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Pretreatment CT Perfusion (CTP) parameter rCBV < 42% lesion volume has recently been shown to predict 90-day mRS. In this study, we aim to assess the relationship between rCBV < 42% and a radiographic follow-up infarct volume delineated on FLAIR images. In this retrospective evaluation of our prospectively collected database, we included acute stroke patients triaged by multimodal CT imaging, including CT angiography and perfusion imaging, with confirmed anterior circulation large vessel occlusion between 9 January 2017 and 10 January 2023. Follow-up FLAIR imaging was used to determine the final infarct volume. Student t, Mann-Whitney-U, and Chi-Square tests were used to assess differences. Spearmans rank correlation and linear regression analysis were used to assess associations between rCBV < 42% and follow-up infarct volume on FLAIR. In total, 158 patients (median age: 68 years, 52.5% female) met our inclusion criteria. rCBV < 42% (ρ = 0.56, p < 0.001) significantly correlated with follow-up-FLAIR infarct volume. On multivariable linear regression analysis, rCBV < 42% lesion volume (beta = 0.60, p < 0.001), ASPECTS (beta = -0.214, p < 0.01), mTICI (beta = -0.277, p < 0.001), and diabetes (beta = 0.16, p < 0.05) were independently associated with follow-up infarct volume. The rCBV < 42% lesion volume is independently associated with FLAIR follow-up infarct volume.

Background: The pretreatment CT perfusion (CTP) marker the relative cerebral blood volume (rCBV) < 42% lesion volume has recently been shown to predict 90-day functional outcomes; however, studies assessing correlations of the rCBV < 42% lesion volume with other outcomes remain sparse. Here, we aim to assess the relationship between the rCBV < 42% lesion volume and the reference standard digital subtraction angiography (DSA)-derived American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN) collateral score, hereby referred as the DSA CS. Methods: In this retrospective evaluation of our prospectively collected database, we included acute stroke patients triaged by multimodal CT imaging, including CT angiography and perfusion imaging, with confirmed anterior circulation large vessel occlusion between 1 September 2017 and 1 October 2023. Group differences were assessed using the Students t test, Mann-Whitney U test and Chi-Square test. Spearmans rank correlation and logistic regression analyses were used to assess associations between rCBV < 42% and DSA CS. Results: In total, 222 patients (median age: 69 years, 56.3% female) met our inclusion criteria. In the multivariable logistic regression analysis, taking into account age, sex, race, hypertension, hyperlipidemia, diabetes, atrial fibrillation, prior stroke or transient ischemic attack, the admission National Institute of Health stroke scale, the premorbid modified Rankin score, the Alberta stroke program early CT score (ASPECTS), and segment occlusion, the rCBV < 42% lesion volume (adjusted OR: 0.98, p < 0.05) was independently associated with the DSA CS. Conclusion: The rCBV < 42% lesion volume is independently associated with the DSA CS.

Background: Collateral status (CS) is an important biomarker of functional outcomes in patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO). Pretreatment CT perfusion (CTP) parameters serve as reliable surrogates of collateral status (CS). In this study, we aim to assess the relationship between the relative cerebral blood flow less than 38% (rCBF <38%), with the reference standard American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score (CS) on DSA. Methods: In this prospectively collected, retrospectively reviewed analysis, inclusion criteria were as follows: (a) CT angiography (CTA) confirmed anterior circulation large vessel occlusion from 9/1/2017 to 10/01/2023; (b) diagnostic CT perfusion; and (c) underwent mechanical thrombectomy with documented ASITN CS. The ratios of the CTP-derived CBF values were calculated by dividing the values of the ischemic lesion by the corresponding values of the contralateral normal region (which were defined as rCBF). Spearman's rank correlation and logistic regression analysis were performed to determine the relationship of rCBF <38% lesion volume with DSA ASITN CS. p ≤.05 was considered significant. Results: In total, 223 patients [mean age: 67.77 ± 15.76 years, 56.1% (n = 125) female] met our inclusion criteria. Significant negative correlation was noted between rCBF <38% volume and DSA CS (ρ = −0.37, p <.001). On multivariate logistic regression analysis, rCBF <38% volume was found to be independently associated with worse ASITN CS (unadjusted OR: 3.03, 95% CI: 1.60–5.69, p <.001, and adjusted OR: 2.73, 95% CI: 1.34–5.50, p <.01). Conclusion: Greater volume of tissue with rCBF <38% is independently associated with better DSA CS. rCBF <38% is a useful adjunct tool in collateralization-based prognostication. Future studies are needed to expand our understanding of the role of rCBF <38% within the decision-making in patients with AIS-LVO. [ABSTRACT FROM AUTHOR]

