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Purpose: To evaluate the relationship between nerve root retraction time, post-operative radiculitis and patient reported outcomes. Methods: Patients who underwent single- or multi-level lumbar discectomy between 2020 and 2022 for lumbar disk herniations were prospectively followed with pre-operative, interoperative and post-operative variables including radiculitis and patient reported outcomes including VAS, ODI and CAT domains Pain interference, Pain intensity and Physical function. Intraoperative nerve root retraction time was recorded. Paired sample two-tailed t-test and multivariate regression were utilized with p < 0.05 being significant. Results: A total of 157 patients who underwent single- or multi-level endoscopic lumbar discectomy. Average patient age was 44 years, and 64% were male patients. Nerve retraction time ranged from 4 to 15 min. Eighteen percent reported new radiculitis at 2-weeks post-operatively. In patients with new-onset radiculitis 79.2% reported significantly worse VAS leg at 2 weeks post-operative (4.2 vs. 8.3, p < 0.001) compared to 12.5% who had improved VAS leg (9.3 vs. 7, p = 0.1181). Patients with radiculitis and worse VAS scores had substantially longer nerve retraction time (13.8 ± 7.5 min) than patients with improved VAS leg (6.7 ± 1.2 min). At 6 months, patients with longer nerve retraction time had no significant improvement in the ODI or CAT compared to the baseline. Conclusions: This is the first study in discectomy literature to show that new onset radiculitis and poorer outcomes in VAS leg correlate with longer nerve retraction time at early and later time points. [ABSTRACT FROM AUTHOR]

Confrontations between police officers and civilians are sometimes videoed and made available to the public. In two experiments, we examined emotional regulation of such videos. Participants viewed a video of a confrontation between a police officer and a civilian and were asked if the officer used excessive force. In experiment 1, we investigated whether the information provided to participants prior to watching a police officer-civilian confrontation video (pre-video information: yes, no) might create a context that would allow them to regulate their emotional responses to the video. Additionally, we examined how that context might affect their judgments of excessive force used by the officer in the video. Results of experiment 1 showed that pre-video warnings influenced excessive force judgments. Results also showed that excessive force judgments were related to the amount of time it took participants to make the excessive force judgments: participants took less time to make a "yes" than a "no" excessive force judgment. In experiment 2, we investigated both the influence of pre-video information and appraisal time on excessive force judgments: participants in different groups were required to withhold their excessive force judgments for different periods of time (appraisal times 0 s, 3 s, 8 s, 13 s). Results of experiment 2 revealed an interaction between pre-video information and appraisal time on excessive force judgments. Excessive force judgments decreased with appraisal time but only when participants were given pre-video information. We think our results have implications for how people may process police officer-civilian confrontation videos when viewing them on the news. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to compare the prevalence of three positive mental health (PMH) outcomes (self-rated mental health, life satisfaction, sense of community belonging) in postpartum women to the general population, and to examine the relationship between protective factors and the three PMH outcomes among postpartum women. Methods: The national cross-sectional Survey on Maternal Health (n = 6558) was analyzed. Analyses were weighted and 95% confidence intervals were calculated. Three adjusted logistic regression models were generated. To compare this sample to the general population of women, estimates from the Canadian Community Health Survey—Annual Component (2018) were used. Results: Compared to the general population of women, a larger proportion of postpartum women reported a strong sense of community belonging. The odds of postpartum women with high self-rated physical health having high self-rated mental health were approximately seven times greater (aOR 6.9, 95% confidence interval [CI] 5.9, 8.1) than postpartum women with lower self-rated physical health. The absence of symptoms of postpartum depression (PPD) or generalized anxiety disorder (GAD) and high self-rated physical health were significantly associated with all three PMH outcomes. Frequent availability of maternal support was associated with greater odds of high life satisfaction (aOR 1.6, 95% CI 1.4, 1.9) and sense of community belonging (aOR 1.4, 95% CI 1.2, 1.6). Conclusions: Our study demonstrated that availability of maternal support, self-rated physical health and absence of symptoms of PPD or GAD were associated with PMH among postpartum women. As physical health had the strongest association with mental health, we encourage further examination of this relationship. [ABSTRACT FROM AUTHOR]

