bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Posttraumatic Stress Disorder, Depression, Anxiety, and Resiliency Within the Unique Population of Spontaneous Coronary Artery Dissection Survivors
Authors: Johnson Alexis K. , Hayes Sharonne N. , Sawchuk Craig , Johnson Matthew P. , Best Patricia J. , Gulati Rajiv , Tweet Marysia S. 
Published: April 2020

Background

Mental health after spontaneous coronary artery dissection (
SCAD
), a cause of myocardial infarction in young women, remains largely unexplored. We assessed the prevalence and severity of psychiatric symptoms after
SCAD
.

Methods and Results

Individuals with confirmed
SCAD
who consented to the Mayo Clinic “Virtual” Multicenter
SCAD
Registry were sent the Posttraumatic Stress Disorder Diagnostic Scale for
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
, Patient Health Questionnaire‐9, Generalized Anxiety Disorder‐7, Anxiety Sensitivity Index, Connor‐Davidson Resilience Scale, 36‐Item Short‐Form Health Survey, and an
SCAD
‐specific questionnaire. Among 782 patients contacted, 512 surveys were returned. Most respondents were women (97.5%), with median age at time of
SCAD
and survey completion of 47 and 52 years, respectively. Eighty‐two percent had at least one trauma, with mild or more posttraumatic stress disorder symptoms in 28%. Symptoms of anxiety and depression were observed in 41% and 32%, respectively. On multivariable analysis, those of younger age at first
SCAD
and low resiliency scored higher on measures of trauma, anxiety, and depression. Those with higher anxiety sensitivity had more severe anxiety and posttraumatic stress disorder symptoms. Emotional and social quality of life was higher in those with high resiliency scores. Time from
SCAD
event to survey completion was associated with lower Generalized Anxiety Disorder‐7 score severity.

Conclusions

Survivors of
SCAD
have significant rates of posttraumatic stress disorder, depression, and anxiety, which are associated with lower quality of life specifically among those with lower resiliency. Given the prevalence and potential impact, screening and treatment for the psychological distress is advised. Behavioral interventions targeted toward resiliency training may be beneficial for this patient population.
Positive Health Beliefs and Blood Pressure Reduction in the DESERVE Study
Authors: Goldmann Emily , Jacoby Rachelle , Finfer Erica , Appleton Noa , Parikh Nina S. , Roberts Eric T. , Boden‐Albala Bernadette 
Published: April 2020

Background

There is growing recognition that positive health beliefs may promote blood pressure (BP) reduction, which is critical to stroke prevention but remains a persistent challenge. Yet, studies that examine the association between positive health beliefs and
BP
among stroke survivors are lacking.

Methods and Results

Data came from the DESERVE (Discharge Educational Strategies for Reduction of Vascular Events) study, a randomized controlled trial of a skills‐based behavioral intervention to reduce vascular risk in a multiethnic cohort of 552 transient ischemic attack and mild/moderate stroke patients in New York City. The exposure was perception that people can protect themselves from having a stroke (ie, prevention self‐efficacy) at baseline. The association between systolic BP (
SBP
) reduction at 12‐month follow‐up and self‐efficacy was examined using linear regression adjusted for key confounders, overall and stratified by age, sex, race/ethnicity, and intervention trial arm. Approximately three quarters endorsed self‐efficacy. These participants had, on average, 5.6 mm Hg greater
SBP
reduction compared with those who did not endorse it (95%
CI
, 0.5–10.7 mm Hg;
P
=0.032). Self‐efficacy was significantly associated with greater
SBP
reduction, particularly among female versus male, younger versus older, and Hispanic versus non‐Hispanic white patients. Sensitivity analysis adjusting for baseline
SBP
instead of elevated
BP
yielded no association between self‐efficacy and
SBP
reduction, but showed sex differences in this association (women: β=5.3; 95%
CI
, −0.2 to 10.8;
P
=0.057; men: β=−3.3; 95%
CI
, −9.4 to 2.9;
P
=0.300; interaction
P
=0.064).

Conclusions

Self‐efficacy was linked with greater
SBP
reduction among female stroke survivors. Targeted strategies to improve health beliefs after stroke may be important for risk factor management.

