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• PAFAH1B1, also known as LIS1, is associated with type I lissencephaly in humans, which is a severe developmental brain disorder believed to result from abnormal neuronal migration. • The aim of this present study is to elucidate the phenotypic presentations and molecular genetic characteristics of PAFAH1B1-related epilepsy in a Chinese cohort. • Notably, the clinical presentation in patients with PAFAH1B1 gene variants exhibits heterogeneity, and this heterogeneity is associated with the specific type of variant. PAFAH1B1, also known as LIS1, is associated with type I lissencephaly in humans, which is a severe developmental brain disorder believed to result from abnormal neuronal migration. Our objective was to characterize the genotypes and phenotypes of PAFAH1B1-related epilepsy. We conducted a comprehensive analysis of the medical histories, magnetic resonance imaging findings, and video-electroencephalogram recordings of 11 patients with PAFAH1B1 variants at the Neurology Department of Beijing Children's Hospital from June 2017 to November 2022. The age of onset of epilepsy ranged from 2 months to 4 years, with a median onset age of 5 months. Among these 11 patients (comprising 6 boys and 5 girls), all were diagnosed with lissencephaly type 1. Predominantly, generalized tonic-clonic and spasm seizures characterized PAFAH1B1-related epilepsy. Additionally, 10 out of the 11 patients exhibited severe developmental disorders. All patients exhibited de novo variants, with three individuals displaying 17p13.3 deletions linked to haploinsufficiency of PAFAH1B1. Four variants were previously unreported. Notably, three patients with 17p13.3 deletions displayed developmental delay and drug resistant epilepsy, whereas the single patient with mild developmental delay, Intelligence Quotient (IQ) 57 and well-controlled seizures had a splicing-site variant. The severity of the phenotype in patients with PAFAH1B1 variants ranged from drug-responsive seizures to severe epileptic encephalopathy. These observations underscore the clinical heterogeneity of PAFAH1B1-related disorders, with most patients exhibiting developmental disorders. Moreover, the severity of epilepsy appears to be linked to genetic variations. [ABSTRACT FROM AUTHOR]

Highlights • Considering biotic factors in determination of growth dynamics of Chinese cork oak across three-dimensional geographical gradients. • The oak growth increased with latitude but decreased with longitude. • Stand conditions and its interactive with climate and soil variables determine geographic variations of oak growth. Abstract Impending climate warming is expected to influence plant growth and distribution ranges. However, synchronous comparisons of growth dynamics associated with biotic factors across latitudinal, longitudinal and altitudinal gradients at a single species’ level have received little attention. In the present study, we investigated growth variations (radial and height growth) of Quercus variabilis along latitudinal, longitudinal and altitudinal gradients; meanwhile, the effects of environmental factors (climate, soil and stand conditions) on growth across the three geographical gradients were ranked and apportioned using linear mixed-effects models. Our results indicated that the radial growth of ringwood and latewood increased with latitude, and latewood and height growth decreased with longitude; furthermore, the growth sensitivity to climate were less in the southern and eastern populations than the northern and western. When pooling all sites’ data, we found that climate variables were not solely decisive factors to drive the geographic variations in the growth of Q. variabilis , stand conditions (stand density and total basal area) and soil properties (Ca, Mg, N and N/P) also played important roles in shaping large geographical patterns of the oak growth. [ABSTRACT FROM AUTHOR]

The itch-scratching cycle is mediated by neural dynamics in the brain. However, our understanding of the neural dynamics during this cycle remains limited. In this study, we examine the neural dynamics of 126 mouse brain areas by measuring the calcium signal using fiber photometry. We present numerous response patterns in the mouse brain during the itch-scratching cycle. Interestingly, we find that a group of brain areas exhibit activation only at the end of histamine-induced scratching behavior. Additionally, several brain areas exhibit transient activation at the onset of scratching induced by chloroquine. Both histamine- and chloroquine-induced itch evoke diverse response patterns across the mouse brain. In summary, our study provides a comprehensive dataset for the diverse activity pattern of mouse brain during the itch-scratching cycle, paving the way for further exploration into the neural mechanisms underlying the itch-scratching cycle. [Display omitted] • Recording from 126 mouse brain areas reveals diverse response pattern in two itch models • In histamine model, some brain areas exhibit activation only at the end of scratch behavior • In chloroquine model, a subset of brain areas exhibits transient activation at scratch onset • The cortex shows distinct functional networks in histamine- and chloroquine-induced itch Chen et al. present a database for itch-evoked responses by conducting fiber photometry across 126 mouse brain areas. Their results reveal a rich diversity of neural dynamic patterns in both histamine- and chloroquine-induced itch models. Notably, several distinct response patterns are identified within the two itch models. [ABSTRACT FROM AUTHOR]

