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Alashjaie R, Kerr EN, AlShoumer A, Hawkins C, Yau I, Weiss S, Ochi A, Otsubo H, Krishnan P, Widjaja E, Ibrahim GM, Donner EJ, Jain P. Surgical outcomes in children with drug-resistant epilepsy and hippocampal sclerosis. Epilepsy Res 2024; 203:107367. [PMID: 38703703 DOI: 10.1016/j.eplepsyres.2024.107367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/09/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Hippocampal sclerosis (HS) is a common surgical substrate in adult epilepsy surgery cohorts but variably reported in various pediatric cohorts. OBJECTIVE We aimed to study the epilepsy phenotype, radiological and pathological variability, seizure and neurocognitive outcomes in children with drug-resistant epilepsy and hippocampal sclerosis (HS) with or without additional subtle signal changes in anterior temporal lobe who underwent surgery. METHODS This retrospective study enrolled children with drug-resistant focal epilepsy and hippocampal sclerosis with or without additional subtle T2-Fluid Attenuated Inversion Recovery (FLAR)/Proton Density (PD) signal changes in anterior temporal lobe who underwent anterior temporal lobectomy with amygdalohippocampectomy. Their clinical, EEG, neuropsychological, radiological and pathological data were reviewed and summarized. RESULTS Thirty-six eligible patients were identified. The mean age at seizure onset was 3.7 years; 25% had daily seizures at time of surgery. Isolated HS was noted in 22 (61.1%) cases and additional subtle signal changes in ipsilateral temporal lobe in 14 (38.9%) cases. Compared to the normative population, the group mean performance in intellectual functioning and most auditory and visual memory tasks were significantly lower than the normative sample. The mean age at surgery was 12.3 years; 22 patients (61.1%) had left hemispheric surgeries. ILAE class 1 outcomes was seen in 28 (77.8%) patients after a mean follow up duration of 2.3 years. Hippocampal sclerosis was noted pathologically in 32 (88.9%) cases; type 2 (54.5%) was predominant subtype where further classification was possible. Additional pathological abnormalities were seen in 11 cases (30.6%); these had had similar rates of seizure freedom as compared to children with isolated hippocampal sclerosis/gliosis (63.6% vs 84%, p=0.21). Significant reliable changes were observed across auditory and visual memory tasks at an individual level post surgery. CONCLUSIONS Favourable seizure outcomes were seen in most children with isolated radiological hippocampal sclerosis. Patients with additional pathological abnormalities had similar rates of seizure freedom as compared to children with isolated hippocampal sclerosis/gliosis.
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Affiliation(s)
- Ream Alashjaie
- Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth N Kerr
- Department of Psychology, Hospital for Sick Children, Toronto, University of Toronto, Ontario, Canada
| | - Azhar AlShoumer
- Division of Neuropathology, Department of Laboratory Medicine and Pathology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cynthia Hawkins
- Division of Neuropathology, Department of Laboratory Medicine and Pathology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ivanna Yau
- Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Shelly Weiss
- Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Ayako Ochi
- Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Hiroshi Otsubo
- Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elysa Widjaja
- Department of Medical Imaging, Lurie Children's Hospital of Chicago, Chicago, United States of America
| | - George M Ibrahim
- Division of Neurosurgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth J Donner
- Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Puneet Jain
- Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
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Champigny CM, Feldman SJ, Beribisky N, Desrocher M, Isaacs T, Krishnan P, Monette G, Dlamini N, Dirks P, Westmacott R. Predictors of neurocognitive outcome in pediatric ischemic and hemorrhagic stroke. Child Neuropsychol 2024; 30:444-461. [PMID: 37204222 DOI: 10.1080/09297049.2023.2213461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/05/2023] [Indexed: 05/20/2023]
Abstract
This clinical study examined the impact of eight predictors (age at stroke, stroke type, lesion size, lesion location, time since stroke, neurologic severity, seizures post-stroke, and socioeconomic status) on neurocognitive functioning following pediatric stroke. Youth with a history of pediatric ischemic or hemorrhagic stroke (n = 92, ages six to 25) underwent neuropsychological testing and caregivers completed parent-report questionnaires. Hospital records were accessed for medical history. Spline regressions, likelihood ratios, one-way analysis of variance, Welch's t-tests, and simple linear regressions examined associations between predictors and neuropsychological outcome measures. Large lesions and lower socioeconomic status were associated with worse neurocognitive outcomes across most neurocognitive domains. Ischemic stroke was associated with worse outcome in attention and executive functioning compared to hemorrhagic stroke. Participants with seizures had more severe executive functioning impairments than participants without seizures. Youth with cortical-subcortical lesions scored lower on a few measures than youth with cortical or subcortical lesions. Neurologic severity predicted scores on few measures. No differences were found based on time since stroke, lesion laterality, or supra- versus infratentorial lesion. In conclusion, lesion size and socioeconomic status predict neurocognitive outcome following pediatric stroke. An improved understanding of predictors is valuable to clinicians who have responsibilities related to neuropsychological assessment and treatments for this population. Findings should inform clinical practice through enhanced appraisals of prognosis and the use of a biopsychosocial approach when conceptualizing neurocognitive outcome and setting up support services aimed at fostering optimal development for youth with stroke.
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Affiliation(s)
- Claire M Champigny
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
| | - Samantha J Feldman
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
| | | | - Mary Desrocher
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
- Department of Psychology, York University, Toronto, Canada
| | - Tamiko Isaacs
- Department of Psychology, York University, Toronto, Canada
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | | | - Nomazulu Dlamini
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Peter Dirks
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, Canada
| | - Robyn Westmacott
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
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Yadav A, Babu S, Krishnan P, Kaur B, Bana RS, Chakraborty D, Kumar V, Joshi B, Lal SK. Zinc oxide and ferric oxide nanoparticles combination increase plant growth, yield, and quality of soybean under semiarid region. Chemosphere 2024; 352:141432. [PMID: 38368965 DOI: 10.1016/j.chemosphere.2024.141432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/20/2024]
Abstract
Zinc (Zn) and iron (Fe) malnutrition are global health challenges that need immediate attention. Hence, to address these issues, a two-pronged approach involving the development and application of novel Zn and Fe products for crop fertilization may be a potential solution. Therefore, zinc oxide (ZnO) (∼13.2 nm) and ferric oxide (Fe2O3) (∼15 nm) nanoparticles (NPs) were synthesized and characterized. Seven nutrients treatments viz, control, ZnO- NPs (25 mg kg-1), Fe2O3-NPs (25 mg kg-1), ZnO + Fe2O3-NPs (25 mg kg-1each), ZnSO4 (55.8 mg kg-1), FeSO4 (60.4 mg kg-1) and ZnSO4+ FeSO4 (55.8 and 60.4 mg kg-1) were arranged in five-time replicated Completely Randomized Design model to test the effectiveness of ZnO and Fe2O3 NPs in two soybean cultivars over conventional zinc sulfate (ZnSO4) and ferrous sulfate (FeSO4) fertilizers. The results indicated that the photosynthetic rate (Pn) and chlorophyll content increased (33.9-86.2%) significantly at the flowering stage with ZnO and Fe2O3 NPs applications, compared to their conventional counterparts. Likewise, the combined application of ZnO and Fe2O3 NPs reduced H2O2 production by 17-19% and increased the superoxide dismutase (SOD) and catalase (CAT) activities by 15-17% and 9.6-11.4% over the combined use of ZnSO4 and FeSO4, respectively. The normalized difference vegetation index (NDVI) showed an increase of 6.9-44.2% under ZnO and Fe2O3 NPs, as well as ZnSO4 and FeSO4. Furthermore, the combined application of NPs enhanced soybean seed yield by 4.6-18.3% compared to conventional Zn and Fe fertilizers. Concerning seed Zn and Fe density, conjoint application of ZnO and Fe2O3 NPs increases Zn by 1.8-2.2-fold and Fe by 19.22-22.58% over the combined application of Zn SO4 and FeSO4, respectively. While the application of NPs significantly decreased seed phytic acid concentrations by 7.3-59.9% compared to the control. These findings suggest that the combined application of ZnO and Fe2O3 NPs effectively enhances soybean productivity, seed nutrient density, and overall produce quality. Therefore, the combined application of ZnO and Fe2O3 -NPs in soybean can be a potential approach for sustainable soybean production and to reduce/arrest Zn and Fe malnutrition in a growing population.
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Affiliation(s)
- Achchhelal Yadav
- Divsion of Agricultural Physics, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.
| | - Subhash Babu
- Divsion of Agronomy, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.
| | - P Krishnan
- Divsion of Agricultural Physics, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Baljeet Kaur
- Division of Plant Pathology, ICAR- Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - R S Bana
- Divsion of Agronomy, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Debashis Chakraborty
- Divsion of Agricultural Physics, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Vikas Kumar
- ICAR- National Institute of Agricultural Economics and Policy Research, New Delhi, 110 012, India
| | - Bhawna Joshi
- Division of Environmental Science, ICAR- Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - S K Lal
- Divsion of Genetics, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
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Deopujari CE, Ambekar S, Yetukuri BR, Diyora B, Ghosh A, Krishnan P, Panigrahi M, Ranjan R, Raman C, Tyagi S, Vaishya S, Venkataramana N, Sinha VD, Paniker D, Das S. Expert panel recommendations for topical hemostatic agent use in varied bleeding sites and situations during neuro-spine surgeries. J Clin Neurosci 2024; 120:30-35. [PMID: 38176112 DOI: 10.1016/j.jocn.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/22/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024]
Abstract
Intraoperative bleeding poses a substantial challenge, particularly in neuro-spine surgeries leading to complications such as hematomas, infections, and hemodynamic instability. Despite their proven efficacy, use of topical hemostatic agents (THAs) lacks comprehensive published literature and guidelines particularly in the Indian setting. The present study provides the first-ever Indian expert panel recommendations for effective adjunct THA use in different intraoperative bleeding sites and situations in neuro-spine surgeries. A comprehensive approach, encompassing a literature review, followed by experience sharing in a meeting using a survey helped integrate expert opinions in the form of practical algorithms to guide THA selection. Our survey results revealed a strong inclination towards specific THAs, flowable gelatin + thrombin being choice of THA for difficult to access and problematic bleeding situations during tumor removal/resection, transsphenoidal hypophysectomy and skull-based procedures. Both oxidized regenerated cellulose (ORC)/Fibrillar and flowable gelatin + thrombin were recommended for continuous oozing. ORC/Fibrillar was preferred for arteriovenous and cavernous malformations. This expert-panel guidance on THA use aims to optimize hemostat use practices and improve surgical outcomes in neuro-spine surgery.
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Affiliation(s)
- C E Deopujari
- Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - S Ambekar
- Department of Neurosurgery, Jaslok Hospital, Mumbai, India
| | - B R Yetukuri
- Department of Neurosurgery and Spine Surgery, Yashoda Hospitals, Hyderabad, India
| | - B Diyora
- Department of Neurosurgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - A Ghosh
- Department of Neurosurgery, Institute of Neurosciences Kolkata, Kolkata, India
| | - P Krishnan
- Department of Neurosurgery, National Neurosciences Centre Calcutta, Kolkata, India
| | - M Panigrahi
- Department of Neurosurgery, Krishna Institute of Medical Sciences, Hyderabad, India
| | - R Ranjan
- Department of Neurosurgery, Aditya Birla Memorial Hospital, Pune, India
| | - C Raman
- Department of Neurosurgery, Nobel Hospital, Pune, India
| | - S Tyagi
- Department of Neurosurgery, Indraprastha Apollo Hospital, New Delhi, India
| | - S Vaishya
- Department of Neurosurgery, Fortis Memorial Research Institute, Gurugram, India
| | - N Venkataramana
- Department of Neurosurgery, Brains Hospital, Bengaluru, India
| | - V D Sinha
- Department of Neurosurgery, Santokba Durlabhji Memorial Hospital, Jaipur, India
| | - D Paniker
- Department of Neurosurgery, Aster Medcity, Kochi, India
| | - S Das
- Johnson and Johnson Private Limited, Mumbai, India.
