Ageism, Job Engagement, Negative Stereotypes, Intergenerational Climate, and Life Satisfaction among Middle-Aged and Older Employees in a University Setting.

This study examined whether age-related discrimination, negative age-related stereotypes about declining abilities due to age, job engagement (cognitive, physical, and emotional), and workplace intergenerational climate in terms of positive intergenerational affect (PIA) and workplace intergenerational inclusiveness (WIG) correlated with life satisfaction in a university setting. The analysis was based on 115-117 faculty and staff, 50 years or older. A Principal Axis factor analysis with Promax rotation on the job-related variable revealed three factors: Experiencing Ageism (discrimination and negative stereotypes), Work Climate (PIA and WIG), and Job Engagement (physical, emotional, and cognitive). The factor-based regression scores on the three-factor-based scores were correlated with life satisfaction and also subjected to hierarchical regression analyses with age, sex, and education entered on the first step and the three factors on the second step. The results of both the correlational and hierarchical regression analysis indicated that experiencing ageism was significantly predictive of life satisfaction, and that ageism may play a more primary role than job engagement and work climate-related variables in accounting for life satisfaction.

Electrocardiographic Changes in Dengue Fever: A Review of Literature.

Dengue fever is a prevalent viral disease that primarily affects tropical nations. Although most symptomatic infections have a relatively benign course, a small percentage of patients experience severe clinical symptoms, such as bleeding and endothelial dysfunction, which can lead to hypovolemic shock and cardiovascular collapse. Dengue fever is now known to involve the heart by inducing myocardial inflammation, arrhythmias, and, in rare cases, fulminant myocarditis, up to 13% in severe dengue. Conduction abnormalities can range from benign sinus bradycardia to fulminant tachyarrhythmias and atrioventricular blocks. Although most conduction disturbances are benign and transient, they can occasionally aggravate pre-existing conditions and even be fatal. Unlike other viral myocarditis like hepatitis C induced myocarditis, dengue causes mainly transient changes, and long-term complications like dilated cardiomyopathy are not noted. There is indeed a paucity of data on how to assess and treat individuals with conduction abnormalities. In this review, the authors have discussed the wide variety of conduction abnormalities seen in dengue, their pathophysiology, clinical consequences, and a method for evaluating and managing these individuals.

The Relationship between Just World Beliefs and Life Satisfaction.

An important and often unexplored factor shaping life satisfaction is one's perception of the world as a "just" place. The "just world hypothesis" is predicated on the idea that the world works as a place where people get what they merit, an idea that often serves as a means for people to rationalize injustices. The research addressing just world beliefs has expanded into a four-factor model that categorizes just world beliefs for self and others into subcategories of distributive and procedural justice. Distributive justice involves evaluations of the fairness of outcomes, allocations, or distribution of resources, while procedural concerns evaluations of the fairness of decision processes, rules, or interpersonal treatment. This study explored the relationship between the four just world beliefs subscales and overall satisfaction with life and examined their associations with demographic variables including ethnicity, age, gender, religion, and social class. The relationships of demographic factors with justice beliefs and life satisfaction generally yielded very small effect sizes. However, respondents who identified themselves as middle and upper class reported higher levels of life satisfaction than those who identified themselves as lower class, with a medium effect size. Consistent with the results of earlier research, regressing life satisfaction on the four justice beliefs subscales indicated that the two self-subscales (distributive and procedural) were significantly predictive of life satisfaction, but the two other subscales (distributive and procedural) were not.

Cultural Dimensions of Diabetes Management: a Qualitative Study of Middle Eastern Immigrants in the U.S.

This study examined how aspects of culture, social support, isolation, and loneliness are perceived as influences in chronic illness management by pre-diabetic (Glycated hemoglobin A1c levels between 5.7 and 6.4) or Type 2 diabetic patients (A1c levels between 6.4 and 8). Twenty-eight Middle Eastern immigrants in the greater Philadelphia area were interviewed using a semi-structured approach. Results were consistent with other research which suggests that patients benefit from family and community support in the management of their illness. However, findings also suggest that even in the presence of strong family and social support, patients report increased feelings of isolation and loneliness because they have to manage a complex illness that requires many lifestyle changes. For immigrant suffering from chronic illnesses, social gatherings, especially those that center on the consumption of traditional ethnic food, can be highly stressful because they need to avoid such foods as part of their daily treatment regimen. The results of this study have significant implications for patients, physicians, and psychologists who can benefit from an increased sensitivity to patients' challenges in illness management by understanding how cultural factors affect compliance in diabetes treatment regimens.

