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1.
Diagnostics (Basel) ; 14(18)2024 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-39335741

RESUMO

BACKGROUND: To achieve a successful result, the orthodontist must use a systematic approach to plan the orthodontic treatment. Defining the correct position of the upper and lower incisors and evaluating their relationship with intermaxillary discrepancy and facial divergence have been recognized as the starting point for the diagnostic decision regarding extractions and anchorage requirements. The aim of our study was to analyze the relationship between intermaxillary discrepancy (ANPg^), mandibular inclination (SN^GoGn), lip incompetence, and the positioning of the upper and lower incisors (UIPs and LIPs) in a group of orthodontic patients. This retrospective study included 290 lateral cephalograms in 122 males (42.1%) and 168 females (57.9%) aged 8 to 53 years (median 14; interquartile range IQR 12-17). Data were analyzed by means of one-way Analysis of Variance (ANOVA) and linear regression analysis. RESULTS: This study showed a statistically significant increase in LIP values in patients with lip incompetence (p < 0.001). Moreover, the distribution of LIPs in groups with various SN^GoGn and ANPg^ angles was significantly different (p < 0.001). The regression analysis also showed a positive association between the LIP and SN^GoGn and between the LIP and ANPg^. CONCLUSION: The LIP presented a statistically significant difference in patients with and without lip incompetence, which varied significantly in subjects with different sagittal malocclusions and vertical face patterns.

2.
Gynecol Oncol Rep ; 55: 101484, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39252760

RESUMO

Introduction: Pembrolizumab is an immunotherapy approved for use in patients with a combined positive score (CPS) greater than one with recurrent cervical cancer. In clinical practice, the CPS score is not typically analyzed in both primary and metastatic specimens. Case descriptions: Case 1A 42-year-old woman with history of an abnormal pap smears who presented with a large pelvic mass with initial biopsy of cervix demonstrating squamous cell carcinoma with negative PDL1 expression and a CPS score of 0. She underwent chemoradiation and presented three months after primary treatment completion with recurrence of squamous cell carcinoma and positive PD-L1 expression with a CPS score of 20. Pembrolizumab was added to cycle three of her systemic chemotherapy regimen of carboplatin/paclitaxel/bevacizumab. She had progression on this regimen and was transitioned to tisotumab vedotin; however, ultimately opted to proceed with hospice secondary to failure to thrive.Case 2A 36-year-old woman with history of an abnormal pap smear in pregnancy and initial biopsy demonstrating endocervical adenocarcinoma, mucinous type. She underwent open radical hysterectomy, bilateral salpingectomy, bilateral oophorepexy, and bilateral pelvic lymph node dissection with subsequent adjuvant chemoradiation. Her initial pathology demonstrated positive PDL1 expression with CPS score of 15. She presented six months after completion of primary treatment with recurrence of endocervical adenocarcinoma, mucinous type and negative PD-L1 expression with a CPS score of < 1. Regardless of this discrepancy, pembrolizumab was added to cycle five of her systemic chemotherapy regimen of carboplatin/paclitaxel/bevacizumab. She initially demonstrated a mixed response; however, ultimately progressed after eight cycles and was transitioned to tisotumab vedotin. Discussion: To our knowledge, discrepancies in PD-L1 expression in a matched setting between primary and metastatic tumors has only been reported once. This is the first case report describing these inconsistencies. Etiologies of and outcomes related to the discrepant expression of PD-L1 should be further studied.

3.
Cureus ; 16(8): e67096, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39290944

RESUMO

ABO discrepancies in plasma cell myeloma (PCM) present unique challenges in blood typing tests and transfusion management. We present the case of a 51-year-old male with PCM who exhibited discrepancies between forward and reverse blood grouping. Further investigation revealed that the patient's blood type was a variant of blood group B. While type III discrepancies, typically characterized by elevated globulin levels causing false-positive reactions in both forward and reverse blood grouping, are common in multiple myeloma, our case differed due to the loss of B antigens secondary to the malignant condition. This caused a discrepancy in forward blood grouping. The rarity of ABO discrepancies in multiple myeloma underscores the importance of thorough evaluation. Awareness of potential antigen alterations in such patients is crucial to ensure safe transfusion practices.

