Endometrial cancer diagnoses prompted by routine cervical cytology: a retrospective case study.

Aims: Endometrial cancer is the commonest gynaecological cancer in New Zealand. Some women have their diagnosis of endometrial cancer prompted by an abnormal cervical cytology screening test. When high-risk human papillomavirus (hr-HPV) testing becomes the primary test for cervical screening, this avenue of incidental diagnosis will be reduced.

Predicting regression of cervical intraepithelial neoplasia grade 2 in women under 25 years.

Background: A number of retrospective and prospective studies have documented substantial rates of regression in cervical intraepithelial neoplasia grade 2 lesions in young women. Initial observational management of cervical intraepithelial neoplasia grade 2 is increasingly accepted as appropriate for women under 25 years of age with screen-detected abnormalities and is included in a number of clinical guidelines. However, there has been a paucity of large prospective studies on observational management with strict inclusion criteria.

Trends in the diagnosis of high-grade cervical abnormalities in young women in the post-vaccination era.

Background: Most cervical cancers are associated with human papillomavirus (HPV) types 16 and 18. In 2008, New Zealand commenced a quadrivalent HPV (virus-like particles of types 6, 11, 16 and 18) vaccination programme.

Aim: Document trends in number of colposcopy referrals and number and grade of cervical abnormalities diagnosed in women (20-24 years) referred to three large colposcopy clinics over time.

Evaluation of guidelines for observational management of cervical intraepithelial neoplasia 2 in young women.

Background: A high rate of regression in young women with cervical intraepithelial neoplasia grade 2 has been recorded. However, there are few prospective data by which to evaluate management guidelines.

Objective: This study evaluates the American Society for Colposcopy and Cervical Pathology recommendations for follow-up of young women with cervical intraepithelial neoplasia 2 using data created by a large prospective multicenter study of observational management.

Impact of human papillomavirus vaccination on rates of abnormal cervical cytology and histology in young New Zealand women.

Aim: Determine the impact of quadrivalent human papillomavirus (HPV) vaccination on abnormal cervical cytology and histology rates in young New Zealand women.

Methods: Retrospective population-based cohort study of women born 1990-1994, with a cervical cytology or histology recorded when aged 20-24 between 1 January 2010 and 31 December 2015. Data was obtained through linking the National Immunisation Register and National Cervical Screening Programme Register.

Changes in human papillomavirus genotypes associated with cervical intraepithelial neoplasia grade 2 lesions in a cohort of young women (2013-2016).

In 2008, a quadrivalent human papillomavirus (HPV) vaccine (genotypes 6, 11, 16, 18) became available in New Zealand. This study investigated whether the proportion of cervical intraepithelial neoplasia grade 2 (CIN2) lesions associated with HPV genotypes 16 and 18 changed over time in young women recruited to a prospective CIN2 observational management trial (PRINCess) between 2013 and 2016. Partial HPV genotyping (16, 18, or other high risk HPV) was undertaken on n = 392 women under 25 years (mean age 21.

Decreased Regional Cerebral Perfusion in Moderate-Severe Obstructive Sleep Apnoea during Wakefulness.

Study Objectives: To investigate gray matter volume and concentration and cerebral perfusion in people with untreated obstructive sleep apnea (OSA) while awake.

Design: Voxel-based morphometry to quantify gray matter concentration and volume. Arterial spin labeling perfusion imaging to quantify cerebral perfusion.

Prediction of driving ability: Are we building valid models?

The prediction of on-road driving ability using off-road measures is a key aim in driving research. The primary goal in most classification models is to determine a small number of off-road variables that predict driving ability with high accuracy. Unfortunately, classification models are often over-fitted to the study sample, leading to inflation of predictive accuracy, poor generalization to the relevant population and, thus, poor validity.

Optimal EEG feature selection from average distance between events and non-events.

