C-Reactive Protein Predicts Hematoma Growth in Intracerebral Hemorrhage

Background and Purpose—Early hematoma growth (EHG) occurs in about one third of patients with spontaneous intracerebral hemorrhage. The main aim of this study was to investigate the potential of plasma C-reactive protein (CRP) for predicting EHG after acute spontaneous intracerebral hemorrhage. Methods—Plasma CRP was measured within 6 hours of onset (median, 120 minutes) in 399 patients with primary or vitamin K antagonist–associated spontaneous intracerebral hemorrhage and without recent infection. Computed tomography brain scans were performed at baseline and repeated within 24 hours (median, 22 hours). The primary outcome was EHG, defined as absolute growth >12.5 cm3 or relative growth >33%. Secondary outcomes included early neurological worsening (ENW) using the Glasgow Coma Scale and 30-day mortality. Multivariable regression analyses were used to evaluate associations of CRP concentration and outcomes. Kaplan–Meier analysis was used for survival. Results—EHG occurred in 25.8%, ENW in 19.3%, and mortality was 31.8% at 30 days. Thirty-day mortality was significantly higher in patients with ENW (hazard ratio, 3.21; 95% confidence interval, 2.00–5.17; P10 mg/L independently predicted EHG (odds ratio, 4.71; 95% confidence interval, 2.75–8.06; P<0.0001) and ENW (odds ratio, 2.70; 95% confidence interval, 1.50–4.84; P=0.0009). Conclusions—CRP>10 mg/L is independently predictive of EHG and ENW, both of which are associated with increased mortality. Inflammation may be important in contributing to EHG and warrants further investigation

Accuracy, repeatability, and interplatform reproducibility of T1 quantification methods used for DCEâ MRI: Results from a multicenter phantom study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142505/1/mrm26903_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142505/2/mrm26903.pd

Absolute risk and predictors of the growth of acute spontaneous intracerebral haemorrhage: a systematic review and meta-analysis of individual patient data.

Background Intracerebral haemorrhage growth is associated with poor clinical outcome and is a therapeutic target for improving outcome. We aimed to determine the absolute risk and predictors of intracerebral haemorrhage growth, develop and validate prediction models, and evaluate the added value of CT angiography. Methods In a systematic review of OVID MEDLINE—with additional hand-searching of relevant studies' bibliographies— from Jan 1, 1970, to Dec 31, 2015, we identified observational cohorts and randomised trials with repeat scanning protocols that included at least ten patients with acute intracerebral haemorrhage. We sought individual patient-level data from corresponding authors for patients aged 18 years or older with data available from brain imaging initially done 0·5–24 h and repeated fewer than 6 days after symptom onset, who had baseline intracerebral haemorrhage volume of less than 150 mL, and did not undergo acute treatment that might reduce intracerebral haemorrhage volume. We estimated the absolute risk and predictors of the primary outcome of intracerebral haemorrhage growth (defined as >6 mL increase in intracerebral haemorrhage volume on repeat imaging) using multivariable logistic regression models in development and validation cohorts in four subgroups of patients, using a hierarchical approach: patients not taking anticoagulant therapy at intracerebral haemorrhage onset (who constituted the largest subgroup), patients taking anticoagulant therapy at intracerebral haemorrhage onset, patients from cohorts that included at least some patients taking anticoagulant therapy at intracerebral haemorrhage onset, and patients for whom both information about anticoagulant therapy at intracerebral haemorrhage onset and spot sign on acute CT angiography were known. Findings Of 4191 studies identified, 77 were eligible for inclusion. Overall, 36 (47%) cohorts provided data on 5435 eligible patients. 5076 of these patients were not taking anticoagulant therapy at symptom onset (median age 67 years, IQR 56–76), of whom 1009 (20%) had intracerebral haemorrhage growth. Multivariable models of patients with data on antiplatelet therapy use, data on anticoagulant therapy use, and assessment of CT angiography spot sign at symptom onset showed that time from symptom onset to baseline imaging (odds ratio 0·50, 95% CI 0·36–0·70; p<0·0001), intracerebral haemorrhage volume on baseline imaging (7·18, 4·46–11·60; p<0·0001), antiplatelet use (1·68, 1·06–2·66; p=0·026), and anticoagulant use (3·48, 1·96–6·16; p<0·0001) were independent predictors of intracerebral haemorrhage growth (C-index 0·78, 95% CI 0·75–0·82). Addition of CT angiography spot sign (odds ratio 4·46, 95% CI 2·95–6·75; p<0·0001) to the model increased the C-index by 0·05 (95% CI 0·03–0·07). Interpretation In this large patient-level meta-analysis, models using four or five predictors had acceptable to good discrimination. These models could inform the location and frequency of observations on patients in clinical practice, explain treatment effects in prior randomised trials, and guide the design of future trials

