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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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Hyperdense artery sign, symptomatic infarct swelling and effect of alteplase in acute ischaemic stroke

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Stroke & Vascular Neurology 2021年第2期6卷 238-243页

作者： Simiao Wu grant mair Geoff Cohen Zoe Morris Anders von Heijne Nick Bradey Lesley Cala Andre Peeters Andrew J Farrall Alessandro Adami Gillian Potter Ming Liu Richard I Lindley Peter A G Sandercock Joanna M Wardlaw the IST-3 Collaborative Group Department of Neurology West China HospitalSichuan UniversityChengduSichuanChina Centre for Clinical Brain Sciences The University of EdinburghEdinburghUK Department of Clinical Sciences Danderyd HospitalStockholmSweden Neuroradiology James Cook University HospitalSouth Tees Hospital NHS TrustMiddlesbroughUK Division of Pathology and Laboratory Medicine School of MedicineThe University of Western AustraliaPerthWestern AustraliaAustralia Department of Neurology Cliniques universitaires Saint-LucBruxellesBelgium Stroke Center IRCCS Sacro Cuore Don CalabriaVeronaItaly Department of Neuroradiology Manchester Centre for Clinical NeurosciencesSalford Royal NHS Foundation TrustSalfordUK Westmead Applied Research Centre Westmead Clinical SchoolThe University of SydneySydneyNew South WalesAustralia The George Institute for Global Health NewtownNew South WalesAustralia UK Dementia Research Institute Centre at the University of Edinburgh EdinburghUnited Kingdom 不详

Background Alteplase improves functional outcomes of patients with acute ischaemic stroke,but its effects on symptomatic infarct swelling,an adverse complication of stroke and the influence of CT hyperdense artery sign(HAS)are *** substudy of the Third International Stroke Trial aimed to investigate the association between HAS and symptomatic infarct swelling and effect of intravenous alteplase on this *** We included stroke patients whose prerandomisation scan was non-contrast ***,masked to clinical information,assessed baseline(prerandomisation)and follow-up(24-48 hours postrandomisation)CT scans for HAS,defined as an intracranial artery appearing denser than contralateral *** infarct swelling was defined as clinically significant neurological deterioration≤7 days after stroke with radiological evidence of midline shift,effacement of basal cisterns or uncal *** Among 2961 patients,HAS presence at baseline was associated with higher risk of symptomatic infarct swelling(OR 2.21;95% CI 1.42 to 3.44).Alteplase increased the risk of swelling(OR 1.69;95% CI 1.11 to 2.57),with no difference between patients with and those without baseline HAS(p=0.49).In patients with baseline HAS,alteplase reduced the proportion with HAS at follow-up(OR 0.67;95% CI 0.50 to 0.91),where HAS disappearance was associated with reduced risk of swelling(OR 0.25,95% CI 0.14 to 0.47).Conclusion Although alteplase was associated with increased risk of symptomatic infarct swelling in patients with or without baseline HAS,it was also associated with accelerated clearance of HAS,which in return reduced swelling,providing further mechanistic insights to underpin the benefits of alteplase.

关键词： infarct swelling effect

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Change in internal energy of thermal diffusion stagnation point Maxwell nanofluid flow along with solar radiation and thermal conductivity

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Chinese Journal of Chemical Engineering 2019年第10期27卷 2352-2358页

作者： mair Khan TSalahuddin ATanveer MYMalik Arif Hussain Department of Mathematics Quaid-i-Azam UniversityIslamabad 44000Pakistan Department of Mathematics Mirpur University of Science and TechnologyMirpur 10250Pakistan 3 Department of MathematicsCollege of SciencesKing Khalid UniversityAbha 61413Saudi Arabia

This paper concerns the characteristics of heat and mass transfer in upper convected Maxwell fluid flow over a linear stretching sheet with solar radiation,viscous desperation and temperature based *** boundary layer approximation,the governing equations are achieved(namely Maxwell,upper convected material derivative,thermal and concentration diffusions).By using the self-similarity transformations the governing PDEs are converted into nonlinear ODEs and solved by RK-4 method in combination with Newton Raphson(shooting technique).The effects of developed parameters on velocity,temperature,concentration,fraction factor,heat and mass diffusions are exemplified through graphs and tabular form and are deliberated in *** values of fraction factor,heat and mass transfer rates with several parameters are computed and *** is noticed that the temperature is more impactable for higher values of radiative heat transport,thermal conductivity and viscous *** comparison data for some limiting case are acquired and are originated to be in good agreement with previously published articles.

关键词： Maxwell nanofluid Viscous dissipation Solar radiation Variable viscosity Thermal conductivity Chemical reaction Stagnation point Shooting method

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Mitochondrial DNA analysis of human remains from the Yuansha site in Xinjiang, China

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Science China(Life Sciences) 2008年第3期51卷 205-213页

作者： Idelisi ABUDURESULE Victor H. mair Xinjiang Cultural Relics and Archaeology Institute Chinese Language and Literature Department of East Asian Languages and Civilizations University of Pennsylvania USA

The Yuansha site is located in the center of the Taklimakan Desert of Xinjiang, in the southern Silk Road region. MtDNA was extracted from fifteen human remains excavated from the Yuansha site, dating back 2,000―2,500 years. Analysis of the phylogenetic tree and the multidimensional scaling (MDS) reveals that the Yuansha population has relatively close relationships with the modern populations of South Central Asia and Indus Valley, as well as with the ancient population of Chawuhu.

