However, in the presence of accumulating lipids and unresolved inflammation, SMC transform to macrophage-like foam cells and migrate to the tunica intima, which impairs their architectural and mechanical properties and leads to plaque progression, destabilization, and vulnerability to rupture. SMC are plaque-stabilizing, in that they contribute to the formation of a fibrous cap overlying the necrotic core. Smooth muscle cells (SMC), normally present in the tunica media, contribute mechanical properties to the vessel wall through contraction and the production of extracellular matrix (ECM) proteins to maintain vascular tone, blood pressure, and blood flow. It is important to detect dangerous plaques and monitor treatments before the acute event of thrombosis, which requires detailed characterization of the vessel wall at the site of lipid deposition. Although this is an ex-vivo study, detection of micro and mesoscale level vascular destabilization as enabled by GQI with tractography could increase the accuracy of diagnosis and assessment of treatment outcomes in individuals with atherosclerosis.Ītherosclerosis is characterized by chronic, unresolved inflammation in the arterial wall, initiated by subendothelial deposition of lipids, primarily cholesterol esters (CE) from low-density lipoproteins, that accumulate and promote progression of the plaque to advanced atherosclerosis. This provides a detailed transmural map of normal and inflamed vessel walls in the setting of atherosclerosis that has not been previously achieved using traditional CMR techniques. GQI with tractography is a new method for atherosclerosis imaging that defines a pathological architectural signature for the atheromatous plaque composed of distributed SMC, ECM, inflammatory cells, and thrombus and lipid. Moreover, the locations of CE were differentiated from cellular constituents by their higher restrictive diffusion properties, which permitted chemical confirmation of CE by high field voxel-guided CMRS. GQI with tractography portrayed the locations of these components across the atherosclerotic vessel wall and differentiated multi-level organization of normal, pro-inflammatory cellular phenotypes, or thrombus. Our methods revealed new structural properties of advanced atherosclerosis incorporating SMC and lipid distributions. We compared rabbits with normal chow diet and cholesterol-fed rabbits with endothelial balloon injury, which accelerates atherosclerosis and produces advanced rupture-prone plaques, in a well-validated rabbit model of human atherosclerosis. We applied cardiovascular magnetic resonance spectroscopy (CMRS) and diffusion weighted CMR (DWI) with generalized Q-space imaging (GQI) analysis to architecturally define features of atheroma and correlated these to the microscopic distribution of vascular smooth muscle cells (SMC), immune cells, extracellular matrix (ECM) fibers, thrombus, and cholesteryl esters (CE). Current bioimaging techniques are unable to capture the pathognomonic distribution of cellular elements of the plaque and thus cannot accurately define its structural disorganization. Atherosclerosis often remains subclinical until extensive inflammatory injury promotes vulnerability of the atherosclerotic plaque to rupture with luminal thrombosis, which can cause the acute event of myocardial infarction or stroke. Resolution occurs through a collaborative effort that is monitored to ensure all systems are operating well.Atherosclerosis is an arterial vessel wall disease characterized by slow, progressive lipid accumulation, smooth muscle disorganization, and inflammatory infiltration. If a problem exists, it is identified and explored quickly. Recently, when I consulted our attorney about a staff performance issue, his first question was “What does say?” There is timely access to all HR staff as well as the Chief Human Resource Officer if needed. The partnership with the HR leadership has led us through the selection and implementation of our first electronic HR system, assisted in the design of new onboarding procedures and systems, broadened our recruitment efforts, and assisted in managing staff performance issues. Quatrro brings expertise from the different sectors of HR who specialize in recruitment, onboarding, HRIS systems, staff documentation management, and staff performance resolution. “ Quatrro’s Human Resources team provides a partnership that allows us to focus on our business We formally had a one-person Human Resources Department for a staff of 75.
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