Children’s Postdisaster Trajectories of PTS Symptoms: Predicting Chronic Distress

BACKGROUND: There are no studies of the distinct trajectories of children’s psychological distress over the first year after a destructive natural disaster and the determinants of these trajectories. OBJECTIVE: We examined these issues using an existing dataset of children exposed to Hurricane Andrew, one of the most devastating natural disasters in US history. METHODS: At 3-months postdisaster, 568 children (55 % girls; grades 3–5) residing in areas most directly affected by the hurricane completed measures of hurricane exposure and stressors, social support, coping, and general anxiety. Children also reported major life events occurring since the hurricane (at 7-months) and posttraumatic stress (PTS) symptoms at 3-, 7-, and 10-months postdisaster. RESULTS: Latent growth mixture modeling identified three trajectories of PTS reactions: resilient (37 %), recovering (43 %), and chronic distress (20 %). Predictors of the trajectories were examined. Odds ratios indicated that, compared to the resilient trajectory, girls were more likely to be in the recovering and chronically distressed trajectories, as were children reporting higher anxiety and greater use of coping strategies that reflected poor emotion regulation. Compared to the recovering trajectory, children in the chronically distressed trajectory had greater odds of reporting high anxiety, less social support, more intervening life events, and greater use of poor emotion regulation strategies. CONCLUSIONS: Hurricane exposure may be less effective in identifying children who develop chronic postdisaster distress than other child (anxiety, coping) and contextual variables (social support, life events). Effective screening after disasters is critical for identifying youth most in need of limited clinical resources

Learning curve for laparoscopic cholecystectomy has not been defined: A systematic review

Background: Laparoscopic cholecystectomy is one of the most performed surgeries worldwide but its learning curve is still unclear. Methods: A systematic review was conducted according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Two independent reviewers searched the literature in a systematic manner through online databases, including Medline, Scopus, Embase, and Google Scholar. Human studies investigating the learning curve of laparoscopic cholecystectomy were included. The Newcastle–Ottawa scale for cohort studies and the GRADE scale were used for the quality assessment of the selected articles. Results: Nine cohort studies published between 1991 and 2020 were included. All studies showed a great heterogeneity among the considered variables. Seven articles (77.7%) assessed intraoperative variables only, without considering patient's characteristics, operator's experience, and grade of gallbladder inflammation. Only five articles (55%) provided a precise cut-off value to see proficiency in the learning curve, ranging from 13 to 200 laparoscopic cholecystectomies. Conclusions: The lack of clear guidelines when evaluating the learning curve in surgery, probably contributed to the divergent data and heterogeneous results among the studies. The development of guidelines for the investigation and reporting of a surgical learning curve would be helpful to obtain more objective and reliable data especially for common operation such as laparoscopic cholecystectomy

Polymorphisms in metabolic genes, their combination and interaction with tobacco smoke and alcohol consumption and risk of gastric cancer: a case-control study in an Italian population.

BACKGROUND: The distribution and the potential gene-gene and gene-environment interaction of selected metabolic genetic polymorphisms was investigated in relation to gastric cancer risk in an Italian population. METHODS: One hundred and seven cases and 254 hospital controls, matched by age and gender, were genotyped for CYP1A1, CYP2E1, mEH, GSTM1, GSTT1, NAT2 and SULT1A1 polymorphisms. Haplotype analysis was performed for EPHX1 exons 3 and 4, as well as CYP2E1 RsaI (*5 alleles) and CYP2E1 DraI (*5A or *6 alleles). The effect modification by alcohol and cigarette smoking was tested with the heterogeneity test, while the attributable proportion (AP) was used to measure the biological interaction from the gene-gene interaction analysis. RESULTS: Gastric cancer risk was found to be associated with the inheritance of GSTT1 null genotype (OR = 2.10, 95%CI: 1.27-3.44) and the SULT1A1 His/His genotype (OR = 2.46, 95%CI: 1.03-5.90). No differences were observed for the haplotype distributions among cases and controls. For the first time an increased risk was detected among individuals carrying the *6 variant allele of CYP2E1 if ever-drinkers (OR = 3.70; 95%CI: 1.45-9.37) with respect to never-drinkers (OR = 0.18; 95% CI: 0.22-1.46) (p value of heterogeneity among the two estimates = 0.001). Similarly, the effect of SULT1A1 variant genotype resulted restricted to ever-smokers, with an OR of 2.58 (95%CI: 1.27-5.25) for the carriers of His allele among smokers, and an OR of 0.86 (95%CI: 0.45-1.64) among never-smokers (p value of heterogeneity among the two estimates = 0.03). The gene-gene interaction analyses demonstrated that individuals with combined GSTT1 null and NAT2 slow acetylators had an additional increased risk of gastric cancer, with an OR of 3.00 (95%CI: 1.52-5.93) and an AP of 52%. CONCLUSION: GSTT1, SULT1A1 and NAT2 polymorphisms appear to modulate individual's susceptibility to gastric cancer in this Italian population, particularly when more than one unfavourable genotype is present, or when combined with cigarette smoke. The increased risk for the carriers of CYP2E1*5A or *6 alleles among drinkers need to be confirmed by larger prospective studies

