Safety and tolerability of NXY-059 for acute intracerebral hemorrhage: the CHANT trial

<p><b>Background and Purpose:</b> NXY-059 is a free radical-trapping neuroprotectant developed for use in acute ischemic stroke. To facilitate prompt administration of treatment, potentially before neuroimaging, we investigated the safety of NXY-059 in patients with intracerebral hemorrhage (ICH).</p> <p><b>Methods:</b> We randomized 607 patients within 6 hours of acute ICH to receive 2270 mg intravenous NXY-059 over 1 hour and then up to 960 mg/h over 71 hours, or matching placebo, in addition to standard care. The primary outcome was safety: the mortality and the frequency of adverse events, and the change from baseline for a variety of serum, imaging, and electrophysiological measurements. We also studied the overall distribution of disability scores on the modified Rankin Scale (mRS) and the Barthel index.</p> <p><b>Results:</b> We treated 300 patients with NXY-059 and 303 with placebo. Treatment groups were well matched for prognostic variables including Glasgow Coma Scale, risk factors, and age. The mean National Institute of Health Stroke Scale score on admission was 14 in both groups. The baseline hemorrhage volume was 22.4±20.1 mL in the NXY-059 group and 23.3±22.8 mL in the placebo group (mean±SD). Most hemorrhages were related to hypertension or anticoagulant use. Mortality was similar in both groups: 20.3% for NXY-059 and 19.8% for placebo-treated patients. The proportion of patients who experienced an adverse event was the same for both groups, whereas for serious adverse events the proportion was slightly higher in the NXY-059 group. However, no pattern emerged to indicate a safety concern. Serum potassium fell transiently in both groups, lower in the NXY-059 group. There were no differences in 3-month function, disability, or neurological deficit scores. The odds ratio for an improved outcome in 3-month mRS scores in the NXY-059 group was 1.01 (95% CI 0.75, 1.35).</p> <p><b>Conclusions:</b> NXY-059 given within 6 hours of acute ICH has a good safety and tolerability profile, with no adverse effect on important clinical outcomes.</p&gt

Phonons in random alloys: the itinerant coherent-potential approximation

We present the itinerant coherent-potential approximation(ICPA), an analytic, translationally invariant and tractable form of augmented-space-based, multiple-scattering theory in a single-site approximation for harmonic phonons in realistic random binary alloys with mass and force-constant disorder. We provide expressions for quantities needed for comparison with experimental structure factors such as partial and average spectral functions and derive the sum rules associated with them. Numerical results are presented for Ni_{55} Pd_{45} and Ni_{50} Pt_{50} alloys which serve as test cases, the former for weak force-constant disorder and the latter for strong. We present results on dispersion curves and disorder-induced widths. Direct comparisons with the single-site coherent potential approximation(CPA) and experiment are made which provide insight into the physics of force-constant changes in random alloys. The CPA accounts well for the weak force-constant disorder case but fails for strong force-constant disorder where the ICPA succeeds.Comment: 19 pages, 12 eps figures, uses RevTex

InAs nanowire transistors with multiple, independent wrap-gate segments

We report a method for making horizontal wrap-gate nanowire transistors with up to four independently controllable wrap-gated segments. While the step up to two independent wrap-gates requires a major change in fabrication methodology, a key advantage to this new approach, and the horizontal orientation more generally, is that achieving more than two wrap-gate segments then requires no extra fabrication steps. This is in contrast to the vertical orientation, where a significant subset of the fabrication steps needs to be repeated for each additional gate. We show that cross-talk between adjacent wrap-gate segments is negligible despite separations less than 200 nm. We also demonstrate the ability to make multiple wrap-gate transistors on a single nanowire using the exact same process. The excellent scalability potential of horizontal wrap-gate nanowire transistors makes them highly favourable for the development of advanced nanowire devices and possible integration with vertical wrap-gate nanowire transistors in 3D nanowire network architectures.Comment: 18 pages, 5 figures, In press for Nano Letters (DOI below

The UK Research Assessment Exercise (RAE 2008) and retail research output

The 2008 Research Assessment Exercise (RAE) in the United Kingdom provides a further opportunity to consider changing trends and patters in retail research, following on a previous commentary (Dawson et al. 2004). This comparison with shows that pressures continue to mount and are impacting retail knowledge creation and dissemination practices, not least in terms of those engaged in retail research, the topics and approaches utilised, the publication tactics and strategies and thus the standing of retail research in the UK and its reputation internationall

Coulomb correlation effects in zinc monochalcogenides

Electronic structure and band characteristics for zinc monochalcogenides with zinc-blende- and wurtzite-type structures are studied by first-principles density-functional-theory calculations with different approximations. It is shown that the local-density approximation underestimates the band gap and energy splitting between the states at the top of the valence band, misplaces the energy levels of the Zn-3d states, and overestimates the crystal-field-splitting energy. Regardless of the structure type considered, the spin-orbit-coupling energy is found to be overestimated for ZnO and underestimated for ZnS with wurtzite-type structure, and more or less correct for ZnSe and ZnTe with zinc-blende-type structure. The order of the states at the top of the valence band is found to be anomalous for ZnO in both zinc-blende- and wurtzite-type structure, but is normal for the other zinc monochalcogenides considered. It is shown that the Zn-3d electrons and their interference with the O-2p electrons are responsible for the anomalous order. The typical errors in the calculated band gaps and related parameters for ZnO originate from strong Coulomb correlations, which are found to be highly significant for this compound. The LDA+U approach is by and large found to correct the strong correlation of the Zn-3d electrons, and thus to improve the agreement with the experimentally established location of the Zn-3d levels compared with that derived from pure LDA calculations

