The advent of high-resolution magnetic resonance imaging (MRI) has enabled in vivo research in a variety of populations and diseases on the structure and function of hippocampal subfields and subdivisions of the parahippocampal gyrus. Due to the many extant and highly discrepant segmentation protocols, comparing results across studies is difficult. To overcome this barrier, the Hippocampal Subfields Group was formed as an international collaboration with the aim of developing a harmonized protocol for manual segmentation of hippocampal and parahippocampal subregions on high-resolution MRI. In this commentary we discuss the goals for this protocol and the associated key challenges involved in its development. These include differences among existing anatomical reference materials, striking the right balance between reliability of measurements and anatomical validity, and the development of a versatile protocol that can be adopted for the study of populations varying in age and health. The commentary outlines these key challenges, as well as the proposed solution of each, with concrete examples from our working plan. Finally, with two examples, we illustrate how the harmonized protocol, once completed, is expected to impact the field by producing measurements that are quantitatively comparable across labs and by facilitating the synthesis of findings across different studies.

Background: COPD is a recognized risk factor for lung cancer, but studies of coexisting COPD in relation to lung cancer outcomes are limited. We assessed the impact of COPD on overall survival (OS) and progression-free survival (PFS) in patients with early-stage non-small cell lung cancer (NSCLC). Abbreviations: HR 5 hazard ratio; HRadj 5 adjusted hazard ratio; MGH 5 Massachusetts General Hospital; NSCLC 5 non-small cell lung cancer; OS 5 overall survival; PFS 5 progression-free survival; SCC 5 squamous cell carcinoma

Traditionally, emotional stimuli have been thought to be automatically processed via a bottom-up automatic “capture of attention” mechanism. Recently, this view has been challenged by evidence that emotion processing depends on the availability of attentional resources. Although these two views are not mutually exclusive, direct evidence reconciling them is lacking. One limitation of previous investigations supporting the traditional or competing views is that they have not systematically investigated the impact of emotional charge of task-irrelevant distraction in conjunction with manipulations of attentional demands. Using event-related fMRI, we investigated the nature of emotion-cognition interactions in a perceptual discrimination task with emotional distraction, by manipulating both the emotional charge of the distracting information and the demands of the main task. Findings suggest that emotion processing is both automatic and modulated by attention, but emotion and attention were only found to interact when finer assessments of emotional charge (comparison of most vs. least emotional conditions) were considered along with an effective manipulation of processing load (high vs. low). The study also identified brain regions reflecting the detrimental impact of emotional distraction on performance as well as regions involved in helping with such distraction. Activity in the dorsomedial prefrontal cortex (PFC) and ventrolateral PFC was linked to a detrimental impact of emotional distraction, whereas the dorsal anterior cingulate cortex and lateral occiptal cortex were involved in helping with emotional distraction. These findings demonstrate that task-irrelevant emotion processing is subjective to both the emotional content of distraction and the level of attentional demand.

The development of the brain, particularly the protracted maturation of the prefrontal cortex (PFC), supports the development of episodic memory. Yet how different regions of the PFC functionally mature to support age-related increases in memory performance remains unclear. We investigated the PFC contribution to subsequent memory (SM) of encoded visual scenes in children, adolescents, and young adults (n = 83). We identified distinct patterns of PFC activations supporting SM: regions in the lateral PFC showed positive SM effects, whereas regions in the superior and medial PFC showed negative SM effects. Both positive and negative SM effects increased with age. The magnitude of negative SM effects in the superior PFC partially mediated the age-related increase in memory. Functional connectivity between lateral PFC and regions in the medial temporal lobe (MTL) increased with age during successful memory formation. In contrast, functional connectivity between the superior PFC and regions in the MTL decreased with age, suggesting an age-related increase in the anti-correlation between these regions. These findings highlight the differential involvement of regions within the PFC supporting memory formation.

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The involvement of the human amygdala in emotion-related processing has been studied using functional magnetic resonance imaging (fMRI) for many years. However, despite the amygdala being comprised of several subnuclei, most studies investigated the role of the entire amygdala in processing of emotions. Here we combined a novel anatomical tracing protocol with eventrelated high-resolution fMRI acquisition to study the responsiveness of the amygdala subnuclei to negative emotional stimuli and to examine intra-amygdala functional connectivity. The greatest sensitivity to negative emotional stimuli was observed in the centromedial amygdala, where the hemodynamic response amplitude elicited by negative emotional stimuli was greater and peaked later than for neutral stimuli. Connectivity patterns converge with extant findings in animals, such that the strongest connectivity was between the lateral nucleus and the nuclei of the basal amygdala. Current findings provide evidence of functional specialization within the human amygdala.

A stochastic version of the Harrison-Millard multistage model of the flow of patients through a hospital division is developed in order to model correctly not only the average but also the variability in occupancy levels, since it is the variability that makes planning difficult and high percent occupancy levels increase the risk of frequent overflows. The model is fit to one year of data from the medical division of an acute care hospital in Adelaide, Australia. Admissions can be modeled as a Poisson process with rates varying by day of the week and by season. Methods are developed to use the entire annual occupancy profile to estimate transition rate parameters when admission rates are not constant and to estimate rate parameters that vary by day of the week and by season, which are necessary for the model variability to be as large as in the data. The final model matches well the mean, standard deviation and autocorrelation function of the occupancy data and also six months of data not used to estimate the parameters. Repeated simulations are used to construct percentiles of the daily occupancy distributions and thus identify ranges of normal fluctuations and those that are substantive deviations from the past, and also to investigate the trade-offs between frequency of overflows and the percent occupancy for both fixed and flexible bed allocations. Larger divisions can achieve more efficient occupancy levels than smaller ones with the same frequency of overflows. Seasonal variations are more significant than day-of-the-week variations and variable discharge rates are more significant than variable admission rates in contributing to overflows.

A main question in emotion and memory literature concerns the relationship between the immediate impact of emotional distraction on perception and the long-term impact of emotion on memory. While previous research shows both automatic and resource-mediated mechanisms to be involved in initial emotion processing and memory, it remains unclear what the exact relationship between the immediate and long-term effects is, and how this relationship may change as a function of manipulations at perception favoring the engagement of either more automatic or mediated mechanisms. Using event-related functional magnetic resonance imaging, we varied the degree of resource availability for processing task-irrelevant emotional information, to determine how the initial (impairing) impact of emotional distraction related to the long-term (enhancing) impact of emotion on memory. Results showed that a direct relationship between emotional distraction and memory was dependent on automatic mechanisms, as this was found only under conditions of limited resource availability and engagement of amygdala (AMY)-hippocampal (HC) mechanisms to both impairing and enhancing effects. A hemispheric disassociation was also identified in AMY-HC, where while both sides were associated with emotional distraction and left AMY and anterior HC were linked to emotional memory, functional asymmetry was only identified in the posterior HC, with only the left side contributing to emotional memory. Finally, areas dissociating between the two opposing effects included the medial frontal, precentral, superior temporal, and middle occipital gyri (linked to emotional distraction), and the superior parietal cortex (linked to emotional memory). These findings demonstrate the relationship between emotional distraction and memory is context dependent and that specific brain regions may be more or less susceptible to the direction of emotional modulation (increased or decreased), depending on the task manipulation, and processes investigated.