Testing Paradigm Research Articles

Differentiation of peripheral and non-peripheral etiologies in children with vertigo/dizziness: The video-head impulse test and suppression head impulse paradigm

ObjectivesTo identify the etiology of vertigo/dizziness and determine the effectiveness of the video-head impulse test (vHIT) and the suppression head impulse paradigm (SHIMP) tests in distinguishing between peripheral and non-peripheral etiologies in children who presented to the otolaryngology department with complaints of vertigo/dizziness. MethodsThe vHIT and SHIMP tests were applied to the children. The vestibulo-ocular reflex (VOR) gain and saccade parameters were compared. ResultsIn 27 children presenting with vertigo/dizziness, the most common etiological factor was inner ear malformation (IEM) (n = 6/27, 22.2%), followed by cochlear implant surgery (11.1%) and migraine (11.1%). Vestibular hypofunction was indicated by the vHIT results at a rate of 60% (9/15 children) and SHIMP results at 73.3% (11/15 children) among the children with a peripheral etiology, while these rates were 8.3% (1/12 children) and 25% (3/12 children), respectively, in the non-peripheral etiology group. SHIMP-VOR and vHIT-VOR gain values had a moderate positive correlation (p = 0.01, r = 0.349). While there were overt/covert saccades in the vHIT, anti-compensatory saccade (ACSs) were not observed in the SHIMP test (p = 0.041). The rates of abnormal vHIT-VOR gain (p = 0.001), over/covert saccades (p = 0.019), abnormal vHIT response (p = 0.014), ACSs (p = 0.001), and abnormal SHIMP response (p = 0.035) were significantly higher in the peripheral etiology group. ConclusionsIEM was the most common etiological cause, and the rate of vestibular hypofunction was higher in these children with peripheral vertigo. vHIT and SHIMP are effective and useful vestibular tests for distinguishing peripheral etiology from non-peripheral etiology in the pediatric population with vertigo/dizziness. These tests can be used together or alone, but the first choice should be the SHIMP test, considering its short application time (approximately 4–5 min) and simplicity.

Abstract 1312: A study of the clinical utility of NTRKs only vs. comprehensive gene fusion panel testing from a single assay platform

Abstract Background: Gene fusions have important implications for therapeutic selection and patient quality of care, and though they have a low prevalence individually, many fusions are targeted effectively, agnostic of any tumor type. Unfortunately, patients in the community oncology setting are most often only tested for NTRK fusions, which have a prevalence of around 1%. Here, we compared side by side the actual clinical actionability differences using real-world testing data between broad vs. NTRK fusion only panels offered by our clinical laboratory, both with identical assay performance characteristics, reimbursement, and cost levels. Methods: Clinical samples(n=8307) from 33 tumor types were tested for known and novel RNA fusions using our hybridization capture RNA-seq based Solid Tumor Fusion Panels in our clinical laboratory, which targets RNA breakpoints at 1104 genes. Deidentified results were analyzed before or after filtering for fusions based on either a Targeted Solid Tumor NGS fusion Panel (16 drug targetable genes) or only NTRKs fusions. Deidentified patient data presented was analyzed according to an IRB-approved protocol. Results: The prevalence of fusions in the cohort was 30.5% involving any of the 1104 targeted genes by the assay (27% in frame, 20% out of frame, and 41% others). Druggable fusions were present in 5.1% (422) of patients, where 53% were female with a median age of 68 years old, and 47% were male with a median age of 70. However, when filtering only for NTRK fusions, only 104 patients had an NTRK fusion (38 NTRK1, 10 NTRK2, 56 NTRK3), while an additional 318 patients had detected fusions from the Targeted Panel. These druggable fusions had the following prevalences; ALK 0.6 %, BRAF 0.3%, FGFR1 0.2%, FGFR2 0.3%, FGFR3 0.4%, FGFR4 0.0% n=4, MET 0.4%, NOTCH1 0.0% n=1, NOTCH2 0.2%, NRG1 0.2%, PDGFB 0.0% n=3, PDGFRA 0.1%, PDGFRB 0% n=0, RAF1 0.2%, RET 0.5%, ROS1 0.2%, excluding NTRK positive cases. The incidence of NTRK 1/2/3 fusions was 1.25%, while 3.8% of patients have other fusions included on the Targeted Panel in the absence of an NTRK fusion. Two (2, 0.02%) patients had both an NTRK fusion and an additional fusion covered on one of the other 16 genes in the Targeted NGS fusion panel. Conclusion: Actionable fusions showed a combined prevalence in the clinical setting of 5.1%. This study demonstrates that when fusion testing is performed, four times more patients can benefit from a therapeutic option than when testing for these 16 genes compared to the widespread panel of the current clinicians’ favorite choice of only NTRK fusions. More data and education are needed to change the testing paradigm of treating physicians to test broader sets of fusions when assay performance and financial considerations are equal to increase cancer care access. Citation Format: Chaugiang Duong, Steven Lau-Rivera, Rory Jackson, Pathum Kanagasunderam, Roya Hariri, Nathan Montgomery, Derek Lyle, Fernando Lopez Diaz. A study of the clinical utility of NTRKs only vs. comprehensive gene fusion panel testing from a single assay platform [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1312.

