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Chapter 28 - Evidence-Based Psychological Interventions for Bipolar Disorders
- Edited by Allan Young, Institute of Psychiatry, King's College London, Marsal Sanches, Baylor College of Medicine, Texas, Jair C. Soares, McGovern Medical School, The University of Texas, Mario Juruena, King's College London
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- Clinical Textbook of Mood Disorders
- Published online:
- 16 May 2024
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- 23 May 2024, pp 294-303
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Summary
Bipolar disorders (BD) are recurrent conditions and many clinical and social impairments persist even with optimal pharmacotherapy. This chapter explores the development of psychological treatments, from initial uncertainties about offering therapies for BD, and then following the tentative steps to offer support to individuals with BD and to their families. Much of the focus is on the rationale, evolution and testing of specific psychological treatments. As well as examining any added value attained from providing psychological treatments alongside medications, we also consider how therapies might be further developed in the future. For example, we discuss how network meta-analysis might shed light on active ingredients that are common to all successful therapies and consider if these components might herald the introduction of multi-modal interventions. The chapter ends by noting the progress being made regarding the mediators and moderators of therapeutic effects and highlighting the importance of continuing to undertake efficacy trials but also comparative effectiveness trials that will enable researchers, clinicians and patients to determine how best to deploy psychological treatments in the real world.
Plant growth regulators differentially suppress goosegrass and smooth crabgrass in creeping bentgrass turf
- John M Peppers, J. Scott McElroy, Shawn D Askew
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- Journal:
- Weed Technology / Accepted manuscript
- Published online by Cambridge University Press:
- 23 May 2024, pp. 1-19
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Goosegrass and smooth crabgrass control in creeping bentgrass is difficult due to a lack of selective herbicides. Based on preliminary field observations, we hypothesized that paclobutrazol and flurprimidol would reduce the overall competitiveness of goosegrass and smooth crabgrass in creeping bentgrass. Greenhouse and field studies were designed to evaluate the effect of several plant growth regulators (PGRs) on goosegrass and smooth crabgrass competitive indices. In greenhouse studies, flurprimidol, paclobutrazol, trinexapac-ethyl, and prohexadione-calcium were applied either preemergence only or preemergence plus two biweekly postemergence applications to goosegrass and smooth crabgrass plants to simulate the first 1.5 months of typical PGR programs utilized on golf courses. Two wk after the final postemergence treatment, above-ground biomass, and root biomass were recorded. Programmatic flurprimidol and paclobutrazol applications reduced smooth crabgrass above-ground biomass 67 and 69%, respectively, and more than trinexapac ethyl or prohexadione-calcium. When averaged across application programs, flurprimidol and paclobutrazol reduced smooth crabgrass root biomass 74% and goosegrass biomass 73-80%. Field studies were established to further evaluate the influence of PGR on smooth crabgrass coverage in creeping bentgrass turf. Treatments consisting of flurprimidol, trinexapac-ethyl, flurprimidol plus trinexapac-ethyl, paclobutrazol, and fenoxaprop-p were applied every three wk from April to August. Weed coverage data were collected throughout the growing season, and final smooth crabgrass control data were collected at the end of the season. In general, flurprimidol-containing treatments more effectively reduced smooth crabgrass coverage throughout the growing season than trinexapac ethyl. After the studies, flurprimidol containing programs controlled smooth crabgrass 68-73%, greater than any other PGR program evaluated. Results from these studies indicate flurprimidol may be used to control smooth crabgrass or goosegrass in creeping bentgrass turf effectively. These are the first reported data regarding the use of flurprimidol for smooth crabgrass or goosegrass control in turf.
Sex-dependent differences in vulnerability to early risk factors for posttraumatic stress disorder: results from the AURORA study
- Stephanie Haering, Antonia V. Seligowski, Sarah D. Linnstaedt, Vasiliki Michopoulos, Stacey L. House, Francesca L. Beaudoin, Xinming An, Thomas C. Neylan, Gari D. Clifford, Laura T. Germine, Scott L. Rauch, John P. Haran, Alan B. Storrow, Christopher Lewandowski, Paul I. Musey, Jr., Phyllis L. Hendry, Sophia Sheikh, Christopher W. Jones, Brittany E. Punches, Robert A. Swor, Nina T. Gentile, Lauren A. Hudak, Jose L. Pascual, Mark J. Seamon, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Brian J. O'Neil, Leon D. Sanchez, Steven E. Bruce, Steven E. Harte, Samuel A. McLean, Ronald C. Kessler, Karestan C. Koenen, Jennifer S. Stevens, Abigail Powers
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- Journal:
- Psychological Medicine , First View
- Published online by Cambridge University Press:
- 22 May 2024, pp. 1-11
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Background
Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD.
MethodsAs part of the longitudinal AURORA study, 2924 patients seeking emergency department (ED) treatment in the acute aftermath of trauma provided self-report assessments of pre- peri- and post-traumatic risk factors, as well as 3-month PTSD severity. We systematically examined sex-dependent effects of 16 risk factors that have previously been hypothesized to show different associations with PTSD severity in women and men.
ResultsWomen reported higher PTSD severity at 3-months post-trauma. Z-score comparisons indicated that for five of the 16 examined risk factors the association with 3-month PTSD severity was stronger in men than in women. In multivariable models, interaction effects with sex were observed for pre-traumatic anxiety symptoms, and acute dissociative symptoms; both showed stronger associations with PTSD in men than in women. Subgroup analyses suggested trauma type-conditional effects.
ConclusionsOur findings indicate mechanisms to which men might be particularly vulnerable, demonstrating that known PTSD risk factors might behave differently in women and men. Analyses did not identify any risk factors to which women were more vulnerable than men, pointing toward further mechanisms to explain women's higher PTSD risk. Our study illustrates the need for a more systematic examination of sex differences in contributors to PTSD severity after trauma, which may inform refined preventive interventions.
