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Touch Helps Hearing:Evidence From Continuous Audio-Tactile Stimulation
No full textOBJECTIVES: Identifying target sounds in challenging environments is crucial for daily experiences. It is important to note that it can be enhanced by nonauditory stimuli, for example, through lip-reading in an ongoing conversation. However, how tactile stimuli affect auditory processing is still relatively unclear. Recent studies have shown that brief tactile stimuli can reliably facilitate auditory perception, while studies using longer-lasting audio-tactile stimulation yielded conflicting results. This study aimed to investigate the impact of ongoing pulsating tactile stimulation on basic auditory processing. DESIGN: In experiment 1, the electroencephalogram (EEG) was recorded while 24 participants performed a loudness-discrimination task on a 4-Hz modulated tone-in-noise and received either in-phase, anti-phase, or no 4-Hz electrotactile stimulation above the median nerve. In experiment 2, another 24 participants were presented with the same tactile stimulation as before, but performed a tone-in-noise detection task while their selective auditory attention was manipulated. RESULTS: We found that in-phase tactile stimulation enhanced EEG responses to the tone, whereas anti-phase tactile stimulation suppressed these responses. No corresponding tactile effects on loudness-discrimination performance were observed in experiment 1. Using a yes/no paradigm in experiment 2, we found that in-phase tactile stimulation, but not anti-phase tactile stimulation, improved detection thresholds. Selective attention also improved thresholds but did not modulate the observed benefit from in-phase tactile stimulation. CONCLUSIONS: Our study highlights that ongoing in-phase tactile input can enhance basic auditory processing as reflected in scalp EEG and detection thresholds. This might have implications for the development of hearing enhancement technologies and interventions
Constructing Chinese Firms as Development Catalysts:State-Firm Public Diplomacy Collaboration in Kenya
No full textThe debate surrounding China's public diplomacy in Africa highlights how the state coordinates and leverages Chinese actors, including firms, to advance diplomatic objectives. However, this article questions the notion of unidirectional state dominance by exploring the intricate interactions between the Chinese state and firms around promoting and publicizing corporate social responsibility (CSR), which is conceptualized as a public diplomacy tool of corporations to engage with the foreign public. Using the lens of public diplomacy, the author examines the unconventional state-firm interplay in the symbolic domain, shedding light on practices of China's expansion in Africa. Through two empirical cases, the author demonstrates the interdependence and collaboration between the Chinese state and firms, revealing their divided interests and contested cooperative efforts to enact public diplomacy in Kenya
New IPECAD Open-Source Model Framework for the Health Technology Assessment of Early Alzheimer's Disease Treatment:Development and Use Cases
No full textObjectives: Reimbursement decisions for new Alzheimer's disease (AD) treatments are informed by economic evaluations. An open-source model with intuitive structure for model cross-validation can support the transparency and credibility of such evaluations. We describe the new model framework (version 2) for the health-economic evaluation of early AD treatment and use it for cross-validation and addressing uncertainty. Methods: A cohort state-transition model using a categorized composite domain (cognition and function) was developed by replicating an existing reference model and testing it for internal validity. Then, features of existing Institute for Clinical and Economic Review (ICER) and lecanemab treatment were implemented for model cross-validation. Additional uncertainty scenarios were performed on choice of efficacy outcome from trial, natural disease progression, treatment effect waning and stopping rules, and other methodological choices. The model is available open-source as R code, spreadsheet, and web-based version via https://github.com/ Results: In the IPECAD model incremental life-years, quality-adjusted life-years (QALY) gains and cost savings were 21% to 31% smaller compared with the ICER model and 36% to 56% smaller compared with the AD-ACE model. IPECAD model results were particularly sensitive to assumptions on treatment effect waning and stopping rules and choice of efficacy outcome from trail. Conclusions: We demonstrated the ability of a new IPECAD open-source model framework for researchers and decision makers to cross-validate other (Health Technology Assessment submission) models and perform additional uncertainty analyses, setting an example for open science in AD decision modeling and supporting important reimbursement decisions
Reply to:‘Enhancing patient-centered care and addressing psychosocial needs in colorectal cancer: The role of the ABCRC tool’
No full textRelationships among adult full, half, and stepsiblings:Does coresidence explain the stepgap?
