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Objective: Maxillomandibular advancement (MMA) is an effective surgical treatment for obstructive sleep apnea (OSA); however, it is unclear how many patients who are referred for MMA actually undergo surgery. This study aims to determine follow-up rates for patients referred for MMA and the reasons behind their choices., Methods: Via retrospective review, we assessed consecutive patients with OSA intolerant to continuous positive airway pressure (CPAP) who underwent drug induced sleep endoscopy (DISE) between 2018 and 2020 at our institution. Patients recommended for MMA based on DISE and other findings were included. Patients were then contacted and administered an IRB-approved survey in present time., Results: One hundred and fifty nine patients were referred to oral maxillofacial surgery (OMFS) for MMA consult. Seventy seven patients (48%) followed up with OMFS and 29 (18%) underwent MMA. Sixty two (40%) patients resumed CPAP. Fifty eight patients (36.5%) were lost to follow up. Seventy three patients (46%) completed our survey. Of those patients, 37 (51%) followed up with OMFS and 17 (23%) underwent MMA. Patients who did not follow up with OMFS cited the invasiveness of the surgery (39%), recovery time (17%), or both (31%) as reasons. Those who pursued consultation cited inability to tolerate CPAP (73%), not being a candidate for inspire (14%), and desire to learn about alternative treatments (14%) as reasons. Of those who did not undergo MMA, 28.6% are not using OSA treatment., Conclusion: Less than half of patients referred for MMA followed up, and less than half of those patients underwent MMA. Most patients cited concerns about the invasiveness of the surgery and recovery process., Level of Evidence: 4 Laryngoscope, 134:2964-2969, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Objective: Since 2011, otolaryngologists aiming to become certified in sleep medicine have had to complete an ACGME accredited sleep medicine fellowship. In addition to standard sleep medicine and sleep surgery fellowships, several institutions have developed hybrid ACGME sleep medicine programs that incorporate sleep surgery training. Our primary aims were to understand the balance between sleep medicine and surgical training requirements and the surgical volume of recent graduates across the three pathways. Our secondary aim was to assess their employment post-graduation. An improved understanding of the current state of sleep surgeon training could better inform both applicants and programs and be used to guide fellowship curriculum development., Methods: Between 2017 and 2023, we identified 26 surgeons who completed a sleep focused fellowship. An anonymous survey was developed and emailed to them. The survey assessed clinic and operating balance, procedures completed during fellowship, and comfort with these procedures as attendings. Finally, the survey assessed the job prospects of graduates. Data were analyzed with Prism 10., Results: There were 19 respondents with 52.6% completing a hybrid fellowship, 21.3% completing a sleep medicine fellowship, and 31.6% completing a sleep surgery fellowship. Approximately 84.8% completed ACGME accredited otolaryngology training prior to fellowship. The three most common surgeries were hypoglossal nerve stimulators, pharyngoplasty, and nasal surgeries. Respondents on average received 2.4 job offers, 55% returned to their residency institution, and 89.5% were in academics., Conclusion: Our survey demonstrates a wide variability in sleep-focused fellowships for surgeons, but the employment market for these trainees is robust., Level of Evidence: N/A Laryngoscope, 2024., (© 2024 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Objective: Continuous Positive Airway Pressure (CPAP) is the typical first treatment for Obstructive Sleep Apnea (OSA); however, patient adherence is often suboptimal. Expansion Sphincter Pharyngoplasty (ESP) is an alternative treatment option for patients with OSA who demonstrate signs of palatal and lateral pharyngeal collapse. The aim of this study is to compare therapeutic outcomes, using the mean disease alleviation concept, for patients who underwent ESP to patients undergoing CPAP therapy., Data Sources: Single-institution retrospective cohort study., Methods: All patients who underwent ESP from 2018 to 2021 or were prescribed CPAP from December to June 2021 at our institution were assessed for inclusion. ESP patients who had pre- and post-operative sleep studies available and CPAP patients who followed up at our institution's sleep clinic were included for analysis. Charts were reviewed for demographic information and sleep study results, and treatment outcomes were measured by calculating mean disease alleviation., Results: There were 77 patients in the ESP group and 107 patients in the CPAP group. AHI reduction was greater in the CPAP group (p = 0.016); however, mean disease alleviation was similar between groups (p = 0.076). One-way ANCOVA demonstrated similar MDA between groups when controlling for patient age, BMI, gender, and pre-operative AHI (F [1,177] = 2,931.6, p = 0.104)., Conclusion: CPAP therapy provided superior reduction in AHI compared to ESP; however, overall treatment efficacy as measured by mean disease alleviation was similar for both groups., Level of Evidence: 3 Laryngoscope, 133:1513-1517, 2023., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Objective(s): Upper airway stimulator (UAS) placement is a treatment for obstructive sleep apnea (OSA) with few complications and low morbidity. UAS placement has traditionally been performed using a three-incision approach, however, it has been implanted using a two-incision approach. This approach could significantly decrease operation time without a difference in postoperative complications, demonstrating its safety and feasibility for UAS placement. The objective was to assess operative time and complication rate in the two-incision approach for UAS placement compared to the three-incision approach., Study Design: Retrospectively reviewed., Methods: Patients who underwent UAS placement using the two- or three-incision approach at a single academic institution from November 2014 to June 2021 were retrospectively reviewed. The two-incision approach did not include the incision at the mid-axillary line. Main outcome measures included operation time and complication rates., Results: Three-hundred forty-eight patients underwent UAS placement. The three-incision approach demonstrated an average operation time of 143.3 minutes whereas the two-incision approach averaged 129.4 minutes (P < .001). There was no significant difference in rate of postoperative complications between the two- and three-incision cohorts including pneumothorax (0% vs. 0.4%, P > .99), patient-reported discomfort (5.6% vs. 6.5%, P > .99), activity restriction (0% vs. 1.4%, P > .50), and incisional pain (0.0% vs. 1.0%, P > .99). No patients experienced incision site bleeding or infection. The two-incision approach was associated with decreased rate of revision surgery (0.0% vs. 5.4%, P = .048)., Conclusion: The UAS two-incision approach proved to have a significantly shorter operative time without an increase in complications as compared to the three-incision approach. This approach is a safe and feasible option., Level of Evidence: 3 Laryngoscope, 132:1687-1691, 2022., (© 2022 The American Laryngological, Rhinological and Otological Society, Inc.)

