bluuebunny/crossref_metadata_2025 huggingface dataset:
A-145 Evaluating Attention and Processing Speed and Executive Functioning Abilities in Hispanic Traumatic Brain Injury Survivors and Healthy Adults
Authors: W Olmos , D Lopez-Hernandez , J Knight , S Saravia , P Litvin , R Rugh-Fraser , F Martinez , R Cervantes , S Mangassarian , A Arzuyan , I Ritchie , D Hardy , D Budding , P Vespa , D Hovda , D Mcarthur , D Plurad , J Fuster , K Boone , E Woo , M Wright
Published: August 2020

Objective

We examined the effects of attention/processing speed (APS) and executive functioning (EF) in Hispanic and Caucasian traumatic brain injury (TBI) survivors and healthy comparison participants (HC).

Method

The sample consisted of 45 HC (21 Hispanics & 24 Caucasian), 28 acute TBI (ATBI; 10 Hispanics & 18 Caucasians), and 26 chronic TBI (CTBI; 9 Hispanics; 17 Caucasians) participants. ATBI participants were tested 6 months post-injury; CTBI participants were tested 12 months or more post-injury. Symbol Digit Modalities Test (SDMT) Oral, SDMT Written, Stroop Word, Stroop Color, and Trail Making Test (TMT) part A were used to create an APS composite (APSC) score. Stroop color-word, TMT part B, Delis-Kaplan Executive Function System verbal fluency composite score, and design fluency composite score were used to create an EF composite (EFC) score.

Results

ANOVAs were used to evaluate group differences. Main effects were found on APSC, p = .000, with HC and CTBI outperforming the ATBI group. Also, we found the HC group outperformed both TBI groups on EFC, p = .000. Furthermore, we found differences between racial/ethnic groups, with Caucasians outperforming Hispanics on EFC performance, p = .029. No interactions were found.

Conclusion

Overall, HC demonstrated better EF compared to both TBI groups, but only APS compared to the ATBI group. Also, CTBI survivors demonstrated better APS abilities compared to ATBI survivors. Our findings suggest improvement in APS during the later stages of TBI recovery. Finally, Caucasians demonstrated better EF compared to Hispanics.
A-147 Post-Concussive Symptoms in Adolescent Athletes with Premorbid Psychiatric History: A Matched Case–Control Study
Authors: C Presley , T Caze , T Tarkenton , M Stokes , S Miller , K Bell , H Batjer , M Cullum
Published: August 2020

Objective

To examine sport-related concussion (SRC) symptoms in adolescent athletes with premorbid psychiatric history (PPH+) compared to a matched control sample without such history (PPH-). It was hypothesized that adolescents with PPH+ would report higher symptom severity both initially and at 3-month follow-up.

Method

Participants aged 13–18 (M age = 14.9) who reported a psychiatric history (N = 29) presented to clinic within 7 days of sustaining a SRC. Subjects were matched to those without premorbid psychiatric history (N = 29) by age, sex, race, sport, and time to clinic ( 1 day). All participants (N = 58) completed the Post-Concussion Symptom Scale (PCSS) at initial visit and 3-month follow-up as part of the North Texas Concussion Registry (ConTex). Independent sample T tests compared PCSS total and cognitive/fatigue, vestibular, ocular, posttraumatic migraine, and anxiety/mood domain scores between groups across time points.

Results

Consistent with our hypothesis, the PPH+ group reported significantly higher PCSS total (M = 41.0/132 vs. M = 27.7/132; p = .02), posttraumatic migraine domain (M = 3.5/6 vs. M = 2.5/6; p = .03), and anxiety domain (M = 1.1/6 vs. M = 0.4/6; p = .002) severity at the initial evaluation. However, there were no significant differences in PCSS total (PPH+ M = 4.1/132 vs. PPH- M = 3.3/132) or domain scores at 3-month follow-up.

Conclusion(s)

After matching by age, sex, race, sport, and time to clinic, adolescents with self-endorsed PPH+ reported higher total symptom, posttraumatic migraine, and anxiety domain symptom severity immediately following SRC but not at 3-month follow-up. Findings suggest that adolescents with PPH+ may experience higher subjective levels of distress following SRC, although further research is needed to understand the role of recovery in this population.
A-153 Working Memory Performance and Brain Activity in the context of Opioid Withdrawal and Relapse
Authors: B Surprenant , K Grimone , T Wagner , H Sarles-Whittlesey , E Jones , D Herman , M Stein , L Sweet
Published: August 2020

Objective

Working memory (WM) deficits are associated with opioid use disorder (OUD). However, little research addresses WM during withdrawal. We used the N-back WM paradigm to assess whether differences exist between persons in withdrawal versus stable opioid doses. We also examined whether N-back performance or associated brain activity during either withdrawal or satiation predict subsequent abstinence versus relapse.

Method

We evaluated N-Back performance and associated brain function of 20 OUD patients during 3 T fMRI. Participants were actively using opioids during the first scan (SOWS M = 8.10, SD = 9.22) and abstained 24 hours before the second scan (SOWS M = 28.26, SD = 11.64), buprenorphine treatment began afterwards. Twelve participants (age: M = 33.92, SD = 5.99) completed both scans and were included in within-subject contrasts. Sixteen participants (age: M = 34.38, SD = 5.38) completed at least one scan and were evaluated on whether brain activation or performance was associated with relapse.

