Late Window Research Articles

Perfusion vs non-perfusion computed tomography imaging in the late window of emergent large vessel ischemic stroke: A systematic review and meta-analysis.

Guidelines recommend the treatment of emergent large vessel ischemic stroke (ELVIS) patients presenting beyond 6 hours of last known well time with endovascular thrombectomy (EVT) based on perfusion computed tomography (CT) neuroimaging. We compared the outcomes (long-term good clinical outcomes, symptomatic intracranial hemorrhage (sICH), and mortality) of ELVIS patients according to the type of CT neuroimaging they underwent. We searched the following databases: Medline, Embase, CENTRAL, and Scopus from January 1, 2015, to June 14, 2023. We included studies of late-presenting ELVIS patients undergoing EVT that had with data for non-perfusion and perfusion CT neuroimaging. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data were pooled using a random effects model. We found 7 observational cohorts. Non-perfusion versus perfusion CT was not statistically significantly different for both long-term clinical (n = 3,224; RR: 0.96; 95% CI 0.86 to 1.06; I2 = 18%) and sICH (n = 3,724; RR: 1.08 95% CI 0.60 to 1.94; I2 = 76%). Perfusion CT had less mortality (n = 3874; RR: 1.22; 95% CI 1.07 to 1.40; I2 = 0%). The certainty of these findings is very low because of limitations in the risk of bias, indirectness, and imprecision domains of the Grading of Recommendations, Assessment, Development and Evaluations. The use of either non-perfusion or perfusion CT neuroimaging may have little to no effect on long-term clinical outcomes and sICH for late-presenting EVT patients. Perfusion CT neuroimaging may be associated with a reduced the risk of mortality. Evidence uncertainty warrants randomized trial data.

Cost-effectiveness of endovascular treatment after 6-24 h in ischaemic stroke patients with collateral flow on CT-angiography: A model-based economic evaluation of the MR CLEAN-LATE trial.

The MR CLEAN-LATE trial has shown that patient selection for endovascular treatment (EVT) in the late window (6-24 h after onset or last-seen-well) based on the presence of collateral flow on CT-angiography is safe and effective. We aimed to assess the cost-effectiveness of late-window collateral-based EVT-selection compared to best medical management (BMM) over a lifetime horizon (until 95 years of age). A model-based economic evaluation was performed from a societal perspective in The Netherlands. A decision tree was combined with a state-transition (Markov) model. Health states were defined by the modified Rankin Scale (mRS). Initial probabilities at 3-months post-stroke were based on MR CLEAN-LATE data. Transition probabilities were derived from previous literature. Information on short- and long-term resource use and utilities was obtained from a study using MR CLEAN-LATE and cross-sectional data. All costs are expressed in 2022 euros. Costs and quality-adjusted life years (QALYs) were discounted at a rate of 4% and 1.5%, respectively. The effect of parameter uncertainty was assessed using probabilistic sensitivity analysis (PSA). On average, the EVT strategy cost €159,592 (95% CI: €140,830-€180,154) and generated 3.46 QALYs (95% CI: 3.04-3.90) per patient, whereas the costs and QALYs associated with BMM were €149,935 (95% CI: €130,841-€171,776) and 2.88 (95% CI: 2.48-3.29), respectively. The incremental cost-effectiveness ratio per QALY and the incremental net monetary benefit were €16,442 and €19,710, respectively. At a cost-effectiveness threshold of €50,000/QALY, EVT was cost-effective in 87% of replications. Collateral-based selection for late-window EVT is likely cost-effective from a societal perspective in The Netherlands.

Presentation of older layers and findings on historical architecture using the method of analytical presentation: Example of the Old Town Hall in Bratislava, Slovakia

Abstract Analytical presentation is one of the methods used in the process of monument restoration. The method displays certain valuable older layers in the form of a cutout in the dominant layer of the facade´s surface. This article seeks to illustrate the method on the example of the facades of the Old Town Hall in Bratislava, Slovakia, and its restorations that were performed in several phases. The floor is presented in the Renaissance style – a part of the wall in medieval style over the arch of the underpass is exposed. The largest areas of analytical presentations are realized on the northern facade in the courtyard. The areas of arcades are restored in light beige colour, respecting the Renaissance colour palette. On the wall, research uncovered important medieval style findings and fragments of the chopped pillars of continuous balconies. A large-scale analytical probe encompassing two floors was realized. A system of various medieval windows, richly decorated and formed by a curved arch or triangular gable, is preserved here with some more recent openings in the Renaissance style. The main facade facing the town square could also be classified as a system of analytical presentations. The tower shows plaster in an Early Baroque style with various windows (Gothic, Renaissance, Baroque) on both facades (Main Square and Kostolná Street). Interesting are Late Gothic double windows with wimpergs. The rest of the facade facing the Main Square is prevailingly designed in the Renaissance style. But in the middle, there is a part reconstructed in the Gothic style with a rich curved decoration. Next to the tower, there is a Gothic portal with an arc and oriel above it. In the part of the Kostolná Street, there is a Gothic plaster reconstructed by applying two methods. One contains a grained plaster in sandy colour, the second has a surface with networking. Various windows and niches (medieval, Renaissance, Baroque) are present here. The complicated analytical presentations contained in the facades of the Old Town Hall raise many questions in the expert discussion.

