Comparison of T1 mapping techniques for ECV quantification. histological validation and reproducibility of ShMOLLI versus multibreath-hold T1 quantification equilibrium contrast CMR

BACKGROUND: Myocardial extracellular volume (ECV) is elevated in fibrosis or infiltration and can be quantified by measuring the haematocrit with pre and post contrast T1 at sufficient contrast equilibrium. Equilibrium CMR (EQ-CMR), using a bolus-infusion protocol, has been shown to provide robust measurements of ECV using a multibreath-hold T1 pulse sequence. Newer, faster sequences for T1 mapping promise whole heart coverage and improved clinical utility, but have not been validated. METHODS: Multibreathhold T1 quantification with heart rate correction and single breath-hold T1 mapping using Shortened Modified Look-Locker Inversion recovery (ShMOLLI) were used in equilibrium contrast CMR to generate ECV values and compared in 3 ways.Firstly, both techniques were compared in a spectrum of disease with variable ECV expansion (n=100, 50 healthy volunteers, 12 patients with hypertrophic cardiomyopathy, 18 with severe aortic stenosis, 20 with amyloid). Secondly, both techniques were correlated to human histological collagen volume fraction (CVF%, n=18, severe aortic stenosis biopsies). Thirdly, an assessment of test:retest reproducibility of the 2 CMR techniques was performed 1 week apart in individuals with widely different ECVs (n=10 healthy volunteers, n=7 amyloid patients). RESULTS: More patients were able to perform ShMOLLI than the multibreath-hold technique (6% unable to breath-hold). ECV calculated by multibreath-hold T1 and ShMOLLI showed strong correlation (r(2)=0.892), little bias (bias -2.2%, 95%CI -8.9% to 4.6%) and good agreement (ICC 0.922, range 0.802 to 0.961, p<0.0001). ECV correlated with histological CVF% by multibreath-hold ECV (r(2)= 0.589) but better by ShMOLLI ECV (r(2)= 0.685). Inter-study reproducibility demonstrated that ShMOLLI ECV trended towards greater reproducibility than the multibreath-hold ECV, although this did not reach statistical significance (95%CI -4.9% to 5.4% versus 95%CI -6.4% to 7.3% respectively, p=0.21). CONCLUSIONS: ECV quantification by single breath-hold ShMOLLI T1 mapping can measure ECV by EQ-CMR across the spectrum of interstitial expansion. It is procedurally better tolerated, slightly more reproducible and better correlates with histology compared to the older multibreath-hold FLASH techniques

Perfectionism and training distress in junior athletes: A longitudinal investigation

Perfectionistic athletes may train harder and for longer than non-perfectionistic athletes, leaving them susceptible to elevated levels of training distress. So far, however, no study has investigated the relationships between perfectionism and training distress, a key indicator of overtraining syndrome. Furthermore, no study has determined psychological predictors of overtraining syndrome. Using a two-wave design, the present study examined perfectionistic strivings, perfectionistic concerns, and training distress in 141 junior athletes (mean age 17.3 years, range 16-19 years) over 3 months of active training. Multiple regression analyses were employed to test cross-sectional and longitudinal relationships between perfectionism and training distress. In all analyses, perfectionism emerged as a significant predictor, but strivings and concerns showed differential relationships. When the cross-sectional relationships were regarded, perfectionistic concerns positively predicted training distress (p .05). The findings suggest that sports scientists who wish to identify athletes at risk of overtraining syndrome may monitor athletes’ perfectionistic concerns as a possible risk factor

A person-oriented approach to multidimensional perfectionism: perfectionism profiles in health and well-being

Advances in understanding of the perfectionism construct have been limited by an almost exclusive reliance on a variable-centered approach. This study utilized a person-oriented approach to examine Hewitt and Flett’s conceptualization of multidimensional perfectionism in relation to health and well-being. Levels of conscientiousness, extraversion, and neuroticism were also assessed. Cluster analyses were employed to examine within-person configurations of self-oriented, other-oriented, and socially prescribed perfectionism (SPP) in university students (n = 538) and adults with chronic illness (n = 773). Five unique configurations were found in both samples and three clusters replicated across samples. “Extreme perfectionists” with high scores across all perfectionism dimensions reported relatively poor physical health, psychological health, psychosocial resources, and well-being along with elevated neuroticism and conscientiousness. A group distinguished by elevated SPP also reported relatively poorer outcomes along with elevated neuroticism and lower conscientiousness. In contrast, “nonperfectionists” reported relatively elevated levels of health and well-being. These profiles differed in their links with health and well-being even after taking into account key differences in conscientiousness and neuroticism. Our results illustrate the importance of employing a person-oriented approach to the study of multidimensional perfectionism, especially as it relates to physical health, mental health, and subjective well-being

Perfectionism, achievement motives, and attribution of success and failure in female soccer players

