Search

This research investigates how self-esteem and loneliness affect the psychological well-being of Online Dating App Users in Bagumbayan, Bocaue, Bulacan, Philippines. Using a sequential exploratory design integrating qualitative and quantitative approaches, the study explores the experiences, challenges, coping strategies, and psychological attributes of 15 participants in the qualitative phase. The subsequent quantitative phase involves 200 respondents assessed through the Rosenberg Self-Esteem Scale, UCLA Loneliness Scale, and Psychological Well-being Scale. The findings reveal a complex landscape: Online Dating App Users exhibit moderate self-esteem and loneliness levels while displaying aboveaverage psychological well-being. Statistically, a moderate positive correlation exists between self-esteem and psychological well-being, alongside a low yet significant correlation between loneliness and psychological well-being. These insights underpin the formulation of the "Swipe Right, Swipe Left: The Realities of Online Dating Apps Program," which aims to empower users and foster emotionally healthy connections within digital dating platforms through workshops and seminars. This study provides crucial insights into the psychological dynamics of Online Dating App Users, offering implications for research and practical interventions promoting well-being in the digital dating sphere. [ABSTRACT FROM AUTHOR]

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with a significant impact on the quality of life of affected patients. This study aimed to correlate serum inflammatory markers with specific tools assessing quality of life, emotional well-being, and loneliness, such as the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), and the UCLA Loneliness Scale. Methods: A pilot observational study including 37 patients with HS was conducted. Inflammatory serum markers, including C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR), were evaluated at baseline, 3 months, and 6 months later. Psychometric scores were also evaluated at the same study intervals. Results: DLQI was correlated with ESR at baseline (Spearman's rho = 0.35, p = 0.03), indicating that poorer quality of life is associated with changes in this serum marker. Disease activity, as reflected by inflammatory markers, was associated with significant psychological burden. Specifically, a worse DLQI score was associated with higher ESR (estimate β = 0.14, 95% confidence interval [CI]: 0.05–0.22; p = 0.001) and higher CRP level (estimate β = 0.25, 95% CI: 0.02–0.48; p = 0.02). Similarly, a worse UCLA score was associated with higher ESR (estimate β = 0.11, 95% CI: 0.02–0.20, p = 0.01). Conclusions: Our study results underline the close relation between systemic inflammatory markers and clinical severity together with psychological burden in HS patients, as indicated by the significant association that was revealed between ESR/CRP and poorer psychometric scores. However, further research is warranted to validate these findings. [ABSTRACT FROM AUTHOR]

Gastrointestinal (GI) tract involvement affects up to 90% of Systemic sclerosis (SSc) patients. The presence of GI symptoms is assessed by the University of California, Los Angeles, and Scleroderma Clinical Trials Consortium Gastrointestinal Scale (UCLA SCTC GIT 2.0). Microbial translocation (MT) is reported in SSc patients consequently to increased intestinal permeability due to intestinal damage (ID) and dysbiosis. Aim of this study was to assess circulating levels of LBP and EndoCab IgM (markers of MT), IL-6 (marker of inflammation), I-FABP and Zonulin (markers of ID) in a cohort of SSc patients and healthy controls (HC). Moreover, we aimed to correlate these parameters with severity of GI symptoms. UCLA SCTC GIT 2.0 questionnaire was administered to 60 consecutive SSc patients. Markers of MT, inflammation and ID were evaluated in SSc patients and HC. SSc patients had higher median value of markers of MT, inflammation and ID than HC. The logistic regression analysis showed LBP as the only variable associated with an UCLA total score "moderate-to-very severe" [OR 1.001 (CI 95%: 1.001–1.002), p < 0.001]. The logistic regression analysis showed LBP [OR 1.002 (CI 95%: 1.001–1.003), p < 0.01] and disease duration [OR 1.242 (CI 95%: 1.023–1.506), p < 0.05] as variables associated with UCLA distension/bloating "moderate-to-very severe". The logistic regression analysis showed LBP as the only variable associated with UCLA diarrhea "moderate-to-very severe" [OR 1.002 (CI 95%: 1.001–1.003), p < 0.01]. SSc patients with dysregulation gut mucosal integrity expressed by high levels of MT and ID biomarkers had more severe GI symptoms. [ABSTRACT FROM AUTHOR]

Genetic risk modeling for dementia offers significant benefits, but studies based on real-world data, particularly for underrepresented populations, are limited. We employ an Elastic Net model for dementia risk prediction using single-nucleotide polymorphisms prioritized by functional genomic data from multiple neurodegenerative disease genome-wide association studies. We compare this model with APOE and polygenic risk score models across genetic ancestry groups (Hispanic Latino American sample: 610 patients with 126 cases; African American sample: 440 patients with 84 cases; East Asian American sample: 673 patients with 75 cases), using electronic health records from UCLA Health for discovery and the All of Us cohort for validation. Our model significantly outperforms other models across multiple ancestries, improving the area-under-precision-recall curve by 31–84% (Wilcoxon signed-rank test p-value <0.05) and the area-under-the-receiver-operating characteristic by 11–17% (DeLong test p-value <0.05) compared to the APOE and the polygenic risk score models. We identify shared and ancestry-specific risk genes and biological pathways, reinforcing and adding to existing knowledge. Our study highlights the benefits of integrating functional mapping, multiple neurodegenerative diseases, and machine learning for genetic risk models in diverse populations. Our findings hold potential for refining precision medicine strategies in dementia diagnosis. Genetic risk modeling of dementia with Elastic Net, using functional genomic data from multiple neurodegenerative disease GWASs shows significant improvements across diverse populations. [ABSTRACT FROM AUTHOR]

Background: TheWagner Cone Prosthesis was designed to address complex femoral deformities during total hip arthroplasty (THA), but its mid-term component survivorship and functional outcomes remain undetermined. The objectives of this study were to determine the implant survivorship, patient satisfaction, functional outcomes, osseointegration as seen radiographically, implant subsidence, and complications of THA using the Wagner Cone Prosthesis stem at intermediate-term follow-up. Methods: This study involved 302 patients with proximal femoral deformities, including developmental hip dysplasia and Legg-Calv'e-Perthes disease, who underwent a total of 320 primary THAs using the Wagner Cone Prosthesis. The average age at the time of surgery was 49.4 ± 14.5 years (range, 18.8 to 85.6 years). Patient satisfaction was recorded using a self-administered questionnaire assessing satisfaction in 4 domains. The University of California at Los Angeles (UCLA) activity score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Oxford Hip Score (OHS), the Forgotten Joint Score (FJS), radiographic outcomes, and complications were recorded. The mean follow-up time was 10.1 years (range, 5.2 to 15.5 years). Results: Survivorship of the Wagner Cone Prosthesis was 98.7% (95% confidence interval [CI]: 97.2% to 100%) with stem revision as the end point and 95.8% (95% CI: 93.5% to 98.2%) with reoperation for any reason as the end point at 10 years postoperatively. In total, 3 stems were revised: 2 for infection and 1 for chronic hip dislocation. The median patient satisfaction score was 95 (interquartile range [IQR], 80 to 100), median UCLA score was 6 (IQR, 6 to 7), median WOMAC score was 18 (IQR, 16 to 22), median OHS was 40 (IQR, 36 to 47), and median FJS was 80 (IQR, 76 to 88) at the time of final follow-up. All Wagner Cone stems that were not revised showed radiographic evidence of osseointegration, with a mean stem subsidence of 0.9 ± 0.8 mm at the most recent follow-up. Conclusions: The use of the Wagner Cone Prosthesis stem in patients with complex femoral anatomy undergoing primary THA is associated with excellent component survivorship, high levels of patient satisfaction, good functional outcomes, and reliable osseointegration with minimal stem subsidence as seen on radiographs at intermediate-term follow-up. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to compare clinical scores and imaging outcomes of bony Bankart lesions that underwent single‐point and modified double‐pulley fixation after at least 2 years of follow‐up. Methods: Patients who underwent surgery to treat bony Bankart injuries were included and divided into groups A and B. A total of 69 patients were included (32 in group A and 37 in group B). Patients in group A underwent arthroscopic modified double‐pulley fixation and patients in group B underwent arthroscopic single‐point fixation. Three‐dimensional computed tomography (3D‐CT) was used to assess glenoid reduction one day after surgery. Postoperative bony union was assessed using 3D‐CT and multiplanar reconstruction images 6 months after surgery. Constant–Murley, Rowe rating system, visual analogue scale and University of California at Los Angeles and American Shoulder and Elbow Surgeons scores were recorded before and after surgery. Results: In terms of imaging measurements, there was no significant group difference in the preoperative size of the glenoid defect, the size of the bony fragment or the expected postoperative size of the glenoid defect. The sizes of the actual postoperative glenoid defects differed significantly between the groups (p = 0.027), as did the absolute difference between the expected and actual glenoid defect sizes (p < 0.001). At 6 months postoperatively, 50.0% of group A patients and 24.3% of group B patients exhibited complete bony union (p = 0.027); the rates of partial union were 37.5% and 56.8%, respectively. At the final follow‐up, all clinical scores were significantly better than the preoperative scores (all p < 0.05), with no significant group differences (not significant). Conclusions: The use of the modified double‐pulley technique with two anchors to treat bony Bankart injuries provides a better reduction of bone fragments than single‐point fixation with two anchors and was associated with a higher rate of early bone union. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Fetal echocardiography may be performed because of noncardiac indications (the pregnancy is identified as high risk for fetal cardiac disease), or because of fetal cardiac indications (abnormal fetal heart at the time of a screening ultrasound). Considering recent improvements in fetal cardiac screening over the past decade, the goal of this single institution study was to reconsider the importance of performing fetal echocardiography purely for screening (noncardiac) indications. We performed a retrospective analysis to review screening and fetal cardiac indications and fetal cardiac findings for fetal echocardiograms performed at UCLA between 2015 and 2019. Fetal heart disease was identified in 391 (15%) of 2592 pregnancies in this study. Among these 391 cases, 227 (58%) occurred in low-risk pregnancies (without screening indications). While 79% of the cases of fetal cardiac disease were referred with fetal cardiac indications, 21% of the cases were referred with exclusively screening indications. Fetal cardiac disease was discovered on fetal echocardiograms in 4% of pregnancies referred for exclusively screening indications, but the frequency of fetal cardiac disease following normal fetal cardiac screening has decreased from 6% in 2015 to 3% in 2019. In our population, we recommend continued referral for fetal echocardiography for pregnancies identified as high risk for CHD. However, as fetal cardiac screening continues to improve, referral for fetal echocardiography following normal fetal cardiac screening will have diminishing value and yield. [ABSTRACT FROM AUTHOR]

