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Objective: Processes of stroke care play an increasingly important role in comparing hospital performance. The relationship between processes of care and outcomes for stroke is unclear. Moreover, in terms of stroke care regionalization, little information is available with regard to the relationships among hospital level of care, processes and outcomes of stroke care. We used nationwide population-based data to examine the relationship between processes of care and mortality and the relationships among hospital level of care, processes and mortality for ischemic stroke. Design: Cross-sectional study. Setting: General acute care hospitals throughout Taiwan. Participants: A total of 31 274 ischemic stroke patients admitted in 2010 through Taiwan's National Health Insurance Research Database. Main Outcome Measures: Processes of care and 30-day mortality. Multilevel modelswere used after adjustment for patient and hospital characteristics to test the relationship between processes of care and 30-day mortality and the relationships among hospital level of care, processes and 30-day mortality. Results: The use of thrombolytic therapy, antithrombotic therapy, statin treatment and rehabilitation assessmentwas associated with lower mortality. Hospital level of carewas associated with the use of thrombolytic therapy, antithrombotic therapy, statin treatment and rehabilitation assessment, and mortality. These processes of care were mediators of the relationship between hospital level of care and mortality. Conclusions: Outcomes among patients with ischemic stroke can be improved by thrombolytic therapy, antithrombotic therapy, statin treatment and rehabilitation assessment. Among patients with ischemic stroke, admission to designated stroke center hospitals may be associated with lower mortality through better processes of care. [ABSTRACT FROM AUTHOR]

Background Heart rate variability (HRV) has been proposed as a predictor of acute stroke outcome. This study aimed to evaluate the predictive value of a novel non-linear method for analysis of HRV, multiscale entropy (MSE) and outcome of patients with acute stroke who had been admitted to the intensive care unit (ICU). Methods The MSE of HRV was analysed from 1 h continuous ECG signals in ICU-admitted patients with acute stroke and controls. The complexity index was defined as the area under the MSE curve (scale 1-20). A favourable outcome was defined as modified Rankin scale 0 - 2 at 3 months after stroke. Results The trends of MSE curves in patients with atrial fibrillation (AF) (n=77) were apparently different from those in patients with non-AF stroke (n=150) and controls (n=60). In addition, the values of complexity index were significantly lower in the patients with non-AF stroke than in the controls (25.8±.3 vs 32.3±4.3, p<0.001). After adjustment for clinical variables, patients without AF who had a favourable outcome were significantly related to higher complexity index values (OR=1.15, 95% CI 1.07 to 1.25, p<0.001). Importantly, the area under the receiver operating characteristic curve for predicting a favourable outcome of patients with non-AF stroke from clinical parameters was 0.858 (95% CI 0.797 to 0.919) and significantly improved to 0.903 (95% CI 0.853 to 0.954) after adding on the parameter of complexity index values (p=0.020). Conclusions In ICU-admitted patients with acute stroke, early assessment of the complexity of HRV by MSE can help in predicting outcomes in patients without AF. [ABSTRACT FROM AUTHOR]

Solution-processed ultra-thin (∼3 nm) zinc tin oxide (ZTO) thin film transistors (TFTs) with a mobility of 8 cm2/Vs are obtained with post spin-coating annealing at only 350 °C. The effect of light illumination (at wavelengths of 405 nm or 532 nm) on the stability of TFT transfer characteristics under various gate bias stress conditions (zero, positive, and negative) is investigated. It is found that the ΔVth (Vthstress 3400 s − stress 0 s) window is significantly positive when ZTO TFTs are under positive bias stress (PBS, ΔVth = 9.98 V) and positive bias illumination stress (λ = 405 nm and ΔVth = 6.96 V), but ΔVth is slightly negative under only light illumination stress (λ = 405 nm and ΔVth = −2.02 V) or negative bias stress (ΔVth = −2.27 V). However, the ΔVth of ZTO TFT under negative bias illumination stress is substantial, and it will efficiently recover the ΔVth caused by PBS. The result is attributed to the photo-ionization and subsequent transition of electronic states of oxygen vacancies (i.e., Vo, Vo+, and Vo++) in ZTO. A detailed mechanism is discussed to better understand the bias stress stability of solution processed ZTO TFTs. [ABSTRACT FROM AUTHOR]

