Stroke and cancer are two of the most common health problems. Moreover, stroke is more common in patients with cancer than in the normal population, due to coagulation problems. Knowing the etiology of stroke is important for determining treatment options. This study aimed to determine the relationship between ischemic lesion topographies using diffusion-weighted magnetic resonance imaging (MRI) and the etiology of stroke in patients with cancer.
All patients with ischemic stroke in the Bezmialem Stroke Registry over a 4- year period were retrospectively analyzed in this study. Patients with acute ischemic stroke and additional diagnoses of solid and active malignancy (excluding hematologic malignancies) were included in the analysis. We investigated whether there was a relationship between the etiology of patients with cancer-related stroke according to the stroke etiologic classification and the diffusion restriction patterns on MRI.
In this registry, 32 of 1472 patients were diagnosed as having active cancer. Fourteen patients were evaluated as having definite cardioembolism, eight patients as probable cardioembolism, and four patients had inadequate examinations. Only one patient was classified as having an atherothrombotic stroke. Isolated acute infarction was seen in 15 of 32 patients. In patients with multiple acute infarct areas (n=17), acute lesions characterized by micro embolisms in a single vessel area were detected in four patients, and acute lesions characterized by bilateral (anterior and/or posterior system) micro embolisms in more than one vessel area in 13 patients.
The most common etiology of stroke in patients with cancer was found to be embolic/ cardioembolic. This is important for the treatment plans for ischemic stroke in patients with cancer.

Neonatal encephalopathy (NE) caused by hypoxia-ischemia (HI) affects around 1 per 1000 term newborns and is the leading cause of acquired brain injury and neurodisability. Despite the use of hypothermia (HT) as a standard of care, the incidence of NE and its devastating outcomes remains a major issue. Ongoing research surrounding add-on neuroprotective strategies against NE is important as HT effects are limited, leaving 50% of treated patients with neurological sequelae. Little is known about the interaction between necroptotic blockade and HT in neonatal HI. Using a preclinical Lewis rat model of term human NE induced by HI, we showed a neuroprotective effect of Necrostatin-1 (Nec-1: a compound blocking necroptosis) in combination with HT. The beneficial effect of Nec-1 added to HT against NE injuries was observed at the mechanistic level on both pMLKL and TNF-α, and at the anatomical level on brain volume loss visualized by magnetic resonance imaging (MRI). HT alone showed no effect on activated necroptotic effectors and did not preserve the brain MRI volume. This study opens new avenues of research to understand better the specific cell death mechanisms of brain injuries as well as the potential use of new therapeutics targeting the necroptosis pathway.

The present study investigated the hydrolysis of protein in hoki roe homogenate using a HT (bacterial), a FP-II (fungal) protease preparations and Alcalase (bacterial) to enhance lipid yield extraction. The degree of hydrolysis was determined at various pH, temperature and time using casein and hoki roe. Total lipid extraction and lipidomic analysis was carried out following proteolysis of hoki roe homogenate. The degree of hydrolysis and SDS-PAGE revealed that the hydrolytic capability of Alcalase was better than HT and FPII. The total extracted lipid yield was better following hydrolysis with Alcalase (19.29 %), compared to HT (18.29 %) and FPII (18.33 %). However, the total phospholipid (PL) and n-3 fatty acid yields were better from HT hydrolysed hoki roe homogenate (PL = 30.7 μmol/g; n-3 = 10.5 %), compared to Alcalase (PL = 22 μmol/g; n-3 = 5.95 %). Overall, this study indicates that HT protease preparation hydrolysis of fish roe homogenate can both enhance lipid extraction and retain lipid quality.

OBJECTIVE: The purpose of this study was to evaluate the differences in the patient-reported functional outcomes, and graft failure in revision ACL reconstruction using quadriceps tendon (QT), Hamstring tendon (HT) and bone-patellar tendon-bone (BPTB) autografts.
METHODS: Between 2010 and 2020, 97 patients who underwent revision ACL reconstruction (40 patients received a QT, 26 an HT and 31 a BPTB graft) met the inclusion criteria. Pre-injury and at 2-year postoperatively patients were evaluated for patient-reported functional outcomes; Lysholm knee score, Tegner activity level and VAS (visual analogue scale) for pain; and graft failure. Patient-reported outcomes and graft failure were compared between the QT, HT and BPTB groups. The patients with graft failure were not included for outcome analysis at 2-years of follow-up.
RESULTS: All three revision groups with QT, HT and BPTB autograft did not differ significantly in terms of age, sex, time from injury to surgery, concomitant injuries and single-stage or double-stage procedures (n.s.). No significant difference was found in the pre-injury patient-reported outcome; Lysholm knee score, Tegner activity and VAS for pain (n.s.) between the three groups. At the 2-year follow-up functional outcomes improved in all three groups and all the patients returned to pre-injury activity level; however, no significant difference was found in functional outcomes at the 2-year follow-up between the three groups (n.s.). Graft failure occurred in 4 (10%), 5 (19%) and 3 (10%) patients of QT, HT and BPTB groups, respectively. However, the rate of failure did not differ significantly between groups.
CONCLUSIONS: All three autografts (QT, HT and BPTB) demonstrated satisfactory patient-reported outcomes in revision ACL reconstruction. Compared with QT and BPTB grafts, HT graft showed a higher tendency for failure rates. With the increasing incidence of revision ACL reconstruction, surgeons should be aware of all the available graft options. The findings of this study will assist the surgeons in the graft selection for revision ACL reconstruction.
METHODS: Level III.

