bluuebunny/crossref_metadata_2025 huggingface dataset:
Talent Development in Music
Authors: Müllensiefen Daniel , Kozbelt Aaron , Olszewski-Kubilius Paula M. , Subotnik Rena F. , Worrell Frank C. , Preckel Franzis
Published: January 2022

Abstract: We present a model for talent development in music that resulted from applying a general framework for Talent development in Achievement Domains (i.e., the TAD framework; Preckel et al., 2020) to the domain of music. The talent development model in the musical domain (TAD music model) draws on the existing literature on musical talent development but also specifies a rigorous framework drawn from empirical research that can be used to identify predictors and indicators of musical talent. The TAD music model provides a multidimensional, dynamic view of talent development in music. Cognitive abilities, personality traits, and psychosocial skills that can potentially serve as predictors at different levels of talent development in music are suggested. The TAD music model can be used to further understandings about the nature of musical talent and its development, for the construction of diagnostic procedures, for empirical investigations of talent development in music, for the training of music teachers’ diagnostic skills, and for the identification and promotion of musically talented children.
Self-Directed Learning Strategies
Authors: Parkes Kelly A.
Published: January 2022

Abstract: This chapter explains the nature of self-directed learning (SDL) by providing an overview of the leading theoretical frameworks with a synthesis of the latest research. It explores connections that SDL has to constructivism, to learner-centered teaching, and the differences observed between SDL and self-regulation. Methods of measuring SDL are addressed and the various elements of self-directed strategies are explored. Self-directed strategies are presented as an overarching learning approach, one in which the learner conceptualizes, designs, conducts, and evaluates their learning. Components of SDL seen in learners include learning motivation, awareness, learning strategies, learning activities, planning and implementing, self-monitoring, interpersonal communication, and evaluation. Suggestions for the ways in which SDL strategies may be implemented in musical settings are given for the strategies of self-management, self-monitoring, and self-modifying behaviors, in both the applied one-to-one studio and classroom settings.
Humanities and Public Policy: Forging Citizens and the Nation
Authors: Fisher-Livne Daniel , Gurwitz Beatrice , Hill Cecily Erin , Kidd Stephen , Muir Scott
Published: January 2022

This chapter explores the evolution of state, local, and federal policies to promote engagement with the humanities in the United States from the Early Republic through the contemporary moment. It focuses particularly on policymakers’ efforts to support or influence educational institutions, libraries, museums, and historic sites. The authors argue that over time, humanities policy has largely focused on the value of the humanities to cultivating a prepared citizenry and forging shared narratives of the American experience, even as views of who comprised that citizenry and whose history and culture ought to be included in representations of the American experience have changed significantly.
Lessons for Positive Arts and Humanities from the Science of Meaning in Life
Authors: Wilkinson Alexis N. , King Laura A.
Published: January 2022

This chapter addresses the likely contributions of art and literature to meaning in life. First, the authors define meaning in life, describe its general features, and consider its place in human flourishing. They consider variables (particularly positive mood) that predict meaning in life and link these factors with the arts and humanities. Then, they consider the place of regularities and routines in meaning in life and place such experiences within the arts and humanities. They then consider the feeling of existential mattering as it relates to participation in culture. Finally, they draw an analogy between difficult times and difficult works of art and literature, and explore the ways that effortful meaning-making might contribute to the Good Life.
The Holiness of Wholeness: Religious Contributions to Human Flourishing
Authors: Pargament Kenneth I. , Wong Serena , Exline Julie J.
Published: January 2022

This chapter proposes that the essential contribution of religion to flourishing goes beyond any single factor. Instead, religion is concerned with human wholeness—that is, how people put the bits and pieces of their lives together into a coherent whole. What lends unity to the lives of many individuals is the focus on sacred matters. Religious institutions are most uniquely concerned with what people hold sacred and how they can develop and foster their relationship with ultimate concerns. Drawing on theory and research, this chapter examines three key ingredients of wholeness and their intimate connections to religion: the capacity to see and approach life with breadth and depth; a life-affirming view of oneself and the world; and the ability to organize the life journey into a cohesive whole. Wholeness may be understood as a superordinate virtue, a major key to human flourishing and life well-lived. Although the focus of this chapter is on “religion at its best,” the authors also acknowledge the darker side of religion and its capacity to lead to suffering and brokenness.
The Role of Passion in the Arts and Humanities: How Quality of Engagement Matters
Authors: Vallerand Robert J. , Sverdlik Anna , Bonneville-Roussy Arielle
Published: January 2022

The arts and humanities are prevalent sources of passion. Whether it is through performing them or appreciating the performance of others, the type of passion that individuals have for the arts and humanities can shape a variety of outcomes. Following the model proposed by Tay, Pawelski, and colleagues (2018, 2019), the present chapter documents the role of passion for the arts and humanities in personal outcomes such as emotions, creativity, performance, well-being, and identity processes. Research on passion for the arts and humanities demonstrates that the type of passion matters: while engaging in the arts and humanities out of harmonious passion leads to adaptive outcomes and even protects against negative ones, being obsessively passionate may be maladaptive. Thus, while engagement in the arts and humanities has the potential to contribute to human flourishing, the quality of engagement matters for those who are passionate about these domains.
The Positive Humanities: Culture and Human Flourishing
Authors: Pawelski James O.
Published: January 2022

