Relationship of blood pressure, antihypertensive therapy, and outcome in ischemic stroke treated with intravenous thrombolysis: retrospective analysis from Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR)

<p><b>Background and Purpose:</b> The optimal management of blood pressure (BP) in acute stroke remains unclear. For ischemic stroke treated with intravenous thrombolysis, current guidelines suggest pharmacological intervention if systolic BP exceeds 180 mm Hg. We determined retrospectively the association of BP and antihypertensive therapy with clinical outcomes after stroke thrombolysis.</p> <p><b>Methods:</b> The SITS thrombolysis register prospectively recorded 11 080 treatments from 2002 to 2006. BP values were recorded at baseline, 2 hours, and 24 hours after thrombolysis. Outcomes were symptomatic (National Institutes of Health Stroke Scale score deterioration ≥4) intracerebral hemorrhage Type 2, mortality, and independence at (modified Rankin Score 0 to 2) 3 months. Patients were categorized by history of hypertension and antihypertensive therapy within 7 days after thrombolysis: Group 1, hypertensive treated with antihypertensives (n=5612); Group 2, hypertensive withholding antihypertensives (n=1573); Group 3, without history of hypertension treated with antihypertensives (n=995); and Group 4, without history of hypertension not treated with antihypertensives (n=2632). For 268 (2.4%) patients, these data were missing. Average systolic BP 2 to 24 hours after thrombolysis was categorized by 10-mm Hg intervals with 100 to 140 used as a reference.</p> <p><b>Results:</b> In multivariable analysis, high systolic BP 2 to 24 hours after thrombolysis as a continuous variable was associated with worse outcome (P<0.001) and as a categorical variable had a linear association with symptomatic hemorrhage and a U-shaped association with mortality and independence with systolic BP 141 to 150 mm Hg associated with most favorable outcomes. OR (95% CI) from multivariable analysis showed no difference in symptomatic hemorrhage (1.09 [0.83 to 1.51]; P=0.58) and independence (1.03 [0.93 to 1.10]; P=0.80) but lower mortality (0.82 [0.73 to 0.92]; P=0.0007) for Group 1 compared with Group 4. Group 2 had a higher symptomatic hemorrhage (1.86 [1.34 to 2.68]; P=0.0004) and mortality (1.62 [1.41 to 1.85]; P<0.0001) and lower independence (0.89 [0.80 to 0.99]; P=0.04) compared with Group 4. Group 3 had similar results as Group 1.</p> <p><b>Conclusions:</b> There is a strong association of high systolic BP after thrombolysis with poor outcome. Withholding antihypertensive therapy up to 7 days in patients with a history of hypertension was associated with worse outcome, whereas initiation of antihypertensive therapy in newly recognized moderate hypertension was associated with a favorable outcome.</p&gt

Ecology of Shakla heel (Brahmanbaria), Bangladesh

The bed Shakla, comprising an average area of 75.0 ha is located in the northeastern region (Brahmanbaria district) of Bangladesh. The study was carried out to assess the ecological aspects of bed ecosystem. Surface run-off and increase inflow of rain water from the upper stretch during monsoon cause inundation and resumption of connection between beel and parent rivers. The range of dissolved oxygen (DO) content ( 4.5-8.9 mg/L) was found congenial for aquatic life. pH was in the alkaline range (7.3-8.5) and free C02 was reletavely high. Lower values of total hardness and total alkalinity indicated less nutrients in the beel water. A wide variation (1.4-27.2 x 103 ceHs/L) in the standing crop of total plankton was recorded during study period of which phytoplankton alone contributed about 90%. Phytoplankton diversity in the beel represented by three groups viz. Chlorophyceae, Myxophyceae and Bacillariophyceae in order of abundance. A total of 52 fish species belonging to 36 genera, 20 families and 1 species of prawn were identified so far from the beel. About l3 types of fishing method were found in operation. Seine nets (moshari berja, ghono berjal) and gill net (current jal) were identified as detrimental gear killing juveniles of different species during post spawning period. Kua fishing was also found harmful due to dewatering nature. A total of 11 species belonging to 11 genera and 10 families of aquatic weeds were identified from the beet The eggs of Macrobrachium Jamarrei were identified into the Najas najas vegetation during April-September

Effects of Ni doping on photocatalytic activity of TiO(2) thin films prepared by liquid phase deposition technique

