Search

Brad Snyder, Todd Wilson, Sheilendra Mehta, Kulvinder Bajwa, Emily Robinson, Todd Worley, Kanayochukwu Aluka, Carol Wolin-Riklin, Erik WilsonDepartment of Surgery, University of Texas Health Sciences Center at Houston, TX, USAAbstract: Adjustable gastric banding (AGB) is quickly becoming the most popular bariatric operation performed in the United States and Canada. Patients are particularly fond of the simplicity of the tool, the relatively low morbidity of the surgery, the quick recovery, and overall results. The gastric band has evolved over its 35-year history into a very successful adjustable tool used to restrict food consumption and limit caloric intake. The percent of excessive weight loss after banding can range from 30%–60% and depends on the time out from surgery. Along with weight loss, there is good resolution of the co-morbid conditions that are associated with excess weight and improvements in quality of life demonstrated after banding. Nutrition and follow up are extremely important after banding to ensure good compliance and adequate weight loss. Failure to follow the postoperative diet, exercise regiment, or mechanical failure of the band can lead to failure to lose adequate weight. While there are particular early and late complications associated with this surgery, the safety profile of the AGB is very appealing when compared to other bariatric operations. As we continue to reduce the morbidity of the procedure, the simple adjustable band concept has a lot of potential to remain a primary technique of maintaining long term weight loss. In conclusion, AGB has and continues to play an important role in the treatment of morbid obesity. It offers reasonably good weight loss results with very little morbidity, and the future of the adjustable band is bright.Keywords: adjustable band, gastric, bariatric, operation, surgery, weight loss, lap-band

The purpose of this study was to investigate whether application of bipolar galvanic vestibular stimulation (GVS) would influence the common modulation of motor unit discharge rate in bilateral soleus muscles during quiet standing. Soleus motor unit activity was recorded with fine wire electrodes in each leg. Subjects stood, with eyes closed, on two adjacent force platforms to record postural sway with the head facing straight ahead, turned to right, or turned left. Subjects also swayed voluntarily without GVS to the same position as evoked during the GVS. There was no difference in the common drive to bilateral soleus motoneurons during quiet standing and voluntary sway tasks. Common drive was significantly lower during right cathode GVS with the head straight or turned to the right. These results demonstrate that manipulation of vestibular afferent input influences the common modulation of bilateral soleus motor unit pairs during quiet standing. [ABSTRACT FROM AUTHOR]

This article reports on an exploratory analysis of existing data obtained through a national survey carried out in Sweden. The survey questionnaire seeks information on a wide range of issues, including healthcare, library use and Internet use. The analysis presented here explores the relationship among these variables and the concept of trust in healthcare institutions. The results indicate that most of the correlations theoretically suggested were very small and that trust in health institutions in general is high but not strongly related to standard demographic variables found in a general survey of a large population. This exploratory study suggests that more specific indicators of health, experience from health institutions and health-related media exposure are needed to test, in greater depth, the relationships between information exposure, health and attitudes towards health institutions. [ABSTRACT FROM AUTHOR]

In this article, the author discusses the similarities and differences between Pharaonic circumcision and reinfibulation and breast augmentation under systems of male dominance and female subordination. Despite the medical problems associated with each, women choose to be reinfibulated or have breast implants. There are systemic reasons associated with male dominance--in the case of reinfibulation, patriarchy and polygamy, and in the case of breast augmentation, institutional interests and phallocentrism--that impinge on women's 'choice' of these procedures. [ABSTRACT FROM AUTHOR]

Information overload is not a new phenomenon: the potential for it has existed ever since information became an important input to any human activity. For example, once the scientific disciplines began to clearly emerge in the seventeenth to the nineteenth centuries, it gradually became impossible for anyone to keep abreast of all of the work in what had been called 'natural philosophy'. In some fields, the degree of specialization is so high that, even within the same discipline, people are unable to keep abreast of all subareas and, in fact, may be completely unable to understand some of them. This paper defines and analyses the phenomenon of information overload and seeks to present organizational therapies that address it. [ABSTRACT FROM AUTHOR]

The latest evaluation of the World Health Organization (WHO) on the health situation in Africa recognizes that District Health Management Teams (DHMT) are not as efficient and effective at delivering primary healthcare as they could be. The 'weakness of information support is acknowledged by most member states as a persistent obstacle to vigorous and objective management'. A shift towards decentralization in many low-income countries has meant that more skills are demanded of primary healthcare (PHC) managers including data and information handling at all levels of the healthcare system. Ministries of Health (MOH) are changing from centralized reporting health information systems, to health management information systems (HMIS), with emphasis on managers utilizing information at the point of collection. The new information management strategies are intended to promote an informational approach to management at the district and operational health service level. Organizations that have an interest in training health service managers also recognize the need for more skills, and the Aga Khan Foundation (AKF) initiated the development of a training package for PHC managers known as the Primary Healthcare Management Advancement Programme (PHC MAP). [ABSTRACT FROM AUTHOR]

