Electrocardiogram-based machine learning for risk stratification of patients with suspected acute coronary syndrome.

Background And Aims: The importance of risk stratification in patients with chest pain extends beyond diagnosis and immediate treatment. This study sought to evaluate the prognostic value of electrocardiogram feature-based machine learning models to risk-stratify all-cause mortality in those with chest pain.

Methods: This was a prospective observational cohort study of consecutive, non-traumatic patients with chest pain.

Physician demography in Lebanon 2024: identifying gaps and proposing solutions for sustainable healthcare system.

Background: Lebanon continues to experience dramatic changes in its medical demography following the ongoing economic crisis of 2019, including brain drain of physicians across different specialties. This paper assesses the landscape of physicians in Lebanon in 2024 to highlight gaps and propose solutions.

Methods: A List of registered physicians is obtained from the Lebanese Order of Physicians (LOP) in Beirut and Tripoli.

Biofabrication of copper oxide nanoparticles using Dalbergia sisso leaf extract for antibacterial, antibiofilm and antioxidant activities.

One of the biggest challenges encountered by the current generation is the evolution of antibiotic resistant bacteria as a result of excessive and inappropriate use of antibiotics. This problem has led to the development of alternative approaches to treat the diseases caused by these multidrug resistant bacteria (MDR). One of the most promising and novel approaches to combat these pathogens is utilization of nanomaterials as antimicrobial agents.

Congenital Insensitivity to Pain and Anhidrosis With Orthopedic and Self-Injury Complications in a 5-Year-Old Boy: A Case Report.

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare autosomal recessive disorder because of NTRK1 gene mutations, leading to an inability to perceive pain and temperature and lack of sweating. Its rarity and unique clinical challenges, such as severe injuries from the inability to sense pain, make reporting cases critical. A 5-year-old boy, the third child of consanguineous parents, was referred for a fractured femur.

Falls prevention interventions for community-dwelling older adults: systematic review and meta-analysis of benefits, harms, and patient values and preferences.

Background: About 20-30% of older adults (≥ 65 years old) experience one or more falls each year, and falls are associated with substantial burden to the health care system, individuals, and families from resulting injuries, fractures, and reduced functioning and quality of life. Many interventions for preventing falls have been studied, and their effectiveness, factors relevant to their implementation, and patient preferences may determine which interventions to use in primary care. The aim of this set of reviews was to inform recommendations by the Canadian Task Force on Preventive Health Care (task force) on fall prevention interventions.

Participant Engagement and Preference Study for Clinical Outcomes Associated With Atrial Fibrillation: The PEARL-AF Study.

Background: Quantifying patients' preferences for health outcomes associated with atrial fibrillation (AF) and its treatments offers a replicable approach to considering the patient perspective in regulatory decision-making.

Objective: The authors conducted a preference survey to estimate the relative importance of AF-related events for use in clinical trial analyses to estimate net health benefits with anticoagulants.

Methods: The survey included nontechnical descriptions of three severities of stroke, systemic embolism, myocardial infarction (MI) with or without subsequent heart failure (HF), major bleeding, clinically relevant nonmajor bleeding, and death.

Military sexual trauma, childhood trauma, and combat trauma: Associations with longitudinal posttraumatic growth among U.S. Veterans.

Objective: Military sexual trauma (MST), childhood trauma, and combat trauma are prevalent among U.S. military personnel.

Diastolic Dysfunction and the Risk of Stroke and Major Bleeding.

Background: Left ventricular diastolic dysfunction (DD) is associated with adverse cardiovascular outcomes including atrial fibrillation. Whether DD is independently associated with incident stroke and transient ischemic attack (TIA) and with bleeding events is not known. We performed this observational cohort analysis to examine the impact of DD on the risk of stroke/TIA and major bleeding.

Using Passive and Active Data to Predict Post-Traumatic Stress Disorder Symptoms and Cannabis Use in Recently Discharged UK Veterans: A Protocol for the MAVERICK Feasibility Study.

Introduction: Post-traumatic stress disorder (PTSD) and comorbid cannabis use disorder (CUD) is a growing concern amongst UK veterans. Co-occurrence of problematic cannabis use, and PTSD is associated with greater PTSD symptom severity, decreased likelihood of cannabis use cessation, worse clinical outcomes, and increased societal burden. Despite increased screening efforts among veterans, there are no effective strategies for predicting risk for PTSD and problematic drug use escalation before these conditions develop, worsen, or become chronic.

Combined left atrial appendage occlusion and catheter ablation procedure for left atrial arrhythmias: A real-world, propensity-matched analysis.

Introduction: Real-world studies comparing safety and efficacy of combined percutaneous left atrial appendage occlusion (LAAO) and catheter ablation (CA) to LAAO alone are limited.

