amVAE: Age-aware multimorbidity clustering using variational autoencoders.

Multimorbidity, the co-occurrence of multiple chronic conditions within the same individual, is increasing globally. This is a challenge for the single patients, as these individuals are subject to a heavy disease and treatment burden, yet evidence on the epidemiology and consequences of multimorbidity remains underexplored. Historically, studies aiming to understand multimorbidity patterns predominantly utilized cross-sectional data, neglecting the essential temporal dynamics which shape multimorbidity progression.

Coronary revascularisation deferral based on quantitative flow ratio or fractional flow reserve: a post hoc analysis of the FAVOR III Europe trial.

Background: Safe deferral of revascularisation is a key aspect of physiology-guided percutaneous coronary intervention (PCI). While recent evidence gathered in the FAVOR III Europe trial showed that quantitative flow ratio (QFR) guidance did not meet non-inferiority to fractional flow reserve (FFR) guidance, it remains unknown if QFR might have a specific value in revascularisation deferral.

Aims: We aimed to evaluate the safety of coronary revascularisation deferral based on QFR as compared with FFR.

Danish cohort study of tympanic membrane retractions and manifestations of Eustachian tube dysfunction.

Objectives: Our objective is to evaluate the prevalence of tympanic membrane (TM) retractions and management of signs of Eustachian tube dysfunction (ETD) in both children and adults following type 1 tympanoplasty or myringoplasty. Furthermore, to identify potential risk factors for developing ETD and TM retractions.

Methods: Retrospective cohort study of 423 patients (5-86 years of age) undergoing 452 procedures.

Quantitative flow ratio versus fractional flow reserve for coronary revascularisation guidance (FAVOR III Europe): a multicentre, randomised, non-inferiority trial.

Background: Fractional flow reserve (FFR) or non-hyperaemic pressure ratios are recommended to assess functional relevance of intermediate coronary stenosis. Both diagnostic methods require the placement of a pressure wire in the coronary artery during invasive coronary angiography. Quantitative flow ratio (QFR) is an angiography-based computational method for the estimation of FFR that does not require the use of pressure wires.

Decrease in injection and rise in smoking and snorting of heroin and synthetic opioids, 2000-2021.

Background: Injecting, smoking, and snorting heroin/synthetic opioids is each associated with unique health risks. It is unclear how route of administration (ROA) preferences have shifted during the opioid epidemic.

Methods: Using 2000-2021 admissions data from SAMHSA TEDS-A, we analyzed trends in heroin/synthetic opioid ROA preferences and factors associated with these preferences.

Correction: Longitudinal models for the progression of disease portfolios in a nationwide chronic heart disease population.

[This corrects the article DOI: 10.1371/journal.pone.

Innovation and adaptation: The rise of a fentanyl smoking culture in San Francisco.

Background: Illicitly manufactured fentanyls and stimulants are implicated in the escalating US mortality from drug overdose. San Francisco, California (SF) has seen declining fentanyl injection while smoking has increased. Beliefs and behaviors surrounding this development are not well understood.

Correction: Longitudinal models for the progression of disease portfolios in a nationwide chronic heart disease population.

[This corrects the article DOI: 10.1371/journal.pone.

Unintended Deformation of Stents During Bifurcation PCI: An OCTOBER Trial Substudy.

Background: Unintended deformation of implanted coronary stents can lead to loss of coronary access, stent thrombosis and coronary events during follow-up. The incidence, mechanisms and clinical outcomes of unintended stent deformations (USD) during complex bifurcation stenting are not well characterized.

Objectives: In a prespecified analysis of the OCTOBER (European Trial on Optical Coherence Tomography Optimized Bifurcation Event Reduction) trial, we aimed to: 1) determine the incidence and characterize mechanisms of USD identified by optical coherence tomography (OCT); and 2) evaluate physician's detection and correction of accidental abluminal rewiring and USD.

How do we understand the value of drug checking as a component of harm reduction services? A qualitative exploration of client and provider perspectives.

Background: Mortality related to opioid overdose in the U.S. has risen sharply in the past decade.

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main Disease With and Without Diabetes: Findings From a Pooled Analysis of 4 Randomized Clinical Trials.

Background: Diabetes may be associated with differential outcomes in patients undergoing left main coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The aim of this study was to investigate outcomes in patients with left main disease with and without diabetes randomized to PCI versus CABG.

Methods: Individual patient data were pooled from 4 trials (SYNTAX [Synergy Between PCI With Taxus and Cardiac Surgery], PRECOMBAT [Premier of Randomized Comparison of Bypass Surgery Versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease], NOBLE [Nordic-Baltic-British Left Main Revascularisation Study], and EXCEL [Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization]) that randomized patients with left main disease to PCI or CABG.

