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Although influenza A viruses predominate globally, influenza B viruses are responsible for a significant and often underappreciated burden. Despite this, immunity to influenza B viruses remains understudied, and there is a perception that vaccine-mediated immune responses to influenza B strains are less robust than influenza A strains. This targeted literature review examines this concept using data from pivotal phase 3 immunogenicity studies on currently licensed seasonal influenza vaccines and explores several explanations for this phenomenon, including immune exposure history, assay limitations, virus-related properties inherent to B lineages, and strain mismatch. Overall, studies demonstrated vaccines induce variable and sometimes less robust immune responses to influenza B strains; however, further studies are needed to fully confirm and understand these observations. In identifying the potential causes of variable performance of current vaccines against influenza, this review aims to guide vaccine development to enhance overall vaccine performance and reduce disease burden worldwide.

Background: Ventricular tachycardia (VT) catheter ablation in the presence of intracardiac thrombi was evaluated in very few studies., Objectives: To investigate in-hospital outcomes of VT ablation in the presence of an intracardiac thrombus, in a large inpatient US registry., Methods: Using the National Inpatient Sample (NIS) database, patients who underwent non-elective VT catheter ablations in the United States between 2016 and 2019 were identified using ICD-10 codes. Sociodemographic, clinical data, in-hospital procedures, and outcomes as well as in-hospital mortality were collected. In-hospital outcomes were compared using propensity score (PS) matching analysis with a 1:3 ratio between patients with and without intracardiac thrombus., Results: A weighted total of 15,725 admissions for non-elective VT ablation were included in the study, of which 190 (1.2%) had a discharge diagnosis of intracardiac thrombus. Patients with intracardiac thrombus had a higher comorbidity burden and were more likely to have ischemic cardiomyopathy and a diagnosis of cardiac aneurysm. In PS analysis, the presence of intracardiac thrombus was significantly associated with higher rates of any in-hospital complications (42.1% vs. 19.3%, p < 0.009), driven by higher periprocedural cerebrovascular accident and vascular injury events. In-hospital mortality rates were not significantly different between the groups., Conclusions: In patients undergoing non-elective VT ablation, intracardiac thrombus was associated with higher rates of in-hospital complications, but not higher in-hospital mortality. These findings suggest that intracardiac thrombus should not contraindicate VT ablation when deemed necessary, while efforts should be made to decrease potential complications., (© 2024 Wiley Periodicals LLC.)

