Short runs of atrial arrhythmia and stroke risk: a European-wide online survey among stroke physicians and cardiologists

Methods: An online survey of cardiologists and stroke physicians was carried out to assess current management of patients with short runs of atrial arrhythmia within Europe. Results: Respondents included 311 clinicians from 32 countries. To diagnose atrial fibrillation, 80% accepted a single 12-lead ECG and 36% accepted a single run of < 30 seconds on ambulatory monitoring. Stroke physicians were twice as likely to accept < 30 seconds of arrhythmia as being diagnostic of atrial fibrillation (OR 2.43, 95% CI 1.19–4.98). They were also more likely to advocate anticoagulation for hypothetical patients with lower risk; OR 1.9 (95% CI 1.0–3.5) for a patient with CHA2DS2-VASc = 2. Conclusion: Short runs of atrial fibrillation create a dilemma for physicians across Europe. Stroke physicians and cardiologists differ in their diagnosis and management of these patients

Dose escalation of desmoteplase for acute ischemic stroke (DEDAS): evidence of safety and efficacy 3 to 9 hours after stroke onset

<p><b>Background and Purpose:</b> Desmoteplase is a novel plasminogen activator with favorable features in vitro compared with available agents. This study evaluated safety and efficacy of intravenous (IV) desmoteplase in patients with perfusion/diffusion mismatch on MRI 3 to 9 hours after onset of acute ischemic stroke.</p> <p><b>Methods:</b> DEDAS was a placebo-controlled, double-blind, randomized, dose-escalation study investigating doses of 90 μg/kg and 125 μg/kg desmoteplase. Eligibility criteria included baseline National Institute of Health Stroke Scale (NIHSS) scores of 4 to 20 and MRI evidence of perfusion/diffusion mismatch. The safety end point was the rate of symptomatic intracranial hemorrhage. Primary efficacy co-end points were MRI reperfusion 4 to 8 hours after treatment and good clinical outcome at 90 days. The primary analyses were intent-to-treat. Before unblinding, a target population, excluding patients violating specific MRI criteria, was defined.</p> <p><b>Results:</b> Thirty-seven patients were randomized and received treatment (intent-to-treat; placebo: n=8; 90 μg/kg: n=14; 125 μg/kg: n=15). No symptomatic intracranial hemorrhage occurred. Reperfusion was achieved in 37.5% (95% CI [8.5; 75.5]) of placebo patients, 18.2% (2.3; 51.8) of patients treated with 90 μg/kg desmoteplase, and 53.3% (26.6; 78.7) of patients treated with 125 μg/kg desmoteplase. Good clinical outcome at 90 days occurred in 25.0% (3.2; 65.1) treated with placebo, 28.6% (8.4; 58.1) treated with 90 μg/kg desmoteplase and 60.0% (32.3; 83.7) treated with 125 μg/kg desmoteplase. In the target population (n=25), the difference compared with placebo increased and was statistically significant for good clinical outcome with 125 μg/kg desmoteplase (P=0.022).</p> <p><b>Conclusions:</b> Treatment with IV desmoteplase 3 to 9 hours after ischemic stroke onset appears safe. At a dose of 125 μg/kg desmoteplase appeared to improve clinical outcome, especially in patients fulfilling all MRI criteria. The results of DEDAS generally support the results of its predecessor study, Desmoteplase in Acute Ischemic Stroke (DIAS).</p&gt

Nonlinear Transient Field Problems with Phase Change using the Boundary Element Method

Peer reviewe

Tricks Of The Trade [pulo Do Gato]

[No abstract available]704245Hoch, W., McConville, J., Helms, S., Newsom-Davis, J., Melms, A., Vincent, A., Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies (2001) Nat Med, 7, pp. 365-368Leite, M.I., Jacob, S., Viegas, S., IgG1 antibodies to acetylcholine receptors in 'seronegative' myasthenia gravis (2008) Brain, 131, pp. 1940-1952Barber, P.A., Anderson, N.E., Vincent, A., Morvan's syndrome associated with voltage-gated K+ channel antibodies (2000) Neurology, 54, pp. 771-772Liguori, R., Vincent, A., Clover, L., Morvan's syndrome: Peripheral and central nervous system and cardiac involvement with antibodies to voltage-gated potassium channels (2001) Brain, 124, pp. 2417-2426Vincent, A., Buckley, C., Schott, J.M., Potassium channel antibody-associated encephalopathy: A potentially immunotherapy-responsive form of limbic encephalitis (2004) Brain, 127, pp. 701-712Irani, S.R., Alexander, S., Waters, P., Antibodies to Kv1 potassium channel-complex proteins leucine-rich, glioma inactivated 1 protein and contactin-associated protein-2 in limbic encephalitis, Morvan's syndrome and acquired neuromyotonia (2010) Brain, 133, pp. 2734-2748Hutchinson, M., Waters, P., McHugh, J., Progressive encephalomyelitis, rigidity, and myoclonus: A novel glycine receptor antibody (2008) Neurology, 71, pp. 1291-129

