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Article
| Open AccessThe burden of post-acute COVID-19 symptoms in a multinational network cohort analysis
Post-acute COVID-19 condition is difficult to quantify because it includes a range of symptoms that may have other causes. In this study, the authors use primary care data from England and Catalonia, Spain, to estimate the incidence of the condition and identify symptoms that occur more frequently following infection than in uninfected controls.
- Kristin Kostka
- , Elena Roel
- & Annika M. Jödicke
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Article
| Open AccessThe metabolic, virulence and antimicrobial resistance profiles of colonising Streptococcus pneumoniae shift after PCV13 introduction in urban Malawi
Pneumococcal vaccination has been shown to promote emergence of non-vaccine S. pneumoniae serotypes. Here, the authors use data from Malawi to investigate whether vaccine introduction also results in changes in metabolic, virulence, and antimicrobial resistance profiles of circulating strains.
- Uri Obolski
- , Todd D. Swarthout
- & Robert S. Heyderman
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Article
| Open AccessCircadian disturbances and frailty risk in older adults
The relationship between circadian function and frailty is not well understood. Here, the authors show that disturbances in circadian rest-activity rhythms were associated with an elevated frailty risk and faster progress of frailty in older adults.
- Ruixue Cai
- , Lei Gao
- & Peng Li
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Article
| Open AccessImpact of vaccinations, boosters and lockdowns on COVID-19 waves in French Polynesia
In this study, the authors develop a mathematical modelling framework to estimate the impacts of non-pharmaceutical interventions and vaccination on COVID-19 incidence. The model accounts for changes in SARS-CoV-2 variant and population immunity, and here they use it to investigate epidemic dynamics in French Polynesia.
- Lloyd A. C. Chapman
- , Maite Aubry
- & Adam J. Kucharski
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Article
| Open AccessMalaria surveillance reveals parasite relatedness, signatures of selection, and correlates of transmission across Senegal
Senegal has initiated a national sentinel surveillance program for malaria parasite genetics. Here, the authors report data from the first year of the program and use it to investigate local malaria incidence, patterns of transmission, and genetic loci under selection.
- Stephen F. Schaffner
- , Aida Badiane
- & Sarah K. Volkman
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Article
| Open AccessAutomated temporalis muscle quantification and growth charts for children through adulthood
Temporalis muscle thickness is a promising marker of lean muscle mass but has had limited utility due to its unknown normal growth trajectory and lack of standardized measurement. Here, the authors develop an automated deep learning pipeline to accurately measure temporalis muscle thickness from routine brain magnetic resonance imaging.
- Anna Zapaishchykova
- , Kevin X. Liu
- & Benjamin H. Kann
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Article
| Open AccessFetal biometry and amniotic fluid volume assessment end-to-end automation using Deep Learning
Fetal biometry and amniotic fluid volume are essential but strenuous measurements in fetal ultrasound screening. Here, the authors show that deep learning models can automate these measurements with high accuracy, using a large and diverse dataset of Moroccan fetal ultrasound images.
- Saad Slimani
- , Salaheddine Hounka
- & El Houssine Bouyakhf
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Comment
| Open AccessThe counterintuitive implications of superspreading diseases
The superspreading that characterized SARS and now COVID-19 can be rapidly quantified; however, its implications for outbreak control were never well understood. Recent studies point to its profound impact on outbreak dynamics and prospects for effective control of a future Disease X. These insights necessitate research into the mechanisms, impact and different modes of superspreading more widely.
- Bjarke Frost Nielsen
- , Kim Sneppen
- & Lone Simonsen
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Comment
| Open AccessLessons for cross-species viral transmission surveillance from highly pathogenic avian influenza Korean cat shelter outbreaks
In this Comment, the authors describe recent outbreaks of highly pathogenic avian influenza in cat shelters in Seoul, South Korea. They discuss potential routes of transmission and describe implications for surveillance of spillover infections in animals in non-agricultural settings.
- Younjung Kim
- , Guillaume Fournié
- & Pierre Nouvellet
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Article
| Open AccessCumulative effect of PM2.5 components is larger than the effect of PM2.5 mass on child health in India
Health impact of air pollution is estimated using PM2.5 mass as exposure metric. Here authors show that the impacts on child health is underestimated in India using this metric relative to the cumulative impact of the various PM2.5 components.
