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1.
Molecules ; 29(17)2024 Sep 06.
Article in English | MEDLINE | ID: mdl-39275087

ABSTRACT

A condensation reaction of salicylic acid with formaldehyde in the presence of sulfuric acid led to the synthesization of the bis(2-hydroxy-3-carboxyphenyl)methane (BHCM) ligand, which was subsequently allowed to bind with nickel (II) ions. In light of the information obtained from the elemental analyses (C, H, and M), spectral (IR, MS, 1H-NMR, and UV-Vis) and thermal and magnetic measurements, the most likely structures of the ligand and complex have been identified. It has been suggested that the BHCM coordinates in a tetradentate manner with two Ni(II) ions to produce an octahedral binuclear complex. The SEM and TEM morphology of the compounds showed spherical shapes. An X-ray diffraction analysis indicated a considerable difference in the diffraction patterns between BHCM (crystalline) and Ni-BHCM (amorphous), and the Scherrer equation was used to calculate the crystallite size. Some optical characteristics were estimated from UV-Vis spectra. The ligand and its nickel(II) complex underlie the range of semiconductors. It was verified that for human lung (A-549) cancer, the BHCM compound displayed a significant barrier to the proliferation test in noncancerous cells (human lung fibroblasts, WI-38), which was also undertaken. To demonstrate the binding affinities of the chosen compounds (BHCM and Ni-BHCM) in the receptor protein's active site [PDB ID: 5CAO], a molecular docking (MD) study was carried out.

2.
Neurocrit Care ; 2024 Jul 09.
Article in English | MEDLINE | ID: mdl-38981999

ABSTRACT

BACKGROUND: Electroencephalography (EEG) is needed to diagnose nonconvulsive seizures. Prolonged nonconvulsive seizures are associated with neuronal injuries and deleterious clinical outcomes. However, it is uncertain whether the rapid identification of these seizures using point-of-care EEG (POC-EEG) can have a positive impact on clinical outcomes. METHODS: In a retrospective subanalysis of the recently completed multicenter Seizure Assessment and Forecasting with Efficient Rapid-EEG (SAFER-EEG) trial, we compared intensive care unit (ICU) length of stay (LOS), unfavorable functional outcome (modified Rankin Scale score ≥ 4), and time to EEG between adult patients receiving a US Food and Drug Administration-cleared POC-EEG (Ceribell, Inc.) and those receiving conventional EEG (conv-EEG). Patient records from January 2018 to June 2022 at three different academic centers were reviewed, focusing on EEG timing and clinical outcomes. Propensity score matching was applied using key clinical covariates to control for confounders. Medians and interquartile ranges (IQRs) were calculated for descriptive statistics. Nonparametric tests (Mann-Whitney U-test) were used for the continuous variables, and the χ2 test was used for the proportions. RESULTS: A total of 283 ICU patients (62 conv-EEG, 221 POC-EEG) were included. The two populations were matched using demographic and clinical characteristics. We found that the ICU LOS was significantly shorter in the POC-EEG cohort compared to the conv-EEG cohort (3.9 [IQR 1.9-8.8] vs. 8.0 [IQR 3.0-16.0] days, p = 0.003). Moreover, modified Rankin Scale functional outcomes were also different between the two EEG cohorts (p = 0.047). CONCLUSIONS: This study reveals a significant association between early POC-EEG detection of nonconvulsive seizures and decreased ICU LOS. The POC-EEG differed from conv-EEG, demonstrating better functional outcomes compared with the latter in a matched analysis. These findings corroborate previous research advocating the benefit of early diagnosis of nonconvulsive seizure. The causal relationship between the type of EEG and metrics of interest, such as ICU LOS and functional/clinical outcomes, needs to be confirmed in future prospective randomized studies.

3.
Nano Lett ; 24(31): 9627-9634, 2024 Aug 07.
Article in English | MEDLINE | ID: mdl-39072492

ABSTRACT

We present large-scale atomistic simulations that reveal triple junction (TJ) segregation in Pt-Au nanocrystalline alloys in agreement with experimental observations. While existing studies suggest grain boundary solute segregation as a route to thermally stabilize nanocrystalline materials with respect to grain coarsening, here we quantitatively show that it is specifically the segregation to TJs that dominates the observed stability of these alloys. Our results reveal that doping the TJs renders them immobile, thereby locking the grain boundary network and hindering its evolution. In dilute alloys, it is shown that grain boundary and TJ segregation are not as effective in mitigating grain coarsening, as the solute content is not sufficient to dope and pin all grain boundaries and TJs. Our work highlights the need to account for TJ segregation effects in order to understand and predict the evolution of nanocrystalline alloys under extreme environments.

