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Article ; Online: Sliding Oblique Metatarsal Osteotomy Fixated With a K-Wire Without Cheilectomy for Hallux Rigidus.

Nakajima, Kenichiro

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons

2021 Volume 61, Issue 2, Page(s) 279–285

Abstract: ... with a K-wire without cheilectomy for hallux rigidus. Pre- and postoperative variables, including ...

Abstract	The current study aimed to assess the outcomes of sliding oblique metatarsal osteotomy fixated with a K-wire without cheilectomy for hallux rigidus. Pre- and postoperative variables, including dorsiflexion angle, visual analog scale score, and Japanese Society for Surgery of the Foot scale score, were assessed using the Wilcoxon signed-rank test. In addition, the surgical effects among the four grades were compared using the Kruskal-Wallis test. In total, 43 patients, including 11, 11, 15, and 6 with grade 1, 2, 3, and 4 hallux rigidus, respectively, were enrolled in this analysis. The mean age of the participants was 56.2 years, and the mean follow-up period was 3.0 years. Mean pre- and postoperative dorsiflexion angles were as follows: overall, 53.0° to 66.5° (p < .001); grade 1, 66.8° to 79.1°; grade 2, 59.1° to 68.6°; grade 3, 43.3° to 61.0°; and grade 4, 40.8° to 53.3°. Mean pre- and postoperative visual analog scale scores were as follows: overall, 70.1 to 6.5 (p < .001); grade 1, 74.2 to 3.0; grade 2, 66.4 to 7.6; grade 3, 69.5 to 8.4; and grade 4, 71.2 to 6.0. Finally, mean pre- and postoperative Japanese Society for Surgery of the Foot scale scores were as follows: overall, 61.2 to 86.6 (p < .001); grade 1, 63.8 to 93.6; grade 2, 68.3 to 85.9; grade 3, 54.4 to 83.1; and grade 4, 60.5 to 83.5. There was no statistically significant difference in the surgical effects among the four grades. Decompressive metatarsal osteotomy without cheilectomy was found to be effective. Moreover, the procedure could be performed for all grades of hallux rigidus.
MeSH term(s)	Follow-Up Studies ; Hallux Rigidus/diagnostic imaging ; Hallux Rigidus/surgery ; Humans ; Metatarsal Bones/surgery ; Metatarsophalangeal Joint/diagnostic imaging ; Metatarsophalangeal Joint/surgery ; Middle Aged ; Osteotomy/methods ; Treatment Outcome
Language	English
Publishing date	2021-08-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1146972-9
ISSN	1542-2224 ; 1067-2516
ISSN (online)	1542-2224
ISSN	1067-2516
DOI	10.1053/j.jfas.2021.07.022
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Book ; Online: Maximum $k$- vs. $\ell$-colourings of graphs

Nakajima, Tamio-Vesa / Živný, Stanislav

2023

Abstract: ... of $\alpha = 1 - 1 / \ell + 2 \ln \ell / k \ell - o(\ln \ell / k \ell) - O(1 / k^2)$; if we fix $d = \ell ... k$ and allow $k, \ell$ to grow large, this is $\alpha = 1 - 1 / \ell + 2 \ln \ell / k \ell - o(\ln ... ell / k \ell)$. By extending the results of Khot, Kindler, Mossel and O'Donnell [SICOMP'07 ...

