bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive reserve disorder in age-related hearing loss: cognitive cortical compensatory to auditory perceptual processing
Authors: Gao Minqian , Feng Tianci , Zhao Fei , Shen Jingxian , Zheng Yiqing , Liang Jiuxing , Yang Haidi
Published: June 2023

The aim of this study is to ascertain the mechanisms of cognitive reserve disorder in age-related hearing loss (ARHL), to study the correlation between ARHL and cognitive decline via EEG, and to reverse the adverse remodeling of auditory–cognitive connectivity with hearing aids (HAs). In this study, 32 participants were enrolled, including 12 with ARHLs, 9 with HAs, and 11 healthy controls (HCs), to undergo EEG, Pure Tone Average (PTA), Montreal Cognitive Assessment (MoCA), and other general cognitive tests. There were the lowest MoCA in the ARHL group (P = 0.001), especially in language and abstraction. In the ARHL group, power spectral density of the gamma in right middle temporal gyrus was significantly higher than HC and HA groups, while functional connectivity between superior frontal gyrus and cingulate gyrus was weaker than HC group (P = 0.036) and HA group (P = 0.021). In the HA group, superior temporal gyrus and cuneus had higher connectivity than in the HC group (P = 0.036). In the ARHL group, DeltaTM_DTA (P = 0.042) and CTB (P = 0.011) were more frequent than in the HC group, while there was less DeltaTM_CTA (P = 0.029). PTA was found to be associated with MoCA (r = −0.580) and language (r = −0.572), DeltaTM_CTB had a likewise correlation with MoCA (r = 0.483) and language (r = 0.493), while DeltaTM_DTA was related to abstraction (r = −0.458). Cognitive cortexes compensate for worse auditory perceptual processing in ARHL, which relates to cognitive decline. The impaired functional connectivity between auditory and cognitive cortexes can be remodeled by HAs. DeltaTM may serve as a biomarker for early cognitive decline and decreased auditory speech perception in ARHL.
Disrupted brain gray matter connectome in social anxiety disorder: a novel individualized structural covariance network analysis
Authors: Zhang Xun , Lai Han , Li Qingyuan , Yang Xun , Pan Nanfang , He Min , Kemp Graham J , Wang Song , Gong Qiyong
Published: June 2023

Phenotyping approaches grounded in structural network science can offer insights into the neurobiological substrates of psychiatric diseases, but this remains to be clarified at the individual level in social anxiety disorder (SAD). Using a recently developed approach combining probability density estimation and Kullback–Leibler divergence, we constructed single-subject structural covariance networks (SCNs) based on multivariate morphometry (cortical thickness, surface area, curvature, and volume) and quantified their global/nodal network properties using graph-theoretical analysis. We compared network metrics between SAD patients and healthy controls (HC) and analyzed the relationship to clinical characteristics. We also used support vector machine analysis to explore the ability of graph-theoretical metrics to discriminate SAD patients from HC. Globally, SAD patients showed higher global efficiency, shorter characteristic path length, and stronger small-worldness. Locally, SAD patients showed abnormal nodal centrality mainly involving left superior frontal gyrus, right superior parietal lobe, left amygdala, right paracentral gyrus, right lingual, and right pericalcarine cortex. Altered topological metrics were associated with the symptom severity and duration. Graph-based metrics allowed single-subject classification of SAD versus HC with total accuracy of 78.7%. This finding, that the topological organization of SCNs in SAD patients is altered toward more randomized configurations, adds to our understanding of network-level neuropathology in SAD.
Neutrophil-only Histological Assessment of Ulcerative Colitis Correlates with Endoscopic Activity and Predicts Long-term Outcomes in a Multicentre Study
Authors: Parigi Tommaso L , Cannatelli Rosanna , Nardone Olga M , Zammarchi Irene , Shivaji Uday , Furfaro Federica , Zardo Davide , Spaggiari Paola , Del Sordo Rachele , Setti Orsola , Majumder Snehali , Smith Samuel C L , Danese Silvio , Armuzzi Alessandro , Villanacci Vincenzo , Ghosh Subrata , Iacucci Marietta
Published: June 2023

Backgrounds and Aims

Absence of neutrophils is the minimum standard to consider histological remission of ulcerative colitis [UC]. The PICaSSO Histological Remission Index [PHRI] is a new simple index for UC, based only on the detection of neutrophils. We evaluate PHRI’s correlation with endoscopy and its prognostic value compared with other established indices.

Methods

Consecutive patients with UC underwent colonoscopy at two referral centres [Birmingham, UK, and Milan, Italy,] and were followed up for 2 years. Correlation between histology (PHRI, Nancy [NHI], and Robarts [RHI] indexes) and endoscopy (Mayo Endoscopic Score [MES], Ulcerative Colitis Endoscopic Index of Severity [UCEIS], and PICaSSO index) was calculated as Spearman coefficients. Diagnostic performance of endoscopy was assessed with receiver operating characteristic [ROC] curves and outcome stratification with Kaplan–Meier curves.