4.
Neurology ; 103(2): e209621, 2024 Jul 23.
Article in English | MEDLINE | ID: mdl-38875512

ABSTRACT

BACKGROUND AND OBJECTIVES: Approximately 30% of critically ill patients have seizures, and more than half of these seizures do not have an overt clinical correlate. EEG is needed to avoid missing seizures and prevent overtreatment with antiseizure medications. Conventional-EEG (cEEG) resources are logistically constrained and unable to meet their growing demand for seizure detection even in highly developed centers. Brief EEG screening with the validated 2HELPS2B algorithm was proposed as a method to triage cEEG resources, but it is hampered by cEEG requirements, primarily EEG technologists. Seizure risk-stratification using reduced time-to-application rapid response-EEG (rrEEG) systems (∼5 minutes) could be a solution. We assessed the noninferiority of the 2HELPS2B score on a 1-hour rrEEG compared to cEEG. METHODS: A multicenter retrospective EEG diagnostic accuracy study was conducted from October 1, 2021, to July 31, 2022. Chart and EEG review performed with consecutive sampling at 4 tertiary care centers, included records of patients ≥18 years old, from January 1, 2018, to June 20, 2022. Monte Carlo simulation power analysis yielded n = 500 rrEEG; for secondary outcomes n = 500 cEEG and propensity-score covariate matching was planned. Primary outcome, noninferiority of rrEEG for seizure risk prediction, was assessed per area under the receiver operator characteristic curve (AUC). Noninferiority margin (0.05) was based on the 2HELPS2B validation study. RESULTS: A total of 240 rrEEG with follow-on cEEG were obtained. Median age was 64 (interquartile range 22); 42% were female. 2HELPS2B on a 1-hour rrEEG met noninferiority to cEEG (AUC 0.85, 95% CI 0.78-0.90, p = 0.001). Secondary endpoints of comparison with a matched contemporaneous cEEG showed no significant difference in AUC (0.89, 95% CI 0.83-0.94, p = 0.31); in false negative rate for the 2HELPS2B = 0 group (p = 1.0) rrEEG (0.021, 95% CI 0-0.062), cEEG (0.016, 95% CI 0-0.048); nor in survival analyses. DISCUSSION: 2HELPS2B on 1-hour rrEEG is noninferior to cEEG for seizure prediction. Patients with low-risk (2HELPS2B = 0) may be able to forgo prolonged cEEG, allowing for increased monitoring of at-risk patients. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that rrEEG is noninferior to cEEG in calculating the 2HELPS2B score to predict seizure risk.


Subject(s)
Electroencephalography , Seizures , Humans , Electroencephalography/methods , Female , Retrospective Studies , Male , Seizures/diagnosis , Seizures/physiopathology , Middle Aged , Aged , Adult , Comparative Effectiveness Research
5.
Mo Med ; 121(1): 60-65, 2024.
Article in English | MEDLINE | ID: mdl-38404435

ABSTRACT

Obstructive Sleep Apnea (OSA) is a major public health problem affecting almost one billion individuals worldwide. Ninety percent of patients with OSA are still undiagnosed. Although an attended polysomnography (PSG) testing is the gold standard to diagnose OSA, it is time-consuming and is associated with higher costs. The Home Sleep Apnea Testing (HSAT) is now available to diagnose OSA. Understanding the indications and limitations of HSAT is important to avoid misdiagnosis and improve patient outcomes.


