Oral Anticoagulation and Risk of Symptomatic Hemorrhagic Transformation in Stroke Patients Treated With Mechanical Thrombectomy: Data From the Nordictus Registry

Introduction: 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. Materials and Methods: 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. Results: 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], p = 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. Conclusions: 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

Cerebrovascular events and outcomes in hospitalized patients with COVID-19: The SVIN COVID-19 Multinational Registry

© 2020 World Stroke Organization.[Background]: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been associated with a significant risk of thrombotic events in critically ill patients. [Aim]: To summarize the findings of a multinational observational cohort of patients with SARS-CoV-2 and cerebrovascular disease. [Methods]: Retrospective observational cohort of consecutive adults evaluated in the emergency department and/or admitted with coronavirus disease 2019 (COVID-19) across 31 hospitals in four countries (1 February 2020–16 June 2020). The primary outcome was the incidence rate of cerebrovascular events, inclusive of acute ischemic stroke, intracranial hemorrhages (ICH), and cortical vein and/or sinus thrombosis (CVST). [Results]: Of the 14,483 patients with laboratory-confirmed SARS-CoV-2, 172 were diagnosed with an acute cerebrovascular event (1.13% of cohort; 1130/100,000 patients, 95%CI 970–1320/100,000), 68/171 (40.5%) were female and 96/172 (55.8%) were between the ages 60 and 79 years. Of these, 156 had acute ischemic stroke (1.08%; 1080/100,000 95%CI 920–1260/100,000), 28 ICH (0.19%; 190/100,000 95%CI 130–280/100,000), and 3 with CVST (0.02%; 20/100,000, 95%CI 4–60/100,000). The in-hospital mortality rate for SARS-CoV-2-associated stroke was 38.1% and for ICH 58.3%. After adjusting for clustering by site and age, baseline stroke severity, and all predictors of in-hospital mortality found in univariate regression (p < 0.1: male sex, tobacco use, arrival by emergency medical services, lower platelet and lymphocyte counts, and intracranial occlusion), cryptogenic stroke mechanism (aOR 5.01, 95%CI 1.63–15.44, p < 0.01), older age (aOR 1.78, 95%CI 1.07–2.94, p ¼ 0.03), and lower lymphocyte count on admission (aOR 0.58, 95%CI 0.34–0.98, p ¼ 0.04) were the only independent predictors of mortality among patients with stroke and COVID-19. [Conclusions]: COVID-19 is associated with a small but significant risk of clinically relevant cerebrovascular events, particularly ischemic stroke. The mortality rate is high for COVID-19-associated cerebrovascular complications; therefore, aggressive monitoring and early intervention should be pursued to mitigate poor outcomes

Critical points based register-concurrency autotuning for GPUs

The unprecedented prevalence of GPGPU is largely attributed to its abundant on-chip register resources, which allow massively concurrent threads and extremely fast context switch. However, due to internal memory size constraints, there is a tradeoff between the per-thread register usage and the overall thread concurrency. This becomes a design problem in terms of performance tuning, since the performance sweet spot which can be significantly affected by these two factors is generally unknown beforehand. In this paper, we propose an effective autotuning solution to quickly and efficiently select the optimal number of registers perthread for delivering the best GPU performance. Experiments on three generations of GPUs (Nvidia Fermi, Kepler and Maxwell) demonstrate that our simple strategy can achieve an average of 10% performance improvement while a max of 50% over the original version without modifying the user code. Additionally, to reduce local cache misses due to register spilling and further improve performance, we explore three optimization schemes (i.e. bypass L1 for global memory access, enlarge local L1 cache and spill into shared memory) and discuss their impact on performance on a Kepler GPU

A faster parallel algorithm and efficient multithreaded implementations for evaluating betweenness centrality on massive datasets

We present a new lock-free parallel algorithm for computing betweenness centrality of massive complex networks that achieves better spatial locality compared with previous approaches. Betweenness centrality is a key kernel in analyzing the importance of vertices (or edges) in applications ranging from social networks, to power grids, to the influence of jazz musicians, and is also incorporated into the DARPA HPCS SSCA#2, a benchmark extensively used to evaluate the performance of emerging high-performance computing architectures for graph analytics. We design an optimized implementation of betweenness centrality for the massively multithreaded Cray XMT system with the Threadstorm processor. For a small-world network of 268 million vertices and 2.147 billion edges, the 16-processor XMT system achieves a TEPS rate (an algorithmic performance count for the number of edges traversed per second) of 160 million per second, which corresponds to more than a 2 × performance improvement over the previous parallel implementation. We demonstrate the applicability of our implementation to analyze massive real-world datasets by computing approximate betweenness centrality for the large IMDb movie-actor network. 1

Hiperhidrosis primaria, tratamiento mediante simpatectomía por videotoracoscopía.

