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

Enhanced Mechanical Properties of Metallic Glass Thin Films via Modification of Structural Heterogeneity

The structure of Cu50Zr50 and Co56Ta35B9 metallic glass thin films (MGTF) was effectively tailored via various applied substrate temperatures by means of the magnetron sputtering technology. Obviously enhanced hardness and elastic modulus are achieved by different compositional MGTFs by increasing the substrate temperature. Compared with the CuZr MGTFs, the CoTaB MGTF deposited at 473 K displays the smaller strain-rate sensitivity exponent, m, and a weaker spectrum intensity based on the nanoindentation creep test, suggesting its better creep resistance. In addition, the STZ volume of the CoTaB MGTF significantly decreases after depositing at higher temperature. According to the nano-scratch analysis, the CoTaB MGTF at the substrate temperatures of 473 K performs the shallower scratch width and the larger H3/E2 value, indicating its better tribological property

Frictional Wear and Corrosion Behavior of AlCoCrFeNi High-Entropy Alloy Coatings Synthesized by Atmospheric Plasma Spraying

High-entropy alloy coatings (HEAC) exhibit good frictional wear and corrosion resistances, which are of importance for structure materials. In this study, the microstructure, surface morphology, hardness, frictional wear and corrosion resistance of an AlCoCrFeNi high-entropy alloy coating synthesized by atmospheric plasma spraying (APS) were investigated. The frictional wear and corrosion resistance of the coating are simultaneously improved with an increase of the power of APS. The influence of the APS process on the microstructure and mechanical behavior is elucidated. The mechanisms of frictional wear and corrosion behavior of the AlCoCrFeNi HEAC are discussed in detail