RESUMO
In patients with repaired tetralogy of Fallot (rTOF), the regurgitant fraction (RF) in left pulmonary artery (LPA) and right pulmonary artery (RPA) is usually unequal. The morphometrics may play a crucial role in this RF discrepancy. Cardiovascular MR of 79 rTOF patients and 20 healthy controls were retrospectively enrolled. Forty-four from the 79 patients were matched in age, sex and body surface area to the 20 controls and were investigated for: (1) phase-contrast flow of main pulmonary artery (MPA), LPA, and RPA; (2) vascular angles: the angles between the thoracic anterior-posterior line (TAPL) with MPA (θM-AP), MPA with RPA (θM-R), and MPA with LPA (θM-L); (3) cardiac angle, the angle between TAPL and the interventricular septum; (4) area ratio of bilateral lung and hemithorax regions. Compared with the 20 controls, the 44 rTOF patients exhibited wider θM-AP, sharper θM-L angle, and a smaller θM-L/θM-R ratio. In the 79 rTOF patients, LPA showed lower forward, backward, and net flow, and greater RF as compared with RPA. Multivariate analysis showed that the RF of LPA was negatively associated with the θM-L/θM-R ratio and the age at surgery (R2 = 0.255). Conversely, the RF of RPA was negatively associated with the left lung/left hemithorax area ratio and cross-sectional area (CSA) of LPA, and positively associated with CSA of RPA and MPA (R2 = 0.366). In rTOF patients, the RF of LPA is more severe than that of RPA, which may be related to the vascular morphometrics. Different morphometric parameters are independently associated with the RF of LPA or RPA, which may offer potential insights for surgical strategies.
Assuntos
Insuficiência da Valva Pulmonar , Tetralogia de Fallot , Septo Interventricular , Humanos , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Tetralogia de Fallot/diagnóstico por imagem , Tetralogia de Fallot/cirurgia , Estudos Retrospectivos , Insuficiência da Valva Pulmonar/diagnóstico por imagem , Insuficiência da Valva Pulmonar/etiologia , Insuficiência da Valva Pulmonar/cirurgia , Valor Preditivo dos TestesRESUMO
BACKGROUND: The myocardial kinetic energy (KE) and its association with pulmonary regurgitation (PR) have yet to be investigated in repaired tetralogy of Fallot (rTOF) patients. PURPOSE: To evaluate the adaptation of myocardial KE in rTOF patients by tissue phase mapping (TPM). STUDY TYPE: Prospective. POPULATION: A total of 49 rTOF patients (23 ± 5 years old; male = 32), 47 normal controls (22 ± 1 year old; male = 29). FIELD STRENGTH/SEQUENCE: 3-T/2D dark-blood three-directional velocity-encoded gradient-echo sequence. ASSESSMENT: Left and right ventricle (LV, RV) myocardial KE in radial (KEr ), circumferential (KEø ), longitudinal (KEz ) directions. The proportions of KE in each direction to the sum of all KE (KErøz ): %KEr , %KEø , %KEz . PR fraction. STATISTICAL TEST: Student's t test, multivariable regression. Statistical significance: P < 0.05. RESULTS: In rTOF group, LV KEz remained normal in systole (P = 0.565) and diastole (P = 0.210), whereas diastolic LV %KEz (62% ± 14% vs. 72% ± 7%) and systolic LV %KEø (9% ± 6% vs. 20% ± 7%) were significantly decreased. The KEr and %KEr of both ventricles significantly increased in the rTOF group (RV in diastole: 6 ± 3 vs. 3 ± 1 µJ and 54% ± 13% vs. 27% ± 7%). The rTOF group exhibited significantly higher RV/LV ratios of %KEr (systole: 1.3 ± 0.3 vs. 1.0 ± 0.3) and %KEø (systole: 1.6 ± 0.8 vs. 1.0 ± 0.3) and significantly lower ratios of %KEz in systole (0.7 ± 0.2 vs. 1.0 ± 0.1) and diastole (0.5 ± 0.2 vs. 0.9 ± 0.1). In multivariable regression analysis, the RV peak systolic KErøz , RV systolic KEz , and LV diastolic %KEø were independently associated with PR fraction in the rTOF group (adjusted R2 = 0.479). DATA CONCLUSION: In rTOF patients, the adaptation of the KE proportion occurred earlier than that of the KE amplitude, and the biventricular balance of %KE was disrupted. PR may cause differential KE adaptation in RV and LV. TPM-derived KE may be useful in investigation of myocardial adaptation in rTOF patients. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 3.
