Prevalence, Predictors and Prognosis of Post-Stroke Hyperglycaemia in Acute Stroke Trials: Individual Patient Data Pooled Analysis from the Virtual International Stroke Trials Archive (VISTA)

<br>Background: Post-stroke hyperglycaemia (PSH) is associated with higher mortality and dependence, but further data on predictors of PSH and its evolution over time are required. We examined the prevalence, predictors, and prognosis of acute PSH using data from well-characterised clinical trials in the VISTA database.</br> <br>Methods: Data were extracted for individual participants enrolled <24 h after stroke with ≥1 blood glucose readings documented. PSH was defined as glucose >7.0 mmol/l. Outcome measures were: (1) prevalence of PSH; (2) predictors of PSH by binary logistic regression; (3) mortality, and (4) favourable functional outcome [modified Rankin Scale (mRS) score <2] at day 90.</br> <br>Results: For 2,649 subjects treated at a median 5.5 h after admission, PSH was present in 1,126 (42.6%, 95% CI 40.7–44.5) on admission and within the first 48 h in 1,421 (53.7%, 95% CI 51.8–55.6). PSH developed between 24 and 48 h in 19.4% (95% CI 17.5–21.4) of initially normoglycaemic subjects. Admission and 48-hour PSH were predicted predominantly by a history of diabetes (for admission PSH: OR 7.40, 95% CI 5.60–9.79) and less clearly by stroke severity. Favourable outcome (mRS <2) at day 90 was less likely with PSH within the first 48 h, advanced age, and higher NIHSS score, and more likely with recombinant tissue plasminogen activator treatment.</br> <br>Conclusions: Over 40% of ischaemic stroke patients are hyperglycaemic on admission, and 20% of those who are initially normoglycaemic develop hyperglycaemia within 48 h. Diabetes is the strongest predictor of acute hyperglycaemia. Hyperglycaemia within the first 48 h is independently associated with higher mortality and poorer functional outcome, with an absolute increase of 12.9%.</br&gt

Agile methods in biomedical software development: a multi-site experience report

BACKGROUND: Agile is an iterative approach to software development that relies on strong collaboration and automation to keep pace with dynamic environments. We have successfully used agile development approaches to create and maintain biomedical software, including software for bioinformatics. This paper reports on a qualitative study of our experiences using these methods. RESULTS: We have found that agile methods are well suited to the exploratory and iterative nature of scientific inquiry. They provide a robust framework for reproducing scientific results and for developing clinical support systems. The agile development approach also provides a model for collaboration between software engineers and researchers. We present our experience using agile methodologies in projects at six different biomedical software development organizations. The organizations include academic, commercial and government development teams, and included both bioinformatics and clinical support applications. We found that agile practices were a match for the needs of our biomedical projects and contributed to the success of our organizations. CONCLUSION: We found that the agile development approach was a good fit for our organizations, and that these practices should be applicable and valuable to other biomedical software development efforts. Although we found differences in how agile methods were used, we were also able to identify a set of core practices that were common to all of the groups, and that could be a focus for others seeking to adopt these methods

Long-Wavelength Instability in Marangoni Convection

Our experiments in thin liquid layers (approximately 0.1 mm thick) heated from below reveal a well-defined long-wavelength instability: at a critical temperature difference across the layer, the depth of the layer in the center of the cell spontaneously decreases until the liquid-air interface ruptures and a dry spot forms. The onset of this critical instability occurs at a temperature difference across the liquid layer that is 35% smaller than that predicted in earlier theoretical studies of a single layer model. Our analysis of a two-layer model yields predictions in accord with the observations for liquid layer depths greater than or equal to 0.15 mm, but for smaller depths there is an increasing difference between our predictions and observations (the difference is 25% for a layer 0.06 mm thick). In microgravity environments the long-wavelength instability observed in our terrestrial experiments is expected to replace cellular convection as the primary instability in thick as well as thin liquid layers heated quasistatically from below

Experimental Control of Thermocapillary Convection in a Liquid Bridge

We demonstrate the stabilization of an isolated unstable periodic orbit in a liquid bridge convection experiment. A model independent, nonlinear control algorithm uses temperature measurements near the liquid interface to compute control perturbations which are applied by a thermoelectric element. The algorithm employs a time series reconstruction of a nonlinear control surface in a high dimensional phase space to alter the system dynamics

Climate Change during and after the Roman Empire: Reconstructing the Past from Scientific and Historical Evidence

Growing scientific evidence from modern climate science is loaded with implications for the environmental history of the Roman Empire and its successor societies. The written and archaeological evidence, although richer than commonly realized, is unevenly distributed over time and space. A first synthesis of what the written records and multiple natural archives (multi-proxy data) indicate about climate change and variability across western Eurasia from c. 100 b.c. to 800 a.d. confirms that the Roman Empire rose during a period of stable and favorable climatic conditions, which deteriorated during the Empire's third-century crisis. A second, briefer period of favorable conditions coincided with the Empire's recovery in the fourth century; regional differences in climate conditions parallel the diverging fates of the eastern and western Empires in subsequent centuries. Climate conditions beyond the Empire's boundaries also played an important role by affecting food production in the Nile valley, and by encouraging two major migrations and invasions of pastoral peoples from Central Asia.Earth and Planetary SciencesHistor

