Signal Intensity Changes Research Articles

Improving Diagnostic Performance of MRI for Temporal Lobe Epilepsy With Deep Learning-Based Image Reconstruction in Patients With Suspected Focal Epilepsy.

To evaluate the diagnostic performance and image quality of 1.5-mm slice thickness MRI with deep learning-based image reconstruction (1.5-mm MRI + DLR) compared to routine 3-mm slice thickness MRI (routine MRI) and 1.5-mm slice thickness MRI without DLR (1.5-mm MRI without DLR) for evaluating temporal lobe epilepsy (TLE). This retrospective study included 117 MR image sets comprising 1.5-mm MRI + DLR, 1.5-mm MRI without DLR, and routine MRI from 117 consecutive patients (mean age, 41 years; 61 female; 34 patients with TLE and 83 without TLE). Two neuroradiologists evaluated the presence of hippocampal or temporal lobe lesions, volume loss, signal abnormalities, loss of internal structure of the hippocampus, and lesion conspicuity in the temporal lobe. Reference standards for TLE were independently constructed by neurologists using clinical and radiological findings. Subjective image quality, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were analyzed. Performance in diagnosing TLE, lesion findings, and image quality were compared among the three protocols. The pooled sensitivity of 1.5-mm MRI + DLR (91.2%) for diagnosing TLE was higher than that of routine MRI (72.1%, P < 0.001). In the subgroup analysis, 1.5-mm MRI + DLR showed higher sensitivity for hippocampal lesions than routine MRI (92.7% vs. 75.0%, P = 0.001), with improved depiction of hippocampal T2 high signal intensity change (P = 0.016) and loss of internal structure (P < 0.001). However, the pooled specificity of 1.5-mm MRI + DLR (76.5%) was lower than that of routine MRI (89.2%, P = 0.004). Compared with 1.5-mm MRI without DLR, 1.5-mm MRI + DLR resulted in significantly improved pooled accuracy (91.2% vs. 73.1%, P = 0.010), image quality, SNR, and CNR (all, P < 0.001). The use of 1.5-mm MRI + DLR enhanced the performance of MRI in diagnosing TLE, particularly in hippocampal evaluation, because of improved depiction of hippocampal abnormalities and enhanced image quality.

The Pairing of Rapid Intensification Events and Eyewall Replacement Cycles in Tropical Cyclones in the Atlantic Basin from 2015 to 2020

Rapid intensification (RI) and eyewall replacement cycles (ERCs) frequently occur in intense tropical cyclones (TCs), often causing rapid, significant changes in intensity and structure. In some TCs, RI and ERCs can occur concurrently or within a short period of one another. This study investigates whether there is a link between RI and ERCs by conducting a statistical analysis of TCs that occurred in the North Atlantic basin from 2015 to 2020. The HURDAT2 dataset was used to detect RI events, while the Morphed Integrated Microwave Imagery archive by the Cooperative Institute for Meteorological Satellite Studies was used to detect ERC events. Three sets of data were constructed from this analysis: TCs with paired RI/ERC events that occurred within 24 h of each other, TCs with RI only, and TCs with ERCs only. Statistics selected for analysis within the constructed datasets were mean duration of phenomena, mean rate of intensification, and mean peak intensity. We performed t-tests to determine the statistical significance of results. The results of this study show that TCs with these paired RI/ERC events often intensified at a faster rate, intensified for longer, and ended up stronger than TCs that only experienced RI or ERCs in isolation.

MRI imaging pattern of metastasis and tuberculous spondylitis in the spine: serial case report

Background: Tuberculous spondylitis and spinal metastasis manifestations have a similar clinical manifestation. Spinal metastasis prevalence is high in malignant process while tuberculosis is frequent in endemic areas. Back pain, paresthesia, and paralysis are commonly caused by vertebral fractures, soft tissue mass, and spinal canal involvement. The magnetic resonance imaging (MRI) is a useful modality in the pattern differentiation of these diseases. This case series aimed to provide a differentiation between those two diseases using MRI. Case report: In the first case, we presented a 24-year-old female complained of hip pain without history of tuberculosis infection or malignancy. Whole spine MRI showed kyphotic deformity, compression of T9 vertebral body, erosion of anterior aspect T8 and T10 vertebral body, and subligamentous abscess at T7-T12 vertebrae level. Tuberculous infection was proven. The second case was a 39-year-old female complained of leg weakness without complaint of cough or breathing difficulty. Whole spine MRI showed kyphotic thoracic vertebrae, compression T10 vertebral body, destruction of inferior endplate T9 vertebrae, bone marrow changes on thoracic vertebral body, and paravertebral soft tissue mass on anterior T6 to T11 vertebral body. Tuberculosis etiology was proven. The third case was a 51-year-old female that came to the hospital due to waist pain with no history of tuberculosis infection or malignancy. Whole spine MRI revealed T8 and T9 vertebral body compression and bone marrow replacement on cervical, thoracic, and lumbar vertebrae, spinous process of thoracic and lumbar, bilateral posterior rib T4-T5, and soft tissue mass at the posterior T9 vertebrae. In the last case, we presented a 58-year-old male that complianed pain in the back and both legs. Lumbosacral MRI showed compression fracture with signal intensity change on L3 vertebral body, bone marrow replacement on thoracic, lumbar, and sacral vertebrae, expanding to epidural and cause spinal canal stenosis. CT-scan thorax showed lung malignancy proven to be non-small cell lung carcinoma. A spinal biopsy revealed malignant infiltration. Conclusion: Tuberculous spondylitis and metastasis differentiation can be a challenge. Early complaints mostly are back pain, paresthesia, and paralysis. Spine MRI can differentiate the pattern of both diseases and identify the possible etiology.

