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Tenecteplase vs Alteplase in Acute Ischemic Stroke Within 4.5 Hours: A Systematic Review and Meta-Analysis of Randomized Trials.

The current European Stroke Organisation expedited recommendation on tenecteplase (TNK) for acute ischemic stroke (AIS) advocates that TNK 0.25 mg/kg can be used alternatively to alteplase (tissue plasminogen activator [TPA]) for AIS of <4.5 hours duration, based on a meta-analytical approach establishing noninferiority. Since the publication of these guidelines, 4 additional randomized controlled clinical trials (RCTs) have provided further insight. We conducted an updated systematic review and meta-analysis including all available RCTs that investigated efficacy and safety of TNK 0.25 mg/kg compared with TPA for the treatment of AIS within 4.5 hours of onset. The primary outcome was defined as the excellent functional outcome at 3 months (modified Rankin Scale [mRS] score 0-1), whereas good functional outcome (mRS score 0-2), reduced disability at 3 months (≥1-point reduction across all mRS scores), symptomatic intracranial hemorrhage (sICH), and 3-month mortality were evaluated as secondary outcomes. Pooled estimates were calculated with random-effects model. A prespecified subgroup analysis was performed stratifying for TNK formulation, that is, original TNK vs biocopy: recombinant human TNK tissue-type plasminogen activator that is available in China and has a different production process. Eleven RCTs were included comprising a total of 3,788 patients treated with TNK vs 3,757 patients treated with TPA. TNK was associated with higher likelihood of excellent functional outcome (risk ratio [RR] 1.05, 95% CI 1.01-1.10; p = 0.012; I2 = 0%; risk difference 2.95%; 95% CI 0.76%-5.14%; p = 0.008; I2 = 0%) and reduced disability at 3 months (common odds ratio 1.10, 95% CI 1.01-1.19; p = 0.034; I2 = 0%) compared with TPA while good functional outcome (RR 1.03, 95% CI 0.99-1.07; p = 0.142; I2 = 28%) was similar between the groups. Regarding safety outcomes, similar rates of sICH (RR 1.12, 95% CI 0.83-1.53; p = 0.456; I2 = 0%) and 3-month mortality (RR 0.97, 95% CI 0.82-1.15; p = 0.727; I2 = 12%) were observed. When stratified for TNK regimen (original vs biocopy), statistical significance in achieving an excellent functional outcome at 3 months was retained for the original TNK (RR 1.05, 95% CI 1.00-1.10; p = 0.044; I2 = 0%). The updated meta-analysis confirms similar safety between TNK 0.25 mg/kg and TPA, while showing that TNK is superior to TPA regarding excellent functional outcome and reduced disability at 3 months. These findings support transitioning to TNK in clinical practice.

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Antenna pattern reconstruction for mid-band massive antenna array based on a single-cut field transformation algorithm in a compact multi-probe anechoic chamber setup

ABSTRACT It has become a common challenge on how to measure radiation patterns of massive antenna arrays working at high frequency with high efficiency and accuracy, which has attracted huge interest from both academia and industry. In this paper, a highly accurate and efficient far field (FF) pattern reconstruction strategy through conducting single cut near field (NF) to FF transformation algorithm based on spherical wave expansion (SWE) is proposed for fast measurements of large base stations (BSs) operating at mid-band. Our objective is to design a compact multi-probe setup to measure key radiation parameters of the massive array, with low-cost and high-efficiency. A BS of 16 × 16 elements operating at mid-band is adopted as the device under test (DUT) in this paper. Analysis is conducted on the impact of measurement distance, sampling range and sampling density on the reconstruction accuracy of the algorithm in the compact multi-probe anechoic chamber setup, demonstrating that the required key information of the main lobe of the DUT can be accurately reconstructed when the measurement range R = 1/20 FF distance, sampling resolution ∆θ = 3°, and sampling range θ ∈ [75°, 105°] are selected, respectively. The impact of phase center offset on the accuracy of FF pattern reconstruction is analyzed when only one sub-array is enabled, demonstrating the effectiveness of the algorithm for sub-array measurements.

