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Improvements in management of transient ischemic attack (TIA) have decreased stroke and mortality post-TIA. Studies examining trends over time on a provincial level are limited. We analyzed whether efforts to improve management have decreased the rate of stroke and mortality after TIA from 2003 to 2015 across an entire province.
Using administrative data from the Canadian Institute for Health Information’s (CIHI) databases from 2003 to 2015, we identified a cohort of patients with a diagnosis of TIA upon discharge from the emergency department (ED). We examined stroke rates at Day 1, 2, 7, 30, 90, 180, and 365 post-TIA and 1-year mortality rates and compared trends over time between 2003 and 2015.
From 2003 to 2015 in Ontario, there were 61,710 patients with an ED diagnosis of TIA. Linear regressions of stroke after the index TIA showed a significant decline between 2003 and 2015, decreasing by 25% at Day 180 and 32% at 1 year (p < 0.01). The 1-year stroke rate decreased from 6.0% in 2003 to 3.4% in 2015. Early (within 48 h) stroke after TIA continued to represent approximately half of the 1-year event rates. The 1-year mortality rate after ED discharge following a TIA decreased from 1.3% in 2003 to 0.3% in 2015 (p < 0.001).
At a province-wide level, 1-year rates of stroke and mortality after TIA have declined significantly between 2003 and 2015, suggesting that efforts to improve management may have contributed toward the decline in long-term risk of stroke and mortality. Continued efforts are needed to further reduce the immediate risk of stroke following a TIA.
The objective of this analysis was to evaluate the short- (8 weeks) and long-term (24 weeks) efficacy of three fixed doses of venlafaxine extended release (ER) and placebo on the social adjustment of patients with generalised anxiety disorder (GAD). We analysed data from 544 outpatients who participated in a 24-week, double-blind, multicentre, parallel-group, placebo-controlled study conducted at 55 centres in five countries. All patients meet the DSM-IV criteria for GAD and were randomly assigned to receive venlafaxine ER 37.5, 75, and 150 mg or matched placebo administered orally once daily. Social adjustment was measured using the Social Adjustment Scale-Self Report, which explores social adaptation in the areas of work, social and leisure, extended family, primary relationship (marital), parental, and family unit. At baseline, the GAD patients had a high level of social dysfunction. Venlafaxine ER showed a dose-related improvement in social impairment during short-term treatment and in sustaining this improvement over the long-term. In the most severely socially impaired subgroup, placebo remission rates on the HAM-A were low, and the magnitude of the venlafaxine-placebo difference on the mean HAM-A total score was high, reaching more than 7 points. The benefits of venlafaxine ER treatment of GAD extend beyond that of improvement of anxiety symptoms to a significant improvement in the impairment of functioning that is associated with the illness.
Increasing numbers of research papers about information retrieval for Health Technology Assessments (HTA), systematic reviews and other evidence syntheses are being published. It is time-consuming for information specialists to keep up-to-date with the latest developments in the field. To help searchers with this challenge, the Interest Group on Information Retrieval (IRG) of Health Technology Assessment International (HTAi) has compiled the best available research evidence on information retrieval aspects into an open-access web resource: Summarized Research in Information Retrieval for HTA (SuRe Info). The resource can be accessed at http://www.sure-info.org
The Sure Info team run topic-specific search strategies in selected relevant databases to identify information retrieval methods publications that fulfil the SuRe Info inclusion criteria. Eligible publications receive a structured abstract containing a brief critical appraisal. Key messages for search practice based on the appraisals and accepted best practice are summarized into topic-specific chapters.
SuRe Info currently offers fourteen chapters, with more in development. SuRe Info chapters fall into two categories: (i) chapters about general search methods that are used across all types of research, such as how to develop search strategies and the availability and use of search filters, and (ii) chapters summarizing the methods to use when searching for specific aspects of HTA (as defined in the European Network for HTA (EUnetHTA) HTA Core Model®), including searching for evidence on clinical effectiveness and safety, and identifying economic evaluations. References at the end of each chapter are linked to appraisals of publications that have been used to develop each chapter. Links to the full-text of the publications are provided when freely available. The SuRe Info chapters are reviewed every six months and updated if new evidence is identified or if resources change.