Results

A total of 192 patients with UC was enrolled, representing all grades of endoscopic severity. Correlation between histology and endoscopy did not differ significantly when using PHRI instead of NHI or RHI. In particular, PHRI’s correlation with MES, UCEIS, and PICaSSO was 0.745, 0.718, and 0.694, respectively. Endoscopically-assessed remission reflected the absence of neutrophils [PHRI = 0] with areas under the ROC curve of 0.905, 0.906, and 0.877 for MES, UCEIS, and PICaSSO, respectively. The hazard ratio for disease flare between patients in histological activity/remission was statistically similar [p >0.05] across indexes [2.752, 2.706, and 2.871 for RHI, NHI, and PHRI, respectively].

Conclusion

PHRI correlates with endoscopy and stratifies risk of relapse similarly to RHI and NHI. Neutrophil-only assessment of UC is a simple yet viable alternative to established histological scores.
Clinical Features and Natural History of Paediatric Patients with Ulcerative Proctitis: A Multicentre Study from the Paediatric IBD Porto Group of ESPGHAN
Authors: Tal Noa , Tzivinikos Christos , Gasparetto Marco , Serban Daniela E , Zifman Eyal , Hojsak Iva , Ledder Oren , Yerushalmy Feler Anat , Rolandsdotter Helena , Aloi Marina , Bramuzzo Matteo , Buderus Stephan , Lionetti Paolo , Norsa Lorenzo , Norden Christoph , Urlep Darja , Romano Claudio , Shaoul Ron , Martinez-Vinson Christine , Karoliny Anna , De Greef Elisabeth , Kang Ben , VIčková Eva , Alvisi Patrizia , Kori Michal , Tavares Marta , Weiss Batia , Hussey Seamus , Qamhawi Maria E , Palomino Pérez Laura M , Henderson Paul , Parmar Raj , Miele Erasmo , Rinawi Firas , Lozano-Ruf Ana , Zamvar Veena , Kolho Kaija-Leena , Shouval Dror S
Published: June 2023

Background and Aims

Ulcerative proctitis [UP] is an uncommon presentation in paediatric patients with ulcerative colitis. We aimed to characterize the clinical features and natural history of UP in children, and to identify predictors of poor outcomes.

Methods

This was a retrospective study involving 37 sites affiliated with the IBD Porto Group of ESPGHAN. Data were collected from patients aged <18 years diagnosed with UP between January 1, 2016 and December 31, 2020.

Results

We identified 196 patients with UP (median age at diagnosis 14.6 years [interquartile range, IQR 12.5–16.0]), with a median follow-up of 2.7 years [IQR 1.7–3.8]. The most common presenting symptoms were bloody stools [95%], abdominal pain [61%] and diarrhoea [47%]. At diagnosis, the median paediatric ulcerative colitis activity index [PUCAI] score was 25 [IQR 20–35], but most patients exhibited moderate–severe endoscopic inflammation. By the end of induction, 5-aminosalicylic acid administration orally, topically or both resulted in clinical remission rates of 48%, 48%, and 73%, respectively. The rates of treatment escalation to biologics at 1, 3, and 5 years were 10%, 22%, and 43%, respectively. In multivariate analysis, the PUCAI score at diagnosis was significantly associated with initiation of systemic steroids, or biologics, and subsequent acute severe colitis events and inflammatory bowel disease-associated admission, with a score ≥35 providing an increased risk for poor outcomes. By the end of follow-up, 3.1% of patients underwent colectomy. Patients with UP that experienced proximal disease progression during follow-up [48%] had significantly higher rates of a caecal patch at diagnosis and higher PUCAI score by the end of induction, compared to those without progression.

Conclusion

Paediatric patients with UP exhibit high rates of treatment escalation and proximal disease extension.
Parental unemployment and adolescents’ subjective wellbeing—the moderating role of educational policies
Authors: Baranowska-Rataj Anna , Högberg Björn , Bernardi Laura
Published: June 2023

Crossover effects of parental unemployment on subjective wellbeing of children attract growing attention in research on social inequalities. Recent economic crises call for identifying policies that mitigate the adverse effects of unemployment. Building on the theoretical insights from Capability Approach, we examine the relationship between parental unemployment and subjective wellbeing of adolescents across countries with different educational policies. We use multilevel modelling and data from the European Union Statistics on Income and Living Conditions (EU-SILC). We combine microdata on 45,992 adolescents in 32 countries with macro-level indicators of educational policies. We find that parental unemployment is associated with lower subjective wellbeing among adolescents, but the magnitude of this association varies depending on access to financial support for participation in education. Adolescents who receive educational allowances and who live in countries with broader access to such support are less harmed by parental unemployment.
Culprit plaque morphology determines inflammatory risk and clinical outcomes in acute coronary syndrome
Authors: Gerhardt Teresa , Seppelt Claudio , Abdelwahed Youssef S , Meteva Denitsa , Wolfram Christopher , Stapmanns Philip , Erbay Aslihan , Zanders Lukas , Nelles Gregor , Musfeld Johanna , Sieronski Lara , Stähli Barbara E , Montone Rocco A , Vergallo Rocco , Haghikia Arash , Skurk Carsten , Knebel Fabian , Dreger Henryk , Trippel Tobias D , Rai Himanshu , Joner Michael , Klotsche Jens , Libby Peter , Crea Filippo , Kränkel Nicolle , Landmesser Ulf , Leistner David M ,   for the OPTICO-ACS study group
Published: June 2023

Aims

Rupture of the fibrous cap (RFC) and erosion of an intact fibrous cap (IFC) are the two predominant mechanisms causing acute coronary syndromes (ACS). It is uncertain whether clinical outcomes are different following RFC-ACS vs. IFC-ACS and whether this is affected by a specific inflammatory response. The prospective, translational OPTIcal-COherence Tomography in Acute Coronary Syndrome study programme investigates the impact of the culprit lesion phenotype on inflammatory profiles and prognosis in ACS patients.

