BackgroundCardiovascular disease is the leading cause of mortality worldwide, accounting for 13%-15% of all deaths. Cardiac rehabilitation has poor compliance and adherence. Telerehabilitation has been introduced to increase patients’ participation, access, and adherence with the help of digital technologies. The target group is patients with heart failure. A telerehabilitation program called “Future Patient” has been developed and consists of three phases: (1) titration of medicine (0-3 months), (2) implementation of the telerehabilitation protocols (3 months), and (3) follow-up with rehabilitation in everyday life (6 months). Patients in the Future Patient program measure their blood pressure, pulse, weight, number of steps taken, sleep, and respiration and answer questions online regarding their well-being. All data are transmitted and accessed in the HeartPortal by patients and health care professionals.ObjectiveThe aim of this paper is to describe the research design, outcome measures, and data collection techniques in the clinical test of the Future Patient Telerehabilitation Program for patients with heart failure.MethodsA randomized controlled study will be performed. The intervention group will follow the Future Patient Telerehabilitation program, and the control group will follow the traditional cardiac rehabilitation program. The primary outcome is quality of life measured by the Kansas City Cardiomyopathy Questionnaire. Secondary outcomes are development of clinical data; illness perception; motivation; anxiety and depression; health and electronic health literacy; qualitative exploration of patients’, spouses’, and health care professionals’ experiences of participating in the telerehabilitation program; and a health economy evaluation of the program. Outcomes were assessed using questionnaires and through the data generated by digital technologies.ResultsData collection began in December 2016 and will be completed in October 2019. The study results will be published in peer-reviewed journals and presented at international conferences. Results from the Future Patient Telerehabilitation program are expected to be published by the spring of 2020.ConclusionsThe expected outcomes are increased quality of life, increased motivation and illness perception, reduced anxiety and depressions, improved electronic health literacy, and health economics benefits. We expect the study to have a clinical impact for future telerehabilitation of patients with heart failure.Trial RegistrationClinicalTrials.gov NCT03388918; https://clinicaltrials.gov/ct2/show/NCT03388918International Registered Report Identifier (IRRID)DERR1-10.2196/14517

Zonal segmentation of the prostate gland using magnetic resonance imaging (MRI) is clinically important for prostate cancer (PCa) diagnosis and image-guided treatments. A two-dimensional convolutional neural network (CNN) based on the U-net architecture was evaluated for segmentation of the central gland (CG) and peripheral zone (PZ) using a dataset of 40 patients (34 PCa positive and 6 PCa negative) scanned on two different MRI scanners (1.5T GE and 3T Siemens). Images were cropped around the prostate gland to exclude surrounding tissues, resampled to 0.5 × 0.5 × 0.5 mm voxels and z-score normalized before being propagated through the CNN. Performance was evaluated using the Dice similarity coefficient (DSC) and mean absolute distance (MAD) in a fivefold cross-validation setup. Overall performance showed DSC of 0.794 and 0.692, and MADs of 3.349 and 2.993 for CG and PZ, respectively. Dividing the gland into apex, mid, and base showed higher DSC for the midgland compared to apex and base for both CG and PZ. We found no significant difference in DSC between the two scanners. A larger dataset, preferably with multivendor scanners, is necessary for validation of the proposed algorithm; however, our results are promising and have clinical potential.

