Inflow Outflow Research Articles

Abstract TMP4: Pulsatile Blood Flow Characteristics Predict Intracranial Aneurysm Growth

Introduction: Oscillations in blood flow over the cardiac cycle are relevant to endothelial function and vascular health. But, as yet the relationship between pulsatile flow characteristics and intracranial aneurysm (IA) growth is unclear. We analyzed time-based hemodynamic indices within unruptured IAs with known growth or stable trajectories. We hypothesize that combining pulsatile parameters can yield a predictive model for IA growth. Methods: Unruptured IA cases with at least 3 imaging studies were identified from UCLA Medical Center electronic medical records. Cases with an increase in diameter of at least 10% were assigned to the growing group and all other cases were assigned to the stable group. 16 stable and 20 growing cases from 2018-2020 qualified for the study. For each IA image study, computational fluid dynamic (CFD) flow simulation was performed and pulsatility index (PI) and wall shear stress PI (WSSPI) were recorded at 5 locations: inflow artery, IA neck, body, dome, and outflow artery. Values were compared with MANOVA. A stepwise logistic regression with growth as the outcome variable and WSSPI and PI at all locations as covariates was then performed. Results: PI was significantly higher in growing IA at the body (0.81±0.44 vs. 1.76±1.18, p=0.006) and dome (1.22±0.76 vs. 1.91±1.20 p=0.04). WSSPI was significantly higher in growing IA at the inflow artery (0.68±0.05 vs. 0.87±0.36, p=0.049), body (1.07±0.22 vs. 1.55±0.73, p=0.02), and dome (1.15±0.30 vs. 1.64±0.70, p=0.01). Logistic regression yielded a predictive model with 88.2% accuracy and AUC of 0.944: logit(growth) = 2.035 х PI_ body + 14.004 х WSSPI_ inflow + 4.263 х WSSPI_ body -17.342. Conclusions: Based on a finding of elevated pulsatility in growing IA, we propose a model to predict subsequent IA growth. This should be further tested in larger CFD studies. Upon confirmation, the model may be helpful in guiding clinical decisions.

Estimating Infiltration in Open‐ended Furrow Irrigation by Modifying Final Infiltration Rate

AbstractThe Kostiakov–Lewis equation is one of the commonly used infiltration equations in furrow irrigation. Elliott and Walker developed a two‐point method to estimate coefficients of the Kostiakov–Lewis equation. The basic infiltration rate (fo) in the Kostiakov–Lewis equation is usually calculated by the inflow–outflow method to determine the other two Kostiakov–Lewis parameters. In that method the entire furrow is used as an infiltrometer, which can cause overestimation of fo. In this study, by considering a correction factor in the mathematical calculations where the newly calculated value of fo is represented as fo* and the values of the a and k parameters, as calculated during the advance phase, are represented as a* and k*. The amount of infiltration volume estimated by the proposed method was evaluated using 21 open‐ended furrow irrigation data sets by calculating the relative error (RE) index. The value of fo decreased and the values of a and k increased by using the proposed method as compared to the Elliott and Walker method. Therefore, the results showed that the proposed method estimated infiltration volume with greater accuracy (average absolute RE = 4.0%) as compared to the Elliott and Walker method (average absolute RE = 7.8%).

The Evaluation of the Four-Chamber Cardiac Dissection Method of the Fetal Heart as an Alternative to Conventional Inflow-Outflow Dissection in Small Gestational-Age Fetuses.

