1,518 research outputs found
Aortic regurgitation in athletes: The challenges of echocardiographic interpretation
Background
Bicuspid aortic valve (BAV) is the most common congenital cardiac defect and prone to premature degeneration causing aortic regurgitation (AR). The assessment of AR in athletic individuals poses several challenges as the pathological left ventricle (LV) remodelling caused by AR may overlap with the physiological remodelling of intense exercise. The purpose of this study is to highlight these challenges, review the existing literature and discuss how to tackle these conundrums. As a real-world example, we compare the resting transthoracic echocardiographic (TTE) findings in a cohort of individuals with BAV and AR, sub-grouped into “highly active” or “lightly active”.
Methods
Adult male subjects with an index TTE performed at a tertiary referral centre between 2019 and 2022 were included if the TTE confirmed a BAV and at least moderate AR. Further strict inclusion criteria were applied and parameters of valve disease severity was made in accordance with existing guidelines. Subjects completed a physical activity questionnaire over the telephone, and were classified into either group 1: “highly active” or group 2: “lightly active” based on their answers. Demographics and TTE parameters were compared between the two groups.
Results
30 male subjects (mean age 44±13 years) with BAV-AR were included – 17 were highly active, and 13 lightly active. There was no significant difference in age (group 1, 45±12.7yrs vs group 2, 42±17yrs; p=0.49), height (p=0.45), weight (p=0.268) or severity of AR, when quantitative assessment was possible. Group 1 had a significantly higher stroke volume (131±17mls vs 102±13 mls; p=0.027), larger LV volumes, diastolic dimensions and significantly larger bi-atrial and right ventricular size. This LV dilatation in the context of AR and athleticism poses a diagnostic and management conundrum. Despite this, none of these 17 highly active individuals demonstrated any of the traditional criteria used to consider surgery.
Conclusion
There is significant overlap between the physiological adaptations to exercise and those caused by AR. Multi-modality imaging and stress testing can aid clinicians in diagnostic and management decisions in exercising individuals when there is discordance between AR severity and symptoms
Nodules et carcinomes thyroïdiens
Face à l’augmentation des incidentalomes thyroïdiens, la gestion appropriée des
nodules thyroïdiens est primordiale afin de permettre la détection des cancers relevants
et d’éviter le surdiagnostic et le surtraitement des microcarcinomes papillaires.
Cet article décrit les grandes lignes de la prise en charge en tenant compte
des nouvelles recommandations
B and I-band optical micro-variability observations of the BL Lac objects S5 2007+777 and 3C371
We have observed S5 2007+777 and 3C371 in the B and I bands for 13 and 8
nights, respectively, during various observing runs in 2001, 2002 and 2004. The
observations resulted in almost evenly sampled light curves, 6-9 hours long. We
do not detect any flares within the observed light curves, but we do observe
small amplitude, significant variations, in both bands, on time scales of hours
and days. The average variability amplitude on time scales of minutes/hours is
2.5% and 1-1.5% in the case of S5 2007+777 and 3C371, respectively. The average
amplitudes increase to 5-12% and 4-6%, respectively, on time scales of days. We
find that the B and I band variations are highly correlated, on both short and
long time scales. During the 2004 observations, which resulted in the longest
light curves, we observe two well defined flux-decay and rising trends in the
light curves of both objects. When the flux decays, we observe significant
delays, with the B band flux decaying faster than the flux in the I band. As a
result, we also observe significant, flux related spectral variations as well.
