Chunlan (China)

Abstract Fc receptors (FcRs) polymorphisms may affect the affinity of rituximab for antibody-dependent cellular cytotoxicity (ADCC) effector cells. The C1qA polymorphism may influence C1q levels, but their significance in treatment response and survival is unknown. This study evaluated the role of FCGR3A, C1qA, and HLA-G polymorphisms in the outcomes of patients with diffuse large B cell lymphoma (DLBCL) treated with rituximab and chemotherapy. Genomic DNA was isolated from the peripheral blood in 314 patients with newly diagnosed DLBCL. The association of polymorphisms in FCGR3A, C1qA, and HLA-G genes with overall response rate (ORR) and overall survival (OS) was analyzed. The ORR for FCGR3A genotypes VV, FV, and FF were 90.3, 82.7, and 84.7%, respectively, there was no statistical difference (P > 0.05). A significant difference was observed in the 5-year OS rate between the FF (51.8%), FV (66.9%), and VV (74.2%) genotypes (P = 0.009). The 5-year OS rate for patient with FF genotypes treated for ≤ six cycles was significantly lower than those treated for > six cycles (46 vs. 65.1%, P = 0.018). No statistically significant relationship was found between the C1qA gene polymorphism and patients' outcomes (P > 0.05). The HLA-G gene polymorphism was rarely detected in this study. FCGR3A gene polymorphism was associated with the survival of DLBCL patients and acted as an independent prognostic factor. Prolonged treatment has been anticipated to improve patients’ survival among rituximab-insensitive FF genotype patients. In contrast, more than six cycles of treatment did not result in additional survival benefits for patients with rituximab-sensitive VV and FV genotype.

Abstract The advancement of lithium‐ion batteries (LIBs) calls for superior electrolyte design to satisfy the booming demands of energy storage markets. Despite being typically indispensable in modern electrolytes, ethylene carbonate (EC) exhibits strong affinity with Li+ and derives organic‐rich SEI, leading to sluggish interfacial dynamics and unsatisfied rate capability. Here, we construct a kinetically favorable electrolyte based on linear carbonates (DMC) and fluoroethylene carbonate (FEC) with functional non‐solvating cosolvent, fluorobenzene (FB). Specifically, DMC and FEC, as weak binding solvents, show facile interfacial kinetics. FB enables a loose coordination chemistry through dipole‐dipole interaction, further lubricating Li+ desolvation and transport through SEI at interphase, which accelerates electrochemical kinetics and enables improved rate performance (257 mA h g−1 is achieved for graphite at 6 C). Moreover, the optimized electrolyte shows decent graphite compatibility, long‐term stability (75 % capacity retention after 350 cycles for NCM622/graphite pouch cells at 1 C) and wide‐temperature adaptability (−40~160 °C). This work reveals that dipole‐dipole interaction between non‐solvating cosolvents and solvents can effectively lower desolvation energy barrier and ultimately enable good rate capability, which provides a new avenue for designing EC‐free electrolyte in high‐rate LIBs.

Background: Large infarct cores on CT or CTP were an exclusion from most trials of Endovascular thrombectomy (EVT). However, large cores may be seen in occasional patients presenting within the early window (0-3 hours) and may not preclude potential benefit from thrombectomy. We studied clinical outcomes with thrombectomy in patients presenting with large cores measured by CT or CTP within 3 hours of last known well (LKW). Methods: From a multicenter prospective cohort study of imaging selection for EVT (SELECT), patients with a large ischemic core (CBF<30%) > 50cc or ASPECT≤5 presenting within 3 hours from LKW to imaging were identified. All patients received CT and CTP with mismatch determination by RAPID software. A blinded independent core-lab adjudicated all images. Good (90 day mRS 0-2) and safety (sICH and mortality) outcomes were compared between patients who received EVT and those with medical management (MM) only. Results: Of 445 patients enrolled, 54 met criteria for large core and early presentation; 28 had ASPECT≤5 (17 EVT, 11 MM) and 40 had CTP >50 cc (26 EVT, 14 MM) and 14 on both CT and CTP. Median (IQR) age 66 years (60, 75), NIHSS 20 (18, 23), LKW to puncture 162 min (range 69-343). Baseline characteristics were similar between EVT and MM. Patients with large core whether on CT (ASPECT≤5) or CTP (CBF>50cc) had more frequent good outcome with EVT (30% overall, CT 35%, and CTP 27% vs 0% MM, p=0.04, Fig 1) Furthermore, EVT resulted in smaller average final infarcts (77 vs 202 ml, p=0.03), similar mortality (31% vs 29%, p=0.87) and sICH (16% vs 6%,p=0.34). In patients who achieved good outcome with thrombectomy, EVT resulted in smaller infarct growth 31 ml (10-58) vs 111 cc (67-233) in patients who had poor outcome, p=0.01. Outcome rates were similar if large core was defined as >70ml. Conclusion: Patients with large core infarct measured by CT or CTP presenting within 3 hours may benefit from EVT. Time may trump imaging in patients with large core who present early.

