Wolff-Parkinson-White syndrome, characterised by accessory pathways, is rarely seen with dextrocardia. We present a case of situs inversus-dextrocardia with Wolff-Parkinson-White syndrome successfully treated via catheter ablation using 3D mapping (EnSite Precision®). Adjustments included reversed electrocardiogram (ECG) electrode placement, EnSite patch positioning, and fluoroscopic views. Coronary sinus access required counterclockwise manoeuvers. Mapping identified a left-sided accessory pathway, necessitating transseptal puncture with mirror-image adjustments. Ablation at the optimal site resulted in success. This case highlights the feasibility of catheter ablation in dextrocardia with tailored procedural modifications.

After Dobbs v. Jackson Women’s Health Organization, the United States Supreme Court decision that overturned Roe v. Wade in 2022, OB/GYN residents’ access to abortion training, which is required in all accredited programs, has come under pressure. To receive the foundational training doctors in the field need, many residents in ban states travel to out-of-state programs where abortion is legal. But demand is high, travel for multiple weeks is expensive, and the capacity to train at host sites is limited.

Training by travel could have ripple effects for the quality of patient care. As the number of OB/GYNs continues to decrease, newly-trained providers will have different, and arguably diminished, skills in delivering not just elective but also medically necessary abortion care. And as exceptions for life and health become how legal, procedural terminations take place in one-third of the United States, there is no guarantee that the doctors in those states will feel comfortable providing that care.

This article explores the residency training provided today, providers’ and institutions’ navigation of abortion bans, and what changes in residency programs might mean for patient care in the coming years. Part I surveys the landscape of abortion law after Dobbs; even the strictest bans contemplate instances when abortion is medically required and legally permitted. Part II summarizes the pre- and post-Dobbs expectations for abortion training for OB/GYN residents, describing how graduate medical education has changed for residents in ban states. Part III assesses shorter and longer-term effects of a system that relies on travel and simulation (the use of models) or is out of compliance with national accreditation standards. Part IV concludes with potential paths forward that depend on state and national organizations supporting and funding the networks of health care professionals that facilitate training across the country.

Farman Saeed Sedeeq and Percem Arman’s article aims to develop a framework of AI governance that avoids shortcomings in existing models such as limited enforceability and rigid data-sharing rules. The goal of the weighty undertaking is to develop a “structured yet flexible approach” to balancing AI advancements in public health with ethical imperatives. Three core “pillars” are used for evaluation: ethical accountability, regulatory adaptability, and transparency. The concept of ethical accountability is explored briefly in this commentary.

This paper addresses the comprehensive regulation of artificial intelligence (“AI”) across its entire lifecycle in the health care sector. It builds on a proposal for a True Lifecycle Approach (“TLA”) to address governance gaps across three phases of AI and expands the framework with detailed practical insights for governing health care AI, drawing on pioneering examples from Qatar, Saudi Arabia, and the United Arab Emirates (“UAE”) as models for global implementation. Beginning with the research and development phase, it highlights the urgent need for robust guidelines and certification processes to ensure that AI technologies are developed in compliance with ethical and safety standards. Moving into the approval stage, the discussion explores how AI systems can be effectively regulated under existing medical device frameworks, emphasizing the need for tailored regulations that consider the unique challenges posed by AI. Finally, the paper delves into the deployment of AI in clinical practice, examining the gaps in current laws and the need for a coherent and consistent regulatory framework that can adapt to AI advancements. The paper argues that the existing legal structures are inadequate, often inconsistent, and fail to address the complexities of AI in health care. It argues for a broader regulatory approach focused on patient safety throughout the AI lifecycle.

Reflections on Claire O’Callaghan and Brendan Parent’s article “Withdrawal of Life-Sustaining Treatment and Organ Donation After Circulatory Death: Consequences of Legislative Separation.”

Financialization of healthcare drains our current system of resources it needs to provide care. It occurs when money is siphoned off for private profit through mechanisms such as rent seeking, gamesmanship, and exploitative price setting. This is not an ethically neutral activity, and the people profiting in this way ought to justify why they are entitled to this money, given the foreseeable negative effects what they are doing has on people’s health. This important problem is masked by current accounting methods and healthcare billing methods, which need to be changed to allow for a more transparent assessment of what is really occurring.

This article assesses a 10-month co-created universal school-based mental health (SBMH) promotion initiative for adolescents (10–19). The study combined quantitative and qualitative components. Pre- and post-intervention surveys were conducted in four schools in Tanzania (n = 400 baseline, 488 endline, with 100 intervention participants at both) and eight schools in Vietnam (n = 1,036 baseline, 893 endline and 436 in panel). In each country, ~90 qualitative interactions (interviews and focus groups) were held at baseline and endline with adolescents, parents, teachers and service providers (total = ~180). In Tanzania, multivariate analysis indicated significant gains among intervention participants relative to peers. Emotional literacy rose 9.5% (p = 0.007; d = 0.57). Attitudes toward help-seeking (p = 0.021; d = 0.50) and prosocial behaviors (p = 0.043, d = 0.38) also improved Active coping increased 15.6% (p = 0.006; d = 0.55). In Vietnam, emotional literacy increased 5.3% (p = 0.012, η2 = .019), and positively, emotion-focused coping declined 14.4% (p = 0.032, η2 = .015). Qualitative evidence reinforces these findings, and suggested spillover effects for nonparticipants. Overall results indicate that co-created universal SBMH initiatives can improve adolescent well-being and offer viable alternatives to limited adolescent-focused mental health services in LMICs.

Hydatid cyst is an infectious disease that occurs in humans due to infection of Echinococcus granulosus larvae. Although cardiac hydatid cysts are rare, right atrial localisation is even rarer. The aim of this article is to emphasise the importance of always being alert and prepared for the risk of anaphylaxis developing due to cyst rupture in paediatric patients with isolated cardiac hydatid cysts, to initiate oral albendazole treatment immediately upon diagnosis, to underline the importance of surgical timing, and to discuss the role of clinical assessment and imaging methods in predicting of cyst rupture.