Search Results (38)

Aim of the study: Traditional Chinese herbs have a unique therapeutic effect on stroke and numerous successful clinical cases. However, these clinical cases are highly dispersed, creating challenges for translational research. This study employs a new paradigm to identify treatment patterns and the active compound interactions contained within these clinical cases, with experimental validation after target screening. Methods and Materials: Stroke-related targets were identified through GEO, DisGeNET, and Genecards. Active ingredients were extracted from BATMAN-TCM 2.0. All herbs and diseases were confirmed by the Pharmacopoeia of the People’s Republic of China (2020 edition) and Medical Subject Heading (MeSH). All networks in this study were constructed by Cytoscape, and data analysis was done by Python. All formulations and herbs were retrieved from the literature review. For the molecular docking process, Autodock was applied as the docking platform, and all the protein structures were downloaded from PDB. For experimental validation after target screening, HT22 cells were incubated with glucose-free DMEM and placed in an anaerobic chamber for 2 h. Subsequently, HT22 cells were reoxygenated for 24 h. Estrogen Receptor 1 (ESR1) protein levels were measured in vitro. Results: seven materials, including Angelicae Sinensis Radix, Pheretima, Chuanxiong Rhizoma, Persicae Semen, Astragali Radix, Carthami Flos, and Radix Paeoniae Rubra, were identified as the core herbs for the treatment of stroke. The targets of the stroke mechanism were screened, and the herbs-compound-target network was constructed. Among them, paeoniflorin (PF) was identified as the core active compound, and its interaction with ESR1 was verified by molecular docking as the key interaction for the treatment of stroke. In vitro experiments showed that PF inhibited cell apoptosis under hypoxia by increasing the expression of ESR1 compared with the oxygen-glucose deprivation-reperfusion (OGD/R) model group. Western showed that PF (100 μM, 200 μM) can significantly increase the decreased ESR1 protein level caused by the OGD/R model. Conclusions: seven key herbs were screened. Further bioinformatics and network pharmacology studies suggested that PF is expected to become a new active compound for the treatment of stroke. In vitro validation further demonstrated that PF enhanced neuronal survival and ESR1 expression under ischemic conditions, supporting its therapeutic candidacy. Full article

Background: This systematic review assessed the current literature regarding the analgesic treatment of central neuropathic pain (CNP) in central nervous system (CNS) conditions, such as spinal cord injuries, multiple sclerosis, post-stroke disorders, and Parkinson’s disease. The aim of this systematic review was to compare the current algorithmic treatment of CNP, which generally does not discriminate among underlying conditions, with RCTs investigating algorithm-recommended and non-algorithm-recommended drugs for differing underlying conditions. Methods: The PubMed and EMBASE databases were used to identify relevant randomized control trials (RCTs). MeSH terms and EmTree terms were searched as well as free text words in the title/abstract of the studies. A risk of bias tool was used to assess all included studies. Results: A total of 903 RCTs were identified from the initial search. Thirty-eight RCTs published between January 2002 and November 2024 fulfilled all the inclusion criteria and none of the exclusion criteria. The review investigated progressive and stable neurological diseases and conditions with associated CNP. Conclusions: From the majority of the included studies, the current recommended treatment algorithm seems to be effective and safe; however, the underlying condition seems to influence how the patient responds to tier-appropriate medication. Full article

