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Background: Stroke is the second leading cause of death and the third leading cause of disability in the general population worldwide. However, the changing trend of ischemic stroke burden attributable to various dietary risk factors has not been fully revealed and may contribute to a better understanding of stroke epidemiology. Aims: Our article aimed to evaluate the temporal trend of diet-related ischemic stroke burden to inform future research and policy-making. Methods: This analysis was based on the data from the Global Burden of Disease (GBD) Study 2019 (spanning years 1990 to 2019), and we used the joinpoint regression to model temporal trends in diet-related ischemic stroke burden across countries and regions of the world during the study period. Six specific dietary factors known to influence stroke risk, including sodium, red meat, fiber, vegetables, whole grains, and fruits, were evaluated in the GBD study to determine their individual and joint impact on ischemic stroke. The changing trend was primarily measured by the average annual percent change (AAPC). Age-standardized rates (ASRs) of mortality and years lived with disability (YLD) per 100,000 population were used to evaluate disease burden. Finally, the socioeconomic background, which was quantified as sociodemographic index (SDI), and its association with diet-related ischemic stroke burden were also explored with the Pearson correlation coefficient. Results: During the study period, the ischemic stroke ASR of mortality attributable to overall dietary risk decreased by an average of 1.6% per year, while the ASR of YLD decreased by an average of 0.2% per year. High sodium diet was still a key driver of diet-related ischemic stroke, accounting for 8.4% and 11.0% of deaths and disabilities, respectively, in 2019. In addition, we found a negative association between temporal evolution of stroke burden and socioeconomic background (r = −0.6603 for mortality and r = −0.4224 for disability, P < 0.001), which suggested that the developing countries with weak social and economic foundation faced greater challenges from the ongoing burden of diet-related strokes compared with developed countries. Conclusions: Our study found declining trends and revealed the current status of diet-related ischemic stroke mortality and disability. Interdisciplinary countermeasures involving the development of effective food policies, evidence-based guidelines, and public education are needed in the future to combat this global epidemic. Data access statement: The data used for analysis were open-access and can be obtained from https://vizhub.healthdata.org/gbd-results/. [ABSTRACT FROM AUTHOR]

Introduction: Post-thrombectomy intraparenchymal hyperdensity (PTIH) in patients with acute ischemic stroke is a common CT sign, making it difficult for physicians to distinguish intracerebral hemorrhage in the early post-thrombectomy period. The aim of this study was to develop an effective model to differentiate intracerebral hemorrhage from contrast extravasation in patients with PTIH. Methods: We retrospectively collected information on patients who underwent endovascular thrombectomy at two stroke centers between August 2017 and January 2023. A total of 222 patients were included in the study, including 118 patients in the development cohort, 52 patients in the internal validation cohort, and 52 patients in the external validation cohort. The nomogram was constructed using R software based on independent predictors derived from the multivariate logistic regression analysis, including clinical factors and CT texture features extracted from hyperdense areas on CT images. The performance and accuracy of the derived nomogram were assessed by the area under the receiver operating characteristic curve (AUC-ROC) and calibration curves. Additionally, decision curve analysis was conducted to appraise the clinical utility of the nomogram. Results: Our nomogram was derived from two clinical factors (ASPECT score and onset to reperfusion time) and two CT texture features (variance and uniformity), with AUC-ROC of 0.943, 0.930, and 0.937 in the development, internal validation, and external validation cohorts, respectively. Furthermore, the calibration plot exhibited a strong agreement between the predicted outcome and the actual outcome. In addition, the decision curve analysis revealed the clinical utility of the nomogram in accurately predicting hemorrhage in patients with PTIH. Conclusion: The developed nomogram, based on clinical factors and CT texture features, proves to be effective in distinguishing intracerebral hemorrhage from contrast extravasation in patients with PTIH. [ABSTRACT FROM AUTHOR]

