Motion-corrected multiparametric renal arterial spin labelling at 3T: Reproducibility and effect of vasodilator challenge

Objectives We investigated the feasibility and reproducibility of free-breathing motion-corrected multiple inversion time (multi-TI) pulsed renal arterial spin labelling (PASL), with general kinetic model parametric mapping, to simultaneously quantify renal perfusion (RBF), bolus arrival time (BAT) and tissue T1. Methods In a study approved by the Health Research Authority, 12 healthy volunteers (mean age, 27.6 ± 18.5 years; 5 male) gave informed consent for renal imaging at 3 T using multi-TI ASL and conventional single-TI ASL. Glyceryl trinitrate (GTN) was used as a vasodilator challenge in six subjects. Flow-sensitive alternating inversion recovery (FAIR) preparation was used with background suppression and 3D-GRASE (gradient and spin echo) read-out, and images were motion-corrected. Parametric maps of RBF, BAT and T1 were derived for both kidneys. Agreement was assessed using Pearson correlation and Bland-Altman plots. Results Inter-study correlation of whole-kidney RBF was good for both single-TI (r2 = 0.90), and multi-TI ASL (r2 = 0.92). Single-TI ASL gave a higher estimate of whole-kidney RBF compared to multi-TI ASL (mean bias, 29.3 ml/min/100 g; p <0.001). Using multi-TI ASL, the median T1 of renal cortex was shorter than that of medulla (799.6 ms vs 807.1 ms, p = 0.01), and mean whole-kidney BAT was 269.7 ± 56.5 ms. GTN had an effect on systolic blood pressure (p < 0.05) but the change in RBF was not significant. Conclusions Free-breathing multi-TI renal ASL is feasible and reproducible at 3 T, providing simultaneous measurement of renal perfusion, haemodynamic parameters and tissue characteristics at baseline and during pharmacological challenge

Variation in reproductive effort, genetic diversity and mating systems across Posidonia australis seagrass meadows in Western Australia

Populations at the edges of their geographical range tend to have lower genetic diversity, smaller effective population sizes and limited connectivity relative to centre of range populations. Range edge populations are also likely to be better adapted to more extreme conditions for future survival and resilience in warming environments. However, they may also be most at risk of extinction from changing climate. We compare reproductive and genetic data of the temperate seagrass, Posidonia australis on the west coast of Australia. Measures of reproductive effort (flowering and fruit production and seed to ovule ratios) and estimates of genetic diversity and mating patterns (nuclear microsatellite DNA loci) were used to assess sexual reproduction in northern range edge (low latitude, elevated salinities, Shark Bay World Heritage Site) and centre of range (mid-latitude, oceanic salinity, Perth metropolitan waters) meadows in Western Australia. Flower and fruit production were highly variable among meadows and there was no significant relationship between seed to ovule ratio and clonal diversity. However, Shark Bay meadows were two orders of magnitude less fecund than those in Perth metropolitan waters. Shark Bay meadows were characterized by significantly lower levels of genetic diversity and a mixed mating system relative to meadows in Perth metropolitan waters, which had high genetic diversity and a completely outcrossed mating system. The combination of reproductive and genetic data showed overall lower sexual productivity in Shark Bay meadows relative to Perth metropolitan waters. The mixed mating system is likely driven by a combination of local environmental conditions and pollen limitation. These results indicate that seagrass restoration in Shark Bay may benefit from sourcing plant material from multiple reproductive meadows to increase outcrossed pollen availability and seed production for natural recruitment.Elizabeth A. Sinclair, Jane M. Edgeloe, Janet M. Anthony, John Statton, Martin F. Breed and Gary A. Kendric

Temperature dependence, accuracy, and repeatability of T-1 and T-2 relaxation times for the ISMRM/NIST system phantom measured using MR fingerprinting

