Organizers: World Health Organization (WHO)
the European Organization for Nuclear Research (CERN) and the University of Cassino and Southern Lazio
\"Particle Pathways\" is a pioneering three-day international conference designed to explore the critical intersection of indoor air pollution and airborne diseases
This multidisciplinary event is dedicated to bridging the gap between two pivotal areas of public health and environmental science
fostering a unique dialogue on the exposure to ambient and viral particles
\"Particle Pathways\" seeks to deepen the understanding on airborne disease transmission
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explore synergies between different fields
environmentally sustainable solutions to mitigate risks associated with air pollution and airborne pathogens
The integration of these disciplines is essential for developing a holistic understanding of the nexus between indoor air pollution and airborne diseases
"Particle Pathways" is a pioneering three-day international conference designed to explore the critical intersection of indoor air pollution and airborne diseases
"Particle Pathways" seeks to deepen the understanding on airborne disease transmission
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is a visionary innovator best known for his Academy Award-winning work on The Matrix trilogy
A pioneer in immersive media and future-facing technologies
Gaeta has spent his career exploring the fusion of storytelling
and artificial intelligence to push the boundaries of how audiences experience narrative worlds
With escape.ai
Gaeta is now focused on showcasing the next generation of AI-generated and AI-enhanced film content
The platform serves as a curated space for cutting-edge audiovisual experiences powered by generative AI
highlighting the future of storytelling through experimental formats and intelligent media
By spotlighting this emerging wave of creative work
Escape.ai is redefining what streaming looks like in the era of artificial intelligence
and how does it tie into your long-standing mission to reinvent cinematic storytelling through technology
You’ve described Escape as a “Neo Cinema” platform
Can you define what Neo Cinema means to you and how it differs from traditional or even modern digital cinema
Neo Cinema is a spirit and movement that is pushing the next paradigm of storytelling and story-world making
It’s built upon the foundations of cinema while also disrupting and evolving it
From The Matrix to Magic Leap to ILMxLAB to Epic Games to Inworld ai
you’ve always worked at the intersection of story and tech
How has that journey informed the DNA of Escape.ai
My journey’s always been about expanding the ways stories and worlds can be experienced and breaking narrative constraints
we experimented with blurring reality with beloved worlds like Star Wars
we showcased the next plateau of cinematic-interactive platforms
And at Inworld we catalyzed the first steps toward intelligent Characters
Escape.ai is where it all comes together — and where creators
This DNA is critical: we’re not just innovating formats; we’re redistributing power
creators can now compete with legacy studios — on their own terms
What are the most exciting or transformative ways you’re seeing Generative AI and game engines used in storytelling today
What excites me most is that the creative asymmetry is disappearing
a small team — or even a solo creator — can now prototype entire worlds
These aren’t shortcuts — they’re force multipliers
AI doesn’t just amplify the natural talents of human storytellers; it levels the playing field by allowing new voices to be heard
It gives indie storytellers the means to launch franchises — and on escape
Do you believe AI filmmaking will eventually merge with traditional Hollywood
or are we witnessing the birth of an entirely new industry
How do you respond to skepticism around the creative legitimacy of AI-assisted content
The human heart and mind is still the source
Human authors are ground zero if something capable of authentic human resonance is the objective
AI tools are just extending the reach of human imagination
in the same way that special effects enabled the making of The Wizard of Oz or 2001: A Space Odyssey
Early computer graphics made films like TRON possible and once it arrived
were people worried that human creativity would go extinct because we were turning to computers to become our next paint brush
our myths — only now we can express them more vividly
AI doesn’t replace creativity; but can help to remove the obstacles between vision and realization
And because creators can now build and publish without a massive budget or corporate backing
we’re actually seeing more human stories — from more voices — than ever before
what role will human authors and actors play in the future of AI-powered cinema
They’ll be at the center — but in new ways
Writers won’t just script linear plots; they’ll design narrative ecosystems
Actors will blend physical and digital performances
creating personas that persist across mediums
It also gives them control over the avatars
and universes they create — and the ability to monetize those assets directly
We’re entering an era of creative sovereignty
You've said Escape.ai isn’t just about technology but about discovering “masters of a new craft.” What are the new skills today’s filmmakers need to thrive in this hybrid creative world
Today’s new masters sometimes think like systems designers
With unprecedented access to rapid iteration they are able to fail fast and learn from mistakes leading to better understanding of story and structure — world-building
This year and beyond we will see a great convergence between this pioneer sector and the pre existing sector of natural creative risk takers
producers and performers that are often frustrated by the “hollywood” media complex they have contributed so much to yet are constrained by
the modern creator is beginning to understand the value of ownership as they become ever more wary of old paradigm exploitation
It’s not enough to make something beautiful — you have to own your world
Escape.ai exists to support that entire creative cycle — from spark to storyworld to platform
You’ve described Escape.ai as a “Netflix for Neo Cinema.” What does that experience look like for viewers — and how does it differ from a traditional streaming platform
Escape.ai appears on its face as a beautifully presented streaming service but it’s not just where you watch — it’s a destination you can enter
Beyond the new world of cutting edge original content there are social places where the creators hang out
Places such as our social feed or our majestic retro future immersive theater
Any visitor to escape can choose to watch videos traditionally or they can literally hit an escape button and find themselves inside a social interactive theater where they can watch and celebrate with friends
where creators can speak directly to audiences
and where fans can support and influence what gets made next
they can also grow it across games (Neo Play is being developed now)
You’ve introduced features like virtual theaters and creator journals — can you talk about how Escape is blurring the lines between streaming
Escape.ai is designed to bring creators and audiences into the same space — not just as viewers
Virtual theaters allow real-time premieres with global participation
Creator journals offer transparency and insight into the creative process
It’s not just entertainment — it’s an ecosystem
And we’re tying this to economic models that reward creators for engagement
IP ownership becomes the foundation for a true creator economy — where success is shared
and fans feel connected to the worlds they help elevate
Escape.ai empowers creators to retain ownership of their IP — a rarity in today’s entertainment world
we’re building a world where artists don’t have to sell their rights to tell their stories
Emergent tech like GenAI makes it easier to produce content — but publishing that content allows fan bases to emerge and that makes ip more valuable
We want creators to not only make iconic worlds — but to own the mythology
the people behind escape are in fact creators as well
We have every intention in collaborating with many of the creators on escape in pursuit of our own originals
For a young filmmaker or game artist reading this — what’s your advice on getting started in Neo Cinema
Start building your universe — even if it’s small
If your ideas are compelling you might even challenge anything on streaming platforms
This is the time for bold creators to step forward
Please know that escape is for creators across the spectrum
from the newly minted to the highly established
and tell the story you want not the one you’ve been told you must
Thank you for the great interview, I urge readers to visit escape.ai and watch a few shorts to experience the future of video streaming and digital story telling
Deloitte’s US Cyber AI & Automation leader – Interview Series
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Antoine is a visionary leader and founding partner of Unite.AI
driven by an unwavering passion for shaping and promoting the future of AI and robotics
he believes that AI will be as disruptive to society as electricity
and is often caught raving about the potential of disruptive technologies and AGI
As a futurist, he is dedicated to exploring how these innovations will shape our world. In addition, he is the founder of Securities.io
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ShareSaveCommentInnovationConsumer TechJohn Gaeta’s Escape AI Launches Alternative Oscars For AI FilmmakersByCharlie Fink
Forbes contributors publish independent expert analyses and insights
XR and The Metaverse for Forbes.Follow AuthorFeb 28
09:58am ESTShareSaveCommentAcademy Award Winner John Gaeta is the founder of neo-cinema platofrm Escape.ai
Hollywood has always been in flux, but few figures embody its ongoing transformation like John Gaeta. Best known for pioneering ‘bullet time’ in The Matrix and shaping immersive entertainment at companies like Magic Leap, Gaeta is once again ahead of the curve. His latest venture, Escape.AI
is a digital-first platform for the next wave of cinematic creators
embracing Neo-Cinema—a term he coined to describe storytelling made with emerging technologies
Escape AI will host its first-ever Escape Awards
an AI-centric film festival and awards show
set one day before the Motion Picture Academy’s Oscars
voting is exclusively done by Escape’s 200+ creators
It’s a bold counterpoint to traditional awards
which have struggled to define AI’s role in filmmaking
Escape.ai is celebrating its launch with its own awards show tomorrow
Neo-Cinema is built for digital-first creators leveraging AI
and virtual production tools to produce high-quality films with smaller teams
“but the way creators achieve that is radically different now.”
