The Polish MacNew heart disease heath-related quality of life questionnaire: A validation study

Background: The MacNew health-related quality of life questionnaire was designed to assess feelings about how heart disease affects their daily physical, emotional and social functioning in patients with 1 of the 3 major coronary artery diagnoses, stable coronary artery disease (CAD) with angina, ST-elevation myocardial infarction (STEMI), and ischemic heart failure (HF). The aim of this study was to determine the reliability and validity of the Polish version of the MacNew in patients with CAD. Methods: Patients with CAD completed a self-report sociodemographic and clinical ques­tionnaire: the MacNew, the Short-Form 36 Health Survey, and HADS at baseline; 10% of the patients completed each questionnaire 2 weeks later. Results: We studied patients with stable CAD with angina (n = 115), with STEMI (n = 112), and with ischemic HF (n = 105). Internal consistency reliability was demonstrated with Cronbach’s a from 0.86 to 0.95 for the MacNew global scale and subscales. The original 3-factor structure was confirmed for the Polish version of the MacNew explaining 53.5% of the variance. Convergent validity of similar MacNew and SF-36 subscales was confirmed in the total group and in each diagnosis. Discriminant validity with the SF-36 health transition was fully confirmed in the total group and in patients with HF and partially confirmed in patients with stable CAD with angina or myocardial infarction. Conclusions: The Polish MacNew health-related quality of life questionnaire can be recommended in patients with stable CAD with angina, myocardial infarction and HF

Does context matter in misophonia? : a multi-method experimental investigation

Introduction: Misophonia is a recently defined disorder in which certain aversive repetitive sounds and associated stimuli elicit distressing and impairing affective, behavioral, and physiological responses. The responses in misophonia may be stronger when the sound is produced by close friends and family, suggesting that the context in which a triggering cue occurs may have an important role in misophonia. As such, the goal of this study was to test experimentally whether the context of the sound source influences affective and psychophysiological responses to triggering stimuli in misophonia. Methods: Sixty one adults with misophonia and 45 controls listened to audio recordings (8 s) of human eating, animals eating, and human mouth smacking sounds (without eating). After a break, the same audio recordings were presented embedded within videos of human eating (congruent stimuli), animals eating (congruent stimuli), and, in the mouth smacking condition, with visually incongruent stimuli (hands playing in mud or in a bowl with a watery dough). Psychophysiological responses - skin conductance response (SCR) and heart rate (HR), and self-reported affective responses (valence, arousal, dominance) were gathered during the experiment in a laboratory. Results: Participants with misophonia assessed all the stimuli as more negative and arousing than the controls, and reported feeling less dominant with respect to the sounds. Animal and mouth smacking sounds were assessed by all the participants as less negative and arousing than human eating sounds, but only in the audio-video conditions. SCR data partially confirmed increased psychophysiological arousal in misophonia participants during an exposure to mouth sounds, but did not reflect the self-report changes in response to different contexts. Misophonia participants had deeper deceleration of HR than controls during human eating sound with congruent video stimuli, while there was no group difference during human mouth smacking with incongruent video stimuli. Conclusion: Results suggest that the context of mouth sounds influences affective experiences in adults with misophonia, but also in participants without misophonia. Presentation of animal eating sounds with congruent visual stimuli, or human mouth smacking sounds with incongruent stimuli, decreased self-report reaction to common misophonic triggers

Mentorship Experiences of Doctoral Students: Understanding Desired Attributes of Doctoral Student Mentors

Background: Mentorship is a critical aspect of the professional development of the doctoral student who wishes to pursue a role in higher education. Continued understanding is needed regarding the needs of the doctoral student when it comes to mentorship. Purpose: The purpose of this study is to describe the needs of a doctoral student from their mentoring relationships, as they work towards their terminal degree. Methods: This is a descriptive, phenomenological qualitative research study within universities that offer doctoral education. One-on-one, semi-structured interviews were conducted using Zoom video conference technology. Each interview, after transcribed, was analyzed following the step-wise approach of a phenomenological study. Credibility was established by 1) research triangulation, 2) bracketing/reflexivity, and 3) peer review. Results: Twelve doctoral students (7 females, 5 males) who were enrolled in doctoral programs with a focus on allied health or exercise science completed the Zoom interviews. Our participants were an average age of 28 3 years, and all twelve had graduate assistantship positions in association with their doctoral programs. Three main themes materialized from the data analyses including 1) guided autonomy, 2) humanistic nature, and 3) professional advocate. Doctoral students want guidance to develop the technical skills necessary for success by providing opportunities to perform with the chance to gain feedback. Mentors were identified as needing to demonstrate humanistic qualities that were rooted in being interpersonal. The importance of a mentor serving as a professional advocate to help the student grow and develop as a professional was also discussed. Conclusions: Doctoral students need their mentors to demonstrate both personal and professional attributes in the mentor relationship. Specifically, they are looking for guidance and feedback through independent learning, as well as a mentor who values them, is relatable, and is invested in their development as a professional