In this paper, we report a new method to activate and control a piezoelectric linear motor using a switching light source through two transparent electrodes and a photoconductive coating. This coating is composed of titanium oxide phthalocyanine (TiOPc), electron transport materials, hole transport materials, and polyvinyl butyral binder. It is used to replace one of the surface electrodes of a piezoelectric serial bimorph to provide an optical interface and to construct an optopiezoelectric composite. The weight percentage of TiOPc nanoparticles, solvent compositions, and film thickness are studied to identify the optimal coating to match the electrical impedance of the piezoelectric serial bimorph in both on and off states. Experimental results show that the photoconductive coating has a good on–off ratio and low electrical impedance under conditions of high concentration of TiOPc, small film thickness, high light intensity, and low frequency. To design this motor based on a one-frequency-two-mode driving method, an analytical solution is derived and an optopiezoelectric linear motor (OP-LM) is developed. Our analytical analysis, finite element simulation, and experimental results demonstrate that traveling waves can be generated by driving this motor at a frequency between the first and the second bending modes with a 90° phase difference between two designed actuating areas. The optimal condition is to match the driving frequency and light switching frequency. The moving direction and velocity of objects in different weight can be optically controlled by illuminating different areas of an optopiezoelectric motor with two 10 W power LEDs and masks. Discussions on the developed theory, simulation, and experimental studies of the OP-LM are provided in this paper.

Background: Interpersonal relationships are understudied components of the stroke treatment paradigm, which become important when patients require long-term care. In this study, we analyzed sociodemographic factors that impact return to home after inpatient rehabilitation (IR). Methods: Stroke patients were identified by ICD9/10 code from a prospective multicenter rehabilitation registry between Jan 2005 & July 2016 (n=6447). Patients were analyzed based upon "Home" vs "Not Home" or "Married" vs "Not Married" groups. Descriptive statistics were provided for all patients. Marital status was used as a proxy for caregiver support. We hypothesized that increased discharge functional independence measure (FIM), ambulation and no insurance predicted return to home. A “return home model” was developed using multivariable regression with a stepwise approach. Odds ratio & 95% CI were calculated. Results: 5378 patients returned Home, 1069 did not return Home. Home patients tended to be younger, married, ambulatory and minorities, with a discharge FIM>75 (p<0.0001). Aphasia, dysphagia and UTI were significantly higher in the “Not Home” group (p<0.0001). Married patients had more stroke risk factors and impairments, indicating increased caregiver needs (Figure). In the model, being a minority and being a woman increased the odds of returning home. Advancing age, being widowed, divorced, separated or never married decreased the odds of returning home. We confirmed that ambulation, increasing discharge FIM and no insurance predicted return to home (Figure). Conclusions: Being married, a woman or a minority increases the odds of returning home after inpatient rehabilitation. Caregiver training and social support for unmarried and male patients are important areas of improvement. Strategies to ensure the successful transition of stroke rehabilitation patients to home are needed, including prospective studies of non-spousal caregiver support.

