Developing a spinal cord injury research strategy using a structured process of evidence review and stakeholder dialogue. Part II: Background to a research strategy

STUDY DESIGN

Literature review/semi-structured interviews.

OBJECTIVE

To develop a spinal cord injury (SCI) research strategy for Australia and New Zealand.

SETTING

Australia.

METHODS

The National Trauma Research Institute Forum approach of structured evidence review and stakeholder consultation was employed. This involved gathering from published literature and stakeholder consultation the information necessary to properly consider the challenge, and synthesising this into a briefing document.

RESULTS

A research strategy 'roadmap' was developed to define the major steps and key planning questions to consider; next, evidence from published SCI research strategy initiatives was synthesised with information from four one-on-one semi-structured interviews with key SCI research stakeholders to create a research strategy framework, articulating six key themes and associated activities for consideration. These resources, combined with a review of SCI prioritisation literature, were used to generate a list of draft principles for discussion in a structured stakeholder dialogue meeting.

CONCLUSION

The research strategy roadmap and framework informed discussion at a structured stakeholder dialogue meeting of 23 participants representing key SCI research constituencies, results of which are published in a companion paper. These resources could also be of value in other research strategy or planning exercises.

SPONSORSHIP

This project was funded by the Victorian Transport Accident Commission and the Australian and New Zealand Spinal Cord Injury Network.

Tevatron constraints on models of the Higgs boson with exotic spin and parity using decays to bottom-antibottom quark pairs

Combined constraints from the CDF and D0 Collaborations on models of the Higgs boson with exotic spin J and parity P are presented and compared with results obtained assuming the standard model value JP=0+. Both collaborations analyzed approximately 10  fb(-) of proton-antiproton collisions with a center-of-mass energy of 1.96 TeV collected at the Fermilab Tevatron. Two models predicting exotic Higgs bosons with JP=0- and JP=2+ are tested. The kinematic properties of exotic Higgs boson production in association with a vector boson differ from those predicted for the standard model Higgs boson. Upper limits at the 95% credibility level on the production rates of the exotic Higgs bosons, expressed as fractions of the standard model Higgs boson production rate, are set at 0.36 for both the JP=0- hypothesis and the JP=2+ hypothesis. If the production rate times the branching ratio to a bottom-antibottom pair is the same as that predicted for the standard model Higgs boson, then the exotic bosons are excluded with significances of 5.0 standard deviations and 4.9 standard deviations for the JP=0- and JP=2+ hypotheses, respectively.

Can Laparoscopic Cholecystectomy be a Feasible Standard in a Rural set up too?--An Experience of 348 cases from a Peripheral set up of Western Nepal

BACKGROUND

Gall stone disease is a common reason for admissions in both acute and elective situations and bears significant morbidity in the rural population of western Nepal. The earlier conventional open method of treatment for the same seems to have been largely seeded by the laparoscopic approach owing to its numerous benefits.

OBJECTIVE

To study the clinical profile of patients with symptomatic gall stones with respect to demography and to assess the feasibility of using Laparoscopic cholecystectomy as the next standard in this set up too as guided by the outcome in terms of complications, conversion rates and potential impact it bears on the health and socioeconomic status in this group.

METHOD

A retrospective analysis of all the patients undergoing an attempted laparoscopic cholecystectomy from 1st Jestha 2068 to 30th Jestha 2070 was done. Relevant medical records were reviewed to study demography, various indications for operations, intra operative events including conversions and complications.

RESULT

Of 348 patients 293 (84.19%) were females and 55 (15.80%) were males. The mean age was 38.46 years (range 15-76 years). Most of the patients belonged to the Palpa district of Lumbini zone and many were from other surrounding areas. Gall stone disease was commonest in people of Brahmin ethnicity. The operating time was < 2 hours for most and most had an uneventful recovery with a mean hospital stay of 3.8 days. The rate of conversion to open cholecystectomy was 6.9% (24 out of 348 patients). Post operative complications were noted in 5 patients (1.42%). Of these 1 sustained a major bile duct injury (0.28%) requiring immediate conversion and repair, 3 had post operative bilioma and 1 had diffuse bleeding from the gall bladder fossa all requiring re explorations. There was no mortality in this study.

