Prevention regulatory focus, desired cultural tightness, civic moral disengagement, and emotional reactions to normative daily transgressions: a serial mediation model among adults in Italy.

Why do people have positive or indifferent reactions to norm violations? The present research hypothesized that individuals who focus on the avoidance of negative outcomes, for example punishments for rule violations, (i.e., a prevention focus) are hypothesized to also have a desire for rigid and clear norms (i.e., desired cultural tightness) as well as punishments for norm violations. Such norms and punishments narrow accepted behavior and, if clearly communicated, can limit rule violations. Consequently, individuals who desire higher levels of cultural tightness should be less likely to justify poor citizenship behavior (i.e., civic moral disengagement) as this behavior is antithetical to desired cultural tightness. Finally, such individuals should also be more likely to react negatively to norm violations. Data for the present study was conducted in Italy. A total of 1,181 participants were included in the analysis; participation requirements were that they be adults who were residents of Italy. Participants completed self-report measures of the prevention focus, desired cultural tightness, civic moral disengagement, and reactions to general norm violations (e.g., exceeding the speed limit, vandalism). The hypothesized serial mediation model was supported. This model can help explain why individuals can fail to react to "everyday" norm violations, as well societal-level violations (e.g., failing to respect hygienic standards during the COVID pandemic). It also calls on the need to develop mass communication approaches that can influence individuals' prevention focus on a large scale, as this can have downstream effects of reactions to such violations.

Significance loss brings to extreme self-care related behaviors: the role of interpersonal influence and obsessive (vs. harmonious) passion.

Building on Significance Quest Theory we hypothesized that significance loss feelings can bring people to extreme self-care related behaviors via (a) the susceptibility to interpersonal influence, and (b) the development of a predominance of obsessive (vs. harmonious) passion toward the self-care. To test these hypotheses, we ran one cross-sectional study among voluntary participants (N = 401). Results confirmed our hypotheses, suggesting that physical appearance is perceived as a fruitful and useful route to maintain or even restoring ones' personal sense of significance. Notably, these results shed light on another scope that can be exploited to achieve social significance (i.e., physical appearance) through extremism, and could represent a starting point to design practical intervention to reduce the examined extreme behaviors.

The Impact of the Need for Cognitive Closure on Attitudes toward Women as Managers and the Sequential Mediating Role of Belief in a Just World and Gender Essentialism.

This research investigated the relation between the need for cognitive closure (i.e., a desire for epistemic certainty) and attitudes toward women as managers among men and women. In a cross-sectional study (total N = 241) collected in Italy, we found that need for cognitive closure, controlling for participants' gender, was related to having more prejudice toward women leaders. Furthermore, the results revealed that the positive relation between the need for cognitive closure and negative attitudes toward women as managers was sequentially mediated by belief in a just world (i.e., the belief that people get what they deserve and deserve what they get and other people do not) and gender essentialism (i.e., the belief that women and men are distinctly, immutably, and naturally different, and thus have complementary skills to bring to the workplace). We suggest that men and women who are characterized by a need for cognitive closure are more sensitive to stereotypes of women as being incompatible with leadership roles. Either priming a low need for cognitive closure or providing contrary stereotypes could obviate the effect on beliefs in a just world and in gender essentialism that impedes progress towards greater gender equality in the workplace.

Motivation to Avoid Uncertainty, Implicit Person Theories about the Malleability of Human Attributes and Attitudes toward Women as Leaders vs. Followers: A Mediational Analysis.

This research investigated the relation between motivation to avoid uncertainty, as reflected in the need for cognitive closure, implicit theories about the malleability of human attributes, and attitudes toward women as leaders vs. followers. In a cross-sectional study (N = 470) conducted in Italy, we hypothesized and found that the need for cognitive closure directly enhanced the belief that women are compatible with followership roles rather than leadership roles. Furthermore, the results from a mediational analysis revealed that the relation between the need for cognitive closure and the belief that women are compatible with followership roles rather than leadership was mediated by implicit person theories (i.e., the conviction that people features are malleable vs. unchangeable). Notably, we obtained these results while controlling for participants' gender, educational level, and age. The theoretical and practical implications are discussed.

Coronary artery evaluation during ECG-gated CT of the thoracic aorta: Do not consider it a negligible clinical information.

