Training Patterns Research Articles

Antimicrobial resistance pattern of the Bacteroides fragilis group strains isolated atateaching hospital in China.

The study was conducted in the microbiology laboratory of the First Affiliated Hospital of Hainan Medical University, Haikou, China, from January 2019 to December 2023. A total of 316 consecutive non-duplicate isolates were collected and identified, that belonged to the Bacteroides fragilis group. Identification of the isolated strains was performed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The minimum inhibitory concentration (MIC) of seven antibiotics was determined by agar dilution method. The presence of cfiA, ermF, and nim genes was determined by polymerase chain reaction (PCR). Correlations between the presence of resistance genes and the MIC values of antibiotics were determined using the Pearson correlation coefficient. In the identification process, 214 isolates (67.7%) were identified as B. fragilis, 52 (16.4%) as Bacteroides thetaiotaomicron, 17 (5.4%) as Bacteroides ovatus, 12 (3.8%) as Bacteroides uniformis, 10 (3.2%) as Phocaeicola vulgatus (=Bacteroides vulgatus), 7 (2.2%) as Bacteroides stercoris, and 4 (1.3%) as Parabacteroides distasonis. The presence of cfiA gene moderately correlated with the MIC of imipenem and meropenem (r = 0.34 and r = 0.42, respectively), while resistance to clindamycin and the presence of ermF gene exhibited a very strong correlation (r = 0.72). In the current study, the most active antimicrobial agents against B. fragilis group bacteria were found to be meropenem, imipenem, metronidazole, and piperacillin/tazobactam; however, resistance to clindamycin renders its empirical use inappropriate.

Novel Approach to Optimizing Express-Local Metro Train Timetable Considering Multiple Train Stopping Patterns

A traditional hybrid operational mode of a metro system usually combines the express and local trains. The stopping patterns of express trains are generally assumed to be the same. To provide a diverse service, this paper aims to explore the train timetable optimization method when the express trains have different stopping patterns. A passenger-oriented timetabling model for reducing passenger waiting time is established, which is proved to be a quadratic programming problem. Then, an Interior Point Method is applied to obtain the best timetable. A case study based on the Guangzhou Metro Network is conducted, symbolizing different operation strategies. The results indicate that the proposed model can efficiently reduce the passenger waiting time by 16.8% and the number of stranded passengers by 15.9%. The practical implications of this research are significant, as it introduces a new approach to train timetable optimization that can be applied to real-world metro systems.

Comparison of the Effect of Resistance, Swimming, and Combination Training Patterns on Bone Density in Female Osteoporotic Rats

Introduction: The aim of the study was to compare the effects of resistance, swimming, and combined training patterns on L5 vertebral mineral density in osteoporotic rats. Methods: In this experimental study, 36 female Wistar rats, each weighing between 170-190 grams, were selected as samples. To verify the induction of osteoporosis, 12 rats were randomly divided into two groups: healthy and alcohol-injected (6 rats). Osteoporosis induction was induced through intraperitoneal injection of a saline solution combined with ethanol over a period of 3 weeks. 24 rats were randomly divided into 4 groups (6 rats): 1. Resistance training, 2. Swimming training, 3. Combined training, and 4. Control. Swimming training (90 minutes per day, 5 days in 12 weeks) and resistance protocol (5 days in 12 weeks, each session 8 sets with 8-12 repetitions of climbing the ladder) and the combined group performed resistance training in 4 sets with 8-12 repetitions of climbing the ladder and swimming training with half the duration of the swimming group. After 12 weeks, samples were collected from the spine and the density of L5 was evaluated using a DEXA machine. Data were analyzed using independent t-test, one-way ANOVA, and Tukey's test with a significance threshold of less than 0.05 in SPSS-16 (P<0.05). Results: In the intragroup comparison, resistance training and combined training significantly increased L5 density (P=0.00). In the intergroup comparison, L5 density of the combined group showed a significant increase compared to the training and control groups (P=0.00). The resistance group showed a significant increase in this variable compared to the swimming and control groups (P=0.00). Conclusion: Using combined exercise as a therapeutic approach can increase bone density; therefore, it serves as an effective strategy for improving osteoporosis.

