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Beheshtian E, Jalilianhasanpour R, Modir Shanechi A, Sethi V, Wang G, Lindquist MA, Caffo BS, Agarwal S, Pillai JJ, Gujar SK, Sair HI. Identification of the Somatomotor Network from Language Task-based fMRI Compared with Resting-State fMRI in Patients with Brain Lesions. Radiology 2021; 301:178-184. [PMID: 34282966 DOI: 10.1148/radiol.2021204594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Resting-state functional MRI (rs-fMRI) is a potential alternative to task-based functional MRI (tb-fMRI) for somatomotor network (SMN) identification. Brain networks can also be generated from tb-fMRI by using independent component analysis (ICA). Purpose To investigate whether the SMN can be identified by using ICA from a language task without a motor component, the sentence completion functional MRI (sc-fMRI) task, compared with rs-fMRI. Materials and Methods The sc-fMRI and rs-fMRI scans in patients who underwent presurgical brain mapping between 2012 and 2016 were analyzed, using the same imaging parameters (other than scanning time) on a 3.0-T MRI scanner. ICA was performed on rs-fMRI and sc-fMRI scans with use of a tool to separate data sets into their spatial and temporal components. Two neuroradiologists independently determined the presence of the dorsal SMN (dSMN) and ventral SMN (vSMN) on each study. Groups were compared by using t tests, and logistic regression was performed to identify predictors of the presence of SMNs. Results One hundred patients (mean age, 40.9 years ± 14.8 [standard deviation]; 61 men) were evaluated. The dSMN and vSMN were identified in 86% (86 of 100) and 76% (76 of 100) of rs-fMRI scans and 85% (85 of 100) and 69% (69 of 100) of sc-fMRI scans, respectively. The concordance between rs-fMRI and sc-fMRI for presence of dSMN and vSMN was 75% (75 of 100 patients) and 53% (53 of 100 patients), respectively. In 10 of 14 patients (71%) where rs-fMRI did not show the dSMN, sc-fMRI demonstrated it. This rate was 67% for the vSMN (16 of 24 patients). Conclusion In the majority of patients, independent component analysis of sentence completion task functional MRI scans reliably demonstrated the somatomotor network compared with resting-state functional MRI scans. Identifying target networks with a single sentence completion scan could reduce overall functional MRI scanning times by eliminating the need for separate motor tasks. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Field and Birn in this issue.
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Affiliation(s)
- Elham Beheshtian
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Rozita Jalilianhasanpour
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Amirali Modir Shanechi
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Varun Sethi
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Guoqing Wang
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Martin A Lindquist
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Brian S Caffo
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Shruti Agarwal
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Jay J Pillai
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Sachin K Gujar
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
| | - Haris I Sair
- From the Division of Neuroradiology, the Russell H. Morgan Department of Radiology and Radiological Science (E.B., R.J., A.M.S., S.A., J.J.P., S.K.G., H.I.S.) and the Department of Neurosurgery (J.J.P.), Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287; Division of Neuroradiology, Department of Radiology, Temple University Hospital, Philadelphia, Pa (V.S.); Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md (G.W., M.A.L., B.S.C.); and the Malone Center for Engineering in Healthcare, the Whiting School of Engineering, Johns Hopkins University, Baltimore, Md (H.I.S.)
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An H, Ford AL, Chen Y, Zhu H, Ponisio R, Kumar G, Shanechi AM, Khoury N, Vo KD, Williams J, Derdeyn CP, Diringer MN, Panagos P, Powers WJ, Lee JM, Lin W. Defining the ischemic penumbra using magnetic resonance oxygen metabolic index. Stroke 2015; 46:982-8. [PMID: 25721017 DOI: 10.1161/strokeaha.114.008154] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Penumbral biomarkers promise to individualize treatment windows in acute ischemic stroke. We used a novel magnetic resonance imaging approach that measures oxygen metabolic index (OMI), a parameter closely related to positron emission tomography-derived cerebral metabolic rate of oxygen utilization (CMRO2), to derive a pair of ischemic thresholds: (1) an irreversible-injury threshold that differentiates ischemic core from penumbra and (2) a reversible-injury threshold that differentiates penumbra from tissue not-at-risk for infarction. METHODS Forty patients with acute ischemic stroke underwent magnetic resonance imaging at 3 time points after stroke onset: <4.5 hours (for OMI threshold derivation), 6 hours (to determine reperfusion status), and 1 month (for infarct probability determination). A dynamic susceptibility contrast method measured cerebral blood flow, and an asymmetrical spin echo sequence measured oxygen extraction fraction, to derive OMI (OMI=cerebral blood flow×oxygen extraction fraction). Putative ischemic threshold pairs were iteratively tested using a computation-intensive method to derive infarct probabilities in 3 tissue groups defined by the thresholds (core, penumbra, and not-at-risk tissue). An optimal threshold pair was chosen based on its ability to predict infarction in the core, reperfusion-dependent survival in the penumbra, and survival in not-at-risk tissue. The predictive abilities of the thresholds were then tested within the same cohort using a 10-fold cross-validation method. RESULTS The optimal OMI ischemic thresholds were found to be 0.28 and 0.42 of normal values in the contralateral hemisphere. Using the 10-fold cross-validation method, median infarct probabilities were 90.6% for core, 89.7% for nonreperfused penumbra, 9.95% for reperfused penumbra, and 6.28% for not-at-risk tissue. CONCLUSIONS OMI thresholds, derived using voxel-based, reperfusion-dependent infarct probabilities, delineated the ischemic penumbra with high predictive ability. These thresholds will require confirmation in an independent patient sample.
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Affiliation(s)
- Hongyu An
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Andria L Ford
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Yasheng Chen
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Hongtu Zhu
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Rosana Ponisio
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Gyanendra Kumar
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Amirali Modir Shanechi
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Naim Khoury
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Katie D Vo
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Jennifer Williams
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Colin P Derdeyn
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Michael N Diringer
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Peter Panagos
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - William J Powers
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.)
| | - Jin-Moo Lee
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.).
| | - Weili Lin
- From the Biomedical Research Imaging Center and Departments of Radiology (H.A., Y.C., W.L.), Biostatistics (H.Z.), and Neurology (W.J.P., W.L.), University of North Carolina at Chapel Hill; Department of Neurology (A.L.F., G.K., N.K., J.-M.L.), Department of Radiology (R.P., K.D.V., C.P.D., J.-M.L.), Department of Emergency Medicine (P.P.), and School of Medicine (A.L.F., G.K., N.K., J.-M.L., R.P., K.D.V., C.P.D., J.-M.L., A.M.S., P.P.), Washington University, St. Louis, MO; and Emergency Department, Barnes-Jewish Hospital, St. Louis, MO (J.W.).
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