First-in-human evaluation of a novel balloon-expandable transcatheter heart valve in patients with severe symptomatic native aortic stenosis: the MyVal-1 study.

AIMS: The aim of this study was to demonstrate the safety and efficacy of the next-generation balloon-expandable Myval transcatheter heart valve (THV) in an intermediate- or high-risk patient population with severe symptomatic native aortic stenosis. METHODS AND RESULTS: MyVal-1 was a first-in-human, prospective, multicentre, single-arm, open-label study. Between June 2017 and February 2018, a total of 30 patients were enrolled at 14 sites across India. Mean age was 75.5±6.7 years; 43.3% had coronary artery disease. The mean Society of Thoracic Surgeons score was 6.4±1.8% and 100% of the patients were in New York Heart Association (NYHA) functional Class II/III/IV pre-procedure. The six-minute walk test and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores were recorded. After successful implantation of the Myval THV, 96.6% and 100% were in NYHA functional Class I/II at 30-day and 12-month follow-up, respectively. Outcomes of the six-minute walk test (148.0±87.4 vs 336.0±202.9 m) and KCCQ score (36.6±11.0 vs 65.9±11.4) improved from baseline to 12-month follow-up. The effective orifice area (0.6±0.2 vs 1.8±0.3 cm2, p<0.0001), mean aortic valve gradient (47.4±8.8 vs 12.0±3.3 mmHg, p<0.0001), peak aortic valve gradient (71.7±13.0 vs 20.3±5.9 mmHg, p<0.0001) and transaortic velocity (4.5±0.4 vs 2.2±0.4 m/s, p<0.0001) improved substantially from baseline to 12 months post procedure. Four all-cause mortality cases were reported up to 12 months. Moreover, there was no other moderate/severe paravalvular leak, aortic regurgitation or need for new permanent pacemaker (PPM) up to 12-month follow-up. CONCLUSIONS: The MyVal-1 study demonstrated the primary safety and efficacy of the Myval THV with no new PPM requirement up to 12-month follow-up. However, future trials with a larger number of patients and long-term follow-up are warranted to establish the safety and efficacy of the device.

Three-year clinical and two-year multimodality imaging outcomes of a thin-strut sirolimus-eluting bioresorbable vascular scaffold: MeRes-1 trial.

AIMS: Although the proof of concept of the bioresorbable vascular scaffold (BRS) is well documented, device-related adverse outcomes with first-generation BRS indicate longer-term surveillance. The current study provides insights into the safety and performance of the MeRes100, a novel second-generation sirolimus-eluting BRS, beyond one-year up to three-year follow-up (FU). METHODS AND RESULTS: A total of 108 enrolled patients with de novo coronary artery lesions who underwent implantation of MeRes100 as part of the first-in-human MeRes-1 trial were followed up clinically beyond one year at two and three years and with multiple modality imaging at six months and two years. At three-year FU, the cumulative major adverse cardiac events rate was 1.87%, in the form of two ischaemia-driven target lesion revascularisations. No scaffold thrombosis was reported. Between six months and two years at quantitative coronary angiography, in-segment late lumen loss (LLL) (0.15±0.22 mm vs. 0.23±0.32 mm; p=0.18) and in-scaffold LLL (0.13±0.22 mm vs. 0.24±0.34 mm; p=0.10) changed insignificantly. IVUS subset analysis revealed a non-significant reduction in mean lumen area (6.17±1.28 mm2 vs. 5.47±1.50 mm2; p=0.21) and minimum lumen area (5.14±1.19 mm2 vs. 4.05±1.42 mm2; p=0.10) at two years compared to post-procedural measurements. OCT subset analysis demonstrated 99.24±2.27% neointimal strut coverage. CONCLUSIONS: The extended outcomes of the MeRes-1 trial demonstrated sustained efficacy and safety of the MeRes100 BRS with maintained lumen patency up to two years by multimodality imaging and no very late scaffold thrombosis up to three-year clinical FU.The MeRes-1 trial is registered at the Clinical Trials Registry-India. CTRI Number: CTRI/2015/04/005706.

