Thwarted Belongingness and Depressive Symptoms Among Older Adults: The Moderating Roles of Self-Warmth, Self-Coldness, and Place of Residence

OBJECTIVES

This study investigated whether the relationship between thwarted belongingness and depressive symptoms was moderated by self-warmth and self-coldness and whether the moderating effects were conditional on place of residence (urban versus rural).

METHODS

A sample of 236 Australian adults aged 65 to 97 years (M = 73.63, SD = 6.53) completed the Geriatric Depression Scale, Interpersonal Needs Questionnaire, and Self-Compassion Scale.

RESULTS

The interaction between thwarted belongingness and self-warmth was significant for urban but not rural older adults. For urban older adults, the relationship between thwarted belongingness and depressive symptoms weakened as levels of self-warmth increased. The association between thwarted belongingness and depressive symptoms was significantly stronger for older adults living in rural areas than in urban areas. The relationship between thwarted belongingness and depressive symptoms strengthened as self-coldness levels increased.

CONCLUSIONS

Self-warmth is a protective factor for older adults living in urban areas and experiencing thwarted belongingness. Self-coldness is an additional risk factor for older adults experiencing thwarted belongingness.

CLINICAL IMPLICATIONS

Interventions focusing on increasing self-warmth among urban older adults and decreasing self-coldness among older adults might weaken the relationship between thwarted belongingness and depressive symptoms.

MicroCT Imaging of Heart Valve Tissue in Fluid

BACKGROUND

Heart valve computational models require high quality geometric input data, commonly obtained using micro-computed tomography. Whether in the open or closed configuration, most studies utilize dry valves, which poses significant challenges including gravitational and surface tension effects along with desiccation induced mechanical changes.

OBJECTIVE

These challenges are overcome by scanning in a stress-free configuration in fluid. Utilizing fluid backgrounds however reduces overall contrast due to the similar density of fluid and tissue.

METHODS

The work presented here demonstrates imaging of the mitral valve by utilizing an iodine-based staining solution to improve the contrast of valve tissue against a fluid background and investigates the role of stain time and concentration.

RESULTS

It is determined that an Olea europaea oil bath with a relatively high concentration, short stain time approach produces high quality imagery suitable for creating accurate 3D renderings.

CONCLUSIONS

Micro-CT scanning of heart valves in fluid is shown to be feasible using iodine staining techniques.

A NEW SEMI-EMPIRICAL AMBIENT TO EFFECTIVE DOSE CONVERSION MODEL FOR THE PREDICTIVE CODE FOR AIRCREW RADIATION EXPOSURE (PCAIRE)

The Predictive Code for Aircrew Radiation Exposure (PCAIRE) is a semi-empirical code that estimates both ambient dose equivalent, based on years of on-board measurements, and effective dose to aircrew. Currently, PCAIRE estimates effective dose by converting the ambient dose equivalent to effective dose (E/H) using a model that is based on radiation transport calculations and on the radiation weighting factors recommended in International Commission on Radiological Protection (ICRP) 60. In this study, a new semi-empirical E/H model is proposed to replace the existing transport calculation models. The new model is based on flight data measured using a tissue-equivalent proportional counter (TEPC). The measured flight TEPC data are separated into a low- and a high-lineal-energy spectrum using an amplitude-weighted ¹³⁷Cs TEPC spectrum. The high-lineal-energy spectrum is determined by subtracting the low-lineal-energy spectrum from the measured flight TEPC spectrum. With knowledge of E/H for the low- and high-lineal-energy spectra, the total E/H is estimated for a given flight altitude and geographic location. The semi-empirical E/H model also uses new radiation weighting factors to align the model with the most recent ICRP 103 recommendations. The ICRP 103-based semi-empirical effective dose model predicts that there is a ∼30 % reduction in dose in comparison with the ICRP 60-based model. Furthermore, the ambient dose equivalent is now a more conservative dose estimate for jet aircraft altitudes in the range of 7-13 km (FL230-430). This new semi-empirical E/H model is validated against E/H predicted from a Monte Carlo N-Particle transport code simulation of cosmic ray propagation through the Earth's atmosphere. Its implementation allows PCAIRE to provide an accurate semi-empirical estimate of the effective dose.

