Global Function Research Articles

Small Effects of Olfactory Identification and Discrimination on Global Cognitive and Executive Performance Over 1 Year in Aging People Without a History of Age-Related Cognitive Impairment.

Olfactory and cognitive performance share neural correlates profoundly affected by physiological aging. However, whether odor identification and discrimination scores predict global cognitive status and executive function in healthy older people with intact cognition is unclear. Therefore, in the present study, we set out to elucidate these links in a convenience sample of 204 independently living, cognitively intact healthy Czech adults aged 77.4 ± 8.7 (61 - 97 years) over two waves of data collection (one-year interval). We used the Czech versions of the Montreal Cognitive Assessment (MoCA) to evaluate global cognition, and the Prague Stroop Test, Trail Making Test, and several verbal fluency tests to assess executive function. As a subsidiary aim, we aimed to examine the contribution of olfactory performance towards achieving a MoCA score above vs. below a published cut-off value. Our findings demonstrate that olfaction, on the one hand, and global cognition and executive function, on the other, are related even in healthy older people.

Evaluation of the therapeutic effects of rehabilitation therapy on patients with amyotrophic lateral sclerosis—a meta-analysis

ObjectiveTo investigate the effect of rehabilitation therapy on the global function, respiratory function, and quality of life in patients with amyotrophic lateral sclerosis (ALS).MethodsPubMed, Web of Science, and The National Library of Medicine (NLM) were systematically searched and the search period was between the date of database establishment and December 31, 2023. The outcome measures finally analyzed included the ALS functional rating scale/revised (ALSFRS/ALSFRS-R), forced vital capacity percentage predicted (FVC%), fatigue severity scale (FSS), and maximal expiratory pressure (MEP).ResultsA total of 13 randomized controlled trials (RCTs) were included, and 5 outcome measures were pooled and analyzed. A total of 657 patients with ALS were enrolled, with 299 in the experimental group (rehabilitation therapy, such as resistance training, endurance training, aerobic training, respiratory muscle training, and standard rehabilitation therapy) and 358 in the control group (conventional interventions, such as simple joint movements or daily stretching). The ALSFRS scores were better in the experimental group than in the control group at 0–4 months (MD = 3.36, 95% CI: 0.82, 5.91, Z = 2.59, p = 0.009) and at 5–8 months (MD = 5.00, 95% CI: −2.42, 7.58, Z = 3.80, p < 0.001). Moreover, the ALSFRS-R scores of the experimental group was better than that of the control group at 5–8 months (MD = 2.83, 95% CI: 1.21, 4.45, Z = 3.42, p < 0.001) and 9–12 months (MD = 1.87, 95% CI: −0.37, 4.11, Z = 1.63, p = 0.10). It was also found that the MEP value of the experimental group was significantly better than that of the control group after intervention (MD = 18.49, 95% CI: 1.47, 35.50, Z = 2.13, p = 0.03). However, there were no significant differences in FVC% value and FSS scores at 0–5 months and 6–12 months between the two groups.ConclusionRehabilitation therapy is helpful in improving the short-, medium-, and long-term global function score of patients with ALS, with positive effects on respiratory function.

Latent Class Analysis of Sleep in Mild Cognitive Impairment Patients and its Influencing Factors

Background: Individuals with mild cognitive impairment (MCI) frequently experience sleep disorders, which may elevate the risk of developing Alzheimer’s disease. Yet, sleep types in MCI patients and the factors influencing them have not been sufficiently investigated. Objective: The objective of this study was to explore potential sleep typing and its influencing factors in patients with MCI using latent class analysis. Methods: A cross-sectional survey was conducted in Jiangsu Province, China. Cognitive function in older adults was assessed using neuropsychological tests, including the Montreal Cognitive Assessment Scale-Beijing version (MoCA), the Mini-Mental State Examination (MMSE), the Activities of Daily Living Scale (ADL), and the Clinical Dementia Rating Scale (CDR). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Latent class analysis based on PSQI scores and multinomial logistic regression analyses were employed to explore the influencing factors of sleep typing. Results: The study included a total of 611 patients with MCI. Latent class analysis identified three latent classes to categorize the sleep patterns of MCI patients: the good sleep type (56.6%), the insufficient sleep type (29.6%), and the difficulty falling asleep type (13.7%). Potential sleep typing is influenced by gender, chronic disease, physical exercise, social activity, brain exercise, smoking, frailty, subjective cognitive status, and global cognitive function. Conclusions: The findings of this study underscore the notable heterogeneity in the sleep patterns of patients with MCI. Future research may provide targeted prevention and interventions to address the characteristics and influencing factors of patients with different subtypes of sleep MCI.