Background: The calcar of the proximal humerus is a fundamental structure for medial humeral column support. This study aimed to assess the outcome of osteosynthesis across cases of unstable proximal humerus fractures (PHFs) with medial calcar comminution, following treatment with a PHILOS locking plate and medial support screw (MSS). Methods: Between January 2010 and December 2018, we retrospectively analyzed the outcomes of 121 cases of osteosynthesis for PHFs with medial column disruption. For the medial support, at least one oblique screw was inserted within 5 mm of the subchondral bone in the inferomedial quadrant of the humeral head. All patients were categorized into two groups: 26 patients in the single MSS group, and 95 in the multiple MSS group. Follow-up after at least an year involved clinical and radiographic outcome evaluations, and correspondingly measuring the Constant-Murley score, University of California, Los Angeles (UCLA) shoulder scale, pain visual analogue scale (VAS), major complications, neck-shaft angle (NSA), humeral head height (HHH), and the eventual time to bone union. Risk factors for the major complications were assessed by multivariate logistic regression analyses. Results: The cohort's mean age was 64.4 ± 15.4 years, and the mean follow-up duration was 19.5 ± 7.6 months. At the final follow-up, between the single MSS and multiple MSS groups, no significant differences in the Constant-Murley score (p = 0.367), UCLA score (p = 0.558), VAS (p = 0.571), time to bone union (p = 0.621), NSA loss (p = 0.424), and HHH loss (p = 0.364) were observed. The incidence of complications (p = 0.446) based on the number of MSS were not significantly different. The initial insufficient reduction after surgery (of NSA < 125°) was found to be a significant risk factor for post-surgical complications. Conclusions: To treat unstable PHFs, the use of at least one MSS along with a locking plate system is sufficient to achieve satisfactory outcomes. Successful operative treatment using a locking plate for PHF treatment is inherent in anatomical fracture reduction, coupled with medial column support. [ABSTRACT FROM AUTHOR]

BackgroundObjectivesMethodsResultsConclusionQuality of life, social support, and loneliness are common problems among older adults in China , but the relationships among these issues have not been clearly identified.The present study aimed to determine the relationships among Quality of life, social support, and loneliness.A total of 560 older adults were randomly selected , the social support rating scale (SSRS), University of California at Los Angeles (UCLA) loneliness scale, and Short-Form 12 (SF-12) were employed to measure their degree of social support, level of loneliness, and quality of life.The average physical component summary (PCS) score was 49.97±16.33, and the average mental component summary (MCS) score was 47.26±11.49. Loneliness plays a partial mediating role between social support and quality of life.Loneliness and a lack of social support will affect the quality of life of the older adults. Thus, we need to urgently strengthen the care and support for the older adults and alleviate the loneliness of the older adults in the community. [ABSTRACT FROM AUTHOR]

As the world comes to terms with the realities surrounding COVID-19, media sources have likened quarantine experiences to that of incarceration. Individuals who have experienced incarceration and individuals who have experienced the incarceration of loved ones (LO), have already experienced periods of time apart. We are exploring the experiences of individuals who have some experience with incarceration; whether they were personally incarcerated, or they experienced the incarceration of a LO. Utilizing snowball sampling, a mixed methods survey was circulated on social media. Survey items included demographic information, questions about incarceration, issues related to COVID-19 quarantines, and the UCLA Loneliness Scale. Results follow similar patterns to previous studies. However, this unique population argues that COVID-19 quarantines are not the same as periods of incarceration. Similarly, future research and community agencies need to examine the unique needs of those who have experienced the incarceration of a loved one. [ABSTRACT FROM AUTHOR]

The integrity of a pressure vessel (PRV) is affected by the decay heat of the molten pool in the lower head, so it is very important to study the natural convection heat transmission in the lower head. Scholars from all over the world have carried out a lot of experimental studies and calculations to determine the convection mechanism and heat transmission characteristics of the molten pool. Most of them were based on the empirical formula of convective heat transmission on the wall of a hemispherical molten pool based on two-dimensional slice experiments and simulation calculations. In this study, FLUENT 2021R1 software was used to simulate the three-dimensional convective heat transmission process of the hemispherical molten pool, and the temperature, velocity and wall heat transmission coefficients of the flow field were analyzed. The results were in good agreement with experimental data from UCLA (University of California, Los Angeles). Through research on the heat transmission of the lower head, the results showed that in the region where the wall angle was θ between approximately 72 and 90 degrees, heat transmission coefficients had larger fluctuations, and a more reasonable empirical relation was proposed. Comparing between the simulation results of CFD and the two-dimensional empirical formula, it was found that the latter one was smaller under the same θ angle condition. Finally, the convection phenomena of different external temperatures were simulated, and the main factors affecting the flow field by temperature were analyzed. [ABSTRACT FROM AUTHOR]

This study aims to understand the mechanisms contributing to the elevated risk of depression among sexual minority older adults compared to heterosexuals. Specifically, the role of loneliness as a potential mediator is investigated to inform targeted interventions for preventing depression in sexual minority populations. Data from the English Longitudinal Study of Ageing, focusing on adults aged over 50, were analysed. Sexual orientation (sexual minority or heterosexual) and loneliness scores (UCLA scale) were assessed at wave six (2010−2011), while depressive symptoms (CES D) were assessed at wave seven (2013–14). Linear regression models and mediation analyses, using g-computation formula and adjusted for confounders, were conducted. The sample included 6794 participants, with 478 (7.0 %) identifying as sexual minorities. After adjustments, sexual minorities scored higher on depressive symptoms at wave seven (mean difference): 0.23, 95 % CI 0.07 to 0.39) and loneliness at wave six (MD: 0.27, 95 % CI 0.08 to 0.46). Loneliness was positively associated with depressive symptoms (coefficient: 0.27, 95 % CI 0.26 to 0.29). In mediation analyses, loneliness explained 15 % of the association between sexual orientation and subsequent depressive symptoms. The dataset used sexual behaviour rather than desire and identity, potentially skewing representation of sexual minorities. Additionally, transgender older adults were not included due to limited gender diversity reported within the ELSA dataset. Loneliness appears to be a significant modifiable mechanism contributing to the heightened risk of depressive symptoms in sexual minority older adults compared with their heterosexual counterparts. • Being a sexual minority older adult is associated with future depressive symptoms. • Similarly, being a sexual minority older adult is associated with loneliness. • Loneliness acts as a mediator between sexual minority older adults and depression. • Reducing loneliness may reduce depressive symptoms. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to evaluate how the initial diagnostic tool used—specifically ultrasound (US) or magnetic resonance imaging (MRI)—for diagnosing proximal hamstring avulsion injury affects the delay before surgery and, secondarily, the outcomes of these injuries. Methods: This was a retrospective analysis of prospectively collected data (2012–2020). It targeted patients primarily treated for proximal hamstring avulsion injury. It included all patients with a preoperative US and/or MRI. Patients were divided into two groups based on the initial diagnostic tool used (US‐first vs. MRI‐first groups). The primary outcomes measure was the time from initial injury to surgical intervention (surgical delay). The secondary outcomes were the Parisien Hamstring Avulsion Score, as well as the activity level as measured by the University of California, Los Angeles (UCLA) Activity Scale and Tegner Activity Scale. Results: The analysis included 392 patients with a mean age of 43.8 ± 13.6 years for the MRI‐first group and 47.6 ± 12.0 years for US‐first group. Patients in the MRI‐first group had a significantly shorter median time from injury to surgery of 20.0 days (interquartile range [IQR]: 11.0–61.0) compared to 30 days (IQR: 18–74) in the US‐first group. At the final follow‐up (4.2 ± 2.2 years for the MRI‐first group and 5.1 ± 1.9 years for the US‐first group), the MRI‐first group had significantly higher mean Tegner Activity Scale and UCLA scores than the US‐first group: The Tegner Activity Scale was median 5 (IQR: 3–7) for the MRI‐first group versus median 4 (IQR: 2–6) for the US‐first group (p < 0.05). The UCLA scores were 7.9 ± 2.4 for the MRI‐first group compared to 7.3 ± 2.4 for the US‐first group (p < 0.05). This difference was more pronounced when comparing the MRI‐first group with the patient‐false negative initial ultrasound. No difference was found regarding the Parisien Hamstring Avulsion Score. Conclusion: MRI as the initial diagnostic tool for proximal hamstring avulsion injury is associated with a shorter time to surgery and better postoperative outcomes in Tegner Activity Scale and UCLA scores, compared to US. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the clinical effect of modified anterolateral and traditional acromioplasty in arthroscopic rotator cuff repair. Methods: The clinical data of 92 patients with total rotator cuff tears admitted to the Department of Joint Surgery of Jinhua Central Hospital from January 2016 to December 2019 were retrospectively analyzed. Among them, 42 patients underwent traditional acromioplasty during arthroscopic rotator cuff repair, and 50 underwent modified anterolateral acromioplasty. Patients were evaluated for preoperative and postoperative shoulder function, pain and critical shoulder angle, and incidence of rotator cuff re-tear at 12 months postoperatively. Results: The preoperative general data of patients in the classic and modified anterolateral acromioplasty groups did not differ significantly (P > 0.05) and were comparable. The UCLA, ASES, and Constant shoulder joint scores were significantly improved in both groups. The VAS score was significantly decreased at 12 months postoperative than preoperative, with a statistically significant difference (P ≤ 0.05). Shoulder function and pain scores did not differ significantly between the two groups at 12 months postoperatively (P > 0.05). The CSA did not differ significantly between preoperative and postoperative 12 months in the traditional acromioplasty group (P > 0.05). However, 12 months postoperative CSA in the modified anterolateral acromioplasty group was significantly smaller than the preoperative CSA, with a statistically significant difference (P ≤ 0.05). The rates of rotator cuff re-tears were 16.67% (7/42) and 4% (2/50) in the two groups at 12 months postoperatively, respectively, with statistically significant differences (P ≤ 0.05). Conclusions: Traditional and modified anterolateral acromioplasty while treating total rotator cuff tears using arthroscopic rotator cuff repair significantly improves shoulder joint function. However, modified anterolateral acromioplasty significantly reduced the CSA value and decreased the incidence of rotator cuff re-tears. [ABSTRACT FROM AUTHOR]

This paper introduces a novel one-dimensional convolutional neural network that utilizes clinical data to accurately detect choledocholithiasis, where gallstones obstruct the common bile duct. Swift and precise detection of this condition is critical to preventing severe complications, such as biliary colic, jaundice, and pancreatitis. This cutting-edge model was rigorously compared with other machine learning methods commonly used in similar problems, such as logistic regression, linear discriminant analysis, and a state-of-the-art random forest, using a dataset derived from endoscopic retrograde cholangiopancreatography scans performed at Olive View–University of California, Los Angeles Medical Center. The one-dimensional convolutional neural network model demonstrated exceptional performance, achieving 90.77% accuracy and 92.86% specificity, with an area under the curve of 0.9270. While the paper acknowledges potential areas for improvement, it emphasizes the effectiveness of the one-dimensional convolutional neural network architecture. The results suggest that this one-dimensional convolutional neural network approach could serve as a plausible alternative to endoscopic retrograde cholangiopancreatography, considering its disadvantages, such as the need for specialized equipment and skilled personnel and the risk of postoperative complications. The potential of the one-dimensional convolutional neural network model to significantly advance the clinical diagnosis of this gallstone-related condition is notable, offering a less invasive, potentially safer, and more accessible alternative. [ABSTRACT FROM AUTHOR]

Background: Colon capsule endoscopy (CCE) has gained momentum as an alternative modality for the investigation of the lower gastrointestinal tract. Of the few challenges that remain, the comparison and – eventually – matching of polyps at different timestamps leads to the potential for double reporting and can contribute to false-positive findings and inaccuracies. With the impending artificial intelligence integration, the risk of double reporting the same polyp due to the lack of information on spatial orientation underscores the necessity for establishing criteria for polyp matching. Objectives: This RAND/University of California, Los Angeles (modified Delphi) process aims to identify the key factors or components used to match polyps within a CCE video. This involves exploring the attributes of each factor to create comprehensive polyp-matching criteria based on international expert consensus. Design: A systematic qualitative study using surveys. Methods: A panel of 11 international CCE experts convened to assess a survey comprised of 60 statements. Participants anonymously rated statement appropriateness on a 1–9 scale (1–3: inappropriate, 4–6: uncertain and 7–9: appropriate). Following a virtual group discussion of the Round 1 results, a Round 2 survey was developed and completed before the final analysis. Results: The factors that were agreed to be essential for polyp matching include (1) timestamp, (2) polyp localization, (3) polyp vascular pattern, (4) polyp size, (5) time interval of the polyp appearance between the green and yellow camera, (6) surrounding tissue, (7) polyp morphology and (8) polyp surface and contour. When five or more factors are satisfied, it was agreed that the comparing polyps are likely the same polyp. Conclusion: This study has established the first complete criteria for polyp matching in CCE. While it might not provide a definitive solution for matching difficult, small and common polyps, these criteria serve as a framework to guide and facilitate the process of polyp-matching. Plain language summary: Creating criteria and standards for matching polyps (abnormal growth in the bowels) on colon capsule video analysis: an international expert agreement using the RAND (modified Delphi process) process Background: Doctors often use colon capsule endoscopy (CCE), a high-tech capsule with two cameras, to record and check for diseases in the small and large bowels as the capsule travels through the intestines. One of the most common conditions in the large bowel is polyps, which are abnormal growths in the lining of the bowel. Comparing and matching polyps in the same video from the capsule can be tricky as they look very similar, leading to the possibility of incorrectly reporting the same polyp twice or more. This can lead to wrong results and inaccuracies. The literature did not have any criteria or standards for matching polyps in CCE before. Aim: Using the RAND/UCLA (modified Delphi) process, this study aims to identify the key factors or components used to match polyps within a CCE video. The goal is to explore each factor and create complete criteria for polyp matching based on the agreement from international experts. Method: A group of 11 international CCE experts came together to evaluate a survey with 60 statements. They anonymously rated each statement on a scale from 1 to 9 (1-3: inappropriate, 4-6: uncertain, and 7-9: appropriate). After discussing the Round 1 results virtually, a Round 2 survey with the same but revised questions was created and completed before the final analysis of their agreement. Results: The main factors for matching polyps are 1) the timing when the polyp was seen, 2) where it is in the bowel, 3) its blood vessel pattern, 4) size, 5) the timing of its appearance between cameras, 6) surrounding tissue features, 7) its shape, and 8) surface features. If five or more of these factors match, the compared polyps are likely the same. Conclusion: This study establishes the first complete criteria for matching polyps in CCE. While it may not provide a definitive solution for matching challenging and small polyps, these criteria serve as a guide to help and make the process of polyp matching easier. [ABSTRACT FROM AUTHOR]

Background: Meniscectomy, whether partial or total, is a common knee surgery, but it considerably increases the risk of knee osteoarthritis (OA). Lateral meniscectomy has more severe consequences than medial meniscectomy, leading to faster OA progression and worse clinical outcomes. Unicompartmental knee arthroplasty (UKA) is a suitable treatment option for lateral OA and has demonstrated better outcomes than total knee arthroplasty (TKA). The aims of this study were to evaluate the clinical and functional results, OA progression in the medial compartment, and implant survivorship following lateral UKA in patients with OA secondary to lateral meniscectomy and to compare these outcomes with those of patients who underwent lateral UKA for primary lateral OA. Methods: Between 2001 and 2017, 214 lateral UKAs were performed. Of these, 42 were performed for OA secondary to lateral meniscectomy. The control group was composed of patients who underwent lateral UKA for primary lateral OA and was formed through a 1:1 case-control matching process based on sex, age, body mass index, and operation date. The outcomes that were studied included range of motion, Knee Society Score, University of California Los Angeles (UCLA) Activity Score, Tegner Activity Scale, Forgotten Joint Score, visual analog scale for pain, OA progression in the medial compartment, and implant survivorship. Results: At a mean follow-up of 10.2 years, both groups demonstrated significant improvements (p < 0.01) after lateral UKA in all clinical and functional scores except the UCLA Activity Score and Tegner Activity Scale. No significant differences in clinical and functional scores were found between the groups. However, patients with OA secondary to meniscectomy exhibited significantly less OA progression in the medial compartment (p = 0.035) and higher 10-year implant survival (97.6% versus 83.3%). Conclusions: Lateral UKA is an effective treatment option for OA secondary to lateral meniscectomy, providing excellent functional outcomes and survivorship. Patients with post-meniscectomy OA exhibited less OA progression in the medial compartment than patients with primary OA and, consequently, had better 10-year implant survivorship. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

In South Korea, the proportion of adults experiencing severe loneliness has been increasing rapidly. Accordingly, this study examines the elements of loneliness experienced by Korean adults and investigates their structural relevance using concept mapping. Korean adults (47) were recruited for individual in-depth interviews based on their scores on the UCLA Loneliness Scale. The interviews yielded 80 unique statements, which were then evaluated using multidimensional scaling and a hierarchical cluster analysis. A cluster map of loneliness was derived, with three clusters: (1) emotional distress due to the actual or anticipated absence of connection in relationships, (2) emotional distance from oneself or from others in a relationship, and (3) powerlessness and emptiness due to being directionless. Two dimensions distinguished these clusters: the lack of a sense of connection or self-assurance, and an inward or outward focus. These findings reveal that loneliness encompasses more than unmet relational needs; it also involves self-attentional focus, indicating a need to reconceptualize the notion of loneliness. The study's implications extend to counseling theory and practices by highlighting the importance of addressing both relational connections and self-perceptions in interventions for loneliness. By expanding the understanding of loneliness through empirical data, this research provides a more comprehensive framework for addressing loneliness. [ABSTRACT FROM AUTHOR]

This qualitative study seeks to comprehend the perception and experience of loneliness among young adults aged 18 to 25, employing the UCLA Scale of Loneliness Version 3 for screening and conducting semi-structured interviews to gain an in-depth understanding. Participants' experiences unveil a nuanced understanding of loneliness, emphasizing the quality of social connections. Loneliness is intricately depicted as an emotional state characterized by emptiness, sadness, and mental struggles, with discernible impacts on physical well-being. Causes encompass the absence of strong bonds, past negative experiences, and situational factors. Coping mechanisms range from engaging in hobbies and digital interactions to sharing emotions and intentional avoidance. Implications underscore the need for targeted interventions recognizing diverse coping strategies, and fostering genuine relationships to alleviate loneliness. Future research should strive for broader samples and cultural diversity to enhance global insights into young adult loneliness. [ABSTRACT FROM AUTHOR]

Background: Epidemiological data reveal that 45% of persons with multiple sclerosis (PwMS) in France are more than 50 years. This population more than 50 is more susceptible to cancer, and this risk may be increased by frequent use of immunosuppressive drugs. Consequently, concerns have arisen about the potential increased risk of cancer in PwMS and how patients should be screened and managed in terms of cancer risk. Objective: To develop evidence-based recommendations to manage the coexistence of cancer and multiple sclerosis (MS). Methods: The French Group for Recommendations in MS collected articles from PubMed and university databases covering the period January 1975 through June 2022. The RAND/UCLA method was employed to achieve formal consensus. MS experts comprehensively reviewed the full-text articles and developed the initial recommendations. A group of multidisciplinary health care specialists then validated the final proposal. Results: Five key questions were addressed, encompassing various topics such as cancer screening before or after initiating a disease-modifying therapy (DMT), appropriate management of MS in the context of cancer, recommended follow-up for cancer in patients receiving a DMT, and the potential reintroduction of a DMT after initial cancer treatment. A strong consensus was reached for all 31 recommendations. Conclusion: These recommendations propose a strategic approach to managing cancer risk in PwMS. [ABSTRACT FROM AUTHOR]

The article discusses the 2023 California Law Review Symposium, titled "Section 1983 and Police Use of Force: Building a Civil Justice Framework," that was held at the University of California, Los Angeles (UCLA) School of Law in 2023. Topics discussed include the effectiveness and limitations of civil rights lawsuits and 1983 as remedies for police violations. Notable attendees and contributors include Peter Bibring, Devon Carbado and Adam Davidson.

In the present study we report the relationship among MRI-based skull and cervical spine morphometric measures as well as symptom severity (disability—as measured by Oswestry Head and Neck Pain Scale and social isolation—as measured by the UCLA Loneliness scale) on biomarkers of allostatic load using estrogen, interleukin-6, C-reactive protein, and cortisol in a sample of 46 CMI patients. Correlational analyses showed that McRae line length was negatively associated with interleukin-6 and C-reactive protein levels, and Analysis of Variance (ANOVA) showed joint effects of morphometric measures (McRae line length, anterior CSF space) and symptom severity (disability and loneliness) on estrogen and intereukin-6 levels. These results are consistent with allostatic load. That is, when the combination of CSF crowding and self-report symptom (disability and loneliness) severity exceed the capacity of biological resilience factors, then biomarkers such as neuroprotective estrogen levels drop, rather than rise, with increasing symptom severity. [ABSTRACT FROM AUTHOR]

Irritability, marked by diminished frustration tolerance, holds significant implications for youth mental health treatment. Despite prior research on irritability trajectories, understanding of individual differences during adolescence remains limited. This study examines the stability and trajectory of irritability across ages 12–18, investigating associations with psychopathology and functioning at age 18. A community sample of families with 3-year-old children (N = 518) was recruited via commercial mailing lists. Irritability was assessed at ages 12, 15, and 18 using the Affective Reactivity Index. Psychopathology at age 18 was evaluated with the Kiddie Schedule for Affective Disorders and Schizophrenia, and functioning was assessed through the UCLA Life Stress Interview. Measurement invariance analyses and latent growth curve modeling were conducted within a structural equation modeling (SEM) framework. Configural, metric, and scalar invariance models were supported. Elevated irritability at age 12 predicted adverse outcomes at age 18, including increased psychotropic medication use, mental health treatment, suicidal ideation, self-injury, and psychiatric disorders. Importantly, these associations persisted even after accounting for corresponding variables at age 12. The trajectory of irritability during early adolescence significantly predicted heightened risks for various outcomes at age 18, including suicidal ideation, depression, anxiety, disruptive behavior disorders, and impaired interpersonal functioning. Limitations include using only youth-reported data at age 18, limited generalizability from a mostly White, middle-class sample, and insufficient exploration of the broader developmental trajectory of irritability. Nevertheless, the findings emphasize the crucial role of irritability's trajectory in influencing various psychopathological and functional outcomes in late adolescence. • This study established full measurement invariance for youth-reported irritability using the ARI across adolescence. • Irritability in adolescence varied widely in both initial levels and rates of change. • Age 12 irritability predicts multiple negative outcomes by age 18, including depression, anxiety, and impairment. • Early adolescent irritability signals late adolescent problems, urging early intervention. [ABSTRACT FROM AUTHOR]

Introduction: The etiology of esophageal squamous papilloma (ESP) is largely unknown. Previous studies have shown a variable association with human papillomavirus (HPV) with conflicting data. The aim of this study was to further investigate the possible association of HPV in our ESP series using RNA in-situ hybridization (ISH) and compare study groups from the United States of America and China. Methods: Demographic and clinical data of patients with ESP were retrieved from the University of California Los Angeles (UCLA) (1/2016-3/2019) and Peking Union Medical College Hospital (PUMCH) (9/2014-3/2019) pathology databases. Hematoxylin and eosin slides were reexamined. Confirmed cases were examined by high- and low-risk HPV RNA ISH. Results: For the UCLA cohort, 13 429 upper endoscopies were performed and 78 biopsies from 72 patients were identified as ESP (F:M = 45:27, 66.7% > 45 years). Seventy-four (94.9%) biopsies were designated as polyps or nodules and 46.6% were located in the mid-esophagus. Other abnormal findings included gastroesophageal reflux disease (48.6%), hiatal hernia (38.9%), and esophagitis (36.1%). For the PUMCH cohort, 63 754 upper endoscopies were performed and 73 biopsies from 71 patients were identified as ESP (F:M = 48:23, 71.8% > 45 years). Sixty-four (87.7%) biopsies were designated as polyps or nodules and 57.5% were located in the mid-esophagus. Other abnormal findings included esophagitis (19.7%), and hiatal hernia (8.5%). No features of conventional cytologic dysplasia or viral cytopathic change were found. None of the cases was associated with squamous cell carcinoma, and none showed positive HPV RNA ISH results. Conclusions: No association was found between ESP and active HPV infection in our 2 cohorts. Other etiopathogenetic mechanisms, such as aging, might contribute to the development of these innocent lesions. [ABSTRACT FROM AUTHOR]

Crizanlizumab, a monoclonal antibody against P-selectin, has been shown to reduce vaso-occlusive crises (VOCs) compared to placebo in patients ≥ 16 years with sickle cell disease (SCD). However, there have been rare reports of patients experiencing severe pain and subsequent complications within 24 hours of crizanlizumab infusions. These events are defined as infusion-related reactions (IRRs). Informed by current literature and clinical experience, a group of content experts developed clinical guidelines for the management of IRRs in patients with SCD. We used the RAND/University of California, Los Angeles (UCLA) modified Delphi panel method, a valid, reproducible technique for achieving consensus. We present our recommendations for managing IRRs, which depend on patient characteristics including: prior history of IRRs to other monoclonal antibodies or medications, changes to crizanlizumab infusion rate and patient monitoring, pain severity relative to patient's typical SCD crises, and severe allergic symptoms. These recommendations outline how to evaluate and manage IRRs in patients receiving crizanlizumab. Future research should validate this guidance using clinical data and identify patients at risk for these IRRs. [ABSTRACT FROM AUTHOR]

Background Loneliness is a global issue, and primary care physicians play an important role in assessing and intervening with loneliness. This study aimed to examine the association between having a usual source of care (USC) or a good quality of primary care, and loneliness. Methods This cross-sectional study was conducted in Japan in 2022. A total of 6,000 residents were randomly sampled from the general population, aged 20–74 years. The outcome was the total score of the University of California, Los Angeles (UCLA) 3-item loneliness scale. The exposure included USC and the Person-Centered Primary Care Measure (PCPCM), which assesses the quality of primary care. We conducted a linear regression analysis to adjust for age, sex, educational status, annual household income, self-rated health, living status (whether alone or not), and the existence of physical health problems. Results Of the 6,000 residents, 1,277 responded to the survey. The median score of the UCLA 3-item loneliness scale was 6.0 and the mean total score of the PCPCM was 2.62. Of the 1,277 individuals, 713 (55.8%) had USC. Having USC was significantly associated with lower scores on the UCLA 3-item loneliness scale; the coefficient was −0.34 (95% confidence interval (CI): −0.57 to −0.12). Also, the total PCPCM score was significantly associated with lower loneliness scores; the coefficient was −0.56 (P < 0.001, 95% CI: −0.78 to −0.35). Conclusions Having USC and a better quality primary care were associated with a lower loneliness score. The quality of primary care could be a factor to mitigate patient loneliness. [ABSTRACT FROM AUTHOR]

This study aims to compare high school students' self-esteem and loneliness levels based on their use of Facebook and its applications. Quantitative research was utilized and 764 high school students participated in the current study. Data were collected through a Facebook Usage & Personal Information Form prepared by the researchers, the UCLA Loneliness scale, and the Coopersmith Self-Esteem inventory. Data were analyzed using descriptive statistics and non-parametric tests. The results of this study show that the selfesteem levels of students who spend less time on Facebook are higher than those of students who spend more time on Facebook. The level of loneliness among students with fewer friends on Facebook is higher than that of students with more friends on Facebook. The selfesteem level of students who added new people to their Facebook friend lists was found to be low, while the self-esteem level of students who did not add new people was found to be high There was no relationship between purpose of Facebook use with self-esteem and loneliness. The highest level of loneliness is observed in the group that rarely receives comments or likes on their status updates, photos, and music videos shared on Facebook. In general, it can be seen that students' levels of loneliness and self-esteem have changed about the use of Facebook and its applications. [ABSTRACT FROM AUTHOR]

By January 2024, the COVID-19 pandemic claimed more than 1.1 million deaths in the United States (U.S.). People in prison are particularly vulnerable to COVID-19 as they have no ability to socially distance, secure masks, disinfect their environment or have as much access to tests or vaccinations as is available in the community. In addition, many of these individuals reside in crowded conditions with little ventilation, which makes the spread of the virus more likely. In this paper, we used data from two projects, including the UCLA Law COVID Behind Bars Data Project and the COVID Prison Project, and supplemented these with publicly available data to examine the number of deaths and infection rates caused by COVID-19 among people in prison and prison staff in the U.S., as reported by the population of those facilities. We found that the incidence of infections and death rates in prisons were affected by crowding, prison security type (maximum, medium, minimum, or mixed) and level of prison (state or federal). People in prison who were less likely to have as much human contact (e.g., maximum-security prisons) were also less likely to be afflicted with COVID-19. People in prison were twice as likely to be infected by COVID-19 but had a similar death rate compared to the general public. Prison overcrowding increased the infection rate. The most effective state health policy was to quarantine people who had close contact with confirmed, positive cases. Further, state prisons demonstrated a higher death rate compared to federal prisons. Greater efforts to ameliorate COVID-19 and similar pathogens should be directed at state prisons with lower-level security and prisons with closer contact with the community. Quarantining close-contacts and restricting movements were the most effective state-level responses to reduce infections in prisons during April 2020 to April 2022. [ABSTRACT FROM AUTHOR]

An experimental and simulation-based approach is used to determine the effects of an arc jet plasma on the refractory ceramic material lanthanum hexaboride ( LaB 6). Experiments are performed at the High Energy Flux Test facilitY (HEFTY) located at UCLA. An SG-100 plasma jet generates an argon plasma into a vacuum chamber and imparts a maximum heat flux of 19.5 MW/ m 2 onto LaB 6 disks. Heat flux results are calibrated using a combination of thermocouple data as well as multiphysics numerical simulations in COMSOL, which aim to replicate the testing environment. Moreover, material characterization tools including scanning electron microscopy, energy-dispersive x-ray spectroscopy, x-ray diffraction, and optical profilometry are used to better understand the mechanisms by which LaB 6 loses mass through evaporation, sublimation, and surface damage during an arc jet exposure. It is determined that a minimum energy fluence of 200–300 MJ/ m 2 produces a consistent LaB 6 melt pool and that an incident heat flux of 19.5 MW/ m 2 results in a 0.11 mm/s surface recession rate. [ABSTRACT FROM AUTHOR]

Background: The problems of students' social interaction and psychological well-being associated with online learning dependent on self-directed learning have become an important topic of research in recent years worldwide due to the COVID-19 pandemic, affecting their Social Emotional Learning. This paper aimed to compare the students' loneliness, social anxiety, social interaction, and general psychological well-being at different stages of online learning (at the beginning and the height of the pandemic), considering their criteria (presence/absence of a job and own family). Methods: For this, the researchers conducted an electronic survey of students (n = 320) twice, in February and May 2020, using four questionnaires: UCLA loneliness scale-3, Social Anxiety Scale for E-Learning Environments, Social Interaction Scale, and Brief Adjustment Scale. The responses at different stages of online learning were compared using Student's t-test. Differences between employed and unemployed students with or without their own families were determined using the analysis of variance (ANOVA). Results: The findings showed that unemployed students without their families suffered the most from loneliness. Social interaction online was rated higher by students with their own families; psychological well-being at the beginning of the distance period and social anxiety at the height of the distance period were higher among unemployed students. Conclusions: This research can become a theoretical basis for a phase-by-phase study of social predictors for the psychological well-being of higher education students and is of practical value for teachers and administrators of online learning aimed at students' socialization. In addition, it provides education officials with information about how students perceive psychological well-being, anxiety, social interaction, and loneliness during distance learning, which can help officials direct their decisions and reforms to improve interaction in the online environment. [ABSTRACT FROM AUTHOR]

Background: The current work reviews the psychosocial factors associated with different urinary methamphetamine concentration levels. Methods: From April to November 2023, 243 participants from Baghdad's Al-Ataa Hospital were the subjects of a cross-sectional descriptive analysis study. We included 73 patients in this study. Result: The urinary methamphetamine concentration levels were from 3 to 92,274 ng/ml, with a mean ± SD of 10,873.6 ± 18,641. Patients diagnosed with major depression disorder exhibited higher scores on GHQ-30, UCLA, MOAS, and BDI-II with a significant P-value of 0.0001, 0.001, 0.0001, and 0.0001, consequently with an effect size of 0.015, 0.001, 1.05, and 3.24, respectively. Conclusions: The multi-screening test can produce a false positive. It frequently interferes with other drugs, especially antidepressants. This will result in patients being stigmatized and accused. On the other hand, those who accidentally come into contact with crystal smoke will experience the same withdrawal symptoms as the addicted patients. Their urinary methamphetamine level (titer) could have negative results. Urinary methamphetamine levels should be zero in healthy patients. In this situation, screening tests, expert opinion, and urine methamphetamine testing are strongly recommended. [ABSTRACT FROM AUTHOR]

Introduction: Loneliness in Japan, accentuated by demographic challenges and the hikikomori phenomenon (extreme social withdrawal), has raised concerns. This study critically examines loneliness dynamics, questioning assumptions embedded in hikikomori classifications. The term "hikikomori," originally signifying prolonged home stay, requires nuanced exploration, especially regarding outgoing behaviors' relationship with loneliness. Objectives: Investigating the intricate connection between outgoing behaviors and loneliness, this study questions the effectiveness of existing hikikomori classifications. Aiming to understand if these classifications accurately represent the loneliness spectrum across age groups, the research emphasizes the significance of comprehending loneliness dynamics amid societal challenges. The study explores an array of factors influencing loneliness, including demographics, mental health, and outgoing behaviors, advocating for a reassessment of assumptions linked to hikikomori classifications. Methods: This secondary analysis employed data from a nationwide Internet addiction survey conducted in July 2012. A sample of 623 participants, representative of Japanese internet users aged 16 and above, was included for analysis. Loneliness was assessed using the UCLA Loneliness Scale, and exposure variables included demographic, mental health, outgoing behaviors, and lifestyle factors. Statistical analyses encompassed descriptive statistics, one-way ANOVA, chi-square tests, and logistic regression. Results: Significant differences were observed in loneliness scores based on sex, age, marital status, employment, and outgoing behaviors. Mental health factors, including dissatisfaction with life and romance, life stress, and psychological distress, emerged as strong contributors to loneliness. The study challenges existing hikikomori classifications, suggesting they may not fully encapsulate the loneliness experiences of individuals engaged in routine school or work activities. Conclusion: Findings underscore the need for a reevaluation of hikikomori, emphasizing loneliness as a complex and multifaceted issue in Japan. The study advocates for nuanced strategies to address loneliness, considering diverse demographic vulnerabilities. Limitations include the pre-pandemic sample and potential unmeasured confounding factors. [ABSTRACT FROM AUTHOR]

