Reading instruction causes changes in category-selective visual cortex

Education sculpts specialized neural circuits for skills like reading that are critical to success in modern society but were not anticipated by the selective pressures of evolution. Does the emergence of brain regions that selectively process novel visual stimuli like words occur at the expense of cortical representations of other stimuli like faces and objects? "Neuronal Recycling" predicts that learning to read should enhance the response to words in ventral occipitotemporal cortex (VOTC) and decrease the response to other visual categories such as faces and objects. To test this hypothesis, and more broadly to understand the changes that are induced by the early stages of literacy instruction, we conducted a randomized controlled trial with pre-school children (five years of age). Children were randomly assigned to intervention programs focused on either reading skills or oral language skills and magnetoencephalography (MEG) data collected before and after the intervention was used to measure visual responses to images of text, faces, and objects. We found that being taught reading versus oral language skills induced different patterns of change in category-selective regions of visual cortex, but that there was not a clear tradeoff between the response to words versus other categories. Within a predefined region of VOTC corresponding to the visual word form area (VWFA) we found that the relative amplitude of responses to text, faces, and objects changed, but increases in the response to words were not linked to decreases in the response to faces or objects. How these changes play out over a longer timescale is still unknown but, based on these data, we can surmise that high-level visual cortex undergoes rapid changes as children enter school and begin establishing new skills like literacy.

Infants' brain responses to social interaction predict future language growth

In face-to-face interactions with infants, human adults exhibit a species-specific communicative signal. Adults present a distinctive "social ensemble": they use infant-directed speech (parentese), respond contingently to infants' actions and vocalizations, and react positively through mutual eye-gaze and smiling. Studies suggest that this social ensemble is essential for initial language learning. Our hypothesis is that the social ensemble attracts attentional systems to speech and that sensorimotor systems prepare infants to respond vocally, both of which advance language learning. Using infant magnetoencephalography (MEG), we measure 5-month-old infants' neural responses during live verbal face-to-face (F2F) interaction with an adult (social condition) and during a control (nonsocial condition) in which the adult turns away from the infant to speak to another person. Using a longitudinal design, we tested whether infants' brain responses to these conditions at 5 months of age predicted their language growth at five future time points. Brain areas involved in attention (right hemisphere inferior frontal, right hemisphere superior temporal, and right hemisphere inferior parietal) show significantly higher theta activity in the social versus nonsocial condition. Critical to theory, we found that infants' neural activity in response to F2F interaction in attentional and sensorimotor regions significantly predicted future language development into the third year of life, more than 2 years after the initial measurements. We develop a view of early language acquisition that underscores the centrality of the social ensemble, and we offer new insight into the neurobiological components that link infants' language learning to their early brain functioning during social interaction.

Treatment and Outcomes of Missed Perilunate Dislocations: A Case Series

Background  Perilunate dislocations are devastating injuries that occur relatively rarely, accounting for only 7% of injuries to the carpus. Unfortunately, approximately 25% of these injuries are missed on initial evaluation. Acutely diagnosed perilunate dislocations may be successfully treated with ligament and osseous repair, depending on the injury pattern. Chronic dislocations, however, are primarily treated with salvage procedures. This case series was performed to investigate the outcomes of patients who sustained a perilunate dislocation that was diagnosed in a delayed fashion and look for any treatment patterns that could be more widely applied to future patients. Methods  Patients presenting to a single institution between 2016 and 2018 with a perilunate injury that either presented in a delayed fashion or was missed on initial assessment were identified and their characteristics were evaluated. The surgical management of these patients was assessed as was their postoperative course at their 2-week, 6-week, 3-month, and 6-month clinic follow-up visits. Results  Eight patients were identified with perilunate dislocations that were diagnosed in a delayed fashion. On average, these dislocations were diagnosed 133 days following the date of injury. All patients were males and 7/8 of them were between 17 and 20 years of age at the time of their injury (mean age: 25.5). They were treated with either primary repair, wrist fusion, proximal row carpectomy, or scaphoid excision and four-corner fusion (SEFCF). Both pain and range of motion improved following surgical management of these injuries. Conclusion  Perilunate dislocations are rare injuries that are notorious for being diagnosed late, at which point primary repair is oftentimes no longer feasible. Salvage procedures are able to improve the range of motion and pain of patients who are found to have chronic dislocations. Our case series highlights the importance of treating each missed perilunate injury individually and avoiding a "one-size-fits-all" approach.

Neuropsychological correlates of early grief in bereaved older adults

Prolonged grief disorder (PGD) is associated with impairments in cognitive functioning, but the neuropsychological correlates of early grief in older adults are poorly understood. This preliminary study cross-sectionally examined neuropsychological functioning in bereaved adults with high and low grief symptoms and a non-bereaved comparison sample and further explored the relationship between multidomain cognitive measures and grief severity. A total of ninety-three nondemented older adults (high grief: n = 44; low grief: n = 49) within 12 months post-bereavement and non-bereaved comparison participants (n = 43) completed neuropsychological battery including global and multiple domain-specific cognitive functioning. Linear regression models were used to analyze differences in multidomain cognitive measures between the groups and specifically examine the associations between cognitive performance and grief severity in the bereaved, after covariate adjustment, including depressive symptoms. Bereaved older adults with higher grief symptoms performed worse than those with lower symptoms and non-bereaved participants on executive functioning and attention and processing speed measures. In the bereaved, poorer executive functioning, attention and processing speed correlated with higher grief severity. Attention/processing speed-grief severity correlation was seen in those with time since loss ≤ 6 months, but not > 6 months. Intense early grief is characterised by poorer executive functioning, attention, and processing speed, resembling findings in PGD. The putative role of poorer cognitive functioning during early grief on the transition to integrated grief or the development of PGD remains to be elucidated.

