Effect of Eicosapentaenoic Acid/Docosahexaenoic Acid on Coronary High-Intensity Plaques Detected Using Noncontrast T1-weighted Imaging: The AQUAMARINE EPA/DHA Randomized Study.

AIM: Omega-3 fatty acids have emerged as a new option for controlling the residual risk for coronary artery disease (CAD) in the statin era. Eicosapentaenoic acid (EPA) is associated with reduced CAD risk in the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention trial, whereas the Statin Residual Risk with Epanova in High Cardiovascular Risk Patients with Hypertriglyceridemia trial that used the combination EPA/docosahexaenoic acid (DHA) has failed to derive any clinical benefit. These contradictory results raise important questions about whether investigating the antiatherosclerotic effect of omega-3 fatty acids could help to understand their significance for CAD-risk reduction. METHODS: The Attempts at Plaque Vulnerability Quantification with Magnetic Resonance Imaging Using Noncontrast T1-weighted Technic EPA/DHA study is a single-center, triple-arm, randomized, controlled, open-label trial used to investigate the effect of EPA/DHA on high-risk coronary plaques after 12 months of treatment, detected using cardiac magnetic resonance (CMR) in patients with CAD receiving statin therapy. Eligible patients were randomly assigned to no-treatment, 2-g/day, and 4-g/day EPA/DHA groups. The primary endpoint was the change in the plaque-to-myocardium signal intensity ratio (PMR) of coronary high-intensity plaques detected by CMR. Coronary plaque assessment using computed tomography angiography (CTA) was also investigated. RESULTS: Overall, 84 patients (mean age: 68.2 years, male: 85%) who achieved low-density lipoprotein cholesterol levels of ＜100 mg/dL were enrolled. The PMR was reduced in each group over 12 months. There were no significant differences in PMR changes among the three groups in the primary analysis or analysis including total lesions. The changes in CTA parameters, including indexes for detecting high-risk features, also did not differ. CONCLUSION: The EPA/DHA therapy of 2 or 4 g/day did not significantly improve the high-risk features of coronary atherosclerotic plaques evaluated using CMR under statin therapy.

Circulating Omega-6, But Not Omega-3 Polyunsaturated Fatty Acids, Are Associated with Clinical Outcomes in Patients with Acute Decompensated Heart Failure.

BACKGROUND: Circulating polyunsaturated fatty acid (PUFA) levels are associated with clinical outcomes in cardiovascular diseases including coronary artery disease and chronic heart failure (HF). However, their clinical implications in acute decompensated HF (ADHF) remain unclear. The aim of this study was to investigate the clinical roles of circulating PUFAs in patients with ADHF. METHODS: Circulating levels of PUFAs, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA) and dihomo-gamma linoleic acid (DGLA), were measured on admission in 685 consecutive ADHF patients. Adverse events were defined as all-cause death and worsening HF. RESULTS: During a median follow-up period of 560 days, 262 (38.2%) patients had adverse events. Although patients with adverse events had lower n-6 PUFA (AA + DGLA) level than those without, n-3 PUFA (EPA + DHA) level was comparable between the groups. Kaplan-Meier analyses showed that lower n-6 PUFA level on admission was significantly associated with the composite of all-cause death and worsening HF, all-cause death, cardiovascular death and worsening HF (p < 0.001, p = 0.005, p = 0.021, p = 0.019, respectively). In a multivariate Cox model, lower n-6 PUFA level was independently associated with increased risk of adverse events (HR 0.996, 95% CI: 0.993-0.999, p = 0.027). CONCLUSIONS: Lower n-6 but not n-3 PUFA level on admission was significantly related to worse clinical outcomes in ADHF patients. Measurement of circulating n-6 PUFA levels on admission might provide information for identifying high risk ADHF patients.

Predictive and sensory integration begins at an early stage of visual processing.

