bluuebunny/crossref_metadata_2025_split huggingface dataset:
A-213 Comparing WAIS-IV Reliable Digit Span and Age Corrected Scaled Score’s Performance Validity Cutoffs when Patients’ Effort is Determined by One or More Performance Validity Tests (PVTs)
Authors: J Livingstone , C Reese 
Published: August 2020

Abstract

Objective
The purpose of the present study was to compare Wechsler Adult Intelligence Scale-IV (WAIS-IV) Reliable Digit Span (RDS) and Digit Span Age-Corrected Scaled Score (DS-ACSS) sensitivity and specificity, when the effort criterion was determined by between one and five performance validity test (PVT) cut scores.

Method
Data were collected from 82 adults (18–49) referred for clinical questions of multiple sclerosis, mild traumatic brain injury, and attention deficit hyperactivity disorder. Patients were administered full neuropsychological batteries,with different combinations of PVTs (including Advanced Clinical Solutions Word Choice, Animals raw score, Trails A T-score, Wisconsin Card Sorting Test [WCST; Suhr & Boyer] equation, and California Verbal Learning Test-II Forced Choice). Chi-square and receiver operating characteristic (ROC) analyses were utilized.

Results
Using established RDS (≤7) and DS-ACSS (≤6) cut scores, specificity was highest (90&37; and 86%, respectively), with equivalent sensitivity (90%), when effort was determined by WCST (Suhr & Boyer) equation failure alone. Related area under the curve for RDS was .90 (CI = .76–1.0) and for DS-ACSS was .88 (CI = .74–1.0).

Conclusions
In this clinical sample, the highest sensitivity and specificity were observed when the RDS cut score was utilized, and effort was based on the WCST criterion. However, the DS-ACSS cut score resulted in strong sensitivity/specificity combinations across more effort classification groups.
A-228 Are Those Who Fail Performance Validity Measures High Utilizers of Healthcare?
Authors: C Cooper , E Trahan , C Muncy , J Higa , J Link , M Reid , R Seegmiller , J Kennedy , L Lu 
Published: August 2020

Abstract

Objective
One study reported that suboptimal effort on performance validity tests (PVTs) is associated with higher healthcare utilization within a VA setting, defined as the number of Emergency Department visits and inpatient hospitalizations. The current study sought to expand on this by examining whether PVT failure is associated with higher number of outpatient visits in a military sample with a history of mild traumatic brain injury (mTBI).

Method
The medical records of 43 participants, 13 of whom failed the PVT Green’s Word Memory Test (WMT), were reviewed for the number of encounters since the mTBI and the reason for the encounter. The two groups (passed vs. failed) did not differ significantly on demographic variables (39 males, mean age 39, 65% Caucasian).

Results
The overall number of medical encounters was not significant between the two groups after controlling for years since the mTBI (F(1, 40) = 2.67, p = .11); however, once three participants with (&gt;2 years) missing records were excluded (final n = 40), the PVT failure group was seen significantly more often, (F(1, 37) = 8.23, p = .01). The PVT failures had a higher number of encounters with physical therapy (t(38) = −2.79, p = .01) and orthopedics (t(38) = −2.10, p = .04).

Conclusions
Preliminary results suggest that suboptimal effort is not associated with higher healthcare utilization; however, when participants with more than two years of missing records were excluded, those who failed PVTs were seen more frequently by physical therapy and orthopedic specialties. Limitations for future investigations are highlighted.
A-235 Construct validity of the National Institutes of Health Toolbox- Cognition Battery (NIHTB-CB) in children and adolescents with cerebral cavernous malformation, type 1 (CCM-1) and their non-affected relatives
Authors: C Petranovich , K Wilson , D Gill , L Morrison , B Hart , R Campbell 
Published: August 2020

Abstract

Objective
This study assessed the convergent validity of the NIHTB-CB in a sample of children and adolescents with CCM-1 and non-affected relatives.

