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Background: Korea recently established 70 emergency medical service areas. However, there are many concerns that medical resources for stroke could not be evenly distributed through the country. We aimed to compare the treatment quality and outcomes of acute stroke among the emergency medical service areas.Methods: This study analyzed the data of 28,800 patients admitted in 248 hospitals which participated in the 8th acute stroke quality assessment by Health Insurance Review and Assessment Service. Individual hospitals were regrouped into emergency service areas according to the address of the location. Assessment indicators and fatality were compared by the service areas. We defined the appropriate hospital by the performance of intravenous thrombolysis.Results: In seven service areas, there were no hospitals which received more than 10 stroke patients for 6 months. In nine service areas, there were no patients who underwent intravenous thrombolysis (IVT). Among 167 designated emergency medical centers, 50 hospitals (29.9%) responded that IVT was impossible 24 hours a day. There are 97 (39.1%) hospitals that meet the definitions of appropriate hospital. In 23 service areas (32.9%) had no appropriate or feasible hospitals. The fatality of service areas with stroke centers were 6.9% within 30 days and 15.6% within 1 year from stroke onset than those without stroke centers (7.7%, 16.9%, respectively).Conclusions: There was a wide regional gap in the medical resource and the quality of treatments for acute stroke among emergency medical service areas in Korea. The poststroke fatality rate of the service areas which have stroke centers or appropriate hospitals were significantly low.

Although the optimal use of prescribed medications for stroke survivors is critical for preventing secondary stroke, longitudinal observations of the natural course of medication persistence and adherence in Korean stroke survivors are rare. Furthermore, studies are needed to identify strong predictors influencing medication adherence and to determine whether these predictors change over time.To evaluate the longitudinal medication persistence and adherence at 3 months and 1 year after discharge in all stroke patients and to identify predictors of long-term medication adherence in patients who can self-medicate.A multicentre, prospective, longitudinal descriptive study.A total of 600 consecutive ischaemic stroke patients were recruited from three stroke centres across Korea, from 1 September, 2017 to 28 February, 2019. Various factors related to medication adherence suggested by the World Health Organisation were investigated through face-to-face interviews at each centre during hospitalisation. Medication persistence and adherence were assessed at 3 months and 1 year after discharge using the eight-item Morisky Medication Adherence Scale through telephone interviews.Of 537 survivors at 3 months, 526 (98.0%) were persistent and 472 (89.7%) were adherent. Of 493 survivors at 1 year, 477 (96.8%) were persistent and 392 (82.2%) were adherent. Medication belief, income and health literacy were statistically significant predictors of three-month medication adherence, which predicted one-year medication adherence with older age and low income.Among Korean stroke survivors, three-month and one-year medication persistence and adherence were relatively good. Medication beliefs and three-month medication adherence were important and modifiable factors predicting three-month adherence and one-year adherence, respectively.To increase long-term adherence to medication, various strategies are needed to improve beliefs about medication, taking into account the patient's age and level of knowledge. These interventions need to be initiated during hospitalisation to form early medication habits after discharge.

Background and Purpose: Although statins are effective in secondary prevention of ischemic stroke, they are also associated with an increase risk of intracranial hemorrhage (ICH) in certain conditions. In the TST trial (Treat Stroke to Target), we prespecified an exploration of the predictors of incident ICH. Methods: Patients with ischemic stroke in the previous 3 months or transient ischemic attack within the previous 15 days and evidence of cerebrovascular or coronary artery atherosclerosis were randomly assigned in a 1:1 ratio to a target LDL (low-density lipoprotein) cholesterol of Results: Among 2860 patients enrolled, 31 incident ICH occurred over a median follow-up of 3 years (18 and 13 in the lower and higher target group, 3.21/1000 patient-years [95% CI, 2.38–4.04] and 2.32/1000 patient-years [95% CI, 1.61–3.03], respectively). While there were no baseline predictors of ICH, uncontrolled hypertension (HR, 2.51 [95% CI, 1.01–6.31], P =0.041) and being on anticoagulant (HR, 2.36 [95% CI, 1.00–5.62], P =0.047)] during the trial were significant predictors. On-treatment low LDL cholesterol was not a predictor of ICH. Conclusions: Targeting an LDL cholesterol of Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875; EUDRACT identifier: 2009-A01280-57.

