Miracle-dz/UniFAR-FTUs huggingface dataset:
Behavioral and Objective Estimates of Auditory Brainstem Integrity

Coordinator, Brainstem Unit, Veterans Administration Medical Center, West Los Angeles, University of California, Los Angeles, California The brainstem is one of the most remarkable functional and structural entities in the human body. It is capable of wondrous things, without which man would be a much less capable organism. In many ways, the auditory brainstem is the clinical diagnostic frontier in audiology. Audiologists are already quite good at the differentiation of cochlear from eighth nerve and peripheral brainstem diseases. Similar proficiency, through the use of dichotic speech tests, can be demonstrated in elucidating damage affecting auditory areas of the brain. As is the case with most disciplines, we are not good at detecting the presence or level of damage when auditory structures within the brainstem are injured. The auditory brainstem does not surrender easily to diagnostic suitors. Its lesion signature is not written in the large script of eighth nerve damage or temporal lobe strokes. Yet, the brainstem's critical role in transmitting information to the brain, and in enabling the human to function as binaural processors of auditory input, makes understanding of its function and how to recognize its dysfunction challenging and invaluable. This is a report on efforts designed to augment the manner in which audiologists approach the patient with suspected brainstem disease or damage. The report is concerned with attempts to find objective means of evaluating auditory brainstem function that can provide the same information as behavioral tests that rely on the voluntary and cooperative participation of a subject. The account of three studies is given, each of which pursued the goal of an analysis of behavioral and objective methods of evaluating the auditory function of the brainstem. The first study compared several established and recent behavioral methods of testing auditory brainstem function to assess the efficacy of those methods. The second study was a direct attempt to examine how the results of selected objective and behavioral tests were correlated. The final study, still in progress, sought to measure objectively a type of auditory performance that was previously amenable only to behavioral exploration.
Spin Thermal Hall Conductivity of a Kagome Antiferromagnet.

A clear thermal Hall signal (κ_{xy}) was observed in the spin-liquid phase of the S=1/2 kagome antiferromagnet Ca kapellasite [CaCu_{3}(OH)_{6}Cl_{2}·0. 6H_{2}O]. We found that κ_{xy} is well reproduced, both qualitatively and quantitatively, using the Schwinger-boson mean-field theory with the Dzyaloshinskii-Moriya interaction of D/J∼0.1. In particular, κ_{xy} values of Ca kapellasite and those of another kagome antiferromagnet, volborthite, converge to one single curve in simulations modeled using Schwinger bosons, indicating a common temperature dependence of κ_{xy} for the spins of a kagome antiferromagnet.
Everyday Cognition in Older Adults: Associations with Neuropsychological Performance and Structural Brain Imaging

Abstract The recently developed Everyday Cognition scales (ECog) measure multiple cognitively relevant functional domains (e.g., Everyday Memory, Everyday Language, Everyday Visuospatial abilities, and three everyday executive domains). The present study further evaluated the validity of the ECog by examining its relationship with objective measures of neuropsychological function, and neurobiological markers of disease as reflected by structural neuroimaging. Participants included 474 older adults (244 normals, 142 with MCI, 88 with dementia). The neuropsychological domains measured were episodic memory, semantic memory, spatial ability, and executive functioning. Brain MRI volumes included total brain (BV), hippocampus (HC) and dorsolateral prefrontal cortex (DLPFC). Neuropsychological measures of episodic memory and executive function were most consistently related to the ECog domains; spatial abilities had a specific relationship to the Everyday Visuospatial ECog domain. HC and BV volumes were related to most ECog domains, while DLPFC volume was independently related to two everyday executive domains (Everyday Planning and Everyday Organization). The pattern of associations varied somewhat as a function of diagnosis. Episodic memory and HC had more consistent associations with the ECog domains in older adults with MCI/dementia than in cognitively normal elderly. (JINS, 2013, 19, 1–12)
Metamemory in Temporal Lobe Epilepsy: A Study of Sensitivity to Repetition at Encoding

