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It has been well documented that Machiavellianism has a positive effect on break-up distress. However, there are few research explored the internal mechanism. In this study, we investigated the mediating role of self-concealment and the moderating role of gender. Machiavellianism Personality Scale, Self-Concealment Scale and Break-up Distress Scale was distributed through an online questionnaire platform. A sample of 869 undergraduate students was received, and their age ranged from 16 to 25 years old (M = 19.48, SD = 1.15). As we predicted, the relationship between Machiavellianism and break-up distress was partially mediated by self-concealment. The direct effect of Machiavellianism on break-up distress and the mediating effect of self-concealment were moderated by gender. Specifically, compared with boys, the effect of Machiavellianism on self-concealment was stronger for girls, while the effect of Machiavellianism on break-up distress was stronger for boys. These findings confirm how Machiavellianism affects break-up distress and provide new intervention ideas for solving the psychological crisis of college students after the dissolution of romantic relationships., Author(s): Yaoguo Geng [sup.1] [sup.2] , Tingting Zhan [sup.1] , Yuwei Zhang [sup.2] , Liping Shi [sup.2] , Jiejing Yu [sup.2] , Wenjing Jin [sup.2] Author Affiliations: (1) grid.207374.5, 0000 [...]

IntroductionSurgery is the primary treatment for resectable, non-metastatic recurrent head and neck squamous cell carcinoma (HNSCC). We explore the safety and oncologic benefit of intraoperative Cesium-131 (Cs-131) brachytherapy combined with salvage local and/or regional surgical resection.Methods and materialsFindings were reported from a single arm multi-institutional prospective phase 1/2 trial involving surgery plus Cs-131 (surgery + Cs-131) treatment. The results of two retrospective cohorts-surgery alone and surgery plus intensity modulated radiation therapy (surgery + ReIMRT)-were also described. Included patients had recurrent HNSCC and radiation history. Safety, tumor re-occurrence, and survival were evaluated.ResultsForty-nine patients were enrolled in the surgery + Cs-131 prospective study. Grade 1 to 3 adverse events (AEs) occurred in 18 patients (37%), and grade 4 AEs occurred in 2 patients. Postoperative percutaneous endoscopic gastrostomy (PEG) tubes were needed in 10 surgery + Cs-131 patients (20%), and wound and vascular complications were observed in 12 patients (24%). No cases of osteoradionecrosis were reported in the surgery + Cs-131 cohort. We found a 49% 2-year disease-free survival at the site of treatment with a substantial number of patients (31%) developing metastatic disease, which led to a 31% overall survival at 5 years.ConclusionsAmong patients with local/regional recurrent HNSCC status-post radiation, surgery + Cs-131 demonstrated acceptable safety with compelling oncologic outcomes, as compared to historic control cohorts.Clinical trial registrationClinicalTrials.gov, identifiers NCT02794675 and NCT02467738.

This study examines Machiavellianism and negative life events in relation to emotional / behavioral problems. Using a sample of adolescents (n = 454), we investigated the degree to which Machiavellianism, negative life events, and the interaction of Machiavellianism and negative life events accounts for variance in emotional / behavioral problems, and also tested for the moderating effect of gender in this respect. The results indicated that (a) Machiavellianism was positively related to negative life events, suggesting that the more adolescents endorsed Machiavellianism, the greater their scores on negative life events; (b) the correlation between Machiavellianism and conduct problems was stronger in boys than girls, thereby suggesting a more substantial relation between Machiavellianism and conduct problems in boys than girls; (c) increasing levels of Machiavellianism could increase the contributions of negative life events to the levels of emotional symptoms, conduct problems, and peer relationship problems. The implication of these findings are interpreted and discussed., Author(s): Xueli Zhu [sup.1] , Yaoguo Geng [sup.1] , Xueying Sai [sup.1] , Minqi Yang [sup.1] , Chai Wei Toh [sup.1] , Tingting Zhan [sup.1] , Jiejing Yu [sup.1] , [...]

