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Background: The isolated heart apparatus is over 100 years old, but remains a useful research tool today. While designs of many large animal systems have been described in the literature, trouble-shooting and refining such a model to yield a stable, workable system has not been previously described. This paper outlines the issues, in tabular form, that our group encountered in developing our own porcine isolated heart rig with the aim of assisting other workers in the field planning similar work. The paper also highlights some of the modern applications of the isolated heart apparatus. Methods Landrace pigs (50-80 kg) were used in a pilot project to develop the model. The model was then used in a study examining the effects of various cardioplegic solutions on function after reanimation of porcine hearts. During the two projects, non-protocol issues were documented as well as their solutions. These were aggregated in this paper. Results: Issues faced by the group without explicit literature solutions included pig size selection, animal acclimatisation, porcine transoesophageal echocardiography, cannulation and phlebotomy for cross-clamping, cardioplegia delivery, heart suspension and rig tuning. Conclusion: Prior recognition of issues and possible solutions faced by workers establishing a porcine isolated heart system will speed progress towards a useable system for research. The isolated heart apparatus remains applicable in transplant, ischaemia reperfusion, heart failure and organ preservation research. [ABSTRACT FROM AUTHOR]

Background: Point-of-care tests (POCT) can assist general practitioners (GPs) in diagnosing and treating patients with acute cardiopulmonary symptoms, but it is currently unknown if POCT impact relevant clinical outcomes in these patients.Objective: To assess whether using POCT in primary care patients with acute cardiopulmonary symptoms leads to more accurate diagnosis and impacts clinical management.Methods: We performed a systematic review in four bibliographic databases. Articles published before February 2016 were screened by two reviewers. Studies evaluating the effect of GP use of POCT on clinical diagnostic accuracy and/or effect on treatment and referral rate in patients with cardiopulmonary symptoms were included.Results: Our search yielded nine papers describing data from seven studies, on the clinical diagnostic accuracy of POCT in a total of 2277 primary care patients with acute cardiopulmonary symptoms. Four papers showed data on GP use of D-dimer POCT in pulmonary embolism (two studies); two studies on Troponin T in acute coronary syndrome; one on heart-type fatty acid-binding protein (H-FABP) in acute coronary syndrome; one on B-type natriuretic peptide (BNP) in heart failure; one on 3-in-1 POCT (Troponin T, BNP, D-dimer) in acute coronary syndrome, heart failure and/or pulmonary embolism. Only one study assessed the effect of GP use of POCT on treatment initiation and one on actual referral rates.Conclusion: There is currently limited and inconclusive evidence that actual GP use of POCT in primary care patients with acute cardiopulmonary symptoms leads to more accurate diagnosis and affects clinical management. However, some studies show promising results, especially when a POCT is combined with a clinical decision rule. [ABSTRACT FROM AUTHOR]

This paper presents a personal understanding of the work of two prominent writers, namely the English‐Polish author Joseph Conrad and the psychotherapist Robert Hobson. I make particular reference to Conrad's novel Heart of Darkness as a work that decidedly influenced the thinking of Hobson. The allegoric themes evoked provide a landscape of rich contemplation, heavily laden with metaphor and allowing an exploration of suicide and loss. With this, I have attempted to make a statement on the impact that suicide has upon the therapist and, in doing so, provide some clinical and personal vignettes relating to my experience with suicide. I also provide an account of a deeply traumatized patient with dissociative identity disorder and chronic suicidal ideation. These reflections draw upon the language of Conrad and Hobson as suicide is considered both in a concrete literal sense and as an expansive non‐linear metaphor. The term 'Conradian Horror' is given particular salience as evoking the dark and dismal vista of suicide and loss. [ABSTRACT FROM AUTHOR]

This paper discusses recurrent debates over whether there are limits in representing the experience of the Sonderkommando in Auschwitz, with particular reference to art by the survivor David Olère and László Nemes' Saul Fia (Son of Saul). It argues that whilst those Sonderkommando who sought to represent the 'heart of hell' were acutely aware of the limits of representation, they remained resolutely committed to communicating that reality; and concludes that whilst Son of Saul cannot, and does not seek to, fully represent the 'heart of hell,' it nevertheless offers an important creative and provocative exploration of aspects of that experience. [ABSTRACT FROM AUTHOR]

The paper aims to contribute to the expansion of a cultural-geographical scope of studies on heritage contested by Pagans and a better understanding of construction of the religious and the secular in inter-religious heritage contestation. The presented case involves multiple stakeholders and a direct clash of the Catholic church and contemporary Pagans over a contested heritage site currently referred to as the archcathedral and the Cathedral Square located in the historical center of Vilnius, Lithuania. Based on observations of communal practices of Romuva, a community of contemporary Lithuanian Pagans, discourses and actions of the Catholic church and representatives of the Vilnius City Municipality and other relevant secular institutions, the analysis looks at both discursive and performative strategies employed by participants. [ABSTRACT FROM AUTHOR]

This paper introduces a spiritually informed heart led psychotherapy (HLP) model as part of a biopsychosocialspiritual (BPSS) approach in clinical practice. HLP model is based on the premise that everyone is on an individual life journey to understand and experience life lessons such as assertiveness, joy, forgiveness. When clients experience traumas, these can create blocks and restrictions, resulting in repeated cycles of psychological distress in an individual's life. HLP regards the ego as being responsible for maintaining the psychological distress. HLP teaches clients to recognise the impact of their ego, become an observer to challenges so that they can understand that the challenges are the life lesson. Honouring the 'heart and soul' rather than the ego enables clients to experience the lesson, make new choices in keeping with their authentic selves and freedom from suffering. HLP can be integrated into traditional psychotherapies or applied as a standalone therapy as part of the BPSS approach. [ABSTRACT FROM AUTHOR]

