Leukoaraiosis is common in patients with acute ischemic stroke. The results from many studies investigating the association between leukoaraiosis and intracranial hemorrhage after thrombolysis remain ...conflicting.
A meta-analysis was performed to compare the risk of post-thrombolytic intracranial hemorrhage in patients with and without leukoaraiosis. Relevant reports were identified by searching PubMed, EmBase, Cochrane Library, and ISI Web of Science through December 2015 using a combination of subjective and random terms. Eligible studies that were original articles with a clear definition of leukoaraiosis and intracranial hemorrhage were selected and analyzed. Funnel plots, Egger's test, and Begg's test were conducted to assess the publication bias. Sensitivity analysis was also performed to evaluate the influence of each individual study.
Eleven trials that enrolled 6912 participants were included. There was a significantly increased risk for acute ischemic stroke patients with leukoaraiosis (odds ratio: 1.89, 95% confidence interval 1.51-2.37, P<0.001). Low heterogeneity and less publication bias was detected among these studies. The results of both computed tomography and magnetic resonance imaging performed on the subgroups of leukoaraiosis were significant. Furthermore, an association between leukoaraiosis and symptomatic intracranial hemorrhage was also confirmed. The odds ratios remained stable with no obvious variations on the sensitivity analysis. The limitations consisted of types of including trials and not matching some baseline variables.
The results of this meta-analysis show that leukoaraiosis approximately doubles the incidence of intracranial hemorrhage after thrombolytic therapy. However, it does not critically affect decision making regarding thrombolysis for patients with acute ischemic stroke. Additional investigations are required.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Objective
The evidence on the relationship between remnant cholesterol (RC) and stroke remains controversial. Therefore, this study aimed to explore the relationship between RC and stroke ...risk in a Chinese population of middle-aged and elderly individuals.
Methods
The present study included 10067 Chinese subjects of middle-aged and elderly individuals. The connection between RC and incident stroke was investigated using the multivariate Cox proportional hazards regression model, several sensitivity analyses, generalized additive models, and smoothed curve fitting.
Results
A total of 1180 participants with stroke were recorded during the follow-up period. The multivariate Cox proportional hazards regression model identified a positive connection between RC and stroke risk (hazard ratio (HR) = 1.087, 95% confidence interval (CI): 1.001–1.180). In addition, the current study discovered a nonlinear connection between RC and incident stroke, and the point of inflection for RC was 1.78 mmol/L. The risk of stroke increased by 25.1% with each unit increase in RC level when RC was < 1.78 mmol/L (HR:1.251, 95%CI: 1.089–1.437,
P
= 0.0015). The results were not affected by sensitivity tests.
Conclusion
The current study showed a positive and nonlinear connection between RC and stroke risk in a middle-aged and elderly Chinese population. These findings provided new information to help researchers better understand the relationship between RC levels and incident stroke.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Tissue-engineered nerve grafts (TENGs) are the most promising way for repairing long-distance peripheral nerve defects. Chitosan and poly (lactic-co-glycolic acid) (PLGA) scaffolds are considered as ...the promising materials in the pharmaceutical and biomedical fields especially in the field of tissue engineering. To further clarify the effects of a chitosan conduit inserted with various quantity of poly (lactic-co-glycolic acid) (PLGA) scaffolds, and their degrades on the peripheral nerve regeneration, the chitosan nerve conduit inserted with different amounts of PLGA scaffolds were used to repair rat sciatic nerve defects. The peripheral nerve regeneration at the different time points was dynamically and comprehensively evaluated. Moreover, the influence of different amounts of PLGA scaffolds on the regeneration microenvironment including inflammatory response and cell state were also revealed. The modest abundance of PLGA is more instrumental to the success of nerve regeneration, which is demonstrated in terms of the structure of the regenerated nerve, reinnervation of the target muscle, nerve impulse conduction, and overall function. The PLGA scaffolds aid the migration and maturation of Schwann cells. Furthermore, the PLGA and chitosan degradation products in a correct ratio neutralize, reducing the inflammatory response and enhancing the regeneration microenvironment. The balanced microenvironment regulated by the degradants of appropriate PLGA scaffolds and chitosan conduit promotes peripheral nerve regeneration. The findings represent a further step towards programming TENGs construction, applying polyester materials in regenerative medicine, and understanding the neural regeneration microenvironment.
