Ventricular longitudinal function is associated with microvascular obstruction and intramyocardial haemorrhage.

Microvascular obstruction (MVO) and intramyocardial haemorrhage (IMH) are associated with adverse prognosis, independently of infarct size after reperfused ST-elevation myocardial infarction (STEMI). Mitral annular plane systolic excursion (MAPSE) is a well-established parameter of longitudinal function on echocardiography.We aimed to investigate how acute MAPSE, assessed by a four-chamber cine-cardiovascular MR (CMR), is associated with MVO, IMH and convalescent left ventricular (LV) remodelling.54 consecutive patients underwent CMR at 3T (Intera CV, Philips Healthcare, Best, The Netherlands) within 3 days of reperfused STEMI. Cine, T2-weighted, T2* and late gadolinium enhancement (LGE) imaging were performed. Infarct and MVO extent were measured from LGE images. The presence of IMH was investigated by combined analysis of T2w and T2* images. Averaged-MAPSE (medial-MAPSE+lateral-MAPSE/2) was calculated from 4-chamber cine imaging.44 patients completed the baseline scan and 38 patients completed 3-month scans. 26 (59%) patients had MVO and 25 (57%) patients had IMH. Presence of MVO and IMH were associated with lower averaged-MAPSE (11.7±0.4 mm vs 9.3±0.3 mm; p<0.001 and 11.8±0.4 mm vs 9.2±0.3 mm; p<0.001, respectively). IMH (β=-0.655, p<0.001) and MVO (β=-0.567, p<0.001) demonstrated a stronger correlation to MAPSE than other demographic and infarct characteristics. MAPSE ≤10.6 mm demonstrated 89% sensitivity and 72% specificity for the detection of MVO and 92% sensitivity and 74% specificity for IMH. LV remodelling in convalescence was not associated with MAPSE (AUC 0.62, 95% CI 0.44 to 0.77, p=0.22).Postreperfused STEMI, LV longitudinal function assessed by MAPSE can independently predict the presence of MVO and IMH

Diabetes mellitus, microalbuminuria, and subclinical cardiac disease: Identification and monitoring of individuals at risk of heart failure

Background-Patients with type 2 diabetes mellitus and elevated urinary albumin:creatinine ratio (ACR) have increased risk of heart failure. We hypothesized this was because of cardiac tissue changes rather than silent coronary artery disease. Methods and Results-In a case-controlled observational study 130 subjects including 50 ACR+ve diabetes mellitus patients with persistent microalbuminuria (ACR > 2.5 mg/mol in males and > 3.5 mg/mol in females, ≥2 measurements, no previous renin- angiotensin-aldosterone therapy, 50 ACR-ve diabetes mellitus patients and 30 controls underwent cardiovascular magnetic resonance for investigation of myocardial fibrosis, ischemia and infarction, and echocardiography. Thirty ACR+ve patients underwent further testing after 1-year treatment with renin-angiotensin-aldosterone blockade. Cardiac extracellular volume fraction, a measure of diffuse fibrosis, was higher in diabetes mellitus patients than controls (26.1±3.4% and 23.3±3.0% P=0.0002) and in ACR+ve than ACR-ve diabetes mellitus patients (27.2±4.1% versus 25.1±2.9%, P=0.004). ACR+ve patients also had lower E0 measured by echocardiography (8.2±1.9 cm/s versus 8.9±1.9 cm/s, P=0.04) and elevated high-sensitivity cardiac troponin T 18% versus 4% ≥14 ng/L (P=0.05). Rate of silent myocardial ischemia or infarction were not influenced by ACR status. Renin-angiotensin-aldosterone blockade was associated with increased left ventricular ejection fraction (59.3±7.8 to 61.5±8.7%, P=0.03) and decreased extracellular volume fraction (26.5±3.6 to 25.2±3.1, P=0.01) but no changes in diastolic function or high-sensitivity cardiac troponin T levels. Conclusions-Asymptomatic diabetes mellitus patients with persistent microalbuminuria have markers of diffuse cardiac fibrosis including elevated extracellular volume fraction, high-sensitivity cardiac troponin T, and diastolic dysfunction, which may in part be reversible by renin-angiotensin-aldosterone blockade. Increased risk in these patients may be mediated by subclinical changes in tissue structure and function

Athletic Cardiac Adaptation in Males Is a Consequence of Elevated Myocyte Mass.