Comparison of brain imaging and physical health between research and clinical neuroimaging cohorts of ageing

OBJECTIVES

To compare brain MRI measures between Adult Changes in Thought (ACT) participants who underwent research, clinical, or both MRI scans, and clinical health measures across the groups and non-MRI subjects.

METHODS

Retrospective cohort study leveraging MRI, clinical, demographic, and medication data from ACT. Three neuroradiologists reviewed MRI scans using NIH Neuroimaging Common Data Elements (CDEs). Total brain and white matter hyperintensity (WMH) volumes, clinical characteristics, and outcome measures of brain and overall health were compared between groups. 1166 MRIs were included (77 research, 1043 clinical, and 46 both) and an additional 3146 participants with no MRI were compared.

RESULTS

Compared to the group with research MRI only, the clinical MRI group had higher prevalence of the following: acute infarcts, chronic haematoma, subarachnoid haemorrhage, subdural haemorrhage, haemorrhagic transformation, and hydrocephalus (each P < .001). Quantitative WMH burden was significantly lower (P < .001) and total brain volume significantly higher (P < .001) in research MRI participants compared to other MRI groups. Prevalence of hypertension, self-reported cerebrovascular disease, congestive heart failure, dementia, and recent hospitalization (all P < .001) and diabetes (P = .002) differed significantly across groups, with smaller proportions in the research MRI group.

CONCLUSION

In ageing populations, significant differences were observed in MRI metrics between research MRI and clinical MRI groups, and clinical health metric differences between research MRI, clinical MRI, and no-MRI groups.

ADVANCES IN KNOWLEDGE

This questions whether research cohorts can adequately represent the greater ageing population undergoing imaging. These findings may also be useful to radiologists when interpreting neuroimaging of ageing.

Sound Level Changes the Auditory Cortical Activation Detected with Functional Near-Infrared Spectroscopy

BACKGROUND

Functional near-infrared spectroscopy (fNIRS) is a viable non-invasive technique for functional neuroimaging in the cochlear implant (CI) population; however, the effects of acoustic stimulus features on the fNIRS signal have not been thoroughly examined. This study examined the effect of stimulus level on fNIRS responses in adults with normal hearing or bilateral CIs. We hypothesized that fNIRS responses would correlate with both stimulus level and subjective loudness ratings, but that the correlation would be weaker with CIs due to the compression of acoustic input to electric output.

METHODS

Thirteen adults with bilateral CIs and 16 with normal hearing (NH) completed the study. Signal-correlated noise, a speech-shaped noise modulated by the temporal envelope of speech stimuli, was used to determine the effect of stimulus level in an unintelligible speech-like stimulus between the range of soft to loud speech. Cortical activity in the left hemisphere was recorded.

RESULTS

Results indicated a positive correlation of cortical activation in the left superior temporal gyrus with stimulus level in both NH and CI listeners with an additional correlation between cortical activity and perceived loudness for the CI group. The results are consistent with the literature and our hypothesis.

CONCLUSIONS

These results support the potential of fNIRS to examine auditory stimulus level effects at a group level and the importance of controlling for stimulus level and loudness in speech recognition studies. Further research is needed to better understand cortical activation patterns for speech recognition as a function of both stimulus presentation level and perceived loudness.

"Paper in a day": A model to encourage psychology collaboration and participation in research/program evaluation

Although psychologists are trained to conduct research as well as clinical work, it can be challenging for psychologists outside of traditional academia to find the time or capacity to engage in research. Providing opportunities for practicing psychologists to conduct research may enhance the generalizability of psychological research, as well as provide benefits to psychologists in terms of collaboration, promotion, and engagement. Yet, several barriers exist, including competing demands on time, lack of institutional support, and limited research confidence. This article describes "Paper in a Day" (PiaD), a novel approach to research engagement that is well-suited for busy practitioners. PiaD considers many of the aforementioned factors and provides a method to navigate the often-daunting prospect of research involvement for the practicing clinician. Through PiaD, two Department of Veterans Affairs (VA) Medical Centers engaged clinicians and trainees in collaborating in a time-limited way to write and publish peer-reviewed articles. The current article outlines the process by which clinicians at these two sites structured research engagement utilizing PiaD, and it was also written utilizing the PiaD model. The authors have now led or participated in the PiaD process five times, with 13 teams of clinicians producing nine peer-reviewed articles and five conference presentations. A brief survey indicated that participants felt engaged in the process and would participate again if given the opportunity. This article outlines barriers and facilitators of the PiaD process, with the hope of encouraging other settings to consider using such a method to enhance research productivity and engagement for psychologists. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effects of head modeling errors on the spatial frequency representation of MEG

OBJECTIVES

We aim to investigate the effects of head model inaccuracies on signal and source reconstruction accuracies for various sensor array distances to the head. This allows for the assessment of the importance of head modeling for next-generation magnetoencephalography (MEG) sensors, optically-pumped magnetometers (OPM).

APPROACH

A 1-shell boundary element method (BEM) spherical head model with 642 vertices was defined. The vertices were randomly perturbed radially up to 2% - 10% of the radius, and the forward signal was calculated for dipolar sources located at 2 cm to 8 cm from the center of the sphere with a 324 sensor array located at 10 cm to 15 cm from the center of the sphere. Source localization was performed for each of these forward signals. The signal for each perturbed spherical head case was analyzed in the spatial frequency domain, and the signal and source localization errors were quantified relative to the unperturbed case.

