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Hussain M, Ahmed K, Begum SS, Kalita MK, Borah P, Bhuyan D, Tamuly S, Medhi D, Paul V, Chakravartya P, Sarkar M. 70 Effect of seasons and additives in Arunachali yak bull semen at different stages of processing and freezing along with fresh semen characteristics. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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2
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Paul V, Ramesh R, Sreeja P, Jarin T, Sujith Kumar PS, Ansar S, Ashraf GA, Pandey S, Said Z. Hybridization of long short-term memory with Sparrow Search Optimization model for water quality index prediction. Chemosphere 2022; 307:135762. [PMID: 35863408 DOI: 10.1016/j.chemosphere.2022.135762] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/09/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
Water quality (WQ) analysis is a critical stage in water resource management and should be handled immediately in order to control pollutants that could have a negative influence on the ecosystem. The dramatic increase in population, the use of fertilizers and pesticides, and the industrial revolution have resulted in severe effects on the WQ environment. As a result, the prediction of WQ greatly helped to monitor water pollution. Accurate prediction of WQ is the foundation of managing water environments and is of high importance for protecting water environment. WQ data presents in the form of multi-variate time-sequence dataset. It is clear that the accuracy of predicting WQ will be enhanced when the multi-variate relation and time sequence dataset of WQ are fully utilized. This article presents the Water Quality Prediction utilising Sparrow Search Optimization with Hybrid Long Short-Term Memory (WQP-SSHLSTM) model. The presented WQP-SSHLSTM model intends to examine the data and classify WQ into distinct classes. To achieve this, the presented WQP-SSHLSTM model undergoes data scaling process to scale the input data into uniform format. Followed by, a hybrid long short-term memory-deep belief network (LSTM-DBN) technique is employed for the recognition and classification of WQ. Moreover, Sparrow search optimization algorithm (SSOA) is utilized as a hyperparameter optimizer of the proposed DBN-LSTM model. For demonstrating the enhanced outcomes of the presented WQP-SSHLSTM model, a sequence of experiments has been performed and the outcomes are reviewed under distinct prospects. The WQP-SSHLSTM model has achieved 99.84 percent accuracy, which is the maximum attainable. The simulation outcomes ensured the enhanced outcomes of the WQP-SSHLSTM model on recent methods.
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Affiliation(s)
- Vince Paul
- Dept. of Computer Science and Engineering, Eranad Knowledge City Technical Campus, Kerala, India
| | - R Ramesh
- DCA, Cochin University of Science and Technology, Kerala, India
| | - P Sreeja
- Department of EEE, KMEA Engineering College, Kerala, India
| | - T Jarin
- Department of EEE, Jyothi Engineering College, Kerala, India.
| | - P S Sujith Kumar
- Ilahia College of Engineering and Technology, Muvattupuzha, Kerala, India
| | - Sabah Ansar
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Ghulam Abbas Ashraf
- Department of Physics, Zhejiang Normal University, Zhejiang, 321004, Jinhua, China.
| | - Sadanand Pandey
- Department of Chemistry, College of Natural Science, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - Zafar Said
- Department of Sustainable and Renewable Energy Engineering, University of Sharjah, 27272, Sharjah, United Arab Emirates; U.S.-Pakistan Center for Advanced Studies in Energy (USPCAS-E), National University of Sciences and Technology (NUST), Islamabad, Pakistan
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3
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Brown M, Krishnananthan N, Paul V. Right heart catherisation – a virtual reality. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Right heart catheterisation (RHC) is the gold standard for assessing patients with pulmonary hypertension. Doctors require training in this procedure in a safe and friendly environment with minimal risk to patients. Due to the Covid pandemic, formal RHC teaching workshops were cancelled in our country, so we sought to develop a Virtual Reality Right Heart Catheterisation (VRRHC) training program to fulfil this area of need without the need for face to face contact. The aim was to improve training, competency and confidence in this technique with improved diagnostic skills and reduction of procedural errors.
Method
We approached a health technology company to design a VRRHC training module based on our current RHC simulation workshops. Phase 1 required virtual insertion of RHC via the right internal jugular vein using micro-puncture, double Seldinger technique under ultrasound guidance, followed by insertion of the RHC to the right atrium, right ventricle and pulmonary artery with pulmonary artery occlusion using real time pressure tracings and fluoroscopy. Thermodilution cardiac outputs and chamber saturations were also performed.
The proprietary platform technology was delivered via a laptop and VR headset. Clinicians perform the VRRHC with imaging, monitoring and haptic feedback with the collection of real time performance tracking allowing user data (e.g. failed steps and proficiency scores) to be captured and subsequently visualised in the learning management system.
We collected analytics and data on user engagement, experience and retention, targeted learning outcomes and learning curve, reduction in operating costs, reduction in procedure times due to higher proficiency, early diagnosis of pulmonary hypertension, reduced complications, improved interpretation and diagnosis.
Results
The program was launched in October 2021. Preliminary data shows a learning curve is associated with both using VR (10–15 minutes) and the RHC procedure itself. Initial time to completion of the RHC was 30–40 mins, reducing to 20–30 minutes with experience and 15 minutes in experts. Completion rates increase with experience from 40–50% to 100% and error rates reduce with frequency of completion.
Conclusion
A Virtual Reality Right Heart Catheter training program is safe, feasible and non-invasive. Increased experience results in increased completion rates, reduced procedure time and reduced errors. Using this program will potentially have beneficial effects on doctor training, outcomes, patient safety and health economics with no risk to a real patient.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Janssen Pharmaceuticals
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Affiliation(s)
- M Brown
- Macquarie University Hospital , Sydney , Australia
| | | | - V Paul
- Campbelltown Hospital, Emergency , Sydney , Australia
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Ng P, Paul V, Shetty S, Lambert J. Percutaneous extraction of a malpositioned subclavian arterial pacing lead using the retained wire technique and a vascular closure device: a case report. Eur Heart J Case Rep 2022; 6:ytac234. [PMID: 35775017 PMCID: PMC9240413 DOI: 10.1093/ehjcr/ytac234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/11/2022] [Accepted: 06/06/2022] [Indexed: 11/12/2022]
Abstract
Background Inadvertent lead malposition (ILM) in the left ventricle (LV) via the subclavian artery is a rare complication during the insertion of cardiac implantable electronic devices (CIED). If not identified, there is a risk of systemic thromboembolism. Transarterial pacing lead extraction often requires surgical removal and carries high risks of bleeding and thromboembolism, but percutaneous extraction has also been previously described. Case summary A 71-year-old female presented with left homonymous hemianopia on Day 1 post-insertion of a dual-chamber permanent pacemaker (PPM). A computed tomography (CT) angiogram of the brain and aortic arch revealed an acute occlusion of a branch of the right posterior circulating artery (PCA) and a malpositioned pacing lead in the left subclavian artery. Urgent percutaneous removal of the transarterial lead using the retained wire technique was successfully performed. Discussion Inadvertent lead malposition in the arterial system is rare and often requires lead extraction due to systemic thromboembolic complications. The retained wire technique has been previously described for percutaneous transvenous lead extraction and exchange, but to our knowledge, we are the first to report utilizing this technique for transarterial lead extraction. Using a case report, we highlight the utility, safety, and effectiveness of the retained wire technique in extracting a malposition lead in the subclavian artery and LV.
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Affiliation(s)
- Primero Ng
- Department of Cardiology, Fiona Stanley Hospital , Perth , Australia
- Department of Cardiology, Royal Perth Hospital , Perth , Australia
| | - Vince Paul
- Department of Cardiology, Fiona Stanley Hospital , Perth , Australia
| | - Sharad Shetty
- Department of Cardiology, Fiona Stanley Hospital , Perth , Australia
| | - James Lambert
- Department of Cardiology, Fiona Stanley Hospital , Perth , Australia
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5
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Brown M, Krishnananthan N, Paul V. Virtual Reality Training in Right Heart Catheterisation. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hildick-Smith D, Landmesser U, Camm AJ, Diener HC, Paul V, Schmidt B, Settergren M, Teiger E, Nielsen-Kudsk JE, Tondo C. Left atrial appendage occlusion with the Amplatzer™ Amulet™ device: full results of the prospective global observational study. Eur Heart J 2021; 41:2894-2901. [PMID: 32243499 DOI: 10.1093/eurheartj/ehaa169] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 01/24/2020] [Accepted: 02/26/2020] [Indexed: 12/21/2022] Open
Abstract
AIMS To evaluate the safety and efficacy of left atrial appendage occlusion (LAAO) with the Amplatzer™ Amulet™ occluder. METHODS AND RESULTS Patients with atrial fibrillation eligible for LAAO were recruited to a prospective global study. Implant procedures were undertaken with echocardiographic guidance. Transoesophageal echocardiography (TOE) was undertaken 1-3 months post-LAAO. Implant and follow-up TOEs were evaluated by a CoreLab. The primary endpoint was a composite of ischaemic stroke and cardiovascular death at 2 years. Serious adverse events were adjudicated by an independent clinical events committee. A total of 1088 patients were enrolled, aged 75.2 ± 8.5 years; 64.5% were male. CHA2DS2-VASc and HAS-BLED scores were 4.2 ± 1.6 and 3.3 ± 1.1, respectively. A total of 71.7% had prior major bleeding, and 82.8% had contraindications to oral anticoagulants. Implant success was 99.1%. Major adverse events (≤7 days post-procedure) occurred in 4.0%, including death (0.3%), stroke (0.4%), major vascular (1.3%), and device embolization (0.2%). A total of 80.2% of patients were discharged on antiplatelet therapy alone. Peridevice flow was <3 mm in 98.4% at follow-up TOE. Device-related thrombus (DRT) was seen in 1.6% of cases. Cardiovascular death or ischaemic stroke occurred in 8.7% of patients at 2 years. The ischaemic stroke rate was 2.2%/year-a 67% reduction compared to the CHA2DS2-VASc predicted rate. Major bleeding (Bleeding Academic Research Consortium type ≥ 3) occurred at rates of 10.1%/year (year 1) and 4.0%/year (year 2). CONCLUSION Following LAAO with the Amplatzer Amulet device, the ischaemic stroke rate was reduced by 67% compared to the predicted risk. Closure was complete in 98.4% of cases and DRT seen in only 1.6%.
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Affiliation(s)
- David Hildick-Smith
- Department of Cardiology, Sussex Cardiac Centre, Brighton and Sussex University Hospitals, 177 Preston Rd, Brighton BN1 6AGE, UK
| | - Ulf Landmesser
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Charitépl. 1, Berlin 10117, Germany
| | - A John Camm
- Cardiology Clinical Academic Group Molecular & Clinical Sciences Institute, St. George's University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK
| | | | - Vince Paul
- Department of Cardiology, Fiona Stanley Hospital, 11 Robin Warren Dr 6150, Perth, Australia
| | - Boris Schmidt
- Cardioangiologisches Centrum Bethanien, Wilhelm-Epstein-Straße 4, Frankfurt 60431, Germany
| | - Magnus Settergren
- Department of Cardiology, Karolinska Universitetssjukhuset, Eugeniavägen 3, Solna 171 76, Stockholm, Sweden
| | - Emmanuel Teiger
- Department of Cardiology, University Hospital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Jens Erik Nielsen-Kudsk
- Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus N, Denmark
| | - Claudio Tondo
- Heart Rhythm Centre at Monzino Cardiac Center, IRCCS, Department of Clinical Sciences and Community Health, University of Milan, Via Francesco Sforza 35, Milan 20122, Italy
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Hussain M, Ahmed K, Chakravarty P, Paul V, Deka BC, Begum SS, Bhuyan D, Borah P, Tamuly S, Medhi D, Barua PM. 148 Superovulation and embryo production response in oestrus-synchronized Arunachali yak. Reprod Fertil Dev 2021. [DOI: 10.1071/rdv33n2ab148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Arunachali breed of yak is reared by the Monpa pastoral community of Arunachal Pradesh in India for their livelihood and nutritional security on highland pastures. In addition to fulfilling the basic needs of highlanders, this animal is associated with poor production potential linked to its inherent reproductive problems, including silent oestrus, seasonality, and inbreeding, making yak rearing a less-profitable venture. In the recent past, efforts have been made to improve reproductive efficiency of Arunachali yak through assisted reproductive techniques. However, a few regimens for superovulation have been tried to date with limited success in terms of superovulatory response and embryo recovery. Therefore, the present study was undertaken to evaluate the efficacy of two different doses and regimes of superovulation: Stimufol (400 and 200µg per animal) and Folligon (1500 and 1000IU per animal) in Arunachali yak. Twenty-four yaks were allotted in 4 groups (of 6 animals each) and subjected to respective superovulation treatment. Thereafter, the treatment response was assessed in terms of expression of oestrus, interval between treatment and oestrus onset, duration of oestrous, number of corpora lutea and embryos recovered, and analysed using two-way statistical analysis between treatment groups. The results (Table 1) showed a significant (P<0.01) variation in onset of oestrus after the treatment, whereas other responses did not differ among the groups. Further, the recovered embryos were categorized as excellent, good, fair, and poor according to cell size, shape, texture, and number of vesicles present in the blastomeres; 58.33, 20.83, 8.33, and 12.5% embryos in these categories were recovered, respectively. The overall embryo recovery rate was 30.77%, ranging from 10.53 to 52.38% in different treatment groups. The numbers of embryos recorded were less than the numbers of CL present, showing the possibility of non-availability of all ovulated oocytes for fertilization in the oviduct due to untrapping by the fimbriae. The effectiveness of treatments depended upon the precision of oestrus detection and the time of ovulation. In our study, the variation in onset of oestrus might be associated with poor expression of behavioural oestrus in the treated animals. Based on the present findings, we conclude that all the treatments are effective in superovulation and embryo recovery. However, the use of Folligon at 1500IU seemed to be comparatively more effective in Arunachali yak.
Table 1.
Mean (n=6) average of treatment responses in yak following different superovulatory treatment
Variable
Treatment
Stimufol
Folligon
400 µg/animal
200 µg/animal
1500 IU/animal
1000 IU/animal
Oestrus response (%)
100
100
100
100
Interval between treatment and oestrus onset (h)
17.67±0.56a
20.83±0.79b
21.17±0.79bc
23.67±1.43c
Duration of oestrous (h)
30.33±1.09
28.50±0.99
31.50±1.50
28.83±1.25
Corpora lutea (n)
2.83±1.22
3.50±1.18
3.50±0.67
3.17±0.87
Embryo recovered (n)
0.83±0.83
1.00±0.81
1.83±0.98
0.33±0.21
Recovery rate (%)
29.41
28.57
52.38
10.53
a–cMeans within a row with different superscripts differ P<0.05.
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Swale M, Young G, Delacroix S, McSpadden L, Ryu K, Di Fiore D, Paul V, Santos M, Tan I, Conradie A, Duong M, Worthley S, Pavia S. 561 The Effect of Device Orientation on R-Wave Amplitudes in the ConfirmRx Cardiac Monitor. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Swale M, Young G, Paul V, Di Fiore D, Santos M, Tan I, Conradie A, Delacroix S, McSpadden L, Ryu K, Worthley S, Pavia S. 466 ConfirmRx Device Movement and R-Wave Amplitudes at 30 Days Post Implant. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Paul V, Joseph A, Sivapathan S, Madronio C, Pathan F. 644 The Impact of a Nurse Led Heart Failure Optimization Clinic. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Chieng D, Lee F, Ireland K, Paul V. Safety and Efficacy Outcomes of Combined Leadless Pacemaker and Atrioventricular Nodal Ablation for Atrial Fibrillation Using a Single Femoral Puncture Approach. Heart Lung Circ 2019; 29:759-765. [PMID: 31208898 DOI: 10.1016/j.hlc.2019.05.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/14/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Atrioventricular nodal (AVN) ablation with permanent pacemaker (PPM) insertion is indicated for rate control in patients with atrial fibrillation (AF) who remain unresponsive to rate or rhythm control strategies. The leadless PPM (Micra Transcatheter Pacing System [TPS], Medtronic, Minneapolis, MN, USA) has the advantage of eliminating transvenous lead and pacemaker pocket-related complications. The aim of this case series was to determine the outcomes of patients who had undergone combined Micra TPS and AVN ablation, performed via a single femoral approach. METHOD A retrospective review was undertaken on patients who had undergone concurrent procedures, across two major hospitals in Perth, Western Australia. Procedural details were obtained from a cardiac devices database whilst patient demographics and clinical information were determined from medical records. RESULTS Fourteen (14) patients underwent concurrent Micra TPS insertion and AVN ablation for symptomatic AF. The average age was 73±9.2 years, and 43% of them were males. There was no acute procedural/device related complication. Over a median follow-up duration of 9 months (36% completing 12-month follow-up), there was no incidence of device complications, in particular device dislodgement, malfunction or infection. One patient had a resuscitated ventricular fibrillation (VF) arrest event with new onset cardiomyopathy during follow-up and required Micra TPS removal. One patient died at 33 days post procedure from a non-cardiac cause. Device performance was excellent with stable sensing and pacing thresholds during the follow-up period. CONCLUSION Our study has shown that combined leadless PPM (Micra TPS) implantation and AVN ablation using a single femoral approach is feasible, with good safety and efficacy profile in the short-medium term. Long-term data involving larger cohorts is needed to confirm the findings of this study and determine the clinical usefulness of this combined approach.
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Affiliation(s)
- David Chieng
- Department of Cardiology, Fiona Stanley Hospital, Perth, WA, Australia; Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia.
| | - Felicity Lee
- Department of Cardiology, Fiona Stanley Hospital, Perth, WA, Australia
| | - Kim Ireland
- Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia
| | - Vince Paul
- Department of Cardiology, Fiona Stanley Hospital, Perth, WA, Australia; GenesisCare, Perth, WA, Australia
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Sajeevan SE, Chatterjee M, Paul V, Baranwal G, Kumar VA, Bose C, Banerji A, Nair BG, Prasanth BP, Biswas R. Impregnation of catheters with anacardic acid from cashew nut shell prevents Staphylococcus aureus biofilm development. J Appl Microbiol 2018; 125:1286-1295. [PMID: 29972893 DOI: 10.1111/jam.14040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/12/2018] [Accepted: 06/29/2018] [Indexed: 12/24/2022]
Abstract
AIM The effect of anacardic acid impregnation on catheter surfaces for the prevention of Staphylococcus aureus attachments and biofilm formations were evaluated. METHODS AND RESULTS Silicon catheter tubes were impregnated using different concentrations of anacardic acids (0·002-0·25%). Anacardic acids are antibacterial phenolic lipids from cashew nut (Anacardium occidentale) shell oil. Anacardic acid-impregnated silicon catheters revealed no significant haemolytic activity and were cytocompatible against fibroblast cell line (L929). Sustained release of anacardic acids was observed for 4 days. Anacardic acid-impregnated silicon catheters efficiently inhibited S. aureus colonization and the biofilm formation on its surface. The in vivo antibiofilm activity of anacardic acid-impregnated catheters was tested in an intraperitoneal catheter-associated medaka fish infection model. Significant reduction in S. aureus colonization on anacardic acid-impregnated catheter tubes was observed. CONCLUSIONS Our data suggest that anacardic acid-impregnated silicon catheters may help in preventing catheter-related staphylococcal infections. SIGNIFICANCE AND IMPACT OF THE STUDY This study opens new directions for designing antimicrobial phytochemical-coated surfaces with ideal antibiofilm properties and could be of great interest for biomedical research scientists.
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Affiliation(s)
- S E Sajeevan
- Center for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and research Center (AIMS), Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - M Chatterjee
- Center for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and research Center (AIMS), Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - V Paul
- Center for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and research Center (AIMS), Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - G Baranwal
- Center for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and research Center (AIMS), Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - V A Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences and Research Center, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - C Bose
- Amrita School of Biotechnology (ASBT), Amrita Vishwa Vidyapeetham, Kollam, Kerala, India
| | - A Banerji
- Amrita School of Biotechnology (ASBT), Amrita Vishwa Vidyapeetham, Kollam, Kerala, India
| | - B G Nair
- Amrita School of Biotechnology (ASBT), Amrita Vishwa Vidyapeetham, Kollam, Kerala, India
| | - B P Prasanth
- Center for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and research Center (AIMS), Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - R Biswas
- Center for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and research Center (AIMS), Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Krishnan G, Paul V, Biswas TK, Chouhan VS, Das PJ, Sejian V. Diurnal variation and oscillatory patterns in physiological responses and HSP70 profile in heat stressed yaks at high altitude. BIOL RHYTHM RES 2018. [DOI: 10.1080/09291016.2018.1424770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- G. Krishnan
- ICAR-National Research Centre on Yak, Dirang, India
- ICAR-National Institute of Animal Nutrition & Physiology, Bangalore, India
| | - V. Paul
- ICAR-National Research Centre on Yak, Dirang, India
| | - T. K. Biswas
- ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - V. S. Chouhan
- ICAR-Indian Veterinary Research Institute, Bareilly, India
| | - P. J. Das
- ICAR-National Research Centre on Ping, Guwahati, India
| | - V. Sejian
- ICAR-National Institute of Animal Nutrition & Physiology, Bangalore, India
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14
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Landmesser U, Tondo C, Camm J, Diener HC, Paul V, Schmidt B, Settergren M, Teiger E, Nielsen-Kudsk JE, Hildick-Smith D. Left atrial appendage occlusion with the AMPLATZER Amulet device: one-year follow-up from the prospective global Amulet observational registry. EUROINTERVENTION 2018; 14:e590-e597. [DOI: 10.4244/eij-d-18-00344] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Krishnan G, Paul V, Biswas TK, Chouhan VS, Das PJ, Sejian V. Adaptation strategies of yak to seasonally driven environmental temperatures in its natural habitat. Int J Biometeorol 2018; 62:1497-1506. [PMID: 29728761 DOI: 10.1007/s00484-018-1549-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 06/08/2023]
Abstract
The gradual increase of ambient temperature (TA) at high altitude can cause heat stress as an effect of climate change and may shift the traditional habitat of yak to further higher altitude. Therefore, an attempt has been made in this study to evaluate the thermo-adaptability of yaks to different seasons at high altitude. The adaptive capabilities of yaks were assessed based on different heat tolerance tests in relation to changes in rectal temperature (RT; °F), respiration rate (RR; breaths/min), pulse rate (PR; beats/min), and plasma heat shock protein (HSP) profile. The experiment was conducted in 24 yaks, divided into three groups based on age as calf (n = 8), adult (n = 8), and lactating cow (n = 8). Thermal adaptability was determined by temperature humidity index (THI), dairy search index (DSI), and Benezra's thermal comfort index (BTCI) along with HSP70 profile. The THI was higher (P < 0.01) in summer than winter which increased from lowest (40.87) to highest (61.03) in summer by 20 points, where yaks were under heat load beyond THI 52. The RT (100.09 ± 0.18 °F), RR (21.76 ± 0.18), and PR (59.78 ± 0.32) increased by 23-35%, and this was correlated to the higher values of DSI exceeding 1 in calves (1.35 ± 0.03), lactating cows (1.29 ± 0.04), and adults (1.23 ± 0.32) during summer in comparison to winter (0.98 ± 0.02). The BTCI also showed values greater (P < 0.01) than 2 in calves (3.47 ± 0.27), lactating cows (3.23 ± 0.28), and adults (2.98 ± 0.29) which reflected 49-75% increase in rectal temperature and respiration rate during summer. Further, heat stress was substantiated by threefold higher (P < 0.01) level of plasma HSP70 in calves (189.61 ± 3.90 pg/ml) followed by lactating cows (168.62 ± 3.03 pg/ml) and adults (155.33 ± 2.30 pg/ml) against the winter average of 87.92 ± 3.19 pg/ml. Present results revealed that yaks were experiencing heat stress in summer at an altitude of 3000 m above sea level and calves were more prone to heat stress followed by lactating cows and adults.
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Affiliation(s)
- G Krishnan
- ICAR-National Research Centre on Yak, Dirang, Arunachal Pradesh, India.
- Animal Physiology Division, ICAR-National Institute of Animal Nutrition & Physiology, Adugodi, Bangalore, 560030, India.
| | - V Paul
- ICAR-National Research Centre on Yak, Dirang, Arunachal Pradesh, India
| | - T K Biswas
- ICAR-National Research Centre on Yak, Dirang, Arunachal Pradesh, India
| | - V S Chouhan
- ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly, India
| | - P J Das
- ICAR-National Research Centre on Pig, Guwahati, India
| | - V Sejian
- Animal Physiology Division, ICAR-National Institute of Animal Nutrition & Physiology, Adugodi, Bangalore, 560030, India
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Chieng D, Stewart B, Paul V. Inappropriate shock from myopotentials due to subcutaneous defibrillator (S-ICD) movement confirmed on fluoroscopy with subsequent device pocket revision. J Interv Card Electrophysiol 2018; 53:263-265. [DOI: 10.1007/s10840-018-0405-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
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Lee F, Anderson H, Nangrahary M, Macdonald T, Nguyen M, Clugston R, Paul V, Xu X. Percutaneous Left Atrial Appendage Occlusion for Stroke Prevention in Non-Valvular Atrial Fibrillation: An Early Experience in Western Australia. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chieng D, Paul V. Clinical Safety and Outcomes of Same Day Leadless Pacemaker (Micra) and Atrioventricular Node Ablation for Atrial Fibrillation using Single Femoral Puncture Approach: A Case Series. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Lin T, Pavia S, Cehic D, O’Donnell D, Paul V, Eccleston D. Gender Differences in Outcome after Device Implantation in Australia: Results from the GenesisCare National Multi-Centre Registry (GCOR-Device). Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lan N, Fietz M, Pachter N, Paul V, Playford D. A Case of Vascular Ehlers-Danlos Syndrome Presenting as a Non–Compaction Cardiomyopathy. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chieng D, Stewart B, Pattani S, Paul V. Novel Use of Fluoroscopic Study to Confirm Subcutaneous Defibrillator (S-ICD) Movement Causing Myopotential Generation and Inappropriate Device Shocks. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Phillips KP, Paul V. Dealing With the Left Atrial Appendage for Stroke Prevention: Devices and Decision-Making. Heart Lung Circ 2017; 26:918-925. [PMID: 28652029 DOI: 10.1016/j.hlc.2017.05.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 05/02/2017] [Indexed: 11/25/2022]
Abstract
Left atrial appendage (LAA) device occlusion represents a major evolution in stroke prevention for atrial fibrillation (AF). Left atrial appendage device occlusion is now a proven strategy which provides long-term thromboembolic stroke prevention for patients with non-rheumatic AF. Evidence supports its benefit as an alternative to long-term anticoagulation while mitigating long-term bleeding risks and improving cardiovascular mortality. The therapy offers expanded options to physicians and patients negotiating stroke prevention (both primary and secondary prevention), but a good understanding of the risks and benefits is required for decision-making. This review aims to summarise the evolution of LAA device occlusion therapy, current knowledge in the field and a snapshot of current status of the therapy in clinical practice in Australia and around the world.
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Affiliation(s)
- Karen P Phillips
- HeartCare Partners, GenesisCare, Greenslopes Private Hospital, Greenslopes, Brisbane, Qld, Australia.
| | - Vince Paul
- Fiona Stanley Hospital, Perth, WA, Australia
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Lee F, Lamont P, Powell A, Paul V, Stoyanov N. Cardiac Manifestations of Myotonic Dystrophy - Complexities in Diagnosis and Management. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kumar S, Paul V, Mahajan R, Marangou J, Waddy P, Lau D, Haqqani H, Sanders P. Left Atrial Appendage Closure in Patients with Contra-Indications to Anticoagulants. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dudziak J, Bolton N, McNeil G, Paul V, Raithatha A, Rogers G, Booker K, Lima E, Jeanrenaud P, Sim K, Wong C, Mohammed A, Mahendran V, Welters I, Tridente A. The fice course and qualification - experience from the cheshire and merseyside group. Intensive Care Med Exp 2015. [PMCID: PMC4798501 DOI: 10.1186/2197-425x-3-s1-a610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Paul V, Tridente A, Kaur P, Mahmood M, Mellors R, Raithatha AH. Critically ill patients with faecal peritonitis: a 5-year review in a tertiary centre. Crit Care 2015. [PMCID: PMC4473064 DOI: 10.1186/cc14454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Chakravarty P, Hussain M, Chauhan MS, Manik RS, Baishya D, Bhuyan S, Soren S, Deori S, Paul V, Das PJ, Doley J, Borah BKD, Krishnan G, Dutta DJ, Deb SM. 257 IN VITRO YAK EMBRYO PRODUCTION THROUGH CONVENTIONAL AND OVUM PICKUP METHODS. Reprod Fertil Dev 2015. [DOI: 10.1071/rdv27n1ab257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Yak is one of the most important economically useful animals for highlanders. The decline in the yak population demands effective measures for conservation and multiplication of elite germplasm. In vitro production of embryos and their cryopreservation and transfer to suitable recipients for production of elite calves may contribute to fulfill the objectives. The work was conducted at the National Research Center on Yak over a period of 3 years. The ovaries of slaughtered animals were used for collecting oocytes through aspiration of follicles followed by slicing of ovaries in the conventional method. Trials were conducted using 7 cyclic parous yaks for ultrasound-guided ovum pickup (OPU) at Nyukmadung farm (2700 m above mean sea level). The technique followed was similar to that in buffaloes with slight modification. Categories of oocytes classified A (2–3 layers of cumulus) and B (at least one layer of cumulus) obtained through the processes were subjected to in vitro maturation using standardized maturation medium (TCM-199 + 10% follicular fluid + sodium pyruvate + l-glutamine + 10% heat inactivated oestrus cow serum + pFSH + 17β oestradiol). The frozen-thawed yak sperm were capacitated using the swing-up method before their incubation with matured oocytes using BO medium. Oocytes matured for 24 h were washed 5 to 6 times with BO medium and then co-incubated with in vitro capacitated spermatozoa (0.1 to 0.25 million) for fertilization (8–10 oocytes per group) in 100-µL droplets of BO medium under mineral oil in 35-mm Petri dishes and placed in a CO2 incubator (5% CO2, 90% RH) at 38.5°C for 16 to 18 h. The presumed zygotes were washed several times in mCR2aa (modified Charles Rosenkrans) washing medium and then cultured in culture medium for 7 days on original beds of granulosa cells. The rates of maturation and fertilization of oocytes collected by conventional and OPU technique were comparable (Table 1). This may be attributed to greater numbers of good quality oocytes recovered in the conventional method. Embryos developed up to the stage of compact morula and blastocysts (24.66% through conventional and 22.73% through OPU) were cryopreserved using the vitrification method for further study. Thirteen embryos were transferred non-surgically to one each of 13 yak recipients; 5 became pregnant and only 1 recipient transferred with a cryopreserved-thawed embryo, developed through OPU, delivered one male calf, leading to the first successful production of an IVF yak calf in the world. The present findings are suggestive of using the OPU technique for in vitro embryo production, though resulting in lower numbers of transferable embryos (Table 1), because availability of ovaries for conventional IVF is a major constraint in yak.
Table 1.Comparative in vitro yak embryo production rate with recovery of oocytes by conventional or ovum pickup (OPU) method
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Malik V, Mckitrick D, Paul V, Arnolda L. The reflex response to Lower Body Negative Pressure (LBNP) is altered in Paroxysmal Atrial Fibrillation (PAF) Patients: Pulmonary Vein Isolation (PVI) has no effect on LBNP response. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cazeau SJ, Daubert JC, Tavazzi L, Frohlig G, Paul V. Responders to cardiac resynchronization therapy with narrow or intermediate QRS complexes identified by simple echocardiographic indices of dyssynchrony: The DESIRE study. Eur J Heart Fail 2014; 10:273-80. [DOI: 10.1016/j.ejheart.2008.02.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2007] [Revised: 01/28/2008] [Accepted: 02/06/2008] [Indexed: 11/28/2022] Open
Affiliation(s)
- Serge J. Cazeau
- Inparys Clinical Research Group; 12 rue Pasteur, 92210 - St. Cloud France
| | | | | | - Gerd Frohlig
- Universitätskliniken des Saarlandes; Homburg Germany
| | - Vince Paul
- St Peters Hospital; Chertsey United Kingdom
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Affiliation(s)
- V Paul
- 4802 10th Avenue, Brooklyn, New York, USA.
