dejaeger, Eddy; Devos, Stefanie; Gantenbein, Andreas R; Kerckhofs, Eric; Schuback, Birgit; Schupp, Wilfried; Putman, Koen

    2017-07-01

    This international study aims to examine the size and determinants of the impact of stroke on five-year survivors' health-related quality of life (HRQoL) in four different European countries. Patients were recruited consecutively in four European rehabilitation centers. Five years after stroke, the EuroQol-visual analog scale (EQ-VAS) was administered in 226 first-ever stroke patients. Impact of stroke was determined by calculating EQ-VAS z-norm scores (= deviation - expressed in SD - of patients' EQ-VAS level relative to their age-and gender-matched national population norms). Determinants of EQ-VAS z-norm scores were identified using multivariate linear regression analysis. Five years post-stroke, patients' mean EQ-VAS was 63.74 (SD = 19.33). Mean EQ-VAS z-norm score was -0.57 [95%CI: (-0.70)-(-0.42)]. Forty percent of the patients had an EQ-VAS z-norm score +0.75 SD. Higher patients' levels of depression, anxiety and disability were associated with increasingly negative EQ-VAS z-norm scores (adjusted R(2)( )=( )0.392). Five years after stroke, mean HRQoL of stroke survivors showed large variability and was more than ½ SD below population norm. Forty percent had a HRQoL level below, 52% on, and 8% above population norm. The variability could only partially be explained by the variables considered in this study. Longitudinal studies are needed to increase our understanding of the size and determinants of the impact of stroke on the HRQoL of long-term stroke survivors. Implications for rehabilitation The current European concept of stroke rehabilitation is focused on the acute and sub-acute rehabilitation phase, i.e., in the first months after stroke. The results of this study show that at five years after stroke, the mean level of HRQoL of stroke survivors remains below the healthy population level. This finding shows the need for continuation of rehabilitation in the chronic phase. At five years after stroke, higher patients' levels of depression

  12. Blood Biomarkers of Ischemic Stroke

    National Research Council Canada - National Science Library

    Jickling, Glen C; Sharp, Frank R

    2011-01-01

    .... Though many candidate blood based biomarkers for ischemic stroke have been identified, none are currently used in clinical practice. With further well designed study and careful validation, the development of blood biomarkers to improve the care of patients with ischemic stroke may be achieved.

  13. One Stroke at a Time

    Science.gov (United States)

    Hollibaugh, Molly

    2012-01-01

    At first glance, a Zentangle creation can seem intricate and complicated. But, when you learn how it is done, you realize how simple it is. Zentangles are patterns, or "tangles," that have been reduced to a simple sequence of elemental strokes. When you learn to focus on each stroke you find yourself capable of things that you may have once…

  14. Dissecting the Genetics of Stroke

    NARCIS (Netherlands)

    M.J.E. van Rijn (Marie Josee)

    2007-01-01

    textabstractStroke is a leading cause of death and disability in the Western world. It is a complex disease resulting from environmental factors and genetic factors, as well as gene-gene and geneenvironment interactions. Many studies have attempted to unravel the genetic aetiology of stroke, but

  15. Musculoskeletal problems in stroke survivors.

    Science.gov (United States)

    Kendall, Richard

    2010-01-01

    Musculoskeletal problems in stoke survivors are common reasons for disability and pain. Shoulder pain is present in 24% of stroke survivors among all complications, second only to depression in 26%. Diagnosis and treatment of the various shoulder pain etiologies can significantly improve quality of life in these patients. This article reviews the common etiologies and treatments of shoulder and hip pain in stroke survivors.

  16. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature i...

  17. Circadian Variation Of Stroke Onset

    Directory of Open Access Journals (Sweden)

    Kamath vasantha

    2003-01-01

    Full Text Available Diurnal variations in various physiological and biochemical functions and certain pathological events like myocardial infarction and stroke have been documented. We studied prospectively one hundred and seven patients of acute onset stroke confirmed by computed tomography for the exact time of onset, risk factors and type of stroke. Patients who were unclear of time of onset and with a diagnosis of cerebral venous thrombosis or sub-arachnoid hemorrhage were excluded. Infarction was detected in 71 patients and hemorrhage in 33 patients. Men out numbered women (1:6:1. Hypertension was more frequent in hemorrhage in the morning time (5 AM-12 noon and more infarction between 12-6 pm. However there was no relation between the time of onset of stroke and various risk-factors of stroke.

  18. Acute Stroke Imaging Research Roadmap

    Science.gov (United States)

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Köhrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Wu, Ona; Warach, Steven

    2009-01-01

    The recent “Advanced Neuroimaging for Acute Stroke Treatment” meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Biomedical Imaging and Bioengineering (NIBIB), industry representatives, and members of the US Food and Drug Administration (FDA) to discuss the role of advanced neuroimaging in acute stroke treatment. The goals of the meeting were to assess state-of-the-art practice in terms of acute stroke imaging research and to propose specific recommendations regarding: (1) the standardization of perfusion and penumbral imaging techniques, (2) the validation of the accuracy and clinical utility of imaging markers of the ischemic penumbra, (3) the validation of imaging biomarkers relevant to clinical outcomes, and (4) the creation of a central repository to achieve these goals. The present article summarizes these recommendations and examines practical steps to achieve them. PMID:18477656

  19. Auditory Hallucinations in Acute Stroke

    Directory of Open Access Journals (Sweden)

    Yair Lampl

    2005-01-01

    Full Text Available Auditory hallucinations are uncommon phenomena which can be directly caused by acute stroke, mostly described after lesions of the brain stem, very rarely reported after cortical strokes. The purpose of this study is to determine the frequency of this phenomenon. In a cross sectional study, 641 stroke patients were followed in the period between 1996–2000. Each patient underwent comprehensive investigation and follow-up. Four patients were found to have post cortical stroke auditory hallucinations. All of them occurred after an ischemic lesion of the right temporal lobe. After no more than four months, all patients were symptom-free and without therapy. The fact the auditory hallucinations may be of cortical origin must be taken into consideration in the treatment of stroke patients. The phenomenon may be completely reversible after a couple of months.

  20. Rehabilitative Games for Stroke Patients

    Directory of Open Access Journals (Sweden)

    A. Pyae

    2015-07-01

    Full Text Available Stroke is one of the major problems in medical and healthcare that can cause severe disability and death of patients especially for older population. Rehabilitation plays an important role in stroke therapy. However, most of the rehabilitative exercises are monotonous and tiring for the patients. For a particular time, they can easily get bored in doing these exercises. The role of patient’s motivation in rehabilitation is vital. Motivation and rehabilitative outcomes are strongly related. Digital games promise to help stroke patients to feel motivated and more engaged in rehabilitative training through motivational gameplay. Most of the commercial games available in the market are not well-designed for stroke patients and their motivational needs in rehabilitation. This study aims at understanding the motivational requirements of stroke patients in doing rehabilitative exercises and living in a post-stroke life. Based on the findings from the literature review, we report factors that can influence the stroke patients’ level of motivation such as social functioning, patient-therapist relationship, goal-setting, and music. These findings are insightful and useful for ideating and designing interactive motivation-driven games for stroke patients. The motivational factors of stroke patients in rehabilitation may help the game designers to design motivation-driven game contexts, contents, and gameplay. Moreover, these findings may also help healthcare professionals who concern stroke patient’s motivation in rehabilitative context. In this paper, we reported our Virtual Nursing Home (VNH concept and the games that we are currently developing and re-designing. Based on this literature review, we will present and test out the ideas how we can integrate these motivational factors in our future game design, development, and enhancement.