•End-to-end neural network model for classifying motor imagery EEG signals.•Using 1-D CNN layers to learn temporal and spatial filters for feature extraction.•Application of transfer learning to ...calibrate the model for individual subjects.•Analysis of the temporal and spatial filters learned by the model.
Goal: To develop and implement a Deep Learning (DL) approach for an electroencephalogram (EEG) based Motor Imagery (MI) Brain-Computer Interface (BCI) system that could potentially be used to improve the current stroke rehabilitation strategies.
Method: The DL model is using Convolutional Neural Network (CNN) layers for learning generalized features and dimension reduction, while a conventional Fully Connected (FC) layer is used for classification. Together they build a unified end-to-end model that can be applied to raw EEG signals. This previously proposed model was applied to a new set of data to validate its robustness against data variations. Furthermore, it was extended by subject-specific adaptation. Lastly, an analysis of the learned filters provides insights into how such a model derives a classification decision.
Results: The selected global classifier reached 80.38%, 69.82%, and 58.58% mean accuracies for datasets with two, three, and four classes, respectively, validated using 5-fold crossvalidation. As a novel approach in this context, transfer learning was used to adapt the global classifier to single individuals improving the overall mean accuracy to 86.49%, 79.25%, and 68.51%, respectively. The global models were trained on 3s segments of EEG data from different subjects than they were tested on, which proved the generalization performance of the model.
Conclusion: The results are comparable with the reported accuracy values in related studies and the presented model outperforms the results in the literature on the same underlying data. Given that the model can learn features from data without having to use specialized feature extraction methods, DL should be considered as an alternative to established EEG classification methods, if enough data is available.
Strokes are a growing cause of mortality and many stroke survivors suffer from motor impairment as well as other types of disabilities in their daily life activities. To treat these sequelae, motor ...imagery (MI) based brain-computer interface (BCI) systems have shown potential to serve as an effective neurorehabilitation tool for post-stroke rehabilitation therapy. In this review, different MI-BCI based strategies, including “Functional Electric Stimulation, Robotics Assistance and Hybrid Virtual Reality based Models,” have been comprehensively reported for upper-limb neurorehabilitation. Each of these approaches have been presented to illustrate the in-depth advantages and challenges of the respective BCI systems. Additionally, the current state-of-the-art and main concerns regarding BCI based post-stroke neurorehabilitation devices have also been discussed. Finally, recommendations for future developments have been proposed while discussing the BCI neurorehabilitation systems.
•BCI methods are among the most effective tool for designing rehabilitation systems.•Use of virtual reality (VR) can increase the efficiency of BCI rehab systems.•“FES,” “Robotics Assistance,” and “Hybrid VR based Models” are main BCI approaches.•In the future, flexible electronics can be used for designing stroke rehab systems.
In a randomized trial involving 664 patients who had had a cryptogenic stroke, closure of a PFO combined with antiplatelet therapy resulted in significantly lower rates of subsequent stroke than ...antiplatelet therapy alone over a median follow-up of 3.2 years.
Commercially used perfluorinated compounds (PFCs) have been widely detected in wildlife and humans, but the sources of human exposure are not fully characterized. The objectives of this study were to ...explore possible associations between concentrations of PFCs in serum and consumption of food with particular focus on seafood, and to compare estimated dietary intakes with determined serum PFC concentrations. Concentrations of 19 PFCs were determined in serum from 175 participants in the Norwegian Fish and Game Study and evaluated with respect to food consumption using multiple linear regression analysis. Associations between estimated individual total dietary intakes of PFCs and serum concentrations were also explored. PFC concentrations in serum were significantly associated (
p
<
0.05) with the consumption of lean fish, fish liver, shrimps and meat, as well as age, breastfeeding history and area of residence (R
2 0.35–0.63). The estimated dietary intakes of perfluorooctanoic acid (PFOA), perfluoroundecanoic acid (PFUnDA) and perfluorooctane sulfonic acid (PFOS) were 0.60, 0.34 and 1.5
ng/kg body weight/day, respectively. Seafood (fish and shellfish) was the major dietary source contributing 38% of the estimated dietary intakes of PFOA, 93% of PFUnDA and 81% of PFOS. The estimated dietary intakes of these three selected PFCs were significantly associated with the corresponding serum PFC concentrations (
p
<
0.05). In conclusion, our results show that consumption of fish and shellfish is a major determinant of serum PFC concentrations. Further, significant relationships between estimated dietary intakes and serum concentrations have been demonstrated for the first time.
Background
Many psychological treatments have shown effect on reducing self‐harm in adults with borderline personality disorder. There is a need of brief psychotherapeutical treatment alternative for ...suicide prevention in specialized outpatient clinics.
