Templeadcock9555
Percutaneous coronary intervention (PCI) in stable coronary artery disease (CAD) is commonly triggered by abnormal myocardial perfusion imaging (MPI). However, due to the possibilities of multivessel disease, serial stenoses and variability of coronary artery perfusion distribution, an opportunity exists to better align anatomic stenosis with perfusion abnormalities to improve revascularization decisions. This study aims to develop a multi-modality fusion approach to assist decision-making for PCI.
Coronary arteries from fluoroscopic angiography (FA) were reconstructed into 3D artery anatomy. Left ventricular (LV) epicardial surface was extracted from SPECT. The artery anatomy and epicardial surface were non-rigidly fused. The accuracy of the 3D fusion was evaluated via both computer simulation and real patient data. Simulated FA and MPI were integrated and then compared with the ground truth from a digital phantom. The distance-based mismatch errors between simulated fluoroscopy and phantom arteries were 1.86 ± 1.43mm for left coronary arteries (LCA) and 2.21 ± 2.50mm for right coronary arteries (RCA). FA and SPECT images in 30 patients were integrated and then compared with the ground truth from CT angiograms. The distance-based mismatch errors between the fluoroscopy and CT arteries were 3.84 ± 3.15mm for LCA and 5.55 ± 3.64mm for RCA. The presence of the corresponding fluoroscopy and CT arteries in the AHA-17-segment model agreed well with a Kappa value of 0.91 (CI 0.89-0.93) for LCA and a Kappa value of 0.80 (CI 0.67-0.92) for RCA.
Our fusion approach is technically accurate to assist PCI decision-making and is clinically feasible to be used in the catheterization laboratory. Future studies are necessary to determine if fusion improves PCI-related outcomes.
Our fusion approach is technically accurate to assist PCI decision-making and is clinically feasible to be used in the catheterization laboratory. Ilomastat cell line Future studies are necessary to determine if fusion improves PCI-related outcomes.Cardiac risk assessment prior to liver transplantation has become widely accepted. With the emergence of nonalcoholic steatohepatitis among the leading causes of end-stage liver disease and the steady rise of the age of liver transplant recipients, the burden of cardiovascular diseases has markedly increased in this population. Selecting appropriate liver transplant candidates is crucial due to the increasing demand for scarce donor organs. The use of noninvasive cardiac imaging for pre-operative assessment of the cardiovascular status of liver transplant recipients has been on the rise, yet the optimal assessment strategy remains an area of active debate. In this review, we examine the relevant literature pertaining to the diagnostic and prognostic applications of noninvasive cardiac imaging in this population. We also propose a simple literature-based evaluation algorithm for CAD surveillance in liver transplant candidates.
There is currently no treatment for attenuating progression of arterial calcification.
F-sodium fluoride positron emission tomography (
F-NaF PET) locates regions of calcification activity. We tested whether vitamin-K
or colchicine affected arterial calcification activity.
154 patients with diabetes mellitus and coronary calcification, as detected using computed tomography (CT), were randomized to one of four treatment groups (placebo/placebo, vitamin-K
[10mg/day]/placebo, colchicine [0.5mg/day]/placebo, vitamin-K
[10mg/day]/ colchicine [0.5mg/day]) in a double-blind, placebo-controlled 2x2 factorial trial of three months duration. Change in coronary calcification activity was estimated as a change in coronary maximum tissue-to-background ratio (TBRmax) on
F-NaF PET.
149 subjects completed follow-up (vitamin-K
placebo = 7376 and colchicine placebo = 7376). Neither vitamin-K
nor colchicine had a statistically significant effect on the coronary TBRmax compared with placebo (mean difference for treatment groups 0·00 ± 0·16 and 0·01 ± 0·17, respectively, p > 0.05). There were no serious adverse effects reported with colchicine or vitamin-K
.
In patients with type 2 diabetes, neither vitamin-K
nor colchicine significantly decreases coronary calcification activity, as estimated by
F-NaF PET, over a period of 3months.
ACTRN12616000024448.
ACTRN12616000024448.
Attenuation correction (AC) using hardware and software solutions has been shown to increase the specificity of SPECT MPI by decreasing false positive results and improving prognostic ability. Theoretically this should reduce downstream testing and unnecessary costs. We sought to assess the consequences of the use of Gd-153 scanning line source attenuation correction during SPECT myocardial perfusion imaging (MPI) on downstream invasive testing.
All patients who underwent a clinically indicated Tc-99m stress SPECT MPI study from 2013 to 2015 at five hospitals (2 with AC and 3 without) were retrospectively reviewed. Patient demographics, results of testing, subsequent coronary angiography within 3 months, and revascularization were recorded. The results of the MPI studies, downstream angiogram utilization, and results of angiography were compared and a propensity matched subgroup analysis was performed.
A total of 9968 patients underwent SPECT MPI during the study time period (6106 performed with AC and l MPI results or downstream invasive testing in this cohort. The clinical utility of scanning line source AC may be limited to facilitating stress-first imaging protocols.
