Integral operators with the generalized sine-kernel on the real axis

The asymptotic properties of integral operators with the generalized sine kernel acting on the real axis are studied. The formulas for the resolvent and the Fredholm determinant are obtained in the large x limit. Some applications of the results obtained to the theory of integrable models are considered.Comment: 17 pages, 2 Postscript figures, submitted to Theor. Math. Phy

Abstract T P54: Generalized Application of SMART (Simplified Management of Acute Stroke using Revised Treatment) IV Thrombolysis Criteria in Acute Ischemic Stroke (AIS) Patients is Safe and Effective

Introduction: Common IV rt-PA exclusion criteria may limit its use. The SMART criteria expand eligibility by reducing exclusions and can increase thrombolysis rates. However, applicability of SMART criteria to non-specialized centers is uncertain. We hypothesized that it is safe and efficacious to use SMART criteria in a wide range of hospital settings. Methods: Retrospective study of 539 consecutive acute ischemic stroke (AIS) patients receiving IV rt-PA using SMART criteria. Patients receiving IV rt-PA at a Comprehensive Stroke Center (CSC; n=267) versus Outlying Spoke Hospital (OSH; n=272) prior to transfer to the CSC were compared. There were 35 OSH (25-500+ beds) encompassing 120,000 sq miles in Northern California. The CSC neurologist was consulted by telephone (64%) or telemedicine (36%) in all cases. Primary outcomes were symptomatic intracranial hemorrhage (sICH) rate and favorable discharge outcome (mRS ≤ 1). Secondary measures were mortality and number of common rt-PA contraindications. Results: OSH patients were younger, had lower baseline mRS, and were clinically more severe. 90% had contraindications to rt-PA, the most common being mild symptoms (49%) and age ≥ 80 (37%). CSC had more contraindications than OSH patients (median (2(1-3) vs. 1(1-2), p &lt; 0.001). Favorable outcome (45% vs. 37%; OR, 0.7[95% CI, 0.5-1.1]), sICH rate (2.6% vs. 5.1%; OR, 2.0[95% CI, 0.8-5.1]), and mortality (9% vs. 14%; OR, 1.6[95% CI, 0.95-2.8]) were not significantly different between groups. After baseline factor adjustment, OSH rt-PA treatment was not associated with increased sICH (adjusted OR, 0.6[95% CI, 0.2-2.0]) or reduced favorable outcome (adjusted OR, 0.97[95% CI, 0.5-1.8]). Conclusion: Generalized application of SMART criteria is safe and effective. Current rt-PA criteria may unnecessarily exclude patients from thrombolysis and need revision. </jats:p