Methods/Design
The DiaS trial was designed as a pragmatic single‐center, two‐armed, parallel‐group observer‐blinded, randomized clinical superiority trial. The participants had at least two criteria from the borderline personality disorder diagnosis and a recent suicide attempt (within a month). The participants were offered 16 weeks of dialectical behavior therapy (DBT) versus up to 16 weeks of collaborative assessment and management of suicidality (CAMS) treatment. The primary composite outcome was the number of participants with a new self‐harm (nonsuicidal self‐injury NSSI or suicide attempt) at week 28 from baseline. Other exploratory outcomes were: severity of borderline symptoms, depressive symptoms, hopelessness, suicide ideation, and self‐esteem.
Results
At 28 weeks, the number of participants with new self‐harm in the DBT group was 21 of 57 (36.8%) versus 12 of 51 (23.5%) in the CAMS treatment (OR: 1.90; 95% CI: 0.80–4.40; P = .14). When assessing the effect of DBT versus CAMS treatment on the individual components of the primary outcome, we observed no significant differences in the number of NSSI (OR: 1.60; 95% CI: 0.70–3.90; P = .31) or number of attempted suicides (OR: 2.24; 95% CI: 0.80–7.50; P = .12).
Conclusion
In adults with borderline personality traits and disorder and a recent suicide attempt, DBT does not seem superior compared with CAMS for reduction of number of self‐harm or suicide attempts. However, further randomized clinical trials may be needed.
High dairy/milk intake has been associated with a low risk of type 2 diabetes observationally, but whether this represents a causal association is unknown.
We tested the hypothesis that high milk ...intake is associated with a low risk of type 2 diabetes and of overweight-obesity, observationally and genetically.
In 97,811 individuals from the Danish general population, we examined the risk of incident type 2 diabetes and of overweight-obesity by milk intake observationally and by LCT-13910 C/T genotype polymorphism (rs4988235) upstream from the lactase (LCT) gene, where TT and TC genotypes are associated with lactase persistence and CC with nonpersistence.
Observationally for any compared with no milk intake, the HR for type 2 diabetes was 1.10 (95% CI: 0.98, 1.24; P = 0.11), whereas the OR for overweight-obesity was 1.06 (1.02, 1.09; P = 0.002). Median milk intake was 5 glasses/wk (IQR: 0-10) for lactase TT/TC persistence and 3 (0-7) for CC nonpersistence. Genetically for lactase TT/TC persistence compared with CC nonpersistence, the OR was 0.96 (0.86, 1.08; P = 0.50) for type 2 diabetes and 1.06 (1.00, 1.12; P = 0.04) for overweight-obesity. In a stratified analysis for type 2 diabetes, corresponding values in those with and without milk intake were 0.88 (0.76, 1.03; P = 0.11) and 1.35 (1.07, 1.70; P = 0.01) (P-interaction: 0.002), whereas no gene-milk interaction on overweight-obesity was found. For a 1-glass/wk higher milk intake, the genetic risk ratio for type 2 diabetes was 0.99 (0.93, 1.06), and the corresponding observational risk was 1.01 (1.00, 1.01). For overweight-obesity, the corresponding values were 1.01 (1.00, 1.02) genetically and 1.00 (1.00, 1.01) observationally.
High milk intake is not associated with a low risk of type 2 diabetes or overweight-obesity, observationally or genetically via lactase persistence. The higher risk of type 2 diabetes in lactase-persistent individuals without milk intake likely is explained by collider stratification bias.
Near-infrared spectroscopy (NIRS) is susceptible to signal artifacts caused by relative motion between NIRS optical fibers and the scalp. These artifacts can be very damaging to the utility of ...functional NIRS, particularly in challenging subject groups where motion can be unavoidable. A number of approaches to the removal of motion artifacts from NIRS data have been suggested. In this paper we systematically compare the utility of a variety of published NIRS motion correction techniques using a simulated functional activation signal added to 20 real NIRS datasets which contain motion artifacts. Principle component analysis, spline interpolation, wavelet analysis, and Kalman filtering approaches are compared to one another and to standard approaches using the accuracy of the recovered, simulated hemodynamic response function (HRF). Each of the four motion correction techniques we tested yields a significant reduction in the mean-squared error (MSE) and significant increase in the contrast-to-noise ratio (CNR) of the recovered HRF when compared to no correction and compared to a process of rejecting motion-contaminated trials. Spline interpolation produces the largest average reduction in MSE (55%) while wavelet analysis produces the highest average increase in CNR (39%). On the basis of this analysis, we recommend the routine application of motion correction techniques (particularly spline interpolation or wavelet analysis) to minimize the impact of motion artifacts on functional NIRS data.
