Findings Of Imaging Studies Research Articles

Brain-based correlates of depression and traumatic brain injury: a systematic review of structural and functional magnetic resonance imaging studies

IntroductionDepression is prevalent after traumatic brain injury (TBI). However, there is a lack of understanding of the brain-based correlates of depression post-TBI. This systematic review aimed to synthesize findings of structural and functional magnetic resonance imaging (MRI) studies to identify consistently reported neural correlates of depression post-TBI.MethodsA search for relevant published studies was conducted through OVID (MEDLINE, APA PsycINFO, and Embase), with an end date of August 3rd, 2023. Fourteen published studies were included in this review.ResultsTBI patients with depression exhibited distinct changes in diffusion- based white matter fractional anisotropy, with the direction of change depending on the acuteness or chronicity of TBI. Decreased functional connectivity (FC) of the salience and default mode networks was prominent alongside the decreased volume of gray matter within the insular, dorsomedial prefrontal, and ventromedial prefrontal cortices. Seven studies reported the correlation between observed neuroimaging and depression outcomes. Of these studies, 42% indicated that FC of the bilateral medial temporal lobe subregions was correlated with depression outcomes in TBI.DiscussionThis systematic review summarizes existing neuroimaging evidence and reports brain regions that can be leveraged as potential treatment targets in future studies examining depression post-TBI.

The Diagnosis and Treatment of Chronic Rhinosinusitis.

Chronic rhinosinusitis (CRS) is a heterogeneous condition characterized by local chronic inflammation of the mucous membranes of the nose and paranasal sinuses. It affects approximately 5% of the population. This review is based on relevant publications retrieved by a selective search of the literature, with particular attention to current national and international guidelines. CRS is defined by, and diagnosed on the basis of, a combination of symptoms and objective findings of nasal endoscopy and imaging studies. It markedly impairs quality of life and gives rise to both direct and indirect health care costs. In 20-45% of cases, CRS is associated with comorbid bronchial asthma and a significantly elevated risk of further diseases (e.g., COPD, OR 1.73; depression, HR 1.50; obstructive sleep apnea, OR 1.91; carcinoma, OR 1.14-5.30). CRS is primarily treated medically with topical steroids (standardized mean difference of nasal symptoms, -0.63 (95% confidence interval [-0.89; -0.37]; standardized mean difference of quality of life as measured by SNOT -22, -5.46 [-8.08; -2.84]), as well as with nasal lavage and, as an option, systemic steroids (and antibiotics where appropriate). If appropriate medical treatment fails to bring about adequate and sustained improvement, endoscopic surgery on the paranasal sinuses is indicated. This improves the individual symptoms, the overall symptom score, and patients' quality of life. Severe refractory CRS with nasal polyposis can be treated with biological agents. CRS calls for individually adapted medical and/or surgical treatment.

The prevalence and anatomy of accessory navicular bone: a meta-analysis

PurposeThere have been over 40 descriptions of the common developmental variants of the accessory ossicles of the feet. Although predominantly asymptomatic, they sometimes may be linked to painful conditions. One of the most common accessory ossicles in the foot is the accessory navicular bone (AN), located on the medial side of the foot. Our research provides a first meta-analysis on this topic that establishes its frequency by contrasting 39 studies from across the globe.MethodsUp to February 2024, PubMed and Embase databases were thoroughly searched for research on the AN. Eligible data regarding AN prevalence was extracted. This study strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.ResultsA total of 39 studies, 11,015 patients, and 36,837 feet were analyzed in our study. The pooled prevalence estimate (PPE) of AN was found to be 17.5% (95%CI: 11.5–25.7) and 12.6% (95%CI: 10.1–15.5) in patients and feet analyses, respectively. Accessory navicular occurred bilaterally in 50.0% of patients, with similar distribution in gender-based groups (21.1% of males and 22.0% of females were confirmed with AN). Accessory navicular was most prevalent in the East Asian population (38.4%) and least prevalent in North Americans (8.0%). No significant differences in AN prevalence were found when comparing different imaging modalities (X-ray and cadaver dissection).ConclusionAccessory navicular is a common finding in imaging studies. Its prevalence depends on the population covered by the study but is not affected by the patient’s gender or the imaging modality utilized for AN assessment.

