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1.
World Neurosurg ; 2024 Sep 18.
Article in English | MEDLINE | ID: mdl-39303975

ABSTRACT

OBJECTIVE: The aim of this study is to evaluate the efficacy of cerebral revascularization for Moyamoya disease (MMD) with extra-cranial internal carotid artery occlusion (ICAO). METHODS: This study retrospectively analyzed 37 patients diagnosed with MMD with extra-cranial ICAO who underwent cerebral revascularization surgery. We conducted propensity score matching for MMD patients without extra-cranial ICAO from database of 932 MMD patients. Outcome data, recurrent strokes and modified Rankin Scale (mRS) were collected during follow-up. RESULTS: A total of 37 MMD patients with extra-cranial ICAO were included in the study. The average follow-up time of MMD patients with extra-cranial ICAO included in the study was 74 months. During the follow-up period, there were 15 hemispheres recurred stroke events. All hemispheres underwent surgery, and the follow-up mRS score was significantly reduced (P <0.001). Kaplan-Meier analysis showed no significant statistical difference in stroke events between the indirect bypass (IB), direct bypass (DB), and combined bypass (CB) groups (P = 0.131). After propensity matching, 48 hemispheres of MMD patients without extra-cranial ICAO were identified from a review of 932 MMD patients. There was no significant statistical difference in stroke events between the MMD patients with extra-cranial ICAO group and the MMD group (P = 0.271). CONCLUSIONS: Cerebral revascularization can prevent recurrent ischemic and hemorrhagic stroke events for MMD patients with extra-cranial ICAO. There was no difference on long-term clinical outcomes after CB, DB, and IB surgery. The cerebral revascularization has similar effect on the MMD patients with extra-cranial ICAO and MMD patients without.

2.
Transl Stroke Res ; 2024 Sep 09.
Article in English | MEDLINE | ID: mdl-39245689

ABSTRACT

The glymphatic system is crucial for clearing metabolic waste from the brain, maintaining neural health and cognitive function. This study explores the glymphatic system's role in Moyamoya disease (MMD), characterized by progressive cerebral artery stenosis and brain structural lesions. We assessed 33 MMD patients and 21 healthy controls using diffusion tensor imaging along the perivascular space (DTI-ALPS) and global cortical gray matter-cerebrospinal fluid (CSF) coupling indices (gBOLD-CSF), which are indirect measurements of the glymphatic system. Cerebral perfusion in patients was evaluated via computed tomography perfusion imaging. We also measured the peak width of skeletonized mean diffusivity (PSMD), white matter hyperintensity (WMH) burden, and cognitive function. MMD patients exhibited lower ALPS and gBOLD-CSF coupling indices compared to controls (P < 0.01), indicating disrupted glymphatic function. Significant cognitive impairment was also observed in MMD patients (P < 0.01). ALPS indices varied with cerebral perfusion stages, being higher in earlier ischemic stages (P < 0.05). Analysis of brain structure showed increased CSF volume, PSMD index, and higher WMH burden in MMD patients (P < 0.01). The ALPS index positively correlated with white matter volume and cognitive scores, and negatively correlated with CSF volume, PSMD, and WMH burden (P < 0.05). Mediation analysis revealed the number of periventricular WMH significantly mediated the relationship between glymphatic dysfunction and cognitive impairment. In summary, MMD patients exhibit significant glymphatic system impairments, associated with brain structural changes and cognitive deficits.

3.
Materials (Basel) ; 17(17)2024 Aug 23.
Article in English | MEDLINE | ID: mdl-39274560

ABSTRACT

With the rapid development of the construction industry worldwide, a large amount of waste concrete is generated each year, which has caused serious environmental problems. As a green and sustainable building material, thermally activated recycled cement (RC) has received widespread attention. However, the unique properties of RC, such as the high water demand and short setting time, necessitate the use of specialized superplasticizers that are different from those used in ordinary Portland cement. As an important component for the application of RC, superplasticizer has an important impact on the performance modification of RC. This article summarizes the recent research progress of potential superplasticizers for RC, with a view to providing a reference for the research and application of superplasticizers for RC. Based on the differences between ordinary Portland cement and RC, the paper discusses potential superplasticizers that may be suitable for RC, and points out that future development of potential modified superplasticizers can include altering the molecular structure to improve adsorption onto the surfaces of RC or to enhance the durability of concrete with RC.

