Publications by authors named "John Thornton"

The demand for high-performance permanent magnets continues to grow across a wide range of advanced technologies. However, conventional powder metallurgy routes for rare-earth magnets such as Sm-Co are limited by the intrinsic brittleness of the powders, reducing manufacturability and yield. Here, we report a single-step, solid-state processing method-friction consolidation (FC)-that enables simultaneous deformation, heating, and chemical transformation of brittle Sm-Co powders.

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Purpose: The clinical feasibility and translation of many advanced quantitative MRI (qMRI) techniques are inhibited by their restriction to 'research mode', due to resource-intensive, offline parameter estimation. This work aimed to achieve 'clinical mode' qMRI, by real-time, inline parameter estimation with a trained neural network (NN) fully integrated into a vendor's image reconstruction environment, therefore facilitating and encouraging clinical adoption of advanced qMRI techniques.

Methods: The Siemens Image Calculation Environment (ICE) pipeline was customised to deploy trained NNs for advanced diffusion MRI parameter estimation with Open Neural Network Exchange (ONNX) Runtime.

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The acquisition of electroencephalography (EEG) concurrently with functional magnetic resonance imaging (fMRI) requires a careful consideration of the health hazards resulting from interactions between the scanner's electromagnetic fields and EEG recording equipment. The primary safety concern is excessive RF-induced heating of the tissue in the vicinity of electrodes. We have previously demonstrated that concurrent intracranial EEG (icEEG) and fMRI data acquisitions (icEEG-fMRI) can be performed with acceptable risk in specific conditions using a head RF transmit coil.

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Background And Aims: Recent advances in acute stroke interventions have highlighted the importance of accurate determination of infarct volume in the evaluation of acute stroke patients, carrying important prognostic and therapeutic implications for treatment planning, outcome prediction, and evaluation of the success of therapeutic interventions. However, there is no consensus on the methodologies employed to measure cerebral infarct volume. We aimed to assess the reproducibility and reliability of methods employed in the clinical determination of infarct volume in acute ischaemic stroke.

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Background And Purpose: Accurate and reproducible methods for assessing infarct volume in acute ischaemic stroke have important therapeutic and prognostic implications for the choice and success of acute therapeutic interventions. However, there is no international consensus on the methodology employed in infarct volume assessment. We aimed to assess the reliability of the ABC/2 score and e-ASPECTS in the determination of infarct volume in acute ischaemic stroke.

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BackgroundIn mechanical thrombectomy procedures, physicians are often forced to cross the clot to get more support in tortuous anatomy. Stentriever procedures always require traversing the clot. Novel delivery assist catheters with a tapered distal tip have been developed to aid aspiration catheter delivery.

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Background: Follow-up infarct volume (FIV) is a proposed surrogate endpoint for proof-of-concept clinical studies in acute ischemic stroke (AIS). This study aimed to provide clinical validation of an automated FIV algorithm, demonstrating the association of imaging biomarkers with clinical outcomes to support the use of these imaging endpoints in clinical trials.

Methods: Data were gathered for adult AIS patients undergoing mechanical thrombectomy with follow-up imaging 12-96 h from initial assessment.

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Background And Objectives: Quantitative and operator-independent biomarkers of disease progression are urgently needed in amyotrophic lateral sclerosis (ALS) research. We assess the potential of skeletal muscle MRI as a sensitive and reliable outcome measure for future ALS clinical trials.

Methods: In this longitudinal cohort study, muscle MRI of head-neck, upper and lower limb regions, alongside clinical and functional assessments, were acquired at three time points over the individual maximum observation period (iMOP) of 1 year in 20 patients with ALS and 16 healthy controls.

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Purpose: Gliomas are the commonest malignant brain tumours. Baseline characteristics on structural MRI, such as size, enhancement proportion and eloquent brain involvement inform grading and treatment planning. Currently, free-text imaging reports depend on the individual style and experience of the radiologist.

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Medical procedures often require proctoring that is traditionally done face-to-face, but this poses a significant carbon footprint and logistical challenges. Little is known about the safety and efficacy of remote "tele"proctoring, particularly in the respiratory field. The aim was to develop, implement, and evaluate a teleproctoring program for bronchoscopy procedures.

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Objectives: To investigate the intramuscular effects of arimoclomol using quantitative magnetic resonance imaging (qMRI) of the thighs in a subset of inclusion body myositis (IBM) participants from a multicentre, randomised, double-blind, placebo-controlled trial, and to further evaluate the utility of qMRI assessments as outcome measures.

Methods: Eighteen participants (10 placebo, 8 arimoclomol-treated) were recruited to undergo an MRI at baseline, 12 and 20 months. Spearman correlations between baseline clinical measures and qMRI measurements [fat fraction (FF), remaining muscle area (RMA), magnetisation transfer ratio (MTR), muscle water T2 (T2m) and fat fraction apparent (FFa)] were used to evaluate construct validity.

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Objective: We measured clinical and quantitative MRI outcome measures in CMT1A to assess long-term responsiveness, establish longitudinal validity and assess MRI as a bridging biomarker.

