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Background: Placenta previa and accreta are serious obstetric conditions that are associated with a high risk of intraoperative massive hemorrhage.Purpose: To develop a scoring system for intraoperative massive hemorrhage combining MRI and clinical characteristics to predict the risk of massive hemorrhage in placenta previa and accreta STUDY TYPE: Retrospective cohort study.Subjects: In all, 374 patients consisting of 259 patients with placenta previa and accreta after previous cesarean section (CS) for the derivation cohort and 115 patients for the validation cohort.Field Strength/sequence: 1.5T single-shot fast spin-echo sequence. [Correction added on October 23, 2019, after first online publication: The field strength in the preceding sentence was corrected.] ASSESSMENT: Using the derivation cohort, clinical and MRI data were collected and multivariable logistic regressions analysis was conducted to develop a scoring system for prediction of intraoperative massive bleeding (blood loss volume > 2000 mL). Finally, the scoring system was validated on 115 patients.Statistical Tests: Student's t-test, Mann-Whitney U-test, X 2 statistics, multivariable analysis, and receiver operating characteristic (ROC) analysis.Results: Ten indicators, including clinically maternal age (1 point), preoperative hemoglobin level (1 point), gravidity number (1 point), number of CS (1 point), and MRI T2 dark intraplacental bands (4 points), cervical canal length (3 points), placenta thickness on the uterine scar area (4 points), empty vascular shadow of the uterus (1 point), low signal discontinuity in the muscular layer of the posterior wall of the bladder (6 points) and attachment position of the placenta (1 point) were imputed. From the ROC analysis, a total score of 7 points was identified as the optimal cutoff value, allowing good differentiation of intraoperative massive bleeding in the derivation cohort (AUC, 0.863; 95% confidence interval [CI]: 0.811-0.916) and in the validation cohort (AUC, 0.933; 95% CI: 0.885-0.980).Data Conclusion: The scoring system for intraoperative massive hemorrhage consists of MRI and clinical indicators, and using a cutoff value of 7 points for a high risk of massive bleeding, the developed scoring system could accurately assess the risk of intraoperative massive hemorrhage in patients with placenta previa and accreta. This scoring system can potentially reduce the incidence of intraoperative massive bleeding by identifying patients at high risk.Level Of Evidence: 3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2020;51:947-958. [ABSTRACT FROM AUTHOR]

Introduction: We sought to translate, cross-culturally adapt, and evaluate the internal consistency and validity of the Chinese version of the 15-Item Myasthenia Gravis Quality of Life (MG-QOL15).Methods: Translation and cross-cultural adaptation of the MG-QOL15 were performed. We used Cronbach's α to test internal consistency, one-way analysis of variance to test construct validity, and Pearson or Spearman correlations to test discriminant and concurrent validity.Results: We enrolled 168 outpatients. Internal consistency was excellent (Cronbach's α = 0.928). The MG-QOL15 discriminated MG severity as stratified by the MG Composite (MGC; P < 0.001) and Osserman class (P = 0.01). Concurrent validity was low to moderate with the subscales of the 36-item Short Form (-0.31 to ∼-0.59), MGC (r = 0.46), and Myasthenia Gravis Activities of Daily Living profile (r = 0.54).Discussion: The Chinese MG-QOL15 showed comparable construct, discriminant and concurrent validity, and internal consistency with to the original version. Muscle Nerve 59:95-99, 2019. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between alcohol drinking and all-cause death in patients with ischemic stroke., Methods: Between January, 2010 and July, 2018, consecutive patients with first-episode ischemic stroke admitted in the West China Hospital, Sichuan University were enrolled, and all the patients were followed up every 3 months.Chi-square test was used to compare the differences in the baseline characteristics between the pre-stroke drinkers and the nondrinkers.The Cox regression model was used to analyze the effects of drinking status, drinking years, drinking frequency, average single alcohol intake before stroke and drinking status during the follow-up period on the mortality of patients after discharge., Results: A total of 855 patients with ischemic stroke were enrolled, and deaths occurred in 140 of these patients.Chi-square test showed significant differences in gender ( P &lt; 0.001), weekly physical exercise time ( P =0.035), smoking ( P &lt; 0.001), and heart disease ( P &lt; 0.001) between the pre-stroke drinkers and nondrinkers.Multivariate Cox regression analysis showed that drinking during the follow-up period ( P =0.001), drinking for less than 28 years before stroke ( P =0.035) and a moderate drinking frequency (5 to 20 times per month for males and 4 to 9 times per month for females; P =0.030) were associated with a lowered risk of death after discharge.No significant effects of pre-stroke drinking status or average single alcohol intake were found on death after ischemic stroke., Conclusions: The drinking years and drinking frequency before stroke and drinking status during the follow-up period are related to the all-cause mortality in patients with ischemic stroke.Investigations of the more specific variables of drinking behaviors during the follow-up period are needed to further clarify the association between drinking and death after ischemic stroke.