A CT angiography, performed for ascending aorta study, revealed, incidentally, an anomalous origin and course of right coronary artery. Anomalies in the origins and course of the coronary arteries are critical information that should not be missed, because they can worsen the patient's prognosis.

Interrupted inferior vena cava draining into the coronary sinus associated with circumflex artery to coronary sinus fistula.

In an adult patient, coronary artery fistula involving the circumflex artery (CX) connected to the coronary sinus caused aneurysm of the left main and CX associated with ectasia of the intermediate branch. The patient had posterolateral infarction with severe ischemic mitral regurgitation and moderate tricuspid regurgitation. A rare venous return anomaly was also present. The inferior vena cava, which was interrupted at the level of the liver, continued with the hemiazygos to drain into a persistent left superior vena cava, which in turn drained into the coronary sinus. Surgery included CX closure and mitral and tricuspid repair. The strategy had to be adapted to the anatomy. The fistula was dissected and snared for cardioplegia delivery, and venous return was achieved by cannulation of the superior vena cava and femoral vein. The procedure was uneventful, and 4 years later the patient is asymptomatic.

Imaging of Strictures in Crohn's Disease.

Crohn's disease (CD) is a chronic inflammation of the digestive tract, and it frequently affects young patients. It can involve any intestinal segment, even though it frequently affects the distal ileum. Up to 80% of patients with CD present with inflammatory behavior, and 5% to 28% develop stricturing disease. Based on the predominant mechanism causing them, strictures can be categorized as inflammatory, fibrotic, or mixed. Determining the relative amounts of inflammation and fibrosis in a stricture can influence treatment decisions. Imaging is an extremely useful tool in patients with small bowel stricturing CD to confirm the diagnosis and to evaluate disease characteristics, usually using CT or MRI. The aim of this paper is to describe how imaging can evaluate a patient with small bowel CD stricture.

Risk evaluation of secondary malignancies after radiotherapy of breast cancer in light of the continuous development of planning techniques.

Secondary cancer risk is a significant concern for women treated with breast radiation therapy due to improved long-term survival rates. We evaluated the potential of new advanced automated planning algorithms together with hybrid techniques to minimize the excess absolute risk (EAR) for secondary cancer in various organs after radiation treatment for early staged breast cancer. Using CT data set of 25 patients, we generated 4 different radiation treatment plans of different complexity, including 3-dimensional conformal radiotherapy (3D-CRT), field-in-field (FinF), hybrid-IMRT (HMRT) and automated hybrid-VMAT (HVMAT) techniques. The organ-equivalent dose (OED) was calculated from differential dose-volume histograms on the basis of the "linear-exponential," "plateau," and "full mechanistic" dose-response models and was used to evaluate the EAR for secondary cancer in the contralateral breast (CB), contralateral lung (CL), and ipsilateral lung (IL). Statistical comparisons of data were performed by a Kruskal-Wallis analysis of variance. The planning objectives were fulfilled with all the planning techniques for both target coverage and organs-at-risk sparing. The differences in EAR for CB, CL and IL secondary tumor induction were not significant among the 4 techniques. For the CB and CL, the mean absolute difference did not reach 1 case of 10000 patient-years. For the IL, the mean absolute difference was up to 5 cases of 10,000 patient-years. In conclusion, the automated HVMAT technique allows an EAR reduction at the level of well-consolidated tangential 3D-CRT or FinF techniques, keeping all the HVMAT dosimetric improvements unchanged. On the basis of this analysis, the adoption of the HVMAT technique poses no increase in EAR and could be considered safe also for younger patients.

Small Bowel Imaging from Stepchild of Roentgenology to MR Enterography, Part II: The Reliable Disclosure of Crohn's Disease and Non-Inflammatory Small Bowel Disorder Plot through MRI Findings.

MRE has become a standard imaging test for evaluating patients with small bowel pathology, but a rigorous methodology for describing and interpreting the pathological findings is mandatory. Strictures, abscess, inflammatory activity, sinus tract, wall edema, fistula, mucosal lesions, strictures, and mesentery fat hypertrophy are all indicators of small bowel damage in inflammatory and non-inflammatory small bowel disease, and they are all commonly and accurately explained by MRE. MRE is a non-invasive modality that accurately assesses the intra-luminal, parietal, and extra-luminal small bowel. Differential MRE appearance allows us to distinguish between Crohn's disease and non-inflammatory small bowel disorder. The purpose of this paper is to present the MRE pathological findings of small bowel disorder.

