Early Versus Delayed Antihypertensive Treatment After Acute Ischemic Stroke by Hypertension History.

Background: We performed a prespecified subgroup analysis of the CATIS-2 trial (China Antihypertensive Trial in Acute Ischemic Stroke II) to compare the effect of early versus delayed antihypertensive treatment on death and disability in patients with and without medical history of hypertension.

Methods: CATIS-2 is a multicenter randomized clinical trial conducted in 106 hospitals in China. The trial randomized 4810 patients with acute ischemic stroke within 24 to 48 hours of symptom onset and elevated systolic blood pressure between 140 and <220 mm Hg to receive antihypertensive treatment immediately after randomization or to discontinue antihypertensive medications for 7 days and then receive treatment on day 8.

Prospective validation of ORACLE, a clonal expression biomarker associated with survival of patients with lung adenocarcinoma.

Human tumors are diverse in their natural history and response to treatment, which in part results from genetic and transcriptomic heterogeneity. In clinical practice, single-site needle biopsies are used to sample this diversity, but cancer biomarkers may be confounded by spatiogenomic heterogeneity within individual tumors. Here we investigate clonally expressed genes as a solution to the sampling bias problem by analyzing multiregion whole-exome and RNA sequencing data for 450 tumor regions from 184 patients with lung adenocarcinoma in the TRACERx study.

Facile synthesis of 2-sulfonylbenzothiazoles cascade SO-NCS addition and S-C(sp) coupling.

A new synthetic route to 2-sulfonylbenzothiazoles (BtsR) employing cascade SO-NCS nucleophilic addition and CuI-catalysed S-C(sp) coupling was developed. Structurally diverse BtsR molecules were readily afforded in high yields from the rapid and benign reaction of 2-iodoarylisothiocyanates with sodium sulfinates in DMSO, generally without the need for further column isolation.

Toward expert-level medical question answering with large language models.

Large language models (LLMs) have shown promise in medical question answering, with Med-PaLM being the first to exceed a 'passing' score in United States Medical Licensing Examination style questions. However, challenges remain in long-form medical question answering and handling real-world workflows. Here, we present Med-PaLM 2, which bridges these gaps with a combination of base LLM improvements, medical domain fine-tuning and new strategies for improving reasoning and grounding through ensemble refinement and chain of retrieval.

The continually evolving landscape of novel therapies in oncogene-driven advanced non-small-cell lung cancer.

Non-small-cell lung cancer (NSCLC) is a highly heterogeneous disease that is frequently associated with a host of known oncogenic alterations. Advances in molecular diagnostics and drug development have facilitated the targeting of novel alterations such that the majority of NSCLC patients have driver mutations that are now clinically actionable. The goal of this review is to gain insights into clinical research and development principles by summary, analysis, and discussion of data on agents targeting known alterations in oncogene-driven, advanced NSCLC beyond those in the and the .

Clonal Integration Promotes the Photosynthesis of Clonal Plant Under Heterogeneous Pb and/or Pyrene Stress.

Clonal plants can support the growth of their ramets in heterogeneous environments through clonal integration between the ramets. However, the role of clonal integration in modulating ramet photosynthesis under toxic stress, especially combined stress, is unclear. This study examines the impact of clonal integration on under three heterogeneous stresses (Pb, pyrene, and Pb+Pyrene) with two stolon connection conditions (connected and disconnected).

Acute Myeloid Leukemia with Normal Cytogenetics and -Mutation: Impact of Mutation Topography on Outcomes.

: About half of adults with acute myeloid leukemia with normal cytogenetics (CN-AML) have mutations. There is controversy regarding their prognosis and best therapy. : We studied 150 subjects with these features using targeted regional sequencing.

Large-Scale Plasma Proteomics Improves Prediction of Peripheral Artery Disease in Individuals With Type 2 Diabetes: A Prospective Cohort Study.

