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BackgroundPleomorphic adenoma (PA), often with the benign-like imaging appearances similar to Warthin tumor (WT), however, is a potentially malignant tumor with a high recurrence rate. It is worse that pathological fine-needle aspiration cytology (FNAC) is difficult to distinguish PA and WT for inexperienced pathologists. This study employed deep learning (DL) technology, which effectively utilized ultrasound images, to provide a reliable approach for discriminating PA from WT.Methods488 surgically confirmed patients, including 266 with PA and 222 with WT, were enrolled in this study. Two experienced ultrasound physicians independently evaluated all images to differentiate between PA and WT. The diagnostic performance of preoperative FNAC was also evaluated. During the DL study, all ultrasound images were randomly divided into training (70%), validation (20%), and test (10%) sets. Furthermore, ultrasound images that could not be diagnosed by FNAC were also randomly allocated to training (60%), validation (20%), and test (20%) sets. Five DL models were developed to classify ultrasound images as PA or WT. The robustness of these models was assessed using five-fold cross-validation. The Gradient-weighted Class Activation Mapping (Grad-CAM) technique was employed to visualize the region of interest in the DL models.ResultsIn Grad-CAM analysis, the DL models accurately identified the mass as the region of interest. The area under the receiver operating characteristic curve (AUROC) of the two ultrasound physicians were 0.351 and 0.598, and FNAC achieved an AUROC of only 0.721. Meanwhile, for DL models, the AUROC value for discriminating between PA and WT in the test set was from 0.828 to 0.908. ResNet50 demonstrated the optimal performance with an AUROC of 0.908, an accuracy of 0.833, a sensitivity of 0.736, and a specificity of 0.904. In the test set of cases that FNAC failed to provide a diagnosis, DenseNet121 demonstrated the optimal performance with an AUROC of 0.897, an accuracy of 0.806, a sensitivity of 0.789, and a specificity of 0.824.ConclusionFor the discrimination of PA and WT, DL models are superior to ultrasound and FNAC, thereby facilitating surgeons in making informed decisions regarding the most appropriate surgical approach.

Magnetoencephalography (MEG) is a robust method for non-invasive functional brain mapping of sensory cortices due to its exceptional spatial and temporal resolution. The clinical standard for MEG source localization of functional landmarks from sensory evoked responses is the equivalent current dipole (ECD) localization algorithm, known to be sensitive to initialization, noise, and manual choice of the number of dipoles. Recently many automated and robust algorithms have been developed, including the Champagne algorithm, an empirical Bayesian algorithm, with powerful abilities for MEG source reconstruction and time course estimation (Wipf et al. 2010; Owen et al. 2012). Here, we evaluate automated Champagne performance in a clinical population of tumor patients where there was minimal failure in localizing sensory evoked responses using the clinical standard, ECD localization algorithm. MEG data of auditory evoked potentials and somatosensory evoked potentials from 21 brain tumor patients were analyzed using Champagne, and these results were compared with equivalent current dipole (ECD) fit. Across both somatosensory and auditory evoked field localization, we found there was a strong agreement between Champagne and ECD localizations in all cases. Given resolution of 8mm voxel size, peak source localizations from Champagne were below 10mm of ECD peak source localization. The Champagne algorithm provides a robust and automated alternative to manual ECD fits for clinical localization of sensory evoked potentials and can contribute to improved clinical MEG data processing workflows.

