Assessment of carotid atherosclerotic disease using three-dimensional cardiovascular magnetic resonance vessel wall imaging: comparison with digital subtraction angiography.

BACKGROUND:A three-dimensional (3D) cardiovascular magnetic resonance (CMR) vessel wall imaging (VWI) technique based on 3D T1 weighted (T1w) Sampling Perfection with Application-optimized Contrast using different flip angle Evolutions (SPACE) has recently been used as a promising CMR imaging modality for evaluating extra-cranial and intra-cranial vessel walls. However, this technique is yet to be validated against the current diagnostic imaging standard. We therefore aimed to evaluate the diagnostic performance of 3D CMR VWI in characterizing carotid disease using intra-arterial digital subtraction angiography (DSA) as a reference. METHODS:Consecutive patients with at least unilateral > 50% carotid stenosis on ultrasound were scheduled to undergo interventional therapy were invited to participate. The following metrics were measured using 3D CMR VWI and DSA: lumen diameter of the common carotid artery (CCA) and segments C1-C7, stenosis diameter, reference diameter, lesion length, stenosis degree, and ulceration. We assessed the diagnostic sensitivity, specificity, accuracy, and receiver operating characteristic (ROC) curve of 3D CMR VWI, and used Cohen's kappa, the intraclass correlation coefficient (ICC), and Bland-Altman analyses to assess the diagnostic agreement between 3D CMR VWI and DSA. RESULTS:The ICC (all ICCs ≥0.96) and Bland-Altman plots indicated excellent inter-reader agreement in all individual morphologic measurements by 3D CMR VWI. Excellent agreement in all individual morphologic measurements were also found between 3D CMR VWI and DSA. In addition, 3D CMR VWI had high sensitivity (98.4, 97.4, 80.0, 100.0%), specificity (100.0, 94.5, 99.1, 98.0%), and Cohen's kappa (0.99, 0.89, 0.84, 0.96) for detecting stenosis > 50%, stenosis > 70%, ulceration, and total occlusion, respectively, using DSA as the standard. The AUC of 3D CMR VWI for predicting stenosis > 50 and > 70% were 0.998 and 0.999, respectively. CONCLUSIONS:The 3D CMR VWI technique enables accurate diagnosis and luminal feature assessment of carotid artery atherosclerosis, suggesting that this imaging modality may be useful for routine imaging workups and provide comprehensive information for both the vessel wall and lumen

Spectrum of malignancies among the population of adults living with HIV infection in China: A nationwide follow-up study, 2008-2011.

BackgroundAlthough increasingly studied in high-income countries, there is a paucity of data from the Chinese population on the patterns of cancer among people living with HIV (PLHIV).MethodsWe conducted a nationwide follow-up study using routinely collected data for adult PLHIV diagnosed on or before 31 December 2011 and alive and in care as of 1 January 2008. Participants were observed from 1 January 2008 (study start) to 30 June 2012 (study end). Main outcome measures were gender-stratified age-standardized incidence rates for China (ASIRC) and standardized incidence ratios (SIR) for all malignancy types/sites observed.ResultsAmong 399,451 subjects, a majority was aged 30-44 years (49.3%), male (69.8%), and Han Chinese (67.9%). A total of 3,819 reports of cancer were identified. Overall, ASIRC was 776.4 per 100,000 for males and 486.5 per 100,000 for females. Malignancy sites/types with highest ASIRC among males were lung (226.0 per 100,000), liver (145.7 per 100,000), and lymphoma (63.1 per 100,000), and among females were lung (66.8 per 100,000), lymphoma (48.0 per 100,000), stomach (47.8 per 100,000), and cervix (47.6 per 100,000). Overall SIR for males was 3.4 and for females was 2.6. Highest SIR was observed for Kaposi sarcoma (2,639.8 for males, 1,593.5 for females) and lymphoma (13.9 for males, 16.0 for females).ConclusionsThese results provide evidence of substantial AIDS-defining and non-AIDS-defining cancer burden among adult Chinese PLHIV between 2008 and 2011. Although further study is warranted, China should take action to improve cancer screening, diagnosis, and treatment for this vulnerable population

‘In the interest of your bank and our country’: two encounters between China and the International Chamber of Commerce

This article examines China’s path to joining the International Chamber of Commerce (ICC), a private international organization founded in Paris in 1920, of which China was a member from 1931–1949 and from 1994 onwards. The article charts the actors and debates behind two meaningful encounters. The first took place while the Nanjing government was raising funds for economic reconstruction, and the ICC aimed to mediate China’s fundraising efforts through private multilateral channels. The second was in the 1980s, when the People’s Republic was seeking to enter the world trade system. ICC members acted as educators and facilitators of world trade practicalities for the People’s Republic, which eventually rejoined the ICC in 1994. The article draws on Chinese, European, and American source material collected from governments, chambers of commerce, and private businessmen to make a twofold contribution. First, it adds nuance to the narrative of China’s economic internationalization by identifying an important non-governmental diplomatic channel. Second, it questions the ICC’s self-proclaimed identity as a non-political economic organization by showing how the political was indissociable from the economic when it came to China’s membership

Assessing bilateral ankle proprioceptive acuity in stroke survivors:An exploratory study

BACKGROUND: Bilateral proprioception deficits were reported in stroke survivors. However, whether bilateral proprioception deficits exist in the ankle joint after stroke was unclear. Ankle proprioception is a significant predictor of balance dysfunction after stroke, and previous studies to date are lacking appropriate evaluation methods. OBJECTIVES: We want to determine whether the active movement extent discrimination apparatus (AMEDA) is a reliable tool for assessing ankle proprioceptive acuity in stroke survivors and the presence of deficits in ankle proprioception on the affected and unaffected sides in patients after stroke. METHODS: Bilateral ankle proprioception was assessed in 20 stroke patients and 20 age-matched healthy controls using AMEDA. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC). RESULTS: The ICC in the affected and unaffected sides was 0.713 and 0.74, respectively. Analysis of variance revealed significant deficits in ankle proprioception in subacute stroke survivors vs. healthy controls (F = 2.719, p = 0.045). However, there were no significant differences in proprioception acuity scores between the affected and unaffected sides in patients after stroke (F = 1.14, p = 0.331). CONCLUSIONS: Stroke survivors had bilateral deficits in ankle proprioceptive acuity during active movements compared with age-matched healthy controls, underscoring the need to evaluate these deficits on both sides of the body and develop effective sensorimotor rehabilitation methods for this patient population. The AMEDA can reliably determine bilateral ankle proprioceptive acuity in stroke survivors

Angle diversity to increase coverage and position accuracy in 3D visible light positioning

The most common approach to light-based indoor positioning relies on multilateration of received signals to the mobile device. Any deficiencies in the fidelity of these light signals can significantly distort position estimates. In this paper, we propose a method to dynamically control the light distribution from the overhead luminaires to mitigate fading effects that would otherwise occur under static lighting. By manipulating the direction of the luminaire, effectively the dispersion pattern, we introduce signal diversity in the form of multiple pointing angles and light distributions. In addition to providing angle diversity, steering and then tracking sustains the maximal line-of-sight path between a source and receiver, which reduces angle-dependent attenuation and optimizes the signal-to-noise ratio for any coordinate without needing to change the physical properties of the source or receiver. This gain in signal strength combats the limited field-of-view of luminaires and photodiodes to provide better overall coverage, which translates directly to increase positioning accuracy, particularly in a 3D space. In the results, we show field-of-view gains of 43% and improvements in MSE of 20cm.Accepted manuscrip