The flux-spectral relation is rather complicated, with loop-like structures
forming during the flux evolution. The presence of spectral variations imply
that the observed variability is not caused by geometric effects. On the other
hand, our results are fully consistent with the hypothesis that the observed
variations are caused by perturbations which affect different regions in the
jet of the sources.Comment: Accepted for publication in Astronomy and Astrophysic
Detecting Trivial Mutant Equivalences via Compiler Optimisations
Mutation testing realises the idea of fault-based testing, i.e., using artificial defects to guide the testing process. It is used to evaluate the adequacy of test suites and to guide test case generation. It is a potentially powerful form of testing, but it is well-known that its effectiveness is inhibited by the presence of equivalent mutants. We recently studied Trivial Compiler Equivalence (TCE) as a simple, fast and readily applicable technique for identifying equivalent mutants for C programs. In the present work, we augment our findings with further results for the Java programming language. TCE can remove a large portion of all mutants because they are determined to be either equivalent or duplicates of other mutants. In particular, TCE equivalent mutants account for 7.4% and 5.7% of all C and Java mutants, while duplicated mutants account for a further 21% of all C mutants and 5.4% Java mutants, on average. With respect to a benchmark ground truth suite (of known equivalent mutants), approximately 30% (for C) and 54% (for Java) are TCE equivalent. It is unsurprising that results differ between languages, since mutation characteristics are language-dependent. In the case of Java, our new results suggest that TCE may be particularly effective, finding almost half of all equivalent mutants
A Cutoff in the X-ray Fluctuation Power Density Spectrum of the Seyfert 1 Galaxy NGC 3516
During 1997 March-July, XTE observed the bright, strongly variable Seyfert 1
galaxy NGC 3516 once every ~12.8 hr for 4.5 months and nearly continuously
(with interruptions due to SAA passage but not Earth occultation) for a 4.2 day
period in the middle. These were followed by ongoing monitoring once every ~4.3
days. These data are used to construct the first well-determined X-ray
fluctuation power density spectrum (PDS) of an active galaxy to span more than
4 decades of usable temporal frequency. The PDS shows no signs of any strict or
quasi-periodicity, but does show a progressive flattening of the power-law
slope from -1.74 at short time scales to -0.73 at longer time scales. This is
the clearest observation to date of the long-predicted cutoff in the PDS. The
characteristic variability time scale corresponding to this cutoff temporal
frequency is 1 month. Although it is unclear how this time scale may be
interpreted in terms of a physical size or process, there are several promising
candidate models. The PDS appears similar to those seen for Galactic black hole
candidates such as Cyg X-1, suggesting that these two classes of objects with
very different luminosities and putative black hole masses (differing by more
than a factor of 10^5) may have similar X-ray generation processes and
structures.Comment: 21 pages, incl. 5 figures, AASTe
Highly anisotropic g-factor of two-dimensional hole systems
Coupling the spin degree of freedom to the anisotropic orbital motion of
two-dimensional (2D) hole systems gives rise to a highly anisotropic Zeeman
splitting with respect to different orientations of an in-plane magnetic field
B relative to the crystal axes. This mechanism has no analogue in the bulk band
structure. We obtain good, qualitative agreement between theory and
experimental data, taken in GaAs 2D hole systems grown on (113) substrates,
showing the anisotropic depopulation of the upper spin subband as a function of
in-plane B.Comment: 4 pages, 3 figure
The swan song: the disappearance of the nucleus of NGC 4051 and the echo of its past glory
BeppoSAX observed the low-luminous Seyfert 1 Galaxy NGC4051 in a ultra-dim
X-ray state. The 2-10 keV flux (1.26 x 10^{-12} erg/cm^2/s) was about 20 times
fainter than its historical average value, and remained steady along the whole
observation (~2.3 days). The observed flat spectrum (\Gamma ~ 0.8) and intense
iron line (EW ~600 eV) are best explained assuming that the active nucleus has
switched off, leaving only a residual reflection component visible.Comment: 5 pages, Latex, 3 Postscript figures, accepted for publication in
MNRA
A Laterally Modulated 2D Electron System in the Extreme Quantum Limit
We report on magnetotransport of a two-dimensional electron system (2DES),
located 32 nm below the surface, with a surface superlattice gate structure of
periodicity 39 nm imposing a periodic modulation of its potential. For low
Landau level fillings , the diagonal resistivity displays a rich pattern
of fluctuations, even though the disorder dominates over the periodic
modulation. Theoretical arguments based on the combined effects of the
long-wavelength, strong disorder and the short-wavelength, weak periodic
modulation present in the 2DES qualitatively explain the data.Comment: 4 pages, 5 figures. to appear in Phys. Rev. Let
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