Fear of exercise and health-related quality of life in patients with an implantable cardioverter defibrillator

Several studies have reported improved survival rates thanks to the use of an implantable cardioverter defibrillator (ICD) in the treatment of patients with life-threatening arrhythmia. However, the effects of the ICD on health-related quality of life (HR-QoL) of these patients are not clear. The aim of this study is to describe HR-QoL and fear of exercise in ICD patients. Eighty-nine ICD patients from the University Hospital in Groningen, the Netherlands, participated in this study. HR-QoL was measured using the Rand-36 and the Quality of Life After Myocardial Infarction Dutch language version questionnaires. Fear of exercise was measured using the Tampa Scale for Kinesiophobia, Dutch version and the Fear Avoidance Beliefs Questionnaire, Dutch version. Association between outcome variables was analysed by linear regression analyses. Study results show that the HR-QoL of patients with ICDs in our study population is significantly worse than that of normal healthy people. Furthermore, fear of exercise is negatively associated with HR-QoL corrected for sex, age and number of years living with an ICD. After implantation of the ICD, patients with a clear fear of exercise should be identified and interventions should be considered in order to increase their HR-QoL

Assessing the deterrent effect of symbolic guardianship through neighbourhood watch signs and police signs: a virtual reality study

This study examines the deterrent effects of neighbourhood watch signs and police signs as measures of symbolic guardianship on burglars versus non-offenders. In a virtual reality experiment, 181 burglars and 172 non-offenders scouted a virtual neighbourhood and were exposed to neighbourhood watch signs and/or signs suggesting police surveillance in the area. With neighbourhood watch signs present, both burglars and non-offenders perceived the neighbourhood residents as more likely to intervene. Burglars were also more likely to select a target closer to the exit than non-offenders when neighbourhood watch signs were present. The presence of police signs reduced the time spent scouting and the distance travelled for both burglars and non-offenders. Furthermore, as compared to non-offenders burglars selected houses with easier access, travelled less distance, and reported higher anticipation of neighbourhood resident intervention. Symbolic guardianship through neighbourhood watch or police sign seems to elicit only small effects in deterring burglars. They should not immediately be discounted as preventive measures, however, as small-effect interventions may be valuable as additions to well-established interventions

c-Axis tunneling in YBa2Cu3O7-\delta/PrBa2Cu3O7-\delta superlattices

In this work we report c-axis conductance measurements done on a superlattice based on a stack of 2 layers YBa2Cu3O{7-\delta} and 7 layers PrBa2Cu3O{7-\delta} (2:7). We find that these quasi-2D structures show no clear superconducting coupling along the c-axis. Instead, we observe tunneling with a gap of \Delta_c=5.0\pm 0.5 meV for the direction perpendicular to the superconducting planes. The conductance spectrum show well defined quasi-periodic structures which are attributed to the superlattice structure. From this data we deduce a low temperature c-axis coherence length of \xi_c=0.24\pm 0.03 nm.Comment: 15 pages, 5 figures. To appear in Phys.Rev.

Automated mobile virtual reality cognitive behavior therapy for aviophobia in a natural setting: a randomized controlled trial

Background: Access to evidence-based psychological treatment is a challenge worldwide. We assessed the effectiveness of a fully automated aviophobia smartphone app treatment delivered in combination with a $5 virtual reality (VR) viewer.Methods: In total, 153 participants from the Dutch general population with aviophobia symptoms and smartphone access were randomized in a single-blind randomized controlled trial to either an automated VR cognitive behavior therapy (VR-CBT) app treatment condition (n = 77) or a wait-list control condition (n = 76). The VR-CBT app was delivered over a 6-week period in the participants' natural environment. Online self-report assessments were completed at baseline, post-treatment, at 3-month and at 12-month follow-up. The primary outcome measure was the Flight Anxiety Situations Questionnaire (FAS). Analyses were based on intent-to-treat.Results: A significant reduction of aviophobia symptoms at post-test for the VR-CBT app compared with the control condition [p Conclusions: This study is the first to show that fully automated mobile VR-CBT therapy delivered in a natural setting can maintain long-term effectiveness in reducing aviophobia symptoms. In doing so, it offers an accessible and scalable evidence-based treatment solution that can be applied globally at a fraction of the cost of current treatment alternatives