Methods and results

This analysis included 398 consecutive ACS patients, of which 62% had RFC-ACS and 25% had IFC-ACS. The primary endpoint was a composite of cardiac death, recurrent ACS, hospitalization for unstable angina, and target vessel revascularization at 2 years [major adverse cardiovascular events (MACE+)]. Inflammatory profiling was performed at baseline and after 90 days. Patients with IFC-ACS had lower rates of MACE+ than those with RFC-ACS (14.3% vs. 26.7%, P = 0.02). In 368-plex proteomic analyses, patients with IFC-ACS showed lower inflammatory proteome expression compared with those with RFC-ACS, including interleukin-6 and proteins associated with the response to interleukin-1β. Circulating plasma levels of interleukin-1β decreased from baseline to 3 months following IFC-ACS (P < 0.001) but remained stable following RFC-ACS (P = 0.25). Interleukin-6 levels decreased in patients with RFC-ACS free of MACE+ (P = 0.01) but persisted high in those with MACE+.

Conclusion

This study demonstrates a distinct inflammatory response and a lower risk of MACE+ following IFC-ACS. These findings advance our understanding of inflammatory cascades associated with different mechanisms of plaque disruption and provide hypothesis generating data for personalized anti-inflammatory therapeutic allocation to ACS patients, a strategy that merits evaluation in future clinical trials.
Simple Ceramics? Design, Decorative Materiality and Anabaptist Pottery in Early Modern Central Europe
Authors: Hill Kat
Published: June 2023

This article traces the manufacture and consumption of faience ceramics made by Hutterite communities in central Europe from the sixteenth to nineteenth centuries. The production, use and survival of Anabaptist Haban ware offers insights into the nature of Anabaptist material regimes and communities and into overlapping but distinct communities of consumption and collecting. Hutterite craftsmen were instructed to produce objects ‘in the same way as was always done’, with regulations about uncomplicated designs and colours. Yet faience Haban ware was highly sought after, and decorative items were made for powerful patrons from materials drawn from all over Europe. Such objects have now become associated with specific national ‘folk’ cultures. These distinctive remnants of Hutterite communities in Germany and central Europe problematize the material dimensions of survival, conformity and separatism in Anabaptist communities and give access to the complicated affective properties of the white faience ware that Hutterites produced.
Structural and mechanistic studies of the N-glycosylation machinery: from lipid-linked oligosaccharide biosynthesis to glycan transfer
Authors: Ramírez Ana S , Locher Kaspar P
Published: June 2023

N-linked protein glycosylation is a post-translational modification that exists in all domains of life. It involves two consecutive steps: (i) biosynthesis of a lipid-linked oligosaccharide (LLO), and (ii) glycan transfer from the LLO to asparagine residues in secretory proteins, which is catalyzed by the integral membrane enzyme oligosaccharyltransferase (OST). In the last decade, structural and functional studies of the N-glycosylation machinery have increased our mechanistic understanding of the pathway. The structures of bacterial and eukaryotic glycosyltransferases involved in LLO elongation provided an insight into the mechanism of LLO biosynthesis, whereas structures of OST enzymes revealed the molecular basis of sequon recognition and catalysis. In this review, we will discuss approaches used and insight obtained from these studies with a special emphasis on the design and preparation of substrate analogs.
Presidential communication during the pandemic: a longitudinal examination of its relationship with partisan perceptions and behaviors in the United States
Authors: Li Yue , Wang Zheng , Li Qin
Published: June 2023

Partisanship played a key role in shaping individuals’ responses to the COVID-19 pandemic in the United States. The current project applies the extended parallel processing model (EPPM) to examine how the content features of White House press conferences were associated with the partisan gap in perceptions and behavior during the early stage of the pandemic. Using supervised machine learning, Study 1 analyzes the White House press conferences regarding the pandemic during 2020. The results demonstrate that the White House focused on efficacy but included minimal threat information. Study 2 uses the threat and efficacy information in White House press conferences to predict perceived threat and efficacy as well as self-quarantine behavior measured by longitudinal surveys using nationally representative samples of U.S. adults. Time-series analysis shows that an increase of threat information from the White House was associated with a subsequent decrease in the partisan gap between Democrats and Republicans on perceived threat and self-quarantine behavior by increasing perceived threat and self-quarantine behavior among Republicans. This study contributes to presidential communication research by systematically examining specific message features and linking them to public perceptions and behaviors in the context of a public health crisis. The study also extends the EPPM to a dynamic model, estimating the asymmetric effects and self-continuity of positive (i.e., efficacy) and negative (i.e., threat) information on perceptions and behaviors.
Multi-ancestry genome-wide analysis identifies shared genetic effects and common genetic variants for self-reported sleep duration
Authors: Scammell B H , Tchio C , Song Y , Nishiyama T , Louie T L , Dashti H S , Nakatochi M , Zee P C , Daghlas I , Momozawa Y , Cai J , Ollila H M , Redline S , Wakai K , Sofer T , Suzuki S , Lane J M , Saxena R
Published: June 2023

