A novel score to predict progression in anterior circulation single subcortical infarction patients

OBJECTIVE

Progressive infarction (PI) has a negative effect on functional prognosis. Our study aimed to develop and validate a risk score for predicting PI in patients with anterior circulation single subcortical infarction (ACSSI).

METHODS

Between January 2020 and October 2022, we retrospectively enrolled 638 eligible patients with ACSSI. Two-thirds of the eligible patients were randomly allocated to the training cohort (n = 425). Another resampling sample was formed through the bootstrap method and was used as the validation group (n = 425). Multivariate logistic regression analysis was used to identify the independent factors associated with PI. Each factor was then point assigned based on β-coefficient and a risk scoring system was developed. This scoring system was internally validated through 1000-bootstrap resamplings. The C-statistic and Hosmer-Lemeshow test were used to assess model discrimination and calibration.

RESULTS

PI occurred in 121 patients, accounting for 19.0% of the total patients. A 7-point NTS score system based on the initial NIHSS score, triglyceride-glucose index, and the number of infarct slices on axial diffusion-weighted imaging was developed. The NTS score showed good discrimination and calibration in the training cohort (C-statistic = 0.686; p value of Hosmer-Lemeshow test = 0.797) and validation cohort (C-statistic = 0.681; p value of Hosmer-Lemeshow test = 0.451). The three risk levels for predicting PI in the training and validation cohorts based on NTS score were as follows: low (0-2, 9.6% vs. 9.3%), intermediate (3-5, 28.2% vs. 26.7%), and high risk (6-7, 60.2% vs. 57.4%).

INTERPRETATION

The NTS score is a valid and convenient risk score for predicting PI in ACSSI patients.

Mn3O4 nanoparticles decorated porous reduced graphene oxide with excellent oxidase-like activity for fast colorimetric detection of ascorbic acid

Mn₃O₄ nanoparticles composed of porous reduced graphene oxide nanosheets (Mn₃O₄@p-rGO) with enhanced oxidase-like activity were successfully fabricated through an in-situ approach for fast colorimetric detection of ascorbic acid (AA). The residual Mn²⁺ in the GO suspension of Hummers method was directly reused as the manganese source, improving the atom utilization efficiency. Benefiting from the uniform distribution of Mn₃O₄ nanoparticles on the surface of p-rGO nanosheets, the nanocomposite exhibited larger surface area, more active sites, and accelerated electron transfer efficiency, which enhanced the oxidase-like activity. Mn₃O₄@p-rGO nanocomposite efficiently activate dissolved O₂ to generate singlet oxygen (¹O₂), leading to high oxidation capacity toward the substrate 3,3',5,5'-tetramethylbenzidine (TMB) without the extra addition of H₂O₂. Furthermore, the prominent absorption peak of the blue ox-TMB at 652 nm gradually decreased in the presence of AA, and a facile and fast colorimetric sensor was constructed with a good linear relationship (0.5-80 μM) and low LOD (0.278 μM) toward AA. Owing to the simplicity and excellent stability of the sensing platform, its practical application for AA detection in juices has shown good feasibility and reliability compared with HPLC and the 2, 4-dinitrophenylhydrazine colorimetric method. The oxidase-like Mn₃O₄@p-rGO provides a versatile platform for applications in food testing and disease diagnosis.