The South-Eastern Desert of Egypt

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Cardiovascular magnetic resonance of scar and ischemia burden early after acute ST elevation and non-ST elevation myocardial infarction

<p>Abstract</p> <p>Background</p> <p>The acute coronary syndrome diagnosis includes different classifications of myocardial infarction, which have been shown to differ in their pathology, as well as their early and late prognosis. These differences may relate to the underlying extent of infarction and/or residual myocardial ischemia. The study aim was to compare scar and ischemia mass between acute non-ST elevation myocardial infarction (NSTEMI), ST-elevation MI with Q-wave formation (Q-STEMI) and ST-elevation MI without Q-wave formation (Non-Q STEMI) in-vivo, using cardiovascular magnetic resonance (CMR).</p> <p>Methods and results</p> <p>This was a prospective cohort study of twenty five consecutive patients with NSTEMI, 25 patients with thrombolysed Q-STEMI and 25 patients with thrombolysed Non-Q STEMI. Myocardial function (cine imaging), ischemia (adenosine stress first pass myocardial perfusion) and scar (late gadolinium enhancement) were assessed by CMR 2–6 days after presentation and before any invasive revascularisation procedure. All subjects gave written informed consent and ethical committee approval was obtained. Scar mass was highest in Q-STEMI, followed by Non-Q STEMI and NSTEMI (24.1%, 15.2% and 3.8% of LV mass, respectively; p < 0.0001). Ischemia mass showed the reverse trend and was lowest in Q-STEMI, followed by Non-Q STEMI and NSTEMI (6.9%, 14.7% and 19.9% of LV mass, respectively; p = 0.012). The combined mass of scar and ischemia was similar between the three groups (p = 0.17). The ratio of scar to ischemia was 3.5, 1.0 and 0.2 for Q-STEMI, Non-Q STEMI and NSTEMI, respectively.</p> <p>Conclusion</p> <p>Prior to revascularisation, the ratio of scar to ischemia differs between NSTEMI, Non-Q STEMI and Q-STEMI, whilst the combined scar and ischemia mass is similar between these three types of MI. These results provide in-vivo confirmation of the diverse pathophysiology of different types of acute myocardial infarction and may explain their divergent early and late prognosis.</p

Estimates for measures of sections of convex bodies

A $\sqrt{n}$ estimate in the hyperplane problem with arbitrary measures has recently been proved in \cite{K3}. In this note we present analogs of this result for sections of lower dimensions and in the complex case. We deduce these inequalities from stability in comparison problems for different generalizations of intersection bodies

Relativistic Elasticity

Relativistic elasticity on an arbitrary spacetime is formulated as a Lagrangian field theory which is covariant under spacetime diffeomorphisms. This theory is the relativistic version of classical elasticity in the hyperelastic, materially frame-indifferent case and, on Minkowski space, reduces to the latter in the non-relativistic limit . The field equations are cast into a first -- order symmetric hyperbolic system. As a consequence one obtains local--in--time existence and uniqueness theorems under various circumstances.Comment: 23 page

Mesenchymal stromal cells:inhibiting PDGF receptors or depleting fibronectin induces mesodermal progenitors with endothelial potential

Realizing the full therapeutic potential of mesenchymal stromal/stem cells (MSCs) awaits improved understanding of mechanisms controlling their fate. Using MSCs cultured as spheroids to recapitulate a three-dimensional cellular environment, we show that perturbing the mesenchymal regulators, platelet-derived growth factor (PDGF) receptors or fibronectin, reverts MSCs toward mesodermal progenitors with endothelial potential that can potently induce neovascularization in vivo. MSCs within untreated spheroids retain their mesenchymal spindle shape with abundant smooth muscle α-actin filaments and fibronectin-rich matrix. Inhibiting PDGF receptors or depleting fibronectin induces rounding and depletes smooth muscle α-actin expression; these cells have characteristics of mesenchymoangioblasts, with enhanced expression of mesendoderm and endoderm transcription factors, prominent upregulation of E-cadherin, and Janus kinase signaling-dependent expression of Oct4A and Nanog. PDGF receptor-inhibited spheroids also upregulate endothelial markers platelet endothelial cell adhesion molecule 1 and vascular endothelial-cadherin and secrete many angiogenic factors, and in vivo they potently stimulate neovascularization, and their MSCs integrate within functional blood vessels that are perfused by the circulation. Thus, MSC potency and vascular induction are regulated by perturbing mesenchymal fate

