Hasil untuk "Internal medicine"

Hagen Holthusen, Paul Steinmann, Ellen Kuhl

We present a physics-based neural network framework for the discovery of constitutive models in fully coupled thermomechanics. In contrast to classical formulations based on the Helmholtz energy, we adopt the internal energy and a dissipation potential as primary constitutive functions, expressed in terms of deformation and entropy. This choice avoids the need to enforce mixed convexity--concavity conditions and facilitates a consistent incorporation of thermodynamic principles. In this contribution, we focus on materials without preferred directions or internal variables. While the formulation is posed in terms of entropy, the temperature is treated as the independent observable, and the entropy is inferred internally through the constitutive relation, enabling thermodynamically consistent modeling without requiring entropy data. Thermodynamic admissibility of the networks is guaranteed by construction. The internal energy and dissipation potential are represented by input convex neural networks, ensuring convexity and compliance with the second law. Objectivity, material symmetry, and normalization are embedded directly into the architecture through invariant-based representations and zero-anchored formulations. We demonstrate the performance of the proposed framework on synthetic and experimental datasets, including purely thermal problems and fully coupled thermomechanical responses of soft tissues and filled rubbers. The results show that the learned models accurately capture the underlying constitutive behavior. All code, data, and trained models are made publicly available via https://doi.org/10.5281/zenodo.19248596.

Tariq Mahmood, Vimal Kumar

Kinga Mate, Pedro de Pablos-Rodríguez, Marta Burbano Herraiz et al.

ABSTRACT Purpose: Focal cryotherapy is a minimally invasive treatment for localized prostate cancer (PCa), but its oncological outcomes, particularly in relation to baseline Gleason Grade Group (GG), remain understudied. This study evaluates its efficacy and the impact while radical of baseline Gleason score on recurrence-free survival. Materials and Methods: A retrospective analysis included 111 patients with localized PCa treated with focal cryotherapy between 2014 and January 2024. Patients with prior treatments or follow-up <12 months were excluded. All patients underwent MRI and transperineal biopsy, and cryotherapy was performed using the Visual ICE Cryoablation System. Confirmatory biopsies were recommended at 12–24 months post-treatment. Recurrence was classified as either in-field (treated or adjacent areas) or out-field (non-adjacent areas). Any recurrence-free survival was defined as the absence of positive biopsy or additional treatment. Radical treatment-free survival was defined as the absence of whole-gland treatment (e.g., radical prostatectomy, radiotherapy), androgen deprivation therapy, metastasis, or death. Outcomes were compared between patients with baseline GG 1 and GG >1. Results: Median follow-up was 35 months (IQR 24–49). Confirmatory biopsies were performed in 78% of patients (n=87), revealing in-field recurrence in 10% and out-field recurrence in 23%. There were no statistically significant differences between ISUP 1 and ISUP >1 groups in terms of protocol biopsy positivity for either in-field recurrence (HR 0.41; 95% CI 0.09–1.9) or out-field recurrence (HR 0.77; 95% CI 0.3–1.98). At three-years, the rates of any recurrence-free and radical treatment-free survival were 63% and 85%, respectively, with no significant variation by baseline GG. Conclusion: Focal cryotherapy provides favorable short-term oncological outcomes in localized PCa, with no significant differences in recurrence-free survival based on baseline Gleason score.

