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Influence of Formulation and Hot-Pressing Conditions on the Performance of Bio-Based Molasses Adhesive for Plywood

j.urnal of Renewable Materials 2024年第8期12卷 1383-1397页

作者： Sutiawan j. Syahfitri A. Kusumah S.S. Hermawan D. Sari R.K. Hakim L. Mardawati E. Lubis M.A.R. Research Center for Biomass and Bioproducts National Research and Innovation Agency Cibinong 16911 Indonesia Forest Product Department Faculty of Forestry and Environment IPB University Bogor 16680 Indonesia Department of Forest Products Faculty of Forestry Universitas Sumatera Utara Medan 20155 Indonesia Research Collaboration Center for Biomass and Biorefinery BRIN and Universitas Padjadjaran Bandung 40600 Indonesia Department of Agro-Industrial Technology Universitas Padjadjaran Bandung 40600 Indonesia

Molasses can serve as a natural adhesive for plywood and particleboard. However, several disadvantages remain, including lower dimensional stability and low bonding strength compared to other adhesives. Therefore, modifications are needed to use molasses as an adhesive for plywood. This research aims to improve bio-based molasses (MO) adhesive for plywood using citric acid (CA) adhesive. In addition, this research aims to analyze the effect of adding citric acid and to investigate the optimum hot-pressing temperature to produce the best quality plywood. In the first stage, the molasses and citric acid were combined in a ratio of 100:0, 75:25, 50:50, 25:75, 0:100 w/w%. Then, the second stage focuses on analyzing the influences of pressing temperature based on an optimum first stage. The research demonstrated that the addition of CA altered the gelation time, solid content, visc-osity, and pH of the molasses adhesives. In addition, the thermal properties of molasses adhesives were changed after mixing with citric acid. These phenomena indicate changes in characteristics, such as the curing of adhesive. Overall, the characteristics of plywood showed a steady improvement as the CA ratio increased but revealed a significant decline for the 25:75 MO-CA ratio. By raising the pressing temperature from 180°C to 200°C, the quality of plywood was effectively improved. The plywood that was bonded using adhesives with a 50:50 MO-CA ratio exhibited superior mechanical properties and improved dimensional stability compared to the plywood bonded solely with MO. Furthermore, the optimal mechanical and physical properties resulted in plywood bonded with a 50:50 MO-CA ratio when subj.cted to a pressing temperature of 200°C. The Thermal and FTIR measurements revealed that CA established ester bonds with both the MO and wood veneers. In conclusion, the mechanical characteristics of plywood were improved, while maintaining its excellent dimensional stability. © 2024 The Authors.

关键词： Citric acid composite molasses plywood pressing temperature

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Rescue from complications after pancreaticoduodenectomies at a low-volume Caribbean center:Value of tailored peri-pancreatectomy protocols

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world j.urnal of Gastrointestinal Surgery 2024年第3期16卷 681-688页

作者： Shamir O Cawich Elij.h Dixon Parul j.Shukla Shailesh V Shrikhande Rahul R Deshpande Fawwaz Mohammed Neil w Pearce wesley Francis Shaneeta j.hnson j.hann Buj.awan Department of Surgery University of the West IndiesSt Augustine 000000Trinidad and Tobago Department of Surgery Faculty of MedicineUniversity of CalgaryCalgaryAlberta T2N2T9Canada Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgical Oncology Tata Memorial CenterHomi Bhabha National UniversityMumbai 400012India Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery University of the West IndiesNassau N-1184Bahamas Department of Surgery Morehouse School of MedicineAtlantaGA 30310United States Department of Surgery General Hospital in Port of SpainPort of Spain 000000Trinidad and Tobago