Abstract The purpose of the current study was to determine whether the level of metacognitive sensitivity previously observed in global Judgments-of-Learning (JOLs) in temporal lobe epilepsy (TLE) patients could also be established when making item-by-item JOLs. Fourteen TLE patients and 14 control participants were compared on a memory task where 39 semantically unrelated word pairs were presented at three different levels of repetition. Thirteen word pairs were assigned to each level. A combined JOL and Feeling-of-Knowing (FOK) task was used to examine metamemory monitoring and control processes. The results showed that control participants outperformed TLE patients on recall and recognition. However, both groups were sensitive to repetition of the word pairs throughout the list, revealing intact online monitoring and control processes at encoding. These results are consistent with the findings of Howard et al. (2010) of intact metamemory in TLE patients and extend the findings of Andrés et al. (2010) of metamemory sensitivity from the global level to the item-by-item level. Finally, the current findings provide additional evidence of a dissociation between memory and metamemory in TLE patients. (JINS, 2013, 19, 1–10)
Prepulse Inhibition in HIV-Associated Neurocognitive Disorders

Abstract Sensorimotor inhibition, or the ability to filter out excessive or irrelevant information, theoretically supports a variety of higher-level cognitive functions. Impaired inhibition may be associated with increased impulsive and risky behavior in everyday life. Individuals infected with HIV frequently show impairment on tests of neurocognitive function, but sensorimotor inhibition in this population has not been studied and may be a contributor to the profile of HIV-associated neurocognitive disorders (HAND). Thirty-seven HIV-infected individuals (15 with HAND) and 48 non-infected comparison subjects were assessed for prepulse inhibition (PPI), an eyeblink startle paradigm measuring sensorimotor gating. Although HIV status alone was not associated with PPI deficits, HIV-positive participants meeting criteria for HAND showed impaired PPI compared to cognitively intact HIV-positive subjects. In HIV-positive subjects, PPI was correlated with working memory but was not associated with antiretroviral therapy or illness factors. In conclusion, sensorimotor disinhibition in HIV accompanies deficits in higher-order cognitive functions, although the causal direction of this relationship requires investigation. Subsequent research on the role of sensorimotor gating on decision-making and risk behaviors in HIV may be indicated. (JINS, 2013, 19, 1–9)
Overuse of Imaging the Male Breast—Findings in 557 Patients

Gynecomastia is the most common abnormality of the male breast. However, breast cancer may occur, albeit with a significantly lower incidence than in females. Imaging is often used as part of the diagnosis. The aim of this study was to assess the utilization and outcome of imaging with mammography or ultrasound of the male breast in a university hospital's department of radiology. A retrospective study assessing the imaging of the male breast in 557 patients over a 10‐year period. Referral was done mainly by general surgeons and general practitioners. The most common indication was enlargement of the breast, described as gynecomastia or swelling in 74% of patients, followed by pain in 24% and “lumps” in 10%. The modalities used were mammography in 65%, ultrasound in 51% and both in 26%. Most examinations, 519, were BI‐RADS 1 or 2, and 38 were BI‐RADS 3 or higher. Altogether 160 patients had additional fine‐needle aspiration or biopsy. Malignancies were diagnosed in five patients (0.89%). Imaging had a sensitivity of 80% and a specificity of 99%. The positive predictive value was 44% and the negative predictive value 99.8%. Malignancies are rare in the male breast. The probability of finding cancer when performing imaging of clinically benign findings in the male breast is negligible. Imaging is not warranted unless there are suspicious abnormalities. Routine imaging of gynecomastia should be discouraged.
Attention Difficulties in a Contemporary Geographic Cohort of Adolescents Born Extremely Preterm/Extremely Low Birth Weight

