OBJECTIVE: This study was designed to use statistical parametric mapping of interictal positron-emission tomography using [18F]Fluorodeoxyglucose (FDG-PET) to compare the brain metabolisms of patients with mesial temporal lobe epilepsy (MTLE)/hippocampal sclerosis and controls. Another aim of this study was to analyze the potential differences among patients in terms of epilepsy duration, side of hippocampal sclerosis, histopathological findings, insult in their history, and postoperative outcomes. METHODS: We analyzed FDG-PET scans from 49 patients with MTLE/hippocampal sclerosis and 24 control subjects. We analyzed the differences in regional glucose metabolism between the patients and the control group and within the patient group using multiple variables. RESULTS: We observed widespread hypometabolism in the patient group in comparison with the control group in temporal and extratemporal areas on the epileptogenic side (ES). On the nonepileptogenic side (NES), we observed the most hypometabolism in the thalamus and the anterior and middle cingulate gyrus. In the group of patients with more severe hippocampal sclerosis, we observed statistically significant hypometabolism in the insula on the ES. In patients with poor postoperative outcomes, we found statistically significant hypometabolism in the insula on the ES and the temporal pole (TP) on the NES. Patients with any insult in their history showed hypermetabolism in the TP on both sides. CONCLUSION: Our study showed that there are widespread changes in metabolism in patients with MTLE in comparison to controls, either inside or outside the temporal lobe. There are significant differences among these patients in terms of postoperative outcomes, degree of hippocampal sclerosis, and insults in their history.

• MeSH
• Adult MeSH
• Epilepsy, Temporal Lobe diagnostic imaging   drug therapy   pathology   surgery   MeSH
• Fluorodeoxyglucose F18 metabolism   MeSH
• Glucose metabolism   MeSH
• Hippocampus diagnostic imaging   metabolism   pathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Brain metabolism   MeSH
• Cerebral Cortex pathology   MeSH
• Postoperative Period MeSH
• Positron-Emission Tomography methods   MeSH
• Predictive Value of Tests MeSH
• Sclerosis diagnostic imaging   metabolism   pathology   MeSH
• Temporal Lobe pathology   MeSH
• Case-Control Studies MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Names of Substances
• Fluorodeoxyglucose F18 MeSH
• Glucose MeSH

BACKGROUND: Lower-limb kinematic and temporospatial differences between back-carried (BC) and non-back-carried (NBC) children are expected based on previous static lower-limb relationships reported in BC children. Back-carrying of children is common among South Africans and becoming popular among Westerners. Establishing the potential effects of back-carrying on lower-limb development and gait is therefore important. RESEARCH QUESTION: Does BC influence the tri-planar instantaneous lower-limb kinematics and temporospatial parameters of the full gait cycle in children, and is there an association between static tibial torsion and the lower-limb gait kinematics? METHODS: Twelve NBC (age = 8.00 ± 0.95 years) and 12 BC (age = 8.08 ± 0.79 years) children were selected. Tri-planar kinematics of the hip, knee, and ankle were captured during gait using an eight-camera motion analysis system and Visual3D software to extract the kinematic data. All static tibial torsion were measured goniometrically. Statistical parametric mapping (SPM) was used to compare joint kinematics during the gait cycle and the association of tibial torsion throughout the gait cycle. RESULTS: SPM revealed significant differences between BC and NBC participants in hip kinematics (mean difference = 2.49°, p = 0.016) at 52-66 % of the gait cycle and knee joint kinematics (mean difference = 3.00°, p = 0.026) at 34-41 % of the gait cycle. Temporospatial differences were non-significant for speed, stride length, stance time, and stride width (p = 0.80, gHedges = 0.10). Significant correlations were evident between static tibial torsion and joint kinematics for the knee (r = -0.44 to -0.69, p = 0.041) for BC children and for the ankle (r = 0.74-0.75, p = 0.025) in NBC children. Larger internal tibial torsion is associated with more in-toeing and internal knee rotation during the swing phase in back-carried children. SIGNIFICANCE: A discrete comparison of kinematics in BC versus NBC children did not yield significant differences, while differences were observed using the SPM. The observed differences are likely of limited clinical importance, implying that caregivers can continue to BC their children.

