Socially prescribed perfectionism predicts next-day binge eating behaviors over 20-days.

Existing research on perfectionism and binge eating suggests that socially prescribed, self-oriented, and other-oriented perfectionism (Socially Prescribed Perfectionism, SPP; Self-Oriented Perfectionism, SOP; and Other-Oriented Perfectionism, OOP) are differentially related to binge eating. However, previous studies have largely utilized cross-sectional methodology. The present study used a 20-day daily diary methodology to examine associations between daily levels of perfectionistic dimensions and next-day binge eating behaviors with a nonclinical sample of emerging adults (N = 263). Zero-inflated negative binomial regression models indicated that daily SPP (but not SOP or OOP) predicted a greater intensity of next-day binge eating behaviors in the count portion of the model; however, daily levels of perfectionistic dimensions did not predict the presence/absence of next-day binge eating behaviors in the zero-inflated portion of the model. Additionally, analyses examining the reverse causal direction (i.e., binge eating behaviors predicting higher next-day perfectionism) failed to provide evidence that the occurrence or intensity of binge eating behaviors predicts next-day levels of SPP, SOP, or OOP. Overall, at a daily level, SPP appears to be a vulnerability factor for binge eating behaviors. It may be helpful for clinicians to target state-levels of SPP to reduce harmful binge eating behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Correlates of elevated blood pressure in healthy children: a systematic review.

The prevalence of hypertension in children is increasing globally. Addressing this will require a robust understanding of associated risk factors. To this end, we conducted a systematic review to identify correlates of elevated blood pressure (BP) in children. Literature searches were conducted using pre-defined search terms from three academic databases. The abstract and full text of identified studies were screened for eligibility by two independent reviewers. A total of 100 studies were included in this systematic review. An assessment tool was first used to assess study quality; a narrative synthesis was then performed. We found a broad range of physiological, social and behavioural factors associated with elevated BP in children. The most common correlate observed was adiposity, suggesting that childhood obesity may be implicated in the increased prevalence of hypertension observed in children. However, the broad range of other factors identified underscores the multi-factorial aetiology of hypertension. Data from a broad range of studies showed that the correlates of hypertension in children are multi-factorial. Therefore, approaches aimed at preventing hypertension must in turn be multi-factorial to ensure that the burden of hypertension in childhood is addressed.

Characterization of epithelial oral dysplasia in non-smokers: First steps towards precision medicine.

OBJECTIVES: Tobacco usage is the strongest risk factor in the development of oral squamous cell carcinoma (OSCC), which mandates careful screening for oral cancers in smokers. However, there are indications that oral potentially malignant lesions, such as oral epithelial dysplasia (OED), in non-smokers (NS) have a higher cancer risk than those in smokers. Without tobacco as an etiology, the development of these lesions in NS may suggest genetic susceptibility. The increasing incidence of OSCC in NS calls for a better understanding of the natural history of OED in NS as compared to that of smokers. MATERIALS AND METHODS: Patients from a population-based longitudinal study with more than 10 years of follow up were analyzed. Of the 455 patients with primary OED (233 mild and 212 moderate dysplasia), 139 were NS and 306 were smokers. Demographic and habit information, clinical information (lesion site, size and appearance; toluidine blue and fluorescent visualization), microsatellite analysis for loss of heterozygosity (LOH) and outcome (progression) were compared between the two groups. RESULTS AND CONCLUSIONS: The majority of patients with OED were smokers. Of these, more were males, non-Caucasians and heavy drinkers. A significantly higher number of OED in NS were in the tongue, whereas a significantly higher number of OED in smokers were in the floor of mouth (FOM). OED in NS showed a greater than 2-fold increase in cancer progression. Strikingly, OED located in the FOM in NS showed a 38-fold increase in cancer progression as compared to those in smokers.

Dysplasia Should Not Be Ignored in Lichenoid Mucositis.

Oral lichen planus is categorized as a potentially malignant condition by the World Health Organization; however, some argue that only lichen planus with dysplasia have malignant potential. Many pathologists call lichen planus with dysplasia "dysplasia with lichenoid mucositis (LM)" or "LM with dysplasia." Previous research has shown that certain high-risk patterns of loss of heterozygosity (LOH) in dysplastic lesions are associated with significantly increased cancer risk. However, LM without dysplasia lacks such molecular patterns, supporting the hypothesis that LM, by itself, is not potentially malignant and that only those with dysplasia have malignant potential. To further investigate the premalignant nature of LM with dysplasia, this study compared the rate of malignant progression of dysplasia with LM with that of dysplasia without LM. Patients from a population-based prospective cohort study with >10 y of follow-up were analyzed. Study eligibility included a histological diagnosis of a primary low-grade dysplasia with or without LM. A total of 446 lesions in 446 patients met the selection criteria; 373 (84%) were classified as dysplasia without LM, while 73 (16%) were classified as dysplasia with LM. Demographic and habit information, clinical information, and outcome (progression) were compared between the 2 groups. Forty-nine of 373 cases of dysplasia (13%) progressed compared to 8% (6/73) of dysplasia with LM. However, the difference was not statistically different ( P = 0.24). The 3- and 5-y rate of progression did not differ between the groups (6.7% and 12.5% for dysplasia without LM and 2.9% and 6.6% for those with LM; P = 0.36). Progression was associated with nonsmoking, location at a high-risk site, and diagnosis of moderate dysplasia regardless of whether LM was present or not. Dysplasia with or without LM had similar cancer risk, and dysplasia should not be discounted in the presence of LM.