Psychometric Evaluation of the Chinese Version of the Family Accommodation Scale for Obsessive–Compulsive Disorder Patient Version

This study aimed to examine the psychometric properties of the Chinese version of the family accommodation scale for obsessive–compulsive disorder (OCD) patient version (FAS-PV). A total of 171 adult OCD patients and 145 family members were enrolled in the present study. The majority of the adult OCD patients (89.5%) reported engaging in at least one accommodating behavior in the past week. The FAS-PV comprised three components that included (a) direct participation and facilitation, (b) provision of reassurance and assumption, and (c) modification of routines and avoidance. The FAS-PV demonstrated excellent internal consistency. The correlation between the total FAS-PV score and the criteria measure demonstrated excellent convergent validity when assessing the OCD symptom severity, global functioning, family functioning, and functioning impairment. The findings supported that the FAS-PV could be used widely in evaluating and identifying the accommodating behavior both in clinical and in research settings, especially in adult OCD patients who usually present to the clinic alone.

Orbital-Optimized Versus Time-Dependent Density Functional Calculations of Intramolecular Charge Transfer Excited States.

The performance of time-independent, orbital-optimized calculations of excited states is assessed with respect to charge transfer excitations in organic molecules in comparison to the linear-response time-dependent density functional theory (TD-DFT) approach. A direct optimization method to converge on saddle points of the electronic energy surface is used to carry out calculations with the local density approximation (LDA) and the generalized gradient approximation (GGA) functionals PBE and BLYP for a set of 27 excitations in 15 molecules. The time-independent approach is fully variational and provides a relaxed excited state electron density from which the extent of charge transfer is quantified. The TD-DFT calculations are generally found to provide larger charge transfer distances compared to the orbital-optimized calculations, even when including orbital relaxation effects with the Z-vector method. While the error on the excitation energy relative to theoretical best estimates is found to increase with the extent of charge transfer up to ca. -2 eV for TD-DFT, no correlation is observed for the orbital-optimized approach. The orbital-optimized calculations with the LDA and the GGA functionals provide a mean absolute error of ∼0.7 eV, outperforming TD-DFT with both local and global hybrid functionals for excitations with a long-range charge transfer character. Orbital-optimized calculations with the global hybrid functional B3LYP and the range-separated hybrid functional CAM-B3LYP on a selection of states with short- and long-range charge transfer indicate that inclusion of exact exchange has a small effect on the charge transfer distance, while it significantly improves the excitation energy, with the best-performing functional CAM-B3LYP providing an absolute error typically around 0.15 eV.

Abstract PO3-11-05: Sexual dysfunction among Brazilian women with early breast cancer on adjuvant endocrine therapy (ET)