Soil disinfestation has been widely used as an effective strategy to improve soil health and crop yield by suppression of soil-borne plant pathogens, but its effect on soil organic carbon (SOC), a crucial factor linked to climate change, remains unknown. A microcosm trial was conducted to evaluate microbial residue carbon (MRC) and its contribution to SOC under chemical soil disinfestation (CSD) with quicklime (QL) and chloropicrin (CP), as well as anaerobic soil disinfestation (ASD) with maize straw (MASD) and soybean straw (SASD). The SOC concentrations were increased by both CSD and ASD. Also, total SOC-normalized MRC concentration was enhanced, with a considerable increase in soil bacterial and fungal MRC, particularly evident under CP and SASD treatment. Due to broad-spectrum biocidal activities, decreased SOC-normalized microbial biomass carbon (MBC) was consistent with the reductions in bacterial and fungal phospholipid fatty acids (PLFAs), consequently increasing MRC accumulation under CSD. Similarly, ASD decreased fungal PLFAs while shifting bacterial PLFAs from aerobic to anaerobic taxa or from gram-negative to -positive taxa, both of which contributed to both MBC and MRC buildup. Collectively, the findings demonstrate that ASD can efficiently increase SOC concentration, with distinct mechanisms underlying MRC generation when compared to traditional CSD. [ABSTRACT FROM AUTHOR]

Background and Purpose: In large vessel occlusion (LVO) stroke patients, relative cerebral blood flow (rCBF)<30% volume thresholds are commonly used in treatment decisions. In the early time window, nearly infarcted but salvageable tissue volumes may lead to pretreatment overestimates of infarct volume, and thus potentially exclude patients who may otherwise benefit from intervention. Our multisite analysis aims to explore the strength of relationships between widely used pretreatment CT parameters and clinical outcomes for early window stroke patients. Methods: Patients from two sites in a prospective registry were analyzed. Patients with LVOs, presenting within 3 hours of last known well, and who were successfully reperfused were included. Primary short‐term neurological outcome was percent National Institutes of Health Stroke Scale (NIHSS) change from admission to discharge. Secondary long‐term outcome was 90‐day modified Rankin score. Spearman's correlations were performed. Significance was attributed to p‐value ≤.05. Results: Among 73 patients, median age was 66 (interquartile range 54‐76) years. Among all pretreatment imaging parameters, rCBF<30%, rCBF<34%, and rCBF<38% volumes were significantly, inversely correlated with percentage NIHSS change (p<.048). No other parameters significantly correlated with outcomes. Conclusions: Our multisite analysis shows that favorable short‐term neurological recovery was significantly correlated with rCBF volumes in the early time window. However, modest strength of correlations provides supportive evidence that the applicability of general ischemic core estimate thresholds in this subpopulation is limited. Our results support future larger‐scale efforts to liberalize or reevaluate current rCBF parameter thresholds guiding treatment decisions for early time window stroke patients. [ABSTRACT FROM AUTHOR]

