Artificial Intelligence Advances in the World of Cardiovascular Imaging

The tremendous advances in digital information and communication technology have entered everything from our daily lives to the most intricate aspects of medical and surgical care. These advances are seen in electronic and mobile health and allow many new applications to further improve and make the diagnoses of patient diseases and conditions more precise. In the area of digital radiology with respect to diagnostics, the use of advanced imaging tools and techniques is now at the center of evaluation and treatment. Digital acquisition and analysis are central to diagnostic capabilities, especially in the field of cardiovascular imaging. Furthermore, the introduction of artificial intelligence (AI) into the world of digital cardiovascular imaging greatly broadens the capabilities of the field both with respect to advancement as well as with respect to complete and accurate diagnosis of cardiovascular conditions. The application of AI in recognition, diagnostics, protocol automation, and quality control for the analysis of cardiovascular imaging modalities such as echocardiography, nuclear cardiac imaging, cardiovascular computed tomography, cardiovascular magnetic resonance imaging, and other imaging, is a major advance that is improving rapidly and continuously. We document the innovations in the field of cardiovascular imaging that have been brought about by the acceptance and implementation of AI in relation to healthcare professionals and patients in the cardiovascular field.

Constipation Caused by Anti-calcitonin Gene-Related Peptide Migraine Therapeutics Explained by Antagonism of Calcitonin Gene-Related Peptide’s Motor-Stimulating and Prosecretory Function in the Intestine

The development of small-molecule calcitonin gene-related peptide (CGRP) receptor antagonists (gepants) and of monoclonal antibodies targeting the CGRP system has been a major advance in the management of migraine. In the randomized controlled trials before regulatory approval, the safety of these anti-CGRP migraine therapeutics was considered favorable and to stay within the expected profile. Post-approval real-world surveys reveal, however, constipation to be a major adverse event which may affect more than 50% of patients treated with erenumab (an antibody targeting the CGRP receptor), fremanezumab or galcanezumab (antibodies targeting CGRP). In this review article we address the question whether constipation caused by inhibition of CGRP signaling can be mechanistically deduced from the known pharmacological actions and pathophysiological implications of CGRP in the digestive tract. CGRP in the gut is expressed by two distinct neuronal populations: extrinsic primary afferent nerve fibers and distinct neurons of the intrinsic enteric nervous system. In particular, CGRP is a major messenger of enteric sensory neurons which in response to mucosal stimulation activate both ascending excitatory and descending inhibitory neuronal pathways that enable propulsive (peristaltic) motor activity to take place. In addition, CGRP is able to stimulate ion and water secretion into the intestinal lumen. The motor-stimulating and prosecretory actions of CGRP combine in accelerating intestinal transit, an activity profile that has been confirmed by the ability of CGRP to induce diarrhea in mice, dogs and humans. We therefore conclude that the constipation elicited by antibodies targeting CGRP or its receptor results from interference with the physiological function of CGRP in the small and large intestine in which it contributes to the maintenance of peristaltic motor activity, ion and water secretion and intestinal transit.

Structural Biology Illuminates Molecular Determinants of Broad Ebolavirus Neutralization by Human Antibodies for Pan-Ebolavirus Therapeutic Development

Monoclonal antibodies (mAbs) have proven effective for the treatment of ebolavirus infection in humans, with two mAb-based drugs Inmazeb™ and Ebanga™ receiving FDA approval in 2020. While these drugs represent a major advance in the field of filoviral therapeutics, they are composed of antibodies with single-species specificity for Zaire ebolavirus. The Ebolavirus genus includes five additional species, two of which, Bundibugyo ebolavirus and Sudan ebolavirus, have caused severe disease and significant outbreaks in the past. There are several recently identified broadly neutralizing ebolavirus antibodies, including some in the clinical development pipeline, that have demonstrated broad protection in preclinical studies. In this review, we describe how structural biology has illuminated the molecular basis of broad ebolavirus neutralization, including details of common antigenic sites of vulnerability on the glycoprotein surface. We begin with a discussion outlining the history of monoclonal antibody therapeutics for ebolaviruses, with an emphasis on how structural biology has contributed to these efforts. Next, we highlight key structural studies that have advanced our understanding of ebolavirus glycoprotein structures and mechanisms of antibody-mediated neutralization. Finally, we offer examples of how structural biology has contributed to advances in anti-viral medicines and discuss what opportunities the future holds, including rationally designed next-generation therapeutics with increased potency, breadth, and specificity against ebolaviruses.

