34,201 research outputs found
Antihypertensive Drugs for Secondary Prevention after Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis
No full textBackground and Purpose: Approximately 30% of ischemic strokes occur after a previous stroke or transient ischemic attack. Arterial hypertension is one of the best established risk factors for first and recurrent stroke, both ischemic and hemorrhagic. Guidelines for the secondary prevention of ischemic stroke support the use of blood pressure (BP)-lowering drugs in most patients. However, the evidence for these recommendations comes from meta-analyses that included both ischemic and hemorrhagic stroke patients, whereas these 2 conditions differ quantitatively in several aspects. With this systematic review and meta-analysis, we aimed at summarizing the current evidence on BP-lowering drugs for secondary prevention in patients with ischemic stroke or transient ischemic attack. Methods: We searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to January 31, 2020. We included randomized controlled trials comparing any specific BP-lowering drug, as monotherapy or combination, with either a control or another BP-lowering drug. Results: Eight studies that enrolled 33 774 patients with ischemic stroke or transient ischemic attack were included in the meta-analysis. Mean follow-up was 25 months (range, 3-48). Moderate-quality evidence indicated that a subsequent stroke occurred in 7.9% (ischemic in 7.4% or hemorrhagic in 0.6%) of patients taking any type of BP-lowering drug compared with 9.7% of patients taking placebo (odds ratio, 0.79 [95% CI, 0.66-0.94]; absolute risk difference, -1.9% [95% CI, -3.1% to -0.5%]). Moderate-quality evidence indicated that mortality occurred similarly in patients taking any type of BP-lowering treatment compared with placebo, with an absolute risk of 7.3% and 7.9%, respectively (odds ratio, 1.01 [95% CI, 0.92-1.10]; absolute risk difference, 0.1% [95% CI, -0.6% to 0.7%]). Conclusions: The use of BP-lowering drugs in patients with ischemic stroke or transient ischemic attack is associated with a 1.9% risk reduction of stroke but does not affect the all-cause mortality risk
Dispelling the Myths Behind First-author Citation Counts
No full textWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Stem cell transplantation for ischemic stroke
No full textBackground Stroke is a leading cause of morbidity and mortality worldwide, with very large healthcare and social costs, and a strong demand for alternative therapeutic approaches. Preclinical studies have shown that stem cells transplanted into the brain can lead to functional improvement. However, to date, evidence for the benefits of stem cell transplantation in people with ischemic stroke is lacking. This is the first update of the Cochrane review published in 2010. Objectives To assess the efficacy and safety of stem cell transplantation compared with control in people with ischemic stroke. Search methods We searched the Cochrane Stroke Group Trials Register (last searched August 2018), CENTRAL (last searched August 2018), MED-LINE (1966 to August 2018), Embase (1980 to August 2018), and BIOSIS (1926 to August 2018). We handsearched potentially relevant conference proceedings, screened reference lists, and searched ongoing trials and research registers (last searched August 2018). We also contacted individuals active in the field and stem cell manufacturers (last contacted August 2018). Selection criteria We included randomized controlled trials (RCTs) that recruited people with ischemic stroke, in any phase of the disease (acute, subacute or chronic), and an ischemic lesion confirmed by computerized tomography or magnetic resonance imaging scan. We included all types of stem cell transplantation, regardless of cell source (autograft, allograft, or xenograft; embryonic, fetal, or adult; from brain or other tissues), route of cell administration (systemic or local), and dosage. The primary outcome was efficacy (assessed as neurologic impairment or functional outcome) at longer term follow-up (minimum six months). Secondary outcomes included post-procedure safety outcomes (death, worsening of neurological deficit, infections, and neoplastic transformation). Data collection and analysis Two review authors independently applied the inclusion criteria, assessed trial quality and risk of bias, and extracted data. If needed, we contacted study authors for additional information. We performed random effects meta-analyses when