Safety of endovascular treatment beyond the 6-h time window in 205 patients

Background and purpose Intra-arterial treatment (IAT) is effective when performed within 6 h of symptom onset in selected stroke patients (‘T < 6H’). Its safety and efficacy is unclear when the patient has had symptoms for more than 6 h (‘T > 6H’) or for an unknown time (unclear-onset stroke, UOS), or woke up with a stroke (wake-up stroke, WUS). In this study we compared the safety of IAT in these four patient groups. Methods Eight-hundred and fifty-nine patients treated with IAT were enrolled. The main outcome parameters were clinical outcome [excellent: modified Rankin Scale (mRS) 0 or 1; or favorable: mRS 0–2] or mortality 3 months after treatment. Further outcome parameters were the rates of vessel recanalization, and cerebral and systemic hemorrhage. Results Six-hundred and fifty-four patients were treated before (T < 6H) and 205 after 6 h or an unknown time (128 T > 6H, 55 WUS and 22 UOS). NIHSS scores were higher in UOS patients than in T < 6H patients, vertebrobasilar occlusion was more common in T > 6H and UOS patients, and middle cerebral artery occlusions less common in T > 6H than in T < 6H patients. Other baseline characteristics were similar. There was no significant difference in clinical outcome and the rate of hemorrhage in multivariable regression analysis. Conclusions Clinical outcome of our four groups of patients was similar with no increase of hemorrhage rates in patients treated after awakening, after an unknown time or more than 6 h. Our preliminary data suggest that treatment of such patients may be performed safely. If confirmed in randomized trials, this would have major clinical implications.

Self-Immolation In Tibet: Beyond The Lens Of The Western Media

This thesis provides a critique of Western media articles concerning self-immolation in Tibet. I begin by illustrating how the Western media provides reductionist accounts of Tibetan self-immolation by depicting the act solely as a form of political protest in response to Chinese occupation. I argue that these limited portrayals of self-immolation can be attributed to the Shangri-La imagery that characterizes much of the Western conceptions of Tibet. Through Shangri-La imagery, both Tibetans and their Buddhist religion are portrayed as utopic, peaceful, and able to provide the antidote to solving Western problems relating to modernization and consumerism. After illustrating the ways in which Shangri-La imagery influences Western media portrayals of Tibetan self-immolation, this thesis explores the commonly disregarded Buddhist dimensions of the act. Looking to Buddhist doctrine, scripture, and history, this thesis establishes a clear relationship between self-immolation and Buddhism, which situates the act as being more complicated than mere political protest. I argue that these limited portrayals given by the Western media are problematic because they overlook a fundamental aspect of self-immolation, thus potentially misrepresenting Tibetans. This thesis explores the Buddhist dimensions of self-immolation as a possible way to further understand what has led more than one hundred Tibetans to perform this act during the time of political crisis.

Monitoring Butterfly Abundance: Beyond Pollard Walks

Most butterfly monitoring protocols rely on counts along transects (Pollard walks) to generate species abundance indices and track population trends. It is still too often ignored that a population count results from two processes: the biological process (true abundance) and the statistical process (our ability to properly quantify abundance). Because individual detectability tends to vary in space (e.g., among sites) and time (e.g., among years), it remains unclear whether index counts truly reflect population sizes and trends. This study compares capture-mark-recapture (absolute abundance) and count-index (relative abundance) monitoring methods in three species (Maculinea nausithous and Iolana iolas: Lycaenidae; Minois dryas: Satyridae) in contrasted habitat types. We demonstrate that intraspecific variability in individual detectability under standard monitoring conditions is probably the rule rather than the exception, which questions the reliability of count-based indices to estimate and compare specific population abundance. Our results suggest that the accuracy of count-based methods depends heavily on the ecology and behavior of the target species, as well as on the type of habitat in which surveys take place. Monitoring programs designed to assess the abundance and trends in butterfly populations should incorporate a measure of detectability. We discuss the relative advantages and inconveniences of current monitoring methods and analytical approaches with respect to the characteristics of the species under scrutiny and resources availability.