bluuebunny/crossref_metadata_2025 huggingface dataset:
Fatal pulmonary hemorrhage, pneumothorax and skin necrosis caused by IRIS to an Aspergillus flavus infection in a young patient with metamizole associated agranulocytosis
Authors: Banz Micha , Stallmach Andreas , Gaßler Nikolaus , Schulze P. Christian , Fritzenwanger Michael , Cornely Oliver , Kurzai Oliver , Pletz Mathias W.
Published: December 2023

We report the case of a young female with steroid-dependent ulcerative colitis (UC) who developed a complex systemic infection with Aspergillus flavus. This occurred following a UC relapse while vacationing in the Middle East, leading to extended use of metamizole and subsequent agranulocytosis. On her return to Germany, she was hospitalized for neutropenic sepsis and later transferred to our hospital due to persistent cytopenia and suspected Hemophagocytic Lymphohistiocytosis (HLH). Despite initial stabilization with targeted treatment for pulmonary Aspergillus flavus infection, her condition rapidly deteriorated following the onset of an Immune Reconstitution Inflammatory Syndrome (IRIS), which manifested as skin necrosis and pneumothorax after the replenishment of neutrophil granulocytes. The patient eventually died from an unmanageable pulmonary hemorrhage. Microscopy of skin necroses showed a massive presence of Aspergillus flavus, but tissue culture remained negative, suggesting effective antifungal treatment yet delayed phagocytosis due to agranulocytosis. This case underscores the need to consider IRIS in immunosuppressed patients who worsen despite aggressive and appropriately targeted treatment, highlighting its potential beyond the commonly recognized context in HIV-positive patients.
Innovating CBT and Answering New Questions: the Role of Internet-Delivered CBT
Authors: Andersson Gerhard
Published: December 2023

Internet-delivered cognitive behavior therapy (ICBT) was developed in the late 1990s, and since then, a large number of studies have been conducted. Many programs have been developed and sometimes implemented, and ICBT has become a major way to investigate and innovate CBT including important questions regarding mechanisms and moderating factors. The aim of this narrative review was to comment on the treatment format, the evidence behind ICBT, innovations, and finally challenges. ICBT has been developed and tested for a range of conditions including both psychiatric and somatic health problems and also transdiagnostic problems like loneliness and poor self-esteem. Meta-analytic reviews suggest that guided ICBT can be as effective as face-to-face CBT and by using individual patient data meta-analytic methods (IPDMA), it is now possible have better power for the search of moderators. There are also several reports of how well ICBT works in regular clinical settings, mostly replicating the results reported in efficacy studies. Cost-effectiveness has also been documented as well as studies using qualitative methodology to document client and clinician experiences. In terms of innovation, there are now studies on problems for which there is limited previous face-to-face research, and one major advancement is the use of factorial design trials in which more than one independent variable is tested. Finally, ICBT has the potential to be useful in times of crisis, with the COVID-19 pandemic being one recent example. Future challenges include use of artificial intelligence in both treatment development and possibly treatment delivery. Another urgent priority is to reach less favored parts of the world as most studies and programs have been tested and implemented in Western countries. In conclusion, ICBT is now an established as a way to develop, test, and deliver CBT.
Intracranial Intracerebral Schwannoma: a Case Report and Review of the Literature
Authors: Henia Mohamed , Linsler Stefan , Schulz-Schaeffer Walter J. , Urbschat Steffi , Becker-Kettern Julia , Garner Malvina , Oertel Joachim , Ketter Ralf
Published: December 2023

Intracranial schwannomas are relatively uncommon, accounting for approximately 8% of all intracranial tumors, while intracerebral schwannomas represent an even rarer entity, responsible for roughly 1% of all intracranial schwannomas. After reviewing the relevant literature, we discussed the clinical journey of a 74-year-old woman who presented with a 3-week history of dizziness and nausea. Magnetic resonance imaging revealed a right temporal mass lesion with perifocal edema. The initial suspicion was the diagnosis of a glioblastoma or metastasis, prompting surgical intervention. During the surgery, a gross total resection of a noninvasive tumor was successfully performed. The patient’s postoperative recovery was uneventful. Histopathological examination and confirmatory immunohistochemistry played a crucial role in reaching the final diagnosis of an intracerebral temporal schwannoma, highlighting the diagnostic challenges posed by radiologically indistinguishable features from metastasis and gliomas. Despite these challenges, complete surgical removal remains the most preferred treatment option, resulting in a favorable long-term prognosis without the need for adjuvant or neoadjuvant chemotherapy. Intracerebral schwannomas are exceedingly rare brain tumors, often found on the brain’s surface or adjacent ventricles. Early and accurate diagnosis can be challenging due to radiological features overlapping with other intracranial pathologies. Nonetheless, histopathological examination and immunohistochemistry remain indispensable tools in establishing a definitive diagnosis and guiding effective treatment strategies. With complete surgical excision, patients with intracerebral schwannomas can expect a positive outcome and a promising long-term prognosis. Further research and case studies are warranted to enhance our understanding of these rare tumors and improve patient outcomes.
Radical Autochthony? Proprietary Political Discourse Among Elites and Peasants in the Anti-Balaka Armed Movement in the Central African Republic
Authors: Lombard Louisa , Vlavonou Gino
Published: December 2023

