Pulmonary influenza infection promotes the awakening of dormant metastatic breast cancer cells

Breast cancer is the most common form of cancer and the second cancer-causing death in females. Although remission rates are high if detected early, survival rates drop substantially when breast cancer becomes metastatic. The most common sites of metastatic breast cancer are bone, liver and lung. Respiratory viral infections inflict illnesses on countless people. The latest pandemic caused by the respiratory virus, SARS-CoV-2, has infected more than 600 million worldwide, with documented COVID-related death upward of 1 million in the United States alone. Respiratory viral infections result in increased inflammation with immune cell influx and expansion to facilitate viral clearance. Prior studies have shown that inflammation, including through neutrophils, can contribute to dormant cancer cells reawakening and outgrowth. Moreover, inhibition of IL6 has been shown to decrease breast cancer lung metastasis in mouse models. However, how respiratory viral infections contribute to breast cancer lung metastasis remains to be unraveled. Using MMTV/PyMT and MMTV/NEU mouse models of breast cancer lung metastasis and influenza A virus as a model respiratory virus, we demonstrated that acute influenza infection and the accompanying inflammation and immune cell influx awakens and dramatically increased proliferation and expansion of dormant disseminated cancer cells (DCC) in the lungs. Acute influenza infection leads to immune influx and expansion, including neutrophils and macrophages, with increased proportion of MHCII+ macrophages in early time points, and a sustained decrease in CD206+ macrophages starting 6 days post-infection until 28 days after the initial infection. Additionally, we observed a sustained accumulation of CD4+ T cells around expanding tumor cells for as long as 28 days after the infection. Notably, neutrophil depletion or IL6 knockout reversed the flu-induced dormant cell expansion in the lung. Finally, awakened DCC exhibited downregulation of vimentin immunoreactivity, suggesting a role for phenotypic plasticity in DCC outgrowth following viral infection. In conclusion, we show that respiratory viral infections awaken and increase proliferation of dormant breast cancer cells in the lung, and that depletion of neutrophils or blocking IL6 reverses influenza-induced dormant cell awakening and proliferation.

Psychological Treatment of Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia Using an Integrative Approach.

Persistent genital arousal disorder/genitopelvic dysesthesia (PGAD/GPD) is characterized by persistent, unwanted physiological genital arousal (i.e., sensitivity, fullness, and/or swelling) in the absence of sexual excitement or desire which can persist for hours to days and causes significant impairment in psychosocial well-being (e.g., distress) and daily functioning. The etiology and course of PGAD/GPD is still relatively unknown and, unsurprisingly, there are not yet clear evidence-based treatment recommendations for those suffering from PGAD/GPD. We present the case of a 58-year-old woman with acquired persistent genital arousal disorder, which began in March 2020; she believed she developed PGAD/GPD due to a period of significant distress and anxiety related to the COVID-19 pandemic. After seeking medical diagnosis and treatment from multiple healthcare providers and trying a combination of pharmacological and medical treatment modalities, she presented for psychological treatment. An integrative therapy approach (3 assessment sessions, 11 treatment sessions), which included cognitive behavior therapy, distress tolerance and emotion regulation skills from dialectical behavior therapy, and mindfulness practice, was utilized. The patient reported improvements anecdotally (e.g., decreased impact on occupational and social functioning, greater self-compassion, less frequent and shorter duration of PGAD/GPD flare-ups, improved ability to cope with PGAD/GPD symptoms, and decreased need for sleeping medication) and on self-report measures (e.g., lower PGAD/GPD catastrophizing, lower anxiety and depression, and greater overall quality of life).We report the use of an integrative (i.e., psychoeducational, cognitive behavioral, dialectical behavioral, and mindfulness-based) intervention, which may be an effective psychological treatment for PGAD/GPD.