- Ekta Chaudhary
- , Franciosalgeo George
- & Unnati Mehta
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Article
| Open AccessRNA N6-methyladenosine modification-based biomarkers for absorbed ionizing radiation dose estimation
Radiation dosimetry are critical for the medical management of individuals exposed to ionizing radiation (IR). Here, authors show that the RNA m6A levels of Ncoa4, Ate1 and Fgf22 genes in peripheral blood cells could serve as dosimetry of IR exposure.
- Hongxia Chen
- , Xi Zhao
- & Gangqiao Zhou
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Article
| Open AccessHierarchical AI enables global interpretation of culture plates in the era of digital microbiology
DeepColony is a multi-level AI solution for the interpretation of bacterial culturing images in clinical microbiology laboratory automations. Here, the authors show it allows presumptive identification and quantitation of relevant pathogens at both colony- and plate-level.
- Alberto Signoroni
- , Alessandro Ferrari
- & Karissa Culbreath
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Article
| Open AccessEffectiveness of the second COVID-19 booster against Omicron: a large-scale cohort study in Chile
This study assesses the effectiveness of a second COVID-19 mRNA booster vaccine against severe disease using data from Chile. The authors find that the effectiveness of the second mRNA booster was high with a range of different background vaccination schemes, but there was evidence of waning over time.
- Alejandro Jara
- , Cristobal Cuadrado
- & Rafael Araos
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Article
| Open AccessUsing drivers and transmission pathways to identify SARS-like coronavirus spillover risk hotspots
Identification of areas with risk factors for spillover of viruses from animals to humans could assist with early detection of emerging infectious diseases. In this study, the authors characterise potential risks for spillover of SARS-like viruses from bats to humans and identify geographical regions in which multiple risk factors cluster together.
- Renata L. Muylaert
- , David A. Wilkinson
- & David T. S. Hayman
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Article
| Open AccessMortality risks from a spectrum of causes associated with sand and dust storms in China
Sand and dust storms pose considerable health risks worldwide. Here, the authors conduct a nationwide multicenter time-series study to examine sand and dust storm-associated mortality risks.
- Can Zhang
- , Meilin Yan
- & Tiantian Li
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Article
| Open AccessReconstructing disease dynamics for mechanistic insights and clinical benefit
Understanding disease progression dynamics is critical for diagnostics and treatment, but capturing dynamics is difficult. Here, the authors present a method for modelling disease progression from high dimensional molecular data that enables patient stratification and high-risk disease state identification, showcased in bladder cancer.
- Amit Frishberg
- , Neta Milman
- & Shai S. Shen-Orr
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Article
| Open AccessLong-term health impacts of COVID-19 among 242,712 adults in England
The duration of symptomatic COVID-19 and its impacts on health and quality of life are not well understood. In this study, the authors report results from a survey of ~275,000 adults in England and find that persistent COVID-19 is relatively rare but is associated with poorer mental health and health-related quality of life.
- Christina J. Atchison
- , Bethan Davies
- & Paul Elliott
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Article
| Open AccessIndividual level analysis of digital proximity tracing for COVID-19 in Belgium highlights major bottlenecks
Digital proximity tracing apps were widely used during the COVID-19 pandemic but have not been thoroughly evaluated. Here, the authors use data from students in Leuven, Belgium and estimate that apps notified only ~4% exposed contacts, had a 1–2 day delay for notification, and identified fewer infected contacts than manual contact tracing.
- Caspar Geenen
- , Joren Raymenants
- & Emmanuel André
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Article
| Open AccessIntelligent surgical workflow recognition for endoscopic submucosal dissection with real-time animal study
AI-enabled cognitive assistance for therapeutic procedures has rarely been pre-clinically validated. Here, the authors propose an intelligent surgical workflow recognition suit AI-Endo for endoscopic submucosal dissection, extensively validated on external and animal trial datasets.
- Jianfeng Cao
- , Hon-Chi Yip
- & Qi Dou
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Article
| Open AccessAutomatic correction of performance drift under acquisition shift in medical image classification
Automatic correction of performance drift caused by changes in image acquisition is key for safe AI deployment. Here, the authors present a solution that restores the expected clinical performance of image classification systems in breast screening and histopathology.
