Aim To evaluate, from a US payer perspective, the cost-effectiveness of treatment strategies for metastatic colorectal cancer (mCRC). Methods We performed a systematic review of published cost-effectiveness analyses of treatment strategies for mCRC with pre-specified search criteria. Results We identified 14 papers that fulfilled our search criteria and revealed varying levels of value amongst current treatment strategies. Older agents such as 5FU, irinotecan, and oxaliplatin provide high value treatments. More modern agents targeting the EGFR or VEGF pathways, such as bevacizumab, cetuximab and panitumumab do not appear to be cost effective treatments at their current costs. The analytical methods used within the papers varied widely, and likely plays a significant role in the heterogeneity in incremental cost effectiveness ratios. Conclusions The cost-effectiveness of current treatment strategies for mCRC is highly variable. Drugs recently approved by the Federal Drug Administration (FDA) for mCRC are not cost-effective, and this is primarily driven by high drug costs.

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One aspect of selfhood that may have relevance for borderline personality disorder (BPD) is variation in sense of body ownership. We employed the rubber hand illusion to manipulate sense of body ownership in BPD. We extended previous research on illusory body ownership in BPD by testing: (i) two illusion conditions: asynchronous and synchronous stimulation, (ii) relationship between illusion experience and BPD symptoms, and (iii) relationship between illusion experience and maladaptive personality traits. We measured illusion strength (questionnaire responses), proprioceptive drift (perceived shift in physical hand position), BPD symptoms (Revised Diagnostic Interview for Borderlines score), and maladaptive personality traits (Personality Inventory for DSM-5) in 24 BPD and 21 control participants. For subjective illusion strength, we found main effects of group (BPD > healthy control, F(1, 43) = 11.94, P = 0.001) and condition (synchronous > asynchronous, F(1, 43) = 22.80, P < 0.001). There was a group × condition interaction for proprioceptive drift (F(1, 43) = 6.48, P = 0.015) such that people with BPD maintained illusion susceptibility in the asynchronous condition. Borderline symptom severity correlated with illusion strength within the BPD group, and this effect was specific to affective (r = 0.45, P < 0.01) and cognitive symptoms (r = 0.46, P < 0.01). Across all participants, trait psychoticism correlated with illusion strength (r = 0.44, P < 0.01). People with BPD are more susceptible to illusory body ownership than controls. This is consistent with the clinical literature describing aberrant physical and emotional experiences of self in BPD. A predictive coding framework holds promise to develop testable mechanistic hypotheses for disrupted bodily self in BPD.

Personal space regulation is a key component of effective social engagement. Personal space varies among individuals and with some mental health conditions. Simulated personal space intrusions in Borderline Personality Disorder (BPD) reveal larger preferred interpersonal distance in that setting. These findings led us to conduct the first test of live interpersonal distance preferences in symptoms in BPD. With direct observation of subjects' personal space behavior in the stop-distance paradigm, we found a 2-fold larger preferred interpersonal distance in BPD than control (n = 30, n = 23). We discuss this result in context of known biology and etiology of BPD. Future work is needed to identify neural circuits underlying personal space regulation in BPD, individual differences in preferred interpersonal distance in relation to specific symptoms and relationship to recovery status.

word count: 261 34 35 Main Text Word Count: 5512 Abstract 46Background: One aspect of selfhood that may have relevance for Borderline Personality 47 Disorder (BPD) is variation in sense of body ownership. We employed the rubber hand illusion 48 (RHI) to manipulate sense of body ownership in BPD. We extended previous research on 49 illusory body ownership in BPD by testing: 1) two illusion conditions: asynchronous & 50 synchronous stimulation, 2) relationship between Illusion experience and core BPD symptoms, 51 and 3) relationship between illusion experience maladaptive personality traits. 53Methods: Participants (24 BPD, 21 control) underwent RHI procedures. We measured illusion 54 strength (questionnaire responses), proprioceptive drift (perceived shift in physical hand 55 position), BPD symptoms (DIB-R score), and maladaptive personality traits (PID-5). 57Results: For subjective illusion strength, we found a main effect of group (BPD > HC, F = 11.94 58 p = 0.001), and condition (synchronous > asynchronous, F(1,43) = 22.80, p < 0.001). There was 59 a group x condition interaction for proprioceptive drift (F(1,43) = 6.48, p = 0.015) such that 60 people with BPD maintained illusion susceptibility in the asynchronous condition. Borderline 61 symptom severity correlated with illusion strength within the BPD group, and this effect was 62 specific to affective symptoms (r = 0.481, p < 0.01). Across all participants, trait psychoticism 63 correlated with illusion strength (r = 0.481, p <0.01). 65Conclusion: People with BPD are more susceptible to illusory body ownership than are healthy 66 controls. This result is consistent with the robust clinical literature describing aberrant physical 67 and emotional experience of self in BPD. A predictive coding interpretation of these results 68 holds promise to develop testable mechanistic hypotheses for experiences of disrupted bodily 69 self in BPD. 70 71 72 73 74 75 76 77 78 79 3 1. Introduction 80 1.1. The embodied self in Borderline Personality Disorder 81 1.1.1. Self-disturbance is a core feature of BPD 82 Aberrations of self-experience and identity are considered a core symptoms of 83 Borderline Personality Disorder (BPD) [1]. Self-disturbance is characterized by a markedly 84 persistent unstable sense of self that can be realized by dramatic shifts in self-image, shifting 85 goals and values, and feelings of emptiness, dissociation, and non-existence [2, 3]. These 86 experiences are distressing and dangerous; in a qualitative study, Brown et al. [4] found that 87 more than 50% of women with BPD and history of self-harm endorsed disturbances in self-88 experience, such as emptiness, numbness, or feeling dead, as reasons for non-suicidal self-89 injury . 90 91 1.1.2. Bodily experience is disrupted in BPD 92 One aspect of selfhood that may have relevance for pathologies of self in BPD is the experience 93 of body ownership. Indeed, abnormal bodily experiences in BPD are common, including bodily 94 dissociation [5], altered pain perception [6],and deficits in interoception...