Age-dependent differences in demographics, risk factors, co-morbidity, etiology, management, and clinical outcome of acute ischemic stroke

Background : Comparisons between younger and older stroke patients including comorbidities are limited. Methods : Prospective data of consecutive patients with first ever acute ischemic stroke were compared between younger (≤ 45 years) and older patients (> 45 years). Results : Among 1004 patients, 137 (14 %) were ≤ 45 years. Younger patients were more commonly female (57 % versus 34 %; p < 0.0001), had a lower frequency of diabetes (1 % versus 15 %; p < 0.0001), hypercholesterolemia (26 % versus 56 %; p < 0.0001), hypertension (19 % versus 65 %; p < 0.0001), coronary heart disease (14 % versus 40 %; p < 0.0001), and a lower mean Charlson co-morbidity index (CCI), (0.18 versus 0.84; p < 0.0001). Tobacco use was more prevalent in the young (39 % versus 26 %; P < 0.0001). Large artery disease (2 % versus 21 %; p < 0.0001), small artery disease (3 % versus 12 %; p = 0.0019) and atrial fibrillation (1 % versus 17 %; p = 0.001) were less common in young patients, while other etiologies (31 % versus 9 %; p < 0.0001), patent foramen ovale or atrial septal defect (44 % versus 26 %; p < 0.0001), and cervical artery dissection (26 % versus 7 %; p < 0.0001) were more frequent. A favorable outcome (mRS 0 or 1) was more common (57.4 % versus 46.9 %; p = 0.023), and mortality (5.1 % versus 12 %; p = 0.009) was lower in the young. After regression analysis, there was no independent association between age and outcome (p = 0.206) or mortality (p = 0.073). Baseline NIHSS score (p < 0.0001), diabetes (p = 0.041), and CCI (p = 0.002) independently predicted an unfavorable outcome. Conclusions : Younger patients were more likely to be female, had different risk factors and etiologies and fewer co-morbidities. There was no independent association between age and clinical outcome or mortalit

Система управления повышением квалификации управленческого персонала организации

Выпускная квалификационная работа посвящена анализу путей повышения эффективности использования человеческих ресурсов. В ходе работы был произведен обзор теоретического материала по управлению человеческими ресурсами; проанализированы размер и структура организации; изучены методы мотивации рассматриваемой организации; проведена оценка удовлетворенности персонала; проанализированы методы, влияющие на эффективность работы персонала; предложены рекомендации по повышению эффективности использования людских ресурсов.The final qualifying work is devoted to the analysis of ways to improve the efficiency of the use of human resources. In the course of the work, a review was made of theoretical material on human resource management; analyzed the size and structure of the organization; the methods of motivation of the organization in question have been studied; staff satisfaction was assessed; analyzed the methods that affect the efficiency of the personnel; recommendations for improving the efficiency of the use of human resources are proposed

Advancing river corridor science beyond disciplinary boundaries with an inductive approach to catalyse hypothesis generation

A unified conceptual framework for river corridors requires synthesis of diverse site-, method- and discipline-specific findings. The river research community has developed a substantial body of observations and process-specific interpretations, but we are still lacking a comprehensive model to distill this knowledge into fundamental transferable concepts. We confront the challenge of how a discipline classically organized around the deductive model of systematically collecting of site-, scale-, and mechanism-specific observations begins the process of synthesis. Machine learning is particularly well-suited to inductive generation of hypotheses. In this study, we prototype an inductive approach to holistic synthesis of river corridor observations, using support vector machine regression to identify potential couplings or feedbacks that would not necessarily arise from classical approaches. This approach generated 672 relationships linking a suite of 157 variables each measured at 62 locations in a fifth order river network. Eighty four percent of these relationships have not been previously investigated, and representing potential (hypothetical) process connections. We document relationships consistent with current understanding including hydrologic exchange processes, microbial ecology, and the River Continuum Concept, supporting that the approach can identify meaningful relationships in the data. Moreover, we highlight examples of two novel research questions that stem from interpretation of inductively-generated relationships. This study demonstrates the implementation of machine learning to sieve complex data sets and identify a small set of candidate relationships that warrant further study, including data types not commonly measured together. This structured approach complements traditional modes of inquiry, which are often limited by disciplinary perspectives and favour the careful pursuit of parsimony. Finally, we emphasize that this approach should be viewed as a complement to, rather than in place of, more traditional, deductive approaches to scientific discovery

Multi-scale analysis of environmental filters limiting the invisibility of stream banks by Asian Knotweed (Fallopia sp.)

