PERFECT Stroke : PERFormance, Effectiveness, and Costs of treatment episodes in Stroke

Stroke is a major cause of death and disability, incurs significant costs to healthcare systems, and inflicts severe burden to the whole society. Stroke care in Finland has been described in several population-based studies between 1967 and 1998, but not since. In the PERFECT Stroke study presented here, a system for monitoring the Performance, Effectiveness, and Costs of Treatment episodes in Stroke was developed in Finland. Existing nationwide administrative registries were linked at individual patient level with personal identification numbers to depict whole episodes of care, from acute stroke, through rehabilitation, until the patients went home, were admitted to permanent institutional care, or died. For comparisons in time and between providers, patient case-mix was adjusted for. The PERFECT Stroke database includes 104 899 first-ever stroke patients over the years 1999 to 2008, of whom 79% had ischemic stroke (IS), 14% intracerebral hemorrhage (ICH), and 7% subarachnoid hemorrhage (SAH). A 18% decrease in the age and sex adjusted incidence of stroke was observed over the study period, 1.8% improvement annually. All-cause 1-year case-fatality rate improved from 28.6% to 24.6%, or 0.5% annually. The expected median lifetime after stroke increased by 2 years for IS patients, to 7 years and 7 months, and by 1 year for ICH patients, to 4 years 5 months. No change could be seen in median SAH patient survival, >10 years. Stroke prevalence was 82 000, 1.5% of total population of Finland, in 2008. Modern stroke center care was shown to be associated with a decrease in both death and risk of institutional care of stroke patients. Number needed to treat to prevent these poor outcomes at one year from stroke was 32 (95% confidence intervals 26 to 42). Despite improvements over the study period, more than a third of Finnish stroke patients did not have access to stroke center care. The mean first-year healthcare cost of a stroke patient was ~20 000 , and among survivors ~10 000 annually thereafter. Only part of this cost was incurred by stroke, as the same patients cost ~5000 over the year prior to stroke. Total lifetime costs after first-ever stroke were ~85 000 . A total of 1.1 Billion , 7% of all healthcare expenditure, is used in the treatment of stroke patients annually. Despite a rapidly aging population, the number of new stroke patients is decreasing, and the patients are more likely to survive. This is explained in part by stroke center care, which is effective, and should be made available for all stroke patients. It is possible, in a suitable setting with high-quality administrative registries and a common identifier, to avoid the huge workload and associated costs of setting up a conventional stroke registry, and still acquire a fairly comprehensive dataset on stroke care and outcome.

Accurate mass-based analysis in human sport doping control : Application of liquid chromatography - time-of-flight mass spectrometry

