Bulletin of Computer Science and Electrical Engineering (BCSEE)
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Functional and Safety Outcomes of Carotid Artery Stenting and Mechanical Thrombectomy for Large Vessel Occlusion Ischemic Stroke With Tandem Lesions
No full textApproximately 10% to 20% of large vessel occlusion (LVO) strokes involve tandem lesions (TLs), defined as concomitant intracranial LVO and stenosis or occlusion of the cervical internal carotid artery. Mechanical thrombectomy (MT) may benefit patients with TLs; however, optimal management and procedural strategy of the cervical lesion remain unclear.
To evaluate the association of carotid artery stenting (CAS) vs no stenting and medical management with functional and safety outcomes among patients with TL-LVOs.
This cross-sectional study included consecutive patients with acute anterior circulation TLs admitted across 17 stroke centers in the US and Spain between January 1, 2015, and December 31, 2020. Data analysis was performed from August 2021 to February 2022. Inclusion criteria were age of 18 years or older, endovascular therapy for intracranial occlusion, and presence of extracranial internal carotid artery stenosis (>50%) demonstrated on pre-MT computed tomography angiography, magnetic resonance angiography, or digital subtraction angiography.
Patients with TLs were divided into CAS vs nonstenting groups.
Primary clinical and safety outcomes were 90-day functional independence measured by a modified Rankin Scale (mRS) score of 0 to 2 and symptomatic intracranial hemorrhage (sICH), respectively. Secondary outcomes were successful reperfusion (modified Thrombolysis in Cerebral Infarction score ≥2b), discharge mRS score, ordinal mRS score, and mortality at 90 days.
Of 685 patients, 623 (mean [SD] age, 67 [12.2] years; 406 [65.2%] male) were included in the analysis, of whom 363 (58.4%) were in the CAS group and 260 (41.6%) were in the nonstenting group. The CAS group had a lower proportion of patients with atrial fibrillation (38 [10.6%] vs 49 [19.2%], P = .002), a higher proportion of preprocedural degree of cervical stenosis on digital subtraction angiography (90%-99%: 107 [32.2%] vs 42 [20.5%], P < .001) and atherosclerotic disease (296 [82.0%] vs 194 [74.6%], P = .003), a lower median (IQR) National Institutes of Health Stroke Scale score (15 [10-19] vs 17 [13-21], P < .001), and similar rates of intravenous thrombolysis and stroke time metrics when compared with the nonstenting group. After adjustment for confounders, the odds of favorable functional outcome (adjusted odds ratio [aOR], 1.67; 95% CI, 1.20-2.40; P = .007), favorable shift in mRS scores (aOR, 1.46; 95% CI, 1.02-2.10; P = .04), and successful reperfusion (aOR, 1.70; 95% CI, 1.02-3.60; P = .002) were significantly higher for the CAS group compared with the nonstenting group. Both groups had similar odds of sICH (aOR, 0.90; 95% CI, 0.46-2.40; P = .87) and 90-day mortality (aOR, 0.78; 95% CI, 0.50-1.20; P = .27). No heterogeneity was noted for 90-day functional outcome and sICH in prespecified subgroups.
In this multicenter, international cross-sectional study, CAS of the cervical lesion during MT was associated with improvement in functional outcomes and reperfusion rates without an increased risk of sICH and mortality in patients with TLs
Early administration of SARS-CoV-2 monoclonal antibody reduces the risk of mortality in hematologic malignancy and hematopoietic cell transplant patients with COVID-19
No full textData on severe acute respiratory distress syndrome coronavirus 2 monoclonal antibody (SARS-CoV-2-specific mAb) use in hematologic malignancy and hematopoietic cell transplantation (HM/HCT) patients are limited. Here, we describe our experience with the use of casirivimab-imdevimab or bamlanivimab for the treatment of coronavirus disease 2019 (COVID-19) in HM/HCT patients.
This was a retrospective chart review at the University of Miami Hospital and Sylvester Comprehensive Cancer Center for HM/HCT patients with COVID-19 who received casirivimab-imdevimab or bamlanivimab from November 21, 2020, to September 30, 2021. Outcomes measured were mortality, hospital admission, and infusion reaction to SARS-CoV-2-specific mAbs.
We identified 59 HM/HCT patients with mild to moderate COVID-19 who received casirivimab-imdevimab or bamlanivimab. Median age was 57 years (interquartile range [IQR]: 45-65). Among the 59 patients, 25 (42%) received cellular therapy: 14 (24%) had undergone allogeneic HCT, nine (15%) autologous HCT, and two (3%) received chimeric antigen receptor T-cell therapy. The median time from COVID-19 symptom onset to SARS-CoV-2-specific mAb administration was 4 (IQR: 3-6) days. Forty-six (78%) patients received SARS-CoV-2-specific mAbs as outpatients and 13 (22%) patients received SARS-CoV-2-specific mAbs during hospitalization. Among patients who received SARS-CoV-2-specific mAbs as outpatients, only four (9%) visited the emergency department at days 10, 11, 15, and 35 after SARS-CoV-2-specific mAb administration. None of these four patients required hospital admission. Among the hospitalized patients, five (38%) were admitted to the hospital with neutropenic fever, four (31%) were already hospitalized for transplantation and cellular therapy, three (23%) were admitted for monitoring of COVID-19 symptoms, and one (8%) was admitted with acute kidney injury. Three hospitalized patients (23%) died at 14, 35, and 59 days after SARS-CoV-2-specific mAb administration; two of these three deaths were attributed to COVID-19 infection. One patient developed an immediate infusion reaction to bamlanivimab, and no infusion reactions were reported to casirivimab-imdevimab use.