BackgroundNeuronal- and circuit-level abnormalities of excitation and inhibition are shown to be associated with tau and amyloid-beta (Aβ) in preclinical models of Alzheimer's disease (AD). These relationships remain poorly understood in patients with AD.MethodsUsing empirical spectra from magnetoencephalography and computational modeling (neural mass model), we examined excitatory and inhibitory parameters of neuronal subpopulations and investigated their specific associations to regional tau and Aβ, measured by positron emission tomography, in patients with AD.ResultsPatients with AD showed abnormal excitatory and inhibitory time-constants and neural gains compared to age-matched controls. Increased excitatory time-constants distinctly correlated with higher tau depositions while increased inhibitory time-constants distinctly correlated with higher Aβ depositions.ConclusionsOur results provide critical insights about potential mechanistic links between abnormal neural oscillations and cellular correlates of impaired excitatory and inhibitory synaptic functions associated with tau and Aβ in patients with AD.FundingThis study was supported by the National Institutes of Health grants: K08AG058749 (KGR), F32AG050434-01A1 (KGR), K23 AG038357 (KAV), P50 AG023501, P01 AG19724 (BLM), P50-AG023501 (BLM and GDR), R01 AG045611 (GDR); AG034570, AG062542 (WJ); NS100440 (SSN), DC176960 (SSN), DC017091 (SSN), AG062196 (SSN); a grant from John Douglas French Alzheimer's Foundation (KAV); grants from Larry L. Hillblom Foundation: 2015-A-034-FEL (KGR), 2019-A-013-SUP (KGR); grants from the Alzheimer's Association: AARG-21-849773 (KGR); PCTRB-13-288476 (KAV), and made possible by Part the CloudTM (ETAC-09-133596); a grant from Tau Consortium (GDR and WJJ), and a gift from the S. D. Bechtel Jr. Foundation.

Methods for electro- or magnetoencephalography (EEG/MEG) based brain source imaging (BSI) using sparse Bayesian learning (SBL) have been demonstrated to achieve excellent performance in situations with low numbers of distinct active sources, such as event-related designs. This paper extends the theory and practice of SBL in three important ways. First, we reformulate three existing SBL algorithms under the majorization-minimization (MM) framework. This unification perspective not only provides a useful theoretical framework for comparing different algorithms in terms of their convergence behavior, but also provides a principled recipe for constructing novel algorithms with specific properties by designing appropriate bounds of the Bayesian marginal likelihood function. Second, building on the MM principle, we propose a novel method called LowSNR-BSI that achieves favorable source reconstruction performance in low signal-to-noise-ratio (SNR) settings. Third, precise knowledge of the noise level is a crucial requirement for accurate source reconstruction. Here we present a novel principled technique to accurately learn the noise variance from the data either jointly within the source reconstruction procedure or using one of two proposed cross-validation strategies. Empirically, we could show that the monotonous convergence behavior predicted from MM theory is confirmed in numerical experiments. Using simulations, we further demonstrate the advantage of LowSNR-BSI over conventional SBL in low-SNR regimes, and the advantage of learned noise levels over estimates derived from baseline data. To demonstrate the usefulness of our novel approach, we show neurophysiologically plausible source reconstructions on averaged auditory evoked potential data.

How do functional brain networks emerge from the underlying wiring of the brain? We examine how resting-state functional activation patterns emerge from the underlying connectivity and length of white matter fibers that constitute its "structural connectome". By introducing realistic signal transmission delays along fiber projections, we obtain a complex-valued graph Laplacian matrix that depends on two parameters: coupling strength and oscillation frequency. This complex Laplacian admits a complex-valued eigen-basis in the frequency domain that is highly tunable and capable of reproducing the spatial patterns of canonical functional networks without requiring any detailed neural activity modeling. Specific canonical functional networks can be predicted using linear superposition of small subsets of complex eigenmodes. Using a novel parameter inference procedure we show that the complex Laplacian outperforms the real-valued Laplacian in predicting functional networks. The complex Laplacian eigenmodes therefore constitute a tunable yet parsimonious substrate on which a rich repertoire of realistic functional patterns can emerge. Although brain activity is governed by highly complex nonlinear processes and dense connections, our work suggests that simple extensions of linear models to the complex domain effectively approximate rich macroscopic spatial patterns observable on BOLD fMRI.

