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Rossella Tarallo,1 Tom P Carberry,2 Annarita Falanga,1 Mariateresa Vitiello,3 Stefania Galdiero,1 Massimiliano Galdiero,3 Marcus Weck21Dipartimento di Farmacia, Università di Napoli "Federico II," and DFM Scarl, Napoli, Italia; 2Molecular Design Institute and Department of Chemistry, New York University, New York, NY, USA; 3Dipartimento di Medicina Sperimentale, Seconda Università degli Studi di Napoli, Napoli, ItaliaAbstract: This contribution reports the synthesis of a poly(amide)-based dendrimer functionalized at the termini with a membrane-interacting peptide derived from the herpes simplex virus (HSV) type 1 glycoprotein H, namely gH625-644. This peptide has been shown to interact with model membranes and to inhibit viral infectivity. The peptidodendrimer inhibits both HSV-1 and HSV-2 at a very early stage of the entry process, most likely through an interaction with the viral envelope glycoproteins; thus, preventing the virus from coming into close contact with cellular membranes, a prerequisite of viral internalization. The 50% inhibitory concentration was 100 and 300 nM against HSV-1 and HSV-2 respectively, with no evidence of cell toxicity at these concentrations. These results show that the functionalization of a dendrimer with the peptide sequence derived from an HSV glycoprotein shows promising inhibitory activity towards viruses of the Herpesviridae family.Keywords: peptidodendrimer, antiviral activity, membranotropic peptides

Background: This study assessed the effectiveness of a cross-departmental case review panel-the Multicap Complex Behaviour Forum (CBF)-in reducing challenging behaviour exhibited by people with intellectual disabilities., Methods: Thirty participants (15 CBF participants and 15 matched-control participants) took part in the study. Behavioural data was collected for each CBF participant (and their matched control) for the three-month period before entering the CBF, during their time in the CBF, and the 3 months after exiting the CBF., Results: There was a significant interaction of group and time observed, with the CBF participants showing more change in behavioural incidents across time. Associated with this change was a noticeable reduction in staff injury costs related to the challenging behaviour of the CBF participants., Conclusions: This study demonstrates that positive behavioural and organisational outcomes are enhanced by fostering collaboration across multiple organisational systems when it comes to supporting people who exhibit challenging behaviours., (© 2024 The Author(s). Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Background: Fetal supraventricular tachycardia (SVT) is rare and proposed predictors of postnatal outcomes in fetal SVT have not been validated. Valid predictors can guide postnatal management., Objectives: The authors correlated fetal characteristics to the incidence of postnatal SVT and compared SVT outcomes in infants with and without a history of fetal SVT., Methods: Mother-fetus dyads with fetal SVT and a structurally normal heart were described and compared with a second cohort of infants with a postnatal diagnosis of SVT., Results: SVT was observed in 78 fetuses and 76 survived to delivery. Maternally administered transplacental antiarrhythmics were used in 49 mother-fetus dyads. Rhythm control was achieved in 37 of 49 (76%). Among fetuses with intermittent SVT, there was no ventricular dysfunction or hydrops. Postnatal SVT occurred in one-half of infants (37 of 76), and 94% presented within the first 2 days of life. The following fetal characteristics were associated with postnatal SVT on univariable analysis: sustained SVT (87% vs 56%), ventricular dysfunction (41% vs 15%), lack of conversion to sinus rhythm (49% vs 10%), and earlier gestational age at delivery (37.6 weeks vs 38.9 weeks; P ≤ 0.01 for each comparison). Compared with infants with a postnatal diagnosis of SVT, infants with a fetal diagnosis presented earlier (median age 0 days vs 17 days; P < 0.01) and had a lower incidence ventricular dysfunction at presentation (5% vs 42%; P < 0.01)., Conclusions: One-half of infants with fetal SVT had postnatal SVT, nearly all within 2 days of life. These data and predictors of postnatal SVT may influence parental counseling and postnatal clinical decision-making., Competing Interests: Funding Support and Author Disclosures NUCATS is funded in part by a Clinical and Translational Science Award (CTSA) grant from the National Institutes of Health. UL1TR001422. This study was supported, in part, by the National Institutes of Health/National Heart, Lung, and Blood Institute K23HL130554 and philanthropic donors. The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)

Introduction: In adults with congenital heart disease, intra-atrial reentrant tachycardia (IART) is a common arrhythmia that causes significant morbidity and mortality. One treatment option for IART is antitachycardia pacing. Atrial antitachycardia pacing algorithms deliver therapy for IART with ≥2:1 conduction, but most algorithms will not recognize IART with 1:1 conduction. Temporary Patient Activated Rx (TPARx) is Medtronic software that can be installed in antitachycardia pacemakers allowing patients to deliver therapies on demand for IART with 1:1 conduction., Methods: Retrospective chart review at a single institution of all patients who had TPARx installed into their pacemaker., Results: Four adults with single ventricle congenital heart disease and IART underwent Fontan conversion, arrhythmia surgery, and placement of an epicardial dual-chamber antitachycardia pacemaker. They had recurrent IART with a long cycle length and 1:1 conduction that failed to trigger antitachycardia pacing therapies. TPARx software was programmed into their pacemakers to allow recognition and treatment of IART with 1:1 conduction. Mean follow-up duration after TPARx programming was 4.9 years. Each patient received at least one successful antitachycardia pacing therapy via TPARx - range 0.4-26 treated IART episodes per year. There were no atrial or ventricular arrhythmias induced with antitachycardia pacing. Two patients were able to discontinue anticoagulation after TPARx installation., Conclusion: This series demonstrates the use of TPARx software as part of a long-term IART management strategy in select patients with IART who have failed more conventional therapies., (© 2022 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.)

Symptoms are the most common indication for ablation in children with atrioventricular nodal reentrant tachycardia (AVNRT). After the procedure, patients may continue to report palpitations. The objective of this study was to quantify the risk and duration of palpitations after pediatric slow pathway modification as well as demographic and technical associations. This was a retrospective review of consecutive patients at a pediatric center who underwent slow pathway modification for AVNRT from 2012 to 2018. Patients with a prior ablation attempt or congenital heart disease were excluded. Palpitations were documented in 35% of patients after ablation. Neither post-ablation echo beats nor other evidence of residual dual AV nodal physiology were associated with a higher risk of post-ablation palpitations. Of the 35 patients with post-ablation palpitations, the median time to resolution of palpitations was 48 months. Acute procedural success was achieved in all 100 cases. There were two recurrences of AVNRT during long-term follow-up and one instance of ectopic atrial tachycardia (3% SVT recurrence). Palpitations after AVNRT ablation occurred in approximately one-third of cases, despite a low recurrence of true arrhythmia. Prior to ablation, patients and families should be counseled that post-ablation palpitations are common and AVNRT recurrence is rare.

An infant with transposition of the great arteries was paced for postoperative heart block (single-site, right ventricular [RV] epicardial). She developed severe left ventricular (LV) dysfunction and septal dyskinesis. Resynchronization was performed at the age of 4 with an LV epicardial lead and an RV septal endocardial lead. The endocardial lead was affixed to the interventricular septum, then tunneled through the RV free wall and attached to an abdominal pulse generator. QRS duration decreased (176 to 122 ms) and LV ejection fraction improved (26 to 61%) and remained stable for 8 years. We present a case of successful resynchronization in congenital heart disease using a transmural RV septal lead., (© 2020 Wiley Periodicals LLC.)

Purpose of Review: The optimal approach to screening young people to decrease the risk of sudden death remains unknown. It deserves the passionate attention that researchers, clinicians and families have given it. The new data from January 2018 to July 2019 are reviewed here., Recent Findings: Cardiac findings associated with a risk of sudden death were reported in 0.4% of screened athletes. Well run programs continue report varying sensitivity for screening ECGs (between 86 and 100%). One major article reported a higher incidence of sudden death in young people than has been previously published (6.8/100 000 athletes)., Summary: The rate of important findings in sophisticated screening programs is approximately 0.4%, suggesting that this is near the population rate of detectable disease in most athletic groups. ECGs are unquestionably capable of detecting disease that can be missed by history and physical, but the performance characteristics of ECGs continue to vary from study to study. In addition, the underlying cost and infrastructure of ECG and echocardiographic screening remains unaddressed by the recent literature. A few small studies have started to look at alternative technology approaches to ECG screening. VIDEO ABSTRACT.

Pulmonary arteriovenous malformations (AVMs) can be a complication of certain postoperative Fontan patients whose hepatic venous blood return is not distributed evenly to both lungs. A ten-year-old female, who had previously undergone staged single ventricle palliation for complex congenital heart disease, underwent a Fontan revision due to significant left-sided pulmonary AVMs and increasing arterial oxygen desaturation. The combination of four-dimensional flow cardiac magnetic resonance imaging and three-dimensional printing enabled presurgical planning for a Fontan takedown and diversion of hepatic venous flow to the azygous vein that resulted in significant clinical improvement.

Purpose: The aim of this study was to systematically investigate the effect of different levels of refractive blur and driver age on nighttime pedestrian recognition and determine whether clothing that has been shown to improve pedestrian conspicuity is robust to the effects of blur., Methods: Nighttime pedestrian recognition was measured for 24 visually normal participants (12 younger mean = 24.9 ± 4.5 years and 12 older adults mean = 77.6 ± 5.7 years) for three levels of binocular blur (+0.50 diopter [D], +1.00 D, +2.00 D) compared with baseline (optimal refractive correction). Pedestrians walked in place on a closed road circuit and wore one of three clothing conditions: everyday clothing, a retro-reflective vest, and retro-reflective tape positioned on the extremities in a configuration that conveyed biological motion (known as "biomotion"); the order of conditions was randomized among participants. Pedestrian recognition distances were recorded for each blur and pedestrian clothing combination while participants drove an instrumented vehicle around a closed road course., Results: The recognition distances for pedestrians were significantly reduced (P < 0.05) by all levels of blur compared with baseline. Pedestrians wearing biomotion clothing were recognized at significantly longer distances than for the other clothing configurations in all blur conditions. However, these effects were smaller for the older adults, who had much shorter recognition distances for all conditions tested., Conclusions: In summary, even small amounts of blur had a significant detrimental effect on nighttime pedestrian recognition. Biomotion retro-reflective clothing was effective, even under moderately degraded visibility conditions, for both young and older drivers.

Purpose: To investigate the effect of different levels of refractive blur on real-world driving performance measured under day and nighttime conditions., Methods: Participants included 12 visually normal, young adults (mean age = 25.8 ± 5.2 years) who drove an instrumented research vehicle around a 4 km closed road circuit with three different levels of binocular spherical refractive blur (+0.50 diopter sphere [DS], +1.00 DS, +2.00 DS) compared with a baseline condition. The subjects wore optimal spherocylinder correction and the additional blur lenses were mounted in modified full-field goggles; the order of testing of the blur conditions was randomized. Driving performance was assessed in two different sessions under day and nighttime conditions and included measures of road signs recognized, hazard detection and avoidance, gap detection, lane-keeping, sign recognition distance, speed, and time to complete the course., Results: Refractive blur and time of day had significant effects on driving performance (P < 0.05), where increasing blur and nighttime driving reduced performance on all driving tasks except gap judgment and lane keeping. There was also a significant interaction between blur and time of day (P < 0.05), such that the effects of blur were exacerbated under nighttime driving conditions; performance differences were evident even for +0.50 DS blur relative to baseline for some measures., Conclusions: The effects of blur were greatest under nighttime conditions, even for levels of binocular refractive blur as low as +0.50 DS. These results emphasize the importance of accurate and up-to-date refractive correction of even low levels of refractive error when driving at night.

