Induction of HIV Neutralizing Antibody Lineages in Mice with Diverse Precursor Repertoires.

The design of immunogens that elicit broadly reactive neutralizing antibodies (bnAbs) has been a major obstacle to HIV-1 vaccine development. One approach to assess potential immunogens is to use mice expressing precursors of human bnAbs as vaccination models. The bnAbs of the VRC01-class derive from the IGHV1-2 immunoglobulin heavy chain and neutralize a wide spectrum of HIV-1 strains via targeting the CD4 binding site of the envelope glycoprotein gp120. We now describe a mouse vaccination model that allows a germline human IGHV1-2(∗)02 segment to undergo normal V(D)J recombination and, thereby, leads to the generation of peripheral B cells that express a highly diverse repertoire of VRC01-related receptors. When sequentially immunized with modified gp120 glycoproteins designed to engage VRC01 germline and intermediate antibodies, IGHV1-2(∗)02-rearranging mice, which also express a VRC01-antibody precursor light chain, can support the affinity maturation of VRC01 precursor antibodies into HIV-neutralizing antibody lineages.

Sex Differences in Outcomes after Endovascular Thrombectomy for Patients with Acute Ischemic Stroke.

INTRODUCTION: Endovascular thrombectomy (EVT) is the standard of care for patients with large-vessel occlusion acute ischemic stroke (AIS). There may be differing recanalization effectiveness based on patients' sex, and understanding such variations can improve patient outcomes by adjusting for differences. We aimed to assess the sex differences in outcome after EVT for patients with AIS. METHODS: We retrospectively analyzed 250 consecutive AIS patients who underwent EVT from July 2019 to February 2022 across two large comprehensive tertiary care stroke centers in China. Outcomes of male patients were compared to females, where poor outcome was defined as a modified Rankin score (mRS) of 3-6 at 90 days. RESULTS: Male patients had higher rates of symptomatic intracranial hemorrhage (sICH) (12.50% vs. 4.05%, p = 0.042) and higher hospitalization costs (114,541.08 vs. 105,790.27 RMB, p = 0.024). Male patients also had a longer median onset-to-needle time (ONT) (146.00 [104.00, 202.00] versus 120.00 [99.25, 144.75], p = 0.026). However, there were no differences in hospitalization length (p = 0.251), 90-day favorable outcome (p = 0.952), and 90-day mortality (p = 0.931) between the sexes. CONCLUSION: Female patients had lower hospitalization costs and sICH rates than males after EVT for AIS. Identifying such differences and implementing measures, including adaptations to workflow optimization, would help to reduce the ONT and last known normal-to-puncture time seen in males to improve patient outcomes. Despite such variations, favorable outcomes and mortality are similar in female and male AIS patients.

SN2 Reaction at the Amide Nitrogen Center Enables Hydrazide Synthesis.

Nucleophilic substitutions are fundamentally important transformations in synthetic organic chemistry. Despite the substantial advances in bimolecular nucleophilic substitutions (SN2) at saturated carbon centers, analogous SN2 reaction at the amide nitrogen atom remains extremely limited. Here we report an SN2 substitution method at the amide nitrogen atom with amine nucleophiles for nitrogen-nitrogen (N-N) bond formation that leads to a novel strategy toward biologically and medicinally important hydrazide derivatives. We found the use of sulfonate-leaving groups at the amide nitrogen atom played a pivotal role in the reaction. This new N-N coupling reaction allows the use of O-tosyl hydroxamates as electrophiles and readily available amines, including acyclic aliphatic amines and saturated N-heterocycles as nucleophiles. The reaction features mild conditions, broad substrate scope (>80 examples), excellent functional group tolerability, and scalability. The method is applicable to late-stage modification of various approved drug molecules, thus enabling complex hydrazide scaffold synthesis.

Metal-Organic Frameworks as a New Platform to Construct Ordered Mesoporous Ce-Based Oxides for Efficient CO2 Fixation under Ambient Conditions.

