Mcgrawdoherty4076

5% versus 86.5%,

< .001). The neurosurgeon and neurologist showed a significant increase in patient-based sensitivity with software assistance (74.8% versus 85.2%,

= .03, and 56.3% versus 84.4%,

< .001, respectively), while the number of false-positive cases did not increase significantly (23 versus 30,

= .20, and 22 versus 24,

= .75, respectively).

Software-aided reading showed significant incremental value in the sensitivity of clinicians in the detection of aneurysms on MRA without a significant increase in false-positive findings, especially for the neurosurgeon and neurologist. Software-aided reading showed equivocal value for the radiologist.

Software-aided reading showed significant incremental value in the sensitivity of clinicians in the detection of aneurysms on MRA without a significant increase in false-positive findings, especially for the neurosurgeon and neurologist. Software-aided reading showed equivocal value for the radiologist.

Delays to reperfusion negatively impact outcomes of patients with ischemic stroke, yet current guidelines recommend selective sequential imaging for thrombectomy candidates. We aimed to quantify and analyze time delays associated with rescanning in sequential acute stroke imaging.

This was a retrospective cohort study of consecutive patients with acute ischemic stroke who underwent imaging for treatment decision-making from January 1, 2017, to June 30, 2020. Rescan time delay was defined as ≥10-minute difference between initial NCCT and CTA ± CTP. Mean rescan time delays in comprehensive and primary stroke centers were compared. Bivariate and multivariable regression analyses assessed clinical and imaging factors associated with rescanning time delays and early outcomes.

A total of 588 patients with acute ischemic were included in statistical analyses. Rescanning occurred in 27.9% (164/588 patients), with a mean time delay of 53.7 (SD, 43.4) minutes. For patients presenting at primary compared with comption of early simultaneous comprehensive CT could minimize treatment delays and improve outcomes.

Definitions of fetal microcephaly and macrocephaly are debatable. A better understanding of their long-term prognoses would help guide parental education and counseling. This study aimed to explore the correlation between 2D and 3D fetal brain MR imaging biometry results and the long-term neurodevelopmental outcomes.

This analysis is a historical cohort study. Fetal brain biometry was measured on 2D and 3D MR imaging using a volumetric MR imaging semiautomated algorithm. We measured and assessed the following brain structures the supratentorial brain volume and cerebellar volume and cerebellar volume/supratentorial brain volume ratio, in addition to commonly used 2D brain MR imaging biometric variables, including occipitofrontal diameter, biparietal diameter, and transcerebellar diameter. Microcephaly was defined as ≤ 3rd percentile; and macrocephaly, as ≥ 97th percentile, corresponding to -2 SDs and +2 SDs. The neurodevelopmental outcome of this study cohort was evaluated using the Vineland-II Adaptive Behavior Scales, and the measurements were correlated to the Vineland standard scores.

A total of 70 fetuses were included. No significant correlation was observed between the Vineland scores and either the supratentorial brain volume, cerebellar volume, or supratentorial brain volume/cerebellar volume ratio in 3D or 2D MR imaging measurements, after correction for multiple comparisons. No differences were found among fetuses with macrocephaly, normocephaly, or microcephaly regarding the median Vineland standard scores.

Provided there is normal brain structure on MR imaging, the developmental milestone achievements in early years are unrelated to 2D and 3D fetal brain MR imaging biometry, in the range of measurements depicted in this study.

Provided there is normal brain structure on MR imaging, the developmental milestone achievements in early years are unrelated to 2D and 3D fetal brain MR imaging biometry, in the range of measurements depicted in this study.

Experience with endoluminal flow diversion for the treatment of posterior circulation aneurysms is limited.

We sought to investigate factors associated with the safety and efficacy of this treatment by collecting disaggregated patient-level data from the literature.

PubMed, EMBASE, and Ovid were searched up through 2019 for articles reporting flow diversion of posterior circulation aneurysms.

Eighty-four studies reported disaggregated data for 301 separate posterior circulation aneurysms.

Patient, aneurysm, and treatment factors were collected for each patient. Outcomes included the occurrence of major complications, angiographic occlusion, and functional outcomes based on the mRS.

Significant differences in aneurysm and treatment characteristics were seen among different locations. Major complications occurred in 22%, angiographic occlusion was reported in 65% (11.3 months of mean follow-up), and good functional outcomes (mRS 0-2) were achieved in 67% (13.3 months of mean follow-up). Multivariate analysis identified age, number of flow diverters used, size, and prior treatment to be associated with outcome measures. Meta-analysis combining the current study with prior large nondisaggregated series of posterior circulation aneurysms treated with flow diversion found a pooled incidence of 20% (

 = 712 patients) major complications and 75% (

 = 581 patients) angiographic occlusions.

