Reasons and evolution of non-thrombolysis in acute ischaemic stroke.

Despite increasing evidence of its efficacy in advanced age or in mild or severe strokes, intravenous thrombolysis remains underused for acute ischaemic stroke (AIS). Our aim was to obtain an updated view of reasons for non-thrombolysis and to identify its changing patterns over time. This is a retrospective study of prospectively collected data from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) from the years 2003-2011. Patients admitted with acute stroke in the past 24 hours who had not had thrombolysis were identified; reasons for non-thrombolysis documented in the prospectively entered data were tabulated and analysed for the group as a whole. Data were analysed for the years 2003-2006 and 2007 forward because of changes in contraindications. A subgroup of patients who arrived within the treatment window ≤180 min was separately analysed for reasons for non-thrombolysis. Predictors of non-thrombolysis were investigated via multivariate regression analyses. In the 2019 non-thrombolysed patients the most frequent reasons for non-thrombolysis were admission delays (66.3%), stroke severity (mostly mild) (47.9%) and advanced age (14.1%); 55.9% had more than one exclusion criterion. Among patients arriving ≤180 min after onset, the main reasons were stroke severity and advanced age. After 2006, significantly fewer patients were excluded because of age (OR 2.65, p<0.001) or (mostly mild) stroke severity (OR 10.56, p=0.029). Retrospectively, 18.7% of all non-thrombolysed patients could have been treated because they only had relative contraindications. Onset-to-admission delays remain the main exclusion criterion for thrombolysis. Among early arrivals, relative contraindications such as minor stroke severity and advanced age were frequent. Thrombolysis rate increased with the reduction of thrombolysis restrictions (eg, age and stroke severity)

Color processing in the early visual system of Drosophila

Color vision extracts spectral information by comparing signals from photoreceptors with different visual pigments. Such comparisons are encoded by color-opponent neurons that are excited at one wavelength and inhibited at another. Here, we examine the circuit implementation of color-opponent processing in the Drosophila visual system by combining two-photon calcium imaging with genetic dissection of visual circuits. We report that coloropponent processing of UVshort/blue and UVlong/green is already implemented in R7/R8 inner photoreceptor terminals of "pale'' and "yellow'' ommatidia, respectively. R7 and R8 photoreceptors of the same type of ommatidia mutually inhibit each other directly via HisCl1 histamine receptors and receive additional feedback inhibition that requires the second histamine receptor Ort. Color-opponent processing at the first visual synapse represents an unexpected commonality between Drosophila and vertebrates; however, the differences in the molecular and cellular implementation suggest that the same principles evolved independently

Incidence of Huanglongbing on several sweet orange cultivars budded onto different rootstocks at the Citrus Experimental Station (EECB), Bebedouro, São Paulo, Brazil.

Huanglongbing (HLB), caused by Candidatus Liberibacter asiaticus and Ca. L. americanus and vectored by Diaphorina citri Kuwayama, was first reported in 2004 in Brazil and it is currently widespread in São Paulo State (Belasque et al., 2010). The EECB, in partnership with Embrapa Cassava & Fruits, conducts a citrus improvement program aimed to select scion and rootstock Citrus cultivars mainly focused on the resistance or tolerance to biotic and abiotic stresses

Cusp energetic particle events: Implications for a major acceleration region of the magnetosphere

The Charge and Mass Magnetospheric Ion Composition Experiment (CAMMICE) on board the Polar spacecraft observed 75 energetic particle events in 1996 while the satellite was at apogee. All of these events were associated with a decrease in the magnitude of the local magnetic field measured by the Magnetic Field Experiment (MFE) on Polar. These new events showed several unusual features: (1) They were detected in the dayside polar cusp near the apogee of Polar with about 79% of the total events in the afternoonside and 21% in the morningside; (2) an individual event could last for hours; (3) the measured helium ion had energies up to and many times in excess of 2.4 MeV; (4) the intensity of 1–200 KeV/e helium was anticorrelated with the magnitude of the local geomagnetic field but correlated with the turbulent magnetic energy density; (5) the events were associated with an enhancement of the low-frequency magnetic noise, the spectrum of which typically extends from a few hertz to a few hundreds of hertz as measured by the Plasma Wave Instrument (PWI) on Polar; and (6) a seasonal variation was found for the occurrence rate of the events with a maximum in September. These characterized a new phenomenon which we are calling cusp energetic particle (CEP) events. The observed high charge state of helium and oxygen ions in the CEP events indicates a solar source for these particles. Furthermore, the measured 0.52–1.15 MeV helium flux was proportional to the difference between the maximum and the minimum magnetic field in the event. A possible explanation is that the energetic helium ions are energized from lower energy helium by a local acceleration mechanism associated with the high-altitude dayside cusp. These observations represent a potential discovery of a major acceleration region of the magnetosphere

Decreasing Clostridium Difficile Health Care - Associated Infections Through Use of a Launderable Mattress Cover

BACKGROUND: The annual incidence of Clostridium difficile infection (CDI) in the United States is estimated to be 330,000 cases. We evaluated the impact of using a launderable mattress and bed deck cover on the incidence of hospital-onset CDI in two long-term acute care hospitals (LTACH)s. METHODS: Two LTACH hospitals began using a launderable mattress and bed deck cover on beds starting in May of 2013. One facility had 74 beds and the other had 30 beds. Covers were changed after every patient. The covers were laundered using hot water, detergent, and chlorine. Rates for CDIs were compared using Poisson regression between the 16 months before use of the launderable cover and the 14 months after the cover started being used. RESULTS: At Hospital A, the use of bedcovers reduced the rate of infections by 47.8% (95% CI 47.1 – 48.6), controlling for the rate of hand washing compliance and length of stay in days. At Hospital B, the use of bedcovers reduced the rate of infections by 50% (95% CI 47.5 – 52.7), controlling for the rate of hand washing compliance and length of stay in days. CONCLUSIONS: The use of a launderable cover for mattresses and bed decks of hospital beds was associated with a decreased rate of healthcare associated CDIs in two LTACHs