A prescribed amount of heat to be removed from biotissues during cryogenic treatment is currently calculated with the use of simple prediction models. Therefore, a significant distinction exists between the calculated and actual doses during the operation. For reliable simulation, it is necessary to have accurate thermal properties of human tissues in a wide low-temperature range, but in the literature the data regarding these thermal properties are inconclusive. In the present paper, the thermal properties of human prostate, kidney, liver, and pancreatic tissues are analyzed. Using differential scanning calorimetry (DSC), the specific heat capacity in the temperature range from –160 to 40oС, the latent heat of melting, and the initial ice melting temperature are measured. The moisture content and cryoscopic temperature of these tissues are also investigated. Due to the difficulties with getting access to a human cardiac muscle and large specimens of other human biotissues, in the present study equivalents (porcine tissues) are used on the basis of their high similarity to human biotissues. In this case, only the thermal conductivity of a porcine cardiac muscle is determined. Based on the measurement results, the thermal properties of the same tissue type and of different types (including healthy tissues and tumors) are compared. The adaptation of experimental data for simulation software is proposed. The impact of the accuracy in determining the thermal properties on the thermal diffusivity is analyzed. The prospects in predicting the thermal properties of different biological tissues are considered. Based on the data obtained, it is possible to more accurately simulate heat transfer during cryoexposure. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to use the Enneagram to understand how thinking (head), feeling (heart), and doing (hand) dimensions of our personality provide a foundation for Christian spiritual formation with relevance for strengthening leadership in the helping professions. Across diverse !elds of study, we consistently !nd these three dimensions of the human experience that are relevant to self-understanding, including leadership development; they are discussed in Enneagram language as three centers of intelligence, or human functioning. Understanding how these function within us can impact our self-awareness as Christians in social work leadership. The Enneagram offers nine distinct personality types organized around these three centers and it teaches balance in how these centers function within one's personality. In contemplative traditions of Christian spirituality, Enneagram re"ection provides a means for wholistic healing and growth and a transformational approach to Christian spirituality for strengthening leadership. [ABSTRACT FROM AUTHOR]

The endogenous and dietary agent, alpha lipoic acid (ALA), is evaluated for its capacity to induce a broad spectrum of adaptive responses via hormetic dose responses and their underlying mechanisms. ALA was shown to induce hormetic effects in a wide range of experimental models within in vitro and in vivo experimental settings which included direct exposure and pre- and post-conditioning experimental protocols. The hormetic effects occur in a broad range of organ systems, including the brain, heart, kidney and other tissues, with possible public health and clinical/therapeutic applications linked to reducing the onset and progression of neurogenerative diseases and also in the preservation of sperm health and functionality during cryopreservation. This paper provides the first integrated assessment of ALA-induced hormetic dose responses. Underlying mechanisms that mediated the occurrence of ALA-induced hormetic effects involved the induction of low levels of ROS that activate key cell signaling antioxidant (e.g. Nrf2) pathways. [Display omitted] • First paper assessing capacity of ALA to induce hormetic dose responses. • ALA was shown to induce hormetic effects in a wide range of experimental models. • Experiments included direct exposure and pre- and post-conditioning protocols. • ALA induced protective effects via hormesis in a broad range of tissues/cell types. • Mechanisms involving low levels of ROS activate key cell signaling pathways. [ABSTRACT FROM AUTHOR]

This essay considers the significance of various efforts – both Protestant and Catholic - to revitalise or revolutionise British religion in the seventeenth century, often seen as compromised by secular entanglement, using the resources of medieval and contemporary mysticism. The engagement with the Rhineland mystics and their Reformation disciples was central to this project, which helped to create the category of 'mysticism' in the English language, as a subversive but vital element in religious life. It is a central argument of this paper that modern 'mysticism' did not emerge simply as a polemical construct. Neither can it be attributed to a reaction against 'the Enlightenment'. Instead, mysticism – understood as a quest to recover a distinct spiritual way in religion, part of a continuous tradition through Christian history – had an agency and provenance of its own. This quest often and increasingly took the form of dissent from the established churches. [ABSTRACT FROM AUTHOR]

We present a wafer-scale fabricated, PDMS-based platform for culturing miniaturized engineered heart tissues (EHTs) which allows highly accurate measurements of the contractile properties of these tissues. The design of the platform is an anisometrically downscaled version of the Heart-Dyno system, consisting of two elastic micropillars inside an elliptic microwell with volume ranging from 3 down to $1\mu \text{L}$ which supports EHT formation. Size downscaling facilitates fabrication of the platform and makes it compatible with accurate and highly reproducible batch wafer-scale processing; furthermore, downscaling reduces the cost of cell cultures and increases assay throughput. After fabrication, the devices were characterized by nanoindentation to assess the mechanical properties of the pillars and transferred to 96-well plates for cell seeding. Regardless the size of the platform, cell seeding resulted in successful formation of EHTs and all tissues were functionally active (i.e. showed cyclic contractions). The precise characterization of the stiffness of the micropillars enabled accurate measurements of the contractile forces exerted by the cardiac tissues through optical tracking of micropillar displacement. The miniature EHT platforms described in this paper represent a proper microenvironment for culturing and studying EHTs. [2020-0130] [ABSTRACT FROM AUTHOR]

Approximately eight of every 1,000 newborns have a congenital heart abnormality, ranging from mild to severe. This paper provides a review of these conditions, beginning with an overview of cardiac embryology, fetal and transitional circulation, newborn cardiac evaluation and principles of newborn cardiac testing. Disorders covered include cyanotic heart defects, persistent pulmonary hypertension of the newborn, acyanotic defects, congestive heart failure and cardiogenic shock, associated congenital heart defects of the dysmorphic newborn, and neonatal arrhythmias. Understanding and appreciation of newborn cardiac physiology is vital for the clinician that is caring for the newborn. [ABSTRACT FROM AUTHOR]

Approximately eight of every 1,000 newborns have a congenital heart abnormality, ranging from mild to severe. This paper provides a review of these conditions, beginning with an overview of cardiac embryology, fetal and transitional circulation, newborn cardiac evaluation and principles of newborn cardiac testing. Disorders covered include cyanotic heart defects, persistent pulmonary hypertension of the newborn, acyanotic defects, congestive heart failure and cardiogenic shock, associated congenital heart defects of the dysmorphic newborn, and neonatal arrhythmias. Understanding and appreciation of newborn cardiac physiology is vital for the clinician that is caring for the newborn. [ABSTRACT FROM AUTHOR]

