Robotic Outcome Assessment in a Non-Human Primate Model of Middle Cerebral Artery Stroke

Stroke is a prevalent disorder with immense socioeconomic impact. A variety of chronic neurological deficits result from stroke. In particular, sensorimotor deficits are a significant barrier to achieving post-stroke independence. Unfortunately, the majority of pre-clinical studies that show improved outcomes in animal stroke models have failed in clinical trials. Pre-clinical studies using non-human primate (NHP) stroke models prior to initiating human trials are a potential step to improving translation from animal studies to clinical trials. Robotic assessment tools represent a quantitative, reliable, and reproducible means to assess reaching behaviour following stroke in both humans and NHPs. We investigated the use of robotic technology to assess sensorimotor impairments in NHPs following middle cerebral artery occlusion (MCAO). Two cynomolgus macaques underwent transient MCAO for 90 minutes. Approximately 1.5 years following the procedure these NHPs and two non-stroke control monkeys were trained in a reaching task with both arms in the KINARM exoskeleton. This robot permits elbow and shoulder movements in the horizontal plane. The task required NHPs to make reaching movements from a centrally positioned start target to 1 of 8 peripheral targets uniformly distributed around the first target. We analyzed four movement parameters: reaction time, movement time (MT), initial direction error (IDE), and number of speed maxima to characterize sensorimotor deficiencies. We hypothesized reduced performance in these attributes during a neurobehavioural task with the paretic limb of NHPs following MCAO compared to controls. Reaching movements in the non-affected limbs of control and experimental NHPs showed bell-shaped velocity profiles. In contrast, the reaching movements with the affected limbs were highly variable. We found distinctive patterns in MT, IDE, and number of speed peaks between control and experimental monkeys and between limbs of NHPs with MCAO. NHPs with MCAO demonstrated more speed peaks, longer MTs, and greater IDE in their paretic limb compared to controls. These initial results qualitatively match human stroke subjects’ performance, suggesting that robotic neurobehavioural assessment in NHPs with stroke is feasible and could have translational relevance in subsequent human studies. Further studies will be necessary to replicate and expand on these preliminary findings.

Explaining and Comparing - Improving United States and European Union-Africa Economic Relations: Policy Memo. ACES Working Papers, 2012

As evidenced by the disparities seen in the world, development does not occur uniformly around the world. Global superpowers like the United States and the European Union collectively dominate other parts of the world simply because of their ability to develop at a faster rate. With the rise of globalization and the increasing connectivity of the world economy, the world has reached a time where it is imperative that those nations and unions holding power to commit to elevating their fellow nations through supportive policy ties. The United States and the European Union, as leading global nations, have an important role in developing the economies of other countries; by taking various policy measures, the US and EU can create stronger economic ties to Africa and create a advantageous relationship for all the regions involved.

Cardiovascular disease in Switzerland - health care, mortality and geographical pattern

SUMMARY Switzerland is facing an aging population and a growing amount of patients with chronic diseases. It is crucial to display health care processes and pathways, to identify inequalities and obstacles, and to point out possibilities for improvements of the Swiss health care system (e.g. increase efficiency). The introductory part of the thesis presents a brief description of the Swiss health care system, health services research and regional variation as well as an introduction of CVD and its epidemiological key figures, aetiology and treatments. This is followed by the description of the utilized methods and data, and the objectives of this thesis. The subsequent sections present the four articles included in this thesis. The first article focuses on a small area analysis on regional variation of avoidable hospitalisations in Switzerland including density of primary care physicians and specialists, rurality and hospital supply factors as explanatory variables in the analysis. Lower rates of avoidable hospitalisations were found in areas with very high supply of primary care physicians, increased avoidable hospitalisation rates in areas with more specialists and in areas with higher proportion of rural residents. The second article aims to examine whether emergency patients with acute ST-segment elevation myocardial infarction were adequately treated, i.e. according to the treatment guidelines, in Switzerland. Results show that older and female patients were less likely to receive revascularization which suggests that the treatment guidelines may not be uniformly applied in Switzerland. Similar to the first article, also in the third article a small area analysis was performed but this time investigating regional variation in costs at the end of life. Strongest associations of cost was found with cause of death, age and language region of the decedents. The strong spatial variation of costs could only partly be explained by the included covariates. Article four aims to examine the relationship of distance to different hospital types and mortality from AMI or stroke. We found that AMI mortality in the Swiss population 30 and older and stroke mortality in those 65 and above increased with distance to central and university hospitals, while adjusting for sociodemographic and economic characteristics of the population. The presentation of the four articles is followed by a discussion, which summarizes the main findings and the strengths and limitations of the presented articles. The thesis concludes with a discussion about the challenges for policy, practice and future research.

