bluuebunny/crossref_metadata_2025 huggingface dataset:
A-212 The Limitations of Hippocampal Volumetric Measurements on Clinical Decision-Making: A Case Study
Authors: Kaser Alyssa , Carlew Anne , Denney David , Nguyen Trung , Ruchinskas Robert
Published: August 2022

Objective: Integrating multiple pieces of information is a well-known clinical challenge, especially in light of emerging technologies such as NeuroQuant, a fully-automated software used alongside magnetic resonance imaging (MRI) to quantify the volume of brain structures. Using population-based normative data, NeuroQuant compares measurements of certain neuroanatomical features to normal controls, providing metrics for structural abnormalities that may influence the concern for a suspected neurodegenerative etiology. Clinicians should be aware of potential confounding factors when incorporating this information into their clinical impression, as illustrated by this case.

Method: We present a unique case study of a 71-year-old Black female who was followed with serial neurological, neuropsychological, and MRI with NeuroQuant evaluations over 10+ years.

Results: The patient’s early neuropsychological testing results, in combination with NeuroQuant volumetric measurements, raised suspicion for a potential neurodegenerative process and thereby influenced treatment decisions. However, on longitudinal follow-up, all clinical evaluations were stable except NeuroQuant measurements. From ages 69 to 71, the patient’s hippocampal volumes respectively shifted from the < 5th to 61st normative percentile (see Table 1).

Conclusion: Novel volumetric analyses should be interpreted with caution when formulating a clinical impression. Potential explanations for the observed change in NeuroQuant percentile include 1) an update to the normative database, 2) a software update, and 3) the patient moving normative age bands. As with neuropsychological testing, understanding the basis of scores produced by NeuroQuant and characteristics of the normative population is important, as this technology is increasingly used to direct clinical decision-making.
A-213 Patient Barriers to Accessing Hospital-Based Neuropsychological Services
Authors: RichWimmer Natalia , Larson Kera , Smith-Russell Dierdre , Tornberg Emma , Williams Cydni N , Hall Trevor A , Vanderlind Michael
Published: August 2022

Objective: Annually, thousands of youths are admitted to pediatric intensive care units (PICUs) and are at increased risk for long-lasting neurocognitive and psychiatric sequelae, referred to as Post Intensive Care Syndrome (PICS). Research shows that youth with PICS strongly benefit from neuropsychological follow-up services; however, high proportions of referred patients (i.e., 25-33% at our hospital) do not attend follow-up appointments. The current study aims to better understand the barriers that hinder families’ abilities to access follow-up services.

Method: Participants included guardians of children ages 0-18 years (N = 149) referred for follow-up neuropsychological assessment and did not attend the appointment. Data was collected via individual 10-minute structured telephone interviews focusing on treatment barriers chosen from prior research on social determinants of health. Participants identified the extent to which various barriers impacted appointment attendance.

Results: Data collection is currently underway. Preliminary results demonstrate time limitations/scheduling difficulties and challenges related to the COVID-19 pandemic as the most frequent barriers to accessing treatment with 60% endorsement rates each. Relatedly, 50% reported difficulty taking time off from work. Several endorsed confusion surrounding the purpose of the appointment (40%), financial concerns (30%), family stress/mental health (30%), limited childcare (20%), transportation (10%), housing difficulties (10%), and language barriers (20%).

Conclusion: Current findings highlight challenges that contribute to inequities in families’ access to care. These challenges represent important targets for interventions aimed at minimizing health care disparities. Such interventions hold promise for mitigating the extent to which PICS-related difficulties negatively impact youth’s social, psychological, and academic functioning following inpatient hospitalization.
A-215 Comparability of BRIEF2 and BRIEF-A Self-Report in Young Adults
Authors: Sady Maegan , Abecassis Maurissa , Koven Nancy S , Barrett-Clarke Adam , Isquith Peter K , Gioia Gerard A , Roth Robert M
Published: August 2022

Objective: The Behavior Rating Inventory of Executive Function (BRIEF) captures perceptions of an individual’s executive functioning in their everyday environment. Two self-report forms span late adolescence into early adulthood: BRIEF2 (ages 11-18) and BRIEF-Adult (ages 18-90). We compared responses on these forms in young adults to evaluate their continuity in this transitional age range.

Method: Participants were 77 college students [age M(SD)= 18.45(0.64), 66% female], without psychiatric or serious medical conditions, who completed the BRIEF2 and BRIEF-A forms in counterbalanced order. Mean scores on shared clinical scales (Inhibit, Self-Monitor, Shift, Emotional Control, Working Memory, Plan/Organize) and Global Executive Composite (GEC) were examined using MANOVA and correlations; T scores were examined in the subsample of 18-year-olds (n=47).

Results: For mean ratings, planned univariate follow-up tests with Bonferroni correction were significant only for the Inhibit scale [F(1,76) = 14.69, p < .001, Cohen’s d = -0.44]. Other effect sizes were < 0.3. Scales correlated well (r range .63 to .82, p < .001). T-score analyses yielded similarly strong relationships (r range .58 to .84), but with significant differences on Emotional Control (d = 0.53) and Plan/Organize (d = -0.47).

Conclusions: Results indicate good correspondence between self-report on the BRIEF2 and BRIEF-A in young adults, with few differences and generally small effect sizes. Nonetheless, statistical corrections should be employed if merging datasets using both BRIEF2 and BRIEF-A, or when examining changes in individuals followed from adolescence into adulthood using the two forms of the BRIEF.
A-220 Hooper Visual Organization Test: Item Analyses and Scale Performance in a Nonclinical Adult Sample
Authors: Chaudhary Zarah K , Hubley Anita M
Published: August 2022

Objective: The 30-item Hooper Visual Organization Test (HVOT) measures visuospatial synthesis. While satisfactory reliability estimates have been reported, some items show poor discrimination and items do not appear to be ordered by increasing difficulty level. Little psychometric evidence, however, has been gathered with healthy nonclinical adults in North America. Examination of item performance in healthy adult samples aids in understanding what might be clinically noteworthy in neurological or psychiatric patients. Thus, we examined HVOT total score performance, item difficulty and discrimination, internal consistency reliability, and correlations of HVOT total scores with demographic and neuropsychological variables in a healthy adult sample in Canada.

Method: Participant were 71 cognitively intact, non-depressed men and women ages 21-82 years (M=51.5, SD=18.3), with 9-21 years of education (M=15.0, SD=2.79), recruited from the general community. Participants were tested individually on various neuropsychological tests (HVOT, MMSE, Block Design, ROCF, Trails, Five Point Test, FAS/Animals, Vocabulary).

Results: Items ranged in difficulty (0.16-1.00) but tended to be easy (M=0.82). Item discrimination ranged from -.17 to.47. Cronbach’s alpha was 0.62. Total scores ranged from 17-29.5 out of 30 (M=25.4) and correlated significantly with age, MMSE, Block Design, ROCF, Trails, and Animals (r=|.29|-|.44|).

Conclusions: Our results suggest that some HVOT items are too easy and/or show poor discrimination. Items are not well-ordered by difficulty. We discuss some notable divergences from proposed re-orderings from clinical samples. Demographic results fit with the literature; correlations with other measures extend previous findings. Our results serve as a guide for revisions and a useful baseline for clinical comparison.
A-222 Normative Reference Values for Crystallized-Fluid Discrepancy Scores for the NIH Toolbox Cognition Battery
Authors: Iverson Grant , Gaudet Charles E , Kissinger-Knox Alicia , Karr Justin E
Published: August 2022

Objective: To translate NIH Toolbox Cognition Battery (NIHTB-CB) Crystallized-Fluid discrepancy scores into research and clinical practice with adults by providing normative data for discrepancy scores for both age-adjusted standard scores and demographic-adjusted T-scores.

Method: We included adult participants from the NIHTB-CB standardization sample who completed all seven neuropsychological tests and who denied having neurodevelopmental, medical, psychiatric, or neurological conditions (n=730; M=47.4 years-old, SD=17.6, range: 18-85; 64.4% women; 63.1% White). Descriptive statistics were calculated for the Fluid and Crystallized composite scores and the Crystallized-Fluid discrepancy score, along with the correlation between the two composite scores. Percentiles were calculated for the discrepancy score, with stratifications by gender, education, and Crystallized composite for the age-adjusted standard scores (SSs) and only the Crystallized composite for the demographic-adjusted T-scores (T).

Results: Crystallized-Fluid discrepancy scores ranged from -40 to 44 (M=-0.63, SD=14.89, Mdn =-1, interquartile range=-11-10) for age-adjusted SSs and from -29 to 27 (M=-0.39, SD=10.49, Mdn=-1, IQR=-8-7) for demographic-adjusted T-scores. Using age-adjusted SSs and demographic-adjusted T-scores, Crystallized-Fluid discrepancy scores of SS=15 and T=11 were at the 16th percentile (1 SD below the mean) and discrepancy scores of SS=21 and T=15 were at the 7th percentile (1.5 SDs below the mean).

Conclusions: Crystallized-Fluid discrepancy scores might prove to be, with future research, a useful within-person interpretive approach for detecting decline from pre-injury or pre-disease levels of cognitive functioning. These normative reference values assist clinicians and researchers in determining the frequency at which given Crystallized-Fluid discrepancy scores occurred among healthy adults in the normative sample.
A-227 A Story Told in Four Parts: Embedded Validity Indicators’ Effectiveness in Predicting Dot Counting Test Validity Classification
Authors: Wisinger Amanda M , Tse Phoebe Ka Yin , Basurto Karen S , Obolsky Maximillian A , Phillips Matthew S , Ovsiew Gabriel I , Resch Zachary J , Soble Jason R , Jennette Kyle J
Published: August 2022

Objective: Combining multiple embedded performance validity tests (PVTs) can produce similar classification accuracy to freestanding PVTs. However, there is a lack of research on the incremental predictive power of various combinations of PVTs. Thus, we compared eight embedded PVTs to assess those that best predict classification accuracy on the Dot Counting Test (DCT).

Method: Sample included 225 patients (mean age=45.96; mean education=13.96; 56% female, 44% male; 35% White, 40% Black, 17% Hispanic, 5% Asian, 2% Other) undergoing neuropsychological evaluation that included multiple embedded PVTs, including: Brief Visuospatial Memory Test-Revised Recognition Discrimination (BVMT-R RD), Stroop Color and Word Test Word Reading T-Score (Stroop-T), Trail Making Test Part A T-Score (TMT-A), Rey Auditory Verbal Learning Test (RAVLT) Forced Choice, RAVLT Effort Score, Digit Span Age Corrected Scaled Score, Reliable Digit Span, and Letter Fluency T-Score. Patients were classified into valid/invalid groups based on four independent criterion PVTs.

