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Intra-arterial thrombolytics during endovascular thrombectomy for acute ischaemic stroke in the Mr CLEAN registry

Stroke & Vascular Neurology 2023年第1期8卷 17-25页

作者： Sabine L Collette reinoud P H Bokkers Aryan Mazuri Geert J LycklamaàNijeholt robert J van Oostenbrugge Natalie E LeCouffe Faysal Benali Charles B L M Majoie jan Cees de Groot gert jan r luijckx Maarten Uyttenboogaart 无 Department of radiology Medical Imaging CentreUniversity Medical Centre GroningenUniversity of GroningenGroningenthe Netherlands Department of radiology Haaglanden Medical CentreThe Haguethe Netherlands Department of Neurology Cardiovascular Research Institute Maastricht(CARIM)Maastricht University Medical CentreMaastrichtthe Netherlands Department of Neurology Amsterdam UMCUniversity of AmsterdamAmsterdam NeuroscienceAmsterdamthe Netherlands Department of radiology Maastricht University Medical CentreMaastrichtthe Netherlands Department of radiology and Nuclear Medicine Amsterdam UMCUniversity of AmsterdamAmsterdam NeuroscienceAmsterdamthe Netherlands Department of Neurology University Medical Centre GroningenUniversity of GroningenGroningenthe Netherlands On behalf of the Mr CLEAN registry investigators

Introduction The efficacy and safety of local intra-arterial(IA)thrombolytics during endovascular thrombectomy(EVT)for large-vessel occlusions is *** analysed how often IA thrombolytics were administered in the Multicenter randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands(Mr CLEAN)registry,whether it was associated with improved functional outcome and assessed technical and safety outcomes compared with EVT without IA *** In this observational study,we included patients undergoing EVT for an acute ischaemic stroke in the anterior circulation from the Mr CLEAN registry(March 2014-November 2017).The primary endpoint was favourable functional outcome,defined as an modified rankin Scale score≤2 at 90 *** endpoints were reperfusion status,early neurological recovery and symptomatic intracranial haemorrhage(sICH).Subgroup analyses for IA thrombolytics as primary versus adjuvant revascularisation attempt were *** Of the 2263 included patients,95(4.2%)received IA thrombolytics during *** IA thrombolytics administered were urokinase(median dose,250000 IU(IQr,193750-250000))or alteplase(median dose,20 mg(IQr,12-20)).No association was found between IA thrombolytics and favourable functional outcome(adjusted Or(aOr),1.16;95%CI 0.71 to 1.90).Successful reperfusion was less often observed in those patients treated with IA thrombolytics(aOr,0.57;95%CI 0.36 to 0.90).The odds of sICH(aOr,0.82;95%CI 0.32 to 2.10)and early neurological recovery were comparable between patients treated with and without IA *** primary and adjuvant revascularisation attempts,IA thrombolytics were more often administered for proximal than for distal *** outcomes were comparable for patients receiving IA thrombolytics as a primary versus adjuvant revascularisation *** Local IA thrombolytics were rarely used in the Mr CLEAN *** the relatively small st

关键词： arterial throm acute

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Management of extracranial carotid artery stenosis during endovascular treatment for acute ischaemic stroke:results from the Mr CLEAN registry

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Stroke & Vascular Neurology 2023年第3期8卷 229-237,I0074-I0085页

作者： Sabine L Collette Michael P rodgers Marianne A A van Walderveen Kars C J Compagne Paul J Nederkoorn Jeannette Hofmeijer Jasper M Martens gert J de Borst gert jan r luijckx Charles B L M Majoie Aad van der Lugt reinoud P H Bokkers Maarten Uyttenboogaart University Medical Centre Groningen University of GroningenGroningenThe Netherlands Leiden University Medical Centre LeidenThe Netherlands Erasmus MC University Medical CentreRotterdamThe Netherlands Amsterdam University Medical Centres University of AmsterdamAmsterdamThe Netherlands rijnstate Hospital ArnhemThe Netherlands University Medical Centre Utrecht University of UtrechtUtrechtThe Netherlands