• Keywords
• Back-carrying, Joint kinematics, Lower-limb development, Temporospatial,
• MeSH
• Biomechanical Phenomena MeSH
• Gait * physiology   MeSH
• Child MeSH
• Lower Extremity * physiology   MeSH
• Ankle Joint * physiology   MeSH
• Knee Joint * physiology   MeSH
• Hip Joint * physiology   MeSH
• Humans MeSH
• Range of Motion, Articular physiology   MeSH
• Tibia * physiology   MeSH
• Torsion, Mechanical MeSH
• Weight-Bearing * physiology   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH

BACKGROUND: No universal solution, based on an approved pedagogical approach, exists to parametrically describe, effectively manage, and clearly visualize a higher education institution's curriculum, including tools for unveiling relationships inside curricular datasets. OBJECTIVE: We aim to solve the issue of medical curriculum mapping to improve understanding of the complex structure and content of medical education programs. Our effort is based on the long-term development and implementation of an original web-based platform, which supports an outcomes-based approach to medical and healthcare education and is suitable for repeated updates and adoption to curriculum innovations. METHODS: We adopted data exploration and visualization approaches in the context of medical curriculum innovations in higher education institutions domain. We have developed a robust platform, covering detailed formal metadata specifications down to the level of learning units, interconnections, and learning outcomes, in accordance with Bloom's taxonomy and direct links to a particular biomedical nomenclature. Furthermore, we used selected modeling techniques and data mining methods to generate academic analytics reports from medical curriculum mapping datasets. RESULTS: We present a solution that allows users to effectively optimize a curriculum structure that is described with appropriate metadata, such as course attributes, learning units and outcomes, a standardized vocabulary nomenclature, and a tree structure of essential terms. We present a case study implementation that includes effective support for curriculum reengineering efforts of academics through a comprehensive overview of the General Medicine study program. Moreover, we introduce deep content analysis of a dataset that was captured with the use of the curriculum mapping platform; this may assist in detecting any potentially problematic areas, and hence it may help to construct a comprehensive overview for the subsequent global in-depth medical curriculum inspection. CONCLUSIONS: We have proposed, developed, and implemented an original framework for medical and healthcare curriculum innovations and harmonization, including: planning model, mapping model, and selected academic analytics extracted with the use of data mining.

• MeSH
• Curriculum * MeSH
• Humans MeSH
• Models, Statistical * MeSH
• Education, Medical * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

OBJECTIVE: To evaluate the benefit of statistical SPECT processing over traditional subtraction methods, we compared ictal-interictal SPECT analyzed by statistical parametric mapping (SPM) (ISAS), statistical ictal SPECT coregistered to MRI (STATISCOM), and subtraction ictal-interictal SPECT coregistered with MRI (SISCOM) in patients with MRI-negative focal temporal lobe epilepsy (nTLE) and extratemporal lobe epilepsy (nETLE). METHODS: We retrospectively identified 49 consecutive cases of drug-resistant focal epilepsy that had a negative preoperative MRI and underwent interictal and ictal SPECT prior to resective epilepsy surgery. Interictal and ictal SPECT scans were analyzed using SISCOM, ISAS, and STATISCOM to create hyperperfusion and hypoperfusion maps for each patient. Reviewers blinded to clinical data and the SPECT analysis method marked the site of probable seizure origin and indicated their confidence in the localization. RESULTS: In nTLE and nETLE, the hyperperfusions detected by STATISCOM (71% nTLE, 57% nETLE) and ISAS (67% nTLE, 53% nETLE) were more often colocalized with surgery resection site compared to SISCOM (38% nTLE, 36% nETLE). In nTLE, localization of the hyperperfusion to the region of surgery was associated with an excellent outcome for STATISCOM (p = 0.005) and ISAS (p = 0.027), but not in SISCOM (p = 0.071). This association was not present in nETLE for any method. CONCLUSION: In an unselected group of patients with normal MRI and focal epilepsy, SPM-based methods of SPECT processing showed better localization of SPECT hyperperfusion to surgical resection site and higher interobserver agreement compared to SISCOM. These results show the benefit of statistical SPECT processing methods and further highlight the challenge of nETLE.

