Effects of trans-endocardial delivery of bone marrow-derived CD133+ cells on angina and quality of life in patients with refractory angina: A sub-analysis of the REGENT-VSEL trial

Background: The REGENT-VSEL trial demonstrated a neutral effect of transendocardial injection of autologous bone marrow (BM)-derived CD133+ in regard to myocardial ischemia. The current sub-analysis of the REGENT VSEL trial aims to assess the effect stem cell therapy has on quality of life (QoL) in patients with refractory angina.Methods: Thirty-one patients (63.0 ± 6.4 years, 70% male) with recurrent CCS II–IV angina, despite optimal medical therapy, enrolled in the REGENT-VSEL single center, randomized, double-blinded, and placebo-controlled trial. Of the 31 patients, 16 individuals were randomly assigned to the active stem cell group and 15 individuals were randomly assigned to the placebo group on a 1:1 basis. The inducibility of ischemia, (≥ one myocardial segment) was confirmed for each patient using Tc-99m SPECT. QoL was measured using the Seattle Angina Questionnaire. Each patient completed the questionnaire prior to treatment and at the time of their outpatient follow-up visits at 1, 4, 6, and 12 months after cell/placebo treatment.Results: The main finding of the REGENT-VSEL trial sub-analysis was that transendocardial injection of autologous BM-derived CD133+ stem cells in patients with chronic refractory angina did not show significant improvement in QoL in comparison to the control group. Moreover, there was no significant difference between cell therapy and placebo in a number of patients showing improvement of at least 1 Canadian Cardiovascular Society class during the follow-up period.Conclusions: Intra-myocardial delivery of autologous CD133+ stem cells is safe and feasible but does not show a significant improvement in the QoL or angina pectoris symptoms in patients with chronic myocardial ischemia

Obstacles to creating and finding Open Educational Resources: the case of research methods in the social sciences

Social Research Methods are approaches to undertaking research shared not only by the social sciences, but by many other disciplines. There is therefore enormous scope for the creation and re-use of open educational resources (OERs) in this field. However, our work with social scientists on a number of recent projects in the context of JISC (Joint Information Systems Committee)/ HEA (Higher Education Academy) supported UK OER programme suggests that there are some barriers to both OER creation and use. Although there are now a number of national and institutional projects creating learning resources in research methods and making them openly available for teachers and students to use, many still use licences that restrict re-use and, in particular, modification; we refer to these materials as ‘grey OERs’. We also found that, in contrast to the well-developed practice of citation in research work, academics and teachers had a narrow notion of licensing and copyright of teaching materials, consistent with a limited experience of sharing teaching materials. The tacit understanding of academics about learning resources also meant that they saw potential users as mainly other academics who were subject experts like themselves. That meant that they gave little weight to the role of broad description and metadata in making resources findable. At the same time, when academics looked for resources, the quality and relevance of those resources and the ability to judge that quickly were paramount. We discuss two approaches that attempt to tackle these issues. First, the development of a mapping tool that supports those creating OERs to identify a range of classificatory and metadata in a way that gives those looking for resources a much wider range of ways of finding them. Second, the development of a website, based on Web 2.0 technology that exploits the contributions of academics using and reviewing research methods OERs. We suggest that the activities on a blog-based website creates a cultural context which constitutes an element of a community of practice of social science academics. Users can find resources by quality, pedagogy, and other metadata as well as content and through vicarious learning about the use and reviewing of resources by other academics, they may develop better practices in their own re-use and attribution of OERs

The introduction of the euro in the perspective of accession and the challenges of absorption

The introduction of the euro is one of the elements of wider strategy of EU integration. After the accession the new member countries tested significant and rapid inflow of portfolio and direct investments. This Inflow—paradoxically— may make it difficult to introduce a common currency. It is additionally strengthened by the ineffectiveness of the exchange rate mechanism. This ineffectiveness may cause that the rate of exchange can be recognized as guaranteed, taking the currency risk off the market participants who invest in the assets denominated in the currencies of the new member countries or raise a credit in the foreign currency. This causes—short and long term—inflow of the investments, and at the same time bigger pressure of appreciation of these currencies. The effect of the inflow, except the real and the nominal appreciation, is additional inflationary pressure. The thesis advanced by the authors is that, after the asset there is a change of efficiency of the rate of the exchange in Poland, Czech Republic and Hungary. The weekly courses such as EUR/PLN, EUR/CZK, EUR/HUF were examined. The correlations of delays were tested and the Ljunga-Boxa autocorrelation (Q) as well.

