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pubmed_abstracts_2020

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Seong, Gil Myeong

Adult; Aged; Critical Care Outcomes; Female; Hematologic Neoplasms; Hospital Mortality; Humans; Intensive Care Units; Logistic Models; Male; Middle Aged; Prognosis; Respiratory Distress Syndrome; Retrospective Studies; Risk Factors; Tidal Volume

Prognosis of Acute Respiratory Distress Syndrome in Patients With Hematological Malignancies.

The intensive care unit (ICU) admission of patients with hematologic malignancies is gradually increasing. Life-threatening events are common, and acute respiratory distress syndrome (ARDS) is one of the most critical conditions. The aim of this study was to investigate the clinical characteristics and outcomes of ARDS in patients with hematological malignancies admitted to the ICU.

Pichiule-Castañeda, Myrian

AIDS Serodiagnosis; Adult; Female; Health Care Surveys; Humans; Male; Middle Aged; Practice Patterns, Nurses'; Practice Patterns, Physicians'; Prescriptions; Primary Health Care

Request for HIV serology in primary care: A survey of medical and nursing professionals.

In the Community of Madrid there is 42.7% late HIV diagnosis. Primary care is the gateway to the health system and the frequency of serological tests requested by these professionals is unknown. The objectives were to establish the frequency of requests for HIV serology by medical and nursing primary care professionals in the Community of Madrid and the factors associated with these requests.

Ornoy, Asher

Animals; Animals, Newborn; Antioxidants; Autism Spectrum Disorder; Behavior, Animal; Disease Models, Animal; Female; Gene Expression Regulation, Developmental; Humans; Male; Mice, Inbred ICR; Oxidative Stress; Prefrontal Cortex; Pregnancy; S-Adenosylmethionine; Sex Characteristics; Valproic Acid

S-adenosyl methionine prevents ASD like behaviors triggered by early postnatal valproic acid exposure in very young mice.

A common animal model of ASD is the one induced by valproic acid (VPA), inducing epigenetic changes and oxidative stress. We studied the possible preventive effect of the methyl donor for epigenetic enzymatic reactions, S-adenosine methionine (SAM), on ASD like behavioral changes and on redox potential in the brain and liver in this model.

Sixtus, Elena

Adult; Cognition; Female; Fingers; Germany; Humans; Male; Mathematics; Problem Solving; Students; Touch Perception; Universities; Young Adult

Stimulating numbers: signatures of finger counting in numerosity processing.

Finger counting is one of the first steps in the development of mature number concepts. With a one-to-one correspondence of fingers to numbers in Western finger counting, fingers hold two numerical meanings: one is based on the number of fingers raised and the second is based on their ordinal position within the habitual finger counting sequence. This study investigated how these two numerical meanings of fingers are intertwined with numerical cognition in adults. Participants received tactile stimulation on their fingertips of one hand and named either the number of fingers stimulated (2, 3, or 4 fingers; Experiment 1) or the number of stimulations on one fingertip (2, 3, or 4 stimulations; Experiment 2). Responses were faster and more accurate when the set of stimulated fingers corresponded to finger counting habits (Experiment 1) and when the number of stimulations matched the ordinal position of the stimulated finger (Experiment 2). These results show that tactile numerosity perception is affected by individual finger counting habits and that those habits give numerical meaning to single fingers.

Trapp, Sabrina

Adult; Attention; Auditory Perception; Cognition; Female; Humans; Male; Photic Stimulation; Young Adult

When the rhythm disappears and the mind keeps dancing: sustained effects of attentional entrainment.

Research has demonstrated that the human cognitive system allocates attention most efficiently to a stimulus that occurs in synchrony with an established rhythmic background. However, our environment is dynamic and constantly changing. What happens when rhythms to which our cognitive system adapted disappear? We addressed this question using a visual categorization task comprising emotional and neutral faces. The task was split into three blocks of which the first and the last were completed in silence. The second block was accompanied by an acoustic background rhythm that, for one group of participants, was synchronous with face presentations, and for another group was asynchronous. Irrespective of group, performance improved with background stimulation. Importantly, improved performance extended into the third silent block for the synchronous, but not for the asynchronous group. These data suggest that attentional entrainment resulting from rhythmic environmental regularities disintegrates only gradually after the regularities disappear.

Wicke, Kristina

Algorithms; Biodiversity; Computational Biology; Game Theory; Mathematical Concepts; Models, Genetic; Models, Statistical; Phylogeny

On the Shapley Value of Unrooted Phylogenetic Trees.

The Shapley value, a solution concept from cooperative game theory, has recently been considered for both unrooted and rooted phylogenetic trees. Here, we focus on the Shapley value of unrooted trees and first revisit the so-called split counts of a phylogenetic tree and the Shapley transformation matrix that allows for the calculation of the Shapley value from the edge lengths of a tree. We show that non-isomorphic trees may have permutation-equivalent Shapley transformation matrices and permutation-equivalent null spaces. This implies that estimating the split counts associated with a tree or the Shapley values of its leaves does not suffice to reconstruct the correct tree topology. We then turn to the use of the Shapley value as a prioritization criterion in biodiversity conservation and compare it to a greedy solution concept. Here, we show that for certain phylogenetic trees, the Shapley value may fail as a prioritization criterion, meaning that the diversity spanned by the top k species (ranked by their Shapley values) cannot approximate the total diversity of all n species.

Mazurek, Micah O

Adolescent; Autism Spectrum Disorder; Child; Child, Preschool; Cognition; Communication; Female; Humans; Male; Psychological Tests; Reproducibility of Results; Stereotyped Behavior; Surveys and Questionnaires

Construct Validity of the Autism Impact Measure (AIM).

The Autism Impact Measure (AIM) was designed to track incremental change in frequency and impact of core ASD symptoms. The current study examined the structural and convergent validity of the AIM in a large sample of children with ASD. The results of a series of exploratory and confirmatory factor analyses yielded a final model with five theoretically and empirically meaningful subdomains: Repetitive Behavior, Atypical Behavior, Communication, Social Reciprocity, and Peer Interaction. The final model showed very good fit both overall and for each of the five factors, indicating excellent structural validity. AIM subdomain scores were significantly correlated with measures of similar constructs across all five domains. The results provide further support for the psychometric properties of the AIM.

Kortrijk, Hans E

Adult; Community Mental Health Services; Employment; Female; Humans; Logistic Models; Male; Mental Disorders; Middle Aged; Netherlands; Quality of Life; Rehabilitation, Vocational; Young Adult

Employment Rates in Flexible Assertive Community Treatment Teams in The Netherlands: An Observational Study.

We determined the proportions of clients treated in Flexible Assertive Community Treatment teams who were unemployed and gained employment and who were employed and lost employment. Secondly, we explored the demographical and clinical factors associated with employment. Data were collected during routine outcome monitoring. We calculated differences in employment rates over a year and explored differences in demographic characteristics at baseline between patient groups. Logistic regression analysis was used to estimate the role of clinical predictor variables on employment status. Over time, 10% remained employed, 5% lost their employment, 3% gained employment and 82% remained unemployed. Clients who found employment were younger, more often male, and had significantly fewer psychosocial problems and a higher subjective quality of life during follow-up than those who remained unemployed. Problems with motivation for treatment at baseline were related to losing employment or remaining unemployed. Better implementation of vocational services is very important for increasing the number of clients gaining employment.

Dobi, Ágnes

Adult; Aged; Aged, 80 and over; Brain Neoplasms; Cranial Irradiation; Dose Fractionation, Radiation; Female; Humans; Male; Middle Aged; Radiotherapy Dosage; Re-Irradiation; Retrospective Studies; Survival Analysis; Young Adult

Boost Irradiation Integrated to Whole Brain Radiotherapy in the Management of Brain Metastases.

Our retrospective analysis aimed to evaluate the clinical value of dose intensification schemes: WBRT and consecutive, delayed, or simultaneous integrated boost (SIB) in brain metastasis (BM) management. Clinical data and overall survival (OS) of 468 patients with BM from various primaries treated with 10 × 3 Gy WBRT (n = 195), WBRT+ 10 × 2 Gy boost (n = 125), or simultaneously 15 × 2.2 Gy WBRT+0.7 Gy boost (n = 148) during a 6-year period were statistically analysed. Significant difference in OS could be detected with additional boost to WBRT (3.3 versus 6.5 months) and this difference was confirmed for BMs of lung cancer and melanoma and both for oligo- and multiplex lesions. The OS was prolonged for the RPA 2 and RPA3 categories, if patients received escalated dose, 4.0 vs. 7.7 months; (p = 0.002) in class RPA2 and 2.6 vs. 4.2 months; (p < 0.0001) in the class RPA 3 respectively. The significant difference in OS was also achieved with SIB. The shortened overall treatment time of SIB with lower WBRT fraction dose exhibited survival benefit over WBRT alone, and could be applied for patients developing BM even with unfavourable prognostic factors. These results warrant for further study of this approach with dose escalation using the lately available solutions for hippocampus sparing and fractionated stereotactic irradiation. The simultaneous delivery of WBRT with reduced fraction dose and boost proved to be advantageous prolonging the OS with shortened treatment time and reduced probability for cognitive decline development even for patients with poor performance status and progressing extracranial disease.

Selebalo-Bereng, Lebohang

Abortion, Induced; Abortion, Legal; Adolescent; Attitude; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Pregnancy; Religion; Sex Factors; South Africa; Spirituality; Young Adult

Reasons for Abortion: Religion, Religiosity/Spirituality and Attitudes of Male Secondary School Youth in South Africa.

This study focused on the relationship between religion, religiosity/spirituality (R/S), and attitudes of a sample of South African male secondary school youth toward women's rights to legal abortion in different situations. We distributed 400 self-administered questionnaires assessing the main variables (attitudes toward reasons for abortion and R/S) to the target sample in six different secondary schools in KwaZulu-Natal, South Africa. The responses of a final sample of 327 learners were then analyzed using the Statistical Package for the Social Sciences (SPSS) software. The findings revealed that religion and R/S play a role in the youths' attitudes toward abortion. While the Hindu subsample indicated higher overall support across the different scenarios, the Muslim subsample reported greater disapproval than the other groups on 'Elective reasons' and in instances of 'Objection by significant others.' The Christian youth had the most negative attitudes to abortion for 'Traumatic reasons' and 'When women's health/life' was threatened. Across the sample, higher R/S levels were linked with more negative attitudes toward reasons for abortion.

Sperry, Brett W

Aged; Aged, 80 and over; Amyloid Neuropathies, Familial; Biopsy; Diphosphates; Female; Humans; Male; Middle Aged; Muscle, Skeletal; Retrospective Studies; Technetium; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Whole Body Imaging

Non-cardiac uptake of technetium-99m pyrophosphate in transthyretin cardiac amyloidosis.

Technetium-based bone scintigraphy is rapidly becoming the most common non-invasive imaging tool in the diagnosis of Transthyretin cardiac amyloidosis (ATTR). Skeletal muscle uptake has been described with technetium-99m-3,3-diphosphono-1,2-propanodicarboxylic acid (TcDPD), and may account for masking of bony uptake. We sought to investigate skeletal muscle uptake of technetium-99m-pyrophosphate (TcPYP) in patients with ATTR.

Qutbi, Mohsen

Aged; Aged, 80 and over; Dipyridamole; Heart Ventricles; Humans; Image Processing, Computer-Assisted; Male; Myocardial Perfusion Imaging; Patient Positioning; Stress, Mechanical; Tomography, Emission-Computed, Single-Photon

The impact of patient-to-detector distance on LV volumes and TID index on SPECT myocardial perfusion imaging: Emphasis on consistent patient-detector positioning in stress and rest phases.

Zaidi, Habib

Artifacts; Magnetic Resonance Imaging; Positron-Emission Tomography; Tomography, X-Ray Computed

Artifact-free quantitative cardiovascular PET/MR imaging: An impossible dream?

Saku, Kosuke

Aged; Aortic Valve; Aortic Valve Insufficiency; Bandages; Cardiac Surgical Procedures; Foreign Bodies; Foreign-Body Reaction; Gossypium; Heart Valves; Humans; Male; Pericardium; Postoperative Complications; Tomography, X-Ray Computed

Inflammatory reaction of a pericardial foreign body after cardiac surgery.

