Abstract W P44: Predicting Omni-directional Lesion Growth in Acute Stroke using Multimodal Intensity Profiles

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Fabien Scalzo ◽  
Wahid Chowdhury ◽  
David S Liebeskind
Keyword(s):  
Acute Stroke ◽  
Specific Model ◽  
Infarct Core ◽  
Directional Growth ◽  
Single Input ◽  
Lesion Growth ◽  
Tissue Recovery ◽  
First Time ◽  
The Relationship

Introduction: Mechanisms of lesion growth in acute stroke remain poorly characterized. Favorable imaging signatures related to regional tissue status may be disclosed with diffusion-weighted (DWI) and perfusion-weighted (PWI) imaging. Certain values of individual parameters, such as prolonged and decreased CBF, are associated with poor tissue recovery, yet scant data are available regarding the directionality of lesion growth and how different perfusion imaging parameters may be combined to best characterize lesion growth. We developed a probabilistic model that exploits DWI and multi-parametric PWI to predict likelihood of lesion growth in every 3D direction. Hypothesis: We test the hypothesis that combined intensity profiles of PWI features predict the likelihood of lesion growth, in every direction. Methods: Retrospective analysis of DWI and PWI acquired within 24 hours of symptom onset with FLAIR sequences acquired four days later. DWI and PWI were co-registered and the lesions were manually delineated on the baseline DWI and follow-up FLAIR. Intensity profiles of perfusion parameters (including CBV, CBF, MTT, TTP, Tmax) were extracted along discrete spherical coordinates (every 5 degrees). A nonlinear regression model was used to capture the relationship between the intensity profile along a direction and the amount of growth in that direction. A cross-validation was performed to evaluate the accuracy of the model in predicting the lesion growth in every direction at day 4. Results: A total of 49 patients were included in the analysis. Mean age was 68.7 (35-91). Median baseline NIHSS was 16 (2-31) and median mRS at discharge was 5 (1-6). Lowest prediction error (62 cm2 IQR [26 86]) in terms of average lesion surface and final directional growth error 7.91 mm IQR [5.2 10.3] was obtained by combining cBV, cBF, TTP, TMAX intensity profiles into a single input vector. Conclusions: For the first time, a direction-specific model of infarct growth has been developed. It provides quantitative insights about the likelihood of lesion growth surrounding a stroke. This prediction is not only based on closeness to the infarct core or the presence of penumbra but relies also on the complex dependencies between joint evidence found in multiple perfusion parameters.

Abstract 188: Correlation of Angiographic Capillary Index Score (CIS) with Diffusion and Perfusion MR Imaging in the DEFUSE 2 Trial

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Michael P Marks ◽  
Firas Al-Ali ◽  
Maarten G Lansberg ◽  
Michael Mlynash ◽  
Stephanie M Kemp ◽  
...  
Keyword(s):  
Endovascular Therapy ◽  
Lesion Volume ◽  
Collateral Flow ◽  
Point Scale ◽  
Median Volume ◽  
Perfusion Mr ◽  
Lesion Growth ◽  
Perfusion Mr Imaging ◽  
The Relationship

Objective: The CIS has been shown to be a predictor of good clinical outcome following endovascular therapy for acute ischemic stroke. We undertook this study to determine the relationship between CIS and baseline diffusion-perfusion imaging as well as angiographic collaterals in DEFUSE 2 study patients. Methods: Patients undergoing endovascular therapy within 12 hours of stroke onset were prospectively enrolled. Only patients with an ICA/M1 occlusion and adequate demonstration of the anterior and posterior circulations at baseline angiography were included in this analysis. Blinded reading of the CIS was made using a 4 point scale from 0 (no capillary blush in ischemic territory) to 3 (blush throughout). Analysis was dichotomized to poor CIS (0-1) versus good (2-3). CIS was correlated with baseline DWI volume, PWI volume (Tmax > 6, Tmax>10), an angiographic collateral score (using a previously described 5 point scale) and subsequent infarct growth. Results: Forty-eight patients had ICA/M1 occlusions and adequate angiographic images to evaluate CIS. Baseline DWI lesion volume correlated with CIS (p=0.001). Median DWI volume for patients with poor CIS (0-1) was 28 (IQR, 11-54) versus 13 (3-27) for those with good CIS (2-3), p=0.011. Baseline T max > 6 volume correlated with CIS (p=0.004). Median volume of tissue at risk (T max > 6 sec) in those with poor CIS was 108 ml (IQR, 74-138) versus 69(43-108) with good CIS, p=0.009. Severe T max delay (> 10 sec) also correlated with CIS (p=0.001). CIS was also found to correlate with angiographic collaterals (p=0.006). On follow-up MRI CIS correlated with subsequent lesion growth (p=0.043). Conclusions: CIS provides a rapid angiographic assessment of capillary blush from collateral flow into the ischemic territory and correlates with angiographic collateral scores. In DEFUSE 2 the CIS score was strongly associated with baseline DWI and PWI lesion volumes and subsequent lesion growth.