Melphalan and dexamethasone with or without bortezomib in newly diagnosed AL amyloidosis: a matched case-control study on 174 patients.

Oral melphalan and dexamethasone (MDex) is a standard treatment for patients with AL amyloidosis who are not eligible for stem cell transplantation at many referral centers. However, following encouraging reports on the activity of bortezomib combined with alkylators and dexamethasone, these combinations are being moved to frontline therapy. We compared the outcome of 87 patients treated with bortezomib plus MDex (BMDex) with that of 87 controls treated with MDex. Patients and controls were matched for age, cardiac and renal function and free light chain burden. A higher rate of complete responses was observed with BMDex (42 vs 19%), but this did not result in a survival improvement in the overall population. However, a significant survival advantage for BMDex was observed in patients without severe (New York Heart Association class III or IV) heart failure and with N-terminal pro-natriuretic peptide type-B <8500 ng/l. Patients treated with full-dose dexamethasone had similar response rates and survival whether they received bortezomib or not. Intermediate-risk patients who are not fit enough to receive high-dose dexamethasone are likely to take the greatest advantage from the addition of bortezomib to MDex.

Stability and energetics of Bursian diodes.

We present an analysis of the stability, energy, and torque properties of a model Bursian diode in a one dimensional Eulerian framework using the cold Euler-Poisson fluid equations. In regions of parameter space where there are two sets of equilibrium solutions for the same boundary conditions, one solution is found to be stable and the other unstable to linear perturbations. Following the linearly unstable solutions into the nonlinear regime, we find they relax to the stable equilibrium. A description of this process in terms of kinetic, potential and boundary-flux energies is given, and the relation to a Hamiltonian formulation is commented on. A nonlocal torque integral theorem relating the prescribed boundary data to the average current in the domain is also provided. The results will be useful for numerical verification purposes, and understanding Bursian diodes in general.

Beyond the Child-Langmuir limit.

This article presents a new formulation of the solution for fully nonlinear and unsteady planar flow of an electron beam in a diode. Using characteristic variables (i.e., variables that follow particle paths) the solution is expressed through an exact analytic, but implicit, formula for any choice of incoming velocity v(0), electric field E(0), and current J(0). For steady solutions, this approach clarifies the origin of the maximal current J(max), derived by Child and Langmuir for v(0) = 0 and by Jaffe for v(0) > 0. The implicit formulation is used to find (1) unsteady solutions having constant incoming flux J(0) > J(max), which leads to formation of a virtual cathode, and (2) time-periodic solutions whose average flux exceeds the adiabatic average of J(max).

Unique FISH patterns associated with cancer progression of oral dysplasia.

Subgroups of patients with oral pre-malignant lesions (OPLs) are at extremely high risk for developing invasive cancer in spite of surgical excision. The objective of this study was to evaluate the utility of specific genes and their associated centromeres as markers to stratify OPLs for their cancer risk. Samples used in this study included 35 oral dysplasia with known outcome and 20 normal oral mucosa. Of the dysplasias, 20 were from an ongoing longitudinal study showing progression. The remaining 15 cases (2 of which progressed) were chosen from the population-based, provincial BC Oral Biopsy Service (OBS). Copy number alterations at EGFR, CEP7, CCND1, and CEP11 were evaluated by fluorescent in situ hybridization (FISH). There was no significant difference in demographics between progressors and non-progressors. Specific FISH profiles at these genes and their corresponding centromeres were associated with progression. High gene gain of CCND1 was associated with an 8-fold elevated risk of progression compared with those with no gain in time-to-progression analysis. Numerical alterations of EGFR and CCND1 and their centromeres might be an effective means for identifying OPLs at risk. Future studies will expand on this analysis and set the stage for application of this approach in routine clinical practice.

Outcomes comparison of 5 coated cardiopulmonary bypass circuits versus an uncoated control group of patients undergoing cardiac surgery.

