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1.
Cytotherapy ; 2024 Jun 12.
Article in English | MEDLINE | ID: mdl-38958627

ABSTRACT

Since their first production in 2007, human induced pluripotent stem cells (iPSCs) have provided a novel platform for the development of various cell therapies targeting a spectrum of diseases, ranging from rare genetic eye disorders to cancer treatment. However, several challenges must be tackled for iPSC-based cell therapy to enter the market and achieve broader global adoption. This white paper, authored by the Japanese Society for Regenerative Medicine (JSRM) - International Society for Cell Therapy (ISCT) iPSC Committee delves into the hurdles encountered in the pursuit of safe and economically viable iPSC-based therapies, particularly from the standpoint of the cell therapy industry. It discusses differences in global guidelines and regulatory frameworks, outlines a series of quality control tests required to ensure the safety of the cell therapy, and provides details and important considerations around cost of goods (COGs), including the impact of automated advanced manufacturing.

2.
Article in English | MEDLINE | ID: mdl-38852706

ABSTRACT

BACKGROUND: Preoperative opioid users (POU) experience worse outcomes and higher complication rates compared to opioid naïve patients (ONP) following shoulder arthroplasty. This study evaluates the effects of socioeconomic status (SES), as measured by the distressed communities index (DCI), on pre- and postoperative opioid use and its influence on clinical outcomes such as readmission and revision surgery. METHODS: A retrospective review of patients who underwent primary shoulder arthroplasty (CPT code 23472) from 2014-2022 at a single academic institution was performed. Exclusion criteria included arthroplasty for fracture, active malignancy, and revision arthroplasty. Demographics, Charlson Comorbidity Index (CCI), DCI, and clinical outcomes including 90-day readmission and revision surgery were collected. Patients were classified according to the DCI score of their zip code. Using the Prescription Drug Monitoring Program database, patient pre- and postoperative opioid use in morphine milligram equivalents (MME) was gathered. RESULTS: Individuals from distressed communities utilized more opioids within 90 days preoperatively compared to patients from prosperous, comfortable, mid-tier, and at-risk populations respectively. Patients from distressed communities also used significantly more opioids within 90 days postoperatively compared to prosperous, comfortable, and mid-tier respectively. Of patients from distressed communities, 35.1% developed prolonged opioid use (filling prescriptions >30 days after surgery), significantly more than all other cohorts. Among all patients, 3.5% were readmitted within 90 days and were more likely to be prolonged opioid users (38.9 vs 21.3%, p<0.001). Similarly, 1.5% of patients underwent revision surgery. Those who underwent revision were significantly more likely to be prolonged opioid users (38.2 vs 21.7%, p=0.002). CONCLUSIONS: Shoulder arthroplasty patients from distressed communities use more opioids within 90 days before and after their surgery and are more likely to become prolonged opioid users placing them at risk for readmission and revision surgery. Identifying patients at an increased risk for excess opioid use is essential to employ appropriate strategies that minimize the detrimental effects of prolonged use following surgery.

3.
Heliyon ; 10(11): e31597, 2024 Jun 15.
Article in English | MEDLINE | ID: mdl-38828302

ABSTRACT

Background: Only 12% of Kenyan women use breast cancer (BC)screening programs. Early identification is critical for reducing the condition's associated morbidity and mortality. Unfortunately, few studies have been conducted on the screening program's implementation and the causes for the low usage rates in Turbo Sub-County, Kenya. The purpose of this study was to learn about women of reproductive age's (WRA) practices, attitudes, and knowledge regarding BC screening programs, as well as to investigate the potential association between lifestyle factors and BC screening service utilization. Methods: Mixed-method approaches were used in an analytical cross-sectional study design. The study included 317 participants selected randomly. An interviewer-administered questionnaire was used to collect quantitative data while focus group discussion (FGD) and key informant interview (KII) guides were used for collecting qualitative data. The Statistical Package for Social Sciences (SPSS) version 26 was used to manage quantitative data, whereas NVivo version 12 was used to analyze qualitative data. Chi-square, Fisher's exact test, and multiple logistic regression were used to assess the degree of relationship between BC screening service uptake and independent variables. The qualitative data was transcribed verbatim, and the transcripts were automatically coded to generate themes. Results: The participants' mean age was 30.14 (9.64). Breast cancer screening services were used by 10.21% of the population. Women who were aware of the signs and symptoms of BC were 71.5 times more likely to undergo screening than their counterparts. Similarly, those with positive attitudes toward BC and screening programs were 84 times more likely to get screened than those with negative attitudes. Breastfeeding increased the likelihood of BC screening by OR = 37 (95% CI: 0.00-0.32), physical activity by OR = 37 (95% CI: 0.00-0.25), and chronic illnesses by OR = 37 (95% CI: 0.00-0.17). Conclusion: Knowledge of signs and symptoms of BC and a positive attitude towards perceived barriers enhanced the probabilities of BC screening. Being physically active, breastfeeding, and having a chronic disease all increased the odds of BC screening uptake. To improve screening rates, it is necessary to provide sufficient information to those who are least likely to be screened.

