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• Four models aim to predict pre-treatment rebleeding after aneurysmal subarachnoid hemorrhage. • We assessed each for risk of bias and clinical applicability using validated tools. • No single model demonstrated a low risk of bias and low applicability concerns in all domains. • No existing model can be recommended for clinical use in their current state. • Future studies revising current models or formulating new ones are needed. Pre-treatment rebleeding following aneurysmal subarachnoid hemorrhage (aSAH) increases the risk of death and a poor neurological outcome. Current guidelines recommend aneurysm treatment "as early as feasible after presentation, preferably within 24 h of onset" to mitigate this risk, a practice termed ultra-early treatment. However, ongoing debate regarding whether ultra-early treatment is independently associated with reduced re-bleeding risk, together with the recognition that re-bleeding occurs even in centres practicing ultra-early treatment due to the presence of other risk-factors has resulted in a renewed need for patient-specific re-bleed risk prediction. Here, we systematically review models which seek to provide patient specific predictions of pre-treatment rebleeding risk. Following registration on the International prospective register of systematic reviews (PROSPERO) CRD 42023421235; Ovid Medline (Pubmed), Embase and Googlescholar were searched for English language studies between 1st May 2002 and 1st June 2023 describing pre-treatment rebleed prediction models following aSAH in adults ≥18 years. Of 763 unique records, 17 full texts were scrutinised with 5 publications describing 4 models reviewed. We used the semi-automated template of Fernandez-Felix et al. incorporating the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) checklist and the Prediction model Risk Of Bias ASsessment Tool (PROBAST) for data extraction, risk of bias and clinical applicability assessment. To further standardize risk of bias and clinical applicability assessment, we also used the published explanatory notes for the PROBAST tool and compared the aneurysm treatment practices each prediction model's formulation cohort experienced to a prespecified benchmark representative of contemporary aneurysm treatment practices as outlined in recent evidence-based guidelines and published practice pattern reports from four developed countries. Reported model discriminative performance varied between 0.77 and 0.939, however, no single model demonstrated a consistently low risk of bias and low concern for clinical applicability in all domains. Only the score of Darkwah Oppong et al. was formulated using a patient cohort in which the majority of patients were managed in accordance with contemporary, evidence-based aneurysm treatment practices defined by ultra-early and predominantly endovascular treatment. However, this model did not undergo calibration or clinical utility analysis and when applied to an external cohort, its discriminative performance was substantially lower that reported at formulation. No existing prediction model can be recommended for clinical use in centers practicing contemporary, evidence-based aneurysm treatment. There is a pressing need for improved prediction models to estimate and minimize pre-treatment re-bleeding risk. [ABSTRACT FROM AUTHOR]

The internal capsule of the basal ganglia is vulnerable to direct pressure from the hematoma and to secondary damage from toxic products of hemorrhage. Our study evaluated the risk and benefits of active strategies including ultra-early surgery and hematoma evacuation through a transsylvian-transinsular approach for moderate basal ganglia hemorrhage.

Key Clinical Message: We describe an ultra‐early stage of autoimmune gastritis (AIG) that occurs prior to the well‐known early‐stage AIG. The key pathology is the shortening of the second layer with degenerated parietal cells. In the management of patients with autoimmune diseases, AIG should be considered even if the endoscopy findings are normal. [ABSTRACT FROM AUTHOR]

Key Clinical Message We describe an ultra‐early stage of autoimmune gastritis (AIG) that occurs prior to the well‐known early‐stage AIG. The key pathology is the shortening of the second layer with degenerated parietal cells. In the management of patients with autoimmune diseases, AIG should be considered even if the endoscopy findings are normal.

