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The Role of Prestroke Glycemic Control on Severity and Outcome of Acute Ischemic Stroke
Clara Hjalmarsson,Karin Manhem,Lena Bokemark,Bj?rn Andersson
Stroke Research and Treatment , 2014, DOI: 10.1155/2014/694569
Abstract: Background/Aim. Relatively few studies have investigated the association of prestroke glycemic control and clinical outcome in acute ischemic stroke (IS) patients, regardless of presence of diabetes mellitus (DM). The aim of this study was to investigate the importance of prestroke glycemic control on survival, stroke severity, and functional outcome of patients with acute IS. Methods. We performed a retrospective survival analysis of 501 patients with IS admitted to Sahlgrenska University Hospital from February 15, 2005, through May 31, 2009. The outcomes of interest were acute and long-term survival; the stroke severity (NIHSS) and the functional outcome, mRS, at 12 months. Results. HbA1c was a good predictor of acute (HR 1.45; CI, 1.09 to 1.93, ) and long-term mortality (HR 1.29; CI 1.03 to 1.62; ). Furthermore, HbA1c >6% was significantly correlated with acute stroke severity (OR 1.29; CI 1.01 to 1.67; ) and predicted worse functional outcome at 12 months (OR 2.68; CI 1.14 to 6.03; ). Conclusions. Our study suggests that poor glycemic control (baseline HbA1c) prior to IS is an independent risk factor for poor survival and a marker for increased stroke severity and unfavorable long-term functional outcome. 1. Introduction Hyperglycemia (HG) in relation to acute IS is common both in patients with and in patients without a diagnosis of DM, and it has been suggested to worsen survival. However, recent results from several clinical studies indicate that particularly patients with stroke and stress HG, but not diabetes, have increased mortality [1–3]. On the contrary, older data by Woo et al. [4] found that patients with acute IS and similar glucose concentrations had similar outcome regardless of whether they had diabetes or not. According to a review published by Capes et al. [5], acute HG predicted increased risk of in-hospital mortality after ischemic stroke (IS) in nondiabetic patients and increased risk of poor functional recovery in nondiabetic stroke survivors. The recent results of Nardi et al. [2] are also in line with this conclusion. In a study published in 2012, Hu et al. [1] evaluated the effects of HG and prestroke glycemic control, as measured by HbA1c, on all-cause and cardiovascular mortality among 1277 IS patients and found a significant association between initial glucose level and mortality in nondiabetic patients. Surprisingly, they also found that DM patients with HbA1c <7.0% had a higher incidence rate of all-cause and cardiovascular death than those with HbA1c ≥7%. Contradictory data have been published by Kamouchi et al. in 2011,
Depression, anxiety, stress, social interaction and health-related quality of life in men and women with unexplained chest pain
Annika Fagring, Karin I Kjellgren, Annika Rosengren, Lauren Lissner, Karin Manhem, Catharina Welin
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-165
Abstract: A self-administered questionnaire about psychosocial factors was completed by 127 men and 104 women with acute UCP admitted consecutively to the Emergency Department (ED) or as in-patients on a medical ward. A reference group from the general population, 490 men and 579 women, participants in the INTERGENE study and free of clinical heart disease, were selected.The UCP patients were more likely to be immigrants, have a sedentary lifestyle, report stress at work and have symptoms of depression and trait-anxiety compared with the reference group. After adjustment for differences in age, smoking, hypertension and diabetes, these factors were still significantly more common among patients with UCP. In a stepwise multivariate model with mutual adjustment for psychosocial factors, being an immigrant was associated with a more than twofold risk in both sexes. Stress at work was associated with an almost fourfold increase in risk among men, whereas there was no independent impact for women. In contrast, depression only emerged as an independent risk factor in women. Trait-anxiety and a low level of social interaction were not independently associated with risk in either men or women. Patients with UCP were two to five times more likely to have low scores for HRQOL.Both men and women with UCP had higher depression scores than referents, but an independent association was only found in women. Among men, perceived stress at work emerged as the only psychosocial variable significantly associated with UCP.Unexplained chest pain (UCP) is a common reason for emergency hospital admission and generates considerable health-care costs for society [1,2]. Previous studies have often defined UCP as non-cardiac, i.e. chest pain that had not been diagnosed as acute myocardial infarction (AMI) or ischemic heart disease (IHD) by a physician [3]. Galmiche et al [4], has developed three diagnostic criteria for functional chest pain of presumed esophageal origin i.e. "1) Midline chest pain or d
Explorative Teaching and Research—From Memory Work to Experience Stories  [PDF]
Karin Widerberg
Creative Education (CE) , 2016, DOI: 10.4236/ce.2016.714196
Abstract: Memory work is an approach developed to help us problematize the things we take for granted and as such an invitation to methodological explorations in teaching and research. By our own stories of memories and experiences we are invited to look for variety—in our own stories as well as in relation to the stories of the others—regarding content as well as interpretations. A set of techniques is developed to make this happen, in writing as well as in analyzing. Focusing on the social aspects of a story does not only imply a possibility to connect different analytical levels (micro and macro) and verify concepts and theories. It also allows us to question or specify fixed or simplified categories and concepts by making other memories, experiences and understandings visible. As such it is an approach that stimulates creativity and knowledge production in both teaching and research, to the joy of all participants. In this article it is illustrated how the approach can be used in different settings and on different themes in both teaching and research hereby also illuminating the kinds of knowledge that can be gained. Cases and detailed accounts of how the approach can be used when teaching a one-day workshop, a three-day course but also in a two-hour lecture in a regular class on BA-level are given. Examples of the use of the approach in different research projects are also presented so as to illuminate the bridge between research and teaching and how research approaches can be made into teaching approaches. The illustrations are meant to inspire further use and development of the approach so as to fit different situations and themes in teaching and research.