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Kunpalin Y, Sichitiu J, Krishnan P, Blaser S, Kulkarni AV, Abbasi N, Ryan G, Shinar S, van Mieghem T. Simple prenatal imaging predictors for postnatal cerebrospinal fluid diversion surgery in fetuses undergoing in utero surgery for spina bifida. Prenat Diagn 2023; 43:1605-1613. [PMID: 37975651 DOI: 10.1002/pd.6453] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES To determine simple prenatal imaging parameters that can easily be acquired to predict the need for postnatal CSF diversion (PCD) surgery in fetuses undergoing open fetal surgery for open spina bifida (OSB). METHODS All fetuses with OSB that underwent open fetal surgery between June 2017 and June 2021 with available follow-up outcomes were included. Imaging parameters including clivus-supraocciput angle (CSA) on magnetic resonance imaging, transcerebellar diameter (TCD) and lateral ventricle size (Vp) on ultrasound (US), were collected pre- and postoperatively. The requirement for PCD surgery was determined at 1 year of age. The predictive strength of each parameter was determined by Receiver Operating Characteristic curve analysis. RESULTS Among 36 babies eligible for the analyses, 41.7% required PCD by one year of age. Pre-operative Vp (AUC 0.71; 95% confidence interval [CI] 0.54-0.88; p = 0.03), TCD (AUC 0.72; 95% CI 0.55-0.89; p = 0.02) and CSA (AUC 0.72; 95% CI 0.51-0.93; p = 0.04) were fair predictors for PCD surgery. After fetal surgery, TCD (AUC 0.93; 95% CI 0.83-1.00; p < 0.0001) and CSA (AUC 0.94; 95% CI 0.83-1.00; p = 0.0005) were outstanding predictors of PCD, whereas post-operative Vp was a fair predictor (AUC 0.71, 95% CI 0.54-0.88, p = 0.03). CONCLUSION Post-operative CSA and TCD were outstanding predictors for the need for PCD surgery.
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Affiliation(s)
- Yada Kunpalin
- Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Joanna Sichitiu
- Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Pradeep Krishnan
- University of Toronto, Toronto, Ontario, Canada
- Department of Diagnostic Imaging, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Ontario Fetal Centre, Toronto, Ontario, Canada
| | - Susan Blaser
- University of Toronto, Toronto, Ontario, Canada
- Department of Diagnostic Imaging, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
- Ontario Fetal Centre, Toronto, Ontario, Canada
| | - Abhaya V Kulkarni
- University of Toronto, Toronto, Ontario, Canada
- Ontario Fetal Centre, Toronto, Ontario, Canada
- Division of Neurosurgery, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
| | - Nimrah Abbasi
- Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
- Ontario Fetal Centre, Toronto, Ontario, Canada
| | - Greg Ryan
- Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
- Ontario Fetal Centre, Toronto, Ontario, Canada
| | - Shiri Shinar
- Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
- Ontario Fetal Centre, Toronto, Ontario, Canada
| | - Tim van Mieghem
- Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
- Ontario Fetal Centre, Toronto, Ontario, Canada
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Singh RN, Krishnan P, Singh VK, Sah S, Das B. Combining biophysical parameters with thermal and RGB indices using machine learning models for predicting yield in yellow rust affected wheat crop. Sci Rep 2023; 13:18814. [PMID: 37914800 PMCID: PMC10620169 DOI: 10.1038/s41598-023-45682-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/23/2023] [Indexed: 11/03/2023] Open
Abstract
Evaluating crop health and forecasting yields in the early stages are crucial for effective crop and market management during periods of biotic stress for both farmers and policymakers. Field experiments were conducted during 2017-18 and 2018-19 with objective to evaluate the effect of yellow rust on various biophysical parameters of 24 wheat cultivars, with varying levels of resistance to yellow rust and to develop machine learning (ML) models with improved accuracy for predicting yield by integrating thermal and RGB indices with crucial plant biophysical parameters. Results revealed that as the level of rust increased, so did the canopy temperature and there was a significant decrease in crop photosynthesis, transpiration, stomatal conductance, leaf area index, membrane stability index, relative leaf water content, and normalized difference vegetation index due to rust, and the reductions were directly correlated with levels of rust severity. The yield reduction in moderate resistant, low resistant and susceptible cultivars as compared to resistant cultivars, varied from 15.9-16.9%, 28.6-34.4% and 59-61.1%, respectively. The ML models were able to provide relatively accurate early yield estimates, with the accuracy increasing as the harvest approached. The yield prediction performance of the different ML models varied with the stage of the crop growth. Based on the validation output of different ML models, Cubist, PLS, and SpikeSlab models were found to be effective in predicting the wheat yield at an early stage (55-60 days after sowing) of crop growth. The KNN, Cubist, SLR, RF, SpikeSlab, XGB, GPR and PLS models were proved to be more useful in predicting the crop yield at the middle stage (70 days after sowing) of the crop, while RF, SpikeSlab, KNN, Cubist, ELNET, GPR, SLR, XGB and MARS models were found good to predict the crop yield at late stage (80 days after sowing). The study quantified the impact of different levels of rust severity on crop biophysical parameters and demonstrated the usefulness of remote sensing and biophysical parameters data integration using machine-learning models for early yield prediction under biotically stressed conditions.
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Affiliation(s)
- R N Singh
- Division of Agricultural Physics, ICAR-Indian Agricultural Research Institute, New Delhi, India
- ICAR-National Institute of Abiotic Stress Management, Pune, Maharashtra, India
| | - P Krishnan
- Division of Agricultural Physics, ICAR-Indian Agricultural Research Institute, New Delhi, India.
| | - Vaibhav K Singh
- Division of Plant Pathology, ICAR-Indian Agricultural Research Institute, New Delhi, India
| | - Sonam Sah
- ICAR-National Institute of Abiotic Stress Management, Pune, Maharashtra, India
| | - B Das
- ICAR-Central Coastal Agricultural Research Institute, Old Goa, Goa, India
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Ashwal E, Blaser S, Leckie A, Kajal D, Krishnan P, Chong K, Roifman M, Toi A, Chitayat D. Anterior extension of the choroid plexus into the frontal horns of the fetal lateral cerebral ventricles: Prenatal findings and postnatal outcome. Prenat Diagn 2023; 43:756-762. [PMID: 36946677 DOI: 10.1002/pd.6344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To evaluate the short- and long-term outcome of fetuses with evidence of extension of the choroid plexus into the frontal horns. METHODS This is a retrospective cohort study of fetuses diagnosed with isolated choroid plexi extending into the frontal horns. Fetuses with major central nervous system anomalies were excluded. Ultrasound and fetal/postnatal magnetic resonance imaging (MRI) were evaluated. Postnatal outcomes, including developmental assessment, were obtained. RESULTS Twenty nine fetuses were diagnosed with choroid plexus extension (22 unilateral and 7 bilateral). Gestational age at diagnosis was 19.3 weeks. Three cases (10.3%) presented with nonspecific extra-CNS findings. At presentation, 8/29 (28%) cases had single/multiple choroid plexus cysts (CPC). Twenty-six (89.6%) cases underwent antenatal MRI. On MRI, four cases had punctate susceptibility weighted imaging (SWI) foci suggesting trace hemosiderin and two cases had ventriculomegaly. Antenatal follow-up demonstrated resolution of the choroid plexus extension in 90% (18/20). Gestational age at delivery was 39.6 weeks. All had normal neurologic examinations within 24 h of life. Postnatal MRI studies were notable for deep venous differences in seven cases. Long-term clinical outcome was assessed in 14 cases with a median follow-up of 1.75 years, with normal neurodevelopment reported in 13/14 (92.8%). CONCLUSIONS Most fetuses with an anterior extension of the choroid plexus as the sole sonographic finding had favorable outcomes.
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Affiliation(s)
- Eran Ashwal
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Susan Blaser
- Department of Radiology, Mount Sinai Hospital, University of Toronto, University of Toronto, Toronto, Ontario, Canada
- Department of Diagnostic Imaging, Division of Neuroradiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Ashley Leckie
- Department of Radiology, Mount Sinai Hospital, University of Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Dilkash Kajal
- Department of Radiology, Mount Sinai Hospital, University of Toronto, University of Toronto, Toronto, Ontario, Canada
| | - Pradeep Krishnan
- Department of Radiology, Mount Sinai Hospital, University of Toronto, University of Toronto, Toronto, Ontario, Canada
- Department of Diagnostic Imaging, Division of Neuroradiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Karen Chong
- Department of Obstetrics and Gynecology, The Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Maian Roifman
- Department of Obstetrics and Gynecology, The Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Ants Toi
- Department of Radiology, Mount Sinai Hospital, University of Toronto, University of Toronto, Toronto, Ontario, Canada
| | - David Chitayat
- Department of Obstetrics and Gynecology, The Prenatal Diagnosis and Medical Genetics Program, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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8
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Domi T, Robertson A, Lee W, Wintle RF, Stence N, Bernard T, Kirton A, Carlson H, Andrade A, Rafay MF, Bjornson B, Kim D, Dowling M, Bonnett W, Rivkin M, Krishnan P, Shroff M, Ertl-Wagner B, Strother S, Arnott S, Wintermark M, Kassner A, deVeber G, Dlamini N. The development of the pediatric stroke neuroimaging platform (PEDSNIP). Neuroimage Clin 2023; 39:103438. [PMID: 37354865 PMCID: PMC10331307 DOI: 10.1016/j.nicl.2023.103438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/15/2023] [Indexed: 06/26/2023]
Abstract
Childhood stroke occurs from birth to 18 years of age, ranks among the top ten childhood causes of death, and leaves lifelong neurological impairments. Arterial ischemic stroke in infancy and childhood occurs due to arterial occlusion in the brain, resulting in a focal lesion. Our understanding of mechanisms of injury and repair associated with focal injury in the developing brain remains rudimentary. Neuroimaging can reveal important insights into these mechanisms. In adult stroke population, multi-center neuroimaging studies are common and have accelerated the translation process leading to improvements in treatment and outcome. These studies are centered on the growing evidence that neuroimaging measures and other biomarkers (e.g., from blood and cerebrospinal fluid) can enhance our understanding of mechanisms of risk and injury and be used as complementary outcome markers. These factors have yet to be studied in pediatric stroke because most neuroimaging studies in this population have been conducted in single-centred, small cohorts. By pooling neuroimaging data across multiple sites, larger cohorts of patients can significantly boost study feasibility and power in elucidating mechanisms of brain injury, repair and outcomes. These aims are particularly relevant in pediatric stroke because of the decreased incidence rates and the lack of mechanism-targeted trials. Toward these aims, we developed the Pediatric Stroke Neuroimaging Platform (PEDSNIP) in 2015, funded by The Brain Canada Platform Support Grant, to focus on three identified neuroimaging priorities. These were: developing and harmonizing multisite clinical protocols, creating the infrastructure and methods to import, store and organize the large clinical neuroimaging dataset from multiple sites through the International Pediatric Stroke Study (IPSS), and enabling central searchability. To do this, developed a two-pronged approach that included building 1) A Clinical-MRI Data Repository (standard of care imaging) linked to clinical data and longitudinal outcomes and 2) A Research-MRI neuroimaging data set acquired through our extensive collaborative, multi-center, multidisciplinary network. This dataset was collected prospectively in eight North American centers to test the feasibility and implementation of harmonized advanced Research-MRI, with the addition of clinical information, genetic and proteomic studies, in a cohort of children presenting with acute ischemic stroke. Here we describe the process that enabled the development of PEDSNIP built to provide the infrastructure to support neuroimaging research priorities in pediatric stroke. Having built this Platform, we are now able to utilize the largest neuroimaging and clinical data pool on pediatric stroke data worldwide to conduct hypothesis-driven research. We are actively working on a bioinformatics approach to develop predictive models of risk, injury and repair and accelerate breakthrough discoveries leading to mechanism-targeted treatments that improve outcomes and minimize the burden following childhood stroke. This unique transformational resource for scientists and researchers has the potential to result in a paradigm shift in the management, outcomes and quality of life in children with stroke and their families, with far-reaching benefits for other brain conditions of people across the lifespan.
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Affiliation(s)
- Trish Domi
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amanda Robertson
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wayne Lee
- Research Operations, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Richard F Wintle
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicholas Stence
- Pediatric Neuroradiology, Children's Hospital Colorado, Aurora, CO, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Timothy Bernard
- Child Neurology and Hemophilia and Thrombosis Center, University of Colorado, Aurora, CO, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Adam Kirton
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Helen Carlson
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea Andrade
- London Health Sciences Centre, London, United Kingdom; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mubeen F Rafay
- Health Sciences Centre Winnipeg, Winnipeg, Manitoba, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bruce Bjornson
- The University of British Columbia, Vancouver, British Columbia, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Danny Kim
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael Dowling
- The University of Texas, Southwestern Austin, TX, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wilmot Bonnett
- The University of Texas, Southwestern Austin, TX, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael Rivkin
- Department of Neurology, Boston, MA, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Manohar Shroff
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Birgit Ertl-Wagner
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen Strother
- Department of Medical Biophysics Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Steven Arnott
- Department of Medical Biophysics Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Max Wintermark
- Department of Neuroradiology, MD Anderson, Houston, TX (M.W.), United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea Kassner
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Gabrielle deVeber
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nomazulu Dlamini
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada,.
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9
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Abstract
In this article, we describe relevant anatomy, mechanisms of injury, and imaging findings of abusive head trauma (AHT). We also briefly address certain mimics of AHT, controversies, pearls, and pitfalls. Concepts of injury, its evolution, and complex nature of certain cases are highlighted with the help of case vignettes.
