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Cognitive impairment, anxiety, depression, fatigue, and dependence in instrumental activities of daily living (ADL) are common after stroke; however, little is known about how these outcomes may differ following treatment with endovascular clot retrieval (ECR), intravenous tissue plasminogen activator (t-PA), or conservative management.
Methods:
Patients were recruited after acute treatment and invited to participate in an outcome assessment 90–120 days post-stroke. The assessment included a cognitive test battery and several questionnaires. The COVID-19 pandemic led to significant disruptions in recruitment and data collection, and the t-PA and conservative management groups were combined into a standard medical care (SMC) group.
Results:
Sixty-two participants were included in the study (ECR = 31, SMC = 31). Mean age was 66.5 (20–86) years, and 35 (56.5%) participants were male. Participants treated with ECR had significantly higher National Institutes of Health Stroke Scale scores at presentation and significantly lower education. After adjusting for stroke severity, premorbid intellectual ability, and age, treatment with ECR was associated with significantly better performances on measures of cognitive screening, visual working memory, and verbal learning and memory. Participants treated with ECR also experienced less fatigue and were more likely to achieve independence in basic and instrumental ADLs. Despite this, cognitive impairment and fatigue were still common among participants treated with ECR and anxiety and depression symptoms were experienced similarly by both groups.
Conclusions:
Cognitive impairment and fatigue were less common but still prevalent following treatment with ECR. This has important practical implications for stroke rehabilitation, and routine assessment of cognition, emotion, and fatigue is recommended for all stroke survivors regardless of stroke treatment and functional outcome.
Social determinants of health (SDoH), such as socioeconomics and neighborhoods, strongly influence health outcomes. However, the current state of standardized SDoH data in electronic health records (EHRs) is lacking, a significant barrier to research and care quality.
Methods:
We conducted a PubMed search using “SDOH” and “EHR” Medical Subject Headings terms, analyzing included articles across five domains: 1) SDoH screening and assessment approaches, 2) SDoH data collection and documentation, 3) Use of natural language processing (NLP) for extracting SDoH, 4) SDoH data and health outcomes, and 5) SDoH-driven interventions.
Results:
Of 685 articles identified, 324 underwent full review. Key findings include implementation of tailored screening instruments, census and claims data linkage for contextual SDoH profiles, NLP systems extracting SDoH from notes, associations between SDoH and healthcare utilization and chronic disease control, and integrated care management programs. However, variability across data sources, tools, and outcomes underscores the need for standardization.
Discussion:
Despite progress in identifying patient social needs, further development of standards, predictive models, and coordinated interventions is critical for SDoH-EHR integration. Additional database searches could strengthen this scoping review. Ultimately, widespread capture, analysis, and translation of multidimensional SDoH data into clinical care is essential for promoting health equity.
During the early stages of human pregnancy, successful implantation of embryonic trophoblast cells into the endometrium depends on good communication between trophoblast cells and the endometrium. Abnormal trophoblast cell function can cause embryo implantation failure. In this study, we added cyclosporine A (CsA) to the culture medium to observe the effect of CsA on embryonic trophoblast cells and the related mechanism. We observed that CsA promoted the migration and invasion of embryonic trophoblast cells. CsA promoted the expression of leukaemic inhibitory factor (LIF) and fibroblast growth factor (FGF). In addition, CsA promoted the secretion and volume increase in vesicles in the CsA-treated group compared with the control group. Therefore, CsA may promote the adhesion and invasion of trophoblast cells through LIF and FGF and promote the vesicle dynamic process, which is conducive to embryo implantation.
