Dispositional Active Coping Predicts Patterns of Adolescents' Cortisol Responsivity in the Context of School-related Stressors.

OBJECTIVE: The goal of this study was to examine the direct and conditional effects of active coping and prior exposure to school-related stressors on cortisol reactivity and recovery in response to an academically salient, social stress task. METHOD: Participants included N= 758 adolescents (50% male; M age = 12.03 years, SD = .49) enrolled in the 7th grade in Title 1 middle schools. Adolescents were predominantly ethnic minorities (62% Hispanic, 12% non-Hispanic White, 11% non-Hispanic Black, 7% Native American, and 8% "other"). Youth completed self-reported assessments of their dispositional use of active coping strategies, prior exposure to school hassles, pubertal status, medication use, and relevant demographic information. In addition, youth engaged in an academically salient group public speaking task adapted for adolescents and provided salivary cortisol sample pre-task, immediately post-task, 15-, and 30-minutes post-task. RESULTS: Results from piecewise latent growth curve modeling revealed that active coping independently predicted lower cortisol reactivity to the stress task. Furthermore, active coping was associated with slower cortisol recovery when adolescents reported not having experienced any school hassles in the past three months and faster recovery when having experienced several school hassles in the past three months. Results from multinomial logistic regressions revealed that greater use of active coping strategies was less likely to predict a hyper-reactive pattern of cortisol responding compared to other patterns. CONCLUSION: Findings provide support for active coping as a way to promote adaptive physiological responding to school-related stressors among ethnically diverse youth residing in low-income communities.

Distinct molecular profile of IRF4-rearranged large B-cell lymphoma.

Pediatric large B-cell lymphomas (LBCLs) share morphological and phenotypic features with adult types but have better prognosis. The higher frequency of some subtypes such as LBCL with IRF4 rearrangement (LBCL-IRF4) in children suggests that some age-related biological differences may exist. To characterize the genetic and molecular heterogeneity of these tumors, we studied 31 diffuse LBCLs (DLBCLs), not otherwise specified (NOS); 20 LBCL-IRF4 cases; and 12 cases of high-grade B-cell lymphoma (HGBCL), NOS in patients ≤25 years using an integrated approach, including targeted gene sequencing, copy-number arrays, and gene expression profiling. Each subgroup displayed different molecular profiles. LBCL-IRF4 had frequent mutations in IRF4 and NF-κB pathway genes (CARD11, CD79B, and MYD88), losses of 17p13 and gains of chromosome 7, 11q12.3-q25, whereas DLBCL, NOS was predominantly of germinal center B-cell (GCB) subtype and carried gene mutations similar to the adult counterpart (eg, SOCS1 and KMT2D), gains of 2p16/REL, and losses of 19p13/CD70. A subset of HGBCL, NOS displayed recurrent alterations of Burkitt lymphoma-related genes such as MYC, ID3, and DDX3X and homozygous deletions of 9p21/CDKN2A, whereas other cases were genetically closer to GCB DLBCL. Factors related to unfavorable outcome were age >18 years; activated B-cell (ABC) DLBCL profile, HGBCL, NOS, high genetic complexity, 1q21-q44 gains, 2p16/REL gains/amplifications, 19p13/CD70 homozygous deletions, and TP53 and MYC mutations. In conclusion, these findings further unravel the molecular heterogeneity of pediatric and young adult LBCL, improve the classification of this group of tumors, and provide new parameters for risk stratification.

Social Identities of Persons With Schizophrenia and Social Functioning: Individual and Family Caregiver Perspectives.

ABSTRACT: We apply social identity theory and self-categorization theory to examine the role of social identities in relation to the recovery of persons with schizophrenia. We assess whether illness-based and non-illness-based identities held by both those with schizophrenia and their caregivers explain additional variance in social functioning in persons with schizophrenia beyond the previously established predictors of negative symptoms and theory of mind. Sixty Mexican-origin adults diagnosed with schizophrenia and their family caregivers were obtained through an outpatient mental health clinic located in either Los Angeles, CA, or in Puebla, Mexico. A three-step hierarchical regression indicated that identity endorsements, from both the perspective of the person with schizophrenia and their caregiver, and negative symptomatology are significant independent predictors of social functioning. Specifically, greater endorsement of nonillness identities both for the person with schizophrenia and also their caregiver is associated with higher social functioning. Illness identity plays an important role in the path to recovery.