Since at least the colonial era, the Central African Republic (CAR) has been a hotbed of rural rebellion and protest. This article explores the political discourses of members of the Anti-Balaka, a diffuse protest movement and armed rebellion, comparing discourses to see how they vary in relation to demographic categories: urban and rural, elites and peasants. Lombard and Vlavonou find that rural peasants demand a moral economy of interpersonal respect, while elite (usually urban) adherents claim inclusion in a system of official recognition and patronage. Both are concerned with respect, but what is radical about the vision of the peasants is that they can enact it on their own.
Public and industry knowledge and perceptions of US swine industry castration practices
Authors: Neary JM , Guthrie AP , Jacobs L
Published: December 2023

In the United States (US), surgical castration of male piglets is typically performed without any form of analgesia. This may raise concerns with the public; however, there is no information regarding current public knowledge on swine industry practices in the US. In this study we gained insight into public knowledge and perception on castration with and without analgesia in comparison to knowledge of industry stakeholders on these same topics. Through an online survey, 119 respondents were asked four questions about castration in the US swine industry. Industry respondents were contacted via social media and networking. The general public sample was accessed through Mechanical Turk. Survey responses were categorised by experience (industry vs public). Industry respondents were more aware of practices compared to the general public. Most public respondents were unaware of castration practices and the lack of analgesia use. Respondents from rural communities were more aware of castration practices than (sub)urban communities and more aware of analgesia use than those from urban communities. Those with more education had greater awareness of castration practices (occurrence not frequency). Based on the results from this first US sample, knowledge on industry practices was especially lacking for public respondents, but also for a minority of industry respondents, indicating opportunities for education and further research on the topic.
The Random Phase Approximation for Interacting Fermi Gases in the Mean-Field Regime
Authors: Christiansen Martin Ravn , Hainzl Christian , Nam Phan Thành
Published: December 2023

We present a general approach to justify the random phase approximation for the homogeneous Fermi gas in three dimensions in the mean-field scaling regime. We consider a system of N fermions on a torus, interacting via a two-body repulsive potential proportional to

$N^{-\frac {1}{3}}$

. In the limit

$N\rightarrow \infty $

, we derive the exact leading order of the correlation energy and the bosonic elementary excitations of the system, which are consistent with the prediction of the random phase approximation in the physics literature.
Mean velocity and temperature profiles in turbulent vertical convection
Authors: Li Min , Jia Pan , Liu Haihu , Jiao Zhenjun , Zhang Yang
Published: December 2023

In this study, mean velocity and temperature profiles for turbulent vertical convection (VC) confined in an infinite channel are investigated theoretically. The analysis starts from the governing equations of the thermal flow, with Reynolds shear stress and turbulent heat flux closed by the mixing length theory. Employing a three-sublayer description of the mean fields, the mean velocity and temperature profiles are found to be linear laws near the channel wall (viscosity-dominated sublayer), and they follow power laws close to the channel centre (turbulence-dominated sublayer). The characteristic scales of velocity, temperature and length in the present profiles arise naturally from the system normalisation, rather than from scaling analyses, thus ensuring a sound mathematical description. The derived profiles are verified fully via various literature data available in the classical regime; further, they are compared with the reported profiles, and the results indicate that the present profiles are the only ones with the ability to interpret data accurately from different sources, demonstrating much better versatility. Meanwhile, we provide analytical arguments showing that in the ultimate regime, the mean profiles in VC may remain in power laws, rather than the log laws inferred by analogy with Rayleigh–Bénard convection (RBC) systems. The power profiles recognised in this study are induced by the effect of buoyancy, which is in parallel with the mean flow in VC and contributes to the streamwise momentum transport, whereas in RBC systems, buoyancy is perpendicular to the mean flow, and does not influence the streamwise momentum transport, resulting in log profiles, being similar to the case of wall shear flows.
Numerical analysis of dynamic acoustic resonance with deformed liquid surfaces: the acoustic fountain
Authors: Cailly William , Yin Jun , Kuhn Simon
Published: December 2023

Applying a focused ultrasonic field on a free liquid surface results in its growth eventually leading to the so-called acoustic fountain. In this work, a numerical approach is presented to further increase the understanding of the acoustic fountain phenomenon. The developed simulation method enables the prediction of the free surface motion and the dynamic acoustic field in the moving liquid. The dynamic system is a balance between inertia, surface tension and the acoustic radiation force, and its nonlinearity is demonstrated by studying the relation between the ultrasonic excitation amplitude and corresponding liquid deformation. We show that dynamic resonance is the main mechanism causing the specific acoustic fountain shapes, and the analysis of the dynamic acoustic pressure allows us to predict Faraday-instability atomisation. We show that strong resonance peaks cause atomisation bursts and strong transient deformations corresponding to previously reported experimental observations. The quantitative prediction of the dynamic acoustic pressure enables us to assess the potential of cavitation generation in acoustic fountains. The observed local high acoustic pressures above both the cavitation and the atomisation threshold hint at the coexistence of these two phenomena in acoustic fountains.
DIVISIBILITY OF SUMS OF PARTITION NUMBERS BY MULTIPLES OF 2 AND 3
Authors: BARUAH NAYANDEEP DEKA
Published: December 2023

