Concerns about penicillin-cephalosporin cross-reactivity have historically led to conservative prescribing and avoidance of cephalosporins in patients with penicillin allergy labels, potentially causing suboptimal outcomes. Recent evidence suggests a lower risk of cross-reactivity, prompting a reassessment of alert systems.

To assess the impact of limited penicillin cross-reactivity alerts on outpatient cephalosporin use and the incidence of adverse reactions in a healthcare setting.

This retrospective cohort study compared cephalosporin prescribing and adverse reactions in patients labeled as penicillin-allergic before and after limiting penicillin cross-reactivity alerts in the electronic medical record at a large academic medical center.

Among 17,174 patients (8,131 pre- and 9,043 post-implementation), there was a statistically significant increase in outpatient cephalosporin prescribing by 8% (P < .001). The use of alternative antibiotic classes decreased. There was no statistically significant increase in adverse events pre- and post-implementation (0.036%–0.058%, P = .547), and no severe events were attributable to cross-reactivity. The alert modification reduced alerts by 92% (P < .001).

The reduction of penicillin-cephalosporin cross-reactivity alerts was associated with increased cephalosporin use, without a significant increase in adverse reactions. This demonstrates that the practice is safe and decreases alert burden.

Syncope is common among pediatric patients and is rarely pathologic. The mechanisms for symptoms during exercise are less well understood than the resting mechanisms. Additionally, inert gas rebreathing analysis, a non-invasive examination of haemodynamics including cardiac output, has not previously been studied in youth with neurocardiogenic syncope.

This was a retrospective (2017–2023), single-center cohort study in pediatric patients ≤ 21 years with prior peri-exertional syncope evaluated with echocardiography and cardiopulmonary exercise testing with inert gas rebreathing analysis performed on the same day. Patients with and without symptoms during or immediately following exercise were noted.

Of the 101 patients (15.2 ± 2.3 years; 31% male), there were 22 patients with symptoms during exercise testing or recovery. Resting echocardiography stroke volume correlated with resting (r = 0.53, p < 0.0001) and peak stroke volume (r = 0.32, p = 0.009) by inert gas rebreathing and with peak oxygen pulse (r = 0.61, p < 0.0001). Patients with syncopal symptoms peri-exercise had lower left ventricular end-diastolic volume (Z-score –1.2 ± 1.3 vs. –0.36 ± 1.3, p = 0.01) and end-systolic volume (Z-score –1.0 ± 1.4 vs. −0.1 ± 1.1, p = 0.001) by echocardiography, lower percent predicted peak oxygen pulse during exercise (95.5 ± 14.0 vs. 104.6 ± 18.5%, p = 0.04), and slower post-exercise heart rate recovery (31.0 ± 12.7 vs. 37.8 ± 13.2 bpm, p = 0.03).

Among youth with a history of peri-exertional syncope, those who become syncopal with exercise testing have lower left ventricular volumes at rest, decreased peak oxygen pulse, and slower heart rate recovery after exercise than those who remain asymptomatic. Peak oxygen pulse and resting stroke volume on inert gas rebreathing are associated with stroke volume on echocardiogram.

The identification of predictors of treatment response is crucial for improving treatment outcome for children with anxiety disorders. Machine learning methods provide opportunities to identify combinations of factors that contribute to risk prediction models.

A machine learning approach was applied to predict anxiety disorder remission in a large sample of 2114 anxious youth (5–18 years). Potential predictors included demographic, clinical, parental, and treatment variables with data obtained pre-treatment, post-treatment, and at least one follow-up.

All machine learning models performed similarly for remission outcomes, with AUC between 0.67 and 0.69. There was significant alignment between the factors that contributed to the models predicting two target outcomes: remission of all anxiety disorders and the primary anxiety disorder. Children who were older, had multiple anxiety disorders, comorbid depression, comorbid externalising disorders, received group treatment and therapy delivered by a more experienced therapist, and who had a parent with higher anxiety and depression symptoms, were more likely than other children to still meet criteria for anxiety disorders at the completion of therapy. In both models, the absence of a social anxiety disorder and being treated by a therapist with less experience contributed to the model predicting a higher likelihood of remission.