Characteristics of healthcare personnel with SARS-CoV-2 infection: 10 emerging infections program sites in the United States, April 2020–December 2021
- Nora Chea, Taniece Eure, Rebecca Alkis Ramirez, Maria Zlotorzynska, Gregory T. Blazek, Joelle Nadle, Jane Lee, Christopher A. Czaja, Helen Johnston, Devra Barter, Melissa Kellogg, Catherine Emanuel, James Meek, Monica Brackney, Stacy Carswell, Stepy Thomas, Scott K. Fridkin, Lucy E. Wilson, Rebecca Perlmutter, Kaytlynn Marceaux-Galli, Ashley Fell, Sara Lovett, Sarah Lim, Ruth Lynfield, Sarah Shrum Davis, Erin C. Phipps, Marla Sievers, Ghinwa Dumyati, Christopher Myers, Christine Hurley, Erin Licherdell, Rebecca Pierce, Valerie L. S. Ocampo, Eric W. Hall, Christopher Wilson, Cullen Adre, Erika Kirtz, Tiffanie M. Markus, Kathryn Billings, Ian D Plumb, Glen R. Abedi, Jade James-Gist, Shelley S. Magill, Cheri T. Grigg
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- Journal:
- Infection Control & Hospital Epidemiology , First View
- Published online by Cambridge University Press:
- 21 May 2024, pp. 1-9
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Background:
Understanding characteristics of healthcare personnel (HCP) with SARS-CoV-2 infection supports the development and prioritization of interventions to protect this important workforce. We report detailed characteristics of HCP who tested positive for SARS-CoV-2 from April 20, 2020 through December 31, 2021.
Methods:CDC collaborated with Emerging Infections Program sites in 10 states to interview HCP with SARS-CoV-2 infection (case-HCP) about their demographics, underlying medical conditions, healthcare roles, exposures, personal protective equipment (PPE) use, and COVID-19 vaccination status. We grouped case-HCP by healthcare role. To describe residential social vulnerability, we merged geocoded HCP residential addresses with CDC/ATSDR Social Vulnerability Index (SVI) values at the census tract level. We defined highest and lowest SVI quartiles as high and low social vulnerability, respectively.
Results:Our analysis included 7,531 case-HCP. Most case-HCP with roles as certified nursing assistant (CNA) (444, 61.3%), medical assistant (252, 65.3%), or home healthcare worker (HHW) (225, 59.5%) reported their race and ethnicity as either non-Hispanic Black or Hispanic. More than one third of HHWs (166, 45.2%), CNAs (283, 41.7%), and medical assistants (138, 37.9%) reported a residential address in the high social vulnerability category. The proportion of case-HCP who reported using recommended PPE at all times when caring for patients with COVID-19 was lowest among HHWs compared with other roles.
Conclusions:To mitigate SARS-CoV-2 infection risk in healthcare settings, infection prevention, and control interventions should be specific to HCP roles and educational backgrounds. Additional interventions are needed to address high social vulnerability among HHWs, CNAs, and medical assistants.
A multi-center validation of the electronic health record admission source and discharge location fields against the clinical notes for identifying inpatients with long-term care facility exposure
- Katherine E. Goodman, Monica Taneja, Laurence S. Magder, Eili Y. Klein, Mark Sutherland, Scott Sorongon, Pranita D. Tamma, Philip Resnik, Anthony D. Harris
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- Journal:
- Infection Control & Hospital Epidemiology , First View
- Published online by Cambridge University Press:
- 18 April 2024, pp. 1-6
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Identifying long-term care facility (LTCF)-exposed inpatients is important for infection control research and practice, but ascertaining LTCF exposure is challenging. Across a large validation study, electronic health record data fields identified 76% of LTCF-exposed patients compared to manual chart review.
Evaluation of the Alkylammonium Method of Determining Layer Charge
- D. A. Laird, A. D. Scott, T. E. Fenton
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- Journal:
- Clays and Clay Minerals / Volume 37 / Issue 1 / February 1989
- Published online by Cambridge University Press:
- 02 April 2024, pp. 41-46
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The layer charge of five smectites, one vermiculitic material, and five reduced-charge clays was determined by the alkylammonium and structural formula methods. The two sets of results were found to be linearly correlated (r =.961); however, the values that were determined by the alkylammonium method were 20 to 30% lower than those determined by the structural formula method, and the regression slope for their linear relationship was 1.67. The fact that the structural formula method includes the effects of cations on the lateral edges of the clay particles probably accounted for some of the differences in the magnitude of the results but should not have caused the regression slope to deviate substantially from 1.00. Therefore, inaccurate estimates of the packing density of alkylammonium cations in the interlayer space of 2:1 phyllosilicates were deemed responsible for the systematic divergence of the results of the two methods. To satisfy the need for a relationship between the two methods of determining layer charge, an empirical means of adjusting the alkylammonium values has been proposed and shown to yield values of layer charge that are comparable to those determined by the structural formula method.
