Objective Safety behaviors have been found to undermine successful exposure in the treatment of anxiety disorders for both adults and children. Although reliable measures of safety behaviors have been developed for use with adults, no such measure has been developed specifically for pediatric populations. In light of this limitation, the current study aimed to develop and validate a measure of the use of safety behaviors suitable for children The Subtle Avoidance Measure for Youth (SAMY).Methods Clinical (n = 174) and community (n = 138) young people, aged 7-13 years, provided data.Results Both exploratory and confirmatory factor analyses supported a three-factor solution of the SAMY, which reflected checking behaviors, behaviors related to image management, and behaviors related to physical protection. The SAMY and its subscales demonstrated strong internal consistency, test-retest reliability, construct validity, and the ability to discriminate between clinical and community participants.Conclusions Given its solid psychometric properties, the SAMY will prove useful for both research and clinical work with anxious young people.Recently there have been several high-profile articles in the national media reporting on US congenital heart surgery programs, which have led in part to closure or curtailing of surgical services of at least 5 programs. These articles stemmed from concerns raised by families and practitioners regarding program outcomes and lack of transparency, which led to news media investigations and reported findings of mortality and complication rates that exceeded national norms. These cases highlight what has been well-documented for many years, the wide variability in care delivery, practices, and outcomes across US centers performing congenital heart surgery (1).Understanding and addressing the unique health needs of people residing in rural America is critical to the American Heart Association's pursuit of a world with longer, healthier lives. Improving the health of rural populations is consistent with the American Heart Association's commitment to health equity and its focus on social determinants of health to reduce and ideally to eliminate health disparities. This presidential advisory serves as a call to action for the American Heart Association and other stakeholders to make rural populations a priority in programming, research, and policy. This advisory first summarizes existing data on rural populations, communities, and health outcomes; explores 3 major groups of factors underlying urban-rural disparities in health outcomes, including individual factors, social determinants of health, and health delivery system factors; and then proposes a set of solutions spanning health system innovation, policy, and research aimed at improving rural health.BACKGROUND It is difficult to noninvasively phenotype atrial fibrillation (AF) in a way that reflects clinical end points such as response to therapy. We set out to map electrical patterns of disorganization and regions of reentrant activity in AF from the body surface using electrocardiographic imaging, calibrated to panoramic intracardiac recordings and referenced to AF termination by ablation. METHODS Bi-atrial intracardiac electrograms of 47 patients with AF at ablation (30 persistent, 29 male, 63±9 years) were recorded with 64-pole basket catheters and simultaneous 57-lead body surface ECGs. Atrial epicardial electrical activity was reconstructed and organized sites were invasively and noninvasively tracked in 3-dimension using phase singularity. In a subset of 17 patients, sites of AF organization were targeted for ablation. RESULTS Body surface mapping showed greater AF organization near intracardially detected drivers than elsewhere, both in phase singularity density (2.3±2.1 versus 1.9±1.6; P=0.02) and number of drivers (3.2±2.3 versus 2.7±1.7; P=0.02). Complexity, defined as the number of stable AF reentrant sites, was concordant between noninvasive and invasive methods (r2=0.5; CC=0.71). In the subset receiving targeted ablation, AF complexity showed lower values in those in whom AF terminated than those in whom AF did not terminate (P less then 0.01). CONCLUSIONS AF complexity tracked noninvasively correlates well with organized and disorganized regions detected by panoramic intracardiac mapping and correlates with the acute outcome by ablation. This approach may assist in bedside monitoring of therapy or in improving the efficacy of ongoing ablation procedures.BACKGROUND Ablation is a widely used therapy for atrial fibrillation (AF); however, arrhythmia recurrence and repeat procedures are common. Studies examining surrogate markers of genetic susceptibility to AF, such as family history and individual AF susceptibility alleles, suggest these may be associated with recurrence outcomes. Accordingly, the aim of this study was to test the association between AF genetic susceptibility and recurrence after ablation using a comprehensive polygenic risk score for AF. METHODS Ten centers from the AF Genetics Consortium identified patients who had undergone de novo AF ablation. AF genetic susceptibility was measured using a previously described polygenic risk score (N=929 single-nucleotide polymorphisms) and tested for an association with clinical characteristics and time-to-recurrence with a 3 month blanking period. Recurrence was defined as >30 seconds of AF, atrial flutter, or atrial tachycardia.  https://www.selleckchem.com/products/cytidine-5-triphosphate-disodium-salt.html  Multivariable analysis adjusted for age, sex, height, body mass index, persigher AF genetic susceptibility was associated with younger age and fewer clinical risk factors but not recurrence. Arrhythmia recurrence after AF ablation may represent a genetically different phenotype compared to AF susceptibility.OBJECTIVE Type 2 diabetes mellitus (T2DM) is known to be related to increased arterial stiffness. However, little is known about the risk of T2DM due to accelerated arterial stiffness and the underlying mechanism involved. We aimed to examine arterial stiffness, as determined by branchial-ankle pulse wave velocity (baPWV), in relation to diabetes mellitus among a community-based population and whether the association was mediated by white blood cell (WBC) counts. Approach and results A total of 1036 Chinese adults aged 64.3 years with complete data were qualified in the present study. The dose-response association between baPWV levels, WBC counts, and risk of T2DM were explored using generalized linear models or multivariate logistic regression models. A mediation analysis was conducted to investigate the role of WBC counts on the association between baPWV and T2DM. After multivariate adjustments, we observed a dose-responsive relationship between increased baPWV and elevated risk of T2DM comparing extreme tertiles of baPWV, the adjusted odds ratio for T2DM risk was 2.