Integrating EEG and Machine Learning to Analyze Brain Changes during the Rehabilitation of Broca's Aphasia.

The fusion of electroencephalography (EEG) with machine learning is transforming rehabilitation. Our study introduces a neural network model proficient in distinguishing pre- and post-rehabilitation states in patients with Broca's aphasia, based on brain connectivity metrics derived from EEG recordings during verbal and spatial working memory tasks. The Granger causality (GC), phase-locking value (PLV), weighted phase-lag index (wPLI), mutual information (MI), and complex Pearson correlation coefficient (CPCC) across the delta, theta, and low- and high-gamma bands were used (excluding GC, which spanned the entire frequency spectrum). Across eight participants, employing leave-one-out validation for each, we evaluated the intersubject prediction accuracy across all connectivity methods and frequency bands. GC, MI theta, and PLV low-gamma emerged as the top performers, achieving 89.4%, 85.8%, and 82.7% accuracy in classifying verbal working memory task data. Intriguingly, measures designed to eliminate volume conduction exhibited the poorest performance in predicting rehabilitation-induced brain changes. This observation, coupled with variations in model performance across frequency bands, implies that different connectivity measures capture distinct brain processes involved in rehabilitation. The results of this paper contribute to current knowledge by presenting a clear strategy of utilizing limited data to achieve valid and meaningful results of machine learning on post-stroke rehabilitation EEG data, and they show that the differences in classification accuracy likely reflect distinct brain processes underlying rehabilitation after stroke.

Marital status and survival in cancer patients: A systematic review and meta-analysis.

BACKGROUND: In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little is known about which types of social support promote better survival rates, and which subgroups of cancer patients are more susceptible to the benefits of it. The aim of this study was to identify, organize, and examine studies reporting on the significance of social support in cancer survival. METHODS: The PubMed, CINAHL and EBSCO databases were searched using the keywords social support/marital status, cancer, and survival/mortality. Where possible we used a meta-analytical approach, specifically a random effect model, in order to combine the results of the hazard ratios in studies from which this information could be obtained. When interpreting clinical relevance, we used the number needed to treat (NNT). RESULTS: Better survival was observed in married patients when compared to unmarried (single, never-married, divorced/separated, and widowed) in overall and cancer-specific survival. Gender group differences showed that the association was statistically significant only in cancer-specific survival when comparing divorced/separated male and female cancer patients (p < 0.001), thus confirming results from the previous meta-analysis. CONCLUSIONS: Being unmarried is associated with significantly worse overall and cancer-specific survival. The most vulnerable group found in our study were divorced/separated men. The results of this review can motivate physicians, oncologists, and other healthcare professionals to be aware of the importance of patients' social support, especially in the identified sub-group.

Maxillary arch dimensions, occlusion assessment and space conditions in patients with cleft palate in the period of deciduous dentition-A retrospective study.

PURPOSE: The aim of this study was to evaluate the maxillary arch dimensions, dentoalveolar relationships and spacing conditions in patients with cleft palate in comparison with the control group. METHODS: The subjects consisted of 31 children with cleft palate only (CP) aged 5.5 ± 0.51 (20 with a cleft of hard and soft palate (SHPC group) and 11 with a cleft of soft palate only (SPC group)). In the control group 30 subjects had a normal occlusion at age 5. Maxillary arch dimensions, dentoalveolar relationship according to the Huddard Bodenham index (HBI) and space conditions were compared with the control group. RESULTS: In all variables of maxillary arch dimensions except for total arch height the control group exhibited greater values. Most of the significant differences were on account of differences between the control and the SHPC group, with only three comparisons yielding significant results when comparing the two groups of children with clefts (SHPC vs SPC, IV-IV central: pDunnett T3= 0.0002, 95%CIDifference=-9.9-(-3.18); V-V distopalatal cusps: pDunnett T3= 0.0002, 95%CIDifference=-9.97-(-3.17); Total arch length: pDunnett T3= 0.0014, 95%CIDifference=1.74-7.85). The three groups differed significantly in anterior HBI only (HKruskal-Wallis=15.56, p = 0.0067). The spacing conditions in both jaws were also shown to be significantly dependent on the group of subjects studied (Upper jaw: χ2omnibus= 16.79, p = 0.0018; lower jaw: χ2omnibus= 13.75, p = 0.0102). CONCLUSIONS: The growth of the upper dental arch at the age of five is impeded in participants with CP in comparison to a control group. It is important to assess the effect of cleft subtypes on growth and development to get a better understanding.