Abstract The Kähler potentials of modular symmetry models receive unsuppressed contributions which may be controlled by a flavor symmetry, where the combination of the two symmetry types is referred to as eclectic flavor symmetry. After briefly reviewing the consistency conditions of eclectic flavor symmetry models, including those with generalised (g)CP, we perform a comprehensive bottom-up study of eclectic flavor symmetry models based on Ω(1) ≅ ∆(27) ⋊ T′, consisting of the flavor symmetry ∆(27) in a semi-direct product with the modular symmetry T′. The modular transformations of different ∆(27) multiplets are given by solving the consistency condition. The eight nontrivial singlets of ∆(27) are related by T′ modular symmetry, and they have to be present or absent simultaneously in any Ω(1) model. The most general forms of the superpotential and Kähler potential invariant under Ω(1) are discussed, and the corresponding fermion mass matrices are presented. Based on the eclectic flavor group Ω(1), two concrete lepton models which can successfully describe the experimental data of lepton masses and mixing parameters are constructed. For the two models without gCP, all six mixing parameters vary in small regions. A nearly maximal atmospheric mixing angle θ 23 and Dirac CP phase δ CP are obtained in the first model. After considering the compatible gCP symmetry and the assumption of R τ $$ \mathfrak{R}\tau $$ = 0 in the first model, the μ − τ reflection symmetry is preserved in the charged lepton diagonal basis. As a consequence, the atmospheric mixing angle and Dirac CP phase are predicted to be maximal, and two Majorana CP phases are predicted to be π.

In clinical practice, we noticed that triple negative breast cancer (TNBC) patients had higher shear-wave elasticity (SWE) stiffness than non-TNBC patients and a higher α-SMA expression was found in TNBC tissues than the non-TNBC tissues. Moreover, SWE stiffness also shows a clear correlation to neoadjuvant response efficiency. To elaborate this phenomenon, TNBC cell membrane-modified polylactide acid-glycolic acid (PLGA) nanoparticle was fabricated to specifically deliver artesunate to regulate SWE stiffness through inhibiting CAFs functional status. As tested in MDA-MB-231 and E0771 orthotopic tumor models, CAFs functional status inhibited by 231M-ARS@PLGA nanoparticles (231M-AP NPs) had reduced the SWE stiffness as well as attenuated hypoxia of tumor as tumor soil loosening agent which amplified the antitumor effects of paclitaxel and PD1 inhibitor. Single-cell sequencing indicated that the two main CAFs (extracellular matrix and wound healing CAFs) that produces extracellular matrix could influence the tumor SWE stiffness as well as the antitumor effect of drugs. Further, biomimetic nanoparticles inhibited CAFs function could attenuate tumor hypoxia by increasing proportion of inflammatory blood vessels and oxygen transport capacity. Therefore, our finding is fundamental for understanding the role of CAFs on affecting SWE stiffness and drugs antitumor effects, which can be further implied in the potential clinical theranostic predicting in neoadjuvant therapy efficacy through non-invasive analyzing of SWE imaging.