Methods: Patients from a large US hospital system undergoing combined LAAO and left-atrial CA from 8/2020 to 2/2024 were retrospectively analyzed and compared to a control group undergoing LAAO alone. Controls were identified using a 1:2 propensity score match based on LAAO device type (Watchman FLX vs.

Pharmacological intervention of behavioural traits and brain histopathology of prenatal valproic acid-induced mouse model of autism.

Autism spectrum disorder (ASD) is one of the leading causes of distorted social communication, impaired speech, hyperactivity, anxiety, and stereotyped repetitive behaviour. The aetiology of ASD is complex; therefore, multiple drugs have been suggested to manage the symptoms. Studies with histamine H3 receptor (H3R) blockers and acetylcholinesterase (AchE) blockers are considered potential therapeutic agents for the management of various cognitive impairments.

Clinical usability of deep learning-based saliency maps for occlusion myocardial infarction identification from the prehospital 12-Lead electrocardiogram.

Introduction: Deep learning (DL) models offer improved performance in electrocardiogram (ECG)-based classification over rule-based methods. However, for widespread adoption by clinicians, explainability methods, like saliency maps, are essential.

Methods: On a subset of 100 ECGs from patients with chest pain, we generated saliency maps using a previously validated convolutional neural network for occlusion myocardial infarction (OMI) classification.

Reducing Alcohol Misuse and Promoting Treatment Initiation Among Veterans Through a Brief Internet-Based Intervention: Protocol for a Randomized Controlled Trial.

Background: Young adult veterans who served after the September 11 attacks on the United States in 2001 (ie, post-9/11) are at heightened risk for experiencing behavioral health distress and disorders including hazardous drinking, posttraumatic stress disorder, and depression. These veterans often face significant barriers to behavioral health treatment, and reaching them through brief mobile phone-based interventions may help reduce drinking and promote treatment engagement.

Objective: Following a successful pilot study, this randomized controlled trial (RCT) aims to further test the efficacy of a brief (ie, single session) mobile phone-delivered personalized normative feedback intervention enhanced with content to promote treatment engagement.

Impact of guideline directed medical therapy on myocardial function in adults with congenital heart disease.

Background: Guideline-directed heart failure therapy with angiotensin receptor blocker/neprilysin inhibitor (ARNi) and sodium-glucose transporter inhibitors (SGLT2i) has been incrementally beneficial in improving outcomes in heart failure patients.

Objective: Evaluate the feasibility and efficacy of guideline-directed medical therapy (GDMT) in adults congenital heart disease (ACHD) patients.

Methods: In a retrospective cohort study, ACHD patients with either New York Heart Association (NYHA) Class II symptoms or systemic ejection fraction (EF) <45%, optimized on a combination of beta-blocker (BB), ARNi, mineralocorticoid receptor antagonist (MRA) and SGLT2i were evaluated.

Long-Term Changes in Atrial Arrhythmia Burden After Renal Denervation Combined With Pulmonary Vein Isolation: SYMPLICITY-AF.

Background: The autonomic nervous system plays an important role in atrial fibrillation (AF) and hypertension. Renal denervation (RDN) lowers blood pressure (BP), but its role in AF is poorly understood.

Objectives: The purpose of this study was to investigate whether RDN reduces AF recurrence after pulmonary vein isolation (PVI).

Exploring predictors of substance use disorder treatment engagement with machine learning: The impact of social determinants of health in the therapeutic landscape.

Background: Improved knowledge of factors that influence treatment engagement could help treatment providers and systems better engage patients. The present study used machine learning to explore associations between individual- and neighborhood-level factors, and SUD treatment engagement.

Methods: This was a secondary analysis of the Global Appraisal of Individual Needs (GAIN) dataset and United States Census Bureau data utilizing random forest machine learning and generalized linear mixed modelling.

Patient preferences for breast cancer screening: a systematic review update to inform recommendations by the Canadian Task Force on Preventive Health Care.

Background: Different guideline panels, and individuals, may make different decisions based in part on their preferences. Preferences for or against an intervention are viewed as a consequence of the relative importance people place on the expected or experienced health outcomes it incurs. These findings can then be considered as patient input when balancing effect estimates on benefits and harms reported by empirical evidence on the clinical effectiveness of screening programs.

Physical Pain Among Urban Native American Emerging Adults: Sociocultural Risk and Protective Factors.

Objective: American Indian/Alaska Native (AI/AN) people have high rates of physical pain. Pain is understudied in urban-dwelling, AI/AN emerging adults, a group with unique sociocultural risk and protective factors. We explore associations between socioeconomic disadvantage, additional sociocultural factors, and pain among urban AI/AN emerging adults.