Results: A forward stepwise logistic regression was performed to predict DCT pass/fail using the aforementioned embedded PVTs as predictors. The model was achieved in three steps (p<.05); Step 1: BVMT-R RD (Classification Accuracy=87.6%; Nagelkerke R2 =.30), Step 2: BVMT-R RD + Stroop-T (Classification Accuracy=89.6%; Nagelkerke R2 =.44); Step 3: BVMT-R RD + Stroop-T + TMT-A (Classification Accuracy=90.1%; Nagelkerke R2 =.49).

Conclusion: BVMT-R RD + Stroop-T + TMT-A reliably predicted the DCT pass/fail group. Thus, this combination of embedded PVTs may be reliable predictors of validity classification when time prohibits delivery of freestanding PVTs, such as the DCT.
A-228 A Story Told in Four Parts: Embedded Validity Indicators’ Effectiveness in Predicting Medical Symptom Validity Test Validity Classification
Authors: Tse Phoebe Ka Yin , Basurto Karen S , Wisinger Amanda M , Obolsky Maximillian A , Chang Fini , Osview Gabriel P , Resch Zachary J , Soble Jason R , Jennette Kyle J
Published: August 2022

Objective: Prior cross-validation studies have demonstrated the utility of embedded Performance Validity Tests (PVT) as reliable indicators of performance validity, though studies of the incremental predictive power from potential combinations of embedded PVTs remain sparse. The goal of the study was to compare the relative utility of eight embedded PVTs to predict pass/fail on the Medical Symptom Validity Test (MSVT).

Methods: The study comprised 225 mixed neuropsychiatric patients referred for outpatient neuropsychological evaluation. The sample was 56% female and racially diverse (40% Black, 35% White, 17% Hispanic, 5% Asian, and 2% other ethnicities). The patients were administered the following eight embedded PVTs: Rey Auditory Verbal Learning Test Forced Choice (RAVLT-FC), RAVLT Effort Score, Digit Span Age Corrected Scaled Score (DS-ACSS), Stroop Color and Word Test Word Reading T-Score, Brief Visual Memory Test-Revised Recognition Discrimination (BVMT-RD), Reliable Digit Span, Letter Fluency T-Score, and Trail Making Test Part A T-Score. The patients were classified into valid/invalid groups based on standard MSVT cut scores.

Results: A forward entry logistic regression model was attained in three steps (p<.05); Step 1: RAVLT-FC (Classification Accuracy=83.2%; Nagelkerke R2 =.27), Step 2: RAVLT-FC + DS-ACSS (Classification Accuracy=84.2%; Nagelkerke R2 =.36); Step 3: RAVLT-FC + DS-ACSS + Stroop Word-T (Classification Accuracy=85.1%; Nagelkerke R2 =.39).

Conclusion: The RAVLT-FC + DS-ACSS + Stroop Word-T combination provides robust predictive power. The study provided a novel approach to selecting embedded PVTs that best stand in place of the MSVT when time constraints limit the use of freestanding PVTs.
A-233 Less Items, Less Problems: Using TOMMe10 to Predict Performance Validity
Authors: Benjamin Tyler B , Beaulieu Ashleigh , Nahmias Leeron , Chhabria Sharvan , Taylor Gabriella , Gibson Douglas
Published: August 2022

Objective: A frequently used standalone performance validity test (PVT) is the Test of Memory Malingering (TOMM), which utilizes two or three visual recognition trials to assess for suboptimal participant effort. In situations with limited time, shortened evaluation times are preferred. One method for this is to look at the error rate on the first 10 TOMM items (TOMMe10) for predicting invalid performance. The objective of this review is to investigate the utility of TOMMe10 in adult neuropsychological evaluations, including potential cutoffs.

Data Selection: A systematic review of available literature was conducted using the PubMed database. The following keywords were used during the search: “TOMM first 10 items” and “TOMMe10.” Eight out of eleven articles were found to have met the inclusion criteria for this review, which required the study to speak to cutoffs used and to the effectiveness of TOMMe10 at predicting performance validity with adults on the TOMM or other validated assessments.

Data Synthesis: All eight studies demonstrated adequate sensitivity, specificity, and discriminability of TOMMe10 for invalid performance, with all but four supporting a cutoff of ≥2 errors. Three proposed a cutoff of ≥1 error, while one proposed a cutoff of ≥3 errors. Both alternate cutoffs demonstrated adequate predictive power.

Conclusions: This research demonstrated that TOMMe10 could accurately predict invalid PVT performance, except in cases of severe memory impairment. Optimal TOMMe10 cutoff results were mixed but a cutoff of ≥2 errors was the most supported. Future research could assess the utility of the various suggested TOMMe10 cutoffs in specific situations.
A-237 Validation and Psychometric Properties of the Word Choice Test-10, An Abbreviated Performance Validity Test
Authors: Beach Jameson , Bain Kathleen , Valencia Julianna , Marceaux Janice , Soble Jason
Published: August 2022

Objective: The purpose of the study was to validate an abbreviated 10-item version of the Word Choice Test (WCT).

Method: One hundred and ten clinically-referred participants (M age=55.92, SD=14.07; M education=13.74, SD=2.43; 84.5% Male; 47.3% White, 32.7% Hispanic, 15.5% African American, 2.7% Multiracial, 0.9% American Indian, 0.9% Other) completed the WCT as part of a larger battery of neuropsychological tests in a Veterans Affairs (VA) outpatient clinic. The sample included individuals with no cognitive diagnosis (n=37), individuals with a cognitive diagnosis (n=43), and individuals that were determined to have invalid performance across multiple criterion PVT measures (n=30).