Objective: This study is aimed to test the association of the Subjective Traumatic Outlook (STO) concept for distinguishing between posttraumatic stress disorder (PTSD) and complex PTSD. Focusing on identity dimensions within identity theory, the research aims to understand how subjective factors influence psychological outcomes, especially in the context of trauma during prolonged war. Findings can inform our understanding of the perception of trauma during wartime., Method: We examined a national sample of 1,895 Ukrainians during the Russian invasion, who completed the International Trauma Questionnaire and the STO. Statistical analyses, including analysis of variance, analysis of covariance, and contrast measurement, were conducted to examine associations while controlling for demographic factors., Results: Our study highlights distinct STO levels associated with varying degrees of trauma-related disorders. Lower STO scores relate to reduced disorder likelihood, while higher STO levels indicate greater risk, particularly for complex PTSD. These distinctions persist even when considering demographic variables associated with wartime conditions., Conclusion: Our research contributes to the understanding of PTSD/complex PTSD during ongoing conflict and underscores the applicability of identity aspects in elucidating the influence of subjective factors on psychological outcomes. This exploration of STO represents another approach to understanding internal perspectives in trauma-related disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This study is aimed to test the symptoms network of International Classification of Diseases, 11th Revision (ICD-11) complex posttraumatic stress disorder (CPTSD) symptoms, using data collected from Ukrainian civilians during the 2022 Russia-Ukraine war. Findings can inform our understanding of the stress response in individuals exposed to continuous trauma and give insight into the nature of CPTSD during the war., Method: A network analysis was conducted on CPTSD symptoms as assessed by the International Trauma Questionnaire using data from a nationally representative sample of 2,000 Ukrainians., Results: While PTSD and disturbances in self-organization clusters did not enmesh, several communities within these clusters were merged. Results highlight that in terms of strength centrality, emotional dysregulation (emotional numbing) and a heightened sense of threat (SoT) were most prominent., Conclusion: The results confirm the ICD-11 structure of CPTSD but suggest that continuous traumatic stress manifests in more condensed associations between CPTSD symptoms and that emotional regulation may play a vital role in activating the CPTSD network. War-exposed populations could be provided with scalable, brief self-help materials focused on fostering emotion regulation and an SoT. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The ongoing Ukraine-Russia war triggered significant mental health consequences, particularly posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A population study with 1895 Ukrainians explored the association between negative war-related beliefs and risk for PTSD and CPTSD. Negative war-related beliefs were shown to be significantly linked to increased risks for PTSD and more so for CPTSD. Interventions that address negative war-related beliefs could mitigate the mental health impact of war., Competing Interests: Declaration of competing interest We declare no conflict of interest or otherwise. The paper is purely academic research., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Pilgrimages and travel to religious Mass Gatherings (MGs) are part of all major religions. This narrative review aims to describe some characteristics, including health risks, of the more well known and frequently undertaken ones., Methods: A literature search was conducted using keywords related to the characteristics (frequency of occurrence, duration, calendar period, reasons behind their undertaking and the common health risks) of Christian, Muslim, Hindu, Buddhist and Jewish religious MGs., Results: About 600 million trips are undertaken to religious sites annually. The characteristics varies between religions and between pilgrimages. However, religious MGs share common health risks, but these are reported in a heterogenous manner. European Christian pilgrimages reported both communicable diseases, such as norovirus outbreaks linked to the Marian Shrine of Lourdes in France, and noncommunicable diseases (NCD). NCD predominated at the Catholic pilgrimage to the Basilica of Our Lady of Guadalupe in Mexico, which documented 11 million attendees in one week. The Zion Christian Church Easter gathering in South Africa, attended by about 10 million pilgrims, reported mostly motor vehicles accidents. Muslim pilgrimages, such as the Arbaeen (20 million pilgrims) and Hajj documented a high incidence of respiratory tract infections, up to 80% during Hajj. Heat injuries and stampedes have been associated with Hajj. The Hindu Kumbh Mela pilgrimage, which attracted 100 million pilgrims in 2013, documented respiratory conditions in 70% of consultations. A deadly stampede occurred at the 2021 Jewish Lag BaOmer MG., Conclusion: Communicable and NCD differ among the different religious MGs. Gaps exists in the surveillance, reporting, and data accessibility of health risks associated with religious MGs. A need exists for the uniform implementation of a system of real-time monitoring of diseases and morbidity patterns, utilising standardised modern information-sharing platforms. The health needs of pilgrims can then be prioritised by developing specific and appropriate guidelines., (© The Author(s) 2024. Published by Oxford University Press on behalf of International Society of Travel Medicine.)

Background : During the first months of the COVID-19 outbreak, an increase was observed in atrial fibrillation (AF)-related mortality in the United States (U.S). We aimed to investigate AF-related mortality trends in the U.S. before, during, and after the COVID-19 pandemic peak, stratified by sociodemographic factors. Methods : using the Wide-Ranging Online Data for Epidemiologic Research database of the Centers for Disease Control and Prevention, we compared the AF-related age-adjusted mortality rate (AAMR) among different subgroups in the two years preceding, during, and following the pandemic peak (2018-2019, 2020-2021, 2022-2023). Result : By analyzing a total of 1,267,758 AF-related death cases, a significant increase of 24.8% was observed in AF-related mortality during the pandemic outbreak, followed by a modest significant decrease of 1.4% during the decline phase of the pandemic. The most prominent increase in AF-related mortality was observed among males, among individuals younger than 65 years, and among individuals of African American and Hispanic descent, while males, African American individuals, and multiracial individuals experienced a non-statistically significant decrease in AF-related mortality during the pandemic decline period. Conclusions : Our findings suggest that in future healthcare crises, targeted healthcare policies and interventions to identify AF, given its impact on patients' outcomes, should be developed while addressing disparities among different patient populations.

In October 2023, the Tel Aviv District was notified of ten cases of measles. The outbreak initiated in a preschool with high vaccination coverage with one dose of MMR vaccine. Serological testing was available for eight patients (six children and two adults). Among the six children vaccinated with one dose of MMR vaccine, primary vaccine failure was demonstrated. Among the adults, secondary vaccine failure was confirmed. The outbreak was successfully contained due to a combination of factors, notably its occurrence within a population characterized by high vaccination coverage in Tel Aviv, during a period of restricted public interactions due to the prevailing state of war in the country. Despite challenging wartime conditions, effective prophylactic measures were promptly executed, encompassing a 2-dose MMR vaccination schedule for close contacts and the broader community of children in the TA district, successfully curbing the outbreak and preventing widespread infections., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier India Pvt Ltd. All rights reserved.)

