[Fillet flap transfer as alternative to conventional lower limb amputation]. / Filetlappentransfer als Alternative zu konventionellen Amputationen der unteren Extremität.

BACKGROUND: The fitting of a prosthesis after lower limb amputation is associated with several challenges. Skeletal stump-prosthesis interfaces and selective nerve transfer can partially overcome these but are also associated with new impairments that emphasize the necessity of innovative approaches. The concept of so-called spare part surgery with the use of fillet flaps could play an important role in this respect. OBJECTIVE: An overview of the classical prosthesis-associated discomforts, advantages and disadvantages of treatment strategies and presentation of alternative surgical concepts. MATERIAL AND METHODS: A selective literature search was carried out considering the experiences of the authors and perspectives with respect to the advantages and disadvantages of the surgical treatment options. Furthermore, a clinical case is presented. RESULTS AND CONCLUSION: The transfer of the sole of the foot as a fillet flap to the weight-bearing region of the amputation stump offers a number of benefits, such as creating a fully weight-bearing stump, prevention of neuralgia, preserved sensation and conservation of the body image. As long as the calcaneal region is not impaired, this technique can be performed in amputations below as well as above the knee. The question of whether parts of the bone should be included in the transfer must be individually evaluated for each patient. This approach enables optimization of the residual limb stump for the subsequent fitting of a prosthesis for the patient.

Social media and body image: Relationships between social media appearance preoccupation, self-objectification, and body image.

Nearly 85 % of emerging adults report using at least one social media site. Research suggests that viewing and internalizing unrealistic body ideals often displayed online may pose harmful effects on young people's body image. However, studies on the relationships between social media usage and body image have predominantly focused on women's drive for thinness. We sought to explore the relationships between social media appearance-related preoccupation (SMARP), body shame and surveillance, and drives for leanness, muscularity, and thinness, specifically examining the moderating role of gender within these relationships. Data from 939 undergraduate students (n = 240 men) were analyzed using multigroup structural equation modeling. Surveillance significantly mediated the positive associations between SMARP and drive for leanness for women and men. For SMARP and drive for muscularity, surveillance was a mediator for men only. Shame emerged as a significant mediator of the positive association between SMARP and drive for thinness for women and men. Moderated mediation was supported, such that the indirect effect of SMARP on drive for thinness was significantly stronger for women. These results suggest that for men in particular, SMARP is not necessarily associated with increased drives for leanness and muscularity unless men are also engaging in body surveillance.

Differences in menopausal quality of life, body appreciation, and body dissatisfaction between women at high and low risk of an eating disorder.

OBJECTIVE: Experiences of menopause and quality of life during menopause can vary extensively among women. While menopause has been associated with negative impacts on eating and body image, it is unclear to what extent quality of life differs by eating disorder risk status. The aim of this study was to explore how menopause symptoms and quality of life differ between those women at high- or low-risk of an eating disorder and the potential protective role of body appreciation. METHOD: This cross-sectional survey study explored differences in menopausal quality of life, body appreciation, and body dissatisfaction among women classified as high- or low-risk of an eating disorder as part of a wider survey on aging, health, and psychological complaints during midlife. Participants were 255 females aged between 40 and 60 years. Participants were classified as high-risk and low-risk of an eating disorder based on Eating Attitudes Test-26 (EAT-26) scores. Differences between groups on the Menopause-Specific Quality of Life Questionnaire (MENQOL), Body Shape Questionnaire (BSQ-16), and Body Appreciation Scale-2 were analyzed. The predictive relationship between menopausal quality of life and body appreciation was also explored. RESULTS: Participants in the high-risk group (n = 111) reported significantly poorer menopausal quality of life compared to the low-risk group (n = 144), scoring significantly higher on the sexual, physical, and psychosocial subscales of the MENQOL. The high-risk group also had significantly greater body dissatisfaction and less body appreciation than the low-risk group. Overall, menopausal quality of life was a significant predictor of body appreciation. DISCUSSION: Women with greater eating disorder risk may be faring less well with menopause. Treating and preventing menopause-related eating disorders will benefit from interventions aimed at not only reducing body dissatisfaction, but actively bolstering body appreciation and supporting the sexual, physical, and psychosocial aspects of the menopausal transition.