Adiposity and Insulin Resistance Moderate Brain Electrophysiology and Affect Regulation in Young Adults

AbstractBackgroundObesity and insulin resistance (IR) may negatively influence affect regulation in young adulthood. The paucity of studies that have investigated such associations have predominantly used functional magnetic resonance imaging. However, electroencephalography (EEG) can evaluate neural signatures in real‐time that may be complementary. Thus, this study investigated how adiposity and IR moderated brain activity and underlying affect regulation using EEG.MethodReal‐time EEG was recorded in 28 lean and obese young adults with and without IR (18‐39 years, 46.4% female). Two event‐related potential (ERP) components of affect regulation, early posterior negativity (EPN) and late positive potential (LPP), were quantified from EEG data. Participants completed the Interactional Picture Affective System task to measure affect regulation, from which mean valence ratings and stimulus‐to‐response‐onset reaction times were calculated. ERP components and affect regulation parameters were then contrasted in three conditions, as follows: 1) Negative – Neutral; 2) Positive – Neutral; and 3) Negative – Positive. Height, weight, body fat percentage (%BF), and serum proteomics were collected. Fasting glucose and insulin readings were obtained to quantify Homeostatic Model Assessment for Insulin Resistance (HOMA‐IR). Hierarchical moderated regression analysis was utilized to test the interrelationships between adiposity, IR, neural activity, and affect regulation.ResultAcross all contrasted conditions, HOMA‐IR and %BF were found to moderate the relationships between frontal and parietal LPP amplitudes during the late latency window and affect regulation. Specifically, higher late frontal LPP amplitudes were associated with less negative and more positive valence ratings to unpleasant and pleasant stimuli, respectively, among participants with low, but not high, IR and %BF levels. In the Negative – Neutral and Negative – Positive conditions, lower late parietal LPP amplitudes were also associated with less negative overall valence ratings in response to unpleasant stimuli, but only in lean, insulin sensitive participants. These results overall suggest that modulation of negative and positive affectivity only occurs in lean young adults without IR.ConclusionYoung adults with greater adiposity and IR showed worse affect regulation than those without obesity and IR. Furthermore, AD‐associated characteristics may start early in life, and EEG signatures may be a useful neuroimaging approach for tracking such events.

Decomposing the late positive potential to cannabis cues in regular cannabis users: A temporal-spatial principal component analysis.

Cannabis use disorder (CUD) is increasing in the United States, yet, specific neural mechanisms of CUD are not well understood. Disordered substance use is characterized by heightened drug cue incentive salience, which can be measured using the late positive potential (LPP), an event-related potential (ERP) evoked by motivationally significant stimuli. The drug cue LPP is typically quantified by averaging the slow wave's scalp-recorded amplitude across its entire time course, which may obscure distinct underlying factors with differential predictive validity; however, no study to date has examined this possibility. In a sample of 105 cannabis users, temporo-spatial Principal Component Analysis was used to decompose cannabis cue modulation of the LPP into its underlying factors. Acute stress was also inducted to allow for identification of specific cannabis LPP factors sensitive to stress. Factor associations with CUD severity were also explored. Eight factors showed significantly increased amplitudes to cannabis images relative to neutral images. These factors spanned early (~372 ms), middle (~824 ms), and late (>1000 ms) windows across frontal, central, and parietal-occipital sites. CUD phenotype individual differences were primarily associated with frontal, middle/late latency factor amplitudes. Acute stress effects were limited to one early central and one late frontal factor. Taken together, results suggest that the cannabis LPP can be decomposed into distinct, temporal-spatial factors with differential responsivity to acute stress and CUD phenotype variability. Future individual difference studies examining drug cue modulation of the LPP should consider (1) frontalcentral poolings in addition to conventional central-parietal sites, and (2) later LPP time windows.

Endovascular treatment for acute ischemic stroke beyond the 24-h time window: Selection by target mismatch profile.

