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Stroke incidence and mortality are disproportionately higher among African Americans than among whites.To describe the recurrent stroke characteristics and determine the predictability of known vascular risk factors for stroke recurrence in African Americans.The authors followed 1,809 African Americans in the African-American Antiplatelet Stroke Prevention Study with recent noncardioembolic ischemic stroke for recurrent stroke, recurrent stroke subtype, and disability.Of the subjects, 10.6% experienced a recurrent stroke during follow-up. The mean interval between eligibility and recurrent stroke was 325 days (median 287 days, SD = 224 days). Stroke recurrence resulted in an average 1.5-point increase in the National Institute of Health Stroke Scale (p0.001) and a 3.5-point decrease in modified Barthel Index (p0.001). Of previously nondisabled subjects, 48% became disabled or died after stroke recurrence (p0.0001). Longitudinal analysis resulted in a hazard for recurrent stroke for each 10-mm Hg increase in systolic blood pressure of 1.103 (95% CI: 1.031 to 1.179, p = 0.004), pulse pressure 1.123 (95% CI: 1.041 to 1.213, p = 0.003), and mean arterial pressure 1.123 (95% CI: 1.001 to 1.260, p = 0.048). Multivariate analysis revealed increases in the recurrent stroke hazard for increases in baseline Glasgow Outcome Score (1.449, 95% CI: 1.071 to 1.961, p = 0.016) and increases in longitudinal pulse pressure (1.009, 95% CI: 1.001 to 1.017, p = 0.029).Recurrent stroke leads to disability and disability predicts recurrent stroke. Hypertension is the most predictive modifiable stroke risk factor.

There is a need to introduce cropping practices in the northern N.S.W. cereal belt that increase N supply for cereal, and in particular wheat, production. Annual crop legumes, grown in rotation with cereal crops, can contribute to the total pool of N in the soil and improve yields of the cereals. Experiments, in 1989 and 1990 at two sites near North Star, N.S.W., are described which aim to (i) assess the effects of chickpea on concentrations of soil nitrate, both in terms of “N sparing” during legume growth and release of N bound in the crop residues; (ii) quantify N2 fixation by chickpea using the natural15N abundance and modified N different techniques; and (iii) explore the concept of water use efficiency (WUE) of N2 fixation for use in the management of N in cropping systems. The two sites and three rates of fertilizer N (0, 50 and 100 kg ha−1) provided six combinations of site, season and nitrate-N fertility. Nitrogen fixed ranged from 29 to 85 kg ha−1, with amounts influenced by method of assessment and fertilizer N treatment. There was general agreement between the natural 15N abundance and modified N difference methods. Soil nitrate spared by chickpea ranged from 6 to 31 kg N ha−1, over sites and treatments, and averaged 11 kg N ha−1 at Windridge and 26 kg N ha−1 at Glenhoma. In the May sampling in the following year, i.e. after the summer and autumn fallow, differences in soil nitrate-N between the chickpea and wheat plots ranged from 29 to 51 kg ha−1, and averaged 44 kg ha−1 (Windridge) and 43 kg ha−1 (Glenhoma). Water use efficiency of chickpea N2 fixation varied between 0.14 and 0.24 kg ha−1 mm−1, with the higher values associated with higher N2 fixation.

Objective To review the rationale, design and baseline data of the Avonex Combination Trial (ACT), an investigator-run study of intramuscular interferon beta-1a (IM IFNβ-1a) combined with methotrexate (MTX) and/or IV methylprednisolone (IVMP) in relapsing—remitting multiple sclerosis (RRMS) patients with continued disease activity on IM IFNβ-1a monotherapy. Methods Eligibility criteria included RRMS, Expanded Disability Status Scale score 0—5.5, and ≥1 relapse or gadolinium-enhancing MRI lesion in the prior year while on IM IFNβ-1a monotherapy. Subjects continued IFNβ-1a 30 mcg IM weekly and were randomized in a 2 × 2 factorial design to adjunctive weekly placebo or MTX 20 mg PO, with or without IVMP 1000 mg/day for three days every other month. ACT was industry-supported, and collaboratively designed and governed by an Investigator Steering Committee with independent Advisory and Data Safety Monitoring Committees. Study operations, MRI analysis and aggregated data were managed by the Cleveland Clinic MS Academic Coordinating Center. Results In total 313 subjects were enrolled with clinical and MRI characteristics typical of RRMS. Most subjects (86.9%) qualified with a clinical relapse, with or without an enhancing MRI lesion, in the preceding year. At baseline, 21.4% had enhancing lesions, and 5.1% had anti-IFNβ neutralizing antibodies. ACT's management and operational structures functioned well. Conclusion This study provides an innovative model for academic—industry collaborative MS research and will enhance understanding of the utility of combination therapy for RRMS patients with continued disease activity on an established first-line treatment. Multiple Sclerosis 2008; 14: 370—382. http://msj.sagepub.com

