Ventricular tachycardia arising from the aortomitral continuity in structural heart disease: characteristics and therapeutic considerations for an anatomically challenging area of origin

BACKGROUND: The aortomitral continuity (AMC) has been described as a site of origin for ventricular tachycardias (VT) in structurally normal hearts. There is a paucity of data on the contribution of this region to VTs in patients with structural heart disease. METHODS AND RESULTS: Data from 550 consecutive patients undergoing catheter ablation for VT associated with structural heart disease were reviewed. Twenty-one (3.8%) had a VT involving the peri-AMC region (age, 62.7+/-11 years; median left ventricular ejection fraction, 43.6+/-17%). Structural heart disease was ischemic in 7 (33%), dilated cardiomyopathy in 10 (47.6%), and valvular cardiomyopathy in 4 (19%) patients, respectively. After 1.9+/-0.8 catheter ablation procedures (including 3 transcoronary ethanol ablations) the peri-AMC VT was not inducible in 19 patients. The remaining 2 patients underwent cryosurgical ablation. Our first catheter ablation procedure was less often successful (66.7%) for peri-AMC VTs compared with that for 246 VTs originating from the LV free wall (81.4%, P=0.03). During a mean follow-up of 1.9+/-2.1 years, 12 (57.1%) patients remained free of VT, peri-AMC VT recurred in 7 patients, and 1 patient had recurrent VT from a remote location. Three patients died. Analysis of 50 normal coronary angiograms demonstrated an early septal branch supplying the peri-AMC area in 58% of cases that is a potential target for ethanol ablation. CONCLUSIONS: VTs involving the peri-AMC region occur in patients with structural heart disease and appear to be more difficult to ablate compared with VTs originating from the free LV wall. This region provides unique challenges for radiofrequency ablation, but cryosurgery and transcoronary alcohol ablation appear feasible in some cases.

Book Review of “The Origins of Social Work: Continuity and Change”. Basingstoke: Palgrave Macmillan, 2005, by Malcolm Payne

Malcolm Payne’s latest work proposes to survey the continuity and change in social work from its inception and origins, up until the present day. In order to do justice to the theme, its author could have concentrated on developing a narrative of a national enterprise, or restricted himself to a regional analysis (Western European Social Work) or opt instead for a more narrowly focused cultural exploration, White Anglo-Saxon Social Work (WASSW). One can only infer that limiting himself in this fashion would have struck the author as parochial, or rather, that only a truly global enterprise could satisfy his capacious mind. One is left to marvel at the invocation of Darwin’s great work and wonder what was the process of the author’s “natural” selection of this material.

Richness of Lichen Species, Especially of Threatened Ones, Is Promoted by Management Methods Furthering Stand Continuity

Lichens are a key component of forest biodiversity. However, a comprehensive study analyzing lichen species richness in relation to several management types, extending over different regions and forest stages and including information on site conditions is missing for temperate European forests. In three German regions (Schwäbische Alb, Hainich-Dün, Schorfheide-Chorin), the so-called Biodiversity Exploratories, we studied lichen species richness in 631 forest plots of 400 m2 comprising different management types (unmanaged, selection cutting, deciduous and coniferous age-class forests resulting from clear cutting or shelterwood logging), various stand ages, and site conditions, typical for large parts of temperate Europe. We analyzed how lichen species richness responds to management and habitat variables (standing biomass, cover of deadwood, cover of rocks). We found strong regional differences with highest lichen species richness in the Schwäbische Alb, probably driven by regional differences in former air pollution, and in precipitation and habitat variables. Overall, unmanaged forests harbored 22% more threatened lichen species than managed age-class forests. In general, total, corticolous, and threatened lichen species richness did not differ among management types of deciduous forests. However, in the Schwäbische-Alb region, deciduous forests had 61% more lichen species than coniferous forests and they had 279% more threatened and 76% more corticolous lichen species. Old deciduous age classes were richer in corticolous lichen species than young ones, while old coniferous age-classes were poorer than young ones. Overall, our findings highlight the importance of stand continuity for conservation. To increase total and threatened lichen species richness we suggest (1) conserving unmanaged forests, (2) promoting silvicultural methods assuring stand continuity, (3) conserving old trees in managed forests, (4) promoting stands of native deciduous tree species instead of coniferous plantations, and (5) increasing the amount of deadwood in forests.

Stratigraphic Continuity in 400 Mhz Short-Pulse Radar Profiles of Firn in West Antarctica

We track dated firn horizons within 400 MHz short-pulse radar profiles to find the continuous extent over which they can be used as historical benchmarks to study past accumulation rates in West Antarctica. The 30-40 cm pulse resolution compares with the accumulation rates of most areas. We tracked a particular set that varied from 30 to 90 m in depth over a distance of 600 km. The main limitations to continuity are fading at depth, pinching associated with accumulation rate differences within hills and valleys, and artificial fading caused by stacking along dips. The latter two may be overcome through multi-kilometer distances by matching the relative amplitude and spacing of several close horizons, along with their pulse forms and phases. Modeling of reflections from thin layers suggests that the - 37 to - 50 dB range of reflectivity and the pulse waveforms we observed are caused by the numerous thin ice layers observed in core stratigraphy. Constructive interference between reflections from these close, high-density layers can explain the maintenance of reflective strength throughout the depth of the firn despite the effects of compaction. The continuity suggests that these layers formed throughout West Antarctica and possibly into East Antarctica as well.

Compactified N = 1 supersymmetric Yang-Mills theory on the lattice: continuity and the disappearance of the deconfinement transition

Fermion boundary conditions play a relevant role in revealing the confinement mechanism of N=1 supersymmetric Yang-Mills theory with one compactified space-time dimension. A deconfinement phase transition occurs for a sufficiently small compactification radius, equivalent to a high temperature in the thermal theory where antiperiodic fermion boundary conditions are applied. Periodic fermion boundary conditions, on the other hand, are related to the Witten index and confinement is expected to persist independently of the length of the compactified dimension. We study this aspect with lattice Monte Carlo simulations for different values of the fermion mass parameter that breaks supersymmetry softly. We find a deconfined region that shrinks when the fermion mass is lowered. Deconfinement takes place between two confined regions at large and small compactification radii, that would correspond to low and high temperatures in the thermal theory. At the smallest fermion masses we find no indication of a deconfinement transition. These results are a first signal for the predicted continuity in the compactification of supersymmetric Yang-Mills theory.

Marital stability, satisfaction and well-being in old age: Variability and continuity in long-term continuously married older persons

Objectives: Recent research shows that the well-documented positive effects of marital stability on well-being and health outcomes are conditional upon the quality of marriage. To date, few studies have explored the relationship between marital satisfaction, well-being and health among very long-term married individuals. This study aims at identifying groups of long-term married persons with respect to marital satisfaction and comparing them longitudinally concerning their well-being outcomes, marital stressors, personality and socio-demographic variables. Method: Data are derived from a survey (data collection 2012 and 2014) with 374 continuously married individuals at wave 1 (mean age: 74.2 years, length of marriage: 49.2 years) and 252 at wave 2. Cluster analyses were performed comparing the clusters with regard to various well-being outcomes. The predictive power of cluster affiliation and various predictors at wave 1 on well-being outcomes at wave 2 was tested using regression analyses. Results: Two groups were identified, one happily the other unhappily married, with the happily married scoring higher on all well-being and health outcomes. Regression analyses revealed that group affiliation at wave 1 was not any longer predictive of health, emotional loneliness and hopelessness two years later, when taking into account socio-demographic variables, psychological resilience and marital strain, whereas it remained an important predictor of life satisfaction and social loneliness. Conclusion: Marital satisfaction is associated with health and well-being in older couples over time, whereas psychological resilience and marital strain are major predictors explaining the variance of these outcomes.

Living in Heterogeneous Woodlands – Are Habitat Continuity or Quality Drivers of Genetic Variability in a Flightless Ground Beetle?

Although genetic diversity is one of the key components of biodiversity, its drivers are still not fully understood. While it is known that genetic diversity is affected both by environmental parameters as well as habitat history, these factors are not often tested together. Therefore, we analyzed 14 microsatellite loci in Abax parallelepipedus, a flightless, forest dwelling ground beetle, from 88 plots in two study regions in Germany. We modeled the effects of historical and environmental variables on allelic richness, and found for one of the regions, the Schorfheide-Chorin, a significant effect of the depth of the litter layer, which is a main component of habitat quality, and of the sampling effort, which serves as an inverse proxy for local population size. For the other region, the Schwäbische Alb, none of the potential drivers showed a significant effect on allelic richness. We conclude that the genetic diversity in our study species is being driven by current local population sizes via environmental variables and not by historical processes in the studied regions. This is also supported by lack of genetic differentiation between local populations sampled from ancient and from recent woodlands. We suggest that the potential effects of former fragmentation and recolonization processes have been mitigated by the large and stable local populations of Abax parallelepipedus in combination with the proximity of the ancient and recent woodlands in the studied landscapes.