The complex sea ice conditions in Arctic waters has different impacts on the legs of the Arctic passage, and ships of specific ice classes face different navigation risks. Therefore, the quantitative analysis of the navigation risks faced in different legs has important practical significance. Based on the POLARIS introduced by IMO, the sea ice condition data from 2011 to 2020 was used to quantify the navigation risk of the Arctic Northeast passage. The risk index outcome (RIO) of the Arctic Northeast Passage were calculated. The navigable windows of the route for ice class 1A ships sailing independently under different sea ice conditions in the last decade were determined, with a navigable period of 91 days under normal sea ice conditions, approximately 175 days under light sea ice conditions and only week 40 close to navigation under severe sea ice conditions. The three critical waters affecting the safety of ships were identified. Combined with the navigable windows and critical waters, recommendations on ship's navigation and manipulation and recommendations for stakeholders were given. The method and results provided reference and support for the assessment of the navigation risk of ships in the Northeast Passage and safety navigation and operations of ships, and satisfied the needs of relevant countries and enterprises to rationally arrange shipment dates and sailing plans based on different ice classes of ships.
A young adult with late diagnosis of scimitar syndrome underwent infradiaphragmatic baffling of the scimitar vein to left atrium through an intra-atrial tunnel using PhotoFix® bovine pericardium with recurrent extensive fibrovascular granulation of the patch causing pulmonary and systemic venous obstruction leading to eventual explantation of the bovine pericardium.
Evidence on the relationship between maternal Hb concentration and spontaneous abortion (SA) risk is limited and conflicting. The purpose of the study was to evaluate whether maternal preconception anaemia or high Hb concentration is associated with risk of SA.
Design:
A population-based cohort study established between 2013 and 2017.
Settings:
Local maternal and child care service centres in each county.
Participants:
In total, 3 971 428 women aged 20–49 years, who participated in National Free Pre-Pregnancy Checkups Project from 2013 to 2016 and successfully got pregnant before 2017 in rural China.
Results:
A total of 101 700 (2·56 %) women were recorded having SA, with highest SA rate in women with severe anaemia (4·58 %). Compared with women with Hb of 110–149 g/l, the multivariable-adjusted OR for SA was 1·52 (95 % CI: 1·25, 1·86) for women with Hb < 70 g/l, 0·92 (0·84, 1·01) for 70–99 g/l, 0·80 (0·77, 0·83) for 100–109 g/l, 1·11 (1·08, 1·15) for 150–159 g/l, 1·12 (1·04, 1·20) for 160–169 g/l and 1·02 (0·93, 1·12) for ≥ 170 g/l, respectively. An approximate U-shaped curve for the risk of SA with Hb concentrations was observed when Hb concentrations less than 145 g/l, above which the association plateaued (Pnon-linear < 0·001).
Conclusions:
Severe anaemia and high Hb concentration before pregnancy were associated with an increased risk of SA. Women with mild anaemia prior to pregnancy had lower risk of SA. Underlying mechanisms need to be further studied.
Aeolian dust deposits from continent and ocean have been extensively investigated to reflect past changes in source aridity and atmospheric circulations. Aeolian flux (AF) as a quantitative dust proxy has been widely used in both palaeoenvironmental reconstruction and numerical simulation. However, available AF data on the Chinese Loess Plateau (CLP) is too limited to assess the temporal–spatial variations at glacial–interglacial timescales, and therefore cannot be used as robust input parameters in palaeoclimate models. Here we investigate eight loess profiles along two N–S-aligned transects on the CLP to quantitatively estimate the AF variations over the last glacial–interglacial cycle. We first establish a refined chronological framework based on optically stimulated luminescence chronology and pedostratigraphic correlation. AF was then estimated by multiplying the sedimentation rate and bulk density. The results show that the AF increases from 2–18 g cm−2 ka−1 in the southeastern CLP to 14–105 g cm−2 ka−1 in the northwestern CLP. At glacial–interglacial scales, the AF varies from 2–20 g cm−2 ka−1 during the last interglacial to 8–105 g cm−2 ka−1 in the last glaciation. Due to more spatial coverage and better age constraints, our AF data can be used to refine other AF datasets and to improve the proxy–model comparison.