Objectives/hypothesis: To assess the efficacy and mechanism of action of a novel approach to mitigate acute and chronic radiation toxicity in a validated animal model., Study Design: Randomized, prospective study using an in vivo rat model., Methods: Experimental animal study utilizing Sprague-Dawley rats divided into three cohorts: 1) radiation + dimethyl sulfoxide (DMSO) (inert vehicle); 2) radiation + RTA-408 (therapeutic drug); and 3) no radiation + DMSO. All animals in the radiation cohorts underwent 40 Gy of radiation with subsequent inferior epigastric axial rotational flap 30 days later in all cohorts with percentage of flap necrosis and vascular density calculated by blinded observers. In a second experiment, an additional three cohorts, underwent serial punch biopsies of the abdominal skin before, during, and after radiation and drug/vehicle control treatment. Transcriptome analysis utilizing gene set enrichment analysis and digital polymerase chain reaction were performed at various time points., Results: The first experiment revealed average flap necrosis of 20% (95% confidence interval [CI] 16-45) in the radiation control group, 3% (95% CI 0-11) in the nonirradiated control, and 3% (95% CI 0.2-10) in the radiation group treated with RTA-408. Vascular density was preserved in the treatment group as compared to the radiated control. Nine rats were included in the second experiment, and transcriptome analyses in the treatment group revealed robust activation of antioxidant pathways with induced expression of genes associated with hypoxia and adipogenesis/angiogenesis., Conclusions: Administration of RTA-408 during radiation treatment in a rat model resulted in transcriptome changes which appear to mitigate the toxic effects of radiation, preserving capillary networks and improving flap survival and tissue healing after subsequent surgery., Level of Evidence: Foundational Evidence, Animal Research Laryngoscope, 132:1196-1204, 2022., (© 2021 The American Laryngological, Rhinological and Otological Society, Inc.)

Exposure to the spaceflight environment causes adaptations in most human physiological systems, many of which are thought to affect women differently from men. Since only 11.5% of astronauts worldwide have been female, these issues are largely understudied. The physiological nuances affecting the female body in the spaceflight environment remain inadequately defined since the last thorough published review on the subject. A PubMed literature search yielded over 2200 publications. Using NASA's 2014 review series 'The effects of sex and gender on adaptation to space' as a benchmark, we identified substantive advancements and persistent knowledge gaps in need of further study from the nearly 600 related articles that have been published since the initial review. This review highlights the most critical issues to mitigate medical risk and promote the success of missions to the Moon and Mars. Salient sex-linked differences observed terrestrially should be studied during upcoming missions, including increased levels of inflammatory markers, coagulation factors and leptin levels following sleep deprivation; correlation between body mass and the severity of spaceflight-associated neuro-ocular syndrome; increased incidence of orthostatic intolerance; increased severity of muscle atrophy and bone loss; differences in the incidence of urinary tract infections; and susceptibility to specific cancers after exposure to ionizing radiation. To optimize health and well-being among all astronauts, it is imperative to prioritize research that considers the physiological nuances of the female body. A more robust understanding of female physiology in the spaceflight environment will support crew readiness for Artemis missions and beyond., (© 2024 The Author(s). Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)

The article demonstrates that externality does predict whose eating and weight is most influenced by being placed in a novel feeding environment. While thus far the generalized construct of external responsiveness has been defined, in part, by the tests used to measure it, these tests appear to reflect a difference in the way information is attended to and processed. The article evaluates how complexity of the external environment and type of reflective thought differentially influenced information processing for a group of 19 overweight and 18 normal-weight male adults. Subjects in face-to-face interview were asked a series of questions involving minimal-search or reflective thought, verbal and visually oriented content. Another person besides the interviewer was seated facing the subject to his left, his right, or was absent during each of the 36 questions presented. The direction of the first eye shift on each question and the frequency of ocular activity varied more strongly for overweight than normal-weight subjects as a function of whether the question required minimal or extended reflection. The direction of first lateral eye movement was more greatly influenced for overweights than normals by the position of the confederate.

Two hundred one non-treatment seeking women with alcoholism, anxiety disorders, alcoholism and anxiety disorders, or neither alcoholism nor anxiety disorders were interviewed to assess core psychopathology associated with eating disorders using the Eating Disorders Examination and DSM-IIIR psychiatric diagnoses using the Schedule of Affective Disorders and Schizophrenia-Lifetime version. Alcoholic women had significantly higher mean scores on each of the Eating Disorders Examination subscales of Restraint, Overeating, Eating Concern, Shape Concern, and Weight Concern compared with nonalcoholic women. Women with anxiety disorders had significantly elevated scores on subscales of Overeating, Eating Concern, and Weight Concern compared with women without anxiety disorders. Women with both alcoholism and anxiety disorders had higher rates of bulimia nervosa and/or eating disorder NOS compared with women with either disorder alone. Implications of these findings are discussed in the context of the co-morbid association between alcoholism, eating disorders, and anxiety disorders. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study sought to provide reference data for the Eating Disorder Inventory (EDI) with use of young adolescent black and white girls. Moreover, the study examined the relationship between race, age, socioeconomic status, and adiposity and each of the eight EDI scales. METHOD: To achieve these aims, data were used that had been collected in Years 3, 5, and 7 as part of the National Heart, Lung, and Blood Institute Growth and Health Study, a longitudinal cohort study of risk factors for obesity in black and white girls. For the present report, data were available from 2,228 girls in Year 3, 2,056 girls in Year 5, and 1,902 girls in Year 7. RESULTS: EDI scores were found to vary by race, age, socioeonomic status, and body weight of respondents. Black girls scored different from white girls on all EDI subscales. Scores on all but two subscales (Body Dissatisfaction, Drive for Thinness) decreased significantly with increasing age. Significant inverse associations were found between maximum parental education and all EDI subscales except Body Dissatisfaction and Perfectionism. Elevated body weight was associated significantly with Body Dissatisfaction, Drive for Thinness, Bulimia, Interoceptive Awareness, and Ineffectiveness. DISCUSSION: Our results illustrate the importance of taking into consideration the potentially confounding role of demographic characteristics and body weight when comparing different race or ethnic groups on the EDI. Copyright 2000 by John Wiley & Sons, Inc. [ABSTRACT FROM AUTHOR]