4.
J Cutan Pathol ; 2024 Jun 25.
Article in English | MEDLINE | ID: mdl-38923071

ABSTRACT

The potential adverse health effects of antiperspirant use are of interest to patients, primary care providers, dermatologists, and pathologists. In rare instances, antiperspirants containing aluminum-zirconium complexes have been associated with granulomatous dermatoses despite being deemed non-sensitizing in experiments. In this case study, we present a detailed examination of an axillary granuloma in a 28-year-old female who had been using an aluminum-zirconium-based antiperspirant for several years and presented with a left axillary nodule that was excised and analyzed using scanning electron microscopy with energy-dispersive x-ray analysis (SEM/EDXA). Histopathological examination revealed a foreign body-type reaction with amphophilic granular material within giant cells that corresponded to collocated zirconium and aluminum on SEM/EDXA elemental maps. Our case adds to the limited reports of axillary granulomas related to aluminum-zirconium complexes. It illustrates the histopathological appearance and in situ distribution of the aluminum-zirconium complexes, supporting the formation of foreign body-type granulomas. Additionally, our case study illustrates the potential role of these compounds in such reactions and aims to increase awareness among pathologists and clinicians.

5.
J Wrist Surg ; 13(3): 282-292, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38808186

ABSTRACT

Background Dorsal bridge plating (DP) of the distal radius is used as a definitive method of stabilization in complex fracture configurations and polytrauma patients. Questions/Purposes This review aims to summarize the current understanding of DP and evaluate surgical outcomes. Methods Four databases were searched following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and registered with PROSPERO. Papers presenting outcome or complication data for DP were included. These were reviewed using the National Institutes of Health Quality Assessment and Methodological Index for Non-Randomised Studies tools. Results were collated and compared to a local cohort of DP patients. Results Literature review identified 416 patients with a pooled complication rate of 17% requiring additional intervention. The most prevalent complications were infection/wound healing issues, arthrosis, and hardware failure. Average range of motion was flexion 46.5 degrees, extension 50.7 degrees, ulnar deviation 21.4 degrees, radial deviation 17.3 degrees, pronation 75.8 degrees, and supination 72.9 degrees. On average, DP removal occurred at 3.8 months. Quality assessment showed varied results. There were 19 cases in our local cohort. Ten displayed similar results to the systematic review in terms of range of motion and radiographic parameters. Higher QuickDASH scores and complication rates were noted. Local DP showed earlier plate removal at 2.9 months compared to previous studies. Conclusion DP is a valid and useful technique for treating complex distal radius fractures. It displays a lower risk of infection and pain compared to external fixation which is commonly used to treat similar injuries. Patients can recover well following treatment both in function and range of motion. Further high-quality studies are required to fully evaluate the technique.

6.
Eat Disord ; : 1-22, 2024 May 30.
Article in English | MEDLINE | ID: mdl-38814278

ABSTRACT

BACKGROUND: Self-stigma of seeking psychological help is a critical factor prohibiting individuals from seeking eating disorder (ED) treatment, but has been widely unexplored in racial/ethnic and sexual minority (SM) samples. The current study examined differences in ED pathology and self-stigma of help-seeking at the intersection of race and gender within a cisgender SM sample. METHODS: Cisgender SM participants (n = 354) identifying as Black, Indigenous, or People of Color (BIPOC; 52%), Asian American and Pacific Islander (AAPI; 24%), or White (24%) were recruited through Prolific Academic. One-way analyses of variance were used to examine differences in the Self-Stigma of Seeking Help Scale (SSOSH) and Eating Pathology Symptom Inventory (EPSI) subscales among men and women in each group. Pearson's correlations explored associations between SSOSH and EPSI subscales within each subgroup. RESULTS: Findings indicated significant between-group differences on the SSOSH and the EPSI subscales of Body Dissatisfaction, Purging, and Excessive Exercise. SSOSH was significantly positively correlated with Body Dissatisfaction in the White SM cis-women group and Binge Eating in the BIPOC SM cis-men group. CONCLUSIONS: Results demonstrate unique, intersectional between-group differences in ED pathology and self-stigma among SM individuals. Further research on the impact of intersectionality on these constructs within larger samples is warranted.

