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Linking the Paul Coverdell National Acute stroke Program to commercial claims to establish a framework for real-world longitudinal stroke research

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stroke & Vascular Neurology 2022年第2期7卷 114-123页

作者： Elisabetta Patorno Sebastian Schneeweiss Mary G George Xin Tong Jessica M Franklin Ajinkya Pawar Helen Mogun Lidia M V R Moura Lee H Schwamm Division of Pharmacoepidemiology and Pharmacoeconomics Department of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA Division for Heart Disease and stroke Prevention NCCDPHPCenters for Disease Control and PreventionAtlantaGeorgiaUSA Epilepsy and Neurophysiology Division Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA Fireman Vascular Center and stroke Division Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA

Background Non-interventional large-scale research on real-world patients who had a stroke requires the use of multiple data sources ensuring access to longitudinal data from large populations with clinically-detailed *** sought to establish a framework for longitudinal research on patients hospitalised with stroke by linking information-rich,deidentified inpatient data from the Paul Coverdell National Acute stroke Program(PCNASP)to commercial and Medicare Advantage longitudinal claims *** All stroke admissions in PCNASP between 2008 and 2015 were evaluated for linkage to longitudinal claims from a commercial insurer using an algorithm based on six available common data fields(patient age,gender,admission date,discharge date,discharge diagnosis and state)and a hospital *** evaluated the linkage quality(via the percentage of unique records in the linked dataset)and the representativeness of the linked *** also described medical history,stroke severity and patterns of medication use among the PCNASP-claims linked *** The linkage produced uniqueness equal to 99.1%.We identified 5644 linked and 98896 unlinked patients who had an ischaemic stroke hospitalisation in claims *** patients were younger than unlinked(69.7 vs 72.5 years),but otherwise similar by medical history,prestroke medication use or lab *** severity was mild and most patients were discharged *** and discharge use of antihypertensive and statins in the PCNASP were greater than their use as measured by filled prescriptions in *** High-quality linkage between the PCNASP and commercial claims data is *** linkage identified differences between reported or recommended versus actual out-of-hospital medication utilisation,highlighting the importance of longitudinal data availability for research aimed to improve the care of patients who had a stroke.

关键词： linkage claims younger

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Evaluation of right-to-left shunt on contrast-enhanced transcranial Doppler in patent foramen ovale-related cryptogenic stroke: research based on imaging

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World Journal of Clinical Cases 2022年第1期10卷 143-154页

作者： Lei Xiao Yan-Hong Yan Ya-Fang Ding Man Liu Li-Juan Kong Chun-Hong Hu Pin-Jing Hui stroke Center the First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina Department of Radiology the First Affiliated Hospital of Soochow UniversitySuzhou 215006Jiangsu ProvinceChina

BACKGROUND Cardiogenic embolism caused by patent foramen ovale(PFO)is a common etiology of cryptogenic stroke(CS),particularly in young and middle-aged *** about right-to-left shunt(RLS)detection using contrast-enhanced transcranial Doppler(c-TCD)are *** to the time phase and number of microbubbles detected on c-TCD,RLS can be classified and *** hypothesized that the characteristics of an infarction lesion on diffusion-weighted imaging differs when combining the type and grade of RLS on c-TCD in patients with PFO-related *** To explore the characteristics of infarction lesions on diffusion-weighted imaging when combining the RLS type and grade determined by *** We retrospectively evaluated CS patients from August 2015 to December 2019 at a tertiary *** total,111 PFO-related CS patients were divided according to whether RLS was permanent(microbubbles detected both at resting state and after the Valsalva maneuver)or latent(microbubbles detected only after the Valsalva maneuver)on *** group was subdivided into small,mild and large RLS according to the grade of shunt on c-TCD.A normal control group was composed of 33 patients who suffered from simple *** and intergroup differences were analyzed in terms of clinical,laboratory and diffusion-weighted imaging lesion *** correlation between RLS grade evaluated by c-TCD and size of PFO determined by transesophageal echocardiography were also *** In 111 patients with PFO-related CS,68 had permanent RLS and 43 had latent *** characteristics and laboratory tests were not significantly different among the permanent RLS,latent RLS and normal control *** proportion of patients with multiple territory lesions in the permanent RLS group(50%)was larger than that in the latent RLS group(27.91%;P=0.021).Posterior circulation was more likely to be affected in the latent RLS group than in the permanent RLS group(30.

关键词： Cryptogenic stroke Patent foramen ovale Right-to-left shunt Contrastenhanced transcranial Doppler Transesophageal echocardiography

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Advancement in stroke research

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stroke & Vascular Neurology 2019年第2期4卷 61-62页

作者： Guo-Yuan Yang Neuroscience and Neuroengineering Center Med-X Research Institute and School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina

stroke is the second most common cause of death in the world especially in the ageing population.1 Thrombolysis and intravascular embolectomy are the main treatment and populated rapidly.23 However,the benefi-ciary is still limited because the mechanistic studies are *** basic research on stroke is improved because of new devices,novel techniques and the development of other disciplines.4 The update of a broad range of topics related to stroke is a widely appreciated *** order to improve the understanding of cellular and molecular mechanisms of stroke,the 2nd Summit of Chinese Basic Science research on stroke 2018 has been held in Beijing,China.

