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Microsurgical resection is an effective method to treat brain arteriovenous malformations (BAVMs). Functional magnetic resonance imaging (fMRI) can evaluate the spatial relationship of nidus and eloquent. Diffuse BAVMs are related to poor outcomes postoperatively. The role of fMRI in evaluating outcomes in patients with different nidus types remains unclear. BAVM patients received microsurgical resection were included from a prospective, multicenter cohort study. All patients underwent fMRI evaluation preoperatively and were regularly followed up postoperatively. Diffuse BAVM is radiologically identified as nidus containing normal brain tissue interspersing between malformed vessels. Lesion-to-eloquent distance (LED) was calculated based on the relationship between nidus and eloquent. The primary outcome was 180-day unfavorable neurological status postoperatively. The risk of primary outcome was investigated within different BAVM nidus types. The LED's performance to predict poor outcome was evaluated using area under curve (AUC). 346 BAVM patients were included in this study. 93 (26.9%) patients were found to have a 180-day unfavorable outcome. Multivariate logistic analysis demonstrated LED (odd ratio [OR], 0.44; 0.34-0.57; P < 0.001) and mRS at admission (OR, 2.59; 1.90-3.54; P < 0.001) as factors of unfavorable outcome. Subgroup analysis showed LED and mRS at admission as factors of unfavorable outcome for patients with compact BAVMs (all P < 0.05), but not for patients with diffuse BAVMs. Subsequent analysis showed that LED performed poorly to predict the unfavorable outcome for patients with diffuse BAVMs, compared with patients with compact BAVMs (AUC as 0.69 vs. 0.86, P < 0.05). A larger cutoff value of LED to unfavorable outcome was found in patients with diffuse BAVMs (15 mm) compared with patients with compact BAVMs (4.7 mm). Usage of LED to evaluate postoperative outcome of patients with diffuse BAVMs differs from its use in patients with compact BAVMs. Specific assessment strategy considering BAVM nidus types could help improve patients' outcome. MITASREAVM cohort (unique identifier: NCT02868008, https://clinicaltrials.gov/study/NCT02868008?term=NCT02868008&rank=1 ).
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Malformaciones Arteriovenosas Intracraneales , Imagen por Resonancia Magnética , Humanos , Malformaciones Arteriovenosas Intracraneales/cirugía , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Masculino , Femenino , Adulto , Imagen por Resonancia Magnética/métodos , Persona de Mediana Edad , Resultado del Tratamiento , Estudios Prospectivos , Adulto Joven , Adolescente , Microcirugia/métodos , Procedimientos Neuroquirúrgicos/métodos , Encéfalo/diagnóstico por imagen , Encéfalo/cirugíaRESUMEN
The technique of matrix acidification or acid fracturing is commonly utilized to establish communication with natural fractures during reservoir reconstruction. However, this process often encounters limitations due to filtration, which restricts the expansion of the primary acid-etching fracture. To address this issue, a computational model has been developed to simulate the expansion of an acid-etching wormhole by considering various factors such as formation process, injection duration, pressure build-up, and time-varying acid percolation rate. By analyzing the pumping displacement of acid-etching wormholes, this model provides valuable insights into the time-dependent quantities of acid percolation. It has been revealed that the filtration rate of acid-etching wormholes is strongly influenced by pumping displacement, viscosity, and concentration of the acid fluid used in stimulation as well as physical properties of the reservoir itself. Notably, viscosity plays a significant role in determining the effectiveness of acid fracturing especially in low-viscosity conditions. Acid concentration within 15% to 20% exhibits maximum impact on successful acid fracturing while concentrations below 15% or above 20% show no obvious effect. Furthermore, it was found that pumping displacement has a major influence on effective fracturing. However, beyond a certain threshold (> 5.0 m3/min), increased pumping displacement leads to slower etching distance for acids used in construction purposes. The simulation also provides real-time distribution analysis for acidity levels within eroded fractures during matrix-acidification processes and quantifies extent of chemical reactions between acids and rocks within these fractures thereby facilitating optimization efforts for design parameters related to matrix-acidification.
