Transvenous and epicardial pacing in children carries significant risks of lead failure and infection. Leadless pacing is an alternative with lower risks of infection, lead failure, and longer battery longevity. A retrievable leadless pacemaker was implanted in an 8-year-old, 24 kg patient with heart block. A systematic review evaluated procedural success and the safety of leadless pacemakers in preadolescents weighing less than 30 kg.

Nematodes are one of the most diverse groups of organisms, but much of their evolutionary history remains unresolved. Genetic tools have greatly advanced this field, especially in cases of cryptic diversity. Here, we reconstructed the mitogenomes of four parasitic nematodes, each from a different genus of the family Pharyngodonidae (Nematoda: Oxyuroidea): Spauligodon, Pharyngodon, Parapharyngodon, and Thelandros. For each species, whole genome sequencing was performed, using an Illumina HiSeq 2500 platform. Mitochondrial genomes were reconstructed using both reference-based mapping and bait-based iterative assembly approaches. The resulting mitogenomes were 13,692 to 16,700 bp long, included 12 protein-coding genes, 22 tRNAs and the 12S and 16S rRNA regions and all lacked the ATP8 gene. All genes were on the same strand and in the same orientation, which is congruent with the composition and organization observed in other oxyurid nematodes. Also as observed in other nematode groups, the four mitogenomes exhibited major differences in gene order. It is still unknown what promotes such extensive gene order rearrangements within nematodes, even amongst related groups, but it is expected to influence the rates of evolution, especially for parasitic species, and help to explain their impressive diversity.

Variations in venous circulation can affect either the superior or inferior vena cava, with diagnoses often being incidental and presenting with highly variable symptoms. This rare case discusses the detection and investigation of bilateral superior vena cava agenesis in an asymptomatic patient.

Jervell and Lange-Nielsen syndrome is a rare inherited disorder characterised by sensorineural hearing loss and a prolonged corrected QT interval, predisposing to malignant arrhythmias. We describe two adult sisters diagnosed after recurrent syncope. Genetic testing confirmed a homozygous KCNQ1 mutation. Awareness of this condition, even in adulthood, is essential to ensure diagnosis, appropriate treatment, and prevention of sudden cardiac death.

Chronic stress can lead to physical and mental health conditions. This study aimed to identify the different stress profiles and stress relief methods among Filipinos living in the Philippines using latent class analysis. A secondary analysis of a cross-sectional study was employed in this study. The stressors and stress-relief practices among Filipinos were investigated using the I-HEART-FILIPINOS data set. Latent class analysis was used to identify the different profiles of stress causes and management methods among 1,196 Filipinos residing in the Philippines, specifically the Northern Luzon area. Four stress-related profiles were identified: (1) low financial stress relieved by eating and exercise; (2) work-related stress relieved by self-care; (3) familial and economic turmoil relieved by eating, exercise and prayer; (4) high financial stress relieved by staying at home and remaining indoors. The four-class solution explained 58% of the variation in the data through classification. Disparities were observed between classes in terms of emotional distress and sociodemographic variables, implying how sociocultural factors could affect stress presentation and management in Filipinos. The findings of this study inform the development of stress management interventions specifically designed to address the needs of underserved populations in the Philippines and neighboring countries to improve overall health.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing in prevalence and is the leading cause of hepatic fibrosis and cirrhosis in the industrialised world. Despite growing evidence for lifestyle interventions, adherence to nutritional and physical activity recommendations and psychological behaviours among patients with MASLD has not been previously characterised in Canada. We conducted a cross-sectional analysis of baseline data from patients with MASLD. Lifestyle adherence, including dietary patterns, physical activity and psychological measures, was assessed at a single time point to describe prevalence and patterns among participants. Adults with MASLD and advanced fibrosis were older (median age 58·4 v. 45·3 years; P < 0·001), had a greater BMI (median 36·3 v. 31·2; P < 0·001) and have higher presence of metabolic risk factors including type 2 diabetes mellitus (P < 0·001), hypertension (P = 0·001), thyroid disease (P = 0·02) and were of White ethnicity (P = 0·002). The prevalence of mood disorder was 31 % for anxiety and 16 % for depressive symptoms based on HADS-A and HADS-D ≥ 8 indicating borderline/abnormal anxiety and depression, respectively. Twenty per cent of patients had a Binge Eating Score ≥ 18 indicating moderate/severe binge eating behaviour. Most had poor adherence to a Mediterranean diet with the energy-restricted Mediterranean Diet Adherence Screener (er-MEDAS) ≤ 7 (56 % with poor adherence, 34 % with moderate adherence), 42 % reported weekly alcohol consumption and one-third had low self-reported activity levels on the International Physical Activity Questionnaire Short Form (IPAQ-SF). Here, we identified barriers to risk reduction in patients with MASLD, including increased prevalence of anxiety and depressive symptoms, high frequency of binge eating behaviours, poor adherence to Mediterranean diet quality and sedentary self-reported activity levels.