SuRe Info is a unique resource, identifying and summarizing current best research evidence on information retrieval aspects for HTA. It supports the timely uptake of potential efficiencies arising from new evidence that may be incorporated into the evidence identification processes of HTA organizations.
Key pathophysiology of sickle cell anaemia includes compensatory erythropoiesis, vascular injury and chronic inflammation, which divert amino acids from tissue deposition for growth/weight gain and muscle formation. We hypothesised that sickle mice maintained on an isoenergetic diet with a high percentage of energy derived from protein (35 %), as opposed to a standard diet with 20 % of energy derived from protein, would improve body composition, bone mass and grip strength. Male Berkeley transgenic sickle mice (S; n 8–12) were fed either 20 % (S20) or 35 % (S35) diets for 3 months. Grip strength (BIOSEB meter) and body composition (dual-energy X-ray absorptiometry scan) were measured. After 3 months, control mice had the highest bone mineral density (BMD) and bone mineral content (BMC) (P < 0·005). S35 mice had the largest increase in grip strength. A two-way ANOVA of change in grip strength (P = 0·043) attributed this difference to genotype (P = 0·025) and a trend in type of diet (P = 0·067). l-Arginine (l-Arg) supplementation of the 20 % diet was explored, as a possible mechanism for improvement obtained with the 35 % diet. Townes transgenic sickle mice (TS; n 6–9) received 0·8, 1·6, 3·2 or 6·4 % l-Arg based on the same protocol and outcome measures used for the S mice. TS mice fed 1·6 % l-Arg for 3 months (TS1.6) had the highest weight gain, BMD, BMC and lean body mass compared with other groups. TS3.2 mice showed significantly more improvement in grip strength than TS0·8 and TS1.6 mice (P < 0·05). In conclusion, the high-protein diet improved body composition and grip strength. Outcomes observed with TS1.6 and TS3.2 mice, respectively, confirm the hypothesis and reveal l-Arg as part of the mechanism.
We investigated whether a higher number of fast-food outlets in an individual’s home neighbourhood is associated with increased prevalence of type 2 diabetes mellitus and related risk factors, including obesity.
Three UK-based diabetes screening studies (one general population, two high-risk populations) conducted between 2004 and 2011. The primary outcome was screen-detected type 2 diabetes. Secondary outcomes were risk factors for type 2 diabetes.
In total 10 461 participants (mean age 59 years; 53 % male; 21 % non-White ethnicity).
There was a higher number of neighbourhood (500 m radius from home postcode) fast-food outlets among non-White ethnic groups (P<0·001) and in socially deprived areas (P<0·001). After adjustment (social deprivation, urban/rural, ethnicity, age, sex), more fast-food outlets was associated with significantly increased odds for diabetes (OR=1·02; 95 % CI 1·00, 1·04) and obesity (OR=1·02; 95 % CI 1·00, 1·03). This suggests that for every additional two outlets per neighbourhood, we would expect one additional diabetes case, assuming a causal relationship between the fast-food outlets and diabetes.
These results suggest that increased exposure to fast-food outlets is associated with increased risk of type 2 diabetes and obesity, which has implications for diabetes prevention at a public health level and for those granting planning permission to new fast-food outlets.
We present an ongoing survey with the Nançay Radio Telescope at L-band. The targeted area is 74° ≲ l < 150° and 3.5° < |b| < 5°. This survey is characterized by a long integration time (18 min), large bandwidth (512 MHz) and high time and frequency resolution (64 μs and 0.5 MHz) giving a nominal sensitivity limit of 0.055 mJy for long period pulsars. This is about 2 times better than the mid-latitude HTRU survey, and is designed to be complementary with current large scale surveys. This survey will be more sensitive to transients (RRATs, intermittent pulsars), distant and faint millisecond pulsars as well as scintillating sources (or any other kind of radio faint sources) than all previous short-integration surveys.