Technique for Transmission Electron Microscopy and X-Ray Powder Diffraction Analyses of the Same Clay Mineral Specimen
- D. A. Laird, M. L. Thompson, A. D. Scott
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- Journal:
- Clays and Clay Minerals / Volume 37 / Issue 3 / June 1989
- Published online by Cambridge University Press:
- 02 April 2024, pp. 280-282
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The effect of older age on outcomes of rTMS treatment for treatment-resistant depression
- Michael K. Leuchter, Cole Citrenbaum, Andrew C. Wilson, Tristan D. Tibbe, Nicholas J. Jackson, David E. Krantz, Scott A. Wilke, Juliana Corlier, Thomas B. Strouse, Gil D. Hoftman, Reza Tadayonnejad, Ralph J. Koek, Aaron R. Slan, Nathaniel D. Ginder, Margaret G. Distler, Hewa Artin, John H. Lee, Adesewa E. Adelekun, Evan H. Einstein, Hanadi A. Oughli, Andrew F. Leuchter
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- Journal:
- International Psychogeriatrics , First View
- Published online by Cambridge University Press:
- 25 March 2024, pp. 1-6
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Clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) for treatment of treatment-resistant depression (TRD) vary widely and there is no mood rating scale that is standard for assessing rTMS outcome. It remains unclear whether TMS is as efficacious in older adults with late-life depression (LLD) compared to younger adults with major depressive disorder (MDD). This study examined the effect of age on outcomes of rTMS treatment of adults with TRD. Self-report and observer mood ratings were measured weekly in 687 subjects ages 16–100 years undergoing rTMS treatment using the Inventory of Depressive Symptomatology 30-item Self-Report (IDS-SR), Patient Health Questionnaire 9-item (PHQ), Profile of Mood States 30-item, and Hamilton Depression Rating Scale 17-item (HDRS). All rating scales detected significant improvement with treatment; response and remission rates varied by scale but not by age (response/remission ≥ 60: 38%–57%/25%–33%; <60: 32%–49%/18%–25%). Proportional hazards models showed early improvement predicted later improvement across ages, though early improvements in PHQ and HDRS were more predictive of remission in those < 60 years (relative to those ≥ 60) and greater baseline IDS burden was more predictive of non-remission in those ≥ 60 years (relative to those < 60). These results indicate there is no significant effect of age on treatment outcomes in rTMS for TRD, though rating instruments may differ in assessment of symptom burden between younger and older adults during treatment.
Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition
- Jarrod J Homer, Stuart C Winter, Elizabeth C Abbey, Hiba Aga, Reshma Agrawal, Derfel ap Dafydd, Takhar Arunjit, Patrick Axon, Eleanor Aynsley, Izhar N Bagwan, Arun Batra, Donna Begg, Jonathan M Bernstein, Guy Betts, Colin Bicknell, Brian Bisase, Grainne C Brady, Peter Brennan, Aina Brunet, Val Bryant, Linda Cantwell, Ashish Chandra, Preetha Chengot, Melvin L K Chua, Peter Clarke, Gemma Clunie, Margaret Coffey, Clare Conlon, David I Conway, Florence Cook, Matthew R Cooper, Declan Costello, Ben Cosway, Neil J A Cozens, Grant Creaney, Daljit K Gahir, Stephen Damato, Joe Davies, Katharine S Davies, Alina D Dragan, Yong Du, Mark R D Edmond, Stefano Fedele, Harriet Finze, Jason C Fleming, Bernadette H Foran, Beth Fordham, Mohammed M A S Foridi, Lesley Freeman, Katherine E Frew, Pallavi Gaitonde, Victoria Gallyer, Fraser W Gibb, Sinclair M Gore, Mark Gormley, Roganie Govender, J Greedy, Teresa Guerrero Urbano, Dorothy Gujral, David W Hamilton, John C Hardman, Kevin Harrington, Samantha Holmes, Jarrod J Homer, Deborah Howland, Gerald Humphris, Keith D Hunter, Kate Ingarfield, Richard Irving, Kristina Isand, Yatin Jain, Sachin Jauhar, Sarra Jawad, Glyndwr W Jenkins, Anastasios Kanatas, Stephen Keohane, Cyrus J Kerawala, William Keys, Emma V King, Anthony Kong, Fiona Lalloo, Kirsten Laws, Samuel C Leong, Shane Lester, Miles Levy, Ken Lingley, Gitta Madani, Navin Mani, Paolo L Matteucci, Catriona R Mayland, James McCaul, Lorna K McCaul, Pádraig McDonnell, Andrew McPartlin, Valeria Mercadante, Zoe Merchant, Radu Mihai, Mufaddal T Moonim, John Moore, Paul Nankivell, Sonali Natu, A Nelson, Pablo Nenclares, Kate Newbold, Carrie Newland, Ailsa J Nicol, Iain J Nixon, Rupert Obholzer, James T O'Hara, S Orr, Vinidh Paleri, James Palmer, Rachel S Parry, Claire Paterson, Gillian Patterson, Joanne M Patterson, Miranda Payne, L Pearson, David N Poller, Jonathan Pollock, Stephen Ross Porter, Matthew Potter, Robin J D Prestwich, Ruth Price, Mani Ragbir, Meena S Ranka, Max Robinson, Justin W G Roe, Tom Roques, Aleix Rovira, Sajid Sainuddin, I J Salmon, Ann Sandison, Andy Scarsbrook, Andrew G Schache, A Scott, Diane Sellstrom, Cherith J Semple, Jagrit Shah, Praveen Sharma, Richard J Shaw, Somiah Siddiq, Priyamal Silva, Ricard Simo, Rabin P Singh, Maria Smith, Rebekah Smith, Toby Oliver Smith, Sanjai Sood, Francis W Stafford, Neil Steven, Kay Stewart, Lisa Stoner, Steve Sweeney, Andrew Sykes, Carly L Taylor, Selvam Thavaraj, David J Thomson, Jane Thornton, Neil S Tolley, Nancy Turnbull, Sriram Vaidyanathan, Leandros Vassiliou, John Waas, Kelly Wade-McBane, Donna Wakefield, Amy Ward, Laura Warner, Laura-Jayne Watson, H Watts, Christina Wilson, Stuart C Winter, Winson Wong, Chui-Yan Yip, Kent Yip
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- Journal:
- The Journal of Laryngology & Otology / Volume 138 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 14 March 2024, pp. S1-S224
- Print publication:
- April 2024
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Changes in evening-shifted loss of control eating severity following treatment for binge-eating disorder
- Angeline R. Bottera, Elizabeth N. Dougherty, Glen Forester, Carol B. Peterson, Ross D. Crosby, Scott G. Engel, Scott J. Crow, Jennifer E. Wildes, Stephen A. Wonderlich
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- Psychological Medicine , First View
- Published online by Cambridge University Press:
- 28 February 2024, pp. 1-8
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Background
Loss of control eating is more likely to occur in the evening and is uniquely associated with distress. No studies have examined the effect of treatment on within-day timing of loss of control eating severity. We examined whether time of day differentially predicted loss of control eating severity at baseline (i.e. pretreatment), end-of-treatment, and 6-month follow-up for individuals with binge-eating disorder (BED), hypothesizing that loss of control eating severity would increase throughout the day pretreatment and that this pattern would be less pronounced following treatment. We explored differential treatment effects of cognitive-behavioral guided self-help (CBTgsh) and Integrative Cognitive-Affective Therapy (ICAT).