BACKGROUND Pancreaticoduodenectomy(PD)is a technically complex operation,with a re-latively high risk for *** ability to rescue patients from post-PD complications is as a recognized quality *** protocols were instituted at our low volume facility in the year *** To document the rate of rescue from post-PD complications with tailored protocols in place as a measure of *** A retrospective audit was performed to collect data from patients who experienced maj.r post-PD complications at a low volume pancreatic surgery unit in Trinidad and Tobago between j.nuary 1,2013 and j.ne 30,***-dardized definitions from the International Study Group of Pancreatic Surgery were used to define post-PD complications,and the modified Clavien-Dindo classification was used to classify post-PD *** Over the study period,113 patients at a mean age of 57.5 years(standard deviation[SD]±9.23;range:30-90;median:56)underwent PDs at this *** complications were recorded in 33(29.2%)patients at a mean age of 53.8 years(SD:±7.9).Twenty-nine(87.9%)patients who experienced maj.r morbidity were salvaged after aggre-ssive treatment of their ***(3.5%)died from bleeding pseudoaneurysm(1),septic shock secondary to a bile leak(1),anastomotic leak(1),and myocardial infarction(1).There was a significantly greater salvage rate in patients with American Society of Anesthesiologists scores≤2(93.3%vs 25%;P=0.0024).CONCLUSION This paper adds to the grow.ng body of evidence that volume alone should not be used as a marker of quality for patients requiring *** low volumes at our facility,we demonstrated that 87.9%of patients were rescued from maj.r *** attributed this to several factors including development of rescue protocols,the competence of the pancreatic surgery teams and continuous,and adaptive learning by the entire institution,cul-minating in the development of tailored peri-pancreatectomy protoc

关键词： Pancreas Complication Rescue Failure Morbidity Mortality Pancreaticoduodenectomy

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Tendency to Avoid Physical Activity and Sport: Associations with weight Stigma, and Psychological Distress in a Two-wave Longitudinal Study

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International j.urnal of Mental Health Promotion 2024年第8期26卷 633-641页

作者： Mohsen S. Lin Y.-C. Huang P.-C. Huang Y.-T. Huang R.-Y. Huang C.H. Chen j.-S. Poon w.C. Griffiths M.D. Lin C.-Y. Health Research Center Life Style Institute Baqiyatallah University of Medical Sciences Tehran *** Iran Health Education Department Faculty of Health Baqiyatallah University of Medical Sciences Tehran *** Iran Department of Early Childhood and Family Education National Taipei University of Education Taipei 106 Taiwan School of Physical Therapy Graduate Institute of Rehabilitation Science College of Medicine Chang Gung University Taoyuan 333 Taiwan Institute of Allied Health Sciences College of Medicine National Cheng Kung University Tainan 701 Taiwan Division of Family Medicine Taipei Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation School of Medicine Tzu Chi University Hualien Taiwan Data Science Degree Program National Taiwan University and Academia Sinica Taipei Taiwan Department of Family Medicine and Community Medicine E-Da Hospital I-Shou University Kaohsiung 824 Taiwan College of Medicine I-Shou University Kaohsiung 840 Taiwan Department of Medical Research E-Da Hospital I-Shou University Kaohsiung 840 Taiwan Sunway Business School Sunway University Selangor 47500 Malaysia International Gaming Research Unit Psychology Department Nottingham Trent University Nottingham NG1 4BU United Kingdom Department of Public Health College of Medicine National Cheng Kung University Tainan 701 Taiwan Biostatistics Consulting Center National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan 704 Taiwan Department of Occupational Therapy College of Medicine National Cheng Kung University Tainan 701 Taiwan

Background: Physical inactivity is a maj.r public health problem worldwide that results in physical and mental health problems. One maj.r issue for physical inactivity is weight stigma (wS), especially perceived wS, which could lead to a tendency to avoid physical activity (PA). To better understand the association between perceived wS and PA, knowledge of the likely mediators in this association such as weight bias internalization (wBI) and psychological distress were investigated in the present study. Methods: Using a two-wave longitudinal study and convenient sampling, 388 Taiwanese participants (55% females; mean age = 29.7 years [SD ± 6.3]) completed two surveys six months apart. Body mass index (BMI), Perceived weight Stigma Scale (PwSS), weight Bias Internalization Scale (wBIS), Depression, Anxiety, Stress Scale (DASS-21), and Tendency to Avoid Physical Activity and Sport Scale (TAPAS) were assessed. Results: A mediation model controlling for age, gender, and BMI with 5000 bootstrapping resamples was performed. Perceived wS exerted significant direct effects on wBI (β = 0.25; p wBI exerted a significant direct effect on tendency to avoid PA (β = 0.47; p wBI and psychological distress on the association between perceived wS and tendency to avoid PA were 0.12 and 0.01, respectively. Conclusion: Given the direct association of perceived wS on the tendency to avoid PA and the mediating role of wBI in this association, interventions addressing perceived wS and wBI may contribute to promoting PA. Therefore, health interventionists (both when planning and executing PA programs) need to consider weight stigmawhen encouraging physical activity. © 2024 The Authors.