Body part categorical matching in chimpanzees (Pan troglodytes).

Humans categorize body parts, reflecting our knowledge about bodies, and this could be useful in higher-level activities involving bodies. We tested whether humans' closest living relatives-chimpanzees-have the same ability using touchscreen tasks, focusing on the major parts: heads, torsos, arms, and legs. Six chimpanzees were trained to perform a body part matching-to-sample task using sets of pictures of chimpanzee bodies, where in each trial, the sample and choice pictures were the same. Five passed the training and received the test sessions, where three trial types were mixed: trained same-individual picture pairs; novel same-individual picture pairs; and novel different-individual picture pairs. All participants performed better than the chance level in all conditions and for all body parts. Further analyses showed differences in performance when the samples were different body parts. For example, the results revealed better performances for heads and torsos than arms and legs in "novel different-individual pairs". The study showed that chimpanzees can visually match and categorize body parts in this experiment setting, even across different chimpanzees' bodies, suggesting potential biological understanding. Different performances for body parts suggested a deviated categorization from humans. We hope this study will inspire future research on the evolution of body perception.

Embodiment of underweight and normal-weight avatars affects bodily self-representations in anorexia nervosa.

Body image distortion (BID) is a crucial aspect of anorexia nervosa (AN), leading to body overestimation, dissatisfaction, and low self-esteem. BID significantly influences the onset, maintenance, and relapse of the pathology. We assessed whether a Full Body Illusion (FBI) using under and normal-weight avatars' bodies affects perceptual body image and body schema estimations in both individuals with anorexia nervosa (AN) and healthy controls (HC). After each embodiment procedure, we asked participants to estimate the width of their hips (Perceptual Body Image Task) and the minimum aperture width of a virtual door necessary to pass through it (Body Schema Task). Additionally, we asked participants to rate the avatars in terms of self-similarity, attractiveness, and implicit disgust (i.e., pleasant/unpleasant body odour). Whereas participants with AN (N = 26) showed changes in body schema estimations after embodying the normal-weight avatar, no changes were found in HC (N = 25), highlighting increased bodily self-plasticity in AN. Notably, individuals with AN rated the normal weight avatar as the most similar to their real body, which was also considered the least attractive and the most repulsive. These ratings correlated with BID severity. Furthermore, at the explicit level, all participants reported feeling thinner than usual after embodying the underweight avatar. Overall, our findings suggest that BID in AN engages multiple sensory channels (from visual to olfactory) and components (from perceptual to affective), offering potential targets for innovative non-invasive treatments aimed at modifying flexible aspects of body representation.

Body talk and body dissatisfaction in Japanese university students: Longitudinal study using the Japanese Body Talk Scale.

This study evaluated the reliability and validity of the Japanese version of the Body Talk Scale (BTS), designed to measure negative fat talk, negative muscle talk, and positive body talk. The study also explored the longitudinal associations between each body talk category and body dissatisfaction. We conducted two separate studies among university students in Japan. Separate confirmatory factor analyses for female and male data indicated that the initially proposed three-factor model demonstrated an acceptable fit, whereas the bi-factor model provided a better fit. The Japanese BTS showed good construct validity, acceptable to adequate internal consistency, and test-retest reliability within 2 weeks. A four-week longitudinal study involving 386 women and 216 men (mean age = 19.22 and 19.62, respectively) revealed that negative fat talk predicted an increase in the discrepancy between the thin ideal body image and the actual body image among women. In contrast, positive body talk was linked to reduced body dissatisfaction and body image discrepancy in women. There were no such significant associations in men. These findings support the use of the Japanese BTS as a valuable instrument for future research on the intrapersonal and interpersonal effects of various types of body talk.

Mitigating Harms of Social Media for Adolescent Body Image and Eating Disorders: A Review.

