Publications by authors named "Karl Young"

Article Synopsis
  • The study investigates the use of guideline-directed medical therapy (GDMT) in patients who survive cardiogenic shock (CS) with heart failure and reduced left ventricular ejection fraction (HFrEF) based on data from a single-center shock registry.
  • Among 520 patients treated for CS, 185 (35.6%) had HFrEF upon discharge, with a median age of 64 years; 41% experienced shock due to acute myocardial infarction, while the rest had heart failure-related shock.
  • At discharge, a substantial portion of patients were prescribed GDMT, including beta-blockers (78%), ACE inhibitors/ARBs (58%), and mineralocorticoid receptor antagonists (55%), yet 10
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The dual sintering of copper (Cu) nanoparticles (NPs) was introduced to produce conductive patterns suitable for flexible electronics applications. In this method, laser irradiation using a Nd:YAG laser with a wavelength of 1064 nm was performed at laser powers of 400, 600 and 800 mJ. The laser irradiation time was 15 and 30 s for each laser power.

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Purpose: The Vespa package (Versatile Simulation, Pulses, and Analysis) is described and demonstrated. It provides workflows for developing and optimizing linear combination modeling (LCM) fitting for H MRS data using intuitive graphical user interface interfaces for RF pulse design, spectral simulation, and MRS data analysis. Command line interfaces for embedding workflows in MR manufacturer platforms and utilities for synthetic dataset creation are included.

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Background: The benefits of standardized care for cardiogenic shock (CS) across regional care networks are poorly understood.

Objectives: The authors compared the management and outcomes of CS patients initially presenting to hub versus spoke hospitals within a regional care network.

Methods: The authors stratified consecutive patients enrolled in their CS registry (January 2017 to December 2019) by presentation to a spoke versus the hub hospital.

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Article Synopsis
  • Little is known about the differences in clinical characteristics and outcomes between patients experiencing cardiogenic shock due to heart failure (HF-CS) versus those due to acute myocardial infarction (AMI; AMI-CS).
  • A study analyzed 520 patients with CS over three years, revealing that HF-CS patients tended to be younger, had fewer cardiac arrests, and utilized less aggressive treatments compared to AMI-CS patients.
  • Despite HF-CS patients having lower cardiac power output and higher pulmonary wedge pressure, they experienced lower rates of in-hospital and 1-year mortality compared to their AMI-CS counterparts.
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Physicians should be aware of possible anatomical variants during cannulation for extracorporeal membrane oxygenation (ECMO). Particular attention to ensure continual visualization of the guidewire before proceeding to final positioning of the ECMO cannulae should be paid. Alternative imaging modalities should be contemplated when uncertainties arise to minimize the risk of inadvertent vascular injuries.

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We report on the first use of laser ablation to make submillimeter, broadband, antireflection coatings (ARCs) based on subwavelength structures (SWSs) on alumina and sapphire. We used a 515 nm laser to produce pyramid-shaped structures with a pitch of about 320 μm and a total height of near 800 μm. Transmission measurements between 70 and 140 GHz are in agreement with simulations using electromagnetic propagation software.

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Directed network motifs are the building blocks of complex networks, such as human brain networks, and capture deep connectivity information that is not contained in standard network measures. In this paper we present the first application of directed network motifs in vivo to human brain networks, utilizing recently developed directed progression networks which are built upon rates of cortical thickness changes between brain regions. This is in contrast to previous studies which have relied on simulations and in vitro analysis of non-human brains.

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Purpose: Establishing a framework to evaluate performances of prospective motion correction (PMC) MRI considering motion variability between MRI scans.

Methods: A framework was developed to obtain quantitative comparisons between different motion correction setups, considering that varying intrinsic motion patterns between acquisitions can induce bias. Intrinsic motion was considered by replaying in a phantom experiment the recorded motion trajectories from subjects.

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This article introduces a new approach in brain connectomics aimed at characterizing the temporal spread in the brain of pathologies like Alzheimer's disease (AD). The main instrument is the development of "directed progression networks" (DPNets), wherein one constructs directed edges between nodes based on (weakly) inferred directions of the temporal spreading of the pathology. This stands in contrast to many previously studied brain networks where edges represent correlations, physical connections, or functional progressions.

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Background: Quantitative neuroimaging analyses have demonstrated gray and white matter abnormalities in group comparisons of different types of non-lesional partial epilepsy. It is unknown to what degree these type-specific patterns exist in individual patients and if they could be exploited for diagnostic purposes. In this study, a two-level multi-modality imaging Bayesian network approach is proposed that uses information about individual gray matter volume loss and white matter integrity to classify non-lesional temporal lobe epilepsy with (TLE-MTS) and without (TLE-no) mesial-temporal sclerosis and frontal lobe epilepsy (FLE).