One of the etiological theories of schizophrenia is dysregulation of the immune system. Autoantibodies specific for the alpha7 subunit of the nicotinic receptor could potentially contribute to the pathophysiology of the disease. In this study, positive antibodies specific for the receptor were found to exist in 23% of the patients diagnosed with schizophrenia (n=21). On the average, levels for the antibody were elevated in the schizophrenia patient population than in controls. The data also suggests that there is a significant correlation between antibody titer and age, lending support to the neurodegenerative nature of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Radiofrequency ablation is a treatment for facetogenic low back pain that targets medial branches of lumbar dorsal rami to denervate facet joints. Clinical outcomes vary; optimizing cannula placement to better capture the medial branch may improve clinical outcomes. A novel parasagittal technique was proposed from an anatomical model; this technique was proposed to optimize capture of the medial branch. The anatomical feasibility of the novel technique has not been evaluated., Objective: To simulate and evaluate the proposed parasagittal technique in its ability to achieve proper cannula placement, and proximity of uninsulated cannula tips to the medial branches of the dorsal rami in cadaveric specimens., Materials and Methods: Under fluoroscopic guidance, 14 cannulae were placed using the parasagittal technique targeting the lumbar medial branches of two cadavers. Meticulous dissection was undertaken to assess cannula alignment and measure proximities to target nerves using a digital caliper., Results: The novel parasagittal technique was successfully performed in a cadaveric model in 12/14 attempts. The technique achieved close proximity of cannula tips to medial branches (0.8 ± 1.1 mm). In two instances cannulae were placed unsuccessfully, where one cannula was too far anterior, the other too far retracted., Conclusion: In this cadaveric simulation study, the feasibility of performing the parasagittal technique for lumbar radiofrequency ablation was evaluated. This study suggests the parasagittal technique is a feasible option for lumbar medial branch radiofrequency ablation., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.)

The Cognitive Theory of Multimedia Learning (CTML) suggests humans learn through visual and auditory sensory channels. Haptics represent a third channel within CTML and a missing component for experiential learning. The objective was to measure visual and haptic behaviors during spatial tasks. The haptic abilities test (HAT) quantifies results in several realms, accuracy, time, and strategy. The HAT was completed under three sensory conditions using sight (S), haptics (H), and sight with haptics (SH). Subjects (n = 22, 13 females (F), 20-28 years) completed the MRT (10.6 ± 5.0, mean ± SD) and were classified as high or low spatial abilities scores with respect to mean MRT: high spatial abilities (HSA) (n = 12, 6F, MRT = 13.7 ± 3.0), and low spatial ability (LSA) groups (n = 10, 7F, MRT = 5.6 ± 2.0). Video recordings gaze and hand behaviors were compared between HSA and LSA groups across HAT conditions. The HSA group spent less time fixating on mirrored objects, an erroneous answer option, of HAT compared to the LSA group (11.0 ± 4.7 vs. 17.8 ± 7.3 s, p = 0.020) in S conditions. In haptic conditions, HSA utilized a hand-object interaction strategy characterized as palpation, significantly less than the LSA group (23.2 ± 16.0 vs. 43.1 ± 21.5 percent, p = 0.022). Before this study, it was unclear whether haptic sensory inputs appended to the mental schema models of the CTML. These data suggest that if spatial abilities are challenged, LSA persons both benefit and utilize strategies beyond the classic CTML framework by using their hands as a third input channel. This data suggest haptic behaviors offer a third type of sensory memory resulting in improved cognitive performance., (© 2024 The Author(s). Anatomical Sciences Education published by Wiley Periodicals LLC on behalf of American Association for Anatomy.)

