Clinical relevance of implicit cognition in addiction

Author(s):  
Andrew J. Waters ◽  
Adam M. Leventhal

Chapter 9 explores the clinical relevance of implicit cognition in addiction, including the associations between drug dependence and implicit measures, relationships with clinical outcomes, and the effects of treatment on implicit measures. The chapter also presents a discussion on the clinical and measurement issues involved.

10.2341/06-16 ◽  
2007 ◽  
Vol 32 (1) ◽  
pp. 60-66 ◽  
Author(s):  
S. Idriss ◽  
T. Abduljabbar ◽  
C. Habib ◽  
R. Omar

Clinical Relevance Even though marginal gap size was not shown to be a direct predictor for the extent of microleakage in resin composite restorations, both material and placement technique appear to be important determinants in microleakage and, thus, probably in clinical outcomes.


2017 ◽  
Vol 24 (9) ◽  
pp. 1224-1233 ◽  
Author(s):  
Nicky Dunn ◽  
Alexander Juto ◽  
Malin Ryner ◽  
Ali Manouchehrinia ◽  
Luca Piccoli ◽  
...  

Background: Rituximab is a chimeric monoclonal anti-CD20 B-cell-depleting antibody increasingly used off-label in multiple sclerosis (MS). The clinical relevance of anti-drug antibodies (ADAs) against rituximab in MS is unknown. Objective: To determine frequency of ADA in relation to B-cell counts, allergic reactions and clinical efficacy in a large cohort of MS-treated patients. Methods: Cross-sectional study with collection of serum samples from 339 MS patients immediately before a scheduled rituximab infusion. ADAs were detected using an in-house–validated electrochemiluminescent immunoassay and a commercial enzyme-linked immunosorbent assay (ELISA) to compare methods. Data on patient demographics and clinical outcomes were retrieved from the Swedish MS Registry and patient records. Results: ADAs were detected in 37% of relapsing–remitting MS and 26% in progressive forms of MS. Presence of ADAs decreased with increasing number of rituximab infusions. There was a significant association between both presence and titres of ADAs and incomplete B-cell depletion, but not with infusion/adverse reactions or clinical outcomes at the group level. Only five patients terminated rituximab during follow-up, four of which were ADA positive. Conclusion: Rituximab treatment is associated with a high degree of ADAs, which correlates with efficacy of B-cell depletion; however, the clinical relevance of ADAs remains uncertain.


2018 ◽  
Author(s):  
Maarten De Schryver ◽  
Sean Hughes ◽  
Jan De Houwer ◽  
Yves Rosseel

During the last two decades a new class of indirect measurement procedures has emerged that has been used widely in psychological science. These procedures were developed in order to circumvent the limitations of self-reports and crack open the hidden world of ‘implicit’ cognition. Yet despite their popularity there seems to be no general framework that constrains (or guides) the way in which we think about the reliability of implicit measures. Instead there are far too many (subjective) researcher degrees of freedom when it comes to deciding how to assess, interpret, and even report reliability. In this paper we introduce such a framework and argue that it can be used by novel and seasoned researchers alike to estimate and interpret the reliability of their implicit measures. Our approach draws on Latent Variable Modeling and the idea of parceling in order to approximate reliability (in the sense of consistency, equivalence, stability) and test the assumptions that underlie those approximations. We close by discussing the implications of our framework for the conceptualization of reliability in particular and for implicit cognition research more generally.


2020 ◽  
pp. 272-282 ◽  
Author(s):  
Laura Mezquita ◽  
Aurélie Swalduz ◽  
Cécile Jovelet ◽  
Sandra Ortiz-Cuaran ◽  
Karen Howarth ◽  
...  

PURPOSE Liquid biopsy specimen genomic profiling is integrated in non–small-cell lung cancer (NSCLC) guidelines; however, data on the clinical relevance for ALK /ROS1 alterations are scarce. We evaluated the clinical utility of a targeted amplicon-based assay in a large prospective cohort of patients with ALK/ROS1-positive NSCLC and its impact on outcomes. PATIENTS AND METHODS Patients with advanced ALK/ROS1-positive NSCLC were prospectively enrolled in the study by researchers at eight French institutions. Plasma samples were analyzed using InVisionFirst-Lung and correlated with clinical outcomes. RESULTS Of the 128 patients included in the study, 101 were positive for ALK and 27 for ROS1 alterations. Blood samples (N = 405) were collected from 29 patients naïve for treatment with tyrosine kinase inhibitors (TKI) or from 375 patients under treatment, including 105 samples collected at disease progression (PD). Sensitivity was 67% (n = 18 of 27) for ALK/ROS1 fusion detection. Higher detection was observed for ALK fusions at TKI failure (n = 33 of 74; 46%) versus in patients with therapeutic response (n = 12 of 109; 11%). ALK-resistance mutations were detected in 22% patients (n = 16 of 74) overall; 43% of the total ALK-resistance mutations identified occurred after next-generation TKI therapy. ALK G1202R was the most common mutation detected (n = 7 of 16). Heterogeneity of resistance was observed. ROS1 G2032R resistance was detected in 30% (n = 3 of 10). The absence of circulating tumor DNA mutations at TKI failure was associated with prolonged median overall survival (105.7 months). Complex ALK-resistance mutations correlated with poor overall survival (median, 26.9 months v NR for single mutation; P = .003) and progression-free survival to subsequent therapy (median 1.7 v 6.3 months; P = .003). CONCLUSION Next-generation, targeted, amplicon-based sequencing for liquid biopsy specimen profiling provides clinically relevant detection of ALK/ROS1 fusions in TKI-naïve patients and allows for the identification of resistance mutations in patients treated with TKIs. Liquid biopsy specimens from patients treated with TKIs may affect clinical outcomes and capture heterogeneity of TKI resistance, supporting their role in selecting sequential therapy.