Biosignal classification systems often have to deal with extraneous features, highly imbalanced datasets, and a low SNR. A robust feature selection/reduction method is a crucial step in this process. Sets of artificial data were generated to test a prototype EEG-based microsleep detection system, consisting of a combination of EEG and 2-s bursts of 15-Hz sinusoids of varied signal-to-noise ratios (SNRs) ranging from 16 to 0.

Efficient and regular patterns of nighttime sleep are related to increased vulnerability to microsleeps following a single night of sleep restriction.

Sleep-deprived people, or those performing extended monotonous tasks, can exhibit brief episodes in which they suspend performance and appear to fall asleep momentarily-behavioral microsleeps ("microsleeps"). In this study, microsleeps were identified using eye video and tracking response during a 20-min continuous tracking task undertaken by 16 healthy volunteers (mean age 24.9 yrs; 8 females, 8 males) in the early afternoon following a normally rested night and a night of restricted sleep (time-in-bed restricted to 4 h).

Distinct neural correlates of time-on-task and transient errors during a visuomotor tracking task after sleep restriction.

Sleep loss leads to both time-on-task slowing of responsiveness and increased frequency of transient response errors. The consequences of such errors during real-world visuomotor tasks, such as driving, are serious and life threatening. To investigate the neuronal underpinning of time-on-task and transient errors during a visuomotor tracking task following sleep restriction, we performed fMRI on 20 healthy individuals when well-rested and when sleep-restricted while they performed a 2-D pursuit-tracking task.

Losing the struggle to stay awake: divergent thalamic and cortical activity during microsleeps.

Maintaining alertness is critical for safe and successful performance of most human activities. Consequently, microsleeps during continuous visuomotor tasks, such as driving, can be very serious, not only disrupting performance but sometimes leading to injury or death due to accidents. We have investigated the neural activity underlying behavioral microsleeps--brief (0.

Cerebral perfusion differences between drowsy and nondrowsy individuals after acute sleep restriction.

Objectives: To investigate changes in resting cerebral blood flow (CBF) after acute sleep restriction. To investigate the extent to which changes in CBF after sleep restriction are related to drowsiness as manifested in eye-video.

Design: Participants were scanned for 5 min using arterial spin labeling (ASL) perfusion imaging after both sleep-restricted and rested nights.

Do complex models increase prediction of complex behaviours? Predicting driving ability in people with brain disorders.

Prediction of complex behavioural tasks via relatively simple modelling techniques, such as logistic regression and discriminant analysis, often has limited success. We hypothesized that to more accurately model complex behaviour, more complex models, such as kernel-based methods, would be needed. To test this hypothesis, we assessed the value of six modelling approaches for predicting driving ability based on performance on computerized sensory-motor and cognitive tests (SMCTests™) in 501 people with brain disorders.

Different models for predicting driving performance in people with brain disorders.

Data from performance on a computerized battery of driving-related sensory-motor and cognitive tests (SMCTests™) were used to predict outcome on a blinded on-road driving assessment in 501 people with brain disorders. Six modelling approaches were assessed: discriminant analysis (DA), binary logistic regression (BLR), nonlinear causal resource analysis (NCRA), and three kernel methods (product kernel density (PK), kernel-product density (KP), and support vector machine (SVM)). At the classification level, the three kernel methods were more accurate for predicting on-road Pass or Fail (SVM 99%, PK 99%, KP 80%) than the other models (DA 75%, BLR 77%, NCRA 66%).

Lapses of responsiveness: Characteristics, detection, and underlying mechanisms.

Lapses in responsiveness ('lapses'), particularly microsleeps and attention lapses, are complete disruptions in performance from approximately 0.5-15 s. They are of particular importance in the transport sector in which there is a need to maintain sustained attention for extended periods and in which lapses can lead to multiple-fatality accidents.

The relationship between behavioural microsleeps, visuomotor performance and EEG theta.

