Cortical semantization of autobiographical memory over subjective chronological time: An fMRI study.

The content and neural representation of autobiographical memories change over time; however, these changes are poorly understood. We hypothesize that the content of memories becomes semanticized, while the neural representation moves from mesial to cortical structures. We conducted an fMRI (functional magnetic resonance imaging) study on the effects of time on autobiographical memory retrieval. Twenty healthy participants were cued by a selection of photographs that represented distinct episodic memories from 1, 2, 6, and 14 years prior to scanning. Our behavioural data of self-report measures of memory qualia suggests a loss of episodic content over time. GLM (general linear model) results demonstrate that across all time points, visual association cortices and mesial temporal lobes were activated. However, we did not observe any GLM differences between memory time points. We used SVM (support vector machine) in order to predict memory time point based on neural activation patterns. We were able to accurately predict classification accuracy for the 1-year (66.7%), 2-year (66.7%), and 14-year (33.4%) memory time points, with an overall classification accuracy of 55.6%. We suggest that our findings can be interpreted in light of cortical semantization; as memories age, they become more semanticized and shift in representation towards cortical structures.

Prolonged Length of Stay After Robotic Prostatectomy: Causes and Risk Factors.

BACKGROUND: Robot-assisted radical prostatectomy (RARP) can generally be performed with 1-2 nights of postoperative monitoring before discharge from the hospital. Little is known about what causes individual patients to remain in hospital beyond the second postoperative day. METHODS: Data for RARPs performed between 2013 and 2015 were extracted from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. The fraction of cases with prolonged length of stay (PLOS) that can be reasonably attributed to complications was examined. Logistic regression was performed to identify risk factors for PLOS in the overall population and separately in the population of patients with PLOS without any perioperative complications. RESULTS: Of 11,440 patients, 10,342 (90.4%) were discharged on postoperative days 0-2; 80.6% (887/1101) of patients with PLOS did not experience any perioperative complications. The most common complication was bleeding requiring transfusion, but this was present in only 5.6% (62/1101) of patients with PLOS. Logistic regression identified predictors of PLOS as age, race, wound class, American Society of Anesthesiologists class, smoking, diabetes, dyspnea, dependent functional health status, congestive heart failure, operative time, and pelvic lymph node dissection. Results of this regression were insensitive to the exclusion of patients who experienced no perioperative complications. CONCLUSIONS: This study utilizes logistic regression on NSQIP data to identify risk factors for PLOS after RARP and, in particular, to evaluate the role of postoperative complications in PLOS. The analysis shows that postoperative complications account for a small minority of cases of PLOS after RARP.

Tablet computers and forensic and correctional psychological assessment: A randomized controlled study.

Mobile computing technology presents various possibilities and challenges for psychological assessment. Within forensic and correctional psychology, assessment of justice-involved persons facilitated by such technology has not been empirically examined. Accordingly, this randomized controlled experiment involved administering questionnaires about risk-needs, treatment readiness, and computerized technology opinions to a large (N = 212) and diverse sample of individuals under custodial correctional supervision using either a tablet computer or traditional paper-and-pencil materials. Results revealed that participants in the paper-and-pencil condition completed the packet of questionnaires faster but omitted items more frequently. Older participants and those with lower levels of education tended to take longer to complete the tablet-administrated measures. The tablet format was rated as more usable irrespective of demographic and personal characteristics, and most participants across the 2 conditions indicated that they would prefer to use computerized technology to complete psychological testing. Administration format did not have a clear effect on attitudes toward correctional rehabilitation services. Noteworthy for researchers is the substantial time saved and absence of practical problems with the tablet condition. Implications for practitioners include the general usability of the devices, their appeal to incarcerated persons, and the potential for tablets to facilitate clinical and administrative tasks with corrections clients. Considering the novel nature of this study, its promising results, and its limitations, future research in this area is warranted. (PsycINFO Database Record

Incidence and impact of acute urinary retention after robot-assisted radical prostatectomy.

OBJECTIVE: To explore the incidence of and potential risk factors for acute urine retention (AUR) after robot-assisted radical prostatectomy (RARP) and its effect on early urine continence. METHODS: A retrospective analysis of patients who underwent RARP by a single surgeon between July 2016 and June 2017 was performed to assess the incidence of AUR and its effect on early continence. Continence was assessed through self-reported questionnaires completed approximately three months after surgery. Early urine continence was defined as using zero pads per day at the time of the three-month follow-up. Descriptive statistics and logistic regression analysis were used to assess independent predictor of AUR. RESULTS: Of 379 patients, 19 (5%) developed AUR after RARP. No significant difference in baseline characteristics between those who developed AUR post-RARP and those who did not. There was no statistically significant difference in the reported early continence and number of pads used per day between patients with AUR and patients without AUR (31.6% vs. 23.1%, P = 0.39), (1.6 vs. 1.4, P = 0.913), respectively. CONCLUSION: AUR post-RARP is an infrequent postoperative complication with no impact on early continence rate. No patient-related factors were associated with the development of AUR.

Improved Outcomes Utilizing a Valveless-Trocar System during Robot-assisted Radical Prostatectomy (RARP).

INTRODUCTION: To evaluate the effect of valveless trocar system (VTS) on intra-operative parameters, peri-operative outcomes, and 30-day postoperative complications in patients undergoing robotic-assisted laparoscopic prostatectomy. METHODS: A total of 200 consecutive patients undergoing Robot-assisted radical prostatectomy by a single surgeon were prospectively evaluated using either the valveless trocar (n = 100) or standard trocars (n = 100). Patient demographics, intra-operative parameters, length of stay, presence or absence of postoperative nausea and vomiting, analog pain score at 0-6 hours, 6-12 hours, 12-18 hours, and >24 hours, and 30-day postoperative complications were analyzed. RESULTS: There were no significant differences in estimated blood loss, intra-operative urine output, length of stay, or 30-day complication rates between the two groups. While the VTS group had higher Body Mass Index (BMI) (28.45 vs. 27.23; P = 0.049), the operative time was significantly shorter in the VTS group (146 minutes vs. 167 minutes; P < .005). The VTS group experienced fewer episodes of nausea (2% vs. 10%; P = 0.0172). The VTS group had less pain intensity compared to the control in the first 18 hours: 0-6 hours (1.9 vs. 2.5; P = 0.034), 6-12 hours (2.8 vs. 3.6; P = 0.044), and 12-18 hours (2.2 vs. 3.1; P = 0.049), respectively. CONCLUSION: The use of a valveless trocar system during robot-assisted robotic prostatectomy may shorten operative times, and reduce postoperative pain scores and nausea episodes without increasing the 30-day complication rate. Further prospective randomized trials should be performed to validate these findings.