Human sport doping control analysis is a complex and challenging task for anti-doping laboratories. The List of Prohibited Substances and Methods, updated annually by World Anti-Doping Agency (WADA), consists of hundreds of chemically and pharmacologically different low and high molecular weight compounds. This poses a considerable challenge for laboratories to analyze for them all in a limited amount of time from a limited sample aliquot. The continuous expansion of the Prohibited List obliges laboratories to keep their analytical methods updated and to research new available methodologies. In this thesis, an accurate mass-based analysis employing liquid chromatography - time-of-flight mass spectrometry (LC-TOFMS) was developed and validated to improve the power of doping control analysis. New analytical methods were developed utilizing the high mass accuracy and high information content obtained by TOFMS to generate comprehensive and generic screening procedures. The suitability of LC-TOFMS for comprehensive screening was demonstrated for the first time in the field with mass accuracies better than 1 mDa. Further attention was given to generic sample preparation, an essential part of screening analysis, to rationalize the whole work flow and minimize the need for several separate sample preparation methods. Utilizing both positive and negative ionization allowed the detection of almost 200 prohibited substances. Automatic data processing produced a Microsoft Excel based report highlighting the entries fulfilling the criteria of the reverse data base search (retention time (RT), mass accuracy, isotope match). The quantitative performance of LC-TOFMS was demonstrated with morphine, codeine and their intact glucuronide conjugates. After a straightforward sample preparation the compounds were analyzed directly without the need for hydrolysis, solvent transfer, evaporation or reconstitution. The hydrophilic interaction technique (HILIC) provided good chromatographic separation, which was critical for the morphine glucuronide isomers. A wide linear range (50-5000 ng/ml) with good precision (RSD<10%) and accuracy (±10%) was obtained, showing comparable or better performance to other methods used. In-source collision-induced dissociation (ISCID) allowed confirmation analysis with three diagnostic ions with a median mass accuracy of 1.08 mDa and repeatable ion ratios fulfilling WADA s identification criteria. The suitability of LC-TOFMS for screening of high molecular weight doping agents was demonstrated with plasma volume expanders (PVE), namely dextran and hydroxyethylstarch (HES). Specificity of the assay was improved, since interfering matrix compounds were removed by size exclusion chromatography (SEC). ISCID produced three characteristic ions with an excellent mean mass accuracy of 0.82 mDa at physiological concentration levels. In summary, by combining TOFMS with a proper sample preparation and chromatographic separation, the technique can be utilized extensively in doping control laboratories for comprehensive screening of chemically different low and high molecular weight compounds, for quantification of threshold substances and even for confirmation. LC-TOFMS rationalized the work flow in doping control laboratories by simplifying the screening scheme, expediting reporting and minimizing the analysis costs. Therefore LC-TOFMS can be exploited widely in doping control, and the need for several separate analysis techniques is reduced.

Structure of bovine prothrombin fragment 1 refined at 2.25 Å resolution

The structure of bovine prothrombin fragment 1 has been refined at 2.25 Å resolution using high resolution measurements made with the synchrotron beam at CHESS. The synchrotron data were collected photographically by oscillation methods (R-merge = 0.08). These were combined with lower order diffractometer data for refinement purposes. The structure was refined using restrained least-squares methods with the program PROLSQ to a crystallographic R-value of 0.175. The structure includes 105 water molecules with occupancies of >0·6. The first 35 residues (Ala1-Leu35) of the N-terminal ?-carboxy glutamic acid-domain (Ala1-Cys48) of fragment 1 are disordered as are two carbohydrate chains of Mr ? 5000; the latter two combine to render 40% of the structure disordered. The folding of the kringle of fragment 1 is related to the close intramolecular contact between the inner loop disulfide groups. Half of the conserved sequence of the kringle forms an inner core surrounding these disulfide groups. The remainder of the sequence conservation is associated with the many turns of the main chain. The Pro95 residue of the kringle has a cis conformation and Tyr74 is ordered in fragment 1, although nuclear magnetic resonance studies indicate that the comparable residue of plasminogen kringle 4 has two positions. Surface accessibility calculations indicate that none of the disulfide groups of fragment 1 is accessible to solvent.

A PEFC With Pt-TiO2/C as Oxygen-Reduction Catalyst

Carbon-supported Pt-TiO2 (Pt-TiO2/C) catalyst with varying atomic ratio of Pt to Ti, namely, 1: 1, 2: 1, and 3: 1, is prepared by sol-gel method and its electrocatalytic activity toward oxygen-reduction reaction (ORR) is evaluated for the application in polymer electrolyte fuel cells (PEFCs). The optimum atomic ratio of Pt to Ti in Pt-TiO2/C and annealing temperature are established by cyclic voltammetry and fuel-cell-polarization studies. Pt-TiO2/C annealed at 750 degrees C with Pt and Ti in atomic ratio of 2: 1, namely, 750 Pt-TiO2/C (2: 1), shows enhanced electrocatalytic activity toward ORR. It is found that the incorporation of TiO2 with Pt ameliorates both electrocatalytic activity and stability of cathode in relation to pristine Pt cathode, currently being used in PEFCs. A power density of 0.75 W/cm(2) is achieved at 0.6 V for the PEFC with 750 Pt-TiO2/C (2: 1) as compared with 0.62 W/cm(2) at 0.6 V achieved with the PEFC comprising Pt/C as cathode catalyst while operating under identical conditions. Interestingly, carbon-supported Pt-TiO2 cathode exhibits only 6% loss in electrochemical surface area after 5000 potential cycles while it is as high as 25% for Pt/C. DOI: 10.1115/1.4002466]

