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Moiré superlattices have emerged as an unprecedented manipulation tool for engineering correlated quantum phenomena in van der Waals heterostructures. With moiré potentials as a naturally configurable solid-state that sustains high exciton density, interlayer excitons in transition metal dichalcogenide heterostructures are expected to achieve high-temperature exciton condensation. However, the exciton degeneracy state is usually optically inactive due to the finite momentum of interlayer excitons. Experimental observation of dark interlayer excitons in moiré potentials remains challenging. Here we directly visualize the dark interlayer exciton transport in WS2/h-BN/WSe2 heterostructures using femtosecond transient absorption microscopy. We observe a transition from classical free exciton gas to quantum degeneracy by imaging temperature-dependent exciton transport. Below a critical degeneracy temperature, exciton diffusion rates exhibit an accelerating downward trend, which can be explained well by a nonlinear quantum diffusion model. These results open the door to quantum information processing and high-precision metrology in moiré superlattices.
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OBJECTIVE: This study aimed to compare the efficacy of enhanced 3D T1-weighted black-blood fast-spin-echo vessel wall magnetic resonance imaging (eVW-MRI) and time-of-flight magnetic resonance angiography (TOF MRA) for follow-up evaluation of aneurysms treated with flow diversion (FD). METHODS: Our study enrolled 77 patients harboring 84 aneurysms treated with FD. Follow-up was by MRI (eVW-MRI and TOF MRA) and digital subtraction angiography (DSA). Two radiologists, blinded to DSA examination results, independently evaluated the images of aneurysm occlusion and parent artery patency using the Kamran-Byrne Scale. Interobserver diagnostic agreement and intermodality diagnostic agreement were acquired. Pretreatment and follow-up aneurysm wall enhancement (AWE) patterns were collected. RESULTS: Based on the Kamran-Byrne Scale, the intermodality agreement between eVW-MRI and DSA was better than TOF MRA versus DSA for aneurysm remnant detection (weighted ĸ = 0.891 v. 0.553) and parent artery patency (ĸ = 0.950 v. 0.221). Even with the coil artifact, the consistency of eVW-MRI with DSA for aneurysm remnant detection was better than that of TOF MRA (weighted ĸ = 0.891 v. 0.511). The artifact of adjunctive coils might be more likely to affect the accuracy in evaluating parent artery patency with TOF MRA than with eVW-MRI (ĸ = 0.077 v. 0.788). The follow-up AWE patterns were not significantly associated with pretreatment AWE patterns and aneurysm occlusion. CONCLUSIONS: The eVW-MRI outperforms TOF MRA as a reliable noninvasive and nonionizing radioactive imaging method for evaluating aneurysm remnants and parent artery patency after FD. The significance of enhancement patterns on eVW-MRI sequences needs more exploration. CLINICAL RELEVANCE STATEMENT: The application of enhanced vessel wall magnetic resonance imaging has proven to be a promising tool to depict aneurysm remnant and parent artery stenosis in order to tailor the antiplatelet therapy strategy in patients after flow diversion. KEY POINTS: ⢠Enhanced vessel wall magnetic resonance imaging has an emerging role in depicting aneurysm remnant and parent artery patency after flow diversion. ⢠With or without the artifact from adjunctive coils, enhanced vessel wall magnetic resonance imaging was better than TOF MRA in detecting aneurysm residual and parent artery stenosis by using DSA imaging as the standard. ⢠Enhanced vessel wall magnetic resonance imaging holds potential to be used as an alternative to DSA for routine aneurysm follow-up after flow diversion.
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Embolización Terapéutica , Aneurisma Intracraneal , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Estudios de Seguimiento , Resultado del Tratamiento , Constricción Patológica/terapia , Embolización Terapéutica/métodos , Imagen por Resonancia Magnética , Angiografía por Resonancia Magnética/métodos , Angiografía de Substracción Digital/métodosRESUMEN
In this study, we have investigated the electron mobility of monolayered (ML) tetrahex-GeC2 by solving the linearized Boltzmann transport equation (BTE) with the normalized full-band relaxation time approximation (RTA) using density functional theory (DFT). Contrary to what the deformation potential theory (DPT) suggested, the ZA acoustic mode was determined to be the most restrictive for electron mobility, not the LA mode. The electron mobility at 300 K is 803 cm2 (V s)-1, exceeding the 400 cm2 (V s)-1 of MoS2 which was calculated using the same method and measured experimentally. The ab initio quantum transport simulations were performed to assess the performance limits of sub-10 nm DG ML tetrahex-GeC2 n-type MOSFETs, including gate lengths (Lg) of 3 nm, 5 nm, 7 nm, and 9 nm, with the underlap (UL) effect considered for the first two. For both high-performance (HP) and low-power (LP) applications, their on-state currents (Ion) can meet the requirements of similar nodes in the ITRS 2013. In particular, the Ion is more remarkable for HP applications than that of the extensively studied MoS2. For LP applications, the Ion values at Lg of 7 and 9 nm surpass those of arsenene, known for having the largest Ion among 2D semiconductors. Subthreshold swings (SSs) as low as 69/53 mV dec-1 at an Lg of 9 nm were observed for HP/LP applications, and 73 mV dec-1 at an Lg of 5 nm for LP applications, indicating the excellent gate control capability. Moreover, the delay time τ and power dissipation (PDP) at Lg values of 3 nm, 5 nm, 7 nm, and 9 nm are all below the upper limits of the ITRS 2013 HP/LP proximity nodes and are comparable to or lower than those of typical 2D semiconductors. The sub-10 nm DG ML tetrahex-GeC2 n-type MOSFETs can be down-scaled to 9 nm and 5 nm for HP and LP applications, respectively, displaying desirable Ion, delay time τ, and PDP in the ballistic limit, making them a potential choice for sub-10 nm transistors.