Background: Few studies have reported electrocardiographic (ECG) changes in patients with intracerebral hemorrhage (ICH). We performed a randomized controlled trial evaluating the safety of pioglitazone (PIO) versus placebo in patients with ICH (NCT00827892). Cardiac toxicity was evaluated with serial ECG. Methods: Patients enrolled into the Safety of Pioglitazone for Hematoma Resolution in ICH (SHRINC) trial were randomly allocated 1:1 to either placebo or PIO. Patients received escalating doses of PIO daily for 3 days (high-dose phase) beginning within 24 hours of symptom onset, followed by a 30mg maintenance dose for the duration of treatment. Serial ECGs were performed at baseline and on days 1, 2, 3 and 90. Zero inflated Poisson regression was used to model the relationship between treatment with PIO and the likelihood of observing new important ECG findings during the high-dose phase. Results: A total of 84 patients were enrolled in SHRINC (42 PIO, 42 placebo). At baseline, 60% of patients in both groups had important abnormal ECG findings, the most common being prolonged QT (Table 1a). During the high-dose phase, 51% in the PIO group and 46% in the placebo group developed at least one new important abnormal ECG finding (Table 1b). In multivariable analysis, after controlling for age, diabetes, baseline PTT, baseline systolic and diastolic blood pressure, PIO was not associated with the likelihood of developing any new important abnormal ECG findings, Rate Ratio 1.27, 95% CI (0.71, 2.28), p=0.42. Conclusions: ECG findings in this cohort of ICH patients were dynamic in the first 72 hours with most patients having abnormal ECGs at baseline and almost half of the cohort developing new findings. The addition of a placebo group allowed us to incorporate the natural history of ICH in our analysis to more clearly understand the effect of PIO. We did not find cardiac toxicity due to PIO as evidenced by ECG changes during the follow up period.

Objective: Telemedicine (TM) has increased the use of intravenous (IV) tissue plasminogen activator (tPA) for management of acute ischemic stroke. Despite its known safety in guiding tPA treatment, TM has not been formally embedded into stroke fellowship training. We compared the safety of tPA administration via TM consultation by neurovascular fellows (NVFs) versus neurovascular attendings (NVAs). Methods: In a retrospective chart review from 4/12 to 4/13, we identified 137 patients who were given IV-tPA at the advice of a NVA or NVF in our 14 spoke TM network. We abstracted baseline characteristics and clinical variables. We compared outcomes in patients treated by NVFs versus NVAs. Logistic regression was performed to compare rates of symptomatic intracranial hemorrhage (sICH), neurological worsening (an increase in NIHSS of ≥2 regardless of etiology), angioedema, and death. Median time between symptom onset and tPA administration was also compared between NVFs and NVAs. Results: Table 1 illustrates baseline characteristics. Of 137 consecutive patients given IV-tPA via TM, fellows treated 48 patients (35%). The sICH rates between patients treated by NVFs and those by NVAs were not significantly different (2.1% vs 1.1%, p=1.00) (Table 2). Neurologic worsening occurred in 6.3% of cases treated by NVFs and 6.7% by NVAs (p=1.00). The rates of angioedema between patients treated by NVFs and those by NVAs were not significantly different (0% vs 1.1%) (Table 2). While death rate was higher in patients treated by NVAs (4.5% vs 0%), this increment was not significant (Table 2). The median minutes between symptom onset and tPA administration was 10.5 more for NVFs than NVAs (143 vs 132.5, p<0.05) (Table 2). Conclusion: Although NVFs took more time to give tPA compared to NVAs, administration of IV tPA via telemedicine was safe when advised by NVFs compared with NVAs. This finding supports the feasibility of formally integrating telemedicine exposure into fellowship training.

Liquid-liquid circulating fluidized bed(LLCFB), which is a novel method of dynamic ice-making, was studied using direct contact heat transfer between droplets and the coolant. In the paper the key problems on droplets formation in LLCFB were investigated by the high resolution digital camera and image processing, the photos of drop formation were obtained. The effects of the shape of jet breakup, jet length on the size and uniformity of drops were revealed. The characteristic of particles size distribution was also presented.