• MeSH
• Adult MeSH
• Electroencephalography MeSH
• Epilepsy * diagnostic imaging   pathology   surgery   MeSH
• Tomography, Emission-Computed, Single-Photon * MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging * MeSH
• Adolescent MeSH
• Young Adult MeSH
• Brain diagnostic imaging   pathology   physiopathology   MeSH
• Retrospective Studies MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Research Support, N.I.H., Extramural MeSH

(1) Background: Understanding children's motor patterns in landing is important not only for sport performance but also to prevent lower limb injury. The purpose of this study was to analyze children's lower limb joint angles and impact force during single-leg landings (SLL) in different types of jumping sports using statistical parametric mapping (SPM). (2) Methods: Thirty children (53.33% girls, M = 10.16 years-old, standard deviation (SD) = 1.52) divided into three groups (gymnastics, volleyball and control) participated in the study. The participants were asked to do SLLs with the dominant lower limb (barefoot) on a force plate from a height of 25 cm. The vertical ground reaction force (GRF) and lower limb joint angles were assessed. SPM{F} one-way analysis of variance (ANOVA) and SPM{t} unpaired t-tests were performed during the landing and stability phases. (3) Results: A significant main effect was found in the landing phase of jumping sport practice in GRF and joint angles. During the stability phase, this effect was exhibited in ankle and knee joint angles. (4) Conclusions: Evidence was obtained of the influence of practicing a specific sport in childhood. Child volleyball players performed SLL with lower impact force and higher knee flexion than child gymnasts. Training in specific jumping sports (i.e., volleyball and gymnastics) could affect the individual capacity to adapt SLL execution.

• Keywords
• childhood, drop jump landing, motor control, motor development, statistical parametric mapping,
• MeSH
• Leg * MeSH
• Biomechanical Phenomena MeSH
• Child MeSH
• Knee Joint MeSH
• Humans MeSH
• Motor Skills MeSH
• Movement * MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

The aim of this study was to examine the effect of attentional focus instructions on the biomechanical variables associated with the risk of anterior cruciate ligament injury of the knee joint during a drop landing task using a time series analysis. Ten female volleyball players (age: 20.4 ± 0.8 years, height: 169.7 ± 7.1 cm, mass: 57.6 ± 3.1 kg, experience: 6.3 ± 0.8 years) performed landings from a 50 cm height under three different attentional focus conditions: (1) external focus (focus on landing as soft as possible), (2) internal focus (focus on bending your knees when you land), and (3) control (no-focus instruction). Statistical parameter mapping in the sagittal plane during the crucial first 30% of landing time showed a significant effect of attentional focus instructions. Despite the similarity in landing performance across foci instructions, adopting an external focus instruction promoted reduced vertical ground reaction force and lower sagittal flexion moment during the first 30% of execution time compared to internal focus, suggesting reduced knee loading. Therefore, adopting an external focus of attention was suggested to reduce most biomechanical risk variables in the sagittal plane associated with anterior cruciate ligament injuries, compared to internal focus and control condition. No significant differences were found in the frontal and horizontal planes between the conditions during this crucial interval.