While some researchers have identified adaptive perfectionism as a key characteristic to achieving elite performance in sport, others see perfectionism as a maladaptive characteristic that undermines, rather than helps, athletic performance. Arguing that perfectionism in sport contains both adaptive and maladaptive facets, the present article presents a study of N 5 74 female soccer players investigating how two facets of perfectionism—perfectionistic strivings and negative reactions to imperfection (Stoeber, Otto, Pescheck, Becker, & Stoll, 2007)—are related to achievement motives and attributions of success and failure. Results show that striving for perfection was related to hope of success and self-serving attributions (internal attribution of success). Moreover, once overlap between the two facets of perfectionism was controlled for, striving for perfection was inversely related to fear of failure and self-depreciating attributions (internal attribution of failure). In contrast, negative reactions to imperfection were positively related to fear of failure and self-depreciating attributions (external attribution of success) and inversely related to self-serving attributions (internal attribution of success and external attribution of failure). It is concluded that striving for perfection in sport is associated with an adaptive pattern of positive motivational orientations and self-serving attributions of success and failure, which may help athletic performance. In contrast, negative reactions to imperfection are associated with a maladaptive pattern of negative motivational orientations and self-depreciating attributions, which is likely to undermine athletic performance. Consequently, perfectionism in sport may be adaptive in those athletes who strive for perfection, but can control their negative reactions when performance is less than perfect

Do Electronic Cigarettes Increase Cigarette Smoking in UK Adolescents? Evidence from a 12-month Prospective Study

Background In cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use. Methods Data were from 2836 adolescents (aged 13–14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels. Results At baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use. Conclusions This is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required

Intravenous sodium nitrite in acute ST-elevation myocardial infarction: a randomized controlled trial (NIAMI).

AIM: Despite prompt revascularization of acute myocardial infarction (AMI), substantial myocardial injury may occur, in part a consequence of ischaemia reperfusion injury (IRI). There has been considerable interest in therapies that may reduce IRI. In experimental models of AMI, sodium nitrite substantially reduces IRI. In this double-blind randomized placebo controlled parallel-group trial, we investigated the effects of sodium nitrite administered immediately prior to reperfusion in patients with acute ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: A total of 229 patients presenting with acute STEMI were randomized to receive either an i.v. infusion of 70 μmol sodium nitrite (n = 118) or matching placebo (n = 111) over 5 min immediately before primary percutaneous intervention (PPCI). Patients underwent cardiac magnetic resonance imaging (CMR) at 6-8 days and at 6 months and serial blood sampling was performed over 72 h for the measurement of plasma creatine kinase (CK) and Troponin I. Myocardial infarct size (extent of late gadolinium enhancement at 6-8 days by CMR-the primary endpoint) did not differ between nitrite and placebo groups after adjustment for area at risk, diabetes status, and centre (effect size -0.7% 95% CI: -2.2%, +0.7%; P = 0.34). There were no significant differences in any of the secondary endpoints, including plasma troponin I and CK area under the curve, left ventricular volumes (LV), and ejection fraction (EF) measured at 6-8 days and at 6 months and final infarct size (FIS) measured at 6 months. CONCLUSIONS: Sodium nitrite administered intravenously immediately prior to reperfusion in patients with acute STEMI does not reduce infarct size

Perfectionism and achievement goals in young Finnish ice-hockey players aspiring to make the Under-16 national team

Research on perfectionism suggests that is it useful to differentiate between perfectionistic strivings and perfectionistic concerns. Regarding the 2 x 2 achievement goal framework, the usefulness of this differentiation was recently demonstrated in a study with university student athletes (Stoeber, Stoll, Pescheck, & Otto, 2008, Study 2), in which it was found that perfectionistic strivings were associated with mastery-approach and performance-approach goals and perfectionistic concerns with mastery-avoidance, performance-approach, and performance-avoidance goals. Because the study was largely exploratory and only used non-elite athletes, the aim of the present research was to replicate and extend these findings by investigating a sample of 138 young, elite ice-hockey players, while adding further measures of perfectionism and using structural equation modelling (SEM) to confirm the relationships between perfectionistic strivings, perfectionistic concerns,and the 2 x 2 achievement goals. The SEM results showed that, in elite athletes also, perfectionistic strivings are associated with mastery-approach and performance-approach goals, whereas perfectionistic concerns are associated with masteryavoidance, performance-approach, and performance-avoidance goals. Our findings corroborate the importance of differentiating between perfectionistic strivings and perfectionistic concerns when studying perfectionism in sports, because only perfectionistic concerns (and not perfectionistic strivings) are associated with maladaptive patterns of achievement goals

Perfectionism and self-conscious emotions in British and Japanese students: Predicting pride and embarrassment after success and failure

Regarding self-conscious emotions, studies have shown that different forms of perfectionism show different relationships with pride, shame, and embarrassment depending on success and failure. What is unknown is whether these relationships also show cultural variations. Therefore, we conducted a study investigating how self-oriented and socially prescribed perfectionism predicted pride and embarrassment after success and failure comparing 363 British and 352 Japanese students. Students were asked to respond to a set of scenarios where they imagined achieving either perfect (success) or flawed results (failure). In both British and Japanese students, self-oriented perfectionism positively predicted pride after success and embarrassment after failure whereas socially prescribed perfectionism predicted embarrassment after success and failure. Moreover, in Japanese students, socially prescribed perfectionism positively predicted pride after success and self-oriented perfectionism negatively predicted pride after failure. The findings have implications for our understanding of perfectionism indicating that the perfectionism–pride relationship not only varies between perfectionism dimensions, but may also show cultural variations