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Mobile stroke care expedites intravenous thrombolysis and endovascular thrombectomy

Stroke & Vascular Neurology 2022年第3期7卷 209-214页

作者： matthew t bender thomas K Mattingly Redi Rahmani Diana Proper Walter A Burnett Jason L Burgett Joshua LEsperance Jeremy t Cushman Webster H Pilcher Curtis G Benesch Adam G Kelly tarun Bhalla Department of Neurosurgery University of Rochester Medical CenterRochesterNew YorkUSA Department of Emergency Medicine University of Rochester Medical CenterRochesterNew YorkUSA Department of Neurology University of Rochester Medical CenterRochesterNew YorkUSA

Background the number of mobile stroke programmes has increased with evidence,showing they expedite intravenous *** questions include whether time savings extend to patients eligible for endovascular therapy and impact clinical *** Our mobile stroke unit(MSU),based at an academic medical centre in upstate New York,launched in October *** reviewed prospective observational data sets over 26 months to identify MSU and non-MSU emergency medical service(EMS)patients who underwent intravenous thrombolysis or endovascular thrombectomy for comparison of angiographic and clinical *** Over 568 days in service,the MSU was dispatched 1489 times(2.6/day)and transported 300 patients(20%of dispatches).Intravenous tissue plasminogen activator(tPA)was administered to 57 MSU patients and the average time from 911 call-to tPA was 42.5 min(±9.2),while EMS transported 73 patients who received tPA at 99.4 min(±35.7)(ptients(12%)received tPA from 3.5 hours to 4.5 hours since last known well and would likely have been outside the window with EMS *** thrombectomy was performed on 21 MSU patients with an average 911 call-to groin puncture time of 99.9 min(±18.1),while EMS transported 54 patients who underwent endovascular thrombectomy(Et)at 133.0 min(±37.0)(p=0.0002).there was no difference between MSU and traditional EMS in modified Rankin score at 90-day clinic follow-up for patients undergoing intravenous thrombolysis or endovascular thrombectomy,whether assessed as a dichotomous or ordinal *** Mobile stroke care expedited both intravenous thrombolysis and endovascular *** is an ongoing need to show improved functional outcomes with MSU care.

关键词： intravenous throm endovascular

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tandem cervical carotid stenting for stenosis with flow diversion embolisation for the treatment of intracranial aneurysms

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Stroke & Vascular Neurology 2019年第1期4卷 43-47页

作者： Jessica K Campos Li-Mei Lin Narlin B Beaty matthew t bender Bowen Jiang David A Zarrin Alexander L Coon Department of Neurosurgery Johns Hopkins University School of MedicineBaltimoreMarylandUSA Department of Neurosurgery University of CaliforniaIrvineOrangeCaliforniaUSA

Background An estimated 2%-3%of the population harbour an intracranial *** atherosclerotic cervical carotid disease is not *** management of these two entities remains a challenge within the *** presentation We report a single case of concomitant carotid stenosis and two ipsilateral unruptured intracranial aneurysms treated with a single-staged cervical carotid stenting and cerebral aneurysm embolisation with the Pipeline embolisation *** No consensus currently exists to guide endovascular treatment of intracranial aneurysms associated with asymptomatic ipsilateral ***,we present a case of asymptomatic moderate carotid stenosis with two ipsilateral intracranial aneurysms and suggest carotid artery stenting takes procedural priority over aneurysm embolisation in single-stage *** rationale for the sequence of neurointerventions is based on the tracking a robust distal access system beyond a stenotic proximal carotid lesion and stabilisation of the ulcerated plaque to avoid thromboembolic complications associated with plaque irritation during aneurysm *** cases and longer follow-up will be needed to further assess the efficacy of this technique.

