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How Music–Video metaphors build destination brand resonance:Dyadic affect, meaning access, and cultural cues
No full textShort-form destination videos often rely on music to carry cultural meaning. This paper links Cognitive Metaphor Theory with the circumplex dyad of pleasure and arousal to explain how music–image pairings build destination brand resonance (DBR). Three experiments show that pleasure is the stable route to DBR, arousal helps only under favorable tone, and their effects are additive. A Meaning-Access Prime (MAP) raises both emotions under identical clips and, in Bayesian structural models, also exerts a direct path to DBR, strongest when pleasant tone is low. DBR then predicts destination brand identification and destination consumption intention. We also show a useful state view: Resonant versus Emergent DBR. The framework provides design rules for co-tuning tone, activation, and cultural cues in creator-made clips that improve resonance, identification, and intention
Severe Symptoms Predict Residual Disease After Transitioning From High to Low Disease Activity in Axial Spondyloarthritis: A Longitudinal Study
No full textObjective: To investigate whether very high disease activity (VHDA) status or severe symptoms when in HDA state predict residual disease after achieving inactive disease/low disease activity (ID/LDA) in axial spondyloarthritis (axSpA).Methods: Prospective data from the SpA-Net registry were used. HDA was defined as an Axial Spondyloarthritis Disease Activity Score (ASDAS)≥2.1, and ID/LDA as ASDAS<2.1. VHDA (predictor 1) was defined as ASDAS>3.5, and severe symptoms when in HDA state (predictor 2) as a score ≥6/10 for fatigue, back pain and/or physical function. Residual disease (outcome) was defined as presence of ≥1 patient-experienced (fatigue, back pain and/or physical function ≥4/10) or objective disease indicator (active peripheral manifestations, active psoriasis, elevated C-reactive protein or physician's impression) after achieving ID/LDA. Associations between either predictor and residual disease were investigated using logistic regression.Results: Overall, 133 patients (58 [43.6%] female, mean age 48.8 [SD 14.5] years) were included. At the HDA time-point, 16 (12.0%) patients had VHDA status and 107 (80.5%) experienced severe symptoms. At the ID/LDA time-point, prevalence of patient-experienced and objective residual disease was 70.7% (n=94/133) and 54% (n=37/68), respectively. VHDA status when in HDA state was not associated with either form of residual disease after achieving ID/LDA. Severe symptoms were associated with patient-experienced residual disease (OR=5.09 [95%CI 1.76-14.71]), but not objective residual disease.Conclusion: Severe symptoms when in HDA state predict patient-experienced, but not objective, residual disease in axSpA, while VHDA status does not predict either form. These findings may aid in anticipating residual disease and guiding management
Implications of inaccurate lymph node staging in early and intermediate-risk rectal cancer on survival-related outcomes in a large Dutch population-based cohort
No full textINTRODUCTION: While clinical lymph node status remains a key determinant in rectal cancer treatment, its accuracy is limited. This study aimed to evaluate the impact of inaccurate MRI-based nodal staging on survival in early and intermediate-risk rectal cancer in a Dutch national cohort.METHODS: This retrospective study analysed data from the Netherlands Cancer Registry. Rectal cancer patients diagnosed between 2014 and 2017 with cT1-3N0M0 rectal cancer undergoing direct TME surgery, and cT1-3N1M0 rectal cancer receiving neoadjuvant short-course radiotherapy (SCRT) followed by direct TME surgery were included. Patients were categorized in four groups based on clinical (cN) and pathological (pN) nodal status: cN0pN0, cN0pN1, cN1pN0, and cN1pN1. Overall survival (OS) and factors associated with OS were analysed using Kaplan-Meier and Cox regression analyses.RESULTS: Among 4080 patients, 19.5 % of 3075 cN0 patients were understaged (pN1) and 62.4 % of 1005 cN1 patients were overstaged (pN0). After a median follow up of 5.7 (IQR 4.6-6.6) years, OS did not differ between cN0pN1 patients undergoing direct surgery and cN1pN1 patients receiving neoadjuvant SCRT followed by surgery (p = 0.154). Multivariable Cox regression analysis revealed that inaccurate cN0 staging was not independently associated with worse OS in pN1 patients, while pT3 disease (HR 1.62, 95 %-CI 1.15-2.27 for pN1; and HR 1.52, 95 %-CI 1.22-1.88 for pN0) was associated with worse OS compared to pT1-2 in both pN1 and pN0 patients.CONCLUSION: Inaccurate clinical nodal staging by MRI is common in early and intermediate-risk rectal cancer, but it does not seem to have a negative impact on OS.</p
Implementation, facilitators and barriers, of eHealth with a self-management approach for informal caregivers of people with dementia:a narrative review
