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Thoracic Surgery Clinics Aug 2024A career in cardiothoracic surgery takes a psychological and emotional toll, which is likely increased by recent changes in our health care environment. The benefits of... (Review)
Review
A career in cardiothoracic surgery takes a psychological and emotional toll, which is likely increased by recent changes in our health care environment. The benefits of leisure pursuits are severalfold, one of which includes supporting physician wellness. However, we are at risk of relying on unhealthy mechanisms to provide relief. The incidence of addiction and substance abuse is high, particularly among women surgeons. There are a variety of opportunities to help ourselves and support our colleagues. We need to promote healthy activities outside of our profession for the long-term well-being of cardiothoracic surgeons and our specialty.
Topics: Humans; Behavior, Addictive; Thoracic Surgery; Substance-Related Disorders; Obsessive Behavior; Surgeons; Leisure Activities
PubMed: 38944450
DOI: 10.1016/j.thorsurg.2024.04.002 -
Thoracic Surgery Clinics Aug 2024The authors provide a brief overview for thoracic surgeons in topics essential to achieving financial well-being as a student, trainee, practicing surgeon, and beyond.... (Review)
Review
The authors provide a brief overview for thoracic surgeons in topics essential to achieving financial well-being as a student, trainee, practicing surgeon, and beyond. While broad in nature, the authors' article is comprehensive, and they cover topics including student loans, asset and wealth management, investment opportunities, financial and estate planning, and insurances. It is hoped that the information provided will allow thoracic surgeons to become more familiar with the financial topics that pertain to thoracic surgeons and provide an introduction to explore financial wellness and literacy more thoroughly.
Topics: Humans; Thoracic Surgery; Surgeons
PubMed: 38944449
DOI: 10.1016/j.thorsurg.2024.04.010 -
Thoracic Surgery Clinics Aug 2024Surgery of the chest is high stakes, and adverse events are common. Given the frequency and severity of such complications, cardiothoracic surgeons are at particularly... (Review)
Review
Surgery of the chest is high stakes, and adverse events are common. Given the frequency and severity of such complications, cardiothoracic surgeons are at particularly high risk of becoming second victims. Even though our primary commitment as doctors is to take care of our patients, surgeons may fall into the emotional and intellectual trap of taking on the whole responsibility of a patient's poor outcome. This viewpoint may lead the physician to develop a heightened self-doubt, greater insecurity, and imposter syndrome, further affecting their ability to prevent complications and tackle difficult cases in the future.
Topics: Humans; Postoperative Complications; Burnout, Professional; Surgeons
PubMed: 38944447
DOI: 10.1016/j.thorsurg.2024.04.009 -
Neuropsychologia Jun 2024Athletes have been found to demonstrate a superior ability to detect subtle variations in dynamic displays (e.g., point-light displays and videos) depicting expert...
Athletes have been found to demonstrate a superior ability to detect subtle variations in dynamic displays (e.g., point-light displays and videos) depicting expert actions compared to non-athletes. The current study aimed to determine whether this advantage also exists when dynamic information is unavailable (i.e., using static images). Using a staircase procedure, two frames from a video depicting an athlete either walking (everyday action) or performing a sprint start (expert action) were presented, and athletes (sprinters) and non-athletes were asked to indicate whether the images were identical or different. We examined whether presenting the images sequentially (temporal task) or simultaneously (spatial task) influenced participants' discrimination performance. We predicted that the sprinters would outperform the non-sprinters in the spatial task as body postures could be compared directly but not in the temporal task due to larger representational momentum effects for athletes. Contrary to our hypotheses, the sprinters and non-sprinters performed similarly in all tasks and conditions. In line with the prediction that representational momentum may impair performance, participants' thresholds were lower for the spatial than the temporal task. However, post-hoc analysis suggested that this effect is likely to be better explained by a task order effect whereby participants who completed the temporal task first exhibited an advantage in the spatial task, while there were no performance differences for participants who completed the opposite task order. In sum, our results provide no evidence for the idea that motor expertise affects action perception (i.e., perceptual resonance) in a simple psychophysical task employing static images.
PubMed: 38944412
DOI: 10.1016/j.neuropsychologia.2024.108945 -
Experimental Neurology Jun 2024Alleviation of motor impairment by aerobic exercise (AE) in Parkinson's disease (PD) patients points to activation of neurobiological mechanisms that may be targetable...
