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1.
Am Heart J ; 269: 167-178, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38123045

RESUMO

BACKGROUND: The risks of leaflet thrombosis and the associated cerebral thromboembolism are unknown according to different anticoagulation dosing after transcatheter aortic valve replacement (TAVR). The aim was to evaluate the incidence of leaflet thrombosis and cerebral thromboembolism between low-dose (30 mg) or standard-dose (60 mg) edoxaban and dual antiplatelet therapy (DAPT) after TAVR. METHODS: In this prespecified subgroup analysis of the ADAPT-TAVR trial, the primary endpoint was the incidence of leaflet thrombosis on 4-dimensional computed tomography at 6-months. Key secondary endpoints were new cerebral lesions on brain magnetic resonance imaging and neurological and neurocognitive dysfunction. RESULTS: Of 229 patients enrolled in this study, 118 patients were DAPT group and 111 were edoxaban group (43 [39.1%] 60 mg vs 68 [61.3%] 30 mg). There was a significantly lower incidence of leaflet thrombosis in the standard-dose edoxaban group than in the DAPT group (2.4% vs 18.3%; odds ratio [OR] 0.11; 95% confidence interval [CI], 0.01-0.55; P = .03). However, no significant difference was observed between low-dose edoxaban and DAPT (15.0% vs 18.3%; OR 0.79; 95% CI, 0.32-1.81; P = .58). Irrespective of different antithrombotic regiments, the percentages of patients with new cerebral lesions on brain MRI and worsening neurological or neurocognitive function were not significantly different. CONCLUSIONS: In patients without an indication for anticoagulation after TAVR, the incidence of leaflet thrombosis was significantly lower with standard-dose edoxaban but not with low-dose edoxaban, as compared with DAPT. However, this differential effect of edoxaban on leaflet thrombosis was not associated with a reduction of new cerebral thromboembolism and neurological dysfunction.


Assuntos
Estenose da Valva Aórtica , Piridinas , Tiazóis , Tromboembolia , Trombose , Substituição da Valva Aórtica Transcateter , Humanos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/métodos , Inibidores da Agregação Plaquetária , Valva Aórtica/cirurgia , Resultado do Tratamento , Tromboembolia/epidemiologia , Tromboembolia/etiologia , Tromboembolia/prevenção & controle , Trombose/epidemiologia , Trombose/etiologia , Trombose/prevenção & controle , Anticoagulantes/uso terapêutico , Estenose da Valva Aórtica/complicações
2.
Sensors (Basel) ; 24(11)2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38894125

RESUMO

With the introduction of deep learning, a significant amount of research has been conducted in the field of computer vision in the past decade. In particular, research on object detection (OD) continues to progress rapidly. However, despite these advances, some limitations need to be overcome to enable real-world applications of deep learning-based OD models. One such limitation is inaccurate OD when image quality is poor or a target object is small. The performance degradation phenomenon for small objects is similar to the fundamental limitations of an OD model, such as the constraint of the receptive field, which is a difficult problem to solve using only an OD model. Therefore, OD performance can be hindered by low image quality or small target objects. To address this issue, this study investigates the compatibility of super-resolution (SR) and OD techniques to improve detection, particularly for small objects. We analyze the combination of SR and OD models, classifying them based on architectural characteristics. The experimental results show a substantial improvement when integrating OD detectors with SR models. Overall, it was demonstrated that, when the evaluation metrics (PSNR, SSIM) of the SR models are high, the performance in OD is correspondingly high as well. Especially, evaluations on the MS COCO dataset reveal that the enhancement rate for small objects is 9.4% higher compared to all objects. This work provides an analysis of SR and OD model compatibility, demonstrating the potential benefits of their synergistic combination. The experimental code can be found on our GitHub repository.

