Incorporating spiritual beliefs into a cognitive model of worry

Cognitive theory and research have traditionally highlighted the relevance of the core beliefs about oneself, the world, and the future to human emotions. For some individuals, however, core beliefs may also explicitly involve spiritual themes. In this article, we propose a cognitive model of worry, in which positive/negative beliefs about the Divine affect symptoms through the mechanism of intolerance of uncertainty. Using mediation analyses, we found support for our model across two studies, in particular, with regards to negative spiritual beliefs. These findings highlight the importance of assessing for spiritual alongside secular convictions when creating cognitive-behavioral case formulations in the treatment of religious individuals

Cardiac myocyte-specific knock-out of calcium-independent phospholipase A2γ (iPLA2γ) decreases oxidized fatty acids during ischemia/reperfusion and reduces infarct size

Calcium-independent phospholipase A(2)γ (iPLA(2)γ) is a mitochondrial enzyme that produces lipid second messengers that facilitate opening of the mitochondrial permeability transition pore (mPTP) and contribute to the production of oxidized fatty acids in myocardium. To specifically identify the roles of iPLA(2)γ in cardiac myocytes, we generated cardiac myocyte-specific iPLA(2)γ knock-out (CMiPLA(2)γKO) mice by removing the exon encoding the active site serine (Ser-477). Hearts of CMiPLA(2)γKO mice exhibited normal hemodynamic function, glycerophospholipid molecular species composition, and normal rates of mitochondrial respiration and ATP production. In contrast, CMiPLA(2)γKO mice demonstrated attenuated Ca(2+)-induced mPTP opening that could be rapidly restored by the addition of palmitate and substantially reduced production of oxidized polyunsaturated fatty acids (PUFAs). Furthermore, myocardial ischemia/reperfusion (I/R) in CMiPLA(2)γKO mice (30 min of ischemia followed by 30 min of reperfusion in vivo) dramatically decreased oxidized fatty acid production in the ischemic border zones. Moreover, CMiPLA(2)γKO mice subjected to 30 min of ischemia followed by 24 h of reperfusion in vivo developed substantially less cardiac necrosis in the area-at-risk in comparison with their WT littermates. Furthermore, we found that membrane depolarization in murine heart mitochondria was sensitized to Ca(2+) by the presence of oxidized PUFAs. Because mitochondrial membrane depolarization and calcium are known to activate iPLA(2)γ, these results are consistent with salvage of myocardium after I/R by iPLA(2)γ loss of function through decreasing mPTP opening, diminishing production of proinflammatory oxidized fatty acids, and attenuating the deleterious effects of abrupt increases in calcium ion on membrane potential during reperfusion

Macrophages and Intravascular OCT Bright Spots A Quantitative Study

ObjectivesThis study hypothesized that bright spots in intravascular optical coherence tomography (IVOCT) images may originate by colocalization of plaque materials of differing indexes of refraction. To quantitatively identify bright spots, we developed an algorithm that accounts for factors including tissue depth, distance from light source, and signal-to-noise ratio. We used this algorithm to perform a bright spot analysis of IVOCT images and compared these results with histological examination of matching tissue sections.BackgroundBright spots are thought to represent macrophages in IVOCT images, and studies of alternative etiologies have not been reported.MethodsFresh human coronary arteries (n = 14 from 10 hearts) were imaged with IVOCT in a mock catheterization laboratory and then processed for histological analysis. The quantitative bright spot algorithm was applied to all images.ResultsResults are reported for 1,599 IVOCT images co-registered with histology. Macrophages alone were responsible for only 23% of the bright spot-positive regions, although they were present in 57% of bright spot-positive regions (as determined by histology). Additional etiologies for bright spots included cellular fibrous tissue (8%), interfaces between calcium and fibrous tissue (10%), calcium and lipids (5%), and fibrous cap and lipid pool (3%). Additionally, we showed that large pools of macrophages in CD68(+) histology sections corresponded to dark regions in comparative IVOCT images; this is due to the fact that a pool of lipid-rich macrophages will have the same index of refraction as a pool of lipid and thus will not cause bright spots.ConclusionsBright spots in IVOCT images were correlated with a variety of plaque components that cause sharp changes in the index of refraction. Algorithms that incorporate these correlations may be developed to improve the identification of some types of vulnerable plaque and allow standardization of IVOCT image interpretation

