Health care resouce use and stroke outcome

Background and Purpose: Outcome in patients hospitalized for acute stroke varies considerably between populations. Within the framework of the GAIN International trial, a large multicenter trial of a neuroprotective agent (gavestinel, glycine antagonist), stroke outcome in relation to health care resource use has been compared in a large number of countries, allowing for differences in case mix. Methods: This substudy includes 1,422 patients in 19 countries grouped into 10 regions. Data on prognostic variables on admission to hospital, resource use, and outcome were analyzed by regression models. Results: All results were adjusted for differences in prognostic factors on admission (NIH Stroke Scale, age, comorbidity). There were threefold variations in the average number of days in hospital/institutional care (from 20 to 60 days). The proportion of patients who met with professional rehabilitation staff also varied greatly. Three-month case fatality ranged from 11% to 28%, and mean Barthel ADL score at three months varied between 64 and 73. There was no relationship between health care resource use and outcome in terms of survival and ADL function at three months. The proportion of patients living at home at three months did not show any relationship to ADL function across countries. Conclusions: There are wide variations in health care resource use between countries, unexplained by differences in case mix. Across countries, there is no obvious relationship between resource use and clinical outcome after stroke. Differences in health care traditions (treatment pathways) and social We thank the coinvestigators and research staff at the participating centers for their support. Glaxo Wellcome sponsored the GAIN International trial, supported the present analyses and reviewed the final draft of the article

Predictions of the arrival time of coronal mass ejections at 1AU: an analysis of the causes of errors

Three existing models of Interplanetary Coronal Mass Ejection (ICME) transit between the Sun and the Earth are compared to coronagraph and in situ observations: all three models are found to perform with a similar level of accuracy (i.e. an average error between observed and predicted 1AU transit times of approximately 11 h). To improve long-term space weather prediction, factors influencing CME transit are investigated. Both the removal of the plane of sky projection (as suffered by coronagraph derived speeds of Earth directed CMEs) and the use of observed values of solar wind speed, fail to significantly improve transit time prediction. However, a correlation is found to exist between the late/early arrival of an ICME and the width of the preceding sheath region, suggesting that the error is a geometrical effect that can only be removed by a more accurate determination of a CME trajectory and expansion. The correlation between magnetic field intensity and speed of ejecta at 1AU is also investigated. It is found to be weak in the body of the ICME, but strong in the sheath, if the upstream solar wind conditions are taken into account

Non-radial solar wind flows induced by the motion of interplanetary coronal mass ejections

A survey of the non-radial flows (NRFs) during nearly five years of interplanetary observations revealed the average non-radial speed of the solar wind flows to be �30 km/s, with approximately one-half of the large (>100 km/s) NRFs associated with ICMEs. Conversely, the average non-radial flow speed upstream of all ICMEs is �100 km/s, with just over one-third preceded by large NRFs. These upstream flow deflections are analysed in the context of the large-scale structure of the driving ICME. We chose 5 magnetic clouds with relatively uncomplicated upstream flow deflections. Using variance analysis it was possible to infer the local axis orientation, and to qualitatively estimate the point of interception of the spacecraft with the ICME. For all 5 events the observed upstream flows were in agreement with the point of interception predicted by variance analysis. Thus we conclude that the upstream flow deflections in these events are in accord with the current concept of the large scale structure of an ICME: a curved axial loop connected to the Sun, bounded by a curved (though not necessarily circular)cross section

Modelling interplanetary CMEs using magnetohydrodynamic simulations

International audienceThe dynamics of Interplanetary Coronal Mass Ejections (ICMEs) are discussed from the viewpoint of numerical modelling. Hydrodynamic models are shown to give a good zero-order picture of the plasma properties of ICMEs, but they cannot model the important magnetic field effects. Results from MHD simulations are shown for a number of cases of interest. It is demonstrated that the strong interaction of the ICME with the solar wind leads to the ICME and solar wind velocities being close to each other at 1 AU, despite their having very different speeds near the Sun. It is also pointed out that this interaction leads to a distortion of the ICME geometry, making cylindrical symmetry a dubious assumption for the CME field at 1 AU. In the presence of a significant solar wind magnetic field, the magnetic fields of the ICME and solar wind can reconnect with each other, leading to an ICME that has solar wind-like field lines. This effect is especially important when an ICME with the right sense of rotation propagates down the heliospheric current sheet. It is also noted that a lack of knowledge of the coronal magnetic field makes such simulations of little use in space weather forecasts that require knowledge of the ICME magnetic field strength