The examination of very small fetal hearts requires special equipment and a specialist that are not available in many general pathology laboratories. Compared to conventional examination, the four-chamber cardiac dissection (4CCD) method can be performed by any pathologist using instruments generally available in pathology services. The aim of this study is to evaluate the efficiency of the 4CCD method in the examination of small fetal hearts using post-mortem magnetic resonance imaging (pm-MRI) at 7T as the standard. Twelve fetuses with gestational ages between 13 and 19 weeks have been included in this study. All fetuses underwent pm-MRI examination prior to pathologic examination. The 4CCD method was used for the cardiac examination in all cases following the same guidelines for cardiac sectioning. The 4CCD was able to identify all cardiac anatomic structures as compared to pm-MRI at 7T, demonstrating a sensibility of 95.8% (95% CI, 94.5–95.8) and specificity of 100% (95% CI, 32.3–100). The overall accuracy in identifying cardiac anatomic structures was 95.8% (95% CI, 93.4–95.8). Additionally, the 4CCD method was able to detect cardiac anomalies with an overall diagnostic accuracy of 91% (95% CI, 85.8–94.2), sensibility of 67.6% (95% CI, 54.5–75.3), and specificity of 97% (95% CI, 93.7–99) as compared to pm-MRI at 7T. The four-chamber view dissection method can be considered as an alternative to the conventional inflow–outflow dissection method in selected cases.

Transesophageal echo-derived left ventricular ejection fraction versus myocardial performance index in predicting outcome following coronary artery bypass grafting surgery

BACKGROUND AND AIMS: Although left ventricular ejection fraction (LVEF) is the most commonly studied echocardiographic parameter for predicting postoperative outcome, its utility is limited by its preload dependency and ability to measure the only systolic function of the left ventricle. The myocardial performance index (MPI), a ratio obtained by summing up the time required for isovolumetric contraction and relaxation against the systolic ejection phase of the cardiac cycle, is the least studied parameter of left ventricular performance in perioperative settings. So, being a composite measure of systolic and diastolic function of the heart, we hypothesized that MPI can be a better predictor of postoperative outcome following coronary artery bypass grafting (CABG). The present study aimed at finding a correlation of LVEF and MPI with postoperative outcome indicators such as vasoactive inotropic score (VIS), the requirement of intra-aortic balloon pump (IABP) to maintain cardiac output, duration of mechanical ventilation, stay in the intensive care unit (ICU), postoperative morbidity and mortality.METHODS: A prospective, observational study was conducted on 110 subjects, scheduled for elective CABG. Transesophageal echocardiography (TEE) was performed after induction of anesthesia and before coronary grafting. Patients with no or grade I mitral regurgitation (vena contracta-VC <0.3 cm, effective regurgitant orifice area <0.2 cm2) and those in normal sinus rhythm were included. Patients with arrhythmia and MR of more than grade I (VC >0.3 cm, EROA >0.2 cm2) were excluded. Pre-CABG LVEF was measured using Simpson's biplane method. MPI was measured using Pulsed-wave Doppler across mitral inflow and left ventricular outflow tract. Subjects were labeled as “good” and “poor” outcomes based on standard criteria for defining the immediate postoperative outcome. Pre-CABG MPI and LVEF were correlated with these postoperative outcome variables following CABG.RESULTS: Of 110 subjects, 14 were excluded due to the presence of more than grade I MR (n = 8) and arrhythmias (n = 6) before CABG. Out of 96 subjects, 66% (n = 63) had “good” outcome and 34% (n = 33) had a “poor” outcome. Pre-CABG MPI and LVEF were (0.51 ± 0.12 and 47.2% ± 8.8%) in subjects with “good” compared to (0.57 ± 0.13 and 42.00% ± 8.70%) (P = 0.032 and 0.007 respectively) “poor” outcome following CABG. A higher pre-CABG MPI (0.57 ± 0.13) alone significantly correlated with increased VIS (r = 0.325, P = 0.001) in contrast to lower LVEF (42% ± 8.7%) (r = −0.181, P = 0.077). Both, lower precardiopulmonary bypass LVEF (40.46% ± 8.81%) and higher MPI (0.6 ± 0.11) were significantly correlated with increased ICU stay in days (r = −0.218 and r = 0.287, respectively). The mean MPI was 0.57 ± 0.08 and LVEF was 39.55% ± 4.05% in those subjects who succumbed in the postoperative period following CABG.CONCLUSION: MPI was a relatively better predictor of postoperative outcome following CABG. Increased Pre-CABG MPI was more consistent with the postoperative inotropic and vasopressor requirement. The requirement of an IABP to maintain cardiac output following CABG and mortality was correlated well with both low preoperative LVEF and higher MPI values.

