Cardiac device implantation and device usage in Fabry and hypertrophic cardiomyopathy

Background Fabry disease (FD) is a treatable X-linked condition leading to progressive cardiac disease, arrhythmia and premature death. We aimed to increase awareness of the arrhythmogenicity of Fabry cardiomyopathy, by comparing device usage in patients with Fabry cardiomyopathy and sarcomeric HCM. All Fabry patients with an implantable cardioverter defibrillator (ICD) implanted in the UK over a 17 year period were included. A comparator group of HCM patients, with primary prevention ICD implantation, were captured from a regional registry database. Results Indications for ICD in FD varied with 72% implanted for primary prevention based on multiple potential risk factors. In FD and HCM primary prevention devices, arrhythmia occurred more frequently in FD over shorter follow-up (HR 4.2, p < 0.001). VT requiring therapy was more common in FD (HR 4.5, p = 0.002). Immediate shock therapy for sustained VT was also more common (HR 2.5, p < 0.001). There was a greater burden of AF needing anticoagulation and NSVT in FD (AF: HR 6.2, p = 0.004, NSVT: HR 3.1, p < 0.001). Conclusion This study demonstrates arrhythmia burden and ICD usage in FD is high, suggesting that Fabry cardiomyopathy may be more ‘arrhythmogenic’ than previously thought. Existing risk models cannot be mutually applicable and further research is needed to provide clarity in managing Fabry patients with cardiac involvement.

Yoruba Epistemology, Art, Language and the Universe of Meanings: A Meta-Analysis

I had the rare privilege of delivering in proxy the original paper of Professor Moyo Okediji at the African Studies Association meeting, where it was first presented on December 2, 2016. Although short in quantity, I consider it to be loaded in quality, contents, intents, intensities, and in its ability to problematize a discourse critical to our understanding of indigenous scholarship and all its epistemological implications that span the entire landscape of the humanities. Indeed, Okediji’s pedagogy is the proverbial Yoruba drum of “ògìdìgbó” which is revealed only to the wise and the prudent, and they are the only two capable of effectively dancing to its rhythm. The paper reminds one of the title of the memoir of Ellen DeGeneres, the famous American comedian, titled Seriously . . . I’m Kid[1]ding. Even as a non-apologist of Ellen DeGeneres, or of any other American comedian for that matter, one would find profound meaning to that title, and embrace it as very deep and philosophical. Like in many Shakespearean plays, many truths are expressed in the acts of the jesters, not in the court of the privileged kings and pundits. This is exactly the way I responded to Okediji’s beautiful write-up. It got me thinking. It is a needed shock therapy, an organic rendition of an intellectual exposition of the Yoruba art. This commentary is janus-faced. On one hand, it looks at the unique way in which Moyo Okediji critiqued the work of Rowland Abiodun, Yoruba Art and Language: Seeking the African in African Art. On the other, it concurs with Abiodun’s thesis of the indispensability of the Yoruba language and oral tradition in the understanding of the Yoruba art. In his contribution to the roundtable forum on Professor Abiodun’s book at the African Studies Association in Washington, DC (December 1-3, 2016), Okediji provided his full presentation in Yoruba language, unalloyed (see the first essay in this forum). In order to broaden the scope of his readership and audiences, I chose to translate his write-up to the English language (Appendix 1). However, I used the translation to underscore the challenges of inter-cultural interpretation. The translation process demonstrates the problem of using one language to dissect another language without the depth of knowledge of the cultural make-up of the originator of the text. The attempt provides the data in which we are able to draw conclusions on a variety of issues: One, it highlights the futility of translation of a cultural theme at any level; two, it speaks to the frustration inherent in the imposition of one language over the art and culture of another; and three, it demonstrates the need for a cultural understanding between the originator of a text and the translator as precluding any reasonable translation and/or interpretation of the text. Using my attempt at translating as an example, I argue that at the very best what my effort could produce was an interpretation rather than a translation of Okediji’s text. I then argue that Okediji’s text brings to light the main thrust of Abiodun’s argument, which is that the indigenous language that births the art and culture of a people is the only channel through which the said art and culture could be most accurately interpreted or critiqued. Any attempt at superimposing other languages on the art can only result in a secondary, if not tertiary, interpretation and consequently a watered-down version of the original. The corollary is that such attempt will of necessity tamper with the sacred epistemological authenticity of the language-art-culture continuum.