Marketing ZFP ◽  
2019 ◽  
Vol 41 (3) ◽  
pp. 48-76 ◽  
Author(s):  
Thorsten Teichert ◽  
Alexander Graf ◽  
Sajad Rezaei ◽  
Philipp Wörfel ◽  
Helen Duh

Academics and managers need to know that key mental processes occur below the conscious awareness threshold. While unconscious processes largely influence consumer decision-making processes, self-report measures do not reveal these processes adequately. Consequently, marketers need to utilise psychologists’ indirect measures that infer unconscious mental content from reaction-time tasks. Three well-known tools are explicated in the present article: the Emotional Stroop Task, the Implicit Association Test (IAT), and the Approach-Avoidance Task (AAT). Each test taps into a different facet of implicit cognition. This research describes these test instruments’ experimental setups and alternative procedures to guide academics and practitioners when they apply implicit measures. The Ask Your Brain (AYB) survey software is presented as an online research platform for executing all three test types and provides a cost-efficient alternative to lab experiments. In this paper’s conceptual part, we outline the three test instruments’ research paradigms and describe their past applications in the marketing domain. We describe each implicit measurement instrument’s conceptual background, summarize its standard test procedures, and briefly discuss relevant methodological criticisms. We describe how the obtained measurement data should be prepared, condensed, and analysed. Subsequently, we present an empirical case to illustrate the concrete application of the different measurement instruments, utilising empirical data gained from a consumer protection study of 104 South African students. These young adults were confronted with alcohol stimuli in the Emotional Stroop Task, IAT, and AAT. They subsequently performed a discrete choice task related to alcoholic drinks and soft drinks. Based on their drink choices, we explore the extent to which the implicit measures relate to their choice behaviour. The Emotional Stroop Task is based on the premise that emotional stimuli attract more visual attention than neutral stimuli. This distraction causes a delay in response when participants are asked to name a displayed word's colour as fast as possible. Although our study could not directly support this premise, alcohol-inclined participants generally reacted more slowly to alcohol and neutral stimuli. The IAT confronts participants with combinations of a bipolar target category and a bipolar attribute category. Category combinations corresponding to the respondent's intuition (compatible) facilitate task performance and result in shorter reaction times. In our study, those individuals who chose significantly more drinks containing alcohol reacted faster to combinations of “alcohol” and “active” (rather than “alcohol” and “miserable”). This finding shows that the IAT can indeed predict choice behaviour. Finally, the AAT postulates that individuals move faster to a desired object and away from an undesired object. Both the reaction times and the error rates indicated this pattern. Individuals were slower and produced more errors during incongruent tasks (push positive items; pull negative items) than congruent tasks (pull liked items, push disliked items). This finding show that implicit measures can identify consumers´ approach and avoidance tendencies. This paper provides methodological insights into three prominent implicit cognition measures, as well as practical suggestions for practitioners and academics. We exemplify each method’s usage for research questions in marketing and consumer research. We particularly suggest using the Emotional Stroop Task for studies on attention-based processes, for example, advertisement exposure. The IAT is recommended for assessing richer cognitive processes, such as product or brand images, and the AAT when studying visceral and biological influences on impulsive consumption. Overall, we encourage marketing researchers to add implicit measures to their toolbox and to explore their contributions further for a better understanding of consumer decision making.


2019 ◽  
Vol 4 (4) ◽  
Author(s):  
Jacqueline Oi Ping Tong

PICO question In canine acute diarrhoea with no identifiable cause, does a daily probiotic supplement in diet, compared to no probiotic supplement, provide better clinical outcomes? Clinical bottom line Five placebo-controlled trials suggested a daily oral probiotic supplement provides better clinical outcomes to dogs that have acute diarrhoea (present < 14 days) without an identifiable cause. However, the strength of the evidence is limited and there is uncertainty around the clinical relevance of the studies to some of the outcomes. The probiotic agents, dose, dosing interval, the feeding methods, diets and the duration of treatment were varied in these studies. These variations can lead to different clinical outcomes.