7.
Article in English | MEDLINE | ID: mdl-38548094

ABSTRACT

BACKGROUND: As the rate of total shoulder arthroplasty (TSA) and preoperative benzodiazepine use rise, there is an increased need to understand the impact of preoperative benzodiazepine use on postoperative opioid consumption following TSA, especially amid the current opioid epidemic. The relationship between preoperative benzodiazepine use and chronic opioid use postoperatively has been well described following other orthopedic procedures; however, the impact on patients undergoing TSA remains unclear. This study aims to identify the impact of preoperative benzodiazepine use on opioid use following TSA. METHODS: A retrospective chart review of 4488 patients undergoing primary TSA (Current Procedural Terminology code 23472) at a single institution from 2014 to 2022 was performed. Patient demographics, surgical variables, comorbidities, Distressed Communities Index (DCI), and clinical outcomes, including readmission and revision, were collected. The Charlson Comorbidity Index (CCI) was used to assess preoperative health status. Opioid use in morphine milligram equivalents (MMEs) and benzodiazepine use were also recorded using the Prescription Drug Monitoring Program Database. Opioid use was collected at 30-, 60-, and 90-day intervals both before and after each patient's date of surgery. Statistical analysis included stepwise logistic regression to identify variables independently affecting benzodiazepine use pre- and postoperatively. RESULTS: Overall, 16% of patients used benzodiazepines within 90 days before their date of surgery. Of those patients, 46.4% were also using preoperative opioids, compared with just 30.0% of patients who were benzodiazepine-naïve (P < .001). Preoperative benzodiazepine use was also associated with increased pre- and postoperative total opioid use in MMEs and the number of opioid prescriptions across all time points when compared to benzodiazepine-naïve patients (P < .001). Furthermore, 37.4% of preoperative benzodiazepine users went on to prolonged opioid use (filled prescriptions >30 days after surgery) compared to 19.0% of those who were benzodiazepine-naïve (P < .001). CONCLUSION: This study demonstrates a significant association between preoperative benzodiazepine use and increased and prolonged opioid use following TSA. Further exploration of risk factors contributing to preoperative benzodiazepine use may help to reduce overall opioid use in patients undergoing TSA.

8.
Neurobiol Learn Mem ; 211: 107915, 2024 May.
Article in English | MEDLINE | ID: mdl-38527649

ABSTRACT

Rat autoshaping procedures generate two readily measurable conditioned responses: During lever presentations that have previously signaled food, rats approach the food well (called goal-tracking) and interact with the lever itself (called sign-tracking). We investigated how reinforced and nonreinforced trials affect the overall and temporal distributions of these two responses across 10-second lever presentations. In two experiments, reinforced trials generated more goal-tracking than sign-tracking, and nonreinforced trials resulted in a larger reduction in goal-tracking than sign-tracking. The effect of reinforced trials was evident as an increase in goal-tracking and reduction in sign-tracking across the duration of the lever presentations, and nonreinforced trials resulted in this pattern transiently reversing and then becoming less evident with further training. These dissociations are consistent with a recent elaboration of the Rescorla-Wagner model, HeiDI (Honey, R.C., Dwyer, D.M., & Iliescu, A.F. (2020a). HeiDI: A model for Pavlovian learning and performance with reciprocal associations. Psychological Review, 127, 829-852.), a model in which responses related to the nature of the unconditioned stimulus (e.g., goal-tracking) have a different origin than those related to the nature of the conditioned stimulus (e.g., sign-tracking).


