Stent-retriever thrombectomy: impact on the future of interventional stroke treatment

Endovascular treatment for acute ischemic stroke has evolved in the past years. The current development of stent-retriever thrombectomy is a landmark in the clinical treatment and study results of acute ischemic stroke. This review summarizes the recent study results, elucidates the shortcomings of endovascular stroke treatment, and takes the opportunity for an outlook on the role of stroke interventions in the future.

EPA guidance on the early detection of clinical high risk states of psychoses

The aim of this guidance paper of the European Psychiatric Association is to provide evidence-based recommendations on the early detection of a clinical high risk (CHR) for psychosis in patients with mental problems. To this aim, we conducted a meta-analysis of studies reporting on conversion rates to psychosis in non-overlapping samples meeting any at least any one of the main CHR criteria: ultra-high risk (UHR) and/or basic symptoms criteria. Further, effects of potential moderators (different UHR criteria definitions, single UHR criteria and age) on conversion rates were examined. Conversion rates in the identified 42 samples with altogether more than 4000 CHR patients who had mainly been identified by UHR criteria and/or the basic symptom criterion ‘cognitive disturbances’ (COGDIS) showed considerable heterogeneity. While UHR criteria and COGDIS were related to similar conversion rates until 2-year follow-up, conversion rates of COGDIS were significantly higher thereafter. Differences in onset and frequency requirements of symptomatic UHR criteria or in their different consideration of functional decline, substance use and co-morbidity did not seem to impact on conversion rates. The ‘genetic risk and functional decline’ UHR criterion was rarely met and only showed an insignificant pooled sample effect. However, age significantly affected UHR conversion rates with lower rates in children and adolescents. Although more research into potential sources of heterogeneity in conversion rates is needed to facilitate improvement of CHR criteria, six evidence-based recommendations for an early detection of psychosis were developed as a basis for the EPA guidance on early intervention in CHR states.

Can we constrain the interior structure of rocky exoplanets from mass and radius measurements?

Aims. We present an inversion method based on Bayesian analysis to constrain the interior structure of terrestrial exoplanets, in the form of chemical composition of the mantle and core size. Specifically, we identify what parts of the interior structure of terrestrial exoplanets can be determined from observations of mass, radius, and stellar elemental abundances. Methods. We perform a full probabilistic inverse analysis to formally account for observational and model uncertainties and obtain confidence regions of interior structure models. This enables us to characterize how model variability depends on data and associated uncertainties. Results. We test our method on terrestrial solar system planets and find that our model predictions are consistent with independent estimates. Furthermore, we apply our method to synthetic exoplanets up to 10 Earth masses and up to 1.7 Earth radii, and to exoplanet Kepler-36b. Importantly, the inversion strategy proposed here provides a framework for understanding the level of precision required to characterize the interior of exoplanets. Conclusions. Our main conclusions are (1) observations of mass and radius are sufficient to constrain core size; (2) stellar elemental abundances (Fe, Si, Mg) are principal constraints to reduce degeneracy in interior structure models and to constrain mantle composition; (3) the inherent degeneracy in determining interior structure from mass and radius observations does not only depend on measurement accuracies, but also on the actual size and density of the exoplanet. We argue that precise observations of stellar elemental abundances are central in order to place constraints on planetary bulk composition and to reduce model degeneracy. We provide a general methodology of analyzing interior structures of exoplanets that may help to understand how interior models are distributed among star systems. The methodology we propose is sufficiently general to allow its future extension to more complex internal structures including hydrogen- and water-rich exoplanets.

On the nucleus structure and activity of comet 67P/Churyumov-Gerasimenko

Images from the OSIRIS scientific imaging system onboard Rosetta show that the nucleus of 67P/Churyumov-Gerasimenko consists of two lobes connected by a short neck. The nucleus has a bulk density less than half that of water. Activity at a distance from the Sun of >3 astronomical units is predominantly from the neck, where jets have been seen consistently. The nucleus rotates about the principal axis of momentum. The surface morphology suggests that the removal of larger volumes of material, possibly via explosive release of subsurface pressure or via creation of overhangs by sublimation, may be a major mass loss process. The shape raises the question of whether the two lobes represent a contact binary formed 4.5 billion years ago, or a single body where a gap has evolved via mass loss.

