Cerebral perfusion simulation using realistically generated synthetic trees for healthy and stroke patients

Background and objective Cerebral vascular diseases are among the most burdensome diseases faced by society. However, investigating the pathophysiology of diseases as well as developing future treatments still relies heavily on expensive in-vivo and in-vitro studies. The generation of realistic, patient-specific models of the cerebrovascular system capable of simulating hemodynamics and perfusion promises the ability to simulate diseased states, therefore accelerating development cycles using in silico studies and opening opportunities for the individual assessment of diseased states, treatment planning, and the prediction of outcomes. By providing a patient-specific, anatomically detailed and validated model of the human cerebral vascular system, we aim to provide the basis for future in silico investigations of the cerebral physiology and pathology. Methods In this retrospective study, a processing pipeline for patient-specific quantification of cerebral perfusion was developed and applied to healthy individuals and a stroke patient. Major arteries are segmented from 3T MR angiography data. A synthetic tree generation algorithm titled tissue-growth based optimization (GBO) is used to extend vascular trees beyond the imaging resolution. To investigate the anatomical accuracy of the generated trees, morphological parameters are compared against those of 7 T MRI, 9.4 T MRI, and dissection data. Using the generated vessel model, hemodynamics and perfusion are simulated by solving one-dimensional blood flow equations combined with Darcy flow equations. Results Morphological data of three healthy individuals (mean age 47 years ± 15.9 [SD], 2 female) was analyzed. Bifurcation and physiological characteristics of the synthetically generated vessels are comparable to those of dissection data. The inability of MRI based segmentation to resolve small branches and the small volume investigated cause a mismatch in the comparison to MRI data. Cerebral perfusion was estimated for healthy individuals and a stroke patient. The simulated perfusion is compared against Arterial-Spin-Labeling MRI perfusion data. Good qualitative agreement is found between simulated and measured cerebral blood flow (CBF). Ischemic regions are predicted well, however ischemia severity is overestimated. Conclusions GBO successfully generates detailed cerebral vascular models with realistic morphological parameters. Simulations based on the resulting networks predict perfusion territories and ischemic regions successfully

Performance assessment of radio occultation data from GeoOptics by comparing with COSMIC data

Responding to the ever-growing demand for environmental information, the National Oceanic and Atmospheric Administration (NOAA) seeks to enter into contracts to purchase Global Navigation Satellite System (GNSS) radio occultation (RO) observations produced by commercial vendors at a low-cost. GeoOptics is one commercial vendor awarded a contract with NOAA. GeoOptics operates the Community Initiative for Cellular Earth Remote Observation (CICERO) constellation of low-earth-orbiting (LEO) 6U CubeSats. The 6U-sized CICERO will enable the deployment of GNSS array consisting of RO satellites in the Earth&rsquo;s atmosphere to obtain many atmospheric observations which can improve weather forecasting. Applying GeoOptics RO data to reliable weather forecasting requires an assessment of its performance. This study analyzes the performance of GeoOptics CubeSats measurements by comparing it with the Constellation Observing System for Meteorology, Ionosphere, and Climate (COSMIC) missions (COSMIC-1 and COSMIC-2). The performance analysis was carried on data coverage capabilities and measurement quality. The analysis of data coverage confirmed that GeoOptics can acquire global observational coverage with adequate low-altitude penetration capability, while there should be updated in local time coverage. The analysis of RO measurement quality showed that GeoOptics RO measurements are comparable to those of COSMIC-2, even though GeoOptics exhibited a lower signal-to-noise ratio (SNR). The potential of GeoOptics allows for the development of a GNSS array in the Earth&rsquo;s atmosphere and a large amount of effective RO measurements to be obtained for reliable weather forecasting. &nbsp;</p

