High Dimensional Classification of Structural MRI Alzheimer’s Disease Data Based on Large Scale Regularization

In this work we use a large scale regularization approach based on penalized logistic regression to automatically classify structural MRI images (sMRI) according to cognitive status. Its performance is illustrated using sMRI data from the Alzheimer Disease Neuroimaging Initiative (ADNI) clinical database. We downloaded sMRI data from 98 subjects (49 cognitive normal and 49 patients) matched by age and sex from the ADNI website. Images were segmented and normalized using SPM8 and ANTS software packages. Classification was performed using GLMNET library implementation of penalized logistic regression based on coordinate-wise descent optimization techniques. To avoid optimistic estimates classification accuracy, sensitivity, and specificity were determined based on a combination of three-way split of the data with nested 10-fold cross-validations. One of the main features of this approach is that classification is performed based on large scale regularization. The methodology presented here was highly accurate, sensitive, and specific when automatically classifying sMRI images of cognitive normal subjects and Alzheimer disease (AD) patients. Higher levels of accuracy, sensitivity, and specificity were achieved for gray matter (GM) volume maps (85.7, 82.9, and 90%, respectively) compared to white matter volume maps (81.1, 80.6, and 82.5%, respectively). We found that GM and white matter tissues carry useful information for discriminating patients from cognitive normal subjects using sMRI brain data. Although we have demonstrated the efficacy of this voxel-wise classification method in discriminating cognitive normal subjects from AD patients, in principle it could be applied to any clinical population

Head-Neck Dual-energy CT Contrast Media Reduction Using Diffusion Models

Iodinated contrast media is essential for dual-energy computed tomography (DECT) angiography. Previous studies show that iodinated contrast media may cause side effects, and the interruption of the supply chain in 2022 led to a severe contrast media shortage in the US. Both factors justify the necessity of contrast media reduction in relevant clinical applications. In this study, we propose a diffusion model-based deep learning framework to address this challenge. First, we simulate different levels of low contrast dosage DECT scans from the standard normal contrast dosage DECT scans using material decomposition. Conditional denoising diffusion probabilistic models are then trained to enhance the contrast media and create contrast-enhanced images. Our results demonstrate that the proposed methods can generate high-quality contrast-enhanced results even for images obtained with as low as 12.5% of the normal contrast dosage. Furthermore, our method outperforms selected competing methods in a human reader study

Translating Radiology Reports into Plain Language using ChatGPT and GPT-4 with Prompt Learning: Promising Results, Limitations, and Potential

The large language model called ChatGPT has drawn extensively attention because of its human-like expression and reasoning abilities. In this study, we investigate the feasibility of using ChatGPT in experiments on using ChatGPT to translate radiology reports into plain language for patients and healthcare providers so that they are educated for improved healthcare. Radiology reports from 62 low-dose chest CT lung cancer screening scans and 76 brain MRI metastases screening scans were collected in the first half of February for this study. According to the evaluation by radiologists, ChatGPT can successfully translate radiology reports into plain language with an average score of 4.27 in the five-point system with 0.08 places of information missing and 0.07 places of misinformation. In terms of the suggestions provided by ChatGPT, they are general relevant such as keeping following-up with doctors and closely monitoring any symptoms, and for about 37% of 138 cases in total ChatGPT offers specific suggestions based on findings in the report. ChatGPT also presents some randomness in its responses with occasionally over-simplified or neglected information, which can be mitigated using a more detailed prompt. Furthermore, ChatGPT results are compared with a newly released large model GPT-4, showing that GPT-4 can significantly improve the quality of translated reports. Our results show that it is feasible to utilize large language models in clinical education, and further efforts are needed to address limitations and maximize their potential

An evolutionary gap in primate default mode network organization

The human default mode network (DMN) is engaged at rest and in cognitive states such as self-directed thoughts. Interconnected homologous cortical areas in primates constitute a network considered as the equivalent. Here, based on a cross-species comparison of the DMN between humans and non-hominoid primates (macaques, marmosets, and mouse lemurs), we report major dissimilarities in connectivity profiles. Most importantly, the medial prefrontal cortex (mPFC) of non-hominoid primates is poorly engaged with the posterior cingulate cortex (PCC), though strong correlated activity between the human PCC and the mPFC is a key feature of the human DMN. Instead, a fronto-temporal resting-state network involving the mPFC was detected consistently across non-hominoid primate species. These common functional features shared between non-hominoid primates but not with humans suggest a substantial gap in the organization of the primate\u27s DMN and its associated cognitive functions

Head Impact Exposure in Youth Football: Elementary School Ages 9–12 Years and the Effect of Practice Structure

Head impact exposure in youth football has not been well-documented, despite children under the age of 14 accounting for 70% of all football players in the United States. The objective of this study was to quantify the head impact exposure of youth football players, age 9–12, for all practices and games over the course of single season. A total of 50 players (age = 11.0 ± 1.1 years) on three teams were equipped with helmet mounted accelerometer arrays, which monitored each impact players sustained during practices and games. During the season, 11,978 impacts were recorded for this age group. Players averaged 240 ± 147 impacts for the season with linear and rotational 95th percentile magnitudes of 43 ± 7 g and 2034 ± 361 rad/s(2). Overall, practice and game sessions involved similar impact frequencies and magnitudes. One of the three teams however, had substantially fewer impacts per practice and lower 95th percentile magnitudes in practices due to a concerted effort to limit contact in practices. The same team also participated in fewer practices, further reducing the number of impacts each player experienced in practice. Head impact exposures in games showed no statistical difference. While the acceleration magnitudes among 9–12 year old players tended to be lower than those reported for older players, some recorded high magnitude impacts were similar to those seen at the high school and college level. Head impact exposure in youth football may be appreciably reduced by limiting contact in practices. Further research is required to assess whether such a reduction in head impact exposure will result in a reduction in concussion incidence