Features of the clinical course of Autoimmune Encephalitis Associated with various antibodies.

Despite the increasing incidence of autoimmune encephalitis and the incomplete recovery observed in patients post-affliction, the issue of timely diagnosis remains unresolved. The primary objective of this study is identification the distinctive clinical presentation features evaluation the management strategies, and assess the outcomes of the disease in patients with various forms of autoimmune encephalitis. The research aims to contribute in a better understanding of the disease progression and facilitate the selection of optimal therapeutic interventions. A retrospective observational study enrolled 68 patients aged 18 years and older with verified autoimmune encephalitis who underwent treatment in state hospitals in Sofia, Bulgaria, from the beginning of 2014 to the end of 2022. The number of patients with pathology linked to antibodies against glycine receptors (Gly-R) was half as much, with 32 and 17 patients, respectively. The primary manifestations of autoimmune encephalitis included cognitive impairments observed in 51 patients, seizures occurring in 44 patients, and mood disorders observed in 22 patients. While the findings of imaging studies were nonspecific, hospitalizations for patients with this pathology, especially those with antibodies to CASPR2 and DPPX, were prolonged (114 and 232 days, respectively). In the vast majority of cases, incomplete recovery with residual symptoms was noted. Among the diverse forms of autoimmune encephalitis, the most prevalent is NMDA-R. Cognitive impairments predominate in the autoimmune encephalitis clinical presentation. Prolonged hospitalization periods and incomplete recovery of patients are characteristic features of autoimmune encephalitis, despite combined therapy involving intravenous administration of methylprednisolone and immunoglobulins.

Intestinal tuberculosis as a diagnostic challenge in a high prevalence center.

The differential diagnosis between Crohn's disease (CD) and intestinal tuberculosis (ITB) continues to pose a diagnostic challenge, as clinical presentation can be indistinguishable, as well as findings in imaging studies and endoscopy. It is essential to make a definitive diagnosis early on, screening for possible latent infectious diseases, especially in patients from endemic areas, as inmmunosuppressive treatment can result in a fatal outcome during the course of TBI.

Cardiac MRI of characteristic motion findings in right bundle branch block.

While there have been many descriptions of characteristic motion findings in left bundle branch block (LBBB), there are few published descriptions of such findings in right bundle branch block (RBBB).The purpose of this study was to assess the frequency of particular regional motion findings in cardiac magnetic resonance imaging (CMR) studies of patients with RBBB, compared with normal subjects. We focused on three distinctive motion patterns that can be seen in RBBB during early systole: delayed apex-ward motion of the RV base, "reverse septal flash", and "basal bulge". The presence and relative magnitude of these findings were independently scored by four experienced observers, in 3-chamber and 4-chamber CMR cines, for both normal subjects and patients with RBBB. These motion patterns were found to be strongly associated with the presence of RBBB. While only moderately sensitive, they were quite specific for RBBB, when present. In particular, with ROC analysis, a combined feature set of the findings in the 4-chamber view had an area under the curve of 0.81.This previously undescribed set of RBBB-associated early-systolic regional motion features (delayed apex-ward motion of the RV base, "reverse septal flash", and "basal bulge") is strongly suggestive of RBBB when present, particularly in the 4-chamber view. Although here evaluated with CMR, it is also likely to be associated with RBBB when seen with other cardiac imaging modalities.

Chronic expanding hematoma

Chronic expansive hematoma (CEH) is a rare lesion, characterized by the persistence and increase in size of an hematoma for a period greater than one month since the initial hemorrhage. The clinical importance of this pathology is due to the fact that it can simulate malignant soft tissue neoplasms, both clinically as a result of its progressive growth and radiologically for its findings in imaging studies. This article will review three cases of CEH in different scenarios, explaining the radiological findings in different imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and PET-CT.

Three potential neurovascular pathways driving the benefits of mindfulness meditation for older adults.