Methods: Twenty patients with CMT1A and 20 matched controls underwent MRI, myometry and clinical assessments up to four times over mean 4-year follow-up. Bilateral calf muscle MRI included T1-weighted sequences with Mercuri grading and three-point Dixon quantitative fat fraction assessment.

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Background: Timely endovascular thrombectomy (EVT) is crucial for improving outcomes in acute ischemic stroke (AIS). This study evaluated the effectiveness of a national quality improvement collaborative (QIC) in reducing process times for potential EVT candidates across a national stroke network.

Methods: A pre-post intervention design using a modified Breakthrough Series approach was implemented across 24 hospitals.

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Background And Purpose: Successful and complete reperfusion should be the aim of every endovascular thrombectomy (EVT) procedure. However, the effect of time delays on successful reperfusion in late window stroke patients presenting 6-to-24 h from onset has not been investigated.

Materials And Methods: We pooled individual patient-level data from seven trials and registries for anterior circulation stroke patients treated with EVT between 6 and 24 h from onset.

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Purpose: Intraprocedural complications during intracranial embolisation include thromboembolic vessel occlusion, catheter tip detachment and coil migration. Stentrievers and aspiration catheters are valuable devices for the management of these complications. We present our experience with the use of these devices.

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Introduction/aims: Studies have demonstrated the potential of muscle MRIs to measure disease progression in ALS. However, the responsiveness and utility of quantitative muscle MRIs in an ALS clinical trial remain unknown. This study aimed to determine the responsiveness of quantitative muscle MRIs to measure disease progression in ALS.

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Purpose: Data for QSM are typically acquired using multi-echo 3D gradient echo (GRE), but EPI can be used to accelerate QSM and provide shorter acquisition times. So far, EPI-QSM has been limited to single-echo acquisitions, which, for 3D GRE, are known to be less accurate than multi-echo sequences. Therefore, we compared single-echo and multi-echo EPI-QSM reconstructions across a range of parallel imaging and multiband acceleration factors.

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Background: Magnetic resonance imaging (MRI) quantification of intramuscular fat accumulation is a responsive biomarker in neuromuscular diseases. Despite emergence of automated methods, manual muscle segmentation remains an essential foundation. We aimed to develop a training programme for new observers to demonstrate competence in lower limb muscle segmentation and establish reliability benchmarks for future human observers and machine learning segmentation packages.

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Background And Aims: Histopathological diagnosis is the gold standard in many acquired inflammatory, infiltrative and amyloid based peripheral nerve diseases and a sensory nerve biopsy of sural or superficial peroneal nerve is favoured where a biopsy is deemed necessary. The ability to determine nerve pathology by high-resolution imaging techniques resolving anatomy and imaging characteristics might improve diagnosis and obviate the need for biopsy in some. The sural nerve is anatomically variable and occasionally adjacent vessels can be sent for analysis in error.

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Objectives: There is conflicting evidence regarding the outcomes of acute stroke patients who present to hospital within normal working hours ('in-hours') compared with the 'out-of-hours' period. This study aimed to assess the effect of time of stroke presentation on outcomes within the Irish context, to inform national stroke service delivery.

Materials And Methods: A secondary analysis of data from the Irish National Audit of Stroke (INAS) from Jan 2016 to Dec 2019 was carried out.

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Article Synopsis
  • The study investigated the impact of endovascular therapy (EVT) on cognitive outcomes following a large vessel occlusion stroke, using data from the ESCAPE trial.
  • Cognitive assessments were performed 90 days post-stroke and included various tests to evaluate memory and cognitive function, with results indicating that EVT significantly improved cognitive outcomes across all tests.
  • Findings showed that EVT was associated with better cognitive performance (higher odds ratios for favorable outcomes), and both final infarct volume and cognitive function had notable correlations, suggesting that both factors influence recovery.
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Background: We investigated the impact of workflow times on the outcomes of patients treated with endovascular thrombectomy (EVT) in the late time window.

Methods: Individual patients' data who underwent EVT in the late time window (onset to imaging >6 hours) were pooled from seven registries and randomized clinical trials. Multiple time intervals were analyzed.

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Quantitative muscle fat fraction (FF) responsiveness is lower in younger Charcot-Marie-Tooth disease type 1A (CMT1A) patients with lower baseline calf-level FF. We investigated the practicality, validity, and responsiveness of foot-level FF in this cohort involving 22 CMT1A patients and 14 controls. The mean baseline foot-level FF was 25.

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The need for biomarkers for acute ischemic stroke (AIS) to understand the mechanisms implicated in pathological clot formation is critical. The levels of the brain natriuretic peptides known as brain natriuretic peptide (BNP) and NT-proBNP have been shown to be increased in patients suffering from heart failure and other heart conditions. We measured their expression in AIS clots of cardioembolic (CE) and large artery atherosclerosis (LAA) etiology, evaluating their location inside the clots, aiming to uncover their possible role in thrombosis.

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Purpose: This study aimed to develop and evaluate a machine learning model and a novel clinical score for predicting outcomes in stroke patients undergoing endovascular thrombectomy.

Materials And Methods: This retrospective study included all patients aged over 18 years with an anterior circulation stroke treated at a thrombectomy centre from 2010 to 2020 with external validation. The primary outcome was day 90 mRS ≥3.

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