Small Bowel Imaging from Stepchild of Roentgenology to MR Enterography: Part I: Guidance in Performing and Observing Normal and Abnormal Imaging Findings.

MRE has become a standard imaging test for evaluating patients with small bowel pathology, but the indications, interpretation of imaging findings, methodology, and appropriate use must be standardized and widely known. Several signs of small bowel damage in inflammatory and non-inflammatory small bowel pathology include strictures, abscess, inflammatory activity, sinus tract, wall edema, fistula, mucosal lesions, and mesentery fat hypertrophy, all of which are widely and accurately explained by MRE. MRE is a non-invasive modality that accurately assesses the intra-luminal, parietal, and extra-luminal small bowel. The differential MRE appearance allows us to distinguish between different small bowel pathologies, such as neoplastic and non-neoplastic small bowel diseases. The purpose of this paper is to present the MRE technique, as well as the interpretation of imaging findings, through the approach of a rigorous stepwise methodology.

Means substitutability in personal significance restoration.

Drawing on Significance Quest Theory, we hypothesized that when people experience a loss of significance related to a specific life domain, they will aim to restore their significance by acting in an extreme manner in a different life domain. To test this hypothesis, we ran two cross-sectional studies using samples of employed people in romantic relationships. Study 1 tested if people experiencing a loss of significance in the romantic relationship domain were more prone to extremism at work. Study 2 tested whether people experiencing work-related significance loss were more prone to engage in obsessive relational intrusion (ORI) toward their romantic partner. Results from both studies confirmed our hypothesis, suggesting that both amorous relationships and careers are perceived as fruitful in maintaining or restoring ones' sense of personal significance, even if the original loss of significance is derived from an unrelated domain. Notably, this research represents one of the first tests of the key assumption of Significance Quest Theory entailing the substitutability of means through which one can attain or renew their sense of significance.

Ambition and extreme behavior: relative deprivation leads ambitious individuals to self-sacrifice.

Ambitious people are characterized by strong motivation toward great and valuable objectives, with the superordinate goal to gain respect and recognition from others. Recent literature regarding ambition demonstrated that it leads individuals to engage in extreme behavior. However, no previous research has investigated under which conditions the relation between ambition and extremism is enhanced. Across two studies, we tested the hypothesis that ambitious individuals are more prone to engage in extreme behavior in the face of relative deprivation (i.e., justice sensitivity), than their less ambitious counterparts. We confirmed our predictions employing a cross-sectional design with an American sample (Study 1) and an experimental design with an Italian sample (Study 2). The present research adds theoretical knowledge and empirical support to the existing literature on ambition, extreme behavior, and relative deprivation, and provides fruitful insight into strategies for preventing extremism.

Increase of Epicardial Adipose Tissue (EAT) With Fat Infiltration of Right Ventricular Myocardium: Is it Always a High-Risk Stigmata or a Worrisome Feature?

Incidental epicardial adipose tissue (EAT) and subepicardial fat infiltration on CT scans are not uncommon and the differential diagnosis can be a challenge. Considering the vastness of the possible disorders, it is important to differentiate physiologic age-related condition from pathologic disease. We present a case of an asymptomatic 81-year-old woman in which according to ECG and CMR findings we considered as possible differential diagnoses arrhythmogenic cardiomyopathy (ACM) dominant-right variant, lipomatosis and physiological growth of epicardial fat. We focus on patient characteristics, location of the fat replacement, heart morphovolumetry, wall motion of the ventricles and absence of late gadolinium enhancement to diagnose pericardial fat hypertrophy and physiological fatty infiltration. The role of EAT is unclear and it could play a part in the development of atherosclerosis and atrial fibrillation. Therefore, the clinicians should not underestimate this condition even if it would be an incidental finding in asymptomatic patients.

Frustration-aggression hypothesis reconsidered: The role of significance quest.

One of the oldest scientific theories of human aggression is the frustration-aggression hypothesis, advanced in 1939. Although this theory has received considerable empirical support and is alive and well today, its underlying mechanisms have not been adequately explored. In this article, we examine major findings and concepts from extant psychological research on hostile aggression and offer an integrative conception: aggression is a primordial means for establishing one's sense of significance and mattering, thus addressing a fundamental social-psychological need. Our functional portrayal of aggression as a means to significance yields four testable hypotheses: (1) frustration will elicit hostile aggression proportionately to the extent that the frustrated goal serves the individual's need for significance, (2) the impulse to aggress in response to significance loss will be enhanced in conditions that limit the individual's ability to reflect and engage in extensive information processing (that may bring up alternative, socially condoned means to significance), (3) significance-reducing frustration will elicit hostile aggression unless the impulse to aggress is substituted by a nonaggressive means of significance restoration, (4) apart from significance loss, an opportunity for significance gain can increase the impulse to aggress. These hypotheses are supported by extant data as well as novel research findings in real-world contexts. They have important implications for understanding human aggression and the conditions under which it is likely to be manifested and reduced.

CT-based radiomics prediction of complete response after stereotactic body radiation therapy for patients with lung metastases.

PURPOSE: Stereotactic body radiotherapy (SBRT) is a key treatment modality for lung cancer patients. This study aims to develop a machine learning-based prediction model of complete response for lung oligometastatic cancer patients undergoing SBRT. MATERIALS AND METHODS: CT images of 80 pulmonary oligometastases from 56 patients treated with SBRT were analyzed. The gross tumor volumes (GTV) were contoured on CT images. Patients that achieved complete response (CR) at 4 months were defined as responders. For each GTV, 107 radiomic features were extracted using the Pyradiomics software. The concordance correlation coefficients (CCC) between the region of interest (ROI)-based radiomics features obtained by the two segmentations were calculated. Pairwise feature interdependencies were evaluated using the Spearman rank correlation coefficient. The association of clinical variables and radiomics features with CR was evaluated with univariate logistic regression. Two supervised machine learning models, the logistic regression (LR) and the classification and regression tree analysis (CART), were trained to predict CR. The models were cross-validated using a five-fold cross-validation. The performance of models was assessed by receiver operating characteristic curve (ROC) and class-specific accuracy, precision, recall, and F1-measure evaluation metrics. RESULTS: Complete response was associated with four radiomics features, namely the surface to volume ratio (SVR; p = 0.003), the skewness (Skew; p = 0.027), the correlation (Corr; p = 0.024), and the grey normalized level uniformity (GNLU; p = 0.015). No significant relationship between clinical parameters and CR was found. In the validation set, the developed LR and CART machine learning models had an accuracy, precision, and recall of 0.644 and 0.750, 0.644 and 0.651, and 0.635 and 0.754, respectively. The area under the curve for CR prediction was 0.707 and 0.753 for the LR and CART models, respectively. CONCLUSION: This analysis demonstrates that radiomics features obtained from pretreatment CT could predict complete response of lung oligometastases following SBRT.

Constrictive Pericarditis With Massive Calcification in Systemic Sclerosis Treated With Pericardiectomy: A Case Report.

Calcific constrictive pericarditis is a very rare complication of systemic sclerosis. This is the first report of surgically treated calcific constrictive pericarditis in systemic sclerosis. A 53 years-old woman, affected by limited systemic sclerosis, had a diagnosis of calcific constrictive pericarditis. She had a medical history of congestive heart failure since 2022. The patient was treated with pericardiectomy. Via a median sternotomy, the pericardium was dissected and removed from the midline to the left phrenic nerve, thus freeing the heart. Three months after the pericardiectomy, there was a significant clinical improvement. The calcific evolution of chronic pericarditis is a rare complication of systemic sclerosis. This case represents, at best of our knowledge, the first report of calcific constrictive pericarditis, in systemic sclerosis, treated with pericardiectomy.

Feasibility-guided automated planning for stereotactic treatments of prostate cancer.