two or more RCTs were available for any outcome. We assessed the certainty of the evidence by using the GRADE approach. Main results In this updated review, we included seven completed RCTs with 401 participants. All tested adult human non-neural stem cells; cells were transplanted during the acute, subacute, or chronic phase of ischemic stroke; administered intravenously, intra-arterially, intracerebrally, or into the lumbar subarachnoid space. Follow-up ranged from six months to seven years. Efficacy outcomes were measured with the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), or Barthel Index (BI). Safety outcomes included case fatality, and were measured at the end of the trial. Overall, stem cell transplantation was associated with a better clinical outcome when measured with the NIHSS (mean difference [MD]-1.49, 95% confidence interval [CI]-2.65 to-0.33; five studies, 319 participants; low-certainty evidence), but not with the mRS (MD-0.42, 95% CI-0.86 to 0.02; six studies, 371 participants; very low-certainty evidence), or the BI (MD 14.09, 95% CI-1.94 to 30.13; three studies, 170 participants; very low-certainty evidence). The studies in favor of stem cell transplantation had, on average, a higher risk of bias, and a sample size of 32 or fewer participants. No significant safety concerns associated with stem cell transplantation were raised with respect to death (risk ratio [RR] 0.66, 95% CI 0.39 to 1.14; six studies, participants; low-certainty evidence). We were not able to perform the sensitivity analysis according to the quality of studies, because all of them were at high risk of bias. Authors’ conclusions Overall, in participants with ischemic stroke, stem cell transplantation was associated with a reduced neurological impairment, but not with a better functional outcome. No obvious safety concerns were raised. However, these conclusions came mostly from small RCTs with high risk of bias, and the certainty of the evidence ranged from low to very low. More well-designed trials are needed
Antiplatelet drugs for secondary prevention in patients with ischemic stroke or transient ischemic attack: a systematic review and network meta-analysis
No full textBackground: Antiplatelet drugs may prevent recurrent ischemic events after ischemic stroke but their relative effectiveness and harms still need to be clarified. Within this network meta-analysis we aimed to summarize the current evidence for using antiplatelet drugs for secondary stroke prevention. Methods: We searched MEDLINE, EMBASE and CENTRAL up to September 2020. Randomized controlled trials (RCTs) assessing antiplatelet drugs for secondary stroke prevention were included. We did pairwise meta-analyses and network meta-analyses using random-effects models. Primary outcomes were all strokes (ischemic or hemorrhagic) and all-cause mortality. Results: The review included 57 RCTs, 50 (n = 165,533 participants) provided data for the meta-analyses. Compared to placebo/no treatment, moderate to high-confidence evidence indicated that cilostazol, clopidogrel, dipyridamole + aspirin, ticagrelor, ticlopidine, and aspirin ≤ 150 mg/day significantly reduced the risk of all strokes (odds ratios, ORs and absolute risk difference, ARD): cilostazol 0.51 (95 % confidence interval, CI, 0.37 to 0.71; 3.6 % fewer), clopidogrel 0.63 (95 % CI, 0.49 to 0.79; 2.7 % fewer), dipyridamole + aspirin 0.65 (95 % CI, 0.55 to 0.78; 2.5 % fewer), ticagrelor 0.68 (95 % CI, 0.50 to 0.93; 2.3 % fewer), ticlopidine 0.74 (95 % CI 0.59 to 0.93; 1.9 % fewer), aspirin ≤ 150 mg/day 0.79 (95 % CI, 0.66 to 0.95; 1.5 % fewer). Aspirin > 150 mg/day and the combinations clopidogrel/aspirin, ticagrelor/aspirin, also decrease all strokes but increase the risk of hemorrhagic events. Only aspirin > 150 mg/day significantly reduced all-cause mortality (OR 0.86, 95 % CI 0.76 to 0.97; ARD 0.9 %, 95 %CI 1.5–0.2 % fewer, moderate confidence). Compared to aspirin ≤ 150 mg/day, clopidogrel significantly reduced the risk of all strokes, cardiovascular events, and intracranial hemorrhage outcomes. Cilostazol also appeared to provide advantages but data are limited to the Asian population. Conclusions: Considering the benefits and harms ratio, cilostazol, clopidogrel, dipyridamole + aspirin, ticagrelor, ticlopidine, and aspirin ≤ 150 mg/day appear to be the best choices as antiplatelet drugs for secondary prevention of patients with ischemic stroke or TIA. Systematic review registration: PROSPERO CRD42020159896
THE TRANSITION OF MOLECULAR OXYGEN
