Effects of Early-Stage Blood Pressure Variability on the Functional Outcome in Acute Ischemic Stroke Patients With Symptomatic Intracranial Artery Stenosis or Occlusion Receiving Intravenous Thrombolysis.

Background: Studies exploring the relationship between blood pressure (BP) fluctuations and outcome in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) are limited. We aimed to investigate the influence of blood pressure variability (BPV) during the first 24 h after IVT on early neurological deterioration (END) and 3-month outcome after IVT in terms of different stroke subtypes. Methods: Clinical data from consecutive AIS patients who received IVT were retrospectively analyzed. The hourly systolic BP of all patients were recorded during the first 24 h following IVT. We calculated three systolic BPV parameters, including coefficient of variability (CV), standard deviation of mean BP (SD) and successive variation (SV), within the first 6, 12, and 24 h after IVT. END was defined as neurological deterioration with an increase in the National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 points within the first 72 h after admission. Follow-up was performed at 90 days after onset, and favorable and poor outcomes were defined as a modified Rankin Scale scores (mRS) of ≤1 or ≥2, respectively. Results: A total of 339 patients, which were divided into those with (intracranial artery stenosis or occlusion group, SIASO group) and without (non-SIASO group) SIASO, were included. Among them, 110 patients (32.4%) were with SIASO. Patients in SIASO group had higher NIHSS on admission and difference in term of mRS at 90 days compared with non-SIASO group (P < 0.001). In SIASO group, patients in favorable outcome group were younger and had lower NIHSS on admission, lower SV-24 h (14.5 ± 4.3 vs. 11.8 ± 3.2, respectively) and lower SD-24 h (12.7 ± 3.8 vs. 10.9 ± 3.3, respectively), compared with patients with poor outcome (all P < 0.05). In the multivariable logistic regression analysis, compared with the lowest SV (SV < 25% quartile), SV50-75% [odds ratio (OR) = 4.449, 95% confidence interval (CI) = 1.231-16.075, P = 0.023] and SV>75% (OR = 8.676, 95% CI = 1.892-39.775, P = 0.005) were significantly associated with poor outcome at 3 months in patients with SIASO, adjusted for age, NIHSS on admission and atrial fibrillation. No BPV parameters were associated with END in SIASO group. In non-SIASO group, there were no significant association between BPV patterns and END or 90-day outcome. Conclusions: SV-24 h had a negative relationship with 3-month outcome in AIS patients with SIASO treated with IVT, indicating that BPV may affect the outcome of AIS.

Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta-Analysis.

PURPOSE: To evaluate and compare the implant survival rates, marginal bone loss, and mechanical complications of prostheses supported by splinted and nonsplinted short implants (≤8.5 mm). MATERIAL AND METHODS: Electronic database (MEDLINE, CENTRAL, Web of Science, and EMBASE) and manual searches up to May 2021 were conducted to identify studies comparing splinted and nonsplinted short implants (≤8.5 mm). The primary outcome was implant survival rate. Secondary outcomes were marginal bone loss and mechanical complications. The quality of included studies and risk-of-bias were assessed according to the Newcastle-Ottawa Scale. A random-effects model was used to analyze the data. RESULTS: Twelve studies fulfilled the inclusion criteria and featured 1506 short implants (596 nonsplinted and 910 splinted) with a follow-up time ranging from 1 to 16 years. Quantitative analysis found no statistically significant differences between splinted and nonsplinted short implants (≤8.5 mm) for survival rate (RR = 0.98; 95% CI 0.96, 1.01; p = 0.26)) and marginal bone loss (SMD = -0.08; 95% CI - 0.23, 0.07; p = 0.28). Veneer chipping, abutment screw breakage, screw loosening, and loss of retention were reported in the selected studies as common complications. However, no statistically significant difference was found between splinted and nonsplinted short implants (RR = 0.56; 95% CI 0.20, 1.54; p = 0.26). CONCLUSIONS: Within the limitations of the present meta-analysis, it might be concluded that splinted short implants (≤8.5 mm) do not present superior performance in survival rate, marginal bone maintenance and prevention of mechanical complications compared with single-unit prostheses.

Biofilm-Induced Antibiotic Resistance in Clinical Acinetobacter baumannii Isolates.

