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

New primary renal diagnosis codes for the ERA-EDTA

The European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry has produced a new set of primary renal diagnosis (PRD) codes that are intended for use by affiliated registries. It is designed specifically for use in renal centres and registries but is aligned with international coding standards supported by the WHO (International Classification of Diseases) and the International Health Terminology Standards Development Organization (SNOMED Clinical Terms). It is available as supplementary material to this paper and free on the internet for non-commercial, clinical, quality improvement and research use, and by agreement with the ERA-EDTA Registry for use by commercial organizations. Conversion between the old and the new PRD codes is possible. The new codes are very flexible and will be actively managed to keep them up-to-date and to ensure that renal medicine can remain at the forefront of the electronic revolution in medicine, epidemiology research and the use of decision support systems to improve the care of patients

Entangled light in transition through the generation threshold

We investigate continuous variable entangling resources on the base of two-mode squeezing for all operational regimes of a nondegenerate optical parametric oscillator with allowance for quantum noise of arbitrary level. The results for the quadrature variances of a pair of generated modes are obtained by using the exact steady-state solution of Fokker-Planck equation for the complex P-quasiprobability distribution function. We find a simple expression for the squeezed variances in the near-threshold range and conclude that the maximal two-mode squeezing reaches 50% relative to the level of vacuum fluctuations and is achieved at the pump field intensity close to the generation threshold. The distinction between the degree of two-mode squeezing for monostable and bistable operational regimes is cleared up.Comment: 7 pages, 4 figures; Content changed: more details added to the discussion. To be published in Phys. Rev.

Spin glass behavior of frustrated 2-D Penrose lattice in the classical planar model

Via extensive Monte Carlo studies we show that the frustrated XY Hamiltonian on a 2-D Penrose lattice admits of a spin glass phase at low temperature. Studies of the Edwards-Anderson order parameter, spin glass susceptibility, and local (linear) susceptibility point unequivocally to a paramagnetic to spin glass transition as the temperature is lowered. Specific heat shows a rounded peak at a temperature above the spin glass transition temperature, as is commonly observed in spin glasses. Our results strongly suggest that the critical point exponents are the same as obtained by Bhatt and Young in the ${\pm}J$ Ising model on a square lattice. However, unlike in the latter case, the critical temperature is clearly finite (nonzero). The results imply that a quasiperiodic 2-D array of superconducting grains in a suitably chosen transverse magnetic field should behave as a superconducting glass at low temperature.Comment: RevTex, 4 pages Including 4 figures. To appear in the June 1 1996 issue of Phys. Rev. B (Rapid Communications). Revised/replaced edition contains an erratum at the end of the paper, also to appear in Phys. Rev.

Security of quantum cryptography using balanced homodyne detection

In this paper we investigate the security of a quantum cryptographic scheme which utilizes balanced homodyne detection and weak coherent pulse (WCP). The performance of the system is mainly characterized by the intensity of the WCP and postselected threshold. Two of the simplest intercept/resend eavesdropping attacks are analyzed. The secure key gain for a given loss is also discussed in terms of the pulse intensity and threshold.Comment: RevTeX4, 8pages, 7 figure

Axions and saxions from the primordial supersymmetric plasma and extra radiation signatures

We calculate the rate for thermal production of axions and saxions via scattering of quarks, gluons, squarks, and gluinos in the primordial supersymmetric plasma. Systematic field theoretical methods such as hard thermal loop resummation are applied to obtain a finite result in a gauge-invariant way that is consistent to leading order in the strong gauge coupling. We calculate the thermally produced yield and the decoupling temperature for both axions and saxions. For the generic case in which saxion decays into axions are possible, the emitted axions can constitute extra radiation already prior to big bang nucleosynthesis and well thereafter. We update associated limits imposed by recent studies of the primordial helium-4 abundance and by precision cosmology of the cosmic microwave background and large scale structure. We show that the trend towards extra radiation seen in those studies can be explained by late decays of thermal saxions into axions and that upcoming Planck results will probe supersymmetric axion models with unprecedented sensitivity.Comment: 16 pages, 7 figures; v2: references added, minor clarifying additions, matches published versio