Noopur Basu, Matthew Ryan, Joshua Altman

Background: Septic arthritis is an uncommon but severe condition that can lead to rapidly progressive articular destruction and septicemia. Although the knee is the most commonly affected joint in septic arthritis, bilateral involvement is an exceedingly rare condition often associated with immunocompromising conditions, medical comorbidities or other sources of infection. Case report: A 74-year-old male immunocompetent patient presented with two to three days of atraumatic bilateral knee pain and swelling with difficulty ambulating, with presenting vital signs concerning for sepsis. Physical exam was notable for large bilateral knee effusions, warmth and significantly limited range of motion. Bilateral knee arthrocentesis was performed with synovial fluid analysis consistent with bilateral septic arthritis. The patient was managed with intravenous antibiotics and operative arthrotomy and irrigation. Synovial fluid cultures from the emergency department and operating room, as well as 4/4 blood cultures all grew Group G streptococcus. No primary source of infection was identified. The patient completed a course of intravenous antibiotics tailored to culture susceptibility and had resolution of symptoms. Why should an emergency physician be aware of this?: Polyarticular septic arthritis carries high morbidity and mortality. Although uncommon, atypical presentations and absence of usual risk factors can lead to delays or missed diagnoses in the emergency department. It is essential to maintain a high index of suspicion in the patient presenting with undifferentiated multifocal joint pain or swelling, in the appropriate clinical context, to make an early diagnosis and initiate aggressive treatment to prevent complications.

Elise M. Martin, Matthew J. Morales, Niki Y. Li et al.

Air pollution and maternal stress during pregnancy are both risk factors for neurodevelopmental disorders and often converge on the same communities. Epidemiological and animal studies suggest that maternal psychosocial stress may worsen the effects of air pollutants on neurodevelopmental outcomes. Previous work utilizing a mouse model of combined prenatal exposure to diesel exhaust particles (DEP) and maternal stress (MS) has found numerous sex-specific effects of DEP/MS exposure on neuroimmune outcomes, dopamine receptors, the gut-brain axis, and social behavior. However, it is unclear how broadly the immune landscape is shifted in the brain and intestinal epithelium following DEP/MS. Here, we analyzed immune gene expression in 5 brain regions important for social behavior and in 3 regions of the intestinal epithelium in both male and female offspring at ∼postnatal day 50, following either DEP/MS or control exposure. We found several interesting overall patterns. First, changes in expression of immune genes such as CD11b and Tlr4 were concentrated in the nucleus accumbens and hippocampus. Tlr4 and Il-17ra mRNA also increased in the jejunum and colon following DEP/MS, but only in females. Second, in the nucleus accumbens, catecholamine-O-methyltransferase (Comt) and dopamine transporter 1 (Slc6a3) gene expression were increased following DEP/MS, indicating increased dopamine degradation at and reuptake from the synapse, respectively. Additionally, dopamine D2 receptor (Drd2) mRNA was decreased following DEP/MS in males. Finally, we observed numerous sex differences in immune gene expression regardless of treatment in both the brain and gut. Together, these findings suggest the nucleus accumbens is a key site for neuroimmune and dopaminergic changes following DEP/MS exposure and indicate female-specific changes in intestinal immunity in young adulthood following these prenatal exposures.

Jen-Ping Chu, Mitul Luhar, Patrick Lynett

Interactions between internal solitary waves and floating canopies of varying length and porosity are examined via laboratory experiments and complementary simulations for a miscible, two-layer system. In both approaches, internal solitary waves of varying amplitudes are generated by a jet-array mechanism that is driven by the nonlinear eKdV solution. Pycnocline displacements, phase speeds, and velocity fields are obtained using synchronized planar laser-induced fluorescence and particle imaging velocimetry systems in the experiment. In the simulations, the canopy is represented as a porous zone with prescribed porosity and hydraulic conductivity determined by the Kozeny-Carman model, which is validated by comparing simulated and measured horizontal velocity profiles. The higher-porosity (transitional) canopy produces a nearly monotonic, albeit minor, amplitude reduction and negligible wave energy dissipation after the interaction. However, the shear layer developed at the bottom edge of the lower-porosity (dense) canopy grows to a comparable strength as the shear sustained by the internal solitary wave profile at the pycnocline. The vortex pair generated by this shear accelerates the upper-layer fluid beneath the canopy, leading to complex nonlinear amplitude modulation and significant wave transformation. With an extended canopy length, the internal solitary waves settle to a quasi-steady state with a significant phase speed reduction. Upon the wave exiting the canopy, flow separation at the downstream edge of the canopy again pairs with the shear at the pycnocline, inducing an intensified jet. This complex interaction leads to energy transfer between kinetic and potential energy under the dense canopy.