Abstract The aim of this study was to evaluate attention difficulties in a contemporary geographic cohort of adolescents born extremely preterm (EP, <28 weeks’ gestation) or extremely low birth weight (ELBW, birth weight <1000 g). The EP/ELBW group included 228 adolescents (mean age = 17.0 years) born in Victoria, Australia in 1991 and 1992. The control group were 166 adolescents (mean age = 17.4 years) born of normal birth weight (birth weight >2499 g) who were recruited in the newborn period and matched to the EP/ELBW group on date of birth, gender, language spoken and health insurance status. Participants were assessed on measures of selective, sustained, and executive (shift and divided) attention, and parents and participants completed behavioral reports. The EP/ELBW group performed more poorly across tests of selective and executive attention, had greater rates of clinically significant difficulties compared with the control group, and also had greater behavioral attention problems as reported by parents. Neonatal risk factors were weakly associated with attention outcomes. In conclusion, higher rates of attention impairments are observed in individuals born EP/ELBW well into adolescence and may have consequences for their transition to adulthood. (JINS, 2013, 19, 1–12)
Asymmetric Attention Networks: The Case of Children

Abstract Visuospatial attention-networks are represented in both hemispheres, with right-hemisphere dominance in adults. Little is known about the lateralization of the attentional-networks in children. To assess the lateralization of attentional-networks in children aged 5 years, performance on a Lateralized-Attention-Network-Test specifically designed for children (LANT-C) was compared with performance on the Attention-Network-Test for children (ANT-C). Participants were 82 children, aged 5–6 years (55% boys, middle–class, mainstream schooling). They were examined with both the ANT-C and the LANT-C along with evaluation of intelligence and attention questionnaires. Multiple analysis of variance showed a main effect for network, with high efficiency for orienting and lower executive efficiency (accuracy; p < .001; η2 = .282). An effect for procedure, elucidated higher efficiency in the ANT-C relatively to the LANT-C (accuracy; p < .01; η2 = .097). A procedure × network interaction effect was also found, showing that this procedure difference is present in the alerting and executive networks (accuracy; p < .05; η2 = .096). LANT-C analysis showed a left visual-field advantage in alerting, (accuracy; p < .05; η2 = .066), while executing with the right hand benefitted executive performance (response-time; p < .05; η2 = .06). Results extend previous findings manifesting a right-hemisphere advantage in children's alerting-attention, pointing to the importance of lateralization of brain function to the understanding of the integrity of attention-networks in children. (JINS, 2014, 20, 1–10)
Dietitians and caterers: an uncertain but critical relationship

Within health care, the occupations of catering officer and dietitian stem from the same root – nursing. However, despite this common base, dietitians have recorded working tensions between these two groups. As caterers and dietitians are both responsible for ensuring the provision of nutritionally adequate and appetising food, their successful collaboration is essential to successful patient feeding. A qualitative study was undertaken to account for the values, ideals and beliefs brought to their practice. A small purposive sample of caterers and dietitians were interviewed to elucidate their views on the importance of their chosen occupation to them. The interviews were recorded and verbatim transcripts made. The content was analysed manually using a grounded theory approach, so that key issues emerged from the interviews per se. These themes – qualification, motivation, reality, constraints and perceptions – provide the basis for describing differing value systems underpinning practice, and highlighting significant interprofessional issues for caterers and dietitians.
Disrupted Structural Connectome Is Associated with Both Psychometric and Real-World Neuropsychological Impairment in Diffuse Traumatic Brain Injury

Abstract Traumatic brain injury (TBI) is likely to disrupt structural network properties due to diffuse white matter pathology. The present study aimed to detect alterations in structural network topology in TBI and relate them to cognitive and real-world behavioral impairment. Twenty-two people with moderate to severe TBI with mostly diffuse pathology and 18 demographically matched healthy controls were included in the final analysis. Graph theoretical network analysis was applied to diffusion tensor imaging (DTI) data to characterize structural connectivity in both groups. Neuropsychological functions were assessed by a battery of psychometric tests and the Frontal Systems Behavior Scale (FrSBe). Local connection-wise analysis demonstrated reduced structural connectivity in TBI arising from subcortical areas including thalamus, caudate, and hippocampus. Global network metrics revealed that shortest path length in participants with TBI was longer compared to controls, and that this reduced network efficiency was associated with worse performance in executive function and verbal learning. The shortest path length measure was also correlated with family-reported FrSBe scores. These findings support the notion that the diffuse form of neuropathology caused by TBI results in alterations in structural connectivity that contribute to cognitive and real-world behavioral impairment. (JINS, 2014, 20, 1–10)
Exercise capacity and cardiovascular changes in patients with β‐thalassaemia major

