Analysis of the lncRNA-miRNA-mRNA network to explore the regulation mechanism in human traumatic brain injury.

Traumatic brain injury (TBI) refers to brain dysfunction with or without traumatic structural injury induced by an external force. Nevertheless, the molecular mechanism of TBI remains undefined. Differentially expressed (DE) lncRNAs, DEmRNAs and DEmiRNAs were selected between human TBI tissues and the adjacent histologically normal tissue by high-throughput sequencing. Gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway analysis of overlapping DEmRNAs between predicted mRNAs of DEmiRNAs and DEmRNAs. The competitive endogenous RNA (ceRNA) network of lncRNA-miRNA-mRNA was established in light of the ceRNA theory. In the ceRNA network, the key lncRNAs were screened out. Then key lncRNAs related ceRNA subnetwork was constructed. After that, qRT-PCR was applied to validate the expression levels of hub genes. 114 DElncRNAs, 1807 DEmRNAs and 6 DEmiRNAs were DE in TBI. The TBI-related ceRNA network was built with 73 lncRNA nodes, 81 mRNA nodes and 6 miRNAs. According to topological analysis, two hub lncRNAs (ENST00000562897 and ENST00000640877) were selected to construct the ceRNA subnetwork. Subsequently, key lncRNA-miRNA-mRNA regulatory axes constructed by two lncRNAs including ENST00000562897 and ENST00000640877, two miRNAs including miR-6721-5p and miR-129-1-3p, two mRNAs including ketohexokinase (KHK) and cyclic nucleotide-gated channel beta1 (CNGB1), were identified. Furthermore, qRT-PCR results displayed that the expression of ENST00000562897, KHK and CNGB1 were significantly decreased in TBI, while the miR-6721-5p expression levels were markedly increased in TBI. The results of our study reveal a new insight into understanding the ceRNA regulation mechanism in TBI and select key lncRNA-miRNA-mRNA axes for prevention and treatment of TBI.

Size-induced d band center upshift of copper for efficient nitrate reduction to ammonia.

Electrocatalytic nitrate reduction (NO3RR) technique has emerged as a hotspot in NH3 production, for its practicability, and a series of advanced electrocatalysts with high activity and robust stability needed to be constructed in today's era. In this work, size-tunable Cu nanoparticles on porous nitrogen-doped hexagonal carbon nanorods (Cu@NHC) were reasonably designed and served for catalyzing NO3RR in neutral media. Especially, Cu30%@NHC demonstrated a remarkable electroactivity for NH3 production as it showed a suitable grain size with massive catalytic centers and favorable d band structure with faster *NO3--to-*NO2- catalytic dynamics. As expected, Cu30%@NHC (3628.28 µg h-1 mgcat.-1) had a much higher NH3 yield than those for Cu20%@NHC (1268.42 µg h-1 mgcat.-1) and Cu40%@NHC (725.03 µg h-1 mgcat.-1). And those collected NH3 products indeed derived from NO3RR process revealed by 15N isotope-labeling and systemic control tests. Moreover, Cu30%@NHC was also durable for NO3RR bulk electrolysis with minor loss in activity. This work offered an effective modifying tactics to boost NO3RR catalysis and could guide the design of other advanced electrocatalysts via size-induced surface engineering.

Unraveling the potential-dependent structure evolution in CuO for electrocatalytic biomass valorization.

Electrocatalytic oxidation of renewable biomass (such as glucose) into high-value-added chemicals provides an effective approach to achieving carbon neutrality. CuO-derived materials are among the most promising electrocatalysts for biomass electrooxidation, but the identification of their active sites under electrochemical conditions remains elusive. Herein, we report a potential-dependent structure evolution over CuO in the glucose oxidation reaction (GOR). Through systematic electrochemical and spectroscopic characterizations, we unveil that CuO undergoes Cu2+/Cu+ and Cu3+/Cu2+ redox processes at increased potentials with successive generation of Cu(OH)2 and CuOOH as the active phases. In addition, these two structures have distinct activities in the GOR, with Cu(OH)2 being favorable for aldehyde oxidation, and CuOOH showed faster kinetics in carbon-carbon cleavage and alcohol/aldehyde oxidation. This work deepens our understanding of the dynamic reconstruction of Cu-based catalysts under electrochemical conditions and may guide rational material design for biomass valorization.