No full textObjectiveseHealth and self-management interventions for informal caregivers of people with dementia show promising positive results for various health outcomes. However, their successful implementation in practice remains inconsistent. The aim of this study is to gain insight into facilitating factors and barriers of the implementation of eHealth interventions with a self-management approach for informal caregivers of people with dementia.MethodThis narrative review included a systematic search of the databases PsycINFO, PubMed and Web of Science. Papers were screened against the inclusion criteria and then the text of eligible papers was qualitatively analyzed both manually and by computer assisted software. Findings were then mapped into the Consolidated Framework for Implementation Research (CFIR).ResultsTwenty papers were selected and seven themes emerged from the qualitative analysis: (1) Organizational, financial, and structural considerations in healthcare; (2) Characteristics of the eHealth interventions; (3) Attitudinal perspectives; (4) Awareness, familiarity and confidence; (5) Resource allocation and support; (6) Personal characteristics of the informal caregivers; and (7) Wider context factors to eHealth intervention implementation. Mapping the findings into the CFIR framework revealed that little is known about the implementation process.ConclusionThe alignment of eHealth interventions with current policy objectives and digital progress underlines their importance in real-world application
The impact of a telepresence robot on group conditions and student engagement:A mixed-method study in higher education
No full textDrawing on team learning theory, this paper examines whether and how a telepresence robot impacts group conditions and student engagement among graduate students collaborating within a hybrid classroom. Hybrid classrooms face challenges, such as an asymmetry of presence, compromising collaborative learning between remote and on-site students. A field experiment was conducted with 17 hybrid classrooms across two Master of Science courses. In the eight experimental groups, one remote student joined via a telepresence robot, while any additional remote students in the same group participated via the smart screen. In the nine control groups, all remote students participated solely via the smart screen. Analysis of short-term longitudinal survey data from 156 students indicated that students in experimental groups with a telepresence robot reported higher levels of social cohesion, psychological safety and group potency, especially in the early course stages. These group conditions positively influenced student engagement. Interviews with ten on-site students reveal that the telepresence robot enhanced remote students' presence through physical embodiment and fostered empowerment via autonomous mobility. This reduced presence asymmetry facilitated more natural interactions, reinforcing group conditions: social cohesion through interpersonal connections, psychological safety through reduced participation barriers, and group potency through increased knowledge sharing. The telepresence robot also fostered inclusive behavior among on-site students, driven by their reciprocation of remote students' engagement and recognition of them as valuable contributors to collaborative learning. These findings advance understanding of team learning and the role of telepresence robots in hybrid classroom settings, promoting more effective virtual inclusion for remote students
Unveiling regions associated with acute and late breast side-effects from breast radiotherapy using voxel-wise image-based data mining analysis
No full textBackground and purpose: Side-effects after breast cancer treatment, including radiotherapy (RT), can drastically affect a patient's quality of life. This study aims to identify anatomical regions where RT dose is related to breast side-effects using the voxel-wise image-based data mining (IBDM) technique. Materials and Methods: Data of 922 patients included in the REQUITE study and who underwent RT after breast-conserving surgery were analysed. All patients were treated supine. We analysed breast pain, oedema, atrophy, induration, and nipple retraction, scored before and after RT by clinicians and patients. We investigated the toxicity burden using the area under the curve for toxicity over time (ToxT-AUC) and applied IBDM by normalising all dose distributions to three reference anatomies. To do so, we established a spatial normalisation pipeline, ensuring that the ipsilateral breast was aligned (flipping all left-side treatments laterally). Dose distributions were converted to equivalent dose in 2 Gy-fraction (EQD 2, α/β = 1.7 Gy and 3 Gy) to account for different RT fractionations. To determine the relevance of each identified region, we used multivariable ordinal regression, including patient-specific factors and clinical variables. Results: Significant regions associated with each breast side-effect were found in different breast quadrants. The regions showed higher mean EQD 2 than the complete breast contour, particularly for grade 2+ (p < 0.01). Dosimetric parameters extracted from the region were significant in multivariable analysis. Conclusion: We found regions within the breast where the local dose associates with breast side-effects after breast RT. This result opens a new hypothesis which could help reduce side-effects after breast radiotherapy.</p
Effectiveness of treatments for post-traumatic stress disorder for older people:A systematic review and meta-analysis of randomized controlled trials
