Oral anticoagulant decreases stroke recurrence in patients with atrial fibrillation detected after stroke

Background: Atrial fibrillation detected after stroke (AFDAS) has a lower risk of ischemic stroke recurrence than known atrial fibrillation (KAF). While the benefit of oral anticoagulants (OAC) for preventing ischemic stroke recurrence in KAF is well established, their role in patients with AFDAS is more controversial. This study aimed to evaluate the association between OAC use and the risk of recurrent ischemic stroke in patients with AFDAS in a real-world setting. Methods: This nationwide retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database. Patients hospitalized with a first-ever ischemic stroke and AFDAS confirmed within 30 days after hospitalization were assigned to OAC and non-OAC cohorts. Inverse probability of treatment weighting was applied to balance the baseline characteristics of the cohorts. The primary outcome was ischemic stroke recurrence. Secondary outcomes were intracranial hemorrhage (ICH), death, and the composite outcome of “ischemic stroke recurrence, ICH, or death.” Multivariate Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI). Results: A total of 4,508 hospitalized patients with stroke and AFDAS were identified. Based on OAC use, 2,856 and 1,652 patients were assigned to the OAC and non-OAC groups, respectively. During the follow-up period (median duration, 2.76 years), the OAC cohort exhibited a lower risk of ischemic stroke recurrence (aHR, 0.84; 95% CI, 0.70–0.99), death (aHR, 0.65; 95% CI, 0.58–0.73), and composite outcome (aHR, 0.70; 95% CI, 0.63–0.78) than did the non-OAC cohort. The risk of ICH (aHR, 0.96; 95% CI, 0.62–1.50) was not significantly different between the two cohorts. Conclusion: OAC use in patients with AFDAS was associated with reduced risk of ischemic stroke recurrence, without an increased risk of ICH. This supports current guidelines recommending OACs for secondary stroke prevention in patients with AF, regardless of the time of diagnosis

Assessing the Decision-Making Process in Human-Robot Collaboration Using a Lego-like EEG Headset

Human-robot collaboration (HRC) has become an emerging field, where the use of a robotic agent has been shifted from a supportive machine to a decision-making collaborator. A variety of factors can influence the effectiveness of decision-making processes during HRC, including the system-related (e.g., robot capability) and human-related (e.g., individual knowledgeability) factors. As a variety of contextual factors can significantly impact the human-robot decision-making process in collaborative contexts, the present study adopts a Lego-like EEG headset to collect and examine human brain activities and utilizes multiple questionnaires to evaluate participants’ cognitive perceptions toward the robot. A user study was conducted where two levels of robot capabilities (high vs. low) were manipulated to provide system recommendations. The participants were also identified into two groups based on their computational thinking (CT) ability. The EEG results revealed that different levels of CT abilities trigger different brainwaves, and the participants’ trust calibration of the robot also varies the resultant brain activities

Network Synchronization among Femtocells

Abstract-To successfully deploy femtocells overlaying the Macrocell as a two-tier that had been shown greatly benefiting communications quality in various manners, it requires to mitigate cross-tier interference between the Macrocell and femtocells, as well as intra-tier interference among femtocells. For this purpose, solutions for interference mitigation have been proposed for femtocells in literatures. However, an essential assumption of these solutions is that all femtocells and the Macrocell shall be synchronized. Such a (network) synchronization of the Macrocells and user deployed femtocells create diverse challenges from conventional synchronization among Macrocells. Existing solutions therefore leverage the global positioning system (GPS) or the wired backhaul (IEEE 1588) to synchronize the Macrocell and all femtocells, however, they are infeasible for LTEAdvanced femtocells suffering a severe penetration loss of GPS signals and a severe jitter on the backhaul with heterogeneous protocols. As a consequence, each femtocell achieving a timing consensus by leveraging synchronization signals broadcasted by the Macrocell or by the neighboring femtocells turns out to be the possible solution. In this paper, we propose a network synchronization algorithm for femtocells. By only utilizing existing synchronization signals, the proposed network synchronization algorithm achieves the timing consensus among femtocells with and without the present of the Macrocell. Yielding an extremely low computational complexity, the proposed algorithm achieves the essential assumption of interference mitigation solutions in literatures and thus enabling the femtocell technology

