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Real-world analysis of two ischaemic stroke and TIA systolic blood pressure goals on 12-month mortality and recurrent vascular events

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Stroke & Vascular Neurology 2024年第5期9卷 519-529页

作者： Jason J sico Xin Hu Laura J Myers Deborah Levine Dawn M Bravata greg W Arling Internal Medicine and Neurology Yale University School of MedicineNew HavenConnecticutUSA Department of Neurology Veterans Affairs Connecticut Healthcare SystemWest HavenConnecticutUSA Yale School of Public Health New HavenConnecticutUSA VA Health Services Research and Development(HSR&D)Center for Healthcare Informatics and Communication and the HSR&D Stroke Quality Enhancement Research Initiative(QUERI) IndianapolisIndianaUSA Richard L.Roudebush VA Medical Center IndianapolisIndianaUSA Departments of Medicine and Neurology University of Michigan School of MedicineAnn ArborMichiganUSA Health Services Research and Development(HSR&D)Center for Healthcare Informatics and Communication and the HSR&D Stroke Quality Enhancement Research Initiative(QUERI) Department of Veterans Affairs(VA) Health Services Research and Development(HSR&D)Precision Monitoring to Transform Care(PRISM)Quality Enhancement Research Initiative(QUERI)IndianapolisIndianaUSA Department of Nursing Purdue UniversityWest LafayetteIndianaUSA

Introduction Whether obtaining the more intensive goal systolic blood pressure(SBP)of140mm Hg).Separate multivariable Cox proportional hazard regressions were used to examine the relationship between average SBP group... 详细信息

Introduction Whether obtaining the more intensive goal systolic blood pressure(SBP)ofg,rather than a less intensive SBP goal ofg poststroke/transient ischaemic attack(TIA)is associated with incremental mortality and recurrent vascular event benefit is largely unexplored using real-world *** SBP excessively may result in poorer *** This is a retrospective cohort study of 26368 Veterans presenting to a Veterans Administration Medical Center(VAMC)with a stroke/TIA between October 2015 and July *** were excluded from the study if they had missing or extreme BP values,receiving dialysis or palliative care,left against medical advice had a cancer diagnosis,were cared for in a VAMC enrolled in a stroke/TIA quality improvement initiative,died or had a cerebrovascular or cardiovascular event within 90 days after their index stroke/*** analytical sample included 12337 *** SBP during 90 days after discharge was assessed in categories(≤105mm Hg,106–115mm Hg,116–130mm Hg,131–140mm Hg and>140mm Hg).Separate multivariable Cox proportional hazard regressions were used to examine the relationship between average SBP groups and time to:(1)mortality and(2)any recurrent vascular event,from 90 days to up to 365 days after discharge from the index emergency department visit or inpatient *** Compared with those with SBP>140mm Hg,patients with SBP between 116 and 130mm Hg had a significantly lower risk of recurrent stroke/TIA(HR 0.77,95%CI 0.60 to 0.99)but not cardiovascular *** with SBP lower than 105mm Hg,compared with those with>140mm Hg demonstrated a statistically significant higher risk of death(HR 2.07,95%CI 1.43 to 3.00),but no statistical differences were found in other SBP *** Data support a more intensive SBP goal to prevent recurrent cerebrovascular events among stroke/TIA patients by 90 days poststroke/TIA compared with less intensive *** low SBPs were associated wit

关键词： dialysis diagnosis TIA

Association between admission haematocrit and mortality among men with acute ischaemic stroke

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Stroke & Vascular Neurology 2018年第3期3卷 160-168页

作者： Jason J sico Laura J Myers Brenda J Fenton John Concato Linda S Williams Dawn M Bravata Neurology Service VA Connecticut Healthcare SystemWest HavenConnecticutUSA Department of Neurology Center for NeuroEpidemiological and Clinical Neurological ResearchYale University School of MedicineNew HavenConnecticutUSA Department of Internal Medicine Yale University School of MedicineNew HavenConnecticutUSA Clinical Epidemiology Research Center(CERC) VA Connecticut Healthcare SystemWest HavenConnecticutUSA Pain Research InformaticsMultimorbidities and Education(PRIME)Center of InnovationVA Connecticut Healthcare SystemWest HavenConnecticutUSA Communication and the HSR&D Stroke Quality Enhancement Research Initiative(QUERI) Richard L Roudebush VA Medical CenterIndianapolisIndianaUSA VA Health Services Research and Development(HSR&D) Center for Healthcare InformaticsRichard L Roudebush VA Medical CenterIndianapolisIndianaUSA Division of Chronic Disease Epidemiology Yale School of Public HealthWest HavenConnecticutUSA Medical Service VA Connecticut Healthcare SystemWest HavenConnecticutUSA Regenstrief Institute IndianapolisIndianaUSA Department of Neurology Indiana University School of MedicineIndianapolisIndianaUSA Department of Internal Medicine Indiana University School of MedicineIndianapolisIndianaUSA

