bluuebunny/crossref_metadata_2025_split huggingface dataset:
Remote device monitoring for implantable cardioverter defibrillators during the COVID-19 pandemic
Authors: Kolk MZH , Tjong FVY , Knops RE 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Remote monitoring (RM) for implantable cardioverter defibrillators (ICDs) is recommended as the standard of care in clinical guidelines. Presumably, the restrictions on face-to-face visits that were imposed during the coronavirus (COVID-19) pandemic have further accelerated the adoption of RM. However, quantitative real-world data on the uptake of RM during the COVID-19 pandemic is lacking.

Purpose
To assess the uptake of RM during the COVID-19 pandemic to a pre-COVID-19 period, and compare the arrhythmic burden between the two groups.

Methods
This is a substudy of the retrospective, observational single-center DISTANT-study. For this substudy, data from patients who were enrolled in the RM program after de novo ICD implantation (single- and dual chamber, biventricular or subcutaneous ICDs) were analysed. The time until RM was initiated per patient was calculated for patient implanted during the COVID-19 pandemic (March 2020-January 2021) and compared to a similar 10-month period pre-COVID-19 (May 2019-March 2020). ICD therapy (shock and/or anti-tachycardia pacing), non-sustained ventricular tachycardia (NSVT), supraventricular tachycardia (SVT) and mortality were registered for each patient. Patients &lt;18 years old at implantation and patients with a follow-up of &lt;6 months were excluded from this analysis.

Results
A total of 134 patients (72.4 % male, mean age 57.3 ±14.9 years) were eligible for this substudy, of which 61 patients in the COVID-19 group and 73 patients in the pre-COVID-19 group. In both groups there was a similar percentage of primary prevention ICD implantations (COVID-19: 43%, pre-COVID: 44%; p=0.888). During COVID-19, RM was initiated more promptly following ICD implantation compared to pre-COVID-19 (respectively 63 days vs. 131 days; p=0.007). Second, in the COVID-19 group 60.7% patients were enrolled in RM within 30 days following implantation compared to 39.7% in the pre-COVID-19 group (p=0.016). In terms of arrhythmic burden, no differences in the occurrence of ICD therapy (p=0.759), NSVT (p=0.267) and SVT (p=0.454) were observed.

Conclusion
During the COVID-19 pandemic RM was initiated more promptly following ICD implantation compared to before the pandemic, however, no differences in arrhythmic burden between groups were observed.
Patient motivation and adherence to an on-demand app-based heart rate and rhythm monitoring infrastructure for atrial fibrillation management through teleconsultation. TeleCheck-AF project results
Authors: Gawalko M , Hermans ANL , Van Der Velden RMJ , Betz K , Verhaert DVM , Pluymaekers NAHA , Vernooy K , Sultan A , Pison L , Manninger M , Duncker D , Evans S , Sohaib A , Linz D , Hendriks JM 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
TeleCheck-AF is a mobile health (mHealth) infrastructure developed to provide remote management and comprehensive care to patients with atrial fibrillation (AF) during the Covid disease-19 pandemic lockdown within cardiology centers in Europe. TeleCheck-AF integrates an on-demand photoplethysmography-based heart rate/rhythm monitoring application supported a scheduled teleconsultation.

Purpose
The current sub-study of the TeleCheck-AF project aimed to provide the first real-world dataset on patient adherence and motivation to a standardized mHealth application integrated in remote AF management.

Methods
Patients were instructed to perform 60-second app-based heart rate/rhythm recordings three times daily and in case of symptoms for seven consecutive days prior to teleconsultation. Motivation was defined as number of days in which the expected number of measurements (≥three/day) were performed per number of days over the entire prescription period. Adherence was defined as number of performed measurements per number of expected measurements over the entire prescription period.

Results
Data from 990 consecutive patients with diagnosed AF (median age 64 [57-71] years, 39% female) from 10 centers that included the highest number of patients (≥25) were analyzed. Patients with both optimal motivation (100%) and adherence (≥100%) constituted 28% of the study population and had a lower percentage of recordings in sinus rhythm (90 [53-100%] vs 100 [64-100%], P&lt;0.001) compared to others. Age and diabetes were predictors of both optimal motivation and adherence (odds ratio [OR] 1.02, 95% coincidence interval [95% CI] 1.01-1.04, P&lt;0.001 and OR, 0.49, 95% CI 0.28-0.86, P=0.013, respectively). Patients with 100% motivation also had ≥100% adherence. Independent predictors for optimal adherence alone were age (OR 1.02, 95% CI 1.00-1.04, P=0.014), female sex (OR 1.70, 95% CI 1.29-2.23, P&lt;0.001), previous AF ablation (OR 1.35, 95%CI 1.03-1.07, P=0.028).

Conclusion
In the TeleCheck-AF project, older age and diabetes were predictors of optimal patient motivation and adherence to app-based heart rate/rhythm monitoring. Therefore, physicians, nurses and allied health specialists involved in the management and care for patients with AF should not be discouraged to provide a mHealth infrastructure to elderly patients. Patient engagement improves mHealth adherence/motivation, hence, it is crucial to tailor the mHelath intervention to the needs and preferences of the patient.
Determining the role of uremic toxins on cardiac electrophysiology and pro-arrhythmia during chronic kidney disease
Authors: Van Ham WB , Bossu A , Houtman MJC , Cornelissen CM , Vos MA , Van Veen TAB 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Young Talent Programme, CVON

Introduction
Chronic kidney disease (CKD) is represented by a diminished filtration capacity of the kidneys. End stage renal disease patients need dialysis treatment to remove waste and toxins from the circulation. However, endogenously produced uremic toxins (UTs) cannot always be filtered during dialysis. UTs are one of the CKD-related factors already linked to maladaptive and pathophysiological remodeling of the heart. Importantly, 50% of the deaths in dialysis patients is cardiovascular related, with sudden cardiac death predominating. However, the mechanisms responsible still remain poorly understood.

Purpose
To assess the potentially increased pro-arrhythmic risk of pre-identified UTs at clinically relevant concentrations: 1) acutely in isolated adult dog ventricular cardiomyocytes (ADCMs) and human induced pluripotent stem cell derived cardiomyocytes (hiPSC-CMs), 2) chronically in iPSC-CMs and 3) both conditions in human embryonic kidney (HEK) cells transfected with constructs that generate different ion channels, using optical and manual electrophysiological in vitro approaches.

Methods and results
Using the voltage sensitive membrane dye FluoVolt and manual patch clamp, action potential duration (APD) prolongation, considered as a pro-arrhythmic parameter, was assessed in ADCMs and iPSC-CMs. Acute exposure of indoxyl sulfate (IS), kynurenine (KYN) or kynurenic acid (KYNA) induced no alterations in APD in ADCMs and iPSC-CMs. iPSC-CMs, although having rather immature electrophysiological characteristics, showed significant APD prolongation when exposed chronically (48h) to those UTs.
Manual patch clamp on HEK293 cells was performed to investigate individual ion currents to reveal underlying mechanisms. The repolarizing current IKr, often most sensitive and responsible for APD alterations, was not acutely affected by IS, KYN, or KYNA. However, chronic exposure (48h) to IS or KYNA significantly decreased IKr at clinically relevant concentrations.
Finally, the protein level of the ion channel conducting IKr was determined in HEK293 cells, to further unveil the mechanism behind the effects of UTs on channels conducting IKr. Chronic exposure (48-72h) of the three UTs decreased total ion channel expression at pathological concentrations, which could be responsible for the decreased IKr and prolonged APD.

Conclusion
The results show the proof of concept to identify potentially pro-arrhythmogenic UTs and their mode of action, allowing the provision of a clinically relevant overview of (patho)physiological concentrations of UTs in both acute and chronic exposure.
Subthreshold delayed afterdepolarizations mediated by reduced tissue conductivity form a substrate for unidirectional block and reentry within the infarcted heart
Authors: Campos F , Shiferaw Y , Whitaker J , O’neill M , Razavi R , Plank G , Bishop MJ 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): British Heart Foundation, Wellcome Trust

Background
Delayed afterdepolarizations (DADs) due to spontaneous calcium release (SCR) events at the subcellular scale have been associated with arrhythmia formation in the border zone (BZ) of infarcted hearts. DADs may not only summate to form ectopic focal sources but may also inactivate sodium channels forming a substrate for unidirectional conduction block and reentry. The role played by infarct anatomy and altered intracellular coupling in facilitating this phenomenon is not fully understood.

Purpose
To use computational modelling to investigate the role of anatomical properties of the infarct BZ in creating a substrate for DAD-mediated conduction block and reentry.