The Positive Humanities are a new field of inquiry and practice concerned with the relationship between culture and human flourishing. They seek to understand the conceptual nuances of this relationship in a variety of contexts in different societies across time. They also investigate the practical effects of cultural engagement on human flourishing, with a particular emphasis on how such engagement can be intentionally optimized to help individuals and communities thrive. Grounded in the wisdom, narrative, aesthetic, and performance traditions of cultures across time and around the world (and thus always inclusive of the arts), they seek insights into the nature and development of human flourishing from this vast storehouse of human experience. The Positive Humanities are also informed by more recent efforts in the sciences to bring empirical methodologies to bear in the investigation of well-being, and their practical emphasis connects them to the educational institutions, creative industries, and cultural organizations through which the humanities are often studied and experienced. This chapter provides an introduction to the Positive Humanities, examining their complex relationship to historical and contemporary approaches to the humanities; exploring their connections to the science of well-being (especially positive psychology); identifying their domains of practical influence; clarifying their definition, aims, and commitments; and suggesting important future directions for the field.
A Walk in the Sun: The Awakening of Human Flourishing in Creative Youth Development
Authors: Chand O'Neal Ivonne
Published: January 2022

Creative Youth Development (CYD) strategically employs the arts and humanities to promote flourishing in youth by linking arts programming to personal youth experiences, providing asset-based safe spaces that emphasize belonging, the development of relationships, and social skills at high levels of expectation to facilitate optimal learning among youth. The current chapter identifies the deep connections between the CYD movement and the study of human flourishing by first providing a brief progressive history of this work culminating in the discussion of two case studies—the Mosaic Model and Arts Amplify Youth!—illustrating how youth from diverse backgrounds found a place where, through the arts and humanities, they could be heard, could feel safe, and could surround themselves with adults and peers who genuinely cared about their well-being, while fostering their creativity, strengthening their sense of self, and developing their own voice to serve as advocates in their own communities.
Creativity and Human Flourishing
Authors: Runco Mark A.
Published: January 2022

Creativity is related to effective problem-solving, adaptability, diverse indicators of success, and various indicators of health, learning, development, and growth. This chapter examines how creativity is related to human flourishing. It ties creative problem-solving to flourishing, the idea being that it is easy to flourish when the individual can creatively solve problems. Much the same logic is used in the discussion of adaptability and creative thinking. Self-actualization is recognized because it has been associated with both creativity and the highest form of psychological health. Divergent thinking, one kind of creative thinking, is brought into the discussion because it describes how ideas may be generated, some of which are original and creative. Divergent thinking is very clearly tied to flourishing, for it allows an individual to identify the fullest range of options and possibilities. Divergent thinking is not linear and does not lead in only one direction, but instead branches out so the individual has more freedom, more latitude, and a very full set of choices which add richness to life. This chapter touches on several different ways that creativity may be associated with human flourishing.
A Relational Conception of Emotional Development
Authors: Mascolo Michael
Published: January 2022

This chapter advances a relational conception of emotions and their development. From a relational view, emotions consist of felt forms of organismic engagement with the world. As modes of engagement, different emotions are organized in terms of different relations between a person’s motives and circumstances. As modes of engagement, emotions are aspects of ongoing adaptive action—emergent configurations of motivational, perceptual, experiential, expressive, and motor processes organized around a particular way of relating to the world. The idea that emotions are felt modes of engagement identifies experience as a primary aspect of emotional life. Building upon a biological grounding, emotions undergo structural change as they develop within intersubjectively-structured exchanges with others. The relational model is illustrated with an analysis of structural changes in jealousy and envy over the course of their development.
Why Are Humans So Emotional?
Authors: Turner Jonathan H.
Published: January 2022

Using cladistic analysis and comparative neurology, the evolution of humans’ unique capacities to be so emotional is analyzed in this chapter. Humans are, in essence, evolved great apes who, contrary to much popular opinion, are not highly social, do not form permanent groups, do not live in nuclear families, and in general, are not highly organized by social structures. What is true of great apes today was also true of the ancestors of great apes and the hominin ancestors of humans. As humans’ hominin ancestors sought to adapt to more open-country habitats without the protection of the forests, natural selection began to enhance emotions by enlarging subcortical areas of the hominin brain, which set into motion the evolution of new social structures for hominins and, furthermore, also set into motion selection for humans’ large neocortex, capacity for spoken language, and eventually, for culture. Human development during the infant–child phase of the life cycle now reflects these longer-term evolutionary patterns in the evolution of humans.
Current Challenges and Advances in Computational and Artificial Agent Modeling for the Simulation of Affective Social Learning and Regulation of Motivated Behaviors
Authors: Rudrauf David , Samson Andrea C. , Debbané Martin
Published: January 2022