Mindfulness meditation has been shown to be beneficial for a range of different health conditions, impacts brain function and structure relatively quickly, and has shown promise with aging samples. Functional magnetic resonance imaging metrics provide insight into neurovascular health which plays a key role in both normal and pathological aging processes. Experimental mindfulness meditation studies that included functional magnetic resonance metrics as an outcome measure may point to potential neurovascular mechanisms of action relevant for aging adults that have not yet been previously examined. We first review the resting-state magnetic resonance studies conducted in exclusively older adult age samples. Findings from older adult-only samples are then used to frame the findings of task magnetic resonance imaging studies conducted in both clinical and healthy adult samples. Based on the resting-state studies in older adults and the task magnetic resonance studies in adult samples, we propose three potential mechanisms by which mindfulness meditation may offer a neurovascular therapeutic benefit for older adults: (1) a direct neurovascular mechanism via increased resting-state cerebral blood flow; (2) an indirect anti-neuroinflammatory mechanism via increased functional connectivity within the default mode network, and (3) a top-down control mechanism that likely reflects both a direct and an indirect neurovascular pathway.

Hematoma crónico expansivo

Chronic expansive hematoma (CEH) is a rare lesion, characterized by the persistence and increase in size of an hematoma for a period greater than one month since the initial hemorrhage. The clinical importance of this pathology is due to the fact that it can simulate malignant soft tissue neoplasms, both clinically as a result of its progressive growth and radiologically for its findings in imaging studies. This article will review 3 cases of CEH in different scenarios, explaining the radiological findings in different imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and PET-CT.

An Equity and Justice-Informed Ethical Framework to Guide Incidental Findings in Brain Imaging Research.

The handling of incidental findings (IFs) in brain imaging studies has been a source of contention among scientists and bioethicists. A conceptual framework informed by diversity, equity, and inclusion (DEI) and distributive justice approaches, namely EUSTICE, is proposed for the ethical handling and reporting of IFs in brain imaging research. I argue that EUSTICE provides a systematic and inclusive approach to addressing the ethical conundrum around IF disclosure and managing IFs proportionately and sensitively in brain imaging research. The EUSTICE framework may have implications for the field of neurosciences or human studies broadly in guiding ethics of IFs in research.

18F-FP-CIT dopamine transporter PET findings in the striatum and retina of type 1 diabetic rats.

Noninvasive methods used in clinic to accurately detect DA neuron loss in diabetic brain injury and diabetic retinopathy have not been reported up to now. 18F-FP-CIT is a promising dopamine transporter (DAT) targeted probe. Our study first applies 18F-FP-CIT PET imaging to assess DA neuron loss in thestriatum and retina of T1DM rat model. T1DM rat model was induced by a single intraperitoneal injection of streptozotocin (STZ) (65mgkg-1, ip). 18F-FP-CIT uptake in the striatum and retina was evaluated at 4 weeks, 8 weeks and 12 weeks after STZ injection. The mean standardized uptake value (SUVmean) and the maximum standardized uptake value (SUVmax) were analyzed. Western blot was performed to confirm the DAT protein levels in the striatum and retina. PET/CT results showed that the SUV of 18F-FP-CIT was significantly reduced in the diabetic striatum and retina compared with the normal one from 4-week to 12-week (p < 0.0001). Western blots showed that DAT was significantly lower in the diabetic striatum and retina compared to the normal one for all three time points (p < 0.05). The results from Western blots confirmed the findings in PET imaging studies. DA neuron loss in thestriatum and retina of T1DM rat model can be non-invasively detected with PET imaging using 18F-FP-CIT targeting DAT. 18F-FP-CIT PET imaging may be a useful tool used in clinic for DR and diabetic brain injury diagnosis in future. The expression level of DAT in striatum and retina may act as a new biomarker for DR and diabetic brain injury diagnosis.

Correlation of Magnetic Resonance Imaging (Neurography) and Electrodiagnostic Study Findings with Intraoperative Findings in Post Traumatic Brachial Plexus Palsy.