A relationship between COVID-19 infection and an increasing incidence of atrial fibrillation has been observed. However, the underlying pathophysiology as a precipitant to AF has not been reviewed. This paper will consider the possible pathological and immunological AF mechanisms as a result, of COVID-19 infection. We discuss the role myocardial microvascular pericytes expressing the ACE-2 receptor and their potential for an organ-specific cardiac involvement with COVID-19. Dysfunctional microvascular support by pericytes or endothelial cells may increase the propensity for AF via increased myocardial inflammation, fibrosis, increased tissue edema, and interstitial hydrostatic pressure. All of these factors can lead to electrical perturbances at the tissue and cellular level. We also consider the contribution of Angiotensin, pulmonary hypertension, and regulatory T cells as additional contributors to AF during COVID-19 infection. Finally, reference is given to two common drugs, corticosteroids and metformin, in COVID-19 and how they might influence AF incidence. [ABSTRACT FROM AUTHOR]

Tensions between sentiments and reason are a well-known feature of Rousseau's moral theory. To explain these tensions, this paper appeals to Rousseau's moral foundationalism. In this foundationalism, I argue, feeling and reason operate jointly to establish the content and normativity of moral law. This joint operation is not always smooth, and additionally there is much leeway in this theory, which explains the theory's ability to accommodate various interpretations and emphases as well as its struggle to delimit specific moral laws, choices, and actions. The most important element of this foundationalism is conscience, which does the work of voicing moral laws with content and normativity grounded in moral sentiments. [ABSTRACT FROM AUTHOR]

Unfortunately, in patients with cancer disease, clinical application of antineoplastic drug results in severe side effects of cardiotoxicity. We aim to review the research focused on elimination or reduction of antineoplastic drug-induced cardiotoxicity without affecting its anticancer efficacy by different agens. This study is based on pertinent papers that were retrieved by a selective search using relevant keywords in PubMed and ScienceDirect. Based on mentioned purpose, various strategies were investigated and proposed, and thousands of compounds were screened. The literature mainly focusing on drugs, natural products and herb extracts with therapeutic efficacies as well as non-pharmacological treatment against differently induced cardiotoxicity during treatment in patients with cancers. Larger future studies are necessary to reach a point of secure cytostatic therapy, improved patient survival and quality of life. Until that moment, baseline and serial cardiac evaluation is recommended to facilitate early identification and treatment of cardiotoxicity. [ABSTRACT FROM AUTHOR]

Osteoporosis (OP) is a kind of chronic metabolic osteopathy, which is caused by many factors. In the pre Qin and Qin Han Dynasties, the Huangdi Neijing put forward the theory of "the heart and the small intestine share a paired relationship". In recent years, with the development of medical research, the relationship between intestinal microecology and osteoporosis has become a new research point. Therefore, in this paper, the author of traditional Chinese medicine "heart and small intestine" theory and modern research intestinal microecology and osteoporosis, in order to clarify the relationship between heart small intestine osteoporosis, in order to provide a new idea for the prevention and treatment of osteoporosis and modern research. [ABSTRACT FROM AUTHOR]

The most important diagnostic tool available in assessment of dysfunction of the autonomic control of the heart is the clinical history which must be taken in the greatest possible detail including from the patient and witnesses of the syncope/event. Correct history taking will make many diagnoses avoiding need for further testing and guide further investigation if needed and when appropriate. This paper focusses on the investigation of patients when required, the available tests, their indications, how to perform them for maximum yield and how to interpret the results. Tilt-testing, carotid sinus massage, active stand, cardiovascular autonomic nervous system tests, ambulatory blood pressure and insertable ECG loop recorder are covered. [ABSTRACT FROM AUTHOR]

Background: Respiratory complications have been well remarked in the novel coronavirus disease (SARS-CoV-2/COVID-19), yet an emerging body of research indicates that cardiac involvement may be implicated in poor outcomes for these patients.Aims: This review seeks to gather and distill the existing body of literature that describes the cardiac implications of COVID-19.Materials and Methods: The English literature was reviewed for papers dealing with the cardiac effects of COVID-19.Results: Notably, COVID-19 patients with pre-existing cardiovascular disease are counted in greater frequency in intensive care unit settings, and ultimately suffer greater rates of mortality. Other studies have noted cardiac presentations for COVID-19, rather than respiratory, such as acute pericarditis and left ventricular dysfunction. In some patients there has been evidence of acute myocardial injury, with correspondingly increased serum troponin I levels. With regard to surgical interventions, there is a dearth of data describing myocardial protection during cardiac surgery for COVID-19 patients. Although some insights have been garnered in the study of cardiovascular diseases for these patients, these insights remain fragmented and have yet to cement clear guidelines for actionable clinical practice.Conclusion: While some information is available, further studies are imperative for a more cohesive understanding of the cardiac pathophysiology in COVID-19 patients to promote more informed treatment and, ultimately, better clinical outcomes. [ABSTRACT FROM AUTHOR]

Objectives: This paper introduces a novel method for the detection and classification of aortic stenosis (AS) using the time-frequency features of chest cardio-mechanical signals collected from wearable sensors, namely seismo-cardiogram (SCG) and gyro-cardiogram (GCG) signals. Such a method could potentially monitor high-risk patients out of the clinic. Methods: Experimental measurements were collected from twenty patients with AS and twenty healthy subjects. Firstly, a digital signal processing framework is proposed to extract time-frequency features. The features are then selected via the analysis of variance test. Different combinations of features are evaluated using the decision tree, random forest, and artificial neural network methods. Two classification tasks are conducted. The first task is a binary classification between normal subjects and AS patients. The second task is a multi-class classification of AS patients with co-existing valvular heart diseases. Results: In the binary classification task, the average accuracies achieved are 96.25% from decision tree, 97.43% from random forest, and 95.56% from neural network. The best performance is from combined SCG and GCG features with random forest classifier. In the multi-class classification, the best performance is 92.99% using the random forest classifier and SCG features. Conclusion: The results suggest that the solution could be a feasible method for classifying aortic stenosis, both in the binary and multi-class tasks. It also indicates that most of the important time-frequency features are below 11 Hz.Significance: The proposed method shows great potential to provide continuous monitoring of valvular heart diseases to prevent patients from sudden critical cardiac situations. [ABSTRACT FROM AUTHOR]

