scholarly journals Advances in Medical Revascularisation Treatments in Acute Ischemic Stroke

Thrombosis ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-14 ◽  
Author(s):  
H. Asadi ◽  
B. Yan ◽  
R. Dowling ◽  
S. Wong ◽  
P. Mitchell
Keyword(s):  
Functional Outcomes ◽  
Large Scale ◽  
Review Article ◽  
Transcranial Ultrasound ◽  
Thrombin Inhibitor ◽  
Ongoing Research ◽  
Stroke Treatment ◽  
Ischaemic Brain ◽  
Complete Recanalisation ◽  
New Treatments

Urgent reperfusion of the ischaemic brain is the aim of stroke treatment and there has been ongoing research to find a drug that can promote vessel recanalisation more completely and with less side effects. In this review article, the major studies which have validated the use and safety of tPA are discussed. The safety and efficacy of other thrombolytic and anticoagulative agents such as tenecteplase, desmoteplase, ancrod, tirofiban, abciximab, eptifibatide, and argatroban are also reviewed. Tenecteplase and desmoteplase are both plasminogen activators with higher fibrin affinity and longer half-life compared to alteplase. They have shown greater reperfusion rates and improved functional outcomes in preliminary studies. Argatroban is a direct thrombin inhibitor used as an adjunct to intravenous tPA and showed higher rates of complete recanalisation in the ARTTS study with further studies which are now ongoing. Adjuvant thrombolysis techniques using transcranial ultrasound are also being investigated and have shown higher rates of complete recanalisation, for example, in the CLOTBUST study. Overall, development in medical therapies for stroke is important due to the ease of administration compared to endovascular treatments, and the new treatments such as tenecteplase, desmoteplase, and adjuvant sonothrombolysis are showing promising results and await further large-scale clinical trials.

Recent Developments in the Downstream Processing of Phycobiliproteins from Algae: A Review

2021 ◽  
Vol 06 ◽  
Author(s):  
Ayekpam Chandralekha Devi ◽  
G. K. Hamsavi ◽  
Simran Sahota ◽  
Rochak Mittal ◽  
Hrishikesh A. Tavanandi ◽  
...  
Keyword(s):  
Cell Wall ◽  
Large Scale ◽  
Downstream Processing ◽  
Review Article ◽  
Current Status ◽  
Wall Structure ◽  
Scale Production ◽  
Cell Wall Disruption ◽  
Recent Developments ◽  
Macro Algae

Abstract: Algae (both micro and macro) have gained huge attention in the recent past for their high commercial value products. They are the source of various biomolecules of commercial applications ranging from nutraceuticals to fuels. Phycobiliproteins are one such high value low volume compounds which are mainly obtained from micro and macro algae. In order to tap the bioresource, a significant amount of work has been carried out for large scale production of algal biomass. However, work on downstream processing aspects of phycobiliproteins (PBPs) from algae is scarce, especially in case of macroalgae. There are several difficulties in cell wall disruption of both micro and macro algae because of their cell wall structure and compositions. At the same time, there are several challenges in the purification of phycobiliproteins. The current review article focuses on the recent developments in downstream processing of phycobiliproteins (mainly phycocyanins and phycoerythrins) from micro and macroalgae. The current status, the recent advancements and potential technologies (that are under development) are summarised in this review article besides providing future directions for the present research area.

scholarly journals Diagnosis of tuberculosis in wildlife: a systematic review

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Jobin Thomas ◽  
Ana Balseiro ◽  
Christian Gortázar ◽  
María A. Risalde
Keyword(s):  
Systematic Review ◽  
Test Performance ◽  
Diagnostic Tests ◽  
Large Scale ◽  
Diagnostic Techniques ◽  
Review Literature ◽  
Meat Industry ◽  
Post Mortem ◽  
Serological Tests ◽  
Ongoing Research