3.
Int J Mol Sci ; 25(11)2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38892130

RESUMO

Acetaminophen overdose is a leading cause of acute liver failure (ALF), and effective treatment depends on early prediction of disease progression. ALF diagnosis currently requires blood collection 24-72 h after APAP ingestion, necessitating repeated tests and hospitalization. Here, we assessed earlier ALF diagnosis using positron emission tomography (PET) imaging of translocator proteins (TSPOs), which are involved in molecular transport, oxidative stress, apoptosis, and energy metabolism, with the radiotracer [18F]GE180. We intraperitoneally administered propacetamol hydrochloride to male C57BL/6 mice to induce ALF. We performed in vivo PET/CT imaging 3 h later using the TSPO-specific radiotracer [18F]GE180 and quantitatively analyzed the PET images by determining the averaged standardized uptake value (SUVav) in the liver parenchyma. We assessed liver TSPO expression levels via real-time polymerase chain reaction, Western blotting, and immunohistochemistry. [18F]GE180 PET imaging 3 h after propacetamol administration (1500 mg/kg) significantly increased liver SUVav compared to controls (p = 0.001). Analyses showed a 10-fold and 4-fold increase in TSPO gene and protein expression, respectively, in the liver, 3 h after propacetamol induction compared to controls. [18F]GE180 PET visualized and quantified propacetamol-induced ALF through TSPO overexpression. These findings highlight TSPO PET's potential as a non-invasive imaging biomarker for early-stage ALF.


Assuntos
Acetaminofen , Falência Hepática Aguda , Camundongos Endogâmicos C57BL , Receptores de GABA , Animais , Falência Hepática Aguda/induzido quimicamente , Falência Hepática Aguda/diagnóstico por imagem , Falência Hepática Aguda/metabolismo , Acetaminofen/efeitos adversos , Masculino , Camundongos , Receptores de GABA/metabolismo , Receptores de GABA/genética , Tomografia por Emissão de Pósitrons/métodos , Fígado/metabolismo , Fígado/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Radioisótopos de Flúor , Compostos Radiofarmacêuticos/metabolismo , Modelos Animais de Doenças , Carbazóis
4.
Clin Hypertens ; 30(1): 18, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38946000

RESUMO

BACKGROUND: Police officers face an increased risk of developing cerebro-cardiovascular diseases (CVD). However, current literature lacks population-based cohort studies specifically focusing on this association. This study aimed to investigate the association between police officers and the risk of developing CVD compared with education officers, while accounting for socioeconomic and demographic factors. METHODS: We used the Korean National Health Insurance Service data spanning from 2009 to 2020. In this population-based retrospective matched cohort study, we identified age, sex, and calendar years of job-enrollment-matched education officers for each police officer. This study evaluated the CVD occurrence, including acute myocardial infarction, ischemic stroke, and hemorrhagic stroke. Using multivariable Cox regression analysis, we determined the risk of developing CVD, expressed as a hazard ratio (HR) and 95% confidence interval (CI). RESULTS: Among 104,134 police officers and 104,134 education officers, 4,391(42.2%) cases and 3,631(34.9%) cases of CVD occurred, respectively. The mean ± standard deviation age was 38.4 ± 9.4 years in police officers and 38.6 ± 9.5 years in education officers. The proportion of men was 84.8 % in both groups. Police officers were significantly associated with a higher risk of developing CVD compared with education officers, with an adjusted HR of 1.15 (95% CI, 1.09-1.22). In addition, police officers had significantly higher risks for acute myocardial infarction (adjusted HR, 1.16; 95% CI, 1.06-1.26) and ischemic stroke (adjusted HR, 1.17; 95% CI, 1.09-1.25). CONCLUSIONS: The findings of our study highlight a significant increase in the risk of developing CVD among police officers, particularly among those aged 45 years and older and those with uncontrolled blood pressure compared to their education officer counterparts. Future cohort studies are required to confirm this association.

5.
J Am Heart Assoc ; 13(3): e032272, 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38293966

RESUMO

BACKGROUND: There are limited data on the efficacy and safety of direct oral anticoagulants (DOACs) in patients with atrial fibrillation with significant tricuspid regurgitation (TR), which can lead to hepatic dysfunction and intestinal malabsorption. We aimed to compare the efficacy and safety of DOACs and warfarin for patients with atrial fibrillation with significant (moderate to severe) TR. METHODS AND RESULTS: A total of 1215 patients with significant TR and atrial fibrillation who were treated with warfarin (N=491) or DOACs (N=724) were retrospectively analyzed. The primary outcomes were ischemic stroke, systemic embolic events, and hospitalization for major bleeding. The secondary outcomes were intracranial hemorrhage, hospitalization for gastrointestinal bleeding, all-cause mortality, and a composite outcome. The median follow-up duration was 2.4 years. In the inverse probability treatment weighting-adjusted cohort, DOACs and warfarin had a similar risk for ischemic stroke and systemic embolic events (adjusted hazard ratio [aHR], 0.95 [95% CI, 0.67-1.36]; P=0.79) and major bleeding (aHR, 0.78 [95% CI, 0.57-1.06]; P=0.11). For the secondary outcomes, relative to warfarin, DOACs had a lower risk of intracranial hemorrhage and the composite outcome, and a comparable risk for gastrointestinal bleeding and all-cause mortality. In the subgroup analysis, the effects of DOACs on ischemic stroke and systemic embolic events were comparable to the effects of warfarin, even in patients with inferior vena cava plethora (increased right atrial pressure) or severe TR. CONCLUSIONS: In this study, relative to warfarin, DOACs demonstrated comparable efficacy for ischemic stroke and systemic embolic events and major bleeding, with a lower intracranial hemorrhage risk in patients with significant TR and atrial fibrillation, indicating their effectiveness and safety.


Assuntos
Fibrilação Atrial , Embolia , AVC Isquêmico , Acidente Vascular Cerebral , Insuficiência da Valva Tricúspide , Humanos , Varfarina/efeitos adversos , Fibrilação Atrial/complicações , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/tratamento farmacológico , Inibidores do Fator Xa/uso terapêutico , Anticoagulantes/efeitos adversos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Estudos Retrospectivos , Insuficiência da Valva Tricúspide/complicações , Embolia/epidemiologia , Embolia/etiologia , Embolia/prevenção & controle , AVC Isquêmico/tratamento farmacológico , Hemorragias Intracranianas/induzido quimicamente , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia Gastrointestinal/epidemiologia , Administração Oral
6.
Diagnostics (Basel) ; 14(15)2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39125550

RESUMO

PURPOSE: Therapeutic hypothermia (TH) is widely acknowledged as one of the interventions for preventing hypoxic ischemic brain injury in comatose patients following cardiac arrest (CA). Despite its recognized efficacy, recent debates have questioned its effectiveness. This preclinical study evaluated the impact of TH on brain glucose metabolism, utilizing fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in a rat model of CA. METHODS: Asphyxia CA was induced in Sprague-Dawley rats using vecuronium. Brain PET images using 18F-FDG were obtained from 21 CA rats, who were randomized to receive either TH or no intervention. Of these, 9 rats in the TH group received hypothermia under general anesthesia and mechanical ventilation for eight hours, while the remaining 12 rats in the non-TH group were observed without intervention. We conducted regional and voxel-based analyses of standardized uptake values relative to the pons (SUVRpons) to compare the two groups. RESULTS: Survival rates were identical in both the TH and non-TH groups (67%). There was no discernible difference in the SUVRpons across the brain cortical regions between the groups. However, in a subgroup analysis of the rats that did not survive (n = 7), those in the TH group (n = 3) displayed significantly higher SUVRpons values across most cortical regions compared to those in the non-TH group (n = 4), with statistical significance after false-discovery rate correction (p < 0.05). CONCLUSIONS: The enhancement in SUVRpons due to TH intervention was only observed in the cortical regions of rats with severe encephalopathy that subsequently died. These findings suggest that the beneficial effects of TH on brain glucose metabolism in this asphyxia CA model may be confined to cases of severe ischemic encephalopathy.