Results

Paired-sample t-tests revealed no significant difference on N-back accuracy (0-back: t = 0.78, p = .45, d = 0.23; 2-back: t = −0.28, p = .78, d = 0.08) or brain activation (2-back versus 0-back) across regions of interest (ROIs) associated with WM in prior studies between satiated and abstinent assessments (ts < 0.5, ps > .05). Contrasting relapsing and abstinent groups at follow-up revealed no significant difference in N-back accuracy (0-back: t = −0.30, p = .77, d = 0.14; 2-back: t = 0.43, p = .67, d = 0.22) or associated ROI brain activation (ts < 1.29, ps > .05).

Conclusion

This is the first investigation of brain and behavioral measures of WM in opiate withdrawal and relapse. No significant differences were found, and effect sizes were small. Further research that investigates direct (compensatory activation) and task-indirect systems (default network, motivation) during cognitive challenges is needed.
A-165 Letter Versus Oject Naming: Exploring the Relationship Between Rapid Naming and Fluid Reasoning Ability
Authors: S Pieciak , Z Imre , M Kibby
Published: August 2020

Objective

Fluid reasoning is associated with rapid naming (RN) ability in multiple studies (e.g., Mano et al., 2019), but less is known about which aspects of RN may be driving this relationship. Hence, the purpose of this study was to determine which is better associated with fluid reasoning ability: letter or object naming.

Method

Participants comprised 226 children, ages 8–12 years (88.5% Caucasian, 53.1% Male), who completed a larger, NIH-funded study (R03HD048752, R15HD065627), representing a community sample. They encompassed children with ADHD, reading disability (RD), RD/ADHD and controls. Measures administered included the CTOPP Letter and Object Naming subtests and the Test of Nonverbal Intelligence, Third Edition (TONI-3).

Results

Linear regression revealed RN predicted TONI-3 scores, F(2, 223) = 7.44, p = .001, but only object naming was significant (Beta = .26, p = .002). Separate regressions demonstrated that RN was not related to TONI-3 performance for controls (p = .12), nor for children with ADHD (p = .58). It displayed a trend for children with RD, F(2, 45) = 2.99, p = .06, with only object naming being significant (Beta = .44, p = .02).

Conclusions

Rapid object naming, but not rapid letter naming, is related to fluid reasoning ability in a mixed sample of children. Further analysis suggests that these findings were driven by children with RD. Future research should investigate whether the semantic or visual aspect of object naming, or both, is driving this relationship.
A-177 Relationship Between Family Members’ Subjective Ratings of Memory Decline and Objective Neuropsychological Test Performance
Authors: H Clark , R Schroeder , P Martin
Published: August 2020

Objective

In cognitive domains such as memory, decline can manifest in several ways. The current study investigated how different memory changes reported by family members on a behavior rating scale were related to neuropsychological test performance. The study also examined if reported memory problems reflected memory impairment specifically, versus general cognitive dysfunction.

Method

Patients (n = 87, mean age = 73.0, mean education = 13.1 years) minimally completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) during dementia evaluations. Information from patients’ family members was obtained via a questionnaire asking about degrees of perceived change (no change, mild change, moderate change, or severe change) in “remembering conversations,” “repeating self,” and “misplacing items.” Spearman correlations were calculated between family members’ perceptions of change and cognitive dysfunction, measured by RBANS index scores.

Results

Perceived changes in misplacing items significantly correlated with RBANS Immediate Memory (rs = −.291, p = .008) and Delayed Memory (rs = −.261, p = .018) indices. The only other correlations that approached statistical significance were between remembering conversations and Immediate Memory (rs = −.209, p = .052) and repeating self and Delayed Memory (rs = −.208, p = .056). No correlations with other RBANS index scores approached statistical significance at p < .05.

Conclusions

While not all results were statistically significant, trends among correlations between RBANS index scores and family-reported changes in patients remembering conversations, repeating themselves, and misplacing items suggest that when these terms are utilized on behavior rating scales, they possess both convergent and discriminant validity. Since misplacing items significantly correlated with both immediate and delayed memory dysfunction, changes in this area might be the most useful to assess on behavior rating scales.
A-184 Comparison of Performance on the Virtual Environment Grocery Store and the CVLT-II
Authors: S Shorter , A Coldiron , C Reed , T Glover , R Gutierrez , J Moore , T Parsons , M Barnett
Published: August 2020

Objective

The Virtual Environment Grocery Store (VEGS) was created to measure memory and everyday functional abilities (Parsons & McMahan, 2017). The objective of this study was to compare young adults’ recall of the VEGS shopping list with the CVLT-II in order to investigate what impact the virtual environment has on recall.

Methods

Young adults (ages 18–26, M = 18.90, SD = 1.60; N = 39) completed the VEGS and the CVLT-II.

Results

Young adults had higher recall on the CVLT-II than VEGS for immediate recall and delayed free recall, but there were no differences on delayed cued recall and delayed recognition.

Conclusion

Immediate and delayed free recall on the VEGS may be more difficult on the VEGS than the CVLT-II, perhaps reflecting the word length effect. The virtual environment may have allowed for deeper levels of processing, explaining the lack of differences on delayed cued recall and delayed recognition.
A-187 Is Once Enough? First Trial Performance on the Free and Cued Selective Reminding Test in a Clinical Sample of Older Adults with Neurocognitive Disorders
Authors: K Gettens , M Daly , T Chaudhry , H Duncanson , J Sherman , M Colvin
Published: August 2020

Objective

There is urgent need for tools that quickly identify neurocognitive disorders (NCD). The Free and Cued Selective Reminding Test (FCSRT) has high sensitivity for detecting NCD severity (Mild vs. Major) and type (amnestic vs. non-amnestic). However, full administration of three learning trials makes it relatively lengthy. We examined whether first trial performance detects NCD type and severity.

