bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automated deep learning segmentation of high-resolution 7 Tesla
postmortem MRI for quantitative analysis of structure-pathology correlations in
neurodegenerative diseases
Authors: Khandelwal Pulkit , Duong Michael Tran , Sadaghiani Shokufeh , Lim Sydney , Denning Amanda E. , Chung Eunice , Ravikumar Sadhana , Arezoumandan Sanaz , Peterson Claire , Bedard Madigan , Capp Noah , Ittyerah Ranjit , Migdal Elyse , Choi Grace , Kopp Emily , Loja Bridget , Hasan Eusha , Li Jiacheng , Bahena Alejandra , Prabhakaran Karthik , Mizsei Gabor , Gabrielyan Marianna , Schuck Theresa , Trotman Winifred , Robinson John , Ohm Daniel T. , Lee Edward B. , Trojanowski John Q. , McMillan Corey , Grossman Murray , Irwin David J. , Detre John A. , Tisdall M. Dylan , Das Sandhitsu R. , Wisse Laura E. M. , Wolk David A. , Yushkevich Paul A. 
Published: April 2024

Abstract
Postmortem MRI allows brain anatomy to be examined at high resolution and to link pathology measures with morphometric measurements. However, automated segmentation methods for brain mapping in postmortem MRI are not well developed, primarily due to limited availability of labeled datasets, and heterogeneity in scanner hardware and acquisition protocols. In this work, we present a high-resolution dataset of 135 postmortem human brain tissue specimens imaged at 0.3 mm3 isotropic using a T2w sequence on a 7T whole-body MRI scanner. We developed a deep learning pipeline to segment the cortical mantle by benchmarking the performance of nine deep neural architectures, followed by post-hoc topological correction. We evaluate the reliability of this pipeline via overlap metrics with manual segmentation in 6 specimens, and intra-class correlation between cortical thickness measures extracted from the automatic segmentation and expert-generated reference measures in 36 specimens. We also segment four subcortical structures (caudate, putamen, globus pallidus, and thalamus), white matter hyperintensities, and the normal appearing white matter, providing a limited evaluation of accuracy. We show generalizing capabilities across whole-brain hemispheres in different specimens, and also on unseen images acquired at 0.28 mm3 and 0.16 mm3 isotropic T2*w fast low angle shot (FLASH) sequence at 7T. We report associations between localized cortical thickness and volumetric measurements across key regions, and semi-quantitative neuropathological ratings in a subset of 82 individuals with Alzheimer’s disease (AD) continuum diagnoses. Our code, Jupyter notebooks, and the containerized executables are publicly available at the project webpage (https://pulkit-khandelwal.github.io/exvivo-brain-upenn/).
Functional MR elastography measures visual cortex stiffening proportional to visual contrast intensity in regions of activation
Authors: Palnitkar Harish R. , Murphy Matthew C. , Sui Yi , Glaser Kevin J. , Manduca Armando , Welker Kirk M. , Campeau Norbert , Huston John , Ehman Richard L. , Arani Arvin 
Published: April 2024

Abstract
Functional MRI (fMRI) is widely used to spatially localize neural activity in the brain associated with functional stimuli. Functional MR Elastography (fMRE) has recently been introduced as a complementary approach that measures the mechanical response to functional stimulus. The hypothesis of the current study is that the stiffness change in fMRE is proportional to the underlying neural activity. This hypothesis is tested by measuring the median stiffness change in the visual cortex as a function of luminance-matched contrast intensity of a checkerboard visual stimulus in 16 healthy subjects. The fMRE signal in the visual cortex was observed to be proportional to the contrast intensity of the visual stimulus. In regions of activation, fMRE signal increased in the range of 2 ± 1% to 5.8 ± 1% and fMRI signal increased by the expected 0.4 ± 0.2% to 0.9 ± 0.2%, for contrast levels of 5% to 100%, respectively. In conclusion, this study shows that the fMRE signal in the visual cortex can be directly modulated by the contrast intensity of a visual stimulus. The presence of some overlap between fMRI and fMRE regions of activation may suggest two distinct mechanisms governing the fMRI and fMRE signals, which will be investigated in future studies.
Perceptual Expectations Are Reflected by Early Alpha Power Reduction
Authors: Sáringer Szabolcs , Fehér Ágnes , Sáry Gyula , Kaposvári Péter 
Published: April 2024

