Saturday, February 11, 2012

Robert JR Graham.com ? Master the Slight Edge - mgokic's posterous

Success: The Slight-Edge Formula
by:?Daniel Sitter

Self-improvement; A great deal has been written on the subject, but does any anyone really know how to successfully implement a creative and manageable plan for its accomplishment? The concept involves goal setting, planning, time management as well as patience, faith, understanding and real desire. Too many times, people approach self improvement haphazardly, unfocused and unclear as to exactly what they want. This is not a paper specifically concerning goal-setting, that will be addressed another time in greater detail, but rather a blueprint for the implementation of the plan you generate during your own self-improvement goal setting exercise.

Many times, we set out on a self-improvement course of action with literally no idea of how to proceed, with only a loose idea of what we really want to accomplish. Basically, at this point, it?s just a dream of a better day. This is actually not what you want; after all, you expect success. You must believe success is possible and probable. Be expectant. Be confident.

Before you begin, sit down and write out your plan of action. Clearly write your goal, your timeframe, identify the specific steps to accomplish during the journey and the obstacles that you expect to encounter along the way. Yes, write this all down. Review it each evening before bed and again when you awaken in the morning. Keep your plan with you at all times and read it aloud to yourself several times during the day. This will imbed it deeply into your subconscious mind where it will steer you in the direction of your goal.

Jeff Olson talks about the Slight-Edge Formula for success. Imagine an incremental system where you consciously plan to improve just ?% each day, or even each week. Can you do that? Sure you can. Everybody can. It has been said that ?you can eat an elephant if you do it one bite at a time.? The same idea holds true with this concept. The premise is to experience minute improvements on a consistent basis that tend to compound over time like interest. A ?% improvement in any skill each day is a 1-?% improvement each week! A 7% improvement each month! An 84% improvement in just 1 year! It?s actually higher than that because all of your advances are compounding at an exponential rate! Are you beginning to see the potential of this compounding power at work within you?

The Slight Edge Formula for success is the answer. Do a little each day and reap the rewards you desire over time, while consistently moving in the direction of your goal. You will always get out in proportion to what you put in. Apply yourself. It pays big dividends!

Most people never begin. They may talk a big talk, but they fail to act. Only a few of those who do take action tend to persist over time. Are you one of the few who are determined to make your life different? Do you want changes badly enough? Then begin now. Persist. Make no excuses.

?What?s in it for me? or WIIFM is your mantra. What is it that?s in it for you that will drive you to pursue the goals that you have defined? Identify this and you have taken the first step toward the success you desire. This can potentially change your life? Nothing will happen until you first decide to get started. You have to make things happen. Do not wait for things to miraculously happen. They will not.

Choose to employ the Slight-Edge Formula into your everyday life events. It is simple, easy to implement and it really works.

Source

Source: http://robertjrgraham.com/2012/02/09/master-the-slight-edge/?utm_source=rss&utm_medium=rss&utm_campaign=master-the-slight-edge

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Source: http://mgokic.posterous.com/robert-jr-grahamcom-master-the-slight-edge

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Friday, February 10, 2012

The visit | Aspie in the family

To help motivate my daughter back to school, the school agreed for a teaching assistant to visit us at home.? We all felt that having someone familiar from school would?bridge the gap between home and?school and help ease my daughter?s worries.? Originally I had intended to sit with my daughter but in the end I decided it was better that I kept my distance to encourage my daughter to talk to the TA.?

Initially though my daughter refused to leave the computer?game she was playing on.? The TA however was very good and started to communicate with her through her special interest and eventually my daughter started to respond.? Unfortunately the TA spoke too much which is a real problem for my daughter as she cannot cope with excessive talking and will often switch off.? To many people this may appear as if she is not listening or is being rude but the fact is my daughter has real problems with understanding spoken language.? This is what happened yesterday.? She was zoning out and the TA kept asking her if she was listening.? It was frustrating; I just wanted to go into the room and tell the TA to give her time to process what she was saying.??However I held back; this was a conversation between the TA and my daughter and?whereever I can I want these people to try and see my daughter?s difficulties though I have now come to realise I am facing huge obstacles.?

