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Anomalous origin of the left circumflex coronary artery from the right pulmonary artery is an extremely rare coronary anomaly out of the group of anomalous coronary arteries arising from the pulmonary artery. We present the case of a 27-year-old male, in whom the diagnosis of an anomalous left circumflex coronary artery from the pulmonary artery was made after sudden cardiac arrest. The diagnosis was confirmed by multimodal imaging and the patient underwent successful surgical correction. Abnormal origins of a coronary artery may become symptomatic later in life and may occur as an isolated cardiac malformation. Due to a potentially unfavorable clinical course, surgical correction should be considered as soon as a diagnosis is made.

NMR-spectroscopic, structural and theoretical data of cyclic alkyl(amino)iminate (CAAI)-stabilised boranes synthesised by halosilane elimination from CAAI–SiMe3 and haloborane precursors highlight the excellent σ- and π-electron donor ability of CAAIs.

The stepwise reduction of a doubly cyclic alkyl(amino)carbene (CAAC)-stabilized 2,3-bis(dibromoboryl)naphthalene enables the isolation of the corresponding mono- and bis(boryl) radicals (one- and two-electron reduction), a 2π-aromatic 1,2-diborete (four-electron reduction), which shows biradical character in the solid-state EPR spectrum, and its cyclic bis(alkylidene)diboron dianion (six-electron reduction). The X-ray crystallographic analysis of the diborete shows a highly strained and twisted four-membered ring with a formal

In the present study, we show how acrylamide-based microgels can be employed for the uptake and release of the drug β-aescin, a widely used natural product with a variety of pharmacological effects. We show how aescin is incorporated into the microgel particles. It has an important influence on the structure of the microgels, by reducing their natural network-density gradient in the swollen state. Moreover, temperature-dependent measurements reveal how the incorporation of aescin stabilizes the microgel particles, while the volume phase transition temperature (VPTT) is almost constant, which is very important for the intended drug release. Finally, it is shown that upon increase of the temperature above the VPTT the particles are able to release aescin from their network, encouraging the use of this particular drug delivery system for hypothermia treatments., The authors acknowledge financial support by the Deutsche Forschungsgemeinschaft (DFG) grant number HE2995/7-1.

Our aim was to assess changes of right ventricular end-diastolic volumes (RVEDVi) and right ventricular ejection fraction (RVEF) in asymptomatic adults with repaired tetralogy of Fallot, with native right ventricular outflow tract and severe pulmonary regurgitation by serial cardiac magnetic resonance imaging (CMR). The study included 23 asymptomatic adults who underwent ���3 CMR studies (total of 88 CMR studies). We compared changes in RVEDVi and RVEF between first and last study (median follow-up: 8.8��years, interquartile range: 6.3 to 13.1 years) and between all study pairs. Variability of measurements between study pairs (65 consecutive and 139 nonconsecutive CMR study pairs) were assessed using Bland-Altman analysis and intraclass correlation coefficients. On average, there were no significant changes of RVEDVi or RVEF over the study period (change in RVEDVi: +0.4 �� 17.8��ml/m2, change in RVEF: -1.0 �� 5.5%). Assessment of variability of measurements between study pairs demonstrated no systematic change in RVEDVi and RVEF between study pairs with limits of agreement within the range of previously published studies (RVEDVi -29.1 to +27.2��ml/m2; RVEF -11.5% to 10.2%). High intraclass correlation coefficients for RVEDVi (0.943, 95% CI 0.906 to 0.965, p

The inaugural issue of Acta Tropica has been published in 1944, at a time of utmost international isolation and uncertainty due to World War II. Now, more than seven decades later, Acta Tropica is a trusted outlet to communicate and disseminate scientific advances in the fields of parasitology and tropical medicine. As a scholarly, peer-reviewed journal, Acta Tropica contributes to the 2030 Agenda for Sustainable Development, particularly the Sustainable Development Goal (SDG) 3, that is "Ensure healthy lives and promote well-being for all of all ages". This article explores how Acta Tropica has evolved over time. Our analysis is based on a systematic review of keywords derived from all issues published in a specific year, arbitrarily selected at decadal snapshots (1950, 1960, 1970, 1980, 1990, 2000, 2010, and 2020). Results indicate a decrease in interdisciplinarity in favour of more specialised expertise in various fields of infectious diseases research and public health with a particular emphasis on low- and middle-income countries. Yet, by examining first and last authors' institutional affiliations and classifying countries by the Human Development Index (HDI), we find that most authors are affiliated with institutions in high- and very high-HDI countries. Over time, the mean number of authors on a paper has increased severalfold (from 1.35 in 1950 to 7.51 in 2020). Taken together, Acta Tropica has become increasingly globally anchored and contributes not only to SDG 3, but increasingly also to SDG 17, that is "Revitalize the global partnership for sustainable development".

