Research Topics
| J S SteinbergSummaryAffiliation: Columbia University Country: USA Publications
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Publications
Desperately seeking a randomized clinical trial of resynchronization therapy for patients with heart failure and atrial fibrillationJonathan S Steinberg
J Am Coll Cardiol 48:744-6. 2006
The federal audit of implantable cardioverter-defibrillator implants: lessons learnedJonathan S Steinberg
Arrhythmia Institute, Valley Health System, Columbia University College of Physicians and Surgeons, New York, NY 10019, USA
J Am Coll Cardiol 59:1270-4. 2012..We describe our experience and responses to such an audit, as well as the to complexities and nuances of practicing evidence-based medicine in the setting of heavy regulatory oversight...
Evolving concepts in the treatment of atrial fibrillationParimal B Maniar
Division of Cardiology, St Luke s Roosevelt Hospital Center, 1111 Amsterdam Avenue, New York, NY 10025, USA
Curr Cardiol Rep 5:358-63. 2003..Catheter ablation of AF may play an increasingly important role in the future...
Psychosocial status predicts mortality in patients with life-threatening ventricular arrhythmiasJonathan S Steinberg
Division of Cardiology, St Luke s Roosevelt Hospital Center, New York, NY 10025, USA
Heart Rhythm 5:361-5. 2008..Quality-of-life (QoL) instruments evaluate various aspects of physical, mental, and emotional health, but how these psychosocial characteristics impact long-term outcome after cardiac arrest and ventricular tachycardia (VT) is unknown...
Randomized study of early intravenous esmolol versus oral beta-blockers in preventing post-CABG atrial fibrillation in high risk patients identified by signal-averaged ECG: results of a pilot studyNomeda Balcetyte-Harris
Division of Cardiology, St Luke s Roosevelt Hospital Center, 1111 Amsterdam Ave, New York, NY 10025
Ann Noninvasive Electrocardiol 7:86-91. 2002..We performed a pilot study of the efficacy of early intravenous esmolol and an oral beta-blocker regimen for prevention of postoperative AF...
QT dispersion and viable myocardium in patients with prior myocardial infarction and severe left ventricular dysfunctionVuy Hun Li
Division of Cardiology, St Luke s Roosevelt Hospital Center, 1111 Amsterdam Ave, New York, NY 10025, USA
Ann Noninvasive Electrocardiol 7:53-9. 2002..However, this relationship is unknown in patients with severe left ventricular dysfunction...
Noninvasive assessment of the biventricular pacing systemJonathan S Steinberg
Division of Cardiology and Arrhythmia Service, St. Luke's-Roosevelt Hospital Center and Columbia University, New York Scripps Hospital, La Jolla, California, USA
Ann Noninvasive Electrocardiol 9:58-70. 2004
Follow-up of patients with unexplained syncope and inducible ventricular tachyarrhythmias: analysis of the AVID registry and an AVID substudy. Antiarrhythmics Versus Implantable DefibrillatorsJ S Steinberg
St Luke s Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
J Cardiovasc Electrophysiol 12:996-1001. 2001....
Antiarrhythmic drug use in the implantable defibrillator arm of the Antiarrhythmics Versus Implantable Defibrillators (AVID) StudyJ S Steinberg
Division of Cardiology, St Luke s Roosevelt Hospital Center, New York, NY 10025, USA
Am Heart J 142:520-9. 2001..The objective of this clinical investigation was to study the need for, and effects of, concomitant AAD use with the ICD in a prospectively defined cohort...
Analysis of cause-specific mortality in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) studyJonathan S Steinberg
Division of Cardiology, St Luke s Roosevelt Hospital Center and Columbia University, New York, NY 10025, USA
Circulation 109:1973-80. 2004..This report describes the cause-specific modes of death in the AFFIRM treatment groups...
