Safety and efficacy of sonothrombolysis for acute ischaemic stroke: a multicentre, double-blind, phase 3, randomised controlled trial.

Background: Pulsed-wave ultrasound increases the exposure of an intracranial thrombus to alteplase (recombinant tissue plasminogen activator), potentially facilitating early reperfusion. We aimed to ascertain if a novel operator-independent transcranial ultrasound device delivering low-power high-frequency ultrasound could improve functional outcome in patients treated with alteplase after acute ischaemic stroke.

Methods: We did a multicentre, double-blind, phase 3, randomised controlled trial (CLOTBUST-ER) at 76 medical centres in 14 countries.

Combined lysis of thrombus with ultrasound and systemic tissue plasminogen activator for emergent revascularization in acute ischemic stroke (CLOTBUST-ER): design and methodology of a multinational phase 3 trial.

Background: We designed a Phase 3 clinical trial to determine the safety and efficacy of adding transcranial ultrasound using an operator-independent headframe to recombinant tissue-plasminogen-activator for the treatment of acute ischemic stroke.

Methods: Combined lysis of thrombus with ultrasound and systemic tissue-plasminogen-activator for emergent revascularization in acute ischemic stroke is a randomized, double-blind, placebo-controlled clinical trial that will enroll subjects with the following main inclusion criteria: less than 4·5 hours from symptom onset (three-hours in US and Canada), age 18-80 years, baseline National Institutes of Health Stroke Scale score ≥ 10, and premorbid modified-Rankin-score of 0-1, eligibility for full dose recombinant tissue-plasminogen-activator. Subjects will receive two-hours of 2-MHz pulsed wave transcranial ultrasound (target group) or sham ultrasound (control group).

Comparative efficacy of different acute reperfusion therapies for acute ischemic stroke: a comprehensive benefit-risk analysis of clinical trials.

Background: Numerous acute reperfusion therapies (RPT) are currently investigated as potential new therapeutic targets in acute ischemic stroke (AIS). We conducted a comprehensive benefit-risk analysis of available clinical studies assessing different acute RPT, and investigated the utility of each intervention in comparison to standard intravenous thrombolysis (IVT) and in relation to the onset-to-treatment time (OTT).

Methods: A comprehensive literature search was conducted to identify all available published, peer-reviewed clinical studies that evaluated the efficacy of different RPT in AIS.

Outcomes following sonothrombolysis in severe acute ischemic stroke: subgroup analysis of the CLOTBUST trial.

Background: Sonothrombolysis is safe and may increase the likelihood of early recanalization in acute ischemic stroke patients.

Aims: In preparation of a phase III clinical trial, we contrast the likelihood of achieving a sustained recanalization and functional independence in a post hoc subgroup analysis of patients randomized to transcranial Doppler monitoring plus intravenous tissue plasminogen activator (sonothrombolysis) compared with intravenous tissue plasminogen activator alone in the CLOTBUST trial.

Methods: We analyzed the data from all randomized acute ischemic stroke patients with pretreatment National Institutes of Health Stroke Scale scores ≥ 10 points and proximal intracranial occlusions in the CLOTBUST trial.

CLOTBUST-hands free: initial safety testing of a novel operator-independent ultrasound device in stroke-free volunteers.

Background And Purpose: We aimed to evaluate safety and tolerability of a novel operator-independent ultrasound device among stroke-free volunteers.

Methods: A headframe containing 18 ultrasound transducers (each operating at 2 MHz, pulsed-wave) was used to expose both temporal windows and the suboccipital window. The transmission characteristics were set to emulate the acoustic characteristics of the exposure levels in the Combined Lysis of Thrombus in Brain Ischemia using Transcranial Ultrasound and Systemic tPA (CLOTBUST) trial and to never exceed Food and Drug Administration mandated diagnostic ultrasound exposure limits.

Exploratory analysis of estimated acoustic peak rarefaction pressure, recanalization, and outcome in the transcranial ultrasound in clinical sonothrombolysis trial.

Purpose: Acoustic peak rarefaction pressure (APRP) is the main factor that influences ultrasound-enhanced thrombolysis. We sought to determine whether recanalization rate and functional outcomes in the Transcranial Ultrasound in Clinical SONothrombolysis (TUCSON) trial could be predicted by estimated in vivo APRP.

Methods: We developed an acoustic attenuation model to estimate the in vivo APRP at the arterial occlusion site in each subject of the TUCSON trial with CT scans eligible for measurements.

Mercury regulation, fate, transport, transformation, and abatement within cement manufacturing facilities: review.

