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1.
Scand J Public Health ; : 14034948231195388, 2023 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-37646484

RESUMO

AIMS: Because media portrayal reflects and shapes public opinion and health policy, investigating news coverage of public health issues is highly relevant for public health research and practice. Addressing a topical issue, this study investigated how newspaper coverage framed COVID-19 vaccines in Austria and German-speaking Switzerland and how it developed over time. METHODS: A quantitative newspaper content analysis of six newspapers from Austria and German-speaking Switzerland published between January 1 and 31, 2022 was conducted. Frames were identified for each country separately through hierarchical cluster analysis (Ward's method) based on frame elements. RESULTS: Four frames were identified in both countries: (1) Evaluating new vaccines, (2) Discussing mandates, (3) Promoting vaccination, (4) Mentioning vaccines. In Frames 1 (Switzerland 86.4%, Austria 93.3%) and 3 (Switzerland 92.7%, Austria 98.9%), most articles included vaccine-endorsing statements, with Swiss coverage including additional negative statements more often than Austrian coverage (43.2%/44.6% vs 4.0%/3.3%). Frame 2 was closely linked to vaccine skepticism only in Austria and contained more evaluative statements in Austrian newspapers (25.4% endorsing, 35.4% rejecting; in Switzerland 14.5%/18.1%). The Austrian tabloid Kronen Zeitung published most articles (497/1091, 45.6%). CONCLUSIONS: The commercialized and comparatively high share of tabloid news coverage in Austria may have contributed to oversimplified and polarizing COVID-19 vaccine debates in this context. Insufficiently balanced and adequate information may contribute to a loss of public trust in vaccination and may therefore affect vaccination uptake. Authorities and public health professionals should consider this effect when designing information campaigns.

2.
BMC Public Health ; 21(1): 1671, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521378

RESUMO

BACKGROUND: Healthcare workers are considered key stakeholders in efforts to address vaccine hesitancy. Midwives' influence in advising expectant parents on early-childhood vaccinations is unquestioned, yet they remain an understudied group. The literature on midwives' attitudes towards vaccinations is also inconclusive. We therefore conducted an explorative qualitative study on midwives' vaccine-hesitant attitudes towards MMR (measles-mumps-rubella) vaccinations in Austria. METHODS: We conducted 12 in-depth interviews on their knowledge, concerns, and beliefs with midwives who self-identified as hesitant or resistant towards early-childhood MMR vaccinations. We analyzed the data using a grounded theory approach to distill common themes and meanings. RESULTS: Healthcare workers' stewardship to address vaccine hesitancy is commonly framed in terms of the "information deficit model": disseminate the right information and remedy publics' information deficits. Our findings suggest that this approach is too simplistic: Midwives' professional self-understanding, their notions of "good care" and "good parenthood" inflect how they engage with vaccine information and how they address it to their clients. Midwives' model of care prioritized good counseling rather than sharing scientific information in a "right the wrong"-manner. They saw themselves as critical consumers of that information and as promoting "empowered patients" who were free, and affluent enough, to make their own choices about vaccinations. In so doing, they also often promoted traditional notions of motherhood. CONCLUSIONS: Research shows that, for parents, vaccine decision-making builds on trust and dialogue with healthcare professionals and is more than a technical issue. In order to foster these interactions, understanding healthcare professionals' means of engaging with information is key to understanding how they engage with their constituents. Healthcare workers are more than neutral resources; their daily praxis influenced by their professional standing in the healthcare system. Similarly, healthcare professionals' views on vaccinations cannot be remedied with more information either. Building better and more diverse curricula for different groups of healthcare workers must attend to their respective roles, ethics of care, and professional beliefs. Taken together, better models for addressing vaccine hesitancy can only be developed by espousing a multi-faceted view of decision-making processes and interactions of healthcare workers with constituents.