Background: Optimal definitive treatment timing for patients with aneurysmal subarachnoid hemorrhage (aSAH) remains controversial. We compared outcomes for aSAH patients with ultra-early treatment versus later treatment at a single large center. Method: Patients who received definitive open surgical or endovascular treatment for aSAH between January 1, 2014, and July 31, 2019, were included. Ultra-early treatment was defined as occurring within 24 h from aneurysm rupture. The primary outcome was poor neurologic outcome (modified Rankin Scale score > 2). Propensity adjustment was performed for age, sex, Charlson Comorbidity Index, Hunt and Hess grade, Fisher grade, aneurysm treatment type, aneurysm type, size, and anterior location. Results: Of the 1013 patients (mean [SD] age, 56 [14] years; 702 [69%] women, 311 [31%] men) included, 94 (9%) had ultra-early treatment. Compared with the non-ultra-early cohort, the ultra-early treatment cohort had a significantly lower percentage of saccular aneurysms (53 of 94 [56%] vs 746 of 919 [81%], P <0.001), greater frequency of open surgical treatment (72 of 94 [77%] vs 523 of 919 [57%], P <0.001), and greater percentage of men (38 of 94 [40%] vs 273 of 919 [30%], P =.04). After adjustment, ultra-early treatment was not associated with neurologic outcome in those with at least 180-day follow-up (OR = 0.86), the occurrence of delayed cerebral ischemia (OR = 0.87), or length of stay (exp(β), 0.13) (P ≥ 0.60). Conclusions: In a large, single-center cohort of aSAH patients, ultra-early treatment was not associated with better neurologic outcome, fewer cases of delayed cerebral ischemia, or shorter length of stay. [ABSTRACT FROM AUTHOR]

Purpose: [68 Ga]Ga-FAPI-04 PET/CT has been widely used in oncology patients. The patients need to lie still for 20–30 min during scan after waiting for 60 min post-tracer injection in traditional [68 Ga]Ga-FAPI-04 PET/CT scan. This is difficult for some patients who are intolerant to prolonged horizontal positioning and waiting time. Therefore, we evaluated the diagnostic value of the images obtained in ultra-early and fast scan (5-min p.i., 30-s acquisition time) by the total-body [68 Ga]Ga-FAPI-04 PET/CT and to investigate whether they could meet the requirements of clinical diagnosis. Methods: Total-body [68 Ga]Ga-FAPI-04 PET/CT was conducted in 12 patients at the Renji Hospital. Patients underwent PET with two acquisitions: 5-min p.i. and 30-s acquisition time (ultra-early and fast imaging) and 60-min p.i. and 300-s acquisition time (traditional imaging). Mean [68 Ga]Ga-FAPI-04 injection dose was 1.85 MBq/kg. Results: Forty-four lesions were detected in 12 patients on traditional imaging. All the 44 lesions on conventional imaging could also detected by ultra-early and fast imaging. For all the 12 patients, the tumor stage did not change, as same lesions were visible for every case in both images. There was no statistically significant difference in SUVmax of lesions between ultra-early and fast imaging and traditional imaging (12.5 ± 8.7 vs 13.7 ± 8.5, P = 0.528). Background bloodpool (4.0 ± 0.6 vs 0.9 ± 0.2, P < 0.001)and liver (2.5 ± 0.7 vs 1.0 ± 0.5, P < 0.001)at traditional imaging showed a significant decrease in SUVmean compared to ultra-early and fast imaging. Conclusions: Ultra-early and fast imaging versus traditional [68 Ga]Ga-FAPI-04 imaging resulted in equivalent tumor detection and lesion uptake. Ultra-early and fast total-body [68 Ga]Ga-FAPI-04 PET/CT scan could meet clinical diagnostic requirements for patients with poor tolerant to prolonged horizontal positioning and waiting time. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Plant Science is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The long-term survival prognosis of patients with high-grade (Hunt-Hess grade IV-V or World Federation of Neurosurgical Societies grade IV-V) aneurysmal subarachnoid hemorrhage (aSAH) is generally poor, and the association between endovascular treatment timing and the prognosis of high-grade aSAH has not been explored in depth. This retrospective cohort study aimed to determine whether endovascular treatment within 24 h of high-grade aSAH is associated with a better prognosis. Methods: We retrospectively analyzed the clinical data of patients with high-grade aSAH who were admitted to our institution between January 2018 and January 2021. The Modified Rankin Scale score was used to assess the 6-month prognosis of patients. Univariate and multivariate logistic regression analyses were used to identify the factors associated with prognosis. The area under the receiver operating characteristic (ROC) curve was used to assess the model's discriminatory ability. Results: Eighty-six patients were included in the study. In the multivariate analysis, the timing of endovascular treatment (odds ratio = 7.003 [1.800-27.242], P = 0.005) was an independent risk factor for prognosis. The ROC curve showed that the predictive power of the timing of endovascular treatment was 0.744, the best cut-off value was 12.5 h, and the corresponding sensitivity and specificity were 71.4 and 70.5%, respectively. Hydrocephalus (P = 0.005) and pulmonary infection (P = 0.029) were also associated with prognosis. In addition, cerebrospinal fluid drainage immediately after endovascular treatment had a significant effect on reducing hydrocephalus formation. Conclusions: Endovascular therapy within 24 h is feasible and improves the prognosis of patients with high-grade aSAH. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Plant Science is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the effect of ultra-early stereotactic surgery on hypertensive intracerebral hemorrhage(HICH)and its influence on inflammatory factors and quality of life. Methods: 93 patients with HICH who were admitted to our hospital from March 2016 to January 2018 were selected, and they were divided into early group(n=45, operation within 6-24 hours of onset) and super-early group(n=48, operation within 6 hours of onset) according to the timing of operation. Relevant indexes of curative effect,inflammatory factors and quality of life were compared between the two groups, and the occurrence of postoperative complications was observed. Results: The mortality of super-early group was lower than that of early group, and the Glasgow coma score(GOS) excellent and good rate was higher than that of early group(P <0.05). There was no significant difference in the postoperative rebleeding rate between the two groups(P>0.05). The levels of interleukin-6(IL-6), high-sensitivity C-reactive protein(hs-CRP) and tumor necrosis factor-α(TNF-α) were decreased in the two groups at 2 weeks after operation, and those in the ultra-early group were lower than those in the early group(P <0.05). The scores of mental health, physical health, social function and material life in the ultra-early group at 3 months and 6 months after operation were higher than those in the early group(P <0.05). The total incidence of postoperative complications in the ultra-early group was lower than that in the early group(P<0.05). Conclusion: Ultra-early stereotactic surgery for HICH has remarkable curative effect, which can effectively improve inflammatory factors and quality of life, and it can also reduce the incidence of postoperative complications. [ABSTRACT FROM AUTHOR]