Objective: To conduct a systematic review of interventions to improve perinatal outcomes to mitigate pregnancy-related mortality and morbidity in Black birthing people., Data Sources: We searched 5 databases from 2000 through the final search date of April 5, 2023: Cumulative Index of Nursing and Allied Health Literature Plus with Full Text (EBSCOhost), Embase (Elsevier), PubMed, and Scopus (Elsevier) and ClinicalTrials.gov., Study Eligibility Criteria: Only quantitative studies were eligible including observational and randomized controlled trials. All participants in selected studies must identify as Black or study results must be stratified by race that includes Black birthing people. The study must (1) measure a perinatal outcome of interest (2) occur in the United States and (3) be written in the English language. Studies were excluded if they were published prior to 2000, not published in the English language, or did not meet the criteria above., Study Appraisal and Synthesis Methods: A data extraction template identified intervention type and perinatal outcome. Perinatal outcomes included but were not limited to: cardiovascular disorders, mortality, or preterm delivery. Interventions included: community programs, educational enhancement, individual counseling, medical intervention, or policy. Risk of bias was assessed using the Mixed Method Appraisal Tool. Three investigators assessed studies individually and group consensus was used for a final decision., Results: From 4,302 unique studies, 41 studies met inclusion criteria. Community programs such as the Supplemental Program for Women, Infants, and Children (WIC) and Healthy Start (n=17, 41.5%) were the most common interventions studied. Individual counseling closely followed (n=15, 36.6%). Medical interventions were not among the more commonly used intervention types (n=9, 21.9%). Most articles focused on preterm delivery (n=28, 68.3%). Few articles studied cardiovascular disorders (n=4, 9.8%) or hemorrhage (n=3, 7.3%). No articles studied pregnancy-related morbidity., Conclusions: Despite current conversations on Black maternal mortality, there is currently limited literature examining interventions addressing perinatal morbidity and mortality in Black birthing people in the United States. These interventions do not address how to mitigate perinatal outcomes of interest. Patient-centered outcomes research is warranted to better understand as well as to resolve inequities related to Black maternal health. El resumen está disponible en Español al final del artículo., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Maladaptive plasticity is linked to the chronification of diseases such as pain, but the transition from acute to chronic pain is not well understood mechanistically. Neuroplasticity in the central nucleus of the amygdala (CeA) has emerged as a mechanism for sensory and emotional-affective aspects of injury-induced pain, although evidence comes from studies conducted almost exclusively in acute pain conditions and agnostic to cell type specificity. Here, we report time-dependent changes in genetically distinct and projection-specific CeA neurons in neuropathic pain. Hyperexcitability of CRF projection neurons and synaptic plasticity of parabrachial (PB) input at the acute stage shifted to hyperexcitability without synaptic plasticity in non-CRF neurons at the chronic phase. Accordingly, chemogenetic inhibition of the PB→CeA pathway mitigated pain-related behaviors in acute, but not chronic, neuropathic pain. Cell-type-specific temporal changes in neuroplasticity provide neurobiological evidence for the clinical observation that chronic pain is not simply the prolonged persistence of acute pain., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Evidence demonstrates efficacy of maxillomandibular advancement (MMA) treatment of obstructive sleep apnea (OSA) and airway expansion. Patient studies are limited to pre/post-surgery comparisons. This cadaveric study evaluated intra-individual relationships between magnitudes of MMA advancement and airway changes. MMA with distraction osteogenesis devices and incremental advancement of the maxillomandibular complex, was performed on cadavers (n = 5). Computed tomography at each 2-mm advancement was used to measure volume and dimension of the oropharyngeal airway. Three-dimensional shape analysis visualized magnitudes and locations of changes. Incremental advancements caused volume, anteroposterior, and lateral dimensions to increase progressively, while length decreased. Changes were significant at lower advancements. Comparisons of MMA indicate alterations in airway volume from 4 to 6 mm and 6 to 8 mm were relatively greater than the changes from 8 to 10 mm (P = 0.044, P = 0.028, respectively), 10 to 12 mm (P = 0.024, P = 0.023), and 12 to 14 mm (P = 0.021, P = 0.019). These results may expand MMA application suggesting 6-8 mm advancements provide substantial increases in airway volume. MMA may be an OSA treatment option when large advancements are not possible. Lower magnitudes of advancement decrease risks of unfavorable facial esthetics from excess protrusion., Competing Interests: Competing interests None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Maternal obesity puts the offspring at high risk of developing obesity and cardio-metabolic diseases in adulthood. Here, using a mouse model of maternal high-fat diet (HFD)-induced obesity, we show that whole body fat content of the offspring of HFD-fed mothers (Off-HFD) increases significantly from very early age when compared to the offspring regular diet-fed mothers (Off-RD). We have previously shown significant metabolic and immune perturbations in the bone marrow of newly-weaned offspring of obese mothers. Therefore, we hypothesized that lipid metabolism is altered in the bone marrow Off-HFD in newly-weaned offspring of obese mothers when compared to the Off-RD. To test this hypothesis, we investigated the lipidomic profile of bone marrow cells collected from three-week-old offspring of regular and high fat diet-fed mothers. Diacylgycerols (DAGs), triacylglycerols (TAGs), sphingolipids and phospholipids, including plasmalogen, and lysophospholipids were remarkably different between the groups, independent of fetal sex. Levels of cholesteryl esters were significantly decreased in offspring of obese mothers, suggesting reduced delivery of cholesterol to bone marrow cells. This was accompanied by age-dependent progression of mitochondrial dysfunction in bone marrow cells. We subsequently isolated CD11b+ myeloid cells from three-week-old mice and conducted metabolomics, lipidomics, and transcriptomics analyses. The lipidomic profiles of these bone marrow myeloid cells were largely similar to that seen in bone marrow cells and included increases in DAGs and phospholipids alongside decreased TAGs, except for long-chain TAGs, which were significantly increased. Our data also revealed significant sex-dependent changes in amino acids and metabolites related to energy metabolism. Transcriptomic analysis revealed altered expression of genes related to major immune pathways including macrophage alternative activation, B-cell receptor signaling, TGFβ signaling, and communication between the innate and adaptive immune systems. All told, this study revealed lipidomic, metabolomic, and gene expression abnormalities in bone marrow cells broadly, and in bone marrow myeloid cells particularly, in the newly-weaned offspring of obese mothers, which might at least partially explain the progression of metabolic and cardiovascular diseases in their adulthood.

The spino-ponto-amygdaloid pathway is a major ascending circuit relaying nociceptive information from the spinal cord to the brain. Potentiation of excitatory synaptic transmission in the parabrachial nucleus (PBN) to central amygdala (CeA) pathway has been reported in rodent models of persistent pain. However, the functional significance of this pathway in the modulation of the somatosensory component of pain was recently challenged by studies showing that spinal nociceptive neurons do not target CeA-projecting PBN cells and that manipulations of this pathway have no effect on reflexive-defensive somatosensory responses to peripheral noxious stimulation. Here, we showed that activation of CeA-projecting PBN neurons is critical to increase both stimulus-evoked and spontaneous nociceptive responses following an injury in male and female mice. Using optogenetic-assisted circuit mapping, we confirmed a functional excitatory projection from PBN→CeA that is independent of the genetic or firing identity of CeA cells. We then showed that peripheral noxious stimulation increased the expression of the neuronal activity marker Fos in CeA-projecting PBN neurons and that chemogenetic inactivation of these cells decreased behavioral hypersensitivity in models of neuropathic and inflammatory pain without affecting baseline nociception. Lastly, we showed that chemogenetic activation of CeA-projecting PBN neurons is sufficient to induced bilateral hypersensitivity without injury. Together, our results indicate that the PBN→CeA pathway is a key modulator of pain-related behaviors that can increase reflexive-defensive and affective-motivational responses to somatosensory stimulation in injured states without affecting nociception under normal physiological conditions., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

