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Eye tracking is a promising and non-invasive method for assessing cognitive processes in neurodegeneration. Our study focuses on the use of stimulus-driven eye tracking as a tool for discovering neurodegenerative conditions. In this study, we examine perceptual organisation (grouping, segmentation), and accentuation (Pinna & Sirigu, 2011) in neurologically impaired and healthy individuals. Based on a preliminary analysis, there are differences in the average number of fixations between clinical and control groups. Additionally, there are variations in the scanned area within specific sets of stimuli between the control and clinical groups. By identifying these differences, our study contributes to a deeper understanding of the mid-level perceptual processes in neurodegeneration.

Perceptual organization contains two interrelated sets of phenomena: visual grouping and figure-ground segmentation. Different types of grouping and segmenting (and interaction and competition between them) have been described. Less clear is what happens once an accent is added in grouping or segmenting. According to several eye tracking experiments (n=35), apart from pop-out effect of particular elements, the overall structure of the visual field is changed. If compared to the non-accentuated stimuli, adding single accent to both grouping and segmentation stimuli induces not only local changes in saccadic processes but also a more global difference in gaze alignment. Most importantly, accent assigns a directional effect to the visual structure, typically decreases the average fixation time (by 11-28% depending on stimuli) and changes location of fixations and decreases their variation (if compared to non-accentuated stimuli). However, no significant differences between the number of fixations in non-accentuated and accentuated stimuli can be observed.

Background: Caudal regression syndrome (CRS) is a rare congenital malformation characterized by incomplete development of the lower spine and spinal cord. Its estimated incidence ranges from 1 to 2 per 100,000 live births, leading to a spectrum of clinical presentations. Although most cases are diagnosed during childhood, only a small number of cases have been documented in adults in the medical literature. Case Report: A 27-year-old woman underwent an outpatient magnetic resonance imaging (MRI) of the thoracolumbar spine due to severe lower back pain experienced for the first time. Despite congenital leg abnormalities and multiple childhood surgeries, no further investigations were conducted at that time. MRI revealed congenital anomalies consistent with CRS, including coccygeal agenesis, L5 sacralization, and spinal cord defects. The patient also had a long-standing pilonidal cyst treated conservatively, now requiring operative treatment due to an abscess. Conclusions: This report underscores a rare case of CRS initially misdiagnosed and mistreated over many years. It emphasizes the importance of considering less common diagnoses, especially when initial investigations yield inconclusive results. This clinical case demonstrates a highly valuable and educative radiological finding. In the literature, such cases with radiological findings in adults are still lacking.

This essay discusses approaches to and strategies for teaching the “Multicultural Middle Ages” at undergraduate level based on a lecture course that we co-taught online in Fall 2020. We outline a few of our lectures (on “Modern Appropriations of the Crusades: Politics, Myths, and Reality”; “Trade, Commerce, and Cultural Exchange”; and “Multicultural Song”) before presenting some ideas for teaching comparatively across cultures. By way of conclusion, we showcase a selection of our students’ “blog post” responses to the course.

Background and Objectives: Magnetic resonance imaging is vital for diagnosing cognitive decline. Brodmann areas (BA), distinct regions of the cerebral cortex categorized by cytoarchitectural variances, provide insights into cognitive function. This study aims to compare cortical thickness measurements across brain areas identified by BA mapping. We assessed these measurements among patients with and without cognitive impairment, and across groups categorized by cognitive performance levels using the Montreal Cognitive Assessment (MoCA) test. Materials and Methods: In this cross-sectional study, we included 64 patients who were divided in two ways: in two groups with (CI) or without (NCI) impaired cognitive function and in three groups with normal (NC), moderate (MPG) and low (LPG) cognitive performance according to MoCA scores. Scans with a 3T MRI scanner were carried out, and cortical thickness data was acquired using Freesurfer 7.2.0 software. Results: By analyzing differences between the NCI and CI groups cortical thickness of BA3a in left hemisphere (U = 241.000, p = 0.016), BA4a in right hemisphere (U = 269.000, p = 0.048) and BA28 in left hemisphere (U = 584.000, p = 0.005) showed significant differences. In the LPG, MPG and NC cortical thickness in BA3a in left hemisphere (H (2) = 6.268, p = 0.044), in V2 in right hemisphere (H (2) = 6.339, p = 0.042), in BA28 in left hemisphere (H (2) = 23.195, p < 0.001) and in BA28 in right hemisphere (H (2) = 10.015, p = 0.007) showed significant differences. Conclusions: Our study found that cortical thickness in specific Brodmann Areas—BA3a and BA28 in the left hemisphere, and BA4a in the right—differ significantly between NCI and CI groups. Significant differences were also observed in BA3a (left), V2 (right), and BA28 (both hemispheres) across LPG, MPG, NC groups. Despite a small sample size, these findings suggest cortical thickness measurements can serve as effective biomarkers for cognitive impairment diagnosis, warranting further validation with a larger cohort.