Abstract WP83: Validation of a Relative Non-Contrast CT Map to Detect Early Ischemic Changes in Acute Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Margy E McCullough-Hicks ◽  
Soren Christensen ◽  
Aditya Srivatsan ◽  
Gregory W Albers ◽  
Maarten Lansberg
Keyword(s):  
Acute Stroke ◽  
Brain Regions ◽  
Lesion Volume ◽  
Stroke Patients ◽  
Infarct Core ◽  
Test Characteristics ◽  
Contrast Ct ◽  
Sensitivity Specificity ◽  
Early Infarction

Background: Discerning signs of early infarct on the non-contrast CT (NCCT) can be difficult. To facilitate interpretation of the NCCT we previously developed a technique to generate symmetry ratio maps of the NCCT (rNCCT maps) on which subtle (≥5%) differences in density between symmetric brain regions are enhanced. We sought to validate the rNCCT map against other measures of early infarction in a large cohort. Methods: rNCCT maps were generated for 146 ischemic stroke patients. We assessed how often a neurologist’s interpretation of the NCCT was changed when provided with the rNCCT map. The neurologist was blinded to CTP and DWI but was given the infarct hemisphere. In addition, using the 24-hour DWI as the gold standard, we assessed the sensitivity, specificity and volumetric accuracy of the rNCCT-defined infarct core and compared this to the test characteristics of CTP-defined infarct core (CBF<38% threshold). Results: Addition of rNCCT overlay map changed clinician’s initial read 64.4% of the time (95% CI 56-72%); the rNCCT identified new areas of ischemia not appreciated on blinded review 86.2% of the time (95% CI 78-92%) and in 35.1% helped rule out early ischemia where the reader was unsure of its presence (95% CI 26-45%). In the 53 patients with reperfusion and follow-up MRI, specificity of rNCCT for final lesion volume was 99.5% for rNCCT [98.5-99.8%] vs. 99.8% [IQR 98.8-99.9%] for CTP (P=0.08). Sensitivity for rNCCT was 19.9% [7.1-28.1%] vs. 17.5% [4.7-32.2%] for CTP (P=0.56). Conclusions: This study validates the rNCCT map for detection of early ischemic changes. It is more quantitative and objective than a clinician’s read of the NCCT alone. The sensitivity and specificity for detecting early ischemic changes on rNCCT were comparable to those achieved with CTP. This indicates that the rNCCT could be a valuable tool in the evaluation of acute stroke patients.

Changes in the prevalence of psychiatric disorder in a community are related to changes in the mean level of psychiatric symptoms

1996 ◽  
Vol 26 (6) ◽  
pp. 1253-1260 ◽  
Author(s):  
Joyce E. Whittington ◽  
Felicia A. Huppert
Keyword(s):  
General Population ◽  
Psychiatric Disorder ◽  
Psychiatric Symptoms ◽  
Population Sample ◽  
General Population Sample ◽  
Cross Sectional ◽  
The Mean ◽  
First Time ◽  
The Relationship

SynopsisThe paper of Anderson et al. (1993), based on cross-sectional data, showed that minor psychiatric disorder in a population is linearly related to the mean number of psychiatric symptoms in the population. The present investigation asks whether the same relationship holds longitudinally as well as cross-sectionally. Data from a 7-year follow-up of a general population sample demonstrate, for the first time, that a relationship exists between changes in prevalence of psychiatric disorder and changes in the mean number of psychiatric symptoms in a given population. Moreover, the relationship is linear; a one-point decrease in mean scores on the GHQ-30 is associated with a 6% decrease in prevalence of disorder.

scholarly journals The Influence of Endplate Morphology on Cage Subsidence in Patients With Stand-Alone Oblique Lateral Lumbar Interbody Fusion (OLIF)