Endovascular treatment for acute ischemic stroke patients with large vessel occlusion (LVO) has been established as a promising clinical intervention within a late time window of 6-24 h after symptom onset. Patients with slow progression, however, may still benefit from endovascular treatment beyond the 24-h time window (very late window). The aim of this study is to report insight into the potential clinical benefits of endovascular treatment for acute ischemic stroke beyond 24 h from symptom onset. A retrospective analysis was performed on consecutive patients undergoing endovascular treatment for acute anterior circulation LVO ischemic stroke beyond 24 h. Participants were recruited between July 2019 and November 2020. Patients were selected based on the DAWN/DEFUSE 3 criteria (Perfusion-RAPID, iSchemaView) and patients receiving treatment beyond 24 h were compared to a group of patients receiving endovascular treatment between 6 and 24 h after symptom onset. The primary outcome was the proportion of patients with functional independence at 90 days (modified Rankin Scale score of 0-2). The secondary outcomes were shift modified Rankin Scale (mRS) analysis and successful reperfusion was defined by thrombolysis in cerebral infarction (TICI) 2b-3 on the final procedure. Safety outcomes were symptomatic intracranial hemorrhage and death at the 90-day follow-up. Propensity score (PS)-matched analyses were employed to rectify the imbalanced baseline characteristics between the two groups. A total of 166 patients were recruited with a median age of 63.0 (56.0-69.0) and 28.9% of all patients were females. Patients in the beyond 24-h group had a longer onset-to-groin time (median = 27.2 vs 14.3 h, p < 0.001) than those in the 6- to 24-h group. There were no statistically significant differences between the two groups in National Institutes of Health Stroke Scale (NIHSS) (median = 12.0 vs 15.0, p = 0.37), perfusion imaging characteristics (core: median = 11.0 vs 9.0 mL, p = 0.86; mismatch volume: median = 106.0 vs 96.0, p = 0.44; mismatch ratio = 6.46 vs 7.24, p = 0.91), and perfusion-to-groin time (median = 72.5 vs 76.0 min, p = 0.77). No significant differences were noted among patients between the two groups in the primary endpoint functional independence analysis (50.0% vs 46.6%, p = 0.77) and in the safety endpoint analysis: mortality (15.0% vs 11.0%, p = 0.71) or symptomatic hemorrhage (0% vs 3.42%, p > 0.999). In PS-matched analyses, there were no significant differences among patients between the two groups in functional independence (50.0% vs 54.8%, p = 0.74), mortality (16.7% vs 9.68%, p = 0.50), or symptomatic hemorrhage (0% vs 6.45%, p = 0.53). Endovascular treatment can be performed safely and effectively in LVO patients beyond 24 h from symptom onset when selected by target mismatch profile. The clinical outcome of these patients was comparable to those treated in the 6- to 24-h window. Larger studies are needed to confirm these findings.

Factors Influencing the Deterioration of Groundnut Seed Health and Its Implications on Storage Capacity

Aims: The current study aimed to investigate the factors influencing seed deterioration in groundnut.&#x0D; Study Design: Three factorial CRD.&#x0D; Place and Duration of Study: The research was conducted at the Department of Seed Science and Technology, Seed Research and Technology Centre, PJTSAU, Rajendranagar, Hyderabad, between february 2022 to march 2023.&#x0D; Methodology: Groundnut seeds harvested at different stages (early, normal, and late) were considered, each with varying seed moisture levels (8%, 10%, and 12%). These seeds were stored under ambient conditions for one year and evaluated for percentage of seed infection, seed rot, and bruchid infection. The assessments were carried out with three replicates, each consisting of 100 seeds. The study was conducted using a three-factorial design as the experimental setup involved three independent variables.&#x0D; Results: Results showed that among the different seed moisture levels, seeds harvested early with 8% moisture content exhibited the lowest percentages of seed infection, seed rot, and bruchid infection at 62.75% and 59.58% respectively after one year of storage. Conversely, seeds from the late harvesting window with 12% seed moisture content displayed the highest percentages of these seed health parameters at 53%, 00%, and 49.42% respectively. Notably, there was significant variation in seed infection rates observed in both 8% and 12% seed moisture content groups.&#x0D; Conclusion: These discoveries reveal the vital significance of timely harvesting and maintaining the right moisture levels to safeguard the quality and health of seeds.

Abstract 211: Comparing Early and Late Window 3mm Trevo Stent Retriever Performance in Medium Vessel Occlusion Thrombectomy

