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The main aim of this study was to assess the prognostic utility of TAPSE/PASP as an echocardiographic parameter of maladaptive RV remodeling in cardiomyopathy patients using cardiac magnetic resonance (CMR) imaging. Furthermore, we sought to compare TAPSE/PASP to TAPSE. The association of the echocardiographic parameters TAPSE/PASP and TAPSE with CMR parameters of RV and LV remodeling was evaluated in 111 patients with ischemic and non-ischemic cardiomyopathy and cut-off values for maladaptive RV remodeling were defined. In a second step, the prognostic value of TAPSE/PASP and its cut-off value were analyzed regarding mortality in a validation cohort consisting of 221 patients with ischemic and non-ischemic cardiomyopathy. A low TAPSE/PASP (

With growing populations and pressing environmental problems, future economies will be increasingly plant-based. Now is the time to reimagine plant science as a critical component of fundamental science, agriculture, environmental stewardship, energy, technology and healthcare. This effort requires a conceptual and technological framework to identify and map all cell types, and to comprehensively annotate the localization and organization of molecules at cellular and tissue levels. This framework, called the Plant Cell Atlas (PCA), will be critical for understanding and engineering plant development, physiology and environmental responses. A workshop was convened to discuss the purpose and utility of such an initiative, resulting in a roadmap that acknowledges the current knowledge gaps and technical challenges, and underscores how the PCA initiative can help to overcome them., National Science Foundation 1916797 David W Ehrhardt, Kenneth D Birnbaum, Seung Yon Rhee; National Science Foundation 2052590 Seung Yon Rhee

Die nosokomiale Pneumonie ist eine haufige Komplikation von Krankenhausaufenthalten mit einer nicht zu vernachlassigenden Letalitat. Im Zuge der Zunahme der multiresistenten Erreger ist eine empirische adaquate Initialtherapie schwierig und bedarf einer genauen Einschatzung des Risikos fur multiresistente Erreger. Dabei ist eine zielgerichtete, zeitlich begrenzte antibiotische Therapie essenziell. Diese sollte nach rationaler und fokussierter Diagnostik erfolgen. Eine Reevaluation der begonnenen Therapie ist unabdingbar, um eventuelle Differenzialdiagnosen nicht zu ubersehen und um die Therapie den mikrobiologischen Befunde sowie dem klinischen und laborchemischen Verlauf anzupassen. In der vorliegenden Ubersichtsarbeit werden die aktuellen nationalen Leitlinien zur Diagnostik und Therapie der nosokomial erworbenen Pneumonie vorgestellt. Besonderer Fokus wird auf die zielgerichtete, risikoadaptierte Therapie gelegt.

Community-acquired pneumonia (CAP) is a frequent and potentially fatal disorder. Due to the notably high mortality within the first days, the immediate initiation of rational diagnostic pathways and treatment is of tremendous prognostic impact. In this review article, the current German guideline on the diagnosis and therapy of CAP is presented. Special focus is put on structured patient management based on the individual risk for early identification of critically ill patients. In particular, risk assessment directly influences rational diagnostics and adequate therapy. New recommendations concerning preventive strategies are also discussed in this article.

The term pulmonary arterial hypertension comprises a group of pulmonary vascular diseases of different etiologies that are characterized by similar precapillary vascular remodeling processes and result in exertional dyspnea and right heart insufficiency. The specific pharmacological treatment approach considers the risk of mortality and phenotypical properties and includes treatment with phosphodiesterase type 5 inhibitors, endothelin receptor antagonists and prostanoids, as well as with more novel substances, such as a soluble guanylyl cyclase stimulator and an oral prostacyclin receptor agonist. The prognosis of the disease is mainly determined by the right heart insufficiency for which there is currently no specific pharmacological treatment. Lung transplantation may be offered as a last option. This review provides an overview of the current European guidelines from 2015 and the recommendations of the Cologne Consensus Conference for pulmonary hypertension from 2016.

Question addressedEchocardiography is not currently considered as providing sufficient prognostic information to serve as an integral part of treatment goals in pulmonary arterial hypertension (PAH). We tested the hypothesis that incorporation of multiple parameters reflecting right heart function would improve the prognostic value of this imaging modality.Methods and main resultsWe pooled individual patient data from a total of 517 patients (mean age 52±15 years, 64.8% females) included in seven observational studies conducted at five European and United States academic centres. Patients were subdivided into three groups representing progressive degrees of right ventricular dysfunction based on a combination of echocardiographic measurements, as follows. Group 1 (low risk): normal tricuspid annular plane systolic excursion (TAPSE) and nonsignificant tricuspid regurgitation (TR) (n=129); group 2 (intermediate risk): normal TAPSE and significant TR or impaired TAPSE and nondilated inferior vena cava (IVC) (n=256); group 3 (high risk): impaired TAPSE and dilated IVC (n=132). The 5-year cumulative survival rate was 82% in group 1, 63% in group 2 and 43% in group 3. Low-risk patients had better survival rates than intermediate-risk patients (log-rank Chi-squared 12.25; pAnswer to the questionThe proposed echocardiographic approach integrating the evaluation of TAPSE, TR grade and IVC is effective in stratifying the risk for all-cause mortality in PAH patients, outperforming the prognostic parameters suggested by current guidelines.

