bluuebunny/crossref_metadata_2025_split huggingface dataset:
Linkage Between Mechanical and Electrical Alternans in Patients with Chronic Heart Failure
Authors: KODAMA MAKOTO , KATO KIMINORI , HIRONO SATORU , OKURA YUJI , HANAWA HARUO , YOSHIDA TSUYOSHI , HAYASHI MANABU , TACHIKAWA HITOSHI , KASHIMURA TAKESHI , WATANABE KENICHI , AIZAWA YOSHIFUSA 
Published: August 2010

Introduction: Progressive heart failure and ventricular fibrillation are major causes of death in patients with chronic heart failure. Mechanical alternans (pulsus alternans) has been observed in patients with severe congestive heart failure. Visible T wave alternans occasionally is a precursor of ventricular fibrillation. We investigated the occurrence of both cardiac alternans in 94 patients with chronic heart failure. Methods and Results: Mean left ventricular ejection fraction (LVEF) of the study population was 35 ± 10%. Mechanical alternans was detected in left ventricular pressure during diagnostic cardiac catheterization. Only sustained mechanical alternans was included in the study. Visible T wave alternans, not microvolt alternans, was noted on standard surface ECG. Cardiac alternans was examined at rest, during physiologic tachycardia, and during stepwise dobutamine loading (2–4–8 μg/kg/min). Prevalences of mechanical and electrical alternans were 19.1% and 4.4% at rest, 45.5% and 8.0% during physiologic tachycardia, and 62.1% and 9.5% under dobutamine loading. Overall, 70 patients (74.5%) showed mechanical alternans and 10 patients (10.6%) showed T wave alternans. T wave alternans always appeared with large mechanical alternans. Among patients with mechanical alternans, cases with T wave alternans showed lower LVEF than those without (27.5 ± 4.4 and 35.1 ± 10.2, P < 0.002). Conclusion: Visible T wave alternans was detectable in patients with chronic heart failure, especially under tachycardia or catecholamine exposure. Investigating mechanical and mechanoelectrical alternans may bring new insights into the management of patients with chronic heart failure. (J Cardiovasc Electrophysiol, Vol. 15, pp. 295‐299, March 2004)
Reversal of Electrical Remodeling After Cardioversion of Persistent Atrial Fibrillation
Authors: RAITT MERRITT H. , KUSUMOTO WALTER , GIRAUD GEORGE , MCANULTY JOHN H. 
Published: August 2010

Introduction: In animals, atrial fibrillation results in reversible atrial electrical remodeling manifested as shortening of the atrial effective refractory period, slowing of intra‐atrial conduction, and prolongation of sinus node recovery time. There is limited information on changes in these parameters after cardioversion in patients with persistent atrial fibrillation. Methods and Results: Thirty‐eight patients who had been in atrial fibrillation for 1 to 12 months underwent electrophysiologic testing 10 minutes and 1 hour after cardioversion. At 1 week, 19 patients still in sinus rhythm returned for repeat testing. Reverse remodeling of the effective refractory period was not uniform across the three atrial sites tested. At the lateral right atrium, there was a highly significant increase in the effective refractory period between 10 minutes and 1 hour after cardioversion (drive cycle length 400 ms: 204 ± 17 ms vs 211 ± 20 ms, drive cycle length 550 ms: 213 ± 18 ms vs 219 ± 23 ms, P < 0.001). The effective refractory period at the coronary sinus and distal coronary sinus did not change in the first hour but had increased by 1 week. The corrected sinus node recovery time did not change in the first hour but was shorter at 1 week (606 ± 311 ms vs 408 ± 160 ms, P = 0.009). P wave duration also was shorter at 1 week (135 ± 18 ms vs 129 ± 13 ms, P = 0.04) consistent with increasing atrial conduction velocity. Conclusion: The atrial effective refractory period increases, sinus node function improves, and atrial conduction velocity goes up in the first week after cardioversion of long‐standing atrial fibrillation in humans. Reverse electrical remodeling of the effective refractory period occurs at different rates in different regions of the atrium. (J Cardiovasc Electrophysiol, Vol. 15, pp. 507‐512, May 2004)
Acute Effects of Left Atrial Radiofrequency Ablation on Atrial Fibrillation
Authors: SCHARF CHRISTOPH , ORAL HAKAN , CHUGH AMAN , HALL BURR , GOOD ERIC , CHEUNG PETER , PELOSI FRANK , MORADY FRED 
Published: August 2010