Introduction Endovascular thrombectomy has been shown to be beneficial for select patients with medium vessel occlusion ischemic strokes. Newer mechanical thrombectomy devices have designs to facilitate navigation of the medium and distal cerebrovasculature. In this single‐center study, we aim to compare the performance of 3mm Trevo NXT stent retrievers (Stryker, Kalamazoo, MI) for medium vessel occlusion mechanical thrombectomy for patients treated within either the early (&lt;6 hour) or late (&gt;6 hour) treatment window. Methods A retrospective review was conducted of acute ischemic stroke patients with medium vessel occlusions (i.e., M2‐M4, ACA, and PCA) who underwent thrombectomy over 5 years (2018‐2022) at a single comprehensive stroke center. Classification into early or late window was defined as time from last known well to groin puncture less than 6 hours or greater than 6 hours, respectively. Primary efficacy outcome included successful recanalization (modified thrombolysis in cerebral infarction [mTICI]&gt;=2B) using 3mm Trevo NXT on either first pass or rescue pass (i.e., after initial pass failure with another device). Primary safety outcome is rate of complications associated with the stent retriever. Primary clinical outcome was National Institutes of Health Stroke Scale (NIHSS) shift between admission and discharge. Results Of 81 patients with medium vessel occlusion ischemic strokes, 38 patients (44.7% female, median age of 73.5 years [IQR 66‐82], median initial NIHSS 13 [IQR 8‐23]) underwent thrombectomy with 3mm Trevo NXT. Stent retriever‐assisted aspiration (versus stent retriever only) was performed in 31/38 (81.6%) patients. Successful recanalization with stent retriever was achieved in 28/38 (73.7%) of patients. There was no significant difference in rate of recanalization between early and late window thrombectomy (16/22 [72.7%] early window vs. 12/16 [75%] late window, p=0.8752). The lack of significant difference in recanalization rate was consistent with stent retriever use during first pass (11/14 [78.6%] early window vs. 9/10 [90%] late window, p=0.6146) and as rescue (5/8 [62.5%] early window vs. 3/6 [50%] late window, p=0.6400). There was no significant difference in the rate of stent retriever complications between early and late windows (1/16 [6.3%] early vs. 0/22 [0%] late, p=0.4211). There was no significant difference in median NIHSS shift from admission to discharge ( ‐6 [IQR ‐16 ‐ 9] early window vs. ‐3 [IQR ‐5 ‐ 4] late window, p=0.3666). Conclusion In both early and late window medium vessel occlusion thrombectomy, the 3mm Trevo NXT as first line and rescue intervention performs comparably and adequately. Future multicenter studies will further characterize novel stent retriever performance in medium vessel occlusion thrombectomies.

Abstract 230: Endovascular therapy for large core ischemic strokes: Meta‐analysis of randomized clinical trials

Introduction Background: Patients with acute strokes with large infarct size are traditionally excluded from endovascular therapies, as like as clinical care. However, questions remain with respect to the safety and efficacy of EVT in these patients. Methods We conducted a meta‐analysis based on pooled data from SELECT 2 trial [1], ANGEL‐ASPECT trial [2], RESCUE Japan [3], and HERMES study [4]. We explored the efficacy of EVT for large infarcts to achieve a favorable 90‐day modified Rankin Scale. Also, we compared favorable outcomes following EVT in those with a core infarct at baseline of more than 70 ml, delayed thrombectomy of more than 6 hours, older than 75 years, and those who received concomitant IV thrombolysis. We also examined the pooled rate of hemorrhagic transformation following EVT in large core strokes. Results This meta‐analysis showed a statistically significant higher rate of favorable outcome in subjects with extremely large infarct size who undergone EVT compared to those who were managed by medical therapy alone (RR: 1.41, 95% CI: [1.05‐1.98], p: 0.03). In the subgroups of patients with core size &gt; 70ml (RR: 1.51, 95% CI: [1.23‐1.87]), late window presentation (LKN to randomization ≥ 6 hours), (RR: 1.53, 95% CI: [1.27‐1.84]), or those 75 or older than 75 years old (RR: 1.43, 95% CI: [1.12‐1.84]), EVT was associated with higher rates of favorable 90‐day mRS score of 0‐3 compared to medical therapy alone. However, EVT was not associated with better outcomes in those who received IV thrombolysis (RR: 1.37, 95% CI: [0.93‐2.01]. Based on pooled data from SELECT‐2, ANGEL‐ASPECT, and RESCUE Japan trials, the overall rate of early symptomatic hemorrhagic transformation among cases with ASPECT 0‐5 in the thrombectomy group was not significantly higher compared to patients who were managed non‐surgically (OR 1.75, 95% CI: [0.89‐3.47]). Conclusion Endovascular therapy is a reasonable option for the management of large infarcts. EVT results in favorable outcome by a delayed thrombectomy for a large core infarct and in older patients.

Clinical and Safety Outcomes of Endovascular Therapy 6 to 24 Hours After Large Vessel Occlusion Ischemic Stroke With Tandem Lesions.

