Abstract W P266: The Discharge Modified Rankin Score Correlates with Established Hemorrhagic Transformation Scores in Ischemic Stroke Patients Treated with Thrombolysis

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
David T Asuzu ◽  
Karin V Nystrom ◽  
Kevin N Sheth ◽  
Janet R Halliday ◽  
Charles Wira ◽  
...  
Keyword(s):  
Goodness Of Fit ◽  
Adverse Outcome ◽  
Hemorrhagic Transformation ◽  
New Haven ◽  
Odds Ratios ◽  
Independent Variable ◽  
Roc Area ◽  
Adverse Patient Outcome ◽  
Good Agreement

Introduction: Several scores have been proposed to predict hemorrhagic transformation (HT) after IV r-tPA therapy. However, their utility in predicting adverse outcome has been limited to assessment of 30- or 90-day Modified Rankin Scale (mRS) scores, which are not readily available at many stroke centers. Studies evaluating discharge mRS scores as a predictor of long-term adverse patient outcome are lacking. Hypothesis: We tested the hypothesis that HT scores predicting long-term adverse outcome after r-tPA therapy correlate with readily available discharge mRS scores. Methods: Clinical data was analyzed from consecutive patients (n = 187) receiving IV r-tPA therapy from January 2009 until May 2013 at the Yale-New Haven Hospital. 8 HT scores were calculated for each patient: DRAGON, ASTRAL, Stroke-TPI, HAT Score, MSS, SITS-ICH, SEDAN and SPAN-100. Univariate logistic regression was performed using each HT score as an independent variable and discharge mRS≥5 or discharge mRS≥4 as the dependent variable. Receiver Operating Characteristic (ROC) analysis was used to test goodness of fit by the DeLong method. Results: All metrics except the HAT Score and SPAN-100 showed good agreement with discharge mRS≥5 (ROC area > 0.7). The 3 HT scores showing the best agreement with discharge mRS≥5 were Stroke-TPI (ROC 0.85 ± 0.07), ASTRAL (ROC 0.85 ± 0.06) and DRAGON (0.83 ± 0.07), with odds ratios: Stroke-TPI (1.09 ± 0.03), ASTRAL (1.17 ± 0.06) and DRAGON (2.23 ± 0.58). These 3 HT scores still performed best when the discharge mRS cutoff was relaxed to mRS ≥ 4, with similar odds ratios but modestly reduced ROC areas: ASTRAL (ROC 0.82 ± 0.06), DRAGON (ROC 0.79 ± 0.07) and Stroke-TPI (ROC 0.76 ± 0.07). Conclusions: Most established HT scores in our study showed good agreement with the discharge mRS score using two separate cutoff values. Therefore, readily available discharge mRS scores may be a useful predictor of adverse outcome following IV r-tPA therapy. These results warrant larger prospective studies to establish associations between discharge mRS scores and 90-day patient outcomes.

Anthropologic Relationships among Prehistoric Northeastern Amerindians

1980 ◽  
Vol 1 (2) ◽  
pp. 145-159
Author(s):  
Edward F. Harris ◽  
Nicholas F. Bellantoni
Keyword(s):  
New York ◽  
Gene Flow ◽  
Material Culture ◽  
New England ◽  
Cultural Barriers ◽  
Group Differences ◽  
Phenetic Analysis ◽  
Trade Relationships ◽  
Good Agreement

Archaeologically defined inter-group differences in the Northeast subarea ate assessed with a phenetic analysis of published craniometric information. Spatial distinctions in the material culture are in good agreement with those defined by the cranial metrics. The fundamental dichotomy, between the Ontario Iroquois and the eastern grouping of New York and New England, suggests a long-term dissociation between these two groups relative to their ecologic adaptations, trade relationships, trait-list associations, and natural and cultural barriers to gene flow.

scholarly journals Semi-Analytical Solution to Assess CO2 Leakage in the Subsurface through Abandoned Wells

Energies ◽  
2021 ◽  
Vol 14 (9) ◽  
pp. 2452
Author(s):  
Tian Qiao ◽  
Hussein Hoteit ◽  
Marwan Fahs
Keyword(s):  
Analytical Solution ◽  
Storage Site ◽  
Co2 Leakage ◽  
Transient Pressure ◽  
Flow Paths ◽  
Abandoned Wells ◽  
Diffusivity Equation ◽  
Carbon Dioxide Co2 ◽  
Good Agreement