Escape.AI functions as a curated platform for these new-age filmmakers
its peer-driven model helps surface standout work without the noise of YouTube or social media algorithms
The Escape Awards is a natural extension of that ecosystem
where AI-assisted films are judged by fellow AI filmmakers—sidestepping the institutional hesitation Hollywood has shown toward AI-driven work
The Escape Awards will take place in a custom-built virtual venue
where attendees will navigate an interactive metaverse-style social space before being ushered into a 3D theater to watch the ceremony
Categories reflect the unique nature of AI-driven filmmaking
recognizing achievements in generative storytelling
The winners—selected by their peers—will have their films showcased to a broader audience
positioning Escape as the go-to hub for next-gen storytelling
Escape.ai’s launch comes amid a fierce industry debate about AI in film
but recent controversies—from AI-assisted performances (The Brutalist
Emilia Pérez) to AI-enhanced VFX (Dune: Part Two)—have fueled anxieties about what counts as “authentic” artistry
Gaeta’s approach sidesteps the debate altogether
“The modern creator isn’t limited to one format,” he says
describing how today’s storytellers are blending film
Escape AI is not competing with Hollywood—it’s building something new alongside it
Gaeta and his team are already looking beyond the awards show
Escape AI plans to expand monetization options for creators
including recurring fan support (Patreon-style)
Whether Hollywood embraces AI or resists it
Escape.AI is staking its claim as the home for the next generation of filmmakers—one where AI isn’t a controversy
Gaeta has been an influential member of the Kern Country track and field community for decades
he was the head boys’ and girls’ coach at Wasco High School in Wasco
Gaeta’s teams captured two South Sequoia League titles
the Wasco girls’ track squad earned a Central Section Championship and produced a Central Section girls’ hurdle champion
Gaeta also served as director of the annual Wasco Relays Track & Field Invitational
he was named a Central Section Track and Field Honoree Coach
Gaeta was the head boys’ and girls’ track and field coach at Frontier High School in Bakersfield
His teams won three Southwest Yosemite League girls’ varsity league titles and two SWYL boys’ varsity league titles
His teams also earned eight SWYL JV/F-S boys’ and girls’ league titles
Gaeta coached Frontier to a boys’ California State Track & Field Championship
Gaeta also served as director of the annual Frontier Frosh-Soph Relays Track & Field Invitational and the annual Titan Top 16 Frosh-Soph Track & Field Invitational
Gaeta was named The Bakersfield Californian boys track & field Coach of the Year in 2010 and 2014
He coached three Central Section hurdle champions
Gaeta also had one hurdler (boy or girl) named to The Bakersfield Californian All-Area Team since 2008
Gaeta also competed in the 120-yard high hurdles and the 400-meter hurdles for the Bakersfield College track and field team
He was a two-time Metropolitan Conference champion in the 120-yard high hurdles in 1974 and 1975 and was elected to the Bakersfield College Track and Field Hall of Fame in 2010
Gaeta has taught world history at Frontier High since 2008
He has been a member of the Kern County Officials Association
refereeing high school and college basketball
Gaeta has been married to Catherine Merlo since 1991
where he was a 400m hurdler on the Bakersfield track and field team
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2024 at Olean General Hospital after a lengthy illness
in Cuba a son of John “Jack” and June (Rose) Gaeta
Dave was a graduate of Cuba Central School Class of 1984. While in high school he played basketball and the trumpet in Marching Band. After graduation he attended JCC where he earned an Associates Degree in Business Administration
He was previously employed in various places in the Southern Tier. In February of 2023
he started his dream job as the Athletic Coordinator for the ARC Allegany-Steuben Special Olympics. His passion for each and every athlete shined through in all he did
“What do you know?” he would instantly respond “Music and Sports.” You could always find him chatting with someone about a game or band. He was an absolute fan of the Toronto Blue Jays
and Buffalo Bills. When it came to music
and The Beatles. Dave’s passion for music was clearly evident by the multitude of bands he played with
but was most known for Channel Six with his friends John Grey and Toby Lindberg. Dave always supported local musicians and saw the good in everyone
always supporting others dreams and passions
He was a member of the Franklinville Fastpitch for over 44 years and during that time his team won numerous championships since 2010 and had 400 career wins. He considered by his fastpitch team the “Gators” his family and he loved everyone on the team like brothers or sons. Throughout the league he found it possible to support everyone regardless of the team they were on
Dave had a generous heart and was great example of what a loving and caring person should be. He always had smile
and love and kindness for others. He was proud to be from Cuba and had a tremendous love for the community.
talented daughter Mackenna (Fey) of Buffalo
and his biggest dream was to see her happy! He would often talk of their father-daughter dates and the special spot they held in his heart
and greatest fan of his life Tina Smith of Cuba; Two brothers Paul (Vicky) Gaeta of Cuba and Mark Gaeta of Scio; three sisters Christina (Jose Mazon) of Cuba
Debra Gaeta of Cuba and Pamela (Thomas) Burch of Friendship; 9 Nieces and Nephews
including Griffin Burch whom he adored dearly and considered his up-and-coming drummer boy; His life long best friend Jim Burdick of Cuba; Mother-in-law Joan Harman of Florida and his fur babies Elijah Joe
he was predeceased by a brother Andrew Gaeta and a sister-in-law Rose Gaeta
Rinker Funeral Home & Memorial Service
Memorials may be made to the Marie Lorenz Dialysis Center
New York 14727 or to the Allegany-Steuben ARC Special Olympics
Dave wishes to extend love and respect to the nurses and staff at the dialysis center who were his life line for seven years at his “Part-time job with full time benefits”.
Online condolences may be sent at www.rinkerfuneralhome.com.
was able to fulfill her lifelong dream of becoming a teacher by earning her Master of Arts in Teaching at Meredith College
she hopes to return to Meredith as a professor to inspire a new generation of teachers
Italy — A Navy ship in service for 53 years that has been a symbol of NATO strength for nearly two decades has a new commander
Colin Price took over command of the amphibious command ship USS Mount Whitney from Capt
Matthew Kiser during a change of command ceremony Friday in the Mediterranean Sea port city north of Naples where the ship is homeported
A fighter pilot who most recently served as executive officer of the aircraft carrier USS Dwight D
Price now is in charge of a vessel that the Navy potentially seeks to decommission next year
saying that Mount Whitney is necessary to keep Russia in check and that the plan ignored lessons learned from the war in Ukraine
Mount Whitney is the Navy’s fourth-oldest commissioned active ship and also the flagship of U.S
It wasn’t clear Friday whether the decommissioning plans are still in place
but shipboard officials noted the vessel’s upcoming full schedule
“It is the multi-use capabilities of our naval vessels to wage war as well as deliver precious cargo and then bring lasting peace that makes the maritime environment so special,” Vice Adm
commander of 6th Fleet and Naval Striking and Support Forces NATO
Mount Whitney’s ability to allow him to simultaneously command U.S
and NATO forces is an increasingly important advantage in the 6th Fleet theater
the ship’s crew stood up a joint task on Mount Whitney after the Oct
The ship spent seven weeks at sea in the Mediterranean as the U.S
worked to keep the Israel-Hamas war from broadening
The ship also participated in several NATO exercises and activities
including BALTOPS 2023 and 2024 and Large Scale Exercise 23
“We’ve witnessed a theater that has more conflict and a more dynamic schedule than any other area in the world,” Kiser said Friday
His next assignment is as commanding officer of the aircraft carrier USS John C
the ship spent seven months in the Red Sea as its namesake carrier strike group battled Iran-backed Houthi militants at a pace unseen in decades
Price also has served as executive officer and commanding officer of Strike Fighter Squadron 154
Price expects that the coming year will be busy with supporting exercises and other 6th Fleet needs
The Mediterranean continues to be an important
dynamic region with threats to NATO’s southern flank and conflict in the Middle East
for whatever role we need to play to make sure that (Anderson) can command and control all the forces in this region,” Price said
A trial date was confirmed today for a felon suspected of fatally shooting a woman outside a garage in Indio in 2016
pleaded not guilty to the murder charge and one felony count of being a convicted felon and narcotic addict in possession of a firearm and a sentence-enhancing allegation of discharging a firearm causing great bodily injury
The defendant's trial is scheduled to begin Oct
2019 in Cathedral City on a fugitive warrant stemming from the Aug
the prosecution brought in witnesses who alleged that Gaeta shot Maher several times outside the garage at a residence on Santa Rosa Avenue
the daughter of the woman who owned the residence
testified that she was in her room at the time of the shooting with her back against the window that faced the garage area where she said "Smokey," the defendant
"At first I heard one (gunshot) and then that's what made me look out my window and I saw (Maher) running out of my garage and him reloading his gun and then shooting her another six more times in the stomach,'' Shaw said
I couldn't really correlate in my mind what was going on and I couldn't really like focus or think.''
Monique Rivas and her husband Hector "Whiskey" Rivera
testified that they didn't tell law enforcement about Gaeta's involvement in the shooting after it occurred because they were fearful
Rivas said she believed Gaeta had someone follow her in a red truck for miles and hit her a few weeks after the incident
Rivera alleged that Gaeta took him on a drive and told him that if anyone said anything or talked to anybody about anything then it would be "another body under his belt."
you don't tell nobody else -- you keep it to yourself
there's consequences behind it,'' Rivera said
Gaeta's defense attorney Melanie Roe alleged that there was a rumor of Rivera being the shooter because
and drove away in his truck shortly after the shots were fired
Maher was found shot multiple times and responding officers performed CPR on her
but she died at the scene a short time later
"When arrested in the area of Date Palm Drive and Ramon Road in Cathedral City
but was safely taken into custody,'' according to Indio police
Maher's mother told KESQ shortly after his arrest
but our family needs justice and the community needs justice."