Abstract Background: Sexual dysfunction is a common health problem in women, and it can occur during breast cancer treatment and survivorship. This study aims to determine the frequency of sexual disfunction among Brazilian women with early breast cancer on adjuvant endocrine therapy and to explore its relationships with patients’ clinical and social characteristics, adherence to ET, quality of life, return to work and healthcare insurance. Methodology: Women with history of early-stage ER+ invasive carcinoma of the breast on adjuvant endocrine therapy for at least 6 months were invited to participate of this study. Sexual dysfunction was evaluated using the Female Sexual Function Index questionnaire (FSFI). A score of < 26.55 in FSFI indicates sexual dysfunction. We evaluated sexually active patients (women should have at least one sexual intercourse in the previous four weeks). Demographic and medical information, site of treatment (private versus public), degree of education (completed high school vs not) were reviewed from medical records. Quality of life was assessed using EORTC QLQ C30 and BR-23 forms and adherence to ET was assessed by the Morisky Medication Adherence Scale (MMAS-8). Additionally, patients were interviewed about return to work. Data collection was performed using RedCap software and statistical analyzes were performed on the software R (R Core Team (2022). Qualitative variables were compared between groups using the Chi-square or exact Chi-square test and for quantitative variables the non-parametric Mann-Whitney test was used. Multivariable analysis was performed using Poisson regression. P < 0.05 was considered significant. Analyzes were performed in SAS 9.4. Results: From June 2021 to May 2023, a total of 461 women with ER+ early-stage breast cancer from 12 Brazilian institutions were included in this analysis. The mean age was 56.0 years (range 22-93 ), 47.7% were non-white and 38.7% were premenopausal. A total of 233 women (50.6%) had private insurance and the remaining were treated in public institutions. Median duration of ET use was 2.78 years (range 6 months- 9.61 years).Only 249 (54%) out of 461 patients who accepted to participate in this study declared to have sexual intercourse in the previous 4 weeks before evaluation and composes the population of this analysis. Sexual disfunction according results of FSFI questionnaire was found in 113 (53.3%) participants. Age was significantly associated with sexual dysfunction with women > 40 years-old having higher rates (95.3%) compared with versus younger patients (4.71% p=0.0069). Patients without sexual dysfunction had significantly higher EORTC QLQ C30 Global health status, Physical Functioning, Emotional Functioning, Sexual Functioning and Sexual Enjoyment scores than those with sexual dysfunction (p = 0.0060, p = 0.0242, p = 0 .0353, p = 0.0002 and p < 0.0001 respectively). ET duration between 2 and 5 years vs < 2 years, higher vs lower education level, EORTC QLQ-BR23 breast symptom and sexual functioning higher scores were significantly associated with the occurrence of sexual dysfunction in multivariated analysis (p < 0.05). Conclusion: In our study, only 54% of women evaluated had sexual intercourse in the previous four weeks and from those women 53.3% reported sexual dysfunction. Factors related to sexual dysfunction were higher education level, ET duration between 2 and 5 years, breast symptom and sexual functioning higher scores. div style=margin-top:10px; margin-bottom:20px;>Characteristic with adjusted prevalence ratios for the occurrence of sexual disfunction XX XX PR: prevalence ratio, EORTC: European Organisation for Research and Treatment of Cancer Citation Format: Daniele Assad-Suzuki, Fernanda Moura, Danielle Santos, Sulene Oliveira, Cristiano Souza, Heloísa Resende, Andrea Shimada, Anna Luiza Galvão, Bruno Souza, Amanda Castro, Monalisa Andrade, Yuri Beckedorff, Maria Cristina Magalhães, Carlos Paiva, Angelica Rodrigues, Daniela Pereira, Daniela Rosa, Romualdo Barroso-Sousa. Sexual dysfunction among Brazilian women with early breast cancer on adjuvant endocrine therapy (ET) [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-11-05.

The modulation effect of cognition on mentalization in late-life depression: a study of gaze perception—a potential screening tool for high-risk group of late-life depression

IntroductionImpairment in mentalization is implicated in the development and maintenance of depression. Major depressive disorders showed significant impairment in social cognition and such impairment appears to be positively associated with the severity of depression. Self-referential gaze perception (SRGP), a measurement of mentalization, was predominantly measured in patients with psychosis but rarely examined in late-life depression (LLD).MethodsTo assess the effect of cognition on the interpretation bias of mentalization, 29 LLD patients and 29 healthy controls were asked to judge if various gaze directions were directed to self in SRGP.ResultsPatients with better cognition showed less unambiguous-SRGP bias than those with worse cognitive scores; this difference was not found in healthy controls. Global cognition and executive function contributed to the SRGP rate in patients.ConclusionThe current study is the first study to explore the relationship between cognition and SRGP in the LLD population. Our study findings suggested that the cognitive function of LLD patients may contribute to the modulation of interpretation bias, which in turn underlie the role of SRGP bias. Greater SRGP bias in patients may reflect social cognition deterioration, impairing the social interaction and functioning of LLD patients. This highlights the need for early intervention and cognitive decline identification to facilitate better prognosis and treatment effectiveness; thus, further studies could navigate the potential of SRGP task as a screening tool for high-risk group of LLD likely to develop dementia.