New-onset sustained ventricular tachycardia after cardiac surgeryJ S Steinberg
Division of Cardiology, Department of Medicine, St Luke s Roosevelt Hospital Center, New York, NY 10025, USA
Circulation 99:903-8. 1999..The de novo occurrence of sustained ventricular tachycardia (VT) after CABG has been described, but the incidence, mortality rate, long-term follow-up, and mechanism are not well defined...
Increased incidence of life-threatening ventricular arrhythmias in implantable defibrillator patients after the World Trade Center attackJonathan S Steinberg
Division of Cardiology, St Luke s Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
J Am Coll Cardiol 44:1261-4. 2004....
Treatment of atrial fibrillation in hypertrophic cardiomyopathyKhashayar Hematpour
Division of Cardiology, St Luke s Roosevelt Hospital Center, New York, NY, USA
Anadolu Kardiyol Derg 6:44-8. 2006..This is because adverse effects of antiarrhythmics and complications after invasive procedures are justifiable only in HCM patients who experience severe symptoms...
The clinical implications of cumulative right ventricular pacing in the multicenter automatic defibrillator trial IIJonathan S Steinberg
Division of Cardiology, St Luke s Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
J Cardiovasc Electrophysiol 16:359-65. 2005..This study was designed to assess whether right ventricular pacing in the implantable cardioverter defibrillator (ICD) arm of the Multicenter Automatic Defibrillator Implantation Trial (MADIT) II was associated with an unfavorable outcome...
Intravenous versus oral beta-blockers for prevention of post-CABG atrial fibrillation in high-risk patients identified by signal-averaged ECG: lessons of a pilot studyParimal B Maniar
Division of Cardiology and Arrhythmia Service, St. Luke's-Roosevelt Hospital Center and Columbia University, 1111 Amsterdam Avenue, New York, NY 10025, USA
Card Electrophysiol Rev 7:158-61. 2003..Thus, all patients without contraindication should receive oral beta-blocker before and after cardiac surgery to prevent post-operative AF...
Comparison of dilated cardiomyopathy and coronary artery disease in patients with life-threatening ventricular arrhythmias: Differences in presentation and outcome in the AVID registryF A Ehlert
St Luke s Roosevelt Hospital Center, New York, NY 10019, USA
Am Heart J 142:816-22. 2001....
Cardiac resynchronization therapy: an updateimpaired left ventricular systolic functionN V Garikipati
Division of Cardiology, Al Sabah Arrhythmia Institute, St Luke s and Roosevelt Hospitals, Columbia University College of Physicians and Surgeons, New York, NY, USA
Minerva Cardioangiol 59:89-100. 2011..We review the current guidelines for cardiac resynchronization therapy, the underlying evidence, the latest developments in the field and directions of future research...
Proarrhythmic effects of procainamide and tocainide in a canine infarction modelJ S Steinberg
Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
J Cardiovasc Pharmacol 19:52-9. 1992..In this model, procainamide and tocainide had no antiarrhythmic efficacy for VT, but had moderate proarrhythmia potential that was unpredictable...
Efficacy of bretylium tosylate for ventricular tachycardiaS Chandrasekaran
Department of Medicine, St Luke s Roosevelt Hospital Center, Columbia University School of Physicians and Surgeons, New York, New York 10025, USA
Am J Cardiol 83:115-7, A9. 1999..The use of bretylium for the treatment of VT should be reexamined...
Inappropriate implantable cardioverter-defibrillator shocks in MADIT II: frequency, mechanisms, predictors, and survival impactJames P Daubert
Cardiology Division, Department of Medicine, University of Rochester Medical Center, Rochester, New York, USA
J Am Coll Cardiol 51:1357-65. 2008..This study sought to identify the incidence and outcome related to inappropriate implantable cardioverter-defibrillator (ICD) shocks, that is, those for nonventricular arrhythmias...