The school have insufficient understanding of the autism spectrum, particularly those who are high functioning and mask their symptoms.? They?also have zilch idea about how girls with high functioning autism or asperger syndrome present, absolutely no idea at all.???Not surprisingly I have faced incredibly ignorant comments such as ?Well she smiles? or??She looks at you? as if to say because she looks at people, because she smiles she can?t be autistic.??The point is, she does smile (sometimes), she does look at you (if there is no emotion involved) but she still?has asperger syndrome and life is still difficult for her in many ways.??I have lost count of the letters I have written and the meetings where I have explained my daughter?s dificulties.? I have even copied them a resource or two explaining some of difficulties associated with asperger syndrome.?

This?has clearly been?a waste of time because we?re now entering a phase where we feel our parenting is now being questioned, no doubt?fuelled by the ever increasing discourse that parents are to blame for every social ill.?

And so it was that I overhead the TA asking my daughter about her sleeping patterns.? Yes, her sleeping patterns.? What do sleeping patterns have to do with helping my daughter return to school?? I?ll tell you why I think the TA asked her this, because she has been told to ask her this, probably by the head teacher or the SENCO (special educational needs coordinator) who have got it in their heads that?my daughter?s school refusal is due to our parenting.? If you read my previous post, you will remember that I wrote about how the head teacher asked the class teacher to call us and tell us that my daughter?s school absences are now a welfare issue.?

It is not parenting that is the issue here but the education of my daughter.? If anyone has been neglectful it is the school, overseen by governmental policy that is deeply flawed.? The lack of understanding of asperger syndrome in a school that is obsessed with meeting governmental targets is having a negative impact on my daughter?s wellbeing.? I?m sure my daughter isn?t the only one to be suffering.? You only have to read about the increase in emotional and mental health problems in children and young people to?question what our education system is doing? to our children.? It?s time we opened our eyes to the sad fact that our education system is failing many of our young people.

Anyway returning to yesterday?s visit, the TA did successfully manage to encourage my daughter back to school though credit must also?be given to the lunchtime club.? The one thing that the school did?do well (and I will give credit where credit is due) is that they organised an art club.? This has really engaged my daughter?and the thought of resuming her club motivated her back.? However, this has all been short lived and this morning my daughter has once again refused to go back into school.??

As a parent, this is an incredibly stressful situation to be in.? We want our daughter to be educated but we also want her to be supported and cared for.? The relentless pressure from the school who show little understanding for our situation creates an additional stress and places us into conflict with the school.? We are not neglectful parents, but loving parents who have totally altered our lives to care for our children.? Why can?t the school see that?

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Source: http://www.aspieinthefamily.com/2012/02/the-visit/?utm_source=rss&utm_medium=rss&utm_campaign=the-visit

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Seven Economical Approaches for a Mature Birthday Party

Article Directory :: Home & Family Articles

Economical tips for an adult celebration include the following: developing a budget-friendly plan and staying with it, identifying the party items that you should purchase, applying natural adornments, adorning the location with photos of the celebrant, utilizing cheap and also multi-purpose items, limiting alcohol consumption, and creating your own invites.

Birthday parties for adults are still sort of the same as children's events. Friends and family members gather for a special occasion. The real difference is that, adult celebrations concentrate more on being together, and much less on the entertainment, prizes and adornments. Nonetheless, such a celebration can still cost you a good amount of money. To have tips on how to create a budget friendly adult party, read this article.

Set up a budget friendly plan and adhere to it

Any party, for it to become successful, demands good preparation; particularly when spending budget is an issue in the 50th birthday party ideas. First, list the names of the visitors who'll be invited as well as the location of the celebration based on the budget. Compose a list of all the items which should be paid for, such as food, beverages, decorations, dessert, invitations, and entertainment, and the like. Arrange these items according to priority. If a specific category must be increased, including the cake, then lessen the budget on the least vital item. It is vital that you find strategies to balance all the items which you must spend money on so you can stay on budget.