According to the World Health Organization, discrepancies in health statistics reflect unequal access to resources. The Truth and Reconciliation Commission of Canada calls for an increase in the number of Indigenous workers within health and social services. The involvement of local community workers is essential to ensure the cultural security of care and the decolonization of services. This article presents the role played by these workers in the expansion of mental health services and social interventions in Nunavik, the contextual considerations that influence their practice and their place within professional teams.
A thematic analysis was conducted on semi-structured interviews done in 2016 with 60 Inuit and non-Inuit individuals working in the broad field of health and social services in Nunavik.
The integration of local community workers is perceived to bring several benefits, including the improvement of interventions and unique learning opportunities. However, several factors hinder this collaboration, such as clarity of mandates, access to pre-requisite training and diplomas, recognition of local knowledge, and staff turnover. More flexibility and support after hiring would allow for the service structure to be adapted to the complex reality of Nunavik.
This article adds to the body of literature highlighting the importance of collaboration with local community workers. The decolonization of services necessarily involves redesigning structures in order to recognize their contribution and to give a place to local knowledge.
This article adds to the body of literature highlighting the importance of collaboration with local community workers. The decolonization of services necessarily involves redesigning structures in order to recognize their contribution and to give a place to local knowledge.
Compared with the general population, people living with dementia have been unequivocally affected by the COVID-19 pandemic. However, there is a paucity of knowledge on the COVID-19 impact on people with dementia and their care partners. The objective of this scoping review was to synthesize the existing literature on the COVID-19 experiences of people with dementia and their care partners.
Following Arksey and O'Malley's scoping review framework, we searched five electronic databases (Scopus, PubMed, CINAHL, EMBASE, and Web of Science) and an online search engine (Google Scholar). Inclusion criteria consisted of English-language articles focusing on the COVID-19 experiences of people with dementia and their care partners.
Twenty-one articles met our inclusion criteria six letters to the editor, seven commentaries, and eight original research studies. In the literature, five main themes were identified (i) care partner fatigue and burnout; (ii) lack of access to services and supports; (iii) worsening neuropsychiatric symptoms and cognitive function; (iv) coping with COVID-19; and (v) the need for more evidence-informed research. Factors such as living alone, having advanced dementia, and the length of confinement were found to exacerbate the impact of COVID-19.
Urgent action is needed to support people living with dementia and their care partners in the pandemic. With little access to supports and services, people with dementia and their care partners are currently at a point of crisis. Collaboration and more evidence-informed research are critical to reducing mortality and supporting people with dementia during the pandemic.
Urgent action is needed to support people living with dementia and their care partners in the pandemic. With little access to supports and services, people with dementia and their care partners are currently at a point of crisis. Collaboration and more evidence-informed research are critical to reducing mortality and supporting people with dementia during the pandemic.Online data collection is being used more and more, especially in the face of the COVID crisis. To examine the quality of such data, we chose to replicate lexical decision and item recognition paradigms from Ratcliff et al. (Cognitive Psychology, 60, 127-157, 2010) and numerosity discrimination paradigms from Ratcliff and McKoon (Psychological Review, 125, 183-217, 2018) with subjects recruited from Amazon Mechanical Turk (AMT). Along with these tasks, we collected data from either an IQ test or a math computation test. Subjects in the lexical decision and item recognition tasks were relatively well-behaved, with only a few giving a significant number of responses with response times (RTs) under 300 ms at chance accuracy, i.e., fast guesses, and a few with unstable RTs across a session. But in the numerosity discrimination tasks, almost half of the subjects gave a significant number of fast guesses and/or unstable RTs across the session. Diffusion model parameters were largely consistent with the earlier studies as were correlations across tasks and correlations with IQ and age. One surprising result was that eliminating fast outliers from subjects with highly variable RTs (those eliminated from the main analyses) produced diffusion model analyses that showed patterns of correlations similar to the subjects with stable performance. Methods for displaying data to examine stability, eliminating subjects, and implementing RT data collection on AMT including checks on timing are also discussed.This paper presents the FACSHuman software program, a tool for creating facial expression materials (pictures and videos) based on the Facial Action Coding System (FACS) developed by Ekman et al. (2002). FACSHuman allows almost all the Action Units (AUs) described in the FACS Manual to be manipulated through a three-dimensional modeling software interface. Four experiments were conducted to evaluate facial expressions of emotion generated by the software and their theoretical efficiency regarding the FACS. The first study (a categorization task of facial emotions such as happiness, anger, etc.) showed that 85% of generated pictures of emotional expressions were correctly categorized. The second study showed that only 82% of the most-used AUs were correctly matched. In the third experiment, two independent FACS coders rated 47 AUs generated by FACSHuman using the standard methodology used in this kind of task (AU identification). Results showed good-to-excellent codification rates (64% and 85%). In the last experiment, 54 combinations of AU were evaluated by the same FACS coders.
