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1.
Radiology ; 311(1): e231934, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38652031

RESUMEN

Cryptogenic stroke refers to a stroke of undetermined etiology. It accounts for approximately one-fifth of ischemic strokes and has a higher prevalence in younger patients. Embolic stroke of undetermined source (ESUS) refers to a subgroup of patients with nonlacunar cryptogenic strokes in whom embolism is the suspected stroke mechanism. Under the classifications of cryptogenic stroke or ESUS, there is wide heterogeneity in possible stroke mechanisms. In the absence of a confirmed stroke etiology, there is no established treatment for secondary prevention of stroke in patients experiencing cryptogenic stroke or ESUS, despite several clinical trials, leaving physicians with a clinical dilemma. Both conventional and advanced MRI techniques are available in clinical practice to identify differentiating features and stroke patterns and to determine or infer the underlying etiologic cause, such as atherosclerotic plaques and cardiogenic or paradoxical embolism due to occult pelvic venous thrombi. The aim of this review is to highlight the diagnostic utility of various MRI techniques in patients with cryptogenic stroke or ESUS. Future trends in technological advancement for promoting the adoption of MRI in such a special clinical application are also discussed.


Asunto(s)
Accidente Cerebrovascular Embólico , Imagen por Resonancia Magnética , Humanos , Accidente Cerebrovascular Embólico/diagnóstico por imagen , Accidente Cerebrovascular Embólico/etiología , Imagen por Resonancia Magnética/métodos , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/etiología , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/etiología
2.
Eur Radiol ; 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39060491

RESUMEN

OBJECTIVES: This study aimed to investigate the dilation of lenticulostriate artery (LSA) identified by whole-brain vessel wall imaging (WB-VWI) in differentiating the etiologic subtypes of single subcortical infarction (SSI) and to determine whether the appearance of dilated LSA was associated with 90-day clinical outcomes in parental atherosclerotic disease (PAD)-related SSI. METHODS: Patients with acute SSI were prospectively enrolled and categorized into PAD-related SSI and cerebral small-vessel disease (CSVD)-related SSI groups. The imaging features of LSA morphology (branches, length, dilation, and tortuosity), plaques (burden, remodeling index, enhancement degree, and hyperintense plaque), and CSVD (white matter hyperintensity, lacunes, cerebral microbleed, and enlarged perivascular space) were evaluated. The logistic regression was performed to determine the association of dilated LSA with PAD-related SSI and 90-day clinical outcomes. RESULTS: In total, 131 patients (mean age, 52.2 ± 13.2 years; 99 men) were included. The multivariate logistic regression analysis revealed that the presence of dilated LSAs (odds ratio (OR), 7.40; 95% confidence interval (CI): 1.88-29.17; p = 0.004)) was significantly associated with PAD-related SSI. Moreover, after adjusting for confounding factors, the association of poor outcomes with the total length of LSAs (OR, 0.94; 95% CI: 0.90-0.99; p = 0.011), dilated LSAs (OR, 0.001; 95% CI: 0.0001-0.08; p = 0.002), and plaque burden (OR, 1.35; 95% CI: 1.11-1.63; p = 0.002) remained statistically significant. CONCLUSION: The dilation of LSA visualized on WB-VWI could differentiate various subtypes of SSI within LSA territory and was a prognostic imaging marker for 90-day clinical outcomes for PAD-related SSI. CLINICAL RELEVANCE STATEMENT: Evaluation of LSA morphology based on WB-VWI can differentiate the pathogenesis and predict clinical outcomes in SSI, providing crucial insights into the etiologic mechanisms, risk stratification, and tailored therapies for these patients. KEY POINTS: The prognosis of SSIs within lenticulostriate territory depend on the etiology of the disease. LSA dilation on WB-VWI was associated with parental atherosclerosis and better 90-day outcomes. Accurately identifying the etiology of SSIs in lenticulostriate territory assists in treatment decision-making.