Gender-Specific Differences in Chronic Subdural Hematoma.

OBJECTIVE: Few studies concerning aspects of gender-specific differences in chronic subdural hematoma (CSDH). This study aimed to determine whether gender-specific differences exist in CSDH regarding clinical, radiological characteristics, and prognosis. METHODS: A total of 585 patients with CSDH were retrospectively identified. Patients were divided into 2 groups based on gender. Clinical, radiological characteristics, and prognosis were compared using Fisher's exact test or Student t test when applicable. The logistic regression model was used to identify independent risk factors associated with death in CSDH patients. The receiver operating characteristic curve was used to detect the sensitivity and specificity of independent risk factors. RESULTS: The average age of women was 71.50±0.92 years, significantly older than 67.30±0.60 years in men. Hypertension, diabetes mellitus, and uremia were significantly more common in women than in men. Alcohol intake was more in males than in females. CSDH patients in males manifested homogeneous iso-dense and homogeneous hyper-dense was obviously more than that in the females. Although homogeneous hypo-dense and mixed density were significantly more common in the females. The average preoperative hematoma volume of the unilateral CSDH in males was 160.85±3.06 cm3, significantly more than 139.60±5.70 cm3 in females. The mortality of females was 7.4%, higher than 1.7% in males (P=0.004). Female, age, uremia, and recurrence were independent risk factors for death in CSDH patients. CONCLUSIONS: Gender-specific differences do exist in CSDH. Female, age, uremia, and recurrence were independent risk factors for death in CSDH patients.

A Novel Tumor-Promoting Role for Nuclear Factor IX in Glioblastoma Is Mediated through Transcriptional Activation of GINS1.

Our previous study illustrated that nuclear factor IX (NFIX) promotes glioblastoma (GBM) progression by inducing migration and proliferation of GBM cells. However, the underlying mechanism of how NFIX regulates GBM cell proliferation remains obscure. In this study, we uncovered that Go-Ichi-Ni-San 1 (GINS1) is upregulated and positively correlated with NFIX in human GBM specimen. NFIX silencing downregulates the expression of GINS1, which is pivotal for cell-cycle progression and proliferation of GBM cells. Replenishment of GINS1 largely rescues the NFIX-null effect on GBM cell proliferation. Mechanistic investigation revealed that NFIX transcriptionally actives GINS1 expression by directly binding to promoter region (-1779 to -1793bp) of the GINS1 gene. Furthermore, knockdown of NFIX sensitizes GBM cells to DNA damage-inducing agents including doxorubicin and temozolomide, in a GINS1-dependent manner. IMPLICATIONS: Our study highlights that targeting NFIX-GINS1 axis could be a novel and potential therapeutic approach for GBM treatment.

Improving medical student recruitment into neurosurgery through teaching reform.

OBJECTIVE: This study aimed to determine whether a combination of case-based learning (CBL) and problem-based learning (PBL) methods in teaching can improve the academic performance and recruitment of medical students for neurosurgery. METHODS: Four classes of fourth-year medical students were randomly divided into two groups. The traditional model group received the traditional teaching method, and the CBL-PBL group received the combined teaching methods of CBL and PBL. After the courses, the differences between the two groups in self-perceived competence, satisfaction with the course, post-class test scores, and clinical practice abilities were compared, and the proportions of neurosurgery major selection in pre- and post-curriculum between the two groups were also analyzed. RESULTS: Self-perceived competence, post-class test scores, and clinical practice abilities in the CBL-PBL group were better than those in the traditional model group. The students in the CBL-PBL group showed a higher degree of satisfaction with the course than those in the traditional model group (χ2 = 12.03, P = 0.007). At the end of the semester, the proportion of students who chose neurosurgery majors in the CBL-PBL group was 13.3%, more than the 3.4% in the traditional model group (χ2 = 3.93, P = 0.048). CONCLUSION: Compared with the traditional teaching method, the CBL and PBL integrated method is more effective for improving the performance of medical students and enhancing their clinical capabilities in neurosurgery teaching. The CBL-PBL method effectively improved students' interests in neurosurgery, potentially contributing to increasing medical student recruitment into neurosurgery.