Identify the event materials that you should buy

Prior to heading out to pick the things that you need for the party, determine which ones you already possess in the house. Look around the home to help you locate existing items that you could use for the event, and take out that specific item from your list. You may also request family and friends if you can lend some of the items in the list that they may have and are not using. The more things you cross off the checklist, the more amount of cash you could save and utilize for the other categories of the occasion.

Use organic decorations

Organic adornments like tiki torches and paper lamps are the mature alternatives of balloons for decorations. Furthermore, these things can also be kept and recycled for another event. These ornamental items also add ambiance to the celebration.

Beautify the area using pictures of the celebrant

Find old and new photographs of the celebrant and utilize these to decorate the area. Distribute them around, like on the food table, walls, and reception area. You might also have a few of these pictures blown up to bigger sizes.

Utilize low-cost and also multi-purpose items

Apply white paper table covers with no designs to cover the tables so visitors can create personal dedications and warm wishes for the bday celebrant. For the centerpiece, you can even use floating candles, which are not just cheap, but pretty, as well.

Control the alcoholic drinks

Alcohol-based drinks are more costly than sodas, thus, control their amount and serve soft drinks, instead. You can even have punch, for people who prefer to really have a liquor.

Design your personal invitations

Developing your own invitations rather than getting them from the retailer or having a specialty shop create customized invitations for the event is far more economical. Simply purchase the craft papers particularly made for invitation cards from the craft shop or the shop that sells school supplies. After that, look for a baby photo of the celebrant, and also a present one and have these imprinted by the computer system onto the craft paper. Design it in an amusing method where you've the celebrant's newborn image on the front and a caption that says "look who's thirty five now?" Then, as soon as the invitation is opened, the current picture of the celebrant appears.

Prepare the event for some time that won't entail any of the 3 major meals of the day. You could just have a dessert party or serve snacks rather than a full course dinner. The focus of an adult party is family and friends getting together, having a relaxing time and catching up with one another's lives.

Written by Patricia Strasser. If you wish to find out more on 50th birthday party ideas, please visit http://www.lifeonrecord.com/Unique/Birthday/Gift-Idea/50th/Unique-50th-Birthday-Gift-Idea.htm

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Source: http://articles.submityourarticle.com/Patricia-Strasser-6828/50th-birthday-party-ideas-251258.php

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Thursday, February 9, 2012

PS3 v4.10 update is live with an improved browser, Sony Entertainment Network nameplate

The latest update for Sony's PlayStation 3 is live and available for download from via your PlayStation Netw...oops, Sony Entertainment Network account. While we get used to the new branding (nothing we could see in the system UI has actually changed at all), there's a few tweaks included in v4.10, like some sorely needed upgrades for the web browser and the ability to set the time and date automatically upon each sign-in. A scan of the forums reveals a few who noticed problems with Netflix post-update (which may or may not be update related, deleting Netflix data from the Game Data utility section and/or installing the newest version seems to fix the issue), however most are just seeing significantly better scores in browser benchmarks like Acid3 and HTML5 Test, better compatibility with most webpages and improved YouTube playback (still 240p). Let us know if you notice any other changes, the system should prompt you the next time you log on for a quick round of Final Fantasy XIII-2.

PS3 v4.10 update is live with an improved browser, Sony Entertainment Network nameplate originally appeared on Engadget on Wed, 08 Feb 2012 10:12:00 EDT. Please see our terms for use of feeds.

Permalink   |  sourcePlayStation.Blog  | Email this | Comments

Source: http://www.engadget.com/2012/02/08/ps3-4-10-update-browser/

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Saturday, January 21, 2012

Greece, creditors edge closer to deal (Reuters)

ATHENS (Reuters) ? Greece and its private bondholders drew closer on Friday to a bond swap deal that would prevent the country from sinking into a chaotic default and ease the euro zone's debilitating debt crisis.