Performance Differences of a Touch-Based Serial Reaction Time Task in Healthy Older Participants and Older Participants With Cognitive Impairment on a Tablet: Experimental Study.

Digital neuropsychological tools for diagnosing neurodegenerative diseases in the older population are becoming more relevant and widely adopted because of their diagnostic capabilities. In this context, explicit memory is mainly examined. The assessment of implicit memory occurs to a lesser extent. A common measure for this assessment is the serial reaction time task (SRTT). This study aims to develop and empirically test a digital tablet-based SRTT in older participants with cognitive impairment (CoI) and healthy control (HC) participants. On the basis of the parameters of response accuracy, reaction time, and learning curve, we measure implicit learning and compare the HC and CoI groups. A total of 45 individuals (n=27, 60% HCs and n=18, 40% participants with CoI-diagnosed by an interdisciplinary team) completed a tablet-based SRTT. They were presented with 4 blocks of stimuli in sequence and a fifth block that consisted of stimuli appearing in random order. Statistical and machine learning modeling approaches were used to investigate how healthy individuals and individuals with CoI differed in their task performance and implicit learning. Linear mixed-effects models showed that individuals with CoI had significantly higher error rates (b=-3.64, SE 0.86; z=-4.25; P<.001); higher reaction times (F1,41=22.32; P<.001); and lower implicit learning, measured via the response increase between sequence blocks and the random block (β=-0.34; SE 0.12; t=-2.81; P=.007). Furthermore, machine learning models based on these findings were able to reliably and accurately predict whether an individual was in the HC or CoI group, with an average prediction accuracy of 77.13% (95% CI 74.67%-81.33%). Our results showed that the HC and CoI groups differed substantially in their performance in the SRTT. This highlights the promising potential of implicit learning paradigms in the detection of CoI. The short testing paradigm based on these results is easy to use in clinical practice.

Chemicals regulation and non-animal methods: displacing the gold standard

Regulating industrial chemicals in foodstuffs and consumer products is a major aspect of protecting populations against health risks. Non-animal testing methods are an essential part of the radical change to the framework for toxicity testing that is long overdue in global economies. This paper discusses reasons why the drive to reduce animal testing for chemical safety testing is so difficult to achieve, as perceived by those who are closely involved in chemicals regulations in different capacities. Progress is slow, despite the fact that the ethico-legal conditions for a move away from animal testing are largely in place, and despite scientific arguments for a radical change in the paradigm of toxicity testing, away from reliance on animal studies. I present empirical data drawn from two studies in a European Commission context promoting non-animal methods. The aim of the paper is modest. It is to foreground the voices of those who deal with the science and regulation of chemicals on a day-to-day basis, rather than to offer a theoretical framework for what I heard from them. I offer a synthesis of the main challenges faced by non-animal alternatives, as these are perceived by people in different stakeholder groups dealing with chemicals regulation. I show where there are pockets of agreement between different stakeholders, and where the main disagreements lie. In particular there is dispute and disagreement over what counts as validation of these alternative tests, and by implication of the traditional ‘gold standard’ of animal testing. Finally, I suggest that the shift to non-animal methods in chemicals regulation demonstrates the need for the concept of validation to be broadened from a purely techno-scientific definition, and be more explictly understood as a demand for trust and acceptance, with more attention given to the complex social, institutional and economic settings in which it operates.