MAIN RESULTS

In the noiseless and high signal-to-noise ratio (SNR) case of approximately >= 6 dB, inaccuracies in our spherical BEM head model led to increased signal and source localization inaccuracies when sensor arrays were closer to the head, especially for deep and superficial sources. In the noisy case however, the higher SNR for closer sensor arrays led to an improved ECD fit and outweighed the effects of head geometry inaccuracies.

SIGNIFICANCE

OPMs may be placed directly on the head, as opposed to the more commonly used superconducting quantum interference device (SQUID) sensors which must be placed a few centimeters away from the head. OPMs thus allow for signals of higher spatial resolution to be captured, resulting in potentially more accurate source localizations. Our results suggest that an increased emphasis on accurate head modeling for OPMs may be necessary to fully realize its improved source localization potential.

Observational study of patient characteristics associated with a timely diagnosis of dementia and mild cognitive impairment without dementia

BACKGROUND

Timely diagnosis of cognitive impairment is a key goal of the National Plan to Address Alzheimer's Disease, but studies of factors associated with a timely diagnosis are limited.

OBJECTIVE

To identify patient characteristics associated with a timely diagnosis of dementia and mild cognitive impairment (MCI).

DESIGN

Retrospective observational study using survey data from the Health and Retirement Study (HRS) from 1995-2016 (interview waves 3-13).

PARTICIPANTS

4,760 respondents with incident dementia and 1,864 with incident MCI identified using longitudinal measures of cognitive functioning.

MAIN MEASURES

Timely or delayed diagnosis based on the timing of a self or proxy report of a healthcare provider diagnosis in relation to respondents first dementia or MCI-qualifying cognitive score, sociodemographic characteristics, health status, health care utilization, insurance provider, and year of first qualifying score.

KEY RESULTS

Only 26.0% of the 4,760 respondents with incident dementia and 11.4% of the 1,864 respondents with incident MCI received a timely diagnosis. Non-Hispanic Black respondents and respondents with less than a college degree were significantly less likely to receive a timely diagnosis of either dementia or MCI than Non-Hispanic White respondents (dementia odds ratio (OR): 0.61, 95% CI: 0.50, 0.75; MCI OR: 0.40, 95% CI: 0.23, 0.70) and those with a college degree (dementia OR for less than high school degree: 0.30, 95% CI: 0.23, 0.38; MCI OR: 0.36, 95% CI: 0.22, 0.60). Respondents that lived alone were also less likely to receive a timely diagnosis of dementia (OR: 0.69, 95% CI: 0.59, 0.81), though not MCI. Timely diagnosis of both conditions increased over time.

CONCLUSIONS

Targeting resources for timely diagnosis of cognitive impairment to individuals from racial and ethnic minorities, lower educational attainment, and living alone may improve detection and reduce disparities around timely diagnosis of dementia and MCI.

Impact of Emergency Medical Service Provider Training and Institutional Volume Experience on ST-Elevation Myocardial Infarction Patient Outcomes in Rural Setting

INTRODUCTION

Rural sites provide management challenges for ST-elevation myocardial infarction (STEMI) patients. The impact of emergency medical service (EMS) training and institutional volume experience on STEMI outcomes was examined.

METHODS

All STEMI patients transferred to Sanford from 32 sites in rural South Dakota from 2010-2019 were analyzed. "Time to electrocardiogram (EKG)" (TEKG) and "Time from EKG to Thrombolytics" (TThrom) were calculated. Sites were compared based on EMS training (advanced life support (ALS) vs. basic life support (BLS)) and institutional volume experience (less than or equal to five vs. greater than five STEMI).

RESULTS

514 STEMI patients from 32 sites in South Dakota were analyzed. Average TEKG was 20 (±15) and 14 (±10) minutes for ALS and BLS trained services, respectively (p=0.25). More experienced sites had an average TEKG of 26 (±15) minutes, while sites with ≤ five STEMI patients had an average time of 15 (±13) minutes. TThrom did not differ significantly between sites based on our metrics.

CONCLUSION

The present study concludes that EMS provider training (BLS vs ALS) and institutional volume experience do not significantly impact patient-related outcomes when treating STEMI patients. This result is possibly attributed to increased educational efforts for rural health care providers in general and the establishment of the South Dakota statewide STEMI Network "Mission: Lifeline" which standardized STEMI care and improved connectivity between remote responders and the larger PCI-capable facilities.

Infant brain imaging using magnetoencephalography: Challenges, solutions, and best practices

The excellent temporal resolution and advanced spatial resolution of magnetoencephalography (MEG) makes it an excellent tool to study the neural dynamics underlying cognitive processes in the developing brain. Nonetheless, a number of challenges exist when using MEG to image infant populations. There is a persistent belief that collecting MEG data with infants presents a number of limitations and challenges that are difficult to overcome. Due to this notion, many researchers either avoid conducting infant MEG research or believe that, in order to collect high-quality data, they must impose limiting restrictions on the infant or the experimental paradigm. In this article, we discuss the various challenges unique to imaging awake infants and young children with MEG, and share general best-practice guidelines and recommendations for data collection, acquisition, preprocessing, and analysis. The current article is focused on methodology that allows investigators to test the sensory, perceptual, and cognitive capacities of awake and moving infants. We believe that such methodology opens the pathway for using MEG to provide mechanistic explanations for the complex behavior observed in awake, sentient, and dynamically interacting infants, thus addressing core topics in developmental cognitive neuroscience.