MethodsIndividuals with BED (N = 112) were randomized to receive CBTgsh or ICAT and completed a 1-week ecological momentary assessment protocol at baseline, end-of-treatment, and 6-month follow-up to assess loss of control eating severity. We used multilevel models to assess within-day slope trajectories of loss of control eating severity across assessment periods and treatment type.
ResultsWithin-day increases in loss of control eating severity were reduced at end-of-treatment and 6-month follow-up relative to baseline. Evening acceleration of loss of control eating severity was greater at 6-month follow-up relative to end-of-treatment. Within-day increases in loss of control severity did not differ between treatments at end-of-treatment; however, evening loss of control severity intensified for individuals who received CBTgsh relative to those who received ICAT at 6-month follow-up.
ConclusionsFindings suggest that treatment reduces evening-shifted loss of control eating severity, and that this effect may be more durable following ICAT relative to CBTgsh.
Methiozolin rate and application frequency influence goosegrass (Eleusine indica) and smooth crabgrass (Digitaria ischaemum) control in turf
- John M. Peppers, J. Scott McElroy, Pawel M. Orlinski, James Baird, Pawel Petelewicz, Mikerly M. Joseph, I. Alejandra Sierra-Augustinus, Marco Schiavon, Shawn D. Askew
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- Journal:
- Weed Technology / Volume 38 / 2024
- Published online by Cambridge University Press:
- 06 February 2024, e24
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Methiozolin is labeled for goosegrass and smooth crabgrass control in golf course putting greens, but no peer-reviewed literature exists regarding this use. Greenhouse experiments were conducted evaluating goosegrass and smooth crabgrass response to increasing rates of methiozolin as affected by weed growth stage. In general, as weed growth stage increased, the methiozolin rate required to reduce weed biomass 90% (WR90) increased. Goosegrass was more sensitive to preemergence-applied methiozolin than smooth crabgrass, and the WR90 was 30.4 and 118 g ai ha–1 for goosegrass and smooth crabgrass, respectively. However, smooth crabgrass was generally more sensitive to postemergence-applied methiozolin than goosegrass. Subsequent field studies were conducted to evaluate goosegrass and smooth crabgrass control with methiozolin applied singularly or sequentially at standard preemergence timings. Results indicated methiozolin applied singularly or sequentially at the label-recommended rate (500 g ha–1) is not persistent enough to provide season-long control of goosegrass and smooth crabgrass. Ten field studies were conducted in Alabama, California, Florida, and Virginia to evaluate frequent methiozolin application programs with the objective of providing selective, season-long goosegrass and smooth crabgrass control. Results from these studies indicate methiozolin can be safely applied to hybrid bermudagrass and creeping bentgrass putting greens despite exceeding the yearly maximum use rate for putting greens (2,500 g ha–1) with some treatments. Methiozolin effectively controlled smooth crabgrass throughout the growing season in California and Virginia when 10 biweekly applications were applied at 250 g ha–1 or higher. In Florida, methiozolin did not acceptably (80%) control goosegrass regardless of application rate. In Virginia, methiozolin acceptably controlled goosegrass only when applied at rates and frequencies that exceeded the maximum yearly methiozolin usage rate. These data indicate that methiozolin has the potential to control smooth crabgrass preemergence when applied frequently, but does not provide acceptable goosegrass control at labeled rates.
Potential underreporting of treated patients using a Clostridioides difficile testing algorithm that screens with a nucleic acid amplification test
- Alice Y. Guh, Scott Fridkin, Dana Goodenough, Lisa G. Winston, Helen Johnston, Elizabeth Basiliere, Danyel Olson, Christopher D. Wilson, Jasmine J. Watkins, Lauren Korhonen, Dale N. Gerding
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 45 / Issue 5 / May 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 590-598
- Print publication:
- May 2024
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Objective:
Patients tested for Clostridioides difficile infection (CDI) using a 2-step algorithm with a nucleic acid amplification test (NAAT) followed by toxin assay are not reported to the National Healthcare Safety Network as a laboratory-identified CDI event if they are NAAT positive (+)/toxin negative (−). We compared NAAT+/toxin− and NAAT+/toxin+ patients and identified factors associated with CDI treatment among NAAT+/toxin− patients.
Design:Retrospective observational study.
Setting:The study was conducted across 36 laboratories at 5 Emerging Infections Program sites.
Patients:We defined a CDI case as a positive test detected by this 2-step algorithm during 2018–2020 in a patient aged ≥1 year with no positive test in the previous 8 weeks.
Methods:We used multivariable logistic regression to compare CDI-related complications and recurrence between NAAT+/toxin− and NAAT+/toxin+ cases. We used a mixed-effects logistic model to identify factors associated with treatment in NAAT+/toxin− cases.