4.
Light Sci Appl ; 13(1): 200, 2024 Aug 21.
Article in English | MEDLINE | ID: mdl-39168972

ABSTRACT

Non-invasive characterization of powders may take one of two approaches: imaging and counting individual particles; or relying on scattered light to estimate the particle size distribution (PSD) of the ensemble. The former approach runs into practical difficulties, as the system must conform to the working distance and other restrictions of the imaging optics. The latter approach requires an inverse map from the speckle autocorrelation to the particle sizes. The principle relies on the pupil function determining the basic sidelobe shape, whereas the particle size spread modulates the sidelobe intensity. We recently showed that it is feasible to invert the speckle autocorrelation and obtain the PSD using a neural network, trained efficiently through a physics-informed semi-generative approach. In this work, we eliminate one of the most time-consuming steps of our previous method by engineering the pupil function. By judiciously blocking portions of the pupil, we sacrifice some photons but in return we achieve much enhanced sidelobes and, hence, higher sensitivity to the change of the size distribution. The result is a 60 × reduction in total acquisition and processing time, or 0.25 seconds per frame in our implementation. Almost real-time operation in our system is not only more appealing toward rapid industrial adoption, it also paves the way for quantitative characterization of complex spatial or temporal dynamics in drying, blending, and other chemical and pharmaceutical manufacturing processes.

5.
Plants (Basel) ; 13(16)2024 Aug 13.
Article in English | MEDLINE | ID: mdl-39204677

ABSTRACT

Strawberries are mainly propagated by stolons, which can be divided into monopodial and sympodial types. Monopodial stolons consistently produce ramets at each node following the initial single dormant bud, whereas sympodial stolons develop a dormant bud before each ramet. Sympodial stolon encompasses both dormant buds and ramet buds, making it suitable for studying the formation mechanism of different stolon types. In this study, we utilized sympodial stolons from Fragaria nilgerrensis as materials and explored the mechanisms underlying sympodial stolon development through transcriptomic and phytohormonal analyses. The transcriptome results unveiled that auxin, cytokinin, and sugars likely act as main regulators. Endogenous hormone analysis revealed that the inactivation of auxin could influence bud dormancy. Exogenous cytokinin application primarily induced dormant buds to develop into secondary stolons, with the proportion of ramet formation being very low, less than 10%. Furthermore, weighted gene co-expression network analysis identified key genes involved in ramet formation, including auxin transport and response genes, the cytokinin activation gene LOG1, and glucose transport genes SWEET1 and SFP2. Consistently, in vitro cultivation experiments confirmed that glucose enhances the transition of dormant buds into ramets within two days. Collectively, cytokinin and glucose act as dormant breakers, with cytokinin mainly driving secondary stolon formation and glucose promoting ramet generation. This study improved our understanding of stolon patterning and bud development in the sympodial stolon of strawberries.

6.
Neurotoxicology ; 103: 310-319, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39004286

ABSTRACT

Isoflurane is one of the most commonly used anaesthetic agents in surgery procedures. During the past decades, isoflurane has been found to cause impairment in neurological capabilities in new-borns and elderly patients. Luteolin is a flavonoid that has been documented to possess a neuroprotective effect. Here we investigated the putative neuroprotective effects of luteolin on isoflurane-induced neurotoxicity in mouse hippocampal neuronal HT22 cells and explored the potential mechanisms. We demonstrated that luteolin improved mitochondrial dysfunction and reduced oxidative stress and apoptosis in isoflurane-treated HT22 cells, and thus inhibiting the isoflurane-induced neuronal injury. Further investigations showed that isoflurane exposure caused miR-214 downregulation, which could be mitigated by treatment with luteolin. Knockdown of miR-214 attenuated the neuroprotection of luteolin on isoflurane-induced neuronal injury. More importantly, luteolin inhibited isoflurane-caused regulation of the PTEN/Akt pathway, while miR-214 knockdown altered the regulatory effect of luteolin on the PTEN/Akt pathway. Furthermore, the effects of miR-214 knockdown on the neuroprotection of luteolin could also be prevented by knockdown of PTEN, implying that the neuroprotective effect of luteolin was mediated by miR-214/PTEN/Akt signaling pathway. These findings provided evidence for the potential application of luteolin in preventing isoflurane-induced neurotoxicity.