Angelidis, George

Adult; Aged; Aged, 80 and over; Angiotensinogen; Coronary Artery Disease; Coronary Circulation; Female; Humans; Male; Middle Aged; Myocardial Perfusion Imaging; Peptidyl-Dipeptidase A; Polymorphism, Genetic; Receptors, Angiotensin; Renin; Renin-Angiotensin System; Tomography, Emission-Computed, Single-Photon

Impact of renin-angiotensin-aldosterone system polymorphisms on myocardial perfusion: Correlations with myocardial single photon emission computed tomography-derived parameters.

Renin-angiotensin-aldosterone system (RAAS) has an important role in atherosclerosis. We investigated the effects of six RAAS gene polymorphisms on myocardial perfusion.

Bateman, Timothy M

3-Iodobenzylguanidine; Adult; Aged; Aged, 80 and over; Body Mass Index; Cardiomyopathies; Female; Heart; Heart Failure; Humans; Image Processing, Computer-Assisted; Male; Mediastinum; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Reproducibility of Results; Tomography, Emission-Computed, Single-Photon; Ventricular Dysfunction, Left; Ventricular Function, Left

Reliability of the ¹²³I-mIBG heart/mediastinum ratio: Results of a multicenter test-retest reproducibility study.

A quantitative measurement, the Heart-to-Mediastinum (H/M) ratio of counts derived from a planar acquisition approximately 4&#160;hours after injection of ¹²³I-mIBG, is a strong predictor of outcomes in patients with stable class II-III heart failure and LVEF&#160;&#8804;&#160;35%. This study assessed the test-retest reproducibility of the H/M ratio in such patients. 47 subjects with class II-III systolic heart failure and LVEF&#160;&#8804;&#160;35% were tested at two time intervals separated by 5 to 14&#160;days. Subjects were imaged twice on the same camera using the same radionuclide dose. Images were sent to a core analysis lab, where three nuclear technologists independently determined the H/M ratios. The primary endpoint was test-retest H/M ratio reproducibility calculated as the absolute difference in mean value determined by the three readers. Mean subject age was 65&#160;&#177;&#160;12&#160;years, 85% were male, and mean BMI was 29&#160;&#177;&#160;6&#160;kg/m². Mean injected activity was 10.18&#160;&#177;&#160;0.43&#160;mCi for first dose and 10.09&#160;&#177;&#160;0.52&#160;mCi for the second dose. The mean and SD values for first and repeat studies were almost identical: the 95% confidence interval of the mean test-retest difference was 0.055 to 0.076. Bland-Altman plots showed no systematic effect of the H/M ratio on the magnitude of the difference between replicate measurements. Inter-reader measurements were nearly identical. There were no serious adverse events despite exposure to ¹²³I-mIBG on 2 occasions in a short time period. The Heart-to-Mediastinum ratio of ¹²³I-mIBG is a consistent and highly reproducible measurement in stable Class II to III heart failure patients.

Pan, Emily Y

Aged, 80 and over; Computer Simulation; Defibrillators, Implantable; Equipment Design; Four-Dimensional Computed Tomography; Humans; Male; Pacemaker, Artificial; Patient Safety; Reproducibility of Results; Risk; Thyroid Neoplasms; Tomography, X-Ray Computed

Potential effects of low-dose average CT on cardiac implantable electronic devices.

Average CT has been shown to be more accurate than conventional helical CT in quantitation of the PET data. The risk of CT irradiation of a cardiac implantable electronic device (CIED) causing an adverse event is low and is generally outweighed by the clinical benefit of a medically indicated examination. However, irradiation of CIED over one breath cycle in cine CT scan for average CT could impose risks on a patient who is pacing dependent. The purpose of this study was to demonstrate that low-dose average CT can be safe for CIED.

Meins, Elizabeth

Academic Success; Adult; Child; Child, Preschool; Female; Humans; Infant; Male; Maternal Behavior; Mother-Child Relations; Parenting; Social Class; United Kingdom; Vulnerable Populations

Mothers' Early Mind-Mindedness Predicts Educational Attainment in Socially and Economically Disadvantaged British Children.

Relations between mothers' mind-mindedness (appropriate and nonattuned mind-related comments) at 8 months (N = 206), and children's educational attainment at ages 7 (n = 158) and 11 (n = 156) were investigated in a British sample. Appropriate mind-related comments were positively correlated with reading and mathematics performance at both ages but only in the low-socioeconomic status (SES) group. Path analyses showed that in the low-SES group, appropriate mind-related comments directly predicted age-11 reading performance, with age-4 verbal ability mediating the relation between appropriate mind-related comments and age-7 reading. In contrast, maternal sensitivity and infant-mother attachment security did not predict children's educational attainment. These findings are discussed in terms of genetic and environmental contributions to reading and mathematics performance.

Lim, Doo Hun

Adult; Behavior; Employment; Female; Goals; Humans; Male; Mentoring; Middle Aged; Republic of Korea; Self Efficacy; Surveys and Questionnaires; Vocational Guidance

Mediating Role of Career Coaching on Job-Search Behavior of Older Generations.

This study focuses on career development processes and options for older workers in South Korea and explores how career coaching enhances their career development efforts and transition needs. The purpose of this study is to investigate the structural relationship between older employees' goal-setting, self-efficacy, and job-search behavior mediated by career coaching. A total of 249 participants were recruited in a metropolitan city in South Korea. Based on the literature review, hypotheses were developed and tested on the structural model and the following findings were revealed. First, the findings indicate a positive effect of self-efficacy on older workers' job-search behavior. Second, the value of career coaching was found to affect older workers' job-search behavior in the South Korean context. Third, career-goal commitment alone did not have a positive significant effect on job-search behavior, but it was influential through the mediating process of the perceived quality of the career coaching program provided by an employment center in South Korea.

Pizzuto, Daniele A

Aged; Biological Transport; Choline; Humans; Lung; Male; Positron Emission Tomography Computed Tomography; Prostate-Specific Antigen; Prostatic Neoplasms; Retrospective Studies

Lung uptake of fluorine-18 fluoroethyl-choline PET-CT in patients with prostate cancer.

Metastatic spreading to the lungs is a negative prognostic factor in patients with prostate cancer (PC). Aim of our study was to assess the prevalence of lung PC metastases in patients with fluorine-18 fluoroethyl-choline (F-18-FECh) PET-CT positive lung lesions and the role of Gleason Score (GS) and common biochemical markers in predicting metastatic spreading to the lungs.

Humbert, Olivier

Biological Transport; Breast Neoplasms; Female; Fluorodeoxyglucose F18; Humans; Lymphatic Metastasis; Middle Aged; Positron Emission Tomography Computed Tomography

SUV calculation in breast cancer: which normalization should be applied when using 18F-FDG PET?

When using 18F-FDG PET, glucose metabolism quantification is affected by various factors. We aimed to investigate the benefit of different standardized uptake value (SUV) normalizations to improve the accuracy of 18F-FDG uptake to predict breast cancer aggressiveness and response to treatment.

Legband, Nathan

Animals; Catheter Obstruction; Catheters, Indwelling; Drainage; Equipment Design; Humans; Male; Models, Animal; Peritoneal Lavage; Peritoneum; Rats; Respiratory Insufficiency; Respiratory Therapy; Time Factors

Preliminary Evaluation of the Viability of Peritoneal Drainage Catheters Implanted in Rats for Extended Durations.

<i>Purpose/Aim</i>: In developing a novel peritoneal oxygenation therapy, catheters implanted into the peritoneal cavity became obstructed with omental tissue and prevented the infusion and removal of fluid from the peritoneal cavity. The obstruction of peritoneal catheters is a significant failure in researching various peritoneal treatments as further fluid administration is no longer possible. The purpose of this preliminary study was to determine the most effective catheter design for infusion and removal of fluid into the peritoneal cavity of rats. <i>Materials and Methods</i>: Four types of catheters were tested including the Jackson-Pratt, round fluted drain, flat fluted drain, and an original design. Three of each catheter type were surgically placed into the peritoneal cavity of rats (<i>n</i> = 12). In order to test the efficacy of each catheter, saline was infused and extracted twice daily. Catheters were scored on a weighted scale based on the amount of time they remained patent, the subjective force needed for extraction/infusion, and the amount of saline removed. <i>Results</i>: The round and flat fluted drain catheters remained patent for the full duration of the study (12 days) compared to the other models which failed after 7&#160;days. These catheters also yielded a high average for extracted saline volume and an easy extraction/infusion. <i>Conclusions</i>: The round and flat fluted drain catheters were recognized as viable options to be used in rats for peritoneal drain studies of up to 12 days.

Cappabianca, Salvatore

Aged; Asymptomatic Diseases; Coronary Artery Disease; Female; Humans; Incidental Findings; Italy; Male; Mandatory Reporting; Multidetector Computed Tomography; Predictive Value of Tests; Prognosis; Radiography, Thoracic; Retrospective Studies; Risk Assessment; Risk Factors; Vascular Calcification

Mandatory Reporting of Coronary Artery Calcifications Incidentally Noted on Chest Multi-Detector Computed Tomography: A Multicentre Experience.

Coronary Artery Calcifications (CACs) are associated with coronary atherosclerosis and Cardiovascular (CV) events. In "non-cardiovascular" settings, CACs can be easily detected on chest Multi-Detector Computed Tomography (MDCT). Their evaluation may help to better stratify CV risk in the general population, especially for primary prevention.

Agrawal, Harsh

Chronic Disease; Clinical Decision-Making; Coronary Occlusion; Humans; Percutaneous Coronary Intervention; Risk Assessment; Risk Factors; Treatment Outcome; Vascular Patency

The Role of Percutaneous Coronary Intervention in the Treatment of Chronic Total Occlusions: Rationale and Review of the Literature.

Chronic total occlusion (CTO) of a coronary artery is defined as an occluded segment with no antegrade flow and a known or estimated duration of at least 12 weeks.

Ottosen, Madelene J

Delivery of Health Care; Emotions; Family; Health Facilities; Humans; Medical Errors

Long-Term Impacts Faced by Patients and Families After Harmful Healthcare Events.

Patients and families report experiencing a multitude of harms from medical errors resulting in physical, emotional, and financial hardships. Little is known about the duration and nature of these harms and the type of support needed to promote patient and family healing after such events. We sought to describe the long-term impacts (LTIs) reported by patients and family members who experienced harmful medical events 5 or more years ago.

Thacker, Purujit J

Aged; Anticoagulants; Female; Head; Humans; Retrospective Studies; Tomography, X-Ray Computed

Rapid Response: To Scan or Not to Scan? The Utility of Noncontrast CT Head for Altered Mental Status.

The aims of the study were the following: (1) to determine how often computed tomography (CT) scans of the head are obtained on rapid responses called for altered mental status (AMS), (2) to determine whether CT imaging of the head is required during all rapid responses called for AMS, (3) to determine which patients would benefit from CT scans of the head in this setting, (4) to note whether an adequate neurologic exam was documented, (5) to determine the cost of CT scans that did not change management, and (6) to examine the role of medications leading to AMS.

Vennapusa, Bharathi

Antibodies, Monoclonal, Humanized; Antineoplastic Agents, Immunological; B7-H1 Antigen; Biomarkers, Tumor; Carcinoma, Non-Small-Cell Lung; Gene Expression Regulation, Neoplastic; Humans; Immunohistochemistry; Immunotherapy; Lung Neoplasms; Observer Variation; Patient Selection; Reproducibility of Results; Sensitivity and Specificity; Urinary Bladder Neoplasms

Development of a PD-L1 Complementary Diagnostic Immunohistochemistry Assay (SP142) for Atezolizumab.

Cancer immunotherapies, such as atezolizumab, are proving to be a valuable therapeutic strategy across indications, including non-small cell lung cancer (NSCLC) and urothelial cancer (UC). Here, we describe a diagnostic assay that measures programmed-death ligand 1 (PD-L1) expression, via immunohistochemistry, to identify patients who will derive the most benefit from treatment with atezolizumab, a humanized monoclonal anti-PD-L1 antibody. We describe the performance of the VENTANA PD-L1 (SP142) Assay in terms of specificity, sensitivity, and the ability to stain both tumor cells (TC) and tumor-infiltrating immune cells (IC), in NSCLC and UC tissues. The reader precision, repeatability and intermediate precision, interlaboratory reproducibility, and the effectiveness of pathologist training on the assessment of PD-L1 staining on both TC and IC were evaluated. We detail the analytical validation of the VENTANA PD-L1 (SP142) Assay for PD-L1 expression in NSCLC and UC tissues and show that the assay reliably evaluated staining on both TC and IC across multiple expression levels/clinical cut-offs. The reader precision showed high overall agreement when compared with consensus scores. In addition, pathologists met the predefined training criteria (≥85.0% overall percent agreement) for the assessment of PD-L1 expression in NSCLC and UC tissues with an average overall percent agreement ≥95.0%. The assay evaluates PD-L1 staining on both cell types and is robust and precise. In addition, it can help to identify those patients who may benefit the most from treatment with atezolizumab, although treatment benefit has been demonstrated in an all-comer NSCLC and UC patient population.