7.
Cardiovasc Intervent Radiol ; 47(2): 200-207, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38151603

RESUMO

PURPOSE: To evaluate the relationship between prospectively generated ablative margin estimates and local tumor progression (LTP) among patients undergoing microwave ablation (MWA) of small renal masses (SRMs). MATERIALS AND METHODS: Between 2017 and 2020, patients who underwent MWA for SRM were retrospectively identified. During each procedure, segmented kidney and tumor shapes were coregistered with intraprocedural helical CT images obtained after microwave antenna placement. Predicted ablation zone shape and size were then overlaid onto the resultant model, and a model-to-model distance algorithm was employed to calculate multiple ablative margin estimates. LTP was modeled as a function of each margin estimate by hazard regression. Models were evaluated using hazard ratios and Akaike information criterion. Receiver operating characteristic curve area under the curve was also estimated using Harrell's and Uno's C indices (HI and UI, respectively). RESULTS: One hundred and twenty-eight patients were evaluated (median age 72.1 years). Mean tumor diameter was 2.4 ± 0.9 cm. LTP was observed in nine (7%) patients. Analysis showed that decreased estimated margin size as measured by first quartile (Q1; 25th percentile), maximum, and average ablative margin metrics was significantly associated with risk of LTP. For every one millimeter increase in Q1, maximum, and mean ablative margin, the hazard of LTP increased 67% (HR: 1.67; 95% CI = 1.25-2.20, UI = 0.93, HI = 0.77), 32% (HR: 1.32; 95% CI 1.09-1.60; UI = 0.93; HI = 0.76), and 48% (HR: 1.48; 95% CI 1.18-1.85; UI = 0.83; HI = 0.75), respectively. CONCLUSION: Prospectively generated ablative margin estimates can be used to predict the risk of local tumor progression following microwave ablation of small renal masses. LEVEL OF EVIDENCE 3: Retrospective cohort study.


Assuntos
Ablação por Cateter , Neoplasias Hepáticas , Humanos , Idoso , Neoplasias Hepáticas/cirurgia , Estudos Retrospectivos , Estudos Prospectivos , Micro-Ondas/uso terapêutico , Resultado do Tratamento , Ablação por Cateter/métodos
8.
Clin Nucl Med ; 49(5): 427-433, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38467577

RESUMO

PURPOSE: The aim of this study was to assess the diagnostic performance of perfusion-only SPECT/CT (Q SPECT/CT) in comparison with that of ventilation/perfusion planar scintigraphy (V/Q planar), perfusion SPECT with ventilation scan (V/Q SPECT), and perfusion SPECT/CT with ventilation scan (V/Q SPECT/CT) in chronic thromboembolic pulmonary hypertension (CTEPH). PATIENTS AND METHODS: Patients with pulmonary hypertension who underwent ventilation-perfusion planar and SPECT/CT were retrospectively recruited. Two nuclear medicine physicians interpreted V/Q planar, V/Q SPECT, V/Q SPECT/CT, and Q SPECT/CT according to the European Association of Nuclear Medicine criteria. The diagnostic accuracy of these modalities for CTEPH was compared using a composite reference standard of pulmonary angiography, imaging test, cardiorespiratory assessment, and follow-up. RESULTS: A total of 192 patients were enrolled, including 85 with CTEPH. The sensitivity of Q SPECT/CT was 98.8%, which similar to that of V/Q planar (97.6%), V/Q SPECT (96.5%), or V/Q SPECT/CT (100.0%). In contrast, Q SPECT/CT exhibited significantly lower specificity (73.8%) compared with V/Q planar (86.9%, P = 0.001), V/Q SPECT (87.9%, P < 0.001), and V/Q SPECT/CT (88.8%, P < 0.001). The significantly lower specificity of Q SPECT/CT, compared with the 3 others, was observed in the subgroup aged ≥50 years ( P < 0.001 for all), but not in those <50 years. CONCLUSIONS: Q SPECT/CT exhibited lower specificity compared with V/Q planar, V/Q SPECT, and V/Q SPECT/CT in diagnosing CTEPH. It might underscore the essential role of a ventilation scan in patients with PH, even with the introduction of SPECT/CT.