Association between global cognitive function and autonomic dysfunction in patients with de novo Parkinson’s disease

Association between global cognitive function and autonomic dysfunction in patients with de novo Parkinson’s disease

Learning-Based Autonomous Channel Access in the Presence of Hidden Terminals

We consider the problem of autonomous channel access (AutoCA), where a group of terminals tries to discover a communication strategy with an access point (AP) via a common wireless channel in a distributed fashion. Due to the irregular topology and the limited communication range of terminals, a practical challenge for AutoCA is the hidden terminal problem, which is notorious in wireless networks for deteriorating throughput and delay performances. To meet the challenge, this paper presents a new multi-agent deep reinforcement learning paradigm, dubbed MADRL-HT, tailored for AutoCA in the presence of hidden terminals. MADRL-HT exploits topological insights and transforms the observation space of each terminal into a scalable form independent of the number of terminals. To compensate for the partial observability, we put forth a look-back mechanism such that the terminals can infer behaviors of their hidden terminals from the carrier-sensed channel states as well as feedback from the AP. A window-based global reward function is proposed, whereby the terminals are instructed to maximize the system throughput while balancing the terminals' transmission opportunities over the course of learning. Considering short-packet machine-type communications, extensive numerical experiments verified the superior performance of our solution benchmarked against the legacy carrier-sense multiple access with collision avoidance (CSMA/CA) protocol.

Association between global cognitive function and autonomic dysfunction in patients with de novo Parkinson’s disease

Association between global cognitive function and autonomic dysfunction in patients with de novo Parkinson’s disease

Phosphate uptake in PhoX: Molecular mechanisms.

PhoX is a high-affinity phosphate binding protein, present in Xanthomonas citri, a phytopathogen responsible for the citrus canker disease. Performing molecular dynamics simulations and different types of computational analyses, we study the molecular mechanisms at play in relation to phosphate binding, revealing the global functioning of the protein: PhoX naturally oscillates along its global normal modes, which allow it to explore both bound and unbound conformations, eventually attracting a nearby negative phosphate ion to the highly positive electrostatic potential on its surface, particularly close to the binding pocket. There, several hydrogen bonds are formed with the two main domains of the structure. Phosphate creates, in this way, a strong bridge that connects the domains, keeping itself between them, in a tight closed conformation, explaining its high binding affinity.

A matching pursuit approach to the geophysical inverse problem of seismic travel time tomography under the ray theory approximation

Summary Seismic travel time tomography is a geophysical imaging method to infer the 3-D interior structure of the solid Earth. Most commonly formulated as a linearized inverse problem, it maps differences between observed and expected wave travel times to interior regions where waves propagate faster or slower than the expected average. The Earth’s interior is typically parametrized by a single kind of localized basis function. Here we present an alternative approach that uses matching pursuits on large dictionaries of basis functions. Within the past decade the (Learning) Inverse Problem Matching Pursuits ((L)IPMPs) have been developed. They combine global and local trial functions. An approximation is built in a so-called best basis, chosen iteratively from an intentionally overcomplete set or dictionary. In each iteration, the choice for the next best basis element reduces the Tikhonov–Phillips functional. This is in contrast to classical methods that use either global or local basis functions. The LIPMPs have proven their applicability in inverse problems like the downward continuation of the gravitational potential as well as the MEG-/EEG-problem from medical imaging. Here, we remodel the Learning Regularized Functional Matching Pursuit (LRFMP), which is one of the LIPMPs, for travel time tomography in a ray theoretical setting. In particular, we introduce the operator, some possible trial functions and the regularization. We show a numerical proof of concept for artificial travel time delays obtained from a contrived model for velocity differences. The corresponding code is available online.