Assuntos
Tocologia , Vacinas , Áustria , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Gravidez , Pesquisa Qualitativa , Vacinação
3.
Neuroimage ; 215: 116857, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-32304885

RESUMO

Feedback signaling the success or failure of actions is readily exploited to implement goal-directed behavior. Two event-related brain potentials (ERPs) have been identified as reliable markers of evaluative feedback processing: the Feedback-Related Negativity (FRN) and the P3. Recent ERP studies have shown a substantial reduction of these components when the feedback's goal relevance (in terms of goal informativeness) was decreased. However, it remains unclear whether this lowering of evaluative feedback processing at the FRN and P3 levels (i) reflects a common regulation process operating across them or (ii) indirectly and mostly depends on valence processing. To address these questions, 44 participants performed a time estimation task wherein the perceived goal relevance of the feedback following each decision was manipulated via instructions in different blocks. We recorded 64-channel EEG and collected subjective ratings of feedback valence and relevance, separately for goal-relevant and irrelevant conditions. ERP results showed a substantial reduction of the FRN and P3 components for irrelevant than relevant feedback, despite the balanced task relevance between them. Moreover, a Principal Component Analysis (PCA) showed that these two successive ERP effects had dissociable spatiotemporal properties. Crucially, a multivariate multiple regression analysis revealed that goal relevance per se, but not valence, was the unique significant predictor of the amplitude reduction of the FRN and P3 when the feedback was goal irrelevant. Our results suggest that although these ERP components exhibit non-overlapping spatiotemporal properties and performance monitoring effects, they can both be modulated by a common, valence-unspecific process related to goal relevance.


Assuntos
Antecipação Psicológica/fisiologia , Biorretroalimentação Psicológica/fisiologia , Encéfalo/fisiologia , Potenciais Evocados/fisiologia , Objetivos , Motivação/fisiologia , Adolescente , Adulto , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Estimulação Luminosa/métodos , Adulto Jovem
4.
Cogn Affect Behav Neurosci ; 20(2): 236-249, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32043206

RESUMO

In a previous study (Paul & Pourtois, 2017), we found that positive mood substantially influenced the neural processing of reward, mostly by altering expectations and creating an optimistic bias. Under positive mood, the Reward Positivity (RewP) component and fronto-medial theta activity (FMθ) in response to monetary feedback were both changed compared with neutral mood. Nevertheless, whether positive valence per se or motivational intensity drove these neurophysiological effects remained unclear. To address this question, we combined a mindset manipulation with an imagery procedure to create and maintain three different affective states using a between-subjects design: a neutral mood, and positive mood with either high or low motivational intensity. After mood induction, 161 participants performed a simple gambling task while 64-channel EEG was recorded. FMθ activity results showed that irrespective of motivational intensity, positive compared with neutral mood altered reward expectancy. By comparison, RewP was not affected by positive mood nor motivational intensity. These results suggest that positive mood, rather than motivational intensity, is likely driving the change in reward expectation during gambling, which could reflect the presence of an optimistic bias. Moreover, at the methodological level, they confirm that the RewP ERP component and FMθ activity can capture dissociable effects during reward processing.


Assuntos
Afeto/fisiologia , Retroalimentação Psicológica/fisiologia , Motivação/fisiologia , Recompensa , Adulto , Antecipação Psicológica/fisiologia , Encéfalo/fisiologia , Eletroencefalografia/métodos , Potenciais Evocados/fisiologia , Feminino , Jogo de Azar , Humanos , Masculino , Adulto Jovem
5.
Mol Psychiatry ; 24(5): 746-756, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-29422521

