CT ​Evaluation ​by ​Artificial ​Intelligence ​for ​Atherosclerosis, Stenosis and Vascular ​Morphology ​(CLARIFY): ​a ​Multi-Center, International Study

Background: Atherosclerosis evaluation by coronary computed tomography angiography (CCTA) is promising for coronary artery disease (CAD) risk stratification, but time consuming and requires high expertise. Artificial Intelligence (AI) applied to CCTA for comprehensive CAD assessment may overcome these limitations. We hypothesized AI aided analysis allows for rapid, accurate evaluation of vessel morphology and stenosis. Methods: This was a multi-site study of 232 patients undergoing CCTA. Studies were analyzed by FDA-cleared software service that performs AI-driven coronary artery segmentation and labeling, lumen and vessel wall determination, plaque quantification and characterization with comparison to ground truth of consensus by three L3 readers. CCTAs were analyzed for: % maximal diameter stenosis, plaque volume and composition, presence of high-risk plaque and Coronary Artery Disease Reporting & Data System (CAD-RADS) category. Results: AI performance was excellent for accuracy, sensitivity, specificity, positive predictive value and negative predictive value as follows: >70% stenosis: 99.7%, 90.9%, 99.8%, 93.3%, 99.9%, respectively; >50% stenosis: 94.8%, 80.0%, 97.0, 80.0%, 97.0%, respectively. Bland-Altman plots depict agreement between expert reader and AI determined maximal diameter stenosis for per-vessel (mean difference -0.8%; 95% CI 13.8% to -15.3%) and per-patient (mean difference -2.3%; 95% CI 15.8% to -20.4%). L3 and AI agreed within one CAD-RADS category in 228/232 (98.3%) exams per-patient and 923/924 (99.9%) vessels on a per-vessel basis. There was a wide range of atherosclerosis in the coronary artery territories assessed by AI when stratified by CAD-RADS distribution. Conclusions: AI-aided approach to CCTA interpretation determines coronary stenosis and CAD-RADS category in close agreement with consensus of L3 expert readers. There was a wide range of atherosclerosis identified through AI.info:eu-repo/semantics/publishedVersio

Design and Integration of an Actuated Nose Strake Control System

Aircraft flight characteristics at high angles of attack can be improved by controlling vortices shed from the nose. These characteristics have been investigated with the integration of the actuated nose strakes for enhanced rolling (ANSER) control system into the NASA F-18 High Alpha Research Vehicle. Several hardware and software systems were developed to enable performance of the research goals. A strake interface box was developed to perform actuator control and failure detection outside the flight control computer. A three-mode ANSER control law was developed and installed in the Research Flight Control System. The thrust-vectoring mode does not command the strakes. The strakes and thrust-vectoring mode uses a combination of thrust vectoring and strakes for lateral- directional control, and strake mode uses strakes only for lateral-directional control. The system was integrated and tested in the Dryden Flight Research Center (DFRC) simulation for testing before installation in the aircraft. Performance of the ANSER system was monitored in real time during the 89-flight ANSER flight test program in the DFRC Mission Control Center. One discrepancy resulted in a set of research data not being obtained. The experiment was otherwise considered a success with the majority of the research objectives being met

a CLARIFY trial sub-study

Publisher Copyright: © 2022Background: The difference between expert level (L3) reader and artificial intelligence (AI) performance for quantifying coronary plaque and plaque components is unknown. Objective: This study evaluates the interobserver variability among expert readers for quantifying the volume of coronary plaque and plaque components on coronary computed tomographic angiography (CCTA) using an artificial intelligence enabled quantitative CCTA analysis software as a reference (AI-QCT). Methods: This study uses CCTA imaging obtained from 232 patients enrolled in the CLARIFY (CT EvaLuation by ARtificial Intelligence For Atherosclerosis, Stenosis and Vascular MorphologY) study. Readers quantified overall plaque volume and the % breakdown of noncalcified plaque (NCP) and calcified plaque (CP) on a per vessel basis. Readers categorized high risk plaque (HRP) based on the presence of low-attenuation-noncalcified plaque (LA-NCP) and positive remodeling (PR; ≥1.10). All CCTAs were analyzed by an FDA-cleared software service that performs AI-driven plaque characterization and quantification (AI-QCT) for comparison to L3 readers. Reader generated analyses were compared among readers and to AI-QCT generated analyses. Results: When evaluating plaque volume on a per vessel basis, expert readers achieved moderate to high interobserver consistency with an intra-class correlation coefficient of 0.78 for a single reader score and 0.91 for mean scores. There was a moderate trend between readers 1, 2, and 3 and AI with spearman coefficients of 0.70, 0.68 and 0.74, respectively. There was high discordance between readers and AI plaque component analyses. When quantifying %NCP v. %CP, readers 1, 2, and 3 achieved a weighted kappa coefficient of 0.23, 0.34 and 0.24, respectively, compared to AI with a spearman coefficient of 0.38, 0.51, and 0.60, respectively. The intra-class correlation coefficient among readers for plaque composition assessment was 0.68. With respect to HRP, readers 1, 2, and 3 achieved a weighted kappa coefficient of 0.22, 0.26, and 0.17, respectively, and a spearman coefficient of 0.36, 0.35, and 0.44, respectively. Conclusion: Expert readers performed moderately well quantifying total plaque volumes with high consistency. However, there was both significant interobserver variability and high discordance with AI-QCT when quantifying plaque composition.publishersversionpublishe