Electrocatalytic Hydrogenation of 5-Hydroxymethylfurfural Promoted by a Ru1 Cu Single-Atom Alloy Catalyst.

Electrochemical reduction of biomass-derived 5-hydroxymethylfurfural (HMF) represents an elegant route toward sustainable value-added chemicals production that circumvents the use of fossil fuel and hydrogen. However, the reaction efficiency is hampered by the high voltage and low activity of electrodes (Cu, Bi, Pb). Herein, we report a Ru1 Cu single-atom alloy (SAA) catalyst with isolated Ru atoms on Cu nanowires that exhibits an electrochemical reduction of HMF to 2,5-dihydroxymethylfuran (DHMF) with promoted productivity (0.47 vs. 0.08 mmol cm-2 h-1 ) and faradic efficiency (FE) (85.6 vs. 71.3 %) at -0.3 V (vs. RHE) compared with Cu counterpart. More importantly, the FE (87.5 %) is largely retained at high HMF concentration (100 mM). Kinetic studies by using combined electrochemical techniques suggest disparate mechanisms over Ru1 Cu and Cu, revealing that single-atom Ru promotes the dissociation of water to produce H* species that effectively react with HMF via an electrocatalytic hydrogenation (ECH) mechanism.

Selective Electrooxidation of Biomass-Derived Alcohols to Aldehydes in a Neutral Medium: Promoted Water Dissociation over a Nickel-Oxide-Supported Ruthenium Single-Atom Catalyst.

The biomass-derived alcohol oxidation reaction (BDAOR) holds great promise for sustainable production of chemicals. However, selective electrooxidation of alcohols to value-added aldehyde compounds is still challenging. Herein, we report the electrocatalytic BDAORs to selectively produce aldehydes using single-atom ruthenium on nickel oxide (Ru1 -NiO) as a catalyst in the neutral medium. For electrooxidation of 5-hydroxymethylfurfural (HMF), Ru1 -NiO exhibits a low potential of 1.283 V at 10 mA cm-2 , and an optimal 2,5-diformylfuran (DFF) selectivity of 90 %. Experimental studies reveal that the neutral electrolyte plays a critical role in achieving a high aldehyde selectivity, and the single-atom Ru boosts HMF oxidation in the neutral medium by promoting water dissociation to afford OH*. Furthermore, Ru1 -NiO can be extended to selective electrooxidation of a series of biomass-derived alcohols to corresponding aldehydes, which are conventionally difficult to obtain in the alkaline medium.

miRNA-204-5p acts as tumor suppressor to influence the invasion and migration of astrocytoma by targeting ezrin and is downregulated by DNA methylation.

microRNAs (miRNAs), through their regulation of the expression and activity of numerous proteins, are involved in almost all cellular processes. As a consequence, dysregulation of miRNA expression is closely associated with the development and progression of cancers. Recently, DNA methylation has been shown to play a key role in miRNA expression dysregulation in tumors. miRNA-204-5p commonly acts in the suppression of oncogenes in tumors. In this study, the levels of miRNA-204-5p were found to be down-regulated in the astrocytoma samples. miRNA-204-5p expression was also down-regulated in two astrocytoma cell lines (U87MG and LN382). Examination of online databases showed that the miRNA-204-5p promoter regions exist in CpG islands, which might be subjected to differential methylation. Subsequently, we showed that the miRNA-204-5p promoter region was hypermethylated in the astrocytoma tissue samples and cell lines. Then we found that ezrin expression was down-regulated with an increase in miRNA-204-5p expression in LN382 and U87MG cells after 5-aza-2'-deoxycytidine (5'AZA) treatment compared with control DMSO treatment. In addition, LN382 and U87MG cells treated with 5'AZA exhibited significantly inhibited cell invasion and migration . In a recovery experiment, cell invasion and migration returned to normal levels as miRNA-204-5p and ezrin levels were restored. Overall, our study suggests that miRNA-204-5p acts as a tumor suppressor to influence astrocytoma invasion and migration by targeting ezrin and that miRNA-204-5p expression is downregulated by DNA methylation. This study provides a new potential strategy for astrocytoma treatment.