The TiO(2) thin films doped by Ni uniformly and non-uniformly were prepared on glass substrate from an aqueous solution of ammonium hexa-fluoro titanate and NiF(2) by liquid phase deposition technique. The addition of boric acid as an F(-) scavenger will shift the equilibrium to one side and thereby deposition of the film is progressed. The rate of the reaction and the nature of deposition depend on growing time and temperature. The resultant films were characterized by XRD, EDAX, UV and SEM. The result shows that the deposited films have amorphous background, which becomes crystalline at 500 degrees C. The EDAX data confirms the existence of Ni atoms in TiO(2) matrix. XRD analysis reveals the peaks corresponding to Ni but no peak of crystalline NiO was found. The transmittance spectra of Ni uniformly and non-uniformly doped TiO(2) thin films show 'blue shift and red shift', respectively. Ni-doped TiO(2) thin films can be used as photocatalyst for the photodegradation of methyl orange dye. It was found that, organic dye undergoes degradation efficiently in presence of non-uniformly Ni-doped TiO(2) thin films when compared to uniformly doped films and pure TiO(2) films under visible light. The photocatalytic activity increases with increase in the concentration of Ni in case of nonuniformly doped thin films but decreases with the concentration when uniformly doped thin films were used

Thrombolysis in very elderly people: controlled comparison of SITS international stroke thrombolysis registry and virtual international stroke trials archive

<p>Objective To assess effect of age on response to alteplase in acute ischaemic stroke.</p> <p>Design Adjusted controlled comparison of outcomes between non-randomised patients who did or did not undergo thrombolysis. Analysis used Cochran-Mantel-Haenszel test and proportional odds logistic regression analysis.</p> <p>Setting Collaboration between International Stroke Thrombolysis Registry (SITS-ISTR) and Virtual International Stroke Trials Archive (VISTA).</p> <p>Participants 23 334 patients from SITS-ISTR (December 2002 to November 2009) who underwent thrombolysis and 6166 from VISTA neuroprotection trials (1998-2007) who did not undergo thrombolysis (as controls). Of the 29 500 patients (3472 aged >80 (“elderly,” mean 84.6), data on 272 patients were missing for baseline National Institutes of Health stroke severity score, leaving 29 228 patients for analysis adjusted for age and baseline severity.</p> <p>Main outcome measures Functional outcomes at 90 days measured by score on modified Rankin scale.</p> <p>Results Median severity at baseline was the same for patients who underwent thrombolysis and controls (median baseline stroke scale score: 12 for each group, P=0.14; n=29 228). The distribution of scores on the modified Rankin scale was better among all thrombolysis patients than controls (odds ratio 1.6, 95% confidence interval 1.5 to 1.7; Cochran-Mantel-Haenszel P<0.001). The association occurred independently among patients aged ≤80 (1.6, 1.5 to 1.7; P<0.001; n=25 789) and in those aged >80 (1.4, 1.3 to 1.6; P0.001; n=3439). Odds ratios were consistent across all 10 year age ranges above 30, and benefit was significant from age 41 to 90; dichotomised outcomes (score on modified Rankin scale 0-1 v 2-6; 0-2 v 3-6; and 6 (death) v rest) were consistent with the results of the ordinal analysis.</p> <p>Conclusions Outcome in patients with acute ischaemic stroke is significantly better in those who undergo thrombolysis compared with those who do not. Increasing age is associated with poorer outcome but the association between thrombolysis treatment and improved outcome is maintained in very elderly people. Age alone should not be a barrier to treatment.</p&gt

Safety of intravenous thrombolysis for acute ischemic stroke in patients receiving antiplatelet therapy at stroke onset

<p><b>Background and Purpose:</b> Antiplatelets (APs) may increase the risk of symptomatic intracerebral hemorrhage (ICH) following intravenous thrombolysis after ischemic stroke.</p> <p><b>Methods:</b> We assessed the safety of thrombolysis under APs in 11 865 patients compliant with the European license criteria and recorded between 2002 and 2007 in the Safe Implementation of Treatments in Stroke (SITS) International Stroke Thrombolysis Register (SITS-ISTR). Outcome measures of univariable and multivariable analyses included symptomatic ICH (SICH) per SITS Monitoring Study (SITS-MOST [deterioration in National Institutes of Health Stroke Scale >= 4 plus ICH type 2 within 24 hours]), per European Cooperative Acute Stroke Study II (ECASS II [deterioration in National Institutes of Health Stroke Scale >= 4 plus any ICH]), functional outcome at 3 months and mortality.</p> <p><b>Results:</b> A total of 3782 (31.9%) patients had received 1 or 2 AP drugs at baseline: 3016 (25.4%) acetylsalicylic acid (ASA), 243 (2.0%) clopidogrel, 175 (1.5%) ASA and dipyridamole, 151 (1.3%) ASA and clopidogrel, and 197 (1.7%) others. Patients receiving APs were 5 years older and had more risk factors than AP nave patients. Incidences of SICH per SITS-MOST (ECASS II respectively) were as follows: 1.1% (4.1%) AP naive, 2.5% (6.2%) any AP, 2.5% (5.9%) ASA, 1.7% (4.2%) clopidogrel, 2.3% (5.9%) ASA and dipyridamole, and 4.1% (13.4%) ASA and clopidogrel. In multivariable analyses, the combination of ASA and clopidogrel was associated with increased risk for SICH per ECASS II (odds ratio, 2.11; 95% CI, 1.29 to 3.45; P = 0.003). However, we found no significant increase in the risk for mortality or poor functional outcome, irrespective of the AP subgroup or SICH definition.</p> <p><b>Conclusion:</b> The absolute excess of SICH of 1.4% (2.1%) in the pooled AP group is small compared with the benefit of thrombolysis seen in randomized trials. Although caution is warranted in patients receiving the combination of ASA and clopidogrel, AP treatment should not be considered a contraindication to thrombolysis.</p&gt

