Despite the recent acceptance of thrombectomy as the standard of care in patients with acute anterior circulation stroke, the benefits of thrombectomy remain uncertain for patients with acute basilar ...artery occlusion (BAO). This study aimed to evaluate the effectiveness and safety of thrombectomy and to identify predictors of outcomes in a large cohort of patients with acute BAO.
This study included 212 consecutive patients with acute BAO who underwent either stent-retriever or contact aspiration thrombectomy as the first-line approach between January 2011 and August 2017 at 3 stroke centers. Clinical and radiologic data were prospectively collected and stored in a database at each center. Multivariable ordinal logistic regression was performed to assess the association between each characteristic and 90-day modified Rankin scale scores. Reperfusion was successful in 91.5% (194/212) of patients; 44.8% (95/212) of patients achieved 90-day modified Rankin scale 0 to 2. The symptomatic hemorrhage rate was 1.9% (4/212) and mortality was 16% (34/212). In a multivariable ordinal regression, younger age, lower National Institute of Health stroke scale on admission, and absence of diabetes mellitus and parenchymal hematoma were significantly associated with a favorable shift in the overall distribution of 90-day modified Rankin scale scores. Treatment outcomes were similar between patients who received stent-retriever thrombectomy and contact aspiration thrombectomy as the first-line technique.
Endovascular thrombectomy was effective and safe for treating patients with acute BAO. Age, the baseline National Institute of Health stroke scale, diabetes mellitus, and parenchymal hematoma were associated with better outcomes. This study showed no superiority of the stent-retriever over the aspiration thrombectomy for treating acute BAO.
Brain organoids derived from human pluripotent stem cells provide a highly valuable in vitro model to recapitulate human brain development and neurological diseases. However, the current systems for ...brain organoid culture require further improvement for the reliable production of high-quality organoids. Here, we demonstrate two engineering elements to improve human brain organoid culture, (1) a human brain extracellular matrix to provide brain-specific cues and (2) a microfluidic device with periodic flow to improve the survival and reduce the variability of organoids. A three-dimensional culture modified with brain extracellular matrix significantly enhanced neurogenesis in developing brain organoids from human induced pluripotent stem cells. Cortical layer development, volumetric augmentation, and electrophysiological function of human brain organoids were further improved in a reproducible manner by dynamic culture in microfluidic chamber devices. Our engineering concept of reconstituting brain-mimetic microenvironments facilitates the development of a reliable culture platform for brain organoids, enabling effective modeling and drug development for human brain diseases.
Although the actual effect of fake news online on voters’ decisions is still unknown, concerns over the perceived effect of fake news online have prevailed in the US and other countries. Based on an ...analysis of survey responses from national samples (n = 1299) in the US, we found a strong tendency of the third-person perception. That is, individuals believed that fake news would have greater effects on out-group members than themselves or in-group members. Additionally, we proposed a theoretical path model, identifying the antecedents and consequences of the third-person perception. The results showed that partisan identity, social undesirability of content, and external political efficacy were positive predictors of the third-person perception. Interestingly, our findings revealed that third-person perception led to different ways of combating fake news online. Those with a greater level of third-person perception were more likely to support the media literacy approach but less likely to support the media regulation approach.
•Individuals showed third-person perception concerning the influence of fake news.•Social undesirability, partisan identity, and efficacy were positive predictors of third-person perception.•Third-person perception leads to support for media literacy intervention to combat fake news.•Third-person perception leads to rejection of media regulation approach.
We aimed to develop a novel prediction model for early neurological deterioration (END) based on an interpretable machine learning (ML) algorithm for atrial fibrillation (AF)-related stroke and to ...evaluate the prediction accuracy and feature importance of ML models. Data from multicenter prospective stroke registries in South Korea were collected. After stepwise data preprocessing, we utilized logistic regression, support vector machine, extreme gradient boosting, light gradient boosting machine (LightGBM), and multilayer perceptron models. We used the Shapley additive explanation (SHAP) method to evaluate feature importance. Of the 3,213 stroke patients, the 2,363 who had arrived at the hospital within 24 h of symptom onset and had available information regarding END were included. Of these, 318 (13.5%) had END. The LightGBM model showed the highest area under the receiver operating characteristic curve (0.772; 95% confidence interval, 0.715-0.829). The feature importance analysis revealed that fasting glucose level and the National Institute of Health Stroke Scale score were the most influential factors. Among ML algorithms, the LightGBM model was particularly useful for predicting END, as it revealed new and diverse predictors. Additionally, the effects of the features on the predictive power of the model were individualized using the SHAP method.
The 20th century's robotic systems have been made from stiff materials, and much of the developments have pursued ever more accurate and dynamic robots, which thrive in industrial automation, and ...will probably continue to do so for decades to come. However, the 21st century's robotic legacy may very well become that of soft robots. This emerging domain is characterized by continuous soft structures that simultaneously fulfill the role of robotic link and actuator, where prime focus is on design and fabrication of robotic hardware instead of software control. These robots are anticipated to take a prominent role in delicate tasks where classic robots fail, such as in minimally invasive surgery, active prosthetics, and automation tasks involving delicate irregular objects. Central to the development of these robots is the fabrication of soft actuators. This article reviews a particularly attractive type of soft actuators that are driven by pressurized fluids. These actuators have recently gained traction on the one hand due to the technology push from better simulation tools and new manufacturing technologies, and on the other hand by a market pull from applications. This paper provides an overview of the different advanced soft actuator configurations, their design, fabrication, and applications.
