50 research outputs found
A note on -Fibonacci sequences and specially multiplicative arithmetic functions
summary:A specially multiplicative arithmetic function is the Dirichlet convolution of two completely multiplicative arithmetic functions. The aim of this paper is to prove explicitly that two mathematical objects, namely -Fibonacci sequences and specially multiplicative prime-independent arithmetic functions, are equivalent in the sense that each can be reconstructed from the other. Replacing one with another, the exploration space of both mathematical objects expands significantly
A note on -Fibonacci sequences and specially multiplicative arithmetic functions
A specially multiplicative arithmetic function is the Dirichlet convolution of two completely multiplicative arithmetic functions. The aim of this paper is to prove explicitly that two mathematical objects, namely -Fibonacci sequences and specially multiplicative prime-independent arithmetic functions, are equivalent in the sense that each can be reconstructed from the other. Replacing one with another, the exploration space of both mathematical objects expands significantly
HER2/neu protein expression and fine needle breast aspiration from Argentinean patients with non-palpable breast lesions
The objective of this pilot project was to investigate whether the breast fine needle aspiration (FNA) technique is a useful tool for determining the increased risk of breast cancer in patients with non-palpable breast lesions. FNA is a minimally invasive technique that isolates mammary epithelial cells from breast cells in the suspicious region. In this study, two FNA samples were collected from 12 patients. The level of HER2/neu expression at the mRNA level (in serum) was measured in each patient. As gene amplification is characteristic of cancer cells and may assist in diagnosis and prognostic assessment, it is crucial that gene amplification of HER2/neu in patients with non-palpable breast lesions is compared to breast biopsy results. In serum, the level of HER2/neu was determined by ELISA assay. Gene amplification was determined by PCR and confirmed by IHC employing monoclonal ERRB2 in the FNA sample. The results indicate that FNA has a good correlation with breast biopsy. FNA combined with mammographic imaging is a strong tool for determining favorable treatment options for patients.Fil: DomĂnguez, Wendy Gabriela. Texas A&M University; Estados Unidos. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Centro CientĂfico TecnolĂłgico Conicet - BahĂa Blanca. Centro de Recursos Naturales Renovables de la Zona Semiarida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiarida; ArgentinaFil: Nardi, HĂ©ctor. Hospital Interzonal Dr JosĂ© Penna. Departamento de GinecologĂa. BahĂa Blanca; ArgentinaFil: Montero, HĂ©ctor. Hospital Español. Departamento de GinecologĂa; ArgentinaFil: Vincent, Esteban. Hospital de la AsociaciĂłn MĂ©dica de BahĂa Blanca. Departamento de GinecologĂa. BahĂa Blanca; ArgentinaFil: Corte, MarĂa Marta. Laboratorio de PatologĂa. BahĂa Blanca; ArgentinaFil: Balogh, Gabriela Andrea. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Centro CientĂfico TecnolĂłgico Conicet - BahĂa Blanca. Centro de Recursos Naturales Renovables de la Zona Semiarida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiarida; Argentin
Completion of neuronal remodeling prompts myelination along developing motor axon branches
Neuronal remodeling and myelination are two fundamental processes during neurodevelopment. How they influence each other remains largely unknown, even though their coordinated execution is critical for circuit function and often disrupted in neuropsychiatric disorders. It is unclear whether myelination stabilizes axon branches during remodeling or whether ongoing remodeling delays myelination. By modulating synaptic transmission, cytoskeletal dynamics, and axonal transport in mouse motor axons, we show that local axon remodeling delays myelination onset and node formation. Conversely, glial differentiation does not determine the outcome of axon remodeling. Delayed myelination is not due to a limited supply of structural components of the axonâglial unit but rather is triggered by increased transport of signaling factors that initiate myelination, such as neuregulin. Further, transport of promyelinating signals is regulated via local cytoskeletal maturation related to activity-dependent competition. Our study reveals an axon branchâspecific fine-tuning mechanism that locally coordinates axon remodeling and myelination
Completion of neuronal remodeling prompts myelination along developing motor axon branches
Neuronal remodeling and myelination are two fundamental processes during neurodevelopment. How they influence each other remains largely unknown, even though their coordinated execution is critical for circuit function and often disrupted in neuropsychiatric disorders. It is unclear whether myelination stabilizes axon branches during remodeling or whether ongoing remodeling delays myelination. By modulating synaptic transmission, cytoskeletal dynamics, and axonal transport in mouse motor axons, we show that local axon remodeling delays myelination onset and node formation. Conversely, glial differentiation does not determine the outcome of axon remodeling. Delayed myelination is not due to a limited supply of structural components of the axon-glial unit but rather is triggered by increased transport of signaling factors that initiate myelination, such as neuregulin. Further, transport of promyelinating signals is regulated via local cytoskeletal maturation related to activity-dependent competition. Our study reveals an axon branch-specific fine-tuning mechanism that locally coordinates axon remodeling and myelination
IV-Thrombolysis in Ischemic Stroke With Unknown Time of OnsetâSafety and Outcomes in Posterior vs. Anterior Circulation Stroke
Background: rt-PA for ischemic stroke in the unknown or extended time window beyond the first 4. 5 h after symptom onset is safe and effective for certain patients after selection by multimodal neuroimaging. However, the evidence for this approach comes mainly from patients with anterior circulation stroke (ACS), while the data on posterior circulation stroke (PCS) are scarce.