No full textAuthor Institution: Research School of Physical Sciences and Engineering, The Australian National University; Molecular Physics Laboratory, SRI InternationalThe origin of the intensity of the transition of molecular oxygen, first observed recently by Eppink et al. [J. Chem. Phys. 108, 1305 (1998).], is discussed. It is shown that the transition borrows its intensity principally from the dipole-allowed transition, through spin-orbit mixing between the and states. Estimated continuum photoabsorption cross sections and discrete oscillator strengths for the system are presented
Observations of Bºs→ψ(2S)η and Bº(s)→ψ(2S)π+π- decays
No full textFirst observations of the B0s
→ψ(2S)η, B0 →ψ(2S)π
+
π
− and B0s
→ψ(2S)π
+
π
− decays are made
using a dataset corresponding to an integrated luminosity of 1.0 fb−1 collected by the LHCb experiment in
proton–proton collisions at a centre-of-mass energy of
√
s = 7 TeV. The ratios of the branching fractions
of each of the ψ(2S) modes with respect to the corresponding J/ψ decays are
B(B0s
→ψ(2S)η)
÷
B(B0s
→J/ψη)
= 0.83± 0.14 (stat)±0.12 (syst) ±0.02 (B),
;
B(B0→ψ(2S)π
+
π
−
)
÷
B(B0→J/ψπ
+
π
−
)
= 0.56± 0.07 (stat)±0.05 (syst)± 0.01 (B),
;
B(B0s
→ψ(2S)π
+
π
−
)
÷
B(B0s
→J/ψπ
+
π
−
)
= 0.34± 0.04 (stat)±0.03 (syst)± 0.01 (B),
where the third uncertainty corresponds to the uncertainties of the dilepton branching fractions of the J/ψ
and ψ(2S) meson decays
Additional file 1: of Comparison of statins for secondary prevention in patients with ischemic stroke or transient ischemic attack: a systematic review and network meta-analysis
No full textNetwork meta-analysis estimates and common standard deviation heterogeneity of primary and secondary outcomes for each comparison: all strokes (Table S1.), all-cause mortality (Table S2.), ischemic stroke (Table S3.), hemorrhagic stroke (Table S4.), cardiovascular event (Table S5.), and rhabdomyolysis, myalgia, or rise in creatine kinase (CK) (Table S6.). Treatments are reported in alphabetic order. Comparisons should be read from left to right. The estimate, odds ratio (OR), and 95% confidence interval are located at the intersection of the column-defining treatment and the row-defining treatment. An OR value below one favors the column-defining treatment for lower triangle, and the row-defining treatment for upper triangle. Significant results are bolded. Pairwise meta-analysis estimates of any statin versus placebo/no statin for primary and secondary outcomes overall, and by stroke subtypes at inclusion (Table S7.), treatment dose (Table S8.), and time from first ischemic event to randomization (Table S9.). Table S10. Sensitivity analysis of any statin versus placebo/no statin for primary and secondary outcomes overall, and including only trials classified as having low risk of bias. Table S11 Dataset underlying the findings of the meta-analyses. (DOCX 53 kb
The Grothendieck-Cousin complex on G/B x G/B
No full textIn his 1978 paper, The Grothendieck-Cousin complex of an induced representation, G. Kempf computes the Cousin complex corresponding to an induced representation of a reductive algebraic group G. His technique uses the geometry of the homogeneous space G/B, B being a Borel subgroup of G. The complex gives a resolution by B-modules, which easily yields the Weyl character formula.Instead of considering G/B, we analyze the analagous situation for . The Cousin complex corresponding to an induced representation in this case consists of G-modules. We are able to study the terms of the complex by exploiting parallels between the B-action on G/B and the G-action on --there is a natural one-to-one correspondence between the orbits of these actions. Our work here is greatly simplified by reducing to the affine situation and applying the theory of A-G modules. We construct a spectral sequence relating the terms of the complexes. Finally, an application to the theory of D-modules is given.Made available in DSpace on 2011-05-07T12:16:39Z (GMT). No. of bitstreams: 2
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G (A, B)-labeling of cacti over groups
No full text© 2016 Author(s). Let G be a group with nonempty subsets A and B. The graph G(A, B) is the simple graph obtained by deleting all loops from the graph whose vertex set is A and where vertices x and y are adjacent if and only if there is a b B such that xb = y or yb = x. In this paper, we present realizations of some cacti as G(A, B)\u27s
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