Results: Total scores on the 10-item abbreviated Word Choice Test (WCT-10) were significantly correlated with total scores on the 50-item WCT standard form (r(108) =.88, p < .01), the Test of Memory Malingering (TOMM) Trial 1 (r(108) =.60, p < .01), and the Reliable Digit Span (RDS) forward/backward (r(108) =.34, p < .01). Receiver operating characteristic curve (ROC) analysis for the WCT-10 indicated optimal cutoff of ≥ 2 errors, with 53% sensitivity and 96% specificity (AUC=.825, p < .001), while ROC analysis for the standard 50-item WCT indicated an optimal cutoff of ≥ 8 errors with 70% sensitivity and 91% specificity (AUC=.890, p < .001).

Conclusions: Results provide evidence for the clinical utility of the WCT-10 as a brief, freestanding performance validity test in a mixed clinical sample of Veterans with and without cognitive impairment. Utilizing the WCT-10 may reduce overall neuropsychological evaluation time, while providing evidence for validity of cognitive test performance.
A-263 Literacy Acquisition Shaped by Bilingual Education
Authors: Florentino Nicole L , Shelton Tiffani P , Lebell Danya S , Caballero Jocelyn , Bouhali Florence , Kovelman Ioulia , Tonkovich Yuuko Uchikoshi , Hoeft Fumiko
Published: August 2022

Objective: This study investigates how literacy acquisition is shaped by bilingual education. We hypothesize that learning a phonetic language, like Spanish, will improve performance on phonologically-based tasks in English. Comparatively, we expect learning a different orthographic system, like Cantonese, will improve performance on semantically-based English tasks.

Methods: Participants included 107 native English speakers between 7 and 9 years old from San Francisco schools. There were 42 children in general education English programs (GENED), 35 in Spanish (Sp) immersion programs, and 30 in Cantonese (Cn) immersion programs. Students scoring less than 85 on a nonverbal intelligence screener were excluded (KBIT-2 Matrices). Groups' performance in English was compared on phonological (CTOPP-2 Blending Words) and orthographic learning tasks (KABC-II Rebus).

Results: One-way ANOVA revealed a significant effect of bilingual education on phonological task performance at the p < .05 level [F(2, 66.4) = 3.52, p = .035]. As predicted, the Spanish-immersion group performed better on the phonological task (Blending Words, p = .035; GENED M = 8.55, Sp M = 10.09, Cn M = 9.03). Performance on the semantic task did not significantly vary among groups [F(2, 67) = 3.11, p = .051].

Conclusions: This suggests that learning a second language may shape literacy acquisition in the primary language. Results indicated that learning Spanish, a phonetic language, was associated with stronger performance on an English phonological task when compared to GENED and Cn immersion. Although the variance between groups on the semantic task was not significant, further research could characterize the impact of different orthography on English acquisition.
A-264 Neurodevelopmental Disorder associated with 8p23.1 Microdeletion Syndrome: A Pediatric Case Study
Authors: Smith Alphonso
Published: August 2022

Objective: 8p23.1 microdeletion syndrome is a rare genetic disorder involving a partial deletion of chromosome 8. Children with this microdeletion are at increased risk for prenatal growth deficiency, congenital heart defects, craniofacial abnormalities, seizures, intellectual deficits, language impairments, motor deficits, and behavioral disorders which emphasizes the need for comprehensive neuropsychological assessment and intervention for these individuals.

Method: This case study presents on the neuropsychological profile of a 9-year-old female with 8p23.1 microdeletion syndrome who had a history of absence seizures, heart valve disease, microcephaly, and developmental delays. The patient previously underwent psychological testing at age 8 and the findings revealed deficits in attention and intellectual functioning; however, her parents now had concerns for her social functioning.

Results: Neuropsychological testing showed broad impairments in intellectual functioning, adaptive functioning, language, academic achievement, attention, executive functioning, memory, visuomotor skills, and social cognition.

Conclusions: Recommendations were made to modify the patient’s special education academic goals, initiate various interventional services at school (e.g., speech therapy, occupational therapy, and social work), and start private ABA therapy. Continued monitoring and medication management with neurology and psychiatry were recommended as well given the patient’s history of absence seizures and problems with attentional-behavioral regulation. This case demonstrates the importance of comprehensive neuropsychological evaluation and treatment of children with certain rare genetic disorders such as 8p23.1 microdeletion syndrome in order to help improve neurodevelopmental outcomes in these patients.
A-265 Neuropsychological Profile Associated with Psychogenic Nonepileptic Seizures, Autism, and Comorbid Neurodevelopmental Conditions
Authors: Kallus Rachel
Published: August 2022

Objective: There is a dearth of data related to psychogenic nonepileptic seizures (PNES) in individuals with autism spectrum disorder (ASD). A neuropsychological case study was completed involving ASD and PNES to improve our understanding of brain behavior relationships and expand our clinical reach within this population.

Method: A 9-year-old male with ASD, comorbid mild intellectual disability, attention-deficit hyperactivity disorder, and oppositional-defiant disorder was evaluated. He exhibited seizure-like episodes, involving staring, tremor, shaking, confusion, and prolonged memory lapses. Prior EEG was consistent with epileptiform focus in the right parasagittal region. Repeat EEG, brain MRI, and 3-day continuous EEG (cEEG) were unremarkable. Clinical episodes during cEEG had no EEG correlate or seizure episodes and included features inconsistent with epileptic seizures, indicating PNES.