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Administration of acetylsalicylic acid (ASA) at early stage after surgery for spontaneous intracerebral hemorrhage (SICH) may increase the risk of postoperative intracranial bleeding (PIB), because of potential inhibition of platelet function. This study aimed to investigate whether early ASA administration after surgery was related to increased risk of PIB. This retrospective study enrolled SICH patients receiving surgery from September 2019 to December 2022 in seven medical institution. Based on postoperative ASA administration, patients who continuously received ASA more than three days within seven days post-surgery were identified as ASA users, otherwise as non-ASA users. The primary outcome was symptomatic PIB events within seven days after surgery. Incidence of PIB was compared between ASA users and non-ASA users using survival analysis. This study included 744 appropriate patients from 794 SICH patients. PIB occurred in 42 patients. Survival analysis showed no statistical difference between ASA users and non-ASA users in incidence of PIB (P = 0.900). Multivariate Cox analysis demonstrated current smoker (hazard ratio [HR], 2.50, 95%CI, 1.33-4.71, P = 0.005), dyslipidemia (HR = 3.03; 95%CI, 1.31-6.99; P = 0.010) and pre-hemorrhagic antiplatelet therapy (HR = 3.05; 95% CI, 1.64-5.68; P < 0.001) were associated with PIB. Subgroup analysis manifested no significant difference in incidence of PIB between ASA users and non-ASA users after controlling the effect from factors of PIB (i.e., sex, age, current smoker, regular drinker, dyslipidemia, pre-hemorrhagic antiplatelet therapy and hematoma location). This study revealed that early ASA administration to SICH patients after surgery was not related to increased risk of PIB.
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Aspirina , Hemorragia Cerebral , Inhibidores de Agregación Plaquetaria , Humanos , Masculino , Femenino , Aspirina/efectos adversos , Aspirina/administración & dosificación , Anciano , Persona de Mediana Edad , Estudios Retrospectivos , Inhibidores de Agregación Plaquetaria/efectos adversos , Inhibidores de Agregación Plaquetaria/administración & dosificación , Hemorragia Posoperatoria/epidemiología , Factores de Riesgo , Adulto , Hemorragias Intracraneales/epidemiologíaRESUMEN
Background and Objective. Sleep-disordered breathing (SDB) poses health risks linked to hypertension, cardiovascular disease, and diabetes. However, the time-consuming and costly standard diagnostic method, polysomnography (PSG), limits its wide adoption and leads to underdiagnosis. To tackle this, cost-effective algorithms using single-lead signals (like respiratory, blood oxygen, and electrocardiogram) have emerged. Despite respiratory signals being preferred for SDB assessment, a lack of comprehensive reviews addressing their algorithmic scope and performance persists. This paper systematically reviews 2012-2022 literature, covering signal sources, processing, feature extraction, classification, and application, aiming to bridge this gap and provide future research references.Methods. This systematic review followed the registered PROSPERO protocol (CRD42022385130), initially screening 342 papers, with 32 studies meeting data extraction criteria.Results. Respiratory signal sources include nasal airflow (NAF), oronasal airflow (OAF), and respiratory movement-related signals such as thoracic respiratory effort (TRE) and abdominal respiratory effort (ARE). Classification techniques include threshold rule-based methods (8), machine learning models (13), and deep learning models (11). The NAF-based algorithm achieved the highest average accuracy at 94.11%, surpassing 78.19% for other signals. Hypopnea detection sensitivity with single-source respiratory signals remained modest, peaking at 73.34%. The TRE and ARE signals proved to be reliable in identifying different types of SDB because distinct respiratory disorders exhibited different patterns of chest and abdominal motion.Conclusions. Multiple detection algorithms have been widely applied for SDB detection, and their accuracy is closely related to factors such as signal source, signal processing, feature selection, and model selection.