CONCLUSION

Laparoscopic cholecystectomy is a safe, reliable and a promising option even in the rural peripheral set up. Due to its well known advantages and superiority over the open conventional method and considering the impact that it holds on the overall outcome, morbidity, health and socioeconomic status of the rural population, it can be recommended as an acceptable feasible standard in rural peripheral set up.

Self-sampling for community respiratory illness: a new tool for national virological surveillance

This report aims to evaluate the usefulness of self-sampling as an approach for future national surveillance of emerging respiratory infections by comparing virological data from two parallel surveillance schemes in England. Nasal swabs were obtained via self-administered sampling from consenting adults (≥ 16 years-old) with influenza symptoms who had contacted the National Pandemic Flu Service (NPFS) health line during the 2009 influenza pandemic. Equivalent samples submitted by sentinel general practitioners participating in the national influenza surveillance scheme run jointly by the Royal College of General Practitioners (RCGP) and Health Protection Agency were also obtained. When comparable samples were analysed there was no significant difference in results obtained from self-sampling and clinician-led sampling schemes. These results demonstrate that self-sampling can be applied in a responsive and flexible manner, to supplement sentinel clinician-based sampling, to achieve a wide spread and geographically representative way of assessing community transmission of a known organism.

The future is now: model-based clinical trial design for Alzheimer's disease

Failures in trials for Alzheimer's disease (AD) may be attributable to inadequate dosing, population selection, drug inefficacy, or insufficient design optimization. The Coalition Against Major Diseases (CAMD) was formed in 2008 to develop drug development tools (DDT) to expedite drug development for AD and Parkinson's disease. CAMD led a process that successfully advanced a clinical trial simulation (CTS) tool for AD through the formal regulatory review process at the US Food and Drug Administration (FDA) and European Medicines Agency (EMA).

Measurement of the B(s)(0) lifetime in the flavor-specific decay channel B(s)(0)→D(s)(-)μ(+)νX

We present an updated measurement of the B(s)(0) lifetime using the semileptonic decays B(s)(0)→D(s)(-)μ(+)νX, with D(s)(-)→ϕπ(-) and ϕ→K(+)K(-) (and the charge conjugate process). This measurement uses the full Tevatron Run II sample of proton-antiproton collisions at √[s]=1.96  TeV, comprising an integrated luminosity of 10.4  fb(-1). We find a flavor-specific lifetime τ(fs)(B(s)(0))=1.479±0.010(stat)±0.021(syst)  ps. This technique is also used to determine the B(0) lifetime using the analogous B(0)→D(-)μ(+)νX decay with D(-)→ϕπ(-) and ϕ→K(+)K(-), yielding τ(B(0))=1.534±0.019(stat)±0.021(syst)  ps. Both measurements are consistent with the current world averages, and the B(s)(0) lifetime measurement is one of the most precise to date. Taking advantage of the cancellation of systematic uncertainties, we determine the lifetime ratio τ(fs)(B(s)(0))/τ(B(0))=0.964±0.013(stat)±0.007(syst).

Measurement of the forward-backward asymmetry in the production of B(±) mesons in pp̄ collisions at √s=1.96 TeV

We present a measurement of the forward-backward asymmetry in the production of B(±) mesons, A(FB)(B(±)), using B(±)→J/ψK(±) decays in 10.4  fb(-1) of pp̄ collisions at sqrt[s]=1.96  TeV collected by the D0 experiment during Run II of the Tevatron collider. A nonzero asymmetry would indicate a preference for a particular flavor, i.e., b quark or ̄b antiquark, to be produced in the direction of the proton beam. We extract A(FB)(B(±)) from a maximum likelihood fit to the difference between the numbers of forward- and backward-produced B(±) mesons. We measure an asymmetry consistent with zero: A(FB)(B(±))=[-0.24±0.41  (stat)±0.19  (syst)]%.