4R is a tobacco cembranoid that binds to and modulates cholinergic receptors and exhibits neuroprotective and anti-inflammatory activity. Given the established function of the cholinergic system in pain and inflammation, we propose that 4R is also analgesic. Here, we tested the hypothesis that systemic 4R treatment decreases pain-related behaviors and peripheral inflammation via modulation of the alpha 7 nicotinic acetylcholine receptors (α7 nAChRs) in a mouse model of inflammatory pain. We elicited inflammation by injecting Complete Freund's Adjuvant (CFA) into the hind paw of male and female mice. We then assessed inflammation-induced hypersensitivity to cold, heat, and tactile stimulation using the Acetone, Hargreaves, and von Frey tests, respectively, before and at different time points (2.5 h - 8d) after a single systemic 4R (or vehicle) administration. We evaluated the contribution of α7 nAChRs 4R-mediated analgesia by pre-treating mice with a selective antagonist of α7 nAChRs followed by 4R (or vehicle) administration prior to behavioral tests. We assessed CFA-induced paw edema and inflammation by measuring paw thickness and quantifying immune cell infiltration in the injected hind paw using hematoxylin and eosin staining. Lastly, we performed immunohistochemical and flow cytometric analyses of paw skin in α7 nAChR-cre::Ai9 mice to measure the expression of α7 nAChRs on immune subsets. Our experiments show that systemic administration of 4R decreases inflammation-induced peripheral hypersensitivity in male and female mice and inflammation-induced paw edema in male but not female mice. Notably, 4R-mediated analgesia and anti-inflammatory effects lasted up to 8d after a single systemic administration on day 1. Pretreatment with an α7 nAChR-selective antagonist prevented 4R-mediated analgesia and anti-inflammatory effects, demonstrating that 4R effects are via modulation of α7 nAChRs. We further show that a subset of immune cells in the hind paw expresses α7 nAChRs. However, the number of α7 nAChR-expressing immune cells is unaltered by CFA or 4R treatment, suggesting that 4R effects are independent of α7 nAChR-expressing immune cells. Together, our findings identify a novel function of the 4R tobacco cembranoid as an analgesic agent in both male and female mice that reduces peripheral inflammation in a sex-dependent manner, further supporting the pharmacological targeting of the cholinergic system for pain treatment., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

We hypothesized that people would exhibit a reticence bias , the incorrect belief that they will be more likable if they speak less than half the time in a conversation with a stranger, as well as halo ignorance , the belief that their speaking time should depend on their goal (e.g., to be liked vs. to be found interesting), when in fact, perceivers form global impressions of each other. In Studies 1 and 2, participants forecasted they should speak less than half the time when trying to be liked, but significantly more when trying to be interesting. In Study 3, we tested the accuracy of these forecasts by randomly assigning participants to speak for 30%, 40%, 50%, 60%, or 70% of the time in a dyadic conversation. Contrary to people's forecasts, they were more likable the more they spoke, and their partners formed global rather than differentiated impressions.

Chronic asymptomatic and acute symptomatic anterior uveitis are forms of ocular inflammation associated with juvenile idiopathic arthritis (JIA) Chronic JIA-associated uveitis is characterized by young age of onset, female predilection, oligoarthritis, and antinuclear antibody (ANA) positivity. Acute JIA-associated uveitis predominantly affects older male juveniles who also develop enthesitis. A type I collagen-derived peptide (melanin-associated antigen [MAA]) induces anterior uveitis in rodents. In this study, we evaluated MAA-induced uveitis in rats as a potential model for JIA-uveitis. We characterized MAA-induced uveitis by assessing its relationship to age and sex; tracking the occurrence of arthritis, enthesitis, and ANA positivity; and measuring vitreous fluid inflammatory biomarkers. Juvenile and adult and male and female Lewis rats ( Rattus norvegicus ) were inoculated with MAA. Slit-lamp biomicroscopy, indirect ophthalmoscopy, and joint examinations were performed 3 times weekly. Rats were euthanized at 4 wk after MAA inoculation, and plasma ANA testing, vitreous inflammatory biomarker assays, and globe histopathology assessments were conducted. Uveitis, arthritis, ANA status, levels of inflammatory biomarkers, histopathology, and joint tomographic images were assessed in relation to age and sex and compared with nonuveitic controls. All MAA-immunized rats developed uveitis characterized by anterior chamber fibrin, iridal vessel dilation, and miosis, and uveal and choroidal lymphocytic infiltration. Levels of the vitreous fluid biomarker CCL5 were higher in uveitic rats compared with control rats. Time to uveitis onset, clinical uveitis scores, and biomarker levels did not differ based on age or sex. None of the MAA-exposed rats had arthritis, enthesitis, or ANA. None of the rats inoculated with MAA that had been treated with matrix metallopeptidase 1 had clinical, histologic, or immunohistochemical evidence of ocular inflammation. In contrast to JIA-associated uveitis in humans, MAA-induced uveitis in rats is not associated with age or sex predilections and MAA is not arthritogenic.