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Overactivation of the NLRP3 inflammasomes induces production of pro-inflammatory cytokines and drives pathological processes. Pharmacological inhibition of NLRP3 is an explicit strategy for the treatment of inflammatory diseases. Thus far no drug specifically targeting NLRP3 has been approved by the FDA for clinical use. This study was aimed to discover novel NLRP3 inhibitors that could suppress NLRP3-mediated pyroptosis. We screened 95 natural products from our in-house library for their inhibitory activity on IL-1ß secretion in LPS + ATP-challenged BMDMs, found that Britannin exerted the most potent inhibitory effect with an IC50 value of 3.630 µM. We showed that Britannin (1, 5, 10 µM) dose-dependently inhibited secretion of the cleaved Caspase-1 (p20) and the mature IL-1ß, and suppressed NLRP3-mediated pyroptosis in both murine and human macrophages. We demonstrated that Britannin specifically inhibited the activation step of NLRP3 inflammasome in BMDMs via interrupting the assembly step, especially the interaction between NLRP3 and NEK7. We revealed that Britannin directly bound to NLRP3 NACHT domain at Arg335 and Gly271. Moreover, Britannin suppressed NLRP3 activation in an ATPase-independent way, suggesting it as a lead compound for design and development of novel NLRP3 inhibitors. In mouse models of MSU-induced gouty arthritis and LPS-induced acute lung injury (ALI), administration of Britannin (20 mg/kg, i.p.) significantly alleviated NLRP3-mediated inflammation; the therapeutic effects of Britannin were dismissed by NLRP3 knockout. In conclusion, Britannin is an effective natural NLRP3 inhibitor and a potential lead compound for the development of drugs targeting NLRP3.
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Inflamasomas , Lactonas , Proteína con Dominio Pirina 3 de la Familia NLR , Sesquiterpenos , Animales , Humanos , Ratones , Inflamasomas/agonistas , Interleucina-1beta/metabolismo , Lactonas/farmacología , Lactonas/uso terapéutico , Lipopolisacáridos/farmacología , Macrófagos , Ratones Endogámicos C57BL , Proteína con Dominio Pirina 3 de la Familia NLR/antagonistas & inhibidores , Sesquiterpenos/farmacología , Sesquiterpenos/uso terapéuticoRESUMEN
Aberrant activation of NLRP3 inflammasome causes the progression of various inflammation-related diseases, but the small-molecule inhibitors of NLRP3 are not currently available for clinical use. Tabersonine (Tab) is a natural product derived from a traditional Chinese herb Catharanthus roseus that is usually used as an anti-tumor agent. In this study we investigated the anti-inflammatory effects and molecular targets of Tab. We first screened 151 in-house natural compounds for their inhibitory activity against IL-1ß production in BMDMs. We found that Tab potently inhibited NLRP3-mediated IL-1ß production with an IC50 value of 0.71 µM. Furthermore, we demonstrated that Tab suppressed the assembly of NLRP3 inflammasome, especially the interaction between NLRP3 and ASC. Interestingly, we found that Tab directly bound to NLRP3 NACHT domain, thereby reducing the self-oligomerization of NLRP3. In addition, we showed that administration of Tab significantly ameliorated NLRP3-driven diseases, such as peritonitis, acute lung injury, and sepsis in mouse models. The preventive effects of Tab were not observed in the models of NLRP3 knockout mouse. In conclusion, we have identified Tab as a natural NLRP3 inhibitor and a lead compound for the design and discovery of novel NLRP3 inhibitors.
