The protective effects of perceived gratitude and expressed gratitude for relationship quality among African American couples.

The current study was designed to investigate the protective effects of gratitude in romantic relationships. Particular attention was given to differentiating the beneficial effects of perceived gratitude (i.e., gratitude from one's partner, or feeling appreciated) versus expressed gratitude (i.e., gratitude to one's partner, or being appreciative) in mitigating the negative effects of ineffective arguing and financial strain on multiple indicators of relationship quality, both concurrently and longitudinally. The sample comprised 316 African American couples with three waves of data spanning approximately 16 months. Results indicated higher levels of perceived gratitude - but not expressed gratitude - weakened the association between relationship stressors and worsened outcomes (i.e., less satisfaction and confidence, more instability) at both between-person and within-person levels. Concurrently, perceived gratitude exhibited protective effects with respect to ineffective arguing and financial strain; longitudinal protective effects were observed only with respect to ineffective arguing. Results highlight the ways in which perceiving gratitude from one's partner, both at a single instance and sustained over many months, can be protective for multiple facets of relationship quality. Collectively, findings underscore the importance of interpersonal gratitude for romantic relationships and its merit for increased attention in research and practice.

Adolescent Substance Use and Individual Beliefs That Drug Use Is Wrong: A Statewide Epidemiological Study.

OBJECTIVE: Informed by cognitive dissonance theory, the current study investigated the ability of youths' belief that drug use is wrong to predict likelihood of past year substance use abstinence as well as frequency of use at grades 8, 10, and 12. METHOD: Study analyses were executed from a statewide epidemiological survey of more than 125,000 youth using multi-group Zero-Inflated Poisson regression modeling. RESULTS: Personal belief that drug use is wrong demonstrated the largest magnitude of effect at each grade among the individual, family, and school-based factors under examination; this finding emerged with respect to predicting past year substance use abstinence as well as rates of substance use among individuals reporting past year use. Although differences across grades were evident for the magnitude of effect within various risk and protective factors, the rank ordering in magnitude of effect between factors was consistent across grades 8, 10, and 12. CONCLUSION: Current results underscore the salience of youths' belief that drug use is wrong in explaining likelihood of past year substance use at multiple time points during adolescence.Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2022.2034877 .

Bogomol'nyi-Prasad-Sommerfield Skyrme model and nuclear binding energies.

We use the classical Bogomol'nyi-Prasad-Sommerfield (BPS) soliton solutions of the BPS Skyrme model together with corrections from the collective coordinate quantization of spin and isospin, the electrostatic Coulomb energies, and a small explicit breaking of the isospin symmetry-accounting for the proton-neutron mass difference-to calculate nuclear binding energies. We find that the resulting binding energies are already in excellent agreement with their physical values for heavier nuclei, demonstrating thereby that the BPS Skyrme model is a distinguished starting point for a detailed quantitative investigation of nuclear and low-energy strong interaction physics.

Skyrmion tubes in achiral nematic liquid crystals.

We analyze the interaction with uniform external fields of nematic liquid crystals within a recent generalized free energy posited by Virga and falling in the class of quartic functionals in the spatial gradients of the nematic director. We review some known interesting solutions, i.e., uniform heliconical structures, which correspond to the so-called twist-bend nematic phase and we also study the transition between this phase and the standard uniform nematic one. The twist-bend phase is further reproduced by three-dimensional simulations. Moreover, we find liquid crystal configurations, which closely resemble some novel, experimentally detected, structures called Skyrmion tubes. Skyrmion tubes are characterized by a localized cylindrically symmetric pattern surrounded by either twist-bend or uniform nematic phase. We study the equilibrium differential equations and find numerical solutions and analytical approximations.

African Americans' relationship quality and depressive symptoms: A longitudinal investigation of the Marital Discord Model.

The present study was designed to examine the complex bidirectional associations between relationship quality and depressive symptoms among African American couples. Informed by the Marital Discord Model, particular attention was devoted to understanding the unique associations of positive and negative dimensions of relationship functioning with depressive symptoms over time, the time frames over which these effects occur, and the model's applicability for African American couples. One hundred seventy-four African American couples (N = 348 individuals) provided information on depressive symptoms, relationship satisfaction, ineffective arguing, and partner support four times over a 25-month period. Hypotheses were tested using Random-Intercept Cross-Lagged Panel Models to separate between- and within-person effects. Results indicated that between-person associations with depressive symptoms were significant for relationship satisfaction (negative association) and ineffective arguing (positive association), but not partner support. Within-person concurrent effects were also significant with depressive symptoms and each of the relationship processes under investigation. Within-person 8-month lagged effects were only significant for partner support and depressive symptoms (negative association); these effects were significant in both directions, but stronger from support to depressive symptoms than from depressive symptoms to support. Study findings provide increased conceptual and analytic precision for understanding the association between couples' relationship quality and African Americans' mental health, including malleable relationship factors that can be targeted in family-focused interventions to promote individual and couple well-being. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Nonuniform localized distortions in generalized elasticity for liquid crystals.

