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1.	Lima, Emilly M., et al. (författare) Deep neural network-estimated electrocardiographic age as a mortality predictor 2021 Ingår i: Nature Communications. - : Springer Nature. - 2041-1723. ; 12:1 Tidskriftsartikel (refereegranskat)abstract The electrocardiogram (ECG) is the most commonly used exam for the screening and evaluation of cardiovascular diseases. Here, the authors propose that the age predicted by artificial intelligence from the raw ECG tracing can be a measure of cardiovascular health and provide prognostic information. The electrocardiogram (ECG) is the most commonly used exam for the evaluation of cardiovascular diseases. Here we propose that the age predicted by artificial intelligence (AI) from the raw ECG (ECG-age) can be a measure of cardiovascular health. A deep neural network is trained to predict a patient's age from the 12-lead ECG in the CODE study cohort (n = 1,558,415 patients). On a 15% hold-out split, patients with ECG-age more than 8 years greater than the chronological age have a higher mortality rate (hazard ratio (HR) 1.79, p < 0.001), whereas those with ECG-age more than 8 years smaller, have a lower mortality rate (HR 0.78, p < 0.001). Similar results are obtained in the external cohorts ELSA-Brasil (n = 14,236) and SaMi-Trop (n = 1,631). Moreover, even for apparent normal ECGs, the predicted ECG-age gap from the chronological age remains a statistically significant risk predictor. These results show that the AI-enabled analysis of the ECG can add prognostic information.
2.	Lozano, Rafael, et al. (författare) Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017 2018 Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138 Tidskriftsartikel (refereegranskat)abstract Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
3.	Ribeiro, Antônio H., et al. (författare) Automatic diagnosis of the 12-lead ECG using a deep neural network 2020 Ingår i: Nature Communications. - : NATURE PUBLISHING GROUP. - 2041-1723. ; 11:1 Tidskriftsartikel (refereegranskat)abstract The role of automatic electrocardiogram (ECG) analysis in clinical practice is limited by the accuracy of existing models. Deep Neural Networks (DNNs) are models composed of stacked transformations that learn tasks by examples. This technology has recently achieved striking success in a variety of task and there are great expectations on how it might improve clinical practice. Here we present a DNN model trained in a dataset with more than 2 million labeled exams analyzed by the Telehealth Network of Minas Gerais and collected under the scope of the CODE (Clinical Outcomes in Digital Electrocardiology) study. The DNN outperform cardiology resident medical doctors in recognizing 6 types of abnormalities in 12-lead ECG recordings, with F1 scores above 80% and specificity over 99%. These results indicate ECG analysis based on DNNs, previously studied in a single-lead setup, generalizes well to 12-lead exams, taking the technology closer to the standard clinical practice. The role of automatic electrocardiogram (ECG) analysis in clinical practice is limited by the accuracy of existing models. In that context, the authors present a Deep Neural Network (DNN) that recognizes different abnormalities in ECG recordings which matches or outperform cardiology and emergency resident medical doctors.
4.	Abbafati, Cristiana, et al. (författare) 2020 Tidskriftsartikel (refereegranskat)
5.	Fernandes, Juliana Folloni, et al. (författare) Transplantation of Hematopoietic Stem Cells for Primary Immunodeficiencies in Brazil: Challenges in Treating Rare Diseases in Developing Countries. 2018 Ingår i: Journal of clinical immunology. - : Springer Science and Business Media LLC. - 1573-2592 .- 0271-9142. ; 38:8, s. 917-926 Tidskriftsartikel (refereegranskat)abstract The results of hematopoietic stem cell transplant (HSCT) for primary immunodeficiency diseases (PID) have been improving over time. Unfortunately, developing countries do not experience the same results. This first report of Brazilian experience of HSCT for PID describes the development and results in the field. We included data from transplants in 221 patients, performed at 11 centers which participated in the Brazilian collaborative group, from July 1990 to December 2015. The majority of transplants were concentrated in one center (n=123). The median age at HSCT was 22months, and the most common diseases were severe combined immunodeficiency (SCID) (n=67) and Wiskott-Aldrich syndrome (WAS) (n=67). Only 15 patients received unconditioned transplants. Cumulative incidence of GVHD grades II to IV was 23%, and GVHD grades III to IV was 10%. The 5-year overall survival was 71.6%. WAS patients had better survival compared to other diseases. Most deaths (n=53) occurred in the first year after transplantation mainly due to infection (55%) and GVHD (13%). Although transplant for PID patients in Brazil has evolved since its beginning, we still face some challenges like delayed diagnosis and referral, severe infections before transplant, a limited number of transplant centers with expertise, and resources for more advanced techniques. Measures like newborn screening for SCID may hasten the diagnosis and ameliorate patients' conditions at the moment of transplant.
6.	Habineza, Theogene, et al. (författare) End-to-end risk prediction of atrial fibrillation from the 12-Lead ECG by deep neural networks 2023 Ingår i: Journal of Electrocardiology. - : Elsevier. - 0022-0736 .- 1532-8430. ; 81, s. 193-200 Tidskriftsartikel (refereegranskat)abstract Background: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias that affects millions of people each year worldwide and it is closely linked to increased risk of cardiovas-cular diseases such as stroke and heart failure. Machine learning methods have shown promising results in evaluating the risk of developing atrial fibrillation from the electrocardiogram. We aim to develop and evaluate one such algorithm on a large CODE dataset collected in Brazil.Methods: We used the CODE cohort to develop and test a model for AF risk prediction for individual patients from the raw ECG recordings without the use of additional digital biomarkers. The cohort is a collection of ECG recordings and annotations by the Telehealth Network of Minas Gerais, in Brazil. A convolutional neural network based on a residual network architecture was implemented to produce class probabilities for the classification of AF. The probabilities were used to develop a Cox proportional hazards model and a Kaplan-Meier model to carry out survival analysis. Hence, our model is able to perform risk prediction for the development of AF in patients without the condition.Results: The deep neural network model identified patients without indication of AF in the presented ECG but who will develop AF in the future with an AUC score of 0.845. From our survival model, we obtain that patients in the high-risk group (i.e. with the probability of a future AF case being >0.7) are 50% more likely to develop AF within 40 weeks, while patients belonging to the minimal-risk group (i.e. with the probability of a future AF case being less than or equal to 0.1) have >85% chance of remaining AF free up until after seven years.Conclusion: We developed and validated a model for AF risk prediction. If applied in clinical practice, the model possesses the potential of providing valuable and useful information in decision- making and patient management processes.