RESUMO

Functional magnetic resonance imaging (fMRI) successfully disentangled neuronal pathophysiology of major depression (MD), but only a few fMRI studies have investigated correlates and predictors of remission. Moreover, most studies have used clinical outcome parameters from two time points, which do not optimally depict differential response times. Therefore, we aimed to detect neuronal correlates of response and remission in an antidepressant treatment study with 7 T fMRI, potentially harnessing advances in detection power and spatial specificity. Moreover, we modeled outcome parameters from multiple study visits during a 12-week antidepressant fMRI study in 26 acute (aMD) patients compared to 36 stable remitted (rMD) patients and 33 healthy control subjects (HC). During an electrical painful stimulation task, significantly higher baseline activity in aMD compared to HC and rMD in the medial thalamic nuclei of the pulvinar was detected (p = 0.004, FWE-corrected), which was reduced by treatment. Moreover, clinical response followed a sigmoid function with a plateau phase in the beginning, a rapid decline and a further plateau at treatment end. By modeling the dynamic speed of response with fMRI-data, perigenual anterior cingulate activity after treatment was significantly associated with antidepressant response (p < 0.001, FWE-corrected). Temporoparietal junction (TPJ) baseline activity significantly predicted non-remission after 2 antidepressant trials (p = 0.005, FWE-corrected). The results underline the importance of the medial thalamus, attention networks in MD and antidepressant treatment. Moreover, by using a sigmoid model, this study provides a novel method to analyze the dynamic nature of response and remission for future trials.


Assuntos
Depressão/diagnóstico por imagem , Transtorno Depressivo Maior/diagnóstico por imagem , Pulvinar/diagnóstico por imagem , Adulto , Antidepressivos/uso terapêutico , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Depressão/tratamento farmacológico , Depressão/fisiopatologia , Transtorno Depressivo Maior/tratamento farmacológico , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Núcleo Mediodorsal do Tálamo/fisiopatologia , Dor/fisiopatologia , Pulvinar/fisiopatologia , Tálamo/fisiopatologia , Adulto Jovem
6.
Mol Psychiatry ; 24(5): 772, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29520037

RESUMO

The author list was presented as last name, first name. The names should have been listed as:Christoph Kraus, Manfred Klöbl, Martin Tik, Bastian Auer, Thomas Vanicek, Nicole Geissberger, Daniela M. Pfabigan, Andreas Hahn, Michael Woletz, Katharina Paul, Arkadiusz Komorowski, Siegfried Kasper, Christian Windischberger, Claus Lamm, Rupert Lanzenberger.

7.
Int J Neuropsychopharmacol ; 22(8): 513-522, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31175352

RESUMO

BACKGROUND: Studies investigating hippocampal volume changes after treatment with serotonergic antidepressants in patients with major depressive disorder yielded inconsistent results, and effects on hippocampal subfields are unclear. METHODS: To detail treatment effects on total hippocampal and subfield volumes, we conducted an open-label study with escitalopram followed by venlafaxine upon nonresponse in 20 unmedicated patients with major depressive disorder. Before and after 12 weeks treatment, we measured total hippocampal formation volumes and subfield volumes with ultra-high field (7 Tesla), T1-weighted, structural magnetic resonance imaging, and FreeSurfer. Twenty-eight remitted patients and 22 healthy subjects were included as controls. We hypothesized to detect increased volumes after treatment in major depressive disorder. RESULTS: We did not detect treatment-related changes of total hippocampal or subfield volumes in patients with major depressive disorder. Secondary results indicated that the control group of untreated, stable remitted patients, compared with healthy controls, had larger volumes of the right hippocampal-amygdaloid transition area and right fissure at both measurement time points. Depressed patients exhibited larger volumes of the right subiculum compared with healthy controls at MRI-2. Exploratory data analyses indicated lower baseline volumes in the subgroup of remitting (n = 10) vs nonremitting (n = 10) acute patients. CONCLUSIONS: The results demonstrate that monoaminergic antidepressant treatment in major depressive disorder patients was not associated with volume changes in hippocampal subfields. Studies with larger sample sizes to detect smaller effects as well as other imaging modalities are needed to further assess the impact of antidepressant treatment on hippocampal subfields.