We analyze a recent generalized free-energy for liquid crystals posited by Virga and falling in the class of quartic functionals in the spatial gradients of the nematic director. We review some known interesting solutions, i.e., uniform heliconical structures, and we find new liquid crystal configurations, which closely resemble some novel, experimentally detected, structures called Skyrmion tubes. These new configurations are characterized by a localized pattern given by the variation of the conical angle. We study the equilibrium differential equations and find numerical solutions and analytical approximations.

Helicoids in chiral liquid crystals under external fields.

Cholesteric liquid crystals, subject to externally applied magnetic fields and confined between two parallel planar surfaces with strong homeotropic anchoring conditions, are found to undergo transitions to different types of helicoidal configurations with disclinations. Analytical and numerical studies are performed in order to characterize their properties. In particular, we produce a phase diagram for the transitions from the nematic state to the helicoidal phases in terms of the molecular chirality and the strength of the applied magnetic field.

Reversal of cardiac cirrhosis following orthotopic heart transplantation.

Irreversible hepatic cirrhosis greatly increases the risks attending heart transplantation (HT), and is accordingly considered to be an absolute contraindication for HT unless combined heart and liver transplantation can be performed. It is now recognized that hepatic cirrhosis can undergo regression if the source of insult is removed, but no cases of post-HT regression of cirrhosis of cardiac origin have hitherto been reported. Here we report a case of cardiac cirrhosis that underwent complete regression following orthotopic HT, and we discuss the implications of this case.

The efficacy and safety of ezetimibe for treatment of dyslipidemia after heart transplantation.

INTRODUCTION: Statins, although the treatment of choice for dyslipidemia after heart transplantation (HT), are not always well tolerated or effective. In such cases, administration of ezetimibe may be useful. AIM: The aim of this study was to assess the efficacy and safety of ezetimibe, with or without statins, after HT. METHOD: Thirty-six HT patients, 97% of whom were males of overall mean age of 57 +/- 13 years, were all unable to reach target lipid levels with statins alone and/or were intolerant of statins. They were prescribed ezetimibe, with or without a statin. Efficacy and safety were evaluated after 1, 3, 6, and 12 months. RESULTS: Thirty-four patients were evaluated at 1 month and 12 months. Ezetimibe was prescribed to 27 patients (75%) because of statin inefficacy, and to 9 patients (25%) because of statin intolerance, manifested by myalgia in 4 cases (11%), hepatotoxicity in 2 cases (6%), and rhabdomyolysis in 3 cases (8%). Lipid levels (mg/dL; baseline vs 1 year) were as follows: cholesterol, 235 +/- 49 versus 167 +/- 32 (P = .013); LDL cholesterol, 137 +/- 47 versus 89 +/- 29 (P = .001); HDL cholesterol, 54 +/- 13 versus 51 +/- 10 (P = .235); and triglycerides, 243 +/- 187 versus 143 +/- 72 (P = .022). There were no cases of liver toxicity, renal dysfunction, or significant alteration of immunosuppressive pharmacokinetics. Ezetimibe was withdrawn from 2 patients because of hand edema or asymptomatic recurrence of rhabdomyolysis first caused by statins. CONCLUSIONS: With or without a statin, ezetimibe was generally well tolerated, reducing total cholesterol, LDL cholesterol, and triglyceride levels with no long-term alteration of HDL cholesterol levels. CPK surveillance is recommended because of a slight continued risk of adverse effects. Further studies should evaluate the benefit for survival.

Adverse effects of mammalian target of rapamycin inhibitors during the postoperative period after cardiac transplantation.

INTRODUCTION: Safety of treatment with mammalian target of rapamycin inhibitors (mTORi) in the postoperative period after heart transplantation (HT) is controversial. METHODS: We evaluated the incidence of postoperative complications (pericardial, pleural, and surgical wound complications) among nine de novo heart transplant recipients treated with mTORi compared with 19 patients who did not receive them during the same period (control group). RESULTS: No significant differences were observed between the two groups regarding sex, age, body mass index, pretransplant diagnosis, history of diabetes mellitus, prior cardiac surgery, or baseline renal function. The main laboratory parameters at 1 month were also similar. During the first 2 months after HT, four patients (44%) in the mTORi group developed severe pericardial effusions requiring drainage, compared to 1 (5%) in the control group (P = .026). All patients presenting this complication in the mTORi group received everolimus. In addition, two cases of sternal dehiscence were observed in the mTORi group, compared to none in the control group (P = .09); one patient on everolimus required sternal reopening and debridement for clinically suspected mediastinitis. Duration of chest tube drainage, quantity of collected pleural fluid, and need for thoracentesis were similar in both groups. CONCLUSIONS: In our series, patients receiving mTORi-particularly everolimus-during the postoperative period after HT showed a higher incidence of severe pericardial effusion requiring drainage, as well as a trend toward a higher incidence of sternal dehiscence, as compared to a group not receiving mTORi. The use of mTORi during the early postcardiac transplant period should be individualized.

Late steroid withdrawal after heart transplantation and incidence of acute rejection.

BACKGROUND: Steroid withdrawal (SW) after heart transplantation (HT) reduces steroid-associated side effects, although it can increase acute rejection episodes (ARE). Patient selection criteria for SW and the time elapsed after HT for this maneuver are controversial issues. The objective of this study was to assess the safety of late SW after HT with regard to the occurrence of ARE and to analyze risk factors resulting in a poor evolution. METHODS: We studied a cohort of 24 patients who underwent SW late after HT. All of them had gone at least 4 years without any ARE. Independent variables were time after HT, general recipient and donor data, risk factors for ARE, and immunosuppression. The dependent variables were occurrence of ARE (proven or not proven with endomyocardial biopsy) and time and severity of ARE. RESULTS: Among 24 HT patients including 96% men with an overall mean age of 57 years who underwent SW, the mean follow-up was 2.32 +/- 0.86 years. Six patients (25%) displayed an ARE >or=2R according to the International Society for Heart and Lung Transplantation (ISHLT) at 5 +/- 3 months after SW. There were no deaths. Time from the last rejection episode to SW was 6.6 +/- 2 years. All ARE were treated with steroid boluses (mean total dose 1583 +/- 1044 mg). Among the HT patients with ARE, 5 (85%) had never experienced ARE after HT. Upon long-term follow-up, there were 2 deaths: 1 sudden death at 30 months after SW and 1 due to allograft vasculopathy at 20 months post-SW. Currently 92% are New York Heart Association (NYHA) functional class I with a mean left ventricular ejection fraction of 67% +/- 10%. CONCLUSIONS: In our series of HT with late SW after HT (even among an HT population with a low risk of rejection), there was a 25% rate of ARE. This study did not allow us to identify risk factors for ARE after SW. We believe that based upon these observations SW should be implemented with caution.

Late noncardiac surgery in heart transplant patients.

OBJECTIVE: Because of improved long-term survival of heart transplants (HT), patients often need noncardiac surgery (NCS). Immunosuppression may increase the infection rate. Inadequate management may increase the risk of dysfunction or acute rejection episodes (ARE). Long-term outcomes of NCS and optimal immunosuppressive management in the perioperative period are not well known. The objective of this study was to analyze the incidence, morbidity, and mortality of late NCS after HT. METHODS: We retrospectively evaluated the incidence and type of late NCS as well as the risk factors for complications and the mortality among 207 HT patients. Immunosuppression and ARE rates were also analyzed. RESULTS: One hundred and sixteen late NCS (84.5% elective) were performed in 72 HT patients (34.8%). Interventions were: 35 urologic (30.2%), 29 abdominal (25%), 14 vascular (12.1%), 13 ENT (11.2%), 11 skin and soft tissue (9.5%), and 7 orthopedic (6%). Malignancy was the main indication for NCS (33.6%). Only 4 patients (5.6%) died preoperatively. Mortality was higher among emergent vs elective procedures (16.6% vs 1%; P = .012) and among patients with preoperative high vs middle/low risk (26.6% vs 0%). Postsurgical infection was the most frequent complication (6.9%). However, there were no relevant complications in 82.8% of HT patients. Hospitalization time was <15 days in two thirds of patients. Immunosuppression was modified in 33 patients (28.4%), especially when the surgical indication was neoplasia (P < .001). None of the patients with NCS displayed allograft dysfunction or an ARE. CONCLUSIONS: More than one-third of HT patients needed a late NCS. In our experience, elective surgical procedures with middle/low preoperative cardiovascular risk are safe. In this context, the risk of rejection was low when immunosuppression was carefully monitored to reduce the risk of infection.

Neither acute rejection nor immunosuppressant drug therapy (cyclosporine or tacrolimus) correlates with expression of either CD40 or CD154 on peripheral blood cells among human cardiac transplant patients.

Acute allograft rejection (AAR) is an important cause of graft loss following heart transplantation (HT). Increasing evidence shows that CD40-CD154 interactions play a central role in the immune processes leading to AAR. In this study we investigated the expression of CD40 and CD154 on peripheral blood cells from HT patients so as to determine possible association with AAR. Using two-color flow cytometry, we determined the expression of CD40 and CD154 in 102 samples of peripheral blood taken from 53 adult HT patients and in 17 samples from healthy adult volunteers. Samples from patients were obtained at the same time as endomyocardial biopsy was performed. We analyzed the relationships between the expression of these molecules and the following parameters: immunosuppressive treatment (cyclosporine vs tacrolimus), gender, age, time post-HT, and AAR (indicated by an ISHLT rating > or =3A). The percentages of HT patients' blood samples showing above-normal CD40 or CD154 expression did not differ significantly from those of controls. The percentage of patients' samples showing above-normal CD40 expression decreased with time after HT. Expression of these molecules was not above normal during rejection episodes, and for neither was there any statistically significant correlation between expression level and the immunosuppressor drug.