Electrocatalytic upcycling of polyethylene terephthalate to commodity chemicals and H2 fuel.

Plastic wastes represent a largely untapped resource for manufacturing chemicals and fuels, particularly considering their environmental and biological threats. Here we report electrocatalytic upcycling of polyethylene terephthalate (PET) plastic to valuable commodity chemicals (potassium diformate and terephthalic acid) and H2 fuel. Preliminary techno-economic analysis suggests the profitability of this process when the ethylene glycol (EG) component of PET is selectively electrooxidized to formate (>80% selectivity) at high current density (>100 mA cm-2). A nickel-modified cobalt phosphide (CoNi0.25P) electrocatalyst is developed to achieve a current density of 500 mA cm-2 at 1.8 V in a membrane-electrode assembly reactor with >80% of Faradaic efficiency and selectivity to formate. Detailed characterizations reveal the in-situ evolution of CoNi0.25P catalyst into a low-crystalline metal oxy(hydroxide) as an active state during EG oxidation, which might be responsible for its advantageous performances. This work demonstrates a sustainable way to implement waste PET upcycling to value-added products.

Risk Factors for Postoperative Rebleeding and Short-Term Prognosis of Spontaneous Cerebellar Hemorrhage.

PURPOSE: Postoperative rebleeding (PRB) is one of the most severe complications after hematoma evacuation of spontaneous intracerebral hemorrhage (ICH). PRB has been proven to be an independent risk factor for poor prognosis. Previous studies have shown that spot sign and blend sign are independent risk factors for PRB of spontaneous ICH. However, the risk factors for PRB of spontaneous cerebellar hemorrhage (SCH) have not been elucidated. The aim of the present study was to investigate the possible risk factors for PRB and short-term prognosis of patients with SCH. PATIENTS AND METHODS: This study identified 62 patients with SCH who underwent hematoma evacuation in our department. Risk factors for PRB and short-term prognosis were identified by a univariable logistic regression model, and predictors with a P value of less than 0.05 were included in the multivariable logistic regression model to identify independent predictors. A receiver operating characteristic (ROC) curve was created to test the sensitivity and specificity of independent risk factors. RESULTS: Hematoma volume was the only independent predictor of PRB (OR=15.14, 95% CI=1.08-213.1, P=0.044). The sensitivity and specificity of hematoma volume to PRB were 63.6% and 89.7%, respectively, and the cutoff value of hematoma volume was >29.3 mL. GCS score ≤8 (OR=5.131, 95% CI=1.030-25.554, P=0.046) and PRB (OR=13.17, 95% CI=1.316-131.798, P=0.028) were independent risk factors for poor prognosis of patients with SCH. The sensitivity and specificity of the GCS score to poor prognosis were 66.7% and 86.2%, respectively. The sensitivity and specificity of the PRB to poor prognosis were 36.4% and 96.6%, respectively. CONCLUSION: Hematoma volume is likely to be a strong predictor of PRB among patients with SCH. GCS scores ≤8 on arrival and PRB were significant predictors of short-term poor outcome.

Selectively Upgrading Lignin Derivatives to Carboxylates through Electrochemical Oxidative C(OH)-C Bond Cleavage by a Mn-Doped Cobalt Oxyhydroxide Catalyst.

Oxidative cleavage of C(OH)-C bonds to afford carboxylates is of significant importance for the petrochemical industry and biomass valorization. Here we report an efficient electrochemical strategy for the selective upgrading of lignin derivatives to carboxylates by a manganese-doped cobalt oxyhydroxide (MnCoOOH) catalyst. A wide range of lignin-derived substrates with C(OH)-C or C(O)-C units undergo efficient cleavage to corresponding carboxylates in excellent yields (80-99 %) and operational stability (200 h). Detailed investigations reveal a tandem oxidation mechanism that base from the electrolyte converts secondary alcohols and their derived ketones to reactive nucleophiles, which are oxidized by electrophilic oxygen species on MnCoOOH from water. As proof of concept, this approach was applied to upgrade lignin derivatives with C(OH)-C or C(O)-C motifs, achieving convergent transformation of lignin-derived mixtures to benzoate and KA oil to adipate with 91.5 % and 64.2 % yields, respectively.