Abstract T P387: Stroke Health and Risk Education Project: main results

Objective: The Stroke Health and Risk Education (SHARE) Project is a cluster-randomized, faith-based, culturally-sensitive, theory-based behavioral intervention trial to reduce key stroke risk factor behaviors.

Methods: Ten Catholic churches in Corpus Christi, Texas were randomized to intervention or control group. Subjects were enrolled as friend or family partners who provided reciprocal support to each other. The intervention group received a 1-year multicomponent intervention that included self-help materials (physical activity guide with pedometer, healthy eating guide, blood pressure management photonovella, and motivational short film), 2 tailored newsletters, 5 motivational interviewing counseling calls, and a peer partnership support workshop. Multilevel modeling, accounting for clustering within pairs and parishes, was used to test treatment differences in the average of two measures of change since baseline (ascertained at 6 and 12 months), using standardized questionnaires, in dietary sodium, dietary fruit and vegetable intake, and physical activity of moderate or greater intensity. The primary endpoint was met if any one of the three outcomes was significant based on a pre-specified p-value threshold of 0.05/3.

Results: Of 801 subjects who consented, 760 completed baseline data assessments. The median age was 52; 84% were Hispanic, the remainder were non-Hispanic whites; 64% were women. The intervention group had a greater increase in fruit and vegetable intake than the control group (0.25 (95% CI: 0.08, 0.42) cups per day, p = 0.002), a greater decrease in sodium intake (-123.17 (-194.76, -51.59) mg/day, p=0.04), but no difference in change in moderate or greater intensity physical activity (-27.47 (-526.32, 471.38) MET-minutes per week, p=0.56).

Conclusion: This cluster-randomized trial was effective in increasing fruit and vegetable intake among Hispanic and non-Hispanic white Catholic parishioners, reaching its primary endpoint. The intervention also seemed to lower sodium intake. Church-based health promotions can be successful in primary stroke prevention efforts.

Abstract W P300: Ethnic Differences in Post-Stroke Quality of Life in the Brain Attack Surveillance in Corpus Christi (BASIC) Project

Background: Mexican Americans (MAs) have worse stroke outcomes than non-Hispanic whites (NHWs), which could translate into worse quality of life (QOL). Our objective was to investigate ethnic differences in post-stroke QOL across multiple domains in a bi-ethnic community.

Methods: Ischemic stroke survivors, identified through the population-based Brain Attack Surveillance in Corpus Christi (BASIC) Project in Nueces County, Texas, participated in in-person interviews 90 days post-stroke from May 2010 - June 2012. The validated short form stroke-specific QOL (SSQOL) was used to assess overall, physical, and psychosocial QOL; scores range from 1-5 with higher scores representing greater QOL. Tobit regression was used to model unadjusted associations between ethnicity and the 3 QOL domains. Models were then adjusted for the following demographic and clinical factors obtained from the medical record and patient interview: age, sex, education, insurance status, marital status, nursing home residence before stroke, prestroke modified Rankin scale, prestroke Informant Questionnaire on Cognitive Decline in the Elderly, initial NIH stroke scale, risk factors, BMI, and a comorbidity index.

Results: A total of 335 ischemic strokes with complete data were identified (66% MA, 34% NHW). QOL was lower among MAs compared to NHWs, both overall (mean difference=-0.3, p=0.02) and in the physical domain (mean difference=-0.4, p=0.008); however, there was no difference in the psychosocial domain (p=0.22). After adjustment for demographic and clinical factors, MAs continued to experience poorer QOL compared to NHWs overall (mean difference=-0.5,p=0.049) and in the physical domain (mean difference=-0.3, p=0.006).

Conclusions: Ethnic disparities in stroke outcome extend to QOL, with MAs experiencing substantially worse post-stroke QOL than NHWs. Interventions are urgently needed to improve stroke outcomes among the rapidly growing MA stroke population.