AbstractAnimal tuberculosis (TB) is a multi-host disease caused by members of the Mycobacterium tuberculosis complex (MTC). Due to its impact on economy, sanitary standards of milk and meat industry, public health and conservation, TB control is an actively ongoing research subject. Several wildlife species are involved in the maintenance and transmission of TB, so that new approaches to wildlife TB diagnosis have gained relevance in recent years. Diagnosis is a paramount step for screening, epidemiological investigation, as well as for ensuring the success of control strategies such as vaccination trials. This is the first review that systematically addresses data available for the diagnosis of TB in wildlife following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The article also gives an overview of the factors related to host, environment, sampling, and diagnostic techniques which can affect test performance. After three screenings, 124 articles were considered for systematic review. Literature indicates that post-mortem examination and culture are useful methods for disease surveillance, but immunological diagnostic tests based on cellular and humoral immune response detection are gaining importance in wildlife TB diagnosis. Among them, serological tests are especially useful in wildlife because they are relatively inexpensive and easy to perform, facilitate large-scale surveillance and can be used both ante- and post-mortem. Currently available studies assessed test performance mostly in cervids, European badgers, wild suids and wild bovids. Research to improve diagnostic tests for wildlife TB diagnosis is still needed in order to reach accurate, rapid and cost-effective diagnostic techniques adequate to a broad range of target species and consistent over space and time to allow proper disease monitoring.

scholarly journals Surgery for Coagulopathy-Related Intracerebral Hemorrhage: Craniotomy vs. Minimally Invasive Neurosurgery

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 564
Author(s):  
Yen-Bo Liu ◽  
Lu-Ting Kuo ◽  
Chih-Hao Chen ◽  
Woon-Man Kung ◽  
Hsin-Hsi Tsai ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Intracerebral Hemorrhage ◽  
Functional Outcomes ◽  
Large Scale ◽  
Promising Result ◽  
Multivariable Logistic Regression Analysis ◽  
Published Data ◽  
Complication Rates ◽  
Minimally Invasive Neurosurgery ◽  
Reduction Of Mortality

Coagulopathy-related intracerebral hemorrhage (ICH) is life-threatening. Recent studies have shown promising results with minimally invasive neurosurgery (MIN) in the reduction of mortality and improvement of functional outcomes, but no published data have recorded the safety and efficacy of MIN for coagulopathy-related ICH. Seventy-five coagulopathy-related ICH patients were retrospectively reviewed to compare the surgical outcomes between craniotomy (n = 52) and MIN (n = 23). Postoperative rebleeding rates, morbidity rates, and mortality at 1 month were analyzed. Postoperative Glasgow Outcome Scale Extended (GOSE) and modified Rankin Scale (mRS) scores at 1 year were assessed for functional outcomes. Morbidity, mortality, and rebleeding rates were all lower in the MIN group than the craniotomy group (8.70% vs. 30.77%, 8.70% vs. 19.23%, and 4.35% vs. 23.08%, respectively). The 1-year GOSE score was significantly higher in the MIN group than the craniotomy group (3.96 ± 1.55 vs. 3.10 ± 1.59, p = 0.027). Multivariable logistic regression analysis also revealed that MIN contributed to improved GOSE (estimate: 0.99650, p = 0.0148) and mRS scores (estimate: −0.72849, p = 0.0427) at 1 year. MIN, with low complication rates and improved long-term functional outcome, is feasible and favorable for coagulopathy-related ICH. This promising result should be validated in a large-scale prospective study.

scholarly journals A 10-Year Follow-Up of Two-Incision and Modified Watson-Jones Total Hip Arthroplasty in Patients with Osteonecrosis of the Femoral Head

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
Shih-Jie Lin ◽  
Tsan-Wen Huang ◽  
Po-Chun Lin ◽  
Feng-Chih Kuo ◽  
Kuo-Ti Peng ◽  
...  
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Functional Outcomes ◽  
Large Scale ◽  
Operation Time ◽  
Harris Hip Score ◽  
Total Hip ◽  
Radiographic Parameters

