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Taking care of volunteers in a stroke trial: a new assisted-management strategy

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Stroke & Vascular neurology 2016年第3期1卷 108-114页

作者： Amber C Stuart Jason J Sico Catherine M Viscoli Ashis H Tayal Silvio E Inzucchi Gary A Ford Karen L Furie Robert Cote J David Spence David Tanne walter n kernan on behalf of the IRIS Trial Investigators Department of Internal Medicine Yale University School of MedicineNew HavenConnecticutUSA Department of neurology Yale University School of MedicineNew HavenConnecticutUSA Department of neurology Service Veterans Affairs Connecticut Healthcare SystemWest HavenConnecticutUSA neuroscience Institute Allegheny Health NetworkPittsburghPennsylvaniaUSA Lewis Katz School of Medicine at Temple University PhiladelphiaPennsylvaniaUSA Division of Medical Sciences Oxford UniversityOxfordUK The Warren Alpert Medical School of Brown University ProvidenceRhode IslandUSA Department of neurology Neurosurgery and MedicineMcGill UniversityMontrealQuebecCanada University of Western Ontario LondonOntarioCanada 10Sheba Medical CenterTel Aviv UniversityTel AvivIsrael 不详

Background and purpose:Providing participants with evidence-based care for secondary prevention is an ethical and scientific priority for trials in stroke *** optimal strategy,however,is *** report the performance of a new approach for delivering preventive care to trial ***:Participants were enrolled in the Insulin Resistance Intervention after Stroke trial,which examined the insulin sensitiser,pioglitazone versus placebo for prevention of stroke and myocardial infarction after ischaemic stroke or transient ischaemic *** care was the responsibility of the participants’personal healthcare providers,but investigators monitored care and provided feedback *** studied achievement of 8 prevention goals at baseline and 3 annual visits,with a focus on 3 priority goals:blood pressurensity lipoprotein(LDL)cholesterolnd antithrombotic ***:The proportion of participants achieving the priority goals was highest for antithrombotic use(96–99%in each year)and similar for blood pressure(66–72%in each year)and LDL(68–70%in each year).All 3 priority goals were achieved by 47–52%of participants in any given ***,only 22%of participants achieved all 3 goals in each ***:A strategy of monitoring care and providing feedback was associated with high average yearly achievement of 3 priority secondary prevention goals,but the majority of trial participants did not persist in being at goal over *** registration number:nCT00091949.

关键词： prevention annually goals

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阻塞性睡眠呼吸暂停是卒中和死亡的危险因素

国际内科双语杂志（中英文） 2005年第12期5卷 68-69页

作者： H. Klar Yaggi John Concato walter n. kernan

以前的研究显示阻塞性睡眠呼吸暂停综合征可能是引起卒中非常重要的因素。然而，在对其他危险因素（包括高血压）作出调整后，此综合征是否仍独立地与卒中或死亡相关还没有被证实。

关键词：阻塞性睡眠呼吸暂停综合征危险因素中和高血压卒中

Plant community on a volcano mountaintop reveals unique high-altitude vegetation in southeastern Brazil

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Journal of Mountain Science 2024年第9期21卷 3018-3030页

作者： Igor Musauer KESSOUS Ruy JoséValka ALVES nílber Gonçalves da SILVA Amilcar walter SAPORETTI JUnIOR Biodiversity Laboratory Federal Institute of EducationScience and Technology of Southern Minas Gerais(IFSULDEMINAS)Av.Dirce Pereira Rosa300-Jardim Esperança37713-100Poços de CaldasMGBrazil Department of Botany National MuseumFederal University of Rio de JaneiroQuinta da Boa Vista s.n.São Cristóvão20949-040Rio de JaneiroRJBrazil Gothenburg Global Biodiversity Centre Carl Skottsbergs Gata 22BSE 41319GothenburgSweden