Susceptibility-weighted image features in AQP4-negative-NMOSD versus MS

ObjectiveTo characterize the susceptibility-weighted image (SWI) features including paramagnetic rim and nodular lesions with signal intensity changes and central vein sign (CVS) associated with aquaporin 4 (AQP4)-immunoglobulin G (IgG)-negative neuromyelitis optica spectrum disorder (NMOSD), and explore whether they can be used as potential imaging biomarkers for differentiating multiple sclerosis (MS) from this disorder. MethodsWe prospectively recruited NMOSD with AQP4-IgG-negative (AQP4- NMOSD) and IgG-positive (AQP4+ NMOSD), and MS subjects from the Clinical and Imaging Patterns of Neuroinflammation Diseases in China (CLUE) project (NCT0410683) between 2019 and 2021. The SWI features including paramagnetic rim and nodular lesions with signal intensity changes and CVS were analyzed and compared among groups, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined for distinguishing MS from AQP4- NMOSD. ResultsWe enrolled a total of 160 consecutive patients (22 AQP4- NMOSD, 65 AQP4+ NMOSD, and 73 MS). We observed paramagnetic rim lesion (0/120 lesions, 0 %) and nodular (1/120, 1 %) lesions with hypointense signals on SWI in the AQP4- NMOSD group. These characteristics were similar to those recorded from AQP4+ NMOSD patients (rim: 0/369 lesions, 0 %, P = 1.000; nodular: 10/369 lesions, 2.7 %, P = 1.000), but differed significantly from those observed in the MS group (rim: 162/1665 lesions, 9.7 %, P<0.001; nodular: 392/1665 lesions, 23.5 %, P < 0.001). AQP4- NMOSD patients had fewer average CVS+ rate (12 %) than MS patients (46 %, p<0.001), similar to AQP4+ NMOSD (13 %, p = 1.000). The SWI imaging features denoting lesions with paramagnetic rim or nodular hypointense SWI signals showed 90.4 % sensitivity, 95.5 % specificity, 98.5 % PPV, and 75 % NPV, and the criteria with≥3 CVS lesions showed sensitivity of 91.8 %, specificity of 90.9 %%, PPV of 97.1 %, and NPV of 76.9 % in distinguishing MS from AQP4- NMOSD. DiscussionThe SWI imaging features including lesions with paramagnetic rim or nodular hypointense SWI signals and 3 CVS lesions carries useful information in distinguishing MS from AQP4- NMOSD.

Near-infrared lunar laser ranging: Research on pointing error of Lunokhod 2 corner reflector based on effective echo signal broadening

The effective echo intensity of lunar laser ranging (LLR) has always been a concern, which not only reflects the detection ability of the LLR system but also affects the ranging uncertainty of LLR. The initial pointing of the corner-cube reflector (CCR) has a certain relationship with the echo intensity and ranging uncertainty of LLR. In our previous work, we analyzed the pointing error of the CCR array by studying the change in echo signal intensity. This paper will continue to research the initial pointing error of the CCR array from the perspective of ranging uncertainty. In this paper, based on the ranging system of the TianQin laser ranging station, the ranging uncertainty is obtained by analyzing the data, and finally, the pointing error of the CCR array is researched by summarizing the variation law of the ranging uncertainty. Firstly, the delay model introduced by the pointing error of the corner reflector is established, and the theoretical uncertainty introduced by the pointing error of the corner reflector is calculated. Secondly, the ranging uncertainty is analyzed through the experiment of LLR. Finally, the pointing error of the CCR array is calculated by inversion of ranging uncertainty. Theoretical analysis and experimental measurement results show that there is a pointing error in the L2 (Lunokhod 2) corner reflector, and its pointing error is about 5° ∼ 10°. This study is of great guiding significance for analyzing and studying the ranging uncertainty of LLR and arranging the next generation of LLR reflectors.