Social media has negative effects on adolescent body image and disordered eating behaviors, yet adolescents are unlikely to discontinue engaging with these platforms. Thus, it is important to identify strategies that can reduce the harms of social media on adolescent mental health. This article reviews research on social media and adolescent body image, and discusses strategies to reduce risks associated with social media use. Topics covered include interventions aimed at mitigating social media's negative impacts, the body-positivity movement, and policies regulating adolescents' social media use. Overall, this review highlights specific factors (such as staffing, duration, modality, facilitator training, and cultural sensitivity) to consider when designing and implementing social media interventions targeting adolescents. This review also discusses psychosocial outcomes associated with body positivity on social media. Finally, policy efforts to reduce the negative impact of social media on adolescents' body image and eating behaviors are described. In sum, there is a strong need to conduct further research identifying optimal approaches to reduce the harms of social media for adolescent body image and eating behavior.

Sexual Function of Women with and without Pregnancy-Related Pelvic Girdle Pain and its Relationship with Physical Activity, Kinesiophobia and Body Image: A Cross-Sectional Comparative Study.

The aim of this study was to compare the sexual function of women with and without pregnancy-related PGP, and to investigate its relationship with physical activity (PA), kinesiophobia, and body image (BI). Demographic characteristics, sexual function (Pregnancy Sexual Response Inventory), PA (Pregnancy Physical Activity Questionnaire), kinesiophobia (Tampa Kinesiophobia Scale), and BI (Body Image in Pregnancy Scale) of 125 pregnant women were recorded. In the PGP group (n = 46), visual analogue scales were used to assess the pain intensity during resting and sexual activity, and Pelvic Girdle Questionnaire was used to evaluate the activity limitation. Although total sexual function and BI scores of the groups were similar (p > 0.05), dyspareunia during pregnancy and level of kinesiophobia were higher, and energy expenditure during moderate-intensity PA was lower in pregnant women with PGP (p < 0.05). The PGP group had moderate activity limitation and reported increased PGP intensity during sexual activities (p < 0.001). PA level was significantly correlated with sexual desire (r = 0.180), and overall sexual function was correlated with kinesiophobia (r = -0.344) and BI (r = -0.199) during pregnancy (p < 0.05). These findings suggest that pregnant women with PGP are more vulnerable to sexual dysfunctions, and there is a need to develop biopsychosocial framework-oriented management strategies which aim to improve PA level and to eliminate psychological factors such as kinesiophobia and negative BI.Clinical Trial Registration: NCT05990361.

Relationship between dyadic communication and body image among women with breast cancer.

PURPOSE: Dyadic communication positively affects marital relationships, good relationships help restore body image, and this study explores the relationship between dyadic communication and body image of breast cancer patients. METHODS: Cross-sectional correlation design with convenience sampling was used to recruit participants from two outpatient medical centers. Demographic information, medical records, and two questionnaires, dyadic communicative resilience scale (DCRS) and body image scale (BIS), were administered. Participants comprised women with breast cancer and their partners. Multiple regression analysis was performed to control related factors to understand the association between the DCRS of the women with breast cancer and their partners and the women's body image. Analysis of variance (ANOVA) was performed to analyze between three categories of couple's communication status (consistent and good, consistent and poor, and inconsistent) and body image of women with breast cancer. RESULTS: Data were obtained from 162 women with breast cancer and 90 partners. The study found (1) significant correlation between the women's perception of their communication and body image, (2) humor in partner's perception of their communication was significantly associated with women's body image, and (3) dyadic communication that both patients and partners were consistent and good in the domain of keeping pre-cancer routines and attractiveness was associated with women's body image. CONCLUSION: The correlation between dyadic communication and the body image of women with breast cancer is significant. Improving communication specific on keeping pre-cancer routines and attractiveness between women with breast cancer and their partners could enhance the women's body image.

[Esthetic reconstruction of traumatic defects by plastic surgery]. / Plastisch-ästhetische Wiederherstellung traumatischer Defekte.