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OBJECTIVE: This study examined racial differences in eating disorder symptomatology in a community-based sample of middle-aged adult Black and White women and investigated predictors of body image dissatisfaction in these two different racial groups, since most research has focused on young adult White women. METHOD: Subjects (538 Black and White women) completed the Eating Disorder Inventory and measures of social pressures about thinness and negative attitudes about overweight. RESULTS: Black and White women reported comparable levels of eating disturbance. However, after controlling for degree of overweight, White women had significantly greater rates of body dissatisfaction than Black women. Nonetheless, both racial groups reported considerable body image dissatisfaction and similar factors were found to predict body dissatisfaction for Black and White women. DISCUSSION: Our data and other recent data indicate that eating disturbance occurs across a much broader age, race, and socioeconomic distribution than previously suspected. Research implications are discussed. [ABSTRACT FROM AUTHOR]

Two hundred one non-treatment seeking women with alcoholism, anxiety disorders, alcoholism and anxiety disorders, or neither alcoholism nor anxiety disorders were interviewed to assess core psychopathology associated with eating disorders using the Eating Disorders Examination and DSM-IIIR psychiatric diagnoses using the Schedule of Affective Disorders and Schizophrenia-Lifetime version. Alcoholic women had significantly higher mean scores on each of the Eating Disorders Examination subscales of Restraint, Overeating, Eating Concern, Shape Concern, and Weight Concern compared with nonalcoholic women. Women with anxiety disorders had significantly elevated scores on subscales of Overeating, Eating Concern, and Weight Concern compared with women without anxiety disorders. Women with both alcoholism and anxiety disorders had higher rates of bulimia nervosa and/or eating disorder NOS compared with women with either disorder alone. Implications of these findings are discussed in the context of the co-morbid association between alcoholism, eating disorders, and anxiety disorders.

Objective: Hypoglossal nerve stimulation (HNS) can be an effective treatment for moderate to severe obstructive sleep apnea (OSA) in positive airway pressure (PAP) intolerant patients. To better understand patient experiences with HNS therapy, we explored reported events from HNS-related Facebook groups and the Manufacturer and User Facility Device Experience (MAUDE) database., Methods: A retrospective analysis of HNS-related Facebook posts from three groups pertaining to HNS therapy, from October 1, 2022 to October 1, 2023, was performed. Posts were analyzed for patient-reported adverse events. Concurrently, the MAUDE database was reviewed for HNS-related events during the same timeframe., Results: From 737 Facebook posts, 132 (17.55%) adverse events were identified. Adverse events included pain (34.85%), stimulation discomfort (14.39%), lip weakness (6.82%) and issues related to lead tethering or tight leads around the neck (3.79%). Analysis of the MAUDE database found 428 adverse events, including pain (24.07%), lip weakness (0.44%), and lead tethering (1.64%)., Conclusion: Facebook group members reported higher rates of lip weakness and lead tethering than recorded in the MAUDE database. These findings illustrate how diverse data sources, such as social media, can enhance our understanding of patient experiences and identify gaps in patient education with HNS therapy., Level of Evidence: NA Laryngoscope, 134:5217-5222, 2024., (© 2024 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Fluorescent hydrogels have emerged as one of the most promising candidates for developing biomimetic materials and artificial intelligence owing to their unique fluorescence and responsive properties. However, it is still challenging to fabricate hydrogel that exhibits synergistic changes in fluorescence color and shape in response to multistimulus via a simple method. Herein, blue‐ and orange‐emitting fluorescent microgels (MGs) both are designed and synthesized with pH‐, thermal‐, and cationic‐sensitivity via one‐step polymerization, respectively. The two fluorescent MGs are incorporated into transparent doubly crosslinked microgel (DX MG) hydrogels with a preset ratio. The DX MG hydrogels can tune the fluorescent color accompanied by size variation via subjecting to external multistimulus. Thus, DX MG hydrogels can be exploited for multiresponsive fluorescent bilayer actuators. The actuators can undergo complex shape deformation and color changes. Inspired by natural organisms, an artificial morning glory with color and size changes are showcased in response to buffer solutions of different pH values. Besides, an intelligent skin hydrogel, imitating natural calotes versicolor, by assembling four layers of DX MG with different ratios of MGs, is tailored. This work serves as an inspiration for the design and fabrication of novel biomimetic smart materials with synergistic functions. [ABSTRACT FROM AUTHOR]

Phosphorene possesses a unique combination of physical and chemical properties, including tunable direct bandgap, anisotropic electronic and optical properties. However, application of phosphorene is hampered by its fast degradation under ambient conditions. It is believed that H2O and O2 play key roles in the instability of phosphorene, but their exact contributions have not yet been completely understood in experiment. Herein, a technique of probing the mechanism of phosphorene oxidation through the evolvement of its photoluminescence spectra in a liquid suspension is introduced. With the addition of H2O2, the photoluminescence intensity of the suspension surprisingly increases, indicating a passivation effect due to the formation of phosphorene oxide, which is also verified by Raman spectroscopy. In contrast, direct addition of H2O leads to irreversible and rapid degradation as shown by the quenching of photoluminescence. Furthermore, monolayer phosphorene suspension photoluminescence at 2.17 eV is obtained by completely eliminating effects from contaminations, substrate strain, dielectric substrate, and oxidation of samples. Solvent protection in combination with the optical probing method provides an effective approach in investigating the chemistry of active materials like phosphorene. Phosphorene has great potential in the range of sensing applications including high‐resolution H2O2 and humidity sensors. [ABSTRACT FROM AUTHOR]

