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Approaches to enable equitable psychiatric genetic research in Africa 在非洲开展公平的精神病基因研究的方法。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-25 DOI: 10.1038/s43856-024-00639-z
Allan Kalungi, Dan J. Stein, Niran Okewole, Segun Fatumo
African populations are currently underrepresented in global psychiatric genetics research. Here, we highlight the importance of conducting psychiatric genetics research in Africa, key issues which have hindered such research, and ongoing initiatives and strategies to overcome these issues. Kalungi et al. highlight the underrepresentation of African populations in psychiatric genetic research. They advocate for strategic investments, capacity building, and collaboration to empower African scientists and institutions, emphasizing community engagement and ethical considerations for robust and culturally sensitive research in Africa.
目前,非洲人口在全球精神病遗传学研究中的代表性不足。在此,我们强调了在非洲开展精神遗传学研究的重要性、阻碍此类研究的关键问题,以及为克服这些问题而正在采取的举措和战略。Kalungi 等人强调了非洲人口在精神病遗传学研究中代表性不足的问题。他们主张进行战略投资、能力建设和合作,以增强非洲科学家和机构的能力,同时强调社区参与和伦理方面的考虑,以便在非洲开展稳健且具有文化敏感性的研究。
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引用次数: 0
A reproducible extended ex-vivo normothermic machine liver perfusion protocol utilising improved nutrition and targeted vascular flows 利用改进的营养和定向血管流量,实现可重复的扩展体外常温机器肝脏灌注方案。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-24 DOI: 10.1038/s43856-024-00636-2
George Clarke, Jingwen Mao, Angus Hann, Yiyu Fan, Amita Gupta, Anisa Nutu, Erwin Buckel Schaffner, Kayani Kayani, Nicholas Murphy, Mansoor N. Bangash, Anna L. Casey, Isla Wootton, Alexander J. Lawson, Bobby V. M. Dasari, M. Thamara P. R. Perera, Hynek Mergental, Simon C. Afford
Normothermic machine perfusion of donor livers has become standard practice in the field of transplantation, allowing the assessment of organs and safe extension of preservation times. Alongside its clinical uses, there has been expanding interest in extended normothermic machine perfusion (eNMP) of livers as a potential vehicle for medical research. Reproducible extended normothermic machine perfusion has remained elusive due to its increased complexity and monitoring requirements. We set out to develop a reproducible protocol for the extended normothermic machine perfusion of whole human livers. Human livers declined for transplantation were perfused using a blood-based perfusate at 36 °C using the Liver Assist device (XVIVO, Sweden), with continuous veno-venous haemofiltration in-parallel. We developed the protocol in a stepwise fashion. Perfusion techniques utilised included: targeted physiological vascular flows, phosphate replacement (to prevent hypophosphataemia), N-acetylcysteine (to prevent methaemoglobin accumulation), and the utilisation of sodium lactate as both a nutritional source and real-time measure of hepatocyte function. All five human livers perfused with the developed protocol showed preserved function with a median perfusion time of 168 h (range 120–184 h), with preserved viability throughout. Livers can be reproducibly perfused in excess of 120 (range 121–184) hours with evidence of preserved hepatocyte and cholangiocyte function. Clarke et al. present a reproducible protocol for the extended normothermic machine perfusion of human livers. Function and are preserved in five human livers perfused between 121–184 h. Circulating blood through human livers at normal body temperature allows transplant surgeons to assess the function of the liver and safely extend the time it is out of the body prior to transplantation. Extending this perfusion of livers beyond 24 h has proven difficult. We evaluated improved techniques to circulate blood through the liver. We found the improved techniques could enable a machine to be used to reliably perfuse livers for more than 24 h, whilst preserving the function of the liver. Our improved method included varying the blood flow according to liver size and removing waste products from the circulating blood. Using our method could enable more livers to be used successfully in transplant operations, reducing the waiting times for people requiring liver transplantation and improving their quality of life.