In this work, hydrophobic mesostructured organosilica thin films, exhibiting isolated mesopores (~ 7 nm), have been successfully deposited by spin-coating using different polystyrene-block-polyethylene oxide copolymers (PS-b-PEO) as structure-directing agents and methyltriethoxysilane (MTES) as organosilica precursor. Different ordered mesostructures (Face Centered Cubic, 2D or 3D Hexagonal and Body Centered Cubic) can be achieved by controlling different synthesis parameters. X-Ray Diffraction (XRD) and Grazing Incidence Small Angle X-Ray Scattering (GISAXS) techniques were used to investigate the mesostructure evolution through thermal and UV treatments. Swelling and shrinkage were evidenced by in-situ XRD and X-Ray Reflectivity measurements during the thermal removal of the meso-templates. Infrared spectroscopy and 29Si NMR were additionally used to investigate the microstructure evolution. The film porosity was estimated thanks to Ellipsometry Porosimetry (EP). Correlation between mechanical properties through nanoindentation measurements and the mesostructure ordering is discussed as well as assessments of the dielectric constant k by mercury contact probe.
We give a general theorem stating that transversely intersecting regular stratified sets have regularly stratified intersection (and union) for a large class of regularity conditions. Such a result was previously known only for Whitney regular stratified sets and for weakly Whitney stratified sets.
It is often useful to know that the transverse intersection of two regularly stratified sets is again regular. That the transverse intersection of two Whitney regular stratified sets is again Whitney regular was apparently first published in 1976 by Chris Gibson  in the Liverpool notes on the topological stability of smooth mappings. In their book “Stratified Morse Theory” , perhaps following Teissier's account for complex analytic varieties in his La Rabida notes  where Teissier attributes the detailed proof given there to Denis Chéniot, Mark Goresky and Robert MacPherson cite the 1972 Comptes Rendus note by Chéniot  for a proof of this result, which is a mistake, as Chéniot does not prove the Whitney regularity of intersections or even discuss it; he is concerned with the frontier condition in the case of a complex variety, and moreover only for intersections with a smooth complex submanifold. This mistake in attribution has unfortunately been copied by many authors.
That the transverse intersection of two weakly Whitney regular stratified sets is again weakly Whitney regular was proved by Karim Bekka in his thesis  and published in .
La compression de poudre céramique
nécessite l'incorporation de molécules organiques assurant la
cohésion des grains entre eux. Comprimer des poudres céramiques
formulées revient à leur fournir une certaine énergie. En
fonction de la formulation de la poudre, on peut mesurer l'énergie
stockée par unité de masse, caractéristique de la poudre.
Récemment, une technique employée dans la métallurgie des
poudres, la Compaction Grande Vitesse (CGV), a été utilisée pour
la mise en forme d'objets céramiques. Cette méthode apporte des
particularités au niveau des propriétés physiques des
comprimés, notamment en terme d'homogénéité par rapport au
pressage uniaxial dit conventionnel. Des comprimés issus des deux
méthodes de mise en forme, et élaborés à partir de poudres
formulées différemment, seront comparés en terme de comportement
à la compression et via l'utilisation d'un modèle mathématique.
Le développement d'un modèle permettant la
prédiction des dimensions de la couche de réaction formée lors
de l'élaboration d'assemblages acier–aluminium par mouillage
réactif TIG est présenté. La croissance de la phase
Fe2Al5 formée à l'interface est régie par les
transferts de chaleur au sein de la structure générés par
l'apport d'énergie du procédé TIG. Une modélisation du
procédé couplée avec la loi de croissance de la phase
constituant la couche de réaction permet alors de prédire
l'épaisseur et la largeur de cette couche.
