bluuebunny/crossref_metadata_2025 huggingface dataset:
B-07 Benzodiazepine Use Is Associated with an Increased Risk for HIV-Associated Neurocognitive Disorders
Authors: Saloner R , Tyree G , Grelotti D , Ma Q , Letendre S , Heaton R , Cherner M
Published: August 2019

Objective

Despite potential for dependence and adverse neurological effects, long-term benzodiazepine (BDZ) use is common among persons living with HIV (PLWH). As PLWH are at risk for CNS dysfunction, we retrospectively examined the association between BDZ use and HIV-associated neurocognitive disorders (HAND).

Methods

306 PLWH (mean age = 45.1 years) underwent comprehensive neurobehavioral evaluations. Current BDZ use (BDZ+) was determined via self-report. Using propensity scores, 153 BDZ- individuals were matched to 153 BDZ+ participants on demographics, HIV disease characteristics, and comorbidities. Multiple regression models examined HAND and demographically-adjusted neurocognitive T-scores as a function of BDZ group, adjusting for estimated premorbid ability, current affective symptoms, and nadir CD4 count. Secondary analyses explored neurocognitive correlates of positive BDZ urine toxicology screens (TOX+).

Results

Median BDZ use was 24 months. Compared to BDZ-, BDZ+ had higher likelihood of HAND (OR = 2.14; p = .003) and poorer global (d = -0.33, p = .005), processing speed (d = -0.29, p = .013), and motor T-scores (d = -0.35, p = 0.003). Compared to BDZ+/TOX-, BDZ+/TOX+ users exhibited additional decrements in global (p = .033), executive function (p = .019), and delayed recall T-scores (p = .006).

Conclusions

BDZ use may elevate risk for HAND, potentially through diffuse neurocognitive slowing and acute compromise of recall and higher-order capacities. These effects are robust to psychosocial and HIV-specific factors and occur in comparison to a tightly-matched BDZ- group. Indications for BDZs (e.g., insomnia) may also impact neurocognition and/or manifest from latent neuropathology. Longitudinal studies should evaluate potential causal associations between HAND and BDZs. Given the extent of BDZ use and possibility of neurocognitive recovery post-abstinence, interventional studies should explore treatment alternatives to BDZs in PLWH.
B-09 Cerebral Grey Matter After Out-Of-Hospital Cardiac Arrest In Good Outcome Survivors
Authors: Byron-Alhassan A , Fang Z , Collins B , Tulloch H , Quinlan B , Le May M , Chakraborty S , Smith A
Published: August 2019

Objective

The purpose of this study was to evaluate the impact of out-of-hospital cardiac arrest (OHCA) on cognitive functioning and brain volumes, in good outcome survivors.

Method

Participants were medically stable OHCA survivors. Two control groups were also recruited: patients who experienced myocardial infarction (MI), and healthy controls (HC) with no history of cardiovascular disease. Neuropsychological assessment was conducted using the Neuropsychological Assessment Battery (NAB). Imaging was performed on a 3T Siemens Trio MRI scanner. Cerebral grey matter volume (GM; measured by voxel-based morphometry in SPM12) results are presented.

Results

Participants (nOHCA = 9, nMI = 19, nHC = 13) ranged in age from 30 to 85 years. When controlling for age, whole-brain analyses revealed decreased GM in anterior cingulate cortex, bilateral hippocampus in the OHCA and in the MI group compared to the HC group. In addition, the MI group had decreased GM compared to the HC in the thalamus and the right dorsolateral prefrontal cortex (p < .001). No significant differences in GM were observed between the MI and OHCA groups. The hippocampus was selected as a region-of-interest for further analyses. The Total NAB Index was correlated with hippocampal GM in the OHCA group but not in the MI group (rOHCA = .78, p = .014).

Conclusions

Results revealed select areas of GM reduction in OHCA and MI groups, suggesting a contribution of cardiovascular disease to observed atrophy. Reductions are related to cognitive performance only in the cardiac arrest group which may suggest that these volume losses represent clinically meaningful changes.
B-10 Cognition, Depressive Symptoms and Disability in Patients with Migraine
Authors: Sebrow L , Klepper J , Seng E
Published: August 2019

Objective

To examine the relationship between cognition and disability, and to evaluate the hypothesis that depressive symptoms moderate this relationship.

Method

Seventy-seven adults with migraine (M age = 45.2, SD = 7.4, 89.6% female, 85.7% White, Non- Hispanic, and 46.8% with a graduate degree) recruited from a headache center completed surveys assessing demographics, disability, (Headache Disability Inventory [HDI]), depressive symptoms (PROMIS Depression), and cognition (Trail Making Test, WAIS-IV Coding and Digit Span, Rey Auditory Verbal Learning Test, Rey Complex Figure Test, Stroop, Letter and Animal Fluency). Correlations examined relationships between cognition and disability; linear regressions examined the interaction between cognition and depressive symptoms on disability.

Results

Higher HDI was associated with lower Animal Fluency (ρ = -.28, p = .014) and Coding (r = -.23, p = .048). PROMIS Depression did not moderate the relationships between Coding (β = -.57, p = .443) and the HDI or Animal Fluency (β = -.69, p = .422) and the HDI. When controlling for the relationship between PROMIS Depression and HDI (β = .51=, p = < .01), Coding was no longer significant (β =-.09, p = .384). In another model, when controlling for the relationship between PROMIS Depression and HDI (β = .51=, p = < .01), Animal Fluency was no longer significant (β = -.15, p = .137).

