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Record W2894779804 · doi:10.1097/md.0000000000012721

Rationale and design of a randomized trial of early intensive blood pressure lowering on cerebral perfusion parameters in thrombolysed acute ischemic stroke patients

2018· article· en· W2894779804 on OpenAlexaff
Vijay K. Sharma, Benjamin Yong‐Qiang Tan, Meng Ying Sim, Amit Kulkarni, Philip A Seow, Chiew S. Hong, Zhengdao Du, Lily Y Wong, Jintao Chen, Elaine Y.H. Chee, Bridget Si Min Ng, Yingliang Low, Jinghao Nicholas Ngiam, Leonard L.L. Yeo, Hock Luen Teoh, Prakash Paliwal, Rahul Rathakrishnan, Arvind Sinha, Bernard Chan, Kenneth Butcher, Craig S. Anderson

Bibliographic record

VenueMedicine · 2018
Typearticle
Languageen
FieldMedicine
TopicAcute Ischemic Stroke Management
Canadian institutionsUniversity of Alberta
FundersNational Medical Research CouncilMedical Research Council
KeywordsMedicineThrombolysisModified Rankin ScaleCerebral blood flowCerebral perfusion pressureBlood pressureRandomized controlled trialPerfusionStroke (engine)Intracerebral hemorrhageAnesthesiaCardiologyIntensive careInternal medicineIschemiaIschemic strokeSubarachnoid hemorrhageIntensive care medicineMyocardial infarction

Abstract

fetched live from OpenAlex

BACKGROUND AND RATIONALE: Uncertainty persists over the optimal management of blood pressure (BP) in the early phase of acute ischemic stroke (AIS). This study aims to determine the safety and effects of intensive BP lowering on cerebral blood flow (CBF) and functional in AIS patients treated with intravenous thrombolysis. METHODS: In a randomized controlled trial, 54 thrombolysed AIS patients with a systolic BP of 160 to 180 mm Hg will be randomized to early intensive BP lowering (systolic target range 140-160 mm Hg) or guideline-based BP management (systolic range 160-180 mm Hg) during first 72-hours using primarily intravenous labetalol. We hypothesize that early intensive BP lowering will not reduce CBF by 20% and/or increase the volume of hypoperfused tissue by >20% on computed tomographic perfusion. Clinical outcome will be assessed using a dichotomized modified Rankin scale (scores 0-1 as excellent outcome vs scores 2-6 as dead or dependent) at 90 days. Other outcome would be symptomatic intracerebral hemorrhage. The trial is registered at ClinicalTrials.gov, NCT03443596. CONCLUSION: This randomized study will provide important information about the physiological effects of BP reduction on cerebral perfusion after intravenous thrombolysis in AIS.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.071
metaresearch head score (Gemma)0.059
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Randomized trial · Consensus signal: Randomized trial
GenreCandidate signal: Protocol · Consensus signal: Protocol
Teacher disagreement score0.071
Threshold uncertainty score0.376

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0710.059
Meta-epidemiology (narrow)0.0040.002
Meta-epidemiology (broad)0.0050.004
Bibliometrics0.0020.001
Science and technology studies0.0020.006
Scholarly communication0.0030.002
Open science0.0030.001
Research integrity0.0070.006
Insufficient payload (model declined to judge)0.0180.004

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.019
GPT teacher head0.264
Teacher spread0.245 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designRandomized trial
Domainnot available
GenreProtocol

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations4
Published2018
Admission routes1
Has abstractyes

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