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Reversing left ventricular hypertrophy (LVH) can reduce the incidence of adverse cardiovascular events. However, there is no clear superiority-inferiority differentiation between angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), beta-blockers (BB), calcium channel blockers (CCB), and diuretics in reversing LVH in hypertensive patients. To provide further evidence for choosing the optimal antihypertensive drug for improving LVH, we performed a network meta-analysis of randomized controlled trials (RCTs) based on the Cochrane library database, Embase, and Pubmed, and identified 49 studies involving 5402 patients that were eligible for inclusion. It was found that ARB could improve LVH in hypertensive patients more effectively than CCB (MD -4.07, 95%CI -8.03 to -0.24) and BB (MD -4.57, 95%CI -8.07 to -1.12). Matched comparison of renin-angiotensin system inhibitors (RASi) showed that the effect of ACEI in reducing left ventricular mass index (LVMi) was not effective as that of ARB (MD -3.72, 95%CI -7.52 to -0.11). The surface under the cumulative ranking for each intervention indicated that the use of ARB was more effective among the different types of antihypertensive drugs (97%). This network meta-analysis revealed that the use of ARB in antihypertensive therapy could achieve better efficacy in reversing LVH in hypertensive patients.
Recent research and anecdotal reports suggest increased use of 'study drugs' or cognitive enhancers (CE) by university students. Evidence suggests students who use CEs tend to perceive them as effective, but whether CEs improve cognition in healthy individuals is unclear and any drug use carries a risk of harm. Two previous studies have investigated the prevalence of use in Australian university student samples and neither assessed university system factors which may contribute to use.
During 2016, a convenience sample of 2133 18-29-year-old students across all five Western Australian universities completed a quantitative anonymous web survey targeting both users and non-users of CE.
Of the final sample, 7.9% reported use of a prescription drug for CE purposes in the last 12 months. Prescription CE use was predicted by greater frequency of illicit drug use and among students who reported they had not had a take-home exam in the last 12 months. Rates of use and predictors of over the counter (28.6%) and illicit drugs (2.4%) were predicted by different individual and contextual factors. There were high rates of reporting positive effects from CE use, but although negative effects were reported less commonly, they were not trivial.
These findings have implications for university policy and university health services raising the issue with students and potentially providing clinical interventions addressing CE use. Further research should include representative samples and address both system and individual variables in understanding patterns of CE use among students.
These findings have implications for university policy and university health services raising the issue with students and potentially providing clinical interventions addressing CE use. Further research should include representative samples and address both system and individual variables in understanding patterns of CE use among students.In neuroanatomy textbooks on humans, the posterior median septum is commonly depicted along the midline of the posterior column of the spinal cord. For intramedullary spinal cord tumors, the standard surgical treatment is posterior midline myelotomy. However, its anatomical basis is still unclear. Therefore, in this study we focused on the ultrastructural characterization of the median structure of the posterior column in an adult rat. In the median part of the fasciculi gracilis, a fine lineal tissue continued from the posterior median sulcus to the 3/4th depth of the fasciculi. At higher magnification, this fine lineal tissue consisted of bundles of astrocytes, which are often disrupted and eventually disappeared. At the junction of the ventral part of the fasciculi cuneatus and the gray commissure, short lineal figures of glial tissues extended dorsally. These lineal figures of glial tissues were morphologically similar to other lineal figures of glial tissues found in the posterior column; bundles of astrocytes extending along the axons that entered the gray commissure and the perivascular lineal figures of glial tissues. In conclusion, this study revealed that the posterior median septum is composed of very fine lineal figures of glial tissues that are often disrupted and eventually disappear. We consider these basic structures to be similar in humans. Therefore, during posterior midline myelotomy, accurately separating along the posterior median septum in the posterior column is extremely difficult.
3D-T
mapping is useful to quantify various neurologic disorders, but data are currently time-consuming to acquire.
To compare the performance of five compressed sensing (CS) algorithms-spatiotemporal finite differences (STFD), exponential dictionary (EXP), 3D-wavelet transform (WAV), low-rank (LOW) and low-rank plus sparse model with spatial finite differences (L + S SFD)-for 3D-T
mapping of the human brain with acceleration factors (AFs) of 2, 5, and 10.
Retrospective.
Eight healthy volunteers underwent T
imaging of the whole brain.
The sequence was fully sampled 3D Cartesian ultrafast gradient echo sequence with a customized T
preparation module on a clinical 3T scanner.
The fully sampled data was undersampled by factors of 2, 5, and 10 and reconstructed with the five CS algorithms. Nintedanib Image reconstruction quality was evaluated and compared to the SENSE reconstruction of the fully sampled data (reference) and T
estimation errors were assessed as a function of AF.
Normalized root mean squared errors (nRMSE) and median normalized absolute deviation (MNAD) errors were calculated to compare image reconstruction errors and T
estimation errors, respectively. Linear regression plots, Bland-Altman plots, and Pearson correlation coefficients (CC) are shown.
For image reconstruction quality, at AF = 2, EXP transforms had the lowest mRMSE (1.56%). At higher AF values, STFD performed better, with the smallest errors (3.16% at AF = 5, 4.32% at AF = 10). For whole-brain quantitative T
mapping, at AF = 2, EXP performed best (MNAD error = 1.62%). At higher AF values (AF = 5, 10), the STFD technique had the least errors (2.96% at AF = 5, 4.24% at AF = 10) and the smallest variance from the reference T
estimates.
This study demonstrates the use of different CS algorithms that may be useful in reducing the scan time required to perform volumetric T
mapping of the brain.
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