Geological carbon storage is an effective method capable of reducing carbon dioxide (CO2) emissions at significant scales. Subsurface reservoirs with sealing caprocks can provide long-term containment for the injected fluid. Nevertheless, CO2 leakage is a major concern. The presence of abandoned wells penetrating the reservoir caprock may cause leakage flow-paths for CO2 to the overburden. Assessment of time-varying leaky wells is a need. In this paper, we propose a new semi-analytical approach based on pressure-transient analysis to model the behavior of CO2 leakage and corresponding pressure distribution within the storage site and the overburden. Current methods assume instantaneous leakage of CO2 occurring with injection, which is not realistic. In this work, we employ the superposition in time and space to solve the diffusivity equation in 2D radial flow to approximate the transient pressure in the reservoirs. Fluid and rock compressibilities are taken into consideration, which allow calculating the breakthrough time and the leakage rate of CO2 to the overburden accurately. We use numerical simulations to verify the proposed time-dependent semi-analytical solution. The results show good agreement in both pressure and leakage rates. Sensitivity analysis is then conducted to assess different CO2 leakage scenarios to the overburden. The developed semi-analytical solution provides a new simple and practical approach to assess the potential of CO2 leakage outside the storage site. This approach is an alternative to numerical methods when detailed simulations are not feasible. Furthermore, the proposed solution can also be used to verify numerical codes, which often exhibit numerical artifacts.

scholarly journals Modeling cesium migration through Opalinus clay: a benchmark for single- and multi-species sorption-diffusion models

2021 ◽  
Author(s):  
Jesús F. Águila ◽  
Vanessa Montoya ◽  
Javier Samper ◽  
Luis Montenegro ◽  
Georg Kosakowski ◽  
...  
Keyword(s):  
Time Discretization ◽  
Single Species ◽  
Opalinus Clay ◽  
Sorption Behavior ◽  
Diffusion Experiment ◽  
Modeling Tools ◽  
Cesium Sorption ◽  
Code Performance ◽  
Good Agreement

AbstractSophisticated modeling of the migration of sorbing radionuclides in compacted claystones is needed for supporting the safety analysis of deep geological repositories for radioactive waste, which requires robust modeling tools/codes. Here, a benchmark related to a long term laboratory scale diffusion experiment of cesium, a moderately sorbing radionuclide, through Opalinus clay is presented. The benchmark was performed with the following codes: CORE2DV5, Flotran, COMSOL Multiphysics, OpenGeoSys-GEM, MCOTAC and PHREEQC v.3. The migration setup was solved with two different conceptual models, i) a single-species model by using a look-up table for a cesium sorption isotherm and ii) a multi-species diffusion model including a complex mechanistic cesium sorption model. The calculations were performed for three different cesium boundary concentrations (10−3, 10−5, 10−7 mol / L) to investigate the models/codes capabilities taking into account the nonlinear sorption behavior of cesium. Generally, good agreement for both single- and multi-species benchmark concepts could be achieved, however, some discrepancies have been identified, especially near the boundaries, where code specific spatial (and time) discretization had to be improved to achieve better agreement at the expense of longer computation times. In addition, the benchmark exercise yielded useful information on code performance, setup options, input and output data management, and post processing options. Finally, the comparison of single-species and multi-species model concepts showed that the single-species approach yielded generally earlier breakthrough, because this approach accounts neither for cation exchange of Cs+ with K+ and Na+, nor K+ and Na+ diffusion in the pore water.

scholarly journals Comparison of numerical and standard sarnat grading using the NICHD and SIBEN methods

2021 ◽  
Author(s):  
Brian H. Walsh ◽  
Chelsea Munster ◽  
Hoda El-Shibiny ◽  
Edward Yang ◽  
Terrie E. Inder ◽  
...  
Keyword(s):  
Predictive Ability ◽  
Roc Curves ◽  
Cerebral Injury ◽  
Neonatal Encephalopathy ◽  
Minimum Threshold ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Grading Systems ◽  
Good Agreement

Abstract Objective The NICHD and SIBEN assessments are adapted from the Sarnat grade, and used to determine severity of neonatal encephalopathy (NE). We compare NICHD and SIBEN methods, and their ability to define a minimum threshold associated with significant cerebral injury. Study design Between 2016 and 2019, 145 infants with NE (77-mild; 65-moderate; 3-severe) were included. NICHD and SIBEN grade and numerical scores were assigned. Kappa scores described agreement between methods, and ROC curves their ability to predict MR injury. Results Good agreement existed between grading systems (K = 0.86). SIBEN defined more infants as moderate, and less as mild, than NICHD (p < 0.001). Both numerical scores were superior to standard grades in predicting MR injury. Conclusion Despite good agreement between methods, SIBEN defines more infants as moderate NE. Both numerical scores were superior to standard grade, and comparable to each other, in defining a minimum threshold for cerebral injury. Further assessment contrasting their predictive ability for long-term outcome is required.

