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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse craig S Anderson Sandeep Ankolekar Lesley cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir john Potter christopher I Price Marc Randall Thompson G Robinson christine Roffe Else c Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute china at Peking University Health Science center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK centre for clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of cardiovascular Sciences and NIHR Leicester Biomedical Research centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and comprehensive Stroke center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%cI 0.85 to 1.54),death or global analysis(MWD 0.00,95%cI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIc⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

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Occurrence of Anguilla luzonensis in the Tributaries along the Lagonoy Gulf,Philippines

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Journal of Fisheries Science 2021年第1期3卷 8-16页

作者： Katrina L.canon Plutomeo M.Nieves Antonino B.Mendoza Jr john christopher c.nolial Niño c.celestial Ronie O.Mediario Raul G.Bradecina Teresa N.Avila Satoshi Kubota Graduate School of Integrated Arts and Sciences Kochi UniversityKohasuOkoNankokuKochi 783-8505Japan Bicol University Tabaco campus Tabaco City 4511AlbayPhilippines Partido State University Goa 4422Camarines SurPhilippines

Anguillids areаvaluable fish commodity *** Anguilla luzonensis have been abundantly found in the northern Philippines and collected for trade,no available records show that it recruited in the mid-part where Lagonoy Gulf,Bicol is *** this study,we investigated the occurrence of *** in the tributaries along the Lagonoy Gulf,Philippines using molecular *** eel specimens were collected in 2018-2019 from the comun river,Albay;the Lagonoy river,camarines Sur;and the Bato river,*** luzonensis was first reported in Lagonoy Gulf using molecular *** was the second most abundant species in the comun and Lagonoy rivers(9.5 and 22.4%,respectively).Anguilla luzonensis collected from the comun and Lagonoy rivers did not show a significant difference(FST=0.00825,p>0.05).Anguilla marmorata was the most dominant species in all tributaries(71.1-98.0%).In the comun and Lagonoy rivers,*** pacifica was the third most abundant species(7.7 and 6.5%,respectively).In addition,Anguilla celebesensis was only found rarely in the comun river(0.9%).This study provides important information for sustainable resource management and effective utilization of the eel species in these regions.

关键词： Anguilla Glass eels Species composition PcR-RFLP DNA sequencing Diversity

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Envita’s Precision cancer care: 35-Fold Improvement in Response Rates

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Journal of cancer Therapy 2024年第4期15卷 99-120页

作者： Sheba Goklany john c. Oertle III Ronald Matthias Jr. Daniel Warren David Medina Rory Sears Robert Zieve Kendra Quart christopher Aussems Jon Moma Shannon Miller Zach Poteet conner coffin courtney Middleton Erika Ware Phylicia Zarnosky Julie Nowak Winlove Suasin Daniel conway chad Burk Ruth Tan-Lim Dino Prato Envita Medical centers Scottsdale AZ USA

New clinical approaches are imperative beyond the widely adopted National comprehensive cancer Network (NccN) guidelines, utilized by prominent cancer institutions. cancer is the leading cause of death among individuals younger than 85 years within the United States. Despite significant technological advances, including the expenditure of hundreds of billions, treatment outcomes and overall survival have not notably improved for most types of advanced cancer over the last several decades. Over the past 24 years, Envita Medical centers has pioneered a unique form of personalized treatment approach for late-stage and refractory cancer patients, introducing groundbreaking innovations in the field. Our integrated algorithm utilizes advanced genomics, transcriptomics, and highly tailored immunotherapy, resulting in remarkable outcome improvements. This study presents Envita’s innovative personalized treatment algorithms and examines the response outcomes of 199 late-stage cancer patients treated at Envita Medical centers over a two-year period. compared to standard of care and palliative chemotherapy, Envita’s treatment demonstrated a remarkable 35-fold improvement in overall response rates (Figure 1). Moreover, 88% of the patients, the majority presenting with Stage 3 or 4 cancer, experienced a 43-fold improvement in quality of life with minimal side effects, as compared to standard of care chemotherapy and palliative care. This revolutionary success is attributed to Envita’s personalized therapeutic algorithms, which incorporate customized immunotherapy. Envita’s precision care approach has also achieved a 100% better response rate compared to over 65 global chemotherapy clinical trials with more than 2700 patients. The results from this study suggest that a wider utilization of Envita’s personalized approach can significantly benefit patients with late-stage and refractory cancer.

