Quantitative imaging for predicting hematoma expansion in intracerebral hemorrhage: A multimodel comparison.

BACKGROUND: Several studies report that radiomics provides additional information for predicting hematoma expansion in intracerebral hemorrhage (ICH). However, the comparison of diagnostic performance of radiomics for predicting revised hematoma expansion (RHE) remains unclear. METHODS: The cohort comprised 312 consecutive patients with ICH. A total of 1106 radiomics features from seven categories were extracted using Python software. Support vector machines achieved the best performance in both the training and validation datasets. Clinical factors models were constructed to predict RHE. Receiver operating characteristic curve analysis was used to assess the abilities of non-contrast computed tomography (NCCT) signs, radiomics features, and combined models to predict RHE. RESULTS: We finally selected the top 21 features for predicting RHE. After univariate analysis, 4 clinical factors and 5 NCCT signs were selected for inclusion in the prediction models. In the training and validation dataset, radiomics features had a higher predictive value for RHE (AUC = 0.83) than a single NCCT sign and expansion-prone hematoma. The combined prediction model including radiomics features, clinical factors, and NCCT signs achieved higher predictive performances for RHE (AUC = 0.88) than other combined models. CONCLUSIONS: NCCT radiomics features have a good degree of discrimination for predicting RHE in ICH patients. Combined prediction models that include quantitative imaging significantly improve the prediction of RHE, which may assist in the risk stratification of ICH patients for anti-expansion treatments.

The clinical value of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and D-dimer-to-fibrinogen ratio for predicting pneumonia and poor outcomes in patients with acute intracerebral hemorrhage.

Background: This study aimed to investigate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and D-dimer-to-fibrinogen ratio (DFR) as predictors of pneumonia and poor outcomes in patients with acute intracerebral hemorrhage (ICH). Methods: We retrospectively examined patients with acute ICH treated in our institution from May 2018 to July 2020. Patient characteristics, laboratory testing data, radiologic imaging data, and 90-day outcomes were recorded and analyzed. Results: Among the 329 patients included for analysis, 183 (55.6%) developed pneumonia. Systolic blood pressure, initial hematoma volume, D-dimer concentration, NLR, PLR, DFR, and white blood cell, platelet, neutrophil, and lymphocyte counts at admission were significantly higher in patients who developed pneumonia than in those who did not; however, the Glasgow coma scale (GCS) score at admission was significantly lower in pneumonia patients compared with non-pneumonia patients (all P <0.05). Multivariate logistic regression showed that the NLR and PLR were independent predictors of pneumonia, and the NLR and DFR were independent predictors of poor 90-day outcomes (modified Rankin scale score 4-6). Conclusion: The NLR and PLR were independent predictors of pneumonia and the NLR and DFR were independent predictors of poor 90-day outcomes. The NLR, PLR, and DFR can provide prognostic information about acute ICH patients.

Corrigendum: New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH Score.

[This corrects the article DOI: 10.3389/fneur.2021.655800.].

New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH Score.

Objectives: The original intracerebral hemorrhage (oICH) score is the severity score most commonly used in clinical intracerebral hemorrhage (ICH) research but may be influenced by hematoma expansion or intraventricular hemorrhage (IVH) growth in acute ICH. Here, we aimed to develop new clinical scores to improve the prediction of functional outcomes in patients with ICH. Methods: Patients admitted to the First Affiliated Hospital of Chongqing Medical University with primary ICH were prospectively enrolled in this study. Hematoma volume was measured using a semiautomated, computer-assisted technique. The dynamic ICH (dICH) score was developed by incorporating hematoma expansion and IVH growth into the oICH score. The ultra-early ICH (uICH) score was developed by adding the independent non-contrast CT markers to the oICH score. Receiver operating characteristic curve analysis was used to compare performance among the oICH score, dICH score, and uICH score. Results: This study included 76 patients (23.3%) with hematoma expansion and 61 patients (18.7%) with IVH growth. Of 31 patients with two or more non-contrast computed tomography markers, 61.3% died, and 96.8% had poor outcomes at 90 days. After adjustment for potential confounding variables, we found that age, baseline Glasgow Coma Scale score, presence of IVH on initial CT, baseline ICH volume, infratentorial hemorrhage, hematoma expansion, IVH growth, blend sign, black hole sign, and island sign could independently predict poor outcomes in multivariate analysis. In comparison with the oICH score, the dICH score and uICH score exhibited better performance in the prediction of poor functional outcomes. Conclusions: The dICH score and uICH score were useful clinical assessment tools that could be used for risk stratification concerning functional outcomes and provide guidance in clinical decision-making in acute ICH.