Subject(s)
Sleep Apnea, Obstructive , Sleep , Humans , Sleep Apnea, Obstructive/diagnosis , Polysomnography
6.
Cureus ; 15(6): e40106, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37425553

ABSTRACT

Vasculitis of the mesenteric vessels is considered rare and typically occurs as a part of systemic inflammation. Isolated mesenteric artery vasculitis without systemic involvement is rarely reported in the literature. Clinical presentation is usually nonspecific which can range from abdominal pain, nausea and vomiting to gangrene and intestinal perforation in severe cases. Recognizing mesenteric artery vasculitis as a potential cause of abdominal pain can be challenging, and delay in diagnosis can lead to significant mortality and morbidity. Herein, we present a case of a 19-year-old male who initially presented with abdominal pain. Later, isolated superior mesenteric artery (SMA) vasculitis was confirmed by CT angiography. Treatment with systemic steroids alone resulted in a marked improvement in the patient's symptoms as well as in radiographic findings.

7.
J Clin Neurophysiol ; 40(5): 434-442, 2023 Jul 01.
Article in English | MEDLINE | ID: mdl-37399042

ABSTRACT

PURPOSE: Lateralized rhythmic delta activity (LRDA) is highly associated with seizures but generalized rhythmic delta activity (GRDA; symmetric by definition) has no known seizure association. A subset of LRDA includes patterns that are "bilateral asymmetric LRDA" (LRDA-ba), falling between purely unilateral LRDA and GRDA. The significance of this finding has not been previously addressed. METHODS: Clinical, EEG, and imaging findings were reviewed in all patients with >6 hours of continuous EEG and LRDA-ba between 2014 and 2019. They were compared with a control group of patients with GRDA, matched 1:1 for prevalence, duration, and frequency of the predominant rhythmic pattern. RESULTS: Two hundred fifty-eight patients with LRDA-ba and 258 matched controls with GRDA were identified. Statistically significant findings included that patients with LRDA-ba were more likely to have presented with an ischemic stroke (LRDA-ba 12.4% vs. GRDA 3.9%) or subdural hemorrhage (8.9% vs. 4.3%); those with GRDA were more likely to have a metabolic encephalopathy (GRDA 10.5% vs. LRDA-ba 3.5%) or "altered mental state" without clear etiology (12.5% vs. 4.3%). Patients with LRDA-ba were significantly more likely to have a background EEG asymmetry (LRDA-ba 62.0% vs. GRDA 25.6%) or focal (arrhythmic) slowing (40.3% vs. 15.5%), and acute (65.5% vs. 46.1%) or focal (49.6% vs. 28.3%) abnormalities on computed tomography scan. Patients with LRDA-ba were more likely to have focal sporadic epileptiform discharges (95.4% vs. 37.9%), lateralized periodic discharges (32.2% vs. 5.0%), and focal electrographic seizures (33.3% vs. 11.2%); however, patients with LRDA-ba alone (i.e., without sporadic epileptiform discharges or PDs) showed only a trend toward increased seizures (17.3%) compared with a matched group of patients with GRDA alone (9.9%, P = 0.08). CONCLUSIONS: Patients with LRDA-ba had a higher proportion of acute focal abnormalities compared with a matched group of patients with GRDA. The LRDA-ba was associated with additional evidence of focal cortical excitability on EEG (sporadic epileptiform discharges and lateralized periodic discharges) and seizures but with only a trend toward increased seizures when other signs of focal excitability were absent.


Subject(s)
Critical Illness , Electroencephalography , Humans , Electroencephalography/methods , Seizures/epidemiology , Tomography, X-Ray Computed/adverse effects , Prevalence , Retrospective Studies
8.
Neurotherapeutics ; 20(4): 1229-1240, 2023 07.
Article in English | MEDLINE | ID: mdl-37296356

