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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 & Vasc.lar 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 c.la 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 cardiovasc.lar 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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Hybrid connectionist model determines cO_2–oil swelling factor

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Petroleum Science 2018年第3期15卷 591-604页

作者： Mohammad Ali Ahmadi Sohrab Zendehboudi lesley A. James Faculty of Engineering and Applied Science Memorial University of Newfoundland St. John's NL A1C 5S7 Canada

In-depth understanding of interactions between crude oil and cO2 provides insight into the cO2-based enhanced oil recovery（EOR） process design and simulation. When cO2 contacts crude oil, the dissolution process takes place. This phenomenon results in the oil swelling, which depends on the temperature, pressure, and composition of the oil. The residual oil saturation in a cO2-based EOR process is inversely proportional to the oil swelling factor. Hence, it is important to estimate this influential parameter with high precision. The current study suggests the predictive model based on the least-squares support vector machine（LS-SVM） to calc.late the cO2–oil swelling factor. A genetic algorithm is used to optimize hyperparameters（у and б^2） of the LS-SVM model. This model showed a high coefficient of determination（R^2= 0.9953） and a low value for the mean-squared error（MSE = 0.0003） based on the available experimental data while estimating the cO2–oil swelling factor. It was found that LS-SVM is a straightforward and accurate method to determine the cO2–oil swelling factor with negligible uncertainty. This method can be incorporated in commercial reservoir simulators to include the effect of the cO2–oil swelling factor when adequate experimental data are not available.

关键词： c02 injection cO2 swelling Genetic algorithm Predictive model Least-squares support vector machine

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Recent applications of isotope analysis to forensic anthropology

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Forensic Sciences Research 2019年第1期4卷 29-44页

作者： Eric J.Bartelink lesley A.chesson Department of Anthropology California State UniversityChicoCAUSA contractor at Defense POW/MIA Accounting Agency(DPAA)laboratory Pacific Architects and Engineers(PAE)HIUSA

Isotope analysis has become an increasingly valuable tool in forensic anthropology case-work over the past decade. Modern-day isotopic investigations on human remains have integrated the use of multi-isotope profiles (e.g. c, N, O, H, S, Sr, and Pb) as well as iso-topic.landscapes ("isoscapes") from multiple body tissues (e.g. teeth, bone, hair, and nails) to predict possible region-of-origin of unidentified human remains. Together, data from various isotope analyses provide additional lines of evidence for human identification, including a decedent's possible region-of-birth, long-term adult residence, recent travel history, and dietary choices. Here, we present the basic principles of isotope analysis and provide a brief overview of instrumentation, analytical standards, sample selection, and sample quality measures. Finally, we present case studies that reflect the diverse applications of isotope analysis to the medicolegal system before describing some future research directions. As shown herein, isotope analysis is a flexible and powerful geolocation tool that can provide new investigative leads for unidentified human remains cases.

关键词： Forensic sciences forensic anthropology stable isotope analysis isoscapes provenancing

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chemical Kinetics and Mechanism

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丛书名： The Molec.lar World

2002年

作者： The Open University Giles clark M Mortimer P G Taylor lesley E Smart lesley E Smart Giles clark

ISBN: (数字)9781847557803

ISBN: (纸本)0854046704;9780854046706;9781847557803

chemical Kinetics and Mechanism considers the role of rate of reaction. It begins by introducing chemical kinetics and the analysis of reaction mechanism, from basic well-established concepts to leading edge research. Organic reaction mechanisms are then discussed, encompassing curly arrows, nucleophilic substitution and E1 and E2 elimination reactions. The book concludes with a case Study on Zeolites, which examines their structure and internal dimensions in relation to their behaviour as molec.lar sieves and catalysts. The accompanying cD-ROM contains the "Kinetics Toolkit", a graph-plotting application designed for manipulation and analysis of kinetic data, which is built into many of the examples, questions and exercises in the text. There are also interactive activities illustrating reaction mechanisms. The Molec.lar World series provides an integrated introduction to all branches of chemistry for both students wishing to specialise and those wishing to gain a broad understanding of chemistry and its relevance to the everyday world and to other areas of science. The books, with their case Studies and accompanying multi-media interactive cD-ROMs, will also provide valuable resource material for teachers and lecturers. (The cD-ROMs are designed for use on a Pc running Windows 95, 98, ME or 2000.)

关键词： chemical kinetics.

