The association of neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio with 3-month clinical outcome after mechanical thrombectomy following stroke

Background and aim Neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) are associated with clinical outcomes in malignancy, cardiovascular disease and stroke. Here we investigate their association with outcome after acute ischaemic stroke treated by mechanical thrombectomy (MT). Methods Patients were selected using audit data for MT for acute anterior circulation ischaemic stroke at a UK centre from May 2016–July 2017. Clinical and laboratory data including neutrophil, lymphocyte and monocyte count tested before and 24 h after MT were collected. Poor functional outcome was defined as modified Rankin Scale (mRS) of 3–6 at 3 months. Multivariable logistic regression analyses were performed to explore the relationship of NLR and LMR with functional outcome. Results One hundred twenty-one patients (mean age 66.4 ± 16.7, 52% female) were included. Higher NLR (adjusted OR 0.022, 95% CI, 0.009–0.34, p = 0.001) and lower LMR (adjusted OR − 0.093, 95% CI (− 0.175)−(− 0.012), p = 0.025) at 24-h post-MT were significantly associated with poorer functional outcome when controlling for age, baseline NIHSS score, infarct size, presence of good collateral supply, recanalisation and symptomatic intracranial haemorrhage on multivariate logistic regression. Admission NLR or LMR were not significant predictors of mRS at 3 months. The optimal cut-off values of NLR and LMR at 24-h post-MT that best discriminated poor outcome were 5.5 (80% sensitivity and 60% specificity) and 2.0 (80% sensitivity and 50% specificity), respectively on receiver operating characteristic curve analysis. Conclusion NLR and LMR tested at 24 h after ictus or intervention may predict 3-month functional outcome

Effect of pairing correlations on incompressibility and symmetry energy in nuclear matter and finite nuclei

The role of superfluidity in the incompressibility and in the symmetry energy is studied in nuclear matter and finite nuclei. Several pairing interactions are used: surface, mixed and isovector dependent. Pairing has a small effect on the nuclear matter incompressibility at saturation density, but the effects are significant at lower densities. The pairing effect on the centroid energy of the isoscalar Giant Monopole Resonance (GMR) is also evaluated for Pb and Sn isotopes by using a microscopic constrained-HFB approach, and found to change at most by 10% the nucleus incompressibility $K_A$. It is shown by using the Local Density Approximation (LDA) that most of the pairing effect on the GMR centroid come from the low-density nuclear surface.Comment: 9 pages, 6 figure

Refeeding Syndrome: A Literature Review

Refeeding syndrome (RFS) describes the biochemical changes, clinical manifestations, and complications that can occur as a consequence of feeding a malnourished catabolic individual. RFS has been recognised in the literature for over fifty years and can result in serious harm and death. Crude estimates of incidence, morbidity, and mortality are available for specific populations. RFS can occur in any individual but more commonly occurs in at-risk populations. Increased awareness amongst healthcare professionals is likely to reduce morbidity and mortality. This review examines the physiology of RFS and describes the clinical manifestations. A management strategy is described. The importance of a multidisciplinary approach is emphasized

An efficient strategy for the collection and storage of large volumes of data for computation

In recent years, there has been an increasing amount of data being produced and stored, which is known as Big Data. The social networks, internet of things, scientific experiments and commercial services play a significant role in generating a vast amount of data. Three main factors are important in Big Data; Volume, Velocity and Variety. One needs to consider all three factors when designing a platform to support Big Data. The Large Hadron Collider (LHC) particle accelerator at CERN consists of a number of data-intensive experiments, which are estimated to produce a volume of about 30 PB of data, annually. The velocity of these data that are propagated will be extremely fast. Traditional methods of collecting, storing and analysing data have become insufficient in managing the rapidly growing volume of data. Therefore, it is essential to have an efficient strategy to capture these data as they are produced. In this paper, a number of models are explored to understand what should be the best approach for collecting and storing Big Data for analytics. An evaluation of the performance of full execution cycles of these approaches on the monitoring of the Worldwide LHC Computing Grid (WLCG) infrastructure for collecting, storing and analysing data is presented. Moreover, the models discussed are applied to a community driven software solution, Apache Flume, to show how they can be integrated, seamlessly