Cash-strapped Greece is fast running out of time as it pushes to wrap up an agreement by Monday paving the way for a fresh injection of aid before 14.5 billion euros ($18.5 billion)of bond repayments fall due in March.

Bankers and government officials close to the talks say an agreement to cut Greece's debt is in sight and that the two sides may be able to present a joint proposal at a meeting of euro zone finance ministers on Monday.

"We are very close to wrapping it up," one source close to the negotiations told Reuters on condition of anonymity.

After a breakdown in talks last week over the coupon, or interest payment, that Greece must offer on its new bonds raised fears of a disastrous bankruptcy, the two sides resumed negotiations on Thursday.

Greek Prime Minister Lucas Papademos, Finance Minister Evangelos Venizelos and Charles Dallara, the head of the Institute of International Finance (IIF) representing bondholders, started a new meeting on Friday morning.

According to one Greek banker, senior euro zone finance officials have scheduled a conference call for Friday afternoon.

HIGH STAKES

The stakes could not be higher. Greece needs to have a deal in the bag before funds are doled out from a 130 billion euro rescue plan that the country's official lenders, the European Union and the International Monetary Fund, drew up in October.

The paperwork involved alone is expected to take weeks, meaning failure to secure a deal soon could put Athens at risk of a chaotic default in March, which in turn could jolt the financial system and tip the global economy into recession.

A large chunk of the bond swap must be agreed by noon on Friday and formalized before Monday's meeting of euro zone finance ministers, Venizelos has said.

"The deal must be completed. There is no more time left," said a Greek government official who requested anonymity.

Adding to the pressure, officials from the "troika" of foreign lenders have begun meetings with the Greek government on Friday to discuss reforms and plans to finalize that bailout package.

Progress has been hard to come by in the latest round of negotiations, with bankers worried about suffering losses far higher than the 50 percent writedown they were expected to take on the nominal value of their bonds.

Actual losses for investors are expected to be much higher depending on the terms, such as the coupon, being negotiated.

A source close to the talks earlier said Athens and its foreign lenders had initially offered a coupon of just over 3.5 percent, but bondholders rejected that as too low. They were seeking a coupon of at least 4 percent, the source said.

VARIABLE COUPON

One of the options being considered is a coupon that rises after staying stable for the first 10 years, another source close to the talks has said.

According to Greek press reports not identifying their sources, the two sides may agree a coupon ranging between 3 and 5 percent, depending on the new bonds' maturities, resulting in a loss for investors of between 65 and 70 percent in terms of net present value.

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For a Breakingviews calculator on how Greek bondholders could get a scalping see: http://graphics.thomsonreuters.com/12/01/BV_GRBZZCT0112_VF.html

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Investors have also bridled at Greece's threat to enforce losses if not enough bondholders sign up to the deal.

The swap is aimed at cutting 100 billion euros off Greece's over 350 billion euro debt load. The second bailout - drawn up on condition Greece pushes through painful cuts and structural reforms - is expected to reduce Greece's debt to a more manageable 120 percent of gross domestic product in 2020 from about 160 percent now.

Greece is stumbling through its worst economic crisis since World War Two, with unemployment at record highs and near-daily protests and strikes against austerity measures that have deepened an already brutal recession.

Nearly one out of two youths is unemployed and anger against waves of tax hikes and pay cuts is running high.