背景:对供体肝脏进行常温机器灌注已成为移植领域的标准做法,可对器官进行评估并安全延长保存时间。在临床应用的同时,人们对延长肝脏常温机器灌注(eNMP)作为医学研究的潜在工具的兴趣也在不断扩大。由于其复杂性和监测要求的增加,可重复的延长常温机器灌注仍然难以实现。方法:使用肝脏辅助设备(XVIVO,瑞典)在 36 °C的温度下使用基于血液的灌注液灌注衰竭的用于移植的人类肝脏,同时进行连续的静脉血液滤过。我们以循序渐进的方式制定了方案:灌注技术包括:有针对性的生理血管流量、磷酸盐置换(防止低磷血症)、N-乙酰半胱氨酸(防止高铁血红蛋白积累),以及利用乳酸钠作为营养源和肝细胞功能的实时测量。采用所制定的方案灌注的五个人肝均显示功能保持完好,中位灌注时间为 168 小时(120-184 小时不等),整个过程中的存活率保持完好:结论:肝脏可重复灌注超过 120 小时(范围为 121-184 小时),且有证据表明肝细胞和胆管细胞功能得以保留。
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引用次数: 0
Comparing role of religion in perception of the COVID-19 vaccines in Africa and Asia Pacific 比较宗教在非洲和亚太地区对 COVID-19 疫苗认知中的作用。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-24 DOI: 10.1038/s43856-024-00628-2
Shihui Jin, Alex R. Cook, Robert Kanwagi, Heidi J. Larson, Leesa Lin
In the midst of the global COVID-19 vaccine distribution challenge, religion stands out as a key determinant of vaccine hesitancy and health choices. Notably, the multifaceted religious environments of Africa and the Asia Pacific remain under-researched in this context. Utilizing data from two survey waves conducted between 2021 and 2022, this cross-sectional study investigated the effects of religious beliefs on perceptions of compatibility between religion and vaccines and COVID-19 vaccine acceptance in Africa and Asia Pacific. Logistic regression models were employed, with interaction terms between socio-economic factors incorporated to account for variations among diverse subpopulations. Among the eight religious groups identified, Atheists and Buddhists in the Asia Pacific exhibit the lowest agreement, with fewer than 60% acknowledging the religious compatibility of vaccines. Willingness to accept vaccines, however, is consistently higher in Asia Pacific by at least four percentage points compared to Africa, with the disparity widening further in the second wave. Impacts of education on vaccine perceptions vary across religious groups, while acknowledging vaccine compatibility with religion positively contributed to vaccine acceptance. Dynamics between region, religion, and other socio-demographic factors have changed substantially over time. All but Atheists and Muslims exhibit a higher propensity to endorse vaccines during Survey Wave 2. Our study reveals complex, context-dependent connections between vaccine attitudes and religion and the heterogeneous effects of time and education among different religious affiliations. Understanding the underlying drivers of these temporal variations helps inform tailored approaches aimed at addressing vaccine hesitancy, promoting vaccine uptake, and improving the well-being of each religious group. This study examined the effects of religious beliefs on thoughts about agreement between religion and vaccines, and COVID-19 vaccine acceptance in Africa and Asia Pacific. Data came from surveys of individuals across many regions during the COVID-19 pandemic in 2021 and 2022. We found lower agreement to compatibility between vaccine and religious belief among Atheists and Buddhists in the Asia Pacific, while Africans were generally less likely to accept the COVID-19 vaccines. In addition, education influenced vaccine views differently across religious groups, and those who felt vaccination was compatible with their religion were more likely to accept a vaccine. These findings show we should monitor vaccine confidence and tailor efforts to reduce vaccine hesitancy among different subgroups of people. Jin et al. explore the role of religion in perception of COVID-19 vaccination across Africa and Asia Pacific regions. They highlight important similarities and differences that may help inform future public health interventions around preventative medicine.
