Cerebrovascular complications and infective endocarditis. impact of available evidence on clinical outcome

Infective endocarditis (IE) is a life-threatening disease. Its epidemiological profile has substantially changed in recent years although 1-year mortality is still high. Despite advances in medical therapy and surgical technique, there is still uncertainty on the best management and on the timing of surgical intervention. The objective of this review is to produce further insight intothe short- and long-term outcomes of patients with IE, with a focus on those presenting cerebrovascular complications

Developing a model to estimate the potential impact of municipal investment on city health

This article summarizes a process which exemplifies the potential impact of municipal investment on the burden of cardiovascular disease (CVD) in city populations. We report on Developing an evidence-based approach to city public health planning and investment in Europe (DECiPHEr), a project part funded by the European Union. It had twin objectives: first, to develop and validate a vocational educational training package for policy makers and political decision takers; second, to use this opportunity to iterate a robust and user-friendly investment tool for maximizing the public health impact of 'mainstream' municipal policies, programs and investments. There were seven stages in the development process shared by an academic team from Sheffield Hallam University and partners from four cities drawn from the WHO European Healthy Cities Network. There were five iterations of the model resulting from this process. The initial focus was CVD as the biggest cause of death and disability in Europe. Our original prototype 'cost offset' model was confined to proximal determinants of CVD, utilizing modified 'Framingham' equations to estimate the impact of population level cardiovascular risk factor reduction on future demand for acute hospital admissions. The DECiPHEr iterations first extended the scope of the model to distal determinants and then focused progressively on practical interventions. Six key domains of local influence on population health were introduced into the model by the development process: education, housing, environment, public health, economy and security. Deploying a realist synthesis methodology, the model then connected distal with proximal determinants of CVD. Existing scientific evidence and cities' experiential knowledge were 'plugged-in' or 'triangulated' to elaborate the causal pathways from domain interventions to public health impacts. A key product is an enhanced version of the cost offset model, named Sheffield Health Effectiveness Framework Tool, incorporating both proximal and distal determinants in estimating the cost benefits of domain interventions. A key message is that the insights of the policy community are essential in developing and then utilising such a predictive tool

Comparison of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage [Usporedba višeslojne kompjuterizirane tomografije i duplex Doppler ultrazvuka u otkrivanju aterosklerotskih karotidnih plakova kompliciranih krvarenjem u plak ]

This study compared sensitivity and specificity of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage. Carotid plaques from 50 patients operated for carotid artery stenosis were analyzed. Carotid endarterectomy was performed within one week of diagnostic evaluation. Results of multidetector-row computed tomography and duplex Doppler ultrasonography diagnostic evaluation were compared with results of histological analysis of the same plaque areas. American Heart Association classification of atherosclerotic plaques was applied for histological classification. Median tissue density of carotid plaques complicated with intraplaque hemorrhage was 14.7 Hounsfield units. Median tissue density of noncalcified segments of uncomplicated plaques was 54.3 Hounsfield units (p = 0.00003). The highest tissue density observed for complicated plaques was 31.8 Hounsfield units. Multidetector-row computed tomography detected plaques complicated with hemorrhage with sensitivity of 100% and specificity of 70.4%, with tissue density of 33.8 Hounsfield units as a threshold value. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed sensitivity of 21.7% and specificity of 89.6% in detecting plaques complicated with intraplaque hemorrhage. Multidetector-row computed tomography showed a very high level of sensitivity and a moderate level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed a low level of sensitivity and a moderate-high level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage

The Spiritual Nature of the Italian Renaissance

This study seeks to investigate the influence of faith in the emergence and development of the Italian Renaissance, in both the artwork and writing of the major artists and thinkers of the day, and the impact that new expressions of faith had on the viewing public. While the Renaissance is often labeled as a secular movement by modern scholars, this interpretation is largely due to the political motives of the Medici family who dominated Florence as the center of this artistic rebirth, on and off again throughout the period. On close examination, the philosophical and creative undercurrents of the movement were much more complex. The thinkers of the era would often place Greco-Roman philosophers in the context of their Christian era and use their wisdom in addition to, rather than superseding, church and biblical authority, embracing figures like Virgil and Augustine in concert rather than opposition. These Christian humanists saw their work as a way to engage humanity in a quest for knowledge in ever expanding ways, but still with an undercurrent of reflection on the role of the divine. Spiritual inquiries of Dante, Lorenzo Valla, and Petrarch in written works are similarly manifested in the visual arts by Leonardo da Vinci, Michelangelo Buonarotti, and Raphael Sanzio. These ‘big three’ painters of the Renaissance portrayed their individual Christian ideas through their own writings, sketchbooks, and all forms of artistic expressions, many of which are evaluated in this paper. Finally, the transition of art to a scale inviting the viewer to experience it personally marked a vital change. The shift from divine proportions to more naturalistic and relatable art also logically harmonizes with the mindset of the broader Renaissance movement. This paper seeks to examine the depth and complexity of key Renaissance figures and how concepts of Christian faith and spirituality translated into their works

Optical Mapping Near-eye Three-dimensional Display with Correct Focus Cues

We present an optical mapping near-eye (OMNI) three-dimensional display method for wearable devices. By dividing a display screen into different sub-panels and optically mapping them to various depths, we create a multiplane volumetric image with correct focus cues for depth perception. The resultant system can drive the eye's accommodation to the distance that is consistent with binocular stereopsis, thereby alleviating the vergence-accommodation conflict, the primary cause for eye fatigue and discomfort. Compared with the previous methods, the OMNI display offers prominent advantages in adaptability, image dynamic range, and refresh rate.Comment: 5 pages, 6 figures, 2 tables, short article for Optics Letter

Andreas Vesalius: Celebrating 500 years of dissecting nature

December 31st, 2014 marked the 500-year anniversary of the birth of Andreas Vesalius. Vesalius, considered as the founder of modern anatomy, had profoundly changed not only human anatomy, but also the intellectual structure of medicine. The impact of his scientific revolution can be recognized even today. In this article we review the life, anatomical work, and achievements of Andreas Vesalius