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SummaryIncreased red blood cell distribution width (RDW), which is a marker of anisocytosis, is associated with mortality and cardiovascular events in the general population and in patients with heart failure or coronary heart disease. We investigated whether RDW in acute cerebral infarction is predictive of functional outcome and mortality. A total of 847 consecutive patients with first-ever acute cerebral infarction who presented to the emergency department within seven days of symptom onset were enrolled in this study. We investigated the association of RDW with poor functional outcome (modified Rankin Scale >2) and all-cause mortality at three months, as well as survival time for one year after stroke onset. Multivariate logistic regression revealed that higher RDW was independently associated with poor functional outcome (adjusted odds ratio [OR], 1.222 per 1% increment in RDW, 95% confidence interval [CI] 1.059–1.409, p=0.006) and all-cause death (adjusted OR, 1.395 per 1% increment in RDW, 95% CI 1.168–1.665, p<0.001) at three months after stroke onset. RDW was an independent predictor of survival in multivariate Cox-proportional regression model (adjusted hazard ratio, 1.328 per 1% increment in RDW, 95%CI 1.178–1.498, p<0.001). The addition of RDW to a survival model significantly increased predictability for survival across the entire follow-up period (weighted average of the area-under the curves, 0.858 vs. 0.841, p<0.05). In conclusion, higher RDW measured in cases of acute stage cerebral infarction was associated with poor functional outcome and mortality. RDW may be used as a biomarker for the prediction of long-term outcomes in patients with acute cerebral infarction.

The visible green and red upconversion emissions in Er(3+)/Yb(3+) doped β-NaGdF4 nanoparticles were enhanced by tridoping with Fe(3+) ions (0-40 mol%). XRD, XPS, ICP-AES and EDS data demonstrated successful incorporation of Fe(3+) ions in NaGdF4:Yb(3+)/Er(3+) nanoparticles. The effect of Fe(3+) tridoping on the upconversion luminescence in NaGdF4:Yb(3+)/Er(3+) NPs was investigated in detail. The green and red emission intensities were enhanced by 34 and 30 times, respectively. The maximum emission was observed in a sample containing 30 mol% Fe(3+) ions. A possible mechanism for the enhanced upconversion emission is proposed. In addition, a layer of silica was coated onto the surface of UCNPs to improve the biocompatibility. Folic acid was covalently linked to the silica coated UCNPs to form UCNP@SiO2-FA nanoprobes, which have been successfully applied to the fluorescent imaging HeLa cells.

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The presence of CMB on MRI and the dichotomized cutoff of ≥5 CMBs might identify subgroups of ischemic stroke patients with AF with high ICH risk and after further validation could help in risk stratification, in anticoagulation decisions, and in guiding randomized trials and ongoing large observational studies.