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Molecular neuroimaging techniques, like PET and SPECT, offer invaluable insights into the brain's in-vivo biology and its dysfunction in neuropsychiatric patients. However, the transition of molecular neuroimaging into diagnostics and precision medicine has been limited to a few clinical applications, hindered by issues like practical feasibility, high costs, and high between-subject heterogeneity of neuroimaging measures. In this study, we explore the use of normative modelling (NM) to identify individual patient alterations by describing the physiological variability of molecular functions. NM potentially addresses challenges such as small sample sizes and diverse acquisition protocols typical of molecular neuroimaging studies. We applied NM to two PET radiotracers targeting the dopaminergic system ([ 11 C]-(+)-PHNO and [ 18 F]FDOPA) to create a reference-cohort model of healthy controls. The models were subsequently utilized on different independent cohorts of patients with psychosis in different disease stages and treatment outcomes. Our results showed that patients with psychosis exhibited a higher degree of extreme deviations (~3-fold increase) than controls, although this pattern was heterogeneous, with minimal overlap of extreme deviations topology (max 20%). We also confirmed that striatal [ 18 F]FDOPA signal, when referenced to a normative distribution, can predict treatment response (striatal AUC ROC: 0.77-0.83). In conclusion, our results indicate that normative modelling can be effectively applied to molecular neuroimaging after proper harmonization, enabling insights into disease mechanisms and advancing precision medicine. In addition, the method is valuable in understanding the heterogeneity of patient populations and can contribute to maximising cost efficiency in studies aimed at comparing cases and controls., Competing Interests: Competing interests: M.d.G. is an employee of GSK, GSK had no role in the design of this study. R.A.M. has received speaker/consultancy fees from Karuna, Janssen, Boehringer Ingelheim, and Otsuka, and co-directs a company that designs digital resources to support treatment of mental illness. F.B. has received consulting fees from Petalouda Therapeutics and has been an employee at Compass Pathways. AE has received consulting fees from Leal Therapeutics. O.H. and M.V. hold a patent application for the use of dopamine imaging as a prognostic tool in mental health (WO2021111116). The other authors do not report any conflict of interest in relation to this article. Ethics: All the research protocols for data acquisitions were approved by local ethics committees and local institutional revision boards. Full details on approval protocol numbers are reported on original references [7, 13, 14, 40–48]. Informed written consent was obtained for all the participants and the studies were conducted following the Declaration of Helsinki and Good Clinical Practice., (© 2025. Crown.)

White matter hyperintensities (WMH) increase with age, with marked interindividual variation. There is a need for normative data by age and sex, to improve individualized WMH burden assessment. In this study, we pooled cross-sectional data from 15 population-based cohorts (14,876 nondemented individuals, age 18-97 years), through the Meta VCI Map consortium. Whole brain and tract-specific MRI-assessed WMH volumes were calculated in MNI-152 space. We used quantile regression to create centile curves of WMH volume versus age, stratified by sex. Total WMH volume and interindividual variance increased exponentially with age for both sexes, with females showing higher WMH volumes. WMH volume increase with aging was not uniform across the white matter, but instead followed one of three different patterns depending on location. Age- and sex-specific normative data for total and regional WMH volumes were created. Our study provides detailed information on the normal distribution of total and regional WMH volumes across adulthood. The normative data enable a quantitative approach to interpreting total and regional WMH volumes in clinical practice and research settings., Competing Interests: Disclosure Statement PSS has served on the Advisory Committees of Biogen Australia and Roche Australia in 2020–2022. NC serves on DSMBs for AstraZeneca. All other authors report no declarations of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background Context: Survival prediction models for patients with spinal metastases may inform patients and clinicians in shared decision-making., Purpose: To externally validate all existing survival prediction models for patients with spinal metastases., Design: Prospective cohort study using retrospective data., Patient Sample: 953 patients., Outcome Measures: Survival in months, area under the curve (AUC), and calibration intercept and slope., Method: This study included patients with spinal metastases referred to a single tertiary referral center between 2016 and 2021. Twelve models for predicting 3, 6, and 12-month survival were externally validated Bollen, Mizumoto, Modified Bauer, New England Spinal Metastasis Score, Original Bauer, Oswestry Spinal Risk Index (OSRI), PathFx, Revised Katagiri, Revised Tokuhashi, Skeletal Oncology Research Group Machine Learning Algorithm (SORG-MLA), Tomita, and Van der Linden. Discrimination was assessed using (AUC) and calibration using the intercept and slope. Calibration was considered appropriate if calibration measures were close to their ideal values with narrow confidence intervals., Results: In total, 953 patients were included. Survival was 76.4% at 3 months (728/953), 62.2% at 6 months (593/953), and 50.3% at 12 months (479/953). Revised Katagiri yielded AUCs of 0.79 (95% CI, 0.76-0.82) to 0.81 (95% CI, 0.79-0.84), Bollen yielded AUCs of 0.76 (95% CI, 0.73-0.80) to 0.77 (95% CI, 0.75-0.80), and OSRI yielded AUCs of 0.75 (95% CI, 0.72-0.78) to 0.77 (95% CI, 0.74-0.79). The other 9 prediction models yielded AUCs ranging from 0.59 (95% CI, 0.55-0.63) to 0.76 (95% CI, 0.74-0.79). None of the twelve models yielded appropriate calibration., Conclusions: Twelve survival prediction models for patients with spinal metastases yielded poor to fair discrimination and poor calibration. Survival prediction models may inform decision-making in patients with spinal metastases, provided that recalibration using recent patient data is performed., Competing Interests: Declaration of competing interest JJV is cofounder and stock-owner of SentryX, HMV receives funding from Elektra. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.)

State apologies for human rights violations are often seen as a key mechanism in reconciliation processes. Nevertheless, they are often contested as well and have not been embraced equally by countries around the world. This raises questions about their universal value and potential to address or redress past harmdoing by countries. In a study across 33 countries (n = 11,023), we found that people around the world consider apologies by states for human rights violations to be reasonably important but tend to be less supportive of the idea that their own country should apologize for past harmdoing. We found that this discrepancy was amplified in countries with stronger honour norms and a stronger collective sense of victim- rather than perpetratorhood. Moving beyond the decontextualized approach that has prevailed in previous psychological research on this topic, our findings show that people's attitudes towards apologies by their country do not exist in a cultural and social vacuum but depend on the extent to which the broader context affords a critical reflection on past harmdoing. As such, they help explain why some countries have been reluctant to offer apologies, and why such gestures may also be more controversial in some contexts than in others., (© 2024 British Psychological Society.)

Biological invasions are a major threat to biodiversity, ecosystem functioning and nature's contributions to people worldwide. However, the effectiveness of invasive alien species (IAS) management measures and the progress toward achieving biodiversity targets remain uncertain due to limited and nonuniform data availability. Management success is usually assessed at a local level and documented in technical reports, often written in languages other than English, which makes such data notoriously difficult to collect at large geographic scales. Here we present the first European assessment of how managers perceive trends in IAS and the effectiveness of management measures to mitigate biological invasions. We developed a structured questionnaire translated into 18 languages and disseminated it to local and regional managers of IAS in Europe. We received responses from 1928 participants from 41 European countries, including 24 European Union (EU) Member States. Our results reveal substantial efforts in IAS monitoring and control, with invasive plants being the primary focus. Yet, there is a general perception of an increase in the numbers, occupied areas, and impacts of IAS across environment and taxonomic groups, particularly plants, over time. This perceived increase is consistent across both EU and non-EU countries, with respondents from EU countries demonstrating more certainty in their responses. Our results also indicate a lack of data on alien vertebrates and invertebrates, reflecting a need for more targeted monitoring and knowledge sharing between managers and policymakers and between countries. Overall, our study suggests that Europe's current strategies are insufficient to substantially reduce IAS by 2030 and hence to meet the Kunming-Montreal Global Biodiversity Framework target., (© 2025 The Author(s). Global Change Biology published by John Wiley & Sons Ltd.)

Brain white matter disruptions have been implicated in contributing to fatigue, brain fog and other central symptoms commonly reported in inflammatory diseases. In this study, we included 252 RA patients with 756 age and sex matched controls and 240 UC patients with 720 age and sex matched controls using the UK Biobank imaging dataset. We looked for differences in total volume of white matter hyperintensities (WMH) between patients compared to controls. Then, using voxelwise analysis, we explored the spatial distribution of these white matter hyperintensities and differences in these between patients and controls and between disease groups. A significantly higher volume of WMH was observed in both the RA (p = 1.9 × 10 -8 , β =  - 0.36, 95% CI =  - 0.48, - 0.23) and UC (p = 0.003, β =  - 0.18 95% CI =  - 0.31, - 0.06) patients compared to their respective control groups. Voxelwise analysis revealed only a small cluster of RA associated WMH compared to controls. These results indicate an increased risk of white matter hyperintensities in patients with RA and UC. These findings help quantify the effect of inflammation from autoimmune diseases on cerebrovascular health and white matter integrity., Competing Interests: Declarations. Competing interests: Jennifer Cox is an industry funded PhD student funded by GlaxoSmithKline and an employee of Johnson & Johnson. GSK and Johnson & Johnson had no role in the design or conduct of the study. Dr. de Groot is a former employee of, and holds shares in GlaxoSmithKline (GSK). GSK had no role in the design or conduct of the study. Dr. Kempton was funded by an MRC Career Development Fellowship (grant MR/J008915/1). Dr. Williams has received research funding from Bionomics, Eli Lilly, the Engineering and Physical Sciences Research Council, GlaxoSmithKline, Johnson & Johnson, Lundbeck, the National Institute of Health Research, Pfizer, Takeda, and Wellcome Trust. The authors acknowledge financial support from the Wellcome Trust and the Engineering and Physical Sciences Research Council for the King’s Medical Engineering Centre and the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed here are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. The other authors report no financial relationships with commercial interests. Ethics approval and consent to participate: The UK Biobank has approval from the North West Multi-centre Research Ethics Committee (MREC) as a Research Tissue Bank (RTB) approval. This research was done under the RTB approval and separate ethical clearance was not required. The UK Biobank Ethics and Governance Council (EGC) was established as an independent guardian of the UK Biobank Ethics and Governance Framework (EGF). All participant materials, including the informed consent form, have been developed and are monitored under this framework. All data received from the UK Biobank is anonymised and additional consent for this research was not required., (© 2024. The Author(s).)