Conclusion

Poorer performance on attention/processing speed and semantic fluency tasks were associated with headache-related disability. These relationships were not moderated by depressive symptoms and were no longer significant when adjusting for depressive symptoms.
B-11 Cognitive Performance in Depressed and Non-Depressed Patients with de novo Parkinson’s disease
Authors: Honsey B , WymanChick K
Published: August 2019

Objective

Compare cognitive performance in early-stage Parkinson Disease (PD) participants with and without depression.

Method

Data from the Parkinson’s Progression Marker Initiative were utilized. We examined data from 422 participants diagnosed with PD within the previous two years (age = 61.7±9.7 years, education = 15.6±3.0 years). Depressive symptoms were assessed using the Geriatric Depression Scale (GDS-15) using a cutoff score of ≤5 to indicate the absence of clinical depression. Cognitive tests included Hopkins Verbal Memory Test-Revised (HVLT-R), Judgment of Line Orientation (JLO), Letter-Number Sequencing (LNS), Symbol Digit Modalities Test (SDMT), and Category Fluency. Motor scores were measured by the Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III. Demographic and clinical variables for the two groups were compared using independent samples t-tests and chi-square analyses.

Results

The non-depressed group (n = 280) was significantly older; t(246.08) = 2.25, p = .026 and had higher education; t(420) = 2.35, p = .019; and duration of PD symptoms; t(170.58) = -2.13, p = .035 than the depressed group (n = 142). The groups did not differ in terms of race, gender, handedness, side of onset, or severity of motor symptoms. There was no significant differences in performance on HVLT, JLO, SDMT, or Category Fluency; however, the non-depressed group performed better on LNS than the depressed group, t(420) = 2.05, p = .041.

Conclusion(s)

There is no significant difference in cognitive performance between early-stage PD participants with and without depression, with the exception of significantly lower working memory performance in the depressed group.
B-16 Evaluating the Effects of Obesity on Cognitive Functioning in a Sample of Multiple Sclerosis Patients
Authors: Newman C , McDermott A
Published: August 2019

Objective

Fergenbaum et al., 2009 found that obesity was linked to increased cognitive issues in otherwise healthy individuals, while another study found obesity to be neuroprotective in a sample of dementia patients (Fitzpatrick et al., 2009). The present study explores whether obesity is associated with worse cognitive dysfunction in those with Multiple Sclerosis (MS).

Method

This study examined archival neuropsychological test data of 40 patients diagnosed with MS. Participants were separated into two groups based on their BMI: healthy/overweight individuals and obese/morbidly obese. ANOVA was performed to compare performances between groups on tasks measuring learning and memory, processing speed, and executive functioning; areas commonly affected in MS.

Results

Significant differences between groups were noted on only portions of two different tests; unstructured verbal learning (p = .003) and mental sequencing (p = .048), but no differences were found in other tasks. Particularly, performance was statistically equal between groups on measures of response inhibition (p = .887), visual processing speed (p = .182), visuospatial learning (p = .118), visuospatial free recall (p = .205), simple auditory attention (p = .630), working memory (p = .223), psychomotor speed (p = .969), and complex divided attention (p = .202).

Conclusion

Obese patients with MS scored significantly better on the majority of tasks that we reviewed. These results seem to contradict a study that examined healthy subjects but seems to replicate findings in at least one clinical population; those with dementia. It is possible that increased BMI in clinical populations may indicate better overall health leading to better cognition, though if it is actually neuroprotective and only limited to MS and dementia is uncertain. Future research endeavors are discussed.
Health Locus of Control and Symptom Validity Testing in a Military Context
Authors: Armistead-Jehle P , Grills C
Published: August 2019

Objective

The base rate of symptom validity test (SVT) failure in the military has been the subject of recent investigation. Secondary gain is a potential factor in this population; however, frank malingering may not account for all cases of SVT failure. As a result, other psychological and social factors potentially associated with validity test failure have been suggested and include nocebo effect, diagnosis threat, and perceived injustice. Locus of Control (LOC) has been associated with a range of medical/psychological conditions/outcomes and this study examined the relationship between LOC and SVT performance.

Method

A retrospective review of adult patients administered the Multi-dimensional Health Locus of Control Scale (MHLCS) and the MMPI-2-RF (n = 53) or the PAI (n = 143) in the context of neuropsychological assessments in a military treatment facility was conducted.

Results

MHLCS Internal and Powerful Others subscales had very limited associations with the evaluated SVTs. However, the MHLCS Chance subscale was significantly correlated with MMPI-2-RF Fp (r = .37, p < .05) and Fs (r = .29, p < .05) and PAI NIM scales (r = .26, p < .01). The MHLCS Chance subscale scores were significantly higher in those failing the PAI NIM (t = 3.0, p < .01) and MMPI-2-RF Fp (t = 2.5, p < .05) and FBS (t = 2.5, p < .05) scales, with moderate to large effect sizes (Cohen’s d ranging from 0.76 to 0.99).

