Impact of Intracranial Volume and Brain Volume on the Prognostic Value of Computed Tomography Perfusion Core Volume in Acute Ischemic Stroke.

BACKGROUND: Computed tomography perfusion (CTP)-estimated core volume is associated with functional outcomes in acute ischemic stroke. This relationship might differ among patients, depending on brain volume. MATERIALS AND METHODS: We retrospectively included patients from the MR CLEAN Registry. Cerebrospinal fluid (CSF) and intracranial volume (ICV) were automatically segmented on NCCT. We defined the proportion of the ICV and total brain volume (TBV) affected by the ischemic core as ICVcore and TBVcore. Associations between the core volume, ICVcore, TBVcore, and functional outcome are reported per interquartile range (IQR). We calculated the area under the curve (AUC) to assess diagnostic accuracy. RESULTS: In 200 patients, the median core volume was 13 (5-41) mL. Median ICV and TBV were 1377 (1283-1456) mL and 1108 (1020-1197) mL. Median ICVcore and TBVcore were 0.9 (0.4-2.8)% and 1.7 (0.5-3.6)%. Core volume (acOR per IQR 0.48 [95%CI 0.33-0.69]), ICVcore (acOR per IQR 0.50 [95%CI 0.35-0.69]), and TBVcore (acOR per IQR 0.41 95%CI 0.33-0.67]) showed a lower likelihood of achieving improved functional outcomes after 90 days. The AUC was 0.80 for the prediction of functional independence at 90 days for the CTP-estimated core volume, the ICVcore, and the TBVcore. CONCLUSION: Correcting the CTP-estimated core volume for the intracranial or total brain volume did not improve the association with functional outcomes in patients who underwent EVT.

Deep learning-based white matter lesion volume on CT is associated with outcome after acute ischemic stroke.

BACKGROUND: Intravenous thrombolysis (IVT) before endovascular treatment (EVT) for acute ischemic stroke might induce intracerebral hemorrhages which could negatively affect patient outcomes. Measuring white matter lesions size using deep learning (DL-WML) might help safely guide IVT administration. We aimed to develop, validate, and evaluate a DL-WML volume on CT compared to the Fazekas scale (WML-Faz) as a risk factor and IVT effect modifier in patients receiving EVT directly after IVT. METHODS: We developed a deep-learning model for WML segmentation on CT and validated with internal and external test sets. In a post hoc analysis of the MR CLEAN No-IV trial, we associated DL-WML volume and WML-Faz with symptomatic-intracerebral hemorrhage (sICH) and 90-day functional outcome according to the modified Rankin Scale (mRS). We used multiplicative interaction terms between WML measures and IVT administration to evaluate IVT treatment effect modification. Regression models were used to report unadjusted and adjusted common odds ratios (cOR/acOR). RESULTS: In total, 516 patients from the MR CLEAN No-IV trial (male/female, 291/225; age median, 71 [IQR, 62-79]) were analyzed. Both DL-WML volume and WML-Faz are associated with sICH (DL-WML volume acOR, 1.78 [95%CI, 1.17; 2.70]; WML-Faz acOR, 1.53 95%CI [1.02; 2.31]) and mRS (DL-WML volume acOR, 0.70 [95%CI, 0.55; 0.87], WML-Faz acOR, 0.73 [95%CI 0.60; 0.88]). Only in the unadjusted IVT effect modification analysis WML-Faz was associated with more sICH if IVT was given (p = 0.046). Neither WML measure was associated with worse mRS if IVT was given. CONCLUSION: DL-WML volume and WML-Faz had a similar relationship with functional outcome and sICH. Although more sICH might occur in patients with more severe WML-Faz receiving IVT, no worse functional outcome was observed. CLINICAL RELEVANCE STATEMENT: White matter lesion severity on baseline CT in acute ischemic stroke patients has a similar predictive value if measured with deep learning or the Fazekas scale. Safe administration of intravenous thrombolysis using white matter lesion severity should be further studied. KEY POINTS: White matter damage is a predisposing risk factor for intracranial hemorrhage in patients with acute ischemic stroke but remains difficult to measure on CT. White matter lesion volume on CT measured with deep learning had a similar association with symptomatic intracerebral hemorrhages and worse functional outcome as the Fazekas scale. A patient-level meta-analysis is required to study the benefit of white matter lesion severity-based selection for intravenous thrombolysis before endovascular treatment.