Diamond-like carbon coating for optical windows

Hard, low stress diamond-like carbon films have been deposited by plasma assisted chemical vapour deposition technique, The various substrates include soft IR components like ZnS and ZnSe windows, Gaseous precursors such as propene, ethyl alcohol and acetone have been used to synthesize the films to study the nature of precursors in determining the film compatibility with the underlying component (substrate), The residual compressive stresses, the Young's modulus and the adhesion energy of the films have been estimated to be 10(10) dynes/cm(2), 10(10) N/m(2) and 1000 ergs/cm(2) respectively. To alleviate film failure, a study on the effects of additive gases such as hydrogen and the use of buffer layers such as ZrO2, has been undertaken, The diamond-like carbon films produced here are hard (5000 kg/mm(2)), specularly smooth in the wavelength region from 2.5 mu m to 20 mu m, with no microstructural features and have excellent adhesion on ZnS and ZnSe windows. The figure of merit of these films for aero-space applications has been evaluated by subjecting the film-buffer layer ZnS or ZnSe composite stack to wind, dust and rain erosion studies and by establishing the integrity of the specular IR transmittance of the stack upto 16 or 20 mu m as the case may be.

Classification of microwatersheds based on morphological characteristics

Three classification techniques, namely, K-means Cluster Analysis (KCA), Fuzzy Cluster Analysis (FCA), and Kohonen Neural Networks (KNN) were employed to group 25 microwatersheds of Kherthal watershed, Rajasthan into homogeneous groups for formulating the basis for suitable conservation and management practices. Ten parameters, mainly, morphological, namely, drainage density (D-d), bifurcation ratio (R-b), stream frequency (F-u), length of overland flow (L-o), form factor (R-f), shape factor (B-s), elongation ratio (R-e), circulatory ratio (R-c), compactness coefficient (C-c) and texture ratio (T) are used for the classification. Optimal number of groups is chosen, based on two cluster validation indices Davies-Bouldin and Dunn's. Comparative analysis of various clustering techniques revealed that 13 microwatersheds out of 25 are commonly suggested by KCA, FCA and KNN i.e., 52%; 17 microwatersheds out of 25 i.e., 68% are commonly suggested by KCA and FCA whereas these are 16 out of 25 in FCA and KNN (64%) and 15 out of 25 in KNN and CA (60%). It is observed from KNN sensitivity analysis that effect of various number of epochs (1000, 3000, 5000) and learning rates (0.01, 0.1-0.9) on total squared error values is significant even though no fixed trend is observed. Sensitivity analysis studies revealed that microwatershecls have occupied all the groups even though their number in each group is different in case of further increase in the number of groups from 5 to 6, 7 and 8. (C) 2010 International Association of Hydro-environment Engineering and Research, Asia Pacific Division. Published by Elsevier B.V. All rights reserved.

Potential of biomass energy for electricity generation in sub-Saharan Africa

The paper explores the biomass based power generation potential of Africa. Access to electricity in sub-Saharan Africa (SSA) is about 26% and falls to less than 1% in the rural areas. On the basis of the agricultural and forest produce of this region, the residues generated after processing are estimated for all the countries. The paper also addresses the use of gasification technology - an efficient thermo-chemical process for distributed power generation - either to replace fossil fuel in an existing diesel engine based power generation system or to generate electricity using a gas engine. This approach enables the implementation of electrification programs in the rural sector and gives access to grid quality power. This study estimates power generation potential at about 5000 MW and 10,000 MW by using 30% of residues generated during agro processing and 10% of forest residues from the wood processing industry, respectively. A power generation potential of 15000 MW could generate 100 terawatt-hours (TWh), about 15% of current generation in SSA. The paper also summarizes some of the experience in using the biomass gasification technology for power generation in Africa and India. The paper also highlights the techno economics and key barriers to promotion of biomass energy in sub-Saharan Africa. (C) 2011 International Energy Initiative. Published by Elsevier Inc. All rights reserved.