Panic buying in the second wave of COVID-19: the moderating effect of past buying experience

PurposeWith the advent of the second wave of COVID-19 pandemic, there is a need to analyse the scenario of panic buying (PB) behaviour of the customers which was evident in the first wave. This paper aims to examine the PB scenario as well as the moderating effect of past buying experience (PBE) on PB in the second wave of the COVID-19 pandemic. Design/methodology/approachThis study is based on the theories of stimulus-organism-response model and the competitive arousal model. Based on these theories, this paper investigates how panic situation created by external stimuli such as perceived scarcity (PS), perceived risk (PR), news in media (NM) and social learning affect the perceived arousal (PA) among people which in turn influence the PB behaviour of customers. Data were collected from 253 customers from different parts of India. Structural equation modelling is used to analyse the moderating effect of PBE on the PB in the second wave of COVID-19 pandemic. FindingsThe results indicate that the PS, PR and NM continue to be strong predictors of a buyer for PA. However, the PB is not reinforced by the moderation effect of PBE. Research limitations/implicationsThis paper investigates the consumers' PB behaviours in the wake of third wave of COVID-19 pandemic which add to the existing literature of COVID-19 pandemic. Moreover, this study also examines how previous buying experience can moderate the PB behaviour of the customers in subsequent phases of COVID-19 pandemic. This supports the potential effectiveness of self-regulation as an intervention strategy for reducing PB behaviours during the COVID-19 pandemic. Practical implicationsThis study emphasises the impact of external stimuli like PS, PR and media coverage on PB behaviour, marketers and policymakers should manage to avoid triggers. Although PBE may not moderate PB during a pandemic, it can play a significant role in future buying behaviour. Anticipating potential triggers and designing effective marketing strategies that cater to customers' needs can help manage PB behaviour during disasters or pandemics. In addition, promoting conscious consumption awareness and self-regulation practices among customers can help manage PB behaviour, benefit the environment and society and make customers more responsible buyers. Originality/valueTo the best of the authors' knowledge, this study examines the PB behaviour of customers during the second wave of COVID-19 pandemic for the first time. This study also investigates the moderating effect of PBE on the PB behaviour of customers during a pandemic which is new and significant that extends the literature on PB behaviour during a pandemic.

"We are out of toilet paper”: Testing the mediating effect of product scarcity on consumers' competitive arousal in family firms

Drawing on Lemon and Verhoef's customer journey, this study examines the context of local family businesses to investigate product scarcity's role as a mediator between information overload and competitive arousal in affecting consumers' behavioural intentions during the first wave of the COVID-19 pandemic. Data were collected regarding purchases in three famous local family businesses operating in the Food and Beverage sector in the North of Italy. Results reveal that during a sanitary emergency, the consumer in family firms are less inclined to react impulsively than those in large distribution, except when they perceive product scarcity, which increases their level of competitiveness towards the market and other consumers. This behaviour towards other businesses is due to the family business efficacy, which pushes family firms in reinventing themselves and takes care of their trusted consumers. The paper ends by highlighting the main theoretical and managerial contributions, delineating new paths of analysis.

The role of human emotions in memorable tourism experience and revisit intention

As tourism research focuses on experience, memorable tourism experience (MTE) is gaining importance among academia and destination managers. However, only limited studies have examined the antecedents and consequences of MTE. Therefore, this study will investigate human emotions with their underlying factors in influencing MTE to cater to revisit intention in tourists. For this study, CFA-SEM is applied to a sample of 1120 tourists from central India to access the empirical relationships. The empirically validated model confirmed the significant relationships among human emotions, MTE, and revisit intention. Results suggested that human emotions significantly influence MTE, which is reflected as revisit intention in tourists. Findings also confirmed the moderating role of the perceived risk of COVID-19 further, exploring the health-linked effects on tourism. This study will help the researchers and destination managers make more informed decisions and strategies to make tourism destinations more sustainable by incorporating human emotions as a significant factor in influencing the tourism experience. The findings will also help destination managers in making tourism more risk-averse.

