PURPOSE: Dual velocity encoding PC-MRI can produce spurious artifacts when using high ratios of velocity encoding values (VENCs), limiting its ability to generate high-quality images across a wide range of encoding velocities. This study aims to propose and compare dual-VENC correction methods for such artifacts. THEORY AND METHODS: Two denoising approaches based on spatiotemporal regularization are proposed and compared with a state-of-the-art method based on sign correction. Accuracy is assessed using simulated data from an aorta and brain aneurysm, as well as 8 two-dimensional (2D) PC-MRI ascending aorta datasets. Two temporal resolutions (30,60) ms and noise levels (9,12) dB are considered, with noise added to the complex magnetization. The error is evaluated with respect to the noise-free measurement in the synthetic case and to the unwrapped image without additional noise in the volunteer datasets. RESULTS: In all studied cases, the proposed methods are more accurate than the Sign Correction technique. Using simulated 2D+T data from the aorta (60 ms, 9 dB), the Dual-VENC (DV) error 0.82±0.07$$ 0.82\pm 0.07 $$ is reduced to: 0.66±0.04$$ 0.66\pm 0.04 $$ (Sign Correction); 0.34±0.04$$ 0.34\pm 0.04 $$ and 0.32±0.04$$ 0.32\pm 0.04 $$ (proposed techniques). The methods are found to be significantly different (p-value <0.05$$ <0.05 $$ ). Importantly, brain aneurysm data revealed that the Sign Correction method is not suitable, as it increases error when the flow is not unidirectional. All three methods improve the accuracy of in vivo data. CONCLUSION: The newly proposed methods outperform the Sign Correction method in improving dual-VENC PC-MRI images. Among them, the approach based on temporal differences has shown the highest accuracy.
- MeSH
- Algorithms * MeSH
- Aorta * diagnostic imaging MeSH
- Artifacts * MeSH
- Phantoms, Imaging MeSH
- Image Interpretation, Computer-Assisted methods MeSH
- Intracranial Aneurysm diagnostic imaging MeSH
- Humans MeSH
- Magnetic Resonance Imaging * methods MeSH
- Brain diagnostic imaging MeSH
- Computer Simulation MeSH
- Image Processing, Computer-Assisted * methods MeSH
- Signal-To-Noise Ratio * MeSH
- Reproducibility of Results MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
PURPOSE: STereotactic Arrhythmia Radioablation (STAR) showed promising results in patients with refractory ventricular tachycardia. However, clinical data are scarce and heterogeneous. The STOPSTORM.eu consortium was established to investigate and harmonize STAR in Europe. The primary goal of this benchmark study was to investigate current treatment planning practice within the STOPSTORM project as a baseline for future harmonization. METHODS AND MATERIALS: Planning target volumes (PTVs) overlapping extracardiac organs-at-risk and/or cardiac substructures were generated for 3 STAR cases. Participating centers were asked to create single-fraction treatment plans with 25 Gy dose prescriptions based on in-house clinical practice. All treatment plans were reviewed by an expert panel and quantitative crowd knowledge-based analysis was performed with independent software using descriptive statistics for International Commission on Radiation Units and Measurements report 91 relevant parameters and crowd dose-volume histograms. Thereafter, treatment planning consensus statements were established using a dual-stage voting process. RESULTS: Twenty centers submitted 67 treatment plans for this study. In most plans (75%) intensity modulated arc therapy with 6 MV flattening filter free beams was used. Dose prescription was mainly based on PTV D95% (49%) or D96%-100% (19%). Many participants preferred to spare close extracardiac organs-at-risk (75%) and cardiac substructures (50%) by PTV coverage reduction. PTV D0.035cm3 ranged from 25.5 to 34.6 Gy, demonstrating a large variety of dose inhomogeneity. Estimated treatment times without motion compensation or setup ranged from 2 to 80 minutes. For the consensus statements, a strong agreement was reached for beam technique planning, dose calculation, prescription methods, and trade-offs between target and extracardiac critical structures. No agreement was reached on cardiac substructure dose limitations and on desired dose inhomogeneity in the target. CONCLUSIONS: This STOPSTORM multicenter treatment planning benchmark study not only showed strong agreement on several aspects of STAR treatment planning, but also revealed disagreement on others. To standardize and harmonize STAR in the future, consensus statements were established; however, clinical data are urgently needed for actionable guidelines for treatment planning.
