medRxiv : the preprint server for health sciences最新文献

{"title":"Dynamic Measures of Glycemia in Relation to Hepatic Features in Adults Without Diabetes.","authors":"Bahar Bakhshi, Naznin Sultana, Matthew Nayor, Honghuang Lin, Jiantao Ma, Devin W Steenkamp, Michelle T Long, Nicole L Spartano, Maura E Walker","doi":"10.64898/2026.09.25.26364009","DOIUrl":"https://doi.org/10.64898/2026.09.25.26364009","url":null,"abstract":"<p><strong>Background & aims: </strong>Dysglycemia is associated with increased risk for hepatic features, including steatosis and fibrosis. Yet, the associations of dynamic measures of glycemia with hepatic features among individuals without diabetes remain understudied.</p><p><strong>Methods: </strong>We included participants from the Framingham Heart Study (FHS) Third Generation cohorts without diabetes who underwent assessment for hepatic steatosis (controlled attenuation parameter [CAP]) and fibrosis (liver stiffness measurement ([LSM]), using vibration-controlled transient elastography, had ≥3 days of continuous glucose monitor data (blinded Dexcom G6 Pro CGM) and completed a mixed meal tolerance test, containing a total of 600 kcal, 75 g carbohydrate, 21 g fat, and 29 g protein (MMTT, 2022-2025). We performed multivariable linear and logistic regression to investigate the associations of standardized 2-h postprandial glucose (2-h PPG) following MMTT, as well as CGM-derived measures, with CAP and log-transformed LSM, as well as hepatic steatosis (CAP≥274ndB/m) and fibrosis (LSM≥8.2 kPa), adjusting for confounders.</p><p><strong>Results: </strong>In 1071 FHS participants (58.3% female, 56.4% normoglycemia), mean age was 60.2 years and BMI 28.2 kg/m ² . Higher 2-h MMTT-PPG and CGM summary measures of glycemic burden (e.g., % time >140 mg/dL) were associated with 23-36% higher odds of steatosis and higher CAP. Similarly, CGM summary measures of glycemic burden (e.g., % time >140 mg/dL) and glycemic variability (e.g., coefficient of variation) were associated with 28-59% higher odds of hepatic fibrosis but not log-LSM.</p><p><strong>Conclusion: </strong>Measures of postprandial and continuous glucose dynamics are associated with hepatic features among individuals without diabetes.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-dependent associations of sleep duration and insomnia symptoms with cognitive decline across five decades of adult life: a multi-cohort longitudinal study.","authors":"Yi Fang, Allysa Quick, Nina Oryshkewych, Nicole Fernandez, Andrew S Lim, Lisa L Barnes, David A Bennett, Andrew Steptoe, Rebecca Hardy, Séverine Sabia, Meredith L Wallace, Yue Leng","doi":"10.64898/2026.09.25.26363056","DOIUrl":"https://doi.org/10.64898/2026.09.25.26363056","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Associations of sleep duration and insomnia symptoms with cognitive decline are inconsistent, and whether they represent modifiable risk factors or early manifestations of neurodegeneration may depend on life stage. We examined how sleep-cognition associations vary with age (44 to &gt;90 years).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We studied 16,884 participants from three cohorts with harmonised measures. In the English Longitudinal Study of Ageing (ELSA: n=9,473, median age 64, range 50 to ≥90), linear mixed-effects models examined age-specific differences in cognitive change (recall and fluency) associated with sleep duration, difficulty falling asleep, nocturnal awakenings, incorporating sleep-by-age-by-time interactions, with initial adjustment for sociodemographic factors and further adjustment for health and lifestyle factors. Sleep characteristics showing consistent age-dependent associations in ELSA were further evaluated in Whitehall II (n=5,580, median age 55, range 44 to 68) and the Rush Memory and Aging Project (MAP: n=1,831, median age 80, range 53 to 102).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;In ELSA, difficulty falling asleep ≥1 time/week (vs &lt;1 time/week) was associated with less favourable 5-year change in recall at age 50 (difference -0·12 SD, 95% CI -0·20 to -0·04), with the association attenuating and reversing towards more favourable change at older ages (p-interaction=0·009 [linear], 0·016 [quadratic]). These persisted after further adjustment for health and lifestyle factors. Short sleep (≤6 h) showed similar patterns that attenuated after further adjustment. Similar age gradients were observed for difficulty falling asleep in Whitehall II and MAP. There was no evidence of age modification on long sleep and nocturnal awakenings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;The cognitive implications of sleep disturbances vary by life stage. In midlife, difficulty falling asleep was associated with faster cognitive decline, supporting its role as a modifiable risk factor. In advanced age, the