Major Orthopaedic Surgery in Persons with Haemophilia A with and without Inhibitors Treated by Emicizumab: A Mid-Term, Large, and Successful Series at a Single Center

Introduction: Patients with Haemophilia (PWH) need orthopaedic treatments and often they undergo surgery. Classically, PWH with inhibitors have to face such procedures earlier than other patients. Major orthopaedic surgery is not easy and complications are frequent. Emicizumab is the first monoclonal antibody introduced for haematological prophylaxis for PWH with inhibitors, achieving an efficacious haemostasis also in patients with severe haemophilia A with inhibitors, later demonstrated for PWH without inhibitors. A few years ago, emicizumab was also proposed for PWH undergoing surgery, as it supports excellent bleeding control. The literature on orthopaedic surgery using an emicizumab protocol is scarce: only isolated case reports with short-term follow-ups are available. Aim: The purpose of this study is the assessment of the mid-term outcomes of major orthopaedic surgery performed in a population of patients with and without inhibitors and an emicizumab regimen. Methods: We reviewed the records of 13 PWH (eight with high-titre inhibitors, five without) with a mean age of 54.6 years, undergoing 15 orthopaedic surgical procedures between 2017 and 2022: primary knee and hip arthroplasty, revision, pseudotumor excision, or amputation. Their prophylaxis consisted of the combination of emicizumab and boluses of rFVIIa (PWH with inhibitors) or rFVIII (PWH without inhibitors). The clinical parameters of evaluation were: VAS, Haemophilic Joint Health Score (HJHS), and standard radiologic studies. Follow-up was conducted at 1, 3, 6 months, and then yearly. The survival rate of all implants was also assessed. Results: The mean follow-up was 38.8 months (range: 12–65). All patients were successfully treated without complications during surgery. During the postoperative period, a patient affected by a septic complication two months after his pseudotumor excision underwent an above-the-knee amputation. All patients were regularly discharged to the rehabilitative ward, reporting satisfaction for pain reduction and improved joint and global function at the VAS and HJHS scores. No revisions or implant failures were recorded. Conclusions: A prophylaxis regimen with emicizumab and factor replacement in PWH with or without inhibitors undergoing major orthopaedic surgery ensures effective bleeding control and good postoperative clinical outcomes at mid-term follow-up, and may be routinely adopted in dedicated high-volume hospitals. This series is the most consistent to date reported at a single Haemophilia centre.

Role of Fetal Cardiac ECHO and Fetal Cardiac MRI in Prediction of Post Natal Hemodynamic Maladaptation in Fetuses of Diabetic Mothers

Background: Maternal diabetes mellitus (DM) is defined as a degree of glucose intolerance with recognition during pregnancy (pregestational or gestational, type 1 or type 2), and it is estimated to be 15% in pregnant females in 2019. The current study aimed to study the role of fetal echocardiography and fetal cardiac magnetic resonance imaging (MRI) in anticipation and diagnosis of hemodynamic maladaptation changes in fetuses of diabetic mothers as predictors for (closure of Patent ductus arteriosus (PDA), persistent pulmonary hypertension and diastolic dysfunction) which were confirmed with post-natal echocardiographic and clinical assessment. Methods: This study was an observational follow-up study that included 80 pregnant diabetic females who were following in the specialized clinics of Ain Shams University Hospitals during the period starting from August 2020 till December 2022. Results: Diabetes affected left ventricle (LV) diastolic function and global cardiac function but did not affect LV systolic function (p-value=0.000). Interventricular septum (IVS) thickness had a significant positive correlation with LV- Myocardial performance index (MPI) and indices of DM such as HbA1c. Diastolic dysfunction was the most affected cardiac parameter in infants of diabetic mothers (p-value=0.002). The hemoglobin A1c (HbA1c) was the most significant predictor for IVS thickness in diabetic mothers' fetuses, especially with a long duration of DM (p-value=0.012). Conclusion: Fetal echocardiography in diabetic mothers is essential and the gold standard modality not only for diagnosing structural abnormalities but also for evaluating the cardiac function of the fetuses. Fetal cardiac MRI could be considered a complementary imaging modality that uses no ionizing radiation, good tissue contrast, and a larger field of view.

