Tijdens een afstudeeronderzoek is onderzoek gedaan naar MRI-compatible pacemakers via literatuuronderzoek en interviews. Uit het onderzoek blijft dat er een tweetal aspecten zijn waar men rekening mee dient te houden bij een MRI-compatible pacemaker. Het eerste aspect heeft betrekking op de scanparameters. De belangrijkste hiervan zijn de SAR en de Gradiënt Slew Rate. De fabrikanten hebben voor elk type pacemakersysteem en leads een maximale SAR en Gradiënt Slew Rate opgesteld. Het tweede aspect heeft betrekking op de bewaking van de patiënt tijdens het MRI-onderzoek. Voorafgaand aan het onderzoek moet de pacemaker in de ‘MRI-stand’ worden gezet. Daarnaast dient de patiënt tijdens het MRI-onderzoek ten alle tijden bewaakt te worden door middel van een MRI-compatible ECG en saturatiemeter
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Objective Animal data suggest that exercise during chemotherapy is cardioprotective, but clinical evidence to support this is limited. This study evaluated the effect of exercise during chemotherapy for breast cancer on long-term cardiovascular toxicity. Methods This is a follow-up study of two previously performed randomised trials in patients with breast cancer allocated to exercise during chemotherapy or non-exercise controls. Cardiac imaging parameters, including T1 mapping (native T1, extracellular volume fraction (ECV)), left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), cardiorespiratory fitness, and physical activity levels, were acquired 8.5 years post-treatment. Results In total, 185 breast cancer survivors were included (mean age 58.9±7.8 years), of whom 99% and 18% were treated with anthracyclines and trastuzumab, respectively. ECV and Native T1 were 25.3%±2.5% and 1026±51 ms in the control group, and 24.6%±2.8% and 1007±44 ms in the exercise group, respectively. LVEF was borderline normal in both groups, with an LVEF<50% prevalence of 22.5% (n=40/178) in all participants. Compared with control, native T1 was statistically significantly lower in the exercise group (β=-20.16, 95% CI -35.35 to -4.97). We found no effect of exercise on ECV (β=-0.69, 95% CI -1.62 to 0.25), LVEF (β=-1.36, 95% CI -3.45 to 0.73) or GLS (β=0.31, 95% CI -0.76 to 1.37). Higher self-reported physical activity levels during chemotherapy were significantly associated with better native T1 and ECV. Conclusions In long-term breast cancer survivors, exercise and being more physically active during chemotherapy were associated with better structural but not functional cardiac parameters. The high prevalence of cardiac dysfunction calls for additional research on cardioprotective measures, including alternative exercise regimens. Trial registration number NTR7247.
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Incentives are frequently used by governments and employers to encourage cooperation. Here, we investigated the effect of centralized incentives on cooperation, firstly in a behavioral study and then replicated in a subsequent neuroimaging (fMRI) study. In both studies, participants completed a novel version of the Public Goods Game, including experimental conditions in which the administration of centralized incentives was probabilistic and incentives were either of a financial or social nature. Behavioral results showed that the prospect of potentially receiving financial and social incentives significantly increased cooperation, with financial incentives yielding the strongest effect. Neuroimaging results showed that activation in the bilateral lateral orbitofrontal cortex and precuneus increased when participants were informed that incentives would be absent versus when they were present. Furthermore, activation in the medial orbitofrontal cortex increased when participants would potentially receive a social versus a financial incentive. These results speak to the efficacy of different types of centralized incentives in increasing cooperative behavior, and they show that incentives directly impact the neural mechanisms underlying cooperation.
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