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•Guide scaffolds are necessary for construction of TENGs to benefeat Schwann cell migration and maturation.•A large number of acid degradation products of PLGA scaffolds adversely affect cell proliferation, migration and apoptosis.•Appropriate amount of PLGA scaffolds balance positive cell guidance and negative degradation inflammation.•Dosage of PLGA and its combination with complementary biomaterials are key factors that affect regeneration effects.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Recently developed cooperative protocol with distributed path selection provides a simple and practical means of achieving full cooperative diversity in wireless networks. While the best path ...selection method can significantly improve bit error rate (BER) performance, it may cause unequal power consumption among relay nodes, which may reduce the lifetime of energy-constrained networks. A path selection method under the equal power constraint has been developed for the amplifyand- forward (AF) protocol, but there is no such method for the decode-and-forward (DF) protocol. In this paper, we develop a distributed path selection method with an equal power constraint for the DF protocol. We also analyze the BER performance of our path-selection method. Numerical results demonstrate that the proposed method can guarantee equal power consumption, while achieving full diversity as the best path selection method and providing significant performance gain relative to noncooperative communication.
Adaptive modulation requires channel state information (CSI), which can be acquired at the receiver by inserting pilot symbols in the transmitted signal. We first analyze the effect linear minimum ...mean square error (MMSE) channel estimation and prediction errors have on bit-error rate (BER). Based on this analysis, we develop adaptive pilot symbol assisted modulation (PSAM) schemes that account for both channel estimation and prediction errors to meet a target BER. While pilot symbols facilitate channel acquisition, they consume part of transmitted power and bandwidth, which in turn, reduces spectral efficiency. With imperfect (and thus, partial) CSI available at the transmitter and receiver, two questions arise naturally: how often should pilot symbols be transmitted, and how much power should be allocated to pilot symbols. We address these two questions by optimizing pilot parameters to maximize spectral efficiency.
The genus Anatrichus Loew, 1860 belongs to the subfamily Oscinellinae of the family Chloropidae. We report the complete mitogenome of Anatrichus pygmaeus as the new representative of the subfamily ...Oscinellinae. The complete mitochondrial genome was 17,125 bp in length. It consisted of 13 protein-coding genes, 22 transfer RNA genes, two ribosomal RNA genes, and a control region. The phylogenetic result showed that the family Chloropidae is monophyletic, and the subfamily Chloropinae is a sister group of the subfamily Oscinellinae.
The effects of various flow or geometry parameters on detonation initiation in supersonic combustible mixtures using a hot jet were investigated, including the free stream Mach number Ma∞, the hot ...jet Mach number Maj, the free stream pressure P∞, the hot jet pressure Pj, the diameter of the hot jet Dj, and the height of the free stream channel Hc. The results show that there exists a free stream Mach number range (Ma∞min, Ma∞max) for the successful initiation. When Ma∞ is beyond that range, the hot jet is not able to initiate the detonation and the flow field maintains a stable shock wave or shock reflection induced by the hot jet. For the other parameters, including the hot jet Mach number, the free stream pressure, the hot jet pressure, the diameter of the hot jet, and the height of the free stream channel Hc, there exists a critical value for the detonation initiation. For the hot jet Mach number Maj, the hot jet pressure Pj, the diameter of the hot jet Dj, when they are larger than the critical values, the initiation can be realized eventually and the larger the parameters the faster the initiation. Otherwise, the flow field will maintain the final stable state as the shock wave or shock reflection. For the free stream pressure P∞ and the height of the free stream channel Hc, when they are larger than the critical values, the flow field will also maintain the final stable state. Otherwise, the detonation initiation can be realized eventually and the smaller the parameters the faster the initiation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Parry-Romberg syndrome (PRS) combined with hemimasticatory spasm (HMS) is a rare craniofacial disorder characterized by unilateral facial tissue atrophy with paroxysmal involuntary contractions of ...the jaw-closing muscles. Although a majority believe that this is a result of demyelination changes from the effect of the facial involvement of PRS on the trigeminal nerve motor branches, the mechanism of PRS is presently unclear. Moreover, the therapeutic effects of existing drugs that target PRS have not been satisfactory. For intolerable spasms of the masticatory muscles, botulinum toxin injection may temporarily relieve the symptoms of spasms. We report a case of HMS secondary to PRS that was treated
a partial resection of the trigeminal nerve motor branch under intraoperative neurophysiological monitoring.