Pierconti, Francesco

Antibodies, Monoclonal; Antibodies, Neoplasm; Artifacts; Carcinoma, Acinar Cell; Humans; Immunohistochemistry; Male; Middle Aged; Prostate; Prostatic Neoplasms; Racemases and Epimerases; Transcription Factors; Transurethral Resection of Prostate; Tumor Suppressor Proteins

34BetaE12 and Alfa-Methylacyl Coenzyme A Racemase (AMACR) Antibodies Better Than p63 Antibody Distinguish Normal and Neoplastic Glands in Prostatic Tissue With Thermal Artifacts.

The occurrence of inked margins with crush artifact derived from the electrocauterization in radical prostatectomy and/or the presence of crushed areas with distorted glands in prostatic samples after transurethral resection of prostate (TURP) can induce a significant interobserver variability during histopathologic evaluation of specimens. The specific immunostaining for basal cell markers 34BetaE12 and p63 and for alfa-methylacyl coenzyme A racemase (AMACR) in neoplastic cells is commonly used as an ancillary tool to establish benign and malignant glands. In this study we carried out the immunohistochemical reactions for p63, 34BetaE12, and AMACR on 3 different and successive paraffin sections to discriminate malignant and benign prostatic glands, distorted and crushed by the thermal artifacts in 60 radical prostatectomies and 50 TURP samples. All prostatic acinar adenocarcinoma showed the loss of basal cell markers and expression of AMACR, whereas p63 failed to stain the basal cell layer in benign crushed prostatic glands. The same cauterized glands were steadily positive for 34BetaE12. The high percentage of p63 false negative cases in benign distorted and crushed glands could be explained by the thermal artifacts which might cause lack of p63 antigenicity. In contrast, the antigenicity of 34BetaE12 and AMACR seem not to be affected by cautery artifacts. Thus, in cauterized suspicious prostatic glands an immunohistochemistry panel including, p63, 34BetaE12, and AMACR or only 34BetaE12 is recommended. In addition, after the first evaluation with only p63, we suggest that a separate and confirmatory staining for 34BetaE12 is strongly recommended.

Shiflett, James M

Biopsy; Cauda Equina; Female; Humans; Infant; Magnetic Resonance Imaging; Prognosis; Rhabdoid Tumor; Spinal Cord Neoplasms; Teratoma

Atypical Teratoid Rhabdoid Tumor of the Cauda Equina in a Child: Report of a Very Unusual Case.

Atypical teratoid/rhabdoid tumors (AT/RT) are highly aggressive malignant primitive neoplasms that commonly occur in children younger than 2 years of age. The prognosis is generally dismal with a median survival time of <1 year. The majority of AT/RT occur in the posterior fossa and less frequently the supratentorium. Primary pediatric spinal AT/RT are exceedingly rare and only 15 cases have been reported to date. Here we report a very unusual case of primary spinal AT/RT extensively involving the spinal cord from T11 down to the cauda equina. In this patient, the tumor was highly aggressive and resulted in extensive dissemination into the nerve roots and paraspinal soft tissue rapidly resulting in the patient's death 1 month after diagnosis. to the best of our knowledge, this degree of involvement of the spine by a primary AT/RT has not been described before.

Franz, Berkeley

Community Health Services; Grounded Theory; Hospitals; Humans; Interviews as Topic; Needs Assessment; Ohio; Organizations, Nonprofit; Qualitative Research; Quality of Health Care; Substance-Related Disorders

Why Don't Hospitals Prioritize Substance Abuse in Their Community Benefit Programming?

The goal of this study was to understand whether Appalachian Ohio hospitals prioritized substance abuse in their IRS-mandated community health needs assessments (CHNAs) and if not, what factors were important in this decision. Analysis of CHNA reports from all 28 hospitals in the region supplemented interview data from in-depth phone interviews, with 17 participants tasked with overseeing CHNAs at 21 hospitals. The CHNA reports show that hospitals in this region prioritize substance abuse and mental health less often than access to care and obesity. Interviews suggest 4 reasons: lack of resources, risk aversion, concern about hospital expertise, and stigma related to substance abuse. Hospitals are playing a larger role in public health as a result of CHNA requirements but resist taking on challenging problems such as substance abuse. The report concludes by summarizing concrete steps to ensure that community benefit efforts address pressing health problems. The implications of this study are manifest in concrete recommendations for encouraging hospitals to address pressing health problems in their community benefit efforts.

Kipping, Erika M

Adolescent; Black or African American; Analgesia; Analgesics; Analgesics, Opioid; Child; Child, Preschool; Cross-Sectional Studies; Emergency Service, Hospital; Ethnicity; Female; Health Status; Hispanic or Latino; Humans; Male; Pain; Pain Management; Pain Measurement; Retrospective Studies; Severity of Illness Index; Treatment Outcome; Young Adult

The Complex Association of Race/Ethnicity With Pain Treatment Quality in an Urban Medical Center With 2 Pediatric Emergency Departments.

This study aimed to explore racial differences in analgesia quality.

Borns, Julia

Adolescent; Advanced Trauma Life Support Care; Child; Child, Preschool; Female; Guideline Adherence; Hospitals, Pediatric; Humans; Infant; Infant, Newborn; Male; Medical Errors; Trauma Centers; Video Recording

Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay.

In treating patients of different ages and diseases in the pediatric resuscitation bay, management errors are common. This study aimed to analyze the adherence to advanced trauma life support and pediatric advanced life support guidelines and identify management errors in the pediatric resuscitation bay by using video recordings.

Hildenbrand, Aimee K

Accidental Injuries; Acute Pain; Adolescent; Analgesics, Opioid; Child; Child, Hospitalized; Female; Humans; Longitudinal Studies; Male; Pain Management; Pain Measurement; Prospective Studies; Risk Factors; Stress Disorders, Post-Traumatic; United States; Wounds and Injuries

Posttraumatic Stress in Children After Injury: The Role of Acute Pain and Opioid Medication Use.

After injury, many children experience posttraumatic stress symptoms (PTSS) that negatively impact recovery. Acute pain and PTSS share neurobiological pathways, and acute dosage of morphine has been linked to reduced PTSS in naturalistic studies. However, the complex interactions between pain, morphine and other opioid use, and PTSS have yet to be investigated in robust pediatric samples.This prospective, longitudinal study examined relationships between acute pain, opioid medications, and PTSS after pediatric injury.

Hoffmann, Jennifer A

Adolescent; Amnesia, Anterograde; Autoantibodies; Brain; Encephalitis; Female; Hashimoto Disease; Humans; Magnetic Resonance Imaging; Receptors, AMPA; Temporal Lobe

A Teenager With Acute Anterograde Amnesia.

Isolated amnesia is an uncommon presenting complaint in the pediatric age group. We report the case of an 18-year-old woman who presented with the acute onset of memory difficulty and an otherwise normal neurologic examination. Brain magnetic resonance imaging demonstrated inflammation in the bilateral temporal lobes. Serum and cerebrospinal fluid testing ultimately revealed a diagnosis of autoimmune encephalitis. Although rare, the acute onset of isolated amnesia deserves a prompt, comprehensive evaluation.

de la Calva, Carolina

Adolescent; Adult; Blood Transfusion; Child; Child, Preschool; Female; Fractures, Bone; Humans; Infant; Length of Stay; Male; Multiple Trauma; Pelvic Bones; Retrospective Studies

Pediatric Pelvic Fractures and Differences Compared With the Adult Population.

Although pelvic fractures in children are rare, because of anatomical differences between an adult's skeleton and a child's skeleton, these lesions in the pediatric population have specific characteristics that need to be borne in mind when dealing with them.

Michelson, Kenneth A

Adolescent; Anaphylaxis; Child; Child, Preschool; Cross-Sectional Studies; Emergency Service, Hospital; Female; Hospital Charges; Hospitalization; Humans; Incidence; Infant; Male; Respiratory Tract Diseases; Retrospective Studies; Severity of Illness Index; United States

Trends in Severe Pediatric Emergency Conditions in a National Cohort, 2008 to 2014.

The objective of this study was to determine the incidence and recent trends in serious pediatric emergency conditions.

Pepple, Kathryn L

Acetazolamide; Administration, Oral; Adult; Aged; Aged, 80 and over; Carbonic Anhydrase Inhibitors; Dose-Response Relationship, Drug; Female; Fluorescein Angiography; Fundus Oculi; Humans; Macula Lutea; Macular Edema; Male; Middle Aged; Retrospective Studies; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity; Young Adult

RESPONSE OF INFLAMMATORY CYSTOID MACULAR EDEMA TO TREATMENT USING ORAL ACETAZOLAMIDE.

To determine the treatment effect of oral acetazolamide on refractory inflammatory macular edema.

Iacono, Pierluigi

Adult; Central Serous Chorioretinopathy; Choroid; Chronic Disease; Female; Fluorescein Angiography; Follow-Up Studies; Fovea Centralis; Fundus Oculi; Humans; Male; Photochemotherapy; Photosensitizing Agents; Prospective Studies; Time Factors; Tomography, Optical Coherence; Verteporfin; Visual Acuity

CHRONIC CENTRAL SEROUS CHORIORETINOPATHY: Early and Late Morphological and Functional Changes After Verteporfin Photodynamic Therapy.

To describe early and late morphological and functional changes in subjects receiving photodynamic therapy (PDT) for chronic central serous chorioretinopathy.

Lee, Junwon

Aged; Aged, 80 and over; Choroid; Choroidal Neovascularization; Coloring Agents; Diagnostic Techniques, Ophthalmological; Female; Fluorescein Angiography; Humans; Indocyanine Green; Male; Middle Aged; Multimodal Imaging; Polyps; Prevalence; Retinal Drusen; Retrospective Studies; Tomography, Optical Coherence

PREVALENCE AND CLINICAL CHARACTERISTICS OF PACHYDRUSEN IN POLYPOIDAL CHOROIDAL VASCULOPATHY: Multimodal Image Study.

To investigate the prevalence of a newly defined drusen type, pachydrusen, soft drusen, and subretinal drusenoid deposits in eyes with polypoidal choroidal vasculopathy and fellow eyes and the relationship between each drusen type and the choroidal thickness, vascular morphology, and hyperpermeability.

Khan, M Ali

Aged; Anterior Chamber; Aphakia, Postcataract; Female; Follow-Up Studies; Humans; Lens Implantation, Intraocular; Male; Polytetrafluoroethylene; Retrospective Studies; Sclera; Suture Techniques; Sutures; Time Factors; Visual Acuity; Vitrectomy

PARS PLANA VITRECTOMY WITH ANTERIOR CHAMBER VERSUS GORE-TEX SUTURED POSTERIOR CHAMBER INTRAOCULAR LENS PLACEMENT: Long-Term Outcomes.

To compare clinical outcomes of combined pars plana vitrectomy (PPV) with anterior chamber intraocular lens (ACIOL) placement versus scleral fixation of a posterior chamber intraocular lens (PCIOL) using Gore-Tex suture.

La Mantia, Alberto

Adult; Aged; Aged, 80 and over; Algorithms; Diabetic Retinopathy; Female; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Humans; Macula Lutea; Male; Middle Aged; ROC Curve; Regional Blood Flow; Retinal Vessels; Retrospective Studies; Tomography, Optical Coherence; Visual Acuity

COMPARING FUNDUS FLUORESCEIN ANGIOGRAPHY AND SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN THE EVALUATION OF DIABETIC MACULAR PERFUSION.

To compare fundus fluorescein angiography (FFA) and swept-source optical coherence tomography angiography (SS-OCTA) in the evaluation of macular perfusion in diabetic patients.

Biggs, Laura J

Adult; Altruism; Australia; Counseling; Female; Focus Groups; Hotlines; Humans; Mental Health Services; Peer Group; Perinatal Care; Pregnancy; Surveys and Questionnaires; Volunteers

Peer supporters' experiences on an Australian perinatal mental health helpline.