Assuntos
Insuficiência da Valva Pulmonar , Tetralogia de Fallot , Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Tetralogia de Fallot/cirurgia , Estudos Prospectivos , Ventrículos do Coração , Miocárdio , Função Ventricular DireitaRESUMO
Virtual labs provide space for students to iteratively test, observe, and revise their understanding so as to improve their scientific literacy. However, one of the challenges that students face is that they need to think and act like scientists so as to be sensitively alert to methodological flaws and various sources of error. This study thus compared the effect of two instructional approaches using a virtual lab to enhance students' scientific literacy. Before students were given the opportunity to conduct science inquiries with the virtual lab, they were required to critique problematic inquiry cases (the critique group) or watch teachers' demonstrations (the teacher demonstration group) before taking part in the inquiry. By analyzing data from 50 middle school students, this study found that the effect of applying virtual labs can be augmented by an instructional design that engages students in critiquing experiments prior to their inquiry with the virtual lab. This study also found a limitation of the use of virtual labs in helping students transfer what they have learned from the teacher's demonstration to new inquiry contexts. A close relation among scientific literacy post-test scores, critiquing performance, and inquiry performance in the inquiry activity was detected, suggesting that student critiquing prior to inquiry is in alignment with the goal of developing students' inquiry skills and scientific literacy with virtual labs.
RESUMO
BACKGROUND: The myocardial adaptive mechanism in patients with repaired tetralogy of Fallot (rTOF) is less understood. We aimed to investigate biventricular myocardial adaptive remodeling in rTOF patients. METHODS: We recruited 32 rTOF patients and 38 age- and sex-matched normal controls. The pulmonary stenosis of rTOF patients was measured using catheterized pressure gradient between right ventricle (RV) and pulmonary artery (PGRVPA). rTOF patients with PGRVPA < 15 mmHg and ≥15 mmHg were classified as low pulmonary stenosis (rTOFlow, n = 19) and high pulmonary stenosis (rTOFhigh, n = 13) subgroups, respectively. Magnetic resonance imaging tissue phase mapping was employed to evaluate the voxelwise biventricular myocardial motion in longitudinal (Vz), radial (Vr), and circumferential (Vφ) directions. RESULTS: The rTOFlow subgroup presented higher pulmonary regurgitation fraction than rTOFhigh subgroup (p < 0.001). Compared with the normal group, only rTOFlow subgroup presented a decreased RV ejection fraction (RVEF) (p < 0.05). The rTOFlow subgroup showed decreased systolic and diastolic Vz in RV and LV, whereas rTOFhigh subgroup showed such change only in RV. In rTOFlow subgroup, RVEF significantly correlated with RV systolic Vr (r = 0.56, p < 0.05), whereas LVEF correlated with LV systolic Vz (r = 0.51, p = 0.02). Prolonged QRS correlated with RV systolic Vr (r = -0.58, p < 0.01) and LV diastolic Vr (r = 0.81, p < 0.001). No such correlations occurred in rTOFhigh subgroup. CONCLUSIONS: The avoidance of unfavorable functional interaction in RV and LV in rTOFhigh subgroup suggested that adequate pulmonary stenosis (PGRVPA ≥ 15 mmHg in this sereis) has a protective effect against pulmonary regurgitation.