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Purpose: To investigate arterial spin labeling (ASL) methods for improved brain perfusion mapping. Previously, pseudo-continuous ASL (pCASL) was developed to overcome limitations inherent with conventional continuous ASL (CASL), but the control scan (null pulse) in the original method for pCASL perturbs the equilibrium magnetization, diminishing the ASL signal. Here, a new modification of pCASL, termed mpCASL is reported, in which the perturbation caused by the null pulse is reduced and perfusion mapping improved.

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A k-space-time Bayesian statistical reconstruction method (K-Bayes) is proposed for the reconstruction of metabolite images of the brain from proton (1H) magnetic resonance (MR) spectroscopic imaging (MRSI) data. K-Bayes performs full spectral fitting of the data while incorporating structural (anatomical) spatial information through the prior distribution. K-Bayes provides increased spatial resolution over conventional discrete Fourier transform (DFT) based methods by incorporating structural information from higher resolution coregistered and segmented structural MR images.

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Glutathione (GSH) is a powerful antioxidant found inside different kinds of cells, including those of the central nervous system. Detection of GSH in the human brain using (1)H MR spectroscopy is hindered by low concentration and spectral overlap with other metabolites. Previous MRS methods focused mainly on the detection of the cysteine residue (GSH-Cys) via editing schemes.

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For magnetic resonance spectroscopic imaging studies of the brain, it is important to measure the distribution of metabolites in a regionally unbiased way; that is, without restrictions to a priori defined regions of interest. Since magnetic resonance spectroscopic imaging provides measures of multiple metabolites simultaneously at each voxel, there is furthermore great interest in utilizing the multidimensional nature of magnetic resonance spectroscopic imaging for gains in statistical power. Voxelwise multivariate statistical mapping is expected to address both of these issues, but it has not been previously employed for spectroscopic imaging (SI) studies of brain.

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Diffusion spectrum imaging (DSI) is a generalization of diffusion tensor imaging to map fibrous structure of white matter and potentially very sensitive to alterations of the cingulum bundles in dementia. In this in-vivo 4T study, DSI parameters especially spatial resolution and diffusion encoding bandwidth were optimized on humans to segment the cingulum bundles for tract level measurements of diffusion. The careful tailoring of the DSI acquisitions in conjunction with fiber tracking provided an optimal DSI setting for a reliable quantification of the cingulum bundle tracts.

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Localized in vivo spectroscopy at high magnetic field strength (>3T) is susceptible to localization artifacts such as the chemical shift artifact and the spatial interference artifact for J-coupled spins. This latter artifact results in regions of anomalous phase for J-coupled spins. These artifacts are exacerbated at high magnetic field due to the increased frequency dispersion, coupled with the limited RF pulse bandwidths used for localization.

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Article Synopsis
  • MRI is widely used in research and clinical settings, but most techniques focus on high-resolution structural imaging, limiting the effectiveness of perfusion MRI, which measures blood flow in the brain due to lower resolution and various artifacts.
  • A new method called K-Bayes is introduced, combining MRI signal modeling in k-space with high-resolution structural MRI data to enhance the reconstruction of perfusion MRI images.
  • The K-Bayes approach shows significant improvements over traditional discrete Fourier transform methods, offering higher resolution, reduced bias, and better precision in analyzing human brain perfusion data.
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Despite the continued spread of magnetic resonance imaging (MRI) methods in scientific studies and clinical diagnosis, MRI applications are mostly restricted to high-resolution modalities, such as structural MRI. While perfusion MRI gives complementary information on blood flow in the brain, its reduced resolution limits its power for detecting specific disease effects on perfusion patterns. This reduced resolution is compounded by artifacts such as partial volume effects, Gibbs ringing, and aliasing, which are caused by necessarily limited k-space sampling and the subsequent use of discrete Fourier transform (DFT) reconstruction.

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The limited bandwidths of volume selective RF pulses in localized in vivo MRS experiments introduce spatial artifacts that complicate spectral quantification of J-coupled metabolites. These effects are commonly referred to as a spatial interference or "four compartment" artifacts and are more pronounced at higher field strengths. The main focus of this study is to develop a generalized approach to numerical simulations that combines full density matrix calculations with 3D localization to investigate the spatial artifacts and to provide accurate prior knowledge for spectral fitting.

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