http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Sex and Gender Differences in Stroke and Their Practical Implications in Acute Care
Johanna Ospel,Nishita Singh,Aravind Ganesh,Mayank Goyal 대한뇌졸중학회 2023 Journal of stroke Vol.25 No.1
There are several controversies regarding the role of sex and gender in the pathophysiology and management of acute stroke. Assessing the role of sex, i.e., biological/pathophysiological factors, and gender, i.e., sociocultural factors, in isolation is often not possible since they are closely intertwined with each other. To complicate matters even more, the functional baseline status of women and men at the time of their first stroke is substantially different, whereby women have, on average, a poorer reported/ascertained baseline function compared to men. These differences in baseline variables account for a large part of the differences in post-stroke outcomes between women and men. Adjusting for these baseline differences is difficult, and in many cases, residual confounding cannot be excluded. Despite these obstacles, a better understanding of how patient sex and gender differences influence acute stroke and stroke care pathways is crucial to avoid biases and allow us to provide the best possible care for all acute stroke patients. Disregarding patient sex and gender on one hand and ignoring potential confounding factors in sex- and gender-stratified analyses on the other hand, may cause researchers to come to erroneous conclusions and physicians to provide suboptimal care. This review outlines sex- and gender-related factors in key aspects of acute stroke, including acute stroke epidemiology, diagnosis, access to care, treatment outcomes, and post-acute care. We also attempt to outline knowledge gaps, which deserve to be studied in further detail, and practical implications for physicians treating acute stroke patients in their daily practice.
Smart City IoT System Network Level Routing Analysis and Blockchain Security Based Implementation
Bommu Samuyelu,M Aravind Kumar,Babburu Kiranmai,N Srikanth,Thalluri Lakshmi Narayana,G V. Ganesh,Gopalan Anitha,Mallapati Purna Kishore,Guha Koushik,Mohammad Hayath Rajvee,S S. Kiran 대한전기학회 2023 Journal of Electrical Engineering & Technology Vol.18 No.2
This paper demonstrates, network-level performance analysis and implementation of smart city Internet of Things (IoT) system with Infrastructure as a Service (IaaS) level cloud computing architecture. The smart city IoT network topology performance is analyzed at the simulation level using the NS3 simulator by extracting most of the performance-deciding parameters. The performance-enhanced smart city topology is practically implemented in IaaS level architecture. The intended smart city IoT system can monitor the principal parameters like video surveillance with a thermal camera (to identify the virus-like COVID-19 infected people), transport, water quality, solar radiation, sound pollution, air quality (O3, NO2, CO, Particles), parking zones, iconic places, E-suggestions, PRO information over low power wide area network in 61.88 km × 61.88 km range. Primarily we have addressed the IoT network-level routing and quality of service (QoS) challenges and implementation level security challenges. The simulation level network topology analysis is performed to improve the routing and QoS. Blockchain technology-based decentralization is adopted to enrich the IoT system performance in terms of security.
Replacing Alteplase with Tenecteplase: Is the Time Ripe?
Nishita Singh,Bijoy K. Menon,Adam A. Dmytriw,Robert W. Regenhardt,Joshua A. Hirsch,Aravind Ganesh 대한뇌졸중학회 2023 Journal of stroke Vol.25 No.1
Thrombolysis for acute ischemic stroke has predominantly been with alteplase for over a quarter of a century. In recent years, with trials showing evidence of higher rates of successful reperfusion, similar safety profile and efficacy of tenecteplase (TNK) as compared to alteplase, TNK has now emerged as another potential choice for thrombolysis in acute ischemic stroke. In this review, we will focus on these recent advances, aiming: (1) to provide a brief overview of thrombolysis in stroke; (2) to provide comparisons between alteplase and TNK for clinical, imaging, and safety outcomes; (3) to focus on key subgroups of interest to understand if there is an advantage of using TNK over alteplase or vice-versa, to review available evidence on role of TNK in intra-arterial thrombolysis, as bridging therapy and in mobile stroke units; and (4) to summarize what to expect in the near future from recently completed trials and propose areas for future research on this evolving topic. We present compelling data from several trials regarding the safety and efficacy of TNK in acute ischemic stroke along with completed yet unpublished trials that will help provide insight into these unanswered questions.