Missing the Target?—Targeted Therapy in Small Cell Lung Cancer  [PDF]
Karin R. Purshouse
Advances in Lung Cancer (ALC) , 2014, DOI: 10.4236/alc.2014.33008

Small cell lung cancer [SCLC] is a devastating form of cancer, with most patients harbouring extensive disease at diagnosis and survival of less than 5% at five years. Progress in novel therapies has been limited. This specialist review explores current targeted therapy options and potential areas of development.

Towards a Semantic Lexicon for Biological Language Processing
Karin Verspoor
Comparative and Functional Genomics , 2005, DOI: 10.1002/cfg.451
Abstract: This paper explores the use of the resources in the National Library of Medicine's Unified Medical Language System (UMLS) for the construction of a lexicon useful for processing texts in the field of molecular biology. A lexicon is constructed from overlapping terms in the UMLS SPECIALIST lexicon and the UMLS Metathesaurus to obtain both morphosyntactic and semantic information for terms, and the coverage of a domain corpus is assessed. Over 77% of tokens in the domain corpus are found in the constructed lexicon, validating the lexicon's coverage of the most frequent terms in the domain and indicating that the constructed lexicon is potentially an important resource for biological text processing.
Using the Response Surface Method to Optimize the Turning Process of AISI 12L14 Steel
Karin Kandananond
Advances in Mechanical Engineering , 2010, DOI: 10.1155/2010/362406
Abstract: The purpose of this paper is to determine the optimal cutting conditions for surface roughness in a turning process. This process is performed in the final assembly department at a manufacturing company that supplies fluid dynamic bearing (FDB) spindle motors for hard disk drives (HDDs). The workpieces used were the sleeves of FDB motors made of ferritic stainless steel, grade AISI 12L14. The optimized settings of key machining factors, depth of cut, spindle speed, and feed rate on the surface roughness of the sleeve were determined using the response surface methodology (RSM). The results indicate that the surface roughness is minimized when the depth of cut is set to the lowest level, while the spindle speed and feed rate are set to the highest levels. Even though the results from this paper are process specific, the methodology deployed can be readily applied to different turning processes. 1. Introduction Hard disk drives (HDDs) are magnetic discs used to store data in most computer systems, and they are rotated by the spindle motors to read-write data. The standard technology for spindle motor is fluid dynamic bearing (FDB) [1]. The crucial part of the FDB is the spindle motor sleeve which contains fluid to reduce the stress between the rotating shaft and sleeve. The turning process is utilized to manufacture the FDB sleeve, and the surface roughness of sleeve is known to affect the quality of the sleeve. Since the surface quality depends on many factors including feed rate, depth of cut, and spindle speed, the surface roughness will be minimized if the relationship between turning process parameters and the surface quality is fully recognized [2]. 2. Literature Review Among the most basic operations performed by machine tools are drilling, milling, grinding, and turning or lathing. The turning process is a machining method that removes material from the surface using a rotating cutting tool that moves to a workpiece. The surface quality, which is measured in terms of surface roughness, is utilized to evaluate the performance of the turning operation. The surface roughness is known to be significantly affected by different cutting parameters, that is, the depth of cut, spindle speed, and feed rate [3]. Therefore, the surface roughness will be optimized if the appropriate cutting conditions are selected. Statistical prediction methods, such as the response surface methodology (RSM), are frequently utilized to model the surface roughness, so that the desired levels of machining parameters are achieved. There are numerous works reporting the success
Effectively Monitoring the Performance of Integrated Process Control Systems under Nonstationary Disturbances
Karin Kandananond
International Journal of Quality, Statistics, and Reliability , 2010, DOI: 10.1155/2010/180293
Abstract: The objective of this paper is to quantify the effect of autocorrelation coefficients, shift magnitude, types of control charts, types of controllers, and types of monitored signals on a control system. Statistical process control (SPC) and automatic process control (APC) were studied under non-stationary stochastic disturbances characterized by the integrated moving average model, ARIMA  (0,1,1). A process model was simulated to achieve two responses, mean squared error (MSE) and average run length (ARL). A factorial design experiment was conducted to analyze the simulated results. The results revealed that not only shift magnitude and the level of autocorrelation coefficients, but also the interaction between these two factors, affected the integrated system performance. It was also found that the most appropriate combination of SPC and APC is the utilization of the minimum mean squared error (MMSE) controller with the Shewhart moving range (MR) chart, while monitoring the control signal (X) from the controller. Therefore, integrating SPC and APC can improve process manufacturing, but the performance of the integrated system is significantly affected by process autocorrelation. Therefore, if the performance of the integrated system under non-stationary disturbances is correctly characterized, practitioners will have guidelines for achieving the highest possible performance potential when integrating SPC and APC.
Monopolizing Clinical Trial Data: Implications and Trends
Karin Timmermans
PLOS Medicine , 2007, DOI: 10.1371/journal.pmed.0040002
Parameter expansion for estimation of reduced rank covariance matrices (Open Access publication)
Karin Meyer
Genetics Selection Evolution , 2008, DOI: 10.1186/1297-9686-40-1-3
Abstract: (To access full article, please see PDF)
Estimating genetic covariance functions assuming a parametric correlation structure for environmental effects
Karin Meyer
Genetics Selection Evolution , 2001, DOI: 10.1186/1297-9686-33-6-557
Abstract: (To access the full article, please see PDF)
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