UNLABELLED: Attenuated inflammatory response and decreased platelet activation have been claimed repeatedly when biocompatible circuits are used for cardiopulmonary bypass. We evaluated five Health Canada approved biocompatible circuit coatings (BCC) against an un-coated control group to determine their effectiveness in improving post-operative outcomes. Patients were assigned to the Control group or one of the 5 coated circuit groups: 40 Control; 33 Trillium; 32 Phisio; 34 Bioline; 33 X; and 11 GBS. Measured outcomes included: ventilator time; ICU time; post-operative chest tube drainage and transfusion volume; high sensitivity C-reactive protein (hsCRP); tau protein; and pre- and 72-hour post-operative anti-saccadic eye movement test comparisons. RESULTS: 183 patients were enlisted into the study. One arm of the study (GBS) was abandoned after 11 patients on account of inconsistent pressure excursions within the oxygenator and the excessive consumption of platelets necessitating transfusion. Patients in the X-coated group had significantly longer ventilator and intensive care unit (ICU) time compared to the three remaining coated circuit study groups. Though not significant, patients in the X group also demonstrated the highest post-operative chest tube losses, the most platelet transfusions, the highest tau protein levels and the lowest post-operative anti-saccadic eye movement test (ASEMT) results compared to the three remaining coated groups. The patients in the Trillium, Bioline and Phisio groups showed an improvement in ventilator and ICU time relative to the Control group. The diabetic patients in the Trillium, Bioline and Phisio groups showed an improvement in bleeding relative to the diabetic patients in the Control group. CONCLUSION: We compared all 5 coated circuits approved for clinical use in Canada against an uncoated control circuit. Three of the 5 coated circuits (Trillium, Phisio and Bioline BCC) were found to improve ventilator and ICU time compared to Control. Further studies are indicated to validate these results and their impact upon approval criteria, purchasing choices and safe clinical practice, especially as applied to higher risk diabetic patients.

CPB-assisted aortic valve replacement in a pregnant 27-year-old with endocarditis.

A 27-year-old, G(3)P( 2)A(0) female with acute Staph aureus (SA) endocarditis successfully underwent CPB-assisted aortic valve replacement with a bioprosthetic aortic valve at 22 weeks' gestation. This patient's presentation of acute endocarditis complicated by septic shock, congestive heart failure, severe aortic insufficiency, multiple septic embolic events and borderline renal failure appeared on the daunting background of chronic heavy tobacco usage, hepatitis C positivity, long-term IV drug abuse and a pregnancy into its twenty-second week. Optimal treatment strategies implemented for both mother and fetus throughout the perioperative period contributed to a successful outcome for both.

A comparison of intra-operative cell-saving strategies upon immediate post-operative outcomes after CPB-assisted cardiac procedures.

Cardiotomy suction has been associated with adverse outcomes under routine conditions in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). We hypothesized that the routine use of a cell saver (CS) in place of the cardiotomy sucker would have no negative impact on transfusion rate (TR), chest tube drainage (CTD), ventilation time (VT) or intensive care unit length of stay (ICULOS) while avoiding the detrimental effects of cardiotomy suction. Retrospective data were collected from 69 patients where a cell saver was not used (NCS). Prospective data were collected from 219 patients who were followed after the implementation of an intra-operative cell saver. No significant increase in transfusion rate, chest tube drainage or ventilation time was found between the NCS group and the CS group. However, post-operative hemoglobin concentrations were significantly higher in the CS group (0.0001) and the CS group spent significantly less time in the ICU (p=0.018).

Nonlinear growth of firehose and mirror fluctuations in astrophysical plasmas.

In turbulent high-beta astrophysical plasmas (exemplified by the galaxy cluster plasmas), pressure-anisotropy-driven firehose and mirror fluctuations grow nonlinearly to large amplitudes, deltaB/B approximately 1, on a time scale comparable to the turnover time of the turbulent motions. The principle of their nonlinear evolution is to generate secularly growing small-scale magnetic fluctuations that on average cancel the temporal change in the large-scale magnetic field responsible for the pressure anisotropies. The presence of small-scale magnetic fluctuations may dramatically affect the transport properties and, thereby, the large-scale dynamics of the high-beta astrophysical plasmas.

The peritoneal explant test for evaluating tissue tolerance to mouthrinses.

