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Evidence for particle acceleration approaching PeV energies in the W51 complex

Science Bulletin 2024年第18期69卷 2833-2841页

作者： Cao, Zhen Aharonian, F. Axikegu Bai, Y.X. Bao, Y.W. Bastieri, D. Bi, X.j. Bi, Y.j. Bian, W. Bukevich, A.V. Cao, Q. Cao, W.Y. Cao, Zhe Chang, j. Chang, j.F. Chen, A.m. Chen, E.S. Chen, H.X. Chen, liang Chen, lin Chen, long Chen, m.j. Chen, m.l. Chen, Q.H. Chen, S. Chen, S.H. Chen, S.Z. Chen, T.l. Chen, Y. Cheng, N. Cheng, Y.D. Cui, m.Y. Cui, S.W. Cui, X.H. Cui, Y.D. Dai, B.Z. Dai, H.l. Dai, Z.G. Danzengluobu Dong, X.Q. Duan, K.K. Fan, j.H. Fan, Y.Z. Fang, j. Fang, j.H. Fang, K. Feng, C.F. Feng, H. Feng, l. Feng, S.H. Feng, X.T. Feng, Y. Feng, Y.l. Gabici, S. Gao, B. Gao, C.D. Gao, Q. Gao, W. Gao, W.K. Ge, m.m. Geng, l.S. Giacinti, G. Gong, G.H. Gou, Q.B. Gu, m.H. Guo, F.l. Guo, X.l. Guo, Y.Q. Guo, Y.Y. Han, Y.A. Hasan, m. He, H.H. He, H.N. He, j.Y. He, Y. Hor, Y.K. Hou, B.W. Hou, C. Hou, X. Hu, H.B. Hu, Q. Hu, S.C. Huang, D.H. Huang, T.Q. Huang, W.j. Huang, X.T. Huang, X.Y. Huang, Y. ji, X.l. jia, H.Y. jia, K. jiang, K. jiang, X.W. jiang, Z.j. jin, m. Kang, m.m. Karpikov, I. Kuleshov, D. Kurinov, K. li, B.B. li, C.m. li, Cheng li, Cong li, D. li, F. li, H.B. li, H.C. li, jian li, jie li, K. li, S.D. li, W.l. li, X.R. li, Xin li, Y.Z. li, Zhe li, Zhuo liang, E.W. liang, Y.F. lin, S.j. liu, B. liu, C. liu, D. liu, D.B. liu, H. liu, H.D. liu, j. liu, j.l. liu, m.Y. liu, R.Y. liu, S.m. liu, W. liu, Y. liu, Y.N. luo, Q. luo, Y. lv, H.K. ma, B.Q. ma, l.l. ma, X.H. mao, j.R. min, Z. mitthumsiri, W. mu, H.j. Nan, Y.C. Neronov, A. Ou, l.j. Pattarakijwanich, P. Pei, Z.Y. Qi, j.C. Qi, m.Y. Qiao, B.Q. Qin, j.j. Raza, A. Ruffolo, D. Sáiz, A. Saeed, m. Semikoz, D. Shao, l. Shchegolev, O. Sheng, X.D. Shu, F.W. Song, H.C. Stenkin, Yu.V. Stepanov, V. Su, Y. Sun, D.X. Sun, Q.N. Sun, X.N. Sun, Z.B. Takata, j. Tam, P.H.T. Key laboratory of Particle Astrophysics & Experimental Physics Division & Computing Center Institute of High Energy Physics Chinese Academy of Sciences Beijing 100049 China University of Chinese Academy of Sciences Beijing 100049 China TIANFU Cosmic Ray Research Center Chengdu China Dublin Institute for Advanced Studies 31 Fitzwilliam Place 2 Dublin Ireland max-Planck-Institut for Nuclear Physics P.O. Box 103980 Heidelberg 69029 Germany School of Physical Science and Technology & School of Information Science and Technology Southwest Jiaotong University Chengdu 610031 China School of Astronomy and Space Science Nanjing University Nanjing 210023 China Center for Astrophysics Guangzhou University Guangzhou 510006 China Tsung-Dao lee Institute & School of Physics and Astronomy Shanghai Jiao Tong University Shanghai 200240 China Institute for Nuclear Research of Russian Academy of Sciences Moscow 117312 Russia Hebei Normal University Shijiazhuang 050024 China University of Science and Technology of China Hefei 230026 China State Key laboratory of Particle Detection and Electronics China Key laboratory of Dark matter and Space Astronomy & Key laboratory of Radio Astronomy Purple Mountain Observatory Chinese Academy of Sciences Nanjing 210023 China Research Center for Astronomical Computing Zhejiang Laboratory Hangzhou 311121 China Key laboratory for Research in Galaxies and Cosmology Shanghai Astronomical Observatory Chinese Academy of Sciences Shanghai 200030 China School of Physics and Astronomy Yunnan University Kunming 650091 China Key laboratory of Cosmic Rays (Tibet University) Ministry of Education Lhasa 850000 China National Astronomical Observatories Chinese Academy of Sciences Beijing 100101 China School of Physics and Astronomy (Zhuhai) & School of Physics (Guangzhou) & Sino-French Institute of Nuclear Engineering and Technology (Zhuhai) Sun Yat-sen University Zhuhai 519000 & Guangzhou 510275 Guangdong China Institute of Frontier and