Inmate records show that Gaeta was released from the Southwest Detention Center on Aug
including a felony child abuse charge in March 2011 and a felony burglary charge in May 2000
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Julie Gaeta is a holistic health coach, yoga instructor, and writer. As the creator of becomingyouwithjulie.com, she shares inspiration on personal growth, plant-based recipes, and finding strength through life’s transitions. For more from Julie, find her on Instagram @becomingyouwithjulie.
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Much of Italy’s beachfront is in the hands of family-run concessions who operate exclusive clubs or charge big money for umbrellas and loungers
But a new ruling is rallying activists on both sides
“They are used to paying to go to the seaside
the institutions will think we’re fine with it.”
another 30 people are preparing to do the same
They are all members of Mare Libero (Free Sea)
the association that since 2019 has swarmed beaches with protesters in an effort to reclaim the space
They want to make Italy’s beaches free to access or at least allocated to beach operators through a transparent bidding process
The European Commission has long criticised Italy’s beach concession renewal system in which state-owned licences are automatically handed down through families of beach operators who use them to run members-only beach clubs or charge for sun loungers and umbrellas. This system of “keeping it in the family” is illegal, according to EU law
which states longstanding beach concessionaires should compete with new operators
View image in fullscreenManuela Salvi
the country’s top court ruled Italy’s automatic renewal of beach concessions invalid and a public tendering process for beach concessions
which cover almost half of the country’s estimated 4,900 miles (7,900km) of coastline
Those running the concessions are so incensed they plan to strike this week
Italy’s coastline remains lined with long stretches of private beaches crowded with people tanning on loungers
“I have spent almost every summer of my life in the same beach club and my mother has done the same for 25 years,” says Mare Libero’s Margherita Welyam
Welyam’s biggest role as a protester is cultural
“In regions where beaches are more privatised
people believe this is the only way they can experience the beach
“My mother used to pay about €3,000 to rent the same cabin
Along the Italian coastline, there are more than 12,000 beach resorts, with daily prices for two loungers and an umbrella averaging €30-35 (£25-30) and reaching up to €700 in the more exclusive places
such as Bagnoli in Naples and San Giovanni a Teduccio in Naples
are often polluted and theoretically off-limits for swimming but are still used due to a lack of alternatives
head of the association of concessionaires of Serapo
says that as long as the government doesn’t stop him and fellow owners from running their businesses
they will continue to open their beach clubs every morning
“But I’m worried about the future,” he says
On Friday, beach concessionaires will strike, opening up at 9.30am instead of 7.30am, to demand government action for legislative clarity. In a press release
the Italian Beach Concessionaires’ Union said: “It should be clear to everyone that there is a real and concrete risk of losing jobs and businesses
and that help from the government is needed now or it will be useless.” If no response is received
the strike will be repeated on August 19 and August 29
When Mare Libero activists staged their own protest and planted their beach umbrellas
there were no consequences for the protesters
including the secretary of the libertarian party Italian Radicals
were charged with participating in an unauthorised protest after one of their actions at Papeete Beach
a renowned beach club on the Adriatic coast
activists continue to target regular and luxury beach clubs
the upmarket establishment where Daniela Santanché
“Municipalities could use these funds to provide lifeguards and toilets on public beaches. Just a few kilometres away in France, this is already the norm. It can be here too,” he says.
Multimodal ML can help predict the outcome of CSF biomarkers in early AD by utilizing non-invasive and economically feasible variables. The integration of computational models into medical practice offers a promising tool for the screening of patients at risk of AD, potentially guiding clinical decisions.
Alzheimer's Disease and Related Dementias
Volume 16 - 2024 | https://doi.org/10.3389/fnagi.2024.1369545
Introduction: Alzheimer's disease (AD) is a progressive neurodegenerative disorder
Current core cerebrospinal fluid (CSF) AD biomarkers
making them impractical as screening tools
Considering the role of sleep disturbances in AD
recent research suggests quantitative sleep electroencephalography features as potential non-invasive biomarkers of AD pathology
quantitative analysis of comprehensive polysomnography (PSG) signals remains relatively understudied
PSG is a non-invasive test enabling qualitative and quantitative analysis of a wide range of parameters
offering additional insights alongside other biomarkers
Machine Learning (ML) gained interest for its ability to discern intricate patterns within complex datasets
offering promise in AD neuropathology detection
this study aims to evaluate the effectiveness of a multimodal ML approach in predicting core AD CSF biomarkers
Methods: Mild-moderate AD patients were prospectively recruited for PSG
followed by testing of CSF and blood samples for biomarkers
PSG signals underwent preprocessing to extract non-linear
time domain and frequency domain statistics quantitative features
Multiple ML algorithms were trained using four subsets of input features: clinical variables (CLINVAR)
quantitative PSG signal features (PSGVAR) and a combination of all subsets (ALL)
Cross-validation techniques were employed to evaluate model performance and ensure generalizability
Regression models were developed to determine the most effective variable combinations for explaining variance in the biomarkers
Gradient Boosting Regressors achieved the best results in estimating biomarkers levels
using different loss functions for each biomarker: least absolute deviation (LAD) for the Aβ42
least squares (LS) for p-tau and Huber for t-tau
The ALL subset demonstrated the lowest training errors for all three biomarkers
the SLEEPVAR subset yielded the best test performance in predicting Aβ42
while the ALL subset most accurately predicted p-tau and t-tau due to the lowest test errors
Conclusions: Multimodal ML can help predict the outcome of CSF biomarkers in early AD by utilizing non-invasive and economically feasible variables
The integration of computational models into medical practice offers a promising tool for the screening of patients at risk of AD
identifying markers for sleep disturbances in early AD stages could pave the way for developing preventive strategies targeting neurodegeneration through sleep intervention
these techniques may limit the feasibility of widespread screening
highlighting the need for less invasive diagnostic methods
thus potentially offering additional insights alongside other biomarkers
it is becoming increasingly clear that relying on a single type of biomarker may not suffice for accurate diagnosis
models that incorporate sleep-related variables to detect AD neuropathology at an early stage of the disease have not yet been fully explored
we hypothesize that ML techniques could enable us to identify
a specific array of diverse non-invasive variables—including those related to sleep—as potential indicators of AD neuropathology
Our research is thus directed at developing a multimodal ML model to serve as an early diagnostic tool that can accurately and non-invasively predict levels of CSF AD core biomarkers
This is critical for identifying AD-specific neuropathological changes and providing novel insights for a non-invasive clinical protocol to monitor AD-related neuropathology
we will train various ML models incorporating different subsets of non-invasive variables
quantitative PSG signal features and a range of clinical variables related to AD pathogenesis
Figure 1 presents a flowchart outlining the study methodology and the ML analysis process for predicting CSF biomarkers
Flowchart of the proposed methodology for biomarker prediction
Our biomarkers are the concentration of Aβ42
and p-tau proteins present in the cerebrospinal fluid
The main steps of the proposed methodology are signal processing
and the prediction of biomarker levels using Machine Learning (ML) models
CSF samples obtained via lumbar puncture and amounting to 8–10 mL
were centrifuged at low speed (2,000 x g for 10 min at 4°C) to pellet any cellular elements
They were then aliquoted in polypropylene tubes before being frozen and stored at −80°C
The samples were then processed for biomarker analysis
and Aβ42 were determined using enzyme-linked immunosorbent assays (Innotest®
and the results were given in parts per million (pg/ml)
IRBLleida Biobank (B.0000682) and Plataforma Biobancos PT17/0015/0027 facilitated the sample collection process
The Aβ42 cut-off values were 600 pg/ml
with values below this suggesting amyloid deposition
The cut-off values for t-tau and p-tau were set at 425 and 65 pg/ml
Values exceeding these cut-offs indicated the presence of neurofibrillary tangles
The ApoE genotype was determined using a Maxwell® RCS blood DNA kit (Promega
USA) and 20 μL of DNA from a 2 mL peripheral blood sample
Participants were categorized as either homozygous or heterozygous carriers of the ApoE4 allele (noted as ApoE4+)
The physicians' annotations included details on any artifacts observed during the recordings
Measures of sleep quality were determined and included total sleep time (TST)
sleep efficiency (SE)—calculated as the percentage of TST relative to the time spent in bed (TIB)—and arousal index (AI)
defined as the total number of arousals per hour of sleep
Apneas were identified using an oronasal thermal sensor and defined as a reduction in the airflow sensor signal by 90% when compared to the pre-event baseline value for more than 10 s
Hypopneas were recognized as a decrease of at least 30% in airflow
and associated with either arousal or a 3% decrease in oxygen saturation from the pre-event baseline
The apnea–hypopnea index (AHI) was defined as the average number of apnea and hypopnea episodes per hour of TST
The oxygen desaturation index (ODI) is the average number of instances per hour of sleep where oxygen saturation decreases by 3% or more
An AHI exceeding 15 events per hour is indicative of obstructive sleep apnea (OSA)
The MATLAB® signal processing toolbox was used to preprocess and analyze signal data offline
To standardize the format of the signals across different PSG channels and to mitigate the effects of the noise during the analysis phase
The preprocessing phase was divided into three main steps:
• Resampling: due to varying sample rates across the channels and subjects, signals were resampled for uniformity based on international guidelines (Bandyopadhyay and Goldstein, 2023), as is detailed in Table 1
each signal was decomposed into five new signals corresponding to the sleep phases: W
Segments identified as “Wake” were discarded
identified as the same sleep stage in their respective hypnogram
These were then resampled at a standard rate of 128 Hz to diminish their size
The resampled signals were further divided into uniform 10-s segments
