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Automatic Segmentation of Aortic Dissection in Contrast-Enhanced CT Images Using Transformer-UNet Cascade Network
No full textAortic Dissection (AD) is a severe condition caused by a tear in the aortic inner wall, allowing blood to flow between the layers of the aortic wall and potentially leading to life-threatening complications. Managing AD involves imaging, medical treatment, and sometimes surgery. CT scans, which produce high-resolution images quickly, are commonly used for AD diagnosis and prognosis evaluation. Accurate segmentation of the True Lumen (TL), False Lumen (FL), and Thrombosis (TH) is crucial, but manual measurement is time-consuming and variable. To address this, computer vision, machine learning, and deep learning methods have been introduced. Although CNN-based models have played a significant role in medical image analysis, they have limitations in comprehensively understanding anatomical structures. To overcome these limitations, Transformer-based models have been introduced, excelling in extracting global context information but being less effective in capturing local texture details. Therefore, this study proposes a model that combines the strengths of CNNs and Transformers. We designed a two-stage model: the first stage uses a 3D Transformer UNet to learn the aorta’s global information, while the second stage uses a 3D UNet to learn the detailed textures of TL, FL, and TH. Additionally, a multi-scale patch extraction method is applied to effectively capture both the aorta’s global information and detailed textures. This model's two-step approach—using a 3D Transformer UNet for global context and a 3D CNN UNet for local texture—has been validated in ablation studies. The model's performance was evaluated using the dataset from Asan Medical Center and compared with existing models such as nnUNet and nnFormer. Our method achieved Dice Similarity Coefficients (DSC) of 0.917, 0.888, and 0.630 for TL, FL, and TH, respectively, demonstrating the highest segmentation accuracy. The model's robustness and generalizability were further assessed using external datasets, showing potential for improving AD diagnosis and treatment across various clinical settings.Maste
The Effects of Remimazolam versus Dexmedetomidine on Recovery after Transcatheter Aortic Valve Replacement under Monitored Anesthesia Care : A Propensity Score-Matched Analysis
No full textBackground: A recent trend of minimalist transcatheter aortic valve replacement (TAVR) under monitored anesthesia care (MAC) emphasizes early recovery and faster discharge from the hospital. Remimazolam besylate is a newer benzodiazepine with a short recovery time, but concerns about its potential to increase the risk of postoperative delirium have been raised. Thus, the authors hypothesized that remimazolam is non-inferior to dexmedetomidine in terms of recovery after TAVR.
Methods: This retrospective cohort study aimed to compare remimazolam versus dexmedetomidine in patients undergoing TAVR under MAC at a tertiary academic hospital between July 2020 and July 2022. The primary endpoint was timely recovery after TAVR, defined as discharge from the intensive care unit within the first day following the procedure. The secondary endpoints were time to be fully awake, oxygen supplementation duration, intubation, need for vasopressor/inotropes, need for temporary pacemakers (TPMs), and incidence of delirium.
Results: The study included 464 patients, of whom 218 received remimazolam and 246 received dexmedetomidine. After propensity matching, 164 patients were included in each group. Patients in the remimazolam group showed no significant difference in terms of timely recovery (risk difference [RD] -0.6; 95% confidence interval [CI] -6.1 to 4.9; p=0.827). Remimazolam usage was associated with a shorter duration of being fully awake (2 [0-4] hours vs. 3 [2-5] hours, p-value=0.011) and a lesser need for postoperative vasopressors/inotropes (12.8% vs. 23.8%, p=0.013) and TPMs (46.3% vs. 65.9%, p<0.001) compared to dexmedetomidine usage. The remimazolam and dexmedetomidine groups showed no significant difference in the incidence of delirium (18.3% vs. 18.9%, p=0.886).