ObjectiveStroke is a devastating and costly disease; however, there is a paucity of information on long-term costs and on how they differ according to 3-month modified Rankin scale (mRS) score, which is a primary outcome variable in acute stroke intervention trials.MethodsWe analyzed a prospective multicenter stroke registry (Clinical Research Collaboration for Stroke in Korea) database through linkage with claims data from the National Health Insurance Service with follow-up to December 2016. Healthcare expenditures were converted into daily cost individually, and annual and cumulative costs up to 5 years were estimated and compared according to the 3-month mRS score.ResultsBetween January 2011 and November 2013, 11,136 patients were enrolled in the study. The mean age was 68 years, and 58% were men. The median follow-up period was 3.9 years (range 0–5 years). Mean cumulative cost over 5 years was $117,576 (US dollars [USD]); the cost in the first year after stroke was the highest ($38,152 USD), which increased markedly from the cost a year before stroke ($8,718 USD). The mean 5-year cumulative costs differed significantly according to the 3-month mRS score (p < 0.001); the costs for a 3-month mRS score of 0 or 5 were $53,578 and $257,486 USD, respectively. Three-month mRS score was an independent determinant of long-term costs after stroke.ConclusionsWe show that 3-month mRS score plays an important role in the prediction of long-term costs after stroke. Such estimates relating to 3-month mRS categories may be valuable when undertaking health economic evaluations related to stroke care.

Background and Purpose— There is a paucity of information about the role of resting heart rate in the prediction of outcome events in patients with ischemic stroke with atrial fibrillation. We aimed to investigate the relationships between the level and variability of heart rate in the acute stroke period and stroke recurrence and mortality after acute ischemic stroke in patients with atrial fibrillation. Methods— Acute patients with ischemic stroke who had atrial fibrillation and were hospitalized within 48 hours of stroke onset were identified from a multicenter prospective stroke registry database. The acute stroke period was divided into early (within 24 hours of hospitalization) and late (72 hours to 7 days from onset) stages, and data on heart rate in both stages were collected. Moreover, the level and variability of heart rate were assessed using mean values and coefficients of variation. Outcome events were prospectively monitored up to 1 year after the index stroke. Results— Among 2046 patients eligible for the early acute stage analysis, 102 (5.0%) had a stroke recurrence, and 440 (21.5%) died during the first year after stroke. A statistically significant nonlinear J-shaped association was observed between mean heart rate and mortality ( P P >0.1 for quadratic and overall effect). The nonlinear and overall effects of the coefficients of variation of heart rate were not significant for all outcome variables. The same results were observed in the late acute stage analysis (n=1576). Conclusions— In patients with atrial fibrillation hospitalized for acute ischemic stroke, the mean heart rate during the acute stroke period was not associated with stroke recurrence but was associated with mortality (nonlinear, J-shaped association). The relationships between heart rate and outcomes were not observed with respect to heart rate variability.

Background and Purpose— The TST trial (Treat Stroke to Target) evaluated the benefit of targeting a LDL (low-density lipoprotein) cholesterol of 4 mm, in a French and Korean population. The follow-up lasted a median of 5.3 years in French patients (similar to the median follow-up time in the SPARCL trial [Stroke Prevention by Aggressive Reduction in Cholesterol Level]) and 2.0 years in Korean patients. Exposure duration to statin is a well-known driver for cardiovascular risk reduction. We report here the TST results in the French cohort. Methods— One thousand seventy-three French patients were assigned to Results— After a median follow-up of 5.3 years, the achieved LDL cholesterol was 66 (1.69 mmol/L) and 96 mg/dL (2.46 mmol/L) on average, respectively. The primary end point occurred in 9.6% and 12.9% of patients, respectively (HR, 0.74 [95% CI, 0.57–0.94]; P =0.019). Cerebral infarction or urgent carotid revascularization following transient ischemic attack was reduced by 27% ( P =0.046). Cerebral infarction or intracranial hemorrhage was reduced by 28% ( P =0.023). The primary outcome or intracranial hemorrhage was reduced by 25% ( P =0.021). Intracranial hemorrhages occurred in 13 and 11 patients, respectively (HR, 1.17 [95% CI, 0.53–2.62]; P =0.70). Conclusions— After an ischemic stroke of documented atherosclerotic origin, targeting a LDL cholesterol of Registration— URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01252875.