The γ-ray emission from the W51 complex is widely acknowledged to be attributed to the interaction between the cosmic rays (CRs) accelerated by the shock of supernova remnant (SNR) W51C and the dense molecular clouds in the adjacent star-forming region, W51B. However, the maximum acceleration capability of W51C for CRs remains elusive. Based on observations conducted with the large High Altitude Air Shower Observatory (lHAASO), we report a significant detection of γ rays emanating from the W51 complex, with energies from 2 to 200 TeV. The lHAASO measurements, for the first time, extend the γ-ray emission from the W51 complex beyond 100 TeV and reveal a significant spectrum bending at tens of TeV. By combining the "π0-decay bump" featured data from Fermi-lAT, the broadband γ-ray spectrum of the W51 region can be well-characterized by a simple pp-collision model. The observed spectral bending feature suggests an exponential cutoff at ∼400 TeV or a power-law break at ∼200 TeV in the CR proton spectrum, most likely providing the first evidence of SNRs serving as CR accelerators approaching the PeV regime. Additionally, two young star clusters within W51B could also be theoretically viable to produce the most energetic γ rays observed by lHAASO. Our findings strongly support the presence of extreme CR accelerators within the W51 complex and provide new insights into the origin of Galactic CRs. © 2024 Science China Press

关键词： Cosmic rays

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Threshold-Based Software-Defined Networking(SDN)Solution for Healthcare Systems against Intrusion Attacks

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Computer modeling in Engineering & Sciences 2024年第2期138卷 1469-1483页

作者： laila m.Halman mohammed j.F.Alenazi Department of Computer Engineering College of Computer ScienceKing Saud UniversityRiyadh11451Saudi Arabia

The healthcare sector holds valuable and sensitive *** amount of this data and the need to handle,exchange,and protect it,has been increasing at a fast *** to their nature,software-defined networks(SDNs)are widely used in healthcare systems,as they ensure effective resource utilization,safety,great network management,and *** this sector,due to the value of thedata,SDNs faceamajor challengeposed byawide range of attacks,such as distributed denial of service(DDoS)and probe *** attacks reduce network performance,causing the degradation of different key performance indicators(KPIs)or,in the worst cases,a network failure which can threaten human *** can be significant,especially with the current expansion of portable healthcare that supports mobile and wireless devices for what is called mobile health,or *** this study,we examine the effectiveness of using SDNs for defense against DDoS,as well as their effects on different network KPIs under various *** propose a threshold-based DDoS classifier(TBDC)technique to classify DDoS attacks in healthcare SDNs,aiming to block traffic considered a hazard in the form of a DDoS *** then evaluate the accuracy and performance of the proposed TBDC *** technique shows outstanding performance,increasing the mean throughput by 190.3%,reducing the mean delay by 95%,and reducing packet loss by 99.7%relative to normal,with DDoS attack traffic.

关键词： Network resilience network management attack prediction software defined networking(SDN) distributed denial of service(DDoS) healthcare

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A Tutorial on Federated learning from Theory to Practice:Foundations,Software Frameworks,Exemplary Use Cases,and Selected Trends

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IEEE/CAA journal of Automatica Sinica 2024年第4期11卷 824-850页

作者： m.Victoria luzón Nuria Rodríguez-Barroso Alberto Argente-Garrido Daniel jiménez-lópez jose m.moyano javier Del Ser Weiping Ding Francisco Herrera Department of Software Engineering Andalusian Research Institute in Data Science and Computational Intelligence(DaSCI)University of GranadaGranada 18071Spain Department of Computer Science and Artificial Intelligence Andalusian Research Institute in Data Science and Computational Intelligence(DaSCI)University of GranadaGranada 18071Spain Department of Communications Engineering University of the Basque Country(UPV/EHU)and also with TECNALIABasque Research&Technology Alliance(BRTA)Spain School of Information Science and Technology Nantong UniversityNantong 226019China