In order to understand the role of biofilm in the emergence of antibiotic resistance, a total of 104 clinical Acinetobacter baumannii strains were investigated for their biofilm-forming capacities and genes associated with biofilm formation. Selected biofilm-formers were tested for antibiotic susceptibilities when grown in biofilm phase. Reversibility of antibiotic susceptibility in planktonic cells regrown from biofilm were investigated. We found 59.6% of the strains were biofilm-formers, among which, 66.1% were non-multidrug resistant (MDR) strains. Presence of virulence genes bap, csuE, and abaI was significantly associated with biofilm-forming capacities. When strains were grown in biofilm state, the minimum biofilm eradication concentrations were 44, 407, and 364 times higher than the minimum bactericidal concentrations (MBC) for colistin, ciprofloxacin, and imipenem, respectively. Persisters were detected after treating the biofilm at 32-256 times the MBC of planktonic cells. Reversibility test for antibiotic susceptibility showed that biofilm formation induced reversible antibiotic tolerance in the non-MDR strains but a higher level of irreversible resistance in the extensively drug-resistant (XDR) strain. In summary, we showed that the non-MDR strains were strong biofilm-formers. Presence of persisters in biofilm contributed to the reduced antibiotic susceptibilities. Biofilm-grown Acinetobacter baumannii has induced antibiotic tolerance in non-MDR strains and increased resistance levels in XDR strains. To address the regulatory mechanisms of biofilm-specific resistance, thorough investigations at genome and transcription levels are warranted.

Ultracompact optical fiber acoustic sensors based on a fiber-top spirally-suspended optomechanical microresonator.

Acoustic wave sensors with a high sensitivity and small size are highly desired for a wide variety of important and emerging applications such as photoacoustic gas sensing and bio-imaging. Here we present an ultracompact optical fiber acoustic sensor based on an optomechanical resonator that is directly in situ printed on the end face of a standard single-mode optical fiber by using an optical 3D µ-printing technology. The fiber-top optomechanical microresonator is composed of a microscale suspended polymer micro-disk that forms a Fabry-Perot interferometric cavity, together with the optical fiber end face, and acts as the acoustic wave-sensitive micromechanical resonator simultaneously. The microbeams for suspending the micro-disk are devised with a spiral structure to overcome the small-size imposed low deflection amplitude so as to improve its sensitivity to acoustic waves. The sensor with a high sensitivity of 118.3 mV/Pa and low noise equivalent acoustic signal level of 0.328µPa/Hz1/2 at audio frequency is experimentally demonstrated. Moreover, with a resonance amplification mechanism, the sensitivity can be enhanced by 40.1 times when the frequency of the acoustic wave matches with the natural resonance frequency of the optomechanical resonator. Such an ultrasmall fiber-tip acoustic sensor has not only a miniaturization-induced broad bandwidth, but also a structure-enhanced ultrahigh sensitivity and thus is very promising in various acoustic wave-based sensing, imaging, and testing applications.

Durable Antimicrobial Behaviour from Silver-Graphene Coated Medical Textile Composites.

Silver nanoparticle (AgNP) and AgNP/reduced graphene oxide (rGO) nanocomposite impregnated medical grade polyviscose textile pads were formed using a facile, surface-mediated wet chemical solution-dipping process, without further annealing. Surfaces were sequentially treated in situ with a sodium borohydride (NaBH4) reducing agent, prior to formation, deposition, and fixation of Ag nanostructures and/or rGO nanosheets throughout porous non-woven (i.e., randomly interwoven) fibrous scaffolds. There was no need for stabilising agent use. The surface morphology of the treated fabrics and the reaction mechanism were characterised by Fourier transform infrared (FTIR) spectra, ultraviolet-visible (UV-Vis) absorption spectra, X-ray diffraction (XRD), Raman spectroscopy, dynamic light scattering (DLS) energy-dispersive X-ray analysis (EDS), and scanning electron microscopic (SEM). XRD and EDS confirmed the presence of pure-phase metallic silver. Variation of reducing agent concentration allowed control over characteristic plasmon absorption of AgNP while SEM imaging, EDS, and DLS confirmed the presence of and dispersion of Ag particles, with smaller agglomerates existing with concurrent rGO use, which also coincided with enhanced AgNP loading. The composites demonstrated potent antimicrobial activity against the clinically relevant gram-negative Escherichia coli (a key causative bacterial agent of healthcare-associated infections; HAIs). The best antibacterial rate achieved for treated substrates was 100% with only a slight decrease (to 90.1%) after 12 equivalent laundering cycles of standard washing. Investigation of silver ion release behaviours through inductively coupled plasmon optical emission spectroscopy (ICP-OES) and laundering durability tests showed that AgNP adhesion was aided by the presence of the rGO host matrix allowing for robust immobilisation of silver nanostructures with relatively high stability, which offered a rapid, convenient, scalable route to conformal NP-decorated and nanocomposite soft matter coatings.

Optical Fiber-Tip Sensors Based on In-Situ µ-Printed Polymer Suspended-Microbeams.

