Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Theory of mind understanding and empathic behavior in children with autism spectrum disorders

This paper begins with a review of past research on theory of mind and empathy in children with ASD. Using varied operational definitions of empathy ranging from physiological heart rate through story vignettes to reports by privileged observers (e.g., teachers) of children's empathic behavior, results of previous studies are limited and contradictory. Thus new evidence is needed to answer two key questions: Are children with ASD less empathic than typically developing children? Do individual differences in theory of mind (ToM) understanding among children with ASD predict differences in their behavioral empathy? An original empirical study of 76 children aged 3-12 years (37 with ASD; 39 with typical development) addressed these. Results showed that children with ASD were significantly less empathic, according to their teachers, than typically developing children. However, this was not because of their slower ToM development. Findings showed equally clearly that ToM understanding was unrelated to empathy in children with ASD. The same was true for typically developing children once age and verbal maturity were controlled. Indeed, even the subgroup of older children with ASD in the sample who passed false belief tests were significantly less empathic than younger preschoolers who failed them

Deception in intimate relationships

This study examined the use of deceptive communication in intimate couple relationships. A total of 80 romantically involved male and female Australian university students read and responded to scenarios depicting men and women perpetrating deceit in couple relationships. Six types of deception were examined, namely: omission, distortion, half-truths, blatant lies, white lies, and failed lies. Respondents rated their own and their partners' use of each type of deception in terms of frequency, morality, and relationship effects. Self-reports of satisfaction with the couple relationship were also obtained. Results indicated that each deceptive strategy apart from the white lie was judged as morally reprehensible on dimensions of blame, guilt, and dishonesty. Respondents used white lies most often, and blatant lies least often, and perceived their partners as behaving similarly. Diminished relationship satisfaction was associated with respondents' frequent use of strategies of blatant lying, partial truthfulness, and attempted deceit and with partners' frequent use of each type of deception apart from the white lie. Frequent use of deception by self and partner was correlated with believing that each type of deception was preferable to having an argument, supporting the suggestion from previous research that couples elect dishonesty as a method of conflict avoidance. However, the strength of a respondent's preference for deception rather than arguing did not independently predict satisfaction once the effects of frequent use of the six deception strategies by self and partner were taken into account

Empathy and theory of mind in deaf and hearing children

Empathy (or sharing another’s emotion) and theory of mind (ToM: the understanding that behavior is guided by true and false beliefs) are cornerstones of human social life and relationships. In contrast to ToM, there has been little study of empathy’s development, especially in deaf children. Two studies of a total of 117 children (52 hearing; 65 deaf children of hearing parents) aged 4–13 years were therefore designed to (a) compare levels of empathy in deaf and hearing children, and (b) explore correlations of ToM with empathy in deaf and hearing groups. Results showed that (a) deaf children scored lower in empathy than their hearing peers and (b) empathy and ToM were significantly correlated for deaf children but not for the hearing. Possible reasons for these divergent developmental patterns were considered, along with implications for future research