Background: Varicella zoster virus (VZV) is among the leading pathogens causing meningitis and encephalitis. While VZV-PCR-positive CSF is considered a gold-standard for diagnosis, it is not-uncommon to detect VZV-DNA in CSF of patients with other acute or chronic illness. Our goal was to determine the clinical relevance of VZV-PCR-positive CSF when investigating patients with neurological symptoms., Methods: In this retrospective cohort from the largest hospital in Israel, we collected demographic, clinical and laboratory data of patients with VZV-PCR-positive CSF, analyzing the significance of various parameters., Results: During a 5-years study, 125 patient-unique VZV-PCR-positive CSFs were recorded, in which only 9 alternative diagnoses were noted. The commonest symptoms were headache (N = 104, 83 %) and rash (N = 96, 76 %). PCR-cycle-threshold (Ct), a surrogate of viral burden, did not significantly vary across the clinical manifestations; however, patients with rash and Ct<35 were prone to develop stroke in the following year (N = 6, 7 %). Empiric nucleoside-analogue treatment was not associated with a better outcome compared to treatment administered upon a positive-PCR result., Discussion: Our findings suggest that in patients with neurological symptoms, detection of VZV-DNA in CSF renders VZV the probable culprit. Nevertheless, a systematic evaluation of treatment and follow-up algorithms of patients with suspected or proved VZV meningitis and encephalitis is needed. The benefits of a prompt treatment should be weighed against the potential complications of nucleoside-analogue. Conversely, the propensity for stroke in patients with higher viral-burden, necessitates further studies assessing VZV causal role, directing additional workup, treatment and monitoring policy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: Atrial fibrillation (AF) catheter ablation in cancer patients has been evaluated in very few studies. We aimed to investigate utilization trends and in-hospital outcomes of AF catheter ablation among cancer patients in a large US inpatient registry. Methods: Utilizing the National Inpatient Sample (NIS) database, patients who underwent AF catheter ablation between 2012 and 2019 were identified. Sociodemographic, clinical data, in-hospital procedures and outcomes were collected. Baseline characteristics and in-hospital outcomes were compared between patients with and without cancer. Results: An estimated total of 67,915 patients underwent AF catheter ablation between 2012 and 2019 in the US. Of them, 950 (1.4%) had a cancer diagnosis. Patients with a cancer diagnosis were older and had higher Charlson Comorbidity Index, CHA2DS2-VASc and ATRIA bleeding indices scores. A higher rate of total complications was observed in cancer patients (10.5% vs. 7.9, p < 0.001), driven mainly by more bleeding and infectious complications. However, no significant differences in cardiac or neurological complications as well as in-hospital mortality rates were observed and were relatively low in both groups. Conclusions: AF catheter ablation in cancer patients is associated with higher bleeding and infectious complication rates, but not with increased cardiac complications or in-hospital mortality in a US nationwide, all-comer registry.

Background: A low-level risk of intussusception following rotavirus vaccination has been observed in some settings and may vary by vaccine type. We examined the association between RotaTeq vaccination and intussusception in low-income settings in a pooled analysis from 5 African countries that introduced RotaTeq into their national immunization program., Methods: Active surveillance was conducted at 20 hospitals to identify intussusception cases. A standard case report form was completed for each enrolled child, and vaccination status was determined by review of the child's vaccination card. The pseudo-likelihood adaptation of self-controlled case-series method was used to assess the association between RotaTeq administration and intussusception in the 1-7, 8-21, and 1-21 day periods after each vaccine dose in infants aged 28-245 days., Results: Data from 318 infants with confirmed rotavirus vaccination status were analyzed. No clustering of cases occurred in any of the risk windows after any of the vaccine doses. Compared with the background risk of naturally occurring intussusception, no increased risk was observed after dose 1 in the 1-7 day (relative incidence = 2.71; 95% confidence interval [CI] = 0.47-8.03) or the 8-21 day window (relative incidence = 0.77; 95%CI = 0.0-2.69). Similarly, no increased risk of intussusception was observed in any risk window after dose 2 or 3., Conclusions: RotaTeq vaccination was not associated with increased risk of intussusception in this analysis from 5 African countries. This finding mirrors results from similar analyses with other rotavirus vaccines in low-income settings and highlights the need for vaccine-specific and setting-specific risk monitoring., Competing Interests: Potential conflicts of interest. N. A. reports being currently employed by Pfizer, financial support from Pfizer for travel to meetings and conferences, and Pfizer stock/stock options. E.L. reports consulting fees from the WHO, payment and honoraria from GSK (recombinant zoster vaccine) and Novartis (coronavirus disease 2019) for activities unrelated to rotavirus vaccines, and participation in the Global Influenza Advisory Board for Sanofi Pasteur and Moderna. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (Published by Oxford University Press on behalf of Infectious Diseases Society of America 2023.)

