Background: Cerebrospinal fluid (CSF) provides insight into the spectrum of Alzheimer’s disease (AD) pathology. While lumbar punctures (LPs) for CSF collection are generally considered safe procedures, many participants remain hesitant to participate in research involving LPs. Objective: To explore factors associated with participant willingness to undergo a research LP at baseline and follow-up research study visit. Methods: We analyzed data from 700 participants with varying cognition (unimpaired, mild cognitive impairment, and dementia) in the Wisconsin Alzheimer’s Disease Research Center. We evaluated the relationship of demographic variables (age, sex, race, ethnicity, and years of education) and clinical variables (waist-to-hip ratio, body mass index, AD parental history, cognitive diagnosis) on decision to undergo baseline LP1. We evaluated the relationship of prior LP1 experience (procedure success and adverse events) with the decision to undergo follow-up LP2. The strongest predictors were incorporated into regression models. Results: Over half of eligible participants opted into both baseline and follow-up LP. Participants who underwent LP1 had higher mean education than those who declined (p = 0.020). White participants were more likely to choose to undergo LP1 (p < 0.001); 33% of African American participants opted in compared to 65% of white participants. Controlling for age, education, and AD parental history, race was the only significant predictor for LP1 participation. Controlling for LP1 mild adverse events, successful LP1 predicted LP2 participation. Conclusion: Race was the most important predictor of baseline LP participation, and successful prior LP was the most important predictor of follow-up LP participation.

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Background Combining multiple surgical procedures into one operative session is widespread in the field of plastic surgery; however, the implications of this practice are not fully understood. Objectives This study compared 30-day complication rates associated with combined plastic surgery procedures compared to index procedures. Methods This retrospective cohort analysis utilized the Tracking Operations and Outcomes for Plastic Surgeons database from 2016-2020 to identify the three most frequent combinations with augmentation mammaplasty, reduction mammaplasty, trunk liposuction, mastopexy, and abdominoplasty. Results The 30-day overall complication rate was 5.0% (1,400 of 26,771 patients), with a higher complication rate for combined procedures compared to index (7.6% vs 4.2%, aOR 1.91 (95% CI 1.61-2.27), p&lt;0.001). There were no significant differences in complication rates for abdominoplasty or mastopexy combinations compared to index. Complication rates for reduction mammaplasty combinations compared to index were not statistically different after controlling for demographics (aOR 1.02 (95% CI 0.61, 1.64) p=0.93). Higher rates of minor and major complications were observed for combinations of trunk liposuction (aOR 4.84, (95% CI 3.31, 7.21), p&lt;0.001) and augmentation mammaplasty (aOR 1.60, (95% CI 1.13, 2.22), p=0.007) compared to index. Conclusions TOPS data suggests that combinations with trunk liposuction or augmentation mammaplasty present with increased risk of complications compared to index, controlling for demographics. Abdominoplasty and mastopexy may be combined with other plastic surgery procedures without increased risk to patients. The complication risk of reduction mammaplasty combinations is mediated by other variables, suggesting the need for shared surgical decision making when recommending these combinations to patients.

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