Objective: Peripheral artery disease (PAD) is a significant complication of type 2 diabetes (T2D), yet the association between plasma proteomics and PAD in people with T2D remains unclear. We aimed to explore the relationship between plasma proteomics and PAD in individuals with T2D, and assess whether proteomics could refine PAD risk prediction.

Research Design And Methods: This cohort study included 1,859 individuals with T2D from the UK Biobank.

Source Material Design for Realizing >50% Indium-Saving Transparent Electrode toward Sustainable Development of Silicon Heterojunction Solar Cells.

Indium (In) reduction is a hot topic in transparent conductive oxide (TCO) research. So far, most strategies have been focused on reducing the layer thickness of In-based TCO films and exploring TCOs. However, no promising industrial solution has been obtained yet.

Single-cell RNA sequencing identifies CXADR as a fate determinant of the placental exchange surface.

The placenta is the critical interface between mother and fetus, and consequently, placental dysfunction underlies many pregnancy complications. Placental formation requires an adequate expansion of trophoblast stem and progenitor cells followed by finely tuned lineage specification events. Here, using single-cell RNA sequencing of mouse trophoblast stem cells during the earliest phases of differentiation, we identify gatekeepers of the stem cell state, notably Nicol1, and uncover unsuspected trajectories of cell lineage diversification as well as regulators of lineage entry points.

Development of an individualized dementia risk prediction model using deep learning survival analysis incorporating genetic and environmental factors.

Background: Dementia is a major public health challenge in modern society. Early detection of high-risk dementia patients and timely intervention or treatment are of significant clinical importance. Neural network survival analysis represents the most advanced technology for survival analysis to date.

Fundus Curvature as a Clinical Marker for Posterior Staphyloma Based on Widefield Optical Coherence Tomography.

Purpose: To investigate the ability to quantify fundus curvature and detect posterior staphyloma using widefield optical coherence tomography (OCT).

Design: Cross-sectional diagnostic evaluation.

Methods: This study reviewed 205 highly myopic eyes of 205 participants.

Validation of novel grading schemes and refinement of the Leibovich risk groups for chromophobe renal cell carcinoma.

Background: Traditional grading systems have proven inadequate in stratifying chRCC patients based on recurrence risk. Recently, several novel grading schemes, including three-tiered, two-tiered, and four-tiered systems, have been proposed, but their prognostic value remains controversial and lacks external validation.

Materials And Methods: We included 528 patients with pathologically proven chRCC (chromophobe renal cell carcinoma) from multiple medical institutions and the Cancer Genome Atlas-Kidney Chromophobe cohort.

A modified and weighted Gower distance-based clustering analysis for mixed type data: a simulation and empirical analyses.

Background: Traditional clustering techniques are typically restricted to either continuous or categorical variables. However, most real-world clinical data are mixed type. This study aims to introduce a clustering technique specifically designed for datasets containing both continuous and categorical variables to offer better clustering compatibility, adaptability, and interpretability than other mixed type techniques.

Association between high-density lipoprotein cholesterol and risk of abdominal aortic aneurysm among males and females aged 60 years and over.

Objective: Whether high-density lipoprotein cholesterol (HDL-C) has a protective role against abdominal aortic aneurysm (AAA) development in both older males and females remains uncertain. This study aims to assess the sex-specific association between HDL-C and incident AAA in older adults from the UK Biobank.

Methods: This cohort study included 86,184 males and 95,682 females aged ≥60 years from the UK biobank.

Consensus Recommendations for Studies of Outflow Facility and Intraocular Pressure Regulation Using Ex Vivo Perfusion Approaches.

Intraocular pressure (IOP) elevation is the primary risk factor and currently the main treatable factor for progression of glaucomatous optic neuropathy. In addition to direct clinical and living animal in vivo studies, ex vivo perfusion of anterior segments and whole eyes is a key technique for studying conventional outflow function as it is responsible for IOP regulation. We present well-tested experimental details, protocols, considerations, advantages, and limitations of several ex vivo model systems for studying IOP regulation.