Assuntos
Afeto/efeitos dos fármacos , Antidepressivos de Segunda Geração/uso terapêutico , Citalopram/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Hipocampo/efeitos dos fármacos , Imageamento por Ressonância Magnética , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico , Cloridrato de Venlafaxina/uso terapêutico , Adolescente , Adulto , Áustria , Transtorno Depressivo Maior/diagnóstico por imagem , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Substituição de Medicamentos , Feminino , Hipocampo/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Indução de Remissão , Resultado do Tratamento , Adulto Jovem
8.
Neuroimage ; 168: 383-391, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28108394

RESUMO

Functional neuroimaging of the human amygdala has been of great interest to uncover the neural underpinnings of emotions, mood, motivation, social cognition, and decision making, as well as their dysfunction in psychiatric disorders. Yet, several factors limit in vivo imaging of amygdalar function, most importantly its location deep within the temporal lobe adjacent to air-filled cavities that cause magnetic field inhomogeneities entailing signal dropouts. Additionally, the amygdala and the extended amygdalar region consist of several substructures, which have been assigned different functions and have important implications for functional and effective connectivity studies. Here we show that high-resolution ultra-high field fMRI at 7T can be used to overcome these fundamental challenges for acquisition and can meet some of the demands posed by the complex neuroanatomy and -physiology in this region. Utilizing the inherently high SNR, we use an optimized preprocessing and data analysis strategy to demonstrate that imaging of the (extended) amygdala is highly reliable and robust. Using unsmoothed single-subject data allowed us to differentiate brain activation during processing of emotional faces in the central and basolateral amygdala and, for the first time, in the bed nucleus of the stria terminalis (BNST), which is critically involved in the neural mechanisms of anxiety and threat monitoring. We also provide a quantitative assessment of single subject sensitivity, which is relevant for connectivity studies that rely on time course extraction of functionally-defined volumes of interest.


Assuntos
Tonsila do Cerebelo/diagnóstico por imagem , Emoções/fisiologia , Expressão Facial , Reconhecimento Facial/fisiologia , Neuroimagem Funcional/métodos , Imageamento por Ressonância Magnética/métodos , Núcleos Septais/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
9.
NMR Biomed ; 31(3)2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29315932

RESUMO

Diffusion-weighted imaging (DWI) provides information on tissue microstructure. Single-shot echo planar imaging (EPI) is the most common technique for DWI applications in the brain, but is prone to geometric distortions and signal voids. Rapid acquisition with relaxation enhancement [RARE, also known as fast spin echo (FSE)] imaging presents a valuable alternative to DWI with high anatomical accuracy. This work proposes a multi-shot diffusion-weighted RARE-EPI hybrid pulse sequence, combining the anatomical integrity of RARE with the imaging speed and radiofrequency (RF) power deposition advantage of EPI. The anatomical integrity of RARE-EPI was demonstrated and quantified by center of gravity analysis for both morphological images and diffusion-weighted acquisitions in phantom and in vivo experiments at 3.0 T and 7.0 T. The results indicate that half of the RARE echoes in the echo train can be replaced by EPI echoes whilst maintaining anatomical accuracy. The reduced RF power deposition of RARE-EPI enabled multiband RF pulses facilitating simultaneous multi-slice imaging. This study shows that diffusion-weighted RARE-EPI has the capability to acquire high fidelity, distortion-free images of the eye and the orbit. It is shown that RARE-EPI maintains the immunity to B0 inhomogeneities reported for RARE imaging. This benefit can be exploited for the assessment of ocular masses and pathological changes of the eye and the orbit.


Assuntos
Imagem de Difusão por Ressonância Magnética , Imagem Ecoplanar , Olho/anatomia & histologia , Órbita/anatomia & histologia , Adulto , Encéfalo/anatomia & histologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Imagens de Fantasmas
10.
Sociol Health Illn ; 40(1): 67-81, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28718520

RESUMO

This article presents two cases of policymaking concerning the vaccine against Human Papilloma Virus (HPV), which is sexually transmitted and carcinogenic. Our analysis focuses on its introduction in Austria and the Netherlands. In both contexts, we find prevention and screening to be at once complementary and competing public health logics and we draw on the concept of 'infrastructure' to understand their roles in shaping the reception of the vaccine. We reveal how the HPV vaccine had to be made 'good enough', much like the Pap smear (Casper and Clarke ), by means of diverse tinkering practices that transformed both the technology and the infrastructures in which they emerged. At the same time, it was important that the vaccine would not come to problematise Pap smear-based screening. The article points to the contextually contingent nature of policymaking around new medical technologies, and the skillful care with which public health infrastructures such as immunisation and screening programmes are handled and tinkered with.


