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Journal of Psychosomatic Research Dec 2018The importance of defense mechanisms in cancer progression and adaptation have been largely observed. However, few studies referred to the generally accepted...
The importance of defense mechanisms in cancer progression and adaptation have been largely observed. However, few studies referred to the generally accepted hierarchical organization of defenses and used validated measurements for defensive assessment. In this systematic review, we investigated the whole hierarchy of defense mechanisms and how they associate with various psychological aspects in cancer patients. A literature search was conducted using electronic databases. Among 1570 records published from 1990 to date, only 15 articles met inclusion criteria. Findings related to cancer patients' defensive functioning and its relations with other physical and psychological variables were extracted. A general consistency emerges on the role of defense mechanisms in cancer progression and recovery. Following the hierarchical organization of defenses, higher physical and emotional functioning emerged as being associated with High-adaptive defenses, while Mental Inhibition defenses, in particular repression, promote psychosomatic symptoms, passive decisional preferences and worse physical and emotional health. Disavowal defenses foster lower anxiety and higher emotional functioning by denying anxiety about death. Image distortion defenses, including both Minor and Major image-distorting defenses, were more frequent in cancer patients than in control groups and finally, Action defenses predicted sleep disturbance and lower survival probability. The early detection of maladaptive defensive functioning may foster appropriate psychotherapeutic intervention and prevent worsening of the illness. Further investigations are required to replicate these findings and highlight associations between defense mechanisms and various aspects of mental functioning in cancer patients.
Topics: Adult; Defense Mechanisms; Female; Humans; Male; Neoplasms
PubMed: 30470322
DOI: 10.1016/j.jpsychores.2018.10.016 -
Plastic and Reconstructive Surgery Jun 2016Facial feminization surgery encompasses a broad range of craniomaxillofacial surgical procedures designed to change masculine facial features into feminine features. The... (Review)
Review
BACKGROUND
Facial feminization surgery encompasses a broad range of craniomaxillofacial surgical procedures designed to change masculine facial features into feminine features. The surgical principles of facial feminization surgery can be applied to male-to-female transsexuals and anyone desiring feminization of the face. Although the prevalence of these procedures is difficult to quantify, because of the rising prevalence of transgenderism (approximately one in 14,000 men) along with improved insurance coverage for gender-confirming surgery, surgeons versed in techniques, outcomes, and challenges of facial feminization surgery are needed. This review is designed to critically appraise the current facial feminization surgery literature.
METHODS
A comprehensive literature search of the Medline, PubMed, and EMBASE databases was conducted for studies published through October of 2014 with multiple search terms related to facial feminization. Data on techniques, outcomes, complications, and patient satisfaction were collected.
RESULTS
Fifteen articles were selected and reviewed from the 24 identified, all of which were either retrospective or case series/reports. Articles covered a variety of facial feminization procedures. A total of 1121 patients underwent facial feminization surgery, with seven complications reported, although many articles did not explicitly comment on complications. Satisfaction was high, although most studies did not use validated or quantified approaches to address satisfaction.
CONCLUSIONS
Facial feminization surgery appears to be safe and satisfactory for patients. Further studies are required to better compare different techniques to more robustly establish best practices. Prospective studies and patient-reported outcomes are needed to establish quality-of-life outcomes for patients. However, based on these studies, it appears that facial feminization surgery is highly efficacious and beneficial to patients.
Topics: Face; Female; Feminization; Humans; Male; Rhytidoplasty; Transsexualism
PubMed: 27219232
DOI: 10.1097/PRS.0000000000002171 -
International Journal of Impotence... Dec 2020The aim of the present systematic review is to evaluate the impact of gender reassignment surgery on the development of urethral complication. A systematic search in... (Review)
Review
The aim of the present systematic review is to evaluate the impact of gender reassignment surgery on the development of urethral complication. A systematic search in accordance the Preferred Reporting Items for Systematic Review and Meta-Analyses statement for original articles published up until June 2019 was performed using the Pubmed, Scopus, Embase, and Web of Science databases. Pooled analyses were done when appropriate. The bibliographic search with the included terms (("Transsexualism"[Mesh])) AND ("Sex Reassignment Surgery"[Mesh]) produced a literature of 879 articles altogether. After removing papers of not interest or articles in which the outcomes could not be deduced, 32 studies were examined for a total of 3463 patients screened. Thirty-two studies met our inclusion criteria and were evaluated, and references were manually reviewed in order to include additional relevant studies in this review. Female-to-male (FtM) surgery and male-to-female (MtF) surgery was discussed in 23 and 10 studies, respectively. One study discussed both. Varying patterns of complications were observed in FtM and MtF surgeries, with increased complications in the former because of the larger size of the neourethra. Meatal stenosis is a particular concern in MtF surgery, with complication rates ranging from 4 to 40%, and usually require meatotomy for repair. Stricture and fistulization are frequently reported complications following FtM surgery. In studies reporting on fistulae involving the urethra, 19-54% of fistulae resolved spontaneously without further surgical intervention. High rates of complications are reported in the current literature, which should be understood by patients and practitioners alike. Shared decision making with patients regarding incidence and management of urethral complications including stricture disease and fistulae, particularly after FtM surgery, is critical for setting expectations and managing postoperative outcomes.
