Search

A reduced-order position observer with stator-resistance adaptation is proposed for motion-sensorless permanent-magnet synchronous motor drives. A general analytical solution for the stabilizing observer gain and stability conditions for the stator-resistance adaptation are derived. Under these conditions, the local stability of the position and stator-resistance estimation is guaranteed at every operating point except the zero frequency, if other motor parameters are known. Furthermore, the effect of inaccurate model parameters on the local stability of the position estimation is studied, and an observer gain design that makes the observer robust is proposed. The proposed observer is experimentally tested using a 2.2-kW motor drive; stable operation at very low speeds under different loading conditions is demonstrated. [ABSTRACT FROM AUTHOR]

Carabid beetles were sampled by pitfall traps in May–September 2002 and 2003 in an experimental organic strawberry field in seven different mulching row treatments and in fescue-growing row spaces to determine the effect of mulches on carabid activity–density and species composition. There were no differences between treatments or row spaces in total numbers of all carabid species in either season. Of the 67 identified species and 4374 individuals, the most trapped ones were Clivina fossor (11.7% of total catch), Dyschirius globosus (10.2%), Patrobus atrorufus (9.3%), Pterostichus niger (8.8%), Bembidion properans (7.4%), Pterostichus melanarius (6.0%), Bembidion lampros (5.7%), Pterostichus crenatus (5.7%), Amara communis (4.1%), Trechus secalis (3.9%), Pterostichus strenuus (3.9%), Loricera pilicornis (3.1%), Harpalus rufipes (2.8%) and Carabus nemoralis (2.6%). Large carabid species P. niger and P. melanarius were trapped more in all mulched rows than in row spaces, and C. nemoralis was trapped more in the mixture of pine woodchip/buckwheat husk mulch than in row spaces, barley straw and birch woodchip mulch. The small but abundant species P. atrorufus was trapped more in buckwheat husk mulch than in row spaces and B. properans in row spaces than in buckwheat husk mulch. H. rufipes, being also a pest in strawberry, was trapped more in cut grass mulch than in row spaces. The Shannon H′ diversity index was significantly higher in the mixture of pine woodchip/buckwheat husk mulch than in black plastic, buckwheat husk mulch or in row spaces, and in birch woodchip and cut grass mulches than in row spaces. The results of trapping studies show the species preference to the specific mulches, and reflect positive or negative effect of mulches on carabid diversity with consequences to plant protection. [ABSTRACT FROM AUTHOR]

Lacewing overwintering chambers placed correctly in the field may be colonized by large numbers of adult common green lacewings (Chrysoperla carnea). This paper reports field results collected over 2 years from chambers placed in a number of European locations. Considerable variation was found in the success rates of the chambers from different areas and some suggestions are made as to why this might be. An experiment was conducted to investigate the potential use of overwintered lacewings in pest control. This attempt was not successful and possible reasons why are discussed. [ABSTRACT FROM AUTHOR]