Psychological science aims at understanding the development and interplay of hidden psychological mechanisms (cognitive, affective, and social) and their causal role in observable behaviors, both in adaptive and maladaptive contexts. It is thus relevant, though highly challenging, to develop computational models and artificial agents derived from psychological theories allowing investigators to explore and test hypotheses through simulations. This chapter reviews and discusses current modeling challenges and advances that are relevant to the understanding and simulation of affective social learning and the development of adaptive and motivated behaviors. The hope is that the chapter will encourage dialogue and the sharing of perspectives with developmental and clinical psychologists. The chapter emphasizes the importance of modeling the complex integration of multiple interacting mechanisms, including processes analogous to the imagination and subjective experience, in order to understand the development of appraisal, emotions, emotion regulation, and their roles in adaptive and maladaptive behaviors.
Emotions in Play
Authors: Veiga Guida , da Silva Brenda M. S. , Gibson Jenny , Rieffe Carolien
Published: January 2022

Play is an important context for children’s emotional and social development. Most play research has been focused on pretend play; however, observational studies have shown that children spend a considerable amount of time engaged in physical play. Although it is thought to be important, little is known about the role of physical play in children’s emotion socialization. Physical play can be categorized in two forms: exercise play and rough-and-tumble play. Both forms involve moderate to vigorous playful body activity, which is accompanied by physiological arousal. In addition, rough-and-tumble play often involves role taking, requiring children to accurately read their partners’ emotional and intentional expressions, control their anger impulses, and cope with frustration. Recent research has shown that exercise play, especially when engaged with peers, is related to emotion understanding and emotion regulation; but this is less clear for rough-and-tumble play. Besides, physical play provides an important mechanism for peer interactions that is less dependent on verbal interactions, which is especially relevant for children with communication impairments, and hearing loss in particular.
Early Interaction
Authors: Messinger Daniel S. , Moffitt Jacquelyn , Mitsven Samantha G. , Ahn Yeojin Amy , Custode Stephanie , Chervonenko Evgeniy , Sadiq Saad , Shyu Mei-Ling , Perry Lynn K.
Published: January 2022

Early interaction is a dynamic, emotional process in which infants influence and are influenced by caregivers and peers. This chapter reviews new developments in behavior imaging—objective quantification of human action—and computational approaches to the study of early emotional interaction and development. Advances in the automated measurement and modeling of human emotional behavior—including objective measurement of facial expressions, machine-learning approaches to detecting interaction and emotion, and electrophysiological measurements of emotional signals—provide new insights into how interaction occurs. Furthermore, advances in automated measurement and modeling can be applied to the study of atypical development, contributing to our understanding of, for example, social affective behaviors in toddlers with autism spectrum disorder (ASD). The chapter concludes by posing questions for future directions of the field of computational approaches to emotion.
Affective Social Learning
Authors: Clément Fabrice , Dukes Daniel
Published: January 2022

From their very origins, psychology and sociology have each tended to follow their own path, without taking the other into consideration. This mutual indifference is particularly problematic when studying processes of socialization. On the developmental psychological side, there is perhaps a tendency to consider the child as a “lone explorer,” while on the sociology side, the irreducibility of the social agent to their individual epistemic endeavor is, of course, central. However, socialization is essentially about transmission, from one generation to the next, of ways of doing, thinking, and feeling. In this chapter, the authors argue that culture is mostly about what is socially relevant, and that what is socially relevant can be learned by observing relevant others’ affective expressions. This affective social learning may help close the gap between psychology and sociology by providing different mechanisms that enable individuals to embody, via their developing emotions, the system of cultural relevance in which they live.
Emotion Regulation Across the Life Span
Authors: Riediger Michaela , Bellingtier Jennifer A.
Published: January 2022

Emotion regulation—the ability to control emotional experiences and expressions—is essential for positive adaption across the life span. Individual and contextual factors contribute to emotion-regulation variance between and within different age groups. Individual factors include, for example, genetic dispositions and neurobiological vulnerabilities. Contextual factors involve opportunities to learn about and practice emotion regulation. In infancy and childhood, the family is especially important for assisting in regulating and teaching about emotions. During adolescence, physiological and socioemotional changes can contribute to transient instability in emotion regulation. Throughout adulthood, favorable average well-being trajectories co-occur with increases in prohedonic motivation. Emotion-regulation abilities are maintained into old age, but toward the end of life, stressors may overtax individuals’ emotion-regulation capacity. This chapter reviews key developmental theories and empirical findings on emotion regulation in childhood, adolescence, and adulthood. It also highlights shortcomings and gaps in the available knowledge and points toward future research directions.
Real-world frequency of BRAF testing and utilization of therapies in patients with advanced melanoma
Authors: Hill Maureen V. , Vidri Roberto J. , Deng Mengying , Handorf Elizabeth , Olszanski Anthony J. , Farma Jeffrey M.
Published: January 2022

