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Generating dermatopathology reports from gigapixel whole slide images with HistoGPT
No full textHistopathology is the reference standard for diagnosing the presence and nature of many diseases, including cancer. However, analyzing tissue samples under a microscope and summarizing the findings in a comprehensive pathology report is time-consuming, labor-intensive, and non-standardized. To address this problem, we present HistoGPT, a vision language model that generates pathology reports from a patient’s multiple full-resolution histology images. It is trained on 15,129 whole slide images from 6705 dermatology patients with corresponding pathology reports. The generated reports match the quality of human-written reports for common and homogeneous malignancies, as confirmed by natural language processing metrics and domain expert analysis. We evaluate HistoGPT in an international, multi-center clinical study and show that it can accurately predict tumor subtypes, tumor thickness, and tumor margins in a zero-shot fashion. Our model demonstrates the potential of artificial intelligence to assist pathologists in evaluating, reporting, and understanding routine dermatopathology cases
High‐precision 3D doping of fused silica glass derived from nanocomposites
No full textGlasses are utilized for their outstanding optical, mechanical, and thermal properties. However, conventional production methods mostly yield in glasses with uniform compositions and material properties. Here a novel lithographic approach is presented for high-resolution 3D dopant integration at defined positions, which enables property modifications in specific regions. For this, a porous glass matrix derived from nanocomposites is shaped using 3D printing or injection molding. Using volumetric 3D printing like computed axial or two-photon lithography, doping is performed within the porous glass using photocurable metal oxide precursors. The dopant is then permanently integrated within the glass during a final sintering step. The local integration of dopants like Ti4+, Co2+, Eu3+ or Tb3+ allow to selectively change the color, luminescence or refractive index within a 3D-shaped glass with micron resolution. The process enables a wide range of novel applications from integrated optics and photonics to mass customization, anti-counterfeiting, and information storage
Consensus recommendations for hyperpolarized [1‐13C] pyruvate MRI multi‐center human studies
No full textMRI of hyperpolarized (HP) [1-13C]pyruvate allows in vivo assessment of metabolism and has translated into human studies across diseases at 15 centers worldwide. To determine consensus on best practice for multi-center studies for development of clinical applications. This paper presents the results of a two-round formal consensus building exercise carried out by experts with HP [1-13C]pyruvate human study experience. Twenty-nine participants from 13 sites brought together expertise in pharmacy methods, MR physics, translational imaging, and data analysis with the goal of providing recommendations and best practice statements on conduct of multi-center human studies of HP [1-13C]pyruvate MRI. Overall, the group reached consensus on approximately two-thirds of 246 statements in the questionnaire, covering HP 13C-pyruvate preparation; MRI system setup, calibration, and phantoms; acquisition and reconstruction; and data analysis and quantification. Consensus was present across categories. Examples include: (i) Different HP pyruvate preparation methods could be used in human studies, but the same release criteria have to be followed; (ii) site qualification and quality assurance must be performed with phantoms and the same field strength must be used, but the rest of the system setup and calibration methods could be determined by individual sites; (iii) the same pulse sequence and reconstruction methods were preferable, but the exact choice should be governed by the anatomical target; (iv) normalized metabolite area-under-curve values and metabolite area under curve were the preferred metabolism metrics. The consensus proces revealed that HP[1-13C] pyruvate MRI as a technology has progressed sufficiently to plan multi-center studies. The work confirmed areas of consensus for multi-center study conduct and identified where further research is required to ascertain best practice
Cardiac MRI of differing ischemia and reperfusion times in a myocardial infarction pig model
No full textThe closed-chest porcine model of myocardial ischemia is an essential tool for preclinical research in cardiology. Current literature reports heterogeneous results regarding myocardial ischemia and reperfusion injury (IRI). This retrospective analysis presents our experience and cardiac magnetic resonance (CMR) findings while establishing a porcine IRI model. 8 male and 12 female juvenile German Landrace pigs received general anesthesia and antiarrhythmic pre-treatment. Myocardial ischemia was induced using transfemoral catheterization and balloon-occlusion of the left anterior descending (LAD) or the left circumflex (LCX) coronary artery under X-ray fluoroscopy guidance. The duration of ischemia varied from 30 to 90 min. CMR was performed at a clinical 3 T system including functional imaging, T1 and T2 mapping and late gadolinium enhancement (LGE) 2–5 h or three days post-reperfusion. Ventricular fibrillation (VF) was a recurrent event, which was counteracted with amiodarone, high blood potassium levels and in one case with propranolol. Males were more likely to experience VF than females and 15 of 20 animals survived the experiment. Resuscitation was required in 47% of the further analyzed animals. CMR revealed IRI in 14 of 15 animals in cardiac segments analogous to those supplied by the respective artery in humans. The mean left ventricular ejection fraction was reduced to 52% and 47% of animals had an impaired wall motion. Ischemia durations of 30–45 min did not result in LGE and in no significant T2 increase, whereas T1 was significantly increased (p = 0.02). Occlusion durations of 60–90 min resulted in LGE and T1 and T2 values both increased compared to 30–45 min of ischemia (p < 0.001 for T1 and p = 0.021 for T2). CMR of porcine myocardial IRI showed varying T1 and T2 patterns for different ischemia and reperfusion durations. For IRI, T1 elevation was the most sensitive marker. Significant myocardial infarction indicated by LGE only occurred after ischemic durations ≥ 60 min; thus, an appropriate occlusion duration must be chosen in pigs to create myocardial IRI for scientific studies
Effiziente Doppelnutzung: Potenzialanalyse von PV-Anlagen auf bestehender Infrastruktur im Stadtgebiet Freiburg