Imaging Inter-Edge State Scattering Centers in the Quantum Hall Regime

We use an atomic force microscope tip as a local gate to study the scattering between edge channels in a 2D electron gas in the quantum Hall regime. The scattering is dominated by individual, microscopic scattering centers, which we directly image here for the first time. The tip voltage dependence of the scattering indicates that tunneling occurs through weak links and localized states.Comment: 4 pages, 5 figure

A Detailed Observational Analysis of V1324 Sco, the Most Gamma-Ray Luminous Classical Nova to Date

It has recently been discovered that some, if not all, classical novae emit GeV gamma rays during outburst, but the mechanisms involved in the production of the gamma rays are still not well understood. We present here a comprehensive multi-wavelength dataset---from radio to X-rays---for the most gamma-ray luminous classical nova to-date, V1324 Sco. Using this dataset, we show that V1324 Sco is a canonical dusty Fe-II type nova, with a maximum ejecta velocity of 2600 km s$^{-1}$ and an ejecta mass of few $\times 10^{-5}$ M$_{\odot}$. There is also evidence for complex shock interactions, including a double-peaked radio light curve which shows high brightness temperatures at early times. To explore why V1324~Sco was so gamma-ray luminous, we present a model of the nova ejecta featuring strong internal shocks, and find that higher gamma-ray luminosities result from higher ejecta velocities and/or mass-loss rates. Comparison of V1324~Sco with other gamma-ray detected novae does not show clear signatures of either, and we conclude that a larger sample of similarly well-observed novae is needed to understand the origin and variation of gamma rays in novae.Comment: 26 pages, 13 figure

Scanned Potential Microscopy of Edge and Bulk Currents in the Quantum Hall Regime

Using an atomic force microscope as a local voltmeter, we measure the Hall voltage profile in a 2D electron gas in the quantum Hall (QH) regime. We observe a linear profile in the bulk of the sample in the transition regions between QH plateaus and a distinctly nonlinear profile on the plateaus. In addition, localized voltage drops are observed at the sample edges in the transition regions. We interpret these results in terms of theories of edge and bulk currents in the QH regime.Comment: 4 pages, 5 figure

Prominent role of volcanism in Common Era climate variability and human history

Climate reconstructions for the Common Era are compromised by the paucity of annually-resolved and absolutely-dated proxy records prior to medieval times. Where reconstructions are based on combinations of different climate archive types (of varying spatiotemporal resolution, dating uncertainty, record length and predictive skill), it is challenging to estimate past amplitude ranges, disentangle the relative roles of natural and anthropogenic forcing, or probe deeper interrelationships between climate variability and human history. Here, we compile and analyse updated versions of all the existing summer temperature sensitive tree-ring width chronologies from the Northern Hemisphere that span the entire Common Era. We apply a novel ensemble approach to reconstruct extra-tropical summer temperatures from 1 to 2010 CE, and calculate uncertainties at continental to hemispheric scales. Peak warming in the 280s, 990s and 1020s, when volcanic forcing was low, was comparable to modern conditions until 2010 CE. The lowest June–August temperature anomaly in 536 not only marks the beginning of the coldest decade, but also defines the onset of the Late Antique Little Ice Age (LALIA). While prolonged warmth during Roman and medieval times roughly coincides with the tendency towards societal prosperity across much of the North Atlantic/European sector and East Asia, major episodes of volcanically-forced summer cooling often presaged widespread famines, plague outbreaks and political upheavals. Our study reveals a larger amplitude of spatially synchronized summer temperature variation during the first millennium of the Common Era than previously recognised

Grazing cattle exposure to neighbouring herds and badgers in relation to bovine tuberculosis risk

Publication history: Accepted - 28 September 2020; Published online - 30 September 2020.Bovine tuberculosis (bTB) can be spread between and among cattle and wildlife hosts e.g. European badger (Meles meles). The majority of cattle in the UK and Ireland are grazed during the summer, potentially exposing them to Mycobacterium bovis. 18 farms were surveyed (39% dairy, 61% beef; fields n = 697) for one grazing season (May-November 2016, n = 148,461 field days) to quantify the co-occurrence of cattle with badger setts and latrines and adjacency to neighbouring cattle herds. 3% (n = 24) of the fields had a badger sett or latrine recorded, dairy cattle were significantly more likely to co-occur with badger setts and latrines than beef cattle. Most farms (89%) grazed cattle adjacent to a neighbouring herd, which accounted for 18% of the grazing season. Potential exposure to neighbouring herds did not differ between production systems but did vary between life stages. A significant positive association between the proportion of time cattle spent grazing fields with setts present and the historic 1-, 3- and 5- year bTB status (p = 0.007, p = 0.013 and p = 0.013 respectively) was found. However, when cattle were grazed in fields with latrines, a significant negative association was found between the proportion of time cattle spent grazing fields with latrines present and the historic 3- and 5- year bTB status (p = 0.033 and p = 0.012 respectively). Historic bTB status and percentage of days spent beside a neighbouring herd was unrelated. Idiosyncrasies at farm-level and between risk factors indicated that individual farm assessments would be beneficial to understand potential exposure risk.This research was funded as part of a PhD studentship by the Department of Agriculture, Environment and Rural Affair