64 results on '"Armitage, Paul"'
Search Results
2. Analytical Approaches for the Segmentation of the Zebrafish Brain Vasculature.
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Kugler, Elisabeth C., Rampun, Andrik, Chico, Timothy J. A., and Armitage, Paul A.
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- 2022
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3. Zebrafish vascular quantification: a tool for quantification of three-dimensional zebrafish cerebrovascular architecture by automated image analysis.
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Kugler, Elisabeth C., Frost, James, Silva, Vishmi, Plant, Karen, Chhabria, Karishma, Chico, Tim J. A., and Armitage, Paul A.
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IMAGE analysis ,ZEBRA danio ,BRACHYDANIO ,GRAPHICAL user interfaces ,FLUORESCENCE microscopy ,EMBRYOLOGY - Abstract
Zebrafish transgenic lines and light sheet fluorescence microscopy allow in-depth insights into three-dimensional vascular development in vivo. However, quantification of the zebrafish cerebral vasculature in 3D remains highly challenging. Here, we describe and test an image analysis workflow for 3D quantification of the total or regional zebrafish brain vasculature, called zebrafish vasculature quantification (ZVQ). It provides the first landmark- or object-based vascular inter-sample registration of the zebrafish cerebral vasculature, producing population average maps allowing rapid assessment of intra- and inter-group vascular anatomy. ZVQ also extracts a range of quantitative vascular parameters from a user-specified region of interest, including volume, surface area, density, branching points, length, radius and complexity. Application of ZVQ to 13 experimental conditions, including embryonic development, pharmacological manipulations and morpholino-induced gene knockdown, shows that ZVQ is robust, allows extraction of biologically relevant information and quantification of vascular alteration, and can provide novel insights into vascular biology. To allow dissemination, the code for quantification, a graphical user interface and workflow documentation are provided. Together, ZVQprovides the first open-source quantitative approach to assess the 3D cerebrovascular architecture in zebrafish. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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4. Enrichment of heavy REE and Th in carbonatite-derived fenite breccia.
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Broom-Fendley, Sam, Elliott, Holly AL, Beard, Charles D, Wall, Frances, Armitage, Paul EB, Brady, Aoife E, Deady, Eimear, and Dawes, William
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BRECCIA ,ROCK texture ,PHONOLITE ,MICROSPACECRAFT ,XENOTIME ,APATITE ,RARE earth metals - Abstract
Enrichment of the heavy rare earth elements (HREE) in carbonatites is rare as carbonatite petrogenesis favours the light (L)REE. We describe HREE enrichment in fenitized phonolite breccia, focusing on small satellite occurrences 1–2 km from the Songwe Hill carbonatite, Malawi. Within the breccia groundmass, a HREE-bearing mineral assemblage comprises xenotime, zircon, anatase/rutile and minor huttonite/thorite, as well as fluorite and apatite. A genetic link between HREE mineralization and carbonatite emplacement is indicated by the presence of Sr-bearing carbonate veins, carbonatite xenoliths and extensive fenitization. We propose that the HREE are retained in hydrothermal fluids which are residually derived from a carbonatite after precipitation of LREE minerals. Brecciation provides a focusing conduit for such fluids, enabling HREE transport and xenotime precipitation in the fenite. Continued fluid–rock interaction leads to dissolution of HREE-bearing minerals and further precipitation of xenotime and huttonite/thorite. At a maximum Y content of 3100 µg g
−1 , HREE concentrations in the presented example are not sufficient to constitute ore, but the similar composition and texture of these rocks to other cases of carbonatite-related HREE enrichment suggests that all form via a common mechanism linked to fenitization. Precipitation of HREE minerals only occurs where a pre-existing structure provides a focusing conduit for fenitizing fluids, reducing fluid – country-rock interaction. Enrichment of HREE and Th in fenite breccia serves as an indicator of fluid expulsion from a carbonatite, and may indicate the presence of LREE mineralization within the source carbonatite body at depth. [ABSTRACT FROM AUTHOR]- Published
- 2021
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5. Single-Input Multi-Output U-Net for Automated 2D Foetal Brain Segmentation of MR Images.
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Rampun, Andrik, Jarvis, Deborah, Griffiths, Paul D., Zwiggelaar, Reyer, Scotney, Bryan W., and Armitage, Paul A.
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IMAGE segmentation ,BRAIN imaging ,MAGNETIC resonance imaging of the brain ,IMAGE fusion ,EDGE detection (Image processing) ,CONVOLUTIONAL neural networks - Abstract
In this work, we develop the Single-Input Multi-Output U-Net (SIMOU-Net), a hybrid network for foetal brain segmentation inspired by the original U-Net fused with the holistically nested edge detection (HED) network. The SIMOU-Net is similar to the original U-Net but it has a deeper architecture and takes account of the features extracted from each side output. It acts similar to an ensemble neural network, however, instead of averaging the outputs from several independently trained models, which is computationally expensive, our approach combines outputs from a single network to reduce the variance of predications and generalization errors. Experimental results using 200 normal foetal brains consisting of over 11,500 2D images produced Dice and Jaccard coefficients of 94.2 ± 5.9% and 88.7 ± 6.9%, respectively. We further tested the proposed network on 54 abnormal cases (over 3500 images) and achieved Dice and Jaccard coefficients of 91.2 ± 6.8% and 85.7 ± 6.6%, respectively. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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6. The Mesoarchean Amikoq Layered Complex of SW Greenland: Part 2. Geochemical evidence for high-Mg noritic plutonism through crustal assimilation.
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Aarestrup, Emil, McDonald, Iain, Armitage, Paul E.B., Nutman, Allen P., Christiansen, Ole, and Szilas, Kristoffer
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- 2021
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7. Lacunar Stroke Lesion Extent and Location and White Matter Hyperintensities Evolution 1 Year Post-lacunar Stroke.
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Valdés Hernández, Maria del C., Grimsley-Moore, Tara, Sakka, Eleni, Thrippleton, Michael J., Chappell, Francesca M., Armitage, Paul A., Makin, Stephen, and Wardlaw, Joanna M.
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WHITE matter (Nerve tissue) ,LACUNAR stroke ,SMOKING ,BRAIN imaging ,BRAIN damage ,HYPERTENSION - Abstract
Lacunar strokes are a common type of ischemic stroke. They are associated with long-term disability, but the factors affecting the dynamic of the infarcted lesion and the brain imaging features associated with them, reflective of small vessel disease (SVD) severity, are still largely unknown. We investigated whether the distribution, volume and 1-year evolution of white matter hyperintensities (WMH), one of these SVD features, relate to the extent and location of these infarcts, accounting for vascular risk factors. We used imaging and clinical data from all patients [ n = 118, mean age 64.9 (SD 11.75) years old] who presented to a regional hospital with a lacunar stroke syndrome within the years 2010 and 2013 and consented to participate in a study of stroke mechanisms. All patients had a brain MRI scan at presentation, and 88 had another scan 12 months after. Acute lesions (i.e., recent small subcortical infarcts, RSSI) were identified in 79 patients and lacunes in 77. Number of lacunes was associated with baseline WMH volume (B = 0.370, SE = 0.0939, P = 0.000174). RSSI volume was not associated with baseline WMH volume (B = 3.250, SE = 2.117, P = 0.129), but predicted WMH volume change (B = 2.944, SE = 0.913, P = 0.00184). RSSI location was associated with the spatial distribution of WMH and the pattern of 1-year WMH evolution. Patients with the RSSI in the centrum semiovale (n = 33) had significantly higher baseline volumes of WMH, recent and old infarcts, than patients with the RSSI located elsewhere [median 33.69, IQR (14.37 50.87) ml, 0.001 ≤ P ≤ 0.044]. But patients with the RSSI in the internal/external capsule/lentiform nucleus experienced higher increase of WMH volume after a year [ n = 21, median (IQR) from 18 (11.70 31.54) ml to 27.41 (15.84 40.45) ml]. Voxel-wise analyses of WMH distribution in patients grouped per RSSI location revealed group differences increased in the presence of vascular risk factors, especially hypertension and recent or current smoking habit. In our sample of patients presenting to the clinic with lacunar strokes, lacunar strokes extent influenced WMH volume fate; and RSSI location and WMH spatial distribution and dynamics were intertwined, with differential patterns emerging in the presence of vascular risk factors. These results, if confirmed in wider samples, open potential avenues in stroke rehabilitation to be explored further. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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8. Post-stroke Cognition at 1 and 3 Years Is Influenced by the Location of White Matter Hyperintensities in Patients With Lacunar Stroke.
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Valdés Hernández, Maria del C., Grimsley-Moore, Tara, Chappell, Francesca M., Thrippleton, Michael J., Armitage, Paul A., Sakka, Eleni, Makin, Stephen, and Wardlaw, Joanna M.