Assuntos
Hipertensão Pulmonar , Embolia Pulmonar , Humanos , Hipertensão Pulmonar/complicações , Hipertensão Pulmonar/diagnóstico por imagem , Estudos Retrospectivos , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico por imagem , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Perfusão
9.
J Clin Hypertens (Greenwich) ; 26(5): 532-542, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38552166

RESUMO

This study evaluated an oscillometric device (OD), Microlife WatchBP Office AFIB, and a hybrid manual auscultatory device (AD), Greenlight 300TM, to determine a suitable blood pressure (BP) measurement device for the Korea National Health and Nutrition Examination Survey in a mercury-free context. Adhering to the 2018 Universal Standard's suggested consensus, the study involved 800 subjects (mean age 51.2 ± 17.5 years; 44.3% male), who underwent triplicate BP measurements following 5 min of rest in a randomized order (OD-first: 398 participants; AD-first: 402 participants). BP difference was calculated as OD value minus AD value, with results stratified by measurement sequence. The overall BP difference and tolerable error probability were -1.1 ± 6.5/-2.6 ± 4.9 mmHg and 89.2%/92.5% for systolic/diastolic BP (SBP/DBP), respectively. Lin's concordance correlation coefficient was 0.907/0.844 for SBP/DBP (OD-first/AD-first: 0.925/0.892 for SBP, 0.842/0.845 for DBP). The overall agreement for hypertension (BP ≥ 140 and/or 90 mmHg) was 0.71 (p < 0.0001), and the OD underestimated the overall hypertension prevalence by 5.1%. Analysis of the AD-first data revealed a lower level of agreement compared to the OD-first data; however, the observed blood pressure difference adhered to Criterion 1 of the 2018 Universal Standard. Microlife met the Criterion 1 of 2018 Universal Standard but underestimated the prevalence of hypertension. The BP discrepancy increased with higher BP levels, male sex, and smaller AC. With increasing age, the discrepancy decreased for SBP and increased for DBP.


Assuntos
Auscultação , Determinação da Pressão Arterial , Inquéritos Nutricionais , Oscilometria , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , República da Coreia/epidemiologia , Inquéritos Nutricionais/métodos , Determinação da Pressão Arterial/métodos , Determinação da Pressão Arterial/instrumentação , Determinação da Pressão Arterial/estatística & dados numéricos , Adulto , Oscilometria/instrumentação , Oscilometria/métodos , Idoso , Auscultação/métodos , Auscultação/instrumentação , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Pressão Sanguínea/fisiologia , Reprodutibilidade dos Testes
10.
Nucl Med Mol Imaging ; 58(5): 291-299, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39036460

RESUMO

Purpose: We aimed to investigate the response to balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) using semi-quantitative analysis of lung perfusion SPECT/CT. Methods: This is a single-center retrospective study of patients with CTEPH who underwent BPA and pre- and post-BPA lung perfusion SPECT/CT between 2015 and 2022. Segmental defects on SPECT/CT were visually assessed and semi-quantitatively scored as 1 (large defect) or 0.5 (moderate defect) in accordance with modified PIOPED II criteria. The perfusion defect score was defined as (Σ segmental defect scores/18) × 100 (%). Associations between perfusion defect score and hemodynamic or functional parameters including WHO functional class, six-minute walking distance (6MWD), serum B-type natriuretic peptide (BNP), mean arterial pulmonary pressure (mPAP), pulmonary vascular resistance (PVR), and tricuspid regurgitation pressure gradient (TRPG) on echocardiography were statistically analyzed. Results: A total of 24 consecutive patients were included. The perfusion defect score significantly improved after BPA (median 58.3% vs. 47.2%, P < 0.001), in conjunction with the WHO functional class, 6MWD, serum BNP, mPAP, and TRPG. Perfusion defect scores were significantly correlated with 6MWD (rho = - 0.583, P < 0.001), serum BNP (rho = 0.514, P < 0.001), mPAP (rho = 0.583, P < 0.001), and PVR (rho = 0.575, P < 0.001). The improvement in the perfusion defect score was significantly associated with improvement in mPAP (rho = 0.844, P < 0.001). Conclusion: Our results suggest that semi-quantitative analysis of lung perfusion SPECT/CT can provide a potential imaging biomarker for monitoring the efficacy of BPA. Supplementary Information: The online version contains supplementary material available at 10.1007/s13139-024-00858-1.