Moderate intensity aerobic exercise alleviates motor deficits in 6-OHDA lesioned rats and reduces serum levels of biomarkers of Parkinson's disease severity without recovery of striatal dopamine or tyrosine hydroxylase.
Alleviation of motor impairment by aerobic exercise (AE) in Parkinson's disease (PD) patients points to activation of neurobiological mechanisms that may be targetable by therapeutic approaches. However, evidence for AE-related recovery of striatal dopamine (DA) signaling or tyrosine hydroxylase (TH) loss has been inconsistent in rodent studies. This ambiguity may be related to the timing of AE intervention in relation to the status of nigrostriatal neuron loss. Here, we replicated human PD at diagnosis by establishing motor impairment with >80% striatal DA and TH loss prior to initiating AE, and assessed its potential to alleviate motor decline and restore DA and TH loss. We also evaluated if serum levels of neurofilament light (NfL) and glial fibrillary acidic protein (GFAP), biomarkers of human PD severity, changed in response to AE. 6-hydroxydopamine (6-OHDA) was infused unilaterally into rat medial forebrain bundle to induce progressive nigrostriatal neuron loss over 28 days. Moderate intensity AE (3× per week, 40 min/session), began 8-10 days post-lesion following establishment of impaired forelimb use. Striatal tissue DA, TH protein and mRNA, and serum levels of NfL/GFAP were determined 3-wks after AE began. Despite severe striatal DA depletion at AE initiation, forelimb use deficits and hypokinesia onset were alleviated by AE, without recovery of striatal DA or TH protein loss, but reduced NfL and GFAP serum levels. This proof-of-concept study shows AE alleviates motor impairment when initiated with >80% striatal DA loss without obligate recovery of striatal DA or TH protein. Moreover, the AE-related reduction of NfL and GFAP serum levels may serve as objective blood-based biomarkers of AE efficacy.
PubMed: 38944332
DOI: 10.1016/j.expneurol.2024.114875 -
Journal of Affective Disorders Jun 2024There is an imbalance between goal-directed and habitual-learning system in patients with obsessive-compulsive disorder (OCD). At present, the relationship between...
BACKGROUND
There is an imbalance between goal-directed and habitual-learning system in patients with obsessive-compulsive disorder (OCD). At present, the relationship between cognitive behavior therapy (CBT) as a first-line therapy and goal-directed and habitual-learning disorder is still unclear. We attempted to discuss the effect of CBT treatment in patients with OCD, using abnormalities in goal-directed and habitual-learning-related brain regions at baseline as predictive factors.
METHODS
A total of 71 subjects, including 35 OCD patients and 36 healthy controls, were recruited. The OCD patients underwent 8 weeks of cognitive-behavioral therapy (CBT). These patients were divided into two groups based on treatment response (N = 18, N = 17). Further subgroup analysis was conducted based on disease duration (N = 17, N = 18) and age of onset (N = 14, N = 21). We collected resting-state ROI-ROI functional connectivity data and apply repeated-measures linear mixed-effects models to investigate the differences of different subgroups.
RESULTS
CBT led to symptom improvement in OCD patients, with varying degrees of effectiveness across subgroups. The orbitofrontal cortex (OFC) and insula, key regions for goal-directed behavior and habitual-learning, respectively, showed significant impacts on CBT efficacy in subgroups with different disease durations and ages of onset.
CONCLUSION
The findings suggest that the goal-directed system may influence the efficacy of CBT through goal selection, maintenance, and emotion regulation. Furthermore, we found that disease duration and age of onset may affect treatment outcomes by modulating functional connectivity between goal-directed and habitual-learning brain regions.
PubMed: 38944296
DOI: 10.1016/j.jad.2024.06.110 -
International Journal of... Jun 2024Cranial electrotherapy stimulation (CES) is a form of non-invasive brain stimulation (NIBS) that has demonstrated potential to modulate neural activity in a manner that...
