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OBJECTIVES: Minor stroke is defined by a score of 5 or less on the National Institutes of Health Stroke Scale (NIHSS). Prior trials have shown efficacy of short term dual antiplatelet therapy (DAPT) in secondary prevention of stroke among patients with transient ischemic attack (TIA) or minor ischemic stroke, but no randomized clinical trials have studied this benefit after intravenous thrombolysis (IVT). Our aim was to investigate the safety of DAPT within 90 days after IVT in patients with acute minor ischemic stroke. PATIENTS AND METHODS: We reviewed medical records of patients older than 18 years that received IVT between January 2015 and December 2022. Patients had a diagnosis of acute minor stroke or averted stroke (complete recovery and negative image on follow-up). Single or dual antiplatelet treatment was started 24 hours after thrombolysis according to the physician's judgment. Patients were divided in two groups: single and dual antiplatelet therapy. We assessed clinical outcome using the modified Rankin scale (mRS), symptomatic intracranial hemorrhage (SICH) and mortality at 90 days. RESULTS: Fifty-three patients met the inclusion criteria, 68% men aged 64±16,5 years. Seventy five percent had an ischemic stroke and 25% had an averted stroke. Median door-to-needle time was 50 minutes. Fifty one percent were in the single antiplatelet group and 49% in the dual antiplatelet therapy group. There were no differences in demographic and clinical characteristics between groups. The 90-day mRS did not show significant difference between groups. No patients had SICH nor died during follow-up. One patient in the single antiplatelet group had stroke recurrence. CONCLUSIONS: Dual antiplatelet therapy after IVT with rtPA for acute minor ischemic stroke appears not to increase the risk of bleeding and mortality compared to single antiplatelet therapy in the first three months after the event. This is the first study to assess this subject in a Latin American population.
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The study of digeneans and their association with mollusks commenced in Europe and South America during the mid-19th to early 20th centuries. Digenean infestation can severely degrade host tissue, leading to diminished energy resources and eventual host mortality. However, these parasites can also induce various non-lethal effects, including changes in growth rates, survival rates, and reproductive capabilities, alongside physiological and behavioral alterations. While numerous studies have explored the ecological effects of digeneans on hosts in Europe and North America, our understanding of these dynamics in South America, particularly in first intermediate hosts, remains limited. Therefore, this paper aims to provide an overview of ecological investigations into digenean-mollusk systems in South America, emphasizing the importance of robust sampling designs and statistical analyses to address key ecological inquiries. Although fascinating examples exist of parasitism influencing different hierarchical levels of digenean-mollusk systems, particularly at the individual, population, and community levels, documentation of their ecosystem-level impacts is comparatively sparse. As South American studies of digenean-mollusk systems from an ecological perspective are still in their early stages, there is immense potential for uncovering unique ecological patterns in this largely unexplored region, propelling us toward further developmental strides in the parasite ecology.
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Resumen La embolia paradojal debido a una malformación arteriovenosa pulmonar (MAVP) aislada es una causa in frecuente de accidente cerebrovascular (ACV) isquémico. Las MAVP son conductos anómalos de alta circulación entre arterias y venas pulmonares, desviando sangre desoxigenada hacia la circulación sistémica y represen tan una fuente menos común de embolias paradojales, especialmente en personas jóvenes. La embolización endovascular es el tratamiento preferido para MAVP clínicamente significativas. Presentamos el caso de una mujer de 34 años con ACV isquémico talámico izquierdo. Se detectó pasaje de burbujas "en cortina" en arterias cerebrales mediante Doppler transcraneal. En ecografía intracardíaca no se encontró foramen oval permeable, motivo por el cual se avanzó con realización de angiotomografía pulmonar, la cual confirmó la presencia de MAVP. La paciente recibió tratamiento endovascular exitoso. Es esencial considerar la MAVP en el diagnóstico etio lógico del ACV isquémico, especialmente en pacientes jóvenes con signos de comunicación anormal de derecha a izquierda. Se recomienda un seguimiento periódico mediante imágenes para evaluar la posible recurrencia o cambios en la MAVP, resaltando la importancia del manejo adecuado de estas malformaciones.
