Associating Surgeon Feedback With Material Physical Properties in the Development Process of a Resective Epilepsy Surgery Simulator.

BACKGROUND: Hands-on neurosurgical simulations, specifically techniques involving white matter disconnection, are underdeveloped owing to the paucity of low indentation materials that can adequately mimic brain dissection. OBJECTIVE: To describe the discovery phase of developing a resective epilepsy surgery simulator by quantifying the physical properties of 6 materials and correlating the scores with surgeon feedback data. METHODS: Six materials, silicone, TissueMatrix, gel support, Synaptive hydrogel, dry SUP706, and moist SUP706 of equal dimension, were evaluated for hardness by measuring their resistance to indentation. Temporal lobe prototypes, 1 for each material, were dissected by 2 neurosurgeons and ordinal ranking assigned. Two null hypotheses were tested: one is that no differences in the indentation properties of the 6 materials analyzed would be elicited and the other is that there would be no correlation between indentation and surgeon feedback scores. Statistical comparison of the means of the different materials was performed using one-way analysis of variance. Surgeon feedback data and indentation score associations were analyzed using the Kendall rank correlation coefficient. RESULTS: A statistically significant effect (P value <.0001; α 0.05) was measured. Gel support and Synaptive hydrogel had the lowest indentation scores and similar physical properties. Moist support material scored lower than dry support (P = .0067). A strong positive correlation (Kendall tau = 0.9333, P < .0001) was ascertained between the surgeon feedback ranking and indentation scores. CONCLUSION: Reasonable material options for developing a resective epilepsy surgery are proposed and ranked in this article. Early involvement of surgeons is useful in the discovery phase of simulator invention.

Slower rates of learning to inhibit behavior in alcohol use disorder.

OBJECTIVE: Alcohol use disorder (AUD) is associated with passive avoidance learning (PAL) deficits. This study investigated PAL deficits in AUD by using a novel growth model approach to quantify patterns of PAL as changes in false alarms over time, rather than the typical index of total false alarms in a PAL task. METHOD: Subjects, 112 (58 men; 54 women) with an AUD and 110 controls (44 men; 66 women), were administered a monetary incentive Go/No-Go task. Subjects could win $0.25 for a hit (response after a GO) or lose $0.25 for a false alarm. RESULTS: PAL rate was quantified as the slope of initial learning phase (across the first 5 blocks) on the Go/No-Go task. The PAL curves indicated rapid learning in first 5 blocks followed by a later slower learning across blocks 6-9 (consolidation phase). A piecewise growth model with random intercepts indicated that AUD status was significantly associated with a slower initial PAL (i.e. learning phase), with B = -0.69, p < 0.001 for the control group and a PAL slope of 0.13 higher for the AUD group indicating a slower learning rate in the AUD group. This effect was not observed in the consolidation phase. CONCLUSIONS: The results suggest that those with an AUD have greater difficulty learning to avoid negative consequences compared with controls. The results also suggest that measuring PAL rate by focusing on the rate of learning early in the task may be a better index of PAL learning than simply looking at overall false alarm rate. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Disinhibited personality, incentives, disincentives, and drinking-related decisions.

Disinhibited personality traits, such as impulsivity (IMP), excitement seeking (ES), and low harm avoidance (HA), are thought to reflect a basic vulnerability toward alcohol use disorder (AUD). However, the specific vulnerability mechanisms associated with each trait are not well understood and there are no studies of the association between disinhibited personality and drinking-related decisions. This study investigated individual differences in drinking-related decisions associated with each trait using a task that manipulated the effects of incentives and disincentives on decisions to attend and drink at different hypothetical drinking events in a sample of 430 young adults (237 men, 193 women, mean age 21.3 years), over 60% of whom had an AUD of varying severity. The results revealed each personality domain was differentially associated with different aspects of drinking decisions. Both IMP and low HA were associated with being more likely to decide to attend party events with moderate and high goal-related responsibility disincentives. We suggest that low HA is associated with reduced sensitivity to the negative consequences of not meeting a responsibility, while IMP is associated with increased discounting of future rewards (associated with meeting a responsibility) relative to the immediate reward of attending a party event. ES was associated with being more responsive to alcohol party incentives when making decisions about attending party events and deciding to drink more at events, with the highest reward potential suggesting that ES is related to a reward sensitivity decision bias. IMP appears to be associated with stronger approach that results in decisions to consume more alcohol regardless of context. The results suggest specific mechanisms by which different domains of disinhibited personality affect actual drinking-related decisions.