Method

187 patients (Mage = 74.7 ± 6.9, Medu = 16 ± 3.1; 58% male) were clinically evaluated. Diagnoses were Mild NCD—amnestic (N = 55), Mild NCD—non-amnestic (N = 67), Major NCD -amnestic (N = 23), and Major NCD –non-amnestic (N = 42). Free recall accuracy (FRA) [number freely recalled/16 *100] and cued recall accuracy (CRA) [(number of cues provided—number recalled with cues)/16 *100] were calculated for each of 3 learning trials.

Results

First trial performance predicted NCD severity (2 (2) = 7.84, p < .03) and type (2 (1) = 59.0, p < .001). First trial FRA predicted NCD severity (B = −3.29, p < .01). First trial FRA and CRA predicted NCD type (CRA better than FRA, (B = −4.54, p < .001). Third trial accuracy did not predict NCD severity [2 (2) = 5.75, p = .06). Third trial accuracy predicted NCD type [2 (2) = 56.6, p < .001]; third trial FRA performed similarly to first trial FRA.

Conclusions

Our results suggest that first trial FCSRT performance may be enough to screen for neurocognitive disorders. Findings identify free recall accuracy as a better predictor of type and cued recall accuracy a better predictor of NCD severity.
A-191 The Role of Memory in Mathematical Abilities
Authors: W Goulart , E Ailes , C Golden , L Lashley
Published: August 2020

Objective

To determine the contribution of different types of memory (Visual Memory, Auditory Memory and Visual Working Memory) to mathematical abilities.

Method

The participants were drawn from a deidentified adult clinical database. A multiple regression tested (n = 91, Mage = 29.9, Medu = 13.3, 49% Caucasian, 57% Female) the ability of the Wechsler Memory Scale Fourth edition (WMS-IV) Auditory Memory Index Score, Visual Memory Index Score, and Visual Working Memory Index Score to predict the Key Math-3rd edition (KM3) Total Test Standard Score.

Results

In a standard regression, Visual Memory, Auditory Memory, and Visual Working Memory indexes significantly predicted KM3 Total Test Standard Scores. The regression was statistically significant, F(3,87) = 17.1, p = < .001, R2 = .370. In this model, WMS-IV Visual Working Memory (beta = .338, p = .004) and Auditory Memory (beta = .271, p = .007) added significantly to the prediction.

Conclusion

The results of this study suggest that memory is important in mathematical calculations and different types of memory make distinct contributions. Furthermore, the Visual Working Memory Index explained a greater percentage of variance than the Auditory Memory Index. This suggests that visual working memory skills play a greater role in mathematical abilities and highlights the importance of the ability to remember and manipulate figures in our minds when solving math problems. The significance of auditory memory to mathematics may be related to remembering how to solve problems, word problems, and verbal problem-solving strategies. The Visual Memory Index may not have contributed unique variance because this composite may overlap with the Visual Working Memory Index, and academic learning may be stored verbally.
A-196 BVRT Copy and Memory Trial Omission Errors Are Associated With Working Memory and Auditory Comprehension Deficits
Authors: A Vickery , J Moses , A Boese , R Maciel , J Lyu
Published: August 2020

Objective

The goal of this study is to examine the cognitive factors that account for omission errors on the Benton Visual Retention Test (BVRT) copy and memory trials using factorial indices based on raw subtest scores of the Wechsler Adult Intelligence Scale-III (WAIS-III) and the Multilingual Aphasia Examination (MAE).

Method

Participants were referred for assessment at the VA Palo Alto Health Care System. One hundred and forty-three participants were sampled. BVRT omission error scores for the copy and memory trials were factor analyzed with age, education level, WAIS-III Digit Span Forward (DSpF), and Letter-Number Sequencing (LNS). These variables were refactored with the spoken language components of the MAE (naming, repetition, verbal fluency, and auditory comprehension).

Results

BVRT copy and memory omission scores were factorially grouped with age and inversely correlated with LNS. A second factor was composed of positive loadings on DSpF, LNS, and education. The BVRT Copy-and-Memory-Omissions-Age-LNS component was inversely and specifically related to the MAE measure of auditory comprehension. The Digit Span Forward-LNS-Education variable loaded strongly on the MAE Repetition component and secondarily on the MAE Verbal Fluency and Naming components.

Conclusions

BVRT copy and memory trial omission errors are strongly and specifically related to failure of auditory comprehension. Errors of this type are not related to the other three components of spoken language.
A-238 Psychometric Equivalence of Prorated Boston Naming Test Scores after Noose Item Removal
Authors: J Attridge , D Zimmerman , J Davis , S Rolin
Published: August 2020

Objective

The Boston Naming Test (BNT) noose item may offend some examinees. One solution is to omit the item, but the equivalence of prorating the BNT has not been established. This study compared prorated BNT (BNT-P) and standard administration (BNT-S) in physical medicine and rehabilitation patients.