Significant improvements in plan quality using automated planning have been previously demonstrated. The aim of this study was to develop an optimal automated class solution for stereotactic radiotherapy (SBRT) planning of prostate cancer using the new Feasibility module implemented in the pinnacle evolution. Twelve patients were retrospectively enrolled in this planning study. Five plans were designed for each patient. Four plans were automatically generated using the 4 proposed templates for SBRT optimization implemented in the new pinnacle evolution treatment planning systems, differing for different settings of dose-fallout (low, medium, high and veryhigh). Based on the obtained results, the fifth plan (feas) was generated customizing the template with the optimal criteria obtained from the previous step and integrating in the template the "a-priori" knowledge of OARs sparing based on the Feasibility module, able to estimate the best possible dose-volume histograms of OARs before starting optimization. Prescribed dose was 35 Gy to the prostate in 5 fractions. All plans were generated with a full volumetric-modulated arc therapy arc and 6MV flattening filter-free beams, and optimized to ensure the same target coverage (95% of the prescription dose to 98% of the target). Plans were assessed according to dosimetric parameters and planning and delivery efficiency. Differences among the plans were evaluated using a Kruskal-Wallis 1-way analysis of variance. The requests for more aggressive objectives for dose falloff parameters (from low to veryhigh) translated in a statistically significant improvement of dose conformity, but at the expense of a dose homogeneity. The best automated plans in terms of best trade-off between target coverage and OARs sparing among the 4 plans automatically generated by the SBRT module were the high plans. The veryhigh plans reported a significant increase of high-doses to prostate, rectum, and bladder that was considered dosimetrically and clinically unacceptable. The feas plans were optimized on the basis on high plans, reporting significant reduction of rectum irradiation; Dmean, and V18 decreased by 19% to 23% (p = 0.031) and 4% to 7% (p = 0.059), respectively. No statistically significant differences were found in femoral heads and penile bulb irradiation for all dosimetric metrics. feas plans showed a significant increase of MU/Gy (mean: 368; p = 0.004), reflecting an increased level of fluence modulation. Thanks to the new efficient optimization engines implemented in pinnacle evolution (L-BFGS and layered graph), mean planning time was decreased to less than 10 minutes for all plans and all techniques. The integration of dose-volume histograms a-priori knowledge provided by the feasibility module in the automated planning process for SBRT planning has shown to significantly improve plan quality compared to generic protocol values as inputs.

Addressing the effect of concern with COVID-19 threat on prejudice towards immigrants: The sequential mediating role of need for cognitive closure and desire for cultural tightness.

The link between threat and anti-immigrant prejudice is well-established. Relatedly, recent research has also shown that situational threats (such as concern with COVID-19 threat) increase anti-immigrant prejudice through the mediating role of desire for cultural tightness. This study aims to further our understanding of the psychological processes underlying the relation between concern with COVID-19 threat and increased negative attitudes towards immigrants by considering the mediational role of an individual epistemic motivation (i.e., the need for cognitive closure). A study was conducted on a large sample of Italian respondents covering all the Italian regions. Findings revealed that high concern with COVID-19 threat led to increased negative attitudes towards immigrants through the sequential mediating role of higher need for cognitive closure, leading in turn to higher desire for cultural tightness. Implications of these findings for a timely contextualized study of anti-immigrant prejudice will be highlighted.

The mediating role of narcissism in the effects of regulatory mode on positivity.

Positivity (i.e., the individual tendency to positively approach life experiences) has proven to be an effective construct applied in positive psychology. However, individuals' self-regulation may have contrasting effects on positivity. We specifically examined whether positivity could be partially explained through two aspects of motivation concerned with self-regulation: locomotion (i.e., a motivational orientation concerned with movement) and assessment (i.e., a motivational orientation concerned with comparison and evaluation). Furthermore, based on previous literature that found a link between these aspects and narcissism, we examined whether "adaptive" and "maladaptive" dimensions of narcissism could mediate the effects of locomotion and assessment on increased or decreased positivity. Narcissism was defined by previous research as adaptive or maladaptive insofar as it leads or does not lead to increased psychological well-being. We estimated a mediation model with multiple independent variables and multiple mediators in a cross-sectional study with self-reported data from 190 university students. We found that both locomotion and assessment were associated with adaptive narcissism, which in turn was positively associated with positivity. However, assessment was also associated with maladaptive narcissism, which in turn was negatively associated with positivity. Relationships between aspects of self-regulation, narcissism, and positivity can have significant implications which will be discussed.

Bib Sign in Proximal Descending Thoracic Aorta Rupture on CT Angiography: Presentation of a Paradigmatic Case.

Thoracic aortic rupture may present with subtle clinical and CT-angiography findings. Recognition of the imaging features of early rupture is key for timely diagnosis and treatment. This report presents a new sign of incipient proximal thoracic aortic rupture on CT-angiography.