Intrinsic Information-Theoretic Models

With this follow-up paper, we continue developing a mathematical framework based on information geometry for representing physical objects. The long-term goal is to lay down informational foundations for physics, especially quantum physics. We assume that we can now model information sources as univariate normal probability distributions N (μ, σ0), as before, but with a constant σ0 not necessarily equal to 1. Then, we also relaxed the independence condition when modeling m sources of information. Now, we model m sources with a multivariate normal probability distribution Nm(μ,Σ0) with a constant variance–covariance matrix Σ0 not necessarily diagonal, i.e., with covariance values different to 0, which leads to the concept of modes rather than sources. Invoking Schrödinger’s equation, we can still break the information into m quantum harmonic oscillators, one for each mode, and with energy levels independent of the values of σ0, altogether leading to the concept of “intrinsic”. Similarly, as in our previous work with the estimator’s variance, we found that the expectation of the quadratic Mahalanobis distance to the sample mean equals the energy levels of the quantum harmonic oscillator, being the minimum quadratic Mahalanobis distance at the minimum energy level of the oscillator and reaching the “intrinsic” Cramér–Rao lower bound at the lowest energy level. Also, we demonstrate that the global probability density function of the collective mode of a set of m quantum harmonic oscillators at the lowest energy level still equals the posterior probability distribution calculated using Bayes’ theorem from the sources of information for all data values, taking as a prior the Riemannian volume of the informative metric. While these new assumptions certainly add complexity to the mathematical framework, the results proven are invariant under transformations, leading to the concept of “intrinsic” information-theoretic models, which are essential for developing physics.

Race/ethnicity and socioeconomic status as predictors of outcome following family therapy in youth at clinical high risk for psychosis.

There is limited research on the effects of sociodemographic and socioeconomic factors on treatment outcomes in youth at clinical high risk for psychosis (CHRp). This study examined sociodemographic factors that may affect functional outcomes within this population. Specifically, we investigated the influence of race/ethnicity (dichotomized as non-Hispanic whites [NHW] vs. people of colour [POC]), socioeconomic status (SES; operationalized as parental years of education), and their interaction on change in psychosocial functioning and symptoms over 6 months in a randomized trial of family-focused therapy. CHRp youth (N = 128) participated in a randomized trial of family therapy (18 sessions of family therapy vs. 3 sessions of family psychoeducation). Sixty-four participants who self-identified as POC and 64 self-identified NHW participants completed baseline and 6-month follow-up measures of positive and negative symptoms and psychosocial (global, role, and social) functioning. Multiple regression models were conducted to test the main effect of race/ethnicity on changes in positive and negative symptoms and functioning, and whether this effect was moderated by parental education. There was a significant interaction between race/ethnicity and parental education, such that higher parental education was associated with greater improvement in global functioning in NHW participants, but there was no relationship between parental education and global functioning in POC. Additionally, higher parental education was associated with a decrease in negative symptoms in NHW participants but not in POC. There were no significant effects of race/ethnicity or parental education on positive symptoms, nor on social or role functioning. Clinicians may consider tailoring psychosocial treatments according to the needs of diverse families who vary in sociodemographic factors such as educational attainment and race/ethnicity.

Development of the pediatric narcolepsy patient-reported outcomes scale (PN-PROs)

BackgroundPediatric narcolepsy is a chronic neurological disorder that impacts the health and overall wellbeing of children and adolescents with the disease. Meaningful and regular assessment of symptom frequency and severity is important for the long-term management of narcolepsy and for optimizing quality of life. However, there is currently no patient-reported outcomes (PROs) measure developed from both patient and expert input that is designed specifically to assess the impact of pediatric narcolepsy on daily life and overall disease burden.MethodsWe conducted a qualitative mixed-methods study to develop a novel patient-reported outcomes measure for pediatric narcolepsy patients. We created and refined a conceptual framework through literature review, semi-structured interviews with narcolepsy experts, and focus groups of children and adolescents with narcolepsy and their parents. Guided by the domains and facets identified in our conceptual framework and further literature review, we developed a PROs item bank. Our team further refined the item bank and classified items through team discussions and expert guidance. Content validity of the item pool was evaluated with expert review, readability analysis, and cognitive interviews with narcolepsy patients.ResultsThrough our processes, we developed a PROs item bank comprising two domains (narcolepsy symptoms and functional impairment) that contains 10 facets. The final item bank consists of 55 items, with 27 items representing five facets of narcolepsy symptoms (behavior, cataplexy, cognitive difficulties, sleep quality, and sleepiness) and 28 items representing five facets of functional impairment (bothered by/worried about symptom, cognitive/academic, global functioning, safety, and social).ConclusionWe developed items for the Pediatric Narcolepsy Patient-Reported Outcomes (PN-PROs) measure that incorporates expert insight, published literature, and testimony from children/adolescents living with narcolepsy and their families. Upon completion of the psychometric testing and content validation process, we believe the PN-PROs will provide a useful longitudinal measure of disease control and standardize outcome assessments in clinical practice and research studies.

