Saving the ischemic penumbra (IP) is key in treating acute ischemic stroke (AIS). We aim to investigate the value of the apparent diffusion coefficient (ADC) map based radiomics model in the identification of IP in AIS.

This study retrospectively analyzed the data of 241 patients with AIS involving the anterior cerebral circulation who were treated in our hospital within 24 h of stroke onset from January 2014 to October 2019. With the perfusion-weighted imaging (PWI)/diffusion-weighted imaging (DWI) mismatch model as the gold standard to determine whether IP exists, we divided patients into PWI/DWI mismatch (84 cases) and non-PWI/DWI mismatch (157 cases). find more Following the DWI high signal area, the region of interest (ROI) was drawn to the maximum level of the lesions on the ADC map, and a total of 896 features were extracted. Maximum correlation and minimum redundancy (mRMR) algorithm were applied to select the optimized features subsets, and then the least absolute shrinkage and selection operator (LASSO) wthe presence of IP in patients with AIS.

The radiomics model based on the ADC map can effectively determine the presence of IP in patients with AIS.

Ventilator-associated pneumonia (VAP) is a severe complication that occurs within patients who must use ventilators in the intensive care unit (ICU). Ventilator care bundles (VCB) have been applied across many developed regions and have produced positive results in controlling VAP. In this study, we report on the implementation and effects of using VCBs to manage VAP in a general tertiary hospital in the Inner Mongolia Autonomous Region of China.

A targeted surveillance method was used to survey all the patients (n=4,716) in the ICU from June 1, 2017 to May 31, 2019. Patients from June 1, 2017 to May 31, 2018, and June 1, 2018, to May 31, 2019, were respectively divided into 2 groups the control group (2,029 patients) and intervention group (2,687 patients). These dates were selected because VCB was implemented from June 1, 2018, in our institution. The variables that were associated with VCB and observed were the head-of-bed elevation, oral care, maintenance of the pressure for the cuff of the endotracheat VCB prevents VAP. Therefore, personnel training, clinical supervision, and surveillance feedback could promote a reduction in intervention measures.

Our results show that VCB prevents VAP. Therefore, personnel training, clinical supervision, and surveillance feedback could promote a reduction in intervention measures.Radiotherapy (RT) has been widely used in the management of benign and malignant brain tumors for decades. However, complications can develop as a result of adjacent structures being exposed to radiation. As such, careful selection of patients and deciding on the most suitable modality of RT are crucial to minimize complications. In general, complications can be subdivided based on its timeline of onset; acute (few days to weeks), early delayed (1-6 months) and late (>6 months). Late complications such as cognitive decline and radiation necrosis can be debilitating and negatively impacts quality-of-life. New strategies to reduce RT-related complications such as with hippocampal sparing-WBRT, memantine, and focal RT (e.g., stereotactic radiosurgery) have had promising results and are being adopted in clinical practice. This review will focus on RT-related complications in the brain, with a focus on WBRT or SRS-related late adverse events, as well as measures to mitigate these complications.The number of countries and states that have legalized assistance in dying under various names (Medical Assistance in Dying, Death with Dignity, etc.) has continued to grow in recent years, allowing this option for more patients. Most of these laws include restrictions for eligibility based on a terminal diagnosis and estimated prognosis, as well as asking certifying providers to attest to the cognitive and psychiatric competence and capacity of patients requesting access. Some laws also require that patients must be able to ‘self-administer’ the regimen, though details vary. Such determinations can be vague and difficult to clearly apply to patients with neurologic conditions and primary or metastatic brain tumors. There is currently a lack of rigorous studies guiding providers on how to apply these important legal criteria to this special and common patient population. As access to legal assistance in dying expands, more research is needed on how to ethically apply the laws and guide patients, families and providers through the process.

The osteogenic capacity of inflammatory dental pulp stem cells (DPSCs-IPs) is reported lower than that of normal dental pulp stem cells (DPSCs-NPs). Down-regulation of Wnt4 may be the key factor affecting the osteogenic ability of DPSCs-IPs. In order to prove that the restoration of Wnt4 expression could improve the osteogenic potential of DPSCs-IPs, Wnt4 overexpressed inflammatory dental pulp stem cells (Wnt4-DPSCs-IPs) were performed to reconstruct bone defects in rats.

Human DPSCs-IPs were cultured and transfected with Wnt4 overexpression lentiviral vector. Stem cell characterization was performed by flow cytometry and induction of multidirectional differentiation. Wnt4-DPSCs-IPs were loaded onto poly (hydroxybutyrate-co-valerate) (PHBV). The compounds were engrafted into artificially-created defect in alveolar bone. The effectiveness of Wnt4-DPSCs-IPs/PHBV in bone regeneration was assessed by micro-CT and immunohistochemical staining of osteocalcin, a representative osteogenic marker.

Collecting data showed that Wnt4 overexpression didn’t change stem cell characteristics of DPSCs-IPs. Wnt4-DPSCs-IPs retain osteogenic, adipogenic and chondrogenic differentiation abilities. Wnt4-DPSCs-IPs/PHBV were more effective than DPSCs-IPs/PHBV in repair of rat bone defects by 3 months’ post-surgical reconstruction.

Restoration of Wnt4 expression could improve the osteogenic potential of DPSCs-IPs. Wnt4 restored DPSCs-IPs may be a feasible resource of seed cells for bone regeneration in future clinical application.

Restoration of Wnt4 expression could improve the osteogenic potential of DPSCs-IPs. Wnt4 restored DPSCs-IPs may be a feasible resource of seed cells for bone regeneration in future clinical application.