Background: This study examined the interplay between engagement in social unrest, mental indicators, state-hope and demographic variables. In addition, mental indicators and state-hope were compared in line with levels of engagement in social unrest., Methods: In a cross-sectional study, conducted from March 23 to April 10, 2023, 2031 Israelis were recruited via a survey company. Participants completed self-report questionnaires to assess engagement in social unrest, anxiety, social unrest related distress, state-hope and demographic variables., Results: Participants with higher engagement in social unrest, who opposed the law reform, were prone to higher levels of social unrest related distress, anxiety, and lower levels of state-hope compared to those not engaged in social unrest activities or those who supported the law reform., Conclusions: Concerns regarding unmet mental health needs, during and following social unrest, regardless of the engagement level, should be actively addressed by mental health professionals and health policy makers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hamama-Raz, Leshem and Ben-Ezra.)

Introduction: Given the increase in youth mental health concerns, the American Academy of Pediatrics (AAP) recommends universal suicide screening for ages 12 and older, with positive screens followed by a brief suicide risk assessment. However, it is unclear how pediatric clinicians incorporate this recommendation into practice. Therefore, the objective of this qualitative study was to identify pediatric clinicians' current practice, attitudes, and barriers to implement the updated universal suicide screening recommendation in primary care., Methods: Community-based pediatric primary care providers (PCPs) in the St. Louis Metropolitan area who by self-report provide mental health care for patients participated. Participants completed a 30-minute semi-structured interview with invitations extended through an electronic listserv in a local Pediatric PCP Learning Collaborative. Interviews were transcribed and analyzed using consensual deductive and inductive approaches until data saturation., Results: Eighteen PCPs participated in the interviews. Interviews described themes related to acceptability of the recommendations, PCPs' current screening practices, and perceived barriers for implementing the recommendations. Overall, PCPs agreed with, but expressed hesitancy about, the recommendation. Frequently mentioned barriers to suicide screening included time, training, and inadequate access to resources for follow-up care for at-risk patients. Yet, PCPs were optimistic they could learn with support and were interested in working in this subject area through quality improvement interventions., Conclusions: PCPs agree with the AAP recommendation about suicide screening but need support to implement into practice. Specifically, PCPs need time sensitive strategies, resources, training, and practice change support to assist these efforts., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: It is unclear how soon after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection it is safe to resume systemic anti-neoplastic treatment in patients with cancer. We assessed the risk of admissions or postponed treatment cycle in vaccinated patients with breast cancer receiving early systemic anti-neoplastic treatment following SARS-CoV-2 infection., Methods: This was a retrospective cohort study conducted during Omicron SARS-CoV-2 outbreak in Israel, January-July 2022. SARS-CoV-2 cohort included 30 vaccinated patients with breast cancer with SARS-CoV-2 infection 7-14 days prior to systemic treatment. All patients had resolved symptoms and a negative antigen detection test on the day of treatment. The pre-coronavirus disease 2019 (COVID-19) pandemic cohort consisted of 49 matched patients with breast cancer treated with systemic anti-neoplastic agents during 2019., Results: In 30 vaccinated patients with breast cancer who received systemic anti-neoplastic treatment 7-14 days following SARS-CoV-2 infection, compared with 49 matched patients treated in 2019, the rates of emergency department (ED) visits (13% versus 6%, respectively), hospitalizations (3% versus 4%), next cycle of treatment given per protocol (90% versus 88%), and death (0% versus 0%) were similar., Conclusion: In a cohort of vaccinated patients with breast cancer who received systemic anti-neoplastic treatment 7-14 days after SARS-CoV-2 infection, we did not observe substantially higher rates of ED visits, hospitalizations, or deaths compared with a similar cohort of pre-COVID-19 patients with breast cancer. Most patients received the next planned cycle on time. Early resumption of systemic anti-neoplastic treatment following SARS-CoV-2 infection in vaccinated patients with breast cancer with a negative antigen test at the day of treatment appeared to be safe. Additional data on larger cohorts and other malignancies are needed to support clinical guidelines., (© 2023. The Author(s).)

