Deep Learning Enables 60% Accelerated Volumetric Brain MRI While Preserving Quantitative Performance: A Prospective, Multicenter, Multireader Trial.

BACKGROUND AND PURPOSE: In this prospective, multicenter, multireader study, we evaluated the impact on both image quality and quantitative image-analysis consistency of 60% accelerated volumetric MR imaging sequences processed with a commercially available, vendor-agnostic, DICOM-based, deep learning tool (SubtleMR) compared with that of standard of care. MATERIALS AND METHODS: Forty subjects underwent brain MR imaging examinations on 6 scanners from 5 institutions. Standard of care and accelerated datasets were acquired for each subject, and the accelerated scans were enhanced with deep learning processing. Standard of care, accelerated scans, and accelerated-deep learning were subjected to NeuroQuant quantitative analysis and classified by a neuroradiologist into clinical disease categories. Concordance of standard of care and accelerated-deep learning biomarker measurements were assessed. Randomized, side-by-side, multiplanar datasets (360 series) were presented blinded to 2 neuroradiologists and rated for apparent SNR, image sharpness, artifacts, anatomic/lesion conspicuity, image contrast, and gray-white differentiation to evaluate image quality. RESULTS: Accelerated-deep learning was statistically superior to standard of care for perceived quality across imaging features despite a 60% sequence scan-time reduction. Both accelerated-deep learning and standard of care were superior to accelerated scans for all features. There was no difference in quantitative volumetric biomarkers or clinical classification for standard of care and accelerated-deep learning datasets. CONCLUSIONS: Deep learning reconstruction allows 60% sequence scan-time reduction while maintaining high volumetric quantification accuracy, consistent clinical classification, and what radiologists perceive as superior image quality compared with standard of care. This trial supports the reliability, efficiency, and utility of deep learning-based enhancement for quantitative imaging. Shorter scan times may heighten the use of volumetric quantitative MR imaging in routine clinical settings.

Fully-automated quantification of regional brain volumes for improved detection of focal atrophy in Alzheimer disease.

Volumetric analysis of structural MR images of the brain may provide quantitative evidence of neurodegeneration and help identify patients at risk for rapid clinical deterioration. This note describes tests of a fully automated MR imaging postprocessing system for volumetric analysis of structures (such as the hippocampus) known to be affected in early Alzheimer disease (AD). The system yielded results that correlated highly with independent computer-aided manual segmentation and were sensitive to the anatomic atrophy characteristic of mild AD.

Hurricane Katrina: prior trauma, poverty and health among Vietnamese-American survivors.

BACKGROUND: The flooding of New Orleans after Hurricane Katrina revealed the disproportionate vulnerability of ethnic minority communities for emergency preparedness, disaster relief and health. Nurses need to analyse Katrina's health consequences for the most vulnerable segments of our society. AIM: To examine factors contributing to differential health outcomes among the New Orleans Vietnamese community in response to Katrina. METHODS: A sample of 113 adult Vietnamese Katrina survivors from New Orleans was recruited. A mixed-method approach, including survey and focus groups, was used to collect data. Survey questions were modified from standardized instruments to evaluate survivors' health status and factors contributing to health outcomes. Multivariate and content analysis were used to investigate effects of prior trauma, financial strain, social support and acculturation level in predicting survivors' health outcomes. RESULTS: Findings suggested financial strain was the strongest risk factor for Vietnamese survivors' post-traumatic stress disorder (PTSD) symptoms, and physical and mental health post-disaster; while social support was a strong protective factor for health. Survivors who perceived higher impact from previous traumatic experiences had poorer physical health, but not PTSD symptoms or poor mental health after controlling for financial strain and social support, suggesting complex relationships among these measures in predicting PTSD symptoms and health. Less-acculturated individuals also reported higher levels of PTSD symptoms and poorer physical health. CONCLUSIONS: Catastrophic events like Katrina can result in disproportionate risk of negative health outcomes among vulnerable populations. Nurses should take into account prior trauma, financial strain, social support network and acculturation level, to adequately address survivors' needs.