Background The optimal management of ipsilateral extracranial internal carotid artery(ICA)stenosis during endovascular treatment(EVT)is *** compared the outcomes of two different strategies:EVT with vs without carotid artery stenting(CAS).Methods In this observational study,we included patients who had an acute ischaemic stroke undergoing EVT and a concomitant ipsilateral extracranial ICA stenosis of≥50%or occlusion of presumed atherosclerotic origin,from the Dutch Multicenter randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands(Mr CLEAN)registry(2014-2017).The primary endpoint was a good functional outcome at 90 days,defined as a modified rankin Scale score≤*** endpoints were successful intracranial reperfusion,new clot in a different vascular territory,symptomatic intracranial haemorrhage,recurrent ischaemic stroke and any serious adverse *** Of the 433 included patients,169(39%)underwent EVT with *** 123/168(73%)patients,CAS was performed before intracranial *** 42/224(19%)patients who underwent EVT without CAS,a deferred carotid endarterectomy or CAS was *** with and without CAS were associated with similar proportions of good functional outcome(47%vs 42%,respectively;adjusted Or(aOr),0.90;95%CI,0.50 to 1.62).There were no major differences between the groups in any of the secondary endpoints,except for the increased odds of a new clot in a different vascular territory in the EVT with CAS group(aOr,2.96;95%CI,1.07 to 8.21).Conclusions Functional outcomes were comparable after EVT with and without *** during EVT might be a feasible option to treat the extracranial ICA stenosis but randomised studies are warranted to prove non-inferiority or superiority.

关键词： stenosis carotid treatment

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Elevated fluid and glycosaminoglycan content in the Achilles tendon contribute to higher intratendinous pressures:Implications for Achilles tendinopathy

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Journal of Sport and Health Science 2024年第6期13卷 863-871页

作者： Lauren Pringels gert-jan Van Valckenborgh Patrick Segers Amelie Chevalier Hedwig Stepman Evi Wezenbeek Arne Burssens Luc Vanden Bossche Department of Physical and rehabilitation Medicine Ghent University HospitalGhent 9000Belgium Department of rehabilitation Sciences and Physiotherapy Ghent UniversityGhent 9000Belgium Department of Electronics and Information Systems Ghent UniversityGhent 9000Belgium Department of Electromechanics University of AntwerpAntwerp 2020Belgium Department of Laboratory Medicine Ghent University HospitalGhent 9000Belgium Department of Orthopedic Surgery Ghent University HospitalGhent 9000Belgium

Background:Tendinopathy alters the compositional properties of the Achilles tendon by increasing fluid and glycosaminoglycan *** has been speculated that these changes may affect intratendinous pressure,but the extent of this relationship remains ***,we aimed to investigate the impact of elevated fluid and glycosaminoglycan content on Achilles tendon intratendinous pressure and to determine whether hyaluronidase(HYAL) therapy can intervene in this potential ***:Twenty paired fresh-frozen cadaveric Achilles tendons were mounted in a tensile-testing machine and loaded up to 5% *** resting(at 0% strain) and dynamic pressure(at 5% strain) were assessed using the microcapillary infusion ***,intratendinous pressure was measured under native conditions before and after infusion of 2 mL physiological ***,80 mg of glycosaminoglycans were administered bilaterally to the paired *** right tendons were additionally treated with 1500 units of ***,both groups were retested,and the glycosaminoglycan content was ***:It was found that both elevated fluid and glycosaminoglycan content resulted in higher intratendinous resting and dynamic pressures(p reatment induced a 2.3-fold reduction in glycosaminoglycan content(p=0.002) and restored intratendinous ***:The results of this study demonstrated that elevated fluid and glycosaminoglycan content in Achilles tendinopathy contribute to increased intratendinous re sting and dynamic pressures,which can be explained by the associated increased volume and reduced permeability of the tendon matrix,*** degrades glycosaminoglycans sufficiently to lower intratendinous pressures and may,therefore,serve as a promising treatment.