背景:在全球面临 COVID-19 疫苗分配挑战的情况下,宗教是决定疫苗接种犹豫和健康选择的关键因素。值得注意的是,非洲和亚太地区多层面的宗教环境在这方面的研究仍然不足:本横断面研究利用 2021 年至 2022 年期间进行的两次调查的数据,调查了宗教信仰对非洲和亚太地区宗教与疫苗兼容性的看法以及 COVID-19 疫苗接受度的影响。研究采用了逻辑回归模型,并加入了社会经济因素之间的交互项,以考虑不同亚人群之间的差异:结果:在确定的八个宗教团体中,亚太地区的无神论者和佛教徒的认同度最低,只有不到 60% 的人承认疫苗的宗教兼容性。然而,与非洲相比,亚太地区接受疫苗的意愿始终高出至少四个百分点,在第二轮调查中,差距进一步扩大。教育对疫苗认知的影响因宗教群体而异,而承认疫苗与宗教的兼容性则对疫苗的接受度有积极的促进作用。地区、宗教和其他社会人口因素之间的关系随着时间的推移发生了很大变化。除无神论者和穆斯林外,其他群体在第二波调查中都表现出更高的疫苗认可倾向:我们的研究揭示了疫苗态度与宗教之间复杂的、取决于环境的联系,以及时间和教育对不同宗教信仰的不同影响。了解这些时空变化的根本原因有助于为解决疫苗犹豫、促进疫苗接种和改善每个宗教团体的福祉提供有针对性的方法。
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引用次数: 0
Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review 常用药物对脊髓损伤进展的影响:系统综述。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-24 DOI: 10.1038/s43856-024-00638-0
Lucie Bourguignon, Louis P. Lukas, Bethany R. Kondiles, Bobo Tong, Jaimie J. Lee, Tomás Gomes, Wolfram Tetzlaff, John L. K. Kramer, Matthias Walter, Catherine R. Jutzeler
Complications arising from acute traumatic spinal cord injury (SCI) are routinely managed by various pharmacological interventions. Despite decades of clinical application, the potential impact on neurological recovery has been largely overlooked. This study aims to highlight commonly administered drugs with potential disease-modifying effects. This systematic literature review included studies referenced in PubMed, Scopus and Web of Science from inception to March 31st, 2021, which assess disease-modifying properties on neurological and/or functional recovery of drugs routinely administered following spinal cord injury. Drug effects were classified as positive, negative, mixed, no effect, or not (statistically) reported. Risk of bias was assessed separately for animal, randomized clinical trials, and observational human studies. We analyzed 394 studies conducting 486 experiments that evaluated 144 unique or combinations of drugs. 195 of the 464 experiments conducted on animals (42%) and one study in humans demonstrate positive disease-modifying properties on neurological and/or functional outcomes. Methylprednisolone, melatonin, estradiol, and atorvastatin are the most common drugs associated with positive effects. Two studies on morphine and ethanol report negative effects on recovery. Despite a large heterogeneity observed in study protocols, research from bed to bench and back to bedside provides an alternative approach to identify new candidate drugs in the context of SCI. Future research in human populations is warranted to determine if introducing drugs like melatonin, estradiol, or atorvastatin would contribute to enhancing neurological outcomes after acute SCI. Patients with spinal cord injury (SCI) are exposed to a wide range of medications treating health conditions arising as a consequence of the initial injury. The effect of providing patients with a large number of medications in the early period after injury, that is in the first days to weeks, on recovery from SCI, however, is typically not considered. This extensive and structured review of evidence from pre-clinical (animal) and clinical (human) studies quantifies these effects for the first time. 144 unique drugs or combinations of drugs previously reported to be administered in animal models or to patients with SCI have been studied for their effect on recovery across 486 distinct experiments. A small subset of drugs are associated with positive effects, and provide potential targets for further study to determine if they can be used to treat SCI. Bourguignon, Lukas et al. systematically review the effect of drugs commonly administered after traumatic spinal cord injury on the neurological recovery in both animal studies and humans. Extensive heterogeneity in study characteristics and results highlight the need for harmonization across the field but also the potential for drug repurposing.
