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

Polyphasic examination on Merismopedia tenuissima CHAB 7021 from Ganjiang River, China revealed the polyphyly of the genus Merismopedia (Cyanobacteria)

Species in the cyanobacterial genus Merismopedia are present in freshwaters at different trophic levels, with some species even as the components of cyanobacterial blooms. However, species diversity in this genus was not fully verified by molecular investigation and polyphasic taxonomic studies. In this study, Merismopedia-like strain tenuissima CHAB 7021 was isolated from Ganjiang River in Jiangxi Province, China, and polyphasic characterization of this strain was performed by morphological observation, ultrastructural examination, chemical detection of pigments and phylogenetic analysis based on 16S rRNA gene sequences. Morphological identification of the strain was supported by the ultrastructural features, as the tiny species Merismopedia tenuissima Lemmermann. The phylogeny based on 16S rRNA gene sequences revealed at least three clades formed by the strains of Merismopedia. The three M. tenuissima strains including M. tenuissima CHAB 7021 was gathered in clade III with distant relationship to the clade I formed by the six Merismopedia strains including the type species M. punctata, and such a genetic distance may propose Merismopedia tenuissima to separate from Merismopedia genus. However intermixture relationship in between strains of M. punctate and M. glauca in the phylogenetic tree still complicated the taxonomic status in the genus Merismopedia. The process for taxonomic revision in the Merismopedia genus still await for examination and further information on more strains of type species M. punctata.</p

Method of building transformer acoustic diagnosis database based on multi physical field coupling modeling

In this paper, a method of building dynamic acoustic diagnosis database of dry-type transformer is proposed. The method is mainly combined with collecting the basic noise of transformer and simulating the acoustic signals of transformer under different working conditions to improve the fault database of transformer. Due to the incomplete working conditions on site, the simulated working conditions are relatively complete, and the marked acoustic signal file is generated, and then form the composition of the database. This paper focuses on the finite element simulation analysis of transformer vibration and noise radiation based on COMSOL, and the idea of establishing transformer biological diagnosis database. Improve the efficiency of transformer fault design and research, and provide reliable and convenient data services for researchers

Describing Chinese Herbal Medicine Telehealth Care for Symptoms Related to Infectious Diseases Such as COVID-19: A Prospective, Longitudinal, Descriptive Cohort Study Protocol

Aim: The aim of our study is to describe Chinese herbal medicine (CHM) therapy, outcomes, and safety with patients experiencing symptoms possibly related to the novel 2019 Coronavirus (COVID-19). Method: In this ongoing prospective, longitudinal, descriptive cohort study at an East Asian medicine school clinical faculty practice, we are observing participants with symptoms related to COVID-19 who consent to participate in telehealth visits and receive individualized CHM. Following screening according to inclusion and exclusion criteria, all participants are asked to obtain a COVID-19 test at the time of enrollment. Licensed practitioners with at least 15 years of CHM practice experience are determining the number of telehealth consultations necessary for each participant. All participants are recommended individualized CHM dispensed either as loose herbs to be decocted at home or granules. Follow-up at 24 and 48?h after each telehealth consult will provide clinicians with information to determine if an additional telehealth consultation is necessary. Additional scheduled follow-up is at 3, 6, and 12 months. We began this study observing telehealth interactions as the clinic was closed to in-person visits. The clinic opened again to in-person visits in late 2020, and we have continued data collection. Ethics and Dissemination: The study has received Institutional Review Board ethics approval and is currently enrolling. Data from this cohort study will be presented online for real-time dissemination to clinicians and scientists, at scientific conferences, and published in peer-review journals. Describing individualized CHM treatment as a potential COVID-19 therapy will provide vital preliminary data on methods, feasibility, acceptability, tolerability, effectiveness, and safety. Findings from our study will inform future controlled trials of individualized CHM therapy for symptoms related to COVID-19. Trial Registration: ClinicalTrials.gov registration number: NCT04380870

Antigenic variations of recent street rabies virus

ABSTRACTThe genetic and/or antigenic differences between street rabies virus (RABV) and vaccine strains could potentially affect effectiveness of rabies vaccines. As such, it is important to continue monitoring the glycoprotein (G) of the street isolates. All RABVG sequences in public database were retrieved and analysed. Using a pseudovirus system, we investigated 99 naturally occurring mutants for their reactivities to well-characterized neutralizing monoclonal antibodies (mAbs) and vaccine-induced antisera. A divergence in G sequences was found between vaccine strains and recent street isolates, with mutants demonstrating resistance to neutralizing mAbs and vaccine-induced antibodies. Moreover, antigenic variants were observed in a wide range of animal hosts and geographic locations, with most of them emerging since 2010. As the number of antigenic variants has increased in recent years, close monitoring on street isolates should be strengthened