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The Data Acquisition System (DAQ) for the LUX-ZEPLIN (LZ) dark matter detector is described. The signals from 745 PMTs, distributed across three subsystems, are sampled with 100-MHz 32-channel digitizers (DDC-32s). A basic waveform analysis is carried out on the on-board Field Programmable Gate Arrays (FPGAs) to extract information about the observed scintillation and electroluminescence signals. This information is used to determine if the digitized waveforms should be preserved for offline analysis. The system is designed around the Kintex-7 FPGA. In addition to digitizing the PMT signals and providing basic event selection in real time, the flexibility provided by the use of FPGAs allows us to monitor the performance of the detector and the DAQ in parallel to normal data acquisition. The hardware and software/firmware of this FPGA-based Architecture for Data acquisition and Realtime monitoring (FADR) are discussed and performance measurements are described.

LUX-ZEPLIN (LZ) is a tonne-scale experiment searching for direct dark matter interactions and other rare events. It is located at the Sanford Underground Research Facility (SURF) in Lead, South Dakota, USA. The core of the LZ detector is a dual-phase xenon time projection chamber (TPC), designed with the primary goal of detecting Weakly Interacting Massive Particles (WIMPs) via their induced low energy nuclear recoils. Surrounding the TPC, two veto detectors immersed in an ultra-pure water tank enable reducing background events to enhance the discovery potential. Intricate calibration systems are purposely designed to precisely understand the responses of these three detector volumes to various types of particle interactions and to demonstrate LZ’s ability to discriminate between signals and backgrounds. In this paper, we present a comprehensive discussion of the key features, requirements, and performance of the LZ calibration systems, which play a crucial role in enabling LZ’s WIMP-search and its broad science program. The thorough description of these calibration systems, with an emphasis on their novel aspects, is valuable for future calibration efforts in direct dark matter and other rare-event search experiments.

Nanostructures are critical for improving the contact area with an electrolyte and catalytic efficiency for the CO 2 reduction reaction (CO 2 RR). However, their hydrophobicity conflicts with the intended increase in the contact area and complicates the determination of the active contact area. Here, bismuth-nickel (BiNi) micro-nano hierarchical catalysts for the CO 2 RR were studied to understand the effects of electrolyte-catalyst contact area variation with the immersion duration in an aqueous electrolyte. The immersed BiNi samples showed about 13.4-fold higher formate production compared to the pristine BiNi sample. The 2-day pre-immersed BiNi sample exhibited faradaic efficiencies (FE%) of ∼80.1% for formate and ∼10% for H 2 with a current density of 10.2 mA cm -2 at -1.5 V vs. Ag/AgCl. In contrast, the pristine BiNi catalysts exhibited an FE% of ∼12.9% for formate and ∼76.3% for H 2 with a current density of 5.38 mA cm -2 . Our experimental results reveal that the improved contact between the electrolyte and the catalyst surface through pre-immersion can lead to enhanced CO 2 RR efficiency for formate production using hierarchical BiNi catalysts.

Background: Patients with chronic kidney disease (CKD) are at high risk for cardiovascular disease (CVD). We aimed to evaluate whether hemodialysis (HD) initiation is associated with CVD risk in patients with CKD., Methods: This self-controlled case series, using data from a nationwide Korean health claims database, included patients with CKD who initiated HD between 2007 and 2019 and experienced CVD, including acute stroke or myocardial infarction (MI), between 2008 and 2020. The risk periods were categorized relative to HD initiation (-60 to -31, -30 to -11, -10 to -1, +1 to +10, +11 to +30, +31 to +60, and +61 to +150 days); the remaining period was set as baseline. The age-adjusted incidence rate ratio (IRR) of CVD in each risk period relative to the baseline was calculated., Results: Of the 74,584 patients with CKD on incident HD, 12,875 patients with CVD (6,367 with ischemic stroke, 2,396 with hemorrhagic stroke, and 4,112 with MI) were included. Compared with the baseline period, the risk of CVD increased in the post-dialysis periods, decreasing with time since HD initiation; the adjusted IRR during the first 10 days after HD initiation was 2.95 (95% confidence interval, 2.44-3.56). Although the risks of ischemic stroke and MI decreased at 1 to 2 months after HD initiation, the hemorrhagic stroke risk was higher for 5 months., Conclusion: After HD initiation, the CVD risk increases in patients with CKD. For CVD prevention, the CVD risk should be carefully evaluated in patients with CKD who require HD.

Moiré superlattice of twisted hexagonal boron nitride (hBN) has emerged as an advanced atomically thin van der Waals interfacial ferroelectricity platform. Nanoscale periodic ferroelectric moiré potentials in twisted hBN allow the hosting of remote Coulomb superlattice potentials to adjacent 2D materials. Therefore, the new strategies for engineering moiré length, angle, and potential strength are essential for developing programmable quantum materials. Here, it demonstrates the realization of twisted hBN-based moiré superlattice platforms and visualizes the moiré domains and ferroelectric properties using Kelvin probe force microscopy (KPFM). Also, the regular moiré superlattice in the large area is reported. It offers the possibility to reproduce uniform moiré structures with precise control piezo stage stacking and heat annealing. It demonstrates cumulative multi-ferroelectric polarization and multi-level domains with multiple angle mismatched interfaces. Additionally, it observes the quasi-1D anisotropic moiré domains and show the highest resolution analysis of the local built-in strain between adjacent hBN layers compared to the conventional methods. Furthermore, in-situ manipulation of moiré potential is demonstrated using femtosecond pulse laser, which results in the optical phonon-induced atomic displacement at the hBN moiré interfaces. The results pave the way to develop precisely programmable moiré superlattice platforms and investigate strongly correlated physics., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Background and Purpose: The immune response following aneurysmal subarachnoid hemorrhage (aSAH) can exacerbate secondary brain injury and impact clinical outcomes. As the immune response after aSAH is a dynamic process, we aim to track and characterize immune cell trajectories over time to identify patterns associated with various clinical outcomes., Methods: In this retrospective single-center study of patients with aSAH, we analyzed immune cell count trajectories, including neutrophil, monocyte, and lymphocyte counts, collected from day 1 to day 14. These trajectories were classified into four distinct clusters utilizing the k-means longitudinal clustering method. A comprehensive multivariable analysis was performed to explore the associations of these immune cell clusters with various clinical outcomes. These outcomes included a Modified Rankin Scale score (mRS) of 3 to 6, indicative of poor functional outcomes, along with complications including shunt dependency, vasospasm, and secondary cerebral infarction., Results: In this study, 304 patients with aSAH were analyzed. The trajectories of immune cell counts, including neutrophils, monocytes, and lymphocytes, were successfully categorized into four distinct clusters for each immune cell type. Within neutrophil clusters, both persistent neutrophilia and progressive neutrophilia were associated with poor functional outcomes, shunt dependency, and vasospasm, with resolving neutrophilia showing a lesser degree of these associations. Within monocyte clusters, early monocytosis was associated with vasospasm, whereas delayed monocytosis was associated with shunt dependency. Within lymphocyte clusters, both early transient lymphopenia and early prolonged lymphopenia were associated with poor functional outcomes., Conclusion: Our study demonstrates that distinct immune cell trajectories post-aSAH, identified through unsupervised clustering, are significantly associated with specific clinical outcomes. Understanding these dynamic immune responses may provide key insights with potential for future therapeutic strategies., 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., (Copyright © 2024 Won, Kim, Jeong, Yang, Choi, Kang, Kim, Kim, Lee, Ban, Bang, Han, Kwon and Oh.)

