Mechanical Thrombectomy for Acute Ischemic Stroke in Metastatic Cancer Patients: A Nationwide Cross-Sectional Analysis

BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) is the standard treatment for large vessel occlusion (LVO) acute ischemic stroke. Patients with active malignancy have an increased risk of stroke but were excluded from MT trials. METHODS: We searched the National Readmission Database for LVO patients treated with MT between 2016-2018 and compared the characteristics and outcomes of cancer-free patients to those with metastatic cancer (MC). Primary outcomes were all-cause in-hospital mortality and favorable outcome, defined as a routine discharge to home (regardless of whether home services were provided or not). Multivariate regression was used to adjust for confounders. RESULTS: Of 40,537 LVO patients treated with MT, 933 (2.3%) had MC diagnosis. Compared to cancer-free patients, MC patients were similar in age and stroke severity but had greater overall disease severity. Hospital complications that occurred more frequently in MC included pneumonia, sepsis, acute coronary syndrome, deep vein thrombosis, and pulmonary embolism (P\u3c0.001). Patients with MC had similar rates of intracerebral hemorrhage (20% vs. 21%) but were less likely to receive tissue plasminogen activator (13% vs. 23%, P\u3c0.001). In unadjusted analysis, MC patients as compared to cancer-free patients had a higher in-hospital mortality rate and were less likely to be discharged to home (36% vs. 42%, P=0.014). On multivariate regression adjusting for confounders, mortality was the only outcome that was significantly higher in the MC group than in the cancerfree group (P\u3c0.001). CONCLUSION: LVO patients with MC have higher mortality and more infectious and thrombotic complications than cancer-free patients. MT nonetheless can result in survival with good outcome in slightly over one-third of patients

Probabilistic Shaping Based Spatial Modulation for Spectral-Efficient VLC

Visible light communication (VLC) is a promising technology for 6th-generation (6G) networks because of its attractive feature such as a wide unlicensed spectrum. In this paper, a novel adaptive coded spatial modulation scheme with probabilistic shaping (PS) is proposed to approach the capacity of the spatial modulation (SM) in VLC channels with intensity modulation and direct detection (IM/DD). In the proposed scheme, spatial and constellation symbols are probabilistically shaped depending on the user's location inside the room and the optical signal-to-noise ratio (OSNR). Moreover, we optimize the channel coding rate to maximize further the achievable rate of the proposed scheme for a given OSNR. Finally, we propose an algorithm to compute the capacity-achieving distribution of the proposed scheme with unipolar M-ary pulse amplitude modulation (PAM) signaling. The proposed scheme outperforms uniform and an orthogonal frequency-division multiplexing (OFDM) based scheme in terms of spectral efficiency (SE) and/or frame error rate (FER). For example, for 8-PAM signaling with N = 8 transmit antennas, the proposed scheme operates within 0.2 dB from the unipolar M-PAM SM VLC channel signaling capacity and outperforms the uniform and OFDM based schemes in terms of FER by at least 1.1 dB and 1.3 dB at a normalized data rate of 1.33 bits per channel use per sub-carrier (b/cu/sc), respectively

Compressive Near-Field Localization For Multipath RIS-aided Environments

Reconfigurable intelligent surfaces (RISs) are considered among the key techniques to be adopted for sixth-generation cellular networks (6G) to enhance not only communications but also localization performance. In this regard, we propose a novel single-anchor localization algorithm for a state-of-the-art architecture where the position of the user equipment (UE) is to be estimated at the base station (BS) with the aid of a RIS. We consider a practical model that accounts for both near-field propagation and multipath environments. The proposed scheme relies on a compressed sensing (CS) technique tailored to address the issues associated with near-field localization and model mismatches. Also, the RIS phases are optimized to enhance the positioning performance, achieving more than one order of magnitude gain in the localization accuracy compared to RISs with non-optimized phases

EMF-Aware Cellular Networks in RIS-Assisted Environments

The deployment of the 5th-generation cellular networks (5G) and beyond has triggered health concerns due to the electric and magnetic fields (EMF) exposure. In this letter, we propose a novel architecture to minimize the population exposure to EMF by considering a smart radio environment with a reconfigurable intelligent surface (RIS). Then, we optimize the RIS phases to minimize the exposure in terms of the exposure index (EI) while maintaining a minimum target quality of service. The proposed scheme achieves up to 20% reduction in EI compared to schemes without RISs

Mobility of LoRaWAN Gateways for Efficient Environmental Monitoring in Pristine Sites