A Novel Mis-Seg-Focus Loss Function Based on a Two-Stage nnU-Net Framework for Accurate Brain Tissue Segmentation

Brain tissue segmentation plays a critical role in the diagnosis, treatment, and study of brain diseases. Accurately identifying these boundaries is essential for improving segmentation accuracy. However, distinguishing boundaries between different brain tissues can be challenging, as they often overlap. Existing deep learning methods primarily calculate the overall segmentation results without adequately addressing local regions, leading to error propagation and mis-segmentation along boundaries. In this study, we propose a novel mis-segmentation-focused loss function based on a two-stage nnU-Net framework. Our approach aims to enhance the model’s ability to handle ambiguous boundaries and overlapping anatomical structures, thereby achieving more accurate brain tissue segmentation results. Specifically, the first stage targets the identification of mis-segmentation regions using a global loss function, while the second stage involves defining a mis-segmentation loss function to adaptively adjust the model, thus improving its capability to handle ambiguous boundaries and overlapping anatomical structures. Experimental evaluations on two datasets demonstrate that our proposed method outperforms existing approaches both quantitatively and qualitatively.

Association of objective sleep duration with cognition and brain aging biomarkers in older adults

Abstract The neuropathological mechanisms underlying the association between sleep duration and mild cognitive impairment (MCI) remain poorly understood. This population-based study included 2032 dementia-free people (age ≥ 60 years; 55.1% women) derived from participants in the Multimodal Interventions to Delay Dementia and Disability in Rural China; of these, data were available in 841 participants for Alzheimer’s plasma biomarkers (e.g., amyloid-β[Aβ], total tau, and neurofilament light chain), 1044 for serum microvascular biomarkers (e.g., soluble adhesion molecules), and 834 for brain MRI biomarkers (e.g., whiter matter, grey matter, hippocampus, lacunes, enlarged perivascular spaces [EPVS], and white matter hyperintensity [WMH]). We used electrocardiogram-based cardiopulmonary coupling analysis to measure sleep duration, a neuropsychological test battery to assess cognitive function, and the Petersen’s criteria to define MCI. Data were analysed with multivariable logistic and general linear models. In the total sample (n = 2032), 510 participants were defined with MCI, including 438 with amnestic MCI and 72 with non-amnestic MCI. Long sleep duration (>8 vs. 6-8 hours) was significantly associated with increased likelihoods of MCI and non-amnestic MCI, and lower scores in global cognition, verbal fluency, attention, and executive function (Bonferroni-corrected P < .05). In the subsamples, long sleep duration was associated with higher plasma Aβ40 and total tau, a lower Aβ42/Aβ40 ratio, and smaller grey matter volume (Bonferroni-corrected P < .05). Sleep duration was not significantly associated with serum soluble adhesion molecules, WMH volume, global EPVS, and lacunes (P > .05). Alzheimer’s and neurodegenerative pathologies may represent common pathways linking long sleep duration with MCI and low cognition in older adults.

“Hip Hop and the Televisual Global South: Atlanta and Sintonia”

In recent years, audiences in the United States and around the globe have witnessed an explosion of television and streaming content focused on hip hop. Such content contemplates, historicizes, promotes, and represents the art form, artists, industry, and regional genres that have together emerged as a central feature of contemporary popular culture. This article explores the spatial and thematic links to the theoretical Global South in Atlanta and Sintonia. Analyzing the series’ respective portrayals of race and inequality from the margins, I examine how hip-hop/ funk and the Global South function as narrative tools and symbolic spaces through which notions of a shared precarity stemming from global flows of capital are constructed, consumed, and challenged. By considering the series’ connections to the Global South, this article contributes to a growing body of work that aims to move beyond research that centers the west and the nation-state.