Background: The pathologic feature of lung adenocarcinoma is extremely complex because the prognosis of same-stage lung adenocarcinoma significantly differs because of pathological diversity. This study aimed to evaluate the clinical association between histologic subtype and recurrence. Further, the prognostic significance of histologic subtype in stage I lung adenocarcinoma was examined., Methods: The medical records of 752 patients with pathological stage I lung adenocarcinoma were reviewed. The size of each histologic subtype was assessed. Receiver operating characteristic curve analysis was performed to identify the prognostic significance of histologic subtype. Univariate and multivariate analyses were conducted to validate the prognostic role of recurrence indicator., Results: The median age of the participants was 64 years, and female patients were predominant. The acinar-predominant subtype (44.7%) was the most common. According to each subtype size for predicting recurrence, >1 cm size of acinar subtype showed significant difference and the only presence of micropapillary and solid subtype themselves showed significant difference. As the area under the receiver operating characteristic curve for recurrence, an acinar subtype size of >1 cm, or the presence of the micropapillary or solid subtypes was 0.710 (P<0.001). This variable was significant for recurrence in the multivariate analysis (P<0.001)., Conclusions: The presence of micropapillary, solid subtype or an acinar size of >1 cm are an independent prognostic factor of stage I lung adenocarcinoma. A more sizable acinar subtype affects the prognosis of stage I lung adenocarcinoma. This factor can provide additional information for predicting prognosis and can be a valuable supplement for the current classification., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-24-905/coif). The authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Endovascular thrombectomy has a recanalization rate over 80%; however, approximately 50% of ischemic stroke patients still experience dependency or mortality. Recently, clinical trials demonstrated the benefits of administering neuroprotective agents prior to endovascular thrombectomy. Additionally, recent studies showed neuroprotective effects of mild hypercapnia in patients resuscitated after cardiac arrest. However, its efficacy in ischemic stroke remains unclear. We aimed to investigate whether carbon dioxide (CO 2 ) per-conditioning has neuroprotective effects in rat models with middle cerebral artery occlusion (MCAO). Rat models received intermittent inhalation of mixed gas during the MCAO period. After surgery, behavioral assessments, infarct size measurement, immunohistochemistry, and western blot analysis were performed. We found CO 2 per-conditioning reduced infarct size and neurological deficit. The number of 8-hydroxy-2-deoxyguanosine (8-OHdG) positive cells and matrix metalloproteinase 9 (MMP-9)/platelet derived growth factor receptor beta (PDGFRβ) double positive cells were significantly decreased after CO 2 per-conditioning. The expressions of tight junction protein and pericytes survival were preserved. This study underscores mild hypercapnia before reperfusion not only reduces neurologic deficit and infarct size, but also maintains the integrity of the blood-brain barrier and neurovascular unit, alongside mitigating oxidative stress in hyperacute stroke rat models. Therapeutic mild hypercapnia before reperfusion is promising and requires further clinical application., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In this study, the effects of the length-to-width ratio on the magnetic and microstructural properties of die-upset Nd-Fe-B magnets were examined. A die-upset magnet with a uniform shape and no significant cracking was successfully developed. During the die-upset process, the applied pressure was not uniform across the magnet and varied depending on its shape and position. In the case of the magnet with a 4:1 ratio, which had the largest length-to-width ratio, there was a higher concentration of stress at the edges compared to the center, resulting in easier grain deformation and growth at the edges, which led to the lowest remanence and ( BH ) max . As the length-to-width ratio approached 1:1, the grain size increased slightly, reducing the coercivity; however, the magnets maintained a uniform grain-size distribution. The change from a rectangular to a square pressing surface resulted in a more uniform stress distribution, particularly at the center and corners, which improved the consistency of the magnetic properties across different regions of the magnet. Consequently, an 11.9% enhancement in ( BH ) max , reaching 285.6 kJ/m 3 , was achieved in the 1:1 ratio die-upset magnet, which is attributed to the uniform grain size and improved grain alignment.

The safety and efficacy of coronavirus disease 2019 (COVID-19) vaccination in patients diagnosed with Moyamoya disease (MMD) have not been established. Using National Health Insurance Service data, this study analyzed the occurrence of stroke-related events and mortality following COVID-19 vaccination among patients diagnosed with MMD from 2008 to 2020. Among 10,297 MMD patients, 296 (2.9%) experienced events and 175 (1.7%) died in 2021. Significant risk factors for events included ages 50-59 (Odds Ratio [OR] 3.29; P = 0.022) and 60 or above (OR 5.20; P = 0.001) (reference group: age in 20s), low BMI (OR 2.00; P = 0.011), previous stroke (OR 1.96; P < 0.001), and COVID-19 infection (OR 2.28; P = 0.034). Female (OR 0.64 [95% CI 0.50-0.82]; p = 0.011), revascularization surgery (RS) (OR 0.38 [95% CI 0.21-0.70]; p < 0.001), and vaccination (OR 0.17 [95% CI 0.13-0.22]; p < 0.001) were associated with reduced odds of stroke-related events. For mortality, significant risks were age over 60 (OR 7.09; P = 0.008), low BMI (OR 3.87; P = 0.001), and prior stroke (OR 1.74; p = 0.004), while being female, RS (OR 0.41; P = 0.022), and vaccination (OR 0.12; P < 0.001) were associated with a lower frequency of mortality. mRNA vaccines were associated with a significantly lower incidence of events, mortality, and COVID-19 infections compared to vector vaccines. COVID-19 vaccination is linked to reduced stroke-related events and mortality in MMD patients, with mRNA vaccines showing a significantly lower incidence compared to vector vaccines. COVID-19 infection raises the risk of events, underscoring the benefit of vaccination., (© 2024. The Author(s).)

Background: White forsythia (Abeliophyllum distichum) is an endangered Korean Peninsula endemic that has been subjected to recent population genomics studies using SNPs via RAD sequencing. Here, we primarily employed the often underutilized haplotype information from RAD loci to further describe the species' previously uninvestigated haplotype-based genomic variation and structure, and genetic-geographic characteristics and gene flow patterns among its five earlier identified genetic groups. We also inferred the time of past events that may have impacted the effective population size of these groups, as well as the species' potential future distribution amidst the warming climate and anthropogenic threats., Results: Our findings emphasized the recognition of the species' regional patterns of genetic structure, and the role of topography and its associated gene flow patterns as some of the possible factors that may have influenced the species' present-day fragmented population distribution. The inferred bottleneck events during the Anthropocene, some of which aligned with the time of historical catastrophic events on the Peninsula (e.g., the Korean War), were revealed to have contributed to the generally low effective population size of its five lineages, particularly those with marginal distributional range. Future distribution under both optimistic and pessimistic climatic scenarios suggests unlikely suitable habitats for these populations to expand from their current range limits, at least in the next 80 years., Conclusions: The small effective population size and landscape-driven limited gene flow among white forsythia populations will remain a big challenge for the conservation management of the species' already fragmented population distribution. To help mitigate these impacts, the merging of various research approaches and the use of genomic data to their full potential is recommended to provide the optimized knowledge-based tools for the conservation of this endangered species, and other similar plants under pressure., (© 2024. The Author(s).)

Importance: Cerebral small vessel disease (SVD) is associated with various cerebrovascular outcomes, but data on sex differences in SVD are scarce., Objective: To investigate whether the frequency, severity, and distribution of cerebral microbleeds (CMB), other SVD markers on magnetic resonance imaging (MRI), and outcomes differ by sex., Design, Setting, and Participants: This cohort study used pooled individual patient data from the Microbleeds International Collaborative Network, including patients from 38 prospective cohort studies in 18 countries between 2000 and 2018, with clinical follow-up of at least 3 months (up to 5 years). Participants included patients with acute ischemic stroke or transient ischemic attack with available brain MRI. Data were analyzed from April to December 2023., Main Outcomes and Measures: Outcomes of interest were presence of CMB, lacunes, and severe white matter hyperintensities determined on MRI. Additionally, mortality, recurrent ischemic stroke, and intracranial hemorrhage during follow-up were assessed. Multivariable random-effects logistic regression models, Cox regression, and competing risk regression models were used to investigate sex differences in individual SVD markers, risk of recurrent cerebrovascular events, and death., Results: A total of 20 314 patients (mean [SD] age, 70.1 [12.7] years; 11 721 [57.7%] male) were included, of whom 5649 (27.8%) had CMB. CMB were more frequent in male patients, and this was consistent throughout different age groups, locations, and in multivariable models (female vs male adjusted odds ratio [aOR], 0.86; 95% CI, 0.80-0.92; P < .001). Female patients had fewer lacunes (aOR, 0.82; 95% CI, 0.74-0.90; P < .001) but a higher prevalence of severe white matter hyperintensities (aOR, 1.10; 95% CI, 1.01-1.20; P = .04) compared with male patients. A total of 2419 patients (11.9%) died during a median (IQR) follow-up of 1.4 (0.7-2.5) years. CMB presence was associated with a higher risk of mortality in female patients (hazard ratio, 1.15; 95% CI, 1.02-1.31), but not male patients (hazard ratio, 0.95; 95% CI, 0.84-1.07) (P for interaction = .01). A total of 1113 patients (5.5%) had recurrent ischemic stroke, and 189 patients (0.9%) had recurrent intracranial hemorrhage, with no sex differences., Conclusions and Relevance: This cohort study using pooled individual patient data found varying frequencies of individual SVD markers between female and male patients, indicating potential pathophysiological differences in manifestation and severity of SVD. Further research addressing differences in pathomechanisms and outcomes of SVD between female and male patients is required.