Risk Factors and Prognostic Value of Swirl Sign in Traumatic Acute Epidural Hematoma.

Objective: Acute epidural hematoma (AEDH) is one of the deadliest lesions in patients after traumatic brain injury. AEDH with swirl sign progresses rapidly and requires timely surgical treatment. This study aims to investigate the risk factors for the occurrence of AEDH with swirl sign and its prognostic value. Methods: Retrospective analysis was performed on 131 AEDH patients, who were divided into swirl sign group and non-swirl sign group based on the brain computed tomographic (CT) scan. Patient information, including gender, age, hypertension, mechanism of injury, Glasgow Coma Scale (GCS) score on admission, time from injury to CT scan, pupillary light reactivity on admission, midline shift, location of hematoma, hematoma volume on admission, oral anticoagulation, and Glasgow Outcome Scale (GOS) score at 3 months were collected. Univariate analysis was used to determine the risk factors for the occurrence of swirl sign. The factors with P < 0.05 were recruited into the multivariate logistic regression analysis and predictive receiver operating characteristic (ROC) curve model. Results: Univariate analysis demonstrated that the GCS score on admission (P = 0.007), pupillary light reactivity (P = 0.003), location of hematoma (P < 0.0001), and GOS score at 3 months (P = 0.007) were risk factors for the occurrence of swirl sign. Multivariate logistic regression model revealed that the location of hematoma (OR = 0.121; 95% CI: 0.019-0.786; P = 0.027) was an independent risk factor for swirl sign, and the occurrence of swirl sign was a significant predictor of unfavorable neurological outcomes (OR = 0.100; 95% CI: 0.016-0.630; P = 0.014). ROC curves demonstrated that the GCS score on admission (AUC = 0.655; 95% CI: 0.506-0.804), pupillary light reactivity (AUC = 0.625; 95% CI: 0.474-0.777) and location of hematoma (AUC = 0.788; 95% CI: 0.682-0.893) can predict the occurrence of swirl sign, respectively. Remarkably, the combination of these three factors (AUC = 0.829; 95% CI: 0.753-0.906) provided a greater power to predict the swirl sign. Conclusion: GCS score on admission, pupillary light reactivity, and location of hematoma are risk factors for the occurrence of swirl sign, respectively. The combination of these three factors might be used to predict whether there is swirl sign in AEDH after traumatic brain injury. Furthermore, swirl sign can be used as an effective predictor of poor prognosis in patients.

Ammonia Thermal Treatment toward Topological Defects in Porous Carbon for Enhanced Carbon Dioxide Electroreduction.

Topological defects, with an asymmetric local electronic redistribution, are expected to locally tune the intrinsic catalytic activity of carbon materials. However, it is still challenging to deliberately create high-density homogeneous topological defects in carbon networks due to the high formation energy. Toward this end, an efficient NH3 thermal-treatment strategy is presented for thoroughly removing pyrrolic-N and pyridinic-N dopants from N-enriched porous carbon particles, to create high-density topological defects. The resultant topological defects are systematically investigated by near-edge X-ray absorption fine structure measurements and local density of states analysis, and the defect formation mechanism is revealed by reactive molecular dynamics simulations. Notably, the as-prepared porous carbon materials possess an enhanced electrocatalytic CO2 reduction performance, yielding a current density of 2.84 mA cm-2 with Faradaic efficiency of 95.2% for CO generation. Such a result is among the best performances reported for metal-free CO2 reduction electrocatalysts. Density functional theory calculations suggest that the edge pentagonal sites are the dominating active centers with the lowest free energy (ΔG) for CO2 reduction. This work not only presents deep insights for the defect engineering of carbon-based materials but also improves the understanding of electrocatalytic CO2 reduction on carbon defects.

Nuclear factor IX promotes glioblastoma development through transcriptional activation of Ezrin.