Assuntos
Implementação de Plano de Saúde/métodos , Vacinas contra Papillomavirus/administração & dosagem , Saúde Pública , Áustria , Feminino , Implementação de Plano de Saúde/organização & administração , Humanos , Entrevistas como Assunto , Masculino , Países Baixos , Neoplasias do Colo do Útero/prevenção & controle , Vacinação/métodos
11.
Cogn Affect Behav Neurosci ; 17(1): 106-123, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27639697

RESUMO

Goal-adaptive behavior requires the rapid detection of conflicts between actions and intentions or goals. Although many studies have focused in the past on the influence of negative affect on this cognitive control process (and more specifically, on error monitoring), little is known about the possible modulatory effects of positive affect on it. To address this question, we used a standard (positive) mood induction procedure (based on guided imagery) and asked participants to carry out a speeded go/no-go task while high-density electroencephalography was recorded concurrently. As a control condition, we used a group with neutral mood. Event-related potential results showed that the error-related negativity (ERN) component, reflecting early error detection within the dorsal anterior cingulate cortex, was not influenced by happy mood. In contrast, the subsequent error positivity (Pe) component, related to the appraisal of the motivational significance of errors, was reliably smaller in the happy than in the neutral mood group. Complementing source localization analyses showed that this effect was explained by decreased activation within the posterior cingulate and insular cortices. These results were obtained in the absence of group differences regarding behavioral performance and tonic arousal. These findings suggest that happy mood likely decreases and changes the motivational significance of worse-than-expected events (Pe), while leaving their earlier automatic detection (ERN) unaltered. We discuss these new results in terms of dynamic changes in the complex interplay of performance monitoring with motivation.


Assuntos
Afeto/fisiologia , Encéfalo/fisiologia , Função Executiva/fisiologia , Felicidade , Motivação/fisiologia , Análise de Variância , Eletroencefalografia , Potenciais Evocados , Feminino , Resposta Galvânica da Pele/fisiologia , Humanos , Inibição Psicológica , Masculino , Atividade Motora/fisiologia , Testes Neuropsicológicos , Distribuição Aleatória , Percepção Visual/fisiologia , Adulto Jovem
12.
Magn Reson Med ; 78(4): 1533-1546, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-27851881

RESUMO

PURPOSE: Proton radiation therapy (PRT) is a standard treatment of uveal melanoma. PRT patients undergo implantation of ocular tantalum markers (OTMs) for treatment planning. Ultra-high-field MRI is a promising technique for 3D tumor visualization and PRT planning. This work examines MR safety and compatibility of OTMs at 7.0 Tesla. METHODS: MR safety assessment included deflection angle measurements (DAMs), electromagnetic field (EMF) simulations for specific absorption rate (SAR) estimation, and temperature simulations for examining radiofrequency heating using a bow-tie dipole antenna for transmission. MR compatibility was assessed by susceptibility artifacts in agarose, ex vivo pig eyes, and in an ex vivo tumor eye using gradient echo and fast spin-echo imaging. RESULTS: DAM (α < 1 °) demonstrated no risk attributed to magnetically induced OTM deflection. EMF simulations showed that an OTM can be approximated by a disk, demonstrated the need for averaging masses of mave = 0.01 g to accommodate the OTM, and provided SAR0.01g,maximum = 2.64 W/kg (Pin = 1W) in OTM presence. A transfer function was derived, enabling SAR0.01g estimation for individual patient scenarios without the OTM being integrated. Thermal simulations revealed minor OTM-related temperature increase (δT < 15 mK). Susceptibility artifact size (<8 mm) and location suggest no restrictions for MRI of the nervus opticus. CONCLUSION: OTMs are not a per se contraindication for MRI. Magn Reson Med 78:1533-1546, 2017. © 2016 International Society for Magnetic Resonance in Medicine.