• Filtering: the channels were filtered with a fifth-order bandpass digital Butterworth filter (Butterworth, 1930). The cutoff frequencies for each channel were set in accordance with the AASM guidelines (Berry et al., 2015), as specified in Table 1
to ensure comparably meaningful spectral content across channels
• Artifact removal: based on the annotations provided by expert physicians
segments containing artifacts were identified and excluded from the signals
Signal frequency ranges and filter settings: the original sample rate (fs0)
and the filter frequencies for the Electrooculogram (EOG)
Features were calculated as the mean across each sleep stage (N1
and REM) for the entire duration of the overnight recording
For segments annotated as distinct sleep stages
parameters were derived from the mean values within 2-min windows
The estimates were obtained using Welch's averaged
modified periodogram method with a Hamming window of 65,536 points for EOG
Frequency domain statistics and spectral parameters computed for Electrooculogram (EOG)
and the Airflow and Oxygen saturation (SpO2) channels of the polysomnography
Statistical analyzes were conducted using R statistical software
Descriptive statistics were calculated for both normally and non-normally distributed quantitative data
with the former presented as mean and standard deviation (SD)
and the latter as median with interquartile range (IQR)
we reported absolute and relative frequencies
we computed Pearson's correlation coefficient to assess the relationship with the target biomarker
a one-way ANOVA test was employed to determine if there were significant differences between the means of two or more groups
a feature selection process was undertaken
This step aimed to reduce the dataset dimensionality with minimal loss of significant information
We performed feature selection on the training partition of the dataset
organizing the variables into four subsets as follows:
• SLEEPVAR: conventional PSG parameters
• PSGVAR: quantitative measure derived from PSG signals
• ALL: a combination of all the above subsets
any feature that was missing in more than 50% of the samples was excluded
An initial feature selection was conducted by retaining only those features that exhibited a correlation coefficient with the target biomarker about 0.1 for CLINVAR and SLEEPVAR and above 0.3 for PSGVAR
The ALL subset was then refined to include only features meeting these criteria
we calculated the correlation coefficient for each pair of features
opting to retain only one variable from pairs where the correlation exceeded 0.9
Further dimensionality reduction was accomplished through principal component analysis (PCA)
we chose to retain enough components to explain 90% of the variance
and ALL based on the selected principal components
we identified the features that most effectively explained the variance (PCA-selected features
we assessed whether the variance chosen through the initial feature selection exhibited a statistically significant linear relationship with the target biomarkers using Pearson's correlation and ANOVA tests as previously described
the data were divided into training and testing subsets
with 25% of the data allocated to the test partition
all subsets were standardized using the mean and standard deviation derived from the training data
ML analyzes were performed using the scikit-learn Machine Learning library in Python (Pedregosa et al., 2011)
We trained several classical ML models using the four subsets of variables that
best explained the variance of the dataset
A Regression model based on the k-nearest neighbors (KNN) algorithm was trained
where the target prediction is based on local interpolation from the nearest neighbors in the training set
we trained two Gaussian Process (GPs) models employing a radial basis function (RBF) kernel and a Matern 3/2 kernel
These GP models were optimized 20 times using the GPy framework in Python
with the optimal solution selected from these iterations
For ensemble learners utilizing bagging techniques
we fitted three Gradient Boosting Regressors (GBRs) with distinct loss functions: least squares (LS)
In terms of models with strong regularization policies
we fitted a linear regression with L2-norm regularization
and another with L1-norm regularization (Lasso)
we trained four Support Vector Regressions (SVRs) using different kernels: linear (LIN)
A total of 61 subjects were recruited for this study
three subjects that did not possess PSG recordings and 9 whose biomarker measures were missing were excluded from the analysis
The population was equally distributed by gender (females were 50.8%)
and the median age of the study population was 75.0 [72.0; 78.0] years
The Body Mass Index (BMI) median was 28.0 [24.4; 31.1]
The most frequently associated comorbidities were hypertension (63.9%)
the median MMSE score was 23.0 [21.0; 25.0]
Only a few patients reported symptoms indicative of poor sleep quality
The cohort was free from significant subjective daytime sleepiness
as indicated by a median score of 5.0 [3.0–8.0] on the Epworth Sleepiness Scale
Histogram (purple) and density plots (dark blue) of the three biomarkers considered for the prediction on our dataset: (left) Aβ42; (center) p-tau; and (right) t-tau
Descriptive characteristics of the study population
Pearson's correlation and the p-value between CSF Aβ42 biomarker and the quantitative variables that were considered relevant by the PCA algorithm
Pearson's correlation and the p-value between CSF p-tau biomarker and the quantitative variables that were considered relevant by the PCA algorithm
Pearson's correlation and the p-value between CSF t-tau biomarker and the quantitative variables that were considered relevant by the PCA algorithm
ANOVA p-value categorical features that were considered relevant by the PCA algorithm for predicting Aβ42 biomarker
ANOVA p-value categorical features that were considered relevant by the PCA algorithm for predicting p-tau biomarkers
ANOVA p-value categorical features that were considered relevant by the PCA algorithm for predicting t-tau biomarkers
Aβ42: For the Aβ42 biomarker
poorer sleep quality (rho = -0.3853; p = 0.0062) and shorter sleep duration on holidays (rho = -0.3981; p = 0.0046) within the CLINVAR subset were linked to lower Aβ42 levels
increased Aβ42 levels were found in individuals with sleep disturbances due to heartburn (p = 0.0296) and those carrying the ApoE genotype (p = 0.0123)
In terms of polysomnography variables (PSGVAR)
certain EEG characteristics during different sleep stages and while awake were positively correlated with Aβ42 levels such as the skewness in the EEG O1-A2 channel during the N1 (EEGO1_A2_sk_N1) and N2 (EEGO1_A2_sk_N2) sleep stages (rho = 0.3534
the only sleep variable (SLEEPVAR) that correlated positively with Aβ42 was the percentage of time spent with oxygen saturation below 90% during sleep (rho = 0.3129
increases were associated with specific EEG patterns during certain sleep stages and a negative correlation was found with the maximum chin electromyography (EMG) value during the N1 sleep stage (rho = –0.3147
In the clinical variables subset (CLINVAR)
and level of education (p = 0.0136) were significantly associated with p-tau levels
significant correlations were identified with features derived from the thoracic effort channel such as the Lempel Ziv during N2 sleep stages (rho = 0.4216
p = 0.0025) and the Sample Entropy during N2 (rho = 0.3927
no significant relationships were observed with the general sleep variables
while the frequency of snoring was positively correlated with t-tau in the CLINVAR subset (p = 0.0149)
Table 10 presents the mean absolute error (MAE) of each model family utilized in estimating the levels of CSF biomarkers. Figures 3–5 provide more comprehensive information
Mean and standard deviation of the mean average error (MAE) of Machine Learning (ML) models for the prediction of Aβ42
biomarkers grouped by the family of models (EM
regression based on k-nearest neighbors; SVR
Mean average error (MAE) of Machine Learning (ML) models for the prediction of Aβ42
The results are shown for three different subsets
All of the models were optimized and evaluated using the PCA transformed subsets
except a Bagging Regressor that was trained using only the features considered by the PCA algorithm as relevant
The models evaluated were: a Bagging Regressor (BR)
a Gradient Boosting Regressor with a least absolute deviation loss (GBR_lad)
a least squares loss (GBR_ls) and a Huber loss (GBR_hb)
a Gaussian Process with a radial basis function kernel (GP_rbf) and a Matern 3/2 kernel (GP_m32)
Support Vector Regression with a linear (SVR_lin)
Gradient Boosting Regressors (GBRs) consistently outperformed other models
the GBR employing the least absolute deviation loss (GBR_lad) trained with the SLEEPVAR subset
had the lowest training and test MAE (Train MEA: 47.54
Mean average error (MAE) of Machine Learning (ML) models for the prediction of p-tau
All the models were optimized and evaluated using the PCA transformed subsets
Mean average error (MAE) of Machine Learning (ML) models for the prediction of t-tau
The models that yielded the most accurate estimations for the levels of the three biomarkers were the GBRs
specifically employing a least absolute deviation (LAD) loss for Aβ42
in addressing the scarcity of training data
employed regularization techniques to construct simpler models
minimal training errors were observed when utilizing the comprehensive ALL subset
the lowest MAE was recorded with the SLEEPVAR subset
the subset comprising only the standard PSG parameters
we trained various ML models to evaluate which combination of selected subsets of non-invasive variables could accurately predict CSF Aβ42
and t-tau biomarker levels in a cohort of patients with mild-moderate AD(AD)
The subsets included clinical variables (CLINVAR) previously established as relevant to AD pathogenesis
quantitative PSG features (PSGVAR) derived from advanced signal analysis
and a combination of all these variables (ALL)
Variable selection was performed using a range of statistical approaches
with an emphasis on those with the highest discriminating power
we investigated the correlations between the selected relevant variables and the CSF biomarkers to determine the nature of their relationships
The Gradient Boosting Regressors (GBRs) emerged as the most effective models in estimating the levels of the three biomarkers
the lowest training errors for all three biomarkers were observed when employing the ALL subset
although the test evaluations showed differing results
the lowest mean average error (MAE) was achieved using the subset consisting solely of conventional PSG parameters
which was thereby identified as the best predictor of the CSF Aβ42 levels
it was found that the combination of clinical variables
and quantitative PSG features most effectively predicted CSF p-tau and t-tau levels
not all the selected variables demonstrated linear relationships with the biomarkers in question
the most significant variables for predicting CSF Aβ42 levels were standard PSG parameters (SLEEPVAR)
these findings need to be corroborated with alternative analytical approaches and through longitudinal follow-up of our cohort
