Aims
A post hoc analysis of RICAMIS trial to evaluate functional outcomes in relation to patient age.
Methods
Patients in RICAMIS were divided into six age groups. The primary outcome was excellent ...functional outcome at 90 days, defined as modified Rankin Scale (mRS) score of 0–1. Compared with patients receiving usual care alone, we investigated the association of remote ischemic conditioning (RIC) effect with functional outcomes in each group and the interaction between RIC effect and age.
Results
Of 1776 patients, 498 were assigned to <60 years, 326 to 60 to <65 years, 325 to 65 to <70 years, 278 to 70 to <75 years, 206 to 75 to <80 years, and 143 to ≥80 years. Higher proportions of primary outcome were found associated with RIC in <60 years group (72.6% vs. 64.8%; adjusted risk difference RD, 6.8%; 95% CI, −1.6% to 15.1%; p = 0.11), 60 to <65 years group (70.7% vs. 67.1%; adjusted RD, 3.1%; 95% CI, −7.2% to 13.3%; p = 0.56), 65 to <70 years group (70.5% vs. 63.6%; adjusted RD, 3.5%; 95% CI, −6.8% to 13.8%; p = 0.51), 70 to <75 years group (59.7% vs. 54.9%; adjusted RD, 4.7%; 95% CI, −7.1% to 16.4%; p = 0.61), 75 to <80 years group (61.5% vs. 55.9%; adjusted RD, 5.7%; 95% CI, −7.8% to 19.1%; p = 0.41), and ≥ 80 years group (59.2% vs. 59.7%; adjusted RD, −2.6%; 95% CI, −18.8% to 13.5%; p = 0.75). No significant interaction between RIC effect and age was found among groups.
Conclusions
This is the first report that RIC effect may be attenuated with increasing age in patients with acute moderate ischemic stroke with respect to functional outcome.
Remote ischemic postconditioning may be effective across age with respect to excellent functional outcome at 90 days, but the effect will be attenuated with increasing age in patients with acute moderate ischemic stroke who are not candidate for intravenous thrombolysis or endovascular therapy.
The neutrophil-to-lymphocyte ratio (NLR) has been demonstrated as a prognostic inflammatory biomarker in ischemic stroke. The study aimed to investigate the association of NLR and its dynamic change ...with long-term outcome and mortality in acute ischemic stroke (AIS) patients who received intravenous thrombolysis (IVT).
From a prospective cohort, AIS patients receiving IVT (alteplase, 0.9 mg/kg) with complete NLR data were retrospectively screened. Based on 3-month modified Rankin scale score (mRS), patients were classified into good group (mRS 0-1) and poor outcome group (mRS 2-6), or survival group (mRS 0-5) and death group (mRS 6). Multivariate logistic regression analysis and receiver operating curve were used to identify prognostic factors and their predictive powers.
A total of 259 eligible patients were enrolled in our study. Logistic regression analysis showed that NLR at 24 h (adjusted odds ratio aOR 1.182), 12 days (aOR 1.218) after IVT was independent predictors of 3-month outcome with the AUC of 0.815, 0.820, respectively, whereas NLR at 24 h (aOR 1.17), 12 days (aOR 1.252) after IVT and percentage changes of NLR between admission and 24 h after IVT (aOR 1.214), and between admission and 12 days after IVT (aOR 1.233) were independent predictors of 3-month mortality with the AUCs of 0.86, 0.902, 0.814, and 0.855, respectively.
The comprehensive report suggests that NLR and its dynamic changes are associated with 3-month outcome and mortality in AIS patients after IVT with good predictive powers.
Anterior circulation stroke (ACS) differs from posterior circulation stroke (PCS) in many ways, but it remains unclear whether there is any difference in early neurological deterioration (END) in two ...stroke territories. We compared post-thrombolytic END between ACS and PCS based on the data from INTRECIS. We screened patients receiving intravenous 0.9 mg/kg alteplase within 4.5 h in the INTRECIS cohort. According to stroke territory, patients were divided into ACS and PCS groups. The primary outcome was incidence of END, which was defined as an increase in NIHSS score ≥ 4 or death within 24 h from baseline. The secondary outcomes were associated factors of END and 90-day modified Rankin Scale (mRS) distribution. Overall, 1194 patients were enrolled in this study: 942 in ACS group and 252 in PCS group. There was no significant difference in the incidence of END between two groups (3.8% vs 5.2%, adjusted p = 0.406). Atrial fibrillation (adjusted p = 0.012) and TOAST classification (adjusted p = 0.009) were associated with END in ACS, while hypertension history (adjusted p = 0.046) and baseline NIHSS score (adjusted p = 0.011) with END in PCS. END was associated with worse outcome on 90-day mRS in ACS and PCS (adjusted p < 0.001). Based on a prospective nationwide cohort, we provided first report for similar incidence, but different risk factors of post-thrombolytic END in ACS vs PCS patients.Trial Registration-URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02854592.