Olanzapine decreased osteocyte maturation and Wnt/ß-catenin signaling during loading of the alveolar bone in rats.

Several studies indicate the influence of olanzapine on bone metabolism; however, the results are contradictory. We evaluated the effects of olanzapine on the Wnt/ß-catenin signaling pathway, physiological alveolar bone turnover, and alveolar bone modeling due to an applied orthodontic force. Adult male rats (n=48) were treated with either olanzapine or a vehicle for 21 days; then 8 rats from each group were sacrificed and the rest were divided into 4 groups: control, appliance-only, olanzapine-only, and olanzapine-appliance. The rats in the appliance groups were mounted with a superelastic closed coil spring that maintained constant orthodontic force between molars and incisors. We studied the effects of olanzapine on physiological alveolar bone turnover on day 21 of the experiment, and on alveolar bone modeling due to orthodontic force on day 56. We determined tooth movement, alveolar bone volume, activity of bone-specific cells, serum alkaline phosphatase (ALP) activity, and gene expression levels of Wnt/ß-catenin signaling target genes. During forced bone modeling, olanzapine increased osteoblast volume (P<0.0001) and ALP activity (P=0.0011) and decreased osteoclast volume (P<0.0001) and gene expression of the Wnt/ß-catenin signaling target genes Fosl1, Axin2, and Dkk1(P=0.001, P=0.0076, and P=0.036, respectively), and the osteocyte markers Sost and Dmp1 (P=0.0432 and P=0.0021, respectively). Similar results were obtained during physiological alveolar bone turnover on day 21, when olanzapine downregulated the gene expression of osteocyte markers and Wnt/ß-catenin signaling target genes. We concluded that olanzapine attenuated osteocyte maturation during forced bone modeling and physiological alveolar bone turnover, potentially through downregulation of the Wnt/ß-catenin signaling pathway.

Nutrition and Congruent Care Improve Wellbeing of Residents With Dementia in Slovenian Care Homes.

Introduction: Current nutritional strategies for people with dementia focus on nutritional diets and regimens, although in recent years congruent care for people with dementia has been increasingly recognized to improve their wellbeing. This includes consistency of care, respecting the variability of psycho-sociological factors, emphasizing the importance of participation in activities, and congruence with the individual's needs and capabilities. When applied to the nutritional aspects of care, it aims to empower people with dementia to have an active role in their care and during meals. Congruent care has previously shown promising results in improving the quality of life of residents, reducing the incidence of negative social interactions and daily intake of medicines. Methods: A mixed methods qualitative-quantitative study was carried out. Out of 102 residential care homes for the elderly in Slovenia, a non-random sample of homes was selected. Seven homes that have implemented congruent care and five who have not implemented it agreed to participate. Content analysis of the transcripts of focus group interviews was carried out, to establish how the congruent care model was included into their everyday practice of care for people with dementia. Qualitative comparative analysis was used to describe the differences in the practice of care between the two groups of homes, in the fields of nutritional and general care. Frequencies and assigned importance of statements relating to different aspects of nutritional care were statistically compared. Results: The introduction of congruent care improved the wellbeing of the people with dementia, as observed by caregivers. The homes that had implemented congruent care gave more attention to the food choice aspects of nutritional care (p = 0.0474, 95%CICongruent = 50.77-72.35%, 95%CINon-congruent = 27.65-49.23%), while the homes that had not were more attentive to the dietary intake aspects (p = 0.0067, 95%CICongruent = 22.79-44.74%, 95%CINon-congruent = 55.26-77.21%). In the homes for the elderly that had implemented congruent care, both caregivers and management reported that the frequency of use of pro re nata medication decreased, which is supported by the results of the linear regression ( R 2 adjusted =78.4, p = 0.005), although the data available is limited. Conclusion: First, the people with dementia in the care homes that had implemented congruent care were observed to have improved in mood, attitudes toward eating and wellbeing, as reported by caregivers. Second, the implementation of congruent care was well received by the management and caregivers of the care homes. A model of implementation of congruent nutritional care for people with dementia is presented.