Two studies were conducted to investigate the relationship between Early Life Adversity and Malevolent Creativity as well as its underlying mechanism. Study 1 established a moderated mediation model to explore the mediating role of Belief in a Just World (BJW) and the moderating role of Dark Triad. A total of 353 college students (Mage = 21.25, SDage = 2.21, 58.9% women) were recruited to fill out questionnaires. The results showed that Early Life Adversity positively predicted Malevolent Creativity behavior and indirectly predicted Malevolent Creativity behavior through BJW. Dark Triad reduced the effects of Early Life Adversity on BJW and intensified the effects of Early Life Adversity on Malevolent Creativity behavior. Study 2 explored the effect of threatening BJW on Malevolent Creativity potential. A total of 180 participants (Mage = 20.53, SDage = 1.7, 64.4% women) were investigated with questionnaires and a Malevolent Creativity Problem‐Solving Task. Study 2 validated study 1 and illustrated that the Malevolent Creativity potential (including fluency, originality, and malevolence) was enhanced when Belief in a Just World was threatened. However, greater fluency was only observed in men. As a whole, these finding emphasizes the important linking role of BJW between Early Life Adversity and Malevolent Creativity, and Dark Triad and gender influence the expression of Malevolent Creativity as well. [ABSTRACT FROM AUTHOR]

BACKGROUND: Depression is prevalent in patients receiving hospice care. Standard antidepressant medications do not work rapidly enough in this setting. Evidence suggests that ketamine rapidly treats treatment refractory depression in the general population. Ketamine׳s role for treating depression in the hospice population warrants further study. METHODS: A retrospective medical record review of 31 inpatients receiving hospice care who received ketamine for depression on a clinical basis was conducted. The primary outcome measure was the Clinical Global Impression Scale, which was used retrospectively to rate subjects׳ therapeutic improvement, global improvement, and side effects from ketamine over 21 days. Additionally, time to onset of therapeutic effect was analyzed. RESULTS: Using the Clinical Global Impression Scale, ketamine was found to be significantly therapeutically effective through the first week after ketamine dosing (p < 0.05), with 93% of patients showing positive results for days 0-3 and 80% for days 4-7 following ketamine dosing. Patients experienced global improvement during all 4 studied time periods following ketamine dosing (p < 0.05). Significantly more patients had either no side effects or side effects that did not significantly impair functioning at each of the 4 assessed time periods following ketamine dosing (p < 0.05). Additionally, significantly more patients experienced their first therapeutic response during days 0-1 following ketamine dosing (p < 0.001) than during any other time period. CONCLUSIONS: These data suggest that ketamine may be a safe, effective, and rapid treatment for clinical depression in patients receiving hospice care. Blinded, randomized, and controlled trials are required to substantiate these findings and support further clinical use of this medication in hospice settings.

Objective: This study sought to analyze the efficacy and safety of postoperative prednisone to reduce reliance on opioids in adult benign oropharyngeal surgery. Study Design: Prospective cohort study. Setting: Single tertiary‐care facility. Methods: Patients undergoing tonsillectomy (T), tonsillectomy and adenoidectomy (T&A), and/or modified uvulopalatopharyngoplasty (UPPP) from December 2020 to January 2023 received the standard of care postoperative management. A prednisone taper was dependent on surgeon preference. Cohorts were based on the prescription of postoperative steroids. Patients completed a survey to assess opioid usage, pain scores, and steroid compliance. Results: Seventy‐two patients were included. The nonsteroid cohort (N = 29) received an average of 467 ± 94.1 morphine milligram equivalents (MME), and the steroid cohort (N = 43) received an average of 285 ± 128 MME (P < 0.001). The nonsteroid cohort consumed 1.62 times more opioids than the steroid cohort (P < 0.002). There were no significant differences in complication or refill rates between treatment groups. There were no significant differences in pain scores on the day of surgery or postoperative days 1, 5, or 10 (P = 0.34, P = 0.66, P = 0.62, and P = 0.22, respectively). Patients undergoing T&A (p = 0.019) or who had current psychiatric medication use (P < 0.006) consumed significantly more opioids. Patients who received a total opioid prescription of >300 MME (40 5‐mL doses of 5 mg/5 mL liquid oxycodone) consumed 2.27 times more postoperative opioids than patients with opioid prescriptions ≤300 MME (P < 0.001). Conclusion: Patients who did not receive steroids consumed 1.62 times more postoperative opioids compared to those who completed a steroid taper. Corticosteroid use was not associated with changes in pain scores, refill rates, or complication rates and may be considered in a multimodal approach to pain management in adults undergoing benign oropharyngeal surgery, although further study is warranted. [ABSTRACT FROM AUTHOR]