As a new approach of creating the photo-exited electron (e-) and hole (h+) mediation zone for highly selective singlet oxygen (1O2) production, the rod-type graphitic carbon nitride (NCN) has been synthesized from the nitric acid-modified melamine followed by the calcination. The NCN exhibited a higher surface area and surface oxygen adsorption ability than bulk graphitic carbon nitride (BCN). The increment of C O and NHx groups on NCN corresponded to e- and h+ mediation groups, respectively, resulting in higher production of 1O2 than BCN. Moreover, those mediation groups on NCN result in higher recombination efficiency and longer e- decay time. As a result, the optimized NCN-0.5 (derived from 0.5 M of nitric acid-modified melamine) displayed 5.8 times higher kinetic rate constant of atrazine (ATZ) removal under UVA-LED irradiation compared to BCN. This study also evaluated the ATZ degradation pathways and toxicity effect of by-products. In addition, continuous flow experiments using NCN-0.5 showed superior ATZ removal performance with a hybrid concept between a slurry photocatalysis and a continuous stirred tank reactor system using actual effluent obtained from a wastewater treatment plant. Thus, this work provides an insight into the strategy for highly selective 1O2 production and the potential for water purification application.

Digital therapeutics is an evidence-based intervention using high-quality software, with the sole purpose of treatment. As many healthcare systems are encountering high demands of quality outcomes, the need for digital therapeutics is gradually increasing in the clinical field. We conducted review of the implications of digital therapeutics in the treatment of neurological deficits for stroke patients. The implications of digital therapeutics have been discussed in four domains: cognition, speech and aphasia, motor, and vision. It was evident that different forms of digital therapeutics such as online platforms, virtual reality trainings, and iPad applications have been investigated in many trials to test its feasibility in clinical use. Although digital therapeutics may deliver high-quality solutions to healthcare services, the medicalization of digital therapeutics is accompanied with many limitations. Clinically validated digital therapeutics should be developed to prove its efficacy in stroke rehabilitation.

OBJECTIVE We evaluated efficacy of combining proximal balloon guiding catheter (antegrade flow arrest) and distal access catheter (aspiration at the site of occlusion) in thrombectomy for anterior circulation ischemic stroke. METHODS We retrospectively analyzed 116 patients who underwent mechanical thrombectomy with stent retriever. The patients were divided by the techniques adopted, the combined technique (proximal balloon guiding catheter and large bore distal access catheter) group (n=57, 49.1%) and the conventional (guiding catheter with stent retriever) technique group (n=59, 50.9%). We evaluated baseline characteristics (epidemiologic data, clinical and imaging characteristics) and procedure details (the number of retrieval attempts, procedure time), as well as angiographic (thrombolysis in cerebral infarction (TICI) score, distal thrombus migration) and clinical outcome (National Institutes of Health Stroke Scale at discharge, modified Rankin Scale [mRS] at 3 months) of them. RESULTS The number of retrieval attempts was lower (p=0.002) and the first-pass successful reperfusion rate was higher (56.1% vs. 28.8%; p=0.003) in the combined technique group. And the rate of final result of TICI score 3 was higher (68.4% vs. 28.8%; p

