Relationship of blood pressure, antihypertensive therapy, and outcome in ischemic stroke treated with intravenous thrombolysis: retrospective analysis from Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR)

<p><b>Background and Purpose:</b> The optimal management of blood pressure (BP) in acute stroke remains unclear. For ischemic stroke treated with intravenous thrombolysis, current guidelines suggest pharmacological intervention if systolic BP exceeds 180 mm Hg. We determined retrospectively the association of BP and antihypertensive therapy with clinical outcomes after stroke thrombolysis.</p> <p><b>Methods:</b> The SITS thrombolysis register prospectively recorded 11 080 treatments from 2002 to 2006. BP values were recorded at baseline, 2 hours, and 24 hours after thrombolysis. Outcomes were symptomatic (National Institutes of Health Stroke Scale score deterioration ≥4) intracerebral hemorrhage Type 2, mortality, and independence at (modified Rankin Score 0 to 2) 3 months. Patients were categorized by history of hypertension and antihypertensive therapy within 7 days after thrombolysis: Group 1, hypertensive treated with antihypertensives (n=5612); Group 2, hypertensive withholding antihypertensives (n=1573); Group 3, without history of hypertension treated with antihypertensives (n=995); and Group 4, without history of hypertension not treated with antihypertensives (n=2632). For 268 (2.4%) patients, these data were missing. Average systolic BP 2 to 24 hours after thrombolysis was categorized by 10-mm Hg intervals with 100 to 140 used as a reference.</p> <p><b>Results:</b> In multivariable analysis, high systolic BP 2 to 24 hours after thrombolysis as a continuous variable was associated with worse outcome (P<0.001) and as a categorical variable had a linear association with symptomatic hemorrhage and a U-shaped association with mortality and independence with systolic BP 141 to 150 mm Hg associated with most favorable outcomes. OR (95% CI) from multivariable analysis showed no difference in symptomatic hemorrhage (1.09 [0.83 to 1.51]; P=0.58) and independence (1.03 [0.93 to 1.10]; P=0.80) but lower mortality (0.82 [0.73 to 0.92]; P=0.0007) for Group 1 compared with Group 4. Group 2 had a higher symptomatic hemorrhage (1.86 [1.34 to 2.68]; P=0.0004) and mortality (1.62 [1.41 to 1.85]; P<0.0001) and lower independence (0.89 [0.80 to 0.99]; P=0.04) compared with Group 4. Group 3 had similar results as Group 1.</p> <p><b>Conclusions:</b> There is a strong association of high systolic BP after thrombolysis with poor outcome. Withholding antihypertensive therapy up to 7 days in patients with a history of hypertension was associated with worse outcome, whereas initiation of antihypertensive therapy in newly recognized moderate hypertension was associated with a favorable outcome.</p&gt

Magnetic phase diagram of the antiferromagnetic pyrochlore Gd2Ti2O7

Gd2Ti2O7 is a highly frustrated antiferromagnet on a pyrochlore lattice, where apart from the Heisenberg exchange the spins also interact via dipole-dipole forces. We report on low-temperature specific heat measurements performed on single crystals of Gd2Ti2O7 for three different directions of an applied magnetic field. The measurements reveal the strongly anisotropic behaviour of Gd2Ti2O7 in a magnetic field despite the apparent absence of a significant single-ion anisotropy for Gd3+. The H-T phase diagrams are constructed for H//111], H//[110] and H//[112]. The results indicate that further theoretical work beyond a simple mean-field model is required.Comment: 4 figure

Driver Distraction and Reliance: Adaptive Cruise Control in the Context of Sensor Reliability and Algorithm Limits

This study investigated how system failures influenced drivers’reliance on Adaptive Cruise Control (ACC). A medium-fidelity driving simulatorwas used to evaluate the effect of driving condition (traffic, rain) and automation(manual control, ACC) on headway maintenance and brake response. Inconditions of rain, the signal continuity of the ACC sensors was degraded and inconditions of heavy traffic, the braking limits of the ACC system were exceeded.Dependent variables included response time to lead vehicle (LV) braking, numberof collisions, and both time headway (THW) and time-to-collision (TTC) atinstant of the brake response. Throughout the drive, a continuous (forced-paced)secondary task was introduced to determine how an in-vehicle task interactedwith ACC reliance. Results showed that the failure type influenced driver’sreliance on ACC with drivers relying more on ACC in traffic periods than in rainperiods. ACC appeared to offer a safety benefit when drivers were distracted withcomplex mental tasks in periods of heavy traffic

First-Order Reorientation of the Flux-Line Lattice in CaAlSi

The flux line lattice in CaAlSi has been studied by small angle neutron scattering. A well defined hexagonal flux line lattice is seen just above Hc1 in an applied field of only 54 Oe. A 30 degree reorientation of this vortex lattice has been observed in a very low field of 200 Oe. This reorientation transition appears to be of first-order and could be explained by non-local effects. The magnetic field dependence of the form factor is well described by a single penetration depth of 1496(1) angstroms and a single coherence length of 307(1) angstroms at 2 K. At 1.5 K the penetration depth anisotropy is 2.7(1) with the field applied perpendicular to the c axis and agrees with the coherence length anisotropy determined from critical field measurements.Comment: 5 pages including 6 figures, to appear in Physical Review Letter