Design framework for polarization-insensitive multifunctional achromatic metalenses

Controlling the wavefront of light, especially on a subwavelength scale, is pivotal in modern optics. Metasurfaces present a unique platform for realizing flat lenses, called metalenses, with thicknesses on the order of the wavelength. Despite substantial effort, however, suppressing the chromatic aberrations over large operational bandwidths of metalenses still remains a challenge. Here, we develop a systematic design method enabling a simultaneous, polarization-insensitive control of the phase and the group delay of a light beam based on libraries of transmission-mode dielectric meta-elements. Mid-infrared achromatic metalenses are designed and theoretically analyzed to have diffraction-limited focal spots with vanishing chromatic aberrations in the operating wavelength range of 6–8.5 μm, while maintaining high focusing efficiencies of 41% on average. The proposed methodology, which can be used as a general design rule for all spectra, also provides a versatile design scheme for ultrashort pulse focusing and achromatic vortex-beam generation (orbital angular momentum), representing a major advance toward practical implementations of functional metalenses.

Behavior of sustainable Reactive Powder Concrete by Using Glass Powder as a Replacement of Cement

Every year, the world produces one million tons of glass garbage. Once the glass has been broken down, it is dumped in landfills, where it will remain inert for hundreds of years. glass is mainly made of silica. For long-term infrastructure development, ground glass as a partial cement substitute may be a major advance (environmentally friendly, energy-saving, and economic). Secondary calcium silicate hydrate is expected to be produced when glass waste is crushed into microscopic particles and then reacts with cement hydrate through pozzolanic interactions (C-S-H). There were experiments done on concrete utilizing (0-35 per cent) ground glass and superplasticizer, silica fume, fine sand and fibres, with the water to binder (cement + glass) ratio maintained constant for all degrees of replacement on compressive strength, modulus of elasticity and tensile strength. Steel is a fixed quantity that applies to all conceivable configurations. Concrete cube samples were made and tested for strength (28 days curing). It was discovered that the recycled glass concrete outperformed control samples in compressive strength tests. Compressive strength, tensile strength, and modulus of elasticity are all greatest in the 25 per cent glass powder. It was decided that using recycled glass trash in place of 25 per cent of the cement was a good idea because of the economic and environmental advantages.

Wave-based optical coherence elastography: the 10-year perspective

After ten years of progress and innovation, optical coherence elastography (OCE) based on the propagation of mechanical waves has become one of the major and, perhaps, one of the most studied OCE branches, producing a fundamental impact in the quantitative and nondestructive biomechanical characterization of tissues. Preceding previous progress made in ultrasound and magnetic resonance elastography; wave-based OCE has pushed to the limit the advance of three major pillars: (1) implementation of novel wave excitation methods in tissues, (2) understanding new types of mechanical waves in complex boundary conditions by proposing advance analytical and numerical models, and (3) the development of novel estimators capable of retrieving quantitative 2D/3D biomechanical information of tissues. This remarkable progress promoted a major advance in answering basic science questions and improving medical disease diagnosis and treatment monitoring in several types of tissues leading, ultimately, to the first attempts of clinical trials and translational research. This paper summarizes the fundamental up-to-date principles and categories of wave-based OCE, revises the timeline and the state-of-the-art techniques and applications lying in those categories, and concludes with a discussion of current challenges and future directions, including clinical translation research.

