[How I deal with this unusual paravalvular leak].

Percutaneous treatment of para-prosthetic valve leaks (PVL) is an alternative to redo surgery. Based on the clinical case of an unusual aortic para-prosthetic leak closure (PVLc), are presented successively the diagnostic difficulties of PVL, the modalities of therapeutic choice, the main technical steps of PVLc followed by a review of results and complications.

Uncertainty and anxiety: Evolution and neurobiology.

Anxiety is a complex phenomenon: Its eliciting stimuli and circumstances, component behaviors, and functional consequences are only slowly coming to be understood. Here, we examine defense systems from field studies; laboratory studies focusing on experimental analyses of behavior; and, the fear conditioning literature, with a focus on the role of uncertainty in promoting an anxiety pattern that involves high rates of stimulus generalization and resistance to extinction. Respectively, these different areas provide information on evolved elicitors of defense (field studies); outline a defense system focused on obtaining information about uncertain threat (ethoexperimental analyses); and, provide a simple, well-researched, easily measured paradigm for analysis of nonassociative stress-enhanced fear conditioning (the SEFL).

Three-Year Outcomes With Fractional Flow Reserve-Guided or Angiography-Guided Multivessel Percutaneous Coronary Intervention for Myocardial Infarction.

Background: In patients with multivessel disease with successful primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction, the FLOWER-MI trial (Flow Evaluation to Guide Revascularization in Multivessel ST-Elevation Myocardial Infarction) showed that a fractional flow reserve (FFR)-guided strategy was not superior to an angiography-guided strategy for treatment of noninfarct-related artery lesions regarding the 1-year risk of death from any cause, myocardial infarction, or unplanned hospitalization leading to urgent revascularization. The extension phase of the trial was planned using the same primary outcome to determine whether a difference in outcomes would be observed with a longer follow-up.

Methods: In this multicenter trial, we randomly assigned patients with ST-segment-elevation myocardial infarction and multivessel disease with successful percutaneous coronary intervention of the infarct-related artery to receive complete revascularization guided by either FFR (n=586) or angiography (n=577).

Doppler echocardiography for surveillance of acute cardiac allograft rejection: a 28-year single-center experience.

Background: Endomyocardial biopsies (EMB) are recommended for the detection of acute cardiac rejection (ACR) despite limited sensitivity. We report the long-term post-transplant results of Doppler echocardiography as a noninvasive alternative of routine EMB.

Methods: Two cohorts of heart transplantation (HT) recipients were chronologically defined as follows: the Dual Monitoring Cohort (DMC) from January 1990 to December 1997 included patients who underwent routine EMB and Doppler echocardiography within 24 hours for ACR surveillance; and the "Echo-First Cohort" (EFC), including patients transplanted from January 1998 to December 2018 with Doppler echocardiography as first-line approach for ACR surveillance.

Head and neck cancer patients under radiotherapy undergoing skin application of hydrogel dressing or hyaluronic acid: results from a prospective, randomized study.

Purpose: Acute radiodermatitis (ARD) is a frequent side effect of radiotherapy, a therapeutic option for head and neck squamous cell carcinoma (HNSCC). It is responsible for pain, quality of life (QoL) impairment, and increased risk of treatment discontinuation, which may compromise the prognosis for patients. Local therapies to prevent or alleviate ARD have been proposed without providing any high level of evidence to establish recommendations.

Tools for faculty assessment of interdisciplinary competencies of healthcare students: an integrative review.

Increasingly, interprofessional teamwork is required for the effective delivery of public health services in primary healthcare settings. Interprofessional competencies should therefore be incorporated within all health and social service education programs. Educational innovation in the development of student-led clinics (SLC) provides a unique opportunity to assess and develop such competencies.

Exploring nurse practitioner practice in Australian rural primary health care settings: A scoping review.

Introduction: Australians in rural areas experience limited access to services and poorer health outcomes than residents of metropolitan areas. Nurse practitioners (NPs) were introduced in 2000 to reduce pressure on the health system, address workforce shortages and improve rural populations' access to health care services.

Objective: This scoping review sought to identify, examine and synthesise research evidence of NP practice in Australian rural primary health care services to better understand how NPs are addressing service gaps in rural areas and to identify existing gaps in our knowledge.

Sex, defense, and risk assessment: Who could ask for anything more?

Over the 30 years since IBNS was founded, a central theme of "Translation" has emerged. This reflects increasing realization that mental disorders such as anxiety and depression are extremely widespread, expensive and painful to societies and individuals across the world. The Blanchard lab has been particularly involved in attempts to understand the evolutionary and functional mechanisms underlying defensive behaviors as a focal component of these disorders.