Both short (≤6 h per night) and long sleep duration (≥9 h per night) are associated with increased risk of chronic diseases. Despite evidence linking habitual sleep duration and risk of disease, the genetic determinants of sleep duration in the general population are poorly understood, especially outside of European (EUR) populations. Here, we report that a polygenic score of 78 European ancestry sleep duration single-nucleotide polymorphisms (SNPs) is associated with sleep duration in an African (n = 7288; P = 0.003), an East Asian (n = 13 618; P = 6 × 10−4) and a South Asian (n = 7485; P = 0.025) genetic ancestry cohort, but not in a Hispanic/Latino cohort (n = 8726; P = 0.71). Furthermore, in a pan-ancestry (N = 483 235) meta-analysis of genome-wide association studies (GWAS) for habitual sleep duration, 73 loci are associated with genome-wide statistical significance. Follow-up of five loci (near HACD2, COG5, PRR12, SH3RF1 and KCNQ5) identified expression-quantitative trait loci for PRR12 and COG5 in brain tissues and pleiotropic associations with cardiovascular and neuropsychiatric traits. Overall, our results suggest that the genetic basis of sleep duration is at least partially shared across diverse ancestry groups.
New Approaches for Studying Conformal Embeddings and Collapsing Levels for W–Algebras
Authors: Adamović Dražen , Frajria Pierluigi Möseneder , Papi Paolo
Published: June 2023

In this paper, we prove a general result saying that under certain hypothesis an embedding of an affine vertex algebra into an affine $W$–algebra is conformal if and only if their central charges coincide. This result extends our previous result obtained in the case of minimal affine $W$-algebras [ 3]. We also find a sufficient condition showing that certain conformal levels are collapsing. This new condition enables us to find some levels $k$ where $W_{k}(sl(N), x, f )$ collapses to its affine part when $f$ is of hook or rectangular type. Our methods can be applied to non-admissible levels. In particular, we prove Creutzig’s conjecture [ 18] on the conformal embedding in the hook type $W$-algebra $W_{k}(sl(n+m), x, f_{m,n})$ of its affine vertex subalgebra. Quite surprisingly, the problem of showing that certain conformal levels are not collapsing turns out to be very difficult. In the cases when $k$ is admissible and conformal, we prove that $W_{k}(sl(n+m), x, f_{m,n})$ is not collapsing. Then, by generalizing the results on semi-simplicity of conformal embeddings from [ 2], [ 5], we find many cases in which $W_{k}(sl(n+m), x, f_{m,n})$ is semi-simple as a module for its affine subalgebra at conformal level and we provide explicit decompositions.
Is benefit sharing with research participants lawful in South Africa? An unexplored question in the governance of genomics research
Authors: Thaldar Donrich , Shozi Bonginkosi
Published: June 2023

Despite advocacy in favour of benefit sharing with research participants in genomics research that is conducted in South Africa, there has been little critical legal engagement with this concept. That is what this article provides by posing the hitherto unexplored—but foundational—question: Is benefit sharing with research participants lawful in South Africa? The answer is clearly ‘no’. South African law provides that it is unlawful to provide any financial or other reward to research participants for donating biospecimens—except for reimbursement of reasonable costs incurred. Accordingly, benefit sharing would be unlawful. The ramifications of this conclusion are far-reaching. Most pertinently, should any benefit-sharing agreements with research be put into practice, such agreements would be unenforceable and would expose all parties involved—including foreign collaborators—to criminal prosecution. The solution for proponents of benefit sharing in South Africa would be to lobby the South African government to revise the relevant law. However, as long as the law remains as it currently is, institutions and individuals all over the world who are involved in genomics research in South Africa would be well advised to comply with the law by not engaging in benefit sharing with research participants.
Peer pressure and discrimination: evidence from international cricket
Authors: Nilesh Fernando A , Eapen George Siddharth
Published: June 2023

We study how peers affect in-group bias. Exploiting several umpiring reforms in international cricket matches—where two umpires make independent decisions in each other’s presence—we show that home-team umpires are less biased when working with a neutral colleague, that is, one who is neither a national of the home nor the foreign team. This temporary debiasing is driven by the social pressure umpires feel to be impartial in the presence of neutral peers. Performance evaluation by visually non-salient monitors does not reduce bias, suggesting that physical presence is an important component of debiasing and peer influence. (JEL J71, J15, D91)
Obesity and prostate cancer screening, incidence, and mortality in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial
Authors: Hurwitz Lauren M , Dogbe Nadine , Barry Kathryn Hughes , Koutros Stella , Berndt Sonja I
Published: June 2023

Background

Though obesity, measured by body mass index (BMI), is an established risk factor for several cancer sites, there is conflicting evidence on whether obesity increases prostate cancer risk or mortality and, if it does, whether it increases risk directly or indirectly by affecting prostate cancer screening efficacy.

Methods

We examined associations between BMI and prostate cancer screening outcomes, incidence, and mortality in men randomly assigned to the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (n = 36 756) between 1993 and 2001. Participants received annual screening with the prostate-specific antigen test and digital rectal exam. Associations between baseline BMI and screening outcomes were assessed via multinomial logistic regression, and associations with prostate cancer incidence and mortality were assessed via Cox proportional hazards regression.