Gibbs energies of formation of intermetallic phases in the systems Pt Mg, Pt Ca and Pt Ba and some applications

The standard Gibbs energies of formation of platinum-rich intermetallic compounds in the systems Pt-Mg, Pt-Ca, and Pt-Ba have been measured in the temperature range of 950 to 1200 K using solid-state galvanic cells based on MgF2, CaF2, and BaF2 as solid electrolytes. The results are summarized by the following equations: ΔG° (MgPt7) = −256,100 + 16.5T (±2000) J/mol ΔG° (MgPt3) = −217,400 + 10.7T (±2000) J/mol ΔG° (CaPt5) = −297,500 + 13.0T (±5000) J/mol ΔG° (Ca2Pt7) = −551,800 + 22.3T (±5000) J/mol ΔG° (CaPt2) = −245,400 + 9.3T (±5000) J/mol ΔG° (BaPt5) = −238,700 + 8.1T (±4000) J/mol ΔG° (BaPt2) = −197,300 + 4.0T (±4000) J/mol where solid platinum and liquid alkaline earth metals are selected as the standard states. The relatively large error estimates reflect the uncertainties in the auxiliary thermodynamic data used in the calculation. Because of the strong interaction between platinum and alkaline earth metals, it is possible to reduce oxides of Group ILA metals by hydrogen at high temperature in the presence of platinum. The alkaline earth metals can be recovered from the resulting intermetallic compounds by distillation, regenerating platinum for recycling. The platinum-slag-gas equilibration technique for the study of the activities of FeO, MnO, or Cr2O3 in slags containing MgO, CaO, or BaO is feasible provided oxygen partial pressure in the gas is maintained above that corresponding to the coexistence of Fe and “FeO.”

Yield stress, thixotropy and shear banding in a dilute aqueous suspension of few layer graphene oxide platelets

We demonstrate a rigidity percolation transition and the onset of yield stress in a dilute aqueous dispersion of graphene oxide platelets (aspect ratio similar to 5000) above a critical volume fraction of 3.75 x 10(-4) with a percolation exponent of 2.4 +/- 0.1. The viscoelastic moduli of the gel at rest measured as a function of time indicate the absence of structural evolution of the 3D percolated network of disks. However a shear-induced aging giving rise to a compact jammed state and shear rejuvenation indicating a homogenous flow is observed when a steady shear stress (sigma) is imposed in creep experiments. We construct a shear diagram (sigma vs. volume fraction phi) and the critical stress above which shear rejuvenation occurs is identified as the yield stress sigma(y) of the gel. The minimum steady state shear rate (gamma) over dot(m) obtained from creep experiments agrees well with the end of the plateau region in a controlled shear rate flow curve, indicating a shear localization below (gamma) over dot(m). A steady state shear banding in the plateau region of the flow curve observed in particle velocimetry measurements in a Couette geometry confirms that the dilute suspensions of GO platelets form a thixotropic yield stress fluid.

Can Superflares Occur on Our Sun?

Recent observations of Sun-like stars, similar to our Sun in their surface temperature (5600-6000 K) and slow rotation (rotational period > 10 d), using the Kepler satellite by Maehara et al. (2012, Nature, 485, 478) have revealed the existence of superflares (with energy of 10(33)-10(35) erg). From statistical analyses of these superflares, it was found that superflares with energy of 10(34) erg occur once in 800 yr, and superflares with 10(35) erg occur once in 5000 yr. In this paper, we examine whether superflares with energy of 10(33)-10(35) erg could occur on the present Sun through the use of simple order-of-magnitude estimates based on current ideas related to the mechanisms of the solar dynamo. If magnetic flux is generated by differential rotation at the base of the convection zone, as assumed in typical dynamo models, it is possible that the present Sun would generate a large sunspot with a total magnetic flux of similar to 2 x 10(23) Mx (= G cm(2)) within one solar cycle period, and lead to superflares with an energy of 10(34) erg. To store a total magnetic flux of similar to 10(24) Mx, necessary for generating 10(35) erg superflares, it would take similar to 40 yr. Hot Jupiters have often been argued to be a necessary ingredient for the generation of superflares, but we found that they do not play any essential role in the generation of magnetic flux in the star itself, if we consider only the magnetic interaction between the star and the hot Jupiter. This seems to be consistent with Maehara et al.'s finding of 148 superflare-generating solar-type stars that do not have a hot Jupiter-like companion. Altogether, our simple calculations, combined with Maehara et al.'s analysis of superflares on Sun-like stars, show that there is a possibility that superflares of 10(34) erg would occur once in 800 yr on our present Sun.