Background: Rheumatoid arthritis (RA) and ulcerative colitis (UC) are two autoimmune diseases where patients report high levels of fatigue, pain, and depression. The effect of systemic inflammation from these diseases is likely affecting the brain, however, it is unknown whether there are measurable neuroanatomical changes and whether these are a contributing factor to these central symptoms., Methods: We included 258 RA patients with 774 age and sex matched controls and 249 UC patients with 747 age and sex matched controls in a case control study utilizing the UK Biobank dataset. We used imaging derived phenotypes (IDPs) to determine whether there were differences in (1) hippocampal volume and (2) additional subcortical brain volumes between patients compared to controls and if there were common regions affected between these two diseases., Results: Patients with UC had moderately smaller hippocampi compared to age and sex matched controls (difference: 134.15 mm 3 , SD ± 64.76, p  = 0.035). This result was not seen in RA patients. RA patients had a significantly smaller amygdala volume than age and sex matched controls (difference: 91.27 mm 3 , SD ± 30.85, p  = 0.0021, adjusted p  = 0.012). This result was not seen in UC patients. All other subcortical structures analyzed were comparable between the patients and control groups., Conclusion: These results indicate there are subcortical brain differences between UC, RA and controls but different regions of the limbic system are preferentially affected by UC and RA. This study may provide evidence for different neurodegenerative mechanisms in distinct autoimmune diseases., Competing Interests: Jennifer Cox is an industry funded PhD student funded by GlaxoSmithKline and an employee of Johnson & Johnson. GSK and Johnson & Johnson had no role in the design or conduct of the study. Marius de Groot is a former employee of, and holds shares in GlaxoSmithKline (GSK). GSK had no role in the design or conduct of the study. Kempton was funded by an MRC Career Development Fellowship (grant MR/J008915/1). Williams has received research funding from Bionomics, Eli Lilly, the Engineering and Physical Sciences Research Council, GlaxoSmithKline, Johnson & Johnson, Lundbeck, the National Institute of Health Research, Pfizer, Takeda, and Wellcome Trust. Marius de Groot was employed by the Groover Consulting. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Cox, de Groot, Kempton, Williams and Cole.)

In recent years, the oak lace bug, Corythucha arcuata, has emerged as a significant threat to European oak forests. This species, native to North America, has in the last two decades rapidly extended its range in Europe, raising concerns about its potential impact on the continent's invaluable oak populations. To address this growing concern, we conducted an extensive study to assess the distribution, colonization patterns, and potential ecological niche of the oak lace bug in Europe. We gathered 1792 unique presence coordinates from 21 Eurasian countries, utilizing diverse sources such as research observations, citizen science initiatives, GBIF database, and social media reports. To delineate the realized niche and future distribution, we employed an ensemble species distribution modelling (SDM) framework. Two future greenhouse gas scenarios (RCP 4.5 and RCP 8.5) were considered across three-time intervals (2021-2040, 2061-2080, and 2081-2100) to project and evaluate the species' potential distribution in the future. Our analysis revealed that significant hotspots rich in host species occurrence for this invasive insect remain uninvaded so far, even within its suitable habitat. Furthermore, the native ranges of Turkey oak (Quercus cerris L.) and Hungarian oak (Quercus frainetto L.) species offer entirely suitable environments for the oak lace bug. In contrast, the pedunculate oak and sessile oak distribution ranges currently show only 40 % and 50 % suitability for colonization, respectively. However, our predictive models indicate a significant transformation in the habitat suitability of the oak lace bug, with suitability for these two oak species increasing by up to 90 %. This shift underlines an evolving landscape where the oak lace bug may exploit more of its available habitats than initially expected. It emphasises the pressing need for proactive measures to manage and stop its expanding presence, which may lead to a harmful impact on the oak population across the European landscape., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: In the Spring of 2020, the world was hit with unparalleled impact by the coronavirus pandemic. Antibiotics were widely used, even without good rationale. The aim of our study was to compare the use of antibiotics in patients with confirmed COVID-19 from three hospitals across Europe (Poland, the Netherlands and Spain) between two subsequent periods in the early days of the pandemic., Method: We analysed data (antibiotics used and variation in the use of antibiotics, patients, admission and disease-related characteristics) from 300 patients admitted in three hospitals (University Hospital in Cracow, University Medical Center in Utrecht and Vall d'Hebron University Hospital in Barcelona) with confirmed infection of SARS-CoV-2 during Q1 2020 and Q4 2020., Results: There was ample variation in terms of patient mix and outcomes across the 3 hospitals. The majority of patients (225 out of 300) in all 3 hospitals received at least 1 antibiotic during the hospitalisation period. A minority of patients (68 out of 300) had their bacterial test results positive during their hospitalisation period. Throughout the 2 study periods, third-generation cephalosporins (ceftriaxone in 170 out of 300 patients) emerged as the most commonly used class of antibiotics. There was an apparent shift towards more rational utilisation of antibiotics, in all three hospitals., Conclusions: Our study shows that during the early stage of COVID-19 pandemic in 2020, antibiotics were frequently used in three European teaching hospitals despite the relatively low incidence of microbiologically confirmed bacterial infections. While in the early days of the COVID-19 pandemic antibiotic prescribing was full of trial and error, we could also confirm a learning curve over time., (© 2024. The Author(s).)

Objective: Patient data is subject to missingness and errors. Patient portals enable patients managing type 2 diabetes mellitus (T2DM) to review and correct data to avoid retesting, medication errors, and diagnostic mistakes. We examined whether patient portal use was associated with electronic health record (EHR) data timeliness in T2DM care., Research Design and Methods: We analyzed EHR data from a panel of adult patients to determine whether portal use improved data timeliness. EHR data timeliness is measured as the number of days between patient encounters, accounting for mean attribute update periods, where available EHR attribute updates for T2DM measurements were present, including body mass, weight, glycated hemoglobin A1c, cholesterol, blood pressure, serum creatinine, and smoking status. We performed negative binomial regressions with fixed effects to estimate the association between patient portal use and EHR data timeliness. Sensitivity analyses were conducted using Poisson regressions., Results: Nearly a third (31.3%) of patients in our sample actively used the health portal. There were fewer days (111.9 days vs. 136.7 days; p  < 0.001) between EHR attribute updates for patients who used health portals compared to patients who did not. Data timeliness was lower among female, non-Hispanic White Medicare beneficiaries. Based on regression analyses, portal use was associated with an expected 3.6 ( p  < 0.001) percentage point decrease in days between attribute updates, indicating improved EHR timeliness., Conclusion: Improving the quality of health information may streamline decision-making in partnership with patients who produce data points across clinical settings. Active use of patient portals and digital health tools in chronic disease care are critical for care management and clinical decision-making, especially for patients managing type 2 diabetes across clinical settings., Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-024-01468-6., Competing Interests: Conflict of interestThe authors of this study have no relevant financial or non-financial interests to disclose., (© The Author(s) 2024.)

