No description available.

Speech and language impairments after left hemisphere stroke are life altering. Neuroprotective interventions, such as tissue plasminogen activator, or tPA, are utilized to diminish the impact of the stroke on functional ability. The purpose of this study was to examine speech and language recovery in the first three months after stroke in individuals with aphasia and to further investigate any differences between individuals who did and individuals who did not receive tPA, using objective speech and language measures. Twenty-six individuals, thirteen of whom received tPA and thirteen who did not, suffering from first-ever left hemisphere stroke with resulting aphasia were enrolled and completed repeated speech and language assessments within 24 hours after stroke, at one and two weeks after stroke. A three month assessment also included an additional quality of life measure. Findings indicate that both individuals who did and those who did not receive tPA demonstrated significant gains in language skills. Results also suggest that the individuals who received tPA have better outcomes at three months compared to those who did not. This is clinically significant as it helps provide prognostic information about the use of tPA and informs decision making for speech pathologists within the acute care hospital.

Association between Smoking and Functional Outcome in Acute Ischemic Stroke Population Treated with Tissue Plasminogen Activator Iretioluwa Ajani1, Oluyemi Rotimi1, Olubunmi Kuku1, Ndukwe Kalu1, Olakunle Oni1, Nwabueze Christian1,Thomas Nathaniel2, Shimin Zheng1* 1Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614 2Department of Neurology, Department of Pharmacology, Physiology & Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208 *Sponsoring faculty Background The effect of smoking on outcome in acute ischemic stroke patients treated with tissue plasminogen activator (TPA) is debatable. Based on the hypothesis that smokers may have more effective thrombolysis with TPA. Some clinical studies have demonstrated a favorable outcome while others have seen worse prognosis or no effect at all. This study seeks to determine the association between smoking and functional improvement in TPA treated and non-treated patients. Methods We analyzed data from the Greenville Health System (GHS) stroke registry on stroke patients between January 2010 and December 2013. Patients were divided into two groups: those treated with TPA and those not treated with TPA but presenting within 4.5 hours. Logistic regression analysis was conducted to assess if smoking was associated with improvement in ambulation. Results Of 1,446 patients, 595 (41.15 %) were treated with TPA (181 smokers (30.42%), 414 non-smokers (69.58 %) and 851 (58.85%) not treated with TPA (198 smokers (23.27 %), 653 non-smokers (76.73 %). In the multiple logistic models, smoking was not independently associated with favorable outcome in patients treated with TPA (OR = 0.84; 95% CI = 0.54 – 1.33; P = 0.46) and those not treated with TPA (OR = 0.96; 95% CI = 0.64 – 1.44; P-value = 0.85) though the bivariate models showed significant association. Conclusion There is no association between smoking and functional outcome in stroke patients regardless of TPA treatment. The effect of smoking on outcome in acute ischemic stroke patients treated with tissue plasminogen activator (TPA) is however stronger than those not treated with TPA.

Det har ofta antagits att en anställd är lycklig därför att han eller hon är framgångsrik. Det finns dock studier som stödjer den alternativa hypotesen, nämligen att lycka är en anledning till varför vissa anställda är mer framgångsrika än andra. Denna studie syftar till att undersöka huruvida lyckliga anställda är mer produktiva och framgångsrika än mindre lyckliga anställda. Det genom att undersöka om personligt disponerad positiv affekt (TPA) kan predicera arbetsprestationer. Deltagarna var 98 anställda, varav 60 kvinnor, som rekryterats från sex organisationer. Resultaten gav stöd åt undersökningens samtliga hypoteser och kan därmed indikera att anställda med högre TPA presterar bättre, har högre lön och mer socialt stöd från arbetskamrater och chefer. Detta betyder att TPA kan leda till gynnsamma resultat för såväl den anställda som för organisationen och att lyckliga anställda kan antas vara mer produktiva och framgångsrika än sina mindre lyckliga arbetskamrater.