Abstract	We present polynomial-time SDP-based algorithms for the following problem: For fixed $k \leq \ell$, given a real number $\epsilon>0$ and a graph $G$ that admits a $k$-colouring with a $\rho$-fraction of the edges coloured properly, it returns an $\ell$-colouring of $G$ with an $(\alpha \rho - \epsilon)$-fraction of the edges coloured properly in polynomial time in $G$ and $1 / \epsilon$. Our algorithms are based on the algorithms of Frieze and Jerrum [Algorithmica'97] and of Karger, Motwani and Sudan [JACM'98]. For $k = 2, \ell = 3$, our algorithm achieves an approximation ratio $\alpha = 1$, which is the best possible. When $k$ is fixed and $\ell$ grows large, our algorithm achieves an approximation ratio of $\alpha = 1 - o(1 / \ell)$. When $k, \ell$ are both large, our algorithm achieves an approximation ratio of $\alpha = 1 - 1 / \ell + 2 \ln \ell / k \ell - o(\ln \ell / k \ell) - O(1 / k^2)$; if we fix $d = \ell - k$ and allow $k, \ell$ to grow large, this is $\alpha = 1 - 1 / \ell + 2 \ln \ell / k \ell - o(\ln \ell / k \ell)$. By extending the results of Khot, Kindler, Mossel and O'Donnell [SICOMP'07] to the promise setting, we show that for large $k$ and $\ell$, assuming Khot's Unique Games Conjecture (UGC), it is \NP-hard to achieve an approximation ratio $\alpha$ greater than $1 - 1 / \ell + 2 \ln \ell / k \ell + o(\ln \ell / k \ell)$, provided that $\ell$ is bounded by a function that is $o(\exp(\sqrt[3]{k}))$. For the case where $d = \ell - k$ is fixed, this bound matches the performance of our algorithm up to $o(\ln \ell / k \ell)$. Furthermore, by extending the results of Guruswami and Sinop [ToC'13] to the promise setting, we prove that it is NP-hard to achieve an approximation ratio greater than $1 - 1 / \ell + 8 \ln \ell / k \ell + o(\ln \ell / k \ell)$, provided again that $\ell$ is bounded as before (but this time without assuming the UGC). Comment: an extra hardness result
Keywords	Computer Science - Data Structures and Algorithms ; Computer Science - Computational Complexity ; Computer Science - Discrete Mathematics
Subject code	512
Publishing date	2023-11-01
Publishing country	us
Document type	Book ; Online
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Article ; Online: Comparison of Surgical Outcomes of Anterior and Posterior Fusion Surgeries for K-line (-) Cervical Ossification of the Posterior Longitudinal Ligament: A Prospective Multicenter Study.

Nagoshi, Narihito / Yoshii, Toshitaka / Egawa, Satoru / Sakai, Kenichiro / Kusano, Kazuo / Tsutsui, Shunji / Hirai, Takashi / Matsukura, Yu / Wada, Kanichiro / Katsumi, Keiichi / Koda, Masao / Kimura, Atsushi / Furuya, Takeo / Sato, Yasunori / Maki, Satoshi / Nishida, Norihiro / Nagamoto, Yukitaka / Oshima, Yasushi / Ando, Kei /

Spine

2023 Volume 48, Issue 13, Page(s) 937–943

Abstract: ... to compare the surgical outcomes of anterior and posterior fusion surgeries in patients with K-line ... Although laminoplasty is effective for patients with K-line (+) OPLL, fusion surgery is recommended for those with K ... up for two years. Of the 478 patients, 45 and 46 with K-line (-) underwent anterior and posterior ...

