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"BROWN, Seth"
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The little book of mahjong : learn how to play, score, and win
\"Disconnect from a device-oriented world and rediscover the classic Chinese game of mahjong--while improving focus, creativity and stimulating memory--with this comprehensive yet gifty guide that includes all the basics of the game, tips and techniques on how to play, and strategies to win both international mahjong and American mahjong. The classic game of mahjong was created over 2,000 years ago during the Qing Dynasty in China, but recently, it's experiencing a renaissance. No longer reserved for older players, mahjong is being rediscovered by millennials and is recognized for its ability to improve brain function, and reduce symptoms of cognitive diseases like dementia. Learning any new game can be difficult, especially one as complex as mahjong, which includes over dozens of tiles with different meanings. But whether you are a complete novice or a casual player looking to brush up on mahjong skills and techniques, The Little Book of Mahjong can help you get ahead in this classic game, whether you are playing international mahjong or American mahjong. With a comprehensive breakdown on all of the various tiles involved in the different versions of the game, explanations of what each tile means, detailed information on scoring, tips on how to improve your skills, and strategies for winning, this guide is perfect for mahjong players both new and old. Including a brief history of the game and its significance as well as full-color photos of game pieces and game objectives, you'll become a mahjong master in no time\"-- Provided by publisher.
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Camouflaging depression
Many individuals with depression have been observed to exert effort to appear non-depressed. This effort, referred to as camouflaging, has been systematically studied among individuals with autism spectrum disorder and attention deficit hyperactivity disorder, but not among individuals with more common disorders such as depression. The purpose of this research was to examine camouflaging amongst individuals with depression and develop a camouflaging instrument specifically for depression. The Camouflaging Depression Scale (CDS) was developed and administered to 292 individuals experiencing varying levels of depression along with other clinical measures. In this sample, engagement in camouflaging was common and similarly occurred among individuals across varying levels of depression and demographic characteristics. The final 14-item CDS had a unitary factor structure with good internal consistency and temporal reliability across two weeks, and the CDS was associated with a self-monitoring scale. CDS scores were also associated with measures of depression, distress, fatigue, and internalized stigma. The CDS provides a means for researchers, diagnosticians, and clinicians to more accurately measure and examine this under-recognized phenomenon.
Journal Article
GASKET-SEAL WATERTIGHT CLOSURE IN MINIMAL-ACCESS ENDOSCOPIC CRANIAL BASE SURGERY
Transnasal endoscopic cranial base surgery is a novel minimal-access method for reaching the midline cranial base. Postoperative cerebrospinal fluid leak remains a persistent challenge. A new method for watertight closure of the anterior cranial base is presented.
To achieve watertight closure of the anterior cranial base, autologous fascia lata was used to create a \"gasket seal\" around a bone buttress, followed by application of a tissue sealant such as DuraSeal (Confluent Surgical, Inc., Waltham, MA). The gasket-seal closure was used to seal the anterior cranial base in a series of 10 patients with intradural surgery for suprasellar craniopharyngiomas (n = 5), planum meningiomas (n = 3), clival chordoma (n = 1), and recurrent iatrogenic cerebrospinal fluid leak (n = 1). Lumbar drains were placed intraoperatively in five patients and remained in place for 3 days postoperatively.
After a mean follow-up period of 12 months, there were no cerebrospinal fluid leaks.
The gasket-seal closure is an effective method for achieving watertight closure of the anterior cranial base after endoscopic intradural surgery.
Journal Article
The Effects of Direct-To-Consumer-Advertising on Mental Illness Beliefs and Stigma
Despite widespread use, little is known about how video direct-to-consumer-advertising (DTCA) influences beliefs about or stigma towards mental illness. The purpose of this study was to examine the effects of a medication advertisement on beliefs and stigma towards one mental disorder—bipolar disorder. A total of 424 participants were randomly assigned to view a medication or automobile advertisement and completed measures of beliefs and stigma towards bipolar disorder before and immediately after the advertisement. The medication advertisement did not lead to changes in perception of biological etiology, but did lead to increases in perception of prevalence, treatability, and controllability. No substantive changes were noted in stigma. In contrast to previous research and speculation, DTCA did not have an immediate, substantial impact on stigma or contribute to the “medicalization” of mental disorders.
Journal Article
THREE-DIMENSIONAL ENDOSCOPIC PITUITARY SURGERY
We describe a novel 3-dimensional (3-D) stereoendoscope and discuss our early experience using it to provide improved depth perception during transsphenoidal pituitary surgery.
Thirteen patients underwent endonasal endoscopic transsphenoidal surgery. A 6.5-, 4.9-, or 4.0-mm, 0- and 30-degree rigid 3-D stereoendoscope (Visionsense, Ltd., Petach Tikva, Israel) was used in all cases. The endoscope is based on \"compound eye\" technology, incorporating a microarray of lenses. Patients were followed prospectively and compared with a matched group of patients who underwent endoscopic surgery with a 2-dimensional (2-D) endoscope. Surgeon comfort and/or complaints regarding the endoscope were recorded.
The 3-D endoscope was used as the sole method of visualization to remove 10 pituitary adenomas, 1 cystic xanthogranuloma, 1 metastasis, and 1 cavernous sinus hemangioma. Improved depth perception without eye strain or headache was noted by the surgeons. There were no intraoperative complications. All patients without cavernous sinus extension (7of 9 patients) had gross tumor removal. There were no significant differences in operative time, length of stay, or extent of resection compared with cases in which a 2-D endoscope was used. Subjective depth perception was improved compared with standard 2-D scopes.