4.
Intensive Care Med ; 2024 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-39287650

RESUMO

PURPOSE: The aim of this study was to assess whether there is a discrepancy between clinical and autopsy-based diagnoses in adult intensive care unit (ICU) patients. METHODS: We conducted a systematic review of cohort studies reporting on conventional autopsy-confirmed missed diagnoses. The discrepancy rate was per study calculated by dividing the number of patients with a missed diagnosis by the number of autopsies. Missed diagnoses were classified according to the Goldman classification as 'major' and 'minor' with major missed diagnoses further differentiated into Class I missed diagnoses (i.e., diagnoses that may have altered therapy or survival) and Class II missed diagnoses (i.e., diagnoses that would not have altered therapy or survival). Class I missed diagnoses constitute the primary outcome of interest. Pooled estimates for discrepancy rates (95% confidence intervals) were calculated using a mixed-effects logistic regression model with 'study' as random effect. Meta-regression was used to assess relationships between major discrepancy rates and autopsy rates, start year of study, and ICU type. RESULTS: Forty-two studies were identified totaling 6305 analyzed autopsies and 1759 patients with missed diagnoses. The pooled discrepancy rates for Class I and major missed diagnoses were 6.5% (5-8.5) and 19.3% (15.3-24), respectively. Meta-regression analysis revealed that autopsy rate was inversely associated with discrepancy rate. Class I discrepancy rates did not change over time. Burn and trauma ICUs had lower discrepancy rates as compared to medical ICUs, possibly because of higher autopsy rates. CONCLUSIONS: Missed diagnoses remain common in ICUs. A higher autopsy rate does not reveal more major diagnostic errors. These data support a clinically driven autopsy policy rather than a systematic autopsy policy.

5.
J Fam Stud ; 30(5): 838-860, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39319027

RESUMO

Most studies of discrepancies in parents' reports about children's psychological problems address younger children and psychological problems. The current contribution shifts the focus to adult children and to well-being. In adult intergenerational relationships, knowledge of children's well-being is more uncertain and there is more room for disagreements to arise, especially in the context of divorce. We analyzed Dutch multi-actor survey data, using a sample of triads of adult children, fathers, and mothers (N = 1,440). Two hypotheses were tested about the origins of discrepancies using structural equation models in which child well-being reports were included of parents and self-reports of children. The analyses supported the notion of relational specificity: when parents have a closer and more harmonious relationship with the child, they evaluate the child more positively than the other parent, after controlling for adult children's self-reports of well-being. Qualified support was obtained for the depression-distortion hypothesis, with mothers who have higher well-being themselves being more positive about the child. Discrepancies were larger among separated parents than among married parents and parent-stepparent combinations. The conclusion is that parents do not always have similar views of adult children's well-being and that disagreements are systematic, with bias stemming from the informant and the relationship.

6.
Pharmacy (Basel) ; 12(4)2024 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-39195851

RESUMO

Complete medication reconciliation during hospital admission is the rationale for further treatment decisions. A consecutive, controlled intervention study was conducted to assess discrepancies in medication reconciliation performed by nurses of the Urology Department compared to the Best Possible Medication History (BPMH) established by pharmacists. This study included pre-intervention (control group, CG), nursing training as a pharmaceutical intervention, and post-intervention (intervention group, IG) groups. The discrepancies were classified as "Missing" (not recorded but taken), "Added" (additionally recorded) "Strength" (incorrect documented dosage), "Intake" (incorrect intake time/schedule), "Double" (double prescription), and "Others" (no clear assignment). Additionally, high-risk drug subgroup discrepancies were particularly prevalent and were evaluated. Training success was compared concerning discrepancies in the CG and IG. Generally, the percentage of discrepancies per patient found was lower in the IG than in the CG (78.1% vs. 87.5%, significantly). The category most identified was "Missing" (IG, 33.3% vs. CG, 35.2%). Overall, a discrepancy of 7.4% each (discrepancies: IG, 27 vs. CG, 38) was determined for high-risk drugs while "Missing" occurred (77.8% vs. 52.6%, out of 7.4%). Despite nursing training only partially reducing discrepancies, the implementation of medication reconciliation using BPMH by pharmacists could improve the process, especially for high-risk drugs.

