bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhanced Conduit Flow Compensates for the Reduction in Left Atrial Passive and Booster Functions in Advanced Diastolic Dysfunction
Authors: Aronson Doron , Sliman Hend , Abadi Sobhi , Maiorov Ida , Perlow Daniel , Mutlak Diab , Lessick Jonathan 
Published: August 2023

AbstractBackgroundQuantification of left atrial (LA) conduit function and its contribution to left ventricular (LV) filling is challenging because it requires simultaneous measurements of both LA and LV volumes. The functional relationship between LA conduit function and the severity diastolic dysfunction remains controversial. We studied the role of LA conduit function in maintaining LV filling in advanced diastolic dysfunction.MethodsWe performed volumetric and flow analyses of LA function across the spectrum of LV diastolic dysfunction, derived from a set of consecutive patients undergoing multiphasic cardiac CT scanning (n=489). From LA and LV time-volume curves we calculated 3 volumetric components: 1) early “passive” emptying volume; 2) late “active” (booster) volume; and 3) conduit volume. Results were prospectively validated on a group of patients with severe aortic stenosis (n=110).ResultsThe early passive filling progressively decreased with worsening diastolic function (P<0.0001). The atrial booster contribution to stroke volume (SV) modestly increases in impaired relaxation (P<0.05) and declined with more advanced diastolic function (P<0.001), thus failing to compensate for the reduction in early filling. The conduit volume increased progressively (P<0.0001), accounting for 75% of SV (IQR 63–81%) with restrictive filling pattern, compensating for the reduction in both early and booster functions. Similar results were obtained in patients with severe aortic stenosis. The pulmonary artery systolic pressure increased in a near-linear fashion when the conduit contribution to SV increased above 60%. Maximal conduit flow rate strongly correlated with mitral E-wave velocity (r=0.71,P<0.0001), indicating that the increase in mitral E-wave in diastolic dysfunction represents the increased conduit flow.ConclusionAn increase in conduit volume contribution to SV represents a compensatory mechanism to maintain LV filling in advanced diastolic dysfunction. The increase in conduit volume despite increasing LV diastolic pressures is accomplished by an increase in pulmonary venous pressure.
Edge Artificial Intelligence for real-time automatic quantification of filariasis in mobile microscopy
Authors: Lin Lin , Dacal Elena , Díez Nuria , Carmona Claudia , Ramirez Alexandra Martin , Argos Lourdes Barón , Bermejo-Peláez David , Caballero Carla , Cuadrado Daniel , Darias Oscar , García-Villena Jaime , Bakardjiev Alexander , Postigo Maria , Recalde-Jaramillo Ethan , Flores-Chavez Maria , Santos Andrés , Ledesma-Carbayo María Jesús , Rubio José M. , Luengo-Oroz Miguel 
Published: August 2023

AbstractFilariasis, a neglected tropical disease caused by roundworms, is a significant public health concern in many tropical countries. Microscopic examination of blood samples can detect and differentiate parasite species, but it is time consuming and requires expert microscopists, a resource that is not always available. In this context, artificial intelligence (AI) can assist in the diagnosis of this disease by automatically detecting and differentiating microfilarias. In line with the target product profile for lymphatic filariasis as defined by the World Health Organization, we developed an edge AI system running on a smartphone whose camera is aligned with the ocular of an optical microscope that detects and differentiates filarias species in real time without the internet connection. Our object detection algorithm that uses the Single-Shot Detection (SSD) MobileNet V2 detection model was developed with 115 cases, 85 cases with 1903 fields of view and 3342 labels for model training, and 30 cases with 484 fields of view and 873 labels for model validation before clinical validation, is able to detect microfilarias at 10x magnification and distinguishes four species of them at 40x magnification:Loa loa, Mansonella perstans, Wuchereria bancrofti, andBrugia malayi. We validated our augmented microscopy system in the clinical environment by replicating the diagnostic workflow encompassed examinations at 10x and 40x with the assistance of the AI models analyzing 18 samples with the AI running on a middle range smartphone. It achieved an overall precision of 94.14%, recall of 91.90% and F1 score of 93.01% for the screening algorithm and 95.46%, 97.81% and 96.62% for the species differentiation algorithm respectively. This innovative solution has the potential to support filariasis diagnosis and monitoring, particularly in resource-limited settings where access to expert technicians and laboratory equipment is scarce.
Identifiability in Functional Connectivity May Unintentionally Inflate Prediction Results
Authors: Orlichenko Anton , Qu Gang , Su Kuan-Jui , Liu Anqi , Shen Hui , Deng Hong-Wen , Wang Yu-Ping 
Published: August 2023