Cardiac remodeling occurs in response to regular athletic training, and the degree of remodeling is associated with fitness. Understanding the myocardial structural changes in athlete's heart is important to develop tools that differentiate athletic from cardiomyopathic change. We hypothesized that athletic left ventricular hypertrophy is a consequence of increased myocardial cellular rather than extracellular mass as measured by cardiovascular magnetic resonance.Forty-five males (30 athletes and 15 sedentary age-matched healthy controls) underwent comprehensive cardiovascular magnetic resonance studies, including native and postcontrast T1 mapping for extracellular volume calculation. In addition, the 30 athletes performed a maximal exercise test to assess aerobic capacity and anaerobic threshold. Participants were grouped by athleticism: untrained, low performance, and high performance (O2max 60 mL/kg per min, respectively). In athletes, indexed cellular mass was greater in high- than low-performance athletes 60.7±7.5 versus 48.6±6.3 g/m(2); P<0.001), whereas extracellular mass was constant (16.3±2.2 versus 15.3±2.2 g/m(2); P=0.20). Indexed left ventricular end-diastolic volume and mass correlated with O2max (r=0.45, P=0.01; r=0.55, P=0.002) and differed significantly by group (P=0.01; P<0.001, respectively). Extracellular volume had an inverse correlation with O2max (r=-0.53, P=0.003 and left ventricular mass index (r=-0.44, P=0.02).Increasing left ventricular mass in athlete's heart occurs because of an expansion of the cellular compartment while the extracellular volume becomes relatively smaller: a difference which becomes more marked as left ventricular mass increases. Athletic remodeling, both on a macroscopic and cellular level, is associated with the degree of an individual's fitness. Cardiovascular magnetic resonance ECV quantification may have a future role in differentiating athlete's heart from change secondary to cardiomyopathy

Effective Rheology of Bubbles Moving in a Capillary Tube

We calculate the average volumetric flux versus pressure drop of bubbles moving in a single capillary tube with varying diameter, finding a square-root relation from mapping the flow equations onto that of a driven overdamped pendulum. The calculation is based on a derivation of the equation of motion of a bubble train from considering the capillary forces and the entropy production associated with the viscous flow. We also calculate the configurational probability of the positions of the bubbles.Comment: 4 pages, 1 figur

Initiation Economic Information for Decision Making Process in Housing Development

Conflict communication among developer and their team at all times happened due to limited financial information. A developer does not automatically construct a unit that will convince the recipients since they have their own viewpoint and mind of their needs, objectives, obstructions, and necessities of economic aspect. A decision is very hard to be made on the housing unit since the recipients have variance on numerous economic issues. This paper aims to identify the economic decision making information for housing development at the initiation phase in Malaysia. Delphi method is implemented in 3 rounds using a questionnaire survey which involved 34 private developers for data collection purposes. The finding shows that authority policies, a market of housing and timing (life cycle of a project) are most necessary information in the economic part. All of the economic information also illustrates that they are crucial and key factors in the decision-making process. The stages in the initiation phase require economic information in the form of a qualitative data bank of a developer

قدرة التلاميذ فى كتابة النص العربى فى تعليم اللغة العربية بالمدرسة الثانوية الإسلامية نور العلم فاريت جلوم 1تنجونج جابونج الشرقية

Penelitian ini dilatar belakangi oleh keinginan untuk mengetahui pelaksanaan pembelajaran bahasa arab yang ditempuh oleh sisiwa kelas VIII di sekolah MTs Nurul Ilmi Parit Culum 1 Tanjung Jabung Timur. Jenis penelitian ini adalah penelitian kualitatif yang bertujuan untuk memperoleh gambaran pelaksanaan pemebelajaran bahasa arab di sekolah MTs Nurul Ilmi Parit Culum 1 Tanjung Jabung Timur. Adapun metode pengumpulan data yang digunakan dalam penelitian ini adalah observasi, wawancara, dan dokumentasi. Teknik pengambilan sampel penelitian dengan menggunakan purposive sampling. Penelitian menemukan bahwa Kemampuan siswa dalam Menulis Teks Bahasa Arab dalam Pembelajaran Bahasa Arab di MTs Nurul Ilmi Parit Culum 1 Tanjung Jabung Timur tidak bisa menulis teks bahasa arab dengan baik karena siswa masih lemah dalam memahami pelajaran bahasa arab. Berdasarkan hasil yang diperoleh dalam penelitian ini, dapat disimpulkan bahwa kemampuan siswa dalam menulis teks arab di sekolah MTs Nurul Ilmi Parit Culum 1 Tanjung Jabung Timur sebagian siswa belum bisa menulis teks arab dengan baik dan benar, karena sebagian ada yang belum mampu menulis teks arab antara huruf yang bersambung dengan yang tidak bersambung, dan sebagian siswa belum bisa membeda huruf-huruf hijaiyah. Adapun factor-faktor yang dihadapi oleh guru dan siswa pada pelaksanaan pembelajaran bahasa arab yaitu latar belakang siswa, kurangnya waktu belajar bahasa arab, dan usaha guru untuk mengatasi kendala-kendala tersebu

مشكلات التلاميذ فى تلفظ الأصوات العربية فى تعليم اللغة العربيةبالمدرسة المتوسطة درما ونيتا مدينةجمبي