Method

Participants (N = 480) completed the BNT-S in an outpatient evaluation. The sample was 34% female and 91% white with average age and education of 46 (SD = 15) and 14 (SD = 3) years, respectively. Diagnoses included traumatic brain injury (62%), mixed neurologic conditions (21%), and stroke (17%). Item level data were entered; items below the start or basal point were entered as correct. BNT-P was calculated by summing correct responses excluding item 48 and then using cross multiplication and division to estimate the 60-item score equivalent. BNT-P and BNT-S scores were compared via Spearman and concordance correlation (CC) coefficients; reflected and log transformed data were examined with paired t-tests and Westlake equivalence tests. BNT-P and BNT-S difference and scaled scores were examined descriptively.

Results

BNT-P (M = 52.7, SD = 7.0, Mdn = 54) and BNT-S (M = 52.6, SD = 7.1, Mdn = 54) raw scores showed very strong associations (rho = .99; CC = .99). Transformed scores were not significantly different (p = .20) and demonstrated equivalence (+/−1.5 points). Score differences (M = 0.01, SD = 0.30; range − 0.5-1) rounded to 0 in 88% of cases. Scaled scores based on prorated raw scores were the same in 96% of cases with a one-point difference observed in 15 cases and a two-point difference in 2 cases.

Conclusion

Findings support the utility of prorated BNT scores in rehabilitation patients.
A-240 Enhanced Interpretation of the Behavior Rating Inventory of Executive Function–Adult Version (BRIEF-A)
Authors: S Trujillo , A Carrillo , J Greene , R Roth , P Isquith , G Gioia , S Iwanicki , C Champ Morera
Published: August 2020

Objective

The Behavior Rating Inventory of Executive Function®—Adult Version (BRIEF-A) is a standardized measure that captures an adult’s executive functions in his or her everyday environment. The current study provides additional statistical evidence to support interpretation of BRIEF-A scores across raters and over time.

Method

Participants were adults, ages 18 to 90 years, from the BRIEF-A Self-Report (N = 1,050) and Informant-Report (N = 1,200) standardization samples, as well as an interrater sample (n = 180) and test–retest samples (n = 50 for Self, n = 44 for Informant). Interrater correlations, base rates of interrater differences, and score differences required for statistical significance were examined. Test–retest correlations and score differences required for statistical significance were examined. Base rates of elevated T scores (≥ 65) were calculated for the standardization samples across age groups.

Results

Interrater correlations ranged from .44 to .68 with an interrater difference of 17–20 T-score points considered significant at p < .05. Approximately 55–73% of raters reported scores within 10 T-score points. Test–retest scores were highly correlated (Self: r = .82–.94; Informant: r = .91–.96), with a between-test difference of 7–11 T-score points considered significant at p < .05. Base rates of elevated T- scores ranged from 3.3% to 15.4% for the Self-Report Form and 4.5% to 16.3% for the Informant-Report Form across the scales/indexes.

Conclusions

These data allow clinicians to interpret BRIEF-A scores across raters and over time by determining the statistical significance of BRIEF-A score differences, as well as quantifying the frequency of the observed differences.
A-242 Examining Normative Reference Values and Item-Level Symptom Endorsement for the Neuro-QoLTM v2.0 Cognitive Function-Short Form
Authors: G Iverson , E Connors , J Marsh , D Terry
Published: August 2020

Objective

We examined the normative reference values, item-level symptom endorsement, internal consistency reliability, and the base rates of symptoms endorsed for the Neuro-QoLTM v2.0 Cognitive Function-Short Form.

Method

The Neuro-QoLTM v2.0 Cognitive Function-Short Form is a fixed 8-item scale that measures subjective cognitive functioning. Raw scores range from 8–40, with higher scores indicating less cognitive concerns. Adults from the general US population completed the scale. The sample was stratified by gender and health status. Individuals were included in the healthy subgroup if they reported no personal history of mental health, neurological, or sleep disorders and rated their overall health, functioning, and quality of life as “good” or better.

Results

A normative sample of 1,009 adults completed this scale and their mean score was 32.60 (SD = 6.89). The healthy subgroup (n = 475) had a higher mean, suggesting less perceived cognitive difficulties (M = 35.12, SD = 5.57). This pattern was consistent for men (all men, M = 31.26, SD = 7.10; healthy men, M = 33.86, SD = 5.95) and women (all women, M = 33.89, SD = 6.43; healthy women, M = 36.42, SD = 4.85). The base rates of those who reported zero cognitive symptoms were consistently higher among the healthy samples (healthy men = 79.2%; all men = 63.9%; healthy women = 90.2%; all women = 80.0%). Internal consistency was measured using Cronbach’s alpha and ranged from 0.87 to 0.94 across groups.

Conclusions

The Neuro-QoLTM v2.0 Cognitive Function-Short Form is a brief, efficient, and reliable measure of perceived cognitive difficulties. The subgroup normative reference values and base rate analyses of individual symptom endorsement presented herein can be used by clinicians and researchers for a more refined interpretation of the scale.
A-244 Examining the Effects of Computer Operating Configuration on Automated Neuropsychological Assessment Metrics V 4.0 (ANAM4) Reaction Time: A Repeated Measures Approach with Clinical and Research Implications
Authors: W Cole , J Arrieux , B Ivins
Published: August 2020

Objective

Computerized cognitive tests are vulnerable to measurement error due to hardware and software configurations of the administration computer. Though automatic score corrections are often provided to account for this, they may mask subtle individual variations in test performance. We investigated the group and individual impact of correcting for measurement error while accounting for possible order effects using data from a larger study of computer platform effects on reaction time measurement.