Pile capacity testing

As there is still uncertainty in accurately predicting the performance of piled foundations based upon design calculations there remains a need to test piles. Several methods of pile testing are available some of which have been in common usage for many years, while others are relatively recent developments. Static pile testing is a well understood and simple test technique that has been in use for many years. This approach has the benefit of directly producing test results but is hindered by the increasing size of associated testing infrastructure as pile capacity increases. A recent variation of classic top-down static testing is bi-directional testing which relies on the incorporation of a specialised loading jack or jacks in the pile shaft at some depth below ground surface. This technique has the ability to apply test loads that greatly exceed those possible in other pile test types by effectively using one portion of the pile capacity to test against the other or others. Alternative pile testing techniques come in the form of rapid and dynamic load tests that have the benefit of quick testing and reduced testing infrastructure but require more complicated analysis and interpretation techniques due to the rapid/dynamic nature of the tests

Ubiquitous CP violation in a top-inspired left-right model

We explore CP violation in a Left-Right Model that reproduces the quark mass and CKM rotation angle hierarchies in a relatively natural way by fixing the bidoublet Higgs VEVs to be in the ratio m_b:m_t. Our model is quite general and allows for CP to be broken by both the Higgs VEVs and the Yukawa couplings. Despite this generality, CP violation may be parameterized in terms of two basic phases. A very interesting feature of the model is that the mixing angles in the right-handed sector are found to be equal to their left-handed counterparts to a very good approximation. Furthermore, the right-handed analogue of the usual CKM phase delta_L is found to satisfy the relation delta_R \approx delta_L. The parameter space of the model is explored by using an adaptive Monte Carlo algorithm and the allowed regions in parameter space are determined by enforcing experimental constraints from the K and B systems. This method of solution allows us to evaluate the left- and right-handed CKM matrices numerically for various combinations of the two fundamental CP-odd phases in the model. We find that all experimental constraints may be satisfied with right-handed W and Flavour Changing Neutral Higgs masses as low as about 2 TeV and 7 TeV, respectively.Comment: 37 pages, 13 figure

Relationship of dysglycemia to acute myocardial infarct size and cardiovascular outcome as determined by cardiovascular magnetic resonance

<p>Abstract</p> <p>Background</p> <p>Improved outcomes for normoglycemic patients suffering acute myocardial infarction (AMI) over the last decade have not been matched by similar improvements in mortality for diabetic patients despite similar levels of baseline risk and appropriate medical therapy. Two of the major determinants of poor outcome following AMI are infarct size and left ventricular (LV) dysfunction.</p> <p>Methods</p> <p>Ninety-three patients with first AMI were studied. 22 patients had diabetes mellitus (DM) based on prior history or admission blood glucose ≥11.1 mmol/l. 13 patients had dysglycemia (admission blood glucose ≥7.8 mmol/l but <11.1 mmol/l) and 58 patients had normoglycemia (admission blood glucose <7.8 mmol/l). Patients underwent cardiac magnetic resonance (CMR) imaging at index presentation and median follow-up of 11 months. Cine imaging assessed LV function and late gadolinium contrast-enhanced imaging was used to quantify infarct size. Clinical outcome data were collected at 18 months median follow-up.</p> <p>Results</p> <p>Patients with dysglycemia and DM had larger infarct sizes by CMR than normoglycemic patients; at baseline percentage LV scar (mean (SD)) was 23.0% (10.9), 25.6% (12.9) and 15.8% (10.3) respectively (p = 0.001), and at 11 months percentage LV scar was 17.6% (8.9), 19.1% (9.6) and 12.4% (7.8) (p = 0.017). Patients with dysglycemia and DM also had lower event-free survival at 18 months (p = 0.005).</p> <p>Conclusions</p> <p>Patients with dysglycemia or diabetes mellitus sustain larger infarct sizes than normoglycemic patients, as determined by CMR. This may, in part, account for their adverse prognosis following AMI.</p