Metal-organic frameworks (MOFs) are proved to be good precursors to derive various nanomaterials with desirable functions, but so far the controllable synthesis of ordered mesoporous derivatives from MOFs has not been achieved. Herein, this work reports, for the first time, the construction of MOF-derived ordered mesoporous (OM) derivatives by developing a facile mesopore-inherited pyrolysis-oxidation strategy. This work demonstrates a particularly elegant example of this strategy, which involves the mesopore-inherited pyrolysis of OM-CeMOF into a OM-CeO2 @C composite, followed by the oxidation removal of its residual carbon, affording the corresponding OM-CeO2 . Furthermore, the good tunability of MOFs helps to allodially introduce zirconium into OM-CeO2 to regulate its acid-base property, thus boosting its catalytic activity for CO2 fixation. Impressively, the optimized Zr-doped OM-CeO2 can achieve above 16 times higher catalytic activity than its solid CeO2 counterpart, representing the first metal oxide-based catalyst to realize the complete cycloaddition of epichlorohydrin with CO2 under ambient temperature and pressure. This study not only develops a new MOF-based platform for enriching the family of ordered mesoporous nanomaterials, but also demonstrates an ambient catalytic system for CO2 fixation.

3D-Printed Thermoplastic Polyurethane Electrodes for Customizable, Flexible Lithium-Ion Batteries with an Ultra-Long Lifetime.

3D printing technology has demonstrated great potential in fabricating flexible and customizable high-performance batteries, which are highly desired in the forthcoming intelligent and ubiquitous energy era. However, a significant performance gap, especially in cycling stability, still exists between the 3D-printed and conventional electrodes, seriously limiting the practical applications of 3D-printed batteries. Here, for the first time, a series of thermoplastic polyurethane (TPU)-based 3D-printed electrodes is developed via fused deposition modeling for flexible and customizable high-performance lithium-ion batteries. The TPU-based electrode filaments in kilogram order are prepared via a facile extrusion method. As a result, the electrodes are well-printed with high dimensional accuracy, flexibility, and mechanical stability. Notably, 3D-printed TPU-LFP electrodes exhibit a capacity retention of 100% after 300 cycles at 1C, which is among the best cycling performance of all the reported 3D-printed electrodes. Such excellent performance is associated with the superb stress cushioning properties of the TPU-based electrodes that can accommodate the volume change during the cycling and thus significantly prevent the collapse of 3D-printed electrode structures. The findings not only provide a new avenue to achieve customizable and flexible batteries but also guide a promising way to erase the performance gap between 3D-printed and conventional lithium-ion batteries.

Compact reconfigurable on-chip polarization beam splitters enabled by phase change material.

In this paper, we present the design of a compact reconfigurable polarization beam splitter (PBS) enabled by ultralow-loss phase-changing Sb2Se3. By harnessing the phase-change-mediated mode coupling in a directional coupler (DC), guided light with different polarizations could be routed into different paths and this routing could be dynamically switched upon the phase change of Sb2Se3. With an optimized DC region, the proposed PBS demonstrates efficient polarization splitting with crosstalk less than -21.3 dB and insertion loss less than 0.16 dB at 1550 nm for both phase states of Sb2Se3, and features energy efficient property benefitting from the nonvolatile phase change of Sb2Se3, which holds great potentials for on-chip applications involving polarization control, including polarization-division multiplexing system, quantum photonics, microwave photonics, etc.

Association Between Hip Bone Mineral Density and Mortality Risk After Hip Fracture: A Prospective Cohort Study.

Factors related to mortality after osteoporotic hip fracture (HF) have been investigated intensively, except for proximal femoral bone mineral density (BMD), which is also the primary cause of osteoporosis. In this study, we aimed to investigate the association of hip BMD with mortality risk after HF. Four hundred and eleven elderly patients with HF in Beijing, China, were included and prospectively followed up with a median time of 3 years. At baseline, quantitative CT technique (QCT) was used to measure areal BMD (aBMD) of the unaffected hip. Areal BMDs of the total hip (TH), femoral neck (FN), trochanter (TR), and intertrochanter were analyzed with postoperative mortality as the primary outcome. A total of 394 patients (78.59 ± 7.59 years, 75.4% female) were included in our final analysis, with 86 (82.23 ± 7.00 years, 81.4% female) dead. All hip bone densities demonstrated a significant association with mortality risks in the unadjusted model, but only TR aBMD remained significantly correlated after adjusting for all covariates. Compared to the lower TR aBMD group, the higher TR aBMD group yielded significantly lower death risks (HR 0.21 95% CI 0.05-0.9, P = 0.036). Higher survival probabilities were observed for higher TH and TR aBMD in survival analysis (P < 0.001). Hip BMD, especially TR BMD assessed by QCT, is an independent risk factor for postoperative mortality following HF. QCT may present a promising avenue for opportunistic analysis in immobilized patients, providing valuable information for early detection and personalized interventions to enhance patient outcomes.

