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Capture of CO2from the air offers a promising approach to addressing climate change and achieving carbon neutrality goals1,2. However, the development of a durable material with high capacity, fast kinetics and low regeneration temperature for CO2capture, especially from the intricate and dynamic atmosphere, is still lacking. Here a porous, crystalline covalent organic framework (COF) with olefin linkages has been synthesized, structurally characterized and post-synthetically modified by the covalent attachment of amine initiators for producing polyamines within the pores. This COF (termed COF-999) can capture CO2from open air. COF-999 has a capacity of 0.96 mmol g–1under dry conditions and 2.05 mmol g–1under 50% relative humidity, both from 400 ppm CO2. This COF was tested for more than 100 adsorption–desorption cycles in the open air of Berkeley, California, and found to fully retain its performance. COF-999 is an exceptional material for the capture of CO2from open air as evidenced by its cycling stability, facile uptake of CO2(reaches half capacity in 18.8 min) and low regeneration temperature (60 °C).

The rapid advancement in artificial intelligence and natural language processing has led to the development of large-scale datasets aimed at benchmarking the performance of machine learning models. Herein, we introduce “RetChemQA”, a comprehensive benchmark dataset designed to evaluate the capabilities of such models in the domain of reticular chemistry. This dataset includes both single-hop and multi-hop question-answer pairs, encompassing approximately 45,000 question and answers (Q&As) for each type. The questions have been extracted from an extensive corpus of literature containing about 2,530 research papers from publishers including NAS, ACS, RSC, Elsevier, and Nature Publishing Group, among others. The dataset has been generated using OpenAI’s GPT-4 Turbo, a cutting-edge model known for its exceptional language understanding and generation capabilities. In addition to the Q&A dataset, we also release a dataset of synthesis conditions extracted from the corpus of literature used in this study. The aim of RetChemQA is to provide a robust platform for the development and evaluation of advanced machine learning algorithms, particularly for the reticular chemistry community. The dataset is structured to reflect the complexities and nuances of real-world scientific discourse, thereby enabling nuanced performance assessments across a variety of tasks.

Recent small subcortical infarcts (SSI) are a common radiographic predecessor to lacunar stroke. SSI is comprised of several pathophysiologic processes such as branch atherosclerotic disease (BAD) and lipohyalinosis, both of which have differing outcomes and natural history. Presently, there is not a proven method to determine whether a SSI is due to BAD or lipohyalinosis in non-stenotic vessels. However, high-resolution vessel wall imaging (HRVWI) has been reported in East Asian cohorts. We aimed to use HRVWI to identify individuals with BAD-related SSI in a North American cohort. We performed a cross-sectional study from the Rhode Island Hospital. All patients had a SSI as defined by consensus criteria. The presence of vessel wall enhancement of parent vessels were reviewed by two authors. Standard descriptive statistical techniques were used. Of 28 patients who underwent HRVWI, 7 met criteria for SSI. The median age was 68 years and 3 were female. Parent vessel wall enhancement was present in 2 patients. In our North American cohort, HRVWI was able to dichotomize individuals based on parent vessel wall enhancement suggestive of a BAD-related SSI. Further studies are needed to expand our cohort size and confirm our findings.

The growing demand for natural treatments has raised concerns among clinicians due to limited scientific evidence supporting their use. This review article addresses the issue by assisting dermatologists and general practitioners in recommending natural treatments for the following common nail disorders: nail brittleness, onychomycosis, periungual verrucae, paronychia, chloronychia, nail psoriasis, nail lichen planus, onychocryptosis, onycholysis, and congenital malalignment of the great toenail. One limitation is the scarcity of existing reviews on natural treatment options for nail disorders in the literature. Through a comprehensive review of existing literature, this article consolidates the available evidence on natural treatment options for these conditions. Although some natural treatments for nail disorders are supported by scientific evidence, the indiscriminate use of such remedies may lead to severe poisoning and health problems. Given the widespread and increasing use of natural treatments, clinicians play a pivotal role in educating patients about evidence-based remedies and debunking misleading claims. By doing so, clinicians can enhance patient safety and improve treatment outcomes. It is essential for healthcare professionals to be well-informed and equipped with the knowledge to differentiate between effective natural treatments and unverified claims, ensuring that patients receive appropriate care.

Introduction: Data on the association between blood pressure variability (BPV) after endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) and outcomes are limited. We sought to identify whether BPV within the first 24 hours post EVT was associated with key stroke outcomes.Methods: We combined individual patient-data from five studies among AIS-patients who underwent EVT, that provided individual BP measurements after the end of the procedure. BPV was estimated as either systolic-BP (SBP) standard deviation (SD) or coefficient of variation (CV) over 24 h post-EVT. We used a logistic mixed-effects model to estimate the association [expressed as adjusted odds ratios (aOR)] between tertiles of BPV and outcomes of 90-day mortality, 90-day death or disability [modified Rankin Scale-score (mRS) > 2], 90-day functional impairment (⩾1-point increase across all mRS-scores), and symptomatic intracranial hemorrhage (sICH), adjusting for age, sex, stroke severity, co-morbidities, pretreatment with intravenous thrombolysis, successful recanalization, and mean SBP and diastolic-BP levels within the first 24 hours post EVT.Results: There were 2640 AIS-patients included in the analysis. The highest tertile of SBP-SD was associated with higher 90-day mortality (aOR:1.44;95% CI:1.08–1.92), 90-day death or disability (aOR:1.49;95% CI:1.18–1.89), and 90-day functional impairment (adjusted common OR:1.42;95% CI:1.18–1.72), but not with sICH (aOR:1.22;95% CI:0.76–1.98). Similarly, the highest tertile of SBP-CV was associated with higher 90-day mortality (aOR:1.33;95% CI:1.01–1.74), 90-day death or disability (aOR:1.50;95% CI:1.19–1.89), and 90-day functional impairment (adjusted common OR:1.38;95% CI:1.15–1.65), but not with sICH (aOR:1.33;95% CI:0.83–2.14).Conclusions: BPV after EVT appears to be associated with higher mortality and disability, independently of mean BP levels within the first 24 h post EVT. BPV in the first 24 h may be a novel target to improve outcomes after EVT for AIS.