Background and Purpose: Swelling of the salivary glands, known as contrast-induced sialadenitis (CIS), is an adverse reaction to iodide contrast agents. However, the incidence and risk factors of CIS after therapeutic neuroendovascular procedures have not yet been established., Materials and Methods: Demographic and procedural factors that may influence the development of CIS were retrospectively analyzed to identify the incidence and risk factors of this condition. A total of 780 patients who underwent therapeutic neuroendovascular procedures between January 1, 2022 and December 31, 2022 were investigated. The risk factors affecting CIS were analyzed using multivariate logistic regression, and the quantitative degree of association between the volume of contrast administered and occurrence of CIS was determined using the receiver operating characteristic (ROC) curve., Results: The incidence of CIS after therapeutic neuroendovascular procedures was 4.2%. Multivariate logistic regression analysis showed that female sex (odds ratio [OR] = 4.420, 95% confidence interval [CI]: 1.377-14.190, p = 0.013), volume of contrast administered (OR = 1.007, 95% CI: 1.003-1.101, p < 0.001), and guiding catheter tip located within the external carotid artery (ECA) (OR = 8.701, 95% CI: 3.459-21.885, p < 0.001) were independently associated with CIS occurrence after therapeutic neuroendovascular procedures. The volume of contrast administered had an area under the ROC curve of 0.723 (95% CI:0.635-0.810; p < 0.001), and the optimal cut-off value of the volume of contrast administered was 205 cc (sensitivity: 0.49, specificity: 0.87)., Conclusions: We observed CIS in 4.2% of our patients undergoing therapeutic neuroendovascular procedures. This represents a higher incidence than previously reported. Female sex, volume of contrast administered, and guiding catheter tip located within the ECA are associated with CIS incidence., Abbreviations: AUC = area under the ROC curve; BMI = body mass index; CIS = contrast-induced sialadenitis; ECA = external cerebral artery; GFR = glomerular filtration rate; ROC = receiver operating characteristic., Competing Interests: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper., (© 2024 by American Journal of Neuroradiology.)

Purpose: Invasive mucinous adenocarcinoma (IMA) of the lungs is a rare subtype of lung adenocarcinoma with a limited understanding of its prognosis, particularly in advanced stages. This study aimed to assess the prognosis of patients with advanced IMA by focusing on treatment modalities., Methods: This single-center retrospective study evaluated 33 patients with IMAs diagnosed with advanced-stage disease or disease progression after curative treatment between 2011 and 2021. The primary outcome was overall survival (OS), and the secondary outcome was progression-free survival (PFS). OS and PFS were calculated from the date of the diagnosis of advanced IMA., Results: The study cohort included 13 patients at the initial advanced stage and 20 patients who progressed after curative treatment. Treatment modalities included conventional chemotherapy in 24 patients (72.7%), targeted therapy in seven (21.2%), immunotherapy in 13 (39.4%), and local ablative therapy (LAT) in 13 (39.4%). The median OS was 32 months (95% confidence interval [CI], 2.9-61.0), with LAT significantly associated with improved OS compared to non-LAT treatment (not reached vs. 11.3 months, p = 0.001). However, there was no significant difference in OS based on conventional chemotherapy (p = 0.396), targeted therapy (p = 0.655), or immunotherapy (p = 0.992). In multivariate analysis, LAT remained an independent prognostic factor for OS (hazard ratio, 0.125; 95% CI, 0.026-0.608; p = 0.01). PFS was 8.6 months (95% CI, 3.6-13.7), with no significant differences observed among the treatment modalities., Conclusion: Our findings suggest that LAT may provide favorable survival outcomes in patients with advanced IMA., (© 2024. The Author(s).)

The cerebral cortex accounts for substantial energy expenditure, primarily driven by the metabolic demands of synaptic signaling. Mitochondria, the organelles responsible for generating cellular energy, play a crucial role in this process. We investigated ultrastructural characteristics of the primary visual cortex in 18 phylogenetically diverse mammals, spanning a broad range of brain sizes from mouse to elephant. Our findings reveal remarkable uniformity in synapse density, postsynaptic density (PSD) length, and mitochondria density, indicating functional and metabolic constraints that maintain these fundamental features. Notably, we observed an average of 1.9 mitochondria per synapse across mammalian species. When considered together with the trend of decreasing neuron density with larger brain size, we find that brain enlargement in mammals is characterized by increasing proportions of synapses and mitochondria per cortical neuron. These results shed light on the adaptive mechanisms and metabolic dynamics that govern cortical ultrastructure across mammals., (© 2024 Wiley Periodicals LLC.)

Objectives: This study explores whether textural features from initial non-contrast CT scans of infarcted brain tissue are linked to hemorrhagic transformation susceptibility., Materials and Methods: Stroke patients undergoing thrombolysis or thrombectomy from Jan 2012 to Jan 2022 were analyzed retrospectively. Hemorrhagic transformation was defined using follow-up magnetic resonance imaging. A total of 94 radiomic features were extracted from the infarcted tissue on initial NCCT scans. Patients were divided into training and test sets (7:3 ratio). Two models were developed with fivefold cross-validation: one incorporating first-order and textural radiomic features, and another using only textural radiomic features. A clinical model was also constructed using logistic regression with clinical variables, and test set validation was performed., Results: Among 362 patients, 218 had hemorrhagic transformations. The LightGBM model with all radiomics features had the best performance, with an area under the receiver operating characteristic curve (AUROC) of 0.986 (95% confidence interval [CI], 0.971-1.000) on the test dataset. The ExtraTrees model performed best when textural features were employed, with an AUROC of 0.845 (95% CI, 0.774-0.916). Minimum, maximum, and ten percentile values were significant predictors of hemorrhagic transformation. The clinical model showed an AUROC of 0.544 (95% CI, 0.431-0.658). The performance of the radiomics models was significantly better than that of the clinical model on the test dataset (p < 0.001)., Conclusions: The radiomics model can predict hemorrhagic transformation using NCCT in stroke patients. Low Hounsfield unit was a strong predictor of hemorrhagic transformation, while textural features alone can predict hemorrhagic transformation., Clinical Relevance Statement: Using radiomic features extracted from initial non-contrast computed tomography, early prediction of hemorrhagic transformation has the potential to improve patient care and outcomes by aiding in personalized treatment decision-making and early identification of at-risk patients., Key Points: • Predicting hemorrhagic transformation following thrombolysis in stroke is challenging since multiple factors are associated. • Radiomics features of infarcted tissue on initial non-contrast CT are associated with hemorrhagic transformation. • Textural features on non-contrast CT are associated with the frailty of the infarcted tissue., (© 2024. The Author(s), under exclusive licence to European Society of Radiology.)