Overlapping symptoms between Alzheimer's disease (AD), behavioral variant of frontotemporal dementia (bvFTD), and schizophrenia (SZ) can lead to misdiagnosis and delays in appropriate treatment, especially in cases of early-onset dementia. To determine the potential of brain signal variability as a diagnostic tool, we assessed the coefficient of variation of the BOLD signal (CV BOLD ) in 234 participants spanning bvFTD (n = 53), AD (n = 17), SZ (n = 23), and controls (n = 141). All underwent functional and structural MRI scans. Data unveiled a notable increase in CV BOLD in bvFTD patients across both datasets (local and international, p < 0.05), revealing an association with clinical scores (CDR and MMSE, r = 0.46 and r = -0.48, p < 0.0001). While SZ and control group demonstrated no significant differences, a comparative analysis between AD and bvFTD patients spotlighted elevated CV BOLD in the frontopolar cortices for the latter (p < 0.05). Furthermore, CV BOLD not only presented excellent diagnostic accuracy for bvFTD (AUC 0.78-0.95) but also showcased longitudinal repeatability. During a one-year follow-up, the CV BOLD levels increased by an average of 35% in the bvFTD group, compared to a 2% increase in the control group (p < 0.05). Our findings suggest that CV BOLD holds promise as a biomarker for bvFTD, offering potential for monitoring disease progression and differentiating bvFTD from AD and SZ., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Leadership competence is increasingly recognized as a critical priority for all physicians, but new graduates often feel only partially prepared for leadership roles. However, integrating more leadership education into the already saturated medical curriculum poses challenges regarding timing and implementation. This study explores this issue by comparing perceptions of medical students during their academic journey to determine if leadership education could begin at the onset of medical studies., Methods: In 2021, internet-based questionnaires were administered to first- and final-year medical students at the University of Oulu, Finland. Participation rates were 100% (116/116) for first-year students and 98% (107/109) for final-year students. Responses to the open-ended question, "How should physicians be led?" were analyzed using qualitative inductive content analysis with thematization., Results: The study identified three main thematic categories common to both groups: (1) traits, (2) leadership approach, and (3) healthcare culture. The theme of leadership approach was further divided into two subcategories: science-oriented leadership based on practice approach and goal-oriented leadership with support as needed. The theme of traits was divided into seven subcategories: education, role model, communication, empowerment, ethics, autonomy, and collegiality. No notable differences emerged between the two groups., Conclusions: Consistent perceptions about physician leadership throughout medical education suggest that leadership education could commence from the first year. It can thus be integrated throughout the existing longitudinal learning of the medical curriculum. Integration into the existing curriculum could facilitate the development of leadership skills without extending the curriculum's content., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Huikko-Tarvainen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Risk stratification scores such as the European Systematic COronary Risk Evaluation (SCORE) are used to guide individuals on cardiovascular disease (CVD) prevention. Adding high-sensitivity troponin I (hsTnI) to such risk scores has the potential to improve accuracy of CVD prediction. We investigated how applying hsTnI in addition to SCORE may impact management, outcome, and cost-effectiveness., Methods: Characteristics of 72,190 apparently healthy individuals from the Biomarker for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project were included into a discrete-event simulation comparing two strategies for assessing CVD risk. The standard strategy reflecting current practice employed SCORE (SCORE); the alternative strategy involved adding hsTnI information for further stratifying SCORE risk categories (S-SCORE). Individuals were followed over ten years from baseline examination to CVD event, death or end of follow-up. The model tracked the occurrence of events and calculated direct costs of screening, prevention, and treatment from a European health system perspective. Cost-effectiveness was expressed as incremental cost-effectiveness ratio (ICER) in € per quality-adjusted life year (QALYs) gained during 10 years of follow-up. Outputs were validated against observed rates, and results were tested in deterministic and probabilistic sensitivity analyses., Results: S-SCORE yielded a change in management for 10.0% of individuals, and a reduction in CVD events (4.85% vs. 5.38%, p<0.001) and mortality (6.80% vs. 7.04%, p<0.001). S-SCORE led to 23 (95%CI: 20-26) additional event-free years and 7 (95%CI: 5-9) additional QALYs per 1,000 subjects screened, and resulted in a relative risk reduction for CVD of 9.9% (95%CI: 7.3-13.5%) with a number needed to screen to prevent one event of 183 (95%CI: 172 to 203). S-SCORE increased costs per subject by 187€ (95%CI: 177 € to 196 €), leading to an ICER of 27,440€/QALY gained. Sensitivity analysis was performed with eligibility for treatment being the most sensitive., Conclusion: Adding a person's hsTnI value to SCORE can impact clinical decision making and eventually improves QALYs and is cost-effective compared to CVD prevention strategies using SCORE alone. Stratifying SCORE risk classes for hsTnI would likely offer cost-effective alternatives, particularly when targeting higher risk groups., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: PJ and IG are fulltime employees of Abbott Diagnostics, one of the providers of diagnostic tests and the assay used in this study. This does not alter our adherence to PLOS ONE policies on sharing data and materials. NM reports conference fees from Abbott Laboratories. SB has received research funding from Abbott, Abbott Diagnostics, Bayer, Boehringer Ingelheim, Siemens, and ThermoFisher; honoraria for lectures from Abbott, Abbott Diagnostics, AstraZeneca, Bayer, Boehringer Ingelheim, Medtronic, Pfizer, Roche, Siemens Diagnostics, Siemens, and ThermoFisher; and honoraria for advisory board memberships and consulting for Boehringer Ingelheim, Bayer, Novartis, Roche, and ThermoFisher. TZ and SB are listed as co-inventor of an international patent on the use of a computing device to estimate the probability of myocardial infarction (International Publication Number WO2022043229A1). TZ is shareholder of the ART.EMIS GmbH Hamburg. VS has had research collaboration with Bayer Ltd (outside the present study). SS reports consultancy and speakers honoraria from Actelion Ltd (unrelated to the present study). All other authors have declared that no competing interests exist., (Copyright: © 2024 Jülicher et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Sleep increases brain fluid transport and the power of pulsations driving the fluids. We investigated how sleep deprivation or electrophysiologically different stages of non-rapid-eye-movement (NREM) sleep affect the human brain pulsations., Methods: Fast functional magnetic resonance imaging (fMRI) was performed in healthy subjects ( n  = 23) with synchronous electroencephalography (EEG), that was used to verify arousal states (awake, N1 and N2 sleep). Cardiorespiratory rates were verified with physiological monitoring. Spectral power analysis assessed the strength, and spectral entropy assessed the stability of the pulsations., Results: In N1 sleep, the power of vasomotor (VLF < 0.1 Hz), but not cardiorespiratory pulsations, intensified after sleep deprived vs. non-sleep deprived subjects. The power of all three pulsations increased as a function of arousal state (N2 > N1 > awake) encompassing brain tissue in both sleep stages, but extra-axial CSF spaces only in N2 sleep. Spectral entropy of full band and respiratory pulsations decreased most in N2 sleep stage, while cardiac spectral entropy increased in ventricles., Discussion: In summary, the sleep deprivation and sleep depth, both increase the power and harmonize the spectral content of human brain pulsations., 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., (Copyright © 2023 Helakari, Järvelä, Väyrynen, Tuunanen, Piispala, Kallio, Ebrahimi, Poltojainen, Kananen, Elabasy, Huotari, Raitamaa, Tuovinen, Korhonen, Nedergaard and Kiviniemi.)

Data on the transfer of elements (such as heavy metals) and their radionuclides into organisms is needed for assessing environmental risks. The current data on many elements, species and environments is limited, but more information can be obtained both from field studies and experimental laboratory studies. However, it is essential to evaluate whether experimental studies adequately predict transfer in natural conditions. Moreover, because of the sparsity of species-specific empirical data, it is a common practice in current radioecological modelling to use data available for related species under the assumption that transfer into organisms is similar within broader taxonomic groups. Earthworms and ground beetles are examples of important invertebrates living near soil surface in terrestrial ecosystems. In this study, the transfer of 34 elements from soil to these organisms was studied in a field study conducted in boreal forest. The earthworm concentrations were compared to the values obtained in an experimental mesocosm study using soil from the field site and were found to be highly correlated. This indicates that the results of mesocosm studies can be used for predicting the transfer of elements from soil to fauna in natural conditions. Furthermore, concentrations in individual earthworm and beetle species were found to be similar to those observed in broader groups of related species, indicating that the generic approach used in current radioecological models may be useful for predicting uptake of elements into single species., (© 2023. The Author(s).)