Computed tomographic evaluation of abdominal fat in minipigs

Computed tomography (CT) exams were conducted to determine the distribution of abdominal fat identified based on the CT number measured in Hounsfield Units (HU) and to measure the volume of the abdominal visceral and subcutaneous fat in minipigs. The relationship between the CT-based fat volumes of several vertebral levels and the entire abdomen and anthropometric data including the sagittal abdominal diameter and waist circumference were evaluated. Moreover, the total fat volumes at the T11, T13, L3, and L5 levels were compared with the total fat volume of the entire abdomen to define the landmark of abdominal fat distribution. Using a single-detector CT, six 6-month-old male minipigs were scanned under general anesthesia. Three radiologists then assessed the HU value of visceral and subcutaneous abdominal fat by drawing the region of interest manually at the T11, T13, L1, L3, and L5 levels. The CT number and abdominal fat determined in this way by the three radiologists was found to be correlated (intra-class coefficient = 0.9). The overall HU ranges for the visceral and subcutaneous fat depots were -147.47 to -83.46 and -131.62 to -90.97, respectively. The total fat volume of the entire abdomen was highly correlated with the volume of abdominal fat at the T13 level (r = 0.97, p < 0.0001). These findings demonstrate that the volume of abdominal adipose tissue measured at the T13 level using CT is a strong and reliable predictor of total abdominal adipose volume

Assessment of the Origin of a Plasma Depletion Band Over the United States During the 8 September 2017 Geomagnetic Storm

Abstract The development of an intense total electron content (TEC) depletion band over the United States during the 8 September 2017 geomagnetic storm was understood as the extension of an equatorial plasma bubble (EPB) to midlatitudes in previous studies. However, this study reports non‐EPB aspects within this phenomenon. First, the simultaneous emergence of the TEC depletion band at midlatitudes and EPBs in the equatorial region indicates that the midlatitude TEC depletion band is not initiated by an EPB. Second, the intensification of TEC depletion at midlatitudes during the decay of TEC depletion at intermediate latitudes is anomalous. Third, the location of the TEC depletion band at midlatitudes is inconsistent with the EPB location estimated from zonal plasma motion. Given ionospheric perturbations in North America from the beginning of the storm, it is plausible that the TEC depletion band was locally generated in association with these perturbations

HLA-B27 association of autoimmune encephalitis induced by PD-L1 inhibitor

Objective While immune checkpoint inhibitors are increasingly used for various cancers, unpredictable immune-related adverse events (irAEs) such as autoimmune encephalitis is life-threatening. Here, we report an association between human leukocyte antigen (HLA) and atezolizumab-induced encephalitis. Methods From an institutional prospective cohort for encephalitis, we identified patients with autoimmune encephalitis after the use of atezolizumab, a PD-L1 (programmed death-ligand 1) inhibitor, from August 2016 to September 2019 and analyzed their HLA genotypes. Results A total of 290 patients received atezolizumab, and seven patients developed autoimmune encephalitis, and five of whom were enrolled for the analysis. The patients presented altered mentality, seizures, or myelitis. Three patients had the HLA-B*27:05 genotype in common (60%), which is significantly frequent given its low frequency in the general population (2.5%). After Bonferroni correction, HLA-B*27:05 was significantly associated with autoimmune encephalitis by atezolizumab (correctedP < 0.001, odds ratio 59, 95% CI = 9.0 similar to 386.9). Interpretation Here we found that three in five patients with autoimmune encephalitis associated with atezolizumab had the rare HLA-B*27:05 genotype. Further systematic analyses in larger cohorts are necessary to investigate the value of HLA screening to prevent the life-threatening adverse events

Human leukocyte antigen associations in postural tachycardia syndrome

Abstract Associations between human leukocyte antigen (HLA) and postural orthostatic tachycardia syndrome (POTS) have not been investigated. We included patients diagnosed with POTS and showing orthostatic heart rate increases ≥ 50 during orthostatic vital sign measurement or experiencing syncope/near‐syncope while standing (prominent POTS; n = 17). DQB1*06:09 was present in seven (41%) patients, a significantly higher percentage than in healthy Koreans (7%; odds ratio [OR] 8.7, 95% confidence interval [CI] 3.1–24.3, corrected P = 3.2 × 10−4) and epilepsy controls (8%; OR 7.9, 95% CI 2.7–23.5, corrected P = 3.2 × 10−4). Six (35.3%) carried the A*33:03‐B*58:01‐C*03:02‐DRB1*13:02‐DQB1*06:09 haplotype. The results signify an autoimmune etiology in prominent POTS