Widespread implementation of EUCAST breakpoints for antibacterial susceptibility testing in Europe

The European Committee on Antimicrobial Susceptibility Testing (EUCAST) was established to harmonise clinical antimicrobial breakpoints and to define breakpoints for new agents in Europe. Data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) external quality assessment (EQA) exercises from 2009 to 2012, from the United Kingdom External Quality Assessment Scheme (UK NEQAS) from November 2009 to March 2013 and data collected by EUCAST through a questionnaire in the first quarter of 2013 were analysed to investigate implementation of EUCAST guidelines in Europe. A rapid change to use of EUCAST breakpoints was observed over time. Figures for implementation of EUCAST breakpoints at the end of the studied period were 61.2% from EARS-Net data and 73.2% from UK NEQAS data. Responses to the EUCAST questionnaire indicated that EUCAST breakpoints were used by?over?50% of laboratories in 18 countries, by 10 to 50% of laboratories in eight countries and by?less than?10% in seven countries. The EUCAST disk diffusion method was used by more than 50% of laboratories in 12 countries, by 10 to 50% of laboratories in ten countries and by?less than?10% in eleven countries. EUCAST guidelines implementation is essential to ensure consistent clinical reporting of antimicrobial susceptibility results and antimicrobial resistance surveillance.

A comparison of homopolymer and block copolymer structure in 6FDA-based polyimides

Two homopolyimides and the corresponding block copolyimide, all based on the 4,4'-(hexafluoroisopropylidene)diphthalic dianhydride (6FDA), have been synthesized and fully atomistic models have been studied using molecular dynamics (MD) simulation. The respective diamines were 1,3-phenylenediamine (mPDA) and 2,3,5,6-tetramethyl-1,4-phenylenediamine (durene). These polyimides are potential candidates for gas separation applications. The synthesized polymers were processed as dense flat membranes. The effects of diamine structure were investigated at the molecular level and an attempt to compare the structural features of homo- and block copolyimides was made. Amorphous models were generated using a hybrid pivot Monte Carlo-MD sampling preparation technique. Average model densities were validated against experimental measurements on the dense films. Cohesive energies, Hildebrand solubility parameters, conformational characteristics, intermolecular interactions and available void spaces were analysed for each system. The durene diamine was found to hinder stacking and increase the available space. This is associated with the steric effect of the methyl substituents. In general, 6FDA-mPDA/durene exhibits an intermediate behaviour with respect to its base polyimides. For most of the examined properties, the differences between different size simulated systems were minor with the exception of the free volume distribution.

Constraints on models for the Higgs boson with exotic spin and parity in VH → Vbb final states

We present constraints on models containing non-standard-model values for the spin J and parity P of the Higgs boson H in up to 9.7 fb(-1) of pp collisions at sqrt[s] = 1.96 TeV collected with the D0 detector at the Fermilab Tevatron Collider. These are the first studies of Higgs boson J(P) with fermions in the final state. In the ZH → ℓℓbb, WH → ℓνbb, and ZH → ννbb final states, we compare the standard model (SM) Higgs boson prediction, J(P) = 0(+), with two alternative hypotheses, J(P) = 0(-) and J(P) = 2(+). We use a likelihood ratio to quantify the degree to which our data are incompatible with non-SM J(P) predictions for a range of possible production rates. Assuming that the production rate in the signal models considered is equal to the SM prediction, we reject the J(P) = 0(-) and J(P) = 2(+) hypotheses at the 97.6% CL and at the 99.0% CL, respectively. The expected exclusion sensitivity for a J(P) = 0(-) (J(P) = 2(+)) state is at the 99.86% (99.94%) CL. Under the hypothesis that our data are the result of a combination of the SM-like Higgs boson and either a J(P) = 0(-) or a J(P) = 2(+) signal, we exclude a J(P) = 0(-) fraction above 0.80 and a J(P) = 2(+) fraction above 0.67 at the 95% CL. The expected exclusion covers J(P) = 0(-) (J(P) = 2(+)) fractions above 0.54 (0.47).