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WHITE matter (Nerve tissue) ,LACUNAR stroke ,CEREBRAL small vessel diseases ,STROKE patients ,COGNITION ,SYMPTOMS ,BRAIN imaging - Abstract
Lacunar strokes are a common type of ischemic stroke. They are known to have long-term cognitive deficits, but the influencing factors are still largely unknown. We investigated if the location of the index lacunar stroke or regional WMH and their change at 1 year could predict the cognitive performance at 1 and 3 years post-stroke in lacunar stroke patients. We used lacunar lesion location and WMH-segmented data from 118 patients, mean age 64.9 who had a brain MRI scan soon after presenting with symptoms, of which 88 had a repeated scan 12 months later. Premorbid intelligence (National Adult Reading Test) and current intelligence [Addenbrooke's Cognitive Exam-Revised (ACE-R)] were measured at 1, 12, and 36 months after the stroke. ANCOVA analyses adjusting for baseline cognition/premorbid intelligence, vascular risk factors, age, sex and total baseline WMH volume found that the recent small subcortical infarcts (RSSI) in the internal/external capsule/lentiform nucleus and centrum semiovale did not predict cognitive scores at 12 and 36 months. However, RSSI location moderated voxel-based associations of WMH change from baseline to 1 year with cognitive scores at 1 and 3 years. WMH increase in the external capsule, intersection between the anterior limb of the internal and external capsules, and optical radiation, was associated with worsening of ACE-R scores 1 and 3 years post-stroke after accounting for the location of the index infarct, age and baseline cognition. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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9. Imbalanced learning: Improving classification of diabetic neuropathy from magnetic resonance imaging.
- Author
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Teh, Kevin, Armitage, Paul, Tesfaye, Solomon, Selvarajah, Dinesh, and Wilkinson, Iain D.
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DIABETIC neuropathies ,CLASSIFICATION ,SUPPORT vector machines ,DECISION trees - Abstract
One of the fundamental challenges when dealing with medical imaging datasets is class imbalance. Class imbalance happens where an instance in the class of interest is relatively low, when compared to the rest of the data. This study aims to apply oversampling strategies in an attempt to balance the classes and improve classification performance. We evaluated four different classifiers from k-nearest neighbors (k-NN), support vector machine (SVM), multilayer perceptron (MLP) and decision trees (DT) with 73 oversampling strategies. In this work, we used imbalanced learning oversampling techniques to improve classification in datasets that are distinctively sparser and clustered. This work reports the best oversampling and classifier combinations and concludes that the usage of oversampling methods always outperforms no oversampling strategies hence improving the classification results. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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10. The Mesoarchean Amikoq Layered Complex of SW Greenland: Part 1. Constraints on the P–T evolution from igneous, metasomatic and metamorphic amphiboles.
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Aarestrup, Emil, Jørgensen, Taus R. C., Armitage, Paul E.B., Nutman, Allen P., Christiansen, Ole, and Szilas, Kristoffer
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- 2020
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11. Predictors of Lesion Cavitation After Recent Small Subcortical Stroke.
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Gattringer, Thomas, Valdes Hernandez, Maria, Heye, Anna, Armitage, Paul A, Makin, Stephen, Chappell, Francesca, Pinter, Daniela, Doubal, Fergus, Enzinger, Christian, Fazekas, Franz, and Wardlaw, Joanna M.
- Abstract
Morphologic evolution of recent small subcortical infarcts (RSSI) ranges from lesion disappearance to lacune formation and the reasons for this variability are still poorly understood. We hypothesized that diffusion tensor imaging (DTI) and blood-brain-barrier (BBB) abnormalities early on can predict tissue damage 1 year after an RSSI. We studied prospectively recruited patients with a symptomatic MRI-defined RSSI who underwent baseline and two pre-specified MRI examinations at 1–3-month and 1-year post-stroke. We defined the extent of long-term tissue destruction, termed cavitation index, as the ratio of the 1-year T1-weighted cavity volume to the baseline RSSI volume on FLAIR. We calculated fractional anisotropy and mean diffusivity (MD) of the RSSI and normal-appearing white matter, and BBB leakage in different tissues on dynamic contrast-enhanced MRI. Amongst 60 patients, at 1-year post-stroke, 44 patients showed some degree of RSSI cavitation on FLAIR, increasing to 50 on T2- and 56 on T1-weighted high-resolution scans, with a median cavitation index of 7% (range, 1–36%). Demographic, clinical, and cerebral small vessel disease features were not associated with the cavitation index. While lower baseline MD of the RSSI (r
s = − 0.371; p = 0.004) and more contrast leakage into CSF (rs = 0.347; p = 0.007) were associated with the cavitation index in univariable analysis, only BBB leakage in CSF remained independently associated with cavitation (beta = 0.315, p = 0.046). Increased BBB leakage into CSF may indicate worse endothelial dysfunction and increased risk of tissue destruction post RSSI. Although cavitation was common, it only affected a small proportion of the original RSSI. [ABSTRACT FROM AUTHOR]- Published
- 2020
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12. Examining the Relationship between Semiquantitative Methods Analysing Concentration-Time and Enhancement-Time Curves from Dynamic-Contrast Enhanced Magnetic Resonance Imaging and Cerebrovascular Dysfunction in Small Vessel Disease.
- Author
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Bernal, Jose, Valdés-Hernández, María, Escudero, Javier, Sakka, Eleni, Armitage, Paul A., Makin, Stephen, Touyz, Rhian M., and Wardlaw, Joanna M.
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CEREBROVASCULAR disease ,MAGNETIC resonance imaging ,TISSUE wounds ,CEREBROSPINAL fluid ,MEDICAL screening - Abstract
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can be used to examine the distribution of an intravenous contrast agent within the brain. Computational methods have been devised to analyse the contrast uptake/washout over time as reflections of cerebrovascular dysfunction. However, there have been few direct comparisons of their relative strengths and weaknesses. In this paper, we compare five semiquantitative methods comprising the slope and area under the enhancement-time curve, the slope and area under the concentration-time curve (SlopeCon and AUCCon), and changes in the power spectrum over time. We studied them in cerebrospinal fluid, normal tissues, stroke lesions, and white matter hyperintensities (WMH) using DCE-MRI scans from a cohort of patients with small vessel disease (SVD) who presented mild stroke. The total SVD score was associated with AUCCon in WMH (p < 0.05), but not with the other four methods. In WMH, we found higher AUCCon was associated with younger age (p < 0.001) and fewer WMH (p < 0.001), whereas SlopeCon increased with younger age (p > 0.05) and WMH burden (p > 0.05). Our results show the potential of different measures extracted from concentration-time curves extracted from the same DCE examination to demonstrate cerebrovascular dysfunction better than those extracted from enhancement-time curves. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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13. The effect of hyperglycemia on neurovascular coupling and cerebrovascular patterning in zebrafish.
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Chhabria, Karishma, Plant, Karen, Bandmann, Oliver, Wilkinson, Robert N, Martin, Chris, Kugler, Elisabeth, Armitage, Paul A, Santoscoy, Paola LM, Cunliffe, Vincent T, Huisken, Jan, McGown, Alexander, Ramesh, Tennore, Chico, Tim JA, and Howarth, Clare
- Abstract
Neurovascular coupling (through which local cerebral blood flow changes in response to neural activation are mediated) is impaired in many diseases including diabetes. Current preclinical rodent models of neurovascular coupling rely on invasive surgery and instrumentation, but transgenic zebrafish coupled with advances in imaging techniques allow non-invasive quantification of cerebrovascular anatomy, neural activation, and cerebral vessel haemodynamics. We therefore established a novel non-invasive, non-anaesthetised zebrafish larval model of neurovascular coupling, in which visual stimulus evokes neuronal activation in the optic tectum that is associated with a specific increase in red blood cell speed in tectal blood vessels. We applied this model to the examination of the effect of glucose exposure on cerebrovascular patterning and neurovascular coupling. We found that chronic exposure of zebrafish to glucose impaired tectal blood vessel patterning and neurovascular coupling. The nitric oxide donor sodium nitroprusside rescued all these adverse effects of glucose exposure on cerebrovascular patterning and function. Our results establish the first non-mammalian model of neurovascular coupling, offering the potential to perform more rapid genetic modifications and high-throughput screening than is currently possible using rodents. Furthermore, using this zebrafish model, we reveal a potential strategy to ameliorate the effects of hyperglycemia on cerebrovascular function. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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14. Case Report: A New Spectroscopy Finding in Infantile Neuroaxonal Dystrophy.
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Martin, Andrew, Jamali, Saharwash, Redhead, Natasha, Armitage, Paul, Desurkar, Archana, and Connolly, Daniel J. A.
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BRAIN anatomy ,DIAGNOSIS of brain diseases ,DIAGNOSIS of child development deviations ,BRAIN diseases ,BASAL ganglia ,CEREBRAL hemispheres ,MAGNETIC resonance imaging ,MOVEMENT disorders ,GENETIC mutation ,NUCLEAR magnetic resonance spectroscopy ,GENETIC testing - Abstract
Infantile neuroaxonal dystrophy (INAD) is a rare autosomal recessive disorder that is associated with developmental delay and regression. A female patient of consanguineous parents presented with gross motor delay at 15 months. She was known to have two paternal uncles who had died with a diagnosis of INAD. Over the next 15 months, she exhibited regression in several domains and following genetic testing was diagnosed with a PLA2G6 mutation in keeping with INAD. The cerebellar vermis demonstrated a significant reduction in the N -acetylaspartate/creatinine (NAA/Cr) ratio of 0.69. This case highlights what we believe to be a new imaging feature of a low NAA/Cr ratio in the cerebellar vermis with normal ratios in the cerebellar hemispheres and basal ganglia in a patient with genetically confirmed diagnosis of INAD. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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15. Do Optic Canal Dimensions Measured on CT Influence the Degree of Papilloedema and Visual Dysfunction in Idiopathic Intracranial Hypertension?