The dynamic response of pump valve motion directly influences the volumetric efficiency of drilling pumps and serves as a critical factor in performance enhancement. This study presents a coupled fluid–structure interaction (FSI) analysis of a novel secondary cushioned pump valve for drilling systems. A validated 3D transient numerical model, integrating piston–valve kinematic coupling and clearance threshold modeling, was developed to resolve the dynamic interactions between reciprocating mechanisms and turbulent flow fields. The methodology addresses critical limitations in conventional valve closure simulations by incorporating a geometrically adaptive mesh refinement strategy while maintaining computational stability. Transient velocity profiles confirm complete sealing integrity with near-zero leakage (<0.01 m/s), while a 39.3 MPa inter-pipeline pressure differential induces 16% higher jet velocities in suction valves compared to discharge counterparts. The secondary cushioned valve design reduces closure hysteresis by 22%, enhancing volumetric efficiency under rated conditions. Parametric studies reveal structural dominance, with increases in cylindrical spring stiffness lowering discharge valve lift by 7.2% and velocity amplitude by 2.74%, while wave spring optimization (24% stiffness enhancement) eliminates pressure decay and reduces perturbations by 90%. Operational sensitivity analysis demonstrates stroke frequency as a critical failure determinant: elevating speed from 90 to 120 rpm amplifies suction valve peak velocity by 59.87% and initial closing shock by 129.07%. Transient flow simulations validate configuration-dependent performance, showing 6.3 ± 0.1% flow rate deviations from theoretical predictions (Q_{t_max} = 40.0316 kg/s) due to kinematic hysteresis. This study establishes spring parameter modulation as a key strategy for balancing flow stability and mitigating cushioning-induced oscillations. These findings provide actionable insights for optimizing high-pressure pump systems through hysteresis control and parametric adaptation. Full article

Atrial leadless pacemakers (ALPMs) offer a minimally invasive solution for patients requiring atrial pacing, but current designs face significant challenges related to fixation stability, perforation risk, and retrievability. This study presents a novel self-expanding nitinol fixation system designed for deployment within the left atrial appendage (LAA), incorporating a flexible adapter for secure pacemaker engagement and retrieval. Finite-element simulations were conducted to assess gravitational displacement across different anatomical orientations, and fixture-expansion behavior was analyzed under various mesh configurations. The pacemaker drop analysis results demonstrated minimal displacement in neutral and upward-tilted LAA models, with increased instability observed in downward-tilted orientations. The fixture-expansion study showed that the 0.2 mm mesh design provided adequate mechanical strength and strain tolerance while maintaining a compact profile. This novel fixation system improves current ALPM limitations by providing stable, retrievable anchoring and favorable biomechanical performance. It may also serve as a dual-function platform for atrial pacing and stroke prevention when integrated with a left atrial appendage (LAA) occluder. These findings support further preclinical validation for clinical translation. Full article

Background/Objectives: Sleep-disordered breathing (SDB), historically referred to as “sleep apnea syndrome”, particularly obstructive sleep apnea (OSA), is an independent risk factor for hypertension (HTN), stroke, heart failure, arrhythmias, and other cardiovascular disorders. Despite the well-established link between OSA and HTN and its high occurrence in cardiovascular disorders, the focus on the complex OSA–HTN axis is often overlooked or inadequately managed, which might explain the lack of notable improvements in cardiovascular outcomes for this patient population. Understanding the complex relationship between OSA and HTN is crucial due to its significant implications for clinical practice and public health. Methods: Using an expanded list of relevant MeSH terms, including “sleep-disordered breathing” and “sleep apnea syndrome”, and following the PRISMA model, peer-reviewed articles were systematically selected. Studies published from January 2000 through December 2024 were identified and screened based on predefined inclusion and exclusion criteria. Results: This review emphasizes both OSA’s independent and interaction effects on cardiovascular health and outcomes across different populations. It identifies key factors mediating the association between OSA and HTN. Conclusions: Multimodal management, including continuous positive airway pressure and lifestyle modification, is essential for treating hypertension related to OSA. Effective management of the OSA–HTN relationship is vital to improving cardiovascular outcomes. Full article

Background: Carotid web (CaW) usually presents as a shelf-like intimal flap at the beginning of the internal carotid artery. It has been proven that CaW is associated with ischemic stroke, particularly in young patients without other risk factors. This case report aimed to describe the carotid web that causes ischemic stroke due to embolic complications. Moreover, both pathologies were successfully treated with endovascular techniques in the presented case study. Methods: A 59-year-old male presented to the neurological department with motor aphasia, right-sided weakness, and hypoesthesia. Computer tomography (CT) of the head and computed tomography angiography (CTA) of the aortic arch and intracranial arteries were performed. Due to the unknown onset of the presented stroke symptoms, diagnostics were extended to magnetic resonance (MR), and based on this, the patient qualified for immediate mechanical thrombectomy (according to the DAWN trial protocol). Intraoperative digital subtraction angiography (DSA) revealed embolism material in the left middle cerebral artery (segment M1). The artery was recanalized via aspiration thrombectomy using the Penumbra system, and complete restoration of flow was obtained (according to the TICI scale). In addition, DSA revealed the presence of CaW changes in the left internal carotid artery (LICA). In the control CT scanning, an acute ischemic area in the left temporal lobe was found. After the treatment, the patient demonstrated complete neurological improvement from his initial presentation. He qualified for carotid artery stenting of the LICA, which was postponed to a later period due to the presence of an area of infarction. The angioplasty with stenting was performed 6 months later, and a carotid antiembolic “mesh” stent (Roadsaver, Terumo) was implanted into the LICA across the carotid web. Conclusions: CaW should be considered in the case of stroke resulting from unknown causes. The presented case study demonstrated that both carotid web and ischemic stroke pathologies can be effectively treated with emerging endovascular techniques. Full article