scholarly journals The Rate of Mutation and the Homozygous and Heterozygous Mutational Effects for Competitive Viability: A Long-Term Experiment With Drosophila melanogaster

Genetics ◽  
2001 ◽  
Vol 158 (2) ◽  
pp. 681-693 ◽  
Author(s):  
David Chavarrías ◽  
Carlos López-Fanjul ◽  
Aurora García-Dorado
Keyword(s):  
Drosophila Melanogaster ◽  
Minimum Distance ◽  
Deleterious Mutations ◽  
Regression Estimate ◽  
Term Experiment ◽  
Degree Of Dominance ◽  
Long Term Experiment ◽  
Rate Of Decline ◽  
Good Agreement

Abstract The effect of 250 generations of mutation accumulation (MA) on the second chromosome competitive viability of Drosophila melanogaster was analyzed both in homozygous and heterozygous conditions. We used full-sib MA lines, where selection hampers the accumulation of severely deleterious mutations but is ineffective against mildly deleterious ones. A large control population was simultaneously evaluated. Competitive viability scores, unaffected by the expression of mutations in heterozygosis, were obtained relative to a Cy/L2 genotype. The rate of decline in mean ΔM ≈ 0.1% was small. However, that of increase in variance ΔV ≈ 0.08 × 10-3 was similar to the values obtained in previous experiments when severely deleterious mutations were excluded. The corresponding estimates of the mutation rate λ ≥ 0.01 and the average effect of mutations E(s) ≤ 0.08 are in good agreement with Bateman-Mukai and minimum distance estimates for noncompetitive viability obtained from the same MA lines after 105 generations. Thus, competitive and noncompetitive viability show similar mutational properties. The regression estimate of the degree of dominance for mild-to-moderate deleterious mutations was ∼0.3, suggesting that the pertinent value for new unselected mutations should be somewhat smaller.

137 Recovery Dynamics in a Biomathematical Model of Fatigue

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A56-A56
Author(s):  
Mark McCauley ◽  
Peter McCauley ◽  
Hans Van Dongen
Keyword(s):  
Sleep Deprivation ◽  
Goodness Of Fit ◽  
Sleep Loss ◽  
Sleep Restriction ◽  
Commercial Aviation ◽  
Circadian Misalignment ◽  
Total Sleep Deprivation ◽  
Homeostatic Process ◽  
Recovery Sleep

Abstract Introduction In commercial aviation and other operational settings where biomathematical models of fatigue are used for fatigue risk management, accurate prediction of recovery during rest periods following duty periods with sleep loss and/or circadian misalignment is critical. The recuperative potential of recovery sleep is influenced by a variety of factors, including long-term, allostatic effects of prior sleep/wake history. For example, recovery tends to be slower after sustained sleep restriction versus acute total sleep deprivation. Capturing such dynamics has proven to be challenging. Methods Here we focus on the dynamic biomathematical model of McCauley et al. (2013). In addition to a circadian process, this model features differential equations for sleep/wake regulation including a short-term sleep homeostatic process capturing change in the order of hours/days and a long-term allostatic process capturing change in the order of days/weeks. The allostatic process modulates the dynamics of the homeostatic process by shifting its equilibrium setpoint, which addresses recently observed phenomena such as reduced vulnerability to sleep loss after banking sleep. It also differentiates the build-up and recovery rates of fatigue under conditions of chronic sleep restriction versus acute total sleep deprivation; nonetheless, it does not accurately predict the disproportionately rapid recovery seen after total sleep deprivation. To improve the model, we hypothesized that the homeostatic process may also modulate the allostatic process, with the magnitude of this effect scaling as a function of time awake. Results To test our hypothesis, we added a parameter to the model to capture modulation by the homeostatic process of the allostatic process build-up during wakefulness and dissipation during sleep. Parameter estimation using previously published laboratory datasets of fatigue showed this parameter as significantly different from zero (p&lt;0.05) and yielding a 10%–20% improvement in goodness-of-fit for recovery without adversely affecting goodness-of-fit for pre-recovery days. Conclusion Inclusion of a modulation effect of the allostatic process by the homeostatic process improved prediction accuracy in a variety of sleep loss and circadian misalignment scenarios. In addition to operational relevance for duty/rest scheduling, this finding has implications for understanding mechanisms underlying the homeostatic and allostatic processes of sleep/wake regulation. Support (if any) Federal Express Corporation

scholarly journals The Relationship between Reputation, Customer Satisfaction, Trust, and Loyalty

