Attitudes of Patients and Their Relatives Towards Artificial Intelligence in Neurosurgery

BACKGROUND: Artificial Intelligence (AI) may favorably support surgeons but may result in concern among patients and their relatives. OBJECTIVE: To evaluate attitudes of patients and their relatives towards the use of AI in neurosurgery. METHODS: In this two-stage cross-sectional survey, a qualitative survey was administered to a focus group of former patients to investigate their perception of AI and its role in neurosurgery. Five themes were identified and used to generate a case-based quantitative survey administered to inpatients and their relatives over a two-week period. Presented AI platforms were rated appropriate and acceptable using 5-point Likert scales. Demographic data was collected. A Chi Square test was performed to determine whether demographics influenced participants' attitudes. RESULTS: In the first stage, 20 participants responded. Five themes were identified: interpretation of imaging (4/20; 20%), operative planning (5/20; 25%), real-time alert of potential complications (10/20; 50%), partially autonomous surgery (6/20; 30%), fully autonomous surgery (3/20; 15%). In the second stage, 107 participants responded. The majority felt appropriate and acceptable to use AI for imaging interpretation (76.7%; 66.3%), operative planning (76.7%; 75.8%), real-time alert of potential complications (82.2%; 72.9%), and partially autonomous surgery (58%; 47.7%). Conversely, most did not feel that fully autonomous surgery was appropriate (27.1%) or acceptable (17.7%). Demographics did not have a significant influence on perception. CONCLUSIONS: The majority of patients and their relatives believed that AI has a role in neurosurgery and found it acceptable. Notable exceptions remain fully autonomous systems, with most wanting the neurosurgeon ultimately to remain in control

ExoMol molecular line lists – XLIII. Rovibronic transitions corresponding to the close-lying X 2Π and A 2Σ+ states of NaO

The sodium monoxide radical (NaO) is observed in night-glow in the Earth’s mesosphere and likely has astronomical importance. This study concerns the optical transitions within the ground X 2Π state and to the very low-lying (Te ≈ 2000 cm−1) excited A 2Σ+ state. A line list consisting of rovibronic term values, allowed electric dipole transitions, Einstein coefficients, and partition functions for varying temperature are produced using a variational solution of the coupled-channel Schrödinger equations using the program duo. multi-reference configuration interaction (MRCI) ab initio calculations characterizing the potential energy curves of the two states, spin-orbit and L-uncoupling non-adiabatic matrix elements, as well as permanent and transition dipole moments were integral in the formation of the final deperturbation model. Ab initio potential energy curves are represented in the analytical Extended Morse Oscillator form and refined, along with the spin-orbit and L-uncoupling functions, by least-squares fitting to the available spectroscopic data. The input experimental data consisted of pure rotational transitions within the fine-structure components of the X 2Π state for v″ ∈ [0, 3] vibrational levels as well as the rovibronic A 2Σ+(v′ = 0) ← X 2Π(v″ = 0) transitions, both with limited coverage over rotational excitation. The lack of data detailing the vibrational structure of the X and A states points to the need for further experimental study of higher excited levels, which would provide a more robust spectroscopic model. The NaO NaOUCMe line list is available via www.exomol.com and the CDS data base

BRS "Symmetry", prehistory and history

Prehistory - Starting from 't Hooft's (1971) we have a short look at Taylor's and Slavnov's works (1971-72) and at the lectures given by Rouet and Stora in Lausanne-1973 which determine the transition from pre-history to history. History - We give a brief account of the main analyses and results of the BRS collaboration concerning the renormalized gauge theories, in particular the method of the regularization independent, algebraic renormalization, the algebraic proof of S-matrix unitarity and that of gauge choice independence of the renormalized physics. We conclude this report with a suggestion to the crucial question: what could remain of BRS invariance beyond perturbation theory.Comment: Talk given at: A Special day in honour of Raymond Stora, Annecy, July 8, 201

White matter integrity as a predictor of response to treatment in first episode psychosis

The integrity of brain white matter connections is central to a patient's ability to respond to pharmacological interventions. This study tested this hypothesis using a specific measure of white matter integrity, and examining its relationship to treatment response using a prospective design in patients within their first episode of psychosis. Diffusion tensor imaging data were acquired in 63 patients with first episode psychosis and 52 healthy control subjects (baseline). Response was assessed after 12 weeks and patients were classified as responders or non-responders according to treatment outcome. At this second time-point, they also underwent a second diffusion tensor imaging scan. Tract-based spatial statistics were used to assess fractional anisotropy as a marker of white matter integrity. At baseline, non-responders showed lower fractional anisotropy than both responders and healthy control subjects (P < 0.05; family-wise error-corrected), mainly in the uncinate, cingulum and corpus callosum, whereas responders were indistinguishable from healthy control subjects. After 12 weeks, there was an increase in fractional anisotropy in both responders and non-responders, positively correlated with antipsychotic exposure. This represents one of the largest, controlled investigations of white matter integrity and response to antipsychotic treatment early in psychosis. These data, together with earlier findings on cortical grey matter, suggest that grey and white matter integrity at the start of treatment is an important moderator of response to antipsychotics. These findings can inform patient stratification to anticipate care needs, and raise the possibility that antipsychotics may restore white matter integrity as part of the therapeutic response

