Statistical analysis of the primary outcome in acute stroke trials

Common outcome scales in acute stroke trials are ordered categorical or pseudocontinuous in structure but most have been analyzed as binary measures. The use of fixed dichotomous analysis of ordered categorical outcomes after stroke (such as the modified Rankin Scale) is rarely the most statistically efficient approach and usually requires a larger sample size to demonstrate efficacy than other approaches. Preferred statistical approaches include sliding dichotomous, ordinal, or continuous analyses. Because there is no best approach that will work for all acute stroke trials, it is vital that studies are designed with a full understanding of the type of patients to be enrolled (in particular their case mix, which will be critically dependent on their age and severity), the potential mechanism by which the intervention works (ie, will it tend to move all patients somewhat, or some patients a lot, and is a common hazard present), a realistic assessment of the likely effect size, and therefore the necessary sample size, and an understanding of what the intervention will cost if implemented in clinical practice. If these approaches are followed, then the risk of missing useful treatment effects for acute stroke will diminish

On the Correlated X-ray and Optical Evolution of SS Cygni

We have analyzed the variability and spectral evolution of the prototype dwarf nova system SS Cygni using RXTE data and AAVSO observations. A series of pointed RXTE/PCA observations allow us to trace the evolution of the X-ray spectrum of SS Cygni in unprecedented detail, while 6 years of optical AAVSO and RXTE/ASM light curves show long-term patterns. Employing a technique in which we stack the X-ray flux over multiple outbursts, phased according to the optical light curve, we investigate the outburst morphology. We find that the 3-12 keV X-ray flux is suppressed during optical outbursts, a behavior seen previously, but only in a handful of cycles. The several outbursts of SS Cygni observed with the more sensitive RXTE/PCA also show a depression of the X-rays during optical outburst. We quantify the time lags between the optical and X-ray outbursts, and the timescales of the X-ray recovery from outburst. The optical light curve of SS Cygni exhibits brief anomalous outbursts. During these events the hard X-rays and optical flux increase together. The long-term data suggest that the X-rays decline between outburst. Our results are in general agreement with modified disk instability models (DIM), which invoke a two-component accretion flow consisting of a cool optically thick accretion disk truncated at an inner radius, and a quasi-spherical hot corona-like flow extending to the surface of the white dwarf. We discuss our results in the framework of one such model, involving the evaporation of the inner part of the optically thick accretion disk, proposed by Meyer & Meyer-Hofmeister (1994).Comment: 24 pages, 8 figures, 2 tables, accepted for publication in Ap

Feasibility of sensor-based technology for monitoring health in developing countries - cost analysis and user perception aspects

Understanding the financial burden of chronic diseases in developing regions still remains an important economical factor which influences the successful implementation of sensor based applications for continuous monitoring of chronic conditions. Our research focused on a comparison of literature-based data with real costs of the management and treatment of chronic diseases in a developing country, and we are using Kosovo as an example here. The results reveal that the actual living costs exceed the minimum expenses that chronic diseases impose. Following the potential of a positive economic impact of sensor based platforms for monitoring chronic conditions, we further examined the users perception of digital technology. The purpose of this paper is to present the varying cost levels of treating chronic diseases, identify the users concerns and requirements towards digital technology and discuss issues and challenges that the application of sensor based platforms imply in low and middle income countries

DNA as a universal substrate for chemical kinetics

Molecular programming aims to systematically engineer molecular and chemical systems of autonomous function and ever-increasing complexity. A key goal is to develop embedded control circuitry within a chemical system to direct molecular events. Here we show that systems of DNA molecules can be constructed that closely approximate the dynamic behavior of arbitrary systems of coupled chemical reactions. By using strand displacement reactions as a primitive, we construct reaction cascades with effectively unimolecular and bimolecular kinetics. Our construction allows individual reactions to be coupled in arbitrary ways such that reactants can participate in multiple reactions simultaneously, reproducing the desired dynamical properties. Thus arbitrary systems of chemical equations can be compiled into real chemical systems. We illustrate our method on the Lotka–Volterra oscillator, a limit-cycle oscillator, a chaotic system, and systems implementing feedback digital logic and algorithmic behavior