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Inflamasomas , Quinolinas , Animales , Ratones , Inflamasomas/metabolismo , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Macrófagos , Quinolinas/farmacología , Interleucina-1beta/metabolismo , Ratones Endogámicos C57BL , Lipopolisacáridos/farmacologíaRESUMEN
OBJECTIVE: The use of a flow diverter (FD) in the treatment of ruptured aneurysms is limited due to the increased risk of perioperative ischemia and hemorrhagic complications. Adjunctive coil embolization and an evidence-based antithrombotic regimen may improve therapeutic safety, although evidence from relevant clinical research is limited. The authors' aim was to further assess the perioperative safety and long-term efficacy of this strategy. METHODS: Data on patients with FD insertion and coil embolization were collected retrospectively at two centers. The perioperative antithrombotic regimen consists of intraoperative tirofiban and continues for 24 hours postoperatively, with the initiation of an orally administered dual-antiplatelet regimen 4 hours prior to tirofiban cessation, rather than purposeful preoperative antiplatelet therapy. Perioperative cerebral ischemia and hemorrhagic complications and long-term aneurysm occlusion rates were recorded to evaluate the safety and efficacy of the procedure, respectively. RESULTS: In total, 67 cases were screened and 41 cases were ultimately included in this study. A total of 2 cases (4.9%) of perioperative cerebral hemorrhagic events occurred, 1 of which (2.4%) was attributable to rerupture of the aneurysm. Cerebral ischemic events were reported in 3 patients, including 1 with cortical thromboembolism and 2 with perforator occlusion of the basilar artery. A median 8-month follow-up was attained in 25 patients (61.0%), with a 92% complete or near-complete occlusion rate. CONCLUSIONS: FD insertion combined with coil embolization is a potentially safe and effective therapeutic strategy for ruptured aneurysms when accompanied with perioperative evidence-based antithrombotic therapy.
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Aneurisma Roto , Embolización Terapéutica , Procedimientos Endovasculares , Aneurisma Intracraneal , Enfermedades Vasculares , Humanos , Tirofibán , Fibrinolíticos , Estudios Retrospectivos , Resultado del Tratamiento , Aneurisma Intracraneal/cirugía , Embolización Terapéutica/métodos , Aneurisma Roto/etiología , Enfermedades Vasculares/etiología , Stents/efectos adversos , Procedimientos Endovasculares/métodosRESUMEN
BACKGROUND: In patients undergoing mechanical thrombectomy (MT), adjunctive antithrombotic might improve angiographic reperfusion, reduce the risk of distal emboli and reocclusion but possibly expose patients to a higher intracranial hemorrhage risk. This study evaluated the safety and efficacy of combined MT plus eptifibatide for acute ischemic stroke. METHODS: This was a propensity-matched analysis of data from 2 prospective trials in Chinese populations: the ANGEL-ACT trial (Endovascular Treatment Key Technique and Emergency Workflow Improvement of Acute Ischemic Stroke) in 111 hospitals between November 2017 and March 2019, and the EPOCH trial (Eptifibatide in Endovascular Treatment of Acute Ischemic Stroke) in 15 hospitals between April 2019 and March 2020. The primary efficacy outcome was good outcome (modified Rankin Scale score 0-2) at 3 months. Secondary efficacy outcomes included the distribution of 3-month modified Rankin Scale scores and poor outcome (modified Rankin Scale score 5-6) and successful recanalization. The safety outcomes included any intracranial hemorrhage, symptomatic intracranial hemorrhage, and 3-month mortality. Mixed-effects logistic regression models were used to account for within-hospital clustering in adjusted analyses. RESULTS: Eighty-one combination arm EPOCH subjects were matched with 81 ANGEL-ACT noneptifibatide patients. Compared with the no eptifibatide group, the eptifibatide group had significantly higher rates of successful recanalization (91.3% versus 81.5%; P=0.043) and 3-month good outcomes (53.1% versus 33.3%; P=0.016). No significant difference was found in the remaining outcome measures between the 2 groups. All outcome measures of propensity score matching were consistent with mixed-effects logistic regression models in the total population. CONCLUSIONS: This matched-control study demonstrated that MT combined with eptifibatide did not raise major safety concerns and showed a trend of better efficacy outcomes compared with MT alone. Overall, eptifibatide shows potential as a periprocedural adjunctive antithrombotic therapy when combined with MT. Further randomized controlled trials of MT plus eptifibatide should be prioritized. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT03844594 (EPOCH), NCT03370939 (ANGEL-ACT).