REGISTRATION

URL
:
https://www.clini​caltr​ials.gov
; Unique identifier:
NCT
01836354.
Prevalence and Prognostic Association of a Clinical Diagnosis of Depression in Adult Congenital Heart Disease: Results of the Boston Adult Congenital Heart Disease Biobank
Authors: Carazo Matthew R. , Kolodziej Meghan S. , DeWitt Elizabeth S. , Kasparian Nadine A. , Newburger Jane W. , Duarte Valeria E. , Singh Michael N. , Opotowsky Alexander R. 
Published: April 2020

Background

In adults with acquired heart disease, depression is common and associated with adverse outcomes. Depression may also be important in adults with congenital heart disease (
CHD
).

Methods and Results

We conducted a cohort study of outpatients with
CHD,
aged ≥18 years, enrolled in a prospective biobank between 2012 and 2017. Clinical data were extracted from medical records. Survival analysis assessed the relationship between depression, defined by a history of clinical diagnosis of major depression, with all‐cause mortality and a composite outcome of death or nonelective cardiovascular hospitalization. A total of 1146 patients were enrolled (age, 38.5±13.8 years; 49.6% women). Depression had been diagnosed in 219 (prevalence=19.1%), and these patients were more likely to have severely complex
CHD
(41.3% versus 33.7%;
P
=0.028), cyanosis (12.1% versus 5.7%;
P
=0.003), and worse functional class (≥
II
; 33.3% versus 20.4%;
P
<0.0001), and to be taking antidepressant medication at time of enrollment (68.5% versus 5.7%;
P
<0.0001). Depression was associated with biomarkers indicative of inflammation (hsCRP [high‐sensitivity C‐reactive protein], 1.71 [25th–75th percentile, 0.82–4.47] versus 1.10 [0.45–2.40];
P
<0.0001) and heart failure (NT‐proBNP [N‐terminal pro‐B‐type natriuretic peptide], 190 [92–501] versus 111 [45–264];
P
<0.0001). During follow‐up of 605±547 days, 137 participants (12.0%) experienced the composite outcome, including 33 deaths (2.9%). Depression was associated with increased risk for both all‐cause mortality (multivariable hazard ratio, 3.0; 95%
CI
, 1.4–6.4;
P
=0.005) and the composite outcome (multivariable hazard ratio, 1.6; 95% CI, 1.1–2.5;
P
=0.025), adjusting for age, sex, history of atrial arrhythmia, systolic ventricular function,
CHD
complexity, and corrected QT interval.

Conclusions
In adults with CHD, major depression is associated with impaired functional status, heart failure, systemic inflammation, and increased risk for adverse outcomes.
From Tear to Fear: Posttraumatic Stress Disorder in Patients With Acute Type A Aortic Dissection
Authors: Pasadyn Selena R. , Roselli Eric E. , Artis Amanda S. , Pasadyn Cassandra L. , Phelan Dermot , Hurley Karen , Desai Milind Y. , Blackstone Eugene H. 
Published: April 2020

Background
Acute type A aortic dissection presents with abrupt onset of pain that requires emergency surgery. However, minimal research exists on posttraumatic stress disorder (PTSD) in survivors. We aimed to quantify the prevalence and describe characteristics of PTSD in patients following dissection.

Methods and Results

A total of 295 adult survivors of surgical dissection with an email on file were administered a cross‐sectional online survey about their dissection experience; 137 returned questionnaires, and 129 (94%) responded to the 4‐item Primary Care PTSD portion of the survey that was part of a larger lifestyle survey designed to study survivors of aortic dissection and surgery. In addition to the PTSD screening, it inquired about current sexual activity, exercise habits, and employment within the preceding 30 days. At a median of 6.8 years (quartile 1=2.6, quartile 3=8.9 years) after dissection, 23% of patients (30/129) screened positive for PTSD, with 44% (57/129) stating that within the past month they felt constantly on guard or watchful or were easily startled. Of those who screened positive and matched to their electronic medical record (n=27), only 2 (7.4%) had been tested and clinically diagnosed with PTSD. Patients who screened positive for PTSD were more likely to report limited current sexual activity than those who did not (odds ratio, 5.3; 95% CI, 1.9–15 [
P=
0.0006]).