Subject(s)
Conditioning, Classical , Reinforcement, Psychology , Animals , Male , Rats , Conditioning, Classical/physiology , Conditioning, Operant/physiology , Goals , Behavior, Animal/physiology
9.
Environ Toxicol Chem ; 43(5): 1161-1172, 2024 May.
Article in English | MEDLINE | ID: mdl-38415890

ABSTRACT

Hydraulic fracturing (HF) is commonly used to enhance onshore recovery of oil and gas during production. This process involves the use of a variety of chemicals to support the physical extraction of oil and gas, maintain appropriate conditions downhole (e.g., redox conditions, pH), and limit microbial growth. The diversity of chemicals used in HF presents a significant challenge for risk assessment. The objective of the present study is to establish a transparent, reproducible procedure for estimating 5th percentile acute aquatic hazard concentrations (e.g., acute hazard concentration 5th percentiles [HC5s]) for these substances and validating against existing toxicity data. A simplified, grouped target site model (gTSM) was developed using a database (n = 1696) of diverse compounds with known mode of action (MoA) information. Statistical significance testing was employed to reduce model complexity by combining 11 discrete MoAs into three general hazard groups. The new model was trained and validated using an 80:20 allocation of the experimental database. The gTSM predicts toxicity using a combination of target site water partition coefficients and hazard group-based critical target site concentrations. Model performance was comparable to the original TSM using 40% fewer parameters. Model predictions were judged to be sufficiently reliable and the gTSM was further used to prioritize a subset of reported Permian Basin HF substances for risk evaluation. The gTSM was applied to predict hazard groups, species acute toxicity, and acute HC5s for 186 organic compounds (neutral and ionic). Toxicity predictions and acute HC5 estimates were validated against measured acute toxicity data compiled for HF substances. This case study supports the gTSM as an efficient, cost-effective computational tool for rapid aquatic hazard assessment of diverse organic chemicals. Environ Toxicol Chem 2024;43:1161-1172. © 2024 ExxonMobil Petroleum and Chemical BV. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.


Subject(s)
Hydraulic Fracking , Organic Chemicals , Water Pollutants, Chemical , Water Pollutants, Chemical/toxicity , Risk Assessment , Organic Chemicals/toxicity , Animals , Computer Simulation , Environmental Monitoring/methods
10.
Personal Ment Health ; 18(2): 157-165, 2024 May.
Article in English | MEDLINE | ID: mdl-38378990

ABSTRACT

Borderline personality disorder (BPD) is associated with greater substance use. Emotion dysregulation has been implicated in both BPD and substance use, yet there is limited research examining the role of emotion dysregulation in the BPD-substance use relation. We examined the independent and interactive associations of BPD symptoms and emotion dysregulation in reported drug use over 1 year. Participants (N = 143) were over-recruited for BPD, assessed via interview, and completed measures of negative and positive emotion dysregulation. Drug use frequency was assessed with monthly surveys over a 1-year period. Results demonstrated interrelations among BPD symptoms and both negative and positive emotion dysregulation. However, when modeling BPD and emotion dysregulation together, only higher BPD symptoms were associated with more frequent drug use. Findings support the relation of BPD symptoms and emotion dysregulation but suggest that emotion dysregulation may not account for drug use frequency above and beyond BPD in community-recruited populations.


Subject(s)
Borderline Personality Disorder , Emotional Regulation , Substance-Related Disorders , Humans , Female , Substance-Related Disorders/epidemiology , Male , Adult , Longitudinal Studies , Young Adult , Affective Symptoms , Middle Aged , Adolescent , Emotions
11.
Eat Disord ; : 1-16, 2024 Feb 20.
Article in English | MEDLINE | ID: mdl-38375554

ABSTRACT

Prior research has been conflicted on whether gay community involvement serves as a risk or protective factor for body image and eating disorders (EDs) in sexual minority men (SMM), perhaps given that prior research has examined community involvement unidimensionally. The present study examined whether non-appearance-based ("social activism") and appearance-based ("going out/nightlife") community involvement differentially predicted ED prevention outcomes in SMM. SMM (N = 73) enrolled in a randomized controlled trial of an ED prevention program completed measures of community involvement, drive for muscularity, body dissatisfaction, and bulimic symptoms at pre-intervention, post-intervention, and 1-month follow-up. "Social activism" community involvement moderated intervention effects for drive for muscularity and body dissatisfaction scores, but not bulimic symptoms, such that those who placed higher importance on social activism demonstrated expected improvements, while those who placed lower importance on social activism did not exhibit expected improvements. "Going out/nightlife" community involvement did not moderate intervention outcomes; however, greater importance of going out/nightlife was associated with increased body dissatisfaction. Findings support that the impact of community involvement on body image and ED risk for SMM may be nuanced. Encouraging community involvement through activism could help enhance ED prevention efforts for SMM.