关键词： population. death intravascular

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Perilipin-2 mediates ferroptosis in oligodendrocyte progenitor cells and myelin injury after ischemic stroke

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Neural Regeneration research 2025年第7期20卷 2015-2028页

作者： Jian Yang Jiang Wu Xueshun Xie Pengfei Xia Jinxin Lu Jiale Liu Lei Bai Xiang Li Zhengquan Yu Haiying Li Department of Neurosurgery&Brain and Nerve research Laboratory The First Affiliated Hospital of Soochow UniversitySuzhouJiangsu ProvinceChina Institute of stroke research Soochow UniversitySuzhouJiangsu ProvinceChina

Differentiation of oligodendrocyte progenitor cells into mature myelin-forming oligodendrocytes contributes to *** of remyelination due to oligodendrocyte progenitor cell death can result in severe nerve *** is an iron-dependent form of regulated cell death caused by membrane rupture induced by lipid peroxidation,and plays an important role in the pathological process of ischemic ***,there are few studies on oligodendrocyte progenitor cell *** analyzed transcriptome sequencing data from GEO databases and identified a role of ferroptosis in oligodendrocyte progenitor cell death and myelin injury after cerebral *** analysis suggested that perilipin-2(PLIN2)was involved in oligodendrocyte progenitor cell ***2 is a lipid storage protein and a marker of hypoxia-sensitive lipid droplet *** further investigation,we established a mouse model of cerebral ischemia/*** found significant myelin damage after cerebral ischemia,as well as oligodendrocyte progenitor cell death and increased lipid peroxidation levels around the infarct *** ferroptosis inhibitor,ferrostatin-1,rescued oligodendrocyte progenitor cell death and subsequent myelin *** also found increased PLIN2 levels in the peri-infarct area that co-localized with oligodendrocyte progenitor ***2 knockdown rescued demyelination and improved neurological *** findings suggest that targeting PLIN2 to regulate oligodendrocyte progenitor cell ferroptosis may be a potential therapeutic strategy for rescuing myelin damage after cerebral ischemia.

关键词： bioinformatics bulk RNA sequencing ferroptosis ischemic stroke myelin injury oligodendrocyte progenitor cell perilipin-2 single-cell RNA sequencing

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Tau in the pancreas:understanding the link between type 2 diabetes mellitus and Alzheimer's disease

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Signal Transduction and Targeted Therapy 2024年第1期9卷 6-7页

作者： Wenlu Li Steffen Tiedt Eng H.Lo Neuroprotection research Laboratories Departments of Radiology and NeurologyMassachusetts General HospitalHarvard Medical SchoolCharlestownMA02129USA Consortium International pour la Recherche Circadienne sur l’AVC(CIRCA) BostonUSA Institute for stroke and Dementia research LMU University HospitalLMU MunichMunichGermany

A recent study published in Molecular Psychiatry proposes a cellular mechanism that may contribute to decreased insulin production in individuals with type 2 diabetes mellitus(T2DM).1 Using a combination of cell culture experiments,animal models and studies in T2DM patients,the authors show that an up-regulation of tau inβ-islet cells can inhibit pancreatic insulin secretion through changes in microtubule assembly.

关键词： T2DM Alzheimer tau

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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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Emerging strategies for nerve repair and regeneration in ischemic stroke:neural stem cell therapy

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Neural Regeneration research 2024年第11期19卷 2430-2443页

作者： Siji Wang Qianyan He Yang Qu Wenjing Yin Ruoyu Zhao Xuyutian Wang Yi Yang Zhen-Ni Guo stroke Center Department of Neurologythe First Hospital of Jilin UniversityChangchunJilin ProvinceChina Neuroscience research Center Department of Neurologythe First Hospital of Jilin UniversityChangchunJilin ProvinceChina Department of Breast Surgery General Surgery Centerthe First Hospital of Jilin UniversityChangchunJilin ProvinceChina

Ischemic stroke is a major cause of mortality and disability worldwide,with limited treatment options available in clinical *** emergence of stem cell therapy has provided new hope to the field of stroke treatment via the restoration of brain neuron *** neural stem cells are beneficial not only in cell replacement but also through the bystander *** stem cells regulate multiple physiological responses,including nerve repair,endogenous regeneration,immune function,and blood-brain barrier permeability,through the secretion of bioactive substances,including extracellular vesicles/***,due to the complex microenvironment of ischemic cerebrovascular events and the low survival rate of neural stem cells following transplantation,limitations in the treatment effect remain *** this paper,we provide a detailed summary of the potential mechanisms of neural stem cell therapy for the treatment of ischemic stroke,review current neural stem cell therapeutic strategies and clinical trial results,and summarize the latest advancements in neural stem cell engineering to improve the survival rate of neural stem *** hope that this review could help provide insight into the therapeutic potential of neural stem cells and guide future scientific endeavors on neural stem cells.