International audienc

Multi-scale analysis of environmental filters limiting the invisibility of stream banks by Asian Knotweed (Fallopia sp.)

International audienc

In vivo evaluation of the first dedicated combined flow-restoration and mechanical thrombectomy device in a swine model of acute vessel occlusion

The use of self-expanding retrievable stents is an emerging and promising treatment strategy for acute stroke treatment. The concept combines the advantages of stent deployment with immediate flow-restoration and of mechanical thrombectomy with definitive thrombus removal. The present study was performed to gain more knowledge about the principle of combined flow restoration and thrombectomy in an established animal model using radiopaque thrombi evaluating efficiency, thrombus-device interaction and possible complications of the first dedicated flow-restoration and mechanical thrombectomy device

Distribution of Asian knotweeds on the Rhône River basin, France: A multi-scale model of invasibility that combines biophysical and anthropogenic factors

International audienceBiotic and abiotic factors are important drivers of the introduction, dispersal and establishment of an invasive species in fluvial corridors. In this study, we propose to better understand the spatial distribution of Asian knotweeds and to model their invasibility at the river basin scale in the Rhône Mediterranean and Corsica regions, France. We implemented a multiscale analysis of biophysical and anthropogenic factors related to the presence of knotweeds. Subbasins were sampled (50–600 km2), a large dataset on knotweed occurrence and biotic/abiotic factors was collected, and logistic regression was applied. A robust logit model (accuracy: 90%; false positive rate: 13%) estimated the probability of the occurrence of knotweeds at the river basin scale. We found clear evidence of: i) spatial scale-dependent water availability for knotweed implantation (e.g., summer vs. winter rainfalls > 250 mm); ii) an important role of hydrogeomorphic forces in dispersal; and iii) interspecific competition in riparian areas. The occurrence of knotweeds is also closely related to human-derived pressures. The management of knotweeds on roads and railways in the vicinity of rivers may be a major source of propagules. Hydraulic infrastructures (dikes and mill weirs) may also have served as locations of knotweed introduction since the end of the nineteenth century and may play a major role in the propagule transfer of knotweed; to date, these infrastructures have provided favourable conditions for knotweed establishment. Despite local water authorities' increasing awareness of invasive plants, local management practices for flood mitigation, low awareness of roads/railway managers, and negative representations of knotweeds have probably largely contributed to their dispersion over decades. The final model intends to integrate these biophysical and human factors by providing an operational tool to help river managers determine the sensitivity of their river basins to knotweed invasion

Age-dependent differences in demographics, risk factors, co-morbidity, etiology, management, and clinical outcome of acute ischemic stroke

BACKGROUND : Comparisons between younger and older stroke patients including comorbidities are limited. METHODS : Prospective data of consecutive patients with first ever acute ischemic stroke were compared between younger ( 45 years). RESULTS : Among 1004 patients, 137 (14 %) were </= 45 years. Younger patients were more commonly female (57 % versus 34 %; p < 0.0001), had a lower frequency of diabetes (1 % versus 15 %; p < 0.0001), hypercholesterolemia (26 % versus 56 %; p < 0.0001), hypertension (19 % versus 65 %; p < 0.0001), coronary heart disease (14 % versus 40 %; p < 0.0001), and a lower mean Charlson co-morbidity index (CCI), (0.18 versus 0.84; p < 0.0001). Tobacco use was more prevalent in the young (39 % versus 26 %; P < 0.0001). Large artery disease (2 % versus 21 %; p < 0.0001), small artery disease (3 % versus 12 %; p = 0.0019) and atrial fibrillation (1 % versus 17 %; p = 0.001) were less common in young patients, while other etiologies (31 % versus 9 %; p < 0.0001), patent foramen ovale or atrial septal defect (44 % versus 26 %; p < 0.0001), and cervical artery dissection (26 % versus 7 %; p < 0.0001) were more frequent. A favorable outcome (mRS 0 or 1) was more common (57.4 % versus 46.9 %; p = 0.023), and mortality (5.1 % versus 12 %; p = 0.009) was lower in the young. After regression analysis, there was no independent association between age and outcome (p = 0.206) or mortality (p = 0.073). Baseline NIHSS score (p < 0.0001), diabetes (p = 0.041), and CCI (p = 0.002) independently predicted an unfavorable outcome. CONCLUSIONS : Younger patients were more likely to be female, had different risk factors and etiologies and fewer co-morbidities. There was no independent association between age and clinical outcome or mortality