Stimulus Complexity and Categorical Effects in Human Auditory Cortex: An Activation Likelihood Estimation Meta-Analysis

Investigations of the functional organization of human auditory cortex typically examine responses to different sound categories. An alternative approach is to characterize sounds with respect to their amount of variation in the time and frequency domains (i.e., spectral and temporal complexity). Although the vast majority of published studies examine contrasts between discrete sound categories, an alternative complexity-based taxonomy can be evaluated through meta-analysis. In a quantitative meta-analysis of 58 auditory neuroimaging studies, we examined the evidence supporting current models of functional specialization for auditory processing using grouping criteria based on either categories or spectro-temporal complexity. Consistent with current models, analyses based on typical sound categories revealed hierarchical auditory organization and left-lateralized responses to speech sounds, with high speech sensitivity in the left anterior superior temporal cortex. Classification of contrasts based on spectro-temporal complexity, on the other hand, revealed a striking within-hemisphere dissociation in which caudo-lateral temporal regions in auditory cortex showed greater sensitivity to spectral changes, while anterior superior temporal cortical areas were more sensitive to temporal variation, consistent with recent findings in animal models. The meta-analysis thus suggests that spectro-temporal acoustic complexity represents a useful alternative taxonomy to investigate the functional organization of human auditory cortex

An fMRI study of unconditioned responses in post-traumatic stress disorder

Background: Both fear and pain processing are altered in post-traumatic stress disorder (PTSD), as evidenced by functional neuroimaging studies showing increased amygdala responses to threats, and increased insula, putamen and caudate activity in response to heat pain. Using psychophysiology and functional magnetic resonance imaging, we studied conditioned and unconditioned autonomic and neuronal responses in subjects with PTSD versus trauma-exposed non-PTSD control (TENC) subjects. A design using an electric shock selected by subjects to be 'highly annoying but not painful' as an unconditioned stimulus (US) with partially reinforced cues allowed us to partly disentangle the expectancy- and prediction-error components from sensory components of the unconditioned response. Results: Whereas responses to the conditioned stimulus (CS) were similar in PTSD and TENC, the former displayed higher putamen, insula, caudate and amygdala responses to the US. Reactivity to the US in the anterior insula correlated with PTSD symptom severity. Functional connectivity analyses using the putamen as a seed region indicated that TENC subjects had increased amygdala-putamen connectivity during US delivery; this connection was disengaged in PTSD. Conclusions: Our results indicate that although neural processing of fear learning in people with PTSD seems to be comparable with controls, neural responses to unconditioned aversive stimuli in PTSD seem to be increased

An fMRI study of unconditioned responses in post-traumatic stress disorder

BACKGROUND: Both fear and pain processing are altered in post-traumatic stress disorder (PTSD), as evidenced by functional neuroimaging studies showing increased amygdala responses to threats, and increased insula, putamen and caudate activity in response to heat pain. Using psychophysiology and functional magnetic resonance imaging, we studied conditioned and unconditioned autonomic and neuronal responses in subjects with PTSD versus trauma-exposed non-PTSD control (TENC) subjects. A design using an electric shock selected by subjects to be 'highly annoying but not painful' as an unconditioned stimulus (US) with partially reinforced cues allowed us to partly disentangle the expectancy- and prediction-error components from sensory components of the unconditioned response. RESULTS: Whereas responses to the conditioned stimulus (CS) were similar in PTSD and TENC, the former displayed higher putamen, insula, caudate and amygdala responses to the US. Reactivity to the US in the anterior insula correlated with PTSD symptom severity. Functional connectivity analyses using the putamen as a seed region indicated that TENC subjects had increased amygdala-putamen connectivity during US delivery; this connection was disengaged in PTSD. CONCLUSIONS: Our results indicate that although neural processing of fear learning in people with PTSD seems to be comparable with controls, neural responses to unconditioned aversive stimuli in PTSD seem to be increased

Standardized Nursing Diagnoses in a Surgical Hospital Setting: A Retrospective Study Based on Electronic Health Data

Introduction: In electronic health records (EHRs), standardized nursing terminologies (SNTs), such as nursing diagnoses (NDs), are needed to demonstrate the impact of nursing care on patient outcomes. Unfortunately, the use of NDs is not common in clinical practice, especially in surgical settings, and is rarely included in EHRs. Objective(s): The aim of the study was to describe the prevalence and trend of NDs in a hospital surgical setting by also analyzing the relationship between NDs and hospital outcomes. Methods: A retrospective study was conducted. All adult inpatients consecutively admitted to one of the 15 surgical inpatient units of an Italian university hospital across 1 year were included. Data, including the Professional Assessment Instrument and the Hospital Discharge Register, were collected retrospectively from the hospital's EHRs. Results: The sample included 5,027 surgical inpatients. There was a mean of 6.3 ± 4.3 NDs per patient. The average distribution of NDs showed a stable trend throughout the year. The most representative NANDA-I ND domain was safety/protection. The total number of NDs on admission was significantly higher for patient whose length of stay was longer. A statistically significant correlation was observed between the number of NDs on admission and the number of intra-hospital patient transfers. Additionally, the mean number of NDs on admission was higher for patients who were later transferred to an intensive care unit compared to those who were not transferred. Conclusion: NDs represent the key to understanding the contribution of nurses in the surgical setting. NDs collected upon admission can represent a prognostic factor related to the hospital's key outcomes

Why is Clinical fMRI in a Resting State?