Presence of paradoxical mid-systolic longitudinal strain (stretching) with speckle tracking in the basal inferior-to-lateral segments in mitral valve prolapse

Abstract Background and Purpose Abnormality in the motion of the inferior papillary muscle was found, in the past, in Mitral Valve Prolapse (MVP). We visually observed an odd movement not only in the inferior wall but also in the anterolateral and inferolateral basal walls in several MVP patients as well. Therefore, the purpose of this work was to analyze this findings with the help of Strain (Speckle Tracking). Methods 60 MVP patients, having a superior displacement of the posterior leaflet of at least 2 mm, and 20 normal controls were included. Longitudinal Strain was calculated in the 3 apical views (Philips iE 33 Matrix - implemented Strain software). The Strain in the 3 above mentioned basal segments was measured at 160 msec from the beginning of systole (mid-systole) and then averaged to form a "triad" that could be compared among the groups for statistical calculations. The Global Longitudinal Strain (GLS) was calculated for all as well. The Mann-Whitney U-test for comparisons was used. A "p" value ≤ 0.05 was considered significant. Results According with the Strain patterns, we could identify two Groups of MVP patients: Group 1: having a "paradoxical" Strain at 160 msec (positive, that means stretching) in at least one of the three told basal segments (n = 35), and Group 2 : not having a "paradoxical" Strain (n = 25) in any of the told three basal segments at the same mid-systolic point. Statistical significance was found between Groups 1 and 2 at 160 msec (fig 1) and at the peak (p< 0.0001 for both) and for GLS (p< 0.01) as well. Group 1 vs controls also displayed significant difference in the Strain at 160 msec (p<0,0001) while Group 2 vs controls did not do and even not at the peak (bull-eye summary view in fig 2 ). Conclusions According with our results, there is a MVP population (more than the half in our series) having a "paradoxical" Strain (stretching) in one of the basal inferior-to-lateral segments in mid-systole. The passive continuous stretching of myocardial cells is known to lead, with time, to the replacement with fibrosis (and fibrosis is a condition that is well known to be a source of arrhythmias, and even malignant). Cardiac Magnetic Resonance (CMR) already demonstrated the presence of fibrosis just in the same basal wall segments in some MVP patients. Thus, considering our results in the Strain, in MVP patients with ventricular arrhythmias it is mandatory to analyze the Strain (not expensive tool), and then, if the Strain were to be found to be "paradoxical" even in only one segment of this previously called "triad", a further evaluation with CMR (even if expensive) is highly recommended to look for the presence of fibrosis. The Strain is highly recommended because the topic is implicated in prognosis, in the further study of arrhythmias, and in the choice of a proper therapy as well. Fig 1 Fig 2

Sensitivity and specificity of relative apical sparing pattern of global longitudinal strain in the diagnosis of cardiac amyloidosis: a systematic review and meta-analysis

