Annals of the New York Academy of Sciences最新文献

Congenital amusia is a neurodevelopmental disorder affecting musical ability. Previous studies have demonstrated that music reward sensitivity has both functional and structural bases. However, the nature of music reward sensitivity and its neural underpinnings in amusia remains unclear. This study combined the Barcelona Music Reward Questionnaire and magnetic resonance imaging to investigate resting-state functional and structural correlates of music reward sensitivity in individuals with amusia. Behavioral results indicate individuals with amusia exhibit reduced sensitivity to music, including social rewards, mood regulation, emotional evocation, sensorimotor processing, and music seeking. Brain imaging revealed abnormalities in several classic cognitive and reward-related functional and structural brain areas. Specifically, individuals with amusia have abnormal resting-state functional activity in the right inferior frontal gyrus (IFG) along with altered functional and structural connectivity between the IFG and the striatum. Notably, reduced sensorimotor sensitivity to music in amusia is associated with increased resting-state functional activity in the IFG and enhanced structural connectivity between the IFG and nucleus accumbens (NAcc). Furthermore, the function of the IFG appears to influence the sensorimotor sensitivity via the IFG-NAcc structural connectivity in amusia. These findings suggest the cognitive system and its interactions with the reward system play crucial roles in developmental music disorder.

The automatic classification of dermoscopic images is essential for the early diagnosis and treatment of skin cancer. However, this task remains challenging due to high visual similarity among lesion types, variations in lesion appearance across progression stages, and the presence of artifacts in the images. While deep learning-based approaches have outperformed traditional machine learning methods, many existing models are computationally intensive and offer limited interpretability. These limitations hinder their integration into clinical workflows where efficiency and transparency are critical. In this study, I propose a framework based on focal modulation networks (FMNs) for skin lesion classification. FMNs are designed to efficiently capture both local and global features, addressing the limitations of transformer-based models in processing high-resolution medical images. I evaluate four FMN variants, namely, Tiny, Small, Base, and Large, on three public datasets: ISIC 2017, ISIC 2018, and ISIC 2019. The highest classification accuracy was obtained on ISIC 2019 with 97.8%, followed by 96.4% on ISIC 2018, and 88.1% on ISIC 2017. These results match or exceed those reported in several previous studies. Additionally, FMNs offer model interpretability through modulator visualization. Overall, the proposed method provides an accurate, efficient, and transparent solution for automated skin lesion classification.

Endoscopic retroflexion in the stomach is an important diagnostic and therapeutic maneuver that is often underappreciated and underperformed by general endoscopists. Beyond providing a comprehensive visualization of the gastric cardia and fundus, the retroflexed endoscope is key to assessing the esophagogastric junction, identifying diaphragmatic hernias, and assessing wrap integrity after fundoplication. Such evaluation is critical given the ever-rising incidence of gastroesophageal reflux disorder, prevalence of diaphragmatic hernias, and demand for antireflux and antiobesity surgeries. Careful retroflexed inspection of the gastric cardia is also important in Helicobacter pylori infection, junctional cancers, and neoplasia associated with Barrett's esophagus. Retroflexion provides therapeutic options in ablation of Barrett's esophagus and dilation of subtle strictures. We review here the diagnostic and potential therapeutic importance of the retroflexed endoscope.

This study aimed to evaluate the accuracy and efficiency of using a modeling tool named uSketch for generating patient-specific diagrams in cases of fetal congenital heart disease (CHD). Furthermore, it sought to explore the feasibility of employing uSketch to improve communication efficacy across diverse clinical settings. uSketch successfully produced matched diagrams for 941 cases (98.4%) by single-click, semi-automatic, or manual methods. The mean time required for diagram generation was significantly shorter with uSketch than that with hand-drawn sketches (0.88 ± 0.58 vs. 6.75 ± 2.95 min, p < 0.05). The expert panel unanimously concluded that uSketch exhibits professional-level capability in generating anatomical schematics for fetal CHD. Families with a CHD fetus receiving uSketch diagrams in addition to textual reports showed significantly higher questionnaire scores compared to those who received textual reports alone (p < 0.05). The questionnaire scores of medical students who utilized uSketch diagrams were significantly higher than those of their peers who employed traditional methods (p < 0.05). In conclusion, uSketch facilitates the generation of anatomical diagrams for fetal CHD. It achieves a remarkable coverage rate of 98.4% by automatic, semi-automatic, or manual methods. The deployment of uSketch can substantially enhance communication effectiveness across various clinical and educational contexts.

Autistic children experience higher rates of anxiety compared to their nonautistic peers; however, psychotherapeutic treatments for anxiety such as cognitive behavioral therapy often have limited effectiveness in this population. This study protocol presents a novel, co-designed video-recorded yoga intervention for anxiety, tailored to the unique needs of autistic children. The proposed randomized controlled trial aims to evaluate the efficacy of this intervention compared to a treatment-as-usual waitlist control group. Primary outcomes include changes in anxiety severity, assessed using the Anxiety Disorders Interview Schedule or DSM-5 (ADIS-5) and the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD). Secondary outcomes examine emotion regulation and intolerance of uncertainty using the Emotion Dysregulation Inventory (EDI) and the Intolerance of Uncertainty Scale Child version (IUSC), alongside physiological changes in heart rate variability. Data will be analyzed using repeated measures analysis to assess intervention effects, with mediation analysis exploring the roles of emotion regulation, intolerance of uncertainty, and autonomic function in anxiety reduction. Findings will contribute to the growing evidence base for complementary interventions in autistic populations. If effective, this co-designed yoga intervention could provide an accessible, adaptable, and scalable option for treating anxiety in autistic children, particularly those facing barriers to traditional therapies.