Purpose: The fibrinogen-to-albumin ratio (FAR) is a novel inflammation marker associated with various diseases. This study aimed to investigate the correlation between FAR and early neurological deterioration (END) after intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS). Patients and Methods: From September 1, 2021, to March 31, 2023, continuously recruited AIS patients who received IVT within 4.5 hours were included in the study. Blood samples were collected in the emergency room before IVT. The National Institutes of Health Stroke Scale (NIHSS) score was assessed upon admission and after thrombolysis within the first 24 hours. END was defined as an increase in the NIHSS score by ≥ 4 points within 24 hours after thrombolysis. Multivariate logistic regression analysis was conducted to explore the relationship between FAR and END, and a receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of FAR for END. Results: 343 participants were recruited, and 59 (17.2%) experienced END. Patients with END had higher FAR levels than those without END (P< 0.001). Multivariate logistic regression analysis showed that FAR was independently associated with END, both as a continuous variable and as a tertile variable (P< 0.005). After excluding patients with hemorrhagic transformation (HT), FAR remained independently associated with END (P< 0.005). The area under the curve (AUC) of FAR for predicting END was 0.650 (95% CI=0.571– 0.729, P< 0.001), with an optimal cutoff of 72.367 mg/g, a sensitivity of 61.6%, and a specificity of 62.6%. Conclusion: FAR upon admission was independently associated with END after IVT and can be an effective predictor. [ABSTRACT FROM AUTHOR]

Meso-diaminopimelate dehydrogenase (meso-DAPDH) from Corynebacterium glutamicum ATCC13032 (CgDAPDH) is a type I meso-DAPDH that shows obvious preference toward meso-diaminopimelate (meso-DAP) and exhibits almost no amination activity toward 2-keto acids. There are seven distinct conserved insertions and deletions (indels) between type I and type II meso-DAPDH. The current functional analysis of indels is not comprehensive in meso-DAPDH. Continuing from our previous work on these indels, we first examined the functions of the other indels shown as insertion residues in type I CgDAPDH. Alanine mutations in M216, T240, K289, and Q290 lost at least 40% of their activity, highlighting the importance of these four sites in CgDAPDH. Molecular dynamic analysis indicated that the four non-active sites altered the dynamic network of interactions within the protein. Subsequently, these four sites together with the previously identified indel-related residues R180, L176, and H193 were targeted by site-saturation mutagenesis to improve the amination ability of CgDAPDH toward pyruvic acid. The most significant improvement was observed with the mutant CgL176R, which showed a six-fold increase toward pyruvic acid in kcat/Km compared to wild-type CgDAPDH. Overall, our study provides new hotspots and ideas for the subsequent protein engineering of CgDAPDH, which may also be applied to other meso-DAPDHs. [ABSTRACT FROM AUTHOR]

The effect of niobium ions with high‐valence doping on high‐voltage LiNi0.5Mn1.5O4 (LNMO) materials was investigated. LiNi0.5Mn1.5−xNbxO4 was prepared by doping high‐valent niobium ions into LiNi0.5Mn1.5O4 material using the organic assisted combustion method. The experimental samples were characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), X‐ray diffraction (XRD), X‐ray photoelectron spectroscopy (XPS), electrochemical impedance (EI), and cyclic voltammetry (CV) analysis. The experimental results show that ‐doping with high‐valence niobium ions changes the orientation of the crystal plane growth of spinel particles, and the morphology of these particles changes from the octahedral shape before doping to the spherical shape after doping. With the increase in doping amount, the crystal structure changes gradually, resulting in the Li0.96Nb1.01O3 impurity phase. The doping of high valence‐niobium ions increases the content of Mn3+ in the material, resulting in the appearance of a 4 V discharge platform and the formation of a 4.7 and 4 V discharge platforms. The doping of Nb can improve the cycling stability of LiNi0.5Mn1.5O4 material, but the specific capacity of the material is reduced. [ABSTRACT FROM AUTHOR]

H‐acid, a prevalent pollutant in dyeing wastewater, is primarily utilized in the pharmaceutical and textile industries. However, H‐acid treatment remains a challenge because of its high concentration, degradation resistance and poor biodegradability. This review examines the principles, characteristics, advantages and disadvantages of the most recently developed advanced practical H‐acid treatment technologies. Furthermore, this review analyzes the existing issues within these methods and explores potential future development trends. © 2023 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