Enhanced migration is pivotal for the malignant development of glioblastoma (GBM), but the underlying molecular mechanism that modulates the migration of the GBM cells remains obscure. Here we show that nuclear factor IX (NFIX) is significantly upregulated in human GBM lesions compared with normal or low-grade gliomas. NFIX deficiency impairs the migration of GBM cells and inhibits the tumor growth in the hippocampus of immunodeficient nude mice. Mechanistically, NFIX silencing suppresses the expression of Ezrin, a protein that crosslinks actin cytoskeleton and plasma membrane, which is also positively correlated with GBM malignancy. NFIX depletion induced migration inhibition of GBM cells can be rescued by the replenishment of Ezrin. Furthermore, we identify a NFIX response element (RE) between -840 and -825 bp in the promoter region of the Ezrin gene. Altogether, our findings show, for the first time that NFIX can transcriptionally upregulate the expression of Ezrin and contribute to the enhanced migration of GBM cells, suggesting that NFIX is a potential target for GBM therapy.

Comparison of Clinical and Radiologic Characteristics and Prognosis of Patients with Chronic Subdural Hematoma with and without a History of Head Trauma.

OBJECTIVE: To compare clinical and radiologic characteristics and prognosis of patients with chronic subdural hematoma (CSDH) with and without a history of head trauma. METHODS: Clinical and radiologic characteristics and prognosis of patients with CSDH with a history of head trauma (HT group) and without a history of head trauma (WHT group) were comparatively analyzed. RESULTS: Mean age in the WHT group was 70.23 ± 11.53 years, which was significantly older than mean age 67.56 ± 11.18 years in the HT group (P = 0.008). Stroke, uremia, anticoagulant therapy, and antiplatelet therapy were encountered more often in the WHT group than the HT group. Motor weakness was more prevalent in the WHT group (P = 0.011). Modified Rankin Scale score of 2-3 was more common in the WHT group (P = 0.03), whereas a score of 4-5 was more common in the HT group (P = 0.014). Hematoma density on CT was mainly homogeneous in the 2 groups, with significantly more homogeneous density in the HT group compared with the WHT group (P = 0.014). There was significantly more mixed density in the WHT group (P = 0.001). Patients with CSDH in the WHT group had higher mortality (P = 0.026) and lower Glasgow Outcome Scale score (P = 0.033). CONCLUSIONS: Patients with CSDH with or without a history of head trauma presented with different clinical and radiologic characteristics. Patients with CSDH without a history of head trauma had a higher mortality and lower GOS score, which indicates these patients warrant more attention.

Clinical and radiological factors predicting recurrence of chronic subdural hematoma: A retrospective cohort study.

BACKGROUND: Chronic subdural hematoma (CSDH) is commonly encountered in the elderly patients and the recurrence rate is still high, therefore, identifying risk factors for CSDH recurrence is essential. The present study aimed to identify clinical and radiological factors predicting the recurrence of CSDH. METHODS: We retrospectively identified 461 patients with CSDH who underwent surgical evacuation in our department. Univariable analyses were performed at first, variables with a P-value of <0.05 were entered into multivariable logistic regression model. Kendall's tau-b test was used to evaluate the relationship between brain atrophy and postoperative pneumocephalus. RESULTS: Univariable analyses revealed that patients with the following characteristics have a higher recurrence rate, including age ≥80 years, antiplatelet and/or anticoagulant use, GOS = 3, the volume of drainage ≥100 ml, midline shift ≥10 mm, severe brain atrophy, severe postoperative pneumocephalus. Multivariable logistic regression demonstrated that midline shift ≥10 mm, severe brain atrophy, severe postoperative pneumocephalus, and volume of drainage ≥100 ml were independent risk factors for CSDH recurrence. Kendall's tau-b test revealed that there was no correlation between brain atrophy and postoperative pneumocephalus. CONCLUSIONS: Midline shift ≥10 mm, severe brain atrophy, severe postoperative pneumocephalus, and volume of drainage ≥100 ml were independent risk factors for CSDH recurrence, CSDH patients with these characteristics should be taken precautions of recurrence and a closely follow-up should be carried out.

Risk Factors Predicting Recurrence of Bilateral Chronic Subdural Hematomas after Initial Bilateral Evacuation.

