A systematic review of the effectiveness of machine learning for predicting psychosocial outcomes in acquired brain injury: Which algorithms are used and why?

Clinicians working in the field of acquired brain injury (ABI, an injury to the brain sustained after birth) are challenged to develop suitable care pathways for an individual client’s needs. Being able to predict psychosocial outcomes after ABI would enable clinicians and service providers to make advance decisions and better tailor care plans. Machine learning (ML, a predictive method from the field of artificial intelligence) is increasingly used for predicting ABI outcomes. This review aimed to examine the efficacy of using ML to make psychosocial predictions in ABI, evaluate the methodological quality of studies, and understand researchers’ rationale for their choice of ML algorithms. Nine studies were reviewed from five databases, predicting a range of psychosocial outcomes from stroke, traumatic brain injury, and concussion. Eleven types of ML were employed with a total of 75 ML models. Every model was evaluated as having high risk of bias, unable to provide adequate evidence for predictive performance due to poor methodological quality. Overall, there was limited rationale for the choice of ML algorithms and poor evaluation of the methodological limitations by study authors. Considerations for overcoming methodological shortcomings are discussed, along with suggestions for assessing the suitability of data and suitability of ML algorithms for different ABI research questions.     

Regression II. Development through regression

As shown in our previous paper (‘Regression I. Experimental approaches to regression’, JAP, 65, 2, 345-65), the common mechanism of regression can be described as reversible dedifferentiation, which is understood as a relative increase of the proportion of low-differentiated (older) systems in actualized experience. Experimental data show that regression following disease (chronic tension headache) is followed by adaptation and an increase in system differentiation in that experience domain which contains systems responsible for that adaptation. The results of mathematical modelling support the idea that reversible dedifferentiation can be one of the mechanisms for increasing the effectiveness of adaptation through learning. Reversible dedifferentiation, which is phenomenologically described as regression, is a general mechanism for restructuring the organism-environment interactions in situations where behaviours that were effective in the past become ineffective. Reversible dedifferentiation has evolved as a component of adaptation when new behaviours are formed and large-scale modifications in the existing behaviours are required in the face of changes in the external and/or internal environment. Thus, the authors believe that this article provides evidence for Jung’s view that regression is not only a ‘return’ to past forms of thinking, affects and behaviour, but that regressive processes provide a significant impetus for psychological growth and development.     

Back to sleep: Teaching adults to arrange safe infant sleep environments

There are over 3,000 sleep related infant deaths each year in the United States. Attempts to teach medical personnel and parents safe infant sleep practices in the infant sleep training literature have demonstrated mixed results. Thus, strategies to teach arrangements of safe infant sleep environments warrant further investigation. Behavioral skills training (BST) is an evidence-based teaching strategy shown to successfully teach various safety skills to children and adults. The current study evaluated the effectiveness of behavioral skills training to teach safe infant sleep practices to typically developing adults. Specifically, differential responding was assessed across multiple environmental arrangements typical of contexts parents may be exposed to when putting an infant to sleep. BST significantly improved appropriate arrangement of a safe sleep environment for infants for all 8 participants.     

Visual aspects of centrally elicited attack behavior in the cat: “Patterned reflexes” associated with selection of and approach to a rat