The tissue cultures of explants of neonatal rat peritoneum have been demonstrated to be a sensitive test for tissue compatibility with wound antiseptics. The present study investigated the suitability of this method to assess the relative toxicity of mouthrinses to tissue. Mouthrinses containing 0.1% chlorhexidine (Chlorhexamed Fluid 0.1%) (A), 0.3% triclosan (Colgate) (B), essential oil in ethanolic solution (Listerine) (C), and amine/stannous fluoride (Meridol) (D) were tested at use concentration and in dilutions of 10, 1, and 0.1% with exposure times of 1, 10, and 30 min, respectively. The mouthrinses (test) and Ringer's solutions (control) were applied to opened rat peritoneum. After thorough irrigation with Ringer's solution, a piece of peritoneum was removed and 1 x 1 mm explants were cut. The explants were cultivated with a bovine serum culture medium in 24-well plates at 37 degrees C in a CO2 incubator (95% air, 5% CO2). After 10 days, the tissue proliferation for the explants was assessed by a stereo microscope at 10x magnification after ethanol fixing and hemalaun staining. With 24 grafts per test, the proliferation rate was calculated relative to a control, which was run for each mouthrinse and concentration/time combination. Data were analyzed using ANOVA (SPSS 11.0) and post-hoc paired t test. Statistical significance of all correlations was tested by setting the significance level at p < 0.05. At most concentrations, D caused significantly less tissue damage than A or B. There was no difference between C and A or C and B at 100%. However, the toxicity of C was significantly less than A or B at 10, 1, and 0.1%. C and D behaved similarly except for the 10% (30 min) and the 1% (10 min) solutions in which C was significantly less toxic. We concluded that the rat peritoneum explant test was demonstrated to be a sensitive test to assess the relative toxicity of mouthrinses to tissue.

German dental faculty attitudes towards computer-assisted simulation systems correlated with personal and professional profiles.

BACKGROUND: Computer technology is increasingly used in practical training at universities. However, in spite of their potential, computer-assisted simulation (CAS) systems still appear to be underutilised. OBJECTIVES: To investigate the practical usage of CAS/computer-assisted learning (CAL) systems, the familiarity and level of use of CAS systems, as well as the acceptance of approved learning content and English as the language of instruction in CAS/CAL systems. METHODS: A survey was conducted in the Departments of Conservative Dentistry and Prosthetic Dentistry of all 32 dental schools in Germany. Besides investigating the usefulness of, familiarity with and level of current usage of CAS systems, the questionnaire also contained questions regarding each respondent's gender, age, academic rank, experience in academia and computer skills, all of which correlated with the responses. RESULTS: The response rate was 90% (112 out of 125). The use of CAS/CAL systems was considered 'partly' to 'very' useful for evaluating the acquisition of knowledge (83.9%), qualitative issues (73.2%) and processes (72.3%) of dental preparation exercises and complex treatment strategies. However, only about half the respondents reported that they knew of, and even fewer used, the following systems in preclinical or clinical training: EDUnet (KaVo, Germany) (46.3%/0.9 %), PREPassistant (KaVo, Germany) (50%/0.9%), or the DentSim system (DenX, Israel) (52.8%/1.9%). The virtual simulation system VRDTS-CP (Novint, USA), used by none of the respondents, was known to only 16.5%. Responders agreed at least partly to accept approved learning content (74.9%) and English as the language of instruction (82.1%) as the standards for CAS systems. CONCLUSION: The survey indicates a distinct discrepancy between a generally positive attitude towards the usefulness of computer technology for dental education, the level of familiarity with current computer systems and their actual use. However, two prerequisites for ultimately decreasing the cost and increasing the usage of CAS systems--the acceptance of approved learning content and English as the language of instruction in CAS systems--seem to be generally accepted by respondents.

Axillary and tympanic membrane temperature measurements are unreliable early after cardiopulmonary bypass.

BACKGROUND AND OBJECTIVE: Inaccurate measurements of body temperature following cardiopulmonary bypass may be associated with serious complications. The purpose of this study was to determine whether axillary and tympanic temperature measurements correlate with the urinary bladder temperature in the early postcardiac surgery period. METHODS: Forty-nine adult patients who underwent cardiac surgery under cardiopulmonary bypass at our institution were prospectively studied. Urinary bladder, right axillary, right tympanic and left tympanic temperature measurements were simultaneously recorded at 0, 6, 12 and 18 h following cardiopulmonary bypass. Patients had one to four sets of recordings and a total of 629 temperature measurements were recorded. The mean difference (bias) between the bladder and each of the other methods and limits of agreement were calculated using Bland and Altman method. RESULTS: The mean core body temperature recorded from the bladder on admission to the intensive care unit was 36.4 degrees C. After 6, 12 and 18 h the mean core body temperature was 37.4 degrees C (range: 35.2-39.0), 37.5 degrees C and 37.45 degrees C, respectively. The mean differences (bias) between the bladder temperature and the other three methods were: left tympanic, 0.65 degrees C (95% CI: -0.24 to 1.58); right tympanic, 0.57 degrees C (95% CI: -0.48 to 1.63) and right axillary, 0.55 degrees C (95% CI: -0.27 to 1.36). CONCLUSIONS: The axilla and tympanic membrane are unreliable sites for core body temperature measurement early after cardiopulmonary bypass in adult patients and clinical decisions should be based on more reliable methods.