A First Comparison of the responses of a He4-based fast-neutron detector and a NE-213 liquid-scintillator reference detector

A first comparison has been made between the pulse-shape discrimination characteristics of a novel $^{4}$He-based pressurized scintillation detector and a NE-213 liquid-scintillator reference detector using an Am/Be mixed-field neutron and gamma-ray source and a high-resolution scintillation-pulse digitizer. In particular, the capabilities of the two fast neutron detectors to discriminate between neutrons and gamma-rays were investigated. The NE-213 liquid-scintillator reference cell produced a wide range of scintillation-light yields in response to the gamma-ray field of the source. In stark contrast, due to the size and pressure of the $^{4}$He gas volume, the $^{4}$He-based detector registered a maximum scintillation-light yield of 750~keV$_{ee}$ to the same gamma-ray field. Pulse-shape discrimination for particles with scintillation-light yields of more than 750~keV$_{ee}$ was excellent in the case of the $^{4}$He-based detector. Above 750~keV$_{ee}$ its signal was unambiguously neutron, enabling particle identification based entirely upon the amount of scintillation light produced.Comment: 23 pages, 7 figures, Nuclear Instruments and Methods in Physics Research Section A review addresse

Towards a first principles description of phonons in Ni50_{50}Pt50_{50} disordered alloys: the role of relaxation

Using a combination of density-functional perturbation theory and the itinerant coherent potential approximation, we study the effects of atomic relaxation on the inelastic incoherent neutron scattering cross sections of disordered Ni$_{50}$Pt$_{50}$ alloys. We build on previous work, where empirical force constants were adjusted {\it ad hoc} to agree with experiment. After first relaxing all structural parameters within the local-density approximation for ordered NiPt compounds, density-functional perturbation theory is then used to compute phonon spectra, densities of states, and the force constants. The resulting nearest-neighbor force constants are first compared to those of other ordered structures of different stoichiometry, and then used to generate the inelastic scattering cross sections within the itinerant coherent potential approximation. We find that structural relaxation substantially affects the computed force constants and resulting inelastic cross sections, and that the effect is much more pronounced in random alloys than in ordered alloys.Comment: 8 pages, 3 eps figures, uses revtex

Results of matching valve and root repair to aortic valve and root pathology

ObjectiveFor patients with aortic root pathology and aortic valve regurgitation, aortic valve replacement is problematic because no durable bioprosthesis exists, and mechanical valves require lifetime anticoagulation. This study sought to assess outcomes of combined aortic valve and root repair, including comparison with matched bioprosthesis aortic valve replacement.MethodsFrom November 1990 to January 2005, 366 patients underwent modified David reimplantation (n = 72), root remodeling (n = 72), or valve repair with sinotubular junction tailoring (n = 222). Active follow-up was 99% complete, with a mean of 5.6 ± 4.0 years (maximum 17 years); follow-up for vital status averaged 8.5 ± 3.6 years (maximum 19 years). Propensity-adjusted models were developed for fair comparison of outcomes.ResultsThirty-day and 5-, 10-, and 15-year survivals were 98%, 86%, 74%, and 58%, respectively, similar to that of the US matched population and better than that after bioprosthesis aortic valve replacement. Propensity-score–adjusted survival was similar across procedures (P > .3). Freedom from reoperation at 30 days and 5 and 10 years was 99%, 92%, and 89%, respectively, and was similar across procedures (P > .3) after propensity-score adjustment. Patients with tricuspid aortic valves were more likely to be free of reoperation than those with bicuspid valves at 10 years (93% vs 77%, P = .002), equivalent to bioprosthesis aortic valve replacement and superior after 12 years. Bioprostheses increasingly deteriorated after 7 years, and hazard functions for reoperation crossed at 7 years.ConclusionsValve preservation (rather than replacement) and matching root procedures have excellent early and long-term results, with increasing survival benefit at 7 years and fewer reoperations by 12 years. We recommend this procedure for experienced surgical teams

Does right thoracotomy increase the risk of mitral valve reoperation?

ObjectiveThe study objective was to determine whether a right thoracotomy approach increases the risk of mitral valve reoperation.MethodsBetween January of 1993 and January of 2004, 2469 patients with mitral valve disease underwent 2570 reoperations (1508 replacements, 1062 repairs). The approach was median sternotomy in 2444 patients, right thoracotomy in 80 patients, and other in 46 patients. Multivariable logistic regression was used to identify factors associated with median sternotomy versus right thoracotomy, mitral valve repair versus replacement, hospital death, and stroke. Factors favoring median sternotomy (P < .03) included coronary artery bypass grafting (30% vs 2%), aortic valve replacement (39% vs 2%), tricuspid valve repair (27% vs 13%), fewer previous cardiac operations, more recent reoperation, and no prior left internal thoracic artery graft. These factors were used to construct a propensity score for risk-adjusting outcomes.ResultsHospital mortality was 6.7% (163/2444) for the median sternotomy approach and 6.3% (5/80) for the thoracotomy approach (P = .9). Risk factors (P < .04) included earlier surgery date, higher New York Heart Association class, emergency operation, multiple reoperations, and mitral valve replacement. Stroke occurred in 66 patients (2.7%) who underwent a median sternotomy and in 6 patients (7.5%) who underwent a thoracotomy (P = .006). Mitral valve replacement (vs repair) was more common in those receiving a thoracotomy (P < .04).ConclusionsCompared with median sternotomy, right thoracotomy is associated with a higher occurrence of stroke and less frequent mitral valve repair. Specific strategies for conducting the operation should be used to reduce the risk of stroke when right thoracotomy is used for mitral valve reoperation. In most instances, repeat median sternotomy, with its better exposure and greater latitude for concomitant procedures, is preferred