关键词： aneurysm carotid stenosis

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Procedural complexity independent of P2Y12 reaction unit(PRU)values is associated with acute in situ thrombosis in Pipeline flow diversion of cerebral aneurysms

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Stroke & Vascular Neurology 2018年第3期3卷 169-175页

作者： Bowen Jiang matthew t bender Erick M Westbroek Jessica K Campos Li-Mei Lin Risheng Xu Rafael J tamargo Judy Huang Geoffrey P Colby Alexander L Coon Department of Neurosurgery Johns Hopkins University School of MedicineBaltimoreMarylandUSA Department of Neurosurgery University of CaliforniaIrvine School of MedicineOrangeCaliforniaUSA Department of Neurosurgery University of CaliforniaLos AngelesLos AngelesCaliforniaUSA

background Acute in situ thrombosis is an ischaemic phenomenon during Pipeline embolisation device(PED)procedures with potentially high morbidity and *** is controversy regarding the role of platelet function testing with P2Y12 assay as a predictor of intraprocedural thromboembolic *** is limited knowledge on whether procedural complexity influences these *** Data were collected retrospectively on 742 consecutive PED cases at a single *** with intraprocedural acute thrombosis were compared with patients without these *** A cohort of 37 PED cases with acute in situ thrombosis(mean age 53.8 years,mean aneurysm size 8.4 mm)was matched with a cohort of 705 PED cases without intraprocedural thromboembolic events(mean age 56.4 years,mean aneurysm size 6.9 mm).All patients with in situ thrombosis received intra-arterial and/or intravenous *** two groups were evenly matched in patient demographics,previous treatment/subarachnoid hemorrhage(SAH)and aneurysm *** was no statistical difference in postprocedural P2Y12 reaction unit(PRU)values between the two groups,with a mean of 156 in the in situ thrombosis group vs 148 in the control group(p=0.5894).Presence of cervical carotid tortuosity,high cavernous internal carotid artery grade,need for multiple PED and vasospasm were not significantly different between the two *** in situ thrombosis group had statistically significant longer fluoroscopy time(60.4 vs 38.4 min,ption exposure(3476 vs 2160 mGy,ptes of adjunctive coiling(24.3% vs 8.37%,p=0.0010)and higher utilisation of balloon angioplasty(37.8% vs 12.2%,pthe in situ thrombosis cohort had higher incidence of major and minor stroke,intracerebral haemorrhage and length of *** Predictors of procedural complexity(higher radiation exposure,longer fluoroscopy time,adjunctive coiling and need for balloon angioplasty)are asso

关键词： P2Y12 matched balloon

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Flow diversion covering the M1 origin as a last resort

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Stroke & Vascular Neurology 2019年第3期4卷 141-147页

作者： Li-Mei Lin matthew t bender Geoffrey P Colby Bowen Jiang Jessica K Campos David A Zarrin Robert W C Young Risheng Xu Justin M Caplan Judy Huang Rafael J tamargo Alexander L Coon Department of Neurosurgery University of California IrvineOrangeCaliforniaUSA Department of Neurosurgery Johns Hopkins University School of MedicineBaltimoreMarylandUSA Department of Neurosurgery University of California Los AngelesLos AngelesCaliforniaUSA

Introduction Internal carotid artery termination(ICAt)and proximal A1 aneurysms can be challenging for open surgical clipping or endovascular *** with flow diversion covering the middle cerebral artery(MCA),an end vessel supplying a terminal circulation,has not been *** A prospective,Institutional Review Board-approved database was analysed for patients with pipeline embolisation device(PED)placement from the anterior cerebral artery(ACA)to the ICA during cerebral aneurysm *** Nine cases were identified,including five proximal A1,three posterior communicating artery and one ICAt aneurysm *** aneurysm size was 8.3 mm(range 3-17),with 67%saccular and 78%*** indication for treatment was significant dome irregularity(44%),recurrence or enlargement(33%),underlying collagen vascular disorder(11%)and traumatic pseudoaneurysm(11%).Preservation of the ipsilateral ACA(with PED placed in A1)was performed when the anterior communicating artery(67%)or contralateral A1(33%)were absent on *** coiling was done in four cases(44%).there was one major stroke leading to mortality(11%)and one minor stroke(11%).Clinical follow-up was 27 months on ***-up digital subtraction angiography(average interval 15 months)showed complete aneurysm obliteration(88%)or dome occlusion with entry remnant(12%).the jailed MCA showed minimal or mild delay(primarily anterograde flow)in 75%of cases and significant delay(reliance primarily on ACA and external carotid artery collaterals)in 25%.Conclusions Covering the MCA with a flow diverting stent should be reserved for select rare *** attention to blood pressure augmentation during the periprocedural period is necessary to minimise potential ischaemic compromise.