Method
Twenty-two participants with CCM-1 and 7 non-affected relatives completed the NIHTB-CB and traditional neuropsychological measures. The following domains were assessed: memory (NIHTB-CB Picture Sequencing Memory and Child and Adolescent Memory Profile- Screening Index), word reading (NIHTB-CB Oral Reading and Wide Range Achievement Test-4th Word Reading [WRAT-4 WR]),processing speed (NIHTB-CB Pattern Comparison and Symbol Digit Modalities Test), and attention/working memory (NIHTB-CB List Sorting and Digit Span).

Results
The non-affected group scored higher than the CCM-1 group on WRAT-4 WR (t = 2.68, p = .02) and NIHTB-CB Oral Reading (t = 2.18, p = .05). The groups did not differ on the other measures (p &gt; .05). Pearson’s correlations ranged from .45 for memory to .81 for word reading, demonstrating adequate construct validity for memory, processing speed, and attention/working memory and good to very good for word reading. The NIHTB-CB was more likely to identify participants as impaired for memory (17.2% vs 6.9%) and processing speed (62.1% vs. 3.4%). The traditional attention/working memory measure was more likely to identify participants as impaired (27.6% vs 3.4%). Impairment rates were similar for the word reading measures.

Conclusions
Of the domains considered, convergent validity was best established for word reading. Although correlations were adequate, rates of impairment differed for memory, processing speed, and attention/working memory, suggesting that caution is warranted when comparing the NIHTB-CB to traditional measures in these areas.
A-247 Overall Test Battery Means from ANAM4 TBI-MIL and D-KEFS: A Within-Subject Comparison of a Traumatic Brain Injury Cognition Composite Score
Authors: B Ivins , J Arrieux , W Cole , G Iverson 
Published: August 2020

Abstract

Objective
Several cognition composite scores have been developed for potential use in traumatic brain injury clinical trials. This analysis examined the equivalence of overall test battery mean (OTBM) from two different test batteries administered consecutively to the same subjects.

Methods
Soldiers were administered the Automated Neuropsychological Assessment Metrics (version 4) TBI-MIL (ANAM4) computerized battery and D-KEFS as part of a larger study comparing within-subject performance from different neuropsychological test batteries. Data from 121 soldiers with complete and valid data on both ANAM4 and D-KEFS and no recent TBI were used in this analysis. OTBMs were calculated for ANAM4 and the seven D-KEFS achievement scores. The OTBMs from the 121 soldiers were ranked from lowest to highest and the percentile rankings from each battery were compared. For each soldier, the differences between the percentile ranks from each battery were also calculated.

Results
Only 53.8% of soldiers who scored below the 20th percentile on ANAM4 also scored below the 20th percentile on D-KEFS. Furthermore, only 47.8% of soldiers who scored at or above the 80th percentile on ANAM4 also scored in that range on D-KEFS. Some soldiers’ performance on each battery diverged by large amounts, for example from 59.5 to 82.6 percentage points. Correlation analysis revealed that the OTBMs and percentile rankings from both batteries were modestly correlated (OTBM r = 0.515, p &lt; 0.001, percentile rank r = 0.499, p &lt; 0.001).

Conclusion
These results suggest that comparing similar cognition composites from different neuropsychological test batteries from different studies in a meta-analytic manner may not be feasible due to psychometric difference between batteries.
A-249 Evidence for Frontal Lobe Involvement in the Visual Processing Streams
Authors: S Leonard , T Hall 
Published: August 2020

Abstract

Objective
Extant literature supports the “Two-Stream Hypothesis” of visual processing including a ventral stream (connecting the occipital lobe to the temporal lobe) and a dorsal stream (connecting the occipital lobe to the parietal lobe), but is not traditionally believed to involve the frontal lobe.

Method
“Eddie”, a healthy 14-year-old male, sustained a penetrating brain injury by accidentally lodging a pool cue through his right orbital bones and piercing his right frontal lobe through to the skull. He was ambulatory, awake, and alert on arrival to the ED, with a laceration, swelling, and bleeding of the eyelid. A cranial CT revealed a complex orbital roof fracture, injury to the orbit, and right frontal contusions. Eddie underwent a right supraorbital craniotomy with repair of the orbital roof fracture and debridement of bony fragments. Post-operative MRI revealed right frontal parenchymal edema and patchy areas of contusion.