关键词： Achilles tendon Achilles tendinopathy Intratendinous pressure Glycosaminoglycans Tendon fluid

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Optimal surgical approach for the treatment of Quervains disease: A surgical-anatomical study

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World Journal of Orthopedics 2018年第2期9卷 7-13页

作者： Alexander r Poublon gert-jan Kleinrensink Anton LA Kerver J Henk Coert Erik T Walbeehm Department of Neuroscience and Anatomy Erasmus MC Department of Plastic and reconstructive surgery Catharina Ziekenhuis Department of Plastic Surgery UMC Utrecht Department of Plastic Surgery Radboud UMC

AIM To determine which of the common used incision techniques has the lowest chance of iatrogenic damage to the nerves which at risk are the superficial branch of the radial nerve(SBrN) and the Lateral Antebrachial Cutaneous Nerve(LABCN).METHODS Twenty embalmed arms were dissected and the course of the SBrN and the LABCN in each individual arm was marked and the distance between the two branches of the SBrN at the location of the First Extensor Compartment(FEC) was measured. This data was used as input in a visualization tool called Computer Assisted Anatomy Mapping(CASAM) to map the course of the nerves in each individual arm. rESULTS This image visualizes that in 90% of the arms, one branch of the SBrN crosses the FEC and one branch runs volar to the compartment. The distance between the two branches was 7.8 mm at the beginning of the FEC and 10.2 mm at the end. Finally the angle of incision at which the chance of damage to the nerves is lowest, is 19.4 degrees volar to the *** CASAM shows the complexity of the course of the SBrN over the FEC. None of the four widely used incision techniques has a significantly lower chance of iatrogenic nerve damage. Surgical skills are paramount to prevent iatrogenic nerve damage.

关键词： De Quervain’s tenosynovitis First dorsal compartment release Wrist surgery

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PUBLIC INVESTMENT IN AGrI-FOOD SYSTEM INNOVATION FOr SUSTAINABLE DEVELOPMENT

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Frontiers of Agricultural Science and Engineering 2023年第1期10卷 124-134页

作者： gert-jan STADS Alejandro NIN-PrATT Keith WIEBE Timothy BSULSEr rui BENFICA International Food Policy research Institute Washington DC 20005USA

research is essential for improvement of agricultural productivity,resource use and resilience,and for food systems transformation more *** article analyzes the drivers of past agricultural productivity growth in low-and middle-income countries(LMICs)and argues that productivity is not growing fast enough to meet the needs of a global population of 10 billion by 2050.A sustainable transformation of agri-food systems in LMICs will need greater and faster technical *** investment in agri-food r&D is therefore needed to accelerate productivity growth and address the social,economic,nutritional and environmental challenges facing *** and bettertargeted investment in sustainable technologies and climate change mitigation and adaptation will be particularly important to reducing the climate change impacts on agriculture and food security in the coming ***,LMICs with small research systems and limited innovation capacity lack the scale and resources to effectively tackle the challenges *** coordination and a clear articulation of roles and responsibilities among national,subregional,regional and global r&D actors(both from the public and private sectors)are essential to ensuring that scarce financial,human,and infrastructure resources are optimized,duplications minimized,and synergies and complementarities enhanced.

关键词： agri-food system innovation r&D investment productivity climate change

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Impact of black cherry on pedunculate oak vitality in mixed forests:Balancing benefits and concerns

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Forest Ecosystems 2023年第6期10卷 690-699页

作者： Ellen Desie Bart Muys jan den Ouden Bart Nyssen rita Sousa-Silva Leon van den Berg Arnold van den Burg gert-jan van Duinen Koenraad Van Meerbeek Maaike Weijters Karen Vancampenhout Division Forest Nature and LandscapeKU Leuven Campus GeelKleinhoefstraat 4B-2240 GeelBelgium Division Forest Nature and LandscapeKU LeuvenCelestijnenlaan 200EBox 2411B-3001 LeuvenBelgium KU Leuven Plant Institute B-3001 LeuvenBelgium Forest Ecology and Management Group Wageningen UniversityP.O.Box 47Wageningenthe Netherlands Bosgroep Zuid-Nederland Huisvenseweg 145591 VD Heezethe Netherlands Young Academy for Sustainability research University of Freiburg79104 Freiburg im BreisgauGermany Aquatic Ecology&Environmental Biology Radboud University NijmegenHeyendaalseweg 1356525 AJ Nijmegenthe Netherlands Biosphere/Zoological Museum Netherlands Onderlangs 176731 BK Otterlothe Netherlands Stichting Bargerveen Toernooiveld 16525 ED Nijmegenthe Netherlands B-WArE research Centre/radboud University Nijmegen Toernooiveld 16525 ED Nijmegenthe Netherlands