Concurrent validity of dynamic bedside quantitative sensory testing paradigms in breast cancer survivors with persistent pain.

Studies on the concurrent validity of clinically applicable testing protocols for conditioned pain modulation (CPM) and temporal summation of pain (TSP) in breast cancer survivors (BCS) with persistent pain are lacking. This study investigated the concurrent validity of two bedside protocols for CPM and TSP in comparison to a respective reference protocol. The participants' preferences for bedside CPM and TSP protocols were assessed. Thirty BCS experiencing persistent pain were included in this study. Each participant underwent a reference test along with two bedside alternatives for assessing both TSP and CPM. For CPM, a cold pressor test (CPT) and blood pressure cuff (BPC) were used as conditioning stimulus. The test stimulus was elicited in parallel by pressure pain threshold after 45 and 90 s of conditioning at the lower limb. The CPM reference test consisted of parallel heat stimuli at the forearms using a two-thermode system. TSP was elicited using a von Frey monofilament (256 mN) and an algometer (98 kPa) at the affected site and opposite lower limb. The TSP reference test consisted of heat stimuli at the affected site and opposite lower limb. Participants' testing preference was examined using a purpose-designed questionnaire. Spearman's rank test examined the correlation between protocols. The two bedside CPM protocols were strongly correlated (r = 0.787-0.939, p < 0.005). A strong correlation was found between the BPC protocol and reference test using the relative effect magnitude (r = 0.541-0.555, p < 0.005). The bedside TSP protocols were moderately correlated with each other only at the lower limb using absolute change scores (r = 0.455, p = 0.012). No significant correlation was found between the bedside and reference TSP protocols. The significantly moderate to very strong correlations between the bedside protocols validate their interchangeability. Researchers and clinicians should be able to choose which bedside protocol they utilize; however, participants favored the use of a BPC and algometer for the evaluation of CPM and TSP, respectively.

Chemical Characterization of Human Body Odor Headspace Components

This study focused on evaluating human body odor volatiles using a chamber approach. Ten participants were asked to sit inside the chamber for 1 h, while using SPME as the extraction technique for vapor sampling. A total of 105 compounds were detected across participants, with nonanal having the highest frequency. PCA statistical analysis depicted tighter clustering in female whole-body odor profiles when compared to males, thus corroborating gender odor differences. Concurrently, various biospecimens (hand, axillary, breath) from the same participants allowed for a comparison between whole-body and individual biospecimen odor signatures. When comparing whole-body sampling and distinctive biospecimens, nonanal and decanal were the only odor volatiles shared. Statistical clustering depicted higher similarity within the odor profiles of individual biospecimens compared to odor profiles of the whole body, indicating distinctiveness of the odor chemical landscape as a function of sampling region. Overall, this study demonstrated that SPME-GC/MS methodology was successful in the extraction, detection, and identification of previously reported human scent volatiles when employing the human chamber for whole-body sampling. Our presented testing paradigm allows for a direct comparison of odor volatiles across the full body and specific body locations that allows odor markers to be furthered exploited for diagnostic and biological detection contexts.

Pain Science in Practice (Part 7): How Is Descending Modulation of Pain Measured?

