The association of cognitive and somatic depressive symptoms with depression recognition and outcomes after myocardial infarction

BACKGROUND: Among patients with acute myocardial infarction (AMI), depression is both common and under-recognized. The association of different manifestations of depression, somatic and cognitive, with depression recognition and long-term prognosis is poorly understood. METHODS AND RESULTS: Depression was confirmed in 481 AMI patients enrolled from 21 sites during their index hospitalization with a Patient Health Questionnaire (PHQ-9) score ≥10. Within the PHQ-9, separate somatic and cognitive symptom scores were derived and the independent association between these domains and the clinical recognition of depression, as documented in the medical records, was evaluated. In a separate multisite AMI registry of 2,347 patients, the association between somatic and cognitive depressive symptoms and 4-year all-cause mortality and 1-year all-cause rehospitalization was evaluated. Depression was clinically recognized in 29% (n=140) of patients. Cognitive depressive symptoms (Relative Risk [RR] per Standard Deviation [SD] increase=1.14; 95% confidence interval [CI] 1.03–1.26; p=0.01) were independently associated with depression recognition, while the association for somatic symptoms and recognition (RR=1.04; 95% CI 0.87–1.26; p=0.66) was not significant. However, unadjusted Cox regression analyses found that only somatic depressive symptoms were associated with 4-year mortality (Hazard Ratio [HR] per SD increase=1.22; 95% confidence interval [CI] 1.08–1.39) or 1-year rehospitalization (HR=1.22; 95%CI 1.11–1.33) while cognitive manifestations were not (HR for mortality=1.01; 95%CI 0.89–1.14; HR for rehospitalization=1.01; 95%CI 0.93–1.11). After multivariable adjustment, the association between somatic symptoms and rehospitalization persisted (HR=1.16; 95% CI:1.06–1.27; p=0.01) but was attenuated for mortality (HR=1.07; 95% CI:0.94–1.21; p=0.30). CONCLUSIONS: Depression after AMI was recognized in fewer than 1 in 3 patients. Although cognitive symptoms were associated with recognition of depression, somatic symptoms were associated with long-term outcomes. Comprehensive screening and treatment of both somatic and cognitive symptoms may be necessary to optimize depression recognition and treatment in AMI patients

The polytrauma clinical triad in patients with chronic pain after motor vehicle collision

Background: The polytrauma clinical triad (PCT) is a complex disorder composed of three comorbid diagnoses of chronic pain, post-traumatic stress disorder (PTSD), and postconcussion syndrome (PCS). PCT has been documented in veterans returning from deployment, but this is the first report on PCT prevalence in nonmilitary personnel after a motor vehicle collision (MVC). Methods: Data were drawn from routine intake assessments completed by 71 patients referred to a community-based clinic for chronic pain management. All patients completed the posttraumatic stress disorder checklist for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (PCL-5), and Rivermead Post-Concussion Symptoms Questionnaire (RPQ) during a standardized intake assessment. An additional modified RPQ score was derived to address previously reported symptom overlap between PCS and chronic pain. Results: Standard and modified RPQ scores yielded PCS prevalence rates of 100% and 54.9% in our sample, respectively. Results suggest that a modified RPQ score, limited to visual and vestibular symptoms, may be more useful PCS screening criteria in patients with chronic pain. PTSD screening criteria on the PCL-5 were met by 85.9% of the patients. More than half of the patients referred for chronic pain after MVC met criteria for PCT (52.1%). Patients who met PCT criteria reported worse headache, overall pain, and sleep quality outcomes. Conclusion: Among patients in our sample with chronic pain after MVC, more than half met criteria for PCT. A modified approach to RPQ scoring limited to visual and vestibular symptoms may be required to screen for PCS in these patients

Assessing inter-beach differences in semi-terrestrial arthropod assemblages on Maltese pocket sandy beaches (Central Mediterranean)

The distinctiveness of macrofaunal assemblages on different sandy beaches in the Maltese Islands was previously suggested by different single-season studies. A multi-seasonal sampling programme using pitfall trapping was implemented on four Maltese beaches to test the occurrence of this phenomenon. A total of 29,302 individuals belonging to 191 species were collected over a 2-year period, during which the beaches were sampled once per calendar season. A total of 77 species were recorded from single Maltese beaches only, of which nine were psammophiles. Non-metric multidimensional scaling analyses of pitfall trap species-abundance data resulted in a weak separation pattern, with samples grouping mainly in terms of beach and island rather than in terms of season or year of sampling, No physical variable could conclusively explain these patterns. It is concluded that although operating on Maltese beaches, macrofaunal assemblage distinctiveness is weaker than originally thought and can be attributed to the presence/absence or abundance of just a few psammophilic species. It is postulated that this phenomenon may be related to the ‘pocket beach’ nature of Maltese beaches, where headlands on either side of the beach to a large extent prevent the occurrence of longshore currents, resulting in semi-isolation of the populations of psammophilic species. A large number of single-beach records reported in this study highlight the high degree of beta diversity and spatial heterogeneity of Maltese beaches, and the conservation importance of the individual beach macrofaunal assemblages.peer-reviewe

