We report on an 86-year-old patient whose unipolar single-chamber pacemaker (Vitatron Ceryx 623), implanted in 1991 due to sinus node arrest, had been continuously active for 33 years without any replacement of the pacemaker unit. No routine outpatient check-up had been carried out for over a decade. The ECG revealed asynchronous ventricular pacing (VOO) at a fixed rate of 50/min, consistent with the manufacturer's defined EOS fallback mode. Despite the failure to switch modes, the patient remained clinically event-free. Upon replacement of the device, complete shell-like calcification of the pocket ("porcelain pocket") was observed; the lead measurements (stimulation threshold 0.5 V/0.4 ms, sensing 7.2 mV, impedance 351 Ω) were excellent, thus the lead was left in place. This case illustrates the remarkable long-term performance of older devices and leads, at the same time it underlines the need for a regular follow-up and the risks of asynchronous pacing in EOS mode.

Patients with cardiac implantable electronic devices (CIEDs) are increasingly presenting for non-cardiac surgery, requiring careful perioperative planning to avoid electromagnetic interference, device malfunction, and haemodynamic instability. Although general anaesthesia is frequently used in such patients, regional anaesthesia may offer several advantages when appropriately selected. We report the successful perioperative management of a 75-year-old man with coronary artery disease and a VVIR permanent pacemaker who underwent elective Lichtenstein hernioplasty under spinal anaesthesia. Following a multidisciplinary evaluation, the pacemaker was temporarily converted to asynchronous VOO pacing using magnet application. Continuous electrocardiographic monitoring, avoidance of monopolar electrocautery, availability of external defibrillation, and perioperative cardiology support ensured a safe perioperative period. The intraoperative and postoperative periods were uneventful. This case highlights the importance of structured CIED assessment, individualised pacemaker management, and careful haemodynamic monitoring when neuraxial anaesthesia is considered in patients with permanent pacemakers.

Fat stigma is a qualitative health research problem because fat bodies encounter persistent moral surveillance in daily life. In response, many fat people present a socially acceptable 'front' to clinicians and researchers. Existing qualitative approaches are therefore somewhat limited to capturing frontstage performances rather than participants' more personal 'backstage' reflections. In response, this methodological paper introduces transformational dramaturgical longitudinalism (TDL), a novel qualitative methodology synthesising Goffman's dramaturgical theory with longitudinal, participant-led design. Comprising a three-stage design, involving two interview cycles and asynchronous written correspondence, TDL was developed via an 18-month study with eight self-identified fat women. This development advances qualitative health research via participant-led pacing and narrative sovereignty; emotional and structural reflexivity as methodological resources; Goffman's dramaturgical architecture operationalised as a design principle not analytic vocabulary; and ongoing consent and narrative revision rights as core ethical architecture. Scope conditions support transferability of TDL to future research projects involving stigma.

Genome and phenotype evolution during hybridization has been a central topic in evolutionary biology, yet the genetic mechanism underlying the hybrid effect variation remain elusive. Here we use the pig as a model and quantify hybrid effects by measuring the phenotypic difference between homozygotes and heterozygotes across 135 traits in 578 F2 individuals from a Eurasian pig cross population. We demonstrate that hybrid effect sizes follow an exponential distribution across the genome. The rate parameter (λ) of this exponential distribution exhibits a hump-shaped pattern with increasing levels of F0 genomic divergence, indicating a genomic transition from inbreeding depression to hybrid vigor and ultimately to hybrid depression. Further analysis reveals that genetic recombination is significantly correlated with the variation in λ, supporting a model in which both recombination and genomic divergence jointly shape the landscape of hybrid effects. Females display lower λ values, with a pronounced reduction in regions exhibiting hybrid depression, revealing a fundamental sex difference in Eurasian pig hybridization. We further show that the λ positively correlates with F2 heterozygote-to-homozygote genotype frequency ratio. This suggests that recombination may introduce advantageous hybrid effect in genetic backgrounds otherwise characterized by inbreeding depression or hybrid depression, resulting in asynchronous evolutionary paces across the genome.

Objective.Accurate and reliable neural decoding of locomotion holds promise for advancing clinical applications such as rehabilitation and prosthetic control, as well as for understanding neural correlates of action. Recent studies have demonstrated successful decoding of locomotion kinematics across species in motorized treadmill settings. However, efforts to decode locomotion speed directly and continuously in more natural contexts-where pace is self-selected rather than externally imposed-are scarce, and those that exist generally achieve only modest accuracy and require intracranial implants. Here, we aim to decode self-paced locomotion speed non-invasively and continuously using cortex-wide electroencephalography (EEG) recordings from rats.Approach.We introduce an asynchronous brain-computer interface (BCI) that processes a continuous stream of 32-electrode skull-surface EEG recordings (0.01-45 Hz) to decode instantaneous speed readouts from a non-motorized treadmill during self-paced locomotion in head-fixed rats. Using recurrent neural networks and a large dataset comprising over 133 h of recordings, we trained decoders to map ongoing EEG activity to treadmill speed.Main results.Our decoding methodology achieves a correlation of 0.88 (R2=0.78) for speed, primarily driven by visual cortex electrodes and low-frequency (<8Hz) oscillations. Moreover, pre-training on a single recording session permitted decoding on other sessions from the same rat, suggesting the presence of uniform neural signatures of locomotion that generalize across sessions but fail to transfer across animals. Finally, we found that cortical states not only carry precise information about the current speed, but also about future and past dynamics, extending up to 1000 ms.Significance.These findings demonstrate that self-paced locomotion speed can be decoded accurately and continuously from non-invasive, cortex-wide EEG. Our approach may provide a useful framework for developing high-performing, non-invasive BCI systems for locomotion and contribute to understanding distributed neural representations of action dynamics.

Many adults with posttraumatic stress disorder (PTSD) related to childhood interpersonal trauma (CIT) face substantial barriers to care and limited access to trauma-specific treatment. We evaluated the efficacy of the Trauma PORTAL (Providing Online tRauma Therapy using an Asynchronous Learning platform), a trauma-focused hybrid therapy integrating self-paced psychoeducational and skills-based modules and virtual therapist-led group sessions, to reduce PTSD symptoms in adults with a history of CIT.