In order to be successful in global health today, all the long-established European tropical research institutes had to undergo a transition which can be described as “hunter-gatherer” and descriptive approaches during colonial and postcolonial times to a deeper understanding of infection biology and finally to public health interventions from which populations at large can benefit. During the 1980s and 1990s, the Swiss Tropical Institute (today: Swiss Tropical and Public Health Institute, Swiss TPH) based in Basel too has changed its focus from individual medicine to a public health context. This article does not present new scientific data but takes a historical perspective. Its aim is to highlight the above-mentioned transformation by focusing on selected malaria research-cum-action interventions during the crucial period of the 1990s, which were tailored to the social-ecological settings where the disease was endemic. In order for this transformation to be successful, we intend to emphasise the importance of (i) having a fundamental understanding of local transmission; (ii) building and nurturing relationships with partner institutions; and (iii) developing a coherent research portfolio as key elements for researching and applying evidence in malaria control and elimination as part of national malaria control programmes.

ispartof: CONGENITAL HEART DISEASE vol:15 issue:2 pages:69-78 status: published

Objective The use of 3-dimensional (3D) transesophageal echocardiography (TEE) in perioperative evaluation of the mitral valve (MV) is increasing progressively, including the use of 3D MV models for quantitative analysis. However, the use of 3D MV models in clinical practice still is limited by the need for specific training and the long time required for analysis. A new stereoscopic visualization tool (EchoPixel True 3D) allows virtual examination of anatomic structures in the clinical setting, but its accuracy and feasibility for intraoperative use is unknown. The aim of this study was to assess the feasibility of 3D holographic display and evaluate 3D quantitative measurements on a volumetric MV image using the EchoPixel system compared with the 3D MV model generated by QLAB Mitral Valve Navigation (MVN) software. Design This was a retrospective comparative study. Setting The study took place in a tertiary care center. Participants A total of 40 patients, 20 with severe mitral regurgitation who underwent mitral valve repair and 20 controls with normal MV, were enrolled retrospectively. Interventions The 3D-TEE datasets of the MV were analyzed using a 3D MV model and stereoscopic display. The agreement of measurements, intraobserver and interobserver variability, and time for analysis were assessed. Measurements and Main Results Fair agreement between the 2 software systems was found for annular circumference and area in pathologic valves, but good agreement was reported for prolapse height and linear annular diameters. A higher agreement for all annular parameters and prolapse height was seen in normal valves. Excellent intraobserver and interobserver reliability was proved for the same parameters; time for analysis between the 2 methods in pathologic valves was substantially equivalent, although longer in pathologic valves when compared with normal MV using both tools. Conclusion EchoPixel proved to be reliable to display 3D TEE datasets and accurate for direct linear measurement of both MV annular sizes and prolapse height compared to QLAB MVN software; it also carries a low interobserver and intraobserver variability for most measurements.

Compared internationally, the history of the Swiss Tropical and Public Health Institute (Swiss TPH) is unusual. Founded in 1944, at a time of utmost isolation, it was a response to specific needs of the government of Switzerland during the Second World War. In 1943, the Swiss Federal Council approached universities in Switzerland and asked them to submit project proposal that had the potential to mitigate possible post-war unemployment and threatening economic isolation. Members of the University of Basel proposed to establish a Swiss Tropical Institute (today: Swiss TPH). With its harbour at the River Rhine, Basel was an important international transport hub. The city was and still is the headquarters of important pharmaceutical companies, such as Novartis Pharma AG and F. Hoffmann-La Roche AG, which were looking for new markets overseas. Last but not least, scientific expeditions to Africa were rather common in the 19th and the beginning of the 20th century for members of Basel's bourgeoisie. Initially, Swiss TPH focused primarily on basic research into diseases of poverty, but over the years it has developed into an important player in public, international and global health. This article sees the development of the institute as a reflection of the visions of its directors from the founder Professor Rudolf Geigy to Professor Jurg Utzinger, who is the current Swiss TPH director. It includes interviews with the four latest of them, discussing their experiences and attempts to adapt the institute to an ever changing global environment. From these lessons learnt we hope to gain insights that could be relevant for today's leaders of scientific institutes; foster public-private partnerships and contribute to solve some of the most pressing global health challenges.

ZusammenfassungIn der Einführung wird anhand von Beispielen und den damit verbundenen Fragestellungen motiviert, wieso und wann man ein logistisches Regressionsmodell verwenden kann und wieso das lineare Regressionsmodell dazu nicht geeignet ist.

ZusammenfassungIn diesem Kapitel geht es darum, die logistische Regression als Klassifikationsmethode zu verwenden. Der Unterschied zwischen Trainings- und Testdaten wird erklärt. Um die Güte des Klassifikators abschätzen zu können, wird zunächst die Fehlerrate und die confusion matrix besprochen. Anschließend wird dieses Thema mit der ROC-Kurve vertieft.