Abstract Background Cardiac amyloidosis (CA), characterized by a progressive infiltration of amyloid fibrils in cardiac tissue, presents a diagnostic challenge due to its resemblance to other cardiomyopathies by echocardiography. Although reduced left ventricular (LV) global longitudinal strain associated with a relative apical sparing pattern (RELAPS) has been associated with CA, its diagnostic accuracy has varied across studies. Purpose The aim of this systematic review and meta-analysis was to assess the diagnostic accuracy of using a quantitative RELAPS on 2D-echocardiography to differentiate patients with either transthyretin (ATTR) or light-chain (AL) cardiac amyloidosis from those with other causes of cardiomyopathies. Methods A comprehensive literature search was performed using PubMed, Scopus, Web of Science, and Cochrane databases from inception till May 2024. We included cohort original studies that reported the sensitivity and specificity of a quantitative RELAPS in differentiating ATTR-CA or AL-CA from other types of cardiomyopathies. RELAPS was defined as average apical longitudinal strain segments divided by the sum of average basal plus average mid longitudinal strains segments. Meta-analysis was performed using bivariate random effects regression to calculate sensitivity and specificity summary estimates. Subgroup analysis assessed the impact of different RELAPS cutoff values (1.0 and 0.9) on diagnostic performance. The risk of bias was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Results A total of 20 studies with 4308 patients were included in our meta-analysis, comprising 2,063 CA patients: 1,066 with ATTR-CA, 942 with AL-CA, and 55 unclassified CA patients. Eight studies used a cutoff of ≥0.9 to define the presence of RELAPS, while twelve studies used a cutoff of ≥1.0. The estimated sensitivity of RELAPS irrespective of the cutoff used for cardiac amyloidosis was 67% (95% confidence interval (CI): 59 - 75), with a specificity of 85% (95% CI: 78 - 90). Subgroup analysis revealed that a RELAPS cutoff >1.0 had higher specificity (87%, 95% CI: 79 - 93) but lower sensitivity (57%, 95% CI: 40 - 72), whereas a cutoff of 0.9 showed higher sensitivity (69%, 95% CI: 65 - 73) but lower specificity (83%, 95% CI: 75 - 90). Conclusion Our results confirm that the RELAPS pattern is an effective and simple diagnostic tool for detecting cardiac amyloidosis using echocardiography, demonstrating fairly good sensitivity and excellent specificity. Moreover, the choice of RELAPS cutoff value impacts diagnostic performance, highlighting its potential role in enhancing the accuracy of echocardiographic evaluations in suspected cases of cardiac amyloidosis. Forest Plot

A strain-based classification is associated with therapy success in cardiac resynchronization therapy-eligible patients

Abstract Introduction Echocardiography-derived septal strain patterns stages are associated with a stepwise increase in survival for each increment in strain stage among patients treated with cardiac resynchronization therapy (CRT). However, it is unknown whether the strain stages could also predict survival in conservatively-treated (i.e. not CRT-implanted) patients. Purpose This study aims to investigate the interplay between septal strain patterns and long-term survival in both CRT- and conservatively-treated patients. Methods In this multicentre study, CRT-eligible patients from six European centres underwent speckle-tracking strain analysis on echocardiography. CRT-treated patients (CRT) were enrolled prospectively and assessed prior to device implantation. Conservatively-treated patients (CON) were assessed retrospectively. Dyssynchrony was graded through analysis of septal strain curves, categorizing patients into five distinct patterns, denoted as strain Stage-0 (no dyssynchrony) through strain Stage-4 (severe dyssynchrony) (Fig. A). The study endpoint was all-cause mortality. Results A total of 267 CRT patients (69% males, 89% left bundle branch block (LBBB) and QRS 166±20 ms) and 167 CON patients (69% males, 87% LBBB, QRS 155±25 ms) were included. Median follow-up time was 49 (40-57) months. CON patients within the highest strain stages had the worst outcome, whereas CRT-treated patients within the highest strain stages had the best survival (Fig. B). A stepwise increase in survival difference was observed between CRT and CON patients for each increment in strain stage (Fig. B-F). Hazard ratios (HR) were: Stage-0: 1.42 (95% CI: 0.59-3.44, p=0.436) / Stage-1: 2.63 (95% CI: 1.19-5.82, p=0.017) / Stage-2: 3.93 (95% CI: 1.20-12.83, p=0.024) / Stage-3: 5.74 (95% CI: 1.72-19.19, p=0.005) and Stage-4: 16.49 (95% CI: 4.84-56.21, p<0.001). Conclusions The strain stages demonstrated a strong survival benefit for CRT-treated compared to conservatively-treated, but CRT-eligible patients. Patients with more severe dyssynchrony (highest strain stages) have most benefit from CRT implantation. These findings underscore the potential value of the strain stages in refining risk stratification and patient selection of CRT.

