Objective
We investigated (1) the associations of pre‐stroke aspirin use with thrombus burden, infarct volume, hemorrhagic transformation, early neurological deterioration (END), and functional ...outcome, and (2) whether stroke subtypes modify these associations in first‐ever ischemic stroke.
Methods
This multicenter magnetic resonance imaging (MRI)‐based study included 5,700 consecutive patients with acute first‐ever ischemic stroke, who did not undergo intravenous thrombolysis or endovascular thrombectomy, from May 2011 through February 2014. Propensity score‐based augmented inverse probability weighting was performed to estimate adjusted effects of pre‐stroke aspirin use.
Results
The mean age was 67 years (41% women), and 15.9% (n = 907) were taking aspirin before stroke. Pre‐stroke aspirin use (vs nonuse) was significantly related to a reduced infarct volume (by 30%), particularly in large artery atherosclerosis stroke (by 45%). In cardioembolic stroke, pre‐stroke aspirin use was associated with a ~50% lower incidence of END (adjusted difference = −5.4%, 95% confidence interval CI = −8.9 to −1.9). Thus, pre‐stroke aspirin use was associated with ~30% higher likelihood of favorable outcome (3‐month modified Rankin Scale score < 3), particularly in large artery atherosclerosis stroke and cardioembolic stroke (adjusted difference = 7.2%, 95% CI = 1.8 to 12.5 and adjusted difference = 6.4%, 95% CI = 1.7 to 11.1, respectively). Pre‐stroke aspirin use (vs nonuse) was associated with 85% less frequent cerebral thrombus‐related susceptibility vessel sign (SVS) in large artery atherosclerosis stroke (adjusted difference = −1.4%, 95% CI = −2.1 to −0.8, p < 0.001) and was associated with ~40% lower SVS volumes, particularly in cardioembolic stroke (adjusted difference = −0.16 cm3, 95% CI = −0.29 to −0.02, p = 0.03). Moreover, pre‐stroke aspirin use was not significantly associated with hemorrhagic transformation (adjusted difference = −1.1%, p = 0.09).
Interpretation
Pre‐stroke aspirin use associates with improved functional independence in patients with first‐ever ischemic large arterial stroke by reducing infarct volume and/or END, likely by decreasing thrombus burden, without increased risk of hemorrhagic transformation. ANN NEUROL 2021;90:763–776
We introduce a new clocking approach for digital systems to achieve better resilience to process, voltage, and temperature (PVT) variations. The proposed scheme is based on elastic clock methodology ...that uses locally generated clocks and elastic handshaking control, thereby achieving efficient and fast adaptation to the variations. However, the elastic clock-based design still requires a significant amount of timing margins due to delay mismatch between the critical path and the replica path for local clock generation, thus reducing the advantages of the elastic clock. We propose a timing error correction scheme tailored to the elastic clock methodology to eliminate such an extra timing margin. We implement an encryption/decryption core in 28-nm CMOS technology for silicon verification. Measurement results show that the proposed scheme reduces energy consumption by 35% and achieves 3.86<inline-formula> <tex-math notation="LaTeX">\times </tex-math></inline-formula> higher performance over the margined baseline design.
Chronic liver disease encompasses diseases that have various causes, such as alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Gut microbiota dysregulation plays a key role ...in the pathogenesis of ALD and NAFLD through the gut-liver axis. The gut microbiota consists of various microorganisms that play a role in maintaining the homeostasis of the host and release a wide number of metabolites, including short-chain fatty acids (SCFAs), peptides, and hormones, continually shaping the host's immunity and metabolism. The integrity of the intestinal mucosal and vascular barriers is crucial to protect liver cells from exposure to harmful metabolites and pathogen-associated molecular pattern molecules. Dysbiosis and increased intestinal permeability may allow the liver to be exposed to abundant harmful metabolites that promote liver inflammation and fibrosis. In this review, we introduce the metabolites and components derived from the gut microbiota and discuss their pathologic effect in the liver alongside recent advances in molecular-based therapeutics and novel mechanistic findings associated with the gut-liver axis in ALD and NAFLD.
