Multivariate models take interactions between cytokines into
Multivariate models take interactions between cytokines into account and were used to accurately distinguish samples from different time points in pregnancy. The distinction accuracy did not increase with increasing time between the gestational time points, indicating that the cytokine development does not depend on time only, but rather physiological milestones during pregnancy. Despite the short time interval between GA 10 and 13 weeks, the model could with almost 70% accuracy distinguish the two time points, indicating a substantial cytokine pattern variation. This interval represents the ending of the vitelline circulation and the transition to full circulation via the placental MK2 Inhibitor IV . VEGF is important for vascular remodelling in early pregnancy, and showed the greatest increase in this time interval. So far, studies on pregnancy complications using cytokine pattern analyses provides promising results , . The methodological simplicity and biological strength of assessing combined cytokine patterns underlie our strong advice of expanded use of such methods to further identify cytokine biomarkers of pregnancy complications.
Declaration of interest
The epidemiology of intracerebral hemorrhage Hemorrhagic stroke is a cerebrovascular disease that can have devastating effects on health. In 2010, 5.3 million people suffered hemorrhagic stroke worldwide. Of those, 80% lived in low- and middle-income countries, 3.0 million died, and 62.8 million lost disability-adjusted life-years (Krishnamurthi et al., 2013). In 2013, 3.2 million people died of hemorrhagic stroke (Mortality and Causes of Death, 2015), of which approximately 1.0 million were young adults (aged 20–64 years) (Krishnamurthi et al., 2015). The two types of hemorrhagic stroke are intracerebral hemorrhage (ICH, within the brain) and subarachnoid hemorrhage. ICH is twice as common as subarachnoid hemorrhage but they are equally deadly. In addition, only 20% of ICH survivors are able to engage in self-care after 6 months, and 74% are left with some remaining symptoms at 12 months. Therefore, ICH is an extremely debilitating disease. A variety of factors contribute to ICH, but hypertension is the most prevalent cause. Current research shows that hypertension accounts for approximately 50% of all ICH cases, but this percentage is down from what it has been in the past (Manno, 2012). The decrease might result from effective antihypertensive therapies, popularization of imaging methods that help to ascertain the etiology of ICH, and increases in other causes (Manno, 2012, Senn et al., 2014, Wang et al., 2015b). Chronic hypertension destroys the small penetrating arteries or arterioles. Therefore, hypertensive ICH often occurs in the basal ganglia, brainstem, cerebellum, and other deep brain tissues (Manno, 2012). Cerebral amyloid angiopathy (CAA) is the second major cause of ICH, accounting for 20% of the incidence (Meretoja et al., 2012). CAA is defined by the deposition of amyloid β in the walls of cortical and leptomeningeal vessels (Weber et al., 2018). ICH caused by CAA is usually located in the lobar of the elderly (Mehndiratta et al., 2012). Other causes of ICH are arteriovenous malformations or systemic diseases, but these are rare. The risk factors for ICH include age, gender, diabetes mellitus, genetic variations in apolipoproteins, ethnicity, geographical location, psychosocial factors, waist-to-hip ratio, and life factors such as smoking, alcohol consumption, and poor eating habits (Costa et al., 2018, O’Donnell et al., 2016). ICH treatment is based mainly on an accurate diagnosis and control of disease progression (Senn et al., 2014). It generally involves prevention of hematoma expansion (coagulopathy and blood pressure correction), control of intracranial pressure, and treatment of edema (Hemphill et al., 2015). However, these seemingly feasible symptomatic treatments, such as reduction of hematoma volume by open surgery, prevention of hematoma expansion by hemostatic therapies (platelet transfusion or recombinant activated factor VII), and intensive antihypertensive treatment, have not provided sufficient benefits in clinical trials (Baharoglu et al., 2016, Mayer et al., 2008, Mendelow et al., 2013, Morotti et al., 2017). Thus, a novel targeted therapeutic strategy that improves survival, functional outcome, and quality of life is imperative.