\nIntroduction: The association between earlobe crease (ELC) and cerebral small vessel disease, including white matter hyperintensities (WMHs) and brain atrophy, is unclear, especially in the setting of acute ischemic stroke (AIS). Here, we aimed to investigate the association between ELC and WMHs as well as brain atrophy among AIS patients. Methods: A total of 730 AIS patients from China were enrolled. Patients were divided into groups without and with ELC, unilateral and bilateral ELC according to pictures of bilateral ears. Logistic regression models were employed to assess the impact of ELC, bilateral ELC on WMHs, periventricular hyperintensities (PVHs), deep white matter hyperintensities (DWMHs), and brain atrophy, as measured by the Fazekas scale and global cortical atrophy scale, in brain magnetic resonance imaging. Results: There were 520 (71.2%) AIS patients with WMHs, 445 (61.0%) with PVH, 462 (63.3%) with DWMH, and 586 (80.3%) with brain atrophy. Compared to those without ELC, patients with ELC were significantly associated with an increased risk of PVH (odds ratio [OR] 1.79; 95% confidence interval [CI], 1.15–2.77) and brain atrophy (OR: 6.18; 95% CI: 3.60–10.63) but not WMHs and DWMH. The presence of bilateral ELC significantly increased the odds of WMHs (OR: 1.60; 95% CI: 1.00–2.56), PVH (OR: 1.87; 95% CI: 1.18–2.96), and brain atrophy (OR: 8.50; 95% CI: 4.62–15.66) when compared to individuals without ELC. Furthermore, we discovered that the association between bilateral ELC and WMHs, PVH, and DWMH was significant only among individuals aged ≤68 (median age) years (all p trend ≤0.041). However, this association was not observed in patients older than 68 years. Conclusions: In Chinese AIS patients, the presence of the visible aging sign, ELC, especially bilateral ELC, showed independent associations with both WMHs and brain atrophy, particularly among those younger than 68 years old. Early detection of subtle white matter hyperintensities (WMHs) or brain atrophy might be important in terms of diagnosis and treatment. We hypothesize that earlobe crease (ELC), a visible sign of aging, may correlate with and aid in the early identification of WMHs and brain atrophy. We reported the association between the ELC and WMHs and brain atrophy among 730 patients with acute ischemic stroke (AIS). We observed that in AIS patients the presence of ELC, especially bilateral ELC, showed independent associations with both WMHs and brain atrophy, particularly among those younger than 68 years old. Our findings suggest that ELC, especially bilateral ELC, might be an easy-to-observe and widely used indicator for predicting the presence of WMHs or brain atrophy. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to determine predictors of early (END) and delayed neurological deterioration (DND) and their association with the functional outcome in patients with acute ischemic stroke (AIS) who participated in the international Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Methods: END and DND (without END) were defined as scores of a ≥2-point increase on the National Institutes of Health Stroke Scale (NIHSS) or a ≥1-point decrease on the Glasgow coma scale or death, from baseline to 24 h and 24–72 h, respectively. Multivariable logistic regression models were used to determine independent predictors of END and DND and their association with 90-day outcomes (dichotomous scores on the modified Rankin scale [mRS] of 2–6 vs. 0–1 and 3–6 vs. 0–2 and death). Results: Of 4,496 patients, 871 (19.4%) and 302 (8.4%) patients experienced END and DND, respectively. Higher baseline NIHSS score, older age, large-artery occlusion due to significant atheroma, cardioembolic stroke subtype, hemorrhagic infarction and parenchymatous hematoma within 24 h were all independent predictors for both END (all p ≤ 0.01) and DND (all p ≤ 0.024). Moreover, higher baseline systolic blood pressure (BP) (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.02–1.12), higher diastolic BP variability within 24 h (OR 1.07, 95% CI 1.04–1.09), patients from Asia (OR 1.25, 95% CI 1.03–1.52) were the only independent predictors for END. However, Asian ethnicity was negatively associated with DND (OR 0.64, 95% CI 0.47–0.86). Hemorrhagic infarction and parenchymatous hematoma within 24 h were the key predictors of END across all stroke subtypes. END and DND were all associated with a poor functional outcome at 90 days (all p < 0.001). Conclusion: We identified overlapping and unique demographic and clinical predictors of END and DND after thrombolysis for AIS. Both END and DND predict unfavorable outcomes at 90 days. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate whether combining renal function status [estimating glomerular filtration rate (eGFR)] with coagulation biomarkers [fibrinogen (Fg) and d-dimer] is more beneficial in predicting in-hospital outcomes following intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) patients., Methods: We studied 417 AIS patients with IVT. According to the cut-offs of coagulation biomarkers (Fg and d-dimer) and eGFR determined by receiver operating characteristic (ROC) curves, the patients were divided into four groups: LFLG (low Fg and low eGFR), LFHG (low Fg and high eGFR), HFLG (high Fg and low eGFR), and HFHG (high Fg and high eGFR); or LDLG (low d-dimer and low eGFR), LDHG (low d-dimer and high eGFR), HDLG (high d-dimer and low eGFR), and HDHG (high d-dimer and high eGFR). Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for poor outcomes at discharge and post-stroke pneumonia across the four groups., Results: The patients in the HFLG and HDLG groups had the poorest prognosis at discharge and the highest risk of in-hospital pneumonia. They experienced 3.00 or 4.59 times higher risk of in-hospital pneumonia than those in the LFHG and LDHG groups (95%CI: 1.07-8.44, p < 0.05; 95%CI: 1.58-13.32, p = 0.005). Similarly, the risk of adverse outcome at discharge was 3.02 and 1.52 times higher in HFLG and HDLG groups (95%CI: 1.63-9.91, p < 0.005; 95%CI: 1.11-5.74, p < 0.05) compared to that in LFHG and LDHG groups. Adding eGFR and Fg or d-dimer to the risk model improved the risk reclassification for in-hospital pneumonia and functional outcomes at discharge., Conclusion: Combining renal function status and coagulation biomarkers within 4.5 h after onset could better predict in-hospital outcomes of AIS patients with IVT., (© 2024 The Author(s). Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)