Jelle Vandersnickt, Vincent Vanlaer, Mathijs Vanrespaille et al.

Internal magnetic fields are an elusive component of stellar structure. However, they can play an important role in stellar structure and evolution models through efficient angular momentum transport and their impact on internal mixing. We strive to explain the 9 components of one frequency multiplet, identified as a low-order quadrupole gravity mode detected in the light curve of the beta Cep pulsator HD 192575 assembled by the Transiting Exoplanet Survey Satellite (TESS). We update the frequencies of the quadrupole mode under investigation using a standard prewhitening method applied to the 1951.46 d TESS light curve, showing that an internal magnetic field is required to simultaneously explain all 9 components. We implement theoretical pulsation computations applicable to the low-order modes of a beta Cep pulsator including the Coriolis force, as well as a magnetic field that is misaligned with respect to the rotation axis. We apply the theoretical description to perform asteroseismic modelling of the amplitudes and frequencies in the multiplet of the quadrupole g-mode of this evolved beta Cep star. Pulsation predictions based on the measured internal rotation frequency of the star cannot explain the observed 9-component frequency splittings of the quadrupole low-order gravity mode. By contrast, we show that the combined effect of the Coriolis force caused by the near-core rotation with a period of about 5.3 d and the Lorentz force due to an internal inclined magnetic field with a maximum strength of around 24 kG does provide a proper explanation of the 9 multiplet frequencies and their relative amplitudes. Given the stellar mass of about 12 solar masses, this work presents the detection and magneto-gravito-asteroseismic modelling of a stable internal magnetic field buried inside an evolved rotating supernova progenitor.

Lukas Buess, Matthias Keicher, Nassir Navab et al.

Generative artificial intelligence (AI) models, such as diffusion models and OpenAI's ChatGPT, are transforming medicine by enhancing diagnostic accuracy and automating clinical workflows. The field has advanced rapidly, evolving from text-only large language models for tasks such as clinical documentation and decision support to multimodal AI systems capable of integrating diverse data modalities, including imaging, text, and structured data, within a single model. The diverse landscape of these technologies, along with rising interest, highlights the need for a comprehensive review of their applications and potential. This scoping review explores the evolution of multimodal AI, highlighting its methods, applications, datasets, and evaluation in clinical settings. Adhering to PRISMA-ScR guidelines, we systematically queried PubMed, IEEE Xplore, and Web of Science, prioritizing recent studies published up to the end of 2024. After rigorous screening, 144 papers were included, revealing key trends and challenges in this dynamic field. Our findings underscore a shift from unimodal to multimodal approaches, driving innovations in diagnostic support, medical report generation, drug discovery, and conversational AI. However, critical challenges remain, including the integration of heterogeneous data types, improving model interpretability, addressing ethical concerns, and validating AI systems in real-world clinical settings. This review summarizes the current state of the art, identifies critical gaps, and provides insights to guide the development of scalable, trustworthy, and clinically impactful multimodal AI solutions in healthcare.

Takuya Mizumoto, Yoshihide Nanno, Jun Ishida et al.