IMPORTANCE: Ischemic stroke is a serious complication of cardiac intervention, including surgery and percutaneous procedures. Endovascular thrombectomy (EVT) is an effective treatment for ischemic stroke and may be particularly important for cardiac intervention patients who often cannot receive intravenous thrombolysis. OBJECTIVE: To examine trends in EVT for ischemic stroke during hospitalization of patients with cardiac interventions vs those without in the United States. DESIGN, SETTING, AND PARTICIPANTS: This cohort study involved a retrospective analysis using data for 4888 US hospitals from the 2016-2020 National Inpatient Sample database. Participants included adults (age ≥18 years) with ischemic stroke (per codes from the International Statistical Classification of Diseases, Tenth Revision, Clinical Modification), who were organized into study groups of hospitalized patients with cardiac interventions vs without. Individuals were excluded from the study if they had either procedure prior to admission, EVT prior to cardiac intervention, EVT more than 3 days after admission or cardiac intervention, or endocarditis. Data were analyzed from April 2023 to October 2023. EXPOSURES: Cardiac intervention during admission. MAIN OUTCOMES AND MEASURES: The odds of undergoing EVT by cardiac intervention status were calculated using multivariable logistic regression. Adjustments were made for stroke severity in the subgroup of patients who had a National Institutes of Health Stroke Scale (NIHSS) score documented. As a secondary outcome, the odds of discharge home by EVT status after cardiac intervention were modeled. RESULTS: Among 634 407 hospitalizations, the mean (SD) age of the patients was 69.8 (14.1) years, 318 363 patients (50.2%) were male, and 316 044 (49.8%) were female. A total of 12 093 had a cardiac intervention. An NIHSS score was reported in 218 576 admissions, 216 035 (34.7%) without cardiac intervention and 2541 (21.0%) with cardiac intervention (P < .001). EVT was performed in 23 660 patients (3.8%) without cardiac intervention vs 194 (1.6%) of those with cardiac intervention (P < .001). After adjustment for potential confounders, EVT was less likely to be performed in stroke patients with cardiac intervention vs those without (adjusted odds ratio [aOR], 0.27; 95% CI, 0.23-0.31), which remained consistent after adjusting for NIHSS score (aOR, 0.28; 95% CI, 0.22-0.35). Among individuals with a cardiac intervention, receiving EVT was associated with a 2-fold higher chance of discharge home (aOR, 2.21; 95% CI, 1.14-4.29). CONCLUSIONS AND RELEVANCE: In this study, patients hospitalized with ischemic stroke and cardiac intervention may be less than half as likely to receive EVT as those without cardiac intervention. Given the known benefit of EVT, there is a need to better understand the reasons for lower rates of EVT in this patient population.

Purpose of Review: Chronic, non-healing wounds affect millions of people globally and demand significant healthcare spending. One of the most important aspects of wound care is the appropriate selection and placement of a wound dressing. One of the key roles of a wound dressing is the optimization of a moist wound environment for healing. A moist wound environment facilitates wound healing by encouraging interaction of growth factors with their targets, epithelialization, angiogenesis, and autolytic debridement of dead tissue. However, while some chronic wounds are highly exudative and require absorptive dressings in order to minimize maceration, other wounds are drier and require more occlusive dressings with the capability of preserving moisture. Given the compelling global demand for wound care, foam dressings have been continuously innovated over the past several decades. Some foam dressings are manufactured to be highly adherent, while others are manufactured with minimal adherence in order to preserve peri-wound skin during dressing changes. Foam dressings are also manufactured within a spectrum of absorptivity and pliability. As such, foam dressings are applicable in a variety of clinical settings. Pressure injuries/ulcers, diabetic foot ulcers, and venous ulcers are a few examples of chronic wounds that have demonstrated clinical improvement with the utilization of foam dressings. Recent Findings: Given the compelling global demand for wound care, foam dressings have been continuously innovated over the past several decades. Some foam dressings are manufactured to be highly adherent, while others are manufactured with minimal adherence in order to preserve peri-wound skin during dressing changes. Foam dressings are also manufactured within a spectrum of absorptivity and pliability. As such, foam dressings are applicable in a variety of clinical settings. Pressure injuries/ulcers, diabetic foot ulcers, and venous ulcers are a few examples of chronic wounds that have demonstrated clinical improvement with the utilization of foam dressings. Summary: Foam dressings are frequently utilized in wound care due to their ease of use, often (relatively) low cost, pliability, fluid absorptivity, and ability to deliver anti-microbial substances, such as silver, to the wound bed. Overall, foam dressings are one of the most useful tools in wound care.

