bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between QRS Duration and Left Ventricular Dyssynchrony in Patients with End‐Stage Heart Failure
Authors: BLEEKER GABE B. , SCHALIJ MARTIN J. , MOLHOEK SANDER G. , VERWEY HARRIETTE F. , HOLMAN EDUARD R. , BOERSMA ERIC , STEENDIJK PAUL , VAN DER WALL ERNST E. , BAX JEROEN J. 
Published: August 2010

Introduction: Patients with end‐stage heart failure and a wide QRS complex are considered candidates for cardiac resynchronization therapy (CRT). However, 20% to 30% of patients do not respond to CRT. Lack of left ventricular dyssynchrony may explain the nonresponse. Accordingly, we evaluated the presence of left ventricular dyssynchrony using tissue Doppler imaging (TDI) in 90 consecutive patients with heart failure. Methods and Results: Ninety patients with severe heart failure (left ventricular ejection fraction <35%, New York Heart Association class III–IV) were prospectively evaluated. Based on QRS duration, 30 consecutive patients with a narrow QRS complex were included (QRS duration ≤120 ms), 30 patients with an intermediate QRS duration (120–150 ms), and 30 patients with a wide QRS complex (>150 ms). All patients underwent TDI to assess left ventricular dyssynchrony. Extensive left ventricular dyssynchrony was defined as an electromechanical delay on TDI between the septum and lateral wall, the so‐called septal‐to‐lateral delay, of >60 ms. Severe dyssynchrony was observed in 27% of patients with narrow QRS complex, 60% with intermediate QRS duration, and 70% with wide QRS complex. No relation existed between QRS duration and septal‐to‐lateral delay. Conclusion: From 30% to 40% of heart failure patients with QRS duration >120 ms do not exhibit left ventricular dyssynchrony, which may explain the nonresponse to CRT. Alternatively, 27% of patients with heart failure and a narrow QRS complex show significant left ventricular dyssynchrony and may be candidates for CRT. (J Cardiovasc Electrophysiol, Vol. 15, pp. 544‐549, May 2004)
Impact of Biphasic Electrical Cardioversion of Atrial Fibrillation on Early Recurrent Atrial Fibrillation and Shock Efficacy
Authors: SIAPLAOURAS STEPHANOS , BUOB AXEL , RÖTTER CARSTEN , BÖHM MICHAEL , JUNG JENS 
Published: August 2010

Introduction: Early recurrent atrial fibrillation (ERAF) after external cardioversion of atrial fibrillation (AF) occurs in 12% to 26% of patients. Whether biphasic cardioversion has an impact on the incidence of ERAF after cardioversion of AF is unclear. Methods and Results: Consecutive patients (n = 216, mean age 66 years, 71% male, 88% with structural cardiovascular disease or hypertension) underwent cardioversion with a biphasic (Bi) or monophasic (Mo) shock waveform in randomized fashion. Energies used were 120‐150‐200‐200 Ws (Bi) or 200‐300‐360‐360 Ws (Mo). The two study groups (Bi vs Mo) did not differ with regard to age, sex, body mass index, underlying cardiovascular disease, left atrial diameter, left ventricular ejection fraction, duration of AF fibrillation, and antiarrhythmic drug therapy. Mean delivered energy was significantly lower in the Bi group (Bi: 186 ± 143 Ws vs Mo: 324 ± 227 Ws; P < 0.001). Overall incidence of ERAF (AF relapse within 1 minute after successful cardioversion) was 8.9% and showed no difference between the two groups (Bi: 8.1% vs Mo: 9.7%, P = NS). Cardioversion was successful in 95.4% of patients. The success rate was comparable in both groups (Bi: 94.3% vs Mo 96.8%; P = NS). First shock efficacy did not differ between Bi and Mo (76.4% vs 67.7%; P = NS). Mean number of shocks were 1.4 shocks per patient in both groups. Conclusion: Biphasic cardioversion allows comparable success rates with significantly lower energies. However, the incidence of ERAF is not influenced by biphasic cardioversion. With the energies used, biphasic and monophasic shock waveforms are comparable with regard to first shock and cmulative shock efficacy.
Myocardial Ischemia and Induction of Sustained Ventricular Tachyarrhythmias:
Authors: STAMBLER BRUCE S. , AKOSAH KWAME O. , MOHANTY PRAMOD K. , WOOD MARK A. , ELLENBOGEN KENNETH A. 
Published: August 2010

