Black individuals' suspicion of Whites' motives negatively predicts expected efficacy with White social partners.

OBJECTIVES: Interracial efficacy is critical to intergroup interactions. However, the antecedents of interracial efficacy are unclear and rarely studied from the perspectives of Black individuals. The current work addresses these empirical gaps by testing whether individual differences in suspicion of Whites' motives negatively relate to expected efficacy in interracial interactions. Suspicion was operationalized as beliefs that Whites' positivity toward people of color (POC) is primarily motivated by concerns with appearing prejudiced. METHOD: Four studies employing correlational and experimental vignette designs with Black adult participants (Ntotal = 2,295; ∼60% female) tested suspicion's hypothesized negative relation with three conceptions of interracial efficacy (general efficacy, liking-based efficacy, and respect-based efficacy). RESULTS: Four studies provided consistent evidence that suspicion of Whites' motives negatively related to expected efficacy in interactions with White social partners. Moreover, this relationship was unique to contexts with White partners and did not extend to imagined interactions with Black partners or members of other outgroup members (e.g., Latine partners). CONCLUSIONS: Results further suggest suspicion increases expected threat (i.e., anticipated uncertainty/anxiety), which undermines Black individuals' confidence in interactions with White partners. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Characterization of cardiac acoustic biomarkers in patients with heart failure.

BACKGROUND: The wearable cardioverter defibrillator (WCD) records electrocardiograms and cardiohemic vibrations that can be algorithmically combined to provide cardiac acoustic biomarkers (CABs). We characterized CAB variability, diurnal variations, and changes over time among heart failure patients. METHODS: Wearable cardioverter defibrillator heart failure patients who had CAB recordings from March 2015 to July 2017 were included. CAB parameters included: electromechanical activation time (EMAT), EMATc (EMAT/RR interval), left ventricular systolic time (LVST), LVSTc (LVST/RR interval), S3 and S4 strengths, and systolic dysfunction index (SDI). Descriptive statistics, correlation analysis, and analysis of variance were used to report temporal and clinical associations. RESULTS: One thousand and sixty-six WCD patients met the study criteria. Diastolic CAB parameters showed significantly greater intra-subject variability than systolic CAB parameters (>29% vs. <15%, p < .01). CAB parameters varied very little with age, gender, and ejection fraction (R2  = 0.004 to 0.06) in this heart failure population. Similarly, all CABs except SDI (R2  = 0.58) were independent of QRS duration, (R2  = -0.01 to 0.58). Heart rate had a more of significant influence on the systolic CABs than the diastolic CABs (p < .05). CABs were significantly different when measured at daytime versus nighttime (p < .01) and were significantly lower at the end of WCD wear compared with the beginning of wear (p < .05). CONCLUSIONS: Noninvasive CABs offer the possibility to assess parameters associated with LV function, clinical status, and other aspects of cardiovascular physiology that differ between normal and heart failure states. The present study provides critical information about typical values in heart failure patients, intra-subject variability, circadian rhythms, and changes over time of these parameters.

Relative predictive value of lung cancer screening CT versus myocardial perfusion attenuation correction CT in the evaluation of coronary calcium.

