Individuals with 22q11 deletion syndrome have a mutation in the TBX1 gene. This is associated with reduced left pulmonary artery/right pulmonary artery ratio in animal models and in humans with structurally normal hearts.

A retrospective analysis was undertaken of patients who underwent surgical repair of Tetralogy of Fallot, truncus arteriosus, and interrupted aortic arch between 01/2007 and 12/2022. The left pulmonary artery/right pulmonary artery ratio on initial and most recent echocardiogram and initial and subsequent intervention on the left pulmonary artery were compared between patients with and without 22q11 deletion.

There were 134 included patients; 19 patients had the deletion (22q11 positive), and 115 patients did not have the deletion (22q11 negative). Tetralogy of Fallot was present in 8/19 and 101/115 patients, truncus arteriosus in 7/19 and 7/115 patients, and interrupted aortic arch in 4/19 and 7/115 patients. Patients who were 22q11 positive had a reduced left pulmonary artery/right pulmonary artery ratio on both the initial echocardiogram [0.88 (interquartile range 0.71, 0.97) versus 1.02 (interquartile range 0.92, 1.12); p < 0.001] and most recent echocardiogram [0.66 (interquartile range 0.62, 0.91) versus 1.01 (interquartile range 0.89, 1.16); p < 0.001] and were more likely to have intervention on the left pulmonary artery at their initial surgery (36% versus 8.7%; p = 0.003).

Patients who were 22q11 positive trended towards reduced left pulmonary artery/right pulmonary artery ratios and need for early surgical intervention on the left pulmonary artery in comparison to patients without 22q11 deletion negative patients.

Governments are increasingly implementing policies to improve population diets, despite food industry resistance to regulation that may reduce their profits from sales of unhealthy foods. However, retail food environments remain an important target for policy action. This study analysed publicly available responses of industry actors to two public consultations on regulatory options for restricting unhealthy food price and placement promotions in retail outlets in Scotland.

We conducted a qualitative content analysis guided by the Policy Dystopia Model to identify the discursive (argument-based) and instrumental (tactic-based) strategies used by industry actors to counter the proposed food retail policies.

Scotland, UK, 2017-2019.

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Most food and retail industry responses opposed the policy proposals. Discursive strategies employed by these actors commonly highlighted the potential costs to the economy, their industries and the public in the context of a financial crisis, and disputed the potential health benefits of the proposals. They claimed that existing efforts to improve population diets, such as nutritional reformulation, would be undermined. Instrumental strategies included using unsubstantiated and misleading claims, building a coordinated narrative focused on key opposing arguments and seeking further involvement in policy decision-making.

These findings can be used by public health actors to anticipate and prepare for industry opposition when developing policies targeted at reducing the promotion of unhealthy food in retail settings. Government action should ensure robust management of conflicts of interest and establishment of guidance for the use of supporting evidence as part of the public health policy process.