Arid central Asia plays an important role in global climate dynamics, but large uncertainties remain in our understanding of the region's hydroclimate variability during the Late Quaternary. Here we present a new, high-resolution record of lacustrine sediment grain-size and element chemistry from Ebinur Lake, which was used to infer lake conditions and related climate changes in the study region between ca. 39.2 and 3.6 ka. End-member modeling analysis of grain-size data and PCA of elemental data show that lake level fluctuated dramatically from 39.2 to 34.0 ka. Subsequently, Ebinur Lake experienced a high stand from 34.0 to 28.0 ka, under humid climate conditions. The subsequent period, from 28.0 to 12.0 ka, was characterized by lake regression under dry climate conditions, whereas afterward (12.0–3.6 ka), considerably higher lake levels and humid conditions again prevailed. Millennial-scale abrupt climate changes, such as Heinrich events (H3 and H1) and the Younger Dryas, which are documented in the North Atlantic region, are also detected in the sediment record from Ebinur Lake. Comparisons with other sediment records from arid central Asia generally support the claim that climate change in this region was influenced mainly by variations in North Atlantic sea surface temperatures, through the westerlies.
Ti–Al alloys are established as promising candidates for aerospace applications due to their lightweight, good elevated temperature strength, and decent corrosion resistance. In this study, a Ti–51Al (at.%) alloy is fabricated by spray deposition. The effects of temperature and strain rate on the deformation behavior of the spray-deposited Ti–Al alloy are investigated. The microstructural evolution of the Ti–Al alloy with different deformation temperatures is discussed in detail. A strain-dependent constitutive equation was proposed to predict the flow stresses at the elevated temperatures for the spray-deposited Ti–Al alloy. The microstructure of the as-deposited Ti–51Al alloy exhibits a α2/γ lamellar-structure with average size 25 ± 2 μm, due to the high cooling rate observed during solidification. The lamellar structure is embedded on a γ matrix. The amount of the α2/γ lamellar-structure reduces gradually with increasing the hot deformation temperature. After hot isostatic pressing at 1523 K, the microstructure is mainly comprised of the γ matrix.
An all-fiberized high-average-power narrow linewidth ns pulsed laser with linear polarization is demonstrated. The laser system utilizes a typical master oscillator power amplifier (MOPA) configuration. The stimulated Brillouin scattering (SBS) is effectively suppressed due to the short fiber length and large mode area in the main amplifier, combined with the narrow pulse duration smaller than the phonon lifetime of SBS effect. A maximal output power of 466 W is obtained with a narrow linewidth of ${\sim}$203.6 MHz, and the corresponding slope efficiency is ${\sim}$80.3%. The pulse duration is condensed to be ${\sim}$4 ns after the amplification, corresponding to the peak power of 8.8 kW and the pulse energy of $46.6~\unicode[STIX]{x03BC}\text{J}$. Near-diffraction-limited beam quality with an $M^{2}$ factor of 1.32 is obtained at the output power of 442 W and the mode instability (MI) is observed at the maximal output power. To the best of our knowledge, this is the highest average output power of the all-fiberized narrow linewidth ns pulsed fiber laser with linear polarization and high beam quality, which is a promising source for the nonlinear frequency conversion, laser lidar, and so on.
Evidence on the association between maternal Hb concentration and preterm birth (PTB) risk is inconclusive. This paper aimed to explore whether women with anaemia or high Hb level before pregnancy would be at higher risk of PTB. We conducted a population-based cohort study with 2 722 274 women aged 20–49 years, who participated in National Free Pre-Pregnancy Checkups Project between 2013 and 2015 and delivered a singleton before 2016 in rural China. Logistic models were used to estimate OR and 95 % CI after adjusting for confounding variables. Restricted cubic spline models were applied to evaluate the dose–response relationships. A total of 192 819 (7·08 %) women had preterm deliveries. Compared with women with Hb of 110–149 g/l, the multivariable-adjusted OR for PTB was 1·19 (95 % CI 0·98, 1·44) for women with Hb<70 g/l, 1·01 (95 % CI 0·97, 1·03) for 70–99 g/l, 0·96 (95 % CI 0·95, 0·98) for 100–109 g/l, 1·04 (95 % CI 1·01, 1·06) for 150–159 g/l, 1·11 (95 % CI 1·05, 1·17) for 160–169 g/l and 1·19 (95 % CI 1·11, 1·27) for ≥170 g/l, respectively. The multivariable-adjusted OR for very PTB (VPTB) was 1·07 (95 % CI 1·03, 1·12) and 1·06 (95 % CI 1·01, 1·12) for women with Hb <110 and ≥150 g/l, compared with those with Hb of 110–149 g/l, respectively. Our study identified a U-shaped relationship between maternal preconception Hb concentration and PTB risk. Both preconception anaemia and high Hb level can significantly increase VPTB risk. Appropriate intervention for women with abnormal Hb levels before pregnancy is very necessary.