(Additional reporting by Athens bureau and Stephen Brown in Berlin; Writing by Harry Papachristou; Editing by Ruth Pitchford)

Source: http://us.rd.yahoo.com/dailynews/rss/business/*http%3A//news.yahoo.com/s/nm/20120120/bs_nm/us_greece_debt

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The Amazing Gecko-Man: a superhero future made possible by probable science

There's no superhero origin story that begins with a bite (or a lick?) from a gecko. Plain 'ol wall climbing powers are, it seems, just not as sexy as wearing skintight suits, slinging webs and crawling up buildings. But if a few bright minds at the University of Southampton have anything to say about it, we could soon find ourselves walking like real-life lizard people (V, anyone?) and suctioning onto various surfaces using the managed properties of light. Lead researcher John Zhang and his UK team have predicted the existence of a force more powerful than gravity and the short-range pull of the Casimir effect, whereby plasmons (electromagnetic waves) captured on a metamaterial and the electrons on a metal resonate and form a bond of attraction. The resultant particle field is supposedly strong enough to "overcome the Earth's gravitational pull" and could even be used to alter the reflectivity of a material. Obvious military and aerospace applications aside, this invisible adhesive could also make its way into our everyday lives -- they just need to need to prove that it, y'know, actually exists first.

The Amazing Gecko-Man: a superhero future made possible by probable science originally appeared on Engadget on Wed, 18 Jan 2012 10:15:00 EDT. Please see our terms for use of feeds.

Permalink Technology Review  |  sourceCornell University  | Email this | Comments


Source: http://feeds.engadget.com/~r/weblogsinc/engadget/~3/NjI2AYh2fBM/

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Friday, January 20, 2012

Non-invasive measurements of tricuspid valve anatomy can predict severity of valve leakage

Non-invasive measurements of tricuspid valve anatomy can predict severity of valve leakage [ Back to EurekAlert! ] Public release date: 18-Jan-2012
[ | E-mail | Share Share ]

Contact: Abby Robinson
abby@innovate.gatech.edu
404-385-3364
Georgia Institute of Technology Research News

An estimated 1.6 million Americans suffer moderate to severe leakage through their tricuspid valves, which are complex structures that allow blood to flow from the heart's upper right chamber to the ventricle. If left untreated, severe leakage can affect an individual's quality of life and can even lead to death.

A new study finds that the anatomy of the heart's tricuspid valve can be used to predict the severity of leakage in the valve, which is a condition called tricuspid regurgitation. The study, conducted by researchers from the Georgia Institute of Technology and Emory University, found that pulmonary arterial pressure, the size of the valve opening and papillary muscle position measurements could be used to predict the severity of an individual's tricuspid regurgitation.

"By being able to identify and measure an individual's particular tricuspid valve anatomical features that we have shown are correlated with increased leakage, clinicians should be able to better target their repair efforts and create more durable repairs," said Ajit Yoganathan, Regents' professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University.

The study was published in the January issue of the journal Circulation: Cardiovascular Imaging. Funding for this work was provided by the American Heart Association and a donation from Tom and Shirley Gurley.

Yoganathan and recent Coulter Department doctoral graduate Erin Spinner teamed with Stamatios Lerakis, a professor of medicine (cardiology), radiology and imaging sciences at Emory University, to non-invasively collect 3-D echocardiograms from 64 individuals who exhibited assorted grades of tricuspid leakage. Subjects included 20 individuals with "trace," 13 with "mild," 17 with "moderate" and 14 with "severe" tricuspid regurgitation. The subjects with "mild" to "severe" leakage exhibited a mix of isolated right, isolated left, and both right and left ventricle dilation.

From the 3-D echocardiography images of the heart they collected, the researchers measured (1) the area of the annulus, which is the fibrous ring that surrounds the tricuspid valve opening; (2) the distance between the annulus and the three right ventricle papillary muscles, which keep the valve shut when the ventricle contracts; and (3) the position of the papillary muscles with respect to the center of the annulus. The clinicians also measured pulmonary arterial pressure using standard clinical methods and assessed the grade of tricuspid regurgitation from "trace" to "severe" with color Doppler imaging.