Hard X-ray stereographic microscopy for single-shot differential phase imaging

The characterisation of fast phenomena at the microscopic scale is required for the understanding of catastrophic responses of materials to loads and shocks, the processing of materials by optical or mechanical means, the processes involved in many key technologies such as additive manufacturing and microfluidics, and the mixing of fuels in combustion. Such processes are usually stochastic in nature and occur within the opaque interior volumes of materials or samples, with complex dynamics that evolve in all three dimensions at speeds exceeding many meters per second. There is therefore a need for the ability to record three-dimensional X-ray movies of irreversible processes with resolutions of micrometers and frame rates of microseconds. Here we demonstrate a method to achieve this by recording a stereo phase-contrast image pair in a single exposure. The two images are combined computationally to reconstruct a 3D model of the object. The method is extendable to more than two simultaneous views. When combined with megahertz pulse trains of X-ray free-electron lasers (XFELs) it will be possible to create movies able to resolve 3D trajectories with velocities of kilometers per second

Sagittal kinematics of mobile unicompartmental knee replacement in anterior cruciate ligament deficient knees

Background: There is a greater risk of tibial component loosening when mobile unicompartmental knee replacement is performed in anterior cruciate ligament deficient knees. We previously reported on a cohort of anterior cruciate ligament deficient patients (n=46) who had undergone surgery, but no difference was found in implant survivorship at mean 5 year follow-up. The purpose this study was to examine the kinematic behaviour of a subcohort of these patients. Methods: The kinematic behaviour of anterior cruciate deficient knees (n=16) after mobile unicompartmental knee replacement was compared to matched intact knees (n=16). Sagittal plane knee fluoroscopy was taken while patients performed step-up and forward lunge exercises. The patellar tendon angle, knee flexion angle and implant position was calculated for each video frame. Findings: The patellar tendon angle was 5° lower in the deficient group, indicating greater anterior tibial translation compared to the intact group between 30 and 40 degrees of flexion. Large variability, particularly from 40-60 degrees of flexion, was observed in the bearing position of the deficient group, which may represent different coping mechanisms. The deficient group took 38% longer to perform the exercises. Interpretation: Kinematic differences were found between the deficient and intact knees after mobile unicompartmental knee replacement; but these kinematic changes do not seem to affect the medium-term clinical outcome. Whether these altered knee kinematics will have a clinical impact is as yet undetermined, but more long-term outcome data is required before mobile unicompartmental knee replacement can be recommended for an anterior cruciate ligament deficient patient

Behaviour of Anterior Cruciate Ligament (ACL) Deficient Knees after Unicompartmental Knee Arthroplasty (UKA)

Abstract:Introduction: ACL-deficiency is a contraindication for UKA because it has been linked with early failure, in particular tibial tray loosening [1]; but a more recent study has shown no difference in the survivorship in ACL-deficient patients at 5 years post-operatively [2]. The purpose of this study was to examine the movement of ACL-deficient knees after UKA when stair climbing, to assess the function of ACL-deficient knees after UKA. Methods:This case-control study involved fluoroscopically examining 16 ACL-deficient knees (14 patients) which had undergone medial UKA. Fluoroscopy videos were taken in the sagittal plane. A matching group of 16 ACL-intact knees (13 patients) were then assessed; groups were matched for age, follow-up time, and gender, and no significant differences were found between the groups (Table 1). Starting with their leg on the step at a knee flexion angle (KFA) of 90°, patients were asked to step up, while ensuring their knee remained within the view of the fluoroscope. The patellar tendon angle (PTA) and KFA was measured on each frame of each fluoroscopic video, and the total time taken to perform the exercise was noted. The PTA is the angle between the patellar tendon and the tibial mechanical axis and it represents the anterior posterior translation of the femur relative to the tibia. In addition, patients were asked to complete three questionnaires; the Oxford Knee Score (OKS), the Tegner Activity Score (TAS) and the Visual Analogue Scale (VAS) Pain Score. Results:No differences were found in the OKS (p=0.35), TAS (p=0.15) or VAS Pain score (p=0.73) between the two groups. When the KFA was ~30° the PTA was 5° lower in the ACL-deficient group compared with the ACL-intact group (p=0.0002, Fig 1). A 2.9° reduction in PTA was also observed at a KFA of 60° (p=0.007, Fig 1). ACL-deficient group took 30.7% (13 s) longer to perform the step-up exercise on average compared to the ACL-intact group, which was significant (p=0.0007).Discussion and Conclusion:The lower PTA in the ACL-deficient knees at 30°, 40° and 60° KFA indicates increased anterior translation of the tibia. A healthy ACL resists anterior tibial translation; therefore the absence of ACL function appears to have caused knee instability at these particular angles. In addition, the increased time taken for the ACL-deficient group to step up indicates hesitancy when stair climbing and may relate to the reduced proprioception within the knee. This study highlights the importance of ACL function in maintaining knee stability after UKA. Knee instability may relate to the tibial loosening reported for ACL-deficient knees after UKA; however, no sign of loosening was observed in this study. ACL reconstruction in conjunction with UKA has been shown to restore stability and may be the best option for ACL-deficient patients with medial compartment osteoarthritis.References:[1] J Goodfellow et al., J Bone Joint Surg [Br]. 1988; 70-B(5):692-701[2] A Boissonneault et al., Knee Surg Sport Tr A. 2013;21(11):2480-