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Affiliation(s)
- Asthik Biswas
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada; Department of Medical Imaging, University of Toronto, Ontario, Canada; Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N3JH, UK.
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada; Department of Medical Imaging, University of Toronto, Ontario, Canada
| | - Ibrahem Albalkhi
- Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N3JH, UK; College of Medicine, Alfaisal University, Al Takhassousi، Al Zahrawi Street interconnecting with, Riyadh 11533, Saudi Arabia
| | - Kshitij Mankad
- Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London WC1N3JH, UK; UCL GOS Institute of Child Health
| | - Manohar Shroff
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada; Department of Medical Imaging, University of Toronto, Ontario, Canada
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10
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Singh RN, Krishnan P, Bhardwaj C, Das B. Improving prediction of chickpea wilt severity using machine learning coupled with model combination techniques under field conditions. ECOL INFORM 2023. [DOI: 10.1016/j.ecoinf.2022.101933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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11
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Biswas A, Krishnan P, Vidarsson L, Shroff M. Cerebral White Matter Tract Anatomy. Neuroimaging Clin N Am 2022; 32:507-528. [PMID: 35843659 DOI: 10.1016/j.nic.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Advances in MR imaging techniques have allowed for detailed in vivo depiction of white matter tracts. The study of white matter structure and connectivity is of paramount importance in leukodystrophies, demyelinating disorders, neoplasms, and various cognitive, neuropsychiatric, and developmental disorders. The advent of advanced "function-preserving" surgical techniques also makes it imperative to understand white matter anatomy and connectivity, to provide accurate road maps for tumor and epilepsy surgery. In this review, we will describe cerebral white matter anatomy with the help of conventional MRI and diffusion tensor imaging.
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Affiliation(s)
- Asthik Biswas
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G1X8, Canada; Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London WC1N3JH, United Kingdom.
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G1X8, Canada
| | - Logi Vidarsson
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G1X8, Canada
| | - Manohar Shroff
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555, University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5G1X8, Canada
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12
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Kantharajan G, Anand A, Krishnan P, Singh RK, Kumar K, Kumar Yadav A, Mohindra V, Shukla SP, Lal KK. Applications of Sentinel-2 satellite data for spatio-temporal mapping of deep pools for monitoring the riverine connectivity and assessment of ecological dynamics: a case from Godavari, a tropical river in India (2016-2021). Environ Monit Assess 2022; 194:558. [PMID: 35781750 DOI: 10.1007/s10661-022-10089-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
Rivers are dynamic ecosystems with diverse habitats that require ample connectivity to ensure the flow of ecosystem services, thus empowering the sustainable development of an entire basin. Geo-spatial tools offer powerful prospects for monitoring of aquatic ecosystems. The usefulness of Sentinel-2 datasets to assess river connectivity has been explored for an un-gauged seasonal river system. The present study was undertaken in five ecologically unique river reaches viz. Wainganga, Wardha, Pranhita, Godavari-mid and Manair in Godavari Basin in the Indian Deccan Plateau to map water spread dynamics at various time scales, i.e., fortnightly, monthly, seasonal, annual and demi-decadal during 2016-2021. The maximum value of perennial water spread per square kilometre of total floodplain area (2016-2021), determined using Sentinel-2 imageries, was observed in river Wardha (0.18) followed by Pranhita (0.12) and Wainganga (0.11). The water spread showed a decreasing trend, while the number of patches in the river corridor increased over time from post-monsoon to pre-monsoon season. The copious perennial habitat with relatively larger patches, incessant flow in river Pranhita and obstructed flow, large-sized patches reported in river Wardha during summer months, hold importance in terms of providing refuge to aquatic biota. This study provides evidence for the impact of water projects on spatio-temporal water spread dynamics in Godavari Basin. The demonstrated utility of Sentinel-2 imagery coupled with gauge station measurements for river continuity assessment and deep pool mapping would aid in enhancing our understanding on environmental flow at a spatial scale, which in turn would aid in effective river management to achieve the Sustainable Development Goals. The implications of this study for sustainable environmental management and limitations are also discussed.
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Affiliation(s)
- G Kantharajan
- ICAR - National Bureau of Fish Genetic Resources, Lucknow, 226002, Uttar Pradesh, India
- ICAR - Central Institute of Fisheries Education, Mumbai, 400061, Maharashtra, India
| | - Arur Anand
- Regional Remote Sensing Centre, NRSC, ISRO-Department of Space, Nagpur, 440033, Maharashtra, India
| | - P Krishnan
- Bay of Bengal Region Inter- Governmental Organization (BOBP-IGO), Chennai, 600018, Tamil Nadu, India
| | - Rajeev K Singh
- ICAR - National Bureau of Fish Genetic Resources, Lucknow, 226002, Uttar Pradesh, India.
| | - Kundan Kumar
- ICAR - Central Institute of Fisheries Education, Mumbai, 400061, Maharashtra, India
| | - Ajay Kumar Yadav
- ICAR - National Bureau of Fish Genetic Resources, Lucknow, 226002, Uttar Pradesh, India
| | - Vindhya Mohindra
- ICAR - National Bureau of Fish Genetic Resources, Lucknow, 226002, Uttar Pradesh, India
| | - S P Shukla
- ICAR - Central Institute of Fisheries Education, Mumbai, 400061, Maharashtra, India
| | - Kuldeep K Lal
- ICAR - National Bureau of Fish Genetic Resources, Lucknow, 226002, Uttar Pradesh, India
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13
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Abstract
BACKGROUND:
Neonatal cerebral venous sinus thrombosis (CVST) can lead to brain injury and neurodevelopmental impairments. Previous studies of neonatal CVST have focused on term infants, and studies of preterm infants are lacking. In this study, we examined the clinical and radiological features, treatment and outcome of CVST in preterm infants.
METHODS:
This was a retrospective, consecutive cohort study of preterm infants (gestational age <37 weeks) with radiologically confirmed CVST. All magnetic resonance imaging/MRV and CT/CTV scans were re-reviewed to study thrombus characteristics and pattern of brain injury. Outcome was assessed by the validated pediatric stroke outcome measure at the most recent clinic visit.
RESULTS:
Twenty-six preterm infants with CVST were studied. Of these, 65% were moderate-late preterm (32–37 weeks), 27% very preterm (28–32 weeks), and 8% extreme preterm (<28 weeks). Most (73%) were symptomatic at presentation with seizures or abnormal exam. Transverse (85%) and superior sagittal (42%) sinuses were common sites of thrombosis. Parenchymal brain injury was predominantly periventricular (35%) and deep white matter (31%) in location. Intraventricular hemorrhage occurred in 46%. Most infants (69%) were treated with anticoagulation. No treated infant (including eleven with pretreatment hemorrhage) had new or worsening post-treatment hemorrhage. Outcomes ranged from no deficits (50%), mild-moderate (25%), and severe (25%) impairment.
CONCLUSIONS:
In our sample of preterm infants with CVST, more than one-quarter were asymptomatic. White matter brain lesions predominated and one-half had neurological deficits at follow-up. Anticoagulation of preterm CVST in this small cohort appeared to be safe. Larger studies of preterm CVST are needed.
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Affiliation(s)
- Rhandi Christensen
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto‚ Ontario‚ Canada (R.C., G.d., N.D., D.M., E.P., M.M.)
| | - Pradeep Krishnan
- Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto‚ Ontario‚ Canada (P.K.)
| | - Gabrielle deVeber
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto‚ Ontario‚ Canada (R.C., G.d., N.D., D.M., E.P., M.M.)
- Child Health Evaluative Sciences Program, Hospital for Sick Children Research Institute‚ Toronto‚ Ontario‚ Canada (G.d.)
| | - Nomazulu Dlamini
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto‚ Ontario‚ Canada (R.C., G.d., N.D., D.M., E.P., M.M.)
| | - Daune MacGregor
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto‚ Ontario‚ Canada (R.C., G.d., N.D., D.M., E.P., M.M.)
| | - Elizabeth Pulcine
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto‚ Ontario‚ Canada (R.C., G.d., N.D., D.M., E.P., M.M.)
| | - Mahendranath Moharir
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto‚ Ontario‚ Canada (R.C., G.d., N.D., D.M., E.P., M.M.)
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14
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Walker K, Domi T, Burton I, Choi EJ, Robertson A, Mangone L, Kassner A, Krishnan P, Muthusami P, Deveber GA, Logan W, Dlamini N. Abstract TP97: White Matter And Deep Grey Matter Structural Variations In Childhood Moyamoya Disease. Stroke 2022. [DOI: 10.1161/str.53.suppl_1.tp97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Moyamoya disease is a progressive steno-occlusive arteriopathy that increases stroke risk. Clinically, cognitive decline is known to occur over time, even in the absence of stroke. MRI measures of cerebrovascular reactivity (CVR) provide an in vivo assessment of cerebrovascular reserve and stroke risk. Typically, in normal-appearing white matter (WM) lower (quantified as negative) CVR is associated with increased apparent diffusion coefficient (ADC). However, the association between negative CVR and ADC in children is not well understood.
Objectives:
To determine (i) whether negative CVR is associated with changes in ADC in normal-appearing WM of children with Moyamoya, ii) whether there is an association between CVR and ADC with structural damage to the brain (by measuring the volume of subcortical structures).
Methods:
Retrospective analysis of a consecutive cohort of nine children with Moyamoya (male = 4, median age = 12.1) with no history of stroke, and seven age and sex-matched controls. ADC values and fractional negativity (fneg), calculated from CVR parametric maps as the fraction of negative CVR voxels within a region of interest (ROI), were extracted from WM and subcortical GM ROIs. Volumes from the subcortical GM regions were extracted and normalized for head size. Analyses of differences was calculated per hemisphere (n=18, bilateral disease n = 4, unilateral n=5) and categorized as affected and unaffected and compared to controls.
Results:
Mean (m) ADC in WM of affected hemispheres (m=807.05, p<0.01) and unaffected (m=814.68, p<0.05) hemispheres were significantly larger compared to controls (m=761.04). A positive relationship was found between fneg and ADC in affected (r=0.37, p=0.24) and unaffected (r=0.26, p=0.62) hemispheres, but with no statistical significance. Increased ADC in the caudate was associated with smaller volume in the affected hemisphere of patients (r =-0.83, p=0.02).
Conclusions:
ADC in normal appearing WM in children with Moyamoya is elevated, and is associated with volume of the caudate in this cohort demonstrating the association between abnormal CVR, perfusion and structural damage in children with Moyamoya and no stroke.
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15
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Moharir MD, Christensen R, Krishnan P, Deveber GA, Dlamini N, MacGregor D, Pulcine L. Abstract TMP95: Cerebral Sinovenous Thrombosis In Preterm Infants. Stroke 2022. [DOI: 10.1161/str.53.suppl_1.tmp95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Neonatal cerebral sinovenous thrombosis (CSVT) can lead to brain injury and long-term neurodevelopmental impairments. Previous studies of neonatal CSVT have primarily focused on term infants, and studies of preterm infants are lacking. In this study, we examined the clinical and radiological features, treatment and outcome of CSVT in preterm infants.
Methods:
This was a retrospective, consecutive cohort study of preterm infants (gestational age <37 weeks) with radiologically confirmed CSVT. All MRI/MRV and CT/CTV scans were re-reviewed to study thrombus characteristics and the pattern of brain injury. Clinical and radiological data were analysed using descriptive statistics, ANOVA and chi-square tests. Outcome was assessed by the validated Pediatric Stroke Outcome Measure (PSOM).
Results:
A total of 26 preterm infants with CSVT were included. Of these, 65% were late preterm, 27% very preterm and 8% extreme preterm. Most (73%) were symptomatic at presentation with seizures or abnormal exam. Transverse (85%) and superior sagittal (42%) sinus were most common sites of thrombosis. Parenchymal brain injury was predominantly periventricular (35%) and deep white matter (31%) in location. Intraventricular hemorrhage occurred in 46%. Most infants (69%) were treated with anticoagulation. None of the treated infants had hemorrhagic complications. Outcome at follow-up ranged from no impairment (39%), mild impairment (19%) and severe impairment (19%).
Conclusions:
Preterm infants with CSVT are often symptomatic and have white matter brain lesions at presentation. Anticoagulation treatment of preterm CSVT in this small cohort appeared to be safe. Further larger studies and treatment.
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16
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Sanvido L, Krishnan P, Domi T, Walker K, Fehlings D, Robertson A, Thapa R, Dlamini N. Abstract TP172: Clinical And Neuroimaging Predictors Of Dyskinetic Cerebral Palsy. Stroke 2022. [DOI: 10.1161/str.53.suppl_1.tp172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Dyskinetic cerebral palsy (DCP) is a non-progressive disorder that results from lesions to the developing fetal brain. Neuroimaging patterns and risk factors for DCP in pre-term infants are poorly understood. Furthermore, neuroimaging differences between preterm and term infants with DCP and its relationship to clinical outcomes are not well established.
