Publications by authors named "Wiener A"

Early life adversity (ELA) is associated with a multitude of neural and behavioral aberrations. To develop treatments to mitigate the effects of ELA, it is critical to determine which aspects of cognition are affected and when these disturbances manifest across the lifespan. Here, we tested the effects of maternal separation, an established rodent model of ELA, on punishment-driven risky decision-making longitudinally in both adolescence (25-55 days old) and adulthood (80-100 days old).

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Background: Patients in low- and middle-income countries (LMICs) are disproportionately affected by liver cancers but there is a lack of understanding of their postoperative outcomes. This study aimed to review the current status of research in LMICs regarding outcomes after oncologic hepatectomy and synthesize the data reported in the literature.

Methods: The PubMed, Scopus, Embase, Web of Science, and World Health Organization (WHO) Global Index Medicus databases were searched from database inception to May 26th, 2022.

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Objectives: Sentinel lymph node (SLN) mapping is a surgical technique with high accuracy in detecting metastases while limiting morbidity associated with full lymphadenectomy in endometrial cancer. Cervical injection of indocyanine green (ICG) dye is associated with very high SLN detection rates; however, iodinated contrast allergy has traditionally been viewed as a contraindication to ICG use. The objective of this study was to describe the use of ICG in a population of patients with iodinated contrast allergies undergoing surgical staging for endometrial cancer.

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With the COVID19 pandemic, use of telehealth has expanded rapidly in subspecialties with limited prior telehealth experience. While telehealth offers many opportunities to improve patient convenience, access, and comfort, the virtual platform poses unique challenges for shared decision making. In this review article, we describe what occurs within a standard in-person breast surgery consult and propose a model for an ideal virtual breast surgery consult, including strategies to foster patient engagement and shared decision making.

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Article Synopsis
  • This study evaluated four methods for pain control during radioactive tracer injections in breast cancer patients, comparing ice alone, ice with a vibrating device, a lidocaine patch, and a combination treatment.
  • Results showed no significant differences in pain scores or patient satisfaction between the standard ice treatment and other methods, with most patients expressing satisfaction overall.
  • Healthcare providers found the lidocaine patch the easiest to use, while treatments involving the vibrating device (Buzzy) were rated more difficult, suggesting that ice may remain a practical and effective standard for pain management.
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Background: The investigation of the fetal umbilical-portal venous system is based on the premise that congenital anomalies of this system may be related to adverse perinatal outcomes. Several small retrospective studies have reported an association between umbilical-portal-systemic venous shunts and intrauterine growth restriction. However, the prevalence of portosystemic shunts in the fetal growth restricted population is yet to be determined.

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Background: In nonpregnant adults, poor sleep is associated with higher blood pressure. Poor sleep is common in the postpartum period and is often attributed to infant caretaking needs. However, its effects on cardiovascular health in individuals with a hypertensive disorder of pregnancy are unknown.

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Effective decision-making involves careful consideration of all rewarding and aversive outcomes. Importantly, negative outcomes often occur later in time, leading to underestimation, or "discounting," of these consequences. Despite the frequent occurrence of delayed outcomes, little is known about the neurobiology underlying sensitivity to delayed punishment during decision-making.

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COVID-19 disease is associated with a significant number of opportunistic infections, including invasive fungal infections such as mucormycosis. The prevalence of the latter is rare, estimated to be between 0.005 and 1.

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Chronic stress can change how we learn and, thus, how we make decisions. Here we investigated the neuronal circuit mechanisms that enable this. Using a multifaceted systems neuroscience approach in male and female mice, we reveal a dual pathway, amygdala-striatal neuronal circuit architecture by which a recent history of chronic stress disrupts the action-outcome learning underlying adaptive agency and promotes the formation of inflexible habits.

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Objective: The objective of this study is to develop a model that will help predict the risk of blood transfusion using information available prior to delivery.

Study Design: The study is a secondary analysis of the Consortium on Safe Labor registry. Women who had a delivery from 2002 to 2008 were included.