Objective: To compare the outcome of patients with up to 60% total body surface area (TBSA) thermal burns undergoing ultra-early and early excision and grafting.Methods: This historical cohort study was performed in two referral burn centers of Shiraz during a 1-year period from 2015 to 2016. We included those patients with thermal burns up to 60% TBSA who underwent ultra-early (48-72 hours) and early (7-10 days) excision and grafting. We excluded those who were hemodynamically unstable and those with electrical burns. The outcome of patients was determined by graft success, operation duration, blood loss, hospital length of stay and mortality rate. Results: We included a total number of 107 patients with mean age of 32.1 ± 11.6 years. There were 65 (60.7%) men and 42 (39.3%) women among the patients. Both study groups were comparable regarding the baseline characteristics. Ultra-early excision and grafting was associated with more, higher graft success rate (p=0.048), lower infection rate (p=0.037), shorter hospital length of stay (p=0.044) and lower mortality rate (p=0.027).Conclusion: Ultra-early excision and grafting in patients with thermal burns covering less than 60% TBSA was associated with higher graft success rate, shorter hospital length of stay, lower infection rate and lower mortality rate when compared to early surgery.

Ultra-early seeding of spring wheat (Triticum aestivum L.) on the northern Great Plains can increase grain yield and grain yield stability compared to current spring wheat planting systems. Field trials were conducted in western Canada from 2015 to 2018 to evaluate the impact of optimal agronomic management on grain yield, quality, and stability in ultra-early wheat seeding systems. Four planting times initiated by soil temperature triggers were evaluated. The earliest planting was triggered when soils reached 0–2.5 °C at a 5 cm depth, with the subsequent three plantings completed at 2.5 °C intervals up to soil temperatures of 10 °C. Two spring wheat lines were seeded at each planting date at two seeding depths (2.5 and 5 cm), and two seeding rates (200 and 400 seeds m−2). The greatest grain yield and stability occurred from combinations of the earliest seeding dates, high seeding rate, and shallow seeding depth; wheat line did not influence grain yield. Grain protein content was greater at later seeding dates; however, the greater grain yield at earlier seeding dates resulted in more protein production per unit area. Despite extreme ambient air temperatures below 0 °C after planting, plant survival was not reduced at the earliest seeding dates. Planting wheat as soon as feasible after soil temperatures reach 0 °C, and prior to soils reaching 7.5–10 °C, at an optimal seeding rate and shallow seeding depth increased grain yield and stability compared to current seeding practices. Adopting ultra-early wheat seeding systems on the northern Great Plains will lead to additional grain yield benefits as climate change continues to increase annual average growing season temperatures.