Background Assistant equipment for the visually impaired has a white cane. If the information in the three-dimensional space is transmitted by sound, the blind can draw a three-dimensional space. Objective This study developed "Visual System," an ambulation aid/guide for the blind that transforms visual-spatial information into auditory information, and verified its utility. Unlike conventional systems, which are in essence simple collision-warning systems, Visual System helps the visually impaired to recreate their surroundings and to be cognizant of the location and proximity of obstacles. Methods Ten subjects with normal vision (mean age: 32.4 years; male-to-female ratio: 6 to 4) were selected for blind tests. The subjects were instructed to detect and avoid obstacles presented in various three-dimensional settings. Prior to the tests, experiments were conducted to determine the distance to each subject. Upon completion of Visual System-based detection training, obstacles were presented and tests conducted. For evaluation, the subjects' vertical position detection, horizontal position detection, distance detection, and overall performance success were each evaluated. Results The total performance scores ranged between 88 (lowest) and 100 (highest), with a mean score of 91.5. Conclusions The results indicate that Visual System as a product can assist the visually impaired in their daily functioning.

Background and Purpose— Two large-scale randomized controlled trials of recurrent stroke prevention suggest that dual antiplatelet therapy with clopidogrel plus aspirin is beneficial for prevention of subsequent ischemic events. There is a paucity of data, however, on the efficacy or effectiveness of such an approach in the treatment of stroke patients with symptomatic large artery atherosclerotic occlusive disease. Methods— We used a multicenter stroke registry database (Clinical Research Collaboration for Stroke in Korea) to analyze acute ischemic stroke patients due to large artery atherosclerotic occlusive disease who were treated with aspirin alone or combination of clopidogrel and aspirin from May 2008 to May 2015. The results were analyzed by intention-to-treat, per-protocol, and as-treated methodologies. The primary end point was the 1-year composite outcome of stroke recurrence, myocardial infarction, and all-cause death. To balance the differences between groups, a frailty model using propensity scores and inverse probability of treatment weighting was used. Results— A total of 5934 patients with symptomatic large artery atherosclerotic occlusive disease were treated either with clopidogrel plus aspirin (n=2903, 49%) or aspirin (n=3031, 51%). The frequency of the primary outcome was 12% (n=353) in the clopidogrel-aspirin group and 14% (n=410) in the aspirin group. The hazards of the primary outcome with combination over aspirin only were significantly reduced in the per-protocol and as-treated analyses (hazard ratio, 0.71; 95% CI, 0.57–0.88; P =0.002 and hazard ratio, 0.81; 95% CI, 0.69–0.96; P =0.02, respectively), but there was borderline significance in the intention-to-treat analysis (hazard ratio, 0.86; 95% CI, 0.74–1.01; P =0.06). Combination therapy was beneficial for all-cause death in all analyses but did not reduce recurrent stroke. Conclusions— Compared with patients receiving aspirin monotherapy, the primary outcome seemed to occur less frequently in patients receiving dual antiplatelet therapy, which is explained mainly by the decrease of all-cause death. Since this is a nonrandomized, retrospective, observational study, our study should be cautiously interpreted.

In this study, magnetic layered double hydroxides (mag-LDHs) were synthesized through compositing magnetite with three different metals (Mg, Cu and Al) under ultrasound (US, 100 kHz frequency and 50 W power). For the first time, mag-LDHs were applied to sonocatalytic reduction of nitrate (NO3−) and the reduction mechanism were determined by conducting kinetic tests and various spectroscopic analyses. Based on the kinetic data, NO3− reduction and the selectivity for N2 highly depends on the ratio between Mg/Al, solution pH and sonication frequency. The best condition for sonocatalytic denitrification was found to be pH 7 operated under 100 kHz (50% power) using the catalyst with lowest amount of Al (mag-LDH-Al0.3Mg1.5). As a proposed mechanism, NO3− is initially reduced to NO2− by Cu0, and then further reduced to N2/NH4+ by Mg0. Hypothetically Al0 could provide sorption sites for hydrogen radicals (·H) dissociated from ultrasound, hence served as reducing sites in denitrification process. The XPS analysis showed an increased peak of Cu0 after the sonocatalytic reduction when catalyst has lower amount of Al. The excessive hydrogen adsorbed on Al0 might spill-over to the adjacent Cu, thus reducing the CuO into Cu0 at high temperature created by the implosion of the microbubbles. Without the use of consumable reducing agents (i.e. H2 gas), sonocatalytic reduction could be a potential candidate of remediation method to treat NO3− polluted water with high N2 selectivity and easy magnetic recovery.