Background Activation of hyaluronic acid (HA) and associated enzyme synthesis has been demonstrated in experimental stroke animal models. Our study aimed to investigate the plasma levels of HA in acute stroke patients and the associationsbetweenHA levels andfunctional outcome. Methods This was a multicenter case-control study. Acute stroke patients and age- and sex-matched non-stroke controls were recruited. Plasma levels of HA in acute stroke patients were determined at <48 hoursand at 48 to 72 hours after stroke onset by standard ELISA. Favorable functional outcome was defined as modified Rankin scale ⩽2 at 3 months after stroke. Results The study included 206 acute stroke patients, including 43 who had intracerebral hemorrhage and 163 who had ischemic stroke, and 159 controls. The plasma levels of HA in the acute stroke patients were significantly higher than those in the controls (219.7 ± 203.4 ng/ml for <48 hours and 343.1 ± 710.3 ng/ml for 48 to 72 hours versus 170.4 ± 127.9 ng/ml in the controls; both P < 0.05). For intracerebral hemorrhage patients, HA ⩽500 ng/ml (<48 hours) was an independent favorable outcome predictor (P = 0.016). For ischemic stroke patients, an inverted U-shaped association between plasma HA (48 to 72 hours) and outcome was noted, indicating that ischemic stroke patients with too high or too low plasma HA levels tended to have an unfavorable outcome. Conclusion HA plasma level was elevated in patients with acute stroke, and can predict 3-month functional outcome, particularly for patients with intracerebral hemorrhage. [ABSTRACT FROM AUTHOR]

Background: Cardioembolic stroke is an under-recognized complication in patients with limb-girdle muscular dystrophy 1B. Here we present a young stroke patient who had a novel lamin A/C gene (LMNA) mutation. Case presentation: This is a 39-year-old man who had slowly progressive proximal muscle weakness and cardiac arrhythmia since adolescent and a family history of similar manifestation. He sustained acute ischemic stroke in the left middle cerebral artery territory. Intravenous recombinant tissue plasminogen activator therapy was given with significant neurological improvement. Additionally, genetic sequencing of the LMNA gene of the patient identified a mutation in c.513+1 G>A that resulted in a splicing aberration. Conclusion: We suggested that LMNA gene related myopathies should be considered in young stroke patients with long-standing myopathic features. [ABSTRACT FROM AUTHOR]

Background: The association between ischemic stroke and 2 single nucleotide polymorphisms (SNPs) on chromosome 12p13, rs12425791 and rs11833579 appears inconsistent across different samples. These SNPs are close to the ninjurin2 gene which may alter the risk of stroke by affecting brain response to ischemic injury. The purpose of this study was to investigate the association between these two SNPs and ischemic stroke risk, as well as prognostic outcomes in a Taiwanese sample. Methods: We examined the relations of these two SNPs to the odds of new-onset ischemic stroke, ischemic stroke subtypes, and to the one year risk of stroke-related death or recurrent stroke following initial stroke in a casecontrol study. A total of 765 consecutive patients who had first-ever ischemic stroke were compared to 977 strokefree, age-matched controls. SNPs were genotyped by Taqman fluorescent allelic discrimination assay. The association between ischemic stroke and SNPs were analyzed by multivariate logistic regression. Cox proportional hazard model was used to assess the effect of individual SNPs on stroke-related mortality or recurrent stroke. Results: There was no significant association between SNP rs12425791 and rs11833579 and ischemic stroke after multiple testing corrections. However, the marginal significant association was observed between SNP rs12425791 and large artery atherosclerosis under recessive model (OR, 2.30; 95%CI, 1.22-4.34; q-value = 0.062). Among the 765 ischemic stroke patients, 59 died or developed a recurrent stroke. After adjustment for age, sex, vascular risk factors and baseline stroke severity, Cox proportional hazard analysis indicated that the hazard ratios were 2.76 (95%CI, 1.34-5.68; q-value, 0.02) and 2.15 (95%CI, 1.15-4.02; q-value, 0.03) for individuals with homozygous variant allele of rs12425791 and rs11833579, respectively. Conclusions: This is a precedent study that found genetic variants of rs12425791 and rs11833579 on chromosome 12p13 are independent predictors of stroke-related mortality or stroke recurrence in patients with incident ischemic stroke in Taiwan. Further study is needed to explore the details of the physiological function and the molecular mechanisms underlying the association of this genetic locus with ischemic stroke. [ABSTRACT FROM AUTHOR]

