Feasibility Testing of the Alert for AFib Intervention.

Improving early detection and treatment of atrial fibrillation (AF) is critical because untreated AF is a major contributor to stroke and heart failure. We sought to generate knowledge about the feasibility of conducting a randomized controlled trial to test the effect of the Alert for AFib intervention on knowledge, attitudes, and beliefs about treatment-seeking for signs and symptoms of AF. Adults ≥65 years old (96% White) at risk for developing AF were randomized to receive the Alert for AFib intervention ( n = 40) or an attention control session ( n = 40). Feasibility goals for recruitment, participant retention, adherence, perceived satisfaction and burden, and intervention fidelity were met. From baseline to study completion, knowledge ( p = .005) and attitudes ( p < .001) about treatment-seeking improved more in the intervention group compared with the control group. Results support testing the effectiveness of the Alert for AFib intervention in a large trial

Anticipatory Smiling: Linking Early Affective Communication and Social Outcome

In anticipatory smiles, infants appear to communicate pre-existing positive affect by smiling at an object and then turning the smile toward an adult. We report two studies in which the precursors, development, and consequences of anticipatory smiling were investigated. Study 1 revealed a positive correlation between infant smiling at 6 months and the level of anticipatory smiling at 8 and 10 months during joint attention episodes, as well as a positive correlation between anticipatory smiling and parent-rated social expressivity scores at 30 months. Study 2 confirmed a developmental increase in the number of infants using anticipatory smiles between 9 and 12 months that had been initially documented in the Study 1 sample [Venezia, M., Messinger, D. S., Thorp, D., & Mundy, P. (2004). The development of anticipatory smiling. Infancy, 6(3), 397–406]. Additionally, anticipatory smiling at 9 months positively predicted parent-rated social competence scores at 30 months. Findings are discussed with regard to the importance of anticipatory smiling in early socioemotional development

Infant Responding to Joint Attention, Executive Processes, and Self-Regulation in Preschool Children

Infant joint attention is related to behavioral and social outcomes, as well as language in childhood. Recent research and theory suggests that the relations between joint attention and social–behavioral outcomes may reflect the role of executive self-regulatory processes in the development of joint attention. To test this hypothesis two studies were conducted. The first, cross-sectional study examined the development of responding to joint attention (RJA) skill in terms of increasing executive efficiency of responding between 9 and 18 months of age. The results indicated that development of RJA was characterized by a decreased latency to shift attention in following another person\u27s gaze and head turn, as well as an increase in the proportion of correct RJA responses exhibited by older infants. The second study examined the longitudinal relations between 12-month measures of responding to joint attention and 36-month attention regulation in a delay of gratification task. The results indicated that responding to joint attention at 12-months was significantly related to children\u27s use of three types of self-regulation behaviors while waiting for a snack reward at 36 months of age. These observations are discussed in light of a developmental theory of attention regulation and joint attention in infancy

The Structure of the Sagittarius Stellar Stream as Traced by Blue Horizontal Branch Stars

We use a sample of blue horizontal branch (BHB) stars from the Sloan Digital Sky Survey Data Release 7 to explore the structure of the tidal tails from the Sagittarius Dwarf Galaxy. We use a method yielding BHB star candidates with up to ~70% purity from photometry alone. The resulting sample has a distance precision of roughly 5% and can probe distances in excess of 100 kpc. Using this sample, we identify a possible extension to the trailing arm at distances of 60-80 kpc from the Sun with an estimated significance of at least 3.8 sigma. Current models predict that a distant `returning' segment of the debris stream should exist, but place it substantially closer to the Sun where no debris is observed in our data. Exploiting the distance precision of our tracers, we estimate the mean line-of-sight thickness of the leading arm to be ~3 kpc, and show that the two `bifurcated' branches of the debris stream differ by only 1-2 kpc in distance. With a spectroscopic very pure BHB star subsample, we estimate the velocity dispersion in the leading arm, 37 km s^-1, which is in reasonable agreement with models of Sgr disruption. We finally present a sample of high-probability Sgr BHB stars in the leading arm of Sgr, selected to have distances and velocities consistent with Sgr membership, to allow further study.Comment: Astrophysical Journal, in press. 17 pages, 15 figure