In this first reported series of purely 3-D endoscopic transsphenoidal pituitary surgery, we demonstrate subjectively improved depth perception and excellent outcomes with no increase in operative time. Three-dimensional endoscopes may become the standard tool for minimal access neurosurgery.
Journal Article
Endoscopic Endonasal Transethmoidal Transcribriform Transfovea Ethmoidalis Approach to the Anterior Cranial Fossa and Skull Base
Abstract
OBJECTIVE
The anterior skull base, in front of the sphenoid sinus, can be approached using a variety of techniques including extended subfrontal, transfacial, and craniofacial approaches. These methods include risks of brain retraction, contusion, cerebrospinal fluid leak, meningitis, and cosmetic deformity. An alternate and more direct approach is the endonasal, transethmoidal, transcribriform, transfovea ethmoidalis approach.
METHODS
An endoscopic, endonasal approach was used to treat a variety of conditions of the anterior skull base arising in front of the sphenoid sinus and between the orbits in a series of 44 patients. A prospective database was used to detail the corridor of approach, closure technique, use of intraoperative lumbar drainage, operative time, and postoperative complications. Extent of resection was determined by a radiologist using volumetric analysis.
RESULTS
Pathology included meningo/encephaloceles (19), benign tumors (14), malignant tumors (9), and infectious lesions (2). Lumbar drains were placed intraoperatively in 20 patients. The CSF leak rate was 6.8% for the whole series and 9% for intradural cases. Leaks were effectively managed with lumbar drainage. Early reoperation for cerebrospinal fluid (CSF) leak occurred in 1 patient (2.2%). There were no intracranial infections. Greater than 98% resection was achieved in 12 of 14 benign and 5 of 9 malignant tumors.
CONCLUSION
The endoscopic, endonasal, transethmoidal, transcribriform, transfovea ethmoidalis approach is versatile and suitable for managing a variety of pathological entities. This minimal access surgery is a feasible alternative to transcranial, transfacial, or combined craniofacial approaches to the anterior skull base and anterior cranial fossa in front of the sphenoid sinus. The risk of CSF leak and infection are reasonably low and decrease with experience. Longer follow-up and larger series of patients will be required to validate the long-term efficacy of this minimally invasive approach.
Journal Article
Combat Medic-Performed Auscultation Versus Thoracic Ultrasound Image Interpretation for Pneumothorax Detection: Look or Listen?
Background Pneumothorax (PTX) is a potentially life-threatening condition encountered by U.S. Army combat medics on the battlefield. PTX, when left untreated, can progress to tension PTX, a leading cause of preventable death on the battlefield which can be difficult to diagnose based on physical exam alone due to variable physical exam findings. Prior literature shows medics can accurately use point-of-care ultrasound (POCUS) to diagnose PTX in cadaver and porcine models; however, no studies have directly compared the diagnostic accuracy of ultrasound (US) and physical exams performed by this population. We sought to compare medic diagnostic accuracy of a simulated PTX using these two diagnostic modalities. Methodology We conducted a prospective, observational study in which medics from the Flight Paramedic Program at Joint Base San Antonio-Sam Houston, TX received a standardized 30-minute training on physical exam and US diagnosis of PTX, followed by a 20-minute hands-on US familiarization session. Participants were then randomly selected into cohorts to evaluate 12 high-fidelity manikin lung fields and 12 thoracic US video clips for the presence of PTX in a simulated combat environment. Cohorts evaluated the same manikins and thoracic US video clips but in opposing sequences. Our primary outcome compared the sensitivity and specificity of PTX identification via thoracic US image interpretation and physical exam. Results In total, 21 medics evaluated 252 hemithoraces and interpreted 252 thoracic US images. We found a statistically significant difference favoring medics' sensitivity with US image interpretation over physical exam to detect PTX (85.7% vs. 72.4%, p = 0.004). There was no statistically significant difference in specificity between these modalities (81.9% vs. 69.4%, p = 0.139). Conclusions After brief training, medics demonstrated greater sensitivity to detect PTX using thoracic US image interpretation compared to physical exam in a simulated combat environment. Further studies involving medics' ultrasound image acquisition capability in human patients in austere combat environments are warranted.
Journal Article
Measuring Perceived Benefits and Perceived Barriers for Physical Activity
Objectives: To evaluate the psychometric properties and relationship to physical activity levels of the Exercise Benefits/Barriers Scale (EBBS) among college students. Methods: A total of 398 college students completed the EBBS and a measure of self-efficacy, the Physical
Exercise Self-Efficacy Scale. In addition, a subsample of 275 students also completed a semistructured interview on physical activity, the Seven-day Physical Activity Recall. Results: Psychometric properties were acceptable, but only benefits significantly accounted for variance in
physical activity levels. Conclusions: Surprisingly, the factorial structure differed from the test developers'.
Journal Article
The Effectiveness of Two Potential Mass Media Interventions on Stigma: Video-Recorded Social Contact and Audio/Visual Simulations
Two approaches that may be particularly well suited for mass media (large scale) stigma interventions are video-recorded social contact and simulations, but research is rather limited. The purpose of this study was to evaluate two potential mass media interventions on different facets of stigma. Participants (
N
= 244) completed stigma measures prior to, immediately following, and 1 week following the random assignment of: (1) video-recorded social contact, (2) an audio/visual simulation, or (3) no intervention. The video-recorded social contact led to decreases on preference for social distance and negative emotions across 1 week, but only a temporary decrease on perceptions of dangerousness. In contrast, no significant changes in stigma were noted following the simulation. In sum, video-recorded social contact appears promising and offers many advantages for mass media implementation including low cost, minimal resources, and ease of dissemination. In contrast, further evaluation of audio/visual simulations is warranted before implementation.
Journal Article