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Item Neural Activity in the Anterior Insula at Drinking Onset and Licking Relates to Compulsion-Like Alcohol Consumption(Society for Neuroscience, 2024-02-28) Starski, Phillip; Morningstar, Mitch D.; Katner, Simon N.; Frasier, Raizel M.; De Oliveira Sergio, Thatiane; Wean, Sarah; Lapish, Christopher C.; Hopf, F. Woodward; Psychiatry, School of MedicineMuch remains unknown about the etiology of compulsion-like alcohol drinking, where consumption persists despite adverse consequences. The role of the anterior insula (AIC) in emotion, motivation, and interoception makes this brain region a likely candidate to drive challenge-resistant behavior, including compulsive drinking. Indeed, subcortical projections from the AIC promote compulsion-like intake in rats and are recruited in heavy-drinking humans during compulsion for alcohol, highlighting the importance of and need for more information about AIC activity patterns that support aversion-resistant responding. Single-unit activity was recorded in the AIC from 15 male rats during alcohol-only and compulsion-like consumption. We found three sustained firing phenotypes, sustained-increase, sustained-decrease, and drinking-onset cells, as well as several firing patterns synchronized with licking. While many AIC neurons had session-long activity changes, only neurons with firing increases at drinking onset had greater activity under compulsion-like conditions. Further, only cells with persistent firing increases maintained activity during pauses in licking, suggesting roles in maintaining drive for alcohol during breaks. AIC firing was not elevated during saccharin drinking, similar to lack of effect of AIC inhibition on sweet fluid intake in many studies. In addition, we observed subsecond changes in AIC neural activity tightly entrained to licking. One lick-synched firing pattern (determined for all licks in a session) predicted compulsion-like drinking, while a separate lick-associated pattern correlated with greater consumption across alcohol intake conditions. Collectively, these data provide a more integrated model for the role of AIC firing in compulsion-like drinking, with important relevance for how the AIC promotes sustained motivated responding more generally.Item The Brain Tumor Segmentation (BraTS-METS) Challenge 2023: Brain Metastasis Segmentation on Pre-treatment MRI(ArXiv, 2023-06-01) Moawad, Ahmed W.; Janas, Anastasia; Baid, Ujjwal; Ramakrishnan, Divya; Jekel, Leon; Krantchev, Kiril; Moy, Harrison; Saluja, Rachit; Osenberg, Klara; Wilms, Klara; Kaur, Manpreet; Avesta, Arman; Cassinelli Pedersen, Gabriel; Maleki, Nazanin; Salimi, Mahdi; Merkaj, Sarah; von Reppert, Marc; Tillmans, Niklas; Lost, Jan; Bousabarah, Khaled; Holler, Wolfgang; Lin, MingDe; Westerhoff, Malte; Maresca, Ryan; Link, Katherine E.; Tahon, Nourel Hoda; Marcus, Daniel; Sotiras, Aristeidis; LaMontagne, Pamela; Chakrabarty, Strajit; Teytelboym, Oleg; Youssef, Ayda; Nada, Ayaman; Velichko, Yuri S.; Gennaro, Nicolo; Connectome Students; Group of Annotators; Cramer, Justin; Johnson, Derek R.; Kwan, Benjamin Y. M.; Petrovic, Boyan; Patro, Satya N.; Wu, Lei; So, Tiffany; Thompson, Gerry; Kam, Anthony; Guzman Perez-Carrillo, Gloria; Lall, Neil; Group of Approvers; Albrecht, Jake; Anazodo, Udunna; Lingaru, Marius George; Menze, Bjoern H.; Wiestler, Benedikt; Adewole, Maruf; Anwar, Syed Muhammad; Labella, Dominic; Li, Hongwei Bran; Iglesias, Juan Eugenio; Farahani, Keyvan; Eddy, James; Bergquist, Timothy; Chung, Verena; Shinohara, Russel Takeshi; Dako, Farouk; Wiggins, Walter; Reitman, Zachary; Wang, Chunhao; Liu, Xinyang; Jiang, Zhifan; Van Leemput, Koen; Piraud, Marie; Ezhov, Ivan; Johanson, Elaine; Meier, Zeke; Familiar, Ariana; Kazerooni, Anahita Fathi; Kofler, Florian; Calabrese, Evan; Aneja, Sanjay; Chiang, Veronica; Ikuta, Ichiro; Shafique, Umber; Memon, Fatima; Conte, Gian Marco; Bakas, Spyridon; Rudie, Jeffrey; Aboian, Mariam; Radiology and Imaging Sciences, School of MedicineClinical monitoring of metastatic disease to the brain can be a laborious and timeconsuming process, especially in cases involving multiple metastases when the assessment is performed manually. The Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) guideline, which utilizes the unidimensional longest diameter, is commonly used in clinical and research settings to evaluate response to therapy in patients with brain metastases. However, accurate volumetric assessment of the lesion and surrounding peri-lesional edema holds significant importance in clinical decision-making and can greatly enhance outcome prediction. The unique challenge in performing segmentations of brain metastases lies in their common occurrence as small lesions. Detection and segmentation of lesions that are smaller than 10 mm in size has not demonstrated high accuracy in prior publications. The brain metastases challenge sets itself apart from previously conducted MICCAI challenges on glioma segmentation due to the significant variability in lesion size. Unlike gliomas, which tend to be larger on presentation scans, brain metastases exhibit a wide range of sizes and tend to include small lesions. We hope that the BraTS-METS dataset and challenge will advance the field of automated brain metastasis detection and segmentation.Item The Successes and Challenges of Implementing Telehealth for Diverse Patient Populations Requiring Prenatal Care During COVID-19: Qualitative Study(JMIR, 2022-03-30) Farrell, Ruth; Collart, Christina; Craighead, Caitlin; Pierce, Madelyn; Chien, Edward; Frankel, Richard; Tucker Edmonds, Brownsyne; Perni, Uma; Coleridge, Marissa; Ranzini, Angela C.; Rose, Susannah; Obstetrics and Gynecology, School of MedicineBackground: Although telehealth appears to have been accepted among some obstetric populations before the COVID-19 pandemic, patients' receptivity and experience with the rapid conversion of this mode of health care delivery are unknown. Objective: In this study, we examine patients' prenatal care needs, preferences, and experiences during the COVID-19 pandemic, with the aim of supporting the development of successful models to serve the needs of pregnant patients, obstetric providers, and health care systems during this time. Methods: This study involved qualitative methods to explore pregnant patients' experiences with prenatal health care delivery at the onset of the COVID-19 pandemic. We conducted in-depth interviews with pregnant patients in the first and second trimester of pregnancy who received prenatal care in Cleveland, Ohio, from May to July 2020. An interview guide was used to probe experiences with health care delivery as it rapidly evolved at the onset of the pandemic. Results: Although advantages of telehealth were noted, there were several concerns noted with the broad implementation of telehealth for prenatal care during the pandemic. This included concerns about monitoring the pregnancy at home; the need for additional reassurance for the pregnancy, given the uncertainties presented by the pandemic; and the ability to have effective patient-provider discussions via a telehealth visit. The need to tailor telehealth to prenatal health care delivery was noted. Conclusions: Although previous studies have demonstrated that telehealth is a flexible and convenient alternative for some prenatal appointments, our study suggests that there may be specific needs and concerns among the diverse patient groups using this modality during the pandemic. More research is needed to understand patients' experiences with telehealth during the pandemic and develop approaches that are responsive to the needs and preferences of patients.