reversal is consistent with diminished arousal capacity accompanying prodromal dementia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Funding: &lt;/strong&gt;US National Institute on Aging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research in context: &lt;/strong&gt;&lt;b&gt;Evidence before this study:&lt;/b&gt; We searched PubMed and Web of Science from database inception to Jan 1, 2026, using terms related to sleep, sleep duration, insomnia, cognitive decline, dementia, and ageing, without language restrictions. Findings on sleep and cognitive ageing are inconsistent and vary by population studied. In the few prospective studies of midlife populations, short sleep and insomnia symptoms have been linked to increased dementia risk, but evidence remains limited. In older populations, findings are more mixed, with several studies reporting null associations and others reporting counterintuitive associations between greater sleep complaints and better cognitive outcomes. Few studies span a sufficient age ","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Clinical Utility of Deep Learning Models for Perivascular Space Segmentation in Alzheimer's Disease.","authors":"Serena Tang, Kyan Younes, Eesha Penukonda, Isabella Hausle, Pamela Thropp, Janine M Lupo, Duygu Tosun","doi":"10.64898/2026.09.27.26363725","DOIUrl":"https://doi.org/10.64898/2026.09.27.26363725","url":null,"abstract":"<p><p>Open-source deep learning models promise scalable quantification of MRI-visible perivascular spaces (PVS), an emerging marker of glymphatic dysfunction in Alzheimer's disease (AD). Whether these models remain valid when applied to heterogeneous AD cohorts and preserve ground-truth derived biological associations has not been established. We benchmarked five open-source nnU-Net-based PVS segmentation models (nnU-Net T1, nnU-Net T1+FLAIR, mcPVS-Net, MedNet-PVS, ADNI-PVS-Net) against manual labels in 60 multi-site ADNI-3 participants balanced across cognitively unimpaired, mild cognitive impairment, and AD dementia, and in 12 publicly available scans from the VAscular Lesions object-level and segmentatiOn (VALDO) challenge. We evaluated overall, voxel, object, and lesion-wise Dice; stratified performance by region, diagnosis, scanner, PVS severity, and white matter hyperintensity (WMH) burden; and tested whether model-derived PVS burden reproduced ground-truth derived associations with AD-related biomarkers. Despite high internal performance, all models showed a specialist-generalist trade-off: the AD-trained ADNI-PVS-Net achieved highest internal performance (overall Dice = 0.58±0.14) but degraded most externally (Dice ≤ 0.11), while MedNet-PVS and mcPVS-Net generalized externally (Dice 0.27-0.30) but systematically misestimated PVS burden. Models were relatively robust across scanner and diagnosis but inconsistent across PVS severity, and some misclassified up to 32% of WMH as PVS. Notably, only AD-trained models reproduced the expected PVS-amyloid biomarker relationship; other models returned a null result, despite comparable or superior Dice scores. These findings show that internal segmentation accuracy and external generalizability alone do not guarantee downstream inferential validity. Careful model selection and cohort-specific validation against manual labels should precede clinical inference in AD.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing spoken discourse in aphasia using multimodal artificial intelligence.","authors":"Marte M J, Lee S, Wang S, Goldin K, Varkanitsa M, Girard J M, Brito R, Wei X, Baker J T, Tie Y, Kiran S, Liebenthal E","doi":"10.64898/2026.09.27.26364108","DOIUrl":"10.64898/2026.09.27.26364108","url":null,"abstract":"<p><p>Discourse analysis can reliably predict real-world communicative success, yet is rarely implemented clinically, due to challenges in manually generating stimulus-specific main concept inventories (MCIs) and scoring patient narratives. We evaluated whether automatically derived macrolinguistic (main concept, sentiment) and microlinguistic (fluency, lexical, syntactic) features extracted from movie clip narrations can augment the clinical assessment of discourse in aphasia. The MCIs generated directly from each clip's video, audio and subtitles using a vision-language model approximated the main concepts healthy controls produced. Group classification (control: n=51; aphasia: n=54) based on the discourse features was excellent (AUC=0.95, 95% CI [0.90, 0.99]), with macrolinguistic features showing the largest group differences (main concept completeness: d=-1.84, 95% CI [-2.30, -1.38]) and strongest associations with aphasia severity (semantic distance to inventory: r=-0.79, 95% CI [-0.87, -0.66]). Findings support the feasibility and scalability of automated criterion-based discourse assessment using ecological stimuli, and highlight its potential for clinical implementation.