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Myocardial analysis from routine 4D cardiac-CT to predict reverse remodeling and clinical outcomes after transcatheter aortic valve implantation.
Get PDFPURPOSE
Our study aimed to determine whether 4D cardiac computed tomography (4DCCT) based quantitative myocardial analysis may improve risk stratification and can predict reverse remodeling (RRM) and mortality after transcatheter aortic valve implantation (TAVI).
METHODS
Consecutive patients undergoing clinically indicated 4DCCT prior to TAVI were prospectively enrolled. 4DCCT-derived left- (LV) and right ventricular (RV), and left atrial (LA) dimensions, mass, ejection fraction (EF) and myocardial strain were evaluated to predict RRM and survival. RRM was defined by either relative increase in LVEF by 5% or relative decline in LV end diastolic diameter (LVEDD) by 5% assessed by transthoracic echocardiography prior TAVI, at discharge, and at 12-month follow-up compared to baseline prior to TAVI.
RESULTS
Among 608 patients included in this study (55 % males, age 81 ± 6.6 years), RRM was observed in 279 (54 %) of 519 patients at discharge and in 218 (48 %) of 453 patients at 12-month echocardiography. While no CCT based measurements predicted RRM at discharge, CCT based LV mass index and LVEF independently predicted RRM at 12-month (ORadj = 1.012; 95 %CI:1.001-1.024; p = 0.046 and ORadj = 0.969; 95 %CI:0.943-0.996; p = 0.024, respectively). The most pronounced changes in LVEF and LVEDD were observed in patients with impaired LV function at baseline. In multivariable analysis age (HRadj = 1.037; 95 %CI:1.005-1.070; p = 0.022) and CCT-based LVEF (HRadj = 0.972; 95 %CI:0.945-0.999; p = 0.048) and LAEF (HRadj = 0.982; 95 %CI:0.968-0.996; p = 0.011) independently predicted survival.
CONCLUSION
Comprehensive myocardial functional information derived from routine 4DCCT in patients with severe aortic stenosis undergoing TAVI could predict reverse remodeling and clinical outcomes at 12-month following TAVI
Wake EEG oscillation dynamics reflect both sleep need and brain maturation across childhood and adolescence.
Get PDFAn objective measure of brain maturation is highly insightful for monitoring both typical and atypical development. Slow wave activity, recorded in the sleep electroencephalogram (EEG), reliably indexes changes in brain plasticity with age, as well as deficits related to developmental disorders such as attention-deficit hyperactivity disorder (ADHD). Unfortunately, measuring sleep EEG is resource-intensive and burdensome for participants. We therefore aimed to determine whether wake EEG could likewise index developmental changes in brain plasticity. We analyzed high-density wake EEG collected from 163 participants 3-25 years old, before and after a night of sleep. We compared two measures of oscillatory EEG activity, amplitudes and density, as well as two measures of aperiodic activity, intercepts and slopes. Furthermore, we compared these measures in patients with ADHD (8-17 y.o., N=58) to neurotypical controls. We found that wake oscillation amplitudes behaved the same as sleep slow wave activity: amplitudes decreased with age, decreased after sleep, and this overnight decrease decreased with age. Oscillation densities were also substantially age-dependent, decreasing overnight in children and increasing overnight in adolescents and adults. While both aperiodic intercepts and slopes decreased linearly with age, intercepts decreased overnight, and slopes increased overnight. Overall, our results indicate that wake oscillation amplitudes track both development and sleep need, and overnight changes in oscillation density reflect some yet-unknown shift in neural activity around puberty. No wake measure showed significant effects of ADHD, thus indicating that wake EEG measures, while easier to record, are not as sensitive as those during sleep
Das war ein Foul! Wie Blickwinkel, Betrachtungsdistanzen und Visualisierungsmethoden die Entscheidungen von Fußballschiedsrichtern beeinflussen
No full textA football referee must choose the right position on the field in order to perceive a foul acurately. In previous research, decision-making for foul calls was compared across different situations within a match or even across different matches, which questions the comparability of decisions that often depend on the situational context. In this study, we experimentally controlled this situational context to investigate the effect of viewing distance and viewing angle on referees’ decision-making. We recreated real-life decision-making situations using markerless tracking devices and virtual reality (VR)
animation processes to render first-person situations. We compared the decision-making accuracy of ten experienced football referees when judging situations from three different viewing angles and distances. Furthermore, we compared their decision-making accuracy in VR scenes with accuracy when viewing the same scenes from a bird’s eye and slow- motion perspective, i.e., with the perspectives