هذا البحث يتصف بالوصفى الكيفي عن مشكلات التلاميذ فى تلفظ الأصوات العربية فى تعليم اللغة العربية بالمدرسة المتوسطة درما ونيتا مدينة جمبي .أما المشكلات التى بحثت الكاتبة هي كيفتلفظ الأصوات العربية فى تعليم اللغة العربية بالمدرسة المتوسطة درما ونيتا مدينة جمبي،و المشكلات التى يواجهها التلاميذ فى تلفظ الأصوات العربية فى تعليم اللغة العربية بالمدرسة المتوسطة درما ونيتا مدينة جمبيوسعي المدرس لمعالجة الصعوبات التى يواجهها التلاميذ فى تلفظ الأصوات العربية فى تعليم اللغة العربية بالمدرسة المتوسطة درما ونيتا مدينة جمبي .وأما طريقة جمع البيانات وهيطريقة المراقبة، المحاورة والوثيقة، بتحليل البيانات وهي تحليل المجال، تحليل التصنيف وتحليل المركب .وأما الحاصل فى هذا البحث أن يكون التلاميذ قادرين فى تلفظ الأصوات العربية فى تعليم اللغة العربية صحيح

دراسة تحليّلة عن نطق أصوات الغة الع بية لدى التلاميذ فى المدسة العالية الحكومية الأولى فى مدينة جامبي

ناقش هذه الرسالة دراسة التحليل في نطق الصوت العربي في طلاب الفصل الحادي عشر في مدرسة عليا نيجري 1 جامبي سيتي. يعتبر هذا البحث بحثا نوعيا ، في حين أن جمع البيانات يستخدم أسلوب الملاحظة والمقابلات والاختبارات وطرق التوثيق. كان موضوع هذه الدراسة مدرسو اللغة العربية وطلاب الصف XIPMIA 2 Madrasah Aliyah Negeri 1 Jambi City. تشير نتائج هذه الدراسة إلى أن نطق الأصوات العربية في الفصل الحادي عشر PMIA 2 بالمدرسة العليا نيجري 1 مدينة جامبي لا يزال لديه بعض الطلاب الذين يجدون صعوبة في نطق الأصوات العربية بشكل جيد. بصرف النظر عن ذلك ، كيفية نطق أصوات nith'iyah و litsawiyah في طلاب الصف الحادي عشر في مدرسة Aliyah Negeri 1 KotaJambim ، لا تزال هناك صعوبات في نطق الحرفين ث و ذ. عند نطق الحرف يبدو مثل الحرف س ، وعندما تنطق الحرف ذ يبدو أيضًا مثل الحرف ز. فيما يتعلق بالعقبات التي يواجهها الطلاب في نطق الأصوات العربية في الفصل الحادي عشر في المدرسة العليا نيجري 1 مدينة جامبي ، وهي الطلاب الذين يفتقرون إلى إتقان دروس اللغة العربية ، وقلة قدرة أعضاء النطق لدى الطلاب ، والطلاب الذين اعتادوا على استخدام لغتهم الأم ، والعوامل المعتادة من البيئة سكن الطلاب. يشير هذا الجانب من البحث إلى أن الطلاب يدربون أنفسهم دائمًا على نطق أصوات اللغة العربية بشكل صحيح وصحيح. لذا فإن طريقة التغلب على الصعوبات التي يواجهها الطلاب في نطق الأصوات العربية في الفصل الحادي عشر PMIA 2 Madrasah Aliyah Negeri 1 Jambi City هي كما يلي: 1. تدريب التكرار الصوتي للغة العربية 2. إعطاء الثناء والقي

Toxoplasma Gondii Infection in HIV/AIDS: Prevalence and Risk Factors

BACKGROUND: Toxoplasmosis is an infection caused by the protozoan Toxoplasma gondii. It is common in severely immunecompromisedpersons.OBJECTIVE: To determine the seroprevalence of T. gondii infection and the risk factors associated with the infection and to investigate the association between T. gondii infection and CD4 cell count.METHODS: Sera collected from 242 HIV positive HAART- naive patients were tested for T. gondii specific immunoglobulin G antibodies. Information was obtained using a structured questionnaire. Baseline CD4 cell counts were obtained from patients case files. Data was managed using SPSS version 20 software and Microsoft Excel worksheet.RESULTS: One hundred and sixty eight (69.4%) subjects were females while 74(30.6%) were males. One hundred (41.3%) of study participants were Toxoplasma IgG antibody positive. Thirty two(32) HIV positive pregnant women were among this group studied with 12( 37.5%) being Toxo IgG antibody positive. Toxoplasma seropositivity was higher in females (42.8%) than in males (39.2%), P= 0.60. CD4 cell count level of &lt; 200 was negatively associated with Toxoplasma seropositivity than CD4 count . 200 by logistic regression (OR= 0.6; 95% CI 0.3- 1.0). Living in proximity with cat was positively associated with T. gondii infection (P= 0.01).CONCLUSION: T. gondii infection is common in pregnant women indicating greater probability of congenital transmission of T. gondii. This could form a basis for recommending intensifying health education and prophylactic treatment for all HIV positive pregnant women. Measures should be taken to prevent stray cats from entering homes.Keywords: Toxoplasma gondii , IgG, Seroprevalence, HIV positive, CD4 cells