Prognostic significance of short-term blood pressure variability in acute stroke

Background and Purpose— Blood pressure variability (BPV) may be an important prognostic factor acutely after stroke. This review investigated the existing evidence for the effect of BPV on outcome after stroke, also considering BPV measurement techniques and definitions. Methods— A literature search was performed according to a prespecified study protocol. Two reviewers independently assessed study eligibility and quality. Where appropriate, meta-analyses were performed to assess the effect of BPV on poor functional outcome. Results— Eighteen studies from 1359 identified citations were included. Seven studies were included in a meta-analysis for the effect of BPV on functional outcome (death or disability). Systolic BPV was significantly associated with poor functional outcome: pooled odds ratio per 10-mm Hg increment, 1.2; confidence interval (1.1–1.3). A descriptive review of included studies also supports these findings, and in addition, it suggests that systolic BPV may be associated with increased risk of intracranial hemorrhage in those treated with thrombolytic therapy. Conclusions— This systematic review and meta-analysis suggest that greater systolic BPV, measured early from ischemic stroke or intracerebral hemorrhage onset, is associated with poor longer-term functional outcome. Future prospective studies should investigate how best to measure and define BPV in acute stroke, as well as to determine its prognostic significance. </jats:sec

The Relationship Between Molecular Gas Tracers and Kennicutt-Schmidt Laws

We provide a model for how Kennicutt-Schmidt (KS) laws, which describe the correlation between star formation rate and gas surface or volume density, depend on the molecular line chosen to trace the gas. We show that, for lines that can be excited at low temperatures, the KS law depends on how the line critical density compares to the median density in a galaxy's star-forming molecular clouds. High critical density lines trace regions with similar physical properties across galaxy types, and this produces a linear correlation between line luminosity and star formation rate. Low critical density lines probe regions whose properties vary across galaxies, leading to a star formation rate that varies superlinearly with line luminosity. We show that a simple model in which molecular clouds are treated as isothermal and homogenous can quantitatively reproduce the observed correlations between galactic luminosities in far infrared and in the CO(1->0) and HCN(1->0) lines, and naturally explains why these correlations have different slopes. We predict that IR-line luminosity correlations should change slope for galaxies in which the median density is close to the line critical density. This prediction may be tested by observations of lines such as HCO^+(1->0) with intermediate critical densities, or by HCN(1->0) observations of intensely star-forming high redshift galaxies with very high densities. Recent observations by Gao et al. hint at just such a change in slope. We argue that deviations from linearity in the HCN(1->0)-IR correlation at high luminosity are consistent with the assumption of a constant star formation efficiency.Comment: Accepted to ApJ. 11 pages, 4 figures, emulateapj format. This version has some additional models exploring the effects of varying metallicity and temperature. The conclusions are unchange

Feasiblity study for a 34 GHz (Ka band) gyroamplifier

The feasibility of using a gyroklystron power tube as the final amplifier in a 400 kW CW 34 GHz transmitter on the Goldstone Antenna is investigated. A conceptual design of the gyroklystron and the transmission line connecting it with the antenna feed horn is presented. The performance characteristics of the tube and transmission line are compared to the transmitter requirements for a deep space radar system. Areas of technical risk for a follow-on hardware development program for the gyroklystron amplifier and overmoded transmission line components are discussed

Randomised controlled trial of a Calcium Channel or Angiotensin Converting Enzyme Inhibitor/Angiotensin Receptor Blocker Regime to Reduce Blood Pressure Variability following Ischaemic Stroke (CAARBS): a protocol for a feasibility study

Introduction Raised blood pressure (BP) is common after stroke and is associated with a poor prognosis, yet trials of BP lowering in the immediate poststroke period have not demonstrated a benefit. One possible explanation for this may be that BP variability (BPV) rather than absolute levels predicts outcome, as BPV is increased after stroke and is associated with poor outcomes. Furthermore, there is evidence of distinct antihypertensive class effects on BPV despite similar BP-lowering effects. However, whether BPV in the immediate poststroke period is a therapeutic target has not been prospectively investigated. The objectives of this trial are to assess the feasibility and safety of recruiting patients following an acute ischaemic stroke or transient ischaemic attack (TIA) to an interventional randomised controlled trial comparing the effects of two different antihypertensive drug classes on BPV. Secondary exploratory objectives are to assess if different therapeutic strategies have diverse effects on levels of BPV and if this has an impact on outcomes. Methods 150 adult patients with first-ever ischaemic stroke or TIA who require antihypertensive therapy for secondary prevention will be recruited within 7 days of the event from stroke services across three sites. After baseline assessments they will be randomly assigned to treatment with a calcium channel blocker or ACE inhibitor/angiotensin receptor blocker-based regimen and followed up for a period of three months. Ethics and dissemination Ethical and regulatory approvals have been granted. Dissemination is planned via publication in peer-reviewed medical journals and presentation at relevant conferences. Trial registration number ISRCTN10853487

