National Survey of Rapid Access Chest Pain Clinics in Australia.

Aim: Rapid access chest pain clinics (RACCs) are an innovative outpatient pathway that allows low-intermediate risk patients to avoid hospitalisation. However, the extent of RACCs in Australia is unknown. We aimed to identify Australian RACCs and describe the characteristics and landscape of this model of care in Australia.

Caval Transcatheter Valve Implantation: An Alternate Transcatheter Approach to the Treatment of Severe Tricuspid Regurgitation.

• Severe TR may lead to heart failure and reduced quality of life when left untreated. • Coaptation defects larger >10 mm are not suitable for closure with tricuspid TEER. • Caval valve implants are an option for inoperable patients with severe TR.

"It would really support the wider harm reduction agenda across the board": A qualitative study of the potential impacts of drug checking service delivery in Scotland.

Drug checking services (DCS) enable individuals to voluntarily submit a small amount of a substance for analysis, providing information about the content of the substance along with tailored harm reduction support and advice. There is some evidence suggesting that DCS may lead to behaviour and system change, with impacts for people who use drugs, staff and services, and public health structures. The evidence base is still relatively nascent, however, and several evidence gaps persist.

Evaluation of real-time monitored ozone concentration from Abuja, Nigeria.

Real-time ozone (O) concentration is vital for accurate analysis of O to inform the public about O concentrations that may have an adverse effect on health. Few studies have analysed air pollution in Abuja, Nigeria and non on real-time ozone concentrations. As a result, there is a scarcity of data and information on real-time ozone pollution, pointing to a gap that needs to be urgently closed to enable a better understanding of ozone pollution and the causes and consequences in terms of the associated health risks.

Qualitative evaluation of a codesigned faith-based intervention for Muslim women in Scotland to encourage uptake of breast, colorectal and cervical cancer screening.

Objectives: This pilot study aimed to evaluate the acceptability of a codesigned, culturally tailored, faith-based online intervention to increase uptake of breast, colorectal and cervical screening in Scottish Muslim women. The intervention was codesigned with Scottish Muslim women (n=10) and underpinned by the reframe, reprioritise and reform model and the behaviour change wheel.

Setting: The study was conducted online, using Zoom, due to the COVID-19 pandemic.

Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment for Post Infarct Angina in Patients With Myocardial Infarction With Non-obstructive Coronary Arteries: A MINOCA-BAT Sub Study Rationale and Design.

Myocardial infarction with non-obstructive coronary arteries (MINOCA) occurs in ~10% of all patients with acute myocardial infarction (AMI), with an over-representation amongst women. Remarkably, it is estimated that as many as 1 in 4 patients with MINOCA experience ongoing angina at 12 months despite having no flow-restricting stenoses in their epicardial arteries. This manuscript presents the rationale behind Randomized Evaluation of Beta Blocker and Angiotensin-converting enzyme inhibitors/Angiotensin Receptor Blocker Treatment (ACEI/ARB) for Post Infarct Angina in MINOCA patients-The MINOCA BAT post infarct angina sub study.

Rapid Access Chest Pain Clinics: An Australian Cost-Benefit Study.

Objective: Chest pain is a large health care burden in Australia and around the world. Its management requires specialist assessment and diagnostic tests, which can be costly and often lead to unnecessary hospital admissions. There is a growing unmet clinical need to improve the efficiency and management of chest pain.

Relative value of cystatin C and creatinine-based estimates of glomerular filtration rate in predicting long-term mortality after cardiac surgery: a cohort study.

Objective: Renal dysfunction predicts an increased risk of both early and long-term mortality after cardiac surgery. Cystatin C enables glomerular filtration rate (GFR) to be estimated accurately and may be superior in this regard to creatinine-based estimates. We hypothesised, therefore, that cystatin C and derived estimates of GFR would independently predict long-term survival after cardiac surgery and would be superior in this respect to traditional estimates of GFR.

Extending alcohol brief advice into non-clinical community settings: a qualitative study of experiences and perceptions of delivery staff.

Background: At a population level, the majority of alcohol-related harm is attributable to drinkers whose consumption exceeds recommended drinking levels, rather than those with severe alcohol dependency. Identification and Brief Advice (IBA) interventions offer a cost-effective approach for reducing this harm. Traditionally, IBA interventions have been delivered in healthcare settings and therefore contextual influences on their use in non-clinical settings are not well understood.

Transcatheter Aortic Heart Valves: Histological Analysis Providing Insight to Leaflet Thickening and Structural Valve Degeneration.

Objectives: This study investigated processes causing leaflet thickening and structural valve degeneration (SVD).

Background: Although transcatheter aortic valve replacement (TAVR) has changed the treatment of aortic stenosis, concerns remain regarding SVD, potentially related to valve thrombosis and thickening, based on studies using computed tomography (CT). Detailed histological analyses are provided to help attain insights into these processes.

Hypertrophic Cardiomyopathy (HCM): New insights into Coronary artery remodelling and ischemia from FFR.

