Correlation of carotid atheromatous plaque inflammation with biomechanical stress: Utility of USPIO enhanced MR imaging and finite element analysis

Objective: The aim of this study was to explore whether there is a relationship between the degree of MR-defined inflammation using ultra small super-paramagnetic iron oxide (USPIO) particles, and biomechanical stress using finite element analysis (FEA) techniques, in carotid atheromatous plaques. Methods and Results: 18 patients with angiographically proven carotid stenoses underwent multi-sequence MR imaging before and 36 h after USPIO infusion. T2 * weighted images were manually segmented into quadrants and the signal change in each quadrant normalised to adjacent muscle was calculated after USPIO administration. Plaque geometry was obtained from the rest of the multi-sequence dataset and used within a FEA model to predict maximal stress concentration within each slice. Subsequently, a new statistical model was developed to explicitly investigate the form of the relationship between biomechanical stress and signal change. The Spearman's rank correlation coefficient for USPIO enhanced signal change and maximal biomechanical stress was -0.60 (p = 0.009). Conclusions: There is an association between biomechanical stress and USPIO enhanced MR-defined inflammation within carotid atheroma, both known risk factors for plaque vulnerability. This underlines the complex interaction between physiological processes and biomechanical mechanisms in the development of carotid atheroma. However, this is preliminary data that will need validation in a larger cohort of patients.

The impact of wall shear stress and pressure drop on the stability of the atherosclerotic plaque

Rupture of vulnerable atheromatous plaque in the carotid and coronary arteries often leads to stroke and heart attack respectively. The mechanism of blood flow and plaque rupture in stenotic arteries is still not fully understood. A three dimensional rigid wall model was solved under steady state conditions and unsteady conditions by assuming a time-varying inlet velocity profile to investigate the relative importance of axial forces and pressure drops in arteries with asymmetric stenosis. Flow-structure interactions were investigated for the same geometry and the results were compared with those retrieved with the corresponding 2D cross-section structural models. The Navier-Stokes equations were used as the governing equations for the fluid. The tube wall was assumed hyperelastic, homogeneous, isotropic and incompressible. The analysis showed that the three dimensional behavior of velocity, pressure and wall shear stress is in general very different from that predicted by cross-section models. Pressure drop across the stenosis was found to be much higher than shear stress. Therefore, pressure may be the more important mechanical trigger for plaque rupture other than shear stress, although shear stress is closely related to plaque formation and progression.

Correlation of macrophage location and plaque stress distribution using USPIO-enhanced MRI in a patient with symptomatic severe carotid stenosis: A new insight into risk stratification

High resolution, USPIO-enhanced MR imaging can be used to identify inflamed atherosclerotic plaque. We report a case of a 79-year-old man with a symptomatic carotid stenosis of 82%. The plaque was retrieved for histology and finite element analysis (FEA) based on the preoperative MR imaging was used to predict maximal Von Mises stress on the plaque. Macrophage location correlated with maximal predicted stresses on the plaque. This supports the hypothesis that macrophages thin the fibrous cap at points of highest stress, leading to an increased risk of plaque rupture and subsequent stroke.

Atheroma: Is calcium important or not? A modelling study of stress within the atheromatous fibrous cap in relation to position and size of calcium deposits

Atheromatous plaque rupture h the cause of the majority of strokes and heart attacks in the developed world. The role of calcium deposits and their contribution to plaque vulnerability are controversial. Some studies have suggested that calcified plaque tends to be more stable whereas others have suggested the opposite. This study uses a finite element model to evaluate the effect of calcium deposits on the stress within the fibrous cap by varying their location and size. Plaque fibrous cap, lipid pool and calcification were modeled as hyperelastic, Isotropic, (nearly) incompressible materials with different properties for large deformation analysis by assigning time-dependent pressure loading on the lumen wall. The stress and strain contours were illustrated for each condition for comparison. Von Mises stress only increases up to 1.5% when varying the location of calcification in the lipid pool distant to the fibrous cap. Calcification in the fibrous cap leads to a 43% increase of Von Mises stress when compared with that in the lipid pool. An increase of 100% of calcification area leads to a 15% stress increase in the fibrous cap. Calcification in the lipid pool does not increase fibrous cap stress when it is distant to the fibrous cap, whilst large areas of calcification close to or in the fibrous cap may lead to a high stress concentration within the fibrous cap, which may cause plaque rupture. This study highlights the application of a computational model on a simulation of clinical problems, and it may provide insights into the mechanism of plaque rupture.

