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Abstract We compared choroid plexus (ChP) manual segmentation on non-contrast-enhanced (non-CE) sequences and reference standard CE T1- weighted (T1w) sequences in 61 multiple sclerosis patients prospectively included. ChP was separately segmented on T1w, T2-weighted (T2w) fluid-attenuated inversion-recovery (FLAIR), and CE-T1w sequences. Inter-rater variability assessed on 10 subjects showed high reproducibility between sequences measured by intraclass correlation coefficient (T1w 0.93, FLAIR 0.93, CE-T1w 0.99). CE-T1w showed higher signal-to-noise ratio and contrast-to-noise ratio (CE-T1w 23.77 and 18.49, T1w 13.73 and 7.44, FLAIR 13.09 and 10.77, respectively). Manual segmentation of ChP resulted 3.073 ± 0.563 mL (mean ± standard deviation) on T1w, 3.787 ± 0.679 mL on FLAIR, and 2.984 ± 0.506 mL on CE-T1w images, with an error of 28.02 ± 19.02% for FLAIR and 3.52 ± 12.61% for T1w. FLAIR overestimated ChP volume compared to CE-T1w (p < 0.001). The Dice similarity coefficient of CE-T1w versus T1w and FLAIR was 0.67 ± 0.05 and 0.68 ± 0.05, respectively. Spatial error distribution per slice was calculated after nonlinear coregistration to the standard MNI152 space and showed a heterogeneous profile along the ChP especially near the fornix and the hippocampus. Quantitative analyses suggest T1w as a surrogate of CE-T1w to estimate ChP volume. Relevance statement To estimate the ChP volume, CE-T1w can be replaced by non-CE T1w sequences because the error is acceptable, while FLAIR overestimates the ChP volume. This encourages the development of automatic tools for ChP segmentation, also improving the understanding of the role of the ChP volume in multiple sclerosis, promoting longitudinal studies. Key points • CE-T1w sequences are considered the reference standard for ChP manual segmentation. • FLAIR sequences showed a higher CNR than T1w sequences but overestimated the ChP volume. • Non-CE T1w sequences can be a surrogate of CE-T1w sequences for manual segmentation of ChP. Graphical Abstract

BackgroundThere are no narrative or systematic reviews of hearing loss in patients with congenital syphilis.ObjectivesThe aim of this study was to perform a scoping review to determine what is known about the incidence, characteristics, prognosis, and therapy of hearing loss in children or adults with presumed congenital syphilis.Eligibility criteriaPROSPERO, OVID Medline, OVID EMBASE, Cochrane Library (CDSR and Central), Proquest Dissertations and Theses Global, and SCOPUS were searched from inception to March 31, 2023. Articles were included if patients with hearing loss were screened for CS, ii) patients with CS were screened for hearing loss, iii) they were case reports or case series that describe the characteristics of hearing loss, or iv) an intervention for hearing loss attributed to CS was studied.Sources of evidenceThirty-six articles met the inclusion criteria.ResultsFive studies reported an incidence of CS in 0.3% to 8% of children with hearing loss, but all had a high risk of bias. Seven reported that 0 to 19% of children with CS had hearing loss, but the only one with a control group showed comparable rates in cases and controls. There were 18 case reports/ case series (one of which also reported screening children with hearing loss for CS), reporting that the onset of hearing loss was usually first recognized during adolescence or adulthood. The 7 intervention studies were all uncontrolled and published in 1983 or earlier and reported variable results following treatment with penicillin, prednisone, and/or ACTH.ConclusionsThe current literature is not informative with regard to the incidence, characteristics, prognosis, and therapy of hearing loss in children or adults with presumed congenital syphilis.