Long-term data and information indicating whether minimally invasive surgery (MIS) approaches are safe and effective with total hip arthroplasty (THA) are lacking. Between 2004 and 2006, 75 patients with alcohol-related osteonecrosis of the femoral head (ONFH) who underwent 75 THAs with the two-incision approach were studied. The medical records, radiographic parameters, and functional outcomes were collected prospectively. All data were compared with those for matched patients who underwent a modified Watson-Jones (WJ) approach. THA using the two-incision approach was associated with longer operation time, more blood loss, more lateral femoral cutaneous nerve injury, and more periprosthetic femoral fractures (p<0.05for all four) than the modified WJ approach. The Harris Hip Score (HHS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) increased significantly from the period preoperatively to 6 weeks postoperatively and thereafter up to the last follow-up in both groups. However, there were no significant differences in terms of radiographic parameters and functional outcomes between the two groups throughout the study period. Both the two-incision and the modified WJ approach provided satisfactory results and survival rates at a mean follow-up of 10.8 years. A prospective, randomized, large-scale cohort study is still warranted for evidence-based recommendations.

scholarly journals Redefining the political moment

2011 ◽  
Vol 3 (2) ◽  
pp. 72-89 ◽  
Author(s):  
James Arvanitakis
Keyword(s):  
Large Scale ◽  
Political Action ◽  
The Political ◽  
Ongoing Research ◽  
The Public ◽  
Political Processes ◽  
John Howard ◽  
Conservative Media ◽  
Definition Of ◽  
War Protest

On 16 February 2003, more than half a million people gathered in Sydney, Australia, as part of a global anti-war protest aimed at stopping the impending invasion of Iraq by the then US Administration. It is difficult to estimate how many millions marched on the coordinated protest, but it was by far the largest mobilization of a generation. Walking and chanting on the streets of Sydney that day, it seemed that a political moment was upon us. In a culture that rarely embraces large scale activism, millions around Australian demanded to be heard. The message was clear: if you do not hear us, we would be willing to bring down a government. The invasion went ahead, however, with the then Australian government, under the leadership of John Howard, being one of the loudest and staunchest supporters of the Bush Administrations drive to war. Within 18 months, anti-war activists struggled to have a few hundred participants take part in anti-Iraq war rallies, and the Howard Government was comfortably re-elected for another term. The political moment had come and gone, with both social commentators and many members of the public looking for a reason. While the conservative media was often the focus of analysis, this paper argues that in a time of late capitalism, the political moment is hollowed out by ‘Politics’ itself. That is to say, that formal political processes (or ‘Politics’) undermine the political practices that people participate in everyday (or ‘politics’). Drawing on an ongoing research project focusing on democracy and young people, I discuss how the concept of ’politics‘ has been destabilised and subsequently, the political moment has been displaced. This displacement has led to a re-definition of ‘political action’ and, I argue, the emergence of a different type of everyday politics.

scholarly journals Fluids of the Future

2021 ◽  
Vol 7 ◽  
Author(s):  
Thomas H. Edwards ◽  
Guillaume L. Hoareau
Keyword(s):  
Acute Care ◽  
Fluid Resuscitation ◽  
Large Scale ◽  
Large Temperature ◽  
Ongoing Research ◽  
Military Research ◽  
Animal Data ◽  
Life Saving ◽  
The Future ◽  
Significant Burden