SYNOPSIS: Understanding the descending pain modulatory system allows for a neuroscientific explanation of naturally occurring pain relief. Evidence from basic science and clinical studies on the effectiveness of drugs in certain patient groups led to pharmacological manipulation of the descending pain modulatory system for analgesia. Understanding mechanisms and theories helps clinicians make sense of chronic musculoskeletal pain. This editorial explains how test paradigms, including conditioned pain modulation, offset analgesia, and stress-induced analgesia work, provide an overview of a placebo analgesia circuitry, and discusses how evoking activity in the descending pain modulatory system using specific paradigms can give new insights into how specific treatments work to reduce pain. J Orthop Sports Phys Ther 2024;54(2):1-6. doi:10.2519/jospt.2024.12113.

Conditioned morphine tolerance promotes neurogenesis, dendritic remodelling and pro-plasticity molecules in the adult rat hippocampus.

Structural neuroplasticity of the hippocampus in the form of neurogenesis and dendritic remodelling underlying morphine tolerance is still less known. Therefore, in this study, we aimed to assess whether unconditioned- and conditioned-morphine tolerance can trigger structural neuroplasticity in the dorsal and ventral parts of the adult male rat hippocampus. Evaluation of the levels of neurogenesis markers (Ki67 and DCX) by immunohistochemistry shows that conditioned morphine tolerance is sufficient to increase the baseline topographic level of hippocampal neurogenesis in adult rats. Dendritic spine visualization by Golgi staining shows that the behavioural testing paradigms themselves are sufficient to trigger the hippocampus subregion-specific changes in the dendritic remodelling along the apical dendrites of hippocampal CA1 pyramidal neurons and dentate granule cells in adult rats. Quantitative reverse transcription polymerase chain reaction of Bdnf, Trkb, Rac-1 and RhoA mRNA levels as pro-plasticity molecules, shows that the conditioned morphine tolerance is effective in changing Bdnf and RhoA mRNA levels in the ventral hippocampus of adult rats. In summary, we demonstrate that the acquisition of morphine tolerance promotes adult neurogenesis, dendritic remodelling and pro-plasticity molecules such as Bdnf/Trkb in the rat hippocampus. Indeed, the structural neuroplasticity of the hippocampus may underlie the newly formed aberrant memory and could provide the initial basis for understanding the neurobiological mechanisms of morphine-tolerance plasticity in the hippocampus.

Polysemy—Evidence from Linguistics, Behavioral Science, and Contextualized Language Models

Abstract Polysemy is the type of lexical ambiguity where a word has multiple distinct but related interpretations. In the past decade, it has been the subject of a great many studies across multiple disciplines including linguistics, psychology, neuroscience, and computational linguistics, which have made it increasingly clear that the complexity of polysemy precludes simple, universal answers, especially concerning the representation and processing of polysemous words. But fuelled by the growing availability of large, crowdsourced datasets providing substantial empirical evidence; improved behavioral methodology; and the development of contextualized language models capable of encoding the fine-grained meaning of a word within a given context, the literature on polysemy recently has developed more complex theoretical analyses. In this survey we discuss these recent contributions to the investigation of polysemy against the backdrop of a long legacy of research across multiple decades and disciplines. Our aim is to bring together different perspectives to achieve a more complete picture of the heterogeneity and complexity of the phenomenon of polysemy. Specifically, we highlight evidence supporting a range of hybrid models of the mental processing of polysemes. These hybrid models combine elements from different previous theoretical approaches to explain patterns and idiosyncrasies in the processing of polysemous that the best known models so far have failed to account for. Our literature review finds that (i) traditional analyses of polysemy can be limited in their generalizability by loose definitions and selective materials; (ii) linguistic tests provide useful evidence on individual cases, but fail to capture the full range of factors involved in the processing of polysemous sense extensions; and (iii) recent behavioral (psycho) linguistics studies, large-scale annotation efforts, and investigations leveraging contextualized language models provide accumulating evidence suggesting that polysemous sense similarity covers a wide spectrum between identity of sense and homonymy-like unrelatedness of meaning. We hope that the interdisciplinary account of polysemy provided in this survey inspires further fundamental research on the nature of polysemy and better equips applied research to deal with the complexity surrounding the phenomenon, for example, by enabling the development of benchmarks and testing paradigms for large language models informed by a greater portion of the rich evidence on the phenomenon currently available.