Background: Digitalisation is rapidly changing health care processes and the health care sector, thus increasing the need to improve the digital competence of future health care professionals., Purpose: The aim of this study was to describe the attitudes of medical and nursing students towards digital health based on self-evaluation as well as to compare the differences in perceptions between the two student groups., Methods: A cross-sectional study was conducted as an online survey using the Webropol in April 2021 at the University of Oulu and Oulu University of Applied Sciences in Finland. The survey questionnaire consisted of seven background questions and 16 statements on a five-point Likert scale (fully disagree to fully agree) to survey student attitudes towards eHealth, and their digital capabilities., Results: A total of 250 medical and nursing students were invited to participate in the study and 170 of them took the survey (response rate 68 %). Of those answered, 38 % (n = 64) were nursing and 32 % (n = 106) medical students. Students generally had a positive attitude towards eHealth and health care digitalisation. The differences in perceptions and preparedness between medical and nursing students were surprisingly small in the two student groups. There was a statistically significant difference between the two groups in three out of 16 statements: these were related to changes in the roles of health care professionals and patients as well as the students' knowledge of information contained in the national patient portal., Conclusions: The results of this study provide a good starting point for further harmonisation of the curriculum for both health professional groups regarding the teaching of eHealth and telemedicine., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The employer of Paula Veikkolainen, Timo Tuovinen and Jarmo Reponen received support for salaries from the MEDigi project financed by Finnish Ministry of Education and Culture [MEDigi OKM/270/523/2017]. Otherwise, the authors declare that they have no other known competing financial interests or personal relationships that may have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Respiratory brain pulsations have recently been shown to drive electrophysiological brain activity in patients with epilepsy. Furthermore, functional neuroimaging indicates that respiratory brain pulsations have increased variability and amplitude in patients with epilepsy compared to healthy individuals. To determine whether the respiratory drive is altered in epilepsy, we compared respiratory brain pulsation synchronicity between healthy controls and patients. Whole brain fast functional magnetic resonance imaging was performed on 40 medicated patients with focal epilepsy, 20 drug-naïve patients and 102 healthy controls. Cerebrospinal fluid associated respiratory pulsations were used to generate individual whole brain respiratory synchronization maps, which were compared between groups. Finally, we analyzed the seizure frequency effect and diagnostic accuracy of the respiratory synchronization defect in epilepsy. Respiratory brain pulsations related to the verified fourth ventricle pulsations were significantly more synchronous in patients in frontal, periventricular and mid-temporal regions, while the seizure frequency correlated positively with synchronicity. The respiratory brain synchronicity had a good diagnostic accuracy (ROC AUC  = 0.75) in discriminating controls from medicated patients. The elevated respiratory brain synchronicity in focal epilepsy suggests altered physiological effect of cerebrospinal fluid pulsations possibly linked to regional brain water dynamics involved with interictal brain physiology.

Primary central nervous system lymphoma (PCNSL) is an aggressive brain disease where lymphocytes invade along perivascular spaces of arteries and veins. The invasion markedly changes (peri)vascular structures but its effect on physiological brain pulsations has not been previously studied. Using physiological magnetic resonance encephalography (MREG BOLD ) scanning, this study aims to quantify the extent to which (peri)vascular PCNSL involvement alters the stability of physiological brain pulsations mediated by cerebral vasculature. Clinical implications and relevance were explored. In this study, 21 PCNSL patients (median 67y; 38% females) and 30 healthy age-matched controls (median 63y; 73% females) were scanned for MREG BOLD signal during 2018-2021. Motion effects were removed. Voxel-by-voxel Coefficient of Variation (CV) maps of MREG BOLD signal was calculated to examine the stability of physiological brain pulsations. Group-level differences in CV were examined using nonparametric covariate-adjusted tests. Subject-level CV alterations were examined against control population Z-score maps wherein clusters of increased CV values were detected. Spatial distributions of clusters and findings from routine clinical neuroimaging were compared [contrast-enhanced, diffusion-weighted, fluid-attenuated inversion recovery (FLAIR) data]. Whole-brain mean CV was linked to short-term mortality with 100% sensitivity and 100% specificity, as all deceased patients revealed higher values (n = 5, median 0.055) than surviving patients (n = 16, median 0.028) (p < .0001). After adjusting for medication, head motion, and age, patients revealed higher CV values (group median 0.035) than healthy controls (group median 0.024) around arterial territories (p ≤ .001). Abnormal clusters (median 1.10 × 10 5 mm 3 ) extended spatially beyond FLAIR lesions (median 0.62 × 10 5 mm 3 ) with differences in volumes (p = .0055)., (© 2022 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.)