The Moderating Effects of Peer and Parental Support on the Relationship Between Vicarious Victimization and Substance Use

General strain theory (GST) hypothesizes that youth are more likely to engage in delinquency when they experience vicarious victimization, defined as knowing about or witnessing violence perpetrated against others, but that this relationship may be attenuated for those who receive social support from significant others. Based on prospective data from youth aged 8 to 17 participating in the Project on Human Development in Chicago Neighborhoods (PHDCN), this article found mixed support for these hypotheses. Controlling for prior involvement in delinquency, as well as other risk and protective factors, adolescents who reported more vicarious victimization had an increased likelihood of alcohol use in the short term, but not the long term, and victimization was not related to tobacco or marijuana use. Peer support did not moderate the relationship between vicarious victimization and substance use, but family support did. In contrast to strain theory’s predictions, the relationship between vicarious victimization and substance use was stronger for those who had higher compared with lower levels of family support. Implications of these findings for strain theory and future research are discussed

Maximizing dose reductions with cardiac CT

Multidetector computed tomography has come a long way in a short time, quickly becoming a standard tool in the cardiac imaging armamentarium. The promise of plaque imaging, combined with both anatomical visualization and stenosis detection, has made this a preferred first line test of many cardiologists and radiologists. This test is well suited to rule out coronary artery disease (obstruction) and still diagnosing subclinical plaque, with may be a good target for anti-atherosclerotic therapies. There has been recent criticism against CT imaging, and cardiac CT specifically, due to the high radiation doses that being employed. New advances have allowed for dramatic dose reductions. These include more routinely performed methods such as dose modulation, and newer methods such as prospective gating or minimizing the field of view. This paper will review the different applications to reduce cardiac CT radiation doses to nominal levels, potentially expanding the applications of cardiac CT by removing one of the biggest barriers

High resolution time-course mapping of early transcriptomic, molecular and cellular phenotypes in Huntington\u27s disease CAG knock-in mice across multiple genetic backgrounds.

Huntington\u27s disease is a dominantly inherited neurodegenerative disease caused by the expansion of a CAG repeat in the HTT gene. In addition to the length of the CAG expansion, factors such as genetic background have been shown to contribute to the age at onset of neurological symptoms. A central challenge in understanding the disease progression that leads from the HD mutation to massive cell death in the striatum is the ability to characterize the subtle and early functional consequences of the CAG expansion longitudinally. We used dense time course sampling between 4 and 20 postnatal weeks to characterize early transcriptomic, molecular and cellular phenotypes in the striatum of six distinct knock-in mouse models of the HD mutation. We studied the effects of the HttQ111 allele on the C57BL/6J, CD-1, FVB/NCr1, and 129S2/SvPasCrl genetic backgrounds, and of two additional alleles, HttQ92 and HttQ50, on the C57BL/6J background. We describe the emergence of a transcriptomic signature in HttQ111/+  mice involving hundreds of differentially expressed genes and changes in diverse molecular pathways. We also show that this time course spanned the onset of mutant huntingtin nuclear localization phenotypes and somatic CAG-length instability in the striatum. Genetic background strongly influenced the magnitude and age at onset of these effects. This work provides a foundation for understanding the earliest transcriptional and molecular changes contributing to HD pathogenesis