Closely-related Borrelia burgdorferi (sensu stricto) strains exhibit similar fitness in single infections and asymmetric competition in multiple infections

Wild hosts are commonly co-infected with complex, genetically diverse, pathogen communities. Competition is expected between genetically or ecologically similar pathogen strains which may influence patterns of coexistence. However, there is little data on how specific strains of these diverse pathogen species interact within the host and how this impacts pathogen persistence in nature. Ticks are the most common disease vector in temperate regions with Borrelia burgdorferi, the causative agent of Lyme disease, being the most common vector-borne pathogen in North America. Borrelia burgdorferi is a pathogen of high public health concern and there is significant variation in infection phenotype between strains, which influences predictions of pathogen dynamics and spread.In a laboratory experiment, we investigated whether two closely-related strains of B. burgdorferi (sensu stricto) showed similar transmission phenotypes, how the transmission of these strains changed when a host was infected with one strain, re-infected with the same strain, or co-infected with two strains. Ixodes scapularis, the black-legged tick, nymphs were used to sequentially infect laboratory-bred Peromyscus leucopus, white-footed mice, with one strain only, homologous infection with the same stain, or heterologous infection with both strains. We used the results of this laboratory experiment to simulate long-term persistence and maintenance of each strain in a simple simulation model.Strain LG734 was more competitive than BL206, showing no difference in transmission between the heterologous infection groups and single-infection controls, while strain BL206 transmission was significantly reduced when strain LG734 infected first. The results of the model show that this asymmetry in competition could lead to extinction of strain BL206 unless there was a tick-to-host transmission advantage to this less competitive strain.This asymmetric competitive interaction suggests that strain identity and the biotic context of co-infection is important to predict strain dynamics and persistence

Hemorrhagic stroke as a complication of fibrynolytic treatment in myocardial infarction

Thromboembolic stroke most often occurs in patients who do not receive fibrynolytic treatment. Intracranial hemorrhage is the most common form of stroke in patients receiving thrombolytic therapy. Majority of thromboembolic stroke occures more than 48 hours after fibrynolytic therapy administration. Hemorrhagic stroke usually occurs in the first 24 hours after fibrynolytic therapy. It is well known that some groups of patients have high risk intracranial hemorrhage as a complication of thrombolytic treatment of myocardial infarction. Fibrynolytic therapy reduces risk of death in myocardial infarction with ST segment elevation and is commonly used in many hospitals. The risk of as serious complication as cerebral hemorrhage, which can cause impaired neurological functions or even death, is very high in patients with recent myocardial infarction and stoke in history, so in this situations primary percutaneous angioplasty should be prefered.Udar zakrzepowo-zatorowy jest najczęstszą formą udaru u chorych nieleczonych fibrynolitycznie, natomiast u pacjentów poddanych terapii fibrynolitycznej najczęściej dochodzi do krwawienia śródczaszkowego. Większość udarów niedokrwiennych występuje ponad 48 godzin od zastosowania tej terapii. Udary krwotoczne powstają najczęściej w ciągu pierwszych 24 godzin. Wiadomo, że niektórzy chorzy są bardziej narażeni na krwawienie śródczaszkowe jako powikłanie leczenia fibrynolitycznego stosowanego w zawale serca. Leczenie takie zmniejsza śmiertelność w zawale serca z uniesieniem odcinka ST i nadal jest powszechnie stosowaną metodą terapeutyczną w wielu ośrodkach. Jednak - ze względu na ryzyko wystąpienia tak poważnego powikłania, jakim jest krwawienie śródczaszkowe, które wiąże się z ryzykiem ciężkiego inwalidztwa, a nawet zgonu - u chorych z zawałem serca i przebytym udarem w wywiadzie oraz towarzyszącymi innymi czynnikami ryzyka krwawienia śródczaszkowego należy preferować pierwotną angioplastykę przed leczeniem fibrynolitycznym