3.
Artículo en Inglés | MEDLINE | ID: mdl-38188941

RESUMEN

Obesity is a severe public health problem. Healthy lifestyle interventions are commonly recommended for fighting obesity. But they are hard to follow and have low efficacy. Pharmacotherapy and surgery are of high efficacy but are beset with side effects. Browning subcutaneous white adipose tissue (WAT) is a practical and efficient approach for combating obesity. Metformin, a commonly used FDA-approved antidiabetic drug, is potent to induce browning of WAT through phosphorylation and activation of AMP-activated protein kinase. However, oral administration of metformin has low oral bioavailability, fast renal clearance, and low target specificity that limit metformin's application in browning WAT. Local and transdermal delivery of metformin directly to subcutaneous WAT using injection or microneedle (MN) in combination with iontophoresis (INT) may solve these problems. In this paper, we administered metformin to C57BL/6J obese mice using the following three routes: transdermal delivery (MN and INT), local injection into inguinal WAT (IgWAT, a type of subcutaneous WAT in mice), and oral gavage. The anti-obesity and metabolic effects of metformin via these delivery routes were determined and compared. As compared to local IgWAT injection and oral gavage delivery, transdermal delivery of metformin using MN and INT resulted in 9% lower body weight and 7% decrease in body fat% accompanied by improved energy metabolism and decreased inflammation through browning IgWAT in obese C57BL/6J mice. Transdermal delivery of metformin using MN and INT is an effective approach in browning subcutaneous WAT for combating obesity and improving metabolic health.

4.
Environ Sci Pollut Res Int ; 31(15): 22243-22257, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38411910

RESUMEN

Indicators for evaluating road traffic energy consumption are critical parameters in the research field of road traffic energy consumption. Improving the applicability of energy consumption indicators can promote the development of green transportation in cities. However, there is currently a lack of systematic analysis of energy consumption indicators in research. Therefore, based on a comprehensive analysis of relevant literature, this study divides the indicators for evaluating road traffic energy consumption into two categories: macro (aimed at traffic systems or traffic flow) and micro (aimed at vehicles). These indicators are subdivided into four categories according to their application characteristics, including general, specific, predictive, and comprehensive. This paper provides a complete summary of various evaluation indicators, including their scope of application, advantages, and limitations, and highlights the relationships between them. Additionally, recommendations are made for the future development of evaluation indicators. Research has found that micro-level general indicators serve as the fundamental components of the mathematical structure for almost all other indicators. Specialized indicators primarily evaluate energy consumption in different driving states of vehicles. Predictive indicators are mainly used for assessing transportation energy consumption in simulation conditions. Comprehensive indicators are mainly applied to evaluate the life cycle energy consumption of vehicles or transportation systems. In future research, the performance of indicators can be improved through the design of standardized indicators, enhancement of energy consumption prediction accuracy, and integration of traffic flow parameters. The research contributes to upgrading energy-saving technologies in road transportation and developing sustainable urban transportation systems.


Asunto(s)
Monitoreo del Ambiente , Transportes , Monitoreo del Ambiente/métodos , Ciudades , Predicción , Accidentes de Tránsito
5.
Huan Jing Ke Xue ; 45(1): 93-103, 2024 Jan 08.
Artículo en Zh | MEDLINE | ID: mdl-38216461

RESUMEN

Vehicle emissions have become one of the most important air pollution sources in China. Promoting vehicle synergistic reduction of pollution and carbon is the key to improving regional environmental quality and achieving the carbon peaking and carbon neutrality goals. Building a collaborative evaluation system and comprehensive quantitative method is an important prerequisite for scientific and effective implementation of vehicle pollution and carbon synergistic reduction. Therefore, it is significant to extensively review existing synergistic evaluation methods and comprehensive environmental benefit accounting methods of atmospheric pollution and carbon reduction. On this basis, we focused on vehicle emission characteristics, systematically organized the key indicators of vehicle collaborative reduction evaluation, and summarized quantitative methods of policy effects from three aspects (health exposure cost, climate change cost, and pollutant control cost), to provide theoretical support for policy formulation, schemes selection, and their effect evaluation. For the future, the assessment of vehicle coordinated emission reduction is proposed to accelerate unified index system establishment, deeply analyze the spatial distribution of environmental benefits, focus on the pollution transfer caused by vehicle electrification, and explore the quantitative methods of climate change cost due to extreme weather.

