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BACKGROUND: The use of a Left Ventricular Assist Device (LVAD) in patients with advanced heart failure refractory to optimal medical management has progressed steadily over the past two decades. Data have demonstrated reduced LVAD efficacy, worse clinical outcome, and higher mortality for patients who experience significant ventricular tachyarrhythmia (VTA). We hypothesize that a novel prophylactic intra-operative VTA ablation protocol at the time of LVAD implantation may reduce the recurrent VTA and adverse events postimplant. METHODS: We designed a prospective, multicenter, open-label, randomized-controlled clinical trial enrolling 100 patients who are LVAD candidates with a history of VTA in the previous 5 years. Enrolled patients will be randomized in a 1:1 fashion to intra-operative VTA ablation (n = 50) versus conventional medical management (n = 50) with LVAD implant. Arrhythmia outcomes data will be captured by an implantable cardioverter defibrillator (ICD) to monitor VTA events, with a uniform ICD programming protocol. Patients will be followed prospectively over a mean of 18 months (with a minimum of 9 months) after LVAD implantation to evaluate recurrent VTA, adverse events, and procedural outcomes. Secondary endpoints include right heart function/hemodynamics, healthcare utilization, and quality of life. CONCLUSION: The primary aim of this first-ever randomized trial is to assess the efficacy of intra-operative ablation during LVAD surgery in reducing VTA recurrence and improving clinical outcomes for patients with a history of VTA.

Given increasing forest disturbances, novel solutions are needed to rapidly recover ecosystem services such as carbon storage, while bolstering climate change adaptation. Reforestation with single-species mixed-provenance plantings is an emerging strategy that may enhance stand productivity and disturbance resistance, while assisted gene flow is a potentially powerful tool for matching seed-source with future planting-site climate. We investigated the potential of mixed-provenance plantings and assisted gene flow for maximizing early growth using a historical dataset for knobcone-Monterey pine (Pinus x attenuradiata), a fire-resilient hybrid developed for low-elevation sites in California, USA. We examined (1) 9-year individual-tree relative growth rate (RGR) in response to neighborhood seed-parent provenance diversity at two test sites and (2) 3-year RGR and survival as functions of parent seed-source climate at 4 test sites. We found 9-year RGR varied with seed provenance diversity, with 3 of 5 provenances showing a positive RGR-diversity relationship. Parent seed-source climate affected 3-year RGR but not survival. Closer climate matches in terms of precipitation as snow (PAS) showed fastest growth. Our results suggest careful selection and arrangement of genetically diverse stock may improve carbon sequestration and initial planting success in a hybrid conifer, with implications for reforestation under climate change and reburn risk.

Objective: Dual use of male condoms and female contraceptives is widely advocated for unplanned pregnancy prevention, yet college students often neglect condoms. This feasibility and acceptability study assessed the efficacy of a self-guided home-based condom-promotion intervention among college students in heterosexual relationships. Participants: Fifty-nine couples who had been together at least 30 days and had penile-vaginal sex at least twice weekly. Methods: Assessments were done at baseline and 6 months later. Outcomes were frequency of condom-unprotected penile-vaginal sex and four psychosocial mediators of condom use. Results: Frequency of unprotected penile-vaginal sex decreased over time. Several corresponding psychosocial mediators showed change, particularly among women. Using actor-partner interdependence modeling, men's increase in condom use was associated with an increase in women's sexual pleasure. Conclusion: Findings support implementation of a brief, self-guided, home-based condom-use intervention that could lower incidence of unplanned pregnancy and STIs among heterosexually active college students.

Work and negotiation experiences were examined among early adolescents (12-15 years) through a survey (N = 157) and follow-up interview (N = 89) conducted in two Canadian cities. Key findings, based on a mixed-method research approach, were (a) gifts were the primary income source; (b) females completed more chores than males, and younger adolescents received payment for chores more than older adolescents; (c) discussion of negotiation rarely occurred between participants and parents or peers; (d) neither age nor gender impacted absence of negotiation; (e) those who had negotiated for more money reported satisfaction; (f) gender differences in negotiation strategies were present; and (g) age differences in beliefs about negotiator qualities were found. Consistencies and changes from extant literature were discussed.

