Trading off spatio-temporal properties in 3D high-speed fMRI using interleaved stack-of-spirals trajectories.

PURPOSE: Highly undersampled acquisitions have been proposed to push the limits of temporal resolution in functional MRI. This contribution is aimed at identifying parameter sets that let the user trade-off between ultra-high temporal resolution and spatial signal quality by varying the sampling densities. The proposed method maintains the synergies of a temporal resolution that enables direct filtering of physiological artifacts for highest statistical power, and 3D read-outs with optimal use of encoding capabilities of multi-coil arrays for efficient sampling and high signal-to-noise ratio (SNR). METHODS: One- to four-shot interleaved spherical stack-of-spiral trajectories with repetition times from 96 to 352 ms at a nominal resolution of 3 mm using different sampling densities were compared for image quality and temporal SNR (tSNR). The one- and three-shot trajectories were employed in a resting state study for functional characterization. RESULTS: Compared to a previously described single-shot trajectory, denser sampled trajectories of the same type are shown to be less prone to blurring and off-resonance vulnerability that appear in addition to the variable density artifacts of the point spread function. While the multi-shot trajectories lead to a decrease in tSNR efficiency, the high SNR due to the 3D read-out, combined with notable increases in image quality, leads to superior overall results of the three-shot interleaved stack of spirals. A resting state analysis of 15 subjects shows significantly improved functional sensitivity in areas of high off-resonance gradients. CONCLUSION: Mild variable-density sampling leads to excellent tSNR behavior and no increased off-resonance vulnerability, and is suggested unless maximum temporal resolution is sought.

Dengue fever outbreak in Cook Island: A rising concern, efforts, challenges, and future recommendations.

The Cook Island government has made several efforts to ensure zero confirmed cases and transmission of COVID-19, especially among visiting travelers. However, the Cook Island ministry of health has to deal with the new strain of dengue fever outbreak, known as dengue fever type 2 (DEN-2), by adopting several measures to control its spread, especially in the affected parts of the subtropical country. This paper aims to describe the dengue fever response taken in Cook Island and suggest recommendations to control the risk of transmission in endemic parts of the world.

15 Years MR-encephalography.

OBJECTIVE: This review article gives an account of the development of the MR-encephalography (MREG) method, which started as a mere 'Gedankenexperiment' in 2005 and gradually developed into a method for ultrafast measurement of physiological activities in the brain. After going through different approaches covering k-space with radial, rosette, and concentric shell trajectories we have settled on a stack-of-spiral trajectory, which allows full brain coverage with (nominal) 3 mm isotropic resolution in 100 ms. The very high acceleration factor is facilitated by the near-isotropic k-space coverage, which allows high acceleration in all three spatial dimensions. METHODS: The methodological section covers the basic sequence design as well as recent advances in image reconstruction including the targeted reconstruction, which allows real-time feedback applications, and-most recently-the time-domain principal component reconstruction (tPCR), which applies a principal component analysis of the acquired time domain data as a sparsifying transformation to improve reconstruction speed as well as quality. APPLICATIONS: Although the BOLD-response is rather slow, the high speed acquisition of MREG allows separation of BOLD-effects from cardiac and breathing related pulsatility. The increased sensitivity enables direct detection of the dynamic variability of resting state networks as well as localization of single interictal events in epilepsy patients. A separate and highly intriguing application is aimed at the investigation of the glymphatic system by assessment of the spatiotemporal patterns of cardiac and breathing related pulsatility. DISCUSSION: MREG has been developed to push the speed limits of fMRI. Compared to multiband-EPI this allows considerably faster acquisition at the cost of reduced image quality and spatial resolution.

Fast imaging for mapping dynamic networks.