Rapid-onset dystonia-parkinsonism associated with the I758S mutation of the ATP1A3 gene: a neuropathologic and neuroanatomical study of four siblings

Rapid-onset dystonia-parkinsonism (RDP) is a movement disorder associated with mutations in the ATP1A3 gene. Signs and symptoms of RDP commonly occur in adolescence or early adulthood and can be triggered by physical or psychological stress. Mutations in ATP1A3 are also associated with alternating hemiplegia of childhood (AHC). The neuropathologic substrate of these conditions is unknown. The central nervous system of four siblings, three affected by RDP and one asymptomatic, all carrying the I758S mutation in the ATP1A3 gene, was analyzed. This neuropathologic study is the first carried out in ATP1A3 mutation carriers, whether affected by RDP or AHC. Symptoms began in the third decade of life for two subjects and in the fifth for another. The present investigation aimed at identifying, in mutation carriers, anatomical areas potentially affected and contributing to RDP pathogenesis. Comorbid conditions, including cerebrovascular disease and Alzheimer disease, were evident in all subjects. We evaluated areas that may be relevant to RDP separately from those affected by the comorbid conditions. Anatomical areas identified as potential targets of I758S mutation were globus pallidus, subthalamic nucleus, red nucleus, inferior olivary nucleus, cerebellar Purkinje and granule cell layers, and dentate nucleus. Involvement of subcortical white matter tracts was also evident. Furthermore, in the spinal cord, a loss of dorsal column fibers was noted. This study has identified RDP-associated pathology in neuronal populations, which are part of complex motor and sensory loops. Their involvement would cause an interruption of cerebral and cerebellar connections which are essential for maintenance of motor control. Electronic supplementary material The online version of this article (doi:10.1007/s00401-014-1279-x) contains supplementary material, which is available to authorized users

Multi-Omics Analysis of Brain Metastasis Outcomes Following Craniotomy

Background: The incidence of brain metastasis continues to increase as therapeutic strategies have improved for a number of solid tumors. The presence of brain metastasis is associated with worse prognosis but it is unclear if distinctive biomarkers can separate patients at risk for CNS related death. Methods: We executed a single institution retrospective collection of brain metastasis from patients who were diagnosed with lung, breast, and other primary tumors. The brain metastatic samples were sent for RNA sequencing, proteomic and metabolomic analysis of brain metastasis. The primary outcome was distant brain failure after definitive therapies that included craniotomy resection and radiation to surgical bed. Novel prognostic subtypes were discovered using transcriptomic data and sparse non-negative matrix factorization. Results: We discovered two molecular subtypes showing statistically significant differential prognosis irrespective of tumor subtype. The median survival time of the good and the poor prognostic subtypes were 7.89 and 42.27 months, respectively. Further integrated characterization and analysis of these two distinctive prognostic subtypes using transcriptomic, proteomic, and metabolomic molecular profiles of patients identified key pathways and metabolites. The analysis suggested that immune microenvironment landscape as well as proliferation and migration signaling pathways may be responsible to the observed survival difference. Conclusion: A multi-omics approach to characterization of brain metastasis provides an opportunity to identify clinically impactful biomarkers and associated prognostic subtypes and generate provocative integrative understanding of disease

Parton distributions for the LHC run II

We present NNPDF3.0, the first set of parton distribution functions (PDFs) determined with a methodology validated by a closure test. NNPDF3.0 uses a global dataset including HERA-II deep-inelastic inclusive cross-sections, the combined HERA charm data, jet production from ATLAS and CMS, vector boson rapidity and transverse momentum distributions from ATLAS, CMS and LHCb, W+c data from CMS and top quark pair production total cross sections from ATLAS and CMS. Results are based on LO, NLO and NNLO QCD theory and also include electroweak corrections. To validate our methodology, we show that PDFs determined from pseudo-data generated from a known underlying law correctly reproduce the statistical distributions expected on the basis of the assumed experimental uncertainties. This closure test ensures that our methodological uncertainties are negligible in comparison to the generic theoretical and experimental uncertainties of PDF determination. This enables us to determine with confidence PDFs at different perturbative orders and using a variety of experimental datasets ranging from HERA-only up to a global set including the latest LHC results, all using precisely the same validated methodology. We explore some of the phenomenological implications of our results for the upcoming 13 TeV Run of the LHC, in particular for Higgs production cross-sections.Comment: 151 pages, 69 figures. More typos corrected: published versio

SoftDropConnect (SDC) -- Effective and Efficient Quantification of the Network Uncertainty in Deep MR Image Analysis

Recently, deep learning has achieved remarkable successes in medical image analysis. Although deep neural networks generate clinically important predictions, they have inherent uncertainty. Such uncertainty is a major barrier to report these predictions with confidence. In this paper, we propose a novel yet simple Bayesian inference approach called SoftDropConnect (SDC) to quantify the network uncertainty in medical imaging tasks with gliomas segmentation and metastases classification as initial examples. Our key idea is that during training and testing SDC modulates network parameters continuously so as to allow affected information processing channels still in operation, instead of disabling them as Dropout or DropConnet does. When compared with three popular Bayesian inference methods including Bayes By Backprop, Dropout, and DropConnect, our SDC method (SDC-W after optimization) outperforms the three competing methods with a substantial margin. Quantitatively, our proposed method generates substantial improvements in prediction accuracy (by 3.4%, 2.5%, and 6.7% respectively for whole tumor segmentation in terms of dice score; and by 11.7%, 3.9%, and 8.7% respectively for brain metastases classification) and greatly reduced epistemic and aleatoric uncertainties. Our approach promises to deliver better diagnostic performance and make medical AI imaging more explainable and trustworthy