Both BRAF/MEK targeted agents and immunotherapy are approved for the treatment of advanced melanoma. BRAF testing is recommended at the time of advanced melanoma diagnosis. In addition, little is known regarding the treatment trends for patients with BRAF mutated tumors. This investigation aims to assess the real-world prevalence of molecular testing and treatment trends for patients with BRAF mutated tumors. Using a de-identified database, patients of age ≥18 years with advanced melanoma from 2013 to 2018 were examined. Molecular testing performed within 3 months of advanced diagnosis was considered to have the test performed at the time of diagnosis. Test prevalence was calculated and compared in groups stratified by the patient, tumor and treatment factors. In total 4459 patients were included; 1936 (43.4%) stage III, 1191 (26.7%) stage IV and 1332 (29.9%) recurrent. Totally 50.4% of patients received systemic treatment; 76.4% stage IV, 71% recurrent patients and 26.7% stage III patients. However, 73.5% received first-line immunotherapy. In total 73.8% of patients had molecular testing, and 50.5% had tested at the time of advanced diagnosis. Of those tested 42% had a BRAF mutated tumor. In total 48% of these patients received first-line immunotherapy whereas 43% received a BRAF inhibitor, with increasing immunotherapy use seen over time. The majority of patients with advanced melanoma undergo molecular testing at the time of advanced diagnosis. Immunotherapy is the most commonly prescribed treatment regardless of BRAF mutational status. These results provide real-world data on the frequency of molecular testing and treatment trends for patients with advanced melanoma.
One-stage Reconstruction of Penile Paraffinoma Using Spiral Stitches FTSG and Evaluation of Sexual Function
Authors: Ismy Jufriady , Amirsyah Mirnasari , Palgunadi I Nyoman , Firdaus Gugum Indra , Fakhrulrizal Fakhrulrizal , Khalilullah Said Alfin
Published: January 2022

Paraffinoma of the penis is rare and caused by paraffin liquid injection. This condition can cause significant penile deformity, ulceration, pain, and sexual dysfunction. However, it can be managed with surgical procedures to obtain normal aesthetic and functional results. Herein, we reported a 42-year-old male with penile paraffinoma who underwent excessive surgical excision of the fibrotic tissue and one-stage reconstruction using a spiral stitch full-thickness skin graft. At one year of follow-up it showed a good aesthetic outcome with no hypertrophic scars, skin contractures, penile curvature, or penile shortening. The sexual evaluation using the International Index of Erectile Function instrument also showed a good result with normal erectile function and satisfaction with sexual sensation. This case is interesting because we used the spiral stitch full-thickness skin graft technique to cover the degloving area and long-term follow-up to evaluate the aesthetic and functional results.
Mediators of the Effect of Corneal Cross-Linking on Visual Acuity for Fungal Ulcers: A Prespecified Secondary Analysis From the Cross-Linking–Assisted Infection Reduction Trial
Authors: Prajna N. Venkatesh , Radhakrishnan Naveen , Lalitha Prajna , Liu Zijun , Keenan Jeremy D. , Arnold Benjamin F , Rose-Nussbaumer Jennifer
Published: January 2022

Purpose:

The purpose of this study was to determine whether astigmatism or corneal scarring is mediating the reduced visual acuity among patients with fungal keratitis randomized to corneal cross-linking (CXL).

Design:

This was a prespecified exploratory outcome from an outcome-masked, 2 × 2 factorial design, randomized controlled clinical trial.

Study Participants:

Consecutive patients presented with moderate vision loss from a smear-positive fungal ulcer at Aravind Eye Hospital, Madurai, India.

Intervention:

Study eyes were randomized to one of 4 treatment combinations using an adaptive randomization protocol. The treatment arms included (1) topical natamycin 5% alone, (2) topical natamycin 5% plus CXL, (3) topical amphotericin B 0.15% alone, and (4) topical amphotericin 0.15% plus CXL. Best spectacle-corrected visual acuity (BSCVA), contact lens over-refraction, and scar size and depth as measured by a masked study ophthalmologist using a standardized protocol were recorded at 3 months. Pentacam Scheimpflug imaging was also obtained at 3 months.

Main Outcome Measures:

BSCVA and contact lens over-refraction, infiltrate and/or scar size and depth, total astigmatism of the front and back of the cornea, total lower-order and higher-order aberrations of the anterior and posterior cornea, and total densitometry of the anterior, central, and posterior stroma were recorded. We performed a mediation analysis looking at the proportion of the effect of CXL on BSCVA that was mediated through scar size, scar depth, astigmatism and density.

Results:

BSCVA at 3 months was available for 99 of 111 patients (89%) who had a mean of 0.82-LogMAR (SD 0.68). Three-month infiltrate and/or scar size (P < 0.001), depth (P < 0.001), and densitometry (P = 0.001) were statistically significant predictors of 3-month BSCVA. Astigmatism seemed to mediate 23% of the effect of CXL on BSCVA, whereas scar size mediated 23%, scar depth 17%, and densitometry 7%.

Conclusions:

Corneal scarring and astigmatism are mediators of worse visual acuity after cross-linking in fungal keratitis. Corneal densitometry may be a helpful cornea-specific variable for clinicians and researchers in determining the effect of corneal scarring on visual acuity in specific patients and as an objective study outcome.

Trial Registration:

NCT02570321.
Systemic immune-inflammation index predicts in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction
Authors: Öcal Lütfi , Keskin Muhammed , Cerşit Sinan , Eren Hayati , Özgün Çakmak Ender , Karagöz Ali , Çakir Hakan , Gürsoy Mustafa Ozan , Doğan Selami , Zhalilov Myrzabek , Türkmen Mehmet Muhsin
Published: January 2022

Objective

This study examines the predictive value of the novel systemic immune-inflammation index (SII) in patients with ST-segment elevation myocardial infarction (STEMI).