Objectives:
1) To describe neuroimaging differences between term and preterm infants with DCP. 2) To investigate relationships between neuroimaging patterns and clinical motor outcome of infants with DCP.
Methods:
Patients with DCP were identified through The Cerebral Palsy Network where clinical details and magnetic resonance images (MRI) were collected on children with DCP. To determine lesion volume and location, manual segmentation was performed using ITK-SNAP software by study neuroradiologist. Lesion severity was graded using a semi-quantitative scale for structural MRIs(Laporta-Hoyos et al. 2018) based on the number of lobes and subcortical structures involved. Motor outcomes was assessed with the Gross Motor Function Classification System.
Results:
Twenty-nine patients with DCP were identified. Preterm infants (n=12, [male= 8, female=4]), and term infants (n=16 term, [male= 6, female=10]) differed in mean gestational age (30.5 versus 39.1 weeks respectively, p=.02). The frequency of periventricular leukomalacia in preterm (89%) and term-born (58%) infants differed (p = 0.02). Lesion severity was associated with: the ventral posterior lateral (VPL) thalamus (r=0.574,p =.01), the posterior limb of the internal capsule (PLIC) (r=0.437p = .04) in term infants, and the right (r = 0.504, p = .01) and left putamen r = 0.629, p = .002) in term infants. Significant negative correlations were found between lesion severity and gross motor function in the VPL thalamus (r= -0.624, p = .001), PLIC (r= -0.735, p < .001), right (r= -0.50, p= .016) and left putamen (r= -0.54 p = .008).
Conclusion:
Our results suggest the timing of lesions in term-born and preterm infants with DCP are associated with neuroimaging lesion patterns. Involvement of subcortical structures and lesion severity scores were associated with gross motor function in this cohort of patients with DCP.
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Affiliation(s)
- Liam Sanvido
- Faculty of Medicine, Univ of Ottawa, Ottawa, Canada
| | | | | | | | - Darcy Fehlings
- Holland Bloorview Kids Rehabilitation Hosp, Toronto, Canada
| | | | - Ritesh Thapa
- Holland Bloorview Kids Rehabilitation Hosp, Toronto, Canada
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17
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Reddy N, Doyle M, Hanagandi P, Taranath A, Dahmoush H, Krishnan P, Oztekin O, Boltshauser E, Shroff M, Mankad K. Neuroradiological Mimics of Periventricular Leukomalacia. J Child Neurol 2022; 37:151-167. [PMID: 34937403 DOI: 10.1177/08830738211026052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM Periventricular leukomalacia (PVL) is a term reserved to describe white matter injury in the premature brain. In this review article, the authors highlight the common and rare pathologies mimicking the chronic stage of PVL and propose practical clinico-radiological criteria that would aid in diagnosis and management. METHODS AND RESULTS The authors first describe the typical brain MRI (magnetic resonance imaging) features of PVL. Based on their clinical presentation, pathologic entities and their neuroimaging findings were clustered into distinct categories. Three clinical subgroups were identified: healthy children, children with stable/nonprogressive neurological disorder, and those with progressive neurological disorder. The neuroradiological discriminators are described in each subgroup with relevant differential diagnoses. The mimics were broadly classified into normal variants, acquired, and inherited disorders. CONCLUSIONS The term "PVL" should be used appropriately as it reflects its pathomechanism. The phrase "white matter injury of prematurity" or "brain injury of prematurity" is more specific. Discrepancies in imaging and clinical presentation must be tread with caution and warrant further investigations to exclude other possibilities.
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Affiliation(s)
- Nihaal Reddy
- Rainbow Children's Hospital and Tenet Diagnostics, Hyderabad, India
| | - Mary Doyle
- Department of Paediatric Neurology, Great Ormond Street Hospital, London, UK
| | - Prasad Hanagandi
- Department of Neuroradiology, King Abdulaziz Medical City, Riyadh Ministry of National Guard Health Affairs, Saudi Arabia
| | - Ajay Taranath
- Department of Radiology, Women's and Children's Hospital, Adelaide, Australia
| | - Hisham Dahmoush
- Department of Radiology, Lucile Packard Children's Hospital, Stanford, CA, USA
| | - Pradeep Krishnan
- Department of Pediatric Neuroradiology, The Hospital for Sick Children, Toronto, Canada
| | - Ozgur Oztekin
- Tepecik Research and Education Hospital, Health Science University, Izmir, Turkey
| | - Eugen Boltshauser
- Department of Pediatric Neurology, University Children's Hospital, Zurich, Steinwiesstrasse, Switzerland
| | - Manohar Shroff
- Department of Pediatric Neuroradiology, The Hospital for Sick Children, Toronto, Canada
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital, London, UK
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18
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Subramanian S, Biswas A, Alves C, Sudhakar S, Shekdar K, Krishnan P, Shroff M, Taranath A, Arrigoni F, Aldinger K, Leventer R, Dobyns W, Mankad K. ACTA2-Related Dysgyria: An Under-Recognized Malformation of Cortical Development. AJNR Am J Neuroradiol 2022; 43:146-150. [PMID: 34857515 PMCID: PMC8757559 DOI: 10.3174/ajnr.a7364] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/27/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Pathogenic variants in the ACTA2 gene cause a distinctive arterial phenotype that has recently been described to be associated with brain malformation. Our objective was to further characterize gyral abnormalities in patients with ACTA2 pathogenic variants as per the 2020 consensus recommendations for the definition and classification of malformations of cortical development. MATERIALS AND METHODS We performed a retrospective, multicentric review of patients with proved ACTA2 pathogenic variants, searching for the presence of malformations of cortical development. A consensus read was performed for all patients, and the type and location of cortical malformation were noted in each. The presence of the typical ACTA2 arterial phenotype as well as demographic and relevant clinical data was obtained. RESULTS We included 13 patients with ACTA2 pathogenic variants (Arg179His mutation, n = 11, and Arg179Cys mutation, n = 2). Ninety-two percent (12/13) of patients had peri-Sylvian dysgyria, 77% (10/13) had frontal dysgyria, and 15% (2/13) had generalized dysgyria. The peri-Sylvian location was involved in all patients with dysgyria (12/12). All patients with dysgyria had a characteristic arterial phenotype described in ACTA2 pathogenic variants. One patient did not have dysgyria or the characteristic arterial phenotype. CONCLUSIONS Dysgyria is common in patients with ACTA2 pathogenic variants, with a peri-Sylvian and frontal predominance, and was seen in all our patients who also had the typical ACTA2 arterial phenotype.
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Affiliation(s)
- S. Subramanian
- From the Division of Pediatric Radiology (S.S.), Department of Radiology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - A. Biswas
- Department of Diagnostic Imaging (A.B., P.K., M.S.), The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - S.V. Sudhakar
- Department of Radiology (S.V.S., K.M.), Great Ormond Street Hospital, NHS Foundation Trust, London, UK
| | - K.V. Shekdar
- Department of Radiology, and Department of Radiology (K.V.S.), Perelman School of Medicine at the University of Pennsylvania, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - P. Krishnan
- Department of Diagnostic Imaging (A.B., P.K., M.S.), The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - M. Shroff
- Department of Diagnostic Imaging (A.B., P.K., M.S.), The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - A. Taranath
- Department of Medical Imaging (A.T.), Women’s and Children’s Hospital, Adelaide, South Australia, Australia
| | - F. Arrigoni
- Neuroimaging Lab (F.A.), Scientific Institute, Istituto di Ricovero e Cura a Carattere Scientifico Eugenio Medea, Bosisio Parini, Italy
| | - K.A. Aldinger
- Department of Pediatrics (K.A.A.), University of Washington School of Medicine, Seattle, Washington,Center for Integrative Brain Research (K.A.A., W.B.D.), Seattle Children’s Research Institute, Seattle, Washington
| | - R.J. Leventer
- Department of Neurology (R.J.L.), Royal Children’s Hospital and Murdoch Children’s Research Institute, Parkville, Victoria, Australia,Department of Pediatrics (R.J.L.), University of Melbourne, Melbourne, Victoria, Australia
| | - W.B. Dobyns
- Center for Integrative Brain Research (K.A.A., W.B.D.), Seattle Children’s Research Institute, Seattle, Washington,Division of Genetics and Metabolism (W.B.D.), Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - K. Mankad
- Department of Radiology (S.V.S., K.M.), Great Ormond Street Hospital, NHS Foundation Trust, London, UK
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Raybaud C, Krishnan P. Hydrocephalus in Children: A Neuroradiological Perspective. Neurol India 2021; 69:S283-S291. [PMID: 35102978 DOI: 10.4103/0028-3886.332282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Concepts about the production, absorption, dynamics, and physiological roles of cerebrospinal fluid (CSF) have dramatically changed over the recent decades. This article will review these new concepts and detail how they must be used for a better assessment and a better understanding of the various aspects of hydrocephalus by using neuroradiological tools.
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Affiliation(s)
- Charles Raybaud
- Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Canada
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Canada
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20
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Singh RN, Mukherjee J, Sehgal VK, Krishnan P, Das DK, Dhakar RK, Bhatia A. Interactive effect of elevated tropospheric ozone and carbon dioxide on radiation utilisation, growth and yield of chickpea (Cicer arietinum L.). Int J Biometeorol 2021; 65:1939-1952. [PMID: 34050433 DOI: 10.1007/s00484-021-02150-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/21/2021] [Accepted: 05/17/2021] [Indexed: 05/21/2023]
Abstract
An experiment was conducted in the Free Air Ozone and Carbon dioxide Enrichment (FAOCE) facility to study the impact of elevated O3, CO2 and their interaction on chickpea crop (cv. Pusa-5023) in terms of phenology, biophysical parameters, yield components, radiation interception and use efficiency. The crop was exposed to elevated O3 (EO:60ppb), CO2 (EC:550 ppm) and their combined interactive treatment (ECO: EC+EO) during the entire growing season. Results revealed that the crop's total growth period was shortened by 10, 14 and 17 days under elevated CO2, elevated O3 and the combined treatment, respectively. Compared to ambient condition, the leaf area index (LAI) under elevated CO2 was higher by 4 to 28%, whilst it is reduced by 7.3 to 23.8% under elevated O3. The yield based radiation use efficiency (RUEy) was highest under elevated CO2 (0.48 g MJ-1), followed by combined (0.41 g MJ-1), ambient (0.38 g MJ-1) and elevated O3 (0.32 g MJ-1) treatments. Elevated O3 decreased RUEy by 15.78% over ambient, and the interaction results in a 7.8% higher RUEy. The yield was 31.7% more under elevated CO2 and 21.9% lower in elevated O3 treatment as compared to the ambient. The combined interactive treatment recorded a higher yield as compared to ambient by 9.7%. Harvest index (HI) was lowest under elevated O3 (36.10%), followed by ambient (39.18%), combined (40.81%), and highest was under elevated CO2 (44.18%). Chickpea showed a positive response to elevated CO2 resulting a 5% increase in HI as compared to ambient condition. Our findings quantified the positive and negative impacts of elevated O3, CO2 and their interaction on chickpea and revealed that the negative impacts of elevated O3 can be compensated by elevated CO2 in chickpea. This work promotes the understanding of crop behaviour under elevated O3, CO2 and their interaction, which can be used as valuable inputs for radiation-based crop simulation models to simulate climate change impact on chickpea crop.
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Affiliation(s)
- R N Singh
- Division of Agricultural Physics, ICAR-IARI, New Delhi, 110012, India
- School of Atmospheric Stress Management, ICAR-NIASM, Pune, 413115, India
| | - Joydeep Mukherjee
- Division of Agricultural Physics, ICAR-IARI, New Delhi, 110012, India.
| | - V K Sehgal
- Division of Agricultural Physics, ICAR-IARI, New Delhi, 110012, India
| | - P Krishnan
- Division of Agricultural Physics, ICAR-IARI, New Delhi, 110012, India
| | - Deb Kumar Das
- Division of Agricultural Physics, ICAR-IARI, New Delhi, 110012, India
| | - Raj Kumar Dhakar
- Division of Agricultural Physics, ICAR-IARI, New Delhi, 110012, India
| | - Arti Bhatia
- Centre for Environmental Science and Climate Resilient Agriculture, ICAR-IARI, New Delhi, 110012, India
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21
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Gorodetsky C, Pulcine E, Krishnan P, Singh J, Moharir M, MacGregor D, Bhathal I, deVeber G, Dlamini N. Childhood arterial ischemic stroke due to mineralizing angiopathy: an 18-year single-center experience. Dev Med Child Neurol 2021; 63:1123-1126. [PMID: 33959946 DOI: 10.1111/dmcn.14903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
Mineralizing angiopathy is a unique, age-specific stroke syndrome characterized by basal ganglia infarction and lenticulostriate calcification after minor head injury in early childhood. There is limited understanding of the pathophysiology, course, and clinical outcome of this syndrome. We describe the clinical and radiographical phenotype of a single-center, consecutively enrolled cohort of children with mineralizing angiopathy from January 2002 to January 2020 and provide a comparative analysis to previously published literature. Fourteen children were identified. Previously unreported findings include: stroke onset in eight children older than 18 months; presence of basal ganglia hemorrhage in four; multifocal basal ganglia infarcts in three; presence of additional non-basal ganglia calcifications in three; and presence of thrombophilia in one. Seven children had moderate-to-severe neurological deficits. There was no symptomatic stroke recurrence (mean follow-up 3y 7mo, SD 1y 7mo). Our expanded phenotype highlights distinct characteristics of mineralizing angiopathy in children and has the potential to inform future research. What this paper adds Children with mineralizing angiopathy are often misdiagnosed as having a limb fracture despite normal x-rays. A magnetic resonance imaging-only approach may miss this entity. Non-contrast computed tomography, in addition to MRI is recommended to identify calcifications in idiopathic arterial ischemic stroke. Most children have moderate-to-severe neurological sequela.