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Algoritmos , Procesamiento de Señales Asistido por Computador , Síndromes de la Apnea del Sueño , Humanos , Síndromes de la Apnea del Sueño/diagnóstico , Síndromes de la Apnea del Sueño/fisiopatología , RespiraciónRESUMEN
BACKGROUND: Surgical treatment demonstrated a reduction in mortality among patients suffering from severe spontaneous intracerebral hemorrhage (SSICH). However, which SSICH patients could benefit from surgical treatment was unclear. This study aimed to establish and validate a decision tree (DT) model to help determine which SSICH patients could benefit from surgical treatment. MATERIALS AND METHODS: SSICH patients from a prospective, multicenter cohort study were analyzed retrospectively. The primary outcome was the incidence of neurological poor outcome (modified Rankin scale as 4-6) on the 180th day posthemorrhage. Then, surgically-treated SSICH patients were set as the derivation cohort (from a referring hospital) and validation cohort (from multiple hospitals). A DT model to evaluate the risk of 180-day poor outcome was developed within the derivation cohort and validated within the validation cohort. The performance of clinicians in identifying patients with poor outcome before and after the help of the DT model was compared using the area under curve (AUC). RESULTS: One thousand two hundred sixty SSICH patients were included in this study (middle age as 56, and 984 male patients). Surgically-treated patients had a lower incidence of 180-day poor outcome compared to conservatively-treated patients (147/794 vs. 128/466, P <0.001). Based on 794 surgically-treated patients, multivariate logistic analysis revealed the ischemic cerebro-cardiovascular disease history, renal dysfunction, dual antiplatelet therapy, hematoma volume, and Glasgow coma score at admission as poor outcome factors. The DT model, incorporating these above factors, was highly predictive of 180-day poor outcome within the derivation cohort (AUC, 0.94) and validation cohort (AUC, 0.92). Within 794 surgically-treated patients, the DT improved junior clinicians' performance to identify patients at risk for poor outcomes (AUC from 0.81 to 0.89, P <0.001). CONCLUSIONS: This study provided a DT model for predicting the poor outcome of SSICH patients postsurgically, which may serve as a useful tool assisting clinicians in treatment decision-making for SSICH.
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Hemorragia Cerebral , Humanos , Persona de Mediana Edad , Hemorragia Cerebral/cirugía , Estudios de Cohortes , Árboles de Decisión , Pronóstico , Estudios Prospectivos , Estudios RetrospectivosRESUMEN
To develop excellent photoelectronic and photovoltaic devices, a semiconductor with high photoelectron production efficiency and broad band absorption is urgently required. In this article, novel II-type PbSe/ZnSe hetero-nanobelts with enhanced near-infrared absorption have been synthesized via a facile strategy of a partial cation-exchange reaction and thermal treatment. Derived from ZnSe·0.5N2H4nanobelts as templates, the belt-like morphology was preserved. Due to the mismatch of the crystal type and parameters between PbSe and ZnSe, the formed PbSe in the form of nanoparticles were separated out and decorated on the nanobelts. Furthermore, the composition ratio of Pb/Zn can be tuned through manipulating the adding amount of Pb2+cations, the reaction temperature and time. The ultraviolet-visible-infrared diffuse spectra measurements suggest that the as-prepared PbSe/ZnSe hetero-nanobelts exhibited a broad band absorption from 300 to 1000 nm. In addition, they demonstrated excellent photoresponsivity in the same wavelength region and displayed a peak at approximately 840 nm. Finally, the enhanced photoelectronic sensing mechanism was discussed.
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The Huainan Basin in eastern China contains abundant shale gas resources; the Lower Permian is an exploration horizon with a high potential for shale gas in marine-continent transitional facies. However, few detailed analyses have investigated shale gas in this area. In this paper, a comprehensive investigation of the geochemical characteristics, physical properties, and gas-bearing capacities of shale reservoirs was conducted, and the resource and exploitation potential were evaluated. The results show that the cumulative thicknesses of the Shanxi Formation (P1s) and lower Shihezi Formation (P2xs) are mostly greater than 35 and 65 m, respectively. The TOC contents of the P1s and P2xs shale vary from 0.11 to 8.87% and from 0.22 to 14.63%, respectively; the kerogens predominantly belong to type II with minor amounts of type I or type III kerogens; average R o values range between 0.83 and 0.94% and between 0.82 and 1.02% in P1s and P2xs, respectively; the shale samples are primarily at a low maturity, while some shale samples have entered the high-maturity stage. The shale reservoirs have low permeability and porosity in P1s and P2xs, respectively. The pores of the P1s shale reservoir are characterized by well-developed micropores and transition pores and poorly developed mesopores, while the pores in the P2xs shale reservoir are all characterized by well-developed micropores and transition pores and some well-developed macropores; the different pore types in the shale reservoirs developed in the organic matter, clay minerals, and pyrite, while a few endogenous fractures developed in the organic matter and structural fractures developed in the minerals. The total shale gas contents in P1s and P2xs are 2.85 and 2.96 m3 t-1, respectively. The P2xs shale reservoir has a higher hydrocarbon generation potential than P1s and has a lower gas generation potential. The total shale gas amounts in P1s and P2xs are 3602.29-4083.04 × 108 and 2811.04-3450.77 × 108 m3, respectively. Further research on shale gas exploration and exploitation for these formations needs to be performed.