Effects of remimazolam versus dexmedetomidine on recovery after transcatheter aortic valve replacement under monitored anesthesia care: a propensity score-matched, non-inferiority study.

Background: Minimalist transcatheter aortic valve replacement (TAVR) under monitored anesthesia care (MAC) emphasizes early recovery. Remimazolam is a novel benzodiazepine with a short recovery time. This study hypothesized that remimazolam is non-inferior to dexmedetomidine in terms of recovery after TAVR. Methods: In this retrospective observational study, remimazolam was compared to dexmedetomidine in patients who underwent TAVR under MAC at a tertiary academic hospital between July 2020 and July 2022. The primary outcome was timely recovery after TAVR, defined as discharge from the intensive care unit within the first day following the procedure. Propensity score matching was used to compare timely recovery between remimazolam and dexmedetomidine, applying a non-inferiority margin of -10%. Results: The study included 464 patients, of whom 218 received remimazolam and 246 received dexmedetomidine. After propensity score matching, 164 patients in each group were included in the analysis. Regarding timely recovery after TAVR, remimazolam was non-inferior to dexmedetomidine (152 of 164 [92.7%] in the remimazolam group versus 153 of 164 [93.3%] in the dexmedetomidine group, risk difference [95% CI]: -0.6% [-6.7% to 5.5%]). The use of remimazolam was associated with fewer postoperative vasopressors/inotropes (21 of 164 [12.8%] vs. 39 of 164 [23.8%]) and temporary pacemakers (TPMs) (76 of 164 [46.3%] vs. 108 of 164 [65.9%]) compared to dexmedetomidine. Conclusions: In patients undergoing TAVR under MAC, remimazolam was non-inferior to dexmedetomidine in terms of timely recovery. Remimazolam may be associated with better postoperative recovery profiles, including a lesser need for vasopressors/inotropes and TPMs.

Effects of Balanced Versus Saline-based Solutions on Acute Kidney Injury in Off-pump Coronary Artery Bypass Surgery: A Randomized Controlled Trial.

OBJECTIVES: To determine whether balanced solutions can reduce the incidence of acute kidney injury after off-pump coronary artery bypass surgery compared with saline. DESIGN: Randomized controlled trial. SETTING: Single tertiary care center. PARTICIPANTS: Patients who underwent off-pump coronary artery bypass surgery between June 2014 and July 2020. INTERVENTIONS: Balanced solution-based chloride-restrictive intravenous fluid strategy. MEASUREMENTS AND MAIN RESULTS: The primary outcome was acute kidney injury within 7 postoperative days, as defined by the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline. The incidence of acute kidney injury was 4.4% (8/180) in the balanced group and 7.3% (13/178) in the saline group. The difference was not statistically significant (risk difference, -2.86%; 95% confidence interval [CI], -7.72% to 2.01%; risk ratio, 0.61, 95% CI, 0.26 to 1.43; p = 0.35). Compared with the balanced group, the saline group had higher levels of intraoperative serum chloride and lower base excess, which resulted in a lower pH. CONCLUSIONS: In patients undergoing off-pump bypass surgery with a normal estimated glomerular filtration rate, the intraoperative balanced solution-based chloride-restrictive intravenous fluid administration strategy did not decrease the rate of postoperative acute kidney injury compared with the saline-based chloride-liberal intravenous fluid administration strategy.

Efficacy of Single-Bolus Administration of Remimazolam During Induction of Anesthesia in Patients Undergoing Cardiac Surgery: A Prospective, Single-Center, Randomized Controlled Study.