Miniature optical fiber-tip sensors based on directly µ-printed polymer suspended-microbeams are presented. With an in-house optical 3D µ-printing technology, SU-8 suspended-microbeams are fabricated in situ to form Fabry⁻Pérot (FP) micro-interferometers on the end face of standard single-mode optical fiber. Optical reflection spectra of the fabricated FP micro-interferometers are measured and fast Fourier transform is applied to analyze the cavity of micro-interferometers. The applications of the optical fiber-tip sensors for refractive index (RI) sensing and pressure sensing, which showed 917.3 nm/RIU to RI change and 4.29 nm/MPa to pressure change, respectively, are demonstrated in the experiments. The sensors and their optical µ-printing method unveil a new strategy to integrate complicated microcomponents on optical fibers toward 'lab-on-fiber' devices and applications.

Optofluidic tunable mode-locked fiber laser using a long-period grating integrated microfluidic chip.

An optofluidic tunable mode-locked fiber laser using a microfluidic chip integrated with long-period grating (LPG) is presented. The microfluidic chip enables ultrafine adjustment of the liquid's refractive index and, thus, LPG's spectrum via tuning the mixing ratio of the microfluidic flows. With such an optofluidic spectrum-tunable filter, the central wavelength of the mode-locked laser can be tuned continuously, while the mode-locking state is steadily maintained. The mode-locked pulses are measured with a pulse duration of 0.9 ps and repetition rate of 12.14 MHz, respectively. Moreover, bound solitons with variable soliton separations are experimentally demonstrated.

Rapid 3D Patterning of Poly(acrylic acid) Ionic Hydrogel for Miniature pH Sensors.

Poly(acrylic acid) (PAA), as a highly ionic conductive hydrogel, can reversibly swell/deswell according to the surrounding pH conditions. An optical maskless -stereolithography technology is presented to rapidly 3D pattern PAA for device fabrication. A highly sensitive miniature pH sensor is demonstrated by in situ printing of periodic PAA micropads on a tapered optical microfiber.

Reduction in mother-to-child transmission of syphilis for 10 years in Shenzhen, China.

BACKGROUND: Untreated maternal syphilis can result in the fetuses being infected. Severe adverse pregnancy outcomes include stillbirth, perinatal death, low birth weight, and congenital syphilis (CS). The World Health Organization has already classified global elimination of CS as a priority. However, this preventable disease is still threatening people's health in the world. METHODS: A Programme of Prevention of Mother-to-Child Transmission of Syphilis in Shenzhen was launched in 2002. All pregnant women in Shenzhen were screened for syphilis by serological methods at their first prenatal care visit. The infected individuals were treated with 3 weekly injections of 2.4 million units of benzathine penicillin. The babies were followed up until 18 months old to diagnose CS. RESULTS: Up to 2011, the Programme of Prevention of Mother-to-Child Transmission of Syphilis in Shenzhen screened 2,077,362 pregnant women and intervened in 7668 mothers infected with syphilis. The screened rate among pregnant women increased from 89.8% in 2002 to 97.4% in 2011. The proportion of those having adverse pregnant outcomes (including spontaneous abortion, premature delivery, and stillbirth) decreased from 27.3% in 2003 to 8.2% in 2011. The incidence of CS decreased from 115/100,000 in 2002 to 10/100,000 (live births) in 2011. CONCLUSIONS: In 2002, in the face of rising CS numbers, Shenzhen adapted a syphilis control program that involved cost-free testing for pregnant women, commitment and collaboration at multiple levels of the health system, and strong supervision and government guidance. Local program and surveillance data suggest that the program has been very successful in reducing CS incidence.

A meta-analysis of tumor necrosis factor-alpha, interleukin-6, and interleukin-10 in preeclampsia.

Inflammation may play a major role in the pathogenesis of preeclampsia (PE). In this meta-analysis, we determined whether maternal polymorphisms and serum concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) were associated with PE. All studies investigating the associations between PE and maternal polymorphisms of TNF-α-308G/A, IL-6-174G/C, and IL-10-1082A/G or serum concentrations of TNF-α, IL-6, and IL-10 were reviewed. We found that neither maternal TNF-α-308G/A (p=0.86, odds ratio [OR]=0.98, 95% confidence interval [CI], 0.76-1.25), IL-6 174G/C (p=0.14, OR=1.23, 95% CI, 0.93-1.61), nor IL-10-1082A/G (p=0.72, OR=1.07, 95% CI, 0.75-1.52) were associated with PE. On the other hand, maternal TNF-α (p<0.00001, weighted mean difference [WMD]=19.63 pg/ml, 95% CI, 18.54-20.72 pg/ml), IL-6 (p<0.00001, WMD=6.58 pg/ml, 95% CI, 5.49-7.67 pg/ml), and IL-10 (p=0.0005, WMD=19.30 pg/ml, 95% CI, 8.42-30.17 pg/ml) concentrations were significantly higher in PE patients versus controls. Our findings strengthen the clinical evidence that PE is accompanied by exaggerated inflammatory responses, but do not support TNF-α-308G/A, IL-6-174G/C, and IL-10-1082A/G as candidate susceptibility loci in PE.