2024 was an excellent year for the Journal of Cardiovascular Electrophysiology with a total of 389 original, high quality, peer-reviewed articles published. I am occasionally asked to identify the top papers published in JCE in the past year. A reasonable method to identify the top journal manuscripts during a particular period of time is based on the number of citations each paper has received. This is an objective approach. However, it is biased in favor of papers that were published earlier in the year giving more time for subsequent authors to cite the paper. With that understanding, here are the top five articles in JCE published in 2024 based on CrossRef citation data on the Wiley Online Library accessed January 13 th, 2025.

Pilomatricoma in the Infraorbital Region

Pediatric Allergy and Immunology in North America - An introductionBianca Olivieri1,2, Ayobami Akenroye3, Carmen Riggioni4,5, Philippe Eigenmann6

The genetic basis of sex determination is typically conserved within species if not within broader lineages. For example, within the stickleback family (Gasterosteidae), AmhY has been identified as a master sex-determination (MSD) gene in multiple species across two genera. By constrast, the existence of within-species variability in the genetic basis of sex determination is not frequently observed but provides an opportunity to understand the evolution and turnover of sex determination systems. In this study, we investigated the consistency with which AmhY is involved in sex determination across 610 individuals from five brook stickleback (Culaea inconstans) populations. We designed a PCR-restriction enzyme assay to identify the presence of AmhY in each individual and recorded sexual morphology in each individual in the field at the time of capture. We found that the genetic sex (presence/absence of AmhY) did not match the field-determined phenotypic sex in up to 27% of individuals within a population. This variation in the genetic basis of sex determination in brook stickleback suggests that the mechanism of sex determination in this species is likely more complex than thought when AmhY was first implicated and may still be evolving. Such within-species variation provides an opportunity to further investigate how and why transitions in sex-determination mechanisms occur.

Introduction Cochrane Rehabilitation recently developed a new definition of rehabilitation for research purposes with 80 global stakeholders, aiming to support and improve the production and reporting of primary and evidence synthesis rehabilitation studies. Objective 1. To compare how Cochrane Systematic Review (CSR) authors describe rehabilitation interventions against criteria derived from the new rehabilitation definition, and 2. To assess limitations or gaps in the rehabilitation definition. Methods: We analysed a sample of 124 randomly-selected CSRs tagged in the Cochrane Rehabilitation database. We converted the Cochrane Rehabilitation definition for research purposes into a set of 13 criteria grouped in the four PICO elements and searched for the corresponding key elements in each CSR. We verified if and where in the review these elements were present. Two reviewers rated each CSR, resolving disagreements a third author when needed. We analysed the findings using descriptive statistics. Results Eight (6.5%) out of 124 CSRs met all rehabilitation definition criteria. These were CSRs that investigated the effects of complex rehabilitation intervention. Three (2.4%) CSRs did not meet any PICO elements. Overall, the ”Intervention-General” element and disability criterion had the highest prevalence of absent and unclear reporting, while the “Intervention-Specific” and “Outcome” elements were most frequently reported, albeit not in the “Description of the intervention” section of the review. Discussion This study showed that the key elements of the new rehabilitation definition are almost always reported in publications identified as rehabilitation review, but not always consistently or clearly. The disability criterion was frequently unreported given that the main aim of rehabilitation is reducing disability. Also, the main elements of rehabilitation were frequently not reported. We did not find important gaps in the new definition. All elements of the new definition should be considered when writing review protocols and designing strategies and tools on rehabilitation topics.

The use of visual methods in qualitative evidence synthesis (QES) adds a valuable dimension to the synthesis process by enhancing understanding and knowledge generation. This paper provides an overview of common visual methods that support various stages of QES, with a worked example from a Cochrane QES using meta-ethnography. The paper also addresses the involvement of stakeholders, and considerations of equity, diversity, inclusion, and reflexivity in the selection and application of visual methods. The authors utilised a combination of remote and in-person visual methods to initiate and develop their synthesis, involving stakeholders throughout the process. Methods used by the review authors included paper labels, cartoons, infographics, virtual whiteboards, and diagrams. The use of visual methods in the QES facilitated data visualisation, remote analysis meetings, interpretation of extensive data, and meaningful patient and public involvement. QES authors are encouraged to consider the use of visual methods, particularly when involving the public in the synthesis process. Keywords: Qualitative Evidence Synthesis, QES, Meta-ethnography, visual methods