Similarly, the predictive role of the AI for CSF Aβ42 that we identified—despite the association not being linear—underscores the importance of detailed and personalized sleep analysis in early AD. Corroborating our findings, studies have demonstrated that arousals differ in their oscillatory composition and have various associations with early AD-related amyloid neuropathology and cognitive function (Chylinski et al., 2021)
Future studies are essential to explore these observations further and to determine if there are causal relationships
The most effective combination of feature groups for predicting CSF p-tau levels overall included quantitative PSG features
Regarding the role of quantitative PSG signal features (PSGVAR)
our findings underscored the significance of the skewness of the EEG signal from the O1-A2 channel during the N1 and N2 sleep stages
We noted a significant positive linear correlation with p-tau levels
potentially resulting in more pronounced alterations in EEG signals from these regions
This could render the signal more unpredictable and with distinct spatial patterns
given the positive correlation between the two variables
Among the conventional PSG variables (SLEEPVAR), we find it noteworthy to highlight that our models selected minimum SaO2 as one of the parameters predictive of CSF p-tau levels, suggesting that more severe hypoxemia may lead to an increase in CSF p-tau levels, given the positive relationship. This finding aligns with previous results indicating that hypoxia triggers tau hyperphosphorylation and memory deficits in rats (Zhang et al., 2014)
these relationships did not follow a linear pattern
As observed for the prediction of CSF p-tau
the ALL subset also emerged as the best subset of variables for CSF t-tau levels
Interestingly, regarding the PSGVAR subset, we found that the Lempel-Ziv and Sample Entropy—both of which are measures of signal complexity (Grassberger and Procaccia, 1983)—are pertinent to predict t-tau levels
Our results indicated that the complexity of the thoracic effort signals
increases with the levels of t-tau during NREM sleep
This discrepancy underscores the need for future research that includes larger populations to compare OSA patients with non-OSA individuals
the negative relationship between insulin serum levels and CSF t-tau we observed
remains to be more extensively investigated
Relevant studies on biomarkers and Machine Learning (ML) models of Alzheimer's disease (AD)
Furthermore, Gaubert et al. (2021) evaluated the efficacy of an ML approach in achieving early AD diagnosis based on Aβ-PET and MRI measurement
introducing a multimodal non-invasive biomarker strategy
qEEG was the strongest predictor of neurodegeneration
ApoEϵ4 and MRI hippocampal volumetry most strongly predicted amyloid (80% NPV
Remarkably, innovative research utilizing Support Vector Machine classifiers and Gate Recurrent Unit network techniques has demonstrated the potential of sleep EEG data, including slow waves and spindles, to distinguish MCI from HC with high accuracy (Geng et al., 2022)
The MCI classification accuracy of the GRU network based on features extracted from sleep EEG was the highest at 93.46%
Their experimental findings demonstrate that
sleep EEG can give more helpful information for identifying MCI and HC
Additionally, pioneering work has proposed a novel diagnostic approach for MCI in AD, combining sleep-related movements with advanced signal processing and ML techniques (Khosroazad et al., 2023)
which explores the relationship between high-frequency movements and respiratory changes during sleep
highlights the potential of advanced quantitative sleep signal feature analyzes in a multimodal ML setting for early detection of AD neuropathology
The approach employs Neural Networks and Kernel algorithms
resulting in high sensitivity (86.75% for NN and 65% for Kernel)
and accuracy (88 and 82.5%) for early detection of MCI in AD
the extensive exploration of advanced quantitative sleep signal features to no invasively detect the AD neuropathology within a multimodal ML framework remains a promising area for future research
our study for the first time integrated clinical variables
and quantitative PSG signal features for the non-invasive prediction of core CSF biomarkers of AD using various ML models
This study is novel in that it applies computational engineering to extract a wide range of quantitative signal features from thoroughly preprocessed PSG signals
identifying potential biomarkers for the early detection of AD
no research has delineated the relationship between these specific quantitative PSG features and AD-related CSF biomarkers of neurodegeneration
suggesting that sleep qEEG could demonstrate a topographic specificity in their associations
Our approach involved working with spectral
and non-linear parameters directly extracted from electrophysiological signals
indicating that PSG recordings may contain additional crucial information for the diagnosis of AD
A significant aspect of this research is the rigorous cross-validation ML methodology employed
We trained multiple ML models to determine which could deliver the best performance for our outcomes
The models most effective at addressing the overfitting issue were Gradient Boosting Regressors
utilizing a least absolute deviation loss function for Aβ42
a least squares loss for p-tau and a Huber loss for t-tau
The other optimized ML models generally handled the scarcity of training data by using regularization to construct simpler models that accept higher training errors
we recommend a cautious interpretation of our results
although we believe they contribute valuable insights
The models that excelled in predicting the levels of the three biomarkers were the Gradient Boosting Regressors
which utilized a LAD loss for Aβ42
These are among the most common loss functions for regression challenges
The distinctions between them are as follows:
LAD loss is less sensitive to outliers but backs a closed-form solution due to its non-continuous derivatives;
2. LS loss, on the other hand, penalizes large deviations more severely, making it less robust to outliers, yet it tends to yield more stable solutions (Natekin and Knoll, 2013);
3. The Huber loss integrates aspects of both LAD and LS losses (Natekin and Knoll, 2013)
For instance, in predicting Aβ42 levels, outliers could be disregarded with relative safety. In contrast, outliers played a more critical role in optimizing the models for the tau-related biomarkers. Examining Figure 1 reveals that p-tau and t-tau have similar density distributions
boosting techniques are generally recognized for their low bias
which is the discrepancy between the average prediction of the model and the actual value
a high-bias model tends to be overly simplistic and does not fit the training data well
leading to significant errors in both the training and the test datasets
it is essential to consider that a low-bias model often has high variance
increasing the risk of overfitting the training data
despite the Gradient Boosting Regressors achieving some of the lowest training errors
their MAEs on the test set were still considerable
even with cross-validation to fine-tune the models for an optimal balance in the bias-variance trade-off
the models may still not generalize well beyond the training data
In terms of ensemble models employing bagging techniques
they typically displayed test errors comparable to those of boosting methods but with increased training errors
and Extra Trees Regressor (ETR) function by aggregating the decisions for T individual decision trees
each trained on a bootstrapped subset of the data
The final prediction is the majority vote across these T trees
This approach reduces the variance associated with single decision trees
resulting in a model that is less prone to overfitting and demonstrates improved generalization
provide insight into the importance of features during training
the application of PCA for dimensionality reduction
obscures the interpretability of model decisions
Other models generally address overfitting by deliberately allowing higher training errors
thereby enhancing their generalization capabilities to new data at the expense of complexity
exhibited higher training errors than test errors
This could indicate that the selected kernel was insufficient in capturing the complexity of the data
potentially necessitating a more sophisticated kernel for optimization
Although GPs can assess feature importance through kernel length scales
this interpretability is lost when PCA is applied
Support Vector Regressors (SVRs) struck a better balance between training and test errors
often with training errors marginally exceeding those of other models
The K-Nearest Neighbors Regressors (KNR) also managed the bias-variance trade-off effectively
sometimes with a training error even surpassing the test error
Regarding the analysis of the three biomarkers
the lowest training errors were associated with the “ALL” subset (incorporating clinical
This could be attributed to the retention of a greater number of principal components for the “ALL” subset compared to others
the principal components of the “ALL” subset represent linear combinations of a broader range of features
thus encapsulating more detailed information about each sample
the “SLEEPVAR” subset—comprising solely sleep parameters evaluated by experts-yielded the lowest MAE during testing
it is important to note that none of the models achieved optimal performance
To ensure the robustness of our findings across various populations
we advocate for subsequent validation studies to be conducted with independent cohorts of cognitively normal subjects
enhancing the predictive accuracy of our models through incorporating data from multiple preclinical cohorts and applying longitudinal
multimodal measures within a nested cross-validation framework represents a promising avenue for future research
An intriguing prospect for further investigation is the integration of neuropsychological assessments and MRI data as well as blood biomarkers into our analytical framework
This approach would allow for a thorough longitudinal evaluation of the clinical progression toward prodromal AD
leading to a deeper comprehension of neurodegenerative mechanisms
it would improve the predictive accuracy of our models and provide less invasive methods for early AD detection
a critical next step would be to identify the most predictive set of features for neurodegeneration
Advanced artificial intelligence techniques could then be employed to determine the ability of these features to differentiate between AD
the exploration of automated analysis of PSG recordings through neural network integration into our model offers a promising direction
Such automation could potentially eliminate the need for manual annotation by enabling the automatic detection of artifacts and sleep stages
This study highlights the potential of ML to assess asymptomatic individuals at risk for AD through the analysis of non-invasive and cost-effective biomarkers
underscoring the ability of ML to uncover complex non-linear relationships within intricate datasets
that may elude traditional statistical methods
This could offer supplementary insights alongside other biomarkers
hinting at AD pathology in asymptomatic individuals
or functioning as an additional diagnostic tool for those ineligibles for CSF biomarkers determination
Ours results also suggest that relying solely on a single type of biomarker may not suffice for a reliable AD early detection
we emphasize the importance of specific quantitative PSG signal features such as EEG skewness
Lempel Ziv and Sample Entropy of thoracic effort signals
