bluuebunny/crossref_metadata_2025 huggingface dataset:
Research Designs and Methods in Self-assessment Studies: A Content Analysis
Authors: Pastore Serafina
Published: April 2018

This paper focuses on self-assessment practices in the higher education field. In the assessment for learning perspective, self-assessment is related to reflection, metacognition, and self-regulation: all these aspects are considered as fundamental prerequisites for students’ future professional development. Despite the recognition of self-assessment educational benefits and implications, research so far lags behind the rise in the rates of align literature review, research design, and methodology. The study attempts to address this gap in the literature. Based on a critical review of institutional changes in the European higher education context, the paper reflected on main issues and problems faced by educational research on self-assessment. It then tried to identify future research pathways on this topic.
Indicators of Husband's Role in Pregnancy and Maternity Care
Authors: Moedjiono Apik Indarty , Kuntoro Kuntoro , Notobroto Hari Basuki
Published: April 2018

The maternal mortality rate (MMR) in developing countries is still a major health problem, including in Indonesia. Antenatal Care (ANC), delivery with skilled birth attendance (SBA) at the time of delivery and delivery in institutional are universally considered important for reducing maternal mortality. Husbands can play a crucial role in pregnancy and childbirth. Therefore, the aim of this study was analyze the indicators of husband's role in pregnancy and maternity care which were suspected as one of the determinants of   ANC and SBA use in Polewali Mandar Regency. The population of this prospective cohort study was all married and pregnant woman, before using contraceptives and contraceptive failure or not using contraception and pregnancy is planned, unplanned pregnancy or mistimed pregnancy in Polewali Mandar 2015 (Size of sample = 100). Samples were randomly selected from participants of screening in 12 sub-districts in Polewali Mandar. Data about husband's role in pregnancy and maternity care was obtained through interviews using a structured questionnaire data processing by using SMART-PLS.  The result of data analysis suggested that the coefficient value that has been standardized from each indicator were as follows: accessibility = 0.944 and engagement = 0.954, dan responsibility = 0.968. Indicators of organizational support in implementing Maternal and Child Health Information System at Polewali Mandar Regency, respectively from the most important are: responsibility, engagement, and accessibility.
Do Stressed Women have Abnormal Glucose Level?
Authors: M. Amirul Adli , V. Gaushinee , S. Abdullah M. , R. Rafaee , T. Syahirah M , M. Amirah , B. Chut Kartika , J. Lily Alma Nadirah A. , H. Sabariah A.
Published: April 2018

Stress is a physical, mental and emotional response to a challenging event and is a normal part of everyone's life.  It has been linked to suppression of the immune system and could increase the risk of getting ill or alter the course of existing illness.  Studies show that stress is associated with increased HBA1c, especially in females.  Therefore the purpose of this study was to determine the prevalence of stress with abnormal glucose value among the women community.  A cross-sectional study was conducted among 168 residents of Mukim Sg. Pelek, Sepang, Selangor.  Participants were selected through a simple random sampling and were asked to answer questionnaires provided.  The Depression, Stress and Anxiety (DASS-21) scale was used to determine the prevalence of stress and random blood sugar (RBS) for measurement of the glucose level.  Data was analyzed using Statistical Package Social Sciences (SPSS) version 20 and Chi-square analyses for determining the association between variables.  The study found that 58.3% of the stressed women in the community have abnormal blood glucose level, which indicated that the risk of getting diabetes is slightly high.  This finding has important implication for designing strategic plans for intervention program on awareness towards coping with stress positively.
Sugar Sweetened Beverages Consumption among University Students of Bangladesh
Authors: Bipasha Munmun Shabnam , Raisa Tahsin Sharmila , Goon Shatabdi
Published: April 2018

Drinking large amounts of sugary beverages can increase the risk of gaining weight and developing Type 2 diabetes, heart disease, and other metabolic diseases. This study examined the preference, prevalence and pattern of sugar sweetened beverages consumption among university students of Bangladesh. A cross-sectional study was carried out from February to April, 2017 among students attending in a private university of Bangladesh. One hundred fifty undergraduates responded (83.4% male, 15.9% female) in this study. Most students (95.4%) reported sugared beverage intake and 53.6% reported more than two days in a week intake. Male students were more likely than female students to report regular sugary beverages intake (85.4% vs. 14.5%). The main reasons for fast food consumption were: good taste and refreshing (80.1%), cost effective (6.6%), easy accessibility (2.6%), increased convenience (8.6%), peer influence (1.3%). Good taste and price were the most important factors in choosing beverages. Coca-Cola (49%), Fanta (25.8%), Sprite(9.9%) and Slice(14.6%) has been reported as mostly consumed beverages among students. Most students (54.5%) reported sugary beverages purchase from neighborhood convenient stores. 94.5% students said that if they would provide with healthful beverages within their food environment, they would prefer drinking healthful beverages (lemon water, non-sugary beverages) instead of sugar beverages. Self-reported sugar-sweetened beverage consumption among undergraduates is substantial and likely contributes considerable non-nutritive calories, which may contribute to weight gain. Specific health education programs, dietary guidelines and effective public awareness campaigns could be initiated to address the unhealthy drinking pattern of university students and improve their health.
Motivation as Mediator between Family Support to the Readiness of Pregnant Woman in Exclusive Breastfeeding
Authors: Mulyani Sri , Subiyanto A. A. , Anantanyu Sapja , Respati Supriyadi Heri , Wiboworini Budiyanti
Published: April 2018

