Rescue intracranial stenting for acute ischemic stroke after the failure of mechanical thrombectomy: A systematic review, meta-analysis, and trial sequential analysis

BackgroundIntracranial rescue stenting (RS) might be an option for acute ischemic stroke after the failure of mechanical thrombectomy (MT). However, the findings were not consistent in previous systematic reviews, and whether the conclusion was supported by sufficient statistical power is unknown.AimTo examine the effect of RS on acute ischemic stroke after the failure of MT with a systematic review, meta-analysis, and trial sequential analysis (TSA).MethodsWe searched Ovid Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to 15 June 2022, without any language restriction. Studies assessing the effect of RS for acute ischemia stroke after MT failure were included. Two reviewers independently screened the retrieved articles, extracted data, and evaluated the quality of the included studies through the New Ottawa Scale (NOS). The primary outcome was the recanalization rate after RS. Secondary outcomes included modified Rankin Scale (mRS) at 3 months after stroke, symptomatic intracranial hemorrhage (sICH), and mortality rate. We synthesized the data through a random-effects model and performed a TSA analysis.ResultsWe included 15 studies (containing 1,595 participants) after screening 3,934 records. The pooled recanalization rate for rescue stenting was 82% (95% CI 77–87%). Compared with non-stenting, rescue stenting was associated with a higher proportion of patients with 0–2 mRS score (OR 3.96, 95% CI 2.69–5.84, p < 0.001) and a lower 90-day mortality rate (OR 0.46, 95% CI 0.32–0.65, p < 0.001), and stenting did not increase sICH rate (OR 0.63, 95% CI 0.39–1.04, p = 0.075). The TSA analysis showed that the meta-analysis of the mRS score had a sufficient sample size and statistical power.ConclusionsOur study showed that rescue stenting was effective and safe for patients with acute ischemia stroke who also had a failed MT, and this result was confirmed in a TSA analysis

Studies of the Mg-Al and cation-incorporated hydrotalcites

Mg-Al and cation-incorporated(containing Zn2+Ni2+Fe3+) hydrotalcites were synthesized and characterized. A detailed comparative analysis of structure and composition was made. Different cations influenced strongly textural parameters of hydrotalcites and the basicity of the obtained Mg-Al oxides after calcinations. With the cation incorporation, the distance of the brucite and the mount of CO32- as the compensating anion changed. Meanwhile the CO2-TPD was used to determine the basicity of the samples. The results showed that the basicity of the calcined hydrotalcites reduced. Finally, the activated hydrotalcite catalysts may efficiently replace homogeneous catalysts in Claisen-Schmidt condensation reaction of the benzaldehyde and propanal. And it was noteworthy that the calcined cation-type (containing Zn2+, Fe3+) hydrotalcites as catalysts did not show significant activity, in agreement with their low basicity

Evaluation of stroke topographic patterns and intracerebral hemodynamics in unilateral internal carotid artery stenosis or occlusion

Objective To study the pathogenesis of cerebrovascular disorders by analysing the categories of cerebral infarct on magnetic resonance imaging (MRI) and intracerebral hemodynamics of patients with unilateral atherosclerotic internal carotid artery stenosis or occlusion (ICASO). Methods From August 2007 to May 2009, 87 ischemic stroke patients who were diagnosed arteriosclerosis ICASO by cerebral arteriography were investigated in Department of Neurology, the First Teaching Hospital of Xinjiang Medical University. Patients with potential cardiac sources of embolism were excluded. Cerebral infarct patterns were detected by MRI and the difference in cerebral hemodynamics were analysed by transcranial Doppler (TCD) among different imaging patterns. Results The infarct patterns in 87 patients were divided into 4 groups: territory infarcts (n = 30, 34.48%), subcortical infarcts (n = 27, 31.03%), border⁃ zone infarcts (n = 18, 20.69%), and disseminated small infarcts (n = 12, 13.79%). The distribution ratio of topographic patterns was significant in different degree of ICASO (χ2 = 7.156, P = 0.028). The topographic pattern was negatively correlated with the degree of ICASO (r = ⁃ 0.275, P = 0.010). Serious internal carotid artery (ICA) stenosis was associated with subcortical infarcts, border⁃zone infarcts (11/36, 30.56%, for all); territory infarcts showed a strong trend to appear mostly in patients with total ICA occulation (17/34, 50.00%). Seventy⁃five cases were involved in the hemodynamics analysis. In different groups of patient the mean flow velocity (Vm) and blood vessel pulsatility index (PI) of the affected side were all significantly lower than those of the intact side, while the lowest was shown in territory infarcts, and then in border⁃zone infarcts (P = 0.000, for all). Conclusion ICASO is mostly seen in patients with territory infarct, and hemodynamic disorder may occur in all infarct patterns. Therefore, cerebral infarct patterns and hemodynamic changes should be adequately considered for selecting optimal therapeutic and preventive measures. DOI：10.3969/j.issn.1672-6731.2011.03.01