Synthesis of New 4-Aminoquinolines and Evaluation of Their In Vitro Activity against Chloroquine-Sensitive and Chloroquine-Resistant Plasmodium falciparum

International audienceThe efficacy of chloroquine, once the drug of choice in the fight against Plasmodium falcipa-rum, is now severely limited due to widespread resistance. Amodiaquine is one of the most potent antimalarial 4-aminoquinolines known and remains effective against chloroquine-resistant parasites, but toxicity issues linked to a quinone-imine metabolite limit its clinical use. In search of new compounds able to retain the antimalarial activity of amodiaquine while circumventing quinone-imine metabolite toxicity, we have synthesized five 4-amino-quinolines that feature rings lacking hydroxyl groups in the side chain of the molecules and are thus incapable of generating toxic quinone-imines. The new compounds displayed high in vitro potency (low nanomolar IC 50), markedly superior to chloroquine and comparable to amodiaquine, against chloroquine-sensitive and chloroquine-resistant strains of P. falcipa-rum, accompanied by low toxicity to L6 rat fibroblasts and MRC5 human lung cells, and metabolic stability comparable or higher than that of amodiaquine. Computational studies indicate a unique mode of binding of compound 4 to heme through the HOMO located on a biphenyl moeity, which may partly explain the high antiplasmodial activity observed for this compound

Axial Spondyloarthritis: Patient-Reported Impact in Europe

This open access book provides an overview of the International Map of Axial Spondyloarthritis (IMAS) project -focusing on Europe-, a wide-ranging, multi-disciplinary collaboration between academic groups, Health Care Professionals (HCPs), patient organizations and Novartis. IMAS was conceived to improve knowledge of Axial Spondyloarthritis (axSpA) and raise awareness of its heavy burden globally. By asking more than 2,000 patients across Europe about the impact of axSpA on multiple aspects of their life, the full extent of this disease was investigated from a direct patient perspective. This allowed a unique understanding of how living with axSpA affects the daily lives and well-being of patients, and how this varies between European countries. Axial Spondyloarthritis: Patient-Reported Impact in Europe highlights opportunities for progressing quality patient care to be applied to health services globally. HCPs, policy makers and patients will find this book to be an indispensable resource for improving the understanding of this chronic condition, including patients’ clinical outcomes, the protection of those at risk of psychological distress, and the economic burden on patients and society

Evolução dos índices de sonolência e fadiga em pacientes com síndrome da apnéia obstrutiva do sono portadores ou não de associação com síndrome das pernas inquietas após CPAP nasal