Background: eHealth increasingly affects the delivery of health care around the world and the quest for more efficient health systems. In Finland, the development of eHealth maturity has been systematically studied since 2003, through surveys conducted every 3 years. It has also been monitored in several international studies. The indicators used in these studies examined the availability of the electronic patient record, picture archiving and communication system, health information exchange, and other key eHealth functionalities., Objective: The first aim is to study the national development in the maturity level of eHealth in primary health care and specialized care between 2011 and 2020 in Finland. The second aim is to clarify the regional differences in the maturity level of eHealth among Finnish hospital districts in 2020., Methods: Data for this study were collected in 2011, 2014, 2017, and 2020, using web-based questionnaires from the Use of information and communication technology surveys in Finnish health care project. In total, 16 indicators were selected to describe the status of eHealth, and they were based on international eHealth studies and Finnish eHealth surveys in 3 areas: applications, regional integration, and data security and information and communications technology skills. The indicators remain the same in all the study years; therefore, the results are comparable., Results: All the specialized care organizations (21/21, 100%) in 2011, 2014, 2017, and 2020 participated in the study. The response rate among primary health care organizations was 86.3% (139/161) in 2011, 88.2% (135/153) in 2014, 85.8% (121/141) in 2017, and 95.6% (130/136) in 2020. At the national level, the biggest developments in eHealth maturity occurred between 2011 and 2014. The development has since continued, and some indicators have been saturated. Primary health care lags behind specialized care organizations, as measured by all the indicators and throughout the period under review. Regionally, there are differences among different types of organizations., Conclusions: eHealth maturity has steadily progressed in Finland nationally, and its implementation has also been promoted through various national strategies and legislative changes. Some eHealth indicators have already been saturated and achieved an intensity of use rate of 100%. However, the scope for development remains, especially in primary health care. As Finland has long been a pioneer in the digitalization of health care, the results of this study show that the functionalities of eHealth will be adopted in stages, and deployment will take time; therefore, national eHealth strategies and legislative changes need to be implemented in a timely manner. The comprehensive sample size used in this study allows a regional comparison in the country, compared with previous country-specific international studies., (©Jari Haverinen, Niina Keränen, Timo Tuovinen, Ronja Ruotanen, Jarmo Reponen. Originally published in JMIR Medical Informatics (https://medinform.jmir.org), 12.08.2022.)

The physiological underpinnings of the necessity of sleep remain uncertain. Recent evidence suggests that sleep increases the convection of cerebrospinal fluid (CSF) and promotes the export of interstitial solutes, thus providing a framework to explain why all vertebrate species require sleep. Cardiovascular, respiratory and vasomotor brain pulsations have each been shown to drive CSF flow along perivascular spaces, yet it is unknown how such pulsations may change during sleep in humans. To investigate these pulsation phenomena in relation to sleep, we simultaneously recorded fast fMRI, magnetic resonance encephalography (MREG), and electroencephalography (EEG) signals in a group of healthy volunteers. We quantified sleep-related changes in the signal frequency distributions by spectral entropy analysis and calculated the strength of the physiological (vasomotor, respiratory, and cardiac) brain pulsations by power sum analysis in 15 subjects (age 26.5 ± 4.2 years, 6 females). Finally, we identified spatial similarities between EEG slow oscillation (0.2-2 Hz) power and MREG pulsations. Compared with wakefulness, nonrapid eye movement (NREM) sleep was characterized by reduced spectral entropy and increased brain pulsation intensity. These effects were most pronounced in posterior brain areas for very low-frequency (≤0.1 Hz) vasomotor pulsations but were also evident brain-wide for respiratory pulsations, and to a lesser extent for cardiac brain pulsations. There was increased EEG slow oscillation power in brain regions spatially overlapping with those showing sleep-related MREG pulsation changes. We suggest that reduced spectral entropy and enhanced pulsation intensity are characteristic of NREM sleep. With our findings of increased power of slow oscillation, the present results support the proposition that sleep promotes fluid transport in human brain. SIGNIFICANCE STATEMENT We report that the spectral power of physiological brain pulsation mechanisms driven by vasomotor, respiration, and cardiac rhythms in human brain increase during sleep, extending previous observations of their association with glymphatic brain clearance during sleep in rodents. The magnitudes of increased pulsations follow the rank order of vasomotor greater than respiratory greater than cardiac pulsations, with correspondingly declining spatial extents. Spectral entropy, previously known as vigilance and as an anesthesia metric, decreased during NREM sleep compared with the awake state in very low and respiratory frequencies, indicating reduced signal complexity. An EEG slow oscillation power increase occurring in the early sleep phase (NREM 1-2) spatially overlapped with pulsation changes, indicating reciprocal mechanisms between those measures., (Copyright © 2022 Helakari et al.)

The physiological pulsations that drive tissue fluid homeostasis are not well characterized during brain activation. Therefore, we used fast magnetic resonance encephalography (MREG) fMRI to measure full band (0-5 Hz) blood oxygen level-dependent (BOLD FB ) signals during a dynamic visual task in 23 subjects. This revealed brain activity in the very low frequency (BOLD VLF ) as well as in cardiac and respiratory bands. The cardiovascular hemodynamic envelope (CHe) signal correlated significantly with the visual BOLD VLF response, considered as an independent signal source in the V1-V2 visual cortices. The CHe preceded the canonical BOLD VLF response by an average of 1.3 (± 2.2) s. Physiologically, the observed CHe signal could mark increased regional cardiovascular pulsatility following vasodilation., 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., (Copyright © 2022 Huotari, Tuunanen, Raitamaa, Raatikainen, Kananen, Helakari, Tuovinen, Järvelä, Kiviniemi and Korhonen.)

