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Somatosensory evoked potentials (SSEPs) are utilized during aneurysm clipping to detect intraoperative ischemia. We assess the diagnostic accuracy of SSEPs in predicting perioperative stroke during aneurysm clipping. A retrospective review was conducted of 429 consecutive patients who underwent surgical clipping for ruptured and unruptured cerebral aneurysms with intraoperative SSEP monitoring from 2006 to 2013. The relationship between perioperative stroke and SSEP changes was analyzed by calculating the sensitivity, specificity, and area under a Receiving Operating Characteristic curve. Sensitivity and specificity were 42% and 90%, respectively. Area under the curve was 0.66 (95% confidence interval, 0.53–0.79). Reclassification of reversible temporary clip changes to correct for paradoxical classification of SSEP false positives raised the sensitivity from 42 to 65% (p = 0.041, Chi squared test). EEG (electroencephalography) changes increased the specificity (98% vs. 90%, p

Acacia mangium is the main plantation species in Vietnam, accounting for more than 54% of the plantation forest estate. However, acacia plantations throughout Vietnam have been widely infected by Ceratocystis manginecans wilt disease, posing a serious threat to the long-term commercial viability of the species. Experiments were performed for the control of C. manginecans on Acacia mangium, testing nine different chemical fungicides, three biological agents, and four bacterial endophytes isolated from Acacia mangium. Experiments in vitro showed the fungicides Lanomyl 680WP, Ao’yo 300SC, Carbenzim 500FL and Ridomil Golf 68WG have a strong inhibitory effect against C. manginecans. The biological agent Biobus 100WP and one bacterial endophyte strain (Bacillus tequilensis K7) isolated from Acacia mangium also had strong inhibitory activity. These fungicides, biological agents and endophytes could also inhibit C. manginecans growth on excised leaves and one-year-old seedlings. These fungicides, biological agents and bacterial endophytes show potential for the control of C. manginecans wilt disease on acacia plantations, although further work is required to determine their efficacy in field trials.

We characterized the microstructural response of the myocardium to cardiovascular disease using diffusion tensor imaging (DTI) and performed histological validation by intact, un-sectioned, three-dimensional (3D) histology using a tissue-clearing technique. The approach was validated in normal (n = 7) and ischemic (n = 8) heart failure model mice. Whole heart fiber tracking using DTI in fixed ex-vivo mouse hearts was performed, and the hearts were processed with the tissue-clearing technique. Cardiomyocytes orientation was quantified on both DTI and 3D histology. Helix angle (HA) and global HA transmurality (HAT) were calculated, and the DTI findings were confirmed with 3D histology. Global HAT was significantly reduced in the ischemic group (DTI: 0.79 ± 0.13°/% transmural depth [TD] and 3D histology: 0.84 ± 0.26°/%TD) compared with controls (DTI: 1.31 ± 0.20°/%TD and 3D histology: 1.36 ± 0.27°/%TD, all p 2 = 0.803) and per-segment analyses (R2 = 0.872). We demonstrated the capability and accuracy of DTI for mapping cardiomyocytes orientation by comparison with the intact 3D histology acquired by tissue-clearing technique. DTI is a promising tool for the noninvasive characterization of cardiomyocytes architecture.

Background Coronary high intensity plaques (CHIPs) detected using cardiovascular magnetic resonance (CMR) coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) have been shown to be positively associated with high-risk morphology observed on intracoronary optical coherence tomography (OCT). This study sought to validate whether CHIPs detected on CATCH indicate the presence of intraplaque hemorrhage (IPH) through ex vivo imaging of carotid and coronary plaque specimens, with histopathology as the standard reference. Methods Ten patients scheduled to undergo carotid endarterectomy underwent CMR with the conventional T1-weighted (T1w) sequence. Eleven carotid atherosclerotic plaques removed at carotid endarterectomy and six coronary artery endarterectomy specimens removed from patients undergoing coronary artery bypass grafting (CABG) were scanned ex vivo using both the conventional T1w sequence and CATCH. Both in vivo and ex vivo images were examined for the presence of IPH. The sensitivity, specificity, and Cohen Kappa (k) value of each scan were calculated using matched histological sections as the reference. k value between each scan in the discrimination of IPH was also computed. Results A total of 236 in vivo locations, 328 ex vivo and matching histology locations were included for the analysis. Sensitivity, specificity, and k value were 76.7%, 95.3%, and 0.75 for in vivo T1w imaging, 77.2%, 97.4%, and 0.78 for ex vivo T1w imaging, and 95.0%, 92.1%, and 0.84 for ex vivo CATCH, respectively. Moderate agreement was reached between in vivo T1w imaging, ex vivo T1w imaging, and ex vivo CATCH for the detection of IPH: between in vivo T1w imaging and ex vivo CATCH (k = 0.68), between ex vivo T1w imaging and ex vivo CATCH (k = 0.74), between in vivo T1w imaging and ex vivo T1w imaging (k = 0.83). None of the coronary artery plaque locations showed IPH. Conclusion This study demonstrated that carotid CHIPs detected by CATCH can be used to assess for IPH, a high-risk plaque feature.

Background Recent studies have demonstrated the potential of in vivo diffusion-weighted MRI (DWI) in detecting myocardial replacement fibrosis for chronic myocardial infarction [1-3]. Despite the potential of this contrastfree technique, detecting diffuse myocardial fibrosis with DWI has not been established. Current cardiac MRI (CMR) techniques to detect diffuse myocardial fibrosis include late gadolinium enhancement (LGE) [4], pre/ post contrast T1 mapping [5], and extracellular volume (ECV) mapping [6]. We propose the application of a recently developed cardiac DWI technique [7] to detect diffuse myocardial fibrosis in HCM patients and compare its performance with established CMR techniques.

Background Currently, there are only two main methods to perform diffusion tensor CMR (DT-CMR) that either rely on the subject exhibiting stable, periodic RR cycle (stimulated echo [1]) or utilize specialized research scanners that have ultra-high gradient strengths (spin-echo [2]). Recent work has demonstrated that gradient moment nulling (GMN) of the second order is capable of yielding robust diffusion weighted images (DWI) [3]. To extend this work, we present a novel DT-CMR sequence prototype that utilizes a M2 GMN gradient scheme that is robust to imperfect B1 refocusing at high main fields (≥3T). We compare this with no GMN compensation (M0) and first order GMN compensation (M1). Patients with advanced heart failure (HF) were also scanned to test its ability in a clinical setting.

Background Regional healthcare facility surveys to quantitatively assess nosocomial infection rates are important for confirming standardized data collection and assessing health outcomes in the era of mandatory reporting. This is particularly important for the assessment of infection control policies and healthcare associated infection rates among hospitals. However, the success of such surveys depends upon high participation and representativeness of respondents. Methods This descriptive paper provides methodologies that may have contributed to high participation in a series of administrative, infection control, and microbiology laboratory surveys of all 31 hospitals in a large southern California county. We also report 85% (N = 72) countywide participation in an administrative survey among nursing homes in this same area. Results Using in-person recruitment, 48% of hospitals and nursing homes were recruited within one quarter, with 75% recruited within three quarters. Conclusions Potentially useful strategies for successful recruitment included in-person recruitment, partnership with the local public health department, assurance of anonymity when presenting survey results, and provision of staff labor for the completion of detailed survey tables on the rates of healthcare associated pathogens. Data collection assistance was provided for three-fourths of surveys. High compliance quantitative regional surveys require substantial recruitment time and study staff support for high participation.