We show that certain sums of partition numbers are divisible by multiples of 2 and 3. For example, if
$p(n)$
denotes the number of unrestricted partitions of a positive integer n (and
$p(0)=1$
,
$p(n)=0$
for
$n<0$
), then for all nonnegative integers m,
$$ \begin{align*}\sum_{k=0}^\infty p(24m+23-\omega(-2k))+\sum_{k=1}^\infty p(24m+23-\omega(2k))\equiv 0~ (\text{mod}~144),\end{align*} $$

where
$\omega (k)=k(3k+1)/2$
.
Status of the Critically Endangered gharial Gavialis gangeticus in the upper Ghaghara River, India, and its conservation in the Girwa–Ghaghara Rivers
Authors: Vashistha Gaurav , Ranjan Vivek , Singh Devvrat , Ugemuge Shantanu S. , Badhawan Akash Deep , Gupta Pulkit
Published: December 2023

The gharial Gavialis gangeticus is a Critically Endangered crocodilian endemic to the Indian subcontinent. Habitat modification by river damming and water extraction has caused a severe decline in its population. The status of the gharial is known within protected areas, but there have been few surveys for this species in unprotected areas. In Katerniaghat Wildlife Sanctuary, a breeding gharial population in Girijapuri Barrage Reservoir has low recruitment, and it has been hypothesized that yearlings disperse downstream into the unprotected Ghaghara River when the barrage gates are opened. We surveyed a 100-km stretch of the Ghaghara River from the Girijapuri Barrage to Chahlari Ghat, observing a total of 84 gharials, including a high proportion of juveniles. A survey in 2021 from Chahlari Ghat to Ayodhya observed 174 gharials, giving a combined total of 258 gharials in a 219-km stretch of the Ghaghara River for the two surveys. Together, these findings confirm the presence of a significant population of gharials in the Ghaghara River. We recommend the adoption of an integrated approach, involving government agencies and local communities along the river, to conserve the protected Girwa–Kaudiyala Rivers and the unprotected Ghaghara River for gharial conservation and recovery. Such a programme will need to tackle the threats facing the gharial and establish baseline data and long-term monitoring protocols for freshwater species conservation in this river system.
Manufacturing Society: How Party Building Reinforces Stability Maintenance in Grassroots China
Authors: He Yanling , Wang Zheng
Published: December 2023

While China's efforts to maintain social stability by recruiting social elites and establishing Party branches in pre-existing social and market organizations have been thoroughly explored, much less attention has been devoted to how grassroots Party organizations (GRPOs) have proactively incubated society and constructed coherent, interrelated and systematic stability maintenance strategies to identify and eliminate social instability in its early stages and prevent its escalation. Using qualitative data gathered from local areas in China, we uncovered three major strategies used by GRPOs to manufacture society: incubating quasi-bureaucratic organizations, co-opting community elites and embedding Party organizations in market and social organizations. In general, GRPOs manufacture society for three reasons: to revitalize the mobilization capacity of the party-state; to increase the available social resources for grassroots authorities; and to establish an input mechanism for citizens. This study not only provides empirical data on how China's stability maintenance regime works in practice but also calls for a rethinking of the capacity of authoritarian resilience.
Structural and metabolic cumulus cell alteration affects oocyte quality in underweight women
Authors: Ji Hong , Zhang Qing , Ding Lu , Chen Rongjuan , Liu Fu , Li Ping
Published: December 2023

This study aimed to investigate the structural and metabolic changes in cumulus cells of underweight women and their effects on oocyte maturation and fertilization. The cytoplasmic ultrastructure was analyzed by electron microscopy, mitochondrial membrane potential by immunofluorescence, and mitochondrial DNA copy number by relative quantitative polymerase chain reaction. The expression of various proteins including the oxidative stress-derived product 4-hydroxynonenal (4-HNE) and autophagy and apoptosis markers such as Vps34, Atg-5, Beclin 1, Lc3-I, II, Bax, and Bcl-2 was assessed and compared between groups. Oocyte maturation and fertilization rates were lower in underweight women (P < 0.05), who presented with cumulus cells showing abnormal mitochondrial morphology and increased cell autophagy. Compared with the mitochondrial DNA copies of the control group, those of the underweight group increased but not significantly. The mitochondrial membrane potential was similar between the groups (P = 0.8). Vps34, Atg-5, Lc3-II, Bax, and Bcl-2 expression and 4-HNE levels were higher in the underweight group compared with the control group (P < 0.01); however, the Bax/Bcl-2 ratio was lower in the underweight group compared with the control group (P = 0.031). Additionally, Beclin 1 protein levels were higher in the underweight group compared with the control group but without statistical significance. In conclusion, malnutrition and other conditions in underweight women may adversely affect ovulation, and the development, and fertilization of oocytes resulting from changes to the intracellular structure of cumulus cells and metabolic processes. These changes may lead to reduced fertility or unsatisfactory reproduction outcomes in women.
CE Workshop 05: Technology and Cognition: Examining new trends and opportunities for neuropsychology
Authors: Schultheis Maria T.
Published: December 2023