In this work, Sm 2 O 3 - and SiO 2 -codoped SnO 2 -Zn 2 SnO 4 ceramic varistors were prepared through traditional ceramic processing, and the effect of Sm 2 O 3 on the resulting microstructure and electrical properties was investigated. The results demonstrated that the ceramics were composed mainly of SnO 2 and Zn 2 SnO 4 , and Sm was distributed homogeneously in the grains and along the grain boundaries. With 0.2 mol% Sm 2 O 3 doping, the grain growth was obviously promoted. Further increases in Sm 2 O 3 to 0.4 mol% resulted in trace amount of SiO 2 and segregations containing elemental Sm via X-ray diffraction patterns and microstructure photos, respectively. In the sample doped with 0.3 mol% Sm 2 O 3 , optimal electrical characteristics of α =9.4, E B =10 V/mm, J L =46 μA/cm 2 and ε ′=1.2×10 4 were obtained. Simultaneously, the sample doped with 0.3 mol% Sm 2 O 3 had the lowest conductance activation energy of 0.16 eV at temperatures lower than 110 °C. This good performance indicates that Sm 2 O 3 - and SiO 2 -codoped SnO 2 -Zn 2 SnO 4 composite ceramics are viable candidate for the manufacture of capacitor-varistor functional devices. [ABSTRACT FROM AUTHOR]

Vitex negundo L. var. heterophylla (Franch.) Rehd. is widely accepted as a functional and medicinal food in China because of the presence of bioactive components which improve the physical condition. In the present study, the bioactive constituents, antioxidant, α -glucosidase and DPP-IV inhibitory activities of V. negundo var. heterophylla were investigated. Two new coumarin glycosides, vitexnegheteroins I-J ( 1 – 2 ), and two new iridoid glycosides, vitexnegheteroins K-L ( 3 – 4 ), were isolated from the leaves and seeds of V. negundo var. heterophylla , together with twenty known compounds. Seven compounds presented stronger antioxidant activities than l -ascorbic acid in both DPPH and ABTS assays. Among them, isoorientin-6″- O -caffeate ( 22 ) also exhibited more potent α -glucosidase inhibitory activity than acarbose with an IC 50 value of 0.24 ± 0.02 μM. These findings further revealed the bioactive components of this edible aromatic plant and disclosed the potency of it to be developed as new antioxidant and α -glucosidase inhibitory agents. [ABSTRACT FROM AUTHOR]

In this work, SiO 2 doped SnO 2 -Zn 2 SnO 4 ceramic composites with excellent varistor and dielectric properties were prepared through traditional ceramic processing. The obtained nonlinear coefficient α was as high as 9.6, and the breakdown electrical field EB and leakage current density JL was as low as 5.9 V/mm and 62 μA/cm 2 , respectively. At a low frequency of 40 Hz, the relative permittivity εr measured at room temperature was higher than 2.5×10 4 . The nonlinear decrease of the semicircle diameter in the complex impedance spectra with increasing DC bias voltage indicates that the grain boundary effect is an important origin of the varistor and giant permittivity properties. With an increase of temperature, the relaxor peak of the imaginary part M ″ of the complex electric modulus shifted to high frequency and the activation energy E a obtained from the M ″ spectrum was about 0.31 eV, much lower than the grain boundary barrier height ϕ b . The results suggest that other mechanisms may also be responsible for the giant permittivity property besides grain boundary barriers. [ABSTRACT FROM AUTHOR]