11.
Clin Res Cardiol ; 113(8): 1242-1250, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38446148

RESUMO

BACKGROUND: Left atrial thrombus (LAT) formation is associated with thromboembolic events. OBJECTIVE: To investigate the incidence and associated factors of LAT in patients with atrial fibrillation (AF) who had been receiving anticoagulation therapy for more than 4 weeks, and to develop a prediction model using clinical and echocardiographic features. METHODS: Medical records of 1,122 patients with AF (mean age, 59.4 ± 11.0 years, 58.3% male) who were on anticoagulation more than 4 weeks and underwent transesophageal echocardiography (TEE) were evaluated. The main outcome was the presence of LAT on TEE. RESULTS: Warfarin and non-vitamin K oral anticoagulants were used in 74.4% and 25.6% of the patients at the time of examination, respectively. LAT was present in 60 patients (5.3%). Presence of LAT on TEE was associated with age ≥ 75 years (odds ratio [OR] 2.13 [95% confidence interval, 0.94-4.58]), persistent/permanent AF (OR 2.61 [1.42-4.93]), CHA2DS2-VASc score ≥ 3 points (OR 1.91 [1.05-3.48]), left ventricular ejection fraction < 40% (OR 2.35 [1.07-4.81]), and severe left atrial enlargement (OR 3.52 [1.89-6.79]). The presence of moderate-to-severe mitral regurgitation was associated with a lower risk of LAT (OR 0.13 [0.04-0.34]). A scoring system composed of the aforementioned predictors showed excellent discrimination performance (area under the curve 0.791 [95% CI, 0.727-0.854]). CONCLUSIONS: LAT was present in a considerable number of patients who were already receiving anticoagulation therapy. A prediction model that combines clinical and echocardiographic predictors could be useful in distinguishing patients who require imaging evaluations before left atrial intervention.


Assuntos
Anticoagulantes , Fibrilação Atrial , Ecocardiografia Transesofagiana , Átrios do Coração , Trombose , Humanos , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/complicações , Fibrilação Atrial/epidemiologia , Masculino , Feminino , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Pessoa de Meia-Idade , Incidência , Trombose/epidemiologia , Trombose/etiologia , Trombose/prevenção & controle , Trombose/diagnóstico , Idoso , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Fatores de Risco , Estudos Retrospectivos , Cardiopatias/epidemiologia , Cardiopatias/diagnóstico , Medição de Risco/métodos
12.
Biosens Bioelectron ; 260: 116446, 2024 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-38820722