Political polarization at the elite level is a major concern in many contemporary democracies, which is argued to alienate large swaths of the electorate and prevent meaningful social change from occurring, yet little is known about how individuals respond to political candidates who deviate from the party line and express policy positions incongruent with their party affiliations. This experiment examines the neural underpinnings of such evaluations using functional MRI (fMRI). During fMRI, participants completed an experimental task where they evaluated policy positions attributed to hypothetical political candidates. Each block of trials focused on one candidate (Democrat or Republican), but all participants saw two candidates from each party in a randomized order. On each trial, participants received information about whether the candidate supported or opposed a specific policy issue. These issue positions varied in terms of congruence between issue position and candidate party affiliation. We modeled neural activity as a function of incongruence and whether participants were viewing ingroup or outgroup party candidates. Results suggest that neural activity in brain regions previously implicated in both evaluative processing and work on ideological differences (insula and anterior cingulate cortex) differed as a function of the interaction between incongruence, candidate type (ingroup versus outgroup), and political ideology. More liberal participants showed greater activation to incongruent versus congruent trials in insula and ACC, primarily when viewing ingroup candidates. Implications for the study of democratic representation and linkages between citizens' calls for social change and policy implementation are discussed. [ABSTRACT FROM AUTHOR]

In the present studies, participants viewed a brief staged video of a physical confrontation between a police officer and a civilian. Participants were then asked if the police officer had used excessive force. When people view videos of police officer-civilian confrontations, their judgements concerning the use of excessive force by officers are likely constrained by various framing factors. Our studies were designed to investigate the effects of two different contextual frames on participants' judgements of police officer use of excessive force. 1) We investigated how informational frames accompanying a confrontation video, might frame judgments about use of excessive force, and 2) we investigated how demographic frames, or demographic characteristics, might frame judgments of excessive force. In Study 1, an informational frame warned participants that the confrontation video captured a very brief segment of an event that transpired over a longer period of time. In Study 2, the video was accompanied with an informational frame in which a rationale for the activity of the police officer was explained. Police officer gender was experimentally manipulated in both studies: participants saw a video of either a female or a male police officer affecting an arrest. Participant demographic information was also collected. Logistic regression analysis showed that judgments of excessive force were related to participant demographic characteristics but not to police officer gender. The informational frames appeared to have no effect on excessive force judgments. The results have implications for future research regarding the types of factors that frame people's judgments of the use of force by police officers when watching police officer-civilian confrontation videos. The results also have implications for efforts to provide a context for these types of videos when they appear in television news programs. [ABSTRACT FROM AUTHOR]

An 86-year-old woman was hospitalized for breathlessness and a large right-sided pleural effusion. Approximately 1 h after thoracentesis, she developed a hemothorax resulting in hypotension and death. Routine postmortem CT scanning showed a large volume right hemothorax and a markedly enlarged liver. In an attempt to determine the origin of bleeding prior to autopsy, a postmortem CT angiogram was performed. Following inadvertent cannulation of the left long saphenous vein and infusion of ∼1,700 mL of a polyethylene glycol 200 and iodine-based radiographic contrast solution into systemic veins using a mechanical pump, CT scanning revealed a dense hepatic "parenchogram" containing multiple large, filling defects indicative of metastases. These were confirmed at autopsy. Microscopic evaluation of the liver using hematoxylin and eosin staining showed marked histological artifact characterized by centrilobular sinusoidal expansion although histology of the adenocarcinoma metastases was typical and apparently unaffected by the contrast solution. Postmortem CT angiography using an aqueous radiographic contrast agent in the so-called venous phase seems to be useful for the identification of hepatic parenchymal metastatic disease although it does cause histological artifact. [ABSTRACT FROM AUTHOR]

Autolytic rupture of the stomach, so called gastromalacia, is a well recognized artifact at autopsy. A 50 year old Asian woman with a past history of alcoholism, head injury and posttraumatic epilepsy was found deceased at home following a 12 h period of feeling unwell, seizures and vomiting. Postmortem CT images of the abdomen showed free gas in the peritoneal cavity adjacent to the stomach and no other abnormality. There were no external or radiological features of putrefaction. Appearances were stated by a radiologist to be strongly suggestive of gastro-intestinal tract perforation. Autopsy revealed typical findings of autolytic gastric rupture without features of peritonitis. Cause of death was determined by the pathologist to be 'complication of status epilepticus (posttraumatic)'. This case demonstrates that gastromalacia may occur rapidly after death and can be detected on postmortem CT, even in the absence of external putrefactive features or CT findings of putrefaction such as gas within the anterior abdominal wall, cardiac chambers or hepatic vasculature. The radiologist with forensic interest must be aware of this postmortem CT artifact in order to avoid ascribing the presence of free intra-peritoneal gas to antemortem perforation of the bowel. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the impact of the COVID-19 pandemic on non-invasive positive airway pressure (PAP) usage among children with sleep-disordered breathing (SDB). Methods: PAP usage data in children with SDB aged 1 to 18 years old at The Hospital for Sick Children, Canada, were analyzed. The PAP usage data were recorded for 3 months prior to and 3 months following the COVID-19 lockdown in Ontario, Canada. The primary outcomes of interest were (i) percentage of days that PAP was used for ≥ 4 h and (ii) average daily usage of PAP based on days when PAP was used. Results: A total of 151 children were included. The mean (± SD) age and BMI were 12.6 ± 4.1 years and 28.7 ± 12.4 kg/m2, respectively. The median (IQR) percentage of days of PAP usage for ≥ 4 h and average nightly PAP usage was significantly higher during compared with prior to the pandemic (76.7 [19.0–94.0] vs 62.0 [15.5–89.0]%, p = 0.02, and 406.0 [244.0–525.0] vs 367.0 [218.0–496.0] min, p = 0.006, respectively). Within this cohort, 95/151 (63%) children with SDB showed increased PAP usage and 56/151 (37%) either decreased the amount of time they used PAP or stopped PAP use altogether. Conclusions: COVID-19 pandemic has provided opportunities for increased PAP usage in a significant number of children with SDB. A subset of children with prior evidence for suboptimal PAP usage showed further decreases in PAP usage during the pandemic. This information is critical for clinicians to provide anticipatory guidance to encourage PAP usage both during the pandemic and beyond. [ABSTRACT FROM AUTHOR]

The feasibility of implicitly assessing medical student burnout was explored, using the Implicit Relational Assessment Procedure (IRAP), to measure longitudinal student burnout over the first two years of medical school and directly comparing it with an existing explicit measure of burnout (Maslach Burnout Inventory; MBI). Three successive cohorts of medical students completed both implicit and explicit measures of burnout at several time points during their first two years of medical school. Both assessments were conducted via the internet within a one-week period during the first week of medical school, the end of the first year of medical school, and the end of the second year, though not all cohorts were able to complete the assessments at all time points. Mixed linear models were used to compare the two measures directly, as well as to evaluate changes over time in each measure separately. Minimal correspondence was observed between the implicit and explicit measures of burnout on a within-subject basis. However, when analyzed separately, all subscales of both measures detected significant change over time in the direction of greater levels of burnout, particularly during the first year of medical school. These results provide preliminary evidence the IRAP is able to assess implicit attitudes related to burnout among medical students, though additional research is needed. The IRAP detected consistent improvements in positive implicit attitudes toward medical training during students' second year of medical school, which was not detected by the MBI. Possible implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to determine whether patient age and procedure type are associated with duration of opioid use in pediatric patients undergoing ambulatory urologic procedures. Methods: We retrospectively reviewed pediatric patients who underwent outpatient urologic procedures from 2013 to 2017. At postoperative visits, parents reported the number of days their child took opioid pain medication. Factors associated with duration of opioid use were evaluated using negative binomial regression models. Results: 805 patients were included: 320 infants (39.8%), 430 children (53.4%), and 55 adolescents (6.8%). Overall mean length of opioid use was 1.7 (± 2.6) days. On average, infants used opioids for the shortest duration: 1.5 (± 2.3) days, followed by children: 1.7 (± 2.5) days, and adolescents: 3.1 (± 4.6) days. In adjusted models, adolescents used opioids for 85.2% longer (95% CI 13.1–161.8%; p < 0.001) than children and infants used opioids for 19.4% shorter duration (95% CI 0.4–34.7%; p = 0.05) than children. Each 1-year increase in age was associated with 6.1% increased duration of opioid use (95% CI 3.9–8.5%; p < 0.0001). Patients who underwent circumcision, hypospadias repair, and penile reconstruction took opioids for 75.9% (95% CI 42.6–117.1%; p < 0.001), 144.2% (95% CI 76.4–238.0%; p < 0.001), and 126.7% (95% CI 48.8–245.3%; p < 0.001) longer respectively than patients who underwent inguinal procedures. Conclusions: Increasing age, circumcision, hypospadias repair, and penile reconstruction are associated with increased duration of opioid use. [ABSTRACT FROM AUTHOR]