Analysis of folded pulse forming line operation

A compact pulse forming line (CPFL) concept based on a folded transmission line and high-breakdown strength dielectric was explored through an effort combining proof-of-principle experiments with electromagnetic modeling. A small-scale folded CPFL was fabricated using surface-mount ceramic multilayer capacitors. The line consisted of 150 capacitors close-packed in parallel and delivered a 300 ns flat-top pulse. The concept was carried to a 10 kV class device using a polymer-ceramic nanocomposite dielectric with a permittivity of 37.6. The line was designed for a 161 ns FWHM length pulse into a matched load. The line delivered a 110 ns FWHM pulse, and the pulse peak amplitude exceeded the matched load ideal. Transient electromagnetic analysis using the particle-in-cell code ICEPIC was conducted to examine the nature of the unexpected pulse shortening and distortion. Two-dimensional analysis failed to capture the anomalous behavior. Three-dimensional analysis replicated the pulse shape and revealed that the bends were largely responsible for the pulse shortening. The bends not only create the expected reflection of the incident TEM wave but also produce a non-zero component of the Poynting vector perpendicular to the propagation direction of the dominant electromagnetic wave, resulting in power flow largely external to the PFL. This analysis explains both the pulse shortening and the amplitude of the pulse.

Enterovirus infections in England and Wales, 2000-2011: the impact of increased molecular diagnostics

There have recently been significant changes in diagnostic practices for detecting enterovirus (EV) infections across England and Wales. Reports of laboratory-confirmed EV infections submitted by National Health Service (NHS) hospital laboratories to Public Health England (PHE) over a 12-year period (2000-2011) were analysed. Additionally, the PHE Virus Reference Department (VRD) electronic database containing molecular typing data from 2004 onwards was interrogated. Of the 13,901 reports, there was a decline from a peak of 2254 in 2001 to 589 in 2006, and then an increase year-on-year to 1634 in 2011. This increase coincided with increasing PCR-based laboratory diagnosis, which accounted for 36% of reported cases in 2000 and 92% in 2011. The estimated annual incidence in 2011 was 3.9/100,000 overall and 238/100,000 in those aged <3 months, who accounted for almost one-quarter of reported cases (n = 2993, 23%). During 2004-2011, 2770 strains were submitted for molecular typing to the VRD, who found no evidence for a predominance of any particular strain. Thus, the recent increase in reported cases closely reflects the increase in PCR testing by NHS hospitals, but is associated with a lower proportion of samples being submitted for molecular typing. The high EV rate in young infants merits further investigation to inform evidence-based management guidance.

Ratchet effect study in Si/SiGe heterostructures in the presence of asymmetrical antidots for different polarizations of microwaves

In this work, we studied the photovoltage response of an antidot lattice to microwave radiation for different antidot parameters. The study was carried out in a Si/SiGe heterostructure by illuminating the antidot lattice with linearly polarized microwaves and recording the polarity of induced photovoltage for different angles of incidence. Our study revealed that with increased antidot density and etching depth, the polarity of induced photovoltage changed when the angle of incidence was rotated 90 degrees. In samples with large antidot density and/or a deeply etched antidot lattice, scattering was dominated by electron interaction with the asymmetrical potential created by semicircular antidots. The strong electron-electron interaction prevailed in other cases. Our study provides insight into the mechanism of interaction between microwaves and electrons in an antidot lattice, which is the key for developing an innovative ratchet-based device. Moreover, we present an original and fundamental example of antidot lattice etching through the use of a two-dimensional electron gas. This system deals with a hole lattice instead of an electron depletion in the antidot lattice region.

