Real-world setting comparison of bridging therapy versus direct mechanical thrombectomy for acute ischemic stroke: A meta-analysis.

BACKGROUND AND PURPOSE: Intravenous Thrombolysis (IVT) prior to Mechanical Thrombectomy (MT) for Acute Ischaemic Stroke (AIS) due to Large-Vessel Occlusion (LVO) remains controversial. Therefore, the authors performed a meta-analysis of the available real-world evidence focusing on the efficacy and safety of Bridging Therapy (BT) compared with direct MT in patients with AIS due to LVO. METHODS: Four databases were searched until 01 February 2023. Retrospective and prospective studies from nationwide or health organization registry databases that compared the clinical outcomes of BT and direct MT were included. Odds Ratios (ORs) and 95 % Confidence Intervals (CIs) for efficacy and safety outcomes were pooled using a random-effects model. RESULTS: Of the 12 studies, 86,695 patients were included. In patients with AIS due to LVO, BT group was associated with higher odds of achieving excellent functional outcome (modified Rankin Scale score 0-1) at 90 days (OR = 1.48, 95 % CI 1.25-1.75), favorable discharge disposition (to the home with or without services) (OR = 1.33, 95 % CI 1.29-1.38), and decreased mortality at 90 days (OR = 0.62, 95 % CI 0.56-0.70), as compared with the direct MT group. In addition, the risk of symptomatic intracranial hemorrhage did not increase significantly in the BT group. CONCLUSION: The present meta-analysis indicates that BT was associated with favorable outcomes in patients with AIS due to LVO. These findings support the current practice in a real-world setting and strengthen their validity. For patients eligible for both IVT and MT, BT remains the standard treatment until more data are available.

Real-world setting comparison of bridging therapy versus direct mechanical thrombectomy for acute ischemic stroke: A meta-analysis

Abstract Background and purpose Intravenous Thrombolysis (IVT) prior to Mechanical Thrombectomy (MT) for Acute Ischaemic Stroke (AIS) due to Large-Vessel Occlusion (LVO) remains controversial. Therefore, the authors performed a meta-analysis of the available real-world evidence focusing on the efficacy and safety of Bridging Therapy (BT) compared with direct MT in patients with AIS due to LVO. Methods Four databases were searched until 01 February 2023. Retrospective and prospective studies from nationwide or health organization registry databases that compared the clinical outcomes of BT and direct MT were included. Odds Ratios (ORs) and 95 % Confidence Intervals (CIs) for efficacy and safety outcomes were pooled using a random-effects model. Results Of the 12 studies, 86,695 patients were included. In patients with AIS due to LVO, BT group was associated with higher odds of achieving excellent functional outcome (modified Rankin Scale score 0-1) at 90 days (OR = 1.48, 95 % CI 1.25-1.75), favorable discharge disposition (to the home with or without services) (OR = 1.33, 95 % CI 1.29-1.38), and decreased mortality at 90 days (OR = 0.62, 95 % CI 0.56-0.70), as compared with the direct MT group. In addition, the risk of symptomatic intracranial hemorrhage did not increase significantly in the BT group. Conclusion The present meta-analysis indicates that BT was associated with favorable outcomes in patients with AIS due to LVO. These findings support the current practice in a real-world setting and strengthen their validity. For patients eligible for both IVT and MT, BT remains the standard treatment until more data are available.

A digital photograph study evaluating facial taperness and square face perception of Taiwanese females.