Topics: Female; Humans; Male; Sex Reassignment Surgery; Transsexualism; Urethra
PubMed: 32488213
DOI: 10.1038/s41443-020-0304-y -
Mutation Research. Reviews in Mutation... 2023The development of resistance by tumor cells to various types of therapy is a significant problem that decreases the effectiveness of oncology treatments. For more than... (Review)
Review
The development of resistance by tumor cells to various types of therapy is a significant problem that decreases the effectiveness of oncology treatments. For more than two decades, comparative transcriptomic studies of tumor cells with different sensitivities to ionizing radiation and chemotherapeutic agents have been conducted in order to identify the causes and mechanisms underlying this phenomenon. However, the results of such studies have little in common and often contradict each other. We have assumed that a systematic analysis of a large number of such studies will provide new knowledge about the mechanisms of development of therapeutic resistance in tumor cells. Our comparison of 123 differentially expressed gene (DEG) lists published in 98 papers suggests a very low degree of consistency between the study results. Grouping the data by type of genotoxic agent and tumor type did not increase the similarity. The most frequently overexpressed genes were found to be those encoding the transport protein ABCB1 and the antiviral defense protein IFITM1. We put forward a hypothesis that the role played by the overexpression of the latter in the development of resistance may be associated not only with the stimulation of proliferation, but also with the limitation of exosomal communication and, as a result, with a decrease in the bystander effect. Among down regulated DEGs, BNIP3 was observed most frequently. The expression of BNIP3, together with BNIP3L, is often suppressed in cells resistant to non-platinum genotoxic chemotherapeutic agents, whereas it is increased in cells resistant to ionizing radiation. These observations are likely to be mediated by the binary effects of these gene products on survival, and regulation of apoptosis and autophagy. The combined data also show that even such obvious mechanisms as inhibition of apoptosis and increase of proliferation are not universal but show multidirectional changes.
Topics: Humans; Gene Expression Profiling; Transcriptome; RNA; Apoptosis; DNA Damage
PubMed: 37657754
DOI: 10.1016/j.mrrev.2023.108467 -
Sensors (Basel, Switzerland) Jul 2021The concepts brought by Industry 4.0 have been explored and gradually applied.The cybersecurity impacts on the progress of Industry 4.0 implementations and their... (Review)
Review
The concepts brought by Industry 4.0 have been explored and gradually applied.The cybersecurity impacts on the progress of Industry 4.0 implementations and their interactions with other technologies require constant surveillance, and it is important to forecast cybersecurity-related challenges and trends to prevent and mitigate these impacts. The contributions of this paper are as follows: (1) it presents the results of a systematic review of industry 4.0 regarding attacks, vulnerabilities and defense strategies, (2) it details and classifies the attacks, vulnerabilities and defenses mechanisms, and (3) it presents a discussion of recent challenges and trends regarding cybersecurity-related areas for Industry 4.0. From the systematic review, regarding the attacks, the results show that most attacks are carried out on the network layer, where dos-related and mitm attacks are the most prevalent ones. Regarding vulnerabilities, security flaws in services and source code, and incorrect validations in authentication procedures are highlighted. These are vulnerabilities that can be exploited by dos attacks and buffer overflows in industrial devices and networks. Regarding defense strategies, Blockchain is presented as one of the most relevant technologies under study in terms of defense mechanisms, thanks to its ability to be used in a variety of solutions, from Intrusion Detection Systems to the prevention of Distributed dos attacks, and most defense strategies are presented as an after-attack solution or prevention, in the sense that the defense mechanisms are only placed or thought, only after the harm has been done, and not as a mitigation strategy to prevent the cyberattack. Concerning challenges and trends, the review shows that digital sovereignty, cyber sovereignty, and data sovereignty are recent topics being explored by researchers within the Industry 4.0 scope, and GAIA-X and International Data Spaces are recent initiatives regarding data sovereignty. A discussion of trends is provided, and future challenges are pointed out.