BACKGROUND Historically, peer reviewing has focused on the importance of research questions/hypotheses, appropriateness of research methods, risk of bias, and quality of writing. Until recently, the issues related to trustworthiness - including but not limited to plagiarism and fraud - have been largely neglected because of lack of awareness and lack of adequate tools/training. We set out to identify all relevant papers that have tackled the issue of trustworthiness assessment to identify key domains that have been suggested as an integral part of any such assessment. METHODS We searched the literature for publications of tools, checklists or methods used or proposed for the assessment of trustworthiness of randomised trials. Data items (questions) were extracted from the included publications and transcribed on Excel including the domain of assessment as described in the original publication. Both authors then independently assessed each data item to see if the original domain(s) could be re-categorised in 5 domains (governance, plausibility, plagiarism, reporting, statistics). RESULTS From the 41 publications we extracted a total of 284 questions and framed 77 summary questions grouped in 5 domains: governance (13 questions); plausibility (16 questions); plagiarism (4 questions), reporting (28 questions and statistics (16 questions). CONCLUSION The proposed menu of domains and questions should encourage peer reviewers, editors, systematic reviewers and developers of guidelines to engage in a more formal trustworthiness assessment. Methodologists should aim to to identify the domains and questions that should be considered mandatory, those that are optional depending on the resources available, and those that could be discarded because of lack of discriminatory power.

Title pageCase ReportProlong embedded Earring at earlobe with erosive oral lichen planusKeywords: oral lichen planus,erosive lichen planus, embedded earringWord count :1151Figures: 3Author: Sutthinun Wichyanrat, MDInstitute: Division of dermatology, Department of medicine, Ramathibodi hospital, Mahidol University, Bangkok, ThailandCorresponding author: Sutthinun WichyanratEmail: s.wichyanrat@gmail.comCase reportProlong embedded earring at earlobe with erosive oral lichen planusKey clinical message Embedded earring in adults is reported to be the causative of erosive lichen planus.Abstract Erosive lichen planus is rare and mostly cannot find the cause of this condition. Embedded earring at earlobe in adults also very rare. We accidentally remove the earring from earlobe and the condition of erosive oral lichen planus seem to improve gradually. Then we hypothesized that the embedded earring may be the factor inducing the erosive lichen planus in this case.Keywords : oral lichen planus, erosive lichen planus, embedded earringIntroduction : The causative of erosive lichen planus is usually unknown, although possible causes of oral lichen planus is immune-related, another factor such as stress and contact allergen have been report in the literatures. The most common contact allergen is metal in amalgam which may be irritate the buccal mucosa and cause oral lichenoid reaction. The distant metal outside the oral area may be the trigger of oral lichen planus, but have never been reported in the literature. We believe this case report may be the first case that the erosive lichen planus is improved after we found the foreign body material inside the earlobe and remove it.Case History and examinations : A 38-years-old Thai female have painful ulcer in upper, lower lip and lateral side of her tongue for 3 years. The physical examination was shown erythematous ulcerative ulcer at upper and lower lip mucosa, and erosive gingiva, and erythematous ulcer at lateral side of tongue.

