Deep Learning-Augmented ECG Analysis for Screening and Genotype Prediction of Congenital Long QT Syndrome.

Importance: Congenital long QT syndrome (LQTS) is associated with syncope, ventricular arrhythmias, and sudden death. Half of patients with LQTS have a normal or borderline-normal QT interval despite LQTS often being detected by QT prolongation on resting electrocardiography (ECG). Objective: To develop a deep learning-based neural network for identification of LQTS and differentiation of genotypes (LQTS1 and LQTS2) using 12-lead ECG. Design, Setting, and Participants: This diagnostic accuracy study used ECGs from patients with suspected inherited arrhythmia enrolled in the Hearts in Rhythm Organization Registry (HiRO) from August 2012 to December 2021. The internal dataset was derived at 2 sites and an external validation dataset at 4 sites within the HiRO Registry; an additional cross-sectional validation dataset was from the Montreal Heart Institute. The cohort with LQTS included probands and relatives with pathogenic or likely pathogenic variants in KCNQ1 or KCNH2 genes with normal or prolonged corrected QT (QTc) intervals. Exposures: Convolutional neural network (CNN) discrimination between LQTS1, LQTS2, and negative genetic test results. Main Outcomes and Measures: The main outcomes were area under the curve (AUC), F1 scores, and sensitivity for detecting LQTS and differentiating genotypes using a CNN method compared with QTc-based detection. Results: A total of 4521 ECGs from 990 patients (mean [SD] age, 42 [18] years; 589 [59.5%] female) were analyzed. External validation within the national registry (101 patients) demonstrated the CNN's high diagnostic capacity for LQTS detection (AUC, 0.93; 95% CI, 0.89-0.96) and genotype differentiation (AUC, 0.91; 95% CI, 0.86-0.96). This surpassed expert-measured QTc intervals in detecting LQTS (F1 score, 0.84 [95% CI, 0.78-0.90] vs 0.22 [95% CI, 0.13-0.31]; sensitivity, 0.90 [95% CI, 0.86-0.94] vs 0.36 [95% CI, 0.23-0.47]), including in patients with normal or borderline QTc intervals (F1 score, 0.70 [95% CI, 0.40-1.00]; sensitivity, 0.78 [95% CI, 0.53-0.95]). In further validation in a cross-sectional cohort (406 patients) of high-risk patients and genotype-negative controls, the CNN detected LQTS with an AUC of 0.81 (95% CI, 0.80-0.85), which was better than QTc interval-based detection (AUC, 0.74; 95% CI, 0.69-0.78). Conclusions and Relevance: The deep learning model improved detection of congenital LQTS from resting ECGs and allowed for differentiation between the 2 most common genetic subtypes. Broader validation over an unselected general population may support application of this model to patients with suspected LQTS.

"Honestly, they are just like us": U.S. parents choose middle-class gender and racial ingroup peers for their children.

Children and adolescents benefit from positive intergroup peer interactions, but they are unlikely to have many opportunities for these interactions if their parents are uncomfortable with them. Drawing primarily on social identity theory (SIT), this study investigated how U.S. parents' (N = 569) comfort with their children's potential intergroup peer interactions (a) differed by child and peer group gender (boy, girl), race (Black, White), and social class (higher-, middle-, or lower-subjective social status), (b) changed over the transition from childhood to adolescence (8-10, 11-13, and 14-16 years), and (c) varied by context intimacy (hanging out vs. sleeping over). The sample was equally balanced between parents of children reflecting those same group memberships. Consistent with SIT, when asked to choose, parents were typically most comfortable with their child spending time with middle-class peers who shared their child's gender and racial ingroup membership. Moreover, parents often explained their decisions with reference to similarities between these peers and their own child or family. Parents' comfort did not differ systematically by child age, but many parents were less comfortable with cross-gender peer interactions in the more intimate sleepover context than the less intimate hangout context. All groups of parents also exhibited at least some openness to cross-group interactions. These findings advance developmental scientists' understanding of parents' roles as potential facilitators or gatekeepers of their children's intergroup peer interactions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Influence of different post-processing methods on the dimensional accuracy of 3D-printed photopolymers for dental crown applications - A systematic review.

OBJECTIVES: To perform a systematic review that provides an overview of the current literature on the influence of different post-processing methods on the accuracy of additive-manufactured (3D-printed) photopolymer crown materials, and whether more research is needed. MATERIALS AND METHODS: The search used three online databases, Ovid (MEDLINE), Scopus and Web of Science which were screen for publications that involved assessing dimensional accuracy in post-processing of 3D printed dental crown materials. Publications that were literature reviews, abstracts, written in a language different from English, or publications that did not assess dimensional accuracy were excluded. RESULTS: The included articles were published between 1995 and 2023. After the removal of duplicates using Endnote, 135 studies remained for further screening, 13 were selected for full-text analysis, and 7 studies were included in the systematic review. A total of 7 articles were examined and categorised based on several factors, such as the type of material, number of specimens per group, print layer thickness, print angle of specimens, 3D printer used, properties of the specimens studied, and the method of analysing the accuracy of the specimens. CONCLUSION: It was found that post-processing washing times outside the prescribed instruction for use (IFU) may have an impact on the physical and biocompatibility characteristics of the material. Studies focusing on inert mediums during post-processing require more detailed investigation. The use of different post-curing conditions does not significantly affect the materials dimensional accuracy.

The impact of perceived racism on walking behavior during the COVID-19 lockdown.

The COVID-19 pandemic lockdown has had a significant impact on people's travel behavior. The level of this impact has been unevenly distributed among different population groups. The recent rise in anti-Asian racism implies that Asians have faced increased stress during the pandemic. As a result, the impact on their travel behavior is likely to differ from other ethnic groups. We examined this hypothesis by focusing on the impact of the pandemic on walking behavior. We collected survey data in Melbourne, Australia, during the pandemic lockdown, and analyzed the data using a Structural Equation Model approach. The results suggest that Asians experienced a significantly higher level of discrimination than other racial groups and were less likely to increase walking than White people. We also found that neighborhood cohesion helped alleviate perceived discrimination and promote walking. This study offers new insights into the role of racism in travel behavior.