Methods
MRI data from a porcine post-infarction heart was used to build the computational model. A phenomenological model was used to simulate SCRs in the BZ. Arrhythmia susceptibility was quantified by pacing the model followed by a pause, to see whether DADs would occur, and an extra S2 beat with different coupling intervals (CIs). Tissue conductivity in the BZ was decreased to investigate the effect of uncoupling on DAD-mediated conduction block.

Results
Subthreshold DADs occurring within the infarct BZ inactivated the fast sodium channels which resulted in block of S2 beats. This occurred most readily in narrow isthmuses where electrotonic load was attenuated by the non-conducting scar. DADs rendered the entire isthmus area refractory establishing a substrate for unidirectional block and reentry (see Fig. A). Reduced tissue conductivity in the BZ reduced electrotonic load on cells undergoing DADs. This led to more local tissue depolarization (Vm) as uncoupling prevented current from flowing to neighboring cells at rest (Fig. B-C). Reduced tissue conductivity also enhanced DAD-mediated block by increasing the vulnerable window for reentry initiation (700ms &lt; S2 CI &lt; 900ms as shown in Fig. D).

Conclusion
Subthreshold DADs provide a substrate for arrhythmogenesis in the infarct BZ. Tissue uncoupling enhanced the arrhythmogenic risk by increasing the time window of unidirectional block.
Selective intracardiac sympathetic denervation acutely modulates left ventricular control
Authors: Kahle AK , Klatt N , Jungen C , Dietenberger A , Kuklik P , Muenkler P , Willems S , Nikolaev V , Scherschel K , Meyer C 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Centre for Cardiovascular Research (DZHK)

Background
The sympathetic nervous system plays an integral role in cardiac physiology. Neuromodulation is emerging as a treatment option for ventricular arrhythmias, but selective intracardiac approaches are rare. Sympathetic nerve fibers innervating the left ventricle have been demonstrated to be amenable to transvenous catheter stimulation along the coronary sinus (CS).

Purpose
The aim of the present study was to modulate left ventricular control by selective sympathetic denervation using epicardial or standard catheter ablation for intracardiac axotomy at the level of the CS.

Methods
First, the impact of epicardial CS ablation on cardiac electrophysiology was studied in a Langendorff model of murine hearts (n=10 each, ablation and control). Second, the impact of transvenous, anatomically-driven axotomy by catheter-based radiofrequency ablation along the CS was evaluated in a healthy ovine in vivo model (n=8) before and during left stellate ganglion stimulation (LSGS).

Results
CS ablation for intracardiac sympathetic axotomy prolonged epicardial ventricular refractory period (VRP) without (41.8±8.4 ms vs. 53.0±13.5 ms; P=0.0487) and with beta1-2-adrenergic receptor blockade (47.8±2.8 ms vs. 73.1±5.0 ms; P=0.0009) and enhanced the increasing effect of beta1-2-adrenergic receptor blockade on epicardial VRP (∆VRP 6.3±7.0 ms vs. 20.0±7.5 ms; P=0.0045) in mice (Figure, A). Mean epicardial wave propagation velocity in the left ventricle was faster in ablated hearts than in controls (1.13±0.05 m/s vs. 1.00±0.02 m/s; P=0.0463), but did not differ in the right ventricle (1.15±0.05 m/s vs. 1.20±0.08 m/s; P=0.7938). Transvenous catheter ablation of the CS reduced systolic (SBP, 57.7±5.0 mmHg vs. 46.9±3.6 mmHg; P=0.0428) and diastolic blood pressure (DBP, 35.5±3.0 mmHg vs. 26.7±1.8 mmHg; P=0.0106) and diminished the blood pressure increase during LSGS in sheep (∆SBP 21.9±3.8 mmHg vs. 10.5±4.2 mmHg; P=0.0234; ∆DBP 9.0±1.9 mmHg vs. 3.0±1.2 mmHg; P=0.0391) (Figure, B, C). Cycle length remained unchanged by LSGS, both before (baseline 653.2±20.6 ms vs. LSGS 627.8±27.5 ms; P=0.2309) and after CS ablation (baseline 734.8±24.2 ms vs. LSGS 746.2±37.3 ms; P=0.7145).