7.
Nurs Crit Care ; 29(5): 1067-1077, 2024 09.
Artigo em Inglês | MEDLINE | ID: mdl-39207037

RESUMO

BACKGROUND: Early mobilization (EM) is acknowledged for its safety and benefits in the recovery of critically ill patients, yet its implementation in intensive care units (ICU) remains inconsistently aligned with established guidelines. This discrepancy highlights a gap between theoretical endorsement and practical application. While barriers to EM have been extensively studied, the intentions and perceived practices of ICU nurses towards EM, especially in certain geographical regions, have not been adequately understood. AIM: The objective of this study is to assess the perceptions, actual practices and intentions of ICU nurses regarding the implementation of EM for patients in the ICU setting. STUDY DESIGN: A cross-sectional, multi-centre, survey-based study. RESULTS: The study collected data through an electronic questionnaire from 227 ICU nurses across eight hospitals in Beijing, China, concerning their experiences, practices and intentions related to EM. The survey response rate was 50% (114 of 227), indicating a moderate level of engagement by the target population. Among the surveyed participants, 68.7% (n = 156) reported having experience with EM for critically ill patients. Of these experienced nurses, 49.3% (n = 77) indicated they carried out EM less frequently than once per week, while only 29.5% (n = 46) reported dedicating more than 20 min to EM activities per patient. Only 24.2% (n = 55) of participants confirmed the presence of specific EM guidelines in their workplace. Notably, guideline adherence could be influenced by the patient's condition severity, which may affect how these protocols are applied. Notably, the approach and frequency of EM practices showed significant variation across different ICUs. A substantial majority (75%, n = 170) of participants expressed a strong intention towards implementing EM, correlating significantly with factors such as having a higher education level (bachelor's degree or higher), receiving departmental support, encountering fewer perceived barriers, and belonging to specific departments like respiratory (SICU) and surgery (RICU). The EM guidelines mentioned by participants were primarily focused on specific protocols and guidance, highlighting the emphasis on structured approaches to EM in their clinical settings. CONCLUSIONS: Despite the recognized experience with EM among ICU nurses, there is a notable divergence between their practices and the recommendations outlined in EM guidelines. This study underscores the need for the establishment of clear, actionable guidelines, alongside the provision of targeted educational programmes and robust support systems, to foster the consistent and effective implementation of EM in ICU settings. RELEVANCE TO CLINICAL PRACTICE: This study underscores the clinical relevance of EM in ICU settings, advocating for the development of precise EM guidelines to improve patient outcomes.


Assuntos
Enfermagem de Cuidados Críticos , Deambulação Precoce , Unidades de Terapia Intensiva , Intenção , Humanos , Estudos Transversais , Deambulação Precoce/enfermagem , Feminino , Masculino , Inquéritos e Questionários , Adulto , China , Atitude do Pessoal de Saúde , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem Hospitalar/psicologia , Estado Terminal/enfermagem
8.
Haemophilia ; 2024 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-39164802

RESUMO

INTRODUCTION: Lonoctocog alfa is a single-chain factor VIII (FVIII) molecule with high binding affinity to von-Willebrand-factor. While it is well known that its plasma activity is underestimated by one-stage clotting assays (OSCA), there is a lack of knowledge on the post-infusion performance of lonoctocog alfa in global coagulation assays or its potential impact on the haemostatic balance in vivo. AIM: To characterize lonoctocog alfa versus octocog alfa in pre- and post-infusion samples obtained from patients undergoing repeated investigation of incremental recovery (IR). METHODS: Eighteen patients with severe haemophilia A (lonoctocog alfa: 10, octocog alfa: 8) were included. A panel of factor-specific and global coagulation assays was applied, comprising a FVIII OSCA, two FVIII chromogenic substrate assays (CSA), rotational thrombelastography and thrombin generation (TG). Potential activation of coagulation was assessed by measuring plasma thrombin markers and levels of activated protein C. RESULTS: Comparable IRs were found for lonoctocog alfa and octocog alfa (2.36 [IU/dL]/[IU/kg] vs. 2.55 [IU/dL]/[IU/kg], respectively). Lonoctocog alfa activities were found to be underestimated by the FVIII OSCA while also the two FVIII CSAs showed statistically significant assay discrepancies on lonoctocog alfa. Effects of both FVIII products on rotational thrombelastography were less distinct than those on TG parameters. No elevated pre- or significantly shifting post-infusion plasma levels of coagulation biomarkers were detected. CONCLUSION: Lonoctocog alfa and octocog alfa showed comparable recovery and safety in vivo as well as similar impacts on TG in vitro. Observed assay discrepancies on lonoctocog alfa demonstrated variability of results also between different FVIII CSAs.

9.
PNAS Nexus ; 3(8): pgae295, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39166100

RESUMO

Individuals who have more ambition-a persistent striving for success, attainment, and accomplishment-are more likely to become leaders. But are these ambitious individuals also more effective in leadership roles? We hypothesize that leader ambition is related to positive self-views of leader effectiveness that remain uncorroborated by relevant third-party actors. In a multiwave, preregistered study, we find evidence for this hypothesis using a sample of executives (N = 3,830 ratings of 472 leaders) who were rated by peers, subordinates, managers, and themselves on ten leadership competencies, including their ability to motivate others, manage collaborative work, coach and develop people, and present and communicate ideas. We consider the implications of our findings for both scholars and practitioners interested in leadership selection and development.

10.
Integr Pharm Res Pract ; 13: 91-99, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39050732

RESUMO

Aim: Medication discrepancies are a major safety concern for hospitalized patients and healthcare professionals. Medication Reconciliation (MR) is a widely used tool in different practice settings to ensure the proper use of medications. Objective: This study aimed to assess the effectiveness of the clinical pharmacists-led MR process in identifying, preventing, and resolving medication discrepancies among hospitalized patients. Patients and Methods: This was a prospective study with an observational and interventional part, conducted at the Internal Medicine Department of a tertiary Hospital in Sudan from January to September 2023. The enrolled patients were divided into two groups, the observation group, in which the routine MR process was performed by doctors (usual care), and the intervention group, in which clinical pharmacists led the MR process. Results: Compared to the usual care, the clinical pharmacists were more efficient in identifying and preventing medication discrepancies (P=0.001). From a total of 1012 medications, clinical pharmacists' interventions contributed to the detection of (39%) equivalent to 2.2 discrepancies per patient, resolving 325 (83%) and preventing (55%) clinically significant discrepancies. Dose discrepancy (43%) was the most common type of identified discrepancies. These interventions were accepted by (98%) of doctors and implemented in (86%) of the total cases. The main predictors of medication discrepancies (P ≤0.05) for patients were the length of hospital stay, patient-hospital transfer, high number of medication histories, and increased number of medications used during hospitalization. Conclusion: Through the implementation of the MR process, the clinical pharmacist's interventions substantially contributed to the detection and resolution of medication discrepancies among hospitalized patients. It is recommended that this intervention be disseminated in more hospitals in Sudan to encourage the implementation of appropriate practices.

11.
PNAS Nexus ; 3(7): pgae247, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38979081

RESUMO

Political advertising on social media has become a central element in election campaigns. However, granular information about political advertising on social media was previously unavailable, thus raising concerns regarding fairness, accountability, and transparency in the electoral process. In this article, we analyze targeted political advertising on social media via a unique, large-scale dataset of over 80,000 political ads from Meta during the 2021 German federal election, with more than 1.1 billion impressions. For each political ad, our dataset records granular information about targeting strategies, spending, and actual impressions. We then study (i) the prevalence of targeted ads across the political spectrum; (ii) the discrepancies between targeted and actual audiences due to algorithmic ad delivery; and (iii) which targeting strategies on social media attain a wide reach at low cost. We find that targeted ads are prevalent across the entire political spectrum. Moreover, there are considerable discrepancies between targeted and actual audiences, and systematic differences in the reach of political ads (in impressions-per-EUR) among parties, where the algorithm favor ads from populists over others.

12.
Cureus ; 16(6): e62225, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39006607

RESUMO

Objectives This study aims to evaluate the concordance between blood gas and biochemical measurement methods for sodium and potassium levels in elderly and non-elderly patients within an emergency department (ED) setting. Methods A retrospective method comparison study was conducted at an ED from February 1, 2023, to March 1, 2023. The study included 414 patients, categorized into "elderly" (aged 65 and above; n = 138, 33.3%) and "non-elderly" (aged 18 to 64; n = 276, 66.7%) groups. Concordance was assessed using Bland-Altman, Passing-Bablok, and Lin's concordance correlation methods. Results In sodium measurements, the elderly group exhibited an average bias of -1.52 mEq/L (95% confidence interval [CI] -2.12 to -0.92), with lower and upper limits of agreement (LoA) at -8.46 and 5.42 mEq/L, respectively, indicating a broader variance than non-elderly patients, who showed an average bias of -0.82 mEq/L with limits of -4.97 to 3.32 mEq/L. For potassium, the elderly group's average bias was -0.46 mEq/L (95% CI -0.36 to -0.57), with limits of agreement from -1.68 to 0.75 mEq/L, compared to non-elderly patients with a bias of -0.29 mEq/L and limits of -0.71 to 0.13 mEq/L. Furthermore, concordance correlation coefficients revealed a reduced agreement in the elderly for both sodium (r ccc = 0.799) and potassium (r ccc = 0.529) compared to the non-elderly cohort (sodium r ccc = 0.821, potassium r ccc = 0.715). Conclusion The study identifies significant discrepancies in sodium and potassium levels between elderly and non-elderly patients, suggesting a need for diagnostic precision. It emphasizes the importance of customizing diagnostic approaches to better serve the elderly population in EDs.

13.
Artigo em Inglês | MEDLINE | ID: mdl-39008199

RESUMO

Parent-child informant discrepancies on psychopathology provide important knowledge on the parent-child relationship and the child's mental health, but mechanisms underlying parent-child informant discrepancies are largely unknown. Therefore, we investigated the relationship between attachment problems and mentalizing capacity and parent-child informant discrepancies on borderline personality disorder (BPD) severity, internalizing, and externalizing pathology in a clinical sample of 91 adolescent girls with BPD and their parents. Results showed that more attachment problems to parents and peers were related to adolescents reporting more severe BPD than parents. Adolescents who described more internalizing symptoms relative to parents, reported more parental attachment problems, but enhanced peer attachment, suggesting those adolescents who do not feel recognized by their parents might turn to their friends. When parents rated adolescents higher on externalizing behaviors, the adolescent reported more attachment problems to parents and lower mentalizing capacity, indicating that this sub-group of adolescents may reflect less about how their behavior affects others.

14.
J Youth Adolesc ; 53(10): 2407-2422, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38864953

RESUMO

Incongruent perceptions of parental emotional expressivity between parents and adolescents may signify relational challenges, potentially impacting adolescents' socioemotional adjustment. Direct evidence is still lacking and father-adolescent discrepancies are overlooked. This study employed a multi-informant design to investigate whether both mother-adolescent and father-adolescent discrepancies in perceptions of parental expressivity are related to adolescents' mental well-being, specifically focusing on loneliness and depression. Analyzing data from 681 families (mean age of adolescents = 15.5 years old, 51.2% girls, 40% only-children) in China revealed that adolescents tended to perceive paternal and maternal emotional expressivity more negatively than their parents, particularly fathers. Polynomial regression and response surface analysis showed significant links between parent-adolescent congruence and incongruence and adolescent loneliness. (In)Congruence between adolescents and mothers or fathers predicted later adolescent depression, mediated by adolescent loneliness and varied by the dimension of emotional expressivity. These findings provide insights into the roles of mothers' and fathers' emotional expressivity in shaping children's mental well-being during adolescence.


Assuntos
Depressão , Solidão , Relações Pais-Filho , Humanos , Solidão/psicologia , Adolescente , Feminino , Masculino , Depressão/psicologia , China , Emoções Manifestas , Adulto
15.
Alzheimers Dement (N Y) ; 10(2): e12486, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38899046

RESUMO

INTRODUCTION: The aim of this study was to analyze discrepancies between self- and proxy-rated health-related quality of life (HRQoL), measured with the EuroQol 5 Dimension 5 Level survey (EQ-5D-5L), in people living with dementia (PlwD) and their caregivers on an individual response level. METHODS: EQ-5D-5L, sociodemographic and clinical data were obtained from baseline data of n = 174 dyads of a cluster-randomized, controlled intervention trial. Self- and proxy-rated EQ-5D-5L health profiles were evaluated in terms of response distribution and agreement (weighted Kappa), and discrepancies in individual dimension level were analyzed using the Paretian Classification of Health Change (PCHC) as well as the presence and degree of inconsistencies between ratings. RESULTS: PlwD had a mean age of 80.1, nearly the half were female and 82.3% were mildly to moderately cognitively impaired. PlwD reported a higher utility index than caregiver proxies (mean 0.75 vs. 0.68, 83% of PlwD > 0.5). According to the PCHC and inconsistency approach, 95% of PlwD rated their health differently compared to proxies; 66% with divergent responses in at least three EQ-5D-5L dimensions. Nine dyads (5%) showed identical ratings. Discrepancies of one higher or lower EQ-5D-5L response represented the most frequent discrepancy (35.4%). Caregivers were two times more likely to report "moderate problems," representing the middle of the 5-point Likert scale. Usual activities had the lowest agreement between ratings (weighted kappa = 0.23). In PlwD reporting no or some problems in EQ-5D-5L-dimensions, proxies were more likely to report more problems and vice versa, especially in the more observable dimension usual activities and less likely in the less observable domains pain/discomfort and anxiety/depression. DISCUSSION: The central tendency bias observed in proxy-ratings could be associated with assessment uncertainties, resulting in an underestimation (overestimation) in PlwD reporting better (worse) health. This diverging trend extends the knowledge from previous studies and underlines the need for more methodological research in this area. Highlights: People living with dementia (PlwD) rate their health differently than proxies.Proxy-ratings over- or underestimate PlwD health when self-ratings are low or high.Proxies indicate a possible central tendency bias.Further research is needed to understand influencing factors.

