Gavestinel does not improve outcome after acute intracerebral hemorrhage: an analysis from the GAIN International and GAIN Americas studies

<p><b>Background and Purpose:</b> Glycine Antagonist in Neuroprotection (GAIN) International and GAIN Americas trials were prospectively designed, randomized, placebo-controlled trials of gavestinel, a glycine-site antagonist and putative neuroprotectant drug administered within 6 hours of suspected ischemic or hemorrhagic stroke. Both trials reported that gavestinel was ineffective in ischemic stroke. This analysis reports the results in those with primary intracerebral hemorrhage.</p> <p><b>Methods:</b> The primary hypothesis was that gavestinel treatment did not alter outcome, measured at 3 months by the Barthel Index (BI), from acute intracerebral hemorrhage, based on pooled results from both trials. The BI scores were divided into 3 groups: 95 to 100 (independent), 60 to 90 (assisted independence), and 0 to 55 (dependent) or dead.</p> <p><b>Results:</b> In total, 3450 patients were randomized in GAIN International (N=1804) and GAIN Americas (N=1646). Of these, 571 were ultimately identified to have spontaneous intracerebral hematoma on baseline head computerized tomography scan. The difference in distribution of trichotomized BI scores at 3 months between gavestinel and placebo was not statistically significant (P=0.09). Serious adverse events were reported at similar rates in the 2 treatment groups.</p> <p><b>Conclusions:</b> These observations from the combined GAIN International and GAIN Americas trials suggest that gavestinel is not of substantial benefit or harm to patients with primary intracerebral hemorrhage. These findings are similar to results previously reported in patients with ischemic stroke.</p&gt

Perinatal mortality in the Cape Province, 1989 - 1991

No Abstract

Counting the cost of preventable diabetes-related lower limb amputations at a single district hospital in KwaZulu-Natal: what does this mean, what can be done?

Background: Healthcare policy decisions are driven by many factors, including cost, hence the need to show costs of diabetes mellitus-related lower limb amputations (DMLLA) to inform amendments to health care. Substantial decreases in amputation rates are associated with specialised podiatry foot clinics and ongoing foot education, as per national guidelines on the multidisciplinary team approach (MDTA) to diabetes health care. There are only two podiatry posts in KwaZulu-Natal (KZN) state health department (DoH).Objectives: Aims were to draft the medical costs for 660 DMLLA at Greys Hospital for the period 2013–2017; to extrapolate costs on annual DMLLA in KZN; to outline socio-economic costs for future investigation; to present evidence that podiatry in the MDTA can decrease numbers of DMLLA.Methods: A retrospective review on clinical data captured in real time and maintained by the Pietermaritzburg Metropolitan Trauma Service (PMTS) and Surgical Service (PMSS) was performed. Costs were analysed on data for 660 patients’ DMLLA at Greys Hospital between 2013 and 2017, and psychological and socio-economic costs via literature review.Results: Medical care at Greys Hospital for 660 DMLLA in the five years cost in excess of ZAR 213 million. Extrapolated to the 1 231 diabetic amputations (2014) equals an annual cost to KZN DoH in excess of ZAR 398 million. Personal, family loss and socio-economic costs are estimated in excess of ZAR five million per amputee, resulting in further cost of ZAR 6.155 billion per annum to KZN. Extrapolation across 11 provinces signifies a national cost of at least ZAR 68 billion.Conclusions: We present a gauge of the cost of DMLLA to KZN and national health. Substantial possible socio-economic losses compound these. The role of podiatrists within MDTA teams has an evidence base to prevent DMLLA

No Significant Evidence of Cognitive Biases for Emotional Stimuli in Children At-Risk of Developing Anxiety Disorders.

This paper explores whether the increased vulnerability of children of anxious parents to develop anxiety disorders may be partially explained by these children having increased cognitive biases towards threat compared with children of non-anxious parents. Parents completed questionnaires about their child’s anxiety symptoms. Children aged 5–9 (n = 85) participated in two cognitive bias tasks: 1) an emotion recognition task, and 2) an ambiguous situations questionnaire. For the emotion recognition task, there were no significant differences between at-risk children and children of non-anxious parents in their cognitive bias scores for reaction times or for accuracy in identifying angry or happy facial expressions. In addition, there were no significant differences between at-risk children and children of non-anxious parents in the number of threat interpretations made for the ambiguous situations questionnaire. It is possible that these cognitive biases only become present subsequent to the development of an anxiety disorder, or only in older at-risk children

