Exploratory study of plasma total homocysteine and its relationship to short-term outcome in acute ischaemic stroke in Nigerians

<p>Abstract</p> <p>Background</p> <p>Hyperhomocysteinemia is a potentially modifiable risk factor for stroke, and may have a negative impact on the course of ischaemic stroke. The role of hyperhomocysteinemia as it relates to stroke in Africans is still uncertain. The objective of this study was to determine the prevalence and short-term impact of hyperhomocysteinemia in Nigerians with acute ischaemic stroke. We hypothesized that Hcy levels are significantly higher than in normal controls, worsen stroke severity, and increase short-term case fatality rates following acute ischaemic stroke.</p> <p>Methods</p> <p>The study employed both a case-control and prospective follow-up design to study hospitalized adults with first – ever acute ischaemic stroke presenting within 48 hours of onset. Clinical histories, neurological evaluation (including National Institutes of Health Stroke Scale (NIHSS) scores on admission) were documented. Total plasma Hcy was determined on fasting samples drawn from controls and stroke cases (within 24 hours of hospitalization). Outcome at 4 weeks was assessed in stroke patients using the Glasgow Outcome Scale (GOS).</p> <p>Results</p> <p>We evaluated 155 persons (69 acute ischaemic stroke and 86 healthy controls). The mean age ± SD of the cases was 58.8 ± 9.8 years, comparable to that of controls which was 58.3 ± 9.9 years (T = 0.32; P = 0.75). The mean duration of stroke (SD) prior to hospitalization was 43.5 ± 38.8 hours, and mean admission NIHSS score was 10.1 ± 7.7. Total fasting Hcy in stroke patients was 10.2 ± 4.6 umol/L and did not differ significantly from controls (10.1 ± 3.6 umol/L; P = 0.88). Hyperhomocysteinemia, defined by plasma Hcy levels > 90^thpercentile of controls (>14.2 umol/L in women and >14.6 umol/L in men), was present in 7 (10.1%) stroke cases and 11 (12.8%) controls (odds ratio 0.86, 95% confidence interval 0.31 – 2.39; P > 0.05). In multiple regression analysis admission NIHSS score (but not plasma Hcy) was a significant determinant of 4 week outcome measured by GOS score (P < 0.0001).</p> <p>Conclusion</p> <p>This exploratory study found that homocysteine levels are not significantly elevated in Nigerians with acute ischaemic stroke, and admission Hcy level is not a determinant of short-term (4 week) stroke outcome.</p

A Program for At-Risk High School Students Informed by Evolutionary Science

Improving the academic performance of at-risk high school students has proven difficult, often calling for an extended day, extended school year, and other expensive measures. Here we report the results of a program for at-risk 9th and 10th graders in Binghamton, New York, called the Regents Academy that takes place during the normal school day and year. The design of the program is informed by the evolutionary dynamics of cooperation and learning, in general and for our species as a unique product of biocultural evolution. Not only did the Regents Academy students outperform their comparison group in a randomized control design, but they performed on a par with the average high school student in Binghamton on state-mandated exams. All students can benefit from the social environment provided for at-risk students at the Regents Academy, which is within the reach of most public school districts

There is no such thing as ‘undisturbed’ soil and sediment sampling: sampler-induced deformation of salt marsh sediments revealed by 3D X-ray computed tomography

Purpose: Within most environmental contexts, the collection of 'undisturbed' samples is widely relied-upon in studies of soil and sediment properties and structure. However, the impact of sampler-induced disturbance is rarely acknowledged, despite the potential significance of modification to sediment structure for the robustness of data interpretation. In this study, 3D-computed X-ray microtomography (μCT) is used to evaluate and compare the disturbance imparted by four commonly-used sediment sampling methods within a coastal salt-marsh. Materials and methods: Paired sediment core samples from a restored salt-marsh at Orplands Farm, Essex, UK were collected using four common sampling methods (push, cut, hammer and gouge methods). Sampling using two different area-ratio cores resulted in a total of 16 cores that were scanned using 3D X-Ray computed tomography, to identify and evaluate sediment structural properties of samples that can be attributed to sampling method. Results and discussion: 3D qualitative analysis identifies a suite of sampling-disturbance structures including gross-scale changes to sediment integrity and substantial modification of pore-space, structure and distribution, independent of sediment strength and stiffness. Quantitative assessment of changes to pore-space and sediment density arising from the four sampling methods offer a means of direct comparison between the impact of depth-sampling methods. Considerable disturbance to samples result from use of push, hammer and auguring samplers, whilst least disturbance is found in samples recovered by cutting and advanced trimming approaches. Conclusions: It is evident that with the small-bore tubes and samplers commonly used in environmental studies, all techniques result in disturbance to sediment structure to a far greater extent than previously reported, revealed by μCT. This work identifies and evaluates for the first time the full nature, extent and significance of internal sediment disturbance arising from common sampling methods

The epidemiology of enterococci

The enterococci are emerging as a significant cause of nosocomial infections, accounting for approximately 10 % of hospital acquired infections. They are found as normal inhabitants of the human gastrointestinal tract, but may also colonize the oropharynx, vagina, perineal region and soft tissue wounds of asymtomatic patients. Until recently, evidence indicated that most enterococcal infections arose from patients' own endogenous flora. Recent studies, however, suggest that exogeneous acquisition may occur and that person-to-person spread, probably on the hands of medical personnel, may be a significant mode of transmission of resistant enterococci within the hospital. The use of broad-spectrum antibiotics, especially cephalosporins, is another major factor in the increasing incidence of enterococcal infections. These findings suggest that barrier precautions, as applied with other resistant nosocomial pathogens, along with more judicial use of antibiotics may be beneficial in preventing nosocomial spread of resistant enterococci.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47899/1/10096_2005_Article_BF01963631.pd

A 140-year record of recent changes in aquatic productivity in a remote, tropical alpine lake in the Rwenzori Mountain National Park, Uganda

Environmental change in many tropical, alpine habitats remains poorly resolved due to an absence of proximate and sustained observations. In the Rwenzori Mountains of East Africa, glaciers have receded rapidly over the last century, and here we assess the impact of this recession through palaeolimnological analyses of a 45 cm sediment core (Buju3) from Lake Bujuku which is closest to the ice-fields and partly supplied by melt water in-flows. 210Pb and 137Cs suggest that Buju3 has an average sedimentation rate of 2.9 mm yr-1 and the base of the core can be dated to 1864 ± 20 years. Contemporary diatom taxa found in the lake are dominated by Tabellaria flocculosa and Synedra spp, but also include Achnanthes minutissima and Fragilaria pinnata. However, the diatom flora for Buju3 is less diverse and dominated by small, tychoplanktonic species of Fragilaria. Over the period associated with glacial recession, organic carbon isotope analysis (δ13C) suggests a small but distinct increase in within-lake productivity, which increases in rate since the mid 1970s up to the present day, in line with a shift towards increased algal productivity (as highlighted by C/N ratios). However, the diatom and pollen records appear rather insensitive to changes in glacier recession since the late 19th century. Key words: Rwenzori Mountains, East Africa, recent environmental change, diatoms, pollen, organic carbon isotope