Environmental monitoring of delicate ecosystems or pristine sites is critical to their preservation. The communication infrastructure for such monitoring should have as little impact on the natural ecosystem as possible. Because of their wide range capabilities and independence from heavy infrastructure, low-power wide area network protocols have recently been used in remote monitoring. In this regard, we propose a mobile vehicle-mounted gateway architecture for IoT data collection in communication-network-free areas. The limits of reliable communication are investigated in terms of gateway speed, throughput, and energy consumption. We investigate the performance of various gateway arrival scenarios, focusing on the trade-off between freshness of data, data collection rate, and end-node power consumption. Then we validate our findings using both real-world experiments and simulations. In addition, we present a case study exploiting the proposed architecture to provide coverage for Wadi El-Gemal national park in Egypt. The results show that reliable communication is achieved over all spreading factors (SFs) for gateway speeds up to 150 km/h with negligible performance degradation at SFs=11,12 at speeds more than 100 km/h. The synchronized transmission model ensures the best performance in terms of throughput and power consumption at the expense of the freshness of data. Nonsynchronized transmission allows time-flexible data collection at the expense of increased power consumption. The same throughput as semisynchronized transmission is achieved using four gateways at only five times the energy consumption, while a single gateway requires seventeen times the amount of energy. Furthermore, increasing the number of gateways to ten increases the throughput to the level achieved by the synchronized scenario while consuming eight times the energy

Polyaniline/Glauconite Nanocomposite Adsorbent for Congo Red Dye from Textile Wastewater

Glauconite (Gl), a naturally occurring clay material, was utilized as an affordable and ecologically friendly adsorbent to explore its capturing capacity towards Congo red (CR) dye from textile industrial waste effluent. To improve adsorption and removal effectiveness, a modification technique utilizing polyaniline (PAN) was investigated. An X-ray diffractometer (XRD), a scanning electron microscope (SEM), and Fourier transformer infrared (FTI-R) were applied as strong familiar characterization techniques for all used adsorbents. The effects of starting concentration, contact duration, adsorbent dose, pH, and temperature on the adsorption process were also studied. The reusability of the adsorbent was studied over four adsorption cycles. The results show that PAN modification of Gl enhances the effectiveness of CR elimination. The clearance efficiency of raw and modified glauconite at 25 °C and pH 7 was 77% and 91%, respectively. The kinetics and isotherms of Congo red dye adsorption were investigated using batch studies to determine the impacts of various experimental conditions. The maximum adsorption capacity of the glauconite/polyaniline (Gl/PAN) nanocomposite rose from 11.9 mg/g for Gl to 14.1 mg/g in accordance with the isotherm analysis, which shows that the Langmuir isotherm properly characterizes the experimental data. The pseudo-second-order model (R2 = 0.998) properly expresses the experimental data. The reusability research proved that the adsorbents may be reused effectively. The overall results suggest that the modified Gl by PAN might be used as a low-cost, natural adsorbent for eliminating CR color from textile effluent

Short-term Outcomes of Hypertensive Crises in Patients with Orthostatic Hypotension

INTRODUCTION: Supine hypertension-orthostatic hypotension disease (SH-OH) poses a management challenge to clinicians. Data on short term outcomes of patients with OH who are hospitalized with hypertensive (HTN) crises is lacking METHODS: The Nationwide Readmission Database 2016-2019 was queried for all hospitalizations of HTN crises. Hospitalizations were stratified according to whether OH was present or not. We employed propensity score to match hospitalizations for patients with OH to those without, at 1:1 ratio. Outcomes evaluated were 30-days readmission with HTN crises or falls, as well as hospital outcomes of in-hospital mortality, acute kidney injury (AKI), acute congestive heart failure (CHF), acute coronary syndrome (ACS), type 2 myocardial infarction (T2MI), aortic dissection, stroke, length of stay (LOS), discharge to nursing home and hospitalization costs. RESULTS: We included a total of 9,451 hospitalization (4,735 in the OH group vs 4,716 in the control group). OH group was more likely to be readmitted with falls (Odds ratio [OR]:3.27, p\u3c0.01) but not with HTN crises(p=0.05). Both groups had similar likelihood of developing AKI (p=0.08), stroke/TIA (p=0.52), and aortic dissection(p=0.66). Alternatively, OH group were less likely to develop acute HF (OR:0.54, p\u3c0.01) or ACS (OR:0.39, p\u3c0.01) in the setting of HTN crises than non-OH group. OH group were more likely to have longer LOS and have higher hospitalization costs. CONCLUSION: Patients with OH who are admitted with HTN crises tend to have similar or lower HTN-related complications to non-OH group while having higher likelihood of readmission with falls, LOS and hospitalization costs. Further studies are needed to confirm such findings