No full textObjectiveThis article aims to compare adult sibling ties of stepsiblings to the ties of full and half-siblings in divorced families, widowed families, and single-parent families.BackgroundSiblings are one of the most stable sources of attachment and companionship over the life course and function as important providers of practical and emotional support when going through important life transitions. Due to a steep rise in divorce over the past decades and accompanied increases in remarriage and multipartner fertility, many adults nowadays not only have full siblings, but also half-siblings and stepsiblings.MethodUsing a new module on adult sibling relationships and random- and fixed-effects modeling (OKiN, N = 4506 dyads nested in N = 1742 respondents), we examine the quality of full, half, and stepsibling ties in adulthood and test the main mechanisms driving a potential stepgap in sibling ties: (1) the (absence) of a shared genetic relatedness and (2) the amount of time shared in the same parental household.ResultsThe weaker bonds adults, on average, have with their stepsiblings compared to their biological (full and half) siblings are largely explained by the shorter period of time they have lived together during childhood. Nevertheless, a substantial gap remains.ConclusionOur results confirm that a stepgap in sibling closeness, contact, and support is visible, but substantially reduced once shared time is considered
Correction: Diffusion-weighted imaging in addition to contrast-enhanced MRI in identifying complete response in HER2-positive breast cancer (Jul, 10.1007/s00330-024-10857-7, 2024)
No full textIn the Abstract of this article, subsection Results, the sentence beginning with “In HR-negative/HER2-positive breast cancer…” should have been “In HR-positive/HER2-positive breast cancer…”. The correct sentence is: In HR-positive /HER2-positive breast cancer the NPV for DCE MRI differs between MRI field strength (1.5 T: 50% vs. 3 T: 81% (p = 0.02)). Furthermore, in the online version of the article, In Section ‘Endpoints’ the equation for ADCmean is displayed incorrectly due to an error in copyediting. Instead of: (Formula presented.) The correct equation is as follows: (Formula presented.) The original article has been corrected.</p
Joint Trajectories of Performance-Based and Self-Reported Physical Functioning in Older Adults:A 20-Year Longitudinal Study in the Netherlands
No full textBackground: The well-known disablement process has been conceptualized as a series of transitions between progressive states of functional decline. We studied joint patterns of change within disablement states defined as walking speed, grip strength, and self-reported disability. Methods: 1702 participants aged 65 and over were included from the Longitudinal Aging Study Amsterdam, spanning seven waves over 20 years (1996–2016). Group-based multi-trajectory modeling yielded trajectory clusters (TCs) of different patterns of change, further characterized by baseline sociodemographic characteristics, physical and cognitive health, and survival rate. Results: Five TCs were identified, distinguished by increasing baseline age. Walking speed and disability showed generally concomitant trajectories. Women had poorer trajectories in grip strength than men, but not in walking speed and disability. Poor physical health distinguished especially the poorest, and cognitive impairment distinguished especially the one-before-poorest from the better TCs. Discussion: The findings suggest that the disablement states are not generally distinct or sequential
A novel positive end-expiratory pressure titration using electrical impedance tomography in spontaneously breathing acute respiratory distress syndrome patients on mechanical ventilation:an observational study from the MaastrICCht cohort
No full textThere is no universally accepted method for positive end expiratory pressure (PEEP) titration approach for patients on spontaneous mechanical ventilation (SMV). Electrical impedance tomography (EIT) guided PEEP-titration has shown promising results in controlled mechanical ventilation (CMV), current implemented algorithm for PEEP titration (based on regional compliance measurements) is not applicable in SMV. Regional peak flow (RPF, defined as the highest inspiratory flow rate based on EIT at a certain PEEP level) is a new method for quantifying regional lung mechanics designed for SMV. The objective is to study whether RPF by EIT is a feasible method for PEEP titration during SMV. Single EIT measurements were performed in COVID-19 ARDS patients on SMV. Clinical (i.e., tidal volume, airway occlusion pressure, end-tidal CO 2) and mechanical (cyclic alveolar recruitment, recruitment, cumulative overdistension (OD), cumulative collapse (CL), pendelluft, and PEEP) outcomes were determined by EIT at several pre-defined PEEP thresholds (1–10% CL and the intersection of the OD and CL curves) and outcomes at all thresholds were compared to the outcomes at baseline PEEP. In total, 25 patients were included. No significant and clinically relevant differences were found between thresholds for tidal volume, end-tidal CO 2, and P0.1 compared to baseline PEEP; cyclic alveolar recruitment rates changed by -3.9% to -37.9% across thresholds; recruitment rates ranged from − 49.4% to + 79.2%; cumulative overdistension changed from − 75.9% to + 373.4% across thresholds; cumulative collapse changed from 0% to -94.3%; PEEP levels from 10 up to 14 cmH 2O were observed across thresholds compared to baseline PEEP of 10 cmH 2O. A threshold of approximately 5% cumulative collapse yields the optimum compromise between all clinical and mechanical outcomes. EIT-guided PEEP titration by the RPF approach is feasible and is linked to improved overall lung mechanics) during SMV using a threshold of approximately 5% CL. However, the long-term clinical safety and effect of this approach remain to be determined.</p