In this paper, the diffusivities of copper in 15 nm thick Ru and Ru-C barrier layers are determined experimentally by using sheet resistance and X-ray diffraction measurements with the Cu/barrier/Si samples. By fitting the dependence of diffusivities on temperature, the activation energy for Cu diffusion in Ru-C film is 1.11 eV, which is substantially higher than that n Ru film (0.54 eV). Microstructural analysis by transmission electron microscopy combined with energy-dispersive X-ray suggests that the higher activation energy for Cu diffusion Ru-C is associated with the stuffing of added carbon atoms on the grain boundaries of the Ru matrix and consequently leading to the superior diffusion barrier performance of the Ru-C film. [ABSTRACT FROM AUTHOR]

BACKGROUND AND PURPOSE Pulsatile tinnitus is a common symptom of intracranial dural arteriovenous fistulas (DAVF). This study aims to characterize the clinical and ultrasonographic features of DAVF in patients with pulsatile tinnitus. METHODS We compared the characteristics of DAVF and carotid duplex sonography (CDS) results between 67 DAVF patients with and without pulsatile tinnitus. We also investigated the relationship between changes in tinnitus status and serial CDS changes in 25 DAVF patients with pulsatile tinnitus. RESULTS Pulsatile tinnitus was highly associated with the location and feeding arteries of DAVF ( P < .001). The sensitivity of resistive index (RI; Norm, >.72) and end diastolic velocity (EDV; Norm, <21 cm/sec) of external carotid artery (ECA) in CDS study for diagnosing DAVF in patients with pulsatile tinnitus was 95% and 92%, respectively. Changes of RI and EDV of ECA also correlated with the changes of tinnitus status. CONCLUSIONS RI and EDV of ECA have high diagnostic sensitivity and reliability for detecting DAVF in patients with pulsatile tinnitus. [ABSTRACT FROM AUTHOR]

Intracranial atherosclerotic disease (ICAD) is a major cause of ischemic stroke, with higher occurrence rates in Asian, black and Hispanic individuals than in white individuals. Important risk factors for ICAD include age, hypertension, diabetes mellitus and metabolic syndrome. ICAD patients have a 10-20% annual risk of stroke, with greater risk in patients with high-grade stenosis (70-99%). Given the high risk of stroke recurrence in symptomatic ICAD patients, effective secondary prevention strategies are needed. Currently, there is no strong evidence supporting the use of anticoagulants in ICAD patients; antiplatelet drugs are still the preferred medication. Recently, angioplasty and stenting for ICAD has emerged as an alternative approach to medical treatment, owing to high technical success rates and low risk of periprocedural complications. However, the rate of in-stent restenosis is moderate, and the long-term benefit of endovascular treatment is not well established. High-quality randomized trials comparing angioplasty/stenting with the best medical therapy in ICAD patients are anticipated. INSET: Key issues. [ABSTRACT FROM AUTHOR]