Effect of endovascular therapy (EVT) in acute large vessel occlusion (LVO) patients with tandem lesions (TLs) within 6-24 hours after last known well (LKW) remains unclear. We evaluated the clinical and safety outcomes among TL-LVO patients treated within 6-24 hours. This multicenter cohort was divided into two groups, based on LKW to puncture time: early window (<6 hours), and late window (6-24 hours). Primary clinical and safety outcomes were 90-day functional independence measured by the modified Rankin Scale (mRS: 0-2) and symptomatic intracranial hemorrhage (sICH). Secondary outcomes were successful reperfusion (modified Thrombolysis in Cerebral Infarction score ≥2b), first-pass effect, early neurological improvement, ordinal mRS, and in-hospital and 90-day mortality. Of 579 patients (median age 68, 32.1% females), 268 (46.3%) were treated in the late window and 311 (53.7%) in the early window. Late window group had lower median National Institutes of Health Stroke Scale score at admission, Alberta Stroke Program Early Computed Tomography Score, rates of intravenous thrombolysis, and higher rates for perfusion imaging. After adjusting for confounders, the odds of 90-day mRS 0-2 (47.7% vs. 45.0%, adjusted odds ratio [aOR] 0.71, 95% confidence interval [CI] 0.49-1.02), favorable shift in mRS (aOR 0.88, 95% CI 0.44-1.76), and sICH (3.7% vs. 5.2%, aOR 0.56, 95% CI 0.20-1.56) were similar in both groups. There was no difference in secondary outcomes. Increased time from LKW to puncture did not predicted the probability of 90-day mRS 0-2 (aOR 0.99, 95% CI 0.96-1.01, for each hour delay) among patients presenting <24 hours. EVT for acute TL-LVO treated within 6-24 hours after LKW was associated with similar rates of clinical and safety outcomes, compared to patients treated within 6 hours.

Maceral evolution of lacustrine shale and its effects on the development of organic pores during low mature to high mature stage: A case study from the Qingshankou Formation in northern Songliao Basin, northeast China

Organic matter (OM) hosted pores are crucial for the storage and migration of petroleum in shale reservoirs. Thermal maturity and macerals type are important factors controlling the development of pores therein. In this study, six lacustrine shale samples with different thermal maturities from the first member of the Qingshankou Formation in the Songliao Basin, of which vitrinite reflectance (Ro) ranging from 0.58% to 1.43%, were selected for a comparative analysis. Scanning electron microscopy (SEM) and reflected light microscopy were combined to investigate the development of organic pores in different macerals during thermal maturation. The results show that alginite and liptodetrinite are the dominant primary macerals, followed by bituminite. Only a few primary organic pores developed in the alginite at the lowest maturity (Ro = 0.58%). As a result of petroleum generation, oil-prone macerals began to transform to initial-oil solid bitumen at the early oil window (Ro = 0.73%) and shrinkage cracks were observed. Initial-oil solid bitumen cracked to oil, gas and post-oil bitumen by primary cracking (Ro = 0.98%). Moreover, solid bitumen (SB) was found to be the dominant OM when Ro > 0.98%, which indicates that SB is the product of oil-prone macerals transformation. Many secondary bubble pores were observed on SB, which formed by gas release, while devolatilization cracks developed on migrated SB. Additionally, at the late oil window (Ro = 1.16%), migrated SB filled the interparticle pore spaces. With further increase in temperature, the liquid oil underwent secondary cracking into pyrobitumen and gas, and spongy pores developed on the pyrobitumen at higher levels of maturity (Ro = 1.43%), which formed when pyrobitumen cracked into gas. Vitrinite and inertinite are stable without any visible pores over the range of maturities, verifying their low petroleum generation potential. In addition, it was concluded that clay minerals could have a catalytic effect on the petroleum generation, which may explain why organic-clay mixtures had more abundant pores than single OM particles. However, after Ro > 0.98%, authigenic minerals occupied the organic pore spaces on the organic-clay mixtures, resulting in fewer pores compared to those observed in samples at the early to peak oil window.

A Monastic Antichrist Satire from Medieval Bury St Edmunds: Interpreting the Iconotypicon Buriense

The so-called Iconotypicon Buriense (‘copy of the Bury picture’) is a painted panel of around 1560 that purports to reproduce a late medieval stained-glass window that was once in the Cellarer’s Chamber at St Edmunds Abbey. While the Iconotypicon has historically been interpreted as an anti-papal portrayal of Antichrist that anticipated the polemic of the Reformation era, this article argues that the original window was in all likelihood a monastic satire that took aim at the enemies of St Edmunds Abbey: bishops, secular clergy and friars. The Iconotypicon is rooted in traditional antisemitic portrayals of Antichrist and antifraternal traditions of monastic critique of the mendicant friars, and, while it is unusual, it is an essentially conservative work of religious art.

ASPECTS-based net water uptake outperforms target mismatch for outcome prediction in patients with acute ischemic stroke and late therapeutic window.

