Daily Affect and Daily Prospective Memory in People after Stroke and Their Partners: The Moderating Role of Resting Heart Rate.

INTRODUCTION: Experimental research suggests that affect may influence prospective memory performance, but real-life evidence on affect-prospective memory associations is limited. Moreover, most studies have examined the valence dimension of affect in understanding the influence of affect on cognitive performance in daily life, with insufficient consideration of the arousal dimension. To maximize ecological validity, the current study examined the relationships between daily affect and daily prospective memory using repeated daily assessments and the role of resting heart rate on these relationships. We examined both valence and arousal of daily affect by categorizing affect into four dimensions: high-arousal positive affect, low-arousal positive affect, high-arousal negative affect, and low-arousal negative affect. METHOD: We examined existing data collected from community-dwelling couples, of which at least one partner had a stroke history. The analytic sample included 111 adults (Mage = 67.46 years, SD = 9.64; 50% women) who provided 1,274 days of data. Among the participants, 58 were living with the effects of a stroke and 53 were partners. Participants completed daily event-based prospective memory tasks (in morning and/or evening questionnaires), reported daily affect in the evening, and wore a wrist-based Fitbit device to monitor resting heart rate over 14 consecutive days. RESULTS: Results from multilevel models show that, within persons, elevated high-arousal negative affect was associated with worse daily prospective memory performance. In addition, lower resting heart rate attenuated the inverse association between high-arousal negative affect and lowered prospective memory performance. We did not find significant associations of high- or low-arousal positive affect and low-arousal negative affect with daily prospective memory. DISCUSSION: Our findings are in line with the resource allocation model and the cue-utilization hypothesis in that high-arousal negative affect is detrimental to daily prospective memory performance. Lower resting heart rate may buffer individuals' prospective memory performance from the influence of high-arousal negative affect. These findings are consistent with the neurovisceral integration model on heart-brain connections, highlighting the possibility that cardiovascular fitness may help maintain prospective memory into older adulthood.

Editorial Perspective: Adverse childhood events causally contribute to mental illness - we must act now and intervene early.

We synthesized critical evidence regarding causal inferences of Adverse Childhood Experience (ACE) exposure and subsequent disease development. Extensive and high-quality research supports causal inferencing and offers a solid ground for policy- and decision-makers interested in translating science into societal action. There is ample evidence supporting system-wide implementation of prevention and treatment even though research on mechanisms needs to and will continue to offer additional insights.

Psychosocial and medical predictors of 14-year mortality and morbidity in male and female coronary artery bypass graft recipients: a prospective observational study.

BACKGROUND: Psychosocial factors may influence mortality and morbidity after coronary bypass surgery (CABG), but it is unclear when, post-surgery, they best predict the outcome, if they interact, or whether results differ for men and women. METHODS: This prospective, observational study assessed depression symptoms, social support, marital status, household responsibility, functional impairment, mortality and need for further coronary procedures over 14 years of follow-up. Data were collected in-hospital post-CABG and at home 1-year later. Mortality and subsequent cardiac procedure data were extracted from a Cardiac Registry. RESULTS: Of 296 baseline participants, 78% (43% were women) completed data at 1-year post-CABG. Long-term survival was shorter with 1-year depression and lower household responsibility but that was not true for the measures taken at baseline [HR for depression = 1.27; 95% CI 1.02-1.59 v. 0.99 (0.78-1.25), and HR = 0.71; 95% CI 0.52-0.97 v. 0.97 (0.80-1.16)] for household responsibility. An interaction between depression symptoms and social support at year 1 [χ2 (11) = 111.05, p < 0.001] revealed a greater hazard of mortality d with increased depression only at mean (HR = 1.67; 95% CI 1.21-2.26) and high social support (HR = 2.23; 95% CI 1.46-3.40). Depression also accounted for increased event recurrence. There were no significant interactions of sex with medical long-term outcomes. CONCLUSIONS: In a sex-balanced sample, depression and household responsibility measured at 1-year post-CABG were associated with significant variance in unadjusted and adjusted predictor models of long-term mortality whereas the same indices determined right after the procedure were not significant predictors.

