Conduction disorders as the first hallmark of isolated cardiac sarcoidosis in a highly active individual: a case report

Background Cardiac sarcoidosis (CS) is an inflammatory disease with various clinical presentations depending on the extension of cardiac involvement. The disease is often clinically silent, therefore diagnosis is challenging. Case summary We discuss the case of a middle-aged highly active individual presenting with an occasional finding of low heart rate during self-monitoring. The electrocardiogram shows a Mobitz 2 heart block; thanks to multimodality imaging CS was diagnosed and corticosteroid therapy improved cardiac conduction. Discussion To our knowledge this is one of the first documented cases of occasional, early finding of CS in a middle-aged highly active individual who presented with cardiac conduction involvement. Despite the very early diagnosis, multimodality imaging suggested an advanced disease with no edema detection at the CMR. Nevertheless, prompt corticosteroid therapy was able to improve clinical conduction. Although non-sustained ventricular arrhythmias were detected, electrophysiological study allowed to discharge the patient safely without implantable cardioverter defibrillator implantation. Light-to moderate physical activity was allowed at mid-term follow up. A multidisciplinary evaluation should be considered to resume a high intensity training.

Comparative Study on Capacity Building for Academic Staff in Internationalisation of Higher Education in Vietnam and Australia

Academics are seen as primary agents in the enactment of higher education internationalisation. However, the achievements of internationalisation are claimed to be constrained by the lack of academics’ involvement and expertise. This research, therefore, compares the policies and practices of capacity building for academics in internationalisation between Australian and Vietnamese universities. More specifically, this research seeks to unpack ideologies and understandings of internationalisation, institutional arrangements of capacity building for academics in internationalisation, and academics’ individual agency in engaging and building their capacity for internationalisation. Using the Capability Approach as a theoretical framework (Sen, 1992, 1999), the research argues that academics’ participation in internationalisation is determined by social and institutional conditions, combined with their individual aspirations and active roles in creating internationalisation and professional development opportunities. This suggests the significance of an enabling structure and active individual agency in expanding academics’ capabilities for successful participation in internationalisation.

The Costs and Benefits of Shareholder Democracy: Gadflies and Low-Cost Activism

We show that there is cross-sectional variation in the quality of shareholder proposals. On average, proposals submitted by the most active individual sponsors are less likely to receive majority support, but they occasionally pass if shareholders mistakenly support them and may even be implemented due to directors’ career concerns. While gadfly proposals destroy shareholder value if they pass, shareholder proposals on average are value enhancing in firms with more informed shareholders. We conclude that more informed voting could increase the benefits associated with shareholder proposals.

Pemikiran Mohammad Hatta Tentang Pendidikan Islam

This paper analyzes Mohammad Hatta's idea of modern Islamic education. Mohammad Hatta is not only known as a national figure and the first Indonesian vice president, but also a faithful, active individual in the field of Islamic education. He also expresses his idea regarding Islamic education in papers. Islamic education discourse still emerges as an important discussion topic today. This paper is the result of a qualitative study with literature review. The study aimed to discover Mohammad Hatta’s idea of modern Islamic education, which still emerges as a problem in today's Indonesian Islamic education. In this case, it is necessary to provide a representative, modern Islamic education in order to deliver ideal Muslim scholars. The study found that the construct of Mohammad Hatta’s idea on modern Islamic education was to create coherence between religion and modern science, comprising sociology, history, and philosophy. Such an idea is not merely an abstract, it was applied through the establishment of Sekolah Tinggi Islam (Islamic College) in 1945 as a modern Islamic higher education.

