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Use of hem-o-lok video with regard to laparoscopic appendectomy in kids: retrospective analysis as well as comparison to ligature cycle and endoscopic operative hole punch.
OBJECTIVE. The purpose of this study was to evaluate in a multicenter dataset the performance of an artificial intelligence (AI) detection system with attention mapping compared with multiparametric MRI (mpMRI) interpretation in the detection of prostate cancer. MATERIALS AND METHODS. MRI examinations from five institutions were included in this study and were evaluated by nine readers. In the first round, readers evaluated mpMRI studies using the Prostate Imaging Reporting and Data System version 2. After 4 weeks, images were again presented to readers along with the AI-based detection system output. LXS196 Readers accepted or rejected lesions within four AI-generated attention map boxes. Additional lesions outside of boxes were excluded from detection and categorization. The performances of readers using the mpMRI-only and AI-assisted approaches were compared. RESULTS. The study population included 152 case patients and 84 control patients with 274 pathologically proven cancer lesions. The lesion-based AUC was 74.9% for MRI and 77.5% for AI with no significant difference (p = 0.095). The sensitivity for overall detection of cancer lesions was higher for AI than for mpMRI but did not reach statistical significance (57.4% vs 53.6%, p = 0.073). However, for transition zone lesions, sensitivity was higher for AI than for MRI (61.8% vs 50.8%, p = 0.001). Reading time was longer for AI than for MRI (4.66 vs 4.03 minutes, p less then 0.001). There was moderate interreader agreement for AI and MRI with no significant difference (58.7% vs 58.5%, p = 0.966). CONCLUSION. Overall sensitivity was only minimally improved by use of the AI system. Significant improvement was achieved, however, in the detection of transition zone lesions with use of the AI system at the cost of a mean of 40 seconds of additional reading time.OBJECTIVE. The purpose of this study was to add to evidence of the long-term prognostic value of coronary CT angiography (CCTA) when combined with nonimaging risk factors and to investigate how CCTA can contribute to the decision to start statin therapy. MATERIALS AND METHODS. Patients underwent CCTA in an outpatient setting for a variety of indications. The National Death Index from February 2004 through December 2018 was queried to identify the outcomes of death due to any cause (all-cause mortality) and death due to coronary artery disease. Framingham and machine learning risk estimation models were constructed. Machine learning inputs were generated from radiologists' descriptions of the findings on structured report forms and not directly from the image pixels. Kaplan-Meier survival curves and Cox proportional hazards were calculated. Clinical benefit was assessed on the basis of the potential impact on assignment of statin therapy. RESULTS. A total of 6892 outpatients were studied, 4452 (64.6%) of whom sk estimation. Similar models might be useful to better target prescription of statins and reduce their overuse.OBJECTIVE. Radiologists often think in terms of metaphors drawn from business, politics, and informatics, but literature can offer equally important insights. CONCLUSION. Kafka's short story "A Hunger Artist" is the tale of a man who does not care for the food he is given and so starves. The same can happen to radiologists even in the midst of plenty, if key ingredients in the recipe for professional fulfillment are missing, radiologists may find themselves wasting away.OBJECTIVE. The objective of our study was to assess the accuracy and reproducibility of right ventricular volumes and function measurements in patients with repaired tetralogy of Fallot using two k-adaptive-t autocalibrating reconstruction for cartesian sampling (kat-ARC) accelerated sequences a morphologic 3D cine sequence and a functional free-breathing 4D flow sequence. SUBJECTS AND METHODS. Seventeen patients who underwent cardiac MRI with gadolinium injection as part of follow-up of repaired tetralogy of Fallot from March 2017 to July 2018 were prospectively included in the initial study population; the final study cohort was composed of 15 of the 17 patients. Ventricle volume measurements were performed on a 3D cine kat-ARC sequence, a 4D flow kat-ARC sequence, and a 2D cine balanced steady-state free precession (bSSFP) sequence. link2 The 2D cine bSSFP sequence was the reference standard in cardiac assessment. Intertechnique and interobserver analyses were performed. Bland-Altman analysis and correlation tesicular measurements in patients with repaired tetralogy of Fallot. The short duration of the 4D flow kat-ARC sequence appears promising for performing volumetric measurements.While Joseph Hooker was considering his upcoming presentation on the geographical distribution of species, he asked Charles Darwin for help with some references. During the ensuing exchange of correspondence, Darwin seems to have contradicted himself, regarding his being aware of Leopold von Buch's observation that distributed varieties become species, prior to writing On the Origin of Species. Literalists and conspiracists have interpreted this apparent self-contradiction as a sign of duplicity and fraud. However, when the correspondence and Hooker's address are analysed in context, there is a more compelling explanation. Simply that, in response to direct questioning by Hooker, Darwin conflated the two names of Von Baer and Von Buch, and made an honest mistake.Aims The aims of this cross-sectional study were to examine the prevalence of lifetime exposure to sexual, physical and psychological violence among a representative sample of women and men in Sweden, and to analyze if there were gender differences regarding the types of violence the participants were exposed to and by whom it was perpetrated. Methods A survey containing questions about lifetime experiences of sexual, physical and psychological violence was sent to a national sample of 10,000 women and 10,000 men aged 18-74; 56.8% of the women and 46.5% of the men agreed to participate. Results Sexual violence in childhood was reported by 26.4% of women and 22.1% experienced sexual violence in adulthood. Among men, 11% disclosed experiences of sexual violence in childhood and 4.5% in adulthood. Physical violence was experienced by 39.3% of women in childhood and by 18.8% as adults, often by a present or former partner. Among men, 59.3% were exposed to physical violence during childhood, often by a peer, and 20.4% as adults. Psychological violence in childhood was experienced by 58.1% of women in childhood and by 21.8% in adulthood. Among male respondents, 69.2% reported experiences of physiological violence in childhood, often by a peer, and 9.4% in adulthood. Conclusions Lifetime violence exposure is common in the Swedish population. Though it affects both women and men, the patterns of type of violence and perpetrators are different. The results suggest that violence prevention early in life is important to target.
The 2019 novel coronavirus outbreak and its associated disease (coronavirus disease 2019 [COVID-19]) have created a worldwide pandemic. Early data suggest higher rate of ischemic stroke in severe COVID-19 infection. We evaluated whether a relationship exists between emergent large vessel occlusion (ELVO) and the ongoing COVID-19 outbreak.