关键词： bystander effect cell replacement extracellular vesicles ischemic stroke neural stem cells neural stem cell engineering

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Status of biomarker development for frontotemporal dementia and amyotrophic lateral sclerosis

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Neural Regeneration research 2024年第10期19卷 2117-2118页

作者： Yue Yang Qi Cheng Jianqun Gao Woojin Scott Kim Brain and Mind Centre&School of Medical Sciences The University of SydneySydneyNSWAustralia Department of Neurology and Neurophysiology Liverpool HospitalSydneyNSWAustralia stroke and Neurology research Group Ingham Institute for Applied Medical ResearchSydneyNSWAustralia Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation ShanghaiChina Clinical research Center for Anesthesiology and Perioperative Medicine ShanghaiChina Translational research Institute of Brain and Brain-Like Intelligence Shanghai Fourth People’s HospitalSchool of MedicineTongji UniversityShanghaiChina

Frontotemporal dementia(FTD) and amyotrophic lateral sclerosis(ALS) are neurodegenerative diseases that belong to the same disease spectrum,with overlapping of genetic and pathological *** mutations in TARDBP,C9ORF72,... 详细信息

关键词： amyotrophic sclerosis diseases

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Exosomes:the next-generation therapeutic platform for ischemic stroke

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Neural Regeneration research 2025年第5期20卷 1221-1235页

作者： Wenjing Yin Hongyin Ma Yang Qu Jiaxin Ren Yingying Sun Zhen-Ni Guo Yi Yang stroke Center Department of NeurologyFirst Hospital of Jilin UniversityChangchunJilin ProvinceChina Neuroscience research Center Department of NeurologyFirst Hospital of Jilin UniversityChangchunJilin ProvinceChina

Current therapeutic strategies for ischemic stroke fall short of the desired objective of neurological functional ***,there is an urgent need to develop new methods for the treatment of this *** are natural cell-derived vesicles that mediate signal transduction between cells under physiological and pathological *** have low immunogenicity,good stability,high delivery efficiency,and the ability to cross the blood–brain *** physiological properties of exosomes have the potential to lead to new breakthroughs in the treatment of ischemic *** rapid development of nanotechnology has advanced the application of engineered exosomes,which can effectively improve targeting ability,enhance therapeutic efficacy,and minimize the dosages *** in technology have also driven clinical translational research on *** this review,we describe the therapeutic effects of exosomes and their positive roles in current treatment strategies for ischemic stroke,including their antiinflammation,anti-apoptosis,autophagy-regulation,angiogenesis,neurogenesis,and glial scar formation reduction ***,it is worth noting that,despite their significant therapeutic potential,there remains a dearth of standardized characterization methods and efficient isolation techniques capable of producing highly purified *** optimization strategies should prioritize the exploration of suitable isolation techniques and the establishment of unified workflows to effectively harness exosomes for diagnostic or therapeutic applications in ischemic ***,our review aims to summarize our understanding of exosome-based treatment prospects in ischemic stroke and foster innovative ideas for the development of exosome-based therapies.

关键词： blood–brain barrier electroacupuncture engineering exercise exosomes ischemic stroke mesenchymal stem cells microglia neuroprotection stents

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Recent research in mechanical properties of geopolymer-based ultrahigh-performance concrete:A review

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Defence Technology（防务技术） 2024年第2期32卷 67-88页

作者： G.Murali Division of research&Innovation Uttaranchal UniversityDehradun 248007India

Due to the growing need for sustainable and ultra-high-strength construction materials,scientists have created an innovative ultra-high-performance concrete called Geopolymer based ultra-highperformance concrete(GUHPC).Besides,in the last few decades,there have been a lot of explosions and ballistic attacks around the world,which have killed many civilians and fighters in border *** this context,this article reviews the fresh state and mechanical properties of ***,the ingredients of GUHPC and fresh properties such as setting time and flowability are briefly ***,the review of compressive strength,flexure strength,tensile strength and modulus of elasticity of fibrous ***,the blast and projectile impact resistance performance was ***,the microstructural characteristics were reviewed using the scanning electron microscope and X-ray Powder *** review outcome reveals that the mechanical properties were increased when 30%silica fume was added to a higher dose of steel fibre to improve the microstructure of *** is hypothesized that the brittleness of GUHPC was mitigated by adding 1.5%steel fibre reinforcement,which played a role in the decrease of contact explosion cratering and *** the need for cement in GUHPC was a key factor in the review,indicating a promising potential for lowering carbon ***,GUHPC research is still in its early stages,so more study is required before its full potential can be utilized.

关键词： Mechanical properties Blast Projectile impact Fibre Geopolymer Silica fume Alkaline activators

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