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Background and Purpose: Intraarterial thrombolysis as an adjunct to mechanical thrombectomy is increasingly being considered to enhance reperfusion in acute ischemic stroke patients. Intraarterial thrombolysis may increase the risk of post‐thrombectomy intracerebral hemorrhage (ICH) in certain patient subgroups. Methods: We analyzed acute ischemic stroke patients treated with mechanical thrombectomy in a multicenter registry. The occurrence of any (asymptomatic and symptomatic) post‐thrombectomy ICH was ascertained using standard definition requiring serial neurological examinations and computed tomographic scans acquired within 48 hours of the thrombectomy. We determined the risk of ICH in subgroups defined by clinical characteristics and the use of intravenous (IV) thrombolysis. Results: A total of 146 (7.5%) patients received intraarterial thrombolysis among 1953 acute ischemic stroke patients who underwent mechanical thrombectomy. The proportion of patients who developed any ICH was 26 (17.8%) and 510 (28.2%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p =.006). The proportion of patients who developed symptomatic ICH was 4 (2.7%) and 30 (1.7%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p =.34). Among patients who received IV thrombolysis (n = 1042), the proportion of patients who developed any ICH was 9 (16.7%) and 294 (30.7%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p =.028). The risk was not different in strata defined by age, gender, location of occlusion, preprocedure National Institutes of Health Stroke Scale score, time interval between symptom onset and thrombectomy, Alberta Stroke Program Early CT Score, systolic blood pressure, and serum glucose concentrations. Conclusions: In patients undergoing mechanical thrombectomy, the risk of any ICH and symptomatic ICH was not increased with intraarterial thrombolysis, including in those who had already received IV thrombolytics. [ABSTRACT FROM AUTHOR]

Food chemical and microbiological contamination are major global food safety issues. This study investigated the combined effects of the food‐borne pathogen Helicobacter pylori (H. pylori) and the pollutant benzo(a)pyrene (Bap) on atrophic gastritis and gut microbiota in Mongolian gerbils. The results demonstrated that simultaneous administration of H. pylori and Bap caused more severe weight loss, DNA damage, and gastritis in Mongolian gerbils compared with those exposed to H. pylori or Bap alone. The combination also significantly increased the serum level of proinflammatory cytokines, including IL‐1β (p <.05), IL‐6 (p <.0001), and TNF‐α (p <.05). Additionally, the H. pylori and Bap combination altered the composition of gut microbiota in Mongolian gerbils: the relative abundance of Lactobacillus and Ligilactobacillus at the genus level (p <.05) was significantly reduced while the relative abundance of Allobaculum and Erysipelotrichaceae enhanced (p <.0001, p <.05). Our study revealed that the synergy of H. pylori and Bap can boost the development of atrophic gastritis and lead to gut microbiota dysbiosis in Mongolian gerbils, which provides essential implications for preventing contaminated foods to sustain life and promote well‐being. [ABSTRACT FROM AUTHOR]