Abnormal strain pattern in arrhythmogenic mitral valve prolapse, the importance of the basal inferolateral myocardial wall

Abstract Introduction The rare, but clinically relevant arrhythmogenic form of mitral valve prolapse (MVP) can lead to malignant arrhythmias and sudden cardiac death. The aim of our study was assessing the characteristics of arrhythmogenic mitral valve prolapse (AMVP), especially regarding the parameters that could be used in risk stratification. Patients and methods: Thorough examinations were performed on 44 patients living with mitral valve prolapse and mitral annular disjunction, including their medical history and symptoms, blood pressure measurement, 12-lead ECG, 24-hour Holter monitoring, transthoracic echocardiography with 2D strain measurement and cardiac magnetic resonance imaging (CMR). The patients were divided into an arrhythmogenic and a non-arrhythmogenic group, according to the criteria determined in the consensus statement of the ESC. For the strain measurement, we included a control group of 20 patients matching in age and gender. Results 53% of patients had inferior ST-T abnormalities and 74% reported palpitation. The prevalence of syncope was higher in the arrhythmogenic group (42,1% vs. 12,5% vs.; p=0,038). In 86,4% of patients the degree of mitral regurgitation was mild or moderate. Left ventricular volumes measured by 3D echocardiography exceeded the upper limit of the normal range with normal left ventricular ejection fraction. The global longitudinal strain (GLS) value was significantly lower in the MVP patients than GLS in the healthy control group (-21,9±2,0 % vs. -20,3±2,4 %; p=0,019). Compared to the control group the longitudinal strain values of the inferolateral (-22,2±8,8 vs. -28,8 ± 7,0; p=0,008) and inferior (-13,2±6,3 vs. -20,9±4,1; p=0,001) basal segments were significantly reduced. In 47% of the patients, late gadolinium enhancement (LGE) could be detected in the inferolateral region with CMR. Conclusions Inferior ECG abnormalities and palpitations are common among patients with MVP, but due to their low specificity they are not suitable for risk stratification. However, syncope can be considered an alarming sign. The typical pattern of segmental longitudinal strain abnormalities and the similar localization of LGE on CMR indicate the importance of the basal inferolateral segment in AMVP.

The Technical Development of a Prototype Lower-Limb Therapy Device for Bed-Resting Users

It is generally recommended that bed-resting patients be mobilised early to promote recovery. The aim of this work was to develop and evaluate the usability of a prototype in-bed lower-limb therapy device that offers various training patterns for the feet and legs, featuring an intuitive user interface and interactive exergames. Based on clinical interviews, the user requirements for the device were determined. The therapy device consisted of two compact foot platforms with integrated electric motors and force sensors. Movement control strategies and a user interface with computer games were developed. Through a touch screen, the target force and position trajectories were defined. Using automatic position and force control algorithms, the device produced leg flexion/extension with synchronised ankle plantarflexion/dorsiflexion as well as leg pressing with adjustable resistive loading. An evaluation test on 12 able-bodied participants showed that the device produced passive (mean position control errors: 8.91 mm linearly and 1.62° in the ankle joints) and active leg training (force control error: 2.52 N). The computer games were proven to be interesting, engaging, and responsive to the training movement. It was demonstrated that the device was technically usable in terms of mechatronics, movement control, user interface, and computer games. The advancements in well-controlled movement, multi-modal training patterns, convenient operation, and intuitive feedback enable the compact therapy device to be a potential system for bed-resting users to improve physical activity and cognitive functionality.

Crustal and Upper Mantle Structure of the Assam Valley Region, NE India: A Review of Geophysical Findings

The northeastern region of India is one of the six most seismically active convergent plate tectonic areas in the world. The north–south convergence along the Indo-Tibetan Himalayan Ranges and the east–west subduction within the Indo-Burma Ranges create a complex stress regime, resulting in significant seismic activity and a history of great/large earthquakes. The region’s intricate strain patterns, active faults, and potential seismic gaps underscore the need for detailed subsurface studies to effectively assess seismic hazards and impending seismicity. Geophysical research is essential for understanding the region’s geodynamic evolution, seismotectonics, and mineral resources. This manuscript reviews the geological and tectonic settings of the region and summarizes recent geophysical studies, including seismic, gravity, magnetic, and magnetotelluric surveys conducted in the Assam Valley and adjacent areas (within latitudes 24.5–28.5° N and longitudes 89–97.5° E). The review highlights key findings on hydrocarbon-bearing sediments, the configuration of the crystalline basement, the heterogeneous structures of the crust and upper mantle, and seismic discontinuities. By synthesizing these results, the review aims to enhance the understanding of seismic hazards in Northeast India, guide mitigation strategies, and identify key knowledge gaps to direct future research efforts.