Conclusions
PTSD is an important mental health consideration in aortic dissection survivors. Physicians should screen these patients for PTSD at follow‐up visits to identify those who test positive and refer them for further testing and treatment, such as trauma‐focused psychotherapy or medication.
Youth Who Achieve Upward Socioeconomic Mobility Display Lower Psychological Distress But Higher Metabolic Syndrome Rates as Adults: Prospective Evidence From Add Health and MIDUS
Authors: Miller Gregory E. , Chen Edith , Yu Tianyi , Brody Gene H. 
Published: April 2020

Background
People with higher socioeconomic status generally enjoy better cardiovascular health across the life course than those with lower status. However, recent studies of upward mobility, where a child goes on to achieve higher socioeconomic status than his or her parents, suggest that it entails a tradeoff between better psychological well‐being and worse cardiometabolic health. In this study, we consider further evidence of this tradeoff in 2 multidecade studies, asking how upward income mobility relates to subsequent perceived stress, depressive symptoms, and metabolic syndrome. We ask parallel questions about downward mobility. Finally, given shifting patterns of mobility in recent generations, we also consider whether mobility's association with health outcomes differs for individuals born in the middle and later parts of the 20th century.

Methods and Results
We analyzed prospective data from Add Health (National Longitudinal Study of Adolescent Health; N=7542) and MIDUS (Midlife in the United States Study; N=1877). In both studies, evidence of the tradeoff was observed. Upward mobility presaged lower perceived stress and fewer depressive symptoms, in combination with higher metabolic syndrome rates. In contrast, downward mobility presaged worse outcomes on all health indicators. The magnitude of the mobility–health associations was similar across cohorts.

Conclusions
These findings provide evidence that upward income mobility is associated with a tradeoff between well‐being and cardiometabolic health. The similarity of the findings across cohorts suggests that this tradeoff is a generalized consequence of ascending the socioeconomic hierarchy, at least for Americans born in the middle and later parts of the 20th century.
Synergetic Use of the WSR-88D Radars, GOES-R Satellites, and Lightning Networks to Study Microphysical Characteristics of Hurricanes
Authors: Hu Jiaxi , Rosenfeld Daniel , Ryzhkov Alexander , Zhang Pengfei 
Published: April 2020

AbstractThis study analyzes the microphysics and precipitation pattern of Hurricanes Harvey (2017) and Florence (2018) in both the eyewall and outer rainband regions. From the retrievals by a satellite red–green–blue scheme, the outer rainbands show a strong convective structure while the inner eyewall has less convective vigor (i.e., weaker upper-level reflectivities and electrification), which may be related to stronger vertical wind shear that hinders fast vertical motions. The WSR-88D column-vertical profiles further confirm that the outer rainband clouds have strong vertical motion and large ice-phase hydrometeor formation aloft, which correlates well with 3D Lightning Mapping Array source counts in height and time. From the results from this study, it is determined that the inner eyewall region is dominated by warm rain, whereas the external rainband region contains intense mixed-phase precipitation. External rainbands are defined here as those that reside outside of the main hurricane circulation, associated with surface tropical storm wind speeds. The synergy of satellite and radar dual-polarization parameters is instrumental in distinguishing between the key microphysical features of intense convective rainbands and the warm-rain-dominated eyewall regions within the hurricanes. Substantial amounts of ice aloft and intense updrafts in the external rainbands are indicative of heavy surface precipitation, which can have important implications for severe weather warnings and quantitative precipitation forecasts. The novel part of this study is to combine ground-based radar measurement with satellite observations to study hurricane microphysical structure from surface to cloud top so as to fill in the gaps between the two observational techniques.
One, No One, and One Hundred Thousand: The Paradigm of the Z–R Relationship
Authors: Ignaccolo Massimiliano , De Michele Carlo 
Published: April 2020

AbstractThe Z–R relationship is a scaling-law formulation, Z = ARb, connecting the radar reflectivity Z to the rain rate R. However, more than 100 Z–R relationships, with different values of the parameters, have been reported in literature. This abundance of relationships is in itself a strong indication that no one “physical” relationship exists, a state of affairs that we find similar to that of the protagonist of Luigi Pirandello’s novel One, No One and One Hundred Thousand. Nevertheless the “elevation” of a simple linear fit in the (logR, logZ) space to the role of “scaling law” is such a widespread tenet in literature that it eclipses the simple realization that the abundance of different intercepts and slopes reflects the inhomogeneous nature of rain, and, in ultimate analysis, the statistical variability existing between the number of drops and drop size distribution. Here, we “eliminate” the contribution of the number of drops by rescaling both reflectivity and rainfall rate to per unit drop variables, (Z, R) → (z, r), so that the remaining variability is due only to the variability of the drop size distribution. We use a worldwide database of disdrometer data to show that for the rescaled variables (z, r) only “one,” albeit approximate, scaling law exists.
Shapes and Fall Speeds of Freezing and Frozen Raindrops
Authors: Rahman Kalimur , Testik Firat Y. 
Published: April 2020