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Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Isquemia Encefálica/tratamiento farmacológico , Isquemia Encefálica/cirugía , Eptifibatida , Humanos , Hemorragias Intracraneales/etiología , Estudios Prospectivos , Accidente Cerebrovascular/tratamiento farmacológico , Accidente Cerebrovascular/cirugía , Trombectomía/métodos , Resultado del TratamientoRESUMEN
BACKGROUND AND PURPOSE: Aneurysmal wall enhancement (AWE) on vessel wall magnetic resonance imaging (VW-MRI) has been described as a new imaging biomarker of unstable unruptured intracranial aneurysms (UIAs). Previous studies of symptomatic UIAs are limited due to small sample sizes and lack of AWE quantification. Our study aims to investigate whether qualitative and quantitative assessment of AWE can differentiate symptomatic and asymptomatic UIAs. METHODS: Consecutive patients with UIAs were prospectively recruited for vessel wall magnetic resonance imaging at 3T from October 2014 to October 2019. UIAs were categorized as symptomatic if presenting with sentinel headache or oculomotor nerve palsy directly related to the aneurysm. Evaluation of wall enhancement included enhancement pattern (0=none, 1=focal, and 2=circumferential) and quantitative wall enhancement index (WEI). Univariate and multivariate analyses were used to identify the parameters associated with symptoms. RESULTS: Two hundred sixty-seven patients with 341 UIAs (93 symptomatic and 248 asymptomatic) were included in this study. Symptomatic UIAs more frequently showed circumferential AWE than asymptomatic UIAs (66.7% versus 17.3%, P<0.001), as well as higher WEI (median [interquartile range], 1.3 [1.0-1.9] versus 0.3 [0.1-0.9], P<0.001). In multivariate analysis, both AWE pattern and WEI were independent factors associated with symptoms (odds ratio=2.03 across AWE patterns [95% CI, 1.21-3.39], P=0.01; odds ratio=3.32 for WEI [95% CI, 1.51-7.26], P=0.003). The combination of AWE pattern and WEI had an area under the curve of 0.91 to identify symptomatic UIAs, with a sensitivity of 95.7% and a specificity of 73.4%. CONCLUSIONS: In a large cohort of UIAs with vessel wall magnetic resonance imaging, both AWE pattern and WEI were independently associated with aneurysm-related symptoms. The qualitative and quantitative features of AWE can potentially be used to identify unstable intracranial aneurysms.
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Vasos Sanguíneos/diagnóstico por imagen , Aneurisma Intracraneal/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Adulto , Anciano , Aneurisma Roto/diagnóstico por imagen , Angiografía de Substracción Digital , Área Bajo la Curva , Angiografía Cerebral , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Aneurisma Intracraneal/terapia , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estudios Prospectivos , Sensibilidad y EspecificidadRESUMEN
We present EPIsembleVis, a web-based comparative visual analysis tool for evaluating the consistency of multiple COVID-19 prediction models. Our approach analyzes a collection of COVID-19 predictions from different epidemiological models as an ensemble and utilizes two metrics to quantify model performance. These metrics include (a) prediction uncertainty (represented as the dispersion of predictions in each ensemble) and (b) prediction error (calculated by comparing individual model predictions with the recorded data). Through an interactive visual interface, our approach provides a data-driven workflow for (a) selecting and constructing the COVID-19 model prediction ensemble based on the spatiotemporal overlap of available predictions of multiple epidemiological models, (b) quantifying the model performance using both the uncertainty of each model prediction ensemble, and the error of each ensemble member that represents individual model predictions, and (c) visualizing the spatiotemporal variability in the projection performance of individual models using a suite of novel ensemble visualization techniques, such as the data availability map, a spatiotemporal textured-tile calendar, multivariate rose chart, and time-series leaflet glyph. We demonstrate the capability of our ensemble visual interface through a case study that investigates the performance of weekly COVID-19 predictions, which are provided through the COVID-19 Forecast Hub UMass-Amherst Influenza Forecasting Center of Excellence [47] for the United States and United States Territories. The EPIsembleVis tool is implemented using open-source web technologies and adaptive system design, rendering it interoperable with Elasticsearch and Kibana for automatically ingesting COVID-19 predictions from online repositories, and it is generalizable for analyzing worldwide projections from more epidemiological models.
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COVID-19 , Modelos Epidemiológicos , Predicción , Humanos , SARS-CoV-2 , Incertidumbre , Estados UnidosRESUMEN
The THz atmospheric limb sounder (TALIS) is a microwave radiometer developed by the National Space Science Center of the Chinese Academy of Sciences for the detection of atmospheric trace gases. The observation range of the instrument mainly focuses on the middle and upper atmosphere (10-100 km above the earth's surface). The detection targets include the temperature, pressure, and more than 10 kinds of atmospheric components. Its scientific goal is to improve our comprehension of atmospheric chemical composition and dynamics, and to monitor environmental pollution and sources in the atmosphere. The TALIS instrument is composed of an antenna, superheterodyne radiometers, and digital fast Fourier transform (FFT) spectrometers. By measuring the atmospheric thermal radiance in the wide frequency band with 118, 190, 240, and 643 GHz as the center frequency, the required volume mixing ratio (VMR) of atmospheric chemical species can be obtained. This paper introduces the characteristics of the TALIS instrument, and establishes a simulation model for the TALIS spectrometer. Through a joint simulation with an atmosphere radiative transfer simulator (ARTS), the TALIS instrument performance is evaluated from the aspects of calibration, the imbalance of two sidebands, the spectrum resolution, and quantization. The simulation results show that the two-point calibration can well-restore the radiance spectrum of the scene target and remove the influence of the spectral response function (SRF); the double side band (DSB) receiver with a 2 MHz resolution can meet the sensitivity and spectrum resolution requirements. Finally, the sensitivity errors of different quantization bits are given by the simulation and the results show that at 8-bit, the sensitivity and its degradation ratio are 1.251 K and 1.036 at a 2 MHz spectrum resolution and 100 ms integration time, respectively.