used in official referee training. We found that decision accuracy is not affected by viewing
angles and distances, but that the referee’s decision certainty is lower when viewing the foul situation from a greater distance. The visualization of the situations had an impact on the referee’s decision-making but only for detecting a simulation (i.e., a player acts like they have been fouled). Slow-motion scenes led to higher decision-making accuracy than VR scenes. Our study suggests a way
to recreate VR situations for experimental studies, allowing researchers to control the
context of each situation. Our findings help to disentangle the mixed findings of previous
studies on distance and viewing angle effects on decision accuracies. Finally, we propose
potential avenues to improve VR animation processes in future studies.Ein*e Fußballschiedsrichter*in muss die richtige Position auf dem Spielfeld wählen, um ein Foul korrekt wahrzunehmen. In früheren Studien wurde die Entscheidungsfindung für eine Foulentscheidung über verschiedene Situationen innerhalb eines Spiels oder sogar zwischen verschiedenen Spielen verglichen, was die Vergleichbarkeit der Entscheidungssituationen infrage stellt, da die Situationen vom jeweiligen Kontext abhängen. In der vorliegenden Studie wurde der Kontext jeder Entscheidungssituation experimentell kontrolliert, um die Auswirkungen der Betrachtungsdistanz und des Blickwinkels auf die Entscheidungsrichtigkeit von Schiedsrichtern zu untersuchen. Dazu wurden reale Entscheidungssituationen mithilfe von markerlosem Tracking und Virtual-Reality(VR)-Animationsverfahren nachgestellt, um Situationen in der Egoperspektive darzustellen. Die Entscheidungsrichtigkeiten von 10 erfahrenen Schiedsrichtern bei der Beurteilung der Situationen aus 3 unterschiedlichen Betrachtungswinkeln und -distanzen wurden verglichen. Außerdem erfolgte ein Vergleich der Entscheidungsrichtigkeiten in VR-Szenen mit den gleichen Szenen aus der Vogelperspektive und in Zeitlupe (den beiden in der offiziellen Schiedsrichterausbildung verwendeten Perspektiven). Dabei stellte sich heraus, dass die Entscheidungsrichtigkeiten nicht durch Betrachtungswinkel- und -distanz beeinflusst werden, aber dass die Sicherheit der Schiedsrichterentscheidung geringer ist, wenn die Foulsituation aus einer größeren Entfernung betrachtet wird. Die Visualisierung der Situationen hatte ebenfalls einen Einfluss auf die Schiedsrichterentscheidung, jedoch nur für die Erkennung einer Simulation (d. h., Situationen in denen ein Spieler nur so tut, als ob er gefoult worden wäre). Bei Szenen in Zeitlupe wurde eine höhere Entscheidungsrichtigkeit erkannt als in VR-Szenen. In dieser Arbeit wird vorgeschlagen, wie VR-Situationen für experimentelle Untersuchungen nachgestellt werden können und dabei den Kontext der einzelnen Situationen zu kontrollieren. Die vorliegenden Ergebnisse tragen dazu bei, die gemischten Ergebnisse vorheriger Studien zum Einfluss der Betrachtungsdistanz und des Blickwinkels auf die Entscheidungsrichtigkeit besser zu verstehen. Schließlich werden mögliche Wege zur Verbesserung von VR-Animationsprozessen in zukünftigen Studien vorgeschlagen
Shift in virus composition in honeybees (Apis mellifera) following worldwide invasion by the parasitic mite and virus vector Varroa destructor.
Get PDFInvasive vectors can induce dramatic changes in disease epidemiology. While viral emergence following geographical range expansion of a vector is well known, the influence a vector can have at the level of the host's pathobiome is less well understood. Taking advantage of the formerly heterogeneous spatial distribution of the ectoparasitic mite Varroa destructor that acts as potent virus vector among honeybees Apis mellifera, we investigated the impact of its recent global spread on the viral community of honeybees in a retrospective study of historical samples. We hypothesized that the vector has had an effect on the epidemiology of several bee viruses, potentially altering their transmissibility and/or virulence, and consequently their prevalence, abundance, or both. To test this, we quantified the prevalence and loads of 14 viruses from honeybee samples collected in mite-free and mite-infested populations in four independent geographical regions. The presence of the mite dramatically increased the prevalence and load of deformed wing virus, a cause of unsustainably high colony losses. In addition, several other viruses became more prevalent or were found at higher load in mite-infested areas, including viruses not known to be actively varroa-transmitted, but which may increase opportunistically in varroa-parasitized bees
Nitrogen availability and plant functional composition modify biodiversity-multifunctionality relationships.