These findings underscore the utility of prediction models that may indicate which children are more likely to remit or are more at risk of non-remission following CBT for childhood anxiety.

High-definition transcranial direct current stimulation (HD-tDCS) has the potential to improve cognitive functioning following neurological injury and in neurodegenerative conditions. In this case report, we present the first use of HD-tDCS in a person with severe anterograde amnesia following carbon monoxide poisoning.

The participant underwent two rounds of HD-tDCS that were separated by 3 months (Round 1 = 30 sessions; Round 2 = 31 sessions). We used finite element modeling of the participant’s structural MRI to develop an individualized montage that targeted multiple brain regions involved in memory encoding, as identified by Neurosynth.

Overall, the participant’s objective cognitive functioning improved significantly following Round 1, declined during the 2 months without HD-tDCS, and again improved following Round 2. Subjective informant reports from family and medical personnel followed this same pattern of improvement following each round with a decline in between rounds. We also provide preliminary evidence of altered brain activity during a learning/memory task using functional near-infrared spectroscopy, which may help establish the physiological effects of HD-tDCS in future work.

Overall, these findings reinforce the potential value of HD-tDCS as a user-friendly method of enhancing cognition following anoxic/hypoxic brain injury.

Research suggests that most mental health conditions have their onset in the critically social period of adolescence. Yet, we lack understanding of the potential social processes underlying early psychopathological development. We propose a conceptual model where daily-life social interactions and social skills form an intermediate link between known risk and protective factors (adverse childhood experiences, bullying, social support, maladaptive parenting) and psychopathology in adolescents – that is explored using cross-sectional data.

N = 1913 Flemish adolescent participants (Mean age = 13.8; 63% girls) were assessed as part of the SIGMA study, a large-scale, accelerated longitudinal study of adolescent mental health and development. Self-report questionnaires (on risk/protective factors, social skills, and psychopathology) were completed during class time; daily-life social interactions were measured during a subsequent six-day experience-sampling period.

Registered uncorrected multilevel linear regression results revealed significant associations between all risk/protective factors and psychopathology, between all risk/protective factors and social processes, and between all social processes and psychopathology. Social processes (social skills, quantity/quality of daily social interactions) were uniquely predicted by each risk/protective factor and were uniquely associated with both general and specific types of psychopathology. For older participants, some relationships between social processes and psychopathology were stronger.

Unique associations between risk/protective factors and psychopathology signify the distinct relevance of these factors for youth mental health, whereas the broad associations with social processes support these processes as broad correlates. Results align with the idea of a social pathway toward early psychopathology, although follow-up longitudinal research is required to verify any mediation effect.

Background of behavioral addictions, which include smartphone addiction, is complicated and unclear. Belonging to an Internet community that shows many forms of virtual pathology and generates new, artificial trends also favors the development of mental implications which include lowered mental immunity, emotional lability, increased depressiveness, aggression, inadequate self-esteem, lowered self-value and personality disorders. Implications regarding the social sphere are above all related to the gradual alienation from the closest environment as a result of preoccupation with the subject of dependence. Those consequences include deterioration of social relations, loss of interpersonal skills and former interests, as well as the minimization of contacts with the closest ones which lead to the sense of social isolation and loneliness.

The aim of this study was to estimate the scale of mobile phone addiction among young adults as well as to establish whether the low level of perceived social support is related to the problematic smartphone use, and whether an addictive pattern of smartphone use is related to the prevalence of depressiveness and excessive daytime sleepiness.

The study involved 567 young-adult respondents from West Pomeranian Voivodship in Poland. The study was carried out using the diagnostic poll method via questionnaire technique. Both the author’s own questionnaire and the following standardized research tools were used: the Mobile Phone Problem Use Scale for Adolescents (MPPUSA), the Beck Depression Inventory (BDI), the Epworth Sleepiness Scale (ESS), the Multidimensional Scale of Perceived Social Support (MSPSS).

Perceived social support was significantly lower in the group of respondents who problematically used their smartphones in comparison with the ones who used them in a correct way (p < 0.05). Severity of depressive symptoms and daytime sleepiness (p < 0.05) was significantly greater in respondents addicted to their mobiles in comparison with non-addicted ones.