Predictors of Caregiver Participation in an Engagement Strategy to Increase Initiation into a Family-Based Preventive Intervention.

Previous studies have shown that engagement strategies can help increase enrollment and initiation of families in evidence-based preventive programs under natural service delivery settings. However, little is known about factors that predict completion of these engagement strategies. This study aimed to examine predictors (i.e., perceived need, perceived barriers, and sociocultural context) of caregiver participation in an evidence-based engagement call strategy. This call was expected to increase initiation into a school-based, family-focused prevention program. In addition, this study examined engagement call completion as a predictor of program initiation among already enrolled families. Participants included ethnically diverse families recruited from three Title I schools (n = 413) who were randomized to receive the prevention program. Results showed that interparental conflict-an indicator of perceived need-was associated with an increased likelihood of completing the engagement call. Furthermore, caregivers from low-socioeconomic status (SES), foreign-born, Spanish-speaking, Hispanic families were more likely to complete the call relative to those from low- and mid-SES, US born, English-speaking, ethnically diverse families. Importantly, engagement call completion was associated with an increased likelihood of program initiation. These findings provide limited support that families with higher perceived needs are more likely to participate in an evidence-based engagement call strategy. Results suggested that the call strategy provides a promising way to reduce attrition from family prevention programs, which is commonly observed between enrollment and initiation. Project Number: R01 DA035855; Date of Registration: 06/15/2014.

Atypical Autoimmune Hematologic Disorders in a Patient With Kabuki Syndrome.

Kabuki syndrome is a rare genetic disorder characterized by congenital anomalies and developmental delay. It is often associated with impaired immune response and autoimmune abnormalities. We report the clinical case of a girl with Kabuki syndrome who developed autoimmune neutropenia, not previously reported, followed by hemolytic anemia and autoimmune thrombocytopenia.

EEG frequency bands in subjective cognitive decline: A systematic review of resting state studies.

As the older population continues to expand, there is a growing prevalence of individuals who experience subjective cognitive decline (SCD), characterized by self-reported failures in cognitive function and an increased risk of cognitive impairment. Recognizing that preventive interventions are typically more effective in preclinical stages, current research endeavors to focus on identifying early biological markers of SCD using resting-state electroencephalogram (rsEEG) methods. To do so, a systematic literature review covering the past 20 years was conducted following PRISMA guidelines, in order to consolidate findings on rsEEG frequency bands in individuals with SCD. Pubmed and Web of Science databases were searched for rsEEG studies of people with SCD. Quality assessments were completed using a modified Newcastle-Ottawa scale. A total of 564 articles published from December 2003 to December 2023 were reviewed, and significant aspects of these papers were analyzed to provide a general overview of the research on this technique. After removing unrelated articles, nine articles were selected for the present study. The review emphasizes patterns in frequency band activity, revealing that individuals classified as SCD exhibited increased theta power than healthy controls, but decreased than MCI. However, findings for the alpha, delta, and beta bands were inconsistent, demonstrating variability across studies and highlighting the need for further research. Although the rsEEG of frequency bands emerges as a promising early biomarker, there is a noteworthy need to establish uniform standards and consistent measurement approaches in order to ensure the reliability and comparability of the results obtained in the research.

Measurement and Functional Equivalence of a Reduced Version of the UPPS Impulsivity Scale Among Hispanic, Non-Hispanic Black, and Non-Hispanic White Adolescents.

The current study aimed to assess the measurement equivalence and functional equivalence of the UPPS (Urgency, Premeditation, Perseverance, Sensation Seeking) Impulsivity Scale among three ethnoracial adolescent samples in the U.S. seventh-grade students who self-identified as Hispanic (n = 472), non-Hispanic Black (n = 89), or non-Hispanic White (n = 90), and completed an English-language version of the Child version of the UPPS, which was shortened and modified to include positive urgency items. Through a series of confirmatory factor analyses, the UPPS demonstrated configural, metric, and partial threshold invariance. Fisher's r-to-z transformations were used to assess the functional equivalence of the UPPS against well-validated measures of self-regulation and mental health commonly associated with impulsivity. We found some group differences in the magnitude of associations. Yet, overall, this study provides evidence that the UPPS can be used to measure distinct factors of impulsivity among Hispanic, non-Hispanic Black, and non-Hispanic White adolescents.

In Situ Simulation: A Strategy to Restore Patient Safety in Intensive Care Units after the COVID-19 Pandemic? Systematic Review.

BACKGROUND: Patient safety is a public health problem worldwide. In situ simulation (ISS) arises as a learning strategy that allows health professionals to immerse themselves in a real environment without endangering the patients until they have learned the skills needed, thus increasing the quality of care. This systematic review aimed to verify the efficacy of the use of "in situ simulation" as a method that will allow health professionals to increase patient safety in Intensive Care Units after the situation experienced during the pandemic caused by the COVID-19 virus. METHODS: Seven studies were reviewed using the PRISMA methodology for systematic reviews. The CASPe guide was used to assess the quality of the manuscripts. RESULTS: The main topics that emerged from this review in relation to in situ simulation were as follows: looking at aspects such as patient self-perception of safety, adverse events, interprofessional communication and health system organization in relation to in situ simulation. CONCLUSIONS: The adequate implementation of in situ simulation after the COVID-19 pandemic in ICU services is shown to be an efficient and effective strategy to promote improvement in the attitudes on a culture of safety and teamwork of professionals.

Development and Validation of a Prediction Model and Score for Transthyretin Cardiac Amyloidosis Diagnosis: T-Amylo.

BACKGROUND: Although transthyretin cardiac amyloidosis (ATTR-CA) is often underdiagnosed, clinical suspicion is essential for early diagnosis. OBJECTIVES: The aim of this study was to develop and validate a feasible prediction model and score to facilitate the diagnosis of ATTR-CA. METHODS: This retrospective multicenter study enrolled consecutive patients who underwent 99mTc-DPD scintigraphy for suspected ATTR-CA. ATTR-CA was diagnosed if Grade 2 or 3 cardiac uptake was evidenced on 99mTc-DPD scintigraphy in the absence of a detectable monoclonal component or by demonstration of amyloid by biopsy. A prediction model for ATTR-CA diagnosis was developed in a derivation sample of 227 patients from 2 centers using multivariable logistic regression with clinical, electrocardiography, analytical, and transthoracic echocardiography variables. A simplified score was also created. Both of them were validated in an external cohort (n = 895) from 11 centers. RESULTS: The obtained prediction model combined age, gender, carpal tunnel syndrome, interventricular septum in diastole thickness, and low QRS interval voltages, with an area under the curve (AUC) of 0.92. The score had an AUC of 0.86. Both the T-Amylo prediction model and the score showed a good performance in the validation sample (ie, AUC: 0.84 and 0.82, respectively). They were tested in 3 clinical scenarios of the validation cohort: 1) hypertensive cardiomyopathy (n = 327); 2) severe aortic stenosis (n = 105); and 3) heart failure with preserved ejection fraction (n = 604), all with good diagnostic accuracy. CONCLUSIONS: The T-Amylo is a simple prediction model that improves the prediction of ATTR-CA diagnosis in patients with suspected ATTR-CA.

Late phonological development in Williams syndrome.

Williams syndrome is a neurodevelopmental genetic disorder characterized by a unique phenotype, including mild to moderate intellectual disability and an uneven neuropsychological profile of relative strengths and weaknesses. Language structure components (i.e., phonology, morphosyntax, and vocabulary) have been considered an area of specific ability compared to pragmatic language use. However, research on phonological development in Williams syndrome is very scarce, and it suggests atypical patterns. Therefore, the aim of the present study was to explore the profiles of late phonological development in Spanish-speaking children, adolescents, and adults with Williams syndrome, based on the analysis of five classes of processes (Syllable Structure, Substitution, Omission, Assimilation, and Addition) in spontaneous speech. The phonological profiles of seven children (aged 3-8 years), and seven adolescents and young adults (aged 14-25 years) with Williams syndrome were compared with two normative groups of typically developing (TD) children at different stages of late phonological development (aged 3 and 5 years). The frequency of phonological processes in the group of children with Williams syndrome was similar to that of 3-year-old TD children, which suggests that they would be in the first stage of late phonological development (expansion stage). The group of older individuals with Williams syndrome showed a much lower frequency of processes, similar to that of 5-year-old TD children in the last stage of phonological development (resolution stage). However, their phonological processes appeared to be persistent and independent of chronological age. Furthermore, asynchronies in quantitative and qualitative profiles (relative frequency) indicated atypical and complex trajectories in late phonological development, which cannot be described as simply delayed or protracted. Remarkable individual differences were observed, especially in the group of adolescents and adults with Williams syndrome, although the majority of cases conformed to the modal profiles of their groups. A major tendency for Omission, including final consonant deletion, may be considered atypical and specific to Williams syndrome at all ages. The results of the present study raise the need for continued and appropriate phonological assessment and treatment for people with Williams syndrome across the lifespan.

Subjective memory complaints in young people: the role of resilience.

OBJECTIVE: Little is known about the origin and associated factors of subjective memory complaints (SMCs) in the young population, although they might be closely related to the psychophysiological states produced by stress exposure, such as anxiety and depression. In this regard, resilience has been related to a reduction in these negative states, as well as to more adaptive hypothalamic-pituitary-adrenal (HPA) axis functioning. We aimed to investigate the importance of depression, anxiety, and HPA axis activity in SMCs in the young population. We also analysed the relationship between resilience and SMCs through the mediation of depression, anxiety, and the cortisol awakening response (CAR). DESIGN: To do so, we measured SMCs, depression and anxiety states, resilience, and the CAR in 77 healthy young people. RESULTS: Both depression and anxiety were associated with SMCs. In addition, greater resilience was related to fewer SMCs through depression and anxiety. However, the CAR was not related to SMCs, and it did not mediate the relationship between resilience and SMCs. CONCLUSION: These results suggest that negative affective states have greater importance in SMCs than HPA functioning in this age group, and they also highlight the importance of resilience in the psychological adjustment to stressful situations.

EEG markers and subjective memory complaints in young and older people.

Subjective memory complaints (SMCs) have been related to subtle cognitive deficits and neural changes. In this study, we investigated whether EEG rhythms, usually altered in mild cognitive impairment and Alzheimer's disease, are also affected in SMCs compared to people without SMCs. Seventy-one older adults (55-74 years old) and 75 young people (18-34 years old) underwent 3 min of EEG recording in a resting-state condition with their eyes open (EO) and eyes closed (EC) and a comprehensive neuropsychological evaluation. The EEG measures included were power spectral delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), beta (13-30 Hz), and EEG reactivity to EO. Compared to controls, older people with SMCs showed increased theta power and a loss of alpha reactivity to EO. Additionally, in older participants with SMCs, the theta power spectral was related to deficits in verbal memory. In contrast, we failed to find differences in the young people with SMCs, compared to the control group, in the power spectral or the EEG reactivity to EO. Our findings suggest that neurophysiological markers of brain dysfunction may identify cognitive changes even before they are observed on objective neuropsychological tests, at least in older people.

Deficits in facial emotional valence processing in older people with subjective memory complaints: Behavioral and electrophysiological evidence.

Subjective memory complaints (SMCs), which occur in the absence of clinical memory deficits, may precede mild cognitive impairment (MCI) or Alzheimer's disease (AD). Some studies have reported a deficit in facial emotion processing in people with MCI or AD. However, it is unclear whether this deficit is also present in older people with SMCs. The present study used behavioral measurements and event-related potentials (ERPs) to investigate the facial emotion processing of 41 older people with SMCs and 38 without SMCs. The task contained 204 images displaying facial emotions (positive, negative, and neutral). In terms of behavior, our results showed that participants with SMCs were slower and less accurate than controls. In terms of ERPs, the N170 latency was longer in men with SMCs than in controls, whereas no differences were observed between groups in the P300 and late positive potential (LPP) latencies or amplitudes. Moreover, in participants with SMCs, higher P300 and LPP amplitudes were related to better performance on working memory, psychomotor speed, and attention. Additionally, women were faster and more accurate than men on the facial emotion-processing task. In sum, these results suggest that older people with SMCs may have deficits in the processing of facial expressions of emotion. However, this deficit seems to affect the structural encoding of faces, rather than the late stages of processing.

An ERP study on facial emotion processing in young people with subjective memory complaints.

Subjective memory complaints (SMCs) are commonly related to aging, but they are also presented by young adults. Their neurophysiological mechanisms are not thoroughly understood, although some aspects related to affective state have been mentioned. Here, we investigated whether facial emotion processing is different in young people with (n = 41) and without (n = 39) SMCs who were exposed to positive, negative, and neutral faces, by recording the event-related potential (ERP) activity. From the ERP activity, the N170 (an index of face processing) and the LPP (an index of motivated attention) components were extracted. Regarding the N170, results showed less amplitude for positive and neutral faces in the participants with SMCs than in those without SMCs. Moreover, women with SMCs displayed longer latencies for neutral faces than women without SMCs. No significant differences were found between the groups in the LPP component. Together, our findings suggest deficits in an early stage of facial emotion processing in young people with SMCs, and they emphasize the importance of further examining affective dimensions.

Subjective Memory Complaints and Decision Making in Young and Older Adults: An Event-Related Potential Study.

Subjective memory complaints (SMCs) may affect decision-making processes. This study aimed to investigate the neuronal correlates of feedback processing during a decision-making task in young and older adults with and without SMCs. Event-related potentials and behavioral performance during the Iowa gambling task were recorded in a total of 136 participants (65 young adults, 71 older adults). The participants were divided into two groups according to their SMCs (with SMCs: n = 60, without SMCs: n = 76). Feedback-related negativity (FRN) and P3 were analyzed in the feedback stage of the decision-making process. Older adults with SMCs scored worse in the ambiguity phase than older adults without SMCs. The FRN latency was longer for losses in older people with SMCs than in older people without SMCs in the first block. No significant differences between young and older adults with and without SMCs were observed in the other ERP measures. Compared to young adults, older adults showed delayed latency in the FRN component and reduced amplitudes and delayed latency in the P3 component. In conclusion, older people with SMCs present deficits in the decision-making process. These deficits are observed at the behavioral level, but also in neural mechanisms of early feedback processing of negative outcomes.

FRN and P3 during the Iowa gambling task: The importance of gender.

Previous research has shown gender-related psychobiological differences in risky and competitive strategies that affect win and loss outcomes. In addition, some studies have found differences in the decision-making process, with women taking longer to reach the same performance as men. However, the underlying neural mechanisms remain unclear. The present study aimed to investigate gender differences in behavioral performance and neural correlates during a decision-making task, the Iowa Gambling Task (IGT). Forty healthy young adults (23 men and 17 women) performed the IGT while the feedback-related negativity (FRN) and P3 were recorded as neural correlates of feedback processing. No gender differences were observed in the behavioral performance on the IGT after 100 and 150 trials, or in the P3 component. In women, but not in men, the FRN component showed a greater amplitude for losses than for wins. There were no significant gender-related differences in behavioral performance, and men and women revealed a similar learning process on the IGT. At the neural level, no direct differences between men and women were observed in the feedback processing stage for the FRN or P3. However, our results indicate that women showed greater sensitivity to losses than to wins during the decision-making task, as reflected in the FRN component.

Benign paroxysmal vertigo secondary to placement of maxillary implants using the alveolar expansion technique with osteotomes: a study of 4 cases.

The osteotome method is an often-used technique of great utility in certain patients with maxillary bone atrophy. However, it has been associated with the provocation of benign paroxysmal positional vertigo (BPPV), which has been described as a consequence of working the implant bed with osteotomes. During the placement of maxillary dental implants using the osteotome technique, the trauma induced by percussion with the surgical hammer, along with hyperextension of the neck during the operation, can displace otoliths and induce BPPV. Four cases of BPPV occurring after the preparation of maxillary implant beds are presented. Treatment consists fundamentally of maneuvers to move the calcium carbonate crystals from their anomalous location in the semicircular canal to their correct place in the utricle.

Explicit Oral Narrative Intervention for Students with Williams Syndrome.