Large-scale pretrained frame generative model enables real-time low-dose DSA imaging:An AI system development and multi-center validation study
No full textBACKGROUND: Digital subtraction angiography (DSA) devices are commonly used in numerous interventional procedures across various parts of the body, necessitating multiple scans per procedure, which results in significant radiation exposure for both doctors and patients. Inspired by generative artificial intelligence techniques, this study proposes GenDSA, a large-scale pretrained multi-frame generative model-based real-time and low-dose DSA imaging system. METHODS: GenDSA was developed to generate 1-, 2-, and 3-frame sequences following each real frame. A large-scale dataset comprising ~3 million DSA images from 27,117 patients across 10 hospitals was constructed to pretrain, fine-tune, and validate GenDSA. Two other datasets from 25 hospitals were used for evaluation. Objective evaluations included SSIM and PSNR. Five interventional radiologists independently assessed the quality of the generated frames using the Likert scale and visual Turing test. Scoring consistency among the radiologists was measured using the Kendall coefficient of concordance (W). The Fleiss' kappa values were used for inter-rater agreement analysis for visual Turing tests. FINDINGS: Using only one-third of the clinical radiation dose, videos generated by GenDSA were perfectly consistent with real videos. Objective evaluations demonstrated that GenDSA's performance (PSNR = 36.83, SSIM = 0.911, generation time = 0.07 s/frame) surpassed state-of-the-art algorithms. Subjective ratings and statistical results from five doctors indicated no significant difference between real and generated videos. Furthermore, the generated videos were comparable to real videos in overall quality (4.905 vs. 4.935) and lesion assessment (4.825 vs. 4.860). CONCLUSIONS: With clear clinical and translational values, the developed GenDSA can significantly reduce radiation damage to both doctors and patients during DSA-guided procedures. FUNDING: This study was supported by the National Key R&D Program and the National Natural Science Foundation of China
Navigating Life With Parkinson's Disease:A Focus Group Study on Coping Strategies and Considerations for Self-Management Support
No full textAim :To investigate the experiences of people with Parkinson's disease in coping with and adapting to their disease and to identify considerations for a tailored self-management support program. Design :A descriptive phenomenological focus group study. Methods :Five semi-structured focus groups were conducted between April 2023 and June 2023 in the Netherlands, with 12 people with Parkinson's disease. Two researchers independently performed an inductive content analysis. Results :Three principal categories emerged: (1) Rational realisation versus emotional experience: the coping strategy transition. This category includes three main coping strategies: denial or avoidance coping, acknowledging with less active coping and proactive and task-oriented coping. (2) Factors that influence coping, including mindset and skills, social circles and communication and access to support and care. (3) Considerations for successful self-management of Parkinson's disease, highlighting key areas such as psycho-emotional guidance, nutrition and lifestyle, peer support and maintaining autonomy and sense of identity. Conclusion: Coping and adaptation strategies are individual and dynamic processes, with multiple key or turning points during the transition between strategies. Tailored self-management support can enhance coping abilities during these transitions, fostering adaptation to a life with Parkinson's disease. Implications for the Profession and/or Patient Care: A patient-focused version of an existing blended self-management support program for family caregivers will be developed, which will be delivered by healthcare professionals. Impact: This study can help healthcare professionals tailor support for people with Parkinson's disease, emphasising their role in facilitating coping and adaptation. Enhancing self-management can improve self-efficacy, quality of life and potentially reduce healthcare utilisation in people with Parkinson's disease. Reporting Method: Findings are reported according to the COREQ guidelines. Patient or Public Contribution: Patients and Parkinson's disease experts participated in the preparation and implications of the findings. All participants could contribute to the self-management support program, either through video interviews or content feedback