Abstract Paradoxical embolism due to an isolated pulmonary arteriovenous malformation (PAVM) is a rare cause of ischemic stroke. PAVMs are abnormal high-flow connec tions between pulmonary arteries and veins, diverting deoxygenated blood into the systemic circulation and they represent a less common source of paradoxical embolisms, especially in young individuals. Endovascular embolization is the preferred treatment for clinically significant PAVMs. We present the case of a 34-year-old woman with a left thalamic ischemic stroke. Severe contrast passage was detected in cerebral arteries through transcranial Doppler. Intracardiac ultrasound did not reveal a patent foramen ovale, prompting further investigation with pulmonary CT angiography, confirming the presence of PAVM. The patient underwent successful endovascular treatment. It is essential to consider PAVM in the etiological di agnosis of ischemic stroke, especially in young patients with signs of abnormal right-to-left communication. Periodic follow-up imaging is recommended to assess potential recurrence or changes in PAVM, emphasizing the importance of appropriate management of these malformations.
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PRCIS: Presented is a novel surgical technique, termed the "pocket" technique, of scleral patch graft placement into a subconjuntival pocket to cover exposed glaucoma tube shunts, which is particularly useful in cases of scarred and thinned conjunctiva and Tenons. ABSTRACT: Exposure of glaucoma tube shunts is an uncommon postoperative complication which poses a significant risk to the patient and may be difficult to repair. In this case series, the authors present 2 cases using a novel surgical technique, the "pocket" technique, to place a scleral patch graft to address tube exposure. Patient 1 remained free of tube exposure at most recent follow-up visit after 21 months, and patient 2 remained free of tube exposure at most recent follow-up visit after 4 months. This technique offers an elegant surgical option that has multiple benefits; it allows for stability of the scleral patch graft even in cases of scarred down, thinned conjunctiva with minimal Tenons, allows for repair along the entire length of the tube shunt including perilimbal exposures, and allows for secondary healing when there is not enough conjunctiva to cover both the opening and the patch. These advantages make the "pocket" technique a quick to perform, minimally invasive surgical approach that is useful for addressing both difficult and straightforward tube exposure cases.
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Túnica Conjuntiva , Implantes para Drenagem de Glaucoma , Glaucoma , Pressão Intraocular , Esclera , Humanos , Túnica Conjuntiva/cirurgia , Esclera/cirurgia , Pressão Intraocular/fisiologia , Glaucoma/cirurgia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Complicações Pós-Operatórias , Cicatriz/cirurgiaRESUMO
Paradoxical embolism due to an isolated pulmonary arteriovenous malformation (PAVM) is a rare cause of ischemic stroke. PAVMs are abnormal high-flow connections between pulmonary arteries and veins, diverting deoxygenated blood into the systemic circulation and they represent a less common source of paradoxical embolisms, especially in young individuals. Endovascular embolization is the preferred treatment for clinically significant PAVMs. We present the case of a 34-year-old woman with a left thalamic ischemic stroke. Severe contrast passage was detected in cerebral arteries through transcranial Doppler. Intracardiac ultrasound did not reveal a patent foramen ovale, prompting further investigation with pulmonary CT angiography, confirming the presence of PAVM. The patient underwent successful endovascular treatment. It is essential to consider PAVM in the etiological diagnosis of ischemic stroke, especially in young patients with signs of abnormal right-to-left communication. Periodic follow-up imaging is recommended to assess potential recurrence or changes in PAVM, emphasizing the importance of appropriate management of these malformations.
La embolia paradojal debido a una malformación arteriovenosa pulmonar (MAVP) aislada es una causa infrecuente de accidente cerebrovascular (ACV) isquémico. Las MAVP son conductos anómalos de alta circulación entre arterias y venas pulmonares, desviando sangre desoxigenada hacia la circulación sistémica y representan una fuente menos común de embolias paradojales, especialmente en personas jóvenes. La embolización endovascular es el tratamiento preferido para MAVP clínicamente significativas. Presentamos el caso de una mujer de 34 años con ACV isquémico talámico izquierdo. Se detectó pasaje de burbujas "en cortina" en arterias cerebrales mediante Doppler transcraneal. En ecografía intracardíaca no se encontró foramen oval permeable, motivo por el cual se avanzó con realización de angiotomografía pulmonar, la cual confirmó la presencia de MAVP. La paciente recibió tratamiento endovascular exitoso. Es esencial considerar la MAVP en el diagnóstico etiológico del ACV isquémico, especialmente en pacientes jóvenes con signos de comunicación anormal de derecha a izquierda. Se recomienda un seguimiento periódico mediante imágenes para evaluar la posible recurrencia o cambios en la MAVP, resaltando la importancia del manejo adecuado de estas malformaciones.
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Malformações Arteriovenosas , Embolia Paradoxal , AVC Isquêmico , Artéria Pulmonar , Artéria Pulmonar/anormalidades , Veias Pulmonares , Veias Pulmonares/anormalidades , Humanos , Adulto , Feminino , Embolia Paradoxal/diagnóstico por imagem , Embolia Paradoxal/etiologia , AVC Isquêmico/etiologia , AVC Isquêmico/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/complicações , Embolização Terapêutica/métodosRESUMO
Uterine carcinosarcoma (UCS) is a rare but aggressive endometrial cancer. Survival outcomes for women diagnosed with UCS remain poor with lower survival than those of endometrioid or high-grade serous uterine cancers. The histopathological hallmark of carcinosarcoma is the presence of both sarcomatous and carcinomatous elements. The survival rates for UCS have not improved for over 40 years; therefore, there is a profound need to identify new treatments. To investigate novel chemotherapy treatment combinations for UCS, we generated a UCS patient-derived organoid (PDO) cell line from a patient that received neoadjuvant treatment with paclitaxel and carboplatin. The PDO cell line (UCS1) was grown in three-dimensional domes. The PDO domes were treated with six individual chemotherapies or nine combinations of those six drugs. Cell death in response to chemotherapy was assessed. We found that the six monotherapies had minimal effectiveness at inducing cell death after 48 h of treatment. The combination of paclitaxel and carboplatin (which is the standard-of-care chemotherapy treatment for UCS) led to a small increase in apoptosis compared with the monotherapies. Importantly, when either carboplatin or paclitaxel was combined with gemcitabine, there was an appreciable increase in cell death. In conclusion, for the UCS1 patient-derived tumor cells, gemcitabine combinations were more effective than carboplatin/paclitaxel. Our data support the use of PDOs to predict responses to second-line chemotherapy.
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BACKGROUND: Osteosarcoma (OS) stands out as the most common bone tumor, with approximately 20% of the patients receiving a diagnosis of metastatic OS at their initial assessment. A significant challenge lies in the frequent existence of undetected metastases during the initial diagnosis. Mesenchymal stem cells (MSCs) possess unique abilities that facilitate tumor growth, and their interaction with OS cells is crucial for metastatic spread. METHODS AND RESULTS: We demonstrated that, in vitro, MSCs exhibited a heightened migration response toward the secretome of non-metastatic OS cells. When challenged to a secretome derived from lungs preloaded with OS cells, MSCs exhibited greater migration toward lungs colonized with metastatic OS cells. Moreover, in vivo, MSCs displayed preferential migratory and homing behavior toward lungs colonized by metastatic OS cells. Metastatic OS cells, in turn, demonstrated an increased migratory response to the MSCs' secretome. This behavior was associated with heightened cathepsin D (CTSD) expression and the release of active metalloproteinase 2 (MMP2) by metastatic OS cells. CONCLUSIONS: Our assessment focused on two complementary tumor capabilities crucial to metastatic spread, emphasizing the significance of inherent cell features. The findings underscore the pivotal role of signaling integration within the niche, with a complex interplay of migratory responses among established OS cells in the lungs, prometastatic OS cells in the primary tumor, and circulating MSCs. Pulmonary metastases continue to be a significant factor contributing to OS mortality. Understanding these mechanisms and identifying differentially expressed genes is essential for pinpointing markers and targets to manage metastatic spread and improve outcomes for patients with OS.