Results:Of 1,801 cases, 1,252 were NAAT+/toxin−, and 549 were NAAT+/toxin+. CDI treatment was given to 866 (71.5%) of 1,212 NAAT+/toxin− cases versus 510 (95.9%) of 532 NAAT+/toxin+ cases (P < .0001). NAAT+/toxin− status was protective for recurrence (adjusted odds ratio [aOR], 0.65; 95% CI, 0.55–0.77) but not CDI-related complications (aOR, 1.05; 95% CI, 0.87–1.28). Among NAAT+/toxin− cases, white blood cell count ≥15,000/µL (aOR, 1.87; 95% CI, 1.28–2.74), ≥3 unformed stools for ≥1 day (aOR, 1.90; 95% CI, 1.40–2.59), and diagnosis by a laboratory that provided no or neutral interpretive comments (aOR, 3.23; 95% CI, 2.23–4.68) were predictors of CDI treatment.
Conclusion:Use of this 2-step algorithm likely results in underreporting of some NAAT+/toxin− cases with clinically relevant CDI. Disease severity and laboratory interpretive comments influence treatment decisions for NAAT+/toxin− cases.
40 APOE x BDNF Genetic Interaction is Associated with Poorer Cognitive Outcomes in Veterans with Histories of mTBI
- Adan F. Ton-Loy, Victoria C. Merritt, Erin D Ozturk, Monica Ly, Alin Alshaheri, Scott F. Sorg, Lisa Delano-Wood
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 147-148
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Objective:
Many Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans have sustained a mild traumatic brain injury (mTBI) during their military service and a substantial “miserable minority” frequently report significant cognitive complaints long after injury. Although existing studies have shown associations between genetic factors (e.g., apolipoprotein E [APOE] and brain-derived neurotrophic factor [BDNF]) and cognitive performance in this vulnerable population, the TBI-genetics literature has generally been varied and inconsistent. Although past findings suggest that individuals who possess APOE £4 and BDNF Met alleles have worse cognitive outcomes after mTBI, this has not been consistently reported. Additionally, the influence of any gene-by-gene interactions on cognition has not been sufficiently explored and therefore remains a critical area of interest. Thus, we examined relationships between APOE and BDNF genotypes on neuropsychological function in a well-characterized sample of younger Veterans with mTBI histories.
Participants and Methods:Participants included Veterans with a history of mTBI who adequately completed performance validity testing. In total, 78 Veterans (84.6% male; age: M=32.95, SD=7.00; race/ethnicity: 51.3% White, 28.2% Hispanic/Latino, and 20.5% Another Race/Ethnicity) completed a structured clinical interview to collect detailed information on TBI history and underwent a comprehensive neuropsychological exam. A buccal swab was also collected to determine APOE and BDNF allele status for each participant. Three cognitive composite scores were computed reflecting memory (8 items), attention/processing speed (7 items), and executive functioning (10 items). Two-way analyses of covariance (ANCOVAs) adjusting for age, sex, and race/ethnicity were used to assess the effects of APOE (ε4+ vs. ε4-) and BDNF (Met+ vs. Met-) on cognitive functioning (ε4+/Met-: n=12, ε4+/Met+: n=8, £4-/Met-: n=35, and ε4-/Met+: n=23).
Results:ANCOVAs revealed no significant main effects for APOE or BDNF genotypes on cognitive functioning; however, there was a significant APOE x BDNF genotype interaction for all three cognitive composites (memory: p=.026, np2=.068; attention/processing speed: p=.045, np2=.055; and executive functioning: p=.031, np2=.064). Specifically, the interaction was such that Veterans in the ε4+/Met+ group demonstrated the poorest cognitive functioning relative to all other allele group combinations (ε4+/Met-, ε4-/Met+, ε4-/Met-).
Conclusions:The results of this preliminary study demonstrate that, compared to the other genetic subgroups in the TBI sample, Veterans with APOE £4 and BDNF Met alleles demonstrated the poorest cognitive functioning across several domains known to be negatively affected in the context of head injury (i.e., memory, attention/processing speed, and executive functioning). These findings are the first to show an APOE x BDNF interaction in Veterans with histories of mTBI. Further
research is necessary to replicate and extend this study in larger samples. Moreover, future work should incorporate neuroimaging variables to better interrogate structural and functional correlates of these observed genetic polymorphism associations in Veterans with mTBI histories.
57 CSF Markers of AD-Related Pathology Relate to aMCI among People with HIV
- Judith D. Lobo, Erin E. Sundermann, Laura M. Campbell, Ben Gouaux, Scott Letendre, Mark W. Bondi, David J. Moore
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 53-54
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Objective:
Older people with HIV (PWH) are at-risk for Alzheimer’s disease (AD) and its precursor, amnestic mild cognitive impairment (aMCI). Identifying aMCI among PWH is challenging because memory impairment is also common in HIV-associated neurocognitive disorders (HAND). The neuropathological hallmarks of aMCI/AD are amyloid-ß42 (Aß42) plaque and phosphorylated tau (p-tau) accumulation. Neurofilament light chain protein (NfL) is a marker of neuronal injury in AD and other neurodegenerative diseases. In this study, we assessed the prognostic value of the CSF AD pathology markers of lower Aß42, and higher p-tau, p-tau/Aß42 ratio, and NfL levels to identify an aMCI-like profile among older PWH and differentiating it from HAND. We assessed the relationship between aMCI and HAND diagnosis and AD biomarker levels
Participants and Methods:Participants included 74 PWH (Mean age=48 [SD=8.5]; 87.4% male, 56.5% White) from the National NeuroAIDS Tissue Consortium (NNTC). CSF Aß42, Aß40, p-tau and NfL were measured by commercial immunoassay. Participants completed a neurocognitive evaluation assessing the domains of learning, recall, executive function, speed of information processing, working memory, verbal fluency, and motor. Memory domains were assessed with the Hopkins Verbal Learning Test-Revised and the Brief Visuospatial Memory Test-Revised, and aMCI was defined as impairment (<1.0 SD below normative mean) on two or more memory outcomes among HVLT-R and BVMT-R learning, delayed recall and recognition with at-least one recognition impairment required. HAND was defined as impairment (<1.0 SD below normative mean) in 2 or more cognitive domains. A series of separate linear regression models were used to examine how the levels of CSF p-tau, Aß42, p-tau/Aß42 ratio, and NfL relate to aMCI and HAND status while controlling for demographic variables (age, gender, race and education). Covariates were excluded from the model if they did not reach statistical significance.
