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Background: The ability to extinguish a maladaptive conditioned fear response is crucial for healthy emotional processing and resiliency to aversive experiences. Therefore, enhancing fear extinction learning has immense potential emotional and health benefits. Mindfulness training enhances both fear conditioning and recall of extinguished fear; however, its effects on fear extinction learning are unknown. Here we investigated the impact of mindfulness training on brain mechanisms associated with fear-extinction learning, compared to an exercise-based program. Methods: We investigated BOLD activations in response to a previously learned fear-inducing cue during an extinction paradigm, before and after an 8-week mindfulness-based stress reduction program (MBSR, n = 49) or exercise-based stress management education program (n = 27). Results: The groups exhibited similar reductions in stress, but the MBSR group was uniquely associated with enhanced activation of salience network nodes and increased hippocampal engagement. Conclusions: Our results suggest that mindfulness training increases attention to anticipatory aversive stimuli, which in turn facilitates decreased aversive subjective responses and enhanced reappraisal of the memory. [ABSTRACT FROM AUTHOR]

This study explored the relation between guilt and identification with the aggressor (IWA) and the moderating role of IWA in the relation between intimate partner violence (IPV) and guilt. An online survey was conducted among a convenience sample of 700 women. IPV survivors demonstrated elevated guilt, and IWA was related to guilt. Furthermore, IWA moderated the relation between IPV and guilt: Among participants with low IWA levels, IPV was unrelated to guilt, but among participants with high IWA levels, IPV was related to guilt. These findings suggest that IWA may be a key element in explaining guilt among IPV survivors., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Accurate detection of graft-versus-host disease (GVHD) is a major challenge in the management of patients undergoing hematopoietic stem cell transplantation (HCT). Here, we demonstrated the use of circulating cell-free DNA (cfDNA) for detection of tissue turnover and chronic GVHD (cGVHD) in specific organs., Methods: We established a cocktail of tissue-specific DNA methylation markers and used it to determine the concentration of cfDNA molecules derived from the liver, skin, lungs, colon, and specific immune cells in 101 patients undergoing HCT., Results: Patients with active cGVHD showed elevated concentrations of cfDNA, as well as tissue-specific methylation markers that agreed with clinical scores. Strikingly, transplanted patients with no clinical symptoms had abnormally high levels of tissue-specific markers, suggesting hidden tissue turnover even in the absence of evident clinical pathology. An integrative model taking into account total cfDNA concentration, monocyte/macrophage cfDNA levels and alanine transaminase was able to correctly identify GVHD with a specificity of 86% and precision of 89% (AUC of 0.8)., Conclusion: cfDNA markers can be used for the detection of cGVHD, opening a window into underlying tissue dynamics in patients that receive allogeneic stem cell transplants., Funding: This work was supported by grants from the Ernest and Bonnie Beutler Research Program of Excellence in Genomic Medicine, The Israel Science Foundation, the Waldholtz/Pakula family, the Robert M. and Marilyn Sternberg Family Charitable Foundation and the Helmsley Charitable Trust (to YD).

The use of cardiopulmonary bypass (CPB) is thought to cause delayed cardiac damage. DNA methylation-based liquid biopsies are novel biomarkers for monitoring acute cardiac cell death. We assessed cell-free DNA molecules as markers for cardiac damage after open-heart surgery. Novel cardiomyocyte-specific DNA methylation markers were applied to measure cardiac cfDNA in the plasma of 42 infants who underwent open-heart surgery. Cardiac cfDNA was elevated following surgery, reflecting direct surgery-related tissue damage, and declined thereafter in most patients. The concentration of cardiac cfDNA post-surgery correlated with the duration of CPB and aortic cross clamping. Strikingly, cardiac cfDNA at 6 h predicted duration of mechanical ventilation and maximal vasoactive-inotropic score better than did maximal troponin levels. Cardiac cfDNA reveals heart damage associated with CPB, and can be used to monitor cardiac cell death, to predict clinical outcome of surgery and to assess performance of cardioprotective interventions., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: Pulmonary embolism, a common and potentially fatal clinical condition, occurs when a blood thrombus becomes lodged in the pulmonary vasculature and creates an acute increment in the pulmonary vascular resistance, which, in turn, creates a right ventricular strain. Among the more familiar electrocardiographic manifestations in acute pulmonary embolism is sinus tachycardia, right bundle branch block and ST-T abnormalities in the right precordium leads. Complete heart block or any type of bradycardia is uncommon. In our case report we present an 81 years old woman who was admitted to our institution with acute pulmonary embolism and complete atrioventricular block, which later resolved with appropriate anticoagulation therapy.

Background: Endothelial progenitor cells (EPCs) have an important role in repair following vascular injury. Telomere length has been shown to be correlated with genome stability and overall cell health. We hypothesized that both EPCs and telomere size are related to protective mechanisms against coronary artery disease. Our aim was to evaluate the level and function of circulating EPCs and telomere length in patients with multiple cardiovascular risk factors and anatomically normal coronary arteries vs. matched controls., Methods: We included 24 patients, with coronary CTA demonstrating normal coronaries and a high risk of CAD of >10% by ASCVD risk estimator. Control groups included 17 patients with similar cardiovascular profiles but with established CAD and a group of 20 healthy volunteers. Circulating EPCs levels were assessed by flow cytometry for expression of vascular endothelial growth factor receptor 2, CD34 and CD133. The capacity of the cells to form colony forming units (CFUs) was quantified after 1 week of culture. Telomere length was determined by the southern blotting technique., Results: Patients with high risk for CVD and normal coronaries had augmented EPCs function, compared with the CAD group (1.1 vs. 0.22 CFU/f; P  = 0.04) and longer telomeres compared with the CAD group (10.7 kb vs. 2.8 kb P  = 0.015). These patients displayed a similar profile to the healthy group., Conclusion: Patients with a high risk for CAD, but normal coronary arteries have EPCs function and telomere length which resemble healthy volunteers, and augmented compared with patients with established CAD, which could serve as a protective mechanism against atherosclerosis development in these high-risk patients., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Intravascular leiomyomatosis (IVL) with intracardiac extension is a rare benign tumour seen exclusively in women, characterized by proliferation of uterine smooth muscle cells through the venous circulation into the inferior vena cava (IVC) and the right heart chambers., Case Summary: A 47 years old women with history of previous hysterectomy due to myomatosis, presented with nausea, anorexia, and bilateral lower limb swelling over the preceding 2 months. An outpatient abdominal ultrasound discovered a mass in the IVC. Echocardiogram and computed tomography demonstrated a large intravascular mass extending from the pelvis to the right heart chambers. The tumour was completely removed in a concomitant open-heart surgery and laparotomy. Post-operative course was uncomplicated. A month later, the patient was feeling well and in good clinical condition. The histological analysis consisted with IVL., Discussion: Intracardiac leiomyomatosis is a rare clinical condition which requires high index of suspicion. Multimodality imaging is usually required to establish the preoperative diagnosis, although the final diagnosis is achieved with tissue investigation. Complete surgical resection of the tumour is curative and associated with good long-term prognosis., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Despite the high prevalence of incest, survivors are reluctant to disclose its existence for reasons such as shame, guilt and the presence of an accusatory and stigmatizing social discourse. The current mixed methods study examined the internal discourses of 13 incest survivors in Israel, reflected in self-reported internal dialogs which emerged during interviews. The qualitative analysis revealed a dialectical tension between two themes - one reflecting an internalization of the social discourse (manifested as quotes taken from social discourse and uttered by the survivors) and the other an agentic discourse (manifested in utterances either resisting the social discourse or showing an empowering advertence to one's own fulcrum). The quantitative analysis showed that for seven participants the internalized social discourse expressions were most frequent, for five the agentic expressions were most frequent, and that for one the discourses were at equilibrium. The ubiquitous sub-themes manifested in the internalized social discourse were: victimhood (feelings of vulnerability and helplessness), survivorship (meaningless existence, despair and hopelessness), negative self-esteem and self-pathology (perception of the self as having pathological psychological problems), and denial/repression of the abuse. The ubiquitous sub-themes manifested in the agentic discourse were: positive self-image and sense of potency, hope, optimism and positive perception of life, and uprising against the parents and institutions that did not give support. The discussion is based on Butler's concept of vulnerability , which suggests how to address the harms inflicted by incest without erasing aspects of the survivors' agency and growth.