Impact of FDI Inflow and FDI Outflow on the GDP of Bangladesh and India

Impact of FDI Inflow and FDI Outflow on the GDP of Bangladesh and India

Estimated policy rules for capital controls

Are capital controls macroprudential or mercantilist? I explore this question using a novel, weekly dataset on policy actions in 21 emerging-market economies (EMEs) from 2001 to 2015, and a new proxy for mercantilist motivations: the weighted appreciation of a country’s currency against those of its trade competitors. Capital controls arebothmercantilist and macroprudential. Moreover, the choice of instruments is systematic: policymakers use two instruments—inflow tightening and outflow easing—to respond to mercantilist concerns, while using only inflow tightening in response to macroprudential concerns. Inflow tightening is countercyclical to bank credit to GDP gap but acyclical to the specific macroprudential concerns related to external or foreign currency borrowing. However,high level of some types of foreign debt reduces countercyclicality to mercantilist concerns. Higher exchange rate pass-through to export prices, and inflation targeting regime with managed exchange rates, increase countercyclicality to mercantilist concerns.

Analysis of the Spatiotemporal Heterogeneity of Various Landscape Processes and Their Driving Factors Based on the OPGD Model for the Jiaozhou Bay Coast Zone, China

To date, various studies have analyzed changes in the landscape but there are few studies which have explored landscape processes and the corresponding driving factors. This study makes up for this deficiency in the systematic theoretical exposition and the spatiotemporal analysis of landscape processes. The results show that the amount of arable land outflow and built-up land inflow have resulted in an increase of 92,311.11 ha of built-up land that is mostly distributed around the administrative center and along the coast of Jiaozhou Bay. The outflow of ecological land is a major resource for replenishing arable land, by 37,016.19 ha, especially in terms of the grassland that is distributed in the hilly areas west of Jiaozhou Bay. The outflow of the salt-field, fish-farm and ecological land outflow have good connectivity, a large patch size, and an irregular shape. The ecological type, elevation, slope, and vegetation coverage are the four factors that have a great influence on all landscape processes. A gentler slope and lower elevation, and proximity to cities and towns land will produce more arable land outflow and built-up land inflow. However, arable land inflow and ecological land outflow are the opposite. This research will guide natural resource management for a rapidly developing coastal zone.

Entry Tear Dominance at CT Angiography Predicts Long-term Clinical Outcomes in Aortic Dissection: Another Piece of the Puzzle.

Entry Tear Dominance at CT Angiography Predicts Long-term Clinical Outcomes in Aortic Dissection: Another Piece of the Puzzle.

Supercritical Accretion of Stellar-mass Compact Objects in Active Galactic Nuclei

Abstract Accretion disks of active galactic nuclei (AGNs) have been proposed as promising sites for producing both (stellar-mass) compact object mergers and extreme mass ratio inspirals. Along with disk-assisted migration, ambient gas inevitably accretes onto compact objects. In previous studies, it was commonly assumed that either an Eddington rate or a Bondi rate takes place, although they can differ by several orders of magnitude. As a result, the mass and spin evolution of compact objects within AGN disks are essentially unknown. In this work, we construct a relativistic supercritical inflow–outflow model for black hole (BH) accretion. We show that the radiation efficiency of the supercritical accretion of a stellar-mass BH (sBH) is generally too low to explain the proposed electromagnetic counterpart of GW 190521. Applying this model to sBHs embedded in AGN disks, we find that, although the gas inflow rates at Bondi radii of these sBHs are commonly highly super-Eddington, a large fraction of inflowing gas eventually escapes as outflows so that only a small fraction accretes onto the sBH, resulting in mildly super-Eddington BH absorption in most cases. We also apply this model to neutron stars (NSs) and white dwarfs (WDs) in AGN disks. It turns out to be difficult for WDs to grow to the Chandrasekhar limit via accretion because WDs are spun up more efficiently to reach the shedding limit before the Chandrasekhar limit. For NSs accretion-induced collapse is possible if NS magnetic fields are sufficiently strong to keep the NS slowly rotating during accretion.