This is a retrospective, observational case series. Data were collected from all patients who presented with ELVO to the Mount Sinai Health System Hospitals across New York City during the peak 3 weeks of hospitalization and death from COVID-19. Patients' demographic, comorbid conditions, cardiovascular risk factors, COVID-19 disease status, and clinical presentation were extracted from the electronic medical record. Comparison was made between COVID-19 positive and negative cohorts. The incidence of ELVO stroke was compared with the pre-COVID period.

Forty-five consecutive ELVO patients presented during the observation period. Fifty-three percent of patients tested pohalf of the ELVO stroke patients during the peak time of the New York City's COVID-19 outbreak were COVID-19 positive, and those patients with COVID-19 were younger, more likely to be male, and less likely to be White. Our findings also suggest an increase in the incidence of ELVO stroke during the peak of the COVID-19 outbreak.
No studies have reported the effect of the coronavirus disease 2019 (COVID-19) epidemic on patients with preexisting stroke. We aim to study the clinical course of COVID-19 patients with preexisting stroke and to investigate death-related risk factors.

We consecutively included 651 adult inpatients with COVID-19 from the Central Hospital of Wuhan between January 2 and February 15, 2020. Data on the demography, comorbidities, clinical manifestations, laboratory findings, treatments, complications, and outcomes (ie, discharged or death) of the participants were extracted from electronic medical records and compared between patients with and without preexisting stroke. The association between risk factors and mortality was estimated using a Cox proportional hazards regression model for stroke patients infected with severe acute respiratory syndrome coronavirus 2.

Of the 651 patients with COVID-19, 49 with preexisting stroke tended to be elderly, male, had more underlying comorbidities and greater severity eath, providing an important message to individuals and health care workers that preventive measures must be implemented to protect and reduce transmission in stroke patients in this COVID-19 crisis.
Anecdotal reports suggest fewer patients with stroke symptoms are presenting to hospitals during the coronavirus disease 2019 (COVID-19) pandemic. We quantify trends in stroke code calls and treatments at 3 Connecticut hospitals during the local emergence of COVID-19 and examine patient characteristics and stroke process measures at a Comprehensive Stroke Center (CSC) before and during the pandemic.

Stroke code activity was analyzed from January 1 to April 28, 2020, and corresponding dates in 2019. Piecewise linear regression and spline models identified when stroke codes in 2020 began to decline and when they fell below 2019 levels. Patient-level data were analyzed in February versus March and April 2020 at the CSC to identify differences in patient characteristics during the pandemic.

A total of 822 stroke codes were activated at 3 hospitals from January 1 to April 28, 2020. The number of stroke codes/wk decreased by 12.8/wk from February 18 to March 16 (
=0.0360) with nadir of 39.6% of expected stro19 medical emergencies such as stroke during the pandemic are critical.
Hospital presentation for stroke-like symptoms decreased during the COVID-19 pandemic, without differences in stroke severity or early outcomes. link3 Individuals living outside of the CSC city were less likely to present for stroke codes at the CSC during the pandemic. Public health initiatives to increase awareness of presenting for non-COVID-19 medical emergencies such as stroke during the pandemic are critical.
The purpose of this study is to examine the ability of ex vivo derived Agatston, Volume, and Density-Volume calcium scores or calcium density measurements to differentiate between carotid plaques based on preoperative cerebrovascular symptomatology.

Thirty-eight carotid plaques were acquired from standard endarterectomy. Micro-computed tomography was performed on the ex vivo samples. Image series were downsampled to represent the resolution of clinical multidetector computed tomography. Agatston, Volume, and Density-Volume carotid calcium scores were then calculated using coronary methodologies. The fractions of low- and high-density calcification were also determined.

The coronary calcium scores could not differentiate between carotid plaques from asymptomatic versus symptomatic patients. However, plaques from asymptomatic patients contained significantly lower fractions of low-density calcification and higher fractions of high-density calcification.

Screening for carotid calcium density in noncontrast computed tomography could reflect plaque stability.
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