Introduction: This study examined the relationship between dobutamine facilitation of ventricular tachyarrhythmia (VT) inducibility with programmed electrical stimulation (PES) and dobutamine stress‐induced myocardial ischemia. Methods and Results: Twenty patients with prior myocardial infarction and cardiac arrest or sustained VT but no sustained VT induced at baseline electrophysiologic testing underwent repeat PES during dobutamine infusion. Ischemia (new or worsened wall‐motion abnormality) was documented by echocardiography performed in conjunction with PES. Eight patients were receiving Class I or III antiarrhythmic drugs and seven beta‐blockers. Dobutamine facilitated induction of sustained VT in 16 patients (80%) and provoked ischemia in 13 patients (65%). Induction of VT was associated with ischemia in 9 patients (56%). VTs associated with ischemia were induced at higher dobutamine doses (26 ± 11 vs 11 ± 10 μg/kg per min, P = 0.02) than were VTs without ischemia (n = 7). Among 13 patients with provoked ischemia, 9 (69%) had VTs induced and 4 remained noninducible. The onset of ischemia occurred at the same dose as induction of VT in 5 patients and at a lower dose in 4 patients. Monomorphic VT (318 ± 59 ms) was induced in 13 patients, of whom 8 (62%) had ischemia. The ECG morphology of VT suggested an origin in a myocardial segment that demonstrated initial viability at low doses then ischemic dysfunction at higher doses preceding VT induction in 7 (88%) of 8 patients. Conclusion: Dobutamine enhances inducibility of sustained VTs during PES. The temporal and anatomic association of dobutamine‐induced ischemia and VT suggests that at high dobutamine doses, ischemia may contribute to ventricular arrhythmia inducibility in some patients.
Delayed Afterdepolarization‐Mediated Triggered Activity Associated with Slow Calcium Sequestration Near the Endocardium
Authors: LAURITA KENNETH R. , KATRA RODOLPHE P. 
Published: August 2010

Introduction: Previously, we have shown that cells near the endocardium are more prone to elevated diastolic intracellular calcium levels than cells near the epicardium. The arrhythmogenic consequence of such regional differences in calcium handling is not clear.Methods and Results: Using optical mapping techniques, calcium transients and action potentials were recorded simultaneously from ventricular sites across the transmural wall of the arterially perfused canine left ventricular wedge preparation during control conditions, and under conditions of increased calcium entry (IK blockade and β‐adrenergic stimulation). Under conditions of enhanced calcium entry, the decay of the calcium transient and diastolic calcium levels during rapid pacing were slower (38%, P < 0.01) and higher (215%, P < 0.02), respectively, near (within ∼3 mm) the endocardium compared to the epicardium (n = 9). Immediately after termination of rapid pacing under conditions of increased calcium entry, ectopic activity and simultaneous delayed afterdepolarizations and spontaneous calcium release events were observed. Over all experiments, ectopic activity occurred more frequently closer to the endocardium compared to the epicardium.Conclusions: Under conditions of enhanced calcium entry, myocytes closer to the endocardium exhibit a higher level of diastolic calcium and greater ectopic activity compared to the epicardium. We show for the first time simultaneous delayed afterdepolarization and spontaneous calcium release events from myocytes in a normally coupled multicellular preparation. These data combined suggest that myocytes near the endocardium are more susceptible to calcium‐mediated triggered activity.
Regional Variation in Capture of Fibrillating Swine Left Ventricle During Electrical Stimulation
Authors: NANTHAKUMAR KUMARASWAMY , JOHNSON PHILLIP L. , HUANG JIAN , KILLINGSWORTH CHERYL R. , ROLLINS DENNIS L. , MCELDERRY HUGH T. , SMITH WILLIAM M. , IDEKER RAYMOND E. 
Published: August 2010

