Risk of “silent stroke” in patients older than 60 years: risk assessment and clinical perspectives

With the increasing size of the elderly population and evolving imaging technology, silent brain infarction (SBI) has garnered attention from both the public and the physicians. Over 20% of the elderly exhibit SBI, and the prevalence of SBI increases steadily with age, ie, 30%–40% in those older than 70 years. Well-known cardiovascular risk factors such as hypertension has been identified as a risk factor of SBI (odds ratio [OR] = 3.47) Besides this, blood pressure (BP) reactivity to mental stress, morning BP surges, and orthostatic BP changes have been demonstrated to contribute to the presence of SBI. Further, a metabolic syndrome not only as a whole syndrome (OR =2.18) but also as individual components could have an influence on SBI. Increased C-reactive protein and interleukin-6, coronary artery disease, body mass index, and alcohol consumption have also been associated with SBI. The ORs and possible mechanisms have been discussed in this article. Overt stroke, dementia, depression, and aspiration pneumonia were all associated with SBI. (overt stroke: hazard ratio [HR] =1.9, 95% confidence interval [CI]: 1.2–2.8; dementia: HR =2.26, 95% CI: 1.09–4.70). We also looked into their close relationship with SBI in this review

Delayed presentation of cerebellar and spinal cord infarction as a complication of computed tomography-guided transthoracic lung biopsy: a case report

INTRODUCTION: Computed tomography-guided transthoracic needle biopsy is a common diagnostic procedure that is associated with various complications including pneumothorax, parenchymal hemorrhage, and hemoptysis. A systemic air embolism is a very rare (0.06 to 0.21%) but potentially fatal complication. CASE PRESENTATION: A 70-year-old Korean male was admitted to our hospital for evaluation of a solitary pulmonary nodule located adjacent to the right inferior pulmonary vein in the medial basal segment of the right lower lobe. A computed tomography-guided needle biopsy was performed by a radiologist using a coaxial needle. A computed tomography image obtained immediately after the biopsy showed intraluminal free air in the proximal ascending aorta. He complained of a mild electrical current sensation in both lower extremities. After three hours he complained of neurological deficit in both lower extremities as well as voiding difficulty. The brain and spine magnetic resonance images showed a right cerebellar and spinal cord infarction at the T8-10 levels. CONCLUSIONS: We report a case of air embolism to the cerebellum and spinal cord causing infarction presenting with an initial symptom of mild electrical current sensation in both lower extremities during the transthoracic needle biopsy. For this potentially fatal complication, early recognition, followed by prompt therapy is critical to reducing morbidity and mortality

Leukoaraiosis is associated with pneumonia after acute ischemic stroke

Diagnostic criteria for stroke associated pneumonia based on the CDC criteria. (DOCX 25 kb

Analysis of Building Energy Savings Potential for Metal Panel Curtain Wall Building by Reducing Thermal Bridges at Joints Between Panels

AbstractTo achieve national greenhouse gas reduction in the building sector, heating and cooling energy in buildings should be reduced. The government has strengthened regulations on insulation performance for building energy savings. However, the building envelope has various thermal bridges. In particular, a metal panel curtain wall comprises a number of thermal bridges at joints between the panels and the fixing units, thus degrading the overall thermal performance. To reduce building energy, it is necessary to reduce thermal bridges in building envelopes. This study aims to analyze the energy saving potential achieved by reducing thermal bridges. For this, the insulation performance and building energy needs of the existing and alternative metal panel curtain wall were evaluated. The alternative metal panel curtain wall that uses plastic molds at joints between panels and the thermally-broken brackets was suggested to reduce heat loss through thermal bridges. As results, the effective U-value of the alternative metal panel curtain wall was reduced by 72% compared with the existing metal panel curtain wall. In addition, annual heating energy needs of the alternative metal panel curtain wall building was reduced by 26%, and annual total energy needs was reduced by 6% because annual cooling energy needs of it slightly increased compared with the existing metal panel curtain wall. In conclusion, the alternative metal panel curtain wall considerably influenced the savings in building energy needs by reducing thermal bridges

Boosting thermal conductivity by surface plasmon polaritons propagating along a thin Ti film

We experimentally demonstrate a boosted in-plane thermal conduction by surface plasmon polaritons (SPPs) propagating along a thin Ti film on a glass substrate. Owing to a lossy nature of metal, SPPs can propagate over centimeter-scale distance even with a supported metal film, and resulting ballistic heat conduction can be quantitatively validated. Further, for a 100-nm-thick Ti film on glass substrate, a significant enhancement of in-plane thermal conductivity compared to bulk value ($\sim 35\%$) is experimentally shown. This study will provide a new avenue to employ SPPs for heat dissipation along a supported thin film, which can be readily applied to mitigate hot-spot issues in microelectronics.Comment: 3 figure

Customer process management A framework for using customer-related data to create customer value

Purpose The proliferation of customer-related data provides companies with numerous service opportunities to create customer value. The purpose of this study is to develop a framework to use this data to provide services. Design/methodology/approach This study conducted four action research projects on the use of customer-related data for service design with industry and government. Based on these projects, a practical framework was designed, applied, and validated, and was further refined by analyzing relevant service cases and incorporating the service and operations management literature. Findings The proposed customer process management (CPM) framework suggests steps a service provider can take when providing information to its customers to improve their processes and create more value-in-use by using data related to their processes. The applicability of this framework is illustrated using real examples from the action research projects and relevant literature. Originality/value "Using data to advance service" is a critical and timely research topic in the service literature. This study develops an original, specific framework for a company's use of customer-related data to advance its services and create customer value. Moreover, the four projects with industry and government are early CPM case studies with real data

Performance Analysis On A Variable Capacity Swash Plate Compressor

A numerical study on the performance of a variable capacity swash plate compressor for an automotive air-conditioning system was carried out. The compressor under investigation had six cylinders and capacity regulation was made by changing the swash plate inclination angle. A numerical simulation program was made based on mathematical modelings on the swash plate dynamics, refrigerant states in various control volumes such as cylinders and crank room, and flows in the opening passages of electric control valve for crank room pressure control. The simulation results such as mass flow rate, compressor power consumption, cooling capacity and COP were compared with measurements within ±5% deviation over various operating conditions except at low operating speed such as idling condition. By using the simulation program, the effect of the crank room pressure on the swash plate inclination angle and the determination of the crank room pressure level by the electric control valve openings could be investigated