In collaboration with Emir Veledar, an assistant professor and statistician in the Rollins School of Public Health at Emory University, the researchers found statistical differences between individuals with ventricular dilation and the control subjects in the parameters of pulmonary arterial pressure, annulus area and papillary muscle displacement. They also found that all three factors were correlated with the grade of tricuspid regurgitation.

"This study's use of advanced cardiovascular imaging, and more specifically 3-D echocardiography, provided new insight into the pathophysiology of tricuspid regurgitation and a good understanding as to why current surgical treatments for tricuspid regurgitation are not good enough," explained Lerakis. "I believe this study will change the focus and direction of future surgical therapies for tricuspid regurgitation only to make them better and more durable."

Based on the findings of this study, said Lerakis, future surgical therapies should not only be focused on the tricuspid annulus, but on the entire tricuspid valve apparatus, including the tricuspid valve papillary muscles and their three-dimensional location within the apparatus.

Individuals in the study with left ventricle dilation exhibited significant displacement of one of the papillary muscles and patients with both ventricles dilated had significant displacement of two papillary muscles. Subjects with right ventricle dilation showed significant displacement of all three papillary muscles.

The researchers also found that patients with a dilated right ventricle were more likely to have a dilated annulus and exhibited the highest pulmonary arterial pressures and highest levels of tricuspid regurgitation. However, not all patients with a dilated right ventricle had significant increases in annulus area, providing evidence that the right ventricle may become dilated without the annulus being affected.

"We think an increase in pulmonary arterial pressure caused geometric changes in the ventricle, which resulted in alterations to the annulus and papillary muscles," explained Yoganathan. "The combination of displacement of all three papillary muscles and annular dilatation may account for the patients with isolated right ventricle dilatation having the largest percentage of severe tricuspid regurgitation."

Knowing which parameters are responsible for significant tricuspid regurgitation and having a non-invasive imaging technique to measure these parameters should help clinicians target repairs to the specific cause of an individual's tricuspid leakage, according to Yoganathan.

In future studies, the researchers plan to study papillary muscle displacements in individuals with specific diseases to see if different disease manifestations exhibit different characteristics.

"Although it has long been accepted that pulmonary hypertension may result in tricuspid regurgitation, this study is one of the first to provide a clinical correlation between the two," said Yoganathan, who is also the Wallace H. Coulter Distinguished Faculty Chair in Biomedical Engineering. "We want to know whether treating an individual's pulmonary hypertension, and thus decreasing one's pulmonary arterial pressure, can reverse the geometric changes that are causing tricuspid regurgitation and return the annulus and papillary muscles to their original positions."

###

Emory University sonographers Jason Higginson, Maria Pernetz and Sharon Howell also contributed to the study.



[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Non-invasive measurements of tricuspid valve anatomy can predict severity of valve leakage [ Back to EurekAlert! ] Public release date: 18-Jan-2012
[ | E-mail | Share Share ]

Contact: Abby Robinson
abby@innovate.gatech.edu
404-385-3364
Georgia Institute of Technology Research News

An estimated 1.6 million Americans suffer moderate to severe leakage through their tricuspid valves, which are complex structures that allow blood to flow from the heart's upper right chamber to the ventricle. If left untreated, severe leakage can affect an individual's quality of life and can even lead to death.

A new study finds that the anatomy of the heart's tricuspid valve can be used to predict the severity of leakage in the valve, which is a condition called tricuspid regurgitation. The study, conducted by researchers from the Georgia Institute of Technology and Emory University, found that pulmonary arterial pressure, the size of the valve opening and papillary muscle position measurements could be used to predict the severity of an individual's tricuspid regurgitation.

"By being able to identify and measure an individual's particular tricuspid valve anatomical features that we have shown are correlated with increased leakage, clinicians should be able to better target their repair efforts and create more durable repairs," said Ajit Yoganathan, Regents' professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University.

The study was published in the January issue of the journal Circulation: Cardiovascular Imaging. Funding for this work was provided by the American Heart Association and a donation from Tom and Shirley Gurley.