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The paper presents a web-based application developed as a medium for executing a serious game to enhance multi-jurisdictional collaborative planning and decision making for mitigation of multiple hazards related to water (i.e., floods, soil erosions, water quality). The gaming application is integrated into the Iowa Watershed Decision Support System (IoWaDSS) designed to serve as a comprehensive multi-sectoral data repository along with the simulation results of process modeling to educate and inform communities on the status of their watersheds during extreme conditions. The interactive serious gaming application was devised to encourage public engagement, facilitate communication and positive relationship between watershed communities, and make the decision process more attractive and transparent for the stakeholders. The web environment offers easily-accessible, user-friendly interfaces that match the skills and knowledge level of a non-technical user. Developed with adaptive design and flexible architecture, the gaming application is generalizable and extendable to support hazard mitigation in other watersheds.
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Suelo , Calidad del Agua , Internet , Iowa , Conducta SocialRESUMEN
PURPOSE: Insufficient nidus occlusion is a matter of great concern to routine Onyx embolization of brain arteriovenous malformations (AVMs). This paper described an efficient method which using the diluted Onyx embolization technique to treat brain AVM. METHODS: The diluted Onyx technique was performed in a series of 15 patients with brain AVMs (10 males, 5 females; age range, 11-44 years). It consists of initial embolization with routine Onyx-18, followed by the diluted Onyx (1.5 mL of Onyx-18 diluted with 0.5 mL of DMSO) through the same microcatheter. The technical skills and angiographic and clinical outcomes were analyzed. RESULTS: A total of 15 embolization sessions were performed with diluted Onyx via 16 arterial feeders in these 15 patients. Each patient underwent one attempt of diluted Onyx through a single feeder except one patient. In this patient, the AVM was simultaneously embolized with diluted Onyx through double microcatheters which were placed in two feeders. When the length of reflux reached to 2 cm (or close to the determined length) and the embolic material could not move distally any more despite some rounds of "injection-reflux-waiting," regular Onyx 18 was changed to diluted Onyx. Antegrade flow of embolic material into the nidus was observed in 12 cases but failed in 3. An average of 90% (range 55-100%) estimated size reduction was achieved, and 6 AVMs were completely obliterated. No functionally relevant complications occurred. CONCLUSION: The diluted Onyx technique could be a useful adjunct to routine Onyx embolization which may offer more embolic material penetrating into the nidus of AVM, but additional work is needed to validate this technique.
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Angiografía por Tomografía Computarizada/métodos , Embolización Terapéutica/métodos , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Malformaciones Arteriovenosas Intracraneales/terapia , Polivinilos/uso terapéutico , Tantalio/uso terapéutico , Adolescente , Adulto , Angiografía de Substracción Digital , Angiografía Cerebral , Niño , Combinación de Medicamentos , Femenino , Humanos , Masculino , Polivinilos/administración & dosificación , Tantalio/administración & dosificación , Resultado del Tratamiento , ViscosidadRESUMEN
PURPOSE: This study aimed to evaluate prognostic parameters associated with favorable clinical prognosis and assess the feasibility and safety of three different treatment strategies in patients with acute intracranial vertebrobasilar artery occlusion (VBAO). METHODS: A total of 159 patients with acute VBAO at 3 stroke centers between September 2015 and October 2018 were retrospectively analyzed. Eighty-nine patients underwent mechanical thrombectomy (MT) alone, 43 underwent MT with additional rescue angioplasty, and 27 underwent primary balloon angioplasty (without or with stenting). In patients treated with primary or rescue balloon angioplasty (without or with stenting), a low-dose intra-arterial tirofiban injection was used. The reperfusion status was assessed after the procedure, and the functional outcome was assessed at 90-day follow-up. The baseline characteristics and 90-day prognosis of three different treatment subgroups were comparatively analyzed. RESULTS: Overall, successful reperfusion and a favorable outcome were achieved in 96.86% (154/159) and 46.54% (74/159) patients, respectively. The onset to puncture time (461.96 min vs 603.59 min, P = 0.000), procedure time (64.12 min vs 70.47 min, P = 0.007), and onset to reperfusion time (526.08 min vs 674.47 min, P = 0.000) were significantly shorter in patients with favorable outcomes than in those with poor outcomes. Among different endovascular treatment subgroups, no significant differences were found in successful reperfusion and 90-day outcome. Low-dose tirofiban did not increase the risk of symptomatic intracranial hemorrhage and the 90-day mortality in patients with acute VBAO. CONCLUSION: Individualized endovascular treatment strategy for selected patients with acute VBAO could achieve satisfactory reperfusion rate and favorable prognosis.