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Affiliation(s)
- Carolina Gorodetsky
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Elizabeth Pulcine
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jaspal Singh
- Neurology Department, Southampton Children's Hospital, Southampton, UK
| | - Mahendranath Moharir
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Daune MacGregor
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ishvinder Bhathal
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Gabrielle deVeber
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Nomazulu Dlamini
- Department of Pediatrics, Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
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Krishnan P, Maity PP, Kundu M. Sensitivity analysis of cultivar parameters to simulate wheat crop growth and yield under moisture and temperature stress conditions. Heliyon 2021; 7:e07602. [PMID: 34377856 PMCID: PMC8327672 DOI: 10.1016/j.heliyon.2021.e07602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 12/03/2020] [Accepted: 07/13/2021] [Indexed: 10/25/2022] Open
Abstract
Sensitivity of cultivar input parameters were characterised on the outputs of yield and growth variables using a web based crop simulation model Web InfoCrop Wheat. The crop model was assessed for each combination of seventeen input cultivar parameters tested under moisture and temperatures stress conditions in four different ecological regions. Three model outputs, total dry matter at harvest, grain yield at harvest and duration of the crop were chosen for subsequent evaluation. The most dominant cultivar parameters were identified to be TPOPT (Optimum Temp), TTVG (Thermal time for germination to 50% Flowering), KDFMAX (Extinction coefficient of leaves at flowering), GNOCF (Slope of storage organ number/m2 to dry matter during storage organ formation), POTGWT (Potential storage organ weight) and PHOTOSENS (Photoperiod sensitivity) which were associated with growth, thermal time accumulation, leaf area index, grain number and photosensitivity. Comparison of crop simulations with all the cultivar parameters incorporated from the experimental observations and those with only the most sensitive cultivar parameters incorporated was performed. Outputs of the crop simulation were significantly correlated with results from the field experiments. The present study could save time and effort in generating all the cultivar parameters required to perform the crop simulation under moisture and temperature stress conditions. The most significant cultivar parameters (TPOPT, TTVG, KDFMAX, GNOCF, POTGWT and PHOTOSENS) identified through the sensitivity analysis conducted in this study could significantly simulate the crop growth and yield of wheat.
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Affiliation(s)
- P Krishnan
- Division of Agricultural Physics, Indian Agricultural Research Institute, New Delhi 110012, India
| | - Pragati Pramanik Maity
- Division of Agricultural Physics, Indian Agricultural Research Institute, New Delhi 110012, India
| | - Monika Kundu
- Division of Agricultural Physics, Indian Agricultural Research Institute, New Delhi 110012, India
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23
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Fehlings D, Krishnan P, Ragguett R, deVeber G, Gorter JW, Hunt C, Kim M, Mesterman R, McCormick A. Neurodevelopmental profiles of children with unilateral cerebral palsy associated with middle cerebral artery and periventricular venous infarctions. Dev Med Child Neurol 2021; 63:729-735. [PMID: 33521966 PMCID: PMC8247945 DOI: 10.1111/dmcn.14818] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 11/29/2022]
Abstract
AIM To compare the neurodevelopment of children with unilateral cerebral palsy (CP) with middle cerebral artery (MCA) and periventricular venous infarctions (PVIs). METHOD In this cross-sectional study, children with unilateral CP completed a neurological exam, unimanual Quality of Upper Extremity Skills Test, hand usage questionnaires, and IQ test. Neuroimaging was obtained from health records. RESULTS Two hundred and forty-five participants with unilateral CP had neuroimaging (151 [61.9%] male, ages 2-18y, median=7y 6mo, interquartile range [IQR]=6y 7mo, with 93.6% in Gross Motor Function Classification System level I/II and 78.8% in Manual Ability Classification System level I/II). Ninety-seven (39.6%) had MCA injuries and 106 (43.3%) had periventricular white matter injuries, of which 48 (45.3%) were PVIs. Median Quality of Upper Extremity Skills Test for the MCA group was 49.2 (IQR=55.8), PVI 79.9 (IQR=23.6) (Mann-Whitney U=988.50, p<0.001). Bimanual hand usage (Children's Hand-use Experience Questionnaire) (Mann-Whitney U=425, p<0.001) and light touch (odds ratio=9.12, 95% confidence interval 1.28-400.76, Fisher's exact test p=0.017) were lower in the MCA compared to the PVI group. Full-scale IQ median centile score for the MCA group was 18.0 (IQR=35.5) and 50.0 (IQR=30.0) for the PVI group (Mann-Whitney U=382, p<0.001). INTERPRETATION Children with unilateral CP and MCA injuries demonstrated lower hand function and usage, decreased light touch, and lower IQs compared to the PVI group. This study aids in defining rehabilitation needs informed by brain injury patterns.
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Affiliation(s)
- Darcy Fehlings
- Department of PaediatricsBloorview Research InstituteHolland Bloorview Kids Rehabilitation HospitalUniversity of TorontoTorontoONCanada
| | - Pradeep Krishnan
- Department of Diagnostic ImagingThe Hospital for Sick ChildrenUniversity of TorontoTorontoONCanada
| | - Renee‐Marie Ragguett
- Department of PaediatricsBloorview Research InstituteHolland Bloorview Kids Rehabilitation HospitalUniversity of TorontoTorontoONCanada
| | - Gabrielle deVeber
- Department of PaediatricsThe Hospital for Sick ChildrenUniversity of TorontoTorontoONCanada
| | - Jan Willem Gorter
- Department of PediatricsCanChildMcMaster Children's HospitalMcMaster UniversityHamiltonONCanada
| | - Carolyn Hunt
- Department of PaediatricsGrandview Children's CentreUniversity of TorontoTorontoONCanada
| | - Marie Kim
- Erinoak Kids Center for Treatment and DevelopmentMississaugaONCanada
| | - Ronit Mesterman
- Department of PediatricsCanChildMcMaster Children's HospitalMcMaster UniversityHamiltonONCanada
| | - Anna McCormick
- Department of Pediatricsthe Children's Hospital of Eastern Ontario (CHEO)OttawaONCanada
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Sreekanth PD, Krishnan P, Rao NH, Soam SK, Srinivasarao C. Mapping surface-water area using time series landsat imagery on Google Earth Engine: a case study of Telangana, India. CURR SCI INDIA 2021. [DOI: 10.18520/cs/v120/i9/1491-1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Jayaraman B, Van Kinh L, Van Sy P, González-Vega C, Krishnan P, Channarayapatna G. PSVI-12 Full-fat Rice Bran as an Alternative Feed Ingredient for Corn in Grow-finish Pigs. J Anim Sci 2021. [DOI: 10.1093/jas/skab054.335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
A study was conducted to evaluate the effects of replacing corn by full-fat rice bran (FFRB) on performance and meat quality characteristics of growing-finishing pigs. A total of 728 pigs [Duroc x (Yorkshire x Landrace); initial body weight (BW) = 24.1 ± 0.11 kg] were randomly distributed to 4 dietary treatments with 7 replicate pens (26 pigs/pen) per treatment. Diets 1, 2, 3 and 4 were formulated replacing corn by 5%, 15%, 30%, and 45% of FFRB, respectively. Growth phases include, phase 1 (24 - 60 kg BW), and phase 2 (61 - 105 kg BW). Data were analyzed as a completely randomized design, and each pen was considered as an experimental unit. During phase 1 and 2, average daily gain (ADG) did not differ (P >0.05) when FFRB was increased from 5 to 30% in the diets. Pigs fed 45% FFRB had lower (P< 0.05) ADG in phase 1 and higher in phase 2 than other dietary treatments. Throughout the study, feed intake was not affected (P > 0.05) by dietary treatments. During phase 1, feed conversion ratio (FCR) was similar (P >0.05) among the treatments, however, during phase 2, pigs fed increasing levels of FFRB linearly improved (P< 0.05) FCR. The overall growth performance was similar (P >0.05) among the dietary treatments. Back-fat thickness and meat color were not affected (P >0.05) by treatments. Saturated fatty acids (palmitic acid, stearic acid) in pig muscle (Longissimus) significantly decreased (linear; P< 0.05) with increasing levels of FFRB in pig diets. Pigs fed increasing levels of FFRB had increased linoleic acid (linear; P< 0.05) and linolenic acid (quadratic; P< 0.05) in meat. In conclusion, FFRB could be used as an alternative feed ingredient for corn up to 45% in swine diets without compromising overall growth performance, back-fat thickness and favoring improved unsaturated to saturated fatty acid profile.
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Affiliation(s)
| | | | - Phan Van Sy
- Institute of Animal Sciences for Southern Vietnam
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26
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Bhattacharya P, Maity PP, Mowrer J, Maity A, Ray M, Das S, Chakrabarti B, Ghosh T, Krishnan P. Assessment of soil health parameters and application of the sustainability index to fields under conservation agriculture for 3, 6, and 9 years in India. Heliyon 2021; 6:e05640. [PMID: 33426319 PMCID: PMC7785834 DOI: 10.1016/j.heliyon.2020.e05640] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/05/2020] [Accepted: 11/27/2020] [Indexed: 12/01/2022] Open
Abstract
The effect of duration of conservation agriculture adoption on soil carbon dynamics and system sustainability was evaluated on farms of 30 villages in the Nilokheri block of Karnal district, Haryana, India. Sustainability was evaluated, in which a number of soil physical, chemical, and biological parameters were measured and a Sustainability Index (SI) was applied. Soil samples were collected from existing conservation agriculture (CA) and conventional tillage (CT) farms. Villages under CA practices were subdivided as CA3, CA6, and CA9 based on the number of years of CA practice adoption. Results showed that bulk density (BD) of 0-15 cm soil depth was 7% greater in CA3 plots, whereas in CA6 and CA9 plots BD values were only 2% and 3% higher than CT. Soil organic carbon (SOC) in 0-15 cm soil depth was found to be greater by 16.32% in CA3 than CT plots, whereas SOC was higher by 38.77% and 61.22% in CA6 and CA9. In CA, for the 0-15 and 15-30 cm soil depths, labile pools were 36% and 22% greater than CT, respectively. For both the soil depths in CA, the recalcitrant pool was 12% and 9% more than CT, respectively. Microbial biomass carbon (MBC) values of the 0-15 cm soil depth were increased over CT by 18.57%, 47.08%, and 71.5% for CA3, CA6, and CA9 respectively. In CA plots, the SI of 0-15 cm soil depth ranged between cumulative ratings (CR) of 18-21, which indicates that CA practice is "sustainable" for both soil depths. For CT, CR ranged from 25 to 30 for both soil depths resulting in a SI of "sustainability with high input". Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) scores showed that SOC had the maximum weight (0.96) towards sustainability, giving it a rank of 1. Effective rooting depth (ERD), BD, texture, and wilting point (WP) ranked 2, 3, 4 and 5, respectively, indicating their corresponding weight of contribution towards the SI. Farmers in the Karnal district should be encouraged to adopt CA practices as they can increase SOC and move the systems from "sustainable with high input" to "sustainable".
