Flow-Diversion Treatment of Unruptured Saccular Anterior Communicating Artery Aneurysms: A Systematic Review and Meta-Analysis

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Development of machine learning models to prognosticate chronic shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage

Background: Shunt-dependent hydrocephalus significantly complicates subarachnoid hemorrhage (SAH), and reliable prognosis methods have been sought in recent years to reduce morbidity and costs associated with delayed treatment or neglected onset. Machine learning (ML) defines modern data analysis techniques allowing accurate subject-based risk stratifications. We aimed at developing and testing different ML models to predict shunt-dependent hydrocephalus after aneurysmal SAH. Methods: We consulted electronic records of patients with aneurysmal SAH treated at our institution between January 2013 and March 2019. We selected variables for the models according to the results of the previous works on this topic. We trained and tested four ML algorithms on three datasets: one containing binary variables, one considering variables associated with shunt-dependency after an explorative analysis, and one including all variables. For each model, we calculated AUROC, specificity, sensitivity, accuracy, PPV, and also, on the validation set, the NPV and the Matthews correlation coefficient (ϕ). Results: Three hundred eighty-six patients were included. Fifty patients (12.9%) developed shunt-dependency after a mean follow-up of 19.7 (± 12.6) months. Complete information was retrieved for 32 variables, used to train the models. The best models were selected based on the performances on the validation set and were achieved with a distributed random forest model considering 21 variables, with a ϕ = 0.59, AUC = 0.88; sensitivity and specificity of 0.73 (C.I.: 0.39–0.94) and 0.92 (C.I.: 0.84–0.97), respectively; PPV = 0.59 (0.38–0.77); and NPV = 0.96 (0.90–0.98). Accuracy was 0.90 (0.82–0.95). Conclusions: Machine learning prognostic models allow accurate predictions with a large number of variables and a more subject-oriented prognosis. We identified a single best distributed random forest model, with an excellent prognostic capacity (ϕ = 0.58), which could be especially helpful in identifying low-risk patients for shunt-dependency

Characterization of adipose-derived stem cells of anatomical region from mice

Abstract\ud \ud Background\ud Stem cells constitute a group of great capacity for self-renewal, long-term viability, and multi-lineage potential. Several studies have provided evidence that adipose tissue represents an alternative source of stem cells, with the main benefit of adipose-derived stem cells being that they can be easily harvested from patients by a simple minimally invasive method and can be easily cultured. The aim of this study was to establish a culture protocol for obtaining and characterizing adipose-derived stem cells (ADSCs) from C57BL/6 J mice.\ud \ud \ud Results\ud The results showed that the yield, viability, and cell morphology obtained differ according to the age of isolated anatomic regions of the adipose tissue from ovarian and epididymis. The results of determination of cyclin D1 showed uniformity in the expression between different populations of ADSCs. A significant increase in the expression of caspase-3 active, was also observed in large cell populations from mice after 120 days. ADSCs were positive for mesenchymal markers CD90 and CD105, Nanog, SSEA-1, CD106, and VEGFR-1, and negative for hematopoietic markers CD34 and CD45. A large number of cells in S + G2/M phases was also observed for both sexes, demonstrating high proliferative capacity of ADSCs.\ud \ud \ud Conclusions\ud We observed that the adipose tissue of C57BL/6 J mice, isolated from the studied anatomic regions, is a promising source for obtaining pluripotent mesenchymal stem cells with high viability and proliferative response.We thank the National Council for Scientific and Technological Development\ud (CNPq), Foundation for Research.\ud Support of the State of São Paulo (FAPESP) – process number: 2013/05251-1,\ud Butantan Institute, Sao Paulo, Brazil, Rennan Lopes Olio by support in graphic\ud design and Rogerio Garcia Novo Pieri by technical assistance

No evidence of association between prothrombotic gene polymorphisms and the development of acute myocardial infarction at a young age

Background : we investigated the association between 9 polymorphisms of genes encoding hemostasis factors and myocardial infarction in a large sample of young patients chosen because they have less coronary atherosclerosis than older patients, and thus their disease is more likely to be related to a genetic predisposition to a prothrombotic state Methods and Results : this nationwide case-control study involved 1210 patients who had survived a first myocardial infarction at an age of 45 years who underwent coronary arteriography in 125 coronary care units and 1210 healthy subjects matched for age, sex, and geographical origin. None of the 9 polymorphisms of genes encoding proteins involved in coagulation (G-455A -fibrinogen: OR, 1.0; CI, 0.8 to 1.2; G1691A factor V: OR, 1.1; CI, 0.6 to 2.1; G20210A factor II: OR, 1.0; CI, 0.5 to 1.9; and G10976A factor VII: OR, 1.0; CI, 0.8 to 1.3), platelet function (C807T glycoprotein Ia: OR, 1.1; CI, 0.9 to 1.3; and C1565T glycoprotein IIIa: OR, 0.9; CI, 0.8 to 1.2), fibrinolysis (G185T factor XIII: OR, 1.2; CI, 0.9 to 1.6; and 4G/5G plasminogen activator inhibitor type 1: OR, 0.9; CI, 0.7 to 1.2), or homocysteine metabolism (C677T methylenetetrahydrofolate reductase: OR, 0.9; CI, 0.8 to 1.1) were associated with an increased or decreased risk of myocardial infarction Conclusions : this study provides no evidence supporting an association between 9 polymorphisms of genes encoding proteins involved in hemostasis and the occurrence of premature myocardial infarction or protection against it