To compare the prognostic value of net water uptake (NWU) and target mismatch (TM) on CT perfusion (CTP) in acute ischemic stroke (AIS) patients with late time window. One hundred and nine consecutive AIS patients with anterior-circulation large vessel occlusion presenting within 6-24 h from onset/last seen well were enrolled. Automated Alberta Stroke Program Early CT Score-based NWU (ASPECTS-NWU) was calculated from admission CT. The correlation between ASPECTS-NWU and CTP parameters was assessed. Predictors for favorable outcome (modified Rankin Scale score ≤ 2) at 90 days were assessed using logistic regression analysis. The ability of outcome prediction between ASPECTS-NWU and TM (an ischemic core < 70 mL, a mismatch ratio ≥ 1.8, and an absolute difference ≥ 15 mL) was compared using receiver operating characteristic (ROC) curve. A higher level of ASPECTS-NWU was associated with a larger ischemic core (r = 0.66, p < 0.001) and a larger hypoperfusion volume (r = 0.38, p < 0.001). ASPECTS-NWU performed better than TM for outcome stratification (area under the curve [AUC], 0.738 vs 0.583, p = 0.004) and was the only independent neuroimaging marker associated with favorable outcomes compared with CTP parameters (odds ratio, 0.73; 95% confidence interval [CI] 0.62-0.87, p < 0.001). An outcome prediction model including ASPECTS-NWU and clinical variables (National Institutes of Health Stroke Scale scores and age) yielded an AUC of 0.828 (95% CI 0.744-0.893; sensitivity 65.4%; specificity 87.7%). ASPECTS-NWU performed better than TM for outcome prediction in AIS patients with late time window and might be an alternative imaging biomarker to CTP for patient selection. Automated Alberta Stroke Program Early CT Score-based net water uptake outperforms target mismatch on CT perfusion for the outcome prediction in patients with acute ischemic stroke and can be an alternative imaging biomarker for patient selection in late therapeutic window. • A higher ASPECTS-based net water uptake was associated with larger ischemic cores and hypoperfusion volumes on CT perfusion. • ASPECTS-based net water uptake outperformed target mismatch for outcome prediction in acute ischemic stroke with extended therapeutic window. • ASPECTS-based net water uptake can be an alternative biomarkerto target mismatch for selecting acute ischemic stroke patients with late therapeutic window.

Association of Dual-Phase Computed Tomography Angiography and CT-Perfusion in Patients with Acute Ischemic Stroke Beyond the 6-Hour Window

Background: There is controversy regarding the need to use advanced imaging to select candidates for thrombectomy in late window acute ischemic stroke (AIS). Hypoattenuation on CT angiography source images (CTA-SI) in arterial phase has been shown to be more sensitive than Alberta Stroke Program Early CT score (ASPECTS) of brain parenchyma to determine tissue at risk of ischemia. Our hypothesis is that the addition of a second acquisition at 35-50 seconds could complement the assessment of hypoperfused tissue that fails to receive flow through pial vessels. Methods: Patients with large vessel occlusion and 6-16 hours from symptom onset, admitted between August 2019 and July 2022 were evaluated with dual-phase CT angiography (CTA) and CT-perfusion. The association between automated CT-perfusion values and dual-phase CTA was assessed through a correlation coefficient. Results: Pearson's coefficient demonstrated a high correlation between ischemic core volume and delayed CTA-SI with an inverse association of -0.91 and between Tmax≥6 sec volume and arterial CTA-SI with a value of -0.83. Conclusion: CTA-derived source images (CTA-SI) in two phases may be useful in the selection of patients with AIS presenting beyond the 6-hour window.

Thermal maturity of crude oils in the Baiyun sag, Pearl River Mouth basin, South China Sea: Insights from biomarkers，aromatic hydrocarbon and adamantane compounds

The Baiyun Sag in the Pearl River Mouth Basin is a hydrocarbon-rich depression in which oil and natural gas fields coexist. The complex characteristics of oil and condensate in the sag have been long-term issues, and one of the questions is the formation stage of black oil, volatile oil and gas condensate in the sag. In this study, to accurately estimate the thermal maturity of oil in the Baiyun Sag, maturity parameters derived from normal alkanes, terpanes, steranes and aromatic hydrocarbons were systematically investigated. In addition, adamantane parameters were used to verify both the oil and condensate maturity. The results show that the saturated hydrocarbon biomarker parameters are not suitable for providing a complete understanding of the oil maturity in the Baiyun Sag. A qualitative evaluation method for various maturity stages of oil was proposed based on the methylphenanthrene distribution fractions, phenyldibenzothiophene maturity parameters, and diamantane concentration. Subsequently, the maturity was quantitatively evaluated using empirical equations based on methyl diamantine. The equations were selected by comparing the calculated equivalent reflectance (Rc) with the qualitatively determined maturity stage of the crude oil. Finally, the calculated vitrinite reflectance values indicated an overestimation of the maturity of light oils and condensate oils, which were thought to be produced in the late oil window (Ro: 1.0%∼1.3%) to wet gas stage (Ro: >1.3%). The new results indicate that the black oils with Rc values ranging between 0.72% and 1.05% was generated during the peak oil window. The Rc values of gas condensates in the eastern and northeastern structural belts range from 1.20% to 1.24%, suggesting that they are products of the late oil window. The maturity levels of gas condensates in the Panyu Low Uplift are the highest (Rc: 1.14%–1.46%) in the sag. They were produced in the late oil to wet gas stages. The oil maturity characteristics confirm the oil exploration potentials of the eastern and northeastern structural belts of the Baiyun Sag.

