Changes in left atrial deformation in hypertrophic cardiomyopathy: Evaluation by vector velocity imaging.

OBJECTIVES: Hypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. We assessed the global and regional left atrial (LA) function and its relation to left ventricular (LV) mechanics and clinical status in patients with HCM using Vector Velocity Imaging (VVI). METHODS: VVI of the LA and LV was acquired from apical four- and two-chamber views of 108 HCM patients (age 40 ± 19years, 56.5% men) and 33 healthy subjects, all had normal LV systolic function. The LA subendocardium was traced to obtain atrial volumes, ejection fraction, velocities, and strain (ϵ)/strain rate (SR) measurements. RESULTS: Left atrial reservoir (ϵsys,SRsys) and conduit (early diastolic SRe) function were significantly reduced in HCM compared to controls (P  - 1.8s(- 1) was 81% sensitive and 30% specific, SRa> - 1.5s(- 1) was 73% sensitive and 40% specific. By multivariate analysis global LVϵsys and LV septal thickness are independent predictors for LAϵsys, while end systolic diameter is the only independent predictor for SRsys, P < .001. CONCLUSION: Left atrial reservoir and conduit function as measured by VVI were significantly impaired while contractile function was preserved among HCM patients. Left atrial deformation was greatly influenced by LV mechanics and correlated to severity of phenotype

Towards the use of the most massive black hole candidates in AGN to test the Kerr paradigm

The super-massive objects in galactic nuclei are thought to be the Kerr black holes predicted by General Relativity, although a definite proof of their actual nature is still lacking. The most massive objects in AGN ($M \sim 10^9 M_\odot$) seem to have a high radiative efficiency ($\eta \sim 0.4$) and a moderate mass accretion rate ($L_{\rm bol}/L_{\rm Edd} \sim 0.3$). The high radiative efficiency could suggest they are very rapidly-rotating black holes. The moderate luminosity could indicate that their accretion disk is geometrically thin. If so, these objects could be excellent candidates to test the Kerr black hole hypothesis. An accurate measurement of the radiative efficiency of an individual AGN may probe the geometry of the space-time around the black hole candidate with a precision comparable to the one achievable with future space-based gravitational-wave detectors like LISA. A robust evidence of the existence of a black hole candidate with $\eta > 0.32$ and accreting from a thin disk may be interpreted as an indication of new physics. For the time being, there are several issues to address before using AGN to test the Kerr paradigm, but the approach seems to be promising and capable of providing interesting results before the advent of gravitational wave astronomy.Comment: 12 pages, 6 figures. v2: some typos correcte

The redshift-dependence of gamma-ray absorption in the environments of strong-line AGN

The case of gamma-ray absorption due to photon-photon pair production of jet photons in the external photon environment like accretion disk and broad-line region radiation field of gamma-ray loud active galactic nuclei (AGN) that exhibit strong emission lines is considered. I demonstrate that this ''local opacity'', if detected, will almost unavoidably be redshift-dependent in the sub-TeV range. This introduces non-negligible biases, and complicates approaches for studying the evolution of the extragalactic background light with contemporary GeV instruments like e.g. the Gamma-ray Large Area Space Telescope (GLAST), etc., where the gamma-ray horizon is probed by means of statistical analysis of absorption features (e.g. Fazio-Stecker relation, etc.) in AGN spectra at various redshifts. It particularly applies to strong-line quasars where external photon fields are potentially involved in gamma-ray production.Comment: 19 pages, 5 figures; accepted for publication in Ap

Maximum black-hole spin from quasi-circular binary mergers

Black holes of mass M must have a spin angular momentum S below the Kerr limit chi = S/M^2 < 1, but whether astrophysical black holes can attain this limiting spin depends on their accretion history. Gas accretion from a thin disk limits the black-hole spin to chi_gas < 0.9980 +- 0.0002, as electromagnetic radiation from this disk with retrograde angular momentum is preferentially absorbed by the black hole. Extrapolation of numerical-relativity simulations of equal-mass binary black-hole mergers to maximum initial spins suggests these mergers yield a maximum spin chi_eq < 0.95. Here we show that for smaller mass ratios q = m/M << 1, the superradiant extraction of angular momentum from the larger black hole imposes a fundamental limit chi_lim < 0.9979 +- 0.0001 on the final black-hole spin even in the test-particle limit q -> 0 of binary black-hole mergers. The nearly equal values of chi_gas and chi_lim imply that measurement of supermassive black-hole spins cannot distinguish a black hole built by gas accretion from one assembled by the gravitational inspiral of a disk of compact stellar remnants. We also show how superradiant scattering alters the mass and spin predicted by models derived from extrapolating test-particle mergers to finite mass ratios.Comment: final version accepted in PRD, new Fig.4 and discussio

Star Captures by Quasar Accretion Disks: A Possible Explanation of the M-sigma Relation