Does pre-operative psychological distress affect patient satisfaction after primary total hip arthroplasty?

<p>Abstract</p> <p>Background</p> <p>There are concerns that pre-operative psychological distress might be associated with reduced patient satisfaction after total hip replacement (THR).</p> <p>Methods</p> <p>We investigated this in a multi-centre prospective study between January 1999 and January 2002. We dichotomised the patients into the mentally distressed (MHS ≤ 56) and the not mentally distressed (MHS > 56) groups based on their pre-operative Mental Health Score (MHS) of SF36.</p> <p>Results</p> <p>448 patients (340 not distressed and 108 distressed) completed the patient satisfaction survey. Patient satisfaction rate at five year was 96.66% (415/448). There was no difference in patient satisfaction or willingness to have the surgery between the two groups. None of pre-operative variables predicted five year patient satisfaction in logistic regression.</p> <p>Conclusions</p> <p>Patient satisfaction after surgery may not be adversely affected by pre-operative psychological distress.</p

Aerodynamic investigations of ventilated brake discs.

The heat dissipation and performance of a ventilated brake disc strongly depends on the aerodynamic characteristics of the flow through the rotor passages. The aim of this investigation was to provide an improved understanding of ventilated brake rotor flow phenomena, with a view to improving heat dissipation, as well as providing a measurement data set for validation of computational fluid dynamics methods. The flow fields at the exit of four different brake rotor geometries, rotated in free air, were measured using a five-hole pressure probe and a hot-wire anemometry system. The principal measurements were taken using two-component hot-wire techniques and were used to determine mean and unsteady flow characteristics at the exit of the brake rotors. Using phase-locked data processing, it was possible to reveal the spatial and temporal flow variation within individual rotor passages. The effects of disc geometry and rotational speed on the mean flow, passage turbulence intensity, and mass flow were determined. The rotor exit jet and wake flow were clearly observed as characterized by the passage geometry as well as definite regions of high and low turbulence. The aerodynamic flow characteristics were found to be reasonably independent of rotational speed but highly dependent upon rotor geometry

STEPWISE Project: Sorption-Enhanced Water-Gas Shift Technology to Reduce Carbon Footprint in the Iron and Steel Industry

ndustrial processes contribute significantly to global carbon dioxide emissions, with iron and steel manufacturing alone responsible for 6% of the total figure. The STEPWISE project, funded through the European Horizon 2020 (H2020) Low Carbon Energy (LCE) programme under grant agreement number 640769, is looking at reducing CO 2 emissions in the iron and steel making industries. At the heart of this project is the ECN technology called sorption-enhanced water-gas shift (SEWGS), which is a solid sorption technology for CO 2 capture from fuel gases such as blast furnace gas (BFG). This technology combines water-gas shift (WGS) in the WGS section with CO 2 /H 2 separation steps in the SEWGS section. Scaling up of the SEWGS technology for CO 2 capture from BFG and demonstrating it in an industrially relevant environment are the key objectives of the STEPWISE project, which are achieved by international collaboration between the project partners towards design, construction and operation of a pilot plant at Swerea Mefos, Luleå, Sweden, next to the SSAB steel manufacturing site