No abstract

BackgroundIncreasing evidence has suggested that the cerebellum is associated with pain and migraine. In addition, the descending pain system of the brainstem is the major site of trigeminal pain processing and modulation and has been discussed as a main player in the pathophysiology of migraine. Cerebellar and brainstem structural changes associated with migraineurs remain to be further investigated.MethodsVoxel-based morphometry (VBM) (50 controls, 50 migraineurs without aura (MWoAs)) and diffusion tensor imaging (DTI) (46 controls, 46 MWoAs) were used to assess cerebellum and brainstem anatomical alterations associated with MWoAs. We utilized a spatially unbiased infratentorial template toolbox (SUIT) to perform cerebellum and brainstem optimized VBM and DTI analysis. We extracted the average diffusion values from a probabilistic cerebellar white matter atlas to investigate whether MWoAs exhibited microstructure alterations in the cerebellar peduncle tracts.ResultsMWoAs showed decreased fractional anisotropy (FA) in the vermis VI extending to the bilateral lobules V and VI of the cerebellum. We also found higher axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) in the right inferior cerebellum peduncle tract in MWoAs. MWoAs exhibited both reduced gray matter volume and increased AD, MD and RD in the spinal trigeminal nucleus (SpV).ConclusionMWoAs exhibited microstructural changes in the cerebellum and the local brainstem. These structural differences might contribute to dysfunction of the transmission and modulation of noxious information, trigeminal nociception, and conduction and integration of multimodal information in MWoAs. These findings further suggest involvement of the cerebellum and the brainstem in the pathology of migraine without aura.Electronic supplementary materialThe online version of this article (10.1186/s10194-019-1045-5) contains supplementary material, which is available to authorized users.

Scheme 4. Pd-catalyzed enantioselective decarboxylative allylic alkylation. [a] [Pd 2 (dba) 3 ] (3.5 mol %), L2 (8.75 mol %). [b] At 55 8C.Scheme 5. Catalytic enantioselective total synthesis of (À)-aspidospermidine. Reaction conditions: a) HCO 2 H, RT; b) LiAlH 4 , THF, À20 8C, then HCl (2 m); c) K 2 OsO 4 ·2 H 2 O, NMO, THF/H 2 O (1:1), then NaIO 4 ; d) 1,2-ethanedithiol, BF 3 ·Et 2 O, CH 2 Cl 2 ; e) Raney nickel, H 2 , EtOH, 60 8C; f) LiAlH 4 , Et 2 O, reflux; g) Na/NH 3 , THF, À78 8C. NMO = Nmethylmorpholine-N-oxide.

Current data confirms that PP is an independent risk factor for stroke but is not a predictor of mortality.

In this paper, we present a new automatic diagnosis method for facial acne vulgaris which is based on convolutional neural networks (CNNs). To overcome the shortcomings of previous methods which were the inability to classify enough types of acne vulgaris. The core of our method is to extract features of images based on CNNs and achieve classification by classifier. A binary-classifier of skin-and-non-skin is used to detect skin area and a seven-classifier is used to achieve the classification task of facial acne vulgaris and healthy skin. In the experiments, we compare the effectiveness of our CNN and the VGG16 neural network which is pre-trained on the ImageNet data set. We use a ROC curve to evaluate the performance of binary-classifier and use a normalized confusion matrix to evaluate the performance of seven-classifier. The results of our experiments show that the pre-trained VGG16 neural network is effective in extracting features from facial acne vulgaris images. And the features are very useful for the follow-up classifiers. Finally, we try applying the classifiers both based on the pre-trained VGG16 neural network to assist doctors in facial acne vulgaris diagnosis.

Evolution of the synthetic strategy that culminated in the first asymmetric total synthesis of the Aspidosperma alkaloid limaspermidine is described. The successful enantioselective route to (-)-limaspermidine proceeds in 10 steps and with the isolation of only six intermediates using a Pd-catalyzed enantioselective decarboxylative allylation we have recently developed. This first enantioselective synthesis of (-)-limaspermidine establishes unambiguously its absolute configuration and allows the first asymmetric formal total synthesis of the Aspidoalbine alkaloid (-)-1-acetylaspidoalbidine.

The catalytic enantioselective and divergent total syntheses of Aspidosperma alkaloids (+)-10-oxocylindrocarpidine 7, (+)-cylindrocarpidine 1, (-)-N-acetylcylindrocarpinol 6, and (+)-aspidospermine 8 have been accomplished in 11 steps from a common precursor (15) on the basis of a highly concise route. The route features three metal-catalyzed reactions, including the key Pd-catalyzed decarboxylative asymmetric allylation of carbazolones developed in our laboratory. Our syntheses, using a combination of C-H activation, enantioselective catalysis, and collective synthesis, represent the first total synthesis of 10-oxocylindrocarpidine and the first asymmetric total synthesis of cylindrocarpidine and N-acetylcylindrocarpinol.

The purpose of this study was to perform a meta-analysis of current literature to determine whether lowering blood pressure (BP) during the acute phase of an ischemic stroke improves short- and long-term outcomes.PubMed, Cochrane, and Embase were searched until September 5, 2014 using combinations of the search terms: blood pressure reduction, reduced blood pressure, lowering blood pressure, ischemic stroke, acute stroke, and intra-cerebral hemorrhage. Inclusion criteria were randomized controlled trial and patients with acute stroke (ischemic or hemorrhagic) treated with an antihypertensive agent or placebo. Outcome measures were change in systolic and diastolic BP (SBP, DBP) after treatment, and short- and long-term dependency and mortality rates.A total of 459 studies were identified, and ultimately 22 studies were included in the meta-analysis. The total number of participants in the treatment groups was 5672 (range, 6–2308), and in the control groups was 5416 (range, 6–2033). In most studies, more than 50% of the participants were males and the mean age was more than 60 years. The mean follow-up time ranged from 5 days to 12 months. As expected, treatment groups had a greater decrease in BP than control groups, and this effect was seen with different classes of antihypertensive drugs. Short-term and long-term dependency rates were similar between treatment and control groups (short-term dependency: pooled odds ratio [OR] = 1.041, 95% confidence interval [CI]: 0.936–1.159, P = 0.457; long-term dependency: pooled OR = 1.013, 95% CI: 0.915–1.120, P = 0.806). Short-term or long-term mortality was similar between the treatment and control groups (short-term mortality: pooled OR = 1.020, 95% CI: 0.749–1.388, P = .902; long-term mortality: pooled OR = 1.039, 95% CI: 0.883–1.222, P = 0.644).Antihypertensive agents effectively reduce BP during the acute phase of an ischemic stroke, but provide no benefit with respect to short- and long-term dependency and mortality.