Attentive Learning of Sequential Handwriting Movements: A Neural Network Model

Defense Advanced research Projects Agency and the Office of Naval Research (N00014-95-1-0409, N00014-92-J-1309); National Science Foundation (IRI-97-20333); National Institutes of Health (I-R29-DC02952-01)

Monkey-based Research on Human Disease: The Implications of Genetic Differences

Assertions that the use of monkeys to investigate human diseases is valid scientifically are frequently based on a reported 90–93% genetic similarity between the species. Critical analyses of the relevance of monkey studies to human biology, however, indicate that this genetic similarity does not result in sufficient physiological similarity for monkeys to constitute good models for research, and that monkey data do not translate well to progress in clinical practice for humans. Salient examples include the failure of new drugs in clinical trials, the highly different infectivity and pathology of SIV/HIV, and poor extrapolation of research on Alzheimer’s disease, Parkinson’s disease and stroke. The major molecular differences underlying these inter-species phenotypic disparities have been revealed by comparative genomics and molecular biology — there are key differences in all aspects of gene expression and protein function, from chromosome and chromatin structure to post-translational modification. The collective effects of these differences are striking, extensive and widespread, and they show that the superficial similarity between human and monkey genetic sequences is of little benefit for biomedical research. The extrapolation of biomedical data from monkeys to humans is therefore highly unreliable, and the use of monkeys must be considered of questionable value, particularly given the breadth and potential of alternative methods of enquiry that are currently available to scientists

Measurement of the νμcharged current quasielastic cross section on carbon with the T2K on-axis neutrino beam

We report a measurement of the νμcharged current quasielastic cross-sections on carbon in the T2K on-axis neutrino beam. The measured charged current quasielastic cross-sections on carbon at mean neutrino energies of 1.94 GeVand 0.93 GeVare (11.95 ± 0.19(stat)-1.47+1.82(syst)) × 10-39cm2/neutron, and (10.64 ± 0.37(stat)-1.65+2.03(syst)) × 10-39cm2/neutron, respectively. These results agree well with the predictions of neutrino interaction models. In addition, we investigated the effects of the nuclear model and the multi-nucleon interaction

Measurement of the electron neutrino charged-current interaction rate on water with the T2K ND280 π0 detector

This paper presents a measurement of the charged current interaction rate of the electron neutrino beam component of the beam above 1.5 GeV using the large fiducial mass of the T2K π0 detector. The predominant portion of the νe flux (∼85%) at these energies comes from kaon decays. The measured ratio of the observed beam interaction rate to the predicted rate in the detector with water targets filled is 0.89±0.08(stat)±0.11(sys), and with the water targets emptied is 0.90±0.09(stat)±0.13(sys). The ratio obtained for the interactions on water only from an event subtraction method is 0.87±0.33(stat)±0.21(sys). This is the first measurement of the interaction rate of electron neutrinos on water, which is particularly of interest to experiments with water Cherenkov detectors

Crises and collective socio-economic phenomena: simple models and challenges

Financial and economic history is strewn with bubbles and crashes, booms and busts, crises and upheavals of all sorts. Understanding the origin of these events is arguably one of the most important problems in economic theory. In this paper, we review recent efforts to include heterogeneities and interactions in models of decision. We argue that the Random Field Ising model (RFIM) indeed provides a unifying framework to account for many collective socio-economic phenomena that lead to sudden ruptures and crises. We discuss different models that can capture potentially destabilising self-referential feedback loops, induced either by herding, i.e. reference to peers, or trending, i.e. reference to the past, and account for some of the phenomenology missing in the standard models. We discuss some empirically testable predictions of these models, for example robust signatures of RFIM-like herding effects, or the logarithmic decay of spatial correlations of voting patterns. One of the most striking result, inspired by statistical physics methods, is that Adam Smith's invisible hand can badly fail at solving simple coordination problems. We also insist on the issue of time-scales, that can be extremely long in some cases, and prevent socially optimal equilibria to be reached. As a theoretical challenge, the study of so-called "detailed-balance" violating decision rules is needed to decide whether conclusions based on current models (that all assume detailed-balance) are indeed robust and generic.Comment: Review paper accepted for a special issue of J Stat Phys; several minor improvements along reviewers' comment