The USEPA's 2010 mercury rule, which would reduce emissions from non-hazardous waste burning cement manufacturing facilities by an estimated 94%, represents a substantial regulatory challenge for the industry. These regulations, based on the performance of facilities that benefit from low concentrations of mercury in their feedstock and fuel inputs (e.g.

Formation of nanooctahedra in molybdenum disulfide and molybdenum diselenide using pulsed laser vaporization.

Pulsed laser vaporization has been used to produce nanooctahedra of MoS2 and MoSe2. The nanooctahedra primarily form in two- or three-layer nested octahedra, although nesting up to five layers has been observed. Tilting the TEM sample stage and mapping how the images of single particles transformed provided the evidence to verify their octahedral geometry.

Social studies: incorporating all children using community and cultural universals as the centerpiece.

This article features an elementary teacher who has worked with the authors for the past 10 years in research on building a classroom community and using cultural universals as the centerpiece for elementary social studies for all children. Cultural universals are basic human needs and social experiences found in all societies, past and present, and include food, shelter, clothing, transportation, communication, family living, money, childhood, government, and so on. Actions related to cultural universals are experienced by all children regardless of their cultures, socioeconomic backgrounds, achievement levels, or special needs, so teachers can connect to these experiences as bases for developing historical, geographic, political, economic, sociological, psychological, or anthropological understandings.

Effects of wastewater disinfection on waterborne bacteria and viruses.

Wastewater disinfection is practiced with the goal of reducing risks of human exposure to pathogenic microorganisms. In most circumstances, the efficacy of a wastewater disinfection process is regulated and monitored based on measurements of the responses of indicator bacteria. However, inactivation of indicator bacteria does not guarantee an acceptable degree of inactivation among other waterborne microorganisms (e.

Self-assembly of linear arrays of semiconductor nanoparticles on carbon single-walled nanotubes.

Ligand-stabilized nanocrystals (NCs) were strongly bound to the nanotube surfaces by simple van der Waals forces. Linear arrays of CdSe and InP quantum dots were formed by self-assembly using the grooves in bundles of carbon single-walled nanotubes (SWNTs) as a one-dimensional template. A simple geometrical model explains the ordering in terms of the anisotropic properties of the nanotube surface.

Biosolids-amended soils: Part I. Effect of biosolids application on soil quality and ecotoxicity.

Investigations of potential risk from biosolids generally indicate that land application does not threaten human or ecosystem health, but questions continue to arise concerning the environmental effects of this practice. This research project was initiated to evaluate ecotoxicity resulting from the amendment of soils with biosolids from municipal wastewater treatment plants. Toxicity was evaluated using standard tests, including earthworm mortality, growth, and reproduction; seedling germination and root elongation; microbial respiration; and nematode mortality and reproduction.

[Diagnostic image (261). A woman with vulval ulcera and uveitis].

A 49-year-old woman suffered from vulval and vaginal ulcera and from oral mucosal lesions and uveitis due to Behçet's disease.

Feasibility of using ultrasonic irradiation to recover active biomass from waste activated sludge.

Under typical operating conditions, the microbial fraction of activated sludge flocs is approximately 40% by weight. The objective of this research is to evaluate the feasibility of using ultrasonic irradiation to disrupt activated sludge flocs allowing for the subsequent separation of active and inactive fractions. If separation of floc components is possible, then methods may be incorporated into wastewater treatment plant operations whereby only the inactive fraction of floc is wasted (i.

Impacts of reduced sulfur components on active and resting ammonia oxidizers.

While there has been significant research on the nature and extent of the impact of inhibitory reduced sulfur with respect to anaerobic (e.g., methanogenic and sulfidogenic) microbial systems, only limited study has yet been conducted on the comparable effects of soluble sulfides which might occur within aerobic wastewater treatment systems.

Toxicity of model aliphatic amines and their chlorinated forms.

Aliphatic amines can be found in many wastewater effluents from industry, agriculture, pharmacy, and food processing. Amines can induce toxicological responses that are relevant in biochemical treatment processes, as well as in natural waters. This research compared the toxicity and inhibition caused by three aliphatic amines (n-propylamine, ethylmethylamine, and trimethylamine) and their chlorinated derivatives.

Primary breast lymphoma, contralateral breast cancer, and bilateral Brenner tumors of the ovary.

Background: Primary lymphoma of the breast is an unusual clinical entity. Its presence with invasive breast cancer and bilateral Brenner tumors of the ovary is very rare.

Case: We report a 62-year-old woman referred for further evaluation of a palpable mass in her breast.

Personal, practical, and professional issues in providing managed mental health care: a discussion for new psychotherapists.