Early-versus-Late Endovascular Stroke Treatment: Similar Frequencies of Nonrevascularization and Postprocedural Cerebrovascular Complications in a Large Single-Center Cohort Study.

Endovascular treatment of acute ischemic stroke is now performed more frequently in the late window in radiologically selected patients. However, little is known about whether the frequency and clinical impact of incomplete recanalization and postprocedural cerebrovascular complications differ between early and late windows in the real world. We retrospectively reviewed all patients with acute ischemic stroke receiving endovascular treatment within 24 hours from 2015 to 2019 and included in the Acute STroke Registry and Analysis of Lausanne. We compared rates of incomplete recanalization and postprocedural cerebrovascular complications (parenchymal hematoma, ischemic mass effect, and 24-hour re-occlusion) in the early (<6 hours) versus late window (6-24 hours, including patients with unknown onset) populations and correlated them with the 3-month clinical outcome. Among 701 patients with acute ischemic stroke receiving endovascular treatment, 29.2% had late endovascular treatment. Overall, incomplete recanalization occurred in 56 patients (8%), and 126 patients (18%) had at least 1 postprocedural cerebrovascular complication. The frequency of incomplete recanalization was similar in early and late endovascular treatment (7.5% versus 9.3%, adjusted P =.66), as was the occurrence of any postprocedural cerebrovascular complication (16.9% versus 20.5%, adjusted P = .36). When analyzing single postprocedural cerebrovascular complications, rates of parenchymal hematoma and ischemic mass effect were similar (adjusted P = .71, adjusted P = .79, respectively), but 24-hour re-occlusion seemed somewhat more frequent in late endovascular treatment (4% versus 8.3%, unadjusted P = .02, adjusted P = .40). The adjusted 3-month clinical outcome in patients with incomplete recanalization or postprocedural cerebrovascular complications was comparable between early and late groups (adjusted P = .67, adjusted P = .23, respectively). The frequency of incomplete recanalization and of cerebrovascular complications occurring after endovascular treatment is similar in early and well-selected late patients receiving endovascular treatment. Our results demonstrate the technical success and safety of endovascular treatment in well-selected late patients with acute ischemic stroke.

Effects of mindfulness and fatigue on emotional processing: an event-related potentials study.

Fatigue is a common experience in everyday life. People who experience fatigue will have more intense negative emotions, and at the same time, their positive emotions will decrease, impairing the individual's emotional processing ability. In previous research, mindfulness meditation reduces the intensity of negative emotional stimuli. However, if individuals continue to be affected by negative emotions when they are fatigued, it is unclear whether mindfulness can buffer the negative association between fatigue and emotions. This study examined whether mindfulness meditation affects the association between fatigue and emotions, using event-related potentials (ERPs). One hundred and forty-five participants completed the experiment. They were randomly assigned to the Mindfulness or Non-mindfulness group; and they were presented with positive, neutral, or negative pictures in an emotional processing task before and after mindfulness or rest. Late positive potential (LPP) is an important indicator of emotional stimuli perceived by individuals, and positive or negative pictures can induce an increase in LPP amplitude more than neutral pictures. Our findings suggest that fatigue significantly affected individuals' LPP amplitudes in the early, mid, and late windows in the Non-mindfulness group, specifically, the more fatigued individuals had lower LPP amplitudes, but not in the Mindfulness group. These results suggest that in a state of fatigue, mindful individuals are able to maintain responsiveness to emotional stimuli by maintaining LPP amplitude. Our study has demonstrated that mindfulness meditation, to some extent, offsets the negative association of fatigue with the neural activation of emotions.

Expectation violations produce error signals in mouse V1.