- MeSH
- Benchmarking * MeSH
- Radiotherapy Dosage MeSH
- Tachycardia, Ventricular surgery radiotherapy MeSH
- Consensus * MeSH
- Organs at Risk * radiation effects MeSH
- Humans MeSH
- Radiotherapy Planning, Computer-Assisted * standards methods MeSH
- Radiosurgery * standards methods MeSH
- Radiotherapy, Intensity-Modulated methods standards MeSH
- Heart radiation effects MeSH
- Arrhythmias, Cardiac MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Europe MeSH
V súčasnosti, aj napriek významnému pokroku v terapii akútnych kardiovaskulárnych (KV) príhod, miera kontroly krvného tlaku a dyslipidémií, ako hlavných rizikových faktorov KV-ochorení (KVO), stagnuje a tradičné prístupy často zlyhávajú. Iniciatívy v oblasti digitálnej medicíny sa začali objavovať už predtým, ako pandémia COVID-19 zásadne ovplyvnila spôsob poskytovania zdravotnej starostlivosti. Artériová hypertenzia je ideálnym kandidátom na vzdialený manažment a digitálne riešenia v tejto oblasti rýchlo pribúdajú. Štúdie preukázali, že metódy telemedicíny signifikantne znižujú systolický, ako aj diastolický tlak pacientov a pomáhajú zlepšovať dosahovanie cieľových hodnôt tlaku a adherenciu k terapii. Bolo však taktiež preukázané, že metódy mHealth (mobile Health) museli byť spojené so súbežnou konzultáciou so zdravotníkom. Aplikácie na monitorovanie vlastného zdravia, prípadne ,,selfcouching‘‘, ktoré fungovali na pasívnom zbere dát, nepreukázali vyššie uvedené výsledky. Taktiež sa ukázalo, že existujú mnohé prekážky v implementácii týchto technológií, ako sú prístrojové (používanie validovaných tlakomerov a metód merania), finančné (úhrady zo zdravotného poistenia, náklady pre pacienta), legislatívne (hlavne ochrana osobných údajov) a taktiež neexistujúca štandardizácia v tejto oblasti. Metódy telemedicíny sa začali uplatňovať aj pri manažmente dyslipidémií, lebo sa zistilo, že vzdialený manažment pacienta so súbežným informovaním samotného pacienta o jeho KV-riziku môže výrazne dopomôcť k zlepšeniu adherencie k terapii a v dosahovaní cieľových hodnôt lipidových parametrov.
Currently, despite significant advances in the treatment of acute cardiovascular (CV) events, rates of blood pressure control and dyslipidemia, as major risk factors for CV disease (CVD), are stagnant and traditional approaches often fail. Initiatives in digital medicine have already started to emerge before the COVID-19 pandemic fundamentally impacted the way healthcare is delivered. Arterial hypertension is an ideal candidate for remote management, and digital solutions in this area are rapidly gaining traction. Studies have shown that telemedicine methods significantly reduce both systolic and diastolic blood pressure of patients and help improve achievement of target blood pressure values and adherence to therapy. However, it was also shown that mHealth (mobile Health) methods had to be associated with concurrent consultation with a healthcare professional. Self-monitoring or “selfcouching” apps that worked on passive data collection did not show the above results. It has also been shown that there are many barriers to the implementation of these technologies, such as instrumentation (use of validated blood pressure monitors and measurement methods), financial (health insurance reimbursement, cost to the patient), legislative (mainly privacy) and also the lack of standardization in this area. Telemedicine methods have also started to be applied in the management of dyslipidemia, where it has been found that remote patient management with simultaneous information to the patient about his/her CV risk can significantly help to improve adherence to therapy and in achieving target values of lipid parameters.
