The intergenerational transmission of risk and trust attitudes: Replicating and extending "Dohmen, Falk, Huffman and Sunde 2012" using genetically informed twin data.

This replication revisits an influential contribution on the intergenerational transmission of risk and trust attitudes, which, based on data from the German Socioeconomic Panel (GSOEP), reveals a positive correlation between parents' and children's attitudes. The authors of the original study argue that socialization in the family is important in the transmission process. The replication is motivated by mounting evidence indicating that within-family transmission has a considerable genetic component, which calls into question socialization as the main transmission pathway. To consider genetic transmission in addition to social transmission, the replication relies on the German twin family panel TwinLife. The findings reveal that, first, most of the variation in children's risk and social trust attitudes is attributable to differences in the non-shared environment, followed by genetic differences, whereas differences in the shared family environment - the main candidate for social transmission - do not matter. Second, correlations between parents' and children's attitudes essentially involve genetic similarity. Third, family conditions do not moderate these relationships. Thus, the findings do not support the socialization assumption.

Interprofessional education as part of becoming a doctor or physiotherapist in a competency-based curriculum.

INTRODUCTION: Interprofessional learning is a critical pre-requisite for future interprofessional work. Structural adaptations in education offer possibilities to introduce new concepts. Rheumatic and musculoskeletal diseases (RMD) are both prevented and treated by physicians and physiotherapists but the development of interprofessional roles is seldom part of curricula. PROJECT DESCRIPTION: A complex, longitudinal interprofessional educational approach for future doctors and physiotherapists was designed and implanted at various stages (anatomy, physical examination, pathology, therapy). Most segments of the RMD curriculum are now based on interprofessional classes. Student satisfaction with learning is continually and comparatively evaluated. Learning success is assessed with practical and written exams. RESULTS: Interprofessional teaching was first introduced in 2013 for 420 first-year and 360 fourth-year medical students, along with 40 first- and third-year physiotherapy majors. The satisfaction with teaching and learning is high and distinctly above average for all teaching areas (satisfaction RMD rated as 2.4; average for all is 3.3). The percentage of those who pass the final exam is 94%. 100% of the students surveyed support the continuation of this interprofessional unit. CONCLUSION: Interprofessional teaching of RMD can be successfully implemented for future physicians and physiotherapists at different learning levels.

Resting myocardial blood flow quantification using contrast-enhanced magnetic resonance imaging in the presence of stenosis: A computational fluid dynamics study.

PURPOSE: The extent to which atherosclerotic plaques affect contrast agent (CA) transport in the coronary arteries and, hence, quantification of myocardial blood flow (MBF) using magnetic resonance imaging (MRI) is unclear. The purpose of this work was to evaluate the influence of plaque induced stenosis both on CA transport and on the accuracy of MBF quantification. METHODS: Computational fluid dynamics simulations in a high-detailed realistic vascular model were employed to investigate CA bolus transport in the coronary arteries. The impact of atherosclerosis was analyzed by inserting various medium- to high-grade stenoses in the vascular model. The influence of stenosis morphology was examined by varying the stenosis shapes but keeping the area reduction constant. Errors due to CA bolus transport were analyzed using the tracer-kinetic model MMID4. RESULTS: Dispersion of the CA bolus was found in all models and for all outlets, but with a varying magnitude. The impact of stenosis was complex: while high-grade stenoses amplified dispersion, mild stenoses reduced the effect. Morphology was found to have a marked influence on dispersion for a small number of outlets in the post-stenotic region. Despite this marked influence on the concentration-time curves, MBF errors were less affected by stenosis. In total, MBF was underestimated by -7.9% to -44.9%. CONCLUSIONS: The presented results reveal that local hemodynamics in the coronary vasculature appears to have a direct impact on CA bolus dispersion. Inclusion of atherosclerotic plaques resulted in a complex alteration of this effect, with both degree of area reduction and stenosis morphology affecting the amount of dispersion. This strong influence of vascular transport effects impairs the accuracy of MRI-based MBF quantification techniques and, potentially, other bolus-based perfusion measurement techniques like computed tomography perfusion imaging.

Contrast agent bolus dispersion in a realistic coronary artery geometry: influence of outlet boundary conditions.

Myocardial blood flow (MBF) quantification using contrast-enhanced first-pass magnetic resonance imaging relies on the precise knowledge of the arterial input function (AIF). Due to vascular transport processes, however, the shape of the AIF may change from the left ventricle where the AIF is measured to the myocardium. We employed computational fluid dynamics simulations in a realistic model of the left circumflex artery to investigate the degree to which this effect corrupts MBF quantification. Different outlet boundary conditions were applied to examine their influence on the solution. Our results indicate that vascular transport processes in realistic coronary artery geometries give rise to non-negligible systematic errors in the MBF values. The magnitude of these errors differs considerably between the outlets of the 3D model. Moreover, outlet boundary conditions are shown to have a significant influence on the outflows at the outlets of the 3D model. In particular, the employed boundary conditions respond differently to an artificially inserted stenosis and to hyperemia condition. Finally, outlet boundary conditions are shown to have an influence on the resulting MBF value. Since MBF errors are different under rest and under hyperemia conditions, overestimation of myocardial perfusion reserve values may occur as well.

Computational fluid dynamics simulations of contrast agent bolus dispersion in a coronary bifurcation: impact on MRI-based quantification of myocardial perfusion.

Contrast-enhanced first-pass magnetic resonance imaging (MRI) in combination with a tracer kinetic model, for example, MMID4, can be used to determine myocardial blood flow (MBF) and myocardial perfusion reserve (MPR). Typically, the arterial input function (AIF) required for this methodology is estimated from the left ventricle (LV). Dispersion of the contrast agent bolus might occur between the LV and the myocardial tissue. Negligence of bolus dispersion could cause an error in MBF determination. The aim of this study was to investigate the influence of bolus dispersion in a simplified coronary bifurcation geometry including one healthy and one stenotic branch on the quantification of MBF and MPR. Computational fluid dynamics (CFD) simulations were combined with MMID4. Different inlet boundary conditions describing pulsatile and constant flows for rest and hyperemia and differing outflow conditions have been investigated. In the bifurcation region, the increase of the dispersion was smaller than inside the straight vessels. A systematic underestimation of MBF values up to -16.1% for pulsatile flow and an overestimation of MPR up to 7.5% were found. It was shown that, under the conditions considered in this study, bolus dispersion can significantly influence the results of quantitative myocardial MR-perfusion measurements.