Ceramide Dynamics and Prognostic Value in Acute and Subacute Ischemic Stroke: Preliminary Findings in a Clinical Cohort
Bibliographic record
Abstract
Background: Ceramides are implicated in sphingolipid signaling. Elevated ceramide levels have been associated with increased cardiovascular risk, but information on their role in acute ischemic stroke (AIS) is limited. The purpose of this study is to investigate the temporal dynamics of ceramide levels in AIS and assess their prognostic utility for long-term outcomes. Methods: This is a prospective pilot study of patients with AIS admitted to Mayo Clinic within 12 h of last known well (LKW). Ceramides were assessed by liquid chromatography mass spectrometry at two time points: T1 (within 12 h of LKW) and T2 (1 - 7 days from LKW). Wilcoxon signed rank test was used to compare paired ceramide levels and ratios. Ordinal logistic regression was used for assessment of associations with long-term outcomes. Results: Twenty-three patients met inclusion criteria (median (range)): age (76 years (45 - 95)); body mass index (25.6 (20.5 - 46.6)); National Institutes of Health Stroke Scale (NIHSS) score (5 (0 - 27)); infarct volume (1.4 cm 3 (0.0 - 36.5)). Long-chain ceramides increased between T1 and T2 whereas very-long chain ceramides decreased, P < 0.05. Upon stratification of patients by prior statin exposure, increase in long-chain ceramide level was present only in statin-naive patients. Greater neurological disability at follow-up was associated with higher ceramide score, C(18:0)/C(24:0) ratio and higher levels of glycated hemoglobin. Conclusions: Long-chain and very-long-chain ceramide are actively implicated in pathologic processes in acute and subacute phases of stroke, with their dynamics being inversely related and potentially modulated by statin therapy. Ceramide levels and ratios might be useful for prognosis of long-term neurological outcomes. J Neurol Res. 2020;10(6):209-219 doi: https://doi.org/10.14740/jnr633
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".