During the alpha and delta variant surges, early administration of bamlanivimab or casirivimab-imdevimab prevented hospitalization and death when given in the outpatient setting. Among patients who received mAbs at or after hospital admission, the risk of COVID-19 disease progression and death remains significant. Larger studies of the use of mAb therapy to treat COVID-19 in this population are needed
Revising Logics
No full textIs logical revision possible? A number of arguments challenge that this is the case, raising considerations based on the unchanging structure of the world, the meaning of logical constants, and the need for a logic in the process of logical revision. In this paper, I resist these arguments and critically assess the associated traditional conception that takes logic to be universal, unchangeable, and necessary. I argue that this conception faces significant challenges and offer the outline of an empiricist alternative that accommodates the intelligibility and possibility of logical revision
Antibiotics reduce Pocillopora coral-associated bacteria diversity, decrease holobiont oxygen consumption and activate immune gene expression
No full textABCA1 deficiency contributes to podocyte pyroptosis priming via the APE1/IRF1 axis in diabetic kidney disease
No full textDecreased ATP Binding Cassette Transporter A1 (ABCA1) expression and caspase-4-mediated noncanonical inflammasome contribution have been described in podocytes in diabetic kidney disease (DKD). To investigate a link between these pathways, we evaluated pyroptosis-related mediators in human podocytes with stable knockdown of ABCA1 (siABCA1) and found that mRNA levels of IRF1, caspase-4, GSDMD, caspase-1 and IL1β were significantly increased in siABCA1 compared to control podocytes and that protein levels of caspase-4, GSDMD and IL1β were equally increased. IRF1 knockdown in siABCA1 podocytes prevented increases in caspase-4, GSDMD and IL1β. Whereas TLR4 inhibition did not decrease mRNA levels of IRF1 and caspase-4, APE1 protein expression increased in siABCA1 podocytes and an APE1 redox inhibitor abrogated siABCA1-induced expression of IRF1 and caspase-4. RELA knockdown also offset the pyroptosis priming, but ChIP did not demonstrate increased binding of NFκB to IRF1 promoter in siABCA1 podocytes. Finally, the APE1/IRF1/Casp1 axis was investigated in vivo. APE1 IF staining and mRNA levels of IRF1 and caspase 11 were increased in glomeruli of BTBR ob/ob compared to wildtype. In conclusion, ABCA1 deficiency in podocytes caused APE1 accumulation, which reduces transcription factors to increase the expression of IRF1 and IRF1 target inflammasome-related genes, leading to pyroptosispriming
Remote Sensing and Artificial Intelligence for Urban Environmental Studies - Chapter 1
No full textThis chapter offers an outline of the concept of the book and its importance to scientists, researchers, stakeholders, and authorities. It seeks to provide a framework for the subjects that have been selected to address the knowledge gap that exists between urban studies and remote sensing with machine learning by fostering a deeper understanding of the scientific principles that underpin both subfields. This chapter also provides an overview of 28 articles written by the world's leading experts in the different fields of urban research, using earth observation databases, statistical techniques, and artificial intelligence to solve urban environmental issues
A comparison performance analysis of eight meta-heuristic algorithms for optimal design of truss structures with static constraints
No full textMetaheuristics have been successfully used for solving complex structural optimization problems. Many algorithms are proposed for truss structure size and shape optimization under some constraints. This study considers eight population-based meta-heuristic methods: African Vultures Optimization Algorithm (AVOA), Flow Direction Algorithm (FDA), Arithmetic Optimization Algorithm (AOA), Generalized Normal Distribution Optimization (GNDO), Stochastic Paint Optimizer (SPO), Chaos Game Optimizer (CGO), Crystal Structure Algorithm (CRY) and Material Generation Algorithm (MGO). These meta-heuristics methods are used to optimize the size of three aluminum truss structures. Optimization aims to reduce the weight of the truss members while meeting a set of displacement and stress constraints. The performance of these methods is assessed by solving and optimizing three well-known truss structure benchmarks under some constraints. The results show that the Stochastic Paint Optimizer (SPO) outperforms the other algorithms in terms of accuracy and convergence rate.
