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Background: Irregular cardiac motion can render conventional segmented cine MRI nondiagnostic. Clustering has been proposed for cardiac motion binning and may be optimized for complex arrhythmias. Purpose: To develop an adaptive cluster optimization method for irregular cardiac motion, and to generate the corresponding time‐resolved cine images. Study Type: Prospective. Subjects: Thirteen with atrial fibrillation, four with premature ventricular contractions, and one patient in sinus rhythm. Field Strength/Sequence: Free‐running balanced steady state free precession (bSSFP) with sorted golden‐step, reference real‐time sequence. Assessment: Each subject underwent both the sorted golden‐step bSSFP and the reference Cartesian real‐time imaging. Golden‐step bSSFP images were reconstructed using the dynamic regularized adaptive cluster optimization (DRACO) method and k‐means clustering. Image quality (4‐point Likert scale), signal‐to‐noise ratio (SNR), contrast‐to‐noise ratio (CNR), edge sharpness, and ventricular function were assessed. Statistical Tests: Paired t‐tests, Friedman test, regression analysis, Fleiss' Kappa, Bland–Altman analysis. Significance level P < 0.05. Results: The DRACO method had the highest percent of images with scores ≥3 (96% for diastolic frame, 93% for systolic frame, and 93% for multiphase cine) and the percentages were significantly higher compared with both the k‐means and real‐time methods. Image quality scores, SNR, and CNR were significantly different between DRACO vs. k‐means and between DRACO vs. real‐time. Cardiac function analysis showed no significant differences between DRACO vs. the reference real‐time. Conclusion: DRACO with time‐resolved reconstruction generated high quality images and has early promise for quantitative cine cardiac MRI in patients with complex arrhythmias including atrial fibrillation. Level of Evidence: 1. Technical Efficacy: Stage 2. [ABSTRACT FROM AUTHOR]

Aim: to reduce the number of paracolostomy complications and improve the quality stoma patients’ life by justifying the use of a comprehensive approach to the end colostomy, including preoperative marking, taking into account the variants of the structure of the muscular-aponeurotic frame of the anterior abdominal wall, as well as the individual features of vascularity and topography of the intestine section undergoing ostomy surgery.Materials and methods. To confirm the effectiveness of the proposed algorithm, an analysis of 52 clinical observations in patients who underwent surgeries with the formation of an end colostomy was carried out, which made up two clinical groups. In group 1 (n = 25) the developed therapeutic and diagnostic algorithm was applied, which included a rational choice of the colostomy localization site, taking into account individual features of the anterior abdominal wall structure, the quality of vascularity of the ostomy intestine, the terminal portion of its mesentery, the length and topography of the end section. Group 2 of patients (n = 27) underwent ostomy creation surgery using traditional techniques, without considering individual features.Results. The obtained results indicate the possibility of reducing the number of early (group 1 — 16 %, group 2 — 40.7 %; p < 0.05) and late (group 1 — 8 %, group 2 — 29.6 %; p < 0.05) paracolostomy complications, decreasing the number of repeated surgical interventions (three cases of re-creation of the stoma in the early postoperative period in group 2 and no indication for repeated interventions in group 1) and improving the quality of life in stoma patient through the application of the developed personalized algorithm. The assessment of the psychological (group 1 — 33.24, group 2 — 53.41) and physical (group 1 — 32.46, group 2 — 54.78) components of health based on the results of the SF-36 survey confirmed the advantages of the proposed tactics and therapeutic and diagnostic algorithm in group 1. The average number of hospital-stay days was also less in patients of clinical group 1 — 12.1 ± 3.4 days vs. 16 ± 4.7 in group 2.Conclusions. The use of patient-centered complex approach to determining the place and method of formation of an end colostomy, which includes taking into account the individual structure of the muscular-aponeurotic frame of the anterior abdominal wall, and the peculiarities of vascularity and topography of the intestine section undergoing ostomy surgery, is accompanied by a low number of early and late paracolostomy complications.

Background: Deep brain stimulation is a treatment for advanced Parkinson's disease and currently tuned to target motor symptoms during daytime. Parkinson's disease is associated with multiple nocturnal symptoms such as akinesia, insomnia, and sleep fragmentation, which may require adjustments of stimulation during sleep for best treatment outcome., Objectives: There is a need for a robust biomarker to guide stimulation titration across sleep stages. This study aimed to investigate whether evoked resonant neural activity (ERNA) is modulated by sleep., Methods: We recorded local field potentials from the subthalamic nucleus of four Parkinson's patients with externalized electrodes while applying single stimulation pulses to investigate the effect of sleep on ERNA., Results: We found that ERNA features change with wakefulness and sleep stages and are correlated with canonical frequency bands and heart rate., Conclusions: Given that ERNA modulates with sleep, it could be used as a robust marker for automatic stimulation titration during sleep. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society., (© 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.)