El objetivo de este análisis era evaluar la eficacia a corto (8 semanas) y largo plazo (24 semanas) de tres dosis fijas de venlafaxina de liberación prolongada (LP) y placebo en la adaptación social de los pacientes contrastorno de ansiedad generalizada (TAG). Analizamos los datos de 544 pacientes ambulatorios que participant en un estudio multicéntrico doble ciego de grupos paralelos controlado con placebo de 24 semanas realizado en 55 centros en cinco países. Todos los pacientes cumplían los criterios del DSM-IV para TAG y se asignaron aleatoriamente para recibir 37,5, 75 y 150 mg de venlafaxina LP o placebo emparejado administrado oralmente una vez al día. La adaptación social se midió utilizando la Escala de Adaptación Social-Autoinforme, que explora la adaptación social en las áreas laboral, social y de ocio, familia extensa, relación primaria (matrimonial), parental y unidad familiar. En la línea de base, los pacientes con TAG tenían un nivel alto de disfunción social. La venlafaxina LP mostró una mejoría relacionada con la dosis en el deterioro social durante el tratamiento a corto plazo y en el mantenimiento de esta mejoria a largo plazo. En el subgrupo con deterioro social mas importante, las tasas de remisión con el placebo en la HAM-A fueron bajas, y la magnitud de la diferencia venlafaxina-placebo en la puntuación total media de la HAM-A fue alta, alcanzando más de 7 puntos. Los beneficios del tratamiento de venlafaxina LP del TAG se extienden más alia de la mejoría de los síntomas de ansiedad, a una mejoría significativa en el deterioro del funcionamiento que se asocia con la enfer medad.
The aim of this paper is to investigate the effect of deleterious mutations in a hybrid zone maintained by selection against hybrids. In such zones, linkage disequilibria among hybrid depression loci, resulting from a balance between migration and selection, are crucial in maintaining the barrier because they allow each locus, in addition to its own selection coefficient, to cumulate indirect selective effects from other loci. Deleterious alleles produce heterosis and increase by this means the effective migration rate in structured populations. In a hybrid zone, they therefore contribute to decrease linkage disequilibria as well as the barrier to gene flow imposed by hybrid depression. However, deleterious mutations have no effect: (i) when selection against hybrids is weak, because linkage disequilibria are small even without heterosis in this case, or (ii) when selection against hybrids is so strong that it overwhelms heterosis. On the other hand, with moderate selection against hybrids, the decrease in the strength of the barrier due to heterosis may reach detectable levels, although it requires relatively small population sizes and/or migration rates. The effect is expected to be small and only within small genomes where loci are tightly linked can it become strong. Nevertheless, neglecting mutational load may to some extent obscure the estimations of selective parameters based either on artificial F1 crosses or on cline characteristics.
The activation energies for poly(ethylene oxide) motion in a polymer clay composite are reported for the polymer intercalated and external to the clay. PEO intercalated into the clay is found to have a lower activation energy for motion but also a larger Arrhenius prefactor, by almost two orders of magnitude, than for PEO found external to the clay. Neutron scattering measurements confirm the presence of two environments and the effects of confinement on the mean square displacement of the PEO.
To cope with its development, a French operator of mobile telephone network
must periodically plan the purchase and the installation of new hardware,
in such a way that a hierarchy of constraints (required and preferred)
This paper presents the “constructive repair” method we used to solve
this problem within the allowed computing time (1 min). This method repairs
the planning during its construction. A sequence of repair procedures is
defined: if a given repair cannot be achieved on a partial solution,
a stronger repair (possibly relaxing more important constraints) is called
We tested our method on ten (both hand-made and real) problems. All our
solutions were at least as good as thoses computed by hand by the engineer in
charge with the planning.
There have been several reports of linkage between genetic markers on the X chromosome at Xq26.3-28 and bipolar affective disorder in family samples obtained from distinct ethnic and geographical origins. As part of a genome search in a series of 23 UK and Icelandic families, specifically selected for their large size and power to resolve the issue of linkage heterogeneity, we have tested the hypothesis that there is a locus for a genetic subtype of bipolar affective disorder which is linked to this region.
In families selected on the basis of absent male to male transmission for affective disorder, we performed two-point and FASTMAP multipoint linkage analyses with markers spanning the region between the genetic loci DXS102 and F8
We found negative lod scores for several models of affection status in families selected under stringent and relaxed criteria for the absence of male to male transmission.
In the family sample we have obtained, our study provides no support for the presence of a locus increasing genetic susceptibility to bipolar affective disorder in this region of the X chromosome. It is likely that our finding reflects heterogeneity of linkage for bipolar and genetically related unipolar disorder that exists in specific ethnic populations. Alternatively the X-linked subtype of the disorder may have been present only in a few of our small families resulting in loss of power to detect the Xq26.3-28 linked subtype.