Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom

Introduction The coronavirus disease (COVID-19) pandemic has changed routine clinical practice worldwide with major impacts on the provision of care and treatment for stroke patients. Methods This retrospective observational study included all patients admitted to the Royal Stoke University Hospital in Stokeon-Trent, UK, with a stroke or transient ischaemic attack between March 15th and April 14th, 2020 (COVID). Patient demographics, characteristics of the stroke, treatment details and logistics were compared with patients admitted in the corresponding weeks in the year before (2019). Results There was a 39.5% (n = 101 vs n = 167) reduction in admissions in the COVID cohort compared with 2019 with more severe strokes (median National Institutes of Health Stroke Scale (NIHSS) 7 vs 4, p = 0.02), and fewer strokes with no visible acute pathology (21.8 vs 37.1%, p = 0.01) on computed tomography. There was no statistically significant difference in the rates of thrombolysis (10.9 vs 13.2%, p = 0.72) and/or thrombectomy (5.9 vs 4.8%, p = 0.90) and no statistically significant difference in time from stroke onset to arrival at hospital (734 vs 576 min, p = 0.34), door-to-needle time for thrombolysis (54 vs 64 min, p = 0.43) and door-to-thrombectomy time (181 vs 445 min, p = 0.72). Thirty-day mortality was not significantly higher in the COVID year (10.9 vs 8.9%, p = 0.77). None of the 7 stroke patients infected with COVID-19 died. Conclusions During the COVID-19 pandemic, the number of stroke admissions fell, and stroke severity increased. There was no statistically significant change in the delivery of thrombolysis and mechanical thrombectomy and no increase in mortality

On trigonometric sums with random frequencies

We prove that if Ik are disjoint blocks of positive integers and nk are independent random variables on some probability space (Ω, F, P) such that nk is uniformly distributed on Ik, then N N−1/2 (sin 2πnkx − E(sin 2πnkx)) k=1 has, with P-probability 1, a mixed Gaussian limit distribution relative to the probability space ((0, 1), B, λ), where B is the Borel σ-algebra and λ is the Lebesgue measure. We also investigate the case when nk have continuous uniform distribution on disjoint intervals Ik on the positive axis

Performance, intestinal histomorphology and bone composition of broiler chickens fed diets supplemented with genistein

The effect of dietary genistein on performance, intestinal morphology, caecal Lactobacillus spp. count, and tibia composition in broiler chickens after 21 and 37 days of feeding was investigated. A total of 360 Cobb 500 broiler chickens (21 days old) were randomly allocated to five treatments with six replicates of 12 birds each. They were fed a basal diet (C) or a basal diet supplemented with 200 (T1), 400 (T2), 600 (T3) and 800 (T4) mg genistein/kg of feed. Genistein supplementation did not affect feed intake, but improved bodyweight, weight gain and feed conversion ratio (FCR) after 21 days, while 600 mg/kg led to a significant increase in FCR after 37 days of feeding. Plasma triglyceride level decreased with dietary genistein after 21 days, while increases were found in T3 and T4 groups after prolonged supplementation. Significantly improved duodenal and jejunal villus length and width, crypt depth and villus/crypt ratio were observed after the first and the second finishing periods, respectively, while adverse effects were found in the ileum for both periods. At 42 days old, greater spleen and heart weights were measured in broilers fed diets with 800 mg/kg than in other broiler groups. The shorter genistein supplementation period (21 days) of 200 and 400 mg/kg had a positive effect on tibia wet weight, ash and calcium (Ca) content, while 37 days of the higher genistein doses administered to the T2, T3 and T4 birds significantly increased caecal lactic acid bacteria (LAB) counts. Thus, recommended doses should not exceed 400 mg/kg. Keywords: broiler performance, blood triglyceride, Lactobacillus, prolonged fattening, small intestinal morpholog

The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK

Background Functional neurological disorder is defined by symptoms not explained by the current model of disease and its pathophysiology. It is found in 8.4% of patients presenting as acute stroke. Treatment is difficult and recurrence rates are high. We introduced hypnotherapy as a therapeutic option in addition to standard stroke unit care. Methods This is an observational study of successive patients with functional neurological disorder presenting as acute stroke treated with hypnotherapy between 1 April 2014 and 1 February 2018. The diagnosis of functional neurological disorder was confirmed by clinical examination and computed tomography/magnetic resonance imaging. Hypnosis was delivered by a hypnotherapy trained stroke physician using imagery for induction. A positive response was defined as a National Institutes of Health Stroke score reduction to 0 or by ≥4 points posthypnotherapy. Costs were calculated as therapist time and benefits as reduction in disability/bed days. Results Sixty-eight patients (mean age 36.4 years, 52 (76%) females, mean baseline National Institutes of Health Stroke 5.0 (range 1–9)) were included. Two patients (3%) could not be hypnotized. Fifty-eight 58 (85%) responded, 47 (81%) required one treatment session, while 19% needed up to three sessions for symptomatic improvement. No adverse events were observed. Disability (modified Rankin Scale) reduced from a mean of 2.3 to 0.5 resulting in an average cost saving of £1,658 per patient. Most (n = 50, 86%) remained well without recurrence at six-month follow-up. Conclusions In this case series, hypnotherapy was associated with rapid and sustained recovery of symptoms. A prospective randomized controlled study is required to confirm the findings and establish generalizability of the results

Strong approximation of lacunary series with random gaps

We investigate the asymptotic behavior of sums (Formula presented.), where f is a mean zero, smooth periodic function on (Formula presented.) and (Formula presented.) is a random sequence such that the gaps (Formula presented.) are i.i.d. Our result shows that, in contrast to the classical Salem–Zygmund theory, the almost sure behavior of lacunary series with random gaps can be described very precisely without any assumption on the size of the gaps. © 2017 Springer-Verlag Wie

IS INTRAVENOUS ASPIRIN SAFE FOR EMERGENT STENTING IN THROMBOLYSED PATIENTS TREATED BY MECHANICAL THROMBECTOMY?