In-Situ Spectroscopic Investigation of 3-D Gas Diffusion Electrodes for Fuel Cell Reactions in Half-Cell Setups

Significant work has already been done in understanding proton exchange membrane fuel cells (PEMFC) over the past decades. In-situ visualization of the fuel-cell reactions has developed considerably and has also helped in understanding the challenges which still exist in various steps of electrochemical processing. Gas diffusion electrode half-cells have been widely promoted for fundamental catalysis research and when coupled with techniques like X-ray absorption spectroscopy (XAS) can be used for in-situ/operando studies of the reaction mechanisms in fuel cell reactions. This is particularly important to address the challenges in low temperature PEMFCs (eg. degradation of catalyst during durability tests) as well as high temperature PEMFCs (eg. poisoning of the Pt catalyst and low oxygen solubility in phosphoric acid).In this presentation, an effort will be made to illuminate the catalytic characteristics during oxygen reduction reaction using in-situ XAS. The co-adsorption of H3PO3 and CO on platinum catalysts will be investigated using the Δµ XANES technique by following the signatures of different species adsorbed on the catalyst surface, and the Efix technique which follows the variation of signal intensity at a fixed energy near to the white line to follow the changes in Pt oxidation. During CO removal through cyclic voltammetry in the presence of 800 µM H3PO3 (as shown in the figure provided) it is possible to see a clear change in signal intensity around the potential of 250 mVAg/AgCl, which was associated with the oxidation of H3PO3 to H3PO4, since CO oxidation takes place at higher potentials (above 600 mVAg/AgCl). It is also interesting to note that when oxidizing H3PO3 to H3PO4, the platinum surface significantly reduced. With these experiments, it can be concluded that the Efix technique has a great potential to better understand what happens to Pt during the oxidation of H3PO3, as well as to identify more clearly the oxidation potential of this species, which is not easy to do based on the electrochemical data alone. Considering that this species is one of the main species responsible for the poisoning of the Pt catalyst during the operation of fuel cells, it is extremely important to understand the life cycle of this compound so that the operating conditions can be adapted to maximize the performance of the catalyst and develop new catalysts more resistant to poisoning by phosphorous species for HT-PEMFCs.Acknowledgements:Prof. Matthias Arenz from University of Bern, Martin Prokopand Tomàs Bystrom from University of Chemistry and Technology Prague, Michael Haumann, Freie Universität Berlin are gratefully thanked for their collaboration. German Research Foundation DFG Project ID RO 2454/19-1, the Bavarian Gender Equality Grant 2019-2021 (for Women in Academia), Petra III DESY (Hamburg, Germany), a member of the Helmholtz Association HGF, P65 beamline (I-20211432) and KMC-3 beamline BESSY (Berlin,Germany). Figure 1

MRI T2 mapping assessment of T2 relaxation time in desmoid tumors as a quantitative imaging biomarker of tumor response: preliminary results.

Because size-based imaging criteria poorly capture biologic response in desmoid-type fibromatosis (DF), changes in MRI T2 signal intensity are frequently used as a response surrogate, but remain qualitative. We hypothesized that absolute quantification of DF T2 relaxation time derived from parametric T2 maps would be a feasible and effective imaging biomarker of disease activity. This IRB-approved retrospective study included 11 patients with DF, managed by observation or systemic therapy, assessed by 3T MRI. Tumor maximum diameter, volume, and T2-weighted signal intensity were derived from manual tumor segmentations. Tumor:muscle T2 signal ratios were recorded. Two readers measured tumor T2 relaxation times using a commercial T2 scanning sequence, manual ROI delineation and commercial calculation software enabling estimation of reader reliability. Objective response rates based on RECIST1.1 and best responses were compared between size-based and signal-based parameters. Median patient age was 52.6 years; 8 subjects were female (73%). Nine patients with longitudinal assessments were followed for an average of 314 days. Median baseline tumor diameter was 7.2 cm (range 4.4 - 18.2 cm). Median baseline T2 was 65.1 ms (range 40.4 - 94.8 ms, n=11); median at last follow-up was 44.3 ms (-32% from baseline; range 29.3 - 94.7 ms, n=9). T2 relaxation times correlated with tumor:muscle T2 signal ratios, Spearman p=0.78 (p<0.001). T2 mapping showed high inter-reader reliability, ICC=0.84. The best response as a percentage change in T2 values was statistically significant (mean -17.9%, p=0.05, paired t-test) while change in diameter was not (mean -8.9%, p=0.12). Analysis of T2 relaxation time maps of DF may offer a feasible quantitative biomarker for assessing the extent of response to treatment. This approach may have high inter-reader reliability.