Introduction: Acutely, when left atrial ablation is performed during atrial fibrillation (AF), the AF may persist and require cardioversion, or it may convert to sinus rhythm or to atrial tachycardia/flutter. The prevalence of these acute outcomes has not been described. Methods and Results: Left atrial ablation, usually including encirclement of the pulmonary veins, was performed during AF in 144 patients with drug‐refractory AF. Conversion to sinus rhythm occurred in 19 patients (13%), to left atrial tachycardia in 6 (4%), and to atrial flutter in 6 (4%). In the 6 patients with a focal atrial tachycardia, the mean cycle length was 294 ± 45 ms. The tachycardia arose in the left atrial roof in 3 patients, the left atrial appendage in 2, and the anterior left atrium in 1. In 3 of 6 patients, the focal atrial tachycardia originated in an area that displayed a relatively short cycle length during AF. In 6 patients, AF converted to macroreentrant atrial flutter with a mean cycle length of 253 ± 47 ms, involving the mitral isthmus in 5 patients and the septum in 1 patient. All atrial tachycardias and flutters were successfully ablated with 1 to 15 applications of radiofrequency energy. Conclusion: When left atrial ablation is performed during AF, the AF may convert to atrial tachycardia or flutter in approximately 10% of patients. Focal atrial tachycardias that occur during ablation of AF may be attributable to driving mechanisms that persist after AF has been eliminated, whereas atrial flutter results from incomplete ablation lines. (J Cardiovasc Electrophysiol, Vol. 15, pp. 515‐521, May 2004)
Conduction Characteristics at the Crista Terminalis During Onset of Pulmonary Vein Atrial Fibrillation
Authors: FYNN SIMON P. , MORTON JOSEPH B. , DEEN VINCENT R. , KISTLER PETER M. , VOHRA JITENDRA K. , SPARKS PAUL B. , KALMAN JONATHAN M. 
Published: August 2010

Introduction: Focal atrial fibrillation (AF) may initiate with an irregular rapid burst of atrial ectopic (AE) activity from a pulmonary vein (PV) focus, but how AF is maintained it is not known. The crista terminalis (CT) is an important line of block in atrial flutter (AFL), but its role in AF has not been determined. The aim of this study was to examine the conduction properties of the CT during onset of AF. Methods and Results: In 10 patients (mean age 38 ± 8 years), we analyzed conduction across the CT during onset of focal AF from an arrhythmogenic PV and during pacing from the same PV at cycle lengths of 700 and 300 ms. A 20‐pole catheter was positioned on the CT using intracardiac echocardiography. In 10 control patients with no history of AF, we analyzed conduction across the CT during pacing from the distal coronary sinus at 700 and 300 ms. In all 10 AF patients, AF was initiated with 1 to 9 AE beats (median 5) from a PV. During sinus rhythm, there were no split components (SC) recorded on the CT. During PV AE activity, discrete SC were recorded on the CT in all patients over 6.3 ± 0.9 bipoles (3.7 ± 0.3 cm). Maximal splitting of SC was 66 ± 31 ms (37–139). There was an inverse relationship between AE coupling intervals and the degree of splitting between SC in all patients. Degeneration to AF was preceded by progressive decrement across the CT. SC were recorded during PV pacing at 700 and 300 ms (maximal distance between SC of 24 ± 3 ms and 43 ± 5 ms, respectively, P < 0.001). Maximum SC at CT in controls was 13 ± 8 ms at 700 ms (P = 0.06 vs AF patients) and 16 ± 9 ms at 300 ms (P < 0.01 vs AF patients). Conclusion: (1) These observations provide evidence of anisotropic, decremental conduction across the CT during onset of focal AF and during pacing from the same PV. A line of functional conduction block develops along this anatomic structure (CT). Whether this line of block acts as an initiator of AF or simply contributes passively to nonuniform fibrillatory conduction is unknown. (2) In some patients with focal AF, development of conduction block along the CT may provide a substrate for typical AFL.
Measuring Patient Acceptance of Implantable Cardiac Device Therapy:
Authors: BURNS JASON L. , SERBER EVA R. , KEIM STEPHEN , SEARS SAMUEL F. 
Published: August 2010