Background There is a need for new approaches to increase the knowledge of the membrane excitability of small nerve fibers both in healthy subjects, as well as during pathological conditions. Our research group has previously developed the perception threshold tracking technique to indirectly assess the membrane properties of peripheral small nerve fibers. In the current study, a new approach for studying membrane excitability by cooling small fibers, simultaneously with applying a slowly increasing electrical stimulation current, is evaluated. The first objective was to examine whether altered excitability during cooling could be detected by the perception threshold tracking technique. The second objective was to computationally model the underlying ionic current that could be responsible for cold induced alteration of small fiber excitability. The third objective was to evaluate whether computational modelling of cooling and electrical simulation can be used to generate hypotheses of ionic current changes in small fiber neuropathy. Results The excitability of the small fibers was assessed by the perception threshold tracking technique for the two temperature conditions, 20 °C and 32 °C. A detailed multi-compartment model was developed, including the ionic currents: Na TTXs , Na TTXr , Na P , K Dr , K M , K Leak , K A , and Na/K-ATPase. The perception thresholds for the two long duration pulses (50 and 100 ms) were reduced when the skin temperature was lowered from 32 to 20 °C (p < 0.001). However, no significant effects were observed for the shorter durations (1 ms, p = 0.116; 5 ms p = 0.079, rmANOVA, Sidak). The computational model predicted that the reduction in the perception thresholds related to long duration pulses may originate from a reduction of the K Leak channel and the Na/K-ATPase. For short durations, the effect cancels out due to a reduction of the transient TTX resistant sodium current (Na v 1.8). Additionally, the result from the computational model indicated that cooling simultaneously with electrical stimulation, may increase the knowledge regarding pathological alterations of ionic currents. Conclusion Cooling may alter the ionic current during electrical stimulation and thereby provide additional information regarding membrane excitability of small fibers in healthy subjects and potentially also during pathological conditions.

Molecular Sensory Physiology" is the youngest among the biological subdisciplines, which are devoted to the understanding of biological activities in terms of chemical structure and bonding. In contrast to metabolic functions, which are concerned with a turnover or transfer of matter, and be it matter as small in size and weight as tone electrons, the new discipline is characterized by the transfer of "signals", the question being: What are the signals made of and how are they transmitted? The present volume is concerned with light signals and their transformation. The first step is the localization and identification of the light acceptor. The difficulties connected with this aim are mostly pertinent to the fact that signal transfer activity can only be followed in the whole organism, and only in rare cases on a subcellular level. Furthermore, the acceptor molecules (chromophores) are frequently not unique or specific in their signal transfer activity, but catalyze known metabolic functions in other places (environments). Thus, we must distinguish the possibilities of finding known holoproteins with hitherto unassigned functions or, on the other hand, known cofactors exhibiting new functions when bound by a new protein. Third, we may have in the new function a slightly modified cofactor. In any case, since we cannot follow the signal transfer activity down to a cell-free system, we must reverse our way of thinking and feed the whole organism with a modified acceptor in order to trace down the signal transformation into "response" and, subsequently, explain the response in terms of chemical structure. In other words: The routine of "natural product chemistry" and its refined methods of structural microanalysis might not apply. Instead, new ways of "bioorganic" imagination applied to suitable mutants of active organisms might lead to success. The difficulties in betraying whole cells with a modified acceptor are enormous, but can be overcome by an intense cooperation between biologists and organic chemists. This cooperation is hampered by "linguistic" problems, which this volume might help to overcome.

Anyone interested in the element boron or refractory materials derived from this element will be delighted by the wealth of detailed information that is presented in this book. The material essentially reflects the state of the art as discussed at a 1972 meeting in Tbilisi, USSR. The contributions by 52 authors (33 separate articles) are grouped into three major sections, i.e., concerning theoretical aspects, preparation and general properties, and thirdly special applications. Most of the articles are written quite concise but are still extremely informative. As may be expected for any compilation of data involving that many contributors to a relatively limited topic, some duplication is apparent. Some articles are extremely specialized while others should find a wide range of interested readers, e.g., on the classification of borides, and on transition-metal borides. The entire works are presented in English. Unfortunately, some of the translations did not turn out too well and could stand improvement. Furthermore, numerous typing errors as well as consistent misspellings should have been eliminated in the proofs. Nevertheless this book is a very worthwhile addition to an institution's library; the rather stiff price for this compilation of (neatly typed) photo-reproduced articles is likely to limit purchases for a personal library. K. Niedenzu