Intensive Ambulance-Delivered Blood-Pressure Reduction in Hyperacute Stroke.

BACKGROUND: Treatment of acute stroke, before a distinction can be made between ischemic and hemorrhagic types, is challenging. Whether very early blood-pressure control in the ambulance improves outcomes among patients with undifferentiated acute stroke is uncertain. METHODS: We randomly assigned patients with suspected acute stroke that caused a motor deficit and with elevated systolic blood pressure (≥150 mm Hg), who were assessed in the ambulance within 2 hours after the onset of symptoms, to receive immediate treatment to lower the systolic blood pressure (target range, 130 to 140 mm Hg) (intervention group) or usual blood-pressure management (usual-care group). The primary efficacy outcome was functional status as assessed by the score on the modified Rankin scale (range, 0 [no symptoms] to 6 [death]) at 90 days after randomization. The primary safety outcome was any serious adverse event. RESULTS: A total of 2404 patients (mean age, 70 years) in China underwent randomization and provided consent for the trial: 1205 in the intervention group and 1199 in the usual-care group. The median time between symptom onset and randomization was 61 minutes (interquartile range, 41 to 93), and the mean blood pressure at randomization was 178/98 mm Hg. Stroke was subsequently confirmed by imaging in 2240 patients, of whom 1041 (46.5%) had a hemorrhagic stroke. At the time of patients' arrival at the hospital, the mean systolic blood pressure in the intervention group was 159 mm Hg, as compared with 170 mm Hg in the usual-care group. Overall, there was no difference in functional outcome between the two groups (common odds ratio, 1.00; 95% confidence interval [CI], 0.87 to 1.15), and the incidence of serious adverse events was similar in the two groups. Prehospital reduction of blood pressure was associated with a decrease in the odds of a poor functional outcome among patients with hemorrhagic stroke (common odds ratio, 0.75; 95% CI, 0.60 to 0.92) but an increase among patients with cerebral ischemia (common odds ratio, 1.30; 95% CI, 1.06 to 1.60). CONCLUSIONS: In this trial, prehospital blood-pressure reduction did not improve functional outcomes in a cohort of patients with undifferentiated acute stroke, of whom 46.5% subsequently received a diagnosis of hemorrhagic stroke. (Funded by the National Health and Medical Research Council of Australia and others; INTERACT4 ClinicalTrials.gov number, NCT03790800; Chinese Trial Registry number, ChiCTR1900020534.).

Gold-Catalyzed Reactions of Enynals with Alkenes for Synthesis Binaphthyl Derivatives.

A PPh3Au[B(C6F5)4]-catalyzed reaction of enynals and alkenes for the construction of binaphthyl derivatives was described. This transformation was achieved through o-Quinodimethane (o-QDM) intermediate's extended conjugated addition process. The reaction has the advantages of wide substrate scopes, mild reaction conditions, high efficiency, and good scalability.

Spatial transcriptome profiling by MERFISH reveals subcellular RNA compartmentalization and cell cycle-dependent gene expression.

The expression profiles and spatial distributions of RNAs regulate many cellular functions. Image-based transcriptomic approaches provide powerful means to measure both expression and spatial information of RNAs in individual cells within their native environment. Among these approaches, multiplexed error-robust fluorescence in situ hybridization (MERFISH) has achieved spatially resolved RNA quantification at transcriptome scale by massively multiplexing single-molecule FISH measurements. Here, we increased the gene throughput of MERFISH and demonstrated simultaneous measurements of RNA transcripts from ∼10,000 genes in individual cells with ∼80% detection efficiency and ∼4% misidentification rate. We combined MERFISH with cellular structure imaging to determine subcellular compartmentalization of RNAs. We validated this approach by showing enrichment of secretome transcripts at the endoplasmic reticulum, and further revealed enrichment of long noncoding RNAs, RNAs with retained introns, and a subgroup of protein-coding mRNAs in the cell nucleus. Leveraging spatially resolved RNA profiling, we developed an approach to determine RNA velocity in situ using the balance of nuclear versus cytoplasmic RNA counts. We applied this approach to infer pseudotime ordering of cells and identified cells at different cell-cycle states, revealing ∼1,600 genes with putative cell cycle-dependent expression and a gradual transcription profile change as cells progress through cell-cycle stages. Our analysis further revealed cell cycle-dependent and cell cycle-independent spatial heterogeneity of transcriptionally distinct cells. We envision that the ability to perform spatially resolved, genome-wide RNA profiling with high detection efficiency and accuracy by MERFISH could help address a wide array of questions ranging from the regulation of gene expression in cells to the development of cell fate and organization in tissues.