Abstract	Study design: A prospective multicenter study. Objective: The objective of this study is to compare the surgical outcomes of anterior and posterior fusion surgeries in patients with K-line (-) cervical ossification of the posterior longitudinal ligament (OPLL). Summary of background data: Although laminoplasty is effective for patients with K-line (+) OPLL, fusion surgery is recommended for those with K-line (-) OPLL. However, whether the anterior or posterior approach is preferable for this pathology has not been effectively determined. Materials and methods: A total of 478 patients with myelopathy due to cervical OPLL from 28 institutions were prospectively registered from 2014 to 2017 and followed up for two years. Of the 478 patients, 45 and 46 with K-line (-) underwent anterior and posterior fusion surgeries, respectively. After adjusting for confounders in baseline characteristics using a propensity score-matched analysis, 54 patients in both the anterior and posterior groups (27 patients each) were evaluated. Clinical outcomes were assessed using the cervical Japanese Orthopaedic Association and the Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire. Results: Both approaches showed comparable neurological and functional recovery. The cervical range of motion was significantly restricted in the posterior group because of the large number of fused vertebrae compared with the anterior group. The incidence of surgical complications was comparable between the cohorts, but the posterior group demonstrated a higher frequency of segmental motor paralysis, whereas the anterior group more frequently reported postoperative dysphagia. Conclusions: Clinical improvement was comparable between anterior and posterior fusion surgeries for patients with K-line (-) OPLL. The ideal surgical approach should be informed based on the balance between the surgeon's technical preference and the risk of complications.
MeSH term(s)	Humans ; Longitudinal Ligaments/surgery ; Treatment Outcome ; Osteogenesis ; Prospective Studies ; Spinal Fusion/adverse effects ; Cervical Vertebrae/surgery ; Retrospective Studies ; Ossification of Posterior Longitudinal Ligament/complications ; Spinal Cord Diseases/surgery ; Decompression, Surgical/adverse effects ; Laminoplasty/adverse effects
Language	English
Publishing date	2023-03-20
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000004634
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Article: Real-world comparison of in-hospital complications after catheter ablation for atrial fibrillation between non-antivitamin K anticoagulants and warfarin: A propensity-matched analysis using nation-wide database.

Miyamoto, Koji / Murata, Shunsuke / Takegami, Misa / Nakajima, Kenzaburo / Kamakura, Tsukasa / Wada, Mitsuru / Ishibashi, Kohei / Inoue, Yuko / Nagase, Satoshi / Aiba, Takeshi / Nishimura, Kunihiro / Kusano, Kengo

International journal of cardiology. Heart & vasculature

2023 Volume 44, Page(s) 101174

Abstract: ... antivitamin K anticoagulants (NOACs) with that of warfarin in catheter ablation (CA) for atrial fibrillation ...

Abstract	Background: Few large-scale, real-world studies have compared the efficacy and safety of non-antivitamin K anticoagulants (NOACs) with that of warfarin in catheter ablation (CA) for atrial fibrillation (AF). Methods: This retrospective, cross-sectional study used a nationwide administrative claims database, to compare complication-incidence rates following CA for AF between NOAC-treated patients and warfarin-treated matched cohorts in the real-world. Among the 32,797,540 records between June 2011 and August 2020 from 426 hospitals, 41,347 patients (38,065 on NOACs and 3,282 on Warfarin) were considered eligible. After performing propensity matching, 6,564 patients (3,282 per group) were analyzed. Results: The overall complication incidence was significantly lower in the NOACs group than in the warfarin group (2.3 % vs. 4.0 %; P < 0.001, odds ratio [OR]: 0.55, 95 % confidence interval [CI]: 0.41-0.74). Although no significant differences in the incidence of cardiac tamponade (1.0 % vs. 1.1 %; P = 0.90, OR: 0.97, 95 % CI: 0.60-1.56) and major bleeding (0.6 % vs. 0.7 %; P = 0.54, OR: 0.83, 95 % CI: 0.44-1.52) were noted, blood transfusion requirements (0.6 % vs. 1.2 %; P = 0.02, OR: 0.52, 95 % CI: 0.30-0.88) and vascular complications (0.2 % vs. 0.5 %; P = 0.02, OR: 0.33, 95 % CI: 0.12-0.79) were significantly lower in the NOACs group than in the warfarin group. Furthermore, the thromboembolic event incidence was significantly lower in the NOACs group than in the warfarin group (0.5 % vs. 1.2 %; P < 0.001, OR: 0.36, 95 % CI: 0.19-0.64). Conclusions: NOACs should be considered as a first-line therapy for periprocedural anticoagulation in patients undergoing CA for AF.
Language	English
Publishing date	2023-01-11
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	2818464-6
ISSN	2352-9067
ISSN	2352-9067
DOI	10.1016/j.ijcha.2023.101174
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Article ; Online: Edoxaban vs. Vitamin K Antagonist for Atrial Fibrillation After Transcatheter Aortic Valve Replacement in Japanese Patients　- A Subanalysis of the ENVISAGE-TAVI AF Trial.