Perinatal mental health is an important public health issue, and peer support is a potentially important strategy for emotional well-being in the perinatal period. PANDA Perinatal Anxiety & Depression Australia provides support to individuals impacted by perinatal mental health issues via the National Perinatal Anxiety & Depression Helpline. Callers receive peer support from volunteers and counselling from paid professional staff. The views and experiences of PANDA peer support volunteers have not previously been studied. We conducted two focus groups and an online survey to explore the experiences of women providing volunteer peer support on the Helpline. Data collection took place in October and November 2013. Two social theories were used in framing and addressing the study aims and in interpreting our findings: the Empathy-Altruism Hypothesis, and the Helper Therapy Principle. All PANDA volunteers were invited to participate (n = 40). Eight volunteers attended a focus group, and 11 survey responses were received. Descriptive statistics were used to analyse quantitative data. All survey respondents 'strongly agreed' that they felt positive about being part of PANDA. Thematic analysis of data from focus groups and open-ended survey responses identified the following themes: motivated to help others, supported to support callers, helping to make a difference and emotional impacts for volunteers. Respondents described a strong desire to support others experiencing emotional distress as a motivator to volunteer. Although perinatal peer support services are designed to benefit those who receive support, this study suggests volunteers may also experience personal benefits from the role.

Joo, Eun-Jeong

Bacteremia; Endocarditis, Bacterial; Health Care Costs; Humans; Length of Stay; Methicillin-Resistant Staphylococcus aureus; Risk Assessment; Risk Factors; Staphylococcal Infections; Time Factors; Treatment Outcome

Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis.

Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals, and has recently emerged in the community. The impact of methicillin-resistance on mortality and medical costs for patients with S. aureus bacteremia (SAB) requires reevaluation.

Mogro-Wilson, Cristina

Adolescent; Adult; Black or African American; Condoms; Fathers; Hispanic or Latino; Humans; Intention; Male; Safe Sex; Surveys and Questionnaires; Young Adult

Increasing condom usage for African-American and hispanic young fathers in a community based intervention.

<b>Objectives:</b> This paper investigates a community-based intervention for young fathers, <i>FatherWorks</i>, compared to care-as-usual, <i>24/7 Dads</i>. We hypothesized that utilizing the <i>FatherWorks</i> intervention (a 15 session parenting intervention, 13 session employment class, paid internship, case management, and access to behavioral health services) will assist in readiness to use condoms and increase condom usage, which may differ by race/ethnicity.<b>Methods:</b> Eligible males (<i>n</i>&#8201;=&#8201;328) were enrolled into a Randomized Control Trial. Participants were 15-24 years old and had fathered one or more children with a female under the age of 21. A survey was taken at baseline and at 15 weeks following the intervention.<b>Results:</b> Analyses of changes indicated that intervention participants improved from the pre-contemplation stage of condom usage towards contemplation, and from preparation to action. The pattern of improvement in the condom use stage of change was different in African-American versus Hispanic participants. Changes in condom use during last intercourse were not significant.<b>Conclusions</b>: Study findings indicate that <i>FatherWorks</i> is successful in increasing the intent to use condoms, with the effect manifesting differently in African-American and Hispanic young fathers. Future work with minority fathers indicates a need for cultural adaptation of the intervention.

Lee, Yang Woon

Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers; Colitis, Ulcerative; Colonoscopy; Crohn Disease; Enzyme-Linked Immunosorbent Assay; Feces; Female; Humans; Inflammatory Bowel Diseases; Leukocyte L1 Antigen Complex; Male; Middle Aged; Point-of-Care Testing; Prospective Studies; Young Adult

The usefulness of fecal calprotectin in assessing inflammatory bowel disease activity.

Fecal calprotectin (FC) is known to correlate with disease activity and can be used as a predictor for relapse or treatment response in inflammatory bowel disease (IBD). We evaluated the usefulness of FC as a biomarker for disease activity in patients with IBD using both enzyme-linked immunosorbent assay (ELISA) and a quantitative point-of-care test (QPOCT).

Agénor, Madina

Adult; Black or African American; Ethnicity; Female; Health Surveys; Hispanic or Latino; Humans; Papillomavirus Infections; Papillomavirus Vaccines; Patient Protection and Affordable Care Act; Racism; Socioeconomic Factors; United States; White People; Young Adult

Racial/ethnic disparities in human papillomavirus vaccination initiation and completion among U.S. women in the post-Affordable Care Act era.

<b>Objective:</b> To ascertain the magnitude and potential mechanisms of racial/ethnic disparities in initiating and completing the 3-dose human papillomavirus (HPV) vaccine among U.S. women in the post-Affordable Care Act era.<b>Design:</b> Using 2015 National Health Interview Survey data, we used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between race/ethnicity and HPV vaccination initiation and completion among black, Latina, Asian, and white U.S. women aged 18-31 years, adjusting for age and geographic region. We also examined the role of socioeconomic and health care factors in potentially explaining racial/ethnic disparities in HPV vaccine uptake and stratified our analyses by age (ages 18-22 and 23-31 years).<b>Results:</b> The prevalence of HPV vaccination initiation and completion among U.S. women aged 18-31 years overall was 35.4% and 22.7%, respectively. We observed no statistically significant difference in the odds of HPV vaccination initiation or completion by race/ethnicity among women aged 18-22 years, adjusting for age and geographic region. Among women aged 23-31 years, Latina ([odds ratio=] 0.59; [95% confidence interval:] 0.47, 0.76) and Asian (0.51; 0.34, 0.75) women had significantly lower adjusted odds of initiating HPV vaccination compared to white women. Further, relative to white women, black (0.46; 0.32, 0.67), Latina (0.45; 0.32, 0.64), and Asian (0.46; 0.28, 0.78) women had significantly lower adjusted odds of completing HPV vaccination. Adding socioeconomic factors to the models attenuated the HPV vaccination initiation adjusted odds ratios for Latina vs. white women and the HPV vaccination completion adjusted odds ratios for both black and Latina vs. white women. The inclusion of health care factors into the models did not further attenuate these odds ratios.<b>Conclusion:</b> Policies and programs that promote socioeconomic equity may mitigate HPV vaccination disparities between black and Latina women and white women. Additional research is needed to identify the drivers of HPV vaccination disparities between subgroups of Asian women and white women.

Hensel, Jennifer M

Ambulatory Care; Canada; Emergency Service, Hospital; Emergency Services, Psychiatric; Female; Health Services Needs and Demand; Humans; Male; Medical Overuse; Mental Disorders; Patient Readmission; Primary Health Care; Quality Improvement; Risk Assessment; Substance-Related Disorders

Acute Care Use for Ambulatory Care-Sensitive Conditions in High-Cost Users of Medical Care with Mental Illness and Addictions.

The role of mental illness and addiction in acute care use for chronic medical conditions that are sensitive to ambulatory care management requires focussed attention. This study examines how mental illness or addiction affects risk for repeat hospitalization and/or emergency department use for ambulatory care-sensitive conditions (ACSCs) among high-cost users of medical care.

Barnes, Roline

Adult; Ambulatory Care Facilities; Arthralgia; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Outcome Assessment, Health Care; Quality Improvement; Quality of Life; South Africa; Surveys and Questionnaires

Joint pain within adult middle-aged women, attending a community clinic in a peri-urban area in South Africa: a cross-sectional survey.

This study aimed to investigate the prevalence of joint pain in women between the ages of 40 and 64 years who attended a community clinic in the Free State to provide micro-information for health care planners.

Turner-Stokes, Lynne

Brain Injuries; Datasets as Topic; Disabled Persons; Factor Analysis, Statistical; Female; Humans; Male; Middle Aged; Needs Assessment; Neurological Rehabilitation; Psychometrics; Spinal Cord Injuries; United Kingdom

The patient categorisation tool: psychometric evaluation of a tool to measure complexity of needs for rehabilitation in a large multicentre dataset from the United Kingdom.

This first psychometric evaluation of the Patient Categorisation Tool examined its properties as an instrument to measure complexity of needs in a mixed population of patients presenting for specialist neurorehabilitation.

Horný, Michal

Adult; Breast Density; Breast Neoplasms; Disclosure; Early Detection of Cancer; Female; Humans; Mammography; Mass Screening; Middle Aged; Ultrasonography; United States

Dense Breast Notification Laws: Impact on Downstream Imaging After Screening Mammography.

Dense breast tissue is a common finding that decreases the sensitivity of mammography in detecting cancer. Many states have recently enacted dense breast notification (DBN) laws to provide patients with information to help them make better-informed decisions about their health. To test whether DBN legislation affected the probability of screening mammography follow-up by ultrasound and magnetic resonance imaging (MRI), we examined the proportion of times screening mammography was followed by ultrasound or MRI for a series of months pre- and post-legislation. The subjects were women aged 40 to 64 years, covered by private health insurance, undergoing screening mammography from 2007 to 2014. Except for Hawaii, Maryland, and New York, DBN legislation significantly increased the probability of ultrasound follow-up in all states that implemented DBN legislation before December 2014. It also increased the probability of MRI follow-up in California, North Carolina, Pennsylvania, and Texas. The financial and access consequences merit further study.

Gary, Rebecca

Adult; Aged; Caregivers; Exercise; Family; Female; Hand Strength; Heart Failure; Humans; Male; Middle Aged; Perception; Physical Functional Performance; Resistance Training; Walk Test

An Intervention to Improve Physical Function and Caregiver Perceptions in Family Caregivers of Persons With Heart Failure.

<b>Objective:</b> This randomized controlled trial was conducted to determine whether a 12-week home-based aerobic and resistance exercise program would improve physical function and caregiving perceptions among family caregivers (FCGs) of persons with heart failure. <b>Method:</b> Overall, 127 FCGs were randomized to one of three groups: usual care attention control (UCAC), psychoeducation only (PE), and psychoeducation plus exercise (PE + EX). Physical function measures (6-min walk test, handgrip, and upper and lower strength) and caregiving perceptions (Bakas Caregiving Outcomes Scale) were obtained at baseline and at 6 months. <b>Results:</b> FCGs in the PE + EX showed significant improvement in 6-min walk distance (<i>p</i> = .012), handgrip, and lower extremity strength compared with the PE and UCAC groups. The combined group had the greatest improvement in caregiver perceptions (<i>p</i> &lt; .001). <b>Conclusion:</b> FCGs in the PE + EX group improved the most in physical function and caregiver perception outcomes. Directions for future research are provided.

Schiltz, Nicholas K

Aged; Aged, 80 and over; Cause of Death; Chronic Disease; Cognitive Dysfunction; Female; Geriatric Assessment; Humans; Male; Middle Aged; Multimorbidity; Retrospective Studies; Survival Rate; United States

The Influence of Multimorbidity on Leading Causes of Death in Older Adults With Cognitive Impairment.

<b>Objective:</b> The aim of this study is to evaluate the relationship of leading causes of death with gradients of cognitive impairment and multimorbidity. <b>Method:</b> This is a population-based study using data from the linked 1992-2010 Health and Retirement Study and National Death Index (<i>n</i> = 9,691). Multimorbidity is defined as a combination of chronic conditions, functional limitations, and geriatric syndromes. Regression trees and Random Forest identified which combinations of multimorbidity associated with causes of death. <b>Results:</b> Multimorbidity is common in the study population. Heart disease is the leading cause in all groups, but with a larger percentage of deaths in the mild and moderate/severe cognitively impaired groups than among the noncognitively impaired. The different "paths" down the regression trees show that the distribution of causes of death changes with different combinations of multimorbidity. <b>Discussion:</b> Understanding the considerable heterogeneity in chronic conditions, functional limitations, geriatric syndromes, and causes of death among people with cognitive impairment can target care management and resource allocation.

Pasion, R

Adult; Aged; Aging; Brain; Decision Making; Electroencephalography; Evoked Potentials; Female; Humans; Male; Middle Aged; Morals; Social Perception

The effect of aging on the (mis)perception of intentionality - an ERP study.

Despite the accumulated knowledge on moral decision-making in the early stages of development, empirical evidence is still limited in the old-aged adults. The current study contributes to unveil the neural correlates of judgments of moral transgressions as a function of aging, by examining the temporal dynamics of neural activation elicited by intentional and accidental harmful actions in three groups of healthy participants: young adults (18-35), adults (40-55), and older adults (60-75). Older adults were slower and less accurate in rating intentionality, compared to the younger groups. In ERP analysis, the older group showed increased P2 amplitude, which was predicted by poorer performance on neuropsychological tests. Reduced amplitudes were found on critical ERP components to moral cognition (N2 and LPP), namely while processing intentional harmful scenarios. Older adults seem to allocate more attentional resources (P2) to the task, probably to compensate the age-related decline in executive functioning, while younger groups show a pronounced negativity while detecting harm (N2) and increased neural activation to encode the intentions behind the acts (LPP).

