Ultra-Early and Short-Term Tranexamic Acid Treatment in Patients With Good- and Poor-Grade Aneurysmal Subarachnoid Hemorrhage

The results of the ULTRA trial showed that ultra-early and short-term treatment with tranexamic acid (TXA) does not improve clinical outcome after aneurysmal subarachnoid hemorrhage (aSAH). Possibly, the lack of a beneficial effect in all patients with aSAH is masked by antagonistic effects of TXA in certain subgroups. In this post hoc subgroup analysis, we investigated the effect of TXA on clinical outcome in patients with good-grade and poor-grade aSAH

State of the art. Overview of concepts, indicators and methodologies used for analyzing the social OMC.

This paper is a detailed analysis about the literature on the Social OMC from 2006-2010, focusing on how OMC research has been carried out. It specifically points to which theoretical framework/concepts are used, and how change is conceptualised and measured. It is organised in five sections. The first concerns visibility and awareness about the OMC; the second analyses research on the EU level coordination process; the third scrutinizes how features of the OMC have been analysed. The fourth and fifth sections, addressing how national integration of the OMC has been researched, respectively address substantive policy change as well as national policy-making. Strikingly, virtually all OMC research adopts theoretical frameworks derived from literature on Europeanisation and/or institutionalisation. Also, as the OMC is voluntary and sanction-free, it depends heavily on how and the the extent to which actors use it (agenda-setting, conflict resolution, maintaining focus on a policy issue, developing a policy dialogue, etc). OMC research has become nuanced and does highlight how, for which purpose and with which outcome actors engage with the OMC. Another finding is that there is data on policy issues addressed through the OMC, learning does take place and there is knowledge about domestic policy problems. However, the linkage between knowledge of an issue and direct use of the OMC for policy change in social policy is weak, but that may change with EU2020, where social policy has received a higher profile. Most research covers the EU-15, much more research needs to be undertaken in newer EU member states

Association between i.v. thrombolysis volume and door-to-needle times in acute ischemic stroke

Centralization of intravenous thrombolysis (IVT) for acute ischemic stroke in high-volume centers is believed to improve the door-to-needle times (DNT), but limited data support this assumption. We examined the association between DNT and IVT volume in a large Dutch province. We identified consecutive patients treated with IVT between January 2009 and 2013. Based on annualized IVT volume, hospitals were categorized as low-volume (≤ 24), medium-volume (25-49) or high-volume (≥ 50). In logistic regression analysis, low-volume hospitals were used as reference category. Of 17,332 stroke patients from 11 participating hospitals, 1962 received IVT (11.3 %). We excluded 140 patients because of unknown DNT (n = 86) or in-hospital stroke (n = 54). There were two low-volume (total 101 patients), five medium-volume (747 patients) and four high-volume hospitals (974 patients). Median DNT was shorter in high-volume hospitals (30 min) than in medium-volume (42 min, p < 0.001) and low-volume hospitals (38 min, p < 0.001). Patients admitted to high-volume hospitals had a higher chance of DNT < 30 min (adjusted OR 3.13, 95 % CI 1.70-5.75), lower risk of symptomatic intracerebral hemorrhage (adjusted OR 0.39, 95 % CI 0.16-0.92), and a lower mortality risk (adjusted OR 0.45, 95 % CI 0.21-1.01), compared to low-volume centers. There was no difference in DNT between low- and medium-volume hospitals. Onset-to-needle times (ONT) did not differ between the groups. Hospitals in this Dutch province generally achieved short DNTs. Despite this overall good performance, higher IVT volumes were associated with shorter DNTs and lower complication risks. The ONT was not associated with IVT volum

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Electrorefraction in quantum dots

We developed a model to calculate the electrorefraction due to the Quantum Confined Stark Effect in strained cylindrical QDs. We followed a numerical matrix diagonalization method using an expansion in plane-wave states. The correct polarization dependence is obtained by using the 4X4 Luttinger-Kohn Hamiltonian for the valence band. The exciton wavefunction is also calculated using a diagonalization approach. We will present the absorption spectra as a function of applied electric field and dot dimensions and discuss the implications for the electrorefraction

Nonlinear behavior of multi-excitonic recombinations in quantum dots

We studied quantum dot arrays using m-PL measurements. Clear multi-excitonic spectra are observed, which are attributed to homogeneous ensembles of QDs in the array. The spectra can be explained by applying a Hartree-Fock based model including the twobody Coulomb and exchange interactions. Eight lines in the m-PL spectrum are attributed to bi-exciton, excited bi-exciton and multi-exciton transitions. These lines show a clear nonlinear behavior since they only appear at high excitation power