Elemental Sulfur/Selenium-Mediated Metal-Free Phosphinothioation and Phosphinoselenoation of Vinylsulfonium Salts with P-H Bonds.

An efficient and facile method has been developed for the construction of novel P-S-C and P-Se-C bonds by facilitating the three-component cross-coupling reaction of P-H bonds with elemental sulfur/selenium and vinylsulfonium salts, utilizing sodium bicarbonate as a base. This approach eliminates the need for the use of toxic and odorous active sulfur/selenium reagents and noble metals, thereby offering a new pathway for synthesizing -phosphinothioates and -phosphinoselenoates via the organic conversion of inorganic sources. The reaction has showcased remarkable versatility in terms of substrate applicability, particularly for organophosphorus compounds containing P-H bonds and vinylsulfonium salt derivatives.

Bidirectional high-speed optical wireless communication with tunable large field of view assisted by liquid crystal metadevice.

Beam-steered infrared (IR) light communication has gained tremendous attention as one of the solutions of congested wireless communication traffic. High performance active beam-steering devices play a crucial role in data allocation and exchange. Conventional beam-steering devices such as spatial light modulator (SLM) and micro-electrical mechanical system (MEMS) mirror and the current emerging nonmechanical beam-steering metasurface-based devices are challenging to realize a large tunable steering angle beyond several degrees, which significantly hinders the spatial application of optical wireless communications (OWC).

All-cause and cause-specific mortality in patients with chronic hepatitis B and concurrent steatotic liver disease.

Background & Aims: Steatotic liver disease (SLD) is prevalent among patients with chronic hepatitis B (CHB). However, the effects of metabolic dysfunction-associated SLD (MASLD) on the long-term survival of such patients remain unknown. Accordingly, this study investigated the mortality risks in patients with CHB and concurrent SLD.

Efficacy and Safety of Dupilumab in Children With Peanut Allergy: A Multicenter, Open-Label, Phase II Study.

Background: Peanut allergy is a potentially life-threatening food allergy in children. This study explored whether dupilumab, a human monoclonal immunoglobulin (Ig)G4 antibody that blocks the activity of interleukin (IL)-4/IL-13, improved safety and desensitization to peanut exposure in children with peanut allergy.

Methods: A Phase II, 24-week, multicenter, single-arm, open-label, proof-of-concept study was conducted in the USA and Canada (NCT03793608).

Sulfur-functionalized sawdust biochar for enhanced cadmium adsorption and environmental remediation: A multidisciplinary approach and density functional theory insights.

Pristine biochar typically exhibits limited capacity for heavy metal adsorption due to its inadequate pore development and insufficient surface functionality. This study introduces an innovative chemical strategy to enhance the surface of sawdust biochar with sulfur-based functional groups (C=S, C-S, S-S, S, S-H, -SO, -SO) to significantly improve cadmium (Cd) adsorption. Sulfur-doping using HSO, NaS, and NaSO markedly increased the sulfur content from 0.

A Clinical Prediction Model For Short-Term Prognosis In Patients With Non Acute Myocardial Infarction Related Cardiogenic Shock.

Background: While acute myocardial infarction (AMI) is widely recognized as the primary cause of Cardiogenic Shock (CS), Non-AMI related CS has been excluded from the majority of CS studies. Information on its prognostic factors remains largely understudied, and it is necessary to focus on these patients to identify the specific risk factors. In this study, we aimed to build and validate a predictive nomogram and risk classification system.

Predicting Futile Recanalization by Cerebral Collateral Recycle Status in Patients with Endovascular Stroke Treatment: The CHANOA Score.

Rationale And Objectives: The correlation between collateral circulation and futile recanalization (FR) is still controversial, and few studies have explored the influence of comprehensive cerebral collateral circulation on FR after endovascular stroke treatment. Therefore, based on cerebral collateral recycle (CCR) status, we aimed to establish an effective scoring system to identify the probability of FR.

Methods: This was a multicenter retrospective cohort study.