Auditory Attention Deployment in Young Adults with Autism Spectrum Disorder

Difficulty listening in noisy environments is a common complaint of individuals with autism spectrum disorder (ASD). However, the mechanisms underlying such auditory processing challenges are unknown. This preliminary study investigated auditory attention deployment in adults with ASD. Participants were instructed to maintain or switch attention between two simultaneous speech streams in three conditions: location (co-located versus ± 30° separation), voice (same voice versus male-female contrast), and both cues together. Results showed that individuals with ASD can selectively direct attention using location or voice cues, but performance was best when both cues were present. In comparison to neurotypical adults, overall performance was less accurate across all conditions. These findings warrant further investigation into auditory attention deployment differences in individuals with ASD.

Acute Calcific Tendinitis of the Flexor Carpi Ulnaris Tendon Treated with Lavage and Steroid Injection: A Case Report

Acute calcific tendinitis (ACT) is a relatively uncommon disorder that can involve the hand and wrist. ACT is frequently misdiagnosed due to a lack of familiarity with the condition and the clinical presentation that can be confused with other conditions. We report a case of acute calcific tendinitis of the flexor carpi ulnaris (FCU) tendon in a 68-year-old woman. She presented with acute left volar wrist pain, erythema, swelling, and restricted range of motion. Due to her inability to take nonsteroidal anti-inflammatory drugs (NSAIDs) and oral prednisone, she was treated with lavage and steroid injection of the calcified mass. Following the injection, there was dramatic improvement in her symptoms. Cortisone injection with lavage is an accepted treatment for rotator cuff calcific tendinitis and is another treatment option for ACT involving the hand and wrist.

Improving Localization Accuracy of Neural Sources by Pre-processing: Demonstration With Infant MEG Data

We discuss specific challenges and solutions in infant MEG, which is one of the most technically challenging areas of MEG studies. Our results can be generalized to a variety of challenging scenarios for MEG data acquisition, including clinical settings. We cover a wide range of steps in pre-processing, including movement compensation, suppression of magnetic interference from sources inside and outside the magnetically shielded room, suppression of specific physiological artifact components such as cardiac artifacts. In the assessment of the outcome of the pre-processing algorithms, we focus on comparing signal representation before and after pre-processing and discuss the importance of the different components of the main processing steps. We discuss the importance of taking the noise covariance structure into account in inverse modeling and present the proper treatment of the noise covariance matrix to accurately reflect the processing that was applied to the data. Using example cases, we investigate the level of source localization error before and after processing. One of our main findings is that statistical metrics of source reconstruction may erroneously indicate that the results are reliable even in cases where the data are severely distorted by head movements. As a consequence, we stress the importance of proper signal processing in infant MEG.

Reduced Theta Sampling in Infants at Risk for Dyslexia across the Sensitive Period of Native Phoneme Learning

Research on children and adults with developmental dyslexia-a specific difficulty in learning to read and spell-suggests that phonological deficits in dyslexia are linked to basic auditory deficits in temporal sampling. However, it remains undetermined whether such deficits are already present in infancy, especially during the sensitive period when the auditory system specializes in native phoneme perception. Because dyslexia is strongly hereditary, it is possible to examine infants for early predictors of the condition before detectable symptoms emerge. This study examines low-level auditory temporal sampling in infants at risk for dyslexia across the sensitive period of native phoneme learning. Using magnetoencephalography (MEG), we found deficient auditory sampling at theta in at-risk infants at both 6 and 12 months, indicating atypical auditory sampling at the syllabic rate in those infants across the sensitive period for native-language phoneme learning. This interpretation is supported by our additional finding that auditory sampling at theta predicted later vocabulary comprehension, nonlinguistic communication and the ability to combine words. Our results indicate a possible early marker of risk for dyslexia.

'Dear Doctor': a randomised controlled trial of a text message intervention to reduce burnout in trainee anaesthetists

One in four doctors in training in the UK reports feeling 'burnt out' due to their work and similar figures are reported in other countries. This two-group non-blinded randomised controlled trial aimed to determine if a novel text message intervention could reduce burnout and increase well-being in UK trainee anaesthetists. A total of 279 trainee anaesthetists (Core Training Year 2, Specialty Training Years 3 or 4) were included. All participants received one initial message sharing support resources. The intervention group (139 trainees) received 22 fortnightly text messages over approximately 10 months. Messages drew on 11 evidence-based themes including: gratitude; social support; self-efficacy; and self-compassion. Primary outcomes were burnout (Copenhagen Burnout Inventory) and well-being (Short Warwick-Edinburgh Mental Well-being Scale). Secondary outcomes were as follows: meaning in work; professional value; sickness absence; and consideration of career break. Outcomes were measured via online surveys. Measures of factors that may have affected well-being were included post-hoc, including the impact of COVID-19 (the first UK wave of which coincided with the second half of the trial). The final survey was completed by 153 trainees (74 in the intervention and 79 in the control groups). There were no significant group differences in: burnout (β = -1.82, 95%CI -6.54-2.91, p = 0.45); well-being (-0.52, -1.73-0.69, p = 0.40); meaning (-0.09, -0.67-0.50, p = 0.77); value (-0.01, -0.67-0.66, p = 0.99); sick days (0.88, -2.08-3.83, p = 0.56); or consideration of career break (OR = 0.44, -0.30-1.18, p = 0.24). Exploratory post-hoc analysis found the intervention was associated with reduced burnout in participants reporting personal or work-related difficulties during the trial period (-9.56, -17.35 to -1.77, p = 0.02) and in participants reporting that the COVID-19 pandemic had a big negative impact on their well-being (-10.38, -20.57 to -0.19, p = 0.05). Overall, this trial found the intervention had no impact. However, given this intervention is low cost and requires minimal time commitment from recipients, it may warrant adaptation and further evaluation.

