Teachers' occupational well-being during the COVID-19 pandemic: The role of resources and demands.

During the COVID-19 pandemic, teachers suddenly faced multiple challenges related to closed schools and remote teaching. This study investigated teachers' occupational well-being (stress, exhaustion, job satisfaction) and its relation to job resources (e.g., support from colleagues), job demands (e.g., technical difficulties), and personal resources (e.g., self-efficacy with digital media). 3250 teachers (82.8% female, M age = 40.16) throughout Germany answered an online survey on resources, demands, and occupational well-being. The resource support from colleagues was particularly positively related to job satisfaction and negatively to stress and exhaustion. The results pattern remained mostly stable after including personal resources in the model.

Evaluation of blood flow distribution asymmetry and vascular geometry in patients with Fontan circulation using 4-D flow MRI.

BACKGROUND: Asymmetrical caval to pulmonary blood flow is suspected to cause complications in patients with Fontan circulation. The aim of this study was to test the feasibility of 4-D flow MRI for characterizing the relationship between 3-D blood flow distribution and vascular geometry. OBJECTIVE: We hypothesized that both flow distribution and geometry can be calculated with low interobserver variability and will detect a direct relationship between flow distribution and Fontan geometry. MATERIALS AND METHODS: Four-dimensional flow MRI was acquired in 10 Fontan patients (age: 16 ± 4 years [mean ± standard deviation], range: 9-21 years). The Fontan connection was isolated by 3-D segmentation to evaluate flow distribution from the inferior vena cava (IVC) and superior vena cava (SVC) to the left and right pulmonary arteries (LPA, RPA) and to characterize geometry (cross-sectional area, caval offset, vessel angle). RESULTS: Flow distribution results indicated SVC flow tended toward the RPA while IVC flow was more evenly distributed (SVC to RPA: 78% ± 28 [9-100], IVC to LPA: 54% ± 28 [4-98]). There was a significant relationship between pulmonary artery cross-sectional area and flow distribution (IVC to RPA: R(2)=0.50, P=0.02; SVC to LPA: R(2)=0.81, P=0.0004). Good agreement was found between observers and for flow distribution when compared to net flow values. CONCLUSION: Four-dimensional flow MRI was able to detect relationships between flow distribution and vessel geometry. Future studies are warranted to investigate the potential of patient specific hemodynamic analysis to improve diagnostic capability.

In vitro study to simulate the intracardiac magnetohydrodynamic effect.

PURPOSE: Blood flow causes induced voltages via the magnetohydrodynamic (MHD) effect distorting electrograms (EGMs) made during magnetic resonance imaging. To investigate the MHD effect in this context MHD voltages occurring inside the human heart were simulated in an in vitro model system inside a 1.5 T MR system. METHODS: The model was developed to produce MHD signals similar to those produced by intracardiac flow and to acquire them using standard clinical equipment. Additionally, a new approach to estimate MHD distortions on intracardiac electrograms is proposed based on the analytical calculation of the MHD signal from MR phase contrast data. RESULTS: The recorded MHD signals were similar in magnitude to intracardiac signals that would be measured by an electrogram of the left ventricle. The dependency of MHD signals on magnetic field strength and electrode separation was well reflected by an analytical model. MHD signals reconstructed from MR flow data were in excellent agreement with the MHD signal measured by clinical equipment. CONCLUSION: The in vitro model allows investigation of MHD effects on intracardiac electrograms. A phase contrast MR scan was successfully applied to characterize and estimate the MHD distortion on intracardiac signals allowing correction of these effects.

Influence of eddy current, Maxwell and gradient field corrections on 3D flow visualization of 3D CINE PC-MRI data.