FEASIBILITY AND ACCEPTABILITY OF A DEPRESSION AND PAIN INTERVENTION WITH OLDER AFRICAN AMERICAN WOMEN

Abstract Older African American women experience social determinants of health that put them at risk for experiencing comorbid pain and depressive symptoms. The purpose of our study was to tailor a preexisting evidence-based depression intervention to include pain and test it in older African American women. We conducted a randomized waitlist control study with 21 frail or pre-frail, African American women, 50 years of age and older with pain and depressive symptoms. The average age of the participants was 64.8 (SD: 10.5), average pain intensity was 7.0 (SD: 1.9) out of 10, and average PHQ-9 depressive symptoms score was11.9 (SD: 4.0). Effect sizes at 12 weeks post intervention were -1.05 for depressive symptoms indicating a substantial decrease in depressive symptoms. We did not see a significant change in pain intensity but identified changes in pain behavior scores. The women described the intervention as beneficial and provided suggestions for future iterations.

Ultra-sensitive detection of tumor necrosis factor alpha based on silver-coated gold core shell and magnetically separated recognition of SERS aptamer sensors.

A highly sensitive tumor necrosis factor α (TNF-α) detection method based on a surface-enhanced Raman scattering (SERS) magnetic patch sensor is reported. Magnetic beads (MNPs) and core shells were used as the capture matrix and signaling probe, respectively. For this purpose, antibodies were immobilized on the surface of magnetic beads, and then Au@4-MBN@Ag core-shell structures coupled with aptamers and TNF-α antigen were added sequentially to form a sandwich immune complex. Quantitative analysis was performed by monitoring changes in the characteristic SERS signal intensity of the Raman reporter molecule 4-MBN. The results showed that the limit of detection (LOD) of the proposed method was 4.37 × 10-15 mg·mL-1 with good linearity (R2 = 0.9918) over the concentration range 10-12 to 10-5 mg·mL-1. Excellent assay accuracy was also demonstrated, with recoveries in the range 102% to 114%. Since all reactions occur in solution and are separated by magnetic adsorption of magnetic beads, this SERS-based immunoassay technique solves the kinetic problems of limited diffusion and difficult separation on solid substrates. The method is therefore expected to be a good clinical tool for the diagnosis of the inflammatory biomarker THF-α and in vivo inflammation screening.

The relationship of proximal lateral collateral ligament hyperintensity with knee joint ligament and meniscus pathologies.

Hyperintensity in the proximal lateral collateral ligament (LCL) is often confusing. This appearance may be alone or accompany other pathologies. To investigate the relationship between the signal intensity (SI) change in the proximal LCL and the knee joint pathologies. The knee MRI scans taken between 2020 and 2022 were queried retrospectively. Patients with acute trauma, instability, knee surgery, or high-grade osteoarthritis were excluded. Included patients were divided into two groups as normal SI and increased SI according to proximal LCL. The difference in ligamentous and meniscal pathologies between the two groups was analyzed using a chi-square test. Inter-observer agreement analysis was performed on 50 randomly selected patients. A total of 351 patients (139 men [39.6%], 212 women [60.4%]; median age = 37 years; interquartile range = 67 years) were included. There were 114 (32.5%) LCLs with normal SI and 237 (67.5%) LCLs with increased SI. Normal SI and increased SI groups had a significant difference in terms of joint side, median age, patellar tendon SI, anterior cruciate ligament SI, and medial collateral ligament SI (P = 0.004, P = 0.004, P = 0.001, P = 0.011, P = 0.004, respectively). A significant difference between the results of two separate LCL examinations in coronal + axial and coronal-only planes (P <0.001). Inter-observer agreement was found to be good to excellent. Hyperintensity in the proximal LCL was more common on the right joint side, in older patients, and patients with hyperintensity in the proximal patellar tendon, anterior cruciate ligament, and medial collateral ligament. Evaluating the LCL only in the coronal plane overestimates the hyperintensity.

Electrochemical Determination of Tetracycline Using the Synergy of a Molybdenum (IV) Sulfide-Thionine Nanocomposite with an Aptamer by Differential Pulse Voltammetry (DPV)

An electrochemical aptasensor was established for the fast and sensitive determination of tetracycline based on the synergistic effect of MoS2-thionine nanocomposite and aptamer. The glassy carbon electrode was coated with MoS2 nanosheets of thionine to immobilize the tetracycline aptamer. In the absence of tetracycline, large quantities of thionin were loaded on the surface of the MoS2 nanosheet to serve as the electrochemical probe. After tetracycline was added to the surface of the electrode, an aptamer analyte complex was produced on the modified electrode. Through intercalation and electrostatic interactions, the complex was substantially adsorbed onto thionine, and the peak currents of the redox signal of thionine decreased. Therefore, the concentration of tetracycline was monitored by the change in signal intensity. Under optimized conditions, the developed electrochemical strategy with MoS2-thionine composite and aptamer exhibited an excellent linear detection range of 1.0 nM–1.0 μΜ and a low detection limit of 0.6 nM with suitable selectivity and stability. Therefore, the fabricated platform offers great potential for food safety, medical detection, and drug analysis.