Orthogeriatric co-managements lower early mortality in long-lived elderly hip fracture: a post-hoc analysis of a prospective study.

OBJECTIVE: To evaluate the clinical effectiveness of orthogeriatric co-management care in long-lived elderly hip fracture patients (age ≥ 90). METHODS: Secondary analysis was conducted in long-lived hip fracture patients between 2018 to 2019 in 6 hospitals in Beijing, China. Patients were divided into the orthogeriatric co-management group (CM group) and traditional consultation mode group (TC group) depending on the management mode. With 30-day mortality as the primary outcome, multivariate regression analyses were performed after adjusting for potential covariates. 30-day mobility and quality of life were compared between groups. RESULTS: A total of 233 patients were included, 223 of whom completed follow-up (125 in CM group, 98 in TC group). The average age was 92.4 ± 2.5 years old (range 90-102). The 30-day mortality in CM group was significantly lower than that in TC group after adjustments for (2.4% vs. 10.2%; OR = 0.231; 95% CI 0.059 ~ 0.896; P = 0.034). The proportion of patients undergoing surgery and surgery performed within 48 h also favored the CM group (97.6% vs. 85.7%, P = 0.002; 74.4% vs. 24.5%, P < 0.001; respectively). In addition, much more patients in CM group could walk with or without aids in postoperative 30 days than in the TC group (87.7% vs. 60.2%, P < 0.05), although differences were not found after 1-year follow-up. And there was no significant difference in total cost between the two groups (P > 0.05). CONCLUSIONS: For long-lived elderly hip fracture patients, orthogeriatric co-management care lowered early mortality, improved early mobility and compared with the traditional consultation mode.

D-π-A-Based Trisubstituted Alkenes as Environmentally Sensitive Fluorescent Probes to Detect Lewy Pathologies.

Lewy pathologies, which mainly consist of insoluble α-synuclein (α-syn) aggregates, are the hallmarks of Parkinson's disease and many other neurodegenerative diseases termed "synucleinopathies". Detection of Lewy pathologies with optical methods is of interest for preclinical studies, while the α-syn fluorescent probe is still in great demand. By rational design, we obtained a series of D-π-A-based trisubstituted alkenes with acceptable optical properties and high binding affinities to α-syn fibrils. Among these probes, FPQXN and TQXN-2 exhibited high binding affinities (6 and 8 nM, respectively), significant fluorescence enhancements (17.2- and 26.6-fold, respectively), and satisfying quantum yields (36.5% and 10.4%, respectively), which met the need for the in vitro neuropathological staining of Lewy pathologies in the PD brain sections. In addition, TQXN-2 showed great potential in fluorescent discrimination of Lewy pathologies and Aß plaques. Our research provides flexible tools for in vitro detection of α-syn aggregates and offers new structural frameworks for the further development of α-syn fluorescent probes.

Compact nonvolatile 2×2 photonic switch based on two-mode interference.