Background Nosocomial pneumonia is one of the most common health care–associated infections in intensive care units (ICUs) worldwide, attributing to high morbidity and mortality. Our study aim is to investigate the effectiveness of oral hygiene with 0.2% chlorhexidine gluconate (CHX) and 0.08% metronidazole (MDE) influencing the microbiologic epidemiology and incidence of nonintubation pneumonia (NIP) and ventilator-associated pneumonia (VAP). Methods Patients who stayed >48 hours in the emergency ICU between 2008 and 2012 were enrolled and provided oral hygiene by swabbing with 0.08% MDE twice daily until discharge or death during the first year (period M), whereas CHX was applied during the following 3 years (period C). The incidence and microbiologic epidemiology of NIP and VAP were studied. Results There were 873 patients enrolled. There were 44 episodes of NIP and 25 episodes of VAP that occurred among 212 patients in period M, and 84 episodes of NIP and 49 episodes of VAP occurred among 661 patients in period C. Overall, the rate of NIP and VAP decreased year by year. Acinetobacter baumannii was the most frequently identified bacteria for NIP (22.9%) and VAP (25.3%), with an annual ascent. Few changes were observed on bacteria distribution for NIP and VAP. Conclusions Oral hygiene with CHX, having reduced the incidence of nosocomial pneumonia among critical ill patients, suggests a benefit of oral hygiene in decreasing the incidence of nosocomial pneumonia, including VAP in ICUs, but not bacterial epidemiology. [ABSTRACT FROM AUTHOR]

We study the behavior of the pulse waves of water into a flexible tube for application to blood flow simulations. In pulse waves both fluid friction and wall viscosity are damping factors, and difficult to evaluate separately. In this paper, the coefficients of fluid friction and wall viscosity are estimated by fitting a nonlinear 1D flow model to experimental data. In the experimental setup, a distensible tube is connected to a piston pump at one end and closed at another end. The pressure and wall displacements are measured simultaneously. A good agreement between model predictions and experiments was achieved. For amplitude decrease, the effect of wall viscosity on the pulse wave has been shown as important as that of fluid viscosity. [ABSTRACT FROM AUTHOR]

Otsu algorithm, an automatic thresholding method, is widely used in classic image segmentation applications. In this paper, a novel two-dimensional (2D) Otsu thresholding algorithm based on local grid box filter is proposed. In our method, firstly by utilizing the coarse-to-fine idea, the 2D histogram is divided into regions by grid technique, and each region is used as a point to form a new 2D histogram, to which 2D Otsu thresholding algorithm and an improved particle swarm optimization (PSO) algorithm are applied to get the region number of the new 2D histogram threshold. Then on the result region, the mean of the 2D histogram is computed base on box filter, and the two algorithms are applied again to obtain the final threshold for the original image. Experimental results on real data show that the proposed algorithm gets better segmentation results than the traditional recursion Otsu algorithm. It significantly reduces the time of segmentation process and simultaneously has the higher segmentation accuracy. [ABSTRACT FROM AUTHOR]

[Display omitted] KRAS mutation and NF-κB both play crucial role in pancreatic cancer; in addition, defensin, the peptide mediator in innate immunity, can inhibit NF-κB. Assuming a strategy that targets both NF-κB and concomitantly the mutated KRAS indirectly via intensive macropinocytosis, we designed and generated a recombinant protein DF 2 -HSA which consists of two molecules of human beta-defensin 2 (HBD2) and a moiety of human serum albumin (HSA). As shown, the recombinant protein DF 2 -HSA markedly down-regulated NF-κB in both KRAS mutant MIA PaCa-2 cells and wild type BxPC-3 cells. Determined by confocal microscopy, the uptake of DF 2 -HSA in MIA PaCa-2 cells was more intense than that in BxPC-3 cells. The uptake was blocked by the specific inhibitor EIPA, indicating that DF 2 -HSA internalized via macropinocytosis. DF 2 -HSA displayed more potent cytotoxicity to cancer cells than HBD2. DF 2 -HSA induced apoptosis in cancer cells. Notably, DF 2 -HSA inhibited tumor cell spheroid formation, an effect comparable to that of salinomycin. DF 2 -HSA inhibited tumor cell migration and invasion. As detected with scanning electron microscopy, DF 2 -HSA strongly depleted filopodia on cell surface; and salinomycin induced similar changes. By in vivo imaging, DF 2 -HSA displayed intense tumor-site accumulation and lasting retention for over 14 days; however, HBD2 showed much less tumor-site accumulation and a shorter retention time for only 24 h. DF 2 -HSA suppressed the growth of pancreatic cancer MIA PaCa-2 xenograft in athymic mice; and its combination with gemcitabine achieved higher antitumor efficacy. In summary, the recombinant defensin/HSA fusion protein that inhibits NF-κb associated with intensive macropinocytosis is highly effective against pancreatic cancer. [ABSTRACT FROM AUTHOR]

