CuO (111) Microcrystalline Evoked Indium-Organic Framework for Efficient Electroreduction of CO2 to Formate.

Electrochemical reduction of carbon dioxide (CO2RR) to formate is economically beneficial but suffers from poor selectivity and high overpotential. Herein, enriched microcrystalline copper oxide is introduced on the surface of indium-based metal-organic frameworks. Benefiting from the CuO (111) microcrystalline shell and formed catalytic active In-Cu interfaces, the obtained MIL-68(In)/CuO heterostructure display excellent CO2RR to formate with a Faradaic efficiency (FE) as high as 89.7% at low potential of only -0.7 V vs. RHE in a flow cell. Significantly, the membrane electrode assembly (MEA) cell based on MIL-68(In)/CuO exhibit a remarkable current density of 640.3 mA cm-2 at 3.1 V and can be stably operated for 180 h at 2.7 V with a current density of 200 mA cm-2. The ex/in situ electrochemical investigations reveal that the introduction of CuO increases the formation rate of the carbon dioxide reduction intermediate *HCOO- and inhibits the competitive hydrogen evolution reaction. This work not only provides an in-depth study of the mechanism of the CO2RR pathways on In/Cu composite catalyst but also offers an effective strategy for the interface design of electrocatalytic carbon dioxide reduction reaction.

Efficacy of Hemoperfusion Cartridge Procedure on Patients Undergoing Cardiac Valve Replacement Surgery with Cardiopulmonary Bypass.

OBJECTIVES: Cardiopulmonary bypass (CPB) induces inflammatory homeostasis dysregulation, closely related to many postoperative adverse effects. Minimizing the systemic inflammatory response to CPB is imperative to improving cardiac surgery safety. This study aimed to retrospectively evaluate the efficacy of the hemoperfusion cartridge, a device recently designed for extracorporeal blood purification to remove cytokines from the blood for patients undergoing cardiac valve replacement surgery using CPB. METHODS: The hemoperfusion (HP) group consisted of 138 patients, who underwent a hemoperfusion cartridge procedure during CPB. The control group included 149 patients, who received standard CPB management. The evaluated indices included inflammatory cytokines, blood biochemical indices, and postoperative outcome indices. RESULTS: Patients in the HP group had relatively lower interleukin (IL)-6 levels (days one and two post-CPB) and IL-8 (day one post-CPB) compared with the control group. Some relatively decreased biochemical blood indices also were observed in the HP group, including a significantly lower lactic acid level (days one, two, and three post-CPB), platelet counts (days one, two, and three post-CPB), and aspartate aminotransferase (days one and three post-CPB). Regarding the postoperative outcomes, no severe complications occurred in the patients; however, the HP group required less ventilation time than the control group. CONCLUSIONS: The hemoperfusion cartridge seems promising in limiting the inflammatory reactions during CPB, with noteworthy potential for application in cardiac surgery.

CoCoCs: co-optimized compressive imaging driven by high-level vision.

Compressive imaging senses optically encoded high-dimensional scene data with far fewer measurements and then performs reconstruction via appropriate algorithms. In this paper, we present a novel noniterative end-to-end deep learning-based framework for compressive imaging, dubbed CoCoCs. In comparison to existing approaches, we extend the pipeline by co-optimizing the recovery algorithm with optical coding as well as cascaded high-level computer vision tasks to boost the quality of the reconstruction. We demonstrate the proposed framework on two typical compressive imaging systems, i.e., single pixel imaging and snapshot video compressive imaging. Extensive results, including conventional image quality criteria, mean opinion scores, and accuracy in image classification and motion recognition, confirm that CoCoCs can yield realistic images and videos, which are friendly to both human viewing and computer vision. We hope CoCoCs will give impetus to bridge the gap between compressive imagers and computer vision and the perception of human.

Key frames assisted hybrid encoding for high-quality compressive video sensing.

Snapshot compressive imaging (SCI) encodes high-speed scene video into a snapshot measurement and then computationally makes reconstructions, allowing for efficient high-dimensional data acquisition. Numerous algorithms, ranging from regularization-based optimization and deep learning, are being investigated to improve reconstruction quality, but they are still limited by the ill-posed and information-deficient nature of the standard SCI paradigm. To overcome these drawbacks, we propose a new key frames assisted hybrid encoding paradigm for compressive video sensing, termed KH-CVS, that alternatively captures short-exposure key frames without coding and long-exposure encoded compressive frames to jointly reconstruct high-quality video. With the use of optical flow and spatial warping, a deep convolutional neural network framework is constructed to integrate the benefits of these two types of frames. Extensive experiments on both simulations and real data from the prototype we developed verify the superiority of the proposed method.