Images in cardiology: acute anterior wall myocardial infarction in a young male with hypertrophic cardiomyopathy and myocardial bridgingSandeep Joshi
Division of Cardiology, St Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York, USA
Clin Cardiol 28:491. 2005
Antiarrhythmic induced electrical storm in Brugada syndrome: a case reportSandeep Joshi
Division of Cardiology, St Luke s Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA
Ann Noninvasive Electrocardiol 12:274-8. 2007..We report a case of a BS diagnosed via procainamide challenge, the resultant near fatal electrical storm aggravated by amiodarone and the eventual resolution with isoproterenol...
Cardiac resynchronization therapy and atrial fibrillationGanesh S Kamath
Al Sabah Arrhythmia Institute and Division of Cardiology, St Luke s and Roosevelt Hospitals, Columbia University College of Physicians and Surgeons, New York, NY10025, USA
Cardiol J 16:4-10. 2009..However, the optimal indications for CRT delivery for patients in this complex cohort remain to be assessed in randomized clinical trials...
Robotically assisted left ventricular epicardial lead implantation for biventricular pacingJoseph J Derose
Division of Cardiothoracic Surgery, St Luke s Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York, USA
J Am Coll Cardiol 41:1414-9. 2003..Ventricular resynchronization might be achieved in a minimally invasive fashion using a robotically assisted, direct left ventricular (LV) epicardial approach...
Signal-averaged P-wave duration does not predict atrial fibrillation after thoracic surgeryD Amar
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center and Cornell University Medical College, New York, New York, USA
Anesthesiology 91:16-23. 1999..The authors sought to determine whether a prolonged SAPWD alone or in combination with clinical or echocardiographic correlates predicts AF after elective noncardiac thoracic surgery...
Time course of moricizine's effect on signal-averaged and 12 lead electrocardiograms: insights into mechanism of actionM E Wechsler
Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
J Am Coll Cardiol 17:1626-33. 1991..Thus, dynamic changes were observed for intraventricular conduction (fQRS, QRS) and ventricular repolarization (JTc) over the dosing interval.(ABSTRACT TRUNCATED AT 250 WORDS)..
Interaction of ischaemia and encainide/flecainide treatment: a proposed mechanism for the increased mortality in CAST IH M Greenberg
Division of Cardiology, St Luke s Roosevelt Hospital, New York, NY 10019, USA
Br Heart J 74:631-5. 1995..To determine whether an interaction between encainide or flecainide and intercurrent ischaemia could account for the observed increase in cardiac and sudden deaths in the study group in the Cardiac Arrhythmia Suppression Trial (CAST) I...
Effects of cardiac resynchronization therapy with or without a defibrillator on survival and hospitalizations in patients with New York Heart Association class IV heart failureJoann Lindenfeld
Department of Medicine, University of Colorado Health Sciences Center, 4200 E Ninth Ave, Denver, CO 80262, USA
Circulation 115:204-12. 2007..We sought to examine the outcomes of NYHA class IV patients enrolled in the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) trial to assess the potential benefits of CRT and CRT-D...
Patterns of atrial fibrillation after coronary artery bypass surgeryJacqueline E Tamis-Holland
St Luke s Roosevelt Hospital Center and Columbia University, College of Physicians and Surgeons, New York, NY 10025, USA
Ann Noninvasive Electrocardiol 11:139-44. 2006..The purpose of this study was to determine whether AF characteristics were independently associated with postoperative length of stay (LOS)...
Cardiac resynchronization therapy in the setting of permanent atrial fibrillation and heart failureJayanthi N Koneru
The Al Sabah Arrhythmia Institute, St Luke s and Roosevelt Hospitals, Columbia University College of Physicians and Surgeons, New York, New York, USA
Curr Opin Cardiol 23:9-15. 2008..This review will summarize the current management strategies of atrial fibrillation in the setting of heart failure...
Cardioversion in patients with left ventricular thrombus is not associated with increased thromboembolic riskSripal Bangalore
Division of Cardiology, Department of Medicine, St Luke's-Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
J Am Soc Echocardiogr 19:438-40. 2006..CONCLUSIONS: Embolism after cardioversion in patients with echocardiographic evidence of LV thrombus was not observed. Cardioversion seems to be safe and further prospective studies are needed to address this...