This is a review paper on the most significant social problem that aims to raise interest and motivate the society to revitalize Gorski Kotar, respecting the objective value of the area popularly called Mala Švica (Little Switzerland), now known as the 'green heart of Croatia'. Following such slogans that idealize one aspect versus the reality of the area depopulation, the question is how to stop these negative movements. The answer is unambiguous, it should start with children. [ABSTRACT FROM AUTHOR]

The traditional Mongolian medicine (TMM) RuXian-I is an empirical formula specifically used for treating the hyperplasia of mammary gland (HMG) in clinic based on the principles of traditional Mongolian medicine, but the treatment mechanism is not completely clear. In this paper, we elaborated the mechanism of RuXian-I in the treatment of HMG induced by estrogen and progestogen from its toxicity and activity. Firstly, RuXian-I exhibited no toxic effect on HMG rats through no changes of body weight and food intake measurement and no pathologic changes of the organs (heart, liver, spleen, lung, and kidney) detected. Secondly, RuXian-I could decrease the increased nipple height and diameter and remarkably relieve the pathologic changes of HMG rats and also alleviate serum sex hormone levels (estradiol (E2), luteinizing hormone (LH), progesterone (P), and testosterone (T)) of HMG rats. Finally, RuXian-I could obviously inhibit the upregulation level of antiapoptotic protein CRYAB of HMG rats and promote mammary gland cell apoptosis of HMG rats via increases of promoting apoptosis protein caspases-3, 8, and 9 and Bax and tumor suppressor protein p53, decreases of antiapoptosis protein Bcl-2, and release of cytochrome c. These results suggested that RuXian-I has protective and therapeutic effects on HMG rats induced by estrogen and progestogen possibly via promoting apoptotic pathway regulated by CRYAB and is a promising agent for treating HMG. [ABSTRACT FROM AUTHOR]

Objectives: We sought to identify and consider methodological issues that may have limited or confounded investigations into links between depression and acute coronary syndrome (ACS) events.Methods: We reviewed salient research studies to identify such issues.Results: Against previous conclusions, we found that lifetime depression is unlikely to have any primary ACS impact, while we clarify that 'incident depression' (depression commencing at variable periods around the time of the ACS event) appears to confer a greater risk than non-incident depression. As the time periods of incident depressions are likely to have quite differing causes, evaluating any consolidated risk period appears unwise. It remains unclear whether it is 'depression' that provides the risk for ACS events or a higher order factor. Variable use of depression measures and failure to evaluate depressive sub-types have further limited clarification. The response by ACS patients to antidepressant medication appears limited, and it remains to be determined whether exposure to an antidepressant might be a contributing factor. Finally, studies may have focused on an excessively refined association, and neglected to recognise that depression is associated with a wide range of vascular events, suggesting that a broader conceptual model may be required.Limitations: The authors have considered only a limited set of studies in preparing this review, with the critique relying at times on subjective interpretation.Conclusions: After decades of research pursuing links between depression and ACS events explanatory links remain obscure, presumably reflecting a range of methodological issues that we have discussed in this paper . [ABSTRACT FROM AUTHOR]

Beyond the general idea of benefiting society and placating the divine, the polyvalent symbols and meanings of ancient religious sacrifices can be interpreted properly only after combining different disciplinary lenses. In this paper, we systematically scrutinize iconographic and ethnohistorical testimonies together with new skeletal and forensic evidence from across the Mesoamerican landscape in order to survey Mesoamerican heart sacrifices. Here we focus on three different heart-extraction procedures, two of which are characterized for the first time. Each reconstructed method (i.e., from below the chest cavity, between two left ribs, and through the sternal bone) provides novel cues regarding the array of ceremonial devices and native concepts of the human body as a cosmic model. Its partitioning and the liberation of vitalizing matter (namely, the heart and blood) fed specific sacred forces during divine cult and mythic reenactment. As for the Aztecs, we conclude that different trunk-opening procedures were practiced as part of ritual sequences that in each case enabled access to the Cosmic Sacred Mountain with its vivifying essences. In this context, native conceptions surrounding the distinctive heart-extraction techniques pose new proxies for analogous sacrificial practices in other parts of the world still awaiting systematic scrutiny. [ABSTRACT FROM AUTHOR]

Background: Traditional preclinical echocardiography (ECHO) modalities, including 1-dimensional motion-mode (M-Mode) and 2-dimensional long axis (2D-US), rely on geometric and temporal assumptions about the heart for volumetric measurements. Surgical animal models, such as the mouse coronary artery ligation (CAL) model of myocardial infarction, result in morphologic changes that do not fit these geometric assumptions. New ECHO technology, including 4-dimensional ultrasound (4D-US), improves on these traditional models. This paper aims to compare commercially available 4D-US to M-mode and 2D-US in a mouse model of CAL.Methods: 37 mice underwent CAL surgery, of which 32 survived to a 4 week post-operative time point. ECHO was completed at baseline, 1 week, and 4 weeks after CAL. M-mode, 2D-US, and 4D-US were taken at each time point and evaluated by two separate echocardiographers. At 4 weeks, a subset (n = 12) of mice underwent cardiac magnetic resonance (CMR) imaging to serve as a reference standard. End systolic volume (ESV), end diastolic volume (EDV), and ejection fraction (EF) were compared among imaging modalities. Hearts were also collected for histologic evaluation of scar size (n = 16) and compared to ECHO-derived wall motion severity index (WMSI) and global longitudinal strain as well as gadolinium-enhanced CMR to compare scar assessment modalities.Results: 4D-US provides close agreement of ESV (Bias: -2.55%, LOA: - 61.55 to 66.66) and EF (US Bias: 11.23%, LOA - 43.10 to 102.8) 4 weeks after CAL when compared to CMR, outperforming 2D-US and M-mode estimations. 4D-US has lower inter-user variability as measured by intraclass correlation (ICC) in the evaluation of EDV (0.91) and ESV (0.93) when compared to other modalities. 4D-US also allows for rapid assessment of WMSI, which correlates strongly with infarct size by histology (r = 0.77).Conclusion: 4D-US outperforms M-Mode and 2D-US for volumetric analysis 4 weeks after CAL and has higher inter-user reliability. 4D-US allows for rapid calculation of WMSI, which correlates well with histologic scar size. [ABSTRACT FROM AUTHOR]

