Detection superiority of 7 T MRI protocol in patients with epilepsy and suspected focal cortical dysplasia

In 11 adult patients with suspicion of Focal cortical dysplasia (FCD) on 1.5 T (n = 1) or 3 T (n = 10) magnetic resonance imaging (MRI), 7 T MRI was performed. Visibility, extent, morphological features and delineation were independently rated and subsequently discussed by three observers. Additionally, head-to-head comparisons with corresponding 3 T images were made in the eight patients with a previous 3 T MRI and sustained suspicion of FCD. Comparison with histopathology was done in the five patients that underwent surgery. All lesions, seen at 1.5 and 3 T, were also recognized on 7 T. At 7 T FLAIR highlighted the FCD-like lesions best, whereas T2 and T2* were deemed better suited to review structure and extent of the lesion. Image quality with the used 7 T MRI setup was higher than the quality with the used 3 T MRI setup. In 2 out of 11 patients diagnosis changed, in one after re-evaluation of the images, and in the other based on histopathology. With the used 7 T MRI setup, FCD-like lesions can be detected with more confidence and detail as compared to lower field strength. However, concordance between radiologic diagnosis and final diagnosis seems to be lower than expected

Natural Language Processing Methods to Identify Oncology Patients at High Risk for Acute Care with Clinical Notes

Clinical notes are an essential component of a health record. This paper evaluates how natural language processing (NLP) can be used to identify the risk of acute care use (ACU) in oncology patients, once chemotherapy starts. Risk prediction using structured health data (SHD) is now standard, but predictions using free-text formats are complex. This paper explores the use of free-text notes for the prediction of ACU instead of SHD. Deep Learning models were compared to manually engineered language features. Results show that SHD models minimally outperform NLP models; an l1-penalised logistic regression with SHD achieved a C-statistic of 0.748 (95%-CI: 0.735, 0.762), while the same model with language features achieved 0.730 (95%-CI: 0.717, 0.745) and a transformer-based model achieved 0.702 (95%-CI: 0.688, 0.717). This paper shows how language models can be used in clinical applications and underlines how risk bias is different for diverse patient groups, even using only free-text data.Comment: 11 pages, 6 figures, 2 table

Lack of effect of pravastatin on cerebral blood flow or parenchymal volume loss in elderly at risk for vascular disease

<p><b>Background and Purpose:</b> Ageing is associated with a decline in cerebral blood flow. Animal studies have shown that cholesterol-lowering therapy with statins might preserve cerebral blood flow (CBF). We examined the effect of 40 mg pravastatin on the decline in CBF and brain volume in a subset of elderly subjects participating in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) trial.</p> <p><b>Methods:</b> Randomization was not stratified according to whether or not subjects participated in the MRI substudy. In 391 men (n=226) and women (n=165) aged 70 to 82 years (mean±SD, 75±3.2), we measured total CBF (in mL/min) at baseline and after a mean±SD follow-up of 33±1.4 months with a gradient-echo phase-contrast MRI technique. Total CBF was defined as the summed flows in both internal carotid and vertebral arteries. Parenchymal volume (whole brain) was segmented with the use of in-house–developed semiautomatic software.</p> <p><b>Results:</b> Total CBF significantly declined in the placebo-allocated group, from 521±83 to 504±92 mL/min (P=0.0036) and in the pravastatin-allocated group from 520±94 to 506±92 mL/min (P=0.018). This decline was not significantly different between treatment groups (P=0.56). There was also a significant reduction in brain volume over time (P<0.001), which was not different between the treatment groups (P=0.47). When expressed per unit of parenchymal volume, the decline in CBF over time was no longer statistically significant.</p> <p><b>Conclusions:</b> Elderly people at risk for cerebral vascular disease had a significant decline in CBF with increasing age that was explained by a concomitant reduction in brain volume. Treatment with 40 mg pravastatin daily had no beneficial effect on total CBF.</p&gt

Kleinverpakking van asperges

De invloed van drie kleinverpakkingsmogelijkheden zoals open verpakking, mouwverpakking (aantwee zijden open) en gesloten wikkelverpakking met PVC-rekfolie werd onderzocht in relatie tot de kwaliteit van asperges. De opzet en resultaten van dit onderzoek zijn weergegeve

Binary and nonbinary description of hypointensity for search and retrieval of brain MR images

Diagnosis accuracy in the medical field, is mainly affected by either lack of sufficient understanding of some diseases or the inter/intra-observer variability of the diagnoses. We believe that mining of large medical databases can help improve the current status of disease understanding and decision making. In a previous study based on binary description of hypointensity in the brain, it was shown that brain iron accumulation shape provides additional information to the shape-insensitive features, such as the total brain iron load, that are commonly used in clinics. This paper proposes a novel, nonbinary description of hypointensity in the brain based on principal component analysis. We compare the complementary and redundant information provided by the two descriptions using Kendall's rank correlation coefficient in order to better understand the individual descriptions of iron accumulation in the brain and obtain a more robust and accurate search and retrieval system