The term vaccine envy (i.e., envy experienced when others are given the opportunity to receive a COVID‐19 vaccine) was coined during the COVID‐19 pandemic and has received media attention. This study is the first to systematically investigate vaccine envy. In two pre‐registered online surveys conducted in May 2021 (N = 1,174) and October/November 2021 (N = 535), we collected data from vaccinated and unvaccinated German participants, including measures of vaccine envy, well‐being, personal experiences during the pandemic, and various trait constructs (e.g., justice sensitivity and self‐esteem). We found that in May 2021, 47% of participants experienced vaccine envy at least sometimes and that vaccine envy was connected to victim sensitivity, subjective perceptions of being threatened by the pandemic, and an increased willingness to be vaccinated. By November 2021, however, vaccine envy among unvaccinated participants had almost disappeared. Our findings advance the understanding of the psychological impact of the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has challenged nations states across the world. They have implemented lockdown and social distancing and with the development of vaccines have gone to great lengths to build herd immunity for their populations. As place managers, local government has played a variety of roles supporting central government edicts related to social distancing and supporting local businesses impacted by lockdowns. The research reported here comparing the role local government has played in Australia, Canada, Italy, and New Zealand shows that they have at different times and for different issues been policy takers from central government, policy shapers, and policy makers adapting national strategies. Local government plays an important complementary role with central governments in both unitary and federal systems of government. The paper contributes to the literature on multi‐level governance, place‐based decision‐making, and disaster and emergency management by offering a framework for analysing municipal roles in crises management both in their relationship with higher layers of government and in their acting as locally placed organisations. Points for practitioners: Cross‐national study: Australia, Canada, Italy, and New Zealand.Examination of local government responses to COVID‐19 pandemic as policy makers, takers, or shapers.Comparison of federal and unitary states. [ABSTRACT FROM AUTHOR]

Using the 2008, 2012, and 2016 waves of the Health and Retirement Study (HRS), this study employs Structural Equation Modeling (SEM) to investigate if financial self‐efficacy mediates the relationship between affective states (e.g., state‐like emotions) and financial satisfaction and if this differs for retirees and non‐retirees. The results show that retirees' negative affective state (negative affect) in wave 1 (2008) is related inversely to their financial self‐efficacy in wave 2 (2012), and financial self‐efficacy is related positively to financial satisfaction in wave 3 (2016). The results show that negative affect is associated with lower financial satisfaction through financial self‐efficacy as a mediating characteristic for retirees. However, for non‐retirees, no statistically significant mediation relationship is found. Findings from this study contribute to the gap in understanding the lingering effects of negative affect on financial behavior and financial satisfaction levels of older adults. This study provides insights into how financial planning practitioners can help clients navigate affective states and financial self‐efficacy as they work together to reach their financial goals. [ABSTRACT FROM AUTHOR]

Many domains of research suggest that high favourability to social power and low favourability to egalitarian ideals predict more prejudice against other groups. In the present article, we describe theory and evidence suggesting that the relations between power, egalitarianism and prejudice may be reversed for one group: fat men. Using both implicit and explicit measures, we found across four studies (N = 602) that target gender moderated the relation between values and attitude toward fat people. For male targets, implicitly but not explicitly measured positivity toward power (over egalitarian) values predicted significantly more spontaneous positive attitudes toward fat (over slim) people. Further, implicit attitude toward power (over egalitarian) values predicted the time‐pressured decision to choose a fat male. Together, the implicit evaluation of values allows us to identify processes in inter‐group attitudes and behaviours that would not be possible to detect using explicit measures of values alone. [ABSTRACT FROM AUTHOR]

Dynamic hydrogels offer the opportunity to meet the expectations of smart materials with adaptable properties such as stimuli responsiveness, self‐healing, shear thinning, stress relaxation, dynamic viscoelasticity, energy dissipation mechanisms, time‐dependent adaptation, etc. In the past decades, reversible C═N bonds including imine, hydrazone, and oxime have received great research interest in the design of dynamic polymer networks (DPNs). Moreover, reversible C═N bonds can be well‐integrated into DPNs in combination with permanent covalent crosslinks and/or other dynamic bonds (supramolecular interactions and dynamic covalent bonds), thus outfitting the hydrogels with enhanced mechanical properties, multiresponsiveness, printability, adhesion, and various other functions. This literature review first describes how reversible C═N bonds can be introduced into hydrogels from the perspective of dynamic bonds and network topologies. The design strategies (building blocks, crosslink type combinations, network topologies) reported in the literature are then discussed, as well as the effects of dynamic crosslinking on the hydrogel properties and the potential applications. [ABSTRACT FROM AUTHOR]

Metabolically healthy or unhealthy obesity is closely related to metabolic syndrome (MetS). To validate a more accurate diagnostic method for obesity that reflects the risk of metabolic disorders in a pre‐clinical mouse model, C57BL/6J mice were fed high‐sucrose–high‐fat and chow diets for 12 weeks to induce obesity. MRI was performed and analysed by chemical shift‐encoded fat–water separation based on the transition region extraction method. Abdominal fat was divided into upper and lower abdominal regions at the horizontal lower border of the liver. Blood samples were collected, and the glucose level, lipid profile, liver function, HbA1c and insulin were tested. k‐means clustering and stepwise logistic regression were applied to validate the diagnosis of hyperglycaemia, dyslipidaemia and MetS, and to ascertain the predictive effect of MRI‐derived parameters to the metabolic disorders. Pearson or Spearman correlation was used to assess the relationship between MRI‐derived parameters and metabolic traits. The receiver‐operating characteristic curve was used to evaluate the diagnostic effect of each logistic regression model. A two‐sided p value less than 0.05 was considered to indicate statistical significance for all tests. We made the precise diagnosis of obesity, dyslipidaemia, hyperglycaemia and MetS in mice. In all, 14 mice could be diagnosed as having MetS, and the levels of body weight, HbA1c, triglyceride, total cholesterol and low‐density lipoprotein cholesterol were significantly higher than in the normal group. Upper abdominal fat better predicted dyslipidaemia (odds ratio, OR = 2.673; area under the receiver‐operating characteristic curve, AUCROC = 0.9153) and hyperglycaemia (OR = 2.456; AUCROC = 0.9454), and the abdominal visceral adipose tissue (VAT) was better for predicting MetS risk (OR = 1.187; AUCROC = 0.9619). We identified the predictive effect of fat volume and distribution in dyslipidaemia, hyperglycaemia and MetS. The upper abdominal fat played a better predictive role for the risk of dyslipidaemia and hyperglycaemia, and the abdominal VAT played a better predictive role for the risk of MetS. [ABSTRACT FROM AUTHOR]

Background: In today's obesogenic environment high‐caloric palatable foods are omnipresent, making it hard for many to reach and maintain a healthy body weight. This study investigates the effects of a health versus hedonic mindset on daily‐life snacking behaviour. The hypothesis is that a health mindset leads to reduced snacking behaviour compared to a hedonic mindset. This effect is expected to be most pronounced with high dietary restraint and least pronounced with high trait self‐control. Methods: For 3 weeks, degree of craving and amount of snacks that were craved and consumed were assessed four times a day, using smartphone Ecological Momentary Assessment (EMA). A total of 111 female participants (body mass index range: 20–23.5) were randomly assigned to a 1‐week health (n = 53) or hedonic (n = 58) mindset, occurring in week 2 of the EMA protocol. The mindset manipulations consisted of text messages, focusing either on the enjoyment of tasty food (hedonic) or on healthy living and eating (health). Results: contrary to our hypotheses, mindset did not affect snacking behaviour. Instead, degree of craving and intake of snacks reduced significantly over time, not moderated by mindset, dietary restraint (Restraint Scale) or trait self‐control (Brief Self‐Control Scale). Importantly, this was not due to reduced compliance. Possibly, the reduced craving and snacking behaviour were due to monitoring and/or socially desirable answering tendencies. Additional time point analyses showed that craving was strongest in the late afternoon (3:30–5:00 PM), and‐across mindset conditions‐degree of craving correlated negatively with trait self‐control. Conclusions: future studies could manipulate degree of monitoring and design individually tailored manipulations. Highlights: Mindset did not significantly influence snacking behaviour.Craving degree and snacking amount decreased over time independent of mindset and/or compliance rate.Reduced craving degree and snacking amount might be due to intense monitoring of snacking behaviour.Participants craved more in the late afternoon (3:30–5:00 PM) compared to the rest of the day.Craving degree correlated negatively with trait self‐control. [ABSTRACT FROM AUTHOR]

With the global rise of impact investments to achieve societal goals, an increasing number of new ventures that aim to create societal impact now seek to go public. However, while many conceptual studies suggest that impact investors are less likely to pursue financially oriented exit plans in exchange for generating societal impact, there is little empirical evidence to back up this claim. Using a propensity score matching approach, we draw on data from Crunchbase and empirically compare the initial public offering (IPO) performance of a large sample of 3398 investments by impact investors with 3398 investments by matched venture capital (VC) investors. We find that impact investor investments are less likely to lead to an IPO than VC investments. Besides, our results indicate that syndication by impact investors increases the likelihood of an IPO. This suggests that companies funded by impact investors benefit more from syndication than their VC‐funded counterparts. Our findings have practical implications for impact investors, portfolio ventures, and policymakers. [ABSTRACT FROM AUTHOR]

Objective: Functioning gonadotroph adenomas (FGAs) are rare pituitary tumours stimulating ovarian function with potential life‐threatening consequences in women. However, a lack of aggregated clinical experience of FGAs impairs management in affected women. The aim of this study is to present the clinical course of FGA‐induced ovarian hyperstimulation syndrome (OHSS) cases as identified by some of the largest UK pituitary endocrine tertiary centres with a view to increasing awareness and improving diagnosis and management of women with FGA. Design: A retrospective observational study; audit of eight UK regional pituitary centres for cases of FGAs. Setting: Specialist neuroendocrine centres in the United Kingdom. Patients and Measurements: Women diagnosed with FGA‐induced OHSS. Description of their clinical course. Results: Seven cases of FGA were identified in women, all causing OHSS. Mean age was 33.4 years at diagnosis. Abdominal pain, irregular periods, headache, and visual disturbances were reported at presentation by 100%, 71%, 57% and 43% of women, respectively. Three of seven women underwent ovarian surgery before FGA diagnosis. Six women underwent transsphenoidal surgery (TSS) with incomplete tumour resection in five of those, but all showed improvement or resolution in symptoms and biochemistry postoperatively. Conclusion: FGA is a rare cause of spontaneous OHSS. TSS improves clinical and biochemical features of ovarian hyperstimulation in FGAs. Improved awareness of FGA will prevent inappropriate emergency ovarian surgery. [ABSTRACT FROM AUTHOR]

The moral exemplars model of reconciliation (Cehajic‐Clancy & Bilewicz, 2021) proposes that through focusing on the moral behavior during the genocide, the descendants of perpetrators, bystanders, and victims could become more willing to reconcile and engage in intergroup contact. In the present article we aim to test the boundary effects of such approach by analyzing the usage of moral exemplars argument in the Polish‐Israeli conflict over the history of the Holocaust. In two studies, we tested whether Poles' and Israeli's estimations of moral behavior and emotions (vs. immoral ones) during the Holocaust are related to their attitudes towards contemporary counterparts. The studies confirmed that higher estimations of moral behavior during the Holocaust were related to more positive attitudes of Israelis towards Poles but not of Poles towards Israelis. On the contrary, higher estimations of such moral behavior among Poles were positively related to secondary antisemitism and harsh criticism of the current role of Israel in the Middle Eastern conflict. The results of our studies suggest that the moral exemplars‐based model of reconciliation should be carefully applied to the contexts in which historical perpetrators and bystanders aim at whitewashing their histories. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders (EDs) impact multiple domains in a person's life including interpersonal interactions. Although a considerable amount of literature has evaluated social comparison and ED pathology, less has focussed on the influence of competitiveness on eating behaviours within ED and community samples. To address this, a systematic scoping review was conducted to evaluate current knowledge on this topic. Method: PRISMA guidelines for scoping reviews were utilised to identify relevant articles in three databases without limits to date or publication type. Results: A total of 2952 articles were identified. After removing duplicates and books, 1782 articles were evaluated against inclusion criteria, and 91 articles were included. Results were synthesised under six differing conceptualisations of competitiveness: competition in pro‐eating disorder communities (n = 28), general personality competitiveness (n = 20), sexual competition hypothesis (n = 18), interpersonal competitiveness with peers (n = 17), familial competitiveness (n = 8) and competitiveness to avoid inferiority (n = 5). Conclusion: Varying conceptualisations of competitiveness were identified within the ED literature, and preliminary evidence suggests competitiveness may be associated with ED pathology in ED and community samples, although results were not uniform. Future research is needed to clarify these relationships and to identify possible clinical implications. Highlights: The literature on competitiveness and eating disorders is fractured by various conceptualisations of competitiveness.Preliminary evidence across conceptualisations suggests competitiveness is associated with disordered eating pathology in clinical and community samples.More peer‐reviewed empirical research is needed to extend the existing literature, which heavily features non‐systematic reviews, theoretical articles and dissertations. [ABSTRACT FROM AUTHOR]

Consumers engage in word‐of‐mouth pervasively, and strategies such as different endorsement types are commonly used to facilitate word‐of‐mouth diffusion. Prior work on endorsement has highlighted the advantage of the majority (e.g., everyone likes it) in persuasion so that companies usually use it to shape consumers' preference, but is the majority endorsement more effective than the minority endorsement (e.g., I personally like it)? This research demonstrates that the persuasiveness of majority or minority endorsement depends on the stages of the consumer decision journey. Minority endorsement can be more influential than majority endorsement in the early stage of the consumer decision journey. This paper theorizes and demonstrates that this effect occurs because minority endorsement emphasizes differentiation from the group and does not have any conformity pressure, which could satisfy consumers' pronounced need for decision autonomy in the early stage. In contrast, majority endorsement is more effective in the late stage because consumers regard it as social proof and can better meet consumers' salient need for decision control. These findings identify psychological needs in the consumer decision journey, contribute to the research on social influence, and provide managerial insights for marketers on when and how to adopt different strategies to influence consumers. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relationship between postural orthostatic tachycardia syndrome (POTS) and pregnancy. Design: Cross‐sectional survey. Setting: International. Sample: A total of 8941 female patients with a diagnosis of POTS. Methods: Data from the survey were analysed using descriptive measures and stratified for comparisons. Main outcome measures: Symptom course of POTS during pregnancy. Secondary outcomes included pregnancy loss, POTS onset during pregnancy and the impacts of a comorbid diagnosis of Ehlers–Danlos syndrome or an autoimmune disorder on symptoms during pregnancy. Results: Overall, 40.8% (n = 3652) of participants reported one or more pregnancies. Most participants experienced worsening of symptoms in the first (62.6%) and third (58.9%) trimesters and 3 months after pregnancy (58.7%), and 81.1% experienced worsening symptoms at any point in their pregnancy. Most participants with worsening symptoms in the first trimester also experienced worsening symptoms in the second (61.6%) and third (68.1%) trimesters, but if they improved in the first trimester then this improvement persisted in the second and third trimesters. Of participants who reported that POTS was triggered by a specific event (41.3%), 8.1% reported pregnancy as the trigger for the onset. Conclusions: Postural orthostatic tachycardia syndrome symptoms in the first trimester of pregnancy may help predict symptom course throughout the duration of pregnancy. Some individuals may experience an initial onset of POTS during pregnancy. This novel information may guide clinicians in counselling patients with POTS who are planning pregnancy. This article includes Author Insights, a video abstract available at: https://players.brightcove.net/3806881048001/default_default/index.html?videoId=6319977749112 [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe a novel lateral approach for hypoglossal nerve stimulator (HNS) implantation in women and provide evidence for its safety and efficacy. Study Design: Retrospective case series. Setting: Single academic medical center. Methods: We identified patients implanted with HNS by a single surgeon from January 2017 to December 2021. Patient characteristics, postoperative complications, surgical duration, response to therapy, and need for revision surgery were recorded. Results: One hundred four patients were included, including 93 males and 11 females. The lateral approach for HNS implantation involves placing the chest incision for the implantable pulse generator and respiratory sensor lead vertically in the anterior axillary line instead of horizontally in the infraclavicular area. No changes are made to the stimulator lead placement. All female patients were implanted using a lateral approach and all male patients were implanted via the standard anterior approach. Half of the patients were implanted via a 2‐incision technique. The median surgical time duration was equivalent in male and female patients (119 [interquartile range (IQR): 105‐138] vs 126 [IQR: 115‐141], respectively). Revision was required in 2 (18%) females versus 6 (6%) males (p =.17). There were equivalent rates of therapy response as well as postoperative complications. Conclusion: A more cosmetic lateral approach is feasible for HNS in female patients and has a similar rate of adverse events and therapy responsiveness. Additional considerations in female patients include the ability to tolerate mammography as well as HNS implantation in the setting of existing breast implants. [ABSTRACT FROM AUTHOR]

Mechanically robust and electrically conductive organohydrogels/hydrogels are increasingly required in flexible electronic devices, but it remains a challenge to achieve organohydrogels/hydrogels with integrated high performances. Herein, inspired by the geometric deformability and robustness of fishing nets, multiscale ionic organohydrogels with outstanding isotropic mechanical robustness are developed. The organohydrogels are prepared by introducing polyacrylamide (PAM) hydrogel, Zn2+ and a binary solvent of glycerol‐water into a crosslinked fibrous mat which is electrospun from poly(acrylic acid) (PAA) and poly(vinyl alcohol) (PVA). Because of the unique structure, the resultant organohydrogels, being mentioned as PAA‐PVA/PAM/Zn2+ organohydrogels, exhibit outstanding tensile strength (9.45 MPa), high stretchability, excellent anti‐fatigue property, skin‐like mechanical behaviors and ionic conductivity. Importantly, the organohydrogels are promising in flexible electronic devices capable of operating properly over a wide temperature range and under harsh mechanical conditions, such as mechanical‐electrical signal transducing materials in flexible mechanosensors and robust electrolytes in zinc ion hybrid supercapacitors. Not only the multiscale design strategy will provide a clue to improve the mechanical properties of soft materials, but also the organohydrogels offer promising materials for future flexible electronic devices. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to develop a scale to screen for eating disorders in female athletes. Methods: Preliminary survey: A total of 275 female athletes (mean age: 19.4 ± 1.0 years) and 7 female athletes diagnosed with eating disorders (mean age: 20.1 ± 2.5 years) were administered screening items prepared based on an existing scale, followed by exploratory factor analysis. Main survey: Six items, relating to three factors, were extracted, and 201 female athletes (mean age: 22.3 ± 4.8 years) and 6 female athletes diagnosed with current or a history of eating disorders (mean age: 18.8 ± 2.9 years) were queried. The diagnostic validity of the scale was then evaluated. Results: Preliminary survey: Questions (α = 0.71) were extracted from six items, relating to three factors, and collectively termed the University of Tokyo's eating disorders inventory in female athletes (TEDIFA). To determine the scale cut‐off score, ROC analysis was performed with the total score, and the cut‐off and gray zone scores were set at 13 and 11, respectively. Main survey: At the cut‐off score of 13, AUC, sensitivity, and specificity were 0.83 (p < 0.05), 75%, and 90%, respectively. Conclusions: The scale that was developed, TEDIFA, consisted of six items. The cut‐off scores were set at 11 for the gray zone (sensitivity: 75%; specificity: 56%; accurate diagnosis rate: 60%), and 13 for positivity (sensitivity: 75%; specificity: 90%; accurate diagnosis rate: 87%), demonstrating the reliability and validity of the scale. [ABSTRACT FROM AUTHOR]

Aims: Feminizing gender‐affirming hormone therapy (GAHT) can be utilized to help transfeminine transgender and gender diverse (TGD) individuals achieve the transformation of outward sex characteristics, thereby leading to improvements in psychological and social well‐being. In this narrative review, we aim to summarize current guidelines for feminizing GAHT management as well as the available literature describing the associated health risks pertaining to cardiovascular disease, thromboembolic disease, bone health, and cancer risks. Methods: Relevant literature from January 2019 through July 2022 pertaining to feminizing GAHT was identified using PubMed, Cochrane Library, EMBASE, and MEDLINE. A narrative summary was performed with the inclusion of more recently published guidance from the World Professional Association for Transgender Health, Standards of Care Version 8. Results: Guidance regarding the prescribing of feminizing GAHT with estrogen, antiandrogen, and progesterone medications is summarized along with considerations of the cardiovascular, thromboembolic, bone health, and cancer risks associated with these therapies. Conclusions: Feminizing GAHT is a highly effective method for transfeminine TGD patients to achieve medically necessary changes in secondary sex characteristics. Knowledge of the health risks of feminizing GAHT is largely drawn from research in the cisgender population, with a growing body of literature in TGD‐specific patient populations. Feminizing GAHT appears to carry a low risk profile for most patients; however, further research describing the risks of hormone management around the time of gender‐affirming surgery and in the aging TGD population is needed to optimize GAHT in the context of the evolving health risks over a TGD patient's lifespan. [ABSTRACT FROM AUTHOR]

In this study, Cu−Cr−Zr alloy specimens were first subjected to aging heat treatment at 500 °C for two different durations (2 hours and 4 hours). Three different coating processes (silver, silver/copper duplex, and copper/silver duplex) were applied to the aged specimens using the physical vapor deposition method. Tensile test, microhardness measurement, wear test, electrical conductivity measurement and structural analysis (x‐ray diffraction and scanning electron microscope) were applied to the specimens. After the aging processes, the highest hardness and strength values of the Cu−Cr−Zr alloy were obtained in the specimens that were aged at 500 °C for 4 hours. When the wear resistance and electrical conductivity of the coated specimens were examined, it was determined that the specimens with duplex surface treatment performed better. [ABSTRACT FROM AUTHOR]

Objective: This study tested the effect of personal values (motivation) and sustained attention (cognitive ability) on children's helping behavior. Method: Children (N = 162, age range 8–9 years, mean = 8.81, SD = 0.43) completed value ranking and go/no‐go tasks, and their helping behavior was examined. Results: Children who valued self‐transcendence over self‐enhancement helped more than others. Surprisingly, children's lack of sustained attention was associated with more helping among those who valued self‐transcendence over self‐enhancement or openness‐to‐change over conservation values. Valuing both self‐transcendence and openness‐to‐change was also associated with more helping. Conclusions: Children are more likely to help others if they value self‐transcendence and openness to change. Notably, children's tendency to act upon these values may be facilitated (rather than obstructed by) low attention skills. [ABSTRACT FROM AUTHOR]

Objective: To compare participants with current food insecurity and different psychopathology profiles on shame, guilt, anxiety, and depression using a cross‐sectional design. Method: Women with current food insecurity (n = 99; 54% White) were placed into four groups based on their endorsement of symptoms of psychopathology: eating disorder with depression/anxiety comorbidity (ED‐C group; n = 17), depression/anxiety only (Depression/anxiety group; n = 34), eating disorder only (ED group; n = 12), and No‐diagnosis group (n = 36). Groups were compared on self‐report measures of shame, guilt, depression, and anxiety using analysis of covariance. Results: The presence of an eating disorder was associated with quadruple the risk of screening positive for comorbid depression and anxiety. The ED‐C group reported elevated shame relative to the ED and No‐diagnosis groups. The ED‐C group reported the highest levels of anxiety, followed by the Depression/anxiety group, and the ED and No‐diagnosis groups. Discussion: The presence of an eating disorder with comorbidity among women with food insecurity is associated with heightened shame. Given shame's status as a transdiagnostic predictor of psychopathology, it may serve as a putative mechanism underlying the relationship between food insecurity and eating disorder comorbidity. Public Significance Statement: Women with food insecurity and an ED were more likely to also screen positive for depression and/or anxiety than women with food insecurity and no ED. Overlap between ED, depression, and anxiety was associated with elevated shame, a harmful, maladaptive emotion with negative psychosocial consequences. [ABSTRACT FROM AUTHOR]

