Characteristics of blood tests in patients with acute cerebral infarction who developed symptomatic intracranial hemorrhage after intravenous administration of recombinant tissue plasminogen activator

Objective Patients suspected as having acute ischemic stroke usually undergo blood tests, including coagulation-related indexes, because thrombocytopenia and coagulopathy are contraindications for recombinant tissue plasminogen activator (rtPA) administration. We aimed to identify blood test indexes associated with symptomatic intracranial hemorrhage (sICH) in patients with acute ischemic stroke who received intravenous rtPA. Methods This retrospective observational study included patients diagnosed with acute ischemic stroke who were treated with intravenous rtPA at the emergency department of a tertiary hospital in Seoul between February 2008 and January 2018. Blood test indexes were compared between the sICH and non-sICH groups. Logistic regression and receiver-operating characteristic curve analyses were performed. Results In this study, 375 patients were finally included. Of 375 patients, 42 (11.2%) showed new intracranial hemorrhage on follow-up brain computed tomography, of whom 14 (3.73%) had sICH. Platelet count, aspartate aminotransferase and lactate dehydrogenase levels were significantly different between the sICH and non-sICH groups, and platelet count showed statistical significance in the regression analysis. Significantly lower platelet counts were observed in the sICH group than in the non-sICH group (174,500 vs. 228,000/mm3, P=0.020). The best cutoff platelet count was 195,000/mm3, and patients with platelet counts of <195,000/mm3 had a 5.4- times higher risk of developing sICH than those with platelet counts of ≥195,000/mm3. Conclusion Platelet count was the only independent parameter associated with sICH among the blood test indexes. Mild thrombocytopenia may increase the risk of sICH after intravenous administration of rtPA

Drug discovery: Insights from the invertebrate Caenorhabditis elegans

Therapeutic drug development is a long, expensive, and complex process that usually takes 12–15 years. In the early phases of drug discovery, in particular, there is a growing need for animal models that ensure the reduction in both cost and time. Caenorhabditis elegans has been traditionally used to address fundamental aspects of key biological processes, such as apoptosis, aging, and gene expression regulation. During the last decade, with the advent of large-scale platforms for screenings, this invertebrate has also emerged as an essential tool in the pharmaceutical research industry to identify novel drugs and drug targets. In this review, we discuss the reasons why C. elegans has been positioned as an outstanding cost-effective option for drug discovery, highlighting both the advantages and drawbacks of this model. Particular attention is paid to the suitability of this nematode in large-scale genetic and pharmacological screenings. High-throughput screenings in C. elegans have indeed contributed to the breakthrough of a wide variety of candidate compounds involved in extensive fields including neurodegeneration, pathogen infections and metabolic disorders. The versatility of this nematode, which enables its instrumentation as a model of human diseases, is another attribute also herein underscored. As illustrative examples, we discuss the utility of C. elegans models of both human neurodegenerative diseases and parasitic nematodes in the drug discovery industry. Summing up, this review aims to demonstrate the impact of C. elegans models on the drug discovery pipeline.Fil: Giunti, Sebastián. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; ArgentinaFil: Andersen, Natalia Denise. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; ArgentinaFil: Rayes, Diego Hernán. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; ArgentinaFil: de Rosa, Maria Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentin

A study on computed tomography cardiothoracic ratio in predicting left ventricular systolic dysfunction

Objective A cardiothoracic ratio ≥0.50 is widely used as an indicator of cardiomegaly, but associations between the cardiothoracic ratio and left ventricular systolic dysfunction (LVSD) have not been investigated previously. We conducted this study to investigate the relationship between cardiothoracic ratio measured using computed tomography (CT) and left ventricular ejection fraction (LVEF), and to determine the optimal cardiothoracic ratio for predicting left ventricular systolic dysfunction (LVSD). Methods A retrospective cross-sectional study was performed using data from patients who underwent both chest CT and echocardiography at the emergency department from January 1 to December 31, 2021. The patients were classified as normal, or having mild, moderate, and severe LVSD based on their LVEF, and the cardiothoracic ratios of each group were compared. The receiver operating characteristic (ROC) curve analyses were used to identify the optimal cardiothoracic ratio for prediction of mild, moderate, and severe LVSD. Results The final study population included 444 patients. The median CT-measured cardiothoracic ratio was 0.54 for patients with normal LVEF, and 0.60 for patients with LVSD (P<0.001). The optimal CT-measured cardiothoracic ratios for predicting mild, moderate, and severe LVSD were 0.56, 0.59, and 0.60, and their areas under the ROC curve were 0.653, 0.690, and 0.680, and negative predictive values were 90%, 94%, and 98%, respectively. Conclusion The best cutoff value for a CT-measured cardiothoracic ratio suggestive of LVSD was 0.56, which is very different from the 0.50 value typically considered an abnormal cardiothoracic ratio. The CT-measured cardiothoracic ratio ≥0.56 can be used as a rough indicator of mild LVSD, and a ratio <0.60 can exclude severe LVSD with a high degree of confidence