The success of the implementation of exclusive breastfeeding in the community is depend on the readiness of pregnant mothers in exclusive breastfeeding. This readiness is influenced by several factors including motivation and support exclusive breastfeeding by family. This study aimed to examine the empirical model that shows the motivational role as mediators of the relationship between family support of readiness pregnant mothers in exclusive breastfeeding. Cross-sectional study performed on pregnant women in Surakarta. A sample of 150 respondents mother in her first time pregnancy. The closed questionnaire of Likert scale developed to measure three variables of the study. Path analysis procedure used to test the hypothesis of motivational role as mediator relations between two other variables. The results showed that all three variables had a significant relation (p <0.001). The relationship between family support to readiness pregnant women after entering motivation as covariates remained significant but decreased significantly path coefficient (β = 0.365; p <0.001 becomes β = 0.260; p = 0.001). Thus the motivation become a mediator relationship with the family support of readiness pregnant mothers in exclusive breastfeeding.
Morbidity Pattern among Out-Patients Attending Urban Health Training Centre in Srinagar
Authors: Kumar Santosh , Ali Haroon , Singh Amit Kumar , Raj Abhishek
Published: April 2018

The current study was designed to identify the morbidity pattern of out-patients attending Urban Health Training Centre in an urban area of a medical college in Srinagar, Pauri Garhwal district, Uttarakhand, North India. The present study record-based retrospective study was conducted among the out-patients attending the regular clinic at the Urban Health Training Centre, of a medical college in Srinagar city of Uttarakhand State of North India during the study period of one year in 2014. Data was retrieved from the OPD registers maintained at the clinic. Data was collected pertaining to socio-demographic profile, morbidity details and treatment pattern. Diseases were identified using the International Classification of Diseases (ICD-10) code. Descriptive analysis was done.  During the study period, a total of 9343 subjects attended the OPD. Among them, majority of them (60%) were females. More than half (56 %) belonged to the age group of 35-65 year age-group. The association of disease classification was found to be statistically significant with respect to gender. The leading morbidity of communicable disease was found to be certain infectious and parasitic diseases especially Typhoid whereas musculoskeletal system and connective tissue disorders were the most common cause among morbidity due to NCDs. Out of all, typhoid was found to cause maximum of morbidity among the subjects. The present study highlights the morbidity pattern of communicable and NCDs among the population of hilly areas of Garhwal, Uttarakhand India. Priority should be preferred for the regular tracking of diseases in terms of preventive and promotive aspects. Morbidity in the out- door clinics reflects the emerging trend of mixed disease spectrum burden comprising communicable and non-communicable diseases.
Dietary Diversity Practice and Associated Factors Among Infants and Young Children in Haramaya Town, Ethiopia
Authors: Gebremichael Berhe , Egata Gudina , Assefa Nega
Published: April 2018

Optimum child feeding is crucial for growth, development, and better health in later life. Dietary diversity is a critical part of the feeding practices. However, there is limited evidence on dietary diversity practice in low-income countries, like Ethiopia. This study assessed dietary diversity practice and associated factors among mothers of infants and young children aged 6-23 months in Haramaya Town, Eastern Ethiopia. Community based cross-sectional study design was used and study participants were selected by simple random sampling. Data were collected using a pre-tested questionnaire by face-to-face interview. The collected data were entered to EpiData version 3.1 and exported to SPSS version 22.0 for analysis. Characteristics of the study participants were described by using frequencies, percentages, summary measures, and tables. Bi-variable and multi-variable analyses were used to identify the associated factors. Statistical significance was declared at p-value < 0.05. The study included 635 participants yielding to a response rate of 98.1%. The prevalence of dietary diversity practice was 25.2%. Mothers learned up to secondary level or above [(AOR=2.97, 95% CI: (1.26, 6.99)], mothers who had job [(AOR=3.21, 95% CI: (1.41, 7.29)], older children [(AOR=2.51, 95% CI: (1.45, 4.34)], male children [(AOR= 2.08, 95% CI: (1.29, 3.33)], healthy children [(AOR=2.65, 95% CI: 1.36, 5.16)] and richest households [(AOR=4.45, 95% CI: 1.94, 10.22)] were associated with dietary diversity practice. Generally, the dietary diversity practice was low. Therefore, attention should be given to mothers with no formal education and efforts should be done to improve the socioeconomic status of the households.
Safe Food Handling Knowledge, Attitude and Practice of Food Handlers in Hospital Kitchen
Authors: Lestantyo Daru , Husodo Adi Heru , Iravati Susi , Shaluhiyah Zahroh
Published: April 2018

Hospital food hygiene plays an important role to patient's health. Studies proved that improper practices and lack of knowledge are contributing factors of foodborne diseases. This study was conducted to determine knowledge, attitude and practice of hospital safe food handling in Semarang, Central Java. A cross sectional study was conducted in two general hospitals' kitchen. Data were collected from 60 food handlers through validated questionnaire. Respondents were grouped into two categories: a. Teaching Hospital, and b.Non-teaching Hospital. Data were collected in February-April 2017. Most of food handlers (80%) were graduated from vocational senior high school (SMK). Respondent's age were 28-37 years (36.7%) in average. Most of respondent‟s work experience (85%) was less than 15 years. The result showed that more than 80% of food handlers have good knowledge in safe food handling procedures, good attitude (66%) and good practices (90%). There was no significant difference of knowledge, attitude and practices between two groups. Results strongly emphasize the need of food hygiene training of hospital food handlers. It also suggest that non food handlers such as nurse or kitchen supervisor should involved in the training. Some aspects of food handlers' safety behavior need to be emphasized.
Having Children with Mental Retardation
Authors: Endriyani Sri , Yunike Yunike
Published: April 2018