Intraoperative application and early experience with novel high-resolution, high-channel-count thin-film electrodes for human microelectrocorticography.

The study objective was to evaluate intraoperative experience with newly developed high-spatial-resolution microelectrode grids composed of poly(3,4-ethylenedioxythiophene) with polystyrene sulfonate (PEDOT:PSS), and those composed of platinum nanorods (PtNRs). A cohort of patients who underwent craniotomy for pathological tissue resection and who had high-spatial-resolution microelectrode grids placed intraoperatively were evaluated. Patient demographic and baseline clinical variables as well as relevant microelectrode grid characteristic data were collected. The primary and secondary outcome measures of interest were successful microelectrode grid utilization with usable resting-state or task-related data, and grid-related adverse intraoperative events and/or grid dysfunction. Included in the analysis were 89 cases of patients who underwent a craniotomy for resection of neoplasms (n = 58) or epileptogenic tissue (n = 31). These cases accounted for 94 grids: 58 PEDOT:PSS and 36 PtNR grids. Of these 94 grids, 86 were functional and used successfully to obtain cortical recordings from 82 patients. The mean cortical grid recording duration was 15.3 ± 1.15 minutes. Most recordings in patients were obtained during experimental tasks (n = 52, 58.4%), involving language and sensorimotor testing paradigms, or were obtained passively during resting state (n = 32, 36.0%). There were no intraoperative adverse events related to grid placement. However, there were instances of PtNR grid dysfunction (n = 8) related to damage incurred by suboptimal preoperative sterilization (n = 7) and improper handling (n = 1); intraoperative recordings were not performed. Vaporized peroxide sterilization was the most optimal sterilization method for PtNR grids, providing a significantly greater number of usable channels poststerilization than did steam-based sterilization techniques (median 905.0 [IQR 650.8-935.5] vs 356.0 [IQR 18.0-597.8], p = 0.0031). High-spatial-resolution microelectrode grids can be readily incorporated into appropriately selected craniotomy cases for clinical and research purposes. Grids are reliable when preoperative handling and sterilization considerations are accounted for. Future investigations should compare the diagnostic utility of these high-resolution grids to commercially available counterparts and assess whether diagnostic discrepancies relate to clinical outcomes.

Leveraging Compliance to Design a Minimally Invasive, Expandable Interbody Cage Capable of Customized Anatomical Fit for Spinal Fusion Surgery

Abstract As spinal fusion surgery continues to transition to less invasive techniques, there remains an unmet need for ever smaller and more complex interbody cages to meet the unique needs of this difficult surgery. This work focuses on the hypothesis that this need can be met using the inherent advantages of compliant mechanisms in a way no previous device has. Deployable Euler Spiral Connectors optimized using a gradient based optimization algorithm were used as the foundation for a device that can stow to a very small size for device insertion then bilaterally deploy to a substantially larger device footprint. Additionally, a continuously adjustable lordotic angle was achieved using the same device so as to result in a customized anatomical fit while potentially reducing hospital inventory requirements. Several tests including finite element analysis, compression testing, shear testing, and deployment in a cadaver were performed as initial verification and validation that the concept device performs reasonably well under typical testing paradigms used for interbody cages.

A novel method for segmentation of titanium microtexture regions via sensor data fusion

The current nondestructive inspection paradigm of mono-modal testing and signal-over-threshold call criteria is insufficient for characterization of microtexture regions in titanium alloys, which exceeds the capabilities of any single, practical sensing technique that could be deployed to a manufacturing environment for quality control. In this work, we develop a data fusion-based solution to microtexture region characterization. The material problem and potential inspection methods are reviewed, and registered datasets are presented. Next, we develop a data fusion algorithm that combines covariance-generalized matching component analysis and a conditionally Gaussian hypermodel to successfully estimate the boundaries and average crystallographic orientations of microtexture regions from scanning electron microscopy electron backscatter diffraction and eddy current testing data.