Visuomotor performance and responsiveness deteriorates with time-on-task due to drowsiness and increased propensity to sleep. Frequent episodes of behavioural microsleep (BM) are also common during extended and monotonous tasks. In this study, simultaneous recording of EEG, eye-video, and continuous visuomotor response is used to investigate visuomotor performance and EEG activity during tonic drowsiness and phasic BMs.

Behavioural microsleeps in normally-rested people.

Sleep-deprived people, or those performing extended monotonous tasks, frequently have brief episodes when performance is suspended and they appear to fall asleep momentarily - behavioural microsleeps (BMs). As BM rates are highly variable between normally-rested people, this study aimed to determine whether there is a relationship between propensity for BMs and measures of sleep. Subjects undertook a continuous 50-min 2-D tracking task and BMs were identified with high temporal accuracy based on simultaneous analysis of visuomotor response, tracking speed, tracking error, vertical electrooculogram, and eye-video.

Comparison of a linear and a non-linear model for using sensory-motor, cognitive, personality, and demographic data to predict driving ability in healthy older adults.

This study compared the ability of binary logistic regression (BLR) and non-linear causal resource analysis (NCRA) to utilize a range of cognitive, sensory-motor, personality and demographic measures to predict driving ability in a sample of cognitively healthy older drivers. Participants were sixty drivers aged 70 and above (mean=76.7 years, 50% men) with no diagnosed neurological disorder.

Measurement of BOLD changes due to cued eye-closure and stopping during a continuous visuomotor task via model-based and model-free approaches.

As a precursor for investigation of changes in neural activity underlying lapses of responsiveness, we set up a system to simultaneously record functional magnetic resonance imaging (fMRI), eye-video, EOG, and continuous visuomotor response inside an MRI scanner. The BOLD fMRI signal was acquired during a novel 2-D tracking task in which participants (10 males, 10 females) were cued to either briefly stop tracking and close their eyes (Stop +Close) or to briefly stop tracking (Stop) only. The onset and duration of eye-closure and stopping were identified post hoc from eye-video, EOG, and visuomotor response.

fMRI correlates of behavioural microsleeps during a continuous visuomotor task.

Behavioural microsleeps (BMs) are brief episodes of absent responsiveness accompanied by slow-eye-closure. They frequently occur as a consequence of sleep-deprivation, an extended monotonous task, and are modulated by the circadian rhythm and sleep homeostatic pressure. In this paper, a multimodal method to investigate the neural correlates of BMs using simultaneous recording of fMRI, eye-video, VEOG, and continuous visuomotor response is presented.

Performance in normal subjects on a novel battery of driving-related sensory-motor and cognitive tests.

Currently, there is no international standard for the assessment of fitness to drive for cognitively or physically impaired persons. A computerized battery of driving-related sensory-motor and cognitive tests (SMCTests) has been developed, comprising tests of visuoperception, visuomotor ability, complex attention, visual search, decision making, impulse control, planning, and divided attention. Construct validity analysis was conducted in 60 normal, healthy subjects and showed that, overall, the novel cognitive tests assessed cognitive functions similar to a set of standard neuropsychological tests.

Functional-MRI correlates of cued slow-eye-closure and task non-responsiveness during visuomotor tracking.

Slow-eye-closure and task non-responsiveness are important behavioural markers of microsleeps. This paper presents preliminary results on the neural correlates of voluntary slow-eye-closure and voluntary non-responsiveness during performance of a continuous visuomotor tracking task. Functional-MRI (fMRI), EEG, eye video, and tracking responses were recorded from 5 normal subjects while they performed a continuous visuomotor tracking task inside an MRI scanner for 10 min.

Sensory-motor and cognitive tests predict driving ability of persons with brain disorders.

Objective: Brain disorders can lead to a decreased ability to perform the physical and cognitive functions necessary for safe driving. This study aimed to determine how accurately a battery of computerized sensory-motor and cognitive tests (SMCTests) could predict driving abilities in persons with brain disorders.

Methods: SMCTests and an independent on-road driving assessment were applied to 50 experienced drivers with brain disorders referred to a hospital-based driving assessment service.