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Skipper, Nicholas T., Igra, Mark S., Littlewood, Revelle, Armitage, Paul, Laud, Peter J., Mollan, Susan P., Sharrack, Basil, Pepper, Irene M., Batty, Ruth, Connolly, Daniel J. A., and Hickman, Simon J.
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ESSENTIAL hypertension ,INTRACRANIAL hypertension ,COMPUTED tomography - Abstract
A recent study found that increased optic canal area on magnetic resonance imaging was associated with worse papilloedema in idiopathic intracranial hypertension (IIH). We repeated this study using more accurate computerized tomography derived measurements. Optic canal dimensions were measured from 42 IIH patients and 24 controls. These were compared with papilloedema grade. There was no correlation between any of the optic canal measurements and papilloedema grade and no significant difference in optic canal measurements between patients and controls. Our results cast doubt on the existing literature regarding the association between optic canal size and the degree of papilloedema in IIH. CT delineates bony anatomy more accurately than MRI and our CT-derived optic canal measurements cast doubt on the existing literature regarding the association between optic canal size and the degree of Papilloedema in IIH. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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16. Patterns of Ancestral Animal Codon Usage Bias Revealed through Holozoan Protists.
- Author
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Southworth, Jade, Armitage, Paul, Fallon, Brandon, Dawson, Holly, Bryk, Jarosław, and Carr, Martin
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Choanoflagellates and filastereans are the closest known single celled relatives of Metazoa within Holozoa and provide insight into how animals evolved from their unicellular ancestors. Codon usage bias has been extensively studied in metazoans, with both natural selection and mutation pressure playing important roles in different species. The disparate nature of metazoan codon usage patterns prevents the reconstruction of ancestral traits. However, traits conserved across holozoan protists highlight characteristics in the unicellular ancestors of Metazoa. Presented here are the patterns of codon usage in the choanoflagellates Monosiga brevicollis and Salpingoeca rosetta, as well as the filasterean Capsaspora owczarzaki. Codon usage is shown to be remarkably conserved. Highly biased genes preferentially use GC-ending codons, however there is limited evidence this is driven by local mutation pressure. The analyses presented provide strong evidence that natural selection, for both translational accuracy and efficiency, dominates codon usage bias in holozoan protists. In particular, the signature of selection for translational accuracy can be detected even in the most weakly biased genes. Biased codon usage is shown to have coevolved with the tRNA species, with optimal codons showing complementary binding to the highest copy number tRNA genes. Furthermore, tRNA modification is shown to be a common feature for amino acids with higher levels of degeneracy and highly biased genes show a strong preference for using modified tRNAs in translation. The translationally optimal codons defined here will be of benefit to future transgenics work in holozoan protists, as their use should maximise protein yields from edited transgenes. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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17. Automatic Rating of Perivascular Spaces in Brain MRI Using Bag of Visual Words.
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González-Castro, Víctor, Valdés Hernández, María del C., Armitage, Paul A., and Wardlaw, Joanna M.
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- 2016
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18. Metric to quantify white matter damage on brain magnetic resonance images.
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Valdés Hernández, Maria, Chappell, Francesca, Muñoz Maniega, Susana, Dickie, David, Royle, Natalie, Morris, Zoe, Anblagan, Devasuda, Sakka, Eleni, Armitage, Paul, Bastin, Mark, Deary, Ian, and Wardlaw, Joanna
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BRAIN diseases ,ANALYSIS of covariance ,CEREBROVASCULAR disease ,COMPUTER software ,MAGNETIC resonance imaging ,STATISTICS ,DATA analysis ,QUANTITATIVE research ,INDEPENDENT living ,TISSUE arrays ,STROKE patients - Abstract
Purpose: Quantitative assessment of white matter hyperintensities (WMH) on structural Magnetic Resonance Imaging (MRI) is challenging. It is important to harmonise results from different software tools considering not only the volume but also the signal intensity. Here we propose and evaluate a metric of white matter (WM) damage that addresses this need. Methods: We obtained WMH and normal-appearing white matter (NAWM) volumes from brain structural MRI from community dwelling older individuals and stroke patients enrolled in three different studies, using two automatic methods followed by manual editing by two to four observers blind to each other. We calculated the average intensity values on brain structural fluid-attenuation inversion recovery (FLAIR) MRI for the NAWM and WMH. The white matter damage metric is calculated as the proportion of WMH in brain tissue weighted by the relative image contrast of the WMH-to-NAWM. The new metric was evaluated using tissue microstructure parameters and visual ratings of small vessel disease burden and WMH: Fazekas score for WMH burden and Prins scale for WMH change. Results: The correlation between the WM damage metric and the visual rating scores (Spearman ρ > =0.74, p < 0.0001) was slightly stronger than between the latter and WMH volumes (Spearman ρ > =0.72, p < 0.0001). The repeatability of the WM damage metric was better than WM volume (average median difference between measurements 3.26% (IQR 2.76%) and 5.88% (IQR 5.32%) respectively). The follow-up WM damage was highly related to total Prins score even when adjusted for baseline WM damage (ANCOVA, p < 0.0001), which was not always the case for WMH volume, as total Prins was highly associated with the change in the intense WMH volume ( p = 0.0079, increase of 4.42 ml per unit change in total Prins, 95%CI [1.17 7.67]), but not with the change in less-intense, subtle WMH, which determined the volumetric change. Conclusion: The new metric is practical and simple to calculate. It is robust to variations in image processing methods and scanning protocols, and sensitive to subtle and severe white matter damage. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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19. White matter hyperintensity reduction and outcomes after minor stroke.
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Wardlaw, Joanna M., Chappell, Francesca M., del Carmen Valdés Hernández, Maria, Makin, Stephen D. J., Staals, Julie, Shuler, Kirsten, Thrippleton, Michael J., Armitage, Paul A., Muñoz-Maniega, Susana, Heye, Anna K., Sakka, Eleni, Dennis, Martin S., and Valdés Hernández, Maria Del Carmen
- Published
- 2017
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20. Application of Texture Analysis to Study Small Vessel Disease and Blood-Brain Barrier Integrity.
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del C. Valdés Hernánde, Maria, González-Castro, Victor, Chappell, Francesca M., Sakka, Eleni, Makin, Stephen, Armitage, Paul A., Nailon, William H., and Wardlaw, Joanna M.
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BLOOD-brain barrier ,MAGNETIC resonance imaging of the brain ,STROKE patients ,WHITE matter (Nerve tissue) ,KRUSKAL-Wallis Test ,HYPERTENSION ,PATIENTS - Abstract
Objectives: We evaluate the alternative use of texture analysis for evaluating the role of blood-brain barrier (BBB) in small vessel disease (SVD). Methods: We used brain magnetic resonance imaging from 204 stroke patients, acquired before and 20 min after intravenous gadolinium administration. We segmented tissues, white matter hyperintensities (WMH) and applied validated visual scores. We measured textural features in all tissues pre- and post-contrast and used ANCOVA to evaluate the effect of SVD indicators on the pre-/post-contrast change, Kruskal-Wallis for significance between patient groups and linear mixed models for pre-/post-contrast variations in cerebrospinal fluid (CSF) with Fazekas scores. Results: Textural "homogeneity" increase in normal tissues with higher presence of SVD indicators was consistently more overt than in abnormal tissues. Textural "homogeneity" increased with age, basal ganglia perivascular spaces scores (p < 0.01) and SVD scores (p < 0.05) and was significantly higher in hypertensive patients (p < 0.002) and lacunar stroke (p = 0.04). Hypertension (74% patients), WMH load (median = 1.5 ± 1.6% of intracranial volume), and age (mean = 65.6 years, SD = 11.3) predicted the pre/post-contrast change in normal white matter, WMH, and index stroke lesion. CSF signal increased with increasing SVD post-contrast. Conclusion: A consistent general pattern of increasing textural "homogeneity" with increasing SVD and post-contrast change in CSF with increasing WMH suggest that texture analysis may be useful for the study of BBB integrity. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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21. Reliability of an automatic classifier for brain enlarged perivascular spaces burden and comparison with human performance.
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González-Castro, Víctor, Valdés Hernández, María del C., Chappell, Francesca M., Armitage, Paul A., Makin, Stephen, and Wardlaw, Joanna M.