Abstract & Learning Objectives:

Advances in technologies continue to offer new opportunities for understanding brain functioning and brain-behavior interactions. The clinical application of these technologies continues to require the understanding of both the benefits and limitations of integrating these novel methodologies. This workshop will provide an overview of several emerging and established technologies in neuropsychological assessment and rehabilitation. This will include discussion of portable brain imaging technologies, neuromodulation technologies, virtual reality simulation and various brain-computer interface devices. In addition, we will discuss how clinical application of these novel devices offer opportunities for growing knowledge in new areas of analysis (i.e., machine learning analysis) and interdisciplinary collaborations. Upon conclusion of this course, learners will be able to:

1.

Identify 3 technologies that are currently employed in neuropsychological research

2.

Assess the strengths and weakness of novel technologies for brain-behavior interface

3.

Examine current clinical applications of neuromodulation technologies and portable brain-imaging technologies
4 Neuropsychological Functioning in an Active Duty Service Member with Partial Agenesis of the Corpus Callosum and Bilateral Ventriculomegaly.
Authors: Wollman Scott C , Hall Matthew G , Haines Mary E
Published: December 2023

Objective:

Partial agenesis of the corpus callosum (PACC) is a rare brain birth defect characterized by incomplete development of the corpus callosum, the primary white matter bundle that connects the right and left hemispheres. PACC can be associated with other congenital abnormalities, including malformation of the brain’s ventricular system, such as colpocephaly or ventriculomegaly, and it is typically considered a pediatric diagnosis. Clinically, this condition may present with a broad continuum of cognitive and socioemotional difficulties ranging from significant day-to-day impairment to relative independence. Newly diagnosed PACC with ventriculomegaly in adults is very rare (0.0200.025%) and little is known about neuropsychological functioning in adults with this condition. The aim of this case study is to add to the literature base for better PACC neuropsychological conceptualization.

Participants and Methods:

This case study involves neuropsychological evaluation of cognitive and behavioral health functioning of a 37-year-old active duty service member (ADSM) with recently identified PACC and ventriculomegaly (via incidental imaging finding). The ADSM reported a history of learning difficulty, though she was able to earn rank of sergeant first class in a low density military occupation specialty (i.e., Mortuary Affairs) over an 18.5 year active duty career.

Results:

Cognitive testing was notable for consistently low to exceptionally low attention and processing speed scores. Mild executive dysfunction was also noted in the areas of planning and inhibition. Emotionally, she endorsed mild somatic and depression symptoms. Interpersonally, she was shy and avoidant with longstanding characterological traits characterized by worry, insecurity, and general tendency to catastrophize.

Conclusions:

This case adds to the broad clinical presentation of PACC with ventriculomegaly, and highlights that even in the context of a significant congenital brain deformity and longstanding cognitive deficits, independent functioning can be achieved.
46 Visuospatial Functions in Patients After COVID-19 Disease
Authors: Olejnik Agnieszka , Ofanowska Joanna , Moszczyhska Katarzyna , Skrzyniarz Pamela , Bala Aleksandra
Published: December 2023

Objective:

“Brain fog” is one of the most common consequences of developing COVID-19. The available research focuses mainly on the decline in overall cognitive performance. Much less papers refers to the evaluation of particular cognitive domains, and when it does, it focuses particularly on attention and memory disorders. The available data on the effects of COVID-19 infection on visuospatial functions is sparse, so the aim of this study was to investigate the level of visuospatial functioning in adults who have a history of COVID-19 infection. It was also intended to explore whether there is a protective effect of vaccination on the cognitive functioning after COVID-19.

Participants and Methods:

The group included sixty volunteers (age: M = 40.12, SD = 16.78; education: M = 12.95 SD = 2.25; sex: M = 20, F = 40) - thirty seven with a history of COVID-19 and twenty three who were never infected with SARS-COV-2. Of those with a history of COVID-19, twenty-four were vaccinated at the time of the disease, and thirteen were not. Subjects from individual groups did not differ demographically. Participants were examined with a set of neuropsychological tests to assess: a) general cognitive functioning - Montreal Cognitive Assessment (MoCA), b) attention - d2 Test of Attention, memory - Rey-Osterieth Complex Figure - delayed recall, and c) visuospatial functions - Rey-Osterieth Complex Figure - copy, Block Design - subtest of WAIS-R and three experimental tasks consisting of: incomplete pictures, rotating puzzles, counting cubes in a 3D tower.

Results:

Subjects who had a history of COVID-19 achieved significantly lower scores in the MoCA test (p = 0.033) compared to those who did not suffer from COVID-19. They also needed more time in mental rotation task (p = 0,04). Statistically significant differences were also found in the d2 Test of Attention GP score (p = 0.001). Moreover, in group of adults who had a history of COVID-19, statistically significant differences were found between the vaccinated and unvaccinated subjects. It turned out that those who were vaccinated during their illness performed significantly better than those who were unvaccinated in the following cognitive domains: attention (d2 Test of Attention) and visuospatial functions (Rey-Osterieth Complex Figure test - copy, Block Design from WAIS-R, as well as experimental trials: incomplete pictures, rotating puzzles, counting cubes).