Exergy Analysis of Organic Rankine Cycles with Zeotropic Working Fluids

Waste heat recovery is one of the possible solutions to improve the efficiency of internal combustion engines. Instead of wasting the exhaust stream of an energy conversion system into the environment, its residual energy content can be usefully recovered, for example in Organic Rankine Cycles (ORC). This technology has been largely consolidated in stationary power plants but not yet for mobile applications, such as road transport, due to the limitations in the layout and to the constraints on the size and weight of the ORC system. An ORC system installed on the exhaust line of a bus powered by a natural gas spark ignition engine has been investigated. The thermal power available at engine exhaust has been evaluated by measuring gas temperature and mass flow rate during real driving operation. The waste thermal power has been considered as heat input for the ORC plant simulation. A detailed heat exchanger model has been developed because it is a crucial component for the ORC performance. The exergy analysis of the ORC was performed comparing different working fluids: R601, R1233zd(E) and two zeotropic blends of the two organic pure fluids. The model allowed the evaluation of the ORC produced energy over the driving cycle and the potential benefit on the engine efficiency

Evaluation of residual stresses in butt welded joint of dissimilar material by FEM

The study proposed within this paper deals with an application of finite element techniques to the thermo-structural analysis of a dissimilar butt-welded joint. Residual stresses induced by the fusion arc-welding of steel joints in power generation plants are a concern to the industry. Nowadays, the application of finite element method appears to be a very efficient method for the prediction and the investigation of the weld-induced residual stresses, nevertheless the detailed modelling of all phenomena involved in such process is still challenging. The structural integrity assessment of welded structures strongly requires a deep investigation of weld-induced residual stresses in order to be compliant with safety requirement of power plant. The longitudinal and transversal residual stresses in dissimilar material butt joints of 8 mm thick for V-groove shape were studied. The developed thermo-mechanical FE model as well as the simulation procedures are detailed and results are discussed. As a result of such work, it has been found out that residual stresses in the two dissimilar plates are characterized by very different magnitudes and distribution

Simultaneous strain and temperature measurements using dual-wavelength BOTDA

Brillouin scattering properties of a bend-insensitive fiber were experimentally investigated at 850 nm and 1550 nm wavelength using Brillouin optical time-domain analysis (BOTDA). A diversity scheme has been adopted, in which the BFS distribution along the same fiber is acquired at the two operating wavelengths. Based on the different wavelength scaling factor of temperature and strain coefficients, simultaneous measurement of strain and temperature at 1-m spatial resolution has been obtained in a proof-of-concept experiment

Calbidin-D28K immunoreactivity in the human cerebellar cortex

Calbindin-D28k (CB) is a calcium-binding protein largely distributed in the cerebellum of various species of vertebrates. As regards the human cerebellar cortex, precise data on the distribution of CB have not yet been reported. Aim of the present work was to analyze the distribution of CB in postmortem samples of human cerebellar cortex using light microscopy immunohistochemical techniques. Immunoreactivity to CB was detected within neuronal bodies and processes distributed in all cortex layers. In the molecular layer, the immunoreactivity was observed in subpopulations of stellate and basket neurons. In the Purkinje neuron layer, the immunoreactivity was observed in practically all the Purkinje neurons. In the granular layer, the immunoreactivity was observed in subpopulations of granules, of Golgi neurons, and also of other types of large neurons (candelabrum, Lugaro neurons, etc.). Immunoreactivity to CB was also observed in axon terminals distributed throughout the cortex according to layer-specific patterns of distribution. The qualitative and quantitative patterns of distribution of CB showed no difference among the different lobes of the cerebellar cortex. This study reports that CB is expressed by different neuron types, both inhibitory (GABAergic) and excitatory (glutamatergic), involved in both intrinsic and extrinsic circuits of the human cerebellar cortex. The study provides further insights on the functional role of CB and on the neuronal types of the cerebellar cortex in which it is expressed