Conclusions: In patients undergoing TAVR, remimazolam was associated with non-inferior intensive care unit stay when compared to dexmedetomidine. Additionally, remimazolam was associated with a more favorable recovery profile, including a shorter duration to be fully awake and reduced postoperative requirements for vasopressors/inotropes and TPMs.|서론: 최근 감시마취관리(monitored anesthesia care, 이하 MAC) 하에 시행되는 경피적 대동맥 판막 치환술(transcatheter aortic valve replacement, 이하 TAVR)은 환자의 빠른 회복과 퇴원을 강조하고 있다. 레미마졸람 베실레이트는 벤조디아제핀 계열의 신약으로, 회복 시간이 짧다는 장점이 있지만 수술 후 섬망 발생 위험이 증가할 수 있다는 우려가 있다. 이에 따라, 본 연구진은 TAVR 후 회복 측면에서 레미마졸람이 덱스메데토미딘에 비해 열등하지 않을 것이라는 가설을 세웠다.
방법: 본 연구는 단일 기관 후향적 연구로, 2020년 7월부터 2022년 7월까지 MAC 하에 TAVR을 시행 받은 환자들에게서 레미마졸람과 덱스메데토미딘을 비교하였다. 연구의 일차 결과지표는 TAVR 후 적시 회복률이고, 수술 후 하루 이내에 중환자실에서 퇴실한 경우로 정의하였다. 연구의 이차 결과지표는 완전히 깨어나는데 걸리는 시간, 산소 보충 기간, 기도 삽관 여부, 혈관수축제/강심제 필요 여부, 임시 심박동기(TPM) 필요 여부, 그리고 섬망 발생률이다.
결과: 464명의 환자 중에서 218명은 레미마졸람, 246명은 덱스메데토미딘을 진정제로 사용하였고, 성향매칭 후 최종분석에는 각 그룹에 164명씩 포함되었다. TAVR 이후 적시 회복률 측면에서, 레미마졸람은 덱스메데토미딘에 비해 열등하지 않은 것으로 나타났다(리스크 차이 [RD] -0.6; 95% 신뢰구간 [CI] -6.1에서 4.9; p=0.827). 레미마졸람 사용은 덱스메데토미딘 사용과 비교했을 때 환자가 완전히 깨어나는데 걸리는 시간이 더 짧았고(2[0-4] 시간 대 3[2-5] 시간, p=0.011), 수술 후 혈관수축제/강심제 사용이 적었으며(12.8% 대 23.8%, p=0.013), TPM 사용이 적었다(46% 대 65.9%, p<0.001). 레미마졸람과 덱스메데토미딘 군은 섬망 발생률에서 유의한 차이가 없었다(18.3% 대 18.9%, p=0.886).
결론: TAVR을 시행 받는 환자들에서, 레미마졸람은 중환자실 재원일 측면에서 덱스메데토미딘에 비해 열등하지 않다고 간주되며, 수술 후 의식회복 시간, 혈관수축제/강심제 투여율 및 TPM 필요성 측면에서 보다 더 유리한 회복 양상과 관련이 있었다.Maste
The Effect of Foreign Workers’ Positive Psychological Capital on Organizational Well-being: Focusing on the Serial Multiple Mediation Effect of Acculturation and Job Crafting
No full textThe Effect of Foreign Workers’ Positive Psychological Capital on Organizational Well-being : Focusing on the Serial Multiple Mediation Effect of Acculturation and Job Crafting
In the rapidly changing domestic social environment, almost all industries, including manufacturing, agriculture, livestock industry, fishing, construction, and service industries, are facing hiring difficulties due to a decrease in the productive population, job seekers' avoidance of production jobs, and an increase in the elderly population in rural areas, reducing the number of foreign workers introduced. It was significantly expanded to 69,000 in 2022 and 120,000 in 2023.
