Time spent at home poststroke: “home-time” a meaningful and robust outcome measure for stroke trials

<p><b>Background and Purpose:</b> Stroke outcome assessment requires some measure of functional recovery. Several instruments are in common use but all have recognized limitations. We examined duration of stay in the patient’s own home over the first 90 days since stroke—"home-time"—as an alternative outcome likely to show graded response with improved reliability.</p> <p><b>Methods:</b> We examined prospectively collected data from the GAIN International trial using analysis of variance with Bonferroni contrasts of adjacent modified Rankin scale score categories.</p> <p><b>Results:</b> We had full outcome data from 1717 of 1788 patients. Increasing home-time was associated with improved modified Rankin scale scores (P<0.0001). The relationship held across all modified Rankin scale grades except 4 to 5.</p> <p><b>Conclusions:</b> Home-time offers a robust, useful, and easily validated outcome measure for stroke, particularly across better recovery levels.</p&gt

Avalanche noise characteristics of thin GaAs structures with distributed carrier generation

It is known that both pure electron and pure hole injection into thin GaAs multiplication regions gives rise to avalanche multiplication with noise lower than predicted by the local noise model. In this paper, it is shown that the noise from multiplication initiated by carriers generated throughout a 0.1 μm avalanche region is also lower than predicted by the local model but higher than that obtained with pure injection of either carrier type. This behavior is due to the effects of nonlocal ionization brought about by the dead space; the minimum distance a carrier has to travel in the electric field to initiate an ionization even

Association between disability measures and healthcare costs after initial treatment for acute stroke

<p><b>Background and Purpose:</b> The distribution of 3-month modified Rankin scale (mRS) scores has been used as an outcome measure in acute stroke trials. We hypothesized that hospitalization and institutional care home stays within the first 90 days after stroke should be closely related to 90-day mRS, that each higher mRS category will reflect incremental cost, and that resource use may be less clearly linked to the National Institutes of Health Stroke Scale (NIHSS) or Barthel index.</p> <p><b>Methods:</b> We examined resource use data from the GAIN International trial comparing 90-day mRS with total length of stay in hospital or other institutions during the first 90 days. We repeated analyses using NIHSS and Barthel index scores. Relationships were examined by analysis of variance (ANOVA) with Bonferroni contrasts of adjacent score categories. Estimated costs were based on published Scottish figures.</p> <p><b>Results:</b> We had full data from 1717 patients. Length of stay was strongly associated with final mRS (P<0.0001). Each mRS increment from 0 to 1–2 to 3–4 was significant (mean length of stay: 17, 25, 44, 58, 79 days; P<0.0005). Ninety-five percent confidence limits for estimated costs (£) rose incrementally: 2493 to 3412, 3369 to 4479, 5784 to 7008, 7300 to 8512, 10 095 to 11 141, 11 772 to 13 560, and 2623 to 3321 for mRS 0 to 5 and dead, respectively. Weaker relationships existed with Barthel and NIHSS.</p> <p><b>Conclusions:</b> Each mRS category reflects different average length of hospital and institutional stay. Associated costs are meaningfully different across the full range of mRS outcomes. Analysis of the full distribution of mRS scores is appropriate for interpretation of treatment effects after acute stroke and more informative than Barthel or NIHSS end points.</p&gt

The Effect of ePortfolio Satisfaction on Students’ Learning Motivation and Internet Self-efficacy

This study aims to investigate the effect of e-Portfolio satisfaction on students’ learn­ing motivation and Internet self-efficacy toward the use of e-Portfolio. The data collected for this study occurred over 3 months. Participants were 450 students taking the course of common at an university. The counting of 443 questionnaires was received. The findings revealed that there were positive correlations between learning motivation, Internet self-efficacy, and e-Portfolio satisfac­tion. For gender, the result showed that there were no significant Internet self-efficacy differences between gender. Besides, there were the significant differences in learning motivations and in Internet self-efficacy between the two groups. Furthermore, the multistep regression analysis in­dicated that the learning motivation was the significant predictor of Internet self-efficacy, and In­ternet self-efficacy was the significant predictor of e-Portfolio satisfaction. Based on the findings, educators and researchers needed to pay attention to these influences and take these factors into consideration in e-Portfolio. The study concludes by assessing the overall gains and shortcomings of the reform effort toward using the e-Portfolio to help student self-learning