as reliable markers for predicting neurodegeneration
The utilization of portable PSG devices may establish a groundwork for their utilization in clinical environments
The demonstration of the viability of these innovative approaches underlines their potential contribution to the early diagnosis of AD
particularly through the prediction of core CSF biomarkers and the exploration of their relationships with sleep patterns
The original contributions presented in the study are included in the article/Supplementary material
further inquiries can be directed to the corresponding author
The studies involving humans were approved by the study adhered to the principles of the Declaration of Helsinki and received approval from the Ethics Committee of Hospital Arnau de Vilanova de Lleida (CE-1218)
The studies were conducted in accordance with the local legislation and institutional requirements
The participants provided their written informed consent to participate in this study
Writing – review & editing
The author(s) declare financial support was received for the research
This work was partially funded by Ministerio de Ciencia
co-financed by European Regional Development Fund (ERDF)
“A way of making Europe” and Spanish Ministry of Economy and Competitiveness
Institute of Health Carlos III (grant number P114/00328); by Generalitat of Catalonia
Department of Health (PERIS 2019 SLT008/18/00050) and Fundació La Marató TV3 (464/C/2014) to GP-R
Co-financed by FEDER funds from the European Union (“A way to build Europe”)
IRBLleida is a CERCA Programme/Generalitat of Catalonia
We would like to thank the patients and personnel of the Hospital Universitari Santa Maria's Sleep and Dementia Unit
as well as the IRBLleida Biobank and Plataforma Biobancos
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations
Any product that may be evaluated in this article
or claim that may be made by its manufacturer
is not guaranteed or endorsed by the publisher
The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fnagi.2024.1369545/full#supplementary-material
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Muñoz-Barrutia A and Piñol-Ripoll G (2024) Predicting Alzheimer's disease CSF core biomarkers: a multimodal Machine Learning approach
Received: 12 January 2024; Accepted: 04 June 2024; Published: 26 June 2024
Copyright © 2024 Gaeta, Quijada-López, Barbé, Vaca, Pujol, Minguez, Sánchez-de-la-Torre, Muñoz-Barrutia and Piñol-Ripoll. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
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*Correspondence: Arrate Muñoz-Barrutia, bWFtdW5vemJAaW5nLnVjM20uZXM=
†These authors share first authorship
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PRODUCTION / FUNDING Italy / Poland
by Davide Abbatescianni
stars Valeria Solarino as an archaeologist uncovering secrets from the past
a process that culminates in a series of brutal murders
a thriller titled Fanum – Shadows of the Past
will premiere on Sunday 20 October in Rome
the young director completed a foundation year in Filmmaking and Art & Design at City of Oxford College
then obtained a BA in Film and Television at the University of the Arts London
she worked as an assistant director on international productions and directed several shorts
The plot of Fanum – Shadows from the Past follows Marianne Byron (portrayed by Valeria Solarino)
who is on the trail of an epoch-making and revolutionary discovery about the ancient Etruscan civilisation
the secrets of the past surface in the present
culminating in a series of brutal murders that seek to desecrate Etruscan culture by emulating their sacrifices
Juggling new discoveries and buried secrets
Marianne must dig not only into the ancient ruins
trying to understand who and what lies behind the murders
How far is Marianne willing to go to uncover it
The script was penned by Cristiano Gazzarrini
The cast is rounded off by Valeria Bilello
The technical crew includes DoP Matteo Bangrazi
and editors Matteo Bugliarello and Artemide Alfieri
The premiere will take place at the Acquario Romano. The screening is organised by Play Entertainment and Italian film magazine Fabrique du Cinéma in collaboration with the Rome Film Fest
the producers and some of the key cast members will be in attendance
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The final clapperboard slams on Il falsario, starring Pietro Castellitto
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Volume 8 - 2014 | https://doi.org/10.3389/fnhum.2014.00987
The limbic system is part of an intricate network which is involved in several functions like memory and emotion
Traditionally the role of the cerebellum was considered mainly associated to motion control; however several evidences are raising about a role of the cerebellum in learning skills
mnemonic and behavioral processes involving also connections with limbic system
In 15 normal subjects we studied limbic connections by probabilistic Constrained Spherical Deconvolution (CSD) tractography
The main result of our work was to prove for the first time in human brain the existence of a direct cerebello-limbic pathway which was previously hypothesized but never demonstrated
We also extended our analysis to the other limbic connections including cingulate fasciculus
Although these pathways have been already described in the tractographic literature we provided reconstruction
quantitative analysis and Fractional Anisotropy (FA) right-left symmetry comparison using probabilistic CSD tractography that is known to provide a potential improvement compared to previously used Diffusion Tensor Imaging (DTI) techniques
The demonstration of the existence of cerebello-limbic pathway could constitute an important step in the knowledge of the anatomic substrate of non-motor cerebellar functions
Finally the CSD statistical data about limbic connections in healthy subjects could be potentially useful in the diagnosis of pathological disorders damaging this system
Fifteen healthy subjects with no history of neurological diseases (8 males
7 females; age range 25–32 years; mean age 29) were recruited
Each subject wrote informed consent and the entire study was approved by Ethical Committee of “I.R.C.C.S.—Istituto di Ricovero e Cura a Carattere Scientifico—Centro Studi Neurolesi Bonino-Pulejo
which confirmed that all examinations are in conformity with relevant regulatory standard
The study was performed with a 3T Achieva Philips scanner (Philips healthcare
Netherlands); using a Quasar Dual gradient system (mode 1: 40 mT/m and 200 mT/m/ms; mode 2: 80 mT/m and 100 mT/m/ms)
For anatomical comparison and segmentation we used the following MRI sequences:
T1-weighted 3D high-resolution Fast Field Echo (FFE) sequence with: TR 25 ms; TE 4.6 ms; flip angle 30°; FOV 240 × 240 mm2; reconstruction matrix 256 × 256; voxel size 1 × 1 × 1 mm; slice thickness 1 mm
T2 weighted 3D high resolution Turbo Spin Echo (TSE) with: TR 2500 ms; TE 380 ms; FOV 250 × 250 mm2; reconstruction matrix 312 × 312; voxel size 0.8 × 0.8 × 0.8 mm; slice thickness 0.8 mm
The use of 3D TSE sequence permitted to obtain high-resolution images with a relative short acquisition time
For tractography we used:
3. Diffusion-weighted (DW) MRI with a dual phase encoded pulsed gradient spin echo sequence; 60 gradient diffusion directions were used in order to improve correction of susceptibility and Eddy’s currents distortion (Embleton et al., 2010) following the rules stated by an electrostatic repulsion model (Jones et al., 1999)
We used probabilistic CSD, that is a modified High Angular Resolution Diffusion Imaging (HARDI) technique. Constrained Spherical Deconvolution estimates, directly from the DW signal, the fiber Orientation Distribution Function (fODF) by means of positive spherical deconvolution (Tournier et al., 2007)
We set to 8 the degree of spherical harmonics to achieve robustness to noise
obtained by deconvolution of a single fiber DW signal response
it was possible to find the components with specific orientation
The use of CSD-based method to extract local fiber orientations allows to overcome several limitations of other commonly used tractographic techniques, such as DTI (Tournier et al., 2007; Jones and Cercignani, 2010)
but the latter increases difficulty to correct eddy currents and motion artifacts
thus we chose a lower b-value in order to obtain better correction
according to an anatomical model-based approach
we selected regions of avoidance (ROAs) that filter out tracts
The combined use of ROIs and ROAs allowed us to obtain more reliable selection of tracts of interest
All MRI data were spatially normalized to Montreal Neurological Institute (MNI) stereotactic space using the SPM8 segmentation toolbox
Segmentation was manually performed by one expert rater using Analyze 11.0 (AnalyzeDirect
the individual volumes obtained from the T1 and T2 sequences were opened into the viewer; second
the contrast values were set to maximally increased visibility of each brain structure; third
the axial view was magnified to make easier the individuation of the cerebellar mask
The fastigial nucleus was segmented by using MNI coordinates and following data provided by other authors (Dimitrova et al., 2002; Park et al., 2014)
In addition, anterior thalamic nuclei, amygdala and hippocampus were also segmented. The hippocampal subregions (CA1, Fimbria, Subiculum and Presubiculum) were detected following the study of Frisoni et al. (2008)
Quantitative analysis was performed with Explore DTI (Leemans et al., 2009); we considered tracts number, tracts volume, tracts length mean, Fractional Anisotropy (FA) and Apparent Diffusion Coefficent (ADC). The study of the FA right-left variability was possible after the CSD data transfer to diffusion spectrum imaging (DSI) Studio
following the instruction provided by the documentation
In order to assess intra- and inter-subjects variability of tracts number (number of streamlines = N.), we calculated a lateralization index (Parker et al., 2005; Lebel and Beaulieu, 2009) according to the following formula: (N
In addition we also assessed FA right-left variability
Statistical significance of the inter-subjects and intra-subjects variability was determined using a 2-tailed t-test; P values <0.05 were considered statistically significant
In 15 out of 15 subjects we segmented the hippocampus (Figure 1) and bilaterally traced fiber bundles passing through the superior cerebellar peduncles, linking the hippocampus and the cerebellum: a direct cerebello-limbic pathway (Figure 2). Mean quantitative analysis of this pathway is shown in Table 1
No statistically significant differences were found comparing intra- and inter-subjects right and left variability for tracts number
sagittal (B) and coronal (C) MRI views of hippocampus (H) and amygdala (A) segmentation
Tridimensional sagittal view of a right cerebello-limbic direct pathway
Mean quantitative analysis of the direct cerebello-limbic pathway for each subject
Anatomical course of the cerebello-limbic direct pathway
The coronal images show the course of a right cerebello-limbic pathway
proceeding through the superior cerebellar peduncle (B)
reaching the temporal lobe (C) and the hippocampus (D)
The hippocampus was widely interested by this white matter fiber pathway. After the detection of hippocampal subregions (Figure 4), we found the involvement of CA1, fimbria, subiculum and presubiculum. In the cerebellum we found that the fibers predominantly reached the vermis, lobules VIII, IX, X, Crus I, Crus II (Figure 5A) and fastigial nucleus (Figure 5B)