Associations between early ischemic signs on non-contrast CT and time since acute ischemic stroke onset: A scoping review.

PURPOSE: Onset to imaging (OTI) time is a crucial factor in determining treatment eligibility for acute ischemic stroke patients, since the treatments are time-dependent. Patients with an unknown OTI time are often excluded from treatment, or advanced imaging is needed, which is not widely and readily available. As non-contrast CT (NCCT) is part of the standard stroke protocol, estimating OTI time using only NCCT would be valuable for patients with an unknown OTI time. Early ischemic signs (EISs) visible on NCCT might be fit for this purpose if an association between these signs and OTI time exists. This scoping review aims to provide an overview of the literature that associated OTI time with qualitative or quantitative EISs, including the hyperdense artery sign (HAS), decrease in grey matter-white matter differentiation, hypodensity, and mass effect. METHOD: The prevalence of the EISs at specific OTI times is assessed, and previously presented associations between the EISs and OTI time are reported. RESULTS: The EIS prevalence varied between the studies. The HAS prevalence decreased after 6 h since onset. The hypodensity prevalence increased with increasing OTI time. Studies quantifying the extent of hypodensity could distinguish patients within and beyond treatment time windows, indicating its potential to estimate OTI time. Finally, mass effect prevalence was seen more often at later OTI times. CONCLUSIONS: It is concluded that, despite the high prevalence variability between studies, some associations between EISs and OTI time can be observed. These are potentially valuable in estimating OTI time and supporting treatment decisions.

Particle formation from pulsed laser irradiation of soot aggregates studied with a scanning mobility particle sizer, a transmission electron microscope, and a scanning transmission x-ray microscope.

We investigated the physical and chemical changes induced in soot aggregates exposed to laser radiation using a scanning mobility particle sizer, a transmission electron microscope, and a scanning transmission x-ray microscope to perform near-edge x-ray absorption fine structure spectroscopy. Laser-induced nanoparticle production was observed at fluences above 0.12 J/cm(2) at 532 nm and 0.22 J/cm(2) at 1064 nm. Our results indicate that new particle formation proceeds via (1) vaporization of small carbon clusters by thermal or photolytic mechanisms, followed by homogeneous nucleation, (2) heterogeneous nucleation of vaporized carbon clusters onto material ablated from primary particles, or (3) both processes.

Effects of solvent on the relative stability of mono and di-aluminium aryloxide complexes of bipyridines: anomalous behavior of [(tBu)2Al(OPh)]2(mu-4,4-bipy).

The temperature dependence of the solution equilibrium constants for [((t)Bu)(2)Al(OPh)]2(mu-4,4'-bipy)(1a), [((t)Bu)2Al(OPh)](2)(mu-bipetha)(2a, bipetha = 1,2-bis(4-pyridyl)ethane), and [((t)Bu)(2)Al(OPh)]2(mu-bipethe)(3a, bipethe =trans-1,2-bis(4-pyridyl)ethylene) in C6D6 and CDCl(3) allow for the determination of DeltaH and DeltaS for the dissociation of one Al(tBu)2OPh moiety from the bridging ligand, i.e., 2[(tBu)2AL(OPh)]2(mu-L)<==>(K1)2AL(OPh)(tBu)2(L)+[(tBu)2Al(mu-OPh)]2. For compounds and the DeltaH values in C6D6[99(2) kJ mol(-1)(2a) and 109(5) kJ mol(-1)(3a)] and CDCl3[115(5) kJ mol(-1)(2a) and 139(7) kJ mol(-1)(3a)] were found to be inversely proportional with the dielectric constant of the solvent. In contrast, the DeltaH value for 1a in CDCl3 is surprisingly small [14.9(7) kJ mol(-1)] and does not fit with the trends adopted by the bipetha and bipethe derivatives or the value obtained in C6D6[110(2) kJ mol(-1)]. Unlike the other compounds and the C6D6 solutions, the CDCl3 solution of 1a allows for the observation of a second equilibrium 2Al(OPh)(tBu)2(L)<==>(K2)[(tBu)2Al(mu-OPh)]2+2L, for which the DeltaH has been determined [4.5(3) kJ mol(-1)]. This result suggests that in CDCl3 bonding of the second Al(tBu)2OPh moiety to Al(OPh)(tBu)2(4,4'-bipy)(1b) is stabilized by the presence of the first aluminium, which is counter to ab initio calculations that predicts the aluminium in Al(OPh)((t)Bu)2(L) should destabilize the Al-N interaction with a second Al(tBu)2OPh group. The BDE for dissociation of both Al(tBu)2OPh moieties from 1a-3a, and the energy of formation of hydrogen bond interactions with CHCl3, has been calculated by ab initio methods, and no unusual effects are inherent in 1a.