Assuntos
Imageamento por Ressonância Magnética/métodos , Melanoma/diagnóstico por imagem , Melanoma/radioterapia , Terapia com Prótons/normas , Tantálio/análise , Neoplasias Uveais/diagnóstico por imagem , Neoplasias Uveais/radioterapia , Animais , Temperatura Alta , Humanos , Segurança do Paciente , Imagens de Fantasmas , Terapia com Prótons/métodos , Suínos , Tantálio/química
15.
Magn Reson Med ; 75(6): 2553-65, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26183320

RESUMO

PURPOSE: To design, evaluate, and apply a bow tie antenna transceiver radiofrequency (RF) coil array tailored for cardiac MRI at 7.0 Tesla (T). METHODS: The radiofrequency (RF) coil array comprises 16 building blocks each containing a bow tie shaped λ/2-dipole antenna. Numerical simulations were used for transmission field homogenization and RF safety validation. RF characteristics were examined in a phantom study. The array's suitability for high spatial resolution two-dimensional (2D) CINE imaging and for real time imaging of the heart was examined in a volunteer study. RESULTS: The arrays transmission fields and RF characteristics are suitable for cardiac MRI at 7.0T. The coil performance afforded a spatial resolution as good as (0.8 × 0.8 × 2.5) mm(3) for segmented 2D CINE MRI at 7.0T which is by a factor of 12 superior versus standardized protocols used in clinical practice at 1.5T. The proposed transceiver array supports 1D acceleration factors of up to R = 6 without impairing image quality significantly. CONCLUSION: The 16-channel bow tie antenna transceiver array supports accelerated and high spatial resolution cardiac MRI. The array is compatible with multichannel transmission and provides a technological basis for future clinical assessment of parallel transmission techniques at 7.0 Tesla. Magn Reson Med 75:2553-2565, 2016. © 2015 Wiley Periodicals, Inc.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Imagem Cinética por Ressonância Magnética/instrumentação , Imagem Cinética por Ressonância Magnética/métodos , Processamento de Sinais Assistido por Computador/instrumentação , Adulto , Desenho de Equipamento , Feminino , Coração/diagnóstico por imagem , Humanos , Masculino , Imagens de Fantasmas , Razão Sinal-Ruído , Transdutores , Adulto Jovem
16.
NMR Biomed ; 29(9): 1173-97, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-25706103

RESUMO

The objective of this study was to document and review advances and groundbreaking progress in cardiac and body MR at ultrahigh fields (UHF, B0 ≥ 7.0 T) with the goal to attract talent, clinical adopters, collaborations and resources to the biomedical and diagnostic imaging communities. This review surveys traits, advantages and challenges of cardiac and body MR at 7.0 T. The considerations run the gamut from technical advances to clinical opportunities. Key concepts, emerging technologies, practical considerations, frontier applications and future directions of UHF body and cardiac MR are provided. Examples of UHF cardiac and body imaging strategies are demonstrated. Their added value over the kindred counterparts at lower fields is explored along with an outline of research promises. The achievements of cardiac and body UHF-MR are powerful motivators and enablers, since extra speed, signal and imaging capabilities may be invested to overcome the fundamental constraints that continue to hamper traditional cardiac and body MR applications. If practical obstacles, concomitant physics effects and technical impediments can be overcome in equal measure, sophisticated cardiac and body UHF-MR will help to open the door to new MRI and MRS approaches for basic research and clinical science, with the lessons learned at 7.0 T being transferred into broad clinical use including diagnostics and therapy guiding at lower fields. Copyright © 2015 John Wiley & Sons, Ltd.