Mental Retardation is a condition in which the intelegency function is under average, which began during the developmental period. Children with mentally retarded have limited mental function, communication skills, ability to maintain themselves and social skills. These conditions impact the mothes’s they responsible to train children’s ability to be independent. The purpose of this study is to explore the mothers’ experience having children with mental retardation at Special School for mentally retarded (SLB) of Karya Ibu Palembang, Indonesia. This is a qualitative research with fenomenology approach from five partisipants with indept interview. Five themes were get including can’t accept reality, burden, the social stigma,need support from relatives, worry about the future, and admitting God’s will. The Adaptation behaviors found in this study are the acceptance of children’s condition, and loving the children thoroughly.
Review of Rabies Preventions and Control
Authors: Balcha Chernet , Abdela Nejash
Published: April 2018

Rabies is an acute viral infection of the central nervous system, caused by a lyssavirus in the family Rhabdoviridae. It is zoonotic viral disease that can affect all mammals, including humans, cats, dogs, and wildlife and farm animals. The virus is present in the saliva of affected animals, and the most frequent method of transmission to humans is by bites, scratches or licks to broken skin or mucous membranes. The disease has a long incubation period (six months) and symptoms may take several weeks to appear after infection. The first clinical symptom is neuropathic pain at the site of infection or wound due to viral replication. Diagnosis can only be confirmed by laboratory tests preferably conducted post mortem on central nervous system tissue removed from cranium. This paper reviews the possible prevention and control of rabies. Essential components of rabies prevention and control include ongoing public education, responsible pet ownership, routine veterinary care and vaccination, and professional continuing education. Control strategies include quarantine, confirmation of diagnosis, determining the origin and spread of an outbreak. Since rabies is invariably fatal and deadly viral disease that can only be prevented the collaborative effort between Veterinarians and human health care professionals are needed in the prevention and control of rabies.
Central Obesity and BMI Associated with Different Phenotypes of Polycystic Ovary Syndrome in Adolescent
Authors: Behbahani Bahar Morshed , Akbaezadeh Marzieh
Published: April 2018

Adipose tissue distribution is effective in metabolic complications resulting from obesity. Fat accumulation in the body, particularly increase in visceral fat, is a major risk factor of diabetes and cardiovascular diseases. The present study aimed to determine the prevalence of obesity and android obesity based on various phenotypes of Polycystic Ovarian Syndrome (PCOS) in 14-18 year old high-school girl students in Shiraz in 2009. This descriptive study was conducted on 14-18 year old high-school girl students in Shiraz in 2009. Considering the confidence coefficient of 95% and loss rate of 20%, a 3190subject sample size was determined for the study. The participants were selected through purposive sampling. After obtaining written informed consents, demographic information questionnaire was completed and the participants were examined regarding hirsutism, acne, alopecia, and menstrual disorders. Besides, the criteria proposed by Adams et al. were employed to diagnose PCOS in sonography. Android obesity and Body Mass Index (BMI) were evaluated, as well. The results of independent t-test showed no significant difference among various phenotypes of PCOS regarding mean android obesity and BMI (P>0.05). The results of the present study revealed no significant relationship between girl adolescents' obesity and various phenotypes of PCOS. However, adolescents should be informed about the long-term hyperandrogenic outcomes which are accompanied by insulin secretion and endanger their health after the age of 40 years.
Sustainability Capacity of HIV/AIDS Programmes in Yogyakarta, Indonesia
Authors: Sebong Perigrinus , Sulistio Dwi Handono , Mahendradhata Yodi
Published: April 2018

The Indonesian government established the prevalence target of HIV <0.50% in 2019 to control the spreading of HIV through the National Medium Term Development Plan. To ensure the sustainability of this development plan, a study of the strategic capacity of HIV/AIDS programmes is needed to provide an overview so that the program can be sustained over time. This study aimed to explore the sustainability capacity of HIV/AIDS programmes in Yogyakarta. This was a descriptive study utilizing a qualitative approach. The study involved 42 participants as key informants selected by a purposive sampling technique, and the data were examined using content analysis. By setting priorities of the local government supported by the Provincial Health Office and with the coordination of the Yogyakarta Province AIDS Commission, the programs are able to maintain sustainable HIV and AIDS programmes in Yogyakarta. Funding capacity, evaluation, programme adaptation and communication have not been optimal to ensure the sustainability. Stability of funding is the main obstacle to achieving the sustainability of HIV and AIDS programs. However, with good planning, partnership structure and sufficient organizational capacity, this approach can ensure the HIV and AIDS programmes will continue with the targets set by the Yogyakarta Provincial Health Office. The government in Yogyakarta needs to increase funding capacity, and improve communication to ensure sustainability. The strategy should include adaptation and evaluation of programs through strengthening private sector financing, formulating a communication plan and improving the capacity to respond to change.
Diabetes Mellitus Prevalence and Burden among Community Acquired Pneumonia Patients
Authors: Ibrahem Reda Abdel Latif , El Najjar Mostafa , Raouf Korani Mohamed Abdel
Published: April 2018