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Bhutta ZA, Giuliani F, Haroon A, Knight HE, Albernaz E, Batra M, Bhat B, Bertino E, McCormick K, Ochieng R, Rajan V, Ruyan P, Cheikh Ismail L, Paul V. Standardisation of neonatal clinical practice. BJOG 2013; 120 Suppl 2:56-63, v. [DOI: 10.1111/1471-0528.12312] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2012] [Indexed: 11/27/2022]
Affiliation(s)
- ZA Bhutta
- Division of Women & Child Health; The Aga Khan University; Karachi; Pakistan
| | - F Giuliani
- SCDU Neonatologia; Dipartimento di Scienze Pediatriche e dell'Adolescenza; Università degli Studi di Torino; Torino; Italy
| | - A Haroon
- Division of Women & Child Health; The Aga Khan University; Karachi; Pakistan
| | - HE Knight
- Nuffield Department of Obstetrics & Gynaecology; Oxford Maternal & Perinatal Health Institute; Green Templeton College; University of Oxford; Oxford; UK
| | | | - M Batra
- University of Washington School of Medicine; Seattle; WA; USA
| | - B Bhat
- Department of Family & Community Health; Ministry of Health; Muscat; Sultanate of Oman
| | - E Bertino
- SCDU Neonatologia; Dipartimento di Scienze Pediatriche e dell'Adolescenza; Università degli Studi di Torino; Torino; Italy
| | - K McCormick
- Department of Paediatrics; John Radcliffe Hospital; Oxford; UK
| | - R Ochieng
- Faculty of Health Sciences; Aga Khan University; Nairobi; Kenya
| | - V Rajan
- Ketkar Nursing Home; Nagpur; India
| | - P Ruyan
- Maternal & Child Health Centre; Beijing Obstetrics & Gynaecology Hospital; Capital Medical University; Beijing; China
| | - L Cheikh Ismail
- Nuffield Department of Obstetrics & Gynaecology; Oxford Maternal & Perinatal Health Institute; Green Templeton College; University of Oxford; Oxford; UK
| | - V Paul
- Department of Paediatrics and WHO Collaborating Centre for Training & Research in Newborn Care; All India Institute of Medical Sciences; New Delhi; India
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Nigam PK, Sharma S, Sareen R, Paul V, Lal A. Lack of precision in HbA(1c) values on variant II in cases of hemoglobin Q India. Indian J Clin Biochem 2012; 21:72-5. [PMID: 23105618 DOI: 10.1007/bf02912916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study was carried out to check the precision of HbA(1c) values on Bio-Rad Variant II in cases of a rare hemoglobin variant Q India. The study was carried out over a three month period on samples collected for HbA(1c) estimation. Seven out of eleven patients showed variable results of HbA(1c) with a very high and unacceptable intraday mean coefficient of variation (CV) of 9.93%. We conclude, that the results of HbA(1c) on Variant II can not be reported without adversely affecting HbA(1c) as a marker of long-term glycemic control in patients who have hemoglobin Q India. The HbA(1c) value of these patients needs to be assessed by a different instrument/method or the glycemic control be monitored by an alternate test like serum Fructosamine.
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Affiliation(s)
- P K Nigam
- Dr Lal PathLabs Pvt Ltd, 'ESKAY HOUSE', 54, Hanuman Road, 110001 New Delhi, India
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Bhanot N, Haran M, Lodha A, Paul V, Goswami R, Chapnick EK. Physicians' attitudes towards self-treatment of latent tuberculosis. Int J Tuberc Lung Dis 2012; 16:169-71. [PMID: 22137678 DOI: 10.5588/ijtld.11.0232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We conducted a cross-sectional study to assess physicians' attitudes towards self-treatment of latent tuberculosis infection (LTBI) based on real-time responses related to actual purified protein derivative (PPD) results, in addition to using hypothetical situations for those who were PPD-negative. We also obtained information on physicians' recommendations for their patients to treat this condition. Although the physicians claimed to recommend optimal treatment to their patients, the majority of them had different attitudes when considering treatment for themselves. There appears to be a discrepancy between physicians' attitudes to self-treatment and their management of patients with LTBI.
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Affiliation(s)
- N Bhanot
- Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA.
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Stoyanov N, Paul V. Clinical Use of Telemonitoring in Chronic Heart Failure: Keeping up with the Times or Misuse of Time? Curr Heart Fail Rep 2012; 9:75-80. [DOI: 10.1007/s11897-011-0074-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Shanmugam N, Boerdlein A, Proff J, Ong P, Valencia O, Maier SKG, Bauer WR, Paul V, Sack S. Detection of atrial high-rate events by continuous home monitoring: clinical significance in the heart failure-cardiac resynchronization therapy population. Europace 2011; 14:230-7. [PMID: 21933802 PMCID: PMC3262405 DOI: 10.1093/europace/eur293] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
AIMS Uncertainty exists over the importance of device-detected short-duration atrial arrhythmias. Continuous atrial diagnostics, through home monitoring (HM) technology (BIOTRONIK, Berlin, Germany), provides a unique opportunity to assess frequency and quantity of atrial fibrillation (AF) episodes defined as atrial high-rate events (AHRE). METHODS AND RESULTS Prospective data from 560 heart failure (HF) patients (age 67 ± 10 years, median ejection fraction 27%) patients with a cardiac resynchronization therapy (CRT) device capable of HM from two multi-centre studies were analysed. Atrial high-rate events burden was defined as the duration of mode switch in a 24-h period with atrial rates of >180 beats for at least 1% or total of 14 min per day. The primary endpoint was incidence of a thromboembolic (TE) event. Secondary endpoints were cardiovascular death, hospitalization because of AF, or worsening HF. Over a median 370-day follow-up AHRE occurred in 40% of patients with 11 (2%) patients developing TE complications and mortality rate of 4.3% (24 deaths, 16 with cardiovascular aetiology). Compared with patients without detected AHRE, patients with detected AHRE>3.8 h over a day were nine times more likely to develop TE complications (P= 0.006). The majority of patients (73%) did not show a temporal association with the detected atrial episode and their adverse event, with a mean interval of 46.7 ± 71.9 days (range 0-194) before the TE complication. CONCLUSION In a high-risk cohort of HF patients, device-detected atrial arrhythmias are associated with an increased incidence of TE events. A cut-off point of 3.8 h over 24 h was associated with significant increase in the event rate. Routine assessment of AHRE should be considered with other data when assessing stroke risk and considering anti-coagulation initiation and should also prompt the optimization of cardioprotective HF therapy in CRT patients.