Introduction: Patient acceptance of implantable device therapy has been established as an important outcome but the operationalization and validation of a measure of patient acceptance of implantable device therapy has not been fully completed. This study sought to validate a new measure of patient acceptance of cardiac implantable devices called the Florida Patient Acceptance Survey (FPAS).Methods: The sample consisted of implantable cardioverter defibrillator (ICD; n = 58), and implantable atrioverter defibrillator (ICD‐AT; n = 96), and pacemaker (PM, n = 84) patients. Mean age of all participants was 69 years; they were mostly male (62%) and married (75%). The final FPAS comprised 15 items with four consistent factors: Return to Function, Device‐Related Distress, Positive Appraisal, and Body Image Concerns.Results: The total FPAS demonstrated good internal consistency (Cronbach's alpha = 0.83), and internal consistency for each of the subscales ranged from 0.74 to 0.89. The FPAS demonstrated convergent, divergent, and discriminant validity when compared to other self‐report measures of QOL, atrial symptoms, depression, and anxiety. A total FPAS score can be formed and between group comparisons with this sample indicated that ICD patients report a high level of acceptance (mean = 76), ICD‐AT patients report a significantly higher level of acceptance (mean = 81.1), and PM patients reported the highest level of patient acceptance (mean = 85.4) of these implantable device groups.Conclusion: This initial psychometric investigation of the FPAS suggests that the FPAS may be useful in both clinical and research settings to assess patient acceptance of implantable cardiac devices.
Short QT Syndrome and Atrial Fibrillation Caused by Mutation in KCNH2
Authors: HONG KUI , BJERREGAARD PREBEN , GUSSAK IHOR , BRUGADA RAMON 
Published: August 2010

Background: The short QT syndrome is a newly described clinical entity characterized by the presence of a short QT interval associated with cardiac tachyarrhythmias including sudden cardiac death at a young age in otherwise healthy individuals. A genetic basis has been identified linking the disease to mutations in KCNH2 in the familial forms and a mutation in KCNQ1 in a sporadic form of the disease.Methods and Results: We identified a family with short QT syndrome with a high incidence of paroxysmal atrial fibrillation in their members and no known history of sudden cardiac death. QT interval ranged from 225 to 240 ms within normal heart rate ranges in the affected individuals. Programmed electrical stimulation (PES) was performed in all affected members, which revealed a remarkably short atrial and ventricular refractory period, and inducibility of atrial and ventricular fibrillation. Treatment with propafenone has maintained the individuals free of atrial fibrillation to date. Genetic analysis identified a missense mutation (C to G substitution at nucleotide 1764) which resulted in the amino acid change (N588K) in KCNH2. This mutation had been previously described in two other families with a high incidence of sudden cardiac death.Conclusions: Our study confirms that N588K is a hotspot for familial form of the short QT syndrome. The disease is clinically heterogeneous, as indicated by the fact that, in the three families with the same mutation, there is a wide range of symptoms, varying from atrial to ventricular fibrillation and sudden death. While the implantation of a defibrillator appears warranted due to the inducibility at PES, the clinical follow‐up provides indication that the class Ic agent propafenone could be effective to prevent episodes of paroxysmal atrial fibrillation.
The Inferior Right Atrial Isthmus: Further Architectural Insights for Current and Coming Ablation Technologies
Authors: CABRERA JOSÉ ANGEL , SÁNCHEZ‐QUINTANA DAMIAN , FARRÉ JERÓNIMO , RUBIO JOSÉ MANUEL , HO SIEW YEN 
Published: August 2010

