1/ #LBBB generates often a classical pattern on #EchoFirst. The pattern is very distinctive in Tissue Doppler of the septum.

The classical pattern arises from the time lapse of the activation and relaxation of the two walls, creating a pattern of interaction due to a sequence temporal imbalances of the tension between the two walls.
2/ As the septum is activated first, it contracts (shortening - septal flash) without activation of the lateral wall, which stretches. This generates slower pressure build up than a normal IVC, which then is prolonged.
3/ During ejection, the LV volume decreases, so both walls shorten. Tension, however, declines first in the septum, as this was activated first. This leads to a tension imbalance, so the lateral wall continues to shorten, the more relaxed septum stretches.
4/ The stretching of the septum builds up an elastic tension in the septum, which is released as recoil, when tension declines in the lateral wall, showing a post systolic shortening in the septum which is due to elasticity.
5/ This classical pattern is also very evident in the strain curves, and an integrated strain analysis will show this, in a semi quantitative way describing how work is wasted by looking at the opposing wall. https://t.co/8DS2F1S0BW
6/ This classical interaction pattern explains all changes seen in apical velocities (apical rocking), basal velocity curves, strain and strain rate.
7/ Applying estimated LV pressure do not add information, simply because the pressure curve is the same for both walls, so the different strain-pressure loops arises from plotting different strain curves against the same pressure curve, the differences lie in the strain.
This is the CLASSICAL pattern. This is dependent on a normally functioning lateral wall (except for the delay) https://t.co/fQ83cMGI3k
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Hugh Everett's birthday! Pioneer of the Many-Worlds Interpretation of quantum mechanics. Let us celebrate by thinking about ontological extravagance. I will do so by way of analogy, because I have found that everyone loves analogies and nobody ever willfully misconstrues them.


We look at the night sky and see photons arriving to us, emitted by distant stars. Let's contrast two different theories about how stars emit photons.

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But! Others object. That is *so many photons*. Most of which we don't observe, and can't observe, since they're moving away at the speed of light. It's too ontologically extravagant to posit a huge number of unobservable things!

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JUST ONE PERSON—UK 🇬🇧 scientists think one immunocompromised person who cleared virus slowly & only partially wiped out an infection, leaving behind genetically-hardier viruses that rebound & learn how to survive better. That’s likely how #B117 started. 🧵 https://t.co/bMMjM8Hiuz


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same thing happened in Boston in another immunocompromised person that was sick for 155 days.

3) What happened in Boston with one 45 year old man who was highly infectious for 155 days straight before he died... is exactly what scientists think happened in Kent, England that gave rise to #B117.


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5) “On its own, the appearance of a new variant in genomic databases doesn’t tell us much. “That’s just one genome amongst thousands every week. It wouldn’t necessarily stick out,” says Oliver Pybus, a professor of evolution and infectious disease at Oxford.

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