12.
Plast Reconstr Surg Glob Open ; 12(1): e5559, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38264442

ABSTRACT

Background: This study aimed to evaluate a novel, multi-site, technology-facilitated education and training course in peripheral nerve surgery. The program was developed to address the training gaps in this specialized field by integrating a structured curriculum, high-fidelity cadaveric dissection, and surgical simulation with real-time expert guidance. Methods: A collaboration between the Global Nerve Foundation and Esser Masterclass facilitated the program, which was conducted across three international sites. The curriculum was developed by a panel of experienced peripheral nerve surgeons and included both text-based and multimedia resources. Participants' knowledge and skills were assessed using pre- and postcourse questionnaires. Results: A total of 73 participants from 26 countries enrolled and consented for data usage for research purposes. The professional background was diverse, including hand surgeons, plastic surgeons, orthopedic surgeons, and neurosurgeons. Participants reported significant improvements in knowledge and skills across all covered topics (p < 0.001). The course received a 100% recommendation rate, and 88% confirmed that it met their educational objectives. Conclusions: This study underscores the potential of technology-enabled, collaborative expert-led training programs in overcoming geographical and logistical barriers, setting a new standard for globally accessible, high-quality surgical training. It highlights the practical and logistical challenges of multi-site training, such as time zone differences and participant fatigue. It also provides practical insights for future medical educational endeavors, particularly those that aim to be comprehensive, international, and technologically facilitated.

13.
Cell Host Microbe ; 32(2): 181-190.e9, 2024 Feb 14.
Article in English | MEDLINE | ID: mdl-38228143

ABSTRACT

The early microbial colonization of the gastrointestinal tract can have long-term impacts on development and health. Keystone species, including Bacteroides spp., are prominent in early life and play crucial roles in maintaining the structure of the intestinal ecosystem. However, the process by which a resilient community is curated during early life remains inadequately understood. Here, we show that a single sialidase, NanH, in Bacteroides fragilis mediates stable occupancy of the intestinal mucosa in early life and regulates a commensal colonization program. This program is triggered by sialylated glycans, including those found in human milk oligosaccharides and intestinal mucus. NanH is required for vertical transmission from dams to pups and promotes B. fragilis dominance during early life. Furthermore, NanH facilitates commensal resilience and recovery after antibiotic treatment in a defined microbial community. Collectively, our study reveals a co-evolutionary mechanism between the host and microbiota mediated through host-derived glycans to promote stable colonization.


Subject(s)
Ecosystem , Neuraminidase , Humans , Bacteroides fragilis , Intestinal Mucosa/microbiology , Polysaccharides
14.
Plast Reconstr Surg Glob Open ; 12(1): e5537, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38260759

ABSTRACT

The lumbosacral plexus is the network of nerves responsible for the motor and sensory function of the pelvis and lower limb. Our observation is that the anatomy of this plexus is less familiar to surgeons than that of the brachial plexus. Damage to the lumbosacral plexus and its terminal branches may have a significant impact on locomotion, posture, and stability. We have designed a visual representation of the lumbosacral plexus to aid clinicians treating peripheral nerve disorders. The utility is illustrated with a case report in which a patient underwent nerve transfers in the lower limb to restore function. A visual representation of the lumbosacral plexus is a valuable adjunct to a clinical examination and helps make sense of clinical signs. The color-coding of each root level and the arrangement of muscles from proximal to distal helps with visual recall. A clear assessment of complex lumbosacral plexus patients is essential for diagnosis and planning. As with the case described, a sound knowledge of the "plexogram" can identify solutions for complex patients and result in significant functional improvements. We hope it helps advance the field of nerve surgery and, particularly, nerve transfers.