Gomez Penedo, Juan Martin

Adult; Bulimia Nervosa; Cognitive Behavioral Therapy; Female; Humans; Interpersonal Psychotherapy; Interpersonal Relations; Psychiatric Status Rating Scales; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome

Patient baseline interpersonal problems as moderators of outcome in two psychotherapies for bulimia nervosa.

<b>Objective:</b> We tested an aptitude by treatment interaction; namely, whether patients' baseline interpersonal problems moderated the comparative efficacy of cognitive-behavioral therapy (CBT) vs. interpersonal psychotherapy (IPT) for bulimia nervosa (BN). <b>Method:</b> Data derived from a randomized-controlled trial. Patients reported on their interpersonal problems at baseline; purge frequency at baseline, midtreatment, and posttreatment; and global eating disorder severity at baseline and posttreatment. We estimated the rate of change in purge frequency across therapy, and the likelihood of attaining clinically meaningful improvement (recovery) in global eating disorder severity by posttreatment. We then tested the interpersonal problem by treatment interactions as predictors of both outcomes. <b>Results:</b> Patients with more baseline overly communal/friendly problems showed steeper reduction in likelihood of purging when treated with CBT vs. IPT. Patients with more problems of being under communal/cold had similar reductions in likelihood of purging across both treatments. Patients with more baseline problems of being overly agentic were more likely to recover when treated with IPT vs. CBT, whereas patients with more problems of being under agentic were more likely to recover when treated with CBT vs. IPT. <b>Conclusions:</b> Interpersonal problems related to communion and agency may inform treatment fit among two empirically supported therapies for BN.

Keefe, John R

Cognition; Defense Mechanisms; Humans; Mentalization; Object Attachment; Personality; Personality Disorders; Psychotherapy

Changing character: A narrative review of personality change in psychotherapies for personality disorder.

<b>Objective:</b> Personality disorder (PD) is a negative prognostic indicator for treatment, and absolute improvements in functioning among these patients are often modest. This may be because personality features that give rise to dysfunction in PD are not targeted optimally during most treatments. <b>Method:</b> Attachment, mentalization, core beliefs, and personality organization/defense use were identified as personality constructs that have been pursued in treatment studies and that are proposed to underlie PD. <b>Results:</b> All constructs correlate with psychiatric symptoms, PD diagnosis, and functioning. Defense mechanisms and core beliefs further distinguish specific PDs, whereas personality organization separates more versus less severe PDs. Evidence from treatment and naturalistic studies indicate that maturation of defense mechanisms temporally precedes improvements in symptoms and functioning. Changes in attachment and mentalization correlate with some outcomes, but mediation of improvement has not been established. In psychodynamic therapy, transference interpretations may promote amelioration of personality dysfunction. With the exception of attachment, the experimental literature is lacking that could explicate the mechanisms by which these personality constructs maintain psychosocial dysfunction. <b>Conclusions:</b> Future research should aim to identify changes in these mechanisms that mediate positive outcomes in PD, as well as the specific therapeutic procedures that best promote positive change in PD.

Katzmann, Josepha

Attention Deficit and Disruptive Behavior Disorders; Child; Conduct Disorder; Humans; Male; Play Therapy; Psychiatric Status Rating Scales; Social Skills

Social skills training and play group intervention for children with oppositional-defiant disorders/conduct disorder: Mediating mechanisms in a head-to-head comparison.

<b>Objective</b>: Social-cognitive information processing, social skills, and social interactions are problem-maintaining variables for aggressive behavior in children. We hypothesized that these factors may be possible mediators of the mechanism of change in the child-centered treatment of conduct disorders (CDs). The aim of the present study (Clinical trials.gov Identifier: NCT01406067) was to examine putative mechanisms of change for the decrease in oppositional-defiant behavior resulting from child-centered treatment of patients with oppositional-defiant disorder (ODD) or CD. <b>Method</b>: 91 children (age 6-12 years) with ODD/CD were randomized to receive either social skills training or to a resource activating play group. Mediator analyses were conducted using path analyses. <b>Results</b>: The assumed mediating effects were not significant. However, alternative models with the putative mediators and outcome in reversed positions showed significant indirect effects of the oppositional-defiant symptoms as mediator for the decrease of disturbance of social-information processing, social skills, and social interactions. <b>Conclusions</b>: The proposed model for mechanisms of change could not be confirmed, with the results pointing to a reversed causality. Variables other than those hypothesized must be responsible for mediating the effects of the intervention on child oppositional-defiant behavior. Possible mechanisms of change were discussed.

Sharma, Mahima

Cognitive Dysfunction; Epigenesis, Genetic; Hippocampus; Humans; Pyramidal Cells

Epigenetics: the panacea for cognitive decline?

Danek, Amory H

Adolescent; Adult; Consciousness; Creativity; Decision Making; Emotions; Female; Humans; Male; Midwestern United States; Problem Solving; Students; Universities; Young Adult

Closing the gap: connecting sudden representational change to the subjective Aha! experience in insightful problem solving.

Two hallmarks of insightful problem solving are thought to be suddenness in the emergence of solution due to changes in problem representation, and the subjective Aha! experience. Although a number of studies have explored the Aha! experience, few studies have attempted to measure representational change. Following the lead of Durso et al. (Psychol Sci 5(2):94-97, 1994) and Cushen and Wiley (Conscious Cognit 21(3):1166-1175, 2012), in this study, participants made importance-to-solution ratings throughout their solution attempts as a way to assess representational change. Participants viewed a set of magic trick videos with the task of finding out how each trick worked, and rated six action verbs for each trick (including one that implied the correct solution) multiple times during solution. They were also asked to indicate the extent to which they experienced an Aha! moment. Patterns of ratings that showed a sudden change towards a correct solution led to stronger Aha! experiences than patterns that showed a more incremental change towards a correct solution, or a change towards incorrect solutions. The results show a connection between sudden changes in problem representations (leading to correct solutions) and the subjective appraisal of solutions as an Aha! experience. This offers the first empirical support for a close relationship between two theoretical constructs that have traditionally been assumed to be related to insightful problem solving.

McCarthy, Aoife J

Biomarkers, Tumor; Diagnosis, Differential; Esophageal Mucosa; Esophageal Neoplasms; Esophagectomy; Humans; Liposarcoma; Male; Middle Aged; Minimally Invasive Surgical Procedures; Polyps; Tomography, X-Ray Computed

Well-Differentiated Liposarcoma (Atypical Lipomatous Tumor) Presenting as an Esophageal Polyp.

White, Carla

Animals; Binding, Competitive; Computer Simulation; Dose-Response Relationship, Drug; Drug Discovery; Humans; Ligands; Linear Models; Mathematical Concepts; Models, Biological; Protein Multimerization; Protein Structure, Quaternary; Receptors, G-Protein-Coupled; Signal Transduction

Ligand Binding Dynamics for Pre-dimerised G Protein-Coupled Receptor Homodimers: Linear Models and Analytical Solutions.

Evidence suggests that many G protein-coupled receptors (GPCRs) are bound together forming dimers. The implications of dimerisation for cellular signalling outcomes, and ultimately drug discovery and therapeutics, remain unclear. Consideration of ligand binding and signalling via receptor dimers is therefore required as an addition to classical receptor theory, which is largely built on assumptions of monomeric receptors. A key factor in developing theoretical models of dimer signalling is cooperativity across the dimer, whereby binding of a ligand to one protomer affects the binding of a ligand to the other protomer. Here, we present and analyse linear models for one-ligand and two-ligand binding dynamics at homodimerised receptors, as an essential building block in the development of dimerised receptor theory. For systems at equilibrium, we compute analytical solutions for total bound labelled ligand and derive conditions on the cooperativity factors under which multiphasic log dose-response curves are expected. This could help explain data extracted from pharmacological experiments that do not fit to the standard Hill curves that are often used in this type of analysis. For the time-dependent problems, we also obtain analytical solutions. For the single-ligand case, the construction of the analytical solution is straightforward; it is bi-exponential in time, sharing a similar structure to the well-known monomeric competition dynamics of Motulsky-Mahan. We suggest that this model is therefore practically usable by the pharmacologist towards developing insights into the potential dynamics and consequences of dimerised receptors.

Ji, Changling

Adsorption; Bacteria, Anaerobic; Biodegradation, Environmental; Carrageenan; Charcoal; Iron; Microspheres; Oxidation-Reduction; Trichloroethanes; Water Pollutants, Chemical

Enhanced reductive dechlorination of 1,1,1-trichloroethane using zero-valent iron-biochar-carrageenan microspheres: preparation and microcosm study.

In this study, a composite remediation material for the enhanced reductive dechlorination (ERD) of 1,1,1-trichloroethane (1,1,1-TCA) in aqueous solution was prepared. This material was comprised of biochar as the carrier and adsorbent, and carrageenan (CG) as the embedding medium to entrap the organic carbon sources and zero-valent iron (ZVI). We determined the suitable biochar dosage and organic carbon source in the composite alongside the optimal preparation conditions. Furthermore, using an anaerobic microcosm study, we discussed the performance and possible mechanisms of the composite on 1,1,1-TCA removal in aqueous solution. From this, we found that the suitable dosage of biochar in water during the preparation of composite microspheres was 0.2% (w/v). Under this condition, the biochar had a strong capacity to adsorb 1,1,1-TCA with a removal efficiency of 84.2%. Soluble starch was selected as the appropriate organic carbon source, because starch-microspheres show an excellent slow-release effect in water. The optimal preparation conditions of microspheres were identified as follows: 2% CG (w/v) colloidal solution, 6% CaCl₂ (w/v) solution, and a 12-h curing time. After 25-day incubation with the composite prepared under optimized conditions, the removal efficiency of 1,1,1-TCA was 95.68%, which was 24.69% higher than that observed in the microcosm with a commercial remediation material. The scanning electron microscopy (SEM) images show that the amounts of ZVI and soluble starch inside the microsphere decreased obviously, while the biochar amount remained about the same. This indicates that 1,1,1-TCA in aqueous solution was mainly removed via soluble starch-enhanced biotic reductive dechlorination and ZVI-enhanced abiotic reductive dechlorination. The changes in microbial community structure demonstrate that the composite stimulated the activities of functional anaerobic bacteria, in particular, regarding dechlorination and fermentation abilities in the microcosm, therefore enhancing the anaerobic biodegradation of 1,1,1-TCA. This study suggests that the composite, entrapping biochar, ZVI, and organic carbon source in CG microspheres can significantly enhance the reductive dechlorination of 1,1,1-TCA in aqueous solution. We anticipate this novel remediation material could be successfully applied to the in situ ERD remediation of natural groundwater mainly contaminated with 1,1,1-TCA.

Shubert, Jennifer

Adolescent; Adult; Character; Child; Female; Human Development; Humans; Male; Personality Development; Young Adult

Examining Character Structure and Function Across Childhood and Adolescence.

Character strengths are an integral component of positive youth development that can promote flourishing. Developmental principles posit constructs become increasingly complex with age, yet this process has not been examined with character. Using a socioeconomically and ethnically diverse sample of 2,467 youth ages 9-19, bifactor models were estimated across elementary, middle, and high school-age groups to examine age differences in character structure and function. With successive age, a greater number of specific character strength factors were identified, suggesting character structure becomes more differentiated across adolescence. Results linking character bifactor models to indicators of positive functioning also supported differentiation in character function across ages. Findings point to the need for theoretical and empirical considerations of character structure and function across development.

Zargaran, Massoumeh

Cytophagocytosis; Giant Cell Tumors; Giant Cells; Granuloma, Giant Cell; Humans; Lichen Planus; Lichen Planus, Oral

Cellular cannibalism and lichen planus malignancy: A suggestive hypothesis.

Monserud, Maria A

Aged; Aged, 80 and over; Depression; Female; Hispanic or Latino; Humans; Male; Marital Status; Mexico; Psychiatric Status Rating Scales; Southwestern United States; Widowhood

Marital Status and Trajectories of Depressive Symptoms Among Older Adults of Mexican Descent.

Little is known about the implications of marital status for the age patterning of depressive symptoms in later life. Drawing on seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly, this research uses growth curve models to examine age trajectories of depressive symptoms among continuously married and recently and continuously widowed older adults of Mexican descent (aged 65 years and older; N = 1,452). The findings demonstrate that despite having a higher mean level of depressive symptoms, the recently widowed experienced a similar rate of increase in distress with age to that of their married counterparts. Compared with the married, the continuously widowed had a steeper rise in depressive symptoms with age, although they had fewer symptoms at younger ages in later life. Physical health, financial strain, social support, and church attendance might account to a certain extent for marital status differences in depressive symptoms across later life.

Herrmann, Lynn K

Awareness; Curriculum; Dementia; Female; Humans; Inservice Training; Male; Middle Aged; Social Stigma; Social Support

A new curriculum to address dementia-related stigma: Preliminary experience with Alzheimer's Association staff.

Hydén, Lars-Christer

Aged, 80 and over; Communication; Dementia; Female; Humans; Interpersonal Relations; Mental Recall

"So they are not alive?": Dementia, reality disjunctions and conversational strategies.

Bradford, Elisabeth Ef

Adult; Aptitude; China; Culture; England; Ethnicity; Ethnopsychology; Female; Humans; Individuality; Male; Social Perception; Task Performance and Analysis; Theory of Mind

Cross-cultural differences in adult Theory of Mind abilities: A comparison of native-English speakers and native-Chinese speakers on the Self/Other Differentiation task.

Theory of Mind (ToM) refers to the ability to compute and attribute mental states to ourselves and other people. It is currently unclear whether ToM abilities are universal or whether they can be culturally influenced. To address this question, this research explored potential differences in engagement of ToM processes between two different cultures, Western (individualist) and Chinese (collectivist), using a sample of healthy adults. Participants completed a computerised false-belief task, in which they attributed beliefs to either themselves or another person, in a matched design, allowing direct comparison between "Self"- and "Other"-oriented conditions. Results revealed that both native-English speakers and native-Chinese individuals responded significantly faster to self-oriented than other-oriented questions. Results also showed that when a trial required a "perspective-shift," participants from both cultures were slower to shift from Self-to-Other than from Other-to-Self. Results indicate that despite differences in collectivism scores, culture does not influence task performance, with similar results found for both Western and non-Western participants, suggesting core and potentially universal similarities in the ToM mechanism across these two cultures.

Recio, Sergio A

Animals; Attention; Behavior, Animal; Discrimination Learning; Photic Stimulation; Rats; Reinforcement, Psychology; Research Design; Visual Perception

The role of stimulus comparison in animal perceptual learning: Effects of a distractor placement.

Research on perceptual learning shows that the way stimuli are presented leads to different outcomes. The intermixed/blocked (I/B) effect is one of these outcomes, and different mechanisms have been proposed to explain it. In human research, it seems that comparison between stimuli is important, and the placement of a distractor between the pre-exposed stimuli interferes with the effect. Results from animal research are usually interpreted in different terms because the type of procedure normally used in animal perceptual learning does not favour comparison. In our experiments, we explore the possibility that a distractor placed between the to-be-discriminated stimuli may interfere with the perceptual learning process in rats. In Experiment 1, two flavoured solutions are presented in an I/B fashion, with a short time lapse between them to favour comparison, showing the typical I/B effect. In Experiment 2, we introduced a distractor in between the solutions, abolishing this effect. Experiment 3 further replicates this by comparing two intermixed groups with or without distractor. The results replicate the findings from human research, suggesting that comparison also plays an important role in animal perceptual learning.

Ogunyankin, Forest

Adult; Depressive Disorder, Major; Exercise Therapy; Feasibility Studies; Humans; Middle Aged; Psychiatric Status Rating Scales; Psychotic Disorders; Schizophrenia

Effects of exercise-based interventions in severe mental illness: a feasibility study.

Génova, Gonzalo

Humans; Peer Review; Publishing; Research Personnel

The Problem Is Not Professional Publishing, But the Publish-or-Perish Culture.

The publication of scientific papers has become increasingly problematic in the last decades. Even if we agree that a renewed model is needed for peer-reviewed scientific publication, we think the problem does not essentially lie in professional publishing-with economic incentives-but in the publish-or-perish culture that dominates the lives of researchers and academics.

Moreno, Yara M F

Child; Child, Preschool; Critical Care; Critical Illness; Dietary Proteins; Dietary Supplements; Enteral Nutrition; Feasibility Studies; Female; Humans; Infant; Length of Stay; Male

Feasibility of Enteral Protein Supplementation in Critically Ill Children.

We describe the protein type and concentration in standard enteral nutrition (EN) formulas and the effect of protein supplementation on the osmolality of standard formulas. We also aimed to examine factors associated with optimal protein delivery in critically ill children.

Iannaccone, Mario

Acute Coronary Syndrome; Biomarkers; Chest Pain; Coronary Vessels; Echocardiography, Stress; Emergency Service, Hospital; Exercise Test; Female; Glycopeptides; Humans; Male; Middle Aged; Myocardial Perfusion Imaging; Prospective Studies; Radionuclide Imaging; Sensitivity and Specificity; Tomography, X-Ray Computed; Troponin T

Diagnostic accuracy of functional, imaging and biochemical tests for patients presenting with chest pain to the emergency department: A systematic review and meta-analysis.

Non-invasive ischaemia tests and biomarkers are widely adopted to rule out acute coronary syndrome in the emergency department. Their diagnostic accuracy has yet to be precisely defined.

Chester, David S

Adolescent; Aggression; Humans; Intimate Partner Violence; Magnetic Resonance Imaging; Male; Prefrontal Cortex; Young Adult

Intimate partner violence perpetration corresponds to a dorsal-ventral gradient in medial PFC reactivity to interpersonal provocation.

Intimate partner violence (IPV) perpetration is often preceded by perceived interpersonal provocations such as slights, insults, and rejections. Yet the neural mechanisms that link provocation to IPV remain unclear. In the context of interactions with strangers, the medial prefrontal cortex (MPFC) has been repeatedly shown to respond to provocation, with more dorsal activation associated with more aggressive reactions and more ventral activation associated with less aggressive reactions. We used functional brain imaging to test whether this dorsal-ventral MPFC reactivity gradient would also correlate with greater aggression towards an unexamined target: intimate partners. To do so, 61 undergraduates (27.87% male, age range: 18-22) reported whether they had ever committed various acts of IPV perpetration (e.g., punching, hitting, shoving) and then were repeatedly provoked by a stranger while undergoing functional MRI (fMRI) scanning. Individuals with a disproportionately dorsal, rather than ventral, MPFC response were more likely to have perpetrated IPV and had perpetrated more kinds of IPV, even when controlling for gender. These findings provide further evidence that the dorsal-ventral MPFC gradient is a critical, biological indicator of whether an individual is more or less likely to react aggressively and suggest new avenues for understanding and potentially preventing IPV perpetration.

de Medeiros, Rafael Barone

Aged; Aged, 80 and over; Cohort Studies; Female; Hospital Mortality; Hospitals, General; Hospitals, University; Humans; Male; Middle Aged; Neoplasms; Palliative Care; Pilot Projects; Prospective Studies; Retrospective Studies; Survival Analysis; Terminally Ill

Serial Palliative Performance Scale Assessment in a University General Hospital: A Pilot Study.

Serial Palliative Performance Scale (PPS) assessments may predict functional decline and prognosis in cancer and noncancer patients and help with end-of-life decision making.

Herisson, Fanny

Animals; Blood Pressure; Blood-Brain Barrier; Brain; Carotid Artery, Common; Disease Models, Animal; Humans; Hypertension; Ligation; Magnetic Resonance Imaging; Male; Posterior Leukoencephalopathy Syndrome; Rats; Rats, Inbred SHR; Sodium, Dietary; Stroke; Thrombotic Microangiopathies

Posterior reversible encephalopathy syndrome in stroke-prone spontaneously hypertensive rats on high-salt diet.

Stroke-prone spontaneously hypertensive rats (SHRSP) on high-salt diet are characterized by extremely high arterial pressures, and have been endorsed as a model for hypertensive small vessel disease and vascular cognitive impairment. However, rapidly developing malignant hypertension is a well-known cause of posterior reversible encephalopathy syndrome (PRES) in humans, associated with acute neurological deficits, seizures, vasogenic cerebral edema and microhemorrhages. In this study, we aimed to examine the overlap between human PRES and SHRSP on high-salt diet. In SHRSP, arterial blood pressure progressively increased after the onset of high-salt diet and seizure-like signs emerged within three to five weeks. MRI revealed progressive T2-hyperintense lesions suggestive of vasogenic edema predominantly in the cortical watershed and white matter regions. Histopathology confirmed severe blood-brain barrier disruption, white matter vacuolization and microbleeds that were more severe posteriorly. Hematological data suggested a thrombotic microangiopathy as a potential underlying mechanism. Unilateral common carotid artery occlusion protected the ipsilateral hemisphere from neuropathological abnormalities. Notably, all MRI and histopathological abnormalities were acutely reversible upon switching to regular diet and starting antihypertensive treatment. Altogether our data suggest that SHRSP on high-salt diet recapitulates the neurological, histopathological and imaging features of human PRES rather than chronic progressive small vessel disease.

Ryu, Hyun-Seung

Aged; Humans; Magnetic Resonance Imaging; Male; Myelitis, Transverse; Orientia tsutsugamushi; Scrub Typhus; Spinal Cord Injuries

Acute transverse myelitis following scrub typhus: A case report and review of the literature.

<b>Context:</b> Scrub typhus is an acute febrile disease caused by <i>Orientia tsutsugamushi</i>. The disease can usually involve the lungs, heart, liver, spleen and brain through hematogenous dissemination. However, very rarely, acute transverse myelitis in the spinal cord develops from scrub typhus. We present a case of acute transverse myelitis following scrub typhus with a review of the literature. <b>Findings:</b> A 66-year-old male visited a hospital for general myalgia, mild headache, and fever in October. He was noted to have thick, black papule skin on his abdomen, which was highly suggestive of scrub typhus. To confirm the diagnosis, <i>O. tsutsugamushi</i> antibody titers were examined and detected highly in serum by an indirect fluorescence antibody assay. Doxycycline, the standard treatment for scrub typhus, was administered. However, after seven days of treatment, he rapidly developed weakness in the right leg, paresthesia in both lower limbs, and voiding difficulty. Spinal magnetic resonance imaging (MRI) revealed lesions with high signal intensity involving the spinal cord at the thoracolumbar junction. Paraparesis gradually improved following steroid pulse therapy for five days. At one-year follow-up, he could walk without cane. <b>Conclusions:</b><i>Orientia tsutsugamushi</i> causes scrub typhus, which can affect not only the brain, but also the spinal cord. Although acute transverse myelitis develops rarely from scrub typhus, this should be considered as differential diagnosis in patients of fever with neurological deficit in endemic areas.

Shimizu, Yukiyo

Adult; Chronic Disease; Electromyography; Exoskeleton Device; Humans; Male; Motion Therapy, Continuous Passive; Muscle, Skeletal; Paraplegia; Spinal Cord Injuries; Thoracic Vertebrae; Upper Extremity; Walking

Voluntary ambulation using voluntary upper limb muscle activity and Hybrid Assistive Limb® (HAL®) in a patient with complete paraplegia due to chronic spinal cord injury: A case report.

<b>Context:</b> We sought to describe our experience with the Hybrid Assistive Limb&#174; (HAL&#174;) for active knee extension and voluntary ambulation with remaining muscle activity in a patient with complete paraplegia after spinal cord injury. <b>Findings:</b> A 30-year-old man with complete paraplegia used the HAL&#174; for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL&#174; session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL&#174; for one month, the patient's manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees. <b>Conclusion/clinical relevance:</b> Knee extension sessions with HAL&#174;, and hip flexor and upper-limb-triggered HAL&#174; ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury.

Ikutomo, Hisashi

Accidental Falls; Aged; Case-Control Studies; Cross-Sectional Studies; Exercise; Female; Fractures, Bone; Gait; Humans; Incidence; Japan; Middle Aged; Muscle Strength; Osteoarthritis, Hip; Quadriceps Muscle; Risk Factors

Incidence and Risk Factors for Falls in Women With End-Stage Hip Osteoarthritis.

Fall-induced injuries and resulting deaths are a serious health problem among older adults. The most common risk factors for falls in older adults are muscle weakness, gait deficiencies, and balance deficits. Patients with end-stage hip osteoarthritis (OA) also have many hip dysfunctions, and these all have the potential to increase the risk of falls. However, the incidence and risk factors for falls in patients with end-stage hip OA remain unclear. The aim of this study was to determine the incidence of falls in women with end-stage hip OA and to identify risk factors for falls in this patient population.

Noah, Sean

Accidental Falls; Aged; Aged, 80 and over; Cohort Studies; Female; Gait; Geriatric Assessment; Humans; Male; Orthotic Devices; Physical Functional Performance; Postural Balance; Range of Motion, Articular; Walking Speed

Four Months of Wearing a Balance Orthotic Improves Measures of Balance and Mobility Among a Cohort of Community-Living Older Adults.

The Centers for Disease Control and Prevention estimated that there were 29 million falls and 7 million injuries in 2014 in the United States. Falls, decreased balance, and mobility disability are common in older adults and often result in loss of independence. Finding interventions to address these issues is important, as this age group is growing exponentially. Prior studies indicate balance and mobility can be improved by the balance-based torso-weighting (BBTW) assessment implemented through wear of a balance orthotic (BO). This study sought to determine the impact of wearing a BO on balance, mobility, and fall risk over time.

Addante, Raymond

Adult; Anxiety; Case-Control Studies; Depression; Female; Humans; Irritable Bowel Syndrome; Male; Middle Aged; Quality of Life; Severity of Illness Index; Stress, Psychological; Surveys and Questionnaires; Young Adult

Predictors of Health-related Quality of Life in Irritable Bowel Syndrome Patients Compared With Healthy Individuals.

Irritable bowel syndrome (IBS) reduces health-related quality of life (HRQOL). It is unclear how having IBS modifies the impact of gastrointestinal (GI), psychosocial, and somatic symptom variables on HRQOL compared with healthy controls (HCs).

Cholankeril, George

Age Factors; Aged; Case-Control Studies; Female; Gastrointestinal Hemorrhage; Hospitalization; Humans; Incidence; Inpatients; Length of Stay; Male; Middle Aged; Percutaneous Coronary Intervention; Retrospective Studies; Risk Factors

Inpatient Outcomes for Gastrointestinal Bleeding Associated With Percutaneous Coronary Intervention.

The goal of this study was to evaluate the impact of inpatient outcomes of gastrointestinal bleeding (GIB) related to percutaneous coronary intervention (PCI).

Solomon, Sanjeev S

Aged; Aged, 80 and over; Barrett Esophagus; Cryotherapy; Deglutition Disorders; Female; Humans; Male; Middle Aged; Nitrogen; Pain; Prospective Studies; Radiofrequency Ablation

Liquid Nitrogen Spray Cryotherapy is Associated With Less Postprocedural Pain Than Radiofrequency Ablation in Barrett's Esophagus: A Multicenter Prospective Study.

Two common endoscopic therapies for eradication of dysplastic Barrett's esophagus are radiofrequency ablation (RFA) and liquid nitrogen spray cryotherapy (LNC). There is no data comparing postprocedural pain. This study aimed to compare the incidence of postprocedural pain between the 2 ablation modalities.

Kim, Nam Hee

Adult; Cigarette Smoking; Cohort Studies; Colonoscopy; Colorectal Neoplasms; Cotinine; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Risk Factors; Self Report; Surveys and Questionnaires

Association Between Cotinine-verified Smoking Status and Risk of Colorectal Neoplasia.

We evaluated the association of urinary cotinine-verified smoking status with the risk of colorectal neoplasia (CRN).

Lopes, Thiago J A

Brazil; Female; Humans; Lower Extremity; Male; Muscle Strength; Physical Endurance; Physical Functional Performance; Torso

Physical Performance Measures of Flexibility, Hip Strength, Lower Limb Power, and Trunk Endurance in Healthy Navy Cadets: Normative Data and Differences Between Sex and Limb Dominance.

Lopes, TJA, Simic, M, Alves, DdS, Bunn, PdS, Rodrigues, AI, Terra, BdS, Lima, MdS, Ribeiro, FM, Vilão, P, and Pappas, E. Physical performance measures of flexibility, hip strength, lower limb power, and trunk endurance in healthy navy cadets: Normative data and differences between sex and limb dominance. J Strength Cond Res 35(2): 458-464, 2021-The objectives were to provide normative data on commonly used physical performance tests that may be associated with musculoskeletal injuries in Navy cadets and assess for sex and limb dominance differences. A large cohort of Navy cadets were assessed for physical performance tests of flexibility (ankle dorsiflexion range of motion and sit and reach), isometric hip strength, lower limb power (single-leg hop), and trunk endurance (plank and side plank tests). Besides providing normative data tables, sex and limb dominance differences were assessed by a 2-way mixed analysis of variance. A total of 545 Brazilian Navy cadets (394 men) representing 79% of the cadets in the Academy participated. Normative reference values were reported as mean ± SD, 95% confidence interval and percentiles. For tests of muscle strength, power, and endurance, men performed better than women (p < 0.001). For flexibility tests, women achieved greater distances than men for the sit and reach test (p < 0.001), but no difference for ankle dorsiflexion (p = 0.51). Overall, there were no clinically relevant differences between limbs. In conclusion, normative data for commonly used physical performance tests were provided. Although no clinically relevant side-to-side differences were found, men presented higher values for lower limb strength and power, as well as trunk endurance than women, whereas women demonstrated increased flexibility. Valuable normative data are provided to professionals who work with young, active populations from the injury prevention or rehabilitation perspective because the current study may help professionals to identify athletes or cadets whose performance is outside the normative values and may be at risk for injury.

Pérez-Castilla, Alejandro

Adolescent; Adult; Biomechanical Phenomena; Cross-Over Studies; Humans; Male; Muscle Strength; Muscle, Skeletal; Resistance Training; Time Factors; Young Adult

Comparison of the Force-, Velocity-, and Power-Time Curves Between the Concentric-Only and Eccentric-Concentric Bench Press Exercises.

Pérez-Castilla, A, Comfort, P, McMahon, JJ, Pestaña-Melero, FL, and García-Ramos, A. Comparison of the force-, velocity-, and power-time curves between the concentric-only and eccentric-concentric bench press exercises. J Strength Cond Res 34(6): 1618-1624, 2020-The aim of this study was to compare the temporal and mechanical variables between the concentric-only and eccentric-concentric bench press (BP) variants. Twenty-one men (age: 22.0 ± 4.2 years, body mass: 73.4 ± 7.7 kg, height: 177.2 ± 8.0 cm; 1 repetition maximum [1RM]: 1.12 ± 0.12 kg·kg) were evaluated during the concentric-only and eccentric-concentric BP variants using 80% 1RM. Temporal (concentric phase duration, propulsive phase duration, and time to reach the maximum values of force, velocity, and power) and mechanical variables (force, velocity, and power), determined using a linear velocity transducer, were compared between both BP variants. All temporal variables were significantly lower during the eccentric-concentric BP compared with the concentric-only BP (p ≤ 0.05; effect size [ES] range: 0.80-2.52). Maximum force as well as the mean values of velocity and power were significantly higher for the eccentric-concentric BP compared with the concentric-only BP (all p < 0.001; ES range: 2.87-3.58). However, trivial to small differences between both BP variants were observed for mean force (ES: 0.00-0.36) as well as for maximum velocity (ES: 0.40) and power (ES: 0.41). The stretch-shortening cycle (i.e., eccentric-concentric BP) mainly enhanced force production at the early portion of the concentric phase, but this potentiation effect gradually reduced over the latter part of the movement. Finally, force was higher for the concentric-only BP during 49% of the concentric phase duration. These results suggest that both BP variants should be included during resistance training programs to optimize force output at different points of the concentric phase.

Jeckell, Aaron S

Adolescent; Athletes; Athletic Injuries; Brain Concussion; Female; Humans; Logistic Models; Male; Neuropsychological Tests; Pilot Projects; Post-Concussion Syndrome; Risk Factors

Team versus individual sport participation as a modifying factor in the development of post-concussion syndrome after first concussion: A pilot study.

Identification of modifying factors that influence the development of post-concussion syndrome (PCS) following sport-related concussion (SRC) has drawn considerable interest. In this pilot study, we investigate the effect of team vs. individual sport participation on the development of PCS in a sample of 136 high school and college student-athletes. Controlling for several confounding variables, we employed a binary logistic regression and chi-squared test. Results of this pilot study indicate that participation in team versus individual sport is not a significant factor in the development of PCS. The identification of other forms of protective mechanisms is discussed.

Price, Julia

Adolescent; Adolescent Behavior; Adult; Child; Female; Humans; Male; Peer Group; Problem Behavior; Substance-Related Disorders; Young Adult

Association With Deviant Peers Across Adolescence: Subtypes, Developmental Patterns, and Long-Term Outcomes.

Indices of deviant peer group involvement are inconsistent and confound type, frequency, and severity of deviant peer behaviors. These measurement approaches thus obfuscate potential meaningful differences in deviant peer involvement in terms of subtypes, developmental patterns, and long-term outcomes. The current study employed latent class analysis to derive subtypes of deviant peer involvement and examined relations to substance use disorder in adulthood, a common outcome of deviant peer involvement. Youth (76% Caucasian) completed assessments across four time points: ages 10-12 years (Time 1; N = 775, 71% male), 12-14 years (Time 2; n = 649, 72% male), 16 years (Time 3; n = 613, 73% male), and 22 years (Time 4; n = 425, 71% male). At Times 1 to 3, participants completed an interview assessing deviant peer involvement. At Time 4, participants completed a structured interview assessing substance use disorder. Classes of youth with different profiles of deviant peer associations were derived at Times 1, 2, and 3. Classes varied by type (conduct problems vs. substance use) and severity of deviant peer behavior. Youth reported higher levels of involvement with deviant peers across adolescence, suggesting that some of these deviant peer behaviors may be normative. Earlier involvement with deviant peers and involvement with groups defined by severe conduct problems and substance use were related to the greatest risk for substance use disorder at Time 4. Type and severity of peer deviant behavior differentially relate to long-term risk for substance use disorder and should be included in screening and assessment for risk across adolescence.

Duan, An Qi

Animals; Blood Flow Velocity; Feasibility Studies; Female; Fetus; Gestational Age; Hemodynamics; Magnetic Resonance Imaging, Cine; Observer Variation; Pregnancy; Prenatal Diagnosis; Reproducibility of Results; Sheep

Feasibility of phase-contrast cine magnetic resonance imaging for measuring blood flow in the sheep fetus.

xmlns:ns0="http://www.w3.org/1998/Math/MathML">Phase-contrast cine MRI (PC-MRI) is the gold-standard noninvasive technique for measuring vessel blood flow and has previously been applied in the human fetal circulation. We aimed to assess the feasibility of using PC-MRI to define the distribution of the fetal circulation in sheep. Fetuses were catheterized at 119-120 days of gestation (term, 150 days) and underwent MRI at &#8764;123 days of gestation under isoflurane anesthesia, ventilated at a <ns0:math><ns0:mrow><ns0:msub><ns0:mrow><ns0:mtext>FI</ns0:mtext></ns0:mrow><ns0:mrow><ns0:msub><ns0:mtext>O</ns0:mtext><ns0:mtext>2</ns0:mtext></ns0:msub></ns0:mrow></ns0:msub></ns0:mrow></ns0:math> of 1.0. PC-MRI was performed using a fetal arterial blood pressure catheter signal for cardiac triggering. Blood flows were measured in the major fetal vessels, including the main pulmonary artery, ascending and descending aorta, superior vena cava, ductus arteriosus, left and right pulmonary arteries, umbilical vein, ductus venosus, and common carotid artery and were indexed to estimated fetal weight. The combined ventricular output, pulmonary blood flow, and flow across the foramen ovale were calculated from vessel flows. Intraobserver and interobserver agreement and reproducibility was assessed. Blood flow measurements were successfully obtained in 61 out of 74 vessels (82.4%) interrogated in 9 fetuses. There was good intraobserver [<i>R</i>&#8201;=&#8201;0.998, <i>P</i> &lt; 0.0001; intraclass correlation (ICC)&#8201;=&#8201;0.997] and interobserver agreement (<i>R</i>&#8201;=&#8201;0.996, <i>P</i> &lt; 0.0001; ICC&#8201;=&#8201;0.996). Repeated MRI measurements showed good reproducibility (<i>R</i>&#8201;=&#8201;0.989, <i>P</i> = 0.0002; ICC&#8201;=&#8201;0.990). We conclude that PC-MRI using fetal catheters for gating triggers is feasible in the major vessels of late gestation fetal sheep. This approach may provide a useful new tool for assessing the circulatory characteristics of fetal sheep models of human disease, including fetal growth restriction and congenital heart disease.

