Risk factors for chest infection in acute stroke: a prospective cohort study

<p><b>Background and Purpose:</b> Pneumonia is a major cause of morbidity and mortality after stroke. We aimed to determine key characteristics that would allow prediction of those patients who are at highest risk for poststroke pneumonia.</p> <p><b>Methods:</b> We studied a series of consecutive patients with acute stroke who were admitted to hospital. Detailed evaluation included the modified National Institutes of Health Stroke Scale; the Abbreviated Mental Test; and measures of swallow, respiratory, and oral health status. Pneumonia was diagnosed by set criteria. Patients were followed up at 3 months after stroke.</p> <p><b>Results:</b> We studied 412 patients, 391 (94.9%) with ischemic stroke and 21 (5.1%) with hemorrhagic stroke; 78 (18.9%) met the study criteria for pneumonia. Subjects who developed pneumonia were older (mean±SD age, 75.9±11.4 vs 64.9±13.9 years), had higher modified National Institutes of Health Stroke Scale scores, a history of chronic obstructive pulmonary disease, lower Abbreviated Mental Test scores, and a higher oral cavity score, and a greater proportion tested positive for bacterial cultures from oral swabs. In binary logistic-regression analysis, independent predictors (P<0.05) of pneumonia were age >65 years, dysarthria or no speech due to aphasia, a modified Rankin Scale score ≥4, an Abbreviated Mental Test score <8, and failure on the water swallow test. The presence of 2 or more of these risk factors carried 90.9% sensitivity and 75.6% specificity for the development of pneumonia.</p> <p><b>Conclusions:</b> Pneumonia after stroke is associated with older age, dysarthria/no speech due to aphasia, severity of poststroke disability, cognitive impairment, and an abnormal water swallow test result. Simple assessment of these variables could be used to identify patients at high risk of developing pneumonia after stroke.</p&gt

Elastic Wave Transmission at an Abrupt Junction in a Thin Plate, with Application to Heat Transport and Vibrations in Mesoscopic Systems

The transmission coefficient for vibrational waves crossing an abrupt junction between two thin elastic plates of different widths is calculated. These calculations are relevant to ballistic phonon thermal transport at low temperatures in mesoscopic systems and the Q for vibrations in mesoscopic oscillators. Complete results are calculated in a simple scalar model of the elastic waves, and results for long wavelength modes are calculated using the full elasticity theory calculation. We suggest that thin plate elasticty theory provide a useful and tractable approximation to the full three dimensional geometry.Comment: 35 pages, including 12 figure

Quantum driven Bounce of the future Universe

It is demonstrated that due to back-reaction of quantum effects, expansion of the universe stops at its maximum and takes a turnaround. Later on, it contracts to a very small size in finite future time. This phenomenon is followed by a " bounce" with re-birth of an exponentially expanding non-singular universe

Dynamics of Phase Transitions by Hysteresis Methods I

In studies of the QCD deconfining phase transition or crossover by means of heavy ion experiments, one ought to be concerned about non-equilibrium effects due to heating and cooling of the system. Motivated by this, we look at hysteresis methods to study the dynamics of phase transitions. Our systems are temperature driven through the phase transition using updating procedures in the Glauber universality class. Hysteresis calculations are presented for a number of observables, including the (internal) energy, properties of Fortuin-Kasteleyn clusters and structure functions. We test the methods for 2d Potts models, which provide a rich collection of phase transitions with a number of rigorously known properties. Comparing with equilibrium configurations we find a scenario where the dynamics of the transition leads to a spinodal decomposition which dominates the statistical properties of the configurations. One may expect an enhancement of low energy gluon production due to spinodal decomposition of the Polyakov loops, if such a scenario is realized by nature.Comment: 12 pages, revised after referee report, to appear in Phys. Rev.

International, collaborative assessment of 146 000 prenatal karyotypes: expected limitations if only chromosome-specific probes and fluorescent in-situ hybridization are used

The development of chromosome-specific probes (CSP) and fluorescent in-situ hybridization (FISH) has allowed for very rapid identification of selected numerical abnormalities. We attempt here to determine, in principle, what percentage of abnormalities would be detectable if only CSP-FISH were performed without karyotype for prenatal diagnosis. A total of 146 128 consecutive karyotypes for prenatal diagnosis from eight centres in four countries for 5 years were compared with predicted detection if probes for chromosomes 13, 18, 21, X and Y were used, and assuming 100% detection efficiency. A total of 4163 abnormalities (2.85%) were found including 2889 (69.4%) (trisomy 21, trisomy 18, trisomy 13, numerical sex chromosome abnormalities, and triploidies) which were considered detectable by FISH. Of these, 1274 were mosaics, translocations, deletions, inversions, rings, and markers which would not be considered detectable. CSP-FISH is a useful adjunct to karyotype for high risk situations, and may be appropriate in low risk screening, but should not be seen as a replacement for karyotype as too many structural chromosome abnormalities will be misse

Developing mHealth Apps with researchers: multi-stakeholder design considerations

The authors have been involved with developing a number of mHealth smartphone Apps for use in health or wellness research in collaboration with researchers, clinicians and patient groups for clinical areas including Sickle Cell Disease, Attention Deficit Hyperactivity Disorder, asthma and infertility treatment. In these types of applications, end-users self-report their symptoms and quality of life or conduct psychometric tests. Physiological data may also be captured using sensors that are internal or external to the device. Following a discussion of the multiple stakeholders that are typically involved in small scale research projects involving end-user data collection, four Apps are used as case studies to explore the issue of non-functional requirements