Conclusions

The current data indicate limited relationships between MHLC internal and powerful others subscales and SVT performance. However, higher Chance subscale scores were associated with failed SVTs.
A Systematic Review of the Specificity of the Test of Memory Malingering in Children
Authors: Clark H , Martin P , Schroeder R
Published: August 2019

Objective

The present study, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, is the first systematic review of the Test of Memory Malingering (TOMM) to examine the specificity of traditional adult cutoffs in children ages 5-18.

Data Selection

Article search terms and selection criteria were identified a priori. A search of PsycINFO and PubMED in January 2018 identified 539 peer-reviewed journal articles published from 1997-2017. Studies were excluded if they did not involve a pediatric sample, did not provide a means for ensuring validity external to the TOMM, contained samples overlapping those of other included studies, or did not provide sufficient data to calculate specificity values at traditional cutoffs. Frequencies of true negatives and false positives were extracted. When not available, these counts were calculated from sample size and specificity values. Data extraction was completed independently by the first two authors with any discrepancies rectified via discussion. Data were synthesized using a fixed effects model to calculate overall specificity.

Data Synthesis

Application of selection criteria resulted in 9 articles comprising 13 samples for Trial 2 and 3 studies comprising 5 samples for Retention. Weighted mean specificity was 0.98 for Trial 2 (n = 662) and 0.99 for Retention (n = 173) at standard cutoffs.

Conclusions

TOMM Trial 2 and Retention at traditional cutoffs maintain specificity values in pediatrics comparable to those of adults. Given limited research on the potential impact of very young age and extremely low cognitive functioning, further research will be important in determining the generalizability of these results across all pediatric populations.
Predictors of Life Expectancy After an Alzheimer’s Disease Diagnosis in a National Multi-Center Autopsy-Confirmed Sample
Authors: Schaffert J , LoBue C , Presley C , Hynan L , Wilmoth K , Lacritz L , Hart J , Cullum C M
Published: August 2019

Objective

Life expectancy varies between 3-12 years following the diagnosis of Alzheimer’s disease (AD) and is an important clinical question for patients and families. Current literature is limited by relatively small sample sizes and a reliance on clinical diagnoses. This study sought to evaluate predictors of AD life expectancy in a large autopsy-confirmed sample.

Methods

Baseline data from individuals 50 years and older clinically and neuropathologically diagnosed with AD (N=764) were obtained from the National Alzheimer’s Coordinating Center. Life expectancy was calculated in months from AD diagnosis to death. Nineteen variables (demographic, medical/health, disease severity, and psychiatric) obtained at dementia diagnosis were examined. Variables that showed significant differences in life expectancy using t-tests and Pearson correlations (14 of 19) were then entered into a forward multiple regression.

Results

Seven predictors in the model explained 27% of the variance in life expectancy (F= 40.7, R-squared= 0.267). Lower MMSE scores (β= 0.339, p < .001), male sex (β= -0.144, p < .001), older age (β= -0.130, p < .001), non-Hispanic Caucasian race/ethnicity (β= 0.115, p < .001), greater impairment on the Functional Activities Questionnaire (β= -0.091, p=.042), abnormal neurological/physical exam (β= -0.083, p=.011), and higher Neuropsychiatric Inventory Questionnaire total scores (β= -0.079, p=.016) predicted shorter life expectancy.

Conclusions

Global cognitive impairment, sex, age, race/ethnicity, functional impairment, abnormal neurological exam findings, and psychiatric symptoms explain a significant proportion of life expectancy following an AD diagnosis. Future studies should explore the relationship between life expectancy, specific neurological abnormalities, and psychiatric symptoms. These 7 predictors could potentially be used to predict life expectancy in individuals diagnosed with AD.
Validating the Reliable Change Index with Tensor-Based Morphometry: the ADNI-MEM and the ADNI-EF
Authors: Lin S , Fletcher E , Gavett B
Published: August 2019

Objective

The Reliable Change Index (RCI) is a commonly used method for interpreting change in neuropsychological test scores over time. However, the RCI is a psychometric phenomenon that, to date, has not been validated by neuroanatomical evidence.

Method

Longitudinal neuroimaging and neuropsychological data from baseline and one-year follow-up visits were retrieved from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The RCI was used to identify participants showing reliable decline on ADNI-MEM and ADNI-EF factor scores, which provide composite measures of memory and executive functioning, respectively. For each cognitive test score, two groups (reliable change vs. no reliable change) were matched on potential confounding variables using a genetic algorithm. Longitudinal neuroanatomical data were analyzed using tensor-based morphometry.

Results

Whole brain analysis revealed that reliable change on ADNI-MEM was associated with extended atrophy of the temporal lobe, the parahippocampal gyrus, the entorhinal cortex, and the posterior cingulate gyrus (Left Figure). Similar extended atrophy patterns were found for reliable change on ADNI-EF, except that the atrophy was more extensive and of higher magnitude (Right Figure). Regional analysis further confirmed that in such brain regions, the reliable change group manifested higher grey matter loss than the no change group.

Conclusion

The current study not only validated clinical usage of the RCI with neuroanatomical evidence but also practically suggested patterns of likely brain atrophy when reliable cognitive decline is detected.
Outcome Following Concussion: Prospective Investigation into the Cumulative Effects of a Prior History of Brain Injury and a History of Repeated Sub-Concussive Injuries on Recovery
Authors: Bailie J , Remigio-Baker R , Cole W , Stuessi K , Ettenhofer M , West T , Qashu F , Gregory E
Published: August 2019

Objective

To investigate the impact of patient history of repeated head injury (RHI) and mild traumatic brain injury (mTBI) on recovery from an acute concussion.