Influences of neutron star parameters on evolutions of different types of pulsar; evolutions of anomalous X-ray pulsars, soft gamma repeaters and dim isolated thermal neutron stars on the P-\.{P} diagram

Influences of the mass, moment of inertia, rotation, absence of stability in the atmosphere and some other parameters of neutron stars on the evolution of pulsars are examined. It is shown that the locations and evolutions of soft gamma repeaters, anomalous X-ray pulsars and other types of pulsar on the period versus period derivative diagram can be explained adopting values of B$<10^{14}$ G for these objects. This approach gives the possibility to explain many properties of different types of pulsar.Comment: 18 pages, 1 figur

Adaptation of Quinoa (Chenopodium quinoa Willd.) to Australian Environments

Quinoa is being evaluated in cropping systems in many countries outside of its natural range of South America. Very few attempts have been made by farmers or researchers to grow or evaluate quinoa under Australian environments. Given the growing popularity of quinoa with consumers, new commercial opportunities for farmers and international interest in the crop, it was timely to undertake a comprehensive evaluation of the potential of quinoa in Australia. Two advanced selections and nine germplasm lines (six of Chilean and three of Bolivian origin) identified in an earlier project were tested in 23 field trials at 14 locations on mainland Australia. Targets included irrigated sites in tropical, Mediterranean, semi-arid and desert climates, and rain-fed sites of south-western Australia with a Mediterranean climate. The field experiments were either a randomised complete block design (RBCD) or a split plot/factorial design with 2–4 replicates, and a linear mixed model was used to compare the treatment lines. Seed yield of quinoa was highest when grown in winter and spring under rain-fed conditions in Geraldton, in spring and summer under irrigation at Bool Lagoon, and summer, autumn and winter under irrigation at Leeton. The highest seed yield achieved was 3 t/ha for a germplasm line from Chile, while the highest yield for a germplasm line from Bolivia was 2.6 t/ha. Advanced selections from Australia yielded well in comparison at most trial sites. Declining seed yield was associated with mean daily temperatures during seed development increasing above 17 °C, mean daily temperatures during flowering declining below 15 °C, and rainfall during seed development under rain-fed conditions falling below 50 mm. Seed produced at Bool Lagoon was the closest in colour to white quinoa imported from Peru; however, it was more than noticeably different. Seed produced at Geraldton and Leeton was significantly larger than from other field sites; however, none were larger than 2 mm in diameter as found in Royal white quinoa from Bolivia. Superior seed colour and seed size were associated with dry conditions at maturity and cool conditions during seed development, respectively. We conclude that quinoa can become a potential crop option for Australian agriculture by exploiting genetic diversity and supplementing with suitable management practices matched to agro-climatic environments. There are reasonable prospects to raise the seed yield potential in areas in all states, especially in the regions where quinoa grew well in our experiments

