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Understanding individual differences in cognitive control is a central goal in psychology and neuroscience. Reliably measuring these differences, however, has proven extremely challenging, at least when using standard measures in cognitive neuroscience such as response times or task-based fMRI activity. While prior work has pinpointed the source of the issue - the vast amount of cross-trial variability within these measures - solutions remain elusive. Here, we propose one potential way forward: an analytic framework that combines hierarchical Bayesian modeling with multivariate decoding of trial-level fMRI data. Using this framework and longitudinal data from the Dual Mechanisms of Cognitive Control project, we estimated individuals' neural responses associated with cognitive control within a color-word Stroop task, then assessed the reliability of these individuals' responses across a time interval of several months. We show that in many prefrontal and parietal brain regions, test-retest reliability was near maximal, and that only hierarchical models were able to reveal this state of affairs. Further, when compared to traditional univariate contrasts, multivariate decoding enabled individual-level correlations to be estimated with significantly greater precision. We specifically link these improvements in precision to the optimized suppression of cross-trial variability in decoding. Together, these findings not only indicate that cognitive control-related neural responses individuate people in a highly stable manner across time, but also suggest that integrating hierarchical and multivariate models provides a powerful approach for investigating individual differences in cognitive control, one that can effectively address the issue of high-variability measures., Competing Interests: Declaration of Competing Interests None declared.

Cognitive control is a critical higher mental function, which is subject to considerable individual variation, and is impaired in a range of mental health disorders. We describe here the initial release of Dual Mechanisms of Cognitive Control (DMCC) project data, the DMCC55B dataset, with 55 healthy unrelated young adult participants. Each participant performed four well-established cognitive control tasks (AX-CPT, Cued Task-Switching, Sternberg Working Memory, and Stroop) while undergoing functional MRI scanning. The dataset includes a range of state and trait self-report questionnaires, as well as behavioural tasks assessing individual differences in cognitive ability. The DMCC project is on-going and features additional components (e.g., related participants, manipulations of cognitive control mode, resting state fMRI, longitudinal testing) that will be publicly released following study completion. This DMCC55B subset is released early with the aim of encouraging wider use and greater benefit to the scientific community. The DMCC55B dataset is suitable for benchmarking and methods exploration, as well as analyses of task performance and individual differences., (© 2022. The Author(s).)

Objective: To present a case series of spontaneous structural failure of bridging stentgrafts (BSGs) after branched endovascular aortic repair (bEVAR), as well as their failure types and their detection. While bEVAR is a safe and effective procedure, one main limitation is the reintervention rate associated with the BSGs. Structural failure of BSGs, defined as fabric disruption, stent fracture with leak or complete separation is a major cause for reinterventions and difficult to detect in computed tomography angiography (CTA)., Methods: From a multicenter bEVAR complication database, structural BSG failures were identified. Patient and BSG characteristics, detection mode, failure type, treatment and outcome were recorded and compared with bEVAR patients with intact BSGs., Results: Twenty-three BSG failures were detected in 12 patients with only 43% directly identified in CTA, after a mean of 21.4 months after implantation. The BSGs were Advanta (n = 4), E-Ventus (n = 16) and BeGraft (n = 3) in 10 renal, 9 superior mesenteric, and 4 celiac branches. Religning with another BSG was successful in 20/22 cases, one BSG failure necessitated renal branch embolization (organ loss), and one mesenteric bypass surgery. Two reintervention-related mortalities occurred., Conclusion: Structural failure of BSGs is a serious limitation for bEVAR, which can result in high reintervention rates and serious complications. BSG failure typically occurs in single-layer types and events are clustered in patients. The necessary reinterventions carry serious morbidity and mortality. Since the use as BSG in bEVAR is off-label with all current BSG manufacturers, caution is advised regarding patient-informed consent., (© 2022. The Author(s).)

Progress in understanding the neural bases of cognitive control has been supported by the paradigmatic color-word Stroop task, in which a target response (color name) must be selected over a more automatic, yet potentially incongruent, distractor response (word). For this paradigm, models have postulated complementary coding schemes: dorsomedial frontal cortex (DMFC) is proposed to evaluate the demand for control via incongruency-related coding, whereas dorsolateral PFC (DLPFC) is proposed to implement control via goal and target-related coding. Yet, mapping these theorized schemes to measured neural activity within this task has been challenging. Here, we tested for these coding schemes relatively directly, by decomposing an event-related color-word Stroop task via representational similarity analysis. Three neural coding models were fit to the similarity structure of multivoxel patterns of human fMRI activity, acquired from 65 healthy, young-adult males and females. Incongruency coding was predominant in DMFC, whereas both target and incongruency coding were present with indistinguishable strength in DLPFC. In contrast, distractor information was strongly encoded within early visual cortex. Further, these coding schemes were differentially related to behavior: individuals with stronger DLPFC (and lateral posterior parietal cortex) target coding, but weaker DMFC incongruency coding, exhibited less behavioral Stroop interference. These results highlight the utility of the representational similarity analysis framework for investigating neural mechanisms of cognitive control and point to several promising directions to extend the Stroop paradigm. SIGNIFICANCE STATEMENT How the human brain enables cognitive control - the ability to override behavioral habits to pursue internal goals - has been a major focus of neuroscience research. This ability has been frequently investigated by using the Stroop color-word naming task. With the Stroop as a test-bed, many theories have proposed specific neuroanatomical dissociations, in which medial and lateral frontal brain regions underlie cognitive control by encoding distinct types of information. Yet providing a direct confirmation of these claims has been challenging. Here, we demonstrate that representational similarity analysis, which estimates and models the similarity structure of brain activity patterns, can successfully establish the hypothesized functional dissociations within the Stroop task. Representational similarity analysis may provide a useful approach for investigating cognitive control mechanisms., (Copyright © 2021 the authors.)