Accumulation of amyloid-β is a key neuropathological feature in brain of Alzheimer's disease patients. Alterations in cerebral haemodynamics, such as arterial impulse propagation driving the (peri)vascular CSF flux, predict future Alzheimer's disease progression. We now present a non-invasive method to quantify the three-dimensional propagation of cardiovascular impulses in human brain using ultrafast 10 Hz magnetic resonance encephalography. This technique revealed spatio-temporal abnormalities in impulse propagation in Alzheimer's disease. The arrival latency and propagation speed both differed in patients with Alzheimer's disease. Our mapping of arterial territories revealed Alzheimer's disease-specific modifications, including reversed impulse propagation around the hippocampi and in parietal cortical areas. The findings imply that pervasive abnormality in (peri)vascular CSF impulse propagation compromises vascular impulse propagation and subsequently glymphatic brain clearance of amyloid-β in Alzheimer's disease., (© The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain.)

Biomarkers sensitive to prodromal or early pathophysiological changes in Alzheimer's disease (AD) symptoms could improve disease detection and enable timely interventions. Changes in brain hemodynamics may be associated with the main clinical AD symptoms. To test this possibility, we measured the variability of blood oxygen level-dependent (BOLD) signal in individuals from three independent datasets (totaling 80 AD patients and 90 controls). We detected a replicable increase in brain BOLD signal variability in the AD populations, which constituted a robust biomarker for clearly differentiating AD cases from controls. Fast BOLD scans showed that the elevated BOLD signal variability in AD arises mainly from cardiovascular brain pulsations. Manifesting in abnormal cerebral perfusion and cerebrospinal fluid convection, present observation presents a mechanism explaining earlier observations of impaired glymphatic clearance associated with AD in humans.

Resting-state functional MRI has shown potential for detecting changes in cerebral blood oxygen level-dependent signal in patients with epilepsy, even in the absence of epileptiform activity. Furthermore, it has been suggested that coefficient of variation mapping of fast functional MRI signal may provide a powerful tool for the identification of intrinsic brain pulsations in neurological diseases such as dementia, stroke and epilepsy. In this study, we used fast functional MRI sequence (magnetic resonance encephalography) to acquire ten whole-brain images per second. We used the functional MRI data to compare physiological brain pulsations between healthy controls ( n  = 102) and patients with epilepsy ( n  = 33) and furthermore to drug-naive seizure patients ( n  = 9). Analyses were performed by calculating coefficient of variation and spectral power in full band and filtered sub-bands. Brain pulsations in the respiratory-related frequency sub-band (0.11-0.51 Hz) were significantly ( P  <   0.05) increased in patients with epilepsy, with an increase in both signal variance and power. At the individual level, over 80% of medicated and drug-naive seizure patients exhibited areas of abnormal brain signal power that correlated well with the known clinical diagnosis, while none of the controls showed signs of abnormality with the same threshold. The differences were most apparent in the basal brain structures, respiratory centres of brain stem, midbrain and temporal lobes. Notably, full-band, very low frequency (0.01-0.1 Hz) and cardiovascular (0.8-1.76 Hz) brain pulses showed no differences between groups. This study extends and confirms our previous results of abnormal fast functional MRI signal variance in epilepsy patients. Only respiratory-related brain pulsations were clearly increased with no changes in either physiological cardiorespiratory rates or head motion between the subjects. The regional alterations in brain pulsations suggest that mechanisms driving the cerebrospinal fluid homeostasis may be altered in epilepsy. Magnetic resonance encephalography has both increased sensitivity and high specificity for detecting the increased brain pulsations, particularly in times when other tools for locating epileptogenic areas remain inconclusive., (© The Author(s) (2020). Published by Oxford University Press on behalf of the Guarantors of Brain.)

Background: Physiological brain pulsations have been shown to play a critical role in maintaining interstitial homeostasis in the glymphatic brain clearance mechanism. We investigated whether psychotic symptomatology is related to the physiological variation of the human brain using fMRI., Methods: The participants (N = 277) were from the Northern Finland Birth Cohort 1986. Psychotic symptoms were evaluated with the Positive Symptoms Scale of the Structured Interview for Prodromal Syndromes (SIPS). We used the coefficient of variation of BOLD signal (CV BOLD ) as a proxy for physiological brain pulsatility. The CV BOLD -analyses were controlled for motion, age, sex, and educational level. The results were also compared with fMRI and voxel-based morphometry (VBM) meta-analyses of schizophrenia patients (data from the Brainmap database)., Results: At the global level, participants with psychotic-like symptoms had higher CV BOLD in cerebrospinal fluid (CSF) and white matter (WM), when compared to participants with no psychotic symptoms. Voxel-wise analyses revealed that CV BOLD was increased, especially in periventricular white matter, basal ganglia, cerebellum and parts of the cortical structures. Those brain regions, which included alterations of physiological fluctuation in symptomatic psychosis risk, overlapped <6% with the regions that were found to be affected in the meta-analyses of previous fMRI and VBM studies in schizophrenia patients. Motion did not vary as a function of SIPS., Conclusions: Psychotic-like symptoms were associated with elevated CV BOLD in a variety of brain regions. The CV BOLD findings may produce new information about cerebral physiological fluctuations that have been out of reach in previous fMRI and VBM studies., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Previously, schizophrenia is found to be related to the variability of the functional magnetic resonance imaging (fMRI) signal in the white matter. However, evidence about the relationship between genetic vulnerabilities and physiological fluctuation in the brain is lacking. We investigated whether familial risk for psychosis (FR) and polygenic risk score for schizophrenia (PRS) are linked with physiological fluctuation in fMRI data. We used data from the Oulu Brain and Mind study (n = 140-149, aged 20-24 years) that is a substudy of the Northern Finland Birth Cohort 1986. The participants underwent a resting-state fMRI scan. Coefficient of variation (CV) of blood oxygen level dependent (BOLD) signal (CV BOLD ) was used as a proxy of physiological fluctuation in the brain. Familial risk was defined to be present if at least one parent had been diagnosed with psychosis previously. PRS was computed based on the results of the prior GWAS by the Schizophrenia Working Group. FR or PRS were not associated with CV BOLD in cerebrospinal fluid, white matter, or grey matter. The findings did not provide evidence for the previous suggestions that genetic vulnerabilities for schizophrenia become apparent in alterations of the variation of the BOLD signal in the brain., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The brain is cleaned from waste by glymphatic clearance serving a similar purpose as the lymphatic system in the rest of the body. Impairment of the glymphatic brain clearance precedes protein accumulation and reduced cognitive function in Alzheimer's disease (AD). Cardiovascular pulsations are a primary driving force of the glymphatic brain clearance. We developed a method to quantify cardiovascular pulse propagation in the human brain with magnetic resonance encephalography (MREG). We extended a standard optical flow estimation method to three spatial dimensions, with a multi-resolution processing scheme. We added application-specific criteria for discarding inaccurate results. With the proposed method, it is now possible to estimate the propagation of cardiovascular pulse wavefronts from the whole brain MREG data sampled at 10 Hz. The results show that on average the cardiovascular pulse propagates from major arteries via cerebral spinal fluid spaces into all tissue compartments in the brain. We present an example, that cardiovascular pulsations are significantly altered in AD: coefficient of variation and sample entropy of the pulse propagation speed in the lateral ventricles change in AD. These changes are in line with the theory of glymphatic clearance impairment in AD. The proposed non-invasive method can assess a performance indicator related to the glymphatic clearance in the human brain.