Abstract: Enantioselective aldol reaction of ketones with aldehydes catalyzed by (2S,5S)-pyrrolidine-2,5-dicarboxylic acid in the presence of an equal molar amount of Et3N was described. By using the new chiral organocatalyst, the direct aldol condensation products were obtained in reasonable yields and up to 90% ee. [Copyright &y& Elsevier]

Abstract: Ecotoxicological effects of cadmium (Cd) on three ornamental plants African marigold (Tagetes erecta), scarlet sage (Salvia splendens) and sweet hibiscus (Abelmoschus manihot) were investigated. Seeds of these plants were exposed to five different concentrations of Cd (0–50mgl−1). Ecotoxicological indexes based on inhibition rate (IC) of seed germination, root and shoot elongation, biomass (fresh weight and dry weight), as well as IC50 (Cd concentration when 50% plants show inhibition) and tolerance indexes (the ratio of maximum root length in an experimental group to that in a control group) were determined. The results indicated that Cd had little effects (p >0.05) on seed germination of the three plants and shoot elongation of scarlet sage (S. splendens). Cadmium had significant (p <0.05) inhibitory effects on root elongation of the three plants and shoot elongation of African marigold (T. erecta). The fresh weight biomass of scarlet sage (S. splendens) was most sensitive to Cd, while that of sweet hibiscus (A. manihot) was least sensitive. On a dry weight basis, African marigold (T. erecta) was the least sensitive, and scarlet sage (S. splendens) was the most sensitive to Cd. Based on IC50 of seed germination, sweet hibiscus (A. manihot) was the most insensitive plant with an IC50 value as high as 428.0gl−1. According to Cd-tolerance indexes under the same Cd concentration, sweet hibiscus (A. manihot) was the most tolerant plant whereas scarlet sage (S. splendens) was the most sensitive one. [Copyright &y& Elsevier]

Purpose: To observe the proliferation and differentiation of human adipose-derived stem cells (hADSCs) on 2D and 3D scaffolds, the sodium alginate and collagen interpenetrating network hydrogel were developed to determine optimal properties for bone tissue engineering.Methods: Three groups of scaffold materials were prepared according to the ratio of sodium alginate to collagen: A (4:1), B (2:1), and C (1:1), respectively. For each group, gel beads (3D surfaces) and freeze-dried films (2D surfaces) were respectively prepared. For gel beads, hADSCs were mixed during the preparation of the beads, and then stem cells were applied to the surface of each film after freeze-drying and sterilization during the preparation of the freeze-dried films. Cell proliferation and osteogenic differentiation potential were detected by cell counting kit, viable/dead cell staining kit, quantitative reverse transcription polymerase chain reaction, and immunofluorescent staining, respectively.Results: Results showed that cell proliferation rate progressively increased with the increase of collagen ratio, with group C of 3D surfaces of gel beads achieving the highest rate. In particular, highest cell viability on the 2D surfaces was achieved in group B. Differences in BGLAP and RUNX2 expression in hADSCs on 2D or 3D surfaces of the 3 groups were statistically significant. Particularly, BGLAP and RUNX2 gene expression levels were highest in group C of freeze-dried films and were highest in group B of gel beads. Furthermore, the trend of immunofluorescence expression of RUNX2 and osteocalcin expression were consistent with the genetic testing results.Conclusions: All data indicated that sodium alginate-collagen scaffolding materials had no adverse impact on the proliferation and osteogenic differentiation of hADSCs. Cell differentiation and proliferation of bone tissue engineering can be promoted with the use of sodium alginate and collagen interpenetrating network hydrogel, and the appropriate ratio of sodium alginate and collagen is 2:1. [ABSTRACT FROM AUTHOR]