Background: Participation in daily physical activity (PA) post-stroke has not previously been investigated as a possible explanatory variable of health-related quality of life (HRQL). The aims were 1) to determine the contribution of daily PA to the HRQL of individuals with chronic stroke and 2) to assess the relationship between the functional ability of these individuals to the amount of daily PA. Methods: The amount of daily PA of forty adults with chronic stroke (mean age 66.5 ± 9.6 years) was monitored using two measures. Accelerometers (Actical) were worn on the hip for three consecutive days in conjunction with a self-report questionnaire [the PA Scale for Individuals with Physical Disabilities (PASIPD)]. The daily physical activity was measured as the mean total accelerometer activity counts/day and the PASIPD scores as the metabolic equivalent (MET) hr/day. HRQL was assessed by the Physical and Mental composite scores of the Medical Outcomes Study Short-Form 36 (SF-36) in addition to the functional ability of the participants. Correlation and regression analyses were performed. Results: After controlling for the severity of the motor impairment, the amount of daily PA, as assessed by the PASIPD and accelerometers, was found to independently contribute to 10-12% of the variance of the Physical Composite Score of the SF-36. No significant relationship was found between PA and the Mental Composite Score of the SF-36.The functional ability of the participants was found to be correlated to the amount of daily PA (r = 0.33 - 0.67, p < 0.01). Conclusion: The results suggest that daily PA is associated with better HRQL (as assessed by the Physical composite score of the SF-36) for people living with stroke. Daily PA should be encouraged to potentially increase HRQL. Accelerometers in conjunction with a self-report questionnaire may provide important measures of PA which can be monitored and modified, and potentially influence HRQL. [ABSTRACT FROM AUTHOR]

Sputtered Ru and Ru-C films 5 nm thick are employed in the Cu/barrier/SiO2/Si system, and their performances as the diffusion barrier as well as the seed layer for direct Cu electroplating are investigated in parallel. Based on the sheet resistance measurement and energy dispersive X-ray line profiles, the 5 nm Ru-C film can retard the diffusion of Cu after a prolonged (30 min) annealing up to 700°C, while the Ru film is an effective barrier up to only 400°C. Direct electroplating of Cu is successfully carried out on both Ru and Ru-C films, which proves that Ru-C is a Cu seed layer in addition to being a robust diffusion barrier. The microstructural characteristics of ultrathin Ru and Ru-C films are also examined, indicating that the superior barrier performance of the 5 nm Ru-C film is associated with its inferior crystallinity and resistance to agglomeration at elevated temperatures. [ABSTRACT FROM AUTHOR]

Ru-Ta and Ru thin films (∼15 nm in thickness) as diffusion barrier for Cu metallization on SiO2/Si and Si substrates are studied. Experimental results show that the Ru-Ta film exhibits amorphous structure until annealing at 700°C, whereas the Ru film crystallizes in as-deposited and annealed States. Sheet resistances of Cu/Ru and Cu/Ru-Ta stacking layers increase after annealing at 500 and 700°C, respectively, regardless of whether the substrate is SiO2/Si or Si. Increase in resistance is concurrent with the formation of Ru2Si3 and Cu3Si when Cu/barrier stacks are deposited on Si substrate, Increase in resistance for Cu/barrier stacks deposited on SiO2/Si substrate is related to the diffusion of Cu through the crystallized barrier to the underlayers. Furthermore, current-voltage measurement also reveals that the Cu/Ru-Ta metallization has a lower leakage current than the Cu/Ru system. The failure mechanism and the effectiveness of Ta addition on barrier performance are discussed. [ABSTRACT FROM AUTHOR]

Background: Our aim was to prospectively investigate the association between carotid artery intima-media thickness (IMT) as well as carotid plaque and incidence of coronary heart disease (CHD) and stroke in Chinese, among whom data are limited. Methods and Findings: We conducted a community-based cohort study composed of 2190 participants free of cardiovascular disease at baseline in one community. During a median 10.5-year follow up, we documented 68 new cases of coronary heart disease and 94 cases of stroke. The multivariate relative risks (RRs) associated with a change of 1 standard deviation of maximal common carotid IMT were 1.38 (95% confidence interval [CI], 1.12-1.70) for CHD and 1.47 (95% CI, 1.28-1.69) for stroke. The corresponding RRs with internal carotid IMT were 1.47 (95% CI, 1.21-1.79) for CHD and 1.52 (95% CI, 1.31-1.76) for stroke. Carotid plaque measured by the degree of diameter stenosis was also significantly associated with increased risk of CHD (p for trend<0.0001) and stroke (p for trend,0.0001). However, these associations were largely attenuated when adjusting for IMT measurements. Conclusions: This prospective study indicates a significant association between carotid IMT and incidence of CHD and stroke in Chinese adults. These measurements may be useful for cardiovascular risk assessment and stratification in Chinese. [ABSTRACT FROM AUTHOR]