Heat-kernels and functional determinants on the generalized cone

We consider zeta functions and heat-kernel expansions on the bounded, generalized cone in arbitrary dimensions using an improved calculational technique. The specific case of a global monopole is analysed in detail and some restrictions thereby placed on the $A_{5/2}$ coefficient. The computation of functional determinants is also addressed. General formulas are given and known results are incidentally, and rapidly, reproduced.Comment: 26p,LaTeX.(Cosmetic changes and eqns (9.8),(11.2) corrected.

Supporting 'design for reuse' with modular design

Engineering design reuse refers to the utilization of any knowledge gained from the design activity to support future design. As such, engineering design reuse approaches are concerned with the support, exploration, and enhancement of design knowledge prior, during, and after a design activity. Modular design is a product structuring principle whereby products are developed with distinct modules for rapid product development, efficient upgrades, and possible reuse (of the physical modules). The benefits of modular design center on a greater capacity for structuring component parts to better manage the relation between market requirements and the designed product. This study explores the capabilities of modular design principles to provide improved support for the engineering design reuse concept. The correlations between modular design and 'reuse' are highlighted, with the aim of identifying its potential to aid the little-supported process of design for reuse. In fulfilment of this objective the authors not only identify the requirements of design for reuse, but also propose how modular design principles can be extended to support design for reuse

Non-Markovian dynamics for an open two-level system without rotating wave approximation: Indivisibility versus backflow of information

By use of the two measures presented recently, the indivisibility and the backflow of information, we study the non-Markovianity of the dynamics for a two-level system interacting with a zero-temperature structured environment without using rotating wave approximation (RWA). In the limit of weak coupling between the system and the reservoir, and by expanding the time-convolutionless (TCL) generator to the forth order with respect to the coupling strength, the time-local non-Markovian master equation for the reduced state of the system is derived. Under the secular approximation, the exact analytic solution is obtained and the sufficient and necessary conditions for the indivisibility and the backflow of information for the system dynamics are presented. In the more general case, we investigate numerically the properties of the two measures for the case of Lorentzian reservoir. Our results show the importance of the counter-rotating terms to the short-time-scale non-Markovian behavior of the system dynamics, further expose the relations between the two measures and their rationality as non-Markovian measures. Finally, the complete positivity of the dynamics of the considered system is discussed

Urothelial Inverted Papilloma of the Lower Urinary Tract—A Benign Lesion or a Precursor of Malignancy?

ObjectiveWe investigated the clinical characteristics and follow-up results of patients with a lower urinary tract inverted papilloma (IP) in our hospital, with the intention of clarifying whether certain groups require more aggressive surveillance.Materials and MethodsWe conducted a retrospective study of lower urinary tract IP, using the pathology database of Taipei Veterans General Hospital, from September 1992 to February 2008. In total, 67 patients were enrolled. Patients' clinical characteristics, symptoms, tumor locations, and follow-up data were analyzed.ResultsAmong the 67 patients diagnosed with IP, 59 were male and eight were female, with a mean age of 67.9 ± 12.4 years. Gross hematuria and lower-urinary-tract symptoms were the most common symptoms. All of the patients received transurethral resection as initial treatment. Thirty-eight of these patients were monitored for a median of 21 months (range: 3–168 months). Seven patients had synchronous urothelial malignancies, and one had recurrent IP during follow-up. No patient had subsequent urothelial carcinoma or IP recurrence without a synchronous or previous urothelial malignancy during follow-up.ConclusionThere is a low incidence of developing a subsequent malignancy with a simple IP lesion during follow-up. Rigorous surveillance may be unnecessary in IP patients without a synchronous or previous urothelial malignancy