scholarly journals Multi-model mapping of phonemic fluency

2021 ◽  
Author(s):  
Lisa Cipolotti ◽  
Tianbo Xu ◽  
Bronson Harry ◽  
Joe Mole ◽  
Grace Lakey ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Small Sample Size ◽  
Small Sample ◽  
Anterior Cingulate ◽  
Functional Region ◽  
Phonemic Fluency ◽  
Number Of Patients ◽  
Lesion Symptom Mapping ◽  
Subcortical Regions ◽  
Over Time

Abstract The voluntary generation of non-overlearned responses is usually assessed with phonemic fluency. Like most frontal tasks, it draws upon different complex processes and systems whose precise nature is still incompletely understood. Many claimed aspects regarding the pattern of phonemic fluency performance and its underlying anatomy remain controversial. Major limitations of past investigations include small sample size, scant analysis of phonemic output and methodologically insufficient lesion analyses approaches. We investigated a large number of patients with focal unilateral right or left frontal (n = 110) or posterior (n = 100) or subcortical (n = 65) lesions imaged with magnetic resonance or computed tomography and compared their performance on the number of overall responses, words produced over time, extremely infrequent/unknown words and inappropriate words generated. We also employed, for the first time parcel-based lesion symptom mapping, tract-wise statistical analysis as well as Bayesian multivariate analysis based on meta-analytically defined functional region of interest, including their interactions. We found that left frontal damage was associated with greater impairment than right frontal or posterior damage on overall fluency performance, suggesting that phonemic fluency shows specificity to frontal lesions. We also found that subcorticals, similar to frontals, performed significantly worse than posteriors on overall performance suggesting that subcortical regions are also involved. However, only frontal effects were found for words produced over time, extremely infrequent/unknown and inappropriate words. Parcel-based lesion symptom mapping analysis found that worse fluency performance was associated with damage to the posterior segment of the left frontal middle and superior gyrus, the left dorsal anterior cingulate gyrus and caudate nucleus. Tract-wise statistical analysis revealed that disconnections of left frontal tracts are critical. Bayesian multivariate models of lesions and disconnectome maps implicated left middle and inferior frontal and left dorsomedial frontal regions. Our study suggests that a set of well localised left frontal areas together with subcortical regions and several left frontal tracts are critical for word generation. We speculate that a left lateralized network exists. It involves medial, frontal regions supporting the process of energization, which sustains activation for the duration of the task and middle and inferior frontal regions concerned with selection, required due to the competition produced by associated stored words, respectively. The methodology adopted represents a promising and empirically robust approach in furthering our understanding of the neurocognitive architecture underpinning executive processes.

Abstract W P224: Higher Pre-Hospital Blood Pressure Prolongs Door to Needle Thrombolysis Times

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Digvijaya Navalkele ◽  
Chunyan Cai ◽  
Mohammad Rahbar ◽  
Renganayaki Pandurengan ◽  
Tzu-Ching Wu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Small Sample Size ◽  
Heart Association ◽  
Small Sample ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Intravenous Tissue Plasminogen Activator ◽  
Number Of Patients

Background: Per American Heart Association guidelines, blood pressure (BP) should be < 185/110 to be eligible for intravenous tissue plasminogen activator (tPA). It is shown that door to needle (DTN) time is prolonged in patients who require anti-hypertensive medications prior to thrombolysis in the emergency department (ED). To our knowledge, no studies have focused on pre-hospital BP and its impact on DTN times. We hypothesize that DTN times are longer for patients with higher pre-hospital BP. Methods: We conducted a retrospective review of acute ischemic stroke patients who presented between 1/2010 and 12/2010 to our ED through Emergency Medical Services (EMS) within 3-hrs of symptom onset. Patients were identified from our registry and categorized into two groups: Pre-hospital BP ≥ 185/110 (Pre-hsp HBP) and < 185/110 (Pre-hsp LBP). BP records were abstracted from EMS sheets. Two groups were compared using two-sample t-test or Wilcoxon rank sum test for continuous variables and Chi-square test or Fisher’s exact test for categorical variables. Results: A total of 107 consecutive patients were identified. Out of these, 75 patients (70%) were treated with tPA. Among the patients who received thrombolysis, 35% had pre-hospital BP ≥ 185/110 (n= 26/75). Greater number of patients required anti-hypertensive medications in ED in high BP group compared to low BP group (Pre-hsp HBP n= 14/26, 54%; Pre-hsp LBP n= 13/49, 27%, p < 0.02). Mean door to needle times were significantly higher in Pre-hsp HBP group. (mean ± SD 87.5± 34.2 Vs. 59.7±18.3, p<0.0001). Analysis of patients only within the Pre-hsp HBP group (n= 26) revealed that DTN times were shorter if patients received pre-hsp BP medications compared to patients in the same group who did not receive pre-hsp BP medication (n= 10 vs 16; mean ± SD 76.5 ± 25.7 Vs. 94.3 ± 37.7, p = 0.20) Conclusion: Higher pre-hospital BP is associated with prolonged DTN times and it stays prolonged if pre-hospital high BP remains untreated. Although the later finding was not statistical significant due to small sample size, pre-hospital blood pressure control could be a potential area for improvement to reduce door to needle times in acute ischemic stroke.