INTRODUCTION: The primary goal is preservation of the affected extremity, which can be associated with limitations in tasks relevant for daily life and a distorted body image caused by the original trauma. Therefore, a secondary goal is to reduce the trauma sequelae. RESULTS: For an esthetic outcome the choice of flap surgery is crucial. Factors such as tissue thickness, skin color, and hair covering need to be considered. The flap should blend seamlessly with the tissue surrounding the defect. The localization and closure of the defect are also important. The flaps undergo vascular, lymphatic and trophic postoperative changes caused by the so-called autonomization. Measures, such as compression therapy reshape the microcirculation and result in volume reduction of the transplant. It is important to preoperatively educate patients about this process. After completion of the conditioning surgical thinning procedures are available for persistent unattractive results, e.g., open surgical and liposuction techniques. CONCLUSION: Microsurgical defect coverage of traumatic skin and soft tissue defects is a compromise between limb preservation and functionality. In cases of missing local soft tissue, secure closure of the defect should be prioritized but initial esthetic considerations should also influence the choice of tissue transplant. Patients should be informed early about the development of the flap surgery and undergo postoperative compression therapy for conditioning. Secondary operative corrections are also possible.

The influence of body image on psychological symptomatology in breast cancer women undergoing intervention: a pre-post study.

Introduction: Body image concerns related to breast cancer surgery may challenge patients' quality of life and their treatment outcomes, thus representing a key aspect to be assessed in the psycho-oncological settings. The present longitudinal study is aimed to (1) investigate the association between preoperative body image and postoperative psychological symptoms in breast cancer patients; (2) explore the impact of pre-/post-surgery variation in body image on psychological symptomatology. Methods: N = 72 women undergoing breast cancer surgery were preoperatively screened (T1) using the Body Uneasiness Test (BUT) and were assessed postoperatively (T2) using the Symptom Checklist-90 Revised (SCL-90-R) and re-administered the BUT. Spearman's correlation was used to investigate the relationship between age, preoperative body image and postoperative psychological symptoms, and variation in body image. To predict post-surgical psychological symptomatology, two separated multiple regression models were used to evaluate preoperative body image and its variation after surgery controlling for covariates (i.e., education; intervention type). P significance was set as 0.05 for all analyses and adjusted for multiple comparisons. Results: At T1, anxiety in relation to body image scores emerged as the most frequently experienced psychological symptomatology after surgery (all adjusted p < 0.05). Significant correlations were observed between all SCL-90-R scores at T2 and avoidance behaviors and depersonalization scores at T1. The associations were most significantly strong for somatization, depression, anxiety, and hostility (all adjusted p < 0.05). However, change in body image between pre- and post-intervention was not associated with psychological symptomatology at T2 (all adjusted p > 0.05). Pre-surgery body avoidance was significantly associated with post-intervention psychological symptoms (SOMß = 0.453, p = 0.0001; DEPß = 0.507, p = 0.0001; AXß = 0.459, p = 0.0001; HOSß = 0.410, p=. 0001). However, increased weight phobia between pre- and post-surgery was statistically associated with increased somatization, anxiety, depression and hostility at T2 (ßSOM = 0.439, p = 0.0001; ßDEP = 0.454, p = 0.0001; ßANX = 0.471, p = 0.0001). Discussion: Overall, pre-/post-intervention body concerns were significantly associated with primary psychological symptoms in breast cancer patients undergoing surgery. Higher levels of body avoidance and weight phobia were significantly associated with the primary psychological dimensions assessed. As body concerns might act as quality-of-life predictors, their evaluation is crucial in fostering patients' well-being and treatment adherence.

Media, Advertising and Inventing (Anna)rexia.

Too many Australians suffer from poor body image and eating disorders. The Israeli, French and Norwegian Governments have created body image legislation to try to address this: it responds to concerns that the countless images of thin women people see can contribute to poor body image. By contrast, Australia does not have a Body Image Law: it has a voluntary code that the advertising industry generally does not follow. This article argues that Australia should enact a Body Image Law that reflects health evidence that body image needs to be improved. The Body Image Law would require disclaimers on images that were not retouched, create a specialised government body to evaluate images and attract civil penalties for breaching it. The authors believe that this is the first Australian article to suggest an Australian Body Image Law of this kind.