Subject(s)
Hippocampus , Isoflurane , Luteolin , MicroRNAs , Neurons , Neuroprotective Agents , PTEN Phosphohydrolase , Proto-Oncogene Proteins c-akt , Signal Transduction , Animals , Isoflurane/toxicity , Isoflurane/pharmacology , PTEN Phosphohydrolase/metabolism , Luteolin/pharmacology , Mice , Proto-Oncogene Proteins c-akt/metabolism , Hippocampus/drug effects , Hippocampus/metabolism , Neurons/drug effects , Neurons/metabolism , MicroRNAs/metabolism , Neuroprotective Agents/pharmacology , Signal Transduction/drug effects , Cell Line , Oxidative Stress/drug effects , Apoptosis/drug effects
7.
ACS Appl Mater Interfaces ; 16(22): 28570-28577, 2024 Jun 05.
Article in English | MEDLINE | ID: mdl-38769608

ABSTRACT

Despite being heralded as the "holy grail" of anodes for their high theoretical specific capacity, lithium (Li) metal anodes still face practical challenges due to difficulties in fabricating ultrathin Li with controllable thickness and suppressing Li dendrites growth. Herein, we introduce a simple and cost-effective dip-coating method to fabricate ultrathin lithium-tin (LiSn) anode with adjustable thicknesses ranging from 4.5 to 45 µm. The in situ formation of Li22Sn5 alloy improves the wettability of the molten Li, enabling the casting of ultrathin Li metal layers on different substrates. More importantly, the abundant Li22Sn5 lithiophilic sites significantly lower the nucleation overpotential, inducing uniform Li deposition and accelerating the electrochemical reaction at the interface. As a result, the symmetric cell assembled with LiSn-Cu electrodes can cycle stably for more than 120 h with a charge/discharge depth of 50%, which is 1.5 times longer than the lifespan of the pure Li anode. In the full cells paired with NCM cathode, the discharge specific capacity is improved from 13.84 to 70.31 mA h g-1 with the LiSn-Cu anode at 8 C. The LiSn-Cu||NCM full cell realized a high energy density of 724.9 Wh kg-1 at the active material level with an N/P ratio of 1.4.

8.
Rev Sci Instrum ; 95(4)2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38564326

ABSTRACT

Optical thin films with high-reflectivity (HR) are essential for applications in quantum precision measurements. In this work, we propose a coating technique based on reactive magnetron sputtering with RF-induced substrate bias to fabricate HR-optical thin films. First, atomically flat SiO2 and Ta2O5 layers have been demonstrated due to the assistance of radio-frequency plasma during the coating process. Second, a distributed Bragg reflector (DBR) mirror with an HR of ∼99.999 328% centered at 1397 nm has been realized. The DBR structure is air-H{LH}19-substrate, in which the L and H denote a single layer of SiO2 with a thickness of 237.8 nm and a single layer of Ta2O5 with a thickness of 171.6 nm, respectively. This novel coating method would facilitate the development of HR reflectors and promote their wide applications in precision measurements.

