Myocardial Extracellular Volume Estimation by CMR Predicts Functional Recovery Following Acute MI

Objectives: In the setting of reperfused acute myocardial infarction (AMI), the authors sought to compare prediction of contractile recovery by infarct extracellular volume (ECV), as measured by T1-mapping cardiac magnetic resonance (CMR), with late gadolinium enhancement (LGE) transmural extent. Background: The transmural extent of myocardial infarction as assessed by LGE CMR is a strong predictor of functional recovery, but accuracy of the technique may be reduced in AMI. ECV mapping by CMR can provide a continuous measure associated with the severity of tissue damage within infarcted myocardium. Methods: Thirty-nine patients underwent acute (day 2) and convalescent (3 months) CMR scans following AMI. Cine imaging, tissue tagging, T2-weighted imaging, modified Look-Locker inversion T1 mapping natively and 15 min post–gadolinium-contrast administration, and LGE imaging were performed. The ability of acute infarct ECV and acute transmural extent of LGE to predict convalescent wall motion, ejection fraction (EF), and strain were compared per-segment and per-patient. Results: Per-segment, acute ECV and LGE transmural extent were associated with convalescent wall motion score (p < 0.01; p < 0.01, respectively). ECV had higher accuracy than LGE extent to predict improved wall motion (area under receiver-operating characteristics curve 0.77 vs. 0.66; p = 0.02). Infarct ECV ≤0.5 had sensitivity 81% and specificity 65% for prediction of improvement in segmental function; LGE transmural extent ≤0.5 had sensitivity 61% and specificity 71%. Per-patient, ECV and LGE correlated with convalescent wall motion score (r = 0.45; p < 0.01; r = 0.41; p = 0.02, respectively) and convalescent EF (p < 0.01; p = 0.04). ECV and LGE extent were not significantly correlated (r = 0.34; p = 0.07). In multivariable linear regression analysis, acute infarct ECV was independently associated with convalescent infarct strain and EF (p = 0.03; p = 0.04), whereas LGE was not (p = 0.29; p = 0.24). Conclusions: Acute infarct ECV in reperfused AMI can complement LGE assessment as an additional predictor of regional and global LV functional recovery that is independent of transmural extent of infarction

Multi-modality image simulation with the Virtual Imaging Platform: Illustration on cardiac echography and MRI

International audienceMedical image simulation is useful for biological modeling, image analysis, and designing new imaging devices but it is not widely available due to the complexity of simulators, the scarcity of object models, and the heaviness of the associated computations. This paper presents the Virtual Imaging Platform, an openly-accessible web platform for multi-modality image simulation. The integration of simulators and models is described and exemplified on simulated cardiac MRIs and ultrasonic images

Wetting of a symmetrical binary fluid mixture on a wall

We study the wetting behaviour of a symmetrical binary fluid below the demixing temperature at a non-selective attractive wall. Although it demixes in the bulk, a sufficiently thin liquid film remains mixed. On approaching liquid/vapour coexistence, however, the thickness of the liquid film increases and it may demix and then wet the substrate. We show that the wetting properties are determined by an interplay of the two length scales related to the density and the composition fluctuations. The problem is analysed within the framework of a generic two component Ginzburg-Landau functional (appropriate for systems with short-ranged interactions). This functional is minimized both numerically and analytically within a piecewise parabolic potential approximation. A number of novel surface transitions are found, including first order demixing and prewetting, continuous demixing, a tricritical point connecting the two regimes, or a critical end point beyond which the prewetting line separates a strongly and a weakly demixed film. Our results are supported by detailed Monte Carlo simulations of a symmetrical binary Lennard-Jones fluid at an attractive wall.Comment: submitted to Phys. Rev.