Results:58% percent of participants were diagnosed with HAND, 50.5% were diagnosed with aMCI. PWH with aMCI had higher levels of CSF p-tau/Aß42 ratio compared to PWH without aMCI (ß=.222, SE=.001, p=.043) while controlling for age (ß=.363, p=.001). No other AD biomarker significantly differed by aMCI or HAND status.
Conclusions:Our results indicate that the CSF p-tau/Aß42 ratio relates specifically to an aMCI-like profile among PWH with high rates of cognitive impairment across multiple domains in this advanced HIV disease cohort. Thus, the p-tau/Aß42 ratio may have utility in disentangling aMCI from HAND and informing the need for further diagnostic procedures and intervention. Further research is needed to fully identify, among a broader group of PWH, who is at greatest risk for aMCI/AD and whether there is increased risk for aMCI/AD among PWH as compared to those without HIV.
73 Identification of 24-Month Cognitive Trajectories Among Clinical High Risk for Psychosis (CHR-P) Using Latent Class Mixture Modeling
- Ryan M. Guest, Jean Addington, Carrie E. Bearden, Kristin S. Cadenhead, Barbara A. Cornblatt, Daniel H. Mathalon, Diana O. Perkins, Ming T. Tsuang, Scott W. Woods, Tyrone D. Cannon, Matcheri S. Keshavan, William S. Stone, Elaine F. Walker
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 857-858
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Objective:
Cohort studies demonstrate that people who later develop schizophrenia, on average, present with mild cognitive deficits in childhood and endure a decline in adolescence and adulthood. Yet, tremendous heterogeneity exists during the course of psychotic disorders, including the prodromal period. Individuals identified to be in this period (known as CHR-P) are at heightened risk for developing psychosis (~35%) and begin to exhibit cognitive deficits. Cognitive impairments in CHR-P (as a singular group) appear to be relatively stable or ameliorate over time. A sizeable proportion has been described to decline on measures related to processing speed or verbal learning. The purpose of this analysis is to use data-driven approaches to identify latent subgroups among CHR-P based on cognitive trajectories. This will yield a clearer understanding of the timing and presentation of both general and domain-specific deficits.
Participants and Methods:Participants included 684 young people at CHR-P (ages 12–35) from the second cohort of the North American Prodromal Longitudinal Study. Performance on the MATRICS Consensus Cognitive Battery (MCCB) and the Wechsler Abbreviated Scale of Intelligence (WASI-I) was assessed at baseline, 12-, and 24-months. Tested MCCB domains include verbal learning, speed of processing, working memory, and reasoning & problem-solving. Sex- and age-based norms were utilized. The Oral Reading subtest on the Wide Range Achievement Test (WRAT4) indexed pre-morbid IQ at baseline. Latent class mixture models were used to identify distinct trajectories of cognitive performance across two years. One- to 5-class solutions were compared to decide the best solution. This determination depended on goodness-of-fit metrics, interpretability of latent trajectories, and proportion of subgroup membership (>5%).
Results:A one-class solution was found for WASI-I Full-Scale IQ, as people at CHR-P predominantly demonstrated an average IQ that increased gradually over time. For individual domains, one-class solutions also best fit the trajectories for speed of processing, verbal learning, and working memory domains. Two distinct subgroups were identified on one of the executive functioning domains, reasoning and problem-solving (NAB Mazes). The sample divided into unimpaired performance with mild improvement over time (Class I, 74%) and persistent performance two standard deviations below average (Class II, 26%). Between these classes, no significant differences were found for biological sex, age, years of education, or likelihood of conversion to psychosis (OR = 1.68, 95% CI 0.86 to 3.14). Individuals assigned to Class II did demonstrate a lower WASI-I IQ at baseline (96.3 vs. 106.3) and a lower premorbid IQ (100.8 vs. 106.2).
Conclusions:Youth at CHR-P demonstrate relatively homogeneous trajectories across time in terms of general cognition and most individual domains. In contrast, two distinct subgroups were observed with higher cognitive skills involving planning and foresight, and they notably exist independent of conversion outcome. Overall, these findings replicate and extend results from a recently published latent class analysis that examined 12-month trajectories among CHR-P using a different cognitive battery (Allott et al., 2022). Findings inform which individuals at CHR-P may be most likely to benefit from cognitive remediation and can inform about the substrates of deficits by establishing meaningful subtypes.
11 - Patents and Competition
- from Part V - Patent Enforcement, Wireless Markets, and Global Competitiveness
- Edited by Jonathan M. Barnett, University of Southern California, Sean M. O'Connor, George Mason University Antonin Scalia Law School, Virginia
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- Book:
- 5G and Beyond
- Published online:
- 14 December 2023
- Print publication:
- 21 December 2023, pp 242-262
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Summary
Times are changing as our global ecosystem for commercializing innovation helps bring new technologies to market, networks grow, and interconnections and transactions become more complex around standards, all to enable vast opportunities to improve the human condition, to further competition, and to improve broad access. The policies that governments use to structure their legal systems for intellectual property, especially patents, as well as for competition—or antitrust—continue to have myriad powerful impacts and raise intense debates over challenging questions. This chapter explores a representative set of debates about policy approaches to patents, to elucidate particular ideas to bear in mind about how adopting a private law, property rights-based approach to patents enables them to better operate as tools for facilitating the commercialization of new technologies in ways that best promote the goals of increasing access while fostering competition and security for a diverse and inclusive society.