Mountains exhibit a high degree of endemism and diversity,however,quantifying their biodiversity can be *** to islands,species isolation in mountainous regions results in comparable patterns of evolution and extinction,rendering their biodiversity unique and highly susceptible to anthropogenic *** topographic relief in mountains plays a crucial role in creating habitat complexity,which in turn contribute to high plant ***,we investigated plant diversity in the volcano mountaintop vegetation on the Poços de Caldas Plateau,a region situated in the ecotone between the Atlantic Forest and Cerrado,characterized by natural radiation and significant anthropogenic *** employed an automated approach through the filtering of georeferenced and non-georeferenced data to obtain a list of plant species in the ***,we statistically investigated the similarity among different high-altitude vegetations belonging to the campos de altitude from the Atlantic Forest and campos rupestres from the *** plateau exhibits high plant diversity,including 1,659 specific and infraspecific taxa,especially belonging to Asteraceae and *** analyses suggest that geographical distance is a strong predictor of dissimilarity and that the Poços de Caldas Plateau is more floristically related to the campos rupestres,despite being associated with campos de *** region possesses a unique set of biodiversity,indicating that it may be a distinct ***,we hypothesize that Pleistocene events likely influenced the conformation of the current floristic composition in the region through species interchange between the Cerrado and Atlantic *** study also highlights the few taxa assessed for conservation status and anthropogenic threats that this habitat is facing.

关键词： Atlantic Forest Biogeography Cerrado Community ecology Grassland

Sodium-glucose cotransporter-2 inhibitors protect tissues via cellular and mitochondrial pathways:Experimental and clinical evidence

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World Journal of Experimental Medicine 2024年第2期14卷 46-52页

作者： Raúl Lelio Sanz Sebastián García Menéndez Felipe Inserra Leon Ferder walter Manucha Department of Pathology Facultad de Ciencias MédicasUniversidad Nacional de CuyoMendoza 5500Argentina Department of Pharmacology Instituto de Medicina y Biología Experimental de CuyoCentro Científico TecnológicoMendoza 5500Argentina Department of nephrology Universidad de MaimónidesCiudad Autónoma de Buenos Aires C1405Argentina Department of Cardiology Universidad de MaimónidesCiudad Autónoma de Buenos Aires C1405Argentina

Mitochondrial dysfunction is a key driver of cardiovascular disease(CVD)in metabolic syndrome and *** dysfunction promotes the production of reactive oxygen species(ROS),which cause oxidative stress and *** II,the main mediator of the renin-angiotensin-aldosterone system,also contributes to CVD by promoting ROS *** activity of sirtuins(SIRTs),a family of proteins that regulate cellular metabolism,also worsens oxidative *** of energy production by mitochondria is a common feature of all metabolic *** SIRT levels and 5’adenosine monophosphate-activated protein kinase signaling stimulate hypoxia-inducible factor 1 beta,which promotes ***,in turn,increases autophagy and mitophagy,processes that clear cells of debris and protect against *** cotransporter-2 inhibitors(SGLT2i),a class of drugs used to treat type 2 diabetes,have a beneficial effect on these *** clinical trials have shown that SGLT2i improves cardiac function and reduces the rate of cardiovascular and renal ***2i also increase mitochondrial efficiency,reduce oxidative stress and inflammation,and strengthen *** findings suggest that SGLT2i hold great potential for the treatment of ***,they are proposed as anti-aging drugs;however,rigorous research is needed to validate these preliminary findings.

关键词： Sodium-glucose cotransporter-2 inhibitors Cardiovascular diseases Sirtuins Oxidative stress Inflammation Mitochondrial dysfunction

卒中和短暂性脑缺血发作患者的卒中预防指南美国心脏协会/美国卒中协会为医疗卫生专业人员制定的指南

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国际脑血管病杂志 2014年第11期22卷 805-841页

作者： walter n.kernan Bruce Ovbiagele Henry R.Black Dawn M.Bravata Marc I.Chimowitz Michael D.Ezekowitz Margaret C.Fang Marc Fisher Karen L.Furie 洪道俊黄招君李小兵周美鸿吴成斯王博卢艺吴裕臣代表美国心脏协会卒中委员会、心血管和卒中护理委员会、临床心脏病学委员会以及周围血管病委员会南昌大学第一附属医院神经内科 330006

本更新版指南旨在为缺血性卒中或短暂性脑缺血发作存活者的卒中预防提供全面和及时的循证推荐.本指南适用于所有为上述患者提供二级预防的临床医生.这些循证推荐包括危险因素的控制、血管闭塞的干预、心源性栓塞的抗栓治疗以及非心源性... 详细信息