Objective: Report the 2-year outcomes of a multicenter randomized controlled trial comparing robotic versus laparoscopic intraperitoneal onlay mesh ventral hernia repair., Background: Ventral hernia repair is one of the most common operations performed by general surgeons. To our knowledge, no studies have been published to date comparing long-term outcomes of laparoscopic versus robotic ventral hernia repair., Methods: The trial was registered at clinicaltrials.gov (NCT03490266). Clinical outcomes included surgical site infection, surgical site occurrence, hernia occurrence, readmission, reoperation, and mortality., Results: A total of 175 consecutive patients were approached that were deemed eligible for elective minimally invasive ventral hernia repair. In all, 124 were randomized and 101 completed follow-up at 2 years. Two-year follow-up was completed in 54 patients (83%) in the robotic arm and 47 patients (80%) in the laparoscopic arm. No differences were seen in surgical site infection or surgical site occurrence. Hernia recurrence occurred in 2 patients (4%) receiving robotic repair versus in 6 patients (13%) receiving laparoscopic repair (relative risk: 0.3, 95% CI: 0.06-1.39; P =0.12). No patients (0%) required reoperation in the robotic arm whereas 5 patients (11%) underwent reoperation in the laparoscopic arm ( P =0.019, relative risk not calculatable due to null outcome)., Conclusions: Robotic ventral hernia repair demonstrated at least similar if not improved outcomes at 2 years compared with laparoscopy. There is potential benefit with robotic repair; however, additional multi-center trials and longer follow-up are needed to validate the hypothesis-generating findings of this study., Competing Interests: S.S. receives a research grant and consulting fees paid to the institution from Activ Surgical. The original study was supported by a research grant from Intuitive. The remaining authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Spatial abilities (SAs) are cognitive resources used to mentally manipulate representations of objects to solve problems. Haptic abilities (HAs) represent tactile interactions with real-world objects transforming somatic information into mental representations. Both are proposed to be factors in anatomy education, yet relationships between SAs and HAs remain unknown. The objective of the current study was to explore SA-HA interactions. A haptic ability test (HAT) was developed based on the mental rotations test (MRT) with three-dimensional (3D) objects. The HAT was undertaken in three sensory conditions: (1) sighted, (2) sighted with haptics, and (3) haptics. Participants (n = 22; 13 females, 9 males) completed the MRT and were categorized into high spatial abilities (HSAs) (n = 12, mean± standard deviation: 13.7 ± 3.0) and low spatial abilities (LSAs) (n = 10, 5.6 ± 2.0) based on score distributions about the overall mean. Each SA group's HAT scores were compared across the three sensory conditions. Spearman's correlation coefficients between MRT and HAT scores indicated a statistically significant correlation in sighted condition (r = 0.553, p = 0.015) but were not significant in the sighted with haptics (r = 0.0.078, p = 0.212) and haptics (r = 0.043, p = 0.279) conditions. These data suggest HAs appear unrelated to SAs. With haptic exploration, LSA HAT scores were compensated; comparing HSA with LSA: sighted with haptics [median (lower and upper quartiles): 12 (12,13) vs. 12 (11,13), p = 0.254], and haptics [12 (11,13) vs. 12 (10,12), p = 0.381] conditions. Migrations to online anatomy teaching may unwittingly remove important sensory modalities from the learner. Understanding learner behaviors and performance when haptic inputs are removed from the learning environment represents valuable insight informing future anatomy curriculum and resource development., (© 2022 American Association for Anatomy.)

Abstract: Previous studies have reported sex differences in patients with irritable bowel syndrome and inflammatory bowel disease, including differences in visceral pain perception. Despite this, sex differences in behavioral manifestations of visceral pain and underlying pathology of the gastrointestinal tract have been largely understudied in preclinical research. In this study, we evaluated potential sex differences in spontaneous nociceptive responses, referred abdominal hypersensitivity, disease progression, and bowel pathology in mouse models of acute and persistent colon inflammation. Our experiments show that females exhibit more nociceptive responses and referred abdominal hypersensitivity than males in the context of acute but not persistent colon inflammation. We further demonstrate that, after acute and persistent colon inflammation, pain-related behavioral responses in females and males are distinct, with increases in licking of the abdomen only observed in females and increases in abdominal contractions only seen in males. During persistent colon inflammation, males exhibit worse disease progression than females, which is manifested as worse physical appearance and higher weight loss. However, no measurable sex differences were observed in persistent inflammation-induced bowel pathology, stool consistency, or fecal blood. Overall, our findings demonstrate sex differences in pain-related behaviors and disease progression in the context of acute and persistent colon inflammation, highlighting the importance of considering sex as a biological variable in future mechanistic studies of visceral pain as well as in the development of diagnostics and therapeutic options for chronic gastrointestinal diseases., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.)

Central amygdala neurons expressing protein kinase C-delta (CeA-PKCδ) are sensitized following nerve injury and promote pain-related responses in mice. The neural circuits underlying modulation of pain-related behaviors by CeA-PKCδ neurons, however, remain unknown. In this study, we identified a neural circuit that originates in CeA-PKCδ neurons and terminates in the ventral region of the zona incerta (ZI), a subthalamic structure previously linked to pain processing. Behavioral experiments show that chemogenetic inhibition of GABAergic ZI neurons induced bilateral hypersensitivity in uninjured mice and contralateral hypersensitivity after nerve injury. In contrast, chemogenetic activation of GABAergic ZI neurons reversed nerve injury-induced hypersensitivity. Optogenetic manipulations of CeA-PKCδ axonal terminals in the ZI further showed that inhibition of this pathway reduces nerve injury-induced hypersensitivity whereas activation of the pathway produces hypersensitivity in the uninjured paws. Altogether, our results identify a novel nociceptive inhibitory efferent pathway from CeA-PKCδ neurons to the ZI that bidirectionally modulates pain-related behaviors in mice., Competing Interests: SS, TW, SV, BB, SC, JM, AA, OS, DV, MP, YC No competing interests declared