BACKGROUND: This study assessed the perception of facial taperness in Taiwanese females among people with dental knowledge and laypersons. Additionally, this study also specified the criteria by which "square face" was defined regarding Taiwanese females' facial taperness. METHODS: A series of digitally modified photos with different levels of facial taperness (Gonion to Gonion/Zygoma point to Zygoma point-Go-Go/Zy-Zy ratio ranges from 65% to 90%) were randomly arranged and presented to the raters. Visual analog scale (VAS) lines were used for scoring the photos on a scale of 0-100. The true or false question about "defining square face" was incorporated in the same questionnaire. The reliability of the true/false square face question and the esthetic evaluation by VAS were assayed. The receiver operating characteristic curve was used to define the cutoff point on "square face." The effects on the raters' genders, orthodontic treatment experience, and their professional background on the perception of a square face were assayed. RESULTS: The overall reliability of the raters was within the acceptable range. The VAS score evaluation revealed that the average expectation for best facial taperness was 75%, whereas the facial taperness of over 83% was considered as the square face. The facial taperness reaching to 90% was regarded as the most unattractive. Gender, therapy, and professional experience have no impact on the standard of square facial form evaluation. CONCLUSION: A face with a taperness greater than 83% was evaluated as a square face, and a face with a taperness around 75% was considered as the most attractive.

Comparing the reliability and accuracy of clinical measurements using plaster model and the digital model system based on crowding severity.

BACKGROUND: This study aims to clarify whether 3Shape™ digital model system could be applied in orthodontic diagnostic analysis with certainty, especially under different crowding condition. Reliability, accuracy and efficiency of 3Shape™ digital model system were assessed by comparing them with traditional plaster cast. METHODS: 29 plaster casts with permanent dentition were transformed into digital models by 3Shape™ D800 scanner. All 29 models were categorized into mild-crowding (arch length discrepancy <3 mm), moderate-crowding (arch length discrepancy >3 mm and <8 mm), and severe-crowding group (arch length discrepancy >8 mm). Fourteen linear measurements were made manually using a digital caliper on plaster casts and virtually using the 3Shape™ Ortho Analyzer software by two examiners. Intra-class Correlation Coefficient (ICC) was used to evaluate intra-examiner reliability, inter-examiner reliability and reliability between two model systems. Paired t test was used to evaluate accuracy between two model systems. Kruskal-Wallis test followed by Mann-Whitney U test was used to evaluate the measurement differences between 3 groups in two model systems. RESULTS: Both intra-examiner and inter-examiner reliability were generally excellent for all measurements made on 3Shape™ digital model and plaster cast (ICC: 0.752-0.993). Reliability between different model systems was also excellent (ICC: 0.897-0.998). Half of the accuracy test showed statistically significant differences (p < 0.05) when digital models were compared with plaster casts. Furthermore, while assessing measurement differences between 3 groups in two model systems, the mandibular required space showed significant difference (p = 0.012) between mild crowding group (0.27 + 0.01 mm) and severe crowding group (0.20 + 0.09 mm). However, the differences were less than 0.5 mm and would not affect clinical decision. CONCLUSION: Using 3Shape™ digital model system instead of plaster casts for orthodontic diagnostic measurements is clinically acceptable.

Endovascular treatment of the extracranial carotid pseudoaneurysms resulting from stab penetrating injury using overlapping bare stents.

Injury pertaining to the common carotid artery may result in complete or partial arterial transection, pseudoaneurysms, or arteriovenous connections. Endovascular treatment option of the pseudoaneurysm has already been established with favorable success rate and minimal morbidity. Our purpose is to report one 18-year-old male patient having 2 traumatic pseudoaneurysms as a result of penetrating stab injury in the extracranial common carotid. The patient was successfully treated using 2 overlapping bare-metal stents. The 2 common carotid pseudoaneurysms had different degree inflow angles defined as the space between the lines indicating the direction of blood flow from the parent artery and through the aneurysmal neck to the dome. Computed tomography angiography was utilized to follow the evolution of the pseudoaneurysms until total occlusion was demonstrated. The treatment modality used in this report represents an alternative approach of the endovascular treatment for the extracranial carotid pseudoaneurysm.

Human object inpainting using manifold learning-based posture sequence estimation.

We propose a human object inpainting scheme that divides the process into three steps: 1) human posture synthesis; 2) graphical model construction; and 3) posture sequence estimation. Human posture synthesis is used to enrich the number of postures in the database, after which all the postures are used to build a graphical model that can estimate the motion tendency of an object. We also introduce two constraints to confine the motion continuity property. The first constraint limits the maximum search distance if a trajectory in the graphical model is discontinuous, and the second confines the search direction in order to maintain the tendency of an object's motion. We perform both forward and backward predictions to derive local optimal solutions. Then, to compute an overall best solution, we apply the Markov random field model and take the potential trajectory with the maximum total probability as the final result. The proposed posture sequence estimation model can help identify a set of suitable postures from the posture database to restore damaged/missing postures. It can also make a reconstructed motion sequence look continuous.