Precision measurement of the top quark mass in lepton + jets final States

We measure the mass of the top quark in lepton+jets final states using the full sample of pp collision data collected by the D0 experiment in Run II of the Fermilab Tevatron Collider at sqrt[s] = 1.96 TeV, corresponding to 9.7 fb(-1) of integrated luminosity. We use a matrix element technique that calculates the probabilities for each event to result from tt production or background. The overall jet energy scale is constrained in situ by the mass of the W boson. We measure m(t) = 174.98 ± 0.76 GeV. This constitutes the most precise single measurement of the top-quark mass.

Observation of s-channel production of single top quarks at the Tevatron

We report the first observation of single-top-quark production in the s channel through the combination of the CDF and D0 measurements of the cross section in proton-antiproton collisions at a center-of-mass energy of 1.96 TeV. The data correspond to total integrated luminosities of up to 9.7 fb(-1) per experiment. The measured cross section is σ(s) = 1.29(-0.24)(+0.26) pb. The probability of observing a statistical fluctuation of the background to a cross section of the observed size or larger is 1.8 × 10(-10), corresponding to a significance of 6.3 standard deviations for the presence of an s-channel contribution to the production of single-top quarks.

Some New Actinide Tetrahalide-NN Dimethylacetamide Complexes

Protactinium tetrachloride reacts with NN dimethyl-acetamide (DMA) in anhydrous, oxygen-free carbon tetrachloride to form PaCl4 · 3 DMA. This can be degraded to PaCl4 · 2.5 DMA but this is a different crystal modification to that previously reported for the MCl4 · 2.5 DMA (M = U, Np, Pu) complexes; three different crystal modifications of the complexes of this type have now been obtained. Actinide tetrabromides form complexes of the type MBr4 · 5 DMA (M = Th, Pa and U) as well as those of the type MBr4 · 2.5 DMA (M = Pa and U only). Reactions in acetone result in the formation of adducts of the type MBr4 · 4 DMA • CH3COCH3 (M = Th and U only). The preparation and interconversion of the various types of complex are discussed and some chemical properties, infrared spectra, NMR spectra and X-ray powder diffraction results are reported.

Measurement of the W boson production charge asymmetry in pp̄→W+X→eν+X events at √s=1.96 TeV

We present a measurement of the W boson production charge asymmetry in pp̄→W+X→eν+X events at a center of mass energy of 1.96 TeV, using 9.7  fb-1 of integrated luminosity collected with the D0 detector at the Fermilab Tevatron Collider. The neutrino longitudinal momentum is determined by using a neutrino weighting method, and the asymmetry is measured as a function of the W boson rapidity. The measurement extends over wider electron pseudorapidity region than previous results and is the most precise to date, allowing for precise determination of proton parton distribution functions in global fits.

Measurement of the direct CP-violating charge asymmetry in Ds ± → ϕ π ± decays

We present a measurement of the direct CP-violating charge asymmetry in Ds+ → ϕ π(±) decays where the ϕ meson decays to K(+)K(-), using the full Run II data set with an integrated luminosity of 10.4  fb-1 of proton-antiproton collisions collected using the D0 detector at the Fermilab Tevatron Collider. The normalized difference A(CP) in the yield of D(s)(+) and D(s)(-) mesons in these decays is measured by fitting the difference between their reconstructed invariant mass distributions. This results in an asymmetry of A(CP) = [-0.38 ± 0.27]%, which is the most precise measurement of this quantity to date. The result is consistent with the standard model prediction of zero CP asymmetry in this decay.

Abstract T P132: Rapid loss of the Mexican American Survival Advantage After Stroke--The BASIC Study

Background/Objective: As a primary, pre-specified objective of the population-based Brain Attack Surveillance in Corpus Christi (BASIC) project we studied trends in mortality following ischemic stroke among Mexican Americans (MAs) and non Hispanic whites (NHWs). MAs were previously found to have lower mortality following stroke than NHWs.