Stress and Resilience in Combat-Related PTSD: Integration of Psychological Theory and Biological Mechanisms

Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder that has a major impact on the ability to function effectively in daily life. PTSD may develop as a response to exposure to an event or events perceived as potentially harmful or life-threatening. It has high prevalence rates in the community, especially among vulnerable groups such as military personnel or those in emergency services. Despite extensive research in this field, the underlying mechanisms of the disorder remain largely unknown. The identification of risk factors for PTSD has posed a particular challenge as there can be delays in onset of the disorder, and most people who are exposed to traumatic events will not meet diagnostic criteria for PTSD. With the advent of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM V), the classification for PTSD has changed from an anxiety disorder into the category of stress- and trauma-related disorders. This has the potential to refocus PTSD research on the nature of stress and the stress response relationship. This review focuses on some of the important findings from psychological and biological research based on early models of stress and resilience. Improving our understanding of PTSD by investigating both genetic and psychological risk and coping factors that influence stress response, as well as their interaction, may provide a basis for more effective and earlier intervention.

Heat acclimation for protection from exertional heat stress (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of heat acclimation interventions aimed at protecting health and performance from exertional heat stress.

Job-related diversity and team performance: An empirical analysis of the US music industry

A significant amount of research has been carried out to investigate the existing bonds between team characteristics and team outcomes in contexts of social creativity. Specifically, how work group diversity affects its performance is of great relevance but unfortunately, there is no clear understanding of the diversity-performance relationship. Therefore, to improve our understanding of this phenomenon, it would be worthwhile to investigate further empirical settings. For this reason, we decided to study the music industry that, to our knowledge, has never been chosen as empirical setting for the application of the theoretical constructs linked to the topic of team diversity and performance. Our research aims at analyze the US music industry to study the relationship between job-related characteristics of team diversity and team performances.

Evaluation of visual stress symptoms in Age-matched Dyslexic, Meares–Irlen syndrome (MIS) and normal adults

AIM To examine the prevalence of dyslexia and Meares–Irlen syndrome (MIS) among female students and determine their level of visual stress in comparison with normal subjects. METHODS A random sample of 450 female medical students of King Saud University Riyadh (age range, 18 - 30 years) responded to a wide range of questions designed to accomplish the aims of this study. The detailed questionnaire consisted of 54 questions with twelve questions enquiring on ocular history and demography of participants while 42 questions were on visual symptoms. Items were categorized into; critical and non-critical questions (CQ and NCQ) and were rated on four point Likert scale. Based on the responses obtained, the subjects were grouped into normal (control), dyslexic with or without MIS (Group 1) and subjects with MIS only (Group 2). Responses were analysed as averages and mean scores were calculated and compared between-groups using one way analysis of variance to evaluate total (TVSS = NCQ + CQ), critical and non-critical visual stress scores. The relationship between categorical variables such as age, handedness and condition were assessed with Chi- Square test. RESULTS The completion rate was 96.8% and majority of the respondents (92%) were normal readers, 2% dyslexic and 6% had MIS. They were age-matched. More than half of the participants had visited an eye care practitioner in the last 2yrs. About 13% were recommended eye exercises and one participant experienced pattern glare. Hand preference was not associated with any condition but Group 1 subjects (3/9, 33%) were significantly more likely to be diagnosed of lazy eye than Group 2 (2/27, 7%) and control (27/414, 5%) subjects. The mean ± SD of TVSS responses were 63 ± 14 but it was 44 ± 9 for CQ and 19 ± 5 for NCQ. Responses from all three variables were normally distributed but the CQ responses were on the average more positive (82%) in Group 2 and less positive (46%) in Group 1 than control. With NCQ, the responses were equally less positive in Group 1 and 2 than control. Group 2 subjects showed significantly higher TVSS (P = 0.002), NCQ (P = 0.006) and CQ (P = 0.008) visual stress scores than control but no difference between Group 1 and control subjects, was observed for all scores (P > 0.05, for all comparisons). CONCLUSION The prevalence of dyslexia and MIS among Saudi female students was 2 and 6%, respectively. Critical questions performed best for assessing visual stress symptoms in dyslexic and MIS subjects. Generally, students with MIS were more sensitive to visual stress than normal students but dyslexics were more likely to present with a lazy eye than MIS and normal readers.