Investigating the effects of the 2007 Texas tobacco tax increase on the smoking behavior of adults

Smoking is major cause of premature mortality and morbidity in the United States. The health consequences of tobacco usage are increasingly concentrated in minority and lower socioeconomic groups. One of the most effective means of deterring tobacco consumption and generating revenue to fund prevention activities is the levying of excise taxes. In 2007 the state of Texas increased the excise tax on cigarettes by $1.00 per pack. This study sought to determine if there was a significant effect on smoking prevalence in the state by examining Behavioral Risk Factor Surveillance System (BRFSS) data for two years leading up to the tax increase-2005 and 2006- and two years post tax increase -2007 and 2008. Results were compared against a chi square distribution and three multiple logistic regression models were created to adjust for race/ethnicity, age, education and income. Results from this study show that there was not a significant decrease in smoking prevalence for most of the groups stratified by age, income and ethnicity. There was not a significant decrease in the younger adults aged 18-34 by income, ethnicity, or education. Smoking prevalence increased for some groups, e.g., Hispanic females. In the regression models, the tax effect was not significant. While overall prevalence decreased by 9%, there were not significant reductions among non-White or Hispanic survey participants. Taxed sales dropped by approximately 17% according to the Texas Comptroller. Without BRFSS data measuring daily cigarette consumption among current smokers, now not assessed, it is impossible to determine whether the discrepancy in reported prevalence and taxes sales is attributable to consumption of fewer cigarettes among smokers or tax avoidance.^

The future obligations of "project manager" as construction integral director (DIPE) in the law of buildings construction in spain (LOE)

In the year 1999 approves the Law of Construction Building (LOE, in Spanish) to regulate a sector such as construction, which contained some shortcomings from the legal point of view. Currently, the LOE has been in force 12 years, changing the spanish world of the construction, due to influenced by internationalization. Within the LOE, there regulating the different actors involved in the construction building, as the Projects design, the Director of Construction, the developer, The builder, Director of execution of the construction (actor only in Spain, similar as construcion engineer and abroad in), control entities and the users, but lacks figure Project manager will assume the delegation of the promoter helping and you organize, direct and management the process. This figure assumes that the market and contracts are not legally regulated in Spain, then should define and establish its regulation in the LOE. (Spain Construction Law) The translation in spanish of the words "Project Manager is owed to Professor Rafael de Heredia in his book Integrated Project Management, as agent acting on behalf of the organization and promoter assuming control of the project, ie Integraded Project Management . Already exist in Spain, AEDIP (Spanish Association Integrated of Project Construction management) which comprises the major companies in “Project Management” in Spain, and MeDIP (Master in Integrated Construction Project) the largest and most advanced studies at the Polytechnic University of Madrid, in "Construction Project Management" they teach which is also in Argentina. The Integrated Project ("Project Management") applied to the construction process is a methodological technique that helps to organize, control and manage the resources of the promoters in the building process. When resources are limited (which is usually most situations) to manage them efficiently becomes very important. Well, we find that in this situation, the resources are not only limited, but it is limited, so a comprehensive control and monitoring of them becomes not only important if not crucial. The alternative of starting from scratch with a team that specializes in developing these follow directly intervening to ensure that scarce resources are used in the best possible way requires the use of a specific methodology (Manual DIP, Matrix Foreign EDR breakdown structure EDP Project, Risk Management and Control, Design Management, et ..), that is the methodology used by "Projects managers" to ensure that the initial objectives of the promoters or investors are met and all actors in process, from design to construction company have the mind aim of the project will do, trying to get their interests do not prevail over the interests of the project. Among the agents listed in the building process, "Project Management" or DIPE (Director Comprehensive building process, a proposed name for possible incorporation into the LOE, ) currently not listed as such in the LOE (Act on Construction Planning ), one of the agents that exist within the building process is not regulated from the legal point of view, no obligations, ie, as is required by law to have a project, a builder, a construction management, etc. DIPE only one who wants to hire you as have been advanced knowledge of their services by the clients they have been hiring these agents, there being no legal obligation as mentioned above, then the market is dictating its ruling on this new figure, as if it were necessary, he was not hired and eventually disappeared from the building process. As the aim of this article is regular the process and implement the name of DIPE in the Spanish Law of buildings construction (LOE)

On the reaction mechanism of l-lactate oxidase: Quantitative structure-activity analysis of the reaction with para-substituted l-mandelates

The rate constants for reduction of the flavoenzyme, l-lactate oxidase, and a mutant (in which alanine 95 is replaced by glycine), by a series of para-substituted mandelates, in both the 2-1H- and 2-2H- forms, have been measured by rapid reaction spectrophotometry. In all cases, significant isotope effects (1H/2H = 3–7) on the rate constants of flavin reduction were found, indicating that flavin reduction is a direct measure of α-C-H bond breakage. The rate constants show only a small influence of the electronic characteristics of the substituents, but show a good correlation when combined with some substituent volume parameters. A surprisingly good correlation is found with the molecular mass of the substrate. The results are compatible with any mechanism in which there is little development of charge in the transition state. This could be a transfer of hydride to the flavin N(5) position or a synchronous mechanism in which the α-C-H is formally abstracted as a H+ while the resulting charge is simultaneously neutralized by another event.