Flare hypercalcemia after letrozole in a patient with liver metastasis from breast cancer: a case report

<p>Abstract</p> <p>Introduction</p> <p>Tamoxifen may occasionally precipitate serious and potentially life-threatening hypercalcemia. However, to date, this has not been documented with aromatase inhibitors.</p> <p>Case presentation</p> <p>A 65-year-old Japanese woman with liver metastasis from breast cancer was admitted to our hospital with vomiting, anorexia, fatigue, arthralgia, muscle pain and dehydration. She had started a course of letrozole five weeks earlier. Our patient's calcium level was 11.6 mg/dL. She was rehydrated and elcatonin was administered. Our patient's parathyroid hormone and parathyroid hormone-related protein levels were not increased and a bone scintigram revealed no evidence of skeletal metastasis. After our patient's serum calcium level returned to within the normal range, letrozole was restarted at one-half of the previous dose (1.25 mg). There were no episodes of hypercalcemia. However, 84 days after restarting letrozole, our patient again complained of arthralgia and treatment was changed to toremifene. During these periods, repeated ultrasonograms revealed no progression of liver metastasis.</p> <p>Conclusion</p> <p>To the best of our knowledge, this is the first case report of flare hypercalcemia after treatment with letrozole in a patient with metastatic breast cancer.</p

Wafer-Scale, Sub-5 nm Junction Formation by Monolayer Doping and Conventional Spike Annealing

We report the formation of sub-5 nm ultrashallow junctions in 4 inch Si wafers enabled by the molecular monolayer doping of phosphorous and boron atoms and the use of conventional spike annealing. The junctions are characterized by secondary ion mass spectrometry and non-contact sheet resistance measurements. It is found that the majority (~70%) of the incorporated dopants are electrically active, therefore, enabling a low sheet resistance for a given dopant areal dose. The wafer-scale uniformity is investigated and found to be limited by the temperature homogeneity of the spike anneal tool used in the experiments. Notably, minimal junction leakage currents (<1 uA/cm2) are observed which highlights the quality of the junctions formed by this process. The results clearly demonstrate the versatility and potency of the monolayer doping approach for enabling controlled, molecular-scale ultrashallow junction formation without introducing defects in the semiconductor.Comment: 21 pages, 5 figure

Wages in high-tech start-ups - do academic spin-offs pay a wage premium?

Due to their origin from universities, academic spin‐offs operate at the forefront of the technological development. Therefore, spin‐offs exhibit a skill‐biased labour demand, i.e. spin‐offs have a high demand for employees with cutting edge knowledge and technical skills. In order to accommodate this demand, spin‐offs may have to pay a relative wage premium compared to other high‐tech start‐ups. However, neither a comprehensive theoretical assessment nor the empirical literature on wages in start‐ups unambiguously predicts the existence and the direction of wage differentials between spin‐offs and non‐spin‐offs. This paper addresses this research gap and examines empirically whether or not spin‐offs pay their employees a wage premium. Using a unique linked employer‐employee data set of German high‐tech start‐ups, we estimate Mincer‐type wage regressions applying the Hausman‐Taylor panel estimator. Our results show that spin‐offs do not pay a wage premium in general. However, a notable exception from this general result is that spin‐offs that commercialise new scientific results or methods provide higher wages to employees with linkages to the university sector – either as university graduates or as student workers

Innovation capacity in the healthcare sector and historical anchors: examples from the UK, Switzerland and the US

Innovation is an integral part of economic development in developed economies. In the post 2008 period, a key policy agenda is that of sustainable development, which calls for innovation in all aspects of value-chains. In this paper, we focus on innovation from the biotech—pharma perspective to see whether or not this will lead to a sustainable future for the regions where there are clusters of firms in this sector. We examine data from a recently completed European Union study of innovation in the Healthcare sector from the UK and Switzerland, countries with an historical base in pharma, to understand how innovation pathways vary at the regional level in the broader life sciences, which incorporate biotech and more. Innovation in the healthcare sector in two regions, Oxfordshire in the UK and Zurich in Switzerland are compared. We contextualize our discussion by drawing on studies that focus on the sector in the US, specifically Boston. The analytical framework comprises three elements: innovation systems and national and regional economic development theories are the first two, followed by approaches which consider organizational or institutional activity. This framework is used to help explain and understand the complexity of how innovation is organized at the sub-national level. The overall context is that it is increasing becoming a condition for government financing of research that it has more immediate application in industry or have the possibility of commercialisation (e.g., translational research)