In this thesis, a novel method for multi-pulse with equal chirp characteristics and more efficient THz generation through two photon absorption (TPA) are investigated and demonstrated. These are all the first time, for our best knowledge, odd multi-pulses generation and innovative approach for efficient THz through TPA are proposed and studied. By modulating the amplitude and phase of the spatial light modulator with the pulse shaper, the number of multi-pulses can be adjustable without the limitation of even number only. Meanwhile, the chirp properties of the generated pulses are with the same characteristics and tunable also. For the case with bandwidth of 10nm, the generated multi-pulses with equal chirps varying from -20000fs^2 to 20000fs^2 are demonstrated and the results have a good agreement with the theoretical estimation. We also discuss the number of the multi-pulses and inequalities of the amplitude of the pulses are limited by the spectral resolution of SLM within the pulse shaper. Regarding to efficient THz radiation, it can be generated more efficiently from a low-temperature-grown GaAs (LT-GaAs) photoconductive (PC) antenna by taking into account the TPA induced photo-carrier in the photoconductor. A rate-equation-based approach using the Drude-Lorentz model taking into account the band-diagram of LT-GaAs is used for the theoretical analysis. The super-linear power dependent photocurrent clarifies the role of TPA. Previously unnoticed THz pulse features and anomalously increasing THz radiation power rather than saturation were observed. These are in good agreement with the theoretical predictions.

No description available.

BACKGROUND: Under the current treatment guidelines for acute ischemic stroke, intravenous alteplase may be used within 3-4.5 hours of symptom recognition or in cases of unknown onset if there is a small lesion on diffusion weighted imaging without increased signal on FLAIR sequence MRI. We seek to determine whether patients with lacunar strokes greater than 4.5 hours post onset with a DWI-FLAIR mismatch on imaging will benefit from thrombolysis with intravenous alteplase. METHODS: We will conduct a multicenter, randomized, double-blinded, placebo-controlled trial of patients presenting with acute ischemic stroke within 4.5 to 6 hours of symptom onset with DWI-FLAIR mismatch and without a large vessel occlusion. A target of 682 patients will be randomized to receive IV alteplase or placebo. The primary outcome is a favorable functional status as defined by a score of 0 or 1 on the modified Rankin scale (mRS) at 90 days. The secondary outcome is ordinal score on the modified Rankin scale at 90 days. The primary safety end points will be symptomatic intracranial hemorrhage (sICH) and death CONCLUSIONS: If intravenous (IV) alteplase is found to be an effective and safe treatment for lacunar stroke with DWI-FLAIR mismatch >4.5 hours from onset, these patients could have significantly reduced morbidity and improved long-term outcomes.

Acute ischemic stroke (AIS) is a major cause of death and disability in the United States. With advancements in therapeutic reperfusion, it has become clear that improving time-to-treatment is among the most important factors in yielding better outcomes for patients. When AIS occurs in the community, away from readily available interventions, timely recognition and transport are paramount to decreasing the time-to-treatment and ultimately increasing rates of reperfusion and reducing morbidity and mortality. Over the past several years, investigations have launched studying the efficacy of mobile stroke units (MSU) in reducing the morbidity and mortality burden of AIS. MSUs are specially designed transport vehicles, run by trained expert stroke management personnel, and stocked with diagnostic imaging equipment in the form of computed tomography scanners and fibrinolytic therapy. In a number of prospective study designs comparing MSUs to standard management by emergency medical services, researchers have utilized several endpoints including time-to-treatment, rates of symptom resolution, and long-term recovery from AIS. These studies have generally demonstrated better outcomes with MSUs and provided evidence for the efficacy of the MSU model in treating AIS. However, most studies have been limited to metropolitan regions of the country, and no randomized-controlled trials have been completed, although one is currently underway. There is little evidence, however, evaluating the cost-effectiveness of MSUs in the management of AIS. The expense of constructing and operating these specialized vehicles over ten years has been estimated to be millions of dollars, while the cost of a single case of AIS can range anywhere from the cost of the emergency department visit to the inclusion of long-term care from resultant sequelae depending on the patient outcome. It remains unclear to what degree the upfront investment in quicker management for AIS is capable of producing downstream cost savings for the healthcare system in the setting of demonstrated improved outcomes. In this study, I propose a method of cost-effectiveness analysis to compare the MSU model to standard management of AIS occurring in metropolitan communities to determine whether MSUs are cost-effective, or possibly cost-saving.