Methods: Ischemic stroke patients treated with IV-thrombolysis in the unknown or extended time window between January 2011 and May 2019 were identified from an institutional registry. The patients were categorized into PCS or ACS based on clinico-radiological findings. We analyzed the hemorrhagic complications, clinical and imaging efficacy outcomes, and mortality rates by comparing the PCS and ACS patient groups. Adjusted outcome analyses were performed after propensity score matching for the relevant factors.
Results: Of the 182 patients included, 38 (20.9%) had PCS and 144 (79.1%) had ACS. Symptomatic acute large vessel occlusion (LVO) was present in 123 patients on admission [27 (22.0%) PCS and 96 (78.0%) ACS]. The score on the National Institutes of Health Stroke Scale (NIHSS), the time from last seen normal, and the door-to-needle times were similar in PCS and ACS. In patients with LVO, the NIHSS score was lower [8 (5â15) vs. 14 (9â18), p = 0.005], and infarction visible on follow-up imaging was less common [70.4 vs. 87.5%; aRD, â18.9% (â39.8 to â2.2%)] in the PCS patient group. There was a trend toward a lower risk for intracranial hemorrhage (ICH) following intravenous thrombolysis in PCS vs. ACS, without reaching a statistical significance [5.3 vs. 16.9%; aRD, â10.4% (â20.4 to 4.0%)]. The incidence of symptomatic ICH [according to the ECASS III criteria: 2.6 vs. 3.5%; aRD, â2.9% (â10.3 to 9.2%)], efficacy outcomes, and mortality rates were similar in PCS and ACS patients.
Conclusions: In this real-world clinical cohort, the safety and the efficacy of rt-PA for ischemic stroke in the unknown or extended time window did not show relevant differences between PCS and ACS, with a trend toward less hemorrhagic complications in PCS. The findings reconfirm the clinician in the usage of rt-PA beyond the first 4.5 h also in selected patients with PCS
Positive emotions in the use of the built space associated with the attributes of biophilic design
O design biofĂlico proporciona soluçÔes de integração da natureza com os ambientes construĂdos, promovendo agradabilidade (pleasantness) e bem-estar para os usuĂĄrios. Este trabalho tem como objetivo identificar emoçÔes positivas dos usuĂĄrios, associadas aos atributos do design biofĂlico na avaliação do ambiente construĂdo do novo campus Unisinos, em Porto Alegre. O mĂ©todo proposto abrange uma etapa qualitativa e outra quantitativa, partindo da pesquisa de satisfação com os usuĂĄrios. Por meio da estruturação de questionĂĄrio, sĂŁo aferidas maiores informaçÔes a respeito das emoçÔes positivas elicitadas pelos atributos da edificação, assim como da intensidade em que essas emoçÔes sĂŁo percebidas pelos alunos na interação com o espaço. Os resultados demonstram a contribuição positiva do campo de estudo do design e emoção, bem como do design biofĂlico, para avaliação do ambiente construĂdo.Biophilic design has brought nature integration solutions with built-in environments, promoting pleasantness and well-being for users. This paper aims to identify usersâ positive emotions associated to the attributes of biophilic design in the evaluation of the built environment of the new Unisinos campus, in Porto Alegre. The proposed method includes a qualitative and a quantitative step, starting with satisfaction survey with the users. A questionnaire was developed to gain more information about the positive emotions elicited by the attributes of the building and the intensity by which those attributes are perceived by the students in interaction with the space. The results demonstrate the positive contribution of the study of design and emotion, as well as biophilic design, to evaluate the built environment
Ischemic stroke and dose adjustment of oral Factor Xa inhibitors in patients with atrial fibrillation
Abstract
Background
Oral Factor Xa inhibitors for the prevention of stroke in atrial fibrillation require dose adjustment based on certain clinical criteria, but the off-label use of the reduced doses is common.
Methods
Data from an observational registry including patients admitted with acute cerebral ischemia while taking oral Factor Xa inhibitors for atrial fibrillation between April 2016 and December 2018 were investigated. The dose regimen of the Xa inhibitor was classified as âappropriateâ, âunderdosedâ and âoverdosedâ in conformity with the European Medicines Agency labelling. The effect of underdosing on the functional factor Xa plasma level on admission, the clinical stroke severity and the functional outcome after 3Â months were investigated.
Results
254 patients with cerebral ischemia while on Factor Xa inhibitors were included. The dose regimen of the Factor Xa inhibitor was appropriate in 166 patients (65%), underdosed in 67 patients (26%) and overdosed in 21 patients (8%). Underdosing was associated with female sex, diabetes mellitus and higher CHA2DS2âVasc scores. Underdosing independently predicted lower anti-Xa plasma levels on admission [median 69.4Â ng/ml (IQR 0.0â121.6) vs. 129.2Â ng/ml (65.5â207.2); pâ<â0.001], was associated with higher NIHSS scores on admission [median 5 (IQR 1â10) vs. 3 (1â7); pâ=â0.041] and worse functional outcome after 3Â months (favorable outcome 26.9% vs. 46.9%; pâ=â0.025).
Conclusion
One in three patients with ischemic stroke during treatment with oral Xa inhibitors used inappropriate dose regimens. Underdosing was associated with lower functional plasma levels, higher clinical stroke severity and worse functional outcome
The anesthetic approach for endovascular recanalization therapy depends on the lesion site in acute ischemic stroke
Purpose
Endovascular therapy (EVT) of large-vessel occlusion in acute ischemic stroke (AIS) may be performed in general anesthesia (GA) or conscious sedation (CS). We intended to determine the contribution of ischemic cerebral lesion sites on the physicianâs decision between GA and CS using voxel-based lesion symptom mapping (VLSM).
Methods
In a prospective local database, we sought patients with documented AIS and EVT. Age, stroke severity, lesion volume, vigilance, and aphasia scores were compared between EVT patients with GA and CS. The ischemic lesions were analyzed on CT or MRI scans and transformed into stereotaxic space. We determined the lesion overlap and assessed whether GA or CS is associated with specific cerebral lesion sites using the voxel-wise Liebermeister test.
Results
One hundred seventy-nine patients with AIS and EVT were included in the analysis. The VLSM analysis yielded associations between GA and ischemic lesions in the left hemispheric middle cerebral artery territory and posterior circulation areas. Stroke severity and lesion volume were significantly higher in the GA group. The prevalence of aphasia and aphasia severity was significantly higher and parameters of vigilance lower in the GA group.
Conclusions
The VLSM analysis showed associations between GA and ischemic lesions in the left hemispheric middle cerebral artery territory and posterior circulation areas including the thalamus that are known to cause neurologic deficits, such as aphasia or compromised vigilance, in AIS-patients with EVT. Our data suggest that higher disability, clinical impairment due to neurological deficits like aphasia, or reduced alertness of affected patients may influence the physicianâs decision on using GA in EVT
Atrial fibrillation detected before or after stroke: role of anticoagulation
BACKGROUND: Atrial fibrillation (AF) known before ischemic stroke (KAF) has been postulated to be an independent category with a recurrence risk higher than that of AF detected after stroke (AFDAS). However, it is unknown whether this risk difference is confounded by pre-existing anticoagulation, which is most common in KAF and also indicates a high ischemic stroke recurrence risk. METHODS: Individual patient data analysis from 5 prospective cohorts of anticoagulated patients following AF-associated ischemic stroke. We compared the primary (ischemic stroke recurrence) and secondary outcome (all-cause death) among patients with AFDAS versus KAF and among anticoagulation-naĂŻve versus previously anticoagulated patients using multivariable Cox, Fine-Gray models and goodness-of-fit statistics to investigate the relative independent prognostic importance of AF-category and pre-existing anticoagulation. RESULTS: Of 4,357 patients, 1,889(43%) had AFDAS and 2,468(57%) had KAF, while 3,105(71%) were anticoagulation-naĂŻve before stroke and 1,252(29%) were previously anticoagulated. During 6,071 patient-years of follow-up we observed 244 recurrent strokes and 661 deaths. Only pre-existing anticoagulation (but not KAF) was independently associated with a higher hazard for stroke recurrence in both Cox and Fine-Gray models. Models incorporating pre-existing anticoagulation showed better fit than those with AF-category; adding AF-category did not result in better model fit. Neither pre-existing anticoagulation nor KAF were independently associated with death. CONCLUSION: Our findings challenge the notion that KAF and AFDAS are clinically relevant and distinct prognostic entities. Instead of attributing an independently high stroke recurrence risk to KAF, future research should focus on the causes of stroke despite anticoagulation to develop improved preventive treatments. This article is protected by copyright. All rights reserved