Patterns of Sexting by Youths: A Latent Class Analysis.

Sexting (exchanging sexual correspondence in the online space) is considered a practice that expresses sexuality in the online space. Between adolescents, sexting can be part of a couple relationship or outside of it, and can be voluntary or coercive. Regardless of motives, sexting has been linked to various negative outcomes. Understanding the factors that influence sexting behavior is essential for developing effective prevention and intervention programs. The present study aimed to identify and compare different profiles of sexting behavior in adolescents using latent class analysis. Participants were 487 Israeli adolescents aged 14-19 (male N = 215, 44%, female N = 272, 56%) years who completed an online survey of demographic factors, online parental mediation, family and friend cohesion, and perception of sexting norms. Two distinct classes of individuals were identified: those who engage in sexting ("sexters") and those who do not ("non-sexters"). Sexters were more likely to be secular, and without a romantic partner. These findings may inform interventions aimed at preventing negative outcomes associated with adolescent sexting.

Three Perspectives on Older Adults' Daily Performance, Health, and Technology Use During COVID-19: Focus Group Study.

Background: During COVID-19 lockdowns, older adults' engagement in daily activities was severely affected, causing negative physical and mental health implications. Technology flourished as a means of performing daily activities in this complex situation; however, older adults often struggled to effectively use these opportunities. Despite the important role of older adults' social environments-including their families and health professionals-in influencing their technology use, research into their unique perspectives is lacking. Objective: This study aimed to explore the daily activity performance, health, and technology use experiences of healthy independent Israeli adults (aged ≥65 years) during COVID-19 from a 3-dimensional perspective: older adults, older adults' family members, and health professionals. Methods: Nine online focus groups, averaging 6-7 participants per group, were conducted with older adults, family members, and health professionals (N=59). Data were analyzed using thematic analysis and constant comparative methods. Results: The intertwining of daily activity performance and health emerged as a central theme, with differences between the groups. Older adults prioritized their self-fulfilling routines based on motivation and choice, especially in social-familial activities. In contrast, family members and health professionals focused on serious physical and mental health COVID-19-related consequences. A consensus among all three groups revealed the meaningful role of technology use during this period in bridging functional limitations. Participants delved into technology's transformative power, focusing on the need for technology to get engaged in daily activities. Conclusions: This study illustrates the profound interplay between daily activity performances, physical and mental health, and technology use, using a 3-dimensional approach. Its focus on technology's uses and benefits sheds light on what older adults need to increase their technology use. Interventions for improving digital activity performance can be tailored to meet older adults' needs and preferences by focusing on motivational and preference-related activities.

Parental Responses to Online Sexual Grooming Events Experienced by Their Teenage Children.

Online sexual grooming (a manipulative process in which the perpetrator locates a young person and creates an abusive relationship with the child that involves sexual exploitation) poses significant challenges to parents. This study examined how parents of adolescent victims of online sexual grooming experienced guiding their children through the event. This qualitative study, conducted in Israel, was based on semi-structured in-depth interviews with 15 parents who guided their adolescents who had been subjected to online sexual grooming. Results indicate that the parents reported a spectrum of emotions, from insecurity and guilt to a sense of control and satisfaction in managing the situation. Also, the reluctance of some parents to engage with the education system indicates potential trust issues. The study demonstrates the urgent need for targeted interventions to equip parents and educational professionals with the necessary knowledge for prevention and effective response to online sexual grooming. Implications for future research, policy, and practice are discussed.

Gender Differences in the Relationship between Lifetime Exposure to Trauma and the Development of Pathological Personality Traits.

Gender differences in the prevalence, types and outcomes of traumas have consistently been reported in the literature. Other research has documented that exposure to trauma is associated with the development and maintenance of pathological personality traits. In the current study, we examined the moderating role of gender in the association between lifetime exposure to trauma and pathological personality traits. The sample included 148 clients who sought treatment at a community mental health clinic. All participants completed online questionnaires including demographic information, the Trauma History Questionnaire (THQ), and the Personality Inventory for DSM-5-Brief Form (PID-5-BF) at the entry to treatment. Our findings documented a significant association between exposure to trauma and pathological personality traits in men, but not in women. Furthermore, this pattern of results was specifically evident within two personality domains: antagonism and detachment. These findings contribute to the theoretical understanding of the interplay between trauma, gender, and the development of pathological personality traits. They expand upon the growing knowledge about the mental health crisis among boys and men by shedding light on the unique vulnerabilities that men face in response to traumatic experiences and how these experiences can have a lasting impact on their adaptive functioning. Consequently, at the clinical level, the current study emphasizes the importance of paying particular attention to men's trauma histories and explicitly exploring these during the intake session.