81 The Relationship Between Fist-Edge-Palm Performance and Informant Related Functional Status in Elderly Veterans
- Ian J Moore, Ian D Comnick, Ron Okolichany, Scott Mooney, Prasad Padala
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 282-283
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Objective:
Explore the relationship between a motor programming and sequencing procedure and informant rating of patients' functional abilities, especially driving. The Fist-Edge-Palm (FEP; Luria, 1970; 1980) task has previously demonstrated merit distinguishing between healthy controls and those with neurodegenerative processes (Weiner et al., 2011). However, associations between FEP performance and informant-rated functional status, particularly driving ability, have been minimally reported. This exploratory review examined the relationship between FEP, informant-rated driving ability, overall functional impairment, and neurocognitive diagnostic severity.
Participants and Methods:41 Veterans seen in a South-Central VA Memory Clinic between 08/2020 and 07/2022 served as participants. Neuropsychological assessment included gathering demographic information, chairside neurobehavioral examination (including FEP), cognitive testing, and collateral informant completed Functional Activities Questionnaire (FAQ). Diagnostic severity [no diagnosis, mild cognitive impairment (MCI), dementia (MNCD)] was determined based on the patient's cognitive and functional deficits as measured by neuropsychological testing and informant-rated functional deficits. Correlational analyses were conducted to examine the strength of possible relationships between FEP performance, diagnostic severity, informant-rated functional status including driving impairment. Linear regression analyses determined the extent to which diagnostic severity and FEP performance predict informant-reported driving and ADL impairments
Results:Participants were 97.5% male, 78% white, 22% black. Diagnostically, 3 patients received no diagnoses, 14 with MCI, and 24 with MNCD. Spearman rank correlations were computed; FEP performance was moderately negatively correlated with diagnostic severity [rho = -.35; p < .05] and driving impairment [rho = -.31; p < .05]. Diagnostic severity was moderately positively correlated with driving [rho= .44; p < .05] and total functional [rho = .65; p < .05] impairment. Total functional impairment positively correlated with reported driving impairment [rho = .58; p < .05]. Simple linear regressions tested if FEP performance and diagnostic severity independently predicted informant-reported driving and functional impairment. FEP performance predicted diagnostic severity (R2 = .12, p < .05) and reported driving impairment severity (R2 = .10, p <.05) but did not predict total functional impairment severity (R2 = .06, p = .14). Diagnostic severity predicted both informant-reported driving impairment severity (R2 = .16, p <.05) and functional severity (R2 = .30, p < .05). Multiple regression tested if diagnostic severity and FEP performance together was more predictive of driving and functional impairment than individually; the overall model was predictive of driving (R2 = .19, p < .05) and total functional (R2 = .30, p < .05) impairment, but only diagnostic severity significantly predicted reported driving (B = .63, p < .05) and functional (B = 6.25, p < .05) impairments.
Conclusions:FEP performance was associated with diagnosis and collateral informant concerns of patient driving ability but not statistically related to overall functional impairment or nondriving related ADLs. FEP demonstrates utility in identification of patients demonstrating concerning driving fitness per collateral informants and diagnostic severity due to rapidity of administration, ease of instructing providers, and implementation in a wide variety of clinical settings when a caregiver or informant may not be available. Future directions include explaining the relationship between FEP and driving ability and exploring associations between FEP and other neuropsychological instruments.
3 Development of a Computerized Neurocognitive Battery for Children and Adolescents Affected by Human Immunodeficiency Virus in Botswana
- J. Cobb Scott, Tyler M Moore, Amelia E Van Pelt, Mogomotsi Matshaba, Ontibile Tshume, Onkemetse Phoi, Boitumelo Thuto, Ruben C Gur, Elizabeth D Lowenthal
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 211-212
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Objective:
Children born to mothers infected with human immunodeficiency virus (HIV) during pregnancy experience increased risk of neurocognitive impairment. In Botswana, HIV infection is common, but standardized cognitive testing is limited. The Penn Computerized Neurocognitive Battery (PennCNB) is a widely used cognitive test battery that streamlines evaluation of neurocognitive functioning. Our group translated and culturally adapted the PennCNB for use among children and adolescents in this high-burden, low-resource setting. The current study examined the construct validity and sensitivity to HIV infection and exposure of the culturally adapted PennCNB among a cohort of HIV-affected children and adolescents in Gaborone, Botswana.
Participants and Methods:628 school-aged children aged 7-17 years (n=223 children living with HIV [HIV+]; n=204 HIV exposed, uninfected [HEU]; and 201 HIV unexposed, uninfected [HUU]) completed the PennCNB. Participants were recruited from a clinic specializing in the care and treatment of HIV+ children and adolescents in Gaborone, Botswana, as well as from local schools. Confirmatory factor analyses were performed on efficiency measures for 13 PennCNB tests. Multiple regressions examined associations between HIV and neurocognitive functioning while controlling for age and sex. Multivariate normative comparisons were used to examine rates of overall cognitive impairment by comparing individual profiles of test scores to the multivariate distribution of test scores using age-normed data from the HUU group.