Effect of high and low cost brood feeds on gonado-somatic index and fecundity of freshwater prawn Macrobrachium rogenbergii de Man

Studies were conducted to observe the effects of different types of feeds on the gonado-somatic index (GSI) and fecundity of freshwater prawn Macrobrachium rogenbergii. Three different treatments (T1 T2 and T3) were designed with three types of feed as follows: (i) Saudi-Bangla Prawn feed 100% - T1 (ii) SaudiBangla prawn feed 50%+ local feed 50%- T2 and (iii) local feed 100%- T3. The results showed that the average value of gonado-somatic index (GSI) was 14.39, 14.35 and 14.36 and the average fecundity of M. rogenbergiiwas 99,741, 98,125 and 97,911 in T1 T2 and T3 respectively. No significant difference (p>00.5) was between gonado-somatic indices (GSI) and fecundities of M. rogenbergii among different feeding trails. The price of Saudi-Bangla prawn feed was very high (Tk. 23/kg) than the local feed (Tk. 14/kg). So, use of local feed was recommended for M. rogenbergii brood rearing

Resource allocation in the cloud for video-on-demand applications using multiple cloud service providers

Abstract Video-on-demand (VoD) applications have become extensively used nowadays. YouTube is one of the most extensively used VoD application. These applications are used for various purposes like entertainment, education, media, etc., of all age groups. Earlier, these applications were supported by private data centers and application servers. Sufficient infrastructure had to be bought and maintained, to support the demand even during unexpected peak times. This approach caused huge loss of resources when the demand is normal as a large portion of the resources remained idle. To overcome this, VoD application providers moved to the cloud, to host their video content’s. This approach reduced the wastage of resources and the maintenance cost of the VoD application provider. The problem is to determine the number of resources to handle the demand while maintaining QoS for every instance. We have designed two algorithms in this paper, namely the multiple cloud resource allocation (MCRA) algorithm and the hybrid MCRA algorithm. Most of the cloud service providers (CSPs) basically provide two types of resource allocation schemes: (i) the reservation scheme and (ii) the on-demand scheme. The reservation scheme provides time-based tariff prices, where the discount is provided for the resources depending on their quantity and reservation time. This scheme is used in the MCRA algorithm to reduce the cost of the VoD application provider. In Hybrid MCRA algorithm both the reservation scheme and on-demand scheme are implemented, to overcome the drawbacks of the MCRA algorithm which are under-subscription and over-subscription. We have analyzed both the algorithms in terms of cost and allocation of resources. These algorithms can help allocate resources in of cloud for VoD applications in a cost-effective way and at the same time not compromise on the QoS of the video content

Predicted modulated differential rates for direct WIMP searches at low energy transfers

The differential event rate for direct detection of dark matter, both the time averaged and the modulated one due to the motion of the Earth, are discussed. The calculations focus on relatively light cold dark matter candidates (WIMP) and low energy transfers. It is shown that for sufficiently light WIMPs the extraction of relatively large nucleon cross sections is possible. Furthermore for some WIMP masses the modulation amplitude may change sign, meaning that, in such a case, the maximum rate may occur six months later than naively expected. This effect can be exploited to yield information about the mass of the dark matter candidate, if and when the observation of the modulation of the event rate is established.Comment: 16 pages, 22 figures; references adde

Effects of Cynodon dactylon on Stress-Induced Infertility in Male Rats

Cynodon dactylon (Family: Poaceae) is known to be a tackler in Indian mythology and is offered to Lord Ganesha. It is found everywhere, even on waste land, road side, dry places, and spreads vigorously on cultivated ground. This study was carried out with an objective to test if the constituents of this plant are useful in coping stress-induced sexual In this study, we considered immobilization stress to induce male infertility and the effect of C. dactylon in restoration of the dysfunction was evaluated by considering sexual behavioral observations, sexual performance, fructose content of the seminal vesicles, epididymal sperm concentration and histopathological examinations as parameters. Treatment of rats under stress with methanolic extract of C. dactylon has shown a promising effect in overcoming stress-induced sexual dysfunction, sexual performance, fructose content, sperm concentration and its effect on accessory sexual organs and body weight. We conclude that active constituents of C. dactylon present in methanolic extract have a potent aphrodisiac and male fertility activity

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)