Results
Neuropsychological evaluation revealed a robust cognitive reserve including verbal skills, working memory, processing speed, and word reading skills in the high average. Eddie demonstrated significant discrepancies in visually mediated skills including relatively weaker visual–spatial skills (24 standard score (SS) points lower than verbal skills), fluid reasoning with visual problem-solving (30 SS points lower than verbal skills), low average judgment of line orientation, and a discrepancy between verbal and visual memory. He also demonstrated mild difficulties consistent with his right orbito-frontal injury including weaknesses regarding impulsivity, self-monitoring, planning, and task approach.

Conclusions
The current case demonstrates possible involvement of the frontal lobe in the visual processing pathways.
A-255 Severe Psychological Dysfunction in a Neurologically Complex Patient during a Pre-Surgical Evaluation for Normal Pressure Hydrocephalus Shunt Implantation
Authors: A Wisinger , J Fink 
Published: August 2020

Abstract

Objective
Psychological syndromes like depression and anxiety are common in neurological conditions and lead to poorer quality of life and disability. However, these syndromes are often under-recognized in neurologic patients and are thus under-diagnosed due to overlapping symptomatology. Here, we report on a patient with a complex neurological history as well as clinically significant affective symptoms.

Participants
The patient is a 69-year-old Caucasian female recently diagnosed with normal pressure hydrocephalus. Relevant medical history was significant for focal epilepsy with complex seizures, obstructive sleep apnea, and cerebrovascular accident. She underwent neuropsychological evaluation as part of a pre-surgical workup for shunt implantation.

Results
The patient’s neurocognitive profile was marked by significant impairments in most cognitive domains and she was not independent in activities of daily living. On self-report measures of current emotional functioning, she reported clinically severe levels of depression, anxiety, apathy, executive dysfunction, and disinhibition. During the clinical interview, she reported experiencing passive suicidal ideation as well as a significant history of traumatic experiences.

Conclusion
The psychological symptoms the patient was experiencing undoubtedly impacted her neurocognitive status and functioning abilities, though she was receiving no treatment for these symptoms. Addressing symptoms resulting from psychological syndromes in patients with neurological conditions is an important role for neuropsychologists, as accurate diagnosis of psychological syndromes can inform treatment recommendations and improve patient outcomes. This case illustrates the importance of documenting a thorough clinical history, including past psychiatric history, as well as a detailed examination of self-reported current psychological functioning as part of a comprehensive neuropsychological case formulation.
Using Nasal Self-Esteem to Predict Revision in Cosmetic Rhinoplasty
Authors: Okland Tyler S , Patel Priyesh , Liu George S , Most Sam P 
Published: August 2020

Abstract

Background
It would be useful if existing tools or outcomes measures could predict which patients are at greater risk of revision surgery following rhinoplasty.

Objectives
The authors sought to determine if a single question assessing nasal self-esteem could be utilized to predict which patients are at greatest risk of revision surgery following rhinoplasty.

Methods
The authors conducted a retrospective chart review of 148 patients who underwent cosmetic rhinoplasty. Results of pre- and postoperative Standardized Cosmesis and Health Nasal Outcomes Survey questionnaires and rates of revision or patient-initiated revision discussions (RD) were collected. Patients were stratified based on answers to Standardized Cosmesis and Health Nasal Outcomes Survey question 5 (SQ5), “Decreased mood and self-esteem due to my nose.”

Results
Of the 148 patients included in the analysis, 72.9% were women, and the mean age was 30.9 (15-59, standard deviation = 10.3) years. Those patients who selected 4 or 5 on SQ5 had an overall revision rate of 16.7% and 18.8%, respectively, and a RD rate of 27.8% and 31.25%, respectively. Those patients who selected 0 through 3 on SQ5 had an overall revision rate of 0% and an overall RD rate of 10.4%. Only SQ5 was predictive of revision and RD on logistic regression analysis (P = 0.0484 and P = 0.0257) after Bonferroni correction.

Conclusions
SQ5 appears to offer a useful adjunct to guide surgical management of the cosmetic rhinoplasty patient. Those patients who reported worse nasal self-esteem and associated mood preoperatively were more likely to request and undergo revision.