关键词： Mediation model physical activity psychological distress weight stigma young adults

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On pancreatic cancer screening by magnetic resonance imaging with the recent evidence by Del Chiaro and colleagues

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Chinese j.urnal of Cancer Research 2015年第4期27卷 417-422页

作者： Yì-Xiáng j.w.ng j.ng-Shan Gong Romaric Loffroy Department of Imaging and Interventional Radiology Faculty of Medicine The Chinese University of Hong Kong Prince of Wales Hospital Department of Radiology Shenzhen People’s Hospital Second Clinical Medicine College of j.nan University Department of Vascular Oncologic and Interventional Radiology Le2i UMR CNRS 6306 University of Dijon School of Medicine Bocage Teaching Hospital

Pancreatic cancer is a lethal disease because incidence and mortality rates are nearly *** 5-year survival rate in western countries is 4%,the lowest among all types of cancer（1）.In China,pancreatic cancer is the sixth leading cause of death from malignant disease,with an overall cumulative 5-year survival rate of 1%to 3%（2,3）.

关键词： screening mortality intraductal cumulative lethal identical mucinous incidence familial pancreas

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Conservative management of spinal pathology with autologous conditioned serum: A systematic review of the literature

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world j.urnal of Orthopedics 2024年第9期15卷 870-881页

作者： Christian j.Raj.ovic Matthew L Merckling Alyssa w Lee Galadu Subah Aryan Malhotra Zachary D Thomas Sabrina L Zeller j.hn V wainwright Merritt D Kinon Department of Neurosurgery Westchester Medical CenterValhallaNY 10595United States

BACKGROUND Chronic inflammatory pain is associated with increased expression of interleukin(IL)-1,an inflammatory cytokine,and activity on its receptor(IL-1R).In response,the body produces IL-1R antagonist(IL-1Ra)to reduce this *** conditioned serum(ACS)is the only biologic therapy for spinal pathologies that enhances the action of endogenous IL-1Ra reserves to improve *** systematic review investigates the effectiveness of ACS in treating pain and dis-ability caused by spinal *** To evaluate the use of ACS as a conservative management option for spinal *** A systematic review of PubMed/Medline was performed to identify studies inve-stigating administration of ACS for treatment of any spinal *** Six articles were included,comprising 684 patients treated with epidural(n=133)or transforaminal(n=551)ACS *** had an average age of 54.0 years with slight female predominance(53.2%).The lumbar spine was most com-monly treated,with 567 patients(82.9%)receiving inj.ctions for lumbar radicu-lopathy(n=67),degenerative disc disease(DDD)(n=372),or spinal stenosis(n=128);cervical inj.ctions were performed in 109 patients(15.9%).Mean(SD)follow-up was 21.7(4.8)weeks from first ACS *** studies investigating mecha-nical lumbar and lumbar or cervical radicular pain reported significant pain re-duction at final follow-up compared to *** achieved comparable or su-perior results to lumbar epidural steroid *** events were reported in 21 patients(3.1%),with no serious adverse *** ACS inj.ction is a safe and effective intervention for pain reduction in many spinal pathologies,including cervical and lumbar radiculopathies.

关键词： Spine Autologous conditioned serum Orthokine Regenokine Epidural steroid inj.ction Interleukin-1 Inter-leukin-1 receptor antagonist

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Exploring impacts of COVID-19 on spatial and temporal patterns of visitors to Canadian Rocky Mountain National Parks from social media big data

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j.urnal of Forestry Research 2024年第4期35卷 13-33页

作者： Dehui Christina Geng Amy Li j.eyu Zhang Howie w.Harshaw Christopher Gaston wanli wu Guangyu w.ng National Park Research Centre Faculty of ForestryUniversity of British ColumbiaVancouver V6T 1Z4Canada Faculty of Applied Science University of British ColumbiaVancouver V6T 1Z3Canada Paul G.Allen School of Computer Science&Engineering University of WashingtonSeattleWA 98195USA Faculty of Kinesiology Sportand RecreationUniversity of AlbertaEdmonton T6G 2J9Canada Department of wood Science Faculty of ForestryUniversity of British ColumbiaVancouver V6T 1Z4Canada