ABSTRACT Aim Regarding the resectability of pancreatic adenocarcinoma (PDAC), not only anatomical factors but also biological and conditional factors have come to be considered. This study examined the impact of the Global Leadership Initiative on Malnutrition (GLIM) criteria on prognosis after resection of anatomically resectable PDAC. Methods The medical records of consecutive patients who underwent resection for resectable PDAC between January 1, 2014, and December 31, 2022, were retrospectively reviewed. Patients were classified as normal, moderately, or severely malnourished according to the GLIM criteria. Results In total, 194 patients were included in the analysis. According to the GLIM criteria, 61 (31.4%), 49 (25.2%), and 84 (42.3%) patients were normal, moderately, and severely malnourished, respectively. Patients with malnutrition had shorter overall, recurrence‐free, and disease‐specific survival (OS, RFS, and DSS) than normal patients (OS, normal vs. moderate, p = 0.015; normal vs. severe, p < 0.001; RFS, normal vs. moderate p = 0.012, normal vs. severe, p < 0.001; DSS, normal vs. moderate, p = 0.023; normal vs. severe, p < 0.001). In multivariate analysis regarding OS using all factors, moderate or severe malnutrition according to the GLIM criteria (p = 0.007), performance status (p = 0.086), preoperative diabetes (p = 0.017), tumor diameter ≥ 3 cm (p = 0.002), lymph node metastasis (p < 0.001), and postoperative adjuvant therapy (p = 0.027) were independent prognostic factors. In multivariate analysis using preoperative factors, malnutrition according to the GLIM criteria remained a significant prognostic factor (p = 0.003). Conclusion The GLIM criteria are effective prognostic predictors in patients with resectable PDAC undergoing upfront surgery. Preoperative nutritional assessment using these criteria may contribute to determining treatment plans for resectable PDAC.

Haowei Du, Dongyan Zhao

Recent works have attempted to integrate external knowledge into LLMs to address the limitations and potential factual errors in LLM-generated content. However, how to retrieve the correct knowledge from the large amount of external knowledge imposes a challenge. To this end, we empirically observe that LLMs have already encoded rich knowledge in their pretrained parameters and utilizing these internal knowledge improves the retrieval of external knowledge when applying them to knowledge-intensive tasks. In this paper, we propose a new internal and external knowledge interactive refinement paradigm dubbed IEKR to utilize internal knowledge in LLM to help retrieve relevant knowledge from the external knowledge base, as well as exploit the external knowledge to refine the hallucination of generated internal knowledge. By simply adding a prompt like 'Tell me something about' to the LLMs, we try to review related explicit knowledge and insert them with the query into the retriever for external retrieval. The external knowledge is utilized to complement the internal knowledge into input of LLM for answers. We conduct experiments on 3 benchmark datasets in knowledge-intensive question answering task with different LLMs and domains, achieving the new state-of-the-art. Further analysis shows the effectiveness of different modules in our approach.

Xiaosong Wang, Xiaofan Zhang, Guotai Wang et al.

The emerging trend of advancing generalist artificial intelligence, such as GPTv4 and Gemini, has reshaped the landscape of research (academia and industry) in machine learning and many other research areas. However, domain-specific applications of such foundation models (e.g., in medicine) remain untouched or often at their very early stages. It will require an individual set of transfer learning and model adaptation techniques by further expanding and injecting these models with domain knowledge and data. The development of such technologies could be largely accelerated if the bundle of data, algorithms, and pre-trained foundation models were gathered together and open-sourced in an organized manner. In this work, we present OpenMEDLab, an open-source platform for multi-modality foundation models. It encapsulates not only solutions of pioneering attempts in prompting and fine-tuning large language and vision models for frontline clinical and bioinformatic applications but also building domain-specific foundation models with large-scale multi-modal medical data. Importantly, it opens access to a group of pre-trained foundation models for various medical image modalities, clinical text, protein engineering, etc. Inspiring and competitive results are also demonstrated for each collected approach and model in a variety of benchmarks for downstream tasks. We welcome researchers in the field of medical artificial intelligence to continuously contribute cutting-edge methods and models to OpenMEDLab, which can be accessed via https://github.com/openmedlab.

B. Wojtsekhowski

The Electron-Ion Collider is under construction at BNL. It will have high-energy high-intensity polarized beams of electrons and hadrons. These beams will allow a high accuracy investigation of nucleon structure in the low- to very-low-x DIS regime. At the same time, similar to the realization at HERA, these beams could be used with an internal target for a very productive investigation of medium- to high-x nucleon structure. Due to a novel regime of electron beam operation and its high polarization and intensity, the Figure-of-Merit of an internal target experiment at EIC will be 500+ times higher than was obtained by HERMES.

Aoyi Wang, Yingdong Wang, Haoyang Peng et al.