- Abstract
In the brain, enlarged perivascular spaces (PVS) relate to cerebral small vessel disease (SVD), poor cognition, inflammation and hypertension. We propose a fully automatic scheme that uses a support vector machine (SVM) to classify the burden of PVS in the basal ganglia (BG) region as low or high. We assess the performance of three different types of descriptors extracted from the BG region in T2-weighted MRI images: (i) statistics obtained from Wavelet transform’s coefficients, (ii) local binary patterns and (iii) bag of visual words (BoW) based descriptors characterizing local keypoints obtained from a dense grid with the scale-invariant feature transform (SIFT) characteristics. When the latter were used, the SVM classifier achieved the best accuracy (81.16%). The output from the classifier using the BoW descriptors was compared with visual ratings done by an experienced neuroradiologist (Observer 1) and by a trained image analyst (Observer 2). The agreement and cross-correlation between the classifier and Observer 2 (κ = 0.67 (0.58–0.76)) were slightly higher than between the classifier and Observer 1 (κ = 0.62 (0.53–0.72)) and comparable between both the observers (κ = 0.68 (0.61–0.75)). Finally, three logistic regression models using clinical variables as independent variable and each of the PVS ratings as dependent variable were built to assess how clinically meaningful were the predictions of the classifier. The goodness-of-fit of the model for the classifier was good (area under the curve (AUC) values: 0.93 (model 1), 0.90 (model 2) and 0.92 (model 3)) and slightly better (i.e. AUC values: 0.02 units higher) than that of the model for Observer 2. These results suggest that, although it can be improved, an automatic classifier to assess PVS burden from brain MRI can provide clinically meaningful results close to those from a trained observer. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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22. Blood-brain barrier failure as a core mechanism in cerebral small vessel disease and dementia: evidence from a cohort study.
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Wardlaw, Joanna M., Makin, Stephen J., Valdés Hernández, Maria C., Armitage, Paul A., Heye, Anna K., Chappell, Francesca M., Muñoz-Maniega, Susana, Sakka, Eleni, Shuler, Kirsten, Dennis, Martin S., and Thrippleton, Michael J.
- Published
- 2017
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23. Sample size considerations for trials using cerebral white matter hyperintensity progression as an intermediate outcome at 1 year after mild stroke: results of a prospective cohort study.
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Chappell, Francesca M., del Carmen Valdés Hernández, Maria, Makin, Stephen D., Shuler, Kirsten, Sakka, Eleni, Dennis, Martin S., Armitage, Paul A., Maniega, Susana Muñoz, Wardlaw, Joanna M., and Muñoz Maniega, Susana
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WHITE matter (Nerve tissue) ,CENTRAL nervous system ,HEALTH outcome assessment ,CLINICAL trials ,HYPOTHETICAL particles ,CARDIOVASCULAR agents ,AGE distribution ,BRAIN diseases ,BRAIN ,CHI-squared test ,LONGITUDINAL method ,MAGNETIC resonance imaging ,PROGNOSIS ,REGRESSION analysis ,RESEARCH funding ,STROKE ,TIME ,LOGISTIC regression analysis ,SAMPLE size (Statistics) ,PREDICTIVE tests ,DISEASE progression ,ODDS ratio ,PSYCHOLOGY - Abstract
Background: White matter hyperintensities (WMHs) are commonly seen on in brain imaging and are associated with stroke and cognitive decline. Therefore, they may provide a relevant intermediate outcome in clinical trials. WMH can be measured as a volume or visually on the Fazekas scale. We investigated predictors of WMH progression and design of efficient studies using WMH volume and Fazekas score as an intermediate outcome.Methods: We prospectively recruited 264 patients with mild ischaemic stroke and measured WMH volume, Fazekas score, age and cardiovascular risk factors at baseline and 1 year. We modelled predictors of WMH burden at 1 year and used the results in sample size calculations for hypothetical randomised controlled trials with different analysis plans and lengths of follow-up.Results: Follow-up WMH volume was predicted by baseline WMH: a 0.73-ml (95% CI 0.65-0.80, p < 0.0001) increase per 1-ml baseline volume increment, and a 2.93-ml increase (95% CI 1.76-4.10, p < 0.0001) per point on the Fazekas scale. Using a mean difference of 1 ml in WMH volume between treatment groups, 80% power and 5% alpha, adjusting for all predictors and 2-year follow-up produced the smallest sample size (n = 642). Other study designs produced samples sizes from 2054 to 21,270. Sample size calculations using Fazekas score as an outcome with the same power and alpha, as well as an OR corresponding to a 1-ml difference, were sensitive to assumptions and ranged from 2504 to 18,886.Conclusions: Baseline WMH volume and Fazekas score predicted follow-up WMH volume. Study size was smallest using volumes and longer-term follow-up, but this must be balanced against resources required to measure volumes versus Fazekas scores, bias due to dropout and scanner drift. Samples sizes based on Fazekas scores may be best estimated with simulation studies. [ABSTRACT FROM AUTHOR]- Published
- 2017
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24. Integrity of normal-appearing white matter: Influence of age, visible lesion burden and hypertension in patients with small-vessel disease.
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Maniega, Susana Muñoz, Chappell, Francesca M., Valdés Hernández, Maria C., Armitage, Paul A., Makin, Stephen D., Heye, Anna K., Thrippleton, Michael J., Sakka, Eleni, Shuler, Kirsten, Dennis, Martin S., and Wardlaw, Joanna M.
- Abstract
White matter hyperintensities accumulate with age and occur in patients with stroke, but their pathogenesis is poorly understood. We measured multiple magnetic resonance imaging biomarkers of tissue integrity in normal-appearing white matter and white matter hyperintensities in patients with mild stroke, to improve understanding of white matter hyperintensities origins. We classified white matter into white matter hyperintensities and normal-appearing white matter and measured fractional anisotropy, mean diffusivity, water content (T1-relaxation time) and blood–brain barrier leakage (signal enhancement slope from dynamic contrast-enhanced magnetic resonance imaging).We studied the effects of age, white matter hyperintensities burden (Fazekas score) and vascular risk factors on each biomarker, in normalappearing white matter and white matter hyperintensities, and performed receiver-operator characteristic curve analysis. Amongst 204 patients (34.3–90.9 years), all biomarkers differed between normal-appearing white matter and white matter hyperintensities (P<0.001). In normal-appearing white matter and white matter hyperintensities, mean diffusivity and T1 increased with age (P<0.001), all biomarkers varied with white matter hyperintensities burden (P<0.001; P=0.02 signal enhancement slope), but only signal enhancement slope increased with hypertension (P=0.028). Fractional anisotropy showed complex age-white matter hyperintensities-tissue interactions; enhancement slope showed white matter hyperintensities-tissue interactions. Mean diffusivity distinguished white matter hyperintensities from normal-appearing white matter best at all ages. Blood–brain barrier leakage increases with hypertension and white matter hyperintensities burden at all ages in normal-appearing white matter and white matter hyperintensities, whereas water mobility and content increase as tissue damage accrues, suggesting that blood–brain barrier leakage mediates small vessel disease-related brain damage. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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25. A qualitative comparison of arterial spin labelling and dynamic susceptibility contrast MRI in 52 children with a range of neurological conditions.
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ARMITAGE, PAUL A., SKIPPER, NICHOLAS, CONNOLLY, DANIEL J. A., and GRIFFITHS, PAUL D.
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Objective: To assess the usefulness of arterial spin labelling (ASL) compared with dynamic susceptibility contrast (DSC) perfusion MRI for typical paediatric neuroimaging applications at 1.5 T. Methods: 52 children (age: 4 months–17 years) with a variety of neurological disorders were scanned using three-dimensional ASL and echoplanar imaging DSC sequences. All images were reviewed by an experienced neuroradiologist; image quality was recorded as “good”, “acceptable” or “poor” and diagnostic value was noted as being “greater”, “similar” or “less” for ASL when compared with DSC. Results: ASL cerebral blood flow (CBF) images were judged to be acceptable in 89% of cases, poor in 11% of cases and good in 0% of cases, while DSC CBF images were acceptable in 88% of cases, poor in 12% of cases and good in 0% of cases. ASL images were judged to have better diagnostic value than DSC images in 28% of cases, about the same in 58% of cases and worse in 14% of cases. Conclusion: The results of this study suggest that ASL offers a realistic alternative to DSC in the paediatric setting for the majority of cases encountered in this study. However, there are some situations where DSC outperforms ASL; so, care is required to choose the most appropriate technique for the pathology under investigation. A larger study is required to corroborate these preliminary findings. Advances in knowledge: ASL is a relatively new perfusion imaging technique whose use has not been explored extensively in the paediatric setting. This work is a preliminary study to evaluate its usefulness in paediatric neuroimaging. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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26. Quantification of total fetal brain volume using 3D MR imaging data acquired in utero.
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Jarvis, Deborah, Akram, Rahim, Mandefield, Laura, Paddock, Michael, Armitage, Paul, and Griffiths, Paul D.