Cross-Entropy Learning for Aortic Pathology Classification of Artificial Multi-Sensor Impedance Cardiography Signals.

An aortic dissection, a particular aortic pathology, occurs when blood pushes through a tear between the layers of the aorta and forms a so-called false lumen. Aortic dissection has a low incidence compared to other diseases, but a relatively high mortality that increases with disease progression. An early identification and treatment increases patients' chances of survival. State-of-the-art medical imaging techniques have several disadvantages; therefore, we propose the detection of aortic dissections through their signatures in impedance cardiography signals. These signatures arise due to pathological blood flow characteristics and a blood conductivity that strongly depends on the flow field, i.e., the proposed method is, in principle, applicable to any aortic pathology that changes the blood flow characteristics. For the signal classification, we trained a convolutional neural network (CNN) with artificial impedance cardiography data based on a simulation model for a healthy virtual patient and a virtual patient with an aortic dissection. The network architecture was tailored to a multi-sensor, multi-channel time-series classification with a categorical cross-entropy loss function as the training objective. The trained network typically yielded a specificity of (93.9±0.1)% and a sensitivity of (97.5±0.1)%. A study of the accuracy as a function of the size of an aortic dissection yielded better results for a small false lumen with larger noise, which emphasizes the question of the feasibility of detecting aortic dissections in an early state.

Bayesian Analysis of Femtosecond Pump-Probe Photoelectron-Photoion Coincidence Spectra with Fluctuating Laser Intensities.

This paper employs Bayesian probability theory for analyzing data generated in femtosecond pump-probe photoelectron-photoion coincidence (PEPICO) experiments. These experiments allow investigating ultrafast dynamical processes in photoexcited molecules. Bayesian probability theory is consistently applied to data analysis problems occurring in these types of experiments such as background subtraction and false coincidences. We previously demonstrated that the Bayesian formalism has many advantages, amongst which are compensation of false coincidences, no overestimation of pump-only contributions, significantly increased signal-to-noise ratio, and applicability to any experimental situation and noise statistics. Most importantly, by accounting for false coincidences, our approach allows running experiments at higher ionization rates, resulting in an appreciable reduction of data acquisition times. In addition to our previous paper, we include fluctuating laser intensities, of which the straightforward implementation highlights yet another advantage of the Bayesian formalism. Our method is thoroughly scrutinized by challenging mock data, where we find a minor impact of laser fluctuations on false coincidences, yet a noteworthy influence on background subtraction. We apply our algorithm to data obtained in experiments and discuss the impact of laser fluctuations on the data analysis.

Bayesian Uncertainty Quantification with Multi-Fidelity Data and Gaussian Processes for Impedance Cardiography of Aortic Dissection.

In 2000, Kennedy and O'Hagan proposed a model for uncertainty quantification that combines data of several levels of sophistication, fidelity, quality, or accuracy, e.g., a coarse and a fine mesh in finite-element simulations. They assumed each level to be describable by a Gaussian process, and used low-fidelity simulations to improve inference on costly high-fidelity simulations. Departing from there, we move away from the common non-Bayesian practice of optimization and marginalize the parameters instead. Thus, we avoid the awkward logical dilemma of having to choose parameters and of neglecting that choice's uncertainty. We propagate the parameter uncertainties by averaging the predictions and the prediction uncertainties over all the possible parameters. This is done analytically for all but the nonlinear or inseparable kernel function parameters. What is left is a low-dimensional and feasible numerical integral depending on the choice of kernels, thus allowing for a fully Bayesian treatment. By quantifying the uncertainties of the parameters themselves too, we show that "learning" or optimising those parameters has little meaning when data is little and, thus, justify all our mathematical efforts. The recent hype about machine learning has long spilled over to computational engineering but fails to acknowledge that machine learning is a big data problem and that, in computational engineering, we usually face a little data problem. We devise the fully Bayesian uncertainty quantification method in a notation following the tradition of E.T. Jaynes and find that generalization to an arbitrary number of levels of fidelity and parallelisation becomes rather easy. We scrutinize the method with mock data and demonstrate its advantages in its natural application where high-fidelity data is little but low-fidelity data is not. We then apply the method to quantify the uncertainties in finite element simulations of impedance cardiography of aortic dissection. Aortic dissection is a cardiovascular disease that frequently requires immediate surgical treatment and, thus, a fast diagnosis before. While traditional medical imaging techniques such as computed tomography, magnetic resonance tomography, or echocardiography certainly do the job, Impedance cardiography too is a clinical standard tool and promises to allow earlier diagnoses as well as to detect patients that otherwise go under the radar for too long.