A rare case of ischemic stroke in a young adult demonstrating coexistence of moyamoya disease and carotid web in angiography was reported. Early recognition and prompt intervention should be stressed in individuals with cryptogenic stroke., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.)

A suitable interlayer between the Mo back electrode and kesterite absorber layer has been proven to have a positive effect on limiting the bulk defects of the absorber by the constitute diffusion. Here, a thin Bi 2 S 3 layer is used as the back-interface intermediate layer for the first time, this innovative approach allows for simultaneous modification of the back contact and reduction of bulk defects, resulting in improving the power conversion efficiency of the kesterite device from 9.66% to 11.8%. The evaporated Bi 2 O 3 thin films turn into the Bi 2 S 3 interlayers after sintering the Cu 2 ZnSnS 4 precursor thin films. The Bi 2 S 3 interlayer can inhibit the decomposition reaction of back contact and suppress the formation of the secondary phases. It can also optimize the Fermi level offset and promote the separation of the photoinduced carriers, resulting from its characteristic of high work function. Besides, a small part of the Bi element can diffuse into Cu 2 ZnSn(S, Se) 4 film and induce the crystal growth and restrain Zn-related defects, which is attributed to forming the low melting-point liquid BiSe x phase during the high-temperature selenization process. The conclusions highlight the bifunction of the thin Bi 2 S 3 intermediate layer, which can provide a new approach to improve the photoelectric conversion efficiency of kesterite solar cells., (© 2024 Wiley‐VCH GmbH.)

