Acute left ventricular dysfunction secondary to right ventricular septal pacing in a woman with initial preserved contractility: a case report

<p>Abstract</p> <p>Introduction</p> <p>Right ventricular apical pacing-related heart failure is reported in some patients after long-term pacing. The exact mechanism is not yet clear but may be related to left ventricular dyssynchrony induced by right ventricular apical pacing. Right ventricular septal pacing is thought to deteriorate left ventricular function less frequently because of a more normal left ventricular activation pattern.</p> <p>Case presentation</p> <p>We report the case of a 55-year-old Tunisian woman with preserved ventricular function, implanted with a dual-chamber pacemaker for complete atrioventricular block. Right ventricular septal pacing induced a major ventricular dyssynchrony, severe left ventricular ejection fraction deterioration and symptoms of congestive heart failure. Upgrading to a biventricular device was associated with a decrease in the symptoms and the ventricular dyssynchrony, and an increase of left ventricular ejection fraction.</p> <p>Conclusion</p> <p>Right ventricular septal pacing can induce reversible left ventricular dysfunction and heart failure secondary to left ventricular dyssynchrony. This complication remains an unpredictable complication of right ventricular septal pacing.</p

Aims and challenges of handicraft and home economics education in Estonia

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Youth representations of environmental protest

A necessary condition for a functioning democracy is the participation of its citizens, including its youth. This is particularly true for political participation in environmental decisions because these decisions can have intergenerational consequences. In this article we examine young people’s beliefs about one form of political participation - protest - in the context of communities affected by fracking and associated anti-fracking protest, and discuss the implications of these representations for education. Drawing on focus groups with 121 young people (age 15-19) in 5 schools and colleges near sites which have experienced anti-fracking protest in England and Northern Ireland, we find young people well-informed about avenues for formal and non-formal political participation against a background of disillusionment with formal political processes and varying levels of support for protest. We find representations of protest as disruptive, divisive, extreme, less desirable than other forms of participation, and ineffective in bringing about change but effective in awareness-raising. These representations are challenging, not least because the way protest is interpreted is critical to the way people think and act in the world. These representations of environmental protest must be challenged through formal education in order to safeguard the UN Convention on the Rights of the Child and ensure that the spirit of Article 11 of the UK Human Rights Act is protected

CRISPR/Cas9-targeted enrichment and long-read sequencing of the Fuchs endothelial corneal dystrophy–associated TCF4 triplet repeat

PURPOSE: To demonstrate the utility of an amplification-free long-read sequencing method to characterize the Fuchs endothelial corneal dystrophy (FECD)-associated intronic TCF4 triplet repeat (CTG18.1). METHODS: We applied an amplification-free method, utilizing the CRISPR/Cas9 system, in combination with PacBio single-molecule real-time (SMRT) long-read sequencing, to study CTG18.1. FECD patient samples displaying a diverse range of CTG18.1 allele lengths and zygosity status (n = 11) were analyzed. A robust data analysis pipeline was developed to effectively filter, align, and interrogate CTG18.1-specific reads. All results were compared with conventional polymerase chain reaction (PCR)-based fragment analysis. RESULTS: CRISPR-guided SMRT sequencing of CTG18.1 provided accurate genotyping information for all samples and phasing was possible for 18/22 alleles sequenced. Repeat length instability was observed for all expanded (≥50 repeats) phased CTG18.1 alleles analyzed. Furthermore, higher levels of repeat instability were associated with increased CTG18.1 allele length (mode length ≥91 repeats) indicating that expanded alleles behave dynamically. CONCLUSION: CRISPR-guided SMRT sequencing of CTG18.1 has revealed novel insights into CTG18.1 length instability. Furthermore, this study provides a framework to improve the molecular diagnostic accuracy for CTG18.1-mediated FECD, which we anticipate will become increasingly important as gene-directed therapies are developed for this common age-related and sight threatening disease

Audience research at the crossroads: the 'implied audience' in media and cultural theory

While audience research, particularly reception studies, has successfully furthered the diverse traditions from which it developed, there now seems to be some uncertainty about the way forward: audience research is at a crossroads. This article argues that the future agenda should not restrict itself to repeating the cultural studies 'canon' of reception research, but should strengthen external relations between audience research and other domains of media and cultural studies, challenging the 'implied audience' - the ways in which audiences are theorized outside audience theory — within the realms of political, policy, technological, economic and social theory. It is further proposed that by developing a multi-level conception of audiences that analytically links the macro and the micro, several existing problems facing reception studies - particularly concerning the nature of audience activity and resistance - may be addressed

Stakeholder discourses about critical literacies and audience participation

[Excerpt] In an increasingly mediatized and datafied society, critical literacies, including critical data literacies, are crucial to navigate through online and offline environments in everyday life (see Chapter 9, this book). In this chapter, we argue that more attention must be paid to critical literacies, particularly in the context of emerging technological environments, if we are to aspire for more consistent patterns of connection between micro and macro socio-political actions.[...](undefined)info:eu-repo/semantics/publishedVersio