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Affiliation(s)
- Priya Bhattacharya
- ICAR- Indian Agricultural Research Institute, Pusa Campus, New Delhi 110012, India
| | | | - Jake Mowrer
- Department of Soil and Crop Sciences Texas A&M University, College Station TX 77843, USA
| | - Aniruddha Maity
- Department of Soil and Crop Sciences Texas A&M University, College Station TX 77843, USA.,ICAR- Indian Grassland and Fodder Research Institute, Jhansi 284003, India
| | - Mrinmoy Ray
- ICAR- Indian Agricultural Statistics Research Institute, New Delhi 110012, India
| | - Shrila Das
- ICAR- Indian Agricultural Research Institute, Pusa Campus, New Delhi 110012, India
| | - Bidisha Chakrabarti
- ICAR- Indian Agricultural Research Institute, Pusa Campus, New Delhi 110012, India
| | - Tridiv Ghosh
- ICAR- Indian Agricultural Research Institute, Pusa Campus, New Delhi 110012, India
| | - P Krishnan
- ICAR- Indian Agricultural Research Institute, Pusa Campus, New Delhi 110012, India
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Aarthi M, Subramanian S, Krishnan P. Colistin resistance among multidrug resistant gram negative bacteria isolated from cancer patients from Chennai, South India. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Anbarasi K, Esther Mary S, Vijayakumar R, Krishnan P. Resistance profile and minimum inhibitory concentration versus minimum biofilm inhibitory concentration of biofilm positive Staphylococci. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Biswas A, Mankad K, Shroff M, Hanagandi P, Krishnan P. Neuroimaging Perspectives of Perinatal Arterial Ischemic Stroke. Pediatr Neurol 2020; 113:56-65. [PMID: 33038575 DOI: 10.1016/j.pediatrneurol.2020.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/24/2020] [Accepted: 08/18/2020] [Indexed: 11/26/2022]
Abstract
Perinatal stroke ranks second only to that of adult stroke in the overall stroke incidence. It is a major contributor to long-term neurological morbidity, which includes cognitive dysfunction, cerebral palsy and seizures. Risk factors for stroke in the perinatal period differ from those in children and tend to be multifactorial. Differences in territorial predilection, response to injury, and stroke evolution exist when compared with childhood and adult stroke, and also among differing gestation age groups in the perinatal period (i.e., extreme preterm versus preterm versus term). The role of imaging is to diagnose stroke, exclude stroke mimics, establish the nature of stroke (arterial versus venous), and aid in prognostication. Magnetic resonance imaging is the mainstay of neuroimaging in perinatal stroke. Advanced imaging techniques such as diffusion tensor imaging and perfusion-weighted imaging are emerging as useful supplements to conventional imaging sequences. Here we describe the neuroimaging of perinatal arterial ischemic stroke with emphasis on imaging techniques, imaging phenotypes, stroke evolution, role of advanced imaging, and differences between stroke in preterm and term neonates. We also briefly describe the emerging role of fetal magnetic resonance imaging in the diagnosis of in utero stroke.
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Affiliation(s)
- Asthik Biswas
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Manohar Shroff
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Prasad Hanagandi
- Department of Medical Imaging, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada
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Shinar S, Blaser S, Chitayat D, Selvanathan T, Chau V, Shannon P, Agrawal S, Ryan G, Pruthi V, Miller SP, Krishnan P, Van Mieghem T. Long-term postnatal outcome of fetuses with prenatally suspected septo-optic dysplasia. Ultrasound Obstet Gynecol 2020; 56:371-377. [PMID: 32196785 PMCID: PMC7496228 DOI: 10.1002/uog.22018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/07/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Septo-optic dysplasia (SOD) is a clinical syndrome characterized by varying combinations of optic nerve hypoplasia, pituitary gland hypoplasia and abnormal cavum septi pellucidi. It is suspected on prenatal imaging when there is non-visualization or hypoplasia of the septal leaflets. Long-term postnatal outcomes of fetuses with prenatally suspected SOD have been documented poorly. The aims of this study were to describe the natural history of deficient septal leaflets, to quantify the incidence of postnatally confirmed SOD and to document the visual, endocrine and long-term neurodevelopmental outcomes of these infants. METHODS This was an observational retrospective study of all fetuses with prenatal imaging showing isolated septal agenesis, assessed at a single tertiary center over an 11-year period. Pregnancy, delivery and neonatal outcomes and pre- and postnatal imaging findings were reviewed. Neonatal evaluations or fetal autopsy reports were assessed for confirmation of SOD. Ophthalmologic, endocrine, genetic and long-term developmental evaluations were assessed. Imaging findings and outcome were compared between infants with and those without postnatally confirmed SOD. RESULTS Of 214 fetuses presenting with septal absence on prenatal ultrasound and magnetic resonance imaging (MRI), 18 (8.4%) were classified as having suspected isolated septal agenesis suspicious for SOD. Uniform prenatal MRI findings in cases with suspected SOD included remnants of the leaflets of the cavum septi pellucidi, fused forniceal columns, normal olfactory bulbs and tracts and a normal optic chiasm. Twelve fetuses were liveborn and five (27.8%) had postnatally confirmed SOD. Only two of these five fetuses had additional prenatal imaging features (pituitary cyst, microphthalmia and optic nerve hypoplasia) supporting a diagnosis of SOD. The other three confirmed SOD cases had no predictive prenatal or postnatal imaging findings that reliably differentiated them from cases without confirmed SOD. Visual and endocrine impairments were present in two (40%) and four (80%) cases with confirmed SOD, respectively. In those with visual and/or endocrine impairment, developmental delay (median age at follow-up, 2.5 (interquartile range, 2.5-7.0) years) was common (80%) and mostly severe. Neonates with isolated septal agenesis and a lack of visual or endocrine abnormalities to confirm SOD had normal development. CONCLUSIONS Only a quarter of fetuses with isolated septal agenesis suggestive of SOD will have postnatal confirmation of the diagnosis. Clinical manifestations of SOD are variable, but neurodevelopmental delay may be more prevalent than thought formerly. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- S. Shinar
- Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai HospitalUniversity of TorontoTorontoONCanada
| | - S. Blaser
- Department of Diagnostic Imaging, Hospital for Sick Children, Department of Medical ImagingUniversity of TorontoTorontoONCanada
| | - D. Chitayat
- Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai HospitalUniversity of TorontoTorontoONCanada
- Division of Clinical and Metabolic Genetics, Hospital for Sick ChildrenUniversity of TorontoTorontoONCanada
| | - T. Selvanathan
- Department of PaediatricsHospital for Sick Children and University of TorontoTorontoONCanada
| | - V. Chau
- Department of PaediatricsHospital for Sick Children and University of TorontoTorontoONCanada
| | - P. Shannon
- Department of Pathology and Laboratory Medicine, Mount Sinai HospitalUniversity of TorontoTorontoONCanada
| | - S. Agrawal
- Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai HospitalUniversity of TorontoTorontoONCanada
| | - G. Ryan
- Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai HospitalUniversity of TorontoTorontoONCanada
| | - V. Pruthi
- Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai HospitalUniversity of TorontoTorontoONCanada
| | - S. P. Miller
- Department of PaediatricsHospital for Sick Children and University of TorontoTorontoONCanada
| | - P. Krishnan
- Department of Diagnostic Imaging, Hospital for Sick Children, Department of Medical ImagingUniversity of TorontoTorontoONCanada
| | - T. Van Mieghem
- Ontario Fetal Centre, Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai HospitalUniversity of TorontoTorontoONCanada
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Biswas A, Krishnan P, Amirabadi A, Blaser S, Mercimek-Andrews S, Shroff M. Expanding the Neuroimaging Phenotype of Neuronal Ceroid Lipofuscinoses. AJNR Am J Neuroradiol 2020; 41:1930-1936. [PMID: 32855186 DOI: 10.3174/ajnr.a6726] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/16/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Neuronal ceroid lipofuscinoses are a group of neurodegenerative disorders characterized by the accumulation of autofluorescent lipopigments in neuronal cells. As a result of storage material in the brain and retina, clinical manifestations include speech delay, cognitive dysfunction, motor regression, epilepsy, vision loss, and early death. At present, 14 different ceroid lipofuscinosis (CLN) genes are known. Recently, the FDA approved the use of recombinant human proenzyme of tripeptidyl-peptidase 1 for CLN2 disease, while phase I/IIa clinical trials for gene therapy in CLN3 and CLN6 are ongoing. Early diagnosis is, therefore, key to initiating treatment and arresting disease progression. Neuroimaging features of CLN1, CLN2, CLN3, and CLN5 diseases are well-described, with sparse literature on other subtypes. We aimed to investigate and expand the MR imaging features of genetically proved neuronal ceroid lipofuscinoses subtypes at our institution and also to report the time interval between the age of disease onset and the diagnosis of neuronal ceroid lipofuscinoses. MATERIALS AND METHODS We investigated and analyzed the age of disease onset and neuroimaging findings (signal intensity in periventricular, deep, and subcortical white matter, thalami, basal ganglia, posterior limb of the internal capsule, insular/subinsular regions, and ventral pons; and the presence or absence of supratentorial and/or infratentorial atrophy) of patients with genetically proved neuronal ceroid lipofuscinoses at our institution. This group consisted of 24 patients who underwent 40 brain MR imaging investigations between 1993 and 2019, with a male preponderance (male/female ratio = 15:9). RESULTS The mean ages of disease onset, first brain MR imaging, and diagnosis of neuronal ceroid lipofuscinoses were 4.70 ± 3.48 years, 6.76 ± 4.49 years, and 7.27 ± 4.78 years, respectively. Findings on initial brain MR imaging included T2/FLAIR hypointensity in the thalami (n = 22); T2/FLAIR hyperintensity in the periventricular and deep white matter (n = 22), posterior limb of the internal capsule (n = 22), ventral pons (n = 19), and insular/subinsular region (n = 18); supratentorial (n = 21) and infratentorial atrophy (n = 20). Eight of 9 patients who had follow-up neuroimaging showed progressive changes. CONCLUSIONS We identified reported classic neuroimaging features in all except 1 patient with neuronal ceroid lipofuscinoses in our study. CLN2, CLN5, and CLN7 diseases showed predominant cerebellar-over-cerebral atrophy. We demonstrate that abnormal signal intensity in the deep white matter, posterior limb of the internal capsule, and ventral pons is more common than previously reported in the literature. We report abnormal signal intensity in the insular/subinsular region for the first time. The difference in the median time from disease onset and diagnosis was 1.5 years.
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Affiliation(s)
- A Biswas
- From the Department of Diagnostic Imaging (A.B., P.K., A.A., S.B., M.S.), The Hospital for Sick Children, Toronto, Canada asthik.biswas@sickkids
| | - P Krishnan
- From the Department of Diagnostic Imaging (A.B., P.K., A.A., S.B., M.S.), The Hospital for Sick Children, Toronto, Canada
| | - A Amirabadi
- From the Department of Diagnostic Imaging (A.B., P.K., A.A., S.B., M.S.), The Hospital for Sick Children, Toronto, Canada
| | - S Blaser
- From the Department of Diagnostic Imaging (A.B., P.K., A.A., S.B., M.S.), The Hospital for Sick Children, Toronto, Canada
| | - S Mercimek-Andrews
- Division of Clinical and Metabolic Genetics (S.M.-A.), Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Canada
| | - M Shroff
- From the Department of Diagnostic Imaging (A.B., P.K., A.A., S.B., M.S.), The Hospital for Sick Children, Toronto, Canada
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Al-Attas MA, Koppolu P, Alanazi SA, Alduaji KT, Parameaswari PJ, Swapna LA, Almoallim H, Krishnan P. Radiographic evaluation of bone density in dentulous and edentulous patients in Riyadh, KSA. Niger J Clin Pract 2020; 23:258-265. [PMID: 32031103 DOI: 10.4103/njcp.njcp_154_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background The Cone Beam Computed Tomography (CBCT) is currently being used as the most common diagnostic method to evaluate the bone density of the maxilla and the mandible for planning dental implant. Aim: The aim of the study is to check the quantitative alveolar bone density in complete or partial edentulous and dentulous male and female patients among Riyadh sample population in Saudi Arabia. Materials and Methods The study involved a cross-sectional analysis of 231 consecutive CBCT images of 231 different patients (115 males and 116 females). The scans were of Saudi National patients who were partially or completely edentulous without any bone infections in the maxilla and the mandible. The findings are presented as descriptive statistics and inferential statistics: student -t-test for two group means, ANOVA for three groups, Post-hoc LSD test for multiple comparisons, Levene statistics for testing the homogeneity of variances and a statistical significance at 5% level. Results Comparison of mean alveolar bone density in maxillae of dentulous male smokers showed a statistically significant difference for bucco-cortical plate and cancellous bone among different regions. In dentulous male nonsmokers, no significant difference was observed for maxillary regions, while in mandibular areas, a statistically significant difference was seen for buccal cortex, palatal cortex, and cancellous bone among different regions. While studying the scans of female dentulous patients, a statistically significant difference was observed in alveolar bone density for all the areas. Conclusion Evaluation of bone density is an important step in treatment planning and this study was aimed to provide insight into bone density patterns of population in Riyadh, Saudi Arabia. Further similar studies in different populations can help in planning for more efficient treatment outcomes.