Objective Anaemia is associated with higher mortality among patients with non-stroke cardiovascular conditions;less is known regarding the relationship between anaemia and mortality among patients with acute ischaemic *** Medical records were abstracted for n=3965 veterans from 131 Veterans Health Administration facilities who were admitted with ischaemic stroke in fiscal year *** values within 24 hours of admission were classified as≤27%,28%-32%,33%-37%,38%-42%,43%-47% or≥48%.Multivariate logistic regression was used to examine the relationship between anaemia and in-hospital,30-day,6-month and 1-year mortality,adjusting for age,medical comorbidities,modified Acute Physiology and Chronic Health Evaluation-III and stroke *** factors were calculated to standardise comparisons between haematocrit tier and other *** Among n=3750 patients included in the analysis,the haematocrit values were≤27%in 2.1%(n=78),28%-32% in 6.2%(n=234),33%-37%in 17.9%(n=670),38%-42% in 36.4%(n=1366),43%-47% in 28.2%(n=1059)and≥48% in 9.1%(n=343).Patients with haematocrit≤27%,compared with patients in the 38%-42% range,were more likely to have died across all follow-up intervals,with statistically significant adjusted ORs(aORs)ranging from 2.5 to *** with polycythaemia(ie,haematocrit≥48%)were at increased risk of in-hospital mortality(aOR=2.9;95%CI 1.4 to 6.0),compared with patients with mid-range admission *** differences between patients receiving and not receiving blood transfusion limited our ability to perform a propensity *** factors in the 1-year mortality model were 0.46(severe anaemia),0.06(cancer)and 0.018(heart disease).Conclusions Anaemia is independently associated with an increased risk of death throughout the first year post stroke;high haematocrit is associated with early poststroke *** anaemia is associated with 1-year mortality to a greater degree than cancer or heart dise

关键词： mortality admitted transfusion

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 pressureg,lowdensity lipoprotein(LDL)cholesterolg 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

AN IMPLEMENTATION OF THE COLLOCATION METHOD FOR INITIAL VALUE PROBLEMS

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International Journal of Modeling, Simulation, and Scientific Computing 2013年第2期4卷 142-154页

作者： RAFAEL g.CAMPOS FRANCISCO DOM´INgUEZ MOTA Facultad de Ciencias Fısico-Matematicas Universidad Michoacana 58060 MoreliaMich.Mexico

An implementation of the standard collocation method based on polynomial interpolation is presented in a matrix framework in this *** underlying differentiation matrix can be partitioned to yield a superconvergent implicit multistep-like method to solve the initial value problem *** first-and second-order versions of this method are L-stable.

关键词： IVP ODE collocation differentiation matrix interpolation superconvergence stability

NUMERICAL SOLUTION OF DIFFERENTIAL EQUATIONS IN IRREgULAR PLANE REgIONS USINg QUALITY STRUCTURED CONVEX gRIDS

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International Journal of Modeling, Simulation, and Scientific Computing 2013年第2期4卷 115-129页

作者： F.DOM´INgUEZ-MOTA P.FERNANDEZ-VALDEZ S.MENDOZA-ARMENTA g.TINOCO-gUERRERO J.g.TINOCO-RUIZ Facultad de Ciencias F´ısico Matem´aticas Universidad Michoacana de San Nicol´as de Hidalgo Edificio“B” Ciudad Universitaria C.P.58040MoreliaMexico

The variational grid generation method is a powerful tool for generating structured convex grids on irregular simply connected domains whose boundary is a polygonal Jordan *** examples that show the accuracy of a finite difference approximation to the solution of a Poisson equation using this kind of structured grids have been recently *** this paper,we compare the accuracy of the numerical solution calculated using those structured grids and finite differences against the solution obtained with Delaunay-like triangulations on irregular regions.

关键词： Numerical grid generation direct generation method finite difference method finite element method Delaunay triangulation.