Background The majority of brachial plexus injuries (BPIs) are caused by trauma; most commonly due to two-wheeler road accidents. It is important to determine whether the lesion in question is pre-ganglionic or post-ganglionic for purposes of surgical planning and prognosis. Diagnostic testing helps the surgeon to not only decide whether surgical intervention is required, but also in planning the procedure, thereby maximizing the patient's chances of early return to function. The aim of the study was to determine the diagnostic efficacy of electrodiagnostic studies (Edx) and magnetic resonance imaging (MRI) individually, and in unison, in detecting the type and site of BPI by comparison with intraoperative findings (which were used as the reference standard) in patients with posttraumatic BPI. Methods It is an observational cross-sectional prospective randomized study, wherein 48 patients with BPI underwent a detailed clinical and neurological examination of the upper limb, Edx, MRI neurography and were subsequently operated upon. We assessed a total of 240 roots. The diagnosis of all spinal roots was noted on Edx. MRI was performed to look for root avulsion, pseudomeningocoele, and/or rupture injury. The patients were subsequently operated upon. All roots were traced from infraclavicular level right up to the foramen to ensure continuity of root or note rupture/ avulsion. The findings were tabulated. Results MRI accurately diagnosed 138 of the 147 injured roots and MRI sensitivity for the detection of BPI was 93.88%, whereas Edx correctly identified 146 out of 147 injured roots and thus, had sensitivity of 99.32%; however, both lacked specificity (18.28 and 20.43%, respectively). With Edx and MRI in unison, sensitivity was 100% which meant that if a given patient with a BPI is subjected to both tests, not a single abnormal root will go unnoticed. Conclusion Edx and MRI are two highly sensitive investigation modalities whose combined sensitivity is 100% for the detection of a root injury. Therefore, we recommend both tests as they are excellent screening tests.

Retrodural space of Okada in the posterior ligamentous complex region: clinical and anatomical findings relevant to lumbar interlaminar epidural injection

BackgroundThe retrodural space of Okada is a potential space posterior to the ligamentum flavum that allows communication with the bilateral facet joints. However, the actual anatomy of this space has...

Foot and Ankle Offset (FAO) Does Not Reflect the Actual Hindfoot Alignment in Cases Involving Ankle and/or Sagittal Foot and Ankle Deformities

Category: Hindfoot; Ankle; Midfoot/Forefoot Introduction/Purpose: The foot and ankle offset (FAO) was developed as a 3D biometric tool to measure hindfoot alignment on weightbearing CT (WBCT) scans. It corresponds to the offset between the hindfoot-to-forefoot midline and the talus and is reported as a percentage of foot-length. (1) Recently, with increased availability of WBCT in both research and clinical practice, the FAO has been widely used for hindfoot alignment assessment. (2) However, after extensive review of WBCT scans the authors of this study have noticed that FAO has a high false negative rate. This study aimed to demonstrate why FAO is inadequate in assessing 3D hindfoot alignment using both case examples and mathematical algorithms. Methods: This was a retrospective study including a cohort of 31 cases with various clinical diagnoses selected from a data base of WBCT in 260 patients. The deformities included valgus or varus ankle deformities, hindfoot deformities combined with sagittal plane deformities of the foot and ankle, rocker bottom foot deformity, ankle equinus, metatarsus primus elevatus, and first metatarsal plantarflexion. All of the latter deformities caused one or more parts of the triangular base for FAO evaluation (the 1st metatarsal, the 5th metatarsal and the calcaneus) to remain off the floor. The medical charts and WBCT scans of each patient were reviewed to evaluate the deformities in more detail. The FAO was measured by two fellowship trained foot and ankle surgeons separately. The clinical and radiographic diagnoses were compared with the FAO value to determine the accuracy and utility of the latter measurement. Limitations of FAO as a semi 3D tool using the tripod theory in assessing the hindfoot alignment were also demonstrated mathematically. Results: For each of these 31 cases examined, the hindfoot alignment information reflected by the FAO value was vastly different from the clinical and imaging study findings. (Table 1). Using the reference value for FAO (Normal 2.3% ± 2.9%, Varus −11.6%± 6.9%, and Valgus 11.4% ± 5.7%), 24 out of 31 cases in the cohort had a normal FAO value, however, among them there were 7 with a valgus ankle or distal tibia plus a normal or cavovarus hindfoot, 2 varus ankles with a normal hindfoot, 1 varus ankle with a valgus hindfoot, 3 cavovarus feet, 1 clubfoot, 1 equinus ankle with cavovarus foot, 2 equinus ankle with severe valgus hindfoot, 4 severe valgus hindfoot and 1 varus hindfoot with sagittal plane deformities, 2 Muller Weiss Disease; 5 out of 31 cases had a varus FAO value, but they all had a valgus ankle with either a varus hindfoot or sagittal plane deformities; 2 out of 31 cases had a valgus FAO value, however both cases had a valgus ankle with a varus hindfoot. Thorough algorithm and geometric evidence were provided. Conclusion: FAO has a very limited capacity to reflect hindfoot deformities, understandable when analyzing how the FAO is designed and measured mathematically. It is not a 3D tool. It does not include the level of the ankle nor the tibia, therefore it is not appropriate nor capable to be used as a hindfoot alignment evaluation tool. The tripod and talus projection theories cannot reflect sagittal plane deformities or coronal plane rotation, and false results are inevitably generated. Reference: 1. Lintz F, Barton T, Millet M, Harries WJ, Hepple S, Winson IG. Ground reaction force calcaneal offset: a new measurement of hindfoot alignment. Foot Ankle Surg. 2012;18(1):9-14. 2. de Cesar Netto C, Day J, Godoy-Santos AL, Roney A, Barbachan Mansur NS, Lintz F, Ellis SJ, Demetracopoulos CA. The use of three-dimensional biometric Foot and Ankle Offset to predict additional realignment procedures in total ankle replacement. Foot Ankle Surg. 2022 Feb 16:S1268-7731(22)00036-4.