本更新版指南旨在为缺血性卒中或短暂性脑缺血发作存活者的卒中预防提供全面和及时的循证推荐.本指南适用于所有为上述患者提供二级预防的临床医生.这些循证推荐包括危险因素的控制、血管闭塞的干预、心源性栓塞的抗栓治疗以及非心源性栓塞性卒中的抗血小板治疗.还对各种特殊情况下复发性卒中的预防提供了推荐意见,包括主动脉弓粥样硬化、动脉夹层分离、卵圆孔未闭、高同型半胱氨酸血症、高凝状态、抗心磷脂抗体综合征、镰状细胞病、脑静脉窦血栓形成以及妊娠.此外,还有专门的章节对颅内出血后抗栓和抗凝治疗的应用以及指南的实施进行了讨论.

关键词：美国心脏协会声明心房颤动颈动脉狭窄高血压缺血短暂性脑缺血发作预防卒中

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PPA与出血性中风相关性

药物不良反应杂志 2001年第1期3卷 10-17页

作者： walter n. kernan Catherine M. Viscoli Lawrence M. Brass Joseph P. Broderick Thomas Brott Edward Feldmann Lewis B. Morgenstern Janet Lee Wilterdink Ralph I. Horwitz 陈关君 M. D. Ph. D.M. D.M. D.M.D.M.D.M. D.M.D.M.D.

背景:PPA(phenylpropanolamine,苯丙醇胺)常见于食欲抑制药和咳嗽感冒药中,以往病例报告表明含PPA的药物与出血性中风有关,通常发生在首次使用后。为阐明二者相关性,我们设计了一项病例对照研究。方法:18～49岁的男、女性研究病例来自美... 详细信息

背景:PPA(phenylpropanolamine,苯丙醇胺)常见于食欲抑制药和咳嗽感冒药中,以往病例报告表明含PPA的药物与出血性中风有关,通常发生在首次使用后。为阐明二者相关性,我们设计了一项病例对照研究。方法:18～49岁的男、女性研究病例来自美国43所医院,其合格标准包括在参与项目前30天内发生蛛网膜下腔出血或颅内出血,而既往并无确诊的脑损伤史。采用随机电话拨号,为每个病例安排2例对照进行面访。结果:调查人群包括702名病例和1376名对照。女性服用含PPA食欲抑制药和出血性中风危险之间相关联的调整比值比为16.58(95％可信区间1.51～182.21,P=0.02);女性首次服用含PPA药物与出血性中风危险之间关联的调整比值比3.13(95％可信区间0.86～11.46,P=0.08),所有首次服用的PPA皆为咳嗽感冒药。男、女性调查人群服用含PPA药物与出血性中风危险二者关联的调整比值比为1.49(95％可信区间0.84～2.64.P=0.17);男、女性调查人群服用含PPA的咳嗽感冒药与出血性中风危险二者关联的调整比值比为1.23(95％可信区间0.68～2.24,P=0.49),服用舍PPA的食欲抑制药与出血性中风危险关联的调整比值比为15.92(95％可信区间1.38～184.13,p=0.03)。对男性的分析结果表明:服用含PPA的咳嗽感冒药未引起出血性中风危险增加,男性无一例使用?

关键词： PPA 出血性中风药理治疗

The Paris 2024 Olympic and Paralympic Games

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Journal of Sport and Health Science 2024年第6期13卷 717-718页

作者： walter Herzog Human Performance Laboratory Faculty of KinesiologyUniversity of CalgaryCalgaryAB T2N 1N4Canada

The first modern Olympic Games took place in Athens in *** in those early days of the Olympics only amateur and gentleman athletes were allowed to participate,today Olympic athletes are highly trained professionals often dedicating decades of preparation for the chance to compete in the Olympic *** sharp contrast to these highly trained athletes,the world’s population becomes less physically active on average,resulting in an obesity epidemic with associated metabolic syndrome and increased mortality through non-communicable diseases(e.g.,Collins et al.^(1)).