ObjectivesAuditory cortical activation of the two hemispheres to monaurally presented tonal stimuli has been shown to be asynchronous in normal hearing (NH) but synchronous in the extreme case of adult-onset asymmetric hearing loss (AHL) with single-sided deafness. We addressed the wide knowledge gap between these two anchoring states of interhemispheric temporal organization. The objectives of this study were as follows: (1) to map the trajectory of interhemispheric temporal reorganization from asynchrony to synchrony using magnitude of interaural threshold difference as the independent variable in a cross-sectional study and (2) to evaluate reversibility of interhemispheric synchrony in association with hearing in noise performance by amplifying the aidable poorer ear in a repeated measures, longitudinal study.DesignThe cross-sectional and longitudinal cohorts were comprised of 49 subjects (AHL; N = 21; 11 male, 10 female; mean age = 48 years) and NH (N = 28; 16 male, 12 female; mean age = 45 years). The maximum interaural threshold difference of the two cohorts spanned from 0 to 65 dB. Magnetoencephalography analyses focused on latency of the M100 peak response from auditory cortex in both hemispheres between 50 msec and 150 msec following monaural tonal stimulation at the frequency (0.5, 1, 2, 3, or 4 kHz) corresponding to the maximum and minimum interaural threshold difference for better and poorer ears separately. The longitudinal AHL cohort was drawn from three subjects in the cross-sectional AHL cohort (all male; ages 49 to 60 years; varied AHL etiologies; no amplification for at least 2 years). All longitudinal study subjects were treated by monaural amplification of the poorer ear and underwent repeated measures examination of the M100 response latency and quick speech in noise hearing in noise performance at baseline, and postamplification months 3, 6, and 12.ResultsThe M100 response peak latency values in the ipsilateral hemisphere lagged those in the contralateral hemisphere for all stimulation conditions. The mean (SD) interhemispheric latency difference values (ipsilateral less contralateral) to better ear stimulation for three categories of maximum interaural threshold difference were as follows: NH (≤ 10 dB)-8.6 (3.0) msec; AHL (15 to 40 dB)-3.0 (1.2) msec; AHL (≥ 45 dB)-1.4 (1.3) msec. In turn, the magnitude of difference values were used to define interhemispheric temporal organization states of asynchrony, mixed asynchrony and synchrony, and synchrony, respectively. Amplification of the poorer ear in longitudinal subjects drove interhemispheric organization change from baseline synchrony to postamplification asynchrony and hearing in noise performance improvement in those with baseline impairment over a 12-month period.ConclusionsInterhemispheric temporal organization in AHL was anchored between states of asynchrony in NH and synchrony in single-sided deafness. For asymmetry magnitudes between 15 and 40 dB, the intermediate mixed state of asynchrony and synchrony was continuous and reversible. Amplification of the poorer ear in AHL improved hearing in noise performance and restored normal temporal organization of auditory cortices in the two hemispheres. The return to normal interhemispheric asynchrony from baseline synchrony and improvement in hearing following monoaural amplification of the poorer ear evolved progressively over a 12-month period.

Robust estimation of the number, location, and activity of multiple correlated brain sources has long been a challenging task in electromagnetic brain imaging from M/EEG data, one that is significantly impacted by interference from spontaneous brain activity, sensor noise, and other sources of artifacts. Recently, we introduced the Champagne algorithm, a novel Bayesian inference algorithm that has shown tremendous success in M/EEG source reconstruction. Inherent to Champagne and most other related Bayesian reconstruction algorithms is the assumption that the noise covariance in sensor data can be estimated from "baseline" or "control" measurements. However, in many scenarios, such baseline data is not available, or is unreliable, and it is unclear how best to estimate the noise covariance. In this technical note, we propose several robust methods to estimate the contributions to sensors from noise arising from outside the brain without the need for additional baseline measurements. The incorporation of these methods for diagonal noise covariance estimation improves the robust reconstruction of complex brain source activity under high levels of noise and interference, while maintaining the performance features of Champagne. Specifically, we show that the resulting algorithm, Champagne with noise learning, is quite robust to initialization and is computationally efficient. In simulations, performance of the proposed noise learning algorithm is consistently superior to Champagne without noise learning. We also demonstrate that, even without the use of any baseline data, Champagne with noise learning is able to reconstruct complex brain activity with just a few trials or even a single trial, demonstrating significant improvements in source reconstruction for electromagnetic brain imaging.

Magnetoencephalography (MEG) is increasingly used for presurgical planning in people with medically refractory focal epilepsy. Localization of interictal epileptiform activity, a surrogate for the seizure onset zone whose removal may prevent seizures, is challenging and depends on the use of multiple complementary techniques. Accurate and reliable localization of epileptiform activity from spontaneous MEG data has been an elusive goal. One approach toward this goal is to use a novel Bayesian inference algorithm-the Champagne algorithm with noise learning-which has shown tremendous success in source reconstruction, especially for focal brain sources. In this study, we localized sources of manually identified MEG spikes using the Champagne algorithm in a cohort of 16 patients with medically refractory epilepsy collected in two consecutive series. To evaluate the reliability of this approach, we compared the performance to equivalent current dipole (ECD) modeling, a conventional source localization technique that is commonly used in clinical practice. Results suggest that Champagne may be a robust, automated, alternative to manual parametric dipole fitting methods for localization of interictal MEG spikes, in addition to its previously described clinical and research applications.