The development of highly accelerated fMRI acquisition techniques has led to novel possibilities to monitor cerebral activity non-invasively and with unprecedented temporal resolutions. With the emergence of dynamic connectivity and its ability to provide a much richer characterization of brain function compared to static measures, fast fMRI may yet play a crucial role in tracking dynamically varying networks. In spite of the dominance of slow hemodynamic contributions to the BOLD signal, high temporal sampling rates nevertheless improve the measurement of physiological noise, yielding an exceptional sensitivity for the detection of periods of transient connectivity at time scales of a few tens of seconds. There is also evidence that relevant BOLD fluctuations are detectable at high frequencies, implying that the benefits of fast fMRI extend beyond the ability to sample nuisance confounds. Here we review the latest technological advancements that have established fast fMRI as an effective acquisition technique, as well as its current and future implications on the analysis of dynamic networks.

Cognitive and behavioral comorbidities in Rolandic epilepsy and their relation with default mode network's functional connectivity and organization.

OBJECTIVE: Rolandic epilepsy (RE) is characterized by typical interictal-electroencephalogram (EEG) patterns mainly localized in centrotemporal and parietooccipital areas. An aberrant intrinsic organization of the default mode network (DMN) due to repeated disturbances from spike-generating areas may be able to account for specific cognitive deficits and behavioral problems in RE. The aim of the present study was to investigate cognitive development (CD) and socioemotional development (SED) in patients with RE during active disease in relation to DMN connectivity and network topology. METHODS: In 10 children with RE and active EEG, CD was assessed using the Wechsler Intelligence Scale for Children-IV (WISC-IV); SED was assessed using the Fünf-Faktoren-Fragebogen für Kinder (FFFK), a Big-Five inventory for the assessment of personality traits in children. Functional connectivity (FC) in the DMN was determined from a 15-minute resting state functional magnetic resonance imaging (fMRI), and network properties were calculated using standard graph-theoretical measures. RESULTS: More severe deficits of verbal abilities tended to be associated with an earlier age at epilepsy onset, but were not directly related to the number of seizures and disease duration. Nonetheless, at the network level, disease duration was associated with alterations of the efficiency and centrality of parietal network nodes and midline structures. Particularly, centrality of the left inferior parietal lobe (IPL) was found to be linked with CD. Reduced centrality of the left IPL and alterations supporting a rather segregated processing within DMN's subsystems was associated with a more favorable CD. A more complicated SED was associated with high seizure frequency and long disease duration, and revealed links with a less favorable CD. SIGNIFICANCE: An impaired CD and - because of their interrelation - SED might be mediated by a common pathomechanism reflected in an aberrant organization, and thus, a potential functional deficit of the DMN. A functional segregation of (left) parietal network nodes from the DMN and a rather segregated processing mode within the DMN might have positive implications/protective value for CD in patients with RE.

Prospective motion correction in functional MRI.

Due to the intrinsic low sensitivity of BOLD-fMRI long scanning is required. Subject motion during fMRI scans reduces statistical significance of the activation maps and increases the prevalence of false activations. Motion correction is therefore an essential tool for a successful fMRI data analysis. Retrospective motion correction techniques are now commonplace and are incorporated into a wide range of fMRI analysis toolboxes. These techniques are advantageous due to robustness, sequence independence and have minimal impact on the fMRI study setup. Retrospective techniques however, do not provide an accurate intra-volume correction, nor can these techniques correct for the spin-history effects. The application of prospective motion correction in fMRI appears to be effective in reducing false positives and increasing sensitivity when compared to retrospective techniques, particularly in the cases of substantial motion. Especially advantageous in this regard is the combination of prospective motion correction with dynamic distortion correction. Nevertheless, none of the recent methods are able to recover activations in presence of motion that are comparable to no-motion conditions, which motivates further research in the area of adaptive dynamic imaging.

Enhanced subject-specific resting-state network detection and extraction with fast fMRI.