12. Assessment of age-related intervertebral disc degenerations of the cervical spine in different age groups: a kinematic MRI study

<h3>BACKGROUND CONTEXT</h3> Cervical intervertebral disc (IVD) degeneration is a common cause of neck and arm pain in adults and a frequent finding in imaging studies. <h3>PURPOSE</h3> This study aimed to assess the age-related degenerations of the cervical IVDs at each cervical spinal level in different age groups using the kinematic magnetic resonance imaging (KMRI). <h3>STUDY DESIGN/SETTING</h3> Cross-sectional study using KMRI. <h3>PATIENT SAMPLE</h3> This study included 1300 symptomatic patients who had undergone upright cervical spine KMRI from February 2019 to November 2021. <h3>OUTCOME MEASURES</h3> Pfirrmann classification of intervertebral disc degeneration. <h3>METHODS</h3> Patients were divided into five equal groups, each with 260 patients based on their ages. Group 1 included patients from 20 to 29 years, group 2 from 30 to 39 years, group 3 from 40 to 49 years, group 4 from 50 to 59 years, and group 5 were patients aged 60 years and above. On T2-weighted sagittal MRI, Pfirrmann grading system was used to grade the IVD degeneration into five grades. Considerable disc degeneration was reported with a Pfirrmann grade IV or V. A total of 7800 cervical IVDs from C2/3 to C7/T1 were evaluated. The severity and pattern of IVD degeneration in each age group was analyzed. <h3>RESULTS</h3> Overall, 4.4% of discs were grade I, 21.0% grade II, 55.1% grade III, 17.1% grade IV, and 2.5% grade V. The number of degenerated discs increased gradually with age groups; 4.9%, 8.4%, 16.4%, 24.6%, and 43.4% in groups 1, 2, 3, 4, and 5, respectively, P < 0.001. In group 1, the most common grade was grade II (41.5%), and the most common degenerated level was C2/3 (25%). In group 2, the most common grade was grade III (53.1%), and the most common degenerated level was C5/6 (29.0%). In group 3, the most common grade was grade III (60.2%), and the most common degenerated level was C5/6 (33.1%). In group 4, the most common grade was grade III (67.0%), and the most common degenerated level was C5/6 (31.3%). In group 5, the most common grade was grade III (56.0%), and the most common degenerated level was C5/6 (24.8%). In all groups, C7/T1 was the least common degenerated disc (6.6%, 3.1%, 3.5%, 4.7% and 8.7% in groups 1, 4 and 5, respectively). In groups 1 and 2, 92.1% and 86.3% of subjects, did not have considerable disc degeneration. In group 5, 19.5% of patients had 2-level disc degeneration, 15.5% had 3-level disc degeneration, and the incidence of 6-level degeneration was 11.2%. In patients with single-level disc degeneration, C5/6 was the most common degenerated level (45.3%). In patients with 2-level degeneration, C5/6 and C6/7 were the most common (49.7%). In patients with 3-level degeneration, C4/5, C5/6, and C6/7 were the most common (38.5%). In patients with 4-level degeneration, C2/3, C3/4, and C5/6 were the most common (36.2%). Skip-level degeneration was found in 18.2%, 30.2%, and 20.3% of patients with 2-level, 3-level, and 4-level degeneration, respectively. <h3>CONCLUSIONS</h3> This study evaluated the severity and pattern of IVD degeneration at each level of the cervical spine in different age groups. The number and severity of degenerated discs increases with age. Adjacent-level degeneration is more common than skip-lesion degeneration in patients with multilevel disc degeneration. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Falciform ligament abscess with disseminated intrahepatic foci: a case report