Despite the introduction of deferoxamine, 50% of thalassaemia major patients die before the age of 35 years predominantly from iron induced heart failure. Indeed, the assessment of myocardial performance may be of particular interest since it can reveal an early myocardial dysfunction. By using impedance cardiography and mass spectrometry, we studied the cardiac function and the oxygen extraction ratio (O2ER) of 14 thalassaemic patients and 15 control healthy subjects during an incremental cycle‐ergometer test. The achieved mechanical power output and the relative O2 uptake did not reach any significant difference between groups. At the highest workload, O2ER reached significantly higher values in thalassaemic patients versus control subjects while the relationship between cardiac index (CI) and O2ER (CI/O2ER) decreased showing a lower contribution of cardiovascular system to maintain O2 uptake. Results of this study imply that CI/O2ER allows an early diagnosis of the iron induced myocardial dysfunction, whereas it is not clinically patent yet. To our knowledge, this is the first study revealing an O2ER pivotal role as compensatory mechanism to maintain a normal working capacity in subjects suffering from thalassaemia major.
Breast MRI in Invasive Lobular Carcinoma: A Useful Investigation in Surgical Planning?

Magnetic resonance imaging (MRI) is highly sensitive in detecting invasive lobular carcinoma (ILC) of the breast. In our institution, patients who are deemed to be suitable for breast conserving surgery (BCS) with unifocal small ILC on standard imaging are offered breast MRI to exclude multifocal and larger ILC. Our study investigates the usefulness of breast MRI in ILC. A prospective cohort study over a 58‐month period, including all consecutive patients with ILC having breast MRI. Primary objective was to find out the proportion of ILC patients where preoperative MRI caused a change in the surgical treatment. Secondary objectives included finding mastectomy rate (initial & final), re‐operation rate, cancer size correlation with different imaging modalities and final histopatholgy, loco‐regional recurrence and disease‐free survival. A total of 334 bilateral breast MRI were performed including 72 (21.5%) MRI for ILC patients. All these MRI were carried out within 2 week of patients given the diagnosis (median 5.5 days). Age range was 24–83 (median 56.5) years. Nineteen of 72 ILC patients (26.4%) had a change in their planned operation from BCS to a different operation owing to MRI findings (seven patients with multifocal cancers, 10 with significantly larger size of the cancer and two with contralateral malignancy). Initial mastectomy rate was 31.9%, final mastectomy rate was 36.1% and re‐operation rate in BCS group was 18.3%. MRI correlated better with ILC histopathology cancer size than mammogram and ultrasound scans. There was no statistically significant difference (p = 0.999) between the cancer size on histology (median 23 mm) and MRI (median 25 mm). However, mammogram (median 17 mm) and ultrasound (median 14.5 mm) scans showed cancer sizes significantly different to final histology cancer size (p = 0.0008 and p = 0.0021 respectively). Over a 44 months median follow‐up (range 27–85), 95.8% disease‐free survival and 98.6% overall survival have been observed. One out of every four patients (26.4%) with ILC had a change in their planned operation due to MRI findings. A relatively high disease‐free survival over a medium‐term follow‐up proves the oncological safety of MRI in ILC. Our study provides evidence in support of the targeted use of preoperative breast MRI among patients with ILC to improve surgical planning.
Quality of Life Following Symptomatic Macromastia Surgery: Short‐ and Long‐term Evaluation