6.
J Colloid Interface Sci ; 656: 556-565, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38011774

RESUMEN

The advancement of the lithium-sulfur (Li-S) batteries is immensely impeded by two main challenges: polysulfide shuttling between the electrodes and Li dendrite formation associated with the Li-metal anode. To tackle these challenges, we synthesized a polydopamine coated bacterial cellulose (PDA@BC) separator in a way to create physical and chemical traps for the shuttling polysulfides and to control the Li+ flux. While nanocellulose offers its dense network as a physical trap, the presence of polydopamine in the separator offers polar functional groups which not only has a high binding energy towards the polysulfides but also helps in redistribution of the Li+ ions across it. The electrochemical and physiochemical results suggest that the synthesized separator can have practical applicability owing to its superior performance compared to a commercial separator. The Li-S batteries assembled with this separator showed a specific discharge capacity of 1449 mAh/g at 0.1C and 877 mAh/g at 1C, and a capacity fade of 0.03 % per cycle over 650 cycles at 1C. Using a PDA@BC separator, a practical Li-S battery cell with S loading of 7.5 mg cm-2 (and E/S ratio of 10 µLmg-1, 82 % S ratio) was also tested at 1C, which delivered a capacity of âˆ¼ 6 mAh cm-2 for 500 cycles.

7.
J Am Heart Assoc ; 13(10): e032856, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38726896

RESUMEN

BACKGROUND: We aimed to investigate the association of characteristics of lenticulostriate artery (LSA) morphology and parental atheromatous disease (PAD) with single subcortical infarction (SSI) and to explore whether the LSA morphology is correlated with proximal plaque features in asymptomatic PAD. METHODS AND RESULTS: Patients with acute SSI were prospectively enrolled and classified as large- and small-SSI groups. The clinical data and imaging features of LSA morphology (branches, length, dilation, and tortuosity) and middle cerebral artery plaques (normalized wall index, remodeling index, enhancement degree, and hyperintense plaques) were evaluated. Logistic regression was performed to determine the association of large SSIs with morphologic features of LSAs and plaques. The Spearman correlation between the morphologic characteristics of LSAs and plaque features in asymptomatic PAD was analyzed. Of the 121 patients recruited with symptomatic PAD, 102 had coexisting asymptomatic contralateral PAD. The mean length of LSAs (odds ratio, 0.84 [95% CI, 0.73-0.95]; P=0.007), mean tortuosity of LSAs (odds ratio, 1.13 [95% CI, 1.05-1.22]; P=0.002), dilated LSAs (odds ratio, 22.59 [95% CI, 2.46-207.74]; P=0.006), and normalized wall index (odds ratio, 1.08 [95% CI, 1.01-1.15]; P=0.022) were significantly associated with large SSIs. Moreover, the normalized wall index was negatively correlated with the mean length of LSAs (r=-0.348, P<0.001), and the remodeling index was negatively correlated with the mean tortuosity of LSAs (r=-0.348, P<0.001) in asymptomatic PAD. CONCLUSIONS: Our findings suggest that mean length of LSAs, mean tortuosity of LSAs, dilated LSAs, and normalized wall index are associated with large SSIs. Moreover, plaque features in asymptomatic PAD are correlated with morphologic features of LSAs.