Resting-state networks have become an important tool for the study of brain function. An ultra-fast imaging technique that allows to measure brain function, called Magnetic Resonance Encephalography (MREG), achieves an order of magnitude higher temporal resolution than standard echo-planar imaging (EPI). This new sequence helps to correct physiological artifacts and improves the sensitivity of the fMRI analysis. In this study, EPI is compared with MREG in terms of capability to extract resting-state networks. Healthy controls underwent two consecutive resting-state scans, one with EPI and the other with MREG. Subject-level independent component analyses (ICA) were performed separately for each of the two datasets. Using Stanford FIND atlas parcels as network templates, the presence of ICA maps corresponding to each network was quantified in each subject. The number of detected individual networks was significantly higher in the MREG data set than for EPI. Moreover, using short time segments of MREG data, such as 50 seconds, one can still detect and track consistent networks. Fast fMRI thus results in an increased capability to extract distinct functional regions at the individual subject level for the same scan times, and also allow the extraction of consistent networks within shorter time intervals than when using EPI, which is notably relevant for the analysis of dynamic functional connectivity fluctuations. Hum Brain Mapp 38:817-830, 2017. © 2016 Wiley Periodicals, Inc.

Probing neuronal activation by functional quantitative susceptibility mapping under a visual paradigm: A group level comparison with BOLD fMRI and PET.

Dynamic changes of brain-tissue magnetic susceptibility provide the basis for functional MR imaging (fMRI) via T2*-weighted signal-intensity modulations. Promising initial work on a detection of neuronal activity via quantitative susceptibility mapping (fQSM) has been published but consistently reported on ill-understood positive and negative activation patterns (Balla et al., 2014; Chen and Calhoun, 2015a). We set out to (i) demonstrate that fQSM can exploit established fMRI data acquisition and processing methods and to (ii) better describe aspects of the apparent activation patterns using fMRI and PET as standards of reference. Under a standardized visual-stimulation paradigm PET and 3-T gradient-echo EPI-based fQSM, fMRI data from 9 healthy volunteers were acquired and analyzed by means of Independent Component Analysis (ICA) at subject level and, for the first time, at group level. Numbers of activated (z-score>2.0) voxels were counted and their mean z-scores calculated in volumes of interest (occipital lobe (Nocc_lobe), segmented occipital gray-matter (NGM_occ_lobe), large veins (Nveins)), and in occipital-lobe voxels commonly activated in fQSM and fMRI component maps. Common but not entirely congruent regions of apparent activation were found in the occipital lobe in z-score maps from all modalities, fQSM, fMRI and PET, with distinct BOLD-negatively correlated regions in fQSM data. At subject-level, Nocc_lobe, NGM_occ_lobe and their mean z-scores were significantly smaller in fQSM than in fMRI, but their ratio, NGM_occ_lobe/Nocc_lobe, was comparable. Nveins did not statistically differ and the ratio Nveins/NGM_occ_lobe as well as the mean z-scores were higher for fQSM than for fMRI. In veins and immediate vicinity, z-score maps derived from both phase and fQSM-data showed positive and negative lobes resembling dipole shapes in simulated field and phase maps with no correlate in fMRI or PET data. Our results show that standard fMRI tools can directly be used for fQSM processing, and suggest that fQSM may have the potential to detect gray-matter activation distant from large veins, to improve detection of veins with stimulus-induced venous oxygen saturation (SvO2) variations, and to better localize areas of activation. However, our results seem to clearly expose issues that phenomenologically resemble an incomplete dipolar inversion and that need to be subject to further investigation.

Attention modulates neuronal correlates of interhemispheric integration and global motion perception.