Study Design: Seventy-five Sprague-Dawley rats were randomly divided into sham, complete spinal cord transection (CSCT) and hyperbaric oxygen (HBO) groups. Among them, rats in HBO group were further divided into 3 hours group (HBO1) and 12 hours group (HBO2).Objective: To study the effects of ultra-early HBO therapy on femoral calcitonin gene-related peptide (CGRP) and bone metabolism of rats with CSCT.Summary Of Background Data: Complete spinal cord injury (SCI) is still an unresolved problem in clinical practice. Studies on changes in (calcitonin gene-related peptide) CGRP and bone metabolism and osteoporosis prevention after SCI have important clinical significance.Methods: Rats in the sham group underwent laminectomy alone, whereas rats in the other three groups underwent laminectomy and CSCT at the level of the 10th thoracic vertebra. Six weeks after operation, rat blood samples and femoral samples from CSCT area were taken and prepared for immunohistochemical staining of CGRP, quantitative polymerase chain reaction (qPCR) of CGRP mRNA, enzyme-linked immunosorbent assay (ELISA) for the levels of serum bone-specific alkaline phosphatase (sBAP), serum osteocalcin (sOC), serum type-I collagen amino-terminal peptide (sNTX), and urinary deoxypyridinoline (uDPD). These data were statistically analyzed using paired LSD or Tamhane.Results: The number of CGRP-positive cells and expression of CGRP mRNA in femur were significantly reduced, and the levels of sBAP, sOC, sNTX, and uDPD were significantly increased in CSCT, HBO1, and HBO2 groups than in the sham group, (P < 0.05-0.01). In addition, the number of CGRP-positive cells, expression of CGRP mRNA in femur, and the levels of sBAP and sOC were significantly enhanced, but the levels of sNTX and uDPD were significantly lowered in HBO1 group than in HBO2 and CSCT groups (P < 0.05).Conclusion: Ultra-early HBO therapy could improve bone turnover, promote bone formation, and prohibit bone resorption by enhancing CGRP synthesis in the sensory neurons in posterior horn of spinal cord.Level Of Evidence: N/A. [ABSTRACT FROM AUTHOR]

Objective: To investigate the severe brain injury after decompressive surgery of skull defects ultra-early (4-6 weeks) the feasibility of row three-dimensional titanium mesh skull patch and its impact on the long-term prognosis of patients, and to explore ultra-early skull repair surgery Are compared with conventional surgery exist advantages. Methods: A retrospective analysis from January 2012-January 2015 after the Brain Injury skull defect repair surgery 99 patients all patients after decompression interval skull patch into two groups according to craniectomy, 4. within-6 weeks for ultra-early group, 52 cases, 3-6 months for the conventional group, 47 cases. Skull patch after 1 month, 3 months, quality of life between the two groups of patients with different international scoring 12 months;comparative analysis peeling scalp surgery time and blood loss between the two groups;two groups were compared after 1 month, 3 months, 12 months, corresponding to the difference complications. Results: Ultra-early group patients after one month of GCS (Glasgow outcome scale, GOS), the US National Institutes of Health neurological deficits (NIHSS) and long-term Karnofsky functional status (Kamofsky performance status, KPS) score compared with the conventional group no significant difference (P＞0.05);super-early group patients 3 months and 12 months of GOS, NIHSS and KPS scores were significantly increased (P＜0.05) than the conventional group. Patients with ultra-early scalp skull patch set release time than conventional repair group was significantly shorter (P＜0.05), the amount of bleeding was significantly reduced (P＜0.05);the next two cranioplasty subdural effusion were significantly lower, the difference statistics significance (P＜0.05). However, the overall complication rate was no significant difference (P＞0.05). Conclusion: Severe brain injury patients after decompression craniectomy in the ultra-early (4-6 weeks) skull patch is clinically safe and effective, it can improve patient outcomes and reduce the probability of occurrence of postoperative complications, and can reduce blood loss during surgery scalp peeling time shortened. [ABSTRACT FROM AUTHOR]