Conclusions
Anatomically-driven axotomy targeting nerve fibers along the CS enables selective intracardiac sympathetic denervation resulting in acute modulation of left ventricular control.
Novel biomarkers predict ablation outcomes in long stranding persistent atrial fibrillation
Authors: Boyalla V , Bodinier B , Kralj-Hans I , Haldar S , Khan HR , Shi R , Cantor E , Hussain W , Jones DG , Jarman JWE , Markides V , Chadeau-Hyam M , Harding SE , Cleland JGF , Wong T 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): NIHR

Background
Ablation of long-standing persistent atrial fibrillation (LSPAF) is not always successful. The arrhythmia burden was reduced by 75% by 12 months in majority (72%) of patients with LSPAF who underwent surgical or percutaneous ablation in the CASA-AF trial. We hypothesised that biomarker(s) improve prediction of clinical success and offer insights into mechanisms.

Objective
To identify biomarkers that predict success (75% arrhythmia burden reduction) after ablation for LSPAF at 12-months.

Methods
Amongst patients participating in the CASA-AF RCT (ISRCTN18250790), pre-ablation serum samples were selected for 20 patients who met criteria for ablation-success at 12 months, and 20 who did not. Olink ProteomicsTM (Sweden) provided analyses using three biomarker panels [inflammation (INFL), cardiovascular III (CVD III), and cell cytology (CELL)] each containing 92 biomarkers. Univariate and multivariable analyses were adjusted for age, sex, BMI, LA diameter and CRP. ROC analysis was undertaken to assess the diagnostic accuracy of the biomarkers. To counter the false discovery rate, Benjamini-Hochberg correction was utilised.

Results
When patients with ablation-success and -failure were compared, no differences in demographics or cardiac function were found. On univariate analysis, several biomarkers in each panel were associated with ablation-success. Multivariable analysis narrowed the range of biomarkers and identified those that were jointly predictive of outcome: INFL (MCP1 + CD8A + CD40, Figure 1), CVD III (FAS + CPB1) and CELL (GCG + ENTPD6 + IL17RB). These joint biomarkers were analysed using ROC (Figure 2), which showed that increases of biomarkers on the INFL panel (MCP1 + CD8A + CD40) were associated with a greater risk of failure and achieved the highest AUC for prediction of outcome [0.82 (0.75-0.87)].

Conclusion
The increase in the serum concentration of markers of inflammation (MCP1 + CD8A + CD40) might be used to identify patients less likely to have sustained benefit from LSPAF ablation. Further studies are required to confirm their prognostic value as pre-procedural biomarkers.
Atrial fibrillation and age synergistically increase clotting potential and promote atrial structural remodeling in goats
Authors: D’ Alessandro E , Scaf B , Sobota V , Van Hunnik A , Kuiper M , Winters J , Van Oerle R , Spronk HMH , Van Nieuwenhoven FA , Ten Cate H , Verheule S , Schotten U 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Netherlands Heart Foundation, European Union

Background
Age is a risk factor for atrial fibrillation (AF) as well as for stroke in patients with AF. However, the effect of ageing on AF mechanisms and on coagulation activity is not well understood.

Purpose
To evaluate the effect of age and AF on coagulation activity, AF characteristics, and atrial structural remodeling.

Methods
Four groups of female goats were investigated: Young sham (Y-Sh: sinus rhythm, &lt;3 years old, n=9), Young AF (Y-AF: 4 weeks of AF, &lt;3 years old, n=7), Old sham (O-Sh: sinus rhythm, &gt;8 years old, n=6), and Old AF (O-AF, 4 weeks of AF, &gt;8 years old, n=8). Groups were matched for body weight. AF was maintained using implantable pacemakers in both AF groups. Clotting potential, expressed as the ability of activated plasma to generate thrombin, was measured using tissue factor-induced thrombin generation assays at baseline and 4 weeks (final). A terminal experiment was performed with atrial contact mapping to study electrophysiological AF properties and to collect atrial tissue for histological analysis.

Results
Thrombin generation analysis showed that 4 weeks of AF induced a significant increase in clotting potential in old, but not in young goats. AF complexity and hemodynamics were not affected by age alone. AF, however, significantly increased the right atrial pressure in old (O-Sh: 6.4±1.9 vs. O-AF: 11.4±3.1 mmHg, p=0.02), but not in young goats. AF induced atrial myocyte hypertrophy and left atrial epicardial endomysial fibrosis in old goats, while this was not the case in young goats.