Rainfall Variation under Different Climate Change Scenarios Based on Cmip3 and Cmip5 Projections: a Case Study in Taiwan

Source: ICHE Conference Archive - https://mdi-de.baw.de/icheArchive

Natural Product Chemistry of Gorgonian Corals of Genus Junceella—Part II

The structures, names, bioactivities, and references of 81 new secondary metabolites obtained from gorgonian corals belonging to the genus Junceella are described in this review. All compounds mentioned in this review were obtained from sea whip gorgonian corals Junceella fragilis and Junceella juncea, collected from the tropical and subtropical Indo-Pacific Ocean

Oral anticoagulant decreases stroke recurrence in patients with atrial fibrillation detected after stroke

BackgroundAtrial fibrillation detected after stroke (AFDAS) has a lower risk of ischemic stroke recurrence than known atrial fibrillation (KAF). While the benefit of oral anticoagulants (OAC) for preventing ischemic stroke recurrence in KAF is well established, their role in patients with AFDAS is more controversial. This study aimed to evaluate the association between OAC use and the risk of recurrent ischemic stroke in patients with AFDAS in a real-world setting.MethodsThis nationwide retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database. Patients hospitalized with a first-ever ischemic stroke and AFDAS confirmed within 30 days after hospitalization were assigned to OAC and non-OAC cohorts. Inverse probability of treatment weighting was applied to balance the baseline characteristics of the cohorts. The primary outcome was ischemic stroke recurrence. Secondary outcomes were intracranial hemorrhage (ICH), death, and the composite outcome of “ischemic stroke recurrence, ICH, or death.” Multivariate Cox proportional hazard models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI).ResultsA total of 4,508 hospitalized patients with stroke and AFDAS were identified. Based on OAC use, 2,856 and 1,652 patients were assigned to the OAC and non-OAC groups, respectively. During the follow-up period (median duration, 2.76 years), the OAC cohort exhibited a lower risk of ischemic stroke recurrence (aHR, 0.84; 95% CI, 0.70–0.99), death (aHR, 0.65; 95% CI, 0.58–0.73), and composite outcome (aHR, 0.70; 95% CI, 0.63–0.78) than did the non-OAC cohort. The risk of ICH (aHR, 0.96; 95% CI, 0.62–1.50) was not significantly different between the two cohorts.ConclusionOAC use in patients with AFDAS was associated with reduced risk of ischemic stroke recurrence, without an increased risk of ICH. This supports current guidelines recommending OACs for secondary stroke prevention in patients with AF, regardless of the time of diagnosis

Efficacy of pharmacologic treatment in tinnitus patients without specific or treatable origin: A network meta-analysis of randomised controlled trials

Background- Although tinnitus has a prevalence between 20 and 42.8%, the currently recommended management for tinnitus, such as tinnitus support and psychologic therapies, are relatively time-consuming and expensive. Several new pharmacologic treatments designed for tinnitus patients without specific origin had been developed but their efficacy remains unclear. Methods- The current Network Meta-Analysis (NMA) of randomised controlled trials (RCTs) was conducted to evaluate the efficacy of different pharmacologic treatments for tinnitus management in tinnitus patients without specific or treatable origin (i.e. primary tinnitus). Databases were searched from inception to April 5th, 2021. All network meta-analytic procedures were conducted under the frequentist model. We calculated the effect size of outcomes with different rating scales with standardized mean difference. PROSPERO registration: CRD42020177742. Findings- Overall, 36 RCTs were included with 2,761 participants. The main results revealed that pharmacologic interventions with brain-acting effect (for example, amitriptyline, acamprosate, and gabapentin) and those with anti-inflammation/anti-oxidant effect (for example, intra-tympanic dexamethasone injection plus oral melatonin) were associated with superior improvement in tinnitus severity and response rate compared to placebo/control. Oral amitriptyline were associated with the highest improvement in tinnitus severity and the fourth highest response rate. None of the investigated interventions was associated with different changes in quality of life compared to placebo/control. All the investigated treatments were associated with similar drop-out rate to placebo/control. Interpretation- The current NMA suggests a potential role for treatments with brain-acting effect (for example, amitriptyline, acamprosate, and gabapentin) or anti-inflammation/anti-oxidant effect (for example, intra-tympanic dexamethasone injection plus oral melatonin) as the preferable effective treatments for tinnitus without specific or treatable origin