The use of remote monitoring of cardiac implantable devices during the COVID-19 pandemic: an EHRA physician survey

It is unclear to what extent the COVID-19 pandemic has influenced the use of remote monitoring (RM) of cardiac implantable electronic devices (CIEDs). The present physician-based European Heart Rhythm Association (EHRA) survey aimed to assess the influence of the COVID-19 pandemic on RM of CIEDs among EHRA members and how it changed the current practice. The survey comprised 27 questions focusing on RM use before and during the pandemic. Questions focused on the impact of COVID-19 on the frequency of in-office visits, data filtering, reasons for initiating in-person visits, underutilization of RM during COVID-19, and RM reimbursement. A total of 160 participants from 28 countries completed the survey. Compared to the pre-pandemic period, there was a significant increase in the use of RM in patients with pacemakers (PMs) and implantable loop recorders (ILRs) during the COVID-19 pandemic (PM 24.2 vs. 39.9%, P = 0.002; ILRs 61.5 vs. 73.5%, P = 0.028), while there was a trend towards higher utilization of RM for cardiac resynchronization therapy-pacemaker (CRT-P) devices during the pandemic (44.5 vs. 55%, P = 0.063). The use of RM with implantable cardioverter-defibrillators (ICDs) and CRT-defibrillator (CRT-D) did not significantly change during the pandemic (ICD 65.2 vs. 69.6%, P = 0.408; CRT-D 65.2 vs. 68.8%, P = 0.513). The frequency of in-office visits was significantly lower during the pandemic (P < 0.001). Nearly two-thirds of participants (57 out of 87 respondents), established new RM connections for CIEDs implanted before the pandemic with 33.3% (n = 29) delivering RM transmitters to the patient's home address, and the remaining 32.1% (n = 28) activating RM connections during an in-office visit. The results of this survey suggest that the crisis caused by COVID-19 has led to a significant increase in the use of RM of CIEDs

Optimising exposure for children and adolescents with anxiety, OCD and PTSD: a systematic review

Cognitive-behavioural therapy is an effective treatment for anxiety disorders in children and young people, however, many do not benefit. Behavioural exposure appears to be the critical ingredient in the treatment of anxiety disorders. Research with adults has identified innovative strategies to optimise exposure-based treatments, yet it is not clear how to optimise the effects of exposure for children and young people. This review was a preliminary exploration of the association between potential optimisation strategies and treatment procedures and outcomes for the treatment of child anxiety symptoms/disorders. We searched PsychInfo and Medline databases using a systematic search strategy and identified 29 articles. We found preliminary evidence that some specific strategies may enhance the effects of exposure, such as dropping safety behaviours, parents and therapists discouraging avoidance, and the use of homework. However, not one significant finding was replicated by another study for the same time point using the same methodology. To a large degree, this lack of replication reflects a limited number of studies combined with a lack of consistency across studies around conceptualisations, methodological approaches, and outcome measures making it difficult to make meaningful comparisons between studies and draw firm conclusions. Examination is needed of a wide range of theoretically-driven potential optimisation strategies using methodologically robust, preclinical studies with children and young people. Furthermore, the methods used in future research must enable comparisons across studies and explore developmental differences in the effects of particular optimisation strategies

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p&nbsp;&lt;.001. Over 24&nbsp;months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10&nbsp;ml/min/1.73&nbsp;m2 decrease), that was most notable in patients with eGFR &lt;30&nbsp;ml/min/1.73&nbsp;m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90&nbsp;ml/min/1.73&nbsp;m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Cardiopoietic cell therapy for advanced ischemic heart failure: results at 39 weeks of the prospective, randomized, double blind, sham-controlled CHART-1 clinical trial

Cardiopoietic cells, produced through cardiogenic conditioning of patients' mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort

How are parental practices and attitudes towards corporal punishment related to child academic, developmental, or psychological–emotional dysfunctioning?

