Age-Related Ventricular Tachycardia Substrate Characteristics for Repaired Tetralogy of Fallot Before Transcatheter Pulmonary Valve Placement.

Background: Ventricular tachycardia (VT) substrate characteristics before transcatheter pulmonary valve replacement (TPVR) in repaired tetralogy of Fallot (rTOF) are unknown.

Objectives: In this study, the authors sought to evaluate substrates for sustained monomorphic VT before TPVR in rTOF.

Methods: Retrospective (2017 to 2021) and prospective (commencing 2021) rTOF patients with native right ventricular outflow tract referred for electrophysiology study (EPS) before TPVR were included.

Cost-Effectiveness Analysis of Inclisiran for the Treatment of Primary Hypercholesterolemia or Mixed Dyslipidemia in Singapore.

Objectives: This analysis evaluated the cost-effectiveness of inclisiran plus standard of care (SoC; comprising statins, ezetimibe, and fenofibrate) in primary hypercholesterolemia or mixed dyslipidemia from a Singapore healthcare system perspective. Inclisiran + SoC was separately compared with SoC, alirocumab + SoC, and evolocumab + SoC.

Methods: A lifetime Markov model in the United Kingdom (UK) was adapted to the Singapore setting.

Metabolomics signatures of serotonin reuptake inhibitor (escitalopram), serotonin norepinephrine reuptake inhibitor (duloxetine) and cognitive-behavioral therapy on key neurotransmitter pathways in major depressive disorder.

Metabolomics provides powerful tools that can inform about heterogeneity in disease and response to treatments. In this exploratory study, we employed an electrochemistry-based targeted metabolomics platform to assess the metabolic effects of three randomly-assigned treatments: escitalopram, duloxetine, and Cognitive-Behavioral Therapy (CBT) in 163 treatment-naïve outpatients with major depressive disorder. Serum samples from baseline and 12 weeks post-treatment were analyzed using targeted liquid chromatography-electrochemistry for metabolites related to tryptophan, tyrosine metabolism and related pathways.

Finerenone and new-onset diabetes in heart failure: a prespecified analysis of the FINEARTS-HF trial.

Background: Data on the effect of mineralocorticoid receptor antagonist therapy on HbA levels and new-onset diabetes are conflicting. We aimed to examine the effect of oral finerenone, compared with placebo, on incident diabetes in the Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure (FINEARTS-HF) trial.

Methods: In this randomised, double-blind, placebo-controlled trial, 6001 participants with heart failure with New York Heart Association functional class II-IV, left ventricular ejection fraction 40% or higher, evidence of structural heart disease, and elevated N-terminal pro-B-type natriuretic peptide levels were randomly assigned to finerenone or placebo, administered orally.

Opening the black box: Think Aloud as a method to study the spontaneous stream of consciousness.

Asking participants to Think Aloud is a common method for studying conscious experience, but it remains unclear whether this approach alters thought qualities-such as meta-awareness, rate of topic shifts, or the content of thoughts in task-absent conditions. To investigate this, we conducted two studies comparing thinking aloud to thinking silently. In Study 1, 111 participants alternated between 15-minute intervals of verbalizing and silently reflecting on their stream of consciousness in a counterbalanced design.

Multiple sclerosis and infection: history, EBV, and the search for mechanism.

SUMMARYInfection has long been hypothesized as the cause of multiple sclerosis (MS), and recent evidence for Epstein-Barr virus (EBV) as the trigger of MS is clear and compelling. This clarity contrasts with yet uncertain viral mechanisms and their relation to MS neuroinflammation and demyelination. As long as this disparity persists, it will invigorate virologists, molecular biologists, immunologists, and clinicians to ascertain how EBV potentiates MS onset, and possibly the disease's chronic activity and progression.

Defining the Critical Requisites for Accurate Simulation of SARS-CoV-2 Viral Dynamics: Patient Characteristics and Data Collection Protocol.

Mathematical models of viral dynamics are crucial in understanding infection trajectories. However, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load data often includes limited sparse observations with significant heterogeneity. This study aims to: (1) understand the impact of patient characteristics in shaping the temporal viral load trajectory and (2) establish a data collection protocol (DCP) to reliably reconstruct individual viral load trajectories.

Predictive validity of obstacle-crossing test variations in identifying fallers after inpatient rehabilitation for stroke.

Background: The ability to step over an obstacle is often evaluated as part of fall-risk and balance assessments. Although different obstacle-crossing tests exist, their comparative predictive validity in stroke is unknown.

Objectives: To examine the predictive validity of different obstacle depths and different obstacle-crossing tests, including a novel, custom-height test and an existing "one-size-fits-all" obstacle test, for predicting post-stroke fallers.

The association of seizure control with neuropathology in dementia.

Seizures in people with dementia (PWD) are associated with faster cognitive decline and worse clinical outcomes. However, the relationship between ongoing seizure activity and postmortem neuropathology in PWD remains unexplored. We compared post-mortem findings in PWD with active, remote, and no seizures using multicentre data from 39 Alzheimer's Disease Centres from 2005 to 2021.

Ethnic Differences in Atrial Fibrillation in the United Kingdom.

Background: Within the United States, White individuals experience a higher risk of atrial fibrillation (AF) while exhibiting a lower AF-related stroke risk compared to other ethnic groups. It is possible that these observations stem from phenomena unique to the United States, such as differential health care access. The United Kingdom provides socialized medicine, which ostensibly promotes equitable health care access.