Feasibility of using fNIRS to explore motor-related regional haemodynamic signal changes in patients with sensorimotor impairment and healthy controls: A pilot study.

While functional near-infrared spectroscopy (fNIRS) can provide insight into cortical brain activity during motor tasks in healthy and diseased populations, the feasibility of using fNIRS to assess haemoglobin-evoked responses to reanimated upper limb motor function in patients with tetraplegia remains unknown. The primary objective of this pilot study is to determine the feasibility of using fNIRS to assess cortical signal intensity changes during upper limb motor tasks in individuals with surgically restored grip functions. The secondary objectives are: 1) to collect pilot data on individuals with tetraplegia to determine any trends in the cortical signal intensity changes as measured by fNIRS and 2) to compare cortical signal intensity changes in affected individuals versus age-appropriate healthy volunteers. Specifically, patients presented with tetraplegia, a type of paralysis resulting from a cervical spinal cord injury causing loss of movement and sensation in both lower and upper limbs. All patients have their grip functions restored by surgical tendon transfer, a procedure which constitutes a unique, focused stimulus for brain plasticity. fNIRS is used to assess changes in cortical signal intensity during the performance of two motor tasks (isometric elbow and thumb flexion). Six individuals with tetraplegia and six healthy controls participate in the study. A block paradigm is utilized to assess contralateral and ipsilateral haemodynamic responses in the premotor cortex (PMC) and primary motor cortex (M1). We assess the amplitude of the optical signal and spatial features during the paradigms. The accuracy of channel locations is maximized through 3D digitizations of channel locations and co-registering these locations to template atlas brains. A general linear model approach, with short-separation regression, is used to extract haemodynamic response functions at the individual and group levels. Peak oxyhaemoglobin (oxy-Hb) changes in PMC appear to be particularly bilateral in nature in the tetraplegia group during both pinch and elbow trials whereas for controls, a bilateral PMC response is not especially evident. In M1 / primary sensory cortex (S1), the oxy-Hb responses to the pinch task are mainly contralateral in both groups, while for the elbow flexion task, lateralization is not particularly clear. This pilot study shows that the experimental setup is feasible for assessing brain activation using fNIRS during volitional upper limb motor tasks in individuals with surgically restored grip functions. Cortical signal changes in brain regions associated with upper extremity sensorimotor processing appear to be larger and more bilateral in nature in the tetraplegia group than in the control group. The bilateral hemispheric response in the tetraplegia group may reflect a signature of adaptive brain plasticity mechanisms. Larger studies than this one are needed to confirm these findings and draw reliable conclusions.

A Clone Selection Algorithm Optimized Support Vector Machine for AETA Geoacoustic Anomaly Detection

Anomaly in geoacoustic emission is an important earthquake precursor. Current geoacoustic anomaly detection methods are limited by their low signal-to-noise ratio, low intensity, sample imbalance, and low accuracy. Therefore, this paper proposes a clone selection algorithm optimized one-class support vector machine method (CSA-OCSVM) for geoacoustic anomaly detection. First, the interquartile range (IQR), cubic spline interpolation, and time window are designed to amplify the geoacoustic signal intensity and energy change rules to reduce the interference of geoacoustic signal noise and intensity. Secondly, to address the imbalance of positive and negative samples in geoacoustic anomaly detection, a one-class support vector machine is introduced for anomaly detection. Meanwhile, in view of the optimization capabilities of the clone selection algorithm, it is adopted to optimize the hyperparameters of OCSVM to improve its detection accuracy. Finally, the proposed model is applied to geoacoustic data anomaly detection in nine different datasets, which are derived from our self-developed acoustic electromagnetic to AI (AETA) system, to verify its effectiveness. By designing comparative experiments with IQR, genetic algorithm OCSVM (GA-OCSVM), particle swarm optimization OCSVM (PSO-OCSVM), and evaluating the performance of the true positive rate (TPR) and false positive rate (FPR), the experimental results depict that the proposed model is superior to the existing state-of-the-art geoacoustic anomaly detection approaches.

Combination of Multiple MRI Parameters Related to Signal Intensity and Volume for Predicting Response to Neoadjuvant Chemoradiotherapy by Patients with Locally Advanced Rectal Cancer.