RESUMO

Understanding brain function is essential for advancing our comprehension of human cognition, behavior, and neurological disorders. Magnetic resonance imaging (MRI) stands out as a powerful tool for exploring brain function, providing detailed insights into its structure and physiology. Combining MRI technology with electrophysiological recording system can enhance the comprehension of brain functionality through synergistic effects. However, the integration of neural implants with MRI technology presents challenges because of its strong electromagnetic (EM) energy during MRI scans. Therefore, MRI-compatible neural implants should facilitate detailed investigation of neural activities and brain functions in real-time in high resolution, without compromising patient safety and imaging quality. Here, we introduce the fully MRI-compatible monolayer open-mesh pristine PEDOT:PSS neural interface. This approach addresses the challenges encountered while using traditional metal-based electrodes in the MRI environment such as induced heat or imaging artifacts. PEDOT:PSS has a diamagnetic property with low electrical conductivity and negative magnetic susceptibility similar to human tissues. Furthermore, by adopting the optimized open-mesh structure, the induced currents generated by EM energy are significantly diminished, leading to optimized MRI compatibility. Through simulations and experiments, our PEDOT:PSS-based open-mesh electrodes showed improved performance in reducing heat generation and eliminating imaging artifacts in an MRI environment. The electrophysiological recording capability was also validated by measuring the local field potential (LFP) from the somatosensory cortex with an in vivo experiment. The development of neural implants with maximized MRI compatibility indicates the possibility of potential tools for future neural diagnostics.


Assuntos
Encéfalo , Imageamento por Ressonância Magnética , Polímeros , Imageamento por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Humanos , Animais , Polímeros/química , Técnicas Biossensoriais/métodos , Poliestirenos/química , Eletrodos Implantados , Compostos Bicíclicos Heterocíclicos com Pontes/química , Tiofenos/química , Desenho de Equipamento , Condutividade Elétrica
13.
JACC Cardiovasc Interv ; 16(24): 2967-2981, 2023 Dec 25.
Artigo em Inglês | MEDLINE | ID: mdl-38151311

RESUMO

BACKGROUND: Subclinical aortic valve complex (valvular and perivalvular) thrombus is not rare after transcatheter aortic valve replacement (TAVR). The risk factors and clinical implications of these findings remain uncertain. OBJECTIVES: This study sought to evaluate the frequency, predictors, and clinical outcome of aortic valve complex thrombus after TAVR. METHODS: In the ADAPT-TAVR (Anticoagulation Versus Dual Antiplatelet Therapy for Prevention of Leaflet Thrombosis and Cerebral Embolization After Transcatheter Aortic Valve Replacement) trial comparing edoxaban vs dual antiplatelet therapy in TAVR patients without an indication for chronic anticoagulation, the frequency of valvular (subclinical leaflet thrombus) and perivalvular (supravalvular, subvalvular, and sinus of Valsalva) thrombus was evaluated by 4-dimensional computed tomography at 6 months. The association of these phenomena with new cerebral thromboembolism on brain magnetic resonance imaging, neurologic and neurocognitive dysfunction, and clinical outcomes was assessed. RESULTS: Among 211 patients with 6-month computed tomography evaluations, 91 patients (43.1%) had thrombus at any aortic valve complex, 30 (14.2%) patients had leaflet thrombus, and 78 (37.0%) patients had perivalvular thrombus. A small maximum diameter of the stent at the valve level and low body surface area were independent predictors of aortic valve complex and perivalvular thrombus, and decreased renal function was an independent predictor of leaflet thrombus. No significant differences were observed in new cerebral lesions, neurologic or neurocognitive functions, or clinical outcomes among patients with or without valvular or perivalvular thrombus. CONCLUSIONS: Subclinical aortic valve complex (valvular and perivalvular) thrombus was common in patients who had undergone successful TAVR. However, these imaging phenomena were not associated with new cerebral thromboembolism, neurologic or neurocognitive dysfunction, or adverse clinical outcomes. (Anticoagulation Versus Dual Antiplatelet Therapy for Prevention of Leaflet Thrombosis and Cerebral Embolization After Transcatheter Aortic Valve Replacement [ADAPT-TAVR]; NCT03284827).


