Iversenmccarty9141

Principle components analysis (PCA) can be used to detect repeating co-variant patterns of resting-state dynamic functional connectivity (DFC) of brain networks, accompanied with sliding-window technique. However, the robustness of PCA-based DFC-state extraction (DFC-PCA) is poorly studied. We investigated the reliability of PCA results and improved the robustness of DFC-PCA for a limited sample size. We first established how PCA-based DFC results varied with sample size and PC order in five rounds of bootstrapping with different sample sizes. The consistency across trials increased with increasing sample size and/or decreasing PC order. We then developed a framework based on PC matching and reordering to obtain a more reliable estimation of co-variant DFC patterns. With either the identical template generated by the surrogate dataset itself or with the external template obtained from existing results, the perceptual hash algorithm was used to reorder PCs according to their patterns. After order correction, reliable results were obtained by averaging across trials within each surrogate dataset. selleckchem This newly developed framework allowed simultaneous measurement and improvement of DFC-PCA. This consistency could also be used as a criterion for PC selection and interpretation to support the reliability and validity of the conclusion.

Ramucirumab (RAM) plus paclitaxel (PTX) therapy has shown promising results as a standard second-line treatment for advanced gastric cancer patients. Recently, combined docetaxel (DOC) plus S-1 (DS) therapy could be regarded as the new standard adjuvant chemotherapy for patients with curatively resected stage III gastric cancer. However, the efficacy and safety of RAM plus PTX therapy in patients treated previously with DOC-containing therapy remains unclear.

This study assessed the clinical outcomes of RAM plus PTX therapy in advanced gastric cancer patients with or without a previous history of treatment with a DOC-containing regimen.

In a series of 107 consecutive patients enrolled for this study, the median PFS and OS were 4.2 and 6.2months, respectively. Fifty-five patients had a history of prior therapy with DOC and 52 did not. There was no significant difference between with and without DOC groups in the ORR (22.2% vs. 23.5%), PFS (4.2 vs. 5.3months), or OS (7.2 vs. 6.4months). In a comparison taking into account the interval from the DOC-containing therapy to the RAM plus PTX therapy, the number of treatment courses was significantly smaller and the PFS significantly shorter in the patient group with an interval of ≤ 6months (median, 2 vs 4.5 courses, P = 0.033; 3.4months vs. 5.1months, P = 0.043).

RAM plus PTX therapy in patients with advanced gastric cancer is effective even in patients who have previously received DOC-containing chemotherapy, especially if the interval is > 6months.

 6 months.The endoscopic endonasal transoculomotor approach (EETA) has been recently described as a doorway to access the parapeduncular space and treat pituitary adenomas with oculomotor extension. Intraoperative identification of the oculomotor triangle endonasally is challenging and dissection can put the internal carotid artery (ICA) at risk. The aim of the present study is to find reliable landmarks that identify the oculomotor triangle (OCMT) during the EETA and protect the ICA from injury. Several lines were defined for calculations. Among them, one oblique line that extends from the inferior margin of the lateral orbital canal recess to the vidian canal was named the clinoid-to-vidian line (CVL), while a vertical line that extends over the most medial point of the paraclival ICA was titled the sagittal paraclival line (SPL). Anatomic relationships between the OCMT to these lines were assessed in 7 cadaveric heads. The intersecting point between the CVL and SPL is located within 2 mm of the center of the OCMT (mean 0.8 ± 0.5 mm), and 1.1 ± 0.8 mm medially and above the parasellar ICA. CVL and SPL are reliable landmarks during the EETA that can both protect the parasellar ICA and anatomically orientate to the blind spot that corresponds with the OCMT. We recommend starting dissection medial and superior to the CVL-SPL intersecting point, and carry the dissection laterally thereafter to avoid inadvertent injury of the ICA.Presurgical discrimination of blood blister-like aneurysms (BBAs) can assist neurosurgeons in clinical decision-making. The aim of this study was to investigate the characteristics of BBAs and construct a useful tool to distinguish BBAs. This study reviewed patients with small/median, hemispherical, and wide-necked aneurysms of the internal carotid artery in our institution. BBAs were identified via their intraoperative findings. A hemodynamic analysis was performed using a patient-specific model. The independent risk factors of BBAs were investigated using a logistic analysis. A scoring system was then established to discriminate BBAs, in which its predicting value was analyzed using receiver operating characteristic (ROC) analysis. A total of 67 aneurysms comprising 21 BBAs were enrolled. Comparing features between BBAs and non-BBAs, statistical significances were found in the aspect ratio (AR), height-to-width ratio, aneurysm angle (AA), wall shear stress gradient (WSSG), and normalized wall shear stress average. A multivariate logistic analysis identified AR (OR = 0.29, p = 0.021), WSSG (OR = 1.54, p = 0.017) and AA (OR = 2.49, p = 0.039) as independent risk factors for BBAs. A scoring system was constructed using these parameters, effectively distinguishing BBAs (AUC = 0.931, p less then 0.01). Our multidimensional scoring system may effectively assist in the discrimination of BBAs from wide-necked non-BBAs.The use of prophylactic anticonvulsants among patients with subarachnoid hemorrhage (SAH) is controversial. We sought to assess the effectiveness of different durations of prophylactic antiepileptic drug (AED) use among SAH patients. We searched the MEDLINE, Embase, Cochrane, and ClinicalTrials.gov databases until March 1, 2020. Randomized controlled trials or observational studies comparing different durations or different drugs were selected. The primary outcome was poor clinical outcomes. The secondary outcome was in-hospital seizure. Bayesian network meta-analysis was also performed to indirectly compare the effectiveness of different prophylaxes. A total of 5 papers were included. Three studies with a total of 959 patients were included in the analysis of the primary outcome; the results showed that long-term exposure to prophylactic AEDs (more than 3 days) led to poor clinical outcomes (OR 1.55; 95% CI 1.01-2.39; p = 0.045). Four studies with 1024 patients were included in the analysis of the secondary outcome; the results showed no association between the duration of prophylactic AED use and the occurrence of in-hospital seizures (OR 0.