Cervical artery dissection is an important cause of stroke, particularly in young adults. Data conflict on the diagnostic evaluation and treatment of patients with suspected cervical artery dissection, leading to variability in practice. We aim to provide an overview of cervical artery dissection in the setting of minor or no reported mechanical trigger with a focus on summarizing the available evidence and providing suggestions on the diagnostic evaluation, treatment approaches, and outcomes. Writing group members drafted their sections using a literature search focused on publications between January 1, 1990, and December 31, 2022, and included randomized controlled trials, prospective and retrospective observational studies, meta-analyses, opinion papers, case series, and case reports. The writing group chair and vice chair compiled the manuscript and obtained writing group members’ approval. Cervical artery dissection occurs as a result of the interplay among risk factors, minor trauma, anatomic and congenital abnormalities, and genetic predisposition. The diagnosis can be challenging both clinically and radiologically. In patients with acute ischemic stroke attributable to cervical artery dissection, acute treatment strategies such as thrombolysis and mechanical thrombectomy are reasonable in otherwise eligible patients. We suggest that the antithrombotic therapy choice be individualized and continued for at least 3 to 6 months. The risk of recurrent dissection is low, and preventive measures may be considered early after the diagnosis and continued in high-risk patients. Ongoing longitudinal and population-based observational studies are needed to close the present gaps on preferred antithrombotic regimens considering clinical and radiographic prognosticators of cervical artery dissection.

We have developed two series of amine-functionalized zirconium (Zr) metal–organic framework-808 (MOF-808), which were produced by postsynthetic modifications to have either amino acids coordinated to Zr ions (MOF-808-AAs) or polyamines covalently bound to the chloro-functionalized structure (MOF-808-PAs). These MOF variants were comprehensively characterized by liquid-state 1H nuclear magnetic resonance (NMR) measurements and potentiometric acid–base titration to determine the amounts of amines, energy-dispersive X-ray spectroscopy to assess the extent of covalent substitution by polyamines, powder X-ray diffraction analysis to verify the maintenance of the MOF crystallinity and structure after postsynthetic modifications, nitrogen sorption isotherm measurements to confirm retention of the porosity, and water sorption isotherm measurements to find the water uptake in the pores of each member of the series. Evaluation and testing of these compounds in direct air capture (DAC) of CO2showed improved CO2capture performance for the functionalized forms, especially under humid conditions: In dry conditions, the l-lysine- and tris(3-aminopropyl)amine-functionalized variants, termed as MOF-808-Lys and MOF-808-TAPA, exhibited the highest CO2uptakes at 400 ppm, measuring 0.612 and 0.498 mmol g–1, and further capacity enhancement was achieved by introducing 50% relative humidity, resulting in remarkable uptakes of 1.205 and 0.872 mmol g–1corresponding to 97 and 75% increase compared to the dry uptakes, respectively. The mechanism underlying the enhanced uptake efficiency was revealed by 13C solid-state NMR and temperature-programmed desorption measurements, indicating the formation of bicarbonate species, and therefore a stoichiometry of 1:1 CO2to each amine site.

Purpose of This Review: Skin grafting is a surgical procedure that involves replacing damaged or missing skin with healthy skin. This technique helps protect wounds, promotes healing, and enhances functionality and appearance. Skin grafting can be beneficial in treating burns, traumatic injuries, chronic ulcers, surgical wounds, and congenital defects, among others. Recent Findings: A range of cellular and tissue-based products (CTPs) can be employed, either in conjunction with autologous skin grafts or independently, to facilitate wound healing. Human skin allografts, sourced from donated human skin, often obtained from cadavers, serve as a valuable resource for wound protection. Allogeneic matrices, comprising neonatal fibroblasts or membranes, alongside chorion, amnion, and other placental products, provide a means to accelerate the wound healing process. Composite matrices, which combine human keratinocytes, fibroblasts, and xenogeneic collagen, provide a solution to replicate the complexity of natural skin. Moreover, acellular matrices derived from xenogeneic collagen or tissue offer a versatile platform for tissue regeneration. Conclusion: Skin grafting is a complex procedure that requires careful planning and postoperative care. Success depends on factors like the type of graft, wound management, and overall health of the patient. Skin grafting has evolved with advancements in surgery, anesthesia, and wound care and remains a crucial technique for restoring function and appearance.

Purpose of Review: Hidradenitis suppurativa is a chronic inflammatory skin condition marked by significant structural changes such as nodules, abscesses, and subcutaneous tunnels, often accompanied by drainage and pain. Medical treatment alone usually does not suffice for optimal disease control. Therefore, surgical interventions, particularly for moderate-to-severe cases with tunnel formation, are a crucial adjunct to medical therapy. This paper aims to outline a practical approach to deroofing in hidradenitis suppurativa, covering the necessary materials, surgical approach, wound care, common complications, and frequent patient questions. Recent Findings: Classically, wide excision of the entire anatomical area affected by hidradenitis suppurativa is performed in the operating room under general anesthesia. As a tissue-sparing alternative, deroofing—excision of tunnels—can be performed in-office under local anesthesia. This method allows for targeted application to either single lesions or entire anatomic regions, preserving the base of the cavity. Post-surgical wounds are typically left to heal by secondary intention. Summary: Deroofing is a safe, in-office procedure for the management of hidradenitis suppurativa, with minimal rates of post-surgical complications. It is generally well-tolerated and associated with high patient satisfaction. When combined with proper medical treatment, deroofing can help patients achieve local disease control. Optimizing post-operative wound care is paramount to facilitate patient recovery.

