Wayne State University

Childhood maltreatment and FKBP5 CATT haplotypes increase identity dissociation risk. While maltreatment often fosters disorganized attachment, the specific role of the FKBP5 CATT haplotype within this developmental pathway remains unknown. In 310 trauma-exposed adults, we assessed childhood maltreatment, disorganized attachment, and identity dissociation. FKBP5 CATT haplotype status was dichotomized (present/absent). Regression models were estimated to examine the pathway Childhood Maltreatment → Disorganized Attachment → Identity Dissociation, comparing two competing hypotheses: 1) The Formation Hypothesis (Maltreatment × CATT → Disorganization), and 2) The Translation Hypothesis (Disorganization × CATT → Identity Dissociation). Model fit was compared using BIC, and simple slopes were examined. Disorganized attachment predicted identity dissociation (β = 0.143, z = 3.83, p < .001), and childhood maltreatment predicted disorganization (β = 0.007, z = 4.46, p < .001). The Formation hypothesis was not supported, as the Maltreatment × CATT interaction did not predict disorganization (β = -0.004, z = -1.18, p = .24). However, the Translation hypothesis was supported by three pieces of evidence: a significant Disorganization × CATT interaction predicting identity dissociation (β = 0.133, z = 2.22, p = .027), model fit (∆BIC = 265.3), and simple slopes showing a strong effect of disorganization on identity dissociation for CATT carriers (β = 0.15, p < .001; +16.5 % per unit) but not for non-carriers (β = 0.02, p = .65). The FKBP5 CATT haplotype does not promote disorganized attachment but amplifies the translation of disorganized attachment into identity dissociation. This result highlights a genetically influenced failure of identity development following disorganized attachment.

To evaluate the use of povidone-iodine infusion during pars plana vitrectomy and to assess its clinical outcomes in the treatment of severe endophthalmitis. A retrospective case series of 40 patients (41 eyes) with clinically or culture-confirmed endophthalmitis underwent pars plana vitrectomy with 0.025% povidone-iodine in the infusion solution. Outcomes included infection resolution, improvements in visual acuity, the need for additional surgeries, and signs of ocular toxicity. Of the 41 eyes treated, infection resolved in 33 (80.4%) eyes postoperatively. Visual acuity improved postoperatively in 29 eyes (70.7%). Mean uncorrected visual acuity improved from 20/3,337 (2.22 ± 0.70 logMAR) preoperatively to 20/540 (1.43 ± 0.88 logMAR) postoperatively ( P < 0.0001). No ocular toxicity or unexplained vision loss related to povidone-iodine infusion was observed. The addition of 0.025% povidone-iodine infusion during pars plana vitrectomy appears safe and led to favorable post-surgical outcomes in a traditionally high-risk cohort.

• Solvation parameter model provides a link between chromatographic and partition processes. • A visualization technique and d -parameter combination is a practical approach to identify surrogate chromatography systems. • Surrogate chromatographic systems are a cost effective approach in estimating partition properties of interest. Many partition processes of interest have been characterised using Abraham's solvation parameter model. However, to estimate physicochemical, environmental, or biophysical properties of compounds requires reliable solute descriptors. Exploitation of the correlation of partition processes and chromatographic retention data is an alternative approach to estimate properties of interest without relying on solute descriptors. The system constants of the solvation parameter model, along with screening tools such as Cos θ, d -parameter, D -parameter, principal component analysis, and hierarchical cluster analysis, facilitate the identification of similarities between partitioning and chromatographic systems. In this review we discuss various screening tools to identify similarities between partitioning and chromatographic systems as well as applications of surrogate chromatographic models to estimate physicochemical, environmental, and biophysical properties of interest.

To investigate longitudinal trends in the American Board of Emergency Medicine (ABEM) Qualifying Examination (QE) performance, identify statistically significant inflection points in pass rates, and determine factors associated with the recent decline observed in 2022. This was a retrospective, observational study conducted in 2 phases. Phase 1 analyzed all QE attempts from 1980 to 2024 (n = 83,254) to identify changepoints using segmented regression and Bayes factor comparisons. Phase 2 focused on QE attempts surrounding the most recent changepoint from 2016 to 2024 (n = 23,784) and used multilevel nonlinear piecewise growth models to examine the association between physician characteristics and QE pass rates before and after the 2022 changepoint. Three statistically significant changepoints were identified: 1988, 2003, and 2022. Although increases in pass rates were noted in 1988 and 2003, 2022 was marked by a decline in pass rates with a steeper drop post-2022 (slope from 2016 to 2022 = -0.17 vs slope 2022 to 2024 = -0.67). From 2016 to 2022, MD graduates had a lesser decline in performance compared with non-MD peers. After 2022, those trained during the COVID pandemic also experienced a lesser decline. ABEM QE pass rates experienced 3 major inflection points since 1980, with the most recent occurring in 2022 and representing a meaningful decline. Physician-level characteristics, particularly medical school degree type and COVID-era training, were significantly associated with this trend.

To examine daily within-person associations between symptoms reported by people with multiple sclerosis (MS) and psychoactive substance use using ecological momentary assessment (EMA). This secondary analysis used EMA data collected 4 times daily for 14 days at baseline and 1-year and 2-year follow-ups. Community. Ambulatory adults with MS (N=258). Participants completed daily EMAs via smartphone, reporting use of psychoactive substances and symptoms. Psychoactive substance use (alcohol, caffeine, nicotine, cannabis, and opioids) was assessed dichotomously (yes/no). Momentary symptoms, including fatigue, pain, stress, and depressive symptoms, were assessed using brief self-report measures. Mixed-effects logistic regression models assessed lagged associations between symptoms and subsequent substance use; multilevel models examined the reverse direction. Momentary increases in stress predicted lower odds of alcohol use. Higher average pain was linked to reduced alcohol use and increased opioid use. Substance use also predicted symptoms: alcohol, nicotine, and cannabis were associated with greater fatigue, whereas caffeine predicted reduced fatigue. Cannabis was linked to higher momentary pain, and opioids to higher average pain. Alcohol was associated with reduced stress, whereas caffeine predicted increased stress. MS symptoms and psychoactive substance use are dynamically and bidirectionally related. These findings improve understanding of how individuals with MS use substances for symptom regulation, which may lead to both beneficial and adverse outcomes.