Electron Spin Resonance Above Tc In Layered Manganites

We have performed electron spin resonance (ESR) and dc magnetization measurements on single crystals of La2(1-x)Sr1+2xMn2O7 up to 800 K with special emphasis on the x = 0.4 composition. The ESR linewidth shows behavior similar to that observed in the three-dimensional perovskites and above ∼500 K can be described by a universal expression ΔHpp(T)=[C/Tχ(T)]ΔHpp (∞). The linewidth and the resonance field become anisotropic below ∼500 K. The anisotropy in the resonance field is proportional to the magnetization M, and we concluded that it is intrinsic to the system. We show that demagnetization effects can explain only part of the anisotropy. The remainder arises from short-range uniaxial terms in the Hamiltonian that are associated with the crystal field and Dzialozhinsky-Moriya interactions. The anisotropy in the linewidth is attributed to the easy-plane ferromagnetic ordering, which also arises from the short-range anisotropy.631717441311744136Ruddlesden, S.N., Popper, P., (1958) Acta Crystallogr., 11, p. 54Moritomo, Y., Asamitsu, A., Kuwahara, H., Tokura, Y., (1996) Nature (London), 380, p. 141Causa, M.T., Tovar, M., Caneiro, A., Prado, F., Ibanez, G., Ramos, C.A., Butera, A., Oseroff, S.B., (1998) Phys. Rev. B, 58, p. 3233Causa, M.T., Alejandro, G., Tovar, M., Pagliuso, P.G., Rettori, C., Oseroff, S.B., Subramanian, M.A., (1999) J. Appl. Phys., 85, p. 5408Huber, D.L., Alejandro, G., Caneiro, A., Causa, M.T., Prado, F., Tovar, M., Oseroff, S.B., (1999) Phys. Rev. B, 60, p. 12155Oseroff, S.B., Moreno, N.O., Pagliuso, P.G., Rettori, C., Huber, D.L., Gardner, J.S., Sarrao, J.L., Alascio, B.R., (2000) J. Appl. Phys., 87, p. 5810Seehra, M.S., Ibrahim, M.M., Babu, V.S., Srinivasan, G., (1996) J. Phys.: Condens. Matter, 8, p. 11283Dominguez, M., Lofland, S.E., Bhagat, S.M., Raychaudhuri, A.K., Ju, H.L., Venkates, T., Greene, R.L., (1996) Solid State Commun., 97, p. 193Lofland, S.E., Kim, P., Dahiroc, P., Bhagat, S.M., Tyagi, S.D., Karabashev, S.G., Shultyatev, D.A., Mukovskii, Y., (1997) Phys. Lett. A, 233, p. 476Kimura, T., Tomioka, Y., Kuwahara, H., Asamitsu, A., Tamura, M., Tokura, Y., (1996) Science, 274, p. 1698Perring, T.G., Aeppli, G., Moritomo, Y., Tokura, Y., (1997) Phys. Rev. Lett., 78, p. 3197Zhou, J.-S., Goodenough, J.B., Mitchell, J.F., (1998) Phys. Rev. B, 58, p. 579Zhou, J.-S., Goodenough, J.B., (1998) Phys. Rev. Lett., 80, p. 2665Kelley, T.M., Argyriou, D.N., Robinson, R.A., Nakotte, H., Mitchell, J.F., Osbron, R., Jorgensen, J.D., (1998) Physica B, 241-243, p. 439Heffner, R.H., MacLaughlin, D.E., Nieuwenhuys, G.J., Kimura, T., Luke, G.M., Tokura, Y., Uemura, Y.J., (1998) Phys. Rev. Lett., 81, p. 1706Potter, C.D., Swiatek, M., Bader, S.D., Argyriou, D.N., Mitchell, J.F., Miller, D.J., Hinks, D.G., Jorgensen, J.D., (1998) Phys. Rev. B, 57, p. 72Chauvet, O., Goglio, G., Molinie, P., Corraze, B., Brohan, L., (1998) Phys. Rev. Lett., 81, p. 1102Hirota, K., Moritomo, Y., Fujioka, H., Kubota, M., Yoshizawa, H., Endoh, Y., (1998) J. Phys. Soc. Jpn., 67, p. 3380Li, J.Q., Matsui, Y., Kimura, T., Tokura, Y., (1998) Phys. Rev. B, 57, pp. R3205Kimura, T., Kumai, R., Tokura, Y., Li, J.Q., Matsui, Y., (1998) Phys. Rev. B, 58, p. 11081Hayashi, T., Miura, N., Tokunaga, M., Kimura, T., Tokura, Y., (1998) J. Phys.: Condens. Matter, 10, p. 11525Suryanarayanan, R., Dhalenne, G., Revcolevschi, A., Prellier, W., Renard, J.P., Dupas, C., Caliebe, W., Chatterji, T., (2000) Solid State Commun., 113, p. 267Kubota, M., Fujioka, H., Ohoyama, K., Hirota, K., Moritomo, Y., Yoshizawa, H., Endoh, Y., (1999) J. Phys. Chem. Solids, 60, p. 116Bhagat, S.M., Lofland, S.E., Mitchell, J.F., (1999) Phys. Lett. A, 259, p. 326Kittel, C., (1997) Introduction to Solid State Physics, , Wiley, New YorkOkochi, M., (1970) J. Phys. Soc. Jpn., 28, p. 897Victoria, C., Barker, R.C., Yelon, A., (1967) Phys. Rev. Lett., 19, p. 792Nagata, K., (1976) J. Phys. Soc. Jpn., 40, p. 1209Nagata, K., Yamamoto, I., Takano, H., Yokozawa, Y., (1977) J. Phys. Soc. Jpn., 43, p. 857. , and references thereinHuber, D.L., Seehra, M.S., (1976) Phys. Status Solidi B, 74, p. 145Stanger, J.-L., Andre, J.-J., Turek, P., Hosokoshi, Y., Tamura, M., Kinoshita, M., Rey, P., Veciana, J., (1997) Phys. Rev. B, 55, p. 8398Van Vleck, J.H., (1950) Phys. Rev., 78, p. 266Kittel, C., (1948) Phys. Rev., 73, p. 15

