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The influence of perivascular tissue on lateral thermal expansion during bipolar vessel sealing

BackgroundLateral heat propagation has been an unavoidable effect of bipolar sealing with the risk of damage to surrounding structures. It is presently unknown whether leaving the perivascular tissue in situ may be advantageous in the sense of an isolation effect. Material and methodsTwo groups were formed from ex vivo carotid specimens. Group A (n = 10) consisted of carotid artery with the perivascular connective tissue in place (mean preparation diameter: 10.57 ± 0.16 mm) and group B (n = 10) of skeletonized carotids (mean vessel diameter: 5.21 ± 0.12 mm). All specimens were fixed on a plastic plate and mounted vertically in a holder. Sealing was performed perpendicular to the axis of the specimens. The temperature during the sealing process was recorded by a thermal camera. Group comparison was performed by a nonparametric test and significance was set at p < 0.05. ResultsMean sealing time in group A was 3.71 ± 0.37 s compared to 3.42 ± 0.37 s (p = 0.009) in group B. The maximum temperature in the middle of the jaws was significantly different. Group A had a temperature of 71.4 ± 3.9 °C and group B had a temperature of 91.4 ± 7.4 °C (p < 0.0001). RILATE risk scores (percent of necrotic zone in relation to potential area of necrosis) at both upper and lower sides of instrumental jaws were significantly different. For group A, it was 14.9 ± 1.6 at the upper side of jaws, 20.4 ± 2.63 at the lower side of jaws and for group B, it was 21.9 ± 3.5 at the upper side of jaws, 30.2 ± 6.2 at the lower side of jaws. ConclusionPerivascular connective tissue acts as an insulator with respect to lateral heat propagation. Peak temperature between instrument jaws is significantly reduced with perivascular tissue in situ. This may result in a negative impact on sealing quality.

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Correlations across timing cues in natural vocalizations predict biases in judging synthetic sound burst durations

AbstractIt is well known that animals rely on multiple sources of information in order to successfully identify sounds in natural environments, to make decisions that are optimal for their survival. For example, rats use duration and pitch cues to respond appropriately to prosocial and distress vocalizations (Saito et al., 2019). Vocalization duration cues are known to co-vary with other temporal cues (Khatami et al., 2018), yet little is known about whether animals rely upon such co-variations to successfully discriminate sounds. In the current study, we find natural alarm vocalizations in rats have onset and offset slopes that are correlated with their duration. Accordingly, vocalizations with faster onset slopes are more likely to have shorter durations. Given that vocalization slopes begin and end within milliseconds, they could provide rapid perceptual cues for predicting and discriminating vocalization duration. To examine this possibility, we train rodents to discriminate duration differences in sequences of synthetic vocalizations and examine how artificially changing the slope impacts duration judgments. We find animals are biased to misjudge a range of synthetic vocalizations as being shorter in duration when the onset and offset slopes are artificially fast. Moreover, this bias is reduced when rats are exposed to multiple synthetic vocalization bursts. The observed perceptual bias is accurately captured by a Bayesian decision-theoretic model that utilizes the empirical joint distribution of duration and onset slopes in natural vocalizations as a prior during duration judgements of synthetic vocalizations. This model also explains why the bias is reduced when more evidence is accumulated across multiple bursts, reducing the prior’s influence. These results support the theory that animals are sensitive to fine-grained statistical co-variations in auditory timing cues and integrate this information optimally with incoming sensory evidence to guide their decisions.

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Comparative analysis of machine learning algorithms for multi-syndrome classification of neurodegenerative syndromes

ImportanceThe entry of artificial intelligence into medicine is pending. Several methods have been used for the predictions of structured neuroimaging data, yet nobody compared them in this context.ObjectiveMulti-class prediction is key for building computational aid systems for differential diagnosis. We compared support vector machine, random forest, gradient boosting, and deep feed-forward neural networks for the classification of different neurodegenerative syndromes based on structural magnetic resonance imaging.Design, setting, and participantsAtlas-based volumetry was performed on multi-centric T1-weighted MRI data from 940 subjects, i.e., 124 healthy controls and 816 patients with ten different neurodegenerative diseases, leading to a multi-diagnostic multi-class classification task with eleven different classes.InterventionsN.A.Main outcomes and measuresCohen’s kappa, accuracy, and F1-score to assess model performance.ResultsOverall, the neural network produced both the best performance measures and the most robust results. The smaller classes however were better classified by either the ensemble learning methods or the support vector machine, while performance measures for small classes were comparatively low, as expected. Diseases with regionally specific and pronounced atrophy patterns were generally better classified than diseases with widespread and rather weak atrophy.Conclusions and relevanceOur study furthermore underlines the necessity of larger data sets but also calls for a careful consideration of different machine learning methods that can handle the type of data and the classification task best.

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