Distribution of left ventricular ejection fraction in angina patients with severe coronary artery disease not amenable to revascularization.

BACKGROUND: As the number of angina patients with severe coronary artery disease not amenable to revascularization increases, new therapies will be developed. How patients with depressed compared to normal left ventricular ejection fraction (LVEF) will respond to new therapies may differ. HYPOTHESIS: We conducted a retrospective chart review to determine the distribution of LVEF in angina patients with severe coronary artery disease (three-vessel disease with \u3e50% stenosis major epicardial vessels or \u3e50% stenosis left main) not amenable to revascularization. METHODS: Patients underwent cardiac catheterization between 2004 and 2009. LVEF, measured by echocardiography, nuclear-gated imaging or radioventriculography within 6 months of catheterization, was recorded. Demographics, symptoms, risk factors, past myocardial infarction, catheterization results, medications, and the Duke Coronary Artery Jeopardy Score were recorded. RESULTS: Eight thousand six hundred and ninety-nine patient charts were reviewed; 124 met criteria. There was a continuous, and not bimodal, distribution of LVEF. Fifty-eight patients (47%) in the normal LVEF group were compared to 66 patients (53%) in the abnormal LVEF group ( CONCLUSION: There is a wide distribution of LVEF among angina patients not amenable to revascularization. A novel finding of this study showed that mortality was high regardless of LVEF. As new therapies for angina are developed, attention will need to be paid to how such therapies affect these two patient groups

Elastic cavitation, tube hollowing, and differential growth in plants and biological tissues

Elastic cavitation is a well-known physical process by which elastic materials under stress can open cavities. Usually, cavitation is induced by applied loads on the elastic body. However, growing materials may generate stresses in the absence of applied loads and could induce cavity opening. Here, we demonstrate the possibility of spontaneous growth-induced cavitation in elastic materials and consider the implications of this phenomenon to biological tissues and in particular to the problem of schizogenous aerenchyma formation

When is Affect Variability Bad for Health? The Association between Affect Variability and Immune Response to the Influenza Vaccination

Objectives—This study addresses methodological and theoretical questions about the association between affect and physical health. Specifically, we examine the role of affect variability and its interaction with mean levels of affect to predict antibody (Ab) levels in response to an influenza vaccination. Methods—Participants (N = 83) received the vaccination and completed daily diary measures of affect four times a day for 13 days. At one and four months post-vaccination, blood was collected from the participants to assess Ab levels. Results—Findings indicate that affect variability and its interaction with mean levels of affect predict an individual’s immune response. Those high in mean positive affect (PA) who had more PA variability were more likely to have a lower Ab response in comparison to those who had high mean PA and less PA variability. Although it did not interact with mean negative affect (NA), NA variability on its own was associated with Ab response, whereby those with less NA variability mounted a more robust immune response. Conclusion—Affect variability is related to immune response to an influenza vaccination and, in some cases, interacts with mean levels of affect. These oscillations in affective experiences are critical to consider in order to unpack the intricacies of how affect influences health. These findings suggest that future researchers should consider the important role of affect variability on physical health-relevant outcomes as well as examine the moderating effect of mean affect levels

Oxytocin, Cortisol, and Cognitive Control During Acute and Naturalistic Stress

Although stress is a strong risk factor for poor health, especially for women, it remains unclear how stress affects the key neurohormones cortisol and oxytocin, which influence stress-related risk and resilience. Whereas cortisol mediates energy mobilization during stress, oxytocin has anti-inflammatory, anxiolytic, and analgesic effects that support social connection and survival across the lifespan. However, how these neurohormones interrelate and are associated with cognitive control of emotional information during stress remains unclear. To address these issues, we recruited 37 college-aged women (Mage = 19.19, SD = 1.58) and randomly assigned each to a one-hour experimental session consisting of either an acute stress (emotionally stressful video) or control (non-stressful video) condition in a cross-sectional manner across the semester. Salivary cortisol and oxytocin samples were collected at baseline and after the video, at which point participants also completed measures assessing affect and an emotional Stroop task. As hypothesized, the emotional stressor induced negative emotions that were associated with significant elevations in cortisol and faster Stroop reaction times. Moreover, higher baseline oxytocin predicted greater positive affect after the stressor and also better cognitive accuracy on the Stroop. Analyses examining the naturalistic stress effects revealed that basal oxytocin levels rose steeply three weeks before the semester’s end, followed by rising cortisol levels one week later, with both neurohormones remaining elevated through the very stressful final exam period. Considered together, these data suggest that women’s collective experiences of stress may be potentially buffered by a synchronous oxytocin surge that enhances cognitive accuracy and reduces stress “when the going gets tough”

Misremembering pain: A memory blindness approach to adding a better end.