Methods

ANAM4 TBI Military’s Simple Reaction Time (SRT) subtest was administered repeatedly on three different computer platforms. We compare two of those platforms: Platform 1, a Dell D630 configured for ANAM4 TBI Military administration; Platform 3, a Dell E6540 with default settings. A mechanical arm with a preset RT was first used to capture measurement error on each platform. SRT was then administered to healthy US Army soldiers in a randomly selected administration order, such that platform 1 was first and platform 3 was third for n = 58 and platform 3 was first and platform 1 second for n = 53.

Results

Platform 3 was on average 43.06 ms slower than Platform 1. Group analyses suggested applying a 43.06 ms correction to Platform 3 scores resulted in scores similar to Platform 1. However, it appears there were subtle practice and fatigue effects for some individuals that were possibly masked by the score correction.

Conclusion

Correcting for error due to computer configurations is important in RT measurement, though there may be subtle individual statistical and clinical implications that are lost at a group analysis level.
A-251 3q29 Deletion Syndrome and Neuropsychological Functioning: Fraternal Twin Case Study
Authors: D Nemeth , K Chustz
Published: August 2020

Objective

The 3q29 Deletion Syndrome, first described in 2005, is a rare chromosomal disorder which results in a wide array of symptoms. Affected individuals present with complex neuropsychiatric profiles. The associated phenotype for this syndrome may include developmental delay, intellectual disabilities, attentional deficits, behavioral disturbances, and social and emotional issues. These individuals are at a higher risk of developing autism or schizophrenia. This case study describes the neuropsychological profiles of two fraternal twin girls, age 7, only one of whom was diagnosed with 3q29 Deletion Syndrome.

Methods

Both girls received comprehensive neuropsychoeducational evaluations to compare and contrast the following dimensions: Neurocognitive, Intellectual, Educational, Attentional, School Behavioral, Affective, and Personality Functioning.

Results

Twin 1, positive for 3q29 Deletion Syndrome, exhibits significant affective, behavioral, and cognitive difficulties secondary to her chromosomal disorder, which included learning disabled and oppositional presentations and emotional dyscontrol. Twin 2 exhibited superior intellectual and social functioning.

Conclusions

This study contributes to the understanding of the clinical presentation of 3q29 Deletion Syndrome by examining the relationship between fraternal twin sisters. Findings are consistent with earlier reports of the chromosomal disorder’s phenotype, yielding neurocognitive, emotional, and behavioral difficulties. Though the twins have widely different neuropsychological profiles, they have a close relationship. Twin 2, who models excellent prosocial behaviors, will be an asset to Twin 1 in all spheres. Ongoing efforts to improve Twin 1’s neuropsychological, social/emotional, and behavioral functioning will be facilitated via both psychological and psychopharmacological interventions.
A-256 A Unique Bilingual Phenotype in the Context of Late Onset MELAS
Authors: Y Patino , M Diaz-Santos
Published: August 2020

Objective

Mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) is a progressive disease with typical onset before age 40 characterized by eventual neurocognitive deterioration. This case study highlights bilingual-bicultural neuropsychological principles within the Socially Responsible Neuropsychology (SRN) model to illustrate the phenotypic presentation of bilingual late-onset MELAS.

Method

The case is a 56-year-old, right-handed, bilingual Latino male (L1 Spanish, L2 English) with 16 years of education in his country of origin and 22 years as an industrial engineer in the U.S. At age 52, he was diagnosed with MELAS after an abrupt episode of olfactory hallucinations and dysgraphia in both languages. MRI revealed acute infarcts in the right parietal lobe and left cerebellum. He was referred for neuropsychological assessment 4 years later to evaluate reported neurocognitive decline and deterioration of L2, and to assist in targeted treatment planning.

Results

The clinical interview revealed significant decline in both receptive and expressive L2 English language capabilities, particularly relative to baseline as an industrial engineer, with relative sparing of L1 Spanish. Consistent with prior acute right hemisphere strokes, the neurocognitive profile also revealed lateralized impairment in visuospatial skills and memory. Notably verbal learning and memory in the mesial temporal system was preserved.

Conclusions

This case study illustrates how late L2 acquisition can lead to bilateral language representation, altering the phenotype of late-onset MELAS. Application of the SRN model highlights the importance of including background information regarding language acquisition and current language use to illustrate a unique bilingual MELAS phenotype and its impact on language loss and recovery.
The Addition of Partial or Circumferential Liposuction to Abdominoplasty Is Not Associated With a Higher Risk of Skin Necrosis
Authors: Raghuram Anjali C , Yu Roy P , Gould Daniel J
Published: August 2020

Background

Combining abdominoplasty with liposuction is a common practice for optimal patient aesthetic outcomes. In the past, several practitioners have argued against liposuction due to the potential for vascular insufficiency, especially with central liposuction. Despite these concerns for flap damage with resultant necrosis, the incidence of this complication has not been comprehensively investigated.

Objectives

The authors therefore examined the incidence of necrotic complications, including skin and fat necrosis as well as partial/total flap loss, in patients who underwent abdominoplasty alone (AA) or abdominoplasty with partial or circumferential liposuction (APCL).