Noncontrast Computed Tomography Markers as Predictors of Revised Hematoma Expansion in Acute Intracerebral Hemorrhage.

Background Noncontrast computed tomography (NCCT) markers are the emerging predictors of hematoma expansion in intracerebral hemorrhage. However, the relationship between NCCT markers and the dynamic change of hematoma in parenchymal tissues and the ventricular system remains unclear. Methods and Results We included 314 consecutive patients with intracerebral hemorrhage admitted to our hospital from July 2011 to May 2017. The intracerebral hemorrhage volumes and intraventricular hemorrhage (IVH) volumes were measured using a semiautomated, computer-assisted technique. Revised hematoma expansion (RHE) was defined by incorporating the original definition of hematoma expansion into IVH growth. Receiver operating characteristic curve analysis was used to compare the performance of the NCCT markers in predicting the IVH growth and RHE. Of 314 patients in our study, 61 (19.4%) had IVH growth and 93 (23.9%) had RHE. After adjustment for potential confounding variables, blend sign, black hole sign, island sign, and expansion-prone hematoma could independently predict IVH growth and RHE in the multivariate logistic regression analysis. Expansion-prone hematoma had a higher predictive performance of RHE than any single marker. The diagnostic accuracy of RHE in predicting poor prognosis was significantly higher than that of hematoma expansion. Conclusions The NCCT markers are independently associated with IVH growth and RHE. Furthermore, the expansion-prone hematoma has a higher predictive accuracy for prediction of RHE and poor outcome than any single NCCT marker. These findings may assist in risk stratification of NCCT signs for predicting active bleeding.

Hematoma Ventricle Distance on Computed Tomography Predicts Poor Outcome in Intracerebral Hemorrhage.

OBJECTIVE: To investigate the relationship between hematoma ventricle distance (HVD) and clinical outcome in patients with intracerebral hemorrhage (ICH). METHODS: We prospectively enrolled consecutive patients with ICH in a tertiary academic hospital between July 2011 and April 2018. We retrospectively reviewed images for all patients receiving a computed tomography (CT) within 6 h after onset of symptoms and at least one follow-up CT scan within 36 h. The minimum distance of hematoma border to nearest ventricle was measured as HVD. Youden index was used to evaluate the cutoff of HVD predicting functional outcome. Logistic regression model was used to assess the HVD data and clinical poor outcome (modified Rankin Scale 4-6) at 90 days. RESULTS: A total of 325 patients were included in our final analysis. The median HVD was 2.4 mm (interquartile range, 0-5.7 mm), and 119 (36.6%) patients had poor functional outcome at 3 months. After adjusting for age, admission Glasgow coma scale, intraventricular hemorrhage, baseline ICH volume, admission systolic blood pressure, blood glucose, hematoma expansion, withdrawal of care, and hypertension, HVD ≤ 2.5 mm was associated with increased odds of clinical poor outcome [odd ratio, 3.59, (95%CI = 1.72-7.50); p = 0.001] in multivariable logistic regression analysis. CONCLUSION: Hematoma ventricle distance allows physicians to quickly select and stratify patients in clinical trials and thereby serve as a novel and useful addition to predict ICH prognosis.

The slice score: A novel scale measuring intraventricular hemorrhage severity and predicting poor outcome following intracerebral hemorrhage.