To compare the effect of different surgical timing in the treatment of patients with ruptured intracranial anterior circulation aneurysms and its effect on the long-term prognosis of patients. The clinical data of 120 patients with ruptured intracranial anterior circulation aneurysms who were admitted in our hospital between March 2010 and October 2015were analyzed retrospectively. All patients were treated with microsurgical clipping. According to surgical timing, they were divided into ultra-early group (<24 h, n=43), early group (24-72 h, n=36) and delayed group (d = 10, n=41). The improvement of intracranial arterial embolization was compared between groups. The incidence rates of postoperative complications in all groups were statistically analyzed. Postoperative recovery of patients was evaluated by the Glasgow scale (GOC), and the long-term prognosis of patients was evaluated by modified Rankin scale (mRS). The rate of complete embolism in the ultra-early group was slightly higher than that in the early group and delayed group (P>0.05); The incidence rates of intraoperative and postoperative complications in ultra-early group were slightly lower than those in early group and delayed group (P>0.05); At 6, 12 and 24 months after surgery, GOS scores of the ultra-early group and delayed group were higher than those of the early group while mRS scores were lower than those of the early group. GOS scores of ultra-early group were higher than those of the delayed group while mRS scores were lower than those of the delayed group (P<0.05). There are no significant differences in surgical effects of different timing of surgery in the treatment of intracranial anterior circulation aneurysm rupture. However, the postoperative recovery and prognosis scores of patients undergoing ultra-early and delayed surgery are slightly better than early surgery. [ABSTRACT FROM AUTHOR]

• A device for testing the ultra-early tensile creep of cement paste was designed. • The tensile creep test of cement paste specimens was carried out by means of tensile test with mold and graded incremental loading. • Tensile creep tests of cement pastes with water cement ratio of 0.25, 0.3 and 0.35 were carried out at ulter-early age. • Characterization of Ultr-Early Tensile Creep of Cement Paste by Variable Viscosity Dashpot Element. • In logarithmic coordinate system, there is a linear relationship between initial viscosity of cement paste and loading age. Tensile creep releases the internal tensile stress caused by the restriction of internal deformation in cement-based structure at ultra-early age (from initial setting to final setting) and thus reduces the risk of cracking under tension. However, the tensile creep measurement at that age is challenging due to insufficient strength of specimens. Therefore, a test device for measuring the tensile creep of ultra-early age cement paste was designed in this study, which applied multilevel incremental tensile load on the ultra-early age cement paste in a tailored molud. The effect of water-cement ratio and loading age on the ultra-early was studied using that device. The results revealed that the specific creep of ultra-early cement paste decreases exponentially with the increase of loading age, while increases with the increase of water-cement ratio. The ultra-early tensile creep of cement paste was characterized by variable viscosity dashpot element. Moreover, the increase rate of viscosity with time under external force was found equal to the creep modulus of cement paste, and in the logarithmic coordinate system, there is a linear relationship between the initial viscosity of cement paste and the loading age. [ABSTRACT FROM AUTHOR]

Introduction: The timing of definitive aneurysm treatment (coiling or clipping) in poor-grade (Hunt-Hess IV or V) subarachnoid haemorrhage (SAH) patients has been a controversial topic. The purpose of this retrospective study was to analyse whether ultra-early coiling of ruptured intracranial aneurysms improves the clinical outcomes of poor-grade SAH patients. Methods: The records of patients with aneurysmal SAH who were treated with endovascular coiling were retrieved. The patients were classified into two groups: group A (patients coiled within 24 h of SAH) and group B (patients coiled ≥ 24 h after SAH). For each group, the patient demographics, Fisher grade, aneurysm characteristics and clinical outcomes were recorded. Outcomes were measured at 6 months using the modified Rankin Scale (mRS). Results: Thirty-one patients were coiled within 24 h of SAH (group A), and fourteen patients were coiled ≥24 h after SAH (group B). Groups A and B had similar clinical and angiographic characteristics. The clinical outcomes showed that a total of 58.1 % of the patients (18 of 31) in group A were independent (mRS 0-2) compared with 21.4 % of the patients (3 of 14) in group B ( P = .028). Univariate analysis demonstrated that ultra-early coiling ( P = .028) proved to be an independent predictor of better clinical outcomes (mRS 0-2). Conclusions: Ultra-early (<24 h after SAH) coiling of ruptured aneurysms was associated with improved clinical outcomes compared to coiling at ≥24 h in poor-grade SAH patients. Larger, prospective studies are required to adequately assess the outcome differences between these two groups. [ABSTRACT FROM AUTHOR]