Results

Individuals with higher BMI were less likely to screen positive via the prostate-specific antigen test and/or digital rectal exam and more likely to have an inadequate screen (all Ptrend < .01). Higher BMI was inversely associated with prostate cancer incidence (per 5 kg/m2 BMI increase: hazard ratio [HR] = 0.94, 95% confidence interval [CI] = 0.91 to 0.97), including incidence of early stage (HR = 0.94, 95% CI = 0.90 to 0.97) and advanced-stage (HR = 0.91, 95% CI = 0.82 to 1.02) disease, but positively associated with prostate cancer mortality (HR = 1.21, 95% CI = 1.06 to 1.37). The association with mortality was not modified by screening outcome (Pinteraction = .13).

Conclusions

Within this screened population, individuals with higher BMI had lower risk of prostate cancer diagnosis but higher risk of prostate cancer mortality. As higher BMI was not positively associated with advanced-stage prostate cancer risk, the increased mortality is unlikely to be due to delayed prostate cancer detection.
‘On the inside I’m grossed out and wanting to puke’: Exploring professional facework and emotional labour as impression management tools in rural emergency medical services
Authors: Biss Danielle C
Published: June 2023

In the foothills of rural Appalachia, situations arise where emergency medical services (EMS) providers—such as paramedics and emergency medical technicians—must reflect professionalism in their ‘face’. However, as EMS providers practice facework in their organizational roles, it is important to consider how they manage professionalism when emotional labour and dirty work are required, such as when supporting patients from underserved rural communities. Guided by 181 hours of participant observation with 23 interviews with EMS providers from two county-wide EMS organizations, this organizational ethnography reveals the value of impression management strategies in the form of emotional labour. Notably, such practices aid in EMS providers’ maintenance of professional face as they encounter face threats on the job. In such moments, EMS providers utilize emotional labour in their corrective and preventive facework. Importantly, this research makes a meaningful theoretical and practical contribution to organizational communication by illustrating the value of impression management, emotional labour, and facework that aid in the management of professionalism.
Implications of ‘net-zero emissions by 2050’ for the hydrocarbon industry: a case study of hydrogen in mature petroleum jurisdictions
Authors: Soliman Hunter Tina , Pettit Jordie , Taylor Madeline
Published: June 2023

Climate change, and the need to wean the world off hydrocarbon sources of energy, will have a significant impact on the hydrocarbon industry, an industry worth hundreds of billions of dollars annually, and which has been in existence for over a century. Even though the phasing out of hydrocarbons as an energy source is inevitable, the demise of the hydrocarbon industry is not. This study, demonstrates that the hydrocarbon industry can make a significant contribution as the world transitions to low carbon energy. in this paper, we discuss the role of the hydrocarbon industry in developing a new hydrogen industry, demonstrating how the industry’s know how will be vital in the development, construction, and delivery of both blue and green hydrogen to an energy hungry world.
Introduction
Authors: Rauch Sheila A.M. , Rothbaum Barbara Olasov
Published: June 2023

With over 50 years combined of clinical care working with those impacted by stress and trauma, we, Drs. Rauch and Rothbaum, wrote Making Meaning of Difficult Experiences as a self-help tool to help process difficult experiences. In this introduction, we present an overall framework for why this self-help tool is needed and how this tool focused on approaching difficult experiences was developed. With our increasingly stressful lives, tools that you can access at your convenience in your everyday life without the need to see a professional can help you get help when you need it. Difficult experiences and trauma have always been a part of life. Most people will experience at least one if not multiple traumatic events in their lives. This self-guided program provides a map to help move through difficult and potentially traumatic experiences for people who wish to work through them independently (outside of a formal therapeutic setting) and emerge on the other side. As the post pandemic world emerges and we prepare for getting back out and into our lives again, Making Meaning has resources for all of us.
Men Under Stress
Authors: Kastrup Marianne , Thompson Kenneth , Gogineni Rama Rao
Published: June 2023

Today individuals may no longer see themselves as either male or female. And yet statistics generally operate with two sexes when providing data on health and disease, where males show shorter life expectancy and a higher morbidity for a number of disorders. Traditionally men have been in “power” in relation to women as part of a hierarchy to their advantage, and the patriarchal ideology sees males as superior from a biological and a sociological perspective, thereby justifying the dominance of males in all areas of society. The significant changes in family structure over the past decades have resulted in more fluid gender roles; the male identity is challenged, and the hegemonic White heterosexual masculinity is under scrutiny. Male mental illness needs attention as many disorders may go un-diagnosed, partly because males are less likely to seek help and disclose mental health problems. A large proportion of men, not only in Western societies, have acquired psychological coping strategies that may be dysfunctional in case of mental distress, and interventions to overcome this should be initiated on both the individual and policy/governmental level.
Religion and Social Psychiatry
Authors: López-Ibor M. I. , Carrasco M. Martín
Published: June 2023