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Neoplasias Ósseas , Osteossarcoma , Animais , Humanos , Metaloproteinase 2 da Matriz/genética , Metaloproteinase 2 da Matriz/metabolismo , Proliferação de Células/genética , Pulmão/metabolismo , Osteossarcoma/genética , Osteossarcoma/patologia , Células Estromais/patologia , Neoplasias Ósseas/metabolismo , Linhagem Celular Tumoral , Microambiente TumoralRESUMO
Upconverting nanoparticles (UCNPs) have found widespread applications in biophotonics and energy harvesting due to their unique non-linear optical properties arising from energy transfer upconversion (ETU) mechanisms. However, accurately characterising the power density-dependent efficiency of UCNPs using the internal quantum yield (iQY) is challenging due to the lack of methods that account for excitation beam-profile distortions. This limitation hinders the engineering of optimal UCNPs for diverse applications. To address this, this work present a novel beam profile compensation strategy based on a general analytical rate-equations model, enabling the evaluation of iQY for ETU processes of arbitrary order, such as ETU2, ETU3, and beyond. The method was applied to characterise the ETU2 and ETU3 processes corresponding to the main emission peaks (474 nm, 650 nm, and 804 nm) of a Yb-Tm codoped core-shell ß-UCNP. Through this approach, the transition power density points (which delimit the distinct non-linear regimes of the upconversion luminescence (UCL)), and the saturation iQY values (which are reached at high excitation power densities above the transition points) were determined. The ETU2 process exhibits a single transition power density point, denoted as ρ2, while the ETU3 processes involve two transition points, ρ2 and ρ3. By compensating for the beam profile, we evaluate the iQY of individual lines across a wide dynamic range of excitation power densities (up to 105 W cm-2), encompassing both non-linear and linear regimes of UCL. This study introduces a valuable approach for accurately characterising the iQY of UCNPs, facilitating a deeper understanding of the upconversion and its performance. By addressing excitation beam-profile distortions, this method provides a comprehensive and reliable assessment of the power density-dependent iQY. The results highlight the applicability and effectiveness of this beam profile compensation strategy, which can be employed for a wide range of UCNPs. This advancement opens new avenues for the tailored design and application of UCNPs in various fields, especially for biophotonics.
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A new family of molecules obtained by coupling Tröger's base unit with dicyanovinylene-terminated oligothiophenes of different lengths has been synthesized and characterized by steady-state stationary and transient time-resolved spectroscopies. Quantum chemical calculations allow us to interpret and recognize the properties of the stationary excited states as well as the time-dependent mechanisms of singlet-to-triplet coupling. The presence of the diazocine unit in Tröger's base derivatives is key to efficiently producing singlet-to-triplet intersystem crossing mediated by the role of the nitrogen atoms and of the almost orthogonal disposition of the two thiophene arms. Spin-orbit coupling-mediated interstate intersystem crossing (ISC) is activated by a symmetry-breaking process in the first singlet excited state with partial charge transfer character. This mechanism is a characteristic of these molecular triads since the independent dicyanovinylene-oligothiophene branches do not display appreciable ISC. These results show how Tröger's base coupling of organic chromophores can be used to improve the ISC efficiency and tune their photophysics.
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Millipedes are key players in recycling leaf litter into soil in tropical ecosystems. To elucidate their gut microbiota, we collected millipedes from different municipalities of Puerto Rico. Here we aim to benchmark which method is best for metagenomic skimming of this highly complex millipede microbiome. We sequenced the gut DNA with Oxford Nanopore Technologies' (ONT) MinION sequencer, then analyzed the data using MEGAN-LR, Kraken2 protein mode, Kraken2 nucleotide mode, GraphMap, and Minimap2 to classify these long ONT reads. From our two samples, we obtained a total of 87,110 and 99,749 ONT reads, respectively. Kraken2 nucleotide mode classified the most reads compared to all other methods at the phylum and class taxonomic level, classifying 75% of the reads in the two samples, the other methods failed to assign enough reads to either phylum or class to yield asymptotes in the taxa rarefaction curves indicating that they required more sequencing depth to fully classify this community. The community is hyper diverse with all methods classifying 20-50 phyla in the two samples. There was significant overlap in the reads used and phyla classified between the five methods benchmarked. Our results suggest that Kraken2 nucleotide mode is the most appropriate tool for the application of metagenomic skimming of this highly complex community.