Watanabe, Yusuke / Hayashida, Kentaro / Yamamoto, Masanori / Yamanaka, Futoshi / Yamasaki, Kazumasa / Naganuma, Toru / Ohno, Yohei / Yamawaki, Masahiro / Morioka, Nobuyuki / Mizutani, Kazuki / Tada, Norio / Ueno, Hiroshi / Nishina, Hidetaka / Izumo, Masaki / Nakajima, Yoshifumi / Ando, Kenji / Takagi, Kensuke / Kimura, Tetsuya / Sugio, Kumiko /

Dangas, George / Van Mieghem, Nicolas M / Hengstenberg, Christian / Chen, Cathy / Jin, James / Unverdorben, Martin / Saito, Shigeru

Circulation journal : official journal of the Japanese Circulation Society

2022 Volume 86, Issue 11, Page(s) 1756–1763

Abstract: ... vitamin K antagonists (VKAs) in patients with AF after TAVR. The primary efficacy and safety outcomes were ...

Abstract	Background: Japanese patients undergoing transcatheter aortic valve replacement (TAVR) are often female and have a small body size, potentially impacting bleeding risk with antithrombotic therapy. Outcomes of direct oral anticoagulant use in these patients with atrial fibrillation (AF) need to be clarified.Methods and Results: This prespecified analysis included Japanese patients from ENVISAGE-TAVI AF, a prospective, randomized, open-label, adjudicator-masked trial that compared treatment with edoxaban and vitamin K antagonists (VKAs) in patients with AF after TAVR. The primary efficacy and safety outcomes were net adverse clinical events (NACE; composite of all-cause death, myocardial infarction, ischemic stroke, systemic embolic event, valve thrombosis, and International Society on Thrombosis and Haemostasis [ISTH]-defined major bleeding) and ISTH-defined major bleeding, respectively. Intention-to-treat (ITT) and on-treatment analyses were performed. Overall, 159 Japanese patients were enrolled (edoxaban group: 82, VKA group: 77) and followed for on average 483 days. Mean patient age was 83.8 years; 52.2% were female. In the ITT analysis, NACE rates were 10.9%/year with edoxaban and 12.5%/year with VKA (hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.38-1.90); major bleeding occurred in 8.9%/year and 7.3%/year, respectively (HR, 1.17; 95% CI, 0.45-3.05). In edoxaban- and VKA-treated patients, rates of ischemic stroke were 1.8%/year and 1.0%/year, respectively; fatal bleeding rates were 0.9%/year and 2.0 %/year. On-treatment results were similar to ITT. Conclusions: In Japanese patients with AF after successful TAVR, edoxaban and VKA treatment have similar safety and efficacy profiles.
MeSH term(s)	Humans ; Female ; Aged, 80 and over ; Male ; Atrial Fibrillation/complications ; Transcatheter Aortic Valve Replacement/adverse effects ; Fibrinolytic Agents/therapeutic use ; Prospective Studies ; Japan ; Anticoagulants/adverse effects ; Hemorrhage/chemically induced ; Vitamin K ; Ischemic Stroke ; Treatment Outcome ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control
Chemical Substances	edoxaban (NDU3J18APO) ; Fibrinolytic Agents ; Anticoagulants ; Vitamin K (12001-79-5)
Language	English
Publishing date	2022-08-11
Publishing country	Japan
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2068090-9
ISSN	1347-4820 ; 1346-9843
ISSN (online)	1347-4820
ISSN	1346-9843
DOI	10.1253/circj.CJ-22-0093
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Article ; Online: Is anterior decompression and fusion more beneficial than laminoplasty for K-line (+) cervical ossification of the posterior longitudinal ligament? An analysis using propensity score matching.

