Personal and Interpersonal Factors Moderate the Relation Between Human-Made Trauma and Hypertension: A Path Analysis Approach.

BACKGROUND: Although the link between trauma, posttraumatic stress disorder (PTSD), and hypertension is established, its underlying mechanisms remain underexplored. OBJECTIVE: This study tested a theoretical model exploring the moderating influence of psychological (emotion regulation) and interpersonal (social support) factors on the mediation between trauma and hypertension, through PTSD. METHODS: We measured these variables through self-reported questionnaire on 212 patients, recruited from internal medicine in a general hospital of Bukavu, a region affected by more than 25 years of armed conflicts. We first evaluated the PTSD mediation in the absence of moderators, before testing each moderator using moderated path analysis. RESULTS: Results showed that PTSD partially mediates the relationship between human-made trauma and hypertension, whereas social support and maladaptive emotion regulation moderate the relationship between human-made trauma and PTSD. CONCLUSIONS: The relationship between human-made trauma, PTSD, and hypertension might be modulated by psychological and interpersonal factors, which paves the way for new interventions targeting emotion regulation and social support to reduce PTSD and hypertension in populations exposed to human-made violence.

Adverse neuropsychological effects associated with cumulative doses of corticosteroids to treat childhood acute lymphoblastic leukemia: A literature review.

Corticosteroids (CS) are an essential component of childhood acute lymphoblastic leukemia treatments (cALL). Although there is evidence that daily doses of CS can have neuropsychological effects, few studies have investigated the role of cumulative doses of CS in short- and long-term neuropsychological effects in cALL. The aims of this review were to identify the measures used for documenting adverse neuropsychological effects (ANEs) of CS treatment and to study the association between cumulative doses of CS and the presence of ANEs. Twenty-two articles met the inclusion criteria. A variety of measures were used to evaluate outcomes in the domains of emotion, behaviour, neurocognition, and fatigue/sleep. The results suggest that we cannot conclude in favour of an association between the cumulative dosage of CS and ANEs. Yet, several factors including the heterogeneity of measures used to evaluate outcomes and reporting biases may limit the scope of the results. We offer several recommendations that could help improve the future published evidence on ANEs in relation to CS treatment in cALL.

Consensus statement on round window vibroplasty.

OBJECTIVE: This study aimed to review current knowledge regarding implantation of the Vibrant Soundbridge floating mass transducer (FMT) at the round window (round window vibroplasty) as well as to form a consensus on steps for a reliable, stable surgical procedure. DATA SOURCES: Review of the literature and experimental observations by the authors. CONCLUSION: Round window (RW) vibroplasty has been established as a reliable procedure that produces good and stable results for patients with conductive or mixed hearing loss. The experience gained over the past few years of the authors' more than 200 implantations has led to consensus on several key points: (1) a wide and bloodless access to the middle ear with facial nerve monitoring, (2) the careful and correct identification and exposure of the round window membrane, (3) a good setup for efficient energy transition of the FMT, namely, perpendicular placement of the FMT with no contact to bone and the placement of cartilage behind the FMT to create a preloaded "spring" function, and (4) 4 points of FMT fixation: a rim of the round window bony overhang left intact both anterior and posterior to the FMT, conductor link stabilization, and cartilage behind the FMT. In addition, the FMT should be covered with soft tissue.

Kinetics of collapse transition and cluster formation in a thermoresponsive micellar solution of P(S-b-NIPAM-b-S) induced by a temperature jump.

Structural changes at the intra- as well as intermicellar level were induced by the LCST-type collapse transition of poly(N-isopropyl acrylamide) in ABA triblock copolymer micelles in water. The distinct process kinetics was followed in situ and in real-time using time-resolved small-angle neutron scattering (SANS), while a micellar solution of a triblock copolymer, consisting of two short deuterated polystyrene endblocks and a long thermoresponsive poly(N-isopropyl acrylamide) middle block, was heated rapidly above its cloud point. A very fast collapse together with a multistep aggregation behavior is observed. The findings of the transition occurring at several size and time levels may have implications for the design and application of such thermoresponsive self-assembled systems.

Coupling the Vibrant Soundbridge to cochlea round window: auditory results in patients with mixed hearing loss.

OBJECTIVE: To assess the functional results of the Vibrant Soundbridge (VBS) placed on the round window (RW) in patients with mixed hearing loss. STUDY DESIGN: Retrospective evaluation of functional hearing, with measurements performed 7 to 9 months postoperatively. SETTINGS: Two tertiary referral hospital centers. SUBJECTS: Twelve individuals with mixed severe hearing loss associated with chronic suppurative otitis media and otosclerosis. INTERVENTION: Surgical placement of the VBS mechanical effector in close contact with the RW membrane to directly drive the inner ear fluids. MAIN OUTCOME MEASUREMENT: Functional hearing gain as analyzed via pure-tone audiometry and speech audiometry with VBS off and on in quiet and in noise. RESULTS: We observed a mean gain of 37.5 dB (0.5-4 kHz) with wide individual differences. The overall gain is mainly due to the air-bone gap recovery, whereas a further 12-dB mean improvement of air-conducted threshold is evident at 2 kHz. The speech reception threshold in quiet shows a mean gain of 24 dB, whereas in noise, it requires a signal-to-noise ratio 7 to 13 dB greater than normal-hearing controls. All patients are daily users of their VBS device. CONCLUSION: A middle ear implant capable of directly driving the cochlear fluids seems to be a promising alternative for individuals with a severe to profound mixed hearing loss. However, variability in hearing recovery is great, likely reflecting variability in responsiveness of the cochlea associated with chronic pathologic findings and, possibly, variability in how the VBS effector interfaces with the RW. Modifying the shape of the VBS effector can improve the mechanical coupling to the RW to better exploit the device's amplification power.