Low image sampling rates used in resting state functional magnetic resonance imaging (rs-fMRI) may cause aliasing of the cardiorespiratory pulsations over the very low frequency (VLF) BOLD signal fluctuations which reflects to functional connectivity (FC). In this study, we examine the effect of sampling rate on currently used rs-fMRI FC metrics. Ultra-fast fMRI magnetic resonance encephalography (MREG) data, sampled with TR 0.1 s, was downsampled to different subsampled repetition times (sTR, range 0.3-3 s) for comparisons. Echo planar k-space sampling (TR 2.15 s) and interleaved slice collection schemes were also compared against the 3D single shot trajectory at 2.2 s sTR. The quantified connectivity metrics included stationary spatial, time, and frequency domains, as well as dynamic analyses. Time domain methods included analyses of seed-based functional connectivity, regional homogeneity (ReHo), coefficient of variation, and spatial domain group level probabilistic independent component analysis (ICA). In frequency domain analyses, we examined fractional and amplitude of low frequency fluctuations. Aliasing effects were spatially and spectrally analyzed by comparing VLF (0.01-0.1 Hz), respiratory (0.12-0.35 Hz) and cardiac power (0.9-1.3 Hz) FFT maps at different sTRs. Quasi-periodic pattern (QPP) of VLF events were analyzed for effects on dynamic FC methods. The results in conventional time and spatial domain analyses remained virtually unchanged by the different sampling rates. In frequency domain, the aliasing occurred mainly in higher sTR (1-2 s) where cardiac power aliases over respiratory power. The VLF power maps suffered minimally from increasing sTRs. Interleaved data reconstruction induced lower ReHo compared to 3D sampling ( p < 0.001). Gradient recalled echo-planar imaging (EPI BOLD) data produced both better and worse metrics. In QPP analyses, the repeatability of the VLF pulse detection becomes linearly reduced with increasing sTR. In conclusion, the conventional resting state metrics (e.g., FC, ICA) were not markedly affected by different TRs (0.1-3 s). However, cardiorespiratory signals showed strongest aliasing in central brain regions in sTR 1-2 s. Pulsatile QPP and other dynamic analyses benefit linearly from short TR scanning.

Introduction: Functional magnetic resonance imaging (fMRI) combined with simultaneous electroencephalography (EEG-fMRI) has become a major tool in mapping epilepsy sources. In the absence of detectable epileptiform activity, the resting state fMRI may still detect changes in the blood oxygen level-dependent signal, suggesting intrinsic alterations in the underlying brain physiology., Methods: In this study, we used coefficient of variation (CV) of critically sampled 10 Hz ultra-fast fMRI (magnetoencephalography, MREG) signal to compare physiological variance between healthy controls (n = 10) and patients (n = 10) with drug-resistant epilepsy (DRE)., Results: We showed highly significant voxel-level (p < 0.01, TFCE-corrected) increase in the physiological variance in DRE patients. At individual level, the elevations range over three standard deviations (σ) above the control mean (μ) CV MREG values solely in DRE patients, enabling patient-specific mapping of elevated physiological variance. The most apparent differences in group-level analysis are found on white matter, brainstem, and cerebellum. Respiratory (0.12-0.4 Hz) and very-low-frequency (VLF = 0.009-0.1 Hz) signal variances were most affected., Conclusions: The CV MREG increase was not explained by head motion or physiological cardiorespiratory activity, that is, it seems to be linked to intrinsic physiological pulsations. We suggest that intrinsic brain pulsations play a role in DRE and that critically sampled fMRI may provide a powerful tool for their identification., (© 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.)

