Approximation Assessment of Photocatalytic Air Cleaning Pavements

This paper examines an approximation method to qualitatively assess the air-cleaning performance (i.e., specifically the elimination of aerial nitrogen oxide, NO, released within vehicular exhaust) by full-scale pavements which contain photo-catalytically reactive titanium dioxide under optimal conditions. Two hypothetical road configurations were considered using this method, including both a two-lane, low traffic density (i.e., 4,000 full-day AADT) and a four-lane, moderate traffic density (i.e., 10,000 full-day AADT) design. These options were then comparatively examined on the basis of expected European Union or United States vehicular emission levels. In each case, this method’s day-time-only percentile elimination approximation results were derived using an extrapolation of lab-based specific contaminant elimination rates (i.e., mass NO removed per surface area per time) relative to contaminant release rates which were projected for EU or US vehicular contaminant emission levels. Using this paper’s approximation method, and assuming best-case scenario conditions (i.e., original, un-aged, peak catalytic performance under optimal temperature, relative humidity, etc. conditions), day-timeonly percentile removals in the ~mid-60% to ~90% range were predicted for EU two- and fourlane roadways with low to moderate traffic densities. These EU contaminant elimination approximation percentiles were higher than the actual, observed range (e.g., typically ~mid-10% to ~mid-60% day-time removal percentiles) of published contaminant elimination values which had been measured according to gas-phase contaminant changes during a number of full-scale studies completed at various EU locations and with EU-related vehicle types and emissions. In the case of similar US highway options, this method’s approximated day-time-only elimination percentile results were lower than what was predicted for similar EU road options, with a range of ~30% to ~40%. These latter, lower US road approximations were believed to be related to higher expected US versus EU vehicle emission levels (i.e., by a factor of ~two- to ~three-fold for light and heavy duty vehicles)

Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial

Background: Pulsed-wave ultrasound increases the exposure of an intracranial thrombus to alteplase (recombinant tissue plasminogen activator), potentially facilitating early reperfusion. We aimed to ascertain if a novel operator-independent transcranial ultrasound device delivering low-power high-frequency ultrasound could improve functional outcome in patients treated with alteplase after acute ischaemic stroke. Methods: We did a multicentre, double-blind, phase 3, randomised controlled trial (CLOTBUST-ER) at 76 medical centres in 14 countries. We included patients with acute ischaemic stroke (National Institutes of Health Stroke Scale score ≥10) who received intravenous thrombolysis (alteplase bolus) within 3 h of symptom onset in North America and within 4·5 h of symptom onset in all other countries. Participants were randomly allocated (1:1) via an interactive web response system to either active ultrasound (2 MHz pulsed-wave ultrasound for 120 min [sonothrombolysis]; intervention group) or sham ultrasound (control group). Ultrasound was delivered using an operator-independent device, which had to be activated within 30 min of the alteplase bolus. Participants, investigators, and those assessing outcomes were unaware of group assignments. The primary outcome was improvement in the modified Rankin Scale score at 90 days in patients enrolled within 3 h of symptom onset, assessed in the intention-to-treat population as a common odds ratio (cOR) using ordinal logistic regression shift analysis. This trial is registered with ClinicalTrials.gov, number NCT01098981. The trial was stopped early by the funder after the second interim analysis because of futility. Findings: Between August, 2013, and April, 2015, 335 patients were randomly allocated to the intervention group and 341 patients to the control group. Compared with the control group, the adjusted cOR for an improvement in modified Rankin Scale score at 90 days in the intervention group was 1·05 (95% CI 0·77–1·45; p=0·74). 51 (16%) of 317 patients in the intervention group and 44 (13%) of 329 patients in the control group died (unadjusted OR 1·24, 95% CI 0·80–1·92; p=0·37) and 83 (26%) and 79 (24%), respectively, had serious adverse events (1·12, 0·79–1·60; p=0·53). Interpretation: Sonothrombolysis delivered by an operator-independent device to patients treated with alteplase after acute ischaemic stroke was feasible and most likely safe, but no clinical benefit was seen at 90 days. Sonothrombolysis could be further investigated either in randomised trials undertaken in stroke centres that are dependent on patient transfer for endovascular reperfusion therapies or in countries where these treatments cannot yet be offered as the standard of care