The scale of the mobile phone addiction phenomenon in respondents was low. Many respondents though expressed a subjective sense of being addicted to their smartphones in comparison with the obtained results. Problematic smartphone use concerns to the same degree members of both sexes, residents of villages and cities, as well as singles and ones in relationships (both formal and informal). The mobile phone addiction is associated with the risk of severe symptoms of depression and excessive daytime sleepiness. Pathologic pattern of smartphone use much more frequently concerned individuals who perceived their social support level as low.

None Declared

The rapid development of civilization is accompanied by many changes affecting human functioning. Technological development, wide access to positive stimuli and the neglect of emotional control and self-awareness in the learning process make it difficult for individuals to control their behavior. Such a loss of control is associated with the development of addictions. Therapists, doctors and researchers more and more often encounter cases of compulsive behavior focused on a specific activity - apart from gambling or playing computer or internet games, more and more often the subjects of preoccupation are compulsive shopping, sexual activities and work (workaholism).

The aim of the research was to try to define the mediating role of depression in the relationship between addiction to shopping and work and loneliness, understood in terms of general loneliness among Polish women.

The study was conducted among 556 women. The research was carried out with the use of the diagnostic survey method, using the questionnaire technique: the De Jong Gierveld Loneliness Scale, the Purchasing Behavior Scale, the Work Addiction Risk Test, Beck Depression Inventory and a questionnaire of our authorship.

Depressiveness is a mediator in the relationship between the feeling of loneliness and the degree of addiction to shopping (β = -0.0246, z = -2.03, p = 0.043) and in the relationship between the feeling of loneliness and the degree of addiction to work (β = -0.0722, z = -4.002, p < 0.001). The direct impact of the feeling of loneliness on the degree of addiction to shopping (p = 0.237) and work (p = 0.576) is statistically insignificant.

In the mediation model adopted, it was shown that depressiveness plays the role of a mediator between the feeling of loneliness and the degree of addiction to shopping and work. The increase in the level of depression increased the degree of addiction to shopping and work. The mediator’s participation lowered the level of the feeling of loneliness. Loneliness was not a significant predictor of addiction to shopping and work. There is a need to include activities aimed at identifying psychological factors influencing the occurrence of addictions to shopping and work among women. It seems important to be able to use psychological help when needed. It is also necessary to take institutional preventive measures to prevent the occurrence of behavioral addictions among women.

None Declared

Healthcare workers are exposed to increased risks of insomnia and aggression during the COVID-19 pandemic.

The aim of the study was to estimate the prevalence rate of insomnia and aggression and identify associated risk factors among healthcare workers during the COVID-19 pandemic

A total of 264 healthcare workers participated in the study. The study was conducted with the diagnostic survey method, using the Buss-Perry Aggression Questionnaire, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index, and a questionnaire of our authorship.

The vast majority of the respondents (81.06%) suffered from insomnia and had poor sleep quality (78.03%). Education (p=0.038), marital (p=0.043) and parental status (p=0.004), and contact with patients suffering from COVID-19 (p=0.024) were statistically significant contributors to insomnia. Working time was found to significantly correlate with insomnia (r=0.124 p=0.044) and a physical aggression (r=0.168 p=0.006), anger (r=0.121 p=0.05), a verbal aggression (r=-0.132 p=0.032). Age was found to significantly correlate with total aggression (r=-0.133 p=0.031), verbal aggression (r=-0.138 p=0.025), anger (r=-0.151 p=0.014). Sex was found to be statistically significantly related to physical aggression (p=0.017), anger (p=0.032), and hostility (p=0.002).

A considerable proportion of HCWs experienced sleep disorders during the pandemic, emphasizing the need to establish ways to reduce long-term adverse outcomes associated with chronic insomnia and adjust interventions under pandemic conditions. Our findings confirm that insomnia and poor sleep quality are consistently associated with aggression.