In this study, exfoliated g-C3N4 (GCN) coupled carbon quantum dots (CNQDs) were prepared via one-pot hydrothermal (HT) treatment at various temperatures (100–200 °C) and in various amounts of time (0–20 h). Comprehensive characterization was conducted to study not only the chemical states, photo-optical properties, particle sizes, and crystal structures, but also the effect of these changes on the degradation of BPA. Photocatalytic degradation was conducted under near-visible LED as a low energy light source (0.128 W cm−3). The CNQD that were prepared at 180 °C for 12 h showed the highest degradation rate (3.6 × 10−2 min−1), which was 3.0 times higher than GCN. These improved photocatalytic activities corresponded to increases in the photo-reactive surface via exfoliation of GCN sheets, introduction of heteroatom oxygen onto GCN sheets, the addition of CQDs, and shortened bandgap. These characteristics allow for the effective transfer and separation of electrons. Nonetheless, the structural breakdown of the CNQD was observed when the HT time was longer than 12 h (180 °C). The defected sheets showed a detrimental effect towards photocatalytic degradation by trapping electrons, leading to shorter electron life times.

Despite the great socioeconomic burden of stroke, there have been few reports of stroke statistics in Korea. In this scenario, the Epidemiologic Research Council of the Korean Stroke Society launched the “Stroke Statistics in Korea” project, aimed at writing a contemporary, comprehensive, and representative report on stroke epidemiology in Korea. This report contains general statistics of stroke, prevalence of behavioral and vascular risk factors, stroke characteristics, pre-hospital system of care, hospital management, quality of stroke care, and outcomes. In this report, we analyzed the most up-to-date and nationally representative databases, rather than performing a systematic review of existing evidence. In summary, one in 40 adults are patients with stroke and 232 subjects per 100,000 experience a stroke event every year. Among the 100 patients with stroke in 2014, 76 had ischemic stroke, 15 had intracerebral hemorrhage, and nine had subarachnoid hemorrhage. Stroke mortality is gradually declining, but it remains as high as 30 deaths per 100,000 individuals, with regional disparities. As for stroke risk factors, the prevalence of smoking is decreasing in men but not in women, and the prevalence of alcohol drinking is increasing in women but not in men. Population-attributable risk factors vary with age. Smoking plays a role in young-aged individuals, hypertension and diabetes in middle-aged individuals, and atrial fibrillation in the elderly. About four out of 10 hospitalized patients with stroke are visiting an emergency room within 3 hours of symptom onset, and only half use an ambulance. Regarding acute management, the proportion of patients with ischemic stroke receiving intravenous thrombolysis and endovascular treatment was 10.7% and 3.6%, respectively. Decompressive surgery was performed in 1.4% of patients with ischemic stroke and in 28.1% of those with intracerebral hemorrhage. The cumulative incidence of bleeding and fracture at 1 year after stroke was 8.9% and 4.7%, respectively. The direct costs of stroke were about ₩1.68 trillion (KRW), of which ₩1.11 trillion were for ischemic stroke and ₩540 billion for hemorrhagic stroke. The great burden of stroke in Korea can be reduced through more concentrated efforts to control major attributable risk factors for age and sex, reorganize emergency medical service systems to give patients with stroke more opportunities for reperfusion therapy, disseminate stroke unit care, and reduce regional disparities. We hope that this report can contribute to achieving these tasks.

Background and Purpose Thrombectomy within 24 hours can improve outcomes in selected patients with a clinical-infarct mismatch. We devised an easy-to-use visual estimation tool that allows infarct volume estimation in centers with limited resources. Methods We identified 1,031 patients with cardioembolic or large-artery atherosclerosis infarction on diffusion-weighted images (DWIs) obtained before recanalization therapy and within 24 hours of onset, and occlusion of the internal carotid or middle cerebral artery. Acute DWIs were mapped onto a standard template and used to create visual reference maps with known lesion volumes, which were then used in a validation study (with 130 cases) against software estimates of infarct volume. Results The DWI reference map chart comprises 144 maps corresponding to 12 different infarct volumes (0.5, 1, 2, 3, 5, 7, 9, 11, 13, 15, 17, and 19 mL) in each of 12 template slices (Montreal Neurological Institute z-axis –15 to 51 mm). Infarct volume in a patient is estimated by selecting a slice with a similar infarct size at the corresponding z-axis level on the reference maps and then adding up over all slices. The method yielded good correlations to software volumetrics and was easily learned by both experienced and junior physicians, with approximately 1 to 2 minutes spent per case. The sensitivity, specificity, and accuracy for detecting threshold infarct volumes (90%). Conclusions We developed easy-to-use reference maps that allow prompt and reliable visual estimation of infarct volumes for triaging patients to thrombectomy in acute stroke.

The α-Fe2O3@nitrogen doped carbon (as donated α-Fe2O3@NC) composites derived from green microalgae was synthesized using one-pot spray pyrolysis, which showed a high discharge capacity of 1281.5 mAh g−1 at 100 mA g−1 as anode materials for lithium ion storage. They also provided good rate performance in a range of 200 mA g−1–1000 mA g−1, and maintained a capacity of 92% after 100 cycles at 200 mA g−1. It demonstrated not only improved electrical conductivity but also effective prevention of the volume expansion of iron oxide during battery charge/discharge by uniformly forming iron oxide nanoparticles on microalgae via spray pyrolysis.

Background and Purpose— This study aimed to compare the effectiveness of dual antiplatelet therapy with clopidogrel-aspirin to that of aspirin monotherapy in patients with acute minor cerebral ischemia using a prospective, nationwide, multicenter, stroke registry database in South Korea. Methods— CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events)-like patients who met eligibility criteria modeled on the CHANCE trial eligibility criteria, including (1) acute minor ischemic stroke defined as National Institutes of Health Stroke Scale score ≤3 or lesion positive transient ischemic attack within 24 hours of onset and (2) noncardioembolic stroke mechanism. Propensity scores using the inverse probability of treatment weighting was used to adjust for baseline imbalances. The primary outcome was the composite of all stroke (ischemic and hemorrhagic), myocardial infarction, and vascular death by 3 months. Results— Among 5590 patients meeting the eligibility criteria, age was 64±13 year and 62.6% were male. Aspirin and combination of clopidogrel-aspirin were administered in 66.1% and 33.9% of patients, respectively. In unadjusted analysis, rates of the 3-month primary vascular event outcome were lower with clopidogrel-aspirin versus aspirin, 9.9% versus 12.2% (hazard ratio, 0.79 [0.67–0.95]). In propensity-weighted Cox proportional hazards regression with robust estimation, clopidogrel-aspirin was associated with a lower risk of the primary vascular event outcome (hazard ratio, 0.76 [0.63–0.92]) and all stroke events (hazard ratio, 0.74 [0.61–0.90]). Among 6 predefined subgroup analyses, 3 showed potential modification of treatment effect, with lesser benefit associated with the absence of prior antiplatelet use ( P interaction =0.01) and younger age (P interaction =0.07), and absence of benefit associated with small vessel occlusion subtype ( P interaction =0.08). Conclusions— Dual antiplatelet therapy with aspirin and clopidogrel was associated with reduced stroke, myocardial infarction, and vascular death in the 3 months following a presenting minor, noncardioembolic ischemic stroke. Benefits may be particularly magnified in patients with a history of prior antiplatelet therapy, older age, and nonsmall vessel disease stroke mechanism.