First report of Impatiens necrotic spot orthotospovirus infecting Tulbaghia violacia Harv. in China.

Tulbaghia violacea Harv. indigenous to southern African countries, is an herbaceous perennial bulbous plant belonging to the family Amaryllidaceae. It is a popular garden plant in China. This attractive plant is traditionally used as medicine and repellent (Kubec et al. 2002; Moodley et al. 2015). In June 2021, T. violacea plants showing typical tospovirus-like symptoms of chlorotic rings patterns, were found at the campus of Yunnan University of Chinese Medicine (Fig.S1). Disease incidence was about 11.0% during the field survey. Total RNA was extracted from symptomatic leaves of T. violacea plants using the TRIzol reagent (ambio, Carlsbad, CA). Reverse transcription (RT)-PCR was conducted to identify the virus using RNA extract as the template. The degenerate primers (dTospo-F2 and dTospo-R2) (Huang et al. 2018) were used to amplify the conserved regions of the orthotospoviral L RNA sequences. No amplification was obtained from extracts of two asymptomatic plants. The amplicons from four symptomatic samples were cloned into the pMD19-T vector (TaKaRa) and sequenced (three clones for each amplicon) by Tsingke (Shanghai, China). The obtained DNA fragments were determined to be 312 bp. The sequences from four symptomatic samples were identical (GenBank acc.no. OK258285) and shared the highest nucleotide identities (98.0%) with a corresponding sequence of segment L of impatiens necrotic spot virus (INSV) isolated (GQ336991) from Phalaenopsis amabilis in Yunnan province, China. To further confirm the INSV infection to T. violacea, the samples were analyzed with the specific primers for the N, NSs and NSm genes of INSV (Table S1), respectively. Amplicons of the expected size, 789 bp, 1344 bp and 912 bp, were produced, respectively. Amplicons were cloned and sequenced. The 789-bp N (ON529554) and 1344-bp NSs (ON529554) gene sequences had 99.1% and 99.3% nucleotide identities with the corresponding region of previously described INSV Phalenopsis isolate (GQ336989), respectively. The 912-bp NSm (ON529553) gene sequence shared 99.5% nucleotide identity with the corresponding region of INSV Phalenopsis isolate (GQ336990). Metavirome and Sanger sequencing were used to complete the genome of INSV from T. violacea. The leaves of the symptomatic sample were used to construct an rRNA-depleted library using Nextera XT reagents (Illumina, San Diego, CA). The library was subjected to RNA-Seq a NovaSeq 6000 platform (Illumina, San Diego, CA). A total of 33,193,233 quality-filtered reads were obtained using BBMAP (https://github.com/BioInfoTools/BBMapBBMap - Bushnell B. - sourceforge.net/projects/bbmap/). Among 161052 reads mapped to virus sequences, 151407 reads (read ratios 94.0%) were mapped to INSV. Three complete segments of INSV genome were determined to 8,778 nt (L segment, Acc. No. ON529552), 4,958 nt (M segment, Acc. No. ON529553), and 2,983 nt (S segment, Acc. No. ON529554) in length. These segments were validated by RT-PCR and Sanger sequencing. Three segments share nucleotide sequence identities of 99.6%, 99.3% and 98.9% with the L (GQ336991), M (GQ336990) and S segments (GQ336989) of INSV Phalenopsis isolate, respectively. The results of sequence comparisons showed no evidence of reassortment between INSV and another orthotospovirus. There was a report of tomato spotted wilt virus infecting T. violacea in Florida, USA (Dey et al. 2019). No other virus infecting T. violacea was reported. INSV has been reported to infect several economically important crops including Phalenopsis, pepper etc. in China (Chen et al. 2016). INSV-infected T. violacea not only losses landscaping value but also plays an important intermedia host role in the spread of INSV. Additional surveys and evaluation will be needed to understand the potential medicinal effect of this virus on this plant. To our knowledge, this is first report of INSV in T. violacea.

Risk Factors Associated With Clinical Outcomes in 323 Coronavirus Disease 2019 (COVID-19) Hospitalized Patients in Wuhan, China.