- Mélanie Roschewitz
- , Galvin Khara
- & Ben Glocker
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Article
| Open AccessEpidemiology of Plasmodium malariae and Plasmodium ovale spp. in Kinshasa Province, Democratic Republic of Congo
Non-falciparum malaria may cause a significant disease burden in highly endemic regions, but epidemiological data is limited. In this study, the authors estimate the incidence and prevalence of P. malariae, P. ovale spp., in Kinshasa, Democratic Republic of Congo and compare to P. falciparum, which known to be common in the region.
- Rachel Sendor
- , Kristin Banek
- & Jonathan B. Parr
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Article
| Open AccessMetabolic fingerprinting on retinal pigment epithelium thickness for individualized risk stratification of type 2 diabetes mellitus
The retina’s role in type 2 diabetes is not well understood. Here, the authors show that retinal pigment epithelium thickness, with its metabolic fingerprints, might offer improved predictability and clinical utility beyond traditional indicators.
- Shaopeng Yang
- , Zhuoting Zhu
- & Wei Wang
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Article
| Open AccessA randomized controlled trial testing a virtual program for Asian American women breast cancer survivors
Virtual support methods have been shown to be an effective aid in cancer survivorship. Here, the authors created a culturally tailored information and support system for Asian American breast cancer patients and showed these resources improved quality of life.
- Eun-Ok Im
- , Wonshik Chee
- & Jun J. Mao
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Article
| Open AccessSARS-CoV-2 genomic surveillance in wastewater as a model for monitoring evolution of endemic viruses
SARS-CoV-2 wastewater surveillance could provide an important means of monitoring population trends as clinical testing decreases. Here, the authors demonstrate the use of wastewater to track variants of concern through a sentinel wastewater surveillance system in South Africa.
- Mukhlid Yousif
- , Said Rachida
- & Kerrigan McCarthy
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Article
| Open AccessThe Personalized Nutrition Study (POINTS): evaluation of a genetically informed weight loss approach, a Randomized Clinical Trial
Genotype patterns may modify diet effects on weight loss, with greater weight loss on genotype-concordant diets. Here, the authors show that with the current ability to genotype participants as fat- or carbohydrate-responders, evidence does not support greater weight loss on genotype-concordant diets.
- Christoph Höchsmann
- , Shengping Yang
- & Corby K. Martin
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Article
| Open AccessImproving model fairness in image-based computer-aided diagnosis
Deep learning models can reflect and amplify human bias, potentially resulting inaccurate missed diagnoses. Here, the authors show that by leveraging the marginal pairwise equal opportunity, their model reduces bias in medical image classification by over 35% compared to baseline models, with minimal impact on AUC values.
- Mingquan Lin
- , Tianhao Li
- & Yifan Peng
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Article
| Open AccessViral kinetics of sequential SARS-CoV-2 infections
In this study, the authors compare the viral kinetics of first and second SARS-CoV-2 infections using data from an occupational surveillance scheme in the National Basketball League. They find that second infections tend to have a faster clearance time, and that clearance times in first and second infections were positively correlated.
- Stephen M. Kissler
- , James A. Hay
- & Yonatan H. Grad
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Article
| Open AccessCost-effectiveness requirements for implementing artificial intelligence technology in the Women’s UK Breast Cancer Screening service
AI technology has the potential to substitute a human reader to aid services struggling to recruit staff or meet patient demand. Here, the authors show that the technology is a viable and potentially cost-effective strategy for use in the NHS.
- Armando Vargas-Palacios
- , Nisha Sharma
- & Gurdeep S. Sagoo
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Review Article
| Open AccessThe promise of data science for health research in Africa
In this Review article, the authors discuss emerging efforts to build ethical governance frameworks for data science health research in Africa and the opportunities to advance these through investments by African governments and institutions, international funding organizations and collaborations for research and capacity development.
- Clement A. Adebamowo
- , Shawneequa Callier
- & Sally N. Adebamowo
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Article
| Open AccessDisentangling age, gender, and racial/ethnic disparities in multiple myeloma burden: a modeling study
Multiple myeloma (MM) is a haematological malignancy that is preceded by monoclonal gammopathy of undetermined significance (MGUS). Here, the authors use a mechanistic model fitted to surveillance data from the United States to investigate whether variation in MM is best explained by incidence of MGUS or rate of progression to MM.