关键词： Envita Medical centers Late-stage cancer Overall Response Rate Quality of Life circulating Tumor cells (cTcs) Mutant Allele Frequency (MAF) Precision care

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Epidemiology of Mpox Outbreaks and Implications for Surveillance in Imo State, Nigeria

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Advances in Infectious Diseases 2024年第1期14卷 206-212页

作者： Adeniyi A. Adeniran Ebubechi c. Eronini Olugbenga Asaolu Simisola Adedeji Adaeze Joy Ugwu Marcus Oludare Faith Ehiaghe Ugba Aibinuomo Ayomide Oluwaseyi Tella Adedamola Dania Oluyinka Olayiwola Olanike Suliat Oladele Tinuola Daniel Musa Haruna Adebayo O. Amao john O. Ibitoye Oluwagbemiga Obembe christopher Obanubi Abdulmalik Abubakar Department of Public and Allied Health Babcock University Ilishan-Remo Nigeria Department of Public Health University of Suffolk Waterfront Building UK Department of Public Health EUCLID University Greater Bajul The Gambia Department of Public Health Liverpool John Moores University Liverpool UK college of Medicine Obafemi Awolowo University Ile-Ife Nigeria Department of Environmental Health Sciences University of Ibadan Ibadan Nigeria Department of Public Health Texila American University Georgetown Guyana School of Public Health University of Port Harcourt Port Harcourt Nigeria Department of community Medicine University College Hospital Ibadan Nigeria Department of Nursing Adeleke University Ede Nigeria Department of Public Health Central University of Nicaragua Managua Nicaragua Faculty of Basic clinical Sciences Lagos State University College of Medicine Ikeja Nigeria catholic Relief Services Abuja Nigeria Department of Political Science Faculty of Social Sciences Bayero University Kano Kano Nigeria

Mpox disease is caused by a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae. The incubation period is usually 6 to 13 days but can range from 5 to 21 days while symptoms and signs may persist for 2 to 5 weeks. Although, the clinical features are usually less severe when compared to the deadly smallpox, the disease can be fatal with case fatality rate between 1% and 10%. In Imo State, Nigeria, there has been a changing epidemiology of the disease in the last 6 years and the frequency and geographic distribution of cases have progressively increased. This study aims to conduct a review of the disease epidemiology between 2017 and 2023 and implications for surveillance in Imo State. Surveillance data from the Surveillance Outbreak Response and Management System (SORMAS) was extracted between January 2017 and December 2023 across the 27 Local Government Areas (LGAs) of Imo State. A line list of 231 suspected cases was downloaded into an excel template and analyzed using SPSS® version 20 software. Analysis was done using descriptive statistics and associations were tested using Fischer’s exact at 0.05 level of significance. Of the 231 suspected cases, 57.1% (132) were males, 42.9% (99) were females and the modal age group was between the ages of 0 - 4 (32.5%). Eight (8) LGAs (districts) accounted for 71% (n = 164) of all the suspected cases. 21.2% (49) were confirmed positive, 27 males (55.1%) and 22 females (44.9%) (p > 0.05). Modal age group was 20 - 24 (22.4%, n = 11), 18% (9) were children under 14 years, p > 0.05. case fatality rate was 8% (n = 4). There was no significant association between mortality and age group. Five (5) LGAs accounted for about 60% (29) of all confirmed cases. These LGAs contribute only 20% to the total population in the State. Only 5.6% and 4% of suspected and confirmed cases, respectively, had knowledge of contact with an infectious source. The study described the epidemiology of Mpox outbreaks between 2017

关键词： Mpox Epidemiology Outbreak Surveillance

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Early anticoagulation in patients with stroke and atrial fibrillation is associated with fewer ischaemic lesions at 1 month: the ATTUNE study

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Stroke & Vascular Neurology 2024年第1期9卷 30-37,I0034页

作者： Angelos Sharobeam Longting Lin christina Lam carlos Garcia-Esperon Yash Gawarikar Ronak Patel Matthew Lee-Archer Andrew Wong Michael Roizman Amanda Gilligan Andrew Lee Kee Meng Tan Susan Day christopher Levi Stephen M Davis Mark Parsons Bernard Yan Melbourne Brain centre at Royal Melbourne Hospital ParkvilleVictoriaAustralia University of New South Wales South Western Sydney clinical School LiverpoolNew South WalesAustralia Department of Neurology John Hunter HospitalNewcastleNew South WalesAustralia Department of Neurology Calvary Public HospitalCanberraAustralian Capital TerritoryAustralia Department of Neurology Northern Hospital EppingEppingVictoriaAustralia Department of Neurology Royal Brisbane and Women's HospitalHerstonQueenslandAustralia The University of Queensland School of Medicine HerstonQueenslandAustralia Neurosciences clinical Institute Epworth HealthcareRichmondVirginiaAustralia Department of Neurology Austin HealthUniversity of MelbourneHeidelbergVictoriaAustralia Flinders University college of Medicine and Public Health AdelaideSouth AustraliaAustralia Department of Neurology Gold Coast University HospitalSouthportQueenslandAustralia The University of Sydney Northern clinical School St LeonardsNew South WalesAustralia Department of Neurology and Neurophysiology Liverpool HospitalLiverpoolNew South WalesAustralia

