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This paper investigates energy resilience of countries by quantifying the supplier diversification of both direct and embodied energy import. In particular, we quantify two approaches to diversify a country's supplier portfolio: by lowering the dependency on each supplier (portfolio diversification) and by having embodied energy suppliers that are different from its direct energy suppliers (portfolio differentiation). We examine possibilities for strategic utilization of embodied energy trade to compensate for low diversity of direct energy trade for three types of fossil resources: coal, oil, and gas. We find that the diversity of embodied energy import is much greater than that of direct energy import. Of the three energy resources, coal enables countries to adopt portfolio diversification and portfolio differentiation more than gas and oil. Our results suggest embodied energy can be considered as a transfer of energy resources across national borders that can directly benefit from the diversity of the world energy production by “skipping” the limited diversity of the world energy export.

Size control of the poly (1,4-phenylene-5-hydroxyisophthalamide) hollow spheres was examined by tuning the polymerization condition, focusing on concentration, temperature and solvent. Higher concentration lowered the diameter owing to the higher degree of super-saturation for nucleation. Temperature drop during the polymerization just before the nucleation was so effective to make the diameter smaller. Moreover, the diameter was susceptive to the solubility of oligomers in the solvent, and higher content of liquid paraffin in the aromatic solvent lowered the solubility, resulting in the decrease in the diameter. Based on these results, the combination of the temperature drop and the solvent effect was the most desirable to prepare the smallest hollow spheres, and the diameter of hollow spheres could be controlled from 4.4 to 0.7 μm.

Three pilot-scale lysimeters were operated for 4.5years to quantify the change in the carbon and nitrogen pool in an old landfill under various air injection conditions. The results indicate that air injection at the bottom layer facilitated homogeneous distribution of oxygen in the waste matrix. Substantial total organic carbon (TOC) decomposition and methane generation reduction were achieved. Considerable amount of nitrogen was removed, suggesting that in situ nitrogen removal via the effective simultaneous nitrification and denitrification mechanism is viable. Moreover, material mass change measurements revealed a slight mass reduction of aged MSW (by approximately 4.0%) after 4.5years of aeration. Additionally, experiments revealed that intensive aeration during the final stage of the experiment did not further stimulate the degradation of the aged MSW. Therefore, elimination of the labile fraction of aged MSW should be considered the objective of in situ aeration.

Energy is a critical component of achieving sustainable development. In addition to the three aspects of promoting access, renewables, and efficiency, the dimension of resilience in energy systems should also considered. The implementation of resilient energy systems requires a quantitative understanding of the socio-economic practices underlying such systems. Specifically, in line with the increasing globalization of trade, there remains a critical knowledge gap on the link between embodied energy in the production and consumption of traded goods. To bridge this knowledge gap, we investigate the resilience of global energy systems through an examination of a diversity measure of global embodied electricity trade based on multi-regional input-output (MRIO) networks. The significance of this research lies in its ability to utilize high resolution MRIO data sets in assessing the resilience of national energy systems. This research indicates that secure and responsible consumption requires the diversification of not only energy generation but also energy imports. This research will lay the ground for further research in the governance of resilience in global energy networks.

As one of the Nitrous Oxide (N 2 O) production pathways, denitrification plays an important role in regulating the emission of N 2 O into the atmosphere. In this study, the influences of different substrate concentrations and transient conditions on the denitrification rate and N 2 O-reducing activities were investigated. Results revealed that N 2 O production rates (i.e. denitrification rates) were stimulated by increased total organic carbon (TOC) concentration, while it was restrained under high oxygen concentrations. Moreover, the impact of nitrate concentrations on N 2 O production rates depended on the TOC/NO 3 − –N ratios. All the N 2 O production rate data fitted well to a multiplicative Monod equation, with terms describing the influence of TOC and nitrate concentrations, and an Arrhenius-type equation. Furthermore, results demonstrated that high temperatures minimized the N 2 O-reducing activities in aged municipal solid waste, resulting in an accumulation of N 2 O. On the other hand, a transient condition caused by changing O 2 concentrations may strongly influence the N 2 O production rates and N 2 O-reducing activities in solid waste. Finally, based on the results, we believe that a landfill aeration strategy properly designed to prevent rising temperatures and to cycle air injection is the key to reducing emissions of N 2 O during remediation of old landfills by means of in situ aeration.