Introducción: La hiperhidrosis es una condición muy frecuente que dificulta la vida de los pacientes, ya que se sienten o son abiertamente rechazados por las otras personas con las que interactúan. La simpatectomía por toracoscopía se ha convertido en un método efectivo, seguro y asequible para el tratamiento de la hiperhidrosis primaria. Material y métodos: Se reporta aquí la experiencia con esta técnica en 80 pacientes consecutivos, intervenidos durante un período de 24 meses. Resultados: Los resultados obtenidos son comparables con los reportados por otros grupos, así como el grado de satisfacción con el procedimiento. Conclusiones: La simpatectomía por toracoscopía es una intervención sencilla y efectiva para tratar la hiperhidrosis. Se debe trabajar en el perfeccionamiento de la técnica para disminuir la incidencia de la sudoración compensatoria, efecto colateral frecuente y molesto de la intervención.Aim: hyperhidrosis is a frequent condition that complicates the life of the patients. They feel or are actually openly rejected by the persons they interact with. Sympathectomy by videothoracoscopy has become the approach of choice for patients with hyperhidrosis. Material and methods: we herein report our experience with thoracoscopic sympathectomy in 80 consecutive patients, operated upon during 24 months. Results: our results are comparable with those reported by other international groups as well as the degree of satisfaction expressed by the patients. Conclusion: videothoracoscopic sympathectomy is an effective and readily available technique to treat hyperhidrosis. More work is needed to diminish the incidence of compensatory sweating, a frequent and annoying side effect of the procedure

Open Innovation Laboratory for Rapid Realization of Sensing, Smart and Sustainable Products (S3 Products) for Higher Education

Higher education methods need to evolve because the new generations of students are learning in different ways. One way is by adopting emergent technologies, new learning methods and promoting the maker movement. As a result, Tecnologico de Monterrey is developing Open Innovation Laboratories as an immediate response to educational challenges of the world. This paper presents an Open Innovation Laboratory for Rapid Realization of Sensing, Smart and Sustainable Products (S3 Products). The Open Innovation Laboratory is composed of a set of specific resources where students and teachers use them to provide solutions to current problems of priority sectors through the development of a new generation of products. This new generation of products considers the concepts Sensing, Smart, and Sustainable. The Open Innovation Laboratory has been implemented in different courses in the context of New Product Development (NPD) and Integrated Manufacturing Systems (IMS) at Tecnologico de Monterrey. The implementation consists of adapting this Open Innovation Laboratory within the course’s syllabus in combination with the implementation of specific methodologies for product development, learning methods (Active Learning and Blended Learning using Massive Open Online Courses MOOCs) and rapid product realization platforms. Using the concepts proposed it is possible to demonstrate that students can propose innovative and sustainable products, and demonstrate how the learning process could be improved using technological resources applied in the higher educational sector. Finally, examples of innovative S3 products developed at Tecnologico de Monterrey are presented

Early Genomic, Epidemiological, and Clinical Description of the SARS-CoV-2 Omicron Variant in Mexico City

Omicron is the most mutated SARS-CoV-2 variant&mdash;a factor that can affect transmissibility, disease severity, and immune evasiveness. Its genomic surveillance is important in cities with millions of inhabitants and an economic center, such as Mexico City. Results. From 16 November to 31 December 2021, we observed an increase of 88% in Omicron prevalence in Mexico City. We explored the R346K substitution, prevalent in 42% of Omicron variants, known to be associated with immune escape by monoclonal antibodies. In a phylogenetic analysis, we found several independent exchanges between Mexico and the world, and there was an event followed by local transmission that gave rise to most of the Omicron diversity in Mexico City. A haplotype analysis revealed that there was no association between haplotype and vaccination status. Among the 66% of patients who have been vaccinated, no reported comorbidities were associated with Omicron; the presence of odynophagia and the absence of dysgeusia were significant predictor symptoms for Omicron, and the RT-qPCR Ct values were lower for Omicron. Conclusions. Genomic surveillance is key to detecting the emergence and spread of SARS-CoV-2 variants in a timely manner, even weeks before the onset of an infection wave, and can inform public health decisions and detect the spread of any mutation that may affect therapeutic efficacy