Multi-frequency VEMPs improve detection of present otolith responses in bilateral vestibulopathy.

To investigate whether multi-frequency Vestibular Evoked Myogenic Potential (VEMP) testing at 500, 750, 1,000, and 2,000 Hz, would improve the detection of present dynamic otolith responses in patients with bilateral vestibulopathy (BV). Prospective study in a tertiary referral center. BV patients underwent multi-frequency VEMP testing. Cervical VEMPs and ocular VEMPs were recorded with the Neuro-Audio system (v2010, Neurosoft, Ivanovo, Russia). The stimuli included air-conducted tone bursts of 500, 750, 1,000, and 2,000 Hz, at a stimulation rate of 13 Hz. Outcome measures included the percentage of present and absent VEMP responses, and VEMP thresholds. Outcomes were compared between frequencies and type of VEMPs (cVEMPs, oVEMPs). VEMP outcomes obtained with the 500 Hz stimulus, were also compared to normative values obtained in healthy subjects. Forty-nine BV patients completed VEMP testing: 47 patients completed cVEMP testing and 48 patients completed oVEMP testing. Six to 15 % more present VEMP responses were obtained with multifrequency testing, compared to only testing at 500 Hz. The 2,000 Hz stimulus elicited significantly fewer present cVEMP responses (right and left ears) and oVEMP responses (right ears) compared to the other frequencies (p ≤ 0.044). Using multi-frequency testing, 78% of BV patients demonstrated at least one present VEMP response in at least one ear. In 46% a present VEMP response was found bilaterally. BV patients demonstrated a significantly higher percentage of absent VEMP responses and significantly higher VEMP thresholds than healthy subjects, when corrected for age (p ≤ 0.002). Based on these results, a pragmatic VEMP testing paradigm is proposed, taking into account multi-frequency VEMP testing. Multi-frequency VEMP testing improves the detection rate of present otolith responses in BV patients. Therefore, multi-frequency VEMPs should be considered when evaluation of (residual) otolith function is indicated.

Recent Advances of DNA-Templated Metal Nanoclusters for Food Safety Detection: From Synthesis, Applications, Challenges, and Beyond.

Food safety concerns have become a significant threat to human health and well-being, catching global attention in recent years. As a result, it is imperative to research conceptually novel biosensing and effective techniques for food matrices detection. Currently, DNA-templated metal nanoclusters (DNA-MNCs) are considered as one of the most promising nanomaterials due to their excellent properties in biosensing. While DNA-MNCs have garnered increasing interest, the reviews of design strategies, applications, and futuristic prospects for biosensing have been hardly found especially in food safety. The synthesis of DNA-MNCs and their use as biosensing materials in food contamination detection, including pathogenic bacteria, toxins, heavy metals, residues of pesticides, and others were comprehensively reviewed. In addition, we summarize the properties of DNA-MNCs briefly and discuss the challenges and future trends. The application of DNA-MNCs powered biosensing has been demonstrated and actively studied, which is a promising paradigm for food safety testing that can supplement or even replace current existing methods. Despite the challenges of difficulty regulating accurately, poor stability, low quantum yield, and difficult commercial transformation, the application prospects of DNA-MNCs biosensors are promising. This review aims to provide insights and directions for the future development of DNA-MNCs based food detection technology.

Процессы когнитивного контроля в тесте Струпа и их отражение в связанных с событиями потенциалах (обзор)