Shelley's Heart is a locative learning tool geo-linked to the churchyard where Mary Shelley is buried along with the heart of her husband, poet Percy Shelley. To commemorate the 200th anniversary of the publication of Frankenstein, this interactive multi-media project debuted on Halloween night, 2018. Featuring biographical facts, quotes and fictional narratives related to the Shelleys and their friends, John Keats and Lord Byron, it provides an active learning experience that is freely available to the general public. Locative projects often feature either factual information (museum audio guides), or fictional stories (ambient literature), but Shelley's Heart combines fact and fiction in order to promote critical thinking. Refining this approach required extensive trial and error experimentation, collaborative brainstorming, user testing, and several phases of production. Insights garnered from this process led to the development of strategies that simultaneously promote implicit and explicit cognition. Cognitive science refers to this interplay as, the 'dual process model' [Kahneman, D. 2011. Thinking, Fast and Slow. New York: Farrar, Straus and Giroux]. This paper explores how the creation of Shelley's Heart led to the development of three key dual process design strategies: 'Match,' 'Affect' and 'Prime', collectively known as 'MAP'. [ABSTRACT FROM AUTHOR]

This paper was originally given as a lecture at the annual meeting of the NACCC, and offers a practical reflection on the rich heritage of the congregational way. Although the best known tenet of congregationalism may be the autonomy and completeness of the local church, this is rooted in the voluntary covenant that binds a church together. This is linked with two other ecclesial treasures of our heritage: faith and service. Matthew 6.21 'Where your treasure is, there your heart will be also', the becomes a promise, as 'Our hearts are rooted deep in this rich, Congregational heritage,' from which our treasure springs. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to assess the role of radiologists, cardiologists, and other medical and non-medical figures in cardiac magnetic resonance imaging (MRI) research in the last 34 years, focusing on first and last authorship, number of published studies, and journal impact factors (IF). Methods: Articles in the field of cardiac MRI were considered in this systematic review and retrospective bibliometric analysis. For included studies, the first and last authors were categorized as cardiologists, radiologists/nuclear medicine physicians, medical doctors (MD) with specialties in both cardiology and radiology/nuclear medicine, and other MD and non-MD. Differences in the number of papers published overall and by year and institution location for the first and last author category were assessed. Mean IF differences between author categories were also investigated. Results: A total of 2053 articles were included in the final analysis. For the first authors (n = 2011), 52% were cardiologists, 22% radiologists/nuclear medicine physicians, 16% other MD, 10% other non-MD, and 1% both cardiologists and radiologists/nuclear medicine physicians. Similarly, the last authors (n = 2029) resulted 54% cardiologists, 22% radiologists/nuclear medicine physicians, 15% other MD, 8% other non-MD, and 2% both cardiologists and radiologists/nuclear medicine physicians. No significant differences due to institution location in the first and last authorship proportions were found. Average journal IF was significantly higher for cardiologist first and last authors when compared to that of radiologists/nuclear medicine physicians (both p < 0.0001). Conclusion: Over 50% of studies in the field of cardiac MRI published in the last 34 years are conducted by cardiologists. [ABSTRACT FROM AUTHOR]

Combining Phonocardiography (PCG) and Electrocardiography (ECG) data has been recognized within the state-of-the-art as of added value for enhanced cardiovascular assessment. However, multiple aspects of ECG data acquisition in a stethoscope form factor remain unstudied, and existing devices typically enforce a substantial change into routine clinical auscultation procedures, with predictably low technology acceptance. As such, in this paper, we present a novel approach to ECG data acquisition throughout the five main cardiac auscultation points, and that intends to be incorporated in a commonly used electronic stethoscope. Therefore, it enables analysis and acquisition of both PCG and ECG signals in a single pass. We describe the development, experimental evaluation, and comparison of the ECG signals obtained using our proposed approach and a gold standard medical device, through metrics that allow the evaluation of morphological similarities. Results point to a high correlation between the two evaluated setups, thus supporting the idea of meaningfully collecting ECG data along medical auscultation points with the proposed form factor. Moreover, this work has led us to conclude that for the studied population, signals acquired on focuses F1, F2, and F3 are usually highly correlated with leads V1 and V2 of the standard ECG medical recording procedure. [ABSTRACT FROM AUTHOR]

This paper begins with the understanding that early trauma leads to powerful dissociative defenses which injure the capacity to feel. It further explores ways to restore this capacity through body-centred attention to affect-in-the-moment in the psychoanalytic situation. Using the author's personal experience while in analysis as well as a case of severe early trauma, he demonstrates the consciousness-killing effect of primitive defenses and shows how body-sensitive techniques hold the promise of restoring the patient's sense of aliveness and hence, opening the unconscious to those affect-images that are the building blocks of the human imagination. A final section focuses on the neglect of feeling in Jungian psychology and suggests that the "creation of consciousness" which Jung described as his personal myth, is quintessentially a process of emotional transformation - of bringing unconscious suffering into consciousness - as feelings. [ABSTRACT FROM AUTHOR]