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Background Multiparametric MRI (mpMRI) is effective for detecting prostate cancer (PCa); however, there is a high rate of equivocal Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions and false-positive findings. Purpose To investigate whether fluorine 18 ( 18 F) prostate-specific membrane antigen (PSMA) 1007 PET/CT after mpMRI can help detect localized clinically significant PCa (csPCa), particularly for equivocal PI-RADS 3 lesions. Materials and Methods This prospective study included participants with elevated prostate-specific antigen (PSA) levels referred for prostate mpMRI between September 2020 and February 2022. 18 F-PSMA-1007 PET/CT was performed within 30 days of mpMRI and before biopsy. PI-RADS category and level of suspicion (LOS) were assessed. PI-RADS 3 or higher lesions at mpMRI and/or LOS 3 or higher lesions at 18 F-PSMA-1007 PET/CT underwent targeted biopsies. PI-RADS 2 or lower and LOS 2 or lower lesions were considered nonsuspicious and were monitored during a 1-year follow-up by means of PSA testing. Diagnostic accuracy was assessed, with histologic examination serving as the reference standard. International Society of Urological Pathology (ISUP) grade 2 or higher was considered csPCa. Results Seventy-five participants (median age, 67 years [range, 52-77 years]) were assessed, with PI-RADS 1 or 2, PI-RADS 3, and PI-RADS 4 or 5 groups each including 25 participants. A total of 102 lesions were identified, of which 80 were PI-RADS 3 or higher and/or LOS 3 or higher and therefore underwent targeted biopsy. The per-participant sensitivity for the detection of csPCa was 95% and 91% for mpMRI and 18 F-PSMA-1007 PET/CT, respectively, with respective specificities of 45% and 62%. 18 F-PSMA-1007 PET/CT was used to correctly differentiate 17 of 26 PI-RADS 3 lesions (65%), with a negative and positive predictive value of 93% and 27%, respectively, for ruling out or detecting csPCa. One additional significant and one insignificant PCa lesion (PI-RADS 1 or 2) were found at 18 F-PSMA-1007 PET/CT that otherwise would have remained undetected. Two participants had ISUP 2 tumors without PSMA uptake that were missed at PET/CT. Conclusion 18 F-PSMA-1007 PET/CT showed good sensitivity and moderate specificity for the detection of csPCa and ruled this out in 93% of participants with PI-RADS 3 lesions. Clinical trial registration no. NCT04487847 © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Turkbey in this issue.

In this paper, we study pseudo-labelling. Pseudo-labelling employs raw inferences on unlabelled data as pseudo-labels for self-training. We elucidate the empirical successes of pseudo-labelling by establishing a link between this technique and the Expectation Maximisation algorithm. Through this, we realise that the original pseudo-labelling serves as an empirical estimation of its more comprehensive underlying formulation. Following this insight, we present a full generalisation of pseudo-labels under Bayes' theorem, termed Bayesian Pseudo Labels. Subsequently, we introduce a variational approach to generate these Bayesian Pseudo Labels, involving the learning of a threshold to automatically select high-quality pseudo labels. In the remainder of the paper, we showcase the applications of pseudo-labelling and its generalised form, Bayesian Pseudo-Labelling, in the semi-supervised segmentation of medical images. Specifically, we focus on: (1) 3D binary segmentation of lung vessels from CT volumes; (2) 2D multi-class segmentation of brain tumours from MRI volumes; (3) 3D binary segmentation of whole brain tumours from MRI volumes; and (4) 3D binary segmentation of prostate from MRI volumes. We further demonstrate that pseudo-labels can enhance the robustness of the learned representations. The code is released in the following GitHub repository: https://github.com/moucheng2017/EMSSL., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mou-Cheng Xu reports financial support was provided by University College London. Mou-Cheng Xu reports financial support was provided by GSK. Neil P. Oxtoby reports financial support was provided by UK Research and Innovation. Daniel C. Alexander reports financial support was provided by Engineering and Physical Sciences Research Council. Joseph Jacob reports financial support was provided by Wellcome Trust. Joseph Jacob reports financial support was provided by NIHR University College London Hospitals Biomedical Research Centre. Daniel C. Alexander reports financial support was provided by Wellcome Trust. Daniel C. Alexander reports was provided by NIHR University College London Hospitals Biomedical Research Centre. Neil P. Oxtoby reports financial support was provided by NIHR University College London Hospitals Biomedical Research Centre. Marius de Groot reports financial support was provided by GSK., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

The Environmental Impact Classification for Alien Taxa (EICAT) is an important tool for biological invasion policy and management and has been adopted as an International Union for Conservation of Nature (IUCN) standard to measure the severity of environmental impacts caused by organisms living outside their native ranges. EICAT has already been incorporated into some national and local decision-making procedures, making it a particularly relevant resource for addressing the impact of non-native species. Recently, some of the underlying conceptual principles of EICAT, particularly those related to the use of the precautionary approach, have been challenged. Although still relatively new, guidelines for the application and interpretation of EICAT will be periodically revisited by the IUCN community, based on scientific evidence, to improve the process. Some of the criticisms recently raised are based on subjectively selected assumptions that cannot be generalized and may harm global efforts to manage biological invasions. EICAT adopts a precautionary principle by considering a species' impact history elsewhere because some taxa have traits that can make them inherently more harmful. Furthermore, non-native species are often important drivers of biodiversity loss even in the presence of other pressures. Ignoring the precautionary principle when tackling the impacts of non-native species has led to devastating consequences for human well-being, biodiversity, and ecosystems, as well as poor management outcomes, and thus to significant economic costs. EICAT is a relevant tool because it supports prioritization and management of non-native species and meeting and monitoring progress toward the Kunming-Montreal Global Biodiversity Framework (GBF) Target 6., (© 2023 The Authors. Conservation Biology published by Wiley Periodicals LLC on behalf of Society for Conservation Biology.)

Forests are important ecosystems that face threats from climate change and global environmental shifts, with invasive alien plant species being a significant concern. Some of these invasive species have already become established, while others are in the process of naturalisation. Although forests are a relatively stable ecosystem, extreme weather events increase their vulnerability to change, and clearings left after natural disturbances are particularly susceptible to invasion by alien plant species (IAPS). We created risk maps of two species that have spread rapidly in the last decade: American pokeweed ( Phytolacca americana ) and the tree of heaven ( Ailanthus altissima ). We prepared a generalised linear model based on the occurrence data collected within the LIFE ARTEMIS project. Eleven environmental variables were used to determine habitat characteristics. We constructed two models for each species: one covering the entirety of Slovenia and the other specifically for the forested areas in Slovenia, with the latter incorporating forest-specific variables (such as forest sanitation felling and monocultures). We observed the presence of both species at lower altitudes and in close proximity to water sources. American pokeweed tends to occur nearer to railways, while the presence of the tree of heaven is associated with areas lacking carbonate parent material and influenced by land use patterns. In forested areas, the occurrence of American pokeweed is influenced by forest habitat characteristics, such as disturbances caused by extreme weather events or the prevalence of Norway spruce monocultures. In contrast, the occurrence of the tree of heaven is influenced by more general environmental variables, such as altitude and proximity to railways. Consequently, we have generated risk maps for the entirety of Slovenia and separately for forested areas, both of which indicate similar levels of risk, particularly for the tree of heaven. The risk map for American pokeweed highlights numerous vulnerable areas, especially forest edges, which are highly susceptible to invasion. Furthermore, there is a higher likelihood of this species occurring in areas that have undergone sanitation felling. This study suggests that the production of risk maps of IAPS could be improved by focussing on habitat types and taking into account habitat-specific variables. This approach could enhance the early detection and management of these invasive species., Competing Interests: The authors declare no conflicts of interest.