Electrocardiographic markers predict hemodynamic parameters in adults with uncorrected secundum atrial septal defect

BackgroundPrecapillary pulmonary hypertension (PH) as complication in atrial septal defect (ASD) is closely related to right heart hemodynamics, such as right atrial pressure (RAP) and pulmonary vascular resistance (PVR). Right heart catheterization (RHC) as the gold standard for their measurement is invasive and not widely available in Indonesia. Electrocardiography (ECG) was proposed to be alternative in this matter.MethodThis is a retrospective observational study with cross-sectional design. We collected data and measured ECG parameters of secundum ASD patients who underwent elective RHC from May 2019 until November 2023. We compared several ECG parameters based on RAP (< 8 and ≥ 8 mmHg) and PVR (< 5 and ≥ 5 WU).ResultEighty-three patients were included. The RV1 was the only ECG marker that showed significant difference based on RAP (AUC 0.639, sensitivity 61.7%, specificity 61.1%, p = 0.030) and PVR (AUC 0.801, sensitivity 73.2%, specificity 81%, p < 0.001). Several ECG parameters were found significantly different based on PVR value only, namely SV5 (AUC 0.773, sensitivity 80.5%, specificity 71.4%, p < 0.001), SV6 (AUC 0.823, sensitivity 80.5%, specificity 81%, p < 0.001), right ventricular Sokolow–Lyon index (RVSLI) (AUC 0.841, sensitivity 82.9%, specificity 83.3%, p < 0.001), R/SV1 (sensitivity 97.6%, specificity 16.7%, p = 0.031) as well as right ventricular strain (sensitivity 87.8%, specificity 69%, p < 0.001). Multivariate regression analysis showed RVSLI (OR 15.66 (4.46–55.02), CI 95%) and right ventricular strain pattern (OR 9.23 (2.43–35.14), CI 95%) had the best predictive value for PVR ≥ 5 WU.ConclusionIn adults with secundum ASD, several ECG markers have potential role in predicting PVR ≥ 5 WU with satisfying sensitivity and specificity, but not in predicting RAP.

Non-Linear Biomechanical Evaluation and Comparison in the Assessment of Three Different Piece Dental Implant Systems for the Molar Region: A Finite Element Study.

The widely available options of different manufacturers in dental implant systems have complicated the selection criteria process for periodontists, necessitating careful consideration of various factors when selecting suitable solutions for individual patient needs. Optimal implant selection requires careful consideration of the patient-specific factors, implant design, and surgical technique. Understanding the biomechanical behavior of implant-tissue interactions is crucial for achieving successful and long-lasting implant therapy. To adequately address this issue and improve the rigorous selection criteria from a biomechanically numerical approach, this research aims to analyze the stress distribution fields, strain patterns, and load transfer displacements within the implant system and the implant-biological interface (gingival and bony tissues) of titanium three-piece to two-one-piece ceramic implant systems. Thus, three different commercially available dental implants designed to be placed in the jaw molar region were considered for evaluation through the finite element method under both oblique and occlusal loading conditions. The results have exhibited an increasing trend to highlight the outstanding behavior of two-piece ceramic implants to dissipate the stress distribution better (6 and 2 times lower than the three- and one-piece systems under occlusal loads and almost 5 and 1.3 times more efficient for oblique loading, respectively), minimize peak stress values (below 100 MPa), and reduce strain peak patterns compared with the other two evaluated designs. On the other hand, the effects generated in biological tissues are strongly associated with implant geometry features. This biomechanical approach could provide a promising strategy for predicting micro-strains and micromotion in implant system pieces and geometries. Hence, these findings contribute to a deeper understanding of the biomechanics spectrum in the behavior of dental implant systems and emphasize the importance of carefully selecting appropriate material systems for accurate patient-specific biomechanical performance.