15.
J Phys Chem Lett ; 15(1): 254-261, 2024 Jan 11.
Article in English | MEDLINE | ID: mdl-38165172

ABSTRACT

The coherence of light has been proposed as a quantum-mechanical control for enhancing light-harvesting efficiency. In particular, optical coherence can be manipulated by changing either the polarization state or the spectral phase of the light. Here, we show that, in weak light, light-harvesting efficiency cannot be controlled using any form of optical coherence in molecular light-harvesting systems and, more broadly, those comprising orientationally disordered subunits and operating on longer-than-ultrafast time scales. Under those conditions, optical coherence does not affect the light-harvesting efficiency, meaning that it cannot be used for control. Specifically, polarization-state control is lost in disordered samples or when the molecules reorient on the time scales of light harvesting, and spectral-phase control is lost when the efficiency is time-averaged over a period longer than the optical coherence time. In practice, efficiency is always averaged over long times, meaning that coherent optical control is only possible through polarization and only in systems with orientational order.

16.
PLoS One ; 19(1): e0279324, 2024.
Article in English | MEDLINE | ID: mdl-38295088

ABSTRACT

BACKGROUND: Treatment of nerve injuries proves to be a worldwide clinical challenge. Acellular nerve allografts are suggested to be a promising alternative for bridging a nerve gap to the current gold standard, an autologous nerve graft. OBJECTIVE: To systematically review the efficacy of the acellular nerve allograft, its difference from the gold standard (the nerve autograft) and to discuss its possible indications. MATERIAL AND METHODS: PubMed, Embase and Web of Science were systematically searched until the 4th of January 2022. Original peer reviewed paper that presented 1) distinctive data; 2) a clear comparison between not immunologically processed acellular allografts and autologous nerve transfers; 3) was performed in laboratory animals of all species and sex. Meta analyses and subgroup analyses (for graft length and species) were conducted for muscle weight, sciatic function index, ankle angle, nerve conduction velocity, axon count diameter, tetanic contraction and amplitude using a Random effects model. Subgroup analyses were conducted on graft length and species. RESULTS: Fifty articles were included in this review and all were included in the meta-analyses. An acellular allograft resulted in a significantly lower muscle weight, sciatic function index, ankle angle, nerve conduction velocity, axon count and smaller diameter, tetanic contraction compared to an autologous nerve graft. No difference was found in amplitude between acellular allografts and autologous nerve transfers. Post hoc subgroup analyses of graft length showed a significant reduced muscle weight in long grafts versus small and medium length grafts. All included studies showed a large variance in methodological design. CONCLUSION: Our review shows that the included studies, investigating the use of acellular allografts, showed a large variance in methodological design and are as a consequence difficult to compare. Nevertheless, our results indicate that treating a nerve gap with an allograft results in an inferior nerve recovery compared to an autograft in seven out of eight outcomes assessed in experimental animals. In addition, based on our preliminary post hoc subgroup analyses we suggest that when an allograft is being used an allograft in short and medium (0-1cm, > 1-2cm) nerve gaps is preferred over an allograft in long (> 2cm) nerve gaps.


Subject(s)
Nerve Regeneration , Sciatic Nerve , Animals , Autografts/transplantation , Allografts/transplantation , Nerve Regeneration/physiology , Transplantation, Homologous/methods , Transplantation, Autologous/methods , Sciatic Nerve/injuries
18.
Vasc Endovascular Surg ; 58(2): 142-150, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37616476

ABSTRACT

BACKGROUND: Phantom limb pain (PLP) and symptomatic neuroma can be debilitating and significantly impact the quality of life of amputees. However, the prevalence of PLP and symptomatic neuromas in patients following dysvascular lower limb amputation (LLA) has not been reliably established. This systematic review and meta-analysis evaluates the prevalence and incidence of phantom limb pain and symptomatic neuroma after dysvascular LLA. METHODS: Four databases (Embase, MEDLINE, Cochrane Central, and Web of Science) were searched on October 5th, 2022. Prospective or retrospective observational cohort studies or cross-sectional studies reporting either the prevalence or incidence of phantom limb pain and/or symptomatic neuroma following dysvascular LLA were identified. Two reviewers independently conducted the screening, data extraction, and the risk of bias assessment according to the PRISMA guidelines. To estimate the prevalence of phantom limb pain, a meta-analysis using a random effects model was performed. RESULTS: Twelve articles were included in the quantitative analysis, including 1924 amputees. A meta-analysis demonstrated that 69% of patients after dysvascular LLA experience phantom limb pain (95% CI 53-86%). The reported pain intensity on a scale from 0-10 in LLA patients ranged between 2.3 ± 1.4 and 5.5 ± .7. A single study reported an incidence of symptomatic neuroma following dysvascular LLA of 5%. CONCLUSIONS: This meta-analysis demonstrates the high prevalence of phantom limb pain after dysvascular LLA. Given the often prolonged and disabling nature of neuropathic pain and the difficulties managing it, more consideration needs to be given to strategies to prevent it at the time of amputation.