BACKGROUND: Most patients with bilateral chronic subdural hematomas (bCSDH) undergo initial bilateral evacuation. Risk factors associated with the recurrence of bCSDH after initial bilateral evacuation have not been published to date. In this study, we aimed to identify risk factors related to recurrence of bCSDH after initial bilateral evacuation, and to develop a prognostic grading system for clinical reference. METHODS: This study included 102 patients with bCSDH who underwent initial bilateral evacuation. Predictors of recurrence were identified via univariate analysis and multivariate logistic regression analysis. A prognostic grading system was created based on the independent predictors combined with a cutoff value. All cases were scored according to the prognostic grading system, and the recurrence rates of the different scores were reanalyzed. RESULTS: Anticoagulant use (odds ratio [OR], 84.266; 95% confidence interval [CI], 13.113-541.522; P < 0.001), severe brain atrophy (OR, 11.551; 95% CI, 2.558-52.163; P = 0.001), and postoperative pneumocephalus volume (PostPV) (OR, 0.978; 95% CI, 0.957-1.000; P = 0.049) were independent risk factors for the recurrence of bCSDH after initial bilateral evacuation. The cutoff value of PostPV was >20.9484 cm3. A prognostic grading system was then developed, and the recurrence rates based on score were determined. Rates were 2.8% for a score of 0-1, 28.1% for a score of 2-3, and 100% for a score of 4-5, showing a significant increase in risk with increasing score (P < 0.001). CONCLUSIONS: Anticoagulant use, severe brain atrophy, and PostPV were identified as independent risk factors for recurrence of bCSDH after initial bilateral evacuation. The prognostic grading system for recurrence of bCSDH after initial bilateral evacuation is reliable and applicable for clinical reference.

Risk Factors for Contralateral Hematoma Progression after Unilateral Evacuation of Bilateral Chronic Subdural Hematomas.

OBJECTIVE: To find risk factors for contralateral hematoma progression (CHP) in bilateral chronic subdural hematomas after initial unilateral evacuation. METHODS: We retrospectively analyzed 53 patients with bilateral chronic subdural hematomas who underwent unilateral surgical evacuation in our department. Risk factors for CHP were identified by univariate analysis, a P value <0.05 were entered into multivariate logistic regression model and a predictive receiver operating characteristic curve model. RESULTS: The progression rate was 32.08%, the average progression interval was 2.32 months. The progression rate of the homogeneous hypodense group was significantly higher than that of the other density group (P = 0.017). The limited type of contralateral hematoma had a significantly lower progression rate than that of the widespread type (P = 0.001). Both pre- and postoperative volume of contralateral hematoma were significantly more in the CHP group compared with the contralateral hematoma without progression group (P = 0.031 and P = 0.001, respectively). Of the 4 risk factors, only postoperative volume of contralateral hematoma was an independent risk factor in multivariate logistic regression model (P = 0.033; 95% confidence interval, 1.005-1.124). The cut-off values of contralateral hematoma volume before and after operation were 29.27 cm3 and 37.84 cm3, respectively. CONCLUSIONS: Contralateral hematoma volume after operation is an independent risk predictor for CHP after unilateral evacuation. An additional surgery on contralateral hematoma or medical treatment should be taken into consideration if the volume is >37.84 cm3 in the first cranial computed tomography scan after surgery.

Chromium-ruthenium oxide solid solution electrocatalyst for highly efficient oxygen evolution reaction in acidic media.

The development of active, acid-stable and low-cost electrocatalysts for oxygen evolution reaction is urgent and challenging. Herein we report an Iridium-free and low ruthenium-content oxide material (Cr0.6Ru0.4O2) derived from metal-organic framework with remarkable oxygen evolution reaction performance in acidic condition. It shows a record low overpotential of 178 mV at 10 mA cm-2 and maintains the excellent performance throughout the 10 h chronopotentiometry test at a constant current of 10 mA cm-2 in 0.5 M H2SO4 solution. Density functional theory calculations further revealed the intrinsic mechanism for the exceptional oxygen evolution reaction performance, highlighting the influence of chromium promoter on the enhancement in both activity and stability.