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BRAIN ,FETAL ultrasonic imaging ,GESTATIONAL age ,MAGNETIC resonance imaging ,REFERENCE values ,RESEARCH evaluation ,THREE-dimensional imaging ,RESEARCH bias - Abstract
Objective: Interpretation of magnetic resonance (MR) imaging of the fetal brain in utero is primarily undertaken using 2D images to provide anatomical information about structural abnormalities. It is now possible to obtain 3D image acquisitions that allow measurement of fetal brain volumes that are potentially useful clinically. The aim of our current work is to provide reference values of total brain volumes obtained from a cohort of low risk fetuses with no abnormalities on ante-natal ultrasonography and in utero MR imaging.Method: Images from volume MR acquisitions of 132 fetuses were used to extract brain volumes by manual segmentation. Reproducibility and reliability were assessed by analysis of the results of two subgroups who had repeated measurements made by the primary and a secondary observer.Results: Intra-observer and inter-observer agreement was high with no statistically significant differences between and within observers (p = 0.476 and p = 0.427, respectively). The results of the brain volume assessments are presented graphically with mean and 95% prediction limits alongside estimates of normal growth rates.Conclusion: We have shown that fetal brain volumes can be reliably extracted from in utero MR (iuMR) imaging 3D datasets with a high degree of reproducibility. The resultant data could potentially be used as a reference tool in the clinical setting. © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]- Published
- 2016
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27. Estimation of trabecular bone parameters in children from multisequence MRI using texture-based regression.
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Lekadir, Karim, Hoogendoorn, Corné, Armitage, Paul, Whitby, Elspeth, King, David, Dimitri, Paul, and Frangi, Alejandro F.
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DIAGNOSIS ,MAGNETIC resonance imaging ,REGRESSION analysis ,BIG data ,ESTIMATION theory - Abstract
Purpose: This paper presents a statistical approach for the prediction of trabecular bone parameters from low-resolution multisequence magnetic resonance imaging (MRI) in children, thus addressing the limitations of high-resolution modalities such as HR-pQCT, including the significant exposure of young patients to radiation and the limited applicability of such modalities to peripheral bones in vivo. Methods: A statistical predictive model is constructed from a database of MRI and HR-pQCT datasets, to relate the low-resolution MRI appearance in the cancellous bone to the trabecular parameters extracted from the high-resolution images. The description of the MRI appearance is achieved between subjects by using a collection of feature descriptors, which describe the texture properties inside the cancellous bone, and which are invariant to the geometry and size of the trabecular areas. The predictive model is built by fitting to the training data a nonlinear partial least square regression between the input MRI features and the output trabecular parameters. Results: Detailed validation based on a sample of 96 datasets shows correlations >0.7 between the trabecular parameters predicted from low-resolution multisequence MRI based on the proposed statistical model and the values extracted from high-resolution HRp-QCT. Conclusions: The obtained results indicate the promise of the proposed predictive technique for the estimation of trabecular parameters in children from multisequence MRI, thus reducing the need for high-resolution radiation-based scans for a fragile population that is under development and growth. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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28. On the computational assessment of white matter hyperintensity progression: difficulties in method selection and bias field correction performance on images with significant white matter pathology.
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Valdés Hernández, Maria, González-Castro, Victor, Ghandour, Dina, Wang, Xin, Doubal, Fergus, Muñoz Maniega, Susana, Armitage, Paul, and Wardlaw, Joanna
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Introduction: Subtle inhomogeneities in the scanner's magnetic fields (B and B) alter the intensity levels of the structural magnetic resonance imaging (MRI) affecting the volumetric assessment of WMH changes. Here, we investigate the influence that (1) correcting the images for the B inhomogeneities (i.e. bias field correction (BFC)) and (2) selection of the WMH change assessment method can have on longitudinal analyses of WMH progression and discuss possible solutions. Methods: We used brain structural MRI from 46 mild stroke patients scanned at stroke onset and 3 years later. We tested three BFC approaches: FSL-FAST, N4 and exponentially entropy-driven homomorphic unsharp masking (ED-HUM) and analysed their effect on the measured WMH change. Separately, we tested two methods to assess WMH changes: measuring WMH volumes independently at both time points semi-automatically (MCMxxxVI) and subtracting intensity-normalised FLAIR images at both time points following image gamma correction. We then combined the BFC with the computational method that performed best across the whole sample to assess WMH changes. Results: Analysis of the difference in the variance-to-mean intensity ratio in normal tissue between BFC and uncorrected images and visual inspection showed that all BFC methods altered the WMH appearance and distribution, but FSL-FAST in general performed more consistently across the sample and MRI modalities. The WMH volume change over 3 years obtained with MCMxxxVI with vs. without FSL-FAST BFC did not significantly differ (medians(IQR)(with BFC) = 3.2(6.3) vs. 2.9(7.4)ml (without BFC), p = 0.5), but both differed significantly from the WMH volume change obtained from subtracting post-processed FLAIR images (without BFC)(7.6(8.2)ml, p < 0.001). This latter method considerably inflated the WMH volume change as subtle WMH at baseline that became more intense at follow-up were counted as increase in the volumetric change. Conclusions: Measurement of WMH volume change remains challenging. Although the overall volumetric change was not significantly affected by the application of BFC, these methods distorted the image intensity distribution affecting subtle WMH. Subtracting the FLAIR images at both time points following gamma correction seems a promising technique but is adversely affected by subtle WMH. It is important to take into account not only the changes in volume but also in the signal intensity. [ABSTRACT FROM AUTHOR]
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- 2016
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29. Blood pressure and sodium: Association with MRI markers in cerebral small vessel disease.
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Heye, Anna K., Thrippleton, Michael J., Chappell, Francesca M., Valdés Hernández, Maria del C., Armitage, Paul A., Makin, Stephen D., Maniega, Susana Muñoz, Sakka, Eleni, Flatman, Peter W., Dennis, Martin S., and Wardlaw, Joanna M.
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- 2016
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30. Rationale, design and methodology of the image analysis protocol for studies of patients with cerebral small vessel disease and mild stroke.
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Valdés Hernández, Maria del C., Armitage, Paul A., Thrippleton, Michael J., Chappell, Francesca, Sandeman, Elaine, Muñoz Maniega, Susana, Shuler, Kirsten, and Wardlaw, Joanna M.
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- 2015
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31. A comparison of location of acute symptomatic vs. 'silent' small vessel lesions.
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Valdés Hernández, Maria del C., Maconick, Lucy C., Muñoz Maniega, Susana, Wang, Xin, Wiseman, Stewart, Armitage, Paul A., Doubal, Fergus N., Makin, Stephen, Sudlow, Cathie L. M., Dennis, Martin S., Deary, Ian J., Bastin, Mark, and Wardlaw, Joanna M.
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STROKE ,ISCHEMIA ,CEREBROVASCULAR disease ,WHITE matter (Nerve tissue) ,BRAIN diseases - Abstract
Background Acute lacunar ischaemic stroke, white matter hyperintensities, and lacunes are all features of cerebral small vessel disease. It is unclear why some small vessel disease lesions present with acute stroke symptoms, whereas others typically do not. Aim To test if lesion location could be one reason why some small vessel disease lesions present with acute stroke, whereas others accumulate covertly. Methods We identified prospectively patients who presented with acute lacunar stroke symptoms with a recent small subcortical infarct confirmed on magnetic resonance diffusion imaging. We compared the distribution of the acute infarcts with that of white matter hyperintensity and lacunes using computational image mapping methods. Results In 188 patients, mean age 67 ± standard deviation 12 years, the lesions that presented with acute lacunar ischaemic stroke were located in or near the main motor and sensory tracts in (descending order): posterior limb of the internal capsule (probability density 0·2/mm
3 ), centrum semiovale (probability density = 0·15/mm3 ), medial lentiform nucleus/lateral thalamus (probability density = 0·09/mm3 ), and pons (probability density = 0·02/mm3 ). Most lacunes were in the lentiform nucleus (probability density = 0·01-0·04/mm3 ) or external capsule (probability density = 0·05/mm3 ). Most white matter hyperintensities were in centrum semiovale (except for the area affected by the acute symptomatic infarcts), external capsules, basal ganglia, and brainstem, with little overlap with the acute symptomatic infarcts (analysis of variance, P < 0·01). Conclusions Lesions that present with acute lacunar ischaemic stroke symptoms may be more likely noticed by the patient through affecting the main motor and sensory tracts, whereas white matter hyperintensity and asymptomatic lacunes mainly affect other areas. Brain location could at least partly explain the symptomatic vs. covert development of small vessel disease. [ABSTRACT FROM AUTHOR]- Published
- 2015
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32. Proton spectroscopic imaging of brain metabolites in basal ganglia of healthy older adults.