ABSTRACTFunctional magnetic resonance (fMRI) is an invaluable tool in studying cognitive processes in vivo. Many recent studies use functional connectivity (FC), partial correlation connectivity (PC), or fMRI-derived brain networks to predict phenotypes with results that sometimes cannot be replicated. At the same time, FC can be used to identify the same subject from different scans with great accuracy. In this paper, we show a method by which one can unknowingly inflate classification results from 61% accuracy to 86% accuracy by treating longitudinal or contemporaneous scans of the same subject as independent data points. Using the UK Biobank dataset, we find one can achieve the same level of variance explained with 50 training subjects by exploiting identifiability as with 10,000 training subjects without double-dipping. We replicate this effect in four different datasets: the UK Biobank (UKB), the Philadelphia Neurodevelopmental Cohort (PNC), the Bipolar and Schizophrenia Network for Intermediate Phenotypes (BSNIP), and an OpenNeuro Fibromyalgia dataset (Fibro). The unintentional improvement ranges between 7% and 25% in the four datasets. Additionally, we find that by using dynamic functional connectivity (dFC), one can apply this method even when one is limited to a single scan per subject. One major problem is that features such as ROIs or connectivities that are reported alongside inflated results may confuse future work. This article hopes to shed light on how even minor pipeline anomalies may lead to unexpectedly superb results.
Examining a Preclinical Alzheimer’s Cognitive Composite for Telehealth Administration, the tPACC, for Reliability between In-Person and Remote Cognitive Testing with Neuroimaging Biomarkers
Authors: Duran Tugce , Gaussoin Sarah A. , Latham Lauren A. , Rundle Melissa M. , Espeland Mark A. , Williams Benjamin J. , Hughes Timothy M. , Craft Suzanne , Sachs Bonnie C. , Bateman James R. , Lockhart Samuel N. 
Published: August 2023

AbstractINTRODUCTIONWe defined a telehealth preclinical Alzheimer’s cognitive composite (tPACC) derived from remotely administered cognitive assessments and examined its relationship with neuroimaging biomarkers.METHODSWe examined neuroimaging and in-person and remote cognitive testing data from the Wake Forest Alzheimer’s Disease Research Center’s Clinical Core cohort and a pilot study to form a modified PACC (PACC5-RAVLT) and tPACC. We performed intraclass correlation coefficient (ICC) analysis for reliability of tPACC and linear regression models to evaluate associations between tPACC and neuroimaging. Bland-Altman plots for agreement were constructed across cognitively normal (NC) and impaired participants.RESULTSThere was a significant positive relationship between in-person tPACC and PACC5-RAVLT (ICC=0.88), in-person PACC5-RAVLT and remote tPACC (ICC=0.73), and in-person tPACC and remote tPACC (ICC=0.82). Overall, tPACC showed significant associations with imaging biomarkers.DISCUSSIONThere is a good agreement between tPACC and PACC5-RAVLT for NC and impaired individuals. The tPACC is associated with common neuroimaging markers.Research in Context1. Systematic Review:We reviewed the literature to identify the reliability of remote cognitive testing, concordance of in-person and remote cognitive testing, and remote Preclinical Alzheimer’s Cognitive Composite (PACC) to differentiate cognitive functioning in older adults with or without cognitive impairment. We searched studies to examine relationships between remote PACC score and neuroimaging biomarkers related to early stages of Alzheimer’s Disease. We found no studies simultaneously examining a telehealth PACC (tPACC) score with neuroimaging biomarkers that provide crucial implications for detecting cognitive differences.2. Interpretation:Our findings reveal that a tPACC score can serve as a harmonized composite measure for heterogeneous cognitive data to discriminate those with or without cognitive impairment and inform neuroimaging outcomes.3. Future Directions:Future work is necessary to test tPACC performance in larger longitudinal studies and relationships with other neuroimaging (e.g., PET) or plasma biomarkers in older adults across the cognitive spectrum.
Subthalamic deep brain stimulation alleviates motor symptoms without restoring deficits in corticospinal suppression during movement preparation in Parkinson’s disease
Authors: Wilhelm Emmanuelle , Derosiere Gerard , Quoilin Caroline , Cakiroglu Inci , Paço Susana , Raftopoulos Christian , Nuttin Bart , Duque Julie 
Published: August 2023