Genetic and environmental variation in methane emissions of sheep at pasture

A total of 2,600 methane (CH4) and 1,847 CO2 measurements of sheep housed for 1 h in portable accumulation chambers (PAC) were recorded at 5 sites from the Australian Sheep CRC Information Nucleus, which was set up to test leading young industry sires for an extensive range of current and novel production traits. The final validated dataset had 2,455 methane records from 2,279 animals, which were the progeny of 187 sires and 1,653 dams with 7,690 animals in the pedigree file. The protocol involved rounding up animals from pasture into a holding paddock before the first measurement on each day and then measuring in groups of up to 16 sheep over the course of the day. Methane emissions declined linearly (with different slopes for each site) with time since the sheep were drafted into the holding area. After log transformation, estimated repeatability (rpt) and heritability (h(2)) of liveweight-adjusted CH4 emissions averaged 25% and 11.7%, respectively, for a single 1-h measurement. Sire × site interactions were small and nonsignificant. Correlations between EBV for methane emissions and Sheep Genetics Australia EBV for production traits were used as approximations to genetic correlations. Apart from small positive correlations with weaning and yearling weights (r = 0.21-0.25, P < 0.05), there were no significant relationships between production trait and methane EBV (calculated from a model adjusting for liveweight by fitting separate slopes for each site). To improve accuracy, future protocols should use the mean of 2 (rpt = 39%, h(2) = 18.6%) or 3 (rpt = 48%, h(2) = 23.2%) PAC measurements. Repeat tests under different pasture conditions and time of year should also be considered, as well as protocols measuring animals directly off pasture instead of rounding them up in the morning. Reducing the time in the PAC from 1 h to 40 min would have a relatively small effect on overall accuracy and partly offset the additional time needed for more tests per animal. Field testing in PAC has the potential to provide accurate comparisons of animal and site methane emissions, with potentially lower cost/increased accuracy compared to alternatives such as SF6 tracers or open path lasers. If similar results are obtained from tests with different protocols/seasonal conditions, use of PAC measurements in a multitrait selection index with production traits could potentially reduce methane emissions from Australian sheep for the same production level

Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness

BACKGROUND: There are conflicting data on the effects of antipsychotic medications on delirium in patients in the intensive care unit (ICU). METHODS: In a randomized, double-blind, placebo-controlled trial, we assigned patients with acute respiratory failure or shock and hypoactive or hyperactive delirium to receive intravenous boluses of haloperidol (maximum dose, 20 mg daily), ziprasidone (maximum dose, 40 mg daily), or placebo. The volume and dose of a trial drug or placebo was halved or doubled at 12-hour intervals on the basis of the presence or absence of delirium, as detected with the use of the Confusion Assessment Method for the ICU, and of side effects of the intervention. The primary end point was the number of days alive without delirium or coma during the 14-day intervention period. Secondary end points included 30-day and 90-day survival, time to freedom from mechanical ventilation, and time to ICU and hospital discharge. Safety end points included extrapyramidal symptoms and excessive sedation. RESULTS: Written informed consent was obtained from 1183 patients or their authorized representatives. Delirium developed in 566 patients (48%), of whom 89% had hypoactive delirium and 11% had hyperactive delirium. Of the 566 patients, 184 were randomly assigned to receive placebo, 192 to receive haloperidol, and 190 to receive ziprasidone. The median duration of exposure to a trial drug or placebo was 4 days (interquartile range, 3 to 7). The median number of days alive without delirium or coma was 8.5 (95% confidence interval [CI], 5.6 to 9.9) in the placebo group, 7.9 (95% CI, 4.4 to 9.6) in the haloperidol group, and 8.7 (95% CI, 5.9 to 10.0) in the ziprasidone group (P=0.26 for overall effect across trial groups). The use of haloperidol or ziprasidone, as compared with placebo, had no significant effect on the primary end point (odds ratios, 0.88 [95% CI, 0.64 to 1.21] and 1.04 [95% CI, 0.73 to 1.48], respectively). There were no significant between-group differences with respect to the secondary end points or the frequency of extrapyramidal symptoms. CONCLUSIONS: The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium. (Funded by the National Institutes of Health and the VA Geriatric Research Education and Clinical Center; MIND-USA ClinicalTrials.gov number, NCT01211522 .)