PURPOSE: The measurement of velocities based on phase contrast MRI can be subject to different phase offset errors which can affect the accuracy of velocity data. The purpose of this study was to determine the impact of these inaccuracies and to evaluate different correction strategies on three-dimensional visualization. METHODS: Phase contrast MRI was performed on a 3 T system (Siemens Trio) for in vitro (curved/straight tube models; venc: 0.3 m/s) and in vivo (aorta/intracranial vasculature; venc: 1.5/0.4 m/s) data. For comparison of the impact of different magnetic field gradient designs, in vitro data was additionally acquired on a wide bore 1.5 T system (Siemens Espree). Different correction methods were applied to correct for eddy currents, Maxwell terms, and gradient field inhomogeneities. RESULTS: The application of phase offset correction methods lead to an improvement of three-dimensional particle trace visualization and count. The most pronounced differences were found for in vivo/in vitro data (68%/82% more particle traces) acquired with a low venc (0.3 m/s/0.4 m/s, respectively). In vivo data acquired with high venc (1.5 m/s) showed noticeable but only minor improvement. CONCLUSION: This study suggests that the correction of phase offset errors can be important for a more reliable visualization of particle traces but is strongly dependent on the velocity sensitivity, object geometry, and gradient coil design.

COVID-19 Pandemic and Student Reading Achievement: Findings From a School Panel Study.

Since 2020, the COVID-19 pandemic had an impact on education worldwide. There is increased discussion of possible negative effects on students' learning outcomes and the need for targeted support. We examined fourth graders' reading achievement based on a school panel study, representative on the student level, with N = 111 elementary schools in Germany (total: N = 4,290 students, age: 9-10 years). The students were tested with the Progress in International Reading Literacy Study instruments in 2016 and 2021. The analysis focused on (1) total average differences in reading achievement between 2016 and 2021, (2) average differences controlling for student composition, and (3) changes in achievement gaps between student subgroups (i.e., immigration background, socio-cultural capital, and gender). The methodological approach met international standards for the analysis of large-scale assessments (i.e., multiple multi-level imputation, plausible values, and clustered mixed-effect regression). The results showed a substantial decline in mean reading achievement. The decline corresponds to one-third of a year of learning, even after controlling for changes in student composition. We found no statistically significant changes of achievement gaps between student subgroups, despite numerical tendencies toward a widening of achievement gaps between students with and without immigration background. It is likely that this sharp achievement decline was related to the COVID-19 pandemic. The findings are discussed in terms of further research needs, practical implications for educating current student cohorts, and educational policy decisions regarding actions in crises such as the COVID-19 pandemic.

Three-directional acceleration phase mapping of myocardial function.

An optimized acceleration encoded phase contrast method termed "acceleration phase mapping" for the assessment of regional myocardial function is presented. Based on an efficient gradient waveform design using two-sided encoding for in vivo three-directional acceleration mapping, echo and repetition times TE = 12-14 ms and TR = 15-17 ms for low accelerations sensitivity aenc = 5-8 m/s(2) were achieved. In addition to phantom validation, the technique was applied in a study with 10 healthy volunteers at 1.5T and 3T to evaluate its feasibility to assess regional myocardial acceleration at 1.5T and 3T. Results of the acceleration measurements were compared with the temporal derivative of myocardial velocities from three-directional velocity encoded standard phase contrast MRI in the same volunteers. The feasibility to assess myocardial acceleration along the radial, circumferential, and longitudinal direction of the left ventricle was demonstrated. Despite improved signal-to-noise-ratio at 3T (34% increase compared with 1.5T), image quality with respect to susceptibility artifacts was better 1.5T compared with 3T. Analysis of global and regional left ventricular acceleration showed characteristic patterns of systolic and diastolic acceleration and deceleration. Comparisons of directly measured and derived myocardial acceleration dynamics over the cardiac cycle revealed good correlation (r = 0.45-0.68, P < 0.01) between both methods.

In vivo noninvasive 4D pressure difference mapping in the human aorta: phantom comparison and application in healthy volunteers and patients.

In this work, we present a systematic phantom comparison and clinical application of noninvasive pressure difference mapping in the human aorta based on time-resolved 3D phase contrast data. Relative pressure differences were calculated based on integration and iterative refinement of pressure gradients derived from MR-based three-directional velocity vector fields (flow-sensitive 4D MRI with spatial/temporal resolution ∼ 2.1 mm(3)/40 ms) using the Navier-Stokes equation. After in vitro study using a stenosis phantom, time-resolved 3D pressure gradients were systematically evaluated in the thoracic aorta in a group of 12 healthy subjects and 6 patients after repair for aortic coarctation. Results from the phantom study showed good agreement with expected values and standard methods (Bernoulli). Data of healthy subjects showed good intersubject consistency and good agreement with the literature. In patients, pressure waveforms showed elevated peak values. Pressure gradients across the stenosis were compared with reference measurements from Doppler ultrasound. The MRI findings demonstrated a significant correlation (r = 0.96, P < 0.05) but moderate underestimation (14.7% ± 15.5%) compared with ultrasound when the maximum pressure difference for all possible paths connecting proximal and distal locations of the stenosis were used. This study demonstrates the potential of the applied approach to derive additional quantitative information such as pressure gradients from time-resolved 3D phase contrast MRI.