IntroductionThis study aimed to better understand patient and caregiver perspectives on social risk screening across different healthcare settings.MethodsAs part of a mixed-methods multisite study, the authors conducted semistructured interviews with a subset of adult patients and adult caregivers of pediatric patients who had completed the Center for Medicare and Medicaid Innovation Accountable Health Communities social risk screening tool between July 2018 and February 2019. Interviews, conducted in English or Spanish, asked about reactions to screening, screening acceptability, preferences for administration, prior screening experiences that informed perspectives, and expectations for social assistance. Basic thematic analysis and constant comparative methods were used to code and develop themes.ResultsFifty interviews were conducted across 10 study sites in 9 states, including 6 primary care clinics and 4 emergency departments. There was broad consensus among interviewees across all sites that social risk screening was acceptable. The following 4 main themes emerged: (1) participants believed screening for social risks is important; (2) participants expressed insight into the connections between social risks and overall health; (3) participants emphasized the importance of patient-centered implementation of social risk screening; and (4) participants recognized limits to the healthcare sector's capacity to address or resolve social risks.ConclusionsDespite gaps in the availability of social risk-related interventions in healthcare settings, patient-centered social risk screening, including empathy and attention to privacy, may strengthen relationships between patients and healthcare teams.Supplement informationThis article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.

INTRODUCTION:Despite recent growth in healthcare delivery-based social risk screening, little is known about patient perspectives on these activities. This study evaluates patient and caregiver acceptability of social risk screening. METHODS:This was a cross-sectional survey of 969 adult patients and adult caregivers of pediatric patients recruited from 6 primary care clinics and 4 emergency departments across 9 states. Survey items included the Center for Medicare and Medicaid Innovation Accountable Health Communities' social risk screening tool and questions about appropriateness of screening and comfort with including social risk data in electronic health records. Logistic regressions evaluated covariate associations with acceptability measures. Data collection occurred from July 2018 to February 2019; data analyses were conducted in February‒March 2019. RESULTS:Screening was reported as appropriate by 79% of participants; 65% reported comfort including social risks in electronic health records. In adjusted models, higher perceived screening appropriateness was associated with previous exposure to healthcare-based social risk screening (AOR=1.82, 95% CI=1.16, 2.88), trust in clinicians (AOR=1.55, 95% CI=1.00, 2.40), and recruitment from a primary care setting (AOR=1.70, 95% CI=1.23, 2.38). Lower appropriateness was associated with previous experience of healthcare discrimination (AOR=0.66, 95% CI=0.45, 0.95). Higher comfort with electronic health record documentation was associated with previously receiving assistance with social risks in a healthcare setting (AOR=1.47, 95% CI=1.04, 2.07). CONCLUSIONS:A strong majority of adult patients and caregivers of pediatric patients reported that social risk screening was appropriate. Most also felt comfortable including social risk data in electronic health records. Although multiple factors influenced acceptability, the effects were moderate to small. These findings suggest that lack of patient acceptability is unlikely to be a major implementation barrier. SUPPLEMENT INFORMATION:This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.

Objectives: High-risk human papillomavirus (hrHPV) infection is a necessary risk factor for cervical and anal dysplasia. Over the last five years, there is increasing evidence that the natural history of hrHPV-induced anal cancer is close to that of cervical cancer. However, evidence-based anal cancer screening recommendations are limited and thus this study aims to characterize the prevalence of cervical dysplasia in women with anal dysplasia. In this study, we aimed to identify the association of anal dysplasia with cervical dysplasia and high-risk HPV subtypes in women. Methods: A retrospective observational study was performed from January 2015 to December 2022 at an academic medical center. Women referred for anal cancer screening with Pap smears and anos-copies were evaluated for lifetime history of cervical dysplasia andfor correlation with hrHPV subtypes during screening. Multivariate logistic regression and chi-square tests were performed. Results: 114 women who underwent anal cancer screening were identified. 78 (68.4%) patients were identified to have anal dysplasia and 16 (20.5%) had high-grade anal dysplasia. Cervical cancer screening data was identified for 109 women, of which 29 (26.6%) had cervical dysplasia, however none had high-grade cervical dysplasia. 50 (43.9%) women were positive for human immunodeficiency virus (HIV). Preliminary analyses show that those with anal dysplasia are more likely to have cervical dysplasia (OR 7.30, p=0.004). Those with cervical dysplasia are more like to have high-risk anal HPV (OR 4.72, p=0.005) and anal dysplasia (OR 7.18, p=0.004). Though those with high-grade anal cytology were not found to have cervical dysplasia, women with HIV were more likely to have cervical dysplasia with high-grade anal cytology (p=0.012). Conclusions: We found that high-risk anal HPV and anal dysplasia were more likely to be found in those with cervical dysplasia. We also found that rates of anal and cervical dysplasia were increased in those with HIV and a history of any malignancy. Since anal dysplasia can be detected and subsequently treated, anal cancer screening should be recommended to women with cervical dysplasia. Further studies are warranted to guide recommendations to screen women with cervical dysplasia for anal dysplasia.