MRI of patients with locally advanced rectal cancer (LARC) can predict the pathological complete response (pCR) to preoperative chemoradiation therapy (CRT). Our purpose was to use MRI results to evaluate the diagnostic value of combined changes in signal intensity (SI) and volume (V) of patients with LARC for predicting pCR to CRT. This retrospective study on 100 patients with LARC analyzed clinical and imaging data that were collected from March, 2018, to March, 2020. Before and after CRT, T2-weighted (T2W), apparent diffusion coefficient (ADC), and contrast-enhanced T1-weighted (ceT1W) data were analyzed. Percent changes of V (%#916;V) and relative SI ratio (%#916;SIR) on different sequences were calculated. After CRT, patients had pathological confirmation as pCR or non-pCR. Data were analyzed using nonparametric tests and receiver operating characteristic (ROC) analysis. There were 34 pCR and 66 non-pCR patients. Except for ADC-%#916;SIR, the combined parameters and single parameters had a greater decrease in the pCR group. The combination of ADC-%#916;V and T2W-%#916;SIR had the greatest diagnostic value (AUC=0.85,cutoff=0.23%) and the combination of ADC-%ΔV% and #916;SIR had the best accuracy (89%, cutoff=44.11%). Except for T2W-%#916;V and T2W-%#916;SIR, the different sequences had moderate differences in diagnostic performance. The diagnostic performance of combined parameters or single parameters on ADC and T2W was significantly better than those on ceT1W (p#916;60;0.01). All sequences except ADC-%#916;SIR provided reliable predictions of pCR, although ceT1W data had limited usefulness.</p>.

A Randomized Clinical Trial Testing the Effect of Digital Behavioral Interventions on Pain and Mental Health Among Adults with Sickle Cell Disease

Background: Patients with sickle cell disease (SCD) suffer a significant disease burden that affects their psychosocial well-being. Digital cognitive-behavioral therapy (CBT) has been utilized in other patient populations and shown to have clinical benefits. Although evidence-based, non-pharmacological interventions for pain management are widely used in other populations, this is not well studied in SCD. There are currently no large-scale, adequately powered clinical trials that evaluate the effectiveness and dissemination potential of digital behavioral pain management interventions for adults with SCD. Objective: The primary goal was to compare the effectiveness of two mobile-phone-delivered programs: 1) digital CBT program tailored for adults with SCD (CBT); or 2) pain and SCD education (Education) for reducing pain symptoms. The secondary goal was to assess whether baseline depression symptoms moderated the effect of these interventions on pain outcomes. Methods: Cognitive Behavioral Therapy and Real-Time Pain Management Intervention for Sickle Cell via Mobile Application (CaRISMA) is a multisite, randomized, pragmatic, comparative effectiveness trial conducted at seven comprehensive sickle cell centers and several community-based organizations in the U.S. The study enrolled adults with SCD who reported chronic pain or using short or long-acting opioids daily. Participants were randomized in a 1:1 ratio to receive either the CBT or Education programs. Both programs utilized identical Facebook Messenger chatbot apps, only the content differed. All intervention participants received health coach support involving weekly phone calls or text messages for a duration of 12 weeks. Participants completed follow up assessments at 3 and 6 months, and daily e-diary entries of 0-10 pain numerical rating scale, mood, and opioid use. The primary outcome was the 6-month change in the PROMIS pain interference. Secondary outcomes included average daily pain intensity for a 2-week period at each time point, change in mean % body area affected by pain (measured by a ‘paintable’ body image within the mobile app), PHQ-9 depression, GAD-7 anxiety, Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) quality of life (social functioning and emotional impact), and Sickle Cell Self-Efficacy Scale (SCSES). Generalized linear mixed models were used to compare changes in 6-month outcomes between study arms after accounting for design variables (study site and baseline depression). Results: Of the 574 participants screened for eligibility, 359 (63%) were consented and randomized (178 to CBT and 181 to Education). Seventy-five percent of participants connected with the chatbot but only 47% completed at least one CBT/education lesson. However, 80% of participants had at least one text message, phone or video session with a health coach. At 6-months, there was a significant decline in pain interference within each arm (CBT [-2.13, 95%CI (-3.42, -0.84)] and Education [-2.66, 95%CI (-3.97, -1.36)]); however, this decline did not differ between arms (p=0.57). There was not a significant 6-month change in daily pain intensity for either arm, however, for % body area covered in pain, both CBT and education conferred a similar relative decrease, 19.2% and 17.1%, respectively. There were significant 6-month improvements within-arms for PHQ-9, GAD-7, and both ASCQ-Me measures, but no between-arm differences emerged. (Table 1). Of these, only the 6-month change in ASCQ-Me emotional impact approached a significant difference between arms with digital CBT conferring slightly greater improvement in scores, 3.51 (95%CI: 2.29, 4.73) compared to education,1.79 (95%CI: .55, 3.04; p=.05). Baseline PHQ depression score (&amp;gt;= 10 vs &amp;lt; 10) did not moderate the effect of treatments on pain interference (p=0.52). Conclusions: Preliminary trial findings suggest that both digital CBT and Education, with health coach support, are effective approaches for management of SCD pain and mental health symptoms. Most participants connected with a health coach and may have derived benefit from this support, however, poor engagement with the digital CBT and education component of the study may have limited the study's ability to detect between arm differences. Secondary analyses will examine the effect of intervention engagement on treatment outcomes.