关键词： Yuansha site ancient DNA mtDNA Xinjiang Central Asia

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急性卒中影像学研究路径图Ⅱ

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国际脑血管病杂志 2014年第2期22卷 81-92页

作者： Max Wintermark Gregory W. Albers Joseph P. Broderick Andrew M. Demchuk Jochen B. Fiebach Jens Fiehler James C. Grotta Gary Houser Tudor G. Jovin Kennedy R. Lees Michael H. Lev David S. Liebeskind Marie Luby Keith W. Muir Mark W. Parsons Rudiger von Kummer Joanna M. Wardlaw Ona Wu Albert J. Yoo Andrei V. Alexandrov Jeffry R. Alger Richard I. Aviv Roland Bammer Jean-Claude Baron Fernando Calamante Bruce C.V. Campbell Trevor C. Carpenter Sφren Christensen William A. Copen Colin P. Derdeyn E. Clarke Haley Jr Pooja Khatri Kohsuke Kudo Maarten G. Lansberg Lawrence L. Latour Ting-Yim Lee Richard Leigh Weili Lin Patrick Lyden grant mair Bijoy IC Menon Patrik Michel Robert Mikulik Raul G. Nogueira Left φstergaard Salvador Pedraza Christian H. Riedel Howard A. Rowley Pina C. Sanelli Makoto Sasaki Jeffrey L. Saver Pamela W. Schaefer Peter D. Schellinger Georgios Tsivgoulis Lawrence R. Wechsler Philip M. White Greg Zaharchuk Osama O. Zaidat Stephen M. Davis Geoffrey A. Donnan Anthony J. Furlan Werner Hacke Dong-Wha Kang Chelsea Kidw ell Vincent N. Thijs Gotz Thomalla Steven J. Warach 严晓铭刘牧张晶晶柯开富不详南通大学附属医院神经内科 226001

卒中影像学研究组（StrokeImagingResearchGroup，STIR）、美国神经放射学学会和美国神经放射学学会基金会在过去1年多的时间时举办了一系列的工作会议，最后一次会议于2013年3月9日至10日在华盛顿召开的卒中治疗专业学术圆桌会议（Stro... 详细信息

卒中影像学研究组（StrokeImagingResearchGroup，STIR）、美国神经放射学学会和美国神经放射学学会基金会在过去1年多的时间时举办了一系列的工作会议，最后一次会议于2013年3月9日至10日在华盛顿召开的卒中治疗专业学术圆桌会议（Stroke Treatment Academy Industry Roundtable，STAIR）期间举行。

关键词：急性卒中影像学神经放射学路径会议基金会学会美国

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Optical Detection of Distal Lung Enzyme Activity in Human Inflammatory Lung Disease

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Biomedical Engineering Frontiers 2021年第1期2卷 44-54页

作者： Alicia Megia-Fernandez Adam Marshall Ahsan R.Akram Bethany Mills Sunay V.Chankeshwara Emma Scholefield Amy Miele Bruce C.McGorum Chesney Michaels Nathan Knighton Tom Vercauteren Francois Lacombe Veronique Dentan Annya M.Bruce Joanne mair Robert Hitchcock Nik Hirani Chris Haslett Mark Bradley Kevin Dhaliwal EaStCHEM The University of Edinburgh School of ChemistryJoseph Black BuildingWest Mains RoadEdinburghUK EH93FJ Translational Healthcare Technologies Group Centre for Inflammation ResearchQueen’s Medical Research InstituteUniversity of Edinburgh47 Little France CrescentEdinburgh BioQuarterEdinburghUK EH164TJ The Roslin Institute and Royal(Dick)School of Veterinary Studies University of EdinburghEaster BushMidlothianUK EH259RG Department of Biomedical Engineering University of Utah36 S Wasatch DrSalt Lake CityUT 84112USA School of Biomedical Engineering&Imaging Sciences King’s College LondonLondonUK SE17EH Mauna Kea Technologies 9Rue d’EnghienParisFrance 75010

Objective and Impact *** is a need to develop platforms delineating inflammatory biology of the distal human *** describe a platform technology approach to detect in situ enzyme activity and observe drug inhibition in the distal human lung using a combination of matrix metalloproteinase(MMP)optical reporters,fibered confocal fluorescence microscopy(FCFM),and a bespoke delivery *** development of new therapeutic agents is hindered by the lack of in vivo in situ experimental methodologies that can rapidly evaluate the biological activity or drug-target engagement in *** optimised a novel highly quenched optical molecular reporter of enzyme activity(FIB One)and developed a translational pathway for in-human *** demonstrate the specificity for matrix metalloproteases(MMPs)2,9,and 13 and probe dequenching within physiological levels of MMPs and feasibility of imaging within whole lung models in preclinical ***,in a first-in-human exploratory experimental medicine study of patients with fibroproliferative lung disease,we demonstrate,through FCFM,the MMP activity in the alveolar space measured through FIB One fluorescence increase(with pharmacological inhibition).*** translational in situ approach enables a new methodology to demonstrate active drug target effects of the distal lung and consequently may inform therapeutic drug development pathways.

关键词： Lung lung specificity

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