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Procedimientos Endovasculares , Insuficiencia Vertebrobasilar/terapia , Anciano , Angioplastia , Angiografía Cerebral , Femenino , Fibrinolíticos/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Stents , Trombectomía , Tirofibán/uso terapéutico , Insuficiencia Vertebrobasilar/diagnóstico por imagenRESUMEN
BACKGROUND: Dehydration is associated with a higher risk of poor outcome and venous thromboembolism in acute ischemic stroke patients. However, the relationship between dehydration and prognosis in patients with cerebral venous thrombosis (CVT) has not yet been investigated. METHODS: Consecutive CVT patients at the First Affiliated Hospital of Zhengzhou University were retrospectively identified from November 2011 through January 2017. Dehydration was evaluated by blood urea/creatinine (U/Cr) ratio > 80. Poor functional outcome was defined as modified Rankin Scale (mRS) of 3-6. Factors such as age, sex, coma, intracerebral hemorrhage, and straight sinus and/or deep CVT involved were adjusted to assess the relationship between dehydration, and prognosis at discharge and long-term follow-up in CVT patients. RESULTS: A total of 220 CVT patients were included, and 85 patients (38.64%) were dehydrated. Multivariate logistic regression analysis indicated that patients with dehydration had a higher risk of mRS of 3-6 at discharge (adjusted odds ratio [OR] 3.629, 95% confidence intervals [CI] 1.526-8.633, P = 0.004) and long-term outcome (adjusted OR 3.831, 95% CI 1.597-9.190, P = 0.003). Subgroup analysis stratified by potential factors that might be associated with dehydration, such as infection, vomiting, pregnancy, and/or postpartum, showed similar results. Multivariate Cox regression analysis further demonstrated that dehydration was associated with higher mortality (adjusted hazard ratio [HR] = 2.301, 95% CI 1.025-5.166, P = 0.043). CONCLUSIONS: The present findings indicate that dehydration is an independent predictor for short-term and long-term unfavorable functional outcome in patients with CVT.
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Deshidratación/complicaciones , Trombosis Intracraneal/diagnóstico , Evaluación de Resultado en la Atención de Salud , Trombosis de la Vena/diagnóstico , Adolescente , Adulto , Creatinina/sangre , Deshidratación/sangre , Femenino , Humanos , Trombosis Intracraneal/sangre , Trombosis Intracraneal/terapia , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Urea/sangre , Trombosis de la Vena/sangre , Trombosis de la Vena/terapia , Adulto JovenRESUMEN
PURPOSE: Periprocedural symptomatic intracranial hemorrhage (sICH) unrelated to coil embolization of intracranial aneurysm has been rarely reported. The incidence and characteristics of this complication remain unclear. This study was designed to elucidate the incidence and characteristics of periprocedural sICH unrelated to coiling of intracranial aneurysm, and to explore the possible mechanisms underlying this complication. METHODS: Included in this retrospective study were 1287 patients with 1394 aneurysms who were treated with coil embolization (476 patients with stent assistance and 811 patients without stents) between May 2008 and August 2017. All procedure-unrelated sICHs that occurred within 30 days after coiling were selected. The technical details of the procedure, clinical characteristics, and medical therapy were recorded. RESULTS: A total of 6 patients developed periprocedural sICH unrelated to coil embolization. All these six patients underwent stent-assisted coiling (SAC). Therefore, there was a 1.3% (6/476) procedure-unrelated sICH rate of SAC and 0% (0/811) in patients underwent coiling without stent during the periprocedural period (P = 0.005, RR 0.987; 95% CI, 0.977-0.997). These phenomena occurred more often in patients who received SAC for ruptured aneurysms vs patients underwent this technique for unruptured aneurysms (2.0 vs 0.7%, P = 0.390, RR 2.896; 95% CI, 0.525-15.968). All these phenomena occurred within 7 days after coiling, and resulted in one mortality, one unfavorable outcome (mRS Score 3), and other four favorable outcomes (mRS Scores 0-2) at 90 days after procedure. CONCLUSION: Our findings suggest that the procedure-unrelated sICH, though less frequent, may exist following stent-assisted coiling of intracranial aneurysm during the periprocedural period. Extra caution may be warranted in patients who were treated with SAC for ruptured aneurysms.