Results: Indices assessing aptitude and intellect were broadly dampened (< 1st-5th percentile), aside from visual-spatial processing (77th percentile). His profile revealed difficulties with language (e.g., receptive and expressive vocabulary, fluency, and comprehension), rote and contextual verbal learning and memory, executive functioning (e.g., working memory, inhibition, and switching), processing speed, and fine motor skills (all < 1st-9th percentile). Visual-perception and visual-motor integration were strengths. See Table 1 for selected neuropsychological results.

Conclusions: Given combined neurodevelopmental diagnoses, neuropsychological challenges were expected. The visuospatial strength was consistent with literature findings that some with ASD display enhanced visual-perception. Because seizure episodes were identified as non-epileptic, while behaviorally concerning, these events were not likely contributing to the neurocognitive presentation. There is need for future studies to examine the neuropsychological profiles and brain-behavior relationships of individuals with PNES and ASD.
A-281 The Relationship Between Mood, Cognition, and Functional Impairment in Recovered COVID-19 Patients
Authors: Keren Yocheved , Russell Katherine E , Basile Rosemarie
Published: August 2022

Objective: Recent studies exploring the psychological and cognitive effects of COVID-19 indicate decline in memory, language, and executive functioning, as well as symptoms of depression and anxiety. The objective of this study was to determine the relationship between acute COVID-19 symptom load and self-report of psychological, cognitive, and functional outcomes after recovery.

Method: 65 adults treated by Staten Island University Hospital for COVID-19 participated in a brief battery of screening measures. The protocol included the Generalized Anxiety Disorder-2, Patient Health Questionnaire-2, Primary Care PTSD Screen for DSM-5, and World Health Organization Schedule Disability Assessment Schedule 2.0 (WHODAS). Participants were asked about 11 symptoms they may have experienced when acutely ill to determine the total COVID-19 symptom load (CSL) and current cognitive and psychological symptoms. Pearson’s correlation was used to investigate associations between variables.

Results: CSL was not associated with total WHODAS score, although it was weakly associated with the Self-Care and Life Activities domains. Current cognitive symptom load was moderately associated with most WHODAS domains. It was most strongly associated with Understanding and Communication (r=0.36; p=0.003). All psychological domains were associated with greater WHODAS impairment, and depression had the strongest association (r=0.43; p< 0.001).

Conclusions: CSL does not appear to predict the functional impacts of COVID-19. Psychological factors, particularly depression, appear to be slightly more associated with functional impairment than cognitive symptoms. Results highlight the importance of targeted intervention for current cognitive and psychological symptoms in recovered COVD-19 patients, regardless of CSL.
A-293 Impulsivity and Executive Function in Older Adults with Personality Disorders
Authors: Bushell Christine , Zweig Richard
Published: August 2022

Objective: This review examines the impact of age on impulsivity-related executive functions (IREF) in personality disorders (PDs) characterized by impulsivity, i.e., antisocial (ASPD)/borderline (BPD) PDs. ASPD/BPD prevalence decreases with age, and general consensus purports a positive age effect on impulsivity -- despite longitudinal studies showing generally reduced executive function (EF) with age. This review explores the apparent contradiction between diminished EF in older adulthood and declines in impulsivity believed to occur with age.

Data Selection: Searches (e.g., “impulsivity”, “aging”, “ASPD”/”BPD”, “EF”) across Google Scholar and PsycINFO yielded studies incorporating self-reported impulsivity and neuropsychological IREF measures. 19 studies (1997-2021) spanning, a) self-reported/trait impulsivity in ASPD/BPD, b) IREF in ASPD/BPD,) c) impulsivity/EF in normal aging, and d) ASPD/BPD in older adulthood, were informally extracted. Included EF studies incorporated measures of inhibition, delay discounting, and/or planning; studies limited to other executive skills were excluded.

Data Synthesis: Cross-sectional, longitudinal, and meta-analytic self-report and neuropsychological results reflect elevated impulsivity in ASPD/BPD groups. Despite prior research suggesting decreased impulsivity with age, this review demonstrates mixed/contradictory results for older ASPD/BPD groups and possible explanations.

Conclusions: Mixed findings perpetuate questions surrounding IREF in older ASPD/BPD groups. However, executive dysfunction and PDs are individually associated with functional impairment in aging. Greater understanding of IREF and ASPD/BPD in aging populations could identify those in need of intervention to mitigate functional consequences. Future research using wider age ranges, consistent operationalization of constructs, and increased control for confounds, would allow for better understanding of PDs’ unique impact on EF in older adulthood and the associated consequences.
A-305 Boston Naming Test Replacement Item 48 (Boomerang) in a Clinical Sample
Authors: Chokshi Avni , King Jason A
Published: August 2022

Objective: The Boston Naming Test (BNT) is a measure of language that assesses confrontation naming and is widely used in clinical neuropsychology. Item 48 contains problematic content (drawing of a noose) that is offensive and causes emotional distress for many examinees. How should clinicians administer and interpret the BNT, considering that existing norms were collected with item 48?

Method: We administered both original item 48 (noose) and new replacement item 48 (boomerang) to a sample of 171 individuals referred for clinical neuropsychological evaluation to our outpatient practice. Our sample was 45% female (77 of 171), with an average age of 62.6 years old (range 18–89; SD 15.3), and average education of 15.9 years (range 7–20; SD 2.5).