OBJECTIVE: This study implemented a piecewise volumetric modulated arc therapy (P-VMAT) for realizing whole-brain radiation therapy (WBRT) with simultaneous integrated boost (SIB) for multiple brain metastases (> 40 metastases) with a conventional C-arm linear accelerator.
METHODS: This study retrospectively analyzed 10 patients with multiple brain metastases (40-120 metastases, median 76), who underwent WBRT and SIB using helical tomotherapy (HT). The prescribed doses were 40 Gy/20 f and 60 Gy/20 f for WBRT and SIB, respectively. Corresponding new HT plans were designed with P-VMAT using 7 arcs. For each arc, the collimator was rotated to 45°, and the field width was limited to 2.5 cm with 0.5 cm overlap with adjacent arcs. Thus, each arc covered only one section of the brain target volume. A conventional dual arc VMAT (DA-VMAT) plan was also designed. HT, P-VMAT, and DA-VMAT plans were compared using dose distribution reviews and dosimetric parameters. ArcCHECK phantom measurements were performed for verification of P-VMAT plans.
RESULTS: No significant differences in the mean coverage of the whole-brain target and metastases were observed between HT and P-VMAT (p > 0.05). The conformity index for the whole-brain target improved with P-VMAT compared with HT (p < 0.05). Furthermore, the volume of 44 Gy V44 (110% of prescribed dose for WBRT) received for whole-brain significantly reduced with P-VMAT from 38.2 ± 12.9% to 23.3 ± 9.4% (p < 0.05), and the maximum dose for organs at risks such as the hippocampus, optical nerve, optical chiasm, and spinal cord declined with P-VMAT (p < 0.05). Unlike HT and P-VMAT, DA-VMAT was clinically unacceptable because V44 in the whole-brain was too high (54.7 ± 8.2%). The mean absolute dose gamma passing rate for P-VMAT plans was 97.6 ± 1.1% (3%/3 mm criterion, 10%).
CONCLUSIONS: P-VMAT is favorable for WBRT and SIB for multiple brain metastases. It provides comparable coverage of whole-brain target and SIB, with better conformity, lower V44, and better dose sparing of organs at risk compared with HT. Furthermore, results show that DA-VMAT fails clinical practice even for a relatively large number of brain metastases with a high degree of plan complexity. The patient specific verification demonstrates the feasibility of P-VMAT for clinical application.

Frequency sweeping interferometry (FSI) based absolute distance ranging has high precision and no ranging blind area. It can be used to realize large-scale and non-cooperative target measurement. However, the nonlinear frequency modulation of the laser seriously affects the ranging accuracy. In this manuscript, a measurement method assisted by Hilbert Transform (HT) and Chirp-z Transform (CZT) is proposed, which can realize the phase unwrapping of the beat signal, the length reduction in the delay fiber of auxiliary optical path, and the improvement of the frequency resolution. The narrow-band frequency suitable for HT is further studied. In the experiment, the ranging resolution is 70 μm and the standard deviation is 12.6 μm within a distance of 4005 mm.

Despite a growing consensus that testing for hereditary thrombophilia (HT) is not recommended in the setting of venous thromboembolism (VTE), such testing is still often requested. We evaluated the effects of HT on the risk of recurrent VTE for patients with lower extremity deep vein thrombosis (DVT).
We conducted a multihospital retrospective study of 867 patients with first-time proximal lower extremity DVT who had undergone testing for HT. Patients with and without HT were compared regarding their VTE recurrence risk via Kaplan-Meier and multivariable analysis.
HT was present in 166 patients (19%). The baseline characteristics were similar between the patients with HT and without HT. No significant difference was found in the recurrence rates between the two groups (HT, 17%; no HT, 15%; P = .345). A Kaplan-Meier survival analysis revealed no significant differences in VTE-free survival between the patients with and without HT (hazard ratio [HR], 1.19; 95% confidence interval [CI], 0.77-1.84; P = .421). On multivariable analysis, the presence of HT was not associated with recurrent VTE. A higher body mass index (HR, 1.06; 95% CI, 1.03-1.10; P = .004) and unprovoked DVT (HR, 2.48; 95% CI, 1.69-3.66; P < .001) were risk factors for recurrence.
HT had no significant impact on the recurrence risk for patients with first-time lower extremity DVT. HT test results would, thus, not be expected to change clinical management and should therefore not be requested routinely for patients with DVT.