Subject(s)
Neuroma , Phantom Limb , Humans , Phantom Limb/diagnosis , Phantom Limb/epidemiology , Phantom Limb/etiology , Retrospective Studies , Cross-Sectional Studies , Quality of Life , Prospective Studies , Treatment Outcome , Amputation, Surgical/adverse effects , Neuroma/diagnosis , Neuroma/epidemiology , Neuroma/surgery , Extremities , Lower Extremity
19.
Behav Res Methods ; 56(1): 500-509, 2024 Jan.
Article in English | MEDLINE | ID: mdl-36703001

ABSTRACT

The stop-signal task is widely used in experimental psychology and cognitive neuroscience research, as well as neuropsychological and clinical practice for assessing response inhibition. The task requires participants to make speeded responses on a majority of trials, but to inhibit responses when a stop signal appears after the imperative cue. The stop-signal delay after the onset of the imperative cue determines how difficult it is to cancel an initiated action. The delay is typically staircased to maintain a 50% stopping accuracy for an estimation of stopping speed to be calculated. However, the validity of this estimation is compromised when participants engage in strategic slowing, motivated by a desire to avoid stopping failures. We hypothesized that maintaining stopping accuracy at 66.67% reduces this bias, and that slowing may also be impacted by the level of experimenter supervision. We found that compared with 50%, using a 66.67% stopping accuracy staircase produced slower stop-signal reaction time estimations (≈7 ms), but resulted in fewer strategic slowing exclusions. Additionally, both staircase procedures had similar within-experiment test-retest reliability. We also found that while individual and group testing in a laboratory setting produced similar estimations of stopping speed, participants tested online produced slower estimates. Our findings indicate that maintaining stopping accuracy at 66.67% is a reliable method for estimating stopping speed and can have benefits over the standard 50% staircase procedure. Further, our results show that care should be taken when comparing between experiments using different staircases or conducted in different testing environments.


Subject(s)
Inhibition, Psychological , Psychomotor Performance , Humans , Reaction Time/physiology , Psychomotor Performance/physiology , Reproducibility of Results
20.
Eat Disord ; 32(2): 140-152, 2024.
Article in English | MEDLINE | ID: mdl-37965714

ABSTRACT

Eating disorders (EDs) are associated with emotion regulation difficulties. However, most studies have examined intrapersonal emotion regulation difficulties and strategies without consideration of interpersonal emotion regulation (IER). Thus, it remains unknown whether intrinsic IER (i.e., how people regulate their emotions through others) is associated with disordered eating. The present study examined whether putatively maladaptive IER strategies such as reassurance seeking and venting were associated with ED cognitions, behaviors, and symptom severity. Additionally, we examined whether IER strategy use varied as a function of probable ED diagnosis. A sample of 181 college students (Mage = 20.01 years, SD = 2.18) from a large northeastern university completed self-report measures of disordered eating, IER strategies, and intrapersonal emotion regulation difficulties. As predicted, reassurance seeking was associated with most ED symptomatology and ED symptom severity except for fasting frequency. Venting was only associated with body dissatisfaction. Associations between reassurance seeking and ED symptom severity and excessive exercise frequency remained significant even after controlling for sex and intrapersonal emotion regulation strategies. Finally, participants with a probable ED diagnosis reported greater reassurance seeking but not venting compared to nonprobable ED cases. These findings highlight the important associations between IER strategy use and disordered eating, namely, reassurance seeking. Additional research is needed to examine the associations between IER strategy use and disordered eating longitudinally.


Emotion regulation difficulties have consistently been associated with eating disorder symptomatology; however, most studies have examined intrapersonal emotion regulation, while ignoring interpersonal emotion regulation. We found that reassurance seeking was differentially associated with eating disorder symptomatology and symptom severity. Even after controlling for sex, intrapersonal emotion regulation strategies, reassurance seeking accounted for variance in symptom severity and excessive exercise frequency.


Subject(s)
Body Dissatisfaction , Emotional Regulation , Feeding and Eating Disorders , Humans , Young Adult , Adult , Emotions/physiology , Self Report
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