The review summarizes the data of Russian and foreign studies on the psychophysiological parameters of the Stroop task execution. In addition, the article considers the main modifications of the task and similar paradigms as well as the key hypotheses explaining the causes of the interference effect and the increase in reaction time to stimuli containing conflicting information. Further, the paper presents data on eventrelated potential (ERP) waves, which are supposed to reflect cognitive control processes, such as conflict detection, overcoming of interference and conflict resolution. The frontocentral N2 wave characterizes the processes of conflict detection and overcoming of interference, and its main neural generator is the anterior cingulate cortex. The N450 wave is primarily generated in the anterior cingulate cortex and prefrontal cortex and is thought to reflect interference suppression. The centroparietal P300 wave and the late positive complex, which appears to be generated in the middle or inferior frontal gyrus and in the extrastriate cortex, are associated with the conflict resolution process. The readiness potential is, supposedly, generated in the motor cortex and reflects the process of selecting and preparing a motor response. Moreover, the review presents the main directions of studies that use the Stroop test paradigm and its modifications. Despite a significant number of existing psychophysical and neurophysiological papers, the question of the brain mechanisms of cognitive control in tasks that cause cognitive conflict remains open, and the neuropsychological role of the ERP waves recorded in such tasks is still not fully explored. Studies into the influence of different types of competing information and the degree of conflict on the psychophysiological indicators in the Stroop task are of considerable interest.

An Extensive-Form Game Paradigm for Visual Field Testing via Deep Reinforcement Learning.

Glaucoma is the leading cause of irreversible but preventable blindness worldwide, and visual field testing is an important tool for its diagnosis and monitoring. Testing using standard visual field thresholding procedures is time-consuming, and prolonged test duration leads to patient fatigue and decreased test reliability. Different visual field testing algorithms have been developed to shorten testing time while maintaining accuracy. However, the performance of these algorithms depends heavily on prior knowledge and manually crafted rules that determine the intensity of each light stimulus as well as the termination criteria, which is suboptimal. We leverage deep reinforcement learning to find improved decision strategies for visual field testing. In our proposed algorithms, multiple intelligent agents are employed to interact with the patient in an extensive-form game fashion, with each agent controlling the test on one of the testing locations in the patient's visual field. Through training, each agent learns an optimized policy that determines the intensities of light stimuli and the termination criteria, which minimizes the error in sensitivity estimation and test duration at the same time. In simulation experiments, we compare the performance of our algorithms against baseline visual field testing algorithms and show that our algorithms achieve a better trade-off between estimation accuracy and test duration. By retaining testing accuracy with reduced test duration, our algorithms improve test reliability, clinic efficiency, and patient satisfaction, and translationally affect clinical outcomes.

Neural specialization with generalizable representations underlies children's cognitive development of attention.

From childhood to adulthood, the human brain develops highly specialized yet interacting neural modules that give rise to nuanced attention and other cognitive functions. Each module can specialize over development to support specific functions, yet also coexist in multiple neurobiological modes to support distinct processes. Advances in cognitive neuroscience have conceptualized human attention as a set of cognitive processes anchored in highly specialized yet interacting neural systems. The underlying mechanisms of how these systems interplay to support children's cognitive development of multiple attention processes remain unknown. Leveraging developmental functional magnetic resonance imaging with attention network test paradigm, we demonstrate differential neurocognitive development of three core attentional processes from childhood to adulthood, with alerting reaching adult-like level earlier, followed by orienting and executive attention with more protracted development throughout middle and late childhood. Relative to adults, young children exhibit immature specialization with less pronounced dissociation of neural systems specific to each attentional process. Children manifest adult-like distributed representations in the ventral attention and cingulo-opercular networks, but less stable and weaker generalizable representations across multiple processes in the dorsal attention network. Our findings provide insights into the functional specialization and generalization of neural representations scaffolding cognitive development of core attentional processes from childhood to adulthood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Development and Validation of an Efficient and Safe Loud Music Exposure Paradigm.