Conclusions:

Among adults who have been infected with COVID-19, there is a decrease in general cognitive performance, but also in individual cognitive abilities, including visuospatial functions. Vaccination significantly reduces the risk of cognitive impairment.
61 Subjective PTSD and Cognitive Complaints in Middle Aged Women who were Hospitalized with COVID-19: A Case Series
Authors: DiBlasi Lori , Mandelbaum Sarah A , JohnKlein Carina , Ossowski Alexandra , Keren Yocheved , Cottone Dina , Russell Katherine E , Basile Rosemarie
Published: December 2023

Objective:

hough there is much that is unknown about “post-COVID conditions” the Center for Disease Control (CDC) recognizes that these conditions represent a wide array of new, returning, or ongoing health issues in individuals who have been infected with the novel corona virus, COVID-19. This case series describes the emotional and cognitive screening of three females in their 50's who contracted COVID-19, and were hospitalized during the course of their illness. This case series hopes to provide an initial framework to discuss the recovery trajectory of post-COVID patients who were hospitalized, who have experienced residual post-traumatic stress and cognitive symptoms.

Participants and Methods:

Three middle-aged female patients (ages 52, 53, 55) were screened in an outpatient post-COVID recovery center for initial and post-COVID emotional, cognitive, and physical symptoms. All three women reported being hospitalized during their illness. The Post-Traumatic Stress Disorder - Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) was administered via clinical interview and the patients were asked about subjective cognitive complaints related to concentration, memory, and word finding.

Results:

All three women reported persisting cognitive problems, including difficulties with concentration, problems with memory, and word finding difficulties. They also endorsed symptoms of post-traumatic stress, such as avoidance of thoughts and events, as well as recurrent nightmares related to the course of their illness.

Conclusions:

The CDC notes that there are no tests that specifically evaluate the multitude of post-COVID conditions. Regardless, this case series suggests that emotional and cognitive screeners may assist in treatment planning and support recovery in this population. Future research should examine the exact nature of the relationship between hospitalization, emotional symptoms, and cognitive functioning in post-COVID patients.
67 COVID-19 Mobile Brain Health
Authors: Li Stephanie , Hwang Phillip , Gurnani Ashita
Published: December 2023

Objective:

Over 80% of hospitalized COVID-19 patients have neurological symptoms, including memory loss, attention difficulties, and trouble thinking clearly that can last for months. The long-term neurological impact of the SARS-CoV-2 virus is unknown and it remains to be seen whether it would create a surge in cases of dementia and cognitive decline years later, which is already a global public health challenge. Examining the cognitive effects of the virus will help with understanding its impact on the brain and inform treatment options. The goal of the present study was to examine cognitive performance among those who have had COVID-19 via mobile-based assessments using smartphone-based cognitive tests. Participants with a previous COVID-19 diagnosis (COVID+) were expected to have worse cognitive performance at baseline than those without COVID-19 (COVID-).

Participants and Methods:

Participants (n=23) with self-reported positive or negative COVID-19 statuses based on polymerase chain reaction or antigen testing were recruited from the Boston area. Inclusion criteria included access to a smartphone with an Android or iOS operation

system and to internet connectivity, along with proficiency in English. Cognitive performance was measured using Defense Automated Neurobehavioral Assessment (DANA) from AnthroTronix. Welch’s 2-sample t-test was used to compare cognitive performance among those with and without COVID-19.

Results:

The sample was comprised primarily of COVID+ (59%), female (59%), and Caucasian (50%) participants that were generally well educated (77% with a bachelor’s degree), and had >1 COVID vaccination (95%). About 50% of the sample reported symptoms of depression and mild anxiety. Results were not indicative of significant differences between COVID+ and COVID- groups at baseline: Simple Reaction Time (Immediate; M = 5.62; p = 0.81), Code Substitution (M = 1.25; p = 0.77), Procedural Reaction Time (M = -7.26; p = 0.49), Spatial Processing (M = -3.14; p = 0.50), Go No Go (M = -1.37; p = 0.89), Match to Sample (M = 2.00; p = 0.57), Memory Search (M = -2.62; p = 0.75), and Simple Reaction Time (Delayed; M = 2.99; p = 0.81).

Conclusions:

Results indicate that cognitive performance at baseline does not differ based on COVID status, emphasizing the need for examination of longitudinal cognitive performance. Future directions include examining the impact of COVID disease severity and reinfection on cognition.
20 The Influence of Brain Injury Severity, Anxiety, and Depression on Objective and Subjective Prospective Memory Problems
Authors: Tetreault Gabrielle , Roy Sarah-Jade , Audy Julie , Rouleau Isabelle , Potvin Marie-Julie
Published: December 2023

Objective:

Following a traumatic brain injury (TBI), the majority of patients report difficulties with prospective memory (PM). However, there is not always a significant relationship between subjective and objective PM measures. Several variables may influence the degree of severity of perceived difficulties, including the severity of the injury and psychoemotional status. The aim of this study was to determine whether the severity of the TBI and anxiety and depressive symptoms were related to objective and subjective difficulties of PM.