关键词： Olympic allowed sharp

Pumping-induced Well Hydraulics and Groundwater Budget in a Leaky Aquifer System with Vertical Heterogeneity in Aquitard Hydraulic Properties

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Acta Geologica Sinica(English Edition) 2024年第2期98卷 477-490页

作者： ZHUAnG Chao LÜChenyang YAn Long LI Yabing ZHOU Zhifang WAnG Jinguo DOU Zhi walter A.ILLMAn School of Earth Sciences and Engineering Hohai UniversityNanjing 211100China School of Geography Earth and Environmental SciencesUniversity of BirminghamBirmingham B152TTU.K. Department of Modern Mechanics University of Science and Technology of ChinaHefei 230027China Department of Earth and Environmental Sciences University of WaterlooOntario N2L 3G1Canada

In groundwater hydrology,aquitard heterogeneity is often less considered compared to aquifers,despite its significant impact on groundwater hydraulics and groundwater resources evaluation.A semi-analytical solution is derived for pumping-induced well hydraulics and groundwater budget with consideration of vertical heterogeneity in aquitard hydraulic conductivity(K)and specific storage(S_(s)).The proposed new solution is innovative in its partitioning of the aquitard into multiple homogeneous sub-layers to enable consideration of various forms of vertically heterogeneous K or S_(s).Two scenarios of analytical investigations are explored:one is the presence of aquitard interlayers with distinct K or S_(s) values,a common field-scale occurrence;another is an exponentially depth-decaying aquitard S_(s),a regional-scale phenomenon supported by statistical *** investigations reveal that a low-K interlayer can significantly increase aquifer drawdown and enhance aquifer/aquitard depletion;a high-S_(s) interlayer can noticeably reduce aquifer drawdown and increase aquitard *** of low-K or high-S_(s) interlayers also significantly impact well hydraulics and groundwater *** the context of an exponentially depth-decaying aquitard S_(s),a larger decay exponent can enhance aquifer *** using current models with a vertically homogeneous aquitard,half the sum of the geometric and harmonic means of exponentially depth-decaying aquitard S_(s) should be used to calculate aquitard depletion and unconfined aquifer leakage.

关键词： hydrogeology aquitard vertical heterogeneity semi-analytical solution well hydraulics groundwater budget

卒中或短暂性脑缺血发作患者的卒中预防指南美国心脏协会／美国卒中协会为医疗卫生专业人员制定的指南

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国际脑血管病杂志 2011年第1期19卷 1-49页

作者： Karen L. Furie Scott E. Kasner Robert J. Adams Gregory W. Albers Ruth L. Bush Susan C. Fagan Jonathan L. Halperin S. Claiborne Johnston Irene Katzan walter n. kernan Pamela H. Mitchell Bruce Ovbiagele Yuko Y. Palesch Ralph L. Sacco Lee H. Schwamm Sylvia Wassertheil-Smoller Tanya n. Turan Deidre Wentworth 李海峰(译) 刘涛(译) 杨潘(译) 王鹏(译) 美国心脏协会卒中委员会心血管护理委员会临床心脏病学委员会医疗质量和转归研究跨学科委员会青岛大学医学院附属医院神经内科 266003

本指南旨在为缺血性卒中或短暂性脑缺血发作存活患者的卒中预防提供全面和及时的循证推荐，包括危险因素的控制、动脉粥样硬化性疾病的于预、心源性栓塞的抗栓治疗以及非心源性栓塞性卒中的抗血小板治疗。另外，还对其他许多特殊情况下... 详细信息

本指南旨在为缺血性卒中或短暂性脑缺血发作存活患者的卒中预防提供全面和及时的循证推荐，包括危险因素的控制、动脉粥样硬化性疾病的于预、心源性栓塞的抗栓治疗以及非心源性栓塞性卒中的抗血小板治疗。另外，还对其他许多特殊情况下的复发性卒中预防提供了推荐意见，包括动脉夹层分离、卯圆孔未闭、高同型半胱氨酸血症、高凝状态、镰状细胞病、脑静脉窦血栓形成、女性卒中（尤其是与妊娠和绝经后雌激素替代治疗相关性卒中）、脑出血后抗凝药的使用等，以及实施本指南及其在高危人群中应用的特定方法。

关键词：美国心脏协会科学声明脑缺血短暂性脑缺血发作卒中卒中预防