Methods: We performed active and passive surveillance, and using source documentation, validated all ischemic stroke cases from January, 2000-December, 2010. Deaths were ascertained from the Texas Department of Health through December 31, 2011. Cumulative 30 day and 1 year mortality adjusted for covariates was estimated using log-binomial models with a linear term for year of stroke onset used to model time trends. Pre-specified adjustment factors were: age, sex, prior stroke or TIA, atrial fibrillation, diabetes, heart disease, hypertension, smoking, high cholesterol and stroke severity. Models used data from the entire study period to estimate adjusted mortality among stroke cases in 2000 and 2010, and to calculate projected ethnic differences.

Results: There were 1,822 ischemic strokes among NHWs and 2,211 among MAs. Between 2000 and 2010, 30 day and 1 year mortality declined among NHWs, from 8.6% to 5.9% (p=0.14), and 21.7% to 17.0% (p=0.06), respectively. Among MAs, 30 day mortality remained stagnant at 5.6% (p=0.98), and a slight decline from 18.3% to 16.4% was observed for 1 year mortality (p=0.41). While, the ethnic differences in 30 day (p=0.01) and 1 year (p=0.07) mortality were robust in 2000, they were not so in 2010 (30 day, p=0.76; 1 year p=0.78). See figure. MAs are projected to have higher post-stroke mortality by 2022.

Conclusions: Overall, mortality following ischemic stroke has declined in the last decade. However, the survival advantage previously documented among MAs vanished by 2010. Further, faster declines in mortality among NHWs than MAs imply a reversal of the survival advantage by approximately 2022.

Abstract T P195: Do Women Benefit More From tPA Than Men? Results From the BASIC Project

Background: Pooled analysis of IV tPA treatment trials showed that women received benefit from treatment while men did not, though it is unclear if these results generalize to treatment in the community. We examined the benefit of tPA by sex in a population-based stroke study in a community without an academic medical center.

Methods: Ischemic strokes were identified from the BASIC Project (2009-2012). tPA treated (n=70) and non-tPA treated cases (arriving ≤3 hours of symptom onset, n=145) with complete data were included. Data were from interviews (baseline and 90 days post-stroke) and medical records. Functional outcome was measured by modified Rankin scale (0-2 vs ≥3). The effect of tPA treatment on functional outcome (mRS 0-2) was determined using a matched propensity score (PS) analysis. Models were adjusted for age and sex-specific effects generated using a treatment by sex interaction. Because the matched analysis resulted in reduced sample size due to inability to match some tPA (n=22) and non-tPA cases (n=97), we explored 2 alternative PS methods (adjustment, weighting) which retained the full sample.

Results: tPA treatment rates were similar in women and men (33% vs 32%, respectively; p=0.94). 25% of women and 32% of men had favorable outcome (p=0.04). Women were older than men (median age 76 vs 72; p=0.02), but initial NIHSS (median 8 vs 7; p=0.36) and 90-day mortality (24% vs 20%; p=0.51) did not differ by sex. Covariates were well balanced between tPA and non-tPA cases after PS matching. In the matched analysis, tPA was associated with favorable outcome in women (OR=4.2; 95% CI: 0.6-30.2) but not men (OR=0.79; 95% CI: 0.1-4.3). Results were consistent when alternative PS models were considered (Figure).

Conclusion: Results from this community-based study were consistent with the previous pooled analysis of tPA trial data, suggesting that women benefit from treatment while men do not. Larger population-based studies are needed to replicate these findings.

Measurement of associated production of z bosons with charm quark jets in pp collisions at √s=1.96 TeV

We present the first measurements of the ratios of cross sections σ(pp → Z+c jet)/σ(pp → Z+jet) and σ(pp → Z+c jet)/σ(pp → Z+b jet) for the associated production of a Z boson with at least one charm or bottom quark jet. Jets have transverse momentum ​pT(jet)​>20  GeV and pseudorapidity |​η(jet)​|<2.5. These cross section ratios are measured differentially as a function of jet and Z boson transverse momenta, based on 9.7  fb(-1) of pp collisions collected with the D0 detector at the Fermilab Tevatron Collider at √s=1.96  TeV. The measurements show significant deviations from perturbative QCD calculations and predictions from various event generators.