In early retinotopic areas of the human visual system, information from the left and right visual hemifields (VHFs) is processed contralaterally in two hemispheres. Despite this segregation, we have the perceptual experience of a unified, coherent, and uninterrupted single visual field. How exactly the visual system integrates information from the two VHFs and achieves this perceptual experience still remains largely unknown. In this study using fMRI, we explored candidate areas that are involved in interhemispheric integration and the perceptual experience of a unified, global motion across VHFs. Stimuli were two-dimensional, computer-generated objects with parts in both VHFs. The retinal image in the left VHF always remained stationary, but in the experimental condition, it appeared to have local motion because of the perceived global motion of the object. This perceptual effect could be weakened by directing the attention away from the global motion through a demanding fixation task. Results show that lateral occipital areas, including the medial temporal complex, play an important role in the process of perceptual experience of a unified global motion across VHFs. In early areas, including the lateral geniculate nucleus and V1, we observed correlates of this perceptual experience only when attention is not directed away from the object. These findings reveal effects of attention on interhemispheric integration in motion perception and imply that both the bilateral activity of higher-tier visual areas and feedback mechanisms leading to bilateral activity of early areas play roles in the perceptual experience of a unified visual field.

Quantification of regional CMRO2 in human brain using dynamic 17O-MRI at 3T.

OBJECTIVE: To investigate the feasibility of cerebral metabolic rate of oxygen consumption (CMRO2) measurements with MRI at 3 Tesla in different brain regions. METHODS: CMRO2 represents a key indicator of the physiological state of brain tissue. Dynamic 17O-MRI with inhalation of isotopically enriched 17O gas has been used to quantify global CMRO2 in brain white (WM) and gray matter (GM). However, global CMRO2 can only reflect the overall oxygen metabolism of the brain and cannot provide enough information on local tissue oxygen metabolism. To investigate the feasibility of determination of regional CMRO2 at a clinical 3 T MRI system, CMRO2 values in frontal, parietal and occipital WM and GM were determined in 5 healthy volunteers and compared to evaluate the regional differences of oxygen metabolism in WM and GM. Additionally, regional CMRO2 values were determined in deep brain structures including thalamus, dorsal striatum, caudate nucleus and insula cortex and in the cerebella, and compared with literature values from 15O-PET studies. RESULTS: In cortical GM the determined CMRO2 values were in good agreement with the literature, whereas values in WM were about 32-48% higher than literature values. Regional analysis revealed a significantly higher CMRO2 in the occipital GM compared to the frontal and parietal GM. By contrast, no significant difference of CMRO2 was observed across the WM. In addition, CMRO2 in deep brain structures was lower compared to literature values and in the cerebella a good hemispheric symmetry of the tissue oxygen metabolism was found. CONCLUSION: Dynamic 17O-MRI enables direct, non-invasive determination of regional CMRO2 in brain structures in healthy volunteers at 3T.

Relationship of V1 Derivation Biphasic P Waves with Morbidity and Mortality in Myocardial Infarction Cases.

OBJECTIVE: To evaluate the biphasic P (V1bP) wave in lead V1 in terms of three-vessel disease (TVD), bypass, and mortality in patients with acute coronary syndrome. STUDY DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Department of Emergency Medicine, University of Health Sciences, Bagcilar Training and Research Hospital, Turkey, between January 2018 and December 2019. METHODOLOGY: A total of 497 patients were admitted to the emergency department due to acute coronary syndrome. Patients were grouped as the right atrium and the left atrium according to the direction of the V1bP wave. Gensini score (GS), left ventricular ejection fraction (LVEF), TVD, bypass, and mortality rates were compared according to these groups. RESULTS: According to the atrial involvement of the patients, the median age was 66 (58-74) years, 220 (44.3%) females and 277 (55.7%) males. In the left atrial group in the V1bP wave, anterior myocardial infarction was the most common in 128 (41.8%) patients, mortality in 17 (5.6%), TVD in 69 (22.5%), and bypass in 13 (4.2%) patients. In the right atrial group, it was found that 127 (66.5%) patients had inferior myocardial infarction, 34 (17.8%) mortality, 66 (34.6%) TVD, and 19 (9.9%) bypass TVD; GS was 89 (80-117) points and LVEF was 45 (36-55)%. In addition, a significant relationship was found with mortality (p=0.019), bypass (p<0.001) and complications (p=0.043). Although the variables showed differences in acute coronary syndrome, mortality, LVEF, GS, mild and/or moderate correlations were found. CONCLUSION: V1bP wave can be a determining parameter for acute coronary syndromes in terms of TVD, bypass, and mortality. KEY WORDS: Emergency department, Biphasic p in lead V1, Three-vessel disease, Bypass, Mortality.