Being regarded as one of the most promising desalination technologies, capacitive deionization (CDI) has attracted wide attention due to its low energy consumption, high salt removal efficiency, low cost and non-secondary pollution. However, fabricating electrode materials with low cost but highly efficient CDI performance still remains a huge challenge. Here in this work, we successfully synthesized nitrogen-doped porous hollow carbon nanoboxes (HCNBs) with controllable shell thickness and abundant hierarchical meso- and micropores. Besides Zeolite Socony Mobil-5 (ZSM-5) template-derived micropores, mesopores were newly developed by in situ polymerization of aminophenol and formaldehyde and subsequent carbonization. The prepared HCNBs samples displayed high specific surface area and pore volume, along with impressive electrochemical performances of 192.82 F g−1 at a current density of 1 A g−1. Further, the existing form of uniformly doped nitrogen in the carbon skeleton of HCNBs could be modified by heat treatment so that the conductivity and surface properties could be tailored to improve their capacitive performance and electrochemical stability. Accordingly, HCNB-based electrodes exhibited high deionization capacity of 32.3 mg g−1 at 1.4 V in 500 mg per L NaCl solution as well as high salt removal retention ability up to 95.40% after 50 cycles, suggesting their promising applications in electrochemical desalination in the future. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study are to: (1) investigate the extent of antagonistic and distal neighboring tooth migration in the maxillary posterior single tooth‐missing site during the healing period of bone augmentation and implant surgery; (2) identify factors associated with tooth migration. Materials and methods: One hundred and forty‐three cases that lost the maxillary first molar were included, and their CBCT data during the edentulous period were obtained. Dentition models were reconstructed from CBCT, and superimpositions were performed, followed by measuring migration distances and calculating migration rates of antagonistic and distal neighboring teeth. Factors were analyzed using multivariate generalized estimating equations (GEE). Results: The mean migration distances were 208 ± 137 μm and 403 ± 605 μm for antagonistic teeth and distal teeth, and the mean migration rates were 26.8 ± 21.2 μm/month and 48.5 ± 76.7 μm/month, respectively. One hundred and nineteen out of 143 distal neighboring teeth migrated toward the edentulous site, and all antagonistic teeth migrated occlusally. Occlusal contact loss and chronic apical periodontitis both significantly accelerated antagonistic tooth migration (p < 0.05), the latter also accelerated distal tooth migration (p < 0.05). Besides, the displacement of the distal teeth was somewhat accelerated by the impacted adjacent third molar and root protrusion into the sinus. Conclusions: The neighboring teeth tend to migrate toward the edentulous gap in the maxillary posterior region. Occlusal contact loss and chronic apical periodontitis are two significant risk factors for accelerating antagonistic tooth migration, and for distal teeth, chronic apical periodontitis is the risk factor. The impacted adjacent third molar and root protrusion into the sinus are also potential risk factors for accelerating the migration of the maxillary distal tooth. Thus, to prevent maxillary edentulous gap reduction, the factors mentioned above should be taken into consideration when planning treatment flow. [ABSTRACT FROM AUTHOR]

A large amount of metallurgical solid waste accumulation poses a serious threat to the environment. Study on synergistic reinforcement of synthetic process of metallurgical solid waste‐based ceramics with fly ash is of great significance in reducing environmental pollution and resource utilization. A metallurgical solid waste‐based ceramic used as building ceramic was developed with the erosion part of used MgO–C bricks and fly ash as main raw materials, and the amount of solid waste added to the prepared ceramics was at least 60 wt% and up to 90 wt%. The effects of fly ash content and sintering temperature on the crystalline phase transitions, morphologies, and the main physical and mechanical properties of ceramics were investigated by X‐ray diffraction, scanning electron microscopy, and mechanical testing. The results show that the obtained ceramics presented maximum bending strength and minimum water absorption, 80.14 MPa and 5.04%, respectively, when the raw material proportions were the erosion part of used refractories accounted for 60 wt%, fly ash 20 wt%, pyrophyllite 10 wt%, and quartz sands 10 wt%, and the process parameters were the sintering temperature 1150°C, sintering time 120 min, and molding pressure 15 MPa. [ABSTRACT FROM AUTHOR]

Metaverse has been going viral across the globe, and virtual reality head‐mounted displays (VR‐HMDs) as the basic infrastructure and entrance to cater to this evolution of social interaction are showing rapid development recently. Pancake optics based on optical path folding provides the feasibility of VR‐HMDs in the form of glasses and is wide recognition. The pancake system has become the current mainstream owing to its large exit pupil diameter (EPD), high resolution, novel compact, and lightweight. Owing to the use of polarization elements, the birefringence in the lens will change the polarization state of the light, resulting in uneven brightness and stray light, seriously reducing the optical performance of the system, so it is necessary to control the birefringence of the lens. In this study, we proposed a pancake system based on a 2.1‐inch LCD display which achieves 10 mm EPD at 11 mm, diagonal field of view (FOV) of 96°, overall length (OAL) of the system less than 20 mm, and support diopter adjustment from ‐7D to ‐1D. The residual birefringence of the lens can be effectively suppressed in four stages: 1) controlling the thickness ratio between the center and the edge of the lens during the optical design, 2) setting a reasonable position and size of the injection gate and cooling system during the mold design process, 3) adopting reasonable injection parameters during the precision injection molding process and 4) eliminating the birefringence of the lens with the lens annealing process. Ultra‐precision machining and correction of the mold cores have been employed to achieve high surface accuracy and low birefringence of the lens. The optomechanical design, assembly, and adjustment process are discussed. Finally, the prototype of the pancake system is experimentally tested, and the results demonstrate pretty well. [ABSTRACT FROM AUTHOR]