Utility of a Modified Oropharyngeal Airway for Performing Tracheal Intubation Using a Fiberoptic Bronchoscope and Video Stylet: A Randomized Crossover Trial Using a Manikin

Purpose. The purpose of this study was to assess if a modified airway (MA), developed by the authors, would act as a guide and improve the performance of intubation when used with a video stylet (VS) or fiberoptic bronchoscope (FOB) for endotracheal intubation. Methods. This randomized crossover simulation study using manikins was conducted with 36 novice operators. Time to complete intubation, time to see the glottis, and success rate of intubation of each device were measured and compared with or without use of MA. Results. For intubation using FOB with MA, the median time to complete intubation significantly reduced from 46 to 31 seconds with a medium effect size (p=0.004, r = 0.483), and the median time to see the glottis significantly reduced from 7 to 5 seconds with a medium effect size (p=0.032, r = 0.357). The overall success rate was not statistically different between FOB with MA (33/36, 91.7%) and FOB alone (31/36, 86.1%); however, the cumulative success rate over time for FOB with MA was higher than that for FOB alone (p=0.333). For intubation using VS, there were no differences in the time to see the glottis and time to complete intubation between VS with MA and VS alone (p=0.065 and p=0.926, respectively), and the cumulative success rate was not statistically significant (p=0.594). Conclusion. Adjunct use of MA helped reduce time to complete intubation in FOB, but not in VS. If an inexperienced operator uses FOB, it would be helpful to use MA as an adjunct device

Engineered Unidirectional Scattering in Metal Wire Networks for Ultrahigh Glass-Like Transparency

Wavelength-scale objects usually diffuse incident light into all directions, thereby resulting in a low transmittance accompanied by a thick haze. The degradation of visibility remains a more challenging problem for metal nanostructures due to the excitation of localized surface plasmon resonances, which impedes their practical use in display applications. Here, we report a broadband, polarization- and angle-independent near-unity transmittance from a network of submicron Ag wires via the suppression of backward scattering. Electromagnetic simulations on a single Ag wire predicted that a conformal, dielectric shell suppresses backward scattering while only boosting the zeroth-order forward scattering. A facile oxidation process on electrospun Ag wires produced Ag/Ag2O core/shell wires randomly dispersed on a glass substrate. Measurements of spatially (1.5 x 1.5 cm(2)) and spectrally (lambda = 480-880 nm) averaged transmittance revealed that Ag/Ag2O wires (with an Ag filling ratio of 3.4%) recorded a transmittance of approximately 99%, relative to a bare glass substrate. A dark-field microscope equipped with a spectrometer quantified the level of the suppressed backward scattering in Ag/Ag2O wires. The scattering engineering technique presented herein will be essential to developing metal particle or wire embedded dielectric films that act as high-transmittance specular surfaces

Rational Design, Synthesis, and Characterization of Deep Blue Phosphorescent Ir(III) Complexes Containing (4′-Substituted-2′-pyridyl)-1,2,4-triazole Ancillary Ligands

On the basis of the results of frontier orbital considerations, 4-substituted-2′-pyridyltriazoles were designed to serve as ancillary ligands in 2-phenylpyridine main ligand containing heteroleptic iridium­(III) complexes that display deep blue phosphorescence emission. The iridium­(III) complexes, <b>Ir1</b>–<b>Ir7</b>, prepared using the new ancillary ligands, were found to display structured, highly quantum efficient (Φ_p = 0.20–0.42) phosphorescence with emission maxima in the blue to deep blue 448–456 nm at room temperature. In accord with predictions based on frontier orbital considerations, the complexes were observed to have emission properties that are dependent on the electronic nature of substituents at the C-4 position of the pyridine moiety of the ancillary ligand. Importantly, placement of an electron-donating methyl group at C-4′ of the pyridine ring of the 5-(pyridine-2′-yl)-3-trifluoromethyl-1,2,4-triazole ancillary ligand leads to an iridium­(III) complex that displays a deep blue phosphorescence emission maximum at 448 nm in both the liquid and film states at room temperature. Finally, an OLED device, constructed using an Ir-complex containing the optimized ancillary ligand as the dopant, was found to emit deep blue color with a CIE of 0.15, 0.18, which is close to the perfect goal of 0.15, 0.15