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Regulatory role of sorting nexin 5 in protein stability and vesic.lar targeting of vesic.lar acetylcholine transporter to synaptic vesicle-like vesicles in Pc12 cells

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The Journal of Biomedical Research 2021年第5期35卷 339-350页

作者： Meihen Sun Xu Han Fei chang Hongfei Xu lesley colgan Yongjian Liu Jiangsu Key laboratory of Xenotransplantation and Department of Medical GeneticsNanjing Medical UniversityNanjingJiangsu 211166China Neuroscience Program University of Utah School of MedicineSalt Lake CityUT 84112USA Department of Neurology University of California San Francisco School of MedicineSan FranciscoCA 94143USA Max Planck Florida Institute for Neuroscience JupiterFL 33458USA

Accurate targeting of vesic.lar acetylcholine transporter(VAchT)to synaptic vesicles(SVs)is indispensable for efficient cholinergic *** studies have suggested that the dileucine motif within the c-terminus of the transporter is sufficient for its targeting to ***,the cytosolic machinery underlying specific regulation of VAchT trafficking and targeting to SVs is still *** we used the c-terminus of VAchT as a bait in a yeast two-hybrid screen to identify sorting nexin 5(SNX5)as its novel interacting ***5 was detected in the SVs enriched LP2 subcellular fraction of rat brain homogenate and showed strong colocalization with VAchT in both brain sections and Pc12 *** assays suggested that the c-terminal domain of VAchT can interact with both BAR and PX domain of *** of SNX5 enhanced the degradation of VAchT and the process was mediated through the lysosomal *** importantly,we found that,in Pc12 cells,the depletion of SNX5 expression significantly decreased the synaptic vesicle-like vesicles(SVLVs)localization of ***,the results suggest that SNX5 is a novel regulator for both stability and SV targeting of VAchT.

关键词： retrograde trafficking vesic.lar targeting synaptic vesicle-like vesicles synaptic vesicles Pc12

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Patterns of antidepressant therapy and clinical outcomes among ischaemic stroke survivors

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Stroke & Vasc.lar Neurology 2021年第3期6卷 384-394,I0018-I0032页

作者： Mark R Etherton Shreyansh Shah Xu Haolin Ying Xian lesley Maisch Deidre Hannah Brianna Lindholm Barbara Lytle laine Thomas Eric E Smith Gregg c Fonarow Lee H Schwamm Deepak L Bhatt Adrian F Hernandez Emily c O'Brien Neurology Massachusetts General HospitalBostonMassachusettsUSA Neurology Duke University School of MedicineDurhamNorth CarolinaUSA Duke clinical Research Institute Duke UniversityDurhamNorth CarolinaUSA American Heart Association Inc DallasTexasUSA clinical Neurosciences University of Calgary Cumming School of MedicineCalgaryAlbertaCanada cardiology Ronald Reagan UCLA Medical CenterLos AngelesCaliforniaUSA cardiovasc.lar Medicine Brigham and Women's HospitalBostonMassachusettsUSA cardiology Duke UniversityDurhamNorth CarolinaUSA Population Health Duke Clinical Research InstituteDurhamNorth CarolinaUSA

Background and purpose Depression is common after stroke and is often treated with antidepressant medications(AD).ADs have also been hypothesised to improve stroke recovery,although recent randomised trials were *** investigated the patterns of in-hospital AD initiation after ischaemic stroke and association with clinical and readmission *** All Medicare fee-for-service beneficiaries aged 65 or older hospitalised for ischaemic stroke in participating Get With The Guidelines-Stroke hospitals between April and December 2014 were eligible for this *** measures included days alive and not in a healthcare institution(home time),all-cause mortality and readmission within 1-year *** score(PS)-adjusted logistic regression models were used to evaluate the associations between AD use and each outcome *** also compared outcomes in patients prescribed selective serotonin reuptake inhibitors(SSRIs)AD versus those prescribed non-SSRI *** Of 21805 AD naive patients included in this analysis,1835(8.4%)were started on an AD at *** started on an AD had higher rates of depression and prior ischaemic stroke,presented with higher admission National Institutes of Health Stroke Scale score and were less likely to be discharged ***,patients started on an SSRI had lower rates of discharge to *** for stroke severity,patients started on an AD had worse all-cause mortality,all-cause readmission,major adverse cardiac events,readmission for depression and decreased ***,AD use was also associated with an increased risk for the sepsis,a falsification endpoint,suggesting the presence of residual *** Patients with ischaemic stroke initiated on AD therapy are at increased risk of poor clinical outcomes and readmission even after PS adjustment,suggesting that poststroke depression requiring medication is a poor prognostic *** research is needed to explore

关键词： prescribed admission founding

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The Future of china＇s E-commerce

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china's Foreign Trade 2012年第10期 15-16页

作者： lesley cui

Analysts believe that in several years, chinese online shoppers will experience an ,evolution from being ＂pricesensitive＂ to ＂experience sensitive＂. B2c online retailers that specialize in specific product catego... 详细信息

关键词：电子商务中国 c2c网站网上购物产品类别零售商敏感

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New interchange English for international communication 2

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2005年

作者： Jack c. Richards Tay lesley

本教材主要使用美国英语，但涉及许多国家、地区和文化，它强调在实际交流活动中培养语言，主要活动有主题讨论、语法结构、语言功能、词汇扩展和语言训练。

ISBN: (纸本)7560022154

关键词：英语

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Deep Inspiration Breath Hold Reduces Dose to the Left Ventricle and Proximal Left Anterior Descending Artery during Radiotherapy for Left-Sided Breast cancers

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Journal of cancer Therapy 2012年第5期3卷 673-679页

作者： lesley A. Jarvis Peter G. Maxim Kathleen c. Horst Department of Radiation Oncology Dartmouth-Hitchcock Medical Center Lebanon USA Department of Radiation Oncology Stanford University Medical Center Stanford USA.