Games theory and strategic alliances: applications to British Russian partnership

PurposeThis conceptual paper examines the need for viable theoretical models of international learning alliances in the light of cooperative games and complexity in two distinguished educational settings. Game theory is used to demonstrate the need for the top managerial executives to acquire a detailed understanding of decision makers' behaviours and trigger the deployment of complex analytical methods. The paper scrutinizes Russia's pursued aggressive approach using shock therapy, also suggest the critical need to reform policy.Design/methodology/approachCombining the critical analysis of (1) cooperative games and (2) adaptive systems structures, a dependable model is derived, which sets the baseline for determining the role of costs and gains. The analysis is supported using a real-world example of an alliance between British University (the X and Y alliance) and Russian University. It also emphasizes the importance of both internal and external pressure variables closely connected with the cooperative games, adaptive system and shock therapy.FindingsTwo features of alliances have been emphasized. The first is the importance of informal relationships in the evolution of partnerships and of cooperation. This is a well-known factor in the success of any relationship. Especially in international partnerships, empathy at the individual level is perhaps necessary to bypass the influence of historical and cultural differences that are barriers at the macro level, preconditions rather than consequences of successful policies and contractual arrangements at the level of organizations and governments. The second feature is interdependence at the cost–benefit level and in the domain of decisions. The cooperation of both partners is required to realize payoffs.Practical implicationsThe implication of this paper is a guideline for regulators and policymakers designing worldwide alliances in higher education. In addition, this paper covers an interesting domain that could be of interest to organizations involved in forming strategic alliances, developing and re-engineering policies for strategic coalitions and setting future profitable payoff relationships within the contextual limitations of X and Y.Originality/valueThis paper creates new knowledge by concisely examining the meaning of strategic alliances in the context of the global education industry.

Shell Shock: The Response of UK Neurology

The neurological and psychological manifestations of trauma, confinement, and terror became apparent throughout Europe as soldiers were evacuated from the trenches of the Western Front. The response in the UK evolved as a result of the experience of medical staff embedded with the troops in base hospitals and the philosophy of those treating returned soldiers in specialist establishment. There were widely disparate approaches to the management encompassing simple supportive care, a psychanalytic approach and radical electric shock therapy. The latter was partially driven by the Queen Square experience in the UK but was also concurrently widely pursued throughout Europe. With experience, care was increasingly undertaken close to the front lines using a philosophy of immediacy and expectation of recovery. Post-war analysis was startlingly unsympathetic, yet the experiences and management of <i>shell shock</i> have guided psychiatric and medical understanding of functional illness and post-traumatic stress over the subsequent century. In this historical review, we have sought to present features of the UK response to the neurological manifestations of trauma, the way in which these changed as the war proceeded and the political and medical response in the aftermath of war.

Ultrasound Assessment in Cardiogenic Shock Weaning: A Review of the State of the Art

Cardiogenic shock (CS) is associated with a high in-hospital mortality despite the achieved advances in diagnosis and management. Invasive mechanical ventilation and circulatory support constitute the highest step in cardiogenic shock therapy. Once established, taking the decision of weaning from such support is challenging. Intensive care unit (ICU) bedside echocardiography provides noninvasive, immediate, and low-cost monitoring of hemodynamic parameters such as cardiac output, filling pressure, structural disease, congestion status, and device functioning. Supplemented by an ultrasound of the lung and diaphragm, it is able to provide valuable information about signs suggesting a weaning failure. The aim of this article was to review the state of the art taking into account current evidence and knowledge on ICU bedside ultrasound for the evaluation of weaning from mechanical ventilation and circulatory support in cardiogenic shock.

How China escaped shock therapy: the market reform debate from Isabella Weber: book rewiev

This piece is a review of the book How China escaped shock therapy: the market reform debate (Weber2021). I endorse this study as the best one to understand the different actual outcomes beteween China and the (disipated) URSS.

Cardiac Device Implantation and Device Usage in Fabry and Hypertrophic Cardiomyopathy

BackgroundFabry disease (FD) is a treatable X-linked condition leading to progressive cardiac disease, arrhythmia and premature death. We aimed to increase awareness of the arrhythmogenicity of Fabry cardiomyopathy, by comparing device usage in patients with Fabry cardiomyopathy and sarcomeric HCM. All Fabry patients with an implantable cardioverter defibrillator (ICD) implanted in the UK over a 17 year period were included. A comparator group of HCM patients, with primary prevention ICD implantation, were captured from a regional registry database. ResultsIndications for ICD in FD varied with 82% implanted for primary prevention based on multiple potential risk factors. In FD and HCM primary prevention devices, arrhythmia occurred more frequently in FD over shorter follow-up (HR 4.2,p<0.001). VT requiring therapy was more common in FD (HR 4.5,p=0.002). Immediate shock therapy for sustained VT was also more common (HR 2.5,p<0.001). There was a greater burden of AF needing anticoagulation and NSVT in FD (AF: HR 6.2,p=0.004, NSVT: HR 3.1,p<0.001). ConclusionThis study demonstrates arrhythmia burden and ICD usage in FD is high, suggesting that Fabry cardiomyopathy may be more ‘arrhythmogenic’ than previously thought. Existing risk models cannot be mutually applicable and further research is needed to provide clarity in managing Fabry patients with cardiac involvement.