Olry, Régis

Cerebral Arteries; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Moyamoya Disease; Neurology; Terminology as Topic

Moyamoya (もやもや): When cerebral arteries go up in smoke.

Pazos, Florencio

Computational Biology; Internet; Molecular Biology; Periodicals as Topic; Software

Characteristics and evolution of the ecosystem of software tools supporting research in molecular biology.

Daily work in molecular biology presently depends on a large number of computational tools. An in-depth, large-scale study of that 'ecosystem' of Web tools, its characteristics, interconnectivity, patterns of usage/citation, temporal evolution and rate of decay is crucial for understanding the forces that shape it and for informing initiatives aimed at its funding, long-term maintenance and improvement. In particular, the long-term maintenance of these tools is compromised because of their specific development model. Hundreds of published studies become irreproducible de facto, as the software tools used to conduct them become unavailable. In this study, we present a large-scale survey of >5400 publications describing Web servers within the two main bibliographic resources for disseminating new software developments in molecular biology. For all these servers, we studied their citation patterns, the subjects they address, their citation networks and the temporal evolution of these factors. We also analysed how these factors affect the availability of these servers (whether they are alive). Our results show that this ecosystem of tools is highly interconnected and adapts to the 'trendy' subjects in every moment. The servers present characteristic temporal patterns of citation/usage, and there is a worrying rate of server 'death', which is influenced by factors such as the server popularity and the institutions that hosts it. These results can inform initiatives aimed at the long-term maintenance of these resources.

Xu, Ting

Adult; Blood Donors; China; Female; Hepatitis B; Hepatitis C; Humans; Logistic Models; Male; Middle Aged; Prevalence; Retrospective Studies; Risk Factors; Syphilis; Transfusion Reaction; Young Adult

Prevalence and trends of transfusion-transmittable infections among blood donors in Southwest China.

The high prevalence of transfusion-transmitted infections (TTIs) is causing serious harm to human health worldwide. The aim of this research was to assess the prevalence and influencing factors of TTIs in Southwest China.

Japuntich, Sandra J

Adult; Aged; Cohort Studies; Colorectal Neoplasms; Female; Follow-Up Studies; Humans; Lung Neoplasms; Male; Middle Aged; Non-Smokers; Prospective Studies; Smokers; Smoking Cessation; Survival Rate; Tobacco Smoking

Smoking Status and Survival Among a National Cohort of Lung and Colorectal Cancer Patients.

The purpose of this study was to explore the association of smoking status and clinically relevant duration of smoking cessation with long-term survival after lung cancer (LC) or colorectal cancer (CRC) diagnosis. We compared survival of patients with LC and CRC who were never-smokers, long-term, medium-term, and short-term quitters, and current smokers around diagnosis.

Mansfield, Abigail K

Adolescent; Adult; Child; Emotional Adjustment; Family; Female; Humans; Interviews as Topic; Male; Middle Aged; Principal Component Analysis; Reproducibility of Results; Stress, Psychological; Surveys and Questionnaires; Young Adult

The Brief Assessment of Family Functioning Scale (BAFFS): a three-item version of the General Functioning Scale of the Family Assessment Device.

The purpose of the present study is to compare results from the 12-item General Functioning Scale (GF-FAD) of the Family Assessment Device (FAD) to a three-item version, the Brief Assessment of Family Functioning Scale (BAFFS), designed to be used when brevity is especially important. We used principal components analysis of the GF-FAD, followed by multiple sample confirmatory factor analyses to test the robustness of the BAFFS in different samples. The BAFFS correlated highly with the GF-FAD, and demonstrated good concurrent validity with another measure of global marital functioning, the Dyadic Adjustment Scale-4 in a help-seeking sample. Like the 12-item version, the BAFFS moderately correlated with an objective, interview-based rating of family functioning, the McMaster Clinical Rating Scale. The BAFFS appears to serve as a good proxy for the GF-FAD when an ultra-brief family assessment measure is needed.

Larkin, Andrew

Conservation of Natural Resources; Environment Design; Female; Humans; Male; Residence Characteristics; Satellite Imagery

Evaluating street view exposure measures of visible green space for health research.

Urban green space, or natural environments, are associated with multiple physical and mental health outcomes. Several proposed pathways of action for these benefits (e.g., stress reduction and attention restoration) require visual perception of green space; however, existing green space exposure measures commonly used in epidemiological studies do not capture street-scale exposures. We downloaded 254 Google Street View (GSV) panorama images from Portland, Oregon and calculated percent of green in each image, called Green View Index (GVI). For these locations we also calculated satellite-based normalized difference vegetation index (NDVI), % tree cover, % green space, % street tree buffering, distance to parks, and several neighborhood socio-economic variables. Correlations between the GVI and other green space measures were low (-0.02 to 0.50), suggesting GSV-based measures captured unique information about green space exposures. We further developed a GVI:NDVI ratio, which was associated with the amount of vertical green space in an image. The GVI and GVI:NDVI ratio were weakly related to neighborhood socioeconomic status and are therefore less susceptible to confounding in health studies compared to other green space measures. GSV measures captured unique characteristics of the green space environment and offer a new approach to examine green space and health associations in epidemiological research.

Khaing, Thet

Aged; Cardiomyopathy, Dilated; Coronary Artery Disease; Coronary Circulation; Female; Heart; Humans; Male; Microcirculation; Middle Aged; Myocardial Ischemia; Myocardial Perfusion Imaging; Myocardium; Percutaneous Coronary Intervention; Prognosis; Tomography, Emission-Computed, Single-Photon

Quantification of myocardial blood flow and myocardial flow reserve with SPECT imaging technique.

Gewirtz, Abigail H

Adult; Child; Child Behavior Disorders; Choice Behavior; Decision Making, Shared; Female; Humans; Male; Parents; Precision Medicine; Treatment Outcome

Does Giving Parents Their Choice of Interventions for Child Behavior Problems Improve Child Outcomes?

Empowering consumers to be active decision-makers in their own care is a core tenet of personalized, or precision medicine. Nonetheless, there is a dearth of research on intervention preferences in families seeking interventions for a child with behavior problems. Specifically, the evidence is inconclusive as to whether providing parents with choice of intervention improves child/youth outcomes (i.e., reduces externalizing problems). In this study, 129 families presenting to community mental health clinics for child conduct problems were enrolled in a doubly randomized preference study and initially randomized to choice or no-choice conditions. Families assigned to the choice condition were offered their choice of intervention from among three different formats of the Parent Management Training-Oregon Model/PMTO (group, individual clinic, home based) and services-as-usual (child-focused therapy). Those assigned to the no-choice condition were again randomized, to one of the four intervention conditions. Intent-to-treat analyses revealed partial support for the effect of parental choice on child intervention outcomes. Assignment to the choice condition predicted teacher-reported improved child hyperactivity/inattention outcomes at 6 months post-treatment completion. No main effect of choice on parent reported child outcomes was found. Moderation analyses indicated that among parents who selected PMTO, teacher report of hyperactivity/inattention was significantly improved compared with parents selecting SAU, and compared with those assigned to PMTO within the no-choice condition. Contrary to hypotheses, teacher report of hyperactivity/inattention was also significantly improved for families assigned to SAU within the no-choice condition, indicating that within the no-choice condition, SAU outperformed the parenting interventions. Implications for prevention research are discussed.

Aoki, Takuya

Adult; Aged; Aged, 80 and over; Bayes Theorem; Case-Control Studies; Female; Hospitalization; Humans; Japan; Longitudinal Studies; Male; Middle Aged; Patient Acceptance of Health Care; Patient Preference; Primary Health Care; Prospective Studies; Referral and Consultation; Young Adult

Effect of Patient Experience on Bypassing a Primary Care Gatekeeper: a Multicenter Prospective Cohort Study in Japan.

To discuss how best to implement the gatekeeping functionality of primary care; identifying the factors that cause patients to bypass their primary care gatekeepers when seeking care should be beneficial.

Darragh, Patrick J

Diagnostic Tests, Routine; Humans; Observational Studies as Topic; Patient Discharge; Patient Discharge Summaries; Randomized Controlled Trials as Topic

A Systematic Review of Interventions to Follow-Up Test Results Pending at Discharge.

Patients are frequently discharged from the hospital before all test results have been finalized. Thirty to 40% of tests pending at discharge (TPADs) return potentially actionable results that could necessitate change in the patients' management, often unbeknownst to their physicians. Delayed follow-up of TPADs can lead to patient harm. We sought to synthesize the existing literature on interventions intended to improve the management of TPADs, including interventions designed to enhance documentation of TPADs, increase physician awareness when TPAD results finalize post-discharge, decrease adverse events related to missed TPADs, and increase physician satisfaction with TPAD management.

Hosangadi, Divya

Bacterial Vaccines; Biomedical Research; Clinical Trials as Topic; Congresses as Topic; Diarrhea; Drug Evaluation, Preclinical; Dysentery; Dysentery, Bacillary; Enterotoxigenic Escherichia coli; Escherichia coli Infections; Humans; Research Report; Shigella; World Health Organization

WHO consultation on ETEC and Shigella burden of disease, Geneva, 6-7th April 2017: Meeting report.

According to the 2015 Global Burden of Disease Study, diarrhea ranked ninth among causes of death for all ages, and fourth among children under 5 years old, accounting for an estimated 499,000 deaths in this young age group. It was also the second most common cause of years lived with disability (2.39 billion YLDs). The goal of the WHO/UNICEF Integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) is to reduce deaths from diarrhea in children under 5 years of age to less than 1 per 1000 live births, by 2025. Development of new and improved vaccines against diarrheal infections is a fundamental element of the strategy towards achieving this goal. Enterotoxigenic Escherichia coli (ETEC) and Shigella are enteropathogens that cause significant global mortality and morbidity, particularly in low- and middle-income countries. In 2016, WHO's Product Development for Vaccines Advisory Committee (PDVAC) recommended that the WHO's Initiative for Vaccine Research (IVR) engage in this area, based on PDVAC's criteria of prioritizing the development of vaccines against pathogens that will address a major unmet public health need, and for which clinical candidates with a good probability of technical success are in the pipeline. As a first step, WHO's IVR convened global subject matter experts to discuss the current global ETEC and Shigella disease burden estimates, including the current understanding of the long-term indirect effects of ETEC and Shigella infection, and how these data may affect future decision making on vaccine development for both pathogens. The available global burden estimates for ETEC and Shigella differ with respect to the relative importance of these two pathogens. The mortality estimates vary between iterations published by the same group, as well as between estimates of different groups, although the uncertainty intervals are broad and overlapping. These variances are attributable to differences in the data available and incorporated in the models; the methods used to detect the pathogens; the modelling methodologies; and, to actual changes in the total number of diarrheal deaths over time. The changes in the most recently reported mortality estimates for these pathogens, as compared to previous iterations, has led to debate as to whether investment in development of stand-alone vaccines, rather than combined vaccines, is warranted from cost-effectiveness and vaccine impact perspectives. Further work will be needed to understand better the variances and uncertainties in the reported mortality estimates to support investment decision making, and ultimately policy recommendations for vaccine use. In addition, a comprehensive assessment of the value proposition for vaccines against these pathogens is needed and will be strengthened if the long-term health consequences associated with diarrhea and dysentery due to these pathogens are better defined.

Burrowes, Kelly S

Collagen; Computer Simulation; Disease Progression; Elastin; Extracellular Matrix; Humans; Lung; Mechanotransduction, Cellular; Models, Biological; Proteoglycans; Pulmonary Alveoli; Pulmonary Fibrosis

Integrated lung tissue mechanics one piece at a time: Computational modeling across the scales of biology.

The lung is a delicately balanced and highly integrated mechanical system. Lung tissue is continuously exposed to the environment via the air we breathe, making it susceptible to damage. As a consequence, respiratory diseases present a huge burden on society and their prevalence continues to rise. Emergent function is produced not only by the sum of the function of its individual components but also by the complex feedback and interactions occurring across the biological scales - from genes to proteins, cells, tissue and whole organ - and back again. Computational modeling provides the necessary framework for pulling apart and putting back together the pieces of the body and organ systems so that we can fully understand how they function in both health and disease. In this review, we discuss models of lung tissue mechanics spanning from the protein level (the extracellular matrix) through to the level of cells, tissue and whole organ, many of which have been developed in isolation. This is a vital step in the process but to understand the emergent behavior of the lung, we must work towards integrating these component parts and accounting for feedback across the scales, such as mechanotransduction. These interactions will be key to unlocking the mechanisms occurring in disease and in seeking new pharmacological targets and improving personalized healthcare.