No full textBackground: Although effective treatments for post-traumatic stress-disorder (PTSD) in adults are well established, research reporting on the effectiveness of treatments for older people remains limited. Aims: To systematically review global evidence reporting on the effectiveness of treatments for PTSD in older adults. Method: We searched several databases for randomized controlled trials on PTSD in older people. Results: From a total of 17,987 search hits, 10 studies met our inclusion criteria; these reported on the effectiveness of narrative exposure therapy (4 trials), Cognitive Behavioural Therapy (2 trials), spiritual-focused psychotherapy (1 trial), life-review therapy (1 trial), collaborative care (1 trial), and physical activity (1 trial). We identified no trials evaluating the effectiveness of pharmacological interventions. Meta-analyses showed that trauma-based psychological treatments improved symptoms of depression (standardised mean difference (SMD) -0.48, 95 % Confidence Interval (CI) -0.74 to -0.23, 7 studies, 504 participants; moderate-certainty evidence) compared to treatment as usual at end of treatment. These interventions also reduced symptoms of PTSD post treatment but certainty of evidence for this outcome was low (SMD -0.29, 95 % CI -0.62 to 0.03, 5 studies, 261 participants). Conclusion: Trauma-based psychological treatments for older people with PTSD are better than treatment as usual in reducing symptoms of depression at post-treatment. These interventions may also reduce symptoms of PTSD, however the quality of evidence remains low. Future large-scale studies are needed to establish which interventions are more likely to be associated with the greatest benefits. Trials evaluating the effectiveness of pharmacological interventions for PTSD in older people are urgently needed
Routine RNA-based analysis of potential splicing variants facilitates genomic diagnostics and reveals limitations of in silico prediction tools
No full textDNA variants affecting pre-mRNA splicing are an important cause of genetic disorders and remain challenging to interpret without experimental data. Although variant classification guidelines recommend experimental characterization of variant splicing effects, the added value of routine diagnostic investigation of patient mRNA splicing has not been systematically described. Here, we assessed the utility of pre-mRNA splicing analysis in a diagnostic setting for 202 suspected splice-altering variants from individuals referred for genetic testing. Pre-mRNA splicing was assessed in patient cells by RT-PCR, followed by agarose gel electrophoresis and Sanger sequencing and/or exon trapping assays. An effect on pre-mRNA splicing was demonstrated in 63% (n = 128/202) of the tested variants. Among the 177 variants initially classified as variants of uncertain significance (VUS), 54% (n = 96/177) were reclassified based on pre-mRNA splicing analysis, including 48% (n = 85/177) that were upgraded to likely pathogenic or pathogenic. We benchmarked the splice prediction algorithms SpliceAI, SQUIRLS, SPiP, and Pangolin, the tools integrated in Alamut on this clinically relevant and experimentally validated dataset, and the CAGI6 splicing VUS dataset and found variable performance dependent on variant type and location. No single tool classified all variants equally well. We describe several examples of hard-to-predict effects and unexpected results highlighting the limitations of prediction tools, including a not previously described variant type affecting U12-splice site subtype. In summary, we provide a framework for RNA-based analysis in a molecular diagnostic setting, demonstrate the added value of routine testing of RNA from individuals with suspected splice-altering variants, and highlight the limitations of in silico prediction tools.</p
Stereotactic radiotherapy on Parkinson's disease induced tremors - a systematic review
No full textBackground: Parkinson's disease (PD) is a neurodegenerative disorder characterized by progressive disability due to bradykinesia, rigidity, and rest tremors. Especially in the treatment of tremors, pharmacological options often fall short. Invasive treatments such as deep brain stimulation are unsuitable in selected patients. Stereotactic radiotherapy (SRT) is a non-invasive alternative. However, implementation is hindered by inconsistent findings across studies. Materials and Methods: This study aims to evaluate the effect of SRT on tremors in PD patients. A PRISMA-guided systematic review identified 183 records. Six studies (n = 193 patients) met inclusion criteria. Outcomes were assessed after 12 months of SRT treatment. Results: All included studies used single-fraction SRT, prescribed doses ranged from 85-165 Gy, with 130-140 Gy being most frequently used. The ventral intermediate nucleus (VIM) was the most commonly targeted structure in three of the six studies. Across all studies tremor improvement was reported in 71 %-100 % of cases, with severity reduction of 38 %-67 % and tremor elimination in three studies varying from 0 % to 70 % of patients. Three studies noted medication reductions in 6 %-75 % of cases. Quality of life (QoL) and tremor recurrence were inconsistently reported: only one study reported no significant QoL improvement. Recurrence rates ranged from 3 %-24 %. Adverse events were present in 7 (7 %) patients. Conclusion: SRT is a promising non-invasive treatment for medically refractory PD tremor, with substantial tremor reduction and low toxicity. However, limitations such as the inconsistent reporting affect the strength of the findings. Future research should emphasize standardized reporting of treatment parameters and outcomes to strengthen evidence on SRT efficacy