The 21st century's robotic legacy may very well become that of soft robots, which show remarkable features superior to those of conventional robots in tasks requiring delicate manipulation and a high degree of maneuverability. This review discusses a particular type of soft actuators—elastic inflatable actuators—which are driven by pressurized fluids and allow for straightforward integration in soft robotics.
Research Summary
Literature suggests that firms may approximate ambidexterity over time by alternating between periods of exploration and exploitation. We theorize and empirically test performance ...implications of two types of temporal transition between exploration and exploitation and their boundary conditions. We find that a discontinuous jump has a negative effect on firm performance while an incremental transition has a positive effect. We also find that the role of firm resources and particularly that of non‐scale‐free resources is critical in shaping the performance effects of the two types of temporal transition. Our findings indicate that the two types of temporal transition have distinct advantages and disadvantages.
Managerial Summary
Firms need to make use of old ideas and search for new ideas to remain competitive. We argue that firms take different approaches to achieve this goal. We find that firms that alternate between old and new ideas in an incremental and continuous manner perform better than firms that switch abruptly between old and new ideas. We also find that the performance effects of the two approaches are more pronounced for firms with limited resources. This finding warns managers of the danger of an abrupt and discontinuous jump between old and new ideas, especially for firms with limited resources.
Multivalued logic (MVL) computing could provide bit density beyond that of Boolean logic. Unlike conventional transistors, heterojunction transistors (H‐TRs) exhibit negative transconductance (NTC) ...regions. Using the NTC characteristics of H‐TRs, ternary inverters have recently been demonstrated. However, they have shown incomplete inverter characteristics; the output voltage (VOUT) does not fully swing from VDD to GND. A new H‐TR device structure that consists of a dinaphtho2,3‐b:2′,3′‐fthieno3,2‐bthiophene (DNTT) layer stacked on a PTCDI‐C13 layer is presented. Due to the continuous DNTT layer from source to drain, the proposed device exhibits novel switching behavior: p‐type off/p‐type subthreshold region /NTC/ p‐type on. As a result, it has a very high on/off current ratio (≈105) and exhibits NTC behavior. It is also demonstrated that an array of 36 of these H‐TRs have 100% yield, a uniform on/off current ratio, and uniform NTC characteristics. Furthermore, the proposed ternary inverter exhibits full VDD‐to‐GND swing of VOUT with three distinct logic states. The proposed transistors and inverters exhibit hysteresis‐free operation due to the use of a hydrophobic gate dielectric and encapsulating layers. Based on this, the transient operation of a ternary inverter circuit is demonstrated for the first time.
A new heterojunction transistor structure used to demonstrate a high‐performance ternary inverter circuit is described. As the proposed heterojunction transistors provide a high on/off current ratio, a low contact resistance, hysteresis‐free operation, and negative transconductance behavior, the ternary inverter using them exhibits full VDD‐to‐GND swing, three distinct logic states, and transient operation.
Latest developments in thin‐film electronics have put skin electronics in the limelight. Integration of multiple skin sensors and wireless power transferring ability are cardinal components for ...continuous acquisition of the human signals, enabling higher level of applications in wearable healthcare and AR/VR devices. Skin sensor is considerably influenced by target body parts and users where it is attached, and thus face various design adjustments for the best performance. However, most skin electronics using conventional fabrication methods have a fixed design for specific targets and users only and face great challenge when they need design changes, for it has to re‐initialize entire fabrication process even for the simplest design modification. Here, in situ and in operando adaptation (SOA) is presented, a revolutionary customizable electronic fabrication platform that allows simultaneous evolvable design modification and addition of new functionality to original skin electronics while they are in operation on a human skin. SOA renders immediate response to various user specifications possible, offering concurrent customization for various wearable and wireless applications including human physiology/motion sensors. Furthermore, SOA offers simultaneous impedance optimization in different body parts and users which enables on‐skin wireless power supply. These findings will prove a boon to the development of customizable wearable skin‐like electronics.
In situ and in operando adaptation (SOA), a customizable electronic fabrication platform, is developed which allows for evolvable functions of skin electronics. SOA renders an immediate response to various user specifications possible, offering concurrent customization for various applications including human physiology/motion sensors. Also, simultaneous impedance optimization of devices on different body parts and users enables on‐skin wireless power supply.
Glutamine is an essential nutrient that regulates energy production, redox homeostasis, and signaling in cancer cells. Despite the importance of glutamine in mitochondrial metabolism, the ...mitochondrial glutamine transporter has long been unknown. Here, we show that the SLC1A5 variant plays a critical role in cancer metabolic reprogramming by transporting glutamine into mitochondria. The SLC1A5 variant has an N-terminal targeting signal for mitochondrial localization. Hypoxia-induced gene expression of the SLC1A5 variant is mediated by HIF-2α. Overexpression of the SLC1A5 variant mediates glutamine-induced ATP production and glutathione synthesis and confers gemcitabine resistance to pancreatic cancer cells. SLC1A5 variant knockdown and overexpression alter cancer cell and tumor growth, supporting an oncogenic role. This work demonstrates that the SLC1A5 variant is a mitochondrial glutamine transporter for cancer metabolic reprogramming.
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•The SLC1A5 variant is a mitochondrial glutamine transporter•The SLC1A5 variant has a mitochondrial targeting sequence•Hypoxia controls SLC1A5 variant expression through HIF-2α•The SLC1A5 variant mediates mitochondrial glutamine metabolism in cancer
Despite the importance of glutamine in cancer metabolism, the mitochondrial glutamine transporter has long been unknown. Yoo et al. show that a variant of SLC1A5 has a mitochondrial targeting signal for mitochondrial localization and is induced by HIF-2α. SLC1A5 variant knockdown suppressed cancer cell growth, supporting an oncogenic role.
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