Standard definitions of social psychology, such as "the study of the way in which people's thoughts, feelings, and behaviors are influenced by the real or imagined presence of other people" (Aronson et al., 2019, p. 3), fail to capture much of what social psychologists actually do and do not capture the basic theoretical foundations of the field. I suggest the field is founded on the construal principle , which holds that to understand and predict human behavior, one must focus on people's proximate (current) construals of themselves and their environment. The construal principle empowers social psychology in three key ways: It (a) accounts for the power of the situation, by acknowledging that construals are highly attuned to social norms; (b) is amenable to study with the experimental method; and (c) provides a unique theoretical framework for how to change human behavior. I discuss the origins and implications of the construal principle and how it distinguishes social psychology from related subdisciplines, including evolutionary social psychology, personality psychology, and social neuroscience. Whereas each subdiscipline is good at accomplishing the tasks it has set for itself, social psychology has unique advantages. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Everyone knows that if you want to learn how to do something, you should get advice from people who do it well. But is everyone right? In a series of studies ( N = 8,693), adult participants played a game after receiving performance advice from previous participants. Although advice from the best-performing advisors was no more beneficial than advice from other advisors, participants believed that it had been-and they believed this despite the fact that they were told nothing about their advisors' performance. Why? The best performers did not give better advice, but they did give more of it, and participants apparently mistook quantity for quality. These studies suggest that performing and advising may often be unrelated skills and that in at least some domains, people may overvalue advice from top performers.

Three-dimensional (3D) digital anatomical models show potential to demonstrate complex anatomical relationships; however, the literature is inconsistent as to whether they are effective in improving the anatomy performance, particularly for students with low spatial visualization ability (Vz). This study investigated the educational effectiveness of a 3D stereoscopic model of the pelvis, and the relationship between learning with 3D models and Vz. It was hypothesized that participants learning with a 3D pelvis model would outperform participants learning with a two-dimensional (2D) visualization or cadaveric specimen on a spatial anatomy test, particularly when comparing those with low Vz. Participants (n = 64) were stratified into three experimental groups, who each attended a learning session with either a 3D stereoscopic model (n = 21), 2D visualization (n = 21), or cadaveric specimen (n = 22) of the pelvis. Medical and pre-medical student participants completed a multiple-choice pre-test and post-test during their respective learning session, and a long-term retention (LTR) test 2 months later. Results showed no difference in anatomy test improvement or LTR performance between the experimental groups. A simple linear regression analysis showed that within the 3D group, participants with high Vz tended to retain more than those with low Vz on the LTR test (R 2  = 0.31, P = 0.01). The low Vz participants may be cognitively overloaded by the complex spatial cues from the 3D stereoscopic model. Results of this study should inform resource selection and curriculum design for health professional students, with attention to the impact of Vz on learning., (© 2021 American Association for Anatomy.)

We investigated intentional thinking for pleasure, defined as the deliberate attempt to have pleasant thoughts while disengaged from the external world. We propose a Trade-Off model that explains when and why thinking for pleasure is enjoyable: People focus on personally meaningful thoughts when thinking for pleasure (especially when prompted to do so), which increases their enjoyment, but they find it difficult to concentrate on their thoughts, which decreases their enjoyment. Thus, the net enjoyment of thinking for pleasure is a trade-off between its benefits (personal meaningfulness) and costs (difficulty concentrating). To test the model, we compared intentional thinking for pleasure to four alternate activities in three studies. Thinking for pleasure was more enjoyable than undirected thinking (Study 1) and planning (Study 3), because it was more meaningful than these activities while requiring a similar level of concentration. Thinking for pleasure was just as enjoyable as playing a video game (Study 2) or unprompted idle time activities (Study 3), but for different reasons: It was more meaningful than these activities, but required more concentration. We discuss the implications of these findings for what people might choose to do during idle times. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Postoperative morbidity after laparoscopic bariatric surgery is considered higher for patients undergoing revisional versus primary procedures. The objective of this retrospective cohort study was to compare outcomes between patients undergoing primary versus revisional robotically assisted laparoscopic (RAL) Roux-en-Y gastric bypass (RYGB)., Methods: Data of all patients who underwent RAL primary and revisional RYGB between 2009 and 2019 at two accredited, high-volume bariatric surgery centers-the Memorial Hermann - Texas Medical Center, Houston, TX, and the Tower Health, Reading Hospital, Reading, PA, were analyzed. Primary outcomes were early (< 30 days) and overall postoperative complications. Secondary outcomes included intraoperative complications, operative times, conversions to laparotomy, length of hospital stay, early (< 30 days) postoperative readmissions and deaths., Results: Data of 1072 patients were analyzed, including 806 primary and 266 revisional RAL RYGB procedures. Longer operative times (203 versus 154 min, P < 0.001), increased number of readmissions for oral intolerance (10.5% versus 6.7%, P = 0.046) and higher rate of gastrojejunal stricture (6.4% versus 2.7%, P = 0.013) were found in the revisional group. Gastrointestinal leak rates were 0.2% for the primary versus 1.1% for the revisional group (P = 0.101). Early (< 30 days) reoperations rates were 2.2% for the primary versus 1.1% for the revisional group (P = 0.318). There were no statistically significant differences between groups in overall and severe complication rates., Conclusion: Patients undergoing RAL primary and revisional RYGB had comparable overall outcomes, with a non-significant higher early complication rate in the revisional group. Despite the study being underpowered to detect differences in specific complication rates, the morbidity seen in the revisional RYGB group remains markedly below literature reports of revisional laparoscopic RYGB and might suggest a benefit of robotic assistance. Further prospective studies are needed to confirm these results., (© 2020. The Author(s).)