Diffusion tensor imaging (DTI) is an MRI analysis method that could help assess cognitive impairment (CI) in the ageing population more accurately. In this research, we evaluated fractional anisotropy (FA) of whole brain (WB) and corpus callosum (CC) in patients with normal cognition (NC), mild cognitive impairment (MCI), and moderate/severe cognitive impairment (SCI). In total, 41 participants were included in a cross-sectional study and divided into groups based on Montreal Cognitive Assessment (MoCA) scores (NC group, nine participants, MCI group, sixteen participants, and SCI group, sixteen participants). All participants underwent an MRI examination that included a DTI sequence. FA values between the groups were assessed by analysing FA value and age normative percentile. We did not find statistically significant differences between the groups when analysing CC FA values. Both approaches showed statistically significant differences in WB FA values between the MCI-SCI and MCI-NC groups, where the MCI group participants showed the highest mean FA and highest mean FA normative percentile results in WB.

BackgroundUntreated perinatal depression and anxiety can have detrimental consequences on family function. Logistical barriers prevent many perinatal women from accessing treatment, and these barriers are compounded for women residing in rural areas. This paper describes a Family-Based Collaborative Care Model (FBCCM) that is designed to bypass barriers to increase access to care for depressed and anxious perinatal women in rural regions of the United States. The FBCCM includes the following two components: (1) a 10-session video-delivered family therapy treatment for perinatal depression and anxiety and (2) a video-delivered infant care provider training on addressing the parenting needs of depressed and anxious mothers. ObjectiveThis paper describes the feasibility of implementing the FBCCM with families and infant care providers. Findings are presented on the preliminary effectiveness of the video-delivered family therapy treatment in reducing maternal depressive and anxiety symptoms, and family conflict. MethodsThis pilot study was carried out using an implementation-effectiveness hybrid trial design without a comparison group. Changes in maternal depressive symptoms, maternal anxiety symptoms, and family conflict were measured at posttreatment, 3 months, and 6 months later. ResultsOn average, mothers (n=24) attended 9.79 (SD 1.02) sessions. On average, their family members (n=24) attended 9.42 (SD 1.28) sessions. A total of 31 infant care providers attended the training on addressing the parenting needs of depressed and anxious mothers. Mothers reported a significant reduction in depressive symptoms (P

Endothelial progenitor cells (EPCs) repair damaged vascular endothelium, and low circulating EPC levels have been associated with cardiovascular disease (CVD). CD34+/KDR+ EPCs are commonly reported in the literature and CD34+/CD133+/KDR+ EPCs are rare in circulation but highly specific for endothelial lineage. HIV-infected (HIV+) adults have chronic inflammation and increased CVD risk, but the relationship between CVD, vascular inflammation, and EPCs in HIV remains unclear. In a pilot study, EPCs were measured in 57 HIV+ men [≥50 years old, HIV-1 RNA

BackgroundSuboptimal adolescent human papillomavirus (HPV) vaccination rates have been attributed to parental perceptions of the HPV vaccine. The internet has been cited as a setting where misinformation and controversy about HPV vaccination have been amplified. ObjectiveWe aimed to test message effectiveness in changing parents’ attitudes and behavioral intentions toward HPV vaccination. MethodsWe conducted a web-based message-testing experiment with 6 control messages and 25 experimental messages and 5 from each of the 5 salient themes about HPV vaccination (theme 1: safety, side effects, risk, and ingredient concerns and long-term or major adverse events; theme 2: distrust of the health care system; theme 3: HPV vaccine effectiveness concerns; theme 4: connection to sexual activity; and theme 5: misinformation about HPV or HPV vaccine). Themes were identified from previous web-based focus group research with parents, and specific messages were developed by the study team using content from credible scientific sources. Through an iterative process of message development, the messages were crafted to be appropriate for presentation on a social media platform. Among the 1713 participants recruited via social media and crowdsourcing sites, 1043 eligible parents completed a pretest survey questionnaire. Participants were then randomly assigned to 1 of the 31 messages and asked to complete a posttest survey questionnaire that assessed attitudes toward the vaccine and perceived effectiveness of the viewed message. A subgroup of participants (189/995, 19%) with unvaccinated children aged 9 to 14 years was also assessed for their behavioral intention to vaccinate their children against HPV. ResultsParents in the experimental group had increased positive attitudes toward HPV vaccination compared with those in the control group (t969=3.03, P=.003), which was associated with increased intention to vaccinate among parents of unvaccinated children aged 9 to 14 years (r=1.14, P=.05). At the thematic level, we identified 4 themes (themes 2-5) that were relatively effective in increasing behavioral intentions by positively influencing attitudes toward the HPV vaccine (χ25=5.97, P=.31, root mean square error of approximation [RMSEA]=0.014, comparative fit index [CFI]=0.91, standardized root mean square residual [SRMR]=0.031). On the message level, messages that provided scientific evidence from government-related sources (eg, the Centers for Disease Control and Prevention) and corrected misinformation (eg, “vaccines like the HPV vaccine are simply a way for pharmaceutical companies to make money. That isn’t true”) were effective in forming positive perceptions toward the HPV vaccination messages. ConclusionsEvidence-based messages directly countering misinformation and promoting HPV vaccination in social media environments can positively influence parents’ attitudes and behavioral intentions to vaccinate their children against HPV.