Ready for EURONEAR NEA surveys using the NEARBY moving source detection platform

In 2015 we started a PhD thesis aiming to write a moving objects processing system (MOPS) aimed to detect near Earth asteroids (NEAs) in astronomical surveys planned within the EURONEAR project. Based on this MOPS experience, in 2017 we proposed the NEARBY project to the Romanian Space Agency, which awarded funding to the Technical University of Cluj-Napoca (UTCN) and the University of Craiovafor building a cloud-based online platform to reduce survey images, detect, validate and report in near real time asteroid detections and NEA candidates. The NEARBY platform was built and is available at UTCN since Feb 2018, being tested during 5 pilot surveys observed in 2017-2018 with the Isaac Newton Telescope in La Palma. Two NEAs were discovered in Nov 2018 (2018 VQ1 and 2018 VN3), being recovered and reported to MPC within 2 hours. Other 4 discovered NEAs were found from a few dozen possible NEA candidates promptly being followed, allowing us to discover 22 Hungarias and 7 Mars crossing asteroids using the NEARBY platform. Compared with other few available software, NEARBY could detect more asteroids (by 8-41%), but scores less than human detection (by about 10%). Using resulted data, the astrometric accurancy, photometric limits and an INT NEA survey case study are presented as guidelines for planning future surveys.</p

More than 160 near Earth asteroids observed in the EURONEAR network

Context. The EUROpean Near Earth Asteroid Research (EURONEAR) is a network which envisions to bring some European contributions into the general context traced by the Spaceguard Foundation which was carried out during the last 15 years mainly by the US with some modest European and amateur contributions. Aims. The number of known near Earth asteroids (NEAs) and potentially hazardous asteroids (PHAs) has increased tremendously, mainly thanks to five major surveys all focused on the discovery of new bodies. But also other facilities are required to follow-up and improvement the orbital parameters and to study the physical properties of the known bodies. These goals are better achieved by a co-ordinated network such as EURONEAR. Methods. Astrometry is mandatory in order to acquire the positional information necessary to define and improve orbits of NEAs and PHAs and to study their trajectories through the solar system, especially in the vicinity of Earth. Photometry is required to derive some physical information about NEAs and PHAs. In order to achieve these objectives, the main method of research of the EURONEAR is the follow-up programme of objects selected by a few criteria, carried out mostly at 1 m-class telescopes endowed with medium and large field cameras. Results. 162 NEAs summing more than 1500 individual positions were observed for a total time of 55 nights in both visiting mode and regular runs using nine telescopes located in four countries. The observations were reduced promptly and reported to the Minor Planet Centre (MPC) which validated and included them in the MPC and NEODyS databases following the improvement of their orbital elements. For one binary NEA we acquired photometry and were able to determine its orbital and rotational periods. Complementary to the follow-up work, as many as 500 unknown moving objects consistent with new Main Belt asteroids and one possible NEA were discovered in the analyzed fields. Conclusions. Our positions present 1\arcsec precision with an accuracy of 0.2–0.4\arcsec, sufficient for achieving our immediate main goals. The observations and data reduction were conducted by our network members, which included some students and amateurs supervised by professional astronomers. In most cases, we increased the observational arcs decreasing the uncertainties in the orbits, while in some cases the new positions allowed us to recover some bodies endangered to be lost, defining their orbits

Ready for EURONEAR NEA surveys using the NEARBY moving source detection platform

In 2015 we started a PhD thesis aiming to write a moving objects processing system (MOPS) aimed to detect near Earth asteroids (NEAs) in astronomical surveys planned within the EURONEAR project. Based on this MOPS experience, in 2017 we proposed the NEARBY project to the Romanian Space Agency, which awarded funding to the Technical University of Cluj-Napoca (UTCN) and the University of Craiovafor building a cloud-based online platform to reduce survey images, detect, validate and report in near real time asteroid detections and NEA candidates. The NEARBY platform was built and is available at UTCN since Feb 2018, being tested during 5 pilot surveys observed in 2017-2018 with the Isaac Newton Telescope in La Palma. Two NEAs were discovered in Nov 2018 (2018 VQ1 and 2018 VN3), being recovered and reported to MPC within 2 hours. Other 4 discovered NEAs were found from a few dozen possible NEA candidates promptly being followed, allowing us to discover 22 Hungarias and 7 Mars crossing asteroids using the NEARBY platform. Compared with other few available software, NEARBY could detect more asteroids (by 8-41%), but scores less than human detection (by about 10%). Using resulted data, the astrometric accurancy, photometric limits and an INT NEA survey case study are presented as guidelines for planning future surveys