Ablation vs medical therapy in the setting of symptomatic atrial fibrillation and left ventricular dysfunctionAndrew D Choi
Al Sabah Arrhythmia Institute and Division of Cardiology, St Luke s and Roosevelt Hospitals, Columbia University College of Physicians and Surgeons, New York, NY, USA
Congest Heart Fail 16:10-4. 2010..These provocative findings provide potent rationale for a randomized clinical trial comparing ablation with pharmacologic therapy...
Novel pathway for sudden cardiac death preventionEyal Herzog
Division of Cardiology Cardiac Care Unit, St Luke s Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
Crit Pathw Cardiol 8:1-6. 2009..We hope that this new novel pathway will help to bridge the gap between the complex guidelines and the actual clinical practice and will help to save many lives...
Intracardiac ultrasound detection of thrombus on transseptal sheath: incidence, treatment, and preventionKataneh Maleki
Arrhythmia Service and Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
J Cardiovasc Electrophysiol 16:561-5. 2005..Using a higher concentration of heparin for the TS system before deployment reduced the risk. The thrombus was retrieved with aspiration without the need to abort the procedure...
Recurrence rate of atrial flutter after initial presentation in patients on drug treatmentAnvar Babaev
Arrhythmia Service and Division of Cardiology, St. Luke's-Roosevelt Hospital Center, and Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
Am J Cardiol 92:1122-4. 2003..Radiofrequency ablation of AFl, which has an excellent safety record, should be evaluated as a first-line approach for most patients with AFl...
Implantable cardioverter-defibrillator therapy and risk of congestive heart failure or death in MADIT II patients with atrial fibrillationWojciech Zareba
Cardiology Unit, Department of Medicine, University of Rochester Medical Center, New York 14642, USA
Heart Rhythm 3:631-7. 2006..Atrial fibrillation (AF) contributes to increased risk of morbidity and mortality. Data regarding the effectiveness of implantable cardioverter-defibrillator (ICD) therapy in AF patients are limited...
QT dispersion as a marker of risk in patients awaiting heart transplantationD J Pinsky
Department of Medicine, Columbia Presbyterian Medical Center, New York, New York 10032, USA
J Am Coll Cardiol 29:1576-84. 1997....
Atrial fibrillation after minimally invasive direct coronary artery bypass surgeryJ E Tamis-Holland
Division of Cardiology, St Luke s Roosevelt Hospital Center, New York, New York 10025, USA
J Am Coll Cardiol 36:1884-8. 2000..The study compared the adjusted risk for developing atrial fibrillation (AF) after minimally invasive direct coronary artery bypass surgery (MIDCAB) and coronary artery bypass graft surgery (CABG)...
Cardioprotection with beta-blockers: myths, facts and Pascal's wagerF H Messerli
Division of Cardiology, St Luke s and Roosevelt Hospitals, Columbia University College of Physicians and Surgeons, New York, NY 10019, USA
J Intern Med 266:232-41. 2009..Thus, recent evidence argues against universal cardioprotective properties of beta-blockers but attest to their usefulness for specific cardiovascular indications...
Cardioversion of atrial fibrillationSubhashini A Gowda
Arrhythmia Service and Division of Cardiology, St Luke's Hospital, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA
Prog Cardiovasc Dis 48:88-107. 2005
Long-term outcome following successful pulmonary vein isolation: pattern and prediction of very late recurrenceArti N Shah
Al Sabah Arrhythmia Institute and Division of Cardiology, The St Luke s Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
J Cardiovasc Electrophysiol 19:661-7. 2008..We sought to determine the long-term outcome of the initial responders who experienced a prolonged AF-free complete response...