Bee diversity in fragmented areas of Volcano Etna (Sicily, Italy) at different degrees of anthropic disturbance (Hymenoptera: Apoidea, Anthophila)

The present three-year study traces the diversity of four bee communities in fragmented pedemontane areas of Volcano Etna (Catania province, Sicily) near the Metropolitan City of Catania, under different land management regimes. The selected areas comprise two different urban parks within Catania (Parco Gioeni and Parco degli Ulivi), a Nature Reserve (Complesso Immacolatelle e Micio Conti, San Gregorio di Catania), and an agroecosystem (a citrus orchard, Aci Catena). Previous data obtained from a well-investigated area (Leucatia, north of Catania) have been used as a control for bee diversity for this study. The results include an outline of bee species richness, data on the composition of bee communities, and seasonal patterns, using several diversity indexes. The study of bee diversity shows a total of 163 species, arranged in five families. The four investigated locations include 104 species arranged in four families: Andrenidae (20 species), Halictidae (15 species), Megachilidae (31 species), and Apidae (38 species); with a similar number of species (102) recorded in the control site (Leucatia). The study highlights strong seasonal variations of bee communities in all investigated sites, with differentiated seasonal patterns, whose compositions are affected mainly by forage sources, suitable nesting sites, as well as human activities. The data obtained provide a rough but basilar framework to assess management strategies to maintain adequate levels of bee diversity, especially for those areas with moderate to high environmental fragmentation. Our findings highlight the importance of season-long sampling of bee population factors if used as indicators in ecological studies

Ag catalysts supported on CeO2, MnO2 and CeMnOx mixed oxides for selective catalytic reduction of NO by C3H6

In the present study CeO2, MnO2 and CeMnOx mixed oxide (with molar ratio Ce/Mn = 1) were prepared by sol-gel method using citric acid as a chelating agent and calcined at 500 °C. The silver catalysts (1 wt.% Ag) over the obtained supports were synthesized by the incipient wetness impregnation method with [Ag(NH3)2]NO3 aqueous solution. The selective catalytic reduction of NO by C3H6 was investigated in a fixed-bed quartz reactor using a reaction mixture composed of 1000 ppm NO, 3600 ppm C3H6, 10 vol.% O2, 2.9 vol.% H2 and He as a balance gas, at WHSV of 25,000 mL g−1 h−1.The physical-chemical properties of the as-prepared catalysts were studied by several characterization techniques, such as X-ray fluorescence analysis, nitrogen adsorption/desorption, X-ray analysis, Raman spectroscopy, transmission electron microscopy with analysis of the surface composition by X-ray energy dispersive spectroscopy and X-ray photo-electron spectroscopy. Silver oxidation state and its distribution on the catalysts surface as well as the support microstructure are the main factors determining the low temperature activity in NO selective catalytic reduction. The most active Ag/CeMnOx catalyst (NO conversion at 300 °C is 44% and N2 selectivity is ~90%) is characterized by the presence of the fluorite-type phase with high dispersion and distortion. The characteristic “patchwork” domain microstructure of the mixed oxide along with the presence of dispersed Ag+/Agnδ+ species improve the low-temperature catalyst of NO reduction by C3H6 performance compared to Ag/CeO2 and Ag/MnOx systems

Análisis de Invarianza y Diferencias de Medias Latentes Entre Adolescentes Americanos, Españoles y Chinos Usando la Escala de Ansiedad Social para Adolescentes (SAS-A)

Background: Social anxiety is one of the most prevalent disorders among adolescents (Stein et al., 2017). The main aim of this study was to analyze the equivalence of scores on the Social Anxiety Scale for Adolescents (SAS-A) using structural equation modeling and identify differences in latent means of social anxiety in China, Spain, and the USA. Method: Random sampling was used to recruit participants, which included 536 Chinese (46% girls), 1,178 Spanish (55.3% girls) and 866 North American (55.1% girls) adolescents. The participants’ ages ranged between 14 and 17 years old. Results: The SAS-A three-factor correlated model of social anxiety remained invariant between the Spanish and North American adolescents, but results could not be replicated in the Chinese adolescents [M2 = ΔS-Bχ2 (Δdf, p) = 4732.56 (36, < .01)]. Analyses of latent differences between Spain and the USA showed that Spanish adolescents had higher scores than North Americans for Fear of Negative Evaluation (TS = -9.630; d = .44) and for Social Avoidance and General Anxiety towards people (TS = -2.717; d = .12). Conclusions: The results are interpreted according to the cultural traits of individualism-collectivism and self-construal, and practical implications are discussed.Antecedentes: la ansiedad social es uno de los trastornos con mayor prevalencia en adolescentes (Stein et al., 2017). Así, el propósito principal de este estudio fue analizar la invarianza de la Escala de Ansiedad Social para Adolescentes (SAS-A) mediante un modelo de ecuaciones estructurales y examinar las diferencias de medias latentes en ansiedad social en adolescentes de China, España y EE.UU. Método: los participantes se seleccionaron a través de muestreo aleatorio: 534 chinos (46% chicas), 1.178 españoles (55,3% chicas) y 866 norteamericanos (55,1% chicas), con edades comprendidas entre los 14 y 17 años. Resultados: las puntuaciones del modelo de tres factores correlacionados de ansiedad social de la SAS-A resultaron invariantes entre adolescentes españoles y norteamericanos, pero estos resultados no fueron replicados en adolescentes chinos [M2 = ΔS-Bχ2 (Δdf, p) = 4732.56 (36, < .01)]. El análisis de medias latentes entre España y EE.UU. mostró que los adolescentes españoles manifestaban niveles más altos de Miedo ante las evaluaciones negativas (TS = -9.630; d = .44) y Evitación social y ansiedad general hacia las personas (TS = -2.717; d = .12). Conclusiones: estos hallazgos fueron interpretados atendiendo al de individualismo-colectivismo y las concepciones culturales de la propia persona, analizando sus implicaciones prácticas