We describe an ambitious ongoing study that has been strongly influenced and inspired by Don Stuss's career-long efforts to identify key cognitive processes that characterize executive control, investigate potential unifying dimensions that define prefrontal function, and carefully attend to individual differences. The Dual Mechanisms of Cognitive Control project tests a theoretical framework positing two key control dimensions: proactive and reactive. The framework's central tenets are that proactive and reactive control modes reflect domain-general dimensions of individual variation, with distinctive neural signatures, involving the lateral pFC as a central node within associated brain networks (e.g., fronto-parietal, cingulo-opercular). In the Dual Mechanisms of Cognitive Control project, each participant is scanned while performing theoretically targeted variants of multiple well-established cognitive control tasks (Stroop, cued task-switching, AX-CPT, Sternberg working memory) in three separate imaging sessions, that each encourages utilization of different control modes plus also completes an extensive out-of-scanner individual differences battery. Additional key features of the project include a high spatio-temporal resolution (multiband) acquisition protocol and a sample that includes a substantial subset of monozygotic twin pairs and participants recruited from the Human Connectome Project. Although data collection is still continuing (target n = 200), we provide an overview of the study design and protocol, along with initial results (n = 80) revealing evidence of a domain-general neural signature of cognitive control and its modulation under reactive conditions. Aligned with Don Stuss's legacy of scientific community building, a partial data set has been publicly released, with the full data set released at project completion, so it can serve as a valuable resource., (© 2021 Massachusetts Institute of Technology.)

Introduction: The basis of disc degeneration is still unknown, but is believed to be a cell-mediated process. Apoptosis might play a major role in degenerative disc disease (DDD). The aim of this study was to correlate the viability of disc cells with the radiological degeneration grades (rDG) in disc herniation., Materials and Methods: Forty anterior IVD's (C4-C7) from 39 patients with DDD were studied histologically and ultrastructurally to quantify healthy, "balloon", chondroptotic, apoptotic and necrotic cells. Patients were classified to their rDG, as having either prolapse (P: DGII + III) and/or osteochondrosis (O: DGIV + V). Similar studies were undertaken on eight control discs., Results: Cell death by necrosis (mean 35%) was common but differed not significantly in both groups. All patients with a disc prolapse DGII + III revealed balloon cells (iAF: mean 32%). All appeared alive and sometimes were hypertrophic. However, significantly less balloon cells were found in the O-Group. Control samples revealed no evidence of "balloon" cells in DGII and only a minor rate in DGIII., Conclusion: According to the different rDG, quantitative changes were obvious in healthy and "balloon" cells, but not for cell death. At the moment it can only be hypothesized if "balloon" cells are part of a repair strategy and/or cause of disc herniation.

Background: Detection of risk factors for an air embolism in the left atrium, left ventricle, or systemic circulation (systemic air embolism, SAE) during a percutaneous core needle biopsy (PCNB) of the thorax., Methods: In a retrospective observational study, all PCNBs of the thorax in 610 patients between 2007 and 2009 were analyzed. The SmartStep™ technique (General Electric) was used for the biopsy, with which the examiner can prepare a batch of three 1.25-mm or 2.5-mm collimated slices within a second using a foot switch in the CT room to check the needle position. The image data thus generated and the control CT scans that followed were examined retrospectively for the presence of intravascular air. Intravascular air was defined as two or more adjacent voxels with absorption values of < -200 HU in the left atrium, left ventricle, aorta, or arteries during or after the procedure. The univariate statistical analysis of categorical variables was made using 2 by 2 tables and the Fisher test. The groups were compared using the Mann-Whitney test. Finally, a multivariate logistic regression analysis was used to identify independent risk factors for the occurrence of an SAE., Results: The radiological incidence of an SAE during a PCNB was 3.8% (23/610 patients), whereas the clinically apparent incidence was 0.49%. Two patients developed clinical symptoms consisting of transient hemiplegia or transient amaurosis; one died due to a fatal SAE of the coronary arteries. The mortality was thus 0.16%. The depth of the needle in the lesion (Wald: 6.859), endotracheal anesthesia (Wald: 5.721), location of the lesion above the level of the left atrium (Wald: 5.159), and prone position of the patients (Wald: 4.317) were independent risk factors for the incidence of an SAE (p < 0.05 each). Using explorative criteria, the acute angle of the needle to the tumor surface, and the transition of ventilated lung were independent factors. The frequency of biopsies, needle penetration depth, and tumor location near the diaphragm or in the lower lobe also played a subordinate role, not however, the needle penetration depth through the lung., Conclusion: If possible, the PCNB should be performed under local anesthesia. We recommend avoiding endotracheal anesthesia and prone position. Whenever possible, patients should be positioned on the back in such a way that the tumor is lower than the left atrium. The tip of the needle should be within the tumor during the biopsy procedure.