BackgroundFalciform ligament abscess (FLA) is a rare disease, and its diagnosis can be challenging without typical image findings of an abscess. We report a patient with FLA that presented as a mass, with an indistinct border between it and the liver, in addition to disseminated foci within the liver. This made it difficult to determine whether it was FLA or a malignancy.Case presentationA 69-year-old man presented with epigastric pain. Contrast-enhanced computed tomography revealed a 25-mm mass below the middle of the diaphragm. Based on an initial diagnosis of infection of the falciform ligament, we administered conservative antibiotic treatment and there was initial improvement in the patient’s clinical condition and laboratory data. However, he continued to experience mild epigastric pain. A month later, imaging studies revealed enlargement of the falciform ligament mass and the emergence of a new nodule in the liver, whereas laboratory findings showed re-elevated C-reactive protein levels. Since conservative treatment had failed, we decided to perform surgery. Considering the imaging study findings, malignant disease could not be ruled out. Based on the operative findings, we performed combined resection of the falciform ligament, left liver, and gallbladder. Histopathological examination of the resected specimens revealed extensive neutrophil infiltration and the presence of giant cells and foam cells within the lesions. These findings were indicative of abscess. Pseudomonas aeruginosa was cultured from the pus in the falciform ligament mass and bile in the gallbladder. Although multiple abscesses postoperatively developed in the residual portion of the liver, they could be treated through antibiotic therapy.ConclusionsFLA can spread to both adjacent and distant organs via its rich vascular and lymphatic networks. When FLA displays atypical image findings and/or an atypical clinical course, it can be difficult to distinguish it from malignant disease. In such cases, surgical treatment, with intraoperative pathological diagnosis, should be attempted.

Vascular loop in the cerebellopontine angle: Clinical-radiological correlation

BackgroundThe brainstem, situated in the posterior fossa, connects the brain to the spinal cord. Owing to its location, the nerves of the brainstem are closely related with vascular structures. ObjectivesTo correlate the finding of vascular loops in the cerebellopontine angle on imaging with symptoms indicative of vestibulocochlear involvement. Materials and methodsThis retrospective descriptive study included all patients evaluated between 2011 and 2017 with findings suggestive of vascular loops in the cerebellopontine angle for whom the clinical history and imaging studies were available. ResultsA total of 102 patients (63 women and 39 men) had vestibulocochlear involvement. The most common clinical indication was dizziness (41.18%). A unilateral vascular loop was found in 43 patients (right: 21.57%, left: 20.59%) and bilateral loops were found in 59 (57.84%) patients. The most common type of vascular loop was type II (right: 69.14%; left: 58.75%). The most common origin of vascular loops was the anterior inferior cerebellar artery (right: 66.67%, left: 65.00%). No associations were observed between vascular loops and sensorineural hearing, nystagmus, or vertigo. There was an association with tinnitus. Conclusions and significanceThe presence of vascular loops is not associated with most auditory symptoms. Nevertheless, all findings on imaging studies must be reported. The interpretation of the findings of imaging studies must be correlated with the clinical symptoms after other more common causes that can explain the symptoms have been ruled out.

Robotic Replica of a Human Spine Uses Soft Magnetic Sensor Array to Forecast Intervertebral Loads and Posture after Surgery.

