Use of Chloroform in Labor.

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Deaths from stroke in US young adults, 1989-2009.

ObjectiveTo determine what the trends in stroke mortality have been over 2 decades in young adults.MethodsIn this cohort study, we analyzed death certificate data for ischemic and hemorrhagic stroke (intracerebral hemorrhage [ICH] and subarachnoid hemorrhage [SAH]) in adults aged 20-44 in the United States for 1989 through 2009, covering approximately 2.2 billion person-years. Poisson regression was used to calculate and compare time trend data between groups and to compare trends in young adults to those in adults over age 45.ResultsMortality from stroke in young adults declined by 35% over the study period, with reductions in all 3 stroke subtypes (ischemic stroke decreased by 15%, ICH by 47%, and SAH by 50%). Black race was a risk factor for all 3 stroke subtypes (relative risk 2.4 for ischemic stroke, 4.0 for ICH, and 2.1 for SAH), but declines in all stroke subtypes were more dramatic in black compared to white participants (p < 0.001 for all stroke subtypes).ConclusionsAlthough hospitalizations for stroke in young patients have been increasing, the apparent decrease in mortality rates and in racial disparities suggests that recognition and treatment in this group may be improving

Scaling of stiffness energy for 3d +/-J Ising spin glasses

Large numbers of ground states of 3d EA Ising spin glasses are calculated for sizes up to 10^3 using a combination of a genetic algorithm and Cluster-Exact Approximation. A detailed analysis shows that true ground states are obtained. The ground state stiffness (or domain wall) energy D is calculated. A D ~ L^t behavior with t=0.19(2) is found which strongly indicates that the 3d model has an equilibrium spin-glass-paramagnet transition for non-zero T_c.Comment: 4 pages, 4 figure

Ordered phase in the two-dimensional randomly coupled ferromagnet

True ground states are evaluated for a 2d Ising model with random near neighbor interactions and ferromagnetic second neighbor interactions (the Randomly Coupled Ferromagnet). The spin glass stiffness exponent is positive when the absolute value of the random interaction is weaker than the ferromagnetic interaction. This result demonstrates that in this parameter domain the spin glass like ordering temperature is non-zero for these systems, in strong contrast to the 2d Edwards-Anderson spin glass.Comment: 7 pages; 9 figures; revtex; new version much extende

Platelet‐Oriented Inhibition in New TIA and Minor Ischemic Stroke ( POINT ) Trial: Rationale and design

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99014/1/ijs12129.pd

Ground-state behavior of the 3d +/-J random-bond Ising model

Large numbers of ground states of the three-dimensional $\pm J$ random-bond Ising model are calculated for sizes up to $14^3$ using a combination of a genetic algorithm and Cluster-Exact Approximation. Several quantities are calculated as function of the concentration $p$ of the antiferromagnetic bonds. The critical concentration where the ferromagnetic order disappears is determined using the Binder cumulant of the magnetization. A value of $p_c=0.222\pm 0.005$ is obtained. From the finite-size behavior of the Binder cumulant and the magnetization critical exponents $\nu=1.1 \pm 0.3$ and $\beta=0.2 \pm 0.1$ are calculated.Comment: 8 pages, 11 figures, revte

Cilostazol for Secondary Stroke Prevention: History, Evidence, Limitations, and Possibilities

Cilostazol is a phosphodiesterase III inhibitor with a long track record of safety that is FDA and EMA approved for the treatment of claudication in patients with peripheral arterial disease. In addition, cilostazol has been approved for secondary stroke prevention in several Asian countries based on trials that have demonstrated a reduction in stroke recurrence among patients with non-cardioembolic stroke. The onset of benefit appears after 60–90 days of treatment, which is consistent with cilostazol’s pleiotropic effects on platelet aggregation, vascular remodeling, blood flow, and plasma lipids. Cilostazol appears safe and does not increase the risk of major bleeding when given alone or in combination with aspirin or clopidogrel. Adverse effects such as headache, gastrointestinal symptoms and palpitations, however, contributed to a 6% increase in drug discontinuation among patients randomized to cilostazol in a large secondary stroke prevention trial (CSPS.com). Due to limitations of prior trials, such as open label design, premature trial termination, large loss to follow-up, lack of functional or cognitive outcome data, and exclusive enrollment in Asia, the existing trials have not led to a change in clinical practice or guidelines in Western countries. These limitations could be addressed by a double-blind placebo-controlled randomized trial conducted in a broader population. If positive, it would increase the evidence in support of long-term treatment with cilostazol for secondary prevention in the millions of patients worldwide who have suffered a non-cardioembolic ischemic stroke

Low back pain education and short term quality of life: a randomized trial

BACKGROUND: Different interventions can reduce the burden of the chronic low back pain. One example is the use of a 'Back School Programme'. This is a brief therapy that uses a health education method to empower participants through a procedure of assessment, education and skill development. This study aimed to evaluate to what extent the programme could improve quality of life in those who suffer from the condition. METHODS: This was a randomized controlled trial. One-hundred and two female patients with low back pain (n = 102) were randomly allocated into two groups, matched in terms of age, weight, education, socioeconomic status, occupation and some aspects of risk behavior. Group 1 (back school group, n = 50) but not group 2 (clinic group, n = 52) received the 'Back School Programme'. Then quality of life using the Short Form Health Survey (SF-36) was assessed at two time points: at baseline and at three months follow-up. The findings were compared both within and between two groups. RESULTS: The 'Back School Programme' was effective in improving patients' quality of life; significant differences were found on all eight subscales of the SF-36 for group 1. In the clinic group (group 2), improvement was observed on three scales (bodily pain, vitality and mental health) but these improvements were less than in group 1. The mean improvement over all eight subscales of the SF-36 was significantly better for the 'Back School Programme' group. CONCLUSION: The 'Back School Programme' is an effective intervention and might improve the quality of life over a period of 3 months in patients who experience chronic low back pain

A new method for analyzing ground-state landscapes: ballistic search

A ``ballistic-search'' algorithm is presented which allows the identification of clusters (or funnels) of ground states in Ising spin glasses even for moderate system sizes. The clusters are defined to be sets of states, which are connected in state-space by chains of zero-energy flips of spins. The technique can also be used to estimate the sizes of such clusters. The performance of the method is tested with respect to different system sizes and choices of parameters. As an application the ground-state funnel structure of two-dimensional +or- J spin glasses of systems up to size L=20 is analyzed by calculating a huge number of ground states per realization. A T=0 entropy per spin of s_0=0.086(4)k_B is obtained.Comment: 10 pages, 11 figures, 35 references, revte

Calculation of ground states of four-dimensional +or- J Ising spin glasses

Ground states of four-dimensional (d=4) EA Ising spin glasses are calculated for sizes up to 7x7x7x7 using a combination of a genetic algorithm and cluster-exact approximation. The ground-state energy of the infinite system is extrapolated as e_0=-2.095(1). The ground-state stiffness (or domain wall) energy D is calculated. A D~L^{\Theta} behavior with \Theta=0.65(4) is found which confirms that the d=4 model has an equilibrium spin-glass-paramagnet transition for non-zero T_c.Comment: 5 pages, 3 figures, 31 references, revtex; update of reference