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Understanding community perspective on the heritage of locality: memory map methodology

PurposeCommunity involvement in heritage preservation requires appropriate approaches. Sanciai (in Lithuanian: Šanciai) historic district in Kaunas (Lithuania) has long-lasting military and industrial heritage, valuable urban structure and connections to the natural frame of the city. Sanciai residents’ willingness to participate in heritage preservation and urban planning prompted the aim of this research – to develop, test and present the mapping methodology, that would be applicable in the process of community involvement into heritage identification, preservation, interpretation and creation process.Design/methodology/approachThe methods of research included analysis of literature and theoretical research, development and testing of the methodology for the community involvement in heritage identification, preservation, interpretation and creation process. The workshop methodology and interactive online map are presented in this research. The memory map methodology developed and presented in this research includes the elements of mental mapping, design thinking and citizen science.FindingsThe methodology was tested in spring of 2021 in two-day online workshops with the students of pro-gymnasium located in Sanciai. Workshop participants together with workshop coordinator and moderators created different layers of the mental map, collected stories from the members of community and gathered the data for online interactive Sanciai memory map. The evaluation of the methodology and workshop results allowed concluding that memory map methodology is a functioning participant, community and research-oriented approach that can be applied in diverse heritage and community related circumstances.Originality/valueThe originality of the research is determined by the synergistic nature of developed memory map methodology which complements traditional mental mapping with creative hands-on techniques, empathy-oriented tasks and interactive online tool. Moreover, the research reveals the importance of local-global connections in urban studies as active local community became the stimulus for memory map methodology. The two-fold aim of the methodology – community cohesion and empowerment as well as research data collection – contributes to the originality of the research as well.

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Tribological properties of dual-freedom sliding roller pairs with a loss of lubrication

Purpose This paper aims to design a novel test device and study the wear properties and the thermal mechanisms of roller pairs in dual-freedom sliding contacts. Design/methodology/approach On the transition process of lubrication regimes, experiments were conducted with various values of running speed and slip ratio obtained by two motorized spindles. Temperature and surviving time would be obtained of GCr15/GCr15 and DLC/GCr15 friction pairs. Micro photography was obtained with a PGI 3D stylus profiler and a confocal microscopy OLS4000-3D. An empirical mode decomposition method was used to eliminate measure errors. Findings Results showed that, even with little initial lubricant, rolling/sliding pairs still rotated for a certain time. With the synthetic actions of the dual-freedom sliding, the loss of lubrication and the tilt, interesting helical grooves appeared. Sliding speeds had remarkable effects on survive time, temperatures and surface topographies. In addition, the equilibrium values of the temperature and the surface roughness were obtained in sufficient oil supply. Extreme wear-out conditions were obtained with starved lubrication. Diamond-like carbon coatings showed better heat resistance and better wear resistance. Originality/value This work would be critical for the life design and the heat treatment of rolling bearings in the full flood lubrication and the starved lubrication. Peer review The peer review history for this article is available at: https://publons.com/publon/10.1108/ILT-05-2024-0164/

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Workplace learning potential in uncertain situations in care work

Purpose This paper aims to examine uncertain situations with potential for learning in care work. While the dominant learning strategy in elderly care is lecture-based education, learning from and during daily care work routines is crucial and suitable. However, little is known about the potential for learning in daily work in elderly care. Design/methodology/approach This paper is based on a doctoral study conducted in Danish nursing homes. Shadowing care workers led to the construction of care work vignettes, which were analyzed and validated in analytic dialogues with field practitioners. Here, a selected vignette forms the empirical base for analyzing uncertainty through the lens of Dewey’s philosophy of learning. Findings The results suggest labeling uncertain situations as noisy, as they are sensorily felt, prompting doubt and perplexity and, hence, reflection and learning. Noisy situations cause breakdowns in action experienced as a tension that triggers reflection, often with colleagues, alongside work. A critical discussion draws attention to silent situations that proceed undisturbedly, according to routine, and, hence, often without reflection. To handle uncertainty, either noisy or silent, care workers must be considered as learning actors. Space and time for reflection are mandatory. Originality/value By focusing on uncertainty in care work, this study contributes to the understanding of workplace learning potential by clarifying the characteristics of situations useful for systematic exploration and collaborative learning from specific instances in work.

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