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Parikh, Jehill, Thrippleton, Michael, Murray, Catherine, Armitage, Paul, Harris, Bridget, Andrews, Peter, Wardlaw, Joanna, Starr, John, Deary, Ian, and Marshall, Ian
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SPECTROSCOPIC imaging ,METABOLITES ,BASAL ganglia ,PROTONS ,HEALTH of older people - Abstract
Object: We sought to measure brain metabolite levels in healthy older people. Materials and methods: Spectroscopic imaging at the level of the basal ganglia was applied in 40 participants aged 73-74 years. Levels of the metabolites N-acetyl aspartate (NAA), choline, and creatine were determined in "institutional units" (IU) corrected for T1 and T2 relaxation effects. Structural imaging enabled determination of grey matter (GM), white matter (WM), and cerebrospinal fluid content. ANOVA analysis was carried out for voxels satisfying quality criteria. Results: Creatine levels were greater in GM than WM (57 vs. 44 IU, p < 0.001), whereas choline and NAA levels were greater in WM than GM [13 vs. 10 IU ( p < 0.001) and 76 versus 70 IU ( p = 0.03), respectively]. The ratio of NAA/cre was greater in WM than GM (2.1 vs. 1.4, p = 0.001) as was that of cho/cre (0.32 vs. 0.16, p < 0.001). A low voxel yield was due to brain atrophy and the difficulties of shimming over an extended region of brain. Conclusion: This study addresses the current lack of information on brain metabolite levels in older adults. The normal features of ageing result in a substantial loss of reliable voxels and should be taken into account when planning studies. Improvements in shimming are also required before the methods can be applied more widely. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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33. Diffuse intrinsic pontine glioma: is MRI surveillance improved by region of interest volumetry?
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Riley, Garan T., Armitage, Paul, Batty, Ruth, Griffiths, Paul, Lee, Vicki, McMullan, John, and Connolly, Daniel
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GLIOMAS ,MAGNETIC resonance imaging ,BRAIN stem ,PEDIATRIC radiology ,PEDIATRICS ,DIAGNOSIS ,TUMORS - Abstract
Background: Paediatric diffuse intrinsic pontine glioma (DIPG) is noteworthy for its fibrillary infiltration through neuroparenchyma and its resultant irregular shape. Conventional volumetry methods aim to approximate such irregular tumours to a regular ellipse, which could be less accurate when assessing treatment response on surveillance MRI. Region-of-interest (ROI) volumetry methods, using manually traced tumour profiles on contiguous imaging slices and subsequent computer-aided calculations, may prove more reliable. Objective: To evaluate whether the reliability of MRI surveillance of DIPGs can be improved by the use of ROI-based volumetry. Materials and methods: We investigated the use of ROI- and ellipsoid-based methods of volumetry for paediatric DIPGs in a retrospective review of 22 MRI examinations. We assessed the inter- and intraobserver variability of the two methods when performed by four observers. Results: ROI- and ellipsoid-based methods strongly correlated for all four observers. The ROI-based volumes showed slightly better agreement both between and within observers than the ellipsoid-based volumes (inter-[intra-]observer agreement 89.8% [92.3%] and 83.1% [88.2%], respectively). Bland-Altman plots show tighter limits of agreement for the ROI-based method. Conclusion: Both methods are reproducible and transferrable among observers. ROI-based volumetry appears to perform better with greater intra- and interobserver agreement for complex-shaped DIPG. [ABSTRACT FROM AUTHOR]
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- 2015
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34. Co2 Sequestration During Interactions Between Fluid and Mafic to Intermediate Intrusive Rocks on Vannøya Island, West Troms Basement Complex, North Norway.
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Priyatkina, Nadezhda S., Kullerud, Kåre, Bergh, Steffen G., Armitage, Paul E. B., and Ravna, Erling J. K.
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- 2012
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35. Relationships between brain and body temperature, clinical and imaging outcomes after ischemic stroke.
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Karaszewski, Bartosz, Carpenter, Trevor K, Thomas, Ralph G R, Armitage, Paul A, Lymer, Georgina Katherine S, Marshall, Ian, Dennis, Martin S, and Wardlaw, Joanna M
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STROKE ,NUCLEAR magnetic resonance spectroscopy ,BODY temperature ,FEVER ,BRAIN damage ,TYMPANIC body temperature - Abstract
Pyrexia soon after stroke is associated with severe stroke and poor functional outcome. Few studies have assessed brain temperature after stroke in patients, so little is known of its associations with body temperature, stroke severity, or outcome. We measured temperatures in ischemic and normal-appearing brain using
1 H-magnetic resonance spectroscopy and its correlations with body (tympanic) temperature measured four-hourly, infarct growth by 5 days, early neurologic (National Institute of Health Stroke Scale, NIHSS) and late functional outcome (death or dependency). Among 40 patients (mean age 73 years, median NIHSS 7, imaged at median 17 hours), temperature in ischemic brain was higher than in normal-appearing brain on admission (38.6°C-core, 37.9°C-contralateral hemisphere, P=0.03) but both were equally elevated by 5 days; both were higher than tympanic temperature. Ischemic lesion temperature was not associated with NIHSS or 3-month functional outcome; in contrast, higher contralateral normal-appearing brain temperature was associated with worse NIHSS, infarct expansion and poor functional outcome, similar to associations for tympanic temperature. We conclude that brain temperature is higher than body temperature; that elevated temperature in ischemic brain reflects a local tissue response to ischemia, whereas pyrexia reflects the systemic response to stroke, occurs later, and is associated with adverse outcomes. [ABSTRACT FROM AUTHOR]- Published
- 2013
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36. Do acute phase markers explain body temperature and brain temperature after ischemic stroke?
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Whiteley WN, Thomas R, Lowe G, Rumley A, Karaszewski B, Armitage P, Marshall I, Lymer K, Dennis M, Wardlaw J, Whiteley, William N, Thomas, Ralph, Lowe, Gordon, Rumley, Ann, Karaszewski, Bartosz, Armitage, Paul, Marshall, Ian, Lymer, Katherine, Dennis, Martin, and Wardlaw, Joanna
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- 2012
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37. Do acute phase markers explain body temperature and brain temperature after ischemic stroke?
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Whiteley, William N., Thomas, Ralph, Lowe, Gordon, Rumley, Ann, Karaszewski, Bartosz, Armitage, Paul, Marshall, Ian, Lymer, Katherine, Dennis, Martin, and Wardlaw, Joanna
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- 2012
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38. A grid overlay framework for analysis of medical images and its application to the measurement of stroke lesions.
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Armitage, Paul, Rivers, C., Karaszewski, B., Thomas, R., Lymer, G., Morris, Z., and Wardlaw, J.
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STROKE patients ,GRAPHICAL user interfaces ,DIFFUSION tensor imaging ,SPECTROSCOPIC imaging ,MEDICAL imaging systems - Abstract
Objectives: To create and evaluate an interactive software tool for measuring imaging data in situations where hand-drawn region-of-interest measurements are unfeasible, for example, when the structure of interest is patchy with ill-defined boundaries. Methods: An interactive grid overlay software tool was implemented that enabled coding of voxels dependent on their imaging appearance with a series of user-defined classes. The Grid Analysis Tool (GAT) was designed to automatically extract quantitative imaging data, grouping the results by tissue class. Inter- and intra-observer reproducibility was evaluated by six observers of various backgrounds in a study of acute stroke patients. Results: The software tool enabled a more detailed classification of the stroke lesion than would be possible with a region-of-interest approach. However, inter-observer coefficients of variation (CVs) were relatively high, reaching 70% in 'possibly abnormal' tissue and around 15-20% in normal appearing tissues, while intra-observer CVs were no more than 13% in 'possibly abnormal' tissue and generally less than 1% in normal-appearing tissues. Conclusions: The grid-overlay method overcomes some of the limitations of conventional Region Of Interest (ROI) approaches, providing a viable alternative for segmenting patchy lesions with ill-defined boundaries, but care is required to ensure acceptable reproducibility if the method is applied by multiple observers. Key Points: • Computer software developed to overcome limitations of conventional regions of interest measurements • This software is suitable for patchy lesions with ill-defined borders • Allows a more detailed assessment of imaging data [ABSTRACT FROM AUTHOR]
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- 2012
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39. MR diffusion and perfusion parameters: relationship to metabolites in acute ischaemic stroke.
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Cvoro, Vera, Marshall, Ian, Armitage, Paul A., Bastin, Mark E., Carpenter, Trevor, Rivers, Carly S., Dennis, Martin S., and Wardlaw, Joanna M.
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ISCHEMIA ,CEREBROVASCULAR disease ,TREATMENT of blood circulation disorders ,METABOLITES ,DIAGNOSTIC imaging ,BIOLOGICAL products ,GENETICS - Abstract
Background Magnetic resonance (MR) diffusion and perfusion imaging are used to identify ischaemic penumbra, but there are few comparisons with neuronal loss and ischaemia in vivo. The authors compared N-acetyl aspartate (NAA, found in intact neurons) and lactate (anaerobic metabolism) with diffusion/perfusion parameters. Methods The authors prospectively recruited patients with acute ischaemic stroke and performed MR diffusion tensor, perfusion (PWI) and proton chemical shift spectroscopic imaging (CSI). We superimposed a 0.5 cm voxel grid on the diffusion-weighted images (DWI) and classified voxels as 'definitely abnormal,' 'possibly abnormal' or normal on DWI appearance, and 'mismatch' for voxels in DWI/PWI mismatch areas. The authors compared metabolite (NAA, lactate), perfusion and apparent diffusion coefficient (ADC) values in each voxel type. Results NAA differentiated 'definitely' from 'possibly abnormal,' and 'possibly abnormal' from 'mismatch' (both comparisons p<0.01) voxels, but not 'mismatch' from 'normal' voxels. Lactate was highest in 'definitely abnormal, ' and progressively lower in 'possibly abnormal, ' 'mismatch, ' than 'normal' voxels (all differences p<0.01). There was no correlation between NAA and ADC or PWI values, but high lactate correlated with low ADC (Spearman r=-0.41, p=0.02) and prolonged mean transit time (Spearman r=0.42, p=0.02). Conclusion ADC and mean transit time indicate the presence of ischaemia (lactate) but not cumulative total neuronal damage (NAA) in acute ischaemic stroke, suggesting that caution is required if using ADC and PWI parameters to differentiate salvageable from non-salvageable tissue. Further refinement of the DWI/PWI concept is required prior to more widespread use. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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40. Neoarchaean to Svecofennian tectono-magmatic evolution of the West Troms Basement Complex, North Norway.