Objective
We conducted a post hoc exploratory analysis of Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke (RICAMIS) to determine whether early remote ischemic conditioning (RIC) ...initiation after stroke onset was associated with clinical outcome in patients with acute moderate ischemic stroke.
Methods
In RICAMIS, patients receiving RIC treatment in the intention‐to‐treat analysis were divided into 2 groups based on onset‐to‐treatment time (OTT): early RIC group (OTT ≤ 24 hours) and late RIC group (OTT 24–48 hours). Patients receiving usual care without RIC treatment from intention‐to‐treat analysis were assigned as the control group. The primary outcome was excellent functional outcome at 90 days.
Results
Among 1,776 patients from intention‐to‐treat analysis, 387 were in the early RIC group, 476 in the late RIC group, and 913 in the control group. In the post hoc exploratory analysis, a higher proportion of excellent functional outcome was found in the early RIC versus control group (adjusted absolute difference = 8.1%, 95% confidence interval CI = 2.5%–13.8%, p = 0.005), but no difference in outcomes was detected in the late RIC versus control group (adjusted absolute difference = 3.3%, 95% CI = −2.1% to 8.6%, p = 0.23), or in the early RIC versus late RIC group (adjusted absolute difference = 5.0%, 95% CI = −1.3% to 11.2%, p = 0.12). Similar results were found in the per‐protocol analysis.
Interpretation
Among patients with acute moderate ischemic stroke who are not candidates for intravenous thrombolysis or endovascular therapy, early RIC initiation within 24 hours of onset may be associated with higher likelihood of excellent clinical outcome. ANN NEUROL 2023;94:561–571
In this study, a solution method derived dual‐band photodetector (PD) based on silicon nanowires /PbS nanocrystalline film n–n heterojunction, which exhibits typical bias‐selectable spectral response ...in both near‐infrared (NIR) and short‐wave infrared (SWIR) bands, is presented. It is found that by adjusting the polarity of the bias voltage, the photoresponse of the device can be switched between three operation modes. The device exhibits high responsivities of 2100 mA W−1 at −0.15 V and 31 mA W−1 at 0 V, respectively, in the NIR region. Remarkably, the maximum responsivity and detectivity under 2000 nm illumination are determined as 290 mA W−1 and 2.4 × 1010 Jones, comparable to or even better than some PbS commercial PDs. The enhanced performance comes from the improved optical absorption and higher efficiency of charge separation and collection owing to the heterojunction geometry. It's also revealed that the bias‐controllable spectral response is attributed to the selectively transportation of photocarriers across the junction barrier. The study demonstrates the capability of detecting two distinct IR regions with the same pixel, which has great potential in future optoelectronic systems for IR imaging applications.
This study presents a solution method derived dual‐band photodetector based on silicon nanowires/PbS nanocrystalline film n–n heterojunction, exhibiting an enhanced photoresponse in both near‐infrared and short‐wave infrared bands. The fabricated heterojunction device with a huge difference between energy barriers of conduction and valence bands are characterized by a bias‐selectable spectral response, showing three operation modes in distinct IR regions.
The Omicron variant of concern (VOC) has surged in many countries and replaced the previously reported VOC. To identify different Omicron strains/sublineages on a rapid, convenient, and precise ...platform, we report a novel multiplex real‐time reverse transcriptase polymerase chain reaction (RT‐PCR) method in one tube based on the Omicron lineage sequence variants' information. Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) subvariants were used in a PCR‐based assay for rapid identification of Omicron sublineage genotyping in 1000 clinical samples. Several characteristic mutations were analyzed using specific primers and probes for the spike gene, del69–70, and F486V. To distinguish Omicron sublineages (BA.2, BA.4, and BA.5), the NSP1:141–143del in the ORF1a region and D3N mutation in membrane protein occurring outside the spike protein region were analyzed. Results from the real‐time PCR assay for one‐tube accuracy were compared to those of whole genome sequencing. The developed PCR assay was used to analyze 400 SARS‐CoV‐2 positive samples. Ten samples determined as BA.4 were positive for NSP1:141–143del, del69–70, and F486V mutations; 160 BA.5 samples were positive for D3N, del69–70, and F486V mutations, and 230 BA.2 samples were without del69–70. Screening these samples allowed the identification of epidemic trends at different time intervals. Our novel one‐tube multiplex PCR assay was effective in identifying Omicron sublineages.