Déjà vu All Over Again: Pacing the Left Bundle Branch Area with Defibrillator LeadsVardhmaan Jain, MD1 and Michael S. Lloyd, MD FHRS11 Section of Cardiac Electrophysiology, Department of Medicine, Emory University School of Medicine, Atlanta, GACorresponding author:Michael Lloyd1364 Clifton Rd NE suite F424Atlanta, GA 30322Mlloyd2@emory.edu@Mlloyd_emoryFunding: noneKeywords: Left bundle branch area pacing (LBBAP), ICD, defibrillator, conduction system pacingDisclosures: VJ: none; ML: research and consulting, Boston Scientific, Medtronic, AbbottLawrence “Yogi” Berra was noted for his simplistic malapropisms that were occasionally profound – earning him the moniker Yogi , after the yoga masters who were reputed for giving wise advice. Excluding one temporary study and case reports, this editorial addresses the third of a similar group of published small series examining implantation of standard active fixation defibrillator leads left bundle branch area pacing (LBBAP) position (see manuscript Table 5).1,2On the surface, this may invoke a sense of déjà vu, but there is a simplistic elegance in the concept of using a single lead to accomplishboth defibrillation and physiologic pacing that warrants repeat examination.In this issue of Journal of Cardiovascular Electrophysiology, Ghosh et al. present their account of patients undergoing LBBAP with the Abbott Medical DurataTM lead (Sylmar, CA).3Twelve patients who had an indication for either cardiac resynchronization therapy (7) or defibrillator (5) and underwent implantation of a 7-F DurataTM DF-4 implantable cardioverter-defibrillator (ICD) stylet-driven lead positioned deep into the interventricular septum. They used a non-deflectable dual curve 9 Fr preformed sheath to angulate this lead for septal penetration. A meticulous combination of electro-anatomical mapping, fluoroscopy, contrast and slack adjustment was used to achieve optimal lead positioning which resulted in LBBAP in unipolar configurations with adequate sensing/pacing in 9 out of 12 patients. In one patient, they were able to achieve adequate LBBA-ICD pacing but poor sensing, whereas two patients were met with failure to penetrate the septum. In 7 out of 9 patients with a successful LBBAP-ICD, they were able to demonstrate successful defibrillation of induced VF. At 5-month follow-up, all successful implants had stable electrical parameters with an increase in median left ventricular ejection fraction from 30 (28.5-35.5)% to 35 (30-36.5)%.The implantation method was not easy, with a median procedure time of 140 minutes, fluoroscopy time of 22.5 minutes, and about 3.5 attempts per patient. Two patients experienced trans-septal perforation and 1 experienced lead micro-dislodgment.This series is the third of its kind, but many uncertainties still exist with this technique. To be clear, Abbott Medical has not formally tested the Durata lead with this type of angulation and flexion and thus advises this practice is off label. Stylet-driven leads have been shown to be associated with increased risk of lead-related complications in the long term, and the number of components that could fail on an extendable/retractable helical defibrillator lead far surpasses a fixed helical lumen-less lead.4 The challenges associated with the extraction of a bulky defibrillator lead embedded deep within the septum remain largely uncharted. As such, extractions could be hindered by an elevated risk of septal perforation, intramyocardial hematoma formation, and ventricular septal defect.The authors observed that the more proximal positioning of the implanted LBBAP-ICD lead within the septum resulted in significant redundancy of the defibrillation coil extending into the right atrium. While they demonstrated adequate defibrillation of induced ventricular fibrillation with this anatomical configuration, the long-term implications remain uncertain. Specifically, concerns arise regarding the potential for progressive tricuspid regurgitation due to interference with the valve apparatus, as well as the possibility of adverse effects on defibrillation thresholds over time. Additionally, the thickened coiled segment of the defibrillator lead posed challenges during implantation, as it was difficult to maneuver through currently available sheaths. Achieving optimal septal positioning required steep angulations, which could introduce a heightened risk of lead fracture over prolonged use.Finally, it should be remembered that cathodal capture of the tip electrode in LBBAP leads results in the QRS complexes we desire- with high-frequency onset and right bundle branch delay morphologies. But for defibrillators in this construct, only bipolar pacing is allowed. In a typical septum, using the interelectrode distances of the lead under study, anodal capture of the RV septum by the ring should be therule rather than the exception at nominal programmed outputs (e.g. , 3V at 0.4ms) if the lead is sufficiently embedded. Capture of the superficial RV septum may not matter if the LV endocardium is depolarized via the Purkinje system, but this hasn’t been proven, and one can be assured these bipolar paced QRSs are not the poster child LBBAP morphologies we are used to seeing. The authors in this series report anodal capture in a minority, but like other series of its kind, granular 12 lead data and rigid criteria for anodal capture are not included. Further, the reduction in QRS duration for those with successful LBBAP in this study was not significantly lower than baseline.Coincidentally, we were asked to provide editorial comment a few months ago on another case series of this type, and, yes, there was a bit of déjà vu when reviewing this account. This does not discount the fact that important and promising breakthroughs are usually heralded by numerous small series, which eventually spark larger, more formal trials, which at this point are sorely needed. Perhaps a greater need lies in the rigorous preclinical testing and design of defibrillator leads and tools specifically intended for placement deep within the septum – an area which subjects leads to forces and geometries entirely different than more traditional implant locations. Ghosh and colleagues should be congratulated on adding to the small but mounting evidence that LBBAP is feasible with a DF4 ICD lead. As the authors note, dedicated non-improvised tools, and continued published clinical experience may better inform us if this practice will be the technique of the future for patients in need of both a defibrillator and ventricular pacing.