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Bergh, Steffen G., Kullerud, Kåre, Armitage, Paul E. B., Bouke Zwaan, Klaas, Corfu, Fernando, Ravna, Erling J. K., and Inge Myhre, Per
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MAGMAS ,GNEISS ,FACIES ,OROGENIC belts - Abstract
The West Troms Basement Complex in coastal North Norway comprises Neoarchaean to Palaeoproterozoic tonalitic gneisses and igneous and metasupracrustal rocks that are limited to the southwest by the Lofoten igneous and high-grade metamorphic suites (1.87-1.77 Ga) and to the east by the Palaeozoic Caledonian Orogen. The tonalites and granitoids (2.89-2.70 Ga) were deformed and metamorphosed to gneisses, locally up to granulite facies (2.69-2.56 Ga), prior to intrusion of the Ringvassoya mafic dyke swarm (2.4 Ga) and were followed by deposition of widespread supracrustal units (2.4-1.97 Ga), some of which were intruded by mafic sills at 2.22 and 1.98 Ga. Younger (< 1.97 Ga) volcano-sedimentary successions formed locally. During the Svecofennian tectonic event (1.8-1.7 Ga) a suite of bimodal plutonic rocks (1.80-1.76 Ga) intruded the gneisses. The tonalitic and granitic gneisses were juxtaposed in between NW-SE trending metasupracrustal belts that created an overall lens-shaped structural pattern. The supracrustal belts were affected by Svecofennian deformation, and variably by amphibolite/granulite facies peak metamorphism and greenschist facies reworking. New structural and geochronological work provides the framework to discuss the tectono-magmatic evolution of the West Troms Basement Complex. Neoarchaean deformation involved crustal contraction (c. 2.6 Ga), probably accretion and tectonic underplating, and was followed by several episodes of Palaeoproterozoic crustal extension/rifting and mafic dyke intrusion (2.4-1.98 Ga). The Svecofennian tectono-magmatic event (1.8-1.7 Ga) was characterized by prolonged arc-related contraction across block-bounding metasupracrustal belts. A progressive Svecofennian tectonic evolution involved early crustal contraction that generated NE-directed ductile thrusts and a gently SW-dipping crustal detachment/foliation at medium- to high-grade metamorphic conditions. Subsequent, macroscopic NE-SW directed upright folding of the main foliation produced steep limbs that became reactivated by orogen-parallel (NW-SE), mostly sinistral strike-slip shear zones and subvertical folds at retrogressive (greenschist facies) metamorphic conditions. The more flat-lying domains of the West Troms Basement Complex, e.g. broad macro-fold hinges, on the other hand accommodated NW-SE directed shortening and SE-directed thrusting. A model of continued NE-SW orthogonal shortening with an increasing transpressive component with time is the most likely tectonic scenario. Such a model requires accretion from an orogenic front to the southwest into a less deformed and metamorphosed foreland to the northeast. [ABSTRACT FROM AUTHOR]
- Published
- 2010
41. Associations between diffusion and perfusion parameters, N-acetyl aspartate, and lactate in acute ischemic stroke.
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Cvoro V, Wardlaw JM, Marshall I, Armitage PA, Rivers CS, Bastin ME, Carpenter TK, Wartolowska K, Farrall AJ, Dennis MS, Cvoro, Vera, Wardlaw, Joanna M, Marshall, Ian, Armitage, Paul A, Rivers, Carly S, Bastin, Mark E, Carpenter, Trevor K, Wartolowska, Karolina, Farrall, Andrew J, and Dennis, Martin S
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- 2009
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42. Lacunar stroke is associated with diffuse blood-brain barrier dysfunction.
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Wardlaw, Joanna M., Doubal, Fergus, Armitage, Paul, Chappell, Francesca, Carpenter, Trevor, Muñoz Maniega, Susana, Farrall, Andrew, Sudlow, Cathie, Dennis, Martin, and Dhillon, Baljean
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Objective Lacunar stroke is common (25% of ischemic strokes) and mostly because of an intrinsic cerebral microvascular disease of unknown cause. Although considered primarily to be an ischemic process, the vessel and tissue damage could also be explained by dysfunctional endothelium or blood-brain barrier (BBB) leak, not just ischemia. We tested for subtle generalized BBB leakiness in patients with lacunar stroke and control patients with cortical ischemic stroke. Methods We recruited patients with lacunar and mild cortical stroke. We assessed BBB leak in gray matter, white matter, and cerebrospinal fluid, at least 1 month after stroke, using magnetic resonance imaging before and after intravenous gadolinium. We measured tissue enhancement for 30 minutes after intravenous gadolinium by two image analysis approaches (regions of interest and tissue segmentation). We compared the enhancement (leak) between lacunar and cortical patients, and associations with key variables, using general linear modeling. Results We recruited 51 lacunar and 46 cortical stroke patients. Signal enhancement after gadolinium was higher in lacunar than cortical stroke patients in white matter ( p < 0.001) and cerebrospinal fluid ( p < 0.003) by both analysis methods, independent of other variables. Signal enhancement after gadolinium was also associated with increasing age and enlarged perivascular spaces, but these did not explain the lacunar-cortical difference. Interpretation Patients with lacunar stroke have subtle, diffuse BBB dysfunction in white matter. Further studies are required to determine the relative contributions of BBB dysfunction and/or ischemia to the microvascular and brain abnormalities in lacunar stroke. Ann Neurol 2009;65:194-202 [ABSTRACT FROM AUTHOR]
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- 2009
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43. Changes in background blood-brain barrier integrity between lacunar and cortical ischemic stroke subtypes.
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Wardlaw JM, Farrall A, Armitage PA, Carpenter T, Chappell F, Doubal F, Chowdhury D, Cvoro V, Dennis MS, Wardlaw, Joanna M, Farrall, Andrew, Armitage, Paul A, Carpenter, Trevor, Chappell, Francesca, Doubal, Fergus, Chowdhury, Debashish, Cvoro, Vera, and Dennis, Martin S
- Published
- 2008
- Full Text
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44. Comparison of 10 different magnetic resonance perfusion imaging processing methods in acute ischemic stroke: effect on lesion size, proportion of patients with diffusion/perfusion mismatch, clinical scores, and radiologic outcomes.
- Author
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Kane I, Carpenter T, Chappell F, Rivers C, Armitage P, Sandercock P, Wardlaw J, Kane, Ingrid, Carpenter, Trevor, Chappell, Francesca, Rivers, Carly, Armitage, Paul, Sandercock, Peter, and Wardlaw, Joanna
- Published
- 2007
- Full Text
- View/download PDF
45. Low-grade sedimentary rocks on Vanna, North Norway: a new occurrence of a Palaeoproterozoic (2.4-2.2 Ga) cover succession in northern Fennoscandia.
- Author
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Bergh, Steffen G., Kullerud, Kåre, Corfu, Fernando, Armitage, Paul E. B., Davidsen, Børre, Johansen, Helge W., Pettersen, Trine, and Knudsen, Stian
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STONE worship ,PETROGLYPHS ,STONECUTTERS ,PETROLOGY ,SEDIMENTARY rocks - Abstract
The Archaean to Palaeoproterozoic West Troms Basement Complex comprises various tonalitic gneisses, felsic and mafic intrusive rocks and intervening narrow NW-SE-trending belts with partly mylonitised, low- to medium-grade, metavolcanic and metasedimentary rocks. The low-grade, parautochthonous Vanna group unconformably overlies 2885 ± 20 Ma tonalitic basement on the island of Vanna. It is composed of siliciclastic sedimentary rocks and intercalated mudstones with well-preserved shallow-water sedimentary structures and internal erosional surfaces. A major diorite body intruded soon after consolidation of the sediments. The stack of sedimentary rocks is tilted and complexly folded and deformed by crustal transpression. Previous workers considered the rocks to be either part of the Neoproterozoic to Cambrian autochthonous cover or a part of the Middle Allochthon, and deformed during the Caledonian orogeny. New U-Pb ages for magmatic zircon and titanite of the diorite sill, however, yield a crystallization age of 2221 ± 3 Ma. Mafic dykes of the underlying tonalitic basement that do not truncate the basement-cover contact have been dated to 2403 ± 3 Ma, which is a maximum age for the sediments. Laser ICP-MS U-Pb analyses of detrital zircons from the Vanna group indicate that the nearby 2885 ± 20 Ma tonalitic basement was the principal source for the sediments. The new U-Pb age determinations from Vanna indicate that the diorite and its associated sedimentary rocks may be coeval with other Palaeoproterozoic siliciclastic successions in northern Fennoscandia. Directly correlatable mafic dyke swarms include 2220 Ma sills throughout northern Finland, the Nipissing diabase (2219 ± 4 to 2210 ± 4 Ma) of the Canadian Shield, and the Scourie dykes (c. 2.4-2.0 Ga) of the Lewisian Complex in Scotland. These intrusive swarms and associated sedimentary units were all formed in the waning stages of continental rifting and sedimentation following the break-up of an Archaean supercontinent. The Svecofennian (c. 1.8-1.7 Ga) orogenic events and regional metamorphism were likely the cause of the transpressive deformation of the Vanna group. [ABSTRACT FROM AUTHOR]
- Published
- 2007
46. Mental Health Consumer and Carer Participation in Professional Education: ‘Getting There Together’ for Children of Parents with Mental Illness and Their Families.