Understanding trends in height and BMI, along with trajectories of weight status, is crucial to identifying the optimal timing for intervention. The objective of this study was to describe trends in height and BMI among children and adolescents and identify the trajectory of weight status over time. This was a longitudinal study with data collected annually (2013–2020). A total of 41 325 students aged 5–18 years from forty-seven schools participated in the study, and a subsample of 11 535 participants with at least five BMI measurements was used for the analyses. Mixed-effects analysis showed significant increases in height over the years for boys (0·19 cm, standard error 0·01, P < 0·001) and girls (0·15 cm, standard error 0·01, P < 0·001). Regarding BMI, an increasing trend over the years was also found in boys (0·04 kg/m2, se 0·01, P < 0·001) and girls (0·04 kg/m², se 0·01, P < 0·001). Analysing weight status trajectories, three groups were identified: consistently normal weight (males 63·7 %, females 64·5 %), increasingly overweight (males 21·8 %, females 20·7 %) and increasingly obese (males 14·5 %, females 14·8 %). We conclude that in adolescence, height was below expected, indicating that children are not reaching their maximum growth potential. Furthermore, the identification of increasing trajectories of overweight and obesity, starting in childhood, emphasises the progressive nature of excessive weight gain before adulthood. These findings highlight the early onset of nutritional deviations in this population, suggesting the need for interventions to promote healthy weight as children transition into adolescence to mitigate future health risks.

Suicidal ideation and trauma exposure are significant health challenges worldwide, and their interaction increases their burden on individuals and communities. However, limited research has been devoted to these conditions in low- and middle-income countries, where the majority of the burden of these disorders exists. Additionally, unique cultural factors that may contribute to differential relationships in these symptoms and disorders make this an important area to explore. This study examines relationships between the number and types of adverse exposures, PTSD symptoms and severity, depression and suicidal ideation in a sample of Cambodian women with experiences of trauma using logistic and linear regressions. Overall, PTSD severity significantly contributes to suicidal ideation, with hyperarousal symptoms playing a particularly influential role in this association. Further, adverse experiences, including physical abuse and parental mental health problems, contributed significantly to increased suicidal ideation. Lastly, depression severity partially mediates the relationship between PTSD severity and suicidal ideation. These results illustrate the significant role of PTSD in the experience of suicidal ideation, particularly within regions like Cambodia with high trauma loads. These findings point to psychological constructs that may be especially important to include in suicidality screening tools and to target within prevention and intervention efforts.

Peer review is an important step in supporting high-quality research publications. However, understanding the review process can be challenging for peer reviewers. The role of the peer reviewer varies from journal-to-journal. Furthermore, it is sometimes difficult for reviewers to understand how to structure and format their review. This article discusses the role of peer review in the Prehospital and Disaster Medicine (PDM) review process and provides guidance for creating a high-quality peer review report.

A previously asymptomatic 7-year-old boy with Duchenne muscular dystrophy unexpectedly developed sudden cardiac arrest with no preceding illness. An automated external defibrillator confirmed the presence of ventricular fibrillation. Cardiac MRI showed prominent myocardial fibrosis with no evidence of acute inflammation. Whole exome sequence revealed no associated pathological variance for lethal ventricular arrhythmias. Life-threatening ventricular fibrillation can occur in young patients with Duchenne muscular dystrophy.