How people remember feeling in the past informs future decisions; however, memory for past emotion is subject to a number of biases. Previous research on choice blindness has shown that people often fail to notice when they are exposed to misinformation about their own decisions, preferences, and memories. This type of misinformation can influence how they later remember past events. In the present study, we examined the memory blindness effect in a new domain: memory for pain. Participants (N = 269) underwent a cold-pressor task and rated how much pain, distress, and positive and negative affect they had experienced. Later, participants were shown their pain ratings and asked to explain them. Some of the participants were shown lower pain ratings than they had actually made. In a second session, participants recalled how painful the task had been and how much distress and positive and negative affect they remembered experiencing. The results indicated that the majority of participants who were exposed to misinformation failed to detect the manipulation, and subsequently remembered the task as being less painful. The participants in the misinformation condition were not overall more willing to repeat the study tasks, but the participants who recalled less distress, less negative affect, and more positive affect were more willing to repeat the study tasks again in a future experiment. These results demonstrate the malleability of memory for painful experiences and that willingness to repeat aversive experiences may depend more on memory for affective reactions to the original experience than on memory for the physical pain itself

Conflict of Interest Policies at Canadian Universities: Clarity and Content

[À l'origine dans / Was originally part of : ESPUM - Dép. médecine sociale et préventive - Travaux et publications]Abstract Discussions of conflict of interest (COI) in the university have tended to focus on financial interests in the context of medical research; much less attention has been given to COI in general or to the policies that seek to manage COI. Are university COI policies accessible and understandable? To whom are these policies addressed (faculty, staff, students)? Is COI clearly defined in these policies and are procedures laid out for avoiding or remedying such situations? To begin tackling these important ethical and governance questions, our study examines the COI policies at the Group of Thirteen (G13) leading Canadian research universities. Using automated readability analysis tools and an ethical content analysis, we begin the task of comparing the strengths and weaknesses of these documents, paying particular attention to their clarity, readability, and utility in explaining and managing COI.This study was supported by a grant from the Institute of Genetics of the Canadian Institutes of Health Researc

Association between obesity and infarct size: insight into the obesity paradox.

Abstract: Background: In patients with coronary heart disease, being overweight or obese is associated with better outcomes, a phenomenon known as the \u27obesity paradox\u27. Despite the high prevalence of obesity in the United Sates, its effects on infarct size are largely unexplored. Methods: Prospective cross-sectional study of 102 consecutive patients admitted with acute myocardial infarction (MI). Standardized forms were used to collect data on body mass index (BMI), waist circumference (WC), cardiovascular risk factors, and medications. Peak troponin I and creatinine phosphokinase (CPK) were used to estimate infarct size. Epicardial and pericardial fat were measured by echocardiography. We used univariate and multivariate analyses to assess whether obesity was associated with infarct size. Correlations between BMI, WC and cardiac fat with cardiac biomarkers were also performed. Results: Mean age was 62±12 years, and 55% were men. Obesity was diagnosed in 69%. On multivariate analysis, obesity was associated with greater infarct size in non-ST elevation MI (p=0.02). A positive correlation was observed between BMI and peak troponin I (rho=0.24, p=0.03), and both, BMI and WC had a positive correlations with CPK levels (rho=0.28, & rho=0.28, both p=0.02). However, in ST elevation MI, obesity was associated with smaller infarct size (p=0.05). Epicardial fat + pericardial fat had a negative correlation with peak CPK levels (rho=-0.36, p=0.05). Conclusions: We observed an opposite association between obesity and infarct size depending on the type of MI. These results were unexpected and may provide insight into the pathophysiology of the obesity paradox