Comparing a novel Catfish flow restoration device and the Solitaire stent retriever for thrombectomy revascularisation in emergent largevessel occlusion stroke:a prospective randomised controlled study

Background The Catfish stent retriever is a newly developed mechanical thrombectomy device for rapid recanalisation in emergent large vessel occlusion(ELVO)stroke.The current trial aimed to assess whether the Catfish stent retriever is non-inferior to the Solitaire stent retriever in terms of outcomes in ELVO stroke.Methods This was a randomised,prospective,parallel-group,multicentre,open-label,non-inferiority study conducted at 18 sites in China.The primary outcome was the proportion of cases with successful recanalisation(modified thrombolysis in cerebral infarction score of 2b or 3)following the procedure.Secondary efficacy outcomes included the National Institutes of Health Stroke Scale scores at 24 hours and 7 days or discharge if earlier,time from artery puncture to successful recanalisation and good clinical outcome(modified Rankin scale score≤2)at 90 days.Safety outcomes included symptomatic intracranial haemorrhage,all cause-death and severe adverse events at 90 days.Results Between 3 March 2019 and 5 June 2021,118 and 120 patients were randomly allocated to the Catfish and Solitaire groups,respectively.The primary endpoint after all endovascular procedures was non-inferior in the Catfish group(88.5%,100/113)than in the Solitaire group(87.7%,100/114),with a rate difference(RD)of 0.78%(95%CI-7.64 to-9.20;p=0.001).Sensitivity analysis only considering the per-protocol set also yielded similar results,with an RD of 0.83%(95%CI-7.03 to-8.70;p<0.001).Additionally,the proportions of cases with good clinical outcomes(47.8%vs 50.0%,p=0.739)and all-cause death rates(17.7%vs 18.8%,p=0.700)were similar in both groups at 90 days.Conclusions The Catfish stent retriever is an effective and safe device for endovascular recanalisation in ELVO stroke..

Staged angioplasty versus regular carotid artery stenting in patients with carotid artery stenosis at high risk of hyperperfusion:a randomised clinical trial

Background and purpose Hyperperfusion(HP)is a devastating complication associated with carotid artery stenting(CAS)or endarterectomy.The efficacy and safety of staged angioplasty(SAP)in patients with CAS at high risk of HP remains unclear.We sought to determine whether SAP is superior to regular CAS in patients with high risk of HP.Methods A randomised,multicentre open-label clinical trial with blinded outcome assessment(STEP)was conducted.Patients with severe carotid stenosis at high risk of HP were randomly assigned(1:1)to the SAP or regular CAS group.The primary endpoint was hyperperfusion syndrome(HPS)and intracerebral haemorrhage(ICH)within 30 days after the procedure.Results From November 2014 to January 2017,a total of 64 patients were enrolled in 11 centres.33 patients were allocated to the SAP group and 31 to the regular CAS group.At 30 days,the rate of primary endpoint was 0.0%(0/33)in the SAP group and 9.7%(3/31)in the regular CAS group(absolute risk reduction(ARR),9.7%;95%CI−20.1% to 0.7%;p=0.11).As one of the secondary endpoints,the incidence of HP phenomenon(HPP)was lower in the SAP group than the regular CAS group(0.0%vs 22.6%,ARR,−22.6%;95% CI−36.8%to−10.2%;p=0.04).Conclusion The rate of HPS and ICH was not significantly lower in SAP group;the extended secondary endpoint of HPP,however,significantly reduced,which suggested that SAP may be a safe and effective carotid revascularisation procedure to prevent HP.

A conceptual framework for ex ante valuation of ecosystem services of brownfield greening from a systematic perspective

Introduction:Although Brownfield greening(BG)can be a crucial solution to green space deficiency in dense urban areas,the potential benefits of different BG initiatives have rarely been quantitatively pre-evaluated.Here,the concept and main features of BG and its costs and benefits are firstly depicted.Next,a conceptual framework is presented which combines ecosystem service(ESS)valuation,economic cost-benefit analysis,and spatial pattern analysis.The framework is used to perform ex ante valuation of the ESS value of BG in Xuhui District,Shanghai.Outcomes:The scenario comparison results show that it can spatially reflect a closer-to-reality value of ESS at the urban scale instead of a theoretical value at the site scale.The ultimate values of ESS(After economic and landscape adjustments)in the composite scenario is more than 21%higher than those in the full-eco scenario,whereas the initial values of ESS(before the adjustments)in the former was 14%lower than those in the latter.These results suggest that a considerable part of brownfield greening projects need to be implemented in the more populated and economically vibrant areas instead of solely in the ecological construction zone,thereby correspondingly providing more cultural and regulation services and forming a better urban green space network.Conclusion:The framework provides a simple,science-based,and feasible tool for making BG decisions from a systematic perspective in dense urban areas.It can help meet the need for applying ESS knowledge to BG-based green space planning and policy making in the context of urban sustainable development.

Development of plant communities after restoration of the Antaibao mining site, China

To investigate the dynamic changes in the artificial vegetation in an abandoned mining site,we analyzed the re lationships among community types,environmental variables and community structure in the process of vegetation restoration in the Antaibao mining site,China by survey of the communities and use of biological dating methods.By means of the quantitative classification method(two-way indicator-species analysis,TWINSPAN)and the ordination technique(de-trended correspondence analysis,DCA;and de-trended canonical correspondence analysis,DCCA),the plant communities were classified into seven groups:community I,Robinia pseudoacacia+Pimus tabulaeformis-Caragana kor-shinskii-Agropyron cristatum;community II,Robinia pseudoacacia-Hippophae rhamnoides-Artemisia capil-laries;community II,Ulmus pumila-Elaeagmus angu-stifolia-Artemisia capillaries;community IV,Caragana korshinskii-Agropyron cristatum+Artemisia capillaries;community V,Hippophae rhamnoides-Elymus dahur-icus;community VI,Elaeagnus angustifolia+Hippophae rhamnoides-Brassica jucea;community VII,Hippophae rhammoides+Elaeagnus angustifolia-Salsola collina.We conclude that the community types and diversity are mainly influenced by the succession time and the soil organic matter content.The forest community is more adaptable to the special inhabitation than the shrub community.