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Aims Typical electrocardiogram (ECG) features of apical hypertrophic cardiomyopathy (ApHCM) include tall R waves and deep or giant T-wave inversion in the precordial leads, but these features are not always present. The ECG is used as the gatekeeper to cardiac imaging for diagnosis. We tested whether explainable advanced ECG (A-ECG) could accurately diagnose ApHCM. Methods and results Advanced ECG analysis was performed on standard resting 12-lead ECGs in patients with ApHCM [ n = 75 overt, n = 32 relative (<15 mm hypertrophy); a subgroup of which underwent cardiovascular magnetic resonance (n = 92)], and comparator subjects (n = 2449), including healthy volunteers (n = 1672), patients with coronary artery disease (n = 372), left ventricular electrical remodelling (n = 108), ischaemic (n = 114) or non-ischaemic cardiomyopathy (n = 57), and asymmetrical septal hypertrophy HCM (n = 126). Multivariable logistic regression identified four A-ECG measures that together discriminated ApHCM from other diseases with high accuracy [area under the receiver operating characteristic (AUC) curve (bootstrapped 95% confidence interval) 0.982 (0.965–0.993)]. Linear discriminant analysis also diagnosed ApHCM with high accuracy [AUC 0.989 (0.986–0.991)]. Conclusion Explainable A-ECG has excellent diagnostic accuracy for ApHCM, even when the hypertrophy is relative, with A-ECG analysis providing incremental diagnostic value over imaging alone. The electrical (ECG) and anatomical (wall thickness) disease features do not completely align, suggesting that future diagnostic and management strategies may incorporate both features. [ABSTRACT FROM AUTHOR]

A controlled fermentation process using straight-grade wheat flour, commercially milled from a grist of Canada Western Red Spring (CWRS) wheat and English wheat, and fresh yeast (Saccharomyces cerevisiae) was found to be effective for developing a naturally derived product (ferment) that could be used for processing bread with the minimum use of dough improvers. The effects of ferment storage, fermentation time, and fermentation temperature on the quality of ferment and bread were evaluated to establish optimal conditions to produce a mature ferment. Trials were conducted on a pilot scale for greater relevance to industrialized bakeries. Ferment was assessed for total titratable acidity (TTA), pH, and viscosity. Breads made with ferment were evaluated for processing parameters, dough properties, and bread quality and compared to a control prepared without ferment. During fermentation, maximum TTA levels in the ferment were achieved at 100 min, then decreased by the end of fermentation, and increased by 24 h of storage at 4 °C. Viscosity was stable during fermentation but decreased by 24 h of storage. Inclusion of ferment resulted in reduced mixing times and improved dough extensibility and crumb softness. Specific loaf volume was not impacted; a slight reduction in crumb brightness and crumb structure was detected. Fermentation for 240 min at 35 °C was determined as optimal with a storage time for 24 h.

Introduction: The genetic variant responsible for haemophilia A (HA) significantly impacts endogenous coagulant factor VIII (FVIII:C) level, thus impacting DDAVP responsiveness. Blood group (BG) also impacts FVIII:C levels, but this is difficult to evaluate in a genetically heterogeneous population. Canada has a large cohort of mild‐moderate HA due to a single point variant: c.6104T>C, p.Val2035Ala—the Twillingate variant. Aim: To evaluate the impact of BG on endogenous FVIII:C levels and DDAVP responsiveness in a single genotype of mild‐moderate HA. Methods: This was a retrospective, single‐centre study. BG and FVIII:C levels were obtained for males with the Twillingate variant. One‐hour absolute and fold increases in FVIII:C post‐DDAVP were calculated. T‐tests and Mann–Whitney U tests were used to compare FVIII:C levels and DDAVP challenge variables between individuals according to BGs (O vs. non‐O). Results: Twenty males were included. There were significant differences between BGs (O vs. non‐O) in their lowest FVIII:C level at age <12 years (medians: 0.05 vs. 0.08 IU/mL; P =.05). Fifteen subjects underwent DDAVP challenges. Mean 1‐h FVIII:C were 0.29 (O BG) versus 0.41 IU/mL (non‐O BG); P =.04. There were no significant differences between BGs (O vs. non‐O) in mean absolute FVIII:C increase (0.20 vs. 0.27 IU/mL; P =.10) and FVIII:C fold increase (3.3‐fold vs. 3.8‐fold; P =.51). Conclusion: In HA subjects with an identical genotype, BG significantly impacts baseline FVIII:C levels and FVIII:C levels post‐DDAVP, but does not impact absolute and fold increases in FVIII:C with DDAVP. [ABSTRACT FROM AUTHOR]

This study draws on a longitudinal dataset of 277 UK learned societies covering the period 2015–2023 to provide evidence-based insights into the changing landscape of society publishing. It identifies a rapid decline in the number of self-published societies and an increasingly complex outsourcing landscape. New publishing partnerships are emerging with university presses and other not-for-profit entities rather than commercial publishers, while all but the largest UK societies have seen their publishing revenues decline in real terms since 2015. In general, UK learned society publishers are seeing their influence wane as market conditions favour publishing models focussed on quantity rather than quality. The decline of independent society publishers represents an unintended consequence of the transition to open access, but the trend towards increased outsourcing may be based on flawed assumptions. Analysis of financial data for a subset of 21 societies indicates that self-published societies have achieved sustained growth in their revenues from publishing while societies with publishing partners have seen a significant decline. For those societies with the means and the will to publish journals in their own right, this study bolsters the case for retaining, or even reclaiming, their independence. [ABSTRACT FROM AUTHOR]