Cortical circuits contain multiple types of inhibitory neurons which shape how information is processed within neuronal networks. Here, we asked whether somatostatin-expressing (SST) and vasoactive intestinal peptide-expressing (VIP) inhibitory neurons have distinct effects on population neuronal responses to noise bursts of varying intensities. We optogenetically stimulated SST or VIP neurons while simultaneously measuring the calcium responses of populations of hundreds of neurons in the auditory cortex (AC) of male and female awake, head-fixed mice to sounds. Upon SST neuronal activation, noise burst representations became more discrete for different intensity levels, relying on cell identity rather than strength. By contrast, upon VIP neuronal activation, noise bursts of different intensity levels activated overlapping neuronal populations, albeit at different response strengths. At the single-cell level, SST and VIP neuronal activation differentially modulated the response-level curves of monotonic and nonmonotonic neurons. SST neuronal activation effects were consistent with a shift of the neuronal population responses toward a more localist code with different cells responding to sounds of different intensities. By contrast, VIP neuronal activation shifted responses toward a more distributed code, in which sounds of different intensity levels are encoded in the relative response of similar populations of cells. These results delineate how distinct inhibitory neurons in the AC dynamically control cortical population codes. Different inhibitory neuronal populations may be recruited under different behavioral demands, depending on whether categorical or invariant representations are advantageous for the task. [ABSTRACT FROM AUTHOR]

The 15th Annual Report from The Society of Thoracic Surgeons Interagency Registry for Mechanically Assisted Circulatory Support includes 29,634 continuous-flow left ventricular assist devices from the 10-year period between 2014 and 2024. The outcomes reported here demonstrate continued improved survival in the current era of fully magnetically levitated devices, with a significantly higher 1-year (85.7% vs 78.4%) and 5-year (59.7% vs 43.7%) survival than those receiving non–magnetically levitated devices. Magnetically levitated device recipients are experiencing a lower incidence of adverse events, including freedom from gastrointestinal bleeding (72.6%), device malfunction (82.9%), and stroke (86.7%) at 5 years. Additionally, a focus on a subgroup of patients younger than 50 years of age has demonstrated both superior outcomes in survival (91.6% survival at 1 year and 72.6% survival at 5 years) and decreased incidence of adverse events compared with older recipients. This younger cohort also demonstrated more tolerance to the characteristics of sex, race, ethnicity, and psychosocial indicators that are associated with worse outcomes after heart transplantation. Based upon these data, a potential net prolongation of life may be realized by considering prolonged left ventricular assist device support prior to heart transplantation in this population. These analyses provide preliminary data that could positively influence adoption of left ventricular assist device technology in groups previously not seen as candidates for this therapy, while providing a more responsible donor allocation strategy for advanced heart failure patients. [Display omitted] [ABSTRACT FROM AUTHOR]

One of the many sources of information easily available to children is the internet and the millions of websites providing accurate, and sometimes inaccurate, information. In the current investigation, we examined children's ability to use credibility information about websites when learning about environmental sustainability. In two studies, children studied two different websites and were tested on what they had learned a week later using a multiple-choice test containing both website items and new distracters. Children were given either no information about the websites or were told that one of the websites (the noncredible website) contained errors and they should not use any information from that website to answer the test. In both studies, children aged 7- to 9-years reported information from the noncredible website even when instructed not to, whereas the 10- to 12-year-olds used the credibility warning to 'edit out' information that they had learned from the noncredible website. In Study 2, there was an indication that the older children spontaneously assessed the credibility of the website if credibility markers were made explicit. A plausible explanation is that, although children remembered information from the websites, they needed explicit instruction to "bind the website content with the relevant source" (the individual websites). The results have implications for children's learning in an open-access, digital age where information comes from many sources, credible and noncredible. Education in credibility evaluation may enable children to be critical consumers of information thereby resisting misinformation provided through public sources.

This study provided workshops for parents on either early literacy or socio-emotional learning to examine the impact on their children's reading and social skills development (n = 576 parents; n = 584 children). Parents of kindergartners were offered interactive workshops designed to help them identify everyday opportunities to support reading skills or social skills development. Families were randomly assigned by school to workshops on one of three topics: (1) traditional text reading, (2) traditional text reading with computer-assisted learning opportunities, and (3) social-emotional learning. As expected, academic performance improved over time across all conditions. Additional gains were detected on specific language and literacy measures among children in both reading conditions whose parents attended the workshops in comparison to children of parents who did not attend. Gains were observed on academic measures for children in the socio-emotional condition relative to children in the reading conditions. Findings suggest that parental involvement in instructional workshops on early literacy and social development may have significant effects for children's academic success. This study provides evidence for the potential of involving parents in their children's educational interventions as a valuable addition to or alternative to traditional child-directed intervention programs to increase positive outcomes, reduce costs, and enhance parental efficacy.