Background and Purpose
The present study aimed to determine sex difference in clinical outcomes after Remote Ischemic Conditioning for Acute Moderate Ischemic Stroke (RICAMIS).
Methods
In this ...secondary analysis of the RICAMIS study, eligible patients aged 18 years or older with acute moderate ischemic stroke who received remote ischemic conditioning (RIC) within 48 h of stroke onset were divided into two groups: men and women. The primary endpoint was an excellent functional outcome, defined as a modified Rankin Scale score of 0–1 at 90 days. Binary logistic regression analyses and generalized linear models were used.
Results
Of 1707 eligible patients, 34% (579) were women. Women had a higher burden of hypertension and diabetes, and less alcohol and smoking consumption than men. The mean systolic blood pressure and blood glucose level at randomization were higher in women than in men. Compared with the control group, RIC was associated with an increased rate of primary endpoint in men (unadjusted odds ratio OR = 1.277; 95% confidence interval CI 0.933–1.644; p = 0.057) and women (unadjusted OR = 1.454; 95% CI 1.040–2.032; p = 0.028). Furthermore, a higher absolute risk difference in primary endpoint between control and RIC groups was found in women (9.2%) than in men (5.7%), but there was no significant interaction effect between sex and intervention on primary outcome (p interaction = 0.545).
Conclusion
Compared with men, women may have a higher probability of excellent functional outcomes at 90 days in the RIC group than in the control group; however, no interaction effect between sex and intervention was found.
Due to the rapid development of information technology, web‐based learning has become a dominant trend. That is, learners can often learn anytime and anywhere without being restricted by time and ...space. Autonomic learning primarily occurs in web‐based learning environments, and self‐regulated learning (SRL) is key to autonomic learning performance. Moreover, sustained attention to web‐based learning activities can be challenging for students. Therefore, a web‐based reading annotation system with an attention‐based self‐regulated learning mechanism (ASRLM), which is based on brainwave detection, is designed to enhance the sustained attention of learners while reading annotated English texts online, and thereby promote online reading performance. In total, 126 Grade 7 students in four classes at a junior high school in New Taipei City, Taiwan, are the participants. Among the four classes, two classes are randomly distributed to the experimental group and the other two classes are randomly distributed to the control group. The experimental group utilizes the ASRLM to support their reading of annotated English texts online, whereas the control group is not supported by the ASRLM while reading annotated English texts online. Experimental results show that sustained attention and reading comprehension of the experimental group are better than those of the control group. Moreover, the web‐based reading system with ASRLM support promotes the sustained attention and reading comprehension of female learners more than those of male learners while reading annotated English texts online. Additionally, learners with high‐SRL ability in the experimental group have better sustained attention and reading comprehension than those learners with low‐SRL ability. Furthermore, the sustained attention and reading comprehension of the experimental group are strongly correlated, and the duration of sustained attention strongly predicts their reading comprehension performance.
Dysregulation of circular RNAs (circRNAs) plays an important role in the development of gastric cancer; thus, revealing the biological and molecular mechanisms of abnormally expressed circRNAs is ...critical for identifying novel therapeutic targets in gastric cancer.
A circRNA microarray was performed to identify differentially expressed circRNAs between primary and distant metastatic tissues and between gastric cancer tissues sensitive or resistant to anti-programmed cell death 1 (PD-1) therapy. The expression of circRNA discs large homolog 1 (DLG1) was determined in a larger cohort of primary and distant metastatic gastric cancer tissues. The role of circDLG1 in gastric cancer progression was evaluated both in vivo and in vitro, and the effect of circDLG1 on the antitumor activity of anti-PD-1 was evaluated in vivo. The interaction between circDLG1 and miR-141-3p was assessed by RNA immunoprecipitation and luciferase assays.
circDLG1 was significantly upregulated in distant metastatic lesions and gastric cancer tissues resistant to anti-PD-1 therapy and was associated with an aggressive tumor phenotype and adverse prognosis in gastric cancer patients treated with anti-PD-1 therapy. Ectopic circDLG1 expression promoted the proliferation, migration, invasion, and immune evasion of gastric cancer cells. Mechanistically, circDLG1 interacted with miR-141-3p and acted as a miRNA sponge to increase the expression of CXCL12, which promoted gastric cancer progression and resistance to anti-PD-1-based therapy.
Overall, our findings demonstrate how circDLG1 promotes gastric cancer cell proliferation, migration, invasion and immune evasion and provide a new perspective on the role of circRNAs during gastric cancer progression.
PDF