Conspicuity limitations make bicycling at night dangerous. This experiment quantified bicyclists' estimates of the distance at which approaching drivers would first recognize them. Twenty five participants (including 13 bicyclists who rode at least once per week, and 12 who rode once per month or less) cycled in place on a closed-road circuit at night-time and indicated when they were confident that an approaching driver would first recognize that a bicyclist was present. Participants wore black clothing alone or together with a fluorescent bicycling vest, a fluorescent bicycling vest with additional retroreflective tape, or the fluorescent retroreflective vest plus ankle and knee reflectors in a modified 'biomotion' configuration. The bicycle had a light mounted on the handlebars which was either static, flashing or off. Participants judged that black clothing made them least visible, retroreflective strips on the legs in addition to a retroreflective vest made them most visible and that adding retroreflective materials to a fluorescent vest provides no conspicuity benefits. Flashing bicycle lights were associated with higher conspicuity than static lights. Additionally, occasional bicyclists judged themselves to be more visible than did frequent bicyclists. Overall, bicyclists overestimated their conspicuity compared to previously collected recognition distances and underestimated the conspicuity benefits of retroreflective markings on their ankles and knees. Participants mistakenly judged that a fluorescent vest that did not include retroreflective material would enhance their night-time conspicuity. These findings suggest that bicyclists have dangerous misconceptions concerning the magnitude of the night-time conspicuity problem and the potential value of conspicuity treatments., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Bicycling at night is more dangerous than in the daytime and poor conspicuity is likely to be a contributing factor. The use of reflective markings on a pedestrian's major joints to facilitate the perception of biological motion has been shown to greatly enhance pedestrian conspicuity at night, but few corresponding data exist for bicyclists. Twelve younger and twelve older participants drove around a closed-road circuit at night and indicated when they first recognized a bicyclist who wore black clothing either alone, or together with a reflective bicycling vest, or a vest plus ankle and knee reflectors. The bicyclist pedalled in place on a bicycle that had either a static or flashing light, or no light on the handlebars. Bicyclist clothing significantly affected conspicuity; drivers responded to bicyclists wearing the vest plus ankle and knee reflectors at significantly longer distances than when the bicyclist wore the vest alone or black clothing without a vest. Older drivers responded to bicyclists less often and at shorter distances than younger drivers. The presence of a bicycle light, whether static or flashing, did not enhance the conspicuity of the bicyclist; this may result in bicyclists who use a bicycle light being overconfident of their own conspicuity at night. The implications of our findings are that ankle and knee markings are a simple and very effective approach for enhancing bicyclist conspicuity at night., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Misperception of speed under low-contrast conditions has been identified as a possible contributor to motor vehicle crashes in fog. To test this hypothesis, we investigated the effects of reduced contrast on drivers' perception and control of speed while driving under real-world conditions. Fourteen participants drove around a 2.85 km closed road course under three visual conditions: clear view and with two levels of reduced contrast created by diffusing filters on the windscreen and side windows. Three dependent measures were obtained, without view of the speedometer, on separate laps around the road course: verbal estimates of speed; adjustment of speed to instructed levels (25 to 70 km h(-1)); and estimation of minimum stopping distance. The results showed that drivers traveled more slowly under low-contrast conditions. Reduced contrast had little or no effect on either verbal judgments of speed or estimates of minimum stopping distance. Speed adjustments were significantly slower under low-contrast than clear conditions, indicating that, contrary to studies of object motion, drivers perceived themselves to be traveling faster under conditions of reduced contrast. Under real-world driving conditions, drivers' ability to perceive and control their speed was not adversely affected by large variations in the contrast of their surroundings. These findings suggest that perceptions of self-motion and object motion involve neural processes that are differentially affected by variations in stimulus contrast as encountered in fog.

Purpose: This study investigated how driving performance of young and old participants is affected by visual and auditory secondary tasks on a closed driving course., Methods: Twenty-eight participants comprising two age groups (younger, mean age = 27.3 years; older, mean age = 69.2 years) drove around a 5.1-km closed-road circuit under both single and dual task conditions. Measures of driving performance included detection and identification of road signs, detection and avoidance of large low-contrast road hazards, gap judgment, lane keeping, and time to complete the course. The dual task required participants to verbally report the sums of pairs of single-digit numbers presented through either a computer speaker (auditorily) or a dashboard-mounted monitor (visually) while driving. Participants also completed a vision and cognitive screening battery, including LogMAR visual acuity, Pelli-Robson letter contrast sensitivity, the Trails test, and the Digit Symbol Substitution (DSS) test., Results: Drivers reported significantly fewer signs, hit more road hazards, misjudged more gaps, and increased their time to complete the course under the dual task (visual and auditory) conditions compared with the single task condition. The older participants also reported significantly fewer road signs and drove significantly more slowly than the younger participants, and this was exacerbated for the visual dual task condition. The results of the regression analysis revealed that cognitive aging (measured by the DSS and Trails test) rather than chronologic age was a better predictor of the declines seen in driving performance under dual task conditions. An overall z score was calculated, which took into account both driving and the secondary task (summing) performance under the two dual task conditions. Performance was significantly worse for the auditory dual task compared with the visual dual task, and the older participants performed significantly worse than the young subjects., Conclusions: These findings demonstrate that multitasking had a significant detrimental impact on driving performance and that cognitive aging was the best predictor of the declines seen in driving performance under dual task conditions. These results have implications for use of mobile phones or in-vehicle navigational devices while driving, especially for older adults.