Cranial electrotherapy stimulation (CES) is a form of non-invasive brain stimulation (NIBS) that has demonstrated potential to modulate neural activity in a manner that may be conducive to improved cognitive performance. While other forms of NIBS, such as transcranial direct current stimulation (tDCS), have received attention in the field as potential acute cognitive enhancers, CES remains relatively unexplored. The current study aimed to assess the efficacy of CES in improving acute cognitive performance under normal experimental conditions, as well as during sessions of induced situational anxiety (threat of shock or ToS). To study this question, participants completed a cognitive battery assessing processing speed and distinct aspects of executive functioning (working memory, inhibition, and task switching) in two separate sessions in which they received active and sham CES. Participants were randomly assigned to between subject groups of either situational anxiety (ToS) or control condition (no ToS). We predicted that active CES would improve performance on assessments of executive functioning (working memory, inhibition, and task switching) relative to sham CES under ToS. We did not find any significant effects of ToS, CES, or an interaction between ToS and CES for any measures of executive functioning or processing speed. These findings suggest that a single dose of CES does not enhance EF or processing speed under normal conditions or during ToS.
PubMed: 38944283
DOI: 10.1016/j.ijpsycho.2024.112388 -
Neuroscience and Biobehavioral Reviews Jun 2024Depersonalisation-derealisation disorder (DDD) is characterised by distressing experiences of separation from oneself and/or one's surroundings, potentially resulting... (Review)
Review
Depersonalisation-derealisation disorder (DDD) is characterised by distressing experiences of separation from oneself and/or one's surroundings, potentially resulting from alterations in affective, cognitive, and physiological functions. This systematic review aimed to synthesise current experimental evidence of relevance to proposed mechanisms underlying DDD, to appraise existing theoretical models, and to inform future research and theoretical developments. Studies were included if they tested explicit hypotheses in DDD samples, with experimental manipulations of at least one independent variable, alongside behavioural, subjective, neurological, affective and/or physiological dependent variables. Some evidence for diminished subjective responsivity to aversive images and sounds, and hyperactivation in neurocircuits associated with emotional regulation when viewing aversive images emerged, corroborating neurobiological models of DDD. Inconsistencies were present regarding behavioural and autonomic responsivity to facial expressions, emotional memory, and self-referential processing. Common confounds included small sample sizes, medication, and comorbidities. Alterations in affective reactivity and regulation appear to be present in DDD; however, further research employing more rigorous research designs is required to provide stronger evidence for these possible mechanisms.
PubMed: 38944228
DOI: 10.1016/j.neubiorev.2024.105783 -
Gastroenterology Jun 2024
PubMed: 38944208
DOI: 10.1053/j.gastro.2024.06.017 -
The Journal of Pain Jun 2024Individuals with chronic pain report disproportionally higher rates of trauma; yet, it is unclear whether different types of trauma (e.g., sexual, accidental trauma) are...
Individuals with chronic pain report disproportionally higher rates of trauma; yet, it is unclear whether different types of trauma (e.g., sexual, accidental trauma) are associated with worse pain outcomes. The present study sought to: 1) identify subgroups of people with chronic pain based on trauma type; and 2) determine whether subgroups differ in terms of pain characteristics over a two-year period. Individuals with chronic pain (N = 1,451) participated in an online study and completed self-report questionnaires at baseline, 3-, 12- and 24-month follow-up. Trauma was assessed via the Life Events Checklist for DSM-5. Pain intensity and interference were measured via the Brief Pain Inventory and pain distribution was evaluated using the Widespread Pain Index. Latent class analyses produced a three-class solution consisting of individuals with high and diverse trauma (16.3%), high sexual trauma (18.4%), and low/accidental trauma (57.1%) with the rest of the sample endorsing no trauma history (8.2%). After controlling for key demographic variables and baseline outcome levels, individuals in the high and diverse trauma group endorsed higher levels of pain severity and interference at the 3 and 12-month follow-ups compared to the group with no trauma (p<.01). Additionally, relative to the no trauma group, individuals in the high sexual trauma group reported higher levels of pain interference and more widespread pain at the 3-month follow-up (p<.05). Findings underscore the importance of screening for trauma and suggest that the type and variety of trauma experienced may be relevant to pain-related outcomes. PERSPECTIVE: This article highlights how an individual's unique trauma history may be related to their current pain experience. Knowledge of the type and frequency of past trauma may have relevant clinical implications for the treatment of chronic pain.
PubMed: 38944173
DOI: 10.1016/j.jpain.2024.104621