scholarly journals Discrepancy of Blast Percentage between the Bone Marrow Aspirate and Flow Cytometry and Its Impact on Survival Outcomes in Patients with Myelodysplastic Syndromes Excess Blast (MDS-EB)

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5441-5441
Author(s):  
Meera Yogarajah ◽  
Phuong L. Nguyen ◽  
Rong He ◽  
Hassan B. Alkhateeb ◽  
Mithun Vinod Shah ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Flow Cytometry ◽  
Small Sample Size ◽  
Scoring Systems ◽  
Standard Of Care ◽  
Risk Groups ◽  
Small Sample ◽  
International Prognostic Scoring System ◽  
P Value ◽  
Number Of Patients

Background MDS is a heterogeneous disease and the revised International Prognostic Scoring System (IPSS-R) is utilized in prognostication. The percentage (%) of blasts in the bone marrow is determined in the aspirate morphologically. Though the former is the standard of care the blast percentage is also reported by flow cytometry and biopsy which can many times be inconsistent. We previously presented the utilization of biopsy based blast percentage which showed meaningful prognostic groups compared to aspirate. In this study we compare the blasts as reported by the aspirate and flow cytometry in MDS-EB in calculating IPSS-R. Methods The MDS database was reviewed for cases of MDS-EB after due IRB approval at the Mayo clinic. We calculated IPSS-R scores based on the aspirate blast % (IPSS-RAsp) and flow blast% (IPSS-Rfl). The aspirate blast percentage was reported morphologically. Suboptimal aspirates were excluded from the study. The flow blast percentage was determined by immunophenotyping. The overall survival (OS) was determined by IPSS-RAsp and IPSS-RFl. OS estimates were calculated by Kaplan-Meier curves and log-rank testing using JMP v.13. Uno's concordance statistic was used to compare the 2 risk scoring systems. Results Of 1322 patients, 431 (33%) cases were identified with MDS-EB out of which 120 (29%) cases had blasts reported in the aspirate and flow. Based on aspirate MDS EB1: 54% (n=65), MDS EB2 46% (n=55). The hematological, cytogenetic and R-IPSS categories were compared between MDS-EB1 and MDS- EB 2. The blast percentage and hemoglobin levels was significantly different between MDS-EB1 and EB2 as seen in table 1, however the IPSS-R risk groups were not significantly different. The flow cytometry was concordant with aspirate in 66/120 (55%) cases. Out of the dis-concordant cases only 20% (11/54) was upstaged by flow cytometry with most of the patients being down staged as expected by the techniques used in processing the blood and hence not reliable when reported low (Figure 1). The OS outcomes based on the IPSS- R asp, IPSS-Rfl areshown in figure 2A,2B .The p value with aspirate based R-IPSS was more significant than flow cytometry based R-IPSS (p= 0.0007 vs 0.0174). We compared the two models for observed OS differences using the Uno model which was not statistically significant. (p= 0.6) Conclusions Both models did not show a difference which is likely due to the very small sample size. However flow cytometry did down stage more patients when disconcordant and may have less value in that setting. It would be ideal to compare all 3 models aspirate, biopsy and flow cytometry however we did not have enough number of patients to do the comparison. Disclosures Patnaik: Stem Line Pharmaceuticals.: Membership on an entity's Board of Directors or advisory committees. Al-Kali:Astex Pharmaceuticals, Inc.: Research Funding.

scholarly journals Connectivity changes in major depressive disorder after rTMS: a review of functional and structural connectivity data