Methods

There were 64 participants from 3 military installations treated for an acute concussion ( < 72 hours) and monitored at < 72 hours, 1 week, 1 month, 3 months, and 6 months. Participants had no concussion in the last year and no history of moderate/severe TBI. TBI history was based on the Ohio State University TBI Identification Method and limited to mTBI with loss of consciousness. Primary outcome was symptoms evaluated using the Neurobehavioral Symptom Inventory. A total of 33 participants completed the study.

Results

Participants were as follows: n = 12 TBI(-)/RHI(-); n = 6 TBI(+)/RHI(-); n = 9 TBI(-)/RHI(+); n = 6 TBI(+)/RHI(+). A multivariate ANOVA examining TBI/RHI group effect on symptoms was significant (F = 2.31, p = 0.010), whereby the TBI(+)/RHI(+) had higher symptom scores than other groups at < 72 hours, 1 week, and 6 months. At 1 month, TBI(+)/RHI(+) had more symptoms than the TBI(-)/RHI(+). At 3 months, the TBI(+)/RHI(+) had higher symptom scores than the TBI(-)/RHI(-) and the TBI(-)/RHI(+). The TBI(-)/RHI(+) did not differ from TBI(-)/RHI(-) except at 1 week where they had lower overall symptoms.

Conclusions

Participants with an acute mTBI had more severe symptoms if they had RHI and a prior remote mTBI. The combination of these two factors had a negative impact on recovery for up to 6 months. RHI in the absence of TBI did not impact recovery.
The Influence of Atypical Sleep Before Baseline Concussion Testing
Authors: Riegler K , Arnett P
Published: August 2019

Objective

To examine the role of an atypical night of sleep prior to baseline neuropsychological testing on symptom reporting and cognitive functioning in student-athletes.

Method

182 (M = 138, F = 44) athletes were assessed on neuropsychological battery at baseline. Athletes were categorized as sleeping a typical amount (within 1.5 hours, N = 128) or less (> 1.5 hours less, N = 54) the night prior to baseline. The Cognitive Health Questionnaire (CHQ) assessed typical levels of sleep and the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) assessed hours of sleep the night before. Independent samples t-tests compared the two groups on the following outcome measures: affective, somatic, sleep, and cognitive post-concussion symptom scale (PCSS) clusters, headache, Beck-Depression Inventory-Fast Screen (BDI-FS), and composites of memory and attention/processing speed.

Results

Athletes getting less sleep than typical the night before a baseline assessment reported significantly more depression symptoms on the BDI-FS (p < .001) and significantly more symptoms on all PCSS symptoms scales: affective (p < .001), cognitive (p < .001), physical (p < .001), and sleep (p = .001). A trend in the same direction was present for headache (p = .06). The groups did not significantly differ on performance on either composite of cognitive functioning (p > .05).

Conclusions

Sleeping less than the typical amount the night before a baseline assessment results in self-reported higher levels of depression symptoms across all domains of the PCSS.
Computerized Cognitive Rehabilitation verses Clinician Directed Therapy in mTBI
Authors: Babakhanyan I , Jensen M , Kim D , West H , Morrissy E , Powell b , Sargent P , Bailie J
Published: August 2019

Background

Cognitive problems following mTBI are common and typically managed with one-on-one clinician directed treatment (CDT); however, this is time and labor intensive. Computerized cognitive rehabilitation (CCR) programs overcome these limitation but the comparable efficacy is not well understood in mTBI.

Method

A randomized controlled trial included 13 active duty service members with a history of mTBI and persistent cognitive complaints. Participants received either CCR (N = 6) or CDT (N = 7) during the initial phase of this study. Treatments were one hour, 3 times a week for 4 weeks. Average age was 32.77 (SD = 7.96). Average intelligence estimated by word reading was average (WTAR M = 107.46, SD = 9.32). Specific measures for attention included Symbol Digit Modality Test (SDMT), Paced Auditory Serial Addition Test (PASAT), Conners Continuous Performance Test (CPT-3), as well as Digit Forward (DF), Digit Backward, and Driving from the Neuropsychological Assessment Battery (NAB). Standard scores corrected for age were analyzed. Change scores were computed between pre and post intervention.

Results

There was a significant difference for SDMT (p = 0.034, d = 1.342) and DF (p = 0.0015, d = 2.33), where those who received CDT showed greater improvement. The groups did not differ on Driving, PASAT, CPT-3, and DB (p’s > 0.62).

Conclusions

Preliminary analysis of data suggests that clinician directed treatment was superior to a computerized intervention matched for time and intensity in treating patients with persistent cognitive complaints following mTBI. Large effects were observed on measures of processing speed and focused attention. This may suggest computerized treatment alone is less effective though further data is needed.
Annualized Decline in Instrumental Activities of Daily Living Is Slower in Hispanics Compared to Non-Hispanics in an Alzheimer’s Disease Sample
Authors: Smith E , Schaffert J , LoBue C , Hart J , Rossetti H , Lacritz L
Published: August 2019

Objective

Research examining the course of Alzheimer’s disease (AD) in Hispanics is lacking. This study examined demographic, psychiatric, cognitive, and genetic predictors of longitudinal functional change in Hispanics and non-Hispanics with AD.