Chemotherapy aided by opening of the blood-brain barrier with intra-arterial infusion of hyperosmolar mannitol improves the outcome in primary central nervous system lymphoma. Proper opening of the blood-brain barrier is crucial for the treatment, yet there are no means available for its real-time monitoring. The intact blood-brain barrier maintains a mV-level electrical potential difference between blood and brain tissue, giving rise to a measurable electrical signal at the scalp. Therefore, we used direct-current electroencephalography (DC-EEG) to characterize the spatiotemporal behavior of scalp-recorded slow electrical signals during blood-brain barrier opening. Nine anesthetized patients receiving chemotherapy were monitored continuously during 47 blood-brain barrier openings induced by carotid or vertebral artery mannitol infusion. Left or right carotid artery mannitol infusion generated a strongly lateralized DC-EEG response that began with a 2 min negative shift of up to 2000 μV followed by a positive shift lasting up to 20 min above the infused carotid artery territory, whereas contralateral responses were of opposite polarity. Vertebral artery mannitol infusion gave rise to a minimally lateralized and more uniformly distributed slow negative response with a posterior-frontal gradient. Simultaneously performed near-infrared spectroscopy detected a multiphasic response beginning with mannitol-bolus induced dilution of blood and ending in a prolonged increase in the oxy/deoxyhemoglobin ratio. The pronounced DC-EEG shifts are readily accounted for by opening and sealing of the blood-brain barrier. These data show that DC-EEG is a promising real-time monitoring tool for blood-brain barrier disruption augmented drug delivery.

Resting-state fMRI results in neurodegenerative diseases have been somewhat conflicting. This may be due to complex partial volume effects of CSF in BOLD signal in patients with brain atrophy. To encounter this problem, we used a coefficient of variation (CV) map to highlight artifacts in the data, followed by analysis of gray matter voxels in order to minimize brain volume effects between groups. The effects of these measures were compared to whole brain ICA dual regression results in Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). 23 AD patients, 21 bvFTD patients and 25 healthy controls were included. The quality of the data was controlled by CV mapping. For detecting functional connectivity (FC) differences whole brain ICA (wbICA) and also segmented gray matter ICA (gmICA) followed by dual regression were conducted, both of which were performed both before and after data quality control. Decreased FC was detected in posterior DMN in the AD group and in the Salience network in the bvFTD group after combining CV quality control with gmICA. Before CV quality control, the decreased connectivity finding was not detectable in gmICA in neither of the groups. Same finding recurred when exclusion was based on randomization. The subjects excluded due to artifacts noticed in the CV maps had significantly lower temporal signal-to-noise ratio than the included subjects. Data quality measure CV is an effective tool in detecting artifacts from resting state analysis. CV reflects temporal dispersion of the BOLD signal stability and may thus be most helpful for spatial ICA, which has a blind spot in spatially correlating widespread artifacts. CV mapping in conjunction with gmICA yields results suiting previous findings both in AD and bvFTD.

The theory on the glymphatic convection mechanism of cerebrospinal fluid holds that cardiac pulsations in part pump cerebrospinal fluid from the peri-arterial spaces through the extracellular tissue into the peri-venous spaces facilitated by aquaporin water channels. Since cardiac pulses cannot be the sole mechanism of glymphatic propulsion, we searched for additional cerebrospinal fluid pulsations in the human brain with ultra-fast magnetic resonance encephalography. We detected three types of physiological mechanisms affecting cerebral cerebrospinal fluid pulsations: cardiac, respiratory, and very low frequency pulsations. The cardiac pulsations induce a negative magnetic resonance encephalography signal change in peri-arterial regions that extends centrifugally and covers the brain in ≈1 Hz cycles. The respiratory ≈0.3 Hz pulsations are centripetal periodical pulses that occur dominantly in peri-venous areas. The third type of pulsation was very low frequency (VLF 0.001-0.023 Hz) and low frequency (LF 0.023-0.73 Hz) waves that both propagate with unique spatiotemporal patterns. Our findings using critically sampled magnetic resonance encephalography open a new view into cerebral fluid dynamics. Since glymphatic system failure may precede protein accumulations in diseases such as Alzheimer's dementia, this methodological advance offers a novel approach to image brain fluid dynamics that potentially can enable early detection and intervention in neurodegenerative diseases., (© The Author(s) 2015.)

Background: Non-communicable diseases (NCDs) cause 63% of deaths worldwide. The leading NCD risk factor is raised blood pressure, contributing to 13% of deaths. A large proportion of NCDs are preventable by modifying risk factor levels. Effective prevention programmes and health policy decisions need to be evidence based. Currently, self-reported information in general populations or data from patients receiving healthcare provides the best available information on the prevalence of obesity, hypertension, diabetes, etc. in most countries., Methods: In the European Health Examination Survey Pilot Project, 12 countries conducted a pilot survey among the working-age population. Information was collected using standardized questionnaires, physical measurement and blood sampling protocols. This allowed comparison of self-reported and measured data on prevalence of overweight, obesity, hypertension, high blood cholesterol and diabetes., Results: Self-reported data under-estimated population means and prevalence for health indicators assessed. The self-reported data provided prevalence of obesity four percentage points lower for both men and women. For hypertension, the self-reported prevalence was 10 percentage points lower, only in men. For elevated total cholesterol, the difference was 50 percentage point among men and 44 percentage points among women. For diabetes, again only in men, the self-reported prevalence was 1 percentage point lower than measured. With self-reported data only, almost 70% of population at risk of elevated total cholesterol is missed compared with data from objective measurements., Conclusions: Health indicators based on measurements in the general population include undiagnosed cases, therefore providing more accurate surveillance data than reliance on self-reported or healthcare-based information only., (© The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Biomarkers are considered as tools to enhance cardiovascular risk estimation. However, the value of biomarkers on risk estimation beyond European risk scores, their comparative impact among different European regions and their role towards personalised medicine remains uncertain. Biomarker for Cardiovascular Risk Assessment in Europe (BiomarCaRE) is an European collaborative research project with the primary objective to assess the value of established and emerging biomarkers for cardiovascular risk prediction. BiomarCaRE integrates clinical and epidemiological biomarker research and commercial enterprises throughout Europe to combine innovation in biomarker discovery for cardiovascular disease prediction with consecutive validation of biomarker effectiveness in large, well-defined primary and secondary prevention cohorts including over 300,000 participants from 13 European countries. Results from this study will contribute to improved cardiovascular risk prediction across different European populations. The present publication describes the rationale and design of the BiomarCaRE project.