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Affiliation(s)
- M A Al-Attas
- Dental Implants and Maxillofacial Prosthodontics, King Saud Medical City, Riyadh, KSA
| | - P Koppolu
- Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, KSA
| | - S A Alanazi
- Ministry of Health, King Saud Medical City, Riyadh, KSA
| | - K T Alduaji
- Dr. Abdulaziz Alajaji Dental Ployclinic, King Saud Medical City, Riyadh, KSA
| | - P J Parameaswari
- Department of Biostatistics, King Saud Medical City, Riyadh, KSA
| | - L A Swapna
- Department of Surgical and Diagnostic Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, KSA
| | - H Almoallim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, KSA
| | - P Krishnan
- Department of Periodontics, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
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Goh Y, Neo WT, Teo YM, Lim YT, Dewi M, Ganpathi IS, Bonney GK, Mali V, Krishnan P, Kapur J. Role of contrast-enhanced ultrasound in the evaluation of post-liver transplant vasculature. Clin Radiol 2020; 75:832-844. [PMID: 32553397 DOI: 10.1016/j.crad.2020.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 05/07/2020] [Indexed: 02/07/2023]
Abstract
Liver transplantation is a frequently used treatment for patients with end-stage liver disease and ultrasound is often the first-line imaging technique for detection of vascular complications after liver transplant. Although colour Doppler ultrasound is a good screening method for evaluation of post-liver transplant vasculature, it has limitations in evaluating small-calibre vessels and vessels in close proximity. Contrast-enhanced ultrasound (CEUS) has been proposed to overcome these limitations by improving visualisation of post-liver transplant vasculature and reducing the number of false-positive cases, which necessitate unnecessary additional investigations such as computed tomography or angiography. Liver transplant anatomy and the wide array of post-transplant imaging findings on colour Doppler have already been well described but literature on the use of CEUS and its image interpretation remain scarce. This review aims to discuss the indications for CEUS after liver transplant, to demonstrate CEUS technique and familiarise readers with the imaging appearances of post-transplant vascular complications on CEUS.
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Affiliation(s)
- Y Goh
- Department of Radiology, National University Hospital, Singapore.
| | - W T Neo
- Department of Radiology, National University Hospital, Singapore
| | - Y M Teo
- Department of Radiology, National University Hospital, Singapore
| | - Y T Lim
- Department of Radiology, National University Hospital, Singapore
| | - M Dewi
- Department of Radiology, National University Hospital, Singapore
| | - I S Ganpathi
- Division of Hepatobiliary & Pancreatic Surgery, National University Hospital, Singapore
| | - G K Bonney
- Division of Hepatobiliary & Pancreatic Surgery, National University Hospital, Singapore
| | - V Mali
- Department of Paediatric Surgery, National University Hospital, Singapore
| | - P Krishnan
- Department of Paediatric Surgery, National University Hospital, Singapore
| | - J Kapur
- Department of Radiology, National University Hospital, Singapore.
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Kim A, Lynskey G, DeMulder D, Krishnan P, Kallakury B, Cohen E. 4:03 PM Abstract No. 234 Prospective pilot evaluation testing the safety and efficacy of the surefire infusion system for delivery of drug-eluting embolic transarterial chemoembolization. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Slim M, Westmacott R, Toutounji S, Singh J, Narang I, Weiss S, Krishnan P, Grbac E, Surmava AM, Andres K, MacGregor D, deVeber G, Moharir M, Dlamini N. Obstructive sleep apnea syndrome and neuropsychological function in pediatric stroke. Eur J Paediatr Neurol 2020; 25:82-89. [PMID: 31787553 DOI: 10.1016/j.ejpn.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 06/04/2019] [Accepted: 11/17/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess the prevalence of obstructive sleep apnea syndrome (OSAS) in children with arterial ischemic stroke (AIS) and to evaluate its association with neuropsychological outcomes. METHODS We conducted a cross-sectional study of sleep health and neuropsychological outcome in children with AIS. A consecutive cohort of children attending a stroke clinic were assessed using a standardized pediatric sleep questionnaire (PSQ) and standardized measures of pediatric stroke outcome and intellectual, executive and adaptive function. High risk for OSAS was defined as PSQ score ≥0.33. RESULTS Overall, 102 children were included (55% males, median age: 9 years [interquartile-range [IQR]: 6-14]). The prevalence of OSAS in children with AIS was significantly higher compared to published normative prevalence rate (25.5% vs 5%, p < 0.001). Children with OSAS were more likely to have infarcts affecting both the anterior and posterior circulation (37.5% vs 9.5%, p = 0.021). In addition, children with OSAS had significantly higher median Pediatric Stroke Outcome Measure (PSOM) scores (2 [IQR: 0-2] vs 1 [IQR: 1-3.5], p = 0.01) and were more likely to be prescribed concomitant medications affecting sleep architecture (50% vs 22.4%, p = 0.007). OSAS was associated with significantly lower scores on intellectual, memory, cognitive, behavioral, attention, executive and adaptive function scales. The association between PSQ and intellectual ability and working memory remained statistically significant upon controlling for potential confounding factors including stroke related characteristics (neurologic impairment and arterial territory). CONCLUSIONS The prevalence of OSAS in children with AIS compared to healthy controls is significantly elevated and is associated with poor neuropsychological outcomes. We highlight the importance of regular screening for OSAS - a modifiable risk factor - in children with AIS. The specific risk factors for OSAS and the potential benefits of therapeutic interventions in this patient population warrant further investigation.
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Affiliation(s)
- Mahmoud Slim
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Robyn Westmacott
- Department of Psychology, The Hospital for Sick Children, Toronto, Canada
| | - Sandra Toutounji
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Jaspal Singh
- Department of Neurology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Indra Narang
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Shelly Weiss
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Pradeep Krishnan
- Division of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Elena Grbac
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Ann-Marie Surmava
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Kathleen Andres
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Daune MacGregor
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | - Gabrielle deVeber
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada
| | | | - Nomazulu Dlamini
- Division of Neurology, The Hospital for Sick Children, Toronto, Canada.
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Emami Z, Dunkley BT, Westmacott R, Robertson A, Krishnan P, Bhathal I, Moharir M, MacGregor D, Pang EW, Dlamini N. Abstract TMP114: Functional and Structural Network Reorganization in Higher-Order Language Following Neonatal Stroke. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.tmp114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Neonatal arterial ischemic stroke (NAIS) is a common form of pediatric stroke often affecting classical language areas in the brain’s left hemisphere. While children with NAIS can acquire basic language skills, adolescence typically reveals the emergence of deficits in higher-order language, such as syntactic language. The reorganization of functional and structural brain networks may provide insight into later-emerging language outcomes and serve as a biomarker in prognostication.
Methods:
A cross-sectional study of eight children with unilateral NAIS (5F; 12.3±3.3 years) and seven neurotypical children (2F; 13.4±2.7 years) was conducted. Participants listened to syntactically correct and incorrect sentences while magnetoencephalography was recorded, and task-related functional connectivity in the time window and frequency band of interest was determined. Structural connectivity between brain regions was investigated using DTI tractography, and language outcomes were assessed using neuropsychological tests.
Results:
An analysis of the syntactic language network (4-7 Hz, 1.2-1.4s) indicated that unlike the typical correlation between left-lateralized functional connectivity and language skill (
p
<0.01), good outcome in patients is correlated with bilateral frontal connectivity (p<0.01). Furthermore, patients exhibit a significant reduction in structural connectivity between the left and right supplementary motor area, compared with controls (
p
=0.007), and the bilateral structural connectivity of this region is positively correlated with measures of working memory and information processing (
p
=0.036).
Conclusions:
The preliminary results suggest that reorganization of functional networks towards bilateral connectivity may support language outcome following early stroke. The supplementary motor area’s role in coordination of interhemispheric functions and in information processing may position it as a key structural region in supporting the compensatory reorganization of functional networks underlying language. Ultimately, measures of functional and structural networks may be used as a prognostic tool for language development in pediatric stroke in order to improve long-term outcomes.
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Bhatia KD, Krishnan P, Kortman H, Klostranec J, Krings T. Acute Cortical Lesions in MELAS Syndrome: Anatomic Distribution, Symmetry, and Evolution. AJNR Am J Neuroradiol 2019; 41:167-173. [PMID: 31806591 DOI: 10.3174/ajnr.a6325] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/02/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND PURPOSE Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome is a rare mitochondrial disorder affecting children and young adults. Stroke-like episodes are often associated with acute cortical lesions in the posterior cerebral cortex and are classically described as asymmetric and transient. In this study we assessed the anatomic distribution of acute cortical lesions, the incidence of symmetry, and the temporal evolution of lesions. MATERIALS AND METHODS This was a retrospective cohort study of patients who had a confirmed genetic diagnosis of a pathogenic variant associated with MELAS and MR imaging performed at our center (2006-2018). Each MR imaging study was assessed for new lesions using T1, T2, FLAIR, DWI, ADC, and SWI. The anatomic location, symmetry, and temporal evolution of lesions were analyzed. RESULTS Eight patients with the same pathogenic variant of MELAS (MT-TL1 m.3243A>G) with 31 MR imaging studies were included. Forty-one new lesions were identified in 17 of the studies (5 deep, 36 cortical). Cortical lesions most commonly affected the primary visual cortex, the middle-third of the primary somatosensory cortex, and the primary auditory cortex. Thirty of 36 cortical lesions had acute cortical diffusion restriction, of which 21 developed cortical laminar necrosis on subacute imaging. Six of 11 studies with multiple lesions showed symmetric cortical involvement. CONCLUSIONS Acute cortical lesions in MELAS most commonly affect the primary visual, somatosensory, and auditory cortices, all regions of high neuronal density and metabolic demand. The most common pattern of temporal evolution is acute cortical diffusion restriction with subacute cortical laminar necrosis and chronic volume loss. Symmetric involvement is more common than previously described.
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Affiliation(s)
- K D Bhatia
- From the Division of Neuroradiology (K.D.B., H.K., J.K., T.K.), Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada
| | - P Krishnan
- Department of Diagnostic Imaging (P.K.), Hospital for Sick Children, Toronto, Ontario, Canada
| | - H Kortman
- From the Division of Neuroradiology (K.D.B., H.K., J.K., T.K.), Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada
| | - J Klostranec
- From the Division of Neuroradiology (K.D.B., H.K., J.K., T.K.), Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada
| | - T Krings
- From the Division of Neuroradiology (K.D.B., H.K., J.K., T.K.), Joint Department of Medical Imaging, Toronto Western Hospital, Toronto, Ontario, Canada
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Affiliation(s)
- V. Vanitha
- Department of Computer Science and Engineering, Sri Ramachandra Engineering and Technology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - P. Krishnan
- Research Systems Management Division, ICAR- National Academy of Agricultural Research Management (NAARM), Hyderabad, India
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Abstract
The objective of this review is to discuss the role of neuroimaging in evaluating pediatric and fetal hydrocephalus based on possible pathophysiologic mechanisms and in the context of differing etiology. Although conventional brain imaging with ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) is commonly used to assess for ventricular enlargement, however, the underlying mechanisms and management of hydrocephalus is a challenge in pediatric population and fetal hydrocephalus. MRI helps define the possible nature of the obstruction, and provides useful functional and anatomic information. MR imaging, in both pediatric and fetal hydrocephalus, thus may help in better understanding of the possible pathophysiologic mechanisms of the varied causal factors. The article focuses on the usage of MRI sequences in both diagnosis and follow-up of pediatric and fetal hydrocephalus, to be able to investigate all possible etiopathogenesis through the CSF pathway and to assess the efficacy of treatment in a non-invasive standardized manner.
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Affiliation(s)
- Pradeep Krishnan
- Department of Neuroradiology, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G1X8, Canada.
| | - Charles Raybaud
- Department of Neuroradiology, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G1X8, Canada
| | | | - Manohar Shroff
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G1X8, Canada
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Fehlings D, Krishnan P, Ragguett RM, Campbell C, Gorter JW, Hunt C, Kawamura A, Kim M, McCormick A, Mesterman R, Samdup D, Walters I, deVeber G. 95 A Comparison of the Developmental Profiles of Individuals with Hemiplegic Cerebral Palsy associated with Middle Cerebral Artery and Periventricular Venous Infarctions. Paediatr Child Health 2019. [DOI: 10.1093/pch/pxz066.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kandhan S, Tamil Arasan B, Krishnan P, Aravindhan S, Srinivasan S, Gunasekaran S. Structural, optical and piezoelectric investigation on brucinium bromide hydrate non linear optical single crystal for optical parametric oscillators, high-power laser, piezo-sensors and transducers applications. J Mol Struct 2019. [DOI: 10.1016/j.molstruc.2018.11.086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Emami Z, Dunkley BT, Robertson A, Hess M, Westmacott R, Krishnan P, Pang EW, Dlamini N. Abstract 53: Reorganization of Functional Language Networks Following Neonatal Arterial Ischemic Stroke. Stroke 2019. [DOI: 10.1161/str.50.suppl_1.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
Neonatal arterial ischemic stroke (NAIS) is the most common form of childhood stroke. Unlike adults with stroke, children with left middle cerebral artery (MCA) NAIS seldom become aphasic, although adolescence often reveals the emergence of higher-order language deficits. Functional language networks may be predictive of later-emerging language outcomes, and can aid to identify at-risk children with NAIS.