Methods

Literature searches were performed in PubMed/Medline and Embase with no query limits. For the systematic review, data from the studies were extracted into a form including primary author, publication year, study design, number of AA and APCL patients, abdominal zone(s) treated with liposuction, average lipoaspirate volume, follow-up time, necrotic complications, and revision procedures. A meta-analysis was separately performed for 13 studies that included patients who underwent both AA and APCL.

Results

The overall rate of necrotic complications was lower in the APCL group (0.39%) compared with the AA group (1.01%). The incidence of necrotic complications was low for all patients, with a pooled partial flap loss rate of 0.24% and a pooled skin necrosis rate of 0.23%. The forest plots revealed that patients who underwent APCL do not face a higher risk of skin necrosis or revision compared with those who underwent AA.

Conclusions

Performing APCL is a safe combined procedural approach and can confer added benefits of improved patient satisfaction and aesthetic outcomes.

Level of Evidence: 4
The promise of placental extracellular vesicles: models and challenges for diagnosing placental dysfunction in utero†
Authors: Block Lindsey N , Bowman Brittany D , Schmidt Jenna Kropp , Keding Logan T , Stanic Aleksandar K , Golos Thaddeus G
Published: August 2020

Monitoring the health of a pregnancy is of utmost importance to both the fetus and the mother. The diagnosis of pregnancy complications typically occurs after the manifestation of symptoms, and limited preventative measures or effective treatments are available. Traditionally, pregnancy health is evaluated by analyzing maternal serum hormone levels, genetic testing, ultrasonographic imaging, and monitoring maternal symptoms. However, researchers have reported a difference in extracellular vesicle (EV) quantity and cargo between healthy and at-risk pregnancies. Thus, placental EVs (PEVs) may help to understand normal and aberrant placental development, monitor pregnancy health in terms of developing placental pathologies, and assess the impact of environmental influences, such as infection, on pregnancy. The diagnostic potential of PEVs could allow for earlier detection of pregnancy complications via noninvasive sampling and frequent monitoring. Understanding how PEVs serve as a means of communication with maternal cells and recognizing their potential utility as a readout of placental health have sparked a growing interest in basic and translational research. However, to date, PEV research with animal models lags behind human studies. The strength of animal pregnancy models is that they can be used to assess placental pathologies in conjunction with isolation of PEVs from fluid samples at different time points throughout gestation. Assessing PEV cargo in animals within normal and complicated pregnancies will accelerate the translation of PEV analysis into the clinic for potential use in prognostics. We propose that appropriate animal models of human pregnancy complications must be established in the PEV field.
Principal component analysis, a useful tool to study cyclin-dependent kinase-inhibitor’s effect on cerebral ischaemia
Authors: Le Roy Lucas , Amara Ahmed , Le Roux Cloé , Bocher Ozvan , Létondor Anne , Benz Nathalie , Timsit Serge
Published: August 2020

Stroke is a leading cause of acute death related in part to brain oedema, blood–brain barrier disruption and glial inflammation. A cyclin-dependant kinase inhibitor, (S)-roscovitine, was administered 90 min after onset on a model of rat focal cerebral ischaemia. Brain swelling and Evans Blue tissue extravasation were quantified after Evans Blue injection. Combined tissue Evans Blue fluorescence and immunofluorescence of endothelial cells (RECA1), microglia (isolectin-IB4) and astrocytes (glial fibrillary acidic protein) were analysed. Using a Student’s t-test or Mann–Whitney test, (S)-roscovitine improved recovery by more than 50% compared to vehicle (Mann–Whitney, P < 0.001), decreased significantly brain swelling by 50% (t-test, P = 0.0128) mostly in the rostral part of the brain. Main analysis was therefore performed on rostral cut for immunofluorescence to maximize biological observations (cut B). Evans Blue fluorescence decreased in (S)-roscovitine group compared to vehicle (60%, t-test, P = 0.049) and was further supported by spectrophotometer analysis (Mann–Whitney, P = 0.0002) and Evans Blue macroscopic photonic analysis (t-test, P = 0.07). An increase of RECA-1 intensity was observed in the ischaemic hemisphere compared to non-ischaemic hemisphere. Further study showed, in the ischaemic hemisphere that (S)-roscovitine treated group compared to vehicle, showed a decrease of: (i) endothelial RECA-1 intensity of about 20% globally, mainly located in the cortex (−28.5%, t-test, P = 0.03); (ii) Microglia’s number by 55% (t-test, P = 0.006) and modulated reactive astrocytes through a trend toward less astrocytes number (15%, t-test, P = 0.05) and astrogliosis (21%, t-test, P = 0.076). To decipher the complex relationship of these components, we analysed the six biological quantitative variables of our study by principal component analysis from immunofluorescence studies of the same animals. Principal component analysis differentiated treated from non-treated animals on dimension 1 with negative values in the treated animals, and positive values in the non-treated animals. Interestingly, stroke recovery presented a negative correlation with this dimension, while all other biological variables showed a positive correlation. Dimensions 1 and 2 allowed the identification of two groups of co-varying variables: endothelial cells, microglia number and Evans Blue with positive values on both dimensions, and astrocyte number, astrogliosis and brain swelling with negative values on dimension 2. This partition suggests different mechanisms. Correlation matrix analysis was concordant with principal component analysis results. Because of its pleiotropic complex action on different elements of the NeuroVascular Unit response, (S)-roscovitine may represent an effective treatment against oedema in stroke.
5′ValCAC tRNA fragment generated as part of a protective angiogenin response provides prognostic value in amyotrophic lateral sclerosis
Authors: Hogg Marion C , Rayner Megan , Susdalzew Sergej , Monsefi Naser , Crivello Martin , Woods Ina , Resler Alexa , Blackbourn Lisle , Fabbrizio Paola , Trolese Maria Chiara , Nardo Giovanni , Bendotti Caterina , van den Berg Leonard H , van Es Michael A , Prehn Jochen H M
Published: August 2020