- Author
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Cowling, Vicki, Edan, Vrinda, Cuff, Rose, Armitage, Paul, and Herszberg, Dassi
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MENTAL health services ,PEOPLE with mental illness ,CHILDREN of parents with intellectual disabilities ,MENTAL health ,PRIMARY care - Abstract
‘Getting There Together’ is a professional education seminar developed as a collaborative project by professionals, mental health consumers and carers aimed at service providers who work with children of parents with mental illness and their families. The need for such professional education concerning this group is well recognised and the project reported herein was initiated by a reference group of professionals, consumers and carers focusing on children of parents with mental illness in the Eastern region of Melbourne (Victoria, Australia). The project began and continued as a collaborative effort during development and implementation, which ensured the experience, point of view and voice of consumers and carers was central to the material prepared, and at the time of seminar presentations. Seminar participants were from the family welfare, child care and supported housing sectors. Seminar participants found the first person accounts of consumers and carers the most helpful aspects of the seminars because they gave new insights into the experiences of carers and of mental health consumers as parents, as well as an understanding of ‘.. the whole family, and how the child fits into the picture’. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
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47. Persistent infarct hyperintensity on diffusion-weighted imaging late after stroke indicates heterogeneous, delayed, infarct evolution.
- Author
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Rivers CS, Wardlaw JM, Armitage PA, Bastin ME, Carpenter TK, Cvoro V, Hand PJ, Dennis MS, Rivers, Carly S, Wardlaw, Joanna M, Armitage, Paul A, Bastin, Mark E, Carpenter, Trevor K, Cvoro, Vera, Hand, Peter J, and Dennis, Martin S
- Published
- 2006
- Full Text
- View/download PDF
48. DSC perfusion MRI-Quantification and reduction of systematic errors arising in areas of reduced cerebral blood flow.
- Author
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Carpenter, Trevor K., Armitage, Paul A., Bastin, Mark E., and Wardlaw, Joanna M.
- Abstract
Dynamic susceptibility contrast (DSC)-MRI is commonly used to measure cerebral perfusion in acute ischemic stroke. Quantification of perfusion parameters involves deconvolution of the tissue concentration-time curves with an arterial input function (AIF), typically with the use of singular value decomposition (SVD). To mitigate the effects of noise on the estimated cerebral blood flow (CBF), a regularization parameter or threshold is used. Often a single global threshold is applied to every voxel, and its value has a dramatic effect on the CBF values obtained. When a single global threshold was applied to simulated concentration-time curves produced using exponential, triangular, and boxcar residue functions, significant systematic errors were found in the measured perfusion parameters. We estimate the errors obtained for different sampling intervals and signal-to-noise ratios (SNRs), and discuss the source of the systematic error. We present a method that partially corrects for the systematic error in the presence of an exponential residue function by applying a linear fit, which removes underestimates of long mean transit time (MTT) and overestimates of short MTT. For example, the correction reduced the error at a temporal resolution of 2.5 s and an SNR of 30 from 29.1% to 11.7%. However, the error is largest in the presence of noise and at MTTs that are likely to be encountered in areas of hypoperfusion; furthermore, even though it is reduced, it cannot be corrected for exactly. Magn Reson Med, 2006. © 2006 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]
- Published
- 2006
- Full Text
- View/download PDF
49. Observations on the relationship between the Platreef and its hangingwall.
- Author
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Holwell, David A., Armitage, Paul E. B., and McDonald, Ian
- Subjects
MINERALS ,PLATINUM ,PLAGIOCLASE ,FELDSPAR ,ALBITE ,MAGMAS ,IGNEOUS rocks - Abstract
Observations on the nature of the contact between the Platreef and its hangingwall have revealed that not only were the hangingwall gabbronorites intruded after the Platreef igneous rocks and the development of platinum group element (PGE) mineralisation, but that there appears to have been a significant time-break separating the two intrusive events. The hangingwall gabbronorites truncate several features present within the Platreef pyroxenites but not in the hangingwall, such as shear zones and reef which has undergone alteration by Fe-rich fluids, implying that these features were formed prior to intrusion of the gabbronorites. A fine-grained leuconorite at the base of the hangingwall exhibits textures showing erosion of Platreef orthopyroxene by fine-grained cumulus plagioclase, suggesting intrusion of a hot magma over cooled Platreef. Xenoliths of reef pyroxenite are also found in the hangingwall. PGE mineralisation is present within basal zones of the hangingwall where the hangingwall overlies mineralised Platreef pyroxenite. We interpret the contact as a magmatic unconformity and, as the gabbronorites do not appear to be PGE-depleted, suggest that PGEs and S were scavenged or assimilated from the reef by the intruding magma, producing zones of orthomagmatic PGE mineralisation in topographic depressions at the base of the crystallising hangingwall. The presence of calc–silicate xenoliths in the hangingwall gabbronorites can be explained by footwall anticlines or diapirism which the relatively thin Platreef had not overtopped, allowing footwall dolomite to be exposed to the main influx of hangingwall magma. The identification of a time-break between Platreef and hangingwall intrusion, and the most likely source of basal hangingwall PGE mineralisation being the underlying Platreef, shows that the magma that formed the gabbronorites could not have been the source of PGE for the Platreef as previously thought. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
50. Structural development of the Mjelde-Skorelvvatn Zone on Kvaløya, Troms: a metasupracrustal shear belt in the Precambrian West Troms Basement Complex, North Norway.
- Author
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Armitage, Paul E. B. and Bergh, Steffen G.
- Subjects
PRECAMBRIAN ,VOLCANOES ,SEDIMENTS ,GEOLOGICAL time scales ,AMPHIBOLITES - Abstract
The Mjelde-Skorelvvatn Zone is one of several metamorphosed and deformed volcanosedimentary belts in the Archaean-Palaeoproterozoic West Troms Basement Complex. The Mjelde-Skorelvvatn Zone is a belt of steeply dipping metasupracrustal rocks (Skorelvvatn Formation) of presumed Palaeoproterozoic age, lying between Archaean (?) anorthositic gneisses (Gråtind Migmatite) and a mafic plutonic complex (Bakkejord Diorite). These units occur on the west limb of a large north-south trending, gently plunging antiform, and all three units share common groups of structures. The structural development of the zone is characterised by three-phase, amphibolite-facies ductile deformation (D
1 -D3 ) and a phase of brittle/semi-ductile faulting of probable post-Caledonian age. D1 generated a penetrative foliation (S1 ) which is axial-planar to isoclinal folds of variable orientation (F1 ). S1 strikes NNW, dips steeply west and exhibits a moderately plunging stretching lineation (L1 ). D2 involved macroscale folding of S1 about a gently SSW-plunging axis (F2 ). The axis is perpendicular to L1 , suggesting that D2 may have been a late stage of D1 .D3 structures are represented by subvertically plunging macrofolds (F3 ) with sinistral geometry and a network of moderately to steeply dipping, lateral shear zones (S3 ) of dominantly sinistral sense and subordinate dextral sense. The geometric and kinematic relationship between S3 shear zones suggests that D3 structures were generated by sinistral transpression with associated minor lateral extrusion. Granitoid pegmatite dykes with a U-Pb titanite age of 1768 ± 4 Ma are shown to have intruded at a late stage of this ductile event, thus constraining a Palaeoproterozoic deformation age. The overall structural character of the Mjelde-Skorelvvatn Zone suggests that it developed during: (i) WSW-ENE crustal shortening (D1-2 ) and later sinistral transpression (D3 ); or (ii) a progressive transpressional event with partitioned east-west crustal contraction (D1 - D2 ) and NW-SE lateral shearing (D3 ). The proposed kinematic model is comparable with models for other shear zones of the West Troms Basement Complex and is linked with tectonic processes in the Palaeoproterozoic terrains of the northernmost Fennoscandian Shield. [ABSTRACT FROM AUTHOR]- Published
- 2005
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