2021 ◽  
Vol 30 ◽  
Author(s):  
G. Schiena ◽  
G. Franco ◽  
A. Boscutti ◽  
G. Delvecchio ◽  
E. Maggioni ◽  
...  
Keyword(s):  
Diffusion Tensor ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Small Sample Size ◽  
Structural Connectivity ◽  
Unipolar Depression ◽  
Brain Regions ◽  
Small Sample ◽  
Anterior Cingulate ◽  
Antidepressant Effect ◽  
Dorsolateral Prefrontal

Abstract Aims In the search for effective therapeutic strategies for depression, repetitive transcranial magnetic stimulation (rTMS) emerged as a non-invasive, promising treatment. This is because the antidepressant effect of rTMS might be related to neuronal plasticity mechanisms possibly reverting connectivity alterations often observed in depression. Therefore, in this review, we aimed at providing an overview of the findings reported by studies investigating functional and structural connectivity changes after rTMS in depression. Methods A bibliographic search was conducted on PubMed, including studies that used unilateral, excitatory (⩾10 Hz) rTMS treatment targeted on the left dorsolateral prefrontal cortex (DLPFC) in unipolar depressed patients. Results The majority of the results showed significant TMS-induced changes in functional connectivity (FC) between areas important for emotion regulation, including the DLPFC and the subgenual anterior cingulate cortex, and among regions that are part of the major resting-state networks, such as the Default Mode Network, the Salience Networks and the Central Executive Network. Finally, in diffusion tensor imaging studies, it has been reported that rTMS appeared to increase fractional anisotropy in the frontal lobe. Limitations The small sample size, the heterogeneity of the rTMS stimulation parameters, the concomitant use of psychotropic drugs might have limited the generalisability of the results. Conclusions Overall, rTMS treatment induces structural and FC changes in brain regions and networks implicated in the pathogenesis of unipolar depression. However, whether these changes underlie the antidepressant effect of rTMS still needs to be clarified.

scholarly journals Pasteurella Endocarditis: A Case Report and Statistical Analysis of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Randall S. Porter ◽  
Christine M. Hay
Keyword(s):  
Liver Disease ◽  
Statistical Analysis ◽  
Clinical Outcomes ◽  
Pasteurella Multocida ◽  
Small Sample Size ◽  
Significant Negative Correlation ◽  
Small Sample ◽  
Review Of The Literature ◽  
Aggressive Management ◽  
Animal Bites

Pasteurella is a genus of commensal bacteria of the oral cavity of several domesticated animals and a common cause of cellulitis after animal bites. Pasteurella has also been reported as a rare cause of endocarditis, with only 35 prior cases of definite Pasteurella endocarditis in the literature. Here, we present a case of Pasteurella multocida endocarditis treated successfully with surgery and antibiosis, as well as a review of the literature with statistical analysis of correlations between risk factors and clinical outcomes, as well as between treatment choices and clinical outcomes. Despite the small sample size, our analysis indicates a statistically significant correlation between comorbid liver disease and mortality, as well as a significant negative correlation between surgical treatment and mortality. This analysis implies a need for surgical management of endocarditis due to Pasteurella species and for more aggressive management of Pasteurella endocarditis in the setting of comorbid liver disease.

scholarly journals Statistical Analysis and Stochastic Modelling of Hydrological Extremes

Water ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1861 ◽  
Author(s):  
Hossein Tabari
Keyword(s):  
Statistical Analysis ◽  
Case Studies ◽  
Small Sample Size ◽  
Stochastic Modelling ◽  
Small Sample ◽  
Climate Conditions ◽  
Hydrological Extremes ◽  
Wide Range ◽  
Scale Models ◽  
Projected Changes

Analysis of hydrological extremes is challenging due to their rarity and small sample size and the interconnections between different types of extremes and gets further complicated by an untrustworthy representation of meso-scale processes involved in extreme events by coarse spatial and temporal scale models as well as biased or missing observations due to technical difficulties during extreme conditions. The special issue “Statistical Analysis and Stochastic Modelling of Hydrological Extremes”—motivated by the need to apply and develop innovative stochastic and statistical approaches to analyze hydrological extremes under current and future climate conditions —encompass 13 research papers. Case studies presented in the papers exploit a wide range of innovative techniques for hydrological extremes analyses. The papers focus on six topics: Historical changes in hydrological extremes, projected changes in hydrological extremes, downscaling of hydrological extremes, early warning and forecasting systems for drought and flood, interconnections of hydrological extremes and applicability of satellite data for hydrological studies. This Editorial provides an overview of the covered topics and reviews the case studies relevant for each topic.