The electrocardiogram (ECG) is a widely disseminated method for detecting heart diseases due to its lower cost than other tests. But, some steps are important for detecting cardiac arrhythmias in ECG signals, which are: preprocessing, segmentation, feature extraction and classification. In this work, we assess how four non-morphological feature extraction methods provide useful ECG classification. Moreover, we propose an innovation in the configuration of the structural co-occurrence matrix (SCM), by combining it with the Fourier transform to extract the main frequencies of the signal. We tested theses methods on four well-known classifiers used in the literature and compare the results with six classical feature extraction methods. Moreover, we followed high standard protocols for developing expert systems for clinical usage. The database chosen for evaluation is the MIT-BIH arrhythmia database. We increased the identification of heart dysrhythmia by 2%, representing an advance on reports on the literature. The developed system is 1.3% more reliable than the current best approach reported, being 10 6 times faster, as well. The HOS with naive Bayes classified pathologies in 22 patients with 94.3% of accuracy. We perceived that SCM–Fourier is 1.5% more accurate than the SCM or Fourier standalone. The feature extractor proposed in this paper compress 97% of the useful information to provide a reliable arrhythmia classification. [ABSTRACT FROM AUTHOR]

In this paper I would like to begin to open up some of the thinking of French philosopher Simone Weil and consider how it might inform our work as existential psychotherapists. It seems to me that this (female) thinker, whose thought is deeply existential, has generally been overlooked in the established canon of existential philosophers. And yet she was once described by Albert Camus as 'the only great spirit of our time'. I will propose that Weil has something to offer us, particularly in her thinking on the nothingness (which she terms God) at the heart of Being and her concept of affliction, and, most challenging of all, her assertion that beauty can exist in the deepest affliction. I will begin by drawing some parallels with other existential thinkers, most notably Heidegger, to illustrate how the basic tenets of Weil's thought are deeply existential. I will then offer up some glimpses of Weil's thinking, noticing how it appears to us and penetrates us though the language of poetry, that is to say most particularly metaphor, and I will demonstrate with two case vignettes how her thought can enrich and enlighten our existential work with clients. [ABSTRACT FROM AUTHOR]

Biomedical wearable sensors enable long-term monitoring applications and provide instantaneous diagnostic capabilities. Physiological monitoring can help in both the diagnosis and the ongoing treatment of a vast number of cardiovascular and pulmonary diseases such as hypertension, dysrhythmia, and asthma. In this paper, we present a system capable of monitoring several vital signals and physiological variables that determine the cardiopulmonary activity status. We explore direct measurements of multiple vital parameters with only one sensor and without special constraints. The system employs a PZT-4 piezo transducer stimulated by a suitable analog front end. The system both generates pulsed ultrasound waves at 1 MHz and amplifies reflected echoes to track internal organ motions, mainly that of the heart apex. According to the respiratory motion of the heart, the proposed system provides respiratory and heart cycles information. Promising results were obtained from six subjects with an average accuracy of 96.7% in heartbeats per minute measurement, referenced to a commercial photoplethysmography sensor. It also exhibits 94.5% sensitivity and 94.0% specificity in respiration detection compared to a spirometer signal as a reference. [ABSTRACT FROM AUTHOR]

In this paper, we recall the basic features of the CospanSpan(Graph) algebra for the compositional description of reconfigurable hierarchical networks. In particular, we focus on compositionality and on the possibility of describing the interactions among physical/biological systems, using a parallel with communication operation not considered in the usual Kleene's algebra. As a novel application, we give a complete compositional description in Span(Graph) of a simplified version of the heart system. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyze the portrayal of Native American people and traditions in Charles de Lint's most recent novel The Wind in His Heart (2017). The theoretical framework for the proposed analysis will be provided by Gerald Vizenor's works dealing with the depiction of Indigenous communities in mainstream (predominantly white) culture and Marek Oziewicz's One Earth, One People (2008) in which the author examines the restorative power of mythopoeic fantasy. Since the works of Charles de Lint, which belong to the category of mythopoeic fantasy, implicitly argue that Indigenous spirituality may play a significant role in the process of restoration discussed by Oziewicz, the inclusion of Oziewicz's perspective will contribute to the overall assessment of de Lint's portrayal of Native people and traditions. [ABSTRACT FROM AUTHOR]

• To present a very recent systematic survey about online heart monitoring systems. • To highlight the number of remote technologies enabled to aid cardiac patient and family. • The IoT-based techniques found are identified and its advances and open issues are discussed. • This survey is interesting both for researchers and health professionals. The Internet of Health Things promotes personalized and higher standards of care. Its application is diverse and attracts the attention of a substantial section of the scientific community. This approach has also been applied by people looking to enhance quality of life by using this technology. In this paper, we perform a survey that aims to present and analyze the advances of the latest studies based on medical care and assisted environment. We focus on articles for online monitoring, detection, and support of the diagnosis of cardiovascular diseases. Our research covers published manuscripts in scientific journals and recognized conferences since the year 2015. Also, we present a reference model based on the evaluation of the resources used from the selected studies. Finally, our proposal aims to help future enthusiasts to discover and enumerate the required factors for the development of a prototype for online heart monitoring purposes. [ABSTRACT FROM AUTHOR]

Uncertainty and imprecision play an important role in the specification and analysis of complex systems. Therefore, it is important to provide methodologies and tools to support the correct development of these systems. In this paper we present a new formalism, based on fuzzy automata, to facilitate the different phases involved in the development of a system where information is fuzzy. The formal syntax and semantics of our formalism are based on previous work, which has been adapted to be easily implemented and automated. We introduce a methodology to analyze systems modelled with one of our fuzzy automata. Finally, we show how our framework can be used to define a model of the heart based on electrocardiograms (ECGs) and use this model to analyze data of real patients. [ABSTRACT FROM AUTHOR]

In this paper we present a compact version of the Heart iteration. One that computes low-rank approximations of large sparse matrices. The new iteration is a restarted Krylov method that is based on explicit restarts and Gram–Schmidt orthogonalizations. It is a simple algorithm that requires a minimal amount of computer storage as well as a minimal number of matrix–vector products per iteration. Yet it enjoys a fast rate of convergence. Numerical experiments illustrate the usefulness of the proposed approach. [ABSTRACT FROM AUTHOR]