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Vesicular Monoamine Transporter Type-2 Inhibitors on Motor Features in HD.","authors":"Nabil Halabi, Annie Killoran, Peg C Nopoulos","doi":"10.64898/2026.09.26.26364085","DOIUrl":"https://doi.org/10.64898/2026.09.26.26364085","url":null,"abstract":"<p><strong>Background: </strong>Huntington's disease (HD) is an inherited neurodegenerative disorder primarily associated with motor and psychiatric manifestations. No disease-modifying treatment currently exists, with vesicular monoamine transporter type-2 inhibitors (VMAT2i's) being the only FDA-approved therapy for motor features in HD. Previous studies evaluated the antichorea effects of VMAT2i's but did not address its effects on non-choreiform features.</p><p><strong>Objectives: </strong>This study aimed to characterize the effect of VMAT2i's on hyperkinetic, hypokinetic and total hypokinetic subscores of the UHDRS motor assessment in patients with motor-manifest HD from the <i>Enroll-HD</i> research platform.</p><p><strong>Methods: </strong>Data from 622 participants were analyzed. Linear mixed effects models were constructed to compare the rates of change of choreiform and non-choreiform motor scores before and after the initiation of a VMAT2i. We calculated and plotted the direction, magnitude and significance of VMAT2i administration on the rates of change of motor subscores. A similar analysis was performed investigating the effect of antipsychotic medications on motor subscales in HD.</p><p><strong>Results: </strong>VMAT2i's reversed progression of hyperkinesis but significantly increased the rates of change in the hypokinetic and total hypokinetic subscores. Antipsychotics also displayed efficacy in reversing progression of chorea but did not significantly influence progression of hypokinesis.</p><p><strong>Conclusions: </strong>The initiation of VMAT2i's was associated with an improvement in hyperkinesis but was associated with worsening of other motor features of HD. Hypokinesis increases progressively in HD and is correlated with functional impairment and global decline. Therefore, the use of VMAT2i's to treat motor features in HD should be a nuanced decision, considering its multipronged impact.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Sensitivity from Tandem Colonoscopy Meta-analyses.","authors":"Pedro Nascimento de Lima, Rachel B Issaka, Carolyn M Rutter","doi":"10.64898/2026.09.25.26364039","DOIUrl":"https://doi.org/10.64898/2026.09.25.26364039","url":null,"abstract":"<p><strong>Background: </strong>Tandem colonoscopy meta-analyses estimate adenoma miss rates, which have been used as a proxy for colonoscopy sensitivity. Doing so overstates sensitivity because it ignores lesions missed by both exams.</p><p><strong>Methods: </strong>We introduce Bayesian and frequentist approaches to estimate white-light colonoscopy (WLC) sensitivity from tandem colonoscopy meta-analyses. Neither approach assumes that the second colonoscopy is perfect. We apply both approaches to reanalyze data from a recent tandem colonoscopy meta-analysis, overall and across ten subgroups. Sensitivity analyses assess how assumptions about the relative performance of enhanced colonoscopy versus WLC affect estimates.</p><p><strong>Results: </strong>Under our Baseline specification, overall WLC sensitivity estimated by the Bayesian model was 0.54 [0.41, 0.63] (posterior mean and 95% credible interval). Sensitivity rose with lesion size: 0.49 [0.35, 0.60] for 1-5 mm adenomas, 0.64 [0.43, 0.78] for 6-9 mm adenomas and 0.84 [0.70, 0.93] for lesions 10 mm or larger. The frequentist plausible range encompassed the Bayesian estimate. The model-implied miss rate (0.35 [0.30, 0.40]) matched the original meta-analysis estimate and was stable across prior specifications. Assuming enhanced colonoscopy was perfect overstated overall sensitivity by 0.12 [0.06, 0.20].</p><p><strong>Limitations: </strong>Tandem colonoscopy data identify the miss rate but not WLC sensitivity, so estimates depend on an external assumption about the relative performance of enhanced colonoscopy versus WLC. As a result, WLC sensitivity estimates varied with the prior specification, especially for small and flat adenomas.</p><p><strong>Conclusions: </strong>WLC sensitivity may be meaningfully lower than previously assumed in CRC screening cost-effectiveness analyses. Modelers should use colonoscopy sensitivity estimates that do not assume a second colonoscopy exam is perfect.