How emotions from content social relevance mediate social media engagement: evidence from European supermarkets during the COVID-19 pandemic

PurposeThe purpose of this study is to examine the antecedents of consumer engagement with supermarkets' social media accounts. Drawing on regulatory fit theory and social sharing of emotions theory, the authors test if the content posted on the social media brand pages of supermarkets dealing with a topic of high social relevance, such as the COVID-19 pandemic, stimulates social media consumer engagement and if and how the engagement is mediated by the arousal of positive and negative emotions.Design/methodology/approachThe authors retrieved data from the Facebook accounts of the top 20 European supermarkets identified in the Deloitte 2020 Global Powers of Retailing report during the first wave of the pandemic from 1 March to 30 June 2020, collecting a sample of 2,524 posts from 8 different countries. After a content analysis to classify COVID-19 content, the authors applied the Baron and Kenny (1986) methodology to verify the hypothesised relationships.FindingsThe findings highlight a positive direct relationship between the social relevance of a topic (COVID-19) and social media consumer engagement mediated by the arousal of positive and negative emotions.Originality/valueTo the best of the authors' knowledge, this is one of the earliest empirical research using Facebook data to investigate the role of the social relevance of content as an antecedent of social media consumer engagement with a specific focus on supermarkets. The paper contributes to the stream of social media literature investigating the antecedents of social media engagement behaviour, exploring the role of topics' choice and aroused emotions, which to date are both under-investigated.

Occlusive Explosion

Clinical Information Patient Initials or Identifier Number: A Relevant Clinical History and Physical Exam: 47yr old man, suffered a blast injury at the workplace after an O2 tank exploded while he was transferring liquid gas into a tank for welding purposes. The impact has caused him to temporary loss of consciousness. Upon awakening, he had severe chest pain associated with shortness of breath. On examination, superficial partial thickness injury on the chest wall, and lungs: reduced breath sound bi-basally, no murmur heard. BP:106/77mmHg, HR:100/min, SPO2 100% on HFM 15L/min. [Formula presented] [Formula presented] [Formula presented] Relevant Test Results Prior to Catheterization: Serial ECGs were done and showed dynamic changes in the anterior leads Bedside echo before invasive coronary angiograms shows mild LVSD, normal valves, and no pericardial effusion [Formula presented] [Formula presented] Relevant Catheterization Findings: Right radial approach 6F system Opitorque catheter for diagnostic angiogram LMS: smooth LAD: ATO mid LAD, DG1 prox ATO LCx: smooth RCA: smooth Impression: ATO to LAD and Diagonal 1 ( Dual ATO) [Formula presented] [Formula presented] [Formula presented] Interventional Management Procedural Step: Right radial coronary angiogram via 6F system EBU 3.0 engaged with good support Sion blue wired into LAD, export catheter delivered, and aspirated red thrombus Pre-dilated with Sapphire 3 SC 2.5x15mm @ 6-10ATM Flow established in LAD, however, decided to interrogate DG1 as it shows ATO BMW wired into the DG1 and pre-dilated with Sapphire 3 SC 2.0x15mm Noted nonflow limiting dissection and decided to stent DG1 with 2.25x34mm@12ATM, dissection sealed and TIMI III flow established Stented mid LAD with 2.5x30mm @12ATM just before LAD/DG1 bifurcation, then stented proximal LAD with 2.5x 26mm@ 12ATM. Post-dilated LAD with 2.75x15mm@ 14-20ATM TIMI II-III flow IV Tirofiban has been given a loading dose due to a high thrombus burden and sluggish flow [Formula presented] [Formula presented] [Formula presented] Conclusion(s): Myocardial infarction is a rare complication of blunt chest trauma. This case demonstrates how blast shock waves result in the dissection of the coronary vessel leading to total occlusion of the two vessels. It also promotes red thrombus within the coronary vessels. Percutaneous coronary intervention is the most suitable way to treat this condition. Intravascular imaging such as IVUS or OCT would be beneficial to demonstrate the physiology behind this MI and would also be helpful in planning and optimizing the lesions. Unfortunately, intravascular imaging was not used for this patient to reduce procedural time as he was treated during the height of the COVID pandemic.Copyright © 2023

Impulse Buying in Live Stream Based on the Stimulus-Organism-Response Framework

Live stream commerce is the most effective method for online marketing and sales. The Malaysian government implementation of movement control order (MCO) and social distancing during the Covid-19 pandemic had a significant impact on consumer purchasing behaviour and ways of conducting business. Hence, this research aims to examine the factors which influence Malaysian consumers' impulse buying in live stream commerce. The Stimulus Organism Response Framework (SOR) is used to assess stimuli (live streamer attractiveness, expertise, scarcity, and promotion) that impact reactions (perceived enjoyment, urge to buy, and arousal) and subsequently influence response behaviour (live stream impulse buying). The total of 385 questionnaires were disseminated during the implementation of MCO 2.0 in 2021. The findings demonstrated that all hypotheses were significant. Perceived enjoyment, arousal, and urge to buy are associated with impulse buying in live stream. This study provides a deeper insight and identifies the key variables that influence live stream impulse buying in Malaysia. The findings would help businesses and marketers to formulate effective marketing strategies and to fill research gaps relating to live stream commerce. © 2022 Authors. All rights reserved.

Evaluating online education for gifted students: Parents' views

Due to the effects of a worldwide outbreak of COVID-19, as in many countries, students in Turkey started to have online education since March 2020. Factors such as their motivation and need for learning, and higher cognitive arousal would make it more difficult for gifted students to become away from schools. In this context, this research aimed to examine the experiences of gifted students during the online education process from their parents' viewpoint. The data, obtained from 15 parents via telephone interviews, were analyzed by descriptive interpretive approach, one of the qualitative research methods. The validity and reliability of the data were ensured. According to the results, seven categories emerged: reflections on education, advantages, disadvantages, psychological impacts, solutions, observed emotions, and suggestions. The results were discussed in terms of gifted students' characteristics, previous online education practices, and suggestions for future use of online education for gifted children after the pandemic period. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

How People Emotionally Respond to the News on COVID-19: An Online Survey

Introduction:During the Coronavirus Disease 2019 (COVID-19) outbreak, news media has played an important role in informing people to satisfy their curiosity about this stressful condition. Regular exposure to such stressful news may elicit different emotions in people and engage them in using strategies to control their emotions. In the present study, we aimed at exploring the most common negative emotion(s) experienced by individuals, as well as the most frequent Emotion Regulation (ER) strategies used facing the COVID-19-related news. We also examined whether the variable of personal relevance can moderate these emotional responses.Methods:617 individuals living in Tehran who regularly read the news about the COVID-19 from the early stages of spread completed an online survey. After excluding the participants with high scores from the Beck Depression Inventory (>18), data obtained from 443 participants were analyzed in terms of the experienced negative emotions and ER strategies.Results:Anxiety (55.8%) was the most common negative emotion reported by participants facing COVID-19-related news and problem-solving was the most frequent strategy used to control negative emotions. Both groups with high and low personal relevance indicated a similar pattern in experiencing high and low arousal emotions, as well as using ER strategies, and no significant differences were found (X2=0.006, p=0.51;X2=0.14, p=0.39, respectively). We also found that participants with high scores in the resilience scale used an integrative rather than a single approach of the ER strategies (rbp=0.15, p=0.01).Conclusion:We found that during the COVID-19 outbreak, news media may have important role in triggering anxiety in people who regularly read the relevant news, and problem-solving was the most frequent strategy among them. Being directly involved with COVID-19 in personal life did not make any differences in the way that individuals emotionally respond to the news. While using an integrative approach in regulating emotion was found in more resilient individuals..

Face Masks Use and Face Perception: Social Judgments and Emotion Recognition

An outbreak of the severe acute respiratory syndrome corona virus (SARS-CoV-2) made face masks use a norm in individuals' daily lives. The information individuals obtained with face perception is potentially affected by regular face mask use. This study investigated the effects of face masks, ethnicities, and sex on the social judgments including sex, age, trustworthiness, facial attractiveness, and approachability. Later, the effects of face masks, ethnicities, and sex, and facial expressions of happy, neutral, and sad faces on valence and arousal were studied. Likert-type scales and Self-Assessment Manikin were used in an online experiment by Psychopy to capture face perception. Only sex influences sex score in an apparent manner, and unmasked faces appear as more attractive. Face masks and ethnicities do not seem to have effects on sex, age, attractiveness, trustworthiness, and approachability. Faces with different expressions influence the scoring in valence and arousal scale. The results of the present study may be informative for the current pandemic for people to have fruitful social engagements. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Sleep disturbances in children with cystic fibrosis and primary ciliary dyskinesia at the beginning and in the first year of COVID-19 pandemic

Introduction: During the COVID-19 pandemic, the lifestyle and sleep habits of children with chronic lung disease have changed. Aims and objectives: To evaluate the differences in sleep habits in the first year of the pandemic in children with cystic fibrosis (CF) and primary ciliary dyskinesia (PCD). Method(s): Primary caregivers of children with CF and PCD aged 3-16 years who were evaluated for sleep habits at the beginning of the pandemic were re-evaluated at the end of the first year of the pandemic. The Sleep Disturbance Scale for Children (SDSC) was used and questions were asked about sleep habits and weight changes during the first year of the pandemic. Result(s): Primary caregivers of 31 children with CF and 14 children with PCD were included in the study. The median age of the children were 10.0 (7.5-12.0) years, 42.2% of the children were female. The mean BMI of children with CF was 15.8+/-1.8, and 20.0+/-3.5 in children with PCD (p:0.001). The mean daily screen time was 2h (1-3) at the beginning and 5h (4-6) in the first year of the pandemic among children with CF, 2h (1-2.2) at the beginning and 5h (4.7-6) in the first year of the pandemic among children with PCD (p<0.001, p:0.001, respectively). There were no differences in terms of disorders of initiating and maintaining sleep, sleep breathing disorders, disorders of arousal, sleep-wake transition disorders, disorders of excessive somnolence, sleep hyperhidrosis scores between two groups during first year of pandemic. Conclusion(s): While daily screen time increased in children with CF and PCD, sleep disturbances and changes in daily habits continued in the first year of the pandemic.

Stockpiling intentions and customer well‐being during the COVID‐19 pandemic

The COVID‐19 pandemic and associated factors influence customers' stockpiling intentions. This study examines the impact of various factors on customers' stockpiling intentions. It develops a model combining threat severity and fear of COVID‐19, customer well‐being dimensions, and constructs relating to the theories of planned behavior and competitive arousal to explain the effect of these on stockpiling intentions. Adopting a quantitative design, we analyzed data from 476 respondents using covariance‐based structural equation modeling. The empirical results confirm that threat severity (with the fear of COVID‐19 as a mediator) and fear of COVID‐19 positively influenced individuals' attitudes toward stockpiling. Additionally, a positive attitude toward stockpiling, subjective norms that support stockpiling, the degree of perceived behavioral control, perceived scarcity, and time pressure positively influence stockpiling intentions. This study's findings thus contribute to a better understanding of customers' stockpiling intentions during a crisis and assist policymakers in developing effective COVID‐19 response and recovery strategies. [ABSTRACT FROM AUTHOR] Copyright of Journal of Consumer Affairs is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Homeostatic Regulation of Energetic Arousal During Acute Social Isolation: Evidence From the Lab and the Field.

Recent evidence suggests that social contact is a basic need governed by a social homeostatic system. Little is known, however, about how conditions of altered social homeostasis affect human psychology and physiology. Here, we investigated the effects of 8 hr of social isolation on psychological and physiological variables and compared this with 8 hr of food deprivation in a lab experiment (N = 30 adult women). Social isolation led to lowered self-reported energetic arousal and heightened fatigue, comparable with food deprivation. To test whether these findings would extend to a real-life setting, we conducted a preregistered field study during a COVID-19 lockdown (N = 87 adults; 47 women). The drop in energetic arousal after social isolation observed in the lab replicated in the field study for participants who lived alone or reported high sociability, suggesting that lowered energy could be part of a homeostatic response to the lack of social contact.

Evaluation of a smartphone application for self-rehabilitation after anterior cruciate ligament reconstruction during a COVID-19 lockdown

Introduction: La rééducation après une intervention chirurgicale est essentielle et conditionne le résultat fonctionnel final. Une application destinée aux patients présentant une lésion du ligament croisé antérieur (LCA) propose un programme d'auto-rééducation (Doct'up, Healing sas, Lyon, France). La pandémie COVID-19 au printemps 2020 a contraint les patients à suspendre leur rééducation postopératoire chez le kinésithérapeute pendant la période de confinement en France. Hypothèse: Une application d'auto-rééducation permet de limiter les conséquences de l'absence de rééducation chez le kinésithérapeute. Matériels et méthodes: Il s'agit d'une étude cas-témoin à partir de l'analyse rétrospective de données collectées de façon prospective incluant deux groupes de patients opérés d'une ligamentoplastie du LCA. Les patients du premier groupe (« App ») étaient opérés juste avant la période de confinement en mars 2020 en France durant la pandémie de COVID-19 et utilisaient uniquement l'application comme moyen de rééducation pendant le confinement. Un groupe de patient témoin apparié opéré 1 an plus tôt (« Standard ») bénéficiaient d'une kinésithérapie traditionnelle. Les 2 groupes bénéficiaient de la même technique de ligamentoplastie. Le critère de jugement principal était l'apparition d'un flexum à 6 semaines. Les critères de jugement secondaires étaient : le flexum du genou à 3 semaines et 6 mois, le réveil du muscle quadriceps et le verrouillage de l'extension du genou à 3 et 6 semaines et le taux de reprise chirurgicale pour syndrome du cyclope à 6 mois. Résultats: Trente-deux patients ont été inclus dans le groupe « App » et 101 patients dans le groupe « Standard ». Après auto-rééducation avec l'application seule, il n'existait pas de différence significative dans les 2 groupes concernant l'apparition d'un flexum à 6 semaines : 9,4% [28/32] vs 4,6% [87/101] p = 0,39. Il existait un meilleur réveil quadricipital (94% [30/32] vs 73% [74/101], p = 0,015) et un meilleur contrôle de l'extension avec cannes (78,1% [25/32] vs 40,6% [41/101], p = 0,0002) à 3 semaines. Il n'y a pas de différence entre les 2 groupes pour les autres critères étudiés (flexum à 3 semaines : 12,5% [4/32] vs 13,8% [14/101];flexum à 6 mois : 3,2% [1/32] vs 1% [1/101], réveil quadricipital à 6 semaines : 97% [31/32] vs 99% [100/101];verrouillage de l'extension avec cannes à 6 semaines : 96,9% [31/32] vs 93,1% [94/101], verrouillage de l'extension sans cannes à 3 semaines : 53,2% [17/32] vs 47,5% [48/101];verrouillage de l'extension sans cannes à 6 semaines : 93,7% [30/32] vs 82,2% [83/101], taux de syndrome du cyclope : 3,1% [1/32] vs 1% [1/101]). Discussion: Une application d'auto-rééducation après chirurgie du LCA utilisée dans le contexte de confinement imposée par la pandémie COVID-19 permet de limiter les conséquences liées à l'absence de kinésithérapeutes et a montré des résultats équivalents à ceux obtenus après rééducation standard avec un recul de 6 mois postopératoire. L'étude montre que l'auto-rééducation après chirurgie du genou est utile en postopératoire après chirurgie du LCA et pourrait être généralisée en complément des protocoles habituellement utilisés chez le kinésithérapeute. Niveau de preuve: IV;Étude rétrospective monocentrique de cohorte. © 2022 Elsevier Masson SAS

Insomnia is a key risk factor for persistent anxiety and depressive symptoms: A 12-month longitudinal cohort study during the COVID-19 pandemic.