No full textCorrection: The support of early-career researchers in health professions education - an expert position statement
No full textAuthors’ response to “Replication and methodological robustness in quantitative typology”
No full textAssessing MRI interpretability of the orbit, paranasal sinuses, and nasopharynx in cochlear implant patients
No full textObjectives: Due to a growing focus on cost-effectiveness in healthcare, safety concerns with CI and the known limitations in image quality, there is an increasing need for well-considered indications before performing magnetic resonance imaging (MRI) in CI (cochlear implant) patients. This study aims to evaluate, for the first time, the clinical utility and limitations of MRI in CI patients for orbital, paranasal, and nasopharyngeal assessments.Materials and methods: CIs were positioned and fixed with bandaging around the head of a test subject at varying angular positions (90°, 120°, and 135°), both unilaterally and bilaterally, with and without the magnet in place. MRI acquisitions included T1-MP-RAGE, T2-TSE, T1-TIRM, and DWI sequences of a 3 Tesla MRI scanner. The MRI images were reconstructed three-dimensionally, and the resulting artifacts were analyzed to determine the interpretability of the predefined orbital, paranasal, and nasopharyngeal structures.Results: Image quality was categorized into four levels of restriction. It was observed that orbital MRI diagnostics in the required sequences (T1, T2, and DWI) are feasible even in patients with bilateral CIs with magnets in situ. Regarding the paranasal sinuses, artifacts affected the sphenoid sinus and parts of the ethmoidal cells; however, as expected, the interpretability improved significantly without the magnet. The nasopharyngeal space, particularly in patients with bilateral CIs and magnets in situ, could be evaluated only with difficulty or was largely not assessable.Conclusion: This study offers insights into the predictive factors influencing the interpretability of MRI scans for the orbit, paranasal sinuses, and nasopharynx in CI patients. In particular, for the sphenoid sinus and nasopharynx, it is strongly advised to consult the responsible CI center before undergoing an MRI examination. This consultation helps assess the necessity of the MRI and, if required, consider the removal of the implant magnet.IntroductionIn recent years, significant progress has been made in enabling cochlear implant (CI) patients to undergo magnetic resonance imaging (MRI). Advances in CI technology have led to substantial improvements, allowing MRI scans of up to 3 Tesla. However, the quality of cranial MRI in CI patients remains considerably affected by implant-related artifacts (1–3). This limitation persists for intracranial MRI assessments, as demonstrated by our recent research, even when the CI magnet is removed (3).MRI of the orbit, paranasal sinuses, and nasopharynx is important for specific indications, particularly in adolescence and adult patients. For example, MRI is crucial for diagnosing orbital masses such as lymphoma, carcinoma, or pseudotumor before biopsy or excision (4–7). While paranasal MRI is less frequently performed, it is invaluable for diagnosing malignancies like adenocarcinoma, squamous cell carcinoma and lymphoma (8), as well as for benign tumors like inverted papillomas (9–11). Furthermore, male adolescents with suspected enlarged adenoids should undergo angio-MRI of the nasopharynx to assess nasopharyngeal masses, such as juvenile nasopharyngeal angiofibromas. This imaging is crucial for planning pre-biopsy embolization and preventing potentially life-threatening hemorrhagic complications (12, 13).With the increasing focus on cost-effectiveness in healthcare and previous studies underscoring the importance of well-founded clinical indications for MRI (14), this study is the first to investigate whether MRI of the orbit, paranasal sinuses and nasopharynx is of additional benefit in patients with CI
Bedürfnisse der Kulturkonsumenten eines periurbanen Raums in Deutschland: eine qualitative Studie mit dem Fokus auf Unterhaltungsmusik und den Besuch von Konzerten
No full textTranslation, validation and extended factor models of the German State Difficulties in Emotion Regulation Scale (S-DERS)
No full textBackgroundDifficulties in emotion regulation are a key transdiagnostic factor in mental health disorders. While much research has focused on emotion regulation difficulties as stable, trait-like constructs, emotion regulation is inherently dynamic, unfolding over time. This highlights the need for state-like measures to capture these temporal dynamics in both laboratory and real-world contexts, such as the State Difficulties in Emotion Regulation Scale (S-DERS). The present study aimed to (a) translate the S-DERS into German, (b) validate its psychometric properties, and (c) provide novel examinations whether state-based emotion regulation difficulties share an underlying general factor or are interconnected but distinct sub-components, complemented with an exploratory network approach.MethodsA sample of 214 participants, predominantly young females, completed the 21-item German version of the S-DERS following a negative mood induction procedure. Participants also completed a broader battery of psychological assessments. Factor structure, reliability, and construct validity were examined using confirmatory factor analysis and exploratory structural equation modeling (ESEM) with cross-loadings. These were compared to bi-factor, higher-order, and network models.ResultsThe German S-DERS demonstrated a robust four-factor structure, high reliability, and strong construct validity, consistent with the original English version. ESEM indicated that extensive cross-loadings were necessary to achieve good model fit. A four-factor correlated model outperformed both bifactor and higher-order models, suggesting that emotion regulation difficulties are best conceptualized as four distinct but interrelated constructs without a shared general factor: (a) Non-acceptance of Current Emotions, (b) Limited Ability to Modulate Current Emotional and Behavioral Responses, (c) Lack of Awareness of Current Emotions, and (d) Lack of Clarity about Current Emotions.ConclusionsThe German version of the S-DERS is a reliable and valid tool for assessing state-like difficulties in emotion regulation. The extended factor models highlight the multidimensional nature of emotion regulation difficulties, with complex interrelations among distinct but related constructs. These insights can inform future research on emotion dysregulation and support efforts to validate the S-DERS in clinical populations