7.	Lindow, Thomas, et al. (författare) Heart age gap estimated by explainable advanced electrocardiography is associated with cardiovascular risk factors and survival 2023 Ingår i: The European Heart Journal - Digital Health. - : Oxford University Press. - 2634-3916. ; 4:5, s. 384-392 Tidskriftsartikel (refereegranskat)abstract AimsDeep neural network artificial intelligence (DNN-AI)-based Heart Age estimations have been presented and used to show that the difference between an electrocardiogram (ECG)-estimated Heart Age and chronological age is associated with prognosis. An accurate ECG Heart Age, without DNNs, has been developed using explainable advanced ECG (A-ECG) methods. We aimed to evaluate the prognostic value of the explainable A-ECG Heart Age and compare its performance to a DNN-AI Heart Age.Methods and resultsBoth A-ECG and DNN-AI Heart Age were applied to patients who had undergone clinical cardiovascular magnetic resonance imaging. The association between A-ECG or DNN-AI Heart Age Gap and cardiovascular risk factors was evaluated using logistic regression. The association between Heart Age Gaps and death or heart failure (HF) hospitalization was evaluated using Cox regression adjusted for clinical covariates/comorbidities. Among patients [n = 731, 103 (14.1%) deaths, 52 (7.1%) HF hospitalizations, median (interquartile range) follow-up 5.7 (4.7-6.7) years], A-ECG Heart Age Gap was associated with risk factors and outcomes [unadjusted hazard ratio (HR) (95% confidence interval) (5 year increments): 1.23 (1.13-1.34) and adjusted HR 1.11 (1.01-1.22)]. DNN-AI Heart Age Gap was associated with risk factors and outcomes after adjustments [HR (5 year increments): 1.11 (1.01-1.21)], but not in unadjusted analyses [HR 1.00 (0.93-1.08)], making it less easily applicable in clinical practice.ConclusionA-ECG Heart Age Gap is associated with cardiovascular risk factors and HF hospitalization or death. Explainable A-ECG Heart Age Gap has the potential for improving clinical adoption and prognostic performance compared with existing DNN-AI-type methods. Graphical Abstract
8.	Pastika, Libor, et al. (författare) Artificial intelligence-enhanced electrocardiography derived body mass index as a predictor of future cardiometabolic disease 2024 Ingår i: npj Digital Medicine. - : Springer Nature. - 2398-6352. ; 7 Tidskriftsartikel (refereegranskat)abstract The electrocardiogram (ECG) can capture obesity-related cardiac changes. Artificial intelligence-enhanced ECG (AI-ECG) can identify subclinical disease. We trained an AI-ECG model to predict body mass index (BMI) from the ECG alone. Developed from 512,950 12-lead ECGs from the Beth Israel Deaconess Medical Center (BIDMC), a secondary care cohort, and validated on UK Biobank (UKB) (n = 42,386), the model achieved a Pearson correlation coefficient (r) of 0.65 and 0.62, and an R2 of 0.43 and 0.39 in the BIDMC cohort and UK Biobank, respectively for AI-ECG BMI vs. measured BMI. We found delta-BMI, the difference between measured BMI and AI-ECG-predicted BMI (AI-ECG-BMI), to be a biomarker of cardiometabolic health. The top tertile of delta-BMI showed increased risk of future cardiometabolic disease (BIDMC: HR 1.15, p < 0.001; UKB: HR 1.58, p < 0.001) and diabetes mellitus (BIDMC: HR 1.25, p < 0.001; UKB: HR 2.28, p < 0.001) after adjusting for covariates including measured BMI. Significant enhancements in model fit, reclassification and improvements in discriminatory power were observed with the inclusion of delta-BMI in both cohorts. Phenotypic profiling highlighted associations between delta-BMI and cardiometabolic diseases, anthropometric measures of truncal obesity, and pericardial fat mass. Metabolic and proteomic profiling associates delta-BMI positively with valine, lipids in small HDL, syntaxin-3, and carnosine dipeptidase 1, and inversely with glutamine, glycine, colipase, and adiponectin. A genome-wide association study revealed associations with regulators of cardiovascular/metabolic traits, including SCN10A, SCN5A, EXOG and RXRG. In summary, our AI-ECG-BMI model accurately predicts BMI and introduces delta-BMI as a non-invasive biomarker for cardiometabolic risk stratification.
9.	Sangha, Veer, et al. (författare) Automated multilabel diagnosis on electrocardiographic images and signals 2022 Ingår i: Nature Communications. - : Springer Nature. - 2041-1723. ; 13:1 Tidskriftsartikel (refereegranskat)abstract The application of artificial intelligence for automated diagnosis of electrocardiograms can improve care in remote settings but is limited by the reliance on infrequently available signal-based data. Here, the authors report the development of a multi-label automated diagnosis model for electrocardiographic images. The application of artificial intelligence (AI) for automated diagnosis of electrocardiograms (ECGs) can improve care in remote settings but is limited by the reliance on infrequently available signal-based data. We report the development of a multilabel automated diagnosis model for electrocardiographic images, more suitable for broader use. A total of 2,228,236 12-lead ECGs signals from 811 municipalities in Brazil are transformed to ECG images in varying lead conformations to train a convolutional neural network (CNN) identifying 6 physician-defined clinical labels spanning rhythm and conduction disorders, and a hidden label for gender. The image-based model performs well on a distinct test set validated by at least two cardiologists (average AUROC 0.99, AUPRC 0.86), an external validation set of 21,785 ECGs from Germany (average AUROC 0.97, AUPRC 0.73), and printed ECGs, with performance superior to signal-based models, and learning clinically relevant cues based on Grad-CAM. The model allows the application of AI to ECGs across broad settings.
10.	Sangha, Veer, et al. (författare) Detection of Left Ventricular Systolic Dysfunction From Electrocardiographic Images 2023 Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 148:9, s. 765-777 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Left ventricular (LV) systolic dysfunction is associated with a >8-fold increased risk of heart failure and a 2-fold risk of premature death. The use of ECG signals in screening for LV systolic dysfunction is limited by their availability to clinicians. We developed a novel deep learning-based approach that can use ECG images for the screening of LV systolic dysfunction.METHODS: Using 12-lead ECGs plotted in multiple different formats, and corresponding echocardiographic data recorded within 15 days from the Yale New Haven Hospital between 2015 and 2021, we developed a convolutional neural network algorithm to detect an LV ejection fraction <40%. The model was validated within clinical settings at Yale New Haven Hospital and externally on ECG images from Cedars Sinai Medical Center in Los Angeles, CA; Lake Regional Hospital in Osage Beach, MO; Memorial Hermann Southeast Hospital in Houston, TX; and Methodist Cardiology Clinic of San Antonio, TX. In addition, it was validated in the prospective Brazilian Longitudinal Study of Adult Health. Gradient-weighted class activation mapping was used to localize class-discriminating signals on ECG images.RESULTS: Overall, 385 601 ECGs with paired echocardiograms were used for model development. The model demonstrated high discrimination across various ECG image formats and calibrations in internal validation (area under receiving operation characteristics [AUROCs], 0.91; area under precision-recall curve [AUPRC], 0.55); and external sets of ECG images from Cedars Sinai (AUROC, 0.90 and AUPRC, 0.53), outpatient Yale New Haven Hospital clinics (AUROC, 0.94 and AUPRC, 0.77), Lake Regional Hospital (AUROC, 0.90 and AUPRC, 0.88), Memorial Hermann Southeast Hospital (AUROC, 0.91 and AUPRC 0.88), Methodist Cardiology Clinic (AUROC, 0.90 and AUPRC, 0.74), and Brazilian Longitudinal Study of Adult Health cohort (AUROC, 0.95 and AUPRC, 0.45). An ECG suggestive of LV systolic dysfunction portended >27-fold higher odds of LV systolic dysfunction on transthoracic echocardiogram (odds ratio, 27.5 [95% CI, 22.3-33.9] in the held-out set). Class-discriminative patterns localized to the anterior and anteroseptal leads (V2 and V3), corresponding to the left ventricle regardless of the ECG layout. A positive ECG screen in individuals with an LV ejection fraction & GE;40% at the time of initial assessment was associated with a 3.9-fold increased risk of developing incident LV systolic dysfunction in the future (hazard ratio, 3.9 [95% CI, 3.3-4.7]; median follow-up, 3.2 years).CONCLUSIONS: We developed and externally validated a deep learning model that identifies LV systolic dysfunction from ECG images. This approach represents an automated and accessible screening strategy for LV systolic dysfunction, particularly in low-resource settings.
11.	Stanaway, Jeffrey D., et al. (författare) Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017 2018 Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994 Tidskriftsartikel (refereegranskat)abstract Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
12.	Zvuloni, Eran, et al. (författare) On Merging Feature Engineering and Deep Learning for Diagnosis, Risk Prediction and Age Estimation Based on the 12-Lead ECG 2023 Ingår i: IEEE Transactions on Biomedical Engineering. - : Institute of Electrical and Electronics Engineers (IEEE). - 0018-9294 .- 1558-2531. ; 70:7, s. 2227-2236 Tidskriftsartikel (refereegranskat)abstract Objective: Over the past few years, deep learning (DL) has been used extensively in research for 12-lead electrocardiogram (ECG) analysis. However, it is unclear whether the explicit or implicit claims made on DL superiority to the more classical feature engineering (FE) approaches, based on domain knowledge, hold. In addition, it remains unclear whether combining DL with FE may improve performance over a single modality.Methods: To address these research gaps and in-line with recent major experiments, we revisited three tasks: cardiac arrhythmia diagnosis (multiclass-multilabel classification), atrial fibrillation risk prediction (binary classification), and age estimation (regression). We used an overall dataset of 2.3M 12-lead ECG recordings to train the following models for each task: i) a random forest taking FE as input; ii) an end-to-end DL model; and iii) a merged model of FE+DL.Results: FE yielded comparable results to DL while necessitating significantly less data for the two classification tasks. DL outperformed FE for the regression task. For all tasks, merging FE with DL did not improve performance over DL alone. These findings were confirmed on the additional PTB-XL dataset. Conclusion: We found that for traditional 12-lead ECG based diagnosis tasks, DL did not yield a meaningful improvement over FE, while it improved significantly the nontraditional regression task. We also found that combining FE with DL did not improve over DL alone, which suggests that the FE was redundant with the features learned by DL.Significance: Our findings provides important recommendations on 12-lead ECG based machine learning strategy and data regime to choose for a given task. When looking at maximizing performance as the end goal, if the task is nontraditional and a large dataset is available then DL is preferable. If the task is a classical one and/or a small dataset is available then a FE approach may be the better choice.