O câncer representa desequilíbrio na homeostase do organismo e os mecanismos de defesa para controlar as células tumorais envolvem respostas do sistema imune inato e adaptativo, sendo que a primeira reação do organismo é a inflamação. O objetivo deste estudo foi caracterizar a resposta inflamatória em linhagens de camundongos C57BL/6, CD4KO, CD8KO, RAG e NUDE. Os animais foram tratados com o carcinógeno DMBA e o agente de promoção tumoral TPA. Os animais foram acompanhados e avaliados por 100 dias, após este período a pele tratada foi retirada e processada para análise de citocinas pró- e anti-inflamatórias e enzima mieloperoxidase (MPO). As citocinas pró e anti-inflamatórias e a enzima MPO foram maiores nos animais CD4KO quando comparados aos outros grupos de animais. As linhagens C57BL/6 WT, CD4KO e NUDE foram avaliadas 48 horas após tratamento com DMBA. Os animais CD4KO apresentaram maior número de neutrófilos e citocinas pró-inflamatórias quando comparados aos grupos C57BL/6 WT e NUDE, enquanto que as citocinas anti-inflamatórias não mostraram diferenças nos 3 grupos tratados. Estes resultados sugerem que os linfócitos TCD4 participam do controle da inflamação causada pelo DMBA e TPA. / Cancer represents imbalance in homeostasis and defense mechanisms to control the tumor cells involving the innate and adaptive immune responses, and the first reaction of the body is inflammation. The aim of this study was to characterize the inflammatory response in the following strains: C57BL/6 WT, CD4KO, CD8KO, RAG and NUDE mice. We treated the animals with the carcinogen DMBA as well as with TPA tumor promoting agent. The animals were followed for 100 days and evaluated after this period, the treated skin was removed and processed for analysis of pro-and anti-inflammatory and enzyme myeloperoxidase (MPO). The pro-and anti-inflammatory cytokines and MPO enzyme were higher in animals CD4KO than the other groups of animals. The C57BL/6 WT and CD4KO NUDE lines were evaluated 48 hours after treatment with DMBA. The CD4KO animals had greater numbers of neutrophils and proinflammatory cytokine than the C57BL/6 WT and NUDE mice, while anti-inflammatory cytokines showed no differences in the three treated groups. These results suggest that CD4 + T lymphocytes participate in the control of the induced by DMBA and TPA.

O câncer representa desequilíbrio na homeostase do organismo e os mecanismos de defesa para controlar as células tumorais envolvem respostas do sistema imune inato e adaptativo, sendo que a primeira reação do organismo é a inflamação. O objetivo deste estudo foi caracterizar a resposta inflamatória em linhagens de camundongos C57BL/6, CD4KO, CD8KO, RAG e NUDE. Os animais foram tratados com o carcinógeno DMBA e o agente de promoção tumoral TPA. Os animais foram acompanhados e avaliados por 100 dias, após este período a pele tratada foi retirada e processada para análise de citocinas pró- e anti-inflamatórias e enzima mieloperoxidase (MPO). As citocinas pró e anti-inflamatórias e a enzima MPO foram maiores nos animais CD4KO quando comparados aos outros grupos de animais. As linhagens C57BL/6 WT, CD4KO e NUDE foram avaliadas 48 horas após tratamento com DMBA. Os animais CD4KO apresentaram maior número de neutrófilos e citocinas pró-inflamatórias quando comparados aos grupos C57BL/6 WT e NUDE, enquanto que as citocinas anti-inflamatórias não mostraram diferenças nos 3 grupos tratados. Estes resultados sugerem que os linfócitos TCD4 participam do controle da inflamação causada pelo DMBA e TPA. / Cancer represents imbalance in homeostasis and defense mechanisms to control the tumor cells involving the innate and adaptive immune responses, and the first reaction of the body is inflammation. The aim of this study was to characterize the inflammatory response in the following strains: C57BL/6 WT, CD4KO, CD8KO, RAG and NUDE mice. We treated the animals with the carcinogen DMBA as well as with TPA tumor promoting agent. The animals were followed for 100 days and evaluated after this period, the treated skin was removed and processed for analysis of pro-and anti-inflammatory and enzyme myeloperoxidase (MPO). The pro-and anti-inflammatory cytokines and MPO enzyme were higher in animals CD4KO than the other groups of animals. The C57BL/6 WT and CD4KO NUDE lines were evaluated 48 hours after treatment with DMBA. The CD4KO animals had greater numbers of neutrophils and proinflammatory cytokine than the C57BL/6 WT and NUDE mice, while anti-inflammatory cytokines showed no differences in the three treated groups. These results suggest that CD4 + T lymphocytes participate in the control of the induced by DMBA and TPA.