Assuntos
Imageamento por Ressonância Magnética/métodos , Insuficiência da Valva Pulmonar/diagnóstico por imagem , Estenose da Valva Pulmonar/diagnóstico por imagem , Tetralogia de Fallot/diagnóstico por imagem , Tetralogia de Fallot/reabilitação , Adulto , Pressão Sanguínea , Estudos de Casos e Controles , Teste de Esforço , Feminino , Frequência Cardíaca , Humanos , Masculino , Insuficiência da Valva Pulmonar/fisiopatologia , Estenose da Valva Pulmonar/fisiopatologia , Volume Sistólico , Tetralogia de Fallot/fisiopatologia , Tetralogia de Fallot/cirurgia , Disfunção Ventricular Esquerda/fisiopatologia , Disfunção Ventricular Direita/fisiopatologia , Função Ventricular Esquerda , Função Ventricular Direita , Adulto JovemRESUMO
We examine theoretically and experimentally the localized electrical modes existing in a bi-inductive electrical lattice containing a bulk or a surface capacitive impurity. By means of the formalism of lattice Green's functions, we are able to obtain closed-form expressions for the frequencies of the impurity (bound-state) eigenmodes and for their associated spatial profiles. This affords us a systematic understanding of how these mode properties change as a function of the system parameters. We test these analytical results against experimental measurements, in both the bulk and surface cases, and find very good agreement. Last, we turn to a series of quench experiments, where either a parameter of the lattice or the lattice geometry itself is rapidly switched between two values or configurations. In all cases, we are able to naturally explain the results of such quench experiments from the larger analytical picture that emerges as a result of the detailed characterization of the impurity-mode solution branches.
RESUMO
We have investigated the influence of nuclear geometric relaxation on the extent of the excited-state electronic delocalization in conjugated zinc porphyrin oligomers using ultrafast transient photoluminescence spectroscopy. By use of metal-coordinating templates that force the oligomers into specific geometries in solution we are able to distinguish clearly between relaxation effects arising from the two vibrational modes that preferentially couple to the electronic transitions in such materials, i.e., carbon-carbon bond stretches and inter-ring torsions. We find that light absorption generates an excited state that is initially strongly delocalized along the oligomer but contracts rapidly following vibrational relaxation of the nuclei along C-C stretch coordinates on the subpicosecond time scale. We are able to monitor such excitonic self-trapping effects by observing the extent to which the concomitant ultrafast rotation of the transition dipole moment is found to correlate with the degree of bending induced in the molecular backbone. We further demonstrate that interporphyrin torsional relaxation leads to a subsequent increase in the excited-state electronic delocalization on a longer time scale (approximately 100 ps). Such dynamic planarization of the molecular backbone is evident from the time-dependent increase in the overall emission intensity and red-shift in the peak emission energy that can be observed for wormlike flexible porphyrin octamers but not for torsionally rigidified cyclic or double-strand octamer complexes. These results therefore indicate that, following excitation, the initially highly delocalized excited-state wave function first contracts and then expands again along the conjugated backbone in accordance with the time periods for the vibrational modes coupled to the electronic transition.
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The derivative of C60, i.e., PCBM, and P3HT (3-hexylthiophene) were dissolved in chloroform:dichlorobenzene mixed solvent, then spin-coated as the active layer for organic solar cells (OSC). The experimental parameters were studied carefully to obtain the optimum power conversion efficiency (PCE), including the solvent mixing ratio, spin-coating speed, annealing conditions for the active layer, etc. The OSC devices were packaged with glass and a newly developed UV-glue to improve the lifetime and PCE. Dichlorobenzene solvent has great effect upon the PCE. Changing the spin-coating speed and increasing the number of steps increased the PCE apparently to 1.4%.
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The system complexity, as calculated from correlation dimension, embedded in each layer and its modulation by specific inputs and general excitatory state are not yet known. The aims of present study were to estimate the system complexity across the cortical layers by analyzing intracortical EEG signals using a nonlinear analytical method, and to identify how layer-related complexity varies with the alteration of thalamic input and brain state. Male Sprague-Dawley rats were anesthetized under l% halothane. Sixteen channels of evoked or spontaneous EEG signals were recorded simultaneously across the six cortical layers in the somatosensory cortex with a single Michigan probe. The system complexity was assessed by computing correlation dimension, D(2), based on the Nonlinear Time Series Analysis data analysis program. Cortical layer IV exhibited a D(2) value, 3.24, that was significantly higher than that of the other cortical layers. The D(2) values in layers IV and II/III were significantly reduced after reversible deactivation of the ventral posterior lateral thalamic nucleus. D(2) decreased with increases in administered halothane concentration from 0.75% to 2.0%, particularly in layer IV. The present findings suggest that cortical layer IV maintains a higher complexity than the other layers and that the complexity of the mid-cortical layers is subject to regulation from specific thalamic inputs and more sensitive to changes in the general state of brain excitation.