MPPT mechanism based on novel hybrid particle swarm optimization and salp swarm optimization algorithm for battery charging through simulink.

In this paper, a battery charging model is developed for solar PV system applications. As a means of photovoltaic power controlling system, buck-boost converter with a Maximum Power Point Tracking (MPPT) mechanism is developed in this paper for maximum efficiency. This paper proposed a novel combined technique of hybrid Particle Swarm Optimisation (PSO) and Salp Swarm Optimization (SSO) models to perform Maximum Power Point Tracking mechanisms and obtain a higher efficiency for battery charging. In order to retrieve the maximum power from the PV array, the Maximum Power Point Tracking mechanism is observed which reaches the maximum efficiency and the maximum power is fed through the buck-boost converter into the load. The buck-boost converter steps up the voltage to essential magnitude. The energy drawn from the PV array is used for the battery charging by means of an isolated buck converter since the buck-boost converter is not directly connected to the battery. The Fractional Order Proportional Integral Derivative (FOPID) controller handles the isolated buck converter and battery to enhance the efficiency obtained through the Maximum Power Point Tracking mechanism. The simulation results show higher steady efficiency by using the hybrid PSOSSO algorithm in all stages. The battery is charged without losing the efficiency obtained from the hybrid PSOSSO algorithm-based Maximum Power Point Tracking mechanism. The higher efficiency was obtained as 99.99% at Standard Test Conditions (STC) and 99.52% at PV partial shading conditions (PSCs) by using the new hybrid algorithm.

Holo-Hilbert spectral-based noise removal method for EEG high-frequency bands.

Simultaneous EEG-fMRI is a growing and promising field, as it has great potential to further our understanding of the spatiotemporal dynamics of brain function in health and disease. In particular, there is much interest in understanding the fMRI correlates of brain activity in the gamma band (> 30 Hz), as these frequencies are thought to be associated with cognitive processes involving perception, attention, and memory, as well as with disorders such as schizophrenia and autism. However, progress in this area has been limited due to issues such as MR-induced artifacts in EEG recordings, which seem to be more problematic for gamma frequencies. This paper presents a noise removal method for the gamma band of EEG that is based on the Holo-Hilbert spectral analysis (HHSA), but with a new implementation strategy. HHSA uses a nested empirical mode decomposition (EMD) to identify amplitude and frequency modulations (AM and FM, respectively) by averaging over frequencies with high and significant powers. Our method examines gamma band by applying two layers of EMD to the FM and AM components, removing components with very low power based on the power-instantaneous frequency spectrum, and subsequently reconstructs the denoised gamma-band signal from the remaining components. Simulations demonstrate that our proposed method efficiently reduces artifacts while preserving the original gamma signal which is especially critical for simultaneous EEG/fMRI studies.

The syndemic burden of HIV/AIDS in Africa amidst the COVID-19 pandemic.

INTRODUCTION: The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) has long affected millions of individuals across the globe. Historically, the prevalence of this disease is particularly noted within the African continent. Before the coronavirus disease 2019 (COVID-19) pandemic, many African countries struggled to effectively manage the increasing burden associated with HIV/AIDS. There is now a need to reassess this in a COVID-19 pandemic context so that the impact of COVID-19 on HIV/AIDS healthcare within Africa can be adequately evaluated. METHODS: Data collection was performed on the PubMed, Ovid MEDLINE and Embase bibliographical databases with a predefined search strategy. Searches were performed in blind duplicate and all articles considering COVID-19 and HIV/AIDS within African healthcare were considered. RESULTS: The COVID-19 pandemic has severely exacerbated the many issues surrounding HIV/AIDS care within many African countries. These impacts are noticeable in medical, psychological, and socio-political contexts. CONCLUSIONS: Before efforts are made to improve the provision of HIV/AIDS and COVID-19 care within Africa, it is important that this issue is brought to the attention of the scientific and clinical community so that the continent can receive the necessary support and aid.