9.
Behav Brain Res ; 465: 114964, 2024 05 08.
Article in English | MEDLINE | ID: mdl-38522596

ABSTRACT

Histamine, an auto-reactive substance and mediator of inflammation, is synthesized from histidine through the action of histidine decarboxylase (HDC). It primarily acts on histamine receptors in the central nervous system (CNS). Increasing evidence suggests that histamine and its receptors play a crucial role in neuroinflammation, thereby modulating the pathology of neurodegenerative diseases. Recent studies have demonstrated that histamine regulates the phenotypic switching of microglia and astrocytes, inhibits the production of pro-inflammatory cytokines, and alleviates inflammatory responses. In the CNS, our research group has also found that histamine and its receptors are involved in regulating inflammatory responses and play a central role in ameliorating chronic neuroinflammation in neurodegenerative diseases. In this review, we will discuss the role of histamine and its receptors in neuroinflammation associated with neurodegenerative diseases, potentially providing a novel therapeutic target for the treatment of chronic neuroinflammation-related neurodegenerative diseases in clinical settings.


Subject(s)
Neurodegenerative Diseases , Humans , Neurodegenerative Diseases/drug therapy , Histamine , Neuroinflammatory Diseases , Central Nervous System , Inflammation/drug therapy , Inflammation/pathology , Microglia/pathology
10.
Turk Neurosurg ; 34(2): 289-298, 2024.
Article in English | MEDLINE | ID: mdl-38497182

ABSTRACT

AIM: To evaluate and compare postoperative ischemic complications to determine the risk factors for ischemic complications following revascularization surgery for Moyamoya disease (MMD). MATERIAL AND METHODS: This single-center retrospective study included 266 procedures between 2016 and 2021. Three types of revascularization approaches including direct bypass, indirect bypass, and combined bypass were performed. To identify risk factors for postoperative ischemic complications and contralateral cerebral infarction, preoperative clinical characteristics and radiographic features were examined using multivariate and ordinal logistic regression analyses. RESULTS: Postoperative ischemic complications occurred in 103 (6.6%) procedures. Ischemic presentation (p=0.001, odds ratios [OR] 5.59, 95% confidence interval [CI] 2.05-15.23), hypertension (p=0.030, OR 2.75, 95%CI 1.11- 6.83), advanced Suzuki stage (p=0.006, OR 3.19, 95%CI 1.40-7.26), and collateral circulation (p=0.001 OR 0.17, 95%CI 0.06-0.47) were risk factors for postoperative ischemic complications. Ordinal regression analysis revealed that unilateral involvement (p=0.043, OR 2.70, 95%CI 0.09-5.31), hemorrhagic presentation (p=0.013, OR 3.45, 95%CI 0.72-6.18), surgical approach (p=0.032, OR -1.38, 95%CI -2.65, -0.12), and collateral circulation [p=0.043, OR -1 .27, 95%CI -2.51, -0.04)] were associated with the type of ischemic complications. History of hypertension (p=0.031) and contralateral computed tomography (CT) perfusion stage (p=0.045) were associated with contralateral infarction. CONCLUSION: Inability of cerebral vessels to withstand changes in blood pressure induced by revascularization-related hemodynamic instability might be associated with postoperative complications in patients with Moyamoya disease.


Subject(s)
Cerebral Revascularization , Hypertension , Moyamoya Disease , Humans , Moyamoya Disease/complications , Moyamoya Disease/diagnostic imaging , Moyamoya Disease/surgery , Retrospective Studies , Risk Factors , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Cerebral Revascularization/adverse effects , Cerebral Revascularization/methods , Hypertension/epidemiology , Hypertension/complications , Treatment Outcome
11.
J Environ Manage ; 357: 120748, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38552508

ABSTRACT

Catalytic pyrolysis technology proves to be a highly effective approach for waste cooking oil management. However, high-pressure drops and easy deactivation of powder catalysts hinder the industrialization of this technology. In this study, a bifunctional SiC ball (ZSM-5/SiC ball structured) catalyst was prepared to produce monocyclic aromatics. Bifunctional SiC ball catalyst demonstrates notable microwave-responsive properties and remarkable catalytic efficacy. Results showed that the content of monocyclic aromatics under BFSB catalysis with microwave heating was the highest. Weight hourly space velocity is no longer one of the main factors affecting microwave-assisted catalytic pyrolysis under bifunctional SiC ball catalyst. Monocyclic aromatics content did not decrease significantly and was still higher than 86% when space velocity increased from 30 h-1 to 360 h-1. The highest space velocity could only be 180 h-1 under Powder ZSM-5, and the content of the monocyclic aromatics dropped rapidly to 67.68%. Furthermore, even after five operating cycles, the content of monocyclic aromatics with bifunctional SiC ball catalyst continues to surpass the initial content observed with Powder ZSM-5 at 500 °C and 180 h-1. Related characterizations revealed that coking is the primary cause of catalyst deactivation for both catalyst types; however, the bifunctional SiC ball catalyst exhibits a 29.1% lower occurrence of polyaromatic coke formation compared to Powder ZSM-5.