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We report methods that improve the quantification of digital bead assays (DBA)─such as the digital enzyme-linked immunosorbent assay (ELISA)─that have found widespread use for high sensitivity measurement of proteins in clinical research and diagnostics. In digital ELISA, proteins are captured on beads, labeled with enzymes, individual beads are interrogated for activity from one or more enzymes, and the average number of enzymes per bead (AEB) is determined based on Poisson statistics. The widespread use of digital ELISA has revealed limitations to the original approaches to quantification that can lead to inaccurate AEB.

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Importance: Although longer times from breast cancer diagnosis to primary surgery have been associated with worse survival outcomes, the specific time point after which it is disadvantageous to have surgery is unknown. Identifying an acceptable time to surgery would help inform patients, clinicians, and the health care system.

Objective: To examine the association between time from breast cancer diagnosis to surgery (in weeks) and overall survival and to describe factors associated with surgical delay.

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  • The study aimed to assess local and regional recurrence rates in women who underwent breast-conserving surgery as part of older clinical trials, while also examining how these rates vary based on the tumor's receptor subtype.
  • Data from 4,404 women diagnosed with breast cancer between 1997 and 2010 was analyzed, revealing a 5-year overall recurrence rate of 4.6%, which was lower than previous estimates, particularly for patients with hormone receptor-positive tumors.
  • The findings indicated that triple-negative breast cancer had the highest recurrence rate (7.1%), and factors like increased lymph node involvement and triple-negative subtype were significantly linked to higher recurrence risks.
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Background: Radiation-associated sarcoma (RAS) is a rare sequela of radiotherapy. Radiotherapy modalities for breast conservation and radiation treatment (BCT) have changed over time. We sought to determine if the incidence of RAS after BCT has changed over time.

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Within weeks of New York State's first confirmed case of COVID-19, New York City became the epicenter of the nation's COVID-19 pandemic. With more than 80,000 COVID-19 hospitalizations during the first wave alone, hospitals in downstate New York were forced to adapt existing procedures to manage the surge and care for patients facing a novel disease. Given the unprecedented surge, effective patient load balancing-moving patients from a hospital with diminishing capacity to another hospital within the same health system with relatively greater capacity-became chief among the capabilities required of New York health systems.

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Working memory (WM) training has gained interest due to its potential to enhance cognitive functioning and reduce symptoms of mental disorders. Nevertheless, inconsistent results suggest that individual differences may have an impact on training efficacy. This study examined whether individual differences in training performance can predict therapeutic outcomes of WM training, measured as changes in anxiety and depression symptoms in sub-clinical and healthy populations.

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Purpose: The available questionnaires for quality-of-life (QoL) assessments are age-group specific, limiting comparability and impeding longitudinal analyses. The comparability of measurements, however, is a necessary condition for gaining scientific evidence. To overcome this problem, we assessed the viability of harmonising data from paediatric and adult patient-reported outcome (PRO) measures.

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Background: Cutaneous melanoma survivors are at increased risk of a second primary melanoma. Valid estimates facilitate counseling on recommended surveillance after a melanoma diagnosis. However, most estimates of 5- and 10-year incidences of second melanomas are from older cohorts and/or single institutions.

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  • Some surgeons are worried about doing immediate breast reconstruction (IBR) for patients with higher-risk breast cancers because of fears about cancer coming back or being detected too late.
  • A study analyzed data from women with stage II/III breast cancer to see how often local-regional recurrences happened among those who had IBR compared to those who did not.
  • Results showed only a 3.6% recurrence rate for women who had IBR, and there was no significant difference in recurrence rates between the two groups, suggesting that IBR can be safely considered for these patients.
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Background: Essential hypertension is an important risk factor for cerebrovascular diseases and a major cause of premature death in industrialized societies. A predisposing factor for essential hypertension is prehypertension: blood pressure (BP) values at rest that are at the higher end of the normal range. Abnormally enhanced cardiovascular responses to motor and emotional tasks have been found as predictors of essential hypertension.

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B cells have essential functions in multiple sclerosis and in its mouse model, experimental autoimmune encephalomyelitis, both as drivers and suppressors of the disease. The suppressive effects are driven by a regulatory B cell (Breg) population that functions, primarily but not exclusively, via the production of IL-10. However, the mechanisms modulating IL-10-producing Breg abundance are poorly understood.

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