BACKGROUND: With evidence of sustained transmission in more than 190 countries, coronavirus disease 2019 (COVID-19) has been declared a global pandemic. Data are urgently needed about risk factors associated with clinical outcomes. METHODS: A retrospective review of 323 hospitalized patients with COVID-19 in Wuhan was conducted. Patients were classified into 3 disease severity groups (nonsevere, severe, and critical), based on initial clinical presentation. Clinical outcomes were designated as favorable and unfavorable, based on disease progression and response to treatments. Logistic regression models were performed to identify risk factors associated with clinical outcomes, and log-rank test was conducted for the association with clinical progression. RESULTS: Current standard treatments did not show significant improvement in patient outcomes. By univariate logistic regression analysis, 27 risk factors were significantly associated with clinical outcomes. Multivariate regression indicated age >65 years (P < .001), smoking (P = .001), critical disease status (P = .002), diabetes (P = .025), high hypersensitive troponin I (>0.04 pg/mL, P = .02), leukocytosis (>10 × 109/L, P < .001), and neutrophilia (>75 × 109/L, P < .001) predicted unfavorable clinical outcomes. In contrast, the administration of hypnotics was significantly associated with favorable outcomes (P < .001), which was confirmed by survival analysis. CONCLUSIONS: Hypnotics may be an effective ancillary treatment for COVID-19. We also found novel risk factors, such as higher hypersensitive troponin I, predicted poor clinical outcomes. Overall, our study provides useful data to guide early clinical decision making to reduce mortality and improve clinical outcomes of COVID-19.

Identification and Fine Mapping of qSCR4.01, a Novel Major QTL for Resistance to Puccinia polysora in Maize.

Southern corn rust (SCR) is a prevalent foliar disease that can lead to severe yield losses in maize. Growing SCR-resistant varieties is the most effective way to control the disease. To identify major quantitative trait loci (QTLs) for SCR resistance, a recombinant inbred line population derived from a cross between CIMBL83 (resistant) and Lx9801 (susceptible) was analyzed. The resistance to SCR had high heritability within the population, and a major QTL on chromosome 4 (qSCR4.01), which can explain 48 to 65% of the total phenotypic variation, was consistently detected across multiple environments. Using a progeny-based fine-mapping strategy, we delimited qSCR4.01 to an interval of ∼770 kb. In contrast to other major QTLs for SCR resistance previously reported on the short arm of chromosome 10, qSCR4.01 is a novel QTL and, therefore, a desirable source of SCR resistance in maize breeding programs.

Strong multiphoton absorption in chiral CdSe/CdS dot/rod nanocrystal-doped poly(vinyl alcohol) films.

Cysteine-capped cadmium selenide/cadmium sulfide (CdSe/CdS) dot/rod nanocrystals (NCs) were synthesized and then doped in poly(vinyl alcohol) (PVA) films. Compared with an L-/D-cysteine-capped NC solution (10-4), the anisotropic factors of the circular dichroism and circular polarized luminescence in the doped PVA films increased by one order of magnitude, probably because of the enhanced anisotropy degree, crystal orientations, and ordered morphologies. The two- and three-photon absorption coefficients of the doped PVA films were determined as 0.58 cm/GW at 800 nm and 2.3×10-4 cm3/GW2 at 1300 nm, respectively. The chiral NC-doped PVA films are promising for applications in chirality-related nonlinear photonic devices.

Hydrothermal Transformation of Titanate Scrolled Nanosheets to Anatase over a Wide pH Range and Contribution of Triethanolamine and Oleic Acid to Control the Morphology.

Mild hydrothermal conditions used for the treatment of titanate scrolled nanosheets (SNSs) suspensions (140 °C, 72 h) resulted in a large variety of anatase TiO2 anisotropic nano-objects depending on the studied parameters: influence of the medium pH and the presence or not of structuring agents (SAs). The present work shows that such a hydrothermal treatment of the SNSs, whatever the pH, resulted in the formation of single-crystalline anatase nanoneedles (NNs) with a specific crystal-elongation direction and a pH-dependent morphological anisotropy with aspect ratios (ARs) from 1 to 8. The SNSs suspensions were prepared by the conventional ultrabasic treatment of TiO2 with NaOH, followed by washing with HNO3 to different pH values. The crystal size of the anatase TiO2 obtained from this hydrothermal treatment increased with the pH of the suspensions, from 15 nm nanoparticles (NPs; AR = 1) at pH 2.2 to 500 nm NNs (AR = 8) at a pH 10.8 with a long axis systematically along the anatase [001] direction. Triethanol amine and oleic acid were used as SAs. Their respective influence, when acting on their own, had little influence on the control of the size, shape, or polydispersity of the NNs. However, their concomitant use provided a much better control of not only the size and polydispersity, which was strongly reduced, but also on (i) the shape and morphology giving rise to a controlled access to well-defined nanorods as opposed to nanoneedles and (ii) the crystal phase purity eliminating the few percent brookite still visible in the X-ray diffraction patterns of samples prepared in SA-free conditions. This approach offers an on-demand control over the production of anatase morphologies with defined aspect ratios.