Objective: For patients presenting with acute ischemic stroke (AIS) caused by large vessel occlusions (LVO), mechanical thrombectomy (MT) is the treatment standard of care in eligible patients. Modified Thrombolysis in Cerebral Infarction (mTICI) grades of 2b, 2c, and 3 are all considered successful reperfusion; however, recent studies have shown achieving mTICI 2c/3 leads to better outcomes than mTICI 2b. This study aims to investigate whether any baseline preprocedural or periprocedural parameters are predictive of achieving mTICI 2c/3 in successfully recanalized LVO patients. Methods: We conducted a retrospective multicenter cohort study of consecutive patients presenting with AIS caused by a LVO from 1 January 2017 to 1 January 2023. Baseline and procedural data were collected through chart review. Univariate and multivariate analysis were applied to determine significant predictors of mTICI 2c/3. Results: A total of 216 patients were included in the study, with 159 (73.6%) achieving mTICI 2c/3 recanalization and 57 (26.4%) achieving mTICI 2b recanalization. We found that a higher groin puncture to first pass time (OR = 0.976, 95%CI: 0.960–0.992, p = 0.004), a higher first pass to recanalization time (OR = 0.985, 95%CI: 0.972–0.998, p = 0.029), a higher admission NIHSS (OR = 0.949, 95%CI: 0.904–0.995, p = 0.031), and a lower age (OR = 1.032, 95%CI: 1.01–1.055, p = 0.005) were associated with a decreased probability of achieving mTICI 2c/3. Interpretation: A lower groin puncture to first pass time, a lower first pass to recanalization time, a lower admission NIHSS, and a higher age were independent predictors of mTICI 2c/3 recanalization. [ABSTRACT FROM AUTHOR]

Background and Purpose: Acute ischemic stroke due to large vessel occlusion (AIS‐LVO) is a major cause of functional dependence. Collateral status (CS) is an important determinant of functional outcomes. Pretreatment CT perfusion (CTP) parameters serve as reliable surrogates of CS. Penumbra Salvage Index (PSI) is another parameter predictive of functional outcomes in AIS‐LVO. The aim of this study is to assess the relationship of pretreatment CTP parameters with PSI. Methods: In this prospectively collected, retrospectively reviewed multicenter analysis, inclusion criteria were as follows: (1) CT angiography confirmed middle cerebral artery (MCA) M1‐segment and proximal M2‐segment occlusion from 9/1/2017 to 9/22/2022; (2) diagnostic CTP; and (3) available diagnostic Magnetic resonance Imaging (MRI) diffusion‐weighted images. Pearson correlation analysis was performed to assess the association between cerebral blood volume (CBV) index and hypoperfusion intensity ratio (HIR) with PSI. p value ≤.05 was considered statistically significant. Results: In total, 131 patients (n = 86, M1 and n = 45, proximal M2 occlusion) met our inclusion criteria. CBV index showed a modest positive correlation with PSI (r = 0.34, p<.001) in patients with proximal MCA occlusion. Similar trends were noted in subgroup analysis of patients with M1 occlusion, and proximal M2 occlusion. Whereas, HIR did not have a strong trend or correlation with PSI. Conclusion: CBV index correlates with PSI, whereas HIR does not. Future studies are needed to expand our understanding of the adjunct role of CBV index with other similar pretreatment CTP‐based markers in clinical evaluation and decision‐making in patients with MCA occlusion. [ABSTRACT FROM AUTHOR]

Objective Methods Results Interpretation Venous outflow (VO) impairment predicts unfavorable outcomes in patients with acute ischemic stroke caused by large vessel occlusion (AIS‐LVO). Prolonged venous transit (PVT), a visual qualitative VO marker on CT perfusion (CTP) time to maximum (Tmax) maps, has been associated with unfavorable 90‐day functional outcomes despite successful reperfusion. This study investigates the association between PVT and percent change on the National Institutes of Health Stroke Scale (NIHSS) among AIS‐LVO patients who have undergone successful reperfusion.We performed a retrospective analysis of prospectively collected data from consecutive adult AIS‐LVO patients with successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b/2c/3). PVT+ was defined as Tmax ≥10 s in the superior sagittal sinus, torcula, or both. The primary outcome was continuous NIHSS percent change and dichotomous NIHSS percent change ≥70%. Regression analyses were performed to assess the effect of PVT on NIHSS percent change.In 119 patients of median (IQR) age 71 (63–81) years, the admission and discharge NIHSS scores were significantly higher in PVT+ patients compared to PVT− patients (17 [14–23.5] vs. 13 [9.5–19], p = 0.011, and 7.5 [4–12] vs. 3 [1–7], p < 0.001, respectively). After adjusting for age, sex, hypertension, diabetes, atrial fibrillation, administration of intravenous thrombolysis (IVT), Alberta Stroke Program Early CT Scores (ASPECTS), mTICI 2c and/or 3, Tmax >6 s volume, and hemorrhagic transformation, PVT+ was significantly associated with lower NIHSS percent change (B = −0.163, 95%CI −0.326 to −0.001, p = 0.049) and was less likely to achieve higher than 70% NIHSS improvement (OR = 0.331, 95% CI 0.127–0.863, p = 0.024).PVT+ was significantly associated with reduced neurological improvement despite successful reperfusion in AIS‐LVO patients, highlighting the critical role of VO impairment in short‐term functional outcomes. These findings further validate PVT as a valuable adjunct imaging biomarker derived from CTP for assessing VO profiles in AIS‐LVO. [ABSTRACT FROM AUTHOR]