Case Management as a Significant Component of Usual Care Psychotherapy for Youth with Disruptive Behavior Problems

Youth with disruptive behavior problems (DBPs) represent the majority of youth served in usual care (UC) psychotherapy, and are at high risk for maladaptive outcomes. Little is known about UC psychotherapeutic strategies utilized with this population. Researchers and clinicians suggest that case management (CM) is a major activity occurring in usual care. CM includes coordinating care with service providers and individuals, including schools, psychiatrists, and community-based services. This study assesses the prevalence and predictors of clinician use of CM in usual care. Results from this study suggest that CM is frequently used in UC psychotherapy with youth with DBPs. The extent of use of CM in UC may have implications for implementation of evidence-based practices in usual care psychotherapy

Does social capital travel? Influences on the life satisfaction of young people living in England and Spain

<p>Abstract</p> <p>Background</p> <p>This study used a social capital framework to examine the relationship between a set of potential protective ('health assets') factors and the wellbeing of 15 year adolescents living in Spain and England. The overall purpose of the study was to compare the consistency of these relationships between countries and to investigate their respective relative importance.</p> <p>Methods</p> <p>Data were drawn from the 2002, English and Spanish components of the WHO Health Behaviour in School-Aged Children (HBSC) survey A total of 3,591 respondents (1884, Spain; 1707, England) aged 15, drawn from random samples of students in 215 and 80 schools respectively were included in the study. A series of univariate, bivariate and multivariate (general linear modelling and decision tree) analyses were used to establish the relationships.</p> <p>Results</p> <p>Results showed that the wellbeing of Spanish and English adolescents is similar and good. Three measures of social capital and 2 measures of social support were found to be important factors in the general linear model. Namely, family autonomy and control; family and school sense of belonging; and social support at home and school. However, there were differences in how the sub components of social capital manifest themselves in each country--feelings of autonomy of control, were more important in England and social support factors in Spain.</p> <p>Conclusions</p> <p>There is some evidence to suggest that social capital (and its related concept of social support) do travel and are applicable to young people living in Spain and England. Given the different constellation of assets found in each country, it is not possible to define exactly the precise formula for applying social capital across cultures. This should more appropriately be defined at the programme planning stage.</p

Effects of Inhibiting CoQ10 Biosynthesis with 4-nitrobenzoate in Human Fibroblasts

Coenzyme Q10 (CoQ10) is a potent lipophilic antioxidant in cell membranes and a carrier of electrons in the mitochondrial respiratory chain. We previously characterized the effects of varying severities of CoQ10 deficiency on ROS production and mitochondrial bioenergetics in cells harboring genetic defects of CoQ10 biosynthesis. We observed a unimodal distribution of ROS production with CoQ10 deficiency: cells with <20% of CoQ10 and 50–70% of CoQ10 did not generate excess ROS while cells with 30–45% of CoQ10 showed increased ROS production and lipid peroxidation. Because our previous studies were limited to a small number of mutant cell lines with heterogeneous molecular defects, here, we treated 5 control and 2 mildly CoQ10 deficient fibroblasts with varying doses of 4-nitrobenzoate (4-NB), an analog of 4-hydroxybenzoate (4-HB) and inhibitor of 4-para-hydroxybenzoate:polyprenyl transferase (COQ2) to induce a range of CoQ10 deficiencies. Our results support the concept that the degree of CoQ10 deficiency in cells dictates the extent of ATP synthesis defects and ROS production and that 40–50% residual CoQ10 produces maximal oxidative stress and cell death

Kawasaki disease: a review with emphasis on cardiovascular complications

Kawasaki disease (KD) is an acute systemic vasculitis that is currently the leading cause of acquired heart disease in childhood in the United States. Cardiovascular complications are the major cause of morbidity, are responsible for virtually all deaths from KD and should be evaluated as soon as possible after the acute phase to establish the baseline status, in order to predict disease progression and determine adequate treatment. In selected patients, electrocardiography (ECG)-gated cardiac computed tomography (CT) and magnetic resonance (MR) imaging are valuable non-invasive techniques that can be used to help diagnose the cardiovascular complications associated with KD. In this article, we review the epidemiology, aetiology and pathogenesis, histopathology, clinical features, cardiovascular complications and imaging, focusing on the role of cardiac CT and MR on the initial assessment and follow-up of the cardiovascular complications of KD