Purpose Before MR fingerprinting (MRF) can be adopted clinically, the derived quantitative values must be proven accurate and repeatable over a range of T1 and T2 values and temperatures. Correct assessment of accuracy and precision as well as comparison between measurements can only be performed when temperature is either controlled or corrected for. The purpose of this study was to investigate the temperature dependence of T1 and T2 MRF values and evaluate the accuracy and repeatability of temperature-corrected relaxation values derived from a B1-corrected MRF–fast imaging with steady-state precession implementation using 2 different dictionary sizes. Methods The International Society of MR in Medicine/National Institute of Standards and Technology phantom was scanned using an MRF sequence of 2 different lengths, a variable flip angle T1, and a multi-echo spin echo T2 at 14 temperatures ranging from 15°C to 28°C and investigated with a linear regression model. Temperature-corrected accuracy was evaluated by correlating T1 and T2 times from each MRF dictionary with reference values. Repeatability was assessed using the coefficient of variation, with measurements taken over 30 separate sessions. Results There was a statistically significant fit of the model for MRF-derived T1 and T2 and temperature (p 500 ms. Both MRF methods showed a strong linear correlation with reference values for T1 (R2 = 0.996) and T2 (R2 = 0.982). MRF repeatability for T1 values was ≤1.4% and for T2 values was ≤3.4%. Conclusion MRF demonstrated relaxation times with a temperature dependence similar to that of conventional mapping methods. Temperature-corrected T1 and T2 values from both dictionaries showed adequate accuracy and excellent repeatability in this phantom study

Professional learning needs in using video calls identified through workshops

BACKGROUND: Most people want to die at home but only half do. Supporting patients in rural locations is challenging. Video calls such as Skype, might help but are not routinely used; we should consider learning needs to increase uptake and ensure effective use. We aimed to identify learning needs of healthcare professionals (HCPs) in using video calls to support patients (and their carers) to die at home. METHODS: Face-to-face workshops were held in five Southwest England locations. Participants discussed advantages, disadvantages, scenarios for use, and the learning needs of video call users. Ideas were documented on flipcharts and discussions audio-recorded. The 116 participants included nurses, allied HCPs, doctors and previously bereaved volunteers. Lists of advantages, disadvantages, scenarios and learning needs were compiled and circulated to participants. In a subsequent online workshop, 21 participants ranked seven groups of learning needs in priority order. RESULTS: Most participants thought video calls could be used to advantage in many end-of-life scenarios, especially in rural areas. Seven themes, covering 59 learning needs for HCPs, were identified (in priority order): (i) confidence and technical ability in using video calls; (ii) being aware of how video calls fit into clinical practice; (iii) managing video calls; (iv) communication skills on ‘camera’; (v) understanding how patients and families may be affected by video call use; (vi) presenting video calls as an option to patients and families to assess their readiness; (vii) normal professional skills that become essential for effective video calls. CONCLUSIONS: Although almost ubiquitous, video call software is not routinely and effectively used in British clinical practice. Supporting patients and families at end-of-life is one example where it could be used to advantage, but clinicians need to plan and practise before using it in real situations. Learning needs were identified that could be developed into learning modules and/or courses. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-016-0657-6) contains supplementary material, which is available to authorized users

Steps on the Path to Clinical Translation: A workshop by the British and Irish Chapter of the ISMRM

The British and Irish Chapter of the International Society for Magnetic Resonance in Medicine (BIC-ISMRM) held a workshop entitled "Steps on the path to clinical translation" in Cardiff, UK, on 7th September 2022. The aim of the workshop was to promote discussion within the MR community about the problems and potential solutions for translating quantitative MR (qMR) imaging and spectroscopic biomarkers into clinical application and drug studies. Invited speakers presented the perspectives of radiologists, radiographers, clinical physicists, vendors, imaging Contract/Clinical Research Organizations (CROs), open science networks, metrologists, imaging networks, and those developing consensus methods. A round-table discussion was held in which workshop participants discussed a range of questions pertinent to clinical translation of qMR imaging and spectroscopic biomarkers. Each group summarized their findings via three main conclusions and three further questions. These questions were used as the basis of an online survey of the broader UK MR community

A Systematic Review of How Multiple Stressors from an Extreme Event Drove Ecosystem-Wide Loss of Resilience in an Iconic Seagrass Community

A central question in contemporary ecology is how climate change will alter ecosystem structure and function across scales of space and time. Climate change has been shown to alter ecological patterns from individuals to ecosystems, often with negative implications for ecosystem functions and services. Furthermore, as climate change fuels more frequent and severe extreme climate events (ECEs) like marine heatwaves (MHWs), such acute events become increasingly important drivers of rapid ecosystem change. However, our understanding of ECE impacts is hampered by limited collection of broad scale in situ data where such events occur. In 2011, a MHW known as the Ningaloo Niño bathed the west coast of Australia in waters up to 4°C warmer than normal summer temperatures for almost 2 months over 1000s of kilometres of coastline. We revisit published and unpublished data on the effects of the Ningaloo Niño in the seagrass ecosystem of Shark Bay, Western Australia (24.6 – 26.6o S), at the transition zone between temperate and tropical seagrasses. Therein we focus on resilience, including resistance to and recovery from disturbance across local, regional and ecosystem-wide spatial scales and over the past 8 yearsThermal effects on temperate seagrass health were severe and exacerbated by simultaneous reduced light conditions associated with sediment inputs from record floods in the south-eastern embayment and from increased detrital loads and sediment destabilisation. Initial extensive defoliation of Amphibolis antarctica, the dominant seagrass, was followed by rhizome death that occurred in 60-80% of the bay’s meadows, equating to decline of over 1000 km2 of meadows. This loss, driven by direct abiotic forcing, has persisted, while indirect biotic effects (e.g. dominant seagrass loss) have allowed colonisation of some areas by small fast-growing tropical species (e.g. Halodule uninervis). Those biotic effects also impacted multiple consumer populations including turtles and dugongs, with implications for species dynamics, food web structure, and ecosystem recovery. We show multiple stressors can combine to evoke extreme ecological responses by pushing ecosystems beyond their tolerance. Finally, both direct abiotic and indirect biotic effects need to be explicitly considered when attempting to understand and predict how ECEs will alter marine ecosystem dynamics

Steps on the Path to Clinical Translation: A workshop by the British and Irish Chapter of the ISMRM

The British and Irish Chapter of the International Society for Magnetic Resonance in Medicine (BIC‐ISMRM) held a workshop entitled “Steps on the path to clinical translation” in Cardiff, UK, on 7th September 2022. The aim of the workshop was to promote discussion within the MR community about the problems and potential solutions for translating quantitative MR (qMR) imaging and spectroscopic biomarkers into clinical application and drug studies. Invited speakers presented the perspectives of radiologists, radiographers, clinical physicists, vendors, imaging Contract/Clinical Research Organizations (CROs), open science networks, metrologists, imaging networks, and those developing consensus methods. A round‐table discussion was held in which workshop participants discussed a range of questions pertinent to clinical translation of qMR imaging and spectroscopic biomarkers. Each group summarized their findings via three main conclusions and three further questions. These questions were used as the basis of an online survey of the broader UK MR community

Phenotypic expression and outcomes in individuals with rare genetic variants of hypertrophic cardiomyopathy

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is caused by rare variants in sarcomere-encoding genes, but little is known about the clinical significance of these variants in the general population. OBJECTIVES: The goal of this study was to compare lifetime outcomes and cardiovascular phenotypes according to the presence of rare variants in sarcomere-encoding genes among middle-aged adults. METHODS: This study analyzed whole exome sequencing and cardiac magnetic resonance imaging in UK Biobank participants stratified according to sarcomere-encoding variant status. RESULTS: The prevalence of rare variants (allele frequency <0.00004) in HCM-associated sarcomere-encoding genes in 200,584 participants was 2.9% (n = 5,712; 1 in 35), and the prevalence of variants pathogenic or likely pathogenic for HCM (SARC-HCM-P/LP) was 0.25% (n = 493; 1 in 407). SARC-HCM-P/LP variants were associated with an increased risk of death or major adverse cardiac events compared with controls (hazard ratio: 1.69; 95% confidence interval [CI]: 1.38-2.07; P < 0.001), mainly due to heart failure endpoints (hazard ratio: 4.23; 95% CI: 3.07-5.83; P < 0.001). In 21,322 participants with both cardiac magnetic resonance imaging and whole exome sequencing, SARC-HCM-P/LP variants were associated with an asymmetric increase in left ventricular maximum wall thickness (10.9 ± 2.7 mm vs 9.4 ± 1.6 mm; P < 0.001), but hypertrophy (≥13 mm) was only present in 18.4% (n = 9 of 49; 95% CI: 9%-32%). SARC-HCM-P/LP variants were still associated with heart failure after adjustment for wall thickness (hazard ratio: 6.74; 95% CI: 2.43-18.7; P < 0.001). CONCLUSIONS: In this population of middle-aged adults, SARC-HCM-P/LP variants have low aggregate penetrance for overt HCM but are associated with an increased risk of adverse cardiovascular outcomes and an attenuated cardiomyopathic phenotype. Although absolute event rates are low, identification of these variants may enhance risk stratification beyond familial disease