Level of Evidence: 4
Upfront triple oral combination therapy including selexipag in a high-risk patient with idiopathic pulmonary arterial hypertension: a case report
Authors: Rossi Serena , Pietrangelo Carla , Pierdomenico Sante Donato , Giuliani Livio 
Published: August 2020

Abstract

Background
Selexipag is an oral selective prostacyclin IP receptor agonist approved in patients with low- and intermediate-risk pulmonary hypertension (PH); evidence in patients at high risk is lacking.

Case summary
A 42-year-old woman with worsening dyspnoea (World Health Organization functional class III–IV) and suspected PH at echocardiographic examination was evaluated in our Pulmonary Hypertension Centre. Right heart catheterization showed pre-capillary PH with reduced cardiac index and increased pulmonary vascular resistance. High-resolution computed tomography excluded parenchymal lung disease and ventilation/perfusion (V/Q) lung scan was negative for mismatched perfusion defects so the conclusive diagnosis was high-risk idiopathic pulmonary arterial hypertension (PAH). The patient refused an initial combination therapy including a parenteral prostacyclin analogue (PCA) in accordance with the ESC/ERS guidelines, so an off-label triple oral combination therapy including a phosphodiesterase-5 inhibitor, an endothelin receptor antagonist, and selexipag was started. At 3- and 6-month follow-up we found a clinical and haemodynamic improvement, so the patient was reclassified as low risk. Her clinical condition is currently stable.

Discussion
Despite the benefit of parenteral PCAs in high-risk PAH, low adherence to treatment may be explained by adverse side effects related to the intravenous route of administration. Given the potential effect seen in our patient, upfront triple oral combination therapy in PAH high-risk patients should be further evaluated in a controlled clinical trial.
May Measurement Month 2018: an analysis of blood pressure screening results from Ecuador
Authors: Peñaherrera Ernesto , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Villalba Jose , Ramirez Maria Isabel , Duarte Yan , Caceres Silvia , Mora Cecilia , Peñaherrera Ruben , Avila Elisa , Arteaga Fabricio , Bravo Jesenia , Hidalgo Eric 
Published: August 2020

Abstract
Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative by the International Society of Hypertension (ISH) aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2018. A volunteer cross-sectional survey was carried out in May 2017 across 33 health centres. Blood pressure measurement, the definition of hypertension (HTN) (mean of the 2nd and 3rd BP measurement ≥ 140/90 mmHg or who were medicated for high BP), and statistical analysis followed the standard MMM protocol. In total, 11 922 individuals (53.7% female) were screened during MMM18. After multiple imputation, 4563 (38.3%) had HTN. Of individuals not receiving antihypertensive medication, 1302 (15.0%) were hypertensive. Of individuals receiving antihypertensive medication, 933 (28.6%) had uncontrolled BP. MMM18 was the largest BP screening campaign done in Ecuador. Hypertension was detected in 38.4% of those screened and almost 4 out of 10 were either not on treatment or were not controlled to the BP goal. These results suggest that appropriate screening can help to identify a significant number of people with high BP. These data should attract the attention of doctors and health care system in Ecuador.
May Measurement Month 2018: an analysis of blood pressure screening results from Chile
Authors: Lanas Fernando , Garcia Maria Soledad , Paccot Melanie , Peña Jimena , Torres Pamela , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Xia Xin 
Published: August 2020

