Measurement Invariance of the Lemmens Internet Gaming Disorder Scale-9 Across Age, Gender, and Respondents.

Although Internet gaming disorder (IGD) has gained increased attention in scientific, clinical, and community contexts, there is still a lack of consensus regarding the best assessment tools (i.e., self-report or other reports) for assessing its symptoms. The present study aimed to investigate the reliability, validity, and measurement invariance of both versions (youth and parent) of The Lemmens Internet Gaming Disorder Scale-9. To achieve this goal, we recruited between June and October 2019 from five Romanian highschools a total of 697 adolescents (11-19 years old) and one of their parents (N = 391). The internal consistency was good in both versions of the instrument (α = 0.772 for the youth version and α = 0.781 for the parent version). Construct validity assessed through confirmatory factor analysis showed support for the one factor structure of the scales, while multigroup confirmatory factor analysis endorsed the invariance across age, gender, and respondents (i.e., parent vs. youth report). The current research identifies both IGD scales to be reliable and valid, arguing for their utility for assessing IGD symptomatology among adolescents. Implications for theory, assessment, and future directions are discussed.

Reduction in the diagnostic interval after the introduction of cancer patient pathways for colorectal cancer in northern Sweden.

OBJECTIVE: To compare the diagnostic interval for patients with colorectal cancer before and after the introduction of cancer patient pathways in northern Sweden. DESIGN: A retrospective study comparing two cohorts (2012 and 2018) of patients diagnosed with colorectal cancer before and after the introduction of cancer patient pathways in 2016. SETTING: Three counties in northern Sweden with large sparsely populated areas and some cities (637143 residents ∼5.1 residents/km2). SUBJECTS: Patients were included from the Swedish Cancer Register. Electronic health records reviews were performed and linked to socioeconomic data from Statistics Sweden. MAIN OUTCOME MEASURES: Differences in the diagnostic intervals, the patient intervals and the characteristics associated with the longest diagnostic intervals and investigations starting at the emergency department. RESULTS: The two cohorts included 411 patients in 2012 and 445 patients in 2018. The median diagnostic interval was reduced from 47 days (IQI 18-99) to 29 days (IQI 9-74) (p < 0.001) after the introduction of cancer patient pathways in general. Though for the cases of cancer in the right-side (ascended) colon, the reduction of the diagnostic interval was not observed and it remained associated with investigations starting at the emergency department. CONCLUSION: Our results indicate that cancer patient pathways contributed to an improvement in the diagnostic interval for patients with colorectal cancer in general, yet not for patients with cancer in the right-side colon. IMPLICATION: In general, cancer patient pathways seem to reduce the diagnostic interval for colorectal cancer but it is not a sufficient solution for all colorectal cancer localisations.

Diagnostic interval for colorectal cancer reduced in general, particularly for patients seeking primary healthcare, after the introduction of cancer patient pathways.Patients with cancer in right-side colon still have long diagnostic intervals and mainly start their investigation through the emergency department.

Failure Locus of an ABS-Based Compound Manufactured through Photopolymerization.

This work investigates the critical plastic strain variation with stress triaxiality and the Lode angle parameter for an Acrylonitrile butadiene styrene (ABS)-based proprietary blend compound (commercial name VeroWhitePlus™ RGD835) manufactured through photopolymerization. Various triaxial states of stress and Lode angles were obtained with the help of notched flat specimens used in tensile loadings, notched round specimens used in compression (upsetting) tests and butterfly specimens used in Arcan tests. The tests were replicated using finite element analyses in order to evaluate the aforementioned parameters.

The role of coping strategies, depression and anxiety in thyroid disease / A megküzdési stratégiák, a depresszió és a szorongás szerepe a pajzsmirigybetegségekben.

Összefoglaló. Bevezetés: A tudományos szakirodalomban számos kérdés fogalmazódik meg a pajzsmirigybetegségeket befolyásoló pszichológiai tényezokrol. Kevés tanulmány készült a pajzsmirigybetegségek és a megküzdési stratégiák kapcsolatáról. Célkituzés: Jelen tanulmányunk célja felmérni a megküzdési stratégiák, a depresszió és a szorongás szintjének változásait a pajzsmirigybetegek (hyperthyreosis és hypothyreosis) esetében a gyógyszeres kezelés (Thyrozol és Euthyrox) hatására. Módszer: A betegeket a szakorvos diagnózisa, illetve a TSH- és fT4-szint alapján hyperthyreosis- (n = 10) és hypothyreosis- (n = 21) csoportba soroltuk. Mindkét csoport tagjait az endokrinológiai kezelés elott és után pszichológiai felmérésnek vetettük alá. A felmérés során a megküzdési stratégiák felméréséhez a következo skálákat alkalmaztuk: Kognitív Érzelem Szabályozás Kérdoív (Cognitive Emotion Regulation Questionnaire - CERQ), Hobfoll-féle Megküzdési Stratégia Kérdoív (Strategic Approach to Coping Scale - SACS). A Beck Depresszió Kérdoívet (Beck Depression Inventory - BDI-II) alkalmaztuk a depresszió felmérésére, az Állapot- és Vonásszorongás Kérdoívet (State-Trait Anxiety Inventory, Form Y - STAI-Y) a szorongás szintjének felmérésére. Eredmények: A két csoport pszichológiai és laboreredményeit összehasonlítottuk a gyógyszeres kezelés elott és után. Mind a hyperthyreosisban, mind a hypothyreosisban szenvedo betegeknél magas volt a depresszió és a szorongás szintje. A hyperthyreosisban szenvedo betegeknél a depresszió magasabb. A gyógyszeres kezelés után a depresszió és a szorongás szintje csökkent mindkét csoportban, a megküzdési stratégiák többnyire változatlanok maradtak. Következtetések: Pajzsmirigybetegeknél a kognitív viselkedésbeli pszichoterápiás beavatkozás a gyógyszeres kezelés kiegészíto alternatívája lehet a szorongás és a depresszió szintjének csökkentése és a diszfunkcionális megküzdési stratégiák módosítása szempontjából. Orv Hetil. 2021; 162(7): 262-268. INTRODUCTION: There is a high interest in the scientific literature in psychological factors that influence the course of thyroid disease. There are a few studies on the link between thyroid disease and coping strategies. OBJECTIVE: In the present study, we aimed to evaluate the manifestation of depression, anxiety and coping strategies in people with thyroid disease and the impact of endocrinological medication on these psychologic items. METHOD: The patients were grouped into two groups, hyperthyroid (n = 10) and hypothyroid (n = 21), according to the diagnosis established by the attending physician, TSH and fT4 level. Patients with hyperthyroidism and hypothyroidism were evaluated before and after endocrinological treatment with the Cognitive Emotion Regulation Questionnaire (CERQ), Strategic Approach to Coping Scale (SACS) for the evaluation of coping strategies, Beck Depression Inventory (BDI-II) for assessing the level of depression, State-Trait Anxiety Inventory, Form Y (STAI-Y) for assessing anxiety. These two groups have been compared. RESULTS: The psychological and laboratory results of the two groups were compared before and after drug treatment. Both patients with hyperthyroidism and with hypothyroidism had high levels of depression and anxiety. In hyperthyroidism, depression is more severe. Following treatment with Thyrozol and Euthyrox, the level of depression and anxiety decreases in patients with hyper- and hypothyroidism; the coping strategies remained almost unchanged. CONCLUSION: Cognitive-behavioral psychotherapeutic intervention could be supplementary to drug treatment in terms of reducing anxiety, depression, and modifying dysfunctional coping strategies for patients with thyroid diseases. Orv Hetil. 2021; 162(7): 262-268.

Acceptance of interferon-gamma release assay by a high-risk urban cohort.

BACKGROUND: QuantiFERON ® -TB Gold (QFT-G), an interferon-gamma release assay, is approved for the diagnosis of latent tuberculosis infection (LTBI). It is unknown if patients at high risk for LTBI will more readily accept LTBI treatment based on tuberculosis skin testing (TST) or QFT-G. METHODS: Prospectively enrolled participants were interviewed, were read an informational paragraph on QFT-G, completed a questionnaire and were tested with QFT-G. RESULTS: A total of 230 consecutive participants with a history of hepatitis C virus infection and active or past illicit drug use were enrolled and underwent QFT-G testing: 77% had recent TST, 82% were human immuno- deficiency virus co-infected, 87% had a history of injection drug use, and 52% a history of homelessness. Of the 230 participants, 148 (64%) stated a preference for TST compared to QFT-G. The majority would take treatment based on either test (68%). A minority of patients (20%) stated a willingness to take LTBI treatment based on TST alone. Black race was associated with a willingness to take treatment based on TST (OR 2.72, 95%CI 1.05-7.10). CONCLUSIONS: Patients at high risk for LTBI were found to prefer TST to QFT-G. Most would accept treatment based on either test, and a subset stated unwillingness to take treatment based on QFT-G results. Outreach and education should accompany QFT-G roll-out in high-risk urban populations.