Since the arrival of Christian missionaries in China through maritime trade networks, missionary activities have been changing from the 16th century to the 18th century. Christian missionaries faced numerous challenges stemming from cultural context and religious policies in China. Throughout history, various religious strategies have been employed to address these challenges. The use of Chinese porcelain to depict Christian imagery holds significant importance. The present study is focused on four representative Chinese porcelains dating from the Ming to Qing dynasties, each associated with specific phases of Christianity in China. Examining the connections between the Christian mission in China and Christian iconography on Chinese porcelain leads to the conclusion that the visual culture associated with the Christian mission in China is influenced by and reflects intercultural or interreligious dialogue with mutual understanding. In the meantime, it signifies an intricate process of interaction, appropriation, hybridization, and adaptation, through which Christian iconography gained new significance on Chinese porcelain. [ABSTRACT FROM AUTHOR]

The Franciscan Order was one of the most important missionary orders in China during the Ming and Qing Dynasties. While rooted in the local communities, they also engaged in various forms of interactions with Chinese literati. This article will begin by briefly discussing the issue of the Franciscans changing from religious habit into Chinese dress as well as their evolving attitude towards Confucianism and Chinese rituals, aiming to illustrate the process of shaping their "Western Confucian" image and their adaptation to Chinese culture. Subsequently, the focus of this paper will be shifted to exploring the modes of interactions between the Spanish Franciscans and the Chinese literati. The author argues that the interactions between the two sides were primarily power-based. These power-based interactions entailed establishing connections with officials and leveraging their influence to safeguard missionary activities. It can be further categorized into three types. The first type involved socializing with officials, while the second type included interaction with Jesuit officials in court, and the third type was direct involvement in official positions. In their engagement with literati, the Franciscans demonstrated a thorough understanding of and adaptation to Chinese societal and cultural norms, thereby facilitating the development of their mission. [ABSTRACT FROM AUTHOR]

Mechanical thrombectomy (MT) is the treatment standard in eligible patients with acute ischemic stroke (AIS) secondary to large vessel occlusions (LVO). Studies have shown that good collateral status is a strong predictor of MT efficacy, thus making collateral status important to quickly assess. The Los Angeles Motor Scale is a clinically validated tool for identifying LVO in the field. The aim of this study is to investigate whether admission LAMS score is also associated with the American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score on digital subtraction angiography (DSA).We conducted a retrospective multicenter cohort study of consecutive patients presenting with AIS caused by LVO from 9/1/2017 to 10/1/2023 with diagnostically adequate DSA imaging. Demographic, clinical, and imaging data was collected through manual chart review. Both univariate and multivariate analysis were applied to assess associations. A p-value <0.05 was considered significant.A total of 308 patients (median age: 68, IQR: 57.5–77) were included in the study. On multivariate logistic regression analysis, we found that lower admission LAMS score (adjusted OR: 0.82, 95% CI: 0.68–0.98, p < 0.05) and higher ASPECTS score (adjusted OR: 1.21, 95% CI: 1.02–1.42, p < 0.05) were independently associated with good DSA ASITN collateral score of 3-4.Admission LAMS and ASPECTS score are both independently associated with DSA ASITN collateral score. This demonstrates the capability of LAMS to act as a surrogate marker of CS in the field. [ABSTRACT FROM AUTHOR]