Extended Signal-Space Separation Method for Improved Interference Suppression in MEG

Objective:

Magnetoencephalography (MEG) signals typically reflect a mixture of neuromagnetic fields, subject-related artifacts, external interference and sensor noise. Even inside a magnetically shielded room, external interference can be significantly stronger than brain signals. Methods such as signal-space projection (SSP) and signal-space separation (SSS) have been developed to suppress this residual interference, but their performance might not be sufficient in cases of strong interference or when the sources of interference change over time.

Methods:

Here we suggest a new method, extended signal-space separation (eSSS), which combines a physical model of the magnetic fields (as in SSS) with a statistical description of the interference (as in SSP). We demonstrate the performance of this method via simulations and experimental MEG data.

Results:

The eSSS method clearly outperforms SSS and SSP in interference suppression regardless of the extent of a priori information available on the interference sources. We also show that the method does not cause location or amplitude bias in dipole modeling.

Conclusion:

Our eSSS method provides better data quality than SSP or SSS and can be readily combined with other SSS-based methods, such as spatiotemporal SSS or head movement compensation. Thus, eSSS extends and complements the interference suppression techniques currently available for MEG.

Significance:

Due to its ability to suppress external interference to the level of sensor noise, eSSS can facilitate single-trial data analysis, exemplified in automated analysis of epileptic data. Such an enhanced suppression is especially important in environments with large interference fields.

What improves the likelihood of people receiving genetic test results communicating to their families about genetic risk?

OBJECTIVE

We currently rely on probands to communicate genetic testing results and health risks within a family to stimulate preventive behaviors, such as cascade testing. Rates of guidelines-based cascade testing are low, possibly due to low frequency or non-urgent communication of risk among family members. Understanding what is being communicated and why may help improve interventions that increase communication and rates of cascade testing.

METHODS

Participants (n = 189) who were to receive both positive and negative colorectal cancer (CRC) sequencing results completed surveys on family communication, family functioning, impact of cancer in the family, and future communication of risk and were participants in eMERGE3. Questions were taken from existing surveys and administered electronically using email and a web driven tool.

RESULTS

Common family member targets of CRC risk communication, before results were received, were mothers and fathers, then sisters and grandchildren and finally, children and brothers. A communication impact score of 0.66 (sd = 0.83) indicated low-to-moderate communication impact. Age and education were significantly associated with frequency of familial communication, but not on the cancer-related impact of familial communication.

CONCLUSIONS

There is infrequent communication about cancer risk from probands to family members.

PRACTICE IMPLICATIONS

These results demonstrate an opportunity to help families improve communication.

Analysis methods for measuring passive auditory fNIRS responses generated by a block-design paradigm

Significance: Functional near-infrared spectroscopy (fNIRS) is an increasingly popular tool in auditory research, but the range of analysis procedures employed across studies may complicate the interpretation of data. Aim: We aim to assess the impact of different analysis procedures on the morphology, detection, and lateralization of auditory responses in fNIRS. Specifically, we determine whether averaging or generalized linear model (GLM)-based analysis generates different experimental conclusions when applied to a block-protocol design. The impact of parameter selection of GLMs on detecting auditory-evoked responses was also quantified. Approach: 17 listeners were exposed to three commonly employed auditory stimuli: noise, speech, and silence. A block design, comprising sounds of 5 s duration and 10 to 20 s silent intervals, was employed. Results: Both analysis procedures generated similar response morphologies and amplitude estimates, and both indicated that responses to speech were significantly greater than to noise or silence. Neither approach indicated a significant effect of brain hemisphere on responses to speech. Methods to correct for systemic hemodynamic responses using short channels improved detection at the individual level. Conclusions: Consistent with theoretical considerations, simulations, and other experimental domains, GLM and averaging analyses generate the same group-level experimental conclusions. We release this dataset publicly for use in future development and optimization of algorithms.

Mid-infrared absorption by soft tissue sarcoma and cell ablation utilizing a mid-infrared interband cascade laser

SIGNIFICANCE

Mid-infrared (MIR) light refers to wavelengths ranging from 3 to 30  μm and is the most attractive spectral region for ablation of soft and hard tissues. This is because building blocks of biological tissue, such as water, proteins, and lipids, exhibit molecular vibrational modes in the MIR wavelengths that result in strong MIR light absorption. To date, researchers investigating MIR lasers for surgical applications have used bulky light sources, such as free electron lasers, nonlinear light generators, and carbon dioxide lasers. We demonstrate the use of a tiny (a few microns wide, a few millimeters long) MIR interband cascade laser (ICL) for surgical thermal ablation applications.

AIM

Our goal is to demonstrate the use of an ICL for surgical thermal ablation and demonstrate its efficacy in ablating normal fibroblasts and primary undifferentiated pleomorphic sarcoma tumor cells (C1619).

APPROACH

We conducted Fourier transform infrared spectroscopy analysis of healthy and cancerous tissue samples, which indicated that the absorption of tumor tissue is higher than healthy tissue around 3.3-μm wavelength. These results enabled us to select an ICL emission wavelength, λ, of 3.3  μm to probe normal fibroblast and primary undifferentiated pleomorphic sarcoma cell survival after ICL exposure.

RESULTS

We show that the absorption of tumorous tissue is higher than that of healthy tissues around the 3-μm MIR wavelength. We demonstrate that the ICL is able to ablate cancer cells at very low-power levels that can be clinically implemented but that this effect does not appear to be specific to C1619 when compared to normal fibroblasts.

CONCLUSIONS

Our study demonstrates that ICLs may represent an exciting new avenue toward precise laser-based thermal ablation.