关键词： primarily resort sided

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Bulking Up the Bay-Position Substituents Enables Enhanced Selectivity of C_(s)‑Symmetric Boron Subphthalocyanine−Subnaphthalocyanine Hybrids

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Precision Chemistry 2024年第4期2卷 161-181页

作者： Nina F.Farac Alan J.Lough timothy P.bender Department of Chemical Engineering and Applied Chemistry University of TorontoTorontoOntario M5S 3E5Canada Department of Chemistry University of TorontoTorontoOntario M5S 3H6Canada Department of Materials Science and Engineering University of TorontoTorontoOntario M5S 3E4Canada Department of Mechanical and Industrial Engineering University of TorontoTorontoOntario M5S 3G8Canada

the precise synthesis of subporphyrinoid hybrids withπ-expanded topologies and unique material properties plays a promising role in the design of functional ***,selective,and controllable routes to boron subphthalocyanine−subnaphthalocyanine hybrids,Bsub(Pc_(3‑p)-Nc_(p))s,are desirable for this purpose yet synthetically challenging due to random mixtures of C_(s-),C_(3v-),and,in some cases,C_(1)-symmetric compounds that form during traditional statistical mixed ***,we addressed this issue by developing a sterically driven mixed cyclotrimerization with enhanced selectivity for the targeted C_(s)-symmetric hybrid and complete suppression of sterically crowded macrocyclic *** process,coupled with a rationally designed precursor bearing bulky phenyl substituents,enabled the synthesis and characterization of bay-position phenylated Ph_(2)-(R_(p))_(8)Bsub(Pc_(2)-Nc_(1))hybrids with halogens(Rp=Cl or F)in their peripheral isoindole *** selectivity ranged between 59 and 72%with remarkable yields,significantly higher than that of conventional mixed *** findings were augmented by theoretical calculations on precursor Lewis basicity as guiding principles into hybrid macrocycle ***,the incorporation of unfused phenyl groups and halogen atoms into the hybrid framework resulted in fine-tuned optical,structural,electronic,and electrochemical *** straightforward approach achieved improved selectivity and controlled narrowing of the product distribution,affording the efficient synthesis of structurally sophisticated Bsub(Pc_(2)-Nc_(1))*** then expands the library of 3-dimensionalπ-extended macrocycles for use in a range of applications,such as in optoelectronic devices with precisely tailored optical properties.

关键词： subphthalocyanine hybrids low-symmetry aromatic macrocycle selective cyclotrimerization sterically driven chemistry broad absorption material properties

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A dual function for the chromatin organizer Special A-t rich Binding Protein 1 in B-lineage cells

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Cellular & Molecular Immunology 2023年第10期20卷 1114-1126页

作者： Morgane thomas Charlotte Bruzeau Ophélie Alyssa Martin Justine Pollet Sébastien bender Claire Carrion Sandrine Le Noir Eric Pinaud Laboratoire Contrôle de la Réponse Immune B et des Lymphoproliférations(CRIBL) Universitéde LimogesCNRS UnitéMixte de Recherche 7276Inserm Unité1262LimogesFrance Centre Hospitalier Universitaire Dupuytren Service d’ImmunopathologieLimogesFrance Centre Hospitalier Universitaire de Limoges Centre National de l’Amylose AL et Autres Maladies par Dépôt d’Immunoglobulines MonoclonalesLimogesFrance Laboratoire Suivi des therapies Innovantes Institut de Genetique HumaineUMR 9002 CNRS-UMMontpellierFrance

