Perfectionism and competitive anxiety in athletes

AbstractThe aim of this study was to examine the relationship between perfectionism and competitive anxiety in a sample of athletes. One hundred and seventy three volunteer athletes (115 males, 58 females) were included in this study. All participants were asked to complete the Competitive Perfectionism Scale (CPS) and the Multidimensional Competitive Anxiety Questionnaire (MCAQ). The results revealed that striving for perfection (positive perfectionism) was negatively associated with cognitive and somatic anxiety, and positively associated with self-confidence. The results also revealed that negative reaction to imperfection (negative perfectionism) was positively associated with cognitive and somatic anxiety, and negatively associated with self-confidence

A study of relationship between suicidal ideas, depression, anxiety, resiliency, daily stresses and mental health among Tehran university students

AbstractThe current study was conducted to explore the relationship between suicidal ideas, depression, anxiety, resiliency, daily stresses and mental health among university students. 265 students of Tehran University were studied. They were asked to answer the Beck's depression and anxiety, suicidal ideation, mental health, daily stresses and resiliency questioners. Pearson correlation coefficient and stepwise regression analyses were used for the data analysis. Suicidal ideations had a significant and negative relationship with resiliency. Anxiety, depression, mental health and daily stresses had a positive relationship with suicidal ideations. Regression analysis revealed that depression had the most contribution in predicting suicidal ideations while anxiety, mental health, Resiliency, and daily stresses were the next contributing factors, respectively. These variables could predict 21 percent of suicidal ideations altogether. Psychological problems and mental health issues and other factors such as resiliency and daily stresses play an important role in suicidal ideations

Role of GABAA receptor signaling in ictogenesis and in the modulation of high-frequency oscillations