Trauma survivors who suffer from posttraumatic stress disorder (PTSD) symptoms may be particularly vulnerable when facing the COVID-19 pandemic. Yet trauma exposure may also lead to salutogenic outcomes, known as posttraumatic growth (PTG). Nevertheless, the implications of PTG attributed to prior trauma, for trauma survivors' adjustment when facing additional stressors, are unclear. Addressing this gap, 528 Israeli trauma survivors were assessed for PTG and PTSD symptoms attributed to prior trauma, as well as peritraumatic stress symptoms related to the pandemic, as part of an online survey. Analyses revealed that being younger, female, quarantined, negatively self-rating one's health status, and suffering from PTSD symptoms were associated with elevated peritraumatic stress symptoms. Furthermore, PTG attributed to prior trauma made a significant contribution in explaining elevated intrusion, avoidance, and hyperarousal symptoms. The present results point to the need for clinicians to take into account reports of PTG attributed to prior trauma when treating trauma survivors during the current pandemic., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: To evaluate the association between maternal asthma and perinatal outcome., Study Design: In this retrospective population-based cohort study, all pregnancies between 1991 and 2014 in a tertiary medical center, were included. Multiple pregnancies and congenital malformations were excluded. Pregnancy course and outcomes were compared between women with and without asthma, and multivariable generalized estimating equations were used to control for confounders., Results: During the study period, 243,363 deliveries met the inclusion criteria, 1.35% of which (n = 3283) occurred in women diagnosed with asthma. Multiple perinatal complications were found to be associated with maternal asthma, including hypertensive disorders, preterm delivery, and cesarean delivery. However, no significant differences between the groups were noted in neonatal outcomes, including perinatal mortality rates and low Apgar scores. In the regression model, maternal asthma was noted as an independent risk factor for preterm delivery, hypertensive disorders of pregnancy, and cesarean delivery (aOR = 1.21, 95%CI 1.1-1.4, p = .007; aOR = 1.35, 95%CI 1.2-1.6, p < .001; and aOR = 1.27, 95%CI 1.2-1.4, p < .001, respectively) while controlling for multiple confounders., Conclusions: Maternal asthma is associated with an increased risk for adverse pregnancy outcome. This association remains significant while controlling for variables considered to coexist with maternal asthma. Nevertheless, perinatal outcome is generally favorable.

To leverage current local drug delivery systems methodology, there is vast use of polymeric particles serving as drug carriers to assure minimal invasive therapy with little systemic distribution of the released drug. There is an increasing interest in poly(methyl methacrylate) (PMMA) serving as carriers in drug delivery. The study aims to develop PMMA carriers for localized drug delivery and release system, combining innovative biomaterial technology and shock wave lithotripsy (SWL), and to study the effect of SWL on various concentrations of PMMA particles. We prepared PMMA particles that contain horseradish peroxidase (HRP) using a double emulsion technique, and investigated the mechanism of in vitro drug release from the carriers following exposure to SWL. We investigated the correlation between production method modifications, concentrations of the carriers subjected to SWL, and shock wave patterns. We successfully produced PMMA particles as drug carriers and stimulated the release of their contents by SWL; their polymeric shell can be shattered externally by SWL treatment, leading to release of the encapsulated drug. HRP enzyme activity was maintained following the encapsulation process and exposure to high dose of SWL pulses. Increased shock wave number results in increased shattering and greater fragmentation of PMMA particles. The results demonstrate a dose-response release of HRP; quantitation of the encapsulated HRP from the carriers rises with the number of SWL. Moreover, increased concentration of particles subjected to the same dose of SWL results in a significant increase of the total HRP release. Our research offers novel technique and insights into new, site-specific drug delivery and release systems., (© 2014 Wiley Periodicals, Inc.)

Patient repositioning when the skin is moist, e.g., due to sweat or urine may cause skin breakdown since wetness increases the skin-support coefficient of friction (COF) and hence also the shear stresses that are generated in the skin when the patient is being moved. This everyday hospital scenario was never studied systematically however. The aim of this study was to simulate such interactions using a biomechanical computational model which is the first of its kind, in order to quantitatively describe the effects of repositioning on the pathomechanics of moisture-related tissue damage. We designed a finite element model to analyze skin stresses under a weight-bearing bony prominence while this region of interest slides frictionally over the support surface, as occurs during repositioning. Our results show, expectedly, that maximal effective stresses in the skin increase as the moisture-contents-related COF between the skin and the mattress rises. Interestingly however, the rise in stresses for a wet interface became more prominent when the skin tissue was stiffer - which represented aging or diabetes. This finding demonstrates how the aged/diabetic skin is more fragile than a young-adult skin when repositioning in a moist environment. The modeling used herein can now be extended to test effects of different moisturizers, creams, lubricants, or possibly other interventions at the skin-support interface for testing their potential in protecting the skin from superficial pressure ulcers in a standard, objective, and quantitative manner.

The problem of reconstruction of digital images from their degraded measurements is regarded as a problem of central importance in various fields of engineering and imaging sciences. In such cases, the degradation is typically caused by the resolution limitations of an imaging device in use and/or by the destructive influence of measurement noise. Specifically, when the noise obeys a Poisson probability law, standard approaches to the problem of image reconstruction are based upon using fixed-point algorithms which follow the methodology first proposed by Richardson and Lucy. The practice of using these methods, however, shows that their convergence properties tend to deteriorate at relatively high noise levels. Accordingly, in the present paper, a novel method for denoising and/or deblurring of digital images corrupted by Poisson noise is introduced. The proposed method is derived under the assumption that the image of interest can be sparsely represented in the domain of a linear transform. Consequently, a shrinkage-based iterative procedure is proposed, which guarantees the solution to converge to the global maximizer of an associated maximum a posteriori criterion. It is shown in a series of computer-simulated experiments that the proposed method outperforms a number of existing alternatives in terms of stability, precision, and computational efficiency.