When People Evaluate Others, the Level of Others’ Narcissism Matters Less to Evaluators Who are Narcissistic

Prior studies have documented how people in general respond to others’ narcissism, but existing research offers few clues about whether and how evaluator narcissism influences judgments of traits associated with narcissism. Participants completed the Narcissistic Personality Inventory and then evaluated hypothetical target persons. Target narcissism was conveyed through a single trait description (Study 1), a list of traits (Study 2), or Facebook content (Study 3). Narcissistic qualities were reliably viewed unfavorably, but narcissistic participants were comparatively less bothered by target narcissism and less positive in their judgments of targets without narcissistic qualities. In each study, symptoms of the presence or absence of narcissism had less impact on the social judgments of participants who were narcissistic

Abstract 13987: Underutilization of Oral Anticoagulant Therapy in At-Risk Patients With Atrial Fibrillation—Insights From a Multistate Healthcare System

Introduction: Oral anticoagulant (OAC) therapy significantly reduces the risk of thromboembolism among at-risk patients with atrial fibrillation (AF). Current guidelines provide strong support for an OAC in men and women with AF and CHA2DS2-VASc scores of \u3e2 and \u3e3, respectively. In spite of this, previous data has suggested that up to 40% of these patients are not treated in accordance with guideline recommendations. Hypothesis: We hypothesized that OAC therapy continues to remain significantly underutilized among at-risk patients with AF in real-world settings. Methods: We sought to evaluate the prevalence of OAC underuse and contributing factors in an ambulatory population of at-risk AF patients within a large multistate healthcare system. EHR and coding (ICD-10) data were used to identify patients with AF, calculate their CHA2DS2-VASc score, and define their current antithrombotic regimen. Demographics were assessed to allow for comparison between those receiving an OAC from those who were not. Chi square or Fisher exact tests were used to examine differences between groups. Results: Data was pulled from our EHR on 8/1/18, identifying 147,455 unique patients with AF, of which 102,728 (76.3%) had a CHA2DS2-VASc score \u3e2 (excluding female gender) (Table). Compared to those on an OAC, patients on antiplatelet therapy were more likely to have coronary artery disease, peripheral vascular disease, and prior MI (p Conclusions: In a contemporary, non-registry setting, OAC underuse remains substantial among at-risk patients with AF. Further investigation into tools that facilitate implementation of guideline-directed medical therapy is needed to limit preventable thromboembolic events in this population

Abstract 14012: Opportunities to Improve the Efficacy and Safety of Oral Anticoagulant Therapy in Atrial Fibrillation—Insights From a Multistate Healthcare System

Introduction: Vitamin K antagonists (VKAs) effectively reduce thromboembolic risk in atrial fibrillation (AF), but are limited by a narrow therapeutic window. Patients with reduced time in the therapeutic range (TTR) also face an increased risk of bleeding and ischemic events. Based in part on this, current guidelines give preference to direct-acting oral anticoagulants (DOACs) over VKAs in AF. Hypothesis: We hypothesized that DOACs are underutilized among those on oral anticoagulant therapy and that TTR remains suboptimal for large numbers of individuals on VKAs in real-world settings. Methods: We sought to evaluate a) the breakdown of OAC type and b) TTR for those on VKAs in an ambulatory population of at-risk AF patients within a large multistate healthcare system. EHR and coding (ICD-10) data were used to identify patients with AF, calculate their CHA2DS2-VASc score, and define their current antithrombotic regimen. For those on a VKA, TTR was assessed with the Rosendaal method and reported as mean values. Demographics were assessed to allow for comparison between those receiving a DOAC and a VKA, as well as, those with high (\u3e70%) vs. low ( Results: Data was pulled from our EHR on 8/1/18, identifying 147,455 unique patients with AF, of which 102,728 (76.3%) had a CHA2DS2-VASc score \u3e2 (excluding female gender). Among these at-risk patients, 61,698 (60.1%) were receiving an OAC, of which 47.8% were on a VKA and 52.2% were on a DOAC. The mean TTR was 56.3%, with 37.1%, 49.9% and 60.8% with TTRs \u3e70%, \u3e60%, and \u3e50%, respectively. Patients on a DOAC were more likely to be female and less likely to have heart failure, coronary artery disease, peripheral vascular disease, diabetes and renal disease (p70% were more likely to be male and less likely to have heart failure, diabetes, and renal disease (p Conclusions: In a contemporary, non-registry setting, VKAs continue to be used in nearly half of at-risk patients on an OAC for AF, with a suboptimal TTR in nearly two thirds. Further investigation is needed into tools that facilitate interchange from a VKA to a DOAC, particularly among those with a suboptimal TTR