Abstract
The predictability of a stimulus can be characterized by its transitional probability. Perceptual expectations derived from the transitional probability of the stimulus were found to modulate the early alpha oscillations in the sensory regions of the brain when neural responses to expected versus unexpected stimuli were compared. The objective of our study was to find out the extent to which this low-frequency oscillation reflects stimulus predictability. We aimed to detect the alpha-power difference with smaller differences in transitional probabilities by comparing expected stimuli with neutral ones. We studied the effect of expectation on perception by applying an unsupervised visual statistical learning paradigm with expected and neutral stimuli embedded in an image sequence while recording EEG. Time–frequency analysis showed that expected stimuli elicit lower alpha power in the window of 8–12 Hz and 0–400 msec after stimulus presentation, appearing in the centroparietal region. Comparing previous findings of expectancy-based alpha-band modulation with our results suggests that early alpha oscillation shows an inverse relationship with stimulus predictability. Although current data are insufficient to determine the origin of the alpha power reduction, this could be a potential sign of expectation suppression in cortical oscillatory activity.
Mechanical ventilation during extracorporeal membrane oxygenation support – New trends and continuing challenges
Authors: Szuldrzynski Konstanty , Kowalewski Mariusz , Swol Justyna 
Published: April 2024

Background The impact of mechanical ventilation on the survival of patients supported with veno-venous extracorporeal membrane oxygenation (V-V ECMO) due to severe acute respiratory distress syndrome (ARDS) remains still a focus of research Methods Recent guidelines, randomized trials, and registry data underscore the importance of lung-protective ventilation during respiratory and cardiac support on ECMO. Results This approach includes decreasing mechanical power delivery by reducing tidal volume and driving pressure as much as possible, using low or very low respiratory rate, and a personalized approach to positive-end expiratory pressure (PEEP) setting. Notably, the use of ECMO in awake and spontaneously breathing patients is increasing, especially as a bridging strategy to lung transplantation. During respiratory support in V-V ECMO, native lung function is of highest importance and adjustments of blood flow on ECMO, or ventilator settings significantly impact the gas exchange. These interactions are more complex in veno-arterial (V-A) ECMO configuration and cardiac support. The fraction on delivered oxygen in the sweep gas and sweep gas flow rate, blood flow per minute, and oxygenator efficiency have an impact on gas exchange on device side. On the patient side, native cardiac output, native lung function, carbon dioxide production (VCO2), and oxygen consumption (VO2) play a role. Avoiding pulmonary oedema includes left ventricle (LV) distension monitoring and prevention, pulse pressure >10 mm Hg and aortic valve opening assessment, higher PEEP adjustment, use of vasodilators, ECMO flow adjustment according to the ejection fraction, moderate use of inotropes, diuretics, or venting strategies as indicated and according to local expertise and resources Conclusion Understanding the physiological principles of gas exchange during cardiac support on femoro-femoral V-A ECMO configuration and the interactions with native gas exchange and haemodynamics are essential for the safe applications of these techniques in clinical practice. Proning during ECMO remains to be discussed until further data is available from prospective, randomized trials implementing individualized PEEP titration during proning.
Footprint Elevation and Fullness of the Upper Pole of the Breast in Free-Style Reduction Mammaplasty Procedures
Authors: Elmelegy Nader 
Published: April 2024