Background: Atrial fibrillation (AF) in young adults is an uncommon and not well studied entity., Methods: Consecutive patients aged 18-45 years admitted to internal or cardiology services in a large tertiary medical center (January 1, 2009 through December 31, 2019) were included. Clinical, electrocardiographic, and echocardiographic data were compared between patients with and without AF at baseline. Predictors of new-onset AF in the young were identified using multivariate Cox regression model among patients free of baseline AF., Results: Final cohort included 16,432 patients with median age of 34 (IQR 26-41) years of whom 8914 (56 %) were men. Patients with AF at baseline (N = 366; 2 %) were older, more likely to be men, and had higher proportion of comorbidities and electrocardiographic conduction disorders. Male sex, increased age, obesity, heart failure, congenital heart disease (CHD) and the presence of left or right bundle branch block were all independently associated with baseline AF in a multivariate model (p < 0.001 for all). Sub-analysis of 10,691 (98 %) patients free of baseline AF identified 85 cases of new-onset AF during a median follow up of 3.5 (IQR 1.5-6.5) years. Multivariate model identified increased age, heart failure, and CHD as independent predictors of new-onset AF. Finally, the CHARGE-AF risk score outperformed the CHA 2 DS 2 -VASc score in AF prediction [AUC of ROC 0.75 (0.7-0.8) vs. 0.56 (0.48-0.65)]., Conclusions: AF among hospitalized young adults is not rare. Screening for new-onset AF in young post hospitalization patients may be guided by specific clinical predictors and the CHARGE-AF risk score., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The current study sheds light on the continuing bonds experience of adult Israeli daughters whose mothers were murdered by their fathers. Through 11 semi structured interviews, common externalized and internalized continuing bonds with the deceased mothers were closely examined. The interpreted results supported the existence of bonds, yet revealed a unique manifestation; the bonds were purposefully and defensively restricted, which seemed to be an adjustive compromise in light of the strong traumatic component of the loss. Our results contribute to the theoretical and clinical understanding of the restrictive effect that trauma components have on loss components in cases of traumatic bereavement.

Background: Enteroviruses (EV) comprise the single most common cause of aseptic meningitis with variable geographical and temporal epidemiology. While EV-PCR in CSF is considered a gold standard for diagnosis, it is not-uncommon to use stool EV as a surrogate. Our aim was to assess the clinical significance of EV-PCR-positive CSF and stool in the investigation of patients with neurological symptoms., Methods: In this retrospective study from Sheba Medical centre, the largest tertiary hospital in Israel, we collected demographic, clinical and laboratory data of patients with EV-PCR-positive between 2016 and 2020. A comparison between various combinations of EV-PCR-positive CSF and stool was conducted. Data regarding EV strain-type and cycle threshold (Ct) were crossed with clinical symptoms and temporal kinetics., Results: Between 2016-2020, 448 CSF samples with positive EV-PCR were recorded from unique patients, the vast majority of which were diagnosed with meningitis (98%, 443/448). Unlike the diverse strain types of EV background activity, meningitis-related EV showed a clear epidemic pattern. In comparison with the EV CSF+/Stool+ group, the EV CSF-/Stool+ group had frequently more alternative pathogens detected and a higher stool Ct-value. Clinically, EV CSF-/Stool+ patients were less febrile and more lethargic and convulsive., Discussion: The comparison of the EV CSF+/Stool+ and CSF-/Stool+ groups suggests that putative diagnosis of EV meningitis is prudent in the febrile, non-lethargic non-convulsive patients with an EV-PCR-positive stool. Otherwise, the detection of stool EV only, in a non-epidemic setup, especially with a high Ct-value, may be incidental and mandate a continuous diagnostic effort for an alternative culprit., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background Routine addition of an atrial lead during an implantable cardioverter-defibrillator (ICD) implantation for primary prevention of sudden cardiac death, in patients without pacing indications, was not shown beneficial in contemporary studies. We aimed to investigate the use and safety of single- versus dual-chamber ICD implantations in these patients. Methods and Results Using the National Inpatient Sample database, we identified patients with no pacing indications who underwent primary-prevention ICD implantation in the United States between 2015 and 2019. Sociodemographic and clinical characteristics, as well as in-hospital complications, were analyzed. Multivariable logistic regression was used to identify predictors of in-hospital complications. An estimated total of 15 940 patients, underwent ICD implantation for primary prevention of sudden cardiac death during the study period, 8860 (55.6%) received a dual-chamber ICD. The mean age was 64 years, and 66% were men. In-hospital complication rates in the dual-chamber ICD and single-chamber ICD group were 12.8% and 10.7%, respectively ( P <0.001), driven by increased rates of pneumothorax/hemothorax (4.6% versus 3.4%; P <0.001) and lead dislodgement (3.6% versus 2.3%; P <0.001) in the dual-chamber ICD group. Multivariable analyses confirmed atrial lead addition as an independent predictor for "any complications" (odds ratio [OR], 1.1 [95% CI, 1.0-1.2]), for pneumo/hemothorax (odds ratio, 1.1 [95% CI, 1.0-1.4]), and for lead dislodgement (odds ratio, 1.3 [95% CI, 1.1-1.6]). Conclusions Despite lack of evidence for clinical benefit, dual-chamber ICDs are implanted for primary prevention of sudden cardiac death in a majority of patients who do not have pacing indication. This practice is associated with increased risk of periprocedural complications. Avoidance of routine implantation of atrial leads will likely improve safety outcomes.