A study of atherosclerosis in patients after radiation for early breast cancer.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 260-260
Author(s):  
V. G. Kirtani ◽  
M. Chang ◽  
A. M. Dobrescu ◽  
S. Zeldis ◽  
J. A. Haas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Coronary Arteries ◽  
Background Radiation ◽  
Small Sample Size ◽  
Screening Method ◽  
Calcium Score ◽  
Small Sample ◽  
Left Hemithorax ◽  
Asymptomatic Patients ◽  
Number Of Patients

260 Background: Radiation therapy (RT) is widely used as part of curative treatment of breast cancer. However, older studies have shown increased cardiac morbidity and mortality from breast RT. A screening method is needed to detect early cardiac damage in this population. Recent data have shown that Electron beam computed tomography (EBCT) can detect early atherosclerosis in coronary arteries by identifying the amount of calcification in the coronaries. In our study we employed this tool to detect occult atherosclerosis caused by breast RT. Methods: We evaluated 20 asymptomatic patients, less than 60 years of age, treated with RT at least 5 years prior to enrollment. Nine received RT to the left and 11 to the right hemithorax. Average interval between RT and CT was 7.7 years (5-14). All patients were treated with external beam RT using tangential technique. The breast was treated to a dose of 4500-5040 cGy and the tumor bed was boosted to a total dose of 6000-6600 cGy. All patients underwent EBCT to compute the volumetric and agatston calcium scores in the coronary arteries and the aorta. Results: Of the 11 patients who had RT to right hemithorax, 8 had calcium score of 0, 2 had very minimally elevated scores and 1 had significantly elevated score (patient 19, interval -14 years). Of the 9 patients who had RT to left hemithorax, 7 had calcium score of 0. None had significantly elevated scores. In the aorta, 11 patients had score of 0 and 8 had minimally elevated scores. Conclusions: Occult atherosclerosis was not detected using EBCT calcium scores in coronaries and aorta in a significant number of patients treated with RT for breast cancer. However, the study is limited by a small sample size. [Table: see text]

Cell cycle and apoptosis regulatory protein (CARP)-1 expression in neuroblastoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9578-9578
Author(s):  
Santosh S. Hanmod ◽  
Samantha Siegel ◽  
James Hatfield ◽  
Edi Levi ◽  
Marwan Zidan ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Regulatory Protein ◽  
Tumor Biology ◽  
Progression Free Survival ◽  
Small Sample ◽  
Immune Histochemistry ◽  
Formalin Fixed Paraffin ◽  
Number Of Patients ◽  
Significant Difference ◽  
Formalin Fixed Paraffin Embedded

9578 Background: Neuroblastoma (NB) is the most common extra-cranial solid tumor in children. The prognosis for patients with high risk NB is still poor. Study of additional prognostic factors will enhance current understanding of the tumor biology and risk stratification. CARP-1 is a recently identified molecule mediating apoptosis signaling by agents like doxorubicin and etoposide. Since these agents are used in the front line treatment of NB, we tested whether CARP-1 expression could be another prognostic factor in NB. Methods: CARP-1 expression was examined by Western blot in a pair of NB cell lines, SK-N-SH and SK-N-SH Dox. We reviewed medical records of patients with NB at Children’s Hospital of Michigan from 2000-2009 and examined CARP-1 expression by immune-histochemistry in the archived, formalin fixed paraffin embedded NB tissues. CARP-1 expression was recorded as positive or negative. Correlation of CARP-1 expression and progression free survival (PFS) was calculated. Results: CARP-1 expression was detected in SK-N-SH but not SK-N-SH Dox, a doxorubicin-resistant derivative of SK-N-SH, suggesting that resistance to doxorubicin is associated with decreased level of CARP-1 expression in NB cells. Of the 30 cases studied, 53 % (16/30) expressed CARP-1. There was no significant difference in N-myc amplification status (13% vs.14%, p=0.3), or proportion of unfavorable Shimada histology (60% vs. 64%, p=0.5) between CARP-1 positive vs. negative groups. Twenty three percent (7/22) patients progressed or relapsed, including 2/16 (13%) in CARP-1 positive group vs. 5/14 (36%) in CARP-1 negative group (p=0.1). There was no significant difference in the PFS at 1 year (94% vs.79%, p=0.2) and 3 year (86% vs.71%, p=0.2) between CARP-1 positive vs. negative groups. Conclusions: CARP-1 expression was decreased in doxorubicin resistant NB cell line. CARP-1 expression was detected in approximately half (53%) of NB tumors. Patients with NB who expressed CARP-1 showed trend towards better 1- & 3-year PFS as compared to those who did not express CARP-1, however, the results are not statistically significant which could be due to the small sample size. Further study with a larger number of patients is warranted to clarify these findings.