Assuntos
Técnicas de Imagem Cardíaca/instrumentação , Aumento da Imagem/instrumentação , Interpretação de Imagem Assistida por Computador/instrumentação , Imageamento por Ressonância Magnética/instrumentação , Processamento de Sinais Assistido por Computador/instrumentação , Imagem Corporal Total/instrumentação , Algoritmos , Técnicas de Imagem Cardíaca/métodos , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Campos Magnéticos , Imageamento por Ressonância Magnética/métodos , Doses de Radiação , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Imagem Corporal Total/métodos
17.
Int J Hyperthermia ; 32(1): 63-75, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26708630

RESUMO

Clinically established thermal therapies such as thermoablative approaches or adjuvant hyperthermia treatment rely on accurate thermal dose information for the evaluation and adaptation of the thermal therapy. Intratumoural temperature measurements have been correlated successfully with clinical end points. Magnetic resonance imaging is the most suitable technique for non-invasive thermometry avoiding complications related to invasive temperature measurements. Since the advent of MR thermometry two decades ago, numerous MR thermometry techniques have been developed, continuously increasing accuracy and robustness for in vivo applications. While this progress was primarily focused on relative temperature mapping, current and future efforts will likely close the gap towards quantitative temperature readings. These efforts are essential to benchmark thermal therapy efficiency, to understand temperature-related biophysical and physiological processes and to use these insights to set new landmarks for diagnostic and therapeutic applications. With that in mind, this review summarises and discusses advances in MR thermometry, providing practical considerations, pitfalls and technical obstacles constraining temperature measurement accuracy, spatial and temporal resolution in vivo. Established approaches and current trends in thermal therapy hardware are surveyed with respect to potential benefits for MR thermometry.


Assuntos
Hipertermia Induzida , Espectroscopia de Ressonância Magnética , Termometria/métodos , Humanos , Neoplasias/terapia , Termometria/instrumentação
18.
BMC Nephrol ; 17(1): 59, 2016 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-27286816

RESUMO

BACKGROUND: Diabetes mellitus (DM) is the leading cause of end-stage renal disease. Little is known about practice patterns of anti-diabetic therapy in the presence of chronic kidney disease (CKD) and correlates with glycaemic control. We therefore aimed to analyze current antidiabetic treatment and correlates of metabolic control in a large contemporary prospective cohort of patients with diabetes and CKD. METHODS: The German Chronic Kidney Disease (GCKD) study enrolled 5217 patients aged 18-74 years with an estimated glomerular filtration rate (eGFR) between 30-60 mL/min/1.73 m(2) or proteinuria >0.5 g/d. The use of diet prescription, oral anti-diabetic medication, and insulin was assessed at baseline. HbA1c, measured centrally, was the main outcome measure. RESULTS: At baseline, DM was present in 1842 patients (35 %) and the median HbA1C was 7.0 % (25(th)-75(th) percentile: 6.8-7.9 %), equalling 53 mmol/mol (51, 63); 24.2 % of patients received dietary treatment only, 25.5 % oral antidiabetic drugs but not insulin, 8.4 % oral antidiabetic drugs with insulin, and 41.8 % insulin alone. Metformin was used by 18.8 %. Factors associated with an HbA1C level >7.0 % (53 mmol/mol) were higher BMI (OR = 1.04 per increase of 1 kg/m(2), 95 % CI 1.02-1.06), hemoglobin (OR = 1.11 per increase of 1 g/dL, 95 % CI 1.04-1.18), treatment with insulin alone (OR = 5.63, 95 % CI 4.26-7.45) or in combination with oral antidiabetic agents (OR = 4.23, 95 % CI 2.77-6.46) but not monotherapy with metformin, DPP-4 inhibitors, or glinides. CONCLUSIONS: Within the GCKD cohort of patients with CKD stage 3 or overt proteinuria, antidiabetic treatment patterns were highly variable with a remarkably high proportion of more than 50 % receiving insulin-based therapies. Metabolic control was overall satisfactory, but insulin use was associated with higher HbA1C levels.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus/tratamento farmacológico , Índice Glicêmico/efeitos dos fármacos , Hipoglicemiantes/uso terapêutico , Insuficiência Renal Crônica/tratamento farmacológico , Adulto , Idoso , Glicemia/metabolismo , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Feminino , Alemanha/epidemiologia , Hemoglobinas Glicadas/metabolismo , Índice Glicêmico/fisiologia , Humanos , Hipoglicemiantes/farmacologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/epidemiologia , Estatística como Assunto
19.
Hum Brain Mapp ; 36(2): 744-55, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25324216