Background: Previous studies have related circulating levels of trace metal elements, of which dietary intake is the major source, to cognitive outcomes. However, there are still relatively few studies evaluating the associations of dietary intake levels of iron, copper, zinc, and manganese with cognitive function (CF). Methods: We leveraged the data of 6863 participants (mean [standard deviation] age = 66.7 [10.5] years) in the Health and Retirement Study (2013/2014). Dietary intake levels of iron, copper, zinc, and manganese were calculated from a semi-quantitative food frequency questionnaire. CF was assessed using the 27-point modified Telephone Interview for Cognitive Status (TICS). We used linear regression models to calculate the mean differences in global CF scores by quintiles of dietary intake levels of trace metal elements. Results: Among the study participants, the mean (SD) values of daily dietary intake were 13.3 (6.3) mg for iron, 1.4 (0.7) mg for copper, 10.7 (4.6) mg for zinc, and 3.3 (1.6) mg for manganese. Compared with the lowest quintile of dietary iron intake (<8.1 mg), the highest quintile (≥17.7 mg) was associated with a lower cognitive score (−0.50, −0.94 to −0.06, P-trend = 0.007). Higher dietary copper was significantly associated with poorer CF (P-trend = 0.002), and the mean difference in cognitive score between extreme quintiles (≥1.8 vs. <0.8 mg) was −0.52 (95% confidence interval: −0.94 to −0.10) points. We did not observe significant associations for dietary intake of zinc (P-trend = 0.785) and manganese (P-trend = 0.368). Conclusion: In this cross-sectional study, higher dietary intake of iron and copper was related to worse CF, but zinc and manganese intake levels were not significantly associated with CF. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis is one of the top ten causes of death globally and the leading cause of death from a single infectious agent. Eradicating the Tuberculosis epidemic by 2030 is one of the top United Nations Sustainable Development Goals. Early diagnosis is essential to achieving this goal because it improves individual prognosis and reduces transmission rates of asymptomatic infected. We aim to support this goal by developing rapid and sensitive diagnostics using machine learning algorithms to minimize the need for expert intervention. Methods and findings: A single molecule fluorescence immunosorbent assay was used to detect Tuberculosis biomarker lipoarabinomannan from a set of twenty clinical patient samples and a control set of spiked human urine. Tuberculosis status was separately confirmed by GeneXpert MTB/RIF and cell culture. Two machine learning algorithms, an automatic and a semiautomatic model, were developed and trained by the calibrated lipoarabinomannan titration assay data and then tested against the ground truth patient data. The semiautomatic model differed from the automatic model by an expert review step in the former, which calibrated the lower threshold to determine single molecules from background noise. The semiautomatic model was found to provide 88.89% clinical sensitivity, while the automatic model resulted in 77.78% clinical sensitivity. Conclusions: The semiautomatic model outperformed the automatic model in clinical sensitivity as a result of the expert intervention applied during calibration and both models vastly outperformed manual expert counting in terms of time-to-detection and completion of analysis. Meanwhile, the clinical sensitivity of the automatic model could be improved significantly with a larger training dataset. In short, semiautomatic, and automatic Gaussian Mixture Models have a place in supporting rapid detection of Tuberculosis in resource-limited settings without sacrificing clinical sensitivity. [ABSTRACT FROM AUTHOR]