This article proposes to analyze the quantitative effects of a gradual physical and "social" exhaustion of a landfill site on an equilibrium waste management service. A gradual social exhaustion of a landfill is defined here as an upward shift of a "subjective factor" associated with the amount of waste, based on the plausible hypothesis that an individual will not accept excessive presence of landfilled waste. Physical exhaustion occurs when the absolute capacity of a landfill site decreases. The paper shows some numerical examples using specific functions and parameters, and proposes appropriate directions for three policy objectives: to decrease the equilibrium waste disposal, to increase the economic surplus of the individual and/or the waste management firm, and to lower the equilibrium collection fee.

An investigation was carried out to elucidate landfill gas (LFG) and the vegetation characteristics in closed landfill. The results indicate that the stabilization process of the landfill is an important factor influencing the components of landfill gases. The coverage, height and species of vegetation increase with the closed time of landfill. Fourteen species were observed in the investigated cells, dominated by Phragmites australis, an invasive perennial plant. The concentrations of methane and carbon dioxide from vegetated cover soil were lower than those from non-vegetated cover soil.

To elucidate the influence of landfill gas (LFG) emission on environmental factors, an ecological investigation that was primarily concerned with the characteristics of vegetation, cover soil, and solid waste in the landfill was carried out. Temporal and spatial variations in vegetation diversity and coverage and their effects on reducing the emission of methane in the landfill were investigated. The results showed that both vegetation coverage and diversity increased with elapsed landfill closure time. The transition trend of the vegetation species was from perennial plant (Phragmites australis) to annual plants. Perennial vegetation was the dominant type of vegetation during the early closure period, and annual vegetation coverage increased with closure time. Vegetation preferentially appeared in areas of comparatively high depth of cover soil, which was characterized by high moisture retentiveness that enabled vegetation growth. The concentrations of methane and carbon dioxide in the cover soil significantly decreased with increasing closure time. The concentrations of methane and carbon dioxide from bare cover soil were higher than those from vegetated cover soil whereas the CO(2) flux of bare cover soil was less than that of vegetated cover soil.

This article examines the findings regarding the neurologic and functional recovery of patients from the Copenhagen Stroke Study. This article presents initial neurologic impairment and disability pattern and speed of recovery, final impairment and disability after completed rehabilitation, and prognostic factors in these stroke patients.

This article describes basic characteristics and primary outcomes of unselected patients with stroke. These patients were part of the Copenhagen Stroke Study, a prospective, consecutive, and community-based study of 1197 acute stroke patients. The setting and care was multidisciplinary and all treatment was performed within the dedicated stroke unit. Neurologic impairment was measured at admission, weekly throughout the hospital stay, and again at the 6-month follow up. Basic activities of daily living, as measured by the Barthel Index, were assessed within the first week of admission, weekly throughout the hospital stay, and again after 6 months. Upon completion of the in-hospital rehabilitation, which averaged 37 days, two-thirds of surviving patients were discharged to their homes, with another 15% being discharged to a nursing home. Only 4% of the patients with very severe strokes reached independent function, as compared with 13% of patients with severe stroke, 37% of patients with moderate stroke, and 68% of patients with mild stroke.

Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has not been clarified. Methods: In 763 unselected patients with stroke admitted within 24 hours from onset, we prospectively studied the relation between leukocyte count and outcome considering relevant confounders and predictors such as initial stroke severity, risk factor profile, body temperature, and infection. Results: Univariate, leukocyte count on admission was significantly related to initial stroke severity (assessed by the Scandinavian Stroke Scale), lesion size on computed tomography, mortality, and outcome in survivors. However, multivariate regression analysis revealed that only the relation between leukocytosis and initial stroke severity was independent of other factors, whereas the relations found univariately between leukocytosis and lesion size, mortality, and outcome in survivors disappeared when initial stroke severity was included in the multivariate model. Conclusion: Leukocytosis on admission was related to initial stroke severity but not to outcome. Leukocyte count on admission seems merely to reflect initial stroke severity and is most likely a stress response with no independent influence on outcome. Our study may suggest that attempts aimed merely at lowering leukocyte count in peripheral circulating blood in the acute phase of stroke cannot be expected to improve outcome.

A recent study suggests that a high plasma level of tissue plasminogen activator (t-PA antigen) is a risk factor for stroke in men. Whether t-PA antigen is a risk factor for stroke in women is unknown. We measured plasma levels of t-PA antigen in 302 nonselected patients with acute ischemic stroke and in 138 healthy control subjects. In a subgroup of the patients, plasma t-PA antigen was remeasured 6 months after the stroke. Women with acute ischemic stroke (n=171) had median plasma t-PA antigen that was 39% higher than the healthy female control subjects (n=86): 10.3 (8.0 to 13.7) versus 7.4 (6.1 to 9.1) ng/mL (median [interquartile range]), P =.0001. At the reexamination of the patients after 6 months, plasma t-PA antigen was unchanged in the female patients. This suggests that the difference in plasma t-PA antigen between the female patients and the healthy control subjects did not result from an acute phase reaction. In a multivariate regression analysis, high t-PA antigen was an independent risk factor for stroke, and high plasma level of t-PA antigen was associated with severe stroke in women. The current data suggest that plasma t-PA antigen is elevated in women with ischemic stroke.

To determine the influence of initially lowered orientation on rehabilitation outcome in stroke patients, and how decreased orientation 6 months after stroke influences ADL and social activities.Prospective, consecutive, and community based.A stroke unit receiving all acute stroke patients from a well-defined catchment area. All stages of rehabilitation were completed within the unit.524 patients with acute stroke.Basic ADL assessed by the Barthel Index (BI) at discharge; discharge placement; higher level ADL and social functions assessed by the Frenchay Activity Index(FAI) at a 6-month follow-up.The independent influence of orientation in acute stroke on rehabilitation outcome was analyzed with multiple linear and logistic regression models, using initial stroke severity (Scandinavian Neurologic Stroke Scale), initial BI, age, sex, comorbidity, prior stroke, and marital status as covariates. A one-point decrease in orientation decreased BI with 9 points (coefficient b=8.66, SE(b)=1.02,p.0001) and reduced the likelihood (1.49, 95% CI: 1.05 to 2.11) of discharge to independent living (b=.40, SE(b)=.18,p=.026). Follow-up examinations 6 month poststroke showed that decreased orientation at this point still exerted a marked, negative influence on ADL and social functions (BI: coefficient b=12.06, SE(b)=1.95,p.0001; FAI: coefficient b=6.28, SE(b)=1.42,p.0001).The level of orientation influences basic ADL and higher level ADL and social activities in acute as well as chronic stroke. This finding suggests that rehabilitation of memory and attention might be relevant in stroke patients with impaired orientation.

Objectives: A "pusher syndrome" encompassing postural imbalance and hemineglect is believed to aggravate the prognosis of stroke patients. Our aim was to determine the incidence, associated neuropsychological symptoms, and the consequences for rehabilitation of ipsilateral pushing. Design: Consecutive and community-based. Setting: A stroke unit receiving all acute stroke patients from a well-defined catchment area. All stages of rehabilitation were completed within the unit. Patients: 647 acute stroke patients admitted during a 1-year period. Excluded were 320 patients who did not receive physiotherapy because they did not have pareses of the leg, had a fast remission, or died. Main Outcome Measures: Gain in activities of daily living (ADL) function (Barthel Index), time course of functional remission, and discharge rate to nursing home. The independent impact of ipsilateral pushing was analyzed with multiple linear and logistic regression analyses. Results: Ipsilateral pushing was found in 10% of the included patients. No significant differences were found in the incidence of hemineglect and anosognosia between patients with and without ipsilateral pushing. No association with side of stroke lesion was found. Ipsilateral pushing had no independent influence on gain in ADL function or discharge rate to nursing home, but patients with ipsilateral pushing used 3.6 weeks ( P Conclusions: The existence of a "pusher syndrome" was not confirmed. Ipsilateral pushing did not affect functional outcome, but showed the process of recovery considerably.