In this manuscript, we demonstrate high-power, narrow-linewidth linearly polarized fiber laser with excellent beam quality through compact one-stage amplification scheme. By employing a single-mode–multimode–single-mode structure seed laser, a linearly polarized Yb-doped fiber laser with narrow linewidth and high output power is achieved. This laser, when used as a master oscillator, can be capable of suppressing the ASE in the process of power amplification. Thus, only one-stage amplification structure is used to scale up the laser power, and linearly polarized output with a polarization extinction ration of 14 dB, a narrow linewidth of 0.3 nm and an output power of 1018 W are achieved. Moreover, due to the good beam quality of seed laser and the well-designed amplifier stage, the beam quality of the output laser is near-diffraction-limited with $M_{x}^{2}\sim 1.18$ and $M_{y}^{2}\sim 1.24$ at the maximum power, and without mode instability occurring.
Structural distortions at the nanoscale are delicately linked with many exotic properties for ferroic thin films. Based on advanced aberration corrected scanning transmission electron microscopy, we observe BiFeO3 thin films with variant tensile strain states and demonstrate at an atomic scale the interplay of intrinsic spontaneous structural distortions with external constraints. Structural parameters (the rhombohedral distortion and domain wall shear distortion) under zero (BiFeO3/GdScO3) and 1.5% (BiFeO3/PrScO3) lateral strain states are quantitatively analyzed which are suppressed within a few unit cells near the film/substrate interfaces. In particular, an interfacial layer with asymmetrical lattice distortions (enhanced and reduced out-of-plane lattice spacing) on the two sides of 109° domain wall is resolved. These structural distortions near the film/substrate interface in ferroic thin films reveal intense tanglement of intrinsic distortions of BiFeO3 with external boundary conditions, which could provide new insights for the development of nanoscale ferroelectric devices.
Japanese brome is a winter annual weed commonly found in wheat fields in China. Laboratory and greenhouse experiments were carried out to determine the effect of temperature, light, pH, osmotic stress, salt stress, and burial depth on the germination and emergence of Japanese brome. Germination was greater than 98% under a wide temperature range of 5 to 30 C and onset of germination was shortened as temperature increased. Light was not required for germination to occur and pH values from 5 to 10 had insignificant effect on germination. Germination was reduced by osmotic stress or salt stress and no germination occurred at −1.3 MPa or 360 mM, suggesting that Japanese brome seed was quite tolerant to osmotic potential and salinity. Seedling emergence was greatest (98%) when seeds were placed on the soil surface but decreased with increasing of burial depth. Only 7% of seedlings emerged at a depth of 5 cm. The results of this study have contributed to our understanding of the germination and emergence of Japanese brome and should enhance our ability to develop better control strategies in wheat farming systems of the Huang-Huai-Hai Plain of China.
The effects of stress-aging processing on corrosion resistance of an Al–Zn–Mg–Cu alloy were investigated. It is found that the one-stage stress-aged alloy is strongly sensitive to the electrochemical corrosion. The poor corrosion resistance of the one-stage stress-aged alloy can be attributed to fine intragranular aging precipitates and continuous distribution of grain boundary precipitates. Meanwhile, the incomplete precipitation of solute atoms results in high electrochemical activity of aluminum matrix. However, when the alloy is two-stage stress-aged, the corrosion resistance is greatly improved. Furthermore, the corrosion resistance decreases firstly and then increases with increasing the first stage stress-aging temperature. Increasing external stress can enhance the corrosion resistance of the two-stage stress-aged alloy. These phenomena are mainly related to aging precipitates within grains and along grain boundaries. The coarse and relatively low-density intragranular aging precipitates, as well as the discontinuously distributed grain boundary precipitates can enhance the corrosion resistance of the stress-aged alloy.