Inoue, Takaki / Maki, Satoshi / Yoshii, Toshitaka / Furuya, Takeo / Egawa, Satoru / Sakai, Kenichiro / Kusano, Kazuo / Nakagawa, Yukihiro / Hirai, Takashi / Wada, Kanichiro / Katsumi, Keiichi / Fujii, Kengo / Kimura, Atsushi / Nagoshi, Narihito / Kanchiku, Tsukasa / Nagamoto, Yukitaka / Oshima, Yasushi / Ando, Kei / Takahata, Masahiko /

Journal of neurosurgery. Spine

2022 , Page(s) 1–8

Abstract: ... LMP) results in better outcomes for patients with K-line-positive (+) cervical ossification ... LMP in patients with K-line (+) OPLL.: Methods: The study included 478 patients enrolled ... of fewer than 2 years were also excluded, leaving 198 patients with K-line (+) OPLL. Propensity score ...

Abstract	Objective: It is unclear whether anterior cervical decompression and fusion (ADF) or laminoplasty (LMP) results in better outcomes for patients with K-line-positive (+) cervical ossification of the posterior longitudinal ligament (OPLL). The purpose of the study is to compare surgical outcomes and complications of ADF versus LMP in patients with K-line (+) OPLL. Methods: The study included 478 patients enrolled in the Japanese Multicenter Research Organization for Ossification of the Spinal Ligament and who underwent surgical treatment for cervical OPLL. The patients who underwent anterior-posterior combined surgery or posterior decompression with instrumented fusion were excluded. The patients with a follow-up period of fewer than 2 years were also excluded, leaving 198 patients with K-line (+) OPLL. Propensity score matching was performed on 198 patients with K-line (+) OPLL who underwent ADF (44 patients) or LMP (154 patients), resulting in 39 pairs of patients based on the following predictors for surgical outcomes: age, preoperative Japanese Orthopaedic Association (JOA) score, C2-7 angle, and the occupying ratio of OPLL. Clinical outcomes were assessed 1 and 2 years after surgery using the recovery rate of the JOA score. Complications and reoperation rates were also investigated. Results: The mean recovery rate of the JOA score 1 year after surgery was 55.3% for patients who underwent ADF and 42.3% (p = 0.06) for patients who underwent LMP. Two years after surgery, the recovery rate was 53.4% for those who underwent ADF and 38.7% for LMP (p = 0.07). Although both surgical procedures yielded good results, the mean recovery rate of JOA scores tended to be higher in the ADF group. The incidence of surgical complications, however, was higher following ADF (33%) than LMP (15%; p = 0.06). The reoperation rate was also higher in the ADF group (15%) than in the LMP group (0%; p = 0.01). Conclusions: Clinical outcomes were good for both ADF and LMP, indicating that ADF and LMP are appropriate procedures for patients with K-line (+) OPLL. Clinical outcomes of ADF 1 and 2 years after surgery tended to be better than LMP, but the analysis did not detect any significant difference in clinical outcomes between the groups. Conversely, patients who underwent ADF had a higher incidence of surgery-related complications. When considering indications for ADF or LMP, benefits and risks of the surgical procedures should be carefully weighed.
Language	English
Publishing date	2022-01-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2158643-3
ISSN	1547-5646 ; 1547-5654
ISSN (online)	1547-5646
ISSN	1547-5654
DOI	10.3171/2021.11.SPINE211205
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Article ; Online: Preceding direct oral anticoagulant administration reduces the severity of stroke in patients with atrial fibrillation - K-PLUS registry.

Nakajima, Makoto / Inatomi, Yuichiro / Ueda, Akihiko / Ito, Yasuyuki / Kouzaki, Yanosuke / Takita, Tomohiro / Wada, Kuniyasu / Yonehara, Toshiro / Terasaki, Tadashi / Hashimoto, Yoichiro / Ando, Yukio

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2021 Volume 89, Page(s) 106–112

Abstract: Background: Stroke severity can be mitigated by preceding anticoagulant administration in acute ischemic stroke patients with atrial fibrillation (AF). We investigated if such mitigative effects are different between warfarin and direct oral ... ...