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tau-PET subtype modifies the association between plasma p-tau217 and memory in Alzheimer's disease.","authors":"Lukai Zheng, Elham Ghanbarian, Carlos Albarrán Morillo, Kyan Younes, Crystal M Glover, Laura A Rabin, Joshua D Grill, Michael Ewers, S Ahmad Sajjadi, Ali Ezzati","doi":"10.64898/2026.09.25.26363629","DOIUrl":"https://doi.org/10.64898/2026.09.25.26363629","url":null,"abstract":"<p><strong>Introduction: </strong>Plasma p-tau217 is associated with Alzheimer's disease pathology and memory performance, but its implications for memory may depend on fibrillar tau topography. We examined whether tau-PET subtype modified the association between plasma p-tau217 and memory.</p><p><strong>Methods: </strong>We analyzed 396 amyloid-positive, tau-positive participants spanning cognitively unimpaired, mild cognitive impairment, and dementia stages from six cohorts with tau-PET and plasma p-tau217; 301 had harmonized memory data. Tau-PET subtypes were derived using data-driven disease progression modelling. Primary cross-sectional models tested subtype×p-tau217 interactions for memory, adjusting for age, sex, education, <i>APOE</i> ε <i>4</i> status, and cohort. Secondary and exploratory analyses examined latent global cognition, non-memory measures, and longitudinal cognitive change.</p><p><strong>Results: </strong>Three tau-PET subtypes were retained: limbic-predominant, medial temporal lobe (MTL)-sparing, and posterior-predominant. Cross-sectionally, MTL-sparing participants had lower plasma p-tau217 than the other subtypes. The association between higher plasma p-tau217 and worse memory differed by subtype (interaction <i>p</i> =0.002) and was stronger in MTL-sparing ( <i>B</i> =-0.191, <i>p</i> <0.001) than in limbic-predominant ( <i>B</i> =-0.07, <i>p</i> =0.002) and posterior-predominant participants ( <i>B</i> =-0.07, <i>p</i> <0.001). The interaction remained significant after additional adjustment for diagnostic group ( <i>p</i> =0.015). This pattern also persisted after additional adjustment for PET tau burden, amyloid Centiloids, or plasma Aβ42/40; none of these biomarkers showed comparable subtype modification. Subtype modification was also observed for a global cognitive composite (interaction <i>p</i> =0.004) and subsequent memory decline in an exploratory analysis conditioned on baseline memory (interaction <i>p</i> =0.016).</p><p><strong>Discussion: </strong>Tau-PET subtype modified the p-tau217-memory association, suggesting that the cognitive implications of plasma p-tau217 may vary with tau topography.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epigenetic age acceleration is associated with brain connectivity changes and the risk of major depression after trauma.","authors":"Alba Navarro-Flores, Hazel Milla, Sarah D Linnstaedt, Xinming An, Jennifer S Stevens, Laura Huff, Nathaniel G Harnett, Alyssa R Roeckner, Katelyn I Oliver, David R Rubinow, Karestan C Koenen, Urs Heilbronner, Thomas G Schulze, Kerry J Ressler, Samuel A McLean, Anthony S Zannas","doi":"10.64898/2026.09.18.26363409","DOIUrl":"10.64898/2026.09.18.26363409","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) is associated with brain dysfunction and age-related diseases. Epigenetic clocks based on DNA methylation patterns estimate biological aging and aim to predict morbidity and mortality. Although MDD has been linked to epigenetic age acceleration (EAA) cross-sectionally, it is unknown whether EAA is associated with MDD after trauma.</p><p><strong>Methods: </strong>We included 706 participants (66% non-white, 64% female) from the multi-ancestry AURORA study, enrolled at emergency departments (ED) within 72 hours after trauma, from whom three age-adjusted epigenetic clocks were measured at enrollment: PhenoAge, GrimAge, and DunedinPACE. Functional MRI and assessment for probable MDD were conducted two weeks and six months later, respectively. Logistic and linear regression models tested the association of EAA with MDD and functional neuroimaging endpoints.</p><p><strong>Results: </strong>A total of 660 participants had available assessments of probable MDD six months after trauma, and from those 160 screened positively (24.2%) after trauma. EAA calculated by GrimAge (OR = 1.44, 95% CI = 1.12 - 1.85, p-adj= 0.012) and DunedinPACE (OR = 1.46, 95% CI = 1.15 - 1.85, p-adj = 0.005), but not PhenoAge (p-adj= 0.239), was significantly associated with MDD 6-months after trauma. Associations remained significant after adjusting for additional confounders, including prior trauma and disability (p= 0.008 for GrimAge, p= 0.010 for DunedinPACE). Subgroup analysis based on a median age split revealed these effects were only observed in participants 35 years of age or older. DunedinPACE was significantly associated with altered connectivity of fourteen brain network pairs after FDR correction (n = 217).</p><p><strong>Conclusions: </strong>EAA is associated with a higher risk of MDD after trauma and with concomitant brain connectivity changes. Calculation of GrimAge and DunedinPACE at the time of ED presentation may help recognize patients at risk for MDD, potentially improving personalized care after trauma.