Integrated primary care behavioural health in a regional network of FQHC agencies during COVID-19.

Objectives: (1) Examine the ability to sustain integrated primary care behavioural health (eg, colocation, communication and coordination) in 40 community health centres, during the COVID-19 pandemic and (2) review adaptations and challenges to provide integrated behavioural health via telehealth.

Methods And Analysis: This qualitative investigation assessed 55 behavioural health consultants (BHCs), via semistructured interviews, spanning 40 practice sites and 10 organisations, on their adjustment to telehealth delivery, modified practice workflows and challenges of maintaining integration while displaced by the pandemic. Assessment of the level of integrated care was also conducted with available semistructured tools.

Not in my treatment center: Leadership's perception of barriers to MOUD adoption.

Introduction: Despite their well-established effectiveness, medications for opioid use disorder (MOUD) are widely underutilized across the United States. In the context of a large publicly funded behavioral health system, we examined the relationship between a range of implementation barriers and a substance use disorder treatment agency's level of adoption of MOUD.

Methods: We surveyed leadership of publicly funded substance use disorder treatment centers in Philadelphia about the significance of barriers to implementing MOUD related to their workforce, organization, funding, regulations, and beliefs about MOUD's efficacy and safety.

Spatio-temporal activity in real time (STAR): optimization of regional fMRI feedback.

The use of real-time feedback has expanded fMRI from a brain probe to include potential brain interventions with significant therapeutic promise. However, whereas time-averaged blood oxygenation level-dependent (BOLD) signal measurement is usually sufficient for probing a brain state, the real-time (frame-to-frame) BOLD signal is noisy, compromising feedback accuracy. We have developed a new real-time processing technique (STAR) that combines noise-reduction properties of multi-voxel (e.

Regionally distinct white matter lesions do not contribute to regional gray matter atrophy in patients with multiple sclerosis.

Purpose: To determine to what extent T1- and T2-regional lesion volumes (RLVs) contribute to total and/or regional gray matter (GM) atrophy in multiple sclerosis (MS).

Methods: We studied 110 (67 relapsing-remitting and 43 secondary-progressive) MS patients. SABRE program was used to parcel the brain into 13 regions per hemisphere.

Regional specificity of magnetization transfer imaging in multiple sclerosis.

Background: The goal of this study was to develop and validate a method for generation of regional magnetization transfer ratio (MTR). We also studied the topography of MTR changes in multiple sclerosis (MS) and in normal controls (NC), and preliminarily examined the clinical usefulness of this method.

Methods: We examined 45 patients with MS (relapsing remitting [RR] = 28 and secondary progressive[SP] = 17] and 19 NC.

Reproducibility and accuracy of quantitative magnetic resonance imaging techniques of whole-brain atrophy measurement in multiple sclerosis.

Background And Purpose: Whole-brain atrophy is of growing interest as an outcome measure in multiple sclerosis (MS) clinical trials. The authors compared the reproducibility and accuracy of 3 quantitative techniques of measurement in patients with MS.

Methods: Thirty-four patients with relapsing-remitting MS (median Expanded Disability Status Scale disability score = 1.

Prediction of neuropsychological impairment in multiple sclerosis: comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden.

Background: Cognition and magnetic resonance imaging correlations are well established in patients with multiple sclerosis (MS), but it is unclear whether lesion burden or atrophy accounts for most of the predictive variance. These indices have been directly compared in only a few studies. No such study included measurement of the third ventricle, which was strongly predictive of neuropsychological competence in the early literature.

A semiautomated measure of whole-brain atrophy in multiple sclerosis.

Brain atrophy is a proposed MRI marker of irreversible pathologic damage in multiple sclerosis (MS). The brain parenchymal fraction (BPF) is the ratio of brain parenchymal volume to the total volume within the surface contour. We developed a semiautomated measure of BPF using commercially available edge-finding and thresholding software (30-min analysis time per patient).

Selective caudate atrophy in multiple sclerosis: a 3D MRI parcellation study.

Deep gray matter damage may be an important component of the multiple sclerosis (MS) disease process. We tested whether caudate atrophy occurs in MS, and whether it correlates with conventional MRI or clinical markers of disease progression. Caudate nuclei of 24 MS patients and 10 age-matched healthy controls were traced, normalized, reconstructed and visualized from MRI scans.

T2 hypointensity in the deep gray matter of patients with multiple sclerosis: a quantitative magnetic resonance imaging study.

Context: While gray matter T2 hypointensity in multiple sclerosis (MS) has been associated with physical disability and clinical course, previous studies have relied on visual magnetic resonance imaging (MRI) assessments.

Objective: To quantitatively determine if T2 hypointensity is associated with conventional MRI and clinical findings in MS.

Design: Case-control study.