In 2014, the US FDA removed the Pregnancy Category Drug lettering system and enacted the “Pregnancy and Lactation Label Ruling.” This ruling required drug products to contain contact information for drug-specific exposure pregnancy registries, narrative-style sections summarizing the known effect of pregnancy, lactation counseling data, and data describing risks for females and males of reproductive potential. This new ruling has added more dialogue and discussion to the patient-provider decision-making process and requires clinicians to provide more individualized counseling based on the current medical literature. This article summarizes the recent evidence for the safety of the most common dermatological therapies for pregnant and lactating women.

Atrial fibrillation is a major cause of ischemic stroke. Technological advances now support prolonged cardiac rhythm monitoring using either surface electrodes or insertable cardiac monitors. Four major randomized controlled trials show that prolonged cardiac monitoring detects subclinical paroxysmal atrial fibrillation in 9% to 16% of patients with ischemic stroke, including in patients with potential alternative causes such as large artery disease or small vessel occlusion; however, the optimal monitoring strategy, including the target patient population and the monitoring device (whether to use an event monitor, insertable cardiac monitor, or stepped approach) has not been well defined. Furthermore, the clinical significance of very short duration paroxysmal atrial fibrillation remains controversial. The relevance of the duration of monitoring, burden of device-detected atrial fibrillation, and its proximity to the acute ischemic stroke will require more research to define the most effective methods for stroke prevention in this patient population.

BackgroundEarly clinical trials validating endovascular therapy (EVT) for emergent large vessel occlusion (ELVO) ischemic stroke in the anterior circulation initially focused on patients with small or absent completed infarctions (ischemic cores) to maximize the probability of detecting a clinically meaningful and statistically significant benefit of EVT. Subsequently, real-world experience suggested that patients with large core ischemic strokes (LCS) at presentation may also benefit from EVT. Several large, retrospective, and prospective randomized clinical trials have recently been published that further validate this approach. These guidelines aim to provide an update for endovascular treatment of LCS.MethodsA structured literature review of LCS studies available since 2019 and grading the strength and quality of the evidence was performed. Recommendations were made based on these new data by consensus of the authors, with additional input from the full SNIS Standards and Guidelines Committee and the SNIS Board of Directors.ResultsThe management of ELVO strokes with large ischemic cores continues to evolve. The expert panel agreed on several recommendations: Recommendation 1: In patients with anterior circulation ELVO who present within 24 hours of last known normal with large infarct core (70–149 mL or ASPECTS 3–5) and meet other criteria of RESCUE-Japan LIMIT, SELECT2, ANGEL-ASPECT, TESLA, TENSION, or LASTE trials, thrombectomy is indicated (Class I, Level A). Recommendations 2–7 flow directly from recommendation 1. Recommendation 2: EVT in patients with LCS aged 18–85 years is beneficial (Class I, Level A). Recommendation 3: EVT in patients with LCS >85 years of age may be beneficial (Class I, Level B-R). Recommendation 4: Patients with LCS and NIHSS score 6–30 benefit from EVT in LCS (Class I, Level A). Recommendation 5: Patients with LCS and NIHSS score <6 and >30 may benefit from EVT in LCS (Class IIa, Level A). Recommendation 6: Patients with LCS and low baseline mRS (0–1) benefit from EVT (Class I, Level A). Recommendation 7: Patients with LCS and time of last known well 0–24 hours benefit from EVT (Class I, Level A). Recommendation 8: It is recommended that patients with ELVO LCS who also meet the criteria for on-label or guideline-directed use of IV thrombolysis receive IV thrombolysis, irrespective of whether endovascular treatments are being considered (Class I, Level B-NR).ConclusionsThe indications for endovascular treatment of ELVO strokes continue to expand and now include patients with large ischemic cores on presentation. Further prospective randomized studies, including follow-up to assess the population-based efficacy of treating patients with LCS, are warranted.

Purpose of Review: Epidermolysis bullosa (EB) is a heterogeneous group of rare inherited disorders that cause skin and mucous membrane fragility. Patients with EB have compromised wound healing due to the underlying genetic defect, which can be further complicated by related comorbidities. Recent Findings: Wound healing in EB patients is challenging due to multiple wounds of varying duration and healing ability. In the absence of a cure, the goal of treatment is to minimize the risk of blister formation, optimize wound care, pain, and itch relief, and address specific complications. However, newly approved therapies like beremagene geperpavec (Vyjuvek) and birch triterpenes (Fisulvez) are paving the way for improved management and quality of life for these patients. Summary: EB is a complex skin disorder that is associated with considerably impaired quality of life. In this review, we discuss wound healing challenges, wound care strategies stratified by EB subtypes, as well as investigational cell-based, protein replacement, and gene therapies. While there are many promising advances, novel and effective treatments are still urgently needed.

