Personal mastery and quality of life in patients with atrial fibrillation after radiofrequency ablation: The mediating role of health promoting behavior.

BACKGROUND: Improving quality of life is vital for patients with atrial fibrillation (AF) after radiofrequency ablation. Quality of life can be affected not only by personal mastery but also by health promoting behavior as previously studied. However, it remains unclear whether health promoting behavior mediates the relationship between personal mastery and quality of life. OBJECTIVES: To explore whether health promoting behavior mediates the relationship between personal mastery and quality of life in patients with AF after radiofrequency ablation. METHODS: A cross-sectional design and convenience sampling were conducted at a tertiary hospital in China. Self-reported questionnaires were used to assess personal mastery, health promoting behavior and quality of life. SPSS and AMOS software were used for statistical analysis. RESULTS: A total of 202 patients with AF after radiofrequency ablation were enrolled (mean age 58.28 ± 12.70 years). The scores for personal mastery and quality of life were 22.52 ± 2.53 points and 62.58 ± 8.59 points, respectively, indicating a limited level. The health promoting behavior exhibited a moderate level, with scores averaging 103.82 ± 8.47 points. There was a positive correlation between the three variables (all P < 0.05). Health promoting behavior played a partial mediating role in the relationship between personal mastery and quality of life in patients with AF after radiofrequency ablation, accounting for 44.79 % of the total effect. CONCLUSIONS: In order to improve quality of life and prognosis, it is necessary to consider enhancing personal mastery and increasing patient compliance with health promoting behavior, which are important ways to improve their quality of life.

Research on the Effect of Manufacturing Agglomeration on Green Use Efficiency of Industrial Land.

Manufacturing agglomeration (MA) is an important way to achieve high-quality industrial development and promote land use efficiency in China. However, there is a lack of research on the relationship between MA and the green use efficiency of industrial land (GUEIL). Based on the panel data of 279 prefecture-level cities in China, from 2004 to 2019, this study analyzes the spatial and temporal differentiation characteristics of MA and GUEIL, then empirically analyzes the impact of MA on GUEIL. The results show that: (1) during the study period, the national MA levels showed a slight decline, followed by a small increase. In addition, the inter-regional differences are mainly characterized as eastern region > central region > northeast region > western region. (2) The national and regional GUEIL showed a trend of increasing, slightly decreasing, and then increasing again. The overall regional differences in efficiency show the characteristics of: eastern region > central region > western region > northeastern region. (3) At the national scale, MA had a "U-shaped" relationship with GUEIL; at the regional scale, MA had a significant "U-shaped" effect on GUEIL in the northeast, central and western regions, while having a single negative effect in the eastern region. Finally, this study provides suggestions for optimizing the manufacturing structure and improving the GUEIL.

Religiousness and Quality of Life Among Older Adults of Different Ethnic Groups in Malaysia: A Five-Year Follow-up Study.

Research has shown that religion is associated with a better quality of life (QoL). This study aims to examine ethnic differences in the association between religion and the QoL of older adults in a predominantly Muslim population within a multicultural setting. Two-wave data of 3,810 participants consisting of mostly Muslims and older adults aged ≥ 55 years were collected as part of the community health surveys conducted in 2013 and 2018 in the South East Asia Community Observatory (SEACO). Both cross-sectional analyses of baseline data and prospective analyses of longitudinal data were conducted. The associations between religiosity and quality of life were mainly positive in the cross-sectional analysis. In the two-wave analysis, religious importance was negatively associated with QoL among the Malays (B = - 1.103, SE B = 0.029, p < .001) and the Chinese (B = - 0.160, SE B = 0.043, p < .001), and a belief in a higher power control was associated with better QoL among the Malays (B = 0.051, SE B = 0.022, p < .005) and poorer QoL domains among the Indians (physical health: B = - 5.412, SE B = 1.382, p < .001; psychological: B = - 3.325, SE B = 1.42, p < .001; social relationship: B = - 5.548, SE B = 1.616, p < .001; environment: B = - 2.586, SE B = 1.288; p < .05). Our study's mixed results suggest that religiosity is positively associated with quality of life in cross-sectional analyses. However, in longitudinal analyses, the results are different. Conclusions with regard to causality based on cross-sectional analyses may be misleading. Health promotion programs should continue to examine the effect of religiousness on health outcomes over time among aging populations across different ethnic groups.

Large-scale genomic analysis reveals the genetic cost of chicken domestication.

BACKGROUND: Species domestication is generally characterized by the exploitation of high-impact mutations through processes that involve complex shifting demographics of domesticated species. These include not only inbreeding and artificial selection that may lead to the emergence of evolutionary bottlenecks, but also post-divergence gene flow and introgression. Although domestication potentially affects the occurrence of both desired and undesired mutations, the way wild relatives of domesticated species evolve and how expensive the genetic cost underlying domestication is remain poorly understood. Here, we investigated the demographic history and genetic load of chicken domestication. RESULTS: We analyzed a dataset comprising over 800 whole genomes from both indigenous chickens and wild jungle fowls. We show that despite having a higher genetic diversity than their wild counterparts (average π, 0.00326 vs. 0.00316), the red jungle fowls, the present-day domestic chickens experienced a dramatic population size decline during their early domestication. Our analyses suggest that the concomitant bottleneck induced 2.95% more deleterious mutations across chicken genomes compared with red jungle fowls, supporting the "cost of domestication" hypothesis. Particularly, we find that 62.4% of deleterious SNPs in domestic chickens are maintained in heterozygous states and masked as recessive alleles, challenging the power of modern breeding programs to effectively eliminate these genetic loads. Finally, we suggest that positive selection decreases the incidence but increases the frequency of deleterious SNPs in domestic chicken genomes. CONCLUSION: This study reveals a new landscape of demographic history and genomic changes associated with chicken domestication and provides insight into the evolutionary genomic profiles of domesticated animals managed under modern human selection.

Do Hispanics prefer to be full code at the end of life? The impact of palliative care consults on clarifying code status preferences and hospice referrals in Spanish-speaking patients.

BACKGROUND: Hispanics often have disparities at the end of life. They are more likely to die full code and less likely to have discussions regarding prognosis and do not resuscitate (DNR)/do not intubate (DNI), despite studies showing Hispanic values comfort over the extension of life. Barriers to patient-centered care include language,socioeconomic status and health literacy. CONTEXT: We evaluated the impact of palliative care (PC) consults on the change of code status and hospice referrals, comparing seriously ill Hispanic and non-Hispanic white patients. METHOD: A retrospective cohort study of all white and Hispanic patients referred to the PC service of a county hospital from 2006 to 2012. We evaluated ethnicity, language, code status at admission and after PC consult, and hospice discharge. Chi-squared tests were used to analyze characteristics among three groups: non-Hispanic white, English-speaking Hispanic, and Spanish-speaking Hispanic patients. RESULTS: Of 925 patients, 511 (55%) were non-Hispanic white, 208 (23%) were English-speaking Hispanic, and 206 (22%) were Spanish-speaking Hispanic patients. On admission, there was no statistically significant difference in code status among the three groups (57%, 64%, and 59% were full code, respectively, p = 0.5). After PC consults, Spanish-speaking Hispanic patients were more likely to change their code status to DNR/DNI when compared with non-Hispanic white and English-speaking Hispanic patients (44% vs. 32% vs. 28%, p = 0.05). Spanish-speaking Hispanic patients were more likely to be discharged to hospice when compared with English-speaking Hispanics and non-Hispanic whites (33%, 29%, and 23%, respectively, p = 0.04). SIGNIFICANCE OF RESULTS: Spanish-speaking Hispanic patients were more likely to change from full code to DNR/DNI compared with non-Hispanic white and English-speaking Hispanic patients, despite similar code status preferences on admission. They were also more likely to be discharged to hospice. PC consults may play an important role in helping patients to align their care with their values and may prevent unwanted aggressive interventions at the end of life.

Disparity in Perceptions of Social Values for Ecosystem Services of Urban Green Space: A Case Study in the East Lake Scenic Area, Wuhan.

Urban green space can bring various ecosystem benefits to diverse social groups. Among those ecosystem benefits, intangible social values are often neglected but highly relevant to human welfare. Existing research on the social values of urban green space often focusses on the perspective of urban inhabitants rather than tourists, even though tourists are also major beneficiaries. By combining different data sources into a comprehensive source about green-space social values, we investigated the disparity between inhabitants' and tourists' perceptions about space-associated social values, and further explored the underlying environmental conditions in the East Lake scenic area, Wuhan. For this, we collected 347 questionnaires through an on-site survey and 11,908 photos uploaded by 2165 social media users (Sina Blog), and we used SolVES (Social Value for Ecosystem Services) to uncover the spatial patterns of social values and the relationships between social value indicators and natural surroundings. Social-value hotspots occurred near water and trails. Perceptions differed, however, between inhabitants and tourists. Inhabitants perceived a larger scale of social values and could benefit more from recreation and economic values. Tourists, on the other hand, showed greater appreciation for aesthetic and cultural values. Environmental features were associated with social values to differing extent; distance to water and land use/cover exerted significantly influence. These findings should be taken into consideration to improve urban spatial planning and to optimize green infrastructures for human welfare.

Viability assessment of Bifidobacterium longum ATCC 15707 on non-dairy foods using quantitative fluorescence microscopy.

This study demonstrates an effective technique for separating and purifying viable bacteria from samples that interfere with viability staining. The viability of Bifidobacterium longum ATCC 15707 was assessed using Percoll Buoyant Density Gradient Centrifugation (PBDC) to separate bacteria from complex non-dairy food matrices and Quantitative Fluorescence Microscopy (QFM) to determine individual cells using LIVE/DEAD BacLight bacterial viability staining. Water agar (3%) was used to retain cells of B. longum and offered a lower fluorescence background with BacLight viability staining, compared with fixation on polycarbonate (PC) black membrane. The effect of drying temperatures and non-dairy foods on viability of B. longum was assessed. B. longum coated on oat, peanut or raisin was separated by filtration, low- and high-speed centrifugation, flotation and sedimentation buoyant density centrifugation. Purified cells were subsequently deposited on water agar for rehydration followed by LIVE/DEAD BacLight viability staining and enumeration. Conventional plate counting was also conducted to compare viability results. Finally, this method was applied to assess cell membrane damages of B. longum incorporated onto non-dairy foods during 24 h drying. Furthermore, viability assessment of B. longum coated onto oat, peanut, or raisin was much lower by plate counting compared to viability staining. Drying appeared to have a greater impact when viability was assessed by plate counting compared to viability staining. IMPORTANCE: Enumeration of viable beneficial bacteria from function foods presents a significant bottleneck for product development and quality control. Interference with microscopic and/or fluorescent techniques by ingredients, time required to incubate plated microbes, and the transient nature of the colony forming unit make rapid assessment of viable bacteria difficult. Viability assessment of Bifidobacterium longum ATCC 15707 by Percoll Buoyant Density Gradient Centrifugation with LIVE/DEAD BacLight viability staining on water agar (3%) was in agreement with serial dilution enumeration. Without the need for incubation viability assessment by staining provided a more rapid means to assess the impact of drying on the viability of B. longum coated onto oat, peanut or raisin.

Evaluation of Cancer-Based Criteria for Use in Mainstream BRCA1 and BRCA2 Genetic Testing in Patients With Breast Cancer.

Importance: Increasing BRCA1 and BRCA2 (collectively termed herein as BRCA) gene testing is required to improve cancer management and prevent BRCA-related cancers. Objective: To evaluate mainstream genetic testing using cancer-based criteria in patients with cancer. Design, Setting, and Participants: A quality improvement study and cost-effectiveness analysis of different BRCA testing selection criteria and access procedures to evaluate feasibility, acceptability, and mutation detection performance was conducted at the Royal Marsden National Health Service Foundation Trust as part of the Mainstreaming Cancer Genetics (MCG) Programme. Participants included 1184 patients with cancer who were undergoing genetic testing between September 1, 2013, and February 28, 2017. Main Outcomes and Measures: Mutation rates, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios were the primary outcomes. Results: Of the 1184 patients (1158 women [97.8%]) meeting simple cancer-based criteria, 117 had a BRCA mutation (9.9%). The mutation rate was similar in retrospective United Kingdom (10.2% [235 of 2294]) and prospective Malaysian (9.7% [103 of 1061]) breast cancer studies. If traditional family history criteria had been used, more than 50% of the mutation-positive individuals would have been missed. Of the 117 mutation-positive individuals, 115 people (98.3%) attended their genetics appointment and cascade to relatives is underway in all appropriate families (85 of 85). Combining with the equivalent ovarian cancer study provides 5 simple cancer-based criteria for BRCA testing with a 10% mutation rate: (1) ovarian cancer; (2) breast cancer diagnosed when patients are 45 years or younger; (3) 2 primary breast cancers, both diagnosed when patients are 60 years or younger; (4) triple-negative breast cancer; and (5) male breast cancer. A sixth criterion-breast cancer plus a parent, sibling, or child with any of the other criteria-can be added to address family history. Criteria 1 through 5 are considered the MCG criteria, and criteria 1 through 6 are considered the MCGplus criteria. Testing using MCG or MCGplus criteria is cost-effective with cost-effectiveness ratios of $1330 per discounted QALYs and $1225 per discounted QALYs, respectively, and appears to lead to cancer and mortality reductions (MCG: 804 cancers, 161 deaths; MCGplus: 1020 cancers, 204 deaths per year over 50 years). Use of MCG or MCGplus criteria might allow detection of all BRCA mutations in patients with breast cancer in the United Kingdom through testing one-third of patients. Feedback questionnaires from 259 patients and 23 cancer team members (12 oncologists, 8 surgeons, and 3 nurse specialists) showed acceptability of the process with 100% of patients pleased they had genetic testing and 100% of cancer team members confident to approve patients for genetic testing. Use of MCGplus criteria also appeared to be time and resource efficient, requiring 95% fewer genetic consultations than the traditional process. Conclusions and Relevance: This study suggests that mainstream testing using simple, cancer-based criteria might be able to efficiently deliver consistent, cost-effective, patient-centered BRCA testing.

Characterization of PM2.5-bound phthalic acid esters (PAEs) at regional background site in northern China: Long-range transport and risk assessment.

Eleven major phthalic acid esters (PAEs) congeners were analyzed for PM2.5 samples collected at Mount Tai, a high elevation mountain site in northern China from June to August 2015. The results showed that the average concentration of PAEs in PM2.5 was 19.48ngm-3, and bis(2-Ethylhexyl) phthalate (DEHP), dibutyl phthalate (DBP) and diisobutyl phthalate (DIBP) were the predominant species in particle-phase, whereas diethyl phthalate (DEP) and dimethyl phthalate (DMP) were the prevailing PAEs in gas-phase. PAE concentrations decreased at the beginning of cloud/fog events, while they increased after the cloud/fog events since the liquid-phase PAEs could be absorbed by solid-phase PAEs. Potential source contribution function (PSCF) analysis and principal component analysis (PCA) revealed that the highest PSCF value of air masses were mainly sourced from southwest of Mount Tai and multiple sources contributed to PAEs. A Monte Carlo simulation was applied to estimate the incremental lifetime cancer risks (ILCR) from inhalation exposure on the basis of DEHP concentrations. The estimated values of ILCR for the general population were lower than the U.S. Environmental Protection Agency threshold, which is 10-6. However, since the local population was exposed to various local emission sources, the actual health risk is undervalued.

Assessment of the Bone Mineral Content in the Mandible by Dual-Energy X-Ray Absorptiometry to Evaluate Short-Term Change.

With the objective of being able to assess response to disease or clinical treatment, the densitometry community has long sought the ability to assess short-term change in bone density. The mandible, known to have a high bone turnover, an increased vascularity, and a greater susceptibility to osteoclastic and osteoblastic activities, has long been suggested but has fallen short as a site from which to monitor an early change in the response to a treatment or a disease. The current study developed a method to assess bone density in the superimposed left and right mandibles. Examining a skull in a positioning platform showed that studies between -5.0° and +12.5° from the preferred 0° orientation generated studies that were statistically similar to studies in the preferred orientation. After establishing the distribution of bone density in the mandibles, a software was developed that would execute a search for an area of intermediate content within the body and ramus regions of the mandible; in subsequent studies of the same individual, the analysis software would place the body and ramus regions in the same location without operator dependence. Studies in a population of subjects showed that the density in the body and ramus regions varied independently and that the density in these regions was independent of age. Repeat studies with repositioning showed repeatability of 1.73% and 2.44% for the body and ramus, resulting in computed least significant change limits of 4.84% for the body and 6.83% for the ramus. Examining 45 subjects undergoing treatment for osteoporosis up to over 46 wk showed 22 (49%) subjects with an increase in 1 of the mandible sites, suggesting a benefit from treatment, whereas 12 (27%) subjects showed a decrease in both mandible sites, suggesting a poor response to treatment. We conclude that applying the methodology and allowing the software to locate and define regions of interest allow assessments of change in the bone mineral content at the mandible that will reflect early changes occurring with disease or treatment.

Does the social gradient remain in the dietary habits of a health-conscious population? A study of Seventh-Day Adventists in West Malaysia.

Background: Socioeconomic status (SES) is a strong predictor of health, and individuals with higher SES generally have better health than those with lower SES. One of the pathways that SES influences health is through health behaviors, such as dietary intake, and a higher SES has been associated with a better diet. The purpose of this study was to determine whether there was a social gradient in dietary habits among the Seventh-Day Adventists, a group of conservative Christians, where healthy eating is part of the doctrinal teaching. Methods: Data from a survey of 574 Adventists residing in West Malaysia, aged 18-80 years, were analyzed. Dietary habits were measured using the Nutrition subscale of Health Promoting Lifestyle Profile II. Results: Education and income were significantly associated with dietary habits before and after controlling for demographics. There was a gradient of association; a higher level of education and higher income were associated with better dietary habits. However, only education remained significantly associated with dietary habits when the other two socioeconomic variables were included. Employment was not significantly associated with dietary habits before or after controlling for demographic variables and the other two sociodemographic variables. Conclusions: This study showed that education is the strongest predictor of healthy diet, and a social gradient in dietary habits still exists even among health-conscious population.

Severity assessment of intracranial large artery stenosis by pressure gradient measurements: A feasibility study.

BACKGROUND: Fractional flow reserve (FFR)-guided revascularization strategy is popular in coronary intervention. However, the feasibility of assessing stenotic severity in intracranial large arteries using pressure gradient measurements still remains unclear. METHODS: Between March 2013 and May 2014, 12 consecutive patients with intracranial large artery stenosis (including intracranial internal carotid artery, middle cerebral M1 segment, intracranial vertebral artery, and basilar artery) were enrolled in this study. The trans-stenotic pressure gradient was measured before and/or after percutaneous transluminal angioplasty and stenting (PTAS), and was then compared with percent diameter stenosis. A Pd /Pa cut-off of ≤0.70 was used to guide stenting of hemodynamically significant stenoses. The device-related and procedure-related serious adverse events and recurrent cerebral ischemic events were recorded. RESULTS: The target vessel could be reached in all cases. No technical complications occurred due to the specific study protocol. Excellent pressure signals were obtained in all patients. For seven patients who performed PTAS, the mean pre-procedural pressure gradient decreased from 59.0 ± 17.2 to 13.3 ± 13.6 mm Hg after the procedure (P < 0.01). Only one patient who refused stenting experienced a TIA event in the ipsilateral MCA territory. No recurrent ischemic event was observed in other patients. CONCLUSION: Mean trans-stenotic pressure gradients can be safely and easily measured with a 0.014-inch fluid-filled guide wire in intracranial large arteries. © 2016 Wiley Periodicals, Inc.

[Speciation and Risk Assessment of Heavy Metals in Surface Sediments from the Heavily Polluted Area of Xiaoqing River].

Th concentrations of Cu, As, Pb, Zn, Cr, Cd, Ni in interstitial water were analyzed by ICP-MS from the heavily polluted area of Xiaoqing River. A modified BCR's sequential extraction procedure was used to investigate the fraction of the heavy metals in the surface sediments. The aquatic toxicity of heavy metals in interstitial water was assessed by US Water Quality Criteria (CCC, CMC). Based on the speciation of the metals in the surface sediments, the ecological risk of heavy metals was assessed with methods of risk assessment code (RAC) and potential ecological risk index. The results showed that: The tested heavy metals would not pose chronic toxicity for aquatic ecosystem. The contents of heavy metals (Cu, Pb, Zn, Cr, Cd, Ni) in the surface sediments were higher than the background values of the local soils, indicating enrichment of heavy metals. Cu, As and Ni were mainly composed with residual fractions, Pb and Cr were mainly constituted of residual and oxidizable fractions, and mass fractions of Zn and Cd existed mainly in acid soluble and reducible factions. The contents of bio-available fractions of Cd, Zn, Cr and Pb in the sediments were higher those of residual fractions, indicating high potential for secondary release. Based on calculation of RAC method, Cu, Pb, Cr and As posed extremely low to low risk to the environment. Accordingly, Ni was of low to medium risk, Cd was of medium to high risk, and Zn was of medium to extremely high risk to the environment. The potential ecological risk of heavy metals in the sediments was in the descending order of Cd > Zn > Ni > As > Cu > Cr > Pb. Cd had high to very high potential ecological risk comparing with the other heavy metals. The potential ecological risk indexes (RI) of the heavy metals in the sediments were in the range of 136.83-264.83, and posed medium to high potential ecological risks for Xiaoqing River.

Assessment of Stroke Volume Variation Perioperatively by Using Arterial Pressure with Cardiac Output.

OBJECTIVE: To observe the sensitivity of stroke volume variation (SVV) for assessing volume change during induction period of general anesthesia. METHODS: Patients who underwent orthopaedic surgery under general anesthesia and mechanical ventilation were divided into two groups randomly. Patients in the group Ⅰwere subjected to progressive central hypovolemia and correction of hypovolemia sequentially; patients in the Group Ⅱ were exposed to hypervolemia alone. Each step was implemented after 5 minutes when the hemodynamics was stable. SVV and cardiac index (CI) were recorded, and Pearson's product-moment correlation was used to analyze correlation between SVV and CI. RESULTS: Forty patients were included in this study, 20 cases in each group. For group Ⅰ patients, SVV was increased significantly along with blood volume reduction, and changes in CI were negatively correlated with changes in SVV (r=-0.605, P<0.01); SVV decreased significantly along with correction of blood volume; changes in CI were negatively correlated with changes in SVV (r=-0.651, P<0.01). For group Ⅱ patients, along with blood volume increase, SVV did not change significantly; changes in CI revealed no significant correlation with changes in SVV (r=0.067, P>0.05). CONCLUSION: SVV is a useful indicator for hypovolemia, but not for hypervolemia.

Impact of Pathologists and Evaluation Methods on Performance Assessment of the Kidney Injury Biomarker, Kim-1.

Attempts to characterize and formally qualify biomarkers for regulatory purposes have raised questions about how histological and histopathological methods impact the evaluation of biomarker performance. A group of pathologists was asked to analyze digitized images prepared from rodent kidney injury experiments in studies designed to investigate sources of variability in histopathology evaluations. Study A maximized variability by using samples from diverse studies and providing minimal guidance, contextual information, or opportunities for pathologist interaction. Study B was designed to limit interpathologist variability by using more uniform image sets from different locations within the same kidneys and allowing pathologist selected interactions to discuss and identify the location and injury to be evaluated but without providing a lexicon or peer review. Results from this study suggest that differences between pathologists and across models of disease are the largest sources of variability in evaluations and that blind evaluations do not generally make a significant difference. Results of this study generally align with recommendations from both industry and the U.S. Food and Drug Administration and should inform future studies examining the effects of common lexicons and scoring criteria, peer review, and blind evaluations in the context of biomarker performance assessment.

Three-dimensional speckle tracking echocardiography for the assessment of left ventricular function and mechanical dyssynchrony.

OBJECTIVE: Evaluation of left ventricular (LV) function and dyssynchrony is of vital importance. A newly-developed three-dimensional (3D) speckle tracking echocardiography (STE) has the potential to circumvent limitations of two-dimensional STE. Our study was to evaluate LV function and dyssynchrony by 3D-STE. METHODS AND RESULTS: Fifty-two non-ischaemic dilated cardiomyopathy patients (DCM) with complete left bundle-branch block and 55 healthy subjects were enrolled. Of these patients, 24 underwent cardiac resynchronization therapy (CRT). 3D-STE was performed before and 1 month after CRT. We measured 3D (3DS), longitudinal (LS), circumferential (CS) and radial (RS) strain of the LV. LV dyssynchrony was evaluated by the standard deviation of time to peak negative value of 3D strain (3DS-SD) and time to reach the minimum regional volume of 16 segments (SDI) related to the heart cycle. DCM patients had significantly lower global 3DS (-17.12 +/- 6.70% vs -38.38 +/- 4.28%, P < 0.01), significantly greater 3DS-SD (11.11 +/- 5.14% vs 4.04 +/- 1.43%, P < 0.01) and SDI (9.69 +/- 4.82% vs 4.23 +/- 1.33%, P < 0.01) than normal volunteers. 3DS, LS, CS, RS had an excellent correlation with LV ejection fraction (LVEF) (r2 = -0.94, -0.91, -0.93, 0.89, respectively, P < 0.01 for all). 3DS-SD correlated well with SDI (ICC = 0.85). For mild, moderate and severe systolic dysfunction, 3DS-SDs were 4.56 +/- 1.53%, 9.87 +/- 2.58%, and 14.55 +/- 4.71%, respectively (P < 0.01) and SDIs were 4.46 +/- 1.27%, 8.19 +/- 2.35%, and 12.83 +/- 4.87%, respectively (P < 0.01), but independently of QRS width. After CRT therapy, global 3DS (-13.12 +/- 2.63% to -14.06 +/- 2.53%, P = 0.025), 3DS-SDs (12.99 +/- 3.92% to 11.53 +/- 4.53%, P = 0.015) and SDIs (10.85 +/- 3.74% to 9.50 +/- 4.63%, P = 0.013) were markedly improved. CONCLUSION: When image quality is optimal, 3D STE seems to be a promising approach assessing LV function and dyssynchrony.

Meta-analysis of gender differences in efficacy outcomes for HIV-positive subjects in randomized controlled clinical trials of antiretroviral therapy (2000-2008).

Women are often underrepresented in randomized clinical trials (RCT) of HIV-1 drugs. As a result, determining whether women have different virologic outcomes compared to men is not always possible because the gender-related analyses usually lack statistical power. To address this important public health concern, the Food and Drug Administration's (FDA) Division of Antiviral Products (DAVP) created a database including 20,328 HIV-positive subjects from 40 RCTs in 18 New Drug Applications (NDAs) submitted to the FDA between 2000 and 2008. These RCTs were conducted for at least 48 weeks in duration and were used to support approval of new molecular entity, new formulation, or major label change. To delineate potential gender differences in antiretroviral treatment (ART), we evaluated the percentage of subjects with HIV RNA less than 50 copies per milliliter at 48 weeks. Analyses of the database represent the most systematic review of gender-related ART efficacy data to date. Overall, the meta-analyses did not demonstrate statistically or clinically significant gender differences in virologic outcome at week 48. However, the corresponding subgroup analyses appear to show several statistically significant gender differences favoring males.

[Assessment of health-related quality of life in hemodialysis patients with SF-36].

OBJECTIVE: To assess health-related quality of life in hemodialysis patients and to identify related socio-demographic and clinical variables. METHODS: By a cluster sampling procedure, 181 hemodialysis patients from 4 hemodialysis centers in Hangzhou completed the SF-36 Scales with self-administration. The means and deviations for each of eight scales were calculated, the results in the samples were compared with those in general population. Univariate analysis and multivariate regression were applied to determine the effect of variables such as age, gender, educational level, employment status,marital status, income,sleep, hemodialysis history, hemoglobin, co-existing diseases and so forth, on quality of life in the patients. RESULTS: The scores of the eight scales in the hemodialysis patients were 57.7 +/-18.2, 6.1 +/-16.6, 63.2 +/-17.4, 27.2 +/-12.9, 31.1 +/-17.0, 41.6 +/-14.6, 58.0 +/-45.2 and 65.3 +/-15.5. Except MH, the scores of all the scale in the patients were significantly lower than those in general population. In the multiple linear stepwise regression model of Physical Component Summary,the seven variables of age, sleep, hemoglobin, skeletal-muscle diseases, married status, diabetes mellitus and cardiopathy were included (P<0.01), while in that of Mental Component Summary, the three variables of age, sleep and hemoglobin were included (P<0.01). CONCLUSION: The quality of life in hemodialysis patients is impaired. Greater attention should be given to interventions that could improve quality of life.