SCMR level II/independent practitioner training guidelines for cardiovascular magnetic resonance: integration of a virtual training environment

Cardiovascular magnetic resonance (CMR) is an important non-invasive imaging modality used for the evaluation of patients with known or suspected heart disease. Despite its clinical importance, CMR is currently not widely available, in part, because of a scarcity of well-trained physicians to perform and interpret the exam. Moreover, current 2018 Society for Cardiovascular Magnetic Resonance (SCMR) training guidelines [1] and also training guidelines from other societies [2, 3] require a significant amount of in-person hands-on experience making training inaccessible for many individuals. This limits the availability of physicians appropriately trained to perform and interpret CMR exams. The purpose of this statement is to provide guidance for implementing a high-quality virtual CMR training program to complement in-person training options

Predation Alters Relationships between biodiversity and Temporal Stability

© 2009 The University of ChicagoDOI: 10.1086/596540Ecologists disagree on how diversity affects stability. At the heart of the controversy is the relationship between diversity and population stability, with conflicting findings from both theoretical and empirical studies. To help reconcile these results, we propose that this relationship may depend on trophic complexity, such that positive relations tend to emerge in multitrophic but not singletrophic communities. This hypothesis is based on the premise that stabilizing weak trophic interactions restrain population oscillations associated with strong trophic interactions in diverse multitrophic communities. We tested this hypothesis using simple freshwater bacterivorous protist communities differing in diversity with and without a predatory protist species. Coupling weak and strong trophic interactions reduced population temporal variability of the stronginteracting species, supporting the stabilizing role of weak interactions. In keeping with our hypothesis, predation altered the overall effect of diversity on population temporal stability and, in particular, caused a reversal of the diversity-stability relationship (negative without predators and positive with predators) for the strong-interacting species. A similar role of predation was also observed when examining the relationship between diversity and temporal stability of community biomass. Together, these findings demonstrated strong interactive effects of trophic interactions and diversity on temporal stability of population and community properties

Awareness and practice of aerobic exercise and yoga among hypertensive patients in Anand city

BACKGROUND: Aerobic exercise is helpful in reducing elevated blood pressure (BP). It was also found that yoga is useful in reducing raised BP. Thus, they both can be used in prevention and treatment of hypertension. Hence, the study aimed to observe both awareness and practice of aerobic exercise and yoga among hypertensive patients in Anand city. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted. A questionnaire was prepared containing 24 questions about awareness and practice of aerobic exercise and yoga among hypertensive patients. The questions were explained to all the patients, and 200 patients were recruited from Anand city through convenience sampling. RESULTS: Two-hundred patients were included in this study, of which 100% were aware of hypertension. 67.68% were aware of the role of aerobic exercise in hypertension, of which 58.29% practiced them. The awareness of the role of yoga in hypertension was noted in 33.67% of patients, of which only 13.07% practiced pranayama and 9.50% practiced asanas. CONCLUSION: There was a complete awareness of hypertension among hypertensive patients. A large number of patients were aware of the role of aerobic exercise in hypertension, but only few of the patients practiced them. However, there was less awareness of the role of yoga in hypertension and even lesser number practiced them

Normal Values of Cardiac Output and Stroke Volume According to Measurement Technique, Age, Sex, and Ethnicity: Results of the World Alliance of Societies of Echocardiography Study

Background: Assessment of cardiac output (CO) and stroke volume (SV) is essential to understand cardiac function and hemodynamics. These parameters can be examined using three echocardiographic techniques (pulsed-wave Doppler, two-dimensional [2D], and three-dimensional [3D]). Whether these methods can be used interchangeably is unclear. The influence of age, sex, and ethnicity on CO and SV has also not been examined in depth. In this report from the World Alliance of Societies of Echocardiography Normal Values Study, the authors compare CO and SV in healthy adults according to age, sex, ethnicity, and measurement techniques. Methods: A total of 1,450 adult subjects (53% men) free of heart, lung, and kidney disease were prospectively enrolled in 15 countries, with even distributions among age groups and sex. Subjects were divided into three age groups (young, 18-40 years; middle aged, 41-65 years; and old, >65 years) and three main racial groups (whites, blacks, and Asians). CO and SV were indexed (cardiac index [CI] and SV index [SVI], respectively) to body surface area and height and measured using three echocardiographic methods: Doppler, 2D, and 3D. Images were analyzed at two core laboratories (one each for 2D and 3D). Results: CI and SVI were significantly lower by 2D compared with both Doppler and 3D methods in both sexes. SVI was significantly lower in women than men by all three methods, while CI differed only by 2D. SVI decreased with aging by all three techniques, whereas CI declined only with 2D and 3D. CO and SV were smallest in Asians and largest in whites, and the differences persisted after normalization for body surface area. Conclusions: The present results provide normal reference values for CO and SV, which differ by age, sex, and race. Furthermore, CI and SVI measurements by the different echocardiographic techniques are not interchangeable. All these factors need to be taken into account when evaluating cardiac function and hemodynamics in individual patients. (J Am Soc Echocardiogr 2021;34:1077-85.