Subject(s)
Microwaves , Pyrolysis , Powders , Biomass , Catalysis , Hot Temperature , Biofuels
12.
J Environ Manage ; 357: 120713, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38552520

ABSTRACT

With the continuous advancement of urban renewal, the application of recycled aggregates (RA) is a win-win measure to solve the treatment of construction waste and provide the required building materials. However, the existence of a large amount of old adhesive mortar (OAM) makes it difficult for RA to equivalently replace natural aggregates (NA) due to their higher water absorption and crushing index, as well as a lower apparent density. From the published literature on enhancing RA, the most mature and easiest method for construction is physical enhancement technology. Therefore, through a review of recent related researches, this article summarizes and compares the modification effects of mechanical grinding technology, traditional heating and grinding technology, and microwave heating technology on the physical properties of RA, including water absorption, apparent density, and crushing value. The related modification mechanisms were discussed. Additionally, the impacts of different physical enhancement technologies on the environment and economy effects are assessed from the perspectives of carbon emissions and cost required during processing. Based on multi-criteria analysis, microwave heating technology is more efficient and cleaner, which is the most recommended in the future.


Subject(s)
Industrial Waste , Recycling , Industrial Waste/analysis , Recycling/methods , Construction Materials , Water , Physical Functional Performance
13.
Environ Sci Pollut Res Int ; 31(12): 18949-18961, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38355856

ABSTRACT

With the implementation of garbage classification, perishable waste has become increasingly concentrated. This has led to a significant change in the VOC release characteristics at residential garbage collection points, posing a potential risk with unknown characteristics. This study investigated the release characteristics, odor pollution, and health risks of VOCs at garbage collection points under different classification effectiveness, seasons, garbage drop-off periods, and garbage collection point types. The results showed that the average concentration of VOCs released from the garbage sorting collection points (SPs) was 341.43 ± 261.16 µg/m3, and oxygenated compounds (e.g., ethyl acetate and acetone) were the main VOC components. The VOC concentration increased as the community classification effectiveness improved, and it was higher in summer (followed by spring, autumn, and winter). Moreover, the VOC concentrations were higher in the evenings than in the mornings and at centralized garbage collection points (CPs) than at SPs. Further, odor activity value (OAV) assessments indicated that acrolein, styrene, and ethyl acetate were the critical odorous components, with an average OAV of 0.87 ± 0.85, implying marginal odor pollution in some communities. Health risk assessments further revealed that trichloroethylene, benzene, and chlorotoluene were the critical health risk substances, with an average carcinogenic risk (CR) value of 10-6-10-4, and a non-carcinogenic risk (HI) value < 1. These results indicated that HIs were acceptable, but potential CRs existed in the communities. Therefore, VOC pollution prevention and control measures should be urgently strengthened at the garbage collection points in high pollution risk scenarios.


Subject(s)
Acetates , Air Pollutants , Volatile Organic Compounds , Environmental Monitoring/methods , Air Pollutants/analysis , Volatile Organic Compounds/analysis , China
14.
Clin Nutr ; 43(3): 787-795, 2024 03.
Article in English | MEDLINE | ID: mdl-38340411