Morbid obesity is increasing in the United States population. Morbidly obese patients may have disabling pulsatile tinnitus (PT) secondary to pseudotumor cerebri syndrome and often seek treatment from otolaryngologists because of this symptom.To determine the effectiveness of weight reduction surgery (WRS) for relief of PT in patients with morbid obesity.Retrospective study of morbidly obese patients with associated PT.Academic tertiary referral center.Sixteen women with morbid obesity and associated PT who underwent WRS.Median age was 34 years (range 24-45 years). Average preoperative body mass index was 45 kg/m2 (range 33-70 kg/m2). Average weight loss was 45+/-17 kg (range 25-99 kg). Average postoperative weight was 75+/-14 kg (range 57-105 kg). The average preoperative cerebrospinal fluid pressure was 344+/-103 mm H2O (range 220-520 mm H2O). Postoperative measurements of cerebrospinal fluid, obtained on 4 patients, revealed an average decrease in pressure of 198 mm H2O (range 120-400 mm H2O). Thirteen patients experienced complete resolution of their PT (81%). Three patients continued to have PT despite significant weight reduction.Weight reduction surgery was effective in relieving PT in morbidly obese patients with associated pseudotumor cerebri syndrome and should be considered when conservative management has failed.

The trend toward eliminating tillage before sowing food legumes directly into crop residues has been driven by the need to reverse soil degradation. It has been stimulated by the accrual of benefits such as improved timeliness of sowing, less labour and machinery input, effective weed control using herbicides, less erosion and runoff, increased soil water storage and improved soil physical and organic fertility.

The objectives of this study were to quantify below-ground nitrogen (BGN) of rainfed fababean (Vicia faba), chickpea (Cicer arietinum), and barley (Hordeum vulgare) and to use the values to determine N balances for the 3 crops. The BGN fraction of legumes in particular represents a potentially important pool of N that has often been grossly underestimated or ignored in calculating such balances. A field experiment was conducted at Breeza on the Liverpool Plains, New South Wales, in which BGN of fababean, chickpea, and barley was estimated using 15N methodologies. Plants were grown in 0.32-m2 microplots and labelled with 15N on 5 occasions during vegetative growth with a total of 1.0 mL of 0.5% 15N urea (98 atom% 15N) using leaf-flap (fababean), leaf-tip (barley), or cut petiole (chickpea) shoot-labelling procedures. At peak biomass (146–170 days after sowing), all plant material and soil to 45 cm depth was sampled from one microplot in each replicate plot and analysed for dry matter (DM), %N, and 15N. At plant maturity, the remaining 3 microplots in each replicate plot were harvested for shoot and grain DM and N. With fababean, 15N enrichments of intact roots and shoots were reasonably uniform at 537‰ and 674‰, respectively. Microplot soil at 0–25 cm depth had a 15N enrichment of 18‰ (natural abundance of 6.1‰). The 25–45 cm soil enrichment was 8.7‰ (natural abundance of 6.3‰). In contrast, 15N enrichment of chickpea shoots was about twice that of recovered roots (685‰ v. 331‰), and the soil enrichment was relatively high (30‰ and 8.8‰ for the 0–25 and 25–45 cm depths, respectively). The 15N enrichments of barley shoots and recovered roots were 2272‰ and 1632‰, respectively, with soil enrichments of 34‰ and 10.7‰ for the 0–25 and 25–45 cm depths, respectively. Estimates of BGN as a percentage of total plant N, after adjusting the 15N shoot-labelling values of fababean and chickpea for uneven distribution of 15N-depleted nodules, were 24% for fababean, 68% for chickpea, and 36% for barley. The BGN values were combined with N2 fixation (fababean and chickpea only) and shoot and grain yield data (all 3 species) to construct N budgets. The inclusion of BGN in the budgets increased N balances by 38 kg N/ha to +36 kg N/ha for fababean and by 93 kg N/ha to +94 kg N/ha for chickpea. As there was no external (N2 fixation) input of N to barley, the inclusion of BGN made no difference to the N balance of the crop of –74 kg N/ha. Such values confirm the importance of BGN of N2-fixing legumes in the N economies of cropping systems.