The purpose of this study was to develop a time-efficient music exposure and testing paradigm that safely creates temporary cochlear dysfunction that could be used in future temporary threshold shift (TTS) studies. A 30-min audio compilation of pop rock music tracks was created. Adult volunteers with normal hearing were then exposed to this music material monaurally through headphones for 30 min at 97 dBA or 15 min at 100 dBA. Levels were measured from the ear of a manikin and are considered to provide an equivalent daily noise dose based on a 3-dB exchange. We assessed the changes in their hearing, by means of distortion product otoacoustic emission (DPOAE) testing, and standard and extended high-frequency pure-tone audiometry before and after exposure. There were 17 volunteers in total. In the first trial, eight volunteers (four females; Mdnage = 31 years [interquartile range, IQR = 4.25]) were included. Although TTS was observed in all eight participants for at least one frequency, a large variation in affected frequencies was observed. To address this issue, the audio material was further remastered to adjust levels across the different frequency bands. Fourteen adults (nine newly recruited and five from the first trial; seven females; Mdnage = 31 years [IQR = 5]) were exposed to the new material. All but two of 17 participants presented clinically significant TTS or decrease in DPOAE amplitude in at least one frequency. Statistically significant average TTS of 7.43 dB was observed at 6 kHz. There were statistically significant average DPOAE amplitude shifts of -2.55 dB at 4 kHz, -4.97 dB at 6 kHz, and -3.14 dB at 8 kHz. No participant presented permanent threshold shift. A monaural music paradigm was developed and shown to induce statistically significant TTS and DPOAE amplitude shifts, without evidence of permanent loss. This realistic and time-efficient paradigm may be considered a viable option for experimental studies of temporary music-induced hearing loss. https://doi.org/10.23641/asha.25016471.

Real-time estimation of EEG-based engagement in different tasks

Objective. Recent trends in brain–computer interface (BCI) research concern the passive monitoring of brain activity, which aim to monitor a wide variety of cognitive states. Engagement is such a cognitive state, which is of interest in contexts such as learning, entertainment or rehabilitation. This study proposes a novel approach for real-time estimation of engagement during different tasks using electroencephalography (EEG). Approach. Twenty-three healthy subjects participated in the BCI experiment. A modified version of the d2 test was used to elicit engagement. Within-subject classification models which discriminate between engaging and resting states were trained based on EEG recorded during a d2 test based paradigm. The EEG was recorded using eight electrodes and the classification model was based on filter-bank common spatial patterns and a linear discriminant analysis. The classification models were evaluated in cross-task applications, namely when playing Tetris at different speeds (i.e. slow, medium, fast) and when watching two videos (i.e. advertisement and landscape video). Additionally, subjects’ perceived engagement was quantified using a questionnaire. Main results. The models achieved a classification accuracy of 90% on average when tested on an independent d2 test paradigm recording. Subjects’ perceived and estimated engagement were found to be greater during the advertisement compared to the landscape video (p = 0.025 and p < 0.001, respectively); greater during medium and fast compared to slow Tetris speed (p < 0.001, respectively); not different between medium and fast Tetris speeds. Additionally, a common linear relationship was observed for perceived and estimated engagement (r rm = 0.44, p < 0.001). Finally, theta and alpha band powers were investigated, which respectively increased and decreased during more engaging states. Significance. This study proposes a task-specific EEG engagement estimation model with cross-task capabilities, offering a framework for real-world applications.

Kagami Ogata syndrome: a small deletion refines critical region for imprinting

Kagami–Ogata syndrome is a rare imprinting disorder and its phenotypic overlap with multiple different etiologies hampers diagnosis. Genetic etiologies include paternal uniparental isodisomy (upd(14)pat), maternal allele deletions of differentially methylated regions (DMR) in 14q32.2 or pure primary epimutations. We report a patient with Kagami–Ogata syndrome and an atypical diagnostic odyssey with several negative standard-of-care genetic tests followed by epigenetic testing using methylation microarray and a targeted analysis of whole-genome sequencing to reveal a 203 bp deletion involving the MEG3 transcript and MEG3:TSS-DMR. Long-read sequencing enabled the simultaneous detection of the deletion, phasing, and biallelic hypermethylation of the MEG3:TSS-DMR region in a single assay. This case highlights the challenges in the sequential genetic testing paradigm, the utility of long-read sequencing as a single comprehensive diagnostic assay, and the smallest reported deletion causing Kagami–Ogata syndrome allowing important insights into the mechanism of imprinting effects at this locus.