Mental Health and Access to Medical Care in Patients with Chronic Cardiovascular Conditions: An Analysis of the Behavior Risk Factor Surveillance System

Introduction. Poor mental health is associated with worse outcomes for chronic diseases. It is unclear whether mental illness predisposes to difficulties with healthcare access. Methods. Using a combined dataset of the 2016-2019 behavioral risk factor surveillance system, we included individuals who reported a chronic cardiovascular condition. Weighted multivariable logistic regression analyses were used to explore the association between domains of mental health and measures of healthcare access including delaying medical care, > 1 year since last routine checkup, lack of a primary care physician (PCP), and cost-related medication nonadherence (CRMNA). Results. Among 1,747, 397 participants, 27% had a chronic cardiovascular condition, 12% had clinical depression, and 12% had poor mental health. Those with poor mental health (OR 3.20 [3.08 – 3.33]) and clinical depression (OR 2.43 [2.35 – 2.52]) were more likely to report delays in medical care.  Those with greater stress frequency (OR 8.47 [6.84 -10.49] stressed all of the time), lower levels of emotional support received (OR 3.07 [2.21 – 4.26] rarely get needed emotional support), and greater life dissatisfaction (6.66 [4.14 – 10.70] very dissatisfied) reported greater delays in medical care. Conclusions. Individuals with poor mental health have greater difficulty accessing medical care independent of socioeconomic variables

Quick separation in chordal and split graphs

In this paper we study two classical cut problems, namely Multicut and Multiway Cut on chordal graphs and split graphs. In the Multicut problem, the input is a graph G, a collection of ℓ vertex pairs (si, ti), i ∈ [ℓ], and a positive integer k and the goal is to decide if there exists a vertex subset S ⊆ V (G) \ {si, ti: i ∈ [ℓ]} of size at most k such that for every vertex pair (si, ti), si and ti are in two different connected components of G − S. In Unrestricted Multicut, the solution S can possibly pick the vertices in the vertex pairs {(si, ti): i ∈ [ℓ]}. An important special case of the Multicut problem is the Multiway Cut problem, where instead of vertex pairs, we are given a set T of terminal vertices, and the goal is to separate every pair of distinct vertices in T × T. The fixed parameter tractability (FPT) of these problems was a long-standing open problem and has been resolved fairly recently. Multicut and Multiway Cut now admit algorithms with running times 2O(k3)nO(1) and 2knO(1), respectively. However, the kernelization complexity of both these problems is not fully resolved: while Multicut cannot admit a polynomial kernel under reasonable complexity assumptions, it is a well known open problem to construct a polynomial kernel for Multiway Cut. Towards designing faster FPT algorithms and polynomial kernels for the above mentioned problems, we study them on chordal and split graphs. In particular we obtain the following results. 1. Multicut on chordal graphs admits a polynomial kernel with O(k3ℓ7) vertices. Multiway Cut on chordal graphs admits a polynomial kernel with O(k13) vertices. 2. Multicut on chordal graphs can be solved in time min{O(2k · (k3 + ℓ) · (n + m)), 2O(ℓ log k) · (n + m) + ℓ(n + m)}. Hence Multicut on chordal graphs parameterized by the number of terminals is in XP. 3. Multicut on split graphs can be solved in time min{O(1.2738k+kn+ℓ(n+m), O(2ℓ·`·(n+m))}. Unrestricted Multicut on split graphs can be solved in time O(4ℓ · ℓ · (n + m)). © Nathalie Bertrand; licensed under Creative Commons License CC-BY 45th International Symposium on Mathematical Foundations of Computer Science (MFCS 2020)

Association of metabolic syndrome with obesity measures, metabolic profiles, and intake of dietary fatty acids in people of Asian Indian origin

Objective: The present community-based cross-sectional study was aimed to examine the association of metabolic syndrome (MS) with obesity measures, metabolic profi les, and intake of dietary fatty acids in Asian Indian population. Patients and Methods: A total of 350 adult (30 years and above) individuals (184 males and 166 females) inhabiting in and around Kolkata, India participated in this study. MS was defi ned using the protocol specifi cally designed for Asian Indian population. Results: The prevalence of MS in the study was 31.4%. The prevalence was signifi cantly higher (P < 0.01) in females (48.2%) as compared to males (16.3%). It was observed that males without MS had signifi cantly higher mean waist circumference (WC P < 0.05); waist– hip ratio (WHR; P < 0.001); triglyceride (TG; P < 0.05); very low density lipoprotein cholesterol (VLDLc; P < 0.05) and fasting blood glucose (FBG; P < 0.01) as compared to females without MS. Signifi cant differences were also observed for dietary intake of total fatty acids (TFA; P < 0.001); saturated fatty acids (SFA; P < 0.001) and polyunsaturated fatty acids (PUFA; P < 0.001) between individuals with and without MS. However, no signifi cant association was observed in individuals with MS after controlling for age and sex. On the other, WC and body mass index (BMI) had signifi cant correlation with SFA: mono unsaturated fatty acids (MUFA; P < 0.01) in individuals without MS even after controlling for age and sex. Conclusion: It seem reasonabl

2-Approximating Feedback Vertex Set in Tournaments

A tournament is a directed graph T such that every pair of vertices is connected by an arc. A feedback vertex set is a set S of vertices in T such that T − S is acyclic. We consider the Feedback Vertex Set problem in tournaments. Here, the input is a tournament T and a weight function w : V(T) → N, and the task is to find a feedback vertex set S in T minimizing w(S) = ∑v∈S w(v). Rounding optimal solutions to the natural LP-relaxation of this problem yields a simple 3-approximation algorithm. This has been improved to 2.5 by Cai et al. [SICOMP 2000], and subsequently to 7/3 by Mnich et al. [ESA 2016]. In this article, we give the first polynomial time factor 2-approximation algorithm for this problem. Assuming the Unique Games Conjecture, this is the best possible approximation ratio achievable in polynomial time

Inflammatory Myofibroblastic Tumor of the Right Atrium

Cardiac inflammatory myofibroblastic tumor (IMT) is a rare entity and is associated with distinct clinical, pathological and molecular features. The clinical behavior, natural history, biological potential, management and prognosis of such tumors are unclear. We present herewith an adolescent girl who presented with similar entity involving the junction of the right atrium and the inferior vena cava (IVC) in association with thrombocytosis and IVC thrombosis leading to obstruction of blood flow. Diagnostic tools included imaging and immuno-histopathology studies. Surgical management included resection of the tumor and thrombo-embolectomy of the IVC under cardiopulmonary bypass. This case is unique due to association of complete obstruction of IVC caused by the strategic location of the tumor, thrombosis of vena cava and association of thrombocytosis. These features have not been reported yet in relation to the cardiac IMT. This report will help in better understanding and management of similar cases in terms of planning cannulation of femoral veins or application of total hypothermic circulatory arrest during cardiopulmonary bypass and prompt us to look for recurrence or metastasis during follow up using echocardiography and laboratory investigations. The possibility of IMT should be kept in the differential diagnosis of cardiac tumors especially in children and adolescents