Untangling the relationships between age, gender, type of sport, perfectionistic self-presentation and motivation on body satisfaction: a cross-sectional study on aesthetic and non-aesthetic female and male athletes aged 10 to 22 years.

Objectives: To explore the relationships between age, gender, type of sport, perfectionistic self-presentation and motivation on body satisfaction among young athletes in one aesthetic sport (gymnastics) and one non-aesthetic sport (basketball). The study hypothesise that (1) age, gender and type of sport (aesthetic or non-aesthetic) will predict body satisfaction scores, (2) autonomous motivation will positively be related to body satisfaction and (3) perfectionistic self-presentation will negatively be related to body satisfaction. Design: Cross-sectional. Method: 209 athletes (132 gymnasts and 77 basketball players) aged 10-22 (median=13) years were recruited. After data screening, 200 athletes were included in analyses (females: n=155; males: n=45). Participants completed an online survey, which assessed demographic information, athlete motivation (Behavioural Regulation in Sport Questionnaire), perfectionistic self-presentation (Perfectionistic Self-Presentation Scale-Junior Form) and body satisfaction (Body Appreciation Scale-2). Results: Hierarchical multiple regression showed age, self-assigned gender, and two facets of perfectionistic self-presentation (ie, perfectionistic presentation and non-disclosure of imperfection) to predict reported levels of body satisfaction significantly. Subsequently, adding motivational variables did not improve the model. A moderation analysis showed that the relationship between non-disclosure of imperfection and body satisfaction was significantly moderated by gender. Conclusions: Two facets of perfectionistic self-presentation were associated with reported body satisfaction. Additionally, the relationship between non-disclosure of imperfection and body satisfaction appears to differ between female and male athletes. Researchers should move beyond sport types and identify factors (eg, perfectionistic self-presentation) at the individual and environmental levels that can protect young athletes' body satisfaction.

Profiling and assessing the risks of image- and performance-enhancing drugs use during the COVID-19 lockdown.

Background: Image and Performance-Enhancing Drugs (IPEDs) can enhance mental and physical capabilities and impact one's overall health. Initially confined in sport environments, IPEDs use has become increasingly widespread in a high-performing society. The present study was aimed at profiling IPEDs use during the COVID-19 lockdown among an international sample of young adults. Methods: A cross-sectional observational study was carried out in eight countries (United Kingdom, Italy, Lithuania, Hungary, Portugal, Spain, Brazil, and Japan) between April and May 2020. The survey questionnaire included validated measurements such as Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI), and Self-Compassion Scale (SCS) as well as questions about the type of IPEDs, purchasing methods and socio-demographic information. Results: A total of 736 IPEDs users were included in the survey. Their mean age was 33.05 years (±SD = 10.06), and 64.2% were female participants. Overall, 6.8% were found at risk of exercise addiction (EAI >24), 27.6% presented high levels of appearance anxiety, and 24.9% revealed low levels of emotional regulation's self-compassion. Most participants (55.6%) purchased IPEDs through pharmacies/specialized shops, while 41.3% purchased IPEDs on the Internet. Online IPEDs buyers were mainly men who had higher scores on the Exercise Addiction Inventory. One or more IPEDs classifiable as "potentially risky" were used by 66.3% of the sample. Users of "potentially risky IPEDs" were younger and primarily men. They showed higher scores both on the Exercise Addiction Inventory and Appearance Anxiety Inventory. Conclusion: This study profiled users of IPEDs when the most restrictive COVID-19 lockdown policies were implemented in all the participating countries. More targeted post-COVID 19 prevention strategies should be implemented according to the emerged socio-demographic and psychopathological traits and cross-cultural differences emerged. Longitudinal studies will also be needed to determine the long-term effect of the COVID-19 lockdown on IPEDs consumption.

