Učinak perinatalne hipoksijsko – ishemijske encefalopatije na projekcijske puteve moždanoga debla u nedonoščeta [Impact of hypoxic-ischemic encephalopathy on projection pathways of the premature infant brainstem]
Bibliographic record
Abstract
Introduction: Improved perinatal care has led to increased survival of premature infants. These children often have different motoric, cognitive and psychological disorders. Perinatal hypoxic-ischemic encephalopathy (HIE) is a major cause of white matter injury and long-term neurological deficits in children. The aim of this study is to analyze cerebral volumes and DTI parameters as major site of white matter injury and compare them with recipient areas in pons and cerebellum in order to find possible selective vulnerability for corticospinal tracts, corticopontine pathways, medial lemnisci and superior, medial and inferior cerebellar peduncles. \nMaterial and methods: In our research we had three groups of participants. The first group consisted of 5 normal term infants (control), the second group included 16 normotypic premature infants without perinatal HIE lesions (normotypic), and the third group included 22 premature infants with perinatal HIE (HIE). Diagnosis of perinatal HIE was based on both MRI and clinical exams. Parental consent for MRI scanning was obtained and all examinations were controlled and approved by the Institutional Review Board of the University of Zagreb School of Medicine. MRI images were obtained using 3T MRI scanner (Magnetom TrioTim, Siemens, Germany), with high resolution T1 MPRAGE sequence in sagittal plane (voxel size = 1x1x1 mm) and dwi sequences (voxel size 1.6x1.6x3 mm). All groups were scanned at two different time points, first at the term or corrected term age and second at the age of two years. Cerebral and cerebellar volumes were measured using semi-automated software (MNI toolbox, Montreal, Canada), and brainstem (mesencephalon, pons, medulla oblongata) was measured using manual segmentation methods (Analyze 8.1, Mayo Clinic, USA). Axonal pathways (corticospinal tracts, corticopontine pathways, medial lemnisci and superior, medial and inferior cerebellar peduncles) were reconstructed and all parameters (volume, FA- fractional anisotropy and ADC-apparent diffusion coefficient) have been measured using Diffusion Toolkit and TrackVis software. Statistical analysis was done using MedCalc v12. \nResults: Normotypic group showed decreased volumes at corrected term age, but their volumes compensate during growth and at the age of 2 years correspond to control group. Unlike normotypic, group with HIE lesions shows statistically significant reduction of measured volumes during corrected term age comparing with normal group, and also at the age of 2 years comparing with both normal and normotypic group. Volumetric analysis of brainstem parts (mesencephalon, pons, medulla oblongata) and its layers (base, tegmentum, tectum) follows that pattern as well as volumetric analysis of brainstem in general, cerebellum and total brain volume. Parameters measured during DTI analysis (volume, FA- fractional anisotropy and ADC-apparent diffusion coefficient) for named axonal pathways showed similar pattern in observed groups. \nConclusion: Origin, trajectory and termination areas of measured axonal pathways are reduced after perinatal HIE. We have found that all measured pathways are regularly damaged in perinatal HIE, as a part of general white matter pathology. Our finding is in the agreement that pathways which are part of the periventricular fiber system and periventricular crossroads are vulnerable in HIE. Also, due to the topographical relationship, damaged periventricular fibers will contribute to reduction of brainstem, expecially pons, as well as cerebellum.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".