Aims: To evaluate the long-term effects of behavioral treatments on glycemic and psychological outcomes for patients with major depressive disorder (MDD) and type 2 diabetes (T2D)., Methods: Program ACTIVE II was a multicenter randomized controlled comparative effectiveness trial of cognitive behavioral therapy (CBT), exercise (EXER), combination treatment (CBT + EXER) and usual care (UC) for adults with MDD and T2D., Results: Primary outcomes: change in A1c and depressive symptoms at 6- (N = 87) and 12-months (N = 75) from baseline. In those with a baseline A1c ≥7.0 %, CBT + EXER showed lasting A1c benefit at 6- (-1.2 %; SE: 0.6; p = 0.032) and 12-months (-1.4 %; SE: 0.6; p = 0.025) compared to UC. All groups had clinically significant improvements in depressive symptoms. At 6 months, CBT + EXER had significant improvements in diabetes-related distress regimen burden (p = 0.005); and social support (CIRS, p = 0.043) compared to UC., Conclusions: The Program ACTIVE II CBT + EXER intervention demonstrated a sustained improvement in A1c for a subgroup of study participants with a baseline A1c ≥7.0 %. However, this finding should be considered preliminary because of small sample size. All 3 behavioral intervention groups demonstrated improvements in psychosocial outcomes one-year post-intervention. These findings point to the enduring benefits of community-based interventions to extend the availability of depression treatment for T2D patients., Competing Interests: Declaration of competing interest Program ACTIVE II was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (R18DK092765 & R34DK071545). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The following conflicts of interest apply to the co-authors: Dr. Mary de Groot is a faculty consultant to Mediflix, Inc. Dr. Kieren Mather is an employee of Eli Lilly, Inc. No artificial intelligence was used in the creation or revision of this manuscript., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Imaging markers of cerebral small vessel disease provide valuable information on brain health, but their manual assessment is time-consuming and hampered by substantial intra- and interrater variability. Automated rating may benefit biomedical research, as well as clinical assessment, but diagnostic reliability of existing algorithms is unknown. Here, we present the results of the VAscular Lesions DetectiOn and Segmentation (Where is VALDO?) challenge that was run as a satellite event at the international conference on Medical Image Computing and Computer Aided Intervention (MICCAI) 2021. This challenge aimed to promote the development of methods for automated detection and segmentation of small and sparse imaging markers of cerebral small vessel disease, namely enlarged perivascular spaces (EPVS) (Task 1), cerebral microbleeds (Task 2) and lacunes of presumed vascular origin (Task 3) while leveraging weak and noisy labels. Overall, 12 teams participated in the challenge proposing solutions for one or more tasks (4 for Task 1-EPVS, 9 for Task 2-Microbleeds and 6 for Task 3-Lacunes). Multi-cohort data was used in both training and evaluation. Results showed a large variability in performance both across teams and across tasks, with promising results notably for Task 1-EPVS and Task 2-Microbleeds and not practically useful results yet for Task 3-Lacunes. It also highlighted the performance inconsistency across cases that may deter use at an individual level, while still proving useful at a population level., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Carole H Sudre reports financial support was provided by Alzheimer’s Society. Marleen de Bruijne reports financial support was provided by Netherlands Organisation for Scientific Research. Kimberlin van Wijnen reports financial support was provided by Netherlands Organisation for Scientific Research. Shuai Chen reports financial support was provided by Netherlands Organisation for Scientific Research. Silvia Ingala, Luigi Lorenzini, Frederik Barkhof reports financial support was provided by EU Framework Horizon 2020 Research and Innovation. Florian Kofler, Bjoern Menze, Benedikt Wiestler reports financial support was provided by Deutsche Forschung Gemeinschaft. Hugo J Kuijf reports financial support was provided by Galen and Hilary Weston Foundation. Juan Domingo Gispert reports financial support was provided by Spanish Ministry of Science and Innovation. Bjoern Menze reports financial support was provided by Helmut Horten Foundation. Florian Dubost reports financial support was provided by Netherlands Organisation for Health Research and Development. Ivan Ezhov reports financial support was provided by DComEx. Marius de Groot reports a relationship with GlaxoSmithKline that includes: employment and equity or stocks. Jose Luis Molinuevo reports a relationship with Lundbeck that includes: employment. Jose Luis Molinuevo reports a relationship with Roche Diagnostics that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with Genentech Inc that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with Novartis that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with Oryzon Genomics, S.A. that includes: board membership, consulting or advisory, and speaking and lecture fees. Juan Domingo Gispert reports a relationship with GE Healthcare that includes: funding grants. Juan Domingo Gispert reports a relationship with Roche Diagnostics that includes: funding grants. Juan Domingo Gispert reports a relationship with Hoffmann-La Roche Limited that includes: funding grants. Juan Domingo Gispert reports a relationship with Biogen that includes: speaking and lecture fees. Juan Domingo Gispert reports a relationship with Philips that includes: speaking and lecture fees. Jose Luis Molinuevo reports a relationship with Lilly that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with Green Valley that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with Janssen that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with MSD that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with Alector that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with BioCross that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with Eisai that includes: board membership, consulting or advisory, and speaking and lecture fees. Jose Luis Molinuevo reports a relationship with ProMIS Neurosciences Inc that includes: board membership, consulting or advisory, and speaking and lecture fees. NVIDIA and Icometrix provided the challenge prizes., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

People with Alzheimer's disease or related dementias and diabetes mellitus (ADRD-DM) are at high risk for hypoglycemic events. Their cognitive impairment and psychosocial situation often hinder detection of hypoglycemia. Extending use and benefits of continuous glucose monitoring (CGM) to people with ADRD-DM could improve hypoglycemia detection, inform care, and reduce adverse events. However, cognitive impairment associated with ADRD presents unique challenges for CGM use. This commentary proposes applying the human-centered design process to CGM, investigating design solutions or interventions needed to integrate CGM into the health care of patients with ADRD-DM. With this process, we can identify and inform CGM designs for people with ADRD-DM, broadening CGM access, increasing detection and treatment of the silent threat posed by hypoglycemia., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Michael Weiner reports stock ownership in AbbVie Inc, Amgen Inc, Boston Scientific Corporation, Bristol-Myers Squibb Company, IBM, Integer Holdings Corp, Johnson & Johnson, Mallinckrodt PLC, Mead Johnson & Company, LLC, Medtronic, Mylan N.V., Novo Nordisk A/S, Perspecta Inc, Pfizer Inc, Roche Pharmaceuticals, Senseonics, Stryker Corp, Teva Pharmaceutical Industries Ltd, and Walgreens Boots Alliance, Inc. Rich Holden provides paid scientific advising to Cook Medical. April Savoy reports stock ownership in Pfizer Inc. and GSK (GlaxoSmithKline) Plc. David Klonoff is a consultant to Eoflow, Fractyl Health, Lifecare, Integrity, Rockley Photonics, and Thirdwayv. All other authors report no conflicts of interest.

People with diabetes often encounter stigma (ie, negative social judgments, stereotypes, prejudice), which can adversely affect emotional, mental, and physical health; self-care, access to optimal health care; and social and professional opportunities. To accelerate an end to diabetes stigma and discrimination, an international multidisciplinary expert panel (n=51 members, from 18 countries) conducted rapid reviews and participated in a three-round Delphi survey process. We achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility, and fear or disgust. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination (ie, unfair and prejudicial treatment) due to diabetes, such as in health care, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. Consequently, we achieved unanimous consensus on a pledge to end diabetes stigma and discrimination., Competing Interests: Declaration of interests In the past 3 years, JSp and EH-T have received competitive research grants from the Diabetes Australia Research Program, the Medical Research Future Fund Targeted Translational Research Accelerator, and the National Health and Medical Research Council of Australia. JSp and EH-T have received an investigator-initiated research grant from Sanofi Diabetes and an unrestricted educational grant from Diabetes Australia and are supported by core funding to the Australian Centre for Behavioural Research in Diabetes derived from the collaboration between Diabetes Victoria and Deakin University. JSp has also received a competitive research grant from the Ian Potter Foundation; a research contract from the Australian Government Department of Health; a consulting fee from Diabetes Canada; honoraria to present at educational meetings from Novo Nordisk and Sanofi Diabetes; honoraria for participating in advisory boards from Insulet and Sanofi Diabetes; and support for attending meetings (including travel) from the Novo Nordisk Foundation. EH-T received honoraria for presentation at educational meetings from Roche Diabetes Care. All these payments have been made directly to the Australian Centre for Behavioural Research in Diabetes; this research centre owns the copyright of the type 1 and type 2 Diabetes Stigma Assessment Scales. JSp is the Chair, JSt the Vice-chair, and EH-T website redevelopment lead of the international PsychoSocial Aspects of Diabetes Study Group (unpaid roles). MG has received project funding from One Drop, Eli Lilly, Boehringer Ingelheim and Eli Lilly Alliance, Abbott, and Genentech and honorarium from Sanofi and Diabetes Sisters (all paid to the diaTribe Foundation). IW has shares in Novo Nordisk. ASe has received competitive research grants from the Juvenile Diabetes Research Foundation and Auckland Medical Research Foundation (all paid to the University of Auckland) and conference attendance support (as an invited speaker) from the International Society for Pediatric and Adolescent Diabetes. BA received conference funding support to present at a RAPID conference hosted by PsychoSocial Aspects of Diabetes and Steno. MdG has received competitive research grants from the American Diabetes Association and National Institute on Aging and received consulting fees from Mediflix and Kenner Family Foundation. SH has received consulting fees from Novo Nordisk, Lilly Diabetes Care, Medtronic Diabetes Care, and Dexcom Germany; received payments of honoraria from Novo Nordisk and Ascensia Diabetes Care; payment for expert testimony from VitalAire; received support for attending meetings from Ascensia, Diabetes Center Berne, Diabeloop, Dexcom, Lilly, Medtronic, Novo Nordisk, Sanofi, Tandem, embecta, and dotcool; received medical equipment from Abbott Diabetes Care, Dexcom, and Ypsomed; and is Head of Communications for #dedoc°, Dedoc Labs. RIGH has received research support from Novo Nordisk; speaker honoraria from EASD, Eli Lilly, Encore, Liberum, Novo Nordisk, and ROVI; and conference attendance funding from Novo Nordisk and Eli Lilly. KK is supported by the UK National Institute for Health Research's Applied Research Collaboration East Midlands and Leicester Biomedical Research Centre; has received research funding from AstraZeneca, Boehringer Ingelheim, Eli Lilly, MSD, Novartis, Novo Nordisk, Roche, Oramed Pharmaceuticals, and Sanofi; received consultancy fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, MSD, Novo Nordisk, Roche, Sanofi, and Servier; and received payments of honoraria from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Novartis, Novo Nordisk, Roche, and Sanofi. RLP has received research funding from the US National Institutes of Health (paid to institution); receieved presentation honorarium from the Diabetes Leadership Council; and is Chair of Policy Track for The Obesity Society Annual Meeting Program Committee (unpaid role). RMP has received research funding and consultancy fees from Eli Lilly. MSe has received conference funding support from the International Diabetes Federation and the International Society for Pediatric and Adolescent Diabetes. MV has received investigator-initiated research funding from Abbott, Bausch, and Novo Nordisk; received consulting feeds from Abbott, Abbvie, Boehringer Ingelheim, and Novo Nordisk; received payments and travel support from Abbott, Abbvie, Boehringer Ingelheim, Novo Nordisk, Eli Lilly, Merck, and Pfizer; has a pending patent with AmpHealth for a digital health intervention; and is a Diabetes Canada Mission Committee member (unpaid role). All other authors report no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Improvement of alkaline water electrolysis is a key enabler for quickly scaling up green hydrogen production. Fe is omnipresent within most industrial alkaline water electrolyzers and its effect on electrolyzer performance needs to be assessed. We conducted three-electrode and flow cell experiments with electrolyte Fe and Ni electrodes. Three-electrode cell experiments show that Fe ([Fe] = 6-357 μM; ICP-OES) promotes HER and OER by lowering both overpotentials by at least 100 mV at high current densities (T = 35°C-91°C). The overpotential of a zero-gap flow cell was decreased by 200 mV when increasing the Fe concentration ([Fe] = 13-549 μM, T = 21°C-75°C). HER benefits from the formation of Fe dendrite layers (SEM/EDX, XPS), which prevent NiH x formation and increase the overall active area. The OER benefits from the formation of mixed Ni/Fe oxyhydroxides leading to better catalytic activity and Tafel slope reduction., Competing Interests: The authors declare no competing interests. We support inclusive, diverse, and equitable conduct of research., (© 2023 The Authors.)