Temporal lobe epilepsy (TLE) is a form of partial epilepsy in which recurrent seizures originating from the hippocampus proper and para-hippocampal structures (i.e. amygdala, entorhinal cortex and temporal neocortex) occur after a latent period of many years following an initial neurological insult. TLE affects between 50-60% of patients suffering from partial epilepsy, and despite a tremendous increase in the number of antiepileptic drugs made available over the past few decades, up to 80% of these patients are non-responsive to anti-epileptic drugs. Although, hypersynchronous activity of neuronal network is responsible for generating epileptic activities, the mechanisms underlying the excessive neuronal synchronization are yet to be understood. γ-Aminobutyric acid (GABA), which acts as the main inhibitory neurotransmitter in the brain, has been identified to play a role in initiation and maintenance of epileptiform discharges. Interestingly, under specific pharmacological manipulations, GABAA receptor-mediated currents are the sole synaptic mechanism contributing to ictogenesis in the hippocampus and they are associated with marked increases in extracellular [K+]. Therefore, it has been proposed that the initiation and maintenance of ictal activity may result from the inability of the neuronal K+-Cl− co-transporter KCC2 to control intra¬cellular Cl− thus inducing depolarizing (and potentially excitatory) GABAA receptor-mediated Cl− currents along with HCO3−-mediated currents. In my thesis, I addressed the role of GABAA receptor-mediated signaling in ictogenesis. The main findings of my studies can be summarized as follows:First I used field potential recordings in extended in vitro brain slices containing the piriform and entorhinal cortices to clearly identify the characteristics of epileptiform discharges and concomitant high-frequency oscillations (HFOs) during bath application of the K+ channel blocker 4-aminopyridine (4AP). Second, I employed this in vitro brain slice preparation, to study the effects induced by KCC2 blockers and by a KCC2 enhancer on the epileptiform discharges and associated HFOs occurring the in piriform and entorhinal cortices during 4AP application. Here, I discovered that in both regions, blocking KCC2 activity abolished ictal discharges whereas enhancing its activity increased the duration of ictal discharge.Next, to support the view that GABAA receptor signaling actively participates to epileptiform synchronization, I analyzed the effects of a carbonic anhydrase inhibitor on the epileptiform activity. My results demonstrate that GABAA receptor-mediated HCO3− efflux is necessary for the long-lasting ictal discharges induced by 4AP. Finally, I studied the contribution of GABAA receptor-mediated signaling to short- and long-lasting 4AP -induced interictal events recorded from the CA3 region of hippocampus by application of KCC2 blockers/enhancer and carbonic anhydrase inhibitor.Altogether, my findings demonstrated that GABAergic transmission can actively contribute to the generation of hypersynchronous activity and epileptiform discharges through KCC2 dependent increases in extracellular [K+]. In addition, excessive load of Cl− into the postsynaptic neuron during activation of GABAA receptors results in dominance of HCO3− current and depolarizing GABA. I anticipate that my findings will provide new information concerning the role of inhibitory transmission in the generation of epileptic discharges as well as a better understanding of the impact of different anti-epileptic drugs.L'épilepsie du lobe temporale (ETL) est une forme d'épilepsie partielle dont les crises d'origine hippocampique et para-hippocampique (i.e. l'amygdale, le cortex entorhinal et le néocortex temporal) surviennent après une période de latence de plusieurs années suivant une insulte neurologique initiale. L'ETL affecte 50 à 60 % des patients souffrant d'épilepsie partielle et malgré le nombre important d'antiépileptiques disponibles au cours des dernières décennies, 80 % de ces patients ne répondent pas au traitement. Malgré le fait que nous sachions que l'activité hypersynchrone des réseaux neuronaux est responsable de la genèse des crises épileptiques, les mécanismes qui sous-tendent cette synchronisation neuronale excessive demeurent jusqu'à maintenant inconnus. Il a été montré que l'acide γ-aminobutyrique (GABA), le principal neurotransmetteur inhibiteur du cerveau, joue un rôle important dans l'initiation et le maintien dans le temps des décharges épileptiformes. Il est cependant intéressant de noter que dans certaines conditions pharmacologiques, l'activation des récepteurs GABAA serait l'unique mécanisme synaptique contribuant à l'ictogénèse dans l'hippocampe et serait associé à une augmentation importante extracellulaire de [K+]. Ainsi, il a été proposé que l'initiation et le maintien dans le temps de l'activité ictale pourrait résulter de l'incapacité du transporteur KCC2 à contrôler les concentrations intracellulaire de Cl−, ce qui induirait un courant lié au chlore et un courant lié au HCO3− dépolarisants (et potentiellement excitateurs) modulés par l'activité des récepteurs GABAergiques. J'ai étudié les courants modulés par les récepteurs GABAA au cours de l'ictogénèse. Les principaux résultats de mes études sont :J'ai employé des techniques d'enregistrement in vitro des potentiels de champs dans des tranches de cerveau contenant le cortex piriforme et entorhinal afin d'identifier les caractéristiques des décharges épileptiformes et des oscillations à hautes fréquences (OHF) après l'application de 4AP. Grâce à l'usage de cette préparation, j'ai étudié les effets d'antagonistes et agonistes de l'activité KCC2 sur les décharges épileptiformes et sur les OHF dans le cortex piriforme et entorhinal. J'ai découvert que dans ces deux régions, bloquer l'activité du KCC2 abolit les décharges ictales tandis qu'une augmentation de son activité induit une augmentation de leur durée. Afin de soutenir l'hypothèse que l'activité modulée par les récepteurs GABAA contribue à la synchronisation épileptiforme, j'ai analysé les effets d'un inhibiteur de l'anhydrase carbonique sur l'activité épileptiforme. Mes résultats ont montré que l'efflux de HCO3− modulé par les récepteurs GABAA est nécessaire à la genèse de l'activité ictale de longue durée. Finalement, j'ai étudié la contribution des courants modulés par les récepteurs GABAA dans la genèse de pointes interictales de longue et courte durée enregistrées dans la région CA3 de l'hippocampe suite à l'application de bloqueurs de l'activité KCC2 et d'inhibiteurs de l'anhydrase carbonique. Dans l'ensemble, mes résultats montrent que la transmission GABAergique peut contribuer à la génèse d'une activité hypersynchrone et de décharges épileptiformes par une augmentation de la concentration extracellulaire de [K+] dépendante du KCC2. De plus, une concentration excessive de Cl− dans le neurone postsynaptique durant l'activation des récepteurs GABAA conduit à une importante dominance du courant HCO3− et de GABA dépolarisant. Je prévois que mes résultats apporteront des nouvelles informations concernant les rôles de la transmission inhibitrice dans la genèse des décharges épileptiques ainsi qu'une meilleure compréhension de l'impact des antiépileptiques

The Feasibility of a Transitional Care Unit for Patients Newly Started on In-Center Hemodialysis: A Research Letter