Fluids are a vital tool in the armament of acute care clinicians in both civilian and military resuscitation. We now better understand complications from inappropriate resuscitation with currently available fluids; however, fluid resuscitation undeniably remains a life-saving intervention. Military research has driven the most significant advances in the field of fluid resuscitation and is currently leading the search for the fluids of the future. The veterinary community, much like our civilian human counterparts, should expect the fluid of the future to be the fruit of military research. The fluids of the future not only are expected to improve patient outcomes but also be field expedient. Those fluids should be compatible with military environments or natural disaster environments. For decades, military personnel and disaster responders have faced the peculiar demands of austere environments, prolonged field care, and delayed evacuation. Large scale natural disasters present field limitations often similar to those encountered in the battlefield. The fluids of the future should, therefore, have a long shelf-life, a small footprint, and be resistant to large temperature swings, for instance. Traumatic brain injury and hemorrhagic shock are the leading causes of preventable death for military casualties and a significant burden in civilian populations. The military and civilian health systems are focusing efforts on field-expedient fluids that will be specifically relevant for the management of those conditions. Fluids are expected to be compatible with blood products, increase oxygen-carrying capabilities, promote hemostasis, and be easy to administer in the prehospital setting, to match the broad spectrum of current acute care challenges, such as sepsis and severe systemic inflammation. This article will review historical military and civilian contributions to current resuscitation strategies, describe the expectations for the fluids of the future, and describe select ongoing research efforts with a review of current animal data.

scholarly journals Decompressive craniectomy for internal carotid artery and middle carotid artery infarctions: a long-term comparative outcome study

2021 ◽  
Vol 51 (1) ◽  
pp. E10
Author(s):  
Jia Xu Lim ◽  
Srujana Venkata Vedicherla ◽  
Shu Kiat Sukit Chan ◽  
Nishal Kishinchand Primalani ◽  
Audrey J. L. Tan ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Decompressive Craniectomy ◽  
Functional Outcomes ◽  
Internal Carotid ◽  
Neurological Status ◽  
Inpatient Mortality ◽  
Stroke Treatment ◽  
Significant Difference ◽  
Cox Proportional Hazard Regression

OBJECTIVE Malignant internal carotid artery (ICA) infarction is an entirely different disease entity when compared with middle cerebral artery (MCA) infarction. Because of an increased area of infarction, it is assumed to have a poorer prognosis; however, this has never been adequately investigated. Decompressive craniectomy (DC) for malignant MCA infarction has been shown to improve mortality rates in several randomized controlled trials. Conversely, aggressive surgical decompression for ICA infarction has not been recommended. The authors sought to compare the functional outcomes and survival between patients with ICA infarctions and those with MCA infarctions after DC in the largest series to date to investigate this assumption. METHODS A multicenter retrospective review of 154 consecutive DCs for large territory cerebral infarctions performed from 2005 to 2020 were analyzed. Patients were divided into ICA and MCA groups depending on the territory of infarction. Variables, including age, sex, medical comorbidities, laterality of the infarction, preoperative neurological status, primary stroke treatment, and the time from stroke onset to DC, were recorded. Univariable and multivariable analyses were performed for the clinical exposures for functional outcomes (modified Rankin Scale [mRS] score) on discharge and at the 1- and 6-month follow-ups, and for mortality, both inpatient and at the 1-year follow-up. A favorable mRS score was defined as 0–2. RESULTS There were 67 patients (43.5%) and 87 patients (56.5%) in the ICA and MCA groups, respectively. Univariable analysis showed that the ICA group had a comparably favorable mRS (OR 0.15 [95% CI 0.18–1.21], p = 0.077). Inpatient mortality (OR 1.79 [95% CI 0.79–4.03], p = 0.16) and 1-year mortality (OR 2.07 [95% CI 0.98–4.37], p = 0.054) were comparable between the groups. After adjustment, a favorable mRS score at 6 months (OR 0.17 [95% CI 0.018–1.59], p = 0.12), inpatient mortality (OR 1.02 [95% CI 0.29–3.57], p = 0.97), and 1-year mortality (OR 0.94 [95% CI 0.41–2.69], p = 0.88) were similar in both groups. The overall survival, plotted using the Cox proportional hazard regression, did not show a significant difference between the ICA and MCA groups (HR 0.581). CONCLUSIONS Unlike previous smaller studies, this study found that patients with malignant ICA infarction had a functional outcome and survival that was similar to those with MCA infarction after DC. Therefore, DC can be offered for malignant ICA infarction for life-saving purposes with limited functional recovery.