Mature age job seekers: the role of proactivity

Purpose In the context of demographic and economic changes, helping mature age job seekers find employment is imperative. The purpose of this paper is to examine mature age job seekers’ proactive personality as a moderator of the relationship between age and job search intensity; and to examine job search self-efficacy as a mediator of this moderation effect. It was hypothesized that the generally negative relationships between age and job search self-efficacy and intensity are weaker among job seekers with a more proactive personality. Design/methodology/approach In total, 188 job seekers between 40 and 64 years completed an online questionnaire. Data were analyzed using structural equation modeling. Findings Consistent with previous research, age was negatively related to job search intensity. Proactive personality was positively related to job search intensity and moderated the relationship between age and job search intensity. Extending previous research, proactive personality also positively predicted job search self-efficacy and moderated the relationship between age and job search self-efficacy which, in turn, positively predicted job search intensity. Research limitations/implications Potential limitations of the study include the cross-sectional design, sample selectivity, and the omission of possibly important control variables. Practical implications Practitioners, organizations, and societies concerned with helping mature age job seekers find employment could provide additional support to those with a less proactive personality and low job search self-efficacy. Originality/value This study extends previous research by showing that mature age job seekers’ job search self-efficacy mediates the moderating effect of proactive personality on the relationship between age and job search intensity.

Older job seekers' job search intensity: The interplay of proactive personality, age and occupational future time perspective

Long-term unemployment of older people can have severe consequences for individuals, communities and ultimately economies, and is therefore a serious concern in countries with an ageing population. However, the interplay of chronological age and other individual difference characteristics in predicting older job seekers' job search is so far not well understood. This study investigated relationships among age, proactive personality, occupational future time perspective (FTP) and job search intensity of 182 job seekers between 43 and 77 years in Australia. Results were mostly consistent with expectations based on a combination of socio-emotional selectivity theory and the notion of compensatory psychological resources. Proactive personality was positively related to job search intensity and age was negatively related to job search intensity. Age moderated the relationship between proactive personality and job search intensity, such that the relationship was stronger at higher compared to lower ages. One dimension of occupational FTP (perceived remaining time left in the occupational context) mediated this moderating effect, but not the overall relationship between age and job search intensity. Implications for future research, including the interplay of occupational FTP and proactive personality, and some tentative practical implications are discussed.

The moderating effects of job control and selection, optimization, and compensation strategies on the age-work ability relationship

Work ability describes employees' capability to carry out their work with respect to physical and psychological job demands. This study investigated direct and interactive effects of age, job control, and the use of successful aging strategies called selection, optimization, and compensation (SOC) in predicting work ability. We assessed SOC strategies and job control by using employee self-reports, and we measured employees' work ability using supervisor ratings. Data collected from 173 health-care employees showed that job control was positively associated with work ability. Additionally, we found a three-way interaction effect of age, job control, and use of SOC strategies on work ability. Specifically, the negative relationship between age and work ability was weakest for employees with high job control and high use of SOC strategies. These results suggest that the use of successful aging strategies and enhanced control at work are conducive to maintaining the work ability of aging employees. We discuss theoretical and practical implications regarding the beneficial role of the use of SOC strategies utilized by older employees and enhanced contextual resources at work for aging employees.

Focus on opportunities as a boundary condition of the relationship between job control and work engagement: A multi-sample, multi-method study

The concept of focus on opportunities describes how many new goals, options, and possibilities employees believe to have in their personal future at work. In this multi-sample, multi-method study, the authors investigated relationships between focus on opportunities and general and daily work engagement and the moderating role of focus on opportunities on between- and within-person relationships between job control and work engagement. Based on a social cognitive theory framework on the motivating potential of a future temporal focus, it was hypothesized that focus on opportunities is positively related to work engagement. Further, consistent with the notion of compensatory resources, it was expected that job control is not related to work engagement among employees with a high focus on opportunities, whereas job control, as an external resource of the work environment, is positively related to work engagement among employees with a low focus on opportunities. Both a cross-sectional survey study (N=174) and a daily diary study (N=64) supported the hypotheses. The study contributes to research on the job demands-resources model as it emphasizes the role of focus on opportunities as a motivational factor in the relationship between job control and work engagement.

Maintaining a focus on opportunities at work: The interplay between age, job complexity, and the use of selection, optimization, and compensation strategies

The concept of focus on opportunities describes how many new goals, options, and possibilities employees believe to have in their personal future at work. This study investigated the specific and shared effects of age, job complexity, and the use of successful aging strategies called selection, optimization, and compensation (SOC) in predicting focus on opportunities. Results of data collected from 133 employees of one company (mean age = 38 years, SD = 13, range 16–65 years) showed that age was negatively, and job complexity and use of SOC strategies were positively related to focus on opportunities. In addition, older employees in high-complexity jobs and older employees in low-complexity jobs with high use of SOC strategies were better able to maintain a focus on opportunities than older employees in low-complexity jobs with low use of SOC strategies.