• This paper presents a semi-analytical finite strain solution for circular tunnels. • The logarithmic strain is used to describe the finite strain behavior of rock mass. • The Young's modulus affects the stress, displacement, plastic and residual regions. • The finite strain solution is more reasonable for a heavily squeezed roadway. This paper presents a semi-analytical finite strain solution for circular roadways excavated in a strain-softening rock mass with a non-associated flow rule. The evolutions of both strength parameters and Young's modulus are considered, and the finite strains are applied to describe both the elastic and plastic behaviors with the logarithmic strain in Lagrangian coordinates. By transforming the derivative of displacement with a new variable that is correlated with displacement, the stress and displacement in the elastic region are obtained in the form of integral equations. Considering the assumption of constant material parameters within a very small region, the plastic region is divided into a number of concentric annuli, whose closed-form solutions of displacement and stress can be recursively obtained. The solution is validated by similarity solutions and numerical simulation. Both the roadway wall displacement and thickness of the plastic (residual) region appear to be smaller than those of the small strain solution. For the elasto-perfectly-plastic rock mass, the finite strain solution is approximately the same as that of small strain solution. However, for the strain-softening rock mass, with the decrease of Young's modulus, the thickness of plastic and residual regions shows the first increase and then decrease trend, finally approaching nil; the difference between the thickness of softening and residual region gradually decreases. The decreasing Young's modulus deterioration coefficient and increasing dilation angle significantly produce the displacement. Both the displacement and the thickness of plastic and residual regions decrease with the increase of Poisson's ratio. When Young's modulus is large, the tangential stress gradually decreases with the increasing radius. When Young's modulus is small, the tangential stress firstly increases to a maximum value, then decreases gradually. Different from the small strain solutions, the roadway wall displacement of finite strain solutions cannot be larger than the excavation radius, which is in compliance with the practical underground engineering condition. The predicted displacement and thickness in both plastic and residual regions are in accordance with the field test results. [ABSTRACT FROM AUTHOR]

Nitrogen (N) is an essential element that plays an important role in crop biomass accumulation and quality formation. Increased crop yield is relied on excessive application of fertilizers, which usually leads to environmental pollution and unsustainable development. Thus, identification and characterization of genes involved in promoting nitrogen use efficiency is of high priority in crop breeding. The activity of nitrate reductase (NR) plays a critical role in nitrogen metabolism. In model plant Arabidopsis , NITRATE REDUCTASE 2 (NIA2), one of the two NRs, is responsible for about 90% of the NR activity. In this study, MdNIA2 gene in apple (Malus domestica) genome was screened out and identified by using AtNIA2 as bait. Phylogenetic analysis revealed that MdNIA2 had the closest evolutionary relationship with MbNIA from Malus baccata. Ectopic expression of MdNIA2 in Arabidopsis elevated the nitrogen use efficiency and increased root hair elongation and formation, resulting in promoted plant growth. Furthermore, the overexpression of MdNIA2 improved salt and drought tolerance in transgenic Arabidopsis and improved the salt tolerance of transgenic apple callus, and MdNIA2 -reagualted NO metabolism might contribute to the abiotic stress tolerance. Overall, our data indicate the critical role of MdNIA2 in regulating nitrogen utilization efficiency and abiotic stress responses. • MdNIA2 family was identified in apple for the first time. • MdNIA2 elevated the nitrogen use efficiency and increased root hair elongation and formation. • MdNIA2 may play a critical role in the regulation of plant growth and abiotic stress response. [ABSTRACT FROM AUTHOR]

Trihelix transcription factors consist of five subfamilies, including GT-1, GT-2, SH4, GTγ, and SIP1, which play important roles in the responses to biotic and abiotic stresses, however, seldom is known about the role of the SIP1 genes in apples. In this study, 12 MdSIP1 genes were first identified in apples by genome-wide analysis, and contained conserved MYB/SANT-like domains. Expression patterns analyses showed that the MdSIP1 genes had different tissue expression patterns, and different transcription levels in response to abiotic stresses, indicating that MdSIP1s may play multiple roles under various abiotic stresses. Among them, the MdSIP1-2 gene was cloned and ectopic transformed into Arabidopsis , and its biology function was identified. The subcellular localization showed that MdSIP1-2 protein was specifically localized in the nucleus, and that overexpression of MdSIP1-2 promoted the development of lateral roots, increased abscisic acid (ABA) sensitivity, and improved salt and drought tolerance. These findings suggested that MdSIP1-2 plays an important role in root development, ABA synthesis, and salt and drought stress tolerance. In conclusion, these results lay a solid foundation for determining the role of MdSIP1 in the growth and development and abiotic stress tolerance of apples. • MdSIP1 family was identified in apple for the first time. • MdSIP1-2 promoted lateral root development, abscisic acid (ABA) sensitivity, drought and salt stress tolerance. • MdSIP1-2 may play a critical role in the regulation of apple growth and abiotic stress response. [ABSTRACT FROM AUTHOR]