This work aimed at measuring the prevalence of Diabetes Mellitus among community acquired pneumonia (CAP) patients and declaring its effect on CAP patient's outcome. Both community acquired pneumonia and diabetes mellitus are common in Egypt, and patients with associated CAP and DM need special care and supervision. This   prospective study was carried out on 108 CAP patients admitted to Abassia Chest Hospital during the period from January 2016 to December 2016. Clinical and radiological diagnosis of pneumonia and DM diagnosis were performed. DM recorded a prevalence of 39.8% among community acquired pneumonia patients. Disturbed level of consciousness is more frequent among diabetic patients than non diabetics. Diabetic patients recorded higher rate of hospital admission, longer duration of hospital stay, higher rate of ICU admission and more sever pneumonia than among non diabetic patients. CURB-65 score showed significant positive correlation with HbA1c of the patients. Associated community-acquired pneumonia and diabetes mellitus is frequent in our locality and labor a double burden on the affected patients leading to poorer prognosis, higher rate of hospitalization with longer duration of hospital stay and ICU admission. So CAP patients with DM need intimate care.
O-Linked β-N-Acetylglucosamine Modification of A20 Enhances the Inhibition of NF-κB (Nuclear Factor-κB) Activation and Elicits Vascular Protection After Acute Endoluminal Arterial Injury
Authors: Yao Dan , Xu Lijuan , Xu Oufan , Li Rujun , Chen Mingxing , Shen Hui , Zhu Huajiang , Zhang Fengyi , Yao Deshang , Chen Yiu-Fai , Oparil Suzanne , Zhang Zhengang , Gong Kaizheng
Published: April 2018

Objective—

Recently, we have demonstrated that acute glucosamine-induced augmentation of protein O-linked β-N-acetylglucosamine (O-GlcNAc) levels inhibits inflammation in isolated vascular smooth muscle cells and neointimal formation in a rat model of carotid injury by interfering with NF-κB (nuclear factor-κB) signaling. However, the specific molecular target for O-GlcNAcylation that is responsible for glucosamine-induced vascular protection remains unclear. In this study, we test the hypothesis that increased A20 (also known as TNFAIP3 [tumor necrosis factor α-induced protein 3]) O-GlcNAcylation is required for glucosamine-mediated inhibition of inflammation and vascular protection.

Approach and Results—

In cultured rat vascular smooth muscle cells, both glucosamine and the selective O-linked N-acetylglucosaminidase inhibitor thiamet G significantly increased A20 O-GlcNAcylation. Thiamet G treatment did not increase A20 protein expression but did significantly enhance binding to TAX1BP1 (Tax1-binding protein 1), a key regulatory protein for A20 activity. Adenovirus-mediated A20 overexpression further enhanced the effects of thiamet G on prevention of TNF-α (tumor necrosis factor-α)–induced IκB (inhibitor of κB) degradation, p65 phosphorylation, and increases in DNA-binding activity. A20 overexpression enhanced the inhibitory effects of thiamet G on TNF-α–induced proinflammatory cytokine expression and vascular smooth muscle cell migration and proliferation, whereas silencing endogenous A20 by transfection of specific A20 shRNA significantly attenuated these inhibitory effects. In balloon-injured rat carotid arteries, glucosamine treatment markedly inhibited neointimal formation and p65 activation compared with vehicle treatment. Adenoviral delivery of A20 shRNA to the injured arteries dramatically reduced balloon injury–induced A20 expression and inflammatory response compared with scramble shRNA and completely abolished the vascular protection of glucosamine.

Conclusions—

These results suggest that O-GlcNAcylation of A20 plays a key role in the negative regulation of NF-κB signaling cascades in TNF-α–treated vascular smooth muscle cells in culture and in acutely injured arteries, thus protecting against inflammation-induced vascular injury.
Settlement of Stenotic Site and Enhancement of Risk Factor Load for Atherosclerosis in Left Anterior Descending Coronary Artery by Myocardial Bridge
Authors: Akishima-Fukasawa Yuri , Ishikawa Yukio , Mikami Tetuo , Akasaka Yoshikiyo , Ishii Toshiharu
Published: April 2018

Objective—

The aim of this study was to investigate the influence of a myocardial bridge (MB) on atherosclerosis development in the left anterior descending artery of the normal heart and the importance of traditional risk factors (RFs). An additional objective was to determine the correlation between intimal thickening and luminal narrowing.

Approach and Results—

The left anterior descending artery from 150 autopsied hearts was treated with formalin perfusion fixation, and each left anterior descending artery was serially cross-sectioned. The intima–media and luminal stenosis ratios were examined using computer-assisted histomorphometry. The luminal stenosis ratio was closely correlated with the intima–media ratio (
r
=0.792;
P
<0.001). When an MB was present, the luminal stenosis ratios proximal to the MB in the RF (+) group were significantly greater than those in the RF (−) group (
P
=0.022 by a multiple comparison test), but there were no differences between the RF (+) and RF (−) groups when an MB was absent. In addition, the site of the greatest stenosis in the MB (+) RF (+) group was 2.5 cm proximal to the MB entrance. Multivariate analyses indicated that age was an independent factor for luminal stenosis ratios ≥50% and 60% (
P
=0.002 and 0.029, respectively). Furthermore, the presence of an MB plus RFs was an independent factor for a luminal stenosis ratio ≥70% (
P
=0.037).