AbstractHypertension is highly prevalent in Chile. The National Health Survey 2016–17 reported a 27.6% prevalence, 68.7% awareness, and 33.3% of hypertensives had controlled blood pressure (BP). 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 worldwide. A cross-sectional survey of volunteers aged ≥18 years old was carried out in May 2018. Blood pressure measurement, the definition of hypertension, and statistical analysis followed the MMM protocol. Ninety-four sites participated, most of them from the Public Health System outpatient clinics distributed along the country. In addition, universities, clinical research sites, and private clinics participated. Hypertension was diagnosed as mean systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or receiving antihypertensive medication. Overall 9344 individuals were screened. After multiple imputation, hypertension prevalence was 29.2%, of which 64.0% were aware of their condition. Of those aware of their hypertension diagnosis, 87.7% were receiving antihypertensive medication and 56.1% of the total number of hypertensives were on antihypertensive medication. Moreover, 15.3% of the participants who were not receiving treatment were considered potential hypertensives identified in the MMM18. MMM18 was one of the largest BP screening campaigns performed in Chile. It demonstrated a high prevalence of hypertension with one-third of these individuals having controlled BP. The high percentage of persons untreated or with uncontrolled hypertension while on pharmacologic treatment suggests that systematic screening programmes may be a useful tool to improve hypertension control in Chile.
May Measurement Month 2018: an analysis of blood pressure screening results from Colombia
Authors: Lopez-Jaramillo Patricio , Otero Johanna , Alvernia Juliana , Ney-Salazar Daniela , Lopez-Lopez Jose , Accini Jose L , Aroca Gustavo , Urina-Triana Miguel , Sánchez-Vallejo Gregorio , Arcos Edgar , Casanova María E , García Henry , Beaney Thomas , Ster Anca Chis , Poulter Neil R 
Published: August 2020

Abstract
High blood pressure (BP) is the leading global preventable cause of death and the most common risk factor for cardiovascular disease (CVD). However, due to its asymptomatic nature, the lack of awareness of this condition causes underdiagnosis and low rates of adherence to pharmacological treatment. Looking for practical approaches to increase awareness worldwide, the International Society of Hypertension (ISH) implemented the 2nd May Measurement Month campaign in 2018 (MMM18). In order to contribute to this initiative, Colombia participated as one of the 89 countries involved in this hypertension screening programme. Blood pressure was measured in subjects from 11 departments in Colombia. Under the leadership of the Fundación Oftalmológica de Santander (FOSCAL), 400 volunteers across the country collected the data following the MMM protocol. Measurements from 35 548 participants with a mean age of 41.9 years were obtained. In total, 9475 (26.7%) of the total population studied had hypertension. Of those with hypertension, 69.9% of these subjects were aware of their condition, 65.0% were on antihypertensive medication, and 43.1% had controlled BP. Of those on medication, 66.3% had controlled BP. Hypertension screening, awareness, treatment, and control should be a priority in public health objectives due to its elevated burden of disease and direct association with increased CVD. The MMM campaign provided a positive impact in the diagnosis of hypertension across Colombia. Although efforts are being made to expand treatment capability and adherence, still more are needed to insure a broader coverage of antihypertensive medication in Colombia.
May Measurement Month 2018: an analysis of blood pressure screening from Kenya
Authors: Ogola Elijah N , Barasa Anders , Gachemba Yubrine M , Barasa Felix , Gitura Bernard M , Nalwa Wafula , Wairagu Anne , Beaney Thomas , Ster Anca Chis , Poulter Neil R 
Published: August 2020

Abstract
Hypertension (HTN) is highly prevalent and the leading cardiovascular risk factor for death globally. A large proportion of individuals with high blood pressure (BP) are unaware leading to under treatment and poor control. To address this, the International Society of Hypertension (ISH) initiated a global mass screening campaign, the May Measurement Month 2017 (MMM17), in which Kenya participated. Following the success of the campaign, its successor MMM18 was launched. Here, we present the Kenyan results for MMM18. Opportunistic screening of consenting adults was done in various sites across Kenya in May 2018, by volunteers trained using ISH material, under the co-ordination of the Kenya Cardiac Society. Blood pressure, pulse rate, weight, and height were measured by standard methods. Definitions of HTN and statistical methods all adhered to the standard MMM protocol. We screened 49 548 subjects, mean age 39.95 (15.3) years. In total, 49.4% had never had a BP measurement taken. After multiple imputation, 17.1% were hypertensive and of those who were hypertensive, 30.7% were aware, 26.6% were on antihypertensive treatment, and 13.0% had controlled BP. Alcohol use, excess weight, and treatment for HTN were associated with higher BP. The Kenyan MMM18 sites successfully screened more than three times the number screened in 2017, hence improving public awareness. Less than half the population had ever had a BP check. Less than a third of the hypertensives were aware with correspondingly poor treatment and control rates. Opportunistic mass screening is useful in raising public awareness.