A new theory of quasars is presented in which the matter of thin accretion disks around black holes is supplied by stars that plunge through the disk. Stars in the central part of the host galaxy are randomly perturbed to highly radial orbits, and as they repeatedly cross the disk they lose orbital energy by drag, eventually merging into the disk. Requiring the rate of stellar mass capture to equal the mass accretion rate into the black hole, a relation between the black hole mass and the stellar velocity dispersion is predicted of the form M_{BH} \propto sigma_*^{30/7}. The normalization depends on various uncertain parameters such as the disk viscosity, but is consistent with observation for reasonable assumptions. We show that a seed central black hole in a newly formed stellar system can grow at the Eddington rate up to this predicted mass via stellar captures by the accretion disk. Once this mass is reached, star captures are insufficient to maintain an Eddington accretion rate, and the quasar may naturally turn off as the accretion switches to a low-efficiency advection mode. The model provides a mechanism to deliver mass to the accretion disk at small radius, probably solving the problem of gravitational instability to star formation in the disk at large radius. We note that the matter from stars that is incorporated to the disk has an average specific angular momentum that is very small or opposite to that of the disk, and discuss how a rotating disk may be maintained as it captures this matter if a small fraction of the accreted mass comes from stellar winds that form a disk extending to larger radius. We propose several observational tests and consequences of this theory.Comment: submitted to Ap

The Search for the Missing Baryons at Low Redshift

At low redshift, only about one-tenth of the known baryons lie in galaxies or the hot gas seen in galaxy clusters and groups. Models posit that these "missing baryons" are in gaseous form in overdense filaments that connect the much denser virialized groups and clusters. About 30% are cool (<1E5 K) and are detected in Ly alpha absorption studies, but about half is predicted to lie in the 1E5-1E7 K regime. Gas is detected in the 2-5E5 K range through OVI absorption studies (7% of the baryons) and possibly near 1E5 K from broad Ly absorption (20% of the baryons). Hotter gas (0.5-2E6 K) is detected at zero redshift by OVII and OVIII K X-ray absorption, and the OVII line strengths seem to correlate with the Galactic soft X-ray background, so it is probably produced by Galactic Halo gas, rather than a Local Group medium. There are no compelling detections of the intergalactic hot gas (0.5-10E6 K) either in absorption or emission and these upper limits are consistent with theoretical models. Claimed X-ray absorption lines are not confirmed, while most of the claims of soft emission are attributable to artifacts of background subtraction and field-flattening. The missing baryons should become detectable with moderate improvements in instrumental sensitivity.Comment: To appear in Annual Review of Astronomy and Astrophysics, Vol 45 (Sept 2007) 44 pages, including 11 figure

Surveillance for foodborne disease outbreaks in Iran, 2006-2011

Background: The outbreaks of foodborne diseases is a major health problem and occur daily in all countries, from the most to the least developed. This study is the first report of foodborne outbreaks in Iran that carried out from 2006 to 2011. Methods: A retrospective, longitudinal study carried out using foodborne disease national surveillance system data from 2006-2011, which have been reported by all provincial health centers to the Center for Communicable Disease Control. Collected data were analyzed using SPSS version 18 software. Results: Since 2006 to 2011, a total of 2250 outbreaks were reported in Iran. Analyzed data showed that the outbreak rate has increased from 0.07/100000 in 2006 to 1.38/100000 population in 2011. Khuzestan, Kermanshah and Qazvin were three provinces that reported more outbreaks than nationally expected outbreak incidence rate during 2011. Analysis of epidemiological characteristics of foodborne outbreaks during 2011 indicated that the numbers of outbreaks were highest in warm months, e.g. 17.8 of total outbreaks was just reported in August. Females and age group of 16-30 years old were more affected and 55 of cases occurred in rural area. Among 684 human samples which have been tested, E. coli, Shigella, Hepatitis A and Vibrio cholera were predominant etiologic agents respectively. Conclusion: Increasing the detection rate of foodborne outbreaks imply the expansion of surveillance activities and improved primary health care in Iran in recent years. Foodborne disease surveillance system is a new program in Iran that should be continued and strengthened including diagnostic laboratory capacities

Where are all the gravastars? Limits upon the gravastar model from accreting black holes

The gravastar model, which postulates a strongly correlated thin shell of anisotropic matter surrounding a region of anti-de Sitter space, has been proposed as an alternative to black holes. We discuss constraints that present-day observations of well-known black hole candidates place on this model. We focus upon two black hole candidates known to have extraordinarily low luminosities: the supermassive black hole in the Galactic Center, Sagittarius A*, and the stellar-mass black hole, XTE J1118+480. We find that the length scale for modifications of the type discussed in Chapline et al. (2003) must be sub-Planckian.Comment: 11 pages, 4 figure

Immunologic factors in patients with chronic polypoid sinusitis

Nasal polyposis is the benign protrusion of soft tissue into the nasal cavity, with multifactorial origin. This study is designed to examine the suggested role of IgE and CD4 and CD8 lymphocytes in the pathogenesis of nasal polyposis. Blood samples were taken from 32 patients with chronic polypoid sinusitis and 32 controls. CD4 and CD8 total lymphocyte count were determined by flow cytometry and the level of serum IgE was measured by ELISA. Nasal discharge samples were also collected for determining IgE level in both patients and controls during surgery. In 68.8% of patients a history of allergy was present. The level of nasal discharge IgE was significantly higher (p 0.05). CD8 concentration and blood lymphocytes were significantly higher (

Immunologic factors in patients with chronic polypoid sinusitis

No Abstract