Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals. Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements. Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers. Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals

Quantum Correlations in non-Markovian Environments

We have studied the analytical Markovian and non-Markovian dynamics of quantum correlations, such as entanglement, quantum discord and Bell nonlocalities for three noisy qubits. Quantum correlation as measured by quantum discord is found to be immune to death contrary to entanglement and Bell nonlocality for initial GHZ- or W-type mixed states

A need for an augmented review when reviewing rehabilitation research

AbstractThere is a need for additional strategies for performing systematic reviews (SRs) to improve translation of findings into practice and to influence health policy. SRs critically appraise research methodology and determine level of evidence of research findings. The standard type of SR identifies randomized controlled trials (RCTs) as providing the most valid data and highest level of evidence. RCTs are not among the most frequently used research design in disability and health research. RCTs usually measure impairments for the primary research outcome rather than improved function, participation or societal integration. It forces a choice between “validity” and “utility/relevance.” Other approaches have effectively been used to assess the validity of alternative research designs, whose outcomes focus on function and patient-reported outcomes. We propose that utilizing existing evaluation tools that measure knowledge, dissemination and utility of findings, may help improve the translation of findings into practice and health policy

g_{rho sigma gamma} coupling constant in light cone QCD

The coupling constant g_{rho sigma gamma} is determined from light cone QCD sum rules. A comparison of our result with the ones existing in literature is presented.Comment: 7 pp, 2 figures (postscript formatted), LaTex formatte

Drug policy for visceral leishmaniasis: a cost-effectiveness analysis.

OBJECTIVE: To facilitate the choice of the best visceral leishmaniasis (VL) treatment strategy for first-line health services in (VL)-endemic areas, we compared in a formal decision analysis the cost and the cost-effectiveness of the different available options. METHODS: We selected four drug regimens for VL on the basis of frequency of use, feasibility and reported efficacy studies. The point estimates and the range of plausible values of effectiveness and cost were retrieved from a literature review. A decision tree was constructed and the strategy minimizing the cost per death averted was selected. RESULTS: Treatment with amphotericin B deoxycholate was the most effective approach in the baseline analysis and averted 87.2% of all deaths attributable to VL. The least expensive and the most cost-effective treatment was the miltefosine regimen, and the most expensive and the least cost-effective was AmBisome treatment. The cost of drug and medical care are the main determinants of the cost-effectiveness ranking of the alternative schemes. Sensitivity analysis showed that antimonial was competitive with miltefosine in the low-resistance regions. CONCLUSION: In areas with >94% response rates to antimonials, generic sodium stibogluconate remains the most cost-effective option for VL treatment, mainly due to low drug cost. In other regions, miltefosine is the most cost-effective option of treatment, but its use as a first-line drug is limited by its teratogenicity and rapid resistance development. AmBisome in mono- or combination therapy is too expensive to compete in cost-effectiveness with the other regimens

Patient and Physician Predictors of FFR/iFR Utilization in ACS and SIHD

Background Despite guidelines supporting FFR/iFR to guide PCI, these modalities remain underutilized. We sought to characterize factors associated with FFR/iFR use in patients undergoing index PCI for an acute coronary syndrome (ACS) or stable ischemic heart disease (SIHD). Methods ICD-9/10 codes were used to identify patients undergoing PCI and receiving FFR/iFR for an ACS (n=1,042,896) or SIHD (n=255,213) in a Medicare claims database from Jan. 1, 2013-June 30, 2018. Patients with functional/anatomical testing were excluded (5d prior in ACS; 60d prior in SIHD). Individuals with FFR/iFR performed 1-60 days prior to PCI were also excluded to limit analysis to non-staged procedures. Results FFR/iFR was performed the same day as PCI in 5.9% and 11.5% of patients with an ACS and SIHD, respectively. FFR/iFR was less likely to be utilized in patients that were \u3e65 years, male, and in those with diabetes, chronic kidney disease or peripheral arterial disease. Of note, a substantial proportion of physicians were non-utilizers of FFR/iFR in ACS (23.9%) and SIHD (18.6%). Use of FFR/iFR was inversely correlated with years since medical school graduation, with the lowest rate observed in physicians \u3e=31 years since graduation (Table). Conclusion This analysis highlights the underutilization of FFR/iFR. Identification of patient- and physician-factors associated with lower rates of FFR/iFR can be helpful to target areas for improvement to increase implementation of this guideline-recommended intervention

Exploring assessment of medical students\u27 competencies in pain medicine - A review

Introduction: Considering the continuing high prevalence and public health burden of pain, it is critical that medical students are equipped with competencies in the field of pain medicine. Robust assessment of student expertise is integral for effective implementation of competency-based medical education. Objective: The aim of this review was to describe the literature regarding methods for assessing pain medicine competencies in medical students. Method: PubMed, Medline, EMBASE, ERIC, and Google Scholar, and BEME data bases were searched for empirical studies primarily focusing on assessment of any domain of pain medicine competencies in medical students published between January 1997 and December 2016. Results: A total of 41 studies met the inclusion criteria. Most assessments were performed for low-stakes summative purposes and did not reflect contemporary theories of assessment. Assessments were predominantly undertaken using written tests or clinical simulation methods. The most common pain medicine education topics assessed were pain pharmacology and the management of cancer and low-back pain. Most studies focussed on assessment of cognitive levels of learning as opposed to more challenging domains of demonstrating skills and attitudes or developing and implementing pain management plans. Conclusion: This review highlights the need for more robust assessment tools that effectively measure the abilities of medical students to integrate pain-related competencies into clinical practice. A Pain Medicine Assessment Framework has been developed to encourage systematic planning of pain medicine assessment at medical schools internationally and to promote continuous multidimensional assessments in a variety of clinical contexts based on well-defined pain medicine competencies

The effect of seating preferences of the medical students on educational achievement

Background: The seat selection and classroom dynamics may have mutual influence on the student performance and participation in both assigned and random seating arrangement. Purpose: The aim of the study was to understand the influence of seat selection on educational achievement. Methods: The seating positions of the medical students were recorded on an architectural plan during each class session and the means and standard deviations of the students’ locations were calculated in X and Y orientations. The locations of the students in the class were analyzed based on three architectural classifications: interactional zone, distance from the board, and access to the aisles. Final exam scores were used to measure the students’ educational achievement. Results: Our results demonstrate that there is a statistically significant relationship between the student's locations in the class and their attendance and educational achievements. Conclusion: Two factors may effect on educational achievement: student seating in the high interactional zone and minimal changes in seating location. Seating in the high interaction zone was directly associated with higher performance and inversely correlated with the percentage of absences. This observation is consistent with the view that students in the front of the classroom are likely more motivated and interact with the lecturer more than their classmates

Investigation of g_f0-rho-gamma and g_a0-rho-gamma coupling constants in light cone sum rules

We present a calculation of the coupling constant f0-->rho-gamma of and a0-->rho-gamma decays from the point of the light cone QCD sum rules. We estimate the coupling constants g_f0-rho-gamma and g_a0-rho-gamma which are an essential ingredient in the analysis of physical processes involving isoscalar f0(980) and isovector a0(980) mesons.Comment: 15 pages- 5 figure