1,532 research outputs found
Deep learning-based insights on T:R ratio behaviour during prolonged screening for S-ICD eligibility
No full textDr. Mohamed ElRefai is receiving unrestricted grant from Boston Scientific. Dr. Benedict Wiles has received unrestricted research funding and consultancy payments from Boston Scientific. Dr. Paul Roberts receives consultancy fees from Boston Scientific and Medtronic. The other authors declare no competing interests.Peer reviewe
Personalising device therapy by redefining the sensing mechanism of the subcutaneous implantable cardioverter defibrillator
No full textVentricular tachyarrhythmias (VTA) are rapid abnormal heart rhythms which can result in haemodynamic compromise, collapse and sudden cardiac death (SCD). The annual global mortality burden attributed to VTA is approximately 6 million. Fortunately, in populations at high risk of arrhythmic death, the implantable cardioverter defibrillator (ICD) significantly reduces mortality and is superior to medical therapy in both the primary and secondary prevention of SCD. The subcutaneous ICD (S‐ICD) represents a new approach in defibrillator therapy. Utilising an entirely avascular location, the S‐ICD can diagnose and treat VTA, whilst avoiding the significant complications that have traditionally been associated with transvenous defibrillator leads. Accurate rhythm detection remains vital and increasingly sophisticated diagnostic algorithms are utilised. Life‐saving therapy must never be incorrectly withheld, but inappropriate shocks, which are themselves associated with increased mortality and psychological morbidity, must also be minimised. The S‐ICD senses electrocardiogram (ECG) signals from a standardised subcutaneous location at which effective defibrillation has been consistently demonstrated. Three different sensing vectors are available of which one is selected for clinical use. Rhythm detection requires certain morphological ECG characteristics to be present in the selected vector and pre‐implant ECG screening is therefore a mandatory requirement. The commonest cause for vector screening failure is the presence of a low R:T ratio, as this prevents the S‐ICD from easily distinguishing R wave signal (ventricular depolarisation) from T wave signal (ventricular repolarisation). The overall axes of ventricular depolarisation and repolarisation are unique to an individual. R and T wave amplitudes are therefore determined, in part, by the angle from which they are observed. Mathematical vector rotation is a novel strategy which can manipulate the angle of observation of an individual’s ECG, using data recorded from the current S‐ICD location.This can produce personalised vectors; unique individualised vectors with a recipient’s maximal R:T ratio. In this thesis, I will describe how personalised vector generation can be achieved, before applying the technique to a cohort of S‐ICD ineligible patients. Significant improvements in R:T ratio and device eligibility will be demonstrated. I will then explore the broader impact of vector rotation on the current rhythm discrimination properties of the S‐ICD system. I will demonstrate that both ventricular fibrillation detection and supraventriculartachycardia discrimination are not impaired by vector rotation. These are key principles of S‐ICD sensing which must be maintained by any future sensing strategy. Finally, I shall consider the phenomena of T wave over‐sensing (TWOS), which despite the current screening process, remains the commonest cause of inappropriate shock therapy in the S‐ICD population. I will describe a new concept, ‘eligible vector time’, and demonstrate experimentally that patients experience chronological fluctuations in their device eligibility. This preliminary work will redefine our current understanding of device eligibility and justify future research into the role of vector rotation in reducing inappropriate shock therapies. In summary, I believe that clinicians and patients should not be restricted by the inherent limitations of standardised vector selection. Personalised vector generation can be achieved from the current S‐ICD location, whilst maintaining the excellent rhythm detection qualities of the S‐ICD system. Increased S‐ICD eligibility can be achieved and the potential to reduce TWOS in the future cannot be ignored
The Ministry of The Sisters of the Order St. Benedict in the Province of Alberta 1955 to 2011
No full textNotes - A history of the Sisters of the Order St. Benedict in Oyen, AB from 1955 to 2011 (2 pages
Interview with Benedict Anderson