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"K-space Optimized Spatial Temporal Architecture for Low Latency in Interventional Cardiac MRI.","authors":"Mark Buckup, Niraj Mahajan, Ana E Rodríguez-Soto, Joni Blood, Sanjeet Hegde, Eleanor L Schuchardt, Beth Printz, Hari K Narayan, Brent L Gordon, Francisco Contijoch","doi":"10.64898/2026.09.21.26363257","DOIUrl":"10.64898/2026.09.21.26363257","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and evaluate a recurrent neural network that operates directly on undersampled golden-angle radial k-space, enabling low-latency cardiac cine reconstruction for interventional cardiac MRI (iCMR).</p><p><strong>Methods: </strong>KOSTAL (K-space Optimized Spatial Temporal Architecture for Low latency) combines a per-coil k-space convolutional gated recurrent unit (convGRU), which learns a mask-conditioned view-sharing rule over the accumulated k-space, with an image-space recurrent module. It was trained and tested on the open-access multi-coil OCMR dataset using 10 simulated golden-angle spokes per frame against a 1000-spoke reference. Ablations varied recurrent module architecture and placement; temporal behavior was assessed using a imaging-plane transition test. Generalization was evaluated without retraining in 23 pediatric patients prospectively scanned during free-breathing using a radial golden-angle bSSFP sequence with binned XD-GRASP and clinical breath-held cine serving as references.</p><p><strong>Results: </strong>At 10 spokes per frame, KOSTAL reached a median SSIM of 0.907 (gridding: 0.622) in under 34 ms of processing time per frame. Image quality (IQ) matched gridded results formed from 7-11 times more spokes. Recurrence in k-space rather than image space accounted for most of this gain (0.891 versus <0.650). IQ recovered from an abrupt plane transition in 75 ms, versus 303 ms for 200-spoke gridding. KOSTAL had the best agreement with the binned reference and the highest long-axis CNR. KOSTAL accurately tracked left-ventricular blood-pool volume (end-diastolic volume bias -0.7 mL) with a shorter lag (71 ms) than iterative reconstruction (239-287 ms).</p><p><strong>Conclusion: </strong>Learned, mask-conditioned recurrence in k-space yields high image quality at a latency compatible with interventional guidance.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13622365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buccal DNA Methylation-Derived EpiScores are Associated with Neonatal Morbidity Burden in Infants born Very Preterm.","authors":"Priyadarshni Patel, Siyu Zhu, Neha Sehgal, Marie Camerota, Brian S Carter, Jennifer Check, Jennifer B Helderman, Julie A Hofheimer, Jonathan S Litt, Elisabeth C McGowan, Charles R Neal, Steven L Pastyrnak, Lynne M Smith, T Michael O'Shea, Carmen Marsit, Barry Lester, Todd M Everson","doi":"10.64898/2026.09.25.26363955","DOIUrl":"10.64898/2026.09.25.26363955","url":null,"abstract":"<p><strong>Background: </strong>Infants <30 weeks gestational age (very preterm (VPT)), are at risk of experiencing multiple serious neonatal morbidities. These morbidities impart serious biological stress, which may be reflected in dysregulated protein expression even after the morbidities have resolved. Recent studies suggest that DNA methylation-based predictors of circulating proteins may reflect the molecular effects of neonatal adversity. The objective of this study is to examine associations between DNA methylation-derived EpiScores, which are externally trained methylation signatures that proxy circulating protein levels, and neonatal morbidity burden in children born VPT. Buccal DNA methylation was obtained at NICU discharge in 537 infants from the NOVI cohort. A total of 111 EpiScores were calculated and tested for association with multimorbidity (0-1 vs. ≥2 morbidities) using adjusted linear regression models. Cross-tissue analyses in an external paired blood-buccal dataset (n=21) were used to identify EpiScores with moderate-to-strong correlations across tissues.</p><p><strong>Results: </strong>Eighteen EpiScores were nominally associated with multimorbidity (p < 0.05), with Melanoma-derived growth regulatory protein (MIA) with FDR < 0.05 (β = 0.0023, p = 4.4 × 10 ). In cross-tissue analyses, 35 EpiScores yielded r > 0.50 (p<0.05), 11 of which showed nominal associations with multimorbidity, including MIA. Overall, the morbidity-associated EpiScores reflected immune, inflammatory, metabolic, and growth-related pathways.</p><p><strong>Conclusions: </strong>Buccal DNA methylation-derived EpiScores capture biological signatures associated with neonatal morbidity burden in very preterm infants.</p>","PeriodicalId":94281,"journal":{"name":"medRxiv : the preprint server for health sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13622599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}