scholarly journals Surgical treatment of tandem stenosis of the internal carotid artery

2021 ◽  
Vol 25 (3) ◽  
pp. 20
Author(s):  
A. D. Pryamikov ◽  
A. B. Mironkov ◽  
A. I. Khripun
Keyword(s):  
Surgical Treatment ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
World Literature ◽  
Large Scale ◽  
Internal Carotid ◽  
Review Article ◽  
Conflicts Of Interests ◽  
Tandem Stenosis ◽  
Instrumental Methods

<p>This review article presents an analysis of the world literature devoted to treating patients with tandem stenosis of the intra- and extra-cranial parts of the internal carotid artery. We indicate the frequency of tandem lesion occurrence and describe the applied instrumental methods of its diagnosis. The review demonstrates the results of tandem stenosis surgical treatment in both early and more modern studies and describes the possibilities of endovascular correction of extra- and intra-cranial stenosis of the internal carotid artery. The authors emphasise the lack of large-scale studies — including randomised studies — regarding combined, tandem carotid stenosis and the need for further studies.</p><p>Received 30 March 2021. Revised 8 May 2021. Accepted 11 May 2021.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflicts of interests.</p><p><strong>Contribution of the authors:</strong> The authors contributed equally to this article.</p>

scholarly journals Towards empathetic autism research: Developing an autism-specific Research Passport

2020 ◽  
Author(s):  
Maria Ashworth ◽  
Laura Crane ◽  
Robyn Steward ◽  
Melissa Bovis ◽  
Liz Pellicano
Keyword(s):  
Large Scale ◽  
Preliminary Evaluation ◽  
Research Projects ◽  
Community Members ◽  
Ongoing Research ◽  
Negative Experiences ◽  
Autism Research ◽  
Iterative Design ◽  
Large Scale Testing ◽  
Autistic Adults

Despite a dramatic increase in the amount of autism research taking place, autistic adults often report negative experiences of participating in such research. In other areas where community members report dissatisfaction (e.g., healthcare, criminal justice), ‘passports’ or ‘toolkits’ have been developed. In the current project, we created a Research Passport that could be used by autistic adults and autism researchers when engaging in research. Using a participatory framework, we designed and developed a Research Passport via an iterative design process. First, focus groups with autistic adults (n=9) and autism researchers (n=6) were used to elicit initial ideas for a Research Passport. Findings showed that the Research Passport (1) was perceived to be a useful idea, but not a panacea for all issues in autism research, (2) needed to be universal and flexible, and (3) could have a broad remit (e.g., to record scores on commonly-used standardized tasks that could, with permission, be shared with different researchers). Next, a preliminary evaluation of a prototype Research Passport was conducted via usability testing in three ongoing research projects. Nine autistic participants provided feedback (via a survey), as did three researchers (via interviews). We identified three themes from these data, highlighting how the Research Passport: (1) promoted positive participant-researcher relationships, (2) provided a structure and framework to support existing practices, and (3) needed to be adapted slightly to facilitate usability and manage expectations. Overall, the Research Passport was perceived to be useful in promoting empathetic autism research. Further design and large-scale testing are warranted.

A National Outcomes Assessment of the Rehabilitation of Adults with Visual Impairments

2000 ◽  
Vol 94 (5) ◽  
pp. 281-291 ◽  
Author(s):  
William R. De l'Aune ◽  
Richard L. Welsh ◽  
Michael D. Williams
Keyword(s):  
Functional Outcomes ◽  
Large Scale ◽  
Outcomes Assessment ◽  
Visual Impairments ◽  
Self Report ◽  
Research Project ◽  
History Of

This article discusses the development of self-report functional outcomes instruments in two years of a three-year large-scale national research project on the rehabilitation of adults with visual impairments. It describes the history of the effort, the process involved, and the methods used in establishing the instruments’ reliability, validity, and responsivity and the results of intermediate analyses of the data.

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