ABSTRACT

Recent evidence suggests that the glucagon-like peptide-1 receptor (GLP-1R) agonists have neuroprotective activities in the CNS in animal models of Parkinson's disease, Alzheimer's disease, and multiple sclerosis (MS). This study aimed to investigate whether a novel long-acting GLP-1R agonist, NLY01, could limit demyelination or improve remyelination as occurs in MS using the cuprizone (CPZ) mouse model. Herein, we assessed the expression of GLP-1R on oligodendrocytes in vitro and found that mature oligodendrocytes (Olig2+PDGFRa-) express GLP-1R. We further confirmed this observation in the brain by immunohistochemistry and found that Olig2+CC1+ cells express GLP-1R. We next administered NLY01 twice per week to C57B6 mice while on CPZ chow diet and found that NLY01 significantly reduced demyelination with greater weight loss than vehicle-treated controls. Because GLP-1R agonists are known to have anorexigenic effect, we then administered CPZ by oral gavage and treated the mice with NLY01 or vehicle to ensure the dose consistency of CPZ ingestion among mice. Using this modified approach, NLY01 was no longer effective in reducing demyelination of the corpus callosum (CC). We next sought to examine the effects of NLY01 treatment on remyelination after CPZ intoxication and during the recovery period using an adoptive transfer-CPZ (AT-CPZ) model. We found no significant differences between the NLY01 and vehicle groups in the amount of myelin or the number of mature oligodendrocytes in the CC. In summary, despite the promising anti-inflammatory and neuroprotective effects of GLP-1R agonists that have been previously described, our experiments provided no evidence to support a beneficial effect of NLY01 on limiting demyelination or enhancing remyelination. This information may be useful in selecting proper outcome measures in clinical trials of this promising class of drugs in MS.


Subject(s)
Demyelinating Diseases , Multiple Sclerosis , Remyelination , Mice , Animals , Cuprizone/toxicity , Glucagon-Like Peptide-1 Receptor/metabolism , Demyelinating Diseases/chemically induced , Demyelinating Diseases/drug therapy , Myelin Sheath , Multiple Sclerosis/metabolism , Disease Models, Animal , Mice, Inbred C57BL
9.
Biochem Genet ; 61(5): 1850-1866, 2023 Oct.
Article in English | MEDLINE | ID: mdl-36869999

ABSTRACT

Autosomal short tandem repeat (STR) population data collected from a well characterized population are needed to correctly assigning the weight of DNA profiles in the courtroom and widely used for ancestral analyses. In this study, allele frequencies for the 15 autosomal short tandem repeat (STR) loci included in the AmpFlSTR® Identifiler® plus kit (D8S1179, D21S11, D7S820, CSF1PO, D3S1358, TH01, D13S317, D16S539, D2S1338, D19S433, VWA, TPOX, D18S51, D5S818, FGA) were obtained by genotyping 332 unrelated individuals of Ghanaian origin. Statistical tests on STR genotype data showed no significant departure from Hardy-Weinberg equilibrium (HWE). The overall match probability, combined power of exclusion and combined power of discrimination for these loci were 1 in 3.85 × 1017, 0.99999893 and 0.99999998, respectively. Polymorphic information content (PIC) greater than 0.70 was observed for all loci except TH01 and D13S317. These statistical parameters confirm that this combination of loci is valuable for forensic identification and parentage analysis. Our results were also compared with those for 20 other human populations analyzed for the same set of markers. We observed that the Ghanaian population grouped with other African populations in two-dimensional principal coordinate (PCO) and a neighbor-joining (N-J) data mapping and placed closest to Nigerians. This observation reflects cultural similarities and geographical factors, coupled with the long history of migration and trading activities between Ghana and Nigeria. Our report provides what we believe to be the first published autosomal STR data for the general Ghanaian population using 15 loci genotyped using the AmpFlSTR® Identifiler® plus kit methodology. Our data show that the loci tested have sufficient power to be used reliably for DNA profiling in forensic casework and help to elucidate the genetic history of people living in the country.


Subject(s)
Genetics, Population , Microsatellite Repeats , Humans , Ghana , Polymerase Chain Reaction , Gene Frequency , DNA Fingerprinting
10.
Radiol Case Rep ; 18(3): 1000-1004, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36684615

ABSTRACT

CODAS syndrome (cerebral, ocular, dental, auricular, skeletal anomalies) is a rare autosomal recessive inherited multisystemic disease that carries an incidence rate of less than 1 in 1,000,000 children worldwide. It has an infancy, neonatal age of onset, characterized by deformities of the central nervous system, eyes, ears, teeth, and skeleton. A 1-year-old female of non-consanguineous parents, first time presented to our pediatrics clinic on November 6, 2021 when she was 4 months of age with developmental delay, as the patient could not support her head and made no eye contact on examination. Microcephaly was observed. She had a positive family history; her sister died at the age of 3 days with microcephaly and diaphragmatic hernia. We recommend that a wider range of centers to get encouraged to report cases of CODAS they might encounter due to the lack of sufficient amounts if solid literature on the topic. To our knowledge, this is the first case to be reported in the literature from Saudi Arabia.