背景:急性创伤性脊髓损伤(SCI)引起的并发症通常会通过各种药物干预来控制。尽管临床应用了几十年,但其对神经系统恢复的潜在影响在很大程度上被忽视了。本研究旨在强调具有潜在疾病调节作用的常用药物:本系统性文献综述包括 PubMed、Scopus 和 Web of Science 中引用的从开始到 2021 年 3 月 31 日的研究,这些研究评估了脊髓损伤后常规用药对神经和/或功能恢复的疾病调节特性。药物效应分为阳性、阴性、混合效应、无效应或未报告(统计)效应。分别评估了动物、随机临床试验和观察性人体研究的偏倚风险:我们分析了 394 项研究,共进行了 486 次实验,评估了 144 种独特药物或药物组合。在 464 项动物实验中,有 195 项(42%)和一项人体研究证明了药物对神经和/或功能结果具有积极的疾病调节作用。甲基强的松龙、褪黑素、雌二醇和阿托伐他汀是最常见的具有积极作用的药物。关于吗啡和乙醇的两项研究报告了对康复的负面影响:尽管在研究方案中观察到很大的异质性,但从床边到工作台再回到床边的研究为确定 SCI 候选新药提供了另一种方法。未来有必要在人群中开展研究,以确定引入褪黑素、雌二醇或阿托伐他汀等药物是否有助于改善急性 SCI 后的神经功能预后。
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引用次数: 0
Eliminating gender bias in biomedical research requires fair inclusion of pregnant women and gender diverse people 要消除生物医学研究中的性别偏见,就必须公平地接纳孕妇和不同性别的人。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-23 DOI: 10.1038/s43856-024-00629-1
Mridula Shankar, A. Metin Gülmezoglu, Joshua P. Vogel, Shivaprasad S. Goudar, Annie McDougall, Manjunath S. Somannavar, Sara Rushwan, Yeshita V. Pujar, Umesh Charantimath, Anne Ammerdorffer, Meghan A. Bohren
Systematic under-representation of pregnant women and gender diverse pregnant people in clinical research has prevented them from benefitting fairly from biomedical advances. The resulting lack of pharmacological safety and efficacy data leads to medicine discontinuation, sub-optimal dosing, and reliance on repurposed therapies. We identify four roadblocks to fair inclusion. First, investment and research are inhibited by protectionist attitudes among research gatekeepers who view pregnancy as a vulnerable state. Second, exclusion ignores human-specific biological variations affecting medication absorption and impacts on the pregnant body. Third, pregnant populations in low-and middle-income countries face a double disadvantage due to gender and location, despite bearing a disproportionate maternal mortality burden. Fourth, perspectives and experiences of pregnant populations are undervalued in clinical intervention design. We propose five actions to optimize fair inclusion: fostering reciprocal partnerships, prioritizing multi-disciplinary research, awareness-raising of the need for pharmaceutical innovation, conducting regulatory analyses, and promoting responsible inclusion over presumptive exclusion. Shankar et al. discuss how to better undertake research and assure health interests of pregnant women and gender diverse pregnant people. Their recommendations include growing research and regulatory partnerships and innovation, plus promoting responsible inclusion in place of presumptive exclusion.
孕妇和不同性别的孕妇在临床研究中的代表性一直不足,这使她们无法公平地受益于生物医学的进步。由于缺乏药理学安全性和有效性数据,导致停药、用药剂量不达标,以及依赖于重新设计的疗法。我们指出了公平纳入的四个障碍。首先,研究把关人的保护主义态度阻碍了投资和研究,他们认为怀孕是一种脆弱的状态。其次,排除法忽视了影响药物吸收和对孕妇身体影响的人体特异性生物变异。第三,中低收入国家的孕妇由于性别和地理位置的原因面临双重不利条件,尽管他们承受着过重的孕产妇死亡负担。第四,在临床干预设计中,孕妇的观点和经验被低估。我们建议采取五项行动来优化公平包容:促进互惠伙伴关系、优先考虑多学科研究、提高对药物创新需求的认识、开展监管分析以及促进负责任的包容而非假定性排斥。
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引用次数: 0
Understanding and mitigating the impact of race with adversarial autoencoders 利用对抗式自动编码器了解和减轻种族的影响。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-23 DOI: 10.1038/s43856-024-00627-3
Kathryn Sarullo, S. Joshua Swamidass
Artificial intelligence carries the risk of exacerbating some of our most challenging societal problems, but it also has the potential of mitigating and addressing these problems. The confounding effects of race on machine learning is an ongoing subject of research. This study aims to mitigate the impact of race on data-derived models, using an adversarial variational autoencoder (AVAE). In this study, race is a self-reported feature. Race is often excluded as an input variable, however, due to the high correlation between race and several other variables, race is still implicitly encoded in the data. We propose building a model that (1) learns a low dimensionality latent spaces, (2) employs an adversarial training procedure that ensure its latent space does not encode race, and (3) contains necessary information for reconstructing the data. We train the autoencoder to ensure the latent space does not indirectly encode race. In this study, AVAE successfully