This study design is susceptible to publication bias. Use of antiplatelet therapy was not uniformly reported.

Endoluminal flow diversion is an important tool in the treatment of posterior circulation aneurysms. Patient age, aneurysm size, prior treatment, and the number of flow diverters used are important factors associated with complications and outcomes.

Endoluminal flow diversion is an important tool in the treatment of posterior circulation aneurysms. Patient age, aneurysm size, prior treatment, and the number of flow diverters used are important factors associated with complications and outcomes.

Atrial fibrillation (AF) is one of the most common predisposing factors for ischemic stroke worldwide. Because of this, patients with AF are prescribed anticoagulant medications to decrease the risk. The availability of different options for oral anticoagulation makes it difficult for some patients to decide a preferred choice of medication. Clinical guidelines often recommend enhancing the decision-making process of patients by increasing their involvement in health decisions. In particular, the use of patient decision aids (PDAs) in patients with AF was associated with increased knowledge and increased likelihood of making a choice. However, the majority of available PDAs are from Western countries.

We aimed to develop and pilot test a PDA to help patients with nonvalvular AF choose an oral anticoagulant for stroke prevention in the local setting. Outcomes were (1) reduction in patient decisional conflict, (2) improvement in patient knowledge, and (3) patient and physician acceptability.

We followed t15 (P<.001). The PDA was acceptable for both patients and doctors.

Our study showed that an app-based PDA for anticoagulation therapy in patients with nonvalvular AF (1) reduced patient decisional conflict, (2) improved patient knowledge, and (3) was acceptable to patients and physicians. A PDA is potentially acceptable and useful in our setting. A randomized controlled trial is warranted to test its effectiveness compared to usual care. PDAs for other conditions should also be developed.

Our study showed that an app-based PDA for anticoagulation therapy in patients with nonvalvular AF (1) reduced patient decisional conflict, (2) improved patient knowledge, and (3) was acceptable to patients and physicians. A PDA is potentially acceptable and useful in our setting. A randomized controlled trial is warranted to test its effectiveness compared to usual care. PDAs for other conditions should also be developed.Sargassum horneri, a brown macroalga, recently invaded the California coast, including into critical foundational communities such as kelp (Macrocystis pyrifera) forests. TR-107 datasheet Despite its rapid spread, empirical tests that evaluate mechanisms underlying S. horneri's invasion success are lacking. To fill this knowledge gap, we conducted three field experiments on temperate rocky reefs in southern California using growth as a proxy for invasion success. We first tested whether S. horneri success differed with herbivory strength and native diversity by conducting a 2-factor experiment varying site (with different baseline levels of urchin densities and native algal diversity) and urchin access. We found S. horneri growth only differed among urchin treatments and not sites. We then evaluated whether S. horneri could successfully invade established algal canopies as a driver or whether it required open space as a passenger via a 2-factor experiment varying S. horneri size (small, medium, large) and canopy type (S. horneri, kelp, -canopy). We found that all S. horneri sizes grew fastest when canopy was lacking and light was high and slower in both canopy habitats with lower light; overall, small S. horneri grew slowest. Finally, we evaluated whether herbivore consumption for native species could facilitate S. horneri's invasion by conducting a 2-factor experiment varying species (M. pyrifera, S. horneri) and herbivore access. We found uncaged algae were consumed and caged algae grew, but there was no difference between species. Taken together, our results suggest that S. horneri is a "passenger" invader that will take advantage of points in time and space where light is plentiful, such as when M. pyrifera is removed via disturbance. Further, our results suggest that herbivory and native algal diversity are likely not key determining factors of the invasion success of S. horneri.In this work, we studied the hydrolytic and photochemical degradation of three low-density polyethylene (LDPE) materials, within the size range of microplastics (MP). The MPs were exposed to mechanical agitation and UV irradiation equivalent to one year of solar UVB + UVA in a stirred photoreactor. Flow cytometry was used to track the formation of small (1-25 μm) MPs by applying Mie's theory to derive the size of MP particles from scattering intensity readings. The calculation was based on a calibration with polystyrene (PS) beads. The results showed that the generation of 1-5 μm MP reached 104-105 MPs in the 1-25 μm range per gram of LDPE. ATR-FTIR and micro-FTIR measurements evidenced the formation of oxygenated moieties, namely hydroxyl, carbonyl, and carbon-oxygen bonds, which increased with irradiation time. We also found evidence of the production of a high number of nanoplastics ( less then 1 μm, NPs). The Dynamic Light Scattering size of secondary NPs was in the hundreds of nm range and might represent up to 1010 NPs per gram of LDPE. Our results allowed the unambiguous spectroscopic assessment of the generation of NPs from LDPE under conditions simulating environmental exposure to UV irradiation and used flow cytometry for the first-time to track the formation of secondary MPs.