Cerium promoted Pd/HZSM-5 catalyst for methane combustion

A series of Pd/HZSM-5 (Si/Al-2 = 165) catalysts without and with additives of oxides of La, Ce, Sm, Nd and Tb were prepared by the impregnation method, and characterized by XRD, Raman spectra, N-2-adsorption, CO-chemisorption, O-2-TPD and CH4-TPR techniques. The catalysts were investigated for low-temperature CH4 combustion, and CeO2 was found to have a significant promoting effect on the activity of Pd/HZSM-5. Pd-Ce/HZSM-5 showed the best methane combustion activity and the improved thermal/hydrothermal reaction stability among tested catalysts. The characterization results of catalysts indicated that CeO2 can effectively promote the formation of crystalline PdO and weaken the bond strength of PdO on Pd-Ce/HZSM-5, resulting in that Pd-Ce/HZSM-5 possessed lower temperatures for oxygen desorption and CH4 reduction than Pd/HZSM-5. This could be ascribed to the covalent property and large oxygen storage/supplying capacity of CeO2. lt is believed that more active PdO species on Pd/HZSM-5 for low-temperature methane combustion process could be effectively promoted due to the introduction of CeO2. (c) 2006 Elsevier Ltd. All rights reserved

Synchronization of a Passive Oscillator and a Liquid Crystal Elastomer Self-Oscillator Powered by Steady Illumination

Self-oscillators have the advantages of actively harvesting energy from external steady environment, autonomy, and portability, and can be adopted as an engine to drive additional working equipment. The synchronous behavior of self-oscillators and passive oscillators may have an important impact on their functions. In this paper, we construct a self-oscillating system composed of a passive oscillator and an active liquid crystal elastomer self-oscillator powered by steady illumination, and theoretically investigate the synchronization of two coupled oscillators. There exist three synchronous regimes of the two coupled oscillators: static, in-phase, and anti-phase. The mechanisms of self-oscillations in in-phase and anti-phase synchronous regimes are elucidated in detail by calculating several key physical parameters. In addition, the effects of spring constant, initial velocity, contraction coefficient, light intensity, and damping coefficient on the self-oscillations of two coupled oscillators are further investigated, and the critical conditions for triggering self-oscillations are obtained. Numerical calculations show that the synchronous regime of self-oscillations is mainly determined by the spring constant, and the amplitudes of self-oscillations of two oscillators increase with increasing contraction coefficient, light intensity, and spring constant, while decrease with increasing damping coefficient. This study deepens the understanding of synchronization between coupled oscillators and may provide new design ideas for energy harvesters, soft robotics, signal detection, active motors, and self-sustained machinery

Effects of Cardiorespiratory Fitness on Blood Pressure Trajectory With Aging in a Cohort of Healthy Men

AbstractBackgroundAlthough the trajectory of blood pressure (BP) with aging is well known, there is a lack of data on how cardiorespiratory fitness (hereafter referred to as fitness) affects age-associated changes in BP.ObjectivesThe objective of the study was to investigate whether fitness alters the aging-BP trajectory.MethodsA cohort from the Aerobics Center Longitudinal Study totaling 13,953 men between 20 and 90 years of age who did not have hypertension, cardiovascular disease, or cancer completed 3 to 28 (mean of 3.8) follow-up medical examinations between 1970 and 2006. Fitness was measured by a maximal treadmill exercise test. Longitudinal data were analyzed using linear mixed models.ResultsDiastolic blood pressure (DBP) tended to increase until nearly 60 years of age, when a decrease was observed. Systolic blood pressure (SBP) tended to increase over all age periods. On multivariate analysis, average SBP increased by 0.30 mm Hg (95% confidence interval: 0.29 to 0.31) with 1-year age increment after adjusting for body fat percent, fitness, resting heart rate, glucose level, triglyceride level, cholesterol level, current smoking, heavy alcohol consumption, and parental history of hypertension. DBP had a yearly increase of 0.14 mm Hg (95% confidence interval: 0.13 to 0.15) before age 60 years. Overall, abnormal SBP (>120 mm Hg) began to occur at approximately 50 years of age and abnormal DBP (>80 mm Hg) began to occur at 60 years of age. Men with higher fitness levels experienced abnormal SBP later than those with low fitness levels.ConclusionsOur findings underscore the potential modifying effect of fitness on BP trajectory with aging over the male adult life span. Improving fitness levels might extend the normal SBP and DBP ranges, delaying the development of hypertension

Carbon-supported PtAu alloy nanoparticle catalysts for enhanced electrocatalytic oxidation of formic acid

The understanding of the electrocatalytic activity of bimetallic nanoparticle catalysts requires the ability to precisely control the composition and phase properties. In this report, we describe a new strategy in the preparation of a series of carbon supported platinum-gold bimetallic nanoparticles with various bimetallic compositions which were loaded onto a carbon black support and subjected subsequently by thermal treatment (Pt(100-m)Au(m)/C). The Pt(100-m)Au(m)/C catalysts are characterized by X-ray diffraction (XRD), transmission electron spectroscopy (TEM), and induced coupled plasma-atomic emission spectroscopy (ICP-AES). The XRD pattern for the bimetallic nanoparticles shows single-phase alloy character. This ability enabled us to establish the correlation between the bimetallic composition and the electrocatalytic activity for formic acid (FA) electrooxidation. The electrocatalytic activities of the catalysts toward FA oxidation reaction are shown to strongly depend on the bimetallic PtAu composition. Within a wide range of bimetallic composition, the Pt(50)Au(50)/C catalyst shows the highest electrocatalytic activity for the FA oxidation, with a mass activity eight times higher than that of Pt/C. The high performance of the PtAu/C catalyst can be ascribed to the increased selectivity toward the FA dehydrogenation at the decreased availability of adjacent Pt atoms. (C) 2011 Elsevier B.V. All rights reserved.National Natural Science Foundation of China[NSFC 20973140]; National Science Foundation[CBET-0709113