Lupus Anticoagulant, Antiphospholipid Syndrome and Cardiac Surgery

The presence of lupus anticoagulant and the related condition antiphospholipid syndrome present a challenge in cardiac surgery where measured anticoagulation may not reflect the in vivo patient status of hypercoagulation. We report the successful management of a patient with lupus anticoagulant presenting for aortic valve replacement and coronary revascularisation. We used heparin for anticoagulation, specialised additional tests of anticoagulation and a reduced protamine dose. We also used tranexamic acid. The clinical problems with anticoagulation in patients with lupus anticoagulant include anticoagulant choice, measurement of adequate anticoagulation, antifibrinolytic usage, protamine dosing and blood product transfusion.

Measurement and modelling of radioxenon plumes in the Ottawa Valley

Since 2001 a real-time radiation monitoring network of Canadian nuclear facilities and major population centres has been implemented for response to nuclear incidents including a possible terrorist attack. Unshielded NaI(Tl) spectroscopic detectors are employed to measure gamma radiation from airborne radioactivity and radioactivity deposited on the ground. These detectors are composed of a standard 3''x3'' cylindrical NaI(Tl) spectrometers with data storage and integrated telemetry. Some of the detectors have been deployed in the Ottawa Valley near Chalk River Laboratories and Ottawa, which has a complex radioxenon environment due to the proximity of nuclear power reactors, and medical isotope facilities. Although not a health threat, these releases have provided an opportunity for the Canadian Meteorological Centre and the Commissariat à l'Energie Atomique to validate their meteorological models. The meteorological models of the two organizations are in good agreement on the origin and the source terms of these releases.

Automated radioxenon monitoring for the comprehensive nuclear-test-ban treaty in two distinctive locations: Ottawa and Tahiti

In preparation for verification of the Comprehensive Nuclear-Test-Ban-Treaty, automated radioxenon monitoring is performed in two distinctive environments: Ottawa and Tahiti. These sites are monitored with SPALAX (Systeme de Prelevement d'air Automatique en Ligne avec l'Analyse des radioXenons) technology, which automatically extracts radioxenon from the atmosphere and measures the activity concentrations of (131m,133m,133,135)Xe. The resulting isotopic concentrations can be useful to discern nuclear explosions from nuclear industry xenon emissions. Ambient radon background, which may adversely impact analyser sensitivity, is discussed. Upper concentration limits are reported for the apparently radioxenon free Tahiti environment. Ottawa has a complex radioxenon background due to proximity to nuclear reactors and medical isotope facilities. Meteorological models suggest that, depending on the wind direction, the radioxenon detected in Ottawa can be characteristic of the normal radioxenon background in the Eastern United States, Europe, and Japan or distinctive due to medical isotope production.

Inhibition of collagen synthesis with prolyl 4-hydroxylase inhibitor improves left ventricular function and alters the pattern of left ventricular dilatation after myocardial infarction

Background- Left ventricular (LV) remodeling after myocardial infarction (MI) is associated with fibrosis, dilatation, and dysfunction. We postulated that prevention of fibrosis after MI with a prolyl 4-hydroxylase inhibitor (P4HI) would preserve LV function and attenuate LV enlargement. Methods and Results- Adult female rats (200 to 250 g) had experimental MI and were then randomized to treatment with P4HI (MI-FG041, n=29) or vehicle (MI-control, n=29) 48 hours after MI for 4 weeks in 2 phases. Echocardiograms were performed weekly with a 15-MHz linear transducer, and at 4 weeks, collagen isoform determinations and in vivo hemodynamics were performed. At randomization, the infarct size and LV function and size were similar in MI-FG041 and MI-control but significantly different from shams (n=9). At week 4, the LV function in MI-FG041 was significantly better than in MI-controls (fractional shortening 21% versus 16%, P=0.01; fractional area change 30% versus 19%, P=0.002; ejection fraction 35% versus 23%, P=0.001). In the FG041 group, LV area in systole was less (P<0.05), the dP/dt(max) after isoproterenol was higher (P<0.05), and types I and III collagen in noninfarcted LV were less than in MI-control. The hydroxyproline/proline ratio was increased by 64% in MI-control and reduced to the sham value in MI-FG041 rats. In the scar tissue, it was reduced by 24% in MI-FG041. Conclusions- This study demonstrates that prevention of interstitial fibrosis with a P4H inhibitor alters the pattern of LV enlargement and produces partial recovery of LV function after MI.

Is the technically limited echocardiographic study an endangered species? endocardial border definition with native tissue harmonic imaging and Optison contrast: a review of 200 cases

OBJECTIVE

Our goal was to determine whether contrast adds diagnostic value to both fundamental and native tissue harmonic imaging (NTHI) for endocardial border definition.