Selective inhibition of adenylyl cyclase by octopamine via a human cloned alpha 2A-adrenoceptor.

1. In this study we have compared the abilities of the enantiomers of the structural isomers of the phenolamines, octopamine and synephrine, and the catecholamines, noradrenaline and adrenaline, to couple selectively a human cloned alpha 2A-adrenoceptor, stably expressed in a Chinese hamster ovary (CHO) cell line, to G-protein linked second messenger pathways mediating an increase and a decrease in cyclic AMP production. 2. The catecholamines couple the alpha 2A-adrenoceptor to both an increase and a decrease in the rate of cyclic AMP production. In the absence of pertussis toxin pretreatment both catecholamines tested showed a dose-dependent decrease with a maximum at 100 nM. After pertussis toxin pretreatment they both produced a dose-dependent increase in cyclic AMP production with a maximum at 10 microM. 3. The phenolamines, octopamine and synephrine were only able to couple the alpha 2A-adrenoceptor to a dose-dependent decrease in cyclic AMP production at concentrations up to 1 mM, with the synephrine isomers being more potent than the corresponding octopamine isomers. The meta-isomers of both phenolamines were more potent than the corresponding para-isomers and the (-)-enantiomers were more potent than the (+)-enantiomers. Thus, (-)-meta-synephrine [(-)-phenylephrine] was the most effective isomer tested with an observable decrease occurring between 100 nM and 1 microM. 4. The effects of octopamine and the catecholamines on the decrease in cyclic AMP production were additive at submaximal concentrations, whilst octopamine reduced the stimulant effect of submaximal concentrations of noradrenaline on cyclic AMP production after pertussis toxin pretreatment. 5. The time courses of the inhibitory effects of both meta-octopamine and noradrenaline were parallel and peaked after a 1 min exposure to the agonist. In contrast, the stimulant effects of noradrenaline after pertussis toxin pretreatment were of a much slower time course with a maximum effect occurring after a 5 min incubation period. 6. Since octopamine and synephrine occur naturally in, and are co-released with catecholamines from, mammalian tissues, the results of the present study suggest that the human cloned alpha 2A-adrenoceptor can be coupled selectively by different endogenous agonists to G-protein pathways mediating the regulation of adenylyl cyclase activity.

Short-term emersion affects cardiac function and regional haemolymph distribution in the crab Cancer magister

Changes in cardiac function and arterial haemolymph flow associated with 6 h of emersion were investigated in the crab Cancer magister using an ultrasonic flowmeter. This species is usually found sublittorally but, owing to the large-scale horizontal water movements associated with extreme tides, C. magister may occasionally become stranded on the beach. Laboratory experiments were designed such that the emersion period was typical of those that might be experienced by this crab in its natural environment. The frequency of the heart beat began to decline sharply almost immediately after the start of the experimental emersion period. Cardiac stroke volume fell more gradually. The combined reduction in these two variables led to a maximum decrease in cardiac output of more than 70 % from the control rate. Haemolymph flow through all the arteries originating at the heart, with the exception of the anterior aorta, also declined markedly during emersion. As the water level in the experimental chamber fell below the inhalant branchial openings, a stereotypical, dramatic increase in haemolymph flow through the anterior aorta began and this continued for the duration of the emersion period. The rapid time course of the decline in heart-beat frequency and the increase in haemolymph flow through the anterior aorta suggest a neural mechanism responding to the absence of ventilatory water in the branchial chambers. These responses may be adaptations, respectively, to conserve energy by reducing the minute volume of haemolymph pumped by the heart and to protect the supply of haemolymph to cephalic elements of the central nervous system. The decline in cardiac stroke volume, which occurs more slowly over the emersion period, may be a passive result of the failure to supply sufficient O2 to meet the aerobic demands of the cardiac ganglion.