Asunto(s)
Placa Aterosclerótica , Humanos , Masculino , Femenino , Anciano , Persona de Mediana Edad , Estudios Prospectivos , Infarto Cerebral/diagnóstico por imagen , Infarto Cerebral/patología , Angiografía por Resonancia Magnética , Enfermedad Cerebrovascular de los Ganglios Basales/diagnóstico por imagen , Enfermedad Cerebrovascular de los Ganglios Basales/patología , Enfermedades Asintomáticas , Angiografía Cerebral/métodos
8.
Neurol Int ; 16(1): 95-112, 2024 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-38251054

RESUMEN

Traumatic brain injury (TBI) is a common diagnosis requiring acute hospitalization. Long-term, TBI is a significant source of health and socioeconomic impact in the United States and globally. The goal of clinicians who manage TBI is to prevent secondary brain injury. In this population, post-traumatic cerebral infarction (PTCI) acutely after TBI is an important but under-recognized complication that is associated with negative functional outcomes. In this comprehensive review, we describe the incidence and pathophysiology of PTCI. We then discuss the diagnostic and treatment approaches for the most common etiologies of isolated PTCI, including brain herniation syndromes, cervical artery dissection, venous thrombosis, and post-traumatic vasospasm. In addition to these mechanisms, hypercoagulability and microcirculatory failure can also exacerbate ischemia. We aim to highlight the importance of this condition and future clinical research needs with the goal of improving patient outcomes after TBI.

9.
Sci Rep ; 14(1): 10621, 2024 05 09.
Artículo en Inglés | MEDLINE | ID: mdl-38729969

RESUMEN

Asymptomatic Leucine-Rich Repeat Kinase 2 Gene (LRRK2) carriers are at risk for developing Parkinson's disease (PD). We studied presymptomatic substantia nigra pars compacta (SNc) regional neurodegeneration in asymptomatic LRRK2 carriers compared to idiopathic PD patients using neuromelanin-sensitive MRI technique (NM-MRI). Fifteen asymptomatic LRRK2 carriers, 22 idiopathic PD patients, and 30 healthy controls (HCs) were scanned using NM-MRI. We computed volume and contrast-to-noise ratio (CNR) derived from the whole SNc and the sensorimotor, associative, and limbic SNc regions. An analysis of covariance was performed to explore the differences of whole and regional NM-MRI values among the groups while controlling the effect of age and sex. In whole SNc, LRRK2 had significantly lower CNR than HCs but non-significantly higher volume and CNR than PD patients, and PD patients significantly lower volume and CNR compared to HCs. Inside SNc regions, there were significant group effects for CNR in all regions and for volumes in the associative region, with a trend in the sensorimotor region but no significant changes in the limbic region. PD had reduced volume and CNR in all regions compared to HCs. Asymptomatic LRRK2 carriers showed globally decreased SNc volume and CNR suggesting early nigral neurodegeneration in these subjects at risk of developing PD.


Asunto(s)
Proteína 2 Quinasa Serina-Treonina Rica en Repeticiones de Leucina , Imagen por Resonancia Magnética , Melaninas , Enfermedad de Parkinson , Sustancia Negra , Humanos , Proteína 2 Quinasa Serina-Treonina Rica en Repeticiones de Leucina/genética , Proteína 2 Quinasa Serina-Treonina Rica en Repeticiones de Leucina/metabolismo , Masculino , Femenino , Persona de Mediana Edad , Melaninas/metabolismo , Imagen por Resonancia Magnética/métodos , Enfermedad de Parkinson/genética , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/patología , Enfermedad de Parkinson/metabolismo , Sustancia Negra/diagnóstico por imagen , Sustancia Negra/patología , Sustancia Negra/metabolismo , Anciano , Heterocigoto , Adulto , Estudios de Casos y Controles
10.
Phys Med Biol ; 69(15)2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39019073

