Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke

Importance It is uncertain whether intravenous methylprednisolone improves outcomes for patients with acute ischemic stroke due to large-vessel occlusion (LVO) undergoing endovascular thrombectomy. Objective To assess the efficacy and adverse events of adjunctive intravenous low-dose methylprednisolone to endovascular thrombectomy for acute ischemic stroke secondary to LVO. Design, Setting, and Participants This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 82 hospitals in China, enrolling 1680 patients with stroke and proximal intracranial LVO presenting within 24 hours of time last known to be well. Recruitment took place between February 9, 2022, and June 30, 2023, with a final follow-up on September 30, 2023.InterventionsEligible patients were randomly assigned to intravenous methylprednisolone (n = 839) at 2 mg/kg/d or placebo (n = 841) for 3 days adjunctive to endovascular thrombectomy. Main Outcomes and Measures The primary efficacy outcome was disability level at 90 days as measured by the overall distribution of the modified Rankin Scale scores (range, 0 [no symptoms] to 6 [death]). The primary safety outcomes included mortality at 90 days and the incidence of symptomatic intracranial hemorrhage within 48 hours. Results Among 1680 patients randomized (median age, 69 years; 727 female [43.3%]), 1673 (99.6%) completed the trial. The median 90-day modified Rankin Scale score was 3 (IQR, 1-5) in the methylprednisolone group vs 3 (IQR, 1-6) in the placebo group (adjusted generalized odds ratio for a lower level of disability, 1.10 [95% CI, 0.96-1.25]; P = .17). In the methylprednisolone group, there was a lower mortality rate (23.2% vs 28.5%; adjusted risk ratio, 0.84 [95% CI, 0.71-0.98]; P = .03) and a lower rate of symptomatic intracranial hemorrhage (8.6% vs 11.7%; adjusted risk ratio, 0.74 [95% CI, 0.55-0.99]; P = .04) compared with placebo. Conclusions and Relevance Among patients with acute ischemic stroke due to LVO undergoing endovascular thrombectomy, adjunctive methylprednisolone added to endovascular thrombectomy did not significantly improve the degree of overall disability.Trial RegistrationChiCTR.org.cn Identifier: ChiCTR210005172

Hazard and Management of Emerging Environmental Pollutants in Food of China

The occurrence of emerging environmental pollutants brings new challenges to food safety in China, which needs to be systematically researched. This study focused on the distribution, hazard characteristics, and sources of antibiotics, endocrine disrupting chemicals (EDCs), perfluorinated compounds (PFCs), and microplastics (MPs) in major foods such as vegetables, fruits, grains, meat, aquatic products, eggs, and milk. It was found that fluoroquinolones showed a high detection rate in aquatic products, vegetables, and milk. Fluoroquinolones were mainly derived from the use of agricultural and veterinary drugs. Bisphenol A (one of phenolic EDCs) was frequently detected in canned food and aquatic products, and nonylphenol was mostly detected in aquatic products. Both EDCs were mainly from food packages. PFCs possessed a high detection rate in aquatic products, livestock meat, poultry meat, and eggs. PFCs were mainly from wastewater treatment plants and food packages. MPs showed a very high detection rate in aquatic products, which were mainly imported by contaminated environmental media. Ingestion of environmental emerging pollutants through food may lead to disease risk of human. Thus, it is recommended to monitor more types of emerging environmental pollutants in the scope of food safety, systematically plan the scientific rules of usage of the chemicals, and formulate a multi-departmental joint management and control mechanism to better cope with the issue of food safety caused by emerging environmental pollutants and effectively ensure food safety

Effect of Lifting Gas Diffusion on the Station-Keeping Performance of a Near-Space Aerostat

During the long-endurance flight of a near-space aerostat, the characteristics of lifting gas diffusion have a great influence on the flight altitude adjustment and station-keeping performance. Thus, in this study, a lifting gas diffusion model and a dynamic model that consider thermal effects, which had not been studied in similar models before, were developed. The dynamic model and thermal model were validated by historic flight data, and the calculated lifting gas diffusion results were compared with the experimental data of other researchers. The variations in the flight endurance, flight altitude, lifting gas diffusion rate, and diffusion coefficient of a near-space aerostat were analyzed. The effects of the ratio of porosity to tortuosity and envelope radiation properties on the mass of the lifting gas and flight altitude were considered in detail. To analyze the effect mechanism of the ratio of porosity to tortuosity and the envelope radiation properties, the envelope and gas temperature, as well as the gas pressure, were studied. The results show that the lifting gas diffusion rate and diffusion coefficient are very sensitive to the change in the ratio of porosity to tortuosity and envelope temperature. The results obtained from the analysis of the lifting gas diffusion can lay a solid foundation for improving the flight performance of near-space aerostats and for providing improved design considerations for aerostats