First Cluster results of the magnetic field structure of the mid- and high-altitude cusps

International audienceMagnetic field measurements from the four Cluster spacecraft from the mid- and high-altitude cusp are presented. Cluster underwent two encounters with the mid-altitude cusp during its commissioning phase (24 August 2000). Evidence for field-aligned currents (FACs) was seen in the data from all three operating spacecraft from northern and southern cusps. The extent of the FACs was of the order of 1 RE in the X-direction, and at least 300 km in the Y-direction. However, fine-scale field structures with scales of the order of the spacecraft separation (300 km) were observed within the FACs. In the northern crossing, two of the spacecraft appeared to lie along the same magnetic field line, and observed very well matched signals. However, the third spacecraft showed evidence for structuring transverse to the field on scales of a few hundred km. A crossing of the high-altitude cusp from 13 February 2001 is presented. It is revealed to be a highly dynamic structure with the boundaries moving with velocities ranging from a few km/s to tens of km/s, and having structure on timescales ranging from less than one minute up to several minutes. The cusp proper is associated with the presence of a very disordered magnetic field, which is entirely different from the magnetosheath turbulence

Development and calibration of a sand pluviation device for preparation of model sand bed for centrifuge tests

A bespoke 0.068m3 (18.5 gallon) sand hopper is employed at the newly established 50gTon centrifuge facility at the University of Sheffield. The sand hopper employs a series of mesh inserts of different diameters which control the flow rate and thus the relative density of the model. A series of calibration tests on equivalent Fraction E and Fraction C sands were performed to calibrate the mesh diameter and drop height for a desired relative density. Result showed that the sand hopper is capable of delivering repeatable relative densities in the range of 30% to above 90%, for both kinds of sand grades. This wide range relative density is considered sufficient to satisfy the needs of researchers preparing dry sand models for testing in the center

Heritability and complex segregation analysis of deafness in Jack Russell Terriers

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Analysis and Modeling of Two Flare Loops Observed by AIA and EIS

We analyze and model an M1.0 flare observed by SDO/AIA and Hinode/EIS to investigate how flare loops are heated and evolve subsequently. The flare is composed of two distinctive loop systems observed in EUV images. The UV 1600 \AA emission at the feet of these loops exhibits a rapid rise, followed by enhanced emission in different EUV channels observed by AIA and EIS. Such behavior is indicative of impulsive energy deposit and the subsequent response in overlying coronal loops that evolve through different temperatures. Using the method we recently developed, we infer empirical heating functions from the rapid rise of the UV light curves for the two loop systems, respectively, treating them as two big loops of cross-sectional area 5\arcsec by 5\arcsec, and compute the plasma evolution in the loops using the EBTEL model (Klimchuk et al. 2008). We compute the synthetic EUV light curves, which, with the limitation of the model, reasonably agree with observed light curves obtained in multiple AIA channels and EIS lines: they show the same evolution trend and their magnitudes are comparable by within a factor of two. Furthermore, we also compare the computed mean enthalpy flow velocity with the Doppler shift measurements by EIS during the decay phase of the two loops. Our results suggest that the two different loops with different heating functions as inferred from their footpoint UV emission, combined with their different lengths as measured from imaging observations, give rise to different coronal plasma evolution patterns captured both in the model and observations.Comment: Accepted for publication in Ap

Comparison of Hinode/XRT and RHESSI detection of hot plasma in the non-flaring solar corona

We compare observations of the non-flaring solar corona made simultaneously with Hinode/XRT and with RHESSI. The analyzed corona is dominated by a single active region on 12 November 2006. The comparison is made on emission measures. We derive emission measure distributions vs temperature of the entire active region from multifilter XRT data. We check the compatibility with the total emission measure values estimated from the flux measured with RHESSI if the emission come from isothermal plasma. We find that RHESSI and XRT data analyses consistently point to the presence of a minor emission measure component peaking at log T ~ 6.8-6.9. The discrepancy between XRT and RHESSI results is within a factor of a few and indicates an acceptable level of cross-consistency.Comment: 12 pages, 3 figures, Letter accepted for publicatio