The efficacy of tranexamic acid treatment with different time and doses for traumatic brain injury: a systematic review and meta-analysis.

OBJECTIVE: Tranexamic acid (TXA) plays a significant role in the treatment of traumatic diseases. However, its effectiveness in patients with traumatic brain injury (TBI) seems to be contradictory, according to the recent publication of several meta-analyses. We aimed to determine the efficacy of TXA treatment at different times and doses for TBI treatment. METHODS: PubMed, MEDLINE, EMBASE, Cochrane Library, and Google Scholar were searched for randomized controlled trials that compared TXA and a placebo in adults and adolescents (≥ 15 years of age) with TBI up to January 31, 2022. Two authors independently abstracted the data and assessed the quality of evidence. RESULTS: Of the identified 673 studies, 13 involving 18,675 patients met our inclusion criteria. TXA had no effect on mortality (risk ratio (RR) 0.99; 95% confidence interval (CI) 0.92-1.06), adverse events (RR 0.93, 95% Cl 0.76-1.14), severe TBI (Glasgow Coma Scale score from 3 to 8) (RR 0.99, 95% Cl 0.94-1.05), unfavorable Glasgow Outcome Scale (GOS < 4) (RR 0.96, 95% Cl 0.82-1.11), neurosurgical intervention (RR 1.11, 95% Cl 0.89-1.38), or rebleeding (RR 0.97, 95% Cl 0.82-1.16). TXA might reduce the mean hemorrhage volume on subsequent imaging (standardized mean difference, -0.35; 95% CI [-0.62, -0.08]). CONCLUSION: TXA at different times and doses was associated with reduced mean bleeding but not with mortality, adverse events, neurosurgical intervention, and rebleeding. More research data is needed on different detection indexes and levels of TXA in patients with TBI, as compared to those not receiving TXA; although the prognostic outcome for all harm outcomes was not affected, the potential for harm was not ruled out. TRIAL REGISTRATION: The review protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42022300484).

On-chip photonic diffractive optical neural network based on a spatial domain electromagnetic propagation model.

An integrated physical diffractive optical neural network (DONN) is proposed based on a standard silicon-on-insulator (SOI) substrate. This DONN has compact structure and can realize the function of machine learning with whole-passive fully-optical manners. The DONN structure is designed by the spatial domain electromagnetic propagation model, and the approximate process of the neuron value mapping is optimized well to guarantee the consistence between the pre-trained neuron value and the SOI integration implementation. This model can better ensure the manufacturability and the scale of the on-chip neural network, which can be used to guide the design and manufacturing of the real chip. The performance of our DONN is numerically demonstrated on the prototypical machine learning task of prediction of coronary heart disease from the UCI Heart Disease Dataset, and accuracy comparable to the state-of-the-art is achieved.

Carboxymethyl chitosan modification of cobalt-zinc bimetallic MOF for tetracycline hydrochloride removal: Exploration of the enhancement mechanism of the process.

This study synthesized a carboxymethyl chitosan-modified bimetallic Co/Zn-ZIF (CZ@CMC) with strong hydrophilicity and adsorption performance via the one-pot method. Tetracycline hydrochloride (TCH) was used as the model contaminant to evaluate the adsorption and peroxymonosulfate (PMS) activation properties of CZ@CMC. Mechanism showed that the adsorption behavior occurred through pore filling, electrostatic attraction, surface complexation, hydrogen bonding, and π-π stacking. In addition, a CZ@CMC/PMS system was constructed, which had excellent catalytic performance. The hydrophilicity and selective adsorption properties of CMC conferred a greatly accelerated CZ@CMC in catalyzing the PMS process with kobs of 0.095 min-1, in which OH, 1O2, SO4-, O2-, and Co(III) were the main ROS which quenching tests, EPR, and chemical probe experiments verified. In addition, the degradation pathways of TCH were obtained utilizing DFT and HPLC-MS and analyzed to show that the system possessed a good detoxification capacity. This work is expected to provide a green, efficient, and stable strategy to enhance the adsorption properties of catalytic materials and subsequently their co-catalytic properties.