Background: Patients with end-stage kidney disease face high mortality and morbidity after dialysis initiation. Transitional care units (TCUs) are typically 4- to 8-week structured multidisciplinary programs targeted toward patients starting hemodialysis during this high-risk time in their care. The goals of such programs are to provide psychosocial support, provide dialysis modality education, and reduce risks of complications. Despite apparent benefits, the TCU model may be challenging to implement, and the effect on patient outcomes is unclear. Objective: To assess a newly created multidisciplinary TCUs’ feasibility for patients newly started on hemodialysis. Design: Before-and-after study. Setting: Kingston Health Sciences Centre hemodialysis unit in Ontario, Canada. Patients: We considered all adult patients (age 18+) who initiated in-center maintenance hemodialysis eligible for the TCU program, although patients on infection control precautions and evening shifts were not able to receive TCU care due to staffing limitations. Measurements: We defined feasibility as eligible patients completing the TCU program in a timely fashion without additional need for space, no signal of harm, and without explicit concerns from TCU staff or patients at weekly meetings. Key outcomes at 6 months included mortality, proportion hospitalized, dialysis modality, vascular access, initiation of transplant workup, and code status. Methods: The TCU care consisted of 1:1 nursing and education until predefined clinical stability and dialysis decisions were satisfied. We compared outcomes among the pre-TCU cohort who initiated hemodialysis between June 2017 and May 2018, and TCU patients who initiated dialysis between June 2018 and March 2019. We summarized outcomes descriptively, along with unadjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: We included 115 pre-TCU patients and 109 post-TCU patients, of whom 49/109 (45%) entered and completed the TCU. The most common reasons for not participating in the TCU included evening hemodialysis shifts (18/60, 30%) or contact precautions (18/60, 30%). The TCU patients completed the program in a median of 35 (25-47) days. We observed no differences in mortality (9% vs 8%; OR = 0.93, 95% CI = 0.28-3.13) or proportion hospitalized (38% vs 39%; OR = 1.02, 95% CI = 0.51-2.03) between the pre-TCU cohort and TCU patients. There was also no difference in use of home dialysis (16% vs 10%; OR = 1.67, 95% CI = 0.64-4.39), non-catheter access (32% vs 25%; OR = 1.44, 95% CI = 0.69-2.98), initiation of transplant workup (14% vs 12%; OR 1.67; 95% CI = 0.64-4.39), and choosing “do not resuscitate” (DNR) orders (22% vs 19%; OR = 1.22, 95% CI = 0.54-2.77). There was no negative patient or staff feedback on the program. Limitations: Small sample size and potential for selection bias given inability to provide TCU care for patients on infection control precautions or evening shifts. Conclusions: The TCU accommodated a large number of patients, who completed the program in a timely fashion. The TCU model was determined to be feasible at our center. There was no difference in outcomes due to the small sample size. Future work at our center is required to expand the number of TCU dialysis chairs to evening shifts and evaluate the TCU model in prospective, controlled studies

Are students performing the same in E-learning and In-person education? An introspective look at learning environments from an Iranian medical school standpoint

Abstract Introduction This study investigated medical students’ intended learning outcomes based on e-learning and in-person education. Methods In this cross-sectional comparative analytical study, a group of 126 undergraduate medical students’ intended learning outcomes under two different teaching methods, including e-learning and in-person, were repeatedly measured based on the census sampling method. Participants were in the preclinical curriculum phase (physiopathology) at Mashhad University of Medical Sciences (MUMS), Iran. Due to expert panel opinion, the same medical teachers and similar difficulty of lessons were considered in two investigated academic semesters. In addition, difficulty and discrimination indexes of formative and summative assessments were controlled for two study groups. The students’ learning outcome index was the knowledge test scores participants received in the relevant lessons of the General Medicine (GM) curriculum preclinical courses. Results The findings indicated that students learning outcomes were significantly higher during e-learning than in in-person education for all examined variables (P < 0.05). Moreover, the difference between students’ Grade Point Average (GPA) categories among the two groups was significant (P = 0.022). Students with a GPA of less than 14 experienced higher increments in their average scores after the e-learning compared to in-person education. Compared to face-to-face courses, improvements in pharmacology, theoretical semiology, and pathology scores after e-learning courses were statistically significant (P < 0.001). The differences in mean scores related to practical pathology and semiology in the two approaches were not statistically significant, P = 0.624 and P = 0.149, respectively. Furthermore, the overall students’ average scores increased significantly during e-learning versus in-person education (P < 0.001). Conclusion We concluded that e-learning could be appreciated as a successful method of medical education and can be used as an alternative educational method. However, considering the importance of practical or clinical courses in medical education, further research about the efficacy of the e-learning approach is highly recommended

Carbachol-induced network oscillations in an in vitro limbic system brain slice

We employed simultaneous field potential recordings from CA3, subiculum and entorhinal cortex in an in vitro brain slice preparation to understand the involvement of these limbic areas in the generation of the field potential oscillations that are induced by bath application of the muscarinic receptor agonist carbachol. Regularly spaced oscillations that mainly presented at theta frequency range (5-12Hz) occurred synchronously in all three structures in the presence of carbachol. These oscillations, which disappeared when slices were perfused with pirenzepine or with glutamatergic receptor antagonists, were categorized as short (4s) with short events oscillating at higher frequencies than long events. Field oscillations were highly synchronized between regions and latency analysis revealed that they often initiated in the entorhinal cortex later than in the other two structures. Blocking GABAA receptors modified the activity patterns of both short and long oscillations and decreased their coherence in the theta frequency range. Finally, blocking KCC2 activity disclosed a pattern of recurrent short oscillations. Our results suggest that in the presence of carbachol both subiculum and CA3 most often drive theta generators in the entorhinal cortex and that these oscillations are influenced but not abolished by altering GABAA receptor signaling

