RESUMEN
The Mesozoic Dipole Low (MDL) is a period, covering at least â¼80 My, of low dipole moment that ended at the start of the Cretaceous Normal Superchron. Recent studies of Devonian age Siberian localities identified similarly low field values a few tens of million years prior to the Permo-Carboniferous Reverse Superchron (PCRS). To constrain the length and timing of this potential dipole low, this study presents paleointensity estimates from Strathmore (â¼411 to 416 Ma) and Kinghorn (â¼332 Ma) lava flows, United Kingdom. Both localities have been studied for paleomagnetic poles (Q values of 6 to 7), and the sites were assessed for their suitability for paleointensity from paleodirections, rock magnetic analysis, and microscopy. Thermal and microwave experiments were used to determine site mean paleointensity estimates of â¼3 to 51 µT (6 to 98 ZAm2) and 4 to 11 µT (9 to 27 ZAm2) from the Strathmore and Kinghorn localities, respectively. These, and all the sites from 200 to 500 Ma from the (updated) Paleointensity database (PINT15), were assessed using the Qualitative Paleointensity criteria (QPI). The procurement of reliable (QPI ≥ 5) weak paleointensity estimates from this and other studies indicates a period of low dipole moment (median field strength of 17 ZAm2) from 332 to 416 Ma. This "Mid-Paleozoic Dipole Low (MPDL)" bears a number of similarities to the MDL, including the substantial increase in field strength near the onset of the PCRS. The MPDL also adds support to the inverse relationship between reversal frequency and field strength and a possible â¼200-My cycle in paleomagnetic behavior relating to mantle convection.
RESUMEN
OBJECTIVE: To identify factors associated with post-stroke fatigue in a sample of stroke survivors without depression. DESIGN: Cross-sectional cohort study. SETTING: Recruitment was from four stroke units in the UK. SUBJECTS: Participants were assessed within four to six weeks of first stroke; those with high levels of depressive symptoms (score ⩾7 Brief Assessment Schedule Depression Cards) were excluded. MAIN MEASURES: Participants were assessed after stroke on the Fatigue Severity Scale of the Fatigue Assessment Inventory, the Rivermead Mobility Index, Nottingham Extended Activities of Daily Living scale, Beck Anxiety Index, Sleep Hygiene Index, 6m walk test, and measures of cognitive ability. RESULTS: Of the 371 participants recruited, 103 were excluded and 268 were assessed. Of the latter, the mean age was 67.7 years (SD 13.5) and 168 (63%) were men. The National Institutes of Health Stroke Scale mean score was 4.96 (SD 4.12). Post-stroke fatigue was reported by 115 (43%) of participants, with 71 (62%) reporting this to be a new symptom since their stroke. Multivariate analysis using the Fatigue Severity Scale as the outcome variable found pre-stroke fatigue, having a spouse/partner, lower Rivermead Mobility Index score, and higher scores on both the Brief Assessment Schedule Depression Cards and Beck Anxiety Index were independently associated with post-stroke fatigue, accounting for approximately 47% of the variance in Fatigue Severity Scale scores. CONCLUSIONS: Pre-stroke fatigue, lower mood, and poorer mobility were associated with post-stroke fatigue.
Asunto(s)
Fatiga/etiología , Índice de Severidad de la Enfermedad , Accidente Cerebrovascular/complicaciones , Afecto , Anciano , Estudios de Cohortes , Estudios Transversales , Fatiga/psicología , Femenino , Humanos , Masculino , Limitación de la MovilidadRESUMEN
Fetomaternal alloimmune thrombocytopenia, caused by the maternal generation of antibodies against fetal human platelet antigen-1a (HPA-1a), can result in intracranial hemorrhage and intrauterine death. We have developed a therapeutic human recombinant high-affinity HPA-1a antibody (B2G1Δnab) that competes for binding to the HPA-1a epitope but carries a modified constant region that does not bind to Fcγ receptors. In vitro studies with a range of clinical anti-HPA-1a sera have shown that B2G1Δnab blocks monocyte chemiluminescence by >75%. In this first-in-man study, we demonstrate that HPA-1a1b autologous platelets (matching fetal phenotype) sensitized with B2G1Δnab have the same intravascular survival as unsensitized platelets (190 hours), while platelets sensitized with a destructive immunoglobulin G1 version of the antibody (B2G1) are cleared from the circulation in 2 hours. Mimicking the situation in fetuses receiving B2G1Δnab as therapy, we show that platelets sensitized with a combination of B2G1 (representing destructive HPA-1a antibody) and B2G1Δnab survive 3 times as long in circulation compared with platelets sensitized with B2G1 alone. This confirms the therapeutic potential of B2G1Δnab. The efficient clearance of platelets sensitized with B2G1 also opens up the opportunity to carry out studies of prophylaxis to prevent alloimmunization in HPA-1a-negative mothers.
