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| 1 | 联合阿司匹林及氯吡格雷双抗治疗急性高危短暂性脑缺血发作及轻度缺血性卒中:一份临床实践指南显示文摘双抗治疗对于高危的短暂性脑缺血发作及轻度卒中患者的治疗效果如何?更具体来说,24小时内给予联合阿司匹林及氯吡格雷的双抗治疗与单用阿司匹林相比,是否会降低高危短暂性脑缺血发作及轻度卒中患者的卒中再发生率及病死率?专家团队目前积极推荐发病后24小时内开启双抗治疗,并持续治疗10-21天。而目前的临床实践一般使用单抗。 | Kameshwar Prasad Reed Siemieniuk Qiukui Hao Gordon Guyatt Martin O Donnell Lyubov Lytvyn Anja Fog Heen Thomas Agoritsas Per Olav Vandvik Sankar Prasad Gorthi Loraine Fisch Mirza Jusufovic Jennifer Muller Brenda Booth Eleanor Horton Auxiliadora Fraiz Jillian Siemieniuk Awah Cletus Fobuzi Neelima Katragunta Bram Rochwerg 李洁(译) 毛晨晖(校) | 2019 | 英国医学杂志中文版2019，22，5： | 1 |
| 2 | Decline in stroke alerts and hospitalisations during the COVID-19 pandemic显示文摘Introduction Patients with stroke-like symptoms may be underutilising emergency medical services and avoiding hospitalisation during the COVID-19 pandemic.We investigated a decline in admissions for stroke and transient ischaemic attack(TIA)and emergency department(ED)stroke alert activations.Methods We retrospectively compiled total weekly hospital admissions for stroke and TIA between 31 December 2018 and 21 April 2019 versus 30 December 2019 and 19 April 2020 at five US tertiary academic comprehensive stroke centres in cities with early COVID-19 outbreaks in Boston,New York City,Providence and Seattle.We collected available data on ED stroke alerts,stroke severity using the National Institutes of Health Stroke Scale(NIHSS)and time from symptom onset to hospital arrival.Results Compared with 31 December 2018 to 21 April 2019,a decline in stroke/TIA admissions and ED stroke alerts occurred during 30 December 2019 to 19 April 2020(p trend<0.001 for each).The declines coincided with state stay-at home recommendations in late March.The greatest decline in hospital admissions was observed between 23 March and 19 April 2020,with a 31%decline compared with the corresponding weeks in 2019.Three of the five centres with 2019 and 2020 stroke alert data had a 46%decline in ED stroke alerts in late March and April 2020,compared with 2019.Median baseline NIHSS during these 4 weeks was 10 in 2020 and 7 in 2019.There was no difference in time from symptom onset to hospital arrival.Conclusion At these five large academic US hospitals,admissions for stroke and TIA declined during the COVID-19 pandemic.There was a trend for fewer ED stroke alerts at three of the five centres with available 2019 and 2020 data.Acute stroke therapies are time-sensitive,so decreased healthcare access or utilisation may lead to more disabling or fatal strokes,or more severe non-neurological complications related to stroke.Our findings underscore the indirect effects of this pandemic.Public health officials,hospital systems and healthcare providers must continue to encourage patients with stroke to seek acute care during this crisis. | Malveeka Sharma Vasileios-Arsenios Lioutas Tracy Madsen Judith Clark Jillian O'Sullivan Mitchell S.VElkind Joshua Z.Willey Randolph S.Marshall Magdy H.Selim David Greer David L.Tirschwell Tina Burton Amelia Boehme Hugo J.Aparicio | 2020 | Stroke & Vascular Neurology2020，5，4： | 1 |
| 3 | Predictors of surgical complications in boys with hypospadias:data from an international registry显示文摘Background Complications are frequently reported after hypospadias repair and there is a need to understand the factors that influence their occurrence.Methods Data from boys with hypospadias born between 2000 and 2020 were obtained from the International Disorders of Sex Development(l-DSD)Registry.Logistic regressions,fisher's exact tests and spearman's correlation tests were performed on the data to assess associations between clinical factors and complication rates.Results Of the 551 eligible boys,data were available on 160(29%).Within the cohort,the median(range)External Masculinization Score(EMS)was 6(2,9).All presented with one or more additional genital malformation and 61(38%)presented with additional extragenital malformations.Disorders of androgen action,androgen synthesis and gonadal development were diagnosed in 28(18%),22(14%)and 9(6%)boys,respectively.The remaining 101(62%)patients were diagnosedas having non-specific 46,XY Disorders of Sex Development.Eighty(50%)boys had evidence of abnormal biochemistry,and gene variants were identified in 42(26%).Median age at first hypospadias surgery was 2 years(0,9),and median length of follow-up was 5 years(0,17).Postsurgical complications were noted in 102(64%)boys.There were no significant associations with postsurgical complications.Conclusions Boys with proximal hypospadias in the I-DSD Registry have high rates of additional comorbidities and a high risk of postoperative complications.No clinical factors were significantly associated with complication rates.High complication rates with no observable cause suggest the involvement of other factors which need investigation. | Kathryn Scougall Jillian Bryce Federico Baronio Rachel L Boal Jose Roberto Castera Sebastián Castro Tim Cheetham Eduardo Correa Costa Feyza Darendeliler Justin H Davies Mirjam Dirlewanger Gabriella Gazdagh Evgenia Globa Gil Guerra-Junior Tulay Guran Gloria Herrmann Paul-Martin Holterhus Ahsen KaragözlüAkgül Renata Markosyan Kenneth McElreavey Marcio Lopes Miranda Anna Nordenstrom Stuart O’Toole Sukran Poyrazoglu Gianni Russo Valerie Schwitzgebel Marianna Stancampiano Michael Steigert S Faisal Ahmed Angela K Lucas-Herald | 2023 | World Journal of Pediatric Surgery2023，6，4： | 0 |
| 4 | Undergraduate Design and Analysis of a LEED Certified Building显示文摘In this technical and educational research endeavor, a diverse group of civil engineering students took on the role of creating the means and methods of producing a successful building design. Architectural, structural, and environmental designs were primarily performed. This was followed by detailed cost analysis with the intent of providing a realistic cost comparison by pricing the intended building, using traditional material and typical building methods, versus pricing the building using recycled material and new present-day technology. Some green features needed to achieve a LEED (Leadership in Energy and Environmental Design) gold certification were considered and applied. It is shown that producing a green building is more costly in present circumstances;however, the additional cost due to greenification pays itself off throughout the years giving in return saving features. Even though the design of a green building comes with detailed planning and costly material, it does generate benefits for the building owner, the society, and most importantly the environment. | Lance Narcida Madison O’Dell Mynor Pacheco Carlos Perla Victor Ramirez Damian Sanchez Jillian Shoemaker Louisa Songco Tadeh Zirakian David Boyajian | 2022 | Journal of Civil Engineering and Architecture2022，16，5： | 0 |
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