This paper presents the results of numerical simulations examining the thermodynamic processes during hydraulic hydrogen compression, using COMSOL Multiphysics^® 6.0. These simulations focus on the application of hydrogen compression systems, particularly in hydrogen refueling stations. The computational models employ the CFD and heat transfer modules, along with deforming mesh technology, to simulate gas compression and heat transfer dynamics. The superposition method was applied to simplify the analysis of hydrogen and liquid piston interactions within a stainless-steel chamber, accounting for heat exchange between the hydrogen, the oil (working fluid), and the cylinder walls. The study investigates the effects of varying compression stroke durations and initial hydrogen pressures, providing detailed insights into temperature distributions and energy consumption under different conditions. The results reveal that the upper region of the chamber experiences significant heating, highlighting the need for efficient cooling systems. Additionally, the simulations show that longer compression strokes reduce the power requirement for the liquid pump, offering potential for optimizing system design and reducing equipment costs. This study offers crucial data for enhancing the efficiency of hydraulic hydrogen compression systems, paving the way for improved energy consumption and thermal management in high-pressure applications. Full article

Background and Objectives: Traumatic spinal cord injury (SCI) is a devastating condition that occurs in two phases: primary and secondary injury. These phases contribute to changes in blood vessels and the influx of inflammatory cells such as neutrophils and lymphocytes. The biomarker known as the neutrophil-to-lymphocyte ratio (NLR) has been suggested as being highly valuable in predicting outcomes for patients with traumatic brain injury, acute ischemic stroke, and traumatic spinal cord injury. Therefore, this review study aims to investigate the prognostic value of the NLR in predicting outcomes for patients with SCI. Materials and Methods: A thorough review of relevant articles was conducted using Mesh keywords in Medline via Embase, PubMed, Google Scholar, and Scopus from 2000 to 2023. The search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. After reviewing the articles and applying inclusion and exclusion criteria, only relevant articles were included in the study. Results: In the initial search, 41 papers were identified. After applying exclusion criteria, only three clinical studies remained for review. It is still debatable whether the NLR can serve as a cost-effective, readily available, and independent predictive factor for both mortality and recovery outcomes in patients with traumatic spinal cord injuries. Conclusions: Our study demonstrates that NLR, a readily available and inexpensive marker, can serve as an independent predictor of both mortality and recovery outcomes in patients with traumatic spinal cord injury. To reach a conclusive decision, additional data are required. Full article