16.
BMC Psychiatry ; 24(1): 475, 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38937737

RESUMO

BACKGROUND: This study aimed to explore discrepancies in adolescents with chronic illness and their parents' perceptions of family resilience, as well as the relationship between these differences and the psychological adjustment of adolescents with chronic illness. METHODS: A cross-sectional study was conducted. A total of 264 dyads of parents (77.7% mothers, mean age 41.60 years, SD = 6.17) and adolescents (48.5% girls, mean age 12.68 years, SD = 2.11) with chronic illness were recruited through convenience sampling from three children's hospitals in Wenzhou, Hangzhou, and Shanghai, China between June 2022 and May 2023. The Chinese version of the Family Resilience Scale and the Psychological Adjustment Scale, which are commonly used measures with good reliability and validity, were employed to assess family resilience and psychological adaption, respectively. The data were analyzed using polynomial regression and response surface analysis. RESULTS: Adolescents with chronic illness reported higher family resilience than their parents (t=-2.80, p < 0.05). The correlations between family resilience and adolescents' psychological adjustment reported by the adolescents (r = 0.45-0.48) were higher than parents (r = 0.18-0.23). In the line of congruence, there were positive linear (a1 = 1.09-1.60, p < 0.001) and curvilinear (a2=-1.38∼-0.72, p < 0.05) associations between convergent family resilience and adolescents' psychological adjustment. In the line of incongruence, when adolescents reported lower family resilience than parents, adolescents had a lower level of psychological adjustment (a3=-1.02∼-0.45, p < 0.05). Adolescents' sociability decreased when the perceived family resilience of parent-adolescent dyads converged (a4 = 1.36, p < 0.01). CONCLUSION: The findings highlighted the importance of considering the discrepancies and congruence of family resilience in the parent-child dyads when developing interventions to improve the psychological adjustment of adolescents with chronic illness. Interventions aimed at strengthening family communication to foster the convergence of perceptions of family resilience in parent-adolescent dyads were warranted.


Assuntos
Ajustamento Emocional , Pais , Resiliência Psicológica , Humanos , Feminino , Adolescente , Masculino , Doença Crônica/psicologia , Estudos Transversais , Pais/psicologia , Adulto , Criança , China , Adaptação Psicológica , Família/psicologia , Pessoa de Meia-Idade
17.
Acta Radiol ; 65(8): 907-912, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38873726

RESUMO

BACKGROUND: Streak artifacts induced by irregular arm positioning have been an issue in diagnosing the abdomen. PURPOSE: To illustrate the risk of misdiagnosis in abdominal computed tomography (CT) of patients with irregular arm positioning through a case-by-case evaluation and to test if it can be solved by the artificial intelligence iterative reconstruction (AIIR) algorithm. MATERIAL AND METHODS: By reviewing 5220 cases of chest and thoracoabdominal CT, 64 patients with irregular arm positioning were enrolled, whose image data were reconstructed using AIIR in addition to routine hybrid iterative reconstruction (HIR). Lesion detection for livers, spleens, kidneys, gallbladders, and pancreas on AIIR images, performed by two radiologists, was compared with those on HIR images. Discrepancies arising from AIIR images included both cases with additional abnormalities and those with corrections made on previous detections. For cases with discrepancies, artifact scores for organs where discrepancies were found, and contrast-to-noise ratios (CNRs) of cysts with discrepancies were compared between two image sets. RESULTS: Additional abnormalities were detected for 15 cases: additional liver cirrhosis (n=2); additional gallbladder stone (n=1); additional cholecystitis (n=1), additional spleen nodule (n=1); additional kidney cysts (n=8); additional liver cysts (3); and additional spleen cyst (n=1). A spleen contusion was corrected for one case. All involved artifact scores were improved on AIIR images. CNRs of involved liver, kidney, and spleen cysts were improved by up to 539.7%, 538.5%, and 245.5%, respectively. CONCLUSION: Irregular arm positioning may induce a variety of misdiagnoses in abdominal CT, which is almost totally avoidable by the AIIR algorithm.


Assuntos
Artefatos , Inteligência Artificial , Posicionamento do Paciente , Interpretação de Imagem Radiográfica Assistida por Computador , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Humanos , Tomografia Computadorizada por Raios X/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Radiografia Abdominal/métodos , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Posicionamento do Paciente/métodos , Adulto , Idoso de 80 Anos ou mais , Algoritmos , Braço/diagnóstico por imagem , Estudos Retrospectivos , Erros de Diagnóstico
18.
J Youth Adolesc ; 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38937330

RESUMO

Previous research has predominantly relied on single-informant reports to establish the association between parental control and children's anxiety. However, there remains ambiguity regarding the extent to which discrepancies in parent-child reports of parental control are related to children anxiety. This study examined parent-child perceived discrepancies in parental control and their association with children's anxiety, along with the moderated effect of parent-child closeness through cross-sectional and prospective analysis. The sample consisted of 790 children (Mage = 11.34, SD = 6.73, 45.60% for girls), with 741 father-child dyads and 760 mother-child dyads included. Data were analyzed using polynomial regressions with response surface analysis. The results indicated that children tended to perceive higher levels of parental psychological control and lower levels of behavioral control compared to their parents' perceptions. In the cross-sectional analysis, a significant association between greater incongruence in psychological/behavioral control and higher levels of children's anxiety at T1 was observed exclusively in father-child dyads. In prospective analysis, for both father-child and mother-child dyads, congruence in higher levels of psychological control was associated with higher levels of children's anxiety at T2, while congruence in higher levels of behavioral control was associated with lower levels of children's anxiety at T2. Additionally, greater incongruence in psychological/behavioral control was linked to higher levels of children's anxiety at T2. Furthermore, mother-child closeness emerged as a significant moderator such that perceived incongruence in psychological/behavioral control could not affect children's anxiety at T2 in the high mother-child closeness condition. These findings highlight the significance of considering parent-child congruence and incongruence when examining the impact of parental control on children's anxiety.

19.
Cureus ; 16(5): e59928, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38854350

RESUMO

Background This in vitro study aimed to assess the vertical disparities in the positioning of complete crown castings when different quantities of cement were used and to determine the optimal amount of cement for cementation while minimizing any marginal discrepancies. Methodology A total of 60 ideal nickel-chromium (Ni-Cr) crown castings were divided into three groups of experimental volumes of glass ionomer cement, with 20 castings in each group. Group I had completely filled volume with cement, group II had it half-filled, and group III had brushed up cement internally. The crowns were cemented by applying a static load of 5 kg to the cementation apparatus for 10 minutes. The marginal discrepancy between the die and the castings was measured pre-cementation and post-cementation using image analysis software in combination with a stereomicroscope (Motic, USA) at predetermined points that were marked on the die. Statistical analysis was performed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 16, Armonk, USA) software. A one-way analysis of variance (ANOVA) was used for the intergroup analysis. A paired sample t-test was used for intragroup analysis. Result  Brushing cement onto the internal surface presented the least mean values (P<0.05) of post-pre-cementation vertical discrepancy (14.92±10.77 µm) when compared to the half-filled cement group (28.42±12.45 µm) and the fully-filled cement group (58.50±20.91 µm). Conclusion Cement volume appeared to be a key factor in the vertical marginal discrepancy of the crown. The cement brush applied to the internal surfaces of the crown showed smaller post-cementation vertical discrepancies.

20.
Artigo em Inglês | MEDLINE | ID: mdl-38869751

RESUMO

Accumulating evidence supports the presence of a general psychopathology dimension, the p factor ('p'). Despite growing interest in the p factor, questions remain about how p is assessed. Although multi-informant assessment of psychopathology is commonplace in clinical research and practice with children and adolescents, almost no research has taken a multi-informant approach to studying youth p or has examined the degree of concordance between parent and youth reports. Further, estimating p requires assessment of a large number of symptoms, resulting in high reporter burden that may not be feasible in many clinical and research settings. In the present study, we used bifactor multidimensional item response theory models to estimate parent- and adolescent-reported p in a large community sample of youth (11-17 years) and parents (N = 5,060 dyads). We examined agreement between parent and youth p scores and associations with assessor-rated youth global functioning. We also applied computerized adaptive testing (CAT) simulations to parent and youth reports to determine whether adaptive testing substantially alters agreement on p or associations with youth global functioning. Parent-youth agreement on p was moderate (r =.44) and both reports were negatively associated with youth global functioning. Notably, 7 out of 10 of the highest loading items were common across reporters. CAT reduced the average number of items administered by 57%. Agreement between CAT-derived p scores was similar to the full form (r =.40) and CAT scores were negatively correlated with youth functioning. These novel results highlight the promise and potential clinical utility of a multi-informant p factor approach.

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