Background: Multiple attempts of thrombectomy have been linked to a higher risk of intracerebral hemorrhage and worsened functional outcomes, potentially influenced by blood pressure (BP) management strategies. Nonetheless, the impact of intensive BP management following successful recanalization through multiple attempts remains uncertain., Aims: This study aimed to investigate whether conventional and intensive BP managements differentially affect outcomes according to multiple-attempt recanalization (MAR) and first-attempt recanalization (FAR) groups., Methods: In this secondary analysis of the OPTIMAL-BP trial, which was a comparison of intensive (systolic BP target: <140 mm Hg) and conventional (systolic BP target = 140-180 mm Hg) BP managements during the 24 h after successful recanalization, we included intention-to-treat population of the trial. Patients were divided into the MAR and the FAR groups. We examined a potential interaction between the number of thrombectomy attempts (MAR and FAR groups) and the effect of BP managements on clinical and safety outcomes. The primary outcome was functional independence at 3 months. Safety outcomes were symptomatic intracerebral hemorrhage within 36 h and mortality within 3 months., Results: Of the 305 patients (median = 75 years), 102 (33.4%) were in the MAR group and 203 (66.6%) were in the FAR group. The intensive BP management was significantly associated with a lower rate of functional independence in the MAR group (intensive, 32.7% vs conventional, 54.9%, adjusted odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.12-0.90, p  = 0.03). In the FAR group, the proportion of patients with functional independence was not significantly different between the BP managements (intensive, 42.5% vs conventional, 54.2%, adjusted OR = 0.73, 95% CI = 0.38-1.40). Incidences of symptomatic intracerebral hemorrhage and mortality rates were not significantly different according to the BP managements in both MAR and FAR groups., Conclusions: Among stroke patients who received multiple attempts of thrombectomy, intensive BP management for 24 h resulted in a reduced chance of functional independence at 3 months and did not reduce symptomatic intracerebral hemorrhage following successful reperfusion., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Currently, conventional dimethoxymethane synthesis methods are environmentally unfriendly. Here, we report a photo-redox catalysis system to generate dimethoxymethane using a silver and tungsten co-modified blue titanium dioxide catalyst (Ag.W-BTO) by coupling CO 2 reduction and CH 3 OH oxidation under mild conditions. The Ag.W-BTO structure and its electron and hole transfer are comprehensively investigated by combining advanced characterizations and theoretical studies. Strikingly, Ag.W-BTO achieve a record photocatalytic activity of 5702.49 µmol g -1 with 92.08% dimethoxymethane selectivity in 9 h of ultraviolet-visible irradiation without sacrificial agents. Systematic isotope labeling experiments, in-situ diffuse reflectance infrared Fourier-transform analysis, and theoretical calculations reveal that the Ag and W species respectively catalyze CO 2 conversion to *CH 2 O and CH 3 OH oxidation to *CH 3 O. Subsequently, an asymmetric carbon-oxygen coupling process between these two crucial intermediates produces dimethoxymethane. This work presents a CO 2 photocatalytic reduction system for multi-carbon production to meet the objectives of sustainable economic development and carbon neutrality., (© 2024. The Author(s).)

Background: The association between arterial stiffness and outcome after endovascular treatment (EVT) is unknown. This study investigated whether arterial stiffness predicts post-EVT outcome in patients with acute ischemic stroke. Methods: This retrospective and observational cohort study included consecutive patients treated with EVT for acute ischemic stroke from June 2020 to November 2022. Arterial stiffness was assessed by brachial-ankle pulse wave velocity. Poor functional outcome was defined as a modified Rankin Scale score ≥3 at 3 months. Results: The mean age of patients included in this study was 71.9 ± 11.8 years, and 57.3% were men. Poor functional outcome was present in 46.8%. Multivariable logistic regression analysis showed that arterial stiffness was independently associated with poor functional outcome (odds ratio 8.640, 95% confidence interval [CI] 1.581-47.228) after adjusting for age, initial stroke severity, hypertension, atrial fibrillation, device pass number, and successful recanalization. A nomogram based on the multivariable statistic model showed a better prediction of poor functional outcome compared to classic risk factor models without arterial stiffness (net reclassification improvement 0.529, 95% CI 0.186-0.873; integrated discrimination improvement 0.046, 95% CI 0.009-0.083). Conclusions: We found that arterial stiffness was an independent predictor of poor functional outcome in patients treated with EVT following acute ischemic stroke.

Despite achieving numerous successes with surface defect inspection based on deep learning, the industry still faces challenges in conducting packaging defect inspections that include critical information such as ingredient lists. In particular, while previous achievements primarily focus on defect inspection in high-quality images, they do not consider defect inspection in low-quality images such as those containing image blur. To address this issue, we proposed a noble inference technique named temporal-quality ensemble (TQE), which combines temporal and quality weights. Temporal weighting assigns weights to input images by considering the timing in relation to the observed image. Quality weight prioritizes high-quality images to ensure the inference process emphasizes clear and reliable input images. These two weights improve both the accuracy and reliability of the inference process of low-quality images. In addition, to experimentally evaluate the general applicability of TQE, we adopt widely used convolutional neural networks (CNNs) such as ResNet-34, EfficientNet, ECAEfficientNet, GoogLeNet, and ShuffleNetV2 as the backbone network. In conclusion, considering cases where at least one low-quality image is included, TQE has an F1-score approximately 17.64% to 22.41% higher than using single CNN models and about 1.86% to 2.06% higher than an average voting ensemble.

Understanding changes in thermodynamic and transport properties during adsorption is crucial for the thermal management of metal-organic frameworks, which also imposes significant challenges for improved performance and energy density of adsorption system. Because of phase transitions in the intermolecular interactions involved in the adsorption phenomena, transport properties including the thermal conductivity exhibit interesting behaviors, yet fully understood. This study employs detailed molecular dynamics simulations to replicate the methane/Cu-BTC adsorption phenomenon for the evaluation of their thermal conductivities across different pressures and temperatures. The molecular simulations show that the thermal conductivities of both the adsorbent (Cu-BTC) and adsorbate (methane, adsorbed phase) vary notably during adsorption processes. Using the concepts of the change in the degree of free movements of the adsorbate molecules and atomic vibration of adsorbent, the reduction of the adsorbate thermal conductivity (∼70-93%) and increase thermal conductivity of the adsorbent (up to 3 times) in Cu-BTC+CH 4 pair are explained., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Purpose: Epidermoid cysts (EC) and dermoid cysts (DC) typically appear as well-circumscribed lesions on CT. This study aimed to clarify the radiologic and histopathologic characteristics of orbital EC and DC and to determine the correlations between them., Methods: The medical records of 69 patients who underwent surgery for orbital DC or EC at Samsung Medical Center between January 2001 and August 2016 were retrospectively reviewed. The size and location of the cysts, rim enhancement, homogeneity of contents, presence of hemorrhagic or calcific components, radiodensity of contents, and extent of bony remodeling were evaluated using CT. Additionally, the cyst lining and contents were examined histopathologically., Results: Among patients with orbital cysts, EC and DC were diagnosed in 10 (14.5%) and 59 (85.5%) patients, respectively. Further, 50.0% of EC and 79.7% of DC were located in the superotemporal quadrant of the orbit. On orbital CT, the average radiodensity of EC and DC was 18.9 ± 56.2 and -67.9 ± 63.3 HU, respectively. The cystic contents were more frequently homogeneous than heterogeneous in both EC and DC; however, the radiodensity of cysts differed significantly, which may be attributed to sebaceous gland activity. Focal bony notching, bone remodeling under pressure, and bony changes from dumbbell-shaped cysts were observed more frequently in DC than in EC., Conclusions: Radiological and histopathological features are correlated in orbital EC and DC. Therefore, orbital EC and DC can be preoperatively differentiated using CT, based on the average radiodensity and bony remodeling., (Copyright © 2024 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.)

Dynamic presynaptic actin remodeling drives structural and functional plasticity at synapses, but the underlying mechanisms remain largely unknown. Previous work has shown that actin regulation via Rac1 guanine exchange factor (GEF) Vav signaling restrains synaptic growth via bone morphogenetic protein (BMP)-induced receptor macropinocytosis and mediates synaptic potentiation via mobilization of reserve pool vesicles in presynaptic boutons. Here, we find that Gef26/PDZ-GEF and small GTPase Rap1 signaling couples the BMP-induced activation of Abelson kinase to this Vav-mediated macropinocytosis. Moreover, we find that adenylate cyclase Rutabaga (Rut) signaling via exchange protein activated by cAMP (Epac) drives the mobilization of reserve pool vesicles during post-tetanic potentiation (PTP). We discover that Rap1 couples activation of Rut-cAMP-Epac signaling to Vav-mediated synaptic potentiation. These findings indicate that Rap1 acts as an essential, convergent node for Abelson kinase and cAMP signaling to mediate BMP-induced structural plasticity and activity-induced functional plasticity via Vav-dependent regulation of the presynaptic actin cytoskeleton., (© 2024 Kim et al.)