Background: Several COVID-19 vaccines were developed and approved in China. Of these, the BIBB-CorV and CoronaVac inactivated whole-virion vaccines were widely distributed in China and developing countries. However, the performance of the two vaccines in the real world has not been summarized. Methods: A living systematic review based on findings from ongoing post-licensure studies was conducted, applying standardized algorithms. Articles published between 1 May 2020 and 31 May 2022 in English and Chinese were searched for in Medline, Embase, WanFang Data, medRxiv, bioRxiv, arXiv, SSRN, and Research Square, using SARS-CoV-2, COVID-19, and vaccine as the MeSH terms. Studies with estimates of safety, immunogenicity, and effectiveness from receiving the BIBB-CorV or CoronaVac vaccine that met the predefined screening criteria underwent a full-text review. The Joanna Briggs Institute’s Critical Appraisal Checklist and the Cochrane risk of bias were used for assessment of the quality. A random-effects meta-regression model was applied to identify the potential impact factors on the vaccines’ effectiveness. Results: In total, 32578 articles were identified, of these, 770 studies underwent a full-text review. Eventually, 213 studies were included. The pooled occurrence of solicited and unsolicited adverse events after any dose of either vaccine varied between 10% and 40%. The top five commonly reported rare adverse events were immunization stress-related responses (211 cases, 50.0%), cutaneous responses (43 cases, 10.2%), acute neurological syndrome (39 cases, 9.2%), anaphylaxis (17 cases, 4.0%), and acute stroke (16 cases, 3.8%). The majority (83.3%) recovered or were relieved within several days. The peak neutralization titers against the ancestral strain was found within 1 month after the completion of the primary series of either vaccine, with a GMT (geometric mean titer) of 43.7 (95% CI: 23.2–82.4), followed by a dramatic decrease within 3 months. At Month 12, the GMT was 4.1 (95% CI: 3.8–4.4). Homologous boosting could restore humoral immunity, while heterologous boosting elicited around sixfold higher neutralization titers in comparison with homologous boosting. The effectiveness of receiving either vaccine against death and severe disease was around 85% for both shortly after the primary series. At Month 12, the protection against death did not decline, while the protection against severe disease decreased to ~75%. Conclusions: Both the BIBP-CorV and CoronaVac inactivated vaccines are safe. Sustained vaccine effectiveness against death was determined 12 months after the primary series, although protection against severe disease decreased slightly over time. A booster dose could strengthen the waning effectiveness; however, the duration of the incremental effectiveness and the additional benefit provided by a heterologous booster need to be studied. Full article

In recent years, convolutional neural networks (CNNs) have emerged as highly efficient architectures for image and audio classification tasks, gaining widespread adoption in state-of-the-art methodologies. While CNNs excel in machine learning scenarios where the data representation exhibits a grid structure, they face challenges in generalizing to other data types. For instance, they struggle with data structured on 3D meshes (e.g., measurements from a network of meteorological stations) or data represented by graph structures (e.g., molecular graphs). To address such challenges, the scientific literature proposes novel graph-based convolutional network architectures, extending the classical convolution concept to data structures defined by graphs. In this paper, we use such a deep learning architecture to examine graphs defined using the ICD-10 codes appearing in the medical data of patients who suffered hemorrhagic stroke in Hungary in the period 2006–2012. The purpose of the analysis is to predict the risk of stroke by examining a patient’s ICD graph. Finally, we also compare the effectiveness of this method with classical machine learning classification methods. The results demonstrate that the graph-based method can predict the risk of stroke with an accuracy of over 73%, which is more than 10% higher than the classical methods. Full article

Slicing 3D polygonal meshes is a fundamental operation in various applications such as virtual surgery, garment simulation, and game development. Existing methods primarily slice meshes using either a single line or a set of line segments approximating a smooth curve. This paper introduces a novel approach to freely slice a triangle mesh using a freeform curve without discretizing it into line segments. The user draws a stroke on the screen, defining the desired cutting trajectory. Subsequently, a freeform curve approximating this stroke is generated and extended into a ruled surface in the user’s viewing direction. To efficiently compute intersections between the ruled surface and a triangle mesh, the Line–Surface Intersection (LSI) problem is broken down into two subproblems: Plane–Curve Intersection (PCI) followed by Line–Line Intersection (LLI). Intersection points are then connected to form polylines, effectively cutting the mesh into multiple submeshes. To ensure the solidity of the submeshes, cross-sections are generated by trimming the ruled surface along the polylines and merged with the corresponding submeshes. Our method empowers users to slice triangle meshes along arbitrary trajectories encompassing both straight and freely curved paths while preserving efficiency and accuracy. The effectiveness of the proposed approach is demonstrated through experimental results showing various examples of mesh slicing. Full article