Objective: This study aimed to explore the relationship between total burden of cerebral small vessel disease (CSVD) and daytime and nighttime heart rate variability (HRV) parameters., Method: Consecutive patients with nondisabling ischemic cerebrovascular events were recruited from the cerebrovascular disease clinic of Changzhou Second People's Hospital between January 2022 and June 2023. A total of 144 enrolled participants were divided into a mild CSVD group (74 patients) and a moderate-to-severe CSVD group (70 patients) based on total burden of CSVD. Various HRV parameters measured during 24-h, 4-h daytime, and 4-h nighttime periods (including natural log-transformed [ln] root mean square of successive RR interval differences [RMSSD], ln absolute power of the high-frequency band [0.15-0.4 Hz] [HF], ln absolute power of the low-frequency band [0.04-0.15 Hz][LF], and LF-to-HF ratio [LF/HF]) were then assessed in the 2 groups. Spearman correlation analysis was used to assess the correlation between total burden of CSVD and HRV parameters. HRV parameters with P -value < 0.05 in correlation analysis were included in the multivariable logistic regression analysis, and restricted cubic spline analysis was performed to assess dose-response relationships., Results: Daytime 4-h lnRMSSD (r = -0.221; P  = 0.008) and 4-h lnHF (r = -0.232; P  = 0.005) were negatively correlated with total burden of CSVD, and daytime 4-h lnLF/HF (r = 0.187; P  = 0.025) was positively correlated with total burden of CSVD. There was no correlation between nighttime HRV parameters and total burden of CSVD. After adjustments were made for potential confounders, daytime 4-h lnRMSSD (OR = 0.34; 95% CI: 0.16-0.76), 4-h lnHF (OR = 0.57; 95% CI: 0.39-0.84), and 4-h lnLF/HF (OR = 2.12; 95% CI: 1.18-3.82) were independent predictors of total burden of CSVD (all P  < 0.05). S-shaped linear associations with moderate-to-severe total burden of CSVD were seen for daytime 4h-lnRMSSD ( P for nonlinearity = 0.543), 4-h lnHF ( P for nonlinearity = 0.31), and 4-h lnLF/HF ( P for nonlinearity = 0.502)., Conclusion: Daytime parasympathetic HRV parameters are independent influencing factors of total burden of CSVD and may serve as potential therapeutic observation indicators for CSVD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Zhang, Lv, Wang, Wang, Zhang and Cao.)

Background: This study was conducted to determine optimal predictive ability of National Institutes of Health Stroke Scale (NIHSS) measurements at baseline, 24 hours, and change from baseline to 24 hours after thrombolysis on functional recovery in patients with acute ischemic stroke who participated in the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study)., Methods and Results: ENCHANTED was an international, multicenter, 2×2 quasifactorial, prospective, randomized open trial of low-dose versus standard-dose intravenous alteplase and intensive versus guideline-recommended blood pressure lowering in thrombolysis-eligible patients with acute ischemic stroke. Absolute (baseline minus 24 hours) and percentage (absolute change/baseline × 100) changes in NIHSS scores were calculated. Receiver operating characteristic curve analyses assessed performance of different NIHSS measurements on 90-day favorable functional recovery (modified Rankin Scale [mRS] score 0-2) and excellent functional recovery (mRS score 0-1). Youden index was used to identify optimal predictor cutoff points. A total of 4410 patients in the ENCHANTED trial were enrolled. The 24-hour NIHSS score had the highest discriminative ability for predicting favorable 90-day functional recovery (mRS score 0-2; area under the curve 0.866 versus 0.755, 0.689, 0.764; P <0.001) than baseline, absolute, and percentage change of NIHSS score, respectively. The optimal cutoff point of 24-hour NIHSS score for predicting favorable functional recovery was ≤4 (sensitivity 66.5%, specificity 87.1%, adjusted odds ratio, 9.44 [95% CI, 7.77-11.48]). The 24-hour NIHSS score (≤3) was the best predictor of 90-day excellent functional recovery (mRS score 0-1). Findings were consistent across subgroups, including sex, race, baseline NIHSS score, stroke subtype, and age., Conclusions: In thrombolysis-eligible patients with acute ischemic stroke, 24-hour NIHSS score (optimal cutpoint of 4) is the strongest predictor of 90-day functional recovery over baseline and early change of NIHSS score., Registration: URL: https://clinicaltrials.gov. Unique Identifier: NCT01422616.

Background: Neutrophils and Lipocalin-2 (LCN2) play pivotal roles in cerebral ischemiareperfusion (I/R) injury. However, their contribution is not fully clarified., Objective: This study aimed to explore the role of LCN2 and its association with neutrophil polarization in I/R injury., Methods: A mouse model of middle cerebral artery occlusion (MCAO) was used to induce cerebral ischemia. LCN2mAb was administered 1 h and Anti-Ly6G was administered for 3d before MCAO. The role of LCN2 in the polarity transition of neutrophils was explored using an in vitro HL-60 cell model., Results: LCN2mAb pretreatment had neuroprotective effects in mice. The expression of Ly6G was not significantly different, but the expression of N2 neutrophils was increased. In the in vitro study, LCN2mAb-treated N1-HL-60 cells induced N2-HL-60 polarization., Conclusion: LCN2 may affect the prognosis of ischemic stroke by mediating neutrophil polarization., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)