Conclusions—

An MB enhances left anterior descending artery atherosclerosis development at a site proximal to the MB entrance, particularly in subjects who have some RFs.
Prevalence and Progression of Late Gadolinium Enhancement in Children and Adolescents With Hypertrophic Cardiomyopathy
Authors: Axelsson Raja Anna , Farhad Hoshang , Valente Anne Marie , Couce John-Paul , Jefferies John Lynn , Bundgaard Henning , Zahka Kenneth , Lever Harry , Murphy Anne M. , Ashley Euan , Day Sharlene M. , Sherrid Mark V. , Shi Ling , Bluemke David A. , Canter Charles E. , Colan Steven D. , Ho Carolyn Y. , Towbin Jeff , Russell Mark , Patel Amit , Kim Bette , Taylor Matthew , Mestroni Luisa
Published: April 2018

Background:

Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) is believed to represent dense replacement fibrosis. It is seen in ≈60% of adult patients with hypertrophic cardiomyopathy (HCM). However, the prevalence of LGE in children and adolescents with HCM is not well established. In addition, longitudinal studies describing the development and evolution of LGE in pediatric HCM are lacking. This study assesses the prevalence, progression, and clinical correlations of LGE in children and adolescents with, or genetically predisposed to, HCM.

Methods:

CMR scans from 195 patients ≤21 years of age were analyzed in an observational, retrospective study, including 155 patients with overt HCM and 40 sarcomere mutation carriers without left ventricular (LV) hypertrophy. The extent of LGE was quantified by measuring regions with signal intensity >6 SD above nulled remote myocardium.

Results:

Patients were 14.3±4.5 years of age at baseline and 68% were male. LGE was present in 70 (46%) patients with overt HCM (median extent, 3.3%; interquartile range, 0.8–7.1%), but absent in mutation carriers without LV hypertrophy. Thirty-one patients had >1 CMR (median interval between studies, 2.4 years; interquartile range, 1.5–3.2 years). LGE was detected in 13 patients (42%) at baseline and in 16 patients (52%) at follow-up CMR. The median extent of LGE increased by 2.4 g/y (range, 0–13.2 g/y) from 2.9% (interquartile range, 0.8–3.2%) of LV mass to 4.3% (interquartile range, 2.9–6.8%) (
P
=0.02). In addition to LGE, LV mass and left atrial volume, indexed to body surface area, and
z
score for LV mass, as well, increased significantly from first to most recent CMR.

Conclusions:

LGE was present in 46% of children and adolescents with overt HCM, in contrast to ≈60% typically reported in adult HCM. In the subset of patients with serial imaging, statistically significant increases in LGE, LV mass, and left atrial size were detected over 2.5 years, indicating disease progression over time. Further prospective studies are required to confirm these findings and to better understand the clinical implications of LGE in pediatric HCM.
Efficacy and Safety of Apixaban, Dabigatran, Rivaroxaban, and Warfarin in Asians With Nonvalvular Atrial Fibrillation
Authors: Chan Yi‐Hsin , See Lai‐Chu , Tu Hui‐Tzu , Yeh Yung‐Hsin , Chang Shang‐Hung , Wu Lung‐Sheng , Lee Hsin‐Fu , Wang Chun‐Li , Kuo Chang‐Fu , Kuo Chi‐Tai
Published: April 2018

Background

Whether non–vitamin K antagonist oral anticoagulants (
NOAC
s) are superior to warfarin among Asians with nonvalvular atrial fibrillation remains unclear.

Methods and Results

In this nationwide retrospective cohort study collected from Taiwan National Health Insurance Research Database, there were 5843, 20 079, 27 777, and 19 375 nonvalvular atrial fibrillation patients taking apixaban, dabigatran, rivaroxaban and warfarin, respectively, from June 1, 2012 to December 31, 2016. Propensity‐score weighting was used to balance covariates across study groups. Patients were followed until the first occurrence of any efficacy or safety outcome or the end date of study. Hazard ratios (95% confidence intervals) comparing apixaban, dabigatran, and rivaroxaban with warfarin were: ischemic stroke/systemic embolism (
IS
/
SE
), 0.55 (0.43–0.69), 0.82 (0.68–0.98), and 0.81 (0.67–0.97); major bleeding, 0.41 (0.31–0.53), 0.65 (0.53–0.80), and 0.58 (0.46–0.72); and all‐cause mortality, 0.58 (0.51–0.66), 0.61 (0.54–0.68), and 0.57 (0.51–0.65). A total of 3623 (62%), 17 760 (88%), and 26 000 (94%) patients were taking low‐dose apixaban (2.5 mg twice daily), dabigatran (110 mg twice daily), and rivaroxaban (10–15 mg once daily), respectively. Similar to all‐dose
NOAC
s, all low‐dose
NOAC
s had lower risk of
IS
/
SE
, major bleeding, and mortality when compared with warfarin. In contrast to other standard‐dose
NOAC
s, apixaban was associated with lower risks of
IS
/
SE
(0.45 [0.31–0.65]), major bleeding (0.29 [0.18–0.46]), and mortality (0.23 [0.17–0.31]) than warfarin.

Conclusions

All
NOAC
s were associated with lower risk of
IS
/
SE
, major bleeding, and mortality compared with warfarin in the largest real‐world practice among Asians with nonvalvular atrial fibrillation. All low‐dose
NOAC
s had lower risk of
IS
/
SE
, major bleeding, and mortality when compared with warfarin. Standard‐dose apixaban caused a lower risk of
IS
/
SE
, major bleeding, and mortality compared with warfarin.
Genome‐Wide Associations of Global Electrical Heterogeneity ECG Phenotype: The ARIC (Atherosclerosis Risk in Communities) Study and CHS (Cardiovascular Health Study)
Authors: Tereshchenko Larisa G. , Sotoodehnia Nona , Sitlani Colleen M. , Ashar Foram N. , Kabir Muammar , Biggs Mary L. , Morley Michael P. , Waks Jonathan W. , Soliman Elsayed Z. , Buxton Alfred E. , Biering‐Sørensen Tor , Solomon Scott D. , Post Wendy S. , Cappola Thomas P. , Siscovick David S. , Arking Dan E.
Published: April 2018

Background

ECG
global electrical heterogeneity (
GEH
) is associated with sudden cardiac death. We hypothesized that a genome‐wide association study would identify genetic loci related to
GEH
.