Unified Expression of the Quasi-Static Electromagnetic Field: Demonstration With MEG and EEG Signals

Objective:

Electromagnetic recordings are useful for non-invasive measurement of human brain activity. They typically sample electric potentials on the scalp or the magnetic field outside the head using electroencephalography (EEG) or magnetoencephalography (MEG), respectively. EEG and MEG are not, however, symmetric counterparts: EEG samples a scalar field via a line integral over the electric field between two points, while MEG samples projections of a vector-valued field by small sensors. Here we present a unified mathematical formalism for electromagnetic measurements, leading to useful interpretations and signal processing methods for EEG and MEG.

Methods:

We represent electric and magnetic fields as solutions of Laplace’s equation under the quasi-static approximation, each field representable as an expansion of the same vector spherical harmonics (VSH) but differently weighted by electro- and magnetostatic multipole moments, respectively.

Results:

We observe that the electric and the magnetic fields are mathematically symmetric but couple to the underlying electric source distribution in distinct ways via their corresponding multipole moments, which have concise mathematical forms. The VSH model also allows us to construct linear bases for MEG and EEG for signal processing and analysis, including interference suppression methods and system calibration.

Conclusion:

The VSH model is a powerful and simple approach for modeling quasi-static electromagnetic fields.

Significance:

Our formalism provides a unified framework for interpreting resolution questions, and paves the way for new processing and analysis methods.

Auditory deficits in infants at risk for dyslexia during a linguistic sensitive period predict future language

Developmental dyslexia, a specific difficulty in learning to read and spell, has a strong hereditary component, which makes it possible to examine infants for early predictors of the condition even prior to the emergence of detectable symptoms. Using magnetoencephalography (MEG), we found smaller and shorter neural responses to simple sounds in infants at risk for dyslexia at 6 as compared to 12 months of age, a pattern that was reversed in age-matched controls. The findings indicate atypical auditory processing in at-risk infants across the sensitive period for native-language phoneme learning. This pattern was robust and localized to the same cortical areas regardless of the modeling parameters/algorithms used to estimate the current distribution underlying the measured activity. Its localization to left temporal and left frontal brain regions indicates a potential impact of atypical auditory processing on early language learning and later language skills because language functions are typically lateralized to the left hemisphere. This interpretation is supported by our further finding that atypical auditory responses in at-risk infants consistently predicted syntactic processing between 18 and 30 months and word production at 18 and 21 months of age. These results suggest a possible early marker of risk for dyslexia in at-risk infants.

Structural templates for imaging EEG cortical sources in infants

Electroencephalographic (EEG) source reconstruction is a powerful approach that allows anatomical localization of electrophysiological brain activity. Algorithms used to estimate cortical sources require an anatomical model of the head and the brain, generally reconstructed using magnetic resonance imaging (MRI). When such scans are unavailable, a population average can be used for adults, but no average surface template is available for cortical source imaging in infants. To address this issue, we introduce a new series of 13 anatomical models for subjects between zero and 24 months of age. These templates are built from MRI averages and boundary element method (BEM) segmentation of head tissues available as part of the Neurodevelopmental MRI Database. Surfaces separating the pia mater, the gray matter, and the white matter were estimated using the Infant FreeSurfer pipeline. The surface of the skin as well as the outer and inner skull surfaces were extracted using a cube marching algorithm followed by Laplacian smoothing and mesh decimation. We post-processed these meshes to correct topological errors and ensure watertight meshes. Source reconstruction with these templates is demonstrated and validated using 100 high-density EEG recordings from 7-month-old infants. Hopefully, these templates will support future studies on EEG-based neuroimaging and functional connectivity in healthy infants as well as in clinical pediatric populations.

Genetic Architecture of Abdominal Aortic Aneurysm in the Million Veteran Program

Supplemental Digital Content is available in the text.

Abdominal aortic aneurysm (AAA) is an important cause of cardiovascular mortality; however, its genetic determinants remain incompletely defined. In total, 10 previously identified risk loci explain a small fraction of AAA heritability.

Genome-wide Modeling of Polygenic Risk Score in Colorectal Cancer Risk

Accurate colorectal cancer (CRC) risk prediction models are critical for identifying individuals at low and high risk of developing CRC, as they can then be offered targeted screening and interventions to address their risks of developing disease (if they are in a high-risk group) and avoid unnecessary screening and interventions (if they are in a low-risk group). As it is likely that thousands of genetic variants contribute to CRC risk, it is clinically important to investigate whether these genetic variants can be used jointly for CRC risk prediction. In this paper, we derived and compared different approaches to generating predictive polygenic risk scores (PRS) from genome-wide association studies (GWASs) including 55,105 CRC-affected case subjects and 65,079 control subjects of European ancestry. We built the PRS in three ways, using (1) 140 previously identified and validated CRC loci; (2) SNP selection based on linkage disequilibrium (LD) clumping followed by machine-learning approaches; and (3) LDpred, a Bayesian approach for genome-wide risk prediction. We tested the PRS in an independent cohort of 101,987 individuals with 1,699 CRC-affected case subjects. The discriminatory accuracy, calculated by the age- and sex-adjusted area under the receiver operating characteristics curve (AUC), was highest for the LDpred-derived PRS (AUC = 0.654) including nearly 1.2 M genetic variants (the proportion of causal genetic variants for CRC assumed to be 0.003), whereas the PRS of the 140 known variants identified from GWASs had the lowest AUC (AUC = 0.629). Based on the LDpred-derived PRS, we are able to identify 30% of individuals without a family history as having risk for CRC similar to those with a family history of CRC, whereas the PRS based on known GWAS variants identified only top 10% as having a similar relative risk. About 90% of these individuals have no family history and would have been considered average risk under current screening guidelines, but might benefit from earlier screening. The developed PRS offers a way for risk-stratified CRC screening and other targeted interventions.