Probing the superconducting ground state of ZrIrSi: A μ\muSR study

The superconducting ground state of newly reported ZrIrSi is probed by means of $\mu$SR technique along with resistivity measurement. The occurrence of superconductivity at $T_\mathrm{C}$ = 1.7 K is confirmed by resistivity measurement. ZF-$\mu$SR study revealed that below $T_\mathrm{C}$, there is no spontaneous magnetic field in the superconducting state, indicates TRS is preserved in case of ZrIrSi. From TF-$\mu$SR measurement, we have estimated the superfluid density as a function of temperature, which is described by an isotropic $s-$wave model with a superconducting gap $2\Delta(0)/k_\mathrm{B}T_\mathrm{C}$ = 5.1, indicates the presence of strong spin-orbit coupling. {\it Ab-initio} electronic structure calculation indicates that there are four bands passing through the Fermi level, forming four Fermi surface pockets. We find that the low-energy bands are dominated by the $4d$-orbitals of transition metal Zr, with substantially lesser weight from the $5d$-orbitals of the Ir-atoms.Comment: 6 pages, 4 figure

Investigation of Superconducting Gap Structure in HfIrSi using muon spin relaxation/rotation

Appearance of strong spin-orbit coupling (SOC) is apparent in ternary equiatomic compounds with 5$d$-electrons due to the large atomic radii of transition metals. SOC plays a significant role in the emergence of unconventional superconductivity. Here we examined the superconducting state of HfIrSi using magnetization, specific heat, zero and transverse-field (ZF/TF) muon spin relaxation/rotation ($\mu$SR) measurements. Superconductivity is observed at $T_\mathrm{C}$ = 3.6 K as revealed by specific heat and magnetization measurements. From the TF$-\mu$SR analysis it is clear that superfluid density well described by an isotropic BCS type $s$-wave gap structure. Furthermore, from TF$-\mu$SR data we have also estimated the superconducting carrier density $n_\mathrm{s}$ = 6.6 $\times$10$^{26}$m$^{-3}$, London penetration depth $\lambda_{L}(0)$ = 259.59 nm and effective mass $m^{*}$ = 1.57 $m_{e}$. Our zero-field muon spin relaxation data indicate no clear sign of spontaneous internal field below $T_\mathrm{C}$, which implies that the time-reversal symmetry is preserved in HfIrSi. Theoretical investigation suggests Hf and Ir atoms hybridize strongly along the $c$-axis of the lattice, which is responsible for the strong three-dimensionality of this system which screens the Coulomb interaction. As a result despite the presence of correlated $d$-electrons in this system, the correlation effect is weakened, promoting electron-phonon coupling to gain importance.Comment: 8 pages, 4 figure

Change Blindness, Attention, and Driving Performance

Concern over older driver high traffic fatality rates has resulted in an effort to identify risk factors and to develop methods of assessment. This study examines two attention-related tasks, Useful Field of View (UFOV) and Change Blindness (CB), in relation to vision and cognitive test batteries and driving performance measures collected using a simulator and an instrumented vehicle. Eight older adults with Alzheimer’s disease and nine comparison subjects between 64 and 81 participated. Factor analysis results indicate that UFOV and CB relate to different factors. While UFOV relates to memory, decision-making, attention, and visual spatial ability, CB relates to vision and attention. The type of images used on a CB task influence how the task relates to driving performance measures. Researchers should be thoughtful when selecting images to include in CB tasks to maximize insight into real-world drivin

Differences in Simulated Car Following Behavior of Younger and Older Drivers

Older drivers are at risk for vehicle crashes due to impairments of visual processing and attention, placing these drivers at greater risk in driving tasks that require continuous attention to neighboring traffic, especially lead vehicles (LVs). We investigated car following behavior in 42 younger drivers (ages 18 to 44 years) and 58 older drivers (ages 65 to 86 years) in a driving simulator. The drivers were instructed to maintain two car lengths from a virtual LV. The LV varied its velocity according to a sum of three sine waves, making the velocity changes unpredictable to the drivers. A Fourier analysis was performed using the vehicle trajectory data to derive measures of coherence, gain, and delay as indices of car following behavior. These measures as well as headway distance were compared between the two groups. Older drivers were less able to match changes in the LV velocity indicated by lower coherence (0.76 v. 0.84, p=0.019) and larger gain (2.24 v. 1.74, p=0.031). However, these drivers followed further behind the LV than younger drivers, a potential compensatory strategy that may reduce collision risk for older drivers

pyseer : a comprehensive tool for microbial pangenome-wide association studies

Genome-wide association studies (GWAS) in microbes have different challenges to GWAS in eukaryotes. These have been addressed by a number of different methods. pyseer brings these techniques together in one package tailored to microbial GWAS, allows greater flexibility of the input data used, and adds new methods to interpret the association results.Peer reviewe

Interviewer: 'Are women and girls ever responsible for the domestic violence they encounter?' Student: 'No, well, unless they did something really, really bad …'

Research shows the ‘gendered nature’ of domestic violence, with Women’s Aid (a UK-based charity) estimating that 1 in 4 women are affected (2014). This paper reports on a project - funded by Comic Relief, completed by Nottinghamshire Domestic Violence Forum (now known as Equation) and evaluated by Nottingham Trent University. The project adopts a Whole School Approach in seeking to prevent domestic violence. Students at three secondary schools attended between one and five blocks of work, and special events. There is evidence of positive developments - with young people showing understanding of domestic violence as well as the margins between healthy and unhealthy relationships. However, not all students could reply ‘never’ to the question of ‘are women and girls to blame for the domestic violence they experience?’, remarking that if the woman had done something ‘really, really bad’ then violence might be justified. We argue that young people’s uncertainties need to be situated within the gender-unequal socio-contexts of contemporary society, and further call for a WSA to domestic violence prevention to be a compulsory part of the UK national curriculum