Results: Our results indicated an overall consistency of 76.6% between the two items (131 of 171 participants). A participant was categorized as consistent if they obtained both scores correct or both scores incorrect on the two items. This result indicates that the original item 48 and replacement item 48 are of similar difficulty in a diverse clinical sample.

Conclusions: In summary, our data indicates that performance on the new replacement item is consistent with performance on the original item roughly ¾ of the time. Considering the multiple potential methods for administering the BNT without original item 48, we believe substituting replacement item 48 represents the most efficient use of clinical time and resources, while giving the examinee the opportunity to demonstrate their performance on an item of comparable difficulty to original item 48.
A-310 Sensitivity and Specificity of the Portland Digit Recognition Test: Online vs In-Person
Authors: Huston Chloe , Poreh Amir
Published: August 2022

Objective: With the proliferation of telehealth and online neuropsychological assessment, a question is raised to whether the results of such measures are comparable to those used in person. Thus, this study aimed to compare the performance of an online adaptation of the Portland Digit Recognition Test (PDRT) at detecting simulators of traumatic brain injury (TBI) to that of the in-person PDRT when TBI patients are utilized.

Methods: 400 participants were randomly assigned to the simulated malingerers’ or the control group and completed an online adaptation of the PDRT. The malingerers’ group was instructed to perform as if they have a TBI. Sensitivity and specificity using the suggest cutoff score for the online PDRT were compared to in-person PDRT scores from published studies using the original suggested cutoffs.

Results: ROC analysis of online PDRT scores used during this study demonstrated a sensitivity of 94% and specificity of 95%. When compared to in-person studies that used samples of TBI patients (e.g. Greve and Bianchini, 2006; Greve et al., 2008; Bianchini et al., 2001), the online version of the PDRT consistently had higher sensitivity but not higher specificity.

Conclusions: This study has helped demonstrate the validity of an online version of the PDRT for detection of malingering. When compared to the sensitivity and specificity of in-person PDRT scores, the online version consistently had higher sensitivity and lower specificity. Additional research and comparisons are needed to further validate the online version of the PDRT for malingering detection.
White matter abnormalities characterize the acute stage of sports-related mild traumatic brain injury
Authors: Mito Remika , Parker Donna M , Abbott David F , Makdissi Michael , Pedersen Mangor , Jackson Graeme D
Published: August 2022

Sports-related concussion, a form of mild traumatic brain injury, is characterized by transient disturbances of brain function. There is increasing evidence that functional brain changes may be driven by subtle abnormalities in white matter microstructure, and diffusion MRI has been instrumental in demonstrating these white matter abnormalities in vivo. However, the reported location and direction of the observed white matter changes in mild traumatic brain injury are variable, likely attributable to the inherent limitations of the white matter models used. This cross-sectional study applies an advanced and robust technique known as fixel-based analysis to investigate fibre tract-specific abnormalities in professional Australian Football League players with a recent mild traumatic brain injury. We used the fixel-based analysis framework to identify common abnormalities found in specific fibre tracts in participants with an acute injury (≤12 days after injury; n = 14). We then assessed whether similar changes exist in subacute injury (>12 days and <3 months after injury; n = 15). The control group was 29 neurologically healthy control participants. We assessed microstructural differences in fibre density and fibre bundle morphology and performed whole-brain fixel-based analysis to compare groups. Subsequent tract-of-interest analyses were performed within five selected white matter tracts to investigate the relationship between the observed tract-specific abnormalities and days since injury and the relationship between these tract-specific changes with cognitive abnormalities. Our whole-brain analyses revealed significant increases in fibre density and bundle cross-section in the acute mild traumatic brain injury group when compared with controls. The acute mild traumatic brain injury group showed even more extensive differences when compared with the subacute injury group than with controls. The fibre structures affected in acute concussion included the corpus callosum, left prefrontal and left parahippocampal white matter. The fibre density and cross-sectional increases were independent of time since injury in the acute injury group, and were not associated with cognitive deficits. Overall, this study demonstrates that acute mild traumatic brain injury is characterized by specific white matter abnormalities, which are compatible with tract-specific cytotoxic oedema. These potential oedematous changes were absent in our subacute mild traumatic brain injury participants, suggesting that they may normalize within 12 days after injury, although subtle abnormalities may persist in the subacute stage. Future longitudinal studies are needed to elucidate individualized recovery after brain injury.
Deep-learning retinal vessel calibre measurements and risk of cognitive decline and dementia
Authors: Cheung Carol Y , Wong Win Lee Edwin , Hilal Saima , Kan Cheuk Ni , Gyanwali Bibek , Tham Yih Chung , Schmetterer Leopold , Xu Dejiang , Lee Mong Li , Hsu Wynne , Venketasubramanian Narayanaswamy , Tan Boon Yeow , Wong Tien Yin , Chen Christopher P L H
Published: August 2022