Narrative skills play a crucial role in organizing experience, facilitating social interaction and building academic discourse and literacy. They are at the interface of cognitive, social, and linguistic abilities related to school engagement. Despite their relative strengths in social and grammatical skills, students with Williams syndrome (WS) do not show parallel cognitive and pragmatic performance in narrative generation tasks. The aim of the present study was to assess retelling of a TV cartoon tale and the effect of an individualized explicit instruction of the narrative structure. Participants included eight students with WS who attended different special education levels. Narratives were elicited in two sessions (pre and post intervention), and were transcribed, coded and analyzed using the tools of the CHILDES Project. Narratives were coded for productivity and complexity at the microstructure and macrostructure levels. Microstructure productivity (i.e., length of narratives) included number of utterances, clauses, and tokens. Microstructure complexity included mean length of utterances, lexical diversity and use of discourse markers as cohesive devices. Narrative macrostructure was assessed for textual coherence through the Pragmatic Evaluation Protocol for Speech Corpora (PREP-CORP). Macrostructure productivity and complexity included, respectively, the recall and sequential order of scenarios, episodes, events and characters. A total of four intervention sessions, lasting approximately 20 min, were delivered individually once a week. This brief intervention addressed explicit instruction about the narrative structure and the use of specific discourse markers to improve cohesion of story retellings. Intervention strategies included verbal scaffolding and modeling, conversational context for retelling the story and visual support with pictures printed from the cartoon. Results showed significant changes in WS students' retelling of the story, both at macro- and microstructure levels, when assessed following a 2-week interval. Outcomes were better in microstructure than in macrostructure, where sequential order (i.e., complexity) did not show significant improvement. These findings are consistent with previous research supporting the use of explicit oral narrative intervention with participants who are at risk of school failure due to communication impairments. Discussion focuses on how assessment and explicit instruction of narrative skills might contribute to effective intervention programs enhancing school engagement in WS students.

["Ready to use" medications. A guide to limit errors when using medications]. / Medicamentos "listos para usar". Una ayuda para limitar los errores de medicación.

Errors in the use of medicines are preventable incidents which may occur at any point in a chain beginning with prescription and continuing on through dispensation and administration of medicine; these errors have multi-factorial causes. Those which are potentially the most dangerous take place in hospital environment and some of them directly affect nursing personnel since they occur during the process when medicines are prepared and administered via an intravenous drip or injection. Pre-diluted medicines for intravenous use, known as "ready to use" preparations, help to reduce the amount of errors associated with the preparation and administration of medicines. These preparations guarantee the correct prescribed dose and eliminate errors related to an incorrectly labeled medicine. Moreover these ready to use medicines avoid a manipulation of the pharmaceutical product, limit the risk of particles being dragged, reduce nursing time employed in preparation of medicines substantially, and prevent accidental needle scratches during the preparation process.

[Preventing nosocomial infections. Dressings soaked in polyhexamethylene biguanide (PHMB)]. / Prevenir la infección nosocomial. Apósitos impregnados con polihexametileno biguanida (PHMB).

Polyhexamethlene biguanide (PHMB) is an antibacterial agent included in the chlorhexidine group which is active against a wide number of microorganisms including Staphylococcus Aureus Methycilin Resistant (MRSA), Vancomycin Resistant Enterococcus Faecalis (VRE) and Acinetobacter baumannii which all cause antibiotic-resistant infections. Traditionally gauze dressings have been used to cover and protect wounds although their porous structure does not constitute an efficient barrier against bacterial penetration, especially when a dressing becomes wet due to the effects of a wound oozing and draining. Recently the use of a dressing soaked in a 0.2% PHMB solution which works as a biological barrier against pathogenic agents has been introduced in clinical practice. On the one hand, this PHMB soaked dressing inhibits bacterial growth in the areas where it is applied and, on the other hand, it prevents the penetration of microorganisms through the dressing itself. Simultaneously while a PHMB soaked dressing carries out these actions, it creates an environment favorable to the proliferation of the normal flora found in the epidermis. As opposed to porous gauze dressings, a PHMB dressing remains active during 72 hours even in wet environs. Its wide anti-micro-bacterial range prevents infections in surgical, acute or chronic wounds and in any type of intra-corporal access susceptible to infection, such as by means of intravascular catheters, tracheotomies, or thoracic tubes. A PHMB dressing can also be used as a primary covering to treat a chronic wound since it does not interfere in the process of tissue reepithelization.