Are cognitive aspects of defense a core feature of anxiety and depression?

Anxiety and depression are highly prevalent behavior disorders, particularly in women. Recent preclinical work using animal models has been suboptimal in predicting the efficacy of drugs targeted at these conditions, suggesting a potential discrepancy between such models and the human disorders. Notably female animals tend to be equal to, or less responsive than, males in these tasks.

Predictors of Clinical Success After Transcatheter Paravalvular Leak Closure: An International Prospective Multicenter Registry.

Background: Transcatheter closure of a symptomatic prosthetic paravalvular leak (PVL) is feasible, but there is presently no conclusive evidence to show consistent efficacy. We aimed to identify predictors of clinical success after transcatheter PVL closure.

Methods: Consecutive patients referred to 24 European centers for transcatheter PVL closure in 2017 to 2019 were included in a prospective registry (, FFPP).

Slimming Neural Networks Using Adaptive Connectivity Scores.

In general, deep neural network (DNN) pruning methods fall into two categories: 1) weight-based deterministic constraints and 2) probabilistic frameworks. While each approach has its merits and limitations, there are a set of common practical issues such as trial-and-error to analyze sensitivity and hyper-parameters to prune DNNs, which plague them both. In this work, we propose a new single-shot, fully automated pruning algorithm called slimming neural networks using adaptive connectivity scores (SNACS).

Dissecting the brain's fear systems responding to snake threats.

We examined the behavioural responses and Fos expression pattern of rats that were exposed to snake threats from shed snakeskin and a live snake. We differentiated the behavioural responses and the pattern of Fos expression in response to the odour cues and mild threat from a live snake. Animals exposed to the snake odour alone or to the confined snake showed a great deal of risk assessment.

Effects of LiBF Addition on the Lithium-Ion Conductivity of LiBH.

Complex hydrides, such as LiBH, are a promising class of ion conductors for all-solid-state batteries, but their application is constrained by low ion mobility at room temperature. Mixing with halides or complex hydride anions, i.e.

Effect of SARs-CoV-2 pandemic on infection prevention behaviors and bacterial burden of high touch surfaces in a medical/surgical setting.

This study aimed to determine the longitudinal efficacy of ultraviolet germicidal disinfection (UV-C) in a non-terminal disinfection context. Moreover, factors influencing enhanced infection prevention behaviors during the SARS-CoV-2 pandemic were evaluated. Sixty nursing staff from three medical/surgical wards in a large military hospital were recruited for a survey and microbiological sampling of high-touch surfaces (stethoscope, personal electronic device, common access card, and hospital ID badge) and portable medical equipment (wheelchairs and mobile commodes).

Recognising and responding to communication and swallowing difficulties in Parkinson's disease.

Background: Communication difficulties, including hypokinetic dysarthria and swallowing difficulties (dysphagia), affect a large percentage of people diagnosed with Parkinson's disease. Onset of these symptoms has been identified in up to 78% of people with early-stage Parkinson's disease. Communication difficulties are frequently disregarded until they have a significant impact on quality of life, while the person may often be unaware of indicators of dysphagia and the associated risk of aspiration pneumonia.

IMPACT-ICU: A Relevant Sustainable Program for Military Institutions.

The IMPACT-ICU program provides staff with tools that make difficult palliative conversations easier; introduces the "3 conversations," incorporates role-play activities, and provides for continued coaching. This program is highly relevant to the military health system, which typically lacks a specialized palliative care service. It is easily transferable to any environment to include austere locations as well as other disparate health care institutions.

Non-motor symptoms of Parkinson's disease.

Background: Parkinson's disease is characterised by a complex array of motor and non-motor symptoms. Motor symptoms are often prioritised for assessment and treatment. Growing evidence highlights the importance of recognising the impact of non-motor symptoms on the person's quality of life.

Percutaneous Myocardial Revascularization in Late-Presenting Patients With STEMI.

Background: The optimal management of patients with ST-segment elevation myocardial infarction (STEMI) presenting late->12 hours following symptom onset-is still under debate.

Objectives: The purpose of this study was to describe characteristics, temporal trends, and impact of revascularization in a large population of latecomer STEMI patients.

Methods: The authors analyzed the data of 3 nationwide observational studies from the FAST-MI (French Registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction) program, conducted over a 1-month period in 2005, 2010, and 2015.