•Deoxynivalenol (DON) and metabolites was present in urine from 256 of 257 individuals.•Children had higher urinary concentrations of DON than other age groups.•Pregnant women and vegetarians had ...similar urinary DON concentrations as other adults.•Estimated intake of DON exceeded the TDI for highly exposed children.•Estimating DON intake from urinary DON is a useful method to monitor DON exposure at the population level.
The Fusarium mycotoxin deoxynivalenol (DON) and its modified forms are present in most samples of grain and grain-based products. Due to the widespread presence of DON in these highly consumed food commodities, nearly all individuals are exposed to DON. Previous estimates of the dietary DON intake in Norway indicated that children’s dietary intake is close to or exceed the TDI of 1 µg/kg bw/day for the sum of DON and three modified forms. One aim of the current study was to determine whether the concentrations of DON in morning urine differ between population groups like men, women, children, vegetarians, and pregnant women. An additional aim was to compare a set of models for estimating the dietary intake of DON based on urinary DON concentrations and also compare these models with DON-intakes estimated using food consumption data. DON and metabolites were detected in the morning urine from 256 out of 257 individuals and with concentrations in similar range as reported from other countries. Children have higher urinary DON-concentration than adults and elderly. The urinary DON-concentration in pregnant women and vegetarians did not differ from other adults. The estimated intake of DON was higher for children than for other age groups on a body weight basis. The correlations between different models for estimating DON-intake based on urinary concentration as well as based on individual food consumption were good (0.79–0.99), but with some outliers. We conclude that Norwegians are exposed to DON in the same range as reported from other countries and that children have a higher exposure than adults. Furthermore, we conclude that intake estimates based on urinary DON concentration is a useful tool for evaluation of the exposure at population level, but due to outliers, the estimates for individuals are uncertain. There are also uncertainties in intake estimates both from food consumption and from urinary DON concentration, and we could not conclude on which approach provides the most accurate exposure estimate.
Objective:Electroconvulsive therapy (ECT) is regarded by many clinicians as the most effective treatment for treatment-resistant bipolar depression, but no randomized controlled trials have been ...conducted, to the authors’ knowledge. They compared efficacy measures of ECT and algorithm-based pharmacological treatment in treatment-resistant bipolar depression.Method:This multicenter, randomized controlled trial was carried out at seven acute-care psychiatric inpatient clinics throughout Norway and included 73 bipolar disorder patients with treatment-resistant depression. The patients were randomly assigned to receive either ECT or algorithm-based pharmacological treatment. ECT included three sessions per week for up to 6 weeks, right unilateral placement of stimulus electrodes, and brief pulse stimulation.Results:Linear mixed-effects modeling analysis revealed that ECT was significantly more effective than algorithm-based pharmacological treatment. The mean scores at the end of the 6-week treatment period were lower for the ECT group than for the pharmacological treatment group: by 6.6 points on the Montgomery-Åsberg Depression Rating Scale (SE=2.05, 95% CI=2.5–10.6), by 9.4 points on the 30-item version of the Inventory of Depressive Symptomatology–Clinician-Rated (SE=2.49, 95% CI=4.6–14.3), and by 0.7 points on the Clinical Global Impression for Bipolar Disorder (SE=0.31, 95% CI=0.13–1.36). The response rate was significantly higher in the ECT group than in the group that received algorithm-based pharmacological treatment (73.9% versus 35.0%), but the remission rate did not differ between the groups (34.8% versus 30.0%).Conclusion:Remission rates remained modest regardless of treatment choice for this challenging clinical condition.
BACKGROUND AND PURPOSE—The GLX (glycocalyx) is a protein/polysaccharide meshwork at the cellular surface. Consisting largely of glycosaminoglycans and proteoglycans, the GLX can shed in response to ...stress. In this study, we assay 11 components of the GLX in plasma from patients with ischemic stroke from a longitudinal cohort.
METHODS—Plasma samples from healthy individuals (N=8), and patients with ischemic stroke day ≥3, day 7, and day 90 (N=9–14) were immunoassayed for diverse components of the GLX.
RESULTS—Median stroke severity was mild (National Institutes of Health Stroke Scale 2.0 (range, 0–6) at day ≤3). Three (keratan-chondroitin-heparan-sulfate) of 4 glycosaminoglycans and CD44 (proteoglycan) were increased at day 7 and returned to baseline at day 90. Proteoglycan syndecan (Syn)-3 increased and Syn-2 levels decreased, significantly.
CONCLUSIONS—Individual GLX components are often assayed as stand-alone biomarkers for endothelial health. This study suggests a full assessment of GLX components is more indicative of the endothelial health of an individual and represents a complex GLX signature that may be valuable as a composite biomarker of disease.
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