The biological targets of traditional Chinese medicine (TCM) are the core effectors mediating the interaction between TCM and the human body. Identification of TCM targets is essential to elucidate the chemical basis and mechanisms of TCM for treating diseases. Given the chemical complexity of TCM, both in silico high-throughput drug-target interaction predicting models and biological profile-based methods have been commonly applied for identifying TCM targets based on the structural information of TCM chemical components and biological information, respectively. However, the existing methods lack the integration of TCM chemical and biological information, resulting in difficulty in the systematic discovery of TCM action pathways. To solve this problem, we propose a novel target identification model NP-TCMtarget to explore the TCM target path by combining the overall chemical and biological profiles. First, NP-TCMtarget infers TCM effect targets by calculating associations between drug/disease inducible gene expression profiles and specific gene signatures for 8,233 targets. Then, NP-TCMtarget utilizes a constructed binary classification model to predict binding targets of herbal ingredients. Finally, we can distinguish TCM direct and indirect targets by comparing the effect targets and binding targets to establish the action pathways of herbal components-direct targets-indirect targets by mapping TCM targets in the biological molecular network. We apply NP-TCMtarget to the formula XiaoKeAn to demonstrate the power of revealing the action pathways of herbal formula. We expect that this novel model could provide a systematic framework for exploring the molecular mechanisms of TCM at the target level. NP-TCMtarget is available at http://www.bcxnfz.top/NP-TCMtarget.

Desiree Louise Draeger, Oliver W. Hakenberg

BackgroundTriple-drug cisplatin- and taxane-based chemotherapy is the standard treatment for metastatic penile squamous cell cancer (PeSCC), with a moderate response rate of 30% to 38%. Relapse after first-line chemotherapy has a poor prognosis and there is no established second-line treatment. Mitomycin C (MMC) is used as an effective chemotherapy in squamous cell carcinoma of other localities. We therefore used MMC as a single agent for the second-line treatment for patients with advanced PeSCC.MethodsNine patients [median age 63 years (range 31 years–81 years)], who, after inguinal and pelvic lymphadenectomy and progression after first-line chemotherapy, received second-line treatment with 20 mg of MMC administered intravenously and weekly, were included in this study. The median number of cycles of MMC was 6 (range 2–12 cycles) and the median cumulative dose was 120 mg absolute (range 40 mg absolute–240 mg absolute). The patients’ toxicity and treatment responses were evaluated, with the latter evaluated using 18F-FDG-PET/CT.ResultsCommon Terminology Criteria for Adverse Events (CTCAE) grades 3 or 4 thrombocytopenia and grades 2 or 3 leukopenia occurred in all patients, as did anemia. In seven patients, the application interval had to be extended due to thrombocytopenia. Stable disease was achieved in two patients, and all others progressed under treatment. Seven patients died of the disease, with most patients dying 6 months after starting MMC therapy. Of the two patients who responded with disease stabilization, one died of progressive disease 14 months after MMC treatment. The other responding patient has been stable for over 1 year and is still receiving treatment, which he tolerates well, and has a good quality of life.ConclusionMMC has only moderate efficacy as a second-line treatment in patients with metastatic PeSCC. With MMC treatment, hematological toxicity is marked.

Alejandro Garcia-Uribe, Todd N. Erpelding, Haixin Ke et al.