Methods and Results

We tested genotyped and imputed variants in black (N=3057) and white (N=10 769) participants in the ARIC (Atherosclerosis Risk in Communities) study and CHS (Cardiovascular Health Study).
GEH
(
QRS
‐T angle, sum absolute
QRST
integral, spatial ventricular gradient magnitude, elevation, azimuth) was measured on 12‐lead
ECG
s. Linear regression models were constructed with each
GEH
variable as an outcome, adjusted for age, sex, height, body mass index, study site, and principal components to account for ancestry.
GWAS
identified 10 loci that showed genome‐wide significant association with
GEH
in whites or joint ancestry. The strongest signal (rs7301677, near

TBX
3

) was associated with
QRS
‐T angle (white standardized β+0.16 [95%
CI
0.13–0.19];
P
=1.5×10
−26
), spatial ventricular gradient elevation (+0.11 [0.08–0.14];
P
=2.1×10
−12
), and spatial ventricular gradient magnitude (−0.12 [95%
CI
−0.15 to −0.09];
P
=5.9×10
−15
). Altogether,
GEH
‐
SNP
s explained 1.1% to 1.6% of
GEH
variance. Loci on chromosomes 4 (near

HMCN
2

), 5 (

IGF
1R

), 11 (11p11.2 region cluster), and 7 (near

ACTB

) are novel
ECG
phenotype‐associated loci. Several loci significantly associated with gene expression in the left ventricle (

HMCN
2

locus—with

HMCN
2

;

IGF
1R

locus—with

IGF
1R

), and atria (

RP
11‐481J2.2

locus—with expression of a long non‐coding
RNA
and

NDRG
4

).

Conclusions

We identified 10 genetic loci associated with
ECG GEH
. Replication of
GEH GWAS
findings in independent cohorts is warranted. Further studies of
GEH
‐loci may uncover mechanisms of arrhythmogenic remodeling in response to cardiovascular risk factors.
Modeling the Transition From Decompensated to Pathological Hypertrophy
Authors: Pascual Florencia , Schisler Jonathan C. , Grevengoed Trisha J. , Willis Monte S. , Coleman Rosalind A.
Published: April 2018

Background

Long‐chain acyl‐CoA synthetases (
ACSL
) catalyze the conversion of long‐chain fatty acids to fatty acyl‐CoAs. Cardiac‐specific
ACSL
1 temporal knockout at 2 months results in a shift from
FA
oxidation toward glycolysis that promotes
mTORC
1‐mediated ventricular hypertrophy. We used unbiased metabolomics and gene expression analyses to examine the early effects of genetic inactivation of fatty acid oxidation on cardiac metabolism, hypertrophy development, and function.

Methods and Results

Global cardiac transcriptional analysis revealed differential expression of genes involved in cardiac metabolism, fibrosis, and hypertrophy development in
Acsl1

H−/−

hearts 2 weeks after
Acsl1
ablation. Comparison of the 2‐ and 10‐week transcriptional responses uncovered 137 genes whose expression was uniquely changed upon knockdown of cardiac
ACSL
1, including the distinct upregulation of fibrosis genes, a phenomenon not observed after complete
ACSL
1 knockout. Metabolomic analysis identified metabolites altered in hearts displaying partially reduced
ACSL
activity, and rapamycin treatment normalized the cardiac metabolomic fingerprint.

Conclusions

Short‐term cardiac‐specific
ACSL
1 inactivation resulted in metabolic and transcriptional derangements distinct from those observed upon complete
ACSL
1 knockout, suggesting heart‐specific
mTOR
(mechanistic target of rapamycin) signaling that occurs during the early stages of substrate switching. The hypertrophy observed with partial
Acsl1
ablation occurs in the context of normal cardiac function and is reminiscent of a physiological process, making this a useful model to study the transition from physiological to pathological hypertrophy.
Contact‐Free Screening of Atrial Fibrillation by a Smartphone Using Facial Pulsatile Photoplethysmographic Signals
Authors: Yan Bryan P. , Lai William H. S. , Chan Christy K. Y. , Chan Stephen Chun‐Hin , Chan Lok‐Hei , Lam Ka‐Ming , Lau Ho‐Wang , Ng Chak‐Ming , Tai Lok‐Yin , Yip Kin‐Wai , To Olivia T. L. , Freedman Ben , Poh Yukkee C. , Poh Ming‐Zher
Published: April 2018

Background

We aimed to evaluate a novel method of atrial fibrillation (
AF
) screening using an
iP
hone camera to detect and analyze photoplethysmographic signals from the face without physical contact by extracting subtle beat‐to‐beat variations of skin color that reflect the cardiac pulsatile signal.