METHODS

Two hundred consecutive patients who underwent stress echocardiography imaging were studied in either fundamental (n = 52) or NTHI mode (n = 148) with an Acuson Sequoia echocardiographic system. Contrast agent (Optison) was administered (0.5 to 1 mL) for enhancement of endocardial borders. Two- and 4-chamber views were analyzed before and after administration of contrast at peak stress for grading of 5 endocardial border segments. Scores from 0 to 5 were assigned to each study for all the images both before and after contrast (0 = 0 segments completely visualized; 5 = 5 segments completely visualized).

RESULTS

The use of Optison contrast significantly enhanced border definition when imaging was performed in either fundamental or NTHI mode. Addition of contrast resulted in better endocardial border definition in fundamental mode (4.1 + or - 1.0 versus 2.3 + or - 1.3, P <.001). However, in NTHI mode, the presence of contrast resulted in enhanced definition of endocardial border compared with its absence (4.8 + or - 0.5 versus 3.3 + or - 1.1, P <.001). The combination of NTHI and contrast resulted in more visualization of endocardium when compared with the combination of fundamental imaging and contrast (4.8 + or - 0.5 versus 4.1 + or - 1.0, P <.001). In addition, interobserver agreement for border detection increased from 83% in fundamental mode without contrast to 95% with the use of NTHI with Optison (P <.001).

CONCLUSION

As defined in 200 cases, the combination of NTHI with Optison contrast results in nearly complete and consistent endocardial border definition.

Metabolism of carvedilol in dogs, rats, and mice

The excretion and biotransformation of carvedilol [1-[carbazolyl-(4)-oxy]-3-[(2-methoxyphenoxyethyl)amino]-2-p ropanol], a new, multiple-action, neurohormonal antagonist that exhibits the combined pharmacological activities of beta-adrenoreceptor antagonism, vasodilation, and antioxidation, were investigated in dogs, rats, and mice. Carvedilol was absorbed well, and biliary secretion was predominant in each species. Carvedilol was metabolized extensively in each species, and elimination of unchanged compound was minor in bile duct-catheterized rats and dogs. In dogs, glucuronidation of the parent compound and hydroxylation of the carbazolyl ring, with subsequent glucuronidation, were the major metabolic pathways. Rats showed the simplest metabolite profile; the primary metabolites were formed by hydroxylation of the carbazolyl ring, with subsequent glucuronidation. Mice displayed the most complicated metabolite profile; glucuronidation of the parent compound and hydroxylation of either the carbazolyl or phenyl ring, with subsequent glucuronidation, were the major metabolic routes. O-Dealkylation was a minor pathway in all species examined.

The use of methotrexate and arterial embolization to avoid surgery in a case of cervical pregnancy

OBJECTIVE

To describe the management of a case of cervical ectopic pregnancy (EP) DESIGN: Case report.

SETTING

University-affiliated teaching hospital.

PATIENT(S)

A 26-year-old woman, gravida 4, para 0-1-2-0 with the diagnosis of a cervical EP.

INTERVENTION(S)

Systemic methotrexate (MTX) and arterial embolization.

RESULT(S)

A cervical EP was diagnosed by ultrasonography. The patient was treated with systemic MTX. Vaginal bleeding began 4 days later and was treated with arterial embolization, thus eliminating the need for surgical intervention. The pregnancy resolved and the patient has resumed normal menstruation and again is attempting pregnancy.

CONCLUSION(S)

Arterial embolization can be used to avoid surgical intervention in cases of cervical EP in which hemorrhage occurs after treatment with chemotherapy.

Distant entry pneumothorax in a competitive fencer

An elite level fencer sustained a penetrating wound to the upper arm after his opponent's blade broke. Standard care for a deep puncture wound was given but it was some time before the athlete presented symptoms of a pneumothorax, which was confirmed by radiograph. Although resolution of this case was unremarkable, the possibility of penetrating thoracic injury, even when the point of entry is well outside the thorax and the athlete is not immediately symptomatic, should be born in mind by medical personnel working with fencers.