During July-September 2022, 14 children suffering from meningoencephalitis tested positive for Coxsackievirus B2 (8 cerebrospinal fluid, 9 stool samples). Mean age 22 months (range 0-60 months); 8 were males. Seven of the children presented with ataxia and 2 had imaging features of rhombencephalitis, not previously described in association with Coxsackievirus B2., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Aims: Previous research has shown that people with disabilities are disproportionately vulnerable to symptoms of psychological distress after exposure to armed conflict. Past work has also shown that individuals displaced by conflict are at heightened risk of post-traumatic stress. Using a national online sample of Ukrainians in the early weeks of the 2022 Russian invasion, we aim to examine associations between functional disability and symptoms of post-traumatic stress., Methods: We examined the association between levels of functional disability in the Ukrainian population and symptoms of post-traumatic stress during the 2022 Russian invasion of Ukraine. We analysed data from a national sample of 2000 participants from across this country, assessing disability using the 12-item World Health Organization Disability Assessment Schedule (WHODAS-12)(six domains of disability) and the International Trauma Questionnaire assessment of post-traumatic stress disorder (PTSD) symptomatology according to the Eleventh Edition of The International Classification of Diseases (ICD-11). Moderated regression examined the impact of displacement status on the disability-post-traumatic stress relationship., Results: Different domains of disability predicted post-traumatic stress symptoms (PTSSs) to varying extents, with overall disability score significantly associated with PTSSs. This relationship was not moderated by displacement status. Consistent with previous research, females reported higher levels of post-traumatic stress., Conclusions: In a study of a general population during a time of armed conflict, individuals with more severe disabilities were at greater risk of PTSSs. Psychiatrists and related professionals should consider pre-existing disability as a risk factor for conflict-related post-traumatic stress.

The current qualitative study aimed to examine the narrative identities of women bereaved to intimate partner femicide. Eleven adult Israeli female offspring whose biological mothers were murdered by their biological fathers were interviewed for the purpose of this study. Due to the uniqueness of their loss experience and circumstances, participants' identity is narrated as a "trisonance": They are not like their fathers, their mothers, nor as society perceives them. This very particular route for identity reconstruction as a means of psychological survival is discussed in light of the literature on identity construction and bereavement and derives recommendations for practice.

The 2022 Russian invasion of the Ukraine created a large-scale humanitarian crisis. PTSD symptoms are common amongst refugees but there is less information on the mental health of internally displaced peoples. We examined a national sample of 2,000 Ukrainians during the Russian invasion, assessing PTSD symptoms using the recent ICD-11 Results showed that displacement was associated with PTSD symptoms (non-displaced M = 11.02 [SD = 4.88], displaced within the Ukraine M = 12.55 [SD = 4.94]; displaced outside the Ukraine M = 12.90 [SD = 4.61]; F (2,1999) = 21.93; p <0.001). Findings underline the risk to those displaced inside their own country in addition to those displaced overseas., Competing Interests: Declaration of Competing Interest We declare no conflict of interest or otherwise. The paper is a purely an academic research., (Copyright © 2022. Published by Elsevier B.V.)