Methods and Results

Patients admitted to the cardiology ward of the hospital for clinical reasons were recruited. Simultaneous facial and fingertip photoplethysmographic measurements were obtained from 217 hospital inpatients (mean age, 70.3±13.9 years; 71.4% men) facing the front camera and with an index finger covering the back camera of 2 independent
iP
hones before a 12‐lead ECG was recorded. Backdrop and background light intensity was monitored during signal acquisition. Three successive 20‐second (total, 60 seconds) recordings were acquired per patient and analyzed for heart rate regularity by Cardiio Rhythm (Cardiio Inc, Cambridge,
MA
) smartphone application. Pulse irregularity in ≥1 photoplethysmographic readings or 3 uninterpretable photoplethysmographic readings were considered a positive
AF
screening result.
AF
was present on 12‐lead
ECG
in 34.6% (n=75/217) patients. The Cardiio Rhythm facial photoplethysmographic application demonstrated high sensitivity (95%; 95% confidence interval, 87%–98%) and specificity (96%; 95% confidence interval, 91%–98%) in discriminating
AF
from sinus rhythm compared with 12‐lead
ECG
. The positive and negative predictive values were 92% (95% confidence interval, 84%–96%) and 97% (95% confidence interval, 93%–99%), respectively.

Conclusions

Detection of a facial photoplethysmographic signal to determine pulse irregularity attributable to
AF
is feasible. The Cardiio Rhythm smartphone application showed high sensitivity and specificity, with low negative likelihood ratio for
AF
from facial photoplethysmographic signals. The convenience of a contact‐free approach is attractive for community screening and has the potential to be useful for distant
AF
screening.
Relationship Between Dual-Task Gait Speed and Walking Activity Poststroke
Authors: Feld Jody A. , Zukowski Lisa A. , Howard Annie G. , Giuliani Carol A. , Altmann Lori J.P. , Najafi Bijan , Plummer Prudence
Published: April 2018

Background and Purpose—

Gait speed does not adequately predict whether stroke survivors will be active in the community. This may be because traditional single-task gait speed does not sufficiently reproduce the demands of walking in the real world. This study assessed whether dual-task gait speed accounts for variance in daily ambulatory activity above what can be predicted with habitual (single task) gait speed in community-dwelling stroke survivors.

Methods—

Twenty-eight community-dwelling individuals, 58.2 years of age (SD=16.6), 8.9 months poststroke (interquartile range, 3.7–19.4), completed a gait and cognitive task in single- and dual-task conditions. Daily ambulatory activity was captured using a physical activity monitor. A regression analysis examined
R

2

changes with single- and dual-task gait speed.

Results—

Single-task gait speed explained 15.3% of the variance in daily ambulatory activity (
P
=0.04). Adding dual-task gait speed to the regression model increased the variance explained by an additional 20.6% (
P
=0.04).

Conclusions—

Gait speed assessed under attention-demanding conditions may improve explanation of variance in daily ambulatory activity after stroke.
Lipid-Lowering Agents and High HDL (High-Density Lipoprotein) Are Inversely Associated With Intracranial Aneurysm Rupture
Authors: Can Anil , Castro Victor M. , Dligach Dmitriy , Finan Sean , Yu Sheng , Gainer Vivian , Shadick Nancy A. , Savova Guergana , Murphy Shawn , Cai Tianxi , Weiss Scott T. , Du Rose
Published: April 2018

Background and Purpose—

Growing evidence from experimental animal models and clinical studies suggests the protective effect of statin use against rupture of intracranial aneurysms; however, results from large studies detailing the relationship between intracranial aneurysm rupture and total cholesterol, HDL (high-density lipoprotein), LDL (low-density lipoprotein), and lipid-lowering agent use are lacking.

Methods—

The medical records of 4701 patients with 6411 intracranial aneurysms diagnosed at the Massachusetts General Hospital and the Brigham and Women’s Hospital between 1990 and 2016 were reviewed and analyzed. Patients were separated into ruptured and nonruptured groups. Univariable and multivariable logistic regression analyses were performed to determine the effects of lipids (total cholesterol, LDL, and HDL) and lipid-lowering medications on intracranial aneurysm rupture risk. Propensity score weighting was used to account for differences in baseline characteristics of the cohorts.

Results—

Lipid-lowering agent use was significantly inversely associated with rupture status (odds ratio, 0.58; 95% confidence interval, 0.47–0.71). In a subgroup analysis of complete cases that includes both lipid-lowering agent use and lipid values, higher HDL levels (odds ratio, 0.95; 95% confidence interval, 0.93–0.98) and lipid-lowering agent use (odds ratio, 0.41; 95% confidence interval, 0.23–0.73) were both significantly and inversely associated with rupture status, whereas total cholesterol and LDL levels were not significant. A monotonic exposure–response curve between HDL levels and risk of aneurysmal rupture was obtained.

Conclusions—

Higher HDL values and the use of lipid-lowering agents are significantly inversely associated with ruptured intracranial aneurysms.
Affect and Sensation: Plato’s Embodied Cognition
Authors: McCready-Flora Ian
Published: April 2018

I argue that Plato, in theTimaeus, draws deep theoretical distinctions between sensation and affect, which comprises pleasure, pain, desire and emotion. Sensation (but not affect) is both ‘fine-grained’ (having orderly causal connections with its fundamental explanatory items) and ‘immediate’ (being provoked absent any mediating psychological state). Emotions, by contrast, are mediated and coarse-grained. Pleasure and pain are coarse-grained but, in a range of important cases, immediate. TheTheaetetusassimilates affect to sensation in a way theTimaeusdoes not. Smell frustrates Timaeus because it is coarse-grained, although unlike pleasure and pain it is so by accident of physiology.
Practical and Productive Thinking in Aristotle
Authors: Müller Jozef
Published: April 2018