The group structure of non-Abelian NS-NS transformations

We study the transformations of the worldvolume fields of a system of multiple coinciding D-branes under gauge transformations of the supergravity Kalb-Ramond field. We find that the pure gauge part of these NS-NS transformations can be written as a U(N) symmetry of the underlying Yang-Mills group, but that in general the full NS-NS variations get mixed up non-trivially with the U(N). We compute the commutation relations and the Jacobi identities of the bigger group formed by the NS-NS and U(N) transformations.Comment: Latex, 11 pages. v2: Typos corrected; version to appear in JHEP

Human T-cell lymphotropic virus (HTLV)-associated encephalopathy: an under-recognised cause of acute encephalitis? Case series and literature review

Human T-cell lymphotropic virus (HTLV)-1-associated myelopathy (HAM) is well described. Clinical features are predominantly consistent with cord pathology, though imaging and autopsy studies also demonstrate brain inflammation. In general, this is subclinical; however, six cases have previously been reported of encephalopathy in HTLV-1-infected patients, without alternative identified aetiology. We describe three further cases of encephalitis in the UK HAM cohort (n = 142), whereas the annual incidence of acute encephalitis in the general population is 0.07-12.6 per 100,000. Clinical features included reduced consciousness, fever/hypothermia, headaches, seizures, and focal neurology. Investigation showed: raised CSF protein; pleocytosis; raised CSF:peripheral blood mononuclear cell HTLV-1 proviral load ratio; and MRI either normal or showing white matter changes in brain and cord. Four of the six previous case reports of encephalopathy in HTLV-infected patients also had HAM. Histopathology, reported in three, showed perivascular predominantly CD8+ lymphocytic infiltrates in the brain. One had cerebral demyelination, and all had cord demyelination. We have reviewed the existing six cases in the literature, together with our three new cases. In all seven with HAM, the spastic paraparesis deteriorated sub-acutely preceding encephalitis. Eight of the nine were female, and four of the seven treated with steroids improved. We propose that HTLV-associated encephalopathy may be part of the spectrum of HTLV-1-induced central nervous system disease

Cross modal perception of body size in domestic dogs (Canis familiaris)

While the perception of size-related acoustic variation in animal vocalisations is well documented, little attention has been given to how this information might be integrated with corresponding visual information. Using a cross-modal design, we tested the ability of domestic dogs to match growls resynthesised to be typical of either a large or a small dog to size- matched models. Subjects looked at the size-matched model significantly more often and for a significantly longer duration than at the incorrect model, showing that they have the ability to relate information about body size from the acoustic domain to the appropriate visual category. Our study suggests that the perceptual and cognitive mechanisms at the basis of size assessment in mammals have a multisensory nature, and calls for further investigations of the multimodal processing of size information across animal species

Weather, climate and the nature of predictability

The prediction and simulation of future weather and climate is a key ingredient in good weather risk management. This chapter briefly reviews the nature and underlying sources of predictability on timescales from hours-ahead to centuries-ahead. The traditional distinction between ‘weather’ and ‘climate’ predictions is described, and the role of recent scientific developments in driving a convergence of these two classic problems is highlighted. The chapter concludes by outlining and comparing the two main strategies used for creating weather and climate predictions, and discussing the challenges of using predictions in quantitative applications

Appearances of screen-detected versus symptomatic colorectal cancers at CT colonography.

OBJECTIVES: The aim of this study was to compare the morphology, radiological stage, conspicuity, and computer-assisted detection (CAD) characteristics of colorectal cancers (CRC) detected by computed tomographic colonography (CTC) in screening and symptomatic populations. METHODS: Two radiologists independently analyzed CTC images from 133 patients diagnosed with CRC in (a) two randomized trials of symptomatic patients (35 patients with 36 tumours) and (b) a screening program using fecal occult blood testing (FOBt; 98 patients with 100 tumours), measuring tumour length, volume, morphology, radiological stage, and subjective conspicuity. A commercial CAD package was applied to both datasets. We compared CTC characteristics between screening and symptomatic populations with multivariable regression. RESULTS: Screen-detected CRC were significantly smaller (mean 3.0 vs 4.3 cm, p < 0.001), of lower volume (median 9.1 vs 23.2 cm(3), p < 0.001) and more frequently polypoid (34/100, 34 % vs. 5/36, 13.9 %, p = 0.02) than symptomatic CRC. They were of earlier stage than symptomatic tumours (OR = 0.17, 95 %CI 0.07-0.41, p < 0.001), and were judged as significantly less conspicuous (mean conspicuity 54.1/100 vs. 72.8/100, p < 0.001). CAD detection was significantly lower for screen-detected (77.4 %; 95 %CI 67.9-84.7 %) than symptomatic CRC (96.9 %; 95 %CI 83.8-99.4 %, p = 0.02). CONCLUSIONS: Screen-detected CRC are significantly smaller, more frequently polypoid, subjectively less conspicuous, and less likely to be identified by CAD than those in symptomatic patients. KEY POINTS: • Screen-detected colorectal cancers (CRC) are significantly smaller than symptomatic CRC. • Screening cases are significantly less conspicuous to radiologists than symptomatic tumours. • Screen-detected CRC have different morphology compared to symptomatic tumours (more polypoid, fewer annular). • A commercial computer-aided detection (CAD) system was significantly less likely to note screen-detected CRC

Effect of faecal occult blood positivity on detection rates and positive predictive value of CT colonography when screening for colorectal neoplasia

To determine the detection rates and positive predictive value (PPV) of computed tomography (CT) colonography (CTC) according to the magnitude of faecal occult blood test (FOBt) positivity