RESUMO

OBJECTIVES: Anticipatory processes prepare the organism for upcoming experiences. The aim of this study was to investigate neural responses related to anticipation and processing of painful stimuli occurring with different levels of uncertainty. EXPERIMENTAL DESIGN: Twenty-five participants (13 females) took part in an electroencephalography and functional magnetic resonance imaging (fMRI) experiment at separate times. A visual cue announced the occurrence of an electrical painful or nonpainful stimulus, delivered with certainty or uncertainty (50% chance), at some point during the following 15 s. PRINCIPAL OBSERVATIONS: During the first 2 s of the anticipation phase, a strong effect of uncertainty was reflected in a pronounced frontal stimulus-preceding negativity (SPN) and increased fMRI activation in higher visual processing areas. In the last 2 s before stimulus delivery, we observed stimulus-specific preparatory processes indicated by a centroparietal SPN and posterior insula activation that was most pronounced for the certain pain condition. Uncertain anticipation was associated with attentional control processes. During stimulation, the results revealed that unexpected painful stimuli produced the strongest activation in the affective pain processing network and a more pronounced offset-P2. CONCLUSIONS: Our results reflect that during early anticipation uncertainty is strongly associated with affective mechanisms and seems to be a more salient event compared to certain anticipation. During the last 2 s before stimulation, attentional control mechanisms are initiated related to the increased salience of uncertainty. Furthermore, stimulus-specific preparatory mechanisms during certain anticipation also shaped the response to stimulation, underlining the adaptive value of stimulus-targeted preparatory activity which is less likely when facing an uncertain event.


Assuntos
Antecipação Psicológica/fisiologia , Encéfalo/fisiopatologia , Dor/fisiopatologia , Incerteza , Adulto , Mapeamento Encefálico , Sinais (Psicologia) , Estimulação Elétrica , Eletroencefalografia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/fisiopatologia , Estimulação Luminosa , Percepção Visual/fisiologia , Adulto Jovem
20.
Neuroimage ; 96: 12-21, 2014 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-24718288

RESUMO

The anticipation of favourable or unfavourable events is a key component in our daily life. However, the temporal dynamics of anticipation processes in relation to brain activation are still not fully understood. A modified version of the monetary incentive delay task was administered during separate functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG) sessions in the same 25 participants to assess anticipatory processes with a multi-modal neuroimaging set-up. During fMRI, gain and loss anticipation were both associated with heightened activation in ventral striatum and reward-related areas. EEG revealed most pronounced P300 amplitudes for gain anticipation, whereas CNV amplitudes distinguished neutral from gain and loss anticipation. Importantly, P300, but not CNV amplitudes, were correlated to neural activation in the ventral striatum for both gain and loss anticipation. Larger P300 amplitudes indicated higher ventral striatum blood oxygen level dependent (BOLD) response. Early stimulus evaluation processes indexed by EEG seem to be positively related to higher activation levels in the ventral striatum, indexed by fMRI, which are usually associated with reward processing. The current results, however, point towards a more general motivational mechanism processing salient stimuli during anticipation.


Assuntos
Atenção/fisiologia , Eletroencefalografia/métodos , Potenciais Evocados P300/fisiologia , Imageamento por Ressonância Magnética/métodos , Motivação/fisiologia , Recompensa , Estriado Ventral/fisiologia , Adulto , Antecipação Psicológica/fisiologia , Mapeamento Encefálico/métodos , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
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