BACKGROUND: Remimazolam is a recently marketed ultrashort-acting benzodiazepine. This drug is considered safe and effective during general anesthesia; however, limited information is available about its effects on patients undergoing cardiac surgery. Therefore, the present study was conducted to evaluate the efficacy and hemodynamic stability of a bolus administration of remimazolam during anesthesia induction in patients undergoing cardiac surgery. METHODS: Patients undergoing elective cardiac surgery were randomly assigned to any 1 of the following 3 groups: anesthesia induction with a continuous infusion of remimazolam 6 mg/kg/h (continuous group), a single-bolus injection of remimazolam 0.1 mg/kg (bolus 0.1 group), or a single-bolus injection of remimazolam 0.2 mg/kg (bolus 0.2 group). Time to loss of responsiveness, defined as modified Observer's Assessment of Alertness/Sedation Scale <3, and changes in hemodynamic status during anesthetic induction were measured. RESULTS: Times to loss of responsiveness were 137 ± 20, 71 ± 35, and 48 ± 9 seconds in the continuous, bolus 0.1, and bolus 0.2 groups, respectively. The greatest mean difference was observed between the continuous and bolus 0.2 groups (89.0, 95% confidence interval [CI], 79.1-98.9), followed by the continuous and bolus 0.1 groups (65.8, 95% CI, 46.9-84.7), and lastly between the bolus 0.2 and bolus 0.1 groups (23.2, 95% CI, 6.6-39.8). No significant differences were found in terms of arterial blood pressures and heart rates of the patients. CONCLUSIONS: A single-bolus injection of remimazolam provided efficient anesthetic induction in patients undergoing cardiac surgery. A 0.2 mg/kg bolus injection of remimazolam resulted in the shortest time to loss of responsiveness among the 3 groups, without significantly altering the hemodynamic parameters. Therefore, this dosing can be considered a favorable anesthetic induction method for patients undergoing cardiac surgery.

Longitudinal associations between gut microbiome diversity and emotional well-being.

OBJECTIVE: While a significant link between emotional well-being (EWB) and the gut microbiome has been reported recently, their temporal relationships remain elusive. This study aims to fill this gap by examining the longitudinal associations between EWB and the Shannon Index (SI), an indicator of gut microbiome diversity. METHOD: The analysis focused on a dataset that collected participants' current EWB and fecal samples in both 2019 and 2022 (N = 57, 56.1% female, Mage = 52.47 years, SD = 12.65). Gut microbiome profiles were generated by sequencing the 16S rRNA gene, from which SI was subsequently calculated. RESULTS: The cross-lagged panel analysis revealed significant positive cross-sectional associations between EWB and SI in both 2019 (ß = .296, SE = 0.121, p = .014) and 2022 (ß = .324, SE = 0.119, p = .006). However, no significant longitudinal associations were found between 2019 EWB and 2022 SI (ß = .068, SE = 0.138, p = .623), nor between 2019 SI and 2022 EWB (ß = -.016, SE = 0.13, p = .899). CONCLUSIONS: Our findings indicate that emotional happiness may be associated with gut microbiome profiles at a particular time point, but they may not serve as predictive factors for each other over time. Future research is needed to establish causal relationships between them. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perceived financial well-being and its association with frontostriatal functional connectivity, real-life anticipatory experiences, and everyday happiness.

Perceived financial well-being (FWB) is an important aspect of life that can affect one's attitude toward future experiences and happiness. However, the relationship between FWB, anticipatory experiences, and happiness, and the brain's functional architecture underlying this relationship remain unknown. Here, we combined an experience sampling method, multilevel modeling, and functional neuroimaging to identify the neural correlates of FWB and their associations with real-world anticipatory experiences and everyday happiness. Behaviorally, we found that individuals with greater FWB felt more positive and more interested when they expected positive events to occur, which in turn resulted in increased everyday happiness. Furthermore, the level of FWB was significantly associated with the strength of functional connectivity (FC) between the nucleus accumbens (NAc) and ventromedial prefrontal cortex (vmPFC) and the local coherence within the vmPFC. The frontostriatal FC and local coherence within the vmPFC were further predictive of everyday happiness via the anticipatory response involving interestedness during positive expectations. Our findings suggest that individual differences in FWB could be reflected in the functional architecture of brain's reward system that may contribute to shaping positive anticipatory experiences and happiness in daily life.

Implication of findings from a two-wave survey on embitterment in South Korea for strategies to promote mental health of the general public.

OBJECTIVE: To examine the prevalence of embitterment by following individuals over time and to statistically evaluate how factors known as correlates of embitterment affect different groups with or without changes in embitterment over time. METHOD: Responses for the posttraumatic embitterment disorder (PTED) self-rating Scale were collected from the same 1,153 adults who participated in a follow-up survey delivered 14 months apart. Suggested cutoff points were applied to identify changes in embitterment and four groups were identified. For each group, the relative impacts of factors that affect changes in or maintenance of embitterment, such as negative life events (NLEs), belief in a just world (BJW), social support, relative deprivation, and resilience, were statistically analyzed. RESULTS: The average PTED scores were relatively high for both surveys (M = 1.73 and 1.58, respectively). "Persistent" or "increased" in embitterment was seen for 47.3% of the participants. In particular, 15.3% (Wave 1) and 12.1% (Wave 2) of participants experienced clinically relevant levels of embitterment. NLEs, BJW, relative deprivation, and resilience showed significant associations with the risk of persistence or deterioration of embitterment. CONCLUSIONS: Our study highlights embitterment as a dynamic emotion that can either be aggravated or moderated over time. Embitterment can be elicited by joint effects of multiple social and interactional factors including known embitterment correlates, and relative deprivation is confirmed as a possible core elicitor of embitterment in the context of comparative justice. These findings imply that additional longitudinal research and development of practices for mental health prevention in general populations are needed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Corticolimbic structural connectivity encapsulates real-world emotional reactivity and happiness.

Emotional reactivity to everyday events predicts happiness, but the neural circuits underlying this relationship remain incompletely understood. Here, we combined experience sampling methods and diffusion magnetic resonance imaging to examine the association among corticolimbic structural connectivity, real-world emotional reactivity and daily experiences of happiness from 79 young adults (35 females). Participants recorded momentary assessments of emotional and happiness experiences five times a day for a week, approximately 2 weeks after brain scanning. Model-based emotional reactivity scores, which index the degree to which moment-to-moment affective state varies with the occurrence of positive or negative events, were computed. Results showed that stronger microstructural integrity of the uncinate fasciculus and the external capsule was associated with both greater positive and negative emotional reactivity scores. The relationship between these fiber tracts and experienced happiness was explained by emotional reactivity. Importantly, this indirect effect was observed for emotional reactivity to positive but not negative real-world events. Our findings suggest that the corticolimbic circuits supporting socioemotional functions are associated with emotional reactivity and happiness in the real world.

Effects of intraoperative inspired oxygen fraction (FiO2 0.3 vs 0.8) on patients undergoing off-pump coronary artery bypass grafting: the CARROT multicenter, cluster-randomized trial.

BACKGROUND: To maintain adequate oxygenation is of utmost importance in intraoperative care. However, clinical evidence supporting specific oxygen levels in distinct surgical settings is lacking. This study aimed to compare the effects of 30% and 80% oxygen in off-pump coronary artery bypass grafting (OPCAB). METHODS: This multicenter trial was conducted in three tertiary hospitals from August 2019 to August 2021. Patients undergoing OPCAB were cluster-randomized to receive either 30% or 80% oxygen intraoperatively, based on the month when the surgery was performed. The primary endpoint was the length of hospital stay. Intraoperative hemodynamic data were also compared. RESULTS: A total of 414 patients were cluster-randomized. Length of hospital stay was not different in the 30% oxygen group compared to the 80% oxygen group (median, 7.0 days vs 7.0 days; the sub-distribution hazard ratio, 0.98; 95% confidence interval [CI] 0.83-1.16; P = 0.808). The incidence of postoperative acute kidney injury was significantly higher in the 30% oxygen group than in the 80% oxygen group (30.7% vs 19.4%; odds ratio, 1.94; 95% CI 1.18-3.17; P = 0.036). Intraoperative time-weighted average mixed venous oxygen saturation was significantly higher in the 80% oxygen group (74% vs 64%; P < 0.001). The 80% oxygen group also had a significantly greater intraoperative time-weighted average cerebral regional oxygen saturation than the 30% oxygen group (56% vs 52%; P = 0.002). CONCLUSIONS: In patients undergoing OPCAB, intraoperative administration of 80% oxygen did not decrease the length of hospital stay, compared to 30% oxygen, but may reduce postoperative acute kidney injury. Moreover, compared to 30% oxygen, intraoperative use of 80% oxygen improved oxygen delivery in patients undergoing OPCAB. Trial registration ClinicalTrials.gov (NCT03945565; April 8, 2019).

Social network position and the Conserved Transcriptional Response to Adversity in older Koreans.

BACKGROUND: Social connections are crucial to human health and well-being. Previous research on molecular mechanisms in health has focused primarily on the individual-level perception of social connections (e.g., loneliness). This study adopted socio-centric social network analysis that includes all social ties from the entire population of interest to examine the group-level social connections and their association with a molecular genomic measure of health. METHODS: Using socio-centric (global) social network data from an entire village in Korea, we investigated how social network characteristics are related to immune cell gene expression among older adults. Blood samples were collected (N = 53, 65-79 years) and mixed effect linear model analyses were performed to examine the association between social network characteristics and Conserved Transcriptional Response to Adversity (CTRA) RNA expression patterns. RESULTS: Social network positions measured by k-core score, the degree of cohesive core positions in an entire village, were significantly associated with CTRA downregulation. Such associations emerged above and beyond the effects of perceived social isolation (loneliness) and biobehavioral risk factors (smoking, alcohol, BMI, etc.). Social network size, defined as degree centrality, was also associated with reduced CTRA gene expression, but its association mimicked that of perceived social isolation (loneliness). CONCLUSIONS: The current findings implicate community-level social network characteristics in the regulation of individual human genome function above and beyond individual-level perceptions of connectedness.

Implicit Theories of Happiness: When Happiness Is Viewed as Changeable, Happy People Are Perceived Much More Positively Than Unhappy People.

Happy people are often perceived positively, perhaps more than they actually are, whereas unhappy people are often perceived negatively, perhaps more than they actually are. What would make this bias stronger or weaker? The present research addresses this question by exploring the roles of implicit theories of happiness in the trait perceptions toward happy and unhappy people. Specifically, four studies (N = 998) tested hypotheses that an incremental theory of happiness would enhance and an entity theory of happiness would attenuate the trait perceptions favoring happy over unhappy people. Results found converging evidence that believing happiness as changeable (incremental theory) enhances the positive perceptions toward happy people, while providing less consistent evidence that believing happiness as fixed (entity theory) mitigates the negative perceptions toward unhappy people. The current research contributes to the literature on essentialism and advances the understanding of the roles of implicit theories of happiness in person perception.

An ensemble machine learning approach to predict postoperative mortality in older patients undergoing emergency surgery.

BACKGROUND: Prediction of preoperative frailty risk in the emergency setting is a challenging issue because preoperative evaluation cannot be done sufficiently. In a previous study, the preoperative frailty risk prediction model used only diagnostic and operation codes for emergency surgery and found poor predictive performance. This study developed a preoperative frailty prediction model using machine learning techniques that can be used in various clinical settings with improved predictive performance. METHODS: This is a national cohort study including 22,448 patients who were older than 75 years and visited the hospital for emergency surgery from the cohort of older patients among the retrieved sample from the Korean National Health Insurance Service. The diagnostic and operation codes were one-hot encoded and entered into the predictive model using the extreme gradient boosting (XGBoost) as a machine learning technique. The predictive performance of the model for postoperative 90-day mortality was compared with those of previous frailty evaluation tools such as Operation Frailty Risk Score (OFRS) and Hospital Frailty Risk Score (HFRS) using the receiver operating characteristic curve analysis. RESULTS: The predictive performance of the XGBoost, OFRS, and HFRS for postoperative 90-day mortality was 0.840, 0.607, and 0.588 on a c-statistics basis, respectively. CONCLUSIONS: Using machine learning techniques, XGBoost to predict postoperative 90-day mortality, using diagnostic and operation codes, the prediction performance was improved significantly over the previous risk assessment models such as OFRS and HFRS.

Post COVID-19, still wear a face mask? Self-perceived facial attractiveness reduces mask-wearing intention.

With the emerging post-COVID era, wearing face masks has become a domain of personal choice. Then, who wants to continue wearing a mask when it is no longer mandatory? In this article, we expect and examine the role of self-perceived facial attractiveness in predicting mask-wearing intention and its mechanism across three studies (total N = 1,030). Studies 1 and 2 demonstrated that individuals with high (vs. low) self-perceived attractiveness were less willing to wear a mask, due to a weaker endorsement of the belief that mask-wearing enhances their perceived attractiveness (i.e., mask attractiveness belief). Study 3 further revealed that this mediational association was stronger in situations where the need to deliver a favorable impression was high (job interview context) versus low (walking a dog context). Overall, we provide a novel finding that self-perceived attractiveness has significant effects on mask-wearing intention via mask attractiveness belief in the post-pandemic of COVID-19. Our findings suggest that mask-wearing can shift from being a self-protection measure during the COVID-19 pandemic to a self-presentation tactic in the post-pandemic era.

Paradoxical Impacts of Social Relationship on Well-Being During the COVID-19 Pandemic.

Social interaction is an important source of psychological and physical well-being during normal times. However, following the COVID-19 outbreak, which spreads rapidly from person to person, social interaction poses a fatal threat to one's health and life. Therefore, several countries including South Korea implemented an intense social distancing mandate to prevent the spread of the virus. During these unique times of pandemic, the current research investigated whether and how an individual's well-being varies as a function of their interaction with various relationship partners using experience sampling data (Study 1) and online longitudinal data (Study 2). The results indicated that being alone was more detrimental to well-being during the pandemic than before it. Specifically, interaction with close relationship partners (e.g., romantic partner, spouse, or friend) was positively related to well-being, whereas interaction with formal relationship partners (e.g., coworker, boss) was negatively linked to momentary well-being during the pandemic. Furthermore, our study showed that the association between social supports from close relationships and well-being was temporally strengthened during COVID-19 pandemic. In sum, the benefits of close relationships on well-being were stronger during the COVID-19 pandemic than before it.

Older people are not always happier than younger people: The moderating role of personality.

The present research explored whether the well-established U-shaped relationship between age and happiness varied with personality. Individuals ranging from 15 to 75 years of age (N = 10,456, 84.9% female) completed online surveys of subjective well-being (i.e. life satisfaction, positive affect, and negative affect) and the Big Five personality traits (International Personality Item Pool [IPIP]). The results of hierarchical multiple regression using the PROCESS macro not only supported the prediction of a U-shaped relationship between age and well-being but also revealed that the quadratic relationship is moderated by agreeableness and neuroticism. Specifically, well-being did not bounce back in later adulthood on the well-being curve across different age groups with low agreeableness and high neuroticism. Moreover, positive affect did not increase and even decreased in later adulthood among those with low agreeableness. This study discusses the potential mechanisms.

Psychological well-being and salivary markers of inflammation: The moderating effect of age.

Increasing evidence suggests a significant impact of higher psychological well-being (PWB) on health outcomes; however, such associations have been studied exclusively in middle-aged to older adults. This study examined the aging effect on PWB measures as well as the moderating effect of age on the link between PWB and inflammation, using salivary markers by comparing the younger adults (n = 127; Mage = 22.98 years) versus older adults (n = 75; Mage = 75.60 years). Older adults showed significantly lower levels of PWB, particularly regarding purpose in life and personal growth. Moreover, higher purpose in life was associated with lower salivary IL-1ß and IL-6 (b = 0.83, p < .001; b = 0.81, p < .01) only in the older adult group but not in younger adults. These findings highlight the potential buffering effect of the sense of living well on physiological pathways in later life.

"Why rush to get vaccinated earlier?": Regulatory focus and COVID-19 vaccination.