This study is conducted in three countries, including Vietnam, Cambodia, and Nepal, which are supporting economic development and replacing insufficient manpower in the domestic manufacturing, agricultural and livestock industries, fisheries, construction, and service industries in the reality that 120,000 foreign workers will be introduced in 2023. An empirical study was conducted on the influence relationship between variables such as positive psychological capital, organizational well-being, acculturation, and job crafting targeting foreign workers. Through research, we predicted that if we enhance the ability to apply job crafting to foreign workers by encouraging their positive psychological capital and increasing their level of acculturation, we predicted that this would have an impact on organizational well-being. As a result of testing the hypothesis, it was demonstrated that there is an influence relationship between each variable, such as foreign workers' positive psychological capital, organizational well-being, cultural adaptation, and job crafting.
As a result of empirical research, positive psychological capital has a positive influence on organizational well-being, cultural adaptation, and job crafting, and acculturation has a positive influence on job crafting and organizational well-being, and job crafting has a positive influence on organizational well-being. It was found to have a positive (+) effect on. In addition, acculturation and job crafting were found to mediate the relationship between positive psychological capital and organizational well-being, and there was a double mediating effect of acculturation and job crafting in the relationship between positive psychological capital and organizational well-being.
The theoretical implications of this study are to verify the mediating effect of acculturation and job crafting in the relationship between positive psychological capital and organizational well-being, and to demonstrate the serial multiple mediating effect of acculturation and job crafting in the relationship between positive psychological capital and organizational well-being. Verified. In particular, given the lack of empirical research on variables such as positive psychological capital, organizational well-being, acculturation, and job crafting targeting foreign workers, this study is significant in verifying the influence relationships of the variables.
The practical implication is that as the influence relationship between each variable such as positive psychological capital, organizational well-being, acculturation, and job crafting of foreign workers has been proven, businesses that hire foreign workers can maintain the positive psychological state of foreign workers. It is necessary to develop education and training programs about job crafting to improve the productivity of businesses, and employers need to devise measures to improve acculturation and organizational well-being in the management of foreign workers. As the size of companies employing foreign workers is small and the number of employees is small, it is expected that there will be various management difficulties. However, as foreign workers' requests for job transfers, job changes, and workplace changes increase, the productivity of companies decreases and there is a shortage of manpower. Rather than replenishment, it is necessary to lower the intention to change jobs through education and training on cultural adaptation and organizational well-being so that foreign workers can work long-term at the company they are currently working for.
The limitations of this study are that studies on the variables used in the study, such as positive psychological capital, organizational well-being, acculturation, and job crafting, were mainly conducted on domestic organizational members, but there is a lack of research on foreign workers. Therefore, there appears to be some room for criticism regarding the consistency of the results of this study, and research targeting foreign workers needs to be expanded in future research. In addition, as the survey on the measurement tool used in this study was translated into Korean from foreign literature and then translated back into Vietnamese, Cambodian, and Nepali, there were concerns and questions about whether foreign workers accurately understood and answered the survey questions.
As the study is limited to a cross-sectional time point, there is a need for longitudinal research. As a suggestion for future research, qualitative research is needed, including interviews with foreign workers, colleagues, and superiors, on each variable, such as positive psychological capital, organizational well-being, acculturation, and job crafting. In addition, Comprehensive research targeting 16 countries where foreign workers are being introduced and research on specific wage levels for the jobs performed by foreign workers, and systematic training on positive psychological capital, job crafting, acculturation, and organizational well-being for CEOs of Employment Permit System companies and foreign workers. There is a need to develop systematic education and training programs on positive psychological capital, organizational well-being, acculturation, and job crafting.