Rape and respectability: ideas about sexual violence and social class

Women on low incomes are disproportionately represented among sexual violence survivors, yet feminist research on this topic has paid very little attention to social class. This article blends recent research on class, gender and sexuality with what we know about sexual violence. It is argued that there is a need to engage with classed distinctions between women in terms of contexts for and experiences of sexual violence, and to look at interactions between pejorative constructions of working-class sexualities and how complainants and defendants are perceived and treated. The classed division between the sexual and the feminine, drawn via the notion of respectability, is applied to these issues. This piece is intended to catalyse further research and debate, and raises a number of questions for future work on sexual violence and social class

Alpha-synuclein mRNA expression in oligodendrocytes in MSA

Multiple system atrophy (MSA) is a progressive neurodegenerative disease presenting clinically with parkinsonian, cerebellar, and autonomic features. α‐Synuclein (αsyn), encoded by the gene SNCA, is the main constituent of glial cytoplasmic inclusion (GCI) found in oligodendrocytes in MSA, but the methods of its accumulation have not been established. The aim of this study is to investigate alterations in regional and cellular SNCA mRNA expression in MSA as a possible substrate for GCI formation. Quantitative reverse transcription polymerase chain reaction (qPCR) was performed on postmortem brain samples from 15 MSA, 5 IPD, and 5 control cases to investigate regional expression in the frontal and occipital regions, dorsal putamen, pontine base, and cerebellum. For cellular expression analysis, neurons and oligodendrocytes were isolated by laser‐capture microdissection from five MSA and five control cases. SNCA mRNA expression was not significantly different between the MSA, IPD and control cases in all regions (multilevel model, P = 0.14). After adjusting for group effect, the highest expression was found in the occipital cortex while the lowest was in the putamen (multilevel model, P < 0.0001). At the cellular level, MSA oligodendrocytes expressed more SNCA than control oligodendrocytes and expression in MSA neurons was slightly lower than that in controls, however, these results did not reach statistical significance. We have demonstrated regional variations in SNCA expression, which is higher in cortical than subcortical regions. This study is the first to demonstrate SNCA mRNA expression by oligodendrocytes in human postmortem tissue using qPCR and, although not statistically significant, could suggest that this may be increased in MSA compared to controls. GLIA 2014;62:964–97

Methionine restriction improves renal insulin signalling in aged kidneys.

Dietary methionine restriction (MR) leads to loss of adiposity, improved insulin sensitivity and lifespan extension. The possibility that dietary MR can protect the kidney from age-associated deterioration has not been addressed. Aged (10-month old) male and female mice were placed on a MR (0.172% methionine) or control diet (0.86% methionine) for 8-weeks and blood glucose, renal insulin signalling, and gene expression were assessed. Methionine restriction lead to decreased blood glucose levels compared to control-fed mice, and enhanced insulin-stimulated phosphorylation of PKB/Akt and S6 in kidneys, indicative of improved glucose homeostasis. Increased expression of lipogenic genes and downregulation of PEPCK were observed, suggesting that kidneys from MR-fed animals are more insulin sensitive. Interestingly, renal gene expression of the mitochondrial uncoupling protein UCP1 was upregulated in MR-fed animals, as were the anti-ageing and renoprotective genes Sirt1, FGF21, klotho, and β-klotho. This was associated with alterations in renal histology trending towards reduced frequency of proximal tubule intersections containing vacuoles in mice that had been on dietary MR for 190days compared to control-fed mice, which exhibited a pre-diabetic status. Our results indicate that dietary MR may offer therapeutic potential in ameliorating the renal functional decline related to ageing and other disorders associated with metabolic dysfunction by enhancing renal insulin sensitivity and renoprotective gene expression

Did Late Cretaceous cooling trigger the Campanian&#8211;Maastrichtian Boundary Event?