Ultrathin Ru-N and Ru-Ta-N films (~ 15 nm in thickness) deposited by reactive sputtering are applied as a diffusion barrier in the Cu/barrier/SiO2/Si systems. After film deposition, the samples are tested before and after annealing at 200-900°C in vacuum for 30 mm. The sheet resistance examined by four-point probe appraises that the Ru-Ta-N barrier would not fail until annealing at 900°C, as compared to Ru-N, which fails after annealing at 600°C. The depth distribution of elements examined by Auger electron spectroscopy confirms different degrees of Cu diffusion into underlayers for the two systems after annealing at 600°C. Also, the cross-sectional microstructures of the Cu/barrier/SiO2/Si samples analyzed by transmission electron microscopy, the crystallinity of barrier films examined by grazing incident angle X-ray diffraction, and the chemical state of barrier characterized by X-ray photoelectron spectroscope might explain the difference in barrier performance for the ultrathin Ru-N and Ru-Ta-N films in the Cu/barrier/SiO2/Si multilayered systems. [ABSTRACT FROM AUTHOR]

Recently, transcranial color-coded sonography (TCCS) has been found to have a diagnostic value in patients with idiopathic Parkinson's disease (IPD), which displays increased hyperechogenicity at the substantia nigra (SN). To use TCCS, to assess the difference in SN hyperechogenicity and intracranial hemodynamics among subjects with IPD, vascular parkinsonism (VP) and controls. Eighty IPD and 30 VP patients, and 60 controls were recruited into this study. The hyperechogenicity area at the SN and midbrain were calculated by encircling the outer circumference from the ipsilateral temporal window, using TCCS in each subject. The hemodynamics of intracranial large arteries, including flow velocity and pulsatility index (PI), were also measured. The presence of SN hyperechogenicity was significantly higher in the IPD patients than in the VP patients and controls (84% vs. 20% & 5%, respectively, p < 0.001). In IPD patients, the SN hyperechogenicity was correlated with the neurological severity and disease duration. Twenty-five (66.7%) VP patients had obvious vascular abnormality, as seen in TCCS study. The mean PI was significantly more elevated in the VP patients than those in the IPD patients and controls (all p < 0.05), but there was no significant difference of flow velocities among the VP, IPD patients and controls. TCCS, combining B-mode imaging for SN echogenicity and trancranial Doppler for intracranial hemodynamics, is a useful diagnostic tool in the differentiation between IPD and VP. These findings also suggest that multiple subcortical vascular lesions may damage the basal ganglia and thalamocortical circuit and result in parkinsonism features in VP patients. [ABSTRACT FROM AUTHOR]