Teaching Research Methods and Using Open Resources

Interviews with Sara Ryan, Oxford University, Alan Bryman, University of Leicester, Dave Harris, MARJON Plymouth, Antje Lindenmeyer, University of Warwick, Kate Orton-Johnson, University of Edinburgh and Sean Moley, the National Centre for Research Methods, Southampton. Interviewed by Anna Gruszczynska, University of Birmingham, Thursday, 24th February, 2011 on their teaching of research methods, their use of online open educational resources and their idea collection of such resources. The Collections Project. Funded by Hefce via Jisc,UK

Surgical Outcomes of Total Anomalous Pulmonary Venous Connection Repair

Background and Objectives: Over the years, surgical repair of total anomalous pulmonary venous connection (TAPVC) outcomes have improved, however, morbidity and mortality still remain significant. This study aims to assess the early and long-term outcomes of surgical treatment of TAPVC children, operated on between 2006 and 2016, in one pediatric center in Poland. Materials and Methods: Diagnostics, surgical treatment, and follow-up data from 83 patients were collected. In addition, survival and risk factor analyses, control echocardiographic, and electrocardiographic examinations were performed. Results: In the analyzed group (n = 83), there were seven hospital deaths (within 30 days after the operation) (8.4%) and nine late deaths (10.8%). The mean follow-up time was 5.5 years, and, for patients who survived, it was 7.1 years. The mean survival time in patients with completed follow-up (n = 70) was 10.3 years; the overall five-year survival rate was 78.4%. Independent mortality risk factors were type I TAPVC, single ventricle physiology, time from admission to operation, intensive care unit stay, postoperative hospital stay, and temporary kidney insufficiency requiring dialysis. Conclusions: The presence of single ventricle physiology and the supracardiac subtype of TAPVC might be negative prognostic factors, while normal heart physiology presents with good post-repair results. This study indicates that cardiac arrhythmias may occur. Morbidity and mortality, related to surgical TAPVC correction, still remain significant

1114 The number of short-axis series for MR left ventricular analysis can be reduced when a combined long-axis and short-axis analysis strategy is used

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Local electromechanical alterations determine the left ventricle rotational dynamics in CRT-eligible heart failure patients

Abstract Left ventricle, LV wringing wall motion relies on physiological muscle fiber orientation, fibrotic status, and electromechanics (EM). The loss of proper EM activation can lead to rigid-body-type (RBT) LV rotation, which is associated with advanced heart failure (HF) and challenges in resynchronization. To describe the EM coupling and scar tissue burden with respect to rotational patterns observed on the LV in patients with ischemic heart failure with reduced ejection fraction (HFrEF) left bundle branch block (LBBB). Thirty patients with HFrEF/LBBB underwent EM analysis of the left ventricle using an invasive electro-mechanical catheter mapping system (NOGA XP, Biosense Webster). The following parameters were evaluated: rotation angle; rotation velocity; unipolar/bipolar voltage; local activation time, LAT; local electro-mechanical delay, LEMD; total electro-mechanical delay, TEMD. Patients underwent late-gadolinium enhancement cMRI when possible. The different LV rotation pattern served as sole parameter for patients’ grouping into two categories: wringing rotation (Group A, n = 6) and RBT rotation (Group B, n = 24). All parameters were aggregated into a nine segment, three sector and whole LV models, and compared at multiple scales. Segmental statistical analysis in Group B revealed significant inhomogeneities, across the LV, regarding voltage level, scar burdening, and LEMD changes: correlation analysis showed correspondently a loss of synchronization between electrical (LAT) and mechanical activation (TEMD). On contrary, Group A (relatively low number of patients) did not present significant differences in LEMD across LV segments, therefore electrical (LAT) and mechanical (TEMD) activation were well synchronized. Fibrosis burden was in general associated with areas of low voltage. The rotational behavior of LV in HF/LBBB patients is determined by the local alteration of EM coupling. These findings serve as a strong basic groundwork for a hypothesis that EM analysis may predict CRT response. Clinical trial registration: SUM No. KNW/0022/KB1/17/15