Background: Despite the significant advances in the reduction mammaplasty fields, they all have drawbacks. A persistent lack of fullness in the upper pole was observed after 6 to 8 months in most of the instances given by the pioneers. The author’s goal was to enhance the cosmetic aspect of the breast and to achieve this goal; they searched for a superior approach that could provide upper pole fullness over the long term. Patients and methods: The project aimed to achieve all the other objectives of breast reduction while also enhancing the footprint elevation and fullness of the upper pole in free-style reduction mammaplasty surgeries. This study was carried out on 117 patients between February 2015 and July 2021. Results: In this study, the upper breast border produced an esthetically acceptable upper border in 114 (97.4%) cases for 2 to 7 years, whereas the outcomes were unsatisfactory for 4 patients (2.6%). Conclusions: The second rib, the second intercostal space, the third rib, the third intercostal space, or more are the possible starting levels of the upper border of the breast footprint. By severing the superior breast ligament and attaching the medial and lateral pillars to the pectoral fascia at the level of the second rib, the upper border of the breast can be stably elevated. Level of Evidence: IV therapeutic
Effect of single-radius design on in vivo kinematics during stair activities after total knee arthroplasty
Authors: Kono Kenichi , Yamazaki Takaharu , Tamaki Masashi , Ishibashi Teruya , Tanaka Sakae , Tomita Tetsuya 
Published: April 2024

Background The single-radius design is one of the major total knee arthroplasty (TKA) designs and widely used all over the world. The objective of this study was to compare in vivo kinematics between the anteroposterior (AP) single-radius design with mediolateral (ML) single-radius (Non Restricted Geometry; NRG) and ML dual-radius (Triathlon) during stair activities. Methods A total of 21 knees in 18 patients (NRG group: 10 knees in 7 patients, Triathlon group: 11 knees in 11 patients) with a clinically successful posterior stabilized TKA were examined. Under fluoroscopic surveillance, each patient performed stair ascending and descending motions. In vivo kinematics were analyzed using 2D/3D registration technique. The knee flexion angle, rotation angle, varus-valgus angle, AP translation of the femorotibial contact point for both the medial and lateral sides of the knee, and post-cam engagement were evaluated. Results There were no significant differences between the two groups in rotation angle and AP translation at each flexion angle. Examining the varus-valgus angle, the NRG group showed varus position at an early flexion angle during both stair activities. Post-cam engagement was observed in both groups during both stair activities. The mean flexion angle of engagement in the NRG group, the post of which was located anterior to the Triathlon, was larger than that in the Triathlon group during both stair activities. Conclusion Despite the same AP single-radius TKA, ML single-radius might affect varus motion at an early flexion angle.
Strategic white matter hyperintensity locations associated with post-stroke cognitive impairment: A multicenter study in 1568 stroke patients
Authors: Coenen Mirthe , de Kort Floor AS , Weaver Nick A , Kuijf Hugo J , Aben Hugo P , Bae Hee-Joon , Bordet Régis , Chen Christopher PLH , Dewenter Anna , Doeven Thomas , Dondaine Thibaut , Duering Marco , Fang Rong , van der Giessen Ruben S , Kim Jonguk , Kim Beom Joon , de Kort Paul LM , Koudstaal Peter J , Lee Minwoo , Lim Jae-Sung , Lopes Renaud , van Oostenbrugge Robert J , Staals Julie , Yu Kyung-Ho , Biessels Geert Jan , Biesbroek J Matthijs 
Published: April 2024

Background: Post-stroke cognitive impairment (PSCI) occurs in up to 50% of stroke survivors. Presence of pre-existing vascular brain injury, in particular the extent of white matter hyperintensities (WMH), is associated with worse cognitive outcome after stroke, but the role of WMH location in this association is unclear. Aims: We determined if WMH in strategic white matter tracts explain cognitive performance after stroke. Methods: Individual patient data from nine ischemic stroke cohorts with magnetic resonance imaging (MRI) were harmonized through the Meta VCI Map consortium. The association between WMH volumes in strategic tracts and domain-specific cognitive functioning (attention and executive functioning, information processing speed, language and verbal memory) was assessed using linear mixed models and lasso regression. We used a hypothesis-driven design, primarily addressing four white matter tracts known to be strategic in memory clinic patients: the left and right anterior thalamic radiation, forceps major, and left inferior fronto-occipital fasciculus. Results: The total study sample consisted of 1568 patients (39.9% female, mean age = 67.3 years). Total WMH volume was strongly related to cognitive performance on all four cognitive domains. WMH volume in the left anterior thalamic radiation was significantly associated with cognitive performance on attention and executive functioning and information processing speed and WMH volume in the forceps major with information processing speed. The multivariable lasso regression showed that these associations were independent of age, sex, education, and total infarct volume and had larger coefficients than total WMH volume. Conclusion: These results show tract-specific relations between WMH volume and cognitive performance after ischemic stroke, independent of total WMH volume. This implies that the concept of strategic lesions in PSCI extends beyond acute infarcts and also involves pre-existing WMH. Data access statement: The Meta VCI Map consortium is dedicated to data sharing, following our guidelines.
The AHA/ASA and DSM-V diagnostic criteria for vascular cognitive impairment identify cases with predominant vascular pathology
Authors: Folloso Melmar C , Villaraza Steven G , Yi-Wen Lo , Pek-Lan Khong , Tanaka Tomotaka , Hilal Saima , Venketasubramanian Narayanaswamy , Li-Hsian Chen Christopher 
Published: April 2024

