Automated echocardiographic detection of heart failure with preserved ejection fraction using artificial intelligence

Background: Detection of heart failure with preserved ejection fraction (HFpEF) involves integration of multiple imaging and clinical features which are often discordant or indeterminate. Objectives: We applied artificial intelligence (AI) to analyze a single apical four-chamber (A4C) transthoracic echocardiogram videoclip to detect HFpEF. Methods: A three-dimensional convolutional neural network was developed and trained on A4C videoclips to classify patients with HFpEF (diagnosis of HF, EF≥50%, and echocardiographic evidence of increased filling pressure; cases) versus without HFpEF (EF≥50%, no diagnosis of HF, normal filling pressure; controls). Model outputs were classified as HFpEF, no HFpEF, or non-diagnostic (high uncertainty). Performance was assessed in an independent multi-site dataset and compared to previously validated clinical scores. Results: Training and validation included 2971 cases and 3785 controls (validation holdout, 16.8% patients), and demonstrated excellent discrimination (AUROC:0.97 [95%CI:0.96-0.97] and 0.95 [0.93-0.96] in training and validation, respectively). In independent testing (646 cases, 638 controls), 94 (7.3%) were non-diagnostic; sensitivity (87.8%; 84.5-90.9%) and specificity (81.9%; 78.2-85.6%) were maintained in clinically relevant subgroups, with high repeatability and reproducibility. Of 701 and 776 indeterminate outputs from the HFA-PEFF and H2FPEF scores, the AI HFpEF model correctly reclassified 73.5 and 73.6%, respectively. During follow-up (median [IQR]:2.3 [0.5-5.6] years), 444 (34.6%) patients died; mortality was higher in patients classified as HFpEF by AI (hazard ratio [95%CI]:1.9 [1.5-2.4]). Conclusion: An AI HFpEF model based on a single, routinely acquired echocardiographic video demonstrated excellent discrimination of patients with versus without HFpEF, more often than clinical scores, and identified patients with higher mortality

Hamstring muscles: Architecture and innervation

Knowledge of the anatomical organization of the hamstring muscles is necessary to understand their functions, and to assist in the development of accurate clinical and biomechanical models. The hamstring muscles were examined by dissection in six embalmed human lower limbs with the purpose of clarifying their gross morphology. In addition to obtaining evidence for or against anatomical partitioning ( as based on muscle architecture and pattern of innervation), data pertaining to architectural parameters such as fascicular length, volume, physiological cross-sectional area, and tendon length were collected. For each muscle, relatively consistent patterns of innervation were identified between specimens, and each was unique with respect to anatomical organization. On the basis of muscle architecture, three regions were identified within semimembranosus. However, this was not completely congruent with the pattern of innervation, as a primary nerve branch supplied only two regions, with the third region receiving a secondary branch. Semitendinosus comprised two distinct partitions arranged in series that were divided by a tendinous inscription. A singular muscle nerve or a primary nerve branch innervated each partition. In the biceps femoris long head the two regions were supplied via a primary nerve branch which divided into two primary branches or split into a series of branches. Being the only muscle to cross a single joint, biceps femoris short head consisted of two distinct regions demarcated by fiber direction, with each innervated by a separate muscle nerve. Architecturally, each muscle differed with respect to parameters such as physiological cross-sectional area, fascicular length and volume, but generally all partitions within an individual muscle were similar in fascicular length. The long proximal and distal tendons of these muscles extended into the muscle bellies thereby forming elongated musculotendinous junctions. Copyright (C) 2005 S. Karger AG, Basel

7th Drug hypersensitivity meeting: part two

No abstract availabl

The present and future of QCD

This White Paper presents an overview of the current status and future perspective of QCD research, based on the community inputs and scientific conclusions from the 2022 Hot and Cold QCD Town Meeting. We present the progress made in the last decade toward a deep understanding of both the fundamental structure of the sub-atomic matter of nucleon and nucleus in cold QCD, and the hot QCD matter in heavy ion collisions. We identify key questions of QCD research and plausible paths to obtaining answers to those questions in the near future, hence defining priorities of our research over the coming decades

Presence of double-stranded RNAs in human and calf isolates of Cryptosporidium parvum

We examined the occurrence of 2 virus-like double-stranded (ds)RNAs in human and calf isolates of Cryptosporidium parvum senso latu and other microorganisms, including 7 other members of the genus. A total of 32 isolates of C. parium, 16 from humans (5 from acquired immune deficiency syndrome patients) and 16 from calves, were analyzed. Ethidium bromide staining, or Northern blot analysis, or reverse transcription/polymerase chain reaction, or all 3 methods, revealed that both genotype 1 and genotype 2 isolates of C. parvum possessed these dsRNAs. No other Cryptosporidium spp. or other organisms examined possessed these dsRNAs. Comparison analysis of partial cDNA sequences of dsRNAs from human and calf isolates revealed a high degree of similarity (>92% and >93% identical nucleotides for large and small dsRNAs, respectively). Slight, consistent differences in nucleotide sequences could be seen at select sites and were associated with an isolate being either genotype 1 or 2. Because of the widespread distribution of the dsRNAs, the similarity of these molecules between isolates, and high host specificity, these nucleic acids may prove to represent species-specific molecular markers for C. parvum. Evidence also suggests that the dsRNA can be utilized for molecular genotyping of C. parvum

TERROR SUPPORT AND RECRUITMENT

We analyse a dynamic model linking terrorist activities to popular support through a recruitment mechanism. It is shown that anti-terrorism policies focusing on liberal ideals (reducing repression, increasing economic opportunity) are effective at abating recruitment, thereby affecting the dynamic stability of terrorist attacks. In contrast, deterrence's comparative advantage is in counteracting hard-core members, implying that terror eradication itself requires an emphasis on hard-core membership, rather than popular support for terror activities.Terrorist networks, Anti-terrorist policies, Terrorist recruitment,