removes information about race from the latent space (AUC ROC = 0.5). In contrast, latent spaces constructed using other approaches still allow the reconstruction of race with high fidelity. The AVAE’s latent space does not encode race but conveys important information required to reconstruct the dataset. Furthermore, the AVAE’s latent space does not predict variables related to race (R2 = 0.003), while a model that includes race does (R2 = 0.08). Though we constructed a race-independent latent space, any variable could be similarly controlled. We expect AVAEs are one of many approaches that will be required to effectively manage and understand bias in ML. Computer models used in healthcare can sometimes be biased based on race, leading to unfair outcomes. Our study focuses on understanding and reducing the impact of self-reported race in computer models that learn from data. We use a model called an Adversarial Variational Autoencoder (AVAE), which helps ensure that the models don’t accidentally use race in their calculations. The AVAE technique creates a simplified version of the data, called a latent space, that leaves out race information but keeps other important details needed for accurate predictions. Our results show that this approach successfully removes race information from the models while still allowing them to work well. This method is one of many steps needed to address bias in computer learning and ensure fairer outcomes. Our findings highlight the importance of developing tools that can manage and understand bias, contributing to more equitable and trustworthy technology. Sarullo and Swamidass use an adversarial variational autoencoder (AVAE) to remove race information from computer models while retaining essential data for accurate predictions, effectively reducing bias. This approach highlights the importance of developing tools to manage bias, ensuring fairer and more trustworthy technology.
背景:人工智能有可能加剧我们面临的一些最具挑战性的社会问题,但也有可能缓解和解决这些问题。种族对机器学习的干扰效应是一个持续的研究课题。本研究旨在利用对抗变异自动编码器(AVAE)来减轻种族对数据衍生模型的影响。在本研究中,种族是一个自我报告的特征。种族通常被排除在输入变量之外,然而,由于种族与其他几个变量之间的高度相关性,种族仍然隐含在数据中:我们建议建立一个模型:(1)学习低维度的潜在空间;(2)采用对抗训练程序,确保其潜在空间不编码种族;(3)包含重构数据的必要信息。我们对自动编码器进行训练,以确保潜在空间不会间接编码种族:在这项研究中,AVAE 成功地从潜在空间中删除了种族信息(AUC ROC = 0.5)。相比之下,使用其他方法构建的潜在空间仍能高保真地重建种族信息。AVAE 的潜在空间没有对种族进行编码,但传达了重建数据集所需的重要信息。此外,AVAE 的潜在空间不能预测与种族有关的变量(R2 = 0.003),而包含种族的模型却能预测(R2 = 0.08):尽管我们构建了一个与种族无关的潜在空间,但任何变量都可以进行类似的控制。我们希望 AVAE 是有效管理和理解 ML 中偏差所需的众多方法之一。
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引用次数: 0
Oral and gut microbiome profiles in people with early idiopathic Parkinson’s disease 早期特发性帕金森病患者的口腔和肠道微生物组概况。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-23 DOI: 10.1038/s43856-024-00630-8
Keaton Stagaman, Matthew J. Kmiecik, Madeleine Wetzel, Stella Aslibekyan, Teresa Filshtein Sonmez, Pierre Fontanillas, 23andMe Research Team, Joyce Tung, Michael V. Holmes, Seth T. Walk, Madelyn C. Houser, Lucy Norcliffe-Kaufmann
Early detection of Parkinson’s disease (PD), a neurodegenerative disease with central and peripheral nerve involvement, ensures timely treatment access. Microbes influence nervous system health and are altered in PD. We examined gut and mouth microbiomes from recently diagnosed patients in a geographically diverse, matched case-control, shotgun metagenomics study. Here, we show greater alpha-diversity in 445 PD patients versus 221 controls. The microbial signature of PD includes overabundance of 16 OTUs, including Streptococcus mutans and Bifidobacterium dentium, and depletion of 28 OTUs. Machine learning models indicate that subspecies level oral microbiome abundances best distinguish PD with reasonably high accuracy (area under the curve: 0.758). Microbial networks are disrupted in cases, with reduced connectivity between short-chain fatty acid-producing bacteria the the gut. Importantly, microbiome diversity metrics are associated with non-motor autonomic symptom severity. Our results provide evidence that predictive oral PD microbiome signatures could possibly be used as biomarkers for the early detection of PD, particularly when there is peripheral nervous system involvement. Stagaman et