Invasive alien species (IAS) adversely impact biodiversity, ecosystem functions, and socio-economics. Citizen science can be an effective tool for IAS surveillance, management, and research, providing large datasets over wide spatial extents and long time periods, with public participants generating knowledge that supports action. We demonstrate how citizen science has contributed knowledge across the biological invasion process, especially for early detection and distribution mapping. However, we recommend that citizen science could be used more for assessing impacts and evaluating the success of IAS management. Citizen science does have limitations, and we explore solutions to two key challenges: ensuring data accuracy and dealing with uneven spatial coverage of potential recorders (which limits the dataset's "fit for purpose"). Greater co-development of citizen science with public stakeholders will help us better realize its potential across the biological invasion process and across ecosystems globally while meeting the needs of participants, local communities, scientists, and decision-makers., Competing Interests: The authors declare no competing interests., (© 2023 The Author(s).)

Semi-supervised learning (SSL) is a promising machine learning paradigm to address the ubiquitous issue of label scarcity in medical imaging. The state-of-the-art SSL methods in image classification utilise consistency regularisation to learn unlabelled predictions which are invariant to input level perturbations. However, image level perturbations violate the cluster assumption in the setting of segmentation. Moreover, existing image level perturbations are hand-crafted which could be sub-optimal. In this paper, we propose MisMatch, a semi-supervised segmentation framework based on the consistency between paired predictions which are derived from two differently learnt morphological feature perturbations. MisMatch consists of an encoder and two decoders. One decoder learns positive attention for foreground on unlabelled data thereby generating dilated features of foreground. The other decoder learns negative attention for foreground on the same unlabelled data thereby generating eroded features of foreground. We normalise the paired predictions of the decoders, along the batch dimension. A consistency regularisation is then applied between the normalised paired predictions of the decoders. We evaluate MisMatch on four different tasks. Firstly, we develop a 2D U-net based MisMatch framework and perform extensive cross-validation on a CT-based pulmonary vessel segmentation task and show that MisMatch statistically outperforms state-of-the-art semi-supervised methods. Secondly, we show that 2D MisMatch outperforms state-of-the-art methods on an MRI-based brain tumour segmentation task. We then further confirm that 3D V-net based MisMatch outperforms its 3D counterpart based on consistency regularisation with input level perturbations, on two different tasks including, left atrium segmentation from 3D CT images and whole brain tumour segmentation from 3D MRI images. Lastly, we find that the performance improvement of MisMatch over the baseline might originate from its better calibration. This also implies that our proposed AI system makes safer decisions than the previous methods.

Introduction: Mental health promotion and screenings are recommended as part of standard preventive care. Mexican immigrants in the U.S. are at high risk for mental health illness especially after the COVID-19 pandemic, however access to mental health prevention for this population has been limited, which results in important implementation and equity gaps. The Ventanilla de Salud (VDS) program provides preventive services through Mexican consulates in the U.S., Objective: The objective of this study was to assess capability, opportunity, and motivation for promotores to implement mental health programming through the VDS, leveraging early experiences of ongoing mental health prevention efforts., Methods: This was a qualitative study using the Capability, Opportunity, and Motivation for Behavior Change model (COM-B). We conducted 9 focus groups with 40 VDS promotores and 6 semi-structured interviews with program stakeholders. Data were analyzed using inductive and deductive coding., Results: We found high levels of interest from the leadership, partners, and promotores to provide mental health services through the VDS. Early implementation of a mental health strategy that included training sessions for promotores and mental health promotion, screenings and referrals for VDS users was ongoing. We identified facilitators and barriers that could affect capability, opportunity, and motivation to provide mental health services. Facilitators included promotores' extensive knowledge about the importance of mental health, promotores service mindset and commitment to provide services to VDS users, and general support from the VDS network and partners. Barriers included promotores ' turnover, need for additional economic compensation, burnout, competing priorities, and lack of mental health professionals to provide clinical services or supervision. Additional investments are recommended to support promotores ' well-being., Conclusion: The main lesson learned from this study was that investing in VDS promotores ' training, resources, and well-being is key to their capability, opportunity and motivation to provide mental health services for Mexican immigrants in the US. Results from this study can be applied to improve the ongoing VDS mental health strategy and increase its impact on the mental health of Mexican immigrants., Competing Interests: At the time of the study MR worked at the Border Health Commission and was responsible for overseeing the Ventanilla de Salud program. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 González Casanova, Martínez Rodriguez, Ortiz Brunel, Rangel Gómez, de Groot, and Fernández.)

Non-native pests, climate change, and their interactions are likely to alter relationships between trees and tree-associated organisms with consequences for forest health. To understand and predict such changes, factors structuring tree-associated communities need to be determined. Here, we analysed the data consisting of records of insects and fungi collected from dormant twigs from 155 tree species at 51 botanical gardens or arboreta in 32 countries. Generalized dissimilarity models revealed similar relative importance of studied climatic, host-related and geographic factors on differences in tree-associated communities. Mean annual temperature, phylogenetic distance between hosts and geographic distance between locations were the major drivers of dissimilarities. The increasing importance of high temperatures on differences in studied communities indicate that climate change could affect tree-associated organisms directly and indirectly through host range shifts. Insect and fungal communities were more similar between closely related vs. distant hosts suggesting that host range shifts may facilitate the emergence of new pests. Moreover, dissimilarities among tree-associated communities increased with geographic distance indicating that human-mediated transport may serve as a pathway of the introductions of new pests. The results of this study highlight the need to limit the establishment of tree pests and increase the resilience of forest ecosystems to changes in climate., (© 2023. The Author(s).)

Purpose: To examine the longitudinal relationship between the age or shelf-life of common type 2 diabetes laboratory tests for serum creatinine, cholesterol, and glycated hemoglobin A1c conducted in outpatient settings and subsequent inpatient hospitalizations and emergency department visits., Methods: This study analyzes panel data from two healthcare delivery systems' electronic health records (EHR) for patients aged 18 years and older managing type 2 diabetes. We used EHR data to quantify the age of three laboratory tests: serum creatinine, cholesterol, and glycated hemoglobin A1c. Encounter data were used to determine the frequency of inpatient hospitalizations and emergency department visits. Negative binomial regressions with fixed effects were performed to compute marginal effects, levels of statistical significance, and 95% confidence intervals., Results: The average age for serum creatinine laboratory tests was 1.51 months (95%CI: 1.49-1.53). We computed older average ages for hemoglobin A1c (mean:6.17 months; 95%CI: 6.11-6.23) and serum creatinine tests (mean: 8.73; 95%CI: 8.65-8.81). Older laboratory tests were associated with an increase in the total expected counts of subsequent inpatient hospitalizations (ME = 0.047; p < 0.001) and ED visits (ME = 0.034; p < 0.001)., Conclusion: Findings from this study indicate that older type 2 diabetes laboratory tests are associated with increases in the total expected count of subsequent inpatient hospitalizations and emergency department visits. Future research should examine the actionability of laboratory test values to determine associations with healthcare outcomes., Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01250-0., Competing Interests: Competing InterestsThe authors of this study have no relevant financial or non-financial interests to disclose., (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Purpose: The purpose of this study was to assess the feasibility of delivering the Diabetes Tune-Up Group (DTU), a cognitive-behavioral-therapy-based (CBT) multidisciplinary intervention for adults with diabetes distress and elevated A1C using a group in-person delivery format., Methods: The DTU intervention consisted of 6 weekly group sessions (90 minutes in duration per session). The groups were cofacilitated by a diabetes care and education specialist (DCES) and a master's-level clinical psychology trainee. The intervention integrated CBT with patient-centered diabetes education. Using a pre/post study design, participants completed assessments at baseline, post-intervention, and 3 months following the intervention., Results: The sample consisted of 29 adults with type 1 diabetes (N = 8) or type 2 diabetes (N = 21) who were predominantly female (79%), White (59%), and educated (56% with a college degree or greater). Participants attended 131 total sessions out of 174 possible sessions, for an overall attendance rate of 75.3%. At 3-month follow-up, significant improvements were observed in A1C values (mean decrease = 0.39%). Diabetes distress improved significantly from baseline (mean = 3.44, SD = 0.68) to post-intervention (mean = 2.94, SD = 0.68), and 3-month follow-up (mean = 2.55, SD = 0.75). Significant improvements were also observed in diabetes self-efficacy from baseline to post-intervention and at 3-month follow-up., Conclusions: This group-based, multidisciplinary intervention resulted in improvements in A1C, diabetes distress, and patient self-efficacy in caring for diabetes. Future studies to validate this intervention approach across settings and delivery platforms are needed.