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Affiliation(s)
- Nesan Shanmugam
- Department of Cardiology, St George's Healthcare NHS Trust, London, UK
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Williams LK, Ellery SM, Leyva-Leon F, Patel KC, Bleasdale RA, Stegemann B, Paul V, Steendijk P, Frenneaux MP. MECHANISMS BY WHICH CARDIAC RESYNCHRONIZATION THERAPY IMPROVES CARDIAC PERFORMANCE IN HEART FAILURE. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)60360-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ellery SM, Williams LK, Leyva-Leon F, Patel KC, Bleasdale RA, Stegemann B, Paul V, Steendijk P, Frenneaux MP. CARDIAC RESYNCHRONIZATION THERAPY: EFFECT OF OPTIMIZING THE V-V INTERVAL IN HEART FAILURE. J Am Coll Cardiol 2011. [DOI: 10.1016/s0735-1097(11)60348-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Young G, Paul V, Disney P, Clugston R, Xu X, Worthley S. Left Atrial Appendage Occlusion Utilising the Amplatzer Cardiac Plug. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
OBJECTIVE To compare gain in knowledge and skills of neonatal resuscitation using tele-education instruction vs conventional classroom teaching. STUDY DESIGN This randomized controlled trial was conducted in the tele-education facility of a tertiary care center. In-service staff nurses were randomized to receive training by tele-education instruction (TI, n=26) or classroom teaching (CT, n=22) method from two neonatology instructors using a standardized teaching module on neonatal resuscitation. Gain in knowledge and skill scores of neonatal resuscitation were measured using objective assessment methods. RESULT Age, educational qualification and professional experience of the participants in two groups were comparable. Pre-training mean knowledge scores were higher in TI group (8.3±1.7 vs 6.6±1.4, P=0.004). However, skill scores were comparable in the two groups (11.7±3 vs 10.3±2.9, P=0.13). Training resulted in a significant and comparable gain in knowledge scores (4.2±2.2 vs 5.3±1.7; P=0.06) and skills scores (4.5±3.3 vs 5.0±3.1, P=0.62) in both the groups. The post-training knowledge scores (TI: 12.5±1.7 vs CT: 12.0±1.7, P=0.37) and the post-training skill scores (TI: 16.0±0.5 vs CT: 15.6±2.5, P=0.55) were comparable in the two groups. However, the post-training scores, adjusted for baseline knowledge scores, were statistically higher in the in-person group compared with the telemedicine group (knowledge: 12.46±0.03 vs 12.16±0.01, P=0.00; skills: 15.6±2.5 vs 16.0±2.8, P=0.00). The quantum of lower scores in the telemedicine group was only 2% for knowledge and 6% for skills. This difference was felt to be of only marginal importance. Satisfaction scores among trainees and instructors were comparable in the two groups. CONCLUSION Tele-education offers a feasible and effective alternative to conventional training in neonatal resuscitation among health-care providers.
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Affiliation(s)
- A Jain
- Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Steinke K, Guertler P, Paul V, Wiedemann S, Ettle T, Albrecht C, Meyer HHD, Spiekers H, Schwarz FJ. ORIGINAL ARTICLE: Effects of long-term feeding of genetically modified corn (event MON810) on the performance of lactating dairy cows. J Anim Physiol Anim Nutr (Berl) 2010; 94:e185-93. [DOI: 10.1111/j.1439-0396.2010.01003.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Veasey RA, Silberbauer J, Schilling RJ, Morgan JM, Paul V, Furniss SS, Sulke N. The evaluation of pulmonary vein isolation and wide-area left atrial ablation to treat atrial fibrillation in patients with implanted permanent pacemakers: the Previously Paced Pulmonary Vein Isolation Study. Heart 2010; 96:1037-42. [PMID: 20483905 DOI: 10.1136/hrt.2009.188425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The practise of catheter ablation for atrial fibrillation (AF) is increasing rapidly and is recommended as the treatment of choice in many patient subgroups. At present, the efficacy of this procedure has been assessed by means of electrocardiographic recording, intermittent Holter monitoring and evaluation of patient symptoms. We sought to evaluate the true efficacy of this procedure in patients with sophisticated permanent pacemakers capable of continuous long-term cardiac rhythm monitoring. METHODS Twenty-five patients (aged 63.7 (9.4), 20 men), seven with persistent AF and 18 with prolonged paroxysmal AF, underwent a mean of 1.7 AF ablation procedures. All the patients had previously been implanted with a pacemaker or atrial defibrillator device. Data were downloaded from the device Holter before catheter ablation and at 2, 4, 6 and 8 months postprocedure(s). The primary outcome measure was AF burden. The secondary outcomes were patient symptom and quality-of-life measures. RESULTS Initial AF burden was 43.8 (35.5)%. After catheter ablation(s), this was significantly reduced at 2 months to 23.8 (35.4)% (p=0.023), at 4 months to 21.4 (34.1)% (p=0.008), at 6 months to 14.5 (28.1)% (p=0.002) and at 8 months to 15.0 (29.4%) (p=0.003). Only nine (36%) of 25 patients demonstrated no recurrence of arrhythmia during follow-up completion, consistent with a long-term cure. Quality-of-life indices showed significant improvement after ablation. CONCLUSIONS Catheter ablation for AF significantly improves patient symptoms and reduces AF burden after long-term beat-to-beat monitoring by implanted cardiac pacemaker and defibrillator devices. However, AF recurrence is common after these procedures.