OBJECTIVES: To quantify extent of intraventricular hemorrhage (IVH) following intracerebral hemorrhage (ICH) with a novel, simple IVH severity score, and to explore and compare its performance in predicting worse outcomes. PATIENTS AND METHODS: A new scoring system for IVH severity was proposed and termed Slice score. The Slice score features non-septum pellucidum section, internal capsule section, third ventricle occipital horn section, three standardized scans for scoring the lateral ventricles. 652 scans from 326 subjects were retrospectively analyzed. The correlations between measured IVH volume and Slice score, original Graeb, LeRoux, and IVH score (IVHS) were compared. The association between these scores and clinical outcomes were evaluated using logistic regression. We then identified clinical thresholds of Slice score by balancing the probability of prediction and accuracy. Primary outcome was defined as 90-day poor outcome (modified Rankin Scale score ≥ 4) and secondary outcome was 90-day mortality. RESULTS: Of 326 ICH patients, 122 (37.4%) had poor outcome and 59 (18.1%) died at 3 months. The Slice score showed the highest correlation with measured IVH volume (R = 0.73, R2 = 0.54, p < 0.001). The observed area under the curve were similar among the Slice, original Graeb, LeRoux score, and IVH score for poor outcome (0.633, 0.633, 0.632, 0.634, respectively), and for mortality (0.660, 0.660, 0.660, 0.656, respectively). All IVH scales were independently associated with 90-day poor outcome and mortality with close odds ratio in adjusted models (all odds ratio > 1.07, all p < 0.05). Multivariable Analyses of categorized Slice score revealed optimal thresholds of 6 and 12 for primary and secondary outcomes (odds ratio 4.20, 95% confidence interval 1.82-10.02, p = 0.001; odds ratio 5.41, 95% confidence interval 1.66-17.43, p = 0.005, respectively). CONCLUSIONS: The Slice score correlated highly with the IVH volume, was a reliable volumetric scale for measuring IVH severity, and could be an easy-to-use tool for predicting 90-day poor outcome and mortality in ICH.

[An improved method for in vivo electroporation of morpholinos into the adult zebrafish retina].

In vivo electroporation of morpholinos (MOs) into the retina of adult zebrafish is an efficient method to study gene function related to retinal disease and regeneration. However, the currently reported methods are complicated with low MO transfer efficiency and high probability to cause collateral damage. The present study was aimed to optimize the existing MO electroporation methods. Two major changes were made to MO electroporation procedure in zebrafish retina. One was to coat the inner side of the electrode with ultrasonic gel. The other was to replace the commonly used round electrode with novel rectangular one. The results showed that the use of ultrasonic gel reduced collateral damage caused by retinal electroporation and simplified the experimental procedure. The rectangular electrode significantly increased transfection efficiency of MO electroporation. In particular, knocking down the expression of Ascl1a in the retina by using our method significantly inhibited the generation of retinal progenitor cells. These results suggest our method is the optimization of the current MO electroporation methods and may be a better alternative for relevant researchers.

A 6-year retrospective study of adverse drug reactions due to drug-drug interactions between nervous system drugs.

OBJECTIVE: The primary objective of this study was to determine the frequency and characteristics of adverse drug reactions (ADRs) due to drug-drug interactions (DDIs) between nervous system drugs recorded for hospitalized patients in China. The secondary objective was to identify and record the possible mechanisms underlying these DDIs. METHODS: In this retrospective study performed from January 2007 to December 2012, we detected and analyzed ADRs caused by potential or actual DDIs between nervous system drugs, by using the Center of Adverse Drug Reaction Monitoring, Bengbu Food and Drug Administration (CADRMBFDA) database. RESULTS: The CADRMBFDA database contained 1,207 reports of ADRs due to nervous system drugs, involving 1,079 hospitalized patients. Of the ADRs reported, 131 (12.14%) were associated with potential and actual DDIs. There were 259 (21.46% of the total ADR reports) reports on potential and actual DDIs. The proportion of serious ADRs (6 out of 131) was significantly higher among actual DDI reports (p < 0.001) than among the remaining reports (6 out of 942). CONCLUSIONS: The results of our study confirmed that the CADRMBFDA database was a valuable resource for detecting actual DDIs. Moreover, the database helps identify drugs that can cause serious ADRs, thus indicating focus areas for healthcare education.

Resonance Raman and density functional theory investigation of the photodissociation dynamics of the A-band absorption of (E)-beta-nitrostyrene in cyclohexane solution.