Diagnostic capabilities of ChatGPT in ophthalmology.

PURPOSE: The purpose of this study is to assess the diagnostic accuracy of ChatGPT in the field of ophthalmology. METHODS: This is a retrospective cohort study conducted in one academic tertiary medical center. We reviewed data of patients admitted to the ophthalmology department from 06/2022 to 01/2023. We then created two clinical cases for each patient. The first case is according to the medical history alone (Hx). The second case includes an addition of the clinical examination (Hx and Ex). For each case, we asked for the three most likely diagnoses from ChatGPT, residents, and attendings. Then, we compared the accuracy rates (at least one correct diagnosis) of all groups. Additionally, we evaluated the total duration for completing the assignment between the groups. RESULTS: ChatGPT, residents, and attendings evaluated 126 cases from 63 patients (history only or history and exam findings for each patient). ChatGPT achieved a significantly lower accurate diagnosis rate (54%) in the Hx, as compared to the residents (75%; p < 0.01) and attendings (71%; p < 0.01). After adding the clinical examination findings, the diagnosis rate of ChatGPT was 68%, whereas for the residents and the attendings, it increased to 94% (p < 0.01) and 86% (p < 0.01), respectively. ChatGPT was 4 to 5 times faster than the attendings and residents. CONCLUSIONS AND RELEVANCE: ChatGPT showed low diagnostic rates in ophthalmology cases compared to residents and attendings based on patient history alone or with additional clinical examination findings. However, ChatGPT completed the task faster than the physicians.

Rapid home therapy infusion of velaglucerase alfa in naïve patients with Gaucher disease.

BACKGROUND: Enzyme replacement therapy (ERT) has revolutionised the management of patients with Gaucher disease (GD). In 2018, we published the safety and efficacy of rapid 10-min infusion of velaglucerase alfa in previously treated patients, mostly on low-dose therapy. AIM: To improve quality of life (QoL) for patients needing lifelong bi-weekly infusions by introducing a 10-min infusion instead of 1 h per label in patients naive to ERT and on high-dose therapy. METHODS: Fifteen naive patients were enrolled; all received bi-weekly infusions of 60 units/kgBW velaglucerase alfa; the infusion rate was gradually reduced in the hospital, followed by home infusions. Each infusion was followed for safety. Efficacy parameters were assessed every 3 months. Patient-reported outcome questionnaires were collected at baseline and follow-up. RESULTS: Ten-minute rapid infusions were well tolerated without related severe adverse events (SAEs). Two patients experienced a non-related SAE and another a possibly related AE. In three patients, the infusion rate was increased to 30 or 60 min (two because of suboptimal response and one because of AE). Two patients dropped out because of an unwillingness to attend follow-up visits during the COVID-19 pandemic. All 13 remaining patients reached the 24-month end-point. The platelet counts increased by a median (range) of 68.38% (12.5-300%) and the lyso-Gb1 levels decreased by 62.6% (32.9-89.9%). CONCLUSION: Home therapy with rapid infusion of high-dose velaglucerase alfa was a safe, effective and preferable alternative for patients with GD naïve to treatment. We believe that shortening the infusion time improves the QoL of patients with GD who have a lifelong commitment to intravenous therapy.

"You Need to Set a Daily Schedule": Understanding Successful Aging via Three-Sided Viewpoints.

This study aimed to identify the constructs related to successful aging in the context of engagement in social and productive activities. A qualitative design was used to explore three viewpoints on the aging period with 9 focus groups (3 each for adults 65 years or older, older adults' family members, and health professionals) and 18 interviews with older adults (older adults Mage = 71.7 years, Standard Deviation = 4.62). The transcripts were analyzed using constructivist grounded theory principles. Three categories were identified for successful aging: (a) engagement with life, including social participation, fixed/flexible schedule, time, and meaningful occupation; (b) self-management abilities, including producing daily schedules, independence, and initiation/striving toward goals; and (c) diversity among older adults, including their views on retirement, being active or not, and their dreams/values/goals. Considering the diverse nature of older adults, recognizing the importance of life engagement and self-management abilities emphasizes the necessity for an occupation-based, self-tailored approach to enable successful aging.

Assessment of the iCare HOME2, a New Intraocular Pressure Self-Measurement Tonometer.

PRCIS: The iCare HOME2 tonometer generally can be considered reliable for most eyes and clinical settings, although it may produce slightly overestimated or underestimated intraocular pressure (IOP) readings in thicker and thinner corneas, respectively. PURPOSE: To evaluate the accuracy, correlation, and analysis of differences in IOP measurements between the gold standard Goldmann applanation tonometer (GAT) and the new, self-measurement iCare HOME2 tonometer (icare). PATIENTS AND METHODS: In this retrospective study, patients were randomly selected from those who attended a routine examination in our clinic. After a complete ocular examination, each patient's IOP was measured and recorded with GAT and iCare HOME2. Central corneal thickness was measured. Eyes with any corneal morbidity were excluded. Pearson correlation coefficient was used to determine the correlation between paired IOP measurements. Bland-Altman plots were graphed for the analysis of differences in IOP between the instruments. RESULTS: One hundred thirty-five eyes of 70 patients were included in the study. The mean IOP measured with GAT was 16.3 ± 6.5 mm Hg (range: 3-56). The mean IOP measured with iCare HOME2 was 16.5 ± 7.3 mm Hg (range: 3-55), ( P = 0.47). A strong, significant positive correlation was found for paired IOP measurements by the 2 instruments ( r = 0.94; P < 0.0001). A small systematic proportional bias was seen for the paired IOP measurements, meaning that with higher IOPs the iCare HOME2 yielded higher IOP readings than GAT, but this difference was clinically insignificant. The instrument underestimated IOPs with corneas thinner than 522 µm, whereas it overestimated IOPs when corneas were thicker than this. CONCLUSION: The iCare HOME2 could be a reliable tonometer for most eyes and clinical settings. Central corneal thickness measurement is recommended in patients who use the instrument.

A Qualitative Study of How Israeli Arab Educational Counselors Handle Image-Based Sexual Abuse of Female Adolescents.

Image-based sexual abuse (IBSA) refers to the nonconsensual production, dissemination, or threat of dissemination of private sexual images of another. Arabs belong to a conservative society where the distribution of a nude photo constitutes a violation of the dignity of the family and may have serious consequences. Based on semistructured in-depth interviews, the present study examined how 32 Arab educational counselors in Israel handle IBSA. Findings suggest that counselors identified the victim as experiencing difficulties that allowed her to be harmed. Also, it was found that counselors were afraid it might harm the victims on the grounds of family honor. These findings indicate that it is necessary to find culturally sensitive solutions both for the prevention and treatment of this phenomenon.

The Bone Biomarker of Quantitative Chemical Shift Imaging in Patients with Type 1 Gaucher Disease Receiving Low-Dose Long-Term Enzyme Replacement Therapy.

Quantitative chemical shift imaging (QCSI) is the most sensitive imaging biomarker to assess bone marrow involvement in Gaucher disease. Widespread QCSI use is limited by test availability. Anecdotal reports describe two patients demonstrating significant improvement in fat fraction (FF) assessed by QCSI following a switch from imiglucerase to taliglucerase alfa. This analysis evaluated bone marrow involvement in adults with Type 1 Gaucher disease receiving low-dose enzyme replacement therapy (ERT) with imiglucerase and/or velaglucerase alfa. We report baseline data for 30 patients meeting eligibility criteria. Median (range) duration and dose of ERT were 18 (5-26) years and 30 (30-60) U/kg/month, respectively. Low FF scores (<0.30) were observed for seven patients (23%; 95% confidence interval, 10-42%) and were more common in females (n = 6) versus males (n = 1; p < 0.025); one female was menopausal. These baseline data demonstrate that prolonged low-dose ERT with imiglucerase or velaglucerase alfa led to an adequate bone response, assessed by QCSI, in the majority of patients. A minority of such patients with suboptimal bone response require therapeutic change. The next phase of the study will address the effect of switching to taliglucerase alfa on bone status for patients with less than optimal QCSI scores (<0.30).

Contribution of Glucosylsphingosine (Lyso-Gb1) to Treatment Decisions in Patients with Gaucher Disease.