Assuntos
Estenose da Valva Aórtica , Próteses Valvulares Cardíacas , Tromboembolia , Trombose , Substituição da Valva Aórtica Transcateter , Humanos , Anticoagulantes/uso terapêutico , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Valva Aórtica/patologia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Tomografia Computadorizada Quadridimensional/efeitos adversos , Próteses Valvulares Cardíacas/efeitos adversos , Inibidores da Agregação Plaquetária , Fatores de Risco , Tromboembolia/etiologia , Trombose/diagnóstico por imagem , Trombose/etiologia , Trombose/prevenção & controle , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/métodos , Resultado do Tratamento
16.
Rev. bras. med. esporte ; 29: e2022_0511, 2023. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1423349

RESUMO

ABSTRACT Introduction The current teaching mode of table tennis in China is satisfactory, but there are still some problems that are the focus of physical education teachers, such as the low efficiency of sports training. Objective Study the effect of abdominal core training on table tennis teaching. Methods Volunteers trained in table tennis at a physical education college were divided into the experimental and control group. Before and after the beginning of the experiment, table tennis students' physical indices and overall physical scores were obtained under a parameterized protocol. Results The overall score of the experimental group resulted from 7.355 (± 1.827) to 9.072 (± 1.992) before training, and the mean difference was 1.2581 points (P < 0.05), indicating a significant difference. The control group score increased from 7.606 (± 1.937) to 7.989 (± 1.440) before training, and the mean difference was 0.1976, P > 0.05, indicating no significant difference. Conclusion Compared with the current way of teaching table tennis, the scheme proposed in this paper showed better sports efficiency and could help students to improve their physical quality and sports ability. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.


RESUMO Introdução O atual modo de ensino do tênis de mesa na China é satisfatório, mas ainda existem alguns problemas que são o foco dos professores de educação física, como a baixa eficiência do treinamento esportivo. Objetivo Estudar o efeito do treinamento do centro abdominal no ensino do tênis de mesa. Métodos Voluntários formados em tênis de mesa em uma faculdade de educação física foram divididos em grupo experimental e de controle. Antes e depois do início da experiência, foram obtidos os índices físicos dos alunos de tênis de mesa e a pontuação física geral sob um protocolo parametrizado. Resultados A pontuação geral do grupo experimental resultou em 7,355 (± 1,827) para 9,072 (± 1,992) antes do treinamento, e a diferença média foi de 1,2581 pontos (P < 0,05), indicando uma diferença significativa. A pontuação do grupo de controle aumentou de 7,606 (± 1,937) para 7,989 (± 1,440) antes do treinamento, sendo a diferença média de 0,1976, P > 0,05, indicando que não houve diferença significativa. Conclusão Em comparação com o atual modo de ensino do tênis de mesa, o esquema proposto neste trabalho apresentou melhor eficiência esportiva podendo ajudar os estudantes a melhorar a sua qualidade física e habilidade esportiva. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción El modo de enseñanza actual del tenis de mesa en China es satisfactorio, pero todavía hay algunos problemas que son el centro de atención de los profesores de educación física, como la baja eficiencia del entrenamiento deportivo. Objetivo Estudiar el efecto del entrenamiento del núcleo abdominal en la enseñanza del tenis de mesa. Métodos Los voluntarios entrenados en tenis de mesa en una escuela de educación física se dividieron en grupo experimental y grupo de control. Antes y después del inicio del experimento, se obtuvieron los índices físicos de los alumnos de tenis de mesa y la puntuación física global bajo un protocolo parametrizado. Resultados La puntuación global del grupo experimental pasó de 7,355 (± 1,827) a 9,072 (± 1,992) antes del entrenamiento, y la diferencia media fue de 1,2581 puntos (P < 0,05), lo que indica una diferencia significativa. La puntuación del grupo de control aumentó de 7,606 (± 1,937) a 7,989 (± 1,440) antes del entrenamiento, y la diferencia media fue de 0,1976, P > 0,05, lo que indica que no hubo diferencias significativas. Conclusión En comparación con la forma actual de enseñar el tenis de mesa, el esquema propuesto en este trabajo presentaba una mayor eficacia deportiva y podía ayudar a los alumnos a mejorar su calidad física y su capacidad deportiva. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

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