Background: Cervical epidural block (CEB) is an effective intervention for managing cervical radicular pain. This study aimed to investigate the current status of performing CEB in South Korea., Methods: Pain physicians affiliated with the Korean Pain Society were asked to complete anonymous questionnaires regarding CEB between September and October 2022. The questionnaire consisted of 24 questions assessing the current status and methods of CEB in detail., Results: Of the 198 surveys collected, 171 physicians (86.4%) reported performing CEB. Among those, the majority (94.7%) used fluoroscopy during the procedure. The paramedian interlaminar (IL) approach was the most preferred method (50.3%). Respondents performing fluoroscopic-guided IL CEB were categorized into two groups based on clinical experience: those with ≤10 years of experience (≤10-year group, n = 91) and those with >10 years of experience (>10-year group, n = 71). The proportion of physicians obtaining informed consent in the ≤10-year group and >10-year group was 50.5% and 56.3%, respectively. When entering the epidural space during IL CEB, the contralateral oblique view was the second most frequently used in both groups (≤10-year group, 42.9%; >10-year group, 29.6%). In targeting the upper cervical lesions (C3-4), the proportion of respondents who used an IL space higher than C6-7 was 17.6% in the ≤10-year group and 29.5% in the >10-year experience group., Conclusions: This study demonstrated variability in the CEB technique used by pain physicians in South Korea. The findings highlight the need for education on informed consent and techniques to enhance safety.

This cross-sectional study aimed to assess the interrelationships between PM 2.5 exposure, heavy metal concentrations, and oxidative stress indicators, while evaluating the impact of antioxidant intake, such as vitamins, on these associations. PM 2.5 exposure assessments were conducted using portable sensor-based monitors; biomarker analyses for heavy metals and oxidative stress were performed in 114 non-smoking adults. We observed that personal or ambient PM 2.5 exposure levels were not associated with increased levels of heavy metals in blood and urine, nor with oxidative stress levels in urine. However, the concentrations of cadmium and lead in blood, and those of chromium and nickel in urine, were significantly associated with the urinary malondialdehyde (MDA) concentration. Additionally, increases in blood cadmium, urinary chromium, and nickel levels were significantly associated with higher urinary MDA concentrations in the non-vitamin-supplement group, but this trend was not observed in the regular vitamin supplement group. Our findings suggest that a regular intake of vitamin supplements might modulate the relationship between heavy metal exposure and oxidative stress, indicating potential protective effects against oxidative damage induced by PM 2.5 and heavy metals. This study highlights the complexity of environmental pollutant exposure and its impact on human health, emphasizing the need for further research to elucidate the underlying mechanisms and explore potential protective strategies.

Purpose: The purpose of this study was to assess whether kinematic alignment (KA) outperforms mechanical alignment (MA) in restoring patellar tracking to native patterns by using a clustering algorithm., Methods: Twenty cadavers (40 knees) were evaluated. For each cadaver, one knee was randomly assigned to KA and the other to MA. KA total knee arthroplasty (TKA) procedures were performed using a caliper-verified technique, while MA TKA procedures utilized a measured resection technique. Subsequently, all specimens were mounted on a customized knee-testing system, and patellar tracking was measured using a motion analysis system. All patellar tracking data were clustered using the density-based spatial clustering of applications with noise algorithm. Differences in patellar tracking patterns and the restoration of native patellar tracking were compared between the two alignment strategies., Results: Patellar tracking patterns following KA were considerably different from MA. Pre- and post-TKA patellar tracking patterns following MA were grouped into separate clusters, whereas a substantial proportion of patellar tracking patterns following KA were grouped into the pre-TKA dominant cluster. Compared to MA, a greater proportion of patellar tracking patterns following KA showed similar patterns to native knees (p < 0.05) and more patellar tracking patterns following KA paired with preoperative patterns (p < 0.01)., Conclusion: KA restored native patellar tracking patterns more closely compared to MA., Level of Evidence: Level I, therapeutic study., (© 2024 European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)

Per- and polyfluoroalkyl substances (PFASs) have been detected in an array of environmental media due to their ubiquitous use in industrial and consumer products as well as potential release from fluorochemical manufacturing facilities. During their manufacture, many fluorotelomer (FT) facilities rely on neutral intermediates in polymer production including the FT-alcohols (FTOHs). These PFAS are known to transform to the terminal acids (perfluoro carboxylic acids; PFCAs) at rates that vary with environmental conditions. In the current study on soils from a FT facility, we employed gas chromatography coupled with conventional- and high-resolution mass spectrometry (GC-MS and GC-HRMS) to investigate the profile of these precursor compounds, the intermediary secondary alcohols (sFTOHs), FT-acrylates (FTAcr), and FT-acetates (FTAce) in soils around the former FT-production facility. Of these precursors, the general trend in detection intensity was [FTOHs] > [sFTOHs] > [FTAcrs], while for the FTOHs, homologue intensities generally were [12:2 FTOH] > [14:2 FTOH] > [16:2 FTOH] > [10:2 FTOH] > [18:2 FTOH] > [20:2 FTOH] > [8:2 FTOH] ∼ [6:2 FTOH]. The corresponding terminal acids were also detected in all soil samples and positively correlated with the precursor concentrations. GC-HRMS confirmed the presence of industrial manufacturing byproducts such as FT-ethers and FT-esters and aided in the tentative identification of previously unreported dimers and other compounds. The application of GC-HRMS to the measurement and identification of precursor PFAS is in its infancy, but the methodologies described here will help refine its use in tentatively identifying these compounds in the environment.

Background: To analyze the outcomes of clipping and coiling for ruptured intracranial aneurysms (RIAs) based on data from the National Health Insurance Service in South Korea, with a focus on variations according to region and hospital size., Methods: This study analyzed the one-year mortality rates for patients with RIAs who underwent clipping or coiling in 2018. Coiling was further categorized into non-stent assisted coiling (NSAC) and stent assisted coiling (SAC). Hospitals were classified as tertiary referral general hospitals (TRGHs), general hospitals (GHs), or semi-general hospitals (sGHs) based on size. South Korea's administrative districts were divided into 15 regions for analysis., Results: In 2018, there were 2,194 (33.1%) clipping procedures (TRGH, 985; GH, 827; sGH, 382) and 4,431 (66.9%) coiling procedures (TRGH, 1,642; GH, 2076; sGH, 713) performed for RIAs treatment. Among hospitals performing more than 20 treatments, the one-year mortality rates following clipping or coiling were 11.2% and 16.0%, respectively, with no significant difference observed. However, there was a significant difference in one-year mortality between NSAC and SAC (14.3% vs. 19.5%, P = 0.034), with clipping also showing significantly lower mortality compared to SAC ( P = 0.019). No significant differences in other treatment modalities were observed according to hospital size, but clipping at TRGHs had significantly lower mortality than at GHs ( P = 0.042). While no significant correlation was found between the number of treatments and outcomes at GHs, at TRGHs, a higher volume of clipping procedures was significantly associated with lower total mortality ( P = 0.023) and mortality after clipping ( P = 0.022)., Conclusion: Using Korea NHIS data, mortality rates for RIAs showed no significant variation by hospital size due to coiling's prevalence. However, differences in clipping outcomes by hospital size and volume in TRGH highlight the need for national efforts to improve clipping skills and standardization. Additionally, the higher mortality rate with SAC emphasizes the importance of precise indications for its application., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2024 The Korean Academy of Medical Sciences.)