2021 ◽  
pp. 219256822199209
Author(s):  
Ziang Hu ◽  
Dengwei He ◽  
Jiawei Gao ◽  
Zhongyou Zeng ◽  
Chao Jiang ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Disc Height ◽  
Treatment Level ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion ◽  
Cage Subsidence ◽  
Disability Questionnaire ◽  
First Time ◽  
The Relationship

Study Design: A retrospective study of prospectively collected radiographic and clinical data. Objective: This study aims to investigate the relationship between endplate morphology parameters and the incidence of cage subsidence in patients with mini-open single-level oblique lateral lumbar interbody fusion (OLIF). Methods: We included 119 inpatients who underwent OLIF from February 2015 to December 2017. A total of 119 patients with single treatment level of OLIF were included. Plain anteroposterior and lateral radiograph were taken preoperatively, postoperatively, and during follow-up. The correlation between disc height, endplate concave angle/depth, cage position and cage subsidence were investigated. Functional rating index (Visual Analogue Scale for pain, and Roland Morris Disability Questionnaire) were employed to assess clinical outcomes. Results: Cage subsidence was more commonly seen at the superior endplates (42/119, 35.29%) than at the inferior endplates (6/119, 5.04%) (p < 0.01). More importantly, cage subsidence was significantly less in patients with superior endplates that were without concave angle (3/20, 15%) than with concave angle (37/99, 37.37%) (p < 0.05). Cage subsidence correlated negatively with preoperative anterior disc height (r = −0.21, p < 0.05), but positively with disc distraction rate (r = 0.27, p < 0.01). Lastly, the distance of cage to the anterior edges of the vertebral body showed a positive correlation (r = 0.26, p < 0.01). Conclusions: This study for the first time demonstrated that endplate morphology correlates with cage subsidence after OLIF. Since relatively flat endplates with smaller concave angle significantly diminish the incidence of subsidence, the morphology of cage surface should be taken into consideration when designing the next generation of cage. In addition, precise measurement of the disc height to avoid over-distraction, and more anteriorly placement of the cage is suggested to reduce subsidence.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

Affirmative Action and Leadership Attitudes in Brazilian Women Managers

2011 ◽  
Vol 10 (3) ◽  
pp. 139-143 ◽  
Author(s):  
Gazi Islam ◽  
Sarah E. S. Zilenovsky
Keyword(s):  
Affirmative Action ◽  
Latin American ◽  
Women Managers ◽  
Psychological Effects ◽  
Preferential Selection ◽  
Justice Perceptions ◽  
First Time ◽  
The Relationship

This note examines the relationship between affirmative action (AA) program perceptions and women’s self-ascribed capacity and desire to become leaders. We propose that women who believe that their organization implements a program of preferential selection toward women will experience negative psychological effects leading to lowered self-expectations for leadership, but that this effect will be moderated by their justice perceptions of AA programs. We test this proposition empirically for the first time with a Latin American female sample. Among Brazilian women managers, desire but not self-ascribed capacity to lead was reduced when they believed an AA policy was in place. Both desire’s and capacity’s relationships with belief in an AA policy were moderated by justice perceptions.

Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Roc Analysis ◽  
Tsh Suppression ◽  
Significant Difference ◽  
Test Specificity ◽  
The Relationship ◽  
Tumor Scintigraphy ◽  
Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

A Decade of Disparities in Diabetes Technology Use and HbA1c in Pediatric Type 1 Diabetes: A Trans-Atlantic Comparison

2020 ◽  
Author(s):  
Ananta Addala ◽  
Marie Auzanneau ◽  
Kellee Miller ◽  
Werner Maier ◽  
Nicole Foster ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Technology Use ◽  
Hemoglobin A1c ◽  
Diabetes Technology ◽  
Design And Methods ◽  
Relationship Of ◽  
The Relationship ◽  
Pediatric Type 1 Diabetes