Keywords: Employment Permit System, foreign workers, positive psychological capital, organizational well-being, Acculturation, job crafting|외국인근로자의 긍정심리자본이 조직웰빙에 미치는 영향: 문화적응과 잡크래프팅의 직렬다중매개효과를 중심으로
급변하는 국내 사회환경 속에서 생산인구의 감소, 구직자의 생산직 기피현상, 농어촌에서 고령층 증가로 인해 제조업, 농업, 축산업, 어업, 건설업, 서비 스업 등 거의 모든 업종에서 구인난에 처해 있어 외국인근로자의 도입인원을 2022년 69,000명, 2023년 120,000명으로 대폭 확대되었다. 이번 연구는 2023년도 12만명의 규모의 외국인근로자가 도입되고 있는 현실에서 국내 제조업, 농축산업, 어업, 건설업, 서비스업 업종에서 부족한 인력을 대체하고 경제발전을 지원하고 있는 베트남, 캄보디아, 네팔 등 3개국의 외국인근로자를 대상으로 긍정심리자본, 조직웰빙, 문화적응, 잡크래프팅 등 각각 변수의 영향 관계에 대하여 실증연구를 진행하였다. 연구를 통해 외국인근로자의 긍정심리자본을 고취시키고, 문화적응의 수준을 높임으로써 외국인근로자에게 잡크래프팅을 적용 할 수 있는 능력을 증진 시킨다면, 조직웰빙에 영향을 미칠 것이라 예측하고 연구를 진행하였다. 가설의 검증 결과, 외국인근로자들의 긍정심리자본, 조직웰빙, 문화적응, 잡크래프팅 등 각 변수 간에 영향 관계가 있음이 실증되었다. 실증연구 결과, 긍정심리자본은 조직웰빙, 문화적응, 잡크래프팅에 정(+)의 영향을 미치고 있으며, 문화적응은 잡크래프팅, 조직웰빙에 정(+)의 영향을 미치고 있으며, 잡크래프팅은 조직웰빙에 정(+)의 영향을 미치고 있는 것으로 나타났다. 또한, 문화적응과 잡크래프팅은 긍정심리자본과 조직웰빙 간의 관계를 매개하는 것으로 나타났으며, 긍정심리자본과 조직웰빙 간의 관계에 있어 문화적응과 잡크래프팅의 이중매개효과가 있는 것으로 나타났다. 이번 연구를 통한 이론적 시사점은 긍정심리자본과 조직웰빙의 영향 관계에서 문화적응과 잡크래프팅의 매개변수 효과를 검증하였고, 긍정심리자본과 조직 웰빙의 영향 관계에서 문화적응과 잡크래프팅의 직렬다중매개 효과를 검증하였다. 특히, 외국인근로자를 대상으로 긍정심리자본, 조직웰빙, 문화적응, 잡크 래프팅 등 각 변수에 대한 실증연구가 부족한 현실에서 이번 연구를 통해 변수의 영향 관계를 검증한 것에 이론적 의미가 크다. 실무적인 시사점은 외국인 근로자의 긍정심리자본, 조직웰빙, 문화적응, 잡크래프팅 등 각 변수의 관계에서 영향 관계가 실증됨에 따라 외국인근로자를 고용하는 사업체에서 외국인근로자의 긍정적인 심리상태를 유지할 수 있는 방안과 사업체의 생산성 향상을 위한 잡크래프팅에 관한 교육·훈련프로그램 개발이 필요하며, 사업주는 외국인 근로자의 관리에 있어 문화적응과 조직웰빙을 향상시킬 수 있는 대책 방안을 강구할 필요가 있다. 외국인근로자를 고용하고 있는 기업체의 규모가 작고, 직원수가 적음에 따라 여러 가지 관리에 어려움이 있을 것으로 예상되지만, 외국인근로자의 이직, 이직요구, 사업장 변경 요구가 확대되어 기업의 생산성이 저하되고 부족한 인력의 재충원보다는 현재 근무하고 있는 사업체에서 외국인 근로자들이 장기근무가 가능하도록 문화적응과 조직웰빙에 대한 교육·훈련을 통해 이직의도를 낮추는 것이 필요하다. 이번 연구에서의 한계점은 연구에 활용된 변수인 긍정심리자본, 조직웰빙, 문화저긍, 잡크래프팅 등에 관한 연구는 국내 조직구성원을 대상으로 주로 연구가 진행되었고 외국인근로자를 대상으로 하는 연구는 부족한 실정이다. 따라서 이번 연구 결과의 일치성 부분에 일부 비판의 여지가 있을 것으로 보이며, 향후 연구에서 외국인근로자를 대상으로 하는 연구가 확대될 필요가 있다. 또한, 이번 연구에서 사용한 측정도구에 대한 설문이 외국문헌에서 사용된 것을 한국어로 번역된 것을 다시 베트남어, 캄보디아어, 네팔어로 번역함에 따라 외국인근로자들이 설문문항의 내용을 정확하게 이해하고 답변하였는지에 대한 염려와 설 문을 횡단적 시점으로 제한됨에 따라 종단적 시점의 연구 필요성이 있다. 향후 연구방안에 대한 제언으로 외국인근로자의 긍정심리자본, 조직웰빙, 문화적응, 잡크래프팅 등 각 변수에 대한 외국인근로자, 동료, 상사의 면담 등 질적 연구가 필요하다. 또한, 외국인근로자가 도입되고 있는 16개 국가들을 대상으로 하는 종합적인 연구 및 외국인근로자가 수행하고 있는 직무에 대해 구체적인 임금수준에 대한 연구가 필요하며, 고용허가제 기업 CEO와 외국인근로자에 대한 긍정심리자본, 조직웰빙, 문화적응, 잡크래프팅 등에 대한 체계적인 교육· 훈련 프로그램의 개발이 필요하다.