Social psychiatry, as a branch of psychiatry, pays special attention to the interpersonal and cultural context of mental disorder and mental well-being. Religiosity is a fundamental part of the cultural context of human beings, but it also plays a decisive role in both health and coping strategies against disease. Sick people give spirituality more importance than the general population. This chapter explores religiosity and spirituality as an important dimension in general health, and specifically in mental health, and its relation to the way one faces life when one loses one’s health. Religion is one of the ways in which people give meaning to their lives, which helps them understand the world. In psychiatric patients, religiosity can affect both psychopathology and the therapy to be applied to the patient. Traditionally, it has been considered that religiosity and spirituality were something too private and personal to be evaluated in the context of clinical practice and, above all, as difficult and uncomfortable to examine in patients. But patients who suffer mental disorder are frequently confronted with spiritual problems. For example, patients suffering from schizophrenia often exhibit delusions about the sense of life. Depressed patients worry about the meaning of loss and death. It is therefore relevant that psychiatrists, psychologists, and other mental health professionals pay attention and develop an understanding of the religious beliefs of their patients.
Social Psychiatry
Authors: Pirkola Sami , Fröjd Sari , Nurmela Kirsti
Published: June 2023

One in 5 of the global population suffered from a common mental disorder, i.e., depressive or anxiety disorder, during the last 12 months. WHO forecasts that depressive and anxiety disorders will become more frequent in the future. ICD-10 and 11 and DSM-5 describe well these and related disorders, their diagnostic, criteria, thresholds and boundaries. These disorders are typically multifactorial and complex, involving a genetic predisposition, a variety of external long- and short-term precipitating factors, and their interactive combinations. They also are greatly influenced by social factors with variety of social consequences. Socioeconomic disadvantage, distress, traumas, and adversities associate with the likelihood of developing a depressive or anxiety disorder. Depressive disorders are largest reasons for non-fatal health loss globally, counted as years lived with disability. Occupational disability caused by depressive and anxiety disorders has become an economic and a public health issue. As people in low socioeconomic status bear the highest proportion of mental suffering, they should be helped both medically and socially. The World Health Organization and several other organizations have developed guidelines for providing evidence-based practices for mental health professionals as well as family physicians and nurses.
Social Psychiatry
Authors: Chadda Rakesh K. , Kallivalyalil Roy Abraham
Published: June 2023

Substance use and addictive disorders can be labeled as a major social malaise, which society faces. Substance use and addictive disorders are an important contributor to the global burden of disease, contributed by disability, unemployment, and physical comorbidities and associated shortened span of life, compounded by a large treatment gap. Society also has a conflicting attitude toward the problem, with critical views as well as acceptance as a part of many social rituals and functions. Social psychiatry is a subspecialty of psychiatry which deals with social factors associated with psychiatric morbidity, social effects of mental illness, psychosocial issues, and social approaches to psychiatric care. Principles of social psychiatry can help in understanding the genesis, especially the role of various social factors in development of substance use disorders and associated complications, as well as in their prevention, treatment, and rehabilitation.
Culture, Ethnicity, and Sleep Patterns and Disorders
Authors: Estafanous Abram , Sedky Karim
Published: June 2023

Sleep disorders are common among the general population. While the biological basis leading to sleep struggles is important to understand, cultural perception and variation should also be considered during management of these disorders. Sleep time and duration, napping, sleep setting, and bed partners can significantly vary by location. During sleep analysis and management, it is essential to consider cultural variability (such as in Japan, where napping during work is thought to enhance productivity) and ethnic differences (such as the higher prevalence of obstructive sleep apnea among African Americans as compared to Caucasians). The aim of this chapter is to discuss cultural and ethnic factors affecting sleep and possible reasons behind these differences.
The Emergence and Development of Social Psychiatry in Romania
Authors: Paziuc Alexandru , Cozman Doina , Lazarescu Mircea
Published: June 2023

The history of Romanian psychiatry has significant sequences. From the 19th century until the interwar period, psychiatric hospitals were established. During the period 1965–1975, unified hospitals were established in Romania. The third wave is the decade 1975–1985, when community psychiatry evolved with goals of active detection of the risk factors to prevent psychological disorders and early treatment. The growing interest during the 1970s in Romania for mental health and the issues of social psychiatry noticed an increase publication of books and scientific events. In 2005, Alexandru Paziuc and colleagues established the Association of Social Psychiatry of Romania, during this period of European transition, in which societal stress and loss of social cohesion and spiritual values directly affected patterns of morbidity and mortality, Much of the treatment in Romania is psychopharmacological, with very limited psychosocial interventions. A negative image of psychological disorder and stigma of illness prevent many people from receiving necessary treatments. Fortunately, the professional organizations and institutions, including religious organizations, are working on removing these barriers, once considered insurmountable, by promoting local and national forums. drafted a list of priorities in mental health, Active participation in WASP congresses and hosting the congress in 2019 advanced the professional identity and scientific aspects of Romanian psychiatry.
Epilogue
Authors: Bennegadi Rachid
Published: June 2023

The WASP Textbook on Social Psychiatry illustrates the social factors, psychosocial aspects associated with psychiatric morbidity, social effects of mental illness, and social approaches to psychiatric care, differentiating sickness, illness, and disease as individual concepts. Integrating social determinants that impact the personality, family, and society allows patients to express their psychological suffering and their psychiatric disorders by means of their own sociocultural references and explanatory models (illness). This allows the therapeutic framework to come together. Freud, Jung, Lacan, Nakkache, neurobiologists, systems thinkers, anthropologists, sociologists, attachment theorists, and traumatologists have provided important knowledge to complement relevance and mobilization of energy from a vital impetus and the structure of personality to restore the meaning of a human life. Psychiatric services need maximum flexibility, responding to changing needs; they must be ready to be confronted, ready to cooperate, ready to take responsibility toward society.
Diffuse Gliomas (WHO Grade 2–3)
Authors: Ahmad Haroon , Schiff David
Published: June 2023