Vascular aging phenotype may be useful in predicting stroke prognosis. In the present study, the relationship between vascular aging phenotypes and outcomes after acute ischemic stroke was investigated. The study included consecutive patients with acute ischemic stroke who had brachial-ankle pulse wave velocity (baPWV) measured to assess vascular aging phenotype. The 2.5th and 97.5th percentile age-specific baPWVs were used as cutoffs to define supernormal vascular aging (SUPERNOVA) and early vascular aging (EVA), respectively, and the remainder was considered normal vascular aging (NVA). A total of 2738 patients were enrolled and followed for a median of 38.1 months. The mean age was 67.02 years and 1633 were male. EVA was 67, NVA was 2605, and SUPERNOVA was 66. Compared with NVA, multivariable logistic regression showed EVA was associated with poor functional outcome (modified Rankin Scale ≥ 3) at 3 months (odds ratio 2.083, 95% confidence interval 1.147‒3.783). Multivariable Cox regression showed EVA was associated with all-cause mortality (hazard ratio 2.320, 95% confidence interval 1.283‒4.197). EVA was associated with poor functional outcome and all-cause mortality after acute ischemic stroke, especially when diabetes or atrial fibrillation coexisted. These findings indicate the vascular aging phenotype, notably EVA, can aid in identifying high-risk stroke patients., (© 2024. The Author(s).)

Monolayer materials typically display intriguing temperature-dependent dielectric and optical properties, which are crucial for improving the structure and functionality of associated devices. Due to its unique photoelectric capabilities, monolayer WSe 2 has recently received a lot of attention in the fields of atomically thin electronics and optoelectronics. In this work, we focus on the evolution of the temperature-dependent dielectric function (ε = ε 1  + i ε 2 ) of monolayer WSe 2 over energies from 0.74 to 6.40 eV and temperatures from 40 to 350 K. We analyze the second derivatives of ε with respect to energy to accurately locate the critical points (CP). The dependence of the observed CP energies on temperature is consistent with the alternative domination of the declining exciton binding energy as the temperature increases., (© 2024. The Author(s).)

Introduction: Women can experience various reproductive events, such as pregnancy, childbirth, lactation, and contraception, which cause long-term changes in female hormones. In middle-aged women, the prevalence of migraine is high, and a clear gender difference is evident. This study investigated the effects of factors associated with past reproductive events on the risk of new migraine in middle-aged premenopausal women., Methods: The influence of reproductive factors on migraine in middle-aged women was investigated using the Korean National Health Insurance Service (KNHIS) and Korean Health Examination (KHE) databases. The reproductive factors of interest were parity, breastfeeding, and oral contraceptive (OC) use. The study included 949,704 middle-aged premenopausal women 40-60 years of age. The study population was divided into two groups based on new diagnosis of migraine during the follow-up period (2009-2018)., Results: The risk of new migraine tended to increase in the primiparous (hazard ratio, HR: 1.179; 95% confidence interval, CI: 1.137-1.221) and multiparous groups (HR: 1.181; 95% CI: 1.142-1.221) compared with the nulliparous group. The breastfeeding ≥12 months group (HR: 1.071; 95% CI: 1.052-1.091) showed a significantly increased risk of new migraine compared with the non-breastfeeding group. All women in the OC groups (< 1 year, HR: 1.048; 95% CI: 1.028-1.069 and ≥ 1 year, HR: 1.100; 95% CI: 1.067-1.134) showed a higher risk of new migraine than those in the non-OC group., Conclusion: The results of the current study indicate that childbirth, longer breastfeeding, and OC use may be associated with a higher risk of new migraine in middle-aged premenopausal women., 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., (Copyright © 2024 Kim, Na, Kim, Bae, An and Park.)

This study aimed to investigate the relationship between complex aortic plaque (CAP) and short-term as well as long-term outcomes following cardioembolic stroke. CAP is a known risk factor for occurrence and recurrence of ischemic stroke. However, the association of CAP on cardioembolic stroke remains unclear. This was retrospective study using prospective cohort of consecutive patients with cardioembolic stroke who underwent transesophageal echocardiography. The functional outcome was evaluated using the modified Rankin Scale score at 3 months, and long-term outcomes were assessed by recurrence of ischemic stroke and occurrence of major adverse cardiovascular events (MACE). Among 759 patients with cardioembolic stroke, 91 (12.0%) had CAP. Early ischemic stroke recurrence within 3 months was associated with CAP (p = 0.025), whereas CAP was not associated with functional outcome at 3 months (odd ratio  1.01, 95% confidence interval [CI]  0.57-1.84, p = 0.973). During a median follow-up of 3.02 years, CAP was significantly associated with ischemic stroke recurrence (hazard ratio = 2.68, 95% CI 1.48-4.88, p = 0.001) and MACE occurrence (hazard ratio = 1.61, 95% CI 1.03-2.51, p = 0.039). In conclusion, CAP was associated with early ischemic stroke recurrence and poor long-term outcomes in patients with cardioembolic stroke. It might be helpful to consider transesophageal echocardiography for patients with cardioembolic stroke to identify CAP., (© 2024. The Author(s).)

The application of geospatial data often allows the tracing of people who are involved in activities of an illegal nature. In June 2021, we estimated the true magnitude of the spread of COVID-19 within the networks of escort-karaoke bars in Seoul, Republic of Korea, using geographic information system (GIS)-based contact tracing that was applied to our epidemiological investigation. Our joint rapid response team, composed of epidemic investigation officers and police personnel, identified 19 paper-traced cases and 158 GIS-traced cases from 5,692 confirmed cases in Seoul during the study period (June to July 2021). Our findings suggest that collaboration with law enforcement agencies and the use of overlaid satellite imagery in outbreak investigations enhances high vigilance and reduces the risk of potential breaches of human rights in the process.

Objectives: To develop and validate a deep learning model for predicting hemorrhagic transformation after endovascular thrombectomy using dual-energy computed tomography (CT)., Materials and Methods: This was a retrospective study from a prospective registry of acute ischemic stroke. Patients admitted between May 2019 and February 2023 who underwent endovascular thrombectomy for acute anterior circulation occlusions were enrolled. Hemorrhagic transformation was defined using follow-up magnetic resonance imaging or CT. The deep learning model was developed using post-thrombectomy dual-energy CT to predict hemorrhagic transformation within 72 h. Temporal validation was performed with patients who were admitted after July 2022. The deep learning model's performance was compared with a logistic regression model developed from clinical variables using the area under the receiver operating characteristic curve (AUC)., Results: Total of 202 patients (mean age 71.4 years ± 14.5 [standard deviation], 92 men) were included, with 109 (54.0%) patients having hemorrhagic transformation. The deep learning model performed consistently well, showing an average AUC of 0.867 (95% confidence interval [CI], 0.815-0.902) upon five-fold cross validation and AUC of 0.911 (95% CI, 0.774-1.000) with the test dataset. The clinical variable model showed an AUC of 0.775 (95% CI, 0.709-0.842) on the training dataset (p < 0.01) and AUC of 0.634 (95% CI, 0.385-0.883) on the test dataset (p = 0.06)., Conclusion: A deep learning model was developed and validated for prediction of hemorrhagic transformation after endovascular thrombectomy in patients with acute stroke using dual-energy computed tomography., Clinical Relevance Statement: This study demonstrates that a convolutional neural network (CNN) can be utilized on dual-energy computed tomography (DECT) for the accurate prediction of hemorrhagic transformation after thrombectomy. The CNN achieves high performance without the need for region of interest drawing., Key Points: • Iodine leakage on dual-energy CT after thrombectomy may be from blood-brain barrier disruption. • A convolutional neural network on post-thrombectomy dual-energy CT enables individualized prediction of hemorrhagic transformation. • Iodine leakage is an important predictor of hemorrhagic transformation following thrombectomy for ischemic stroke., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

The Berry curvature dipole (BCD) serves as a one of the fundamental contributors to emergence of the nonlinear Hall effect (NLHE). Despite intense interest due to its potential for new technologies reaching beyond the quantum efficiency limit, the interplay between BCD and NLHE has been barely understood yet in the absence of a systematic study on the electronic band structure. Here, we report NLHE realized in NbIrTe 4 that persists above room temperature coupled with a sign change in the Hall conductivity at 150 K. First-principles calculations combined with angle-resolved photoemission spectroscopy (ARPES) measurements show that BCD tuned by the partial occupancy of spin-orbit split bands via temperature is responsible for the temperature-dependent NLHE. Our findings highlight the correlation between BCD and the electronic band structure, providing a viable route to create and engineer the non-trivial Hall effect by tuning the geometric properties of quasiparticles in transition-metal chalcogen compounds., (© 2024. The Author(s).)