Participants and Methods:

50 patients (mean age = 31,3 years old) with a TBI (20 mild and 30 moderate/severe) in the post-acute phase of recovery and 15 matched healthy control participants (mean age = 32,3 years old) were recruited. They completed inventories assessing the presence of anxiety (BAI) and depressive (BDI) symptoms and performed the Ecological test of prospective memory (TEMP), an objective measure of PM. The Comprehensive Assessment of PM (CAPM), a subjective measure of PM, was also filled out by participants and their relatives.

Results:

In patients with moderate/severe TBI, significant correlations were found between the CAPM and the BDI (r =.601, p<.001) and the BAI (r =.507, p=.004). A negative correlation was also observed between the relatives’ CAPM scores and the performance of the patients on the TEMP (r= -.374, p=.042). In patients with mild TBI, there was only a strong significant correlation between the CAPM and the BAI scores (r =.574, p=.008). However, no other correlation was significant between this group of patients and their relatives. Additionally, results on the TEMP were not significantly correlated with the CAMP completed by healthy control participants or their relatives. A linear regression conducted in the group of participants with TBI showed that BAI and BDI scores are the only significant predictors of the results on the CAPM (31% of the variance), while TBI severity is the only significant predictor of the results on the TEMP (37% of the variance).

Conclusions:

The perception of PM difficulties in patients with a TBI does not seem to be related to their objective performance. Anxiety and depressive symptoms appear to influence their perception more than their objective performance. As suggested by their relatives, a decrease in self-awareness could explain the lack of relationship between subjective PM difficulties of patients with moderate/severe TBI and their objective performance. On the other hand, TBI severity is more strongly related to objective performance on PM tests. These results highlight the importance of using different measures to accurately assess PM and the various factors influencing this construct.
28 Cognitive, Emotional, and Interactional Determinants in Loneliness, in a Heterogeneous Sample of Puerto Ricans with ABI in the Chronic Phase
Authors: Palmer-Cancel Santiago J. , Jimenez Julio , Salas Christian
Published: December 2023

Objective:

An acquired brain injury (ABI) is a neurological pathology that generates a physical injury in the brain. These include cerebrovascular accidents (CVA) and traumatic brain injuries (TBI). Brain injuries can cause cognitive, emotional, and social problems, which have the potential to severely alter a person’s independence and quality of life. Loneliness, thesubjective experience of social isolation, has been shown to be the best predictor of mental health problems and poorquality of life in patients with ABI. This study aimed to explore the relationship between cognitive, emotional, and social determinants and loneliness in Puerto Ricans with ABI in the chronic phase.

Participants and Methods:

Cross-sectional, exploratory, and correlational methods were implemented. Assessments included the Frontal Systems Behavioral Scale - Spanish version (FrSBe-SP), Perth Emotional Reactivity Scale -Spanish version (PERS), Anticipated Stigma and Concealment (ASC), and the University of California Los Angeles - Loneliness Scale (UCLA-LS).

Results:

A total of seventeen participated (n=17). Twenty-nine percent of participants were female. Forty-seven percent had history of previous CVA and fifty-two percent had history of TBI. Correlational analyses suggest a positive and significant relationship between executive dysfunction (FrSBe-SP) and feelings of loneliness (UCLA-LS) (p=.601), as well as a positive and significant relationship between neuroticism-negative emotional reactivity (PERS) and feelings of loneliness (UCLA-LS) (p=.736). Correlational analysis suggests there is no significant relationship between anticipated stigma (ASC) and feelings of loneliness (UCLA-LS) (p=.282).

Conclusions:

Our findings suggest that there is a significant relationship between cognitive determinants (executive functions) and emotional determinants (neuroticism) with feelings of loneliness in people with a history of ABI. These results support the connection between executive dysfunction, the tendency to experience negative emotions, and the subjective experience of loneliness, consistent with previous studies. However, our study did not find any significant relationship between interactional determinants, such as stigma and concealment, and loneliness. Understanding the role of cognition, emotions, and social variables in reported feelings of loneliness is important for clinical neuropsychological assessment and rehabilitation interventions.
35 Preliminary reliability of the Coma Recovery Scale, Revised (CRS-R) in children with a history of disorders of consciousness after acquired brain injury
Authors: Ludwig Natasha N , Suskauer Stacy , Slomine Beth
Published: December 2023

Objective:

The Coma Recovery Scale-Revised (CRS-R) is the gold standard assessment of adults with disorders of consciousness (DoC); however few studies have examined the psychometric properties of the CRS-R in pediatric populations. This study aimed to demonstrate preliminary intra-rater and inter-rater reliability of the CRS-R in children with acquired brain injury (ABI).

