The Paradox of Fiction Revisited—Improvised Fictional and Real-Life Social Rejections Evoke Associated and Relatively Similar Psychophysiological Responses

Theatre-based practices, such as improvisation, are frequently applied to simulate everyday social interactions. Although the improvisational context is acknowledged as fictional, realistic emotions may emerge, a phenomenon labelled the ‘paradox of fiction’. This study investigated how manipulating the context (real-life versus fictional) modulates psychophysiological reactivity to social rejection during dyadic interactions. We measured psychophysiological responses elicited during real-life (interview) and fictional (improvisation exercises) social rejections. We analysed the heart rate (HR), skin conductance, facial muscle activity, and electrocortical activity (electroencephalographic (EEG) alpha asymmetry) of student teachers (N = 39) during various social rejections (devaluing, interrupting, nonverbal rejection). All social rejections evoked negative EEG alpha asymmetry, a measure reflecting behavioural withdrawal motivation. Psychophysiological responses during real-life and fictional rejections correlated, and rejection type modified the responses. When comparing responses across all rejection types, facial muscle activity and EEG alpha asymmetry did not differ between real-life and fictional rejections, whereas HR decelerated and skin conductance increased during fictional rejections. These findings demonstrate that regardless of cognitive awareness of fictionality, relatively subtle social rejections elicited psychophysiological reactivity indicating emotional arousal and negative valence. These findings provide novel, biological evidence for the application of theatre-based improvisation to studying experientially everyday social encounters

Effects of Improvisation Training on Student Teachers’ Behavioral, Neuroendocrine, and Psychophysiological Responses during the Trier Social Stress Test

Objectives Teaching involves multiple performance situations, potentially causing psychosocial stress. Since the theater-based improvisation method is associated with diminished social stress, we investigated whether improvisation lessened student teachers’ stress responses using the Trier Social Stress Test (TSST; preparatory phase, public speech, and math task). Moreover, we studied the influence of interpersonal confidence (IC) – the belief regarding one’s capability related to effective social interactions – on stress responses. Methods The intervention group (n = 19) received a 7-week (17.5 h) improvisation training, preceded and followed by the TSST. We evaluated experienced stress using a self-report scale, while physiological stress was assessed before (silent 30-s waiting period) and during the TSST tasks using cardiovascular measures (heart rate, heart rate variability [HRV]), electrodermal activation, facial electromyography (f-EMG), and EEG asymmetry. Hypothalamus-pituitary-adrenal (HPA-axis) reactivity was assessed through repeated salivary cortisol sampling. Results Compared to the control group (n = 16), the intervention group exhibited less f-EMG activity before a public speech and higher HRV before the math task. The low IC intervention subgroup reported significantly less stress during the math task. The controls showed a decreased heart rate before the math task, and controls with a low IC exhibited higher HRV during the speech. Self-reported stress and cortisol levels were positively correlated during the post-TSST preparatory phase. Conclusions These findings suggest that improvisation training might diminish stress levels, specifically before a performance. In addition, interpersonal confidence appears to reduce stress responses. The decreased stress responses in the control group suggest adaptation through repetition. Keywords: Improvisation; Anticipatory anxiety; Interpersonal confidence; Psychophysiology; Teacher education; Trier Social Stress TestPeer reviewe

Bupropion Causes Misdiagnosis in Brain Dopamine Transporter Imaging for Parkinsonism

Objective: The objective of this study was to report long-lasting effects of bupropion on brain dopamine transporter (DAT) in a patient with depression and parkinsonism. Methods: The patient was a 52-year old man who had been treated with 150 mg/d of bupropion for depression. The patient developed cognitive problems, bradykinesia, and reduced stride length for which he was scanned with [123I]FP-CIT single photon emission computed tomography after the recommended 1-week discontinuation of bupropion. Levodopa treatment trial was initiated without a response. Eleven months later, the patient was scanned for a second time after a 1-month stoppage of bupropion. Results: The first scan was abnormal with left putamen specific binding ratio of 1.99 (SDs from the reference value mean, −2.40), right putamen of 2.27 (SD, −1.84), left caudate of 2.33 (SD, −2.26), and right caudate of 2.29 (SD, −2.18). The second scan (after 1-month discontinuation) was normal, and specific binding ratios had increased from 5.2% to 31.7% in all striatal regions as compared with the first scan. Brain magnetic resonance imaging and [18F]fluorodeoxyglucose positron emission tomography imaging were normal, and there was no levodopa response or other features supporting neurodegenerative parkinsonism. Conclusions: Bupropion has previously generally been discontinued 1 week prior DAT imaging, which meets the recommended, albeit arbitrary, time interval of 5 plasma clearance half-lives before the scan. One-week discontinuation of bupropion before DAT imaging may be insufficiently short. Our case shows that longer medication washout and rescan may be needed when there is contradiction between the imaging result and clinical outcome in patients with medications affecting DAT binding</p