주제어: 고용허가제, 외국인근로자, 긍정심리자본, 조직웰빙, 문화적응, 잡크래프팅Docto
Central Nervous System Infection with Hypervirulent Klebsiella pneumoniae
No full textHypervirulent Klebsiella pneumoniae (hvKp) infections are being increasingly reported globally, and cause severe central nervous system (CNS) and multiorgan infections even in immunocompetent individuals. The recent emergence of hvKp antibiotic resistance has generated escalating concern about effective infection control for this potentially neuroinvasive pathogen. Herein, we report two cases of Klebsiella pneumoniae-related CNS infection, including one patient with antimicrobial-resistant hvKp, confirmed by string test that demonstrated a hypermucoviscous phenotype
Effect of biologic therapies on quality of life in severe asthma: Findings from the PRISM study
No full textBackground: Anti-type 2 (T2) biologic therapies (biologics) improve exacerbation rates, lung function, and asthma-related quality of life (QoL) in patients with severe T2 asthma. However, studies comparing different biologics are lacking. We evaluated the QoL in patients with severe asthma comprehensively and compare the efficacy of different T2-directed biologics using QoL questionnaires.
Methods: We compared the QoL between severe and mild-to-moderate asthma and between severe asthma with and without biologics treatment. Data of mild-to-moderate were extracted from the Cohort for Reality and Evolution of Adult Asthma in Korea, and data of severe asthma were collected from the Precision Medicine Intervention in Severe Asthma. We included 183 pa tients with severe asthma treated with T2 biologics or conventional therapy between April 2020 and May 2021 and assessed QoL of them using the Questionnaire for Adult Korean Asthmatics (QLQAKA), Severe Asthma Questionnaire (SAQ), and EuroQoL-5Dimensions (EQ-5D) at baseline and 6 months.
Results: The EQ-5D index (0.803) of severe asthma was lower than that of other chronic diseases representing a worse QoL. The scores for all questions of QLQAKA, except “cough,” were lower (less control) in the severe asthma group than in the mild-to-moderate asthma group at baseline and 6 months (P 0.05).
