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The present study aims to delineate the effects of family violence and parent-adolescent conflict on antisocial behavior exhibited by adolescents in the Chinese casino city of Macau. The social interaction perspective indicates the significance of coercive family processes in relation to adolescents' antisocial behavior, and the related moderating role of positive parenting behavior. How this process is experienced by Chinese Macau adolescents, who are influenced by traditional Chinese culture, is explored. This article examines the relationship of family violence and parent-adolescent conflict with adolescents' antisocial behavior in Macau. It also examines the possible moderating role of parental support in this relationship. Using a stratified proportional approach, a random sample of 1889 Grade 7 to Grade 12 students was taken from Macau high schools. The young people reported their neutral/positive behavior and delinquent behavior, family conflict, and emotional and instrumental support they received from parents. Multiple regression analyses suggest that family violence and parent-adolescent conflict are correlated with adolescent antisocial behavior. Moreover, both instrumental and emotional support from parents can moderate the effect of family conflict on adolescents' antisocial behavior. Parents providing instrumental and emotional support to Macau Chinese adolescents is negatively correlated with adolescent antisocial behavior in Macau. In view of the long and unstable working hours of parents working in a gambling city, social workers in Macau could develop more innovative programs to support parents in Macau.

Objective Methods Results Discussion Letters of recommendation (LORs) are an important part of pain medicine fellowship applications that may be subject to implicit bias by the letter's author. This study evaluated letters of recommendation for applications to pain medicine fellowships in the United States to characterize biases and differences among applicants over four application cycles.This was a retrospective single‐site cohort study. De‐identified LORs were collected from 2020 to 2023 from one institution. The Valence Aware Dictionary and sEntiment Reasoner (VADER) natural language processing package scored positive LOR sentiment. In addition, the deep learning tool, Empath, scored LORs for 15 sentiments. Wilcoxon rank‐sum and one‐way ANOVA tests compared scores between applicant demographics: gender, race, medical school type, residency specialty, and chief resident status, as well as letter writers' academic position.Nine hundred and sixty‐four applications were studied over four application cycles. Program directors wrote fewer words (p = 0.020) and less positively (p < 0.001) compared to department chairs and letter writers with neither position. Department chairs wrote with less “negative emotion” compared to both program directors and writers with neither position (p < 0.001). Anesthesiologist applicants received more letters highlighting “achievement” (p < 0.001) while PM&R applicants submitted letters with less “negative emotion” (p < 0.001) compared to other specialties. Chief residents' letters scored higher in “leader” sentiment (p < 0.001) and lower in “negative emotion” (p < 0.001).Linguistic content did not favor certain genders or races over others. However, disparities in LORs do exist depending on an applicant's specialty and chief resident status, as well as the academic status of the letter writer. [ABSTRACT FROM AUTHOR]

Introduction There are currently no published studies using patient reviews of pain physicians to quantitatively assess patient preferences for pain physician attributes. The aim of the present study was to use natural language processing to quantitatively analyze patient reviews of pain physicians by determining the effect of physician demographics and word frequency on positive review outcomes. Methods Using a peer-reviewed algorithm, online Healthgrades reviews of pain physicians practicing in the USA were scored according to their positive sentiment from -1 to 1. These sentiment scores and star ratings were used to compare physicians by age, gender and region of practice. Frequency analysis of words and bigrams was performed for all reviews. Results There were 15 101 reviews collected among 1275 pain physicians which showed male physicians received higher star ratings and review sentiment scores than female physicians. Pain physicians younger than 55 years received higher star ratings and sentiment scores than those of 55 years and older. Frequency analysis revealed that words most commonly used in the more positive patient reviews included 'care', 'professional', 'patient', 'help' and 'kind'; the words most commonly used in less positive reviews included 'pain', 'back', 'office', 'time' and 'years'. Conclusions Male and/or younger pain physicians receive more positive reviews. Patients highly rate pain physicians who are perceived as personable. Patients lowly rate physicians who are perceived as providing ineffective treatment of their pain as well as when they experience barriers to their access to care. [ABSTRACT FROM AUTHOR]

Introduction: Letters of recommendation (LORs) are a highly influential yet subjective and often enigmatic aspect of the residency application process. This study hypothesizes that LORs do contain valuable insights into applicants and can be used to predict outcomes. This pilot study utilizes natural language processing and machine learning (ML) models using LOR text to predict interview invitations for otolaryngology residency applicants. Methods: A total of 1642 LORs from the 2022–2023 application cycle were retrospectively retrieved from a single institution. LORs were preprocessed and vectorized using three different techniques to represent the text in a way that an ML model can understand written prose: CountVectorizer (CV), Term Frequency‐Inverse Document Frequency (TF‐IDF), and Word2Vec (WV). Then, the LORs were trained and tested on five ML models: Logistic Regression (LR), Naive Bayes (NB), Decision Tree (DT), Random Forest (RF), and Support Vector Machine (SVM). Results: Of the 337 applicants, 67 were interviewed and 270 were not interviewed. In total, 1642 LORs (26.7% interviewed) were analyzed. The two best‐performing ML models in predicting interview invitations were the TF‐IDF vectorized DT and CV vectorized DT models. Conclusion: This preliminary study revealed that ML models and vectorization combinations can provide better‐than‐chance predictions for interview invitations for otolaryngology residency applicants. The high‐performing ML models were able to classify meaningful information from the LORs to predict applicant interview invitation. The potential of an automated process to help predict an applicant's likelihood of obtaining an interview invitation could be a valuable tool for training programs in the future. Level of Evidence: N/A Laryngoscope, 134:4016–4022, 2024 [ABSTRACT FROM AUTHOR]

Objective: To develop a novel software method (AR2) for reducing muscle contamination of ictal scalp electroencephalogram (EEG), and validate this method on the basis of its performance in comparison to a commercially available software method (AR1) to accurately depict seizure-onset location. Methods: A blinded investigation used 23 EEG recordings of seizures from 8 patients. Each recording was uninterpretable with digital filtering because of muscle artifact and processed using AR1 and AR2 and reviewed by 26 EEG specialists. EEG readers assessed seizure-onset time, lateralization, and region, and specified confidence for each determination. The two methods were validated on the basis of the number of readers able to render assignments, confidence, the intra-class correlation (ICC), and agreement with other clinical findings. Results: Among the 23 seizures, two-thirds of the readers were able to delineate seizure-onset time in 10 of 23 using AR1, and 15 of 23 using AR2 (p

Key points This follow‐up dual‐institutional and longitudinal study further evaluated for underlying gender biases in LORs for rhinology fellowship. Explicit and implicit linguistic gender bias was found, heavily favoring male applicants [ABSTRACT FROM AUTHOR]

A 62-year-old man underwent an elephant trunk procedure followed by thoracic endovascular aortic repair (TEVAR). Computed tomography angiography-based models were built to quantify volume of the whole aorta and true and false lumens preoperatively, before TEVAR, after TEVAR, and at follow-up at 3, 6, and 12 months. With TEVAR, descending aortic true lumen volume increased by 54%, then increased additionally by 60% during 12 months. The descending aortic false lumen volume regressed continuously for 12 months following TEVAR, with the most rapid rate from 6 to 12 months at 16 cm3/month. TEVAR immediately increased true lumen volume and continued to remodel the true and false lumens throughout the following 12 months.

Tumor suppressor p53 plays an important role in mediating growth inhibition upon telomere dysfunction. Here, we show that loss of the p53 target gene cyclin-dependent kinase inhibitor 1A (CDKN1A, also known as p21(WAF1/CIP1)) increases apoptosis induction following telomerase inhibition in a variety of cancer cell lines and mouse xenografts. This effect is highly specific to p21, as loss of other checkpoint proteins and CDK inhibitors did not affect apoptosis. In telomerase, inhibited cell loss of p21 leads to E2F1- and p53-mediated transcriptional activation of p53-upregulated modulator of apoptosis, resulting in increased apoptosis. Combined genetic or pharmacological inhibition of telomerase and p21 synergistically suppresses tumor growth. Furthermore, we demonstrate that simultaneous inhibition of telomerase and p21 also suppresses growth of tumors containing mutant p53 following pharmacological restoration of p53 activity. Collectively, our results establish that inactivation of p21 leads to increased apoptosis upon telomerase inhibition and thus identify a genetic vulnerability that can be exploited to treat many human cancers containing either wild-type or mutant p53.

This article discusses a case report of a 64-year-old male with recurrent idiopathic orbital myositis (IOM). The patient initially responded to prednisone treatment but experienced a recurrence of symptoms. He then opted for Acthar Gel treatment, which resulted in symptomatic improvement but also caused an increase in blood pressure. The article highlights the lack of specific literature on Acthar Gel's effectiveness in treating IOM after corticosteroid therapy has failed, but notes its general efficacy in treating inflammation with fewer adverse effects. The article concludes that more data is needed to evaluate the epidemiological implications of treating IOM with Acthar Gel. [Extracted from the article]

Background: Patients increasingly use physician rating websites to evaluate and choose potential healthcare providers. A sentiment analysis and machine learning approach can uniquely analyse written prose to quantitatively describe patients' perspectives from interactions with their physicians. Methods: Online written reviews and star scores were analysed from Healthgrades.com using a natural language processing sentiment analysis package. Demographics of otolaryngologists were compared and a multivariable regression for individual words was performed. Results: This study analysed 18 546 online reviews of 1240 otolaryngologists across the USA. Younger otolaryngologists (aged less than 40 years) had higher sentiment and star scores compared with older otolaryngologists (p < 0.001). Male otolaryngologists had higher sentiment and star scores compared with female otolaryngologists (p < 0.001). 'Confident', 'kind', 'recommend' and 'comfortable' were words associated with positive reviews (p < 0.001). Conclusion: Positive bedside manner was strongly reflected in better reviews, and younger age and male gender of the otolaryngologist were associated with better sentiment and star scores. [ABSTRACT FROM AUTHOR]

Numerous eponymous surgical approaches are used in the treatment of upper extremity pathology, especially in the trauma setting. Knowledge of anatomy and planes is critical to maximize visualization, achieve anatomic reduction, and avoid iatrogenic injury to critical neurovascular structures. Understanding the history of these commonly used eponymous upper extremity approaches (Kaplan, Kocher, Boyd, Thompson, and Henry) provides a humanistic perspective of each of these surgeons' narratives, which shaped their description of anatomic approaches that have forever changed the course of hand and upper extremity surgeries, providing greater means and possibilities to treat our patients. [ABSTRACT FROM AUTHOR]