al. investigate the associations between early idiopathic Parkinson’s disease (PD) and the diversity and composition of both saliva and stool microbiomes in a large, geographically diverse US cohort. Abundances of saliva microbes, particularly Prevotella, Neisseria, and Streptococcus OTUs, best distinguish between controls and cases. Parkinson’s disease (PD) is a neurodegenerative disease that is characterized by both motor symptoms, such as tremors, and non-motor symptoms, such as constipation. Our aim was to determine whether there were differences in the number and types of microbes living in the saliva and intestines of people with and without PD. We saw significant differences in the microbial communities living in healthy controls compared to people with PD. Additionally, we found that the proportions of microbe types in saliva were the best at distinguishing between controls and cases, and identified the specific kinds of microbes that were driving this distinction. These results highlight the potential importance of the saliva microbiome in understanding the causes and symptomatology of PD.
背景:帕金森病是一种累及中枢神经和周围神经的神经退行性疾病,早期发现帕金森病可确保及时治疗。微生物影响神经系统的健康,并在帕金森病中发生改变:我们在一项地理多样性、匹配病例对照、霰弹枪元基因组学研究中检测了新近确诊患者的肠道和口腔微生物组:结果:我们发现 445 例帕金森病患者与 221 例对照组相比,α-多样性更高。帕金森病的微生物特征包括16个OTUs(包括变异链球菌和双歧杆菌)的过度丰富和28个OTUs的减少。机器学习模型表明,亚种水平的口腔微生物组丰度最能区分腹泻病,准确率相当高(曲线下面积:0.758)。病例中的微生物网络遭到破坏,肠道中产生短链脂肪酸的细菌之间的连接性降低。重要的是,微生物组多样性指标与非运动性自主神经症状严重程度相关:我们的研究结果提供了证据,表明具有预测性的口腔帕金森病微生物组特征有可能被用作早期检测帕金森病的生物标志物,尤其是在有外周神经系统受累的情况下。
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引用次数: 0
A click-based electrocorticographic brain-computer interface enables long-term high-performance switch scan spelling 基于点击的大脑皮层电图脑机接口可实现长期高性能开关扫描拼写。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-22 DOI: 10.1038/s43856-024-00635-3
Daniel N. Candrea, Samyak Shah, Shiyu Luo, Miguel Angrick, Qinwan Rabbani, Christopher Coogan, Griffin W. Milsap, Kevin C. Nathan, Brock A. Wester, William S. Anderson, Kathryn R. Rosenblatt, Alpa Uchil, Lora Clawson, Nicholas J. Maragakis, Mariska J. Vansteensel, Francesco V. Tenore, Nicolas F. Ramsey, Matthew S. Fifer, Nathan E. Crone
Brain-computer interfaces (BCIs) can restore communication for movement- and/or speech-impaired individuals by enabling neural control of computer typing applications. Single command click detectors provide a basic yet highly functional capability. We sought to test the performance and long-term stability of click decoding using a chronically implanted high density electrocorticographic (ECoG) BCI with coverage of the sensorimotor cortex in a human clinical trial participant (ClinicalTrials.gov, NCT03567213) with amyotrophic lateral sclerosis. We trained the participant’s click detector using a small amount of training data (<44 min across 4 days) collected up to 21 days prior to BCI use, and then tested it over a period of 90 days without any retraining or updating. Using a click detector to navigate a switch scanning speller interface, the study participant can maintain a median spelling rate of 10.2 characters per min. Though a transient reduction in signal power modulation can interrupt usage of a fixed model, a new click detector can achieve comparable performance despite being trained with even less data (<15 min, within 1 day). These results demonstrate that a click detector can be trained with a small ECoG dataset while retaining robust performance for extended periods, providing functional text-based communication to BCI users. Amyotrophic lateral sclerosis (ALS) is a progressive disease of the nervous system that causes muscle weakness and leads to paralysis. People living with ALS therefore struggle to communicate with family and caregivers. We investigated whether the brain signals of a participant with ALS could be used to control a spelling application. Specifically, when the participant attempted a grasping movement, a computer method detected increased brain signals from electrodes implanted on the surface of his brain, and thereby generated a mouse-click. The participant clicked on letters or words from a spelling application to type sentences. Our method was trained using 44 min’ worth of brain signals and performed reliably for three months without any retraining. This approach can potentially be used to restore communication to other severely paralyzed individuals over an extended time period and after only a short training period. Candrea et al. develop a brain-computer interface click detection algorithm using electrocorticographic signals. Using this click detector, a clinical trial participant with amyotrophic lateral sclerosis was able to control a switch-scanning spelling application and achieve high rates of spelling without model retraining.