Pleiotropy in the Genetic Predisposition to Rheumatoid Arthritis: A Phenome-Wide Association Study and Inverse Variance-Weighted Meta-Analysis

OBJECTIVE

This study was undertaken to investigate the hypothesis that a genetic predisposition toward rheumatoid arthritis (RA) increases the risk of 10 cardiometabolic and autoimmune disorders previously associated with RA in epidemiologic studies, and to define new genetic pleiotropy present in RA.

METHODS

Two approaches were used to test our hypothesis. First, we constructed a weighted genetic risk score (wGRS) and then examined its association with 10 prespecified disorders. Additionally, a phenome-wide association study (PheWAS) was carried out to identify potential new associations. Second, inverse variance-weighted regression (IVWR) meta-analysis was used to characterize the association between genetic susceptibility to RA and the prespecified disorders, with the results expressed as odds ratios (ORs) and 95% confidence intervals (95% CIs).

RESULTS

The wGRS for RA was significantly associated with type 1 diabetes mellitus (DM) (OR 1.10 [95% CI 1.04-1.16]; P = 9.82 × 10^-4 ) and multiple sclerosis (OR 0.82 [95% CI 0.77-0.88]; P = 1.73 × 10^-8 ), but not with other cardiometabolic phenotypes. In the PheWAS, wGRS was also associated with an increased risk of several autoimmune phenotypes including RA, thyroiditis, and systemic sclerosis, and with a decreased risk of demyelinating disorders. In the IVWR meta-analyses, RA was significantly associated with an increased risk of type 1 DM (P = 1.15 × 10^-14 ), with evidence of horizontal pleiotropy (Mendelian Randomization-Egger intercept estimate P = 0.001) likely driven by rs2476601, a PTPN22 variant. The association between type 1 DM and RA remained significant (P = 9.53 × 10^-9 ) after excluding rs2476601, with no evidence of horizontal pleiotropy (intercept estimate P = 0.939). RA was also significantly associated with type 2 DM and C-reactive protein levels. These associations were driven by variation in the major histocompatibility complex region.

CONCLUSION

This study presents evidence of pleiotropy between the genetic predisposition to RA and associated phenotypes found in other autoimmune and cardiometabolic disorders, including type 1 DM.

SciPy 1.0: fundamental algorithms for scientific computing in Python

SciPy is an open-source scientific computing library for the Python programming language. Since its initial release in 2001, SciPy has become a de facto standard for leveraging scientific algorithms in Python, with over 600 unique code contributors, thousands of dependent packages, over 100,000 dependent repositories and millions of downloads per year. In this work, we provide an overview of the capabilities and development practices of SciPy 1.0 and highlight some recent technical developments.

SciPy 1.0: fundamental algorithms for scientific computing in Python

SciPy is an open-source scientific computing library for the Python programming language. Since its initial release in 2001, SciPy has become a de facto standard for leveraging scientific algorithms in Python, with over 600 unique code contributors, thousands of dependent packages, over 100,000 dependent repositories and millions of downloads per year. In this work, we provide an overview of the capabilities and development practices of SciPy 1.0 and highlight some recent technical developments.

SciPy 1.0: fundamental algorithms for scientific computing in Python

SciPy is an open-source scientific computing library for the Python programming language. Since its initial release in 2001, SciPy has become a de facto standard for leveraging scientific algorithms in Python, with over 600 unique code contributors, thousands of dependent packages, over 100,000 dependent repositories and millions of downloads per year. In this work, we provide an overview of the capabilities and development practices of SciPy 1.0 and highlight some recent technical developments.

MNE-BIDS: Organizing electrophysiological data into the BIDS format and facilitating their analysis

The development of the Brain Imaging Data Structure (BIDS; Gorgolewski et al., 2016) gave the neuroscientific community a standard to organize and share data. BIDS prescribes file naming conventions and a folder structure to store data in a set of already existing file formats. Next to rules about organization of the data itself, BIDS provides standardized templates to store associated metadata in the form of Javascript Object Notation (JSON) and tab separated value (TSV) files. It thus facilitates data sharing, eases metadata querying, and enables automatic data analysis pipelines. BIDS is a rich system to curate, aggregate, and annotate neuroimaging databases.

Gender dynamics in digital health: overcoming blind spots and biases to seize opportunities and responsibilities for transformative health systems

Much remains to ensure that digital health affirms rather than retrenches inequality, including for gender. Drawing from literature and from the SEARCH projects in this supplement, this commentary highlights key gender dynamics in digital health, including blind spots and biases, as well as transformative opportunities and responsibilities. Women face structural and social barriers that inhibit their participation in digital health, but are also frequently positioned as beneficiaries without opportunities to shape such projects to better fit their needs. Furthermore, overlooking gender relations and focussing on women in isolation can reinforce, rather than address, women’s exclusions in digital health, and worsen negative unanticipated consequences. While digital health provides opportunities to transform gender relations, gender is an intimate and deeply structural form of social inequality that rarely changes due to a single initiative or short-term project. Sustained support over time, across health system stakeholders and levels is required to ensure that transformative change with one set of actors is replicated and reinforced elsewhere in the health system. There is no one size prescriptive formula or checklist. Incremental learning and reflection is required to nurture ownership and respond to unanticipated reactions over time when transforming gender and its multiple intersections with inequality.

