Effects of fibrosis morphology on reentrant ventricular tachycardia inducibility and simulation fidelity in patient-derived models

Myocardial fibrosis detected via delayed-enhanced magnetic resonance imaging (MRI) has been shown to be a strong indicator for ventricular tachycardia (VT) inducibility. However, little is known regarding how inducibility is affected by the details of the fibrosis extent, morphology, and border zone configuration. The objective of this article is to systematically study the arrhythmogenic effects of fibrosis geometry and extent, specifically on VT inducibility and maintenance. We present a set of methods for constructing patient-specific computational models of human ventricles using in vivo MRI data for patients suffering from hypertension, hypercholesterolemia, and chronic myocardial infarction. Additional synthesized models with morphologically varied extents of fibrosis and gray zone (GZ) distribution were derived to study the alterations in the arrhythmia induction and reentry patterns. Detailed electrophysiological simulations demonstrated that (1) VT morphology was highly dependent on the extent of fibrosis, which acts as a structural substrate, (2) reentry tended to be anchored to the fibrosis edges and showed transmural conduction of activations through narrow channels formed within fibrosis, and (3) increasing the extent of GZ within fibrosis tended to destabilize the structural reentry sites and aggravate the VT as compared to fibrotic regions of the same size and shape but with lower or no GZ. The approach and findings represent a significant step toward patient-specific cardiac modeling as a reliable tool for VT prediction and management of the patient. Sensitivities to approximation nuances in the modeling of structural pathology by image-based reconstruction techniques are also implicated.

How much are translation studies in debt to Soren Kierkegaard?

The significance of Jacques Derrida's philosophical contribution to translation studies is becoming more widely acknowledged, thanks to authors such as Lawrence Venuti, Kaisa Koskinen, Rosemary Arrojo, Lieven Tack and africa Vidal Claramonte. However, what remains unknown is the debt which Derrida owes to the thinking of SOren Kierkegaard. This article sets out this legacy for the purposes of presenting some basic principles of deconstruction and in order to further promote its dissemination in the area of translation studies. At the same time, this article aims to be both a tribute to the Danish philosopher and a recognition of his contribution to modern-day thinking. Ultimately, the objective of this piece of research is to demonstrate how the ramifications of Kierkegaard's ideas are still relevant and, to a certain extent, are present in the area of translation studies. Among other things, this article shows how notions which are so fundamental to Kierkegaardian thinking, such as subjectivity', decision', instant' or impossible' echo in several recent texts regarding translation studies.