COVID-19 posed challenges for global tourism *** in visitor temporal and spatial patterns and their associated determinants pre-and peri-pandemic in Canadian Rocky Mountain National Parks are *** was collected through social media programming and analyzed using spatiotemporal analysis and a geographically weighted regression(GwR)*** highlight that COVID-19 significantly changed park visitation *** tended to explore more remote areas *** GwR model also indicated distance to nearby trails was a significant influence on visitor *** results indicate that the pandemic influenced tourism temporal and spatial *** research presents a novel approach using combined social media big data which can be extended to the field of tourism management,and has important implications to manage visitor patterns and to allocate resources efficiently to satisfy multiple obj.ctives of park management.

关键词： Tourism management Social media big data National parks COVID-19 Geographical weighted regression

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STCF conceptual design report (Volume 1): Physics & detector

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Frontiers of physics 2024年第1期19卷 1-154页

作者： M.Achasov X.C.Ai L.P.An R.Aliberti Q.An X.Z.Bai Y.Bai O.Bakina A.Barnyakov V.Blinov V.Bobrovnikov D.Bodrov A.Bogomyagkov A.Bondar I.Boyko Z.H.Bu F.M.Cai H.Cai j.j.Cao Q.H.Cao X.Cao Z.Cao Q.Chang K.T.Chao D.Y.Chen H.Chen H.X.Chen j.F.Chen K.Chen L.L.Chen P.Chen S.L.Chen S.M.Chen S.Chen S.P.Chen w.Chen X.Chen X.F.Chen X.R.Chen Y.Chen Y.Q.Chen H.Y.Cheng j.Cheng S.Cheng T.G.Cheng j.P.Dai L.Y.Dai X.C.Dai D.Dedovich A.Denig I.Denisenko j.M.Dias D.Z.Ding L.Y.Dong w.H.Dong V.Druzhinin D.S.Du Y.j.Du Z.G.Du L.M.Duan D.Epifanov Y.L.Fan S.S.Fang Z.j.Fang G.Fedotovich C.Q.Feng X.Feng Y.T.Feng j.L.Fu j.Gao Y.N.Gao P.S.Ge C.Q.Geng L.S.Geng A.Gilman L.Gong T.Gong B.Gou w.Gradl j.L.Gu A.Guevara L.C.Gui A.Q.Guo F.K.Guo j.C.Guo j.Guo Y.P.Guo Z.H.Guo A.Guskov K.L.Han L.Han M.Han X.Q.Hao j.B.He S.Q.He X.G.He Y.L.He Z.B.He Z.X.Heng B.L.Hou T.j.Hou Y.R.Hou C.Y.Hu H.M.Hu K.Hu R.j.Hu w.H.Hu X.H.Hu Y.C.Hu j.Hua G.S.Huang j.S.Huang M.Huang Q.Y.Huang w.Q.Huang X.T.Huang X.j.Huang Y.B.Huang Y.S.Huang N.Hüsken V.Ivanov Q.P.j. j.j.j.a S.j.a Z.K.j.a H.B.j.ang j.j.ang S.Z.j.ang j.B.j.ao Z.j.ao H.j.j.ng X.L.Kang X.S.Kang B.C.Ke M.Kenzie A.Khoukaz I.Koop E.Kravchenko A.Kuzmin Y.Lei E.Levichev C.H.Li C.Li D.Y.Li F.Li G.Li G.Li H.B.Li H.Li H.N.Li H.j.Li H.L.Li j.M.Li j.Li L.Li L.Li L.Y.Li N.Li P.R.Li R.H.Li S.Li T.Li w.j.Li X.Li X.H.Li X.Q.Li X.H.Li Y.Li Y.Y.Li Z.j.Li H.Liang j.H.Liang Y.T.Liang G.R.Liao L.Z.Liao Y.Liao C.X.Lin D.X.Lin X.S.Lin B.j.Liu C.w.Liu D.Liu F.Liu G.M.Liu H.B.Liu j.Liu j.j.Liu j.B.Liu K.Liu K.Y.Liu K.Liu L.Liu Q.Liu S.B.Liu T.Liu X.Liu Y.w.Liu Y.Liu Y.L.Liu Z.Q.Liu Z.Y.Liu Z.w.Liu I.Logashenko Y.Long C.G.Lu j.X.Lu N.Lu Q.F.Lü Y.Lu Y.Lu Z.Lu P.Lukin F.j.Luo T.Luo X.F.Luo Y.H.Luo H.j.Lyu X.R.Lyu j.P.Ma P.Ma Y.Ma Y.M.Ma F.Maas S.Malde D.Matvienko Z.X.Meng R.Mitchell A.Nefediev Y.Nefedov S.L.Olsen Q.Ouyang P.Pakhlov G.Pakhlova X.Pan Y.Pan E.Passemar