Objective: Obese women with polycystic ovary syndrome (PCOS) exhibit a hypercoagulable state, with the suggestion that this may be obesity‐driven rather than an intrinsic facet of PCOS; however, this has not yet been definitively determined since body mass index (BMI) is so highly correlated with PCOS. Therefore, only a study design where obesity, insulin resistance and inflammation are matched can answer this question. Design: This was a cohort study. Patients Weight and aged‐matched nonobese women with PCOS (n = 29) and control women (n = 29) were included. Measurements Plasma coagulation pathway protein levels were measured. Circulating levels of a panel of nine clotting proteins known to differ in obese women with PCOS were determined by Slow Off‐rate Modified Aptamer (SOMA)‐scan plasma protein measurement. Results: Women with PCOS showed a higher free androgen index (FAI) and anti‐Müllerian hormone, but measures of insulin resistance, and C reactive protein (as a marker of inflammation), did not differ between the nonobese women with PCOS and the control women. Seven pro‐coagulation proteins (plasminogen activator inhibitor‐1, fibrinogen, fibrinogen gamma chain, fibronectin, d‐dimer, P‐selectin and plasma kallikrein) and two anticoagulant proteins (vitamin K‐dependent protein‐S and heparin cofactor‐II) known to be elevated in obese women with PCOS did not differ from controls in this cohort. Conclusions: This novel data show that clotting system abnormalities do not contribute to the intrinsic mechanisms underlying PCOS in this nonobese noninsulin resistant population of women with PCOS matched for age and BMI, and without evidence of underlying inflammation, but rather the clotting factor changes are an epiphenomenon coincident with obesity; therefore, increased coagulability is unlikely in these nonobese PCOS women. [ABSTRACT FROM AUTHOR]

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Hereditary hypofibrinogenemia is a rare fibrinogen disorder characterised by decreased levels of fibrinogen. Pregnant women with hypofibrinogenemia are at risk of adverse obstetrical outcomes, depending on the fibrinogen level. Aim: We investigated how the physiological changes of hemostasis throughout the pregnancy impact the hemostatic balance in a woman with hereditary mild hypofibrinogenemia. Methods: Fibrin clot properties were analyzed by turbidimetry and scanning electron microscopy, clot weight and red blood cells retention were measured by whole clot contraction, and in vitro thrombin generation was assessed by calibrated automated thrombogram and ex vivo by TAT. Results: Throughout the pregnancy, the fibrinogen levels increased reaching normal values in the third trimester (activity 3.1 g/L, antigen 3.2 g/L). In parallel, the fibrin polymerisation increased, the fibrinolysis decreased, the fibrin clot network became denser with thicker fibrin fibers, and the fibrin clot weight and red blood cells retention increased, reaching control's value at the third trimester. Similarly, in vitro and ex vitro thrombin generation increased, reaching maximum values at the delivery. Conclusion: In this case of hereditary mild hypofibrinogenemia we observed a physiological increase of fibrinogen and thrombin generation. Future studies should focus on moderate and severe hypofibrinogenemia, to assess fibrinogen variation and the overall impact of increased TG on the hemostasis balance. [ABSTRACT FROM AUTHOR]

We identify the effects of greening vacant lots on nearby housing prices and show how neighborhood attributes matter to these outcomes. Using data from a longstanding program in Philadelphia, we find that prices for houses within 1,000 feet of a greened vacant lot rise by about 4%, consistent with the literature, with the effect size increasing over time. Using the extensive data available in Philadelphia, we show how these effects vary by the attributes of the neighborhood in which they occur, with larger effects in areas with a high share of vacant land and higher‐than‐average median household incomes, with peak responses estimated at 19% and 15%, respectively. We demonstrate the importance of sample selection bias adjustment for identification of the effect of vacant lot greening. [ABSTRACT FROM AUTHOR]

Overcrowding in healthcare environments (e.g., hospitals) has become a widely identified problem in today's healthcare. This research documents whether and how social crowding affects consumers' self‐perceived health risks in healthcare environments and its downstream effect. One pilot study (secondary data analysis), seven laboratory experiments, and a field survey (Study 6) demonstrated that social crowding increased individuals' self‐perceived health risks through a lack of control (Studies 1–6), thereby leading to overspending on the healthcare products (Study 5). Furthermore, the mediating process was moderated by choice and disease symptom severity (Studies 3 and 4). The findings of this research theoretically enrich our understanding of how social crowding interacts with individual disease symptoms and the services provided in the healthcare environment, and practically provide important implications for healthcare practitioners in managing consumers' health risks and consumption behavior. [ABSTRACT FROM AUTHOR]

This conceptual analysis contributes to extending the transformative potential of mindfulness for consumers and society by creating a mindfulness matrix that uncovers new linkages across previously siloed mindfulness literatures and by arguing that next‐generation mindfulness research and practice should draw on underexplored synergies between these. The paper makes three key contributions: First, it illustrates how a shift in understanding mainstream mindfulness from a predominate focus on the Self may create new opportunities for individual and collective wellbeing. Second, its mindfulness matrix offers an integrative mapping of relevant literatures to different motivations for engaging in mindfulness, suggesting opportunities for integration between diverse schools of thought. Finally, it argues that to broaden the scope of mindfulness to generate wisdom and transformative capacity in one and all, we need a stronger emphasis on understanding mindfulness as prosocial engagement. This offers new opportunities for research and interventions that promote consumer, organizational, and societal wellbeing. [ABSTRACT FROM AUTHOR]

Objective: There have been case reports of adverse events of hypoglossal nerve stimulator (HNS) implantation not seen in previous clinical trials, including pneumothorax and pleural effusion. The purpose of this study was to determine the rates of these complications and potential risk factors. Study Design: Retrospective case‐control study during 2014 to 2021. Setting: Twenty‐five health care organizations across the United States. Methods: The TriNetX Research Network was queried by using disease codes to retrospectively identify patients with obstructive sleep apnea who underwent HNS implantation. Rates of pneumothorax, pleural effusion, other complications, and need for revision/replacement or explant were determined. Results: We identified 1813 patients from 25 health care organizations who underwent HNS implantation. The average age was 60 years, and there were 68% males and 32% females. Of the cohort, 2.4% (n = 44 from 7 implant centers) experienced a pneumothorax, and 0.6% (n = 11) were diagnosed with a pleural effusion on the day of surgery. Patients who experienced pneumothorax were more likely to have a history of chronic lower respiratory diseases when compared with those who did not (odds ratio, 2.2; 95% CI, 1.1‐4.1; P =.02). Conclusion: The incidence of intraoperative pneumothorax and pleural effusion during HNS implantation may be greater than initially thought. Patients with chronic lower respiratory diseases may be at increased risk. This should be communicated with patients during the informed consent process. [ABSTRACT FROM AUTHOR]