Neuronal Intranuclear Inclusion Disease with NOTCH2NLC GGC Repeat Expansion: A Systematic Review and Challenges of Phenotypic Characterization.

Neuronal intranuclear inclusion disease (NIID) is a highly clinically heterogeneous neurodegenerative disorder primarily attributed to abnormal GGC repeat expansions in the NOTCH2NLC gene. This study aims to comprehensively explore its phenotypic characteristics and genotype-phenotype correlation. A literature search was conducted in PubMed, Embase, and the Cochrane Library from September 1, 2019, to December 31, 2022, encompassing reported NIID cases confirmed by pathogenic NOTCH2NLC mutations. Linear regressions and trend analyses were performed. Analyzing 635 cases from 85 included studies revealed that familial cases exhibited significantly larger GGC repeat expansions than sporadic cases (p < 0.001), and this frequency significantly increased with expanding GGC repeats (p trend < 0.001). Age at onset (AAO) showed a negative correlation with GGC repeat expansions (p < 0.001). The predominant initial symptoms included tremor (31.70%), cognitive impairment (14.12%), and muscle weakness (10.66%). The decreased or absent tendon reflex (DTR/ATR) emerged as a notable clinical indicator of NIID due to its high prevalence. U-fiber was observed in 79.11% of patients, particularly prominent in paroxysmal disease-dominant (87.50%) and dementia-dominant cases (81.08%). Peripheral neuropathy-dominant cases exhibited larger GGC repeat expansions (median = 123.00) and an earlier AAO (median = 33.00) than other phenotypes. Moreover, a significant genetic anticipation of 3.5 years was observed (p = 0.039). This study provides a comprehensive and up-to-date compilation of genotypic and phenotypic information on NIID since the identification of the causative gene NOTCH2NLC. We contribute a novel diagnostic framework for NIID to support clinical practice.

Tigecycline Resistance-Associated Mutations in the MepA Efflux Pump in Staphylococcus aureus.

Tigecycline is an important antibacterial drug for treating infection by clinical multidrug-resistant bacteria, and tigecycline-resistant Staphylococcus aureus (TRSA) has been increasingly reported in recent years. Notably, only rpsJ and mepA are associated with the tigecycline resistance of S. aureus. The mepA gene encodes MepA efflux pumps, and the overexpression of mepA has been confirmed to be directly related to tigecycline resistance. Although the mutations of MepA widely occur, the associations between TRSA and mutations of MepA are still unclear. In this study, we explored mutations in the mepA genes from various sources. Then, tigecycline resistance-associated mutations T29I, E287G, and T29I+E287G in MepA were identified, and their effects were evaluated through mutant deletion and complementation, tigecycline accumulation assay, and molecular docking experiments. Results showed that the MICs of tigecycline, gentamicin, and amikacin increased in special complementary transformants and recovered after the addition of the efflux pump inhibitor carbonyl cyanide 3-chlorophenylhydrazone (CCCP). The tigecycline accumulation assay of the mepA-deleted mutant strain and its complementary transformants showed that T29I, E287G, and T29I+E287G mutations promoted tigecycline efflux, and molecular docking showed that mutations T29I, E287G, and T29I+E287G decreased the binding energy and contributed to ligand binding. Moreover, we inferred the evolutionary trajectory of S. aureus under the selective pressure of tigecycline in vitro. Overall, our study indicated that mutations in MepA play important roles in tigecycline resistance in S. aureus. IMPORTANCE Previous analysis has shown that overexpression of MepA is an exact mechanism involved in tigecycline resistance apart from the rpsJ mutation and is usually dependent on the mutant mepR. However, no research has evaluated the effects of diverse mutations discovered in TRSA in MepA. This study demonstrates that the mutations in MepA confer resistance to tigecycline without overexpression and provides genotypic references for identifying TRSA. Although tigecycline resistance-associated mutations in MepA identified in this study have not been observed in clinical isolates, the mechanism should be explored given that S. aureus strains are prevalent in the environment. Measures should be implemented to contain TRSA within the time window before tigecycline resistance-associated mutations in MepA are prevalent.

Pulmonary arterial hypertension associated with congenital heart disease: An omics study.

Pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is a severely progressive condition with uncertain physiological course. Hence, it has become increasingly relevant to clarify the specific mechanisms of molecular modification, which is crucial to identify more treatment strategies. With the rapid development of high-throughput sequencing, omics technology gives access to massive experimental data and advanced techniques for systems biology, permitting comprehensive assessment of disease occurrence and progression. In recent years, significant progress has been made in the study of PAH-CHD and omics. To provide a comprehensive description and promote further in-depth investigation of PAH-CHD, this review attempts to summarize the latest developments in genomics, transcriptomics, epigenomics, proteomics, metabolomics, and multi-omics integration.

Modified cardiopulmonary bypass with low priming volume for blood conservation in cardiac valve replacement surgery.

BACKGROUND: The adverse effects of cardiopulmonary bypass during open cardiac surgery, including hemodilution, seem to be inevitable, especially for patients who generally have a relatively lower BMI with relatively small blood volumes. This study reports the modification and use of a cardiopulmonary bypass (CPB) system to reduce priming volume and hemodilution. METHODS: This is a retrospective study of 462 adult patients who underwent cardiac valve replacement surgery from January 2019 to September 2021 at the General Hospital of Western Theater Command. The modified group consisted of 212 patients undergoing modified CPB. The control group included 250 patients receiving conventional CPB. Evaluated indices included fluid intake and output volumes during CPB, intraoperative indices related to CPB operation, usage of blood products during the peri-CPB period, and postoperative outcomes. RESULTS: The modified group displayed a significant reduction in the crystalloid (200 mL vs. 600 mL, P < 0.05) and colloid priming volumes (450 mL vs. 1100 mL, P < 0.05), and ultrafiltration solution volume (750 mL vs. 1200 mL, P < 0.05). Furthermore, the modified group had a significantly lower rate of defibrillation (30.2% vs. 41.2%, P < 0.05). The intraoperative urine volume (650 mL vs. 500 mL, P < 0.05) and intraoperative hematocrit (Hct) (26% vs. 24%, P < 0.05) of the modified CPB group were also higher than in the control group. The modified group required a lower infusion volume of packed red blood cells (250 mL vs. 400 mL, P < 0.05) and lower infusion rates of packed red blood cells (17.9% vs. 25.2%, P < 0.05) and fresh frozen plasma (1.41% vs. 5.2%, P < 0.05). In addition, the modified group showed significantly improved indices related to postoperative recovery. CONCLUSIONS: The modified CPB system effectively conserves blood and shows noteworthy potential for application in cardiac valve replacement surgery.

Photonic machine learning with on-chip diffractive optics.

Machine learning technologies have been extensively applied in high-performance information-processing fields. However, the computation rate of existing hardware is severely circumscribed by conventional Von Neumann architecture. Photonic approaches have demonstrated extraordinary potential for executing deep learning processes that involve complex calculations. In this work, an on-chip diffractive optical neural network (DONN) based on a silicon-on-insulator platform is proposed to perform machine learning tasks with high integration and low power consumption characteristics. To validate the proposed DONN, we fabricated 1-hidden-layer and 3-hidden-layer on-chip DONNs with footprints of 0.15 mm2 and 0.3 mm2 and experimentally verified their performance on the classification task of the Iris plants dataset, yielding accuracies of 86.7% and 90%, respectively. Furthermore, a 3-hidden-layer on-chip DONN is fabricated to classify the Modified National Institute of Standards and Technology handwritten digit images. The proposed passive on-chip DONN provides a potential solution for accelerating future artificial intelligence hardware with enhanced performance.

The occurrence and contamination of optrA-positive methicillin-resistant Staphylococcus aureus from duck farms in Guangdong, China.