Conclusion
Four weeks of AF and advanced age synergistically enhanced coagulation potential and promoted atrial structural remodeling in goats. Complexity of atrial conduction was affected by AF, but not by age.
Implementing Just Culture to Improve Patient Safety
Authors: Murray John S , Clifford Joan , Larson Stacey , Lee Jonathan K , Sculli Gary L 
Published: May 2022

ABSTRACT

Introduction
The number of deaths in the United States related to medical errors remains unacceptably high. Further complicating this situation is the problem of underreporting due to the fear of the consequences. In fact, the most commonly reported cause of underreporting worldwide is the fear of the negative consequences associated with reporting. As health care organizations along the journey to high-reliability strive to improve patient safety, a concerted effort needs to be focused on changing how medical errors are addressed. A paradigm shift is needed from immediately assigning blame and punishing individuals to one that is trusting and just. Staff must trust that when errors occur, organizations will respond in a manner that is fair and appropriate.

Materials and Methods
An extensive review of the literature from 2017 until January 2022 was conducted for the most current evidence describing the principles and practices of “just culture” in health care organizations. Additionally, recommendations were sought on how health care organizations can go about implementing “just culture” principles.

Results
Twenty sources of evidence on “just culture’ were retrieved and reviewed. The evidence was used to describe the concept and principles of “just culture” in health care organizations. Furthermore, five strategies for implementing “just culture” principles were identified.

Conclusions
Improving patient safety requires that high-reliability organizations strive to ensure that the culture of the organization is trusting and just. In a trusting and just culture, adverse events are recognized as valuable opportunities to understand contributing factors and learn rather than immediately assign blame. Moving away from a blame culture is a paradigm shift for many health care organizations yet critically important for improving patient safety.
The “Politics”
Authors: Walker Michael L. 
Published: May 2022

Abstract
In this chapter, the problem of race as an organizing principle in Golden County jails is explored. The chapter describes a set of racialized principles known as “the politics” and explains how adherence to the politics varied from one housing unit to the next and from one type of temporary holding place to the next. In so doing, the chapter reveals cleavages in the logic of racial classification and the purported conflict said to be inherent to race relations in penal organizations. Equally important, this chapter introduces the term “flat hierarchy” and covers the many ways that race was used to distribute resources across the three racialized groups of penal residents. Finally, the author explains how deputies increased (rather than decreased) the likelihood of violence in the housing units by supporting and exploiting the politics for their own interests.
An Intimate Immensity
Authors: Christie Douglas E. 
Published: May 2022

Abstract
This chapter considers the practices of relinquishment that enable one to enter and become lost inside of what Gaston Bachelard describes as “an intimate immensity.” It gives particular attention to the work of twentieth-century artist Agnes Martin and her ideas about merging and formlessness,” about entering “a world without objects, without interruption,” and her sense of what it is to know oneself as part of something endless, infinite. It situates Martin’s work in relation to the sense of openness and freedom that Meister Eckhart, Marguerite Porete, and other Christian mystics call “living without a why.” With the help of these interlocutors, this chapter examines what it means to relinquish dependence on what Eckhart refers to as “ways” or Ruusbroec calls “modes” and open oneself to possibility of living with radical trust and beholding the other with simple openness and love.
Spiritual Bodies and Mental Reality in Blake
Authors: Townsend Chris 
Published: May 2022

Abstract
William Blake is often thought of as a kind of materialist, given the very physical and even embodied nature of his craft; yet his own writings repeatedly and forcefully reject materialism and even the physical world in favour of what Blake called spiritual reality. Taking Berkeley’s thought as its guide, this chapter proposes one way in which the materiality of Blake’s work can be reconciled with his immaterialism: that for Blake, as for Berkeley, what we traditionally think of as physical bodies are already immaterial forms. The chapter outlines the full extent of what we know of Blake’s reading of Berkeley, before reconstructing some of his most Berkeleian concepts in his poetry: the spiritual body, the minute particular, and the structure of generality and general ideas.
Manufacturing Dissent
Authors: Adams R. J. C. 
Published: May 2022

Abstract
Chapter 3 introduces the National Loan’s potential subscribers and explores the ways in which the loan was promoted. At the same time, it develops the narrative of the National Loan campaign, running from August 1919 to August 1920. The chapter surveys the National Loan’s promotional meetings, press advertisements, and other marketing initiatives. It highlights the extent to which the National Loan relied on the endorsement of senior Roman Catholic clergy. It also shows how, by provoking the British government, the loan was instrumentalized as a driver of public sentiment. Finally, it explores contemporary reports of National Loan collecting subscriptions by intimidation.