Written by a former corporate manager pursuing counseling as a 2nd career, this article offers pointed views on managed mental health. Values of practitioners that are a mismatch for managed care are noted, and more specific disadvantages and advantages are examined. Loss of client confidentiality is addressed and procedures and technologies for its reclamation are noted.

Stability of the bacterial communities supported by a seven-stage biological process treating pharmaceutical wastewater as revealed by PCR-DGGE.

The stabilities of the bacterial community structures supported by seven full-scale biological reactors treating pharmaceutical wastewater were investigated by denaturing gradient gel electrophoresis (DGGE) of polymerase chain reaction (PCR) amplified 16S rRNA gene fragments. Effluent quality from this treatment process was consistently high with respect to BOD5 (<30 mgl(-1)), soluble COD (<500 mgl(-1)), and total ammonia (< 5 mgl(-1) as N) concentrations. Long-term community structure stability was studied by comparing the similarity of PCR-DGGE fingerprints from samples collected 87 days apart between which the influent wastewater characteristics were relatively stable.

Aerobic biological treatment of a pharmaceutical wastewater: effect of temperature on cod removal and bacterial community development.

The effect of temperature was studied on the efficiency of soluble COD removal and bacterial community development during the aerobic biological treatment of a pharmaceutical wastewater. Using wastewater and bacterial inoculum obtained from the full-scale facility treating this wastewater, batch laboratory cultures were operated at 5 degrees C intervals from 30 degrees C to 70 C. Following four culture transfers to allow for bacterial acclimation, residual soluble COD levels were measured and bacterial community fingerprints were obtained by denaturing gradient gel electrophoresis (DGGE) of polymerase chain reaction (PCR)-amplified 16S rRNA gene fragments.

Thermophilic aerobic treatment of a synthetic wastewater in a membrane-coupled bioreactor.

Synthetic wastewater containing alpha-lactose and gelatin was treated in a thermophilic membrane-coupled bioreactor (MBR). Thermophilic (>45 degrees C) treatment represents a potentially advantageous process for high-temperature as well as high-strength industrial wastewaters susceptible to reactor autoheating. Thermophilic systems, however, generally support a nonflocculating biomass that resists conventional methods of cell separation from the treated wastewater.

Chemical characterization of synthetic soil from composting coal combustion and pharmaceutical by-products.

Land application of coal combustion by-products (CCBs) mixed with solid organic wastes (SOWs), such as municipal sewage sludge, has become increasingly popular as a means of productively using what were once considered waste products. Although bulk chemical and physical properties of several of these CCB-SOW materials have been reported, detailed information about their synthesis and mineralogy of the CCB-SOW materials has not been reported. In this paper, chemical and mineralogical properties of a soil-like material obtained from composting a mixture of CCBs with a pharmaceutical fermentation by-product (FB) were investigated at the laboratory and field scale.

Phylogenetic analysis of bacterial communities in mesophilic and thermophilic bioreactors treating pharmaceutical wastewater.

The phylogenetic diversity of the bacterial communities supported by a seven-stage, full-scale biological wastewater treatment plant was studied. These reactors were operated at both mesophilic (28 to 32 degrees C) and thermophilic (50 to 58 degrees C) temperatures. Community fingerprint analysis by denaturing gradient gel electrophoresis (DGGE) of the PCR-amplified V3 region of the 16S rRNA gene from the domain Bacteria revealed that these seven reactors supported three distinct microbial communities.

Inhibition of insulin receptor phosphorylation by PC-1 is not mediated by the hydrolysis of adenosine triphosphate or the generation of adenosine.

Individuals with insulin resistance show increased levels of PC-1 expression in skeletal muscle and fibroblasts, and in transfected cell lines that overexpress PC-1 there is a reduction in the insulin-stimulated insulin receptor tyrosine phosphorylation. As PC-1 is a type II transmembrane protein with extracellular phosphodiesterase and pyrophosphatase activity, increased expression of PC-1 at the cell surface will decrease extracellular adenosine triphosphate levels and increase extracellular adenosine levels. Consequently it is possible that PC-1-mediated insulin resistance could be caused either by a decrease in adenosine triphosphate or an indirect increase in adenosine levels.

Fiber-linked telescope array: description and laboratory tests of a two-channel prototype.

We present a complete two-telescope version of a fiber-linked coherent array that is meant to be used for mounting on the dish of a radio telescope. This was built with 20-cm amateur telescopes and includes three different servo subsystems for guiding, nulling of the air path difference, and fiber length control. Laboratory tests of the fully integrated system in front of a star simulator are described.