Termination of persistent atrial fibrillation resistant to cardioversion by a single radiofrequency applicationBengt Herweg
Arrhythmia Service, St. Luke's-Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
Pacing Clin Electrophysiol 26:1420-3. 2003..The observations and failure of repeated internal and external cardioversion suggest a rapidly firing arrhythmia focus sustaining atrial fibrillation amenable to curative pulmonary vein ablation...
Role of electrophysiologic studies, signal-averaged electrocardiography, heart rate variability, T-wave alternans, and loop recorders for risk stratification of ventricular arrhythmiasShahriar Iravanian
Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA
Am J Geriatr Cardiol 14:16-9. 2005..The utility, indications, and limitations of each test in clinical practice are discussed, especially for the purpose of postmyocardial infarction risk stratification in the elderly population...
Catheter cryoablation of supraventricular tachycardia: results of the multicenter prospective "frosty" trialPeter L Friedman
Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
Heart Rhythm 1:129-38. 2004..Cryomapping can reversibly identify targets for ablation and can help minimize the risk of inadvertent AV block during ablation...
Anatomic substrate, procedural results, and clinical outcome of ultrasound-guided left atrial-pulmonary vein disconnection for treatment of atrial fibrillationBengt Herweg
Division of Cardiology, University of South Florida, Tampa, Florida, USA
Am J Cardiol 95:871-5. 2005..During a follow-up of 549 +/- 330 days after ablation, the AF-free survival rate was 80% and comparable in paroxysmal and persistent AF. PV stenosis was detected in only 1 asymptomatic patient, who required no intervention...
Prevalence, predictors, and prognosis of atrial fibrillation early after pulmonary vein isolation: findings from 3 months of continuous automatic ECG loop recordingsSandeep Joshi
The Al Sabah Arrhythmia Institute and Division of Cardiology, St Luke s Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA
J Cardiovasc Electrophysiol 20:1089-94. 2009..quot; This study characterizes early recurrences and determines implications of early AF following PVI...
Activation of the endogenous coagulation system in patients with atrial flutter: relationship to echocardiographic markers of thromboembolic riskGanesh S Kamath
Division of Cardiology, St Luke s and Roosevelt Hospitals, 1111 Amsterdam Avenue, New York, NY 10025, USA
Cardiol J 17:390-6. 2010....
The utility of 12-lead Holter monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapyGanesh S Kamath
Al Sabah Arrhythmia Institute and Division of Cardiology, St Luke s and Roosevelt Hospitals, Columbia University College of Physicians and Surgeons, New York, NY, USA
J Am Coll Cardiol 53:1050-5. 2009..This study sought to determine the incidence of ineffective capture using 12-lead Holter monitoring and to assess whether this affects response to cardiac resynchronization therapy (CRT)...
Acute conversion of persistent atrial fibrillation during dofetilide initiationDelia Cotiga
Arrhythmia Service and Division of Cardiology, St Luke s Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA
Pacing Clin Electrophysiol 30:1527-30. 2007..We hypothesized that the acute pharmacological conversion rate of D is higher than previously reported if used in a healthier cohort of patients with persistent AF...
Very late recurrences of atrial fibrillation after pulmonary vein isolationEitan M Klein
St Luke s Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, NY 10025, USA
Hosp Pract (Minneap) 38:40-4. 2010..These recurrences have important clinical implications in the care of patients, specifically with regard to the increased risk of stroke associated with AF...
Hypertension and hypertensive heart disease are associated with increased ostial pulmonary vein diameterBengt Herweg
Arrhythmia Service and Division of Cardiology, St. Luke's-Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
J Cardiovasc Electrophysiol 16:2-5. 2005....
Atrial fibrillation and obesity--results of a meta-analysisNikolas Wanahita
Division of Cardiology, Beth Israel Medical Center, New York, NY, USA
Am Heart J 155:310-5. 2008..However, the role of obesity as a risk factor for the development of AF is unknown. The study aims to evaluate the role of obesity as a risk factor for the development of AF...