11.
Polymers (Basel) ; 14(23)2022 Dec 04.
Article in English | MEDLINE | ID: mdl-36501692

ABSTRACT

Artificial implants are very essential for the disabled as they are utilized for bone and joint function in orthopedics. However, materials used in such implants suffer from restricted mechanical and tribological properties besides the difficulty of using such materials with complex structures. The current study works on developing a new polymer green composite that can be used for artificial implants and allow design flexibility through its usage with 3D printing technology. Therefore, a natural filler extracted from corn cob (CC) was prepared, mixed homogeneously with the Polylactic-acid (PLA), and passed through a complete process to produce a green composite filament suit 3D printer. The corn cob particles were incorporated with PLA with different weight fractions zero, 5%, 10%, 15%, and 20%. The physical, mechanical, and tribological properties of the PLA-CC composites were evaluated. 3D finite element models were constructed to evaluate the PLA-CC composites performance on a real condition implant, hip joints, and through the frictional process. Incorporating corn cob inside PLA revealed an enhancement in the hardness (10%), stiffness (6%), compression ultimate strength (12%), and wear resistance (150%) of the proposed PLA-CC composite. The finite element results of both models proved an enhancement in the load-carrying capacity of the composite. The finite element results came in line with the experimental results.

12.
J Cardiovasc Dev Dis ; 9(11)2022 Nov 08.
Article in English | MEDLINE | ID: mdl-36354782

ABSTRACT

Background: Cerebral venous sinus thrombosis (CVST) secondary to nephrotic syndrome (NS) is rarely reported. Additionally, treating steroid-sensitive nephrotic syndrome (SSNS) that changes to steroid resistance (SRNS) is difficult, with many relapses and side effects. Case presentation: A 32-month-old SSNS male child turned into SRNS and developed cerebral venous sinus thrombosis (CVST), a rare complication of NS. As a result of the administration of combined pulse methylprednisolone and IV Rituximab (RTX) therapy, the patient showed marked improvement, the results of urine analysis were remarkably improved, and the child started to respond to treatment. Conclusion: Successful treatment of a rare case of juvenile SSNS behaving as SRNS with the development of CVST could be established using combined steroid pulse therapy, Enoxaparin, and the B lymphocytes monoclonal antibodies RTX.

13.
Sci Rep ; 12(1): 17710, 2022 Oct 21.
Article in English | MEDLINE | ID: mdl-36271129

ABSTRACT

Covalent and non-covalent nanofluids were tested inside a circular tube fitted with twisted tape inserts with 45° and 90° helix angles. Reynolds number was 7000 ≤ Re ≤ 17,000, and thermophysical properties were assessed at 308 K. The physical model was solved numerically via a two-equation eddy-viscosity model (SST k-omega turbulence). GNPs-SDBS@DW and GNPs-COOH@DW nanofluids with concentrations (0.025 wt.%, 0.05 wt.% and 0.1 wt.%) were considered in this study. The twisted pipes' walls were heated under a constant temperature of 330 K. The current study considered six parameters: outlet temperature, heat transfer coefficient, average Nusselt number, friction factor, pressure loss, and performance evaluation criterion. In both cases (45° and 90° helix angles), GNPs-SDBS@DW nanofluids presented higher thermohydraulic performance than GNPs-COOH@DW and increased by increasing the mass fractions such as 1.17 for 0.025 wt.%, 1.19 for 0.05 wt.% and 1.26 for 0.1 wt.%. Meanwhile, in both cases (45° and 90° helix angles), the value of thermohydraulic performance using GNPs-COOH@DW was 1.02 for 0.025 wt.%, 1.05 for 0.05 wt.% and 1.02 for 0.1 wt.%.