Anterior (A) and posterior (B) views of a segmented hippocampus with manually colored subregions: CA1 (red)
subiculum and presubiculum (blue) and fimbria (yellow)
Tridimensional multiplanar view of a direct cerebello-limbic pathway
An oblique sagittal view depicts that the large part of the fibers connects the vermis (green arrow)
IX and X (white arrow) with the hippocampus (white arrowhead) (A)
In a right targeted parasagittal view the isolated connection between hippocampus (white arrowhead) and fastigial nucleus (red arrowhead) can be seen (B)
We did not find streamlines between amygdala and the cerebellum
Furthermore, we isolated the following white matter limbic pathways: cingulate fasciculus, uncinate fasciculus, inferior longitudinal fasciculus, fornix (Figure 6) and anterior thalamic pathway, which is made by four main fiber bundles orientated toward: prefrontal cortex, cingulate gyrus, mammillary bodies, parietal cortex, temporal cortex, occipital cortex and hippocampus (Figure 7)
Each pathway was colored manually after morphological isolation
in order to show them separately: cingulate fasciculus (blue)
fornix (red) and inferior longitudinal fasciculus (green) (B)
Tractographic reconstruction of right anterior thalamic pathway after the placement of a ROI corresponding to right anterior thalamic nuclei (yellow ROI)
This pathway (A) is composed by seven white matter bundles which are connected respectively to: cingulate gyrus and prefrontal cortices (green arrow)
frontal and secondary motor cortices (orange arrow)
mammillary bodies (red arrow) and hippocampus (red ROI)
The posterior view (B) shows better temporal projections (white arrows)
We assessed intra- and inter-subjects right-left variability also for these pathways looking at the following data: tracts number, tracts length mean, tracts volume, FA and ADC values. Table 2 shows the mean quantitative analysis of all volunteers
No differences were found between subjects (inter-subjects variability p > 0.05) for all parameters
Mean quantitative analysis for all subjects of main pathways of the limbic network
On the other hand, analyzing the FA of each previously described pathway, we detected a significant intra-subjects variability only for the following tracts: fornices, uncinate fasciculi and anterior thalamic pathways with right predominance (Figure 8)
Fractional Anisotropy (FA) right-left intra-subject variability analysis of each limbic pathway
Statistical significance is indicated by asterisks (p < 0.05)
suggesting that the existence of cerebello-limbic connections may allow the emotional processing modulation
despite the fact that it was never demonstrated
In our study we detected and analyzed for the first time in human brain a direct cerebello-limbic pathway with probabilistic CSD
This pathway consists of a white matter bundle connecting the hippocampus and the cerebellum passing through the superior cerebellar peduncle
Main cerebellar areas reached by this pathway are vermis
Quantitative comparison showed that there are no statistically significant differences in shape and size of this white matter bundle between each subject analyzed
The comparative analysis of right and left bundles showed no significant differences
with good right-left symmetry for each subject
it might be possible that specific motor skills of the amygdala do not necessarily require a direct connection with the cerebellum
For the present study we studied main pathways of the limbic system (cingulate fasciculus, inferior longitudinal fasciculus, uncinated fasciculus, anterior thalamic connections and fornix) using probabilistic CSD technique, in order to overcome intrinsic limitation of DTI and to obtain more accurate data. Indeed, recently Kristo et al. (2013) showed that CSD tractography is more reliable than traditional DTI in the white matter tracts reconstruction and analysis
Although other studies described the white matter connections of the limbic system (Mega et al., 1997; Catani et al., 2013)
to our knowledge no previous reconstruction and statistical analysis of these fiber bundles using probabilistic CSD in human were reported in the literature
probabilistic CSD is probably the most reliable practical option for clinical use
Unfortunately, according to Takao et al. (2013) data about FA asymmetry “are somewhat inconsistent”
therefore further studies involving larger number of subjects comparing different technical approaches should be carried out to clarify the issue
the demonstration of a direct cerebello-limbic pathway in human brain
the morphological and statistical analysis by probabilistic CSD of major white matter pathways involved into limbic network
Both these findings might be potentially useful to explore pathological conditions damaging this system
further studies need to be performed in order to clarify the physiological role of this new direct connection and its involvement in pathological conditions
Alessandro Arrigo: study concepts/study design
data interpretation; Enricomaria Mormina: study concepts/study design
data interpretation; Giuseppe Pio Anastasi: Guarantor of integrity of entire study
approval of final version of submitted manuscript; Michele Gaeta: study concepts/study design
data interpretation; Alessandro Calamuneri: statistical analysis
manuscript revision; Angelo Quartarone: Guarantor of integrity of entire study
approval of final version of submitted manuscript; Simona De Salvo: data acquisition; Daniele Bruschetta: literature research
manuscript revision; Giuseppina Rizzo: literature research
manuscript revision; Fabio Trimarchi: literature research
manuscript revision; Demetrio Milardi: study concepts/study design
Understanding anterograde amnesia: disconnections and hidden lesions
amnesia and the hippocampal-anterior thalamic axis
The effects of selective lesions within the anterior thalamic nuclei on spatial memory in the rat
Optimal imaging parameters for fiber-orientation estimation in diffusion MRI
Morphological asymmetry in anterior limb of human internal capsule revealed by confocal laser and polarized light microscopy
Functional topography of primary emotion processing in the human cerebellum
Neurological Anatomy in Relation to Clinical Medicine
The organization of the human cerebellum estimated by intrinsic functional connectivity
Emotion and motivation: the role of the amygdala
Principles and limitations of computational algorithms in clinical diffusion tensor MR tractography
Diffusion tensor tractography of the limbic system
Deterministic and probabilistic tractography based on complex fibre orientation distributions
Distortion correction for diffusion-weighted MRI tractography and fMRI in the temporal lobes
Limbic and callosal white matter changes in euthymic bipolar i disorder: an advanced diffusion magnetic resonance imaging tractography study
Transcranial cerebellar direct current stimulation (tcDCS): motor control
Mapping local hippocampal changes in Alzheimer’s disease and normal ageing with MRI at 3 Tesla
Anterior thalamic lesions stop synaptic plasticity in retrosplenial cortex slices: expanding the pathology of diencephalic amnesia
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Ascending projections of the cerebellar fastigial nucleus to the hippocampus
amygdala and other temporal lobe sites: evoked potential and histological studies in monkeys and cats
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The anterior thalamus provides a subcortical circuit supporting memory and spatial navigation
Probabilistic fiber tracking using the residual bootstrap with constrained spherical deconvolution MRI
Twenty-five pitfalls in the analysis of diffusion MRI data
Optimal strategies for measuring diffusion in anisotropic systems by magnetic resonance imaging
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Reliability of two clinicaly relevant fiber pathways
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analyzing and visualizing diffusion MR data
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A direct hippocampo-cerebellar projection in chicken
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Impairment of radial maze delayed nonmatching after lesions of anterior thalamus and parahippocampal cortex
“Behavioural neuroanatomy: large-scale networks
the limbic system and the hemispheric specializations,” in Principles of Behavioral and Cognitive Neurology
Cortical and subcortical connections of the human claustrum revealed in vivo by constrained spherical deconvolution tractography
Functional relationships between the hippocampus and the cerebellum: an electrophysiological study of the cat
Hippocampal-Cerebellar interaction during spatio-temporal prediction
O’Reilly
Distinct and overlapping functional zones in the cerebellum defined by resting state functional connectivity
Color schemes to represent the orientation of anisotropic tissues from diffusion tensor data: application to white matter fiber tract mapping in the human brain
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Derivation of high-resolution MRI atlases of the human cerebellum at 3T and segmentation using multiple automatically generated templates
Lateralization of ventral and dorsal auditory-language pathways in the human brain
A pitfall in the reconstruction of fibre ODfs using spherical deconvolution of diffusion MRI data
Pathological laughter and crying in patients with multiple system atrophy-cerebellar type
Exaggerated crying and tremor with a cerebellar cyst
Abnormalities of cortical-limbic-cerebellar white matter networks may contribute to treatment-resistant depression: a diffusion tensor imaging study
Contributions of the amygdala to emotion processing: from animal models to human behavior
The anatomy of extended limbic pathways in Asperger syndrome: a preliminary diffusion tensor imaging tractography study
A default mode of brain function: a brief history of an evolving idea
The role of the cerebellum in cognition and behaviour: a selective review
The cerebellum: a new key structure in the navigation system
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Trimarchi F and Milardi D (2014) Constrained spherical deconvolution analysis of the limbic network in human
with emphasis on a direct cerebello-limbic pathway
Received: 14 August 2014; Accepted: 19 November 2014; Published online: 08 December 2014
Copyright © 2014 Arrigo, Mormina, Anastasi, Gaeta, Calamuneri, Quartarone, De Salvo, Bruschetta, Rizzo, Trimarchi and Milardi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
distribution and reproduction in other forums is permitted
provided the original author(s) or licensor are credited and that the original publication in this journal is cited
*Correspondence: Alessandro Arrigo, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Via Consolare Valeria, 1 Messina, 98125, Italy e-mail:YWxlc3NhbmRyby5hcnJpZ29AaG90bWFpbC5jb20=
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from her upcoming EP ‘Blur Divine’ a series of “unlove” songs
Julia Gaeta shares the third single, “Fragments of Pain,” from her upcoming EP Blur Divine
“is about someone who is in deep limerence
looking for clues and meaning that the object of their obsession might love them back
but all they’re really seeing is reflections of themselves
This track draws from my love of 90s pop and big choruses about saccharine love
but it’s really a dark song about delusion.”