• Gas bubbles in a non-Newtonian fluid under the influence of an external acoustic. • It transforms the generalized RP-equation for viscoelastic fluids. • A wide range of physical parameter values to address convergence issues. • Response Surface Methodology (RSM) is employed to investigate. • Rheological fluid on the pressure threshold required for inertial cavitation. Ultrasound imaging, or sonography, utilizes high-frequency sound waves to create images of the internal structures of the human body. It is widely applied in medical diagnostics due to its non-invasive nature and real-time capabilities. Ultrasound waves are emitted into the body, and their reflections are captured to generate detailed images of organs, tissues, fetuses during pregnancy, and more. The interaction between sound waves and biological tissues and issues related to propagation, reflection, and absorption of ultrasound are crucial considerations for improving image quality and safety. It is frequently used to keep an eye on the health and development of the fetus throughout pregnancy. The examination of several organs, including the heart, liver, kidneys, and blood arteries, is also done to look for anomalies, tumors, and other diseases. The dynamics of spherical gas bubbles within a non-Newtonian fluid exposed to an external sonic field are examined in this paper. The mathematical model offers a useful foundation for examining bubble behavior since it incorporates the additional stress tensor of a tangent hyperbolic fluid. The generalized RP problem may be transformed into an ordinary differential equation that can be solved using numerical methods, allowing a large range of parameter values to be investigated and resolving convergence difficulties. Particularly noteworthy are the numerical results for long acoustic cycles. The link between input and output variables is also investigated using an experimental methodology closely related to sensitivity analysis, which is important for possible device development. This innovative approach offers a fresh perspective on the subject. [ABSTRACT FROM AUTHOR]

We introduce Branched Latent Neural Maps (BLNMs) to learn finite dimensional input–output maps encoding complex physical processes. A BLNM is defined by a simple and compact feedforward partially-connected neural network that structurally disentangles inputs with different intrinsic roles, such as the time variable from model parameters of a differential equation, while transferring them into a generic field of interest. BLNMs leverage latent outputs to enhance the learned dynamics and break the curse of dimensionality by showing excellent in-distribution generalization properties with small training datasets and short training times on a single processor. Indeed, their in-distribution generalization error remains comparable regardless of the adopted discretization during the testing phase. Moreover, the partial connections, in place of a fully-connected structure, significantly reduce the number of tunable parameters. We show the capabilities of BLNMs in a challenging test case involving biophysically detailed electrophysiology simulations in a biventricular cardiac model of a pediatric patient with hypoplastic left heart syndrome. The model includes a 1D Purkinje network for fast conduction and a 3D heart-torso geometry. Specifically, we trained BLNMs on 150 in silico generated 12-lead electrocardiograms (ECGs) while spanning 7 model parameters, covering cell-scale, organ-level and electrical dyssynchrony. Although the 12-lead ECGs manifest very fast dynamics with sharp gradients, after automatic hyperparameter tuning the optimal BLNM, trained in less than 3 h on a single CPU, retains just 7 hidden layers and 19 neurons per layer. The resulting mean square error is on the order of 1 0 − 4 on an independent test dataset comprised of 50 additional electrophysiology simulations. In the online phase, the BLNM allows for 5000x faster real-time simulations of cardiac electrophysiology on a single core standard computer and can be employed to solve inverse problems via global optimization in a few seconds of computational time. This paper provides a novel computational tool to build reliable and efficient reduced-order models for digital twinning in engineering applications. The Julia implementation is publicly available under MIT License at https://github.com/StanfordCBCL/BLNM.jl. [ABSTRACT FROM AUTHOR]

Organ transplantation is the ultimate option to treat terminal illness by transplanting the deceased or damaged organs with healthy organs for improving the patient's life expectancy. The number of organs needed and the organs available for transplantation vary enormously. The tremendous advancements in utilizing big data analytics in the healthcare system make it efficient to explore decision-making information. To make optimal decisions in organ transplantation, this paper proposes a modified convolutional neural network-hybrid extreme learning machine (MCNN-HELM) based prediction model. The proposed MCNN-HELM model utilizes three different real-time datasets as inputs which contain records of liver, heart, and lung transplantation details of the donor and recipient. At first, the missing values and inaccurate data present in real-time datasets are removed via pre-processing. The pre-processed data are then trained using the MCNN-HELM model that efficiently determines the suitable donor for the recipient by minimizing the waiting time of the recipient for the matching organ donor. Moreover, the MCNN-HELM model gives initial preference to patients with high-risk rates to improve their quality of life. The proposed MCNN-HELM model achieves training accuracy of 97.5% with a computational time of 2.2 s, while the precision value of estimated factual outcomes, potential outcomes, and the accuracy of the best donor type are obtained by 16.3582, 16.1401, and 0.6784 which are more efficient than other state-of-the-art methods. [ABSTRACT FROM AUTHOR]

LINKED CONTENT: This article is linked to Wiese et al paper. To view this article, visit https://doi.org/10.1111/apt.17533 [ABSTRACT FROM AUTHOR]

The next generation of implantable leadless pacemakers will require vibrational energy harvesters in order to increase the lifetime of the pacemaker. This paper reports for the first time the use of a piezoelectric MEMS linear energy harvester device that fits inside a pacemaker capsule. The silicon based MEMS cantilever device uses CMOS compatible Aluminum Nitride as the piezoelectric layer. The developed harvester operates based on a shock-induced vibration that is generated from the low frequency (60–240 beats per minute) high acceleration (>1 g) vibration of the heart. The off-resonance, high g impulses force the high-frequency harvester to oscillate at its resonant frequency. A power density of 97 and 454 μW cm −3 g −2 was achieved for a heart rate of 60 and 240 beats per minute respectively. The forced oscillation causes the linear harvester to dampen after 100–200 ms which reduces the average power compared to a typical sinusoidal excitation. A two and four cantilever system occupies 35% and 70% of the overall volume of the capsule while obtaining 2.98 and 5.96 μW respectively at a heart rate of 60 bpm respectively and 1 g acceleration. The results in this paper demonstrate that a shock-induced linear MEMS harvester can produce enough electrical energy from the vibration of a heart to power a leadless pacemaker while maintaining a small volume. [ABSTRACT FROM AUTHOR]