When data privacy is imposed as a necessity,Federated learning(Fl)emerges as a relevant artificial intelligence field for developing machine learning(ml)models in a distributed and decentralized *** allows ml models to be trained on local devices without any need for centralized data transfer,thereby reducing both the exposure of sensitive data and the possibility of data interception by malicious third *** paradigm has gained momentum in the last few years,spurred by the plethora of real-world applications that have leveraged its ability to improve the efficiency of distributed learning and to accommodate numerous participants with their data *** virtue of Fl,models can be learned from all such distributed data sources while preserving data *** aim of this paper is to provide a practical tutorial on Fl,including a short methodology and a systematic analysis of existing software ***,our tutorial provides exemplary cases of study from three complementary perspectives:i)Foundations of Fl,describing the main components of Fl,from key elements to Fl categories;ii)Implementation guidelines and exemplary cases of study,by systematically examining the functionalities provided by existing software frameworks for Fl deployment,devising a methodology to design a Fl scenario,and providing exemplary cases of study with source code for different ml approaches;and iii)Trends,shortly reviewing a non-exhaustive list of research directions that are under active investigation in the current Fl *** ultimate purpose of this work is to establish itself as a referential work for researchers,developers,and data scientists willing to explore the capabilities of Fl in practical applications.

关键词： Data privacy distributed machine learning federated learning software frameworks

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Fever assessment in children under five: Are we following the guidelines?

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World journal of Clinical Pediatrics 2024年第1期13卷 62-72页

作者： Hasan m Isa Ahmed j Isa murtadha A Alnasheet mahmood m mansoor Department of Pediatrics Salmaniya Medical ComplexManama 26671Bahrain Department of Pediatrics Arabian Gulf UniversityManama 26671Bahrain Department of General Surgery Salmaniya Medical ComplexManama 26671Bahrain

BACKGROUND Fever is a common cause of medical consultation and hospital admission,particularly among ***,the United Kingdom’s National Institute for Health and Care Excellence(NICE)updated its guidelines for assessing fever in children under five years of *** efficient assessment and management of children with fever are crucial for improving patient *** To evaluate fever assessment in hospitalized children and to assess its adherence with the NICE Fever in under 5s *** We conducted a retrospective cohort review of the electronic medical records of children under five years of age at the Department of Pediatrics,Salmaniya medical Complex,Bahrain,between june and july *** data,vital signs during the first 48 h of admission,route of temperature measurement,and indications for admission were *** was defined according to the NICE *** children were divided into five groups according to their age(0-3 months,>3-6 months,>6-12 months,>12-36 months,and>36-60 months).Patients with and without fever were compared in terms of demography,indication for admission,route of temperature measurement,and other vital *** with the NICE Fever in the under 5s guideline was *** compliance was defined as>95%,partial compliance as 70%-95%,and minimal compliance as≤69%.Pearson’sχ^(2),Student’s t test,the mann-Whitney U test,and Spearman’s correlation coefficient(rs)were used for *** Of the 136 patients reviewed,80(58.8%)were *** median age at admission was 14.2[interquartile range(IQR):1.7-44.4]months,with the most common age group being 36-60 ***-six(26.4%)patients had fever,and 100(73.6%)were *** commonest age group for febrile patients(>12-36 months)was older than the commonest age group for afebrile patients(0-3 months)(P=0.027).The median weight was 8.3(IQR:4.0-13.3)*** with fever had higher weight than those without fever[10.2(IQR:7.3-13.0)vs 7

关键词： Fever Pediatrics Admission patterns Temperature measurement Guidelines Bahrain

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Generation of polarized electron beams through self-injection in the interaction of a laser with a pre-polarized plasma

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High Power laser Science and Engineering 2024年第3期 67-73页

作者： l.R.Yin X.F.li Y.j.Gu N.Cao Q.Kong m.Büscher S.m.Weng m.Chen Z.m.Sheng Key laboratory of Nuclear Physics and Ion-beam Application (mo E) Institute of Modern Physics Department of Nuclear Science and Technology Fudan University State Key laboratory of High Field laser Physics Shanghai Institute of Optics and Fine Mechanics Chinese Academy of Sciences SANKEN (Institute of Scienti?c and Industrial Research) Osaka University Sichuan Research Institute Shanghai Jiao Tong University Peter Grünberg Institut (PGI-6) Forschungszentrum Jülich Institut für laser- und Plasmaphysik Heinrich-Heine-Universit?t Düsseldorf Key laboratory for laser Plasmas (mo E) School of Physics and Astronomy Shanghai Jiao Tong University Collaborative Innovation Center of IFSA Shanghai Jiao Tong University Tsung-Dao lee Institute Shanghai Jiao Tong University

Polarized electron beam production via laser wakefield acceleration in pre-polarized plasma is investigated by particlein-cell simulations. The evolution of the electron beam polarization is studied based on the Thomas±Bargmann±michel±Telegdi equation for the transverse and longitudinal self-injection, and the depolarization process is found to be influenced by the injection schemes. In the case of transverse self-injection, as found typically in the bubble regime, the spin precession of the accelerated electrons is mainly influenced by the wakefield. However, in the case of longitudinal injection in the quasi-1D regime (for example, F. Y. li et al., Phys. Rev. lett. 110, 135002 (2013)), the direction of electron spin oscillates in the laser field. Since the electrons move around the laser axis, the net influence of the laser field is nearly zero and the contribution of the wakefield can be ignored. Finally, an ultra-short electron beam with polarization of 99%can be obtained using longitudinal self-injection.

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Nano-enhanced solid-state hydrogen storage:Balancing discovery and pragmatism for future energy solutions

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Nano Research 2024年第10期17卷 8729-8753页

作者： Chaochao Dun Xinyi Wang linfeng Chen Sichi li Hanna m.Breunig jeffrey j.Urban The molecular Foundry Lawrence Berkeley National Laboratory BerkeleyBerkeleyCA 94720USA Energy Analysis and Environmental Impacts Division Lawrence Berkeley National LaboratoryBerkeleyCA 94720USA lawrence livermore National laboratory LivermoreCA 94550USA

Nanomaterials have revolutionized the battery industry by enhancing energy storage capacities and charging speeds,and their application in hydrogen(H_(2))storage likewise holds strong potential,though with distinct challenges and mechanisms.H_(2) is a crucial future zero-carbon energy vector given its high gravimetric energy density,which far exceeds that of liquid ***,its low volumetric energy density in gaseous form currently requires storage under high pressure or at low *** review critically examines the current and prospective landscapes of solid-state H_(2) storage technologies,with a focus on pragmatic integration of advanced materials such as metal-organic frameworks(mOFs),magnesium-based hybrids,and novel sorbents into future energy *** materials,enhanced by nanotechnology,could significantly improve the efficiency and capacity of H_(2) storage systems by optimizing H_(2) adsorption at the nanoscale and improving the kinetics of H_(2) uptake and *** discuss various H_(2) storage mechanisms—physisorption,chemisorption,and the Kubas interaction—analyzing their impact on the energy efficiency and scalability of storage *** review also addresses the potential of“smart mOFs”,single-atom catalyst-doped metal hydrides,mXenes and entropy-driven alloys to enhance the performance and broaden the application range of H_(2) storage systems,stressing the need for innovative materials and system integration to satisfy future energy ***-throughput screening,combined with machine learning algorithms,is noted as a promising approach to identify patterns and predict the behavior of novel materials under various conditions,significantly reducing the time and cost associated with experimental *** closing,we discuss the increasing involvement of various companies in solid-state H_(2) storage,particularly in prototype vehicles,from a techno-economic *** forward-looking perspective underscores t

关键词： nanomaterials nanotechnology solid-state H_(2)storage techno-economic analysis model-driven material development processes

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Drought events influence nutrient canopy exchanges and green leaf partitioning during senescence in a deciduous forest

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Forest Ecosystems 2024年第1期11卷 110-119页

作者： j.Touche C.Calvaruso P.De Donato m.-P.Turpault INRAE BEFF-54000NancyFrance UmR 7359 GeoRessourcesFaculte des Sciences-Campus des Aiguillettes54506Vandoeuvre Les NancyFrance EcoSustain Environmental Engineering OfficeResearch and DevelopmentKanfen57330France

