To determine the extent that demographics, clinical characteristics, comorbidities, and complications contribute to the risk of in-hospital mortality and morbidity in acute stroke.
Data of ...consecutive patients admitted to 14 stroke units cooperating within the Berlin Stroke Register were analyzed. The association of demographics, clinical characteristics, comorbidities, and complications with the risk of in-hospital death and poor outcome at discharge was assessed, and independent attributable risks were calculated, applying average sequential attributable fractions.
In a 3-year period, 16,518 consecutive patients with ischemic or hemorrhagic stroke were documented. In-hospital mortality was 5.4%, and 45.7% had a poor outcome (modifed Rankin Scale score ≥3). In patients with length of stay (LOS) ≤7 days, 37.5% of in-hospital deaths were attributed to stroke severity, 23.1% to sociodemographics (age and prestroke disability), and 28.9% to increased intracranial pressure (iICP) and other complications. In those with LOS >7 days, age and stroke severity accounted for 44.1%, whereas pneumonia (12.2%), other complications (12.6%), and iICP (8.3%) contributed to one-third of in-hospital deaths. For poor outcome, attributable risks were similar for prestroke disability, stroke severity, pneumonia, and other complications regardless of the patient's LOS.
Approximately two-thirds of early death and poor outcome in acute stroke is attributed to nonmodifiable predictors, whereas main modifiable factors are early complications such as iICP, pneumonia, or other complications, on which stroke unit treatment should focus to further improve the prognosis of acute stroke.
The injection and mixing of contaminant mass into the fuel in inertial confinement fusion (ICF) implosions is a primary factor preventing ignition. ICF experiments have recently achieved an ...alpha-heating regime, in which fusion self-heating is the dominant source of yield, by reducing the susceptibility of implosions to instabilities that inject this mass. We report the results of unique separated reactants implosion experiments studying pre-mixed contaminant as well as detailed high-resolution three-dimensional simulations that are in good agreement with experiments. At conditions relevant to mixing regions in high-yield implosions, we observe persistent chunks of contaminant that do not achieve thermal equilibrium with the fuel throughout the burn phase. The assumption of thermal equilibrium is made in nearly all computational ICF modeling and methods used to infer levels of contaminant from experiments. We estimate that these methods may underestimate the amount of contaminant by a factor of two or more.
Compositional mapping of Mars at the 100-metre scale with the Mars Odyssey Thermal Emission Imaging System (THEMIS) has revealed a wide diversity of igneous materials. Volcanic evolution produced ...compositions from low-silica basalts to high-silica dacite in the Syrtis Major caldera. The existence of dacite demonstrates that highly evolved lavas have been produced, at least locally, by magma evolution through fractional crystallization. Olivine basalts are observed on crater floors and in layers exposed in canyon walls up to 4.5 km beneath the surface. This vertical distribution suggests that olivine-rich lavas were emplaced at various times throughout the formation of the upper crust, with their growing inventory suggesting that such ultramafic (picritic) basalts may be relatively common. Quartz-bearing granitoid rocks have also been discovered, demonstrating that extreme differentiation has occurred. These observations show that the martian crust, while dominated by basalt, contains a diversity of igneous materials whose range in composition from picritic basalts to granitoids rivals that found on the Earth.
Whilst a diverse array of phosphorus (P)-adsorbent materials is currently available for application to freshwater aquatic systems, selection of the most appropriate P-adsorbents remains problematic. ...In particular, there has to be a close correspondence between attributes of the P-adsorbent, its field performance and the management goals for treatment. These management goals may vary from a rapid reduction in dissolved P to address seasonal enrichments from internal loading, targeting external fluxes due to anthropogenic sources, or long-term inactivation of internal P inventories contained within bottom sediments. It also remains a challenge to develop new methods and materials that are ecologically benign and cost-effective. We draw on evidence in the literature and the authors’ personal experiences in the field, to summarise the attributes of a range of P-adsorbent materials. We offer ‘guiding principles’ to support practical use of existing materials and outline key development needs for new materials.
Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus and all cause mortality. Long-term survivors of ...hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with the estimated prevalence of MetS being 31-49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal of reviewing literature and recommend practices appropriate to HCT recipients. Here we deliver consensus recommendations to help clinicians provide screening and preventive care for MetS and cardiovascular disease among HCT recipients. All HCT survivors should be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors.
Neutrons are unique particles to probe samples in many fields of research ranging from biology to material sciences to engineering and security applications. Access to bright, pulsed sources is ...currently limited to large accelerator facilities and there has been a growing need for compact sources over the recent years. Short pulse laser driven neutron sources could be a compact and relatively cheap way to produce neutrons with energies in excess of 10 MeV. For more than a decade experiments have tried to obtain neutron numbers sufficient for applications. Our recent experiments demonstrated an ion acceleration mechanism based on the concept of relativistic transparency. Using this new mechanism, we produced an intense beam of high energy (up to 170 MeV) deuterons directed into a Be converter to produce a forward peaked neutron flux with a record yield, on the order of 10(10) n/sr. We present results comparing the two acceleration mechanisms and the first short pulse laser generated neutron radiograph.
The chloroplast genome of angiosperm plants is usually maternally inherited and therefore dispersed through seeds but not by pollen. Chloroplast markers with intraspecific variation provide a means ...to study seed-mediated population structure and to compare rates of seed- and pollen-mediated gene flow. Given its size, a relatively small number of consensus PCR primers are currently available for the chloroplast genome. Only a subset of these primers have detected intraspecific genetic variation in angiosperm plant populations. Many existing primers were intended for phylogenetic comparisons and therefore targeted coding regions of the chloroplast genome. Chloroplast introns and intergenic spacer regions should exhibit the highest levels of intraspecific polymorphism because they are less constrained by selection to maintain gene function. Only a subset of the available primers amplify noncoding regions. Additionally, many available primers amplify regions much larger than the 600-1000 bp that can be sequenced using two terminal primers. Although amplification of large regions is convenient for restriction site surveys, this method may fail to detect the majority of nucleotide substitutions or small insertion/deletion events.
Over many decades, isolated regions (e.g., islands, rural and remote areas) have heavily relied on diesel engine for producing power and energy. However, due to depleting fossil fuels and concerning ...emissions, biodiesels could be the substitute for diesel in power generation sectors. This study developed a single-zone thermodynamic model to predict the engine performances such as brake power (BP), torque, brake thermal efficiency (BTE), brake-specific fuel consumption (BSFC) and ignition delay (ID) times for diesel and jojoba biodiesel. The experiments were conducted on a fully automated, 4-cylinder, 4-stroke, liquid-cooled direct injection 3.7-L diesel engine fueled with diesel (D100) and three jojoba blends (JB5, JB10, and JB20) to validate the model. The performance simulation results agreed with experimental data for all tested fuels at 1200 to 2400 rpm speed and 25%, 50%, 75%, and 100% loading operation. The minimum error (3.7%) was observed for BP for D100 at 2000 rpm and 100% load, and the maximum error (19.2%) was found for JB10 at 1200 rpm and 25% loading operation. As load increases from 25 to 100%, the BSFC and torque difference between diesel and JB20 decreases from 10 to 6.5 and 9 to 6%, respectively. A shorter ID time was observed in JB5 compared to JB10 and JB20. Furthermore, a significant reduction was observed in CO (7.55%) and HC (6.65%) emission for JB20 at 25% and 1200 rpm compared to diesel fuel; however, NOx emission was increased up to 10.25% under any given conditions.
We report on a novel compact laser-driven neutron source with an unprecedented short pulse duration (<50 ps) and high peak flux (>10(18) n/cm(2)/s), an order of magnitude higher than any existing ...source. In our experiments, high-energy electron jets are generated from thin (<3 μm) plastic targets irradiated by a petawatt laser. These intense electron beams are employed to generate neutrons from a metal converter. Our method opens venues for enhancing neutron radiography contrast and for creating astrophysical conditions of heavy element synthesis in the laboratory.
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