Going beyond Mindfulness: How Concentration and Tranquility Commonly Co-Arising with Mindfulness Account for Mental Health.

Concentration and tranquility usually co-arise with mindfulness during mindfulness practice and in daily life and may potentially contribute to mental health; however, they have rarely been studied in empirical research. The present study aimed to examine the relationship of concentration and tranquility with mindfulness and indicators of mental health. With no existing self-report measure assessing concentration and tranquility, the Concentration Scale and Tranquility Scale were first developed and validated. Items were developed based on the extant literature, rated by a group of experts, and selected according to their ratings. Exploratory factor analyses (EFA; n = 384) and confirmatory factor analyses (CFA; n = 384) were employed in separate samples of university students and community adults to establish the factor structure of both scales. Their construct validity was established in another similar sample (n = 333) by examining their correlations with variables including (a) concentration-related concepts, (b) tranquility-related concepts, (c) mindfulness-related concepts, and (d) perceived stress and psychological distress. The relationships between concentration, tranquility, mindfulness, perceived stress and psychological distress were then examined by hierarchical multiple regressions, both cross-sectionally and longitudinally. A single-factor structure was found by the EFA and confirmed by the CFA for both scales. Concentration and tranquility were significantly and positively associated with (a) attentional control and (b) mindfulness and nonattachment; and negatively associated with (c) irritability and (d) perceived stress and psychological distress. Concentration and tranquility were found to have a significant incremental value over the effect of mindfulness on indicators of mental health. Concentration and tranquility can incrementally explain mental health above and beyond the effect of mindfulness.

Relationship between Early Vasopressor Administration and Spinal Cord Hemorrhage in a Porcine Model of Acute Traumatic Spinal Cord Injury.

Current practice guidelines for acute spinal cord injury (SCI) recommend augmenting mean arterial blood pressure (MAP) for the first 7 days post-injury. After SCI, the cord may be compressed by the bone/ligaments of the spinal column, limiting regional spinal cord blood flow. Following surgical decompression, blood flow may be restored, and can potentially promote a "reperfusion" injury. The effects of MAP augmentation on the injured cord during the compressed and decompressed conditions have not been previously characterized. Here, we used our porcine model of SCI to examine the impact of MAP augmentation on blood flow, oxygenation, hydrostatic pressure, metabolism, and intraparenchymal (IP) hemorrhage within the compressed and then subsequently decompressed spinal cord. Yucatan mini-pigs underwent a T10 contusion injury followed by 2 h of sustained compression. MAP augmentation of ∼20 mm Hg was achieved with norepinephrine (NE). Animals received MAP augmentation either during the period of cord compression (CP), after decompression (DCP), or during both periods (CP-DCP). Probes to monitor spinal cord blood flow (SCBF), oxygenation, pressure, and metabolic responses were inserted into the cord parenchyma adjacent to the injury site to measure these responses. The cord was harvested for histological evaluation. MAP augmentation increased SCBF and oxygenation in all groups. In the CP-DCP group, spinal cord pressure steadily increased and histological analysis showed significantly increased hemorrhage in the spinal cord at and near the injury site. MAP augmentation with vasopressors may improve blood flow and reduce ischemia in the injured cord but may also induce undesirable increases in IP pressure and hemorrhage.

A Direct Comparison between Norepinephrine and Phenylephrine for Augmenting Spinal Cord Perfusion in a Porcine Model of Spinal Cord Injury.

Current clinical guidelines recommend elevating the mean arterial blood pressure (MAP) to increase spinal cord perfusion in patients with acute spinal cord injury (SCI). This is typically achieved with vasopressors such as norepinephrine (NE) and phenylephrine (PE). These drugs differ in their pharmacological properties and potentially have different effects on spinal cord blood flow (SCBF), oxygenation (PO2), and downstream metabolism after injury. Using a porcine model of thoracic SCI, we evaluated how these vasopressors influenced intraparenchymal SCBF, PO2, hydrostatic pressure, and metabolism within the spinal cord adjacent to the injury site. Yorkshire pigs underwent a contusion/compression SCI at T10 and were randomized to receive either NE or PE for MAP elevation of 20 mm Hg, or no MAP augmentation. Prior to injury, a combined SCBF/PO2 sensor, a pressure sensor, and a microdialysis probe were inserted into the spinal cord adjacent to T10 at two locations: a "proximal" site and a "distal" site, 2 mm and 22 mm from the SCI, respectively. At the proximal site, NE and PE resulted in little improvement in SCBF during cord compression. Following decompression, NE resulted in increased SCBF and PO2, whereas decreased levels were observed for PE. However, both NE and PE were associated with a gradual decrease in the lactate to pyruvate (L/P) ratio after decompression. PE was associated with greater hemorrhage through the injury site than that in control animals. Combined, our results suggest that NE promotes better restoration of blood flow and oxygenation than PE in the traumatically injured spinal cord, thus providing a physiological rationale for selecting NE over PE in the hemodynamic management of acute SCI.