Y.P.Pei H.P.Peng L.Peng X.Y.Peng X.j.Peng K.Peters S.Pivovarov E.Pyata B.B.Qi Y.Q.Qi w.B.Qian Y.Qian C.F.Qiao j.j.Qin j.j.Qin L.Q.Qin X.S.Qin T.L.Qiu j.Rademacker C.F.Redmer H.Y.Sang Anhui University Hefei 230039China Beihang University Beijing 100191China Budker Institute of Nuclear Physics Novosibirsk 630090Russia CAS Key Laboratory of Theoretical Physics Institute of Theoretical PhysicsChinese Academy of SciencesBeijing 100190China Cavendish Laboratory University of CambridgeJJ Thomson AveCambridge CB30HEUnited Kingdom Central China Normal University Wuhan 430079China Central South University Changsha 410083China China University of Geosciences Wuhan 430074China China University of Mining and Technology Xuzhou 221116China École Polytechnique Fédérale de Lausanne(EPFL) LausanneSwitzerland Fudan University Shanghai 200433China Goethe University Frankfurt D-60325 Frankfurt am MainGermany Guangxi Normal University Guilin 541004China Guangxi Uninversity Nanning 530004China Hangzhou Institute for Advanced Study UCASHangzhou 310024China Hebei Normal University Shijiazhuang 050024China Hebei University Baoding 071002China Hefei University of Technology Hefei 230601China Helmholtz Institute Mainz Staudinger Weg 18D-55099 MainzGermany Henan Normal University Xinxiang 453007China Henan University Kaifeng 475004China High Energy Physics Center Chung-Ang UniversitySeoul 06974Korea Higher School of Economy 11 Pokrovsky Bulvar Moscow 109028Russia Huangshan University Huangshan 245000China Hubei University of Automotive Technology Shiyan 442002China Hunan Normal University Changsha 410081China Hunan University of Science and Technology Xiangtan 411201China Hunan University Changsha 410082China Indiana University BloomingtonIndiana 47405USA Inner Mongolia University Hohhot 010021China Institute of Advanced Science Facilities Shenzhen 518107China Institute of High Energy Physics Chinese Academy of SciencesBeijing 100049China Institute of Modern Physics Chinese Academy of SciencesLanzhou 730000China Institute of Physics Academia SinicaTaipeiTaiwan 11529China Institute of Theoretical Physics Chinese Academy of SciencesBeijing 100190China j.lin University Changch

The superτ-charm facility(STCF)is an electron–positron collider proposed by the Chinese particle physics *** is designed to operate in a center-of-mass energy range from 2 to 7 GeV with a peak luminosity of 0.5×10^(35) cm^(–2)·s^(–1) or *** STCF will produce a data sample about a factor of 100 larger than that of the presentτ-charm factory—the BEPCII,providing a unique platform for exploring the asymmetry of matter-antimatter(charge-parity violation),in-depth studies of the internal structure of hadrons and the nature of non-perturbative strong interactions,as well as searching for exotic hadrons and physics beyond the Standard *** STCF proj.ct in China is under development with an extensive R&D *** document presents the physics opportunities at the STCF,describes conceptual designs of the STCF detector system,and discusses future plans for detector R&D and physics case studies.