Diabetes and depression represent a prevalent, bidirectional, and impactful comorbidity that affects patient and family quality of life, glycemic self-management, long-term diabetes complications, usage of medical services, medical costs, and early mortality. Primary care providers (PCPs) are frequently the first medical providers to observe changes in mood and diabetes management, as well as the primary point of contact for making referrals to specialty providers (e.g. endocrinology, psychiatry). PCPs play a critical role in screening, evaluating, and treating these conditions. Critical to fostering and maintaining a position of trust and patient engagement in medication recommendations is the use of person-centered, nonjudgmental language used by the provider within the clinical encounter. Key strategies for the management of these conditions include the following: routine screening for depressive symptoms, securing access to behavioral health professionals, either within or beyond the primary care setting, collaboration with diabetes care and education specialists to support problem-solving of diabetes self-management, and monitoring the use and effectiveness of antidepressant medications., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author.)

A comprehensive search of published literature in brain volumetry was conducted in three autoimmune diseases - systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and ulcerative colitis (UC) - with the intention of performing a meta-analysis of published data. Due to the lack of data in RA and UC, the reported meta-analysis was limited to SLE. The MEDLINE database was searched for studies from 1988 to March 2022. A total of 175 papers met the initial inclusion criteria, and 16 were included in a random-effects meta-analysis. The reduction in the number of papers included in the final analysis is primarily due to the lack of overlap in measured and reported brain regions. A significantly lower volume was seen in patients with SLE in the hippocampus, corpus callosum, and total gray matter volume measurements as compared to age- and sex-matched controls. There were not enough studies to perform a meta-analysis for RA and UC; instead, we include a summary of published volumetric studies. The meta-analyses revealed structural brain abnormalities in patients with SLE, suggesting that lower global brain volumes are associated with disease status. This volumetric difference was seen in both the hippocampus and corpus callosum and total gray matter volume measurements. These results indicate both gray and white matter involvements in SLE and suggest there may be both localized and global reductions in brain volume., (© 2022. The Author(s).)

Purpose of the Review: One of the major threats to tree health, and hence the resilience of forests and their provision of ecosystem services, is new and emerging pests. Therefore, forest health monitoring is of major importance to detect invasive, emerging and native pest outbreaks. This is usually done by foresters and forest health experts, but can also be complemented by citizen scientists. Here, we review the use of citizen science for detection and monitoring, as well as for hypothesis-driven research and evaluation of control measures as part of forest pest surveillance and research. We then examine its limitations and opportunities and make recommendations on the use of citizen science for forest pest monitoring., Recent Findings: The main opportunities of citizen scientists for forest health are early warning, early detection of new pests, monitoring of impact of outbreaks and scientific research. Each domain has its own limitations, opportunities and recommendations to follow, as well as their own public engagement strategies. The development of new technologies provides many opportunities to involve citizen scientists in forest pest monitoring. To enhance the benefits of citizen scientists' inclusion in monitoring, it is important that they are involved in the cocreation of activities., Summary: Future monitoring and research may benefit from tailor-made citizen science projects to facilitate successful monitoring by citizen scientists and expand their practice to countries where the forest health sector is less developed. In this sense, citizen scientists can help understand and detect outbreaks of new pests and avoid problems in the future., Competing Interests: Conflict of InterestNone of the authors had a conflict of interests., (© The Author(s) 2022.)

Background: Most psychotherapy outcome research focuses on symptom reduction as a primary outcome. However, most patients do not seek psychological treatment exclusively for symptom relief, but mainly because they can no longer do what they want to do or used to do. Therefore, besides symptom reduction, also disability in daily functioning should be a focus of psychotherapy outcome research. Yet, until now there is a paucity in research pertaining to the relation between symptom reduction and reduction of disability during psychological treatment., Aims: For this reason, the aim of the current study was to examine the relationship between changes in symptom reduction (reduction in general symptom distress) and changes in self-reported disability over a period of two years in patients that receive psychotherapy for mood and anxiety disorders (N = 1182)., Results: We found strong correlations between both outcome measures at all measurement points. Furthermore, results demonstrated a decrease in both outcome measures from start to end of treatment with a moderate effect for symptom distress and a small effect for experienced disability. Cross-lagged panel analysis demonstrated that a decrease in symptom distress predicted a subsequent decrease in self-reported disability, and a decrease in self-reported disability equally predicted a subsequent decrease in experienced symptom distress., Conclusion: Our results seem to indicate that both outcome measures are interchangeable in psychotherapy outcome studies for internalizing disorders., (© 2022 Wiley Periodicals LLC.)

Introduction: Both the DHS and the PFNA are common and well-studied treatment options for stable trochanteric fractures. The aim of the current study was to compare the implant failure rates of these two implants in 31A1 type trochanteric femoral fractures., Materials and Methods: A single-centre observational cohort study was conducted in the Hip Fracture Unit of a multicentre level 1 trauma teaching hospital between December 2016 and October 2018. Patients with an AO/OTA type 31A1 fracture were included. Pathological fractures, bilateral fractures, high-energy traumas and patients younger than 18 years of age were excluded. Surgery was performed using either a DHS or PFNA. Both were used routinely for stable trochanteric fractures, and allocation was decided by the surgeon performing the operation. The primary outcome of this study was the implant failure rate in the first postoperative year. Secondary outcomes included the reoperation rate, functional recovery, pain and morphine use., Results: Data were available from 126 patients treated with a DHS (n = 32, 25.4%) or PFNA (n = 95, 74.6%). Minor differences were observed in the patient characteristics including the prevalence of cognitive impairment (18.8% vs 40.2%; P = 0.028), prefracture independence in activities of daily living (87.1% vs 67.4%; P = 0.034) and prefracture mobility (independently without aides: 61.3% vs 40.4%; P = 0.033). Fractures treated with a DHS showed 25% implant failures, compared to 1.1% for fractures treated with a PFNA (P = 0.004). No differences were observed in any of the secondary outcomes., Conclusions: Significantly more implant failures were observed for the DHS compared the PFNA within 1 year after surgery. Despite the fact that this did not result in differences in revision surgery, we conclude that the PFNA, considering the minimal number of implant-related fractures is a viable implant for A1 type trochanteric fractures., (© 2021. The Author(s).)

Aim: One potential barrier for people with diabetes to reach glycemic goals is diabetes distress. Accumulating evidence suggests diabetes distress may be linked to individuals' emotion regulation capacities. Thus, we conducted two studies to elucidate a model for how emotion regulation impacts diabetes distress and A 1c levels and determine preliminary effect size estimates for an intervention targeting poor emotion regulation on glycemic control., Methods: Study I used structural equation modeling to assess the cross-sectional relationships between these variables in a sample of 216 individuals with Type 1 and Type 2 diabetes. Study II built on findings from Study I that highlighted the role of emotion regulation capacities in diabetes distress and A 1c by conducting a pilot study of an emotion-focused behavioral intervention compared to treatment as usual in a sample of individuals with Type 2 diabetes., Results: Study I examined two potential explanatory models with one of the models (Model II) showing a more comprehensive view of the data revealing a total effect of poor emotional regulation of 42% of all effects on A 1c levels. Study II tested an emotion-focused behavioral intervention in patients with Type 2 diabetes compared to treatment as usual and found medium sized reductions in A 1c levels and smaller reductions in diabetes distress that correlated with changes in emotion regulation., Conclusions: These studies suggest that, in people with diabetes, elevated A 1c levels and diabetes distress are linked with poor emotion regulation. While the effect sizes from Study 2 are preliminary, an emotion-focused behavioral intervention may reduce both A 1c and diabetes distress levels, through improvements in emotion regulation. Overall, these data suggest that targeting difficulties in emotion regulation may hold promise for maximizing improvement in diabetes distress and A 1c in individuals with diabetes., (Copyright © 2022. Published by Elsevier Ltd.)

The response to our publication by Andrew Viner and Stewart Ayrey is much appreciated [...].

