11 research outputs found

    Optical mapping and optogenetics in cardiac electrophysiology research and therapy:a state-of-the-art review

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    State-of-the-art innovations in optical cardiac electrophysiology are significantly enhancing cardiac research. A potential leap into patient care is now on the horizon. Optical mapping, using fluorescent probes and high-speed cameras, offers detailed insights into cardiac activity and arrhythmias by analysing electrical signals, calcium dynamics, and metabolism. Optogenetics utilizes light-sensitive ion channels and pumps to realize contactless, cell-selective cardiac actuation for modelling arrhythmia, restoring sinus rhythm, and probing complex cell–cell interactions. The merging of optogenetics and optical mapping techniques for ‘all-optical’ electrophysiology marks a significant step forward. This combination allows for the contactless actuation and sensing of cardiac electrophysiology, offering unprecedented spatial–temporal resolution and control. Recent studies have performed all-optical imaging ex vivo and achieved reliable optogenetic pacing in vivo, narrowing the gap for clinical use. Progress in optical electrophysiology continues at pace. Advances in motion tracking methods are removing the necessity of motion uncoupling, a key limitation of optical mapping. Innovations in optoelectronics, including miniaturized, biocompatible illumination and circuitry, are enabling the creation of implantable cardiac pacemakers and defibrillators with optoelectrical closed-loop systems. Computational modelling and machine learning are emerging as pivotal tools in enhancing optical techniques, offering new avenues for analysing complex data and optimizing therapeutic strategies. However, key challenges remain including opsin delivery, real-time data processing, longevity, and chronic effects of optoelectronic devices. This review provides a comprehensive overview of recent advances in optical mapping and optogenetics and outlines the promising future of optics in reshaping cardiac electrophysiology and therapeutic strategies

    Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment Options

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    Atrial fibrillation (AF) is the most common cardiac arrhythmia. AF increases the risk of stroke, heart failure, dementia, and hospitalization. Obesity significantly increases AF risk, both directly and indirectly, through related conditions, like hypertension, diabetes, and heart failure. Obesity-driven structural and electrical remodeling contribute to AF via several reported mechanisms, including adiposity, inflammation, fibrosis, oxidative stress, ion channel alterations, and autonomic dysfunction. In particular, expanding epicardial adipose tissue during obesity has been suggested as a key driver of AF via paracrine signaling and direct infiltration. Weight loss has been shown to reverse these changes and reduce AF risk and recurrence after ablation. However, studies on how obesity affects pharmacologic or interventional AF treatments are limited. In this review, we discuss mechanisms by which obesity mediates AF and treatment outcomes, aiming to provide insight into obesity-drug interactions and guide personalized treatment for this patient subgroup.</p

    Failure to thrive in an Australian context: a clinical profile

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    This paper explores the identffication of a pilot sample of Australian failure to thrive (FTT) infants in a New South Wales community setting. It examines problems of infant recruitment to date and describes the subsequent shift in research focus since the onset of the proiect in 2000. Part II of the paper presents a clinical profile of failure to thrive in an Australian infant of 8 months

    Competency in paediatric dysphagia: a professonal requirement for speech pathologists in Australia

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    Although dysphagia competency with clients of all ages is a professional requirement for speech pathologists working in Australia (see the Competency-Based Occupational Standards, Speech Pathology Australia, 2001), undergraduate speech pathology students have overall less clinical and theoretical exposure to paediatric dysphagia than adult dysphagia. Except for Jakobs (2004) and Mathisen (2003, 2004), no researchers have explored the extent to which the speech pathology profession is equipped to meet the increasing demand for service provision in paediatric dysphagia across the Australian health sector. This paper highlights the need for tertiary institutions to increase clinical and theoretical training in paediatric dysphagia at both the undergraduate and postgraduate level

    Digital disruption in retailing and beyond

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    The increased disruption of business models through digital technologies creates opportunities and challenges for retail businesses and their network partners. Digital transformation – the process of digitalization of previously analogue operations, procedures, organizational tasks, and managerial processes in order to drive value for customers, employees and other stakeholders – is the order of the day. With that in mind, this article provides a purposeful overview of research in the field of digital transformation with a focus on retailing and customer-facing functions of digital technologies such as managing customer journeys, assessing the impact of sensory marketing and the use of service robots on the one hand, and their strategic implications for business models such as servitization on the other. This article concludes by highlighting immediate as well as long-term challenges in the field, with a focus on disruptive technologies, innovations and trends that retail marketing-management will likely face in the near future.</p

    Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

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    Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

    The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis