Concealed Forms Research Articles

Brugada Syndrome: Focus for the General Pediatrician.

Brugada Syndrome is an "inherited" channelopathy characterized by a predisposition to syncope and sudden death. It typically presents in young adults but is also known to affect the pediatric population, even if the prevalence is low compared to the adult population. The diagnostic ECG pattern shows coved-type ST-segment elevation in the right precordial leads, occurring spontaneously or after provocative drug tests with IV administration of Class I antiarrhythmic drugs. However, the electrocardiographic findings may vary, and transient or concealed forms of the syndrome further complicate diagnosis, necessitating thorough evaluation and close clinical follow-up. The clinical presentation of Brugada Syndrome may range from asymptomatic individuals to patients who have experienced syncope or sudden cardiac arrest. The syndrome remains underdiagnosed due to its elusive symptoms and the absence of abnormal findings between episodes. Additionally, specific triggers such as fever, certain medications and alcohol consumption may unmask the electrocardiographic changes and provoke arrhythmias in susceptible individuals. Given its elusive nature, early diagnosis and risk stratification are crucial in identifying individuals who may benefit from an implantable cardioverter defibrillator, the mainstay of treatment for high-risk patients, or pharmacological interventions.

The Caste of Campus Habitus: Caste and Gender Encounters of the First-generation Dalit Women Students in Indian Universities

This article critically examines the university academic spaces and the campus culture determined by a particular form of the dominant habitus which is, in effect, actively excluding the first-generation women students belonging to the marginalized sections of Indian society. As this dominant habitus is constantly reproduced on university campuses, with or without contentions, entering the academic spaces of Indian universities for first-generation Dalit women—who are deprived of both cultural and social capital—is invariably becoming a herculean task. Therefore, this article analyses the concealed forms of dominant campus habitus that structurally create a conducive environment for privileged students and a rigid glass ceiling for first-generation Dalit women students in their journey toward higher education. Notwithstanding the limitations associated with their social status of being first-generation learners, the formations of alternative cultural capital and resilience of the Dalit women students have been analysed from a feminist perspective, proving that one could overcome these social challenges through the acquired cultural capital. The analytical concepts and theoretical frameworks of this article have been developed based on empirical/ethnographic data collected from women research scholars at a prominent university in South India. The narratives were collected in the academic year 2020–2021 through in-depth interviews and focused group discussions.

Racism detection by analyzing differential opinions through sentiment analysis using stacked ensemble GCR-NN

Because of the unquestionable person of the stage on the worldwide field, a few surviving and new types of bias have arisen. Prejudice has surfaced through online entertainment in both concealed and open forms, concealed through the use of images and open through the distribution of discriminatory expressions under fake characters, to generate contempt, viciousness, and cultural flimsiness. Prejudice is currently flourishing on the basis of diversity, origin, language, culture, and, most importantly, religion, despite the fact that it is frequently associated with nationality. It has been deemed a grave threat to global harmony as well as social, political, and social fortitude that web-based entertainment's capacity to incite racial tensions. Therefore, it is necessary to keep an eye on social media, which serves as the primary channel through which racist ideas are disseminated, identify racist expressions, and swiftly criminalize them. By analyzing the sentiment of tweets, this study aims to identify biased tweets. By combining gated recurrent units (GRU), convolutional neural networks (CNN), and recurrent neural networks (RNN), gated convolutional recurrent neural networks (GCR-NN) are formed. This is done to make use of the superior presentation provided by deep learning. GRU is at the top of the GCR-NN model for extracting acceptable and recognizable characteristics from unrefined text, whereas CNN dissects fundamental components for RNN to create precision expectations. The proposed GCR-NN's presentation within the framework of machine learning (ML) and deep learning models is the subject of numerous analyses. The results show that GCR-NN performs better and has a precision of 0.98 that is higher. In 97% of tweets, the proposed GCR-NN model can recognize extremist remarks.

Illegal Control Over the Territory in International Law and the Status of Donbas Determination

Total rejection of the aggression and territory occupation in the international law leads to their hybrid and concealed forms using gangs and mercenaries, proclaiming new “states” etc. These activities constitute serious threat to international security, can cause and already cause the fragmentation of states, anarchy, criminalization of politics, new forms of expansionism and so on. The authors of the article generalize the forms of illegal control over the territory in international law and their application considering the status of Donbas determination.
 International law for more than a century provides for the possibility of separate regulation of the sovereignty and legal rights of the state to the territory, on the one hand, and the implementation of the regime of illegal control over the territory – on the other. Authors argue that in the modern sense, primarily developed by doctrine and courts, illegal control over the territory can be considered as a legal regime, one of the forms of which is occupation, while others are defined as effective, overall, general, de facto control and related to undisclosed actions and informal means used by the aggressor states. This regime is characterized by the exercise of power over the territory by the will of a foreign state, and the forms of implementation of the regime differ depending on whether such a will is officially recognized or concealed.
 The transformation of international humanitarian law after the Second World War erased the boundaries between recognized and officially unrecognized occupation. But unlike occupation, the fact of which may be obvious, the fact of effective or other control over the territory requires the determination by judicial authorities.
 The qualification of illegal control by the Russian Federation of the Donbas in national and international law is ambiguous. The authors argue that the full recognition of the international armed conflict between Ukraine and Russia in Donbas, as well as Russia’s illegal control over latter should be expected in the process of consideration of a number of cases in the international judicial institutions.

Using humor to disguise racism in television news: the case of the Roma

Abstract It has been argued that more research is needed on the role of humor in the expression of racism. One reason is that, in the ‘post racial’ society, overt racism has become publicly unacceptable and, therefore, tends to appear in more concealed forms. In this paper, as part of a larger project on media representations of the Roma, we look at the role of humor in a Romanian television news clip reporting on the financial rewards of begging. We draw on the critical scholarship in humor research and carry out a multimodal critical discourse analysis of a news report selected from a larger corpus. We argue that through humor a recontextualisation of the Roma’s situation takes place, transforming their actual situation of poverty and social marginalisation into a humorous account of cultural failure, incompetence, stupidity and calculated money grabbing. We show that humor is one way by which culture becomes represented as embodied by ethnic minorities.

Diagnostic evaluation and arrhythmia mechanisms in survivors of unexplained cardiac arrest.

Identifying the cause of unexplained cardiac arrest is critical for appropriate management of both survivors and their family members. Aborted cardiac arrests whose cause remains unknown following investigation with a surface ECG, echocardiogram, and coronary angiogram are deemed unexplained. Many of these unexplained arrests are felt to be secondary to concealed forms of cardiac channelopathies and latent or subtle cardiomyopathies. This recognition has led to evaluating a diagnostic role for a series of additional investigations, including advanced imaging, genetic testing, and provocative forms of testing, including sodium channel blockade and treadmill testing. Despite evidence of an improved diagnostic yield through their systematic usage, clinical guidelines have yet to endorse a formal algorithm delineating investigations that must be performed before assigning a label of idiopathic ventricular fibrillation, which has resulted in markedly variables thresholds for concluding this diagnosis. Debate remains regarding the need for an invasive electrophysiology study among these patients, though identification of arrhythmic culprits requiring intracardiac electrograms for diagnostic confirmation have suggested a potential role when an initial comprehensive evaluation is unrevealing. Although progress is being made, the sizeable portion of arrests that remain unexplained despite completion of a comprehensive evaluation highlights an ongoing need for further research and additional tools to help unravel the ongoing mysteries of these near fatal events.

Young children’s perceptions of ubiquitous computing and the Internet of Things

AbstractUbiquitous computing (ubicomp) and the Internet of things (IoT) are turning into everyday household technology at an ever‐increasing pace, for example, in the form of connected toys. However, while ubicomp and IoT are changing and shaping children’s digital and technological landscape, not much is known about how children perceive these omnipresent and concealed forms of digital technology. This qualitatively oriented paper explores 3‐ to 6‐year‐old Finnish children’s perceptions of ubicomp and IoT via interviews and a design task. Initially, the children were skeptical toward the idea that tangible objects, such as toys, could be computer and/or Internet enabled. However, these perceptions were subject to change when children were introduced to a scientific conception of what computers and the Internet are and asked to apply their knowledge to a technological design task. Implications for early years digital literacy education are discussed in the paper.

The biopolitics of declassing Palestinian professional women in a settler-colonial context

This article argues that the biopolitics of declassing Palestinian professional women in Israel, which constitutes part of the logic of eliminating the native, is mediated by colonial violence that secures labor market class sovereignty for settlers. In this context, the term declassing refers to rendering this class invisible by disregarding the women’s presence and/or value in the labor market. The study unpacks the logic of elimination through the racialized, everyday lived experience of middle-class professional women in Bedouin society who succeeded in entering the Jewish workplace. These women face sophisticated erasure tactics, paralleling various manifestations of the direct politics of fear that discipline the body, will and mind, as well as indirect opposition reflected in the settler-colonial reinforcement of patriarchal power against women. This article reveals concealed violent forms of power practiced by the colonialists to declass Palestinian women and preserve colonialist class superiority in the labor market.

Eriophyoid Mites (Acariformes, Eriophyoidea) from Rosaceae: Taxonomic Diversity, Host-Parasite Relationships, and Ability to Cause Galls

A review on the complex of species of eriophyoid mites associated with Rosaceae is given, focused on the phylogeny, biology, and distribution of their host plants and galls induced by these mites. About 200 species of 39 genera from 3 families ofEriophyoidea are known from Rosaceae. Among them, 6 species from 2 genera belong to Phytoptidae, 178 species from 27 genera, to Eriophyidae, and 28 species from 10 genera, to Diptilomiopidae; 7 genera of the latter family are represented on Rosaceae by a single species each. The ability to induce galls is discussed using the example of the most widespread and numerous genera of the family Eriophyidae from Rosaceae. Mites of two large subfamilies, Eriophyinae and Phyllocoptinae, include both vagrant and concealed forms. The types of galls caused by mites are related to the systematic position of mites and the distribution of mites and their host plants. The hypothesis of host shifts of eriophyoid mites from other plant families to Rosaceae is considered. Most of the species which presumably switched to Rosaceae have been described from Southeast Asia. Morphological similarity between vagrant and concealed forms from the paraphyletic tribes Eriophyini and Phyllocoptini, and also Aceriini and Anthocoptini is discussed. Their pairwise similarity might be the result of evolution (Eriophyini → Phyllocoptini and Aceriini → Anthocoptini) connected with change oflife style.

The Brugada Syndrome - From Gene to Therapy.

It is almost a quarter of century that a pioneering work of 2 researchers named Brugada brought the entire scientific community to understanding the molecular, clinical, and electrophysiological aspects of a distinctive syndrome. It affects mainly young adults with syncope and/or sudden cardiac death caused by polymorphic ventricular tachycardia or ventricular fibrillation in the absence of any sign of cardiac degeneration or alteration. Although the involvement of the epicardial layer of the right ventricular outflow tract, and the requirement of pharmacologic challenge for unveiling concealed forms, have been fully characterized, many areas of uncertainties remain to be elucidated, such as the unpredictable usefulness of programmed ventricular stimulation, the role of radiofrequency catheter ablation for reducing ST-segment elevation, and the value of risk stratification in patients diagnosed with upper displacement of right precordial leads. How much Brugada syndrome is an intense field of research is witnessed by 4 different consensus committees that took place in a relatively short period of time considering the recent discovery of this intricate arrhythmogenic disease. The main focus of this review is to describe the milestones in Brugada syndrome from its first phenotypic and genotypic appraisals to recent achievements in electrical therapies proposed for the management of this fascinating rhythm disturbance that, despite new diagnostic and therapeutic learnings, still predisposes to sudden cardiac death.

Read between the lines – Subtle ECG changes to be recognised as a risk factor for sudden cardiac death

Background: Although the majority of sudden cardiac deaths (SCD) are due to CAD and poor LVEF, there is a considerable fraction of idiopathic ventricular fibrillation (IVF) causing SCD that is secondary to channelopathies and other inherited arrhythmias. Objective: The present report aims to raise awareness about the prevalence of inherited arrhythmogenic disorders, besides the commonly attributed CAD causing SCD. Case report: We report the case of a patient with a history of sudden collapse after routine duty. He had ventricular fibrillation and was successfully defibrillated to normal sinus rhythm. On examination, he was found to have a structurally normal heart, and the ECG showed early repolarisation (ERPS) with a short QT interval. Review of the literature: SCD is defined as IVF in the absence of an identifiable cause. IVF could be the manifestation of concealed forms of arrhythmogenic disorders exacerbated by appropriate triggers. Long QT syndrome presents with structurally normal heart, QT prolongation, syncope, and SCD. Incomplete penetrance gene presents as Brugada syndrome, short QT syndrome, ERPS, sinus node dysfunction, and progressive conduction defects. Subtle ECG changes may be present, which, if identified early, can lead to further focused evaluation, leading to the prevention of a potentially life-threatening arrhythmia. ECG changes that should be looked for include: ERPS changes, especially in the inferior and lateral leads, ‘Rs’ in the inferior leads – >2 mm deep in lead II, small slurred S wave in the inferior leads, incomplete or complete RBBB with J point elevation and coved ST segment in V1 and V2 for Brugada, and long or short QT interval. Conclusion/summary: It is important to recognise channelopathies causing SCD. This is because a majority of these channelopathies are ‘inherited’ and can cause more deaths in the family. Such potential information obtained from ECG features can help categorise patients as ‘suspected high-risk’ and provide appropriate advice.

An Examination of Violence Practiced against Disabled Brazilians in Relation to Sustainable Development

Although there are no national data and statistics regarding violence against disabled citizens in Brazil, findings from a number of small-scale research studies suggest that it is a problem of considerable magnitude. This article draws on the existing literature on violence and oppression, empirical studies on violence against disabled people in Brazil and interviews with a sample of disabled Brazilians to argue that the most prevalent forms of violence in the nation are subtle and concealed forms of oppression that reproduce discriminatory power structures in Brazilian society. Such power structures prevent the developing world in general and Brazil in particular from securing democratic and sustainable development in the post-2015 era, when disadvantaged people must be at the center. The analysis is organized in three parts. First, I outline briefly the main issues in defining impairment, disability and violence, since these represent political choices that shape policy decisions. Second, I analyze the forms of violence that affect disabled Brazilians and the relationships and institutions that create and sustain them. Third, I describe and evaluate the government's key current strategies aimed at addressing violence against disabled Brazilians. The purpose here is to suggest ways in which violence against disabled Brazilians can be addressed in public policies as a sustainable development issue and thus help close the "gap" between disabled and nondisabled populations to create truly sustainable democratic societies that honor human dignity.

Ideologies in archaeology

Archaeologists have often used the term ideology to vaguely refer to a realm of ideas. Scholars from Marx to Zizek have developed a sharper concept, arguing that ideology works by representing or misrepresenting power relations through concealment, enhancement, or transformation of real social relations between groups. Ideologies in Archaeology examines the role of ideology in this latter sense as it pertains to both the practice and the content of archaeological studies. While ideas like reflexive archaeology and multivocality have generated some recent interest, this book is the first work to address in any detail the mutual relationship between ideologies of the past and present ideological conditions producing archaeological knowledge. Contributors to this volume focus on elements of life in past societies that went without saying and that concealed different forms of power as obvious and unquestionable. From the use of burial rites as political theater in Iron Age Germany to the intersection of economics and elite power in Mississippian mound building, the contributors uncover complex manipulations of power that have often gone unrecognized. They show that Occam s razor the tendency to favor simpler explanations is sometimes just an excuse to avoid dealing with the historical world in its full complexity. Jean-Paul Demoule s concluding chapter echoes this sentiment and moreover brings a continental European perspective to the preceding case studies. In addition to situating this volume in a wider history of archaeological currents, Demoule identifies the institutional and cultural factors that may account for the current direction in North American archaeology. He also offers a defense of archaeology in an era of scientific relativism, which leads him to reflect on the responsibilities of archaeologists. Includes contributions by: Susan M. Alt, Bettina Arnold, Uzi Baram, Reinhard Bernbeck, Matthew David Cochran, Jean-Paul Demoule, Kurt A. Jordan, Susan Kus, Vicente Lull, Christopher N. Matthews, Randall H. McGuire, Rafael Mico, Cristina Rihuete Herrada, Paul Mullins, Sue Novinger, Susan Pollock, Victor Raharijaona, Roberto Risch, Kathleen Sterling, Ruth M. Van Dyke, and LouAnn Wurst

Sudden Cardiac Death and Genetic Ion Channelopathies

Sudden cardiac death is a common outcome of several cardiac disorders such as acute myocardial ischemia, myocardial infarction, and heart failure. However, ≈5% to 15% of cardiac arrest victims fail to show evidence of structural abnormalities at autopsy.1–3 In 1997, a panel of experts defined sudden death in the absence of an identifiable cause as idiopathic ventricular fibrillation (IVF): “IVF is the terminology that best acknowledges our current inability to identify a causal relationship between the clinical circumstance and the arrhythmia.”4 In the same article, the requirements for the diagnosis of IVF were identified on the basis of the clinical tools available at the time. In 1992, using the phenotypes observed in the IVF registry, we advanced the hypothesis that IVF could be the manifestation of concealed forms of arrhythmogenic disorders5 exacerbated by appropriate triggers. A few years later, the discovery of the genes of long-QT syndrome (LQTS)6–8 and the detection of incomplete penetrance9 supported this early hypothesis. Incomplete penetrance and variable expressivity in inherited arrhythmogenic disorders imply that the distinctive ECG patterns that characterize these disorders may be concealed.10 Interestingly, however, the absence of the ECG markers of the disease is not an indicator of favorable outcome, as demonstrated by the evidence that the incidence of cardiac arrest in LQTS patients with normal QTc during the first 40 years of life is ≈4%, ie, 0.1%/y.11,12 In the last 15 years, the results of mutation screening in sudden unexplained death syndrome or sudden infant death syndrome, the so-called molecular autopsy, have been reported in several studies (Table 1).13–20 Although the yield of molecular autopsy reported by different studies is highly variable, ranging from 4% to 30%, it is sufficient to prove the concept …

The changing spectrum of arrhythmogenic (right ventricular) cardiomyopathy

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a clinically and genetically heterogeneous heart muscle disorder associated with ventricular arrhythmias and risk of sudden death. The disease is heredo-familial, and mutations in desmosomal genes have been identified in about half of patients. Recent experimental models confirm this disease develops after birth due to progressive myocardial dystrophy. Genotype-phenotype correlations, including magnetic resonance and pathology studies on heart specimens, are currently demonstrating that the spectrum of the disease is wider than initially thought and usually referred to with the adjective "right ventricular", with the evidence of biventricular or even isolated left ventricular forms, so that it is increasingly identified simply as "arrhythmogenic cardiomyopathy". A revision of the diagnostic criteria encompassing familial, electrocardiographic, arrhythmic, morpho-functional and histopathologic findings, has been made to improve diagnostic sensitivity and specificity, in particular of the concealed forms and left-dominant subtypes of the disease. Experimental models are mandatory to gain an insight into the cascade of cellular and molecular events leading from gene defect to myocardial dystrophy in ARVC.

Cardiogenetic screening of first-degree relatives after sudden cardiac death in the young: a population-based approach

This editorial refers to ‘Cardiogenetic screening of first-degree relatives after sudden cardiac death in the young: a population-based approach’ by A. Hendrix et al. , on page 716. The term sudden unexpected death syndrome (SUDS) was first used by Professor Michael Davies 25 years ago to describe deaths that remain unexplained despite expert pathological review.1 He recommended that SUDS be made a specific diagnostic category on the death certificate to aid bereaved families and to promote research in the field. Sudden unexpected death syndrome or, as it is frequently termed, sudden arrhythmic death syndrome (SADS) represents a potentially avoidable cause of death in an otherwise healthy individual. The emotional and psychological consequences of these deaths are devastating for the families affected and this is compounded by the fact that a significant proportion are due to inherited conditions, hence raising complex questions regarding clinical and genetic screening and its consequences. Once one excludes acute myocardial infarction and structural heart disease (e.g. hypertrophic cardiomyopathy, aortic stenosis, and anomalous coronary arteries), the principal causes of sudden deaths are electrical-ion channelopathies: long QT syndrome, Brugada syndrome, cathecholaminergic polymorphic ventricular tachycardia, and concealed forms of cardiomyopathy such as arrhythmogenic right ventricular cardiomyopathy (ARVC). A cardiologist facing the task of screening families for these disorders must be prepared to keep an open mind and ensure that first-degree relatives are …

192 Assessment of a relationship between functional and structural abnormalities in Brugada syndrome

Although Brugada syndrome (BrS) is a primarily electrical disease leading to conduction slowing, it is now acknowledged that structural alterations of the myocardium are frequently associated. Those two factors, may result in both contraction heterogeneity and remodeling of the right ventricle (RV). Radionuclide angiocardiography (RNA) with phase analysis is able to quantify contraction delays and to evaluate volumes and systolic function of ventricles. The aim of this study was to assess both functional and structural alterations of the RV in patients with BS and to investigate a relationship between them. Multiharmonic Fourier phase analysis of planar RNA was used to quantify contraction heterogeneity, and gated bloodpool SPECT to assess ventricular volumes and function in 71 patients with proven BrS [classified according to their spontaneous ECG pattern recorded just prior to ERNA as: concealed (n=26), type 2/3 (n=28), type 1 (n=17)] and 18 controls. RV contraction heterogeneity was greater in patients with BrS compared to controls (17.2±0.4° vs 15.1±0.7° respectively, p=0.007), and increased according to the repolarisation pattern from concealed forms to type 1 (ANOVA p=0.02). The increase of RV contraction heterogeneity was associated with an increased apex to RVOT contraction delay (r=0.4, p=0.006). RV end-diastolic and end-systolic volumes were greater in patients with BrS compared to controls (156±6 vs 134±7 ml, and 88±4 vs 73±4 ml respectively, p=0.02), to a similar proportion so as the ejection fraction was not significantly impaired (44±1% vs 45±2% respectively, p=0.4). Finally, there was no relationship between the magnitude of contraction heterogeneity and RV remodeling. The left ventricle was free of abnormality. In patients with BrS, RV contraction heterogeneity increases with the magnitude of repolarisation abnormalities, contrary to RV remodeling which is present to a mild extent whatever the repolarisation pattern.

Brugada-Syndrom

In 1992, a new syndrome (Brugada syndrome, BS) was described consisting of syncopal episodes and/or sudden death in patients with a structurally normal heart and an electrocardiogram characteristic of right bundle branch block with ST segment elevation in leads V 1 -V 3 . The disease is genetically determined with an autosomal dominant pattern of transmission, and different mutations that affect the structure and function of the cardiac sodium channel gene SCN5A have been identified. BS can be diagnosed by ECG if the manifest form is present; at the present time, three different ECG types of BS are known. In patients with transient forms, the ECG can be modulated by the administration of antiarrhythmic drugs. Application of ajmaline (1 mg/kg i.v.), procainamide (10 mg/kg i.v.) or flecainide (2 mg/kg i.v.) accentuate ST segment elevation or are capable of unmasking concealed or intermittent forms of the disease. BS has been described as being associated with life-threatening ventricular tachyarrhythmias and a high incidence of sudden death. Antiarrhythmic drugs such as amiodarone or beta-blocking agents do not prevent sudden death in symptomatic or asymptomatic individuals. Implantation of an automatic cardioverter defibrillator is the only form of treatment currently proven to be effective. Gene therapy may offer a cure in the future.

Arrhythmogenic right ventricular cardiomyopathy: an update

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart muscle disease that predominantly affects the right ventricle (RV). The main pathologic feature is the progressive loss of RV myocardium and...

A internalização da exclusão

Procura-se mostrar as formas dissimuladas que as políticas públicas neoliberais colocaram em funcionamento com a finalidade de reduzir custos econômicos, sociais e políticos das formas de exclusão objetivas (repetência e evasão), sem alterar em essência a seletividade da escola, criando um campo de exclusão subjetiva (auto-exclusão, exclusão entre ciclos, "trilhas de progressão continuada diferenciadas"), no qual a responsabilidade da exclusão recai sobre o próprio excluído. São apresentadas três teses na tentativa de compreender este movimento. A primeira trata da conversão da exclusão objetiva em exclusão subjetiva; a segunda mostra como os mecanismos da avaliação informal são acionados no sentido de criar "trilhas de progressão continuada diferenciadas" nas propostas de organização por ciclos de progressão continuada; e, finalmente, a terceira aponta a desresponsabilização da escola em relação à escolarização das camadas populares ("aprender a aprender"), na esteira da desresponsabilização do próprio Estado mínimo proposto pelas atuais políticas públicas. Finalmente, apresentam-se por contraste elementos para uma política alternativa voltada para as responsabilidades formativas da escola que visem a transformar a relação entre as pessoas e entre estas e a natureza.