In thermoelectrics, entropy engineering as an emerging paradigm-shifting strategy can simultaneously enhance the crystal symmetry, increase the solubility limit of specific elements, and reduce the lattice thermal conductivity. However, the severe lattice distortion in high-entropy materials blocks the carrier transport and hence results in an extremely low carrier mobility. Herein, the design principle for selecting alloying species is introduced as an effective strategy to compensate for the deterioration of carrier mobility in GeTe-based alloys. It demonstrates that high configurational entropy via progressive MnZnCdTe3 and Sb co-alloying can promote the rhombohedral-cubic phase transition temperature toward room temperature, which thus contributes to the enhanced density-of-states effective mass. Combined with the reduced carrier concentration via the suppressed Ge vacancies by high-entropy effect and Sb donor doping, a large Seebeck coefficient is attained. Meanwhile, the severe lattice distortions and micron-sized Zn0.6Cd0.4Te precipitations restrain the lattice thermal conductivity approaching to the theoretical minimum value. Finally, the maximum zT of Ge0.82Sb0.08Te0.90(MnZnCdTe3)0.10 reaches 1.24 at 723 K via the trade-off between the degraded carrier mobility and the improved Seebeck coefficient, as well as the depressed lattice thermal conductivity. These results provide a reference for the implementation of entropy engineering in GeTe and other thermoelectric materials. [ABSTRACT FROM AUTHOR]

In this paper, we introduce a kernel-based nonlinear Bayesian model for a right-censored survival outcome data set. Our kernel-based approach provides a flexible nonparametric modeling framework to explore nonlinear relationships between predictors with right-censored survival outcome data. Our proposed kernel-based model is shown to provide excellent predictive performance via several simulation studies and real-life examples. Unplanned hospital readmissions greatly impair patients' quality of life and have imposed a significant economic burden on American society. In this paper, we focus our application on predicting 30-day readmissions of patients. Our survival Bayesian additive regression kernel model (survival BARK or sBARK) improves the timeliness of readmission preventive intervention through a data-driven approach. [ABSTRACT FROM AUTHOR]

Background: Patients with ankylosing spondylitis (AS) are especially prone to sustaining spinal fractures. A 72-year-old male with AS had a previous T10/11 chalkstick fracture requiring a T8-L1 fusion 1 year ago. He subsequently presented with a newly diagnosed acute chalkstick fracture of L1 which was treated without surgery. Case Description: A 72-year-old male with AS and a T10/11 chalkstick fracture had undergone a T8-L1 thoracolumbar fusion 1 year ago. He newly presented after a fall from his bed with a new acute L1 chalkstick fracture that was successfully managed nonsurgically. Conclusion: Patients with AS are at high risk for spinal fractures. Here, elderly male, following an original T10/11 chalkstick fracture and a T8-L1 fusion 1 year ago, presented with a new acute L1 chalkstick fracture managed without surgery. [ABSTRACT FROM AUTHOR]

Hierarchical porous activated carbon particles covered with graphene were prepared by spray-drying a GO/maltodextrin aqueous suspension followed by carbonization and activation. The as-prepared core–shell particles had a high specific surface area (up to 2457 m2 g−1) and exhibited an outstanding specific capacitance (up to 405 F g−1 at 0.2 A g−1, 299 F g−1 at 1 A g−1 and 199 F g−1 at 50 A g−1) along with excellent cycling stability, high energy density and power density in a KOH electrolyte. Moreover, the spontaneous formation of the core–shell structure during the spray-drying process was verified by DFT calculations with the support of XPS chemical analysis and TEM characterization. This designable and controllable strategy of spray-drying could be introduced to design and develop new composite materials with a core–shell structure for potential applications in energy storage, catalysis and adsorption. [ABSTRACT FROM AUTHOR]