OBJECTIVES: Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA), is an important zoonotic microorganism that increasingly causes public health concern worldwide. The objective of this study was to determine the prevalence and transmission of S. aureus in duck farms and evaluate its antimicrobial resistance and genetic characteristics. METHODS: The samples associated with ducks, feeders, and the environment were collected on 14 duck farms from four areas in Guangdong, China, from 2020 to 2021. All isolates were subjected to antimicrobial susceptibility testing. A comprehensive epidemiological survey of S. aureus was conducted by S. aureus protein A typing and whole-genome sequencing. RESULTS: A total of 560 samples were collected. The prevalence rate of MRSA among ducks (8.1%, 11 of 135) was higher compared with that in environmental samples. OptrA-positive ST398-t034 MRSA were first detected from duck farms in China. A total of 79.3% (34 of 46) S. aureus isolates showed multidrug-resistant phenotypes. Notably, some isolates carried multidrug-resistant genes encoding macrolide-lincosamide-streptogramin B, pleuromutilin-pleuromutilin-streptogramin A, and oxazolidinone. Analysis of the virulence genes revealed that the MRSA isolates carried genes encoding gamma-hemolysin, enterotoxin, and leukocidin. ST9-t899 is a primary clonal lineage among duck- and environment-associated MRSA. Single-nucleotide polymorphism analysis showed the potential contamination relationship of optrA-positive ST2308 MRSA isolates carrying the gamma-hemolysin genes and the leukocidin virulence genes between airborne dust and sick ducks. CONCLUSION: The contamination of MRSA, especially optrA-positive MRSA, between food animals and the environment is a growing public health concern worldwide. Based on One Health principles, continuous surveillance of MRSA is urgently needed.

LOEN: Lensless opto-electronic neural network empowered machine vision.

Machine vision faces bottlenecks in computing power consumption and large amounts of data. Although opto-electronic hybrid neural networks can provide assistance, they usually have complex structures and are highly dependent on a coherent light source; therefore, they are not suitable for natural lighting environment applications. In this paper, we propose a novel lensless opto-electronic neural network architecture for machine vision applications. The architecture optimizes a passive optical mask by means of a task-oriented neural network design, performs the optical convolution calculation operation using the lensless architecture, and reduces the device size and amount of calculation required. We demonstrate the performance of handwritten digit classification tasks with a multiple-kernel mask in which accuracies of as much as 97.21% were achieved. Furthermore, we optimize a large-kernel mask to perform optical encryption for privacy-protecting face recognition, thereby obtaining the same recognition accuracy performance as no-encryption methods. Compared with the random MLS pattern, the recognition accuracy is improved by more than 6%.

Prevalence of Livestock-Associated MRSA ST398 in a Swine Slaughterhouse in Guangzhou, China.

Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) is an important zoonotic microorganism that is increasingly causing public health concern worldwide. The objective of this study was to determine the transmission and occurrence of MRSA in a slaughterhouse environment and evaluate its antimicrobial resistance and genetic characterization. In this study, we conducted a comprehensive epidemiological survey of S. aureus by spa typing and whole-genome sequencing (WGS) of samples obtained from the pork production chain, the environment, and community residents. To clarify the evolutionary relationships of MRSA sequence type (ST) 398 in this study and global isolates, 197 published whole-genome sequences data of MRSA ST398 strains were downloaded from the GenBank database and included in the phylogenetic analysis. A total of 585 porcine samples (snout and carcass swabs), 78 human nasal samples, and 136 environmental samples were collected. The MRSA isolates were detected at higher frequencies in samples from swine (15.0%) than carcasses (10.0%), slaughterhouse workers (8.0%), community residents (0%), and environment samples (5.9%). The spa typing results showed that t571 accounted for a higher proportion than other spa types. Closely related isolates from the samples of swine, slaughterhouse workers, carcasses, carrier vehicle, and surrounding fishpond water indicate that MRSA ST398 strains may spread among swine, humans, and the environment. MRSA ST398-t571 isolates were genetically different from global strains, except for two Korean isolates, which showed genetic closeness with it. In addition, a MRSA ST398 isolate recovered from an infected patient in Europe differed by only 31 SNPs from the airborne dust-associated strain isolated in this study, thereby suggesting potential transmission among different countries. Antimicrobial susceptibility testing results demonstrated that 99.0% (96/97) of MRSA and 95.1% (231/243) of methicillin-sensitive S. aureus (MSSA) showed multidrug-resistant (MDR) phenotypes. According to WGS analysis, the poxtA-carrying segment (IS431mec-optrA-IS1216-fexB-IS431mec) was reported in MRSA ST398 isolates for the first time. The coexistence of cfr and optrA in a plasmid was first detected in MRSA ST398. The potential transmission of MRSA among humans, animals, and the environment is a cause for concern. The emergence and transmission of LA-MRSA ST398 with high levels of resistance profiles highlight the urgent need for LA-MRSA surveillance.