We construct a data set of metal–organic framework (MOF) linkers and employ a fine-tuned GPT assistant to propose MOF linker designs by mutating and modifying the existing linker structures. This strategy allows the GPT model to learn the intricate language of chemistry in molecular representations, thereby achieving an enhanced accuracy in generating linker structures compared with its base models. Aiming to highlight the significance of linker design strategies in advancing the discovery of water-harvesting MOFs, we conducted a systematic MOF variant expansion upon state-of-the-art MOF-303 utilizing a multidimensional approach that integrates linker extension with multivariate tuning strategies. We synthesized a series of isoreticular aluminum MOFs, termed Long-Arm MOFs (LAMOF-1 to LAMOF-10), featuring linkers that bear various combinations of heteroatoms in their five-membered ring moiety, replacing pyrazole with either thiophene, furan, or thiazole rings or a combination of two. Beyond their consistent and robust architecture, as demonstrated by permanent porosity and thermal stability, the LAMOF series offers a generalizable synthesis strategy. Importantly, these 10 LAMOFs establish new benchmarks for water uptake (up to 0.64 g g–1) and operational humidity ranges (between 13 and 53%), thereby expanding the diversity of water-harvesting MOFs.

The synthetic scalability of water harvesting metal–organic frameworks (MOFs) is crucial for making these promising materials accessible and widely available for use in household devices. Herein, we present a facile, sustainable, and high-yield synthesis method to produce a series of water-harvesting MOFs, including MOF-303, CAU-23, MIL-160, MOF-313, CAU-10, and Al-fumarate. Using readily available reactants and water as the only solvent, we were able to synthesize these materials at the kilogram scale in a 200 L batch reactor with yields of 84–96% and space-time yields of 238–305 kg/day/m3under optimized reaction conditions. We also show that our procedure preserves framework crystallinity, porosity, and water-harvesting performance of the MOFs synthesized at scale.

The Stroke Treatment Academic Industry Roundtable XII included a workshop to discuss the most promising approaches to improve outcome from acute stroke. The workshop brought together representatives from academia, industry, and government representatives. The discussion examined approaches in 4 epochs: pre-reperfusion, reperfusion, post-reperfusion, and access to acute stroke interventions. The participants identified areas of priority for developing new and existing treatments and approaches to improve stroke outcomes. Although many advances in acute stroke therapy have been achieved, more work is necessary for reperfusion therapies to benefit the most possible patients. Prioritization of promising approaches should help guide the use of resources and investigator efforts.

Purpose of Review: Incontinence-associated dermatitis (IAD) is a common irritant contact dermatitis associated with exposure to urine or feces. This review provides an overview of the etiology, diagnosis, and clinical management of IAD. Recent Findings: Incontinent patients should follow a comprehensive preventive care regimen to minimize the occurrence of IAD. This regimen includes daily and as-needed cleansing using specialized “no-rinse” cleansers to cleanse the skin, remove irritants, and provide protection. Additionally, cleansers containing miconazole may be added to provide additional defense and reduce candidal infections. To reduce frictional irritation and preserve the skin barrier, it is recommended to minimize towel drying and apply an emollient moisturizer and skin protectant. Additionally, incorporating fecal collection devices or protective hydrocolloid dressings in combination with or as alternatives to adult containment briefs has proven effective in reducing the prevalence of IAD by minimizing exposure to moisture, irritants, and friction. Summary: IAD causes significant discomfort and is a risk factor for pressure ulcers and skin infections. Elderly hospitalized patients and individuals with fecal incontinence are at a high risk for developing IAD. Diagnosing IAD can be challenging as it is often misdiagnosed as stage I and II pressure ulcers. Visual indicators of pressure ulcers include distinct lesions over bony prominences, non-blanchable erythema, and localized skin changes with or without necrosis. Prevention of IAD involves minimizing exposure to stool and/or urine and implementing a skincare regimen that includes gentle cleansing, moisturization, and application of a skin protectant.

We leveraged the power of ChatGPT and Bayesian optimization in the development of a multi-AI-driven system, backed by seven large language model-based assistants and equipped with machine learning algorithms, that seamlessly orchestrates a multitude of research aspects in a chemistry laboratory (termed the ChatGPT Research Group). Our approach accelerated the discovery of optimal microwave synthesis conditions, enhancing the crystallinity of MOF-321, MOF-322, and COF-323 and achieving the desired porosity and water capacity. In this system, human researchers gained assistance from these diverse AI collaborators, each with a unique role within the laboratory environment, spanning strategy planning, literature search, coding, robotic operation, labware design, safety inspection, and data analysis. Such a comprehensive approach enables a single researcher working in concert with AI to achieve productivity levels analogous to those of an entire traditional scientific team. Furthermore, by reducing human biases in screening experimental conditions and deftly balancing the exploration and exploitation of synthesis parameters, our Bayesian search approach precisely zeroed in on optimal synthesis conditions from a pool of 6 million within a significantly shortened time scale. This work serves as a compelling proof of concept for an AI-driven revolution in the chemistry laboratory, painting a future where AI becomes an efficient collaborator, liberating us from routine tasks to focus on pushing the boundaries of innovation.