Small molecule inhibitors of HCV replication from Pomegranate

Hepatitis C virus (HCV) is the causative agent of end-stage liver disease. Recent advances in the last decade in anti HCV treatment strategies have dramatically increased the viral clearance rate. However, several limitations are still associated, which warrant a great need of novel, safe and selective drugs against HCV infection. Towards this objective, we explored highly potent and selective small molecule inhibitors, the ellagitannins, from the crude extract of Pomegranate (Punica granatum) fruit peel. The pure compounds, punicalagin, punicalin, and ellagic acid isolated from the extract specifically blocked the HCV NS3/4A protease activity in vitro. Structural analysis using computational approach also showed that ligand molecules interact with the catalytic and substrate binding residues of NS3/4A protease, leading to inhibition of the enzyme activity. Further, punicalagin and punicalin significantly reduced the HCV replication in cell culture system. More importantly, these compounds are well tolerated ex vivo and `no observed adverse effect level' (NOAEL) was established upto an acute dose of 5000 mg/kg in BALB/c mice. Additionally, pharmacokinetics study showed that the compounds are bioavailable. Taken together, our study provides a proof-of-concept approach for the potential use of antiviral and non-toxic principle ellagitannins from pomegranate in prevention and control of HCV induced complications.

After transition in a soft-walled microchannel

In comparison to the flow in a rigid channel, there is a multifold reduction in the transition Reynolds number for the flow in a microchannel when one of the walls is made sufficiently soft, due to a dynamical instability induced by the fluid-wall coupling, as shown by Verma & Kumaran (J. Fluid Mech., vol. 727, 2013, pp. 407-455). The flow after transition is characterised using particle image velocimetry in the x-y plane, where x is the streamwise direction and y is the cross-stream coordinate along the small dimension of the channel of height 0.2-0.3 mm. The flow after transition is characterised by a mean velocity profile that is flatter at the centre and steeper at the walls in comparison to that for a laminar flow. The root mean square of the streamwise fluctuating velocity shows a characteristic sharp increase away from the wall and a maximum close to the wall, as observed in turbulent flows in rigid-walled channels. However, the profile is asymmetric, with a significantly higher maximum close to the soft wall in comparison to that close to the hard wall, and the Reynolds stress is found to be non-zero at the soft wall, indicating that there is a stress exerted by fluid velocity fluctuations on the wall. The maximum of the root mean square of the velocity fluctuations and the Reynolds stress (divided by the fluid density) in the soft-walled microchannel for Reynolds numbers in the range 250-400, when scaled by suitable powers of the maximum velocity, are comparable to those in a rigid channel at Reynolds numbers in the range 5000-20 000. The near-wall velocity profile shows no evidence of a viscous sublayer for (y upsilon(*)/nu) as low as two, but there is a logarithmic layer for (y upsilon(*)/nu) up to approximately 30, where the von Karman constants are very different from those for a rigid-walled channel. Here, upsilon(*) is the friction velocity, nu is the kinematic viscosity and y is the distance from the soft surface. The surface of the soft wall in contact with the fluid is marked with dye spots to monitor the deformation and motion along the fluid-wall interface. Low-frequency oscillations in the displacement of the surface are observed after transition in both the streamwise and spanwise directions, indicating that the velocity fluctuations are dynamically coupled to motion in the solid.