Background The optimal time to commence anticoagulation in patients with atrial fibrillation(AF)after ischaemic stroke or transient ischaemic attack(TIA)is unclear,with guidelines differing in recommendations.A limitation of previous studies is the focus on clinically overt stroke,rather than radiologically obvious diffusion-weighted imaging ischaemic *** aimed to quantify silent ischaemic lesions and haemorrhages on MRI at 1month in patients commenced on early(chaemic lesions and more haemorrhages in the early anticoagulant group at 1-month *** A prospective multicentre,observational cohort study was performed at 11 Australian stroke *** and MRI data were collected at baseline and follow-up,with blinded imaging assessment performed by two *** of commencement of anticoagulation was at the discretion of the treating stroke *** We recruited 276 patients of whom 208 met the eligibility *** average age was 74.2 years(SD±10.63),and 79(38%)patients were *** National Institute of Health Stroke Scale score was 5(IQR 1–12).Median baseline ischaemic lesion volume was 5mL(IQR 2–17).There were a greater number of new ischaemic lesions on follow-up MRI in patients commenced on anticoagulation≥4days after index event(17%vs 8%,p=0.04),but no difference in haemorrhage rates(22%vs 32%,p=0.10).Baseline ischaemic lesion volume of≤5mL was less likely to have a new haemorrhage at 1month(p=0.02).There was no difference in haemorrhage rates in patients with an initial ischaemic lesion volume of>5mL,regardless of anticoagulation *** commencing anticoagulationciated with fewer ischaemic lesions at 1month in AF *** is no increased rate of haemorrhage with early *** results suggest that early anticoagulation after mild-to-moderate acute ischaemic stroke associated w

关键词： patients lesions ischaemic

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Listening plus : authentic recordings with tasks to develop listening skills and learner training (student's book) / john McDOWELL,christopher HART.

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1987年

作者： john McDOWELL christopher HART.

来源：畅想之星图书光盘版（南... 评论

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Machine Learning and Deep Learning Methods for Enhancing Building Energy Efficiency and Indoor Environmental Quality – A Review

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能源与人工智能(英文) 2022年第4期10卷 262-289页

作者： Paige Wenbin Tien Shuangyu Wei Jo Darkwa christopher Wood john Kaiser calautit Department of Architecture and Built Environment University of NottinghamNottingham NG72RDUK

The built environment sector is responsible for almost one-third of the world’s final energy consumption. Hence, seeking plausible solutions to minimise building energy demands and mitigate adverse environmental impacts is necessary. Artificial intelligence (AI) techniques such as machine and deep learning have been increasingly and successfully applied to develop solutions for the built environment. This review provided a critical summary of the existing literature on the machine and deep learning methods for the built environment over the past decade, with special reference to holistic approaches. Different AI-based techniques employed to resolve interconnected problems related to heating, ventilation and air conditioning (HVAc) systems and enhance building performances were reviewed, including energy forecasting and management, indoor air quality and occupancy comfort/satisfaction prediction, occupancy detection and recognition, and fault detection and diagnosis. The present study explored existing AI-based techniques focusing on the framework, methodology, and performance. The literature highlighted that selecting the most suitable machine learning and deep learning model for solving a problem could be challenging. The recent explosive growth experienced by the research area has led to hundreds of machine learning algorithms being applied to building performance-related studies. The literature showed that existing research studies considered a wide range of scope/scales (from an HVAc component to urban areas) and time scales (minute to year). This makes it difficult to find an optimal algorithm for a specific task or case. The studies also employed a wide range of evaluation metrics, adding to the challenge. Further developments and more specific guidelines are required for the built environment field to encourage best practices in evaluating and selecting models. The literature also showed that while machine and deep learning had been successfully applied in

关键词： Artificial intelligence Building energy management Deep learning Heating,ventilation and air conditioning (HVAc) Indoor environmental quality(IEQ) Machine learning Occupancy detection Thermal comfort

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Investigation of normal,lateral,and oblique impact of microscale projectiles into unidirectional glass/epoxy composites

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Defence Technology（防务技术） 2022年第11期18卷 1960-1978页

作者： christopher S.Meyer Isabel G.catugas john W.Gillespie Jr. Bazle Z.Gama Haque University of Delaware center for composite Materials(UD-ccM) 101 Academy StreetNewarkDE19716USA