SAtB1(Special A-t rich Binding protein 1)is a cell type-specific factor that regulates the genetic network in developing t cells and *** t cells,SAtB1 is required for lineage commitment,VDJ recombination,development and *** that its expression varies during B-cell differentiation,the involvement of SAtB1 needs to be clarified in this *** a KO mouse model in which SAtB1 was deleted from the pro-B-cell stage,we examined the consequences of SAtB1 deletion in naive and activated B-cell *** model indicates first,unlike its essential function in t cells,that SAtB1 is dispensable for B-cell development and the establishment of a broad IgH ***,we show that SAtB1 exhibits an ambivalent function in mature B cells,acting sequentially as a positive and negative regulator of Ig gene transcription in naive and activated cells,***,our study indicates that the negative regulatory function of SAtB1 in B cells extends to the germinal center response,in which this factor limits somatic hypermutation of Ig genes.

关键词： B cells Nuclear factor Ambivalent Somatic hypermutation

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Coronavirus Disease 2019 and Liver Injury:A Retrospective Analysis of Hospitalized Patients in New York City

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Journal of Clinical and translational Hepatology 2021年第4期9卷 551-558页

作者： Joshua M.bender Howard J.Worman Department of Medicine Vagelos College of Physicians&SurgeonsColumbia UniversityNew YorkNYUSA Department of Pathology and Cell Biology Vagelos College of Physicians&SurgeonsColumbia UniversityNew YorkNYUSA

Background and Aims:Coronavirus disease 2019(COVID-19)is a global threat,affecting more than 100 million people and causing over 2 million *** laboratory test abnormalities are an extrapulmonary manifestation of COVID-19,yet characterization of hepatic injury is *** objective was to further characterize and identify causes of liver injury in patients with ***:We conducted a retrospective cohort study of 551 patients hospitalized with COVID-19 at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center between March 1,2020 and May 31,*** analyzed patient demographics,liver laboratory test results,vital signs,other relevant test results,and clinical outcomes(mortality and intensive care unit admission).Results:Abnormal liver laboratory tests were common on hospital admission for COVID-19 and the incidence increased during *** those with elevated serum alanine aminotransferase and/or alkaline phosphatase activities on admission,58.2%had a cholestatic injury pattern,35.2%mixed,and 6.6%*** liver disease was not associated with outcome;however,abnormal direct bilirubin or albumin on admission were associated with intensive care unit stay and *** average,patients who died had greater magnitudes of abnormalities in all liver laboratory tests than those who *** hepatitis was a mechanism of severe hepatocellular injury in some ***:Liver laboratory test abnormalities are common in hospitalized patients with COVID-19,and some are associated with increased odds of intensive care unit stay or *** hepatocellular injury is likely attributable to secondary effects such as systemic inflammatory response syndrome,sepsis,and ischemic hepatitis.

关键词： Aminotransferase Bilirubin Ischemic hepatitis SARS-CoV-2

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A dahlia flower extract has antidiabetic properties by improving insulin function in the brain

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Life Metabolism 2023年第4期2卷 39-50页

作者： Dominik Pretz Philip M.Heyward Jeremy Krebs Joel Gruchot Charles Barter Pat Silcock Nerida Downes Mohammed Zubair Rizwan Alisa Boucsein Julia bender Elaine J.Burgess Geke Aline Boer Pramuk Keerthisinghe Nigel B.Perry Alexander tups Centre for Neuroendocrinology School of Biomedical SciencesUniversity of OtagoDunedin 9054New Zealand Department of Physiology School of Biomedical SciencesUniversity of OtagoDunedin 9054New Zealand Maurice Wilkins Centre for Molecular Biodiscovery University of AucklandAuckland 1010New Zealand Department of Medicine University of OtagoWellingtonWellington South 6242New Zealand Centre for Endocrine Diabetes and Obesity Research Wellington Regional HospitalNewtownWellington 6021New Zealand Product Development Research Centre University of OtagoDunedin 9054New Zealand Department of Chemistry The New Zealand Institute for Plant and Food ResearchUniversity of OtagoDunedin 9054New Zealand