Minimal fluoroscopic approaches and factors associated with radiation dose when high-definition mapping is used for supraventricular tachycardia ablation: insight from the CHARISMA registry

Abstract Funding Acknowledgements Type of funding sources: None. Background Limited data exist on factors associated with radiation exposure during ablation procedures when a high definition mapping technology is used. Purpose To report factors associated with radiation exposure and data on feasibility and safety of a minimal fluoroscopic approach using the Rhythmia mapping system in supraventricular tachycardia (SVT) ablation procedures. Methods Consecutive patients indicated for arrhythmia ablation were enrolled in the CHARISMA study at 12 centers. We included in this analysis consecutive right-side procedures performed through a minimal fluoroscopy approach with the Rhythmia mapping system were analyzed. A 3D geometry of chambers of interest was reconstructed on the basis of the electroanatomic information taken from the mapping system. Fluoroscopy was used only if deemed necessary. The effective dose (ED) was calculated using accepted formula. For our purpose high dose exposure was defined as an ED greater than the median value of ED of the population exposed to radiation. Results This analysis included 325 patients (mean age = 56 ± 17 years, 57% male) undergoing SVT procedures (152 AVNRT, 116 AFL, 41 AP and 16 AT). During the study, 27481 seconds of fluoroscopy was used (84.6 ± 224 seconds per procedure), resulting in a mean equivalent ED of 1.1 ± 3.7 mSv per patient. The mean reconstructed RA volume was 99 ± 54 ml in a mean mapping time of 12.2 ± 7 min. The mean number of radiofrequency ablations (RFC) to terminate each arrhythmia was 9.4 ± 9 (mean RFC delivery time equal to 6.7 ± 6 min). 192 procedures (59.1%) were completed without any use of fluoroscopy; during the remaining 133 procedures (39.9%), 206.6 ± 313.4 seconds of fluoroscopy was used (median ED = 1.2 mSv). In a minority of the cases (n = 25, 7.7%) the fluoroscopy time was higher than 5 minutes (median ED = 6.5 mSv), whereas radiologic exposure time greater than 1 minute occurred in ninety cases (27.7%, median ED = 2.1 mSv). On multivariate logistic analysis adjusted for baseline confounders the RFC application time (OR = 1.0014, 95%CI: 1.0007 to 1.0022; p = 0.0001) was independently associated to an ED greater than 1.2 mSv, whereas female gender had an inverse association (0.54, 0.29 to 0.98; p = 0.0435). Acute success was reached in 97.8% of the cases. During a mean of 290.7 ± 169.6 days follow-up, no major adverse events related to the procedure were reported. Overall, the recurrence rate of the primary arrhythmia during follow-up was 2.5%. Conclusions In our experience, arrhythmias ablation through minimal fluoroscopy approach with the use of a novel ablation technology is safe, feasible, and effective in common right atrial arrhythmias. High-dose exposure occurred in a very limited number of cases, without any reduction of the safety and acute and long-term effectiveness profile

Peer Perceptions of Social Skills in Socially Anxious and Nonanxious Adolescents

Previous studies using adult observers are inconsistent with regard to social skills deficits in nonclinical socially anxious youth. The present study investigated whether same age peers perceive a lack of social skills in the socially anxious. Twenty high and 20 low socially anxious adolescents (13–17 years old) were recorded giving a 5-min speech. Unfamiliar peer observers (12–17 years old) viewed the speech samples and rated four social skills: speech content, facial expressions, posture and body movement, and way of speaking. Peer observers perceived high socially anxious adolescents as significantly poorer than low socially anxious adolescents on all four social skills. Moreover, for all skills except facial expressions, group differences could not be attributed to adolescents’ self-reported level of depression. We suggest that therapists take the perceptions of same age peers into account when assessing the social skills of socially anxious youth

Children’s Postdisaster Trajectories of PTS Symptoms: Predicting Chronic Distress

There are no studies of the distinct trajectories of children’s psychological distress over the first year after a destructive natural disaster and the determinants of these trajectories