Conclusion: QoL was worse in severe asthma than in mild-to-moderate asthma and other chronic diseases. T2 biologics equally improved QoL in patients with severe asthma
Serum MRGPRX2 as a Long-term Biomarker for Iodinated Contrast Media-Induced Anaphylaxis
No full textThe diagnosis of anaphylaxis is based on the clinical history. The utility of tryptase measurements in clinical setting is limited. Mas-related G protein-coupled receptor-X2 (MRGPRX2) is expressed in mast cells and is involved in the degranulation of these cells. We evaluated the potential of MRGPRX2 as a diagnostic biomarker in patients with iodinated contrast media (ICM)-induced immediate hypersensitivity reactions (IHRs). A total of 173 patients with documented ICM-induced IHR within 4 months from registration were enrolled and skin tests for the culprit ICM were performed. The time interval was evaluated as the duration between the onset of ICM-induced IHR and the measurement of serum MRGPRX2 levels. Serum MRGPRX2 concentration was determined using an enzyme-linked immunosorbent assay kit. Of the 173 patients, 33 and 140 were included in the anaphylaxis and non-anaphylaxis groups, respectively. Serum MRGPRX2 levels were significantly higher in the anaphylaxis than in the non-anaphylaxis group (29.9 ± 24.1 vs. 20.7±17.5, P = 0.044). Serum MRGPRX2 showed a moderate predictive ability for anaphylaxis, with an area under the curve of 0.61 (P = 0.058). When groups were classified based on the time interval, T1(0-2months) and T2 (2-4months), patients with anaphylaxis had higher MRGPRX2 levels compared to the non-anaphylaxis group in the T2 group (36.5±19.2 vs. 20.5±19.0, P = 0.035). This pilot study shows that serum MRGPRX2 is a potential long-term biomarker for predicting anaphylaxis, particularly ICM-induced anaphylaxis. Further studies are needed to determine the role of MRGPRX2 in anaphylaxis in a larger population of patients with various drug-induced IHRs
Prognostic Value of Mitral Annular Calcification in Liver Transplant Patients: Implication in Posttransplant Outcomes
No full textBackground: With the rise of metabolic diseases and aging in liver transplant (LT) candidates, mitral annular calcification (MAC) is more recognizable. Despite cardiovascular risk becoming a leading cause of mortality in LT recipients, the influence of MAC remains unexamined. This study investigates the prevalence, related factors, and impact of MAC on LT outcomes.
Methods: We explored 4148 consecutive LT patients who underwent routine pretransplant echocardiography from 2008 to 2019. Multivariate logistic analysis and the tree-based Shapley additive explanation scores in machine learning were used to evaluate the significant and important related factors. The primary outcome was 30-d major adverse cardiac events (MACE), and the secondary outcome was a median of 5-y cumulative all-cause mortality.
Results: MAC was found in 123 (3.0%) patients. Significant and important related factors included age, alcoholic liver disease, chronic kidney disease, hyperuricemia, hypertension, and coronary artery disease. The MACE rate was higher in patients with MAC compared with those without MAC at 30 d ( P 10 y post-LT.
Conclusions: The presence of MAC before LT was linked to increased 30-d MACE and lower long-term survival rates, especially in women. Identification and management of MAC and potential risk factors are crucial for improving post-LT survival
Enhancer of zeste homolog 2 (EZH2)-dependent sirtuin-3 determines sensitivity to glucose starvation in radioresistant head and neck cancer cells
No full textSirtuin 3 (SIRT3) regulates mitochondrial function as a mitochondrial deacetylase during oxidative stress. However, the specific regulatory mechanism and function of SIRT3 in radioresistant cancer cells are unclear. In this study, we aim to investigate how SIRT3 determines the susceptibility to glucose deprivation and its regulation in p53-based radioresistant head and neck cancer cells. We observed mitochondrial function using two established isogenic radioresistant subclones (HN3R-A [p53 null] and HN3R-B [p53 R282W]) with intratumoral p53 heterogeneity. Cell counting analysis was performed to evaluate cell proliferation and cell death. The correlation between the regulation of SIRT3 and enhancer of zeste homolog 2 (EZH2) was confirmed by immunoblotting and chromatin immunoprecipitation assay. p53-deficient radioresistant cells (HN3R-A) expression reduced SIRT3 levels and increased sensitivity to glucose deprivation due to mitochondrial dysfunction compared to other cells. In these cells, activation of SIRT3 significantly prevented glucose deprivation-induced cell death, whereas the loss of SIRT3 increased the susceptibility to glucose deficiency. We discovered that radiation-induced EZH2 directly binds to the SIRT3 promoter and represses the expression. Conversely, inhibiting EZH2 increased the expression of SIRT3 through epigenetic changes. Our findings indicate that p53-deficient radioresistant cells with enhanced EZH2 exhibit increased sensitivity to glucose deprivation due to SIRT3 suppression. The regulation of SIRT3 by EZH2 plays a critical role in determining the cell response to glucose deficiency in radioresistant cancer cells. Therefore, EZH2-dependent SIRT3 could be used as a predictive biomarker to select treatment options for patients with radiation-resistance
Overcoming the age-dependent SARS-CoV-2 vaccine response through hybrid immunity: analysis of humoral and cellular immunity with mass cytometry profiling
No full textBackground: Age-dependent immune responses to coronavirus disease 2019 (COVID-19) vaccinations and breakthrough infections (BIs) in young and middle-aged individuals are unclear.
