Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation

Нові поверхнево-активні речовини культури Pseudomonas аureofaciens NB-1

Background. Important problems of technologies of biosurfactants production are the search for active strain-producers, optimization of their biosynthesis, as well as elaboration of effective methods of biosurfactants isolation from cultural liquid after fermentation.Objective. The influence of extractants to release surfactant lipids from the supernatant of cultural liquid of the strain P. aureofaciens NB-1 and investigation of their ability to use for protection of the steel against corrosion.Methods. Surfactants were isolated by extraction of various solvents and their mixtures, their composition and weight were analyzed. The effectiveness of corrosion inhibition was analyzed by corrosion rate of steel plates.Results. Microorganisms of strain P. aureofaciens NB-1 synthesize extracellular biosurfactants of rhamnolipid and lipopeptid nature. It was shown that at pH 11, biosurfactants yield using ethylacetate and isopropanol (2:1) was 3.71 g/L, exceeding their output at pH 3 to 54 %. The efficacy of using the supernatant of cultural liquid P. aureofaciens NB-1 (dilution 1:10) for corrosion protection of St3 steel in aggressive medium was shown.Conclusions. The methods of optimal isolation of surfactant of P. aureofaciens NB-1by the selection solvents and control of pH indicators were elaborated. As a result the synthesis parameters were significantly increased. It was shown that obtained product is perspective as inhibitor of metal corrosion. Проблематика. При создании технологий биогенных поверхностно-активных веществ (ПАВ) актуальными проблемами являются как поиск активных штаммов-продуцентов и оптимизация их биосинтеза, так и разработка эффективных способов их выделения из постферментационной культуральной жидкости.Цель исследования. Исследование влияния экстрагирующего вещества на выход поверхностно-активных липидов из супернатанта культуральной жидкости штамма P. aureofaciens NB-1 и их использование для защиты стали от коррозии.Методика реализации. ПАВ выделяли путем экстракции растворителями различной природы и их смесями, сравнивали их массы, анализировали состав. Эффективность действия ПАВ как ингибиторов коррозии анализировали по скорости коррозии.Результаты исследований. Микроорганизмы рода P. aureofaciens NB-1 синтезируют внеклеточные ПАВ рамнолипидной и липопептидной природы. При рН 11 количество извлеченных ПАВ при использовании этилацетата с изопропанолом (2:1) достигало 3,71 г/л, что превышало их выход при рН 3 на 54 %. Показана эффективность использования супернатанта культу­ральной жидкости P. aureofaciens NB-1 при разведении 1:10 для защиты от коррозии стали Ст3 в агрессивных средах.Выводы. Результаты показывают, что путем подбора оптимального экстрагента и регулированием рН можно существенно повысить показатели синтеза ПАВ штамма P. aureofaciens NB-1, а полученный продукт перспективен как экологически безопасный ингибитор коррозии металлов.Проблематика. При створенні технологій біогенних поверхнево-активних речовин (ПАР) актуальними проблемами є як пошук активних штамів-продуцентів й оптимізація їх біосинтезу, так і розроблення ефективних способів виділення продуктів із постферментаційної культуральної рідини.Мета досліджень. Дослідження впливу екстрагуючої речовини на вихід поверхнево-активних ліпідів із супернатанту культуральної рідини штаму P. aureofaciens NB-1 та їх використання для захисту сталі від корозії.Методика реалізації. ПАР виділяли екстракцією розчинниками різної природи та їх сумішами, порівнювали маси екстрактів та їх склад. Ефективність дії ПАР як інгібіторів корозії аналізували за швидкістю корозії.Результати дослідження. Мікроорганізми роду P. aureofaciens NB-1 синтезують позаклітинні ПАР рамноліпідної та ліпопептидної природи. При рН 11 кількість вилучених ПАР при використанні етилацетату з ізопропанолом (2:1) сягає 3,71 г/л, що перевищує їх вихід за рН 3 на 54 %. Показано ефективність використання супернатанту культуральної рідини P. aureofaciens NB-1 за розведення 1:10 для захисту від корозії сталі Ст3 в агресивних середовищах.Висновки. Результати показують, що підбором оптимального екстрагента та регулюванням рН можна істотно підвищити вихід ПАР штаму P. aureofaciens NB-1, а отриманий продукт є перспективним як екологічно безпечний інгібітор корозії металів

Sodium Citrate as an Environmentally Friendly Corrosion Inhibitor of Steel in a Neutral Environment

In this work we investigated the inhibiting effect of sodium citrate, an environmentally safe corrosion inhibitor, on low-alloy steel 09G2S in a neutral environment using electrochemical methods. Potentiodynamic studies showed that sodium citrate reduces corrosion currents of 09G2S steel in a 0.1% NaCl solution and reaches its maximum efficiency at a concentration of 2.5 g/l. Electrochemical impedance spectroscopy results indicate the adsorption of citrate ions and the formation of a protective film, which probably consists of Fe-citrate complexes. The formation of a protective film on the steel surface in sodium citrate-inhibited solutions was confirmed by the results of scanning electron microscopy and EDX analysis. Hence, our research shows that sodium citrate has satisfactory anticorrosion properties and can be used as a basic component during the development of environmentally safe inhibitor compositions for the protection of low-alloyed carbon steels in neutral environments of recirculating water supply systems in petroleum refineries, petrochemical plants, and other industries

