The Relationship Between CA and Humor

Research has shown that communication apprehension is seen as a negative effect of speaking in public as well as in other situations. The nervous and anxious feelings experienced in these contexts take away from understanding and add to the breakdown of interpersonal relationships. On the other hand, humor is found to be an excellent coping mechanism to deal with embarrassing and fear-related anxieties and it adds to group cohesiveness. The relationship between CA and humor was of investigated to determine what effects CA has on humor and how well the use of humorous messages alleviates the problems associated with CA. Results of this study showed that there was a substantial link between CA and humor. Subjects were 566 undergraduate student volunteers at Eastern Illinois University who were enrolled in a variety of classes across the curriculum. Each participant was given a questionnaire containing the PRCA-24 and the Humor Orientation Scale along with a computerized sheet for recording responses. Data were collected during one month. Descriptive analyses were conducted and correlations, T-tests, and post hoc analyses were computed, and offer support for the the conclusion that CA and humor orientation are significantly related. There was substantial evidence to reject the null hypothesis suggesting no relation between CA and an individual\u27s level of humor orientation. Specifically, people who reported using humor in their communication with others regularly (humor frequency) and effectively (humor effectiveness) have lower levels of CA. By contrast, people who do not report using humor in their communication with others regularly and effectively have higher levels of CA

Gender Differences in S-Nitrosoglutathione Reductase Activity in the Lung

S-nitrosothiols have been implicated in the etiology of various pulmonary diseases. Many of these diseases display gender preferences in presentation or altered severity that occurs with puberty, the mechanism by which is unknown. Estrogen has been shown to influence the expression and activity of endothelial nitric oxide synthase (eNOS) which is associated with increased S-nitrosothiol production. The effects of gender hormones on the expression and activity of the de-nitrosylating enzyme S-nitrosoglutathione reductase (GSNO-R) are undefined. This report evaluates the effects of gender hormones on the activity and expression of GSNO-R and its relationship to N-acetyl cysteine (NAC)-induced pulmonary hypertension (PH). GSNO-R activity was elevated in lung homogenates from female compared to male mice. Increased activity was not due to changes in GSNO-R expression, but correlated with GSNO-R S-nitrosylation: females were greater than males. The ability of GSNO-R to be activated by S-nitrosylation was confirmed by: 1) the ability of S-nitrosoglutathione (GSNO) to increase the activity of GSNO-R in murine pulmonary endothelial cells and 2) reduced activity of GSNO-R in lung homogenates from eNOS−/− mice. Gender differences in GSNO-R activity appear to explain the difference in the ability of NAC to induce PH: female and castrated male animals are protected from NAC-induced PH. Castration results in elevated GSNO-R activity that is similar to that seen in female animals. The data suggest that GSNO-R activity is modulated by both estrogens and androgens in conjunction with hormonal regulation of eNOS to maintain S-nitrosothiol homeostasis. Moreover, disruption of this eNOS-GSNO-R axis contributes to the development of PH

The Near-Earth Object Surveyor Mission

The Near-Earth Object (NEO) Surveyor mission is a NASA observatory designed to discover and characterize near-Earth asteroids and comets. The mission's primary objective is to find the majority of objects large enough to cause severe regional impact damage ($>$140 m in effective spherical diameter) within its five-year baseline survey. Operating at the Sun-Earth L1 Lagrange point, the mission will survey to within 45 degrees of the Sun in an effort to find the objects in the most Earth-like orbits. The survey cadence is optimized to provide observational arcs long enough to reliably distinguish near-Earth objects from more distant small bodies that cannot pose an impact hazard. Over the course of its survey, NEO Surveyor will discover $\sim$200,000 - 300,000 new NEOs down to sizes as small as $\sim$10 m and thousands of comets, significantly improving our understanding of the probability of an Earth impact over the next century.Comment: accepted to PS

Polymorphisms near TBX5 and GDF7 are associated with increased risk for Barrett's esophagus.

BACKGROUND & AIMS: Barrett's esophagus (BE) increases the risk of esophageal adenocarcinoma (EAC). We found the risk to be BE has been associated with single nucleotide polymorphisms (SNPs) on chromosome 6p21 (within the HLA region) and on 16q23, where the closest protein-coding gene is FOXF1. Subsequently, the Barrett's and Esophageal Adenocarcinoma Consortium (BEACON) identified risk loci for BE and esophageal adenocarcinoma near CRTC1 and BARX1, and within 100 kb of FOXP1. We aimed to identify further SNPs that increased BE risk and to validate previously reported associations. METHODS: We performed a genome-wide association study (GWAS) to identify variants associated with BE and further analyzed promising variants identified by BEACON by genotyping 10,158 patients with BE and 21,062 controls. RESULTS: We identified 2 SNPs not previously associated with BE: rs3072 (2p24.1; odds ratio [OR] = 1.14; 95% CI: 1.09-1.18; P = 1.8 × 10(-11)) and rs2701108 (12q24.21; OR = 0.90; 95% CI: 0.86-0.93; P = 7.5 × 10(-9)). The closest protein-coding genes were respectively GDF7 (rs3072), which encodes a ligand in the bone morphogenetic protein pathway, and TBX5 (rs2701108), which encodes a transcription factor that regulates esophageal and cardiac development. Our data also supported in BE cases 3 risk SNPs identified by BEACON (rs2687201, rs11789015, and rs10423674). Meta-analysis of all data identified another SNP associated with BE and esophageal adenocarcinoma: rs3784262, within ALDH1A2 (OR = 0.90; 95% CI: 0.87-0.93; P = 3.72 × 10(-9)). CONCLUSIONS: We identified 2 loci associated with risk of BE and provided data to support a further locus. The genes we found to be associated with risk for BE encode transcription factors involved in thoracic, diaphragmatic, and esophageal development or proteins involved in the inflammatory response