It has been previously suggested that the electrical brain stimulation which elicits quiet-biting attack in the cat actively affects the way the central nervous system processes visual and tactile information concerned with the reflexes involved in the terminal aspects of attack. In order to examine the effects of brain stimulation on a nonterminal aspect of attack – the stimulated cat's selection of and approach to a rat – cats were implanted with attack-eliciting electrodes in both the lateral hypothalamus and the midbrain ventral tegmental area. These cats were then tested in an 8-ft-long cage, one end of which was divided into three, 2-ft-long parallel compartments, whose openings faced the end of the cage from which the cat commenced its approach. An anesthetized rat was placed at the back of one compartment, a bowl of food at the back of another compartment, and the third compartment contained no object. It was found in the first experiment that the attack elicited by nearly all electrodes was selectively directed at the rat. However, the success of the cat in finding the compartment containing the rat varied dramatically for different electrodes in the same cat. Further, these differences were stable and did not change as the cat gained experience with the task. The results suggested that the stimulation of different brain sites in the same cat differentially affected the visual neural mechanisms involved in guiding a cat to a rat. Previous studies have also suggested that the effects of brain stimulation which elicits quiet-biting attack are largely lateralized to the side of the brain stimulated. In order to determine if the effects of stimulation on the neural mechanisms mediating the visually guided approach of a cat to a rat were also lateralized, attempts were made in a second experiment to disrupt the visual input to one side of the brain by unilaterally transecting the optic tract. It was found that this manipulation interfered with the visually guided selective approach to a rat, if the cat was stimulated through hypothalamic or mid-brain electrodes ipsilateral to the optic tract transection, but not if the hypothalamic or midbrain stimulation was on the contralateral (visually intact) side of the brain. However, any final interpretation of the results was confounded by the finding in all of these cats of a complex syndrome of neglect of all contralateral sensory information.     

L’annonce d’un décès en milieu hospitalier

Announcing a death is always a delicate moment for close familial members but also for caregivers. Law gives some precisions about how this information must be delivered. Recently the state council judged that the lack of empathy from caregivers and the late of the death announcement can create a damage. This judgement gives more precisions about how a death announcement must be in a hospital. This topic is pretty similar with the information which must be given to close familial members about organ donation. This latter is definitely more exceptional and the procedure is a way more regulated. There are much rules which explain how this information must be delivered.     

Cerebral blood flow in 5‐ to 8‐month‐olds: Regional tissue maturity is associated with infant affect

Infancy is marked by rapid neural and emotional development. The relation between brain function and emotion in infancy, however, is not well understood. Methods for measuring brain function predominantly rely on the BOLD signal; however, interpretation of the BOLD signal in infancy is challenging because the neuronal‐hemodynamic relation is immature. Regional cerebral blood flow (rCBF) provides a context for the infant BOLD signal and can yield insight into the developmental maturity of brain regions that may support affective behaviors. This study aims to elucidate the relations among rCBF, age, and emotion in infancy. One hundred and seven mothers reported their infants' (infant age M ± SD = 6.14 ± 0.51 months) temperament. A subsample of infants completed MRI scans, 38 of whom produced usable perfusion MRI during natural sleep to quantify rCBF. Mother‐infant dyads completed the repeated Still‐Face Paradigm, from which infant affect reactivity and recovery to stress were quantified. We tested associations of infant age at scan, temperament factor scores, and observed affect reactivity and recovery with voxel‐wise rCBF. Infant age was positively associated with CBF in nearly all voxels, with peaks located in sensory cortices and the ventral prefrontal cortex, supporting the formulation that rCBF is an indicator of tissue maturity. Temperamental Negative Affect and recovery of positive affect following a stressor were positively associated with rCBF in several cortical and subcortical limbic regions, including the orbitofrontal cortex and inferior frontal gyrus. This finding yields insight into the nature of affective neurodevelopment during infancy. Specifically, infants with relatively increased prefrontal cortex maturity may evidence a disposition toward greater negative affect and negative reactivity in their daily lives yet show better recovery of positive affect following a social stressor.     

睡眠剥夺对风险决策的影响机制探讨

许多行业的决策者必须在睡眠不足的状态下做出选择与判断。睡眠剥夺是睡眠不足的实验室模型, 被证明能显著影响风险决策, 但内在机制不明。基于前人研究基础提出假设模型, 即睡眠剥夺通过影响个体的反馈加工、风险感知、抑制控制、决策理性, 进而影响风险决策。拟通过实验室研究与现场研究, 采用简单赌博任务、概率折扣任务、双选择Oddball任务等研究范式, 对比睡眠剥夺前后被试在执行上述实验任务时的行为差异, 同时比较执行控制网络、奖赏网络等脑功能网络连接强度, 以及任务诱发的FRN等脑电成分在睡眠剥夺前后的变化, 进而论证上述反应被试反馈加工等心理过程的行为-脑电-脑成像指标的变化与睡眠剥夺后被试风险决策变化的关系。研究结果将科学地解释睡眠剥夺影响风险决策的内在机制, 为进一步探讨如何规避睡眠不足导致的决策失误提供理论与实证依据。     