Introduction: While it has been shown that electrical stimulation can capture a region of myocardium during ventricular fibrillation (VF), the ideal location to stimulate to maximize capture of the fibrillating in vivo left ventricle (LV) is not known. We previously demonstrated a mean directionality to the propagation of VF wavefronts in swine from posterior to anterior LV. We hypothesized that this directionality of VF wavefronts would affect capture of the LV epicardium while stimulating during VF.Methods and Results: In seven open‐chest swine, during different VF episodes, electrical stimulation was performed singly or simultaneously from two lines of 26 epicardial electrodes, one on the posterior LV adjacent to the posterior descending coronary artery and another on the anterior LV adjacent to the left anterior descending coronary artery. Mapping was performed between the line of stimulating electrodes with 768 recording electrodes 2‐mm apart. The incidence and extent of epicardium captured by stimulation through the lines of stimulating electrodes were determined in the mapped region. Capture occurred during 67% of 78 VF episodes. Capture from the posterior LV line was achieved in 88% of the episodes and from the anterior LV line in 44% of the episodes (P = 0.001). The maximum amount of myocardium captured was also much greater for stimulating from the posterior as compared to the anterior LV line (232 ± 168 mm2 vs 64 ± 124 mm2, P = 0.003). A significant part of the variability in capture was related to the direction of the mean VF wavefront velocity vector in each animal (r = 0.84, P < 0.05).Conclusion: Electrical stimulation from the posterior LV resulted in a greater incidence and extent of LV capture than stimulation from the anterior LV. A significant component of the variability in capture is related to the mean direction of VF wavefronts.
Morphology of the Thoracic Veins and Left Atrium in Paroxysmal Atrial Fibrillation Initiated by Superior Caval Vein Ectopy
Authors: HUANG BIEN‐HSIEN , WU MEI‐HAN , TSAO HSUAN‐MING , TAI CHING‐TAI , LEE KUN‐TAI , LIN YENN‐JIANG , HSIEH MING‐HSIUNG , LEE SHIH‐HUANG , CHEN YI‐JEN , KUO JEN‐YUAN , CHEN SHIH‐ANN 
Published: August 2010

Introduction: The structural changes of the superior caval vein, pulmonary veins, and left atrium in atrial fibrillation initiated by superior caval vein ectopy have not been reported.Methods and Results: Nine patients with atrial fibrillation initiated by superior caval vein ectopic beats (male = 5, 54 ± 10 years) and 15 control (n = 15, male =  10, 52 ±  8 years) without any cardiac arrhythmias were included in this study. Using gadolinium‐enhanced magnetic resonant angiography with three‐dimensional reconstruction, the parameters of the superior caval vein morphology (length, various diameters, area, eccentricity, and volume) were measured. The morphological parameters of the four pulmonary veins (diameter, ostial area, and eccentricity) were also measured at the pulmonary vein–left atrial junction in an oblique sagittal section from the multiple‐plane reconstruction images. The left atrial diameters and volume were measured. The different morphological parameters were compared between the two groups. The patients with atrial fibrillation initiated by superior caval vein ectopic beats exhibited a more eccentric structure of the second part of the superior caval vein as compared to the control group. All the ectopic beats initiating atrial fibrillation were located in the second part of the superior caval vein. Furthermore, the patients with atrial fibrillation initiated by superior caval vein ectopic beats had a larger superior caval vein volume, left atrial volume, and pulmonary vein size, and more eccentric pulmonary vein ostia than the controls.Conclusion: Structural changes of the superior caval vein were demonstrated in the patients with atrial fibrillation initiated by superior caval vein ectopic beats. These findings might explain the arrhythmogenic mechanism of atrial fibrillation initiated by superior caval vein ectopy.
An evaluation of the collapse and recovery of the yellowtail flounder (Limanda ferruginea) stock on the Grand Bank
Authors: Brodie William B. , Walsh Stephen J. , Maddock Parsons Dawn 
Published: August 2010

