C-reactive protein (CRP) is an inflammatory biomarker of inflammation and may reflect progression of vascular disease. Conflicting evidence suggests CRP may be a prognostic biomarker of ischemic stroke outcome. Most studies that have examined the relationship between CRP and ischemic stroke outcome have used mortality or subsequent vascular event as the primary outcome measure. Given that nearly half of stroke patients experience moderate to severe functional impairments, using a biomarker like CRP to predict functional recovery rather than mortality may have clinical utility for guiding acute stroke treatments. The primary aim of this study was to systematically and critically review the relationship between CRP and long-term functional outcome in ischemic stroke patients to evaluate the current state of the literature. PubMed and MEDLINE databases were searched for original studies which assessed the relationship between acute CRP levels measured within 24 hours of symptom onset and long-term functional outcome. The search yielded articles published between 1989 and 2012. Included studies used neuroimaging to confirm ischemic stroke diagnosis, high-sensitivity CRP assay, and a functional outcome scale to assess prognosis beyond 30 days after stroke. Study quality was assessed using the REMARK recommendations. Five studies met all inclusion criteria. Results indicate a significant association between elevated baseline high sensitivity CRP and unfavorable long-term functional outcome. Our results emphasize the need for additional research to characterize the relationship between acute inflammatory markers and long-term functional outcome using well-defined diagnostic criteria. Additional studies are warranted to prospectively examine the relationship between high sensitivity CRP measures and long-term outcome.
The exponentially increasing amount of information accumulated from past to current engineering projects has created an environment where repurposing existing data to support new projects is paramount to sustainable success. Strategic planning and early design decisions, specifically, occur in decision-making environments that require information support capabilities that lie outside of traditional engineering analyses. In order to advance towards a more complete planning environment, a pragmatic methodology has been developed for modern aerospace data and information collection, categorisation, and utilisation with a focus on current efforts in hypersonic vehicle research and development. The main thrust has been to provide insights into financial and technical trends that support objective programmatic and planning decision-making. The end-product is a suite of graphical decision-making interfaces, linked through a unified hypersonic database. The graphical interfaces are capable of highlighting the key project drivers along varying levels of categorisation and refinement. Aided by these newly developed data and information support interfaces covering past and present hypersonic efforts, the planner's forecasting assessment of present and future hypersonic research and development efforts is pragmatically enriched towards a more complete managerial program-planning framework.
In an effort to quantify the feasibility of candidate space architectures for astronauts servicing Geosynchronous Earth Orbit (GEO) satellites, a conceptual assessment of architectureconcept and operations-technology combinations has been performed. The focus has been the development of a system with the capability to transfer payload to and from geostationary orbit. Two primary concepts of operations have been selected: (a) Direct insertion/re-entry (Concept of Operations 1 -CONOP 1); (b) Launch to low-earth orbit at Kennedy Space Center inclination angle with an orbital transfer to/from geostationary orbit (Concept of Operations 2 -CONOP 2). The study concludes that a capsule and de-orbit propulsion module system sized for the geostationary satellite servicing mission is feasible for a direct insertion/re-entry concept of operation CONOP 1. Vehicles sized for CONOP 2 show overall total mass savings when utilising the aero-assisted orbital transfer vehicle de-orbit propulsion module options compared to the pure propulsive baseline cases. Overall, the consideration of technical, operational and cost factors determine if either the aero-assisted orbital transfer vehicle concepts or the re-usable/expendable ascent/de-orbit propulsion modules is the preferred option.
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