Review of Cash Flow Statement of Selected Companies of Steel Industry (Tata Steel and Sail)

The main objective of this study is to assess the ability of the enterprise to generate cash and cash equivalents of the industry. The researcher has selected two companies on the basis of the judgemental sampling method and the researcher has used for the data analysis like mean, trend analysis, and pair “t” test. The researcher has found out the review of the cash flow statement of TATA Steel and SAIL shows the cash inflow and cashes outflow of both the companies, which represents similar solvency and liquidity of both the companies. Thus, investors can invest in both companies because both companies have a sound cash position. So, it should be easy to identify the best investment option for investors. The cash flow statements of the selected two industries of steel sectors have been analysed using different parameters. The selected steel industries are TATA Steel and Steel Authority of India Limited (SAIL). The comparative evaluation of the cash flow statement describes the various variables of cash inflows and outflows of cash of both the industries and the similarity in inflows and outflows of cash. There are 12 variables that were very similar and the data of both the industries were available for the study period. From the analysis, it is concluded that both industries have more similarities in the cash inflow and cash outflow of cash flow statement.

Abstract 13317: Optimization of Left Ventricular Assist Device Therapy: A Combined in vitro and in silico Strategy to Reduce Thromboembolic Adverse Events via Evidence-Based Surgical Configuration and Medical Management

Introduction: Left Ventricular Assist Devices are growing in frequency and importance in the treatment of medical-refractory heart failure. The incidence of thromboembolic events is a principal cause of mortality and morbidity for these patients, despite third generation pumps greatly reducing in-pump thrombosis. Hypothesis: To understand this problem, we hypothesize that LVAD-induced hemodynamics precondition platelets to activate and aggregate, leading to incipient thrombus formation which may propagate throughout the circulation, explaining the high incidence of thromboembolic events in the absence of in-pump thrombosis. Methods: A combined computational and in vitro modeling approach is used to simulate blood flow in the left ventricle, LVAD inflow cannula, outflow graft and aortic arch, with the goal of understanding the role of LVAD therapy in hemodynamics. Results: A systematic optimization of surgical parameters (inflow cannula angle, inflow cannula insertion depth, outflow graft anastomosis angle, outflow graft diameter) and medical management (LVAD speed, blood pressure, aortic valve opening frequency) based on Lagrangian metrics confirmed that the thrombogenicity of LVAD therapy can be potentially be significantly reduced. These metrics allow for quantitative comparisons of device management. Guidelines of optimum ranges of therapy configurations, and definition of “high risk” surgical configurations to avoid have been proposed. Conclusions: Reducing thrombogenicity and improving hemocompatibility is the next frontier in durable LVAD therapy for advanced heart failure. Risk-benefit analysis of many surgical configurations and medical management strategies can be quantitatively analyzed. Systematic analysis can serve as the rationale for future clinical trials that will optimize patient outcomes and reduce complications.

Construction of weak solutions to compressible Navier–Stokes equations with general inflow/outflow boundary conditions via a numerical approximation

The construction of weak solutions to compressible Navier–Stokes equations via a numerical method (including a rigorous proof of the convergence) is in a short supply, and so far, available only for one sole numerical scheme suggested in Karper (Numer Math, 125(3):441–510, 2013) for the no slip boundary conditions and the isentropic pressure with adiabatic coefficient \(\gamma >3\). Here we consider the same problem for the general non zero inflow–outflow boundary conditions, which is definitely more appropriate setting from the point of view of applications, but which is essentially more involved as far as the existence of weak solutions is concerned. There is a few recent proofs of existence of weak solutions in this setting, but none of them is performed via a numerical method. The goal of this paper is to fill this gap. The existence of weak solutions on the continuous level requires several tools of functional and harmonic analysis and differential geometry whose numerical counterparts are not known. Our main strategy therefore consists in rewriting of the numerical scheme in its variational form modulo remainders and to apply and/or to adapt to the new variational formulation the tools developed in the theoretical analysis. In addition to the result, which is new, the synergy between numerical and theoretical analysis is the main originality of the present paper.