Changes of uterine morphology and endometrial T2 signal intensity in the fibrotic repair secondary to endometrial injury

Objective: To investigate the value of uterine morphological parameters and endometrial T2 signal intensity (T2-SI) in evaluating the degree of the fibrotic repair secondary to endometrial injury. Methods: From Sep. 2018 to Feb. 2023, this study prospectively enrolled 29 patients with fibrotic repair secondary to severe endometrial injury (severe group), 17 patients with fibrotic repair secondary to mild to moderate endometrial injury (mild to moderate group), and 40 healthy women of reproductive age (control group) in Nanjing Drum Tower Hospital. The length of uterine cavity (LUC), length of cervix and isthmus (LCI), width of upper uterine cavity (WUUC) and width of lower uterine cavity (WLUC) were measured using magnetic resonance imaging. T2-SI of endometrium and subcutaneous fat of buttocks were measured, and endometrial normalized T2-SI (nT2-SI; T2-SI of endometrium/T2-SI of subcutaneous fat of buttocks) was calculated. Statistical analyses of data were performed using one-way analysis of variance, Mann-Whitney U test, intraclass correlation coefficient, Spearman rho test, area under the receiver operating characteristic curve (AUC). Results: LUC, WUUC, WLUC and endometrial nT2-SI of severe group [(19.7±3.5) mm, (26.9±6.4) mm, (7.9±1.4) mm, 0.73±0.11, respectively] were significantly lower than those of the control group (all P<0.01), while LCI and WUUC/LUC [(51.3±7.3) mm and 1.38±0.34] were significantly higher than those of the control group (all P<0.001). LUC and WLUC of severe group were significantly lower than those of mild to moderate group [(32.4±5.1) mm and (8.8±1.2) mm; all P<0.05], while LCI and WUUC/LUC were significantly higher than those of mild to moderate group [(41.8±8.6) mm and 0.94±0.16; all P<0.001]. LUC and endometrial nT2-SI of mild to moderate group were significantly lower than those of the control group [ (32.4±5.1) vs (35.3±3.5) mm, 0.68±0.13 vs 0.80±0.12; all P<0.01]. LUC, WUUC, WLUC and endometrial nT2-SI were significantly negatively correlated to the degree of the fibrotic repair secondary to endometrial injury (Spearman rho:-0.794, -0.441, -0.471 and -0.316, respectively; all P<0.05), while LCI and WUUC/LUC were significantly positively correlated to the degree of the fibrotic repair secondary to endometrial injury (Spearman rho: 0.481 and 0.674, respectively; all P<0.05). LUC and WUUC/LUC showed high value in distinguishing severe group from the control group or mild to moderate group (all AUC>0.9, all P<0.001). Conclusion: As noninvasive and quantitative biomarkers, uterine morphological parameters and endometrial nT2-SI could evaluate the degree of the fibrotic repair secondary to endometrial injury.

Tetracationic bis-triarylborane tetraynes as dual fluorescence and SERS sensors for DNA, RNA and proteins

We report herein two new dual luminescent and Raman (SERS)-active probes, able to sense submicromolar concentrations of DNA and protein in aqueous samples. Both analogues, characterized by a tetrayne linker connecting two triarylborane fluorophores, show high binding affinities and strong fluorescent and SERS responses to ds-DNA, ds-RNA, and protein (BSA). Detailed studies revealed that both the neutral and tetracationic analogue bind to ds-DNA/RNA grooves and protein (BSA) with similar affinities, at variance to previous non-charged triarylboranes, which interacted only with BSA. The fluorimetric response upon binding to BSA was different to that observed for previous analogues; the tetracationic analogue emission was enhanced and the neutral analogue emission quenched, this selectivity being attributed to the difference in solvatochromism of the triarylborane fluorophore (charged vs neutral). The neutral dye did not show any SERS signal due to the lack of interaction with negatively charged Ag nanoparticles, stressing the importance of positive charge for the application of SERS sensing. The SERS signal of the tetrayne linker of the tetracationic analogue was shifted by −81 cm−1 compared to that of the previously studied diyne analogue. The SERS signal intensity change was proportional to dye binding to ds-DNA, and completely quenched by nanomolar concentrations of BSA, such a specific response being attributed to the complete immersion of the dye within BSA.