- John H. Huber
- , Mengmeng Ji
- & Su-Hsin Chang
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Article
| Open AccessmRNA-1273 bivalent (original and Omicron) COVID-19 vaccine effectiveness against COVID-19 outcomes in the United States
Bivalent mRNA COVID-19 vaccines have been developed to provide broader protection against SARS-CoV-2 variants. In this cohort study based on electronic health records from the United States, the authors estimate the effectiveness of bivalent, compared to monovalent, vaccines and no vaccination against a range of COVID-19-related outcomes.
- Hung Fu Tseng
- , Bradley K. Ackerson
- & Lei Qian
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Article
| Open AccessBreastfeeding and impact on childhood hospital admissions: a nationwide birth cohort in South Korea
Benefits of breastfeeding are well established, but a comprehensive study about its impacts on hospitalizations is lacking. Here, the authors use Korean nationwide birth cohort data (n = 1,608,540) and find that breastfeeding for at least 6 months was associated with a lower risk for subsequent hospital admissions.
- Jeong-Seon Lee
- , Jae Il Shin
- & Dong Keon Yon
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Article
| Open AccessA comparative study of postnatal anthropometric growth in very preterm infants and intrauterine growth
The majority of growth references for preterm infants were assumed to reflect intrauterine growth. Here, the authors identify postnatal growth patterns of very preterm infants that are distinctly different than intrauterine growth.
- Fu-Sheng Chou
- , Hung-Wen Yeh
- & Reese H. Clark
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Comment
| Open AccessZoonotic malaria requires new policy approaches to malaria elimination
WHO guidelines for classification of malaria elimination in a country require that the risk of human infection from zoonotic, as well as nonzoonotic, malaria parasites is negligible. In this Comment, the authors discuss the implications of this policy for countries, such as Malaysia, with no recent reported nonzoonotic cases but ongoing zoonotic transmission.
- Kimberly M. Fornace
- , Chris J. Drakeley
- & Kamruddin Ahmed
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Article
| Open AccessFood inflation and child undernutrition in low and middle income countries
The 21st Century has witnessed a series of global food crises, though little is known about how rising food prices affect child nutrition. The authors show that increases in the real price of food elevate the risk of a child being wasted, which in turn poses a serious risk for their survival.
- Derek Headey
- & Marie Ruel
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Article
| Open AccessEstimating the burden of severe malarial anaemia and access to hospital care in East Africa
Severe malarial anaemia is a clinical manifestation of severe malaria, with the burden highly concentrated in children. In this work, authors statistically model household survey and in-hospital data to estimate the proportion of severe malarial anaemia cases that access hospital care.
- Peter Winskill
- , Aggrey Dhabangi
- & Lucy C. Okell
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Article
| Open AccessQuantifying the causal impact of biological risk factors on healthcare costs
Understanding the causal impact that risk factors have on healthcare cost is critical to evaluate healthcare interventions. Here, authors show that waist circumference, body mass index, and blood pressure have robust causal impact on healthcare cost.
- Jiwoo Lee
- , Sakari Jukarainen
- & Andrea Ganna
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Article
| Open AccessNon-invasive assessment of normal and impaired iron homeostasis in the brain
Assessment of different iron compounds in the living brain remains an open challenge. Here, the authors present a magnetic resonance imaging method which is sensitive to the iron homeostasis in the brain, and increases the detection of tumor tissue.
- Shir Filo
- , Rona Shaharabani
- & Aviv A. Mezer
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Article
| Open AccessPrevious immunity shapes immune responses to SARS-CoV-2 booster vaccination and Omicron breakthrough infection risk
In this study, the authors investigate immune responses following a third (booster) SARS-CoV-2 vaccination dose in a cohort of healthcare professionals in Denmark. They find stronger immune responses among those with a prior infection, and correlation between lower antibody responses and higher risk of subsequent breakthrough infection.