Abstract
Brodie, W. B., Walsh, S. J., and Maddock Parsons, D. 2010. An evaluation of the collapse and recovery of the yellowtail flounder (Limanda ferruginea) stock on the Grand Bank. – ICES Journal of Marine Science, 67: 1887–1895. In 1994, the biomass of yellowtail flounder on the Grand Bank had declined to 20% of the biomass associated with the maximum sustainable yield (Bmsy) because of overfishing in the 1980s, and the Northwest Atlantic Fisheries Organization (NAFO) declared a moratorium on fishing of this stock (and several others in the area). After 4 years of moratorium, the biomass had quadrupled, the fishery was reopened, and the biomass is now well above Bmsy. Based on advice developed within a precautionary approach framework, total allowable catches were set corresponding to a fishing mortality of ≤0.67 × Fmsy. When the fishery was reopened in 1998, several measures to reduce the fishing mortality and ensure continued recovery were introduced. We review and evaluate the science and the management strategies developed during the decline, collapse, and recovery, noting that yellowtail flounder is the only groundfish stock on the Grand Bank that has fully recovered after its collapse. Key management measures included the elimination of fishing by non-NAFO vessels, protection of strong year classes, and keeping the fishing mortality below 0.67 × Fmsy. Although overfishing is viewed as causing the stock decline, productivity was strongly affected by climatic conditions during the collapse and recovery. Changes in water temperature coincided with major changes in the catch and fishing mortality.
Competition for land
Authors: Smith Pete , Gregory Peter J. , van Vuuren Detlef , Obersteiner Michael , Havlík Petr , Rounsevell Mark , Woods Jeremy , Stehfest Elke , Bellarby Jessica 
Published: August 2010

A key challenge for humanity is how a future global population of 9 billion can all be fed healthily and sustainably. Here, we review how competition for land is influenced by other drivers and pressures, examine land-use change over the past 20 years and consider future changes over the next 40 years.Competition for land, in itself, is not a driver affecting food and farming in the future, but is an emergent property of other drivers and pressures. Modelling studies suggest that future policy decisions in the agriculture, forestry, energy and conservation sectors could have profound effects, with different demands for land to supply multiple ecosystem services usually intensifying competition for land in the future.In addition to policies addressing agriculture and food production, further policies addressing the primary drivers of competition for land (population growth, dietary preference, protected areas, forest policy) could have significant impacts in reducing competition for land. Technologies for increasing per-area productivity of agricultural land will also be necessary. Key uncertainties in our projections of competition for land in the future relate predominantly to uncertainties in the drivers and pressures within the scenarios, in the models and data used in the projections and in the policy interventions assumed to affect the drivers and pressures in the future.
Dissociation and the Self in the magical pre‐Oedipal field
Authors: Salman Sherry 
Published: August 2010

This paper explores the clinical relevance of Jung's idea of the Self in pre‐Oedipal and pre‐individuation psychology. Incorporating data from neurobiology and recent theories of memory and narrative reconstruction, a post‐modern conception of the Self is proposed akin to what Jung called a ‘dream of totality’. Such a conception of the Self is distinguished from a reified structure or a deified imago, and is considered to be that aspect of psychological functioning consonant with emerging meanings, and the birth of new psychological ground. Links are made back to Flournoy, William James, and depth psychology's early interest in teleology, the occult, and the creative capacities of the psyche.Updating this mystery tradition, clinical material illustrates how narratives of the Self are present in such pre‐Oedipal dynamics as dissociation and projective identification. These dynamics are understood not only as primitive defences but as reconstitutive symbolic metaphors and mythopoetic expressions of an emergent rather than a superordinate Self.
Picture interpretation and Jungian typology
Authors: Bergeron Derek P. , Rosen David H. , Arnau Randolph C. , Mascaro Nathan 
Published: August 2010

AbstractThis study examined a Jungian picture interpretation schema, which utilizes a specific quadrant method. This proposed schema, which is used in training at the C. G. Jung Institute in Zürich, attaches significance to specific areas of a drawing. The upper left of a drawing is associated with the father; the lower left with the unconscious; the lower right with the mother; and the upper right with the future. Three questions served as the foci of this study: Is the schema valid? Do certain types within Jung's personality theory respond better than others to the schema? Does the schema work best when it elicits a strong affective response from the person who created the picture? Subjects took one of two tests: a space domain test, or a colour associative test. The results revealed only two significant effects: a positive association (in the space domain test) between unconscious material with the unconscious quadrant and a negative association (in the colour associative test) of mother material with the mother quadrant. These results suggest that the Jungian quadrant schema used to interpret drawings is invalid and of minimal practical utility. Other methods of picture interpretation are discussed as well as suggestions for future research that would be helpful to this field.
Encountering the shadow in rites of passage: a study in activations
Authors: Casement Ann 
Published: August 2010