Topics: Blockchain; Computer Security; Forecasting; Industry; Technology
PubMed: 34372425
DOI: 10.3390/s21155189 -
Antioxidants (Basel, Switzerland) Nov 2022Background: A decrease in serum paraoxonase (PON-1) and arylesterase (ARE) activity has been reported in rheumatoid arthritis (RA) patients and linked to chronic... (Review)
Review
Background: A decrease in serum paraoxonase (PON-1) and arylesterase (ARE) activity has been reported in rheumatoid arthritis (RA) patients and linked to chronic inflammation and impaired antioxidant defense. Methods: A systematic review and meta-analysis were performed to critically appraise the current evidence on plasma/serum concentrations of PON-1 and ARE activity in RA patients and healthy controls. The Web of Science, PubMed, Scopus, and Google Scholar databases were searched from inception to November 2021. We used random-effects meta-analysis. The risk of bias was estimated using the Joanna Briggs Institute Critical Appraisal Checklist tool. The certainty of the evidence was assessed with GRADE. The study complied with the PRISMA statements and was registered in PROSPERO (CRD42022345380). Results: Seventeen studies reported PON-1 activity (1144 RA patients, 797 controls) and ten reported ARE activity (1367 RA patients, 1037 controls). RA patients had significantly lower PON-1 (SMD = −1.32, 95% CI −1.94 to −0.70; p < 0.001) and ARE activity (SMD = −0.91, 95% CI −1.37 to −0.46; p < 0.001). There was substantial heterogeneity (PON, I2 97%; ARE, 95.7%, p < 0.001 for both). There was no publication bias. The pooled SMD values did not significantly change after sensitivity analysis. The certainty of the evidence was very low due to the observational nature of the studies and the large heterogeneity. Conclusion: Our meta-analysis has shown that both serum PON-1 and ARE activity are significantly lower in RA patients, suggesting a deficit in antioxidant defense mechanisms in this disease.
PubMed: 36552525
DOI: 10.3390/antiox11122317 -
Psycho-oncology Sep 2022The purpose of this review was to synthesise the literature on the topic of masculinity and testicular cancer (TC) and investigate the relative impact of TC on men's... (Review)
Review
OBJECTIVE
The purpose of this review was to synthesise the literature on the topic of masculinity and testicular cancer (TC) and investigate the relative impact of TC on men's view of their masculinity.
METHODS
Searches were conducted across four databases (MEDline, PsycInfo, CINAHL Plus and Scopus) for articles published before April 2022 that included (1) TC and (2) masculinity. Two researchers independently rated studies for inclusion with a third resolving conflicts. Of the 6464 articles screened, 24 articles (10 quantitative and 14 qualitative) were included in the review. Articles were rated for quality and a narrative synthesis was performed.
RESULTS
Overall, results indicated some men experience a shift in the way they relate to their sense of masculinity following diagnosis and treatment for TC. Being single and without children was related to the experience of negative masculinity-related outcomes, possibly due to a compounding lack of relational support and being unable to conform to protector, provider traditions. Men who described testicle loss as symbolic of their diminished masculinity were also negatively impacted. However, recent, high-quality literature on the topic using standardised masculinity measures was limited.
CONCLUSION
Some men experience a reduced sense of masculinity after TC, however the impact of TC on masculinity remains person dependent. Further research using validated masculinity measures is required to uncover psycho-social variables that may account for whether and how meaning is made between TC and its treatment and any subsequent impact on perceived masculinity. Such factors may better support these men in life beyond cancer.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO. International Prospective Register of Systematic Reviews: CRD42020185649.
Topics: Child; Humans; Male; Masculinity; Neoplasms, Germ Cell and Embryonal; Testicular Neoplasms
PubMed: 35789023
DOI: 10.1002/pon.5994 -
The International Journal of Eating... May 2021The experience of sexual harassment (SH) may exacerbate the drive toward an ideal and often unattainable physical appearance, creating the foundation of unhealthy... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The experience of sexual harassment (SH) may exacerbate the drive toward an ideal and often unattainable physical appearance, creating the foundation of unhealthy eating, and greater shape and weight concerns. This systematic review aimed to synthesize evidence on the relationship between SH and eating disorder psychopathology, as well as mediating and moderating factors that contribute to this relationship.
METHOD
Six key databases were searched from inception to August 2020; including CINAHL, PsycInfo, PubMed, Medline, Scopus, and Web of Science.
RESULTS
Overall, 15 studies meeting inclusion criteria were found, with 14 reporting a statistically significant relationship between SH and eating disorder psychopathology. A meta-analysis with 12 cross-sectional studies confirmed a small but significant effect for this concurrent association. Moderators of this relationship included gender, posttraumatic stress, and anxiety. No studies in this review conducted true mediation.
DISCUSSION
Conclusions about causal and mediating relationship between SH and eating disorder psychopathology are constrained by the preponderance of cross-sectional design (14 of the 15 studies). Therefore, it is recommended that future studies focus on the use of longitudinal design, and also on adolescent populations, where first experiences of SH are usually reported, and which is also the peak age of onset for eating disorders.