The Campanian-Maastrichtian (83-66 Ma) was a period of global climate cooling, featuring significant negative carbon-isotope (delta C-13) anomalies, such as the Late Campanian Event (LCE) and the Campanian-Maastrichtian Boundary Event (CMBE). A variety of factors, including changes in temperature, oceanic circulation and gateway opening, have been invoked to explain these delta C-13 perturbations, but no precise mechanism has yet been well constrained. In order to improve our understanding of these events, we measured stable carbon and oxygen isotopes of hemipelagic sediments from the Shuqualak-Evans cored borehole (Mississippi, USA) and compared the data with previously published sea-surface temperature (SST) estimates from the same core. We found that the CMBE can be recognised, unambiguously, in the Shuqualak-Evans core, and that it is associated with an interval of cooler SSTs suggesting a possible mechanistic link between palaeotemperat ure change and this event. Determining the precise position of the LCE in the Shuqualak-Evans core is more problematic, but it may also be associated with cooler SSTs. Our combined records of carbon cycling and SSTs compare well with other studies and provide evidence that cooling during the CMBE (and possibly LCE) was global in nature and affected surface waters, in addition to the deep-ocean. We suggest that short-term cooling drove intensification of high-latitude deep-water formation, which in turn led to changes in the ratio of carbonate to organic carbon burial that led to a negative delta C-13 excursion. Critically, the absence of warming during these intervals implies that the Late Cretaceous events must not have been associated with an appreciable increase in atmospheric pCO(2), and was likely associated with decreased pCO(2)

Structural, magnetic and electrical properties of single crystalline La_(1-x)Sr_xMnO_3 for 0.4 < x < 0.85

We report on structural, magnetic and electrical properties of Sr-doped LaMnO_3 single crystals for doping levels 0.4 < x < 0.85. The complex structural and magnetic phase diagram can only be explained assuming significant contributions from the orbital degrees of freedom. Close to x = 0.6 a ferromagnetic metal is followed by an antiferromagnetic metallic phase below 200 K. This antiferromagnetic metallic phase exists in a monoclinic crystallographic structure. Following theoretical predictions this metallic antiferromagnet is expected to reveal an (x^2-y^2)-type orbital order. For higher Sr concentrations an antiferromagnetic insulator is established below room temperature.Comment: 8 pages, 7 figure

Time-integrated luminosity recorded by the BABAR detector at the PEP-II e+e- collider

This article is the Preprint version of the final published artcile which can be accessed at the link below.We describe a measurement of the time-integrated luminosity of the data collected by the BABAR experiment at the PEP-II asymmetric-energy e+e- collider at the ϒ(4S), ϒ(3S), and ϒ(2S) resonances and in a continuum region below each resonance. We measure the time-integrated luminosity by counting e+e-→e+e- and (for the ϒ(4S) only) e+e-→μ+μ- candidate events, allowing additional photons in the final state. We use data-corrected simulation to determine the cross-sections and reconstruction efficiencies for these processes, as well as the major backgrounds. Due to the large cross-sections of e+e-→e+e- and e+e-→μ+μ-, the statistical uncertainties of the measurement are substantially smaller than the systematic uncertainties. The dominant systematic uncertainties are due to observed differences between data and simulation, as well as uncertainties on the cross-sections. For data collected on the ϒ(3S) and ϒ(2S) resonances, an additional uncertainty arises due to ϒ→e+e-X background. For data collected off the ϒ resonances, we estimate an additional uncertainty due to time dependent efficiency variations, which can affect the short off-resonance runs. The relative uncertainties on the luminosities of the on-resonance (off-resonance) samples are 0.43% (0.43%) for the ϒ(4S), 0.58% (0.72%) for the ϒ(3S), and 0.68% (0.88%) for the ϒ(2S).This work is supported by the US Department of Energy and National Science Foundation, the Natural Sciences and Engineering Research Council (Canada), the Commissariat à l’Energie Atomique and Institut National de Physique Nucléaire et de Physiquedes Particules (France), the Bundesministerium für Bildung und Forschung and Deutsche Forschungsgemeinschaft (Germany), the Istituto Nazionale di Fisica Nucleare (Italy), the Foundation for Fundamental Research on Matter (The Netherlands), the Research Council of Norway, the Ministry of Education and Science of the Russian Federation, Ministerio de Ciencia e Innovación (Spain), and the Science and Technology Facilities Council (United Kingdom). Individuals have received support from the Marie-Curie IEF program (European Union) and the A.P. Sloan Foundation (USA)