Background: The long-term survival prognosis of patients with high-grade (Hunt-Hess grade IV-V or World Federation of Neurosurgical Societies grade IV-V) aneurysmal subarachnoid hemorrhage (aSAH) is generally poor, and the association between endovascular treatment timing and the prognosis of high-grade aSAH has not been explored in depth. This retrospective cohort study aimed to determine whether endovascular treatment within 24 h of high-grade aSAH is associated with a better prognosis., Methods: We retrospectively analyzed the clinical data of patients with high-grade aSAH who were admitted to our institution between January 2018 and January 2021. The Modified Rankin Scale score was used to assess the 6-month prognosis of patients. Univariate and multivariate logistic regression analyses were used to identify the factors associated with prognosis. The area under the receiver operating characteristic (ROC) curve was used to assess the model's discriminatory ability., Results: Eighty-six patients were included in the study. In the multivariate analysis, the timing of endovascular treatment (odds ratio = 7.003 [1.800-27.242], P = 0.005) was an independent risk factor for prognosis. The ROC curve showed that the predictive power of the timing of endovascular treatment was 0.744, the best cut-off value was 12.5 h, and the corresponding sensitivity and specificity were 71.4 and 70.5%, respectively. Hydrocephalus ( P = 0.005) and pulmonary infection ( P = 0.029) were also associated with prognosis. In addition, cerebrospinal fluid drainage immediately after endovascular treatment had a significant effect on reducing hydrocephalus formation., Conclusions: Endovascular therapy within 24 h is feasible and improves the prognosis of patients with high-grade aSAH., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wu, Huang, Liu, He, Ju, Chen, Zhang and Yi.)

Purpose: To describe the therapeutic effect and possibility of the ultra-early surgery for poor-grade aneurysmal subarachnoid hemorrhage (Hunt-Hess grades IV - V). Materials and Methods: Nine cases with intracranial aneurysms, demonstrated by computed tomographic angiography (CTA), were treated by ultra-early surgery under general anesthesia within 24 hours from subarachnoid hemorrhage (SAH), 5 cases were treated within 6 hours and 4 cases in 6 - 24 hours. Preoperative Hunt-Hess grade: 6 cases were IV and 3 cases were V. The clinical outcome was evaluated by Glasgow Outcome Scores (GOS). Results: In operation, difficult dissection occurred in 5 cases (55.6%), and rupture of aneurysm occurred and temporary obstructions were performed in 4 cases (44.4%). After clipping of aneurysm, 2 cases underwent V-P shunt because of hydrocephalus, pulmonary infection occurred in 3 cases, hypothalamus reaction accompanied with upper gastrointestinal hemorrhage in 2 cases. The clinical outcome were favorable (GOS 4 - 5) in 4 cases (44.4%), dissatisfied (GOS 2 - 3) in 3 cases (33.3%), and dead (GOS 1) in 2 cases (22.2%) when patients departed from our hospital. Conclusion: The ultra-early surgery can avoid early rebleeding of intracranial aneurysm, therefore, should be considered in the treatment of Hunt-Hess grade IV-V intracranial aneurysms. The appliance of CTA can make it possible to use of ultra-early surgery and improve the therapeutic effect. [ABSTRACT FROM AUTHOR]