Objective: To determine the time course of both neurological and functional recovery from stroke. Design: Prospective, consecutive, and community based. Setting: The stroke unit of a hospital in Copenhagen, Denmark. This setting receives all acute stroke patients admitted from a well-defined catchment area of 239,886 inhabitants within the city of Copenhagen. Acute treatment as well as all stages of rehabilitation are cared for within the stroke unit regardless of age, stroke severity, and premorbid condition. Patients: 1,197 patients with acute stroke. Main Outcome Measures: Weekly examinations of neurological deficits (using the Scandinavian Neurological Stroke Scale) and functional disabilities (Activity of Daily Living (ADL) measured by the Barthel Index) were performed from the time of acute admission to the end of rehabilitation. These evaluations were repeated 6 months poststroke. Time course of recovery was stratified according to initial stroke severity and disability. Results: Functional recovery was completed within 12.5 weeks (95% confidence interval (CI) 11.6 to 13.4) from stroke onset in 95% of the patients. However, 80% of the patients had reached their best ADL function within 6 weeks (CI 5.3 to 6.7) from onset. The time course of functional recovery was strongly related to initial stroke severity. Best ADL function was reached within 8.5 weeks (CI 8 to 9) in patients with initially mild strokes, within 13 weeks (CI 12 to 14) in patients with moderate strokes, within 17 weeks (CI 15 to 19) in patients with severe strokes, and within 20 weeks (CI 16 to 24) in patients with very severe strokes. After these time-points, no significant changes occurred. However, a valid prognosis of functional outcome can be made much earlier. Best ADL function was reached by 80% of the patients with initially mild strokes within 3 weeks (CI 2.6 to 3.4), within 7 weeks (CI 6 to 8) of the patients with moderate strokes, and within 11.5 weeks (CI 10 to 13) of the patients with severe and very severe strokes. The time course of neurological recovery followed a pattern similar to that of functional recovery, but preceeded functional recovery by 2 weeks on average. Conclusions: A reliable prognosis can in all stroke patients be made within 12 weeks from stroke onset. Even in patients with severe and very severe strokes, neurological and functional recovery should not be expected after the first 5 months.

Time course and degree of the recovery of walking function after stroke and the influence of initial lower extremity (LE) paresis were studied prospectively in a community-based population of 804 consecutive acute stroke patients. Walking function and degree of LE paresis were assessed weekly using the Barthel index and the Scandinavian Neurological Stroke scale, respectively. Initially, 51% had no walking function, 12% could walk with assistance, and 37% had independent walking function. At the end of rehabilitation, 21% had died, 18% had no walking function, 11% could walk with assistance, and 50% had independent walking function. Recovery of walking function occurs in 95% of the patients within the first 11 weeks after stroke. The time and the degree of recovery are related to both the degree of initial impairment of walking function and to the severity of LE paresis, p < .0001. A valid prognosis of walking function in patients with initially no/mild/moderate leg paresis can be made in 3 weeks, and further recovery should not be expected after 9 weeks. A valid prognosis of walking function in patients with initially severe leg paresis or paralysis can be made in 6 weeks, and further improvement of walking function should not be expected later than 11 weeks after stroke.

