Right Ventricular Function and Outcomes Stratified by the Effective Regurgitant Orifice Area in Secondary Tricuspid Regurgitation.

Background: In patients with moderate and severe secondary tricuspid regurgitation (STR), the effective regurgitant orifice area (EROA), corrected using the proximal isovelocity surface area (PISA) method for tricuspid valve leaflet tethering and low TR jet velocities, has an unclear threshold for identifying high-risk patients. This study aimed to establish a risk-based EROA cutoff and assess the impact of right ventricular (RV) remodeling on outcomes in low-risk STR patients according to EROA.

Methods: We included 513 consecutive outpatients (age 75±13 years, 47% male) with moderate and severe STR.

Treatment with 5-MTHF to support the one-carbon cycle can overcome the deleterious impact of a triple SNP mutation in the male partner's MTHFR gene for a couple with a history of repeated miscarriage.

A couple presenting with more than 3 years' history of infertility and three miscarriages was tested for serum homocysteine levels and for the two principal MTHFR SNPs: 677C < T and 1298A < C, as per our general policy for patients with infertility of long duration. The woman was found to be wild type for both MTHFR SNPs with a serum homocysteine 10.5 µM, slightly higher than our accepted normal value of 8.

Unique dental arrangement in a new species, (Placodermi, Arthrodira) from the Middle Devonian of Mount Howitt, Victoria, Australia.

Well-preserved specimens of a new species of arthrodiran placoderm, sp. nov. (Middle Devonian of Victoria, Australia), reveals previously unknown information on the dermal skeleton, body-shape and dentition of the wide-spread genus .

Medial pulvinar stimulation for focal drug-resistant epilepsy: interim 12-month results of the PULSE study.

Objective: This study aims to evaluate the efficacy and safety of deep brain stimulation (DBS) of the medial pulvinar nucleus (PuM) in reducing seizure frequency and addressing comorbidities in patients with drug and vagal nerve-resistant focal epilepsy.

Methods: This is an open-label prospective treatment trial with a planned enrollment of 12 patients suffering from medically refractory epilepsy (Clinical trial gov NCT04692701), for which the interim 12-month post-implantation results for the first 6 patients are being reported. Inclusion criteria were focal epilepsy not suitable for or after failed surgical intervention and previous failure of neurostimulation therapies (vagus nerve stimulation or anterior thalamic nucleus DBS).

Lungfishes.

Alice Clement introduces the lungfishes, a group of sarcopterygian fishes that uses lungs to breathe and is the living sister group to tetrapod vertebrates.