Endothelial dysfunction in children with steroid-resistant nephrotic syndrome

Background: Steroid-resistant nephrotic syndrome (SRNS) is associated with early atherosclerosis because of comorbidities including persistent hyperlipidemia and hypertension. The aim of this study was to determine the incidence of abnormal carotid intima-media thickening (cIMT) as an early sign of atherosclerosis in a small group of children with SRNS. Methods: A total of 8 children with SRNS (mean age, 10.8±4.2 years at recruitment andmeandisease duration, 40.9±20.7 months) were studied; all children were normotensive. B-mode ultrasound was used to measure cIMT, and the results were compared with healthy controls. Results: Children with SRNS had significantly thicker CIMT (0.44±0.04 mm), compared to the controls (0.37±0.59mm)(P < 0.01). A high level of total cholesterol (5.4±2.0 mmol/L; normal < 5.2 mmol/L) was reported in these children, while normal levels of lowdensity lipoprotein, very-low-density lipoprotein, triglyceride, and high-density lipoprotein were found. Also, the mean creatinine level was 45.1±15.0 µmol/L, and the mean urea level was 4.2±1.8 mmol/L. Conclusions: Children with SRNS had an abnormal vascular phenotype with a thicker CIMT, compared to the controls and showed evidence of hypercholesterolemia

Colliding Axion-Dilaton Plane Waves from Black Holes

The colliding plane wave metric discovered by Ferrari and Iba\~{n}ez to be locally isometric to the interior of a Schwarzschild black hole is extended to the case of general axion-dilaton black holes. Because the transformation maps either black hole horizon to the focal plane of the colliding waves, this entire class of colliding plane wave spacetimes only suffers from the formation of spacetime singularities in the limits where the inner horizon itself is singular, which occur in the Schwarzschild and dilaton black hole limits. The supersymmetric limit corresponding to the extreme axion-dilaton black hole yields the Bertotti-Robinson metric with the axion and dilaton fields flowing to fixed constant values. The maximal analytic extension of this metric across the Cauchy horizon yields a spacetime in which two sandwich waves in a cylindrical universe collide to produce a semi-infinite chain of Reissner-Nordstrom-like wormholes. The focussing of particle and string geodesics in this spacetime is explored.Comment: 19 pages, 6 figure

The Achievable Rate of Interweave Cognitive Radio in the Face of Sensing Errors

Cognitive radio (CR) systems are potentially capable of mitigating the spectrum shortage of contemporary wireless systems. In this paper, we provide a brief overview of CR systems and the important research milestones of their evolution, along with their standardization activities, as a result of their research. This is followed by the detailed analysis of the interweave policy-based CR network (CRN) and by a detailed comparison with the family of underlay-based CRNs. In the interweave-based CRN, sensing of the primary user's (PU) spectrum by the secondary user's (SU) has remained a challenge, because the sensing errors prevent us from fulfilling the significant throughput gains that the concept of CR promises. Since missed detection and false alarm errors in real-time spectrum sensing cannot be avoided, based on a new approach, we quantify the achievable rates of the interweave CR by explicitly incorporating the effect of sensing errors. The link between the PU transmitter and the SU transmitter is assumed to be fast fading. Explicitly, the achievable rate degradation imposed by the sensing errors is analyzed for two spectrum sensing techniques, namely, for energy detection and for magnitude squared coherence-based detection. It is demonstrated that when the channel is sparsely occupied by the PU, the reusing techniques that are capable of simultaneously providing low missed detection and false alarm probabilities cause only a minor degradation to the achievable rates. Furthermore, based on the achievable rates derived for underlay CRNs, we compare the interweave CR and the underlay CR paradigms from the perspective of their resilience against spectrum sensing errors. Interestingly, in many practical regimes, the interweave CR paradigm outperforms the underlay CR paradigm in the presence of sensing errors, especially when the SNR at the SU is below 10 dB and when the SNR at the PU is in the range of 10-40 dB. Furthermore, we also provide rules of thumb that identify regimes, where the interweave CR outperforms the underlay CR

Soliton response to transient trap variations

The response of bright and dark solitons to rapid variations in an expulsive longitudinal trap is investigated. We concentrate on the effect of transient changes in the trap frequency in the form of temporal delta kicks and the hyperbolic cotangent functions. Exact expressions are obtained for the soliton profiles. This is accomplished using the fact that a suitable linear Schrodinger stationary state solution in time can be effectively combined with the solutions of non-linear Schrodinger equation, for obtaining solutions of the Gross-Pitaevskii equation with time dependent scattering length in a harmonic trap. Interestingly, there is rapid pulse amplification in certain scenarios