RESUMEN

Objective.We aim to develop a Multi-modal Fusion and Feature Enhancement U-Net (MFFE U-Net) coupling with stem cell niche proximity estimation to improve voxel-wise Glioblastoma (GBM) recurrence prediction.Approach.57 patients with pre- and post-surgery magnetic resonance (MR) scans were retrospectively solicited from 4 databases. Post-surgery MR scans included two months before the clinical diagnosis of recurrence and the day of the radiologicaly confirmed recurrence. The recurrences were manually annotated on the T1ce. The high-risk recurrence region was first determined. Then, a sparse multi-modal feature fusion U-Net was developed. The 50 patients from 3 databases were divided into 70% training, 10% validation, and 20% testing. 7 patients from the 4th institution were used as external testing with transfer learning. Model performance was evaluated by recall, precision, F1-score, and Hausdorff Distance at the 95% percentile (HD95). The proposed MFFE U-Net was compared to the support vector machine (SVM) model and two state-of-the-art neural networks. An ablation study was performed.Main results.The MFFE U-Net achieved a precision of 0.79 ± 0.08, a recall of 0.85 ± 0.11, and an F1-score of 0.82 ± 0.09. Statistically significant improvement was observed when comparing MFFE U-Net with proximity estimation couple SVM (SVMPE), mU-Net, and Deeplabv3. The HD95 was 2.75 ± 0.44 mm and 3.91 ± 0.83 mm for the 10 patients used in the model construction and 7 patients used for external testing, respectively. The ablation test showed that all five MR sequences contributed to the performance of the final model, with T1ce contributing the most. Convergence analysis, time efficiency analysis, and visualization of the intermediate results further discovered the characteristics of the proposed method.Significance. We present an advanced MFFE learning framework, MFFE U-Net, for effective voxel-wise GBM recurrence prediction. MFFE U-Net performs significantly better than the state-of-the-art networks and can potentially guide early RT intervention of the disease recurrence.


Asunto(s)
Neoplasias Encefálicas , Glioblastoma , Imagen por Resonancia Magnética , Recurrencia Local de Neoplasia , Humanos , Glioblastoma/diagnóstico por imagen , Glioblastoma/patología , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/patología , Recurrencia Local de Neoplasia/diagnóstico por imagen , Procesamiento de Imagen Asistido por Computador/métodos , Redes Neurales de la Computación , Estudios Retrospectivos , Recurrencia , Masculino , Femenino , Persona de Mediana Edad
11.
ACR Open Rheumatol ; 6(4): 189-200, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38265177

RESUMEN

OBJECTIVE: Acute visual impairment is the most feared complication of giant cell arteritis (GCA) but is challenging to predict. Magnetic resonance imaging (MRI) evaluates orbital pathology not visualized by an ophthalmologic examination. This study combined orbital and cranial vessel wall MRI to assess both orbital and cranial disease activity in patients with GCA, including patients without visual symptoms. METHODS: Patients with suspected active GCA who underwent orbital and cranial vessel wall MRI were included. In 14 patients, repeat imaging over 12 months assessed sensitivity to change. Clinical diagnosis of ocular or nonocular GCA was determined by a rheumatologist and/or ophthalmologist. A radiologist masked to clinical data scored MRI enhancement of structures. RESULTS: Sixty-four patients with suspected GCA were included: 25 (39%) received a clinical diagnosis of GCA, including 12 (19%) with ocular GCA. Orbital MRI enhancement was observed in 83% of patients with ocular GCA, 38% of patients with nonocular GCA, and 5% of patients with non-GCA. MRI had strong diagnostic performance for both any GCA and ocular GCA. Combining MRI with a funduscopic examination reached 100% sensitivity for ocular GCA. MRI enhancement significantly decreased after treatment (P < 0.01). CONCLUSION: In GCA, MRI is a sensitive tool that comprehensively evaluates multiple cranial structures, including the orbits, which are the most concerning site of pathology. Orbital enhancement in patients without visual symptoms suggests that MRI may detect at-risk subclinical ocular disease in GCA. MRI scores decreased following treatment, suggesting scores reflect inflammation. Future studies are needed to determine if MRI can identify patients at low risk for blindness who may receive less glucocorticoid therapy.

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