A Call for More Culture-Based Research to Understand Body Dissatisfaction and Disordered Eating in Men: Commentary on Monocello et al. (2024).

Using culture-based approaches, Monocello et al. revealed that young Korean men generally shared the same perceptions of fatness, including three categories ("too thin," "balanced," and "too fat"). The "balanced" category was most consistent with local South Korean culture, and the "too fat" category was associated with higher body dissatisfaction and disordered eating. Even though cultural differences in body ideals are an essential factor to consider in the development of body dissatisfaction and disordered eating, little research has applied culture-based approaches to explore body ideals in men, including how these ideals may be related to men's body image or eating behaviors. Thus, Monocello et al.'s work is a timely and vital contribution to the literature. In this commentary, we expand on Monocello et al.'s work by not only illustrating the roles of local cultures but also introducing the potential influences of external cultures via acculturation in shaping body ideals which, in turn, contribute to body dissatisfaction and disordered eating in men. We also provide future research directions to call for more culture-based research to understand body dissatisfaction and disordered eating among men in different cultural contexts.

Psychometric properties of the arabic translation of the Physical Appearance Comparison Scale-Revised (PACS-R) in adults.

BACKGROUND: Physical comparison may be a factor in body dissatisfaction and related issues, like eating disorders and depression. The Physical Appearance Comparison Scale-Revised (PACS-R) is a scale developed to assess the frequency of physical comparison. Because there is no validated scale for body comparison in Arabic, this study aims to address this gap by validating the PACS-R in the Arabic language. METHODS: The PACS-R was translated to Arabic following a conventional forward-backward translation procedure, and was administered to a sample of 359 Lebanese adults along with The Depression Anxiety Stress Scale, and the Rosenberg self-esteem scale (RSES) for convergent validity. The factor structure was studied by confirmatory factor analysis (CFA), and composite reliability was assessed using McDonald's omega and Cronbach's alpha. RESULTS: Results suggested a one-factor structure of the Arabic PACS-R, with good internal consistency (McDonald's ω = 0.97 / Cronbach α = 0.97). Measurement invariance was established across sex groups, with no significant difference being reported between males and females in terms of PACS-R scores (15.42 ± 10.64 vs. 13.16 ± 11.88; t(357) = 1.84; p = .066). Finally, adequate convergent validity was tested and found to be adequate, with PACS-R scores found to be correlated negatively with self-esteem and positively with psychological distress. CONCLUSION: The present findings preliminarily establish the Arabic PACS-R as an effective instrument for researchers and practitioners aiming to explore the physical comparison among Arabic-speaking populations, thus contributing to research and clinical work in the Arabic community.

Tackling bisexual erasure: An explorative comparison of bisexual, gay and straight cisgender men's body image.

Previous body image research often grouped both gay and bisexual men into a single category: sexual minoritised men, limiting our understanding of how sexual identity influences body image. However, there is strong reason to believe that bisexual and gay men experience distinct body image concerns. Here, we explored motivations to alter one's leanness and muscularity, as well as (dis)satisfaction with body fat, muscularity, height and penis size, and functionality appreciation across gay, bisexual, and straight cisgender men. We sampled 378 white participants aged 18 to 85 (nbisexual = 125, ngay = 128, nstraight = 125). We found that bisexual men were significantly less motivated to be lean and showed lower muscularity dissatisfaction relative to gay men but showed comparable levels to straight men. Our findings demonstrate that despite research perceiving the body image of bisexual and gay men as homogenous, they experience differences in their body image concerning leanness and muscularity dissatisfaction. Future body image research should incorporate this understanding by not artificially grouping bisexual and gay cisgender men and instead acknowledging the potential uniqueness in their experiences.

Experiences of body image in the gender non-binary community: A qualitative analysis.