Global Disparities in Outcomes of Pregnant Individuals With Rheumatic Heart Disease: A Scoping Review.

Background: Rheumatic heart disease (RHD) remains as 1 of the major contributors to indirect pregnancy-related mortality and morbidity worldwide and disproportionately affects marginalized populations.

Objectives: In this scoping review, the authors sought to explore the socioeconomic, cultural, and health care access-related causes of global disparities in outcomes of pregnancy among individuals with RHD.

Methods: We performed a literature search of all studies published between January 1, 1990, and January 1, 2022, that investigated causes for disparate outcomes in pregnant individuals with RHD.

Global Health Inequities in Electrophysiology Care: A State-of-the-Art Review.

This state-of-the-art review examines disparities in the diagnosis, management, and outcomes of cardiac arrhythmias globally. These arrhythmias include atrial fibrillation, ventricular tachyarrhythmias underlying sudden cardiac death, and bradyarrhythmias associated with sinus node and atrioventricular node disease. Arrhythmias in low- and middle-income countries often result in higher mortality rates due to complex and poorly documented risk factors, lack of clinical expertise among health care personnel, lack of sufficient infrastructure, and challenges in access to care.

Preference for HIV Pre-exposure Prophylaxis Access Among Men who Have Sex With Men in China: A Discrete Choice Experiment.

Background: HIV pre-exposure prophylaxis (PrEP) is highly effective but not widely used by men who have sex with men (MSM; 27%) in China.

Methods: In June 2023, an online cross-sectional survey with a discrete choice experiment (DCE) was distributed to PrEP-eligible MSM in China who were at least 18 years old. The DCE explored attributes of PrEP modality (daily pill, on-demand pill, injections, implants), clinical care model (same-day, 2-visit, telehealth prescription), medication pickup (clinic, community health center, pharmacy, MSM-focused community-based organization, home delivery), enhanced support (self-management, smartphone app, text reminder, anonymous peer support group), and cost.

Artificial womb technology - A more physiologic solution to treating extreme prematurity.

Treatment of extreme premature infants (EPI) is limited by developmental immaturity primarily of the lung. A paradigm shift towards a more physiologic treatment of EPI as fetal neonates or , by keeping them in a womb-like environment to allow continued organ maturation, is the rationale for artificial womb technology. In this review, we discuss the artificial placenta and womb technology, it's rationale, the history of its development, the most recent preclinical models described in the literature and finally pertinent ethical considerations.

Ultrasound-activated erythrocyte membrane-camouflaged Pt (II) layered double hydroxide enhances PD-1 inhibitor efficacy in triple-negative breast cancer through cGAS-STING pathway-mediated immunogenic cell death.

Immunogenic cell death (ICD) offers a promising avenue for the treatment of triple-negative breast cancer (TNBC). However, optimizing immune responses remains a formidable challenge. This study presents the design of RBCm@Pt-CoNi layered double hydroxide (RmPLH), an innovative sonosensitizer for sonodynamic therapy (SDT), aimed at enhancing the efficacy of programmed cell death protein 1 (PD-1) inhibitors by inducing robust ICD responses.

Demographics, psychiatric comorbidities, and hospital outcomes across eating disorder types in adolescents and youth: insights from US hospitals data.

Objective: The aim of our study was to delineate the differences in demographics, comorbidities, and hospital outcomes by eating disorder types in adolescents and transitional-age youth (15-26 years), and measure the association with psychiatric comorbidities.

Methods: We conducted a cross-sectional study using the nationwide inpatient sample (2018-2019) and included 7,435 inpatients (age 12-24 years) with a primary diagnosis of eating disorders: anorexia nervosa (AN, 71.7%), bulimia nervosa (BN, 4.

Barriers to Research Faced by High-Income Versus Low- and Middle-Income Country Otolaryngologists and Otolaryngology Residents.

Objective: This study aims to compare research productivity and barriers to research between high-income countries (HICs) and low- and middle-income countries (LMICs) otolaryngologists.

Study Design: Cross-sectional survey.

Setting: International survey.

Malnutrition in Spine Oncology: Where Are We and What Are We Measuring?

Study Design: Scoping review.

Objective: To identify which markers are used as surrogates for malnutrition in metastatic spine disease and which are the most studied outcomes associated with it.

Methods: A scoping review was performed by searching the PubMed/Medline, EMBASE, and Web of Science databases up to July 2022.

PICC Lines in Pregnancy and Other Peripartum Vascular Access Considerations.

Importance: To decrease associated infectious and thrombotic morbidity, it is important to understand the indications and risks of peripherally inserted central catheters (PICCs) and other vascular access means in pregnancy.

Objectives: The objectives are 3-fold: (1) discuss indications and contraindications, approach to placement, and associated complications for PICC lines, arterial catheters, centrally inserted central catheters, and peripheral intravenous catheters; (2) review available data regarding complications associated with these catheters in pregnancy; and (3) propose an evidence-based approach to clinical decision making regarding vascular access in 2 clinical scenarios among pregnant patients.

Evidence Acquisition: A literature review identified relevant research, review articles, textbook chapters, databases, and societal guidelines, with a focus on obstetrical anesthesia and obstetric literature.