Percutaneous closure of the patent foramen ovale (PFO) is generally regarded as a safe and effective procedure, indicated in patients with a prior PFO-associated stroke. While it is highly safe, rarely, it could be accompanied by a migration of the device, mainly caused by the interplay of a specific PFO morphology and inappropriate device sizing. Herein, we outline a seldom-observed complication of an unintentional detachment of the PFO closure device during implantation, leading to its migration into the abdominal aorta, and a unique management approach. Due to the inability to recapture the occluder with a snare, which is considered to be a mainstay of endovascular retrieval methods, two coronary guidewires were maneuvered through the mesh of the occluder and then captured with a snare proximally to the occluder. This innovative dual-wire–snare system was carefully pulled to the common femoral artery, a position deemed suitable for surgical extraction via arteriotomy, which was achieved successfully. Full article

Perineuronal nets (PNN) are a special highly structured type of extracellular matrix encapsulating synapses on large populations of CNS neurons. PNN undergo structural changes in schizophrenia, epilepsy, Alzheimer’s disease, stroke, post-traumatic conditions, and some other brain disorders. The functional role of the PNN microstructure in brain pathologies has remained largely unstudied until recently. Here, we review recent research implicating PNN microstructural changes in schizophrenia and other disorders. We further concentrate on high-resolution studies of the PNN mesh units surrounding synaptic boutons to elucidate fine structural details behind the mutual functional regulation between the ECM and the synaptic terminal. We also review some updates regarding PNN as a potential pharmacological target. Artificial intelligence (AI)-based methods are now arriving as a new tool that may have the potential to grasp the brain’s complexity through a wide range of organization levels—from synaptic molecular events to large scale tissue rearrangements and the whole-brain connectome function. This scope matches exactly the complex role of PNN in brain physiology and pathology processes, and the first AI-assisted PNN microscopy studies have been reported. To that end, we report here on a machine learning-assisted tool for PNN mesh contour tracing. Full article

Objectives: post-stroke depression (PSD), cognitive impairment, and sleep disturbances are the most common post-stroke conditions. To aid clinical practice for a highly confounded clinical problem, a clearer understanding of the associations between comorbid PSD, post-stroke cognitive impairment, and sleep disturbances is necessary. Materials and Methods: a scoping review of the literature was conducted according to the recommended guidelines using the search term [“stroke (mesh term) AND depression (in the abstract) AND cognitive (in the abstract) AND sleep (in the abstract)”]. Results: 10 studies met the criteria for inclusion. Only one study reported a co-occurrence of post-stroke emotional distress and sleep disturbances at a rate of 10.7%. Poor sleep and cognitive impairment are independent risk factors for PSD. The relationship between post-stroke poor sleep and cognitive impairment is ambiguous. None of the studies examined how PSD, cognitive impairment, and sleep disturbances interact to influence stroke outcomes. Conclusions: the dearth of studies indicates either a lack of awareness of the potential relationship between the three outcomes and the possible range of inter-related non-motor outcomes after stroke or the practical challenges in designing appropriate studies. The included studies had methodological weaknesses in their observational design and use of imprecise, subjective outcome measurements. Important knowledge gaps are identified for future research. Full article

Background: This study investigates the relationship between sleep patterns and ischemic stroke beyond the predominant focus on obstructive sleep apnea. Through a systematic review of the existing literature, we aim to elucidate the connections between insomnia, sleep duration, cardiovascular factors, and ischemic stroke onset. Methods: We searched databases, including MEDLINE, SciELO, Scopus, and Science Direct, using an adapted PICO framework. Using a search strategy with MeSH words, keywords, and expressions related to insomnia and stroke, we included clinical trials and analytical observational epidemiological studies, comprising cohort, case–control, and cross-sectional studies. Results: Following the initial search, we identified 984 records, with 779 titles and abstracts screened for eligibility after removing duplicates. From these, 63 full-text articles, including 5 in the data synthesis, were reviewed. Our findings highlight a significant correlation between poor sleep quality, extreme sleep durations, and a heightened risk of ischemic stroke, along with established cardiovascular risk factors, such as hypertension, hyperlipidemia, obesity, and diabetes. Conclusions: This systematic review offers a comprehensive analysis of ischemic stroke prevalence and its association with cardiovascular factors, such as hypertension, hyperlipidemia, obesity, and diabetes. It suggests that poor sleep quality and extreme sleep durations, particularly long ones, are linked to a heightened risk of ischemic stroke. Full article