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Background: According to current guidelines, patients with heart valve disease should be followed by Heart Valve Clinics (HVCs). Regular quality analysis is a major prerequisite of an HVC's program, but few data have been reported so far. Methods: We retrospectively collected patients with isolated, native aortic valve stenosis who had been visited in our HVC at least once between 2021 and 2024. For each outpatient visit, symptoms, physical examination, echocardiographic data, complementary tests, and indications were acquired. Also, adverse events (hospitalization, unplanned procedures, and death) were retrieved. Results: A total of 320 patients were included. Mean visits/patient ratio was 1.2. At the first visit, 69.7% already had severe aortic stenosis, and severe symptoms (NYHA ≥ III) were evident in 24.4%. In addition, 26.5%, 59.1%, 12.8%, and 1.6% were in Généreux stage I, II, III, and IV, respectively. Overall, 197 (78.5%) and 54 (21.5%) patients received an indication for transcatheter AVR and surgical AVR, respectively. AVR-free survival was 46%, 23%, and 6% at 6, 12, and 24 months, respectively (mean 8.8 months CI95% 7.7–9.9). Adverse event-free survival was 97.2%, 95.5%, and 85% at 3, 6, and 12 months, respectively. Conclusions: Patients referred to our HVC already had an advanced disease with cardiac damage. Transcatheter AVR was mostly indicated, and it showed excellent short-term results. A low rate of adverse events was seen among patients in follow-up, but the odds of receiving AVR were high and driven by Généreux's stage. Despite these favorable results, further efforts to sensitize earlier patient referral should be made. [ABSTRACT FROM AUTHOR]

Based on the repertory grid technique, we developed Explore Your Meanings (EYME), a digital platform that helps patients explore identity values and internal conflicts using virtual reality (VR). EYME was part of a research project treating depression in young adults, including 10 weekly, 1-h sessions aimed at changing personal constructs-cognitive schemas that shape how individuals interpret reality. We present the case of Mary, a 21-year-old woman diagnosed with persistent major depressive disorder and social phobia. Early sessions with EYME revealed key implicit dilemmas in Mary's worldview, such as feeling that she had to be selfish (an undesired personal characteristic) to become smarter and more self-confident (desired pole). As Mary visualized these constructs in VR, she began to recognize her identity conflicts and strengths, ultimately helping her to improve her negative self-image. Interventions focused on reframing these constructs, particularly around "intelligence" and introducing "emotional intelligence," which helped Mary adopt a more nuanced view of herself. A key session involved a two-chair dialog between her "critical" and "emotional" selves, facilitating the integration of polarized aspects of her personality. In subsequent sessions, EYME reinforced these changes, with Mary reinterpreting behaviors like being "selective" as protective rather than negative. By the end of therapy, she no longer met the criteria for depression or social phobia, and her psychological distress had normalized., (© 2025 Wiley Periodicals LLC.)

Virtual environments like online videogames offer increasingly more people the opportunity to socialize purely within the digital plane. These interactions, often done through customizable avatars, have brought about the concept of the "virtual-self," understood as the multiple identities that can be expressed in virtual environments. This can take many forms and fulfill different psychological roles, from portraying the individual's ideal-self to allowing them to explore what it feels like to be someone completely different. In this study, we used a constructivist perspective to put forward a typology of the different ways in which players construe their virtual identities in online videogames. We administered the repertory grid technique to 202 online videogame players to measure their perceived discrepancies between their actual-self (how they see themselves), ideal-self (how they wish to be), and virtual-self (how they see their main character in a game of their choice). After conducting a cluster analysis, we found three main patterns of virtual-self construal. The projection-type, where players with a high actual-ideal discrepancy created a virtual character resembling their ideal-self; the exploration-type, where players with a lower actual-ideal discrepancy tended to create a character that was different from both their actual and ideal selves; and the proximal-type, where players created characters that were similar to their actual-self. This typology can be a useful resource for any videogame research that wishes to include an identity perspective, as well as in the diagnosis and treatment of internet gaming disorder.