Mammary hypertrophy or macromastia can cause a wide range of symptoms (physical, psychosomatic or behavioral), which affect patients’ quality of life. Breast reduction can, in most of the cases, solve the problem. However, certain factors could have a negative effect on the outcome of surgery. The aims of this study were to discover the degree of patient satisfaction (short‐ and long‐term) and to evaluate results of reduction mammoplasty, and also to ascertain which factors may have a negative role on the effectiveness of breast reduction surgery. We carried out a prospective and longitudinal study of 121 patients who underwent breast reduction surgery. Quality of life, outcome of surgery (complications and sequelae) and degree of patient satisfaction were evaluated at 1 month and at 1 year after reduction mammoplasty. Mean patient age was 40.71 (SD = 12.02). Among them, 35.5% were overweight, 44.6% were obese and 34.7% were smokers. The most common symptom was pain. The mean amount of resected breast tissue was 1785 g (SD = 876). A total of 27.3% of the patients suffered complications and 30.60% suffered sequelae. Our results show an improvement in symptoms (p < 0.001) and quality of life (p < 0.001 to p = 0.002) 1 month after and 1 year after breast reduction compared with the preoperative situation. Neither age, body mass index, smoking habit nor the amount of tissue removed had a negative effect on the results of surgery. One year after surgery, the majority of patients were satisfied with the outcome (96.6%), they would recommend it to others (96.6%), and they would undergo surgery a second time (95.8%). Conclusions: Breast reduction is highly efficient in resolving symptoms and in improving quality of life. It leads to a high level of short‐ and long‐term satisfaction irrespective of each patient's individual characteristics.
Salience and Default Mode Network Coupling Predicts Cognition in Aging and Parkinson’s Disease

Abstract Objectives: Cognitive impairment is common in Parkinson’s disease (PD). Three neurocognitive networks support efficient cognition: the salience network, the default mode network, and the central executive network. The salience network is thought to switch between activating and deactivating the default mode and central executive networks. Anti-correlated interactions between the salience and default mode networks in particular are necessary for efficient cognition. Our previous work demonstrated altered functional coupling between the neurocognitive networks in non-demented individuals with PD compared to age-matched control participants. Here, we aim to identify associations between cognition and functional coupling between these neurocognitive networks in the same group of participants. Methods: We investigated the extent to which intrinsic functional coupling among these neurocognitive networks is related to cognitive performance across three neuropsychological domains: executive functioning, psychomotor speed, and verbal memory. Twenty-four non-demented individuals with mild to moderate PD and 20 control participants were scanned at rest and evaluated on three neuropsychological domains. Results: PD participants were impaired on tests from all three domains compared to control participants. Our imaging results demonstrated that successful cognition across healthy aging and Parkinson’s disease participants was related to anti-correlated coupling between the salience and default mode networks. Individuals with poorer performance scores across groups demonstrated more positive salience network/default-mode network coupling. Conclusions: Successful cognition relies on healthy coupling between the salience and default mode networks, which may become dysfunctional in PD. These results can help inform non-pharmacological interventions (repetitive transcranial magnetic stimulation) targeting these specific networks before they become vulnerable in early stages of Parkinson’s disease. (JINS, 2016, 22, 205–215)
Chronic Mastitis in Egypt and Morocco: Differentiating between Idiopathic Granulomatous Mastitis and IgG4‐Related Disease

Idiopathic granulomatous mastitis (IGM) is a benign, frequently severe chronic inflammatory lesion of the breast. Its etiology remains unknown and reported cases vary in their presentation and histologic findings with an optimal treatment algorithm yet to be described owing mainly to the disease's heterogeneity. IgG4‐related disease (IgG4‐RD) is a newly recognized systemic fibroinflammatory condition characterized by a dense lymphoplasmacytic infiltrate with many IgG4‐positive plasma cells, storiform fibrosis, and obliterative phlebitis. Immunosuppressive therapy is considered to be an effective first‐line therapy for IgG4‐RD. We sought to clarify and classify chronic mastitis according to the histologic findings of IgG4‐RD mastitis with respect to IGM and to develop a robust diagnostic framework to help select patients for optimal treatment strategies. Using the largest collection to date (43 cases from Egypt and Morocco), we show that despite sharing many features, IGM and IgG4‐RD mastitis are separate diseases. To diagnostically separate the diseases, we created a classification schema—termed the Michigan Classification—based upon our large series of cases, the consensus statement on IgG4‐RD, and the histologic description of IGM in the literature. Using our classification, we discerned 17 cases of IgG4‐RD and 8 cases of IGM among the 43 chronic mastitis cases, with 18 indeterminate cases. Thus, our Michigan Classification can form the basis of rational stratification of chronic mastitis patients between these two clinically and histopathologically heterogeneous diseases.