Assessment of hemodynamic function with pulsed doppler ultrasound

Recent refinements in pulsed Doppler technology have made possible the noninvasive assessment of hemodynamic function. The application of the Doppler frequency shift principle to study discrete velocity events at a measured distance from the transducer is discussed. The accuracy and limitations of Doppler techniques in determining ascending aortic and peripheral blood flow velocities in infants with various cardiac lesions are examined. Noninvasive assessment of myocardial contractility is also described. Most studies performed to date suggest that pulsed Doppler techniques provide a sensitive approach to the measurement of flow velocity and acceleration in appropriate selected circumstances. However, distinctions between volume flow and flow velocity must be considered in the interpretation of data

The politics of civil rights in the Truman administration

(print) xi, 261 p. ; 22 cmPreface ix -- The Rhetoric of Politics 3 -- The Civil Rights Committee Delivers -- Its Report 41 -- Presidential Politics of Civil Rights : 1948 79 -- The Congress, the Coalition, and the Federal Executive 137 -- Presidential Politics of Civil Rights : 1952 183 -- Conclusion 237 -- Bibliography 241 -- Index 25

The relative contributions of carotid duplex scanning, magnetic resonance angiography, and cerebral arteriography to clinical decisionmaking: A prospective study in patients with carotid occlusive disease

AbstractPurpose: Recent reports suggest that 80% to 90% of patients can safely undergo carotid endarterectomy on the basis of duplex scanning alone without cerebral angiography. Other investigators have recommended that a complementary imaging study such as magnetic resonance angiography (MRA) also be obtained.Methods: We prospectively evaluated 103 consecutive patients with carotid occlusive disease. Eighty percent of patients were symptomatic. All 103 patients underwent duplex scanning and arteriography. Additional noninvasive tests included computed tomography, magnetic resonance imaging, and MRA in 50%, 56%, and 48% of patients, respectively. At a multispecialty conference all studies except angiograms were reviewed, and a treatment decision was made by a panel of attending vascular surgeons, neurosurgeons, and neurologists. The cerebral angiograms then were reviewed and changes made to final treatment plans were noted.Results: After review of noninvasive studies, 30 of 103 of patients (29%) were believed to require arteriography because of diagnostic uncertainty of carotid occlusion in three patients, suggestion of nonatherosclerotic disease in four, suggestion of proximal disease in two, suboptimal noninvasive studies in one, and uncertainty of therapy despite good-quality noninvasive studies in 20 patients primarily with borderline stenoses and unclear symptoms. In 10 of these 30 patients (33%) management decisions were changed on the basis of angiogram results. Of the remaining 73 patients (71%) in whom the panel felt comfortable proceeding with operative or medical therapy without angiography, only one patient (1.4%) would have had management altered by results of angiography. MRA results concurred with duplex findings in 92% of studies, but did not alter management in any patient.Conclusions: In patients with good-quality duplex images, focal atherosclerotic bifurcation disease, and clear clinical presentation, treatment decisions can be made without arteriography. In 30% of patients angiography is useful in clarifying decisionmaking. MRA is unlikely to influence management decisions and is thus rarely indicated. (J Vasc Surg 1996;23:950-6.

Promoting Positive Identity Development in Troubled Youth: A Developmental Intervention Science Outreach Research Approach

This article illustrates how developmental intervention science outreach research contributes to knowledge development on the promotion of positive identity development by describing results from the Miami Youth Development Project. The project is committed to the use of descriptive and explanatory knowledge about evidence-based individual and institutional intervention strategies for promoting developmental change in self and identity. Our efforts, described here, include a method for measuring theoretically and personally meaningful identity change, a procedure for integrating key aspects of qualitative and quantitative data through relational data analysis, and an evidence-based positive youth development intervention that fosters measurable and meaningful identity change

Muonium Decay

Modifications of the mu+ lifetime in matter due to muonium (M = mu+ e-) formation and other medium effects are examined. Muonium and free mu+ decay spectra are found to differ at O(alpha m_e/m_mu) from Doppler broadening and O(alpha^2 m_e/m_mu) from the Coulomb bound state potential. However, both types of corrections are shown to cancel in the total decay rate due to Lorentz and gauge invariance respectively, leaving a very small time dilation lifetime difference, (tau_M - tau_mu+)/tau_mu+ = alpha^2 m_e^2/ 2m_mu^2 \simeq 6\times 10^-10, as the dominant bound state effect. It is argued that other medium effects on the stopped mu+ lifetime are similarly suppressed.Comment: 14 pages, revte

Dynamics of entanglement for coherent excitonic states in a system of two coupled quantum dots and cavity QED

The dynamics of the entanglement for coherent excitonic states in the system of two coupled large semiconductor quantum dots ($R/a_{B}\gg 1$) mediated by a single-mode cavity field is investigated. Maximally entangled coherent excitonic states can be generated by cavity field initially prepared in odd coherent state. The entanglement of the excitonic coherent states between two dots reaches maximum when no photon is detected in the cavity. The effects of the zero-temperature environment on the entanglement of excitonic coherent state are also studied using the concurrence for two subsystems of the excitonsComment: 7 pages, 6 figure

Balloon dilation of mitral stenosis in adult patients: Postmortem and percutaneous mitral valvuloplasty studies