- Laura Pérez-Alós
- , Cecilie Bo Hansen
- & Peter Garred
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Article
| Open AccessBenefit-cost analysis of coordinated strategies for control of rabies in Africa
Control of rabies in Africa through mass vaccination of dogs may be compromised by cross-border transmission. Here, the authors use mathematical modelling and a benefit-cost analysis to demonstrate that coordinating rabies control measures across borders could lead to the elimination of dog rabies in Africa.
- A. Bucher
- , A. Dimov
- & J. Zinsstag
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Article
| Open AccessHighly pathogenic avian influenza A (H5N1) in marine mammals and seabirds in Peru
Highly pathogenic avian influenza (HPAI) A/H5N1 has recently emerged in the Americas and has been implicated in mass die-off events of pelicans and sea lions. Here, the authors report sampling and characterisation of HPAI A/H5N1 genomes from five marine mammal and seabird species in Peru.
- Mariana Leguia
- , Alejandra Garcia-Glaessner
- & Jesus Lescano
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Article
| Open AccessMining multi-center heterogeneous medical data with distributed synthetic learning
Here the authors present Distributed Synthetic Learning, a system that addresses data privacy, isolated data islands, and heterogeneity concerns in healthcare analytics by learning to generate state-of-the-art synthetic data for downstream tasks.
- Qi Chang
- , Zhennan Yan
- & Dimitris N. Metaxas
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Article
| Open AccessEffect of SARS-CoV-2 prior infection and mRNA vaccination on contagiousness and susceptibility to infection
It is unclear whether SARS-CoV-2 immunity decreases transmission through reduction in contagiousness of cases or susceptibility of contacts. Here, the authors use testing and contact data from Geneva, Switzerland and find that increased protection of contacts was the main driver of reduced transmission.
- Denis Mongin
- , Nils Bürgisser
- & Delphine Sophie Courvoisier
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Article
| Open AccessMetagenomic sequencing of post-mortem tissue samples for the identification of pathogens associated with neonatal deaths
Rapid identification of pathogens in neonatal infection, and corresponding antimicrobial susceptibility profiles, would improve patient outcomes and assist in antibiotic stewardship. In this work, the authors utilize metagenomic next-generation sequencing of post-mortem tissue samples to identify pathogens associated with neonatal deaths.
- Vicky L. Baillie
- , Shabir A. Madhi
- & Courtney P. Olwagen
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Article
| Open AccessEffects of public-health measures for zeroing out different SARS-CoV-2 variants
China maintained a ‘zero-COVID’ policy from early in the pandemic until late 2022 that employed various public health interventions with the aim of COVID-19 containment. Here, the authors use data from 131 outbreaks in China to estimate the effects of a range of interventions against different SARS-CoV-2 variants in diverse settings.
- Yong Ge
- , Xilin Wu
- & Shengjie Lai
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Article
| Open AccessAccelerated evolution of SARS-CoV-2 in free-ranging white-tailed deer
White-tailed deer are an important reservoir of SARS-CoV-2 in the USA and continued monitoring of the virus in deer populations is needed. In this genomic epidemiology study from Ohio, the authors show that the virus has been introduced multiple times to deer from humans, and that it has evolved faster in deer.
- Dillon S. McBride
- , Sofya K. Garushyants
- & Andrew S. Bowman
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Article
| Open AccessThe challenge of population aging for mitigating deaths from PM2.5 air pollution in China
Estimating health burden of air pollution against the background of population aging is of significance for achieving Sustainable Development Goal 3.9. Here, the authors show that population aging is expected to be the leading contributor to increased deaths attributable to PM2.5 in China by 2035, which will counter the positive gains achieved by improvements in air pollution and healthcare.
- Fangjin Xu
- , Qingxu Huang
- & Brett A. Bryan
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Article
| Open AccessGabapentinoid consumption in 65 countries and regions from 2008 to 2018: a longitudinal trend study
With their misuse potential, there is a need to understand the global consumption of gabapentinoids. Here, authors show a + 17.20% worldwide average annual increase in consumption of gabapentinoids from 2008 to 2018.
- Adrienne Y. L. Chan
- , Andrew S. C. Yuen
- & Kenneth K. C. Man
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Matters Arising
| Open AccessReply to: The pitfalls of interpreting hyperintense FLAIR signal as lymph outside the human brain
- Mehmet Sait Albayram
- , Garrett Smith
- & Onder Albayram