None Declared

Behavioral addictions are a growing problem in the society. Digital technologies are used by people of different ages, and their number is increasing every year. The precise reasons for the development of addictions remain unknown. In the case of behavioral addictions, especially Internet addiction, the significance of personality traits and behaviors predisposing an individual to addiction, such as depressiveness, anxiety, hostile attitude, aggression, impulsiveness, psychotic behaviors, shyness and self-esteem disorders, are emphasized. Personality predispositions play an essential role in Internet addiction.

The aim of this study was a general assessment of the level of Internet addiction with regard to personality traits according to the Big Five model by Costa and McCrae among women from the West Pomeranian Voivodeship.

The study involved 556 women, whose average age was 34 years and who met the inclusion criteria: female sex, age of 18 years or above, place of residence in the West Pomeranian Voivodship, an informed consent for participation in the study, and completion of the set of questionnaires. The study was conducted using a diagnostic poll method with a questionnaire technique. To carry out the analysis both author’s own and standardized tools were used: the author’s questionnaire covering socio-demographic data, the NEO-Five Factor Inventory which assesses the levels of personality traits, and the Internet Addiction Test used to measure behaviors and characteristics related to compulsive use of the Internet.

Most (70.9%) of the women were average users of the Internet, 25% of respondents were at risk of addiction, and the least numerous group of women (4.1%) was addicted to the Internet. Conscientiousness negatively correlated with Internet addiction (r = -0.22; p < 0.001; R2 = 4.9%). Openness to experience was conducive to Internet addiction (r = 0.15; p < 0.001; R2 = 11.1%). A positive link between neuroticism and Internet addictions was established (r = 0.33; p < 0.001; R2 = 11.1%). No significant relationships between Internet addiction and extraversion (r = 0.03; p = 0.45) as well as agreeableness (r = -0.07; p = 0.10) were demonstrated.

The type of personality of the studied women implicated relationships to Internet addiction. Neuroticism might be a personality trait that particularly predisposes to an increased risk of Internet addiction. Openness to experience was conducive to Internet Addiction. Low levels of conscientiousness more often become addicted to the Internet.

None Declared

Social network addicts may differ significantly from non-addicts in terms of personality traits, such as agreeableness, neuroticism, and conscientiousness. Addicts may be prone to negative emotions and unpleasant experiences, which may be associated with a higher level of neuroticism. Addicts often fail to cope in the real world, often experience negative emotions, quickly give up their goals, see themselves and others in a negative light, and escape into virtual reality. The virtual world is devoid of the anxiety that an individual faces in real life interactions, hence the tendency for addiction among people with higher levels of neuroticism. The primary cause of Internet Addiction may be innate temperamental traits (i.e., impulsiveness of behavior and impulsiveness of decisions) that influence the susceptibility to functional and chemical addictions. According to the concept of addictive personality, people who have this problem are prone to addiction as such, regardless of what they are addicted to.

The purpose of this study was to generally assess the degree of women’s dependence on social networking sites on the example of Facebook, taking into account personality traits according to the five-factor model of personality, the so-called Big Five by Costa and McCrae

The study included 556 women. This survey-based study was carried out using the questionnaire technique. The following research tools were used to analyze behavioral addictions in adult women: the Bergen Face- book Addiction Scale (BFAS), the NEO Five-Factor Inventory (NEO FFI) and the author’s questionnaire.

Among the surveyed women, 69.6% were average Facebook users, of whom 16.4% had scores indicating possible Facebook addiction, and 14.0% had scores indicating addiction. The higher the neuroticism, the more serious the Facebook addiction (r = 0.26; p < 0.001; R2 = 6.7%). A weak negative correlation was obtained for the agreeableness subscale e (r = -0.08; p < 0.05; R2 = 7.2%). A weak negative correlation was also obtained for the subscale of conscientiousness (r = -0.16; p < 0.001; R2 = 2.6%). There was no statistically significant correlation between the log10 score obtained on the BFAS and the score on the NEO-FFI subscales of extraversion (r = 0.04; p = 0.40) and openness to experience (r = 0.04; p = 0.30).

The personality types of the studied women indicated relationships in terms of behavioral addictions. Women characterized by neuroticism showed stronger addiction to Facebook. Women characterized by high conscientiousness were at lower risk of behavioral addictions, while agreeableness as a personality trait significantly protected the surveyed women against Facebook addiction.

None Declared