ABSTRACT

BACKGROUND AND OBJECTIVE: Lysine and its pathway metabolites have been identified as novel biomarkers for metabolic and vascular diseases. The role of them in the identification of moyamoya disease (MMD) has not been elucidated. This study aimed to determine the association between lysine pathway metabolites and the presence of MMD. METHODS: We prospectively enrolled 360 MMD patients and 89 healthy controls from September 2020 to December 2021 in Beijing Tiantan Hospital. Serum levels of lysine, pipecolic acid and 2-aminoadipic acid were measured by liquid chromatography-mass spectrometry. We employed logistic regression and restricted cubic spline to explore the association between these metabolites and the presence of MMD. Stratified analyses were also conducted to test the robustness of results. RESULTS: We observed that lysine levels in MMD patients were significantly higher and pipecolic acid levels were significantly lower compared to HCs (both p < 0.001), while no difference was found in the level of 2-AAA between both groups. When comparing metabolites by quartiles, elevated lysine levels were linked to increased odds for MMD (the fourth quartile [Q4] vs the first quartile [Q1]: odds ratio, 3.48, 95%CI [1.39-8.75]), while reduced pipecolic acid levels correlated with higher odds (Q4 vs Q1: odds ratio, 0.08; 95 % CI [0.03-0.20]). The restricted cubic spline found a L-shaped relationship between pipecolic acid level and the presence of MMD, with a cutoff point at 2.52 µmol/L. Robust results were also observed across subgroups. CONCLUSION: Elevated lysine levels were correlated with increased odds of MMD presence, while lower pipecolic acid levels were associated with higher odds of the condition. These results suggest potential new biomarkers for the identification of MMD. CLINICAL TRIAL REGISTRY NUMBER: URL: https://www.chictr.org.cn/. Unique identifier: ChiCTR2200061889.


Subject(s)
Moyamoya Disease , Humans , 2-Aminoadipic Acid , Biomarkers , Lysine , Cross-Sectional Studies , Case-Control Studies
15.
Phys Med Biol ; 69(2)2024 Jan 10.
Article in English | MEDLINE | ID: mdl-38086076

ABSTRACT

Objective. Convolutional neural networks (CNNs) have made significant progress in medical image segmentation tasks. However, for complex segmentation tasks, CNNs lack the ability to establish long-distance relationships, resulting in poor segmentation performance. The characteristics of intra-class diversity and inter-class similarity in images increase the difficulty of segmentation. Additionally, some focus areas exhibit a scattered distribution, making segmentation even more challenging.Approach. Therefore, this work proposed a new Transformer model, FTransConv, to address the issues of inter-class similarity, intra-class diversity, and scattered distribution in medical image segmentation tasks. To achieve this, three Transformer-CNN modules were designed to extract global and local information, and a full-scale squeeze-excitation module was proposed in the decoder using the idea of full-scale connections.Main results. Without any pre-training, this work verified the effectiveness of FTransConv on three public COVID-19 CT datasets and MoNuSeg. Experiments have shown that FTransConv, which has only 26.98M parameters, outperformed other state-of-the-art models, such as Swin-Unet, TransAttUnet, UCTransNet, LeViT-UNet, TransUNet, UTNet, and SAUNet++. This model achieved the best segmentation performance with a DSC of 83.22% in COVID-19 datasets and 79.47% in MoNuSeg.Significance. This work demonstrated that our method provides a promising solution for regions with high inter-class similarity, intra-class diversity and scatter distribution in image segmentation.


Subject(s)
COVID-19 , Humans , COVID-19/diagnostic imaging , Neural Networks, Computer , Image Processing, Computer-Assisted
16.
J Neurosurg ; 140(3): 764-773, 2024 Mar 01.
Article in English | MEDLINE | ID: mdl-37877987

