Machine learning aids clinical decision-making in patients presenting with angina and non-obstructive coronary artery disease.

Aims: The current gold standard comprehensive assessment of coronary microvascular dysfunction (CMD) is through a limited-access invasive catheterization lab procedure. We aimed to develop a point-of-care tool to assist clinical guidance in patients presenting with chest pain and/or an abnormal cardiac functional stress test and with non-obstructive coronary artery disease (NOCAD).

Methods And Results: This study included 1893 NOCAD patients (<50% angiographic stenosis) who underwent CMD evaluation as well as an electrocardiogram (ECG) up to 1-year prior.

Spectrum bias in algorithms derived by artificial intelligence: a case study in detecting aortic stenosis using electrocardiograms.

Aims: Spectrum bias can arise when a diagnostic test is derived from study populations with different disease spectra than the target population, resulting in poor generalizability. We used a real-world artificial intelligence (AI)-derived algorithm to detect severe aortic stenosis (AS) to experimentally assess the effect of spectrum bias on test performance.

Methods And Results: All adult patients at the Mayo Clinic between 1 January 1989 and 30 September 2019 with transthoracic echocardiograms within 180 days after electrocardiogram (ECG) were identified.

The 12-lead electrocardiogram as a biomarker of biological age.

Background: We have demonstrated that a neural network is able to predict a person's age from the electrocardiogram (ECG) [artificial intelligence (AI) ECG age]. However, some discrepancies were observed between ECG-derived and chronological ages. We assessed whether the difference between AI ECG and chronological age (Age-Gap) represents biological ageing and predicts long-term outcomes.

Mindfulness and human occupation: A scoping review.

Background: Mindfulness is an emergent construct with implications for our understanding of approaches to engagement in human occupation. Little is known about how mindfulness is being applied and what its possibilities are in the occupation-based disciplines.

Objective: The purpose of this scoping review was to summarize, describe, and identify gaps in the existing literature on mindfulness in relation to human occupation.

Statutory definitions of mental illness for involuntary hospitalization as related to substance use disorders.

Objective: In New York City, individuals gravely disabled by substance use disorders repeatedly present to emergency rooms yet rarely remain in treatment for more than several days and often sign out against medical advice. Although these individuals are at high risk of death and often lack the capacity to make treatment decisions, the laws in New York State are unclear about whether substance use disorders qualify as mental illnesses for the purpose of involuntary hospitalization. To better understand the national landscape of civil commitment law, with a specific focus on substance use disorders, a review was conducted of mental health statutes in all 50 states and the District of Columbia (D.

Transference-focused psychotherapy in the general psychiatry residency: a useful and applicable model for residents in acute clinical settings.

Transference-focused psychotherapy (TFP) is a manualized, psychodynamic treatment for severe personality disorders. Training in TFP during residency can provide a readily applicable model for understanding and treating personality pathology in a variety of settings, even for residents who do not obtain additional training in psychodynamic treatments or go on to practice psychotherapy. Although TFP was developed as a long-term outpatient treatment, the authors have found the diagnostic and theoretical framework and the clinical techniques described in the TFP treatment manual to be useful in acute settings, even when the clinician does not have a clearly established relationship with the patient.

Competency to be resentenced and the Rockefeller Drug Law reform act: how does it affect the mentally Ill?

Many of the mentally ill prisoners in this country have been convicted of drug crimes. New York State's Rockefeller Drug Laws from the 1970s established harsh sentences for drug crimes to quell a perceived epidemic. These laws were reformed in 2004 to allow the option of resentencing, with the possibility of lighter sentences.