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Embolización Terapéutica/métodos , Aneurisma Intracraneal/terapia , Hemorragias Intracraneales/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , StentsRESUMEN
BACKGROUND AND PURPOSE: Symptomatic intracranial hemorrhage (SICH) pose a major safety concern for endovascular treatment of acute ischemic stroke. This study aimed to evaluate the risk and related factors of SICH after endovascular treatment in a real-world practice. METHODS: Patients with stroke treated with stent-like retrievers for recanalizing a blocked artery in anterior circulation were enrolled from 21 stroke centers in China. Intracranial hemorrhage was classified as symptomatic and asymptomatic ones according to Heidelberg Bleeding Classification. Logistic regression was used to identify predictors for SICH. RESULTS: Of the 632 enrolled patients, 101 (16.0%) were diagnosed with SICH within 72 hours after endovascular treatment. Ninety-day mortality was higher in patients with SICH than in patients without SICH (65.3% versus 18.8%; P<0.001). On multivariate analysis, baseline neutrophil ratio >0.83 (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.24-3.46), pretreatment Alberta Stroke Program Early Computed Tomography Score of <6 (OR, 2.27; 95% CI, 1.24-4.14), stroke of cardioembolism type (OR, 1.91; 95% CI, 1.13-3.25), poor collateral circulation (OR, 1.97; 95% CI, 1.16-3.36), delay from symptoms onset to groin puncture >270 minutes (OR, 1.70; 95% CI, 1.03-2.80), >3 passes with retriever (OR, 2.55; 95% CI, 1.40-4.65) were associated with SICH after endovascular treatment. CONCLUSIONS: Incidence of SICH after thrombectomy is higher in Asian patients with acute ischemic stroke. Cardioembolic stroke, poor collateral circulation, delayed endovascular treatment, multiple passes with stent retriever device, lower pretreatment Alberta Stroke Program Early Computed Tomography Score, higher baseline neutrophil ratio may increase the risk of SICH.
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Isquemia Encefálica/terapia , Hemorragias Intracraneales/etiología , Sistema de Registros , Stents , Accidente Cerebrovascular/terapia , Trombectomía/efectos adversos , Anciano , Anciano de 80 o más Años , Arteriopatías Oclusivas/complicaciones , Arteriopatías Oclusivas/epidemiología , Isquemia Encefálica/epidemiología , Isquemia Encefálica/etiología , Enfermedades Arteriales Cerebrales/complicaciones , Enfermedades Arteriales Cerebrales/epidemiología , China/epidemiología , Femenino , Humanos , Hemorragias Intracraneales/diagnóstico , Hemorragias Intracraneales/epidemiología , Masculino , Persona de Mediana Edad , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/etiología , Trombectomía/estadística & datos numéricosRESUMEN
BACKGROUNDS AND PURPOSE: This study was aimed at investigating the outcomes and predictors for the poor functional outcome after endovascular treatment (EVT) in a large, mostly Asian population. METHODS: Between January 2014 and June 2016, acute stroke patients with anterior circulation occlusion and EVT were retrospectively enrolled from 21 stroke centers in China. The main outcomes were modified Rankin Scale (0-2 as functional independence, 3-6 as poor) at 90 days, symptomatic intracranial hemorrhage (sICH) at 72 h, and death at 90 days. Logistic regression was used to identify predictors for poor functional outcome at 90 days. RESULTS: Of the 698 patients, 304 (43.6%) patients had functional independence at 90 days. The sICH rate was 15.5% (108/698) and mortality rate at 90 days was 25.4% (177/698). Age (OR 1.04, 95% CI 1.02-1.07), National Institutes of Health Stroke Scale score at admission (11-20 vs. ≤10, OR 2.38, 95% CI 1.23-4.59; ≥21 vs. ≤10, OR 3.66, 95% CI 1.72-7.80), baseline glucose level (OR 1.09, 95% CI 1.01-1.18), onset to groin puncture >6 h (OR 1.88, 95% CI 1.06-3.31), sICH (OR 15.49, 95% CI 5.16-46.43), and pneumonia (OR 3.15, 95% CI 1.86-5.32) were independent predictors of poor functional outcomes, while good recanalization (OR 0.26, 95% CI 0.13-0.54), preoperative Alberta Stroke Program Early CT Score 8-10 (OR 0.48, 95% CI 0.28-0.83), and good collateral flow (OR 0.50, 95% CI 0.32-0.79) were protective factors. CONCLUSIONS: This study provides evidence in real world to support the performance of EVT in acute anterior circulation stroke patients in Chinese population. Patients with small infarct core, successful recanalization, good collateral status, and short treatment delay without sICH or pneumonia may benefit from EVT.