关键词： electron–positron collider tau-charm region high luminosity STCF detector conceptual design

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Seasonal changes in Hermit Thrush (Catharus guttatus) song syntax

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Avian Research 2024年第2期15卷 172-179页

作者： Sean P.Roach Luke C.McLean j.ff w.MacLeod Leslie S.Phillmore Psychology Department University of New Brunswick Saint John100 Tucker Park RoadSaint JohnNBCanada Department of Psychology and Neuroscience Dalhousie University1355 Oxford StHalifaxNSB3H 4J1Canada

In many songbird species,birdsong features phonological syntax,meaning that the units within their vocal se-quences are ordered in a non-random way that adheres to a *** such syntactical patterns have been richly described in many species,comparatively little is known about how those patterns contribute to song achieving its important *** each of song’s main functions,territorial defense and mate attraction,evidence of a role for syntax is *** species for which syntax has been thoroughly described is the Hermit Thrush(Catharus guttatus),which presents song types from their repertoires in a semi-predictable order and,in doing so,rapidly cycle up and down the frequency *** obj.ctive of the present study was to explore the importance of song syntax in the Hermit Thrush through a within-subj.ct examination of how measures of syntax,such as the predictability of song type order within song sequences,shift over the breeding *** hypothesized that,if such syntactical characteristics are important to breeding behaviour,they would be most prominent at the start of the breeding season when activity associated with territory establishment and mate attraction is most *** revealed that,as predicted,the rigidness of song type ordering within se-quences was highest at the start of the season and declined *** song type sequences were most predictable at the vitally important early part of the breeding season fit our hypothesis that this aspect of song syntax is important to song’s functions related to territory establishment and/or mate *** work will clarify whether that role relates to one of song’s two main functions or serves song transmission in some broader way.

关键词： Birdsong Hermit Thrush Seasonal change Stereotypy Syntax

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A functional tacrolimus-releasing nerve wrap for enhancing nerve regeneration follow.ng surgical nerve repair

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Neural Regeneration Research 2025年第1期20卷 291-304页

作者： Simeon C.Daeschler Katelyn j.w.So Konstantin Feinberg Marina Manoraj.j.nny Cheung j.nnifer Zhang Kaveh Mirmoeini j.aul Santerre Tessa Gordon Gregory HBorschel SickKids Research Institute Neuroscience and Mental Health ProgramTorontoONCanada Institute of Biomaterials and Biomedical Engineering University of TorontoTorontoONCanada Indiana University School of Medicine IndianapolisINUSA Division of Plastic and Reconstructive Surgery the Hospital for Sick ChildrenTorontoONCanada Translational Biology and Engineering Program Ted Rogers Centre for Heart ResearchInstitute of Biomedical EngineeringFaculty of DentistryUniversity of TorontoTorontoONCanada

Axonal regeneration follow.ng surgical nerve repair is slow and often incomplete,resulting in poor functional recovery which sometimes contributes to lifelong ***,there are no FDA-approved therapies available to promote nerve *** accelerates axonal regeneration,but systemic side effects presently outweigh its potential benefits for peripheral nerve *** authors describe herein a biodegradable polyurethane-based drug delivery system for the sustained local release of tacrolimus at the nerve repair site,with suitable properties for scalable production and clinical application,aiming to promote nerve regeneration and functional recovery with minimal systemic drug *** is encapsulated into co-axially electrospun polycarbonate-urethane nanofibers to generate an implantable nerve wrap that releases therapeutic doses of bioactive tacrolimus over 31 *** and drug loading are adj.stable for applications in small and large caliber nerves,and the wrap degrades within 120 days into biocompatible *** released from the nerve wrap promotes axon elongation in vitro and accelerates nerve regeneration and functional recovery in preclinical nerve repair models while off-target systemic drug exposure is reduced by 80%compared with systemic *** its surgical suitability and preclinical efficacy and safety,this system may provide a readily translatable approach to support axonal regeneration and recovery in patients undergoing nerve surgery.

关键词： biodegradable local drug delivery nerve inj.ry nerve regeneration nerve wrap tacrolimus

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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： j.son Philip Appleton Lisa j.woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala Mark Dixon Timothy j.England Kailash Krishnan Grant Mair Keith w Muir j.hn Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C Sandset j.ffrey L Saver Angela Shone Aloysius Niroshan Siriwardena j.anna 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],adj.sted 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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