Comparison of Morphologic Findings in Patients with Dextrocardia with Situs Solitus vs Situs Inversus: a Retrospective Study.

BACKGROUND: Studies on dextrocardia have been limited by low numbers. Hence, it is very difficult to find the most common diagnosis in patients with dextrocardia, who are seeking medical attention in tertiary care center. AIMS AND OBJECTIVE: To identify the most common diagnostic pattern in patients with dextrocardia with different situs. METHODS: It is a retrospective study with records dating back to up to last 21 years from a major tertiary care center in south India. All the patients with diagnosis of dextrocardia (defined as right-sided baso-apical axis of heart) will be included in the study. Segmental analysis will be done as defined previously. RESULTS: There were total of n = 378 patients with dextrocardia, 43.3% were females and median age was 1 year while mean age was 7 years. Situs solitus was present in 43.1%, Situs inversus in 38.1%, and Situs ambiguus in 18.8%. In patients with situs solitus and dextrocardia, the most common diagnosis was congenitally corrected TGA ± PS/PA followed by Double outlet Right ventricle ± PS/PA; whereas in patients with Situs inversus and dextrocardia, the most common diagnosis was Double outlet Right ventricle ± PS/PA followed by normal hearts and Left to right shunts. CONCLUSION: In patients with dextrocardia who are seeking medical advice in a tertiary care center, they are more likely to have situs solitus followed by situs inversus. In situs solitus atrio-ventricular discordance with right ventricular outflow obstruction is the most common lesion suggesting L-looping is the most predominant mechanism. In patients with situs inversus, DORV with RVOTO is the most common lesion.

In vivo toxicity evaluation of biologically synthesized silver nanoparticles and gold nanoparticles on adult zebrafish: a comparative study.

In this study, toxicity of biologically synthesized silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs) was compared using zebrafish as a model organism. At 96 h, LC50 of AgNPs and AuNPs was found to be 24.5 µg/L and 41 mg/L, respectively. Following the LC50 determination, half of the LC50 of AgNPs (12.25 µg/L) and AuNPs (20.5 mg/L) was exposed to adult zebrafishes for 14 days. Morphological changes, liver marker enzymes, reactive oxygen species (ROS) generation, genotoxic effects and mRNA expression levels of oxidative stress and innate immune response related genes were studied using nanoparticle treated gill, liver and blood cells. In this study, AgNP-treated gill and liver tissues showed a number of morphological changes such as cell membrane damage, irregular cell outlines, pyknotic nuclei and complete disruption of gill and liver cells; on the contrary, AuNPs treated liver tissues alone showed such changes. The levels of liver marker enzymes such as alanine aminotransferase and aspartate aminotransferase were increased after AgNPs treatment when compared to AuNPs treatment. AgNP-treated liver cells showed higher levels of ROS generation than the control; on the other hand, AuNPs treatment exhibited lower levels of ROS generation than the control. Interestingly, AgNP-treated blood cells showed micronuclei formation and nuclear abnormalities, while AuNPs treatment did not show such effects. Based on these observations, it is clear that AgNPs may cause oxidative stress and immunotoxicity to adult zebrafish than the AuNPs. However, these results clearly reveal the significance of relatively safe and less toxic bionanomaterials for possible biomedical applications.

Photochemistry and Photophysics of the 3-Styrylidenebenz[e]indanes.

The photochemical and photophysical properties of the extended conformers of trans- and cis-1-(2-naphthyl)-2-phenylethenes (t- and c-NPEB ) are strikingly different than those of their rigid analogues, trans- and cis-3-styrylidenebenz[e]indane (t- and c-BPE). The fluorescence quantum yield and lifetime at 25°C in methylcyclohexane drop from 0.76 and 22.2 ns in t-NPEB to 0.0051 and 0.25 ns in t-BPE, and there are complementary changes in the photoisomerization quantum yields. In both cases, photoisomerization occurs in S2 , a stilbenic excited state. The differences in behavior are traced to the diminished S1 /S2 energy gap on the alkyl substitution afforded by the five-membered ring in BPE. The effect of viscosity on the torsional relaxation of t-BPE, evaluated in glycerol/methanol mixtures at 25°C and in 95/5 and 99.9/0.1 glycerol/methanol (% v/v) as a function of T, is well accounted for by the medium-enhanced barrier model. Absorption and fluorescence spectra of t-BPE in pure glycerol reveal aggregate formation. Quenching of t-BPE fluorescence in methylcyclohexane by tri-n-butylamine (TBA) leads to exciplex fluorescence. Comparison with analogous results for t-NPEB suggests that charge transfer involves primarily the naphthalenic S1 state in t-NPEB and the stilbenic S2 state in t-BPE.

Clinical Outcomes of patients with coronary artery disease who underwent FFR evaluation of intermediate coronary lesionS- COFFRS study.

BACKGROUND: We undertook this study to validate the impact of FFR-guided coronary interventions among Indian patients, which is not readily available as of date. Our patients differ from their western counterparts, both in terms of risk profile (younger, more metabolic syndrome, lipid rich diet) as well as their coronary size. METHODS: We retrospectively evaluated 282 patients with intermediate stenosis in their coronary arteries, who underwent FFR to assess the functional severity of the lesion. There were 3 groups: Group 1-FFR>0.8 and kept on medical follow-up; Group 2-FFR≤0.8 and underwent revascularisation; and Group 3-FFR≤0.8 and refused to undergo revascularization. 281(99.6%) patients had regular follow-up in our clinic. RESULTS: Median age-57 years (range=28-78). Males=230, 90 patients were in Group 1, 175 in group 2 (PCI in 144 & CABG in 31) and 17 in group 3. Median follow-up of patients was 17.9 months (2 to 56 months). Three patients(3.4%) in Group 1 had MACE (1 STEMI, 2 UA); 4 patients (2.3%) in Group 2 had Non-STE-ACS; 7 patients (41%) in Group 3 had MACE (3 deaths with acute LVF, 2 NSTEMI, 2 STEMI) CONCLUSION: In our experience, MACE events were not higher in patients with FFR>0.8 and kept under medical therapy and were similarly lower in patients with FFR ≤0.8 and underwent revascularisation (p=0.73). Also MACE events were higher in patients with FFR≤0.8 and did not undergo revascularisation compared to other two appropriately treated groups (p=0.03). FFR based revascularization decision appears to be a safe strategy in Indian patients.

First-in-human evaluation of a novel poly-L-lactide based sirolimus-eluting bioresorbable vascular scaffold for the treatment of de novo native coronary artery lesions: MeRes-1 trial.

AIMS: The MeRes-1 trial sought to study the safety and effectiveness of a novel sirolimus-eluting bioresorbable vascular scaffold (MeRes100 BRS) in treating de novo native coronary artery lesions by clinical evaluation and using multiple imaging modalities. METHODS AND RESULTS: The MeRes-1 first-in-human trial was a single-arm, prospective, multicentre study, which enrolled 108 patients with de novo coronary artery lesions (116 scaffolds were deployed to treat 116 lesions in 108 patients). At six months, quantitative coronary angiography revealed in-scaffold late lumen loss of 0.15±0.23 mm with 0% binary restenosis. Optical coherence tomography demonstrated minimum scaffold area (6.86±1.73 mm2) and percentage neointimal strut coverage (99.30%). Quantitative intravascular ultrasound analysis confirmed a 0.14±0.16 mm2 neointimal hyperplasia area. At one year, major adverse cardiac events, a composite of cardiac death, any myocardial infarction and ischaemia-driven target lesion revascularisation, occurred in only one patient (0.93%) and there was no scaffold thrombosis reported. At one year, computed tomography angiography demonstrated that all scaffolds were patent and in-scaffold mean percentage area stenosis was 11.33±26.57%. CONCLUSIONS: The MeRes-1 trial demonstrated the safety and effectiveness of MeRes100 BRS. The favourable clinical outcomes and effective vascular responses have provided the basis for further studies in a larger patient population. The MeRes-1 trial is registered at the Clinical Trials Registry-India.

Anticancer activity of biologically synthesized silver and gold nanoparticles on mouse myoblast cancer cells and their toxicity against embryonic zebrafish.

The aim of this study was to evaluate the anticancer activity of bioinspired silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs) against mouse myoblast cancer cells (C2C12). Both AgNPs and AuNPs were biologically synthesized using Spinacia oleracea Linn., aqueous leaves extract. UV-Vis. spectrophotometer, high resolution-transmission electron microscopy (HR-TEM), field emission-scanning electron microscopy (FE-SEM) and X-ray diffraction (XRD) studies supported the successful synthesis of AgNPs and AuNPs. Both these NPs have shown cytotoxicity against C2C12 cells even at very low concentration (5µg/mL). Acridine orange/Ethidium bromide (AO/EB) dual staining confirmed the apoptotic morphological features. The levels of caspase enzymes (caspase-3 and caspase-7) were significantly up-regulated in NPs treated myoblast cells than the plant extract. Furthermore, in zebrafish embryo toxicity study, AgNPs showed 100% mortality at 3µg/mL concentration while AuNPs exhibited the same at much higher concentration (300mg/mL). Taken together, these results provide a preliminary guidance for the development of biomaterials based drugs to fight against the fatal diseases for example cancer.

First-in-human evaluation of a novel poly-L-lactide based sirolimus-eluting bioresorbable vascular scaffold for the treatment of de novo native coronary artery lesions: MeRes-1 trial

AIMS: The MeRes-1 trial sought to study the safety and effectiveness of a novel sirolimus-eluting bioresorbable vascular scaffold (MeRes100 BRS) in treating de novo native coronary artery lesions by clinical evaluation and using multiple imaging modalities. METHODS AND RESULTS: The MeRes-1 first-in-human trial was a single-arm, prospective, multicentre study, which enrolled 108 patients with de novo coronary artery lesions (116 scaffolds were deployed to treat 116 lesions in 108 patients). At six months, quantitative coronary angiography revealed in-scaffold late lumen loss of 0.15±0.23 mm with 0% binary restenosis. Optical coherence tomography demonstrated minimum scaffold area (6.86±1.73 mm2) and percentage neointimal strut coverage (99.30%). Quantitative intravascular ultrasound analysis confirmed a 0.14±0.16 mm2 neointimal hyperplasia area. At one year, major adverse cardiac events, a composite of cardiac death, any myocardial infarction and ischaemia-driven target lesion revascularisation, occurred in only one patient (0.93%) and there was no scaffold thrombosis reported. At one year, computed tomography angiography demonstrated that all scaffolds were patent and in-scaffold mean percentage area stenosis was 11.33±26.57%...

Flecainide challenge test: Predictors of unmasking of type 1 Brugada ECG pattern among those with non-type 1 Brugada ECG pattern.

BACKGROUND: Many subjects in community have non-type 1 Brugada pattern ECG with atypical symptoms, relevance of which is not clear. Provocative tests to unmask type 1 Brugada pattern in these patients would help in diagnosing Brugada Syndrome. However sensitivity and specificity of provocating drugs are variable. METHODS: We studied 29 patients referred to our institute with clinical presentation suggestive but not diagnostic of Brugada or with non-Type 1 Brugada pattern ECG. Flecainide Challenge Test (FCT) was done in these patients (IV Flecainide test in 4 patients and Oral Flecainide in 25 patients). Resting 12-lead ECG with standard precordial leads and ECG with precordial leads placed 1 Intercostal space above were performed after flecainide administration every 5 min for first 30 min and every 30 min thereafter until ECG became normal or upto 6 h. The positivity was defined as inducible Type 1 Brugada pattern in atleast 2 right sided leads. RESULT: Median age was 35(range = 5-65) years. In 16 (55%) patients the Type 1 Brugada pattern was unmasked. There were no episodes of major AV block, atrial or ventricular tachyarrhythmia. Three groups were considered for analysis: Group 1(n = 9) - FCT Positive among patients with non-type 1 Brugada ECG pattern, Group 2(n = 4) - FCT Negative among the patients with non-type 1 Brugada ECG pattern, and Group 3(n = 7) - FCT Positive among patients with no spontaneous Brugada ECG pattern. Binary logistic regression analysis found that family h/o SCD was predictive of FCT positivity in Group 1 (Odd's ratio 21, 95% Confidence interval 1.04 to 698.83, p = 0.004). CONCLUSION: Oral flecainide is useful and safe for unmasking of Type I Brugada pattern. In our study, among the many variables studied, family history of sudden cardiac death was the only predictor of flecainide test positivity among those with non-Type 1 Brugada pattern.