2008 ◽  
Vol 33 (3) ◽  
pp. 247-257 ◽  
Author(s):  
J. L. Ferracane

Clinical Relevance The inevitable generation of stress in dental composites that undergo polymerization shrinkage continues to mandate a precise and careful placement technique to ensure successful clinical outcomes.


2020 ◽  
Vol 8 (7) ◽  
pp. 232596712093210
Author(s):  
Daniel P. Berthold ◽  
Lukas N. Muench ◽  
Cameron Kia ◽  
Connor G. Ziegler ◽  
Samuel J. Laurencin ◽  
...  

Background: Surgeon- and patient-specific characteristics as they pertain to total shoulder arthroplasty (TSA) are limited in the literature. The influence of surgeon upper extremity dominance in TSA and whether outcomes vary among patients undergoing right or left TSA with respect to surgeon handedness have yet to be investigated. Purpose: To determine whether surgeon or patient upper extremity dominance has an effect on clinical outcomes after primary TSA at short-term follow-up. Study Design: Case series; Level of evidence, 4. Methods: A retrospective chart review was performed on prospectively collected data from an institutional shoulder registry. Patients who underwent primary TSA for glenohumeral osteoarthritis from June 2008 to August 2012 were included in the study. Preoperative and postoperative American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test (SST), and visual analog scale (VAS) pain scores were evaluated. To determine the clinical relevance of ASES scores, the minimal clinically important difference (MCID), the substantial clinical benefit (SCB), and the patient acceptable symptom state (PASS) were used. Active forward elevation, abduction, and external rotation were recorded for each patient. Glenoid version was also evaluated preoperatively on standard radiographs. Results: Included in this study were 40 patients (n = 44 shoulders; mean age, 69.0 ± 7.3 years) with a mean follow-up of 36.5 ± 16.2 months. Final active range of motion between patients who underwent dominant versus nondominant and left versus right TSA by a right-handed surgeon was not significantly different. Clinical outcomes including the ASES, SST, and VAS pain scores were compared, and no statistical significance was identified between groups. With regard to the ASES score, 89% of patients achieved the MCID, 64% achieved the SCB, and 60% reached or exceeded the PASS. No significant difference in preoperative glenoid version between groups could be found. Conclusion: With the numbers available, neither patient nor surgeon upper extremity dominance had a significant influence on clinical outcomes after primary TSA at short-term follow-up. Clinical Relevance: The influence of surgeon and patient upper extremity dominance on TSA outcomes is an important consideration, given the preferential use of the dominant extremity exhibited by most patients during activities of daily living. To this, operating on a right shoulder might be technically more demanding for a right-handed surgeon and vice versa, as it is considered in other subspecialties.


2017 ◽  
Vol 18 (3) ◽  
pp. 299-302 ◽  
Author(s):  
Anthony Lemaire ◽  
Viktor Dombrovskiy ◽  
Siavash Saadat ◽  
George Batsides ◽  
Aziz Ghaly ◽  
...  

2019 ◽  
Vol 70 (9) ◽  
pp. 1925-1932 ◽  
Author(s):  
Caroline Agnelli ◽  
Emilio Bouza ◽  
María del Carmen Martínez-Jiménez ◽  
Raquel Navarro ◽  
Maricela Valerio ◽  
...  

Abstract Background The clinical relevance and the potential prognostic role of persistently negative (1,3)-β-D-glucan (BDG) in adults with proven candidemia is unknown. Methods This retrospective study included all adults diagnosed with candidemia our tertiary university hospital from 2012–2017 who had at least 2 serum BDG determinations throughout the episode of fungemia (Fungitell Assay; positive cut-off ≥80pg/mL). Epidemiology and clinical outcomes were compared between patients with all negative versus any positive BDG tests. Poor clinical outcomes included complications due to candidemia or 30-day all-cause mortality. Results Overall, 26/148 (17.6%) candidemic adults had persistently negative BDG tests. These patients were less likely to present Candida growth in all 3 sets of blood cultures (15.4% vs 45.1%; P = .005) and had less severe clinical presentations (median Pitt score, 0 [interquartile range {IQR} 0–1] vs 1 [IQR 0–2] in patients with any positive BDG test; P = .039). Although adequate treatment was equally provided to both groups (96.2% in persistently negative group vs 93.4 in positive group; P = .599), the persistently negative group had a higher rate of microbiological clearance in the first follow-up blood cultures (92.3% vs 69.7% in positive group; P = .005), fewer complications due to candidemia (7.7% vs 33.6% in positive group; P = .008), a lower 30-day mortality rate (3.8% vs 23.8% in positive group; P = .004), and a shorter in-hospital stay (34 days [IQR 18–55] vs 51 days [IQR 35–91] in positive group; P = .003). In the multivariate analysis, persistently negative BDG tests were independently associated with better prognoses (odds ratio 0.12, 95% confidence interval 0.03–0.49; P = .003). Conclusions Candidemic patients with persistently negative BDG tests present a better prognosis than the comparative group, probably due to a lower systemic fungal burden. In this context, the appropriate use of persistently negative BDG results could be an aid to individualize therapeutic management in the near future.


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