Background: Although linear ablation of the right atrial isthmus in patients with isthmus‐dependent atrial flutter can be highly successful, recurrences and complications occur in some patients. Our study provides further morphological details for a better understanding of the structure of the isthmus.Methods and Results: We examined the isthmic area in 30 heart specimens by dissection, histology, and scanning electron microscopy. This area was bordered anteriorly by the hinge of the tricuspid valve and posteriorly by the orifice of the inferior caval vein. With the heart in attitudinal orientation, we identified and measured the lengths of three levels of isthmus: paraseptal (24 ± 4 mm), central (19 ± 4 mm), and inferolateral (30 ± 3 mm). Comparing the three levels, the central isthmus had the thinnest muscular wall and the paraseptal isthmus the thickest wall. At all three levels, the anterior part was consistently muscular whereas the posterior part was composed of mainly fibro‐fatty tissue in 63% of hearts. The right coronary artery was less than 4 mm from the endocardial surface of the inferolateral isthmus in 47% of hearts. Inferior extensions of the atrioventricular node were present in the paraseptal isthmus in 10% of hearts, at 1–3 mm from the endocardial surface.Conclusions: The thinner wall and shorter length of the central isthmus together with its distance from the right coronary artery, and nonassociation with the atrioventricular node or its arterial supply, should make it the preferred site for linear radiofrequency ablation.
Carl Gustav before he became Jung
Authors: Grivet‐Shillito Marie‐Laure 
Published: August 2010

It was not until 1983 that Jung's first texts were published in London as The Zofingia Lectures. Not translated into French, The Zofingia Lectures are still not available to the French‐speaking public. This delay is due to an oversight: tucked away in a drawer, these texts were only discovered after Jung's death. There are five lectures that were given between 28 November 1896 and 7 January 1899. Although written when young – Carl was twenty‐one when he delivered the first lecture – they are worthy of interest. These lectures outline the major aspects of his subsequent work and reveal what we can call Carl's psychic wound and the tremendous energy that he drew on to survive.However, without reading between the lines and without subjecting Jung to psychoanalytical interpretations, the author attempts to link the dynamics of these first works to certain autobiographical or epistolary confidences. This wound or Carl's father complex and the resulting deprivation are clearly mapped out here.
Interviews on Freud and Jung on Freud and Jung with Henry A. Murray in 1965
Authors: Roazen Paul 
Published: August 2010

Abstract:Henry Murray became one of the legendary figures in the history of American psychology. Not only was he a leading pioneer in the field of personality theory, but he created (with Christiana Morgan) the Thematic Apperception test. He also took a leading role in making psychological profiles for the American government's Office of Strategic Services during World War II. For years Murray headed the Harvard Psychological Clinic, and also worked on the writings of Herman Melville for almost half of his long life. Murray took a wholly independent path from Freudian and Jungian organizations, yet his memories of contact with Freud and Jung are worth recording.These interviews with Murray were conducted in 1965. To take only one example, the circumstances of Jung's getting his honorary degree from Harvard in 1936 are elucidated, as well as Freud's inquiry to Murray about why he himself had missed out on that occasion. A postcript to the interview, illustrating Murray's capacities as a writer, concerns his spirited response to the Princeton philosopher Walter Kaufmann's inquiry about Roazen's account of the 1936 honorary degree in his 1975 Freud and His Followers.
Corps de Ballet: the case of the injured ballet dancer
Authors: Turner Bryan S. , Wainwright Steven P. 
Published: August 2010

Abstract This paper contributes to debate on social constructionism in the sociology of health and illness through a study of injury among ballet dancers. In this empirical study of classical ballet dancers, we outline a phenomenology of the injured and ageing body in terms of a critical commentary on constructionism. We explore dancers’ experiences of embodiment to illustrate our critique of recent interpretations of dance as a textual practice. Those forms of social constructionism that define the body as a text provide a forceful attack on discourses of authority and legitimation, but we argue that they are problematic as epistemologies and ontologies of embodiment. Through a phenomenological understanding of the experiences of embodiment, we observe how injury and ageing disrupt the practical accomplishments that underpin the ballet habitus and the dancer's identity. Although ballet injuries can terminate a dancing career, they are accepted as an inevitable part of the vocation of ballet. Our aim is to understand the interaction between injuries, dancers’ experiences of discomfort and the social support that emerges from the ballet dancers as a social group. We draw on the concepts of social solidarity and collective consciousness in Emile Durkheim to show that injury is mediated through the social bonding of dancers into a professional ballet company, where injury is accepted as a sign of vocational commitment, and suggest that this ‘collective effervescence’ gives a novel meaning to the idea of a corps de ballet.
Dr. No‐body: The Construction of the Doctor as an Embodied Subject in British General Practice 1955–97
Authors: Gothill Matthew , Armstrong David 
Published: August 2010