Abstract INTRODUCTION We investigated in vivo the microstructural integrity of the pathway connecting the locus coeruleus to the transentorhinal cortex (LC‐TEC) in patients with Alzheimer's disease (AD) and frontotemporal dementia (FTD). METHODS Diffusion‐weighted MRI scans were collected for 21 AD, 20 behavioral variants of FTD (bvFTD), and 20 controls. Fractional anisotropy (FA), mean, axial, and radial diffusivities (MD, AxD, RD) were computed in the LC‐TEC pathway using a normative atlas. Atrophy was assessed using cortical thickness and correlated with microstructural measures. RESULTS We found (i) higher RD in AD than controls; (ii) higher MD, RD, and AxD, and lower FA in bvFTD than controls and AD; and (iii) a negative association between LC‐TEC MD, RD, and AxD, and entorhinal cortex (EC) thickness in bvFTD (all p

Abstract Background Carotid endarterectomy is currently recommended for patients with recently symptomatic carotid stenosis ≥50%, based on randomised trials conducted 30 years ago. Several factors such as carotid plaque ulceration, age and associated comorbidities might influence the risk-benefit ratio of carotid revascularisation. A model developed in previous trials that calculates the future risk of stroke based on these features can be used to stratify patients into low, intermediate or high risk. Since the original trials, medical treatment has improved significantly. Our hypothesis is that patients with carotid stenosis ≥50% associated with a low to intermediate risk of stroke will not benefit from additional carotid revascularisation when treated with optimised medical therapy. We also hypothesise that prediction of future risk of stroke in individual patients with carotid stenosis can be improved using the results of magnetic resonance imaging (MRI) of the carotid plaque. Methods Patients are randomised between immediate revascularisation plus OMT versus OMT alone. Suitable patients are those with asymptomatic or symptomatic carotid stenosis ≥50% with an estimated 5-year risk of stroke of

Background: Disease activity in the first years after a diagnosis of relapsing-remitting multiple sclerosis (RRMS) is a negative prognostic factor for long-term disability. Markers of both clinical and radiological responses to disease-modifying therapies (DMTs) are advocated. Objective: The objective of this study is to estimate the value of cerebrospinal fluid (CSF) inflammatory markers at the time of diagnosis in predicting the disease activity in treatment-naïve multiple sclerosis (MS) patients exposed to dimethyl fumarate (DMF). Methods: In total, 48 RRMS patients (31 females/17 males) treated with DMF after the diagnosis were included in this 2-year longitudinal study. All patients underwent a CSF examination, regular clinical and 3T magnetic resonance imaging (MRI) scans that included the assessment of white matter (WM) lesions, cortical lesions (CLs) and global cortical thickness. CSF levels of 10 pro-inflammatory markers – CXCL13 [chemokine (C-X-C motif) ligand 13 or B lymphocyte chemoattractant], CXCL12 (stromal cell-derived factor or C-X-C motif chemokine 12), tumour necrosis factor (TNF), APRIL (a proliferation-inducing ligand, or tumour necrosis factor ligand superfamily member 13), LIGHT (tumour necrosis factor ligand superfamily member 14 or tumour necrosis factor superfamily member 14), interferon (IFN) gamma, interleukin 12 (IL-12), osteopontin, sCD163 [soluble-CD163 (cluster of differentiation 163)] and Chitinase3-like1 – were assessed using immune-assay multiplex techniques. The combined three-domain status of ‘no evidence of disease activity’ (NEDA-3) was defined by no relapses, no disability worsening and no MRI activity, including CLs. Results: Twenty patients (42%) reached the NEDA-3 status; patients with disease activity showed higher CSF TNF ( p = 0.009), osteopontin ( p = 0.005), CXCL12 ( p = 0.037), CXCL13 ( p = 0.040) and IFN gamma levels ( p = 0.019) compared with NEDA-3 patients. After applying a random forest approach, TNF and osteopontin revealed the most important variables associated with the NEDA-3 status. Six molecules that emerged at the random forest approach were added in a multivariate regression model with demographic, clinical and MRI measures of WM and grey matter damage as independent variables. TNF levels confirmed to be associated with the absence of disease activity: odds ratio (OR) = 0.25, CI% = 0.04–0.77. Conclusion: CSF inflammatory markers may provide prognostic information in predicting disease activity in the first years after DMF initiation. CSF TNF levels are a possible candidate in predicting treatment response, in addition to clinical, demographic and MRI variables.