•Optimization of truss structures with static constraints is considered.•Eight recently meta-heuristic algorithms are compared for optimization purposes.•Three truss design structures (25, 75, and 120 member truss) are used.•Utilize 25 and 72-member trusses along with 120-dome-member truss structures.•Stochastic Paint Optimizer outperforms better than other algorithms
Cost-Effectiveness of Steroids for Prolonging the Surgery-Free Interval in Subglottic Stenosis
No full textOBJECTIVESRepeat endoscopic dilation (ED) in the operating room for subglottic stenosis (SGS) remains an economic burden to patients. The cost-effectiveness (CE) of adjuvant serial intralesional steroid injections (SILSI) to prolong the surgery-free interval (SFI) in SGS patients requiring ED has yet to be studied. METHODSDetails of the cost of SILSI and ED were received from our tertiary academic center. SFI, cost of intervention, and the effect of SILSI on prolonging SFI were collected from a systematic review by Luke et al. SGS etiologies in the review included idiopathic, iatrogenic, or autoimmune. A break-even analysis, comparing the cost of SILSI alone with the cost of repeat ED, was performed to determine if SILSI injections were cost-effective in prolonging the SFI. RESULTSAverage extension of the SFI with SILSI was an additional 219.3 days compared to ED alone based on a systematic review of the literature. 41/55 (74.5%) cases did not require further ED once in-office SILSI management began. SILSI administered in a 4-dose series in 3-to-7-week intervals (~39,429.00) has an absolute risk reduction (ARR) of at least 19.18% with the use of SILSI. Based on the literature, SILSI prevents ~3 out of every 4 cases of SGS at sufficient follow-up from undergoing repeat ED, resulting in an ARR of ~75%. CONCLUSIONSSILSI is economically reasonable if it prolongs the SFI of at least one case of recurrence out of 5. SILSI, therefore, can be CE in extending the interval for surgical ED. LEVEL OF EVIDENCEN/A Laryngoscope, 2023
Optimizing Truss Structures Using Composite Materials under Natural Frequency Constraints with a New Hybrid Algorithm Based on Cuckoo Search and Stochastic Paint Optimizer (CSSPO)
No full textThis article highlights the absence of published paradigms hybridized by The Cuckoo Search (CS) and Stochastic Paint Optimizer (SPO) for optimizing truss structures using composite materials under natural frequency constraints. The article proposes a novel optimization algorithm called CSSPO for optimizing truss structures made of composite materials, known as fiber-reinforced polymer (FRP) composites, to address this gap. Optimization problems of truss structures under frequency constraints are recognized as challenging due to their non-linear and non-convex search spaces that contain numerous local optima. The proposed methodology produces high-quality optimal solutions with less computational effort than the original methods. The aim of this work is to compare the performance of carbon FRP (CFRP), glass FRP (GFRP), and steel using a novel hybrid algorithm to provide valuable insights and inform decision-making processes in material selection and design. Four benchmark structure trusses with natural frequency constraints were utilized to demonstrate the efficiency and robustness of the CSSPO. The numerical analysis findings indicate that the CSSPO outperforms the classical SPO and exhibits comparable or superior performance when compared to the SPO. The study highlights that implementing CFRP and GFRP composites in truss construction leads to a notable reduction in weight compared to using steel
Effects of small hydropower dams on macroinvertebrate and fish assemblages in southern Brazil
No full textHydropower dams affect freshwater biodiversity by virtue of modifying flow regimes and degrading habitat conditions both above and below the water impoundment and diversion structure. In recent decades, there has been a global proliferation of Small Hydropower Plants (SHPs) propelled by incentive policies and a general perception that small dams are less harmful to the environment. However, limited science is available on the effects of SHPs on freshwater biodiversity, which is concerning considering their sheer numbers and the high variability in the size and operation of dams classified as SHPs. We investigated the ecological effects of 12 SHPs on macroinvertebrate and fish assemblages of the Chapeco River Basin, Brazil. Our study included sites located upstream of the SHPs and sites directly affected by their operations (i.e., reservoir, dewatering section and downstream of the powerhouse). This design allowed us to quantify shifts in taxonomic composition and examine the relative role of different SHP attributes (e.g., dam height, reservoir area, age) in explaining these changes. Our results reveal that SHPs modify the composition of both macroinvertebrate and fish assemblages, but the magnitude of such changes vary widely among dams. Both assemblages exhibited directionality in taxonomic shifts, resulting in a gradual replacement of taxa associated with fast-flowing habitats by other groups more commonly associated with standing waters. We also found that changes in assemblage structureare related to structural (dam height, reservoir area) and spatial attributes (distance from headwaters) of SHPs, although the predictive power of these attributes varied taxonomically and among reservoir, dewatering and downstream sites. Overall, our results demonstrate that SHPs have important and heterogeneous effects on freshwater assemblages, which may manifest individually or cumulatively across the riverscape. This suggests that it is unlikely that a priori classifications of dams based on their structural attributes can replace site-specific and cumulative impact assessments. The results also shed light on the need for better understanding of how SHP attributes shape their ecological effects, so that a full assessment of the potential environmental impacts of the wide range of "small" dams is possible