Targeted deletion of Hand2 in cardiac neural crest-derived cells influences cardiac gene expression and outflow tract development

AbstractThe basic helix–loop–helix DNA binding protein Hand2 has critical functions in cardiac development both in neural crest-derived and mesoderm-derived structures. Targeted deletion of Hand2 in the neural crest has allowed us to genetically dissect Hand2-dependent defects specifically in outflow tract and cardiac cushion independent of Hand2 functions in mesoderm-derived structures. Targeted deletion of Hand2 in the neural crest results in misalignment of the aortic arch arteries and outflow tract, contributing to development of double outlet right ventricle (DORV) and ventricular septal defects (VSD). These neural crest-derived developmental anomalies are associated with altered expression of Hand2-target genes we have identified by gene profiling. A number of Hand2 direct target genes have been identified using ChIP and ChIP-on-chip analyses. We have identified and validated a number of genes related to cell migration, proliferation/cell cycle and intracellular signaling whose expression is affected by Hand2 deletion in the neural crest and which are associated with development of VSD and DORV. Our data suggest that Hand2 is a multifunctional DNA binding protein affecting expression of target genes associated with a number of functional interactions in neural crest-derived cells required for proper patterning of the outflow tract, generation of the appropriate number of neural crest-derived cells for elongation of the conotruncus and cardiac cushion organization. Our genetic model has made it possible to investigate the molecular genetics of neural crest contributions to outflow tract morphogenesis and cell differentiation

Evaluation of mechanical and thermal nociception as objective tools to measure painful and nonpainful lameness phases in multiparous sows

The objective of this study was to quantify pain sensitivity differences using mechanical nociception threshold (MNT) and thermal nociception threshold (TNT) tests when sows were in painful and nonpainful transient lameness phases. A total of 24 mixed parity crossbred sows (220.15 ± 21.23 kg) were utilized for the MNT test, and a total of 12 sows (211.41 ± 20.21 kg) were utilized for the TNT test. On induction day (D0), all sows were anesthetized and injected with Amphotericin B (10mg/mL) in the distal interphalangeal joint space in both claws of one randomly selected hind limb to induce transient lameness. Three days were compared: (1) D-1 (sound phase, defined as 1 d before induction), (2) D+1 (most lame phase, defined as 1 d after induction), and (3) D+6 (resolution phase, defined as 6 d after induction). After completion of the first round, sows were given a 7-d rest period and then the procedures were repeated with lameness induced in the contralateral hind limb. During the MNT test, pressure was applied perpendicularly to 3 landmarks in a randomized sequence for each sow: 1) middle of cannon on the hind limb (cannon), 2) 1 cm above the coronary band on the medial hind claw (medial claw), and 3) 1 cm above the coronary band on the lateral hind claw (lateral claw). During the TNT test, a radiant heat stimulus was directed 1 cm above the coronary band. The data were analyzed using the MIXED procedure in SAS with sow as the experimental unit. Differences were analyzed between sound and lame limbs on each day. For the MNT test, pressure tolerated by the lame limb decreased for every landmark (P \u3c 0.05) when comparing D-1 and D+1. The sound limb tolerated more pressure on D+1 and D+6 than on baseline D-1 (P \u3c 0.05). Thermal stimulation tolerated by the sound limb did not change over the 3 d (P \u3e 0.05). However, the sows tolerated less heat stimulation on their lame limb on D+1 compared to D-1 levels (P \u3c 0.05). Both MNT and TNT tests indicated greater pain sensitivity thresholds when sows were acutely lame