van der Hoeven E.J.R.J.,St Antonius Hospital |
Schonewille W.J.,St Antonius Hospital |
Vos J.A.,St Antonius Hospital |
Algra A.,University Utrecht |
And 11 more authors.
Trials | Year: 2013
Background: Despite recent advances in acute stroke treatment, basilar artery occlusion (BAO) is associated with a death or disability rate of close to 70%. Randomised trials have shown the safety and efficacy of intravenous thrombolysis (IVT) given within 4.5 h and have shown promising results of intra-arterial thrombolysis given within 6 h of symptom onset of acute ischaemic stroke, but these results do not directly apply to patients with an acute BAO because only few, if any, of these patients were included in randomised acute stroke trials.Recently the results of the Basilar Artery International Cooperation Study (BASICS), a prospective registry of patients with acute symptomatic BAO challenged the often-held assumption that intra-arterial treatment (IAT) is superior to IVT. Our observations in the BASICS registry underscore that we continue to lack a proven treatment modality for patients with an acute BAO and that current clinical practice varies widely.Design: BASICS is a randomised controlled, multicentre, open label, phase III intervention trial with blinded outcome assessment, investigating the efficacy and safety of additional IAT after IVT in patients with BAO. The trial targets to include 750 patients, aged 18 to 85 years, with CT angiography or MR angiography confirmed BAO treated with IVT. Patients will be randomised between additional IAT followed by optimal medical care versus optimal medical care alone. IVT has to be initiated within 4.5 h from estimated time of BAO and IAT within 6 h. The primary outcome parameter will be favourable outcome at day 90 defined as a modified Rankin Scale score of 0-3.Discussion: The BASICS registry was observational and has all the limitations of a non-randomised study. As the IAT approach becomes increasingly available and frequently utilised an adequately powered randomised controlled phase III trial investigating the added value of this therapy in patients with an acute symptomatic BAO is needed (clinicaltrials.gov: NCT01717755). © 2013 van der Hoeven et al.; licensee BioMed Central Ltd.
Orpin P.G.,Park Veterinary Group |
Esslemont R.J.,Bh Tec Inc.
Cattle Practice | Year: 2010
The culling and wastage within dairy herds is a major loss to the dairy industry. This paper reviews the incidence and estimated costs of culling and aims to provide practical guidance on how culling audits can be used in veterinary practice to identify profit opportunities for the farmer. The economic losses, however, are largely defined by the culling reason and whether the cow exits the herd as a cow sold live at the end of a productive lactation, as an emergency cull (but live) in early lactation or as a dead animal of no value. The development of a web based health planning tool (www.myhealthyherd. com) has allowed veterinary practitioners and fanners to enter data on culling and reasons for culling. This approach enables a comprehensive culling audit to performed on the basis not only of overall incidence or incidence by culling reason but also allows a detailed economic analysis of culling costs compared to farmer agreed targets. Analysis of data from 843 herds in the UK utilising the myhealthyherd program demonstrated that the mean culling rate was 22% with the predominant reasons for culling being fertility, udder health and lameness. 23% of all culls were removed due to "sickness/death and casualty". On a national basis this is equivalent to 5% of the national herd being culled annually for these reasons. Detailed economic analysis and audit on an annual basis is a more reliable basis for assessment of culling performance than simply calculating culling rates.
Radley J.D.,University of Birmingham |
Coram R.A.,Bh Tec Inc.
Geology Today | Year: 2014
Quartzite pebbles and cobbles, commonly known as Bunter quartzites, are widely dispersed throughout southern Britain. They can be traced back to Early Triassic pebble beds outcropping in the Wessex Basin and the English Midlands. Derived fossils within the quartzites confirm that most, if not all, were derived from Ordovician and Devonian terrains, over what is now the general region of the Armorican peninsula of north-west France. In Early Triassic times that area of ancient rocks formed part of a chain of young Variscan mountains which were subject to a monsoonal climate, and shed vast quantities of eroded quartzite. Ultimately, this debris was transported northwards into what is now southern Britain, by the Budleighensis river system. © 2014 John Wiley & Sons Ltd, The Geologists' Association & The Geological Society of London.
PubMed | University of Valencia, SumagrupoVeterinario, CEU Cardenal Herrera University and Bh Tec Inc.
Type: Case Reports | Journal: The Journal of small animal practice | Year: 2015
A nine-year-old English bulldog presented with an acute history of dyspnoea, tachycardia and discomfort localising to the ventral thorax following a fall down the stairs that morning. After the dog was stabilised, thoracic radiographs revealed a luxation of the third and fourth sternebrae with dorsal displacement of the caudal segment. The sternum was reduced and stabilised with a contoured 12-hole 3 5-mm dynamic compression plate applied to the ventral surface of the sternum. The dogs initial recovery was rapid, cardiorespiratory parameters returning to normal in the first 24 hours. For 2 weeks postoperatively the dog exhibited difficulty in rising from a prone position. After this time there was a full recovery. Clinical examination at 8 months postoperatively did not reveal any abnormalities. Telephone follow-up was performed at 18 months and no complications or cardiorespiratory compromise were reported. To the authors knowledge, this is the first reported case of a traumatic dislocation of the sternum and its management in the dog.