Crustacean cardioexcitatory peptides may inhibit the heart in vivo.

Peptide neurohormones exist as functionally similar analogues in a wide variety of invertebrate and vertebrate phyla, and many have been implicated as cardiovascular regulators. In decapod crustaceans, these include the pentapeptide proctolin, crustacean cardioactive peptide (CCAP) and the FMRF amide-related peptides F1 and F2, all of which are found in the pericardial organs located immediately upstream of the heart. Cardioexcitatory activity has been demonstrated by these four peptides in both isolated and semi-isolated arthropod hearts; CCAP, however, has minimal effects on the heart of Cancer magister. In the present study, we determined the effects of proctolin, F1 and F2 on the heart of the crab C. magister in both in vitro (semi-isolated heart) and in vivo (whole animal) preparations. In semi-isolated hearts, infusion of each peptide caused cardioexcitation, increasing the rate and stroke volume of the heart. In whole crabs, the peptides were cardioinhibitory; the strongest effects were observed with F1 and F2, which dramatically decreased heart rate, cardiac stroke volume and cardiac output. These results cast doubt on current perceptions of the functional role of cardioactive peptides in the regulation of invertebrate cardiovascular performance in vivo.

CARDIOVASCULAR ADAPTATIONS ENHANCE TOLERANCE OF ENVIRONMENTAL HYPOXIA IN THE CRAB CANCER MAGISTER

Unrestrained crabs instrumented with probes for ultrasonic measurement of arterial haemolymph flow were subjected to 6 h of hypoxic exposure. During this interval, the inhalant O2 partial pressure was reduced in steps from 18 to 3 kPa. Measurement of haemolymph flow through all arteries leaving the heart allowed direct calculation of cardiac output, stroke volume and the distribution of cardiac output for both non-stressed and hypoxic animals. Resting levels of cardiac output were low compared with previously reported values for this and other species of decapod crustaceans. During exposure to the most severe level of hypoxia tested, haemolymph flow through the anterior arteries decreased while flow through the posterior aorta and sternal artery increased by 55 % and 27 % respectively. Cardiac output increased from a control value of 9.8±1.6 to 11.9±1.2 ml kg-1 min-1 despite a decrease in heart-beat frequency. Scaphognathite beat frequency increased from 82.1±4.3 min-1 to more than 120 min-1 after 90 min of hypoxic exposure and remained at this level for the duration of the exposure period. The decrease in haemolymph flow, via the anterior arteries, to the antero-dorsal region of the animal concurrent with an increase in flow to the posterior and antero-ventral regions, via the posterior aorta and sternal artery, implicates an active mechanism for redistribution of haemolymph flow during hypoxic exposure. The high rate of scaphognathite pumping, presumably to maximise O2 uptake during experimental hypoxia, was probably made possible by an increased blood supply to these organs, which are perfused by downstream branches of the sternal artery.

Homeoviscous Properties Implicated by the Interactive Effects of Pressure and Temperature on the Hydrothermal Vent Crab Bythograea thermydron.

Specimens of the hydrothermal vent crab Bythograea thermydron, collected from 13° N on the East Pacific Rise, were exposed to pressures greater than those in their natural habitat over a range of temperatures to assess how increased hydrostatic pressure affects a species that requires high pressure to survive. We measured heart beat frequency and contraction waveform at pressures ranging from 28 MPa (normal environmental pressure for this species) to 62 MPa at 5°, 10°, and 20°C. At 5°C, increased hydrostatic pressure induced bradycardia or acardia in conjunction with marked disruption of the ventricular contraction waveform. The animals did not survive following decompression. The effects of increased pressure were less pronounced at 10°C and almost negligible at 20°C. Our results support previous findings at subambient pressures which suggest that the lipid bilayers of cell and organelle membranes are the primary sites affected by short-term pressure variation in deep-sea organisms. We also found evidence of an adaptive mechanism of pressure temperature interaction in these animals from the eurythermic habitat of the hydrothermal vents.