We aimed to evaluate if prior oral anticoagulation (OAC) and its type determines a greater risk of symptomatic hemorrhagic transformation in patients with acute ischemic stroke (AIS) subjected to ...mechanical thrombectomy.
Consecutive patients with AIS included in the prospective reperfusion registry NORDICTUS, a network of tertiary stroke centers in Northern Spain, from January 2017 to December 2019 were included. Prior use of oral anticoagulants, baseline variables, and international normalized ratio (INR) on admission were recorded. Symptomatic intracranial hemorrhage (sICH) was the primary outcome measure. Secondary outcome was the relation between INR and sICH, and we evaluated mortality and functional outcome at 3 months by modified Rankin scale. We compared patients with and without previous OAC and also considered the type of oral anticoagulants.
About 1.455 AIS patients were included, of whom 274 (19%) were on OAC, 193 (70%) on vitamin K antagonists (VKA), and 81 (30%) on direct oral anticoagulants (DOACs). Anticoagulated patients were older and had more comorbidities. Eighty-one (5.6%) developed sICH, which was more frequent in the VKA group, but not in DOAC group. OAC with VKA emerged as a predictor of sICH in a multivariate regression model (OR, 1.89 95% CI, 1.01-3.51,
= 0.04) and was not related to INR level on admission. Prior VKA use was not associated with worse outcome in the multivariate regression model nor with mortality at 3 months.
OAC with VKA, but not with DOACs, was an independent predictor of sICH after mechanical thrombectomy. This excess risk was associated neither with INR value by the time thrombectomy was performed, nor with a worse functional outcome or mortality at 3 months.
The insect microbiota performs essential functions in their metabolism, contributing to the proper functioning of the immune system and favoring digestion. The cricket species Acheta domesticus has ...recently been authorized for human consumption. The massive production of this species implies large energy costs in the breeding area, so variations in room temperature could mean significant savings in production costs. This study aims to analyze the influence of temperature on the composition of the intestinal microbiota, considering the hypothesis that changes in temperature affect the microbiota of ectothermic insects. For this, two groups of crickets were selected in separate boxes and subjected to temperatures of 20 ºC and 30 ºC, respectively. Subsequently, their intestines were removed and their bacterial populations were quantified using metagenomic techniques. The results obtained showed that the most abundant taxa hardly varied in all samples. Abundance relatives of Bacteria belonging to the phylum Firmicutes was 31.5 ± 2.06%, in Bacteroidetes 24.25 ± 3.89% and in Proteobacteria 44 ± 4.85%. The only sample showing difference was that reared at 30ºC, in which 0.8% of Actinobacteria was detected. In conclusion, it could be said that the rearing temperature of cricket farms has slightly influenced the composition of the intestinal microbiota, therefore the initial hypothesis is accepted. Incidentally, high mortality has been observed in the sample kept at 30ºC, suggesting that this factor should be carefully considered in massive rearing of crickets.
La microbiota de los insectos desempeña funciones esenciales en el metabolismo de los mismos, contribuyendo al correcto funcionamiento del sistema inmune y favoreciendo la digestión. La especie de grillo Acheta domesticus ha sido recientemente autorizada para consumo humano. La producción masiva de esta especie implica grandes costes energéticos en la zona de cría, por lo que variaciones en la temperatura de la sala pueden suponer un importante ahorro en el coste de producción. Este estudio tiene como objetivo analizar la influencia de la temperatura en la composición de la microbiota intestinal, planteándose la hipótesis de que los cambios de temperatura afectan a la microbiota de insectos ectotermos. Para ello se seleccionaron dos grupos de grillos en cajas separadas y se les sometió a temperaturas de 20 ºC y 30 ºC respectivamente. Posteriormente se les extrajo el intestino y se cuantificaron sus poblaciones bacterianas mediante técnicas metagenómicas. Al cuantificar estas poblaciones se observó que la mayor parte de la microbiota en todas las muestras es similar a nivel taxonómico de filo y nivel de clase, excepto a la temperatura de 30 ºC en la que se detecta un pequeño porcentaje de Actinobacterias.
(Headache 2010;50:99‐168)
Background.— It has been suggested that homocysteine (Hcy) and the 5′‐10′‐methylenetetrahydrofolate reductase (MTHFR) C677T variant are implicated in the pathogenesis of ...migraine. Homocysteine has the potential to damage endothelium and accelerate atherosclerosis. Genetic factors such as the MTHFR C677T polymorphism, and other polymorphisms in folate‐related genes associated with high homocysteine levels, may contribute to increasing this vascular risk.