The vitality of European forests continues to decline due to new pests and diseases,climate-change related disturbances and high loads of atmospheric nitrogen *** soil health is a major factor underpinning the low vitality of West-European *** tree species with soil ameliorative traits is proposed as an avenue to counteract soil acidification and improve overall forest *** we evaluate the impact of black cherry(Prunus serotina Ehrh.),a known rich litter species,on the vitality of neighboring pedunculate oak(Quercus robur L.)in ten mixed forests on sand in Germany,Belgium and the *** found that black cherry admixture increases foliar N and P to a surplus whereas it causes deficiencies in foliar Mg,thereby resulting in an overall negative effect on oak foliar nutrient ***,defoliation of oak leaves by herbivory decreases with the proximity of black *** structural equation modelling(SEM),we tested the hypothesized‘improved soil health’*** analyses showed that black cherry admixture leads to lower accumulation in the humus layer,resulting in higher soil base saturation which has a positive effect on foliar Ca yet a negative effect on total ***,the SEM illustrated that herbivory of oak leaves decreases when black cherry is admixed,both via dilution and improved soil *** effects of black cherry on oak vitality via“improved soil health”in our SEM are however small in comparison to direct ***,our study showed that the combined positive and negative impacts of black cherry on oak vitality are limited,which tempers the potential benefits of using the rich litter species to counteract oak decline via improved soil health–yet,the concern of black cherry as an invasive alien species negatively affecting the vitality of mature pedunculate oak trees may also be exaggerated.

关键词： rich litter species Black cherry Nutrient cycling Insect herbivory Dilution effect Humus type Pedunculate oak Plant-soil interaction

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Species-specific,pan-European diameter increment models based on data of 2.3 million trees

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Forest Ecosystems 2018年第3期5卷 277-295页

作者： Mart-jan Schelhaas Geerten M Hengeveld Nanny Heidema Esther Thurig Brigitte rohner Giorgio Vacchiano Jordi Vayreda John redmond Jaroslaw Socha Jonas Fridman Stein Tomter Heino Polley Susana Barreiro gert-jan Nabuurs Wageningen University and research Wageningen Environmental Research(WENR)Droevendaalsesteeg 36708PB WageningenThe Netherlands Wageningen University and research BiometrisDroevendaalsesteeg 16708PB WageningenThe Netherlands Wageningen University and research Forest and Nature Conservation Policy GroupDroevendaalsesteeg 36708PB WageningenThe Netherlands Swiss Federal Institute for Forest Snow and Landscape Research WSLResource AnalysisZuercherstrasse 111CH-8903 BirmensdorfSwitzerland European Commission Joint Research CentreDirectorate DSustainable Resources-Bio-Economy UnitIspraItaly CrEAF 08193 Cerdanyola del VallesSpain Univ Autonoma Barcelona 08193 Cerdanyola del VallesSpain Forest Service Department of AgricultureFood and the MarineJohnstown Castle EstateCo.WexfordIreland Department of Biometry and Forest Productivity Institute of Forest Resources ManagementFaculty of ForestryUniversity of Agriculture in KrakowAI.29Listopada 4631-425CracowPoland Swedish University of Agricultural Sciences (SLU) 90183 UmeaSweden Norwegian Institute of Bioeconomy research P.O.Box 115N-143 1AsNorway Thunen Institute Institute of Forest EcosystemsAlfred-Mo1ler-Strabe 1Haus41/4216225 EberswaldeGermany Forest research Centre (CEF) Instituto Superior de AgronomiaUniversidade de LisboaTapada da Ajuda1349-017Lisbon.Portugal Wageningen University and research Forest Ecology and Forest Management GroupDroevendaalsesteeg 36708PBWageningenThe Netherlands

