Implantation of engineered adipocytes that outcompete tumors for resources suppresses cancer progression.

Tumors acquire an increased ability to obtain and metabolize nutrients. Here, we engineered and implanted adipocytes to outcompete tumors for nutrients and show that they can substantially reduce cancer progression. Growing cells or xenografts from several cancers (breast, colon, pancreas, prostate) alongside engineered human adipocytes or adipose organoids significantly suppresses cancer progression and reduces hypoxia and angiogenesis. Transplanting modulated adipocyte organoids in pancreatic or breast cancer mouse models nearby or distal from the tumor significantly suppresses its growth. To further showcase therapeutic potential, we demonstrate that co-culturing tumor organoids derived from human breast cancers with engineered patient-derived adipocytes significantly reduces cancer growth. Combined, our results introduce a novel cancer therapeutic approach, termed adipose modulation transplantation (AMT), that can be utilized for a broad range of cancers.

Neurocognitive Profiles Associated With Limited English Proficiency in Cognitively Intact Adults.

OBJECTIVE: The objective of the present study was to examine the neurocognitive profiles associated with limited English proficiency (LEP). METHOD: A brief neuropsychological battery including measures with high (HVM) and low verbal mediation (LVM) was administered to 80 university students: 40 native speakers of English (NSEs) and 40 with LEP. RESULTS: Consistent with previous research, individuals with LEP performed more poorly on HVM measures and equivalent to NSEs on LVM measures-with some notable exceptions. CONCLUSIONS: Low scores on HVM tests should not be interpreted as evidence of acquired cognitive impairment in individuals with LEP, because these measures may systematically underestimate cognitive ability in this population. These findings have important clinical and educational implications.

BNT-15: Revised Performance Validity Cutoffs and Proposed Clinical Classification Ranges.

BACKGROUND: Abbreviated neurocognitive tests offer a practical alternative to full-length versions but often lack clear interpretive guidelines, thereby limiting their clinical utility. OBJECTIVE: To replicate validity cutoffs for the Boston Naming Test-Short Form (BNT-15) and to introduce a clinical classification system for the BNT-15 as a measure of object-naming skills. METHOD: We collected data from 43 university students and 46 clinical patients. Classification accuracy was computed against psychometrically defined criterion groups. Clinical classification ranges were developed using a z -score transformation. RESULTS: Previously suggested validity cutoffs (≤11 and ≤12) produced comparable classification accuracy among the university students. However, a more conservative cutoff (≤10) was needed with the clinical patients to contain the false-positive rate (0.20-0.38 sensitivity at 0.92-0.96 specificity). As a measure of cognitive ability, a perfect BNT-15 score suggests above average performance; ≤11 suggests clinically significant deficits. Demographically adjusted prorated BNT-15 T-scores correlated strongly (0.86) with the newly developed z -scores. CONCLUSION: Given its brevity (<5 minutes), ease of administration and scoring, the BNT-15 can function as a useful and cost-effective screening measure for both object-naming/English proficiency and performance validity. The proposed clinical classification ranges provide useful guidelines for practitioners.

The emotion word fluency test as an embedded performance validity indicator - Alone and in a multivariate validity composite.

OBJECTIVE: This project was designed to cross-validate existing performance validity cutoffs embedded within measures of verbal fluency (FAS and animals) and develop new ones for the Emotion Word Fluency Test (EWFT), a novel measure of category fluency. METHOD: The classification accuracy of the verbal fluency tests was examined in two samples (70 cognitively healthy university students and 52 clinical patients) against psychometrically defined criterion measures. RESULTS: A demographically adjusted T-score of ≤31 on the FAS was specific (.88-.97) to noncredible responding in both samples. Animals T ≤ 29 achieved high specificity (.90-.93) among students at .27-.38 sensitivity. A more conservative cutoff (T ≤ 27) was needed in the patient sample for a similar combination of sensitivity (.24-.45) and specificity (.87-.93). An EWFT raw score ≤5 was highly specific (.94-.97) but insensitive (.10-.18) to invalid performance. Failing multiple cutoffs improved specificity (.90-1.00) at variable sensitivity (.19-.45). CONCLUSIONS: Results help resolve the inconsistency in previous reports, and confirm the overall utility of existing verbal fluency tests as embedded validity indicators. Multivariate models of performance validity assessment are superior to single indicators. The clinical utility and limitations of the EWFT as a novel measure are discussed.

Reexamining performance validity cutoffs within the Complex Ideational Material and the Boston Naming Test-Short Form using an experimental malingering paradigm.