2014 ◽  
Vol 4 (3) ◽  
pp. 368 ◽  
Author(s):  
Roshana Gul
Keyword(s):  
Customer Satisfaction ◽  
Customer Loyalty ◽  
Significant Relationship ◽  
Positive Sign ◽  
Medical College ◽  
Independent Variable ◽  
Relationship Of ◽  
The Relationship ◽  
Self Administered Questionnaire

Though a lot of studies have been done to conclude customer loyalty as dependent variable but still there is a vast margin of researches to be conducted in future in different spheres of this construct. On the other hand the truth of the importance of customer loyalty as an enduring asset cannot be falsified. It is fundamental for organizations to build up long term and mutual beneficial associations with the customers. The purpose of this research paper is to show the inter relationship of reputation, customer satisfaction and trust on customer loyalty. According to the observations reputation is the major independent variable that has significant relationship with customer satisfaction, customer loyalty, and trust. Data for this research study was taken from the Islamia University, Quaid-e-Azam Medical College, and different banks located at various geographic locations of Bahawalpur region of Pakistan. Data was collected through self administered questionnaire and analyzed by using regression through SPSS. The results have been drawn from 150 users of NISHAT LINEN and it was found that there is positive and significant relationship among reputation, customer satisfaction, trust and customer loyalty. Hence the studies give the positive sign that with the increment of reputation, customer satisfaction and trust the customer loyalty enhances.  

Geothermal modeling of soil or mine tailings with concurrent freezing and deposition

1998 ◽  
Vol 35 (2) ◽  
pp. 234-250 ◽  
Author(s):  
JF (Derick) Nixon ◽  
Nick Holl
Keyword(s):  
Snow Cover ◽  
Mine Tailings ◽  
Frozen Soil ◽  
Freezing And Thawing ◽  
Frozen Ground ◽  
Geothermal Model ◽  
Winter Time ◽  
Upper Boundary ◽  
Good Agreement

A geothermal model is described that simulates simultaneous deposition, freezing, and thawing of mine tailings or sequentially placed layers of embankment soil. When layers of soil or mine tailings are placed during winter subfreezing conditions, frozen layers are formed in the soil profile that may persist with time. The following summer, warmer soil placement may not be sufficient to thaw out layers from the preceding winter. Remnant frozen soil layers may persist for many years or decades. The analysis is unique, as it involves a moving upper boundary and different surface snow cover functions applied in winter time. The model is calibrated based on two uranium mines in northern Saskatchewan. The Rabbit Lake scenario involves tailings growth to a height of 120 m over a period of 24 years. At Key Lake, tailings increase in height at a rate of 1.3 m/year. Good agreement between the observed position of frozen layers and those predicted by the model is obtained. Long-term predictions indicate that from 80 to 200 years would be required to thaw out the frozen layers formed during placement, assuming 1992 placement conditions continue. Deposition rates of 1.5-3 m/year give the largest amounts of frozen ground. The amount of frozen ground is sensitive to the assumed snow cover function during winter.Key words: geothermal, model, tailings, freezing, deposition.

Long-term thermal two- and three-dimensional analysis of roller compacted concrete dams supported by monitoring verification

2010 ◽  
Vol 37 (4) ◽  
pp. 600-610 ◽  
Author(s):  
Vladan Kuzmanovic ◽  
Ljubodrag Savic ◽  
John Stefanakos
Keyword(s):  
Thermal Analysis ◽  
Boundary Conditions ◽  
Thermal Field ◽  
Numerical Models ◽  
Three Dimensional ◽  
Roller Compacted Concrete ◽  
Rcc Dam ◽  
Field Investigations ◽  
Good Agreement

This paper presents two-dimensional (2D) and three-dimensional (3D) numerical models for unsteady phased thermal analysis of RCC dams. The time evolution of a thermal field has been modeled using the actual dam shape, RCC technology and the adequate description of material properties. Model calibration and verification has been done based on the field investigations of the Platanovryssi dam, the highest RCC dam in Europe. The results of a long-term thermal analysis, with actual initial and boundary conditions, have shown a good agreement with the observed temperatures. The influence of relevant parameters on the thermal field of RCC dams has been analyzed. It is concluded that the 2D model is appropriate for the thermal phased analysis, and that the boundary conditions and the mixture properties are the most influential on the RCC dam thermal behavior.

Newborn assessment and long-term adverse outcome: A systematic review

1999 ◽  
Vol 180 (4) ◽  
pp. 1024-1029 ◽  
Author(s):  
Jeroen E. van de Riet ◽  
Frank P.H.A. Vandenbussche ◽  
Saskia Le Cessie ◽  
Marc J.N.C. Keirse
Keyword(s):  
Systematic Review ◽  
Adverse Outcome
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