ZusammenfassungDas lineare Regressionsmodell wird zu Kapitelbeginn als zweistufiges Modell neu interpretiert. Darauf aufbauend wird das logistische Regressionsmodell äquivalent als Modell für binäre Zielgrößen eingeführt. Dabei wird gezeigt, dass die logistische Regression ein Spezialfall der verallgemeinerten linearen Modelle (GLM) ist. Als wichtige Komponenten solcher Modelle werden Verteilung, Erwartungswert, linearer Prädiktor und Linkfunktion besprochen. Als Alternative zu dieser Herangehensweise wird die logistische Regression als latentes Variablenmodell vorgestellt. Anschließend wird die Interpretation der Modellparameter auf der Skala der Log-Odds, Odds und Wahrscheinlichkeit ausführlich besprochen. Den Abschluss bildet ein kurzer Ausblick auf Modelle mit mehreren Variablen und Methoden der Parameterschätzung bzw. Inferenz.

ZusammenfassungIm Ausblick geht es um die Überprüfung der Modellannahmen und häufige Probleme der logistischen Regression. Zusätzlich wird darauf eingegangen, wie die logistische Regression auf mehr als zwei Klassen erweitert werden kann.

ZusammenfassungIn diesem Kapitel wird illustriert, wie die bis jetzt gelernten Konzepte mit der Statistiksoftware R umgesetzt werden können. Anhand eines Beispiels wird gezeigt, wie ein Modell ausgehend von Daten geschätzt werden kann. Anschließend wird die Effektstärke inkl. Vertrauensintervall auf der Skala der Log-Odds und der Odds bestimmt. Es folgen Vorhersagen auf der Skala der Log-Odds, der Odds und der Wahrscheinlichkeit. Den Abschluss bildet die effiziente Bearbeitung von gruppierten Daten.

ZusammenfassungAusgehend von dem Begriff der Wahrscheinlichkeit werden die Begriffe der Odds (Chance) und Log-Odds eingeführt und anhand von einem Beispiel illustriert. Beide Größen werden später bei der Interpretation des logistischen Regressionsmodells eine zentrale Rolle spielen. Neben exakten Definitionen wird Wert auf ein intuitives Verständnis der Zusammenhänge gelegt. Die Begriffe Risk-Ratio und Odds-Ratio erlauben es, Wahrscheinlichkeiten bzw. Odds für ein Ereignis in zwei verschiedenen Situationen zu vergleichen.

Objectives People living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) may be lost to follow-up (LTFU), which hampers the assessment of outcomes. We estimated mortality for patients starting ART in a rural region in sub-Saharan Africa and examined risk factors for death, correcting for LTFU. Study Design and Setting We analyzed data from Ancuabe, Mozambique, where patients LTFU are traced by phone and home visits. We used cumulative incidence functions to estimate mortality and LTFU. To correct for LTFU, we revised outcomes based on tracing data using different inverse probability weights (maximum likelihood, Ridge regression, or Bayesian model averaging). We fitted competing risk models to identify risk factors for death and LTFU. Results The analyses included 4,492 patients; during 8,152 person-years of follow-up, 486 patients died, 2,375 were LTFU, 752 were traced, and 603 were found. At 4 years after starting ART, observed mortality was 11.9% (95% confidence interval [CI]: 10.9–13.0), but 23.5% (95% CI: 19.8–28.0), 21.6% (95% CI: 18.7–25.0), and 23.3% (95% CI: 19.7–27.6) after correction with maximum likelihood, Ridge regression, and Bayesian model averaging weights, respectively. The risk factors for death included male sex, lower CD4 cell counts, and more advanced clinical stage. Conclusion In ART programs with substantial LTFU, mortality estimates need to take LTFU into account.

Heart failure is an increasing reason for hospitalization and the leading cause of death in patients with adult congenital heart disease (ACHD). Recently, the European Society of Cardiology and the American Heart Association published consensus documents on the management of chronic heart failure in ACHD patients. However, little data and/or guidelines are available for the management of (sub)acute heart failure. The ACHD population is heterogeneous by definition and often has complex underlying anatomy, which could pose a challenge to the physician confronted with the ACHD patient in (sub)acute heart failure. Recognizing the underlying anatomy and awareness of the possible complications related would result in better treatment, avoid unnecessary delays, and improve outcomes of the ACHD patient with (sub)acute heart failure. This review focuses on the management of (sub)acute heart failure in ACHD with specific attention to lesion-specific issues.

In diesem Kapitel findet man alle Losungen zu den Kontrollfragen aus den vorherigen Kapiteln.