In many clinical conditions, such as head trauma, stroke, and low cardiac output states, the brain is at risk for hypoxic-ischemic injury. The metabolic rate and oxygen consumption of the brain are reflected in internal jugular venous oxygen saturation (sijvO2). The current gold standard for monitoring brain oxygenation is invasive; it requires jugular vein catheterization under fluoroscopic guidance and therefore is rarely used. Photoacoustic (PA) measurement, on the other hand, can estimate the oxygen consumption of the brain non-invasively in real time. Such a convenient method can potentially aid earlier detection and prevention of impending hypoxic brain injury. A dual-wavelength photoacoustic tomography (PAT) and ultrasound imaging (US) system was used to image the internal jugular vein (IJV) and estimate the sijvO2 in seven healthy volunteers. The system captured simultaneous co-registered PAT and US images at a rate of five frames per second. For each volunteer, the internal jugular vein was identified under ultrasound guidance, then, additional PA images from two optical wavelengths were collected and used to estimate the oxygen saturation of the internal jugular vein. For each volunteer, the oxygen saturation was calculated from transverse and longitudinal views of the internal jugular vein. The average sijvO2 was 72 +/- 7 %. The preliminary results are encouraging and agree with those reported in the literature. Photoacoustic images were successfully used to calculate the blood hemoglobin oxygen saturation in the internal jugular vein. These results raise confidence that this emerging technology can be used clinically for accurate, noninvasive estimation of sijvO2. In addition, the fast co-registration with US images makes the technique suitable for studying the temporal variations of oxygen saturation in response to physiologic challenges in clinical settings.

Mohammed A. Talle, Anton F. Doubell, Pieter-Paul S. Robbertse et al.

(1) Background: Altered cardiac morphology and function are associated with increased risks of adverse cardiac events in hypertension. Our study aimed to assess left ventricular (LV) morphology, geometry, and function using cardiovascular magnetic resonance (CMR) imaging in patients with hypertensive crisis. (2) Methods: Patients with hypertensive crisis underwent CMR imaging at 1.5 Tesla to assess cardiac volume, mass, function, and contrasted study. Left ventricular (LV) function and geometry were defined according to the guideline recommendations. Late gadolinium enhancement (LGE) was qualitatively assessed and classified into ischemic and nonischemic patterns. Predictors of LGE was determined using regression analysis. (3) Results: Eighty-two patients with hypertensive crisis (aged 48.5 ± 13.4 years, and 57% males) underwent CMR imaging. Of these patients, seventy-eight percent were hypertensive emergency and twenty-two percent were urgency. Diastolic blood pressure was higher under hypertensive emergency (<i>p</i> = 0.032). Seventy-nine percent (92% of emergency vs. 59% of urgency, respectively; <i>p</i> = 0.003) had left ventricular hypertrophy (LVH). The most prevalent LV geometry was concentric hypertrophy (52%). Asymmetric LVH occurred in 13 (22%) of the participants after excluding ischemic LGE. Impaired systolic function occurred in 46% of patients, and predominantly involved hypertensive emergency. Nonischemic LGE occurred in 75% of contrasted studies (67.2% in emergency versus 44.4% in urgency, respectively; <i>p</i> < 0.001). Creatinine and LV mass were independently associated with nonischemic LGE. (5) Conclusion: LVH, altered geometry, asymmetric LVH, impaired LV systolic function, and LGE are common under hypertensive crisis. LVH and LGE more commonly occurred under hypertensive emergency. Longitudinal studies are required to determine the prognostic implications of asymmetric LVH and LGE in hypertensive crisis.

Ricardo Fontes-Carvalho, Gláucia Maria Moraes de Oliveira, Pedro Gonçalves-Teixeira et al.

Víctor Ernesto González Velázquez, Lázaro Roque Pérez, Elys María Pedraza Rodríguez et al.