Educational content is consistently adapted to enhance the learning experience of students at all experience and skill levels. Student motivation and accessibility are key factors in teaching science to a broad audience. The presented experiments engage the students by relating the content to that which is immediately relevant to them: the threat of global water scarcity. Through a series of experiments, students discover a potential solution employing metal–organic frameworks (MOFs), porous materials capable of harvesting water from the atmosphere, even at low relative humidity. To make this laboratory experience accessible to everyone, the experiments and required equipment are simplified without compromising the performance of the MOF, as confirmed through characterization by powder X-ray diffraction and water sorption measurements. A post-lab assessment indicates that the cutting-edge nature of the materials and related research fuels student motivation and spurs a broader conversation about ongoing scientific research.

During the past two years Lebanon has gone through a series of crises that have pushed its residents to the brink of ruin. A financial collapse engineered by the governing [...]

Background: Atrial fibrillation (AF) and congestive heart failure often coexist due to their shared risk factors leading to potential worse outcome, particularly cerebrovascular events. The aims of this study were to calculate the rates of ischemic and severe bleeding events in ischemic stroke patients having both AF and reduced ejection fraction (rEF) (⩽40%), compared to ischemic stroke patients with AF but without rEF.Methods: We performed a retrospective analysis that drew data from prospective studies. The primary outcome was the composite of either ischemic (stroke or systemic embolism), or hemorrhagic events (symptomatic intracranial bleeding and severe extracranial bleeding).Results: The cohort for this analysis comprised 3477 patients with ischemic stroke and AF, of which, 643 (18.3%) had also rEF. After a mean follow-up of 7.5 ± 9.1 months, 375 (10.8%) patients had 382 recorded outcome events, for an annual rate of 18.0%. While the number of primary outcome events in patients with rEF was 86 (13.4%), compared to 289 (10.2%) for the patients without rEF; on multivariable analysis rEF was not associated with the primary outcome (OR 1.25; 95% CI 0.84–1.88). At the end of follow-up, 321 (49.9%) patients with rEF were deceased or disabled (mRS ⩾3), compared with 1145 (40.4%) of those without rEF; on multivariable analysis, rEF was correlated with mortality or disability (OR 1.35; 95% CI 1.03–1.77).Conclusions: In patients with ischemic stroke and AF, the presence of rEF was not associated with the composite outcome of ischemic or hemorrhagic events over short-term follow-up but was associated with increased mortality or disability.

Introduction: Ischaemic stroke patients with atrial fibrillation (AF) are at high risk of stroke recurrence despite oral anticoagulation therapy. Patients with cardiovascular comorbidities may take both antiplatelet and oral anticoagulation therapy (OAC/AP). Our study aims to evaluate the safety and efficacy of OAC/AP therapy as secondary prevention in people with AF and ischaemic stroke.Patients and methods: We performed a post-hoc analysis of pooled individual data from multicenter prospective cohort studies and compared outcomes in the OAC/AP cohort and patients on DOAC/VKA anticoagulation alone (OAC cohort). Primary outcome was a composite of ischaemic stroke, systemic embolism, intracranial bleeding, and major extracranial bleeding, while secondary outcomes were ischaemic and haemorrhagic events considered separately. A multivariable logistic regression analysis was performed to identify independent predictors for outcome events. To compare the risk of outcome events between the two cohorts, the relation between the survival function and the set of explanatory variables were calculated by Cox proportional hazard models and the results were reported as adjusted hazard ratios (HR). Finally another analysis was performed to compare the overall risk of outcome events in both OAC/AP and OAC cohorts after propensity score matching (PSM).Results: During a mean follow-up time of 7.5 ± 9.1 months (median follow-up time 3.5 months, interquartile range ±3), 2284 stroke patients were on oral anticoagulants and 215 were on combined therapy. The multivariable model demonstrated that the composite outcome is associated with age (OR: 1.03, 95% CI: 1.01–1.04 for each year increase) and concomitant antiplatelet therapy (OR: 2.2, 95% CI: 1.48–3.27), the ischaemic outcome with congestive heart failure (OR: 1.55, 95% CI: 1.02–2.36) and concomitant antiplatelet therapy (OR: 1.93, 95% CI: 1.19–3.13) and the haemorrhagic outcome with age (OR: 1.03, 95% CI: 1.01–1.06 for each year increase), alcoholism (OR: 2.15, 95% CI: 1.06–4.39) and concomitant antiplatelet therapy (OR: 2.22, 95% CI: 1.23–4.02). Cox regression demonstrated a higher rate of the composite outcome (hazard ratio of 1.93 [95% CI, 1.35–2.76]), ischaemic events (HR: 2.05 [95% CI: 1.45–2.87]) and bleeding outcomes (HR: 1.90 [95% CI, 1.06–3.40]) in OAC/AP cohort. After PSM analysis, the composite outcome remained more frequent in people treated with OAC + AP (RR: 1.70 [95% CI, 1.05–2.74]).Discussion: Secondary prevention with combination of oral anticoagulant and antiplatelet therapy after ischaemic stroke was associated with worse outcomes in our cohort.Conclusion: Further research is needed to improve secondary prevention by investigating the mechanisms of recurrent ischaemic stroke in patients with atrial fibrillation.