Objectives: The use of remote sensing technologies such as radar is gaining popularity as a technique for contactless detection of physiological signals and analysis of human motion. This paper presents a methodology for classifying different events in a collection of phase modulated continuous wave radar returns. The primary application of interest is to monitor inmates where the presence of human vital signs amidst different, interferences needs to be identified. Methods: A comprehensive set of features is derived through time and frequency domain analyses of the radar returns. The Bhattacharyya distance is used to preselect the features with highest class separability as the possible candidate features for use in the classification process. The uncorrelated linear discriminant analysis is performed to decorrelate, denoise, and reduce the dimension of the candidate feature set. Linear and quadratic Bayesian classifiers are designed to distinguish breathing, different human motions, and nonhuman motions. The performance of these classifiers is evaluated on a pilot dataset of radar returns that contained different events including breathing, stopped breathing, simple human motions, and movement of fan and water. Results: Our proposed pattern classification system achieved accuracies of up to $93$% in stationary subject detection, $90$% in stop-breathing detection, and $86$% in interference detection. Conclusion: Our proposed radar pattern recognition system was able to accurately distinguish the predefined events amidst interferences. Significance: Besides inmate monitoring and suicide attempt detection, this paper can be extended to other radar applications such as home-based monitoring of elderly people, apnea detection, and home occupancy detection. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper is to increase the accuracy of human cardiac diffusion tensor (DT) estimation in diffusion magnetic resonance imaging (dMRI) with a few diffusion gradient directions. Methods: A structure prior constrained (SPC) method is proposed. The method consists in introducing two regularizers in the conventional nonlinear least squares estimator. The two regularizers penalize the dissimilarity between neighboring DTs and the difference between estimated and prior fiber orientations, respectively. A novel numerical solution is presented to ensure the positive definite estimation. Results: Experiments on ex vivo human cardiac data show that the SPC method is able to well estimate DTs at most voxels, and is superior to state-of-the-art methods in terms of the mean errors of principal eigenvector, second eigenvector, helix angle, transverse angle, fractional anisotropy, and mean diffusivity. Conclusion: The SPC method is a practical and reliable alternative to current denoising- or regularization-based methods for the estimation of human cardiac DT. Significance: The SPC method is able to accurately estimate human cardiac DTs in dMRI with a few diffusion gradient directions. [ABSTRACT FROM AUTHOR]

Objective: A novel method is developed to identify ablation targets for the catheter treatment of ventricular tachycardia (VT). Methods: The method is based on pace-mapping, which is a validated technique to determine the catheter ablation targets. Conventionally, it consists of stimulating the heart ventricle from various sites and comparing the resulting activation pathways to that of a clinical VT by the analysis of surface electrocardiograms (ECG). In this paper, a novel pace-mapping method is presented, which does not require a reference ECG recording of the VT. A three-dimensional correlation gradient map is reconstructed by semiautomatic analysis of ECG morphological changes within the network of pace-mapping sites. In these maps, abnormal points are identified by high correlation gradient values (i.e., corresponding to slow propagation of the electric influx, as in the core of the reentrant VT circuit). The relation between the conventional and reference-less method is described theoretically and evaluated in a retrospective study including 24 VT ablation procedures. Results: The “reference-less” method was able to identify normal points with a high accuracy (negative predictive value: NPV = 97%), and to detect more abnormal points, as predicted by the theory. Correlation gradients computed by the proposed method were significantly higher in ablation zones than in other zones of the ventricle (p < 10–12), indicating excellent prediction of the ablation targets. Significance: The reference-less method might either be used in complement of the conventional method or to treat patients in whom VT cannot be induced during the intervention. [ABSTRACT FROM AUTHOR]

This paper presents a novel method of classifying heart conditions from an electrocardiography (ECG) signal. For this purpose, the R-R intervals of ECG signal are analyzed by Gamma distribution parameters and classified into normal (NR) or abnormal (AN) ECG waves. For the normal ECG waves, the heart condition is further investigated by analyzing the dynamic behavior of heart activity based on the correlation between successive R-R intervals and long-term analysis. The classification of heart conditions is made by estimating the conditional class probabilities using class probability output networks (CPONs). The simulation for classifying heart conditions using the MIT-BIH data sets reveals that the proposed approach is effective for classifying heart conditions and allows more accurate classification than the existing classifiers such as the k-NN and SVM. [ABSTRACT FROM AUTHOR]

The maturation of photon-counting detector (PCD) technology promises to enhance routine CT imaging applications with high-fidelity spectral information. In this paper, we demonstrate the power of this synergy and our complementary reconstruction techniques, performing 4D, cardiac PCD-CT data acquisition and reconstruction in a mouse model of atherosclerosis, including calcified plaque. Specifically, in vivo cardiac micro-CT scans were performed in four ApoE knockout mice, following their development of calcified plaques. The scans were performed with a prototype PCD (DECTRIS, Ltd.) with 4 energy thresholds. Projections were sampled every 10 ms with a 10 ms exposure, allowing the reconstruction of 10 cardiac phases at each of 4 energies (40 total 3D volumes per mouse scan). Reconstruction was performed iteratively using the split Bregman method with constraints on spectral rank and spatio-temporal gradient sparsity. The reconstructed images represent the first in vivo, 4D PCD-CT data in a mouse model of atherosclerosis. Robust regularization during iterative reconstruction yields high-fidelity results: an 8-fold reduction in noise standard deviation for the highest energy threshold (relative to unregularized algebraic reconstruction), while absolute spectral bias measurements remain below 13 Hounsfield units across all energy thresholds and scans. Qualitatively, image domain material decomposition results show clear separation of iodinated contrast and soft tissue from calcified plaque in the in vivo data. Quantitatively, spatial, spectral, and temporal fidelity are verified through a water phantom scan and a realistic MOBY phantom simulation experiment: spatial resolution is robustly preserved by iterative reconstruction (10% MTF: 2.8–3.0 lp/mm), left-ventricle, cardiac functional metrics can be measured from iodine map segmentations with ~1% error, and small calcifications (615 μm) can be detected during slow moving phases of the cardiac cycle. Given these preliminary results, we believe that PCD technology will enhance dynamic CT imaging applications with high-fidelity spectral and material information. [ABSTRACT FROM AUTHOR]