Corporal punishment (CP) is a widely spread disciplining practice among parents and caregivers globally. Our paper aimed to explore the relationship between the parental attitudes towards CP, expected outcomes of CP, and parenting practices on one hand, with the reported dysfunctions of their children, on the other. Additionally, we aimed to explore the relationship between the use of CP and the reported academic, developmental, and psychological–emotional dysfunctions of their children. The present study involved a nationally representative sample of 1186 parents in Serbia, who had at least one child aged 0–18 years at the moment of interviewing. The parents filled out a series of questionnaires on their attitudes towards CP, expectations of CP outcomes, and their parental practices. Findings indicate that parents that report having a child with dysfunctions have positive attitudes towards CP and expect positive outcomes of CP. These parents also report using more CP as a disciplining method, as well as other harsh disciplining practices. We also identified parental positive expectations of CP, use of physical assault, psychological aggression, neglect as significant predictors of reported child dysfunctions severity. Having all the results in mind, we can assume that children with health-related and school-related issues might be at potential risk of further maltreatment.This is the peer reviewed version of the paper:Grujicic, R., Toskovic, O., Lazarević, L. B., Mandic-Maravic, V., Mitkovic-Voncina, M., Radanović, A., Radosavljev-Kircanski, J., Videnović, M., Pekmezovic, T., & Pejovic Milovancevic, M. (2022). How are parental practices and attitudes towards corporal punishment related to child academic, developmental, or psychological–emotional dysfunctioning? European Child & Adolescent Psychiatry. [https://doi.org/10.1007/s00787-022-02061-z

How are parental practices and attitudes towards corporal punishment related to child academic, developmental, or psychological–emotional dysfunctioning?

Corporal punishment (CP) is a widely spread disciplining practice among parents and caregivers globally. Our paper aimed to explore the relationship between the parental attitudes towards CP, expected outcomes of CP, and parenting practices on one hand, with the reported dysfunctions of their children, on the other. Additionally, we aimed to explore the relationship between the use of CP and the reported academic, developmental, and psychological–emotional dysfunctions of their children. The present study involved a nationally representative sample of 1186 parents in Serbia, who had at least one child aged 0–18 years at the moment of interviewing. The parents filled out a series of questionnaires on their attitudes towards CP, expectations of CP outcomes, and their parental practices. Findings indicate that parents that report having a child with dysfunctions have positive attitudes towards CP and expect positive outcomes of CP. These parents also report using more CP as a disciplining method, as well as other harsh disciplining practices. We also identified parental positive expectations of CP, use of physical assault, psychological aggression, neglect as significant predictors of reported child dysfunctions severity. Having all the results in mind, we can assume that children with health-related and school-related issues might be at potential risk of further maltreatment.Peer-reviewed manuscript: [http://ipir.ipisr.org.rs/handle/123456789/908

A real-time inversion attack on the GMR-2 cipher used in the satellite phones

The GMR-2 cipher is a type of stream cipher currently being used in some Inmarsat satellite phones. It has been proven that such a cipher can be cracked using only one single-frame (15 bytes) known keystream but with a moderate executing times. In this paper, we present a new thorough security analysis of the GMR-2 cipher. We first study the inverse properties of the cipher\u27s components to reveal a bad one-way character of the cipher. By then introducing a new concept called ``valid key chain according to the cipher\u27s key schedule, we propose an unprecedented real-time inversion attack using a single-frame keystream. This attack comprises three phases: (1) table generation; (2) dynamic table look-up, filtration and combination; and (3) verification. Our analysis shows that, using the proposed attack, the size of the exhaustive search space for the 64-bit encryption key can be reduced to approximately $2^{13}$ when a single-frame keystream is available. Compared with previous known attacks, this inversion attack is much more efficient. Finally, the proposed attack is carried out on a 3.3-GHz PC, and the experimental results thus obtained demonstrate that the 64-bit encryption-key could be recovered in approximately 0.02 s on average