scholarly journals An Update on Antibodies to Necleosome Components as Biomarkers of Sistemic Lupus Erythematosus and of Lupus Flares

2019 ◽  
Vol 20 (22) ◽  
pp. 5799 ◽  
Author(s):  
Gian Marco Ghiggeri ◽  
Matteo D’Alessandro ◽  
Domenico Bartolomeo ◽  
Maria Ludovica Degl’Innocenti ◽  
Alberto Magnasco ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Small Sample Size ◽  
Organ Damage ◽  
Small Sample ◽  
Target Organ ◽  
Basic Unit ◽  
Wide Field ◽  
Basic Point ◽  
Clinical Prognosis ◽  
Over Time

Systemic lupus erythematosus (SLE) is an autoimmune disease with variable clinical expression. It is a potentially devastating condition affecting mostly women and leading to clinically unpredictable outcomes. Remission and flares may, in fact, alternate over time and a mild involvement limited to few articular sites may be followed by severe and widespread organ damage. SLE is the prototype of any autoimmune condition and has, for this reason, attracted the interest of basic immunologists. Therapies have evolved over time and clinical prognosis has, in parallel, been improved. What clinicians still lack is the possibility to use biomarkers of the disease as predictors of outcome and, in this area, several studies are trying to find solutions. Circulating autoantibodies are clearly a milestone of clinical research and the concrete possibility is to integrate, in the future, classical markers of activation (like C3) with target organ autoantibodies. Anti-dsDNA antibodies represent a basic point in any predictive attempt in SLE and should be considered the benchmark for any innovative proposal in the wide field of target organ pathologies related to SLE. DNA is part of the nucleosome that is the basic unit of chromatin. It consists of DNA wrapped around a histone octamer made of 2 copies each of Histone 2A, 2B, 3, and 4. The nucleosome has a plastic organization that varies over time and has the potential to stimulate the formation of antibodies directed to the whole structure (anti-nucleosome) or its parts (anti-dsDNA and anti-Histones). Here, we present an updated review of the literature on antibodies directed to the nucleosome and the nucleosome constituents, i.e., DNA and Histones. Wetriedto merge the data first published more than twenty years ago with more recent results to create a balanced bridge between old dogma and more recent research that could serve as a stimulus to reconsider mechanisms for SLE. The formation of large networks would provide the chance of studying large cohorts of patients and confirm what already presented in small sample size during the last years.

Job insecurity fluctuations and support towards Italian precarious schoolteachers

2020 ◽  
Vol 25 (6) ◽  
pp. 631-647
Author(s):  
Marianna Giunchi ◽  
Pedro Marques-Quinteiro ◽  
Chiara Ghislieri ◽  
Anne-Marie Vonthron
Keyword(s):  
Social Support ◽  
Job Insecurity ◽  
Small Sample Size ◽  
Well Being ◽  
School Principal ◽  
Small Sample ◽  
Limited Attention ◽  
Negative Consequences ◽  
Content Type ◽  
Over Time

PurposeThe negative consequences of job insecurity on the well-being of individuals are well known. However, the perceptions of job insecurity over time and how some factors such as social support may affect them have received limited attention. This study follows precarious schoolteachers for three weeks before the end of their contract to explore how their perceptions of job insecurity evolve over time.Design/methodology/approachThe participants were 47 precarious schoolteachers who first completed a general questionnaire, then a diary survey on nine occasions over the course of the three weeks. Data was analysed with MPLUS 7.3.FindingsThe results suggest intra-individual differences regarding the way job insecurity was perceived over time. An additional discovery was that support provided by the school principal was negatively related to changes in job insecurity over time.Research limitations/implicationsThe relatively small sample size, which includes only precarious schoolteachers, and the methodology complexity of the diary are limitations of this study.Practical implicationsThis study highlights the subjective nature of the perceptions of job insecurity. It also shows the importance of the school principal's social support towards precarious schoolteachers; therefore, practitioners should propose interventions to enhance the quality of principal–teachers relationships.Originality/valueThis study contributes to the literature by investigating how perceptions of job insecurity evolve over time and the role of social support.

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