Introduction: Intraoperative stenting is used during mechanical thrombectomy (MT) to manage severe stenosis or dissection. Antiplatelet agents are required intraoperatively to maintain patency of the stent. However, antiplatelets are contraindicated in the first 24 hours after thrombolysis. We evaluated outcomes and complications of patients stented with and without intravenous aspirin during MT.Methods: All patients who required emergent stenting during MT at our centre between 2010 and 2020 were included. Patients were thrombolysed before MT, unless there were contraindications. Aspirin 500 mg intravenously was given intraoperatively at the discretion of the operator. Outcomes (death, symptomatic intracranial haemorrhage (sICH), and functional outcome (modified Rankin scale: mRS) were ascertained at 90 days by an independent physician.Results: 107 patients (mean age 65.0 SD 11.0 years, mean NIHSS 18 SD 13, 80 (75%) thrombolysed) had a stent placed. Of these 52 (48.6%) were given aspirin and 55 (51%) were not. There were no significant differences in outcome (mRS 0–2 50vs36%, sICH 6vs15%, death 21vs24%) with and without aspirin. Thrombolysed patients had overall better outcomes (mRS 0–2 48vs33% p ¼ 0.2, sICH 6vs22% p ¼ 0.03, death 16vs41% p ¼ 0.02) than patients not thrombolysed, with no difference between those also treated with aspirin or not.Conclusions: Perioperative intravenous aspirin did not affect complications or functional outcome, whether given alone or in combination with thrombolysis. While the interpretation of the findings is limited by the small size of the cohort and the observational nature of the study, our data suggest that intraoperative aspirin for stenting during mechanical thrombectomy is safe

Comparison of two schizophyllum commune strains in production of acetylcholinesterase inhibitors and antioxidants from submerged cultivation

In recent years, fungi have been recognized as producers of acetylcholinesterase (AChE) inhibitors, agents important for the prevention of Alzheimer\u2019s disease (AD). This study aimed to examine the AChE inhibitory, the antioxidative and antibacterial activity of two different Schizophyllum commune strains that originated from Serbia (SRB) and Italy (IT). Submerged cultivation of grown mycelia (M) and fermentation broth (F) of ethanol (EtOH) and polysaccharide (PSH) extracts lasted for 7, 14, 21 and 28 days. For AChE activity Ellman method was performed, while for antioxidative activity, sevendifferent assays were conducted: DPPH, ABTS, FRAP, SOA, OH, NO together with total phenolic content. Antimicrobial screen, LC\u2013MS/MS technique and FTIR measurements were performed. Different isolates exhibited different AChE activity, with PSH being the strongest (SRB, M, 28 days IC90 79.73 \ub1 26.34 \ub5g/mL), while in EtOH extracts, IT stood out (F, 14 days, IC50 0.8 \ub1 0.6 \ub5g/mL). PSH extracts (7 days) exhibit significant antioxidative activity (AO), opposite to EtOH extracts where 14 and 21days periods stood out. Only tw extracts showed antibacterial activity. Following LC\u2013MS/MS analysis p-hydroxybenzoic and gallic acids were the most abundant phenolics. PSH extracts demonstrated remarkable results, making this study debut and introducing S. commune as a valuable resource of AChE inhibitors

Identification of a Glass Substrate to Study Cells Using Fourier Transform Infrared Spectroscopy: Are We Closer to Spectral Pathology?

The rising incidence of cancer worldwide is causing an increase in the workload in pathology departments. This, coupled with advanced analysis methodologies, supports a developing need for techniques that could identify the presence of cancer cells in cytology and tissue samples in an objective, fast, and automated way. Fourier transform infrared (FT-IR) microspectroscopy can identify cancer cells in such samples objectively. Thus, it has the potential to become another tool to help pathologists in their daily work. However, one of the main drawbacks is the use of glass substrates by pathologists. Glass absorbs IR radiation, removing important mid-IR spectral data in the fingerprint region (1800 cm-1 to 900 cm-1). In this work, we hypothesized that, using glass coverslips of differing compositions, some regions within the fingerprint area could still be analyzed. We studied three different types of cells (peripheral blood mononuclear cells, a leukemia cell line, and a lung cancer cell line) and lymph node tissue placed on four different types of glass coverslips. The data presented here show that depending of the type of glass substrate used, information within the fingerprint region down to 1350 cm-1 can be obtained. Furthermore, using principal component analysis, separation between the different cell lines was possible using both the lipid region and the fingerprint region between 1800 cm-1 and 1350 cm-1. This work represents a further step towards the application of FT-IR microspectroscopy in histopathology departments