13.	da Cunha, Wiliam Ferreira, et al. (författare) Reactive Scattering between Excitons and Charge Carriers in Conjugated Polymers 2014 Ingår i: The Journal of Physical Chemistry C. - : American Chemical Society (ACS). - 1932-7447 .- 1932-7455. ; 118:41, s. 23451-23458 Tidskriftsartikel (refereegranskat)abstract The temperature influence on the scattering process between an exciton and a positively charged carrier (polaron or bipolaron) is theoretically investigated using a version of the SuSchriefferHeeger (SSH) model modified to include temperature, Coulomb interactions, and an external electric field. In general, it is observed that the products of the reactive scattering are spin independent when thermal effects are taken into account. For the interaction between a polaron and an exciton, the polaron can be annihilated, when subjected to temperatures higher than a critical value, or pass through the exciton maintaining both their consistencies, if a lower temperature regime is considered. Regarding the recombination between a bipolaron and an exciton, it is observed that the bipolaron can be annihilated whereas the exciton dissociates into two trions or into one polaron and one trion. In all cases, the recombination mechanisms depend on a suitable balance between temperature and electric field. These results may extend the knowledge about electroluminescence process in conjugated polymers, thus being of potential use to improve internal quantum efficiency in polymer light-emitting diodes.
14.	de Sousa, Leonardo Evaristo, et al. (författare) Dynamical exciton decay in organic materials: the role of bimolecular recombination 2019 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : ROYAL SOC CHEMISTRY. - 1463-9076 .- 1463-9084. ; 21:4, s. 1711-1716 Tidskriftsartikel (refereegranskat)abstract Excitons play a critical role in light emission when it comes to organic semiconductors. In high exciton concentration regimes, monomolecular and bimolecular routes for exciton recombination can yield different products affecting significantly the materials optical properties. Here, the dynamical decay of excitons is theoretically investigated using a kinetic Monte Carlo approach that addresses singlet exciton diffusion. Our numerical protocol includes two distinct exciton-exciton interaction channels: exciton annihilation and biexciton cascade emission. Our findings reveal that these channels produce different consequences concerning diffusion and spectroscopic properties, being able to explain diverging experimental observations. Importantly, we estimate critical exciton densities for which bimolecular recombination becomes dominant and investigate its effect on average exciton lifetimes and diffusion lengths.
15.	Ferreira da Cunha, Wiliam, et al. (författare) Impurity effects on polaron dynamics in graphene nanoribbons 2015 Ingår i: Carbon. - : Elsevier. - 0008-6223 .- 1873-3891. ; 91, s. 171-177 Tidskriftsartikel (refereegranskat)abstract The impurity effects on the dynamics of polarons in armchair graphene nanoribbons are numerically investigated in the scope of a two-dimensional tight-binding approach with lattice relaxation. The results show that the presence of an impurity changes significantly the net charge distribution associated to the polaron structure. Moreover, the interplay between external electric field and the local impurities plays the role of drastically modifying the polaron dynamics. Interestingly, nanoribbons containing mobile polarons are noted to take place even when considering high impurity levels, which is associated with the highly conductive character of the graphene nanoribbons. This investigation may enlighten the understanding of the charge transport mechanism in carbon-based nanomaterials. (C) 2015 Elsevier Ltd. All rights reserved.
16.	Ferreira Monteiro, Fabio, et al. (författare) Encapsulated beta-carotene in ZnO nanotubes: Theoretical insight into the stabilization dynamics 2015 Ingår i: Chemical Physics Letters. - : ELSEVIER SCIENCE BV. - 0009-2614 .- 1873-4448. ; 636, s. 62-66 Tidskriftsartikel (refereegranskat)abstract The stabilization dynamics of a molecular dye (beta-carotene) encapsulated in single-wall zinc oxide nanotubes (ZnONTs) is theoretically investigated in the scope of molecular dynamics and density functional theory simulations. Our findings show that the beta-carotene encapsulation in ZnONTs is an energetically favorable process. Once encapsulated, this molecular dye remains close to the ZnONT wall, in accordance with recent experimental reports. Interestingly, the interaction between the beta-carotene and ZnONT can form a charge delocalization state, where an amount of charge concentrated on beta-carotene is transferred to ZnONT. (C) 2015 Elsevier B.V. All rights reserved.
17.	Kastinen, Tuuva, et al. (författare) Electronic couplings and rates of excited state charge transfer processes at poly(thiophene-co-quinoxaline)-PC71BM interfaces: two- versus multi-state treatments 2019 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : ROYAL SOC CHEMISTRY. - 1463-9076 .- 1463-9084. ; 21:46, s. 25606-25625 Tidskriftsartikel (refereegranskat)abstract Electronic coupling between adjacent molecules is one of the key parameters determining the charge transfer (CT) rates in bulk heterojunction (BHJ) polymer solar cells (PSCs). We calculate theoretically electronic couplings for exciton dissociation (ED) and charge recombination (CR) processes at local poly(thiophene-co-quinoxaline) (TQ)-PC71BM interfaces. We use eigenstate-based coupling schemes, i.e. the generalized Mulliken-Hush (GMH) and fragment charge difference (FCD) schemes, including 2 to multiple (3-11) states. Moreover, we study the effects of functionals, excited state methods, basis sets, surrounding media, and relative placements of TQ and PC71BM on the coupling values. Generally, both schemes provide consistent couplings with the global hybrid functionals, which yield more charge-localized diabatic states and constant coupling values regardless of the number of states, and so the 2-state schemes may be sufficient. The (non-tuned and optimally tuned) long-range corrected (LRC) functionals result in more notable mixing of the local components with the CT states. Employing multiple states reduces the mixing and thus improves the LRC results, although the method still affects the GMH CR couplings. As the FCD scheme is less sensitive, we recommend combining it with the multi-state treatment for polymer-fullerene systems when using the LRC functionals. Finally, we employ the 11-state FCD couplings to calculate the ED and CR rates, which are consistent with the experimental rates of the polymer-fullerene systems. Our results provide more insight into choosing a suitable eigenstate-based coupling scheme for predicting the electronic couplings and CT rates in photoactive systems.
18.	Passos Abreu, Ana Virginia, et al. (författare) Impact of the Electron-Phonon Interactions on the Polaron Dynamics in Graphene Nanoribbons 2016 Ingår i: Journal of Physical Chemistry A. - : AMER CHEMICAL SOC. - 1089-5639 .- 1520-5215. ; 120:27, s. 4901-4906 Tidskriftsartikel (refereegranskat)abstract The influence of the electron-phonon (e-ph) interactions on the filed-included polaron dynamics in armchair graphene nanoribbons (GNRs) is theoretically investigated in the scope of a two-dimensional tight-binding model. The results show that the localization of the polaronic charge increases when the strength of e-ph coupling also increases. Consequently, the polaron saturation velocity decreases for higher e-ph coupling strengths. Interestingly, the interplay between the e-ph coupling strength and the GNR width changes substantially the polaron dynamics properties.
19.	Ribeiro Jr, Luiz Antonio, et al. (författare) Spin-Orbit Effects on the Dynamical Properties of Polarons in Graphene Nanoribbons 2018 Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 8 Tidskriftsartikel (refereegranskat)abstract The dynamical properties of polarons in armchair graphene nanoribbons (GNR) is numerically investigated in the framework of a two-dimensional tight-binding model that considers spin-orbit (SO) coupling and electron-lattice (e-l) interactions. Within this physical picture, novel polaron properties with no counterparts to results obtained from conventional tight-binding models are obtained. Our findings show that, depending on the systems width, the presence of SO coupling changes the polarons charge localization giving rise to different degrees of stability for the charge carrier. For instance, the joint action of SO coupling and e-l interactions could promote a slight increase on the charge concentration in the center of the lattice deformation associated to the polaron. As a straightforward consequence, this process of increasing stability would lead to a depreciation in the polarons motion by decreasing its saturation velocity. Our finds are in good agreement with recent experimental investigations for the charge localization in GNR, mostly when it comes to the influence of SO coupling. Moreover, the contributions reported here provide a reliable method for future works to evaluate spin-orbit influence on the performance of graphene nanoribbons.
20.	Ribeiro, Luiz Antonio, et al. (författare) Bloch oscillations in organic and inorganic polymers 2017 Ingår i: Journal of Chemical Physics. - : AMER INST PHYSICS. - 0021-9606 .- 1089-7690. ; 146:14 Tidskriftsartikel (refereegranskat)abstract The transport of polarons above the mobility threshold in organic and inorganic polymers is theoretically investigated in the framework of a one-dimensional tight-binding model that includes lattice relaxation. The computational approach is based on parameters for which the model Hamiltonian suitably describes different polymer lattices in the presence of external electric fields. Our findings show that, above critical field strengths, a dissociated polaron moves through the polymer lattice as a free electron performing Bloch oscillations. These critical electric fields are considerably smaller for inorganic lattices in comparison to organic polymers. Interestingly, for inorganic lattices, the free electron propagates preserving charge and spin densities localization which is a characteristic of a static polaron. Moreover, in the turning points of the spatial Bloch oscillations, transient polaron levels are formed inside the band gap, thus generating a fully characterized polaron structure. For the organic case, on the other hand, no polaron signature is observed: neither in the shape of the distortion-those polaron profile signatures are absent-nor in the energy levels-as no such polaron levels are formed during the simulation. These results solve controversial aspects concerning Bloch oscillations recently reported in the literature and may enlighten the understanding about the charge transport mechanism in polymers above their mobility edge. Published by AIP Publishing.
21.	Ribeiro, Luiz Antonio, et al. (författare) Concentration effects on intrachain polaron recombination in conjugated polymers 2015 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : Royal Society of Chemistry. - 1463-9076 .- 1463-9084. ; 17:2, s. 1299-1308 Tidskriftsartikel (refereegranskat)abstract The influence of different charge carrier concentrations on the recombination dynamics between oppositely charged polarons is numerically investigated using a modified version of the Su-Schrieffer-Heeger (SSH) model that includes an external electric field and electron-electron interactions. Our findings show that the external electric field can play the role of avoiding the formation of excited states (polaron-exciton and neutral excitation) leading the system to a dimerized lattice. Interestingly, depending on a suitable balance between the polaron concentration and the electric field strength, the recombination mechanism can form stable polaron-excitons or neutral excitations. These results may provide guidance to improve the electroluminescence efficiency in Polymer Light Emitting Diodes.
22.	Ribeiro, Luiz Antonio, et al. (författare) Dynamic Formation of Bipolaron-Exciton Complexes in Conducting Polymers 2018 Ingår i: Journal of Physical Chemistry A. - : AMER CHEMICAL SOC. - 1089-5639 .- 1520-5215. ; 122:15, s. 3866-3872 Tidskriftsartikel (refereegranskat)abstract The recombination dynamics of two oppositely charged bipolarons within a single polymer chain is numerically studied in the scope of a one-dimensional tight-binding model that considers electron electron and electron-phonon (e-ph) interactions. By scanning among values of e-ph coupling and electric field, novel channels for the bipolaron recombination were yielded based on the interplay between these two parameters. The findings point to the formation of a compound species formed from the coupling between a bipolaron and an exciton. Depending on the electric field and e-ph coupling strengths, the recombination mechanism may yield two distinct products: a trapped (and almost neutral) or a moving (and partially charged) bipolaron-exciton. These results might enlighten the understanding of the electroluminescence processes in organic light-emitting devices.
23.	Ribeiro, Luiz Antonio, et al. (författare) Temperature effects on intrachain recombination of bipolarons in conjugated polymers 2014 Ingår i: Chemical Physics Letters. - : Elsevier. - 0009-2614 .- 1873-4448. ; 614, s. 151-155 Tidskriftsartikel (refereegranskat)abstract The temperature influence over the intrachain recombination dynamics between oppositely charged bipolarons has been theoretically investigated using a version of the Su-Schrieffer-Heeger model. The results shown that, below of a critical temperature regime, these charge carriers can recombine into a biexciton. This excited state is a light emissive specie that can emit one photon and turn into an exciton state. This specie can thereafter decay to the ground state by other photon emission. This knowledge can enlighten the understanding needed to improve the internal quantum efficiency of electroluminescence in Polymer Light Emitting Diodes.
24.	Ribeiro, Luiz Antonio, et al. (författare) Transport of Polarons in Graphene Nanoribbons 2015 Ingår i: The Journal of Physical Chemistry Letters. - : American Chemical Society. - 1948-7185. ; 6:3, s. 510-514 Tidskriftsartikel (refereegranskat)abstract The field-induced dynamics of polarons in armchair graphene nanoribbons (GNRs) is theoretically investigated in the framework of a two-dimensional tight-binding model with lattice relaxation. Our findings show that the semiconductor behavior, fundamental to polaron transport to take place, depends upon of a suitable balance between the GNR width and the electronphonon (eph) coupling strength. In a similar way, we found that the parameter space for which the polaron is dynamically stable is limited to an even narrower region of the GNR width and the eph coupling strength. Interestingly, the interplay between the external electric field and the eph coupling plays the role to define a phase transition from subsonic to supersonic velocities for polarons in GNRs.
25.	Rivera Vila, Henrique Vieira, et al. (författare) On the Angular Distribution of the H+Li-2 Cross Sections: a Converged Time-Independent Quantum Scattering Study 2018 Ingår i: Scientific Reports. - : NATURE PUBLISHING GROUP. - 2045-2322. ; 8 Tidskriftsartikel (refereegranskat)abstract A thorough time-independent quantum scattering study is performed on a benchmark potential energy surface for the H+Li-2 reaction at the fundamental electronic state. Integral and differential cross sections are calculated along with thermal rate coefficients until convergence is reached. Our findings show that vibrational and rotational excitations of the reactant hinder reactivity, though for the latter a considerable reaction promotion was spotted as we increase the reactant rotational quantum number until the critical value of j = 4. Such a promotion then begins to retract, eventually becoming an actual inhibition for larger j. In a straightforward manner, the concept of time-independent methods implemented in this study allowed this accurate state-to-state analysis. Furthermore, a nearly isotropic behaviour of the scattering is noted to take place from the angular point of view. Remarkably, our computational protocol is ideally suited to yield converged thermal rate coefficients, revealing a non-Arrhenius pattern and showing that J-shifting approach fails to describe this particular reaction. Our results, when compared to previous and independent ones, reinforce the latest theoretical reference for future validation in the experimental field.
26.	Roth, Gregory A, et al. (författare) Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019 : Update From the GBD 2019 Study 2020 Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 76:25, s. 2982-3021 Tidskriftsartikel (refereegranskat)abstract Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019. Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019. Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases.
27.	Silva, Gesiel Gomes, et al. (författare) Bipolaron Dynamics in Graphene Nanoribbons 2019 Ingår i: Scientific Reports. - : NATURE PUBLISHING GROUP. - 2045-2322. ; 9 Tidskriftsartikel (refereegranskat)abstract Graphene nanoribbons (GNRs) are two-dimensional structures with a rich variety of electronic properties that derive from their semiconducting band gaps. In these materials, charge transport can occur via a hopping process mediated by carriers formed by self-interacting states between the excess charge and local lattice deformations. Here, we use a two-dimensional tight-binding approach to reveal the formation of bipolarons in GNRs. Our results show that the formed bipolarons are dynamically stable even for high electric field strengths when it comes to GNRs. Remarkably, the bipolaron dynamics can occur in acoustic and optical regimes concerning its saturation velocity. The phase transition between these two regimes takes place for a critical field strength in which the bipolaron moves roughly with the speed of sound in the material.
28.	Silva, Gesiel Gomes, et al. (författare) Influence of quasi-particle density over polaron mobility in armchair graphene nanoribbons 2018 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : ROYAL SOC CHEMISTRY. - 1463-9076 .- 1463-9084. ; 20:24, s. 16712-16718 Tidskriftsartikel (refereegranskat)abstract An important aspect concerning the performance of armchair graphene nanoribbons (AGNRs) as materials for conceiving electronic devices is related to the mobility of charge carriers in these systems. When several polarons are considered in the system, a quasi-particle wave function can be affected by that of its neighbor provided the two are close enough. As the overlap may affect the transport of the carrier, the question concerning how the density of polarons affect its mobility arises. In this work, we investigate such dependence for semiconducting AGNRs in the scope of nonadiabatic molecular dynamics. Our results unambiguously show an impact of the density on both the stability and average velocity of the quasi-particles. We have found a phase transition between regimes where increasing density stops inhibiting and starts promoting mobility; densities higher than 7 polarons per 45 angstrom present increasing mean velocity with increasing density. We have also established three different regions relating electric field and average velocity. For the lowest electric field regime, surpassing the aforementioned threshold results in overcoming the 0.3 angstrom fs(-1) limit, thus representing a transition between subsonic and supersonic regimes. For the highest of the electric fields, density effects alone are responsible for a stunning difference of 1.5 angstrom fs(-1) in the mean carrier velocity.
29.	Young, William J., et al. (författare) Genetic analyses of the electrocardiographic QT interval and its components identify additional loci and pathways 2022 Ingår i: Nature Communications. - : Springer Nature. - 2041-1723. ; 13 Tidskriftsartikel (refereegranskat)abstract The QT interval is a heritable electrocardiographic measure associated with arrhythmia risk when prolonged. Here, the authors used a series of genetic analyses to identify genetic loci, pathways, therapeutic targets, and relationships with cardiovascular disease. The QT interval is an electrocardiographic measure representing the sum of ventricular depolarization and repolarization, estimated by QRS duration and JT interval, respectively. QT interval abnormalities are associated with potentially fatal ventricular arrhythmia. Using genome-wide multi-ancestry analyses (>250,000 individuals) we identify 177, 156 and 121 independent loci for QT, JT and QRS, respectively, including a male-specific X-chromosome locus. Using gene-based rare-variant methods, we identify associations with Mendelian disease genes. Enrichments are observed in established pathways for QT and JT, and previously unreported genes indicated in insulin-receptor signalling and cardiac energy metabolism. In contrast for QRS, connective tissue components and processes for cell growth and extracellular matrix interactions are significantly enriched. We demonstrate polygenic risk score associations with atrial fibrillation, conduction disease and sudden cardiac death. Prioritization of druggable genes highlight potential therapeutic targets for arrhythmia. Together, these results substantially advance our understanding of the genetic architecture of ventricular depolarization and repolarization.
30.	Agarwal, Anubha, et al. (författare) Toward a Universal Definition of Etiologies in Heart Failure : Categorizing Causes and Advancing Registry Science 2024 Ingår i: Circulation Heart Failure. - : American Heart Association. - 1941-3289 .- 1941-3297. ; 17:4 Forskningsöversikt (refereegranskat)abstract Heart failure (HF) is a well-described final common pathway for a broad range of diseases however substantial confusion exists regarding how to describe, study, and track these underlying etiologic conditions. We describe (1) the overlap in HF etiologies, comorbidities, and case definitions as currently used in HF registries led or managed by members of the global HF roundtable; (2) strategies to improve the quality of evidence on etiologies and modifiable risk factors of HF in registries; and (3) opportunities to use clinical HF registries as a platform for public health surveillance, implementation research, and randomized registry trials to reduce the global burden of noncommunicable diseases. Investment and collaboration among countries to improve the quality of evidence in global HF registries could contribute to achieving global health targets to reduce noncommunicable diseases and overall improvements in population health.
31.	Antonio Ribeiro, Luiz, et al. (författare) Polaron stability in molecular semiconductors: theoretical insight into the impact of the temperature, electric field and the system dimensionality 2015 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : Royal Society of Chemistry. - 1463-9076 .- 1463-9084. ; 17:14, s. 8973-8982 Tidskriftsartikel (refereegranskat)abstract A semi-empirical Holstein-Peierls model is used to study the temperature effects on the polaron stability in organic semiconductors at a molecular scale. The approach takes into account both intra- and intermolecular electron-lattice interactions and is aimed at describing charge transport in the system. Particularly, we present a systematic numerical investigation to characterize the influence of both temperature and electric field on the stability as well as mobility of the polaron. It is found that the parameter space for which the polaron is dynamically stable is quite limited and the variations in some of these parameters strongly depend on the temperature. The electric field can play a role in further localizing the charge causing a compression of the lattice distortions associated with the polaron, increasing thereby its stability, up to a field strength of approximately 2.0 mV angstrom(-1). Considering field strengths higher than this critical value, the polaron is annihilated spreading charge through the lattice. Furthermore, we have studied the polaron mobility as a function of the anisotropy of the system, going from a one-dimensional system via a highly anisotropic two-dimensional system to a uniform two-dimensional system. There is a clearly observed mobility edge for the polaron; it exhibits a high mobility in the one-dimensional system but as the coupling in the second dimension is turned on the polaron slows down and becomes immobile in the uniform system. The results provided by this transport mechanism are in good agreement with experimental observations and may provide guidance to improve the charge transport in organic optoelectronic devices.
32.	Bacharova, Ljuba, et al. (författare) ISE/ISHNE Expert Consensus Statement on ECG Diagnosis of Left Ventricular Hypertrophy : The Change of the Paradigm. The joint paper of the International Society of Electrocardiology and the International Society for Holter Monitoring and Noninvasive Electrocardiology 2023 Ingår i: Journal of Electrocardiology. - 0022-0736 .- 1532-8430. ; 81, s. 85-93 Forskningsöversikt (refereegranskat)abstract The ECG diagnosis of LVH is predominantly based on the QRS voltage criteria, i.e. the increased QRS complex amplitude in defined leads. The classical ECG diagnostic paradigm postulates that the increased left ventricular mass generates a stronger electrical field, increasing the leftward and posterior QRS forces. These increased forces are reflected in the augmented QRS amplitude in the corresponding leads. However, the clinical observations document increased QRS amplitude only in the minority of patients with LVH. The low sensitivity of voltage criteria has been repeatedly documented. We discuss possible reasons for this shortcoming and proposal of a new paradigm.
33.	Bacharova, Ljuba, et al. (författare) ISE/ISHNE expert consensus statement on the ECG diagnosis of left ventricular hypertrophy : The change of the paradigm 2023 Ingår i: Annals of Noninvasive Electrocardiology. - 1082-720X. ; 29:1, s. e13097- Tidskriftsartikel (refereegranskat)abstract The ECG diagnosis of LVH is predominantly based on the QRS voltage criteria. The classical paradigm postulates that the increased left ventricular mass generates a stronger electrical field, increasing the leftward and posterior QRS forces, reflected in the augmented QRS amplitude. However, the low sensitivity of voltage criteria has been repeatedly documented. We discuss possible reasons for this shortcoming and proposal of a new paradigm. The theoretical background for voltage measured at the body surface is defined by the solid angle theorem, which relates the measured voltage to spatial and non-spatial determinants. The spatial determinants are represented by the extent of the activation front and the distance of the recording electrodes. The non-spatial determinants comprise electrical characteristics of the myocardium, which are comparatively neglected in the interpretation of the QRS patterns. Various clinical conditions are associated with LVH. These conditions produce considerable diversity of electrical properties alterations thereby modifying the resultant QRS patterns. The spectrum of QRS patterns observed in LVH patients is quite broad, including also left axis deviation, left anterior fascicular block, incomplete and complete left bundle branch blocks, Q waves, and fragmented QRS. Importantly, the QRS complex can be within normal limits. The new paradigm stresses the electrophysiological background in interpreting QRS changes, i.e., the effect of the non-spatial determinants. This postulates that the role of ECG is not to estimate LV size in LVH, but to understand and decode the underlying electrical processes, which are crucial in relation to cardiovascular risk assessment.
34.	Chen, Lin Yee, et al. (författare) P Wave Parameters and Indices : A Critical Appraisal of Clinical Utility, Challenges, and Future Research—A Consensus Document Endorsed by the International Society of Electrocardiology and the International Society for Holter and Noninvasive Electrocardiology 2022 Ingår i: Circulation: Arrhythmia and Electrophysiology. - 1941-3149. ; 15:4, s. 010435-010435 Forskningsöversikt (refereegranskat)abstract Atrial cardiomyopathy, characterized by abnormalities in atrial structure and function, is associated with increased risk of adverse cardiovascular and neurocognitive outcomes, independent of atrial fibrillation. There exists a critical unmet need for a clinical tool that is cost-effective, easy to use, and that can diagnose atrial cardiomyopathy. P wave parameters (PWPs) reflect underlying atrial structure, size, and electrical activation; alterations in these factors manifest as abnormalities in PWPs that can be readily ascertained from a standard 12-lead ECG and potentially be used to aid clinical decision-making. PWPs include P wave duration, interatrial block, P wave terminal force in V1, P wave axis, P wave voltage, P wave area, and P wave dispersion. PWPs can be combined to yield an index (P wave index), such as the morphology-voltage-P-wave duration ECG risk score. Abnormal PWPs have been shown in population-based cohort studies to be independently associated with higher risks of atrial fibrillation, ischemic stroke, sudden cardiac death, and dementia. Additionally, PWPs, either individually or in combination (as a P wave index), have been reported to enhance prediction of atrial fibrillation or ischemic stroke. To facilitate translation of PWPs to routine clinical practice, additional work is needed to standardize measurement of PWPs (eg, via semiautomated or automated measurement), confirm their reliability and predictive value, leverage novel approaches (eg, wavelet analysis of P waves and machine learning algorithms), and finally, define the risk-benefit ratio of specific interventions in high-risk individuals. Our ultimate goal is to repurpose the ubiquitous 12-lead ECG to advance the study, diagnosis, and treatment of atrial cardiomyopathy, thus overcoming critical challenges in prevention of cardiovascular disease and dementia.
35.	da Cunha, Wiliam Ferreira, et al. (författare) Quasiparticle description of transition metal dichalcogenide nanoribbons 2019 Ingår i: Physical Review B. - : AMER PHYSICAL SOC. - 2469-9950 .- 2469-9969. ; 99:3 Tidskriftsartikel (refereegranskat)abstract An effective two-dimensional real-space model is developed to investigate the nature of charge distribution in nanoribbons of transition metal dichalcogenides. Our description is based on a lattice relaxation endowed tight-binding Hamiltonian with spin-orbit and Hubbard interactions, which is parameterized to describe molybdenum disulfide lattices. As our main finding, we observed that electron-phonon coupling induces the creation of quasiparticles such as polarons in the same fashion as observed in conducting polymers and graphene nanoribbons. These similarities suggest that the charge transport in transition metal dichalcogenides can also be mediated by quasiparticles, which is a fundamental aspect concerning the application of these structures in electronics. We determine a range of possible electron-phonon coupling that correctly describes the system and also the critical value where quasiparticle transport is present. Our findings may have profound consequences on the understanding of the transport mechanism of transition metal dichalcogenides nanoribbons.
36.	Ferreira da Cunha, Wiliam, et al. (författare) Critical temperature and products of intrachain polaron recombination in conjugated polymers 2014 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : Royal Society of Chemistry. - 1463-9076 .- 1463-9084. ; 16:32, s. 17072-17080 Tidskriftsartikel (refereegranskat)abstract The intrachain recombination dynamics between oppositely charged polarons is theoretically investigated through the use of a version of the Su-Schrieffer-Heeger (SSH) model modified to include an external electric field, an extended Hubbard model, Coulomb interactions, and temperature effects in the framework of a nonadiabatic evolution method. Our results indicate notable characteristics concerning the polaron recombination: (1) it is found that there exists a critical temperature regime, below which an exciton is formed directly and (2) a pristine lattice is the resulting product of the recombination process, if the temperature is higher than the critical value. Additionally, it is found that the critical electric field regime plays the role of drastically modifying the system dynamics. These facts suggest that thermal effects in the intrachain recombination of polarons are crucial for the understanding of electroluminescence in optoelectronic devices, such as Polymer Light Emitting Diodes.
37.	Karnouskos, Stamatis, et al. (författare) Key Directions for Industrial Agent Based Cyber-Physical Production Systems 2019 Ingår i: 2019 IEEE INTERNATIONAL CONFERENCE ON INDUSTRIAL CYBER PHYSICAL SYSTEMS (ICPS 2019). - : IEEE. - 9781538685006 ; , s. 17-22 Konferensbidrag (refereegranskat)abstract Rapid technology advances and increasing digitalization bring new opportunities but also put new challenges to modern production systems. Industrial agent concepts and technologies can be used to address the needs of modern Cyber-Physical Production Systems (CPPS). To do so, their interplay, especially in industrial settings, needs to be better understood and assessed. Key directions for investigations that are relevant for industrial agent based CPPS are analyzed in this work, mainly the design patterns, interfaces between agents and CPPS, metrics to evaluate the quality of agent based CPPS, and distributed intelligence implemented in or by agents. Although efforts exist both in agent and CPPS domains, their amalgamation still has several aspects that are under-investigated, especially when considering large-scale systems of CPPS, and the proposed four directions discussed in this work, seem promising to address several of the key underlying challenges.
38.	Ntalla, Ioanna, et al. (författare) Multi-ancestry GWAS of the electrocardiographic PR interval identifies 202 loci underlying cardiac conduction 2020 Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 11:1 Tidskriftsartikel (refereegranskat)abstract The electrocardiographic PR interval reflects atrioventricular conduction, and is associated with conduction abnormalities, pacemaker implantation, atrial fibrillation (AF), and cardiovascular mortality. Here we report a multi-ancestry (N=293,051) genome-wide association meta-analysis for the PR interval, discovering 202 loci of which 141 have not previously been reported. Variants at identified loci increase the percentage of heritability explained, from 33.5% to 62.6%. We observe enrichment for cardiac muscle developmental/contractile and cytoskeletal genes, highlighting key regulation processes for atrioventricular conduction. Additionally, 8 loci not previously reported harbor genes underlying inherited arrhythmic syndromes and/or cardiomyopathies suggesting a role for these genes in cardiovascular pathology in the general population. We show that polygenic predisposition to PR interval duration is an endophenotype for cardiovascular disease, including distal conduction disease, AF, and atrioventricular pre-excitation. These findings advance our understanding of the polygenic basis of cardiac conduction, and the genetic relationship between PR interval duration and cardiovascular disease. On the electrocardiogram, the PR interval reflects conduction from the atria to ventricles and also serves as risk indicator of cardiovascular morbidity and mortality. Here, the authors perform genome-wide meta-analyses for PR interval in multiple ancestries and identify 141 previously unreported genetic loci.
39.	Pereira Junior, Marcelo Lopes, et al. (författare) Stationary polaron properties in organic crystalline semiconductors 2019 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : ROYAL SOC CHEMISTRY. - 1463-9076 .- 1463-9084. ; 21:5, s. 2727-2733 Tidskriftsartikel (refereegranskat)abstract Polarons play a crucial role in the charge transport mechanism when it comes to organic molecular crystals. The features of their underlying properties - mostly the ones that directly impact the yield of the net charge mobility - are still not completely understood. Here, a two-dimensional Holstein-Peierls model is employed to numerically describe the stationary polaron properties in organic semiconductors at a molecular scale. Our computational protocol yields model parameters that accurately characterize the formation and stability of polarons in ordered and disordered oligoacene-like crystals. The results show that the interplay between the intramolecular (Holstein) and intermolecular (Peierls) electron-lattice interactions critically impacts the polaron stability. Such an interplay can produce four distinct quasi-particle solutions: free-like electrons, metastable polarons, and small and large polarons. The latter governs the charge transport in organic crystalline semiconductors. Regarding disordered lattices, the model takes into account two modes of static disorder. Interestingly, the results show that intramolecular disorder is always unfavorable to the formation of polarons whereas intermolecular disorder may favor the polaron generation in regimes below a threshold for the electronic transfer integral strength.
40.	Ramani-Chander, Anusha, et al. (författare) Applying systems thinking to identify enablers and challenges to scale-up interventions for hypertension and diabetes in low-income and middle-income countries : protocol for a longitudinal mixed-methods study 2022 Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12 Tidskriftsartikel (refereegranskat)abstract Introduction: There is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to 27 collaborative projects, which were funded by the Global Alliance for Chronic Diseases (GACD) 2019 Scale Up Call, reflecting a total funding investment of approximately US$50 million. These projects represent diverse countries, contexts and adopt varied approaches and study designs to scale-up complex, evidence-based interventions to improve hypertension and diabetes outcomes. A systematic inquiry of these projects will provide necessary scientific insights into the enablers and challenges in the scale up of complex NCD interventions.Methods and analysis: We will apply systems thinking (a holistic approach to analyse the inter-relationship between constituent parts of scaleup interventions and the context in which the interventions are implemented) and adopt a longitudinal mixed-methods study design to explore the planning and early implementation phases of scale up projects. Data will be gathered at three time periods, namely, at planning (T-P), initiation of implementation (T-0) and 1-year postinitiation (T-1). We will extract project-related data from secondary documents at T-P and conduct multistakeholder qualitative interviews to gather data at T-0 and T-1. We will undertake descriptive statistical analysis of T-P data and analyse T-0 and T-1 data using inductive thematic coding. The data extraction tool and interview guides were developed based on a literature review of scale-up frameworks.Ethics and dissemination: The current protocol was approved by the Monash University Human Research Ethics Committee (HREC number 23482). Informed consent will be obtained from all participants. The study findings will be disseminated through peer-reviewed publications and more broadly through the GACD network.
41.	Ribeiro Junior, Luiz Antonio, et al. (författare) Trap-assisted charge transport at conjugated polymer interfaces 2016 Ingår i: Chemical Physics Letters. - : ELSEVIER SCIENCE BV. - 0009-2614 .- 1873-4448. ; 644, s. 121-126 Tidskriftsartikel (refereegranskat)abstract The trap-assisted charge transport in conjugated polymers is numerically investigated in the framework of a one-dimensional tight-binding model. Our findings show that a polaron trapped within an interchain region can be released migrating between the chains at low temperature regimes. Conversely, a trapped bipolaron cannot be released even considering high temperature values. Interestingly, for systems containing more than one polaron, the formation of trapped states is avoided and there is no charge transfer between the chains. Considering more than one bipolaron, the generation of trapped states occurs and a bipolaron can migrates between the chains. (C) 2015 Elsevier B.V. All rights reserved.
42.	Ribeiro, Luiz Antonio, et al. (författare) Charge Carrier Scattering in Polymers: A New Neutral Coupled Soliton Channel 2018 Ingår i: Scientific Reports. - : NATURE PUBLISHING GROUP. - 2045-2322. ; 8 Tidskriftsartikel (refereegranskat)abstract The dynamical scattering of two oppositely charged bipolarons in non-degenerate organic semiconducting lattices is numerically investigated in the framework of a one-dimensional tight-biding-Hubbard model that includes lattice relaxation. Our findings show that it is possible for the bipolaron pair to merge into a state composed of a confined soliton-antisoliton pair, which is characterized by the appearance of states within less than 0.1 eV from the Fermi level. This compound is in a narrow analogy to a meson confining a quark-antiquark pair. Interestingly, solitons are quasi-particles theoretically predicted to arise only in polymer lattices with degenerate ground state: in the general case of nondegenerate ground state polymers, isolated solitons are not allowed.
43.	Ribeiro, Luiz Antonio, et al. (författare) Impact of the electron-phonon coupling symmetry on the polaron stability and mobility in organic molecular semiconductors 2016 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : ROYAL SOC CHEMISTRY. - 1463-9076 .- 1463-9084. ; 18:3, s. 1386-1391 Tidskriftsartikel (refereegranskat)abstract The influence of the interplay between symmetric and antisymmetric inter-molecular electron-phonon (e-ph) coupling mechanisms on the polaron stability and mobility in organic semiconductors has been theoretically investigated at a molecular level. A semi-empirical Holstein-Peierls model is used which in addition to the symmetric and antisymmetric inter-molecular e-ph interactions also includes an antisymmetric intra-molecular e-ph coupling. Our results show that the symmetric e-ph coupling plays the role of destabilizing the polaron as a result of temperature induced phonons that, via the symmetric coupling, affects the charge distribution of the polaron. Considering this kind of coupling, the parameter space for which the polaron is dynamically stable is strongly temperature-dependent. For the combination of symmetric e-ph coupling strength and temperature, which results in a stable polaron, the velocity of the polaron, and therefore also the charge carrier mobility, is not affected by the symmetric e-ph coupling strength.
44.	Ribeiro, Luiz Antonio, et al. (författare) Nonadiabatic dynamics of injected holes in conjugated polymers 2017 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : ROYAL SOC CHEMISTRY. - 1463-9076 .- 1463-9084. ; 19:15, s. 10000-10008 Tidskriftsartikel (refereegranskat)abstract The dynamics of injected holes in short transient times that precede polaron formation is numerically studied in the framework of a tight-binding electron-phonon interacting approach aimed at describing organic one-dimensional lattices. In particular, the direct impact of internal and external factors on the conversion of injected holes into polarons is carefully investigated. The results show that a hole injected at levels lower than the highest occupied molecular orbital forms self-trapped bound structures that can merge spontaneously to form a polaron after, at least, one picosecond. On the other hand, the life-time of such structures substantially decreases (up to a few hundreds of femtoseconds) when the influence of external electric fields, temperature effects and impurities is considered. Importantly, the critical values of the aforementioned factors in promoting the quenching of the self-trapped structures are obtained. These findings may enlighten the understanding of the mechanism of charge carrier generation in Polymer Light Emitting Diodes when several kinds of excitations are present.
45.	Ribeiro, Luiz Antonio, et al. (författare) Polaron dynamics in anisotropic Holstein-Peierls systems 2017 Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : ROYAL SOC CHEMISTRY. - 1463-9076 .- 1463-9084. ; 19:5, s. 4078-4084 Tidskriftsartikel (refereegranskat)abstract Polaron dynamics in anisotropic organic molecular semiconductors is theoretically investigated and simulated in the framework of a semi-classical Holstein-Peierls model. Our computational protocol is presented and applied to studies of a two-dimensional molecular crystal. The intermolecular (Peierls) parameters for a particular crystal direction are systematically changed in order to study the effect of anisotropy in the system. The usefulness of this methodology is highlighted by studying the polaron dynamics on a picosecond timescale, which provides a microscopic insight into the influence of the interplay between different intramolecular parameters on the charge transport mechanism. Our results show that the polaron mobility is substantially reduced in going from an anisotropic to an isotropic relationship between the Peierls parameters for different directions in the crystal. Interestingly, the molecular charge distribution presents three different signatures corresponding to a one-dimensional polaron, a two-dimensional polaron, and an intermediate state for which the polaron localization depends on the degree of anisotropy. Importantly, the two-dimensional polaron, which is present in the essentially isotropic system, is immobile whereas the other two types of polarons are mobile. This, in order for polaron transport to occur in a two-dimensional molecular based system, this system has to be anisotropic.
46.	Ribeiro, Luiz Antonio, et al. (författare) Temperature Effects on the Scattering of Polarons and Bipolarons in Organic Conductors 2014 Ingår i: Journal of Physical Chemistry A. - : American Chemical Society. - 1089-5639 .- 1520-5215. ; 118:32, s. 6272-6277 Tidskriftsartikel (refereegranskat)abstract The scattering process between an electron-polaron and a hole-bipolaron has been simulated using a version of the Su-Schrieffer-Heeger (SSH) model modified to include an external electric field, Coulomb interactions, and temperature effects in the scope of nonadiabatic molecular dynamics. The simulations reveal remarkable details concerning the polaron-bipolaron recombination reaction. It is found that there exists a critical temperature regime below which a hole-bipolaron and a mixed state composed by an electron-polaron and an exciton are formed and a hole-bipolaron and a free electron are the resulting products of the collisional process, if the temperature is higher than the critical value. In addition, it is obtained that both channels depend sensitively on the strength of the applied electric field. These significant results may provide guidance to understand processes regarding electro-luminescence in polymer diodes.
47.	Rodrigues Meurer, Ywlliane da Silva, et al. (författare) Postnatal exposure to fluoxetine led to cognitive-emotional alterations and decreased parvalbumin positive neurons in the hippocampus of juvenile Wistar rats 2021 Ingår i: International Journal of Developmental Neuroscience. - : John Wiley & Sons. - 0736-5748 .- 1873-474X. ; 81:7, s. 616-632 Tidskriftsartikel (refereegranskat)abstract The exposure to selective serotonin reuptake inhibitors (SSRIs) during development results in behavioural impairment in adulthood in humans and animal models. Indeed, serotonergic overexpression in early life leads to structural and functional changes in brain circuits that control cognition and emotion. However, the effects of developmental exposure to these substances on the behaviour of adolescent rats are conflicting and remain poorly characterised. We performed a behavioural screening to investigate the effects of postnatal exposure to fluoxetine on memory and behaviours related to anxiety, anhedonia, and depression, as well we evaluate the parvalbumin expression in hippocampus of juvenile (similar to PND45) female and male rats. Fluoxetine (daily 20 mg/kg s.c. injections from PND7-PND21)- or vehicle-treated adolescent rats went through several behavioural tasks (from PND 38 to PND52) and were subject to transcardial perfusion and brain removal for immunohistochemical analysis (PND53). We found that postnatal exposure to fluoxetine increased anxiety- and depression-like behaviours in the open field and sucrose preference and forced swimming tests, respectively. In addition, this treatment induced working memory and short-term (but not long-term) recognition memory impairments, and reduced parvalbumin-positive inter-neurons in the hippocampus. In addition, the results revealed developmental sex-dependent effects of fluoxetine postnatal treatment on adolescent rats' behaviour. These outcomes indicate that affective disorders and mnemonic alterations caused by SSRIs perinatal exposure can be present at adolescence.
48.	Schnabel, Renate B., et al. (författare) Searching for Atrial Fibrillation Poststroke : A White Paper of the AF-SCREEN International Collaboration 2019 Ingår i: Circulation. - 1524-4539. ; 140:22, s. 1834-1850 Tidskriftsartikel (refereegranskat)abstract Cardiac thromboembolism attributed to atrial fibrillation (AF) is responsible for up to one-third of ischemic strokes. Stroke may be the first manifestation of previously undetected AF. Given the efficacy of oral anticoagulants in preventing AF-related ischemic strokes, strategies of searching for AF after a stroke using ECG monitoring followed by oral anticoagulation (OAC) treatment have been proposed to prevent recurrent cardioembolic strokes. This white paper by experts from the AF-SCREEN International Collaboration summarizes existing evidence and knowledge gaps on searching for AF after a stroke by using ECG monitoring. New AF can be detected by routine plus intensive ECG monitoring in approximately one-quarter of patients with ischemic stroke. It may be causal, a bystander, or neurogenically induced by the stroke. AF after a stroke is a risk factor for thromboembolism and a strong marker for atrial myopathy. After acute ischemic stroke, patients should undergo 72 hours of electrocardiographic monitoring to detect AF. The diagnosis requires an ECG of sufficient quality for confirmation by a health professional with ECG rhythm expertise. AF detection rate is a function of monitoring duration and quality of analysis, AF episode definition, interval from stroke to monitoring commencement, and patient characteristics including old age, certain ECG alterations, and stroke type. Markers of atrial myopathy (eg, imaging, atrial ectopy, natriuretic peptides) may increase AF yield from monitoring and could be used to guide patient selection for more intensive/prolonged poststroke ECG monitoring. Atrial myopathy without detected AF is not currently sufficient to initiate OAC. The concept of embolic stroke of unknown source is not proven to identify patients who have had a stroke benefitting from empiric OAC treatment. However, some embolic stroke of unknown source subgroups (eg, advanced age, atrial enlargement) might benefit more from non-vitamin K-dependent OAC therapy than aspirin. Fulfilling embolic stroke of unknown source criteria is an indication neither for empiric non-vitamin K-dependent OAC treatment nor for withholding prolonged ECG monitoring for AF. Clinically diagnosed AF after a stroke or a transient ischemic attack is associated with significantly increased risk of recurrent stroke or systemic embolism, in particular, with additional stroke risk factors, and requires OAC rather than antiplatelet therapy. The minimum subclinical AF duration required on ECG monitoring poststroke/transient ischemic attack to recommend OAC therapy is debated.
49.	Ubels, Jasper, et al. (författare) Cost-Effectiveness of Rheumatic Heart Disease Echocardiographic Screening in Brazil : Data from the PROVAR+ Study 2020 Ingår i: Global heart. - : Ubiquity Press. - 2211-8179 .- 2211-8160. ; 15:1 Tidskriftsartikel (refereegranskat)abstract Introduction: In recent years, new technologies - noticeably ultra-portable echocardiographic machines - have emerged, allowing for Rheumatic Heart Disease (RHD) early diagnosis. We aimed to perform a cost-utility analysis to assess the cost-effectiveness of RHD screening with handheld devices in the Brazilian context.Methods: A Markov model was created to assess the cost-effectiveness of one-time screening for RHD in a hypothetical cohort of 11-year-old socioeconomically disadvantaged children, comparing the intervention to standard care using a public perspective and a 30-year time horizon. The model consisted of 13 states: No RHD, Undiagnosed Asymptomatic Borderline RHD, Diagnosed Asymptomatic Borderline RHD, Untreated Asymptomatic Definite RHD, Treated Asymptomatic Definite RHD, Untreated Mild Clinical RHD, Treated Mild Clinical RHD, Untreated Severe Clinical RHD, Treated Severe Clinical RHD, Surgery, Post-Surgery and Death. The initial distribution of the population over the different states was derived from primary echo screening data. Costs of the different states were derived from the Brazilian public health system database. Transition probabilities and utilities were derived from published studies. A discount rate of 3%/year was used. A cost-effectiveness threshold of $25,949.85 per Disability Adjusted Life Year (DALY) averted is used in concordance with the 3x GDP per capita threshold in 2015.Results: RHD echo screening is cost-effective with an Incremental Cost-Effectiveness Ratio of $10,148.38 per DALY averted. Probabilistic modelling shows that the intervention could be considered cost-effective in 70% of the iterations.Conclusion: Screening for RHD with hand held echocardiographic machines in 11-year-old children in the target population is cost-effective in the Brazilian context.Highlights: A cost-effectiveness analysis showed that Rheumatic Heart Disease (RHD) echocardiographic screening utilizing handheld devices, performed by non-physicians with remote interpretation by telemedicine is cost-effective in a 30-year time horizon in Brazil.The model included primary data from the first large-scale RHD screening program in Brazilian underserved populations and costs from the Unified Health System (SUS), and suggests that the Incremental Cost-Effectiveness Ratio of the intervention is considerably below the acceptable threshold for Brazil, even after a detailed sensitivity analysis.Considering the high prevalence of subclinical RHD in Brazil, and the significant economic burden posed by advanced disease, these data are important for the formulation of public policies and surveillance approaches.Cost-saving strategies first implemented in Brazil by the PROVAR study, such as task-shifting to non-physicians, computer-based training, routine use of affordable devices and telemedicine for remote diagnosis may help planning RHD control programs in endemic areas worldwide.
50.	Varma, Niraj, et al. (författare) 2021 ISHNE/ HRS/ EHRA/ APHRS collaborative statement on mHealth in Arrhythmia Management : Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society 2021 Ingår i: Annals of Noninvasive Electrocardiology. - : Wiley. - 1082-720X .- 1542-474X. ; 26:2 Forskningsöversikt (refereegranskat)abstract This collaborative statement from the International Society for Holter and Noninvasive Electrocardiology/ Heart Rhythm Society/ European Heart Rhythm Association/ Asia Pacific Heart Rhythm Society describes the current status of mobile health ("mHealth") technologies in arrhythmia management. The range of digital medical tools and heart rhythm disorders that they may be applied to and clinical decisions that may be enabled are discussed. The facilitation of comorbidity and lifestyle management (increasingly recognized to play a role in heart rhythm disorders) and patient self-management are novel aspects of mHealth. The promises of predictive analytics but also operational challenges in embedding mHealth into routine clinical care are explored.

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