A Comparison of Hypnotic Induction, Task Motivation, and a "Cold Start" Control Group on Hypnotizability.

Groups of participants (N = 164) were randomly assigned to three conditions: Group 1 received a trance induction, Group 2 received task-motivational instructions, and Group 3-"cold start" control-was simply told, "We will begin the hypnosis procedure now." All participants received the Creative Imagination Scale suggestions and then completed the Creative Imagination Scale and Inventory Scale of Hypnotic Depth. The three conditions did not differ significantly either on the Creative Imagination Scale or in reported hypnotic depth. These results are consistent with prior studies which show that trance induction and task-motivational yield similar results, but they are inconsistent inasmuch as the trance induction and task-motivational groups did not differ from the control group. These results, however, are predictable from socio-cognitive perspectives that the context of hypnosis itself can elicit hypnotic behaviors.

Photoisomerization of cis-1,2-di(1-Methyl-2-naphthyl)ethene at 77 K in Glassy Media.

cis-1,2-Di(1-methyl-2-naphthyl)ethene, c-1,1, undergoes photoisomerization in methylcyclohexane, isopentane and diethyl ether/isopentane/ethanol glasses at 77 K. On 313 nm excitation the fluorescence of c-1,1 is replaced by fluorescence from t-1,1. Singular value decomposition reveals that the spectral matrices behave as two component systems suggesting conversion of a stable c-1,1 conformer to a stable t-1,1 conformer. However, the fluorescence spectra are λexc dependent. Analysis of global spectral matrices shows that c-1,1 is a mixture of two conformers, each of which gives one of four known t-1,1 conformers. The λexc dependence of the c-1,1 fluorescence spectrum is barely discernible. Structure assignments to the resolved fluorescence spectra are based on the principle of least motion and on calculated geometries, energy differences and spectra of the conformers. The relative shift of the c-1,1 conformer spectra is consistent with the shift of the calculated absorption spectra. The calculated structure of the most stable conformer of c-1,1 agrees well with the X-ray crystal structure. Due to large deviations of the naphthyl groups from the ethenic plane in the conformers of both c- and t-1,1 isomers, minimal motion of these bulky substituents accomplishes cis → trans interconversion by rotation about the central bond.

Acute outcome of treating patients admitted with electrical storm in a tertiary care centre.

BACKGROUND: Electrical storm (ES) is a life threatening emergency. There is little data available regarding acute outcome of ES. AIMS: The study aimed to analyze the acute outcome of ES, various treatment modalities used, and the factors associated with mortality. METHODS: This is a retrospective observational study involving patients admitted with ES at our centre between 1/1/2007 and 31/12/2013. RESULTS: 41 patients (mean age 54.61 ± 12.41 years; 86.7% males; mean ejection fraction (EF) 44.51 ± 16.48%) underwent treatment for ES. Hypokalemia (14.63%) and acute coronary syndrome (ACS) (14.63%) were the commonest identifiable triggers. Only 9 (21.95%) patients already had an ICD implanted. Apart from antiarrhythmic drugs (100%), deep sedation (87.8%), mechanical ventilation (24.39%) and neuraxial modulation using left sympathetic cardiac denervation (21.95%) were the common treatment modalities used. Thirty-three (80.49%) patients could be discharged after a mean duration of 14.2 ± 2.31 days. Eight (19.5%) patients died in hospital. The mortality was significantly higher in those with EF < 35% compared to those with a higher EF (8 (42.11% vs 0 (0%), p = 0.03)). There was no significant difference in mortality between those with versus without a structural heart disease (8 (21.1% vs 0 (0%), p = 0.32)). Comparison of mortality an ACS with ES versus ES of other aetiologies (3 (50%) vs 5 (14.29) %, p = 0.076)) showed a trend towards significance. CONCLUSION: With comprehensive treatment, there is reasonable acute survival rate of ES. Hypokalemia and ACS are the commonest triggers of ES. Patients with low EF and ACS have higher mortality.