Butein,a rare chalcone found in the toxic plant toxicodendron vernicifluum,has been shown to regulate glucose homeostasis via inhibition of the nuclear factor kappa-B kinase subunit beta(IKKβ)/nuclear factor kappa B(NF-κB)pathway in the ***,we investigated whether the nonpoisonous plant Dahlia pinnata could be a source of butein as a potential treatment for type 2 diabetes(t2D).In mice fed a high-fat diet(HFD)to induce glucose intolerance,an oral *** petal extract improved glucose tolerance at doses of 3.3 mg/kg body weight and 10 mg/kg body ***,this effect was not mediated by butein alone but by butein combined with the closely related flavonoids,sulfuretin and/or ***,the extract improved systemic insulin *** of phosphatidylinositol 3-kinase to block insulin signaling in the brain abrogated the glucoregulatory effect of the orally administered *** extract reinstated central insulin signaling and normalized astrogliosis in the hypothalamus of HFD-fed *** NF-κB reporter zebrafish to determine IKKβ/NF-κB activity,a potent anti-inflammatory action of the extract was found.A randomized controlled crossover clinical trial on participants with predia-betes or t2D confirmed the safety and efficacy of the extract in *** conclusion,we identified an extract from the flower petals of *** as a novel treatment option for t2D,potentially targeting the central regulation of glucose homeostasis as a root cause of the disease.

关键词： inflammation hypothalamus signal transduction neuroendocrine arcuate nucleus

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Medium-scale travelling Ionospheric Disturbances （MStID） modelling using dense German GPS network

Medium-scale Travelling Ionospheric Disturbances （MSTID） m...

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第三届中国卫星导航学术年会

作者： Steffen Schn Michael bender Jens Wickert Institut für Erdmessung (IfE) Leibniz Universit t HannoverGermany Helmholtz Centre Potsdam German Research Centre for Geosciences (GFZ)Telegrafenberg14473 PotsdamGermany

the MStIDs are wave-like perturbations of the ionospheric plasma,which cause the most common ionospheric disturbances in mid-latitude *** the MStIDs have velocities of several hundred meters per second and wavelengths of several hundred *** wave-like effect of the MStID is one of the main obstacles for accurate interpolation of ionospheric corrections in a medium-scale reference GPS *** this paper we show a new method of detecting and modeling MStIDs using dense German GPS *** between-epoch single difference ionospheric delays from a medium scale dense GPS network are used to estimate the parameter of the MStID ***,wavelength and *** efficiency of the approach is tested with data from about 320 GPS stations in and near Germany.A MStID wave moving from east to west across Germany was observed at September 27 in *** wavelength is about 302 km,with a period of ～7 minutes and velocity of about 700 m/s.

关键词： MStID GPS dense GPS network

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Pre-Failure Behavior of Deep-Situated Osaka Clay

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China Ocean Engineering 1998年第4期13卷 453-465页

作者： t.HONGO M.FUKUDA t.ADACHI F.OKA Vice DirectorProfessorSchool of GraduatesKyoto UniversitySakyo-ku HonmachiKyotoJapanAcademician of Chinese Academy of EngineeringGeotechnical Engineering DepartmentNanjing Hydraulic Research Institute.Nanjing 210024P.RChina DirectorOsaka Soil Test LabItachibori 4-3-2Nishi-kuOsakaJapan.of Depart.Osaka Soil Test LabItachibori 4-3-2Nishi-kuOsakaJapan

Great interest has been aroused on deeply-situated Osaka clay since Kobe Earthquake in 1994. In this paper is presented the analysis on the results of a series of lab tests on Osaka clay situated from 100 m to 1500 m under the ground. the wave velocity method, bender element method, LDt and the formula derived by the authors are used, focus is put on the pre-failure mechanical behavior of the clay. the analysis shows that, (i) pore-pressure coefficient B is less than 1.0, (ii) the relationship between shear modulus and Poisson's ratio is not in agreement with that reported before, (iii) the modulus measured with LDt is still less than that measured with bender element method, and (iv) there are two threshold strains, within which the clay can be considered as elastic, and both of them are larger than that reported before.

关键词： pre-failure behavior natural clays wave velocity method bender element LDt

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