ABSTRACT

OBJECTIVE: The optimal surgical approach for hemorrhagic moyamoya disease (hMMD) continues to be a topic of debate. The authors' prior research demonstrated that both combined and indirect revascularization were efficacious. However, questions remain regarding the long-term prognosis consistency between these two treatments. Therefore, the objective of this study was to evaluate and compare the enduring effects of these surgical modalities on adult hMMD, extending the findings of the authors' previous studies. METHODS: The authors recruited patients diagnosed with hMMD between 2010 and 2015. The patients were categorized into two groups: those who underwent combined revascularization (superficial temporal artery-middle cerebral artery bypass alongside dural reverse application) and those who underwent indirect revascularization (encephaloduroarteriosynangiosis [EDAS]). The primary and secondary endpoints of this study were instances of rebleeding, confirmed with CT scan, and death resulting from rebleeding, respectively. The authors estimated rebleeding-free and death-free survival rates by utilizing the Kaplan-Meier survival method. They used Cox regression to adjust for confounders and to evaluate the effects of the varying surgical modalities on the endpoints. RESULTS: After an average follow-up period of 114 months, 35 patients (28.6%) experienced 40 rebleeding events, yielding an average annual incidence of 3.5%. Of the 79 patients who received combined revascularization, 17 (21.5%) experienced rebleeding events. Similarly, of 43 patients who underwent EDAS, 18 (41.9%) experienced rebleeding events (p = 0.018). Most rebleeding instances occurred 61-120 months after surgery (21 patients [60%]), followed by 12-60 months (11 patients [31.4%]). Multivariate survival analysis highlighted significant differences in surgical outcomes (HR 0.33, 95% CI 0.15-0.74, p = 0.007). The authors observed that 8 patients (10.1%) died of rebleeding events in the combined group, as well as 10 patients (23.3%) in the EDAS group. Despite the lack of a statistically significant difference in mortality (p = 0.051), multivariable survival analysis found a significant difference (HR 0.31, 95% CI 0.10-0.97, p = 0.044). CONCLUSIONS: High rebleeding rates persist in adult hMMD patients, even after revascularization. Combined revascularization proved superior to EDAS in preventing long-term rebleeding. In contrast, EDAS alone did not display a clear effect on reducing long-term rebleeding rates.


Subject(s)
Cerebral Revascularization , Moyamoya Disease , Adult , Humans , Follow-Up Studies , Moyamoya Disease/diagnostic imaging , Moyamoya Disease/surgery , Vascular Surgical Procedures
17.
J Neurosurg ; 140(6): 1707-1715, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38157529

ABSTRACT

OBJECTIVE: The objective of this retrospective study was to establish a novel system for evaluating collateralization of the external carotid artery in patients with moyamoya disease (MMD) following direct and indirect revascularization surgeries. METHODS: The authors conducted a retrospective analysis of 456 patients diagnosed with MMD who underwent direct and indirect revascularization procedures at Beijing Tiantan Hospital, Capital Medical University, between January 2015 and May 2023. Using a newly proposed digital subtraction angiography (DSA)-based evaluation system, the authors assessed collateralization angiogenesis objectively and in a standardized manner. RESULTS: The authors' findings indicated that there was no significant difference in collateralization angiogenesis between patients undergoing direct or indirect cerebral revascularization (p = 0.702). However, after cerebral revascularization, patients with ischemic MMD exhibited significantly higher collateralization angiogenesis compared with those with hemorrhagic MMD (p = 0.007). Children with MMD demonstrated higher angiogenesis levels than adults (p < 0.001), but subgroup analysis showed age-specific variations. In adults, collateralization angiogenesis was significantly greater in those with ischemic MMD (p = 0.006), whereas in children, no significant difference was noted between ischemic and hemorrhagic MMD (p = 0.962). Furthermore, regardless of MMD type, direct and indirect revascularization methods yielded similar collateralization angiogenesis (p = 0.962 and p = 0.963, respectively). Importantly, the Matsushima grading system revealed significant differences in angiogenesis in patients with ischemic MMD (p < 0.001). CONCLUSIONS: The newly introduced DSA-based evaluation system offers an objective and standardized method for assessing collateralization angiogenesis in MMD. This study supports the efficacy of both direct and indirect revascularization surgical procedures and highlights distinct pathophysiological processes of ischemic and hemorrhagic disease subtypes. These findings contribute to a better understanding of surgical outcomes and aid in the selection of appropriate treatment strategies for patients with MMD.