Topics: Adolescent; Cross-Sectional Studies; Feeding and Eating Disorders; Gender Identity; Humans; Psychopathology; Sexual Harassment
PubMed: 33751633
DOI: 10.1002/eat.23499 -
Psychological Bulletin Mar 2015Despite the widely held belief that men are more narcissistic than women, there has been no systematic review to establish the magnitude, variability across measures and... (Meta-Analysis)
Meta-Analysis Review
Despite the widely held belief that men are more narcissistic than women, there has been no systematic review to establish the magnitude, variability across measures and settings, and stability over time of this gender difference. Drawing on the biosocial approach to social role theory, a meta-analysis performed for Study 1 found that men tended to be more narcissistic than women (d = .26; k = 355 studies; N = 470,846). This gender difference remained stable in U.S. college student cohorts over time (from 1990 to 2013) and across different age groups. Study 1 also investigated gender differences in three facets of the Narcissistic Personality Inventory (NPI) to reveal that the narcissism gender difference is driven by the Exploitative/Entitlement facet (d = .29; k = 44 studies; N = 44,108) and Leadership/Authority facet (d = .20; k = 40 studies; N = 44,739); whereas the gender difference in Grandiose/Exhibitionism (d = .04; k = 39 studies; N = 42,460) was much smaller. We further investigated a less-studied form of narcissism called vulnerable narcissism-which is marked by low self-esteem, neuroticism, and introversion-to find that (in contrast to the more commonly studied form of narcissism found in the DSM and the NPI) men and women did not differ on vulnerable narcissism (d = -.04; k = 42 studies; N = 46,735). Study 2 used item response theory to rule out the possibility that measurement bias accounts for observed gender differences in the three facets of the NPI (N = 19,001). Results revealed that observed gender differences were not explained by measurement bias and thus can be interpreted as true sex differences. Discussion focuses on the implications for the biosocial construction model of gender differences, for the etiology of narcissism, for clinical applications, and for the role of narcissism in helping to explain gender differences in leadership and aggressive behavior. Readers are warned against overapplying small effect sizes to perpetuate gender stereotypes.
Topics: Female; Gender Identity; Humans; Male; Narcissism; Personality; Personality Disorders; Self Concept; Sex Characteristics; Students
PubMed: 25546498
DOI: 10.1037/a0038231 -
Canadian Journal of Psychiatry. Revue... May 2021Suicide in Canadian men is high and rising. Research consistently indicates increased suicide risk in male subgroups including sexual minority, Indigenous, middle-aged,... (Review)
Review
OBJECTIVE
Suicide in Canadian men is high and rising. Research consistently indicates increased suicide risk in male subgroups including sexual minority, Indigenous, middle-aged, and military men. The current scoping review addresses the research question: Among male subgroups featured in Canadian suicide research, what are the key findings to inform suicide prevention efforts?.
METHOD
A scoping review was undertaken in accord with PRISMA-ScR guidelines. Structured searches were conducted in CIHAHL, Medline, PsychInfo, and Web of Science to identify studies reporting suicidality (suicidal ideation, plans and/or attempts) and suicide among men in Canada. Inclusion criteria comprised primary empirical studies featuring Canadian male subgroups published in English from 2009 to 2020 inclusive.
RESULTS
Sixty-eight articles met the inclusion criteria, highlighting significant rates of male suicidality and/or suicide in 3 categories: (1) health inequities ( = 29); (2) age-specific ( = 30); and (3) occupation ( = 9). The health inequities category included sexual minority men, Indigenous, and other marginalized males (i.e., homeless, immigrant men, and men who use opiates). Age-specific men focused on adolescents and youth, and middle-aged and older males. Active military, veterans, and first responders featured in the occupation category. Studies compared at risk male subgroups to females, general male populations, and/or other marginalized groups in emphasizing mental health disparities and increased suicide risk. Some men's suboptimal connections to existing mental health care services were also highlighted.
CONCLUSION
While male subgroups who are vulnerable to suicidality and suicide were consistently described, these insights have not translated to tailored upstream suicide prevention services for Canadian boys and men. There may be some important gains through integrating social and mental health care services for marginalized men, implementing school-based masculinity programs for adolescent males, orientating clinicians to the potential for men's mid-life suicide risks (i.e., separation, bereavement, retirement) and lobbying employers to norm help-seeking among activate military, veterans, and first responder males.
Topics: Adolescent; Aged; Canada; Female; Humans; Male; Masculinity; Men's Health; Middle Aged; Suicidal Ideation; Suicide Prevention
PubMed: 33719600
DOI: 10.1177/07067437211000631