Coercivity Values Enhancement by Incorporation of Magnetic Powders in Inorganic Matrix Hosts

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New Journal of glass and Ceramics 2013年第1期3卷 1-5页

作者： J. R. Martínez J. Román de Alba I. g. Blanco-Esqueda A. guerrero-Serrano g. Ortega-Zarzosa Centro de Investigación en Materiales Avanzados S.C. Chihuahua México Departamento de Físico-Matemáticas Universidad Autónoma de San Luis Potosí San Luis Potosí México Facultad de Ciencias Universidad Autónoma de San Luis Potosí San Luis Potosí México

Enhancement in coercivity values of precursor powders of cobalt ferrite embedded in silica xerogel as well as polyaniline was observed using vibrating sample magnetometry. We compared the magnetic properties of pure precursor powders of ferrite cobalt prepared by coprecipitation method and those embedded in xerogel and polyaniline matrix, prepared by sol-gel and by a conventional in situ chemical oxidation polymerization, respectively. The main magnetic effect is the altered coercivity value growing two magnitude orders for the precursor powders of cobalt ferrite embedded in silica xerogel and in polyaniline. The value goes from 52 Oe to 2200 Oe and 1054 Oe for pure coprecipitated precursor powder and embedded in silica xerogel, and embedded in polyaniline, respectively, without any heat-treatment.

关键词： Magnetic Material Nanocomposite Xerogels Polyaniline

generalized Invertibility of Operators through Spectral Sets

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Advances in Linear Algebra & Matrix Theory 2023年第2期13卷 21-35页

作者： E. Salgado-Matias S. V. Djordjević g. Kantún-Montiel Facultad de Ciencias Fí sico Matem&aacuteticas Benem&eacuterita Universidad Aut&oacutenoma de Puebla Puebla Mexico

If an operator is not invertible, we are interested if there is a subspace such that the reduction of the operator to that subspace is invertible. In this paper we give a spectral approach to generalized inverses considering the subspace determined by the range of the spectral projection associated with an operator and a spectral set containing the point 0. We compare the cases, 0 is a simple pole of the resolvent function, 0 is a pole of order n of the resolvent function, 0 is an isolated point of the spectrum, and 0 is contained in a circularly isolated spectral set.

关键词： generalized Inverse Matrix Form Resolvent Function Spectral Projection

A manus dominated pterosaur track assemblage from gansu,China: implications for behavior

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Science Bulletin 2015年第2期60卷 264-272,I0003页

作者：李大庆邢立达 Martin g. Lockley Laura Pi uela 张建平代辉 Jeong Yul Kim W. Scott Persons IV 孔得来 geological Museum of gansu School of the Earth Sciences and Resources China University of Geosciences Dinosaur Trackers Research group University of Colorado Denver Denver CO 80217 USA Museo del Jura'sico de Asturias MUJA (Jurassic Museum of Asturias) 33328 Colunga Spain Department of Earth Science Education Korea National University of Education Cheongwon Chungbuk 363-791South Korea Department of Biological Sciences University of Alberta 11455 Saskatchewan Drive Edmonton AB T6G 2E9 Canada The Administrative Bureau of Liujiaxia Dinosaurs National geopark

The Yangouxia dinosaur tracksites are well known for a diverse assemblage of tetrapod tracks preserved as natural impressions （concave epireliefs） on large bedding planes, representing a locally widespread surface marking the transition from a sand- to a mud-dominated sequence in the Hekou group. Previous ichnological studies at these large sites have focused on the morphology and ichnotaxonomy of the tracks, including a single trackway representing the first pterosaur tracks reported from China. Here, we report a distinctly different assemblage associated with minor sandstones in the mud-dominated sequence 20 m above the main tracksite level. This assemblage consists of at least 20 pterosaur manus track casts attributed to a single ichnotaxon （Pteraichnus）. No pes tracks have been identified. These tracks mostly occur in random orientations, although one possible trackway segment is inferred, to represent walking ***-only pterosaur track assemblages are common and likely reflect differential registration depths of manus and pes and/or sub optimal preservation conditions. The tracks are associated with distinctive invertebrate traces including Cochlichnus, Spongeliomorpha and Paleophycus and suggest the pterosaurs were likely feeding on the invertebrate tracemakers.

关键词： Early Cretaceous gansu Province Yangouxia Pterosaurs Pteraichnus Lanzhou Minhe Basin