Cervical disc implants are conventional surgical treatments for patients with degenerative disc disease, such as cervical myelopathy and radiculopathy. However, the surgeon still must determine the candidacy of cervical disc implants mainly from the findings of diagnostic imaging studies, which can sometimes lead to complications and implant failure. To help address these problems, a new approach was developed to enable surgeons to preview the post-operative effects of an artificial disc implant in a patient-specific fashion prior to surgery. To that end, a robotic replica of a person’s spine was 3D printed, modified to include an artificial disc implant, and outfitted with a soft magnetic sensor array. The aims of this study are threefold: first, to evaluate the potential of a soft magnetic sensor array to detect the location and amplitude of applied loads; second, to use the soft magnetic sensor array in a 3D printed human spine replica to distinguish between five different robotically actuated postures; and third, to compare the efficacy of four different machine learning algorithms to classify the loads, amplitudes, and postures obtained from the first and second aims. Benchtop experiments showed that the soft magnetic sensor array was capable of precisely detecting the location and amplitude of forces, which were successfully classified by four different machine learning algorithms that were compared for their capabilities: Support Vector Machine (SVM), K-Nearest Neighbor (KNN), Random Forest (RF), and Artificial Neural Network (ANN). In particular, the RF and ANN algorithms were able to classify locations of loads applied 3.25 mm apart with 98.39% ± 1.50% and 98.05% ± 1.56% accuracies, respectively. Furthermore, the ANN had an accuracy of 94.46% ± 2.84% to classify the location that a 10 g load was applied. The artificial disc-implanted spine replica was subjected to flexion and extension by a robotic arm. Five different postures of the spine were successfully classified with 100% ± 0.0% accuracy with the ANN using the soft magnetic sensor array. All results indicated that the magnetic sensor array has promising potential to generate data prior to invasive surgeries that could be utilized to preoperatively assess the suitability of a particular intervention for specific patients and to potentially assist the postoperative care of people with cervical disc implants.

Assessment of pulmonary embolism severity and the risk of early death.

Currently, venous thromboembolism, including deep vein thrombosis and acute pulmonary embolism (PE), is globally the third most frequent acute cardiovascular syndrome with rising incidence rates. The clinical presentation of PE is heterogenous: from incidental findings on imaging studies to sudden cardiac death. Hemodynamic instability identifies patients at high risk of early mortality. In hemodynamically stable patients, further stratification into intermediate- and low-risk categories is advised, preferably using a combined risk assessment strategy based on clinical parameters, laboratory findings, and imaging markers. Treatment should be tailored to the risk of early death, with more aggressive treatments reserved for patients at higher risk of complications. This review offers an update on the current strategies for assessing PE severity and the risk of early death and discusses developments in predicting mortality risk in patients with PE.

It’s time for sex in cognitive neuroscience

ABSTRACT In a discussion paper published in the special issue of Cognitive Neuroscience, Sex Differences in the Brain, we investigated whether certain experimental parameters contributed to findings in functional magnetic resonance imaging studies of sex differences during long-term memory. Experimental parameters included: the number of participants, stimulus type(s), whether or not performance was matched, whether or not sex differences were reported, the type of between-subject statistical test used, and the contrast(s) employed. None of these parameters determined whether or not differences were observed, as all included studies reported sex differences. We also conducted a meta-analysis to determine if there were any brain regions consistently activated to a greater degree in either sex. The meta-analysis identified sex differences (male > female) in the lateral prefrontal cortex, visual processing regions, parahippocampal cortex, and the cerebellum. We received eight commentaries in response to that paper. Commentaries called for an expanded discussion on various topics including the influence of sex hormones, the role of gender (and other social factors), the pros and cons of equating behavioral performance between the sexes, and interpreting group differences in patterns of brain activity. There were some common statistical assumptions discussed in the commentaries regarding the ‘file drawer’ issue (i.e., the lack of reporting of null results) and effect size. The current paper provides further discussion of the various topics brought up in the commentaries and addresses some statistical misconceptions in the field. Overall, the commentaries echoed a resounding call to include sex as a factor in cognitive neuroscience studies.