Assessment of Model Accuracy in Eyes Open and Closed EEG Data: Effect of Data Pre-Processing and Validation Methods.

Eyes open and eyes closed data is often used to validate novel human brain activity classification methods. The cross-validation of models trained on minimally preprocessed data is frequently utilized, regardless of electroencephalography data comprised of data resulting from muscle activity and environmental noise, affecting classification accuracy. Moreover, electroencephalography data of a single subject is often divided into smaller parts, due to limited availability of large datasets. The most frequently used method for model validation is cross-validation, even though the results may be affected by overfitting to the specifics of brain activity of limited subjects. To test the effects of preprocessing and classifier validation on classification accuracy, we tested fourteen classification algorithms implemented in WEKA and MATLAB, tested on comprehensively and simply preprocessed electroencephalography data. Hold-out and cross-validation were used to compare the classification accuracy of eyes open and closed data. The data of 50 subjects, with four minutes of data with eyes closed and open each was used. The algorithms trained on simply preprocessed data were superior to the ones trained on comprehensively preprocessed data in cross-validation testing. The reverse was true when hold-out accuracy was examined. Significant increases in hold-out accuracy were observed if the data of different subjects was not strictly separated between the test and training datasets, showing the presence of overfitting. The results show that comprehensive data preprocessing can be advantageous for subject invariant classification, while higher subject-specific accuracy can be attained with simple preprocessing. Researchers should thus state the final intended use of their classifier.

Real-life dental examination elicits physiological responses different to visual and auditory dental-related stimuli.

BACKGROUND: Previous studies on dental anxiety have examined the psychophysiological responses evoked in dentally anxious subjects by dental-related stimuli, but not during a real-life dental examination, which was achieved in the present study. METHODS: The heart rate, skin conductance level, and heart rate variability of 25 subjects with dental anxiety and 25 healthy controls were examined. Anxiety was determined by the Modified Dental Anxiety Scale and the Dental Anxiety Scale-Revised. The psychophysiological reactions of the two groups were compared during exposure to dental-related pictures, dental-related sounds, and an actual examination in a dental surgery. RESULTS: All the dental-related stimuli provoked an increase in heart rate, i.e. visual stimuli (p<0.001; 95% CI 0.98-3.95 bpm), auditory stimuli (p<0.001; 95% CI 1.34-4.99 bpm), and a dental examination (p<0.001; 95% CI 1.26-5.39 bpm). Dental-related pictures provoked inferior skin conductance level changes compared to dental-related sounds and the dental examination (visual modality vs auditory p<0.001; 95% CI 0.039-0.152; visual modality vs examination p<0.001; 95% CI 0.083-0.275). Heart rate variability manifested in a complex pattern of responses to the dental examination. However, when exposed to all three dental-related stimuli presentation conditions, the heart rate (F = 0.352, p = 0.556), skin conductance level (F = 0.009, p = 0.926), and heart rate variability parameters of subjects with dental anxiety did not differ in comparison to the healthy controls. CONCLUSIONS: This pilot study represents an evaluation of psychophysiological reactions during a real-life dental examination compared to single modality stimuli, and shows that a real-life dental examination provokes an increase in heart rate, heart rate variability and skin conductance level. Additionally, autonomic responses did not differ between the experimental and control groups. The key issue for future studies is the effect of real-life situations on the physiological and psychological state of the subjects, which should be considered when planning new research and studied in depth.