Aims: Our aim was to test the prediction and clinical applicability of high-sensitivity assayed troponin I for incident cardiovascular events in a general middle-aged European population., Methods and Results: High-sensitivity assayed troponin I was measured in the Scottish Heart Health Extended Cohort (n = 15 340) with 2171 cardiovascular events (including acute coronary heart disease and probable ischaemic strokes), 714 coronary deaths (25% of all deaths), 1980 myocardial infarctions, and 797 strokes of all kinds during an average of 20 years follow-up. Detection rate above the limit of detection (LoD) was 74.8% in the overall population and 82.6% in men and 67.0% in women. Troponin I assayed by the high-sensitivity method was associated with future cardiovascular risk after full adjustment such as that individuals in the fourth category had 2.5 times the risk compared with those without detectable troponin I (P < 0.0001). These associations remained significant even for those individuals in whom levels of contemporary-sensitivity troponin I measures were not detectable. Addition of troponin I levels to clinical variables led to significant increases in risk prediction with significant improvement of the c-statistic (P < 0.0001) and net reclassification (P < 0.0001). A threshold of 4.7 pg/mL in women and 7.0 pg/mL in men is suggested to detect individuals at high risk for future cardiovascular events., Conclusion: Troponin I, measured with a high-sensitivity assay, is an independent predictor of cardiovascular events and might support selection of at risk individuals.

Based on an earlier survey of putative psyllid vectors of apple proliferation (AP), carried out in 2009 and 2010, Cacopsylla picta (Förster) populations infected with 'Candidatus Phytoplasma mali' were detected in at least two commercial apple (Malus domestica Borkh.) orchards in southern Finland (1). To establish the presence of 'Ca. P. mali' in apple trees, a survey was conducted in 17 commercial apple orchards in August 2012. Phytosanitary inspectors tracked the source of the 'Ca. P. mali' by collecting 33 leaf samples from trees showing probable symptoms. Typical symptoms, including elongated stipules and witches' broom, were rare. Total DNA was extracted from leaves using a DNeasy Plant Mini Kit (Qiagen, Hilden, Germany) and screened for 'Ca. P. mali' with real-time PCR (2) and the commercial Apple Proliferation Group - complete PCR reaction kit (Loewe Biochemica GmbH, Sauerlach, Germany). Two samples tested positive and results were confirmed with TaqMan PCR and conventional PCR assays and DNA sequencing in the Food and Environment Research Agency (Fera), in the United Kingdom. One positive sample was taken from an orchard in Lohja, southern Finland, where high 'Ca. P. mali' incidence in overwintered C. picta was observed in 2010 (1). 'Ca. P. mali' was found in a >40-year-old 'Red Melba' tree with witches' broom but without elongated stipule symptoms. The other positive sample was collected from an orchard in the Aland Islands, where the infected 'Lobo' tree showed symptoms of elongated stipules. This orchard was not monitored for AP vectors. No small fruit symptoms were noted by inspectors or growers in either of the orchards. The positive samples were further analyzed for subtypes using PCR/RFLP and primers AP13/AP10 (3). The amplicons (776 bp) were sequenced and digested with HincII and BspHI (New England BioLabs Inc., Ipswich, MA) following manufacturer's instructions. Both samples proved to be apple proliferation subtypes AT-1 on the basis of RFLP and the sequenced 776-bp region. Sequences of the 776-bp amplicon of the Lohja and Aland isolates showed 100% and 99% identity, respectively, with sequences of apple proliferation isolates (accession nos. L22217.1 and CU469464.1) in GenBank. Both suspected psyllid vectors of 'Ca. P. mali' C. picta and C. melanoneura (Förster) occur in Finland, but their distribution, abundance, and transmission specificity is inadequately documented. The next step to evaluate the risk of spread of apple proliferation in commercial orchards is an extensive survey of the occurrence of Cacopsylla species infected with 'Ca. P. mali'. References: (1) A. Lemmetty et al. B. Insectol. 64:257, 2011. (2) P. Nikolić et al. Mol. Cell. Probes. 24:303, 2010. (3) W. Jarausch et al. Mol. Cell. Probes 14:17, 2000.

This paper investigates the effect of the operation distance (i.e., practical use) between an antenna and a human body on wireless body area network (WBAN) channel path gain. Different use cases in WBAN on-external (ext) and on-on links with different antenna-body distances for ultra wideband (UWB) technology are considered. These studies are carried out with two types of planar UWB antennas in the vicinity of a real human body. Corresponding scenarios are repeated by computer simulations, and differences between these environs (i.e., challenges in the modelling of the measurement situation) are analysed and discussed.