AbstractThis study investigates the shapes and fall speeds of freezing and frozen raindrops through field observations using an instrument called the high-speed optical disdrometer (HOD) that we developed recently. Our field observations showed that while the shapes of all of the observed freezing raindrops and a portion of the frozen raindrops (39% of the frozen raindrops that are larger than 1.0 mm in volume equivalent diameter D) resemble the shapes of warm raindrops, majority of frozen raindrops (61% of the frozen raindrops with D > 1.0 mm) exhibited a distinct feature such as a spicule, bulge, cavity, or aggregation. Field observations of axis ratios (i.e., ratio of the vertical to horizontal chord) and fall speeds were compared with the predictions of available models. Separate empirical axis ratio parameterizations were developed for the freezing and frozen raindrops using the HOD field observations and extensions to an available shape model were also incorporated. For the fall speeds of freezing and frozen raindrops, field observations demonstrated a good agreement with the predictions of the available parameterizations. Frozen raindrops showed a larger scatter of fall speeds around the mean fall speed of a given drop size than those of the freezing raindrops due to the shape variety among the frozen raindrops with the aforementioned distinct features. The drag coefficients for the observed hydrometeors were compared with the predictions of the available drag coefficient models. Separate “drag coefficient–Reynolds number” relationships for freezing and frozen raindrops were developed.
Temporal Bone Encephaloceles: Utility of Preoperative Imaging
Authors: Worrall Douglas M. , Pai Akila , Garneau Jonathan C. , Perez Enrique R. , Cosetti Maura K. , Smouha Eric E. , Wanna George B. 
Published: April 2020

ObjectiveTo determine the diagnostic efficacy and clinical value of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) among patients with suspected temporal bone encephaloceles (TBE).Study DesignRetrospective chart review from 2006 to 2018.SettingTertiary referral center.Subjects and MethodsThe subjects underwent surgery for a clinically suspected TBE or cerebrospinal fluid (CSF) leak. Preoperative imaging test characteristics of CT and MRI, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated for TBE scans and compared with intraoperative findings.ResultsFifty‐seven subjects with otorrhea, middle ear effusion, hearing loss, and/or meningitis with suspected TBE or CSF leak were identified. All had preoperative CT scans, and 61% (35/57) had preoperative MRI scans. Intraoperatively, 37 of 57 patients (65%) were found to have a TBE. CT scans (17% sensitivity, 100% specificity, 100% PPV, 46% NPV) were less sensitive than MRI (58% sensitivity, 100% specificity, 100% PPV, 24% NPV) for detecting TBEs. Furthermore, the time from initial scan to operative repair was significantly longer in those who had a CT followed by MRI scan compared with CT alone or a fused CT‐MRI scan (mean = 68 vs 15 days, respectively; P =. 004).ConclusionCT and MRI provide complementary information that may aid surgical planning. However, imaging cannot always rule out TBE. In cases with high clinical suspicion, surgical confirmation is often required for definitive diagnosis and treatment. The cost of an additional preoperative study should be considered before its use.
UTE T2* mapping of tendinopathic patellar tendons: an MRI reproducibility study
Authors: Agergaard Anne-Sofie , Malmgaard-Clausen Nikolaj M , Svensson Rene B , Nybing Janus D , Boesen Mikael , Kjaer Michael , Magnusson S. Peter , Hansen Philip 
Published: April 2020

Background There is currently a lack of imaging modalities that can be used as a sensitive measure in tendinopathy. Recent findings suggest the applicability of ultra-short echo time (UTE) magnetic resonance imaging (MRI) T2* mapping in tendons, but the reproducibility remains unknown. Purpose To evaluate test–retest reproducibility of UTE MRI T2* mapping of tendinopathic patellar tendons and to evaluate the intra- and inter-observer reproducibility of the measurement. Material and Methods Fifteen patients with chronic patellar tendinopathy were evaluated with UTE MRI twice in a 3.0-T scanner on the same day. Manual segmentation of the patellar tendon was performed by two blinded investigators and automated T2*map reconstruction was performed in custom-made software. Results There was a significant and numerically small difference in test–retest T2* values (T2*meandiff = 0.06 ± 0.07 ms ≈ 3.7%; P = 0.006) with an ICC = 0.91 (95% confidence interval [CI] 0.58–0.98; typical error of 3.0%). The intra- and inter-observer reproducibility showed no significant bias ( P = 0.493 and P = 0.052), and generally substantial reproducibility was demonstrated for T2* (intra-observer ICC = 0.99; 95% CI 0.98–1.00 and inter-observer ICC = 0.99; 95% CI 0.96–1.00, and typical error 1.3% and 1.3%, respectively). Conclusion These data demonstrate a small bias between repeated measurements for UTE T2*, but with a very low associated mean difference (3.7%) between the two tests. The high ICC values and low typical error % demonstrate reproducibility of repeated T2*-mapping sessions. Further, the method showed substantial intra- and inter-observer reproducibility for T2* values proving feasibility for use of UTE T2* mapping in research and clinical practice.
A Multicenter Study of Radiographic Measures Predicting Failure of Arthroscopy in Borderline Hip Dysplasia: Beware of the Tönnis Angle
Authors: McQuivey Kade S. , Secretov Erwin , Domb Benjamin G. , Levy Bruce A. , Krych Aaron J. , Neville Matthew , Hartigan David E. 
Published: April 2020

Background: Hip arthroscopy has been previously demonstrated to be an effective treatment for adult mild hip dysplasia. There are many radiographic parameters used to classify hip dysplasia, but to date few studies have demonstrated which parameters are of most importance for predicting surgical outcomes. Purpose: To identify preoperative radiographic parameters that are associated with poor outcomes in the arthroscopic treatment of adult mild hip dysplasia. Study Design: Case-control study; Level of evidence, 3. Methods: Radiographic analysis was performed in patients with mild hip dysplasia who underwent arthroscopic surgery between 2009 and 2015. Preoperative radiographic measurements included lateral center edge angle, Tönnis angle, neck shaft angle, anterior center edge angle, alpha angle, femoral head extrusion index, and acetabular depth-to-width ratio. Failure was defined as failure to achieve the minimal clinically important difference (MCID) utilizing the modified Harris Hip Score or as the need for secondary operation. The equal variance t test was used to analyze radiographic parameters. Statistical significance was determined using a P value of .05. Results: A total of 373 hips underwent analysis with an average follow-up of 41 months (range, 24-102 months). Of these, 46 hips (12%) required secondary operation, and 95 (25%) failed to meet the MCID. The overall failure rate was 32.4%. There was no single measurement or combination thereof associated with failure to reach the MCID. Higher preoperative Tönnis angles were associated with secondary operation, with a mean of 6.7° (95% CI, 5.3°-8.1°) in the secondary operation group versus 4.8° (95% CI, 4.4°-5.3°) in the nonsecondary operation group ( P = .006). The odds ratio was 1.12 (95% CI, 1.0-1.2; P = .05) per degree increase in Tönnis angle for secondary operation. In patients with a Tönnis angle >10°, 84% required secondary operation. Conclusion: Higher Tönnis angles portend a higher risk for revision surgery. The probability of secondary operation was increased by a magnitude of 1.12 with each degree increase in the Tönnis angle. In patients with a Tönnis angle >10°, 84% required a secondary operation.
Politico-Critical Analysis: A New Research Framework Applied to Psychiatry
Authors: Grech Paulann , Grech Reuben 
Published: April 2020

Background: This article presents a new framework called politico-critical analysis based on the contentions of Foucauldian discourse analysis. The framework was developed to address a number of shortcomings and assess further aspects of importance to fields such as mental health and psychiatry. Aim: To present the main principles and steps of the politico-critical analysis framework and, subsequently, to demonstrate its application to a study on the therapeutic alliance in psychiatry. Method: The rationale and main principles of politico-critical analysis are described and applied to a study, the aim of which was to explore the knowledge and power interface in the therapeutic alliance in a psychiatric hospital in Malta. Data were collected during two phases; in the first phase, 10 care receivers, who were selected through purposeful random sampling in a psychiatric hospital in Malta, were interviewed to explore their perception of the knowledge–power balance in the psychiatric therapeutic alliance. The second phase consisted of collecting data from and analyzing a 60-page sample of medical records pertaining to the study participants interviewed in Phase 1. Results: Four themes emerged from the politico-critical analysis of care receivers’ interviews, depicting the knowledge–power interface within therapeutic alliances. From the analysis of medical records, three themes emerged, which shed light on the knowledge–power matrix within the alliances under study. Conclusions: The politico-critical analytical framework was regarded as a helpful agent in facilitating the exploration of the knowledge–power matrix within the psychiatric therapeutic alliance. Strengths and limitations were acknowledged, and the framework might help guide similar potential research.