Reduction of implant RF heating through modification of transmit coil electric field.

In this work, we demonstrate the possibility to modify the electric-field distribution of a radio frequency (RF) coil to generate electric field-free zones in the body without significantly altering the transmit sensitivity. Because implant heating is directly related to the electric-field distribution, implant-friendly RF transmit coils can be obtained by this approach. We propose a linear birdcage transmit coil with a zero electric-field plane as an example of such implant-friendly coils. When the zero electric-field plane coincides with the implant position, implant heating is reduced, as we demonstrated by the phantom experiments. By feeding RF pulses with identical phases and shapes but different amplitudes to the two orthogonal ports of the coil, the position of the zero electric-field plane can also be adjusted. Although implant heating is reduced with this method, a linear birdcage coil results in a whole-volume average specific absorption rate that is twice that of a quadrature birdcage coil. To solve this issue, we propose alternative methods to design implant-friendly RF coils with optimized electromagnetic fields and reduced whole-volume average specific absorption rate. With these methods, the transmit field was modified to reduce RF heating of implants and obtain uniform transmit sensitivity.

Content-Free Awareness: EEG-fcMRI Correlates of Consciousness as Such in an Expert Meditator.

The minimal neural correlate of the conscious state, regardless of the neural activity correlated with the ever-changing contents of experience, has still not been identified. Different attempts have been made, mainly by comparing the normal waking state to seemingly unconscious states, such as deep sleep or general anesthesia. A more direct approach would be the neuroscientific investigation of conscious states that are experienced as free of any specific phenomenal content. Here we present serendipitous data on content-free awareness (CFA) during an EEG-fMRI assessment reported by an extraordinarily qualified meditator with over 50,000 h of practice. We focused on two specific cortical networks related to external and internal awareness, i.e., the dorsal attention network (DAN) and the default mode network (DMN), to explore the neural correlates of this experience. The combination of high-resolution EEG and ultrafast fMRI enabled us to analyze the dynamic aspects of fMRI connectivity informed by EEG power analysis. The neural correlates of CFA were characterized by a sharp decrease in alpha power and an increase in theta power as well as increases in functional connectivity in the DAN and decreases in the posterior DMN. We interpret these findings as correlates of a top-down-initiated attentional state excluding external sensory stimuli and internal mentation from conscious experience. We conclude that the investigation of states of CFA could provide valuable input for new methodological and conceptual approaches in the search for the minimal neural correlate of consciousness.

Fully automated morphological analysis of patients with obstructive sleep apnea.

BACKGROUND/AIM: Obstructive sleep apnea syndrome (OSAS) is a disease characterized by episodic hypoxia. We aimed to use the Freesurfer program for global evaluation of morphological changes in OSAS patients. MATERIALS AND METHODS: Three-dimensional T1-weighted images were obtained, and intracranial morphology was assessed in 18 patients with OSAS and 20 controls. Results of the volume and the cortical thickness analyses of both groups were compared statistically. RESULTS: The total cortical, left-right hemispheres gray matter (GM), corpus callosum, and total GM volumes were lower in OSAS patients when compared with the control group (P < 0.001). The average cortical thickness was lower in OSAS patients bilaterally in pars orbitalis, paracentral, rostral middle frontal, middle frontal, orbital, and superior frontal gyri when compared with the control group (P < 0.05). Furthermore, the volume and average cortical thickness of multiple anatomic regions, apart from the brain parts mentioned above, were decreased unilaterally (e.g., hippocampus, cingulum, putamen, thalamus) in OSAS patients (P < 0.05). CONCLUSION: Multiple morphologic changes occur in the cerebral structures of OSAS patients due to intermittent ischemia episodes. Detection of those areas with Freesurfer is easier. New studies with large series would be needed for these subjects.