Inter-subject correlation during long narratives reveals widespread neural correlates of reading ability.

Recent work using fMRI inter-subject correlation analysis has provided new information about the brain's response to video and audio narratives, particularly in frontal regions not typically activated by single words. This approach is very well suited to the study of reading, where narrative is central to natural experience. But since past reading paradigms have primarily presented single words or phrases, the influence of narrative on semantic processing in the brain - and how that influence might change with reading ability - remains largely unexplored. In this study, we presented coherent stories to adolescents and young adults with a wide range of reading abilities. The stories were presented in alternating visual and auditory blocks. We used a dimensional inter-subject correlation analysis to identify regions in which better and worse readers had varying levels of consistency with other readers. This analysis identified a widespread set of brain regions in which activity timecourses were more similar among better readers than among worse readers. These differences were not detected with standard block activation analyses. Worse readers had higher correlation with better readers than with other worse readers, suggesting that the worse readers had "idiosyncratic" responses rather than using a single compensatory mechanism. Close inspection confirmed that these differences were not explained by differences in IQ or motion. These results suggest an expansion of the current view of where and how reading ability is reflected in the brain, and in doing so, they establish inter-subject correlation as a sensitive tool for future studies of reading disorders.

Individualized red-cell transfusion strategy for non-cardiac surgery in adults: a randomized controlled trial.

BACKGROUND: Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion. METHODS: Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly assigned to an individualized strategy, a restrictive strategy following China's guideline or a liberal strategy with a transfusion threshold of hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the proportion of patients who received red blood cells (superiority test) and a composite of in-hospital complications and all-cause mortality by day 30 (non-inferiority test). RESULTS: We enrolled 1182 patients: 379, 419, and 384 received individualized, restrictive, and liberal strategies, respectively. Approximately 30.6% (116/379) of patients in the individualized strategy received a red-cell transfusion, less than 62.5% (262/419) in the restrictive strategy (absolute risk difference, 31.92%; 97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI: 2.70-5.30%; P <0.001), and 89.8% (345/384) in the liberal strategy (absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio, 20.06; 97.5% CI: 12.74-31.57; P <0.001). No statistically significant differences were found in the composite of in-hospital complications and mortality by day 30 among the three strategies. CONCLUSION: The individualized red-cell transfusion strategy using the West-China-Liu's Score reduced red-cell transfusion without increasing in-hospital complications and mortality by day 30 when compared with restrictive and liberal strategies in elective non-cardiac surgeries. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01597232.

A highly replicable decline in mood during rest and simple tasks.

Does our mood change as time passes? This question is central to behavioural and affective science, yet it remains largely unexamined. To investigate, we intermixed subjective momentary mood ratings into repetitive psychology paradigms. Here we demonstrate that task and rest periods lowered participants' mood, an effect we call 'Mood Drift Over Time'. This finding was replicated in 19 cohorts totalling 28,482 adult and adolescent participants. The drift was relatively large (-13.8% after 7.3 min of rest, Cohen's d = 0.574) and was consistent across cohorts. Behaviour was also impacted: participants were less likely to gamble in a task that followed a rest period. Importantly, the drift slope was inversely related to reward sensitivity. We show that accounting for time using a linear term significantly improves the fit of a computational model of mood. Our work provides conceptual and methodological reasons for researchers to account for time's effects when studying mood and behaviour.

Construction of classification models for pathogenic bacteria based on LIBS combined with different machine learning algorithms.

Bacteria, especially foodborne pathogens, seriously threaten human life and health. Rapid discrimination techniques for foodborne pathogens are still urgently needed. At present, laser-induced breakdown spectroscopy (LIBS), combined with machine learning algorithms, is seen as fast recognition technology for pathogenic bacteria. However, there is still a lack of research on evaluating the differences between different bacterial classification models. In this work, five species of foodborne pathogens were analyzed via LIBS; then, the preprocessing effect of five filtering methods was compared to improve accuracy. The preprocessed spectral data were further analyzed with a support vector machine (SVM), a backpropagation neural network (BP), and k-nearest neighbor (KNN). Upon comparing the capacity of the three algorithms to classify pathogenic bacteria, the most suitable one was selected. The signal-to-noise ratio and mean square error of the spectral data after applying a Savitzky-Golay filter reached 17.4540 and 0.0020, respectively. The SVM algorithm, BP algorithm, and KNN algorithm attained the highest classification accuracy for pathogenic bacteria, reaching 98%, 97%, and 96%, respectively. The results indicate that, with the support of a machine learning algorithm, LIBS technology demonstrates superior performance, and the combination of the two is expected to be a powerful tool for pathogen classification.

Efficacy of pediatric dermatology Extension for Community Healthcare Outcomes (ECHO) sessions on augmenting primary care providers' confidence and abilities.