AbstractBackgroundParkinson’s disease (PD) patients exhibit alterations in neurophysiological mechanisms underlying movement preparation, especially the suppression of corticospinal excitability – called “preparatory suppression” – considered to propel movement execution by increasing motor neural gain in healthy individuals.ObjectiveDeep brain stimulation (DBS) of the subthalamic nucleus (STN) being an attractive treatment for advanced PD, we aimed to investigate the potential contribution of this nucleus to PD-related changes in such corticospinal dynamics.MethodsOn two consecutive days, we applied single-pulse transcranial magnetic stimulation over both primary motor cortices in 20 PD patients treated with bilateral STN-DBS (ON vs. OFF), as well as 20 healthy control subjects. Motor-evoked potentials were elicited at rest or during a left- or right-hand response preparation in an instructed-delay choice reaction time task. Preparatory suppression was assessed by expressing amplitudes of motor potentials evoked during movement preparation relative to rest.ResultsAdvanced PD patients exhibited a deficit in corticospinal suppression during movement preparation, limited to the responding hand (especially the most-affected), independently of STN-DBS. Significant links between preparatory suppression and clinical variables were found for least-affected hands only.ConclusionOur study provides evidence of altered corticospinal dynamics during movement preparation in advanced PD patients treated with STN-DBS. Consistent with results in earlier-stage patients, preparatory suppression deficits were limited to the responding hand and most pronounced on the most-affected side. STN-DBS did not restore this abnormality, which warrants further investigations into possible neuroanatomical sources of such corticospinal suppression, necessary to understand the consistent lack of this mechanism in PD patients.
A Co-Creation Process Toward Sustainable Adoption of Integrated Care for Prevention of Unplanned Hospitalizations
Authors: Herranz Carmen , Gómez Alba , Hernández Carme , González-Colom Rubèn , Contel Joan Carles , Cano Isaac , Piera-Jiménez Jordi , Roca Josep 
Published: August 2023

ABSTRACTIntroductionComplex chronic patients (CCP) are prone to unplanned hospitalizations leading to a high burden on healthcare systems. To date, interventions to prevent unplanned admissions show inconclusive results. We report a co-creation process performed into the EU initiative JADECARE (2020-2023) to elaborate an integrated care program aiming at preventing unplanned hospitalizations.MethodsA two-phase process of structured interviews and design thinking (DT) sessions was conducted. Firstly, we assessed the management of CCP in Catalonia (ES) through twenty interviews (five patients and fifteen professionals), including the results of a cluster analysis of 761 hospitalizations, followed by two DT sessions (Oct 2021 to Feb 2022). Then, we examined the 30- and 90-day post-discharge periods of 49,604 hospitalizations as input for two DT sessions with seven professionals.DiscussionThe co-creation process identified poor personalization of the interventions, the need for organizational changes, immature digitalization, and suboptimal services evaluation as main explanatory factors of the observed efficacy-effectiveness gap. Additionally, a program for prevention of unplanned hospitalizations, to be evaluated during 2023-2025, was generated.ConclusionsA digitally enabled adaptive case management approach to foster collaborative work, as well as organizational re-engineering, are endorsed for value-based prevention of unplanned hospitalizations.
Perspectives of professional experts in relation to the development of community-based exercise for young adults with schizophrenia – A qualitative study
Authors: Andersen MF , Roed K , Riis A , Rafn BS , Ebdrup BH , Midtgaard J 
Published: August 2023