New times, new politics: history and memory during the final years of the CPGB

This article examines the relationship between collective memory, historical interpretation and political identity. It focuses on the dissolution of the Communist Party of Great Britain (CPGB) as constructed through collective narrative memory, and on Marxist interpretations of history. The divisions within the party and the wider Marxist community, stretching from 1956 until 1991, were often framed around questions of historical interpretation. The events of 1989–1991 created an historical and mnemonic crisis for CPGB members who struggled to reconcile their past identities with their present situation. Unlike the outward-facing revisionism of other political parties, this was an intensely personal affair. The solution for many was to emphasise the need to find new ways to progress socialist aims, without relying on a discredited grand narrative. In contrast, other Communist parties, such as the Communist Party of Britain, which had been established (or ‘re-established’) in 1988, fared rather better. By adhering to the international party line of renewal and continued struggle, the party was able to hold its narrative together, condemning the excesses of totalitarian regimes, while reaffirming the need for international class struggle

Extension of Lorenz Unpredictability

It is found that Lorenz systems can be unidirectionally coupled such that the chaos expands from the drive system. This is true if the response system is not chaotic, but admits a global attractor, an equilibrium or a cycle. The extension of sensitivity and period-doubling cascade are theoretically proved, and the appearance of cyclic chaos as well as intermittency in interconnected Lorenz systems are demonstrated. A possible connection of our results with the global weather unpredictability is provided.Comment: 32 pages, 13 figure

A Feasibility Study of Methodological Issues and Short-Term Outcomes in Seriously Injured Older Adults

Background: For any given traumatic injury, older adults experience a longer hospitalization, more complications, and higher mortality than do younger patients. Objectives: To prospectively identify problems in designing follow-up studies in seriously injured older adults without head injury and to examine outcomes after serious trauma in older adults who were sent to a level I trauma center. Methods: A short-term descriptive follow-up design was used in which each patient served as his or her baseline. Eligible patients had injuries that required admission to an intensive care unit, a hospital length of stay longer than 72 hours, or surgery. Patients with isolated hip fractures, central nervous system injuries, and burn injuries were excluded. Data were collected by using standardized instruments during the acute hospital stay and 3 months after discharge from the hospital. Results: During a representative 2-month period, 21% of a potential 77 subjects died in the hospital, 44% had cognitive impairment that precluded participation, and 17% declined to participate. Twenty older adults (mean age 73.5 years) who were injured in motor vehicle crashes (45%), falls (35%), or pedestrian accidents (15%) or who had gunshot wounds (5%) were enrolled. Ten percent died after discharge. Levels of physical disability at 3 months after discharge were higher than those before the injury (score on Sickness Impact Profile physical subscale 24.5 vs 10.9, P = .02), and psychological distress (Impact of Event Scale score 20.9) remained elevated. Conclusion: Mortality, disability, and posttraumatic psychological distress after discharge are problems in seriously injured older adults

HST Imaging Polarimetry of the Gravitational Lens FSC10214+4724

We present imaging polarimetry of the extremely luminous, redshift 2.3 IRAS source FSC10214+4724. The observations were obtained with HST's Faint Object Camera in the F437M filter, which is free of strong emission lines. The 0.7 arcsec long arc is unresolved to 0.04 arcsec FWHM in the transverse direction, and has an integrated polarization of 28 +/- 3 percent, in good agreement with ground-based observations. The polarization position angle varies along the arc by up to 35 deg. The overall position angle is 62 +/- 3 deg east of north. No counterimage is detected to B = 27.5 mag ($3\sigma$), giving an observed arc to counterimage flux ratio greater than 250, considerably greater than the flux ratio of 100 measured previously in the I-band. This implies that the configuration of the object in the source plane at the B-band is different from that at I-band, and/or that the lensing galaxy is dusty.Comment: 17 pages, 3 figures. Accepted for publication in Astronomical Journal, February 199

ImpZ: a new photometric redshift code for galaxies and quasars

We present a combined galaxy-quasar approach to template-fitting photometric redshift techniques and show the method to be a powerful one. The code (ImpZ) is presented, developed and applied to two spectroscopic redshift catalogues, namely the Isaac Newton Telescope Wide Angle Survey ELAIS N1 and N2 fields and the Chandra Deep Field North. In particular, optical size information is used to improve the redshift determination. The success of the code is shown to be very good with Delta z/(1+z) constrained to within 0.1 for 92 per cent of the galaxies in our sample. The extension of template-fitting to quasars is found to be reasonable with Delta z/(1+z) constrained to within 0.25 for 68 per cent of the quasars in our sample. Various template extensions into the far-UV are also tested.Comment: 21 pages. MNRAS in press. Minor alterations to match MNRAS final proo