Silica encapsulation of metal perovskite nanocrystals in a photoluminescence type display application.

Perovskite nanocrystals (PeNCs) are attractive in high-color gamut display technology as light converters which can achieve saturated green and red lights, respectively. However, PeNCs are intrinsically fragile against ambient conditions, such as moisture and oxygen and it is hard to maintain their performance in long-term operation. In this work, a new hierarchical encapsulation method is proposed, integrated with surface modification by halide ions protection, nano-scaled encapsulation by in situ capping SiO2 and embedding into poly (methyl methacrylate) (PMMA) matrix composites, to achieve a stable perovskite light converting composite sheet for LED remote-type encapsulation. The storage stability, as well as the operational stability of perovskite composites, were confirmed by the spectra evolution from encapsulated LEDs with normalized blue emission intensity. The 2D maps of spectra and aging measurement indicate that the silica encapsulation can well protect the PeNCs in the PMMA matrix from the ambient circumstance during a long-term storage process. Additionally, the hierarchical encapsulation for PeNCs/silica/PMMA showed better operational stability than the direct encapsulation of PeNCs/PMMA, and the correspondent Commission Internationale de L'Eclairage color coordinates tracking also indicated more stable color properties, which demonstrates the great potential in photoluminescent display applications.

High-throughput single-cell gene-expression profiling with multiplexed error-robust fluorescence in situ hybridization.

Image-based approaches to single-cell transcriptomics, in which RNA species are identified and counted in situ via imaging, have emerged as a powerful complement to single-cell methods based on RNA sequencing of dissociated cells. These image-based approaches naturally preserve the native spatial context of RNAs within a cell and the organization of cells within tissue, which are important for addressing many biological questions. However, the throughput of these image-based approaches is relatively low. Here we report advances that lead to a drastic increase in the measurement throughput of multiplexed error-robust fluorescence in situ hybridization (MERFISH), an image-based approach to single-cell transcriptomics. In MERFISH, RNAs are identified via a combinatorial labeling approach that encodes RNA species with error-robust barcodes followed by sequential rounds of single-molecule fluorescence in situ hybridization (smFISH) to read out these barcodes. Here we increase the throughput of MERFISH by two orders of magnitude through a combination of improvements, including using chemical cleavage instead of photobleaching to remove fluorescent signals between consecutive rounds of smFISH imaging, increasing the imaging field of view, and using multicolor imaging. With these improvements, we performed RNA profiling in more than 100,000 human cells, with as many as 40,000 cells measured in a single 18-h measurement. This throughput should substantially extend the range of biological questions that can be addressed by MERFISH.

High-performance multiplexed fluorescence in situ hybridization in culture and tissue with matrix imprinting and clearing.

Highly multiplexed single-molecule FISH has emerged as a promising approach to spatially resolved single-cell transcriptomics because of its ability to directly image and profile numerous RNA species in their native cellular context. However, background-from off-target binding of FISH probes and cellular autofluorescence-can become limiting in a number of important applications, such as increasing the degree of multiplexing, imaging shorter RNAs, and imaging tissue samples. Here, we developed a sample clearing approach for FISH measurements. We identified off-target binding of FISH probes to cellular components other than RNA, such as proteins, as a major source of background. To remove this source of background, we embedded samples in polyacrylamide, anchored RNAs to this polyacrylamide matrix, and cleared cellular proteins and lipids, which are also sources of autofluorescence. To demonstrate the efficacy of this approach, we measured the copy number of 130 RNA species in cleared samples using multiplexed error-robust FISH (MERFISH). We observed a reduction both in the background because of off-target probe binding and in the cellular autofluorescence without detectable loss in RNA. This process led to an improved detection efficiency and detection limit of MERFISH, and an increased measurement throughput via extension of MERFISH into four color channels. We further demonstrated MERFISH measurements of complex tissue samples from the mouse brain using this matrix-imprinting and -clearing approach. We envision that this method will improve the performance of a wide range of in situ hybridization-based techniques in both cell culture and tissues.