Four experiments in northern New South Wales comparing fallow management treatments of no-tillage, cultivated with the stubble retained, and cultivated with the stubble burned, from 1981 to 1990, were sampled for weeds between wheat harvest and seeding on a number of occasions during this period. Eighty weed species were identified, 23 of which were found at all 4 sites but only 13 were recorded in the samples taken. These were dwarf amaranth, wild turnip, spear thistle, Australian bindweed, fleabane, bladder ketmia, prickly lettuce, turnip weed, variegated thistle, common sowthistle, dandelion, wild oats and native millet. The density of weeds during the fallow period decreased by 97% from 1981 to 1990 with some species eliminated, probably because of the herbicides used, particularly glyphosate and chlorsulfuron. These included Boggabri and redroot amaranth, button grass, caustic weed, dense crassula, fat hen, legumes, common peppercress, hedge mustard, London rocket, shepherd’s purse, wild mustard, sorghum-almum, paradoxa grass, wild zinnia, and wireweed. Twenty-four weed species were classified as a problem or a potential problem in the future at 1 or more sites. Seventeen weed species, including perennial grasses, often were tolerant to glyphosate at the rates used. The densities of common sowthistle and wild oat were reduced after 10 years, but still remained at all 4 sites. Plant density of species with wind-blown seeds was greater in no-tillage plots than stubble-retained or stubble-burned plots. Weeds whose seeds are dispersed by wind and weeds tolerant to glyphosate were the most troublesome. The perennial grass native millet increased at all 4 sites.

Functions quantifying relationships between N2 flxation by legumes and other factors would be useful to farmers in the management of legumes and nitrogen in their production systems. The 2 most critical factors regulating N2 flxation are legume yield and soil nitrate and both should be included as independent variables in the functions. Data from 9 experiments in northern New South Wales on soil nitrate at sowing, yields of shoot and grain dry matter (DM) and N of chickpea, and - 15 N of shoots of chickpea and non N2-flxing reference crops (wheat, barley, and uninoculated chickpea) were used to determine the percentage of chickpea N derived from N2 flxation (Pflx), total N2 flxed, and N balance (flxed N2 minus grain N). Data were then subjected to simple and multivariate regression analyses with Pflx and total N2 flxed as the dependent variables and soil nitrate, shoot N, and grain yield as the independent variables. Simple regression coe-cients (r 2 ) for Pflx were 0¢26 with shoot N as the independent variable, 0¢59 with soil nitrate, and 0¢62 with grain yield. Coe-cient values were increased in the 2-factor (multiple) regressions to 0¢74 (P

Chickpea has potential as a rotation or break crop in the northern grains region of New South Wales and Queensland. Definition of that potential requires information on chickpea N2 fixation and on effects of chickpea on maintenance of soil N fertility and delivery of mineral N for use by a following cereal crop. Results from 6 experiments in northern NSW in which chickpea and wheat in one season were followed by wheat in subsequent seasons indicated variable N2 fixation by chickpea (mean 73 kg/ha; range 4-116 kg/ha), associated with variable Pfix (percentage of chickpea N derived from N2 fixation) (mean 57%; range 4-79%). There were no consistent differences between chickpea and wheat in effects on soil water, either pre-harvest or after the summer fallow. Chickpea ‘spared’ nitrate, relative to wheat (mean 15 kg/ha; range 1-35 kg/ha), and mineralised additional nitrate during the summer fallow (mean 18 kg/ha; range 5-40 kg/ha). Nitrate-N in the top 1·2 m of the soil profile at sowing of the following wheat crop was on average 89 kg/ha after chickpea (range 63-113 kg/ha) and 56 kg/ha after wheat (range 33-94 kg/ha). Nitrogen mineralisation rates during the summer fallow at 2 sites of 0·17 and 0· 21 kg N/ha · day (after chickpea), although greater than the rates after wheat (0· 07 and 0·12 kg N/ha · day), were not sufficient to meet the N requirements of a moderate to high yielding cereal crop. We concluded that chickpea did not fix sufficient N2 or mineralise sufficient N from residues either to maintain soil N fertility or to sustain a productive chickpea{wheat rotation without inputs of additional fertiliser N.