On-chip nonvolatile photonic switches enabled by phase change materials (PCMs) are promising building blocks for power-efficient programmable photonic integrated circuits. However, large absorption loss in conventional PCMs (such as Ge2Sb2Te5) interacting with weak evanescent waves in silicon waveguides usually leads to high insertion loss and a large device footprint. In this paper, we propose a 2×2 photonic switch based on two-mode interference in a multimode slot waveguide (MSW) with ultralow loss Sb2S3 integrated inside the slot region. The MSW supports two lowest order TE modes, i.e., symmetric TE00 and antisymmetric TE01 modes, and the phase of Sb2S3 could actively tune two-mode interference behavior. Owing to the enhanced electric field in the slot, the interaction strength between modal field and Sb2S3 could be boosted, and a photonic switch containing a ∼9.4 µm-long Sb2S3-MSW hybrid section could effectively alter the light transmission between bar and cross ports upon the phase change of Sb2S3 with a cross talk (CT) less than -13.6 dB and an insertion loss (IL) less than 0.26 dB in the telecommunication C-band. Especially at 1550 nm, the CT in the amorphous (crystalline) Sb2S3 is -36.1 dB (-31.1 dB) with a corresponding IL of 0.073 dB (0.055 dB). The proposed 2×2 photonic switch is compact in size and compatible with on-chip microheaters, which may find promising applications in reconfigurable photonic devices.

Mental health status of medical students during postgraduate entrance examination.

BACKGROUND: The postgraduate entrance examination can be a milestone for many medical students to advance their careers. An increasing number of students are competing for limited postgraduate offers available, and failure to enter postgraduate studies can have adverse mental health consequences. In this paper, we aim to investigate the mental health status of medical students during the postgraduate application entrance examination and to provide a targeted basis for mental health education and psychological counselling. METHODS: Using the Symptom Checklist-90 scale (SCL-90) questionnaire, the mental health status of 613 students who passed two rounds of the Postgraduate Entrance Examination in 2019 to enroll in Guangzhou Medical University in China was evaluated and followed up for retesting 6 months later. We used SPSS 20.0 statistical software for comparative analysis, including One-Sample T-Test, Independent-Samples T-Test, Paired Samples T-Test and Chi-square Test. RESULTS: Our data showed that 12.10% of students had mental health problems during the postgraduate entrance examination, and it decreased significantly to 4.40% at the 6-month follow-up after the examination period finished (P < 0.01). Somatization was the most significant symptom of the students both during and after the postgraduate entrance examination stages. All SCL-90 factors were scored significantly lower both in and after the postgraduate entrance examination stages than the 2008 national college student norm score (P < 0.01). Excluding psychiatric factors, all other SCL-90 factors in the postgraduate entrance examination stage scored higher than the graduate stage (P < 0.05), and the total score of SCL-90 in female medical students was higher compared to male students (P < 0.05). CONCLUSION: The postgraduate entrance examination event has a significant negative influence on students' mental health. The mental health of college and graduate students as an important part of their higher education experience should be systematically studied, and psychological counselling or help should be provided to them throughout their studies, specifically during the examination period. Educating applicants about mental health should be implemented during the postgraduate entrance examination curriculum.

Reconfigurable hybrid silicon waveguide Bragg filter using ultralow-loss phase-change material.

Reconfigurable silicon photonic devices attract much research attention, and hybrid integration with tunable phase-change materials (PCMs) exhibiting large refractive index contrast between amorphous (Am) and crystalline (Cr) states is a promising way to achieve this goal. Here, we propose and numerically investigate a Sb2Se3-Si hybrid waveguide Bragg filter operating in the telecom C-band on the silicon-on-insulator (SOI) platform. The proposed device consists of a Bragg grating (BG) with a thin top layer of ultralow-loss Sb2Se3 PCM interacting with evanescent field of the silicon waveguide mode. By harnessing the ultralow-loss and reversible index change of Sb2Se3 film, the spectral response of the hybrid BGs could be dynamically tuned. We also theoretically investigate the reversible phase transitions between Am and Cr states of Sb2Se3 film that could be attained by applying voltage pulses on the indium-tin-oxide (ITO) strip heater covered on Sb2Se3 film. Thermal simulations show that a 2 V (4.5 V) pulse with a duration of 400 ns (55 ns) applied to electric contacts would produce crystallization (or amorphization). The proposed structure may find great potential for on-chip phase tunable devices on a silicon platform.

Augmented and virtual reality usage in awake craniotomy: a systematic review.

