Patterns and timing of Doppler-detected intracavitary and aortic flow in hypertrophic cardiomyopathy

This study describes the velocity characteristics of left ventricular and aortic outflow in 25 patients with hypertrophic “obstructive” cardiomyopathy. Systematic pulsed and continuous wave Doppler analysis combined with phonocardiography and M-mode echocardiography was used to establish the pattern and timing of outflow in the basal and provoked states. This analysis suggests that 1) the high velocity left ventricular outflow jet can be reliably discriminated from both aortic flow and the jet of mitral regurgitation using Doppler ultrasound; 2) the Doppler velocity contour responds in a characteristic fashion to provocative influences including extrasystole and Valsalva maneuver; 3) the onset of mitral regurgitation occurs well before detectable systolic anterior motion of the mitral valve; 4) left ventricular flow velocities are elevated at the onset of systolic anterior motion of the mitral valve, suggesting a significant contribution of the Venturi effect in displacing the leaflets and chordae; 5) the high velocities of the outflow jets are largely dissipated by the time flow reaches the aortic valve; and 6) late systolic flow in the ascending aorta is nonuniform, with formation of distinct eddies that may contribute to “preclosure” of the aortic valve

The Galactic Exoplanet Survey Telescope (GEST)

The Galactic Exoplanet Survey Telescope (GEST) will observe a 2 square degree field in the Galactic bulge to search for extra-solar planets using a gravitational lensing technique. This gravitational lensing technique is the only method employing currently available technology that can detect Earth-mass planets at high signal-to-noise, and can measure the frequency of terrestrial planets as a function of Galactic position. GEST's sensitivity extends down to the mass of Mars, and it can detect hundreds of terrestrial planets with semi-major axes ranging from 0.7 AU to infinity. GEST will be the first truly comprehensive survey of the Galaxy for planets like those in our own Solar System.Comment: 17 pages with 13 figures, to be published in Proc. SPIE vol 4854, "Future EUV-UV and Visible Space Astrophysics Missions and Instrumentation

Intravascular ultrasound imaging: In vitro validation and pathologic correlation

AbstractIntravascuiar ultrasound imaging is a new method in which high resolution images of the arterial wall are obtained with use of a catheter placed within an artery. An in vitro Plexiglas well model was used to validate measurements of the luminal area, and an excellent correlation was obtained. One hundred thirty segments of fresh peripheral arteries underwent ultrasound imaging and the findings were compared with the corresponding histopathologic sections. luminal areas determined with ultrasound imaging correlated well with those calculated from microscopic slides (r = 0.98).Three patterns were identified on the ultrasound images: 1) distinct interface between media and adventitia, 2) indistinct interface between media and adventitia but different echo density layers, and 3) diffuse homogeneous appearance. The types of patterns depended on the relative composition of the and adventitia. Calcification of intimal plaque obscured underlying structures. Atherosclerotic plaque was readily visualized but could not always be differentiated from the underlying media

The OGLE View of Microlensing towards the Magellanic Clouds. III. Ruling out sub-solar MACHOs with the OGLE-III LMC data

In the third part of the series presenting the Optical Gravitational Lensing Experiment (OGLE) microlensing studies of the dark matter halo compact objects (MACHOs) we describe results of the OGLE-III monitoring of the Large Magellanic Cloud (LMC). This unprecedented data set contains almost continuous photometric coverage over 8 years of about 35 million objects spread over 40 square degrees. We report a detection of two candidate microlensing events found with the automated pipeline and an additional two, less probable, candidate events found manually. The optical depth derived for the two main candidates was calculated following a detailed blending examination and detection efficiency determination and was found to be tau=(0.16+-0.12)10^-7. If the microlensing signal we observe originates from MACHOs it means their masses are around 0.2 M_Sun and they compose only f=3+-2 per cent of the mass of the Galactic Halo. However, the more likely explanation of our detections does not involve dark matter compact objects at all and rely on natural effect of self-lensing of LMC stars by LMC lenses. In such a scenario we can almost completely rule out MACHOs in the sub-solar mass range with an upper limit at f<7 per cent reaching its minimum of f<4 per cent at M=0.1 M_Sun. For masses around M=10 M_Sun the constraints on the MACHOs are more lenient with f ~ 20 per cent. Owing to limitations of the survey there is no reasonable limit found for heavier masses, leaving only a tiny window of mass spectrum still available for dark matter compact objects.Comment: Accepted for publication in MNRAS. On-line data available on OGLE website: http://ogle.astrouw.edu.p

Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study

Limited data on the coagulation profile in children affected by the SARS-CoV-2 infection are available. We aimed to evaluate the role of d-dimers as predictors of poor outcomes in a pediatric population affected by the SARS-CoV-2 infection or multisystem inflammatory syndrome (MIS-C). We performed a retrospective cross-sectional multicenter study. Data from four different centers were collected. Laboratory tests, when performed, were collected at the time of diagnosis, and 24, 48, 72, 96, 120 and beyond 120 h from diagnosis; blood counts with formula, an international normalized ratio (INR), activated partial thromboplastin time (aPTT), D-dimers and fibrinogen values were collected. Data regarding clinical history, management and outcome of the patients were also collected. Three hundred sixteen patients with a median age of 3.93 years (IQR 0.62–10.7) diagnosed with COVID-19 or MIS-C were enrolled. Fifty-eight patients (18.3%) showed a severe clinical outcome, 13 (4.1%) developed sequelae and 3 (0.9%) died. The univariate analysis showed that age, high D-dimer values, hyperfibrinogenemia, INR and aPTT elongation, and low platelet count were associated with an increased risk of pediatric intensive care unit (PICU) admission (p < 0.01). Three multivariate logistic regressions showed that a d-dimer level increase was associated with a higher risk of PICU admission. This study shows that D-dimer values play an important role in predicting the more severe spectrum of the SARS-CoV-2 infection, and was higher also in those that developed sequelae, including long COVID-19

Design and conduct of 'Xtreme Alps' : a double-blind, randomised controlled study of the effects of dietary nitrate supplementation on acclimatisation to high altitude

The study of healthy human volunteers ascending to high altitude provides a robust model of the complex physiological interplay that emulates human adaptation to hypoxaemia in clinical conditions. Nitric oxide (NO) metabolism may play an important role in both adaptation to high altitude and response to hypoxaemia during critical illness at sea level. Circulating nitrate and nitrite concentrations can be augmented by dietary supplementation and this is associated with improved exercise performance and mitochondrial efficiency. We hypothesised that the administration of a dietary substance (beetroot juice) rich in nitrate would improve oxygen efficiency during exercise at high altitude by enhancing tissue microcirculatory blood flow and oxygenation. Furthermore, nitrate supplementation would lead to measurable increases in NO bioactivity throughout the body. This methodological manuscript describes the design and conduct of the ‘Xtreme Alps’ expedition, a double-blind randomised controlled trial investigating the effects of dietary nitrate supplementation on acclimatisation to hypobaric hypoxia at high altitude in healthy human volunteers. The primary outcome measure was the change in oxygen efficiency during exercise at high altitude between participants allocated to receive nitrate supplementation and those receiving a placebo. A number of secondary measures were recorded, including exercise capacity, peripheral and microcirculatory blood flow and tissue oxygenation. Results from this study will further elucidate the role of NO in adaption to hypoxaemia and guide clinical trials in critically ill patients. Improved understanding of hypoxaemia in critical illness may provide new therapeutic avenues for interventions that will improve survival in critically ill patients