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Infarto Encefálico/terapia , Procedimientos Endovasculares , Trombectomía , Terapia Trombolítica , Anciano , Infarto Encefálico/diagnóstico por imagen , Infarto Encefálico/mortalidad , Infarto Encefálico/fisiopatología , China , Evaluación de la Discapacidad , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/mortalidad , Femenino , Humanos , Hemorragias Intracraneales/inducido químicamente , Masculino , Persona de Mediana Edad , Recuperación de la Función , Sistema de Registros , Estudios Retrospectivos , Factores de Riesgo , Trombectomía/efectos adversos , Trombectomía/mortalidad , Terapia Trombolítica/efectos adversos , Terapia Trombolítica/mortalidad , Factores de Tiempo , Resultado del TratamientoRESUMEN
This publication presents an annotated accident dataset which fuses traffic data from radar detection sensors, weather condition data, and light condition data with traffic accident data (as illustrated in Fig. 1) in a format that is easy to process using machine learning tools, databases, or data workflows. The purpose of this data is to analyze, predict, and detect traffic patterns when accidents occur. Each file contains a timeseries of traffic speeds, flows, and occupancies at the sensor nearest to the accident, as well as 5 neighboring sensors upstream and downstream. It also contains information about the accident type, date, and time. In addition to the accident data, we provide baseline data for typical traffic patterns during a given time of day. Overall, the dataset contains 6 months of annotated traffic data from November 2020 to April 2021. During this timeframe, and 361 accidents occurred in the monitored area around Chattanooga, Tennessee. This dataset served as the basis for a study on topology-aware automated accident detection for a companion publication [1].
RESUMEN
The surge in face mask use due to COVID-19 has raised concerns about micro(nano)plastics (MNPs) from masks. Herein, focusing on fabric structure and polymer composition, we investigated MNP generation characteristics, mechanisms, and potential risks of surgical polypropylene (PP) and fashionable polyurethane (PU) masks during their wearing and photoaging based on stereomicroscope, µ-Fourier transform infrared spectroscopy (µ-FTIR), and scanning electron microscope (SEM) techniques. Compared with new PP and PU masks (66 ± 16 MPs/PP-mask, 163 ± 83 MPs/PU-mask), single- and multiple-used masks exhibited remarkably increased MP type and abundance (600-1867 MPs/PP-mask, 607-2167 MPs/PU-mask). Disinfection exacerbated endogenous MP generation in masks, with washing (416 MPs/PP-mask, 30,708 MPs/PU-mask) being the most prominent compared to autoclaving (219 MPs/PP-mask, 553 MPs/PU-mask) and alcohol spray (162 MPs/PP-mask, 18,333 MPs/PU-mask). Photoaging led to massive generation of MPs (8.8 × 104-3.7 × 105 MPs/PP-layer, 1.0 × 105 MPs/PU-layer) and NPs (5.2 × 109-3.6 × 1013 NPs/PP-layer, 3.5 × 1012 NPs/PU-layer) from masks, presenting highly fabric structure-dependent aging modes as "fragmentation" for fine fiber-structure PP mask and "erosion" for 3D mesh-structure PU mask. The MNPs derived from PP/PU mask caused significant deformities of Zebrafish (Danio rerio) larvae. These findings underscore the potential adverse effects of masks on humans and aquatic organisms, advocating to enhance proper use and rational disposal for masks.
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COVID-19 , Máscaras , Polipropilenos , Poliuretanos , Textiles , Polipropilenos/química , COVID-19/prevención & control , Poliuretanos/química , Humanos , Textiles/análisis , Animales , SARS-CoV-2 , Polímeros/química , Microplásticos/toxicidad , Pez Cebra , Contaminación de Equipos/prevención & controlRESUMEN
Multiple gene abnormalities are major drivers of tumorigenesis. NF-κB p65 overactivation and cGAS silencing are important triggers and genetic defects that accelerate tumorigenesis. However, the simultaneous correction of NF-κB p65 and cGAS abnormalities remains to be further explored. Here, we propose a novel Induced Dual-Target Rebalance (IDTR) strategy for simultaneously correcting defects in cGAS and NF-κB p65. By using our IDTR approach, we showed for the first time that oncolytic adenovirus H101 could reactivate silenced cGAS, while silencing GAU1 long noncoding RNA (lncRNA) inhibited NF-κB p65 overactivation, resulting in efficient in vitro and in vivo antitumor efficacy in colorectal tumors. Intriguingly, we further demonstrated that oncolytic adenoviruses reactivated cGAS by promoting H3K4 trimethylation of the cGAS promoter. In addition, silencing GAU1 using antisense oligonucleotides significantly reduced H3K27 acetylation at the NF-κB p65 promoter and inhibited NF-κB p65 transcription. Our study revealed an aberrant therapeutic mechanism underlying two tumor defects, cGAS and NF-κB p65, and provided an alternative IDTR approach based on oncolytic adenovirus and antisense oligonucleotides for efficient therapeutic efficacy in tumors.