Field experiments were conducted in 2001 and 2002 at the University of Thessaly Research Farm in Velestino, using three planting dates, namely: ultra-early (U-E, March 1 or 2), early (E), and normal (N) that were at least 2 weeks apart. Three maize hybrids were used: Eleonora, Pregia, and Constanza of 130, 123, and 125 day maturities, respectively. Maize emergence in the U-E planting was delayed by 8 days (19 DAP) compared with the N planting. Ear formation, fertilization and the black-layer appearance were always approximately 2 weeks ahead for the U-E compared with the other plantings. Although percentage emergence in the U-E was initially (at 4 WAP) the lowest, the final stands were similar (>94%) in either planting. Plant height and plant dry matter were lower at the U-E compared with the N planting. Only the hybrid Pregia showed the highest ratio below ground (BG) to above ground (AG) at all plantings. Leaf area index (LAI) at V6-V8 stage was highest in the N planting (differences were mainly due to hybrid Eleonora). In 2001, grain yield in the U-E was 22% lower than that of N planting. The yield component primarily responsible for this yield penalty in the U-E planting was the number of grains and not the number of rows or test weight. In 2002, however, the situation was reverse; the U-E planting gave 10% higher yields than the N planting. Irrigation in 2002 was 33% lower than that in 2001. It appears that the increased yield of the U-E planting was manifested when maize irrigation was the least favorable. The positive effect of the U-E planting is documented for the least favorable conditions. Grain moisture content at harvest was steadily lower in the U-E compared with the other plantings. Regarding weed control, it appears that a POST-application of herbicides would offer a higher weed control and grain yields than a PRE-application of herbicides. [ABSTRACT FROM AUTHOR]

Ultra-early seeding of spring wheat (Triticum aestivum L.) on the northern Great Plains can increase grain yield and grain yield stability compared to current spring wheat planting systems. Field trials were conducted in western Canada from 2015 to 2018 to evaluate the impact of optimal agronomic management on grain yield, quality, and stability in ultra-early wheat seeding systems. Four planting times initiated by soil temperature triggers were evaluated. The earliest planting was triggered when soils reached 0–2.5 °C at a 5 cm depth, with the subsequent three plantings completed at 2.5 °C intervals up to soil temperatures of 10 °C. Two spring wheat lines were seeded at each planting date at two seeding depths (2.5 and 5 cm), and two seeding rates (200 and 400 seeds m−2). The greatest grain yield and stability occurred from combinations of the earliest seeding dates, high seeding rate, and shallow seeding depth; wheat line did not influence grain yield. Grain protein content was greater at later seeding dates; however, the greater grain yield at earlier seeding dates resulted in more protein production per unit area. Despite extreme ambient air temperatures below 0 °C after planting, plant survival was not reduced at the earliest seeding dates. Planting wheat as soon as feasible after soil temperatures reach 0 °C, and prior to soils reaching 7.5–10 °C, at an optimal seeding rate and shallow seeding depth increased grain yield and stability compared to current seeding practices. Adopting ultra-early wheat seeding systems on the northern Great Plains will lead to additional grain yield benefits as climate change continues to increase annual average growing season temperatures. [ABSTRACT FROM AUTHOR]

Objective: To determine if ultra-early (<24 h) venous thromboembolism (VTE) prophylaxis was associated with hematoma growth in spontaneous intracerebral hemorrhage (ICH).Background: Patients with ICH have a high risk of VTE. Pharmacological prophylaxis such as unfractionated heparin (UFH) have been demonstrated to reduce VTE. However, published datasets exclude patients with recent ICH out of concern for hematoma enlargement. American Heart/Stroke Association guidelines recommend UFH 1-4 days after hematoma stabilization while the European Stroke Organization has no recommendations on when to begin UFH. Our institutional practice is to obtain stability CT scans at 6 to 24 h and to begin UFH following documented clinical and radiologic stability. We examined the impact of this practice on hematoma expansion.Methods: We performed a retrospective cohort analysis of consecutive ICH patients treated at a single tertiary academic referral center in the US. Demographic and clinical characteristics were abstracted. ICH volume was measured via 3D volumetrics for a CT head done on admission, follow-up stability, and prior to discharge. The primary outcome was analyzed as ≥3 mL hematoma enlargement. Secondary outcomes include hematoma expansion of ≥6mL and ≥ 33%, length of stay (LOS), discharge disposition and mortality.Results: A total of 163 ICH patients were analyzed. There were 58 (35.6%) patients in the ultra-early UFH group and UFH was initiated on average at 13.8 h from initial scan. There were 105 (64.6%) patients in the standard group who initiated UFH at an average of 46.6 h. The primary outcome of hematoma enlargement ≥3 mL was observed in 2/58(3.4%) patients with ultra-early initiation of UFH and in 7/105(6.7%) in the standard group (p=0.49). Secondary outcomes were not significant including hematoma expansion in the ultra-early group ≥ 6 mL 3/58 (5.2%) and ≥33% 7/58 (12.1%) (p=0.91, 0.61, respectively) as well as mortality or LOS.Conclusion: Venous thromboembolism prophylaxis started ultra-early (≤24 h) after ICH was not associated with hematoma expansion. [ABSTRACT FROM AUTHOR]