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Affiliation(s)
- R A Veasey
- Department of Cardiology, Eastbourne Hospital, East Sussex Hospitals NHS Trust, Eastbourne, UK
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Herzog K, Brockhan-Lüdemann M, Kaske M, Beindorff N, Paul V, Niemann H, Bollwein H. Luteal blood flow is a more appropriate indicator for luteal function during the bovine estrous cycle than luteal size. Theriogenology 2010; 73:691-7. [DOI: 10.1016/j.theriogenology.2009.11.016] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Revised: 09/30/2009] [Accepted: 11/29/2009] [Indexed: 10/20/2022]
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Rauch AV, Paul V, ter Horst L, Bauer J, Ohrmann P, Konrad C, Dannlowski U, Egloff B, Heindel W, Arolt V, Suslow T. Repressive coping style modulates neural responses during encoding of emotional faces. KLIN NEUROPHYSIOL 2010. [DOI: 10.1055/s-0030-1250866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Leclercq C, Padeletti L, Cihák R, Ritter P, Milasinovic G, Gras D, Paul V, Van Gelder IC, Stellbrink C, Rieger G, Corbucci G, Albers B, Daubert JC. Incidence of paroxysmal atrial tachycardias in patients treated with cardiac resynchronization therapy and continuously monitored by device diagnostics. Europace 2010; 12:71-7. [PMID: 19864311 DOI: 10.1093/europace/eup318] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS Little is known about the incidence of paroxysmal atrial tachycardias (PAT) in patients with heart failure (HF). The availability of cardiac resynchronization therapy (CRT) devices with extended diagnostics for AT enables continuous monitoring of PAT episodes. The aim of the study was to assess the incidence over time of PAT in HF patients treated with CRT. METHODS AND RESULTS Consecutive patients in NYHA functional class III or IV despite optimal drug therapy, QRS duration > or = 130 ms, left ventricular ejection fraction < or = 35%, and left ventricular end-diastolic dimension > or = 55 mm were eligible for enrolment. Patients with permanent or persistent atrial fibrillation (AF) were not included in the study. The first follow-up examination was performed 2 weeks after implantation, to optimize atrial sensing and CRT. Subsequent follow-up examinations were carried out 15 and 28 weeks after implantation, to collect the telemetric data. A total of 173 patients (67 +/- 11 years, M 116) were enrolled. Complete arrhythmia monitoring data were available from 120 patients over a mean follow-up of 183 +/- 23 days. Atrial tachycardia episodes were detected through telemetry in 25 of 120 patients (21%) during at least one follow-up examination. Atrial tachycardia episodes were recorded in 29 and 17% (P = NS) of patients with and without previous history of AF, respectively. CONCLUSION More than 20% of the overall HF patient population treated with CRT suffer PAT episodes. Paroxysmal atrial tachycardia may interfere with response to CRT. Therefore, telemetric data may be relevant to drive the appropriate therapy in each patient.
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Affiliation(s)
- C Leclercq
- Hôpital Pôntchaillou CHU, University of Rennes, Rennes, France.
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Williams LK, Ellery S, Patel K, Leyva F, Bleasdale RA, Phan TT, Stegemann B, Paul V, Steendijk P, Frenneaux M. Short-term hemodynamic effects of cardiac resynchronization therapy in patients with heart failure, a narrow QRS duration, and no dyssynchrony. Circulation 2009; 120:1687-94. [PMID: 19822812 DOI: 10.1161/circulationaha.108.799395] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiac resynchronization therapy produces both short-term hemodynamic and long-term symptomatic/mortality benefits in symptomatic heart failure patients with a QRS duration >120 ms. This is conventionally believed to be due principally to relief of dyssynchrony, although we recently showed that relief of external constraint to left ventricular filling may also play a role. In this study, we evaluated the short-term hemodynamic effects in symptomatic patients with a QRS duration <120 ms and no evidence of dyssynchrony on conventional criteria and assessed the effects on contractility and external constraint. METHODS AND RESULTS Thirty heart failure patients (New York Heart Association class III/IV) with a left ventricular ejection fraction < or =35% who were in sinus rhythm underwent pressure-volume studies at the time of pacemaker implantation. External constraint, left ventricular stroke work, dP/dtmax, and the slope of the preload recruitable stroke work relation were measured from the end-diastolic pressure-volume relation before and during delivery of biventricular and left ventricular pacing. The following changes were observed during delivery of cardiac resynchronization therapy: Cardiac output increased by 25+/-5% (P<0.05), absolute left ventricular stroke work increased by 26+/-5% (P<0.05), the slope of the preload recruitable stroke work relation increased by 51+/-15% (P<0.05), and dP/dtmax increased by 9+/-2% (P<0.05). External constraint was present in 15 patients and was completely abolished by both biventricular and left ventricular pacing (P<0.05). CONCLUSIONS Cardiac resynchronization therapy results in an improvement in short-term hemodynamic variables in patients with a QRS <120 ms related to both contractile improvement and relief of external constraint. These findings provide a potential physiological basis for cardiac resynchronization therapy in this patient population.
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Affiliation(s)
- Lynne K Williams
- Department of Cardiovascular Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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Paul V, Feindt P, Gams E, Kasi A, Straub U, Priebe J, Meyer U, Gersonde K. Ein Intrathorakales Herzunterstützungssystem (IVAD) zur Behandlung von myokardialem Pumpversagen. BIOMED ENG-BIOMED TE 2009. [DOI: 10.1515/bmte.1995.40.s1.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Beindorff N, Honnens A, Penno Y, Paul V, Bollwein H. Effects of human chorionic gonadotropin on luteal blood flow and progesterone secretion in cows and in vitro-microdialyzed corpora lutea. Theriogenology 2009; 72:528-34. [PMID: 19515407 DOI: 10.1016/j.theriogenology.2009.04.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Revised: 04/08/2009] [Accepted: 04/12/2009] [Indexed: 10/20/2022]
Abstract
To check human chorionic gonadotropin (hCG) effects on luteal blood flow (LBF) and progesterone (P(4)) synthesis, six cows received either 3000 IU hCG or saline (NaCl) on Day 7 (Day 1=ovulation) during two estrous cycles. Plasma P(4) and LBF were measured before (0h) and up to 48h after treatment. Luteal blood flow increased by 51% (P<0.05) at 1h after hCG administration and returned to baseline levels thereafter. Plasma P(4) levels were increased from pretreatment levels by 30% at 1h (P=0.05) and 81% at 48h (P=0.02) after hCG treatment. In contrast, NaCl did not cause changes in LBF and P(4) (P>0.05). Additionally, central and peripheral parts of 14 abattoir-derived corpora lutea of the mid-luteal phase (Day 8 to 12) were perfused with Ringer solution in an in vitro microdialysis system, supplemented with 50 or 150 IU/mL hCG for 1h. Application of 50 IU/mL hCG showed no influence on P(4) response (P>0.05) in both central and peripheral parts, whereas 150 IU/mL hCG resulted in an increase of P(4) synthesis (P=0.002) in the central parts only. In vivo, hCG provoked an immediate and long-term rise in P(4) but only a temporary elevation of LBF. Luteal blood flow itself does not seem to be the exclusive cause for an increase in P(4), because the in vitro data clearly showed direct effects of hCG on P(4) secretion. Interestingly, different P(4) secretion patterns could be found between central and peripheral parts of the corpus luteum in both control and hCG perfused corpora lutea.
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Affiliation(s)
- N Beindorff
- Clinic for Cattle, School of Veterinary Medicine Hannover, Bischofsholer Damm 15, 30173 Hannover, Germany.
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Parsai C, Bijnens B, Sutherland GR, Baltabaeva A, Claus P, Marciniak M, Paul V, Scheffer M, Donal E, Derumeaux G, Anderson L. Toward understanding response to cardiac resynchronization therapy: left ventricular dyssynchrony is only one of multiple mechanisms. Eur Heart J 2008; 30:940-9. [DOI: 10.1093/eurheartj/ehn481] [Citation(s) in RCA: 178] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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