Methods

A total of 1660 patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) were enrolled in the study. In-hospital and 3-year outcomes were compared between the four groups (Q1–4). The SII was calculated using the following formula: neutrophil*platelet/lymphocyte.

Results

The frequency of in-hospital cardiogenic shock, acute respiratory failure, acute kidney injury, ventricular arrhythmia, stent thrombosis, recurrent myocardial infarction, major adverse cardiac events and mortality were significantly higher in the high SII groups (Q3 and Q4). Logistic regression models demonstrated that Q3 and Q4 had an independent risk of mortality and Q4 had an independent risk of cardiogenic shock compared to Q1. Receiver operating characteristic analysis showed that the best cutoff value of SII to predict the in-hospital mortality was 1781 with 66% sensitivity and 74% specificity. Kaplan–Meier overall survivals for Q1, Q2, Q3 and Q4 were 97.6, 96.9, 91.6 and 81.0%, respectively. Cox proportional analysis for 3-year mortality demonstrated that Q3 and Q4 had an independent risk for mortality compared to Q1.

Conclusion

SII, a novel inflammatory index, was found to be a better predictor for in-hospital and long-term outcomes than traditional risk factors in patients with STEMI undergoing pPCI.
Patterns and outcomes of invasive management of type 2 myocardial infarction in the United States
Authors: Smilowitz Nathaniel R. , Shah Binita , Lorin Jeffrey , Berger Jeffrey S.
Published: January 2022

Background

Type 2 myocardial infarction (MI) occurs due to a mismatch in myocardial oxygen supply and demand without unstable coronary artery disease. We sought to identify patterns, predictors and outcomes of invasive management of type 2 MI in the USA.

Methods

Adults aged ≥18 years hospitalized with type 2 MI were identified in a cross-sectional study from the 2018 National Inpatient Sample. Invasive management was defined as invasive coronary angiography or revascularization. Patient, hospital and geographic characteristics associated with invasive management were identified by multivariable logistic regression. Propensity-matched cohorts were generated to evaluate associations between invasive vs. conservative management and mortality.

Results

We identified 268 850 admissions with type 2 MI in 2018. Type 2 MI patients had a high burden of comorbidities and were commonly admitted with diagnoses of circulatory (39.7%), infectious (23.1%) or respiratory (10.8%) illness. Only 11.2% of type 2 MI were managed invasively, of which 17.9% underwent coronary revascularization. Odds of invasive management were higher with commercial insurance [adjusted OR (aOR) 1.39; 95% confidence interval (CI), 1.27–1.52] and lower with Medicaid (aOR 0.86; 95% CI, 0.76–0.96) vs. Medicare. Significant heterogeneity in invasive management of type 2 MI was observed by geographic region (range 7.2–13.8%), independent of patient and hospital factors. Invasive management was associated with lower in-hospital mortality than conservative management overall (3.9 vs. 9.1%; P < 0.001) and in propensity-matched analyses (OR, 0.70; 95% CI, 0.59–0.84).

Conclusion

Invasive management of type 2 MI varies by insurance status and geography, highlighting uncertainty regarding optimal management and potential disparities in clinical care.
F-18 DOPA PET/CT in pediatric patients with hyperinsulinemic hypoglycemia: A correlation with genetic analysis
Authors: Sagar Sambit , Arora Geetanjali , Damle Nishikant , Sharma Rajni , Jain Vandana , Jana Manisha , Tripathi Madhavi , Bal Chandrasekhar , Goel Prabudh
Published: January 2022

Aim

Persistent hyperinsulinemic hypoglycemia is a rare but life-threatening disease of infancy and childhood. 18F-DOPA PET/CT has been shown to be a useful modality in the localization of focal pancreatic lesions in these patients. We aimed to assess the role of 18F-DOPA PET/CT in such patients at our institution.

Materials and methods

In this prospective study, 18F-DOPA PET/CT scans and clinical details of 20 children with clinical diagnosis of hyperinsulinemic hypoglycemia were reviewed. Scans were acquired at 5 min postinjection of 2-3 mCi of 18F-DOPA on dedicated PET/CT scanners (Biograph mCT, Siemens Inc and Discovery PET/CT, GE). Abdominal spot images over 1–2 bed positions were acquired. Additionally, genetic mutation status, where available, was correlated to the scan findings.

Results

Out of 20 children (7 female and 13 male), 13 were infants. The age of the children ranged from 3 months to 8 years. Fifteen children had undergone gene analysis, 12 were positive for mutation in ABCC8, 1 for GLUD-1, 1 for GCK mutations and 1 had not shown any mutation. 18F-DOPA PET/CT scan showed 5 focal pancreatic lesions in 5 children (1 in each), two focal lesions in 1 child and diffuse pancreatic uptake in 14 children.