Abstract	Background: Stroke severity can be mitigated by preceding anticoagulant administration in acute ischemic stroke patients with atrial fibrillation (AF). We investigated if such mitigative effects are different between warfarin and direct oral anticoagulants (DOACs). Material and methods: We collected data from a regional multicenter stroke registry. Ischemic stroke or transient ischemic attack patients with AF were included. Background characteristics, National Institutes of Health Stroke Scale (NIHSS) score on admission, lesion characteristics, and in-hospital death were analyzed according to preceding antithrombotic agents at onset. Results: A total of 2173 patients had AF; 628 were prescribed warfarin, 272 DOACs, 429 antiplatelets alone, and 844 no antithrombotics. The NIHSS score on admission was lowest in the DOACs group compared to the other groups. In neuroimaging analysis, small ischemic lesions were observed more frequently in the DOACs group, while large ischemic lesions were less frequent in this group. When the no antithrombotics group was used as a reference, the adjusted odds ratio for moderate to severe stroke was 0.56 (95% confidence interval, 0.40-0.78) in the DOACs group, while it was 0.98 (0.77-1.24) in the warfarin group and 0.94 (0.72-1.22) in the antiplatelets group. In-hospital mortality was lowest in the DOACs group compared to the other groups. Conclusion: Preceding DOAC administration might mitigate the severity of stroke in AF patients more strongly than other antithrombotics, possibly leading to a better outcome in patients with stroke.
MeSH term(s)	Administration, Oral ; Aged ; Aged, 80 and over ; Anticoagulants/administration & dosage ; Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Fibrinolytic Agents/administration & dosage ; Fibrinolytic Agents/therapeutic use ; Humans ; Ischemic Stroke/drug therapy ; Ischemic Stroke/etiology ; Ischemic Stroke/prevention & control ; Middle Aged ; Warfarin/administration & dosage ; Warfarin/therapeutic use
Chemical Substances	Anticoagulants ; Fibrinolytic Agents ; Warfarin (5Q7ZVV76EI)
Language	English
Publishing date	2021-05-06
Publishing country	Scotland
Document type	Journal Article ; Multicenter Study
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2021.04.027
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Article ; Online: Fine-tuned regulation of the K

Wang, Caijuan / Yamamoto, Hiroshi / Narumiya, Fumika / Munekage, Yuri Nakajima / Finazzi, Giovanni / Szabo, Ildiko / Shikanai, Toshiharu

The Plant journal : for cell and molecular biology

2017 Volume 89, Issue 3, Page(s) 540–553

Abstract: KEA3 is a thylakoid membrane localized K ...

Abstract	KEA3 is a thylakoid membrane localized K
MeSH term(s)	Arabidopsis/genetics ; Arabidopsis/metabolism ; Arabidopsis Proteins/genetics ; Arabidopsis Proteins/metabolism ; Carbon Dioxide/metabolism ; Electron Transport/genetics ; Electron Transport/radiation effects ; Gene Expression Regulation, Plant/radiation effects ; Immunoblotting ; Light ; Mutation ; Oxygen/metabolism ; Phenotype ; Photosynthesis/genetics ; Photosystem I Protein Complex/genetics ; Photosystem I Protein Complex/metabolism ; Potassium-Hydrogen Antiporters/genetics ; Potassium-Hydrogen Antiporters/metabolism ; Proton-Motive Force/genetics ; Proton-Motive Force/radiation effects ; Reverse Transcriptase Polymerase Chain Reaction ; Thylakoids/genetics ; Thylakoids/metabolism
Chemical Substances	Arabidopsis Proteins ; KEA3 protein, Arabidopsis ; Photosystem I Protein Complex ; Potassium-Hydrogen Antiporters ; Carbon Dioxide (142M471B3J) ; Oxygen (S88TT14065)
Language	English
Publishing date	2017-02-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1088037-9
ISSN	1365-313X ; 0960-7412
ISSN (online)	1365-313X
ISSN	0960-7412
DOI	10.1111/tpj.13405
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Article ; Online: Pre-Hospital Delay in Patients with Acute Ischemic Stroke in a Multicenter Stroke Registry: K-PLUS.