Pulmonary hypertension (PH) comprises a group of pulmonary vascular diseases that are characterized by progressive exertional dyspnea and right heart insufficiency ultimately resulting in right heart decompensation. The classification is into five clinical subgroups that form the absolutely essential basis for decisions on the indications for different pharmacological and non-pharmacological forms of treatment. The guidelines were updated in 2015 and in addition to the hitherto existing pharmacological treatment options of phosphodiesterase type 5 inhibitors, endothelin receptor antagonists and prostacyclins, the soluble guanylate cyclase stimulator riociguat has now been incorporated for treatment of certain forms of PH. This article provides an overview of the new treatment recommendations in the current guidelines, e. g. for PH patients who are in intensive care units due to surgical interventions or progressive right heart insufficiency.

Die pulmonale Hypertonie (PH) ist eine chronisch progrediente Erkrankung der pulmonalen Zirkulation multifaktorieller Ursache. Die aktuelle diagnostische Klassifikation der PH unterscheidet funf Hauptgruppen, die als Gemeinsamkeit einen erhohten mittleren pulmonalarteriellen Druck und pulmonalen Gefaswiderstand aufweisen. Klassifiziert werden die pulmonalarterielle Hypertonie (PAH), die PH durch Linksherzerkrankung, die PH bei Lungenerkrankungen und/oder Hypoxie, die chronische thromboembolische pulmonale Hypertonie (CTEPH) und die PH mit unklaren bzw. multifaktoriellen Mechanismen. Aktuelle Fortschritte in der Grundlagenforschung sowie die Zulassung neuer Medikamente und Etablierung von Therapiestrategien vor allem bei der PAH und CTEPH erfordern eine differenzierte Betrachtung der Erkrankung, eine sorgfaltige Diagnosestellung und Therapieeinleitung sowie regelmasige Verlaufskontrollen. In diesem Beitrag mochten wir einen aktuellen Uberblick uber die komplexe medikamentose Therapie der PAH geben.

Background: Persistent congestion with deteriorating renal function is an important cause of adverse outcomes in heart failure. Renal Doppler ultrasonography has been proposed to assess renal congestion but is not fully characterized, and current approaches do not reflect the full continuum of renal congestion. We aimed to characterize new approaches to evaluate renal congestion using Doppler ultrasonography. Methods: We enrolled 205 patients with suspected or pre-diagnosed pulmonary hypertension (PH) undergoing right heart catheterization. PH is the most common precursor to right ventricular failure, and thus represents an ideal scenario to study congestion. Patients underwent renal Doppler ultrasonography and assessment of invasive cardiopulmonary haemodynamics, echocardiography, renal function, intra-abdominal pressure, and hormonal and hydration status. Four renal venous flow patterns (RVFPs) and a novel renal venous stasis index (RVSI) were defined. The rate of PH-related morbidity and all-cause mortality (composite endpoint) was evaluated for 1 year post-discharge. Associations with outcome were assessed using Cox proportional hazard models. Prognostic utility of RVSI and RVFP was compared using receiver operating characteristic (ROC) curves. Findings: RVSI increased across the RVFPs (p

© The Author(s) 2018. Published by Oxford University Press. The future of agricultural research depends on data. The sheer volume of agricultural biological data being produced today makes excellent data management essential. Governmental agencies, publishers and science funders require data management plans for publicly funded research. Furthermore, the value of data increases exponentially when they are properly stored, described, integrated and shared, so that they can be easily utilized in future analyses. AgBioData (https://www.agbiodata.org) is a consortium of people working at agricultural biological databases, data archives and knowledgbases who strive to identify common issues in database development, curation and management, with the goal of creating database products that are more Findable, Accessible, Interoperable and Reusable. We strive to promote authentic, detailed, accurate and explicit communication between all parties involved in scientific data. As a step toward this goal, we present the current state of biocuration, ontologies, metadata and persistence, database platforms, programmatic (machine) access to data, communication and sustainability with regard to data curation. Each section describes challenges and opportunities for these topics, along with recommendations and best practices.

Type 2 diabetes is more prevalent in US American minority populations of African or Native American descent than it is in European Americans. However, the proportion of this epidemiological difference that can be ascribed to genetic or environmental factors is unknown. To determine whether genetic ancestry is correlated with diabetes risk in Latinos, we estimated the proportion of European ancestry in case-control samples from Mexico and Colombia in whom socioeconomic status had been carefully ascertained.We genotyped 67 ancestry-informative markers in 499 participants with type 2 diabetes and 197 controls from Medellín (Colombia), as well as in 163 participants with type 2 diabetes and 72 controls from central Mexico. Each participant was assigned a socioeconomic status scale via various measures.Although European ancestry was associated with lower diabetes risk in Mexicans (OR [95% CI] 0.06 [0.02-0.21], p = 2.0 x 10(-5)) and Colombians (OR 0.26 [0.08-0.78], p = 0.02), adjustment for socioeconomic status eliminated the association in the Colombian sample (OR 0.64 [0.19-2.12], p = 0.46) and significantly attenuated it in the Mexican sample (OR 0.17 [0.04-0.71], p = 0.02). Adjustment for BMI did not change the results.The proportion of non-European ancestry is associated with both type 2 diabetes and lower socioeconomic status in admixed Latino populations from North and South America. We conclude that ancestry-directed search for genetic markers associated with type 2 diabetes in Latinos may benefit from information involving social factors, as these factors have a quantitatively important effect on type 2 diabetes risk relative to ancestry effects.