Previous studies have explored the associations of retinal vessel calibre, measured from retinal photographs or fundus images using semi-automated computer programs, with cognitive impairment and dementia, supporting the concept that retinal blood vessels reflect microvascular changes in the brain. Recently, artificial intelligence deep-learning algorithms have been developed for the fully automated assessment of retinal vessel calibres. Therefore, we aimed to determine whether deep-learning-based retinal vessel calibre measurements are predictive of risk of cognitive decline and dementia. We conducted a prospective study recruiting participants from memory clinics at the National University Hospital and St. Luke’s Hospital in Singapore; all participants had comprehensive clinical and neuropsychological examinations at baseline and annually for up to 5 years. Fully automated measurements of retinal arteriolar and venular calibres from retinal fundus images were estimated using a deep-learning system. Cox regression models were then used to assess the relationship between baseline retinal vessel calibre and the risk of cognitive decline and developing dementia, adjusting for age, gender, ethnicity, education, cerebrovascular disease status, hypertension, hyperlipidemia, diabetes, and smoking. A total of 491 participants were included in this study, of whom 254 developed cognitive decline over 5 years. In multivariable models, narrower retinal arteriolar calibre (hazard ratio per standard deviation decrease = 1.258, P = 0.008) and wider retinal venular calibre (hazard ratio per standard deviation increase = 1.204, P = 0.037) were associated with increased risk of cognitive decline. Among participants with cognitive impairment but no dementia at baseline (n = 212), 44 progressed to have incident dementia; narrower retinal arteriolar calibre was also associated with incident dementia (hazard ratio per standard deviation decrease = 1.624, P = 0.021). In summary, deep-learning-based measurement of retinal vessel calibre was associated with risk of cognitive decline and dementia.
A diagnosis model of parental care: How parents optimize their provisioning strategy in brood reduction?
Authors: Zhu Zhen-Qin , Zi Shu-Mei , Gao Li-Fang , Zhang Xiao-Dan , Liu Fang-Yuan , Wang Qian , Du Bo
Published: August 2022

Altricial birds often display biased preferences in providing parental care for their dependent offspring, especially during food shortages. During this process, such inflexible rules may result in provisioning errors. To demonstrate how parents optimize their provisioning strategies, we proposed a “diagnosis model” of parental care to posit that parents will undergo a diagnosis procedure to test whether selecting against some particular offspring based on phenotype is an optimal strategy. We tested this model in an asynchronous hatching bird, the Azure-winged Magpie Cyanopica cyanus, based on 10 years of data about demography and parental provisioning behaviors. Given their higher daily survival rates, core offspring (those hatched on the first day) merits an investment priority compared with their marginal brood mates (those hatched on later days). However, a marginal offspring also merited a priority if it displayed greater weight gain than the expected value at the early post-hatching days. Parents could detect such a marginal offspring via a diagnosis strategy, in which they provisioned the brood at the diagnosis stage by delivering food to every nestling that begged, then biased food toward high-value nestlings at the subsequent decision stage by making a negative response to the begging of low-value nestlings. In this provisioning strategy, the growth performance of a nestling became a more reliable indicator of its investment value than its hatching order or competitive ability. Our findings provide evidence for this “diagnosis model of parental care” wherein parents use a diagnosis method to optimize their provisioning strategy in brood reduction.
Stability, survival, and patient satisfaction with CAD/CAM versus conventional multistranded fixed retainers in orthodontic patients: a 6-month follow-up of a two-centre randomized controlled clinical trial
Authors: Gera Arwa , Pullisaar Helen , Cattaneo Paolo M , Gera Shadi , Vandevska-Radunovic Vaska , Cornelis Marie A
Published: August 2022

Objectives

The primary aim of this two-arm parallel two-centre randomized controlled trial was to compare computer-aided design and computer-aided manufacturing (CAD/CAM) versus conventional multistranded fixed retainers (FRs) in terms of stability over 6 months. Secondary outcomes were failure rates and patient satisfaction.

Methods

Patients were randomized to CAD/CAM or conventional FRs in both arches, in 1:1 ratio and blocks of four. Allocation concealment was secured by using sequentially numbered envelopes. Patients were blinded. Retainers were bonded at the end of orthodontic treatment (T0), and patients were recalled after 1 (T1), 3 (T3), and 6 (T6) months. First-time retainer failures were recorded and digital impressions were taken. Arch widths and lengths, as well as Little’s Irregularity Index (LII), were measured. Additionally, patients answered satisfaction questionnaires. Linear mixed models were applied for measurements and patient satisfaction. Survival analyses were estimated with Kaplan-Meier curves, along with Cox-regression modelling.

Results

One hundred and eighty-one patients were randomized (98 in Centre 1, and 83 in Centre 2): Ninety in the CAD/CAM group and 91 in the conventional group. Three subjects dropped out at baseline, as they did not attend any of the follow-up appointments.168 patients attended the T6 visit. There were no significant differences in arch dimensions between T0 and T6, whilst the LII was different only in the CAD/CAM group (mean difference: 0.2 mm; 95% confidence interval: 0.1 to 0.4; P < 0.001). Within 6 months, 39 upper retainers (19 out of 88 CAD/CAM and 20 out of 90 conventional retainers) and 52 lower retainers failed (26 out of 88 CAD/CAM and 26 out of 90 conventional retainers), with no significant difference between the survival of both types of retainers (hazard ratios conventional to CAD/CAM: upper arch: 0.99 [P =0.99], lower arch: 0.93 [P = 0.80]). There were no significant changes in patient satisfaction between the groups. No harms were observed.

Conclusions

There were no clinically significant differences in LII, arch widths and lengths between CAD/CAM and conventional retainers after 6 months. There was no difference in failures and in patient satisfaction between both types of FRs.