AbstractBackgroundPhysical activity is a key modifiable factor in protecting physical and mental health in people with severe mental illness including schizophrenia. Therefore, early promotion of physical activity is recommended and programmes supporting long-term maintenance of physically active behaviour are warranted. This study aimed to explore the perspectives of professional experts in relation to the development of a sustainable community-based exercise programme tailored to young adults with schizophrenia and intended to promote change and adoption of physical activity.MethodsWe conducted nine semi-structured interviews with 11 clinical and professional experts. Qualitative content analysis, as described by Graneheim and Lundman, was applied to analyse data.ResultsWe identified four categories: (1) living a physical active life with schizophrenia, (2) exercise as promotor of personal recovery, (3) prescribing safe and relevant exercise, and (4) instructors’ qualifications and formation.ConclusionsWhen developing sustainable community-based exercise programmes tailored to young adults with schizophrenia, developers should ensure instructors’ qualifications and provide an exercise protocol. In addition, developers should consider providing an inclusive and recovery-oriented exercise environment.Key messagesWhat is already known on this topicPhysical activity is a key modifiable factor in protecting physical and mental health in people with severe mental illness, including schizophrenia.Sustainable community-based programmes to support adoption of physical activity for young adults with schizophrenia are warranted.What this study addsDevelopers of community-based exercise for young adults with schizophrenia must ensure a strategy for identifying and training exercise instructors and the provision of a protocol for delivering safe and clinically relevant exercise.Community-based exercise may have the potential to promote personal recovery and thus considerations regarding the balance between overcoming potential barriers towards participation while promoting a non-clinical exercise environment are provided.How this study might affect research, practice or policyThese findings could support and inform the development of community-based programmes promoting physical activity for people with schizophrenia and may be adaptable or inspirable to other psychiatric populations in other geographical settings.
PanCanAID – Pancreas Cancer Artificial Intelligence Driven Diagnosis in CT Scan Imaging: A Protocol for a Multicentric Ambispective Diagnostic Study
Authors: Safavi-Naini Seyed Amir Ahmad , Behnamnia Armin , Khorasanizadeh Faezeh , Soroush Ali , Zamani Farhad , Salahshour Faeze , Sadeghi Amir , Mirtajaddini Seyedmahdi , Zandi Ashkan , Shojaeian Fatemeh , Saeedi Maryam , Ehasni Azade , Chavoshi Khamneh Abdolhamid , Mohsenifar Zhaleh , Azmoudeh Ardalan Farid , Firouznia Kavous , Shahrokh Shabnam , Raoufi Masoomeh , Dehghan Pooneh , Ketabi Moghadam Pardis , Mansour-Ghanaei Alireza , Mellatdoust Parinaz , Malekpour Habib , Rasekhi Alireza , Mansour-Ghanaei Fariborz , Sohrabi Masoudreza , Zarei Fariba , Radmard Amir Reza , Ghanaati Hossein , Assadzadeh Aghdaei Hamid , Zali Mohammad Reza , Rabiee Hamid R. 
Published: August 2023