Lead (Pb) is a highly toxic pollutant and represents a serious threat to wildlife, affecting various systems in animal bodies. Especially prone to Pb poisoning are waterbirds, which may inadvertently ingest spent gunshot, fishing sinkers and contaminated sediments. This research thus focused on evaluating Pb concentrations in the blood of 170 Mute swans (Cygnus olor; a widespread species of waterbirds) at their summer (urban locations in Małopolskie and rural locations in Świętokrzyskie regions) and winter (the urban section of Wisła River in Krakow) sites in Poland (Europe). The study concentrated on comparing blood Pb concentrations according to sites and locations, verifying the influence of sex and age factors, examining the impact on hematocrit (Ht), glutathione (GSH) levels and body condition. Mean blood Pb concentrations (measured with ICP-OES) differed significantly between summer and winter sites (Regression by Maximum Likelihood Estimation (RML), p < 0.001) reaching higher values at winter sites. Concentrations did not differ from year to year (RML, p = 0.028). At summer sites, concentrations differed from location to location: swans from urban locations in Małopolskie had higher blood Pb concentrations (0.055 μg/g) than from rural Świętokrzyskie (0.008 μg/g; RML, p < 0.001). In summer and winter birds, neither sex nor age groups differed significantly the concentrations (RML, p > 0.231). Pb concentrations correlated weakly with Ht and GSH levels (Spearman test) and had no influence on body condition (proxied by scaled mass index; GLM, p = 0.246). We concluded that differences between summer and winter sites were dictated mainly by the type of habitat (rural vs. urban) that birds occupied in different seasons.

Tritium is a radionuclide released to the atmosphere by nuclear industries in various forms, mainly HTO and to a lesser extent HT. However, some nuclear sites may emit predominantly HT in the atmosphere. The HT is oxidized to HTO essentially in the top cm of soils, and that the formed HTO is then possibly released into the atmosphere. HTO is an assimilable form by plants. Therefore, it is important to understand the environmental behaviour of HT. In this work, we adapt the bacterial oxidation model of HT in soils of Ota et al. (2007) by laboratory experiments on soils typical of western France, and we have in particular adapted the frequency factor A and the Michaelis-Menten enzymatic reaction parameter (Km) on the basis of an Arrhenius equation in function of the porosity of the soil. We then applied this model to the environment near the reprocessing plant of Orano la Hague (France), which emits a significant amount of HT. Based on the adapted model, and knowing the atmospheric variations of HTO and HT over the period 2013-2016, we estimated that the mean HTO activity in soil due to atmospheric HT reached 0.6 Bq.L-1 (with a peak value of 5 Bq.L-1) while the mean value with all sources taken into account is 6.2 Bq.L-1. Then, in an environment such as that surrounding the Orano La Hague plant, where near-field atmospheric HT activity is very high, the bacterial oxydation contribution to produce HTO in the soil can be considered as approximately 10%. The flux to the atmosphere from these source representing approximately. 1.5 Bq.m-2.d-1. If we consider an area of 2 km around the plant (i.e. 13 km2), we estimate 218 Bq.s-1 of HTO was released by the soil, representing less than 0.1% of the direct atmospheric release of HTO around the site. From this work, it appears clear that this secondary source term from the soil is insignificant at this specific site.

The glutamic acid decarboxylase 65 antibody (GAD65-Ab) is an autoimmune marker in some diseases such as diabetes or autoimmune disorders of the central nervous system such as stiff-man syndrome. It can appear with other pancreatic autoantibodies, such as insulin autoantibodies (IAA), presenting as early signs of pancreatic islet β-cells impairing, and play roles in the pathogenesis of type1 diabetes (T1D) and latent autoimmune diabetes in adults (LADA). Positive GAD65-Ab is rarely observed in insulin-dependent diabetic patients with other acquired autoimmune diseases, such as Sjogren\'s syndrome (SS). Besides, LADA revealed by islet autoantibodies such as GAD65-Ab can also be complicated with Hashimoto\'s thyroiditis (HT), another autoimmune thyroid disease. To date, whether GAD65-Ab positive in patients with autoimmune diseases predicts the onset or progression to T1D or LADA remains unknown. Herein, two unique cases of middle-aged Chinese Han women free from diabetes for three years are described despite their blood tests persistently testing positive for GAD65-Ab or IAA. Both patients suffered from HT and SS. Follow-up OGTTs (oral glucose tolerance test) for three years revealed that the patients had a well-controlled glycemic level and normal pancreatic function. However, one of the patients had a temporary increase of postprandial glucose after a short-term loss of diet control. The presence of auto-immune antibodies in these patients had little impact on glucose tolerance or insulin secretion in 3 years. The study postulate that both the primary immune injury caused by serum GAD65-Ab positive, an autoimmune marker, and increased body weight contribute to the progression of LADA.