Bicuspid aortic valve is associated with altered wall shear stress in the ascending aorta.

BACKGROUND: Hemodynamics may play a role contributing to the progression of bicuspid aortic valve (BAV) aortopathy. This study measured the impact of BAV on the distribution of regional aortic wall shear stress (WSS) compared with control cohorts. METHODS AND RESULTS: Local WSS distribution was measured in the thoracic aorta of 60 subjects using 4-dimensional (4D) flow-sensitive magnetic resonance imaging. WSS analysis included 15 BAV patients: 12 with fusion of the right-left coronary cusp (6 stenotic) and 3 with fusion of the right and noncoronary cusp. The right-left BAV cohort was compared with healthy subjects (n=15), age-appropriate subjects (n=15), and age-/aorta size-controlled subjects (n=15). Compared with the age-appropriate and age-/aorta size-matched controls, WSS patterns in the right-left BAV ascending aorta were significantly elevated, independent of stenosis severity (peak WSS=0.9 ± 0.3 N/m(2) compared with 0.4 ± 0.3 N/m(2) in age-/aorta size-controlled subjects; P<0.001). Time-resolved (cine) 2D images of the bicuspid valves were coregistered with 4D flow data, directly linking cusp fusion pattern to a distinct ascending aortic flow jet pattern. The observation of right-anterior ascending aorta wall/jet impingement in right-left BAV patients corresponded to regions with statistically elevated WSS. Alternative jetting patterns were observed in the right and noncoronary cusp fusion patients. CONCLUSIONS: The results of this study demonstrate that bicuspid valves induced significantly altered ascending aorta hemodynamics compared with age- and size-matched controls with tricuspid valves. Specifically, the expression of increased and asymmetric WSS at the aorta wall was related to ascending aortic flow jet patterns, which were influenced by the BAV fusion pattern.

Three-dimensional flow characteristics in ventricular assist devices: impact of valve design and operating conditions.

OBJECTIVE: The use of paracorporeal ventricular assist devices has become a well-established procedure for patients with cardiogenic shock. However, implantation of ventricular assist devices is often associated with severe complications, such as thrombosis inside the ventricular assist device and subsequent embolic events. It was the purpose of this study to use flow-sensitive 4-dimensional magnetic resonance imaging for a detailed analysis of the 3-dimensional (3D) flow dynamics inside a clinical routine ventricular assist device and to study the effect of different system adjustments and a new valve design on flow patterns. METHODS: A routinely used clinical paracorporeal ventricular assist device was integrated into a magnetic resonance-compatible mock loop. Flow-sensitive 3D magnetic resonance imaging was performed to measure time-resolved 3-directional flow velocities (spatial resolution ∼ 1.2 mm, temporal resolution = 42.4 ms) in the entire device under ideal conditions (full fill, full empty, ejection fraction = 88%), insufficient filling (ejection fraction = 81%), and insufficient emptying (ejection fraction = 67%) of the pump chamber. In addition, a new valve design was evaluated. Flexible control and monitoring of pressures at inlet and outlet were used to generate realistic boundary conditions. RESULTS: Flow pattern changes for different operating conditions were clearly identified and included reduced velocities during systolic outflow for impaired filling (78% reduction in pump flow compared with optimal operating conditions) and impaired clearing of the pump chamber for insufficient emptying (52% reduction). For all operating conditions, 3D visualization revealed vortex flow inside the ventricular assist device at typical locations of thrombus formation near the valve systems. Most noticeably, the new valve design provided similar global ventricular assist device function (pump flow 3.6 L/min), but vortex formation was eliminated. CONCLUSIONS: The results of this study provide insight into the mechanisms underlying possible thrombus formation inside a ventricular assist device and the effect of different system adjustments. The presented methods may permit the optimization of future ventricular assist device systems with respect to optimal flow conditions.