I argue that, on Aristotle’s account, practical thinking (unlike productive thinking) has as its origin a desire whose object is the very thing that one reasons about how to promote. This means: (a) there is only a contingent relationship between the desire that one practically reasons about how to satisfy and the action one decides on; (b) practical thinking and action (unlike productive thinking and production) cannot be separated from the agent. I also show how my account of practical thinking can shed new light on Aristotle’s claim that the virtuous agent must decide on her virtuous actions ‘for themselves’.
A checklist of the helminth parasites of sympatric rodents from two Mayan villages in Yucatán, México
Authors: PANTI-MAY JESÚS ALONSO , DIGIANI MARÍA CELINA , PALOMO-ARJONA EDUARDO EMIR , GURUBEL-GONZÁLEZ YESSICA MARGELY , NAVONE GRACIELA T. , WILLIAMS CARLOS MACHAIN- , HERNÁNDEZ-BETANCOURT SILVIA F. , ROBLES MARÍA DEL ROSARIO
Published: April 2018

In this survey, 19 species of helminths including Cestoda (Davaineidae, Hymenolepididae, and Taeniidae), Acanthocephala (Oligacanthorhynchidae), and Nematoda (Trichuridae, Ornithostrongylidae, Heligmonellidae, Oxyuridae, and Gongylonematidae) from Rattus rattus, Mus musculus, Sigmodon toltecus, Heteromys gaumeri, and Peromyscus yucatanicus in two Mayan villages in Yucatán, México, were recorded. Ten species of helminths were collected in both localities. The highest species richness was recorded in R. rattus from Xkalakdzonot (6 taxa). Twelve species are new records for Yucatán and two are registered for the first time in México. This survey constitutes the first checklist of helminth parasites in small rodents in the south-southeast of México.
A new species of Caribbean toad (Bufonidae, Peltophryne) from southern Hispaniola
Authors: LANDESTOY T. MIGUEL A. , TURNER DANIEL B. , MARION ANGELA B. , HEDGES S. BLAIR
Published: April 2018

Peltophryne armata sp. nov. is described from the South paleoisland of Hispaniola, West Indies. This is the only native toad species known to inhabit the Barahona Peninsula, Dominican Republic, in the southernmost part of Hispaniola, and it is allopatric with the widely distributed Hispaniolan toad species, P. guentheri Cochran. However, in a molecular phylogeny, the closest relative of P. armata sp. nov. is the Puerto Rican species P. lemur Cope, with which it shares a protrusive snout, large orbits, a depressed head, indistinct or absent infraorbital crests, and a long and complex advertisement call, but differs from it greatly by the very long cephalic crests, and in the massive and spinose parotoid glands that converge medially on the dorsum. The new species is similar in ecology and larval morphology to the Cuban P. florentinoi Moreno & Rivalta, but differs from it in adult morphology. The tadpole of the new species is described. Peltophryne fracta is placed in the synonymy of P. guentheri.
Modeling a Stratocumulus-Topped PBL: Intercomparison among Different One-Dimensional Codes and with Large Eddy Simulation
Authors: Bechtold P. , Krueger S. K. , Lewellen W. S. , van Meijgaard E. , Moeng C.-H. , Randall D. A. , van Ulden A. , Wang S.
Published: April 2018

Several one-dimensional (ID) cloud/turbulence ensemble modeling results of an idealized nighttime marine stratocumulus case are compared to large eddy simulation (LES). This type of model intercomparison was one of the objects of the first Global Energy and Water Cycle Experiment Cloud System Study boundary layer modeling workshop held at the National Center for Atmospheric Research on 16–18 August 1994.

Presented are results obtained with different 1D models, ranging from bulk models (including only one or two vertical layers) to various types (first order to third order) of multilayer turbulence closure models. The ID results fall within the scatter of the LES results. It is shown that ID models can reasonably represent the main features (cloud water content, cloud fraction, and some turbulence statistics) of a well-mixed stratocumulus-topped boundary layer.

Also addressed is the question of what model complexity is necessary and can be afforded for a reasonable representation of stratocumulus clouds in mesoscale or global-scale operational models. Bulk models seem to be more appropriate for climate studies, whereas a multilayer turbulence scheme is best suited in mesoscale models having at least 100- to 200-m vertical resolution inside the boundary layer.
Three-Dimensional Structure of Mass-Weighted Isentropic Time-Mean Meridional Circulations
Authors: Kanno Yuki , Iwasaki Toshiki
Published: April 2018

The present study develops a diagnostic framework for investigating the three-dimensional (3D) structure of mass-weighted isentropic time-mean (T-MIM) meridional circulations and conducts a preliminary analysis of the winter hemispheres. The T-MIM meridional velocity can unfold, in the zonal direction, time-averaged two-dimensional (2D) mass-weighted isentropic zonal means. Furthermore, the T-MIM velocity can be decomposed into the unweighted isentropic time-mean (uTM) velocity and the temporal eddy-correlated transport velocity, the so-called bolus velocity. The bolus velocity greatly contributes to the 2D extratropical direct circulation in the troposphere and to the Brewer–Dobson circulation in the stratosphere. The 3D bolus velocity seems to reflect the geographical distributions of baroclinic instability wave activity. In the boreal winter, both low-level equatorward flows and upper-level poleward flows are located around the North Pacific and North Atlantic storm tracks. In the austral winter, low-level equatorward flows extend zonally across the midlatitudes. In the subtropics, the 3D bolus velocity is found to be significant in the upper branch of the Hadley circulation. A zonal momentum equation is formulated to examine the 3D momentum balance of the meridional circulation in the T-MIM framework. In the extratropics, the uTM and bolus meridional velocities are in geostrophic balance with the stationary and transient components of the 3D Eliassen–Palm (EP) flux divergence, respectively. The pressure gradient force of transient baroclinic instability waves balances with the low-level equatorward flows of the bolus velocity in the storm tracks.