Drug–drug interactions in pediatric oncology patients

BackgroundDrug–drug interactions (DDIs) can negatively affect pharmacotherapy. However, pediatric DDI studies are scarce. We undertook an exploratory study to investigate prevalence and clinical relevance of DDIs between cytostatic and noncytostatic drugs in outpatient pediatric oncology patients.ProcedureAfter informed consent and inclusion, the following information was collected: currently prescribed noncytostatic and cytostatic drugs, comorbidities, and use of over‐the‐counter (OTC) drugs, complementary and alternative medicines (CAMs), and dietary supplements. All medication was screened for DDIs according to two databases: Micromedex® Solutions and the Dutch drug database G‐Standard. The researcher presented DDIs with an associated potential for adverse outcome and a proposal for intervention to three independent experts. If the experts considered a DDI to be potentially clinically relevant and requiring intervention, the physician was notified.ResultsSeventy‐three patients were included (median age 8.9 years). A total of 67 different DDIs were counted (66 in Micromedex® Solutions, 14 in G‐Standard, and 13 DDIs in both databases). The medication reviews resulted in 35 interventions related to 11 different DDIs. The majority of DDIs concerned noncytostatic drugs (25/35) and one third occurred between cytostatic and noncytostatic drugs (10/35). The use of QTc‐interval‐prolonging drugs resulted in one intervention. The use of OTC drugs, CAM, or dietary supplements did not lead to DDIs.ConclusionsThis study resulted in a selection of 11 potentially clinically relevant DDIs for 73 outpatients in our pediatric oncology department. Interventions were formulated in close collaboration between physicians and clinical pharmacists. Future research should focus on assessing DDIs concerning QTc‐interval prolongation.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137518/1/pbc26410_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137518/2/pbc26410.pd

Instrumental Music Influences Recognition of Emotional Body Language

In everyday life, emotional events are perceived by multiple sensory systems. Research has shown that recognition of emotions in one modality is biased towards the emotion expressed in a simultaneously presented but task irrelevant modality. In the present study, we combine visual and auditory stimuli that convey similar affective meaning but have a low probability of co-occurrence in everyday life. Dynamic face-blurred whole body expressions of a person grasping an object while expressing happiness or sadness are presented in combination with fragments of happy or sad instrumental classical music. Participants were instructed to categorize the emotion expressed by the visual stimulus. The results show that recognition of body language is influenced by the auditory stimuli. These findings indicate that crossmodal influences as previously observed for audiovisual speech can also be obtained from the ignored auditory to the attended visual modality in audiovisual stimuli that consist of whole bodies and music

Stroke risk in patients with device-detected atrial high-rate episodes

Cardiovascular implantable electronic devices (CIEDs) can detect atrial arrhythmias, i.e. atrial high-rate episodes (AHRE). The thrombo-embolic risk in patients showing AHRE appears to be lower than in patients with clinical atrial fibrillation (AF) and it is unclear whether the former will benefit from oral anticoagulants. Based on currently available evidence, it seems reasonable to consider antithrombotic therapy in patients without documented AF showing AHRE >24 hours and a CHA(2)DS(2)-VASc score (congestive heart failure, hypertension, age >= 75 years [doubled], diabetes mellitus, prior stroke [doubled], vascular disease, age 65-74 years and female sex) >= 1, awaiting definite answers from ongoing randomised clinical trials. In patients with AHR

Extended RDF: Computability and Complexity Issues

ERDF stable model semantics is a recently proposed semantics for ERDF ontologies and a faithful extension of RDFS semantics on RDF graphs. In this paper, we elaborate on the computability and complexity issues of the ERDF stable model semantics. Based on the undecidability result of ERDF stable model semantics, decidability under this semantics cannot be achieved, unless ERDF ontologies of restricted syntax are considered. Therefore, we propose a slightly modified semantics for ERDF ontologies, called ERDF #n- stable model semantics. We show that entailment under this semantics is, in general, decidable and also extends RDFS entailment. Equivalence statements between the two semantics are provided. Additionally, we provide algorithms that compute the ERDF #n-stable models of syntax-restricted and general ERDF ontologies. Further, we provide complexity results for the ERDF #nstable model semantics on syntax-restricted and general ERDF ontologies. Finally, we provide complexity results for the ERDF stable model semantics on syntax-restricted ERDF ontologies

Usage of Tacrolimus and Mycophenolic Acid During Conception, Pregnancy, and Lactation, and Its Implications for Therapeutic Drug Monitoring: A Systematic Critical Review

BACKGROUND: Conception, pregnancy, and lactation following solid organ transplantation require appropriate management. The most frequently used immunosu

Gut-microbe derived TMAO and its association with more progressed forms of AF:Results from the AF-RISK study

Introduction: The importance of gut microbiome in cardiovascular disease has been increasingly recognized. Trimethylamine N-oxide (TMAO) is a gut microbe-derived metabolite that is associated with cardiovascular disease, including atrial fibrillation (AF). The role of TMAO in clinical AF progression however remains unknown. Methods and results: In this study we measured TMAO and its precursor (betaine, choline, and L- carnitine) levels in 78 patients using plasma samples from patients that participated in the AF-RISK study. 56 patients suffered from paroxysmal AF and 22 had a short history of persistent AF. TMAO levels were significantly higher in patients with persistent AF, as compared to those with paroxysmal AF (median [IQR] 5.65 [4.7–9.6] m/z versus 4.31 [3.2–6.2] m/z, p < 0.05), while precursor levels did not differ. In univariate analysis, we observed that for every unit increase in TMAO, the odds for having persistent AF increased with 0.44 [0.14–0.73], p < 0.01. Conclusion: These results suggest that higher levels of TMAO are associated with more progressed forms of AF. We therefore hypothesize that increased TMAO levels may reflect disease progression in humans. Larger studies are required to validate these preliminary findings.Trial Registration number: Clinicaltrials.gov NCT01510210