Culture in the Organization of Autobiographical Memory

This chapter outlines a cultural dynamic theory as the framework to understand and predict the effects of cultural variables on the organization of autobiographical memory. The theory posits that autobiographical memory takes place in the dynamic transaction between an active individual and his or her changing environment; it is situated in culturally conditioned time and space over a multitude of timescales; and it develops in the process of children acquiring cultural knowledge about the self and the purpose of the past through early socialization. The organization of autobiographical memory is discussed in terms of objective, subjective, and structural components and applies the theoretical model of the cultural dynamic theory to discuss the influence of culture on each of the components. To illustrate the overarching influence of culture on remembering, parallel findings of episodic memory as typically assessed in laboratory settings with non-personal materials (e.g., stories) are further discussed, and vicarious memory for events that happened to other people. Although these three types of memory vary in the degree of personal relevance or self-involvement, it is demonstrated that their organizational components are similarly and inevitably conditioned by cultural variables as the cultural dynamic theory predicts. Whereas this discussion focuses on extant findings involving the comparison between Westerners, especially European-Americans, and East Asians, the cultural dynamic theory should also apply to other cultural groups for the understanding of the dynamic impact of culture on remembering.

1601. Evaluation of Synergy with β-Lactams Plus Aztreonam Against Pseudomonas aeruginosa (PSA)

Background Combination therapy is often employed in the treatment of PSA infections. Agents commonly used in combination with β-lactams include aminoglycosides, polymyxins, and fluoroquinolones but are limited by resistance and toxicity concerns. The use of dual β-lactam therapy is an emerging area of interest for the treatment of patients with resistant Gram-negative pathogens. This study evaluated synergy between β-lactam agents and aztreonam (ATM) against PSA isolates with varying degrees of susceptibility. Methods 4 PSA clinical isolates were collected from Albany Medical Center; 1 ATCC isolate was used (Table 1). Synergy with cefepime (FEP), meropenem (MER), and ceftazidime (CAZ), each in combination with ATM, was assessed using fractional inhibitory concentration index determined by checkerboard method. Synergistic combinations were tested in 24-hour time-kill, utilizing minimum and steady-state physiological concentrations (Cmin and Css). Tested bacteria were grown to late log phase, diluted to 1 × 106 cfu/mL and incubated at 37°C for 24 hours. Samples were drawn at 0, 2, 4, 6 and 24 hours. Synergy in time-kill was defined as ≥ 2 log10 cfu/mL kill greater than the most active individual agent at 24 hours. Results In checkerboard studies, combinations with ATM resulted in 80% synergy with FEP and 60% synergy with MER or CAZ combinations. ATM/MER and ATM/CAZ time-kill experiments resulted in indifference for most organisms and concentrations tested. For both single and combination regimens, initial killing was observed but varying degrees of regrowth occurred by 24 hours. The only strain with no regrowth at 24 hours was AMC-PSA2 (bactericidal activity and no regrowth at 24 hours observed for MER Cmin MER Css, and MER+ATM Css). Against AMC-PSA2, CAZ+ATM at Cmin was synergistic with limited regrowth observed. Conclusion Against PSA, tested β-lactam combinations with ATM resulted in lack of synergy in time-kill experiments, despite checkerboard results. Due to the extent of regrowth observed with nearly all single agent and combination regimens, testing of alternative combinations, including those that evade common resistance mechanisms such as efflux pumps or β-lactamases, and studies of dynamic concentrations are warranted. Disclosures All authors: No reported disclosures.

The Gothic as a Theory of Symbolic Exchange

Inheriting longstanding norms that require reciprocation between the living and the dead, the Gothic interprets the cultural shifts of the late eighteenth century as a breach in such reciprocation, a breach that it hopes to address through its own account of symbolic exchange. In a wide range of scenarios - ghost tales, stories of sexual transgression, accounts of unborn and undead figures - it proposes that a body, a corpse, or a sexually active individual is inexplicable, out of place, haunting, until it receives the status of human being through a symbolic act. In some tales, it even provides counterfactual narratives of interchanges with supernatural figures - Satan, Dracula - to conceive of how symbolic exchange with the inhuman might cut across, replicate, or disturb human reciprocation. The Gothic thus attempts to redress the conditions of a certain modernity by calling upon -- and theorizing -- the fundamental imperatives of symbolic exchange.