Asunto(s)
Anticuerpos/uso terapéutico , Proteínas Recombinantes/uso terapéutico , Trombocitopenia Neonatal Aloinmune/tratamiento farmacológico , Antígenos de Plaqueta Humana/inmunología , Plaquetas/inmunología , Vasos Sanguíneos/patología , Supervivencia Celular/inmunología , Femenino , Citometría de Flujo , Humanos , Inmunoglobulina G/sangre , Integrina beta3 , Masculino , Proteínas Mutantes/inmunología , Programas Informáticos , Trombocitopenia Neonatal Aloinmune/sangre , Trombocitopenia Neonatal Aloinmune/inmunologíaRESUMEN
BACKGROUND: We evaluated the effect of treating platelets (PLTs) using ultraviolet (UV)C light without the addition of any photosensitizing chemicals on PLT function in vitro and PLT recovery and survival in an autologous radiolabeled volunteer study. STUDY DESIGN AND METHODS: For in vitro studies, pooled or single buffy coat-derived PLT concentrates (PCs) were pooled and split to obtain identical PCs that were either treated with UVC or untreated (n = 6 each) and stored for 7 days. PLT recovery and survival were determined in a two-arm parallel autologous study in healthy volunteers performed according to BEST guidelines. UVC-treated or untreated PCs (n = 6 each) were stored for 5 days and were compared to fresh PLTs from the same donor. RESULTS: There were no significant differences on Day 7 of storage between paired UVC-treated and control PC units for pH, adenosine triphosphate, lactate dehydrogenase, CD62P, CD63, PLT microparticles, and JC-1 binding, but annexin V binding, lactate accumulation, and expression of CD41/61 were significantly higher in treated units (p < 0.05). Compared with control units, the recovery and survival of UVC-treated PC were reduced after 5 days of storage (p < 0.05) and when expressed as a percentage of fresh values, survival was reduced by 20% (p = 0.005) and recovery by 17% (p = 0.088). CONCLUSION: UVC-treated PLTs stored for 5 days showed marginal changes in PLT metabolism and activation in vitro and were associated with a degree of reduction in recovery and survival similar to other pathogen inactivation systems that are licensed and in use.
Asunto(s)
Plaquetas/efectos de la radiación , Seguridad de la Sangre/métodos , Rayos Ultravioleta , Análisis de Varianza , Biomarcadores/sangre , Capa Leucocitaria de la Sangre , Plaquetas/fisiología , Supervivencia Celular/efectos de la radiación , Humanos , Concentración de Iones de Hidrógeno/efectos de la radiación , Activación Plaquetaria/efectos de la radiación , Glicoproteínas de Membrana Plaquetaria/metabolismoRESUMEN
Background Post-stroke fatigue is common and disabling. Objectives The aim of NotFAST was to examine factors associated with fatigue in stroke survivors without depression, six months after stroke. Methods Participants were recruited from four UK stroke units. Those with high levels of depressive symptoms (score ≥7 on Brief Assessment Schedule Depression Cards) or aphasia were excluded. Follow-up assessment was conducted at six months after stroke. They were assessed on the Fatigue Severity Scale, Rivermead Mobility Index, Nottingham Extended Activities of Daily Living scale, Barthel Index, Beck Anxiety Index, Brief Assessment Schedule Depression Cards, Impact of Event Scale-Revised, and Sleep Hygiene Index. Results Of the 371 participants recruited, 263 (71%) were contacted at six months after stroke and 213 (57%) returned questionnaires. Approximately half (n = 109, 51%) reported fatigue at six months. Of those reporting fatigue initially (n = 88), 61 (69%) continued to report fatigue. 'De novo' (new) fatigue was reported by 48 (38%) of those not fatigued initially. Lower Nottingham Extended Activities of Daily Living scores and higher Beck Anxiety Index scores were independently associated with fatigue at six months. Conclusions Half the stroke survivors reported fatigue at six months post-stroke. Reduced independence in activities of daily living and higher anxiety levels were associated with the level of fatigue. Persistent and delayed onset fatigue may affect independence and participation in rehabilitation, and these findings should be used to inform the development of appropriate interventions.