Insects are the most abundant animals on Earth, and the microbiota within their guts play important roles by engaging in beneficial and pathological interactions with these hosts. In this study, we ...comprehensively characterized insect-associated gut bacteria of 305 individuals belonging to 218 species in 21 taxonomic orders, using 454 pyrosequencing of 16S rRNA genes. In total, 174,374 sequence reads were obtained, identifying 9,301 bacterial operational taxonomic units (OTUs) at the 3% distance level from all samples, with an average of 84.3 (± 97.7) OTUs per sample. The insect gut microbiota were dominated by Proteobacteria (62.1% of the total reads, including 14.1% Wolbachia sequences) and Firmicutes (20.7%). Significant differences were found in the relative abundances of anaerobes in insects and were classified according to the criteria of host environmental habitat, diet, developmental stage, and phylogeny. Gut bacterial diversity was significantly higher in omnivorous insects than in stenophagous (carnivorous and herbivorous) insects. This insect-order-spanning investigation of the gut microbiota provides insights into the relationships between insects and their gut bacterial communities.
The acquisition of physiological data are essential to efficiently predict and treat cardiac patients before a heart attack occurs and effectively expedite motor recovery after a stroke. This goal ...can be achieved by using wearable wireless sensor network platforms for real-time healthcare monitoring. In this paper, we present a wireless physiological signal acquisition device and a smartphone-based software platform for real-time data processing and monitor and cloud server access for everyday ECG/EMG signal monitoring. The device is implemented in a compact size (diameter: 30 mm, thickness: 4.5 mm) where the biopotential is measured and wirelessly transmitted to a smartphone or a laptop for real-time monitoring, data recording and analysis. Adaptive digital filtering is applied to eliminate any interference noise that can occur during a regular at-home environment, while minimizing the data process time. The accuracy of ECG and EMG signal coverage is assessed using Bland-Altman analysis by comparing with a reference physiological signal acquisition instrument (RHS2116 Stim/Recording System, Intan). Signal coverage of R-R peak intervals showed almost identical outcome between this proposed work and the RHS2116, showing a mean difference in heart rate of 0.15 ± 4.65 bpm and a Wilcoxon's
value of 0.133. A 24 h continuous recording session of ECG and EMG is conducted to demonstrate the robustness and stability of the device based on extended time wearability on a daily routine.
Stress leaves a lasting impression on an organism and reshapes future responses. However, the influence of past experience and stress hormones on the activity of neural stress circuits remains ...unclear. Hypothalamic corticotropin-releasing hormone (CRH) neurons orchestrate behavioral and endocrine responses to stress and are themselves highly sensitive to corticosteroid (CORT) stress hormones. Here, using in vivo optical recordings, we find that CRH neurons are rapidly activated in response to stress. CRH neuron activity robustly habituates to repeated presentations of the same, but not novel stressors. CORT feedback has little effect on CRH neuron responses to acute stress, or on habituation to repeated stressors. Rather, CORT preferentially inhibits tonic CRH neuron activity in the absence of stress stimuli. These findings reveal how stress experience and stress hormones modulate distinct components of CRH neuronal activity to mediate stress-induced adaptations.
The development of safe, reliable, yet economical energy storage has been reemphasized with recent incidents involving the explosion and subsequent recall of lithium‐ion batteries. The organic liquid ...electrolyte used in the conventional lithium‐ion battery can potentially act as a fuel for combustion in a thermal‐runaway reaction, and hence an alternative with a significantly reduced flammability must be sought. All‐solid‐state batteries have the potential to meet safety and reliability requirements with the possibility of increasing the volumetric energy density of the system, making these a promising candidate for the development of the next generation of energy storage. Moreover, the sodium‐ion battery exhibits a better cost‐efficiency without significantly compromising the energy density, making the combination of the sodium chemistry with the solid electrolyte an attractive choice for safe and economical energy storage. Here, a general background on the recent development of ceramic and glass‐ceramic sodium‐ion‐conducting electrolytes is provided with regard to oxide‐, sulfide‐, and hydride‐based electrolytes. The ionic conductivity, chemical stability, and mechanical properties of the sodium‐based solid electrolyte are discussed, which is followed by a perspective on future developments in the field.
A general overview of the development of Na‐ion‐conducting solid electrolytes is discussed. Specifically, the properties of oxide‐, sulfide‐, and hydride‐type solid electrolytes are explored: the ionic conductivity, chemical stability, and mechanical properties. Furthermore, a brief background on the development and a perspective on the future direction for Na‐ion‐conducting solid electrolytes are given.