Background and Purpose . Atherosclerosis is the main cause of common carotid artery occlusion in most reports. This study aimed to identify the major causes of common carotid artery occlusion and compare the clinical features and carotid duplex ultrasonography findings of patients with common carotid artery occlusion attributable to each cause. Methods. Patients with common carotid artery occlusion documented by carotid duplex ultrasonography at the Neurovascular Laboratory (National Taiwan University Hospital) from 1988 to 2003 were included. Medical records and ultrasonographic findings were reviewed in detail to clarify the possible etiology of common carotid artery occlusion. Results. A total of 44 patients (male, 27 [61%]; female, 17 [39%]; mean age, 58 years) had common carotid artery occlusion attributable to a carotid duplex ultrasonography-identifiable cause. The causes of common carotid artery occlusion included atherosclerosis (17 [39%]), Takayasu's arteritis (11 [25%]), postirradiation arteriopathy (7 [16%]), cardiac embolism (6 [14%]), syphilis (1), blunt trauma (1), and homocystinuria (1). Among the patients with common carotid artery occlusion due to the 4 major causes, 27 (66%) had ischemic stroke and 14 (34%) had no symptoms or nonlocalizing symptoms. The frequency of symptomatic common carotid artery occlusion was 83% in those with cardioembolism, 76% in those with atherosclerosis, 71% in those with postirradiation arteriopathy, and 36% in those with Takayasu's arteritis. Common carotid artery occlusion usually involved the carotid bulb and distal common carotid artery in atherosclerosis (88%) and postirradiation arteriopathy (100%), but not in Takayasu's arteritis (27%). Echogenicity of occluded material was heterogeneous in atherosclerosis and postirradiation arteriopathy patients but homogeneous in all Takayasu's arteritis patients. The authors postulate that the thrombotic mechanism might differ according to etiology. Conclusions. The causes of common carotid artery occlusion are diverse. Atherosclerosis, Takayasu's arteritis, and postirradiation arteriopathy are the most common causes of common carotid artery occlusion in Taiwan. The clinical features, pathophysiology, and carotid duplex ultrasonography findings vary according to the cause of common carotid artery occlusion. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the feasibility and safety of stent implantation to treat ostial vertebral artery stenosis. Method: Fifty-eight symptomatic patients (44 men; mean age 72 years, range 54 to 88) with 67 ostial vertebral artery lesions received 67 balloon-expandable coronary stents. Follow-up angiography was performed if restenosis was suspected or during later catheterization for other indications. Restenosis was defined as >50% diameter narrowing. Result Technical success was 100%. Periprocedural neurological complications included 2 (3.4%) posterior and 1 (1.7%) anterior strokes. Other complications included 1 (1.7%) massive gastrointestinal hemorrhage requiring blood transfusion and endoscopic therapy, 1 (1.7%) femoral pseudoaneurysm requiring surgical repair, and 1 (1.7%) large shoulder hematoma secondary to a ruptured small branch of the thoracoacromial artery. Antiplatelet medication was discontinued in the ulcer patient, and the vertebral stent occluded at 8 months. At a mean follow-up of 31.3±17.1 months, 1 (1.7%) patient died after coronary bypass 2 months after stenting. One (1.7%) patient reported recurrent dizziness at 14 months and had angiographic evidence of in-stent restenosis. Angiographic evaluation of 32 (48%) lesions at a mean 11.0±9.6 months uncovered restenosis in 8 (25%) vessels, including the 2 cases noted above. Aside from these 2 patients, none of the other patients with restenosis were symptomatic. Multivariant Cox regression analysis showed reference vessel diameter as the only independent predictor of restenosis. Conclusion: Symptomatic ostial vertebral artery stenosis can be treated with relative safety using coronary techniques and equipment. Reference vessel diameter was the only predictor of restenosis in vertebral artery ostial stents. [ABSTRACT FROM AUTHOR]

Background: Stenting has been used as an alternative treatment for patients with internal carotid artery (ICA) stenosis. Color-coded duplex sonography (CDS) is able to measure not only the prestenting stenosis but also the poststenting hemodynamic changes. The purpose of this study was to quantify, using CDS, the hemodynamic changes after ICA stenting. Methods: Both symptomatic and asymptomatic patients were included in this study. The degree of ICA stenosis before stenting was required to be more than 50%. Thirty-two treated ICAs were included to compare the prestenting and poststenting CDS findings, including the diameter and cross-sectional area of the lumen, the flow peak systolic and end-diastolic velocities, the resistivity index and the amount of flow in bilateral extracranial carotid and vertebral arteries. Results: After stenting, the turbulent flow pattern in the stenotic ICA recovered to laminar flow, and the reversed ophthalmic flow direction normalized. Of the CDS parameters applied to evaluate the effect of stenting on ICA stenosis, the diameter, residual area, peak systolic velocity, diastolic velocity and the ration of systolic flow velocity ratio in the ICA to that in the common carotid artery (CCA) were altered significantly. The mean area and residual area of these stenotic ICAs showed increases of 24% (p = 0.005) and 84% (p = 0.001) after ICA stenting, respectively. The mean peak systolic flow velocity significantly decreased by 71%. The mean diastolic flow velocity also significantly decreased (by 77%). Both the systolic and diastolic velocities of the ipsilateral CCA significantly increased after stenting. The amount of flow in the contralateral ICA decreased significantly after stenting. The change in the amount of flow in the vertebral arteries after ICA stenting was insignificant. Conclusions: The results of this CDS study clearly demonstrated the hemodynamic changes after ICA stenting. The carotid stenting significantly changed the ICA flow pattern, diameter, residual area, peak systolic velocity and ICA to CCA velocity ratio. [ABSTRACT FROM AUTHOR]