OBJECTIVE: This study was designed to cross-validate previously published performance validity cutoffs embedded within the Complex Ideational Material (CIM) and the Boston Naming Test-Short Form (BNT-15). METHOD: Seventy healthy undergraduate students were randomly assigned to either a control condition (n = 40) and instructed to perform to the best of their ability or an experimental malingering (n = 30) condition and instructed to feign cognitive impairment while avoiding detection. All participants were administered the same battery of neuropsychological tests. RESULTS: Previously published validity cutoffs within the CIM (raw score ≤9 or T-score ≤29) and BNT-15 (≤12) produced good classification accuracy using both experimental malingering and psychometrically defined invalid responding as criterion variable. However, a BNT-15 completion time ≥85 s produced a better signal detection profile than BNT-15 accuracy scores. CONCLUSIONS: Results support the clinical utility of existing cutoffs. Given the relatively high base rate of failure even in the control group (5-15%), and the perfect specificity of CIM ≤9 and BNT-15 ≤ 11 to noncredible responding, relabeling this range of performance as "Abnormal" instead of "Impaired" would better capture the uncertainty in its clinical interpretation.

Cognitive profiles of older adults with a prior traumatic brain injury versus healthy controls: A meta-analysis.

OBJECTIVE: To determine cognitive outcomes in older adults (≥ 50 years old) having sustained a traumatic brain injury (TBI) using meta-analysis. METHODS: MedLine and PsycInfo databases were searched to identify studies comparing neuropsychological profiles in older adults with and without a history of TBI across various injury severities and times post-injury. Ten studies (n = 717) meeting inclusion criteria were identified. Tests were divided into functional modalities and average effect sizes were calculated across studies on a test-by-test basis. RESULTS: Older adults post-TBI performed worse than the non-TBI group on all cognitive outcomes evaluated (d = -0.34 to -0.75), with naming and vocabulary having the largest effect, M -0.75 (95% CI, -0.98 to -0.52). CONCLUSIONS: TBI in older adults leads to moderate deficits on all measured cognitive abilities, with the largest effects observed in naming and vocabulary abilities. The findings pertain broadly to TBI of mixed injury severities and times post-injury, although the majority of participants sustained TBIs of mild uncomplicated severity within one-year post-injury. Future research must address methodological limitations such as variability in reporting injury information, inconsistency in defining older age, and lack of orthopaedic comparison groups in order to permit more nuanced conclusions for this population.

Performance validity in undergraduate research participants: a comparison of failure rates across tests and cutoffs.

OBJECTIVE: This study compared failure rates on performance validity tests (PVTs) across liberal and conservative cutoffs in a sample of undergraduate students participating in academic research. METHOD: Participants (n = 120) were administered four free-standing PVTs (Test of Memory Malingering, Word Memory Test, Rey 15-Item Test, Hiscock Forced-Choice Procedure) and three embedded PVTs (Digit Span, letter and category fluency). Participants also reported their perceived level of effort during testing. RESULTS: At liberal cutoffs, 36.7% of the sample failed ≥1 PVTs, 6.7% failed ≥2, and .8% failed 3. At conservative cutoffs, 18.3% of the sample failed ≥1 PVTs, 2.5% failed ≥2, and .8% failed 3. Participants were 3 to 5 times more likely to fail embedded (15.8-30.8%) compared to free-standing PVTs (3.3-10.0%). There was no significant difference in failure rates between native and non-native English speaking participants at either liberal or conservative cutoffs. Additionally, there was no relation between self-reported effort and PVT failure rates. CONCLUSIONS: Although PVT failure rates varied as a function of PVTs and cutoffs, between a third and a fifth of the sample failed ≥1 PVTs, consistent with high initial estimates of invalid performance in this population. Embedded PVTs had notably higher failure rates than free-standing PVTs. Assuming optimal effort in research using students as participants without a formal assessment of performance validity introduces a potentially significant confound in the study design.

Conducting research with non-clinical healthy undergraduates: does effort play a role in neuropsychological test performance?

Poor effort by examinees during neuropsychological testing has a profound effect on test performance. Although neuropsychological experiments often utilize healthy undergraduate students, the test-taking effort of this population has not been investigated previously. The purpose of the present study was to determine whether undergraduate students exercise variable effort in neuropsychological testing. During two testing sessions, participants (N = 36) were administered three Symptom Validity Tests (SVTs), the Test of Memory Malingering, the Dot Counting Test, and the Victoria Symptom Validity Test (VSVT), along with various neuropsychological tests. Analyses revealed 55.6% of participants in Session 1 and 30.8% of participants in Session 2 exerted poor effort on at least one SVT. Poor effort on the SVTs was significantly correlated with poor performance on various neuropsychological tests and there was support for the temporal stability of effort. These preliminary results suggest that the base rate of suboptimal effort in a healthy undergraduate population is quite high. Accordingly, effort may serve as a source of variance in neuropsychological research when using undergraduate students.