Financial stress and outcomes after acute myocardial infarction

Little is known about the association between financial stress and health care outcomes. Our objective was to examine the association between self-reported financial stress during initial hospitalization and long-term outcomes after acute myocardial infarction (AMI).We used prospective registry evaluating myocardial infarction: Event and Recovery (PREMIER) data, an observational, multicenter US study of AMI patients discharged between January 2003 and June 2004. Primary outcomes were disease-specific and generic health status outcomes at 1 year (symptoms, function, and quality of life (QoL)), assessed by the Seattle Angina Questionnaire [SAQ] and Short Form [SF]-12. Secondary outcomes included 1-year rehospitalization and 4-year mortality. Hierarchical regression models accounted for patient socio-demographic, clinical, and quality of care characteristics, and access and barriers to care.Among 2344 AMI patients, 1241 (52.9%) reported no financial stress, 735 (31.4%) reported low financial stress, and 368 (15.7%) reported high financial stress. When comparing individuals reporting low financial stress to no financial stress, there were no significant differences in post-AMI outcomes. In contrast, individuals reporting high financial stress were more likely to have worse physical health (SF-12 PCS mean difference -3.24, 95% Confidence Interval [CI]: -4.82, -1.66), mental health (SF-12 MCS mean difference: -2.44, 95% CI: -3.83, -1.05), disease-specific QoL (SAQ QoL mean difference: -6.99, 95% CI: -9.59, -4.40), and be experiencing angina (SAQ Angina Relative Risk = 1.66, 95%CI: 1.19, 2.32) at 1 year post-AMI. While 1-year readmission rates were increased (Hazard Ratio = 1.50; 95%CI: 1.20, 1.86), 4-year mortality was no different.High financial stress is common and an important risk factor for worse long-term outcomes post-AMI, independent of access and barriers to care.Sachin J. Shah, Harlan M. Krumholz, Kimberly J. Reid, Saif S. Rathore, Aditya Mandawat, John A. Spertus, Joseph S. Ros

Effect of mill type on the size reduction and phase transformation of gamma alumina

The influence of stress modes and comminution conditions on the effectiveness of particle size reduction of a common catalyst support; γ-Alumina is examined through a comparative assessment of three different mill types. Air jet milling is found to be the most effective in reducing particle size from a d90 of 37 µm to 2.9 µm compared to planetary ball milling (30.2 µm) and single ball milling (10.5 µm). XRD and TEM studies confirm that the planetary ball mill causes phase transformation to the less desired α-Alumina resulting in a notable decrease in surface area from 136.6 m2/g to 82.5 m2/g as measured by the BET method. This is consistent with the large shear stresses under high shear rates prevailing in the planetary ball mill when compared to the other mill types. These observations are consistent with a shear-induced phase transformation mechanism brought about by slip on alternate close packed oxygen layers from a cubic close packed to a hexagonal close packed structure

Tackling transition:the value of peer mentoring

This paper is aimed at those interested in the promotion of student retention in higher education; particularly those with an interest in peer mentoring as a means of student support. It critically discusses the results of an exploratory study analysing the perceptions of peer mentors and mentees within five universities in the United Kingdom. The aim of the study was to analyse how student peer mentoring can aid transition into university by focusing specifically on how senior students can support their junior counterparts in their first year at university. The paper discusses the results of a survey which was completed by 329 student peer mentors and mentees. Focusing on the benefits and outcomes of participation in Mentoring Programmes, the survey was distinctive in that it asked mentors and mentees similar questions. From a theoretical perspective, the paper contributes to debates about peer support in higher education showing that participation in such programmes can have positive outcomes from both social and pedagogic perspectives. Practically speaking, the results have important implications for Higher Education Institutions as the research highlights the importance of putting into place formally structured Peer Mentoring Programmes which facilitate student support at a time when new students are most at risk of ‘dropping out’