Loss-of-function mutations in the ribonuclease angiogenin are associated with amyotrophic lateral sclerosis. Angiogenin has been shown to cleave transfer RNAs during stress to produce ‘transfer-derived stress-induced RNAs’. Stress-induced tRNA cleavage is preserved from single-celled organisms to humans indicating it represents part of a highly conserved stress response. However, to date, the role of tRNA cleavage in amyotrophic lateral sclerosis remains to be fully elucidated. To this end, we performed small RNA sequencing on a human astrocytoma cell line to identify the complete repertoire of tRNA fragments generated by angiogenin. We found that only a specific subset of tRNAs is cleaved by angiogenin and identified 5′ValCAC transfer-derived stress-induced RNA to be secreted from neural cells. 5′ValCAC was quantified in spinal cord and serum from SOD1G93A amyotrophic lateral sclerosis mouse models where we found it to be significantly elevated at symptom onset correlating with increased angiogenin expression, imbalanced protein translation initiation factors and slower disease progression. In amyotrophic lateral sclerosis patient serum samples, we found 5′ValCAC to be significantly higher in patients with slow disease progression, and interestingly, we find 5′ValCAC to hold prognostic value for amyotrophic lateral sclerosis patients. Here, we report that angiogenin cleaves a specific subset of tRNAs and provide evidence for 5′ValCAC as a prognostic biomarker in amyotrophic lateral sclerosis. We propose that increased serum 5′ValCAC levels indicate an enhanced angiogenin-mediated stress response within motor neurons that correlates with increased survival. These data suggest that the previously reported beneficial effects of angiogenin in SOD1G93A mice may result from elevated levels of 5′ValCAC transfer RNA fragment.
Pyk2 overexpression in postsynaptic neurons blocks amyloid β1–42-induced synaptotoxicity in microfluidic co-cultures
Authors: Kilinc Devrim , Vreulx Anaïs-Camille , Mendes Tiago , Flaig Amandine , Marques-Coelho Diego , Verschoore Maxime , Demiautte Florie , Amouyel Philippe ,   Neuro-CEB Brain Bank, Eysert Fanny , Dourlen Pierre , Chapuis Julien , Costa Marcos R , Malmanche Nicolas , Checler Frédéric , Lambert Jean-Charles
Published: August 2020

Recent meta-analyses of genome-wide association studies identified a number of genetic risk factors of Alzheimer’s disease; however, little is known about the mechanisms by which they contribute to the pathological process. As synapse loss is observed at the earliest stage of Alzheimer’s disease, deciphering the impact of Alzheimer’s risk genes on synapse formation and maintenance is of great interest. In this article, we report a microfluidic co-culture device that physically isolates synapses from pre- and postsynaptic neurons and chronically exposes them to toxic amyloid β peptides secreted by model cell lines overexpressing wild-type or mutated (V717I) amyloid precursor protein. Co-culture with cells overexpressing mutated amyloid precursor protein exposed the synapses of primary hippocampal neurons to amyloid β1–42 molecules at nanomolar concentrations and induced a significant decrease in synaptic connectivity, as evidenced by distance-based assignment of postsynaptic puncta to presynaptic puncta. Treating the cells with antibodies that target different forms of amyloid β suggested that low molecular weight oligomers are the likely culprit. As proof of concept, we demonstrate that overexpression of protein tyrosine kinase 2 beta—an Alzheimer’s disease genetic risk factor involved in synaptic plasticity and shown to decrease in Alzheimer’s disease brains at gene expression and protein levels—selectively in postsynaptic neurons is protective against amyloid β1–42-induced synaptotoxicity. In summary, our lab-on-a-chip device provides a physiologically relevant model of Alzheimer’s disease-related synaptotoxicity, optimal for assessing the impact of risk genes in pre- and postsynaptic compartments.
Machine learning and structural econometrics: contrasts and synergies
Authors: Iskhakov Fedor , Rust John , Schjerning Bertel
Published: August 2020

We contrast machine learning (ML) and structural econometrics (SE), focusing on areas where ML can advance the goals of SE. Our views have been informed and inspired by the contributions to this special issue and by papers presented at the second conference on dynamic structural econometrics at the University of Copenhagen in 2018, ‘Methodology and Applications of Structural Dynamic Models and Machine Learning'. ML offers a promising class of techniques that can significantly extend the set of questions we can analyse in SE. The scope, relevance and impact of empirical work in SE can be improved by following the lead of ML in questioning and relaxing the assumption of unbounded rationality. For the foreseeable future, however, ML is unlikely to replace the essential role of human creativity and knowledge in model building and inference, particularly with respect to the key goal of SE, counterfactual prediction.
Debiased machine learning of conditional average treatment effects and other causal functions
Authors: Semenova Vira , Chernozhukov Victor
Published: August 2020