No full textBiodiversity typically increases multiple ecosystem functions simultaneously (multifunctionality) but variation in the strength and direction of biodiversity effects between studies suggests context dependency. To determine how different factors modulate the diversity effect on multifunctionality, we established a large grassland experiment manipulating plant species richness, resource addition, functional composition (exploitative vs. conservative species), functional diversity and enemy abundance. We measured ten above- and belowground functions and calculated ecosystem multifunctionality. Species richness and functional diversity both increased multifunctionality, but their effects were context dependent. Richness increased multifunctionality when communities were assembled with fast-growing species. This was because slow species were more redundant in their functional effects, whereas different fast species promoted different functions. Functional diversity also increased multifunctionality but this effect was dampened by nitrogen enrichment and enemy presence. Our study suggests that a shift towards fast-growing communities will not only alter ecosystem functioning but also the strength of biodiversity-functioning relationships
Gut-liver axis: Pathophysiological concepts and medical perspective in chronic liver diseases.
Get PDFAvailability of substance use screening and treatment within HIV clinical sites across seven geographic regions within the IeDEA consortium.
Get PDFBACKGROUND
Overwhelming evidence highlights the negative impact of substance use on HIV care and treatment outcomes. Yet, the extent to which alcohol use disorder (AUD) and other substance use disorders (SUD) services have been integrated within HIV clinical settings is limited. We describe AUD/SUD screening and treatment availability in HIV clinical sites participating in the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium.
METHODS
In 2020, 223 IeDEA HIV clinical sites from 41 countries across seven geographic regions completed a survey on capacity and practices related to management of AUD/ SUD. Sites provided information on AUD and other SUD screening and treatment practices.
RESULTS
Sites were from low-income countries (23%), lower-middle-income countries (38%), upper-middle income countries (17%) and high-income counties (23%). AUD and SUD screening using validated instruments were reported at 32% (n=71 located in 12 countries) and 12% (n=27 located in 6 countries) of the 223 sites from 41 countries, respectively. The North American region had the highest proportion of clinics that reported AUD screening (76%), followed by East Africa (46%); none of the sites in West or Central Africa reported AUD screening. 31% (n=69) reported both AUD screening and counseling, brief intervention, psychotherapy, or Screening, Brief Intervention, and Referral to Treatment; 8% (n=18) reported AUD screening and detox hospitalization; and 10% (n=24) reported both AUD screening and medication. While the proportion of clinics providing treatment for SUD was lower than those treating AUD, the prevalence estimates of treatment availability were similar.
CONCLUSIONS
Availability of screening and treatment for AUD/SUD in HIV care settings is limited, leaving a substantial gap for integration into ongoing HIV care. A critical understanding is needed of the multilevel implementation factors or feasible implementation strategies for integrating screening and treatment of AUD/SUD into HIV care settings, particularly for resource-constrained regions
An RNA replicon system to investigate promising inhibitors of feline coronavirus.
Get PDFFIPV is of great significance in the cat population around the world, causing 0.3%-1.4% of feline deaths in veterinary practices (2). As there are neither effective preventive measures nor approved treatment options available, there is an urgent need to identify antiviral drugs against FIPV. Our FCoV replicon system provides a valuable tool for drug discovery in vitro. Due to the lack of cell culture systems for serotype I FCoVs (the serotype most prevalent in the feline population) (2), a different system is needed to study these viruses. A viral replicon system is a valuable tool for studying FCoVs. Overall, our results demonstrate the utility of the serotype I feline coronavirus replicon system for antiviral screening as well as to study this virus in general. We propose several compounds representing promising candidates for future clinical trials and ultimately with the potential to save cats suffering from FIP
Correlation of CT-based bone mineralization with drilling-force measurements in anatomical specimens is suitable to investigate planning of trans-pedicular spine interventions.
Get PDFThis interdisciplinary study examined the relationship between bone density and drilling forces required during trans-pedicular access to the vertebra using fresh-frozen thoraco-lumbar vertebrae from two female body donors (A, B). Before and after biomechanical examination, samples underwent high-resolution CT-quantification of total bone density followed by software-based evaluation and processing. CT density measurements (n = 4818) were calculated as gray values (GV), which were highest in T12 for both subjects (GVmaxA = 3483.24, GVmaxB = 3160.33). Trans-pedicular drilling forces F (Newton N) were highest in L3 (FmaxB = 5.67 N) and L4 (FmaxA = 5.65 N). In 12 out of 13 specimens, GVs significantly (p < 0.001) correlated with force measurements. Among these, Spearman correlations r were poor in two lumbar vertebrae, fair in five specimens, and moderately strong in another five specimens, and highest for T11 (rA = 0.721) and L5 (rB = 0.690). Our results indicate that CT-based analysis of vertebral bone density acquired in anatomical specimens is a promising approach to predict the drilling force appearance as surrogate parameter of its biomechanical properties by e.g., linear regression analysis. The study may be of value as basis for biomechanical investigations to improve planning of the optimal trajectory and to define safety margins for drilling forces during robotic-assisted trans-pedicular interventions on the spine in the future
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