Positron emission tomography (PET) of prostate-specific membrane antigen (PSMA) allows for accurate diagnosis and staging of prostate cancer (PCa). Compared to other PSMA PET tracers available, [18F]PSMA-1007 is predominantly excreted via the hepatobiliary tract resulting in low renal excretion which improves evaluation of the pelvic area. However, some patients do show high urinary uptake of [18F]PSMA-1007. The present study aimed to investigate this sudden high urinary uptake of [18F]PSMA-1007 by evaluating [18F]PSMA-1007 PET scans from PCa patients. In this single-center retrospective study, patients that underwent [18F]PSMA-1007 PET imaging between July 2018 and January 2021 were included. Data regarding the individual patient characteristics, scan acquisition and batch production were analyzed. To determine the urinary excretion of [18F]PSMA-1007, a region of interest was drawn in the bladder, and standardized uptake values (SUVs) were calculated and compared to SUVs in the prostate. An SUVmax of >10 was considered high urinary excretion, an SUVmax 7.5−10 intermediate and an SUVmax < 7.5 low urinary excretion. A total of 344 patients underwent [18F]PSMA-1007 PET/CT imaging, with 37 patients receiving three or more [18F]PSMA-1007 PET/CT scans. The mean SUVmean and SUVmax of the bladder were 3.9 (SD 2.9) and 5.9 (SD 4.2), respectively. Fourteen percent of patients showed high urinary uptake of [18F]PSMA-1007. Twelve of the thirty-seven patients (32.4%) that had multiple scans showed a varying urinary uptake of [18F]PSMA-1007 per PSMA PET/CT scan. In terms of patient characteristics, risk factors, medication and blood laboratory results, no significant influencing variables were found. Nor was there a difference observed in the batch size and the mean radiochemical purity of PSMA-1007 for high- and low-excreting patients. However, the bladder volume affected the mean SUVmax in the bladder significantly, with higher SUVs in lower bladder volumes. In this study, we observed that a higher SUV in the urinary tract seemed to occur in patients with low bladder volume. A prospective study is needed to corroborate this hypothesis.

Background: Mexican immigrants in the United States face mental health challenges, disparities, and limited access to healthcare; however, mental health promotion efforts specifically targeting this population have been insufficient. The objective of this study was to develop and test a mental health promotion intervention based on protective mental health factors and coping strategies for Mexican immigrants recruited through a free, consulate-based program in Atlanta., Material and Methods: Working with the Ventanilla de Salud program, we conducted a longitudinal study in three phases: formative research and design, pre-intervention assessment and post-implementation evaluation. The intervention was designed based on the health promotion model and interviews with stakeholders. Qualitative information was collected by semi-structured interviews with participants before and after the intervention. Quantitative outcomes were knowledge about protective factors and coping mechanisms, and psychosocial distress. Differences were assessed using the Wilcoxon non-parametrical test. Intent-to-treat analysis was conducted with all participants who signed the informed consent (carrying last observation forward), and a complete case analysis was conducted with those who attended at least 70% of the sessions and completed the post- implementation evaluation., Results: Twenty-five participants were enrolled in the intervention. Mean age was 38 years, and the majority were women. Only nine participants attended at least 70% of the sessions and completed the final evaluation. Men, those who did not complete high school, and workers in service or construction jobs were more likely to drop out. Knowledge about protective factors [pre- vs. post-intervention median (inter-quartile range) = 111 (100, 120) vs. 115 (100, 124)] and coping mechanisms [96 (85, 104) vs. 99 (90, 110)], as well as psychosocial distress [3 (2, 3) vs. 2 (2, 3)] improved after the intervention in both intent-to treat and complete case analyses ( p < 0.05). Qualitative results also support improvements in targeted protective factors., Discussion: The intervention was successful in improving psychological distress among Mexican immigrants. These results support the implementation of evidence-based mental health promotion interventions among Mexican immigrants via free and familiar programs. A limitation was the high attrition; future studies should explore approaches to improve retention in this population., Competing Interests: IG served as Emory University's director of the Ventanilla de Salud Atlanta program at the time of the implementation of the study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Martínez Rodríguez, González Vázquez, Márquez Serrano, Groot, Fernandez and Gonzalez Casanova.)

Increasing trends in environmental temperatures and changes in the hydrological cycle caused by climate change are affecting organisms around the world. Water balance is an important feature of organisms as warmer and drier environments increase water vapour pressure deficit and cutaneous water loss. The aim of our study was to understand the hourly kinetics of losses under water-restricted conditions. In general, these kinetics are thought to be negligible, and values from water loss studies have often been summed or averaged for population and species comparisons. We compiled a cross-species data set of instantaneous water loss (EWL i ) of lizards in which weight was recorded every hour for 12 h (a period considered ecologically relevant for lizards) under standardized conditions with minimal disturbance. We statistically tested whether the duration of the experiment affected the values and found that the duration affected 83% of the data sets. In most cases, water loss was significantly higher during the first hour. This is likely a result of increased activity due to acclimation to the experimental conditions. However, as the experiment progressed, other temporal patterns of EWL i occurred that were not consistent between species. In addition, the average value and the first and last values of EWL i changed significantly for most species as the experiment progressed. These results suggest that the hourly kinetics of water loss should not be ignored, while experimental procedures in which EWL is recorded continuously rather than only at the beginning and end of the experiment should be used to find finer temporal variations., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Individuals' self-tracking of subjectively experienced phenomena related to health can be challenging, as current options for instrumentation often involve too much effort in the moment or rely on retrospective self-reporting, which is likely to impair accuracy and compliance., Objective: This study aims to assess the usability and perceived usefulness of low-effort, in-the-moment self-tracking using simple instrumentation and to establish the amount of support needed when using this approach., Methods: In this exploratory study, the One Button Tracker-a press-button device that records time stamps and durations of button presses-was used for self-tracking. A total of 13 employees of an academic medical center chose a personal research question and used the One Button Tracker to actively track specific subjectively experienced phenomena for 2 to 4 weeks. To assess usability and usefulness, we combined qualitative data from semistructured interviews with quantitative results from the System Usability Scale., Results: In total, 29 barriers and 15 facilitators for using the One Button Tracker were found. Ease of use was the most frequently mentioned facilitator. The One Button Tracker's usability received a median System Usability Scale score of 75.0 (IQR 42.50), which is considered as good usability. Participants experienced effects such as an increased awareness of the tracked phenomenon, a confirmation of personal knowledge, a gain of insight, and behavior change. Support and guidance during all stages of the self-tracking process were judged as valuable., Conclusions: The low-effort, in-the-moment self-tracking of subjectively experienced phenomena has been shown to support personal knowledge gain and health behavior change for people with an interest in health promotion. After addressing barriers and formally validating the collected data, self-tracking devices may well be helpful for additional user types or health questions., (©Tom H van de Belt, Aimee de Croon, Faye Freriks, Thomas Blomseth Christiansen, Jakob Eg Larsen, Martijn de Groot. Originally published in JMIR Formative Research (https://formative.jmir.org), 01.03.2022.)

International trade in plants and climate change are two of the main factors causing damaging tree pests (i.e. fungi and insects) to spread into new areas. To mitigate these risks, a large-scale assessment of tree-associated fungi and insects is needed. We present records of endophytic fungi and insects in twigs of 17 angiosperm and gymnosperm genera, from 51 locations in 32 countries worldwide. Endophytic fungi were characterized by high-throughput sequencing of 352 samples from 145 tree species in 28 countries. Insects were reared from 227 samples of 109 tree species in 18 countries and sorted into taxonomic orders and feeding guilds. Herbivorous insects were grouped into morphospecies and were identified using molecular and morphological approaches. This dataset reveals the diversity of tree-associated taxa, as it contains 12,721 fungal Amplicon Sequence Variants and 208 herbivorous insect morphospecies, sampled across broad geographic and climatic gradients and for many tree species. This dataset will facilitate applied and fundamental studies on the distribution of fungal endophytes and insects in trees., (© 2022. The Author(s).)

Objective: To compare the mental health experiences associated with coronavirus disease 2019 (COVID-19) in adults with and without diabetes., Research Design and Methods: Between 29 May 2020 and 30 June 2020, 2,176 U.S. adults completed an online survey including demographics, COVID-19 experiences, depression (eight-item Patient Health Questionnaire) and anxiety (seven-item Generalized Anxiety Disorder) symptoms, perceived stress (10-item Perceived Stress Scale), resilience (Brief Resilience Scale), and diabetes-related distress (in participants with diabetes) (17-item Diabetes Distress Scale)., Results: Mean age was 49.6 years (SD 16.9); participants were primarily women (80.0%) and White (88.3%), with an annual household income of ≥$60,000 (57.6%). One hundred reported a diagnosis of type 1 diabetes (4.6%), 304 type 2 diabetes (13.9%), and 145 prediabetes (6.6%). Nearly one-third (29.7%) indicated decreases in income attributable to the pandemic. Participants with type 1 diabetes had higher levels of diabetes distress than participants with type 2 diabetes (P < 0.05), with moderate severity in both groups. Participants with type 2 diabetes had significantly more comorbidities and COVID-19 risk factors than all other groups (all P < 0.01). After controlling for covariates, participants with type 2 diabetes reported significantly more depressive symptoms than those without diabetes (P < 0.05) and lower levels of resilience (P < 0.05). Subgroup analyses by sex and age indicated that women and younger adults, particularly those age 18-34 years, reported significantly more depression and anxiety symptoms, stress, and diabetes-related distress and lower levels of resilience than men and adults age ≥51 years., Conclusions: In this naturalistic observational study, participants with type 2 diabetes reported more depression, lower resilience, and significantly more COVID-19 risk factors and medical comorbidities than participants without diabetes. Overall, our participants demonstrated worse depression and anxiety symptoms during compared with before the pandemic., (© 2021 by the American Diabetes Association.)