Background: There are major challenges in determining the etiology of vascular cognitive impairment (VCI) clinically, especially in the presence of mixed pathologies, such as vascular and amyloid. Most recently, two criteria (American Heart Association/American Stroke Association (AHA/ASA) and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)) have been proposed for the clinical diagnosis of VCI but have not as yet been validated using neuroimaging. Aims: This study aims to determine whether the AHA/ASA and DSM-V criteria for VCI can distinguish between cases with predominantly vascular pathology and cases with mixed pathology. Methods: A total of 186 subjects were recruited from a cross-sectional memory clinic–based study at the National University Hospital, Singapore. All subjects underwent clinical and neuropsychological assessment, magnetic resonance imaging (MRI) and carbon 11-labeled Pittsburgh Compound B ([11C] PiB) positron emission tomography (PET) scans. Diagnosis of the etiological subtypes of VCI (probable vascular mild cognitive impairment (VaMCI), possible VaMCI, non-VaMCI, probable vascular dementia (VaD), possible VaD, non-VaD) were performed following AHA/ASA and DSM-V criteria. Brain amyloid burden was determined for each subject with standardized uptake value ratio (SUVR) values ⩾1.5 classified as amyloid positive. Results: Using κ statistics, both criteria had excellent agreement for probable VaMCI, probable VaD, and possible VaD (κ = 1.00), and good for possible VaMCI (κ = 0.71). Using the AHA/ASA criteria, the amyloid positivity of probable VaMCI (3.8%) and probable VaD (15%) was significantly lower compared to possible VaMCI (26.7%), non-VaMCI (33.3%), possible VaD (73.3%), and non-VaD (76.2%) (p < 0.001). Similarly, using the DSM-V criteria, the amyloid positivity of probable VaMCI (3.8%) and probable VaD (15%) was significantly lower compared to possible VaMCI (26.3%), non-VaMCI (32.1%), possible VaD (73.3%), and non-VaD (76.2%) (p < 0.001). In both criteria, there was good agreement in differentiating individuals with non-VaD and possible VaD, with significantly higher (p < 0.001) global [11C]-PiB SUVR, from individuals with probable VaMCI and probable VaD, who had predominant vascular pathology. Conclusion: The AHA/ASA and DSM-V criteria for VCI can identify VCI cases with little to no concomitant amyloid pathology, hence supporting the utility of AHA/ASA and DSM-V criteria in diagnosing patients with predominant vascular pathology. Data access statement: Data supporting this study are available from the Memory Aging and Cognition Center, National University of Singapore. Access to the data is subject to approval and a data sharing agreement due to University policy.
Diagnostic Evaluation of Autism Spectrum Disorder in Pediatric Primary Care
Authors: Nasir Arwa K. , Strong-Bak Whitney , Bernard Marie 
Published: April 2024