Elevated Albumin to Globulin Ratio on Day 7 is Associated with Improved Function Outcomes in Acute Ischemic Stroke Patients with Intravenous Thrombolysis.

Background and Purpose: Albumin to globulin ratio (A/G) has been established as a representative biomarker for assessing inflammation and nutritional status. However, the prognostic value of A/G has rarely been reported in acute ischemic stroke (AIS) patients with intravenous thrombolysis (IVT). Methods: A total of 311 AIS patients who had undergone IVT and completed 3-month follow-up were retrospectively recruited in this study. Albumin (Alb), globulin (Glb) and A/G on admission, within 24 hours after IVT and on day 7 were recorded. Poor outcome was defined as death or major disability (modified Rankin Scale, 3-6) at 3 months. Results: Among the 311 cases, 260 patients had admission blood samples, 296 cases had blood samples within 24 hours after IVT and 126 cases had blood samples on day 7. The patients with and without available blood samples were well-balanced. During the first 24 h, we observed A/G to increase significantly compared with baseline whereas at day 7 it was almost back to baseline in patients with a poor outcome. Receiver operating characteristic (ROC) curves analysis showed that A/G had a better performance in discriminating patients at high risk and low risk of a poor outcome than either Alb or Glb alone and carried the highest predictive ability on day 7 (AUC = 0.807). Lower 7-day A/G was independently associated with a poor outcome (per-SD increase, OR = 0.182, 95% CI: 0.074-0.446). Conclusion: A/G is an important prognostic indicator for AIS outcomes and merits dynamic monitoring.

Admission Random Blood Glucose, Fasting Blood Glucose, Stress Hyperglycemia Ratio, and Functional Outcomes in Patients With Acute Ischemic Stroke Treated With Intravenous Thrombolysis.

BACKGROUND: Stress hyperglycemia ratio (SHR), calculated as glucose/glycated hemoglobin, has recently been developed for assessing stress hyperglycemia and could provide prognostic information for various diseases. However, calculating SHR using random blood glucose (RBG) drawn on admission or fasting blood glucose (FBG) could lead to different results. This study intends to evaluate the association between SHR and functional outcomes in patients with acute ischemic stroke (AIS) with recombinant tissue plasminogen activator (r-tPA) intravenous thrombolysis. METHODS: Data from 230 patients with AIS following thrombolytic therapy with r-tPA in the Third Affiliated Hospital of Wenzhou Medical University from April 2016 to April 2019 were retrospectively reviewed. SHR1 was defined as [RBG (mmol/L)]/[HbA1c (%)] and SHR2 was defined as [FBG (mmol/L)]/[HbA1c (%)]. The outcomes included early neurological improvement (ENI), poor function defined as a modified Rankin Scale score (mRS) of 3-6, and all-cause death in 3 months. Multivariable logistic regression was performed to estimate the association between SHR and adverse outcomes. RESULTS: After adjustment for possible confounders, though patients with AIS with higher SHR1 tend to have a higher risk of poor outcome and death and unlikely to develop ENI, these did not reach the statistical significance. In contrast, SHR2 was independently associated with poor functional outcome (per 0.1-point increases: odds ratios (OR) = 1.383 95% CI [1.147-1.668]). Further adjusted for body mass index (BMI), triglyceride-glucose index (TyG), and diabetes slightly strengthen the association between SHR (both 1 and 2) and adverse outcomes. In subgroup analysis, elevated SHR1 is associated with poor functional outcomes (per 0.1-point increases: OR = 1.246 95% CI [1.041-1.492]) in non-diabetic individuals and the association between SHR2 and the poor outcomes was attenuated in non-cardioembolic AIS. CONCLUSION: SHR is expected to replace random or fasting glucose concentration as a novel generation of prognostic indicator and a potential therapeutic target.

Predictive Value of Globulin to Prealbumin Ratio for 3-Month Functional Outcomes in Acute Ischemic Stroke Patients.