Brain activity was measured by magnetoencephalography to investigate the spatiotemporal stage of visual processing at which predictive and sensory integration begins. We examined the consequences of a visual mismatch between preliminary prediction and incoming stimulus. Following auditory cues (1000- and 1250-Hz tones) for prediction, congruent and incongruent images, pictures of two musical keys, were presented to volunteers. When they predicted visual inputs on the basis of preceding auditory cues, we detected a mismatch signal for predictive-sensory incongruities in the striate and extrastriate areas for 100-200 ms after image presentation. As this signal reflects a compatibility analysis, we propose that the integration process begins in these areas approximately 100 ms after image presentation.

Modulation of early auditory processing by visually based sound prediction.

Brain activity was measured by magnetoencephalography (MEG) to investigate whether the early auditory system can detect changes in audio-visual patterns when the visual part is presented earlier. We hypothesized that a template underlying the mismatch field (MMF) phenomenon, which is usually formed by past sound regularities, is also used in visually based sound prediction. Activity similar to the MMF may be elicited by comparing an incoming sound with the template. The stimulus was modeled after a keyboard: an animation in which one of two keys was depressed was accompanied by either a lower or higher tone. Congruent audio-visual pairs were designed to be frequent and incongruent pairs to be infrequent. Subjects were instructed to predict an incoming sound based on key movement in two sets of trials (prediction condition), whereas they were instructed not to do so in the other two sets (non-prediction condition). For each condition, the movement took 50 ms in one set (Delta = 50 ms) and 300 ms in the other (Delta = 300 ms) to reach the bottom, at which time a tone was delivered. As a result, only under the prediction condition with Delta = 300 ms was additional activity for incongruent pairs observed bilaterally in the supratemporal area within 100-200 ms of the auditory stimulus onset; this activity had spatio-temporal properties similar to those of MMF. We concluded that a template is created by the visually based sound prediction only after the visual discriminative and sound prediction processes have already been performed.

Functional Neuromuscular Stimulation for articular angle control with an Inverse Dynamics Model tuned by a neural network.

A Functional Neuromuscular Stimulation (FNS) system was developed to restore the motor function of people with central nervous system disorders. An FNS articular angle control system with an Inverse Dynamics Model (IDM) tuned by a neural network was proposed. The system was designed to control the elbow joint angles by learning the characteristics of the neuromuscular system of controlled limbs. Three kinds of control schemes using the IDM were proposed. In a simulation experiment, the system was able to learn the abnormal characteristics of a limb and any changes in these characteristics, and then allow for better control of the limb. The results of experiments using human participants showed that the system had ability to control both normal and paralysed limbs.

Improved computed radiography image quality from a BaFl:Eu photostimulable phosphor plate.

Recent advances in the design of photostimulable phosphor (PSP) plates for computed radiography (CR) systems have made it possible to manufacture plates made of BaFI:Eu phosphor material in the cassette form. The image quality of this plate, six BaF(Br,I):Eu plates, and one BaFBr:Eu plate were evaluated in terms of presampling modulation transfer function (MTF), normalized Wiener spectra (WSN), and detective quantum efficiency (DQE). Compared with the best-performing BaF(Br,I):Eu plate, the BaFI:Eu plate provided DQE that was higher, at spatial frequencies of 0.5, 1.0, and 2.0 cycles/mm, by 12% (21.8 versus 19.4), 13% (18.8 versus 16.7), and 11% (12.0 versus 10.8), respectively. Since presampling MTF values of the two plates were comparable, the BaFI:Eu plate's higher DQE is attributable to total WSN conversely being lower by 17% [8.65 x 10(-5) (mm2) versus 10.38 x 10(-5) (mm2)], 17% [5.85 x 10(-5) (mm2) versus 7.03 x 10(-5) (mm2)], and 12% [2.82 x 10(-5) (mm2) versus 3.19 x 10(-5) (mm2)] at the specified frequencies, respectively, primarily due to the contribution of x-ray quantum WSN. This jibes with the high x-ray absorption provided by the 27%-higher x-ray attenuation coefficients (7.54 versus 6.07, at 60 KeV) that BaFI offers over BaF(Br(0.85),I(0.15)), a result of the high atomic number of BaFI's exclusively iodine halide content. The results were consistent with earlier studies of several of these same plates and indicate that BaFI:Eu is a promising avenue to lower image noise and higher overall CR system image quality.