The relationship between dietary inflammatory index and metabolic syndrome and its components: a case study in Kashi urban, Xinjiang

IntroductionThis paper examines the association between the dietary inflammatory index (DII) and the risk of metabolic syndrome (MS) and its components among Uygur adults in Kashi, Xinjiang.MethodsThe study used the multi-stage random cluster sampling method to investigate the adult residents of Uighu aged over 18 years old in one county and one township/street of three cities in Kashi between May and June 2021. All dietary data collected were analyzed for energy and nutrient intake with a nutritional analysis software, followed by a calculation of DII. Logistic regression was used to estimate the association between DII and the risks of MS and its components.ResultsThe maximum DII value across our 1,193 respondents was 4.570 to 4.058, with an average value of 0.256. When we analyzed the DII as a continuous variable, we determined the anti-inflammatory diet has been identified as a mitigating factor for metabolic syndrome (OR = 0.586, 95% CI = 0.395–0.870), obesity (OR = 0.594, 95% CI = 0.395–0.870), elevated fasting glucose levels (OR = 0.422, 95% CI = 0.267–0.668), and hypertension (OR = 0.698, 95% CI = 0.488–0.996). When the model was adjusted by sex, age, and occupation, we found a significant correlation between high- and low-density lipoproteinemia and DII (OR = 1.55, 95% CI = 1.040–2.323). The present study identified four distinct dietary patterns among the population under investigation. There was a linear trend in the incidence of MS and hypertension across low, middle, and high levels of fruits and milk dietary pattern model (p = 0.027; p = 0.033), within this dietary pattern may serve as protective factors against MS and hypertension, suggesting that fruits and milk within this dietary pattern may serve as protective factors against MS and hypertension. And the linear trend in the incidence of elevated fasting glucose and obesity across the low, medium, and high scores of meet and eggs dietary pattern (p = 0.006; p < 0.001), suggest that a diet rich in meat may potentially contribute to an increased risk of developing elevated fasting glucose levels and obesity. An observed linear trend in the incidence rate of high fasting blood glucose across low, moderate, and high scores of dried fruits and nuts dietary pattern (p = 0.014), indicating that increased consumption of nuts acted as a protective factor against elevated fasting blood glucose levels and contributed to their reduction.DiscussionThe dietary inflammation index was integrated with the findings from the study on the dietary patterns of the sampled population, revealing that an anti-inflammatory diet demonstrated a protective effect against metabolic syndrome, obesity, high fasting blood glucose, and hypertension in this specific population. laying the foundation for further research

Cost-effectiveness of tirofiban for acute ischemic stroke without large or medium-sized vessel occlusion: A Markov modelling analysis from the Chinese and United States perspectives.

BackgroundThe RESCUE BT2 trial recently showcased the efficacy of tirofiban in treating acute ischemic stroke (AIS) without large or medium-sized vessel occlusion. To further assess the value of tirofiban from the perspectives of Chinese and US healthcare system, a study was conducted to evaluate its cost-effectiveness.MethodsA hybrid model, integrating a short-term decision tree with a long-term Markov model, was developed to assess cost-effectiveness between tirofiban and aspirin for stroke patients without large or medium-sized vessel occlusion. Efficacy data for tirofiban was sourced from the RESCUE BT2 trial, while cost information was derived from published papers. Outcomes measured included respective cost, effectiveness, and incremental cost-effectiveness ratio (ICER). We conducted a one-way sensitivity analysis to assess the robustness of the results. Additionally, we performed probabilistic sensitivity analysis (PSA) through 10,000 Monte Carlo simulations to evaluate the uncertainties associated with the results.ResultsThe study revealed that tirofiban treatment in AIS patients without large or medium-sized vessel occlusion led to a considerable reduction of 2141 Chinese Yuan (CNY) in total cost, along with a lifetime gain of 0.14 quality-adjusted life years (QALYs). In the US settings, tirofiban also exhibited a lower cost ($197,055 versus$201,984) and higher effectiveness (4.15 QALYs versus 4.06 QALYs) compared to aspirin. One-way sensitivity analysis revealed that post-stroke care costs and stroke utility had the greatest impact on ICER fluctuation in both Chinese and US settings. However, these variations did not exceed the willingness-to-pay threshold. PSA demonstrated tirofiban's superior acceptability over aspirin in over 95% of potential scenarios.ConclusionTirofiban treatment for AIS without large or medium-sized vessel occlusion appeared dominant compared to aspirin in both China and the US