Method

Longitudinal change in instrumental activities of daily living (IADL) was examined over 10 years (M = 4.15 years) in 292 subjects (Hispanic = 67, non-Hispanic = 225). All were part of the Texas Alzheimer’s Research & Care Consortium and included those with AD (n = 217) and those with mild cognitive impairment at baseline who progressed to AD at follow-up (n = 75). Baseline comparisons were conducted between ethnic groups for demographics, Geriatric Depression Scale (GDS-30) score, Mini Mental State Examination (MMSE) score, presence of apolipoprotein ɛ4 alleles (APOE4), and annualized IADL change scores and then entered into a multiple linear regression model as predictors of annualized IADL change.

Results

The Hispanic group had significantly more females (χ2 = 5.71, p = .017), lower education [MH = 9.96(4.39), MNH = 15.26(2.70)], higher depression scores [GDS-30; MH = 9.45(5.89), MNH = 5.51(4.29)], lower MMSE scores [MH = 23.31(4.33), MNH = 24.65(3.21)], and slower annualized IADL change [MH = 1.19(1.42), MNH = 2.02(1.60)]. Regression results were significant (F = 3.66, p = .001, R2 = .08 ), with higher baseline MMSE (p = .007) and Hispanic origin (p = .010) predicting slower annualized IADL change. Demographics, APOE4 status, and depression did not significantly predict IADL change.

Conclusions

Higher cognitive functioning at baseline and Hispanic origin was associated with slower functional decline over an average 4-year period of time. Despite having lower MMSE scores at baseline, greater depression, and less education, the Hispanic group had a slower decline in IADLs compared to non-Hispanics. Further research is needed to better understand how/why Hispanic origin is associated with slower functional decline.
Comparison of Rates of Impairment Between Three Sets of Normative Data for Spanish-speakers of Mexican Origin in a Healthy Cohort
Authors: Kamalyan L , Hussain M , Morlett-Paredes A , Umlauf A , Franklin D , Suarez P , Rivera-Mindt M , Artiola i Fortuny L , Cherner M , Heaton RMarquine M
Published: August 2019

Objective

With over 37 million Spanish-speakers, the US is the second country in the world with the largest number of Spanish-speakers. Identification of neurological dysfunction via neuropsychological testing for this language group requires knowledgeable application of available tests and normative data. Accordingly, we investigated whether rates of neurocognitive impairment (NCI) varied based on the Spanish language normative method used.

Method

Participants included 254 healthy native Spanish-speakers (Age: M = 37.3, SD = 10.4; Education: M = 10.7, SD = 4.3; 59% Female; 78.7% of known Mexican origin/descent) living in the US-Mexico border region. Participants completed the Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test (TMT) A&B, and Animal Naming in Spanish. Raw test scores were converted to demographically-adjusted T-scores based on normative adjustments developed for this population (Neuropsychological Norms for the US-Mexico Border Region in Spanish [NP-NUMBRS]) and norms developed based on samples in Mexico (Latin American Norms from Mexico [LAN-M] and NEUROPSI). Rates of NCI (T < 40) based on the different normative methods were compared via McNemar’s tests.

Results

Rates of NCI for NP-NUMBRS and NEUROPSI fell between the expected 15-17%. Compared to NP-NUMBRS, significantly lower rates were found when applying LAN-M for HVLT-R Total (4%) and Delayed Recall (8%), TMT-A (1%), and Animal Naming (10%; all ps < .0002). No significant differences were found for TMT-B (p > .05).

Conclusions

Present findings revealed that while the NP-NUMBRS and NEUROPSI norms yielded similar NCI rates, and LAN-M norms underestimated NCI on three tests. This highlights the importance of carefully considering available normative adjustments for Spanish-speakers when applying them to specific populations.
AGR - 2 Diagnosis of Posterior Cortical Atrophy Through Inter-Departmental Collaboration
Authors: John S , Silva M , Newman N , Loring D
Published: August 2019

Objective

We present a patient with rapidly progressive visual decline of 2-year duration that interfered with daily functioning. She was evaluated by neuro-ophthalmology and neurology prior to neuropsychological referral. A series of evaluations led to diagnosis of posterior cortical atrophy, demonstrating the importance of inter-departmental collaboration.

Method

A 66-year old white female presented with a 2-year history of progressive changes to vision and memory. Medical history included hypertension, dyslipidemia, and a strong family history of optic neuropathy causing blindness. She was diagnosed with a left homonymous hemianopia. MRI revealed "significant cortical atrophy more remarkable on the right temporal, parietal, and occipital regions." She reported dressing apraxia, unsteady gait, declines in reading and writing, and difficulty recalling well-learned information.

Results

She was a good historian, had fluent speech and no apparent comprehension difficulty. Neuropsychological evaluation revealed relatively preserved language and verbal abilities, including confrontation naming, in the presence of otherwise impaired performances across all domains of functioning. She demonstrated agraphia, acalculia, left-right confusion, and difficulties with motor programming. Perceptual and constructional tasks revealed prominent deficits in visual integration, map orientation, form discrimination, and construction of simple geometric designs. She was perseverative and susceptible to verbal and visual stimulus pull.