Participants and Methods:

Participants included 3 individuals (ages 10, 15, and 17 years) previously admitted to an inpatient pediatric neurorehabilitation unit with DoC after ABI who were followed in an outpatient brain injury clinic due to ongoing severe disability. ABI etiology included traumatic brain injury (TBI; n=2) and encephalitis (n=1). Study participation took place on average 4.6 years after injury (range 2-9). The Glasgow Outcome Scale-Extended, Pediatric Version (GOS-E Peds), a measure of outcome after pediatric brain injury, was administered as part of screening. Two participants were placed in the GOS-E Peds “lower severe disability” category (i.e., score of 6) and one was placed in the “upper severe disability” category (i.e., score of 5). The CRS-R includes 6 subscales measuring responsivity including Auditory (range 0-4), Visual (range 05), Motor (range 0-6), Oromotor/Verbal (range 03), Communication (range 0-2), and Arousal (range 0-3) with higher scores indicating higherlevel function. Subscales are totaled for a CRS-R Total score. Behaviors shown during the CRS-R are used to determine state of DoC [Vegetative State (VS), Minimally Conscious State (MCS) or emergence from a minimally conscious state (eMCS)] based on 2002 Aspen Guidelines. Participants were administered the CRS-R three consecutive times on the same day. Administrations were completed by two raters in this order: Rater 1 (1A), Rater 1 (1B) and Rater 2. Intra-rater reliability was deemed by percent agreement across the 6 subscales between Rater 1A and 1B. Inter-rater reliability was deemed by percent agreement across the 6 subscales between 1A and 2.

Results:

Mean CRS-R Total score for Rater 1A was 22 (SD=1.73, range 20-23), Rater 1B was 22 (SD=1.73, range 20-23), and Rater 2 was 21.33 (SD=2.08, range 19-23). Intra-rater reliability was 100% and inter-rater reliability was 94% across all subscales. All participants were deemed eMCS at all 3 ratings.

Conclusions:

Data from this very small sample of children suggests that the CRS-R demonstrates both intra-rater and inter-rater reliability in patients with a history of DoC after ABI. Given that all children were at the high end of the scale (eMCS), further research is needed with a larger sample of children with a range of states of DoC.
36 Exploring Neuropsychological Care for Pediatric Patients in Neurocritical Care and Outpatient Follow-Up
Authors: Naylor Paige E , Jagusch Andrea , Basel Emma , Loman Michelle , Vogt Elisabeth
Published: December 2023

Objective:

Integration of neuropsychological services into multidisciplinary clinics for pediatric patients requiring neurocritical care has previously been shown to improve access to care and promote connection to vital services for children recovering from traumatic brain injuries or other serious insults or infections impacting the brain. As such, the objective of this study is two-fold. First, to explore the unique model of care provided by a neuropsychological inpatient service at the Medical College of Wisconsin/Children’s Wisconsin. Secondly, to describe the benefit of neuropsychology in the Brain Recovery Assessment and Interdisciplinary Needs Clinic (BRAIN) a neurocritical care outpatient follow-up multidisciplinary clinic.

Participants and Methods:

Participants include N =298 pediatric inpatients from a Level 1 Pediatric Trauma center referred to the neuropsychological inpatient consultation service from February 2020 to July 2022. Qualitative methods were used to describe the flow and number of patients initially referred to the neuropsychological inpatient service and then those who followed up in outpatient neuropsychological care prior to and after the implementation of a multi-disciplinary clinic for children admitted to the Neurocritical Care Unit. Rates of follow-up with neuropsychological care were compared pre- and post-establishment of the multidisciplinary clinic. Additional analyses were conducted to explore factors known to impact follow-up with care post-hospitalization (e.g., socioeconomic status, race, ethnicity).

Results:

Prior to the establishment of the BRAIN clinic, approximately 60 to 70% of patients were referred for outpatient neuropsychological follow-up. Approximately 30% of patients referred to the inpatient neuropsychological service following the establishment of the BRAIN clinic were referred for multidisciplinary care, while 20% did not require additional intervention and 50% were referred for outpatient neuropsychological follow-up. Analyses indicated increased follow-up rates with neuropsychological care following the establishment of the BRAIN clinic.

Conclusions:

Integration of neuropsychology into inpatient care and subsequent multidisciplinary settings for pediatric patients with traumatic brain injuries or other serious insults and CNS infections increased access to neuropsychological care. Additional clinical implications will be discussed.
62 Effect of Blast TBI on Axonal Structure in Networks of Emotional Regulation and Cognitive Control
Authors: Gee Stephanie C , Hodges Kathleen , Walker Nicole C , Madore Michelle R.
Published: December 2023

Objective:

Blast-related traumatic brain injury (bTBI) is one of the most common injuries among Veterans who have served in recent wars in Iraq and Afghanistan. Despite representing a distinct mechanism of injury, long-term clinical and functional outcomes of bTBI are generally comparable with non-blast-related traumatic brain injury (TBI). However, controversy remains over whether bTBI etiology differentially impacts emotional regulation and neurocognition - particularly with respect to post-traumatic stress disorder (PTSD) and verbal and visual memory. Through diffusion tensor imaging (DTI), the present study investigates the microstructural pathophysiology of bTBI, compared to non-blast TBI, in neural pathways involved in emotional regulation and cognitive control.