Aluminium alkyl and aryloxide complexes of pyrazine and bipyridines: synthesis and structure.

The reaction of AlMe(3) and [((t)Bu)(2)Al(micro-OPh)](2) with pyrazine (pyz), 4,4'-bipyridine (4-4'-bipy), 1,2-bis(4-pyridyl)ethane (bpetha) and 1,2-bis(4-pyridyl)ethylene (bpethe) yields (Me(3)Al)(2)(micro-pyz)(1), (Me(3)Al)(2)(micro-4,4'-bipy)(2), (Me(3)Al)(2)(micro-bpetha)(3), (Me(3)Al)(2)(micro-bipethe)(4), Al((t)Bu)(2)(OPh)(pyz)(5), [((t)Bu)(2)Al(OPh)](2)(micro-4,4-bipy)(6a), [((t)Bu)(2)Al(OPh)](2)(micro-bpetha)(7a), [((t)Bu)(2)Al(OPh)](2)(micro-bipethe)(8a). Compounds 1-4, 6a and 7a have been confirmed by X-ray crystallography. In solution compounds 1-4 undergo a rapid ligand-dissociation equilibrium resulting in a time-average spectrum in the (1)H NMR. In contrast, the solution equilibria for compounds 5-8a are sufficiently slow such that the mono-aluminium compounds may be observed by (1)H NMR spectroscopy: Al((t)Bu)(2)(OPh)(4,4-bipy)(6b), Al((t)Bu)(2)(OPh)(bpetha)(7b) and Al((t)Bu)(2)(OPh)(bpethe)(8b). The inability to isolate [((t)Bu)(2)Al(OPh)](2)(micro-pyz) and the relative stability of each complex is discussed with respect to the steric interactions across the bridging ligand (L) and the electronic effect on one Lewis acid-base interaction by the second Lewis acid-base interaction on the same ligand.

Carbon-sulfur bond cleavage in Bis(N-alkyldithiocarbamato)cadmium(II) complexes: heterolytic desulfurization coupled to topochemical proton transfer.

Three bis(N-alkyldithiocarbamato)cadmium(II) complexes [Cd(S(2)CNHR)(2)] (1, R = n-C(3)H(7); 2, R = n-C(5)H(11); 3, n-C(12)H(25)) were prepared by metathesis of the corresponding lithium salt, Li[S(2)CNHR], with cadmium chloride. The crystal structures of 2 and 3 consist of planar molecular units of [Cd(S(2)CNHR)(2)] connected by intermolecular Cd.S interactions to give a one-dimensional chain. The chains are connected by a network of intermolecular N-H.S hydrogen bonds between the dithiocarbamato nitrogen atom and bridging sulfur atoms in neighboring chains. In solution, the (113)Cd NMR spectrum of 2 is dependent on concentration and temperature, indicative of a dimerization equilibrium mediated by similar Cd.S intermolecular bridging interactions. In the solid state, thermal gravimetric analyses show that all three complexes decompose smoothly via a heterolytic C-S bond cleavage reaction to give the corresponding alkyl isothiocyanate and cadmium sulfide as the primary products, with the formation of primary amine and CS(2) as coproducts. These products can result only from the net transfer of protons between N-alkyldithiocarbamato ligands in the solid state. Thus, the C-S bond cleavage reaction is interpreted in terms of the topochemical arrangement of molecular units in the crystalline state, which provides a pathway for proton transfer between ligands via N-H.S hydrogen bonds. Decomposition was also initiated by addition of a tertiary amine to a solution of [Cd(S(2)CNHR)(2)]. This confirms that C-S bond cleavage must be coupled to deprotonation of the -NH group, and explains why dialkylated derivatives [Cd(S(2)CNR(2))(2)] are inert to this particular mode of C-S bond cleavage. This system thus constitutes an unusual example of heterolytic, nonoxidative C-S bond cleavage that appears to proceed by a topochemical transfer of protons, which has implications for C-S bond cleavage processes in single-source precursors for II-VI semiconductor materials.