Coronary artery calcium scores (CACS) from lung cancer screening computed tomography (LCSCT) or myocardial perfusion attenuation correction computed tomography (ACCT) are not routinely performed or reported. CACS from LCSCT and ACCT have not been directly compared in the same patient population. We identified 66 patients who underwent both LCSCT (non-gated) and ECG-gated cardiac CT (CCT) within a 2-year span. Of this population, 40 subjects had also undergone ACCT. Using the Agatston method, CACS for 264 individual vessels from the LCSCT population and for 160 vessels from ACCT population were calculated and evaluated for agreement with ECG-gated CCT as the gold standard. Secondary analysis included a comparison of individual vessel contribution to variations in agreement and a comparison of total CACS from CCT, LCSCT, and ACCT for respective MACE prediction. CACS from LCSCT demonstrated a strong Pearson correlation, r = 0.9017 (0.876-0.9223), with good agreement when compared to CACS from CCT. CACS from ACCT demonstrated a significantly (P < 0.00001) weaker correlation, r = 0.5593 (0.4401-0.6592). On an individual vessel basis, CACS from all major vessels (LM, LAD, LCX, and RCA) contributed to the weaker correlation. For total vessel CACS, LCSCT demonstrated comparable area under the curve (AUC) for the receiver operating characteristic (ROC) curve (LCSCT AUC = 0.8133 and CCT AUC = 0.8302, P = 0.691) for prediction of MACE. Although ACCT demonstrated a similar AUC (ACCT AUC = 0.7969, P = 0.662) for MACE prediction the cutoff value for elevated risk was extremely low. In conclusion, LCSCT outperformed ACCT at calcium scoring by providing better agreement and comparable risk assessment to CCT despite the absence of ECG-gating. It is therefore reasonable to use LCSCT images to derive and report Agatston-based CACS for cardiovascular risk assessment, whereas the use of ACCT images to report Agatston-based CACS is not currently practical.

Imaging Atherosclerotic Plaque Calcification: Translating Biology.

Calcification of atherosclerotic lesions was long thought to be an age - related, passive process, but increasingly data has revealed that atherosclerotic calcification is a more active process, involving complex signaling pathways and bone-like genetic programs. Initially, imaging of atherosclerotic calcification was limited to gross assessment of calcium burden, which is associated with total atherosclerotic burden and risk of cardiovascular mortality and of all cause mortality. More recently, sophisticated molecular imaging studies of the various processes involved in calcification have begun to elucidate information about plaque calcium composition and consequent vulnerability to rupture, leading to hard cardiovascular events like myocardial infarction. As such, there has been renewed interest in imaging calcification to advance risk assessment accuracy in an evolving era of precision medicine. Here we summarize recent advances in our understanding of the biologic process of atherosclerotic calcification as well as some of the molecular imaging tools used to assess it.

A longitudinal, collaborative, practice-based learning and improvement model to improve post-discharge heart failure outcomes.

BACKGROUND: Practice-based learning and improvement is one of the Accreditation Council of Graduate Medical Education's core competencies fortrainees. Residencyprograms have grappled with how to accomplish this goal. AIM: We describe our institution's unique, longitudinal post-graduate year process and project. SETTING: West Haven, VA Medical Center. PARTICIPANTS: Yale University School of Medicine junior residents on ambulatory electives and faculty preceptor. PROGRAM DESCRIPTION: Longitudinal program aimed to decrease re-admissions for hospitalized patients with congestive heart failure. DISCUSSION: We feel that our longitudinal project is a novel innovation worthy of further study.

Ancient differentiation of the H and I haplomes in diploid Hordeum species based on 5S rDNA.

5S rDNA clones from 12 South American diploid Hordeum species containing the HH genome and 3 Eurasian diploid Hordeum species containing the II genome, including the cultivated barley Hordeum vulgare, were sequenced and their sequence diversity was analyzed. The 374 sequenced clones were assigned to "unit classes", which were further assigned to haplomes. Each haplome contained 2 unit classes. The naming of the unit classes reflected the haplomes, viz. both the long H1 and short I1 unit classes were identified with II genome diploids, and both the long H2 and long Y2 unit classes were recognized in South American HH genome diploids. Based upon an alignment of all sequences or alignments of representative sequences, we tested several evolutionary models, and then subjected the parameters of the models to a series of maximum likelihood (ML) analyses and various tests, including the molecular clock, and to a Bayesian evolutionary inference analysis using Markov chain Monte Carlo (MCMC). The best fitting model of nucleotide substitution was the HKY+G (Hasegawa, Kishino, Yano 1985 model with the Gamma distribution rates of nucleotide substitutions). Results from both ML and MCMC imply that the long H1 and short I unit classes found in the II genome diploids diverged from each other at the same rate as the long H2 and long Y2 unit classes found in the HH genome diploids. The divergence among the unit classes, estimated to be circa 7 million years, suggests that the genus Hordeum may be a paleopolyploid.