Methods: This nationwide multicenter prospective cohort study analyzed immune responses in participants of the ChAdOx1 (ChAd)-ChAd-mRNA vaccine group using cytometry by time-of-flight, anti-spike protein antibody (Sab) and anti-nucleocapsid antibody (Nab) titers, plaque reduction neutralization tests (PRNTs), and interferon-gamma (IFN-γ) release assays at various time points.
Results: We evaluated 347 participants with an average age of 38.9 ± 9.4 years (range: 21-63). There was a significant inverse correlation between age and Sab levels after the second dose (slope - 14.96, P = 0.032), and this was more pronounced after the third dose (slope - 208.9, P < 0.001). After BIs, older participants showed significantly higher Sab titers (slope 398.8, P = 0.001), reversing the age-related decline observed post-vaccination. This reversal was also observed in PRNTs against wild-type SARS-CoV-2 and the BA.1 and BA.5 variants. IFN-γ responses increased markedly after the third dose and Bis, but showed a weak positive correlation with age, without statistical significance. Immune cell profiling revealed an age-dependent decrease in the proportions of B-cell lineage cells. The proportions of naive CD4+ and CD8+ T cells were inversely correlated with age, whereas the proportions of mature T cell subsets with memory function, including memory CD4+ T, CD8+ TEM, CD8+ TEMRA, and TFH cells, increased with age.
Conclusions: Age-dependent waning of the serologic response to COVID-19 vaccines occurred even in middle-aged individuals, but was reversed after BIs. IFN-γ responses were preserved, compensating for the decrease in naive T cell populations, with an increase in memory T cell populations
Evaluation of Aortic Diseases Using Four-Dimensional Flow Magnetic Resonance Imaging
No full textThe complex hemodynamic environment within the aortic lumen plays a crucial role in the progression of aortic diseases such as aneurysms and dissections. Traditional imaging modalities often fail to provide comprehensive flow dynamics that are essential for precise risk assessment and timely intervention. The advent of time-resolved, three-dimensional (3D) phase-contrast magnetic resonance imaging (4D flow MRI) has revolutionized the evaluation of aortic diseases by allowing a detailed visualizations of flow patterns and quantification of hemodynamic parameters. This review explores the utility of 4D flow MRI in the assessment of thoracic aortic diseases, highlighting the key hemodynamic parameters, including flow velocity, wall shear stress, oscillatory shear index, relative residence time, vortex, turbulent kinetic energy, flow displacement, pulse wave velocity, aortic distensibility, energy loss, and stasis. We elucidate the significant findings of studies utilizing 4D flow MRI in the context of aortic aneurysms and dissections, highlighting its role in enhancing our understanding of disease mechanisms and improving clinical outcomes. This review underscores the potential of 4D flow MRI to refine risk stratification and guide therapeutic decisions, ultimately contributing to better management of aortic diseases