Oliver T.H.,UK Center for Ecology and Hydrology |
Thomas C.D.,University of York |
Hill J.K.,University of York |
Brereton T.,Bh Tec Inc. |
Roy D.B.,UK Center for Ecology and Hydrology
Global Change Biology | Year: 2012
Climate warming threatens the survival of species at their warm, trailing-edge range boundaries but also provides opportunities for the ecological release of populations at the cool, leading edges of their distributions. Thus, as the climate warms, leading-edge populations are expected to utilize an increased range of habitat types, leading to larger population sizes and range expansion. Here, we test the hypothesis that the habitat associations of British butterflies have expanded over three decades of climate warming. We characterize the habitat breadth of 27 southerly distributed species from 77 monitoring transects between 1977 and 2007 by considering changes in densities of butterflies across 11 habitat types. Contrary to expectation, we find that 20 of 27 (74%) butterfly species showed long-term contractions in their habitat associations, despite some short-term expansions in habitat breadth in warmer-than-usual years. Thus, we conclude that climatic warming has ameliorated habitat contractions caused by other environmental drivers to some extent, but that habitat degradation continues to be a major driver of reductions in habitat breadth and population density of butterflies. © 2012 Blackwell Publishing Ltd.
Waeber B.,PPA MP |
Pruvot E.,Bh Tec Inc.
Revue Medicale Suisse | Year: 2013
Orthostatic hypotension is encountered frequently in everyday practice. It is often very disabling because of its troublesome symptomalogy. Orthostatic hypotension may be due to several causes and can be easily diagnosed by measuring blood pressure and heart rate after 3 minutes in upright posture. Its treatment comprises in all cases non-pharmacological interventions which can be associated whenever required by medications, in particular midodrine and fludrocortisone. © Médecine et Hygiène 2010.
Rossetti A.O.,Bh Tec Inc. |
Rossetti A.O.,University of Lausanne |
Alvarez V.,University of Lausanne |
Januel J.-M.,University of Lausanne |
Burnand B.,University of Lausanne
Journal of Neurology | Year: 2013
Status epilepticus (SE) prognosis is related to nonmodifiable factors (age, etiology), but the exact role of drug treatment is unclear. This study was undertaken to address the prognostic role of treatment adherence to guidelines (TAG). We prospectively studied over 26 months a cohort of adults with incident SE (excluding postanoxic). TAG was assessed in terms of drug doses (±30 % of recommendations) and medication sequence; its prognostic impact on mortality and return to baseline conditions was adjusted for etiology, SE severity [Status Epilepticus Severity Score (STESS)], and comorbidities. Of 225 patients, 26 (12 %) died and 82 (36 %) were discharged with a new handicap; TAG was observed in 142 (63 %). On univariate analysis, age, etiology, SE severity, and comorbidities were significantly related to outcome, while TAG was associated with neither outcome nor likelihood of SE control. Logistic regression for mortality identified etiology [odds ratio (OR) 18.8, 95 % confidence interval (CI) 4.3-82.8] and SE severity (STESS ≥3; OR 1.7, 95 % CI 1.2-2.4) as independent predictors, and for lack of return to baseline, again etiology (OR 7.4, 95 % CI 3.9-14.0) and STESS ≥3 (OR 1.7, 95 % CI 1.4-2.2). Similar results were found for the subgroup of 116 patients with generalized-convulsive SE. Receiver operator characteristic (ROC) analyses confirmed that TAG did not improve outcome prediction. This study of a large SE cohort suggests that treatment adherence to recommendations using current medications seems to play a negligible prognostic role (class III), confirming the importance of the biological background. Awaiting further treatment trials, it appears mandatory to apply resources towards identification of new therapeutic approaches. © 2012 Springer-Verlag.
Diaper D.,Bh Tec Inc.
AAAI Workshop - Technical Report | Year: 2011
Communication bad spots on a commuter's train journey provide an example of context for the activities of a work system (user and devices) attempting to transfer large volumes of data. A simplified set theoretic based approach illustrates how the activities, their context, and device context capture can start to be analyzed. It is argued that context is not significantly harder to model than other, human aspects in a general systems analysis. Copyright © 2011, Association for the Advancement of Artificial Intelligence. All rights reserved.
Diaper D.,Bh Tec Inc.
AAAI Workshop - Technical Report | Year: 2011
Representing context information associated with people and digital devices performing activities is presented using a formal systems model based on a legal but simplified version of set theory. A five set Venn diagram, the PentaVenn diagram, allows analysts to work using a graphical logic rather than with equations. Model symmetry is shown to facilitate identifying different types of context, tangible and intangible. Copyright © 2011, Association for the Advancement of Artificial Intelligence. All rights reserved.
Marcelino C.G.,Bh Tec Inc. |
Wanner E.F.,Bh Tec Inc. |
Almeida P.E.M.,Bh Tec Inc.
IEEE SSCI 2014 - 2014 IEEE Symposium Series on Computational Intelligence - CIES 2014: 2014 IEEE Symposium on Computational Intelligence for Engineering Solutions, Proceedings | Year: 2015
The consumption of electric energy for general supply of a country is increasing over the years. In Brazil, energy demand grows, on average, 5% per year and the power source is predominantly hydroelectric. Many of the power plants installed in Brazil do not operate efficiently, from the water consumption point of view. The normal mode of operation (NMO) equally divides power demand between existing generation units of a power plant, regardless if this individual demand represents or not a good operation point for each unit. The unit dispatch problem is defined as the attribution of operational values to each unit inside a power plant, given some criteria to be met. In this context, an optimal solution for the dispatch problem means production of electricity with minimal water consumption. This work proposes a multi-objective approach to solve the electric dispatch problem in which the objective functions considered are: maximization of hydroelectric productivity function and minimization of the distance between NMO and optimized control mode (OCM). The proposed approach is applied to a large hydroelectric plant operating in Brazil. Results indicate that it is possible to identify operating points near NMO that present productivity efficiency, saving in one month about 14.6 million m3 of water. Moreover, higher productivity can be achieved with smaller differences between NMO and OCM in lower power demands. Finally, it is worth to mention that the simplicity and the nature of the proposed approach indicate that it can be easily applied to studies of similar power plants, and thus can potentially be used to provide further economy on water consumption to larger extents of the hydroelectric production. © 2014 IEEE.