Context Preserving Focal Probes for Exploration of Volumetric Medical Datasets

During real-time medical data exploration using volume rendering, it is often difficult to enhance a particular region of interest without losing context information. In this paper, we present a new illustrative technique for focusing on a user-driven region of interest while preserving context information. Our focal probes define a region of interest using a distance function which controls the opacity of the voxels within the probe, exploit silhouette enhancement and use non-photorealistic shading techniques to improve shape depiction.187-19

Outcomes after TAVI in patients with atrial fibrillation and a history of recent PCI:Results from the ENVISAGE-TAVI AF trial

Background: Patients with atrial fibrillation (AF) and a recent (≤ 90 days) percutaneous coronary intervention (PCI) undergoing transcatheter aortic valve implantation (TAVI) are at high bleeding risk due to the addition of oral antiplatelet (OAP) agents on top of oral anticoagulants. Data on outcomes of these patients are needed to optimize antithrombotic treatment. Methods: This analysis compared annualized clinical event rates in patients with and without a recent PCI enrolled in ENVISAGE-TAVI AF, a prospective, randomized, open-label, adjudicator-masked trial comparing edoxaban and vitamin K antagonists in AF patients after TAVI. The primary efficacy and safety outcomes were net adverse clinical events (NACE) and major bleeding. Results: Overall, 132 (94.3%) patients with a recent PCI (n = 140) received OAP after TAVI, compared with 692 (55.9%) patients without a recent PCI (n = 1237). Among patients with a recent PCI on OAP agents, use of dual antiplatelet therapy decreased to 5.5%, and use of single antiplatelet therapy (SAPT) increased to 78.0% over 3 months post-randomization. Conversely, use of SAPT predominated at all time points in patients without a recent PCI history. There were no significant differences in the incidence of NACE or other outcomes assessed, except for major bleeding events, which were more frequent in patients with vs without a recent PCI history (hazard ratio [95% confidence interval]: 2.17 [1.27, 3.73]; P = 0.005). Conclusions: Patients with AF undergoing TAVI with a recent PCI have a similar risk of ischemic events and mortality, but an increased risk of major bleeding compared with patients without a recent PCI. Graphical abstract: [Figure not available: see fulltext.].</p

Uninterrupted edoxaban vs. vitamin K antagonists for ablation of atrial fibrillation: the ELIMINATE-AF trial.

AIMS: Edoxaban is a direct factor Xa inhibitor approved for stroke prevention in atrial fibrillation (AF). Uninterrupted edoxaban therapy in patients undergoing AF ablation has not been tested. METHODS AND RESULTS: The ELIMINATE-AF trial, a multinational, multicentre, randomized, open-label, parallel-group study, was conducted to assess the safety and efficacy of once-daily edoxaban 60 mg (30 mg in patients indicated for dose reduction) vs. vitamin K antagonists (VKAs) in AF patients undergoing catheter ablation. Patients were randomized 2:1 to edoxaban vs. VKA. The primary endpoint (per-protocol population) was time to first occurrence of all-cause death, stroke, or International Society of Thrombosis and Haemostasis-defined major bleeding during the period from the end of the ablation procedure to end of treatment (90 days). Overall, 632 patients were enrolled, 614 randomized, and 553 received study drug and underwent ablation; 177 subjects underwent brain magnetic resonance imaging to assess silent cerebral infarcts. The primary endpoint (only major bleeds occurred) was observed in 0.3% (1 patient) on edoxaban and 2.0% (2 patients) on VKA [hazard ratio (95% confidence interval): 0.16 (0.02-1.73)]. In the ablation population (modified intent-to-treat population including patients with ablation), the primary endpoint was observed in 2.7% of edoxaban (N = 10) and 1.7% of VKA patients (N = 3) between start of ablation and end of treatment. There were one ischaemic and one haemorrhagic stroke, both in patients on edoxaban. Cerebral microemboli were detected in 13.8% (16) patients who received edoxaban and 9.6% (5) patients in the VKA group (nominal P = 0.62). CONCLUSION: Uninterrupted edoxaban therapy represents an alternative to uninterrupted VKA treatment in patients undergoing AF ablation

Identification of Candidate Genes for Dyslexia Susceptibility on Chromosome 18

Background: Six independent studies have identified linkage to chromosome 18 for developmental dyslexia or general reading ability. Until now, no candidate genes have been identified to explain this linkage. Here, we set out to identify the gene(s) conferring susceptibility by a two stage strategy of linkage and association analysis. Methodology/Principal Findings: Linkage analysis: 264 UK families and 155 US families each containing at least one child diagnosed with dyslexia were genotyped with a dense set of microsatellite markers on chromosome 18. Association analysis: Using a discovery sample of 187 UK families, nearly 3000 SNPs were genotyped across the chromosome 18 dyslexia susceptibility candidate region. Following association analysis, the top ranking SNPs were then genotyped in the remaining samples. The linkage analysis revealed a broad signal that spans approximately 40 Mb from 18p11.2 to 18q12.2. Following the association analysis and subsequent replication attempts, we observed consistent association with the same SNPs in three genes; melanocortin 5 receptor (MC5R), dymeclin (DYM) and neural precursor cell expressed, developmentally down-regulated 4-like (NEDD4L). Conclusions: Along with already published biological evidence, MC5R, DYM and NEDD4L make attractive candidates for dyslexia susceptibility genes. However, further replication and functional studies are still required.Publisher PDFPeer reviewe