Prevalent presence of periodic actin-spectrin-based membrane skeleton in a broad range of neuronal cell types and animal species.

Actin, spectrin, and associated molecules form a periodic, submembrane cytoskeleton in the axons of neurons. For a better understanding of this membrane-associated periodic skeleton (MPS), it is important to address how prevalent this structure is in different neuronal types, different subcellular compartments, and across different animal species. Here, we investigated the organization of spectrin in a variety of neuronal- and glial-cell types. We observed the presence of MPS in all of the tested neuronal types cultured from mouse central and peripheral nervous systems, including excitatory and inhibitory neurons from several brain regions, as well as sensory and motor neurons. Quantitative analyses show that MPS is preferentially formed in axons in all neuronal types tested here: Spectrin shows a long-range, periodic distribution throughout all axons but appears periodic only in a small fraction of dendrites, typically in the form of isolated patches in subregions of these dendrites. As in dendrites, we also observed patches of periodic spectrin structures in a small fraction of glial-cell processes in four types of glial cells cultured from rodent tissues. Interestingly, despite its strong presence in the axonal shaft, MPS is disrupted in most presynaptic boutons but is present in an appreciable fraction of dendritic spine necks, including some projecting from dendrites where such a periodic structure is not observed in the shaft. Finally, we found that spectrin is capable of adopting a similar periodic organization in neurons of a variety of animal species, including Caenorhabditis elegans, Drosophila, Gallus gallus, Mus musculus, and Homo sapiens.

Realization of wide circadian variability by quantum dots-luminescent mesoporous silica-based white light-emitting diodes.

Human comfort has become one of the most important criteria in modern lighting architecture. Here, we proposed a tuning strategy to enhance the non-image forming photobiological effect on the human circadian rhythm based on quantum-dots-converted white light-emitting diodes (QDs-WLEDs). We introduced the limiting variability of the circadian action factor (CAF), defined as the ratio of circadian efficiency and luminous efficiency of radiation. The CAF was deeply discussed and was found to be a function of constraining the color rendering index (CRI) and correlated color temperatures. The maximum CAF variability of QDs-WLEDs was found to be dependent on the QDs' peak wavelength and full width at half maximum. With the optimized parameters, the packaging materials were synthesized and WLEDs were packaged. Experimental results show that at CRI > 90, the maximum CAF variability can be tuned by 3.83 times (from 0.251 at 2700 K to 0.961 at 6500 K), which implies that our approach could reduce the number of tunable channels, and could achieve wider CAF variability.

Structural optimization for remote white light-emitting diodes with quantum dots and phosphor: packaging sequence matters.

White light-emitting diodes (WLEDs) with quantum dots (QDs) and phosphor have attracted tremendous attentions due to their excellent color rendering ability. In the packaging process, QDs layer and phosphor-silicone layer tend to be separated to reduce the reabsorption losses, and to maintain the stability of QDs surface ligands. This study investigated the packaging sequence between QDs and phosphor on the optical and thermal performances of WLEDs. The output optical power and PL spectra were measured and analyzed, and the temperature fields were simulated and validated experimentally by infrared thermal imager. It was found that when driven by 60 mA, the QDs-on-phosphor type WLEDs achieved luminous efficiency (LE) of 110 lm/W, with color rendering index (CRI) of Ra = 92 and R9 = 80, while the phosphor-on-QDs type WLEDs demonstrated lower LE of 68 lm/W, with Ra = 57 and R9 = 24. Moreover, the QDs-on-phosphor type WLEDs generated less heat than that of another, consequently the highest temperature in the QDs-on-phosphor type was lower than another, and the temperature difference can reach 12.3°C. Therefore, in terms of packaging sequence, the QDs-on-phosphor type is an optimal packaging architecture for higher optical efficiency, better color rendering ability and lower device temperature.

Advanced principal component analysis method for phase reconstruction.