Effect of Lifting Gas Diffusion on the Station-Keeping Performance of a Near-Space Aerostat

During the long-endurance flight of a near-space aerostat, the characteristics of lifting gas diffusion have a great influence on the flight altitude adjustment and station-keeping performance. Thus, in this study, a lifting gas diffusion model and a dynamic model that consider thermal effects, which had not been studied in similar models before, were developed. The dynamic model and thermal model were validated by historic flight data, and the calculated lifting gas diffusion results were compared with the experimental data of other researchers. The variations in the flight endurance, flight altitude, lifting gas diffusion rate, and diffusion coefficient of a near-space aerostat were analyzed. The effects of the ratio of porosity to tortuosity and envelope radiation properties on the mass of the lifting gas and flight altitude were considered in detail. To analyze the effect mechanism of the ratio of porosity to tortuosity and the envelope radiation properties, the envelope and gas temperature, as well as the gas pressure, were studied. The results show that the lifting gas diffusion rate and diffusion coefficient are very sensitive to the change in the ratio of porosity to tortuosity and envelope temperature. The results obtained from the analysis of the lifting gas diffusion can lay a solid foundation for improving the flight performance of near-space aerostats and for providing improved design considerations for aerostats

TopoLAP: Topology Recovery for Building Reconstruction by Deducing the Relationships between Linear and Planar Primitives

Limited by the noise, missing data and varying sampling density of the point clouds, planar primitives are prone to be lost during plane segmentation, leading to topology errors when reconstructing complex building models. In this paper, a pipeline to recover the broken topology of planar primitives (TopoLAP) is proposed to reconstruct level of details 3 (LoD3) models. Firstly, planar primitives are segmented from the incomplete point clouds and feature lines are detected both from point clouds and images. Secondly, the structural contours of each plane segment are reconstructed by subset selection from intersections of these feature lines. Subsequently, missing planes are recovered by plane deduction according to the relationships between linear and planar primitives. Finally, the manifold and watertight polyhedral building models are reconstructed based on the optimized PolyFit framework. Experimental results demonstrate that the proposed pipeline can handle partial incomplete point clouds and reconstruct the LoD3 models of complex buildings automatically. A comparative analysis indicates that the proposed method performs better to preserve sharp edges and achieves a higher fitness and correction rate than rooftop-based modeling and the original PolyFit algorithm

Venetoclax combined with daunorubicin and cytarabine (2 + 6) as induction treatment in adults with newly diagnosed acute myeloid leukemia: a phase 2, multicenter, single-arm trial

Abstract Background Venetoclax (Ven) combined with intensive chemotherapy was proven effective in the management of acute myeloid leukemia (AML). However, the severe and prolonged myelosuppression remains a concern to worry about. To explore more appropriate combination regimens, we designed Ven combining daunorubicin and cytarabine (DA 2 + 6) regimen as induction therapy, aimed to evaluate the effectiveness and safety in adults de novo AML. Methods A phase 2 clinical trial was performed in 10 Chinese hospitals to investigate Ven combined with daunorubicin and cytarabine (DA 2 + 6) in patients with AML. The primary endpoints were overall response rate (ORR), comprising of complete remission (CR), complete remission with incomplete blood cell count recovery (CRi), and partial response (PR). Secondary endpoints included measurable residual disease (MRD) of bone marrow assessed by flow cytometry, overall survival (OS), event-free survival (EFS), disease-free survival (DFS), and the safety of regimens. This study is a currently ongoing trial listed on the Chinese Clinical Trial Registry as ChiCTR2200061524. Results Overall, 42 patients were enrolled from January 2022 to November 2022; 54.8% (23/42) were male, and the median age was 40 (range, 16–60) years. The ORR after one cycle of induction was 92.9% (95% confidence interval [CI], 91.6–94.1; 39/42) with a composite complete response rate (CR + CRi) 90.5% (95% CI, 89.3–91.6, CR 37/42, CRi 1/42). Moreover, 87.9% (29/33) of the CR patients with undetectable MRD (95% CI, 84.9–90.8). Grade 3 or worse adverse effects included neutropenia (100%), thrombocytopenia (100%), febrile neutropenia (90.5%), and one mortality. The median neutrophil and platelet recovery times were 13 (5–26) and 12 (8–26) days, respectively. Until Jan 30, 2023, the estimated 12-month OS, EFS, and DFS rates were 83.1% (95% CI, 78.8–87.4), 82.7% (95% CI, 79.4–86.1), and 92.0% (95% CI, 89.8–94.3), respectively. Conclusion Ven with DA (2 + 6) is a highly effective and safe induction therapy for adults with newly diagnosed AML. To the best of our knowledge, this induction therapy has the shortest myelosuppressive period but has similar efficacy to previous studies