While resting state fMRI (rs-fMRI) has gained widespread application in neuroimaging clinical research, its penetration into clinical medicine has been more limited. We surveyed a neuroradiology professional group to ascertain their experience with rs-fMRI, identify perceived barriers to using rs-fMRI clinically and elicit suggestions about ways to facilitate its use in clinical practice. The electronic survey also collected information about demographics and work environment using Likert scales. We found that 90% of the respondents had adequate equipment to conduct rs-fMRI and 82% found rs-fMRI data easy to collect. Fifty-nine percent have used rs-fMRI in their past research and 72% reported plans to use rs-fMRI for research in the next year. Nevertheless, only 40% plan to use rs-fMRI in clinical practice in the next year and 82% agreed that their clinical fMRI use is largely confined to pre-surgical planning applications. To explore the reasons for the persistent low utilization of rs-fMRI in clinical applications, we identified barriers to clinical rs-fMRI use related to the availability of robust denoising procedures, single-subject analysis techniques, demonstration of functional connectivity map reliability, regulatory clearance, reimbursement, and neuroradiologist training opportunities. In conclusion, while rs-fMRI use in clinical neuroradiology practice is limited, enthusiasm appears to be quite high and there are several possible avenues in which further research and development may facilitate its penetration into clinical practice

Electron Spin Resonance dosimetry using organic compounds (alanine and ammonium tartrate) for mixed neutron-gamma fields

Alongside with the development of Neutron Capture Therapy (NCT) and the use of thermal neutrons for radiotherapeutic purposes, many efforts have been devoted to the characterization of the beam in order to optimize therapy procedures. Reliable dose measurements should be able to determine the various (neutrons and photonic) components of the mixed beam usually employed for therapy. This paper studies the effect of additives such as boric and gadolinium nuclei on the sensitivity of neutron organic (alanine and ammonium tartrate) dosimeters analyzed through Electron Spin Resonance (ESR) technique (Marrale, 2014). These dosimeters were exposed to a mixed (neutron-gamma) field mainly composed of thermal neutrons. The choice of 10B and 64Gd as nuclei additives is due to their very high capture cross section for thermal neutrons. Also, after the nuclear reaction with thermal neutrons are emitted particles, which in turn release their energy in the vicinity of the reaction site (Marrale, 2008). The irradiation with mixed field (neutron-gamma) were performed within the thermal column of the TRIGA reactor, University of Pavia. Dosimeters readout was performed through the Electron Spin Resonance spectrometer Bruker ECS106 located at the Laboratory of Dosimetry ESR / TL of the Department of Physics and Chemistry - University of Palermo. We found that the addition of Gadolinium allows to largely increase the sensitivity of the dosimeters for thermal neutrons. In particular, a low concentration (5% by weight) of gadolinium oxide leads to an improvement of the sensitivity of neutrons more than 10 times. In addition, for this low content of gadolinium the photon tissue equivalence is not heavily reduced. This experimental analyses are compared with computational analyses carried out by means of Monte Carlo simulations performed with the MCNP (Monte Carlo N-Particle) transport code. A good agreement was observed for alanine dosimeters

Dosimetry to Electron Spin Resonance (ESR) using organic compounds (alanine and ammonium tartrate) for mixed neutron-gamma fields

Alongside with the development of Neutron Capture Therapy (NCT) and the use of thermal neutrons for radiotherapeutic purposes, many efforts have been devoted to the characterization of the beam in order to optimize therapy procedures. Reliable dose measurements should be able to determine the various (neutrons and photonic) components of the mixed beam usually employed for therapy. This paper studies the effect of additives such as Boric and Gadolinium nuclei on the sensitivity of neutron organic (alanine and ammonium tartrate) dosimeters analyzed through Electron Spin Resonance (ESR) technique. These dosimeters were exposed to a mixed (neutron-gamma) field mainly composed of thermal neutrons. The choice of 10B and 64Gd as nuclei additives is due to their very high capture cross section for thermal neutrons. Also, after the nuclear reaction with thermal neutrons are emitted particles, which in turn release their energy in the vicinity of the reaction site. The irradiation with mixed (neutron-gamma) field were performed within the thermal column of the TRIGA reactor, University of Pavia. Dosimeters readout was performed through the Electron Spin Resonance (ESR) spectrometer Bruker ECS106 located at the Laboratory of Dosimetry ESR / TL of the Department of Physics and Chemistry - University of Palermo. We found that the addition of Gadolinium allows to largely increase the sensitivity of the dosimeters for thermal neutrons. In particular, a low concentration (5% by weight) of gadolinium oxide leads to an improvement of the sensitivity of neutrons more than 10 times. In addition, for this low content of gadolinium the photon tissue equivalence is not heavily reduced. This experimental analyses are compared with computational analyses carried out by means of Monte Carlo simulations performed with the MCNP (Monte Carlo N-Particle) transport code. A good agreement was observed for alanine dosimeters

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection