Discover and read the best of Twitter Threads about #CardioED
Most recents (24)
What is meant my Pulsus Paradoxus ?
A one-stop pathophysiology thread you’d ever need 🧵
#MedTwitter #MedStudentTwitter #MedEd #FOAMed #CardioEd #USMLE #ICU #EMTwitter
A one-stop pathophysiology thread you’d ever need 🧵
#MedTwitter #MedStudentTwitter #MedEd #FOAMed #CardioEd #USMLE #ICU #EMTwitter
To understand Pulsus Paradoxus in detail,
It is essential to realise for a fact that, 1. Pleural pressure, 2. Abdominal pressure, 3. Heart chamber pressures & 4. Lung pressures, are all interconnected, interact & react among each other.
It is essential to realise for a fact that, 1. Pleural pressure, 2. Abdominal pressure, 3. Heart chamber pressures & 4. Lung pressures, are all interconnected, interact & react among each other.
As we inspire —> the diaphragm moves down, creating a more negative intra-pleural pressure & a more positive abdominal pressure —> this adds up to ⬆️ venous return to right atrium —> excess blood enters RV & ⬆️ right ventricular end diastolic pressure (RVED)
How my half day work ✂️ on a Saturday is progressing…😄
1. Young lady with 🫀 disease referred by ENT doc with epistaxis 👃
1. Young lady with 🫀 disease referred by ENT doc with epistaxis 👃
Pounding heart 💓 with loud P2 & PSM at the lower left sternal area
I got the mother and she said since 6 months she is blue 🔵
Centralcyanosis➕Clubbing➕VSD➕PulmHTN
There was Hx of recurrent LRTIs in childhood.
I got the mother and she said since 6 months she is blue 🔵
Centralcyanosis➕Clubbing➕VSD➕PulmHTN
There was Hx of recurrent LRTIs in childhood.
I sent her 🏠 to get old records 🔖 and our suspicion of cyanotic CHD with incd 🫁 blood flow due to TOGV was right 🫵🏽
#ACC23 #WCCardio is jam packed w/ >300 sessions over 3 days w/ >80 live-streaming sessions around the world 🔥
Here’s how you can make the most of it👇🏻 (🧵)
@ACCinTouch @DougDrachmanMD @EdwardFryMD @Pooh_Velagapudi @agtruesdell @KBerlacher @taraloujones @SarasVallabhMD
1/5…
Here’s how you can make the most of it👇🏻 (🧵)
@ACCinTouch @DougDrachmanMD @EdwardFryMD @Pooh_Velagapudi @agtruesdell @KBerlacher @taraloujones @SarasVallabhMD
1/5…
1. Are you attending #ACC23 #WCCardio in-person?
Great!
‘Coz you can install the App & get everything you need to navigate the meeting 👇🏻
iPhone: apps.apple.com/us/app/acc-23-…
Android: play.google.com/store/apps/det…
#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd
2/5…
Great!
‘Coz you can install the App & get everything you need to navigate the meeting 👇🏻
iPhone: apps.apple.com/us/app/acc-23-…
Android: play.google.com/store/apps/det…
#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd
2/5…
2. Not very App savvy? No problem!
You can use ACC Online Program Planner to build an itinerary that meets all your needs 👇🏻
abstractsonline.com/pp8/#!/10674
#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd #MedStudentTwitter
3/5…
You can use ACC Online Program Planner to build an itinerary that meets all your needs 👇🏻
abstractsonline.com/pp8/#!/10674
#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd #MedStudentTwitter
3/5…
#CRT2023 @CRT_meeting had been an great success but behind this extraordinary meeting is an army of unsung heroes who work backstage & made it happen.
I had a chance to meet w/ them and wanted to take a moment to acknowledge their immense contribution 👏
@ron_waksman @hect2701
I had a chance to meet w/ them and wanted to take a moment to acknowledge their immense contribution 👏
@ron_waksman @hect2701
What is the Diagnosis?
#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #CardioEd #cardiologist #CardioTwitter
#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #CardioEd #cardiologist #CardioTwitter
Credit: @EM_RESUS Thank you very much for your interesting case and kind reminder.🥂
Rhabdomyolysis
1/7 A thread 🧵Intravascular lithotripsy (IVL) can help modify calcified lesions - why doesn’t it harm soft tissue? Let’s dig deeper. A thread🧵@DGK_org @YoungDgk @AvrahamCooperMD @PCRonline @Dr_DanMD @SCAI @guilbon @Hannah_Billig_ @yourheartdoc1 #CardioTwitter #CardioEd
2/7 Back in 80s extracorporal shockwave lithotripsy was introduced as a novel noninvasive treatment of renal stones. 40 years into the future we’ve taken this technique to the next level #IVL #MedTwitter
doi.org/10.1016/S0301-…
doi.org/10.1016/S0301-…
3/7 Changes have been made to utilize shock waves intravascularly:
➡️emitters mounted on balloon angioplasty catheters delivering waves pulsatile & circumferential
➡️minimal peak negative pressure pulses (0.3 MPa)
➡️into target vessel via 0.014 wire
➡️balloon inflated to 4 atm
➡️emitters mounted on balloon angioplasty catheters delivering waves pulsatile & circumferential
➡️minimal peak negative pressure pulses (0.3 MPa)
➡️into target vessel via 0.014 wire
➡️balloon inflated to 4 atm
Beautiful anatomy graphics from @medics_AbuSaif
#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #anatomy
#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #anatomy
TOP 🔟 ECHOCARDIOGRAPHY CASES ➡️ November 2022 (personal opinion) #medtwitter #pocus #echofirst #cardioed #cardiotwitter #medicaleducation #ENARM #FOAMed
⬇️🧵
⬇️🧵
10. Subaortic membrane in the outflow tract of LV @Irina67790690
9. Septal rupture complicating acute myocardial infarction @CyntiaMachain
🆘59 year male smoker
k/c/o COPD, DM, HTN with DCMP (EF=20%) palpitations and dizziness x 2 days
O/E : B/L crepts +, rest
ECG👇
#Medtwitter #MedEd2022 #ECG #CardioEd
k/c/o COPD, DM, HTN with DCMP (EF=20%) palpitations and dizziness x 2 days
O/E : B/L crepts +, rest
ECG👇
#Medtwitter #MedEd2022 #ECG #CardioEd
What is the likely rhythm ?
Answer - 𝘼𝙩𝙧𝙞𝙖𝙡 𝙁𝙞𝙗𝙧𝙞𝙡𝙡𝙖𝙩𝙞𝙤𝙣
📍Absent discrete P-waves
📍Fibrillatory waves (f-waves)
📍Irregularly irregular QRS complexes
📍Absent discrete P-waves
📍Fibrillatory waves (f-waves)
📍Irregularly irregular QRS complexes
📌#Cardiorenal Syndrome
Pathophysiology as a key to the therapeutic approach
#CardioTwitter #CardioEd #NephroTwitter #Review
Pathophysiology as a key to the therapeutic approach
#CardioTwitter #CardioEd #NephroTwitter #Review
Management & therapeutic approach📝
1/ #tweetorial
Management of Atrial Fibrillation (AF) with Rapid Ventricular Response (RVR) - KEY POINTS
➡️ Patients with atrial fibrillation who are unstable due to an RVR should be treated with synchronized cardioversion.
- Read More: manualofmedicine.com/topics/cardiol…
#meded #foamed
Management of Atrial Fibrillation (AF) with Rapid Ventricular Response (RVR) - KEY POINTS
➡️ Patients with atrial fibrillation who are unstable due to an RVR should be treated with synchronized cardioversion.
- Read More: manualofmedicine.com/topics/cardiol…
#meded #foamed
2/
➡️ Medications commonly used to control heart rate in atrial fibrillation include :
👉Calcium channel blockers (CCBs)
👉Beta-adrenergic blockers
👉Digoxin
👉Amiodarone.
#cardioed #CardioTwitter
➡️ Medications commonly used to control heart rate in atrial fibrillation include :
👉Calcium channel blockers (CCBs)
👉Beta-adrenergic blockers
👉Digoxin
👉Amiodarone.
#cardioed #CardioTwitter
3/
➡️ Calcium Channel Blockers or Beta Blockers are the first-line medications for most patients with Afib with an RVR.
➡️ All AV node–blocking medications are contraindicated for rate control of Afib in the setting of WPW, where conduction occurs through the accessory pathway.
➡️ Calcium Channel Blockers or Beta Blockers are the first-line medications for most patients with Afib with an RVR.
➡️ All AV node–blocking medications are contraindicated for rate control of Afib in the setting of WPW, where conduction occurs through the accessory pathway.
Joint British Society consensus recommendations for magnetic resonance imaging for patients with cardiac implantable electronic devices.
1. Recommendations for MRI workflows in patients with cardiac implantable electronic devices.
#CardioEd #Cardiotwitter #CardioScience
1. Recommendations for MRI workflows in patients with cardiac implantable electronic devices.
#CardioEd #Cardiotwitter #CardioScience
2. Workflow for provision of MRI to patients with MR Conditional cardiac implantable electronic devices.
3. Suggested additional steps required prior to performing MRI for patients with CIEDs that are MR Unlabelled or do not fulfil MR conditions.
#CardioEd #Cardiology #Cardio
3. Suggested additional steps required prior to performing MRI for patients with CIEDs that are MR Unlabelled or do not fulfil MR conditions.
#CardioEd #Cardiology #Cardio
4. Suggested consent statement for implanting cardiologists when potentially implanting an MR Unlabelled device, or revising/upgrading a device that may then become MR Unlabelled.
#MedEd #MedTwitter #FOAMed #cardio #CardioEd #Cardiology #CardioScience #Cardiotwitter
#MedEd #MedTwitter #FOAMed #cardio #CardioEd #Cardiology #CardioScience #Cardiotwitter
Landolfi’s sign #Cardiotwitter
🧵 1/7 Ever wondered why the Osborn wave looks the way it does? Stay with me during my newest #tweetorial. A thread 🧵1/7
#cardiotwitter #EPeeps #CardioEd #MedTwitter @TRassafMD @YoungDgk @DGK_org @YoungDZHK @AaronGoodman33 @Steph_Achenbach @fuzzymittens @AvrahamCooperMD
#cardiotwitter #EPeeps #CardioEd #MedTwitter @TRassafMD @YoungDgk @DGK_org @YoungDZHK @AaronGoodman33 @Steph_Achenbach @fuzzymittens @AvrahamCooperMD
2/7 History
First described in 1953 by Osborn (camel-hump sign) upon #hypothermia in dogs. Upon systemic analysis similar #ECG patterns have been described in
➡️ hypercalcemia
➡️ brain injury
➡️ SAB
➡️ vasospastic angina / ischemia
First described in 1953 by Osborn (camel-hump sign) upon #hypothermia in dogs. Upon systemic analysis similar #ECG patterns have been described in
➡️ hypercalcemia
➡️ brain injury
➡️ SAB
➡️ vasospastic angina / ischemia
3/7 Emslie-Smith et al showed that Osborn waves manifested more in epicardial than endocardial leads. Others finally showed that 4-aminopyridine sensitive transient outward current (Ito) is responsible and predominantly located in epicardium. ⬇️ heart rate led to ⬆️ Ito current
#Immunosuppressive therapy in virus-negative inflammatory CMP : 20-year follow-up of the #TIMIC trial
Immunosuppressive Tx of virus-negative inflammatory #CMP is associated to a persistent improvement of LV
function and better outcomes during long-term follow-up
#HeartFailure
Immunosuppressive Tx of virus-negative inflammatory #CMP is associated to a persistent improvement of LV
function and better outcomes during long-term follow-up
#HeartFailure
#Immunosuppressive Tx promoted an improvement in cardiac function in 88% of the cases compared the placebo group
A persistent ⤴️ in the #LVEF is seen in long -term (up to 20 years) clinical outcomes of the whole cohort of 85 patients originally enrolled in the #TIMIC trial
A persistent ⤴️ in the #LVEF is seen in long -term (up to 20 years) clinical outcomes of the whole cohort of 85 patients originally enrolled in the #TIMIC trial
Recurring virus-negative myocarditis responding to #immunosuppressive therapy
EKG showing LBBB (A) resolving after therapy (B)
(C and D) Echo apical view showing recovery of LV dysfunction from EF -28% ➡️ up to 51%
#HeartFailure #EchoFirst @ESC_Journals academic.oup.com/eurheartj/adva…
EKG showing LBBB (A) resolving after therapy (B)
(C and D) Echo apical view showing recovery of LV dysfunction from EF -28% ➡️ up to 51%
#HeartFailure #EchoFirst @ESC_Journals academic.oup.com/eurheartj/adva…
🧵 1/8 Myocardial bridging is present when part of coronary artery dips into & underneath heart muscle. Let’s dig deeper. 📖
Educational thread 🧵 1/8
#MedEd #CardioEd #CardioTwitter #MedTwitter #radialfirst @JACCJournals @YoungDgk @DGK_org @AGIKinterv @CardioNerds @escardio
Educational thread 🧵 1/8
#MedEd #CardioEd #CardioTwitter #MedTwitter #radialfirst @JACCJournals @YoungDgk @DGK_org @AGIKinterv @CardioNerds @escardio
📍2/8 Myocardial bridging is a congenital coronary artery anomaly, in which a segment of the artery (tunnel segment) dips into the myocardium (myocardial bridge).
📍3/8 Methods of detection vary greatly in sensitivity.
Myocardial bridging is seen in
🥇30% of pts in autopsy
🥈20% of pts in coronary CT-scan
🥉5% of pts in coronary angiography
#CardioTwitter #MedTwitter #RadialFirst
Myocardial bridging is seen in
🥇30% of pts in autopsy
🥈20% of pts in coronary CT-scan
🥉5% of pts in coronary angiography
#CardioTwitter #MedTwitter #RadialFirst
VOLVEMOS AL ATAQUE! ⚡️⚡️ Nuevo 🧵
Hoy uno de los temas más controvertidos y que más pereza nos da a los Cardiólogos (adjuntos y resis)… 🥁🥁
El intervalo QT…¿cómo se valora? 😵💫
Una vez leído no se os quedará la misma cara que se os quedó al ver los #Oscars2022 🥶
Hoy uno de los temas más controvertidos y que más pereza nos da a los Cardiólogos (adjuntos y resis)… 🥁🥁
El intervalo QT…¿cómo se valora? 😵💫
Una vez leído no se os quedará la misma cara que se os quedó al ver los #Oscars2022 🥶
📚El QT va desde el inicio de la Q al final de la onda T y representa el conjunto de despolarizacion y repolarización miocárdica #CardioEd
Es la representación del potencial de acción miocárdico! 🤓
Es la representación del potencial de acción miocárdico! 🤓
Peeeero, no es tan fácil 😵💫 y tiene condicionantes!
✅ Edad 👶🏼
✅ Sexo 🚺🚹
✅ Frecuencia 💓
✅ y otros …💊🧂
✅ Edad 👶🏼
✅ Sexo 🚺🚹
✅ Frecuencia 💓
✅ y otros …💊🧂
One of the best examples I’ve seen of Kussmaul’s sign: inspiratory increase in JVP.
Why does this happen?
My first #tweetorial 🧵, a la @AvrahamCooperMD @tony_breu @AndreMansoor
#meded #cardioed #cardiotwitter @CooperCVFellows @CooperIMRes @BrighamMedRes @PennCVFellows
1/
Why does this happen?
My first #tweetorial 🧵, a la @AvrahamCooperMD @tony_breu @AndreMansoor
#meded #cardioed #cardiotwitter @CooperCVFellows @CooperIMRes @BrighamMedRes @PennCVFellows
1/
2/ Normally, with inspiration, the negative intrathoracic pressure is transmitted to the heart chambers (❤️ is in the thorax, after all), which makes JVP decrease. Here is an example of normal: neck veins collapsing with inspiration, then filling again with expiration.
3/ Inspiration also causes increased RV filling, but it is easily accommodated by the RV. RA pressure doesn’t change much from the increased filling itself; more predominant is drop in thoracic pressure. Very satisfyingly seen with invasive CVP/RAP measurement, as shown.
TOP 🔟 ECHOCARDIOGRAPHY CASES ➡️ January 2022 (in my opinion) #medtwitter #pocus #echofirst #cardioed #cardiotwitter #medicaleducation #ENARM
⬇️🧵
⬇️🧵
10. Septal bounce - In effusive constrictive pericarditis - @ahmed_ellaien
9. Pulmonary embolism and right ventricular thrombus in transit @carlosjuanatey
Dominick Angiolillo on the dilemma of perioperative antiplatelet therapy
#CVCT2021 @CVCTForum @docbhardwaj @SantosGallegoMD @AHajduczok @DrRaniKhatib @hvanspall @DrRajivsankar @rachkataria @FaiezZANNAD @drdargaray @ShahzebKhanMD @DVervoort94 @SolovevaAnzhela @cristina_gavina
#CVCT2021 @CVCTForum @docbhardwaj @SantosGallegoMD @AHajduczok @DrRaniKhatib @hvanspall @DrRajivsankar @rachkataria @FaiezZANNAD @drdargaray @ShahzebKhanMD @DVervoort94 @SolovevaAnzhela @cristina_gavina
Some great insights on limitations of perioperative antiplatelet Rx & limitations of guidelines - the issue perioperative antiplatelet and HBR are not the same! #CVCT2021 @CVCTForum @docbhardwaj @SantosGallegoMD @AHajduczok @DrRaniKhatib @DrRajivsankar @FaiezZANNAD @DLBHATTMD
Basic concepts on bridging antiplatelets and why #cangrelor is best suited
#CVCT2021 @CVCTForum @docbhardwaj @SantosGallegoMD @AHajduczok @DrRaniKhatib @hvanspall @DrRajivsankar @mirvatalasnag @SuzanneJBaron @DLBHATTMD @Pooh_Velagapudi @sabeedak1 @SABOURETCardio
#CVCT2021 @CVCTForum @docbhardwaj @SantosGallegoMD @AHajduczok @DrRaniKhatib @hvanspall @DrRajivsankar @mirvatalasnag @SuzanneJBaron @DLBHATTMD @Pooh_Velagapudi @sabeedak1 @SABOURETCardio
Ecografía pulmonar 🫁. Guía fácil y práctica de como utilizarla. ABRO HILO
#POCUS #CardioEd #echofirst #ENARM #medicaleducation #ultrasound #MedEd #Cardiology
#POCUS #CardioEd #echofirst #ENARM #medicaleducation #ultrasound #MedEd #Cardiology
Es curioso porque clásicamente se decía que la ecografía pulmonar no era posible. Harrison afirmaba que " los ultrasonidos (US) se disipan rápidamente en el aire por lo que carecen de utilidad en la evaluación del parénquima pulmonar" ¿Qué ha cambiado?
Daniel Lichtenstein, un intensivista francés, redescubrió la ecografía pulmonar. Es cierto que los US no se transmiten bien por el aire, pero Lichtensein descubrió que pequeñas alteraciones en la relación aire-agua a nivel pulmonar formaban artefactos ecográficos característicos.
1/ #tweetorial
💠 Pearls in Syncope ECG Interpretation.
➡️ In the patient with syncope, the ECG should be scrutinized for signs of Ischemia, Bradydysrhythmias, Tachydysrhythmias, and Conduction delays.
--Read More:
manualofmedicine.com/topics/cardiol…
#meded #foamed #medtwitter #cardioed
💠 Pearls in Syncope ECG Interpretation.
➡️ In the patient with syncope, the ECG should be scrutinized for signs of Ischemia, Bradydysrhythmias, Tachydysrhythmias, and Conduction delays.
--Read More:
manualofmedicine.com/topics/cardiol…
#meded #foamed #medtwitter #cardioed
2/
➡️ Additional critical diagnoses to consider that can be detected with ECG:
👉Ventricular Preexcitation (WPW)
👉Brugada syndrome
👉Long or short QT syndromes
👉Hypertrophic Cardiomyopathy
👉Arrhythmogenic right ventricular dysplasia
👉Catecholaminergic polymorphic VT
➡️ Additional critical diagnoses to consider that can be detected with ECG:
👉Ventricular Preexcitation (WPW)
👉Brugada syndrome
👉Long or short QT syndromes
👉Hypertrophic Cardiomyopathy
👉Arrhythmogenic right ventricular dysplasia
👉Catecholaminergic polymorphic VT
3/
➡️ Ventricular Preexcitation (WPW)
👉 PR segment < 120 ms
👉 QRS complex > 110 ms
👉 Slurred upstroke of the initial part of the R wave (delta wave)
➖ Type A: delta wave in all precordial leads, R > S in lead V1
➖ Type B: negative delta waves in leads V1 and V2
➡️ Ventricular Preexcitation (WPW)
👉 PR segment < 120 ms
👉 QRS complex > 110 ms
👉 Slurred upstroke of the initial part of the R wave (delta wave)
➖ Type A: delta wave in all precordial leads, R > S in lead V1
➖ Type B: negative delta waves in leads V1 and V2
1/ #tweetorial
💠 Beyond Diuresis – Treatment Adjuncts in Cardiogenic Pulmonary Edema.
➡️ Diuretics have traditionally been a mainstay of therapy for cardiogenic pulmonary edema.
manualofmedicine.com/topics/cardiol…
#meded #foamed #medtwitter #cardiotwitter #cardioed
💠 Beyond Diuresis – Treatment Adjuncts in Cardiogenic Pulmonary Edema.
➡️ Diuretics have traditionally been a mainstay of therapy for cardiogenic pulmonary edema.
manualofmedicine.com/topics/cardiol…
#meded #foamed #medtwitter #cardiotwitter #cardioed
2/
➡️ Diuretics may not be the preferred initial therapy for those patients with vascular failure, who are often euvolemic, or those with cardiogenic shock, who are often hypovolemic.
➡️ Diuretics may not be the preferred initial therapy for those patients with vascular failure, who are often euvolemic, or those with cardiogenic shock, who are often hypovolemic.
3/
➡️ In these patients, the emergency provider should first optimize preload and afterload reduction with the use of noninvasive positive pressure ventilation (NPPV), nitrates, or inotropes as indicated.
➡️ In these patients, the emergency provider should first optimize preload and afterload reduction with the use of noninvasive positive pressure ventilation (NPPV), nitrates, or inotropes as indicated.
1/24 This month’s #EHJCaseReports #tweetorial focuses on percutaneous left atrial appendage occlusion.
Is #LAAO the exact solution for preventing stroke & embolism in #AF pts who can’t tolerate #OAC?
Or, a new problem while seeking a solution?
doi.org/10.1093/ehjcr/…
#CardioEd
Is #LAAO the exact solution for preventing stroke & embolism in #AF pts who can’t tolerate #OAC?
Or, a new problem while seeking a solution?
doi.org/10.1093/ehjcr/…
#CardioEd
2/24
🎯 The rationale of #LAAO
🔸 In non-valvular #AF patients, 90% of thrombus is located in the #LAA
🔸 These thrombi embolise to the 🧠 & cause #stroke
🎯 Don't miss the ‘#EHRA_ESC #EAPCI expert consensus document on catheter-based #LAAO –an update’ doi.org/10.1093/europa…
🎯 The rationale of #LAAO
🔸 In non-valvular #AF patients, 90% of thrombus is located in the #LAA
🔸 These thrombi embolise to the 🧠 & cause #stroke
🎯 Don't miss the ‘#EHRA_ESC #EAPCI expert consensus document on catheter-based #LAAO –an update’ doi.org/10.1093/europa…
3/24
#LAA closure devices should be safe, efficent and easy to deploy.
📌 Currently available catheter-based devices for #LAAO have different principles.
A- Plug ➡️ Watchman
B- Pacifier ➡️ Amplatzer Amulet
C- Ligation ➡️ Lariat
doi.org/10.1093/europa…
#LAA closure devices should be safe, efficent and easy to deploy.
📌 Currently available catheter-based devices for #LAAO have different principles.
A- Plug ➡️ Watchman
B- Pacifier ➡️ Amplatzer Amulet
C- Ligation ➡️ Lariat
doi.org/10.1093/europa…