Twenty gastric carcinoma cases were studied for the detection of CD44 aberrant transcripts using a cDNA/PCR/blot-hybridization technique which can detect splice variants containing an aberrant exon 11 of the CD44 gene. All the tumor tissues as well as their metastatic foci demonstrated overexpression of CD44 splice variants of more than 1.0 kbp than corresponding normal gastric mucosas. Six out of nine (66.7%) well-differentiated or intestinal type gastric cancers overexpressed more than three aberrant transcripts, whereas ten out of eleven (90.9%) poorly differentiated or diffuse type cancers overexpressed single or two lower molecular weight variants. These results indicate that the detection of CD44 transcription variants can serve as a powerful tool for the diagnosis of gastric cancer. It is also suggested from the difference in variant expression pattern that well-differentiated type and poorly differentiated type gastric carcinomas have different genetic pathways.

Progression of acute stroke after arrival at hospital is frequent and the prognosis severe. However, risk factors and mechanisms behind progression are largely unknown. A prospective, community-based study of 868 patients with acute stroke was undertaken to discover factors of importance in the development of stroke in progression. Diagnosis of progression was based on the Scandinavian Neurological Stroke Scale. Patients were divided according to whether progression occurred early (within 36 hours from stroke onset) or late (within the first week from onset). Results were analysed by comparing patients with and without progression. Marked progression developed in 32%. Risk factors for early progression were identified as systolic blood pressure on admission (decreased the relative risk by 0.66 per 20 mm Hg increase, 95% CI 0.55-0.83) and diabetes (increased the relative risk by 1.9, 95% CI 1.1-3.3). Stroke severity was the only risk factor found in late progression (OR 1.4 per 20-point increase in stroke severity, 95% CI 1.1-1.7). These relations were independent of age, sex, blood glucose, heart disease, and other stroke risk factors. Early progression is related to systolic blood pressure and diabetes. Late progression is related to initial stroke severity. Although this study does not prove that a causal relationship exists between systolic blood pressure and the development of early progression, such a relationship would, however, explain our findings.

We examined tyrosine kinase activity of epidermal growth factor (EGF) receptor in a total of 34 human gastric carcinomas as well as in non-neoplastic gastric mucosa from the same patients. EGF receptor kinase activity of the carcinoma tissues and the non-neoplastic mucosa were 1.28 +/- 1.00 (Mean +/- S.E.) and 0.16 +/- 0.04 respectively, if the EGF receptor kinase activity of human placenta is 10. Twenty-one (62%) carcinoma tissues showed higher EGF receptor kinase activity than corresponding non-neoplastic mucosa, while in 6 cases (18%) the kinase activity was higher in the non-neoplastic mucosa than in the tumor tissues. No obvious correlation was observed between the increased kinase activity in the tumors and histological type or tumor staging. One tumor showed extremely high receptor kinase activity with ERBB gene amplification. This tumor showed strong immunoreactivity to EGF itself.

Wandel A, Jorgensen HS, Nakayama H, Raaschou HO, Olsen TS. Prediction of walking function in stroke patients with initial lower extremity paralysis: the Copenhagen Stroke Study. Arch Phys Med Rehabil 2000;81:736-8. Objectives: The majority of stroke patients with initial leg paralysis do not regain independent walking. We characterize the minority who, despite initial leg paralysis, regained independent walking. Design: Consecutive and community based. Setting: A stroke unit receiving all stroke patients from a well-defined community. Patients: A total of 859 acute stroke patients; 157 (15%) initially had leg paralysis. Main Outcome Measures: Scandinavian Stroke Scale (SSS) and Barthel index (BI) on admission and weekly during rehabilitation. Univariate and multivariate statistics were considered. Results: Of the 157 patients with initial leg paralysis, 84 (60%) died; 73 (40%) survived. Fifteen (21%) survivors regained walking function (the walking group), and 58 (79%) did not (the nonwalking group). The BI on admission was the only factor of significant predictive value ( p p p Conclusion: Only 10% of stroke patients with initial leg paralysis regained independent walking. In these patients, BI on admission was high and leg strength improved quickly in the first week. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation