Modified Nasoseptal Flap Technique to Prevent the Recurrence of Rathke's Cleft Cyst.

Background: Rathke's cleft cysts (RCCs) are benign epithelial lesions arising from the Rathke's pouch remnants that fail to regress during embryogenesis. Some RCCs become symptomatic and require treatment. Cyst fenestration and drainage of its contents is the preferred procedure to treat symptomatic cases but carries a risk of recurrence. We propose the use of a novel modified nasoseptal flap technique to partially line the cyst wall to avoid recurrence. Methods: This was a prospective, observational study that included all RCC patients admitted to the Department of Neurosurgery, Aster Medcity, from April 2015 to May 2018. The modified nasoseptal flap technique was performed in all patients. They underwent preoperative and postoperative ophthalmological, endocrine, endoscopic, and MRI evaluations to look for recurrence. Results: Ten patients underwent the modified nasoseptal flap technique. The median follow-up was 36 months. Postoperatively, all patients were relieved from headaches. Moreover, their visual fields and pituitary functions normalized. None of the patients developed recurrence of RCC on follow-up brain MRI. On endoscopic examination, all patients had retained patency of the fenestra. The longest follow-up was 72 months. Conclusions: The modified nasoseptal flap technique maintains patency and avoids recurrence of RCCs on long-term follow-up.

Intracranial necrotising sarcoid granulomatosis mimicking petroclival meningioma.

We present a unique case of biopsy-proven necrotising sarcoidosis involving the central nervous system in a man in his 40s. The patient presented with a 2-week history of right-sided headache and diplopia. He had right trochlear and abducens nerve palsy, sensory blunting over V1 and V2 segment of right trigeminal sensory nerve and right sensory neural hearing loss. A contrast-enhanced MRI revealed an enhancing dural-based mass lesion in the petroclival area suggestive of probable meningioma. Surgical resection was attempted and intraoperative consultation with frozen section revealed granulomata. So, the lesion was biopsied and surgical intervention was terminated. A diagnosis of necrotising neurosarcoidosis was confirmed on histopathology. He was treated with steroids after excluding other causes of intracranial necrotising granulomas like tuberculosis and he clinically responded favourably. We report one of the very few case reports of histologically proven necrotising sarcoidosis involving the central nervous system mimicking petroclival meningioma.

Do We Trust the Crowd? Effects of Crowdsourcing on Perceived Credibility of Online Health Information.

Crowdsourcing websites such as Wikipedia have become go-to places for health information. To what extent do we trust such health content that is generated by other Internet users? Will it make a difference if such entries are curated by medical professionals? Does the affordance of crowdsourcing make users feel like they themselves could be contributors, and does that influence their credibility judgments? We explored these questions with a 2 (Crowdsourcing: absence vs. presence) × 2 (Professional source: absence vs. presence) × 2 (Message: sunscreen vs. milk) between-subjects experiment (N = 189). Two indirect paths for crowdsourcing effects were found. The crowd-as-source path suggests that crowdsourcing negatively affects content credibility through decreased source trustworthiness and information completeness. In contrast, the self-as-source path indicates that crowdsourcing elevates source trustworthiness via heightened interactivity and sense of control. Although the additional professional source raises perceived gatekeeping on the site, it does not have substantial influence on credibility judgments. Theoretical and practical implications of the findings are discussed.

Are We More Reactive to Persuasive Health Messages When They Appear in Our Customized Interfaces? The Role of Sense of Identity and Sense of Control.

Online users today are provided with a variety of customization tools to build their own information environment. A growing number of public health messages reach their target audiences via these digital venues. Given the deeply personal and individualized nature of customized environments, do online users show lesser reactance to persuasive health messages? Or, are they more likely to show reactance because they feel intruded upon? We conducted a 2 (Customization: present vs. absent) × 2 (Message threat: high vs. low) experiment (N = 145) to find out. Data showed that interface customization increases the sense of control and sense of identity among users. Sense of control is positively associated with threat to freedom of action, causing more affective reactance. In contrast, a sense of identity is negatively associated with anger toward the persuasive message. Theoretical and practical implications for online health campaigns are discussed.

Older Adults' Activities on Facebook: Can Affordances Predict Intrinsic Motivation and Well-Being?

This study investigated how older adults' use of specific features on Facebook is associated with intrinsic motivation and well-being. A content analysis and an online survey were conducted with Facebook users older than 60 years (N = 202). Results showed that profile customization and commenting are positively associated with feelings of autonomy and relatedness, respectively, both predictors of enjoyment on Facebook. Posting photos is positively associated with a feeling of competence, which is related to well-being. The findings advance knowledge about the theoretical mechanisms underlying effects of Facebook use on well-being, and provides design recommendations that address older users' needs.

Can Interactive Media Attenuate Psychological Reactance to Health Messages? A Study of the Role Played by User Commenting and Audience Metrics in Persuasion.

Health advocacy messages can generate psychological reactance and lead to message rejection. Could we offset this negative outcome by providing more agency and interactivity to message receivers? Are individuals more likely to be receptive if health campaigns provided them an opportunity to comment on the advocacy messages? Will they be more likely to follow the advocated behavior if a lot of other receivers have expressed approval of those messages, i.e., will they follow the bandwagon and show lesser reactance? We investigated these questions by conducting a 2 (bandwagon cue: strong vs. weak) X 2 (comment action: presence vs. absence) X 2 (message threat: high vs. low) between-subjects experiment (N = 179) with an online health message. Findings suggest that strong bandwagon cues can reduce reactance and improve persuasion by eliciting bandwagon perceptions. Comment action is associated with a strong sense of agency, which positively predicts intention to follow the message recommendation. Technological affordances interact with threat level of the message and with each other in influencing users' evaluation and acceptance of persuasive health messages.

Development of a lead foil crown delineation technique for implant rehabilitations to generate patient specific finite element model of occlusal loading points.

Understanding the clinical biomechanical basis of dental implant supported functional rehabilitation of edentulous jaws improves precision, longevity and overall success of a planned treatment. Stress distribution pattern around dental implants is an important determinant for rate of bone resorption around them. During planning the treatment for most prosthetic rehabilitations, the surgeon uses a software to virtually plan the dimension, position and angulation of the implants considering only the quantity of available bone in the area of interest but does not usually consider the strain generated around the implants after prosthetically loading them. We hence hypothesise that dental implants not be subjected to abnormal strain they should be positioned and angulated not only based on volume of bone available but also based on the vector of occlusal load. The virtual FEA model to analyse the stress distribution would hence require alveolar bone with future tooth/ teeth in centric relation to be modelled. This paper proposes a simple innovative technique to develop a 3D FE model of occlusal loading surface by using a radio-opaque malleable lead foil to generate a patient specific FE model. This would greatly minimise modelling errors and also help determine the best position of the dental implant based on both the volume of bone in the CT scan and the results of FE analyses.•Functional rehabilitation using dental implant supported prosthesis needs to be biomechanically analysed to know and understand the stress distribution pattern around the implant.•When teeth (Loading points) are missing, patient specific virtual model of occlusal loading points cannot be generated.•'Lead foil crown delineation technique' helps to generate patient specific 3D model of occlusal surface for load application.

The Idiosyncrasies of Everyday Digital Lives: Using the Human Screenome Project to Study User Behavior on Smartphones.

Most methods used to make theory-relevant observations of technology use rely on self-report or application logging data where individuals' digital experiences are purposively summarized into aggregates meant to describe how the average individual engages with broadly defined segments of content. This aggregation and averaging masks heterogeneity in how and when individuals actually engage with their technology. In this study, we use screenshots (N > 6 million) collected every five seconds that were sequenced and processed using text and image extraction tools into content-, context-, and temporally-informative "screenomes" from 132 smartphone users over several weeks to examine individuals' digital experiences. Analyses of screenomes highlight extreme between-person and within-person heterogeneity in how individuals switch among and titrate their engagement with different content. Our simple quantifications of textual and graphical content and flow throughout the day illustrate the value screenomes have for the study of individuals' smartphone use and the cognitive and psychological processes that drive use. We demonstrate how temporal, textual, graphical, and topical features of people's smartphone screens can lay the foundation for expanding the Human Screenome Project with full-scale mining that will inform researchers' knowledge of digital life.

What Happens When You Click and Drag: Unpacking the Relationship between On-Screen Interaction and User Engagement with an Anti-Smoking Website.

Interactive media provide a physically active experience for users to click, slide, mouseover, and zoom-in/out, but how this increased amount of on-screen interaction is associated with cognitive and attitudinal outcomes has remained unexplored. We tackled this issue by conducting an online study where we recorded the amount of on-screen interaction on a targeted interactive feature, sliders, and correlated it with user engagement, attitudes toward anti-smoking messages, and smoking outcome beliefs, while controlling their baseline smoking outcome beliefs (N = 149). We found that the number of clicks and drags on sliders was positively associated with their attitudes toward anti-smoking messages and smoking outcome belief, but only among nonsmokers who are power users of technology. An increase in perceptual bandwidth influenced by interacting with the slider was significantly correlated with greater user engagement among these users. In contrast, for smokers who are not power users, greater on-screen interaction showed a negative correlation with their user engagement mediated by an increase in defensive processing.

Can Mobile Apps Motivate Fitness Tracking? A Study of Technological Affordances and Workout Behaviors.

Can workout apps actually motivate users to sustain an exercise routine? If so, what are the key characteristics of these apps that engage long-term users? We conducted a content analysis to find out. Guided by the Motivational Technology Model and Self-Determination Theory, we explored the relationship between technological affordances of BodySpace, a highly ranked body building and weightlifting app, and behavioral outcomes (number of workouts tracked, weight lifted, and cardio hours) and goal attainment rate (percentage of body fat and weight goal achieved). A total of 682 profiles were used for analysis, revealing that the use of features of the app that elicit relatedness, autonomy, and competence predicted exercise outcomes. However, these relationships were moderated by gender, consistent with prior research on the differential workout motivations between males and females.

Should Machines Express Sympathy and Empathy? Experiments with a Health Advice Chatbot.

When we ask a chatbot for advice about a personal problem, should it simply provide informational support and refrain from offering emotional support? Or, should it show sympathy and empathize with our situation? Although expression of caring and understanding is valued in supportive human communications, do we want the same from a chatbot, or do we simply reject it due to its artificiality and uncanniness? To answer this question, we conducted two experiments with a chatbot providing online medical information advice about a sensitive personal issue. In Study 1, participants (N = 158) simply read a dialogue between a chatbot and a human user. In Study 2, participants (N = 88) interacted with a real chatbot. We tested the effect of three types of empathic expression-sympathy, cognitive empathy, and affective empathy-on individuals' perceptions of the service and the chatbot. Data reveal that expression of sympathy and empathy is favored over unemotional provision of advice, in support of the Computers are Social Actors (CASA) paradigm. This is particularly true for users who are initially skeptical about machines possessing social cognitive capabilities. Theoretical, methodological, and practical implications are discussed.

Being There in the Midst of the Story: How Immersive Journalism Affects Our Perceptions and Cognitions.

Immersive journalism in the form of virtual reality (VR) headsets and 360°-video is becoming more mainstream and is much touted for inducing greater "presence" than traditional text. But, does this presence influence psychological outcomes of reading news, such as memory for story content, perceptions of credibility, and empathy felt toward story characters? We propose that two key technological affordances of VR (modality and interactivity) are responsible for triggering three presence-related cognitive heuristics (being-there, interaction, and realism), which influence news readers' memory and their perceptions of credibility, empathy, and story-sharing intentions. We report a 3 (storytelling medium: VR vs. 360°-video vs. Text) × 2 (story: "The displaced" and "The click effect") mixed-factorial experiment, in which participants (N = 129) experienced two New York Times stories (that differed in their emotional intensity) using one of the three mediums (VR, 360°-video, Text). Participants who experienced the stories using VR and 360°-video outperformed those who read the same stories using text with pictures, not only on such presence-related outcomes as being-there, interaction, and realism, but also on perceived source credibility, story-sharing intention, and feelings of empathy. Moreover, we found that senses of being-there, interaction, and realism mediated the relationship between storytelling medium and reader perceptions of credibility, story recall, and story-sharing intention. These findings have theoretical implications for the psychology of virtual reality, and practical applications for immersive journalism in particular and interactive media in general.

Motivating contributions to online forums: can locus of control moderate the effects of interface cues?

In an effort to encourage users to participate rather than lurk, online health forums provide authority badges (e.g., guru) to frequent contributors and popularity indicators (e.g., number of views) to their postings. Studies have shown the latter to be more effective, implying that bulletin-board users are motivated by external validation of their contributions. However, no consideration has yet been given to individual differences in the influence of such popularity indicators. Personality psychology suggests that individuals with external, rather than internal, locus of control are more likely to be other-directed and therefore more likely to be motivated by interface cues showing the bandwagon effect of their online posts. We investigate this hypothesis by analyzing data from a 2 (high vs. low authority cue) × 2 (strong vs. weak bandwagon cue) experiment with an online health community. Results show that strong bandwagon cues promote sense of community among users with internal, rather than external, locus of control. When bandwagon cues are weak, bestowal of high authority serves to heighten their sense of agency. Contrary to prediction, weak bandwagon cues appear to promote sense of community and sense of agency among those with external locus of control. Theoretical and practical implications are discussed.

A Comparative Prospective Study of Two Different Treatment Sequences i.e. Bottom Up-Inside Out and Topdown-Outside in, in the Treatment of Panfacial Fractures.

PURPOSE: To compare the sequence bottom-up inside-out with top-down outside-in, in the treatment of pan facial fractures and to evaluate the outcome of these approaches. PATIENTS AND METHODS: The data from 11 patients with panfacial fracture are prospectively analysed. Five cases are treated with bottom-up approach and six patients with top-down approach. RESULTS: There were 11 male patients (six in top-down approach and five in bottom-up approach), ranging in age from 24 to 50 years. All injuries were result of RTA (n = 11, 100 %). Final treatment outcome was excellent in 3 (50 %), 1 (16 %) good and 2 (32 %) cases were fair in topdown approach, 3 (60 %) excellent and 2 (40 %) fair in bottom up approach with contingency coefficient value (P < .632) which was insignificant. There was no significant deviation from the two groups in the final treatment outcome. CONCLUSION: Within the limitation of low sample size we found that both bottom-up inside-out and top-down outside-in approaches have similar clinical outcomes. Hence it could be suggestive to start fixation of least disrupted (more stable) facial half as a guide for reconstruction of the remaining. Choice of the bottom-up inside-out or top-down outside-in sequence should be according to the pattern of fractures and preference of the surgeon. However, further controlled clinical trials, comparative studies with a larger sample size would be better to evaluate the final clinical outcome of individual techniques.

Association of matrix metalloproteinase 1 gene promoter mutation and residual ridge resorption in edentulous patients of South Indian origin.

BACKGROUND: Matrix metalloproteinase (MMP) are involved in bone transformation at the extraction site postdental extraction. We examined the genetic association between single nucleotide polymorphisms of MMP-1 and continuous atrophy of edentulous mandible. METHODS: Buccal cells from 33 edentulous patients were collected using sterile wooden spatula and were suspended in 15 ml falcon tubes containing 1.5 ml of cell lysis buffer, without proteinase K. The cells were transported to the laboratory on ice and were stored at -20°C until being processed. RESULTS: Of the samples analyzed, 26 edentulous patients (78.8%) carried 2G allele, while 7 of them (21.2%) carried 1G allele. CONCLUSION: The patients with the alveolar bone resorption exhibited more of 2G allele while only 21.2% of them showed 1G allele, associated with excessive atrophy of edentulous mandible. This study may provide genetic background to identify susceptible individuals prone to develop jawbone atrophy after dental extraction.

Can Customizing an Avatar Motivate Exercise Intentions and Health Behaviors Among Those with Low Health Ideals?

Studies have shown that self-resembling avatars in health games and other applications can heighten exercise intentions, but objective self-awareness (OSA) theory suggests that this effect is likely to be true only for those who believe in the ideal of a healthy self. How can avatars be used to motivate those who do not hold this ideal and may not be motivated by avatars to pursue healthy activities? One possibility is to afford individuals the ability to customize their avatar, so they are not only more self-aware but also feel in control of their persona, both of which are necessary conditions for behavior change according to OSA. In order to test this prediction, participants in an online virtual environment created an avatar of the same sex or opposite sex by choosing among a small or large number of possible traits, then completed a series of items measuring self-awareness, sense of control, health-focused behavior, and ideal internalization. Results show that customizing a same-sex avatar can overcome differences in health intentions and behaviors between individuals with high and low levels of prior health-ideal internalization.

Does screen size matter for smartphones? Utilitarian and hedonic effects of screen size on smartphone adoption.

This study explores the psychological effects of screen size on smartphone adoption by proposing an extended Technology Acceptance Model (TAM) that integrates an empirical comparison between large and small screens with perceived control, affective quality, and the original TAM constructs. A structural equation modeling analysis was conducted on data collected from a between-subjects experiment (N=130) in which users performed a web-based task on a smartphone with either a large (5.3 inches) or a small (3.7 inches) screen. Results show that a large screen, compared to a small screen, is likely to lead to higher smartphone adoption by simultaneously promoting both the utilitarian and hedonic qualities of smartphones, which in turn positively influence perceived ease of use of-and attitude toward-the device respectively. Implications and directions for future research are discussed.

Can interface features affect aggression resulting from violent video game play? An examination of realistic controller and large screen size.

Aggressiveness attributed to violent video game play is typically studied as a function of the content features of the game. However, can interface features of the game also affect aggression? Guided by the General Aggression Model (GAM), we examine the controller type (gun replica vs. mouse) and screen size (large vs. small) as key technological aspects that may affect the state aggression of gamers, with spatial presence and arousal as potential mediators. Results from a between-subjects experiment showed that a realistic controller and a large screen display induced greater aggression, presence, and arousal than a conventional mouse and a small screen display, respectively, and confirmed that trait aggression was a significant predictor of gamers' state aggression. Contrary to GAM, however, arousal showed no effects on aggression; instead, presence emerged as a significant mediator.

To tweet or to retweet? That is the question for health professionals on twitter.

Guided by the MAIN model ( Sundar, 2008 ), this study explored the effects of three interface cues conveying source attributes on credibility of health messages in Twitter: authority cue (whether a source is an expert or not), bandwagon cue (the number of followers that a source has-large vs. small), and source proximity cue (distance of messages from its original source-tweet vs. retweet). A significant three-way interaction effect on perceived credibility of health content was found, such that when a professional source with many followers tweets, participants tend to perceive the content to be more credible than when a layperson source with many followers tweets. For retweets, however, the exact opposite pattern was found. Results also show that for tweets, content credibility was significantly associated with the perceived expertise of proximal source, whereas for retweets, it was associated with the perceived trustworthiness of proximal source. Theoretical and practical implications are discussed.