Preliminary reports have documented the utility of percutaneous balloon valvuloplasty of the mitral valve in adult patients with mitral stenosis, but the mechanism of successful valve dilation and the effect of mitral valvuloplasty on cardiac performance have not been studied in detail. Accordingly, mitral valvuloplasty was performed in five postmortem specimens and in 18 adult patients with rheumatic mitral stenosis, using either one (25 mm) or two (18 and 20 mm) dilation balloons. Postmortem balloon dilation resulted in increased valve orifice area in all five postmortem specimens, secondary to separation of fused commissures and fracture of nodular calcium within the mitral leaflets. In no case did balloon dilation result in tearing of valve leaflets, disruption of the mitral ring or liberation of potentially embolic debris.Percutaneous mitral valvuloplasty in 18 patients with severe mitral stenosis (including 9 with a heavily calcified valve) resulted in an increase in cardiac output (4.3 ± 1.1 to 5.1 ± 1.5 liters/min, p < 0.01) and mitral valve area (0.9 ± 0.2 to 1.6 ± 0.4 cm2, p < 0.0001), and a decrease in mean mitral pressure gradient (15 ± 5 to 9 ± 4 mm Hg, p < 0.0001), pulmonary capillary wedge pressure (23 ± 7 to 18 ± 7 mm Hg, p < 0.0001) and mean pulmonary artery pressure (36 ± 12 to 33 ± 12 mm Hg, p < 0.01). Left ventriculography before and after valvuloplasty in 14 of the 18 patients showed a mild (≤1 +) increase in mitral regurgitation in five patients and no change in the remainder. Embolic phenomena were not observed in any patient.Serial radionuclide ventriculography showed an increase in left ventricular peak filling rate (2.20 ± 1.20 to 2.50 ± 1.20 end-diastolic volumes per second [EDV/s], p < 0.05). Serial echocardiography/phonocardiography showed improvement in mitral valve excursion (11 ± 6 to 14 ± 6 mm, p < 0.001), mitral EF slope (7 ± 4 to 13 ± 5, p < 0.001), left atrial diameter (5.7 ± 0.9 to 5.3 ± 0.8 cm, p < 0.001), S2-opening snap interval (0.07 ± 0.03 to 0.08 ± 0.02 second, p < 0.02) and mitral valve area (0.9 ± 0.2 to 1.5 ± 0.4 cm2, p < 0.0001). All patients were discharged from the hospital with de- creased symptoms after valvuloplasty.It is concluded that percutaneous mitral valvuloplasty can be performed in adult patients with mitral stenosis, including patients with calcific disease, and can result in significant improvement in valvular function. The mechanisms of successful dilation include commissural separation and fracture of nodular calcium

Single-Electron Spectroscopy

Contains research goals and objectives, reports on four research projects and a list of publications.David and Lucille Packard FoundationJoint Services Electronics Program Grant DAAH04-95-1-0038U.S. Navy - Office of Naval Research Grant N00014-93-1-0633National Science Foundation Young Investigator Awar

Comparison of Pittsburgh compound B and florbetapir in cross-sectional and longitudinal studies.

IntroductionQuantitative in vivo measurement of brain amyloid burden is important for both research and clinical purposes. However, the existence of multiple imaging tracers presents challenges to the interpretation of such measurements. This study presents a direct comparison of Pittsburgh compound B-based and florbetapir-based amyloid imaging in the same participants from two independent cohorts using a crossover design.MethodsPittsburgh compound B and florbetapir amyloid PET imaging data from three different cohorts were analyzed using previously established pipelines to obtain global amyloid burden measurements. These measurements were converted to the Centiloid scale to allow fair comparison between the two tracers. The mean and inter-individual variability of the two tracers were compared using multivariate linear models both cross-sectionally and longitudinally.ResultsGlobal amyloid burden measured using the two tracers were strongly correlated in both cohorts. However, higher variability was observed when florbetapir was used as the imaging tracer. The variability may be partially caused by white matter signal as partial volume correction reduces the variability and improves the correlations between the two tracers. Amyloid burden measured using both tracers was found to be in association with clinical and psychometric measurements. Longitudinal comparison of the two tracers was also performed in similar but separate cohorts whose baseline amyloid load was considered elevated (i.e., amyloid positive). No significant difference was detected in the average annualized rate of change measurements made with these two tracers.DiscussionAlthough the amyloid burden measurements were quite similar using these two tracers as expected, difference was observable even after conversion into the Centiloid scale. Further investigation is warranted to identify optimal strategies to harmonize amyloid imaging data acquired using different tracers

Fermi Constants and ``New Physics''

Various precision determinations of the Fermi constant are compared. Included are muon and (leptonic) tau decays as well as indirect prescriptions employing \alpha, m_Z, m_W, \ssthwmzms, \Gamma(Z\to\ell^+\ell^-), and $\Gamma(Z \to \nu\bar \nu)$ as input. Their good agreement tests the standard model at the $\pm 0.1$ level and provides stringent constraints on new physics. That utility is illustrated for: heavy neutrino mixing, 2 Higgs doublet models, S, T, and U parameters and excited $W^{\ast^\pm}$ bosons (Kaluza-Klein excitations). For the last of those examples, m_{W^\ast}\gsims 2.9 TeV is found.Comment: 14 page