ABSTRACTWithin Australian universities, neoliberalism has transformed education into a marketplace and product, where academic employees are regulated and controlled through metrics, productivity, and pressure to maintain and increase ‘value’. In this environment, disabled academics face increasing barriers to workplace participation and meaningful inclusion. To explore the lived experiences of disabled academics, this article draws upon qualitative survey and interview data collected from disabled academics to consider the ways that the academy excludes and disables them. Specifically, we argue that the way time is regulated and managed within the neoliberal university is ableist, and fails to account for the crip temporalities by which disabled academics live their lives. The concept of crip and cripping time in relation to disabled academics opens up new ways of thinking, doing, and being that are not constrained by normative (clock) time that marginalises disabled subjects. While we focus on an Australian context, the near-universalising ‘logics’ of normative time and neoliberal-ableism inherent to universities and societies more generally has implications for everyone. We argue that it is incumbent upon universities to rethink prevailing notions of time that currently elide the experiences and capacities of disabled academics.

Metal–organic frameworks (MOFs) have emerged as a class of porous materials with facile uptake and release of water, turning them into excellent substrates for real-world atmospheric water harvesting applications. The performance of different MOF systems was experimentally characterized at the bulk level by assessing the total amount of water taken up and the release kinetics, leaving the question behind of what the upper limit of the pristine materials actually is. Moreover, recent devices rely on fluidized bed reactors that exploit the harvesting capacities of MOFs at the single-crystal (SC) level. In this publication, we present a novel methodology based on Raman spectroscopy, for acquiring water adsorption isotherms and kinetic curves with a sub-micrometer resolution that provides valuable insights into the material behavior probing the pristine MOF at the SC level. We investigated isolated MOF-801 particles in situ and could dissect contributions of intra- and inter-particle effects on the water harvesting performance of MOF-801 via adsorption–desorption isotherms and kinetic curves. Using spontaneous Raman spectroscopy, we found an almost 20-fold faster uptake for the undisturbed crystalline material. Correlative imaging based on four-wave mixing and coherent anti-Stokes Raman scattering further localized the uptaken water inside MOF-801 and identified inter-particle condensation as the main source for the discrepancies between the performance at the bulk and SC level. Our studies determined an upper limit of around 91.9 L/kgMOF/day for MOF-801.

Large vessel occlusion stroke due to underlying intracranial atherosclerotic disease (ICAD-LVO) is prevalent in 10 to 30% of LVOs depending on patient factors such as vascular risk factors, race and ethnicity, and age. Patients with ICAD-LVO derive similar functional outcome benefit from endovascular thrombectomy as other mechanisms of LVO, but up to half of ICAD-LVO patients reocclude after revascularization. Therefore, early identification and treatment planning for ICAD-LVO are important given the unique considerations before, during, and after endovascular thrombectomy. In this review of ICAD-LVO, we propose a multistep approach to ICAD-LVO identification, pretreatment and endovascular thrombectomy considerations, adjunctive medications, and medical management. There have been no large-scale randomized controlled trials dedicated to studying ICAD-LVO, therefore this review focuses on observational studies.

Occlusive and nonocclusive cervicocephalic thrombi can be encountered during neurovascular imaging in patients with acute ischemic stroke. Radiographic and morphological characteristics on basic and advanced imaging modalities can be important clues towards determination of pathomechanism and the choice of acute and subacute treatment modalities. The aim of this review article is to evaluate the epidemiology, radiographic properties, histologic clot composition of cervicocephalic arterial thrombi, and its response to various medical and endovascular therapy modalities. Future studies are needed to derive and validate a classification system for extracranial and intracranial partially occlusive thrombi to enable further testing of various stroke treatment and prevention strategies in these patients.

Background: The aim of this study was to determine the effect of smoking status on subsequent stroke risk in patients with minor ischemic stroke or TIA and to determine whether smoking modifies the effect of clopidogrel-based DAPT on subsequent stroke risk.Methods: This was a post-hoc analysis of the Platelet Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) trial, which had a 90-day follow-up period. We used multivariable Cox regression and subgroup interaction analysis to determine the effect of smoking on the risk of subsequent ischemic stroke and major hemorrhage, respectively.Results: Data from 4877 participants enrolled in the POINT trial were analyzed. Among these, 1004 were current smokers and 3873 were non-smokers at the time of index event. Smoking was associated with a non-significant trend toward an increased risk of subsequent ischemic stroke during follow up (adjusted HR, 1.31 (95% CI, 0.97–1.78), p= 0.076). The effect of clopidogrel on ischemic stroke did not differ between non-smokers (HR, 0.74 (95% CI, 0.56–0.98), p= 0.03) and smokers (HR, 0.63 (95% CI, 0.37–1.05), p= 0.078), pfor interaction = 0.572. Similarly, the effect of clopidogrel on major hemorrhage did not differ between non-smokers (hazard ratio, 1.67 (95% CI, 0.40–7.00), p= 0.481) and smokers (HR, 2.59 (95% CI, 1.08–6.21), p= 0.032), pfor interaction = 0.613.Conclusions: In this post-hoc analysis of the POINT trial we found that the effect of clopidogrel on reducing subsequent ischemic stroke as well as risk of major hemorrhage did not depend on smoking status, indicating that smokers benefit to a similar degree from DAPT as non-smokers.