The UCLA (University of California, Los Angeles) Loneliness Scale is frequently employed instrument for assessing the structure of loneliness in psychology studies. Although many studies have tested the scale's factor structure, the literature has produced inconsistent findings or different results. Some studies support a unidimensional structure, while other studies support a multidimensional structure including two-factor, three-factor, five-factor models. Moreover, these dimensions are denoted differently across studies. Hence, this study employs meta-analytical structural equation modeling (MASEM) to investigate the factor structure of the UCLA Loneliness Scale, MASEM provides more precise parameter estimations than conventional structural equation modeling and allows for the synthesis of conflicting findings concerning factor structure. Furthermore, MASEM provides an examination of the factor structure by utilizing correlation matrices from studies in which the scale has been employed but without a specific examination of its factor structures. Consequently, this study analyzed the correlation matrices from 52 studies encompassing 52 correlation matrices. The results of the meta-analysis revealed that the two-factor and second-order three-factor models provided the best fit for the pooled correlation matrix. Even when considering subgroup analyses based on sample size and sample age, which are possible variables that can explain heterogeneity, the three-factor structure of the scale remained consistent. This suggests that different variables may account for the observed heterogeneity. [ABSTRACT FROM AUTHOR]

Background: In cases of adolescent and early adulthood eating disorders, despite the importance of the patients' relationship with their parents, conflict and confusion frequently occur among them. Interpersonal psychotherapy (IPT) is a present-focused psychotherapy that emphasizes the interpersonal context of symptoms. We developed a remote family education and support program exclusively for parents of patients with eating disorders, based on the principle of IPT. The use of IPT is expected to reduce conflicts in the patient-parent relationship. Consequently, parents will be better able to listen to patients, and patients will be better able to express their thoughts and desires. In this study, we describe the protocol for a randomized controlled trial designed to examine the effectiveness of this program in promoting effective communication in their home based on active listening skills of parents of patients with adolescent and early adulthood eating disorders. Methods: Participants will be parents of patients aged 12–29 years with adolescent and early adulthood eating disorders. Individually randomized, parallel-group trial design will be employed. Seventy participants will be allocated to one of two treatment conditions: (1) remote family education and support program (four, 150 min weekly group sessions) for parents plus treatment-as-usual for patients (consultation by physicians or no treatment), or (2) waiting for the control condition (parents will wait to start the program for 8 weeks) plus treatment-as-usual for patients. The primary outcome measure will be parents' active listening ability as measured by the Active Listening Attitude Scale at 8 weeks after randomization. Additionally, perception of social support (Social Provision Scale-10 item), loneliness (UCLA Loneliness Scale), mental health status (K6), family function (Family Assessment Device), and parent-evaluated eating disorder symptoms (Anorectic Behavior Observation Scale) will be assessed. Data from the intention-to-treat sample will be analyzed 8 weeks after randomization. Discussion: This is the first study to evaluate the effectiveness of a family education and support program for parents of patients with adolescent and early adulthood eating disorders based on IPT. If this type of intervention is effective, although indirect, it could be a new support method for this patient population. Trial registration: Clinical Trials. gov ID NCT05840614. Plain English summary: For patients with adolescent and early adulthood eating disorders, although the relationship with their parents is an important interpersonal dynamic, conflicts and confusion often arise between patients and their parents. On the other hand, parents who live with individuals with eating disorders are frequently involved in interpersonal disputes, leading to a heavy psychological burden and elevated levels of depression and anxiety. It has been found that highly depressed or anxious parents tend to have difficulty listening carefully to their patients. Additionally, parental anxiety often promotes an overprotective response. Interpersonal psychotherapy (IPT) is a present-focused psychotherapy that emphasizes the interpersonal context of symptoms. In IPT, the patient and therapist work within interpersonal therapeutic domains, such as interpersonal role disputes with different expectations and role transitions. We developed a remote family education and support program exclusively for parents of patients with eating disorders based on IPT principles. In the present study, we describe the protocol for a randomized controlled trial designed to examine the effectiveness of this program in promoting effective communication within their homes, focusing on the active listening skills of parents of patients with adolescent and early adulthood eating disorders. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff injury (RCI) is a common musculoskeletal ailment and a major cause of shoulder pain and limited functionality. The ensuing pain and restricted movement significantly impact overall quality of life. This study aims to systematically review the effects of extracorporeal shock wave therapy (ESWT) on RCI. Methods: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. A literature search, spanning inception to November 1, 2023, will include databases such as PubMed, Web of Science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO, and China National Knowledge Infrastructure (CNKI) to identify ESWT studies for RCI treatment. Excluding retrospectives, bias risk will be assessed with the Cochrane tool. Two researchers will independently screen, extract data, and evaluate bias risk. Revman 5.3 software will be used for data analysis. Results: This study aims to objectively and comprehensively evaluate the effectiveness and safety of randomized controlled trials of ESWT in the treatment of RCI, and analyze in detail the effect of ESWT in the treatment of RCI. Results will be analyzed using the Pain Visual Analogue Scale (VAS), Constant-Murley score, University of California Los Angeles score (UCLA), and American Shoulder and Elbow Surgeons form (ASES). If applicable, subgroup analysis will also be performed to divide patients into groups according to the energy level of ESWT, the time of intervention, and the degree of tearing of RCI. Finally, the results are submitted for publication in a peer-reviewed journal. Discussion and conclusion: There is existing evidence suggesting that ESWT may contribute to the amelioration of pain and functional limitations associated with Rotator Cuff Injury (RCI). This systematic review aims to update, consolidate, and critically evaluate relevant evidence on the effects of ESWT for RCI. The anticipated outcomes may serve as a valuable reference for clinical ESWT practices, covering treatment methods, timing, and intensity. Moreover, this review aspires to provide high-quality evidence addressing the impact of ESWT on RCI-related pain. Simultaneously, the findings of this systematic review are poised to offer guidance to clinicians and rehabilitation therapists. This guidance is intended to enhance the management of pain and functional impairments experienced by individuals with RCI, ultimately leading to improvements in their physical well-being. Trial registration: Protocol registration numberCRD42023441407. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441407. [ABSTRACT FROM AUTHOR]

This study aimed to examine the moderating effect of coping flexibility on the relationship between objective and subjective social isolation and depression in older adults. This study involved the analysis of data collected through a self-report survey administered to 243 participants aged 65 years or older. Participants were given the option to complete the survey online or offline, with most surveys conducted online (209 participants). A total of 234 participants (109 men and 125 women) were included in the final analysis, after excluding nine participants who did not meet the recruitment criteria. The Korean version of the Lubben Social Network Scale-18 and UCLA Loneliness Scale were used to measure objective and subjective social isolation, respectively. In this study, the moderating effects were examined using the PROCESS macro in SPSS 4.0. The results are as follows. First, we found that women had higher levels of depression than men, depression increased as age increased, and lower education as well as being single were associated with increased levels of depression. Second, objective as well as subjective social isolation had significant positive influences on depression. Furthermore, coping flexibility had a significant moderating effect on the relationship between subjective social isolation and depression. However, coping flexibility had no moderating effect on the relationship between objective social isolation and depression. This study provides theoretical evidence of the factors necessary to prevent social isolation and mental health problems in old age. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff tendinopathy (RCT) is a widespread musculoskeletal disorder and a primary cause of shoulder pain and limited function. The resulting pain and limited functionality have a detrimental impact on the overall quality of life. The purpose of this study was to perform a systematic review of the effects of extracorporeal shock wave therapy (ESWT) for RCT. Methods: The literature search was conducted on the following databases from inception to February 20, 2024: PubMed, Web of Science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO, and China National Knowledge Infrastructure (CNKI) were checked to identify the potential studies exploring the effect of ESWT for the treatment of Rotator cuff tendinopathy (Calcification or non-calcification), control group for sham, other treatments (including placebo), without restriction of date, language. Two researchers independently screened literature, extracted data, evaluated the risk of bias in the included studies, and performed meta-analysis using RevMan 5.3 software. Results: A total of 16 RCTs with 1093 patients were included. The results showed that compared with the control group, ESWT for pain score Visual Analogue Scale/Score (VAS) (SMD = -1.95, 95% CI -2.47, -1.41, P < 0.00001), function score Constant-Murley score (CMS) (SMD = 1.30, 95% CI 0.67, 1.92, P < 0.00001), University of California Los Angeles score (UCLA) (SMD = 2.69, 95% CI 1.64, 3.74, P < 0.00001), American Shoulder and Elbow Surgeons form (ASES) (SMD = 1.29, 95% CI 0.93, 1.65, P < 0.00001), Range of motion (ROM) External rotation (SMD = 1.00, 95% CI 0.29, 1.72, P = 0.02), Total effective rate (TER) (OR = 3.64, 95% CI 1.85, 7.14, P = 0.0002), the differences in the above results were statistically significant. But ROM-Abduction (SMD = 0.72, 95% CI -0.22, 1.66, P = 0.13), the difference was not statistically significant. Conclusion: Currently limited evidence suggests that, compared with the control group, ESWT can provide better pain relief, functional recovery, and maintenance of function in patients with RCT. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical outcomes of a modified arthroscopic triple‐row (TR) repair technique with the suture bridge (SB) repair technique in treating L‐shaped delaminated rotator cuff tears. Various surgical techniques for L‐shaped delaminated rotator cuff tears have been reported, many of which aid in increasing the contact area and pressure of the rotator cuff. However, there is still debate over which technique yields superior results. Methods: From January 2017 to March 2020, 61 cases of L‐shaped delaminated rotator cuff tears were included in this study. Of these, 34 cases underwent the modified arthroscopic triple‐row repair technique, while 27 cases were addressed with the suture bridge repair technique. Functional assessment was conducted using the American Shoulder and Elbow Surgeons (ASES) score, the University of California Los Angeles (UCLA) shoulder score, the Constant score (CS), and the visual analogue scale (VAS) score. Magnetic Resonance Imaging (MRI) assessments for rotator cuff healing were performed at the 24‐month postoperative mark. Statistical evaluations were conducted using SPSS for Windows (Version 25.0, IBM, Armonk, NY, USA), employing the Wilcoxon signed‐rank test to compare preoperative and postoperative data and ROM differences, and the Mann–Whitney U test for statistical differences in clinical outcome scores between the two groups. A p‐value of less than 0.05 was considered statistically significant. Results: Comparative analysis of the preoperative and final follow‐up scores revealed a substantial enhancement in shoulder function, as indicated by the ASES, UCLA, CS, and VAS scores, with statistical significance (p < 0.001). At both the preoperative stage and final follow‐up, no notable differences were observed in ASES, UCLA, CS, and VAS scores between the two groups. However, the TR repair group exhibited lower VAS scores than the SB group at 1 and 3 months postoperatively. Active range of motion (ROM) showed significant improvement in both groups. No significant differences in ROM were noted between the two groups either before the surgery or at the final follow‐up. Conclusion: The study demonstrates that both the modified arthroscopic TR and SB techniques for L‐shaped delaminated cuff tears yield satisfactory outcomes, with no significant differences in overall clinical performance. Notably, early postoperative pain management appears more effective with the modified TR technique, suggesting its potential for enhanced early recovery experiences. This technique's design, promoting securer fixation and optimal contact conditions, is implied to facilitate superior long‐term healing, warranting further investigation into its long‐term benefits. [ABSTRACT FROM AUTHOR]

Objectives: Bankart lesion is one of the most common lesions of the glenohumeral joint. Several double‐row suture methods were reported for Bankart repair, which could provide more stability, yet more motion limitation and complications. Therefore, we introduced a new double‐row Bankart repair technique, key point double‐row suture which used one anchor in the medial line. The purpose of this article is to investigate the clinical outcomes of this new method and to compare it with single‐row suture. Methods: Seventy‐eight patients receiving key point double‐row suture or single‐row suture from October 2010 to June 2014 were collected retrospectively. The basic information including gender, age, dominant arm, and number of episodes of instability was collected. Before surgery, the glenoid bone loss was measured from the CT scan. The visual analogue scale, American shoulder and elbow surgeons, the University of California at Los Angeles shoulder scale, and subjective shoulder value were valued before surgery and at the last follow‐up. Results: Forty‐four patients (24 patients receiving single‐row suture and 20 patients receiving key point double‐row suture) were followed up successfully. The follow‐up period was 9.2 ± 1.1 years (range, 7.8–11.4 years). At the last follow‐up, no significant differences were detected for any of the clinical scores. The recurrence rate was 12.5% for the single‐row group and 10% for the double‐row group, respectively (p = 0.795) 14 patients (31.8%) in the single‐row group and nine patients (26.5%) in the double‐row group were tested for active range of motion. A statistically significant difference was found only for the internal rotation at 90° abduction (48.9° for single‐row and 76.7° for key point double‐row, p = 0.033). Conclusion: The key point double‐row sutures for Bankart lesions could achieve similar long‐term outcomes compared with single‐row suture, and one medial anchor did not result in a limited range of motion. The low recurrence rate and previous biomechanical results also indicate the key point double‐row suture is a reliable method. [ABSTRACT FROM AUTHOR]

Introduction: Loneliness poses a significant health problem and existing psychological interventions have shown only limited positive effects on loneliness. Based on preliminary evidence for impaired oxytocin signaling in trait-like loneliness, the current proof-of-concept study used a randomized, double-blind, placebo-controlled design to probe intranasal oxytocin (OT) as an adjunct to a short-term modular-based group intervention for individuals suffering from high trait-like loneliness (HL, UCLA Loneliness Scale ≥55). Methods: Seventy-eight healthy HL adults (56 women) received five weekly group psychotherapy sessions. HL participants received OT or placebo before the intervention sessions. Primary outcomes were trait-like loneliness measured at baseline, after the intervention, and again at two follow-up time points (3 weeks and 3 months), and, assessed at each session, state loneliness (visual analog scale), perceived stress (Perceived Stress Scale, PSS-10), quality of life (World Health Organization Five Well-Being Index, WHO-5), and the therapeutic relationship (Group Questionnaire, GQ-D). Results: The psychological intervention was associated with significantly reduced perceived stress and improved trait-like loneliness across treatment groups, which was still evident at the 3-month follow-up. OT had no significant effect on trait-like loneliness, quality of life, or perceived stress. However, compared to placebo, OT significantly facilitated the decrease in state loneliness within sessions and significantly improved positive bonding between the group members. Conclusion: Despite significantly improved trait-like loneliness after the intervention, OT did not significantly augment this effect. Further studies are needed to determine optimal intervention designs to translate the observed acute effects of OT into long-term benefits. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the association between muscle density as an indicator of fatty infiltration of lower extremity muscles and physical activity (PA) after total hip arthroplasty (THA) and identify the patient characteristics with high postoperative PA. Methods: This study included 62 female patients who underwent THA for unilateral hip osteoarthritis. Muscle density of the gluteus maximus, gluteus medius, iliopsoas, and quadriceps muscles was measured using computed tomography (CT). PA was assessed using University of California, Los Angeles (UCLA) activity scores. CT and UCLA activity score were obtained before and 1 year after THA. The patients were divided into two groups, sufficient (score ≥ 6) and insufficient (score < 6) activity groups, based on their level of PA as determined by their UCLA activity score 1 year after THA. The association of PA with the amount of changes in muscle density was examined with Spearman's rank correlation coefficient. Logistic regression analysis was performed to identify postoperative factors determining PA at 1 year after THA. Results: Spearman's rank correlation coefficient showed a significantly positive association between recovery in PA and an increase in muscle density of the gluteus maximus, gluteus medius, iliopsoas, and quadriceps muscles. Additionally, logistic regression analysis confirmed that postoperative muscle densities of the gluteus maximus and quadriceps muscles were variables determining the PA 1 year after THA. Conclusion: The findings of this study indicated that the improvement of fatty infiltration in lower limb muscles, especially in the gluteus maximus and quadriceps, is likely to promote the increase in postoperative PA. [ABSTRACT FROM AUTHOR]

The article discusses the challenges faced by individuals with severe mental illness (SMI) in California when it comes to obtaining emergency mental health treatment and the impact of California's community property laws on marriages affected by SMI. The author argues that existing laws inadequately address the unique challenges faced by SMI individuals and proposes a novel equitable solution to protect mentally ill individuals from implicitly compelled divorce. The article highlights the difficulties faced by individuals in accessing timely mental health treatment and the deficiencies in California's mental health infrastructure. California's mental health system is inadequate and has negative consequences for marriages. The lack of access to mental health treatment places strain on marriages and can lead to financial issues due to the state's community property system. When a spouse cannot receive timely treatment for their mental illness and engages in harmful behavior, the shared financial risk can arise. Lawyers recommend divorce as a solution to protect assets. California should limit tort recovery to fifty percent of community property for judgments resulting from severe mental illness to address this issue. The state's mental health system is insufficient, impacting individuals with mental health emergencies and their families. There is a need for a modification to California's tort recovery laws. This document discusses the challenges faced by individuals with serious mental illnesses (SMI) in seeking and maintaining treatment. Many individuals with SMI experience anosognosia, a condition that prevents them from recognizing their own mental health decline. This, coupled with symptoms like delusions or hallucinations, makes treatment difficult. California has legal pathways for obtaining [Extracted from the article]

Adolescence is an important period characterized by various transitions and changes. Experiencing social anxiety is a growing phenomenon among adolescents and affects their well-being and mental health. It is necessary to pay attention and understand the factors related to social anxiety to improve the subjective well-being of adolescents. The current study aimed to examine the mediating roles of mindfulness and loneliness in the association between social anxiety and subjective well-being among adolescents. Social Anxiety Scale for Adolescents, Mindful Attention Awareness Scale Adolescent Form, UCLA Loneliness Scale Short Form, Adolescent Subjective Well Being Scale and General Information Form were used to collect data. 543 Turkish adolescents (53.6% female) participated in the study. The age range of the participants was 15 to 18 years, with a mean age of 16.45 years (SD=1.10). The results demonstrated that social anxiety was negatively associated with mindfulness and subjective well-being, and positively associated with loneliness. It has been determined that social anxiety had an indirect effect on subjective well-being through mindfulness and loneliness. Mindfulness mitigated the adverse impacts of social anxiety on subjective well-being whereas loneliness exacerbated this association. These results have shown that adolescents with high levels of social anxiety have lower mindfulness and higher loneliness, which in turn lead to less subjective well-being. The findings of the current study suggest that this situation may be ameliorable with mindfulness-based and loneliness-based interventions. [ABSTRACT FROM AUTHOR]

Background: Shaft fractures account for 20% and 1-3% of all humerus fractures, respectively. Open dynamic compression plate fixation (Open fixation with DCP) with absolute stability is the current gold standard for treating shaft humerus fractures. The goal of MIPO was to provide a more stable fixation, which would increase the union rate and decrease open plating side effects including infection and radial nerve palsy. Aim: The purpose of this study was to assess the clinical and radiological outcomes of the MIPPO technique in the treatment of humeral shaft fractures. Patients and methods: thirty cases of shaft humerus fractures were examined during the period from August 2022 to March 2023. The history, clinical examination, and radiographic (X-ray) examination were used to select cases. According to UCLA score, the result was noted and filled up. Results: Union was achieved in 17 to 22 weeks with the mean 19.4±4.1. Only 5% nonunion was seen in our cases. It was observed that the median UCLA score was excellent (34). Conclusion: In shaft humerus fractures, results from minimally invasive plate osteosynthesis with anterior bridge plating were favorable. They offer the fracture site some support, and the fracture hematoma is not disturbed. MIPO keeps the blood vessels healthy, which lowers the danger of infection and wound disintegration. [ABSTRACT FROM AUTHOR]

Magnetic resonance imaging (MRI) can detect disease recurrence after focal therapy for prostate cancer, but there is no robust guidance regarding its use. The TARGET consensus recommendations provide guidance on the acquisition, interpretation, and reporting of MRI after focal therapy, as well as minimum standards for study reporting. Magnetic resonance imaging (MRI) can detect recurrences after focal therapy for prostate cancer but there is no robust guidance regarding its use. Our objective was to produce consensus recommendations on MRI acquisition, interpretation, and reporting after focal therapy. A systematic review was performed in July 2022 to develop consensus statements. A two-round consensus exercise was then performed, with a consensus meeting in January 2023, during which 329 statements were scored by 23 panellists from Europe and North America spanning urology, radiology, and pathology with experience across eight focal therapy modalities. Using RAND Corporation/University of California-Los Angeles methodology, the Transatlantic Recommendations for Prostate Gland Evaluation with MRI after Focal Therapy (TARGET) were based on consensus for statements scored with agreement or disagreement. In total, 73 studies were included in the review. All 20 studies (100%) reporting suspicious imaging features cited focal contrast enhancement as suspicious for cancer recurrence. Of 31 studies reporting MRI assessment criteria, the Prostate Imaging-Reporting and Data System (PI-RADS) score was the scheme used most often (20 studies; 65%), followed by a 5-point Likert score (six studies; 19%). For the consensus exercise, consensus for statements scored with agreement or disagreement increased from 227 of 295 statements (76.9%) in round one to 270 of 329 statements (82.1%) in round two. Key recommendations include performing routine MRI at 12 mo using a multiparametric protocol compliant with PI-RADS version 2.1 standards. PI-RADS category scores for assessing recurrence within the ablation zone should be avoided. An alternative 5-point scoring system is presented that includes a major dynamic contrast enhancement (DCE) sequence and joint minor diffusion-weighted imaging and T2-weighted sequences. For the DCE sequence, focal nodular strong early enhancement was the most suspicious imaging finding. A structured minimum reporting data set and minimum reporting standards for studies detailing MRI data after focal therapy are presented. The TARGET consensus recommendations may improve MRI acquisition, interpretation, and reporting after focal therapy for prostate cancer and provide minimum standards for study reporting. Magnetic resonance imaging (MRI) scans can detect recurrent of prostate cancer after focal treatments, but there is a lack of guidance on MRI use for this purpose. We report new expert recommendations that may improve practice. [ABSTRACT FROM AUTHOR]

Background Proximal humeral fractures (PHFs) often occur in elderly individuals who experience low-energy falls. Open reduction and internal fixation (ORIF) of the proximal humerus is typically performed in young, active patients because of their good bone quality and high functional demands. Although good short-term results have been reported after ORIF in young patients, few studies have specifically evaluated long-term outcomes. Questions/purposes (1) What are the long-term clinical outcomes scores and (2) radiologic outcomes of non-osteoporotic three-part and four-part PHFs treated with locking plates? (3) What complications occurred after treatment, and what factors are associated with poor postoperative functional outcomes scores and avascular necrosis (AVN) of the humeral head after ORIF? Methods Between June 2005 and December 2012, we surgically treated 774 patients for displaced two-, three-, and four-part PHFs. Approximately 75% (581 of 774) underwent ORIF, 10% (77 of 774) underwent hemiarthroplasty, 7% (54 of 774) underwent intramedullary nailing, 5% (39 of 774) underwent reverse shoulder arthroplasty, and the remaining 3% (23 of 774) underwent other surgical treatments. We considered those who had ORIF as potentially eligible. Based on that criterion, 75% (581) were eligible. However, only patients with nonosteoporotic three- and four-part PHFs (cortical thickness of the proximal humeral diaphysis greater than 6 mm on a preoperative AP radiograph of the affected shoulder) and a minimum of 10 years of follow-up were included. Sixtyfour percent (498 of 774) of the patients were excluded because of simple or osteoporotic fractures, 1% (7 of 774) were excluded because of ipsilateral limb multiple fractures, 0.3% (2 of 774) were excluded because of pathologic PHFs, and another 2% (13 of 774) were lost before the minimum study follow-up of 10 years, leaving 8% (61 of 774) for analysis here. The mean age at surgery was 45 ± 12 years, with a mean follow-up of 13 years. Fifty-seven percent (35 of 61) of the patients were men. Patientreported outcomes were evaluated using the University of California Loas Angeles (UCLA) score (range 0 to 35; higher scores represent better shoulder function) and Constant score (range 0 to 100; higher scores represent better shoulder function) at least 10 years postoperatively. Postoperative radiographs were reviewed to assess the cortical bone thickness of the proximal humerus, neckshaft angle, head-to-tuberosity distance, and radiologically confirmable complications. Logistic regression analysis was performed to evaluate factors associated with poor postoperative functional scores (UCLA score ≤ 27 or Constant score ≤ 70) and AVN of the humeral head; the association between AVN and postoperative functional outcomes was also assessed. Results At the most-recent follow-up, these patients had a mean UCLA score of 31 ± 3 and a Constant score of 88 ± 10. The mean neck-shaft angle was 133° ± 10°, and 23% (14 of 61) of patients experienced AVN of the humeral head during follow-up. Twenty-nine complications in 30% (18 of 61) of patients were reported. After controlling for potentially confounding variables such as age and gender, we found that the presence of greater tuberosity malposition (odds ratio 18 [95% confidence interval 2 to 167]; p = 0.01) and immediate postoperative neck-shaft angle less than 130° (OR 19 [95% CI 3 to 127]; p = 0.002) were associated with poor postoperative functional scores. Fourpart PHFs (OR 13 [95% CI 2 to 82]; p = 0.008) and metaphyseal extension less than 8 mm (OR 7 [95% CI 1 to 35]; p = 0.03) were associated with AVN of the humeral head. For patients who met the criteria for anatomic reduction (achievement of all of the following three criteria: neckshaft angle ≥ 130°, head-shaft displacement < 5 mm, and head-to-tuberosity distance greater than or equal to 3 mm and less than or equal to 20 mm), there were no differences in postoperative functional scores between patients with AVN and those without. Conclusion ORIF of nonosteoporotic proximal humeral fractures with locking plates led to favorable functional and radiologic outcomes at a minimum of 10 years of follow-up. When encountering complex PHFs in patients with good bone quality, every effort must be made to achieve an anatomic reduction of the fracture as far as possible, which may not reduce the risk of AVN (this occurred in nearly one-fourth of patients). However, good outcomes can usually be expected, even in patients with AVN. Because this was a retrospective study with a high risk of bias owing to sparse data, the factors associated with poor post-operative functional outcomes must be further investigated in large prospective studies. Level of Evidence Level III, therapeutic study. [ABSTRACT FROM AUTHOR]

Background: In the last decades, several adjunctive treatments have been proposed to reduce mortality in septic shock patients. Unfortunately, mortality due to sepsis and septic shock remains elevated and NO trials evaluating adjunctive therapies were able to demonstrate any clear benefit. In light of the lack of evidence and conflicting results from previous studies, in this multidisciplinary consensus, the authors considered the rational, recent investigations and potential clinical benefits of targeted adjunctive therapies. Methods: A panel of multidisciplinary experts defined clinical phenotypes, treatments and outcomes of greater interest in the field of adjunctive therapies for sepsis and septic shock. After an extensive systematic literature review, the appropriateness of each treatment for each clinical phenotype was determined using the modified RAND/UCLA appropriateness method. Results: The consensus identified two distinct clinical phenotypes: patients with overwhelming shock and patients with immune paralysis. Six different adjunctive treatments were considered the most frequently used and promising: (i) corticosteroids, (ii) blood purification, (iii) immunoglobulins, (iv) granulocyte/monocyte colony-stimulating factor and (v) specific immune therapy (i.e. interferon-gamma, IL7 and AntiPD1). Agreement was achieved in 70% of the 25 clinical questions. Conclusions: Although clinical evidence is lacking, adjunctive therapies are often employed in the treatment of sepsis. To address this gap in knowledge, a panel of national experts has provided a structured consensus on the appropriate use of these treatments in clinical practice. [ABSTRACT FROM AUTHOR]