Body image concerns are prevalent within transgender communities - many transgender people engage in disordered eating to suppress or accentuate secondary sex characteristics and reduce gender dysphoria. However, this research has mostly been conducted with binary transgender people. Here, we examine how non-binary people experience and relate to their bodies. Semi-structured one-on-one interviews were conducted with 13 gender non-binary individuals living in Australia. Photo elicitation techniques were utilised, and the transcribed interview data were analysed using reflexive thematic analysis. Six themes were identified: Expansive Understandings of Body Image, Body Image can be Linked to Gender Dysphoria, Cultivating a Preferred Body can Lead to Gender Euphoria, Appreciating Diversity in Non-Binary Body Ideals, The Androgynous Body Ideal is not Universally Accepted, and Experiencing the Body as Functional rather than Aesthetic. The present findings highlight the diversity of experiences of body image for non-binary people. The non-binary concept of body image was found to be expansive, stressing various physical attributes involved in social gender recognition and physiological sources of gender dysphoria. Some participants valued gender-affirming medical intervention, others were accepting of their bodies as they are, attributing their body confidence to the process of affirming their non-binary gender.

Effects of repetitive transcranial magnetic stimulation of the right inferior parietal lobe on the body image perception in anorexia nervosa: A pilot randomized controlled study.

INTRODUCTION: Restrictive anorexia nervosa (AN) is associated with distorted perception of body shape, previously linked to hypoactivity and reduced excitability of the right inferior parietal lobe (rIPL). Here, we investigated the impact of high-frequency repetitive transcranial magnetic stimulation (HF rTMS) of the rIPL on body shape perception in patients with AN. METHODS: Seventeen patients with AN (median [Q1_Q3] age, 35 [27_39] years; disease duration, 12 [6_18] years) were randomly assigned to receive real or sham HF (10 Hz) rTMS of the rIPL over a period of 2 weeks, comprising 10 sessions. The primary outcome measure was the Body Shape Questionnaire (BSQ). Secondary outcomes included eating disorder symptoms, body mass index, mood, anxiety, and safety. Data collection were done at baseline, post-rTMS, and at 2 weeks and 3 months post-rTMS. RESULTS: Following both real and sham rTMS of the rIPL, no significant differences were observed in body shape perception or other parameters. Both real and sham rTMS interventions were deemed safe and well tolerated. Notably, serious adverse events were associated with the underlying eating and mood disorders, resulting in hospitalization for undernutrition (five patients) or suicidal attempts (two patients). CONCLUSION: This pilot study does not support the use of rTMS of the rIPL as an effective method for improving body shape perception in individuals with the restrictive form of AN. Further research is warranted to comprehensively explore both the clinical and neurophysiological effects of HF rTMS in this population.

Body image, self-efficacy, and sleep quality among patients with breast cancer: A latent profile and mediation analysis.

PURPOSE: As a sign of femininity, impaired breast after surgery causes particularly confusion for patients with breast cancer resulting in increased body image distress, which has negative impacts on sleep quality. And self-efficacy enables patients to use positive and effective coping strategies to maintain a favorable night's sleep. Therefore, our study is to explore the heterogeneity in body image experienced by patients with breast cancer and to examine the mediation effects of self-efficacy between body image and sleep quality. METHOD: Between July 2023 and October 2023, 251 patients with breast cancer were recruited for the Be Resilient to Breast Cancer program. They responded to the General Perceived Self-Efficacy Scale, Body Image Scale, and Pittsburgh Sleep Quality Index Scale. Data were analyzed using a latent profile analysis (LPA) and mediation analysis. RESULTS: Results of the LPA indicated that body image could be classified into three subgroups as follows: low (43.0%), moderate (45.5%), and high (11.5%). Furthermore, the mediation analysis demonstrated two partially mediated effects upon comparing the low and moderate (standard error, SE = 0.548, 95% confidence interval, CI = 0.009, 0.366) and the high and low (SE = 0.848, 95% CI = 0.570, 3.909) body image groups. CONCLUSION: Heterogeneity exists in body image, and self-efficacy mediates the relationship between body image and sleep quality. Hence, promoting self-efficacy can buffer the negative impacts of body image on sleep quality in patients with breast cancer, and self-efficacy-orientated interventions should also receive more attention in clinic.