Measuring the effect of nurse practitioner (NP)-led care on health-related quality of life in adult patients with atrial fibrillation: study protocol for a randomized controlled trial

Abstract Background Atrial fibrillation (AF) is a common arrhythmia associated with significant morbidity, mortality, and healthcare resource use. The prevalence of AF is increasing with a growing and aging population, and timely access to care for these patients is a concern. Nontraditional models of care delivery, such as nurse practitioner (NP)-led clinics, may improve access to care and quality of care, but they require formal assessment. The objective of this study is to assess the effect of NP-led care on the health-related quality of life (HRQoL) of adult patients with AF. Methods/design We plan a randomized controlled trial comparing NP-led care vs. standard care. Inclusion criteria are ≥18 years of age, documented nonvalvular AF, willingness to give informed consent, and capacity to complete questionnaires. Patients referred for electrophysiological intervention who are clinically unstable or unable to attend follow-up visits will not be eligible to participate. Patients will be asked for verbal consent during the initial triage phone call from the nurse. Randomization will occur via a secure website. The intervention includes an NP consult, including medical history, physical examination, patient teaching, treatment plan, and follow-up at 3 and 6 months. The control arm involves usual cardiologist consultation with follow-up determined by the cardiologist’s practice pattern. The primary outcome will be the difference in change in Atrial Fibrillation Effect on Quality of Life Survey scores at 6 months between groups. Secondary outcomes will include difference in change of EQ-5D scores at 6 months between groups, difference in composite outcomes of death resulting from cardiovascular cause, hospitalizations and emergency department visits between groups, and satisfaction with NP-led care measured by the Consultant Satisfaction Questionnaire. A sample size of 70 per group will ensure adequate power despite a potential 10% loss to follow-up. Discussion Our study will determine the effect of NP-led AF care on HRQoL in patients with AF, as well as measure its impact on relevant outcomes such as death, hospitalization, and emergency department visits. Our findings may have implications for delivery of care to patients with AF. Trial registration ClincalTrials.gov, NCT02745236 . Registered on 16 April 2016

Critical international normalized ratio results after hours To call or not to call? Résultats critiques du rapport international normalisé après les heures d'ouverture Appeler ou ne pas appeler? Objectif Déterminer si le moment du signalement de résultats

Abstract Objective To determine whether the timing of notification of critical international normalized ratio (INR) results (during or after clinic hours) altered the clinician's ability to affect same-day patient care. Design Retrospective chart review. Setting The Anticoagulation Management Service at the University of Alberta Hospital in Edmonton. Main outcome measures Differences in the proportion of patients with critical INR results having same-day care altered (by changing warfarin dose, administering vitamin K, or referring for assessment) between those with results reported during clinic hours compared with those with results reported after clinic hours. Differences by highly critical INR results (> 9.0 vs ≤ 9.0) and whether patients experienced thromboembolism or bleeding within 30 days were also assessed. Results Same-day patient care was affected for 174 out of 200 (87.0%) critical INR results reported during clinic hours compared with 101 out of 200 (50.5%) reported after clinic hours (P < .001). The most common reason for not being able to intervene was that warfarin had already been taken. Warfarin dose alteration was the most frequent change (97.1% during clinic hours and 96.0% after hours). When patients with INRs greater than 9.0 were assessed separately, the ability to affect care increased for INRs reported both during and after clinic hours (92.9% and 63.6%, respectively), largely attributable to oral vitamin K use. Overall, thromboembolic and major bleeding event rates were low and were similar in both groups. Conclusion Same-day care was less likely to be affected by critical INR results communicated after hours, most commonly because the patient had already taken their daily warfarin dose. However, after-hours care was still affected for 1 out of 2 patients, which is meaningful and supports current practice. Editor's KEy Points • Sustaining on-call services requires health care resources and might affect patient safety. This retrospective chart review aimed to determine whether the timing of notification of critical international normalized ratio (INR) results affected the ability of clinicians to intervene and alter patient care on the same day. • The data showed that clinicians were significantly (P < .001) less likely to affect care in managing critical INR results after hours (50.5%) compared with during clinic hours (87.0%). • Strategies to improve after-hours management might include improved timing of INR testing and warfarin dosing, increased availability of vitamin K (eg, at the patient's home or a local pharmacy), and technology-based systems facilitating information sharing. • Although long-standing laboratory policies mandate alerting clinicians about critical INR results regardless of the time of day, limited data support this practice, and these results provide a benchmark to guide future research and resource allocation. This article has been peer reviewed