Rotational effects of chickpea, an important N2-fixing pulse legume of the northern grains region, on subsequent wheat require quantification of the contribution of the legume to soil N and the N status of the wheat, and of suppression of soil and stubble-borne pathogens, such as crown rot (Fusarium graminearum Schwabe Group 1). Results from selected treatments of 10 experiments in northern New South Wales in which chickpea and wheat in one season were followed by wheat in following seasons indicated generally higher dry matter (DM) and grain yields of wheat after chickpea than after wheat. Responses to chickpea were -0·8 to 3·3 t/ha (shoot DM) and -3 to 39 kg N/ha (shoot N). Responses in wheat grain yields were -0·1 to 1·7 t/ha (mean 0·85 t/ha); grain N responses were -2 to 33 kg/ha (mean 19 kg/ha). Grain protein responses were small (0·6%) and variable. Although these productivity responses could be explained largely in terms of additional nitrate-N following chickpea, we measured reduced incidences of crown rot in wheat after chickpea (range 1-36%, mean of 12%), compared with wheat after wheat (range 5-52%, mean 30%). Modelling the incidence of crown rot indicated highly significant interactions between prior crop and total water (pre-plant soil water plus in-crop rainfall). When wheat followed chickpea, incidence of the disease declined sharply with increasing water. When wheat followed wheat, there was a marginal decline in disease incidence with increasing water. Our results support the strategy of using legumes in rotation with wheat in the northern grains region for enhanced soil-N supply and disease-break effects.

Four experiments were commenced after a 1980 wheat crop, and a fifth after the 1981 crop, at different sites representing the major soil types of northern New South Wales in the 550-700 mm rainfall zone, to examine the influence of 3 fallow management practices [no tillage (NT); stubble retention after harvest, cultivation (SM); stubble burning after harvest, cultivation (SB)] on wheat production. Data considered in this paper cover the continuous wheat subtreatments of the 5 experiments (1981-90). Nitrogen applied at 50 kg Nlha in addition to the basal treatment was included as a treatment from 1986 to 1988. Across all sites and seasons, grain yields were in the order SB>SM = NT, stubble retention having a greater effect than tillage. In some years at some sites, differences in grain yield and grain N yield were not significant. In others, when significant yield differences occurred, variations in grain yield and grain N yield were highly correlated with differences in soil N available for the crop. The data show that the influence of fallow management interacted with season and crop nutrition, and required long-term study for proper assessment.

Summary: Resume: Zusammenfassung Cotton, soybeans and the weed species Datura stramonium L. were grown in the glasshouse under simulated spray and furrow irrigation. Oxadiazon at different rates was applied as a pre-emergence treatment. The number of Datura, was decreased by higher rates of oxadiazon under spray irrigation but not with sub-irrigation. Control at 4 kg/ha with spray irrigation was 75% but less than 15% with sub-irrigation. Soybeans were less tolerant to oxadiazon than cotton but phytotoxicity was evident in both crops at 4 kg/ha. La lutte contre le Datura stramonium L. avec l'oxadiazon sous irrigation simulee par aspersion ou par submersion. Du coton, des sojas et une espece de mauvaise herbe: Datura stramonium L., ont ete cultives en serre, sous irrigation simulee par aspersion ou par submersion. L'oxadiazon a ete applique h differents taux en traitement de prevlevee. Le nombre de Datura a ete diminue parles doses les plus elevees d'oxadiazon sous irrigation par aspersion mais pas par submersion. L'efBcacite herbicide a,4 kg/ha a ete de 57% avec l'irrigation par aspersion mais moins de 15% avec l'irrigation par submersion. Les sojas se sont montres moins resistants a l'oxadiazon que le coton, mais la phytotoxiciteetait evidente dans ces deux cultures a 4 kg/ha. Die Bekampfung von Datura stramonium L. mit Oxadiazon unter simulierter Beregnung und Furchenbewasserung Baumwolle, Sojabohnen und das Unkraut Datura stramonium L. wurden unter simulierter Beregnung und Furchenbewasserung im Gewachshaus gezogen. Oxadiazon wurde mit verschiedenen Aufwandmengen im Vorauflauf angewendet. Bei hoheren Aufwandmengen ging die Anzahl von Datura bei Beregnung zuruck, nicht aber bei UntergrundbewSsser-ung. Bei 4 kg/ha und Beregnung betrug die Bekampfung 75 %, bei UntergrundbewSsserung aber weniger als 15%. Die Sojabohnen waren gegenuber Oxadiazon weniger tolerant als Baumwolle, aber bei beiden Kulturpflanzen trat bei 4 kg/ha Phytotoxizitat auf.