Nagao, Yoichiro / Nakajima, Makoto / Inatomi, Yuichiro / Ito, Yasuyuki / Kouzaki, Yanosuke / Wada, Kuniyasu / Yonehara, Toshiro / Terasaki, Tadashi / Hashimoto, Yoichiro / Ando, Yukio

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2020 Volume 29, Issue 11, Page(s) 105284

Abstract: Purpose: There is scant data related to prehospital delay in cases of acute ischemic stroke from multicenter studies conducted after change of the therapeutic window of intravenous tissue plasminogen activator (iv-tPA) administration to within 4.5 h of ... ...

Abstract	Purpose: There is scant data related to prehospital delay in cases of acute ischemic stroke from multicenter studies conducted after change of the therapeutic window of intravenous tissue plasminogen activator (iv-tPA) administration to within 4.5 h of onset. We investigated factors causing prehospital delay and their associations with clinical outcomes using data from a regional multicenter stroke registry. Methods: Data from the multicenter regional stroke registry were analyzed. Patients admitted within 24 h of the last known well time were categorized according to whether their admission was early (≤ 4 h; n = 2350) or delayed (> 4 h; n = 2752). We then compared patients' backgrounds and outcomes between the two groups. Results: Five-thousand, one-hundred two patients presented at hospitals within 24 h of onset. On multivariate analysis, atrial fibrillation, higher NIHSS score on admission, anterior circulation stroke, detection of symptoms immediately after onset, and emergency system use were positively associated with early admission, whereas modified Rankin Scale (mRS) score before onset, onset at home, diabetes, current smoking, dementia and symptom detection between 00:00 and 06:00 h were negatively associated. Early admission was associated with mRS scores of 0-2 at discharge independent of backgrounds, stroke severity, and thrombolytic therapy (odds ratio, 1.56; 95% confidence interval, 1.32-1.84). Conclusions: Certain patient factors relating to prehospital delay, such as lack of awareness of onset or non-cardioembolic etiology, are crucial but often inevitable. However, earlier admission was associated mRS scores of 0-2 independent of other factors. This study may help to plan educational activities to general population or public awareness campaigns.
MeSH term(s)	Aged ; Aged, 80 and over ; Brain Ischemia/diagnosis ; Brain Ischemia/drug therapy ; Databases, Factual ; Emergency Medical Services ; Female ; Fibrinolytic Agents/administration & dosage ; Humans ; Japan ; Male ; Patient Admission ; Prospective Studies ; Registries ; Risk Factors ; Stroke/drug therapy ; Thrombolytic Therapy ; Time Factors ; Time-to-Treatment ; Treatment Outcome
Chemical Substances	Fibrinolytic Agents
Language	English
Publishing date	2020-09-07
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2020.105284
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Article ; Online: Discovery of Pb-Free Perovskite Solar Cells via High-Throughput Simulation on the K Computer.

Nakajima, Takahito / Sawada, Keisuke

The journal of physical chemistry letters

2017 Volume 8, Issue 19, Page(s) 4826–4831

Abstract: We performed a systematic high-throughput simulation with density functional theory for 11 025 compositions of hybrid organic-inorganic halide compounds in ... ...

Abstract	We performed a systematic high-throughput simulation with density functional theory for 11 025 compositions of hybrid organic-inorganic halide compounds in ABX
Language	English
Publishing date	2017-10-05
Publishing country	United States
Document type	Journal Article
ISSN	1948-7185
ISSN (online)	1948-7185
DOI	10.1021/acs.jpclett.7b02203
Database	MEDical Literature Analysis and Retrieval System OnLINE

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