ORFEUS II and IUE Spectroscopy of EX Hydrae

Using ORFEUS-SPAS II FUV spectra, IUE UV spectra, and archival EUVE deep survey photometry, we present a detailed picture of the behavior of the magnetic cataclysmic variable EX Hydrae. Like HUT spectra of this source, the FUV and UV spectra reveal broad emission lines of He II, C II-IV, N III and V, O VI, Si III-IV, and Al III superposed on a continuum which is blue in the UV and nearly flat in the FUV. Like ORFEUS spectra of AM Her, the O VI doublet is resolved into broad and narrow emission components. Consistent with its behavior in the optical, the FUV and UV continuum flux densities, the FUV and UV broad emission line fluxes, and the radial velocity of the O VI broad emission component all vary on the spin phase of the white dwarf, with the maximum of the FUV and UV continuum and broad emission line flux light curves coincident with maximum blueshift of the broad O VI emission component. On the binary phase, the broad dip in the EUV light curve is accompanied by strong eclipses of the UV emission lines and by variations in both the flux and radial velocity of the O VI narrow emission component. The available data are consistent with the accretion funnel being the source of the FUV and UV continuum and the O VI broad emission component, and the white dwarf being the source of the O VI narrow emission component.Comment: 21 pages, 10 Postscript figures; LaTeX format, uses aaspp4.sty; table2.tex included separately because it must be printed sideways - see instructions in the file; accepted on 1999 Feb 20 for publication in The Astrophysical Journa

Extreme Variability in the Be-Type, Periodic Recurrent X-Ray Transient A0538 - 66: A Highly Eccentric Interacting Binary

We present optical spectroscopy and photometry and IUE spectroscopy of the counterpart of the extremely powerful LMC recurrent X-ray transient A0538 – 66. During one 16.6 day outburst cycle at the end of 1980 December the optical spectra show steadily increasing Balmer and He I emission (indicative of an expanding envelope) superposed on a B2 III–IV spectrum. There is a substantial optical brightness increase of 2 mag at the peak, accompanied by the sudden turn-on of He IIλ 4686. These and other optical spectra show significant radial velocity changes but we can find no clear correlation with the 16.6 day cycle. Further optical and IUE spectra were obtained at the peak of subsequent outbursts, and these show very strong and broad (∼ 5000 km s−1) emission lines. We interpret the system as a ∼ 1 M⊙ compact object in a highly eccentric (e ∼ 0.7) orbit about the ∼ 12 M⊙ B star with a binary period equal to the flare period. Continuum measurements indicate that the emitting region at outburst is several times the size of the B star thus implying that at periastron passage the envelope of the primary is tidally expanded by the neutron star. Although this is now the best example of a growing group of recurrent X-ray transients, A0538 – 66 is unique in its optical behaviour and peak Lx when compared with other galactic X-ray transients and shell/Be stars

Disk Diffusion Propagation Model for the Outburst of XTE J1118+480

We present a linear diffusion model for the evolution of the double-peaked outburst in the transient source XTEJ1118+480. The model treats the two outbursts as episodic mass deposition at the outer radius of the disk followed by evolution of disk structure according to a diffusion process. We demonstrate that light curves with fast-rise, exponential decay profile are a general consequence of the diffusion process. Deconvolution of the light curve proves to be feasible and gives an input function specifying mass deposition at the outer disk edge as well as the total mass of the disk, both as functions of time. The derived evolution of total disk mass can be correlated with the observed evolution of the ~0.1 Hz QPO in the source reported in Wood et al. (2000).Comment: 26 pages, 6 figures, accepted for publication in Ap