No full textOn October 1, 2008, Benedict Anderson presented a talk at Columbia University in which he discussed his upcoming book, a biography of the Chinese-Indonesian journalist Kwee Thiam Tjing. Having found a book of Kwee’s writings in a second-hand bookshop in Indonesia in 1962, Anderson describes his surprise that no one could identify the pseudonymous author, who wrote what Anderson considers to be “the greatest piece of prose written in the first half of the 20th century by anybody in Indonesia.” For years after Kwee’s death, Anderson explains, details of the journalist’s life and work were forgotten. It was only recently that Anderson was himself able to write about the author, in the process considering the role of cosmopolitanism in the life of the colonial subject
A new algorithm to reduce T-wave over-sensing based on phase space reconstruction in S-ICD system
No full textBackground and objective:The subcutaneous implantable cardioverter defibrillator (S-ICD) reduces mortality in individuals at high risk of sudden arrhythmic death, by rapid defibrillation of life-threatening arrhythmia. Unfortunately, S-ICD recipients are also at risk of inappropriate shock therapies, which themselves are associated with increased rates of mortality and morbidity. The commonest cause of inappropriate shock therapies is T wave oversensing (TWOS), where T waves are incorrectly counted as R waves leading to an overestimation of heart rate. It is important to develop a method to reduce TWOS and improve the accuracy of R-peak detection in S-ICD system.MethodsThis paper introduces a novel algorithm to reduce TWOS based on phase space reconstruction (PSR); a common method used to analyse the chaotic characteristics of non-linear signals.ResultsThe algorithm was evaluated against 34 records from University Hospital Southampton (UHS) and all 48 records from the MIT-BIH arrhythmia database. In the UHS analysis we demonstrated a sensitivity of 99.88%, a positive predictive value of 99.99% and an accuracy of 99.88% with reductions in TWOS episodes (from 166 to 0). Whilst in the MIT-BIH analysis we demonstrated a sensitivity of 99.87%, a positive predictive value of 99.99% and an accuracy of 99.91% for R wave detection. The average processing time for 1 min ECG signals from all records is 2.9 s.ConclusionsOur algorithm is sensitive for R-wave detection and can effectively reduce the TWOS with low computational complexity, and it would therefore have the potential to reduce inappropriate shock therapies in S-ICD recipients, which would significantly reduce shock related morbidity and mortality, and undoubtedly improving patient's quality of life
Deep learning methods for screening patients' S-ICD implantation eligibility
No full textSubcutaneous Implantable Cardioverter-Defibrillators (S-ICDs) are used for prevention of sudden cardiac death triggered by ventricular arrhythmias. T Wave Over Sensing (TWOS) is an inherent risk with S-ICDs which can lead to inappropriate shocks. A major predictor of TWOS is a high T:R ratio (the ratio between the amplitudes of the T and R waves). Currently, patients' Electrocardiograms (ECGs) are screened over 10 s to measure the T:R ratio to determine the patients' eligibility for S-ICD implantation. Due to temporal variations in the T:R ratio, 10 s is not a long enough window to reliably determine the normal values of a patient's T:R ratio. In this paper, we develop a convolutional neural network (CNN) based model utilising phase space reconstruction matrices to predict T:R ratios from 10-second ECG segments without explicitly locating the R or T waves, thus avoiding the issue of TWOS. This tool can be used to automatically screen patients over a much longer period and provide an in-depth description of the behavior of the T:R ratio over that period. The tool can also enable much more reliable and descriptive screenings to better assess patients' eligibility for S-ICD implantation.</p
Misconceived Configurations of Ruth Benedict
No full textRuth Benedict has been the subject of a number of studies in both Japan and America. However, these studies have, up until now, maintained their international borders and avoided any cross-fertilization of knowledge. In America, three full length biographies, along with numerous other articles, have been devoted to the work and life of Benedict. In contrast, Japanese attention has mainly focused on Benedict's famous study of the Japanese, the Chrysanthemum and the Sword. Thus, on the Japanese side few have pursued the motivations of the author behind this book, whereas in America, Benedict the cultural anthropologist tends to figures large, leaving little room for discussion of Chrysanthemum.