Impairment in the control of coupled cyclic movements of ipsilateral hand and foot after total callosotomy

Integrity of both cerebral hemispheres is required to control in-phase or anti-phase coupling of ipsilateral hand and foot oscillations, as shown by the impairment of these tasks when performed on the healthy side of hemiplegic patients. On this basis, coupling of hand–foot movements was analysed in a right-handed subject (ME) who underwent a total resection of the corpus callosum. Oscillations of the prone hand and foot, paced by a metronome at different frequencies, as well as EMG activity in extensor carpi radialis (ECR) and tibialis anterior (TA) muscles were analysed by measuring the average phase difference between the hand and foot movements and EMG cycles.

ME performed in-phase movements (right-hand extension coupled to right-foot dorsal flexion) at frequencies up to 3 Hz, though the hand cycle progressively lagged the foot cycle as the frequency increased. At 3 Hz the hand lag reached −142° (as compared to about 25° in healthy subjects). The lag increased even further after application of an inertial load to the hand, reaching 180° at 1.8 Hz (about 50° in healthy subjects). ME's hand lag is caused by the lack of any anticipatory reaction in hand movers. In contrast to healthy subjects, which activate the ECR earlier than the TA when the frequency increases, ME activated the ECR later than TA at all frequencies higher than 0.9 Hz.

Anti-phase movements (hand extension coupled to foot plantar flexion) were performed only upto 1 Hz in unloaded conditions. At 0.6 Hz, movements were in tight phase-opposition (3°), but at 1 Hz, the hand lag reached −34° because of a delayed ECR activation. After hand loading ME was unable to couple movements in anti-phase. In contrast, normal subjects maintain a tight anti-phase coupling up to 2.0 Hz, both with an unloaded or loaded hand. Similar deficits were observed by ME when performing in-phase and anti-phase coupling on the left side, as well as when he was blindfolded.

In normal subjects, an anticipated muscular activation of hand movers compensates for hand loading. Since this compensation must depend on monitoring the hand delay induced by loading, the absence in ME of such compensatory reaction suggests that callosal division had apparently compromised the mechanisms sustaining feedback compensation for differences in the biomechanical limb properties. They also confirm and reinforce the idea that elaboration of the afferent message, aiming at controlling the phase of the movement association, needs the co-operation of both cerebral hemispheres.     

Effects of right and left hemisphere damage on performance of the "Right Hemisphere Communication Battery"

A Hebrew adaptation of Gardner and Brownell's (1986) "Right Hemisphere Communication Battery" (HRHCB) was administered to 27 right brain-damaged (RBD) patients, 31 left brain-damaged (LBD) patients, and 21 age-matched normal controls. Both patient groups showed deficits relative to controls and overall there was no difference between the two patient groups. A factor analysis of patients' scores on the HRHCB yielded two interpretable factors, a verbal and a nonverbal one. These factors were not lateralized. Performance of patients on the HRHCB correlated significantly and positively with performance on most tests of basic language functions, measured with a Hebrew adaptation of the "Western Aphasia Battery" (HWAB) and with other cognitive functions measured with standardized neuropsychological tests. There were stronger correlations of HRHCB with subtests of the HWAB in LBD patients and with nonlanguage cognitive tests in RBD patients. In the LBD group, HRHCB subtests' scores correlated negatively with lesion extent in frontal and temporal perisylvian regions. Such localization was not observed in RBD patients. The results argue against selective right hemisphere (RH) involvement in the RHCB, alleged to measure pragmatic aspects of language use, and show, instead, bilateral involvement. The results also argue against a modular organization of these functions of language use, especially in the RH.