Subject(s)
Angiography, Digital Subtraction , Carotid Artery, External , Cerebral Revascularization , Collateral Circulation , Moyamoya Disease , Humans , Moyamoya Disease/surgery , Moyamoya Disease/diagnostic imaging , Cerebral Revascularization/methods , Male , Female , Retrospective Studies , Adult , Child , Collateral Circulation/physiology , Middle Aged , Adolescent , Young Adult , Carotid Artery, External/surgery , Carotid Artery, External/diagnostic imaging , Child, Preschool , Treatment Outcome , Neovascularization, Physiologic
18.
Nanomaterials (Basel) ; 13(24)2023 Dec 07.
Article in English | MEDLINE | ID: mdl-38132994

ABSTRACT

Optical anisotropy offers a heightened degree of flexibility in shaping optical properties and designing cutting-edge devices. Quasi-one-dimensional Ta2NiS5, with giant optical anisotropy, has been used in the development of new lasers and sensors. In this research endeavor, we successfully acquired the complete dielectric tensor of Ta2NiS5, utilizing the advanced technique of Mueller matrix spectroscopic ellipsometry, enabling a rigorous quantitative assessment of its optical anisotropy. The results indicate that Ta2NiS5 demonstrates giant birefringence and dichroism, with Δnmax = 1.54 and Δkmax = 1.80. This pursuit also delves into the fundamental underpinnings of this optical anisotropy, drawing upon a fusion of first-principles calculations and critical points analysis. The anisotropy of Ta2NiS5 arises from differences in optical transitions in different directions and is shown to be due to van Hove singularities without exciton effects. Its giant optical anisotropy is expected to be useful in the design of novel optical devices, and the revelation of the physical mechanism facilitates the modulation of its optical properties.

19.
Article in English | MEDLINE | ID: mdl-37934636

ABSTRACT

Offline reinforcement learning (RL) optimizes the policy on a previously collected dataset without any interactions with the environment, yet usually suffers from the distributional shift problem. To mitigate this issue, a typical solution is to impose a policy constraint on a policy improvement objective. However, existing methods generally adopt a "one-size-fits-all" practice, i.e., keeping only a single improvement-constraint balance for all the samples in a mini-batch or even the entire offline dataset. In this work, we argue that different samples should be treated with different policy constraint intensities. Based on this idea, a novel plug-in approach named guided offline RL (GORL) is proposed. GORL employs a guiding network, along with only a few expert demonstrations, to adaptively determine the relative importance of the policy improvement and policy constraint for every sample. We theoretically prove that the guidance provided by our method is rational and near-optimal. Extensive experiments on various environments suggest that GORL can be easily installed on most offline RL algorithms with statistically significant performance improvements.

20.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 40(4): 743-752, 2023 Aug 25.
Article in Chinese | MEDLINE | ID: mdl-37666765

ABSTRACT

Corona virus disease 2019 (COVID-19) is an acute respiratory infectious disease with strong contagiousness, strong variability, and long incubation period. The probability of misdiagnosis and missed diagnosis can be significantly decreased with the use of automatic segmentation of COVID-19 lesions based on computed tomography images, which helps doctors in rapid diagnosis and precise treatment. This paper introduced the level set generalized Dice loss function (LGDL) in conjunction with the level set segmentation method based on COVID-19 lesion segmentation network and proposed a dual-path COVID-19 lesion segmentation network (Dual-SAUNet++) to address the pain points such as the complex symptoms of COVID-19 and the blurred boundaries that are challenging to segment. LGDL is an adaptive weight joint loss obtained by combining the generalized Dice loss of the mask path and the mean square error of the level set path. On the test set, the model achieved Dice similarity coefficient of (87.81 ± 10.86)%, intersection over union of (79.20 ± 14.58)%, sensitivity of (94.18 ± 13.56)%, specificity of (99.83 ± 0.43)% and Hausdorff distance of 18.29 ± 31.48 mm. Studies indicated that Dual-SAUNet++ has a great anti-noise capability and it can segment multi-scale lesions while simultaneously focusing on their area and border information. The method proposed in this paper assists doctors in judging the severity of COVID-19 infection by accurately segmenting the lesion, and provides a reliable basis for subsequent clinical treatment.


Subject(s)
COVID-19 , Humans , COVID-19/diagnostic imaging , Respiratory Rate , Tomography, X-Ray Computed
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