Conclusion

18F-DOPA PET/CT is a useful modality for localizing focal pancreatic lesions in children with persistent hyperinsulinemic hypoglycemia. The detection rate is significantly higher in patients with ABCC8 paternal monoallelic recessive gene mutation. 18F-DOPA PET/CT scan consequent to findings on genetic analysis appears to be useful in planning the management of children with hyperinsulinism.
Optimization of pediatric FDG-PET/CT examinations based on physical indicators using the SiPM-PET/CT system
Authors: Owaki Yoshiki , Minamishima Kazuya , Nakajima Kiyotaka
Published: January 2022

Objective:

This study aimed to investigate the appropriate Silicon photomultiplier -PET/CT acquisition and image reconstruction conditions for each age group.

Methods:

The original phantom was developed to reflect the thickness and width of the torso in each age group (neonates, 1-year-olds, 5-year-olds, 10-year-olds, 15-year-olds, and adults). The ratio of hot spheres to background radioactivity was 4:1, and the radioactivity concentration was adjusted according to the Japanese consensus guidelines for appropriate implementation of pediatric nuclear medicine examinations. We evaluated the root mean square error (RMSE) as an assessment/function of the standardized uptake value of each hot sphere, the background variability (N
10 mm), the % contrast of the hot sphere (Q
H, 10 mm/N
10 mm), and the noise equivalent counts to determine the optimal reconstruction parameters and the appropriate acquisition time.

Results:

The minimum RMSE was obtained by setting the half-width of the Gaussian filter to 0-2 mm for iteration 1 or 2 and to 2-4 mm for iteration 3 or more. The acquisition times that satisfied the image quality equivalent to 120 s acquisitions in the adult phantoms were 30 s in the neonatal and 1-year-old phantoms, 60 s in the 5- and 10-year-old phantoms, and 75 s in the 15-year-old phantoms.

Conclusion:

This study demonstrated that good PET images could be obtained with short acquisition times when the examination is performed under appropriate reconstruction conditions.
Comparison of 99mTc-methyl diphosphonate bone scintigraphy and 68Ga-DOTANOC PET/computed tomography in articular manifestation of rheumatoid arthritis
Authors: Shamim Shamim Ahmed , Arora Geetanjali , Kumar Naresh , Behera Abhishek , Hussain Jhangir , Gupta Ranjan , Kumar Rakesh , Bal Chandrasekhar
Published: January 2022

Objective

Tc-99m methyl diphosphonate (MDP) bone scintigraphy is used to assess disease activity in rheumatoid arthritis (RA). Somatostatin receptor (SSTR) expression in RA has been reported previously. SSTR-based PET/computed tomography (CT) may be superior to bone scintigraphy to know disease extent and in locating inflammatory joints that can be further targeted with peptide receptor radionuclide therapy thereby opening up new theranostic avenues. Based on these facts, the present study was designed to compare Tc-99m MDP bone scintigraphy and Ga-68 DOTANOC PET/CT in patients with RA.

Materials and methods

Patients with a clinical diagnosis of RA were injected with 111–185 MBq of Ga-68 DOTANOC and 740 MBq of Tc-99m MDP intravenously. Images were acquired 30–45 min postinjection for Ga-68 DOTANOC on dedicated PET/CT scanners. Triple-phase bone scans were acquired on a dual-head gamma camera. PET/CT and MDP scan images were visually assessed by two experienced nuclear medicine physicians.

Results

Nineteen patients (16 women and 3 men) with a clinical diagnosis of RA were included in the study. Clinically, 196 joints in these 19 patients were diagnosed positive for RA. Of these 196 joints, Tc-99m MDP uptake was seen in 157 joints (80%). On Ga-68 DOTANOC scan, tracer uptake was seen in 151 of 196 joints (77%) with a lesion to background ratio of at least 2 in most of the joints.

Conclusion

Ga-68 DOTANOC is equally good as an MDP scan for detection of RA with the added advantage of being used as a theranostic modality. However, further evaluation with a larger sample size and joint-to-joint comparison is warranted.
Predicting pathological response and overall survival in locally advanced gastric cancer patients undergoing neoadjuvant chemotherapy: the role of PET/computed tomography
Authors: Güç Zeynep Gülsüm , Turgut Bülent , Avci Arzu , Cengiz Fevzi , Eren Kalender Mehmet , Alacacioğlu Ahmet
Published: January 2022

Background

Gastric cancer is the second leading cause of cancer-related deaths, with a 5-year survival rate of about 20–25%. The ability to predict pathological response (PR) to neoadjuvant chemotherapy (NACT); hence, overall survival (OS) probability of patients can allow the clinician to individualize treatment strategies. We investigated the role of F-18 fluorodeoxyglucose PET-computed tomography (F-18 FDG PET/CT) in predicting histopathologic response and prognosis in locally advanced gastric cancer (LAGC) patients undergoing NACT.

Methods

F-18FDG PET/CT images taken before and after NACT, adenocarcinoma histopathology and operation pyesis reports of 43 LAGC patients were analyzed. Maximum (SUVmax) and mean (SUVmean) standardized uptake values, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of lesions were measured before and after NACT. Changes in percentage were calculated for ΔSUVmax%, ΔSUVmean%, ΔMTV%, ΔTLG%, and cutoff values were determined by receiver operating characteristic curve analysis. NACT response in pathology pyesis was determined according to the College of American Pathologists classification. PR and OS were analyzed with Kaplan–Meier and Cox proportional hazards regression models based on cutoffs found with PET measurements.