Although lipid peroxidation has long been associated with spinal cord injury (SCI), the specific role of lipid peroxidation-derived byproducts such as acrolein in mediating damage remains to be fully understood. Acrolein, an α-β unsaturated aldehyde, is highly reactive with proteins, DNA, and phospholipids and is considered as a second toxic messenger that disseminates and augments initial free radical events. Previously, we showed that acrolein increased following traumatic SCI and injection of acrolein induced tissue damage. Here, we demonstrate that microinjection of acrolein into the thoracic spinal cord of adult rats resulted in dose-dependent tissue damage and functional deficits. At 24 h (acute) after the microinjection, tissue damage, motoneuron loss, and spinal cord swelling were observed on sections stained with Cresyl Violet. Luxol fast blue staining further showed that acrolein injection resulted in dose-dependent demyelination. At 8 weeks (chronic) after the microinjection, cord shrinkage, astrocyte activation, and macrophage infiltration were observed along with tissue damage, neuron loss, and demyelination. These pathological changes resulted in behavioral impairments as measured by both the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale and grid walking analysis. Electron microscopy further demonstrated that acrolein induced axonal degeneration, demyelination, and macrophage infiltration. These results, combined with our previous reports, strongly suggest that acrolein may play a critical causal role in the pathogenesis of SCI and that targeting acrolein could be an attractive strategy for repair after SCI. [ABSTRACT FROM AUTHOR]

The Tetratricopeptide repeat (TPR)-like superfamily with TPR conserved domains is widely involved in the growth and abiotic stress in many plants. In this report, the gene MdTPR16 belongs to the TPR family in apple (Malus domestica). Promoter analysis reveal that MdTPR16 incorporated various stress response elements, including the drought stress response elements. And different abiotic stress treatments, drought especially, significantly induce the response of MdTPR16. Overexpression of MdTPR16 result in better drought tolerance in apple and Arabidopsis by up-regulating the expression levels of drought stress-related genes, achieving a higher chlorophyll content level, more material accumulation, and overall better growth compared to WT in the drought. Under drought stress, the overexpressed MdTPR16 also mitigate the oxidative damage in cells by reducing the electrolyte leakage, malondialdehyde content, and the H 2 O 2 and O 2 − accumulation in apples and Arabidopsis. In conclusion, MdTPR16 act as a beneficial regulator of drought stress response by regulating the expression of related genes and the cumulation of reactive oxygen species (ROS). • MdTPR16 positively regulates drought tolerance in apple seedlings. • The MdTPR16 gene enhances plant resistance by inducing the expression of drought-related genes. • After drought stress, the MdTPR16 gene reduces ROS accumulation in plants. • MdTPR16 may be used in the future to breeding drought-resistant varieties. [ABSTRACT FROM AUTHOR]

Objectives To assess the outcomes in aggressively treated patients with aneurysmal intracerebral hematoma (ICH) and signs of brain herniation, and to investigate possible predictive factors. Methods This retrospective study included 43 patients with aneurysmal ICH who presented to the Emergency Department with brain herniation and received aggressive surgical treatment between 2008 and 2016. Emergency surgical clipping, hematoma removal, and external decompression were combined as an aggressive surgical treatment. Outcomes were assessed using in-hospital survival and the Glasgow Outcome Scale at a 6-month follow-up. Results All the patients were World Federation of Neurological Societies grade V on presentation. The mean hematoma volume was 59.1 ± 16.5 mL. The in-hospital mortality rate was 48.8%. At the 6-month follow-up, favorable outcomes were achieved in 7 patients (16.3%). Significant factors related to death included bilateral mydriasis, lower initial Glasgow Coma Scale (GCS) score, larger hematoma volume, and no recovery of pupil reactivity after surgery. Bilateral restoration of pupil reactivity and higher initial GCS score were associated with 6-month favorable outcomes. Patients with an intrasylvian hematoma were more likely than those with an intraparenchymal hematoma to achieve a favorable outcome (62.5% vs. 5.7%; P = 0.001). Conclusions Our data indicate that the protocol of aggressive surgical treatment in patients with a herniated aneurysmal ICH might be warranted. Despite mydriasis, favorable outcomes might be achieved in some patients. However, careful individual patient-centered decision making is essential, particularly when bilateral pupil dilation persists. [ABSTRACT FROM AUTHOR]