14.
Molecules ; 27(16)2022 Aug 15.
Article in English | MEDLINE | ID: mdl-36014448

ABSTRACT

Textile reinforced concrete (TRC) has gained attention from the construction industry due to several characteristics such as its lightweight, high tensile strength, design flexibility, corrosion resistance and remarkably long service life. Some structural applications that utilize TRC components include precast panels, structural repairs, waterproofing elements and façades. TRC is produced by incorporating textile fabrics into thin cementitious concrete panels. However, in order to use this strengthening method in construction practice, a design model is required. Investigating the combined effect of conventional steel and textile reinforcement on the ductility behavior of composite TRC/RC one-way slab is vitally important. Therefore, the current study describes the proper methods of calculating the ductility of the composite concrete reinforced by a direct combination of conventional steel and textile reinforcement. Four methods are presented to calculate the ductility of the three considered one-way slab specimens. The three slabs having dimensions 1500 mm × 500 mm × 50 mm were reinforced by steel bars (SRC), by steel with one layer of carbon fabric (SRC + 1T), and by steel with two layers of carbon fabric (SRC + 2T). The three slab specimens were cast by the hand lay-up method, removed from the molds, cured, and then tested in flexure after 28 days using the four-point bending method. The obtained results and calculations revealed the non-reasonability of using the conventional method based on yielding of steel reinforcement as the only criterion in the ductility determination. The results also confirmed the suitability of using the energy-based method over other discussed methods in the calculation of the ductility for the hybrid reinforced members.

15.
J Stroke Cerebrovasc Dis ; 31(7): 106527, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35523053

ABSTRACT

BACKGROUND: There is limited evidence on the effect and relevance of cardiovascular parameters on the cerebrovascular system when an intracerebral hemorrhage (ICH) occurs. While recent studies evaluating this relationship are conflicting, one evaluating the effect of systolic cardiac function on clinical outcomes in ICH patients, found low cardiac ejection fractions to be associated with poor clinical outcomes. Our primary objective was to study such correlations and identify various cardiovascular disease states that may be associated with hematoma expansion. METHODS: This is an IRB-approved single-center retrospective study utilizing our institutional "Get with the Guidelines"-Stroke registry between 2013 and 2017. Patients included were older than 18 years of age, admitted with an acute ICH, and had an echocardiogram during their hospitalization. Univariate and multivariate logistical regression analyses were used to identify cardiovascular predictors of hematoma expansion. RESULTS: Two-hundred forty-nine patients were identified from our GWTG-S registry that met initial inclusion criteria. Of these patients, a history of peripheral arterial disease (PAD) (p = 0.015), presence of aortic stenosis (AS) on the echocardiogram (p = 0.025), and a positive spot sign on the CT-angiogram (CTA) of the head (p < 0.001) were found to be independently associated with ICH expansion. Both a history of hypertension and elevated blood pressure on presentation were not significant predictors. Additionally, patients with a history of congestive heart failure had decreased odds of hematoma expansion (p = 0.027). CONCLUSION: This exploratory study highlights potential novel cardiac predictors of hematoma expansion, including PAD and AS, which warrant further study. Larger prospective studies are needed to further investigate such associations to ultimately optimize cardio-cerebral health.


Subject(s)
Cerebral Hemorrhage , Hematoma , Cerebral Angiography , Cerebral Hemorrhage/complications , Cerebral Hemorrhage/diagnostic imaging , Cerebral Hemorrhage/therapy , Hematoma/complications , Hematoma/etiology , Humans , Predictive Value of Tests , Retrospective Studies
16.
Cureus ; 14(2): e22323, 2022 Feb.
Article in English | MEDLINE | ID: mdl-35317044

ABSTRACT

Interrupted inferior vena cava (IVC) with azygos continuation is one of the anomalies of the inferior vena cava (AIVCs) where venous drainage of the lower extremities is accomplished through a dilated azygos system and is usually accompanied by other congenital malformations such as polysplenia. AIVCs are more common in patients younger than 40 presenting with deep venous thrombosis (DVT). However, pulmonary embolism (PE) in association with AIVCs remains underreported. In this article, we describe a rare case of a 23-year-old male who presented with syncope secondary to sub-massive pulmonary embolism in the setting of an interrupted vena cava draining directly into the azygous vein.