Variation of water mass exchange on tidal scale in Balikpapan Bay

Balikpapan Bay is enclosed water influenced by freshwater from river runoff and saline water from Makassar Strait. The exchange of water mass was examined by 3D numerical model simulation-Hamburg Shelf Ocean Model (HAMSOM) with horizontal resolutions approx. 150 m and 10 vertical layers applied in Balikpapan Bay. The thirteen tidal components, daily river runoff, atmospheric forcing, subsurface temperature, and Salinity in 3D used for model input. The tidal elevation from Geospatial Information Agency (BIG) model fits with this result from 01/03/2020 to 31/03/2020. It has coefficient correlation 0,99 with a significant level of 95% and Root Mean Square Error (RMSE) is 0,1 m. The volume and salt transport in the mouth (Line-A) and middle (Line-B) of bay was examined. The maximum transport in Line-A during spring (neap) high to low tide and low to high tide is −18364.72 m3/s (−1717.57 m3/s) and −17532.27 m3/s (4258.86 m3/s) for volume. Then, 531,947,898.90 kg.psu./s (−45,127,135.38 kg.psu./s) and −536,410,944.50 kg.psu./s (140,700,437.97 kg.psu./s) for salinity. Positive (negative) of water transport is inflow (outflow) to Balikpapan Bay. The net transport in a day during the spring (neap) is −832.45 m3/s (5976.43 m3/s) for volume and −4,463,045.58 kg.psu./s (185,827,573.35 kg.pau./s) for salt. The vertical structure of net volume and salt transport bot in Line-A and Line-B shows the water goes to outer bay in surface and inner bay in subsurface. While in the spring tide the surface deeper than neap tide. It indicated that water mass exchange dominantly influenced by river in surface and tidal in subsurface. It also shows that water mass from inner bay more easy flushing during spring tide than neap tide and vice versa

Carotid arterial wall MRI of apolipoprotein e–deficient mouse at 7 T using DANTE-prepared variable-flip-angle rapid acquisition with relaxation enhancement

PurposeTo optimize a sequence combining the delay alternating with nutation for tailored excitation (DANTE) preparative module with the variable-flip-angle rapid acquisition with relaxation enhancement (VF-RARE) sequence (DANTE-VF-RARE) and to investigate its feasibility for vessel wall imaging in Apolipoprotein E–Deficient (ApoE−/−) mouse at 7 Tesla (T). Materials and methodsSpecific T1/T2 values were used for producing a sharper vessel wall in the variable-flip-angle optimization scheme. The DANTE RF pulse flip angle and pulse train length were optimized for maximizing the wall-lumen contrast.ApoE−/− (fed high fat diet for 20/40/ 60 weeks, n = 9/4/4) and wild-type mice (controls, n = 3) were imaged at 7 T using VF-RARE, DANTE-VF-RARE, time-of-flight (TOF) angiography, and multi-slice T1-weighted 2D RARE coupled with inflow outflow saturation bands (IOSB-RARE). Wall-lumen contrast-to-noise-ratio efficiency (CNReff), lumen area (LA), and wall area (WA) were compared between DANTE-VF-RARE and 2D IOSB-RARE sequences. Additionally, linear regression analysis was conducted between MR measurements and histomorphometric planimetry results. ResultsResidual blood signal was observed in the four out of eighteen carotids on VF-RARE images, whereas it was significantly suppressed on DANTE-VF-RARE images. Compared with IOSB-RARE, DANTE-VF-RARE offered significantly improved CNReff (P < 0.001). The LA and WA were both comparable (P = 0.085 and 0.112, respectively) and showed excellent agreement between DANTE-VF-RARE and IOSB-RARE (ICC = 0.96 and 0.95, respectively). The luminal stenosis identified by DANTE-VF-RARE was in consistent with the results of TOF. Strong correlations were found between MR measurements and histopathological analysis for both WA (DANTE-VF-RARE: r = 0.92, slope = 0.94, P < 0.001; IOSB-RARE: r = 0.93, slope = 0.94, P < 0.001) and LA (DANTE-VF-RARE: r = 0.82, slope = 0.54, P < 0.001; IOSB-RARE: r = 0.78, slope = 0.50, P < 0.001). ConclusionDANTE-VF-RARE achieves effective blood signal suppression and is a feasible approach for the 3D carotid arterial wall imaging of ApoE−/− mouse at 7 T.