Impact of COVID-19 Pandemic on Severe Ventricular Arrhythmia and Icd Therapy

BACKGROUND AND OBJECTIVES: The regular clinical follow-up of the patient with the implantable cardioverter-defibrillator (ICD) device was seriously affected by the COVID-19 outbreak. Due to the high risk of contamination, patients didn’t admit to the clinics for the ICD device control. It has been observed that arrhythmic events increased during the COVID-19 outbreak. In this study, we aimed to investigate the frequency of severe ventricular arrhythmias and ICD device therapy in COVID-19 patients with ICD.METHODS: In this single center-observational study, we assessed severe ventricular arrhytmias and ICD therapies by analyzing recorded data of 33 patients (24 males, 72.7%) 3 months before and after getting COVID-19 during the COVID-19 pandemic in Van, Turkey, between 15 August 2020 and 15 January 2021. RESULTS: Before the diagnosis of COVID-19, 6 ventricular tachycardias and 1 ventricular fibrillation were observed. When we analyzed the records after the diagnosis COVID-19, 17 ventricular tachycardia and 3 ventricular fibrillation episodes were observed. Considering the the ICD device therapies, 5 of these severe tachyarrhythmias were terminated by antitachycardia pacing (ATP) and 2 with shock therapy before the diagnosis of COVID-19. After the COVID-19, 14 of them were terminated by ATP and 6 of them ere terminated by shock therapy.CONCLUSION: The effects of the COVID-19 pandemic, especially on ventricular arrhythmia, have not been reported sufficiently. In our study, it was observed that life-threatening ventricular arrhythmias and the ICD therapies were increased in patients with COVID-19, especially in the first month after the diagnosis COVID-19.

Records management at the Council of Europe (1): three years of shock therapy

While the Council of Europe as an Intergovernmental Organization has proven remarkably resilient, its archives and records appear to be increasingly fragile. This article documents and analyses the development of records management and archives management within the Council of Europe between 2000 and 2003. This was a period that saw major changes in the way that records were treated in the organization, notably the preparation and implementation of an organization-wide archives policy, and the introduction of an archives management training programme for Council of Europe staff. The concept of archives and records was extended from paper to electronic and audio-visual materials. An internal network of archive correspondents was introduced to increase communication, consultation, co-ordinate RM and facilitate the implementation of the archives policy, and a series of measures was taken to improve access to the archives and records. It was during this period that the first steps were taken in the introduction of archives and records management standards ISAD(G) and ISO 15489. The article highlights the lack of continuity of RM and the increasing vulnerability of records within the organization, suggesting that the lack of professional staff is the most critical issue; the analysis of the developments in this period also illustrates the impact that personal initiatives can have in such a context.

SANKSI PIDANA KEMATIAN BAGI ORANG KORUPSI DI INDONESIA (Death Criminal Sanctions For Personnel Of Corruption In Indonesia)

The application of capital punishment itself has been regulated in Indonesia as contained in the law. Article 2 paragraph (2) of Corruption Act concerning Eradication of Corruption Crimes. According to Romli Atmasasmita, it was argued that the death penalty for corruptors was effectively implemented in the People's Republic of China (PRC), and it was quite successful to reduce corruption. This certainly can be used as an example in Indonesia in imposing capital punishment for corruptors. The imposition of capital punishment for perpetrators of corruption is urgently needed as "shock therapy" because psychologically the death penalty aims for the benefit of general prevention so that others do not participate in committing crimes. Also, the application of capital punishment is based on the reason that capital punishment is more certain than the prison sentence because the prison sentence is often followed by running away, forgiveness, or because of the release. When compared from an economic standpoint, basically the death sentence is more efficient when compared to life imprisonment. As for the problems that can be formulated, namely: legal arrangements regarding corruption in the Corruption Act; the application of capital punishment sanctions against perpetrators of corruption in Indonesia. The results of the study show that: Corruption is a type of extraordinary crime ("extra-ordinary crime") that must be handled extraordinarily, so that the act is contrary to the 1945 Constitution, therefore it does not need to be protected by the 1945 Constitution. accommodated in Article 2 paragraph (2) of the Corruption Act, must meet the requirements "in certain circumstances" by the Elucidation of Article 2 paragraph (2), but its application has never been implemented, so it is necessary to review the rules "in certain circumstances".