It is widely accepted that CF lung disease starts before clinical symptoms become apparent or spirometry deteriorates. Computed chest tomography (CT) is the reference method for identifying structural changes in CF; however, radiation exposure limits its use as a monitoring tool. It has been suggested that the Lung Clearance Index (LCI) measured by Multiple Breath Washout (MBW) for assessing ventilation inhomogeneity is a more sensitive surrogate marker than spirometry allowing non-invasive monitoring of CF lung disease. The aim of this study was to prospectively investigate the diagnostic accuracy of the LCI in comparison to CT in CF patients with early lung disease and normal FEV(1) (>80% pred.). MBW and ultra-low-dose CT were performed in 34 patients (6-26 years). LCI was abnormal in 76.5% subjects. LCI and CT correlated significantly in 82.3%. LCI was related to presence and extent of structural lung changes observed on CT with a sensitivity of 88%. Diagnostic accuracy of the LCI for detecting CF lung disease in patients with normal FEV(1) was good when compared to CT. Results indicate that structural changes are unlikely if a normal LCI is measured. We speculate that serial measurements of the LCI for assessing ventilation inhomogeneity may help to identify early structural lung disease and help to reduce the individual cumulative radiation dose. The LCI may be a suitable surrogate marker for monitoring progression of CF lung disease and effect of treatment in both, clinical care and research settings., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

We assessed Calcofluor white staining, Aspergillus polymerase chain reaction, and a galactomannan enzyme immunoassay for diagnosis of fungal infection with use of computed tomography-guided percutaneous lung biopsy specimens obtained from 61 patients. The sensitivity and specificity of computerized tomography, Aspergillus polymerase chain reaction, and galactomannan enzyme immunoassay were 100% and 50%, 100% and 86%, and 88% and 94%, respectively.

Patients with small hepatocellular carcinoma (HCC) can be cured by liver transplantation (LT). However, many patients drop out during the waiting time as a result of tumor progression. We prospectively investigated the effect of transarterial chemoembolization on long-term survival of 116 patients with HCC listed for LT. Intention-to-treat analysis revealed that patients with either complete or partial response to therapy (no vital tumor or devascularization of > or =30%, respectively) as assessed by computed tomographic scan before LT had far better 1-, 2-, and 5-year survival rates (100, 93.2, and 85.7%; and 93.8, 83.6, and 66.2%, respectively) compared with those with no response or with tumor progression (82.4, 50.7, and 19.3%). Posttransplant survival analysis showed a marked survival benefit according to transarterial chemoembolization response: patients with complete or partial response had 1-, 2-, and 5-year survival rates of 89.1, 85.1, and 85.1%, and 88.6, 77.4, and 63.9%, respectively, compared with 68.6, 51.4, and 51.4% for patients whose disease did not respond to therapy. Subgroup analysis, however, showed that these benefits were only seen in patients whose disease met the Milan criteria, but not in disease exceeding the Milan criteria but fitting the expanded University of California at San Francisco criteria. These patients were also more likely to drop out as a result of tumor progression while waiting for LT (dropout rate 12.1 vs. 2.9%) and to develop recurrent HCC (21.6 vs. 7.6%). Downstaged patients did even worse, with a dropout rate of 26.7% and a 5-year survival rate of only 25%. In conclusion, the response to preoperative chemoembolization may predict long-term outcome after LT., ((c) 2007 AASLD.)

Irpex lacteus, a wood-decaying basidiomycete, was isolated from a pulmonary abscess of an immunosuppressed child. This medical strain was compared morphologically and by sequencing of the ribosomal intergenic spacers with specimens from both culture collections and herbarium desiccated material. The patient was treated successfully with amphotericin B.