Human Gastrointestinal Juices Intended for Use in In Vitro Digestion Models

The aim of this study was to characterise the individual human gastric and duodenal juices to be used in in vitro model digestion and to examine the storage stability of the enzymes. Gastroduodenal juices were aspirated, and individual variations in enzymatic activities as well as total volumes, pH, bile acids, protein and bilirubin concentrations were recorded. Individual pepsin activity in the gastric juice varied by a factor of 10, while individual total proteolytic activity in the duodenal juice varied by a factor of 5. The duodenal amylase activity varied from 0 to 52.6 U/ml, and the bile acid concentration varied from 0.9 to 4.5 mM. Pooled gastric and duodenal juices from 18 volunteers were characterised according to pepsin activity (26.7 U/ml), total proteolytic activity (14.8 U/ml), lipase activity (951.0 U/ml), amylase activity (26.8 U/ml) and bile acids (4.5 mM). Stability of the main enzymes in two frozen batches of either gastric or duodenal juice was studied for 6 months. Pepsin activity decreased rapidly and adjusting the pH of gastric juice to 4 did not protect the pepsin from degradation. Lipase activity remained stable for 4 months, however decreased rapidly thereafter even after the addition of protease inhibitors. Glycerol only marginally stabilised the survival of the enzymatic activities. These results of compositional variations in the individual gastrointestinal juices and the effect of storage conditions on enzyme activities are useful for the design of in vitro models enabling human digestive juices to simulate physiological digestion

The impact of digital start-up founders’ higher education on reaching equity investment milestones

This paper builds on human capital theory to assess the importance of formal education among graduate entrepreneurs. Using a sample of 4.953 digital start-ups the paper evaluates the impact of start-up founding teams’ higher education on the probability of securing equity investment and subsequent exit for investors. The main findings are: (1), teams with a founder that has a technical education are less likely to remain self-financed and are more likely to secure equity investment and to exit, but the impact of technical education declines with higher level degrees, (2) teams with a founder that has doctoral level business education are less likely to remain self-financed and have a higher probability of securing equity investment, while undergraduate and postgraduate business education have no significant effect, and (3) teams with a founder that has an undergraduate general education (arts and humanities) are less likely to remain self-financed and are more likely to secure equity investment and exit while postgraduate and doctoral general education have no significant effect on securing equity investment and exit. The findings enhance our understanding of factors that influence digital start-ups achieving equity milestones by showing the heterogeneous influence of different types of higher education, and therefore human capital, on new ventures achieving equity milestones. The results suggest that researchers and policy-makers should extend their consideration of universities entrepreneurial activity to include the development of human capital

Rowing against the wind: how do times of austerity shape academic entrepreneurship in unfriendly environments?

[EN] Academic spin-offs (ASOs) help universities transfer knowledge or technology through business projects developed by academic staff. This investigation aims at analyzing the critical factors for spin-off creation at universities operating in crisis-raven, entrepreneurship-unfriendly environments. Such factors revolve around four types of resources: environmental, institutional, organizational, and personal. Focusing on a Southern European context, as an example of an unfriendly environment affected by economic crisis, an entrepreneurial university (the Technical University of Valencia in Spain, UPV) is our research setting. Through a case study approach, we examine the potential of UPV as a springboard for ASOs. Our results show an adverse local environment, a rather favorable influence of institutional and organizational drivers, and a mixed role of personal factors. Our findings illustrate that UPV consistently supports spin-off creation due to a greater (rather positive) reflexivity from its institutional, organizational and personal resources than the (negative) imprinting of the unfriendly environment. This helps counter-balance the structural unfriendliness for academic entrepreneurship, and trigger a crisis-led risk-taking attitude by academic staff. Hence, UPV should continue with its current strategy of supporting academic entrepreneurship, and might transfer best practices to other universities also affected by unfavorable environmental conditions. Generally speaking, we would advise universities facing adverse circumstances to develop rules and mechanisms for academic entrepreneurship, carefully revise and improve malfunctions, and become involved throughout the whole process of spin-off development. 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