Online support groups for young women with breast cancer: a proof-of-concept study.

OBJECTIVE: This initial study examined a therapist-led, synchronous, online support group (OSG) with psycho-education (OSG + E) compared to self-help psycho-education (E). The study aims were to examine proof of concept-feasibility, acceptability, and usefulness-and to hone methods for a formal RCT. METHODS: One hundred five young breast cancer survivors (<50 years) post-treatment were randomized either to OSG + E or E. OSG + E received a therapist-led 10-week synchronous online intervention. E received a self-help workbook. Assessments were at baseline, 10 weeks, and 3 months, with willing OSG + E members completing post-study interviews. Researchers used inductive analysis, generating qualitative themes for feasibility, acceptability, and usefulness. We examined trajectories for one primary and two secondary quantitative outcomes and a combined moderator to discover who preferentially benefitted from the intervention. RESULTS: Qualitative analyses revealed that synchronous chat was at times challenging, but minimal technical coaching, structure, set topics, and professional facilitation enabled conversations that were focused and meaningful. A combined moderator indicated that generally more women benefitted from OSG + E relative to E and particularly those women in semi-rural and rural areas. CONCLUSIONS: This study suggests that therapist-led synchronous OSGs are feasible, acceptable, and useful for young breast cancer survivors and that a future RCT with a larger sample size, perhaps more focused on non-urban areas, is needed to establish its effectiveness.

Prospective associations of depression with survival: a population-based cohort study in patients with newly diagnosed breast cancer.

Psychological factors may influence survival in breast cancer patients but results of previous research are inconclusive. This prospective population-based study tested whether depression predicts mortality in breast cancer patients. Routinely collected depression screening data were merged with electronically archived provincial cancer registry data and censored data from British Columbia Vital Statistics (extracted in December 2012). Cox proportional-hazards regression analyses were conducted to predict all-cause and breast cancer-specific mortality as a function of depression after controlling for biomedical confounders. Of 1,646 patients, 1,604 had breast cancer stages I-III and 42 had stage IV breast cancer. 176 (11.0 %) versus 28 (66.7 %) were deceased after a median follow-up of 76 months. In patients with curable breast cancer, depression predicted all-cause (HR = 1.54 (95 % CI 1.06-2.25); p = 0.024), but not breast cancer-specific mortality (HR = 1.51 (95 % CI 0.95-2.41); p = 0.084). No association was shown for metastatic disease. Stage-specific analyses demonstrated a 2-2.5-fold increase in breast cancer-specific and all-cause mortality in patients with stage I and II disease, but not in patients with stage III or IV breast cancer. In stage I breast cancer patients, age moderated effects of depression such that depressed younger patients diagnosed at age 45 (i.e., mean age -1SD) showed a ninefold (HR = 9.82 (95 % CI 2.26-42.68); p = 0.002) increase in all-cause mortality and depressed patients at 57 a 3.7-fold (HR = 3.69 (95 % CI 1.44-9.48); p = 0.007) increase, while no association was evident in older patients at age 69 (mean age +1SD). Depression is strongly associated with mortality in younger patients with early stage breast cancer.

Yoga and psychophysiological determinants of cardiovascular health: comparing yoga practitioners, runners, and sedentary individuals.

BACKGROUND: The evidence of cardiovascular benefits of yoga is promising, but lacks demonstrations of specificity compared to other interventions. PURPOSE: The present cross-sectional study examined cardiovascular health markers in long-term practitioners of yoga (yogis), runners, and sedentary individuals. METHODS: We compared physiological, psychological, and lifestyle variables associated with cardiovascular health across groups. RESULTS: Yogis (n = 47) and runners (n = 46) showed favorable profiles compared to sedentary individuals (n = 52) on heart rate, heart rate variability, depression, perceived stress, and cigarette smoking. Runners and male yogis showed superior aerobic fitness compared to the sedentary group. Runners reported greater social support compared to other groups. Yogis demonstrated a lower respiration rate compared to sedentary individuals and were more likely to refrain from eating meat compared to other groups. CONCLUSIONS: Yogis and runners demonstrated several cardiovascular health advantages over sedentary individuals. Our findings raise the possibility that yoga may improve aerobic fitness in men but not women.

Measuring symptoms in gastrointestinal cancer: a systematic review of assessment instruments.

PURPOSE: It is critical for gastrointestinal cancer researchers and clinicians to have access to comprehensive, sensitive and simple-to-use symptom measures that allow them to understand and quantify the subjective patient experience. Development and validation of such scales requires training in psychometrics and occasionally uses technical jargon that can be difficult to penetrate. This review evaluates existing measures of gastrointestinal cancer symptoms, provides tool descriptions, and uses predefined, objective quality criteria to rate psychometric quality and facilitate tool choices for researchers and clinicians. METHODS: MEDLINE, EMBASE, CINAHL, and PsycINFO databases were systematically reviewed for scales assessing gastrointestinal cancer and gastrointestinal cancer site-specific symptoms. Evaluation criteria were the following: breadth of domain coverage (content validity), high internal consistency (α ≥ .80), sensitivity to change, and extent of validation. RESULTS: In n = 36 validation studies, 26 gastrointestinal cancer symptom measures were identified. Of these, n = 13 tools met criteria for recommendation, and six in particular showed strong psychometric properties. The Functional Assessment of Cancer Therapy-Colorectal (FACT-C), European Organization for Research and Treatment of Cancer (EORTC) gastric cancer module (QLQ-STO22), FACT-Hepatobiliary (FACT-Hep), and EORTC oesophagus, oesophago-gastric junction and stomach module (QLQ OG-25) were identified as the most comprehensive and best validated scales for each of the major gastrointestinal cancer sites. The FACT-Colorectal Symptom Index (FCSI-9) and the National Comprehensive Cancer Network (NCCN) FACT-Hepatobiliary Symptom Index (FHSI-18) were specifically validated in patients with advanced colorectal and liver cancer and also demonstrated superior psychometric properties. CONCLUSIONS: Several comprehensive, well-validated scales exist to adequately assess gastrointestinal cancer site-specific symptoms. Specifically, gastrointestinal cancer submodules of the FACT quality of life questionnaire represent adequate tool choices in most instances and overall, were better validated than the respective EORTC tools. Further improvement of existing, highly rated measures is recommended.

Let's Enjoy an Evening on the Couch? A Daily Life Investigation of Shared Problematic Behaviors in Three Couple Studies.

Symptom-system fit theory proposes that problematic behaviors are maintained by the social system (e.g., the couple relationship) in which they occur because they help promote positive relationship functioning in the short-term. Across three daily life studies, we examined whether mixed-gender couples reported more positive relationship functioning on days in which they engaged in more shared problematic behaviors. In two studies (Study 1: 82 couples who smoke; Study 2: 117 couples who are inactive), days of more shared problematic behavior were accompanied by higher daily closeness and relationship satisfaction. A third study with 79 couples post-stroke investigating unhealthy eating failed to provide evidence for symptom-system fit. In exploratory lagged analyses, we found more support for prior-day problematic behavior being associated with next-day daily relationship functioning than vice-versa. Together, findings point to the importance of a systems perspective when studying interpersonal dynamics that might be involved in the maintenance of problematic behaviors.

Daily Rumination-Affect Associations in Dyads During the COVID-19 Pandemic.

OBJECTIVES: Negative and repetitive self-oriented thinking (rumination) is associated with lower well-being and health. The social context of rumination remains underexplored and mostly centers on marital relationships. To embrace the diversity of older adult relationships, this study includes a range of different relationships (e.g., spouses, siblings, friends, etc.) and examines the role of rumination by close others on individual well-being during the coronavirus disease 2019 pandemic. METHODS: Using daily diary data from 140 Canadian older adults (M = 72.21 years, standard deviation [SD] = 5.39, range: 63-87 years, 47% women, 71% university educated) and a close other of their choice (M = 59.95 years, SD = 16.54, range: 18-83 years, 78% women, 81% university educated), this project builds on past research examining daily life rumination dynamics from a dyadic perspective. For 10 days, both dyad members reported their daily rumination and affect quality in the evening. RESULTS: Multilevel models replicate past work showing that individual rumination was associated with higher negative affect (within-person: b = 0.27, p < .001, between-person: b = 0.57, p < .001) and lower positive affect (within-person: b = -0.18, p < .001, between-person: b = -0.29, p < .001). Importantly, we additionally observed that partner rumination was associated with higher negative affect (b = 0.03, p = .038) and lower positive affect (b = -0.04, p = .023), highlighting the social context of rumination. DISCUSSION: Findings illustrate the significance of rumination for the self and others and underline the merit of taking a dyadic perspective on what is typically viewed as an individual-level phenomenon.

Daily solitude and well-being associations in older dyads: Evidence from daily life assessments.

Older adults spend significant time by themselves, especially since COVID-19. Solitude has been associated with positive and negative outcomes. Partners need to balance social connectedness with time for one's own needs. This project examines how individual and partner solitude are associated with daily affect and relationship quality in dyads of older adults and a close other. One-hundred thirty-six older adults plus a close other rated their relationship quality and reported affect, solitude, and its characteristics (desired and bothersome) every evening for 10 days. Over and above overall associations, individual and partner effects emerged; when individual desired solitude was up, participants reported more positive affect and their partners less negative affect. When bothersome solitude was up, participants and their partners alike reported more negative affect and less positive affect. Desired solitude was associated with more support, whereas bothersome solitude was associated with less partner support. Findings provide further evidence on the potential benefits of solitude, highlighting the importance of considering the social context of what is often believed to be an individual-level phenomenon.

How many meta-analyses does it take to settle a question?

Psychological treatments (PTs) are used as adjuncts to cardiac care. This issue of Psychosomatic Medicine provides a meta-analysis by Rutledge et al. (3) on the effects of PT and cardiac rehabilitation on depression and cardiac outcomes, and the journal recently published a systematic review and meta-regression on a similar topic by Dickens et al. (4). This editorial compares the results from these two meta-analyses and discusses the problems associated with combining different types of PT and other treatments, dose-response effects, floor effects, collapsing across outcomes, and therapist qualifications. PTs have mixed but generally positive effects on reducing mortality and cardiac outcomes, but it remains a challenge explaining how such beneficial outcomes can be achieved by relatively small effects on well-being (typical effect sizes: d = 0.2-0.3). Randomized controlled trials are needed on timing of PT, patients with cardiac problems who will benefit most from PT, and the mechanisms by which PT improves cardiac outcomes.

Nonequilibrium dynamical mean-field theory: an auxiliary quantum master equation approach.

We introduce a versatile method to compute electronic steady-state properties of strongly correlated extended quantum systems out of equilibrium. The approach is based on dynamical mean-field theory (DMFT), in which the original system is mapped onto an auxiliary nonequilibrium impurity problem imbedded in a Markovian environment. The steady-state Green's function of the auxiliary system is solved by full diagonalization of the corresponding Lindblad equation. The approach can be regarded as the nontrivial extension of the exact-diagonalization-based DMFT to the nonequilibrium case. As a first application, we consider an interacting Hubbard layer attached to two metallic leads and present results for the steady-state current and the nonequilibrium density of states.

Electrodermal activity at acupuncture points differentiates patients with current pain from pain-free controls.

This study evaluated whether electrodermal resistance at acupuncture points (AP) systematically varies as a function of pain. The study was conceived as a proof-of-principle study in support of research on acupuncture and other complementary medicine approaches. Specifically, this study investigates whether or not electrodermal activity systematically differentiates arthritis patients with current pain from pain-free controls. Participants with rheumatoid arthritis (n = 32) and a typical pain level of at least 3 (on a 0-10 scale) were compared with case controls (n = 28) who had no medical diagnosis and were pain free. Electrodermal resistance at AP was measured with a commercial ohmmeter and compared to heart rate, blood pressure, and ratings on the Pain Catastrophization Scale and the McGill Melzack Pain Questionnaire. There were consistent differences between the experimental group and the control group on all markers of pain. Similarly, there were significant group differences and some trends for electrodermal activity at the AP labeled 'bladder,' 'gall bladder,' and 'small intestine.' It is concluded that the concept of electrodermal resistance at AP possesses criterion validity for distinguishing pain from a no pain state. This research provides support for the usefulness of measuring electrodermal activity when testing energy-based models of disease, and can be seen as a bridge between Western and Chinese medicine.

A Bayesian approach to blood rheological uncertainties in aortic hemodynamics.

Computational hemodynamics has received increasing attention recently. Patient-specific simulations require questionable model assumptions, for example, for geometry, boundary conditions, and material parameters. Consequently, the credibility of these simulations is much doubted, and rightly so. Yet, the matter may be addressed by a rigorous uncertainty quantification. In this contribution, we investigated the impact of blood rheological models on wall shear stress uncertainties in aortic hemodynamics obtained in numerical simulations. Based on shear-rheometric experiments, we compare the non-Newtonian Carreau model to a simple Newtonian model and a Reynolds number-equivalent Newtonian model. Bayesian Probability Theory treats uncertainties consistently and allows to include elusive assumptions such as the comparability of flow regimes. We overcome the prohibitively high computational cost for the simulation with a surrogate model, and account for the uncertainties of the surrogate model itself, too. We have two main findings: (1) The Newtonian models mostly underestimate the uncertainties as compared to the non-Newtonian model. (2) The wall shear stresses of specific persons cannot be distinguished due to largely overlapping uncertainty bands, implying that a more precise determination of person-specific blood rheological properties is necessary for person-specific simulations. While we refrain from a general recommendation for one rheological model, we have quantified the error of the uncertainty quantification associated with these modeling choices.

Health psychology and behavioral medicine researchers in Canada: An environmental scan.

The purpose of this study is to characterize contemporary Canadian health psychology through an environmental scan by identifying faculty, research productivity and strengths, and collaborator interconnectivity. Profiles at Canadian universities were reviewed for faculty with psychology doctorates and health psychology research programs. Publications were obtained through Google Scholar and PubMed (Jan/18-Mar/21). A total of 284 faculty were identified. Cancer, pain, and sleep were key research topics. The collaborator network analysis revealed that most were linked through a common network, with clusters organized around geography, topic, and trainee relationships. Canada is a unique and productive contributor to health psychology.

Everyday Pain in Middle and Later Life: Associations with Daily and Momentary Present-Moment Awareness as One Key Facet of Mindfulness.

This study investigated everyday associations between one key facet of mindfulness (allocating attention to the present moment) and pain. In Study 1, 89 community-dwelling adults (33-88 years; Mage = 68.6) who had experienced a stroke provided 14 daily end-of-day present-moment awareness and pain ratings. In Study 2, 100 adults (50-85 years; Mage = 67.0 years) provided momentary present-moment awareness and pain ratings three times daily for 10 days. Multi-level models showed that higher trait present-moment awareness was linked with lower overall pain (both studies). In Study 1, participants reported less pain on days on which they indicated higher present-moment awareness. In Study 2, only individuals with no post-secondary education reported less pain in moments when they indicated higher present-moment awareness. Findings add to previous research using global retrospective pain measures by showing that present-moment awareness might correlate with reduced pain experiences, assessed close in time to when they occur.