Augmented and virtual reality (AR, VR) are becoming promising tools in neurosurgery. AR and VR can reduce challenges associated with conventional approaches via the simulation and mimicry of specific environments of choice for surgeons. Awake craniotomy (AC) enables the resection of lesions from eloquent brain areas while monitoring higher cortical and subcortical functions. Evidence suggests that both surgeons and patients benefit from the various applications of AR and VR in AC. This paper investigates the application of AR and VR in AC and assesses its prospective utility in neurosurgery. A systematic review of the literature was performed using PubMed, Scopus, and Web of Science databases in accordance with the PRISMA guidelines. Our search results yielded 220 articles. A total of six articles consisting of 118 patients have been included in this review. VR was used in four papers, and the other two used AR. Tumour was the most common pathology in 108 patients, followed by vascular lesions in eight patients. VR was used for intraoperative mapping of language, vision, and social cognition, while AR was incorporated in preoperative training of white matter dissection and intraoperative visualisation and navigation. Overall, patients and surgeons were satisfied with the applications of AR and VR in their cases. AR and VR can be safely incorporated during AC to supplement, augment, or even replace conventional approaches in neurosurgery. Future investigations are required to assess the feasibility of AR and VR in various phases of AC.

Association of Early Increase in Body Temperature with Symptomatic Intracranial Hemorrhage and Unfavorable Outcome Following Endovascular Therapy in Patients with Large Vessel Occlusion Stroke.

INTRODUCTION: The aim of this study was to investigate for possible associations between an early increase in body temperature within 24 hours of endovascular therapy (EVT) for large vessel occlusion stroke and the presence of symptomatic intracranial hemorrhage (sICH) and other clinical outcomes. METHODS: This was a retrospective study of consecutive patients with large vessel occlusion stroke who were treated with EVT from August 2018 to June 2021. Patients were divided into two groups based on the presence of fever, as defined by a Peak Body Temperature (PBT) of ≥37.3 °C. The presence of sICH and other clinical outcomes were compared between the two groups. RESULTS: The median NIHSS admission score (IQR) was 16.0 (12.0, 21.0), with higher NIHSS scores in the PBT ≥37.3 °C group than in the PBT <37.3 °C group (18 vs 14, respectively; p = 0.002). There were no differences in clinical outcomes at 3 months between patients with PBT <37.3 °C and patients with PBT between 37.3 °C and 38 °C. However, patients with PBT ≥38 °C had an increased risk of sICH (adjusted odds ratio (OR) = 8.8, 95% confidence interval (95% CI): 1.7-46.0; p = 0.01), increased inpatient death or hospice discharge (OR = 10.5, 95% CI: 2.0-53.9; p = 0.005), poorer clinical outcome (OR = 25.6, 95% CI: 5.2-126.8; p < 0.001), and increased 3-month mortality (OR = 6.6, 95% CI: 1.8-24.6; p = 0.01). CONCLUSIONS: Elevated PBT (≥38 °C) within 24 hours of EVT was significantly associated with an increased incidence of symptomatic intracranial hemorrhage, discharge to hospice or inpatient death, poorer clinical outcome and 3-month mortality, and with less functional independence. Further large-scale, prospective and multicenter trials are needed to confirm these findings.

Shortening door-to-puncture time and improving patient outcome with workflow optimization in patients with acute ischemic stroke associated with large vessel occlusion.

OBJECTIVE: We aimed to evaluate door-to-puncture time (DPT) and door-to-recanalization time (DRT) without directing healthcare by neuro-interventionalist support in the emergency department (ED) by workflow optimization and improving patients' outcomes. METHODS: Records of 98 consecutive ischemic stroke patients who had undergone endovascular therapy (EVT) between 2018 to 2021 were retrospectively reviewed in a single-center study. Patients were divided into three groups: pre-intervention (2018-2019), interim-intervention (2020), and post-intervention (January 1st 2021 to August 16th, 2021). We compared door-to-puncture time, door-to-recanalization time (DRT), puncture-to-recanalization time (PRT), last known normal time to-puncture time (LKNPT), and patient outcomes (measured by 3 months modified Rankin Scale) between three groups using descriptive statistics. RESULTS: Our findings indicate that process optimization measures could shorten DPT, DRT, PRT, and LKNPT. Median LKNPT was shortened by 70 min from 325 to 255 min(P < 0.05), and DPT was shortened by 119 min from 237 to 118 min. DRT shortened by 132 min from 338 to 206 min, and PRT shortened by 33 min from 92 to 59 min from the pre-intervention to post-intervention groups (all P < 0.05). Only 21.4% of patients had a favorable outcome in the pre-intervention group as compared to 55.6% in the interventional group (P= 0.026). CONCLUSION: This study demonstrated that multidisciplinary cooperation was associated with shortened DPT, DRT, PRT, and LKNPT despite challenges posed to the healthcare system such as the COVID-19 pandemic. These practice paradigms may be transported to other stroke centers and healthcare providers to improve endovascular time metrics and patient outcomes.