To date, there has been no systematic examination of cross-cultural differences in group-based shame, guilt, and regret following wrongdoing. Using a community sample ( N = 1358), we examined people's reported experiences of shame, guilt, and regret following transgressions by themselves and by different identity groups (i.e., family, community, country) in Burkina Faso, Costa Rica, Indonesia, Japan, Jordan, the Netherlands, Poland, and the United States. We assessed whether any variation in this regard can be explained by the relative endorsement of individualistic or collectivistic values at the individual level and at the country level. Our findings suggest that people's reported experience of these emotions mostly depends on the transgression level. We also observe some variation across individuals and countries, which can be partially explained by the endorsement of collectivistic and individualistic values. The results highlight the importance of taking into account individual and cultural values when studying group-based emotions, as well as the identity groups involved in the transgression., Competing Interests: The authors declared no potential conflicts of interest., (© 2021 The Authors. European Journal of Social Psychology published by John Wiley & Sons Ltd.)

The COVID-19 pandemic caused a drastic drop in passenger air transport demand due to two forces: supply restriction and demand depression. In order for airlines to recover, the key is to identify which force they are fighting against. We propose a method for separating the two forces of COVID-19 and evaluating the respective impact on demand. Our method involves dividing passengers into different segments based on passenger characteristics, simulating different scenarios, and predicting demand for each passenger segment in each scenario. Comparing the predictions with each other and with the real situation, we quantify the impact of COVID-19 associated with the two forces, respectively. We apply our method to a dataset from Air France-KLM and show that from March 1st to May 31st 2020, the pandemic caused demand at the airline to drop 40.3% on average for passengers segmented based on age and purpose of travel. The 57.4% of this decline is due to demand depression, whereas the other 42.6% is due to supply restriction. In addition, we find that the impact of COVID-19 associated with each force varies between passenger segments. The demand depression force impacted business passengers between age 41 and 60 the most, and it impacted leisure passengers between age 20 and 40 the least. The opposite result holds for the supply restriction force. We give suggestions on how airlines can plan their recovery using our results and how other industries can use our evaluation method., (© 2021 The Authors. Decision Sciences published by Wiley Periodicals LLC on behalf of Decision Sciences Institute.)

To determine the effect of patient immigrant status on physician trainees' diabetes treatment decisions. Participants were 140 physician trainees ('providers'). Providers viewed videos and vignettes of virtual patients differing in immigrant status (born in Mexico or U.S.; other characteristics held constant). Analyses were completed at the group and individual levels. Providers were less likely to refer foreign-born (vs. U.S.-born) patients to endocrinology. Individual-level results showed an almost even split between treatment ratings for foreign-born vs. U.S.-born patients for three decisions (take no action, add oral hypoglycemic agent, add/switch to insulin), explaining why group-level differences for these ratings did not emerge (i.e., they were cancelled out). Physician trainees are less likely to refer foreign-born patients to endocrinology. Half of individual-level decisions were influenced by patient immigrant status, but group-level analyses mask these differences. Systematic treatment differences based on non-relevant factors could lead to adverse outcomes for immigrants., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The domestic cat (Felis silvestris catus) is a valued companion animal throughout the world. Over 60 different cat breeds are accepted for competition by the cat fancy registries in different countries. Genetic markers, including short tandem repeats and SNPs, are available to evaluate and manage levels of inbreeding and genetic diversity, population and breed structure relationships, and individual identification for forensic and registration purposes. The International Society of Animal Genetics (ISAG) hosts the Applied Genetics in Companion Animals Workshop, which supports the standardization of genetic marker panels and genotyping for the identification of cats via comparison testing. SNP panels have been in development for many species, including the domestic cat. An ISAG approved core panel of SNPs for use in cat identification and parentage analyses is presented. SNPs (n = 121) were evaluated by different university-based and commercial laboratories using 20 DNA samples as part of the ISAG comparison testing procedures. Different SNP genotyping technologies were examined, including DNA arrays, genotyping-by-sequencing and mass spectroscopy, to select a robust and efficient panel of 101 SNPs as the ISAG core panel for cats. The SNPs are distributed across all chromosomes including two on the X chromosome and an XY pseudo-autosomal sexing marker (zinc-finger XY; ZFXY). A population study demonstrated that the markers have an average polymorphic information content of 0.354 and a power of exclusion greater than 0.9999. The SNP panel should keep testing affordable while also allowing for the development of additional panels to monitor health, phenotypic traits, hybrid cats and highly inbred cats., (© 2021 The Authors. Animal Genetics published by John Wiley & Sons Ltd on behalf of Stichting International Foundation for Animal Genetics.)

For non-native tree species with an origin outside of Europe a detailed compilation of enemy species including the severity of their attack is lacking up to now. We collected information on native and non-native species attacking non-native trees, i.e. type, extent and time of first observation of damage for 23 important non-native trees in 27 European countries. Our database includes about 2300 synthesised attack records (synthesised per biotic threat, tree and country) from over 800 species. Insects (49%) and fungi (45%) are the main observed biotic threats, but also arachnids, bacteria including phytoplasmas, mammals, nematodes, plants and viruses have been recorded. This information will be valuable to identify patterns and drivers of attacks, and trees with a lower current health risk to be considered for planting. In addition, our database will provide a baseline to which future impacts on non-native tree species could be compared with and thus will allow to analyse temporal trends of impacts., (© 2021. The Author(s).)

Purpose: Expansions of a subset of short tandem repeats (STRs) have been implicated in approximately 30 different human genetic disorders. Despite extensive application of exome sequencing (ES) in routine diagnostic genetic testing, STRs are not routinely identified from these data., Methods: We assessed diagnostic utility of STR analysis in exome sequencing by applying ExpansionHunter to 2,867 exomes from movement disorder patients and 35,228 other clinical exomes., Results: We identified 38 movement disorder patients with a possible aberrant STR length. Validation by polymerase chain reaction (PCR) and/or repeat-primed PCR technologies confirmed the presence of aberrant expansion alleles for 13 (34%). For seven of these patients the genotype was compatible with the phenotypic description, resulting in a molecular diagnosis. We subsequently tested the remainder of our diagnostic ES cohort, including over 30 clinically and genetically heterogeneous disorders. Optimized manual curation yielded 167 samples with a likely aberrant STR length. Validations confirmed 93/167 (56%) aberrant expansion alleles, of which 48 were in the pathogenic range and 45 in the premutation range., Conclusion: Our work provides guidance for the implementation of STR analysis in clinical ES. Our results show that systematic STR evaluation may increase diagnostic ES yield by 0.2%, and recommend making STR evaluation a routine part of ES interpretation in genetic testing laboratories., (© 2021. The Author(s), under exclusive licence to the American College of Medical Genetics and Genomics.)

This work presents a single-step deep-learning framework for longitudinal image analysis, coined Segis-Net. To optimally exploit information available in longitudinal data, this method concurrently learns a multi-class segmentation and nonlinear registration. Segmentation and registration are modeled using a convolutional neural network and optimized simultaneously for their mutual benefit. An objective function that optimizes spatial correspondence for the segmented structures across time-points is proposed. We applied Segis-Net to the analysis of white matter tracts from N=8045 longitudinal brain MRI datasets of 3249 elderly individuals. Segis-Net approach showed a significant increase in registration accuracy, spatio-temporal segmentation consistency, and reproducibility compared with two multistage pipelines. This also led to a significant reduction in the sample-size that would be required to achieve the same statistical power in analyzing tract-specific measures. Thus, we expect that Segis-Net can serve as a new reliable tool to support longitudinal imaging studies to investigate macro- and microstructural brain changes over time., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objectives: To assess non-invasive imaging for detection and quantification of gland structure, inflammation and function in patients with primary Sjogren's syndrome (pSS) using PET-CT with 11C-Methionine (11C-MET; radiolabelled amino acid), and 18F-fluorodeoxyglucose (18F-FDG; glucose uptake marker), to assess protein synthesis and inflammation, respectively; multiparametric MRI evaluated salivary gland structural and physiological changes., Methods: In this imaging/clinical/histology comparative study (GSK study 203818; NCT02899377) patients with pSS and age- and sex-matched healthy volunteers underwent MRI of the salivary glands and 11C-MET PET-CT. Patients also underwent 18F-FDG PET-CT and labial salivary gland biopsies. Clinical and biomarker assessments were performed. Primary endpoints were semi-quantitative parameters of 11C-MET and 18F-FDG uptake in submandibular and parotid salivary glands and quantitative MRI measures of structure and inflammation. Clinical and minor salivary gland histological parameter correlations were explored., Results: Twelve patients with pSS and 13 healthy volunteers were included. Lower 11C-MET uptake in parotid, submandibular and lacrimal glands, lower submandibular gland volume, higher MRI fat fraction, and lower pure diffusion in parotid and submandibular glands were observed in patients vs healthy volunteer, consistent with reduced synthetic function. Disease duration correlated positively with fat fraction and negatively with 11C-MET and 18F-FDG uptake, consistent with impaired function, inflammation and fatty replacement over time. Lacrimal gland 11C-MET uptake positively correlated with tear flow in patients, and parotid gland 18F-FDG uptake positively correlated with salivary gland CD20+ B-cell infiltration., Conclusion: Molecular imaging and MRI may be useful tools to non-invasively assess loss of glandular function, increased glandular inflammation and fat accumulation in pSS., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology.)