Muscle function at the wrist following 9 d of immobilization and suspension

The purpose of this study was to evaluate the effects of 9 d of immobilization and partial suspension on muscle function at the wrist. Twelve female subjects (19-27 yr) wore a cast suspended from the neck by a sling that immobilized muscles acting on the wrist. Atrophy, muscle damage indicators, isometric and isokinetic strength, reaction time, speed of movement, and fatigability were assessed. Forearm muscle cross-sectional area decreased by 4.1% following immobilization and suspension. There was no indication that significant muscle degeneration occurred during immobilization or when muscles resumed normal function. Isometric strength for flexion and extension decreased by 29.3 and 32.5%, respectively. Concentric strength decrements for flexion, extension, pronation, and supination ranged from 8.9-21.7% at 2.11 and 3.16 rad.s-1. Eccentric strength decrements at 2.11 rad.s-1 for the same movements ranged from 12.5-18.5%. Fatigability was unaffected. Greater relative strength losses compared to decreased muscle cross-sectional area may be the result of a decrease in contractile protein density or unidentified neural factors following immobilization and partial suspension. However, neuromuscular control of reaction time was not affected.

Muscle function at the wrist following 9 d of immobilization and suspension

The purpose of this study was to evaluate the effects of 9 d of immobilization and partial suspension on muscle function at the wrist. Twelve female subjects (19-27 yr) wore a cast suspended from the neck by a sling that immobilized muscles acting on the wrist. Atrophy, muscle damage indicators, isometric and isokinetic strength, reaction time, speed of movement, and fatigability were assessed. Forearm muscle cross-sectional area decreased by 4.1% following immobilization and suspension. There was no indication that significant muscle degeneration occurred during immobilization or when muscles resumed normal function. Isometric strength for flexion and extension decreased by 29.3 and 32.5%, respectively. Concentric strength decrements for flexion, extension, pronation, and supination ranged from 8.9-21.7% at 2.11 and 3.16 rad.s-1. Eccentric strength decrements at 2.11 rad.s-1 for the same movements ranged from 12.5-18.5%. Fatigability was unaffected. Greater relative strength losses compared to decreased muscle cross-sectional area may be the result of a decrease in contractile protein density or unidentified neural factors following immobilization and partial suspension. However, neuromuscular control of reaction time was not affected.

The relationship of early versus two-minute recovery echocardiographic values following maximal effort resistance exercise

Two-dimensionally directed M-mode echocardiography was used to measure left ventricular systolic function following maximal dynamic resistance exercise (RE). Upright measurements were made from the long axis parasternal view at rest, 20 seconds post-exercise, and two minutes post-exercise. Thirty-two successful studies were recorded from a total of 37 trained and untrained male subjects who were heterogeneous as to mode and level of training. Resistance-trained men averaged 3.8 +/- 2.4 yrs of training for 9.7 +/- 3.0 hr/wk, and endurance-trained men averaged 6.4 +/- 3.9 yr of training at 202.5 +/- 112.6 km/wk of cycling, running, and swimming. The trained men competed at the state or regional level. The RE protocol (knee extensions) was performed as follows: Set 1 (10 s rest) Set 2 (10 s rest) Set 3 60% 1-RM@8 reps 60% 1-RM@8 reps 60% 1-RM to fatigue. The RE protocol produced significant post-exercise reductions in end-systolic diameter (p less than 0.0002) and significant post-exercise increases in fractional shortening (p less than 0.0001) and velocity of circumferential fiber shortening (p less than 0.0002). The inotropic variables were still significantly different at two minutes post-exercise compared to the 20 second measure, suggesting that early recovery is a better approximation of maximal values. Velocity of circumferential fiber shortening at 20 seconds and two minutes was significantly correlated (r = 0.39) and fractional shortening was not (r = 0.34) at these serial measurement times.(ABSTRACT TRUNCATED AT 250 WORDS)

Induction of cylindrical confronting cisternae (AIDS inclusions) in Daudi lymphoblastoid cells by recombinant alpha-interferon

Cylindrical confronting cisternae (CCC), also known as test-tube and ring-shaped forms, are frequently present in the cytoplasm of lymphocytes and occasionally in other cells from patients with acquired immunodeficiency syndrome (AIDS). Recent data indicate that the presence of these cisternae and tubuloreticular structures (TRS) in lymphocytes from patients at risk for AIDS is predictive of the development of this syndrome. CCC are formed by an alteration of the membranes of the rough endoplasmic reticulum, but the mechanism by which they are formed or demonstration of their induction by specific agents has not been previously reported. We cultured Daudi lymphoblastoid cells in medium containing recombinant alpha-interferon and induced the formation of both TRS and CCC. The number of CCC formed in Daudi cells was directly proportional to the concentration of interferon used and the length of culture. CCC were in direct continuity with TRS, which were induced in cells by interferon at an earlier time. The percentage of cell sections containing TRS stayed the same or decreased somewhat after 72 hours of culture, whereas the number of CCC increased. Our results indicate that CCC could be present in various cells from patients with AIDS and other diseases as a result of elevated interferon levels in these conditions.