When left to their own devices, people could choose to enjoy their own thoughts. But recent work suggests they do not. When given the freedom, people do not spontaneously choose to think for pleasure, and when directed to do so, struggle to concentrate successfully. Moreover, people find it somewhat boring and much less enjoyable than other solitary activities. One reason for this is that people may not know how to think for pleasure. Specifically, they may not know what to think about to make this both a meaningful and pleasant experience. We tested this prediction in two preregistered studies, by providing specific examples of meaningful topics (Study 1) or instructing participants to think "meaningful" thoughts (Study 2). Although providing specific examples of meaningful topics boosted how meaningful and enjoyable people found thinking for pleasure (Study 1), asking people to think "meaningful" thoughts (as compared with pleasurable ones) did not, because some of the meaningful topics people thought about were negative (Study 2). In order for thinking for pleasure to be pleasurable, people need to focus on topics that are both meaningful and positive. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Introduction/purpose: Some clinical indicators suggest hypercoagulability/hyperaggregability in patients with morbid obesity. Thromboelastography (TEG®) has been used to profile coagulation status in surgical patients. We aimed to assess coagulation profiles in patients with morbid obesity undergoing bariatric surgery by correlating demographic and patient characteristics to pre-operative TEG® values., Materials and Methods: Pre-operative TEG® values from 422 patients undergoing bariatric surgery were evaluated. TEG® results were analyzed by gender, use of medications known to alter the coagulation profile, and body mass index (BMI)., Results: Patients have a mean of 45.03 ± 11.8 years, female (76.3%), and with a mean BMI of 42 kg/m 1 . The overall coagulation profile of female patients was significantly different from males, even in the sub-cohort without use of medications known to alter coagulation. The majority of patients (94%) with a G value > 15 dynes/cm 1 (clot strength) were female. In females, there was no association between BMI and TEG® values; however, in men, there was a statistically significant difference in TEG® values for those with BMI < 40 kg/m 1 compared to those with BMI > 50 kg/m 2 ., Conclusions: TEG®-based analysis of coagulation profiles offers unique insights. Compared to laboratory normal values (R time, angle, maximal amplitude, and G values), patients with morbid obesity may have a tendency for hypercoagulability/hyperaggregability, with mean values at the higher limit. A significant hypercoagulable difference in TEG® values was identified in female as compared to male patients. Male patients with a BMI greater than 50 kg/m 2 were also found to be increasingly hypercoagulable., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Reduction in faculty positions in higher education and increased graduate matriculation rates represent a higher education conundrum. Planned happenstance theory (PHT) is a career development model focusing on positive outcomes resulting from unpredictable precareer events. This mixed methods study explores how PHT applies to the career paths of a clinical anatomy (CA) postgraduate cohort. It provides insight into educational practices designed to equip students for labor markets inside and outside academia. Alumni of CA (n = 12; 2014-2018) were interviewed about career-related events transpiring from graduate studies to present, allowing exploration on how PHT contextualizes their shared experiences. Planned happenstance career inventory (PHCI) enumerated planned happenstance skill (PHS) scores. Total PHS was referenced 527 times across 12 interviews. Of the PHS references, curiosity established highest incidence (154 references, 29%), optimism (132 references, 25%), flexibility (101 references, 19%), risk-taking (85 references, 16%), and persistence (55 references, 10%) and 43 distinct happenstance events were documented. In addition, social networking (52 references) arose as an emergent code and was divided into internal networking (28 references, 54%) and external networking (24 references, 46%). Application of the five-point PHCI scale revealed: curiosity (4.4 ± 0.3; mean ± SD), flexibility (3.6 ± 0.7), persistence (4.4 ± 0.3), optimism (4.3 ± 0.4), and risk-taking (4.1 ± 0.5). Curiosity had the strongest association with happenstance event incidence. Social networking was a key substituent of PHT not yet described in the literature. Educational practices incorporating PHT concepts, with emphasis on curiosity, may provide graduates novel metacognitive skills needed to develop novel career paths., (© 2020 American Association for Anatomy.)

Objectives: Mid-life adults have notably higher rates of alcohol and other substance misuse than older adults and maintain higher levels of use over time. Social isolation has been linked to higher risk use with increasing age. The purpose of this study is to examine the associations between social relationships, drinking, and misuse of sedative-tranquilizers., Methods: The data for this study come from the national Midlife in the United States study wave 2 (MIDUS 2) of adults ( N  = 3378; 53.3% women) aged 40 and older. Past month alcohol use and past year sedative medication misuse were assessed with social support and strain. Multinomial logistic regressions evaluated the relationship of (a) support and (b) strain to use and co-use of alcohol and sedatives., Results: Of the sample, 58.4% used alcohol only, 1.7% only misused sedatives, and 3.5% co-used alcohol/misused sedative-tranquilizers. Support from friends was associated with 1.18 increased risk of co-using compared to not using either substance. Source of strain was associated with co-use for middle-aged and older adults. Familial strain was associated with increased risk of co-using for middle-aged adults. Friend-related strain was associated with increased risk of co-use for older adults., Conclusion: Evidence suggests that older co-users may differ from those in midlife in terms of social risk factors. As the aging population increases, elucidating the potential mechanisms by which social factors impact concurrent alcohol use and sedative-tranquilizer medication misuse aid the development of targeted interventions and prevention programs in these groups.