Blur Divine isn’t just a collection of love songs – quite the opposite
These are unlove songs veiled in facades of closeness
They tell the story of how loving someone can sometimes mean walking the perilous path of losing oneself
the act of unloving another becomes of utmost importance
Visual themes on this EP – on the cover
etc – are of absinthe and murky swamps
representing the continual warping of reality that can easily swallow those who feel the most
Gaeta has been inspired by personal events
the push-pull energy of gritty Paris nights
Her perception of the city feels constantly in flux – a testament to the idea that we create our own realities
The EP was mostly written between two locations in Paris
beginning with the 2020 pandemic lockdowns after Gaeta had just moved to Paris from Berlin
One was a sublet in the 8th floor of a 1970s apartment complex
with renowned Père Lachaise Cemetery as her backyard and the sprawling cityscape of Paris in the front
The apartment felt like a lo-fi sex dungeon with faux leather curtains
mysterious stains and a mirror surrounding the bed
it represented a window into a collective psyche of others’ pain and pleasure
The second location was more isolated from much of the city’s hustle and bustle
providing an introspective and personal space to create
These dual locations certainly influenced the record’s dynamic
Julia Gaeta “Hangin On A Dream” single artwork
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she is a past master in the art of "nerding-out" with music
and is excited to explore that passion by sharing the stories of artists everywhere
Julia Gaeta Shares “Hangin On A Dream” Single off Forthcoming ‘Blur Divine’ EP
it was like monsters with guitars and I was blown away.”
Mark Morton: “I was starting to break out of the clouds
I could tell that was happening and it felt really free to be creative.”
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Deafheaven – ‘Lonely People With Power’ [Album Review]
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2024 (GLOBE NEWSWIRE) -- Shockwave Medical
a pioneer in the development and commercialization of transformational technologies for the treatment of cardiovascular disease
announced today the appointment of Renee Gaeta as Chief Financial Officer (CFO)
who previously announced his decision to retire
“Renee is a highly skilled and accomplished executive with a proven track record in the medical device and healthcare industries,” said Doug Godshall
“I am thrilled to welcome Renee to Shockwave and look forward to partnering with her through our next phase of growth and profitability
I would also like to thank Dan Puckett for his exemplary leadership and outsized contribution to the success of Shockwave
fortunately he will continue to work with us in a consulting capacity.”
Renee most recently served as CFO at Eko Health where she led both the finance and human resources teams as the organization grew its digital cardiopulmonary care platform
She has also served as a member of the board of directors and the audit committee of Candel Therapeutics since August 2022
Renee was CFO and a member of the executive team at Establishment Labs Holdings
where she played a key role in the company’s successful initial public offering and the growth of the global business
in accounting from Loyola Marymount University and is a Certified Public Accountant in the State of California
“Shockwave is one of the most exciting and innovative companies in the medical technology industry and it is an honor to be joining the company at such a pivotal time in its growth,” said Renee
“The progress Shockwave has made in establishing IVL as a standard of care while also strategically expanding the business to help patients is inspiring
I am thrilled to be part of the team and the mission to transform treatment paradigms for poorly served patient populations with breakthrough technologies.”
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on April 4th at Care Dimensions Hospice House in Lincoln
a daughter of the late Frank and Raffaella “Raffie” (Penta) Gaeta
educated in the Medford Public Schools and at Boston University
Fran first met her husband of 50 years
but they did not start dating until they worked on their first political campaign together
She worked with children with disabilities in the Connecticut Public Schools
where she co-pioneered a multi-college mental health counseling referral service in Boston
she restructured a 10-town nonprofit multi-service hotline as President of CODE (Committee on Drug Education) and served as a long-time member and a two-term Chair of the Concord Housing Authority
where she worked with her close friends to develop affordable housing for low-income people
and engaging woman who was passionate about her family
She had the uncanny ability to connect with
and appreciate people from all walks of life
Her positive outlook and genuine concern for others was infectious
In addition to her beloved parents and husband
Fran was pre-deceased by her sister Norma Barricelli (Jean-Pierre)
Maillis of Watertown; her grandchildren Cecelia
Family and friends will honor and remember Frances’ life by gathering for calling hours in the Joyce Funeral Home
Her Funeral Mass will be celebrated on Thursday morning at 11 a.m
Burial will follow at Mount Auburn Cemetery in Cambridge
In lieu of flowers, memorial donations may be made to Sanctuary Place of Health Imperatives, 942 W. Chestnut Street, Brockton, Massachusetts 02301, or by visiting healthimperatives.app.neoncrm.com/forms/sanctuary-place
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today announced the appointment of Renee Gaeta as Chief Financial Officer (CFO) and member of the executive leadership team
“Eko is at a key moment in its journey to build a comprehensive platform for digital cardiopulmonary care.” said Connor Landgraf
“Renee’s experience in guiding global public and private medical technology companies through sustained stages of high growth is ideal for Eko
Her strategic vision and knowledge of finance and healthcare will help us expand our impact on patient care.”
Gaeta previously served as CFO and member of the executive team at Establishment Labs Holdings
where she played a key role in the company’s successful Initial Public Offering (IPO) and Follow-On Offering
Revenue more than tripled during her tenure
as did the company’s valuation after the IPO
they grew direct sales in addition to distributor revenue
launched new products and expanded markets
and ran an FDA clinical trial for a Class III device
Corporate Controller and executive team member at Sientra
In this role she was instrumental in preparing the company during its pre-IPO stage
establishing compliant systems and controls
and she also played a key role in the company’s successful IPO and Follow-On Offering
rising through the organization to the role of Director
Gaeta joins Eko during a period of significant company milestones
Food and Drug Administration (FDA) cleared Eko’s artificial intelligence (AI) algorithms for detecting heart murmurs and atrial fibrillation
and also issued an Emergency Use Authorization (EUA) for Eko’s novel rapid screening test for low ejection fraction (low EF)
Eko launched the first AI-powered cardiopulmonary telehealth platform for virtual physical exams
Eko and 3M™ Littmann® Stethoscopes launched a collaboration of the Littmann CORE Digital Stethoscope that marries best-in-class 3M Littmann stethoscope technology with advanced Eko digital innovations
bringing the company’s total funding to $100 million
a peer-reviewed publication in the Journal of the American Heart Association (AHA) validated Eko’s AI algorithm as a clinical tool for detecting heart murmurs
with comparable performance to that of an expert cardiologist
a company making a difference in providing the highest standard of cardiopulmonary care,” said Mrs
“Eko has developed the next evolution in digital health solutions focused on improving patient care
and I look forward to working with the team to execute on the company’s priorities
accelerate growth and enhance value for shareholders and all stakeholders."
Product MarketingEkobrit.gould@ekohealth.com