Background Ultra-early surgical clot removal relieves mechanical compression on adjacent normal brain tissue and limits the toxic effects of a hematoma, which might improve the outcomes in patients with intracerebral hemorrhage (ICH); however, hematoma expansion frequently occurs within 20 hours after the ictus, and this limits the use of ultra-early surgery. Computed tomography angiography spot sign was recently validated as an important predictor of hematoma expansion in patients with ICH. Methods Fifty-nine patients with ICH and negative spot sign who received ultra-early stereotactic aspiration (<6 hours after ictus; n = 32 [Ultra-early group]) or routine stereotactic aspiration (≥6 hours after ictus; n = 27 [Routine group]) were included in retrospective analysis. Results The percentage of rebleeding was not significantly different between the 2 groups. Perihematoma edema 7 days after surgery in the Ultra-early group was significantly less frequent than that in the Routine group. For long-term outcomes, the proportion of patient fatalities and Glasgow Outcome Scale score were not significantly different between the 2 groups; however, for patients with severe symptoms, the rate of good neurological outcome in the Ultra-early group was higher than that in the Routine group. Conclusions Ultra-early stereotactic aspiration might decrease the volume of perihematoma edema and improve the functional outcomes to some extent, without increasing the recurrence of ICH and patient fatalities. Our findings suggest that using negative spot sign as an indicator for performing ultra-early stereotactic aspiration could be a safe and effective protocol for ICH patients. [ABSTRACT FROM AUTHOR]

Objective: To compare the outcome of patients with up to 60% total body surface area (TBSA) thermal burns undergoing ultra-early and early excision and grafting., Methods: This historical cohort study was performed in two referral burn centers of Shiraz during a 1-year period from 2015 to 2016. We included those patients with thermal burns up to 60% TBSA who underwent ultra-early (48-72 hours) and early (7-10 days) excision and grafting. We excluded those who were hemodynamically unstable and those with electrical burns. The outcome of patients was determined by graft success, operation duration, blood loss, hospital length of stay and mortality rate., Results: We included a total number of 107 patients with mean age of 32.1 ± 11.6 years. There were 65 (60.7%) men and 42 (39.3%) women among the patients. Both study groups were comparable regarding the baseline characteristics. Ultra-early excision and grafting was associated with more, higher graft success rate ( p =0.048), lower infection rate ( p =0.037), shorter hospital length of stay ( p =0.044) and lower mortality rate ( p =0.027)., Conclusion: Ultra-early excision and grafting in patients with thermal burns covering less than 60% TBSA was associated with higher graft success rate, shorter hospital length of stay, lower infection rate and lower mortality rate when compared to early surgery.

Purpose: To describe the therapeutic effect and possibility of the ultra-early surgery for poor-grade aneurysmal subarachnoid hemorrhage (Hunt-Hess grades IV-V)., Materials and Methods: Nine cases with intracranial aneurysms, demonstrated by computed tomographic angiography (CTA), were treated by ultra-early surgery under general anesthesia within 24 hours from subarachnoid hemorrhage (SAH), 5 cases were treated within 6 hours and 4 cases in 6 - 24 hours. Preoperative Hunt-Hess grade: 6 cases were IV and 3 cases were V. The clinical outcome was evaluated by Glasgow Outcome Scores (GOS)., Results: In operation, difficult dissection occurred in 5 cases (55.6%), and rupture of aneurysm occurred and temporary obstructions were performed in 4 cases (44.4%). After clipping of aneurysm, 2 cases underwent V-P shunt because of hydrocephalus, pulmonary infection occurred in 3 cases, hypothalamus reaction accompanied with upper gastrointestinal hemorrhage in 2 cases. The clinical outcome were favorable (GOS 4-5) in 4 cases (44.4%), dissatisfied (GOS 2-3) in 3 cases (33.3%), and dead (GOS 1) in 2 cases (22.2%) when patients departed from our hospital., Conclusion: The ultra-early surgery can avoid early rebleeding of intracranial aneurysm, therefore, should be considered in the treatment of Hunt-Hess grade IV-V intracranial aneurysms. The appliance of CTA can make it possible to use of ultra-early surgery and improve the therapeutic effect.