Expired gas backflow in oxygen delivery tubing.

Using capnography, we investigated the backflow of expired gas into oxygen delivery tubing in 18 sedated patients receiving supplementary oxygen via a disposable facemask during spinal anaesthesia. At 5 cm from the mask, with an oxygen flow of 2 l.min(-1), carbon dioxide was detected in the oxygen delivery tubing of three patients (18%) on coughing. With the patient wearing the facemask but the oxygen tubing disconnected from the oxygen source, carbon dioxide was detectable 1 m from the facemask (i.e. at the fresh gas outlet) in 14 patients. In a second group of 20 similar patients, no carbon dioxide was detected sampling at the fresh gas outlet with flows of 2 and 4 l.min(-1). Assuming that detection of carbon dioxide indicates at least the possibility of contamination, oxygen tubing should be strictly single-use in this setting. Our findings suggest that filters are not required to protect gas supply outlets, provided that the patient's facemask is removed when the fresh gas outlet is disconnected.

Understanding bodywork for the patient with cancer.

The goal of this article is to increase oncology nurses' understanding of common bodywork modalities and the current research about them in the oncology setting. Bodywork is a broad term that incorporates massage and energy modalities. Eleven modalities are described. In addition, issues related to safety, licensure, making referrals, and nurses' and bodyworkers' roles are discussed. Better knowledge will increase oncology nurses' abilities to assess and guide patients' bodywork choices and facilitate discussions with patients, physicians, and bodyworkers to ensure that patients with cancer are receiving safe and effective care.

The management of patients with morbid obesity in the anaesthetic assessment clinic.

One hundred and two patients with body mass indices of 37 kg x m(-2) or greater were interviewed in an outpatient assessment clinic over an 18-month period. All had been listed for elective surgery under general anaesthesia. All patients were given an explanation of the problems of morbid obesity in relation to anaesthesia. Three options were then offered to the patients: 1) to proceed with general anaesthesia as planned; 2) to undergo the planned procedure under some form of regional anaesthesia, or 3) to postpone surgery and attempt to lose significant amounts of weight. At this initial consultation, 24 patients chose option 1, 21 patients chose option 2, and 52 patients chose option 3. Four patients decided not to have the planned surgery. One patient decided to have his surgery performed at another hospital under general anaesthesia. Of the 52 patients who opted to lose weight, only eight succeeded in reducing their body mass index (BMI) by 3 or more during the period of the study. Of these eight, only four had reduced their BMI to below 35. In this study, an explanation of the problems of obesity in relation to anaesthesia, in advance of the date of surgery, had a significant effect on the type of anaesthesia chosen by most morbidly obese patients that were interviewed. Unfortunately, of those who decided to try and lose weight, only the occasional patient achieved significant weight loss. Although a laudable and advocated aim, optimization of patients with regard to their weight proved impractical in our study.

Quantitative, multiplexed detection of bacterial pathogens: DNA and protein applications of the Luminex LabMAP system.

Escherichia coli, Salmonella, Listeria monocytogenes and Campylobacter jejuni are bacterial pathogens commonly implicated in foodborne illnesses. Generally used detection methods (i.e., culture, biochemical testing, ELISA and nucleic acid amplification) can be laborious, time-consuming and require multiple tests to detect all of the pathogens. Our objective was to develop rapid assays to simultaneously detect these four organisms through the presence of antigen or DNA using the Luminex LabMAP system. For nucleic acid detection, organism-specific capture probes corresponding to the 23S ribosomal RNA gene (rrl) were coupled covalently to LabMAP microspheres. Target molecules included synthetic complementary oligonucleotides and genomic DNA isolated from ATCC type strains or other well-characterized strains of each organism. Universal PCR primers were designed to amplify variable regions of bacterial 23S ribosomal DNA, yielding biotinylated amplicons of 86 to 109 bp in length. Varying quantities of targets were hybridized to the combined microsphere sets, labeled with streptavidin-R-phycoerythrin and analyzed on the Luminex(100) system. Results of nucleic acid detection assays, obtained in 30 to 40 min following amplification, correctly and specifically identified each bacterial species with a detection sensitivity of 10(3) to 10(5) genome copies. Capture-sandwich immunoassays were developed with organism-specific antibodies coupled to different microsphere sets. Microspheres were incubated with organism-specific standards and reactivity was assessed with biotinylated detection antibodies and streptavidin-R-phycoerythrin. In the immunoassays, microsphere-associated fluorescence was organism concentration dependent with detectable response at < or = 1000 organisms/ml and with no apparent cross-reactivity. We have demonstrated that the Luminex LabMAP system is a rapid, flexible platform capable of simultaneous, sensitive and specific detection of pathogens. The practical significance of this multiplexing approach would be to provide more timely, economical and comprehensive information than is available with conventional isolation and identification methodologies.

False-positive epidural catheter aspiration tests in needle through needle combined spinal-epidural anaesthesia.

We describe two separate episodes of free aspiration of clear fluid through epidural catheters during needle-through-needle combined spinal-epidural anaesthesia in the lateral position. Although both catheters were assumed to have been located intrathecally, both subsequently gave negative test doses and were used as epidural catheters. In the second patient, the position of the catheter was investigated using contrast spiral computerised tomography scanning, which showed epidural contrast spread only. This is the first time such an occurrence has been recognised, and we consider its significance for catheter site confirmation testing in combined spinal-epidural anaesthesia.

Generation of a minimal alpha5beta1 integrin-Fc fragment.

The tertiary structure of the integrin heterodimer is currently unknown, although several predictive models have been generated. Detailed structural studies of integrins have been consistently hampered for several reasons, including the small amounts of purified protein available, the large size and conformational flexibility of integrins, and the presence of transmembrane domains and N-linked glycosylation sites in both receptor subunits. As a first step toward obtaining crystals of an integrin receptor, we have expressed a minimized dimer. By using the Fc dimerization and mammalian cell expression system designed and optimized by Stephens et al. (Stephens, P. E., Ortlepp, S., Perkins, V. C., Robinson, M. K., and Kirby, H. (2000) Cell. Adhes. Commun. 7, 377-390), a series of recombinant soluble human alpha(5)beta(1) integrin truncations have been expressed as Fc fusion proteins. These proteins were examined for their ligand-binding properties and for their expression of anti-integrin antibody epitopes. The shortest functional alpha(5)-subunit truncation contained the N-terminal 613 residues, whereas the shortest beta(1)-subunit was a fragment containing residues 121-455. Each of these minimally truncated integrins displayed the antibody binding characteristics of alpha(5)beta(1) purified from human placenta and bound ligand with the same apparent affinity as the native receptor.

CD73 expression and fyn-dependent signaling on murine lymphocytes.

CD73 is a glycosyl phosphatidylinositol-anchored protein with both ecto-enzyme activity (ecto-5'-nucleotidase) and signal transducing capabilities for human T lymphocytes. We now report an analysis of the distribution and function of CD73 in murine lymphoid tissues made possible by the development of the first monoclonal antibodies (mAb) specific for murine CD73. Subsets of T and B lymphocytes are CD73+ and the level of expression increases with lymphocyte maturation in both species. Among B cells, CD73 is largely restricted to cells which have undergone isotype switching. The signal transmitting function of CD73 is also conserved, as splenic T cells treated with anti-CD73 mAb plus phorbol 12-myristate 13-acetate proliferate and secrete IL-2. Fyn-/- mice are unresponsive to CD73 ligation, however, demonstrating the requirement for this tyrosine kinase in CD73-mediated signal transduction. CD73 is down-regulated after mAb plus cross-linking, suggesting that expression may be controlled by interaction with a ligand. Only small numbers of thymocytes are CD73+, so CD73 receptor functions are unlikely to be important for developing T cells. However, immunohistochemical analysis reveals that reticular and vascular cells throughout the thymus and other lymphoid tissues are markedly CD73+. Therefore, CD73 might mediate lymphocyte-stromal cell interactions or condition the local microenvironment to facilitate lymphocyte development and/or function.

Thermal softening of tracheal tubes: an unrecognized hazard of the Bair Hugger active patient warming system.

The Bair Hugger system is a new and highly effective active patient warming system which produces a layer of warm air between the patient and the warming system. We report an instance of marked softening and distortion of a polyvinyl chloride tracheal tube caused by this layer. We also present laboratory data indicating that this is a likely problem under routine theatre conditions, with suggestions for prevention.

Perinatal mortality in lambs in southern Brazil.

Hypothermia and dystocia were found to be the most common causes of perinatal mortality in 8 commercial wool flocks in one region of southern Brazil. It was established that low birth weight and poor maternal instinct in the ewes predisposed to losses due to hypothermia but that there appeared to be no association with adverse weather conditions. Other factors possibly predisposing to losses are discussed.