Participants and Methods:

Participants included 36 Veterans (25% female; age M = 36.33, SD = 10.11; years of education M = 15.67, SD = 2.34). Axial diffusivity (AD) in networks of emotional and cognitive control was acquired using magnetic resonance imaging (MRI) with a DTI protocol. Analyses of variance (ANOVA) were used to compare Veterans with self-reported bTBI (n = 23) to those with non-blast-related TBI (n = 13).

Results:

In the left hemisphere, Veterans with bTBI exhibited significantly smaller AD in axonal projections from the caudate nucleus (CN) to the orbitofrontal cortex (OFC), as well as in projections from the putamen to the OFC (p < 0.05). In the right hemisphere, Veterans with bTBI also exhibited significantly smaller AD in networks connecting the hippocampus to the amygdala (p < 0.05).

Conclusions:

Compared to Veterans with non-blast-related TBI, Veterans with bTBI exhibited decreased AD in neural pathways from the CN to the OFC, the putamen to the OFC, and the hippocampus to the amygdala - indicative of increased axonal injury in these areas. Our results suggest that, on a microstructural level, emotional and cognitive networks are susceptible to longitudinal blast-related white matter damage. This is consistent with the literature in post-concussion syndrome (PCS) and provides a potential mechanism underlying results previously reported from this sample, describing subjective cognitive complaints in the absence of objective clinical deficits. As such, therapies that target networks of emotional and cognitive control may be particularly beneficial for Veterans with bTBI.
72 Neurocognitive and Emotional Symptoms of Pediatric Concussion Due to Physical Assault: A Case Series
Authors: Mandelbaum Sarah A , DiBlasi Lori , Ossowski Alexandra , Keren Yocheved , Pezzino Victoria , Russell Katherine E , Basile Rosemarie
Published: December 2023

Objective:

Much of the pediatric concussion literature focuses on sports and recreation related injuries, while there is a relative paucity of research on the cognitive and psychological sequelae associated with assault. However, it is understood that children with assault-related injuries demonstrate a longer recovery time. This case series reviews the data of four teenagers who were administered cognitive, emotional, and behavioral screeners after sustaining an assault related concussion.

Participants and Methods:

Four pediatric female patients (ages 13,14,15,15) with a recent history of concussion due to physical assault presented for evaluation at a hospital-based concussion clinic. All four patients were administered a computerized cognitive screener as well as self-report measures for mood, anxiety, post-traumatic stress disorder (PTSD), and sleep disturbance.

Results:

All four of the pediatric cases reported significant symptoms of PTSD, depression, anxiety, and sleep disturbance. For all four patients, the most notable problems across cognitive performance measures were observed in the areas of simple and complex attention.

Conclusions:

Results of this case series revealed clinically significant anxiety, depression, PTSD-symptoms, and sleep disturbance in conjunction with poor simple and complex attention. These pediatric cases illustrate the potential link between assault-related concussions, emotional and behavioral symptoms, and cognitive functioning. Furthermore, assault-related concussions may elevate risk toward attentional problems associated with psychological distress. Early evaluation of PTSD and mood related symptomatology is suggested to best support treatment planning and recovery in this population. Future studies are needed to explore the nature of the relationship between cognitive and emotional sequelae in patients who present with assault-related concussions.
82 Heart Rate Variability Biofeedback for Mild Traumatic Brain Injury
Authors: Lu Hsueh-Chen (Jason) , Gevirtz Richard , Cheng Yang-Chi , Tseng Wei-Lung , Wu Shih-I
Published: December 2023

Objective:

Heart rate variability (HRV) can be an indicator of the flexibility of the central and autonomic nervous systems. Heart rate variability biofeedback (HRV-BF) has been shown to validate the neuro-peripheral relationship and enhance the interaction between top-down and bottom-up processes. Few previous studies have focused on the treatment outcomes of HRV-BF in traumatic brain injury, and such studies have been mostly limited to pilot studies or case reports. The purpose of this study is to investigate the efficacy of HRV-BF for neuropsychological functioning in patients with mild traumatic brain injury (mTBI).

Participants and Methods:

Forty-one patients with mTBI were referred from the neurosurgery outpatient program and randomly assigned to a psychoeducation group or a HRV-BF intervention group. The psychoeducation group received standard medical care and one 60-minute psychoeducation session after brain injury. The HRV-BF group received standard medical care and one 60-minute session of the HRV-BF intervention weekly for 10 weeks. All participants received performance-based and self-reported neuropsychological measures of memory, executive function, mood, and information processing at week 1 of injury (pretest) and week 12 (posttest).

Results:

Participants in HRV-BF improved significantly after the intervention compared with the psychoeducation group on the Verbal Learning Test, Frontal Assessment Battery, Verbal Fluency Test, Paced Auditory Serial Addition Test, Trail Making Test, Dysexecutive Questionnaire, Depression Inventory, and Checklist of Post-concussion Symptoms.

Conclusions:

HRV-BF was found to be an efficacious and efficient intervention for improving neuropsychological functioning in patients with mTBI and a potential candidate for mTBI rehabilitation.