• Keywords
• ACL, kinematics, kinetics, statistical parametric mapping,
• MeSH
• Biomechanical Phenomena physiology   MeSH
• Knee Joint * physiology   MeSH
• Humans MeSH
• Young Adult MeSH
• Anterior Cruciate Ligament Injuries physiopathology   MeSH
• Attention * physiology   MeSH
• Volleyball * physiology   MeSH
• Check Tag
• Humans MeSH
• Young Adult MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Recent findings suggest that specific deficits in neural synchrony and binding may underlie cognitive disturbances in schizophrenia and that key aspects of schizophrenia pathology involve discoordination and disconnection of distributed processes in multiple cortical areas associated with cognitive deficits. In the present study we aimed to investigate the underlying cortical mechanism of disturbed frontal-temporal-central-parietal connectivity in schizophrenia by examination of the synchronization patterns using wavelet phase synchronization index and coherence between all defined couples of 8 EEG signals recorded at different cortical sites in its relationship to positive and negative symptoms of schizophrenia. 31 adult schizophrenic outpatients with diagnosis of paranoid schizophrenia (mean age 27.4) were assessed in the study. The obtained results present the first quantitative evidence indicating direct relationship between wavelet phase synchronization and coherence in pairs of EEG signals recorded from frontal, temporal, central and parietal brain areas and positive and negative symptoms of schizophrenia. The performed analysis demonstrates that the level of phase synchronization and coherence in some pairs of EEG signals is inversely related to positive symptoms, negative symptoms and general psychopathology in temporal scales (frequency ranges) given by wavelet frequencies (WFs) equal to or higher than 7.56 Hz, and positively related to negative symptoms in wavelet frequencies equal to or lower than 5.35 Hz. This finding suggests that higher and lower frequencies may play a specific role in binding and connectivity and may be related to decreased or increased synchrony with specific manifestation in cognitive deficits of schizophrenia.

• MeSH
• Adult MeSH
• Electroencephalography methods   MeSH
• Cortical Synchronization * MeSH
• Humans MeSH
• Brain Mapping MeSH
• Young Adult MeSH
• Cerebral Cortex physiopathology   MeSH
• Statistics, Nonparametric MeSH
• Schizophrenia, Paranoid pathology   physiopathology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

BACKGROUND: The progressive cardiomyopathy that develops in boys with Duchenne and Becker muscular dystrophy (DMD/BMD) is presumed to be a secondary consequence of the fibrosis within the myocardium. There are only limited data on using parametric imaging in these patients. The purpose of this study was to assess native T1 and extracellular volume (ECV) values in DMD patients. METHODS: The Czech population of males with DMD/BMD was screened. All eligible patients fulfilling the inclusion criteria were included. Forty nine males underwent cardiac magnetic resonance (MR) examination including T1 native and post-contrast mapping measurements. One DMD patient and all BMD patients were excluded from statistical analysis. Three groups were compared - Group D1 - DMD patients without late gadolinium enhancement (LGE) (n = 23), Group D2 - DMD patients with LGE (n = 20), and Group C - gender matched controls (n = 13). RESULTS: Compared to controls, both DMD groups had prolonged T1 native relaxation time. These results are concordant in all 6 segments as well as in global values (1041 ± 31 ms and 1043 ± 37 ms vs. 983 ± 15 ms, both p < 0.05). Group D2 had significantly increased global ECV (0.28 ± 0.044 vs. 0.243 ± 0.013, p < 0.05) and segmental ECV in inferolateral and anterolateral segments in comparison with controls. The results were also significant after adjustment for subjects' age. CONCLUSION: DMD males had increased native T1 relaxation time independent of the presence or absence of myocardial fibrosis. Cardiac MR may provide clinically useful information even without contrast media administration.

• Keywords
• Cardiac magnetic resonance, Cardiomyopathy, Duchene muscular dystrophy, T1 mapping; extracellular volume,
• MeSH
• Muscular Dystrophy, Duchenne diagnostic imaging   MeSH
• Gadolinium analysis   MeSH
• Cardiomyopathies diagnostic imaging   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Adolescent MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH
• Names of Substances
• Gadolinium MeSH