Structure-Relaxivity Mechanism of an Ultrasmall Ferrite Nanoparticle T1 MR Contrast Agent: The Impact of Dopants Controlled Crystalline Core and Surface Disordered Shell.

Ultrasmall ferrite nanoparticles (UFNPs) have emerged as powerful magnetic resonance imaging (MRI) T1 nanoprobe for noninvasive visualization of biological events. However, the structure-relaxivity relationship and regulatory mechanism of UFNPs remain elusive. Herein, we developed chemically engineered 3.8 nm ZnxFe3-xO4@ZnxMnyFe3-x-yO4 (denoted as ZnxF@ZnxMnyF) nanoparticles with precise dopants control in both crystalline core and disordered shell as a model system to assess the impact of dopants on the relaxometric properties of UFNPs. It is determined that the core-shell dopant architecture allows the optimal tuning of r1 relaxivity for Zn0.4F@Zn0.4Mn0.2F up to 20.22 mM-1 s-1, which is 5.2-fold and 6.5-fold larger than that of the original UFNPs and the clinically used Gd-DTPA. Moreover, the high-performing UFNPs nanoprobe, when conjugated with a targeting moiety AMD3100, enables the in vivo MRI detection of small lung metastasis with greatly enhanced sensitivity. Our results pave the way toward the chemical design of ultrasensitive T1 nanoprobe for advanced molecular imaging.

Shortening Door-to-Needle Time by Multidisciplinary Collaboration and Workflow Optimization During the COVID-19 Pandemic.

OBJECTIVES: This study aims to evaluate shortening door-to-needle time of intravenous recombinant tissue plasminogen activator of acute ischemic stroke patients by multidisciplinary collaboration and workflow optimization based on our hospital resources. MATERIALS AND METHODS: We included patients undergoing thrombolysis with intravenous recombinant tissue plasminogen activator from January 1, 2018, to September 30, 2020. Patients were divided into pre- (January 1, 2018, to December 31, 2019) and post-intervention groups (January 1, 2020, to September 31, 2020). We conducted multi-department collaboration and process optimization by implementing 16 different measures in prehospital, in-hospital, and post-acute feedback stages for acute ischemic stroke patients treated with intravenous thrombolysis. A comparison of outcomes between both groups was analyzed. RESULTS: Two hundred and sixty-three patients received intravenous recombinant tissue plasminogen activator in our hospital during the study period, with 128 and 135 patients receiving treatment in the pre-intervention and post-intervention groups, respectively. The median (interquartile range) door-to-needle time decreased significantly from 57.0 (45.3-77.8) min to 37.0 (29.0-49.0) min. Door-to-needle time was shortened to 32 min in the post-intervention period in the 3rd quarter of 2020. The door-to-needle times at the metrics of ≤ 30 min, ≤ 45 min, ≤ 60 min improved considerably, and the DNT> 60 min metric exhibited a significant reduction. CONCLUSIONS: A multidisciplinary collaboration and continuous process optimization can result in overall shortened door-to-needle despite the challenges incurred by the COVID-19 pandemic.

Perceptions on basilar artery occlusion management in China versus other countries: Analysis of the after the BEST of BASICS (ABBA) survey.