Early diagnosis and better rhythm management to improve outcomes in patients with atrial fibrillation: the 8th AFNET/EHRA consensus conference

Aims Despite marked progress in the management of atrial fibrillation (AF), detecting AF remains difficult and AF-related complications cause unacceptable morbidity and mortality even on optimal current therapy.Methods and results This document summarizes the key outcomes of the 8th AFNET/EHRA Consensus Conference of the Atrial Fibrillation NETwork (AFNET) and the European Heart Rhythm Association (EHRA). Eighty-three international experts met in Hamburg for 2 days in October 2021. Results of the interdisciplinary, hybrid discussions in breakout groups and the plenary based on recently published and unpublished observations are summarized in this consensus paper to support improved care for patients with AF by guiding prevention, individualized management, and research strategies. The main outcomes are (i) new evidence supports a simple, scalable, and pragmatic population-based AF screening pathway; (ii) rhythm management is evolving from therapy aimed at improving symptoms to an integrated domain in the prevention of AF-related outcomes, especially in patients with recently diagnosed AF; (iii) improved characterization of atrial cardiomyopathy may help to identify patients in need for therapy; (iv) standardized assessment of cognitive function in patients with AF could lead to improvement in patient outcomes; and (v) artificial intelligence (AI) can support all of the above aims, but requires advanced interdisciplinary knowledge and collaboration as well as a better medico-legal framework.Conclusions Implementation of new evidence-based approaches to AF screening and rhythm management can improve outcomes in patients with AF. Additional benefits are possible with further efforts to identify and target atrial cardiomyopathy and cognitive impairment, which can be facilitated by AI.</p

Management of Recovery Products PRM (Products Return Management)

Product Recovery Management (PRM) includes management of use and worn out products, components and materials. The aim of recovery management product is retrieval the economic and ecological value and it is leads to reduction of the final waste. Note, that traditional approach many Producers is very shallow. Producers for many years din not pay attention on re-use of many products. Products have been designed in such way, that assembly and distribution were limited to a minimum. First of all concerns were triggered by fear of additional charges for “green product”

Logistic processes in the municipal waste management in selected companies

W obecnych czasach gospodarka odpadami, zwłaszcza odpadami komunalnymi, staje się coraz ważniejsza. Ze względu na to, że odpady stanowią coraz większy problem, zarówno pod względem ekonomicznym, jak i środowiskowym ich liczba rośnie z każdym rokiem, ważne jest więc podjęcie działań w celu poprawnego postępowania z odpadami. Nieużytkowane odpady są kierowane na składowiska odpadów i mają negatywny wpływ nie tylko na środowisko ekologiczne, ale także środowisko społeczne - składowiska mogą mieć znaczący wpływ również na warunki życia społecznego. Celem artykułu jest przedstawienie procesów gospodarowania odpadami komunalnymi zgodnie z zasadami zrównoważonego rozwoju ekonomicznego i ochrony środowiska. Opisano procesy zachodzące w czasie gospodarowania odpadów komunalnych w oparciu o działalność wybranego przedsiębiorstwa. Wzrost świadomości ekologicznej, recyklingu, pozyskiwania surowców wtórnych wpływa na racjonalne gospodarowanie odpadami komunalnymi. Aby móc odpady poddać recyklingowi należy zebrać je oraz przetransportować do zakładów utylizacji, sortowni lub bezpośrednio na wysypiska odpadów.Paper discussed the processes of municipal waste management in line with the principles of sustainable economic development and environmental protection. The processes involved in the management of municipal waste are described on the basis of the selected activity enterprise. Increasing environmental awareness, recycling, and recycling of raw materials will affect the rational management of municipal waste. In order to be able to recycle waste, it is necessary to collect and transport it to disposal plants, sorting centres or directly to landfill sites

Sprężone obiekty kolejowe w aspekcie doświadczeń firmy Budimex

Fundusze europejskie przyznane Polsce w ramach perspektywy UE na lata 2014–2020 stanowią znaczący bodziec dla budownictwa infrastrukturalnego w naszym kraju. Co prawda przetargów organizowanych przez PKP w latach 2014–2017 było niewspółmiernie mniej niż organizowanych w tym samym czasie przez GDDKiA, jednak i w tych drugich do wykonania zdarzały się obiekty w ciągu linii kolejowych