The accuracy of echocardiography versus surgical and pathological classification of patients with ruptured mitral chordae tendineae: a large study in a Chinese cardiovascular center

BACKGROUND: The accuracy of echocardiography versus surgical and pathological classification of patients with ruptured mitral chordae tendineae (RMCT) has not yet been investigated with a large study. METHODS: Clinical, hemodynamic, surgical, and pathological findings were reviewed for 242 patients with a preoperative diagnosis of RMCT that required mitral valvular surgery. Subjects were consecutive in-patients at Fuwai Hospital in 2002-2008. Patients were evaluated by thoracic echocardiography (TTE) and transesophageal echocardiography (TEE). RMCT cases were classified by location as anterior or posterior, and classified by degree as partial or complete RMCT, according to surgical findings. RMCT cases were also classified by pathology into four groups: myxomatous degeneration, chronic rheumatic valvulitis (CRV), infective endocarditis and others. RESULTS: Echocardiography showed that most patients had a flail mitral valve, moderate to severe mitral regurgitation, a dilated heart chamber, mild to moderate pulmonary artery hypertension and good heart function. The diagnostic accuracy for RMCT was 96.7% for TTE and 100% for TEE compared with surgical findings. Preliminary experiments demonstrated that the sensitivity and specificity of diagnosing anterior, posterior and partial RMCT were high, but the sensitivity of diagnosing complete RMCT was low. Surgical procedures for RMCT depended on the location of ruptured chordae tendineae, with no relationship between surgical procedure and complete or partial RMCT. The echocardiographic characteristics of RMCT included valvular thickening, extended subvalvular chordae, echo enhancement, abnormal echo or vegetation, combined with aortic valve damage in the four groups classified by pathology. The incidence of extended subvalvular chordae in the myxomatous group was higher than that in the other groups, and valve thickening in combination with AV damage in the CRV group was higher than that in the other groups. Infective endocarditis patients were younger than those in the other groups. Furthermore, compared other groups, the CRV group had a larger left atrium, higher aortic velocity, and a higher pulmonary arterial systolic pressure. CONCLUSIONS: Echocardiography is a reliable method for diagnosing RMCT and is useful for classification. Echocardiography can be used to guide surgical procedures and for preliminary determination of RMCT pathological types

PolarLight: a CubeSat X-ray Polarimeter based on the Gas Pixel Detector

The gas pixel detector (GPD) is designed and developed for high-sensitivity astronomical X-ray polarimetry, which is a new window about to open in a few years. Due to the small mass, low power, and compact geometry of the GPD, we propose a CubeSat mission Polarimeter Light (PolarLight) to demonstrate and test the technology directly in space. There is no optics but a collimator to constrain the field of view to 2.3 degrees. Filled with pure dimethyl ether (DME) at 0.8 atm and sealed by a beryllium window of 100 micron thick, with a sensitive area of about 1.4 mm by 1.4 mm, PolarLight allows us to observe the brightest X-ray sources on the sky, with a count rate of, e.g., ~0.2 counts/s from the Crab nebula. The PolarLight is 1U in size and mounted in a 6U CubeSat, which was launched into a low Earth Sun-synchronous orbit on October 29, 2018, and is currently under test. More launches with improved designs are planned in 2019. These tests will help increase the technology readiness for future missions such as the enhanced X-ray Timing and Polarimetry (eXTP), better understand the orbital background, and may help constrain the physics with observations of the brightest objects.Comment: Accepted for publication in Experimental Astronom

Efficiently identifying genome-wide changes with next-generation sequencing data

We propose a new and effective statistical framework for identifying genome-wide differential changes in epigenetic marks with ChIP-seq data or gene expression with mRNA-seq data, and we develop a new software tool EpiCenter that can efficiently perform data analysis. The key features of our framework are: (i) providing multiple normalization methods to achieve appropriate normalization under different scenarios, (ii) using a sequence of three statistical tests to eliminate background regions and to account for different sources of variation and (iii) allowing adjustment for multiple testing to control false discovery rate (FDR) or family-wise type I error. Our software EpiCenter can perform multiple analytic tasks including: (i) identifying genome-wide epigenetic changes or differentially expressed genes, (ii) finding transcription factor binding sites and (iii) converting multiple-sample sequencing data into a single read-count data matrix. By simulation, we show that our framework achieves a low FDR consistently over a broad range of read coverage and biological variation. Through two real examples, we demonstrate the effectiveness of our framework and the usages of our tool. In particular, we show that our novel and robust ‘parsimony’ normalization method is superior to the widely-used ‘tagRatio’ method. Our software EpiCenter is freely available to the public

Author Correction: Re-detection and a possible time variation of soft X-ray polarization from the Crab

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X-ray Polarimetry of the accreting pulsar 1A~0535+262 in the supercritical state with PolarLight

The X-ray pulsar 1A 0535+262 exhibited a giant outburst in 2020, offering us a unique opportunity for X-ray polarimetry of an accreting pulsar in the supercritical state. Measurement with PolarLight yielded a non-detection in 3-8 keV; the 99% upper limit of the polarization fraction (PF) is found to be 0.34 averaged over spin phases, or 0.51 based on the rotating vector model. No useful constraint can be placed with phase resolved polarimetry. These upper limits are lower than a previous theoretical prediction of 0.6-0.8, but consistent with those found in other accreting pulsars, like Her X-1, Cen X-3, 4U 1626-67, and GRO J1008-57, which were in the subcritical state, or at least not confidently in the supercritical state, during the polarization measurements. Our results suggest that the relatively low PF seen in accreting pulsars cannot be attributed to the source not being in the supercritical state, but could be a general feature.Comment: accepted for publication in Ap