Abstract Objective To promote a better radiological interpretation of spine degeneration, a consistent standardization of the acquisition, interpretation and description of Magnetic Resonance Imaging (MRI) l findings. Materials and methods In order to achieve this objective, a consensus among experts in imaging of degenerative spine disease (DSD) from Italian radiological societies (SIRM—Italian Society of Radiology, AINR—Italian Association of Neuroradiology) was achieved. The representatives of the Italian inter-societal working group examined the literature produced by European/American task forces on optimizing the study sequences, classification of degenerative disc changes, spondylo-arthrosis, osteochondrosis, synovial and ligament pathologies of the spinal column, and on canal and foraminal stenosis. The document-resulted from the consensus between experts—was then presented to the scientific societies of Neurosurgery (SINCH) and Orthopedics and Traumatology (SIOT) for their approval. Results This position paper presents a proposal for an optimized MRI protocol for studying DSD and provides a glossary of terms related to this pathology and indications on their use. The international terminological recommendations have been translated and adapted to the Italian language and clinical practice and clinical cases have been used to illustrate some of the main classifications. Conclusions This revision of international DSD guidelines/recommendations and consensus made it possible to (1) update the nomenclature to international standards and (2) harmonize the MRI protocol and description of radiological findings, adapting both (1, 2) to the Italian context. With this position paper we intend to contribute to an improvement of the communication among doctors and between physicians and their patients as well as the quality of the radiological reports.

Abstract Background Combining MRI techniques with machine learning methodology is rapidly gaining attention as a promising method for staging of brain gliomas. This study assesses the diagnostic value of such a framework applied to dynamic susceptibility contrast (DSC)-MRI in classifying treatment-naïve gliomas from a multi-center patients into WHO grades II-IV and across their isocitrate dehydrogenase (IDH) mutation status. Methods Three hundred thirty-three patients from 6 tertiary centres, diagnosed histologically and molecularly with primary gliomas (IDH-mutant = 151 or IDH-wildtype = 182) were retrospectively identified. Raw DSC-MRI data was post-processed for normalised leakage-corrected relative cerebral blood volume (rCBV) maps. Shape, intensity distribution (histogram) and rotational invariant Haralick texture features over the tumour mask were extracted. Differences in extracted features across glioma grades and mutation status were tested using the Wilcoxon two-sample test. A random-forest algorithm was employed (2-fold cross-validation, 250 repeats) to predict grades or mutation status using the extracted features. Results Shape, distribution and texture features showed significant differences across mutation status. WHO grade II-III differentiation was mostly driven by shape features while texture and intensity feature were more relevant for the III-IV separation. Increased number of features became significant when differentiating grades further apart from one another. Gliomas were correctly stratified by mutation status in 71% and by grade in 53% of the cases (87% of the gliomas grades predicted with distance less than 1). Conclusions Despite large heterogeneity in the multi-center dataset, machine learning assisted DSC-MRI radiomics hold potential to address the inherent variability and presents a promising approach for non-invasive glioma molecular subtyping and grading.

Abstract Objective To assess the current framework of interventional and diagnostic neuroradiology in Europe Methods The UEMS (European Union of Medical Specialists) Section of Radiology and the subspecialty UEMS Division of Neuroradiology collected by e-mail a survey on the situation of diagnostic and Interventional Neuroradiology’ training and practice in Europe. The questionnaire was sent to the national delegates from 31 UEMS member countries, belonging to the European Union, the European Economic Area and the Council of Europe. In case of uncertain or discordant replies, the survey envisaged the involvement of neuroradiology scientific societies’ experts for providing a decisive answer. Results A formal post-residency training in diagnostic and interventional neuroradiology is provided respectively by 12/31 and 20/31 of the European countries. Currently, for becoming neuroradiologist in a country without fellowship program, a radiologist should (1) get subspecialty credits, (2) follow training inside national or international neuroradiology departments, or (3) perform the main reporting activity in neuroradiology. In nearly 2/3 of the States included in the survey, the neurointerventional procedures are provided by radiologists (22/31) and in the most frequent scenario a specific training in neurovascular is required to all radiologist or non-radiologist candidates (18/31). Conclusions The European framework of neuroradiology’s training and practice that emerged through this survey is fragmented, but there is an increasing attention by European scientific societies and institutions to create a common path of training and practice that can guarantee high educational and patient care standards.