Introduction: Angina, myocardial ischemia, and coronary artery physiology in hypertrophic cardiomyopathy (HCM) are poorly understood. However, coronary computed tomography angiography (CCTA) with fractional flow reserve from CT (FFR) analysis offers a non-invasive method for evaluation of coronary artery volume to myocardial mass ratio (V/M) that may provide insight into such mechanisms. Thus, we sought to investigate changes in V/M in HCM.

Prevalence and impact of scan-related anxiety during coronary CT angiography: A prospective cohort study of 366 patients.

Background: Scanxiety, the anxiety/stress associated with an imaging test, has never been evaluated in relation to coronary CT angiography (Coronary CTA). As it could impact heart rate and thereby affect image quality of Coronary CTA, we aimed to evaluate the prevalence, severity, and impact of scanxiety on quality and interpretability of Coronary CTA.

Methods: 366 consecutive patients were prospectively presented with a clinical questionnaire comprising two tests to evaluate their scan-related anxiety: the Impact of Event IES-6 (6 questions, final score 0-24) and a visual stress-scale (1 question, score 1-10).

Should UK Pneumococcal Vaccine Eligibility Criteria Include Alcohol Dependency in Areas with High Alcohol-Related Mortality?

A recently reported steep increase in the incidence of invasive pneumococcal disease (IPD) in adults in the North East of England was primarily associated with pneumococcal sero-types found in the 23-valent pneumococcal polysaccharide vaccine (PPSV23). This region also has one of the highest rates of alcohol-related premature mortality and morbidity in the UK. Given that alcohol dependence is long acknowledged as one of the strongest risk factors for IPD mortality, we feel there is an increasingly compelling case to look again at the divergence of UK vaccine guidance from that of the World Health Organisation and the Centre for Disease Control in the USA, in the non-inclusion of alcoholism as an indicator condition that would potentially benefit from receiving PPSV23 vaccine.

Role of MDCT Imaging in Planning Mitral Valve Intervention.

Purpose Of Review: Recent advancements in transcatheter valvular interventions have resulted in a growing demand for advanced cardiac imaging to help guide these procedures.

Recent Findings: Both echocardiography and multi-detector computed tomography have played essential roles in the maturation of transcatheter aortic valve replacement and are now building on these experiences and helping inform the nascent field of transcatheter mitral interventions. Advanced imaging is essential to aid in the diagnosis and determination of the mechanism of mitral regurgitation.

Lithium + Colchicine: A Potential Strategy to Reduce Pro-inflammatory Effects of Lithium Treatment.

Purpose: Rosenblat and McIntyre (Acta Psychiatr Scand. 2015;132: 180-191) propose that immune disorders are important mediators between bipolar disorders and medical comorbidities. Rosenblat et al (Bipolar Disord.

Observation and assessment of the nutritional quality of 'out of school' foods popular with secondary school pupils at lunchtime.

Background: The contemporary Scottish diet is unhealthy and a risk factor for poor health outcomes including obesity. Over a third of Scottish children are at risk of being overweight or obese, and there have been calls to strengthen the evidence base on the role of the food retail environment around schools in influencing the consumption of unhealthy foods.

Methods: We examined the food retail environment around five secondary schools in Glasgow city, Scotland.

Investigating local policy drivers for alcohol harm prevention: a comparative case study of two local authorities in England.

Background: The considerable challenges associated with implementing national level alcohol policies have encouraged a renewed focus on the prospects for local-level policies in the UK and elsewhere. We adopted a case study approach to identify the major characteristics and drivers of differences in the patterns of local alcohol policies and services in two contrasting local authority (LA) areas in England.

Methods: Data were collected via thirteen semi-structured interviews with key informants (including public health, licensing and trading standards) and documentary analysis, including harm reduction strategies and statements of licensing policy.

Coronary lumen volume to myocardial mass ratio in primary microvascular angina.

Background: Microvascular angina (MVA) is an incompletely understood clinical entity. Computational analysis of coronary Computed Tomography Angiography (CTA) has shown an association between low coronary lumen volume to myocardial mass (V/M) ratio and lower Fractional Flow Reserve values, independent of plaque measures. We hypothesized that low V/M ratio may be present in patients with MVA.

Fractional flow reserve derived from coronary computed tomography angiography reclassification rate using value distal to lesion compared to lowest value.

Introduction: A standardised approach to the interpretation of FFRCT data is currently lacking. We evaluated the rate of reclassification of FFRCT positivity using the FFRCT value distal to an anatomical stenoses compared to the lowest FFRCT value.

Method: Patients who underwent coronary CTA and FFRCT analysis were eligible.

Imaging for structural heart procedures: focus on computed tomography.

The success and continued rapid clinical integration of transcatheter valve technologies relies on imaging modalities to guide safe and effective device deployment. In particular, cardiac imaging, using both echocardiography and CT, is an integral resource for the multidisciplinary team. These modalities can provide valuable insight for the proceduralist at each stage of transcatheter-based valve insertion, as they can be used reliably to define the anatomy of interest and its relationship to surrounding structures, determine accurate device sizing, assess patients for valve-in-valve procedures, and screen for adverse features or procedural contraindications.