Background: Over the last decades, many forest simulators have been developed for the forests of individual European countries. The underlying growth models are usually based on national datasets of varying size, obtained from National Forest Inventories or from long-term research plots. Many of these models include country-and location-specific predictors, such as site quality indices that may aggregate climate, soil properties and topography effects. Consequently, it is not sensible to compare such models among countries, and it is often impossible to apply models outside the region or country they were developed for. However, there is a clear need for more generically applicable but still locally accurate and climate sensitive simulators at the European scale, which requires the development of models that are applicable across the European continent. The purpose of this study is to develop tree diameter increment models that are applicable at the European scale, but still locally accurate. We compiled and used a dataset of diameter increment observations of over 2.3 million trees from 10 National Forest Inventories in Europe and a set of 99 potential explanatory variables covering forest structure, weather, climate, soil and nutrient ***: Diameter increment models are presented for 20 species/species groups. Selection of explanatory variables was done using a combination of forward and backward selection methods. The explained variance ranged from10% to 53% depending on the species. Variables related to forest structure(basal area of the stand and relative size of the tree) contributed most to the explained variance, but environmental variables were important to account for spatial patterns. The type of environmental variables included differed greatly among ***: The presented diameter increment models are the first of their kind that are applicable at the European scale. This is an important step towards the development of a new ge

关键词： European forests Diameter increment model Climate change Growth modelling National forest inventory

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长江入海泥沙的交换和输移过程——兼论泥质区的“泥库”效应

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地理学报 2011年第3期66卷 291-304页

作者：刘红何青 gert jan Weltje 陈吉余华东师范大学河口海岸学国家重点实验室上海200062 中交上海航道勘察设计研究院有限公司上海200120 Delft University of Technology Faculty of Civil Engineering and GeosciencesP.O.Box5048NL-2600GA DelftThe Netherlands

采用粒度谱的计算方法分析高浊度河口混合环境下悬浮泥沙和表层沉积物的交换过程,研究悬浮泥沙在河口—陆架系统的输移和归宿问题。分析表明:(1)大约有47%的悬浮泥沙沉积在长江口拦门沙海域及水下三角洲前缘,超过50%的悬浮泥沙摆脱河口... 详细信息

采用粒度谱的计算方法分析高浊度河口混合环境下悬浮泥沙和表层沉积物的交换过程,研究悬浮泥沙在河口—陆架系统的输移和归宿问题。分析表明:(1)大约有47%的悬浮泥沙沉积在长江口拦门沙海域及水下三角洲前缘,超过50%的悬浮泥沙摆脱河口的"束缚"进入杭州湾以及向南沿浙闽海岸输运,122.5°～123°E是长江悬浮泥沙向东扩散的重要界限。本文提供的粒度谱计算方法可适用于多种潮汐环境的泥沙输运和沉积的定量计算。(2)长江口悬浮泥沙与表层沉积物高交换区(交换率>0.6)主要分布在南槽口外的泥质区和杭州湾附近海域,其中长江口外泥质区的交换率高达0.9以上,说明该区域悬浮泥沙大量参与供沙和造床过程。在10～100年尺度上,长江口南槽口外的泥质区和杭州湾存在着一个显著的沉积中心,其泥沙交换速率可高达2～3cm/a以上。(3)由于受沿岸流和台湾暖流的影响,从长江口输出的大部分悬浮泥沙首先沉积在长江口南槽口外的泥质区,随后在潮流的作用下向长江口、杭州湾和沿海岸向南输运,泥质区充当了长江口系统泥沙输运和入海泥沙向南输送的"泥库"。长江口泥质区既是长江入海泥沙向口外输送的泥沙"汇",也是涨潮输入长江河口和杭州湾、浙闽沿岸泥质带的泥沙"源"。(4)由于长江口外余流向南槽口外汇聚,南槽口外含沙量较高,而且长江口水下三角洲前缘潮滩仍处于缓慢淤涨状态,上述水动力和地貌的综合分析证实了长江口外泥质区的"泥库"效应。在长江入海泥沙减少的背景下,"泥库"对河口地貌发育的贡献明显;随着流域减沙的不可逆转,口门附近的"泥库"将发挥愈来愈重要的向河口系统供沙的功能。

关键词：长江口泥库泥质区沉积中心粒度谱计算

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Value of macrobiopsies and transanal endoscopic microsurgery in the histological work-up of rectal neoplasms:A retrospective study

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World Journal of Gastrointestinal Oncology 2017年第6期9卷 251-256页