Calcium carbonate, total and organic carbon and accumulation rate characteristics at DSDP Leg 78A Holes

Bulk sediment accumulation rates and carbonate and carbonate-free accumulation rates corrected for tectonic tilting have been calculated for Leg 78A sediments. These rates are uniformly low, ranging from 0.1 to 6.8 g/(cm**2 x 10**3 yr.), reflecting the pelagic-hemipelagic nature of all the sediments drilled in the northern Lesser Antilles forearc. Rates calculated for Sites 541 and 542 [0.6-6.8 g/(cm**2 x 10**3 yr.)], located on the lower slope of the accretionary prism, are significantly greater than the Neogene rates calculated for oceanic reference Site 543 [0.1-2.4 g/(cm**2 x 10**3)]. This difference could be the result of (1) tectonic thickening of accretionary prism sediments due to folding, small-scale faulting, and layer-parallel shortening; (2) deposition in shallower water farther above the CCD (carbonate compensation depth) resulting in preservation of a greater percentage of calcareous microfossils; or (3) a greater percentage of foraminiferal sediment gravity flows. Terrigenous turbidites are not documented in the Leg 78A area because of (1) great distance from South American sources; (2) damming effects of east-west trending tectonic elements; and (3) location on the Tiburon Rise (Site 543). This lack of terrigenous material, characteristic of intraoceanic convergent margins, suggests that published sedimentation models for active continental convergent margins with abundant terrigenous influxes are not applicable to intraoceanic convergent margin settings.

(Table 1) Summary of basalt unit thickness, vesicularity, number of flow units, and average porosity at ODP Site 135-839

An inflatable drill-string packer was used at Site 839 to measure the bulk in-situ permeability within basalts cored in Hole 839B. The packer was inflated at two depths, 398.2 and 326.9 mbsf; all on-board information indicated that the packer mechanically closed off the borehole, although apparently the packer hydraulically sealed the borehole only at 398.2 mbsf. Two pulse tests were run at each depth, two constant-rate injection tests were run at the first set, and four were run at the second. Of these, only the constant-rate injection tests at the first set yielded a permeability, calculated as ranging from 1 to 5 * 10**-12 m**2. Pulse tests and constant-rate injection tests for the second set did not yield valid data. The measured permeability is an upper limit; if the packer leaked during the experiments, the basalt would be less permeable. In comparison, permeabilities measured at other Deep Sea Drilling Project and Ocean Drilling Program sites in pillow basalts and flows similar to those measured in Hole 839B are mainly about 10**-13 to 10**-14 m**2. Thus, if our results are valid, the basalts at Site 839 are more permeable than ocean-floor basalts investigated elsewhere. Based on other supporting evidence, we consider these results to be a valid measure of the permeability of the basalts. Temperature data and the geochemical and geotechnical properties of the drilled sediments all indicate that the site is strongly affected by fluid flow. The heat flow is very much less than expected in young oceanic basalts, probably a result of rapid fluid circulation through the crust. The geochemistry of pore fluids is similar to that of seawater, indicating seawater flow through the sediments, and sediments are uniformly underconsolidated for their burial depth, again indicating probable fluid flow. The basalts are highly vesicular. However, the vesicularity can only account for part of the average porosity measured on the neutron porosity well log; the remainder of the measured porosity is likely present as voids and fractures within and between thin-bedded basalts. Core samples, together with porosity, density, and resistivity well-log data show locations where the basalt section is thin bedded and probably has from 15% to 35% void and fracture porosity. Thus, the measured permeability seems reasonable with respect to the high measured porosity. Much of the fluid flow at Site 839 could be directed through highly porous and permeable zones within and between the basalt flows and in the sediment layer just above the basalt. Thus, the permeability measurements give an indication of where and how fluid flow may occur within the oceanic crust of the Lau Basin.

Elegant extracts : being a copious collection of instructive, moral, and entertaining passages from the most eminent British poets.

In 12 books; each book has special engraved t.p., illustrated, with title: Elegant extracts from the most eminent British poets.

A bibliography of the works of Robert Lewis Stevenson,

Titles transcribed line for line.

A canticle of pan : and other poems /

One of fourteen uniformly bound volumes in 3/4 blue leather, specially bound for the author.

Goethe's Werke /

A set composed of volumes of various editions uniformly bound.

Professional papers by the Corps of Royal Engineers ... Royal Engineers Institute.

Three Occasional papers were published separately in pamphlet form in 1876, but were not printed uniformly nor paged consecutively, and have therefore not been included in the first volume, but are bound together as an appendix to it.

Répertoire général du Théâtre Français, composé des tragédies, comédies et drames des auteurs du premier et du second ordre. restés au Théâtre Français: avec une table générale ...

Imperfect: v. 13 containing the 3d vol. of the tragedies by Crébillon wanting. The present set has in its place: Œuvrres de Crébillon, t. III. Paris, Stéréotype d'Herhan. XI=1802, lettered uniformly with the set: Théâtre français 13 (Crébillon 3.--v.67 containing the Table générale is also wanting.

History of the United States from the discovery of the American continent.

Engraved armorial bookplates of C.L. Peirson.

L'angeleida, poema, ristampato secondo la rarissima ediz. del MDXC per servire d'appendice al Paradiso perduto di Milton.

Bound uniformly with Milton's Traduzione delle opere poetiche, 1840, and lettered: [Tom.] 4.

Supplemental volume to the works of Alexander Pope, Esq. : printed from the original manuscripts; containing a considerable addition to his private correspondence : the whole accompanied by notes, explanatory, biographical, and literary.

Index: p. [189]-195.