Objective: The aim of this study was to compare clinical and patient-reported outcomes of robotic versus laparoscopic ventral hernia repair (LVHR) at 1-year postoperative., Summary of Background Data: Despite a relative lack of research at low risk for bias assessing robotic ventral hernia repair (RVHR), the growth of RVHR has been rapid. We previously reported short-term results of the first randomized control trial comparing RVHR versus LVHR; there was no clear difference in clinical outcomes but increased operative time and cost with robotic repair., Methods: Patients from a multicenter, blinded randomized control trial comparing RVHR versus LVHR were followed at 1 year. Outcomes included wound complication (surgical site infection, surgical site occurrence, wound dehiscence), hernia occurrence including recurrence and port site hernia, readmission, reoperation, and patient-reported outcomes (functional status, pain, and satisfaction with repair and cosmesis)., Results: A total of 124 patients were randomized and 113 patients (91%; 60 robot, 53 laparoscopic) completed 1-year follow-up. Baseline demographics were similar in both groups. No differences were seen in wound complication (15% vs 15%; P = 0.899), hernia recurrence (7% vs 9%; P = 0.576), or readmission (2% vs 6%; P = 0.251). No patients underwent reoperation in the robotic arm, whereas 5 (9%) did in the laparoscopic arm (P = 0.020). No differences were seen in patient-reported outcomes. Both arms reported clinically significant improvements in functional status, low pain scores, and high satisfaction scores at 1-year post repair., Conclusion: This study confirms that robotic ventral hernia repair is safe when compared to laparoscopy. Further studies are needed to confirm these findings., Competing Interests: SKS reports grants/payments from C-SATS and Activ Surgical. The remaining authors report no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Do conversations end when people want them to? Surprisingly, behavioral science provides no answer to this fundamental question about the most ubiquitous of all human social activities. In two studies of 932 conversations, we asked conversants to report when they had wanted a conversation to end and to estimate when their partner (who was an intimate in Study 1 and a stranger in Study 2) had wanted it to end. Results showed that conversations almost never ended when both conversants wanted them to and rarely ended when even one conversant wanted them to and that the average discrepancy between desired and actual durations was roughly half the duration of the conversation. Conversants had little idea when their partners wanted to end and underestimated how discrepant their partners' desires were from their own. These studies suggest that ending conversations is a classic "coordination problem" that humans are unable to solve because doing so requires information that they normally keep from each other. As a result, most conversations appear to end when no one wants them to., Competing Interests: The authors declare no competing interest.

Central amygdala (CeA) neurons expressing protein kinase Cδ (PKCδ + ) or somatostatin (Som + ) differentially modulate diverse behaviors. The underlying features supporting cell-type-specific function in the CeA, however, remain unknown. Using whole-cell patch-clamp electrophysiology in acute mouse brain slices and biocytin-based neuronal reconstructions, we demonstrate that neuronal morphology and relative excitability are two distinguishing features between Som + and PKCδ + neurons in the laterocapsular subdivision of the CeA (CeLC). Som + neurons, for example, are more excitable, compact, and with more complex dendritic arborizations than PKCδ + neurons. Cell size, intrinsic membrane properties, and anatomic localization were further shown to correlate with cell-type-specific differences in excitability. Lastly, in the context of neuropathic pain, we show a shift in the excitability equilibrium between PKCδ + and Som + neurons, suggesting that imbalances in the relative output of these cells underlie maladaptive changes in behaviors. Together, our results identify fundamentally important distinguishing features of PKCδ + and Som + cells that support cell-type-specific function in the CeA., (Copyright © 2021 Adke et al.)

Food production--especially raising animals for meat--has a massive negative impact on the environment and contributes to global warming. To address this, we investigated whether information about food sustainability would increase purchases of sustainable foods by patrons of university cafés. In Study 1, patrons were randomly assigned either to see a menu that had sustainability labels indicating the degree of environmental impact of each item, or to see a menu without labels. Women who saw the labels were significantly more likely to purchase sustainable foods, whereas men were not influenced by the labels. In Study 2 we targeted one sustainable menu item (a veggie burger) and, in a 2 (sustainability) x 2 (taste) design, varied whether patrons learned that the veggie burger was especially sustainable or especially tasty. Women were significantly more likely to purchase the veggie burger if they learned it was sustainable or tasty, but again, the manipulations had no effect on men. We discuss why women are more likely to change their food choices to eat more sustainably than are men., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: We investigated the long-term cognitive effects of concussion in 19,261 members of the general population and a cohort of varsity American football players with a history of frequent head impacts, using tests that are known to be sensitive to small changes in performance., Methods: We asked 19,261 participants to complete a demographic questionnaire and 12 cognitive tests measuring aspects of executive function, including inhibitory control. We compared the performance of those reporting a history of concussion (post-concussion) to those reporting no history of concussion (non-concussed) on the cognitive battery and four non-cognitive variables. We used the results of this population-level study to predict the profile of cognitive performance in varsity American football players, who completed the same cognitive tasks., Results: Post-concussion and non-concussed participants did not differ on 11 of the 12 cognitive tasks employed. However, on a test of inhibitory control based on the classic Stroop paradigm, post-concussion participants showed accuracy-related impairments specific to the incongruent conditions of the task. Post-concussion participants reported higher levels of anxiety, depression, and trouble concentrating. An entirely independent sample of 74 varsity American football players demonstrated the same pattern of impairment: compared to healthy controls, they scored significantly lower on the test of inhibitory control but were indistinguishable from controls on the 11 other tasks., Interpretation: Self-reported concussion is not associated with long-term general effects on cognitive function. Nevertheless, those who report at least one concussion and those who expose themselves to long-term frequent sport-related head impacts do have a modest, but statistically robust, deficit of inhibitory control.