Dexmedetomidine sedation leading to refractory cardiogenic shockTina C Sichrovsky
St Luke s Roosevelt Hospital Center Columbia University, 1111, Amsterdam Ave, New York City, NY 10025, USA
Anesth Analg 106:1784-6. 2008..We postulate that, in certain susceptible individuals, dexmedetomidine may lead to terminal complications. We therefore urge caution about using dexmedetomidine in the electrophysiology laboratory...
A randomized controlled trial to evaluate the safety and efficacy of cardiac contractility modulation in patients with systolic heart failure: rationale, design, and baseline patient characteristicsWilliam T Abraham
The Ohio State University Heart Center, Division of Cardiovascular Medicine, Columbus, OH 43210 1252, USA
Am Heart J 156:641-648.e1. 2008..Baseline characteristics for patients randomized in this trial are also presented...
Quality of life in the antiarrhythmics versus implantable defibrillators trial: impact of therapy and influence of adverse symptoms and defibrillator shocksEleanor B Schron
Clinical Trials Group, National Heart, Lung, and Blood Institute, Bethesda, MD, USA
Circulation 105:589-94. 2002..Adverse symptoms were associated with reduced self-perceived QoL in both groups, and sporadic shocks were associated with reduced QoL in ICD recipients...
Percent right ventricular pacing predicts outcomes in the DAVID trialArjun D Sharma
Regional Cardiology Associates, Sacramento, California 95819, USA
Heart Rhythm 2:830-4. 2005..Pacing was more frequent in the DDDR group...
Follow-up of robotically assisted left ventricular epicardial leads for cardiac resynchronization therapySandeep Joshi
J Am Coll Cardiol 46:2358-9. 2005
Reduction in ventricular tachyarrhythmias with statins in the Multicenter Automatic Defibrillator Implantation Trial (MADIT)-IIAnant K Vyas
Heart Research Follow up Program of the Cardiology Unit of the Department of Medicine, University of Rochester Medical Center, Rochester, New York 14642, USA
J Am Coll Cardiol 47:769-73. 2006....
Acute and chronic sequelae of ventricular dyssynchronyAngelo Auricchio
Prog Cardiovasc Dis 48:227-31. 2006
The World Trade Center attack: increased frequency of defibrillator shocks for ventricular arrhythmias in patients living remotely from New York CityOmer L Shedd
Division of Cardiovascular Medicine and Malcolm Randall Veteran Affairs Medical Center, University of Florida, Gainesville, Florida 32610, USA
J Am Coll Cardiol 44:1265-7. 2004....
Driving and implantable cardioverter-defibrillator shocks for ventricular arrhythmias: results from the TOVA studyChristine M Albert
Center for Arrhythmia Prevention, Division of Preventive Medicine and Cardiovascular Division, Brigham and Women s Hospital, Boston, Massachusetts 02215 1204, USA
J Am Coll Cardiol 50:2233-40. 2007..This study examined the risk of implantable cardioverter-defibrillator (ICD) shocks for ventricular tachycardia (VT) or ventricular fibrillation (VF) associated with driving...
Postoperative atrial fibrillation: a billion-dollar problemJonathan S Steinberg
J Am Coll Cardiol 43:1001-3. 2004
The rationale for nontransvenous leads and cardiac resynchronization devicesJonathan S Steinberg
Pacing Clin Electrophysiol 26:2211-2. 2003
Magnetocardiography throws its hat in the ringJonathan S Steinberg
J Cardiovasc Electrophysiol 17:402-4. 2006
Echocardiography for cardiac resynchronization therapy: recommendations for performance and reporting--a report from the American Society of Echocardiography Dyssynchrony Writing Group endorsed by the Heart Rhythm SocietyJohn Gorcsan
University of Pittsburgh, Pittsburgh, Pennsylvania 15213 2582, USA
J Am Soc Echocardiogr 21:191-213. 2008..Since this is rapidly changing field with new information being added frequently, future modification and refinements in approach are anticipated to continue...