Stenting for severe carotid stenosis has been proposed as an alternative for patients with high surgical risk for endarterectomy, but its effectiveness and safety has never been evaluated in large case series in a pure Asian population. One hundred and eighteen ethnic Chinese patients (mean age 72.8 years) with 129 severely narrowed carotid arteries were stented electively using self-expanding stents. The mean pre-treatment diameter stenosis was 85% and final residual diameter stenosis 14%. The peri-procedural stroke and death rate was 4.2%. One (0.8%) late ischemic stroke and 2 (1.7%) deaths occurred during a mean follow-up of 16.3 months, and the restenosis rate was 3.1%. Carotid stenting, therefore, can be done safely and effectively in Chinese patients.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The authors describe two cases of cerebral venous thrombosis (CVT) in patients with nephrotic syndrome. The main clinical features of CVT were persistent headache, hemiparesis, and seizure, and the diagnosis was based on magnetic resonance imaging and magnetic resonance angiography. Both showed acquired deficiency of free protein S. The neurologic symptoms remained stationary in the first patient, who received no anticoagulation therapy, but resolved rapidly in the second, treated with intravenous heparin and supplemented with fresh frozen plasma. CVT should be suspected in patients with nephrotic syndrome who present with symptoms of intracranial hypertension or any focal neurologic deficit. [ABSTRACT FROM AUTHOR]

A nonvolatile charge trapping memory is demonstrated on a thin film transistor (TFT) using a solution processed ultra-thin (~7 nm) zinc tin oxide (ZTO) semiconductor layer with an Al2O3/Ni-nanocrystals (NCs)/SiO2 dielectric stack. A positive threshold voltage (VTH) shift of 7 V is achieved at gate programming voltage of 40 V for 1 s but the state will not be erased by applying negative gate voltage. However, the programmed VTH shift can be expediently erased by applying a gate voltage of  −10 V in conjunction with visible light illumination for 1 s. It is found that the sub-threshold swing (SS) deteriorates slightly under light illumination, indicating that photo-ionized oxygen vacancies ( and/or ) are trapped at the interface between Al2O3 and ZTO, which assists the capture of electrons discharged from the Ni NCs charge trapping layer. The light-bias coupling action and the role of ultra-thin ZTO thickness are discussed to elucidate the efficient erasing mechanism. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented on a case of Stevens-Johnson syndrome (SJS) caused due to a single dose of Aggrenox in a patient.

Objective In-hospital stroke (IHS) is an uncommon but serious medical emergency. Early recanalization through endovascular thrombectomy (EVT) may offer a vital therapeutic choice. This study compared the clinical features and outcomes between IHS and community-onset stroke (COS). Methods From a single-center registry of 2813 patients with ischemic stroke, those who had received EVT for acute ischemic stroke were included and classified into the IHS and COS groups based on their stroke onset scenario. We compared the outcomes including successful recanalization, symptomatic intracranial hemorrhage, functional independence (modified Rankin Scale score, 0–2) at 90 days, and mortality between the two groups. Results A total of 24 patients with IHS (mean age, 70 years; 54% men) and 105 patients with COS (mean age, 73 years; 47% men) were included. The most frequently reported reasons for admission in patients with IHS were cardiovascular and oncological diseases. The initial National Institutes of Health Stroke Scale (NIHSS) scores and main occluded vessels were similar between the two groups. Patients with IHS received a higher number of active malignancy diagnoses, were more likely to withhold antithrombotic agents, and exhibited higher prestroke functional dependency. The median onset-to-puncture time was 192 min in IHS and 217 min in COS (P = 0.15). The percentages of successful recanalization (79% vs 71%), symptomatic hemorrhage (0% vs 9%), functional independence (42% vs 40%), and mortality (17% vs 12%) were comparable between the two groups. After adjustment for covariates, initial NIHSS scores and successful recanalization were the most important predictors for functional independence at 90 days. Conclusions Despite having disadvantages at baseline, patients with IHS could still benefit from timely EVT to achieve favorable outcomes. A well-designed acute stroke protocol tailored for IHS should be developed. [ABSTRACT FROM AUTHOR]