ABSTRACT Lipids are essential to all living organisms, as an energy source, as an important cellular structural component, and as a communication tool. In this study, we used global lipidomic methods to evaluate the lipids in leaf-cutter ant fungal gardens. Leaf-cutter ants and their coevolved fungal cultivar, Leucoagaricus gongylophorus, are a model mutualistic system. The fungus enzymatically digests fresh plant material that the ants cut and deliver, converting energy and nutrients from plants and providing them to the ants through specialized hyphal swellings called gongylidia. Using combined liquid chromatography, ion mobility spectrometry, and tandem mass spectrometry, we evaluated differences between the molecular species of lipids in the leaf-cutter ant fungal garden ecosystem. This lipidomic study characterized leaves that are fed to the gardens, gongylidia that are produced by the fungus to feed the ants, and spatially resolved regions of the fungal garden through stages of leaf degradation. Lipids containing alpha-linolenic acid (18:3) were enriched in leaves and the top of the gardens but not dominant in the middle or bottom regions. Gongylidia were dominated by lipids containing linoleic acid (18:2). To evaluate the communicative potential of the lipids in fungal gardens, we conducted a behavioral experiment that showed Atta leaf-cutter ants responded differently to 18:3 and 18:2 fatty acids, with aggression toward 18:3 and attraction for 18:2. This work demonstrates the role of lipids in both the transfer of energy and as an interkingdom communication tool in leaf-cutter ant fungal gardens. IMPORTANCE In this work, we examined the role of lipids in the mutualism between leaf-cutter ants and fungus. These ants cut fresh leaf material, which they provide to their fungal cultivar, that converts energy and nutrients from the plants and provides it to the ants in specialized hyphal swellings called gongylidia. This work constitutes the first example of a global lipidomics study of a symbiotic system and provides insights as to how the fungus modifies plant lipids into a usable source for the ants. Through a behavioral experiment, this work also demonstrates how lipids can be used as an interkingdom communication tool, in this case, as an attractant rather than as a repellant, which is more often seen. Author Video: An author video summary of this article is available.

Background: The amygdala and the hippocampus are two limbic structures that play a critical role in cognition and behavior, however their manual segmentation and that of their smaller nuclei/subfields in multicenter datasets is time consuming and difficult due to the low contrast of standard MRI. Here, we assessed the reliability of the automated segmentation of amygdalar nuclei and hippocampal subfields across sites and vendors using FreeSurfer in two independent cohorts of older and younger healthy adults. Methods: Sixty-five healthy older (cohort 1) and 68 younger subjects (cohort 2), from the PharmaCog and CoRR consortia, underwent repeated 3D-T1 MRI (interval 1–90 days). Segmentation was performed using FreeSurfer v6.0. Reliability was assessed using volume reproducibility error (ε) and spatial overlapping coefficient (DICE) between test and retest session. Results: Significant MRI site and vendor effects (p ​0.43, p ​ ​0.80). Conclusion: Our results support the use of volumetric measures of larger amygdalar nuclei and hippocampal subfields in multisite MRI studies. These measures could be useful for disease tracking and assessment of efficacy in drug trials.