Yoganathan and recent Coulter Department doctoral graduate Erin Spinner teamed with Stamatios Lerakis, a professor of medicine (cardiology), radiology and imaging sciences at Emory University, to non-invasively collect 3-D echocardiograms from 64 individuals who exhibited assorted grades of tricuspid leakage. Subjects included 20 individuals with "trace," 13 with "mild," 17 with "moderate" and 14 with "severe" tricuspid regurgitation. The subjects with "mild" to "severe" leakage exhibited a mix of isolated right, isolated left, and both right and left ventricle dilation.

From the 3-D echocardiography images of the heart they collected, the researchers measured (1) the area of the annulus, which is the fibrous ring that surrounds the tricuspid valve opening; (2) the distance between the annulus and the three right ventricle papillary muscles, which keep the valve shut when the ventricle contracts; and (3) the position of the papillary muscles with respect to the center of the annulus. The clinicians also measured pulmonary arterial pressure using standard clinical methods and assessed the grade of tricuspid regurgitation from "trace" to "severe" with color Doppler imaging.

In collaboration with Emir Veledar, an assistant professor and statistician in the Rollins School of Public Health at Emory University, the researchers found statistical differences between individuals with ventricular dilation and the control subjects in the parameters of pulmonary arterial pressure, annulus area and papillary muscle displacement. They also found that all three factors were correlated with the grade of tricuspid regurgitation.

"This study's use of advanced cardiovascular imaging, and more specifically 3-D echocardiography, provided new insight into the pathophysiology of tricuspid regurgitation and a good understanding as to why current surgical treatments for tricuspid regurgitation are not good enough," explained Lerakis. "I believe this study will change the focus and direction of future surgical therapies for tricuspid regurgitation only to make them better and more durable."

Based on the findings of this study, said Lerakis, future surgical therapies should not only be focused on the tricuspid annulus, but on the entire tricuspid valve apparatus, including the tricuspid valve papillary muscles and their three-dimensional location within the apparatus.

Individuals in the study with left ventricle dilation exhibited significant displacement of one of the papillary muscles and patients with both ventricles dilated had significant displacement of two papillary muscles. Subjects with right ventricle dilation showed significant displacement of all three papillary muscles.

The researchers also found that patients with a dilated right ventricle were more likely to have a dilated annulus and exhibited the highest pulmonary arterial pressures and highest levels of tricuspid regurgitation. However, not all patients with a dilated right ventricle had significant increases in annulus area, providing evidence that the right ventricle may become dilated without the annulus being affected.

"We think an increase in pulmonary arterial pressure caused geometric changes in the ventricle, which resulted in alterations to the annulus and papillary muscles," explained Yoganathan. "The combination of displacement of all three papillary muscles and annular dilatation may account for the patients with isolated right ventricle dilatation having the largest percentage of severe tricuspid regurgitation."

Knowing which parameters are responsible for significant tricuspid regurgitation and having a non-invasive imaging technique to measure these parameters should help clinicians target repairs to the specific cause of an individual's tricuspid leakage, according to Yoganathan.

In future studies, the researchers plan to study papillary muscle displacements in individuals with specific diseases to see if different disease manifestations exhibit different characteristics.

"Although it has long been accepted that pulmonary hypertension may result in tricuspid regurgitation, this study is one of the first to provide a clinical correlation between the two," said Yoganathan, who is also the Wallace H. Coulter Distinguished Faculty Chair in Biomedical Engineering. "We want to know whether treating an individual's pulmonary hypertension, and thus decreasing one's pulmonary arterial pressure, can reverse the geometric changes that are causing tricuspid regurgitation and return the annulus and papillary muscles to their original positions."

###

Emory University sonographers Jason Higginson, Maria Pernetz and Sharon Howell also contributed to the study.



[ Back to EurekAlert! ] [ | E-mail | Share Share ]

?


AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.


Source: http://www.eurekalert.org/pub_releases/2012-01/giot-nmo011812.php

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