The feasibility of [F-18]EF5-PET/CT to image hypoxia in ovarian tumors: a clinical study

Rationale Evaluation of the feasibility of [F-18]EF5-PET/CT scan in identifying hypoxic lesions in ovarian tumors in prospective clinical setting. Methods Fifteen patients with a suspected malignant ovarian tumor were scanned with [F-18]EF5 and [F-18]FDG-PET/CT preoperatively. The distribution of [F-18]EF5-uptake, total intraabdominal metabolic tumor volume (TMTV), and hypoxic subvolume (HSV) were assessed. Results [F-18]EF5-PET/CT suggested hypoxia in 47% (7/15) patients. The median HSV was 87 cm(3)(31% of TMTV). The [F-18]EF5-uptake was detected in primary tumors and in four patients also in intra-abdominal metastases. The [F-18]EF5-uptake in cancer tissue was low compared to physiological excretory pathways, complicating the interpretation of PET/CT images. Conclusions [F-18]EF5-PET/CT is not feasible in ovarian cancer imaging in clinical setting due to physiological intra-abdominal [F-18]EF5-accumulation. However, it may be useful when used complementarily to FDG-PET/CT.</div

Comparison of standardized uptake values between Tc-99m-HDP SPECT/CT and F-18-NaF PET/CT in bone metastases of breast and prostate cancer

Background: Despite recent technological advances allowing for quantitative single-photon emission computed tomography (SPECT), quantitative SPECT has not been widely used in the clinical practice. The aim of this study is to evaluate the feasibility of quantitative SPECT for measuring metastatic bone uptake in breast and prostate cancer by comparing standard uptake values (SUVs) measured with Tc-99m-HDP SPECT/CT and F-18-NaF PET/CT.Methods: Twenty-six breast and 27 prostate cancer patients at high risk of bone metastases underwent both Tc-99m-HDP SPECT/CT and F-18-NaF PET/CT within 14days of each other. The SPECT and PET data were reconstructed using ordered-subset expectation-maximization algorithms achieving quantitative images. Metastatic and benign skeletal lesions visible in both data sets were identified, and their maximum, peak, and mean SUVs (SUVmax, SUVpeak, and SUVmean) were determined. SUV ratios (SUVRs) between the lesions and adjacent normal appearing bone were also calculated. Linear regression was used to evaluate the correlations between the SUVs of SPECT and PET and Bland-Altman plots to evaluate the differences between the SUVs and SUVRs of SPECT and PET.Results: A total of 231 skeletal lesions, 129 metastatic and 102 benign, were analyzed. All three SUV measures correlated very strongly between SPECT and PET (R(2)0.80, pConclusion: The strong correlation between SUVs and similar SUVRs of Tc-99m-HDP SPECT/CT and F-18-NaF PET/CT demonstrate that SPECT is an applicable tool for clinical quantification of bone metabolism in osseous metastases in breast and prostate cancer patients.</div

Comparison of reprojected bone SPECT/CT and planar bone scintigraphy for the detection of bone metastases in breast and prostate cancer

Objective The aim of this study was to compare reprojected bone SPECT/CT (RBS) against planar bone scintigraphy (BS) in the detection of bone metastases in breast and prostate cancer patients. Methods Twenty-six breast and 105 prostate cancer patients with high risk for bone metastases underwent Tc-99m-HMDP BS and whole-body SPECT/CT, 1.5-T whole-body diffusion-weighted MRI and F-18-NaF or F-18-PSMA-1007 PET/CT within two prospective clinical trials (NCT01339780 and NCT03537391). Consensus reading of all imaging modalities and follow-up data were used to define the reference standard diagnosis. The SPECT/CT data were reprojected into anterior and posterior views to produce RBS images. Both BS and RBS images were independently double read by two pairs of experienced nuclear medicine physicians. The findings were validated against the reference standard diagnosis and compared between BS and RBS on the patient, region and lesion levels. Results All metastatic patients detected by BS were also detected by RBS. In addition, three metastatic patients were missed by BS but detected by RBS. The average patient-level sensitivity of two readers for metastases was 75% for BS and 87% for RBS, and the corresponding specificity was 79% for BS and 39% for RBS. The average region-level sensitivity of two readers was 64% for BS and 69% for RBS, and the corresponding specificity was 96% for BS and 87% for RBS. Conclusion Whole-body bone SPECT/CT can be reprojected into more familiar anterior and posterior planar images with excellent sensitivity for bone metastases, making additional acquisition of planar BS unnecessary.Peer reviewe