<strong>Background:</strong> cutaneous malignant melanoma is the most lethal skin tumor, so it is important to know the risk factors for mortality in patients who suffer from it. <br /><strong>Objective:</strong> to determine the prognostic factors of mortality in patients with cutaneous malignant melanoma diagnosed and treated at the Celestino Hernández Robau Teaching University Hospital between January 2010 and December 2015. <br /><strong>Method:</strong> a retrospective cohort analytical observational study was carried out. The population consisted of all patients with cutaneous malignant melanoma diagnosed and treated at the Hospital in the study period (N = 142), and the sample was 112 patients. The variables analyzed were: age, sex, skin color, histological subtype, Breslow index, Clark level, mitotic index, lymph node involvement, distant metastasis, ulceration, topographic location, clinical stage, type of treatment, and lactate dehydrogenase levels blood at diagnosis. The Odds Ratio (OR) and its confidence intervals (CI) were determined for the statistically significant factors. The area under the ROC curve was evaluated for the quantitative variables and a multivariate analysis was performed using Binary Logistic Regression. It was a reliability of 95 %. <br /><strong>Results:</strong> the multivariate analysis identified as prognostic factors of mortality the Breslow index with a C statistic of 0.849 (CI: 0.770–0.923), the Clark V level (OR: 1.246; CI: 0.985-1.870), mitotic index ≥ 6mm2 (OR: 12.408; CI: 9.012-14.897), lymph node involvement ≥ 2 nodes (OR = 6.316; CI = 4.541-8.291), metastasis to lung or other viscera (OR: 6.206; CI: 4.342-8.001), tumor location on the head, neck or trunk (OR: 9.720; CI: 7.684-12.546), ulceration (OR: 0.528; CI: 0.120-0.856), non-surgical treatment (OR: 8.311; CI: 7.098-9.366) and the LDH value in blood ≥333 IU / l (OR: 18.905; CI: 14.750-21.053). <br /><strong>Conclusions:</strong> the prognostic factors of mortality in patients with a diagnosis of cutaneous malignant melanoma were the Breslow index, the Clark level, the mitotic index, lymph node involvement, metastases to the lung or other viscera, the location of the tumor in the head, neck or trunk, the presence of ulceration, non-surgical treatment and the highest values of LDH in blood.

Natalia Buda, Agnieszka Skoczylas, Marcello Demi et al.

Background: This study concerns the application of lung ultrasound (LUS) for the evaluation of the significance of vertical artifact changes with frequency and pleural line abnormalities in differentiating pulmonary edema from pulmonary fibrosis. Study Design and Methods: The study was designed as a diagnostic test. Having qualified patients for the study, an ultrasound examination was performed, consistent with a predetermined protocol, and employing convex and linear transducers. We investigated the possibility of B-line artifact conversion depending on the set frequency (2 MHz and 6 MHz), and examined pleural line abnormalities. Results: The study group comprised 32 patients with interstitial lung disease (ILD) (and fibrosis) and 30 patients with pulmonary edema. In total, 1941 cineloops were obtained from both groups and analyzed. The employment of both types of transducers (linear and convex) was most effective (specificity 91%, specificity 97%, positive predictive value (PPV) 97%, negative predictive value (NPV) 91%, LR(+) 27,19, LR(−) 0.097, area under curve (AUC) = 0.936, <i>p</i> = 7 × 10⁻⁶). Interpretation: The best accuracy in differentiating the etiology of B-line artifacts was obtained with the use of both types of transducers (linear and convex), complemented with the observation of the conversion of B-line artifacts to Z-line.

Sabine Dziemian, Sabine Dziemian, Sabine Dziemian et al.

ObjectivesWorking memory is essential for daily life skills like reading comprehension, reasoning, and problem-solving. Healthy aging of the brain goes along with working memory decline that can affect older people’s independence in everyday life. Interventions in the form of cognitive training are a promising tool for delaying age-related working memory decline, yet the underlying structural plasticity of white matter is hardly studied.MethodsWe conducted a longitudinal diffusion tensor imaging study to investigate the effects of an intensive four-week adaptive working memory training on white matter integrity quantified by global and tract-wise mean diffusivity. We compared diffusivity measures of fiber tracts that are associated with working memory of 32 young and 20 older participants that were randomly assigned to a working memory training group or an active control group.ResultsThe behavioral analysis showed an increase in working memory performance after the four-week adaptive working memory training. The neuroanatomical analysis revealed a decrease in mean diffusivity in the working memory training group after the training intervention in the right inferior longitudinal fasciculus for the older adults. There was also a decrease in mean diffusivity in the working memory training group in the right superior longitudinal fasciculus for the older and young participants after the intervention.ConclusionThis study shows that older people can benefit from working memory training by improving their working memory performance that is also reflected in terms of improved white matter integrity in the superior longitudinal fasciculus and the inferior longitudinal fasciculus, where the first is an essential component of the frontoparietal network known to be essential in working memory.