Resonance Raman spectra were obtained for (E)-beta-nitrostyrene in cyclohexane solution with excitation wavelengths in resonance with the charge transfer (CT)-band absorption spectrum. These spectra indicate that the Franck-Condon region photodissociation dynamics have multidimensional character with motion predominantly along the nominal NO(2) symmetric stretch mode (nu(14)), the nominal C=C stretch mode (nu(8)), the nominal benzene ring stretch mode (nu(9)), accompanied by a smaller amount of motion along the nominal ONO symmetric bend/benzene ring stretch mode (nu(34)), the nominal CCH in-plane bending mode (nu(20)), the nominal HC=CH in-plane bending mode (nu(18)), the nominal NO(2) asymmetric stretch mode (nu(11)), the nominal C-N stretch/benzene ring breathing mode (nu(27)), and the nominal CCC trigonal bending mode (nu(25)). A preliminary resonance Raman intensity analysis was done and these results for (E)-beta-nitrostyrene were compared to results previously reported for several nitrobenzene and trans-stilbene compounds. The differences and similarities between the CT-band resonance Raman spectra and vibrational reorganizational energies for (E)-beta-nitrostyrene relative to those for nitrobenzene and trans-stilbene were briefly discussed.

Resonance Raman intensity analysis of the excited state proton transfer dynamics of 2-nitrophenol in the charge-transfer band absorption.

Resonance Raman spectra were obtained for 2-nitrophenol in cyclohexane solution with excitation wavelengths in resonance with the charge-transfer (CT) proton transfer band absorption. These spectra indicate that the Franck-Condon region photodissociation dynamics have multidimensional character with motion along more than 15 normal modes: the nominal CCH bend+CC stretch nu(12) (1326 cm(-1)), the nominal CCC bend nu(23) (564 cm(-1)), the nominal CO stretch+NO stretch+CC stretch nu(14) (1250 cm(-1)), the nominal CCH bend+CC stretch+COH bend nu(15) (1190 cm(-1)); the nominal CCH bend+CC stretch nu(17) (1134 cm(-1)), the nominal CCC bend+CC stretch nu(22) (669 cm(-1)), the nominal CCN bend nu(27) (290 cm(-1)), the nominal NO(2) bend+CC stretch nu(21) (820 cm(-1)), the nominal CCO bend+CNO bend nu(25) (428 cm(-1)), the nominal CC stretch nu(7) (1590 cm(-1)), the nominal NO stretch nu(8) (1538 cm(-1)), the nominal CCC bend+NO(2) bend nu(20) (870 cm(-1)), the nominal CC stretch nu(6) (1617 cm(-1)), the nominal COH bend+CC stretch nu(11) (1382 cm(-1)), nominal CCH bend+CC stretch nu(9) (1472 cm(-1)). A preliminary resonance Raman intensity analysis was done and the results for 2-nitrophenol were compared to previously reported results for nitrobenzene, p-nitroaniline, and 2-hydroxyacetophenone. The authors briefly discuss the differences and similarities in the CT-band absorption excitation of 2-nitrophenol relative to those of nitrobenzene, p-nitroaniline, and 2-hydroxyacetophenone.

Resonance Raman study of short-time photodissociation dynamics of the charge-transfer band absorption of nitrobenzene in cyclohexane solution.

Resonance Raman spectra were obtained for nitrobenzene in cyclohexane solution with excitation wavelengths in resonance with the charge-transfer (CT) band absorption spectrum. These spectra indicate that the Franck-Condon region photodissociation dynamics have multidimensional character with motion mainly along the nominal NO2 symmetric stretch mode (nu 11), the nominal benzene ring stretch mode (nu 7), accompanied by a moderate degree of motion along the nominal ONO symmetry bend/benzene ring stretch mode (nu 23), the nominal C-N stretch/benzene ring breathing mode (nu 16), the nominal CCC bending mode (nu 20) and the nominal CCH in-plane bending mode (nu 14). A preliminary resonance Raman intensity analysis was done and the results for nitrobenzene were compared to previously reported results for several nitroalkanes.