INTRODUCTION: Uncertainty remains on the optimal management of basilar artery occlusion (BAO). Two large randomized controlled trials (RCTs) in 2019 and 2021 demonstrated neutral results with respect to the use of endovascular therapy (EVT) for BAO. This study aimed to understand regional variation in physicians' perceptions towards the treatment of BAO as stratified by physician respondents from China versus outside China, prior to the publication of studies demonstrating a benefit of EVT for BAO. METHODS: An international online survey was conducted of stroke neurologists and neurointerventionalists from January to March 2022. Survey questions evaluated physician opinions toward the use of EVT in BAO, as well as the clinical and imaging features underlying treatment decisions. Respondents were dichotomized as either from China or from other countries and differences between groups were analyzed. RESULTS: There were 1245 physician respondents across 73 countries of which 295 (23.7%) were from China. Compared to respondents from the rest of the world, respondents from China were more likely to be interventionalists (71.5% vs 35.0%; p < 0.0001). Overall, more than 95% of respondents believed that EVT was superior to medical therapy under certain circumstances. Chinese respondents were more likely to believe that further RCTs were necessary than respondents from other countries (93.6% vs 76.2%; p < 0.0001). Chinese respondents were more likely to use advanced imaging in later time windows and use a premorbid mRS threshold of ≤2 for BAO selection to EVT. CONCLUSION: Most stroke physicians believe EVT is beneficial in selected patients with BAO. Clinical and imaging modality differences were observed in the selection criteria used for EVT. There was greater inclination to enroll all trial eligible patients in a BAO RCT by respondents from China as compared to other parts of the world.

Population-environment dynamics across world's top 100 urban agglomerations: With implications for transitioning toward global urban sustainability.

Urbanization is a long-term global trend critical for shaping human-Earth sustainability in the Anthropocene. In past decades, much progress has been made in researching urban sustainability, particularly global assessments of the big picture and case studies of individual cities. Here we examine the world's top 100 urban agglomerations (UAs) in terms of size-that rank high on sustainability agendas and cover 28% of the global UA area-regarding four broadly concerned challenges: population shrinkage, slum development, greenness loss, and heat exposure. Instead of merely focusing on global/regional "averages" or individual cases, we take one step further to identify the "anomalies" of urban sustainability among the 100 UAs for each dimension and on the whole as multi-dimensional coupled infrastructure systems. Results show: (1) urban population of the 100 UAs increased by 36% during 2000-2020; (2) urban slums occurred in 85% of 34 examined UAs in the Global South; (3) urban greenness declined in the 100 UAs by 8% during 2000-2019; and (4) 79% of the 100 UAs were projected to have less than 30 EHDs per year during 2021-2030. Our findings provide global baselines for place-based problem-driven policymaking for the examined UAs and suggest improving urban green infrastructure as their top policy imperative. Our findings point to a critical research gap in the urban sustainability literature: Studying sustainability transitions of the "abnormally" sustainable UAs identified in this study that had exceptional performances on the four examined sustainability dimensions, e.g., Beijing of China and Milan of Italy.

Understanding the distribution and drivers of PM2.5 concentrations in the Yangtze River Delta from 2015 to 2020 using Random Forest Regression.

Understanding the drivers of PM2.5 is critical for the establishment of PM2.5 prediction models and the prevention and control of regional air pollution. In this study, the Yangtze River Delta is taken as the research object. Spatial cluster and outlier method was used to analyze the temporal and spatial distribution and variation of surface PM2.5 in the Yangtze River Delta from 2015 to 2020, and Random Forest was utilized to analyze the drivers of PM2.5 in this area. The results indicated that (1) based on the spatial cluster distribution of PM2.5, the northwest and north of Yangtze River Delta region were mostly highly concentrated and surrounded by high concentrations of PM2.5, while lowly concentrated and surrounded by low concentrations areas were distributed in the southern; (2) the relationship between PM2.5 concentrations and drivers in the Yangtze River Delta was modeled well and the explanatory rate of drivers to PM2.5 were more than 0.9; (3) temperature, precipitation, and wind speed were the main driving forces of PM2.5 emission in the Yangtze River Delta. It should be noted that the repercussion of wildfire on PM2.5 was gradually prominent. When formulating air pollution control measures, the local government normally considers the impact of weather and traffic conditions. In order to reduce PM2.5 pollution caused by biomass combustion, the influence of wildfire should also be taken into account, especially in the fire season. Meanwhile, high leaf area was conducive to improving air quality, and the increasing green area will help reduce air pollutants.