Background: Available retrospective data suggest the upgrade rate for intraductal papilloma (IP) without atypia on core biopsy (CB) ranges from 0 to 12%, leading to variation in recommendations. We conducted a prospective multi-institutional trial (TBCRC 034) to determine the upgrade rate to invasive cancer (IC) or ductal carcinoma in situ (DCIS) at excision for asymptomatic IP without atypia on CB. Methods: Prospectively identified patients with a CB diagnosis of IP who had consented to excision were included. Discordant cases, including BI-RADS > 4, and those with additional lesions requiring excision were excluded. The primary endpoint was upgrade to IC or DCIS by local pathology review with a predefined rule that an upgrade rate of ≤ 3% would not warrant routine excision. Sample size and confidence intervals were based on exact binomial calculations. Secondary endpoints included diagnostic concordance for IP between local and central pathology review and upgrade rates by central pathology review. Results: The trial included116 patients (median age 56 years, range 24–82) and the most common imaging abnormality was a mass (n = 91, 78%). Per local review, 2 (1.7%) cases were upgraded to DCIS. In both of these cases central pathology review did not confirm DCIS on excision. Additionally, central pathology review confirmed IP without atypia in core biopsies of 85/116 cases (73%), and both locally upgraded cases were among them. Conclusion: In this prospective study of 116 IPs without atypia on CB, the upgrade rate was 1.7% by local review, suggesting that routine excision is not indicated for IP without atypia on CB with concordant imaging findings. [ABSTRACT FROM AUTHOR]

The article presents a list of editors and peer reviewers for "Journal of Business Ethics" in 2020, including Iiris Aaltio, Wei He, and Karen Maas.

Purpose: To investigate the impact of hydrocortisone treatment and illness severity on health-related quality of life (HRQoL) at 6 months in septic shock survivors from the ADRENAL trial. Methods: Using the EuroQol questionnaire (EQ-5D-5L) at 6 months after randomization we assessed HRQoL in patient subgroups defined by hydrocortisone or placebo treatment, gender, illness severity (APACHE II < or ≥ 25), and severity of shock (baseline peak catecholamine doses < or ≥ 15 mcg/min). Additionally, in subgroups defined by post-randomisation variables; time to shock reversal (days), treatment with renal replacement therapy (RRT), and presence of bacteremia. Results: At 6 months, there were 2521 survivors. Of these 2151 patients (85.3%-1080 hydrocortisone and 1071 placebo) completed 6-month follow-up. Overall, at 6 months the mean EQ-5D-5L visual analogue scale (VAS) was 70.8, mean utility score 59.4. Between 15% and 30% of patients reported moderate to severe problems in any given HRQoL domain. There were no differences in any EQ-5D-5L domain in patients who received hydrocortisone vs. placebo, nor in the mean VAS (p = 0.6161), or mean utility score (p = 0.7611). In all patients combined, males experienced lower pain levels compared to females [p = 0.0002). Neither higher severity of illness or shock impacted reported HRQoL. In post-randomisation subgroups, longer time to shock reversal was associated with increased problems with mobility (p = < 0.0001]; self-care (p = 0.0.0142), usual activities (p = <0.0001] and pain (p = 0.0384). Amongst those treated with RRT, more patients reported increased problems with mobility (p = 0.0307) and usual activities (p = 0.0048) compared to those not treated. Bacteraemia was not associated with worse HRQoL in any domains of the EQ-5D-5L. Conclusions: Approximately one fifth of septic shock survivors report moderate to extreme problems in HRQoL domains at 6 months. Hydrocortisone treatment for septic shock was not associated with improved HRQoL at 6 months. Female gender was associated with worse pain at 6 months. [ABSTRACT FROM AUTHOR]

Land tenure systems vary considerably across forager societies. The economic defensibility model explains this variation by considering the costs and benefits of defending resources that vary in density and predictability. The purpose of our study was to describe and explain the variation in tenure systems across 30 hunter-gatherer societies from across the world using the economic defensibility model. We used qualitative data from the Human Relations Area Files (HRAF) database on defense and sharing of resources among groups, and quantitative data from Binford's Frames of References (2001) as indicators of resource density, resource predictability, and competition for resources. However, we were unable to explain the variation in territoriality using these independent variables. We argue that the diversity and complexity of foragers' subsistence strategies is one of the main reasons for our failure to find correlations between territoriality and resource density and predictability. We propose that it may better to conceptualize tenure systems in foraging societies as assemblages of multiple property regimes. [ABSTRACT FROM AUTHOR]

We describe an unusual case of a 42-year-old female with an unresectable succinate dehydrogenase subunit B (SDHB)-related pterygopalatine fossa paraganglioma. She underwent somatostatin receptor imaging with 68Ga-DOTA(0)-Tyr(3)-octreotate (68Ga-DOTATATE) positron emission tomography/computed tomography (PET/CT), which showed uptake in the above mentioned tumor. Hence, the patient was started on octreotide, a cold somatostatin analog, and responded with tumor stabilization and improvement of clinical symptoms for 36 months since initiation of octreotide therapy. This case demonstrates the role of 68Ga-DOTATATE PET/CT in diagnostic localization and its subsequent role in treatment using cold somatostatin analog as a potential choice of therapy in the management of paraganglioma in an unusual location with limited therapeutic options. [ABSTRACT FROM AUTHOR]

Background: There is an increasing concern over adolescent concussions in sports due to risks of long-term negative effects. This study analyzed data over three school years on reported concussion incidence rates by season, high school grade levels and gender, and reported symptoms by school nurses versus athletic trainers, from New Jersey student-athlete concussion data available from an online school-based surveillance system. Methods: School nurses and athletic trainers reported 300 concussions within five days from when each occurred over three school years, 2015–2018, in team sports and physical education in New Jersey high schools. Analysis was further conducted on symptoms and number of symptoms reported by school nurses versus school athletic trainers for each documented student-athlete concussion. Estimated concussion incidence rates were calculated using state agency verified school enrollment data. Findings: Concussions most commonly occurred during fall, followed by spring, then winter. Concussion incidence rates ranged from 6.3/1000 (4.99, 7.55) – 9.1/1000 (7.27, 10.98) students over the three school years of the study. Athletic trainers completed 86% of the reports while nurses completed 11% (position or title of 3%, or n = 7, were not disclosed); the values were similar when considering only fall pre-season and regular season sports (88, 10, 2%, respectively). On average, across the three school years, athletic trainers reported about 3.5 symptoms per report while nurses reported 2.7 (values in fall seasons only were 3.7 and 3.1, respectively.) Conclusions: Certified athletic trainers, compared to school nurses, more often completed concussion report forms and reported more symptoms per injured student, perhaps due partly to closer contact and immediate care provided after injury. Additionally, this study had a higher concussion incidence rate during fall sports seasons compared to winter and spring. Future research can further improve our understanding of concussions among adolescent student-athletes to better inform concussion identification, management and recovery protocols. [ABSTRACT FROM AUTHOR]

One of the challenges of animal cognition research is overcoming anthropocentric sensory biases—in particular, favoring visual information and cues despite the dominance of other sensory cues in many nonhuman research subjects. As such, it is particularly important for animal cognition researchers to explicitly mention steps taken to control for and attend to the sensory world of their study species. Dogs are well known for their reliance on olfaction, but the extent to which dog cognition and behavior research accounts for olfactory cues or incorporates olfactory controls is unknown. With this bibliographic study, we reviewed canine research published in the past 10 years (2008–2018) in 13 scientific journals and coded the 481 resulting papers for mentions of olfactory or odor cues or controls. Our findings indicate that despite widespread acceptance of the significance of olfaction to dogs, scientific methodology rarely takes olfactory information processing into account. Finally, we propose a simple rubric of recommended reporting of olfactory information in research contexts, with the aims to help attune researchers to the umwelt of their study subjects, and to enhance the methodological reproducibility of canine cognition research. [ABSTRACT FROM AUTHOR]

By what measure should a policy maker choose between two mediums that deliver the same or similar message or service? Between, say, video consultation or a remote patient monitoring application (i.e. patient-facing digital health innovations) and in-person consultation? To answer this question, we sought to identify measures which are used in randomised controlled trials. But first we used two theories to frame the effects of patient-facing digital health innovations on – 1) transaction costs (i.e. the effort, time and costs required to complete a clinical interaction); and 2) process outcomes and clinical outcomes along the care cascade or information value chain, such that the 'value of information' (VoI) is different at each point in the care cascade or value chain. From the trials, we identified three categories of measures: outcome (process or clinical), satisfaction, and cost. We found that although patient-facing digital health innovations tend to confer much of their value by altering process outcomes, satisfaction, and transaction costs, these measures are inconsistently assessed. Efforts to determine the relative value of and choose between mediums of service delivery should adopt a metric (i.e. mathematical combination of measures) that capture all dimensions of value. We argue that 'value of information' (VoI) is such a metric – it is calculated as the difference between the 'expected utility' (EU) of alternative options. But for patient-facing digital health innovations, 'expected utility' (EU) should incorporate the probability of achieving not only a clinical outcome, but also process outcomes (depending on the innovation under consideration); and the measures of utility should include satisfaction and transaction costs; and also changes in population access to services, and health system capacity to deliver more services, which may result from reduction in transaction costs. [ABSTRACT FROM AUTHOR]