Objetivo: A associação síndrome de apnéia obstrutiva do sono / síndrome de pernas inquietas (SAOS-SPI) tem sido mencionada na literatura há muito. Ambas podem ser responsáveis por queixas de fadiga e sonolência secundárias à fragmentação do sono noturno. O objetivo deste estudo é avaliar a evolução dos sintomas de fadiga e sonolência diurna excessiva antes e após o tratamento com pressão aérea positiva contínua (CPAP) em pacientes portadores de SAOS, com e sem SPI. Método: Estudo prospectivo e comparativo entre um grupo de 13 pacientes com SAOS e um grupo de 17 com SAOS +SPI. Exames laboratoriais e polissonografia (PSG) foram realizados no início do estudo. A escala de sonolência de Epworth (ESE) e o questionário de fadiga/depressão de Pichot (PIC) foram aplicados antes do tratamento com CPAP e 3 meses após. Os resultados foram comparados. Resultados: No início do estudo não foram encontradas diferenças significativas na avaliação laboratorial e PSG. Ambos os grupos apresentavam inicialmente pontuação semelhante na avaliação da ESE e PIC (p=0,73 e 0,08, respectivamente). Após CPAP, os pacientes SAOS+SPI apresentaram maiores ESE e PIC (p=0,017 e 0,03, respectivamente). Conclusão: Apesar de resposta inicial favorável em ambos os grupos, o CPAP foi aparentemente menos eficaz na redução das queixas de fadiga e sonolência nos pacientes apnéicos com associação a SPI.Background and Purpose: The association of obstructive sleep apnea syndrome (OSAS) and restless legs syndrome (RLS) has been reported in the literature for many years. Both conditions may be responsible for fatigue and somnolence complaints secondary to nocturnal sleep disruption. The primary concern of this study is to evaluate the outcome of fatigue and daytime sleepiness symptoms at baseline and after continuous positive air pressure (CPAP) treatment in OSAS patients with and without RLS. Method: A prospective and comparative study between a group of 13 patients with OSAS and a group of 17 patients with OSAS+RLS. Laboratory blood tests and polysomnography were performed at baseline. The Epworth Sleepiness Scale (ESS) and the Pichot’s questionnaire of fatigue/depression (PIC) were applied before and after 3 months of CPAP treatment. Results were compared. Results: No significant differences were found on PSG and laboratory results at baseline. Both groups had similar ESS and PIC scores at baseline (p=0.73 and 0.08, respectively). After n-CPAP, OSAS+RLS patients showed higher ESS and PIC scores (p=0.017 and 0.03, respectively). Conclusions: Despite a favorable general response, n-CPAP seemed less effective in treating fatigue and sleepiness in the OSAS+RLS group

Axial Spondyloarthritis: Patient-Reported Impact in Europe

This open access book provides an overview of the International Map of Axial Spondyloarthritis (IMAS) project -focusing on Europe-, a wide-ranging, multi-disciplinary collaboration between academic groups, Health Care Professionals (HCPs), patient organizations and Novartis. IMAS was conceived to improve knowledge of Axial Spondyloarthritis (axSpA) and raise awareness of its heavy burden globally. By asking more than 2,000 patients across Europe about the impact of axSpA on multiple aspects of their life, the full extent of this disease was investigated from a direct patient perspective. This allowed a unique understanding of how living with axSpA affects the daily lives and well-being of patients, and how this varies between European countries. Axial Spondyloarthritis: Patient-Reported Impact in Europe highlights opportunities for progressing quality patient care to be applied to health services globally. HCPs, policy makers and patients will find this book to be an indispensable resource for improving the understanding of this chronic condition, including patients’ clinical outcomes, the protection of those at risk of psychological distress, and the economic burden on patients and society

Stellar Population Variations in the Milky Way's Stellar Halo

If the stellar halos of disk galaxies are built up from the disruption of dwarf galaxies, models predict highly structured variations in the stellar populations within these halos. We test this prediction by studying the ratio of blue horizontal branch stars (BHB stars; more abundant in old, metal-poor populations) to main-sequence turn-off stars (MSTO stars; a feature of all populations) in the stellar halo of the Milky Way using data from the Sloan Digital Sky Survey. We develop and apply an improved technique to select BHB stars using ugr color information alone, yielding a sample of ~9000 g<18 candidates where ~70% of them are BHB stars. We map the BHB/MSTO ratio across ~1/4 of the sky at the distance resolution permitted by the absolute magnitude distribution of MSTO stars. We find large variations of BHB/MSTO star ratio in the stellar halo. Previously identified, stream-like halo structures have distinctive BHB/MSTO ratios, indicating different ages/metallicities. Some halo features, e.g., the low-latitude structure, appear to be almost completely devoid of BHB stars, whereas other structures appear to be rich in BHB stars. The Sagittarius tidal stream shows an apparent variation in BHB/MSTO ratio along its extent, which we interpret in terms of population gradients within the progenitor dwarf galaxy. Our detection of coherent stellar population variations between different stellar halo substructures provides yet more support to cosmologically motivated models for stellar halo growth.Comment: Astronomical Journal, in press. 10 pages, 5 color figures. Much better printed in colo