AbstractIntroductionPancreatic cancer is thought to have an extremely dismal prognosis. Most cancer-related deaths occur from metastasis rather than the primary tumor, although individuals with tumors smaller than 1 cm in diameter have more than 80% 5-year survival. Thus, the current protocol introduces PanCanAID project which intends to develop several computer-aided-diagnosis (CAD) systems to enhance pancreatic cancer diagnosis and management using CT scan imaging.Methods and analysisPatients with pathologically confirmed pancreatic ductal adenocarcinoma (PDAC) or pancreatic neuroendocrine tumor (PNET) will be included as pancreatic cancer cases. The controls will be patients without CT evidence of abdominal malignancy. A data bank of contrast-enhanced abdominopelvic CT scans, survival data, and demographics will be collected from ten medical centers in four provinces. Endosonography images and clinical data, if available, will be added to the data bank. Annotation and manual segmentation will be handled by radiologists and confirmed by a second expert radiologist in abdominal imaging. PanCanAID intelligent system is designed to (1) detect abdominopelvic CT scan phase, (2) segment pancreas organ, (3) diagnose pancreatic cancer and its subtype in arterial phase CT scan, (4) diagnose pancreatic cancer and its subtype in non-contrast CT scan, (5) carry out prognosis (TNM stage and survival) based on arterial phase CT scan, (6) and estimate tumor resectability. A domain adaptation step will be handled to use online data and provide pancreas organ segmentation to reduce the segmentation time. After data collection, a state-of-the-art deep learning algorithm will be developed for each task and benchmarked against rival models.ConclusionPanCanAID is a large-scale, multidisciplinary AI project to assist clinicians in diagnosing and managing pancreas cancer. Here, we present the PanCanAID protocol to assure the quality and replicability of our models. In our experience, the effort to prepare a detailed protocol facilitates a positive interdisciplinary culture and the preemptive identification of errors before they occur.
What should be included in an educational programme for non-health professional exercise instructors in charge of community-based exercise targeting young adults in antipsychotic treatment – A focus group study of stakeholder perspectives
Authors: Andersen MF , Roed K , Sørensen V , Riis A , Rafn BS , Ebdrup BH , Midtgaard J 
Published: August 2023

AbstractBackgroundExercise plays a crucial role in addressing the increased cardiometabolic morbidity and premature mortality in people with schizophrenia. When delivered in community-based settings, exercise may also reduce loneliness, while promoting overall physical active behaviours. Skilled instructors are essential to deliver effective community-based exercise; however, knowledge about their roles and required training is lacking. We investigated stakeholders’ perspectives on components needed for an educational programme for non-health professional exercise instructors delivering community-based exercise targeting young adults in antipsychotic treatment.MethodsWe conducted six focus groups comprising a total of 30 individuals representing five different stakeholder groups, namely clinical staff within mental health, physiotherapists, exercise instructors, young adults in antipsychotic treatment, and relatives to young adults in antipsychotic treatment. Data were analysed using qualitative content analysis, as described by Graneheim and Lundman.ResultsThe analysis identified three categories: (i)acknowledging mental illness, (ii)applying a resource-oriented approach, and (iii)promoting exercise as a shared activity, and one overarching theme:instructors as guardians of an inclusive culture.ConclusionsAn educational programme for exercise instructors delivering community-based exercise to young adults in antipsychotic treatment should focus on securing an inclusive culture that embraces an anti-stigmatising approach. Results of the current study informed the development of an educational programme consisting of an instructor manual, a one-day educational programme for instructors, and a continuous exchange of experiences between instructors.
Influence of Prior SARS-CoV-2 Infection on COVID-19 Severity: Evidence from the National COVID Cohort Collaborative
Authors: Hendrix Nathaniel , Sidky Hythem , Sahner David K. ,   The N3C Consortium
Published: August 2023

AbstractBackgroundA large share of SARS-CoV-2 infections now occur among previously infected individuals. In this study, we sought to determine whether prior infection modifies disease severity relative to no prior infection.MethodsWe used data from first and second COVID-19 episodes in the National COVID Cohort Collaborative, a nationwide collection of de-identified electronic health records. We used nested logistic regressions of monthly cohorts weighted on the inverse probability of prior infection to assess risk of hospitalization, death, and increased severity in the first versus second infection cohorts.ResultsWe included a total of 2,058,274 individuals in the analysis, 147,592 of whom had two recorded infections. The impact of prior infection differed meaningfully between months. Prior infection was largely protective prior to March 2022, with odds ratios (ORs) as low as 0.66 (95% confidence interval: 0.51 to 0.86) in November 2021 for hospitalization. and as low as 0.23 (0.06 to 0.86) in June 2021 for death. However, prior infection was associated with an increased risk of hospitalization and death, mostly after March 2022 when the ORs were as high as 1.87 (1.26 to 2.80) and 2.99 (1.65 to 5.41) in April 2022, respectively. The overall OR for more severe disease was 1.06 (1.03 to 1.10) among previously infected individuals.ConclusionIn the pandemic’s first two years, previously infected patients generally had less severe disease than people without prior infection. During the Omicron era, however, previously infected patients had the same or worse severity of disease as patients without prior infection.