17.
J Clin Neurophysiol ; 39(5): 372-382, 2022 Jul 01.
Article in English | MEDLINE | ID: mdl-35239561

ABSTRACT

SUMMARY: In this narrative review, we summarize recent research on the prognostic significance of biomarkers of sleep in continuous EEG and polysomnographic recordings in intensive care unit patients. Recent studies show the EEG biosignatures of non-rapid eye movement 2 sleep (sleep spindles and K-complexes) on continuous EEG in critically ill patients better predict functional outcomes and mortality than the ictal-interictal continuum patterns. Emergence of more complex and better organized sleep architecture has been shown to parallel neurocognitive recovery and correlate with functional outcomes in traumatic brain injury and strokes. Particularly interesting are studies which suggest intravenous dexmedetomidine may induce a more biomimetic non-rapid eye movement sleep state than intravenous propofol, potentially providing more restorative sleep and lessening delirium. Protocols to improve intensive care unit sleep and neurophysiological studies evaluating the effect of these on sleep and sleep architecture are here reviewed.


Subject(s)
Critical Illness , Delirium , Electroencephalography , Humans , Intensive Care Units , Prognosis , Sleep/physiology
18.
Neurologist ; 26(6): 271-273, 2021 Nov 04.
Article in English | MEDLINE | ID: mdl-34734906

ABSTRACT

INTRODUCTION: Wake-up strokes are challenging to manage due to unknown time of onset. Recently, the wake-up trial demonstrated that recombinant tissue plasminogen activator (rtPA) could be administered based on the magnetic resonance imaging (MRI)- diffusion weighted imaging/fluid attenuated inversion recovery mismatch. Many still doubt the safety results due to the higher rate of hemorrhagic conversion reported. Although it was statistically insignificant, the study was terminated early. Furthermore, Corona virus disease-19 is associated with coagulopathy and a higher risk of hemorrhagic conversion. CASE REPORT: A 46-year-old fully functioning male presented with a wake-up right hemiparesis, right facial droop, and expressive aphasia. His National Institute of Health Stroke Scale was 4 upon arrival. Last known well state was >4.5 hours. He tested positive for SARS-CoV-2 viral infection. He had left distal-M2 occlusion. He was deemed not a candidate for rtPA. Hyperacute-MRI protocol showed diffusion weighted imaging/fluid attenuated inversion recovery mismatch. The patient received rtPA at 6.5 hours from the last knwn well state. Follow-up MRI-susceptibility weighted imaging revealed fragmented clot. The stroke burden was less than that shown on the initial computed tomography-perfusion scans implying saved penumbra. There was no hemorrhagic conversion despite low fibrinogen levels. CONCLUSION: The hyperacute-MRI protocol for wake-up COVID-19 associated strokes might be a safe option.


Subject(s)
Brain Ischemia , COVID-19 , Ischemic Stroke , Stroke , Brain Ischemia/drug therapy , Diffusion Magnetic Resonance Imaging , Humans , Magnetic Resonance Imaging , Male , Middle Aged , SARS-CoV-2 , Stroke/diagnostic imaging , Stroke/drug therapy , Thrombolytic Therapy , Tissue Plasminogen Activator/therapeutic use
19.
Nanomaterials (Basel) ; 11(8)2021 Jul 31.
Article in English | MEDLINE | ID: mdl-34443809

ABSTRACT

Numerical studies were performed to estimate the heat transfer and hydrodynamic properties of a forced convection turbulent flow using three-dimensional horizontal concentric annuli. This paper applied the standard k-ε turbulence model for the flow range 1 × 104 ≤ Re ≥ 24 × 103. A wide range of parameters like different nanomaterials (Al2O3, CuO, SiO2 and ZnO), different particle nanoshapes (spherical, cylindrical, blades, platelets and bricks), different heat flux ratio (HFR) (0, 0.5, 1 and 2) and different aspect ratios (AR) (1.5, 2, 2.5 and 3) were examined. Also, the effect of inner cylinder rotation was discussed. An experiment was conducted out using a field-emission scanning electron microscope (FE-SEM) to characterize metallic oxides in spherical morphologies. Nano-platelet particles showed the best enhancements in heat transfer properties, followed by nano-cylinders, nano-bricks, nano-blades, and nano-spheres. The maximum heat transfer enhancement was found in SiO2, followed by ZnO, CuO, and Al2O3, in that order. Meanwhile, the effect of the HFR parameter was insignificant. At Re = 24,000, the inner wall rotation enhanced the heat transfer about 47.94%, 43.03%, 42.06% and 39.79% for SiO2, ZnO, CuO and Al2O3, respectively. Moreover, the AR of 2.5 presented the higher heat transfer improvement followed by 3, 2, and 1.5.

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