Abstract:Jung's concept of the shadow is explored in this paper through his writings on its realization and assimilation in which he says the shadow may be experienced as the regressed and denied ‘other self’ in each individual. However, this is not the whole picture, and he also points to the fact that the shadow contains more than something merely negative. While in no way treating them as ‘patients’, the paper will also touch on the experience of the anthropologist, Bronislaw Malinowski, and the writer, Joseph Conrad, in their personal encounters with the shadow. All three encountered the shadow whilst going through rites of passage of their own and each owes much to the Romantic Movement. In this context, attention is directed to the writings of the philosopher and theologian, Johann Gottfried von Herder, who discovered a deeper understanding of his destiny in the course of a sea voyage.
Daimonic elements in early trauma
Authors: Kalsched Donald E. 
Published: August 2010

Abstract: This paper explores some of the ‘daimonic’ elements of unconscious mentation that emerge both in dreams and in the transference/countertransference field with early‐trauma patients and illustrates these with an extended clinical example. An archaic and typical (archetypal) ‘trauma complex’ is articulated (with diagram) as a bi‐polar structure consisting of divine child protected and/or persecuted by an inner ‘guardian angel’. Sources of this structure and its mythological inner objects are traced to trauma at the stage of what Winnicott calls ‘unintegration’ and to flooding by dis­integration anxiety at a time before nascent ego‐structure has formed.In an extended case example, the author shows how the patient's traumatized innocence and desire for a new start, thwarted by self‐attacking defences, pulls him into playing the inflated role of her guardian angel, leading to re‐traumatization in the transference. Working through is seen as the necessary disillusionment and humanization of these daimonic structures as they are projected, suffered, and transmuted by the analytic partners in the stormy process of psychotherapy.
Developmental aspects of trauma and traumatic aspects of development
Authors: Urban Elizabeth 
Published: August 2010

Abstract: In this paper I try to show that inherent in healthy development are emotional experiences that are the stuff of trauma. Failure to reintegrate these experiences means that they can serve as a resonating board for difficulties in later life, adding to their traumatic impact. Focusing on global changes that occur at the end of the first year, I exemplify these developments with an infant observation and show how a six‐year‐old boy's failure to integrate them contributed to his experiencing a normal life event as a trauma. I then offer clinical material from the analysis of a man to demonstrate how later life events resonated with early experience associated with this period. All are linked to a complex pattern of object relations I have come across clinically, whereby feelings of grief associated with an idealized object are split off from feelings of grievance against an object experienced as persecutory because of its perceived superior status.
An Exploratory Analysis of the Impact of Market Orientation on New Product Performance
Authors: Atuahene‐Gima Kwaku 
Published: August 2010

For many firms, emphasizing the importance of market orientation has taken on a mantra‐like quality. Mission statements and memos, policies, and procedures all highlight the importance of staying in touch with the customer. It is also widely assumed that the relationship between market orientation and new product performance depends on environmental conditions and product characteristics. To date, however, little empirical evidence has been presented to support the assumption that market orientation influences new product performance.Kwaku Atuahene‐Gima addresses this research need in a study of 275 Australian firms. In addition to exploring the relationship between market orientation and new product development activities and performance, his study examines the effects of environmental conditions and product characteristics. Specifically, the study investigates whether the relationship between market orientation and new product performance depends on the degree of product newness to customers and the firm; the intensity of market competition and the hostility of the industry environment; and the stage of the product life cycle at which the new product was introduced.The survey results provide strong support for the basic proposition that market orientation influences new product performance and development activities. The results show a strong positive relationship between market orientation and a new product's market performance. Market orientation is also shown to have a strong positive effect on proficiency of predevelopment activity, proficiency of launch activity, service quality, product advantage, marketing synergy, and teamwork.Although market orientation is generally found to be an important factor in the success of new products, its influence varies depending on the type of new product—that is, radical versus incremental. Market orientation appears to have greater influence on new product performance when the product represents an incremental change to both the customers and the firm. However, this does not mean that a market‐oriented approach is unnecessary in the development of radically hew products.Market orientation also has a greater effect when the perceived intensity of market competition and industry hostility are high, and during the early stage of the product life cycle. Because market competition and industry hostility typically intensify as the product life cycle progresses, these findings suggest that the effects of market orientation are pervasive. In other words, managers should not limit their expectations of market orientation to specific projects or specific stages of the development process and product life cycle.