This paper provides estimation and inference methods for the best linear predictor (approximation) of a structural function, such as conditional average structural and treatment effects, and structural derivatives, based on modern machine learning tools. We represent this structural function as a conditional expectation of an unbiased signal that depends on a nuisance parameter, which we estimate by modern machine learning techniques. We first adjust the signal to make it insensitive (Neyman-orthogonal) with respect to the first-stage regularisation bias. We then project the signal onto a set of basis functions, which grow with sample size, to get the best linear predictor of the structural function. We derive a complete set of results for estimation and simultaneous inference on all parameters of the best linear predictor, conducting inference by Gaussian bootstrap. When the structural function is smooth and the basis is sufficiently rich, our estimation and inference results automatically target this function. When basis functions are group indicators, the best linear predictor reduces to the group average treatment/structural effect, and our inference automatically targets these parameters. We demonstrate our method by estimating uniform confidence bands for the average price elasticity of gasoline demand conditional on income.
May Measurement Month 2018: an analysis of blood pressure screening in Libya
Authors: Beaney Thomas , Ster Anca Chis , Poulter Neil R , Xia Xin , Fageh Hatem , Msalam Omar , Derbi Hawa A , Osman Afaf M , Aghilla Mohamed , Bettamer Zaki A , Fhail Alboum Mabroukah O , Elsari Osama T , Elhemali Emhemed M , Zidan Rabea A , Musbah Abdunnabi , Eltawell Hazem , Ben Masaud Hesham A ,   The MMM Data collectors
Published: August 2020

Elevated blood pressure (BP) is an important public health concern and leads to several adverse cardiovascular outcomes. In the stepwise survey done in Libya by the Libyan Cardiac Society and National Centre for Disease Control in 2009, the percentage of hypertension was 40.6%. To raise awareness of high BP and to highlight the size of the problem and the need for screening. A cross-sectional opportunistic study included men and women aged ≥18 years. Blood pressure was measured three times and a questionnaire was completed. Hypertension was defined as BP ≥140/90 mmHg based on the mean of the 2nd and 3rd readings, or on antihypertensive treatment. Among 7279 participants, the mean age was 44.3 ± 14.8 years, 57.8% male, 2567 (35.3%) of the participants had hypertension of whom 63.4% were aware of having hypertension, 55.8% on medication, and of those on medication 50.9% had controlled BP. This survey identified a high proportion of individuals with high BP, which highlights the need for a more strategic approach to fighting hypertension.
May Measurement Month 2018: an analysis of blood pressure screening results from Albania
Authors: Burazeri Genc , Qirjako Gentiana , Beaney Thomas , Ster Anca Chis , Xia Xin , Ylli Alban , Muja Herion , Cumashi Rudina , Dika Qamil , Roshi Enver , Poulter Neil R
Published: August 2020

This article reports on May Measurement Month (MMM) 2018, which consisted of the 2nd round of the hypertension screening campaign conducted in Albania, a former communist country in South Eastern Europe. The hypertension screening campaign in Albania was conducted during the period 13–31 May 2018. Overall, there were eight sites from seven districts of the country involving 7046 participants aged ≥18 years (61% women and 39% men; overall mean age 46.8 ± 15.7 years). Blood pressure was measured with OMRON sphygmomanometers (Omron Healthcare, Kyoto, Japan). Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg, or diastolic blood pressure (DBP) ≥90 mmHg, or on treatment for hypertension. Self-reported information included height and weight, diabetes, smoking status, and alcohol intake. The proportion of participants with hypertension was 37.2% of whom only 52.1% exhibited awareness. Furthermore, only a quarter of hypertensive individuals were properly treated and controlled. Significant predictors of high SBP and/or high DBP included a previous diagnosis of hypertension, being on antihypertensive medication, frequent alcohol intake, and being overweight and obese. The MMM 2018 campaign in Albania had a unique value for early detection of hypertension, particularly among younger adults. Policymakers and decision-makers in Albania and elsewhere should also rely on the MMM screening campaigns which have a great potential for prevention and control of hypertension in the general population.
May Measurement Month 2018: an analysis of blood pressure screening results from Angola
Authors: Victória Pereira Savarino , Neto Marisa , Feijão Ana , Oliveira Pombalino , Brandão Maria , Soito Ermelinda , Mbala Claudio , João Armando , Manuel Carlos , Mundombe Leonardo , Muela Henrique , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Fernandes Mário
Published: August 2020

Elevated blood pressure (BP) is a growing burden worldwide with high prevalence in the world and with a huge impact on public health. May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2018. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. In Angola 14 433 individuals (mean age 38.6 years; 53.7% female; 99.9% black) in 6 of 18 provinces were screened. In total, 99.0% of screenees provided three BP readings with an average BP from 2nd and 3rd reading of 126/80 mmHg. After imputation, 4844 (33.6%) had hypertension of whom 54.2% were aware of their diagnosis and 46.3% were on antihypertensive medication. Of those medicated, 42.6% were controlled and of all hypertensive individuals, 19.7% were controlled. We screened 2603 individuals with untreated hypertension and 1285 with inadequately treated hypertension. Angolan MMM18 emerges as a continuation of the Angolan MMM17 study, the largest BP screening campaign undertaken in Angola, enabling us to compare the 2 years. This year’s results also showed a high percentage of hypertensive individuals and almost 3900 adults with untreated or inadequately treated hypertension, demonstrating that there is still a long way to go but also that the Angolan MMM is being effective at raising awareness at least among these individuals.