作者： Guus MJ Bokkerink gert-jan van der Wilt Dirk de Jong Han HJM van Krieken robert P Bleichrodt Johannes HW de Wilt Andreas JA Bremers Department of Surgery Radboud University Nijmegen Medical Center Department of Health Evidence Radboud University Nijmegen Medical Center Department of Gastroenterology Radboud Uni-versity Nijmegen Medical Center Department of Pathology Radboud University Nijmegen Medical Center Department of of Surgery Saint Francis Hospital

To evaluate a step up approach: Taking macrobiopsies and performing excision biopsies in patients with suspected rectal cancer in which biopsies taken though the flexible endoscope showed benign histology. METHODSPatients with a rectal neoplasm who underwent flexible endoscopy and biopsies were included. In case of benign biopsies rigid rectoscopy and macrobiopsies were employed. If this failed to prove malignancy, transanal endoscopic microsurgery (TEM) was used in a final effort to establish a certain preoperative diagnosis. The preoperative results were compared with the findings after surgical excision and follow up to calculate the reliability of this algorithm. rESULTSOne hundred and thirty-two patients were included. One hundred and ten patients with a carcinoma and 22 with an adenoma. Seventy-five of 110 carcinomas were proven malignant after flexible endoscopy. With the addition of rigid endoscopy and taking of macrobiopsies, this number increased to 89. Performing TEM excision biopsies further enlarged the number of proven malignancies to 100. CONCLUSIONThe step-up approach includes taking macrobiopsies through the rigid rectoscope and performing excision biopsies using transanal endoscopic microsurgery in addition to flexible endoscopy. This approach, reduced the number of missed preoperative malignant diagnoses from 32% to 9%.

关键词： rectal cancer Histology Biopsy Macrobiopsy Transanal endoscopic microsurgery Sampling error

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Synthesis of an IS and Steviol Glycoside Analysis by a Validated Internal Standard Method

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American Journal of Analytical Chemistry 2018年第11期9卷 547-559页

作者： jan M. C. Geuns Tom Struyf Stijn Ceunen gert Steurs Wim De Borggraeve Laboratory of Functional Biology KU Leuven Leuven Belgium Division of Molecular Design and Synthesis KU Leuven Leuven Belgium

The internal standard (IS) method is the best method for the analysis of samples, as it is independent of errors in injection volume, changes in sample volumes, and changes in sensitivity of the detector, etc. Use of an internal standard allows for the correction of losses due to sample clean-up of complex samples. An ideal IS is a compound that has properties very similar to, and that behaves as the compounds to be analysed. Ideally, only in the last step of analysis (HPLC), the IS should be well separated from the compounds of the mixture to be analysed. After testing several existing compounds with negative results, we decided to synthesise the 19-O-β-D-galactopyranosyl-13-O-β-D-glucopyranosyl-steviol as IS. This is the 19-galactosyl ester of steviolmonoside (13-O-β-D-glucopyranosyl-steviol). The IS was made according to published methods. Steviolmonoside (SM) was made from purified commercial rubusoside (rub) by refluxing it in 10% KOH for 2 h. SM was precipitated and crystallized from MeOH. The hydroxyls of the glucose unit of SM were protected by acetylation. The acetylated SM was crystallized from acetone and dissolved in 1,2-dichloroethane. Then Ag2CO3 on Celite and tetra-acetylated galactopyranosyl bromide were added and the mixture was refluxed for 2 h. After cooling, BaO in MeOH was added to remove the acetyl groups. The 1,2-dichloroethane fraction was then extracted three times with equal volumes of water and the water fraction containing the IS was further purified on a C18 flash chromatography column. Traces of unreacted SM were removed by preparative HPLC on an Alltima C18 column (250 mm × 22 mm, particle size 10 μm) with AcCN:water (35:65, 20 ml/min). Detection was at 210 nm (KNAUEr, “Smartline” UV detector 2500). The collected IS fraction from the HPLC was completely dried. Mixtures of steviol glycosides (SVglys) containing IS could be purified over SPE cartridges without change of the SVgly over IS ratio. The calibration curves for rebaudioside A (

关键词： Steviol Glycosides Internal Standard Method Validation Quantification Purification

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