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Light Detection and Ranging (LiDAR) technology is positioning itself as one of the most effective non-destructive methods to collect accurate information on ground crop fields, as the analysis of the three-dimensional models that can be generated with it allows for quickly measuring several key parameters (such as yield estimations, aboveground biomass, vegetation indexes estimation, perform plant phenotyping, and automatic control of agriculture robots or machinery, among others). In this survey, we systematically analyze 53 research papers published between 2005 and 2022 that involve significant use of the LiDAR technology applied to the three-dimensional analysis of ground crops. Different dimensions are identified for classifying the surveyed papers (including application areas, crop species under study, LiDAR scanner technologies, mounting platform technologies, and the use of additional instrumentation and software tools). From our survey, we draw relevant conclusions about the use of LiDAR technologies, such as identifying a hierarchy of different scanning platforms and their frequency of use as well as establishing the trade-off between the economic costs of deploying LiDAR and the agronomically relevant information that effectively can be acquired. We also conclude that none of the approaches under analysis tackles the problem associated with working with multiple species with the same setup and configuration, which shows the need for instrument calibration and algorithmic fine tuning for an effective application of this technology.
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The objective of this study was to assess the effects of feeding gelatin capsules containing fish oil, treated with alcoholic solutions of flavoring agents followed by drying, on lactation performance, rumen fatty acids content and milk enrichment of fatty acids. In Trial 1, four multiparous ruminally fistulated Holstein cows were randomly assigned to one of four dietary treatments sequences in a 4 × 4 Latin square design. Treatments consisted of (1) Control with no capsules, (2) Control plus 200 untreated capsules per cow/day, mixed with the TMR, (3) Control plus 200 treated capsules per cow/day placed directly into the rumen, (4) Control plus 200 treated capsules per cow/day, mixed with the TMR. In Trial 2, three fistulated Holstein and three fistulated Jersey multiparous cows were randomly assigned to three dietary treatments sequences in a replicated 3 × 3 Latin square design. Treatments consisted of (1) Control with no capsules fed to the cows, (2) Control plus 180 untreated capsules per cow/day, (3) Control plus 180 treated capsules per cow/day. Compared to control, feeding fish oil capsules significantly (Trial 1) or numerically (Trial 2) reduced milk fat concentration and yield. Furthermore, in both trials, the feeding of untreated or treated capsules had no effect on animal performance or milk composition. In both trials, compared to controls, supplementing the diet with fish oil capsules consistently increased total trans C18:1 isomers and DHA concentration in the rumen and milk fat. However, for both trials, capsule protection treatment had a minimal effect on the concentration of any of the reported rumen and milk fatty acids. When assessed under laboratory control conditions, due to water absorption, the treated capsule weight was increased by 40% while resistance to pressure decreased by 84% after 2 h of incubation in water. The results of this study suggest that due to a reduction in the capsule shell's resistance to abrasion, treated capsules marginally prevented the release of fish oil in the rumen.
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Society often relies on social algorithms that adapt to human behavior. Yet scientists struggle to generalize the combined behavior of mutually-adapting humans and algorithms. This scientific challenge is a governance problem when algorithms amplify human responses to falsehoods. Could attempts to influence humans have second-order effects on algorithms? Using a large-scale field experiment, I test if influencing readers to fact-check unreliable sources causes news aggregation algorithms to promote or lessen the visibility of those sources. Interventions encouraged readers to fact-check articles or fact-check and provide votes to the algorithm. Across 1104 discussions, these encouragements increased human fact-checking and reduced vote scores on average. The fact-checking condition also caused the algorithm to reduce the promotion of articles over time by as much as -25 rank positions on average, enough to remove an article from the front page. Overall, this study offers a path for the science of human-algorithm behavior by experimentally demonstrating how influencing collective human behavior can also influence algorithm behavior.