Conclusions

The pattern on neuropsychological testing, with prominent visual spatial and perceptual difficulties, was consistent with posterior cortical atrophy. The decline in visual ability is likely exacerbated but not entirely explained by left hemianopia. Neuropsychological, neuroimaging, and visual field evidence demonstrated posterior cortical atrophy in the absence of positive biomarker evidence, leading to initiation of anti-cholinesterase therapy.
Analysis of several key factors influencing deep learning-based inter-residue contact prediction
Authors: Wu Tianqi , Hou Jie , Adhikari Badri , Cheng Jianlin
Published: August 2019

Motivation

Deep learning has become the dominant technology for protein contact prediction. However, the factors that affect the performance of deep learning in contact prediction have not been systematically investigated.

Results

We analyzed the results of our three deep learning-based contact prediction methods (MULTICOM-CLUSTER, MULTICOM-CONSTRUCT and MULTICOM-NOVEL) in the CASP13 experiment and identified several key factors [i.e. deep learning technique, multiple sequence alignment (MSA), distance distribution prediction and domain-based contact integration] that influenced the contact prediction accuracy. We compared our convolutional neural network (CNN)-based contact prediction methods with three coevolution-based methods on 75 CASP13 targets consisting of 108 domains. We demonstrated that the CNN-based multi-distance approach was able to leverage global coevolutionary coupling patterns comprised of multiple correlated contacts for more accurate contact prediction than the local coevolution-based methods, leading to a substantial increase of precision by 19.2 percentage points. We also tested different alignment methods and domain-based contact prediction with the deep learning contact predictors. The comparison of the three methods showed deeper sequence alignments and the integration of domain-based contact prediction with the full-length contact prediction improved the performance of contact prediction. Moreover, we demonstrated that the domain-based contact prediction based on a novel ab initio approach of parsing domains from MSAs alone without using known protein structures was a simple, fast approach to improve contact prediction. Finally, we showed that predicting the distribution of inter-residue distances in multiple distance intervals could capture more structural information and improve binary contact prediction.

Availability and implementation

https://github.com/multicom-toolbox/DNCON2/.

Supplementary information

Supplementary data are available at Bioinformatics online.
Active Sleep Promotes Coherent Oscillatory Activity in the Cortico-Hippocampal System of Infant Rats
Authors: Del Rio-Bermudez Carlos , Kim Jangjin , Sokoloff Greta , Blumberg Mark S
Published: August 2019

Active sleep (AS) provides a unique developmental context for synchronizing neural activity within and between cortical and subcortical structures. In week-old rats, sensory feedback from myoclonic twitches, the phasic motor activity that characterizes AS, promotes coherent theta oscillations (4–8 Hz) in the hippocampus and red nucleus, a midbrain motor structure. Sensory feedback from twitches also triggers rhythmic activity in sensorimotor cortex in the form of spindle bursts, which are brief oscillatory events composed of rhythmic components in the theta, alpha/beta (8–20 Hz), and beta2 (20–30 Hz) bands. Here we ask whether one or more of these spindle-burst components are communicated from sensorimotor cortex to hippocampus. By recording simultaneously from whisker barrel cortex and dorsal hippocampus in 8-day-old rats, we show that AS, but not other behavioral states, promotes cortico-hippocampal coherence specifically in the beta2 band. By cutting the infraorbital nerve to prevent the conveyance of sensory feedback from whisker twitches, cortical-hippocampal beta2 coherence during AS was substantially reduced. These results demonstrate the necessity of sensory input, particularly during AS, for coordinating rhythmic activity between these two developing forebrain structures.
Roy-model bounds on the wage effects of the Great Migration
Authors: Gardner John R
Published: August 2019

This paper combines a Roy model of migration and counterfactual wages with racial differences in migration rates during the Great Migration to recover lower bounds on black–white differences in the wage impacts of northward migration. Identification is predicated on the idea that, when migration is more selective for whites, regional wage differentials for whites will be more contaminated with selection bias. In this case, the black–white difference in North–South wage differentials bounds the racial difference in wage impacts from below. Furthermore, as long as the impact of migration on whites’ wages is nonnegative, a lower bound on the black–white difference in wage impacts is also a lower bound on the impact itself for blacks. Applying the identification result, I find that northward migration increased blacks’ wages by at least 36% more than whites’, and hence by at least 36%, on average between 1940 and 1970.
Placing sexually transmitted infection surveillance data in perspective by using national probability sample surveys
Authors: Heijne Janneke C M , van Aar Fleur , Meijer Suzanne , de Graaf Hanneke , van Benthem Birgit H B
Published: August 2019

Background

Many European countries do not have comprehensive sexually transmitted infection (STI) surveillance in place. The objective was to investigate whether national probability sample surveys are useful in placing STI surveillance into perspective.

Methods

We used data from the Dutch national cross-sectional probability sample survey on sexual health 2016 (18–34-year-old sexually active individuals). Descriptive analyses were performed regarding STI testing (last year). Test numbers were extrapolated from the survey and compared with surveillance data from sexual health centres (SHCs) (complete) and general practitioners (GPs) (representative estimates from 7% of all GPs). Statistical differences in characteristics between SHC attendees and general population (according to weighted survey participants) were determined using χ2 statistic. Predictors of recent testing at GPs or SHCs were determined using multinomial multivariable logistic regression.

Results

Of the 17 222 survey invitees, 3217 (19%) were eligible for analyses. Testing uptake was higher in women (17.2%, 14.8–20.0%) than men (11.5%, 9.1–14.3%). The majority of tests were conducted by GPs followed by SHCs and hospitals. Number of tests extrapolated from the survey was similar to SHC surveillance data, but higher than GP surveillance data (women only). Testing at SHCs was associated with high-risk behaviour and with living in highly urbanized areas. Low education level and older age were, next to high-risk behaviour factors, determinants of testing at GPs.

Conclusions

National probability sample surveys are useful for placing STI surveillance data into perspective by providing insights in testing patterns in the general population and identifying strengths and weaknesses of national surveillance systems.
Modelling surface NMR spin-echo experiments in a heterogeneous B1 field
Authors: Grombacher Denys
Published: August 2019

Surface nuclear magnetic resonance (NMR) measurements show great promise for characterization of subsurface water content, pore-sizes and permeability. The link between surface NMR and pore-size/permeability is founded in the connection between the NMR signal's time dependence and the geometry of the pore-space. To strengthen links between the NMR signal and pore-geometry multipulse surface NMR sequences have been developed to estimate the parameter T2, which carries a strong link to pore-geometry and has formed the basis for NMR-based permeability estimation in the petroleum industry for decades. Producing reliable subsurface characterizations from multipulse surface NMR measurements that measure T2 requires that the forward model is able to accurately predict the transverse magnetization at the time when the measurement occurs. Traditional surface NMR T2 forward models employ an analytic expression for the transverse magnetization, an expression developed in the context of laboratory NMR experiments conducted under conditions significantly different from surface NMR and which require several assumptions to simplify the underlying Bloch equation. To investigate the reliability of this analytic expression under surface NMR conditions, a synthetic comparison is performed where the analytic expression is contrasted against the transverse magnetization predicted from a solution of the full-Bloch equation without the same simplifying assumptions and which can appropriately weight heterogeneity in the applied and background magnetic fields. The comparison shows that the analytic expression breaks down in a range of conditions typical to surface NMR measurements.
The differential impacts of PEPFAR transition on private for-profit, private not-for-profit and publicly owned health facilities in Uganda
Authors: Wilhelm Jess Alan , Paina Ligia , Qiu Mary , Zakumumpa Henry , Bennett Sara
Published: August 2019

While transition of donor programs to national control is increasingly common, there is a lack of evidence about the consequences of transition for private health care providers. In 2015, President’s Emergency Plan for AIDS Relief (PEPFAR) identified 734 facilities in Uganda for transition from PEPFAR support, including 137 private not-for-profits (PNFP) and 140 private for-profits (PFPs). We sought to understand the differential impacts of transition on facilities with differing ownership statuses. We used a survey conducted in mid-2017 among 145 public, 29 PNFP and 32 PFP facilities reporting transition from PEPFAR. The survey collected information on current and prior PEPFAR support, service provision, laboratory services and staff time allocation. We used both bivariate and logistic regression to analyse the association between ownership and survey responses. All analyses adjust for survey design. Public facilities were more likely to report increased disruption of sputum microscopy tests following transition than PFPs [odds ratio (OR) = 5.85, 1.79–19.23, P = 0.005]. Compared with public facilities, PNFPs were more likely to report declining frequency of supervision for human immunodeficiency virus (HIV) since transition (OR = 2.27, 1.136–4.518, P = 0.022). Workers in PFP facilities were more likely to report reduced time spent on HIV care since transition (OR = 6.241, 2.709–14.38, P < 0.001), and PFP facilities were also more likely to discontinue HIV outreach following transition (OR = 3.029, 1.325–6.925; P = 0.011). PNFP facilities’ loss of supervision may require that public sector supervision be extended to them. Reduced HIV clinical care in PFPs, primarily HIV testing and counselling, increases burdens on public facilities. Prior PFP clients who preferred the confidentiality and service of private facilities may opt to forgo HIV testing altogether. Donors and governments should consider the roles and responses of PNFPs and PFPs when transitioning donor-funded health programs.
Who Speaks and Why? An Examination of Outspokenness on Social Networking Sites and a Reflection on Assessing Public Opinion Online
Authors: Chia Stella C
Published: August 2019

Incorporating the spiral of silence theory and the model of corrective behavior, this study utilized a national survey (N = 373) to investigate the questions of who chooses to speak out on social networking sites (SNSs) and for what reasons in the context of same-sex marriage in Taiwan. Strong partisans were found the most outspoken; they spoke out to prevent media influence that might sway public opinion to the disagreeable side. Only respondents of low attitude extremity would refrain themselves from speaking out on SNSs when perceiving opinion incongruence. Nonpartisans who held a neutral stand could be motivated to speak out when perceiving majority’s support for same-sex marriage. The roles that opinion stances or attitude extremity each play in public opinion process online are discussed.
The Organism as a Whole in an Analysis of Death
Authors: Huang Andrew P , Bernat James L
Published: August 2019

Although death statutes permitting physicians to declare brain death are relatively uniform throughout the United States, academic debate persists over the equivalency of human death and brain death. Alan Shewmon showed that the formerly accepted integration rationale was conceptually incomplete by showing that brain-dead patients demonstrated a degree of integration. We provide a more complete rationale for the equivalency of human death and brain death by defending a deeper understanding of the organism as a whole (OaaW) and by using a novel strategy with shared objectives to justify death determination criteria. Our OaaW account describes different types of OaaW, defining human death as the loss of status as a human OaaW. We defend human death as similar to nonhuman death in terms of wakefulness, but also distinct in terms of the sui generis properties, particularly conscious awareness. We thereby defend the equivalency of brain death and human death using a resulting neurocentric rationale.
On Pellegrino and Thomasma’s Admission of a Dilemma and Inconsistency
Authors: Kopelman Loretta M
Published: August 2019