Results

Cutoffs were ΔSUVmax = 33.31%, ΔSUVmean = 42.96%, ΔMTV = 30.38%, and ΔTLG = 28.14%, and all patients showed significance in PR and OS based on these cutoffs (all P < 0.01). PET/CT findings before and after NACT (ΔMTV > 30.38%, ΔTLG > 28.14%) predicted PR with 100% sensitivity and specificity. Multivariate analysis showed ΔSUVmean as an independent risk factor predicting OS (hazard ratio 0.348, 95% confidence interval 2.91–22.3, P = 0.03).

Conclusions

Metabolic parameters obtained with F-18 FDG PET/CT scanning before and after NACT in LAGC patients can accurately predict PR and OS.
Dosimetry in Lu-177-PSMA-617 prostate-specific membrane antigen targeted radioligand therapy: a systematic review
Authors: Nautiyal Amit , Jha Ashish K , Mithun Sneha , Rangarajan Venkatesh
Published: January 2022

Background

177Lu-prostate-specific membrane antigen (PSMA) gained popularity as a choice of agent in the treatment of patients with advanced prostate cancer or metastatic castration-resistant stage of prostate carcinoma (mCRPC) diseases. However, this treatment may cause fatal effects, probably due to unintended irradiation of normal organs. We performed an extensive systematic review to assess the organs at risk and the absorbed dose received by tumor lesions in 177Lu-PSMA therapy.

Design

In this review, published peer-reviewed articles that cover clinical dosimetry in patients following peptide radionuclide ligand therapy using 177Lu-PSMA have been included. Two senior researchers independently checked the articles for inclusion. A systematic search in the database was made using PubMed, Publons and DOAJ. All selected articles were categorized into three groups: (1) clinical studies with the technical description of dosimetry in 177Lu-PSMA therapy (2) organ dosimetry in 177Lu-PSMA therapy or (3) tumor dosimetry in 177Lu-PSMA therapy.

Result

In total, 182 citations were identified on PSMA therapy and 17 original articles on 177Lu-PSMA dosimetry were recognized as eligible for review. The median absorbed dose per unit of administered activity for kidneys, salivary, liver, spleen, lacrimal and bone marrow was 0.55, 0.81, 0.1, 0.1, 2.26 and 0.03 Gy/GBq, respectively. The median absorbed dose per unit of activity for tumor lesions was found in a range of 2.71–10.94 Gy/GBq.

Conclusion

177Lu-PSMA systemic radiation therapy (SRT) is a well-tolerated and reliable treatment option against the management of the mCRPC stage of prostate carcinoma. Lacrimal glands and salivary glands are the major critical organs in 177Lu-PSMA SRT. Besides, tumors receive 3–6 times higher absorbed doses compared to organs at risk.
Implementation of a Palliative Care Program in a Rural Hospital
Authors: McLawhorn Vicki , Beaman Sherrill
Published: January 2022

Palliative care has become an integral part of today's health care system. Inclusion of palliative care has been shown to positively affect patient satisfaction and can also impact medical costs. One of the ways palliative care can have such influence is through the development of prognostic awareness or a patient's understanding of their likely illness trajectory. Although palliative care programs have multiplied in general, there are still notable discrepancies in program availability, particularly in smaller rural hospitals. Despite numerous health care thought leaders' recommendations regarding the “ideal” palliative care team, this is not always feasible due to resource allocation. This article aims to describe 1 rural hospital's development of and initial outcomes from a hospital-based palliative care program.
Running on Empty
Authors: Price Deborah M. , Bigelow April , Mason Heidi , Harden Karen
Published: January 2022

The COVID-19 pandemic has created a global health crisis. Novel and intolerable pressures have been placed upon nurses affecting their capacity to provide care. The aim of this exploratory study was to determine the impact of the COVID-19 pandemic on nursing care delivery, the empathetic response of nurses to their patients and family members, and the emotional and physical well-being of the nurses. Four frontline nurses were interviewed while in the midst of the pandemic. Common themes emerged from analysis of the nurses' narratives and included changes in role, increased workload, depersonalized and mechanical care delivery, communication challenges with patient and family members, deficits in palliative care education, perceived poor administrative support, and physical/emotional exhaustion. Clinical leaders and nursing staff have opportunities to engage in supportive endeavors, which can restore focus and regain positive perceptions, strengthen coping skills, and deliver palliative care education in response to the ongoing challenges and stressors created by the COVID-19 pandemic. Together, they can build resilience in frontline nurses and ultimately impact delivery of compassionate and empathetic care to patients.
The Effectiveness of Emotion Regulation Therapy for Adolescent Females With Nonsuicidal Self-Injury Disorder
Authors: Ataie Shima , Gharraee Banafsheh , Shahboulaghi Farahnaz Mohammadi
Published: January 2022