Male-assisted training and injury patterns: hypergraph-enhanced analysis of injuries in women's water polo.

The aim of this study is to compare the injury patterns of female water polo players before and after the implementation of the Male-Assisted Female Training (MAFT) program. The study seeks to identify key factors influencing these changes and propose corresponding injury prevention measures. We utilized pattern analysis and classification techniques to explore the injury data. A Hypergraph Neural Network (HGNN) was employed for pattern extraction, where each athlete was represented as a node in a hypergraph, with node dimensions capturing high-order relational embedding information. We applied the graph Laplacian operator to aggregate neighborhood features and visualize structural and feature differences in hypergraphs based on different influencing factors. Additionally, we introduced graph structure regularization to improve classification accuracy and prevent overfitting in the relatively small dataset, enhancing our ability to identify critical factors affecting injury types. The analysis revealed significant differences in injury patterns before and after the MAFT program, with specific influencing factors being identified through both pattern recognition and classification techniques. The classification models, supported by graph structure regularization, achieved improved accuracy in distinguishing key features that contributed to changes in injury types. These findings provide insights into the critical factors influencing injury patterns in female water polo players and highlight the effectiveness of the MAFT program in mitigating certain injury risks. Based on the identified features, we propose targeted preventive measures to reduce injury incidence, particularly in relation to changes brought about by the MAFT training mode. Further research is needed to refine these measures and explore their long-term effectiveness.

Baseline gene expression in BALB/c and C57BL/6 peritoneal macrophages influences but does not dictate their functional phenotypes.

Macrophages are effector cells of the immune system and essential modulators of immune responses. Different functional phenotypes of macrophages with specific roles in the response to stimuli have been described. The C57BL/6 and BALB/c mouse strains tend to selectively display distinct macrophage activation states in response to pathogens, namely, the M1 and M2 phenotypes, respectively. Herein we used RNA-Seq and differential expression analysis to characterize the baseline gene expression pattern of unstimulated resident peritoneal macrophages from C57BL/6 and BALB/c mice. Our aim is to determine if there is a possible predisposition of these mouse strains to any activation phenotype and how this may affect the interpretation of results in studies concerning their interaction with pathogens. We found differences in basal gene expression patterns of BALB/c and C57BL/6 mice, which were further confirmed using RT-PCR for a subset of relevant genes. Despite these differences, our data suggest that baseline gene expression patterns of both mouse strains do not appear to determine by itself a specific macrophage phenotype.

Investigating the Construction Procedure and Safety Oversight of the Mechanical Shaft Technique: Insights Gained from the Guangzhou Intercity Railway Project

Currently, subway and underground engineering projects are vital for alleviating urban congestion and enhancing citizens’ quality of life. Among these, excavation engineering for foundation pits involves the most accidents in geotechnical engineering. Although there are various construction methods, most face issues such as a large footprint, high investments, resource waste, and low mechanization. Addressing these, this paper focuses on a subway foundation pit project in Guangzhou using mechanical shaft sinking technology. Using intelligent cloud monitoring, we analyzed the stress–strain patterns of the cutting edge and segments. The results showed significant improvements in construction efficiency, cost reduction, safety, and resource conservation. Based on this work, this paper makes the following conclusions: (1) The mechanical shaft sinking method offers advantages such as small footprint, high mechanization, minimal environmental impact, and cost-effectiveness. The achievements include a 22.22% reduction in construction time, a 20.27% decrease in investment, and lower worker risk. (2) Monitoring confirmed that all cutting edge and segment values remained safe, demonstrating the method’s feasibility and rationality. (3) Analyzing shaft monitoring data and field uncertainties, this study proposes recommendations for future work, including precise segment lowering control and introducing high-precision total stations and GPS technology to mitigate tunneling and assembly inaccuracies. The research validates the mechanical shaft sinking scheme’s scientific and logical nature, ensuring safety and contributing to technological advancements. It offers practical insights, implementable suggestions, and significant economic benefits, reducing project investment by RMB 41,235,600. This sets a benchmark for subway excavation projects in South China and beyond, providing reliable reference values. Furthermore, the findings provide valuable insights and guidance for industry peers, enhancing overall efficiency and sustainable development in subway construction.