Appraisal of groundwater resource in Holocene soil deposits by resistivity, hydrochemical and granulomerial studies in the Gulf of Mannar Coast from Southern India

This article is aimed to delineate groundwater sources in Holocene deposits area in the Gulf of Mannar Coast from Southern India. For this purpose 2-D electrical resistivity tomography (ERT), hydrochemical and granulomerical studies were carried out and integrated to identify hydrogeological structures and portable groundwater resource in shallow depths which in general appears in the coastal tracts. The 2-D ERT was used to determine the two-dimensional subsurface geological formations by multicore cable with Wenner array. Low resistivity of 1-5 Omega m for saline water appeared due to calcite at the depth of about 5 m below the ground level (bgl). Sea water intrusion was observed around the maximum resistivity as 5 Omega m at the 8 m depth, bgl in the calcite environs, but the calcareous sandstone layer shows around 15-64 Omega m at the 6 m depth, bgl. The hydrochemical variation of TDS, HCO3-, Cl-, Na+, K+, Ca2+, and Mg2+ concentrations was observed for the saline and sea water intrusion in the groundwater system. The granulometic analysis shows that the study area was under the sea between 5400 and 3000 year ago. The events of ice melting an unnatural ice-stone rain/hail among 5000-4000 years ago resulted in the inundation of sea over the area and deposits of late Holocene marine transgression formation up to Puthukottai quartzite region for a stretch of around 17 km.

Thermal Properties Measurement of Micro-Electromechanical System Sensors by Digital Moire Method

The thermal properties of a micro-electromechanical system sensor were analysed by a novel digital moire method. A double-layer micro-cantilever sensor (60 mu m long, 10 mu m width and 2 mu dm thick) was prepared by focused ion beam milling. A grating with frequency of 5000 lines mm- I was etched on the cantilever. The sensor was placed into a scanning electron microscope system with a high temperature device. The observation and recording of the thermal deformation of the grating were realised in real-time as the temperature rose from room temperature to 300 degrees C at intervals of 50 degrees C. Digital moire was generated by interference of the deformed grating and a digital virtual grating. The thermal properties including strain distribution of the sensor and the linear expansion coefficient of polysilicon were accurately measured by the phase-shifted moire patterns.

Efecto del asa, manitol e intensidad lumínica sobre el crecimiento de apices in vitro de yuca (Manihot esculenta crantz): observaciones preliminares

En el presente estudio se trat6 de determinar la influencia de 3 factures: Ácido Acetil Salicílico (ASAP). Manitol e intensidad de la Luz, sobre el crecimiento de plantas de yuca (Manihot esculenta ) in vitro. Se trabajó con explantes de la variedad M-Col 22 con una edad promedio de 7 meses. Los explantes fueron yemas apicales quo se inocularon en el medio básico Murashigo y Skoog. Los cultivos fueron mantenidos en un cuarto do incubación a 26 +/- 2C, 3000 lux y un fotoperiodo de 16 horas. Cuando las plantas alcanzaron 3 cm de Altura aproximadamente a los 120 días, fue realizada la inoculación de las yemas en los diferentes medios para los experimentos programados. Se efectuaron 4 tratamientos para el factor ASA, siendo estos 0, 2, 5 y 10 mg/1 de ASA. Para el factor Manitol 0, 100, 300 y 500 mg/1, y finalmente para luz fueron probadas 4 intensidades 5000 1000, 1500 y 2500 lux. Se observó buen resultado en todos los tratamientos, sin embargo aunque los 3 factores estudiados inhibieron el desarrollo de plantas de yuca in vitro, se observó mejor efecto con el factor ASA. La adición de 2 mg/1 de este ácido resultó ser una concentración altamente inhibitoria pare las 3 variables estudiadas (altura, número de hojas y número de yemas). La concentración de 100 mg/1 do Manitol inhibió el crecimiento de las plantas en forma más eficiente que los demás tratamientos. En el caso del efecto de la Intensidad lumínica, se observó que 500 lux fue el tratamiento más efectivo en la reducción del crecimiento.