Objective: We aimed to evaluate and compare the association between globulin to albumin ratio (GAR) and globulin to prealbumin ratio (GPR) and 3-month functional prognosis of acute ischemic stroke (AIS) patients receiving intravenous thrombolysis therapy. Methods: 234 AIS patients undergoing intravenous thrombolysis were retrospectively enrolled with acute ischemic stroke from February 2016 to October 2019. Blood sample was collected within 24 h after admission. Poor outcome was defined as the modified Rankin Scale (mRS) ≥ 3 and a favorable outcome as mRS < 3. Severe stroke was defined as the National Institutes of Health Stroke Scale (NIHSS) score > 10 on admission. Student's t-test, Mann-Whitney U test, Chi-square test, logistics' regression analysis, and receiver operating characteristic (ROC) analysis were performed. Results: Patients with poor functional outcome had higher GAR and GPR levels compared with favorable functional group (p = 0.001, p < 0.001, respectively). Severe stroke was also associated with these two increasing variables. After adjustment for confounding factors, multivariate logistic regression analysis indicated that GPR was an independent indicator predictor of AIS. Conclusions: The 24 h GPR level can predict the 3-month functional outcome in AIS patients accepting recombinant tissue plasminogen activator (r-tPA) intravenous thrombosis.

Does Osteoporosis Affect the Adjacent Segments Following Anterior Lumbar Interbody Fusion? A Finite Element Study.

BACKGROUND: Adjacent segment degeneration is a common complication following anterior lumbar interbody fusion (ALIF). Osteoporosis is becoming increasingly prevalent in the elderly population and thus patients undergoing ALIF may experience osteoporosis with age. However, the influence of osteoporosis on adjacent segment degeneration after ALIF remains unclear. METHODS: Three finite element models of the L3-S1 segment, including a healthy model, an ALIF model, and an ALIF with osteoporosis model, were used for analysis. ALIF was simulated at the L4-L5 segment. Based on a hybrid test method, the models were imposed with a preload of 400 N and an adjusted moment in flexion, extension, lateral bending, and axial torsion. Intradiscal pressure, shear stress on anulus fibrosus, and range of motion at L3-L4 and L5-S1 were calculated and compared. RESULTS: In each direction, the maximal values of intradiscal pressure and shear stress on anulus fibrosus at L3-L4 and L5-S1 were found in the ALIF model, and the minimal values were found in the healthy model. At L3-L4 and L5-S1, the maximal values of range of motion in most directions were found in the ALIF model followed by the ALIF with osteoporosis model, and the minimal values were found in the healthy model. However, the maximal value of range of motion at L5-S1 in axial torsion was found in the ALIF with osteoporosis model. CONCLUSIONS: Osteoporosis may mitigate the adverse influence of ALIF on adjacent segments.

Comparison Between 7 Osteoporotic Vertebral Compression Fractures Treatments: Systematic Review and Network Meta-analysis.

BACKGROUND: Vertebroplasty (VP), kyphoplasty (KP), SpineJack system (SJ), radiofrequency kyphoplasty (RFK), Kiva system (Kiva), Sky kyphoplasty system (SK), and conservative treatment are widely used in the treatment of osteoporotic vertebral compression fractures (OVCFs). However, it is still unknown which is the best intervention. The aim of the current study was to evaluate the effectiveness and safety of VP, KP, SJ, RFK, Kiva, SK, and CT in the treatment of OVCFs. METHODS: Randomized controlled trials and cohort studies comparing VP, KP, SJ, RFK, Kiva, SK, or CT for the treatment of OVCFs were identified on the basis of databases including PubMed, the Cochrane Library, Web of Science, and Springer Link. A network meta-analysis was performed using STATA 15.1. RESULTS: A total of 56 studies with 6974 patients and 7 interventions were included in this study. The results of the surface under the cumulative probability demonstrated that SK was the best intervention in decreasing VAS scores and recovering middle vertebral height, RFK was the best intervention in improving ODI scores and decreasing incidence of new fractures, SJ was the best intervention to restore kyphosis angle, and Kiva was the best intervention to reduce incidence of bone cement leakage. Cluster analysis showed that SK was the preferable intervention on the basis of the outcomes of VAS, ODI, middle vertebral height, and kyphotic angle, and RFK was the preferable treatment in decreasing the incidence of adverse events. In our network meta-analysis, node-splitting analysis and loop inconsistency analysis showed no significant inconsistencies. CONCLUSIONS: SK may be the most effective treatment in relieving pain, improving the quality of life, and recovering vertebral body height and kyphotic angle, while RFK may be the safest intervention for OVCFs. However, considering the limitations of this study, more high-quality trials are needed in the future to confirm the current conclusion.