We evaluated the value of Aspergillus PCR as a tool for diagnosing invasive aspergillosis from whole-blood samples during antifungal therapy. In a 3-year study, 36 patients receiving antifungal therapy due to chest radiographic findings highly suggestive of fungal pneumonia were evaluated. The PCR results from whole-blood samples were compared to those obtained from bronchoalveolar lavage fluids and/or tissue specimens. A total of 205 whole-blood samples, 15 fine-needle aspirations or tissue biopsy specimens, and 21 bronchoalveolar lavage fluids and tracheal secretions were analyzed using PCR. Of the 36 patients, 15 had proven, 9 had probable, and 12 had possible invasive Aspergillus infection according to European Organization for Research and Treatment of Cancer/Mycosis Study Group definitions. For patients with proven infection the sensitivity values of PCR in lung and blood samples were 100 and 40%, respectively. The negative predictive value of blood monitoring under conditions of antifungal treatment was 44%. Clearance of fungal DNA from blood was associated with resolution of clinical symptoms in six of nine patients with proven infection. Repeated positive PCR results for Aspergillus were associated with fatal outcome, as three of six patients died. For patients with probable infection the sensitivity values of PCR in lung fluid and blood were 66 and 44%, respectively. The benefit of PCR diagnosis using whole-blood samples is limited when sampling takes place after treatment has been started. Performance of Aspergillus PCR using tissue samples is recommended in addition to microscopic examination and culture technique for sensitive detection of fungal infection.

Background: We report the experience of a single institution with the minimally invasive resection of mediastinal masses using the da Vinci robotic surgical system., Methods: From August 2001 to June 2003, 14 patients (5 men and 9 women aged from 21 to 77 years) with mediastinal masses were operated on minimally invasively with the da Vinci robotic system. This consisted of 9 thymectomies (6 thymomas, 2 nonatrophic thymic glands, 1 thymic cyst), 3 resections of paravertebral neurinomas, 1 ectopic mediastinal parathyroidectomy, and 1 resection of a lymphangioma., Results: Complete, extended thymectomy was accomplished in all 9 cases, proven by examination of the thymic bed and resected specimen. In 1 patient with an hourglass-shaped neurinoma, conversion to an open procedure was necessary because the excessive size of the tumor limited vision. The median overall operation time was 166 minutes (range, 61 to 182) including 110 minutes (range, 46 to 142) for the robotic act. There were no intraoperative complications or surgical mortality., Conclusions: These preliminary results of our series suggest that application of the da Vinci robotic surgical system for resection of selected mediastinal masses is technically feasible and safe. It provides an alternative to open approaches and "conventional" thoracoscopy. Nevertheless, this new technique requires further investigation in larger series and longer follow-up.

Fungal infections still represent a serious complication after organ transplantation. Early diagnosis and aggressive treatment are crucial. Because of the many diagnostic problems involved, we present a case of mucormycosis--primarily affecting the paranasal sinuses with later intracranial extension--in a highly immunized recipient of a third renal transplant. Although fungal infection was suspected from various imaging techniques, only the detection of typical fungal hyphae in the infected tissue was diagnostic. Neither the blood tests and cerebrospinal fluid examinations performed nor cultures from maxillary sinus fluid were of any diagnostic help. Surgical debridement from a transnasal as well as an intracranial approach and systemic amphotericin B together with the discontinuation of immunosuppression after removal of the rejected graft were able to save the patient. This case stresses the importance of early diagnosis that can only be made from tissue biopsies and allows appropriate timely treatment.

A case of acute, spontaneous cervical hemorrhage caused by a ruptured aneurysm of the inferior thyroid artery is described. This lesion was accompanied by an arteriovenous fistula within the thyroid gland that caused a flow-induced aneurysm. Diagnosis and treatment were successfully performed by selective angiography with endovascular occlusion and embolization. Both diagnostic and therapeutic management are discussed, and the related literature is reviewed. To our knowledge, this is the first reported case of an aneurysm of a thyroid artery in conjunction with an intraparenchymatous arteriovenous fistula of the thyroid gland.

We evaluated the histopathologic and cryosectional appearance of bone bruise injuries of the knee detected on MRI. Histologic evaluation of bone biopsies from 3 patients revealed microfractures of cancellous bone, edema and bleeding in the fatty marrow. Between intact lamellar bone trabecules, fragments of hyaline cartilage mixed with highly fragmented bone trabecules were found. Postmortem specimens were obtained from 2 more patients, killed in motor vehicle accidents. MRI revealed bone bruise injuries of the lateral femoral condyle and of the lateral tibial plateau in 1 knee and anterior cruciate ligament disruption, a medial meniscus tear and bone bruise injury of the tibial plateau and of the lateral femoral condyle in the other specimen. The specimens were embedded in physiologic saline solution and frozen to -30 degrees C. By rotationcryotomy, 1 mm slices were removed from the surface of the specimens and documented on photographs. Subchondral lesions and bleeding were found, corresponding to the MR images.