OBJECTIVES: The health psychology literature has paid little attention to individuals' intention to vaccinate earlier. Building on regulatory focus theory, which proposes two distinct self-regulatory foci: promotion and prevention focus (Higgins, 1997), the present study tests whether, how, and why regulatory focus contributes to the intention to vaccinate earlier (IVE) and whether IVE predicts actual behavior. METHOD: This study used a longitudinal design with data collected at two-time points (3.5 months apart). At Time 1, 487 unvaccinated participants completed a survey assessing regulatory focus, ideal and ought reason for IVE (i.e., hopes/wishes and felt obligation/pressure regarding earlier vaccination, respectively), and IVE through leftover vaccines-vaccines that become available due to last-minute vaccination appointment cancellations. At Time 2, 364 participants reported on the attempts they made to get a leftover vaccine, whether they were vaccinated, and if so, the vaccination type (general vs. leftover vaccine), along with the date of vaccination. RESULTS: A promotion focus was associated with IVE via ideal reason (ß = .141, 95% confidence interval, CI [.085, .198]), whereas a prevention focus was associated with IVE via ought reason (ß = .031, 95% CI [.012, .057]). Furthermore, both the promotion focus (ß = .029, 95% CI [.016, .050]) and prevention focus paths (ß = .006, 95% CI [.001, .015]) extended to vaccinating via leftover vaccines. CONCLUSIONS: The present study illuminates how regulatory focus, especially promotion focus, can be a predictor of earlier vaccination. Our findings suggest that promotion-focused messages highlighting desirable outcomes of vaccination may help encourage earlier vaccination. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Peak systolic myocardial velocity in patients undergoing surgical aortic valve replacement for severe aortic stenosis: prognostic value and natural course.

Myocardial systolic longitudinal function has been known to decrease in patients with severe aortic stenosis (AS). Preoperative peak systolic myocardial velocity at the septal mitral valve annulus (S'), measured using Doppler tissue imaging, was used as an indicator for myocardial systolic longitudinal function. The prognostic value and natural course of S' after surgical aortic valve replacement for severe AS have not been elucidated. This retrospective observational study included patients from January 2006 to December 2018. The patients were divided to 2 groups (pre-S'HIGH vs. pre-S'LOW) with a cut-off 5.4 cm/s of preoperative S' (pre-S') that was identified by restricted cubic spline curve. The primary outcome was postoperative long-term all-cause mortality. Nine hundred and five patients were analyzed. All-cause mortality rate at the median follow-up period of 5.2 years was 12% in pre-S'LOW and 8% in pre-S'HIGH. Multivariate analysis showed that pre-S'LOW was associated with an increased all-cause mortality (hazard ratio, 1.60; 95% confidence interval, 1.04-2.48; P = 0.032). Significantly different trajectories of postoperative S' (post-S') were found between two groups (P < 0.001 for difference): In pre-S'LOW, post-S' increased within 6 months after surgery, and gradually decreased over time, whereas it slowly decreased up to 5 years after surgery and then reached a plateau in pre-S'HIGH. The difference in pre-S' level maintained over time, and remained consistent in the adjusted analysis. Pre-S' < 5.4 cm/s was found to be associated with an increased long-term all-cause mortality. In addition, the trajectories for post-S' were different according to pre-S', which remained after adjustment.

Driving pressure-guided ventilation and postoperative pulmonary complications in thoracic surgery: a multicentre randomised clinical trial.

BACKGROUND: Airway driving pressure, easily measured as plateau pressure minus PEEP, is a surrogate for alveolar stress and strain. However, the effect of its targeted reduction remains unclear. METHODS: In this multicentre trial, patients undergoing lung resection surgery were randomised to either a driving pressure group (n=650) receiving an alveolar recruitment/individualised PEEP to deliver the lowest driving pressure or to a conventional protective ventilation group (n=650) with fixed PEEP of 5 cm H2O. The primary outcome was a composite of pulmonary complications within 7 days postoperatively. RESULTS: The modified intention-to-treat analysis included 1170 patients (mean [standard deviation, sd]; age, 63 [10] yr; 47% female). The mean driving pressure was 7.1 cm H2O in the driving pressure group vs 9.2 cm H2O in the protective ventilation group (mean difference [95% confidence interval, CI]; -2.1 [-2.4 to -1.9] cm H2O; P<0.001). The incidence of pulmonary complications was not different between the two groups: driving pressure group (233/576, 40.5%) vs protective ventilation group (254/594, 42.8%) (risk difference -2.3%; 95% CI, -8.0% to 3.3%; P=0.42). Intraoperatively, lung compliance (mean [sd], 42.7 [12.4] vs 33.5 [11.1] ml cm H2O-1; P<0.001) and Pao2 (median [inter-quartile range], 21.5 [14.5 to 30.4] vs 19.5 [13.5 to 29.1] kPa; P=0.03) were higher and the need for rescue ventilation was less frequent (6.8% vs 10.8%; P=0.02) in the driving pressure group. CONCLUSIONS: In lung resection surgery, a driving pressure-guided ventilation improved pulmonary mechanics intraoperatively, but did not reduce the incidence of postoperative pulmonary complications compared with a conventional protective ventilation. CLINICAL TRIAL REGISTRATION: NCT04260451.

Adaptive aspects of maximizing in times of COVID-19: coping efforts linking maximization to well-being.

Introduction: Maximization, the tendency to make the best choices by thoroughly searching and comparing alternatives, has long been considered a negative correlate of well-being. However, recently, it was proposed that having a maximizing tendency can lead to better coping efforts in some stressful situations and thus could be more adaptive. The objective of the present research was to demonstrate positive features of maximization and identify the coping strategies that mediate the relationship between maximization and well-being during the COVID-19 pandemic. Methods: A sample of 3,493 participants responded to an online survey from January 20 to October 11 of 2020. The 13-item Maximization Scale assessed individuals' maximizing tendency in terms of the maximization index and its three subdimensions (i.e., high standards, alternative search, and decision difficulty). The use of four coping strategies (i.e., preventive measures, cognitive appraisal, self-distraction, and social connection) during the COVID-19 pandemic was assessed. Hedonic and eudaimonic aspects of well-being were measured. We developed a mediation model and examined both whether there was an indirect link between maximization and well-being through the coping strategies and whether there was a direct link between maximization and well-being. Results: Path analysis revealed negative direct associations between maximization measures (i.e., an index and three subdimensions) and well-being. In addition, significant indirect paths were found with varying directions depending on maximization dimensions and coping strategy types. There were positive indirect associations between the maximization index and well-being via preventive measures, between high standards and well-being through preventive measures and cognitive appraisal, and between alternative search and well-being through self-distraction and social connection. Negative indirect associations were found between decision difficulty and well-being through cognitive appraisal, self-distraction, and social connection. Discussion: The current study confirmed the existence of inconsistent mediation effects between maximization and well-being via coping and highlighted coping efforts as one of the positive aspects of maximization. Discussion addressed the double-edged effect of maximization on well-being and its beneficial nature in times of distress. Future studies should examine other potential situations and moderators that can delineate maximization's various characteristics with a longitudinal design and samples from diverse backgrounds.

Longitudinal examinations of changes in well-being during the early period of the COVID-19 pandemic: Testing the roles of extraversion and social distancing.

The present research, by using longitudinal data collected in South Korea (N = 69,986) during the early period of the COVID-19 pandemic (1 January-7 April 2020), examined the pandemic-related changes in the relationship between extraversion and well-being. Multilevel analyses revealed that participants experienced decreased well-being during the pandemic. When analyzing the responses (n = 3,229) completed during all the periods encompassing the COVID-19-related events (e.g., outbreak of COVID-19), we found the greater within-person decreases in well-being among extraverts than introverts after the intensive social distancing. This finding suggests that social distancing, as a necessary means to curb the spread of COVID-19, inadvertently reduced well-being of extraverts. Implications for the person-environment fit literature, limitations, and future research avenues are discussed.