背景:脑机接口(BCI)可通过神经控制电脑打字应用,恢复运动和/或语言障碍患者的交流。单指令点击检测器提供了一种基本但功能强大的能力:我们试图在一名患有肌萎缩性脊髓侧索硬化症的人类临床试验参与者(ClinicalTrials.gov,NCT03567213)身上测试使用长期植入的高密度皮质电图(ECoG)BCI(覆盖感觉运动皮层)进行点击解码的性能和长期稳定性。我们使用少量训练数据训练了参与者的点击检测器(结果:通过使用点击检测器来浏览开关扫描拼写界面,研究对象可以保持每分钟 10.2 个字符的中位拼写速度。虽然信号功率调制的瞬时降低可能会中断固定模型的使用,但新的点击检测器在使用更少数据进行训练的情况下也能获得相当的性能(结论:新的点击检测器在使用更少数据进行训练的情况下也能获得相当的性能):这些结果表明,点击检测器可以使用较小的心电图数据集进行训练,同时在较长时间内保持稳健的性能,从而为 BCI 用户提供基于文本的功能性通信。
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引用次数: 0
Advanced three-dimensional X-ray imaging unravels structural development of the human thymus compartments 先进的三维 X 射线成像揭示了人类胸腺各区的结构发展。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-22 DOI: 10.1038/s43856-024-00623-7
Savvas Savvidis, Roberta Ragazzini, Valeria Conde de Rafael, J. Ciaran Hutchinson, Lorenzo Massimi, Fabio A. Vittoria, Sara Campinoti, Tom Partridge, Olumide K. Ogunbiyi, Alessia Atzeni, Neil J. Sebire, Paolo De Coppi, Alberto Mittone, Alberto Bravin, Paola Bonfanti, Alessandro Olivo
The thymus, responsible for T cell-mediated adaptive immune system, has a structural and functional complexity that is not yet fully understood. Until now, thymic anatomy has been studied using histological thin sections or confocal microscopy 3D reconstruction, necessarily for limited volumes. We used Phase Contrast X-Ray Computed Tomography to address the lack of whole-organ volumetric information on the microarchitecture of its structural components. We scanned 15 human thymi (9 foetal and 6 postnatal) with synchrotron radiation, and repeated scans using a conventional laboratory x-ray system. We used histology, immunofluorescence and flow cytometry to validate the x-ray findings. Application to human thymi at pre- and post-natal stages allowed reliable tracking and quantification of the evolution of parameters such as size and distribution of Hassall’s Bodies and medulla-to-cortex ratio, whose changes reflect adaptation of thymic activity. We show that Hassall’s bodies can occupy 25% of the medulla volume, indicating they should be considered a third thymic compartment with possible implications on their role. Moreover, we demonstrate compatible results can be obtained with standard laboratory-based x-ray equipment, making this research tool accessible to a wider community. Our study allows overcoming the resolution and/or volumetric limitations of existing approaches for the study of thymic disfunction in congenital and acquired disorders affecting the adaptive immune system. The thymus is the organ responsible for programming the immune system. It consists of two main compartments, named medulla and cortex. The medulla contains onion-shaped parts known as “Hassall’s bodies”. By imaging thymi at different stages of development with advanced x-ray methods, we gain understanding of changes that occur over time in 3D. We quantified how much of the thymus was occupied by these different components as they change with age, showing that Hassall’s bodies can take up 25% of the medulla, and should therefore be considered a proper part of the thymus with a purpose. Having a better understanding of the thymus can prove important in targeting conditions such as Down syndrome and thymic tumours, as well as provide information about structure. Savvidis et al. present x-ray 3D imaging visualizing the internal anatomy of the human thymus across developmental stages. Quantification and evolution of Hassall’s bodies and medulla-to-cortex ratio, indicate they should be considered a third compartment of the thymic anatomy.