In this study, sodium (Na)-alginate/carbon nanotubes (CNTs) composite spheres were synthesized by an energy-saving dripping-gelatinization method. With the combination of the good biocompatibility of Na-alginate and excellent adsorption properties of CNTs, the porous composite spheres turned out to be a promising candidate as an adsorbent in hemoperfusion. The adsorption results showed that the maximum adsorption capacity for VB12 was 21.6 mg/g for the as-prepared composite spheres with 60 wt% CNTs. Scanning electron microscopy observations indicated that a compact shell formed during the Na-alginate gelatinization, which restricted the potential adsorption capacity of CNTs, even though the ratio of CNTs increased further. An obvious enhancement of the adsorption capacity was achieved by a modified freeze-casting-gelatinization process. Specifically, the VB12 adsorption reached 40.6 mg/g, which was much higher than that of commercialized clinically used activated carbon and macroporous resin spheres (i.e., 14.0 and 15.3 mg/g, respectively). This dramatic improvement could be attributed to the hierarchical porous structure, a higher pore volume and porous shell acquired during the freeze-casting process. These hierarchical pores could not only provide a radial throughway for VB12 diffusion, but also create more adsorption sites, which were proved by Brunauer-Emmett-Teller and mercury porosimetry analyses. [ABSTRACT FROM AUTHOR]

Hollow carbon spheres (HCSs) with flexible morphology configuration and pore structure have always been expected owing to their promising broad applications. In this work, chemical reaction kinetics guided strategy was proposed to tailor the size and pore structure of HCSs based on the modified stöber method. By varying the reaction temperature and the moment of adding carbon precursors to the solution of tetrapropyl orthosilicate (TPOS), the particle size, cavity diameter, shell thickness and pore size could be tuned conveniently. By altering the reaction temperature from 6 to 45 °C or varying the time-lag of adding carbon precursors from 0 to 180 min, the size, shell thickness and pore size of HCSs could be successfully tailored in the range of 199–697 nm, 10–104 nm and 4.35–18.87 nm, respectively. Moreover, the resulting HCSs not only exhibited excellent adsorption for Vitamin B 12 (VB 12), methylene blue (MB) and Cr(Ⅵ), but also featured with selective adsorption for different-sized adsorbates. This demonstrates that the chemical reaction kinetics guided pore structure tuning strategy could be an effective way to develop adsorbents with specific pore structure. [Display omitted] • Chemical reaction kinetics guided pore structure tuning strategy was proposed for fabricating HCSs. • The particle size, shell thickness and pore size were successfully tailored. • As-prepared HCSs with tunable pore structure exhibited good adsorption selectivity. [ABSTRACT FROM AUTHOR]

Antibiotics are widely used to treat bacterial infection and reduce the mortality rate, while antibiotic overuse can cause gut microbiota dysbiosis. The impact of antibiotics on gut microbiota is not fully understood. In our study, four commonly used antibiotics (ceftazidime, cefoperazone-sulbactam, imipenem-cilastatin, and moxifloxacin) were given subcutaneously to mice, and their impacts on the gut microbiota composition and serum cytokine levels were evaluated through 16S rRNA analysis and a multiplex immunoassay. Antibiotic treatment markedly reduced gut microbiota diversity and changed gut microbiota composition. Antibiotic treatment significantly increased and decreased the abundance of Firmicutes and Bacteroidota, respectively. The antibiotic treatments increased the abundance of opportunistic pathogens such as Enterococcus and decreased that of Lachnospiraceae and Muribaculaceae . For moxifloxacin, the significantly high abundance of Enterococcus and Klebsiella was observed after 14 and 21 days of treatment. However, a relatively low abundance of opportunistic pathogens was found after 14 days of imipenem-cilastatin treatment. Additionally, the serum levels of various pro-inflammatory cytokines, such as IL-1β, IL-12 (p70), and IL-17, significantly increased after 21 days of antibiotic treatments. Overall, these results provide a guide for rational use of antibiotics in clinical settings: short-term use of moxifloxacin is recommended with regard to gut microbiota health, and the 14-day use of imipenem-cilastatin may have a less severe impact than other antibiotics.IMPORTANCEAntibiotic treatments are directly associated with changes in gut microbiota and are effective against both pathogens and beneficial bacteria. Gut microbiota dysbiosis induced by antibiotic treatment could increase the risk of some diseases. Therefore, an adequate understanding of gut microbiota changes after antibiotic use is crucial. In this study, we investigated the effects of continuous treatment with antibiotics on gut microbiota, serum cytokines, and intestinal inflammatory response. Our results suggest that short-term use of moxifloxacin is recommended, and the 14-day use of imipenem-cilastatin may have a less severe effect on gut microbiota health than cefoperazone-sulbactam. These results provide useful guidance on the rational use of antibiotics with regard to gut microbiota health., Competing Interests: The authors declare no conflict of interest.

