A nomogram prediction model for short-term aortic-related adverse events in patients with acute Stanford type B aortic intramural hematoma: development and validation.

Background: This study is to examine the factors associated with short-term aortic-related adverse events in patients with acute type B aortic intramural hematoma (IMH). Additionally, we develop a risk prediction nomogram model and evaluate its accuracy. Methods: This study included 197 patients diagnosed with acute type B IMH. The patients were divided into stable group (n = 125) and exacerbation group (n = 72) based on the occurrence of aortic-related adverse events. Logistic regression and the Least Absolute Shrinkage and Selection Operator (LASSO) method for variables based on baseline assessments with significant differences in clinical and image characteristics were employed to identify independent predictors. A nomogram risk model was constructed based on these independent predictors. The nomogram model was evaluated using various methods such as the receiver operating characteristic curve, calibration curve, decision analysis curve, and clinical impact curve. Internal validation was performed using the Bootstrap method. Results: A nomogram risk prediction model was established based on four variables: absence of diabetes, anemia, maximum descending aortic diameter (MDAD), and ulcer-like projection (ULP). The model demonstrated a discriminative ability with an area under the curve (AUC) of 0.813. The calibration curve indicated a good agreement between the predicted probabilities and the actual probabilities. The Hosmer-Lemeshow goodness of fit test showed no significant difference (χ 2 = 7.040, P = 0.532). The decision curve analysis (DCA) was employed to further confirm the clinical effectiveness of the nomogram. Conclusion: This study introduces a nomogram prediction model that integrates four important risk factors: ULP, MDAD, anemia, and absence of diabetes. The model allows for personalized prediction of patients with type B IMH.

Analysis of Short-Term Clinical Outcomes and Influencing Factors in Patients with Acute Type B Aortic Intramural Hematoma Treated with Optimal Medical Therapy.

This study aimed to investigate the short-term predictors of aortic-related adverse events in patients with acute type B aortic intramural hematoma (IMH) initially treated with optimized medical therapy.A total of 157 patients with acute type B IMH were included in this study. These patients were divided into worsening group (n = 45) and stable group (n = 112) based on the incidence of aortic-related adverse events. The clinical data and imaging features of the two groups were compared. Multivariate logistic regression analysis of predictors of aortic-related adverse events in type B IMH was performed. Receiver operating characteristic (ROC) curve was applied to determine the optimal cutoff value for maximum descending aorta diameter (MDAD). Kaplan-Meier survival curve was used to analyze the incidence of aortic-related adverse events.Worsening and stable groups were statistically significant in diuretics, abnormal D-dimer level, observation endpoint systolic blood pressure (SBP), MDAD, aortic atherosclerosis, ulcer-like projection (ULP), and thickness of hematoma (P < 0.05). Multivariate logistic regression showed that abnormal D-dimer level (OR = 12.464, P = 0.025), MDAD (OR = 1.113, P = 0.030), and ULP (OR = 5.849, P = 0.022) were powerful independent risk factors for predicting aortic-related adverse events in type B IMH, and observation endpoint SBP within 100-120 mmHg (OR = 0.225, P = 0.014) was a protective factor for predicting aortic-related adverse events in type B IMH. The cutoff value of MDAD was 35.2 mm.Short-term imaging is recommended for type B IMH patients with abnormal D-dimer level, MDAD > 35.2 mm, and ULP. Blood pressure should also be strictly monitored and controlled during the acute phase of IMH.

Optical Kerr effect spectroscopy of CS2 in monocationic and dicationic ionic liquids: insights into the intermolecular interactions in ionic liquids.

A comparative study of the intermolecular dynamics of CS2 in monocationic and dicationic ionic liquids (ILs) was performed using optical heterodyne-detected Raman-induced Kerr effect spectroscopy (OHD-RIKES). The reduced spectral densities (RSDs) of mixtures of CS2 in 1-alkyl-3-methylimidazolium bis[(trifluoromethane)sulfonyl]amide ([CnC1im][NTf2] for n = 3-5) and 1,2n-bis(3-methylimidazolium-1-yl) alkane bis[(trifluoromethane)sulfonyl]amide ([(C1im)2C2n][NTf2]2 for n = 3-5) were investigated as a function of concentration at 295 K. An additivity model was used to obtain the CS2 contribution to the RSD of a mixture in the 0-200 cm-1 region. One of the aims of this study is to show how CS2 can be used as a probe of intermolecular/interionic interactions in ILs. The concentrations were chosen such that the CS2-to-imidazolium ring mole fraction of a mixture with [(C1im)2C2n][NTf2]2 (DIL(2n)) is the same as that of a mixture with [CnC1im][NTf2] (MIL(n)). As found previously for CS2 in monocationic ILs, the intermolecular spectrum of CS2 in dicationic ILs is lower in frequency and narrower than that of neat CS2. The new result is that the intermolecular spectrum of CS2 is higher in frequency in DIL(2n) than in the corresponding MIL(n), indicating that CS2 molecules experience a stiffer potential in dicationic ILs than in monocationic ILs. The intermolecular dynamics of CS2 being higher in frequency in DIL(2n) than in MIL(n) is consistent with recent molecular dynamics simulations (Lynden-Bell and Quitevis, J. Chem. Phys., 2018, 148, 193844) that show the stiffer potential is the result of greater confinement of CS2 in DIL(2n) than in MIL(n). We also show in this study how effects due to dilution and the intermolecular potential seen by a solute molecule in solution are unraveled.