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Aneurysmal subarachnoid hemorrhage (aSAH) is associated with early and delayed brain injury due to several underlying and interrelated processes, which include inflammation, oxidative stress, endothelial, and neuronal apoptosis. Treatment with melatonin, a cytoprotective neurohormone with anti-inflammatory, anti-oxidant and anti-apoptotic effects, has been shown to attenuate early brain injury (EBI) and to prevent delayed cerebral vasospasm in experimental aSAH models. Less is known about the role of endogenous melatonin for aSAH outcome and how its production is altered by the pathophysiological cascades initiated during EBI. In the present observational study, we analyzed changes in melatonin levels during the first three weeks after aSAH.
A new formulation to calculate the shakedown limit load of Kirchhoff plates under stochastic conditions of strength is developed. Direct structural reliability design by chance con-strained programming is based on the prescribed failure probabilities, which is an effective approach of stochastic programming if it can be formulated as an equivalent deterministic optimization problem. We restrict uncertainty to strength, the loading is still deterministic. A new formulation is derived in case of random strength with lognormal distribution. Upper bound and lower bound shakedown load factors are calculated simultaneously by a dual algorithm.