The current use of elastography ultrasound faces challenges, including vulnerability to subjective manipulation, echo signal attenuation, unknown risks of elastic pressure and high imaging hardware cost. Here, the author shows a virtual elastography to empower low-end ultrasound devices with state-of-art elastography function.

Objective: The data regarding the mutation landscape in Chinese patients with thyroid cancer are limited. The diagnostic performance of thyroid nodul es by fine-needle aspiration (FNA) cytology needs optimization, especially in indeterminate nodules. Methods: A total of 1039 FNA and surgical resection samples tested using the targeted multigene next-generation sequencing (NGS) panel were retrospectively collected. The features of gene alterations in different thyroid tumors wer e analyzed, and the diagnostic efficacy was evaluated. Results: Among 1039 samples, there were 822 FNA and 217 surgical FFPE samples. Among 207 malignant thyroid resections, a total of 181 out of 193 papillary thyroid carcinomas (PTCs) were NGS-positive (93.8%), with a high prevalence of BRAF mutations (81.9%, 158/193) and a low prevalence of RAS (1.0%, 2/193) and TERT promoter mutations (3.6%, 7/193). Gene fusions, involving the RET and NTRK3 genes, were present in 20 PTCs (10.4%) and mutually exclusive with other driver mutations. Two of three follicular thyroid carcinomas harbored multiple mutations. RET gene point mutations were common in medullary thyroid carcinoma (8/11, 72.7%). The combination of cytology and DNA–RNA-based NGS analysis demonstrated superior diagnostic value (98.0%) in FNA samples. For indeterminate thyroid nodules, the diagnostic sens itivity and specificity of NGS testing were 79.2 (38/48) and 80.0% (8/10), respectively. Two mutation-positive benign cases harbored NRAS and TSHR mutations, respectively. Conclusions: Our study revealed the distinct molecular profile of thyroid tu mors in the Chinese population. The combination of NGS testing and FNA cytology could facilitate the accurate diagnosis of thyroid nodules, especially for indeterminate nodules.

The relationship between the brain's structural wiring and the functional patterns of neural activity is of fundamental interest in computational neuroscience. We examine a hierarchical, linear graph spectral model of brain activity at mesoscopic and macroscopic scales. The model formulation yields an elegant closed-form solution for the structure-function problem, specified by the graph spectrum of the structural connectome's Laplacian, with simple, universal rules of dynamics specified by a minimal set of global parameters. The resulting parsimonious and analytical solution stands in contrast to complex numerical simulations of high dimensional coupled nonlinear neural field models. This spectral graph model accurately predicts spatial and spectral features of neural oscillatory activity across the brain and was successful in simultaneously reproducing empirically observed spatial and spectral patterns of alpha-band (8-12 Hz) and beta-band (15-30 Hz) activity estimated from source localized magnetoencephalography (MEG). This spectral graph model demonstrates that certain brain oscillations are emergent properties of the graph structure of the structural connectome and provides important insights towards understanding the fundamental relationship between network topology and macroscopic whole-brain dynamics. .

Electromagnetic brain imaging is the reconstruction of brain activity from non-invasive recordings of the magnetic fields and electric potentials. An enduring challenge in this imaging modality is estimating the number, location, and time course of sources, especially for the reconstruction of distributed brain sources with complex spatial extent. Here, we introduce a novel robust empirical Bayesian algorithm that enables better reconstruction of distributed brain source activity with two key ideas: kernel smoothing and hyperparameter tiling. Since the proposed algorithm builds upon many of the performance features of the sparse source reconstruction algorithm - Champagne and we refer to this algorithm as Smooth Champagne. Smooth Champagne is robust to the effects of high levels of noise, interference, and highly correlated brain source activity. Simulations demonstrate excellent performance of Smooth Champagne when compared to benchmark algorithms in accurately determining the spatial extent of distributed source activity. Smooth Champagne also accurately reconstructs real MEG and EEG data.