Background and Objectives: Children with autism spectrum disorder (ASD) continue to experience significant delays in diagnosis and interventions. One of the main factors contributing to this delay is a shortage of developmental-behavioral specialists. Diagnostic evaluation of ASD by primary care pediatricians (PCPs) has been shown to be reliable and to decrease the interval from first concern to diagnosis. In this paper, we present the results of a primary care ASD diagnosis program in which the PCP serves as the primary diagnostician and leverages the infrastructure of the primary care medical home to support the child and family during the pre- and post-diagnostic periods, along with data on parental satisfaction with this model. Methods: Retrospective data from a cohort of patients evaluated through this program were analyzed to determine the mean age at diagnosis and interval from referral for evaluation to diagnosis. We used survey methodology to obtain data from parents regarding their satisfaction with the process. Results: Data from 8 of 20 children evaluated from April 2021 through May 2022 showed a median age of diagnosis of 34.5 months compared to the national average of 49 months. Mean interval from referral for evaluation to diagnosis was 3.5 months. Parental survey responses indicated high satisfaction. Conclusions: This model was successful in shortening the interval from referral to diagnosis resulting in significant decrease of age at diagnosis compared with the national average. Widespread implementation could improve access to timely diagnostic services and improve outcomes for children with ASD.
Determination of Compassion and Compassion Fatigue in Intensive Care Nurses
Authors: Özan Ahmet , Polat Hatice 
Published: April 2024

Introduction Compassion is defined as the sadness felt by a living thing or a person due to a negative situation. Compassion fatigue describes emotional, physical, social and spiritual exhaustion or a decrease in these feelings. The concept of compassion, which is at the center of nursing, may be related to compassion fatigue in nurses. Objective The aims of the study were to determine the level of compassion fatigue and compassion among intensive care nurses and to examine the relationship between them. Methods This study was conducted through descriptive research and cross-sectional survey. The population of the research consisted of intensive care nurses from two hospitals in Turkey. Since the universe is accessible, the sample selection method was not used ( n = 182). Demographic data form, Compassion Fatigue sub-dimension of the Professional Quality of Life Scale and Compassion Scale were used in the study. Results The mean score of the nurses’ compassion fatigue was 15.86 ± 7.22, and compassion was 72.21 ± 7.28. There was a moderate negative relationship between compassion and compassion fatigue ( r = −.405). It was determined that the nurses’ compassion was at a moderate level and their compassion fatigue was at a low level. Conclusion It can be assumed that ICU nurses’ compassion is at a medium level and their compassion fatigue is at a low level. It was established that as the compassion level of the nurses increased, the level of compassion fatigue decreased. Developing a sense of compassion in nurses working in intensive care units can reduce compassion fatigue.
Clonal hematopoiesis of indeterminate potential in patients with immunoglobulin light-chain AL amyloidosis
Authors: Lopedote Paolo , Evans Benjamin , Marchetti Alfredo , Chen Tianzeng , Moscvin Maria , Boullt Samuel , Bolli Niccolò , Bianchi Giada 
Published: April 2024

Abstract
Immunoglobulin light-chain (AL) amyloidosis is characterized by the deposition of misfolded monoclonal free light chains, with cardiac complications accounting for patient mortality. Clonal hematopoiesis of indeterminate potential (CHIP) has been associated with worse cardiovascular outcomes in the general population. Its significance in AL amyloidosis remains unclear. We collected clinical information and outcome data on 76 patients with a diagnosis of AL amyloidosis who underwent deep targeted sequencing for myeloid neoplasia–associated mutations between April 2018 and August 2023. Variant allele frequency was set at 2% to call CHIP-associated mutations. CHIP mutations were present in patients with AL amyloidosis at a higher frequency compared with age-matched control individuals. Sixteen patients (21%) had at least 1 CHIP mutation. DNMT3A was the most frequent mutation (7/16; 44%). Compared with patients without CHIP, patients with CHIP had a higher prevalence of t(11;14) translocation (69% vs 25%, respectively; P = .004). Furthermore, among patients with renal involvement, those with CHIP had a lower Palladini renal stage (P = .001). At a median follow-up of 32.5 months, the presence of CHIP was not associated with worse overall survival or major organ dysfunction progression-free survival. Larger studies and longer follow-up are needed to better define the impact of CHIP in patients with AL amyloidosis.