Glucosylsphingosine (lyso-Gb1), the deacylated form of glucocerebroside, was shown to be the most specific and sensitive biomarker for diagnosing Gaucher disease (GD). The aim of this study is to assess the contribution of lyso-Gb1 at the time of diagnosis for treatment decisions in naïve patients with GD. Newly diagnosed patients from July 2014 to November 2022 were included in this retrospective cohort study. The diagnosis was done by sending a dry blood spot (DBS) sample for GBA1 molecular sequencing and lyso-Gb1 quantification. Treatment decisions were based on symptoms, signs, and routine laboratory tests. We diagnosed 97 patients (41 males), both type 1 (n = 87), and neuronopathic (n = 10). The median (range) age at diagnosis was 22 (1-78), with 36 children. In 65 patients, GD-specific therapy was started with a median (range) lyso-Gb1, 337 (60-1340) ng/mL, significantly higher than in patients who did not go on to treatment, 153.5 (9-442) ng/mL. Using a receiver operating characteristic (ROC) analysis, a cutoff of lyso-Gb1 > 250 ng/mL was associated with treatment with a sensitivity of 71% and specificity of 87.5%. Predictors of treatment were thrombocytopenia, anemia, and elevated lyso-Gb1 (>250 ng/mL). In conclusion, lyso-Gb1 levels contribute to the medical decision related to the initiation of treatment, mainly among mildly affected newly diagnosed patients. For patients with a severe phenotype, as for all patients, the main value of lyso-Gb1 would be to monitor response to therapy. The variable methodology and differences in the units of lyso-Gb1 measurements between laboratories prevent the adaptation of the exact cut-off we found in general practice. However, the concept is that a significant elevation, i.e., a several-fold increase from the diagnostic lyso-Gb1 cutoff, is related to a more severe phenotype and, accordingly, to the decision regarding the initiation of GD-specific therapy.

A Qualitative Examination of School Counselors' Experiences of Sextortion Cases of Female Students in Israel.

Sextortion (a portmanteau of "sexual" and "extortion") is a relatively new phenomenon of sexual exploitation, which occurs when a person threatens another with the distribution of sexual content on the Internet, to obtain more pictures or videos, money, or have some other demand met. The current study examined how school counselors in Israel perceive the phenomenon of online sextortion. To this end, we conducted a qualitative study based on 20 semi-structured in-depth interviews with school counselors working in middle schools and high schools in Israel, who treated adolescent girls blackmailed over the Internet on sexual grounds. Findings indicate that the school counselors had difficulty in identifying and defining the cases they treated as instances of sextortion, and that in their view the harm was slight. Findings also indicate that school counselors associated the causes of sextortion with the victims and their backgrounds. We found differences between the Arab and secular and national-religious state education in the way Jewish counselors treated the victims and involved additional actors such as the victim's parents and the police. This underscores the importance of providing educational staff with adequate knowledge and tools that are culturally suited to the victims.

The social-encoding benefit in face recognition is generalized to other-race faces.

Faces are visual stimuli that convey rich social information. Previous experiments found better recognition for faces that were evaluated based on their social traits than on their perceptual features during encoding. Here, we ask whether this social-encoding benefit in face recognition is also found for categories of faces that we have no previous social experience with, such as other-race faces. To answer this question, we first explored whether social and perceptual evaluations for other-race faces are consistent and valid. We then asked whether social evaluations during encoding improve recognition for other-race faces. Results show that social and perceptual evaluations of own- and other-race faces were valid. We also found high agreement in social and perceptual evaluations across individuals from different races. This indicates that evaluations of other-race faces are not random but meaningful. Furthermore, we found that social evaluations facilitated face recognition regardless of race, demonstrating a social-encoding benefit for both own- and other-race faces. Our findings highlight the role of social information in face recognition and show how it can be used to improve recognition of categories of faces that are hard to recognize due to lack of experience with them.

Real-Life Experience with Oral Eliglustat in Patients with Gaucher Disease Previously Treated with Enzyme Replacement Therapy.

Three types of enzyme replacement therapies (ERTs) and two substrate reduction therapies (SRTs) are approved for symptomatic patients with type 1 Gaucher disease (GD1). Eliglustat is the second SRT approved, yet the first to be approved as first-line therapy for any adult patients with compatible CYP2D6 metabolizer genotype. Herein we report safety and efficacy data of the first 29 patients switched from ERT to eliglustat from the Gaucher Unit at Shaare Zedek Medical Center (SZMC) between 07/2017 and 06/2022; the median (range) time on ERT was 13 (0.66-30) years, and the median (range) time on eliglustat was 7 (1-52) months. Most patients switched due to oral preference or sub-optimal response to low-dose ERT. Twelve patients stopped eliglustat after a median (range) of 4 (1-18) months; 11 due to adverse events (AEs) and one due to personal request. There were no drug-related serious AEs and no drug-related cardiac events. Most AEs were mild and transient, mainly dyspepsia. Efficacy achievements were reflected by maintaining stability. We concluded that switching from ERT to eliglustat is safe if choosing the appropriate patients. Reassuring patients to tolerate early AEs may reduce discontinuation. Following the response and compliance to therapy is important to ensure long-term efficacy.

A Comprehensive Assessment of Qualitative and Quantitative Prodromal Parkinsonian Features in Carriers of Gaucher Disease-Identifying Those at the Greatest Risk.

Carriers of GBA1 gene variants have a significant risk of developing Parkinson's disease (PD). A cohort study of GBA carriers between 40−75 years of age was initiated to study the presence of prodromal PD features. Participants underwent non-invasive tests to assess different domains of PD. Ninety-eight unrelated GBA carriers were enrolled (43 males) at a median age (range) of 51 (40−74) years; 71 carried the N370S variant (c.1226A > G) and 25 had a positive family history of PD. The Montreal Cognitive Assessment (MoCA) was the most frequently abnormal (23.7%, 95% CI 15.7−33.4%), followed by the ultrasound hyperechogenicity (22%, 95% CI 14−32%), Unified Parkinson's Disease Rating Scale part III (UPDRS-III) (17.2%, 95% CI 10.2−26.4%), smell assessment (12.4%, 95% CI 6.6−20.6%) and abnormalities in sleep questionnaires (11%, 95% CI 5.7−19.4%). Significant correlations were found between tests from different domains. To define the risk for PD, we assessed the bottom 10th percentile of each prodromal test, defining this level as "abnormal". Then we calculated the percentage of "abnormal" tests for each subject; the median (range) was 4.55 (0−43.5%). Twenty-two subjects had more than 15% "abnormal" tests. The limitations of the study included ascertainment bias of individuals with GBA-related PD in relatives, some incomplete data due to technical issues, and a lack of well-characterized normal value ranges in some tests. We plan to enroll additional participants and conduct longitudinal follow-up assessments to build a model for identifying individuals at risk for PD and investigate interventions aiming to delay the onset or perhaps to prevent full-blown PD.

Social Support and Psychological Distress among the Bedouin Arab Elderly in Israel: The Moderating Role of Gender.

In Israel, as in other developed countries, mental health problems are common among older adults who are members of disadvantaged ethnic minorities that are experiencing cultural and social changes. The main goals of the current study were: (a) to examine gender differences in the levels of psychological distress and social support among Bedouin elders, and (b) to examine the moderating role of gender in the associations between social support indices and psychological distress. We used a cross-sectional design, and independent t-tests and hierarchical linear regression analysis were performed. The study was conducted in homes and in social clubs and community centers for elderly people and involved face-to-face interviews and self-administered questionnaires. A convenience sample of 170 Bedouin Arab elderly people living in Israel participated in the study. Participants completed self-report questionnaires that assessed psychological distress, perceived social support, instrumental social support, and socio-demographic characteristics. Male elders reported lower levels of psychological distress and higher levels of instrumental support. Female elders, who reported low levels of both perceived and instrumental support, also reported higher levels of psychological distress. Among the women, there were significant associations between psychological distress and perceived social support, and instrumental support only when the levels of support were low. This study underscores the moderating role of gender in the associations between different types of social support and psychological distress among elderly people belonging to ethnic and cultural underprivileged minority groups.

Consensus care recommendations for alfapump® in cirrhotic patients with refractory or recurrent ascites.

BACKGROUND: The alfapump® is an implantable class III medical device that pumps ascitic fluid from the peritoneal space to the urinary bladder from where it is excreted. The pump reduces or abrogates the need for repeated paracentesis in patients with recurrent or refractory ascites. AIMS: To improve outcomes for alfapump® implantation and pre- and post-implant patient management in both clinical trial and real-world settings by development of consensus recommendations. METHODS: The alfapump® working group consisting of hepatologists and surgeons with extensive experience in implantation of the alfapump® and patient management met on two occasions: (1) to determine the key areas where recommendations should be made; and (2) to discuss the experiences of the working group within those areas and formulate draft statements. Developed statements were submitted to the group and consensus sought on relevance and wording through a collaborative iterative approach in order to consolidate the recommendations into consensus statements. Only recommendations agreed upon unanimously were included. RESULTS: Twenty-three consensus recommendations were developed in the areas of pre-implantation procedure, (three statements), surgical implant procedure (11 statements), immediate post-implant care (three statements) and long-term management (six statements). CONCLUSIONS: The consensus statements are a valuable reference resource for physicians managing patients with the alfapump® and for those considering management strategies for patients with refractory ascites.