We report the temperature dependences of the dielectric function ε = ε 1 + i ε 2 and critical point (CP) energies of the uniaxial crystal GaSe in the spectral energy region from 0.74 to 6.42 eV and at temperatures from 27 to 300 K using spectroscopic ellipsometry. The fundamental bandgap and strong exciton effect near 2.1 eV are detected only in the c-direction, which is perpendicular to the cleavage plane of the crystal. The temperature dependences of the CP energies were determined by fitting the data to the phenomenological expression that incorporates the Bose-Einstein statistical factor and the temperature coefficient to describe the electron-phonon interaction. To determine the origin of this anisotropy, we perform first-principles calculations using the mBJ method for bandgap correction. The results clearly demonstrate that the anisotropic dielectric characteristics can be directly attributed to the inherent anisotropy of p orbitals. More specifically, this prominent excitonic feature and fundamental bandgap are derived from the band-to-band transition between s and p z orbitals at the Γ-point.

Introduction: Stenotic thoracic ligamentum flavum hypertrophy can cause leg and/or low back pain similar to that caused by lumbar spinal stenosis. However, the thoracic spine may occasionally be overlooked in patients with leg and/or low back pain. An accurate understanding of the prevalence of stenotic thoracic ligamentum flavum hypertrophy and its associated factors is necessary., Methods: In this prevalence study, we reviewed whole-spine MRI scans of patients who visited the pain clinic complaining of leg and/or low back pain between 2010 and 2019. We analyzed the overall prevalence and prevalence according to the age group, sex, grade of lumbar disc degeneration, and thoracic level. In addition, we identified factors independently associated with stenotic thoracic ligamentum flavum hypertrophy occurrence., Results: Among 1896 patients, the overall prevalence of stenotic thoracic ligamentum flavum hypertrophy was 9.8% (185/1896), with the highest prevalence observed in the ≥80-year-old age group among all age groups (15.9%, 14/88). The region with the highest prevalence was the T10/11 level (3.0%, 57/1896). Multivariable logistic regression analysis revealed that when compared with the <50-year-old age group, all other age groups were significantly associated with stenotic thoracic ligamentum flavum hypertrophy (p<0.01). In addition, grade 5 of lumbar disc degeneration was significantly associated with stenotic thoracic ligamentum flavum hypertrophy (p=0.03)., Conclusions: Given the possibility for missed stenotic thoracic ligamentum flavum hypertrophy to potentially result in neurological complications, extending lumbar spine MRI covering the lower thoracic region may be considered for patients over 50 years of age with suspected severe lumbar disc degeneration., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Purpose: In young patients (aged 18-60 years) with patent foramen ovale (PFO)-associated stroke, percutaneous closure has been found to be useful for preventing recurrent ischemic stroke or transient ischemic attack (TIA). However, it remains unknown whether PFO closure is also beneficial in older patients., Methods: Patients aged ≥60 years who had a cryptogenic stroke and PFO from ten hospitals in South Korea were included. The effect of PFO closure plus medical therapy over medical therapy alone was assessed by a propensity-score matching method in the overall cohort and in those with a high-risk PFO, characterized by the presence of an atrial septal aneurysm or a large shunt., Results: Out of the 437 patients (mean age, 68.1), 303 (69%) had a high-risk PFO and 161 (37%) patients underwent PFO closure. Over a median follow-up of 3.9 years, recurrent ischemic stroke or TIA developed in 64 (14.6%) patients. In the propensity score-matched cohort of the overall patients (130 pairs), PFO closure was associated with a significantly lower risk of a composite of ischemic stroke or TIA (hazard ratio [HR]: 0.45; 95% confidence interval [CI]: 0.24-0.84; P=0.012), but not for ischemic stroke. In a subgroup analysis of confined to the high-risk PFO patients (116 pairs), PFO closure was associated with significantly lower risks of both the composite of ischemic stroke or TIA (HR: 0.40; 95% CI: 0.21-0.77; P=0.006) and ischemic stroke (HR: 0.47; 95% CI: 0.23-0.95; P=0.035)., Conclusion: Elderly patients with cryptogenic stroke and PFO have a high recurrence rate of ischemic stroke or TIA, which may be significantly reduced by device closure.

Background: The effectiveness of endovascular treatment for in-hospital stroke remains debatable. We aimed to compare the outcomes between patients with in-hospital stroke and community-onset stroke who received endovascular treatment., Methods: This prospective registry-based cohort study included consecutive patients who underwent endovascular treatment from January 2013 to December 2022 and were registered in the Selection Criteria in Endovascular Thrombectomy and Thrombolytic Therapy study and Yonsei Stroke Cohort. Functional outcomes at day 90, radiological outcomes, and safety outcomes were compared between the in-hospital and community-onset groups using logistic regression and propensity score-matched analysis., Results: Of 1,219 patients who underwent endovascular treatment, 117 (9.6%) had in-hospital stroke. Patients with in-hospital onset were more likely to have a pre-stroke disability and active cancer than those with community-onset. The interval from the last known well to puncture was shorter in the in-hospital group than in the community-onset group (155 vs. 355 min, p<0.001). No significant differences in successful recanalization or safety outcomes were observed between the groups; however, the in-hospital group exhibited worse functional outcomes and higher mortality at day 90 than the community-onset group (all p<0.05). After propensity score matching including baseline characteristics, functional outcomes after endovascular treatment did not differ between the groups (OR: 1.19, 95% CI 0.78-1.83, p=0.4). Safety outcomes did not significantly differ between the groups., Conclusion: Endovascular treatment is a safe and effective treatment for eligible patients with in-hospital stroke. Our results will help physicians in making decisions when planning treatment and counseling caregivers or patients., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Cancer can induce hypercoagulability, which may lead to stroke. This occurs when tumor cells activate platelets as part of their growth and metastasis. Tumor cells activate platelets by generating thrombin and expressing tissue factor, resulting in tumor cell-induced platelet aggregation. Histopathological studies of thrombi obtained during endovascular thrombectomy in patients with acute stroke and active cancer have shown a high proportion of platelets and thrombin. This underscores the crucial roles of platelets and thrombin in cancer-associated thrombosis. Cancer-associated stroke typically occurs in patients with active cancer and is characterized by distinctive features. These features include multiple infarctions across multiple vascular territories, markedly elevated blood D-dimer levels, and metastasis. The presence of cardiac vegetations on echocardiography is a robust indicator of cancer-associated stroke. Suspicion of cancer-associated stroke during endovascular thrombectomy arises when white thrombi are detected, particularly in patients with active cancer. Cancer-associated stroke is almost certain when histopathological examination of thrombi shows a very high platelet and a very low erythrocyte composition. Patients with cancer-associated stroke have high risks of mortality and recurrent stroke. However, limited data are available on the optimal treatment regimen for stroke prevention in these patients. Thrombosis mechanism in cancer is well understood, and distinct therapeutic targets involving thrombin and platelets have been identified. Therefore, direct thrombin inhibitors and/or antiplatelet agents may effectively prevent stroke recurrence. Additionally, this strategy has potential benefits in cancer treatment as accumulating evidence suggests that aspirin use reduces cancer progression, metastasis, and cancer-related mortality. However, clinical trials are necessary to assess the efficacy of this strategy involving the use of direct thrombin inhibitors and/or antiplatelet therapies.

Objective: Stents have been widely used for coil embolization for intracranial aneurysms. Few studies have analyzed the risk factors of recanalization through long-term follow-up observation of only stent-assisted coiling. We analyzed the risk factors for recanalization through long-term observations., Methods: A total number of 399 unruptured aneurysms treated by stent-assisted coil embolization between 2003 and 2016 in a single institution were analyzed for determining the factors associated with recanalization including the patient characteristics, aneurysms, and procedural variables. All patients underwent angiographic follow-up with digital subtraction angiography or magnetic resonance angiography at 24 months or more following the procedure., Results: Recanalization occurred in 8%. The mean time for the recanalization was 21.1 ± 14.0 months (range, 5-51 months). The receiver operating characteristic curve analysis indicated areas under the curve for a maximum aneurysm size of 0.773 (cut-off, 6.415 mm). Multivariate analysis revealed that the maximum aneurysm size and parent artery curvature at which the aneurysm developed were significantly associated with recanalization. In parent artery curvature, the bifurcation group (OR, 9.02; 95% CI, 2.53-32.13; p  = 0.001) and the convex group (OR, 3.68; 95% CI, 1.17-11.50; p  = 0.025) were independent predictors of recanalization compared with the straight group., Conclusion: The maximum aneurysm size and parent artery curvature are risk factors associated with recanalization in stent-assisted coil embolization., 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., (Copyright © 2024 Won, Kim, Ban and Kwon.)