Advanced aging, vascular dysfunction, and nitric oxide (NO) bioavailability are recognized risk factors for Alzheimer's disease (AD). However, the contribution of AD, per se, to this putative pathophysiological mechanism is still unclear. To better answer this point, we quantified cortical perfusion with arterial spin labeling (PVC-CBF), measured ultrasound internal carotid (ICA), and femoral (FA) artery blood flow in a group of patients with similar age (~78 years) but different cognitive impairment (i.e., mild cognitive impairment MCI, mild AD-AD1, moderate AD-AD2, and severe AD-AD3) and compared them to young and healthy old (aged-matched) controls. NO-metabolites and passive leg-movement (PLM) induced hyperemia were used to assess systemic vascular function. Ninety-eight individuals were recruited for this study. PVC-CBF, ICA, and FA blood flow were markedly (range of 9–17%) and significantly (all p < 0.05) reduced across the spectrum from YG to OLD, MCI, AD1, AD2, AD3 subjects. Similarly, plasma level of nitrates and the values of PLM were significantly reduced (range of 8–26%; p < 0.05) among the six groups. Significant correlations were retrieved between plasma nitrates, PLM and PVC-CBF, CA, and FA blood flow. This integrative and comprehensive approach to vascular changes in aging and AD showed progressive changes in NO bioavailability and cortical, extracranial, and peripheral circulation in patients with AD and suggested that they are directly associated with AD and not to aging. Moreover, these results suggest that AD-related impairments of circulation are progressive and not confined to the brain. The link between cardiovascular and the central nervous systems degenerative processes in patients at different severity of AD is likely related to the depletion of NO.

Social engagement is fundamental to successful aging and linked to better emotional, physical, and cognitive health. Maintaining social engagement is challenging for many older adults but especially for those with a cognitive impairment (CI). Information and communication technologies (ICT) can provide enhanced opportunities for social and cognitive engagement for older adults with a CI via increased information, education, and social connectivity access. This study used a pre-test post-test design to evaluate the feasibility, acceptability, and preliminary efficacy of the PRISM-CI software system, a tablet-based application designed to enhance access to resources, information, and social engagement, in 52 individuals with a CI between the ages of 65–88 years who had access to PRISM-CI for five months. Findings show that social isolation, loneliness, and depressive symptoms significantly decreased, and mobile device proficiency significantly increased, from baseline to follow-up. Results highlight ICTs potential to foster social engagement among older adults with a CI. [ABSTRACT FROM AUTHOR]

Objectives: To examine the cross-national associations between familism and self-efficacy dimensions, and levels of burden and depression. Methods: Sociodemographic, familism, self-efficacy, depressive symptoms, and burden variables were measured in 349 dementia family caregivers from the US and Spain. Results: US sample: greater support from family was positively related to self-efficacy for obtaining respite and self-efficacy for controlling upsetting thoughts and behaviors. Both self-efficacy constructs were negatively related to depression. Similar findings were obtained for burden. Spanish sample: higher scores on family as referents were associated with lower scores on self-efficacy for obtaining respite; lower scores on self-efficacy for obtaining respite were associated with higher depressive symptomatology. Discussion: Study findings suggest that a significant interplay exists between the various facets of familism and self-efficacy, leading to differential caregiving outcomes. Unique cultural contexts and values derived from each country may exert distinct influences on how the caregiving role is perceived and appraised. [ABSTRACT FROM AUTHOR]

IntroductionA main obstacle that impedes standardized clinical and research applications of arterial spin labeling (ASL), is the substantial differences between the commercial implementations of ASL from major MRI vendors. In this study, we compare a single identical 2D gradient-echo EPI pseudo-continuous ASL (PCASL) sequence implemented on 3T scanners from three vendors (General Electric Healthcare, Philips Healthcare and Siemens Healthcare) within the same center and with the same subjects.Material and methodsFourteen healthy volunteers (50% male, age 26.4±4.7years) were scanned twice on each scanner in an interleaved manner within 3h. Because of differences in gradient and coil specifications, two separate studies were performed with slightly different sequence parameters, with one scanner used across both studies for comparison. Reproducibility was evaluated by means of quantitative cerebral blood flow (CBF) agreement and inter-session variation, both on a region-of-interest (ROI) and voxel level. In addition, a qualitative similarity comparison of the CBF maps was performed by three experienced neuro-radiologists.ResultsThere were no CBF differences between vendors in study 1 (p>0.1), but there were CBF differences of 2-19% between vendors in study 2 (p0.1) but one of the ROIs (p