<b>Objective:</b> As diabetes technology use in youth increases worldwide, inequalities in access may exacerbate disparities in hemoglobin A1c (HbA1c). We hypothesized an increasing gap in diabetes technology use by socioeconomic status (SES) would be associated with increased HbA1c disparities. <p> </p> <p><b>Research Design and Methods: </b>Participants aged <18 years with diabetes duration ≥1 year in the Type 1 Diabetes Exchange (T1DX, US, n=16,457) and Diabetes Prospective Follow-up (DPV, Germany, n=39,836) registries were categorized into lowest (Q1) to highest (Q5) SES quintiles. Multiple regression analyses compared the relationship of SES quintiles with diabetes technology use and HbA1c from 2010-2012 and 2016-2018. </p> <p> </p> <p><b>Results: </b>HbA1c was higher in participants with lower SES (in 2010-2012 & 2016-2018, respectively: 8.0% & 7.8% in Q1 and 7.6% & 7.5% in Q5 for DPV; and 9.0% & 9.3% in Q1 and 7.8% & 8.0% in Q5 for T1DX). For DPV, the association between SES and HbA1c did not change between the two time periods, whereas for T1DX, disparities in HbA1c by SES increased significantly (p<0.001). After adjusting for technology use, results for DPV did not change whereas the increase in T1DX was no longer significant.</p> <p> </p> <p><b>Conclusions: </b>Although causal conclusions cannot be drawn, diabetes technology use is lowest and HbA1c is highest in those of the lowest SES quintile in the T1DX and this difference for HbA1c broadened in the last decade. Associations of SES with technology use and HbA1c were weaker in the DPV registry. </p>

ЗУБРЫ НА СЕВЕРЕ РОССИИ — НАСТОЯЩЕЕ И БУДУЩЕЕ

2019 ◽  
pp. 42-44
Author(s):  
I.V. GUSAROV ◽  
V.A. OSTAPENKO ◽  
T.V. NOVIKOVА
Keyword(s):  
Biological Diversity ◽  
Climatic Conditions ◽  
Economic Consequences ◽  
European Bison ◽  
Rare And Endangered Species ◽  
The North ◽  
Rare And Endangered ◽  
Relationship Of ◽  
First Time ◽  
The Relationship

Впервые в мире создана популяция зубров на территории 60 градусов северной широты. В новых климатических условиях разведения и сохранения зубров определены и проанализированы факторы существования вида на севере Европейской части РФ. Выявлены признаки, динамика численности, которые являются составной частью системы, предназначенной для управления биоразнообразием. Интродукция, являясь процессом введения в экосистему нехарактерных для нее видов, может усиливать изменения биоценозов как положительно, так и отрицательно. Насколько быстро и успешно проходит процесс адаптации заселенного вида, и усматривается его влияние на окружающую среду зависит дальнейшее существование зубров и в целом биоразнообразия. В статье обсуждаются вопросы взаимоотношения зубров с другими видами копытных и хозяйственной деятельностью человека, а также дальнейшим использованием зубров в сельскохозяйственном производстве. Пластичность зубров, выявление изменений и их анализ при вселении видов в новые условия обитания необходимы не только для определения развития или деградации биоценозов и в целом экосистемы, но и прогноза социально-экономических последствий интродукции как одного из методов сохранения редких и исчезающих видов фауны.For the first time in the world, a bison population has been created in an area of 60 degrees north latitude. In the new climatic conditions of breeding and preservation of bison, the factors of the species existence in the north of the European part of the Russian Federation are identified and analyzed. The signs, dynamics of abundance, which are an integral part of the system designed to manage biodiversity are identified, since the preservation of biological diversity on the planet is one of the main problems of our time. Introduction, being the process of introducing non-typical species into an ecosystem, can enhance changes in biocenoses, both positively and negatively. The question posing sounds especially when it comes to such a large hoofed animal as the European bison. How quickly and successfully the process of adaptation of the universe takes place and its environmental impact is seen depends on the continued existence of bison and biodiversity in general. The article discusses the relationship of bison with other types of ungulates and human activities, as well as the further use of bison in agricultural production. How these issues will be resolved positively depends on the future of these animals. Thus, the plasticity of bison, the identification of changes and their analysis, with the introduction of species into new habitat conditions is necessary not only to determine the development or degradation of biocenoses and the ecosystem as a whole, but also to predict the socio-economic consequences due to the introduction as one of the methods of preserving rare and endangered species of fauna.

RESULTS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE FOR CHALAZION TREATMENT

2011 ◽  
pp. 100-104
Author(s):  
Thi Thu Nguyen ◽  
Viet Hien Vo ◽  
Thi Em Do
Keyword(s):  
Success Rate ◽  
Key Words ◽  
Triamcinolone Acetonide ◽  
Lower Eyelid ◽  
Upper Eyelid ◽  
Interventional Trial ◽  
The Mean ◽  
First Time

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.

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