Edmund Pellegrino and David Thomasma’s writings have had a worldwide impact on discourse about the philosophy of medicine, professionalism, bioethics, healthcare ethics, and patients’ rights. Given their works’ importance, it is surprising that commentators have ignored their admission of an unresolved and troubling dilemma and inconsistency in their theory. The purpose of this article is to identify and state what problems worried them and to consider possible solutions. It is argued that their dilemma stems from their concerns about how to justify professional rules restricting colleagues from performing acts they view as direct, active, and formal (intentional) killings, such as physician-assisted suicide, mercy killing, and abortion. It is further argued that their inconsistency is that they both assert and deny that professional colleagues should not use their moral or theological values to impose professional restrictions on other colleagues without adequate philosophical grounds. At risk are their arguments about the nature of an internal morality for medicine, a secular and multicultural basis for medical ethics, and a nonarbitrary way to determine what acts fall outside the ends of medicine. These are arguments they claim also apply to other healthcare professions. The article begins with a brief overview of their key positions to provide the context in which they make their admission.
Pentatricopeptide repeat protein DEK40 is required for mitochondrial function and kernel development in maize
Authors: Ren Ru Chang , Lu Xiaoduo , Zhao Ya Jie , Wei Yi Ming , Wang Li Li , Zhang Lin , Zhang Wen Ting , Zhang Chunyi , Zhang Xian Sheng , Zhao Xiang Yu
Published: August 2019

Pentatricopeptide repeat protein DEK40 functions in processing of cox3, nad2, and nad5 transcripts and is required for mitochondrial function in maize.
PYL9 is involved in the regulation of ABA signaling during tomato fruit ripening
Authors: Kai Wenbin , Wang Juan , Liang Bin , Fu Ying , Zheng Yu , Zhang Wenbo , Li Qian , Leng Ping
Published: August 2019

Abscisic acid (ABA) regulates fruit ripening, yet little is known about the exact roles of ABA receptors in fruit. In this study, we reveal the role of SlPYL9, a tomato pyrabactin resistance (PYR)/pyrobactin resistance-like (PYL)/regulatory component of ABA receptors (RCAR) protein, as a positive regulator of ABA signaling and fruit ripening. SlPYL9 inhibits protein phosphatase-type 2C (PP2C2/6) in an ABA dose-dependent way, and it interacts physically with SlPP2C2/3/4/5 in an ABA-dependent manner. Expression of SlPYL9 was observed in the seeds, flowers, and fruits. Overexpression and suppression of SlPYL9 induced a variety of phenotypes via altered expression of ABA signaling genes (SlPP2C1/2/9, SlSnRK2.8, SlABF2), thereby affecting expression of ripening-related genes involved in ethylene release and cell wall modification. SlPYL9-OE/RNAi plants showed a typical ABA hyper-/hypo-sensitive phenotype in terms of seed germination, primary root growth, and response to drought. Fruit ripening was significantly accelerated in SlPYL9-OE by 5–7 d as a result of increased endogenous ABA accumulation and advanced release of ethylene compared with the wild-type. In the SlPYL9-RNAi lines, fruit ripening was delayed, mesocarp thickness was enhanced, and petal abscission was delayed compared with the wild-type, resulting in conical/oblong and gourd-shaped fruits. These results suggest that SlPYL9 is involved in ABA signaling, thereby playing a role in the regulation of flower abscission and fruit ripening in tomato.
Problem-Solving Courts and the Criminal Justice System
Authors: DeMatteo David , Heilbrun Kirk , Arnold Shelby , Thornewill Alice
Published: August 2019

Individuals with behavioral health disorders are significantly overrepresented in the criminal justice system. The incarceration of offenders with substance use disorders and mental illness has contributed to dramatic growth in the incarcerated population in the United States. Problem-solving courts provide judicially supervised treatment for behavioral health needs commonly found among offenders, including substance abuse and mental health, and they treat a variety of offender populations. By addressing the problems that underlie criminal behavior, problem-solving courts seek to decrease the “revolving door” that results when offender needs are not addressed. Problem-solving courts use a team approach among the judge, defense attorney, prosecutor, and treatment providers, which is a paradigm shift in how the justice system treats offenders with special needs. Offenders in problem-solving courts are held accountable for their behavior while being provided with judicially supervised treatment designed to reduce the risk of reoffending. Despite the proliferation of problem-solving courts, there are unanswered questions about how they function, how effective they are, and the most promising ways to implement problem-solving justice. Problem-Solving Courts and the Criminal Justice System is the first book to focus broadly on problem-solving courts. The changing landscape of the criminal justice system, recent development of problem-solving courts, and ongoing shift toward offender rehabilitation underscore the need for this book. This book provides those in the fields of mental health, criminal justice, law, and related fields with a comprehensive foundation of information related to the role of problem-solving courts in reforming the criminal justice system. This book also provides researchers, academics, administrators, and policy-makers with an overview of the existing research on problem-solving courts, including the challenges faced by researchers when examining these courts.