Nonequilibrium Ionization Effects on Synthetic Spectra in the AWSoM Solar Corona

In this work, we combined AWSoM’s nonequilibrium ionization (NEI) calculations from Szente et al. with the synthetic spectral computations of SPECTRUM to predict nonequilibrium line intensities across the entire domain of the AWSoM 3D global model. We find that the resulting spectra are strongly affected by nonequilibrium effects in the fast-wind regions and streamer edges and that these effects propagate to narrowband images from SoHO/EIT, SECCHI/EUVI, and SDO/AIA. The dependence shows a different nature for each line observed, resulting in significant changes in line intensity, which need to be accounted for during plasma diagnostics. However, we also find that these effects depend on the local plasma properties, and that no single correction can be developed to account for nonequilibrium effects in observed spectra and images. With a comparison to observational data, we saw that the changes due to NEI, while significant, are not sufficient to account for the differences between Hinode/EIS spectra and AWSoM/SPECTRUM predictions.

NIMG-28. DIFFUSION DIFFERENCES IN LOW TO HIGH GRADE GLIOMA TRANSFORMATION

Abstract PURPOSE Apparent diffusion coefficient (ADC) maps offer tremendous insight into cellularity and local tissue environment. Proliferation of tumor cells results in increased local cellularity and cell density, thus impairing the free diffusion of water molecules. Therefore, hypointense ADC signals are thought to reflect regions of increased cellularity, and are useful imaging markers for distinguishing neoplastic cellular processes. In this study, we tested the hypothesis that changes in ADC intensity over the course of disease progression differ in progressing gliomas within the tumor-delineated region. METHODS Sixty-three glioma patients from our brain bank were separated into two groups. Group 1 included patients with Grade 1-3 gliomas at surgical diagnosis and progressed to a Grade 4 glioma at autopsy. The second group of patients were those with an initial and final Grade 4 glioma diagnosis. Contrast-enhancing tumor regions on MRI sequences were annotated with an established machine-learning algorithm for each patient on their initial and final MRIs. Average ADC intensity within the contrast enhancing regions was extracted and change in signal intensity between the first and last MRI was calculated for each patient. Finally, the mean intensity difference between Group 2 and Group 1 were evaluated using a linear mixed model. RESULTS We report a negative mean difference between the Group 2 and Group 1s change in ADC intensity over time (p=0.03). CONCLUSIONS These findings suggest changes in cellularity, identified by ADC, are greater in patients who progress from low-to-high grade gliomas. With these results, it may be concluded that change in ADC hypointensity, as a proxy for cellularity, may be a defining imaging characteristic to identify progressing gliomas.

Automatic Detection and Classification of Modic Changes in MRI Images Using Deep Learning: Intelligent Assisted Diagnosis System.

Modic changes (MCs) are the most prevalent classification system for describing intravertebral MRI signal intensity changes. However, interpreting these intricate MRI images is a complex and time-consuming process. This study investigates the performance of single shot multibox detector (SSD) and ResNet18 network-based automatic detection and classification of MCs. Additionally, it compares the inter-observer agreement and observer-classifier agreement in MCs diagnosis to validate the feasibility of deep learning network-assisted detection of classified MCs. A retrospective analysis of 140 patients with MCs who underwent MRI diagnosis and met the inclusion and exclusion criteria in Tianjin Hospital from June 2020 to June 2021 was used as the internal dataset. This group consisted of 55 males and 85 females, aged 25 to 89 years, with a mean age of (59.0 ± 13.7) years. An external test dataset of 28 patients, who met the same criteria and were assessed using different MRI equipment at Tianjin Hospital, was also gathered, including 11 males and 17 females, aged 31 to 84 years, with a mean age of 62.7 ± 10.9 years. After Physician 1 (with 15 years of experience) annotated all MRI images, the internal dataset was imported into the deep learning model for training. The model comprises an SSD network for lesion localization and a ResNet18 network for lesion classification. Performance metrics, including accuracy, recall, precision, F1 score, confusion matrix, and inter-observer agreement parameter Kappa value, were used to evaluate the model's performance on the internal and external datasets. Physician 2 (with 1 year of experience) re-labeled the internal and external test datasets to compare the inter-observer agreement and observer-classifier agreement. In the internal dataset, when models were utilized for the detection and classification of MCs, the accuracy, recall, precision and F1 score reached 86.25%, 87.77%, 84.92% and 85.60%, respectively. The Kappa value of the inter-observer agreement was 0.768 (95% CI: 0.656, 0.847),while observer-classifier agreement was 0.717 (95% CI: 0.589, 0.809).In the external test dataset, the model's the accuracy, recall, precision and F1 scores for diagnosing MCs reached 75%, 77.08%, 77.80% and 74.97%, respectively. The inter-observer agreement was 0.681 (95% CI: 0.512, 0.677), and observer-classifier agreement was 0.519 (95% CI: 0.290, 0.690). The model demonstrated strong performance in detecting and classifying MCs, achieving high agreement with physicians in MCs diagnosis. These results suggest that deep learning models have the potential to facilitate the application of intelligent assisted diagnosis techniques in the field of spine research.