The purpose of this study was to analyze motion of the left anterior descending coronary artery (laD) and left ventricle during normal breathing and deep inspiration breath hold (DIBH). This is a dosimetric study utilizing free-breathing and static DIBH scans from eleven patients treated with radiotherapy for breast cancer. The anterior-posterior displacement along the length of the laD was measured in each respiratory phase. Standard treatment plans targeting the whole breast without treatment of the internal mammary lymph nodes were generated and dose to the laD and LV calc.lated. Non-uniform movement of the laD during respiratory maneuvers with the proximal third exhibiting the greatest displacement was observed. In DIBH compared to end-expiration (EP), the mean posterior displacement of the proximal 1/3 of the laD was 8.99 mm, the middle 1/3 of the artery was 6.37 mm, and the distal 1/3 was 3.27 mm. In end-inspiration (IP) compared to end-expiration the mean posterior displacements of the proximal 1/3 of the laD was 2.08 mm, the middle 1/3 of the artery was 0.91 mm, and the distal 1/3 was 0.97 mm. Mean doses to the laD using tangential treatment fields and a prescribed dose of 50.4 Gy were 11.32 Gy in EP, 8.98 Gy in IP, and 3.50 Gy in DIBH. Mean doses to the LV were 2.38 Gy in EP, 2.31 Gy in IP, and 1.24 Gy in DIBH. In conclusion, inspiration and especially DIBH, cause a displacement of the origin and proximal 2/3 of the laD away from the chest wall, resulting in sparing of the most critical segment of the artery during tangential radiotherapy.

关键词： Breast Radiotherapy Deep-Inspiration Breath Hold (DIBH) Respiratory Gating Left Anterior Descending Artery (laD) Left Ventricle (LV)

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Bone Mineral “Quality”: Differing characteristics of calcified Microsphere Populations at the Osteoporotic and Osteoarthritic Femoral Artic.lation Front

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Journal of Biomedical Science and Engineering 2014年第9期7卷 739-755页

作者： Kathryn M. Linton lesley D. Hordon Roger c. Shore Jean E. Aaron Institute of Membrane and Systems Biology Faculty of Biological Sciences University of Leeds Leeds UK Oral Biology Department Leeds Dental Institute University of Leeds Leeds UK

The mineral front consists of large populations of organically enshrouded calcified microspheres (filamentous clusters) about 1 micron in diameter and associated smaller numbers of variably dense nanospheres, 30 - 40 nm in diameter. The discrete objects persist and modulate in maturity, and may constitute a variable “qualitative” factor in the skeletal inorganic phase, exemplified by the biomechanically contrasting pathologies of osteoporosis (OP;fracture, low stress condition) and osteoarthritis (OA;non fracture, high stress condition). The aim was to compare the artic.lation front material for morphological and trace element diversity using fresh female femoral head discards (from Dewsbury District Hospital NHS Mid-Yorkshire Trust). These were prepared for histology of the cartilage/bone interface region by immersion in hydrazine hydrate to expose the anorganic mineral topography for microscopy and FEGSEM microanalysis. 1) Mineral microsphere morphology (compared to animals as arbitrary controls) suggested that calcified microspheres from OP (n = 19) tended to be small (0.5 - 0.7 microns), smooth and compacted;those from OA (n = 19) were large (0.5 - 4.0 microns), uneven and irregularly dispersed. Respective calcified nanospheres from OP were similarly smaller (30 - 50 nm) than those from OA (>100 nm). In subchondral bone a proportion of the filamentous microspheres had fused into a fine-textured phase in OP and a coarse-textured phase in OA. 2) Trace element analysis (compared to positive porcine Si and Mg and other peaks) suggested a diminution with mineral maturity, and also with age effecting OP and OA similarly, with minor differences detected between them. It was concluded that calcified objects constituting the inorganic phase vary regionally with age and in fracture and nonfracture, being diminished in size (not number) in weak OP and enlarged (compared to porcine control) in stronger OA, with Si or Mg “doping” diminishing with time, perhaps influencing th

关键词： Bone Mineral Quality calcified Microspheres Si Mg Trace Elements Osteoporosis Osteoarthritis

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