The increase in the frequency and intensity of drought events expected in the coming decades in Western Europe may disturb forest biogeochemical cycles and create nutrient deficiencies in *** possible origin of nutrient deficiency is the disturbance of the partitioning of the green leaf pool during the leaf senescence period between resorption,foliar leaching and senesced ***,the effects of drought events on this partitioning and the consequences for the maintenance of tree nutrition are poorly *** experiment in a beech forest in meuse(France)was conducted to assess the effect of drought events on nutrient canopy exchanges and on the partitioning of the green leaf pool during the leaf senescence *** aim was to identify potential nutritional consequences of droughts for *** nutrient dynamics,including resorption,chemistry of green and senesced leaves,foliar absorption and leaching in mature beech stands from 2012 to 2019 allowed us to compare the nutrient exchanges for three nondry and three dry years(i.e.,with an intense drought event during the growing season).During dry years,we observed a decrease by almost a third of the potassium(K)partitioning to resorption(*** efficiency),thus reducing the K reserve in trees for the next growing *** result suggests that with the increased drought frequency and intensity expected for the coming decades,there will be a risk of potassium deficiency in trees,as already observed in a rainfall exclusion experiment on the same study *** foliar leaching and higher parititioning to the senesced leaves for K and phosphorus(P)were also *** addition,a slight increase in nitrogen(N)resorption efficiency occurred during dry years which is more likely to improve tree *** calcium(Ca)negative resorption decreased,with no apparent consequence in our study *** results show that nutrient exchanges in the canopy and the partitioning of the green leaf

关键词： Natural drought Beech forest Canopy Resorption Foliar leaching Senesced leaves Nutrition

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A multi-shot target wheel assembly for high-repetition-rate, laser-driven proton acceleration

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High Power laser Science and Engineering 2024年第2期 91-98页

作者： j.Pe?as A.Bembibre D.Cortina-Gil l.martín A.Reija C.Ruiz m.Seimetz A.Alejo j.Benlliure Instituto Galego de Física de Altas Enerxías Universidade de Santiago de Compostela laboratorio láser de Aceleración y Aplicaciones RIAIDT Universidade de Santiago de Compostela Instituto Universitario de Física Fundamental y matemáticas y Dpto.de Didáctica de la matemática y de las Ciencias Experimentales Universidad de Salamanca Instituto de Instrumentación para Imagen molecular (I3m) CSIC-Universitat Politècnica de València

A multi-shot target assembly and automatic alignment procedure for laser–plasma proton acceleration at high repetition rate are introduced. The assembly is based on a multi-target rotating wheel capable of hosting more than 5000 targets,mounted on a 3D motorized stage to allow rapid replenishment and alignment of the target material between laser irradiations. The automatic alignment procedure consists of a detailed mapping of the impact positions at the target surface prior to the irradiation that ensures stable operation of the target, which alongside the purpose-built design of the target wheel, enables operation at rates up to 10 Hz. Stable and continuous laser-driven proton acceleration at 10 Hz is demonstrated, with observed cut-off energy stability about 15%.

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magnetic Topological Dirac Semimetal Transition Driven by SOC in Eumg_(2)Bi_(2)

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Chinese Physics letters 2024年第1期41卷 63-67页

作者：王佳萌钱浩吉姜琦乔山叶茂 State Key laboratory of Functional materials for Informatics Shanghai Institute of Microsystem and Information TechnologyChinese Academy of SciencesShanghai 200050China Center of materials Science and Optoelectronics Engineering University of Chinese Academy of SciencesBeijing 100049China Research Center for Intelligent Chips and Devices Zhejiang LabHangzhou 311121China Center for Transformative Science ShanghaiTech UniversityShanghai 201210China School of Physical Science and Technology ShanghaiTech UniversityShanghai 201210China Shanghai Synchrotron Radiation Facility Shanghai Advanced Research InstituteChinese Academy of SciencesShanghai 201204China

magnetic topological semimetals have been at the forefront of condensed matter physics due to their ability to exhibit exotic transport *** the interplay between magnetic and topological orders in systems with broken time-reversal symmetry is crucial for realizing non-trivial quantum *** delve into the electronic structure of the rare-earth-based antiferromagnetic Dirac semimetal Eumg_(2)Bi_(2) using first-principles calculations and angle-resolved photoemission *** calculations reveal that the spin-orbit coupling(SOC)in Eumg_(2)Bi_(2) prompts an insulator to topological semimetal transition,with the Dirac bands protected by crystal *** linearly dispersive states near the Fermi level,primarily originating from Bi 6p orbitals,are observed on both the(001)and(100)surfaces,confirming that Eumg_(2)Bi_(2) is a three-dimensional topological Dirac *** research offers pivotal insights into the interplay between magnetism,SOC and topological phase transitions in spintronics applications.

关键词： spectroscopy topological Dirac

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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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