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Combined lysis of thrombus with ultrasound and systemic tissue plasminogen activator for emergent revascularization in acute ischemic stroke (CLOTBUST-ER): Design and methodology of a multinational phase 3 trial

Background We designed a Phase 3 clinical trial to determine the safety and efficacy of adding transcranial ultrasound using an operator-independent headframe to recombinant tissue-plasminogen-activator for the treatment of acute ischemic stroke. Methods Combined lysis of thrombus with ultrasound and systemic tissue-plasminogen-activator for emergent revascularization in acute ischemic stroke is a randomized, double-blind, placebo-controlled clinical trial that will enroll subjects with the following main inclusion criteria: less than 4·5 hours from symptom onset (three-hours in US and Canada), age 18–80 years, baseline National Institutes of Health Stroke Scale score ≥ 10, and premorbid modified-Rankin-score of 0–1, eligibility for full dose recombinant tissue-plasminogen-activator. Subjects will receive two-hours of 2-MHz pulsed wave transcranial ultrasound (target group) or sham ultrasound (control group). The projected sample size is approximately 824 subjects. Results The primary endpoint, based on intention-to-treat criteria of patients enrolled within three-hours of symptom onset is the comparison between target and control groups of modified-Rankin-score scores at day 90 poststroke assessed using the proportional odds method. The study will have two planned interim analyses after approximately one-third and two-thirds of subjects have reached the 90-day modified-Rankin-score evaluation. Safety outcomes are symptomatic intracranial hemorrhage within 24 h and an overall analysis of adverse events. Conclusions Since intravenous recombinant tissue-plasminogen-activator remains the only medical therapy to reverse ischemic stroke applicable in the emergency department, our trial will determine if the additional use of transcranial ultrasound improves functional outcomes in patients with severe acute ischemic stroke (NCT#01098981)

Effects of a lipid-based nutrient supplement during pregnancy and lactation on maternal plasma fatty acid status and lipid profile: Results of two randomized controlled trials

It is unknown whether a novel small-quantity lipid-based nutrient supplement (SQ-LNS) containing alpha-linolenic (ALA) and linoleic acids impacts maternal plasma lipids and fatty acid status. We measured plasma fatty acids (wt%) and lipid concentrations at 36 wk gestation and breast milk fatty acids (wt%) at 6 months postpartum in a subsample of women enrolled in a randomized controlled trial studying the effects of SQ-LNS on birth outcomes and child growth. Women≤20 wk gestation in Ghana (n=1,320) and Malawi (n=1,391) were assigned to receive daily either: 1) iron-folic acid (pregnancy); 2) multiple micronutrients (pregnancy and lactation); or 3) SQ-LNS (pregnancy and lactation). At 36 wk, plasma ALA levels were higher in those receiving SQ-LNS. SQ-LNS increased breast milk ALA in Ghana but not Malawi. There was no effect on plasma lipids or other selected fatty acids. SQ-LNS may impact plasma and breast milk ALA levels depending on the population

Effects of reinforcing preselected approximations on the topography of the rat's bar press

The effects of different shaping approximations on the topography of the rat's bar press were investigated in two experiments. Behavior was classified into discrete components, and changes in components and their sequential organization were analyzed. Experiment 1 examined response form early in training and found that specific components reinforced during shaping were incorporated into press sequences. Experiment 2 investigated how response form changed when a shaping contingency was relaxed later in training. Two topographies were selected for reinforcement, and both appeared in the press sequences of all subjects by the end of shaping. Subsequently, all variations of bar pressing were reinforced, and neither topography was necessary to satisfy the contingency. Although the frequency of the topographies reinforced during shaping declined for 3 of 4 subjects during this phase, the most frequent press sequence for 2 rats at the end of training included both unnecessary topographies. Variability in press topographies declined when all emitted variants were reinforced. However, all subjects emitted novel response forms throughout training. The results demonstrate that specific response–reinforcer contingencies influence response form by modulating component availability and organization