Varespladib and cardiovascular events in patients with an acute coronary syndrome: the VISTA-16 randomized clinical trial

IMPORTANCE: Secretory phospholipase A2(sPLA2) generates bioactive phospholipid products implicated in atherosclerosis. The sPLA2inhibitor varespladib has favorable effects on lipid and inflammatory markers; however, its effect on cardiovascular outcomes is unknown. OBJECTIVE: To determine the effects of sPLA2inhibition with varespladib on cardiovascular outcomes. DESIGN, SETTING, AND PARTICIPANTS: A double-blind, randomized, multicenter trial at 362 academic and community hospitals in Europe, Australia, New Zealand, India, and North America of 5145 patients randomized within 96 hours of presentation of an acute coronary syndrome (ACS) to either varespladib (n = 2572) or placebo (n = 2573) with enrollment between June 1, 2010, and March 7, 2012 (study termination on March 9, 2012). INTERVENTIONS: Participants were randomized to receive varespladib (500 mg) or placebo daily for 16 weeks, in addition to atorvastatin and other established therapies. MAIN OUTCOMES AND MEASURES: The primary efficacy measurewas a composite of cardiovascular mortality, nonfatal myocardial infarction (MI), nonfatal stroke, or unstable angina with evidence of ischemia requiring hospitalization at 16 weeks. Six-month survival status was also evaluated. RESULTS: At a prespecified interim analysis, including 212 primary end point events, the independent data and safety monitoring board recommended termination of the trial for futility and possible harm. The primary end point occurred in 136 patients (6.1%) treated with varespladib compared with 109 patients (5.1%) treated with placebo (hazard ratio [HR], 1.25; 95%CI, 0.97-1.61; log-rank P = .08). Varespladib was associated with a greater risk of MI (78 [3.4%] vs 47 [2.2%]; HR, 1.66; 95%CI, 1.16-2.39; log-rank P = .005). The composite secondary end point of cardiovascular mortality, MI, and stroke was observed in 107 patients (4.6%) in the varespladib group and 79 patients (3.8%) in the placebo group (HR, 1.36; 95% CI, 1.02-1.82; P = .04). CONCLUSIONS AND RELEVANCE: In patients with recent ACS, varespladib did not reduce the risk of recurrent cardiovascular events and significantly increased the risk of MI. The sPLA2inhibition with varespladib may be harmful and is not a useful strategy to reduce adverse cardiovascular outcomes after ACS. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01130246. Copyright 2014 American Medical Association. All rights reserved

Self-reported sex differences in high-functioning adults with autism: a meta-analysis

Background: Sex differences in autistic symptomatology are believed to contribute to the mis- and missed diagnosis of many girls and women with an autism spectrum condition (ASC). Whilst recent years have seen the emergence of clinical and empirical reports delineating the profile of young autistic girls, recognition of sex differences in symptomatology in adulthood is far more limited. Methods: We chose here to focus on symptomatology as reported using a screening instrument, the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R). In a meta-analysis, we pooled and analysed RAADS-R data from a number of experimental groups. Analysis of variance (ANOVA) searched for the presence of main effects of Sex and Diagnosis and for interactions between these factors in our sample of autistic and non-autistic adults. Results: In social relatedness and circumscribed interests, main effects of Diagnosis revealed that as expected, autistic adults reported significantly greater lifetime prevalence of symptoms in these domains; an effect of Sex, in circumscribed interests, also suggested that males generally reported more prevalent symptoms than females. An interaction of Sex and Diagnosis in language symptomatology revealed that a normative sex difference in language difficulties was attenuated in autism. An interaction of Sex and Diagnosis in the sensorimotor domain revealed the opposite picture: a lack of sex differences between typically-developing men and women and a greater prevalence of sensorimotor symptoms in autistic women than autistic men. Conclusions: We discuss the literature on childhood sex differences in relation to those which emerged in our adult sample. Where childhood sex differences fail to persist in adulthood, several interpretations exist, and we discuss, for example, an inherent sampling bias that may mean that only autistic women most similar to the male presentation are diagnosed. The finding that sensorimotor symptomatology is more highly reported by autistic women is a finding requiring objective confirmation, given its potential importance in diagnosis