BACKGROUND: Insomnia is a risk factor for affective disorders. This study examined whether individuals with insomnia symptoms early in the pandemic, either pre-existing or new-onset, were more vulnerable to anxiety and depressive symptoms over time than those who maintained normal sleep. Additionally, sleep-related factors such as pre-sleep arousal were assessed for their influence on clinically significant anxiety and depression risk. METHODS: Using a global online survey with 3-, 6-, and 12-month follow-ups between April 2020 and May 2021, data from 2069 participants (M = 46.16 ± 13.42 years; 75.3 % female) with pre-existing, new-onset, or no insomnia symptoms was examined using mixed-effects and logistic regression models. RESULTS: New-onset and pre-existing insomnia predicted persistent anxiety and depressive symptoms longitudinally (p's < 0.001), over other known risk factors, including age, sex, and previous psychiatric diagnoses. Anxiety and depressive symptoms in both insomnia groups remained above clinically significant thresholds at most time points, whereas normal sleepers remained subclinical. Pre-sleep arousal was found to increase the risk of clinically significant anxiety (OR = 1.05) and depressive symptoms (OR = 1.09) at 12-months. Sleep effort contributed to anxiety (OR = 1.06), whereas dysfunctional sleep-related beliefs and attitudes predicted clinically significant depression (OR = 1.22). LIMITATIONS: Insomnia group categorization was based on self-report at baseline supported by a validated measure. High participant attrition was observed at 3-months (53 %; n = 971), but retention remained steady till 12-months (63 %, n = 779). CONCLUSIONS: Insomnia is a modifiable risk factor for persistent anxiety and depressive symptoms that needs to be addressed in mental healthcare. Additionally, pre-sleep arousal may be an important transdiagnostic process linking insomnia with affective disorders.

AN ANALYSIS OF PERSONAL FACTORS AFFECTING LEARNING MOTIVATION: A RESEARCH ON THE ONLINE EDUCATION PROCESS DURING COVID-19 PERIOD IN TURKIYE

In 2019 Covid-19 appeared and spread quickly all over the world, affecting every structure of society, as well as the education system. One of the measures taken to prevent the further spread of the disease was mandatory online education at universities in Turkiye. This sudden change has significantly affected students' learning motivations for face-to-face education. In this context, this study aims to determine the factors of arousal, beliefs, goals, and needs that affect the students' learning motivations as personal factors during online education in Turkiye during the Covid-19 pandemic. For this aim, a semi-structured interview technique was used on a sample of 34 students. According to the findings, the internal factors on arousals were;mainly interest/curiosity/attention and the external factors on arousals were mainly;compulsory attendance requirements. Also, the internal factors on success beliefs were mainly;determination, and the external factors mainly include motivational speeches. Besides, the internal factors on goals were mainly;the need to learn for the future and the external factors on goals were mainly;homework and studies. Lastly, findings indicated that the internal needs of the students were mainly;success, and the external needs were mainly;communication © 2023,Turkish Online Journal of Distance Education.All Rights Reserved.

Clinical Improvement Following Delayed Initiation of Immunotherapy in a Case of LGI1 Antibody Encephalitis Presenting with Faciobrachial Dystonic Seizures Following COVID-19 Vaccination

Objective To demonstrate a case of suspected post-vaccine autoimmune encephalitis associated with leucine-rich glioma-inactivated protein (LGI1) antibodies with significant clinical improvement after initiation of immunotherapy nearly a year after symptom onset. Background Although the autoimmune encephalitides have overlap in presentation, some have unique manifestations (such as orofacial dyskinesias seen with NMDA encephalitis). These unique associations can serve as a clinical marker of response to treatment and even allow for earlier initiation of immunotherapy while awaiting results from antibody testing. LGI1 encephalitis characteristically presents with faciobrachial dystonic seizures (FBDS) that are refractory to anti-seizure medications (ASMs) but responsive to immunotherapy. Design/Methods Case report Results A previously healthy and highly independent 89-year-old woman developed what she described as abnormal posturing and spasms of the right shoulder two to three weeks after receiving the J&J COVID-19 vaccine. The abnormal movements progressed to involve the right side of her face and were refractory to multiple ASMs. EEG captured multiple events without epileptiform correlate. Several months later she developed paranoia, delusions, and hallucinations. Autoimmune encephalopathy panel returned positive for the LGI1-antibody around nine months after the onset of FBDS. Upon our initial exam, she had a fluctuating level of arousal, impaired recall of recent events, and was tangential in conversation. There were frequent, brief, repetitive, dystonic movements of the right side of the face consistent with FBDS. Admission was arranged for immunotherapy (intravenous methylprednisolone and intravenous immunoglobulin). Upon follow-up four weeks later, there was significant improvement in arousal and concentration with resolution of FBDS and delusions. Conclusions This case highlights a classic case of LGI1 encephalitis after vaccination presenting with FBDS and progressive cognitive changes. Despite immunotherapy being delayed, there was marked clinical improvement. It is important to recognize this entity and that it typically has a favorable outcome.

Evaluation of Sedative and Analgesic Practices and Outcomes in Mechanically Ventilated Patients

INTRODUCTION: Sedative and analgesic agents are used for patient comfort during mechanical ventilation (MV) but can cause deleterious effects such as prolonged MV and delirium. Maintaining light sedation and performing daily awakening trials (DATs) can reduce untoward effects. We assessed the relationship between sedative and analgesic dose and 28-day MV-free survival in medical ICU (MICU), surgical ICU (SICU), and cardiac (CICU) patients, hypothesizing that higher doses would be associated with lower 28-day MV-free survival. METHOD(S): In this single-center retrospective study, MICU, SICU, and CICU patients admitted to a tertiary care hospital from 1/1/21-6/30/21 and on MV admitted for 1-7 days were randomly selected if their goal Sedation Agitation Scale (SAS) score was 3-4. Baseline demographics and clinical characteristics were collected. The primary outcome was correlation between average sedative or analgesic dose and 28-day MV-free survival. Secondary outcomes included time at goal SAS score, DAT completion, and deep sedation (SAS < 3) within 48 hours of intubation. The primary outcome was evaluated using linear regression;secondary outcomes were assessed with descriptive statistics. RESULT(S): 411 subjects, including 99 MICU, 54 SICU, and 27 CICU patients, were evaluated. 53% were male and the median age and weight were 66.5 years (IQR, 56-77) and 84 kg (IQR 70-100), respectively. 8% of MICU patients but no SICU or CICU patients had Covid-19. A history of chronic opioid use was most common in MICU and SICU patients (19% and 17%, respectively) and CICU patients most often had a history of chronic kidney disease (33%). Doses of dexmedetomidine, propofol, midazolam, and fentanyl demonstrated poor correlation with 28-day MV-free survival among all patients, with R-squared values of 0.002, 0.06, 0.01, and 0.1, respectively. The association of sedative dose was strongest for midazolam in MICU patients, with each 1mg/hr increase corresponding to a 0.6 day reduction in 28- day MV-free survival. SAS scores were 3-4 70% of the time, SATs were completed in 73% of appropriate cases, and 57% of patients were deeply sedated within 48 hours of intubation. CONCLUSION(S): In this regression analysis, sedative and analgesic doses were not associated with 28-day MV-free survival in a mixed critically ill population.

Tweet Emotion Dynamics: Emotion Word Usage in Tweets from US and Canada

Over the last decade, Twitter has emerged as one of the most influential forums for social, political, and health discourse. In this paper, we introduce a massive dataset of more than 45 million geo-located tweets posted between 2015 and 2021 from US and Canada (TUSC), especially curated for natural language analysis. We also introduce Tweet Emotion Dynamics (TED) - metrics to capture patterns of emotions associated with tweets over time. We use TED and TUSC to explore the use of emotion-associated words across US and Canada;across 2019 (pre-pandemic), 2020 (the year the pandemic hit), and 2021 (the second year of the pandemic);and across individual tweeters. We show that Canadian tweets tend to have higher valence, lower arousal, and higher dominance than the US tweets. Further, we show that the COVID-19 pandemic had a marked impact on the emotional signature of tweets posted in 2020, when compared to the adjoining years. Finally, we determine metrics of TED for 170,000 tweeters to benchmark characteristics of TED metrics at an aggregate level. TUSC and the metrics for TED will enable a wide variety of research on studying how we use language to express ourselves, persuade, communicate, and influence, with particularly promising applications in public health, affective science, social science, and psychology. © European Language Resources Association (ELRA), licensed under CC-BY-NC-4.0.