Registration

ClinicalTrials.gov NCT04389879.
Sympathetic activation in heart failure
Authors: Gronda E , Dusi V , D’Elia E , Iacoviello M , Benvenuto E , Vanoli E
Published: August 2022

Sympathetic activation has been long appreciated exclusively as a fundamental compensatory mechanism of the failing heart and, thus, welcome and to be supported. In the initial clinical phases of heart failure (HF), the sympathetic nervous system overdrive plays a compensatory function aimed at maintaining an adequate cardiac output despite the inotropic dysfunction affecting the myocardium. However, when the sympathetic reflex response is exaggerated it triggers a sequence of unfavourable remodelling processes causing a further contractile deterioration that unleashes major adverse cardiovascular consequences, favouring the HF progression and the occurrence of fatal events. Eventually, the sympathetic nervous system in HF was demonstrated to be a ‘lethality factor’ and thus became a prominent therapeutic target. The existence of an effective highly specialized intracardiac neuronal network immediately rules out the old concept that sympathetic activation in HF is merely the consequence of a drop in cardiac output. When a cardiac damage occurs, such as myocardial ischaemia or a primary myocardial disorder, the adaptive capability of the system may be overcame, leading to excessive sympatho-excitation coupled with attenuation till to abolishment of central parasympathetic drive. Myocardial infarction causes, within a very short time, both a functional and anatomical remodelling with a diffuse up-regulation of nerve growth factor (NGF). The subsequent nerve sprouting signal, facilitated by a rise in the levels of NGF in the left stellate ganglion and in the serum, triggers an increase in cardiac nerve density in both peri-infarct and non-infarcted areas. Finally, NFG production decreases over time, supposedly as an adaptative response to the prolonged exposure to sympathetic overactivity, leading in the end to a reduction in sympathetic nerve density. Accordingly, NGF levels were markedly reduced in patients with severe congestive heart failure. The kidney is the other key player of the sympathetic response to HF as it indeed reacts to under-perfusion and to loop diuretics to preserve filtration at the cost of many pathological consequences on its physiology. This vicious loop ultimately participates to the chronic and disruptive sympathetic overdrive.

In conclusion, sympathetic activation is the natural physiological consequence to life stressors but also to any condition that may harm our body. It is the first system of reaction to any potential life-threatening event. However, in any aspect of life over reaction is never effective but, in many instances, is, actually, life threatening. One for all is the case of ischaemia-related ventricular fibrillation which is, strongly facilitated by sympathetic hyperactivity. The take home message? When, in a condition of harm, everybody is yelling failure is just around the corner.
Antibacterial, antibiofilm, and antimotility signatures of some natural antimicrobials against Vibrio cholerae
Authors: Caigoy Jant Cres , Xedzro Christian , Kusalaruk Waraporn , Nakano Hiroyuki
Published: August 2022

Vibrio cholerae is an etiological cause of cholera and has been implicated in several epidemics. Exploration of the antimicrobial signatures of culinary spices has become an important industrial tool to suppress the growth of foodborne bacterial pathogens including Vibrio spp. The antibiofilm and antimotility activities of some selected natural antimicrobial agents were then evaluated. All the extracts showed vibriostatic activities with minimum inhibitory concentration (MIC) ranging from 0.1% to 0.4%. Cinnamon and black pepper demonstrated significant biofilm inhibition activity from 94.77% to 99.77% when administered at 100% MIC. Black pepper extract also demonstrated the highest biofilm inhibition activity against the established biofilms of V. cholerae O1 and O139. Cinnamon, calabash nutmeg, and black pepper significantly inhibited swimming and swarming motility by 85.51% to 94.87%. Sub-MICs (50% and 75%) of some extracts were also effective as an antibiofilm and antimotility agent against the tested strains. The findings of our study suggest the potential application of natural antimicrobial agents such as spices in food to inhibit biofilm formation and motility, which consequently mitigate the virulence and persistence of the pathogen in the food supply chain.
impMKT: the imputed McDonald and Kreitman test, a straightforward correction that significantly increases the evidence of positive selection of the McDonald and Kreitman test at the gene level
Authors: Murga-Moreno Jesús , Coronado-Zamora Marta , Casillas Sònia , Barbadilla Antonio
Published: August 2022

The McDonald and Kreitman test is one of the most powerful and widely used methods to detect and quantify recurrent natural selection in DNA sequence data. One of its main limitations is the underestimation of positive selection due to the presence of slightly deleterious variants segregating at low frequencies. Although several approaches have been developed to overcome this limitation, most of them work on gene pooled analyses. Here, we present the imputed McDonald and Kreitman test (impMKT), a new straightforward approach for the detection of positive selection and other selection components of the distribution of fitness effects at the gene level. We compare imputed McDonald and Kreitman test with other widely used McDonald and Kreitman test approaches considering both simulated and empirical data. By applying imputed McDonald and Kreitman test to humans and Drosophila data at the gene level, we substantially increase the statistical evidence of positive selection with respect to previous approaches (e.g. by 50% and 157% compared with the McDonald and Kreitman test in Drosophila and humans, respectively). Finally, we review the minimum number of genes required to obtain a reliable estimation of the proportion of adaptive substitution (α) in gene pooled analyses by using the imputed McDonald and Kreitman test compared with other McDonald and Kreitman test implementations. Because of its simplicity and increased power to detect recurrent positive selection on genes, we propose the imputed McDonald and Kreitman test as the first straightforward approach for testing specific evolutionary hypotheses at the gene level. The software implementation and population genomics data are available at the web-server imkt.uab.cat.