BACKGROUND: Individuals with osteoporosis are predisposed to hip fracture during trips, stumbles or falls, but half of all hip fractures occur in those without generalised osteoporosis. By analysing ordinary clinical CT scans using a novel cortical thickness mapping technique, we discovered patches of markedly thinner bone at fracture-prone regions in the femurs of women with acute hip fracture compared with controls. METHODS: We analysed CT scans from 75 female volunteers with acute fracture and 75 age- and sex-matched controls. We classified the fracture location as femoral neck or trochanteric before creating bone thickness maps of the outer 'cortical' shell of the intact contra-lateral hip. After registration of each bone to an average femur shape and statistical parametric mapping, we were able to visualise and quantify statistically significant foci of thinner cortical bone associated with each fracture type, assuming good symmetry of bone structure between the intact and fractured hip. The technique allowed us to pinpoint systematic differences and display the results on a 3D average femur shape model. FINDINGS: The cortex was generally thinner in femoral neck fracture cases than controls. More striking were several discrete patches of statistically significant thinner bone of up to 30%, which coincided with common sites of fracture initiation (femoral neck or trochanteric). INTERPRETATION: Femoral neck fracture patients had a thumbnail-sized patch of focal osteoporosis at the upper head-neck junction. This region coincided with a weak part of the femur, prone to both spontaneous 'tensile' fractures of the femoral neck, and as a site of crack initiation when falling sideways. Current hip fracture prevention strategies are based on case finding: they involve clinical risk factor estimation to determine the need for single-plane bone density measurement within a standard region of interest (ROI) of the femoral neck. The precise sites of focal osteoporosis that we have identified are overlooked by current 2D bone densitometry methods.

• MeSH
• Densitometry methods   MeSH
• Femoral Neck Fractures diagnostic imaging   etiology   MeSH
• Bone Density physiology   MeSH
• Femur Neck diagnostic imaging   MeSH
• Humans MeSH
• Osteoporosis complications   diagnosis   MeSH
• Tomography, X-Ray Computed methods   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Case-Control Studies MeSH
• Check Tag
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH
• Geographicals
• Czech Republic MeSH

BACKGROUND: Duchenne muscular dystrophy (DMD) patients are monitored periodically for cardiac involvement, including cardiac MRI with gadolinium-based contrast agents (GBCA). Texture analysis (TA) offers an alternative approach to assess late gadolinium enhancement (LGE) without relying on GBCA administration, impacting DMD patients' care. The study aimed to evaluate the prognostic value of selected TA features in the LGE assessment of DMD patients. RESULTS: We developed a pipeline to extract TA features of native T1 parametric mapping and evaluated their prognostic value in assessing LGE in DMD patients. For this evaluation, five independent TA features were selected using Boruta to identify relevant features based on their importance, least absolute shrinkage and selection operator (LASSO) to reduce the number of features, and hierarchical clustering to target multicollinearity and identify independent features. Afterward, logistic regression was used to determine the features with better discrimination ability. The independent feature inverse difference moment normalized (IDMN), which measures the pixel values homogeneity in the myocardium, achieved the highest accuracy in classifying LGE (0.857 (0.572-0.982)) and also was significantly associated with changes in the likelihood of LGE in a subgroup of patients with three yearly examinations (estimate: 23.35 (8.7), p-value = 0.008). Data are presented as mean (SD) or median (IQR) for normally and non-normally distributed continuous variables and numbers (percentages) for categorical ones. Variables were compared with the Welch t-test, Wilcoxon rank-sum, and Chi-square tests. A P-value < 0.05 was considered statistically significant. CONCLUSION: IDMN leverages the information native T1 parametric mapping provides, as it can detect changes in the pixel values of LGE images of DMD patients that may reflect myocardial alterations, serving as a supporting tool to reduce GBCA use in their cardiac MRI examinations.

• Keywords
• Cardiac MRI, Duchenne muscular dystrophy, Radiomics, Texture analysis,
• MeSH
• Child MeSH
• Muscular Dystrophy, Duchenne * diagnostic imaging   MeSH
• Gadolinium MeSH
• Contrast Media MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Adolescent MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Gadolinium MeSH
• Contrast Media MeSH