Grade 2 and grade 3 diffuse gliomas are challenging tumors to treat. They are uncommon, with an incidence rate of 1.35 per 100,000 per year, making them difficult to study. They have a younger median age of onset: 30–40 and 40–60 years old for grade 2 and 3, respectively, making long-term treatment toxicity significant in decision-making. The overwhelming majority of gliomas are sporadic. IDH mutation and 1p/19q co-deletion carry the most weight in prognostication; both are prognostic and predictive. Tumors that are “molecularly equivalent to GBM” and harbor TERT promoter gene mutation, EGFR amplification, or loss of chromosome 7p with gain of chromosome 10q have poor prognosis. The most common presentation for all glial tumors is seizures and is most frequent in grade 2 gliomas. Higher grade gliomas have a higher incidence of presenting with fixed neurologic deficits. Gadolinium-enhanced brain magnetic resonance imaging is the standard for assessing suspected brain tumors. As of 2016, pathologic diagnosis is based on molecular markers including IDH mutation and 1p/19q co-deletion. Surgery is required for tissue diagnosis, and a maximal safe resection has been shown to improve overall survival. Radiation doses of 50–54 Gy and 60 Gy for grade 2 and 3 tumors, respectively, is standard. Chemotherapy for oligodendrogliomas is well established, and both procarbazine, lomustine, and vincristine (PCV) and temozolomide (TMZ) are used. For grade 3 astrocytic tumors, TMZ is generally used but is supported by evidence in the adjuvant setting only. Recent preliminary data support concomitant TMZ use in IDH-mutated astrocytomas only. Results from CATNON and CODEL studies should answer these questions.
Rare Tumors in Adults, Including Medulloblastoma
Authors: Shiue Kevin , DeWitt Logan S. , Kindler John M. , Watson Gordon A.
Published: June 2023

This chapter discusses six rare tumors of the central nervous system in adults: medulloblastoma in adults, cerebellar liponeurocytoma, diffuse leptomeningeal glioneuronal tumor (DLGNT), ganglioglioma, pineal parenchymal tumors, and pleomorphic xanthoastrocytoma (PXA). The incidence, clinical characteristics, histology, radiographic details, treatment, and outcomes are outlined for each disease. Magnetic resonance imaging (MRI) characteristics are provided for each tumor type. Importantly, following the 2016 World Health Organization (WHO) classification of brain tumors, the molecular profile of each tumor type is provided. Current knowledge on molecular advancements within the study of each of these tumors is reviewed and is a key theme as new molecular discoveries are incorporated into evolving treatment approaches. Multidisciplinary management, often at centers with specialized neuro-oncology providers, is recommended for these rare tumors. References are provided for more detailed information.
Pediatric High-Grade Glioma
Authors: Sait Sameer Farouk , Freret Morgan , Karajannis Matthias
Published: June 2023

Pediatric high-grade gliomas (pHGGs) represent 8–12% of all pediatric central nervous system tumors and comprise a spectrum of histologies that includes anaplastic astrocytoma (WHO grade 3), glioblastoma (WHO grade 4), and diffuse midline glioma, H3K27M mutant (WHO grade 4). Diffuse intrinsic pontine gliomas (DIPG) are pHGG of the brainstem that are generally diagnosed based on clinical and imaging findings alone, but, if biopsied, pathology most commonly reveals diffuse midline glioma, H3K27M mutant. Evidence from genetic and epigenetic molecular profiling studies has revealed significant molecular diversity among pHGGs. These studies led to a major reclassification of pHGGs into molecular-based tumor subgroups, as compared to earlier primarily histology-based tumor subgroups. Findings show that these molecular subgroups of pHGG correlate with clinically meaningful factors, including tumor location and prognosis. The most important molecular groups are the histone mutations related pHGG (H3.K27-mutated midline and H3.G34-mutated hemispheric pHGG); the rare isocitrate dehydrogenase (IDH1/2)-mutated pHGG occurring mainly in young adults; the BRAFV600E mutant cortical tumors arising from transformation of lower grade tumors, the heterogenous H3/IDH/BRAF wildtype pHGGs and infant HGGs. Another important group occurs in patients with constitutional mismatch repair deficiency, a cancer predisposition syndrome wherein patients develop hypermutant glioblastoma. Standard treatment for pHGG includes maximally safe surgical resection followed by radiation and chemotherapy. This chapter provides a comprehensive review of the clinical, genetic, and therapeutic aspects relevant to oncologists caring for children, adolescents, and young adults with pHGGs.
Principles of Systemic Therapy in Neuro-Oncology
Authors: Andreatos Nikolaos , Peereboom David M.
Published: June 2023