Burn Care in the Era of Rapid Enzymatic Debridement: Challenging the Dogma that Healing Beyond 21 Days Results in Hypertrophic Scarring

Deep burns are characterized by the presence of a necrotic eschar that delays healing and results in a local and systemic inflammatory response and following healing by secondary intention: heavy scarring. Early surgical debridement followed by grafting was a major advance in deep burn care and is now the standard of care, reducing mortality and hypertrophic scarring. Eschars have alternatively been managed by non-surgical, autolytic debridement, which often results in infection-inflammation, slow epithelialization, granulation tissue formation and subsequent scarring. Studies based on these traditional approaches have demonstrated an association between delayed wound closure (beyond 21 days) and scarring. Early enzymatic debridement with NexoBrid (NXB) followed by appropriate wound care is a novel minimally invasive modality that challenges the well-accepted dictum of a high risk of hypertrophic scarring associated with wound closure that extends beyond 21 days. This is not surprising since early and selective removal of only the necrotic eschar often leaves enough viable dermis and skin appendages to allow healing by epithelialization over the dermis. In the absence of necrotic tissue, healing is similar to epithelialization of clean dermal wounds (like many donor sites) and not healing by the secondary intention that is based on granulation tissue formation and subsequent scarring. If and when granulation islands start to appear on the epithelializing dermis, they and the inflammatory response generally can be controlled by short courses (1-3 days) of topically applied low strength corticosteroid ointments minimizing the risk of hypertrophic scarring, albeit with wound closure delayed beyond the magic number of 21 days. Results from multiple studies and field experience confirm that while deep burns managed with early enzymatic debridement often require more than 21 days to reepithelialize, long-term cosmetic results are at least as good as with excision and grafting.

Grazing weakens competitive interactions between active methanotrophs and nitrifiers modulating greenhouse-gas emissions in grassland soils

Grassland soils serve as a biological sink and source of the potent greenhouse gases (GHG) methane (CH4) and nitrous oxide (N2O). The underlying mechanisms responsible for those GHG emissions, specifically, the relationships between methane- and ammonia-oxidizing microorganisms in grazed grassland soils are still poorly understood. Here, we characterized the effects of grazing on in situ GHG emissions and elucidated the putative relations between the active microbes involving in methane oxidation and nitrification activity in grassland soils. Grazing significantly decreases CH4 emissions while it increases N2O emissions basing on 14-month in situ measurement. DNA-based stable isotope probing (SIP) incubation experiment shows that grazing decreases both methane oxidation and nitrification processes and decreases the diversity of active methanotrophs and nitrifiers, and subsequently weakens the putative competition between active methanotrophs and nitrifiers in grassland soils. These results constitute a major advance in our understanding of putative relationships between methane- and ammonia-oxidizing microorganisms and subsequent effects on nitrification and methane oxidation, which contribute to a better prediction and modeling of future balance of GHG emissions and active microbial communities in grazed grassland ecosystems.

Dark exciton anti-funneling in atomically thin semiconductors

Transport of charge carriers is at the heart of current nanoelectronics. In conventional materials, electronic transport can be controlled by applying electric fields. Atomically thin semiconductors, however, are governed by excitons, which are neutral electron-hole pairs and as such cannot be controlled by electrical fields. Recently, strain engineering has been introduced to manipulate exciton propagation. Strain-induced energy gradients give rise to exciton funneling up to a micrometer range. Here, we combine spatiotemporal photoluminescence measurements with microscopic theory to track the way of excitons in time, space and energy. We find that excitons surprisingly move away from high-strain regions. This anti-funneling behavior can be ascribed to dark excitons which possess an opposite strain-induced energy variation compared to bright excitons. Our findings open new possibilities to control transport in exciton-dominated materials. Overall, our work represents a major advance in understanding exciton transport that is crucial for technological applications of atomically thin materials.

Description and Demo of the Best Practice Caregiving Database on 44 Research Proven Dementia Caregiving Programs

A major advance in family caregiving has been the development, testing, and community delivery of research-proven, evidence-based support programs for family or friend caregivers of persons living with dementia. This presentation showcases and demos Best Practice Caregiving (BPC), a new online resource with comprehensive profiles for 44 of the top evidence-based dementia caregiving programs that are ready for scaling in communities. For these 44 programs, BPC is a database that presents key research findings with links to all its published articles, comprehensive program descriptions including all implementation features, and survey data on program delivery experiences from 324 healthcare and community organizations that offered the program as a regular part of their service portfolio 2019. BPC enables professionals to make side-by-side comparisons of the 44 programs, with the goal of increasing implementations of these evidence-based programs by healthcare and community service organizations.