Given the prevalence and consequences of the nonsuicidal self-injury disorder (NSSID) among adolescents, this study aimed to analyze the effectiveness of emotion regulation therapy (ERT) among adolescents with NSSID. The present study is an after-trial, mixed-method intervention design. Six participants completed questionnaires at baseline, during their treatment, and follow-up. In-depth interviews were made after the intervention. The quantitative findings were consistent with the pattern of the qualitative findings that prominently supported the treatment efficiency concerning the difficulties in emotion regulation. The research findings indicated that ERT had a positive effect on adolescents with NSSID.
Optimization of Preoperative Anemia in Lower Limb Joint Replacement Surgery
Authors: Maki Sara , Verma Neil , Morris Winifred , Smith Jay
Published: January 2022

BACKGROUND:

Orthopaedic procedures such as total hip and total knee replacements carry a significant risk of postoperative anemia, necessitating allogenic blood transfusions (ABTs), and an increased hospital length of stay.

AIM:

Our aim was to investigate whether the implementation of a local protocol designed to detect and treat preoperative anemia resulted in reduced ABT rates and a shorter duration of length of hospital stay (LOS).

METHODS:

We retrospectively audited 683 patients undergoing primary hip and knee replacements. We collated data for all patients about hospital length of stay and blood transfusions received. Both descriptive statistics and univariate analysis were performed.

RESULTS:

Approximately 21.6% of the cohort within the study who were anemic at preoperative clinic had a significantly increased median LOS of 2 days (p < .001) and an increased packed red cell transfusion rate compared with non-anemic patients (26.1% vs. 2.21%, p < 001). However, treatment of preoperative anemia did not show any significant difference in transfusion rates compared with patients who did not receive corrective treatment. The median LOS was higher by 1 day in the treated group compared with the nontreated cohort (p = .005).

CONCLUSION:

There is significant evidence to suggest that preoperative anemia can increase LOS and increase the risk of requiring postoperative blood transfusions. However, anemia should be regarded as a characteristic that can add to the outcome in a cumulative manner, as opposed to an isolated factor. Further research is needed on how to better manage preoperative anemia in order to improve patients' outcomes.
Orthopaedic Nursing and Heart Failure
Authors: Kujath Amber S. , Frei Judith
Published: January 2022

Heart failure prevalence increases with age and is one of the most common reasons for inpatient hospitalizations. There are many opportunities for orthopaedic nurses to recognize the risks and symptoms of heart failure during an episode of orthopaedic care. In the context of bundled care, the orthopaedic nurse plays a key role in the prevention and early identification of complications that can prolong hospitalization and increase hospital readmission. This article presents two cases of patients with heart failure. The pathophysiology and management of heart failure with reduced ejection fraction and heart failure with preserved ejection fraction are reviewed. Opportunities for orthopaedic nurses to impact care of patients at risk for or with heart failure are also highlighted.
Direct Discharge to Home From the Pediatric Cardiovascular ICU
Authors: Gal Dana B. , Kwiatkowski David M. , Cribb Fabersunne Camila , Kipps Alaina K.
Published: January 2022

OBJECTIVES:

To describe direct discharge to home from the cardiovascular ICU.

DESIGN:

Mixed-methods including retrospective Pediatric Cardiac Critical Care Consortium and Pediatric Acute Care Cardiology Collaborative data and survey.

SETTING:

Tertiary pediatric heart center.

PATIENTS:

Patients less than 25 years old, with a cardiovascular ICU stay of greater than 24 hours and direct discharge to home from January 1, 2016, to December 8, 2020, were included. Select data describing patients discharged from acute care internally and nationally from Pediatric Acute Care Cardiology Collaborative sites were compared with the direct discharge to home cohort.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Encounter- and patient-specific characteristics. Seven-day and 30-day readmission and 30-day mortality served as surrogate safety markers. A survey of cardiovascular ICU frontline providers assessed comfort and skills related to direct discharge to home.

There were 364 direct discharge to home encounters that met inclusion criteria. The majority of direct discharge to home encounters were associated with a surgery or procedure (305; 84%). There were 27 encounters (7.4%) for medical technology–dependent patients requiring direct discharge to home. Unplanned 7-day readmissions among direct discharge to home patients was 1.9% compared with 4.6% (p = 0.04) of patients discharged from acute care internally. Readmission among those discharged from acute care internally did not differ from those at Pediatric Acute Care Cardiology Collaborative sites nationally. Frontline cardiovascular ICU providers had mixed levels of confidence in technical aspects and low levels of confidence in logistics of direct discharge to home.

CONCLUSIONS:

Cardiovascular ICU direct discharge to home was not associated with increased unplanned readmissions compared with patients discharged from acute care and may be safe in select patients. Frontline cardiovascular ICU providers feel time constraints challenge direct discharge to home. Further research is needed to identify patient characteristics associated with safe direct discharge to home and systems needed to support this practice.

Summary statistics are described using proportions or medians with interquartile ranges (IQRs) and were performed using Microsoft Excel (Microsoft, Redmond, WA). Two-sample tests of proportions were used to compare readmission frequency of the DDH cohort compared with internal and national PAC3 data using STATA Version 15 (StataCorp, College Station, TX).