The present study was conducted to evaluate the anti-parasitic activity of a pure compound from Streptomyces sp. HL-2-14 against fish parasite Ichthyophthirius multifiliis, and elucidate its chemical structure. By electron ionization mass spectrometry (ESI-MS) and nuclear magnetic resonance spectrum (1H NMR and 13C NMR), the compound was identified as amphotericin B (AmB). The in vitro trials revealed that AmB can effectively kill the theronts and tomonts of I. multifiliis with the median lethal concentration (LC50) of 0·8 mg L−1 at 30 min for the theronts and 4·3 mg L−1 at 2 h for the tomonts, respectively. AmB at 5 mg L−1 significantly reduced I. multifiliis infectivity prevalence and intensity on grass carp (Ctenopharyngodon idella), and consequently decreased fish mortality, from 100% in control group to 30% in treated group. The 72 h acute toxicity (LC50) of AmB on grass carp was 20·6 mg L−1, but fish mortality was occurred when exposure to 13·0 mg L−1. These results indicated that AmB was effective in the therapy of I. multifiliis infection, but the safety concentration margin is relatively narrow. Further efforts aiming to decrease the toxicity and improve the therapeutic profile remain to be needed.
In this paper, we propose a tracking algorithm to detect power lines from millimeter-wave radar video. We propose a general framework of cascaded particle filters which can naturally capture the temporal correlation of the power line objects, and the power-line-specific feature is embedded into the conditional likelihood measurement process of the particle filter. Because of the fusion of multiple information sources, power line detection is more effective than the previous approach. Both the accuracy and the recall of power line detection are improved from around 68% to over 92%.
Adopting small-world neural networks of the Hodgkin-Huxley (HH) model, the stimulation parameters in desynchronisation and its possible implications for vagus nerve stimulation (VNS) are numerically investigated. With the synchronisation status of networks to represent epilepsy, then, adding pulse to stimulations to 10% of neurons to simulate the VNS, we obtain the desynchronisation status of networks (representing antiepileptic effects). The simulations show that synchronisation evolves into desynchronisation in the HH neural networks when a part (10%) of neurons are stimulated with a pulse current signal. The network desynchronisation appears to be sensitive to the stimulation parameters. For the case of the same stimulation intensity, weakly coupled networks reach desynchronisation more easily than strongly coupled networks. The network desynchronisation reduced by short-stimulation interval is more distinct than that of induced by long stimulation interval. We find that there exist the optimal stimulation interval and optimal stimulation intensity when the other stimulation parameters remain certain.
The spore wall of Nosema bombycis plays an important role in microsporidian pathogenesis. Protein fractions from germinated spore coats were analysed by two-dimensional polyacrylamide gel electrophoresis and MALDI-TOF/TOF mass spectrometry. Three protein spots were identified as the hypothetical spore wall protein NbHSWP12. A BAR-2 domain (e-value: 1.35e-03) was identified in the protein, and an N-terminal protein-heparin interaction motif, a potential N-glycosylation site, and 16 phosphorylation sites primarily activated by protein kinase C were also predicted. The sequence analysis suggested that Nbhswp12 and its homologous genes are widely distributed among microsporidia. Additionally, Nbhswp12 gene homologues share similar sequence features. An indirect immunofluorescence analysis showed that NbHSWP12 localized to the spore wall, and thus we renamed it spore wall protein 12 (NbSWP12). Moreover, NbSWP12 could adhere to deproteinized N. bombycis chitin coats that were obtained by hot alkaline treatment. This novel N. bombycis spore wall protein may function in a structural capacity to facilitate microsporidial spore maintenance.