Focus on the phase reconstruction from three phase-shifting interferograms with unknown phase shifts, an advanced principal component analysis method is proposed. First, use a simple subtraction operation among interferograms, two intensity difference images are obtained easily. Second, set the center region of the data of intensity difference images to zero, and then construct a covariance matrix to obtain a transformation matrix. Third, two principal components of interferograms can be determined by the Hotelling transform and then phase can be calculated from the two normalized principal components by an arctangent function. By means of the simulation calculation and the experimental research, it is proved that the phase with high precision can be obtained rapidly by the proposed algorithm.

Probing the mechanism of the interaction between l-cysteine-capped-CdTe quantum dots and Hg(2+) using capillary electrophoresis with ensemble techniques.

A good understanding of the mechanism of interaction between quantum dots (QDs) and heavy metal ions is essential for the design of more effective sensor systems. In this work, CE was introduced to explore how l-cysteine-capped-CdTe QDs (l-cys-CdTe QDs) interacts with Hg(2+) . The change in electrophoretic mobility can synchronously reflect the change in the composition and property of QDs. The effects of the free and capping ligands on the system are discussed in detail. ESI-MS, dynamic light scattering (DLS), zeta potential, and fluorescence (FL) were also applied as cooperative tools to study the interaction mechanism. Furthermore, the interaction mechanism, which principally depended on the concentration of Hg(2+) , was proposed reasonably. At the low concentration of Hg(2+) , the formation of a static complex between Hg(2+) and the carboxyl and amino groups of l-cys-CdTe QDs surface was responsible for the FL quenching. With the increase of Hg(2+) concentration, the capping l-cys was stripped from the surface of l-cys-CdTe QDs due to the high affinity of Hg(2+) to the thiol group of l-cys. Our study demonstrates that CE can reveal the mechanism of the interaction between QDs and heavy metal ions, such as FL quenching.

Direct visualization of horizontal gene transfer in cotton plants.

Plant mitochondrial and chloroplast genes that underwent horizontal transfer have been identified by parasite and grafting systems, respectively. Here, we directly observed 3 horizontal gene transfer (HGT) events in the 45 second axillary shoots of grafted cotton plants (Gossypium barbadense and Gossypium hirsutum) after extirpating the first axillary bud. The second axillary shoots showed phenotypic variations in cotton flowers and seeds that were evidence of spontaneous development from cells in the grafting site. As the progeny segregated and did not show stable inheritance across 3 generations, inheritance of traits in our study differed from the stable heredity of HGT plants in previous studies. In those studies, plants were artificially regenerated from the graft junctions, and inheritance involved only the movement of chloroplast DNA or genomic material between cells. Our findings may provide a feasible method to enhance plant breeding and the study of HGT.

Immunoglobulin G4-related disease: Multiple organ occupation on CT.

One case involved a 61-year-old woman who was admitted to hospital with liver occupation, subsequently found multiple organ occupation, and was eventually pathologically identified as having immunoglobulin G4-related disease.

Association between lower neutrophil-to-albumin ratio and early neurological improvement in patients with acute cerebral infarction after intravenous thrombolysis.

Elevated neutrophil counts and decreased albumin levels have been linked to an unfavorable prognosis in acute cerebral infarction (ACI). The objective of this study is to explore the correlation between the neutrophil-to-albumin ratio (NAR) and the early neurological improvement (ENI) of ACI patients following intravenous thrombolysis (IVT). ACI patients who underwent IVT between June 2019 and June 2023 were enrolled. The severity of ACI was assessed using the National Institutes of Health Stroke Scale (NIHSS). ENI was defined as a reduction in NIHSS score of ≥ 4 or complete resolution of neurological deficit within 24 h after IVT. Propensity score match (PSM) and logistic regression analysis were used to explore the correlation between these variables and the early neurological outcomes of patients. A total of 545 ACI patients were included, with 253 (46.4 %) experiencing ENI. Among the 193 pairs of patients after PSM, there was a significant association between NAR and ENI (OR, 0.89; 95 % CI, 0.85-0.94; p < 0.001). The restricted cubic splines analysis revealed a significant nonlinear correlation between NAR and ENI (p for nonlinear = 0.0004; p for overall = 0.0002). The optimal cutoff for predicting ENI was determined as a NAR level of 10.20, with sensitivity and specificity values of 73.6 % and 60.9 %. NAR levels are associated with ENI in ACI patients after IVT. The decreased levels of NAR indicate an increased likelihood of post-thrombolysis ENI in ACI patients.