The prognosis of patients with embolic stroke of undetermined source (ESUS) may vary according to the underlying cause. Therefore, we aimed to divide ESUS into subtypes and assess the long-term outcomes. Consecutive patients with acute ischemic stroke who underwent a comprehensive workup, including transesophageal echocardiography and prolonged electrocardiography monitoring, were enrolled. We classified ESUS into minor cardioembolic (CE) ESUS, arteriogenic ESUS, two or more causes ESUS, and no cause ESUS. Arteriogenic ESUS was sub-classified into complex aortic plaque (CAP) ESUS and non-stenotic (< 50%) relevant artery plaque (NAP) ESUS. A total of 775 patients were enrolled. During 1286 ± 748 days follow-up, 116 major adverse cardiovascular events (MACE) occurred (4.2 events/100 patient-years). Among the ESUS subtypes, CAP ESUS was associated with the highest MACE frequency (9.7/100 patient-years, p = 0.021). Cox regression analyses showed that CAP ESUS was associated with MACE (hazard ratio 2.466, 95% confidence interval 1.305-4.660) and any stroke recurrence (hazard ratio 2.470, 95% confidence interval, 1.108-5.508). The prognosis of ESUS varies according to the subtype, with CAP ESUS having the worst prognosis. Categorizing ESUS into subtypes could improve patient care and refine clinical trials., (© 2024. The Author(s).)

Objective: The aim of this study was to identify predictive factors of postoperative cerebral infarction (PostCI) following combined bypass (CB) surgery in adult patients with moyamoya disease (MMD) using quantitative parameters from the rapid processing of perfusion and diffusion (RAPID) perfusion CT (PCT) software., Methods: The authors retrospectively reviewed 276 total hemispheres in patients with MMD who underwent CB. Preoperative volumes of time-to-maximum (Tmax) > 4 sec and > 6 sec were obtained from the RAPID analysis of PCT. These quantitative parameters, along with other clinical and angiographic factors, were statistically analyzed to determine the significant predictors for PostCI following CB., Results: PostCI occurred in 17 hemispheres (6.16%). PCA involvement (p = 0.016), and the volume of Tmax > 6 sec (p < 0.001) and Tmax > 4 sec (p < 0.001), were identified as variables related to PostCI in the univariable analysis. In the multivariable analysis, the volume of Tmax > 6 sec (OR 1.013, 95% confidence interval 1.007-1.019, p < 0.001) was determined to be an independent predictive factor significantly associated with PostCI after CB in adult patients with MMD. In the receiver operating characteristic (ROC) curve, the cutoff value of the preoperative volume of Tmax > 6 sec was determined to be 59.5 ml (sensitivity 82.4%, specificity 71.9%, area under the ROC curve 0.811)., Conclusions: For adult patients with MMD and a large volume of Tmax > 6 sec over 59.5 ml, more caution is required when deciding to undergo bypass surgery and in postoperative management.

Purpose: To evaluate the clinical outcomes of intravenous tocilizumab (TCZ) injection in patients with moderate-to-severe active thyroid eye disease (TED)., Methods: Patients with active and moderate-to-severe TED who did not respond to conventional therapies were treated with TCZ from June 2019 to January 2021. The medical records of the patients were evaluated before the treatment. We analyzed patient demographics, including the duration of Graves' disease and TED, and assessed subjective symptoms, such as diplopia and ocular movement, clinical activity score (CAS), modified NOSPECS score, and exophthalmos before treatment and at 4, 8, 12, and 16 weeks after the first drug injection. Blood tests, including TSH Rc Ab and TS Ab, were performed before treatment and 24 weeks after the first injection. And orbital computed tomography (CT) was performed and Barrett's Index was calculated at baseline and after completion of all injections., Results: Nineteen completed the scheduled treatment. There were no significant side effects, other than herpes zoster in one case and headache and dermatitis in another. Clinical symptoms before and 16 weeks after the treatment showed mean CAS decreased by 2.4 points, mean modified NOSPECS score decreased by 3.7 points, and mean exophthalmos decreased by 0.4 mm. Diplopia and extraocular muscle limitation improved in ten and remained stationary in five of the 15 patients, who presented with extraocular motility abnormalities. Six of 11 patients who underwent orbit CT showed improvement in muscle size. The mean TSH Rc Ab decreased by 7.5 IU/L and TS-Ab decreased by 162.9%., Conclusion: TCZ can treat active moderate-to-severe TED, showing high drug compliance and reasonable response to inflammation and extraocular motility abnormality., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Nutrient runoff into rivers caused by human activity has led to global eutrophication issues. The Nakdong River in South Korea is currently facing significant challenges related to eutrophication and harmful algal blooms, underscoring the critical importance of managing total nitrogen (T-N) levels. However, traditional methods of indoor analysis, which depend on sampling, are labor-intensive and face limitations in collecting high-frequency data. Despite advancements in sensor allowing for the measurement of various parameters, sensors still cannot directly measure T-N, necessitating surrogate regression methods. Therefore, we conducted T-N predictions using a water quality dataset collected from 2018 to 2022 at 157 observatories within the Nakdong River basin. To account for the water quality characteristics of each location, we employed a clustering technique to divide the basin and compared a Gaussian mixture model with K-means clustering. Moreover, optimal regressor for each cluster was selected by comparing multiple linear regression (MLR), random forest, and XGBoost. The results showed that forming four clusters via K-means clustering was the most suitable approach and MLR was reasonably accurate for all clusters. Subsequently, recursive feature elimination cross-validation was used to identify suitable parameters for T-N prediction, thus leading to the construction of high-accuracy T-N prediction models. Clustering was useful not only for improving the regressors but also for spatially analyzing the water quality characteristics of the Nakdong River. The MLR model can reveal causal relationships and thus is useful for decision-making. The results of this study revealed that the combination of a simple linear regression model and clustering method can be applied to a wide watershed. The clustering-based regression model showed potential for accurately predicting T-N at the basin level and is expected to contribute to nationwide water quality management through future applications in various fields., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: There have been few reports on the preventative value of intensive blood pressure (BP) management for stroke since the American College of Cardiology/American Heart Association (ACC/AHA) announced the new criteria for hypertension (HTN) in 2017. This study aimed to identify optimal BP for prevention of stroke in healthy adults under 65 years., Methods: We conducted a 10-year observational study on the risk of stroke, subclassified as hemorrhagic stroke (HS) or ischemic stroke (IS), according to BP categories (low-normal BP, high-normal BP, elevated BP, stage 1 HTN, and stage 2 HTN) using the National Health Insurance Service Database., Results: In 2008, a health checkup was conducted for a total of 8,327,751 participants, and 949,551 of them enrolled in this study. The risk of HS increased from stage 2 HTN (adjusted hazard ratio [AHR], 3.036 [95 % confidence interval [CI], 2.159-4.252]) in men to stage 1 HTN (AHR, 2.972; 95 % CI, 2.256-3.897) in women. The risk of IS increased in both men (AHR, 1.404 [95 % CI, 1.164-1.693]) and women (AHR, 2.012 [95 % CI, 1.603-2.526]) with stage 1 HTN. The overall risk of stroke increased in men (AHR, 1.386; [95 % CI, 1.180-1.629]) and women (AHR, 2.363 [95 % CI, 1.973-2.830]) with stage 1 HTN., Conclusion: This study underscores the importance of maintaining BP below Stage 1 HTN to prevent stroke in healthy adults aged below 65 years. These findings highlight the significance of the new HTN guidelines established by the ACC/AHA in 2017., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)