Non-specific peptide size effects in the recognition by site-specific T-cell clones. Demonstration with a T site of myoglobin

Six regions (T sites) of myoglobin (Mb) were found by a comprehensive synthetic strategy to stimulate Mb-primed lymph-node cells. To define precisely the N-terminal boundary of the immunodominant T site (residues 107-120) with site-specific T-cell clones and to determine the effects of peptide size on their stimulation, two sets of peptides were employed. In one set, the peptides were elongated to the left from His-113 by one-residue increments of the Mb sequence. The other set represented an identical stepwise elongation by one-residue increments of the Mb sequence, but which were extended by additional unrelated ('nonsense') residues to a uniform size of 14 residues. Examination of the proliferative responses of eight T-cell clones, derived from Mb-primed DBA/2 (H-2d) or SJL (H-2s) mice, revealed a dramatic non-specific size requirement. In every clone, the longer nonsense-extended peptides achieved maximum stimulating activity at a lower optimum peptide dose than its natural-sequence, but shorter, analogue. In addition, slight (one-residue) differences in the N-terminal boundaries among the clones was observed. Thus, the fine specificity of each clone was mapped to the region from residue 111 or 112 to about residue 120 of Mb, which coincides with the site of B-cell recognition and resides in a small discrete surface region of the protein chain.

Site recognition by protein-primed T cells shows a non-specific peptide size requirement beyond the essential residues of the site. Demonstration by defining an immunodominant T site in myoglobin

In previous studies, six T sites within myoglobin (Mb) were localized. To define precisely the boundaries of the T sites, a new approach is introduced and applied here to the T site residing within residues 107-120 of Mb. Two sets of peptides were synthesized. One set represents a stepwise elongation by one-residue increments of the Mb sequence. The other set represents an identical stepwise addition of one-residue increments of the Mb sequence, but which were extended by additional unrelated (nonsense) residues to a uniform size of 14 residues. The longer peptides (nonsense-extended) usually gave higher proliferative responses than did their shorter counterparts having the same Mb region. Thus a minimum peptide size is required for optimal T-cell stimulation. The T site subtends, in three high-responder mouse strains, residues 109-119 or 110-120, depending on strain, and, in three low-responder strains, maps to residues 108-120. Thus, in this case, the T site coincides with the site of B-cell recognition and resides in a small discrete surface region of the protein chain.

Clinical implications of models for recovery from alcoholism

Various models of alcoholism are hotly championed and condemned by clinicians and theoreticians alike. Choice of model is important because it determines clinical thinking about the process of recovery from alcoholism. This paper conceptualizes the steps a patient must take to recover from alcoholism. It shows how three common models of alcoholism, the medical, the moral and the symptom, can be combined to visualize the separate tasks which must be carried out to recover from alcoholism. The distinct tasks are obscured because in clinical practice they are overlapping or simultaneous.

Argininosuccinic aciduria: prenatal studies in a family at risk

We have monitored two successive pregnancies in a family which we found to be at risk for argininosuccinic aciduria. We measured argininosuccinic acid (ASA) concentrations in amniotic fluid and utilized an indirect assay of ASA lyase activity in cultured amniotic fluid cells. The assay procedure is based on the uptake of 14C from [14C]citrulline and of [3H]leucine into protein. ASA was easily measured in amniotic fluid from the first fetus at risk, whereas none was detectable in control fluids. Amniotic fluid cells cultured from this fetus had only 5.5% of control ASA lyase activity. The pregnancy was terminated, and hepatic ASA lyase activity in the fetus was shown to be about 1.3% of control values. In addition, eight fetal tissues were analyzed for ASA, and all had significant accumulation. ASA was not detected in amniotic fluid from the second fetus at risk, and ASA lyase activity in cultured cells was 80% of control activity. Enzymatic analysis of erythrocyte lysate confirmed the diagnosis of an unaffected child (ASA lyase = 46% of control) and indicated heterozygosity. Thus, we provide further evidence that argininosuccinic aciduria can be diagnosed successfully in utero by indirect assay of ASA lyase activity in cultured amniotic fluid cells. In addition, high amniotic fluid ASA concentrations provide strong adjunctive evidence for such a prenatal determination, and may prove to be sufficient for diagnosis.