Systemic therapy in neuro-oncology refers to the use of any drugs administered systemically rather than locally. The most commonly used drugs are cytotoxic agents, but recent years have seen the advent of targeted therapies such as small-molecule oral compounds and monoclonal antibodies; anti-angiogenic agents; immunotherapy; and, most recently, cellular therapies. Systemic therapies for central nervous system (CNS) malignancies face unique obstacles posed by the blood–brain barrier, although some drugs, such as anti-angiogenic agents and immunotherapies, exert their effects outside of it. Molecular markers that can guide the use of chemotherapy for CNS tumors include IDH, 1p/19q co-deletion, and MGMT status. For diffuse WHO grade 2–4 gliomas in adults, most subgroups of patients have superior outcomes with radiation and chemotherapy compared to radiation therapy alone. Patients with primary CNS lymphoma are best treated with regimens that include rituximab and high-dose methotrexate. Patients with brain metastases can experience clinical benefit with newer targeted agents. All patients should be encouraged to enroll in clinical trials whenever possible.
Neuro-Oncology in the Elderly
Authors: Internò Valeria , Rudà Roberta , Soffietti Riccardo
Published: June 2023

This chapter covers the main aspects of management of glioblastomas, low-grade gliomas, and primary central nervous system (CNS) lymphomas in the elderly. An extensive use of available geriatric scales is recommended to distinguish fit versus unfit patients before deciding any treatment. In the case of fit patients with high-grade glioma, surgical resection as complete as possible followed by radiotherapy and concomitant/adjuvant temozolomide is the standard of care. In the case of unfit patients with high-grade glioma, biopsy followed either by hypofractionated radiotherapy in case of O6-methylguanine DNA methyltransferase (MGMT) unmethylated tumors or temozolomide in case of MGMT methylated tumors should be proposed. Supportive care should be reserved to patients with low performance status or high burden of comorbidities. Low-grade gliomas in elderly patients are rare and should be treated with surgery, radiotherapy, and adjuvant temozolomide when appropriate. Primary CNS lymphomas following biopsy should receive an up-front methotrexate-based regimen. In case of a complete response to chemotherapy whole brain-radiation therapy should be reserved at tumor progression to delay neurocognitive deterioration.
Consulting in the Intensive Care Unit
Authors: Wijdicks Eelco F.M.
Published: June 2023

This chapter discusses common requests for neurologic consults and alerts the neurologist about what to expect, how to take a history, how to gain an understanding of the severity of the patient’s critical illness, how to address common causes of decline in consciousness and failure to awaken, and how to judge the multi pharmacy used by intensivists and, in particular, how it can confound examination. The chapter provides an overview of how to interpret test results and request additional tests in these patients, and it discusses how to proceed with a detailed assessment of major clinical neurologic complications that are encountered in the intensive care unit.
Acute Focal Neurologic Findings and Asymmetries in the Intensive Care Unit
Authors: Wijdicks Eelco F.M.
Published: June 2023

Focal and potentially localizing signs in the presenting patient are immediately worrisome. Clinical signs that immediately capture attention, in addition to fixed pupil(s) and extensor posturing, are a dense hemiplegia or paraplegia. In other circumstances, neurologic abnormalities such as apraxia, neglect, or aphasia may be present but concealed in “acute confusion or agitation.” Neurologic examination in a critically ill patient may focus on explaining the cause of a focal finding, and these findings often have major consequences that lead to medical or surgical interventions; the decision to intervene may even be irrespective of neuroimaging results. This chapter reviews the affected anatomy and examination techniques, discusses how to collate the findings, and explains how to localize the lesion in acutely ill neurologic patients.
Neurologic Manifestations of Viral Outbreaks
Authors: Wijdicks Eelco F.M.
Published: June 2023

Infectious outbreaks are commonly bacterial and food-borne and may become deadly due to sepsis. Viral outbreaks causing neurologic manifestations are primarily seasonal and are often bound to a geographic region. Global outbreaks are becoming more common: West Nile encephalitis was one of the more recent severe widespread outbreaks, when a viral disease endemic to Africa began appearing in Europe and the Americas. This mostly incidental experience changed when the SARS-CoV-2 (COVID-19) pandemic emerged in 2019, leading to intensive care units filled with ventilated patients by the hundreds of thousands worldwide. Neurologic complications of COVID-19 soon became apparent. This chapter will review prior and recent experiences and recognition of major infections.
Neurologic Complications of Acute Renal Disease
Authors: Wijdicks Eelco F.M.
Published: June 2023

In this chapter, the neurologic manifestations of acute renal failure are discussed in relation to the most common clinical problems seen in critically ill patients and to those that may pose difficulty in assessment during consultation in the intensive care unit. The clinical features of uremic encephalopathy range from early asterixis to profound drowsiness, but the manifestations are typical of any encephalopathy caused by an acute metabolic derangement. The recognition of uremic encephalopathy is not trivial, because in many intensive care units, its signs and symptoms are usually an indication to initiate hemodialysis. Hypertensive encephalopathy or posterior reversible encephalopathy syndrome is included in this chapter because of its common interrelation with acute or chronic renal failure.
Neurologic Complications of Cardiac Surgery
Authors: Wijdicks Eelco F.M.
Published: June 2023

Advances in cardiac surgery have improved long-term outcome in patients with coronary and valvular disease, but some of the gains have been counterbalanced by damage to the brain. This chapter reviews the most important neurologic complications of coronary artery and valve repair surgery in patients recovering in the cardiac surgery intensive care unit. The major complications are acute stroke, which may require endovascular treatment; seizures; peripheral nerve injury; retinal damage; and more long-term neuropsychologic impairment. Each of these complications is very uncommon in most academic practices but, once present, requires immediate action and the potential involvement of many consulting specialist, including neurologists and endovascular interventionalists.