The influence of transformations in supply on methamphetamine initiation among people injecting opioids in the United States.

Background: Co-use of methamphetamine (MA) and opioids (pharmaceutical pills, heroin and fentanyls) has increased in the United States and is represented in rising mortality. Although coinciding with the import of low cost, high potency and purity methamphetamine, the relationship between supply and demand in propelling this polydrug use is not well understood. We consider the influence of macro changes in supply on the uptake of opioid and methamphetamine co-use by injection at the level of individual drug and injection initiation in West Virginia, a state which leads the US in drug overdose mortality.

Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis.

Background: Previous meta-analyses have shown reduced risks of composite adverse events with intravascular imaging-guided percutaneous coronary intervention (PCI) compared with angiography guidance alone. However, these studies have been insufficiently powered to show whether all-cause death or all myocardial infarction are reduced with intravascular imaging guidance, and most previous intravascular imaging studies were done with intravascular ultrasound rather than optical coherence tomography (OCT), a newer imaging modality. We aimed to assess the comparative performance of intravascular imaging-guided PCI and angiography-guided PCI with drug-eluting stents.

Monitoring outcome measures for cardiometabolic disease during rehabilitation and follow-up in people with spinal cord injury.

Study Design: Controlled pragmatic intervention with follow-up.

Objectives: To describe cardiometabolic risk outcomes after a pragmatic intervention implemented into standard spinal cord injury (SCI) rehabilitation.

Setting: Inpatient SCI rehabilitation in East-Denmark.

African immigrants' favorable preterm birth rates challenge genetic etiology of the Black-White disparity in preterm birth.

Background: We examined over a million California birth records for 2010 through 2021 to investigate whether disparities in preterm birth (PTB) by nativity and race support the widely held but hitherto unsubstantiated belief that genetic differences explain the persistent Black-White disparity in PTB.

Methods: We examined PTB rates and risk ratios among African-, Caribbean-, and U.S.

OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions.

Background: Imaging-guided percutaneous coronary intervention (PCI) is associated with better clinical outcomes than angiography-guided PCI. Whether routine optical coherence tomography (OCT) guidance in PCI of lesions involving coronary-artery branch points (bifurcations) improves clinical outcomes as compared with angiographic guidance is uncertain.

Methods: We conducted a multicenter, randomized, open-label trial at 38 centers in Europe.

Danish study of Non-Invasive Testing in Coronary Artery Disease 3 (Dan-NICAD 3): study design of a controlled study on optimal diagnostic strategy.

Introduction: Current guideline recommend functional imaging for myocardial ischaemia if coronary CT angiography (CTA) has shown coronary artery disease (CAD) of uncertain functional significance. However, diagnostic accuracy of selective myocardial perfusion imaging after coronary CTA is currently unclear. The Danish study of Non-Invasive testing in Coronary Artery Disease 3 trial is designed to evaluate head to head the diagnostic accuracy of myocardial perfusion imaging with positron emission tomography (PET) using the tracers Rubidium (Rb-PET) compared with oxygen-15 labelled water PET (O-water-PET) in patients with symptoms of obstructive CAD and a coronary CT scan with suspected obstructive CAD.

Otosclerosis and stapedotomy: hearing improvement, complications, and analysis of potential prognostic factors in a series of 93 cases.

Background: Stapedotomy is a common treatment for conductive hearing loss in otosclerosis patients.

Aims/objectives: Results of stapedotomy were assessed in terms of hearing improvement and risk of complications. Potential prognostic factors affecting outcomes were identified.

The motives and methods of methamphetamine and 'heroin' co-use in West Virginia.

Background: Opioid and methamphetamine co-use is increasing across the USA with overdoses involving these drugs also rising. West Virginia (WV) has led the US in opioid overdose death rates since at least 2013 and rising co-use of methamphetamine with opioids has played a greater role in deaths over the last 5 years.

Methods: This study used rapid ethnography to examine methods and motivations behind opioids and methamphetamine co-use from the viewpoint of their consumers.

Comparison of definitions of coronary artery reference sizes and effects on stent selection and evaluation of stent expansion.

Accurate determination of coronary reference size is essential for optimal stent selection and evaluation of stent expansion during percutaneous coronary intervention (PCI). Several approaches for reference size estimation have been published with no universal agreement. The aim of this study was to investigate if potential differences in coronary reference size estimation lead to differences in stent and balloon selection and in detection of stent under expansion.