Evaluation of the GeneQuence® DNA Hybridization Method in Conjunction with 24-Hour Enrichment Protocols for Detection of Salmonella spp. in Select Foods: Collaborative Study

A multilaboratory study was conducted to compare performance of the GeneQuence® DNA hybridization (DNAH) method incorporating new 24 h enrichment protocols and reference culture procedures for detection of Salmonella spp. in select foods. Six food types (raw ground turkey, raw ground beef, dried whole egg, milk chocolate, walnuts, and dry pet food) were tested by the DNAH method and by the culture methods of either the U.S. Department of Agriculture-Food Safety and Inspection Service (USDA-FSIS) or the U.S. Food and Drug Administration's Bacteriological Analytical Manual (FDA/BAM). Fifteen laboratories participated in the study. Four of the foods tested (raw ground turkey, dried whole egg, milk chocolate, and dry pet food), showed no statistically significant differences in performance between the DNAH method and the reference procedure as determined by Chi square analysis. Sensitivity rates for the DNAH method ranged from 92 to 100. The DNAH method, with the specific enrichment protocol evaluated, was found to be ineffective for detection of Salmonella spp. in walnuts. For raw ground beef, results from one trial showed a statistically significant difference in performance, with more positives obtained by the reference method. However, evidence suggests that the difference in the number of positives was likely due to lack of homogeneity of the test samples rather than to DNAH method performance.

SITTING PATTERNS, PHYSICAL ACTIVITY, AND PHYSICAL FUNCTIONING IN OLDER ADULTS

We examined cross-sectional associations between physical function and device-based (activPAL) sedentary patterns and physical activity. Physical function tasks included time to complete 5 chair stands and walk a 10-foot gait speed course. We estimated associations using linear regression models adjusting for age and sex; coefficients represent estimated change in mean activPAL measures associated with each second increase in gait/chair stands time. Longer gait speed times were associated with more total sitting time (b=0.19, p < 0.01), fewer steps (b=-788.0, p<0.001), fewer sitting breaks (b=-1.7, p<0.01), and more prolonged sitting bouts (b=0.19, p<0.01). Longer chair stand times were associated with more total sitting time (b=0.06, p<0.001), less standing time (b=-0.04, p<0.01), fewer steps (b=-176.8, p<0.001), fewer sitting breaks (b=-0.45, p<0.01), and more prolonged sitting bouts (b=0.07, p<0.001). Prolonged patterns of sitting time and higher total sitting time, in addition to lower physical activity, were consistently associated with worse physical function.

Nurse and midwife researcher collaboration in eastern sub-Saharan Africa: a social network analysis

AIM

To investigate the collaborative networks among expert clinical nurse and midwifery researchers in eastern and southern Africa.

METHODS

Thirty-eight clinical nurse and midwifery researchers completed an online survey to analyse collaboration between respondents. Data were analysed using social network analysis, generating a network map and associated measurements.

RESULTS

Regional collaboration was poor. Those links that did exist centred on geographic proximity and participation in regional and international organizations.

CONCLUSION

These results help us to understand better ways to strengthen and support nursing and midwifery clinical research in eastern and southern Africa.

IMPLICATIONS FOR NURSING POLICY

Clinical nursing and midwifery research capacity building efforts should focus on supporting collaboration networks among individuals and institutions in the region.

Systematic analysis of dark and camouflaged genes reveals disease-relevant genes hiding in plain sight

BACKGROUND

The human genome contains "dark" gene regions that cannot be adequately assembled or aligned using standard short-read sequencing technologies, preventing researchers from identifying mutations within these gene regions that may be relevant to human disease. Here, we identify regions with few mappable reads that we call dark by depth, and others that have ambiguous alignment, called camouflaged. We assess how well long-read or linked-read technologies resolve these regions.

RESULTS

Based on standard whole-genome Illumina sequencing data, we identify 36,794 dark regions in 6054 gene bodies from pathways important to human health, development, and reproduction. Of these gene bodies, 8.7% are completely dark and 35.2% are ≥ 5% dark. We identify dark regions that are present in protein-coding exons across 748 genes. Linked-read or long-read sequencing technologies from 10x Genomics, PacBio, and Oxford Nanopore Technologies reduce dark protein-coding regions to approximately 50.5%, 35.6%, and 9.6%, respectively. We present an algorithm to resolve most camouflaged regions and apply it to the Alzheimer's Disease Sequencing Project. We rescue a rare ten-nucleotide frameshift deletion in CR1, a top Alzheimer's disease gene, found in disease cases but not in controls.

CONCLUSIONS

While we could not formally assess the association of the CR1 frameshift mutation with Alzheimer's disease due to insufficient sample-size, we believe it merits investigating in a larger cohort. There remain thousands of potentially important genomic regions overlooked by short-read sequencing that are largely resolved by long-read technologies.

Auditory attention switching with listening difficulty: Behavioral and pupillometric measures

Pupillometry has emerged as a useful tool for studying listening effort. Past work involving listeners with normal audiological thresholds has shown that switching attention between competing talker streams evokes pupil dilation indicative of listening effort [McCloy, Lau, Larson, Pratt, and Lee (2017). J. Acoust. Soc. Am. 141(4), 2440-2451]. The current experiment examines behavioral and pupillometric data from a two-stream target detection task requiring attention-switching between auditory streams, in two participant groups: audiometrically normal listeners who self-report difficulty localizing sound sources and/or understanding speech in reverberant or acoustically crowded environments, and their age-matched controls who do not report such problems. Three experimental conditions varied the number and type of stream segregation cues available. Participants who reported listening difficulty showed both behavioral and pupillometric signs of increased effort compared to controls, especially in trials where listeners had to switch attention between streams, or trials where only a single stream segregation cue was available.