Results.— We recruited 427 migraine patients (199 without aura MO; 228 with aura MA), and 310 controls in a neurologic clinic. Hcy levels and 6 polymorphisms corresponding to 6 folate‐related genes, including the MTHFR C677T variant, were determined in all migraine participants and in a subset of 155 controls. We found higher sex‐adjusted Hcy levels in MA (mean: 11.02 µM) than MO patients (9.86 µM; P = .005 for the difference). Hcy levels higher than 12.0 µM doubled the risk for MA (OR = 2.145; 95% confidence intervals CI = 1.3‐3.4; P = .001), and those higher than 15.0 µM incurred a 6‐fold increase (OR = 5.95; 95% CI = 2.1‐20.0, P < .001). The number of MTHFR 677T alleles was the best genetic predictor of Hcy levels (r2 = 0.06; P = 6.2e‐6; corrected for genetic variants analyzed) and this effect remained significant after correction for other confounding factors. Using multi‐dimensionality reduction approaches, we observed significant epigenetic interaction among some of the folate‐related genetic variants to predict higher Hcy levels, and also among higher Hcy levels and folate‐related genetic variants to predict the end‐diagnosis of MA only among migraineurs. In controls, Hcy levels and the number of MTHFR 677T alleles were found to be intermediate between those observed in MA and MO patients.
Conclusion.— Our results suggest that MA patients have higher Hcy levels. We also observed complex epigenetic interaction among folate‐related enzymes, sex, and Hcy levels predicting MA phenotype. Nevertheless, genetic factors explained only a minor proportion of the variance for both Hcy plasma levels and for predicting MA phenotype. Determination of MTHFR C677T polymorphisms and Hcy levels may be useful to identify patients with a high risk of suffering from MA.
We investigated whether pre-treatment with statins is associated with surrogate markers of amyloid and hypertensive angiopathies in patients who need to start long-term oral anticoagulation therapy. ...A prospective multicenter study of patients naive for oral anticoagulants, who had an acute cardioembolic stroke. MRI was performed at admission to evaluate microbleeds, leukoaraiosis and superficial siderosis. We collected data on the specific statin compound, the dose and the statin intensity. We performed bivariate analyses and a logistic regression to investigate variables associated with microbleeds. We studied 470 patients (age 77.5 ± 6.4 years, 43.7% were men), and 193 (41.1%) of them received prior treatment with a statin. Microbleeds were detected in 140 (29.8%), leukoaraiosis in 388 (82.5%) and superficial siderosis in 20 (4.3%) patients. The presence of microbleeds, leukoaraiosis or superficial siderosis was not related to pre-treatment with statins. Microbleeds were more frequent in patients with prior intracerebral hemorrhage (OR 9.7, 95% CI 1.06-90.9) and in those pre-treated antiplatelets (OR 1.66, 95% CI 1.09-2.53). Prior treatment with statins was not associated with markers of bleeding-prone cerebral angiopathies in patients with cardioembolic stroke. Therefore, previous statin treatment should not influence the decision to initiate or withhold oral anticoagulation if these neuroimaging markers are detected.
Fannia pusio (Wiedemann, 1830) is a species belonging to the family Fanniidae, which is of great forensic, sanitary, and veterinary interest. The behavioral peculiarities of this species, depending ...on the temperature at which it is found, may provide additional information for
future research. The application of entomology in the forensic field has focused especially on the early colonizing taxa of corpses that are in the initial stage of decomposition. However, species occurring at more advanced stages can contribute to further knowledge, as is the case with
F. pusio. In addition, the species has the ability to colonize buried corpses that are inaccessible to larger dipterans. On the other hand, the sanitary and veterinary interest of this species is due to the performance of females as phoretic hosts of Dermatobia hominis eggs that
cause myiasis in both animals and humans. In the current study, the behavior of F. pusio was observed at a temperature range of 5°C to 40°C. We found that its viability range is limited between 15°C and 35°C; above and below these temperatures, adults survive but oviposition
does not take place. Data collected by statistical analysis were subsequently applied to calculate the post-mortem interval (PMI) using isomorphen and isomegalen diagrams. The results show a directly proportional relationship between growth rate and temperature increase. However, a slowdown
in the growth of individuals was observed at extreme temperatures (5°C and 35°C). The results shown in this manuscript, together with the existing bibliography of other species, help to broaden the knowledge of F. pusio, which has not been studied in such depth until now.
The Horizon 2020 LC-BAT-10-2020 project LIBERTY ("
Lightweight Battery System for Extended Range at Improved Safety
") focusses on the areas of battery
lifetime,
increased range
,
safety
and ...environmental
sustainability
. The project aims to develop a battery pack that will have the same
useful lifetime
as those of current combustion engines, i.e.
up to 20 years or 300,000 km
. At present, the lifetime of a battery is typically lower, with guarantees of up to 10 years or around 150,000 km. LIBERTY targets a
range increase of up to 20% compared to the benchmark vehicle
, thus
allowing driving up to 500 km on a single charge
. Then, an ultra-fast-charging below 18 minutes is targeted, less than half the time realized by contemporary technologies. Improved and standardized battery safety and environmental life-cycle sustainability performance will serve other important aspects addressed by this project. To reach these goals the project is currently researching and developing the LIBERTY innovations described in more detail in the following sections.