Learning atomic human actions using variable-length Markov models.

Visual analysis of human behavior has generated considerable interest in the field of computer vision because of its wide spectrum of potential applications. Human behavior can be segmented into atomic actions, each of which indicates a basic and complete movement. Learning and recognizing atomic human actions are essential to human behavior analysis. In this paper, we propose a framework for handling this task using variable-length Markov models (VLMMs). The framework is comprised of the following two modules: a posture labeling module and a VLMM atomic action learning and recognition module. First, a posture template selection algorithm, based on a modified shape context matching technique, is developed. The selected posture templates form a codebook that is used to convert input posture sequences into discrete symbol sequences for subsequent processing. Then, the VLMM technique is applied to learn the training symbol sequences of atomic actions. Finally, the constructed VLMMs are transformed into hidden Markov models (HMMs) for recognizing input atomic actions. This approach combines the advantages of the excellent learning function of a VLMM and the fault-tolerant recognition ability of an HMM. Experiments on realistic data demonstrate the efficacy of the proposed system.

[Determination content of the antidepressant extraction and analysis the trace elements from Morinda officinalis].

OBJECTIVE: To study on the antidepressive extraction and determinated the content of the oligosaccharides I , the proteins and the trace elements from Morinda officinalis. METHODS: We analyzed the content of the total oligosaccharides, the proteins and the trace elements by Phenol-Sulferic acid, Coomassie brilliant blue and inductive coupling plasm atomic emission spectrometer (ICP-AES) methods, respectively. RESULTS: The percent of the oligosaccharides and the proteins were 89.4% and 0.19% in the extraction from M. officinalis, respectively. The total actively oligosaccharides I were subjected to the D-941 ion column chromatography to give the extraction in which hardly and protein were determined. 12 kinds of trace element including Zn, Fe, Ca ect. in the extraction (the oligosaccharides I) were determined by ICP-AES without the noxious trace elements including As, Cd, Pb ect. CONCLUSION: The antidepressive activity extraction(the oligosaccharides I ) was a highly pure and vegetal oligosaccharides.

Effect of mild hypothermia on brain dialysate lactate after fluid percussion brain injury in rodents.

OBJECTIVE: To investigate the effects of mild hypothermia on brain microdialysate lactate after fluid percussion traumatic brain injury (TBI) in rats. METHODS: Brain dialysate lactate before and after fluid percussion brain injury (2.1 +/- 0.2 atm) was measured in rats with preinjury mild hypothermia (32 degrees C), postinjury mild hypothermia (32 degrees C), injury normothermia (37 degrees C), and the sham control group. Mild hypothermia (32 degrees C) was induced by partial immersion in a water bath (0 degrees C) under general anesthesia and maintained for 2 hours. RESULTS: In the normothermia TBI group, brain extracellular fluid lactate increased from 0.311 +/- 0.03 to 1.275 +/- 0.08 mmol/L within 30 minutes after TBI (P < 0.01) and remained at a high level (0.546 +/- 0.05 mmol/L) (P < 0.01) at 2 hours after injury. In the postinjury mild hypothermic group, brain extracellular fluid lactate increased from 0.303 +/- 0.03 to 0.875 +/- 0.05 mmol/L at 15 minutes after TBI (P < 0.01) and then gradually decreased to 0.316 +/- 0.04 mmol/L at 2 hours after TBI (P > 0.05). In the preinjury mild hypothermic group, brain extracellular fluid lactate remained at normal levels after injury (P > 0.05). CONCLUSION: The cerebral extracellular fluid lactate level increases significantly after fluid percussion brain injury. Preinjury mild hypothermia completely inhibits the cerebral lactate accumulation, and early postinjury mild hypothermia significantly blunts the increase of cerebral lactate level after fluid percussion injury.