Low-cost, vanadium-based mixed metal oxides mostly have a layered crystal structure with excellent kinetics for lithium-ion batteries, providing high energy density. The existence of multiple oxidation states and the coordination chemistry of vanadium require cost-effective, robust techniques to synthesize the scaling up of their morphology and surface properties. Hydrothermal synthesis is one of the most suitable techniques to achieve pure phase and multiple morphologies under various conditions of temperature and pressure. We attained a simple one-step hydrothermal approach to synthesize the reduced graphene oxide coated Nickel Vanadate (rGO@Ni3V2O8) composite with interconnected hollow microspheres. The self-assembly route produced microspheres, which were interconnected under hydrothermal treatment. Cyclic performance determined the initial discharge/charge capacities of 1209.76/839.85 mAh g&minus, 1 at the current density of 200 mA g&minus, 1 with a columbic efficiency of 69.42%, which improved to 99.64% after 100 cycles. High electrochemical performance was observed due to high surface area, the porous nature of the interconnected hollow microspheres, and rGO induction. These properties increased the contact area between electrode and electrolyte, the active surface of the electrodes, and enhanced electrolyte penetration, which improved Li-ion diffusivity and electronic conductivity.

To enhance the processing efficiency of CO2 capture from flue gas of post-combustion emission using fixed-bed adsorption system, the regenerable adsorbents and low pressure drop should be required. The uniform-sized Polyacrylonitrile (PAN) nanoparticles were synthesized, followed by the surface-modification with alkylamine (APAN) and sec-butanol (APAN-OH) as a strategy for achieving the stabilization of the amine group in the repeated CO2 adsorption/desorption cycles. The synthesized APAN-OH nanoparticles were interconnected one another by Ca-Alg nanofiber as a linker and formed the millimeter-sized sphere with hierarchical pores. At 25 °C and 1 bar, CO2 adsorption capacity of a Hierarchically porous spherical adsorbent (HPSA) reached to ~2.07 mmol CO2/g HPSA and physicochemical stability of HPSA was achieved even in 50 cycles of CO2 adsorption/desorption. Also, the selectivity for CO2 capture was calculated as about 71 by the IAST model at CO2/N2 molar ratio of 15:85. Extremely low pressure drop values were recorded in the fixed-bed adsorption system packed with HPSAs, compared with those of APAN-OH nanoparticles. The superior regenerable and large-sized adsorbent with the interior structure resulting in low pressure drop is expected to take the CO2 capture technology a step further.

Background A delay of transfer for patients with acute stroke needing emergent revascularization is a huge hurdle for efficacy of revascularization. The objective of this study was to investigate changes of transportation time calculated by image to door (ITD) time (from checking brain images at first contact hospital to arriving at our emergency center) before and after 2015. Methods This study was performed in a retrospective manner from 2013 into 2017. Acute ischemic stroke (AIS) patients having intravenous thrombolysis and/or mechanical thrombectomy during the observation period were enrolled. Among them, those who had revascularization under ‘Drip-and-Ship’ or ‘Ship-and-Drip’ paradigm were selected. Results During the observation period, 225 patients were treated under ‘Drip-and-Ship’ or ‘Ship-and-Drip’ paradigm. Twenty-three were excluded due the lack of detailed data. Among 202 patients, 73 and 129 were treated under Drip-and-Ship and Ship-and-Drip paradigms, respectively. In 2013, 35 patients from 18 hospitals (median distance, 25 km) were transferred to our regional stroke center and their median ITD time was 116 minutes. It was gradually decreased after 2015. In 2017, ITD time was significantly (P

Practical lithium metal batteries require full and reversible utilization of thin metallic Li anodes. This introduces a fundamental challenge concerning how to create solid-electrolyte interphases (SEIs) that are able to regulate interfacial transport and protect the reactive metal, without adding appreciably to the cell mass. Here, we report on physicochemical characteristics of Langmuir–Blodgett artificial SEIs (LBASEIs) created using phosphate-functionalized reduced graphene oxides. We find that LBASEIs not only meet the challenges of stabilizing the Li anode, but can be facilely assembled in a simple, scalable process. The LBASEI derives its effectiveness primarily from its ability to form a durable coating on Li that regulates electromigration at the anode/electrolyte interface. In a first step towards practical cells in which the anode and cathode capacities are matched, we report that it is possible to achieve stable operations in both coin and pouch cells composed of a thin Li anode with the LBASEI and a high-loading intercalation cathode.