Spacesuits and spacecraft must endure high velocity impacts from micrometeoroids. This work considers the impact of 100 μm diameter projectiles into composite targets at velocities from 0.5 km/s to 2 km/*** work begins by presenting an energy-based theoretical model relating depth of penetration(Do P)and impact force to impact velocity, characteristic time, and threshold velocity and force. Next, this work compares numerical simulations of normal impact on composites to the theoretical model. Numerical simulations are conducted with LS-DYNA and the well-known composite model, MAT-162. The numerical models consider unidirectional S2-glass fiber reinforced Sc-15 epoxy composite laminates. The numerical model shows good correlation with the theoretical model. The numerical model also investigates lateral impact, parallel to the fiber direction, and oblique impact at angles from 30°to 82.5°.This work decomposes oblique impact into normal and lateral components, and compares them with normal and lateral impact results. The results show good correlation of the normal component of oblique results with the theoretical model. This numerical and theoretical study focuses on Do P, velocity, and penetration resistance force as functions of time. The theoretical model and numerical simulations are used to determine new Do P parameters: characteristic time of depth of penetration and threshold impact velocity. These models are a first step in developing the capability to predict Do P for oblique,microscale, high-speed impact on composite materials.

关键词： Microscale Hypervelocity impact composites Erosion Penetration

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Building community consensus for Scientific Metadata with YAMZ

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Data Intelligence 2023年第1期5卷 242-260页

作者： Jane Greenberg Scott Mcclellan christopher Rauch Xintong Zhao Mat Kelly Yuan An john Kunze Rachel Orenstein claire Porter Vanessa Meschke Eric Toberer Metadata Research center College of Computing and InformaticsDrexel University3675 Market St 10th floorPhiladelphiaPA19104USA 2Dept.of PhysicsColorado School of Mines1500 Illinois StGoldenCO 80401USA

This paper reports on a demonstration of YAMZ(Yet Another Metadata Zoo)as a mechanism for building community consensus around metadata *** demonstration is motivated by the complexity of the metadata standards environment and the need for more user-friendly approaches for researchers to achieve vocabulary *** paper reviews a series of metadata standardization challenges,explores crowdsourcing factors that offer possible solutions,and introduces the YAMZ system.A YAMZ demonstration is presented with members of the Toberer materials science laboratory at the colorado School of Mines,where there is a need to confirm and maintain a shared understanding for the vocabulary supporting research documentation,data management,and their larger metadata *** demonstration involves three key steps:1)Sampling terms for the demonstration,2)Engaging graduate student researchers in the demonstration,and 3)Reflecting on the *** results of these steps,including examples of the dialog provenance among lab members and voting,show the ease with YAMZ can facilitate building metadata vocabulary *** conclusion discusses implications and highlights next steps.

关键词： Metadata standards FAIR metadata consensus building community metadata Domain metadata

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A single nucleotide mutation in the dual-oxidase 2(DUOX2) gene causes some of the panda's unique metabolic phenotypes

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National Science Review 2022年第2期9卷 34-42页

作者： Agata M.Rudolf Qi Wu Li Li Jun Wang Yi Huang Jacques Togo christopher Liechti Min Li chaoqun Niu Yonggang Nie Fuwen Wei john R.Speakman State Key Laboratory of Molecular Development Institute of Genetics and Developmental Biology Chinese Academy of Sciences Institute of Zoology Chinese Academy of Sciences Institute of Microbiology Chinese Academy of Sciences Institute of Biological and Environmental Sciences University of Aberdeen centre of Excellence for Animal Ecology and Genetics Chinese Academy of Sciences Shenzhen Key Laboratory of Metabolic Health Center for Energy Metabolism and Reproduction Shenzhen Institute of Advanced Technology Chinese Academy of Sciences

The giant panda(Ailuropoda melanoleuca) is an iconic bear native to china,famous for eating almost exclusively *** unusual dietary behavior for a carnivore is enabled by several key adaptations including low physical activity,reduced organ sizes and hypothyroidism leading to lowered energy *** adaptive phenotypes have been hypothesized to arise from a panda-unique single-nucleotide mutation in the dual-oxidase 2(DUOX2) gene,involved in thyroid hormone *** test this hypothesis,we created genome-edited mice carrying the same point mutation as the panda and investigated its effect on metabolic *** mice were 27% smaller than heterozygous and wild-type ones,had 13 % lower body mass-adjusted food intake,5 5 % decreased physical activity,lower mass of kidneys(11%) and brain(5%),lower serum thyroxine(T4:36%),decreased absolute(12%) and mass-adjusted(5%) daily energy expenditure,and altered gut *** with T4 reversed the effects of the *** work uses a state-of-the-art genome editing approach to demonstrate the link between a single-nucleotide mutation in a key endocrine-related gene and profound adaptive changes in the metabolic phenotype,with great importance in ecology and evolution.

关键词： giant panda DUOX2 mutation metabolic rate thyroid hormones DUOX2 mice and microbiota

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