The Sengkang General Hospital Orthopaedic Spine Outpatient Service is facing a growing challenge of increasing number of referrals and waiting times, placing a significant burden on the system. Primary care referrals have an average wait time of 61.1 days, with 34.5%f patients waiting longer than 60 days from referral to appointment, to see a spine physician.Back pain is a very common presentation, with the vast majority resolving after conservative management which commonly includes analgesia, physiotherapy and reassurance. Unfortunately, many referrals from primary care involve patients who have yet to explore the avenues of conservative management with 90% of our referrals being managed without surgery. Globally, triage services in Western countries conducted by allied health professionals have shown to be an effective method at addressing the escalating wait times with high satisfaction rates. We have endeavoured to emulate this within our department through the implementation of the Spine Triage and Rehabilitation (STAR) Clinic. The STAR clinic aims to empower physiotherapists with the ability to triage patients into surgical and non-surgical categories with their primary physiotherapy expertise to reduce waiting times and increase outpatient capacity.More than 300 patients were recruited, and their progress was tracked over 13 months under the four Ss of: waiting timeS, cost Savings, Safety and patient Satisfaction. This pilot study has been overwhelmingly positive, with significantly reduced waiting times and high cost savings, without any compromise on patient safety and satisfaction., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Pancake virtual reality head-mounted displays (VR-HMDs) have attracted the attention of researchers in both academia and industry because of the compact size and light weight. However, owing to the use of optical path folding, there exist various stray lights in the optical system, which seriously degrades user experience. In this study, we analyze the causes and effects of multiple types of stray light systematically and design a VR-HMD with low stray light, large exit pupil diameter (EPD), compact form and light weight. Subsequently, several effective stray light suppression solutions are proposed and implemented. Finally, a prototype of a compact pancake VR-HMD system is successfully demonstrated. The prototype has stray light of less than 2.3%, a diagonal field of view (FOV) of 96° and an EPD of 10 mm at an 11 mm eye relief (ERF).

Study Design: A systematic review., Purpose: This study aimed to evaluate the prevalence of coexisting lumbar spondylosis (LS) and knee osteoarthritis (KOA), which has clinical implications on the screening, diagnosis, and management of orthopedic patients., Overview of Literature: Due to current global health trends, the number of affected patients is expected to increase substantially. However, no prior systematic reviews have discussed this topic., Methods: A systematic literature search was conducted in June 2021 in the PubMed, Embase, Scopus, CINAHL, and Cochrane CENTRAL databases. Clinical and epidemiological studies that reported quantitative data on the prevalence of coexisting LS and KOA were included. Studies which reported data on only LS or KOA alone were excluded. Odds ratios (ORs) and 95% confidence intervals (CI) for LS or KOA were retrieved or calculated for meta-analysis. Fixed-effects and random-effects models were used, and statistical significance was considered when p<0.05. Heterogeneity was evaluated using Cochran's Q test and the I2 statistic. Risk of bias was assessed using the MINORs (methodological index for nonrandomized studies) criteria., Results: This review included nine studies (5,758 patients). Four studies (4,164 patients) defined KOA and LS by a Kellgren-Lawrence (KL) grade of ≥2 and were included in the meta-analysis. Two other studies defined KOA and LS by a joint space narrowing grade of ≥2. The remaining three studies reported other outcomes. The combined ORs of having KOA of KL grade ≥2 due to LS was 1.75 (95% CI, 1.22-2.50; p=0.002), while the combined OR of having LS of KL grade ≥2 due to KOA was 1.84 (95% CI, 1.23-2.77; p=0.003)., Conclusions: In patients with either KOA or LS, the odds of having a concurrent knee-spine presentation are significantly increased. This may have implications for clinical decision-making and treatment strategies. Further high-level studies with larger patient populations are required to confirm these results in specific populations.