This essay discusses relations between the Kingdoms of Siam and Italy, 1900–1930, focusing on the central role played by Italian architects and engineers in the introduction of European building knowledge and techniques in Siam. The general context is the extensively described phenomenon of “cultivated emigration” involving a significant segment of the European professionals working abroad in the late nineteenth and early twentieth centuries. In this particular case, however, we have examined Italian expatriates in South East Asia. Several researchers have published papers on the subject in recent years, but a thorough framework for the study has yet to be set up. The perspective chosen for the article is European. In addition to housing the source of the research, Europe is first and foremost where the building culture expressed by the projects analyzed here was forged and understood. In this article, we do not deal directly with the complex problem of the encounter between the Italian and Siamese building cultures. Instead, we have tracked the export to Siam of two European construction techniques (reinforced concrete and metal structure, especially as applied to bridge construction), emphasizing the contribution provided by Italian architects and engineers.

Affordances are the perception of what a technical artifact can do. They bridge a technically-determinist perspective with social constructivist theory, acknowledging the material aspects of technology while allowing for user agency. Yet most affordance theory separates out the engagement process into producers and consumers. On one hand, this lens is essential because it considers how an end user interprets, engages, and utilizes technology through their social structure. It highlights how engagement is both constrained and enabled by the creator, but also documents how such engagement might differ from a creator's intention(s) completely. On the other hand, this framework doesn't consider the interactional dimensions of affordances theory. This paper fills this gap, relying on sociotechnical theory to analyze three case studies across three different platforms (Twitter, Google Scholar, and Yandex). In doing so, we explain how pundits, propagandists, and conspiracy theorists 'activate affordances' to validate their claims. When audiences are primed to 'do their own research,' disinformation becomes a more entangled, participatory process. [ABSTRACT FROM AUTHOR]

Background: There are no narrative or systematic reviews of hearing loss in patients with congenital syphilis. Objectives: The aim of this study was to perform a scoping review to determine what is known about the incidence, characteristics, prognosis, and therapy of hearing loss in children or adults with presumed congenital syphilis. Eligibility criteria: PROSPERO, OVID Medline, OVID EMBASE, Cochrane Library (CDSR and Central), Proquest Dissertations and Theses Global, and SCOPUS were searched from inception to March 31, 2023. Articles were included if patients with hearing loss were screened for CS, ii) patients with CS were screened for hearing loss, iii) they were case reports or case series that describe the characteristics of hearing loss, or iv) an intervention for hearing loss attributed to CS was studied. Sources of evidence: Thirty-six articles met the inclusion criteria. Results: Five studies reported an incidence of CS in 0.3% to 8% of children with hearing loss, but all had a high risk of bias. Seven reported that 0 to 19% of children with CS had hearing loss, but the only one with a control group showed comparable rates in cases and controls. There were 18 case reports/ case series (one of which also reported screening children with hearing loss for CS), reporting that the onset of hearing loss was usually first recognized during adolescence or adulthood. The 7 intervention studies were all uncontrolled and published in 1983 or earlier and reported variable results following treatment with penicillin, prednisone, and/or ACTH. Conclusions: The current literature is not informative with regard to the incidence, characteristics, prognosis, and therapy of hearing loss in children or adults with presumed congenital syphilis. [ABSTRACT FROM AUTHOR]

Variations in visual perspective in autobiographical memory recall exemplify memory as a malleable and dynamic construct. Research examining variations in vantage point during autobiographical memory retrieval has identified a distinction between first-person (recalling a memory through one's own eyes) and third-person (recalling a memory as an observer) perspectives. In her target article, St. Jacques (2024) reviews the lack of consensus regarding whether memories retrieved from a third-person perspective are considered false memories versus memory distortions. In this commentary, we begin with a brief discussion highlighting the distinction between false and distorted memories. We then present findings derived from secondary data analyses examining the relationship between visual perspective and memory distortions on two different "false memory" measures in (N = 112) participants. Study findings underscore that recalling autobiographical memories with an observer perspective may be a distinct type of memory distortion. [ABSTRACT FROM AUTHOR]