By reading the literature on the doctor‐patient relationship in British general practice as an account of the emergence of the doctor as a human subject, connections can be demonstrated between the discipline’s methods and the recent problematisation of the figure of the general practitioner herself.This theme can be traced through an evolving construction of the object of general practice known as ‘the patient’, and through the changing portrayal of the power relation between doctor and patient. Furthermore, the same theories and techniques which have been used to examine the consultation and construct an image of the patient as a psycho‐social agent have, in a parallel process, served to generate images of the doctor as an embodied and vulnerable individual.
Development of Novel Products Through Intraorganizational and Interorganizational Networks
Authors: Tidd Joe 
Published: August 2010

The pendulum appears to be swinging away from the merger mania of the 1980s, with many leaner‐and meaner organizations refocusing on their core competencies. However, these more focused organizations often lack the breadth of skills and expertise necessary for developing products and services which cut across traditional technological and marketing boundaries. Complex product systems such as those under development in the home automation industry include elements from such disparate sectors as consumer electronics, telecommunications, construction, and energy. A narrow focus may prevent the novel forms of innovation necessary for successful development of such products.Using the home automation industry as an example, Joe Tidd examines the challenges involved in the development of complex product systems. When products and services cut across traditional marketing and technological boundaries, radical innovation is difficult because different firms and industries are typically responsible for developing the various subsystems and components. Successful development efforts may require novel forms of innovation–for example, architectural innovation and technology fusion. Architectural innovation involves changes in the way the components of a product are linked together, but leaves the core design concepts untouched. Technology fusion creates new products and market opportunities through the blending of diverse technologies from various fields.Two organizational factors affect a firm's ability to develop and commercialize new products based on novel forms of innovation: the internal organization of the firm, and the firm's links with other organizations, including suppliers, customers, and networks of collaborating organizations. Within a firm, the development of complex product systems is likely to require managing across traditional product‐division boundaries. The breadth of competencies required may necessitate strong interfirm linkages.Comparing organizational approaches and the networks of alliances for home automation in the United States, Europe, and Japan, it appears that European firms tend to be more narrowly focused then American and Japanese firms. A rigid focus on core competencies may cause these European firms to overlook the potential for new products. Because various technologies and industries are involved, open networks are more effective than closed networks or alliances. European and American firms tend to favor closed strategic alliances, while Japanese firms typically participate in open networks and overlapping consortia. This approach gives Japanese firms an edge in the home automation industry.
Seller–Buyer Interactions During the Commercialization of Technological Process Innovations
Authors: Athaide Gerard A. , Meyers Patricia W. , Wilemon David L. 
Published: August 2010

For buyers and sellers alike, high‐tech process innovations can be a double‐edged sword. On the one hand, technological process innovations (e.g., computer hardware and software, factory automation equipment) offer buyers the potential for reduced production costs and enhanced product quality. However, early adoption of such innovations is often a risky proposition. For the seller, successful commercialization requires stimulating not only adoption, but also successful implementation of the innovation. In other words, effective management of seller—buyer relations during the development and commercialization process go a long way toward determining the success of a high‐tech process innovation.Gerard A. Athaide, Patricia W. Meyers, and David L. Wilemon examine the relationship marketing activities employed by successful sellers of high‐tech process innovations. They identify eight strategic marketing objectives that underlie these relationship marketing activities: product customization, information gathering on product performance, product education and training, ongoing product support, proactive political involvement (to encourage support for the innovation from the various affected parties in the buyer's organization), product demonstration and trial, real‐time problem‐solving assistance, and clarification of the product's relative advantage.Their findings suggest that successful sellers engage in relationship marketing activities throughout all phases of the commercialization process. Rather than simply trying to close a deal, these firms seek active involvement from potential customers, ranging from codesigning of products to seeking feedback on product‐related problems or desired modifications.This broader scope of customer involvement necessitates cooperation among various groups in the seller's organization. Product development and engineering work closely with the customer during product customization. Those groups must communicate effectively with the salespeople who demonstrate the product and with the customer support people who obtain feedback and provide real‐time problem‐solving support. In other words, these relationship marketing activities cut across functional barriers. Consequently, a clear understanding of the buyer's needs and environment is essential throughout the seller's organization, not just in the sales and marketing departments.