Úvod: Mnohé štúdie a metaanalýzy preukázali, že telemonitorovanie krvného tlaku ako aj iných faktorov metabolického syndrómu môže zlepšiť ich manažment. Avšak mnoho pacientov nevyužíva telemonitorovanie kvôli osobným, technologickým a iným bariéram. Cieľom tejto štúdie bolo zistenie aké sú perspektívy a prekážky telemonitoringu lipitenzie na Slovensku z pohľadu pacienta. Metódy: Táto štúdia bola realizovaná ako dotazníková a mala za cieľ osloviť 2 545 pacientov. Dotazník pozostával z častí zameraných na osobné charakteristiky pacienta, návyky z hľadiska merania krvného tlaku (TK), na využívanie smart-technológií, ich predpokladané prínosy a prekážky z hľadiska pacienta ako aj na znalosť lipidového profilu a kardiovaskulárneho rizika samotným pacientom. Výsledky: Celkovo sme získali 252 odpovedí od pacientov (9,9 %). Z celkového počtu opýtaných má arteriálnu hypertenziu 67,4 %, kým nefarmakologickú terapiu užíva 7,9 %. Denne si TK meria len 21,2 % hypertonikov, signifikantne vyšší počet mužov ako žien (p = 0,011) a najčastejšie si meria TK veková kategória 31–45 rokov. Až 19,4 % využíva nositeľné zariadenia a 6,3 % tlakomery prepojené s aplikáciou. Signifikantne častejšie smart-technológie využíva kategória 31–45-ročných (p = 0,01). Závažné prekážky využitia smart-technológií neboli identifikované, väčšina si vyžadovala funkciu vzdialených konzultácií, úpravy liekov a jednoduché užívateľské rozhranie. Väčšina pacientov nevie svoju hodnotu LDL-cholesterolu a až 45,7 % tých čo vie, malo zvýšené hladiny. Záver: Celkovo prevláda záujem o využitie metód telemedicíny krvného tlaku, pri jej implementácii na Slovensku bude však nutná spolupráca pacienta a lekára.
Introduction: Numerous studies and meta-analyses have demonstrated that telemonitoring of blood pressure and other factors of metabolic syndrome can improve their management. However, many patients do not use telemonitoring due to personal, technological, and healthcare barriers. The aim of this study was to identify the perspectives and barriers to telemonitoring of lipid levels in Slovakia from the patient’s point of view. Methods: This study was conducted as a questionnaire-based survey targeting 2,545 patients. The questionnaire consisted of sections focused on patients’ personal characteristics, habits regarding blood pressure measurement, the use of smart technologies, their perceived benefits and barriers, as well as the patients’ knowledge of their lipid profile and cardiovascular risk. Results: A total of 252 responses were obtained (9.9 % response rate). Among the respondents, 67.4 % had hypertension, while 7.9 % were on non-pharmacological therapy. Only 21.2 % of hypertensive patients measured their blood pressure daily, with a significantly higher proportion of men compared to women (p = 0.011), and the most frequent blood pressure monitoring was observed in the 31–45 age group. A total of 19.4 % used wearable devices, and 6.3 % used blood pressure monitors connected to an app. Smart technology use was significantly more common in the 31–45 age group (p = 0.01). No severe barriers to the use of smart technologies were identified; most patients required features such as remote consultations, medication adjustments, and user-friendly interfaces. The majority of patients were unaware of their LDL-C values, and 45.7 % of those who were aware had elevated levels. Conclusion: There is a prevailing interest in implementing telemedicine methods for blood pressure monitoring. However, collaboration between patients and physicians will be necessary for its successful implementation in Slovakia.