Repeated exposure to visual sequences changes the form of evoked activity in the primary visual cortex (V1). Predictive coding theory provides a potential explanation for this, namely that plasticity shapes cortical circuits to encode spatiotemporal predictions and that subsequent responses are modulated by the degree to which actual inputs match these expectations. Here we use a recently developed statistical modeling technique called Model-Based Targeted Dimensionality Reduction (MbTDR) to study visually evoked dynamics in mouse V1 in the context of an experimental paradigm called "sequence learning." We report that evoked spiking activity changed significantly with training, in a manner generally consistent with the predictive coding framework. Neural responses to expected stimuli were suppressed in a late window (100-150ms) after stimulus onset following training, whereas responses to novel stimuli were not. Substituting a novel stimulus for a familiar one led to increases in firing that persisted for at least 300ms. Omitting predictable stimuli in trained animals also led to increased firing at the expected time of stimulus onset. Finally, we show that spiking data can be used to accurately decode time within the sequence. Our findings are consistent with the idea that plasticity in early visual circuits is involved in coding spatiotemporal information.

Effects of synthetic maturation on phenanthrenes and dibenzothiophenes over a maturity range of 0.6 to 4.7% EASY%Ro

As the exploration target of the shale gas industry is shifting to more deeply buried strata, it is of great application value to study the distribution of molecular maturity ratios in the late dry gas zone and the mechanisms behind them for a robust thermal maturity evaluation. This study investigates the continuous molecular evolution of parent and alkylated phenanthrenes (P, A-Ps), anthracenes (An, A-An), and dibenzothiophenes (DBT, A-DBTs) during the synthetic maturation (Gold tube hydrous pyrolysis) from 0.6% to 4.7% EASY%Ro of two marine shales. The two untreated samples show different elemental composition, bulk geochemistry, and molecular geochemistry characteristics. The distribution sequence of classes with different degrees of alkylation indicates that higher reaction energy is needed for the demethylation of compounds with a lower degree of alkylation. However, the occurrence of trimethyl- and dimethyl-classes of A-Ps and A-DBTs at 550 °C (EASY%Ro: 4.4%) and 600 °C (EASY%Ro: 4.7%) is proposed to result from the breakdown of pyrobitumen at high pyrolysis temperature. The inclusion of An with P when calculating maturity ratios has an influence on their correlation with EASY%Ro at very high maturity. Common molecular thermal ratios including MPI-1, MPI-3, MPDF, MPR, and DMPR were calculated and compared with previous works. All proxies show general trends of firstly increasing and then decreasing along with thermal evolution. The separate trends in the molecular thermal evolution of the two source rocks could be attributed to the difference in organic matter composition and sedimentary facies. Two new thermal molecular maturity ratios applicable in the late gas window, i.e. 2+3-MDBT/4-MDBT and (2,4,6-TMDBT + 1,4,6-TMDBT)/(3,4,6-TMDBT + 2,6,7-TMDBT) are proposed based on the sensitivity of 2+3-MDBT, 2,4,6-TMDBT and 1,4,6-TMDBT isomers towards high maturity.

Specialist Perspectives on the Imaging Selection of Large Vessel Occlusion in the Late Window.

The proper imaging modality for use in the selection of patients for endovascular thrombectomy (EVT) presenting in the late window remains controversial, despite current guidelines advocating the use of advanced imaging in this population. We sought to understand if clinicians with different specialty training differ in their approach to patient selection for EVT in the late time window. We conducted an international survey of stroke and neurointerventional clinicians between January and May 2022 with questions focusing on imaging and treatment decisions of large vessel occlusion (LVO) patients presenting in the late window. Interventional neurologists, interventional neuroradiologists, and endovascular neurosurgeons were defined as interventionists whereas all other specialties were defined as non-interventionists. The non-interventionist group was defined by all other specialties of the respondents: stroke neurologist, neuroradiologist, emergency medicine physician, trainee (fellows and residents) and others. Of 3000 invited to participate, 1506 (1027 non-interventionists, 478 interventionists, 1declined to specify) physicians completed the study. Interventionist respondents were more likely to proceed directly to EVT (39.5% vs. 19.5%; p < 0.0001) compared to non-interventionist respondents in patients with favorable ASPECTS (Alberta Stroke Program Early CT Score). Despite no difference in access to advanced imaging, interventionists were more likely to prefer CT/CTA alone (34.8% vs. 21.0%) and less likely to prefer CT/CTA/CTP (39.1% vs. 52.4%) for patient selection (p < 0.0001). When faced with uncertainty, non-interventionists were more likely to follow clinical guidelines (45.1% vs. 30.2%) while interventionists were more likely to follow their assessment of evidence (38.7% vs. 27.0%) (p < 0.0001). Interventionists were less likely to use advanced imaging techniques in selecting LVO patients presenting in the late window and more likely to base their decisions on their assessment of evidence rather than published guidelines. These results reflect gaps between interventionists and non-interventionists reliance on clinical guidelines, the limits of available evidence, and clinician belief in the utility of advanced imaging.