6G White Paper on Edge Intelligence

In this white paper we provide a vision for 6G Edge Intelligence. Moving towards 5G and beyond the future 6G networks, intelligent solutions utilizing data-driven machine learning and artificial intelligence become crucial for several real-world applications including but not limited to, more efficient manufacturing, novel personal smart device environments and experiences, urban computing and autonomous traffic settings. We present edge computing along with other 6G enablers as a key component to establish the future 2030 intelligent Internet technologies as shown in this series of 6G White Papers. In this white paper, we focus in the domains of edge computing infrastructure and platforms, data and edge network management, software development for edge, and real-time and distributed training of ML/AI algorithms, along with security, privacy, pricing, and end-user aspects. We discuss the key enablers and challenges and identify the key research questions for the development of the Intelligent Edge services. As a main outcome of this white paper, we envision a transition from Internet of Things to Intelligent Internet of Intelligent Things and provide a roadmap for development of 6G Intelligent Edge

Dopamine transporter binding in symptomatic controls and healthy volunteers: Considerations for neuroimaging trials

ObjectiveTo evaluate possible differences between brain dopamine transporter (DAT) binding in a group of symptomatic parkinsonism patients without dopaminergic degeneration and healthy individuals.BackgroundDopaminergic neuroimaging studies of Parkinson’s disease (PD) have often used control groups formed from symptomatic patients with apparently normal striatal dopamine function. We sought to investigate whether symptomatic patients can be used to represent dopaminergically normal healthy controls.MethodsForty healthy elderly individuals were scanned with DAT [123I]FP-CIT SPECT and compared to 69 age- and sex-matched symptomatic patients with nondegenerative conditions (including essential tremor, drug-induced parkinsonism and vascular parkinsonism). An automated region-of-interest based analysis of the caudate nucleus and the anterior/posterior putamen was performed. Specific binding ratios (SBR = [ROI-occ]/occ) were compared between the groups.ResultsDAT binding in symptomatic patients was 8.6% higher in the posterior putamen than in healthy controls (p = 0.03). Binding correlated negatively with age in both groups but not with motor symptom severity, cognitive function or depression ratings.ConclusionsPutaminal DAT binding, as measured with [123I]FP-CIT SPECT, was higher in symptomatic controls than in healthy individuals. The reason for the difference is unclear but can include selection bias when DAT binding is used to aid clinical diagnosis and possible self-selection bias in healthy volunteerism. This effect should be taken into consideration when designing and interpreting neuroimaging trials investigating the dopamine system with [123I]FP-CIT SPECT.</p

Prospective comparison of 18F-PSMA-1007 PET/CT, whole-body MRI and CT in primary nodal staging of unfavourable intermediate- and high-risk prostate cancer

Purpose To prospectively compare F-18-prostate-specific membrane antigen (PSMA)-1007 positron emission tomography (PET)/CT, whole-body magnetic resonance imaging (WBMRI) including diffusion-weighted imaging (DWI) and standard computed tomography (CT), in primary nodal staging of prostate cancer (PCa).Methods Men with newly diagnosed unfavourable intermediate- or high-risk PCa prospectively underwent F-18-PSMA-1007 PET/CT, WBMRI with DWI and contrast-enhanced CT within a median of 8 days. Six readers (two for each modality) independently reported pelvic lymph nodes as malignant, equivocal or benign while blinded to the other imaging modalities. Sensitivity, specificity and accuracy were reported according to optimistic (equivocal lesions interpreted as benign) and pessimistic (equivocal lesions interpreted as malignant) analyses. The reference standard diagnosis was based on multidisciplinary consensus meetings where available histopathology, clinical and follow-up data were used.Results Seventy-nine patients completed all the imaging modalities, except for one case of interrupted WBMRI. Thirty-one (39%) patients had pelvic lymph node metastases, which were detected in 27/31 (87%), 14/31 (45%) and 8/31 (26%) patients by F-18-PSMA-1007 PET/CT, WBMRI with DWI and CT, respectively (optimistic analysis). In 8/31 (26%) patients, only F-18-PSMA-1007 PET/CT detected malignant lymph nodes, while the other two imaging modalities were reported as negative. At the patient level, sensitivity and specificity values for F-18-PSMA-1007 PET/CT, WBMRI with DWI and CT in optimistic analysis were 0.87 (95%CI 0.71-0.95) and 0.98 (95%CI 0.89-1.00), 0.37 (95%CI 0.22-0.55) and 0.98 (95%CI 0.89-1.00) and 0.26 (95%CI 0.14-0.43) and 1.00 (95%CI 0.93-1.00), respectively.Conclusion F-18-PSMA-1007 PET/CT showed significantly greater sensitivity in nodal staging of primary PCa than did WBMRI with DWI or CT, while maintaining high specificity.</div