- MeSH
- Digital Health MeSH
- Dyslipidemias prevention & control MeSH
- Hypertension * epidemiology prevention & control MeSH
- Humans MeSH
- Blood Pressure Determination methods MeSH
- Surveys and Questionnaires MeSH
- Heart Disease Risk Factors MeSH
- Statistics as Topic MeSH
- Telemedicine * methods MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Slovakia MeSH
- MeSH
- Digital Health MeSH
- Physicians, Primary Care MeSH
- Humans MeSH
- Professional Competence MeSH
- Primary Health Care * organization & administration MeSH
- Telemedicine methods MeSH
- Vaccination MeSH
- Check Tag
- Humans MeSH
- Publication type
- Interview MeSH
- MeSH
- Digital Technology MeSH
- Long-Term Care MeSH
- Information Technology MeSH
- Congresses as Topic MeSH
- Humans MeSH
- Social Work MeSH
- Telemedicine MeSH
- Health Information Systems * MeSH
- Check Tag
- Humans MeSH
- Publication type
- News MeSH
PURPOSE: The purpose of this narrative review is to provide a comparison of several countries with different legislation and approaches to pharmacovigilance and to point out how these impact the number of adverse drug reactions (ADRs) that are reported to national competent authorities. METHODS: Legislative and statistical data regarding ADR reporting from various national competent authorities' websites, databases, and pharmacovigilance centers were used. In combination with the WHO pharmacovigilance quantitative indicator that was applied to evaluate the effectiveness of particular national pharmacovigilance systems in our scope. RESULTS: The study compared pharmacovigilance systems in six countries, focusing on ADR reporting from 2010 onwards. All countries required MAHs to report ADRs, while healthcare professionals' obligations varied. Per-capita ADR reports increased in all countries with available data, with the United States having a significantly higher reporting rate, possibly due to FDA campaigns. Despite starting later, China's per-capita reporting rate surpassed that of the Czech Republic and Japan. The study highlighted various measures taken by countries to enhance ADR reporting systems since the inception of their programs, contributing to the overall increase in reporting rates. CONCLUSIONS: ADR reporting is a global priority, with efforts made by different countries to strengthen their pharmacovigilance systems. Some success can be seen in gradually improving per-capita ADR reporting rates. The varying reporting rates and measures taken by each country may serve as a basis for further research and exchange of best practices to improve drug safety monitoring worldwide.
- MeSH
- Biomimetics MeSH
- Philosophy MeSH
- Information Systems MeSH
- Humans MeSH
- Neural Networks, Computer MeSH
- Computer Systems MeSH
- Industry MeSH
- Robotics MeSH
- Machine Learning MeSH
- Man-Machine Systems MeSH
- Models, Theoretical MeSH
- Artificial Intelligence * MeSH
- Consciousness MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- Keywords
- Mediately,
- MeSH
- Digital Health * MeSH
- Humans MeSH
- Mobile Applications MeSH
- Breast Neoplasms diagnosis MeSH
- Neoplasms therapy MeSH
- Antineoplastic Agents, Immunological administration & dosage adverse effects MeSH
- Telemedicine MeSH
- Check Tag
- Humans MeSH
- Publication type
- Interview MeSH
Lipidomics and metabolomics communities comprise various informatics tools; however, software programs handling multimodal mass spectrometry (MS) data with structural annotations guided by the Lipidomics Standards Initiative are limited. Here, we provide MS-DIAL 5 for in-depth lipidome structural elucidation through electron-activated dissociation (EAD)-based tandem MS and determining their molecular localization through MS imaging (MSI) data using a species/tissue-specific lipidome database containing the predicted collision-cross section values. With the optimized EAD settings using 14 eV kinetic energy, the program correctly delineated lipid structures for 96.4% of authentic standards, among which 78.0% had the sn-, OH-, and/or C = C positions correctly assigned at concentrations exceeding 1 μM. We showcased our workflow by annotating the sn- and double-bond positions of eye-specific phosphatidylcholines containing very-long-chain polyunsaturated fatty acids (VLC-PUFAs), characterized as PC n-3-VLC-PUFA/FA. Using MSI data from the eye and n-3-VLC-PUFA-supplemented HeLa cells, we identified glycerol 3-phosphate acyltransferase as an enzyme candidate responsible for incorporating n-3 VLC-PUFAs into the sn1 position of phospholipids in mammalian cells, which was confirmed using EAD-MS/MS and recombinant proteins in a cell-free system. Therefore, the MS-DIAL 5 environment, combined with optimized MS data acquisition methods, facilitates a better understanding of lipid structures and their localization, offering insights into lipid biology.
- MeSH
- Data Mining * methods MeSH
- Phosphatidylcholines metabolism chemistry MeSH
- HeLa Cells MeSH
- Mass Spectrometry methods MeSH
- Humans MeSH
- Lipidomics * methods MeSH
- Lipids chemistry analysis MeSH
- Metabolomics methods MeSH
- Fatty Acids, Unsaturated metabolism chemistry MeSH
- Software MeSH
- Tandem Mass Spectrometry methods MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