Cerebral white matter hyperintensity can lead to cerebral small vessel disease, MRI images in the brain are used to assess the degree of pathological changes in white matter regions. In this paper, ...we propose a framework for automatic 3D segmentation of brain white matter hyperintensity based on MRI images to address the problems of low accuracy and segmentation inhomogeneity in 3D segmentation. We explored correlation analyses of cognitive assessment parameters and multiple comparison analyses to investigate differences in brain white matter hyperintensity volume among three cognitive states, Dementia, MCI and NCI. The study explored the correlation between cognitive assessment coefficients and brain white matter hyperintensity volume.
This paper proposes an automatic 3D segmentation framework for white matter hyperintensity using a deep multi-mapping encoder-decoder structure. The method introduces a 3D residual mapping structure for the encoder and decoder. Multi-layer Cross-connected Residual Mapping Module (MCRCM) is proposed in the encoding stage to enhance the expressiveness of model and perception of detailed features. Spatial Attention Weighted Enhanced Supervision Module (SAWESM) is proposed in the decoding stage to adjust the supervision strategy through a spatial attention weighting mechanism. This helps guide the decoder to perform feature reconstruction and detail recovery more effectively.
Experimental data was obtained from a privately owned independent brain white matter dataset. The results of the automatic 3D segmentation framework showed a higher segmentation accuracy compared to nnunet and nnunet-resnet, with a
-value of <0.001 for the two cognitive assessment parameters MMSE and MoCA. This indicates that larger brain white matter are associated with lower scores of MMSE and MoCA, which in turn indicates poorer cognitive function. The order of volume size of white matter hyperintensity in the three groups of cognitive states is dementia, MCI and NCI, respectively.
The paper proposes an automatic 3D segmentation framework for brain white matter that achieves high-precision segmentation. The experimental results show that larger volumes of segmented regions have a negative correlation with lower scoring coefficients of MMSE and MoCA. This correlation analysis provides promising treatment prospects for the treatment of cerebral small vessel diseases in the brain through 3D segmentation analysis of brain white matter. The differences in the volume of white matter hyperintensity regions in subjects with three different cognitive states can help to better understand the mechanism of cognitive decline in clinical research.
Treatment-resistant depression (TRD) is a chronic and severe psychiatric illness associated with limited therapeutic options. Deep brain stimulation (DBS) is a promising therapy for TRD patients. ...However, its safety and efficacy are still unclear. Here we reported the safety and efficacy of lateral habenula (LHb) DBS for a TRD patient who had failed medical, psychological, electroconvulsive, and ketamine therapy. The DBS system is compatible with 3T magnetic resonance imaging along with local field potential (LFP) streaming. Two DBS electrodes were implanted at the bilateral LHb without any complication. The patient showed acute stimulation effects and achieved long-term improvements in his depression, anxiety, and sleep with left LHb 160 Hz frequency stimulation, accompanying the change of LFPs. These results provided clinical evidence toward the safety and efficacy and electrophysiological basis of LHb DBS for TRD.
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