Abstract only Introduction: Statin therapy might be associated with an increased risk of hemorrhagic stroke, which has been attributed to low LDL-cholesterol levels and antithrombotic effects. ...Hypothesis: Previous statin therapy is associated with surrogate markers of amyloid and hypertensive angiopathies in patients with cardioembolic stroke who need to start long-term oral anticoagulation (OA). Methods: A prospective multicenter study of patients included in the HERO study (Intracerebral Hemorrhage due to Oral Anticoagulants: Prediction of the Risk by Magnetic Resonance). Patients were naïve for OA and had an acute cardioembolic ischemic stroke (TIA or infarct). A MR examination was performed during admission to evaluate: 1) Microbleeds (-MB-, number, distribution, burden); 2) Leukoaraiosis (-LK- presence and degree); 3) Superficial siderosis (-SS-, presence). We collected data on the specific statin, the dose and the statin intensity (low, medium or high according to accepted classifications). We also recorded demographic data and traditional vascular risk factors. Results: We studied 470 patients (age 77.5±6.4 years, 43.7% were men). A total of 193 (41.1%) patients received prior treatment with any statin, of whom 43.5% received simvastatin and 41.3% atorvastatin. Statin intensity was low in 14.5%, medium in 61.1%, high in 16.5% and unknown in 10.8%. LK was detected in 82.5% and was severe in 19.8%. SS was detected in 20 (4.3%) patients. MBs were detected in 140 (29.8%) patients and the distribution was lobar in 55%, deep in 30% and both in 15%. Of the MB group 74 (53%) had 1 MB, 66 (47%) had >1 MB, and 11.4% had >5 MBs. The presence of MB, LK or SS was not related to the pre-treatment with statin. The statin intensity was not related to the presence of SS, the presence/degree of LK, and the presence/distribution/burden of MBs. MBs were detected with increased frequency in hypertensive patients (p=0.09). LK presence and degree were increased in patients with MB (p=0.012) and SS (p=0.041). Conclusion: In conclusion, prior treatment with statins is not associated with surrogate markers of bleeding-prone cerebral angiopathies in patients with cardioembolic stroke. Therefore previous statin treatment should not influence the decision to start long-term oral anticoagulation.
A high potential of thermosolar power generation systems is the use of thermal storage and/or hybridization to overcome dependability of solar resource availability. The incorporation of these ...technologies can be of special interest for isolated units intended for distributed generation systems. Among the thermosolar systems, dish–Stirling technology is the one with more possibilities to be used as a system to feed power independently, i.e., due to the modularity of the units that range between 3 and 25 kWe, depending on the supplier. Thus, the present analysis is focused on studying integration of both hybridization and thermal storage in an isolated unit of 10 kWe dish–Stirling. In particular, hybridization will enable a more continuous operation of the system. Hybridization is analyzed both for a conventional fuel, such as natural gas, and for a renewable energy source, biogas. Analysis of performance of the dish–Stirling system enables to determine the interest of introducing the complementary technologies referred above. Regarding the specific case evaluated in this paper, analyzed data show that hybridization has an advantage that depends on the nature of fuel used, being of 20 % for natural gas and 112 % for biogas in relation to output power of solar-only operation. Thermal energy storage system shows no significant benefits when implemented to a variable power system.
The association between cancer and stroke is well documented and entails a worse prognosis for both pathologies. However, the prevalence of active and occult cancer among stroke patients is not ...sufficiently established, and neither are the predictors of cancer-associated stroke. Their knowledge is important for better identification and optimisation of the treatment of these patients.
The aim of this retrospective study is to analyse the characteristics of ischaemic stroke in patients with and without active cancer in a sample of patients admitted to a stroke unit for two years. An overall descriptive and case-control analysis is performed to assess the differences between the two groups.
In a sample of 616 patients with ischaemic stroke, a prevalence of cancer was found to be 19.2%, which was active (prior or diagnosed after the stroke) in 7.5% of them. Active cancer was associated with the finding of lesions in several vascular territories, lower haemoglobin and haematocrit values, and higher fibrinogen and C-reactive protein values, a tendency to worse functional status and higher mortality at three months.
A high prevalence of systemic cancer, of any type, as well as active and occult, was found among patients with ischaemic stroke. The presence of ischaemic lesions in several vascular territories and some laboratory markers could be factors to consider in attributing the stroke to cancer or looking for an occult neoplasm in some patients.
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