IMPORTANCE: International guidelines recommend avoiding intravenous thrombolysis (IVT) in patients with ischemic stroke who have a recent intake of a direct oral anticoagulant (DOAC). OBJECTIVE: To determine the risk of symptomatic intracranial hemorrhage (sICH) associated with use of IVT in patients with recent DOAC ingestion. DESIGN, SETTING, AND PARTICIPANTS: This international, multicenter, retrospective cohort study included 64 primary and comprehensive stroke centers across Europe, Asia, Australia, and New Zealand. Consecutive adult patients with ischemic stroke who received IVT (both with and without thrombectomy) were included. Patients whose last known DOAC ingestion was more than 48 hours before stroke onset were excluded. A total of 832 patients with recent DOAC use were compared with 32 375 controls without recent DOAC use. Data were collected from January 2008 to December 2021. EXPOSURES: Prior DOAC therapy (confirmed last ingestion within 48 hours prior to IVT) compared with no prior oral anticoagulation. MAIN OUTCOMES AND MEASURES: The main outcome was sICH within 36 hours after IVT, defined as worsening of at least 4 points on the National Institutes of Health Stroke Scale and attributed to radiologically evident intracranial hemorrhage. Outcomes were compared according to different selection strategies (DOAC-level measurements, DOAC reversal treatment, IVT with neither DOAC-level measurement nor idarucizumab). The association of sICH with DOAC plasma levels and very recent ingestions was explored in sensitivity analyses. RESULTS: Of 33 207 included patients, 14 458 (43.5%) were female, and the median (IQR) age was 73 (62-80) years. The median (IQR) National Institutes of Health Stroke Scale score was 9 (5-16). Of the 832 patients taking DOAC, 252 (30.3%) received DOAC reversal before IVT (all idarucizumab), 225 (27.0%) had DOAC-level measurements, and 355 (42.7%) received IVT without measuring DOAC plasma levels or reversal treatment. The unadjusted rate of sICH was 2.5% (95% CI, 1.6-3.8) in patients taking DOACs compared with 4.1% (95% CI, 3.9-4.4) in control patients using no anticoagulants. Recent DOAC ingestion was associated with lower odds of sICH after IVT compared with no anticoagulation (adjusted odds ratio, 0.57; 95% CI, 0.36-0.92). This finding was consistent among the different selection strategies and in sensitivity analyses of patients with detectable plasma levels or very recent ingestion. CONCLUSIONS AND RELEVANCE: In this study, there was insufficient evidence of excess harm associated with off-label IVT in selected patients after ischemic stroke with recent DOAC ingestion.

Following acute injury, stromal cells promote tissue regeneration by a diversity of mechanisms. Time-resolved single-cell RNA sequencing of muscle mesenchymal stromal cells (MmSCs) responding to acute injury identified an ‘early-responder’ subtype that spiked on day 1 and expressed a notable array of transcripts encoding immunomodulators. IL-1β, TNF-α and oncostatin M each strongly and rapidly induced MmSCs transcribing this immunomodulatory program. Macrophages amplified the program but were not strictly required for its induction. Transfer of the inflammatory MmSC subtype, tagged with a unique surface marker, into healthy hindlimb muscle induced inflammation primarily driven by neutrophils and macrophages. Among the abundant inflammatory transcripts produced by this subtype, Cxcl5was stroma-specific and highly upregulated with injury. Depletion of this chemokine early after injury revealed a substantial impact on recruitment of neutrophils, a prolongation of inflammation to later times and an effect on tissue regeneration. Mesenchymal stromal cell subtypes expressing a comparable inflammatory program were found in a mouse model of muscular dystrophy and in several other tissues and pathologies in both mice and humans. These ‘early-responder’ mesenchymal stromal cells, already in place, permit rapid and coordinated mobilization and amplification of critical cell collaborators in response to injury.

Metal–organic frameworks (MOFs) are excellent candidates for water harvesting from desert air. MOF-303 (Al(OH)(PZDC), where PZDC is 1-H-pyrazole-3,5-dicarboxylate), a robust and water-stable MOF, is a particularly promising water-harvesting sorbent that can take up water at low relative humidity and release it under mild heating. Accordingly, development of a facile, high-yield synthesis method for its production at scale is highly desirable. Here we report detailed protocols for the green, water-based preparation of MOF-303 on both gram and kilogram scales. Specifically, four synthetic methods (solvothermal, reflux, vessel and microwave), involving different equipment requirements, are presented to guarantee general accessibility. Typically, the solvothermal method takes ~24 h to synthesize MOF-303, while the reflux and vessel methods can reduce the time to 4–8 h. With the microwave-assisted method, the reaction time can be further reduced to just 5 min. In addition, we provide guidance on the characterization of MOF-303, as well as water-harvesting MOFs in general, to ensure high quality of the product in terms of its purity, crystallinity, porosity and water uptake. Furthermore, to address the need for future commercialization of this material, we demonstrate that our protocol can be employed to produce 3.5 kg per batch with a yield of 91%. MOF-303 synthesized at this large scale shows similar crystallinity and water uptake capacity compared to the respective material produced at a small scale. Our synthetic procedure is green and water-based, and can produce the MOF within hours.