(1) Background: Implantable cardioverter defibrillators (ICDs) have become the standard of care in the prevention of sudden cardiac death, yet studies have shown that competing causes of death may limit ICD benefits. The Norton scale is a pressure ulcer risk score shown to have prognostic value in other fields. The purpose of this study was to assess the use of the Norton scale as an aid for ICD patient selection; (2) Methods: The study was comprised of consecutive patients who underwent defibrillator implantation at Sheba Medical Center between 2008 and 2016. A competing risk analysis was performed to assess the likelihood of death prior to device therapy; (3) Results: 695 patients were included. A total of 59 (8.5%) patients had low admission Norton scale score (ANSS) (≤14), 81 (11.7%) had intermediate ANSS (15−17), and the remainder (79.8%) had high (18−20) ANSS. The cumulative probability of all-cause mortality within one year of ICD implantation in patients with low ANSS was 30%, compared with 20% and 7% among the intermediate- and high-ANSS groups, respectively. Moreover, the one-year mortality rate without ICD therapy in low-ANSS patients was over four-fold compared with that of high-ANSS patients (33% versus 7%, p < 0.0001); (4) Conclusions: The Norton scale could be a useful additional tool in predicting the life expectancy of ICD candidates, thereby improving patient selection.

The 2022 Russian invasion of the Ukraine created a large-scale humanitarian crisis that has intensified as the conflict persists. The impact of armed conflict, such as forced migration, exposure to violence, supply shortages, destruction of infrastructure, and interruption of essential services, can have serious negative consequences for the mental health and wellbeing of Ukrainians living through the invasion and its aftermath. At the same time threat to a nation can trigger a wave of patriotism. Such feelings of patriotic belonging, love, pride and caring for a country can help maintain national group cohesion and respect for civic authorities. We studied demographic and war related factors associated with patriotic attitudes and posttraumatic stress disorder (PTSD) symptoms in a national Ukraine sample of 2000 respondents six weeks into this crisis. Respondents completed an online inventory assessing patriotic attitudes, PTSD symptoms, having relatives wounded or killed, having relatives who left Ukraine due to the war, alongside key demographics. Hierarchical regressions found that having relatives that were wounded or that left Ukraine because of the war and those coming from a Ukrainian speaking region were associated with patriotic attitudes. Patriotic attitudes were positively associated with elevated risk for PTSD symptoms. Mental health professionals should consider the potential mental health burden of existential national conflicts amongst civilian populations with strongly patriotic attitudes., Competing Interests: Declaration of competing interest None., (Copyright © 2022. Published by Elsevier Ltd.)

Background: There is cumulative evidence of the importance of exploring the change of dynamics between symptoms over time as reflective of consolidation of psychopathology., Aims: To explore the interactions between symptoms of ICD-11 adjustment disorder before and after the second lockdown of the COVID-19 pandemic in Israel and identify the most central symptoms and their concurrent and prospective associations with probable adjustment disorder., Method: This is a population-based study drawn from a probability-based internet panel. A representative sample of the adult Israeli population was assessed at two time points (T1, pre-second lockdown, n = 1029, response rate 76.17%; T2, post-second lockdown, n = 764, response rate 74.24%). Symptoms of adjustment disorder were assessed by the International Adjustment Disorder Questionnaire (IADQ)., Results: Although the overall strength of associations at the two measurement points was similar and two same communities were found, there was a significant change in their structure, with a more consolidated network at T2. The most central item was 'difficult to relax' in both networks. Cross-sectionally, all symptoms of failure to adapt significantly predicted adjustment disorder. 'Worry a lot more' (preoccupation) and 'difficult to adapt to life' (failure to adapt) at T1 significantly predicted this diagnosis at T2., Conclusions: Adjustment disorder symptoms consolidated during the second lockdown of the pandemic. In line with the ICD-11 conceptualisation of adjustment disorder, both preoccupation and failure-to-adapt symptoms have prognostic validity. This highlights the importance of identifying and targeting adjustment disorder symptoms during a period of stress such as the COVID-19 pandemic.