Forward osmosis (FO) has been increasingly studied in the past decade for its potential as an emerging low-energy water and wastewater treatment process. However, the term “low-energy” may only be ...suitable for those applications in where no further treatment of the draw solution (DS) is required either in the form of pretreatment or post-treatment to the FO process (e.g. where the diluted DS is the targeted final product which can be used directly or simply discarded). In most applications, FO has to be coupled with another separation process in a so-called hybrid FO system to either separate the DS from the final product water or to be used as an advanced pre-treatment process to conventional desalination technologies. The additional process increases the capital cost as well as the energy demand of the overall system which is one of the several challenges that hybrid FO systems need to overcome to compete with other separation technologies. Yet, there are some applications where hybrid FO systems can outperform conventional processes and this study aims to provide a comprehensive review on the current state of hybrid FO systems. The recent development and performance of hybrid FO systems in different applications have been reported. This review also highlights the future research directions for the current hybrid FO systems to achieve successful implementation.
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•In most applications, FO is coupled with another process to form a hybrid system.•The recent development and performance of hybrid FO systems have been reviewed.•Hybrid FO systems can outperform conventional processes in some applications.•Future research directions to achieve full-scale implementation have been discussed.
A breakthrough was achieved this year by Okuzumi and colleagues, who successfully detected misfolded α-synuclein in serum through a modified seed amplification assay.1 Using immunoprecipitation ...followed by real-time quaking-induced conversion (RT-QUIC) in serum samples, the investigators showed high diagnostic performance in distinguishing a study group with clinically diagnosed Parkinson's disease (n=221) and multiple system atrophy (n=39) from non-neurodegenerative controls (n=128; area under the curve 0·96 95% CI 0·95–0·99 in Parkinson disease and 0·64 0·49–0·79 in multiple system atrophy).Okuzumi and colleagues identified structural differences between serum immunoprecipitation-RT-QUIC-derived amplified seeds from people with Parkinson's disease and those with multiple system atrophy. H-JK has received research funds from the Seoul National University Hospital, the National Information Society Agency, the Ministry of Science and ICT, the Ministry of Health and Welfare, Samil Pharmaceutical, Emocog, GemVax and KAEL, and Bukwang Pharm; and has received a travel grant from the International Parkinson and Movement Disorder Society. BJ reports grants or contracts from Peptron Korea, Abbvie Korea, and GemVax and KAEL; received consulting fees from AspenNeuroscience; received payment or honoraria for lectures for the Asian and Oceanian Parkinson's Disease and Movement Disorders Congress (AOPMC) 2023, Neurophysiology Education Course MDS–Asian and Oceanian Section (MDS-AOS), International Association of Parkinsonism and Related Disorders 2023, MDS-AOS Parkinson's disease online course, World Congress of Neurology (WCN) 2023, Asian Oceanian Congress of Neurology (AOCN) 2022, Movement Disorder Society of Australia and New Zealand 2022, WCN 2021, Mongolia Developing World Education Program 2021, Taichung Veterans General Hospital 40th Celebration 2021, MDS 2021, Basic Science Summer School Taiwan 2021, AOPMC 2021, and AOCN 2021; received support for attending meetings or travel from MDS 2022; and has a patent registered patent (South Korea), patent pending (South Korea), and patent pending (USA) for the apparatus and method for quantitative gait analysis based on single 2D video.
With the onset of COVID-19 and the resulting shelter in place guidelines combined with remote working practices, human mobility in 2020 has been dramatically impacted. Existing studies typically ...examine whether mobility in specific localities increases or decreases at specific points in time and relate these changes to certain pandemic and policy events. However, a more comprehensive analysis of mobility change over time is needed. In this paper, we study mobility change in the US through a five-step process using mobility footprint data. (Step 1) Propose the Delta Time Spent in Public Places (DELTATSPP) as a measure to quantify daily changes in mobility for each US county from 2019-2020. (Step 2) Conduct Principal Component Analysis (PCA) to reduce the DELTATSPP time series of each county to lower-dimensional latent components of change in mobility. (Step 3) Conduct clustering analysis to find counties that exhibit similar latent components. (Step 4) Investigate local and global spatial autocorrelation for each component. (Step 5) Conduct correlation analysis to investigate how various population characteristics and behavior correlate with mobility patterns. Results show that by describing each county as a linear combination of the three latent components, we can explain 59% of the variation in mobility trends across all US counties. Specifically, change in mobility in 2020 for US counties can be explained as a combination of three latent components: 1) long-term reduction in mobility, 2) no change in mobility, and 3) short-term reduction in mobility. Furthermore, we find that US counties that are geographically close are more likely to exhibit a similar change in mobility. Finally, we observe significant correlations between the three latent components of mobility change and various population characteristics, including political leaning, population, COVID-19 cases and deaths, and unemployment. We find that our analysis provides a comprehensive understanding of mobility change in response to the COVID-19 pandemic.
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