Methods:
Five neurotypical children (2F; 5 RH; mean 12.7 ± 2.6 years), and five children with unilateral-MCA NAIS (3F; 5 RH; mean 11.3 ± 2.0 years) listened to semantically correct and incorrect sentences while magnetoencephalography (MEG) was recorded. Task-related functional connectivity was calculated using the phase lag index (PLI) across regions of interest. The relationship between the functional brain networks and language skill was examined.
Results:
Neurotypical children showed increased global functional connectivity for semantically correct sentences 1.8 to 2.0 seconds from stimulus onset in the theta band (4-7 Hz;
p
<0.05). The top connections in the theta band and time window of interest involved a significantly greater number of nodes in the left frontal lobe for controls compared to patients (
p
<0.05), while patients recruited a greater number of temporal lobe nodes than controls (
p
<0.05). Furthermore, patient language networks demonstrated a more bilateral distribution than those of typically-developed children (37.5% vs. 30% of top connections). The mean connectivity strength in the language network was positively correlated with vocabulary skill (r=0.84) for patients, and with word reading ability for both patients and neurotypical children (r=0.95, r=0.88, respectively).
Conclusions:
These results suggest reorganization of expected unilateral and frontal language networks towards a bilateral and temporal distribution following stroke, with less reliance on traditional language nodes. Such reorganization may underlie the language ability trajectory of children with neonatal MCA stroke. Reorganization of functional brain networks may be used as a predictive marker for language development following neonatal stroke, which can ultimately guide precision medicine and improve long-term outcomes.
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Affiliation(s)
| | | | | | | | | | - Pradeep Krishnan
- Dept of Diagnostic Imaging, The Hosp for Sick Children, Toronto, Canada
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Singh J, Krishnan P, Slim M, Pontigon AM, Paterson J, Moharir M, MacGregor D, Dlamini N, Westmacott R, deVeber G. Abstract WMP120: The Role of Age, Lesion Location and Volume in Predicting Long-Term Neurological Outcomes in Pediatric Ischemic Stroke. Stroke 2019. [DOI: 10.1161/str.50.suppl_1.wmp120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction:
The balance of plasticity versus vulnerability to acute ischemic injury in the immature brain across development remains controversial. We aimed to investigate the relationship between age at stroke and lesion location and volume with long-term outcomes following arterial ischaemic stroke (AIS).
Hypothesis:
Age at stroke onset interacts with lesion location and volume to predict long-term neurological outcomes.
Methods:
In a single-centre prospective study, children aged term birth to 18 years with acute symptomatic AIS from 1992 to 2016 who underwent neuroimaging (CT/MRI) within 14 days of stroke onset were studied. Long term outcomes were assessed with the Pediatric Stroke Outcome Measure (PSOM). Outcomes were defined as normal (score 0-0.5 on 1-5 PSOM subscales), otherwise abnormal. AIS lesions were classified based on major (anterior, middle, posterior, other) cerebral arteries and branch sub-territories (e.g. MCA-lateral lenticulostriate). For each vascular territory, the proportion of infarcted brain was estimated as ‘small’ (≤50% territory) or ‘large’ (>50% territory). Factors predictive of long term outcomes were evaluated using logistic regression models.
Results:
Among 285 children, median age at stroke onset was 22 months (IQR: 0.03-101), 41% were females. PSOM scoring at median 9 years (IQR: 4-15) post-stroke was normal in 61%. Abnormal outcome was associated with age 1-4 years (OR=2.2, 95% CI: 1.02-4.9), ‘large’ proportion infarcts involving cortex within any major artery territory (OR=6.1, 95% CI: 2.6-14.4), and subcortical infarcts: OR= 2.7 (95% CI: 1.4-5.4) for small proportion infarcts; OR=8.3 (95% CI: 4.2-16.6) for large proportion infarcts in either medial or lateral lenticulostriate arteries; OR=15.8 (95% CI: 5-50.3) for large volume lesions in both lenticulostriate territories. In multivariate logistic regression, age, cortical and subcortical infarcts predicted long-term neurologic outcomes.
Conclusions:
In addition to age at stroke onset, infarct location including volume plays a key role in predicting long-term neurological outcomes in children. While the relationship between age and neurological outcomes seems to be bimodal, a linear effect of lesion volume on stroke outcomes is evident.
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Affiliation(s)
- Jaspal Singh
- Dept of Neurology, Univ Hosp Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Pradeep Krishnan
- Dept of Diagnostic Imaging, The Hosp for Sick Children, Toronto, Canada
| | - Mahmoud Slim
- Div of Neurology, The Hosp for Sick Children, Toronto, Canada
| | | | - Julie Paterson
- Div of Neurology, The Hosp for Sick Children, Toronto, Canada
| | | | - Daune MacGregor
- Div of Neurology, The Hosp for Sick Children, Toronto, Canada
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Krishnan P, Khayrullin A, Martinez L, Mendhe B, Fulzele S, Liu Y, Mattison JA, Hamrick MW. VERY LONG-CHAIN CERAMIDES ARE INCREASED IN SERUM EXOSOMES WITH AGING IN BOTH HUMAN SUBJECTS AND NON-HUMAN PRIMATES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- P Krishnan
- Medical College of Georgia at Augusta University, Marietta, Georgia, United States
| | - A Khayrullin
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - L Martinez
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - B Mendhe
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - S Fulzele
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Y Liu
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - J A Mattison
- National Institute on Aging, National Institutes of Health, Washington, DC, USA
| | - M W Hamrick
- Medical College of Georgia at Augusta University, Augusta, GA, USA
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Pramanik P, Chakrabarti B, Bhatia A, Singh SD, Mridha N, Krishnan P. Effect of elevated carbon dioxide on soil hydrothermal regimes and growth of maize crop (Zea mays L.) in semi-arid tropics of Indo-Gangetic Plains. Environ Monit Assess 2018; 190:661. [PMID: 30345462 DOI: 10.1007/s10661-018-6988-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/18/2018] [Indexed: 06/08/2023]
Abstract
To see the effect of climate change on the variation of soil hydrothermal regimes and growth of maize crop, an experiment was conducted in free-air carbon dioxide enrichment (FACE) facility during the kharif season of 2015 at Climate Change Facility of Indian Agricultural Research Institute, New Delhi, India. Under elevated CO2 and ambient condition, surface bulk density (BD) were 1.38 Mgm-3 and 1.44 Mgm-3, respectively but BD were not significantly different. During different days after sowing (DAS), in 0 to 10-cm soil depth, soil water content (SWC) in FACE varied between 14.58-20.70%, whereas in ambient condition, SWC variations were in between 19.33-22.94%. In 10 to 20-cm soil depth, SWC ranged in between 20.47-27.14% in FACE and 23.57-25.42% in ambient condition for different DAS. It is also observed that the arrival of peak surface ST was 1 h early in elevated CO2 condition. Photosynthetic rate increased by 5.7% on 44 DAS and 18.1% on 70 DAS under elevated carbon dioxide condition. Elevated carbon dioxide had reduced the stomatal conductance but the reduction was not significant. Like variation in air temperature for climate change, more intensive study is required to see the effect of climate change on soil temperature and its effect on crop growth.
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Affiliation(s)
- P Pramanik
- Division of Agricultural Physics, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India.
| | - Bidisha Chakrabarti
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - Arti Bhatia
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - S D Singh
- Centre for Environment Science and Climate Resilient Agriculture, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - N Mridha
- Division of Agricultural Physics, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
| | - P Krishnan
- Division of Agricultural Physics, ICAR-Indian Agricultural Research Institute, New Delhi, 110 012, India
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Kouzmitcheva E, Krishnan P, Dlamini N, deVeber G, MacGregor DL, Moharir M. Child Neurology: Mimics of cerebral sinovenous thrombosis: A pediatric case series. Neurology 2018; 91:e1545-e1548. [PMID: 30323079 DOI: 10.1212/wnl.0000000000006363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Elizabeth Kouzmitcheva
- From the Division of Neurology (E.K., N.D., G.d., D.L.M., M.M.), Department of Pediatrics, and Department of Diagnostic Imaging (P.K.), the Hospital for Sick Children, University of Toronto, Ontario, Canada.
| | - Pradeep Krishnan
- From the Division of Neurology (E.K., N.D., G.d., D.L.M., M.M.), Department of Pediatrics, and Department of Diagnostic Imaging (P.K.), the Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Nomazulu Dlamini
- From the Division of Neurology (E.K., N.D., G.d., D.L.M., M.M.), Department of Pediatrics, and Department of Diagnostic Imaging (P.K.), the Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Gabrielle deVeber
- From the Division of Neurology (E.K., N.D., G.d., D.L.M., M.M.), Department of Pediatrics, and Department of Diagnostic Imaging (P.K.), the Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Daune L MacGregor
- From the Division of Neurology (E.K., N.D., G.d., D.L.M., M.M.), Department of Pediatrics, and Department of Diagnostic Imaging (P.K.), the Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Mahendranath Moharir
- From the Division of Neurology (E.K., N.D., G.d., D.L.M., M.M.), Department of Pediatrics, and Department of Diagnostic Imaging (P.K.), the Hospital for Sick Children, University of Toronto, Ontario, Canada
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48
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Schnell G, Tripathi R, Beyer J, Reisch T, Krishnan P, Dekhtyar T, Irvin M, Hall C, Yu Y, Mobashery N, Redman R, Pilot-Matias T, Collins C. Characterization of demographics and NS5A genetic diversity for hepatitis C virus genotype 4-infected patients with or without cirrhosis treated with ombitasvir/paritaprevir/ritonavir. J Viral Hepat 2018; 25:1078-1088. [PMID: 29624809 DOI: 10.1111/jvh.12906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/16/2018] [Indexed: 01/08/2023]
Abstract
Hepatitis C virus (HCV) genotype 4 (GT4) is genetically diverse with 17 confirmed and 4 provisional subtypes. In this report, HCV GT4-infected patient samples from Phase 2/3 clinical studies were analysed to characterize global demographics and genetic diversity of GT4 infection among patients treated with ombitasvir (OBV, NS5A inhibitor) plus paritaprevir/r (NS3/4A inhibitor codosed with ritonavir). Among 17 subtypes isolated from GT4-infected patients in the PEARL-I and AGATE-I studies, subtype prevalence by country of enrolment and country of origin suggested that subtypes 4a and 4d were likely circulating in Europe, while heterogeneous GT4 subtypes and a portion of GT4a detected in European and North American countries were likely due to immigration of HCV-infected patients from Africa. The distributions of birth cohort and race were also significantly different across GT4 subtypes 4a, 4d, and non-4a/4d. In addition, phylogenetic analyses of NS5A sequences revealed clustering within subtype 4a which segregated by the patient-reported country of origin and the presence of the L30R/S polymorphism. HCV NS5A sequences derived from GT4a-infected patients who originated from Europe and the United States clustered separately from sequences derived from patients who originated from Egypt, suggesting that genetically distinct strains of subtype 4a may be circulating globally. Finally, NS5A baseline polymorphisms were frequently detected at amino acid positions of interest for the inhibitor-class and OBV retained activity against 37 of 39 NS5A GT4 clinical isolates, with no impact on treatment outcome in the PEARL-I and AGATE-I studies.
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Affiliation(s)
- G Schnell
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - R Tripathi
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - J Beyer
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - T Reisch
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - P Krishnan
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - T Dekhtyar
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - M Irvin
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - C Hall
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - Y Yu
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - N Mobashery
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - R Redman
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - T Pilot-Matias
- Research & Development, AbbVie Inc., North Chicago, IL, USA
| | - C Collins
- Research & Development, AbbVie Inc., North Chicago, IL, USA
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49
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Sreeraj CR, Abhilash KR, Deepak Samuel V, Krishnan P, Purvaja R, Ramesh R. Occurrence of Live Rhodolith Bed of <i>Lithophyllum kotschyanum</i> Unger (Corallinaceae:Lithophylloideae) in Palk Bay:First Record from India. CURR SCI INDIA 2018. [DOI: 10.18520/cs%2fv114%2fi03%2f445-446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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50
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Sreeraj CR, Abhilash KR, Deepak Samuel V, Krishnan P, Purvaja R, Ramesh R. Occurrence of Live Rhodolith Bed of <i>Lithophyllum kotschyanum</i> Unger (Corallinaceae:Lithophylloideae) in Palk Bay:First Record from India. CURR SCI INDIA 2018. [DOI: 10.18520/cs/v114/i03/445-446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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