Tectonic and metallogenic implications of W-Sn related granitoid rocks in the Kawthaung-Bankachon area, southernmost part of Myanmar: Constraints from petrology, geochemistry, and U-Pb zircon geochronology

Granitoid rocks are widely distributed along the N-S trending tectonic belts encompassing Myanmar, Thailand, Peninsular Malaysia, and Indonesia and these granitoid rocks are host to the world's largest deposits of tin-tungsten, in terms of both production and reserves. The investigated study area belongs to the southernmost part of the Central Cretaceous-Eocene granitoid belt of SE Asia in the border region of Myanmar and Thailand within the Sibumasu or Shan-Thai Terrane. The granitoid units in the area are biotite granite, muscovite-biotite granite, porphyritic biotite granite, and diorite which occur locally as dykes. All granitic rocks in the area are recognized in the High-K calc-alkaline series and show a high abundance of Cs, Rb, U, Th, K, Pb, Nd, Zr, and Sn. Based on the major oxide composition and tectonic discrimination diagram, all granitoid rocks in the area fall in the peraluminous, S-type granite category and within the Post-Orogenic Granite and Post-Collisional Granite fields. Radiometric dating by LA ICP-MS U-Pb zircon method yielded the ages of 78.97 ± 0.63 Ma (biotite granite), 79.59 ± 0.76 Ma (muscovite-biotite granite), and 79.14 ± 0.91 Ma (porphyritic biotite granite) and 49.48 ± 0.83 Ma for the biotite granite from the Yadanabon W-Sn deposit. According to the zircon U-Pb ages, the timing of the granitoid intrusions of the Kawthaung-Bankachon area is the Campanian (Late Cretaceous) to Eocene. The magmatism and W-Sn mineralization in the area is attributable to the Indian Ocean subduction and collision between the west Myanmar Terrane and the Sibumasu Terrane

Створення й обґрунтування матриці модельних рядів трубних пропелерних турбін для малих ГЕС

Статтю присвячено подальшому розвитку малої гідроенергетики на базі надійних і дешевих нерегульованих трубних пропелерних гідротурбін з жорстко зафіксованими робочими і напрямними лопатями. Такі турбіни використовуються переважно на низьконапірних малих ГЕС. Основним їх недоліком є неможливість регулювання генерованої потужності. Однак у статті запропоновано рішення, які цей недолік зводять до мінімуму. Створено матрицю модельних рядів трубних пропелерних гідротурбін, на основі якої підприємства зможуть налагоджувати випуск технічно й екологічно обґрунтованої номенклатури таких машин. Матриця складається з чотирьох модельних рядів, кожен з яких містить шість моделей турбін (лише другий модельний ряд – сім моделей). Вся матриця містить 25 моделей турбін, але у випадку потреби її можна розширити в бік збільшення або зменшення. Принцип створення матриці полягає в тому, що кожен її модельний ряд є геометричною прогресією зі знаменником 21/2. У якості початку та членів геометричної прогресії виступають діаметри робочих коліс турбін. Методику створення матриці модельних рядів трубних пропелерних гідротурбін можна розповсюдити й на інші типи турбін. Запропоновано також технічно й екологічно обґрунтовані правила комплектування машинних майданчиків низьконапірних малих ГЕС потужності до 200 кВт моделями турбін зі створеної матриці. Згідно з наведеними рекомендаціями на одній ГЕС повинно бути встановлено не менш, ніж дві різні суміжні турбіни з одного модельного ряду. Найкращий варіант – три різні суміжні турбіни з одного модельного ряду, але для детальнішого обґрунтування вибору кількості турбін ще буде потрібно виконати техніко-економічний аналіз. Це буде тематикою наших наступних досліджень. Використання науково-практичних результатів, викладених у статті, дозволить покращити технічні характеристики малих ГЕС з трубними пропелерними турбінами та звести до мінімуму їх можливий негативний вплив на життєдіяльність річкової флори і фауни у нижніх б’єфах.The paper is devoted to further development of small hydropower on the basis of reliable and cheap unregulated tubular propeller hydroturbines with rigidly fixed operating and guide blades. Such turbines are used mainly at low-pressure small hydroelectric power stations. Their main drawback is the impossibility of generated power regulation. However, solutions that minimize this shortcoming are proposed in this paper. Matrix of 4 model series of tubular propeller hydroturbines has been created. The nomenclature of turbines presented in this matrix is aimed at improving technical characteristics of small hydropower plants and reducing their negative impact on the environment. The rules for equipping machine platforms of low-pressure small hydroelectric power plants with capacity up to 200 kW with models of turbines from the created matrix are proposed, and their technical and environmental justification is performed. According to the recommendations given in the paper, at least two different adjacent turbines from the same model line should be installed at one HPP. The best option is three different adjacent turbines from the same model series, but technical and economic analysis should be performed for more detailed justification of the choice of the number of turbines. This is the subject of our further investigations. The application of scientific and practical results presented in the paper will improve technical characteristics of small hydropower plants with tubular propeller turbines and minimize their possible negative impact on the life of river flora and fauna in lower basin