Douglas Lummis, however, has attempted to straddle both sides of the fence with his piece A New Look at the Chrysanthemum and the Sword. Unfortunately, for his background knowledge on Benedict, he turns to Margaret Mead but fails to realise that the intricate relationship between Mead and Benedict has greatly influenced the portrait painted by her. The result is a rather heavy-handed attempt to prove that Chrysanthemum is merely a piece of "political literature" penned by a poet inhabiting the facade of a cultural anthropologist. Nevertheless, this image created by Lummis has managed to colour a large number of subsequent comments on both the book and author in Japan.
This paper will identify some of Lummis' major arguments against the background of the material he has used to formulate his arguments. Lummis' ideas derive from Mead's biography of Benedict, but by re-examining this biography and comparing it with other biographies on Benedict--and Mead--it becomes obvious that Mead's interpretation of Benedict's complex life was but one side of story. Thus, Lummis' use of Mead must also be considered when assessing the validity of his interpretation of Benedict
Benedict XVI’s Interpretation of the Psalms
No full textThis article aims to analyze the way Pope Benedict XVI quotes and interprets biblical psalms. In the introductory section, the author presents statistics and the ways in which Benedict XVI quotes Book of Psalms, and then offers a general, introductory look at psalms and their analysis in papal catechesis. In subsequent sections of the article, the author focuses on the pope’s historical-critical exegesis and linguistic analyses of the psalms, followed by the pope’s Christological, ecclesiological, Mariological, and actualizing reading of the Psalms. In the concluding section, the author discusses the relationship of the psalms to prayer, the pope’s references to the Fathers of the Church and recalls Benedict XVI’s most personal statements on the Psalms
Misconceived Configurations of Ruth Benedict
No full textRuth Benedict has been the subject of a number of studies in both Japan and America. However, these studies have, up until now, maintained their international borders and avoided any cross-fertilization of knowledge. In America, three full length biographies, along with numerous other articles, have been devoted to the work and life of Benedict. In contrast, Japanese attention has mainly focused on Benedict's famous study of the Japanese, the Chrysanthemum and the Sword. Thus, on the Japanese side few have pursued the motivations of the author behind this book, whereas in America, Benedict the cultural anthropologist tends to figures large, leaving little room for discussion of Chrysanthemum.
Douglas Lummis, however, has attempted to straddle both sides of the fence with his piece A New Look at the Chrysanthemum and the Sword. Unfortunately, for his background knowledge on Benedict, he turns to Margaret Mead but fails to realise that the intricate relationship between Mead and Benedict has greatly influenced the portrait painted by her. The result is a rather heavy-handed attempt to prove that Chrysanthemum is merely a piece of "political literature" penned by a poet inhabiting the facade of a cultural anthropologist. Nevertheless, this image created by Lummis has managed to colour a large number of subsequent comments on both the book and author in Japan.
This paper will identify some of Lummis' major arguments against the background of the material he has used to formulate his arguments. Lummis' ideas derive from Mead's biography of Benedict, but by re-examining this biography and comparing it with other biographies on Benedict--and Mead--it becomes obvious that Mead's interpretation of Benedict's complex life was but one side of story. Thus, Lummis' use of Mead must also be considered when assessing the validity of his interpretation of Benedict.departmental bulletin pape
Political Power In The Pope Benedict XVI’s Teaching
No full textPrzedmiot niniejszego artykułu stanowi nauczanie społeczne Kościoła katolickiego ze szczególnym uwzględnieniem interpretacji i wkładu weń papieża Benedykta XVI. Autor pragnie dokonać rekonstrukcji stanowiska papieża Benedykta odnośnie władzy politycznej. W ramach artykułu autor analizuje sposób, w jaki zjawisko władzy politycznej interpretowane jest w katolickiej nauce społecznej oraz sposób, w jaki papież Benedykt XVI interpretował i rozwijał nauczanie Kościoła dotyczące tej problematyki. Dodatkowo rozbudowany został fragment dotyczący stosunku Benedykta XVI do systemu politycznego demokracji.The subject of this article is catholic social teaching including its interpretation and contribution of Pope Benedict XVI. Author tries to reconstruct the point of view of Benedict XVI about political power. In the article, the author analyzes how catholic social teaching interprets political power problem as well as the problem of how Benedict XVI’s interpretation and developing of catholic social teaching refer to the issue of political power. Additionally, the author analyzes the problem of attitude of Benedict XVI to political system of democracy
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