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Algoritmos , Política , Humanos , Terapia Comportamental , Comportamento de MassaRESUMO
The quantum yield (QY) evaluation of upconverting nanoparticles (UCNPs) is an essential step in the characterisation of such materials. The QY of UCNPs is governed by competing mechanisms of populating and depopulating the electronic energy levels involved in the upconversion (UC), namely linear decay rates and energy transfer rates. As a consequence, at low excitation, the QY excitation power density (ρ) dependence obeys the power law ρn-1, where n represents the number of absorbed photons required for the emission of a single upconverted photon and determines the order of the energy transfer upconversion (ETU) process. At high power densities, the QY transits to a saturation level independent of the ETU process and the number of excitation photons, as a result of an anomalous power density dependence present in UCNPs. Despite the importance of this non-linear process for several applications (e.g., living tissue imaging and super-resolution-microscopy), little has been reported in the literature regarding theoretical studies to describe the UC QY, especially for ETUs with order higher than two. Therefore, this work presents a simple general analytical model, which introduces the concept of the transition power density points and QY saturation to characterise the QY of an arbitrary ETU process. The transition power density points determine where the power density dependence of the QY and the UC luminescence changes. The results provided in this paper from fitting the model to experimental QY data of a Yb-Tm codoped ß-UCNP for 804 nm and 474 nm emissions (ETU2 and ETU3 processes, respectively) exemplify the application of the model. The common transition points found for both processes were compared to each other showing strong agreement with theory, as well as, compared to previous reports when possible.
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BACKGROUND: JC polyomavirus (JCV) has an ethno-geographical distribution across human populations. OBJECTIVE: Study the origins of the population of Misiones (Argentina) by using JCV as genetic marker. METHODS: Viral detection and characterization was conducted by PCR amplification and evolutionary analysis of the intergenic region sequences. RESULTS: 22 out of 121 samples were positive for JCV, including 5 viral lineages: MY (n = 8), Eu-a (n = 7), B1-c (n = 4), B1-b (n = 2) and Af2 (n = 1). MY sequences clustered within a branch of Native American origin that diverged from its Asian counterpart about 21,914 years ago (HPD 95% interval 15,383-30,177), followed by a sustained demographic expansion around 5000 years ago. CONCLUSIONS: JCV in Misiones reflects the multiethnic origin of the current population, with an important Amerindian contribution. Analysis of the MY viral lineage shows a pattern consistent with the arrival of early human migrations to the Americas and a population expansion by the pre-Columbian native societies.
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Vírus JC , Humanos , Vírus JC/genética , Evolução Biológica , Dinâmica Populacional , Migração Humana , América/epidemiologia , DNA Viral/genéticaRESUMO
Tasks we often perform in our everyday lives, such as reading or looking for a friend in the crowd, are seemingly straightforward but they actually require the orchestrated activity of several cognitive processes. Free-viewing visual search requires a plan to move our gaze on the different items, identifying them, and deciding on whether to continue with the search. Little is known about the electrophysiological signatures of these processes in free-viewing because there are technical challenges associated with eye movement artefacts. Here, we aimed to study how category information, as well as ecologically relevant variables such as the task performed, influence brain activity in a free-viewing paradigm. Participants were asked to observe/search from an array of faces and objects embedded in random noise. We concurrently recorded electroencephalogram and eye movements and applied a deconvolution analysis approach to estimate the contribution of the different elements embedded in the task. Consistent with classical fixed-gaze experiments and a handful of free-viewing studies, we found a robust categorical effect around 150 ms in occipital and occipitotemporal electrodes. We also report a task effect, more negative in posterior central electrodes in visual search compared with exploration, starting at around 80 ms. We also found significant effects of trial progression and an interaction with the task effect. Overall, these results generalise the characterisation of early visual face processing to a wider range of experiments and show how a suitable analysis approach allows to discern among multiple neural contributions to the signal, preserving key attributes of real-world tasks.