Case Report on Deep Vein Arterialization in No Option Peripheral Arterial Disease

Case Report on Deep Vein Arterialization in No Option Peripheral Arterial Disease

Steady-State Navier–Stokes Equations in Thin Tube Structure with the Bernoulli Pressure Inflow Boundary Conditions: Asymptotic Analysis

Steady-state Navier–Stokes equations in a thin tube structure with the Bernoulli pressure inflow–outflow boundary conditions and no-slip boundary conditions at the lateral boundary are considered. Applying the Leray–Schauder fixed point theorem, we prove the existence and uniqueness of a weak solution. An asymptotic approximation of a weak solution is constructed and justified by an error estimate.

Effect of Blood Flow Rate on the Accuracy of Central Venous Pressure Measurement during Continuous Renal Replacement Therapy

Background: The objective of this study was to study the influence of extracorporeal blood flow rate (BFR) on the accuracy of central venous pressure (CVP) measurement during continuous renal replacement therapy (CRRT). Methods: Eligible patients were randomly divided into 3 groups based on the location of catheters used for their CRRT and CVP measurement. CVP levels measured at increased extracorporeal BFR (from 0 to 300 mL/min) in the normal and reverse positions of inlet and outlet lines connected to the CV catheter (CVC) in the course of the CRRT session were collected. Results: CVP levels measured at different extracorporeal BFRs did not significantly differ between and among the 3 groups. Inversion of inlet and outlet lines connected to the catheters did not affect the accuracy of CVP measurement. BFR had a negative correlation with inflow/access pressure but a positive correlation with outflow/return pressure. Neither inflow pressure nor outflow pressure was correlated with CVP. Conclusions: Extracorporeal BFR has no influence on the accuracy of CVP measurement during CRRT with the net machine balance adjusted to zero regardless of the location of the catheter and the connection method between catheters and CRRT lines. Thus, CRRT does not need to be discontinued to obtain an accurate CVP measurement.

Blood Flow Restriction Therapy Impact on Musculoskeletal Strength and Mass

Background:Blood flow restriction (BFR) training restricts arterial inflow and venous outflow from the extremity and can produce gains in muscle strength at low loads. Low-load training reduces joint stress and decreases cardiovascular risk when compared with high-load training, thus making BFR an excellent option for many patients requiring rehabilitation.Indications:Blood flow restriction has shown clinical benefit in a variety of patient populations including healthy patients as well as those with osteoarthritis, anterior cruciate ligament reconstruction, polymyositis/dermatomyositis, and Achilles tendon rupture.Technique Description:This video demonstrates BFR training in 3 clinical areas: upper extremity resistance training, lower extremity resistance training, and low-intensity cycling. All applications of BFR first require determination of total occlusion pressure. Upper extremity training requires inflating the tourniquet to 50% of total occlusion pressure, while lower extremity exercises use 80% of total occlusion pressure. Low-load resistance training exercises follow a specific repetition scheme: 30 reps followed by a 30-second rest and then 3 sets of 15 reps with 30-seconds rest between each. During cycle training, 80% total occlusion pressure is used as the patient cycles for 15 minutes without rest.Results:Augmenting low-load resistance training with BFR increases muscle strength when compared with low-load resistance alone. In addition, low-load BFR has demonstrated an increase in muscle mass greater than low-load training alone and equivalent to high-load training absent BFR. A systematic review determined the safety of low-load training with BFR is comparable to traditional high-intensity resistance training. The most common adverse effects include exercise intolerance, discomfort, and dull pain which are also frequent in patients undergoing traditional resistance training. Severe adverse effects including deep vein thrombosis, pulmonary embolism, and rhabdomyolysis are exceedingly rare, less than 0.006% according to a national survey. Patients undergoing BFR rehabilitation experience less perceived exertion and demonstrate decreased pain scores compared with high-load resistance training.Conclusion:Blood flow restriction training is an effective alternative to high-load resistance training for patients requiring musculoskeletal rehabilitation for multiple disease processes as well as in the perioperative setting. Blood flow restriction has been shown to be a safe training modality when managed by properly trained physical therapists and athletic trainers.