Due to the shortage of pediatric dermatologists and the abundance of skin disorders presenting in childhood, general pediatricians shoulder the management of many pediatric dermatologic disorders and would benefit from additional dermatology-specific training. To address this educational gap, general pediatricians were enrolled in a pediatric dermatology-specific Project Extension for Community Healthcare Outcomes (ECHO) program and surveyed to assess the efficacy of the program in increasing providers' ability and confidence in managing pediatric dermatologic conditions. Providers unanimously reported increased confidence and abilities in assessment and management of pediatric dermatologic conditions. Pediatric dermatology Project ECHO demonstrated high efficacy in improving general practitioners' comfort and knowledge on dermatology-specific topics and may be used as an education model for enhancing primary care providers' knowledge and management of common disorders.

Performance Evaluation of Nasal Prong Interface for CPAP Delivery on a Critical Care Ventilator: A Bench Experiment.

BACKGROUND: The RAM cannula (Neotech, Valencia, CA) has become a commonly used interface for CPAP in neonatal intensive care. Performance characteristics of this interface used with a critical care ventilator are not well described. METHODS: This was a bench study utilizing a lung simulator configured as an actively breathing infant (weights of 800 g, 1.5 kg, and 3 kg) with moderate lung disease and a critical care ventilator in CPAP mode with leak compensation on. Three sizes of the RAM cannulae (preemie, newborn, and infant) were compared to 3 BabyFlow nasal prongs (Dräger Medical, Lübeck, Germany) (medium, large, and extra-large). Fabricated nasal models produced a 70% occlusive fit for the RAM cannula and an occlusive fit with the Dräger prongs. Delivered flow and pressure levels were recorded at 9 CPAP levels between 5 and 20 cm H2O. RESULTS: The Dräger prongs produced a mean airway pressure ([Formula: see text]) within 0.20 cm H2O (range -0.10 to 0.35) of the set CPAP across all evaluated prong sizes and CPAP levels. In contrast, the RAM cannula produced [Formula: see text] values that averaged 8.5 cm H2O (range -15 to -3.5) below the set CPAP levels. The deficit in delivered versus target CPAP level for the RAM cannula increased with greater set CPAP. Set CPAP of 5 cm H2O delivered [Formula: see text] values that ranged from 0.6 to 1.5 cm H2O (difference of 3.5-4.4 cm H2O). Set CPAP of 20 cm H2O delivered [Formula: see text] values that ranged from 5.0 to 8.4 cm H2O (difference of 11.7-15 cm H2O). Inspiratory flow required to achieve set CPAP levels did not differ between interfaces, suggesting high resistance in the RAM cannula device masks the delivered CPAP levels. CONCLUSIONS: Use of the RAM cannula with a 30% leak on a critical care ventilator delivered [Formula: see text] values lower than set CPAP. This may be clinically meaningful and should be considered when choosing a nasal interface.

Dexmedetomidine versus midazolam for sedation during endoscopy: A meta-analysis.

Patients undergoing endoscopy frequently require sedation, which commonly includes the administration of midazolam or dexmedetomidine. Previous meta-analyses have mainly focused on comparing the effects of these two drugs in intensive care unit patients. In the present study, randomized controlled trials (RCTs) that compared the sedative and clinical effectiveness of these two drugs in patients undergoing endoscopy were searched in a number of databases. The meta-analysis showed that dexmedetomidine demonstrated a significantly lower rate of respiratory depression and adverse events compared with those presented upon midazolam administration. A significant difference was also observed in the sedation potency of the sedatives. The current controlled data suggest that dexmedetomidine may be an alternative to midazolam in the sedation for endoscopy. However, more high-quality and well-designed studies are required to further evaluate this conclusion.

Successful one-stage extraction of an intracardiac and intravenous leiomyoma through the right atrium under transesophageal ultrasound monitoring.

PURPOSE: Intravenous leiomyomatosis is a rare disorder characterized by benign smooth-muscle tumours, termed leiomyomas, which originate from uterine leiomyomas or pelvic veins. Tumours may extend into the right-sided heart chambers, termed intracardiac leiomyomatosis (ICLM), and may be potentially life-threatening due to mechanical interference with cardiac structures or pulmonary arteries. While surgical excision is the optimal therapy, incomplete retrieval of a tumour or fatal retroperitoneal hemorrhage may occur. We present a case where intraoperative transesophageal ultrasound (TEU) guided complete removal of an intracardiac leiomyoma in a single-stage surgery solely through the right atrium without vein injury. CLINICAL FEATURES: A 46-yr-old female patient presented with a two-week history of exertional dyspnea, palpitations, and syncope. Preoperative imaging modalities revealed a continuous solid mass extending from the inferior vena cava (IVC) into the right atrium, and the patient subsequently underwent open heart surgery for tumour removal and definitive diagnosis. A systematic intraoperative TEU examination performed before resection showed that the serpentine tumour was free from any attachment to the IVC and the heart. Furthermore, the diameter of the intracardiac end of the tumour was wider than that of the IVC. Given these findings, the surgeons carefully drew the cord-like tumour out of the right atrium under close TEU monitoring without vein injury. Post-extraction TEU examination showed complete removal of the tumour. Microscopic examination of the specimen confirmed the diagnosis of intravenous leiomyomatosis. CONCLUSIONS: For cases with ICLM, intraoperative TEU plays a significant role in helping to plan the surgical approach, monitor the movement of the tumour and the IVC during the extraction, and assess the completeness of tumour resection.