Comparison of apical transportation and centering ability of Mtwo and Reciproc R25 in severely curved canals using cone-beam computed tomography

Background: Apical transportation (AT) of the root canal moves the physiologic canal terminus to a new location on the external root surface and results in the accumulation of debris and residual microorganisms due to inadequate cleaning and shaping of the canal end. This study aimed to assess the prevalence of AT following canal preparation with Mtwo and Reciproc R25 using cone-beam computed tomographic (CBCT). Materials and Methods: In this in vitro study, 40 mesiobuccal root canals of the maxillary molars with 19–22 mm length and (>40°) taper were prepared in two groups using Mtwo and Reciproc R25 rotary systems along with irrigation with 2.5% NaOCl. CBCT scans were obtained of the canals before and after preparation under similar conditions, and the values were measured using the device software. The amount of AT was measured according to Gambill et al. Data were analyzed using SPSS 17 and Chi-square and t-tests. P < 0.05 was considered significant. Results: Both systems caused some degrees of AT. No significant difference was found between the two systems in terms of the amount and direction of AT (P > 0.05); overall, the frequency of AT toward the mesial wall was greater than that toward the distal direction. However, this difference was not statistically significant. Conclusion: The mean amount of AT and the ability to keep the instruments in severely curved canals were not significantly different in canals prepared by Mtwo and Reciproc rotary systems. Thus, these systems can be used in the clinical setting with the lowest risk of AT

Management of a massive choledochal cyst in a 12 year-old girl: Which imaging modalities should be performed preoperatively?

A previously well 12 year-old girl presented to the emergency department with a three-day history of fatigue, pruritus, and epigastric discomfort. Abdominal ultrasound revealed a cystic mass in the right upper quadrant measuring 17.0 × 13.2 × 11.7 cm. Magnetic resonance imaging (MRI) confirmed the diagnosis of a choledochal cyst and hepatobiliary iminodiacetic acid (HIDA) scintigraphy demonstrated a communication between the cyst and biliary tree. Percutaneous cholangiography was also performed but did not provide additional diagnostic information. The patient was brought to the operating room a few days later for open resection of the choledochal cyst, cholecystectomy, and Roux-en-Y hepaticojejunostomy. Frozen sections were obtained to ensure complete excision of cyst mucosa. The patient continues to do well more than 18 months post-operatively with no signs of recurrent inflammation or malignancy. Multiple imaging modalities may be used preoperatively to assess the anatomy and subtype of choledochal cysts. The role of invasive options, such as percutaneous cholangiography or endoscopic retrograde cholangiopancreatograpy (ERCP), remains limited and unclear. Here, we present a potential imaging algorithm to assist with preoperative workup and avoid invasive diagnostic procedures whenever possible

Rapid, direct fabrication of antireflection-coated microlens arrays by photoembossing

Photoembossing is a rapid, low cost process to create surface relief structures in polymer thin films via a reaction/diffusion mechanism. It is demonstrated that this technique can be used to create a microlens array of which the focal length can be easily controlled by tuning the processing parameters. In addition, the technique is shown to be particularly interesting since it does not require any physical contact during the development of the microlens array. Additional coatings (e.g., a solution-processable antireflection coating) can therefore be applied prior to the development of the microlens array when the film is still flat. This stimulates the formation of films with a homogeneous thickness distribution and obviates the use of further postprocessing steps

Therapeutic Potential of Umbilical Cord Blood Stem Cells on Brain Damage of a Model of Stroke

Introduction: Human cord blood-derived stem cells are a rich source of stem cells as well as precursors. With regard to the researchers have focused on the therapeutic potential of stem cell in the neurological disease such as stroke, the aim of this study was the investiga-tion of the therapeutic effects of human cord blood-derived stem cells in cerebral ischemia on rat. Methods: This study was carried out on young rats. Firstly, to create a laboratory model of ischemic stroke, carotid artery of animals was occluded for 30 minutes. Then, umbilical cord blood cells were isolated and labeled using bromodeoxyuridine and 2×105 cells were injected into the experimental group via the tail vein. Rats with hypoxic condi-tions were used as a sham group. A group of animals did not receive any injection or sur-geries were used as a control. Results: Obtained results were evaluated based on behavior-al responses and immunohistochemistry, with emphasis on areas of putamen and caudate nucleus in the control, sham and experimental groups. Our results indicated that behavioral recovery was observed in the experimental group compared to the either the sham or the control group. However, histological studies demonstrated a low percent of tissue injury in the experimental group in comparison with the sham group. Conclusion: Stem cell trans-plantation is beneficial for the brain tissue reparation after hypoxic ischemic cell death