Assessment of Right Ventricle Function in Patients with Mitral Repair: Case Series.

We aim to assess right ventricular function in patients undergoing mitral valve repair using trans-esophageal echocardiography, focusing on the predictive value of right ventricular longitudinal strain compared to other echocardiographic measures. Retrospective analysis. Toronto General Hospital. Thirty elective patients undergoing mitral valve repair. Quantitative assessment of right ventricular function using transesophageal echocardiography images pre- and post-mitral valve repair, including right ventricular longitudinal strain, fractional area change, tricuspid annular plane systolic excursion, and systolic peak velocity (S'). 3 patterns of RV strain were identified with right ventricular longitudinal strain emerging as the most significant discriminator among right ventricular functional subgroups, with 43% of cases showing worsening, 20% showing no change, and 37% showing improvement. No correlation was found between right ventricular performance parameters and the need for vasopressors post-cardiopulmonary bypass. There was also no association between initial right ventricular longitudinal strain and difficulty in weaning off bypass or increased demand for pressors. Changes in tricuspid annular plane systolic excursion across all cases warrant further investigation with a larger cohort. Right ventricular longitudinal strain is a valuable tool for assessing right ventricular function post-mitral valve repair, offering insights into immediate postoperative outcomes and long-term right ventricular remodeling. Despite limitations like single-surgeon experience and institution-specific choice of pressors, our study provides useful insights into right ventricular function post-mitral repair surgery, paving the way for future research in larger patient populations.

Comparative study of the “blueberry-on-top" phenomenon. a recently recognized strain pattern in patients with apicalvariant hypertrophic cardiomyopathy

Comparative study of the “blueberry-on-top" phenomenon. a recently recognized strain pattern in patients with apicalvariant hypertrophic cardiomyopathy

Regional strain patterns in patients with mitral valve prolapse

Regional strain patterns in patients with mitral valve prolapse

Atypical left ventricular strain pattern in repaired TOF

Atypical left ventricular strain pattern in repaired TOF

A rare neurological association of bicuspid aortic valve: A case report

A 45-year-old male presented to the Emergency Department with a 2-h history of sudden onset right-sided headache and difficulty walking. Initial non-contrast computed tomography (CT) of the brain was unremarkable. Twelve-lead electrocardiogram showed left ventricular (LV) hypertrophy with strain pattern. On echocardiography, the aortic valve was noted to be bicuspid, associated with at least moderate eccentric aortic regurgitation and moderate aortic stenosis. In view of the initial presentation of ataxia and headaches, and the finding of bicuspid aortic valve (BAV) on echocardiography, an urgent CT of aorta and carotid arteries was performed, revealing dissection of the right vertebral artery and a right lateral medullary infarct. Aortic root dilatation and aortic dissection are well known complications of BAV. However, vertebral artery dissection in the context of BAV with a normal aortic root is unusual, and to our knowledge has only been reported once in the literature so far.

The Variation in Foot Arch Types among Athletes from Various Sports Disciplines: Analysis and Implications for Athletic Performance

The foot arch is one of the many parts of the leg that plays a crucial role in supporting and balancing body weight, as well as regulating body movement during walking and running. Despite this, research on the foot, particularly in student-athletes, remains limited. Therefore, this study aims to analyze the variations in arch types of the foot among student-athletes from various sports disciplines. The research employs an observational study method with participants being student-athletes from soccer, futsal, archery, and pencak silat. Foot measurements are taken using the wet test, while height is measured with a stadiometer, and body weight and BMI are assessed using the Omron Carada Body Fat Scan. The results indicate that futsal and soccer athletes predominantly have normal foot arches, with 90% in each group, while only 10% exhibit flat arches. In contrast, archery and pencak silat athletes show a greater variation in arch distribution, with 30% and 40% having flat arches, and 70% and 60% having normal arches, respectively. The study concludes that while normal foot arches are the most common among athletes, the distribution of foot arches varies by sport, which may reflect the biomechanical needs and specific training patterns inherent to each sport.