背景:胸腺负责T细胞介导的适应性免疫系统,其结构和功能的复杂性尚未完全明了。迄今为止,对胸腺解剖结构的研究都是通过组织学薄切片或共聚焦显微镜三维重建来进行的,而且必须是在体积有限的情况下:方法:我们使用相位对比 X 射线计算机断层扫描来解决缺乏有关其结构成分微观架构的整个器官容积信息的问题。我们使用同步辐射扫描了 15 个人体胸腺(9 个胎儿胸腺和 6 个出生后胸腺),并使用传统的实验室 X 射线系统进行了重复扫描。我们使用组织学、免疫荧光和流式细胞术验证了 X 射线的研究结果:结果:应用于人类出生前和出生后阶段的胸腺,可对哈索尔体的大小和分布以及髓质与皮质的比例等参数的演变进行可靠的跟踪和量化,这些参数的变化反映了胸腺活动的适应性。我们的研究表明,哈索尔体可占据髓质体积的25%,这表明它们应被视为胸腺的第三区室,并可能对其作用产生影响。此外,我们还证明了使用标准实验室 X 射线设备可以获得兼容的结果,使更多人可以使用这一研究工具:我们的研究克服了现有方法在研究影响适应性免疫系统的先天性和后天性疾病的胸腺功能障碍时存在的分辨率和/或体积限制。
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引用次数: 0
Biomarkers and point of care screening approaches for the management of preeclampsia 治疗子痫前期的生物标志物和护理点筛查方法。
IF 5.4 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2024-10-22 DOI: 10.1038/s43856-024-00642-4
Ka Wai Ng, Nandita Chaturvedi, Gerard L. Coté, Stephanie A. Fisher, Samuel Mabbott
Preeclampsia is a multi-organ pregnancy complication, that is primarily detected when pregnant people have high blood pressure, and is confirmed by testing for the presence of protein in the urine. While more specific and accurate diagnostic and imaging tests are becoming available, they are still in the process of undergoing widespread regulatory adoption, and so are not yet the standard of care. Since biochemical processes are a precursor to the systemic progression of disease, we review some established, emerging, and promising biomarkers that are proposed to be associated with preeclampsia, and newly developed approaches for screening them at the point of care, to reduce the burden of the disease. Ng, Chaturvedi et al. discuss established, emerging, and promising biomarkers related to preeclampsia. They highlight novel approaches for screening these biomarkers at the point of care, aiming to democratize testing and reduce the burden of the disease.
子痫前期是一种多器官妊娠并发症,主要是在孕妇出现高血压时被发现,并通过检测尿液中是否含有蛋白质来确认。虽然越来越多的特异性和准确的诊断和成像检测方法已经问世,但这些方法仍在监管部门的广泛采用过程中,因此尚未成为治疗标准。由于生化过程是疾病全身进展的前兆,我们回顾了一些已确定的、新出现的和有希望的与子痫前期相关的生物标志物,以及新开发的在护理点筛查这些生物标志物的方法,以减轻疾病负担。
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引用次数: 0
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Communications medicine
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