Pericardial Constriction and Myocardial Restriction in Pediatric Mulibrey Nanism: A Complex Disease With Diastolic Dysfunction

BackgroundMulibrey nanism (MUL) is a rare condition with profound growth delay. Congestive heart failure is a major determinant of prognosis. The aim was to delineate pericardial constriction and myocardial functional abnormalities in a pediatric MUL sample. MethodsA total of 23 MUL patients and 23 individually sex- and age-matched healthy control subjects were prospectively assessed in a cross-sectional study with echocardiography. ResultsClinical signs of heart failure were present in 7 MUL patients, with severe congestive heart failure in 2. Significant diastolic dysfunction, mainly related to constriction, was found in MUL patients without pericardiectomy (N = 18)—septal bounce, pronounced hepatic vein atrial reversal and right heart inflow–outflow variations, and decreased inferior vena cava collapse during respiration. The appearance of the pericardium was not different from that of control subjects. Longitudinal diastolic myocardial velocities were similar to those in control subjects, suggesting an absence of significant myocardial restriction. Right ventricular free wall longitudinal systolic strain and bilateral longitudinal myocardial systolic velocities were decreased in MUL patients, indicating mild biventricular systolic dysfunction. Myocardial motion abnormalities and persistent congestive heart failure were common (in 3 of 6) in MUL patients with a history of pericardiectomy. Cardiac dimensions were similar between MUL patients and control subjects when adjusting for body size, except for smaller biventricular volumes. ConclusionsMUL disease presents with significant constriction-related diastolic dysfunction and mild bilateral systolic dysfunction. Constriction–restriction assessments during follow-up could be of benefit in decision-making regarding pericardiectomy in MUL disease. Myocardial abnormalities were prevalent among MUL patients who had undergone pericardiectomy and are consistent with progression of myocardial disease in a significant proportion of patients.

How does labor transfer affect environmental pollution in rural China? Evidence from a survey

In the context of increasingly serious rural environmental pollution in China, this paper specifically examines the impact of China's rural labor transfer (RLT) on rural environmental pollution. Based on the micro data of rural communities from the Chinese Family Database and the China Community Governance Survey, we investigate the impacts of RLT on agricultural pollution (AP), rural industrial pollution (RIP), and rural domestic pollution (RDP). Furthermore, we identify the mechanisms of RLT affecting rural environmental pollution by applying the mediation effect model. The results show that, with more migrant labors flowing out of the village, the probabilities of AP and RIP decrease, while the probability of RDP increases. However, different transfer modes have heterogeneous effects on rural environmental pollution. When RLT includes the whole family, higher probabilities of AP, RIP, and RDP will present, while RLT with some (but not all) family members gives rise to higher probabilities of AP and RDP, and a lower probability of RIP. In addition, the effects of RLT on the above three types of pollution are different between communities with labor net inflow and labor net outflow. Labor net outflow significantly aggravates the probabilities of AP and RDP in the outflow communities, but reduces the probability of RIP. In contrast, labor net inflow significantly increases the probability of RIP in the inflow communities. The results of mechanism analysis reveal that RLT increases the probability of AP by increasing the proportion of left-behind elderly and children, but lessens the probability of AP by increasing the amount of idle cultivated land. Moreover, RLT renders communities less likely to suffer from RIP, because RLT lowers the probability of high-polluting enterprises moving into communities. However, by improving rural residents' per capita disposable income, RLT increases the likelihood of communities exposing to RDP.