Results:Confirmatory factor analysis supported four hypothesized neurocognitive domains: executive functioning, episodic memory, complex cognition, and sensorimotor/processing speed. As expected, there were main effects of age on cognitive performance across all domains (ps < .001), and there were small sex differences, with females performing better in executive functioning and males performing better on visuospatial processing. Children and adolescents living with HIV performed significantly worse than HUU across all domains (ps < .001), with the largest effect sizes on measures of abstraction, working memory, and processing speed. HEU also performed worse than HUU across several domains, with smaller effect sizes. Multivariate normative comparisons indicated that 27% of the HIV+ group evidenced global neurocognitive impairment.
Conclusions:Overall, results support the validity of a neurocognitive battery adapted for use in Botswana, a non-Western, resource-limited setting. Results indicated that the adapted battery applied to children and adolescents with limited computer familiarity had a similar factor structure as in Western settings, indicating that the PennCNB appeared to assess the hypothesized neurocognitive domains. Hypothesized associations with age and sex supported the battery’s construct validity. Moreover, the battery appears to be sensitive to cognitive impairments associated with perinatally-acquired HIV and in utero HIV-related exposures, as it discriminated between the HUU, HIV+, and HEU groups. Differences were found in specific domains and in detection of overall impairment, including approximately one quarter of children and adolescents living with HIV in this cohort evidencing global neurocognitive impairment. Together, these results provide evidence that the PennCNB could serve as a useful tool for the assessment of neurocognitive functioning in school-aged children and adolescents from Botswana and, potentially, other resource-limited settings.
55 Hoarding Behaviors in Late Life Depression are Associated with Increased Burden of Executive Dysfunction, Disability, and Poorer Response to Depression Treatment
- Michelle T. Kassel, Philip S. Insel, Emma Rhodes, Kai Woodworth, Christina Garrison-Diehn, Derek D. Satre, Duygu Tosun, J. Craig Nelson, Carol A. Mathews, R. Scott Mackin
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 840-841
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Objective:
Late Life Major Depressive Disorder (LLD) and Hoarding Disorder (HD) are common in older adults with prevalence estimates up to 29% and 7%, respectively. Both LLD and HD are characterized by executive dysfunction and disability. There is evidence of overlapping neurobiological dysfunction in LLD and HD suggesting potential for compounded executive dysfunction and disability in the context of comorbid HD and LLD. Yet, prevalence of HD in primary presenting LLD has not been examined and potential compounded impact on executive functioning, disability, and treatment response remains unknown. Thus, the present study aimed to determine the prevalence of co-occurring HD in primary presenting LLD and examine hoarding symptom severity as a contributor to executive dysfunction, disability, and response to treatment for LLD.
Participants and Methods:Eighty-three adults ages 65-90 participating in a psychotherapy study for LLD completed measures of hoarding symptom severity (Savings Inventory-Revised: SI-R), executive functioning (WAIS-IV Digit Span, Letter-Number Sequencing, Coding; Stroop Interference; Trail Making Test-Part B; Letter Fluency), functional ability (World Health Organization Disability Assessment Schedule-II-Short), and depression severity (Hamilton Depression Rating Scale) at post-treatment. Pearson's Chi-squared tests evaluated group differences in cognitive and functional impairment rates and depression treatment response between participants with (HD+LLD) and without (LLD-only) clinically significant hoarding symptoms. Linear regressions were used to examine the association between hoarding symptom severity and executive function performance and functional ability and included as covariates participant age, years of education, gender, and concurrent depression severity.
Results:At post-treatment, 24.1% (20/83) of participants with LLD met criteria for clinically significant hoarding symptoms (SI-R.41). Relative to LLD-only, the LLD+HD group demonstrated greater impairment rates in Letter-Number Sequencing (χ2(1)=4.0, p=.045) and Stroop Interference (χ2(1)=4.8, p=.028). Greater hoarding symptom severity was associated with poorer executive functioning performance on Digit Span (t(71)=-2.4, β=-0.07, p=.019), Letter-Number Sequencing (t(70)=-2.1, β=-0.05, p=.044), and Letter Fluency (t(71)=-2.8, β=-0.24, p=.006). Rates of functional impairment were significantly higher in the LLD+HD (88.0%) group compared to the LLD-only (62.3%) group, (χ2(1)=5.41, p=.020). Additionally, higher hoarding symptom severity was related to greater disability (t(72)=2.97, β=0.13, p=.004). Furthermore, depression treatment response rates were significantly lower in the LLD+HD group at 24.0% (6/25) compared to 48.3% (28/58) in the LLD-only group, χ2(1)=4.26, p=.039.
Conclusions:The present study is among the first to report prevalence of clinically significant hoarding symptoms in primary presenting LLD. The findings of 24.1% co-occurrence of HD in primary presenting LLD and increased burden on executive functioning, disability, and depression treatment outcomes have important implications for intervention and prevention efforts. Hoarding symptoms are likely under-evaluated, and thus may be overlooked, in clinical settings where LLD is identified as the primary diagnosis. Taken together with results indicating poorer depression treatment response in LLD+HD, these findings underscore the need for increased screening of hoarding behaviors in LLD and tailored interventions for this LLD+HD group. Future work examining the course of hoarding symptomatology in LLD (e.g., onset age of hoarding behaviors) may provide insights into the mechanisms associated with greater executive dysfunction and disability.
Invited Symposium 1: Traumatic Brain Injury: Highlighting the Contributions of Dr. Harvey S. Levin Ph.D., ABPP-CN, FACSM 1946 - 2022
- Maya Troyanskaya, Randall Scott Scheibel, Felicia C. Goldstein, Linda Ewing-Cobbs, Erin D. Bigler, Elisabeth A. Wilde
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 399-400
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Harvey S. Levin obtained his Bachelor’s degree from City College of New York, in New York city, Ph.D. in Clinical Psychology from the University of Iowa, in Iowa City, completed his internships in Clinical Neuropsychology and Pediatric Psychology at the University of Iowa Hospitals in Iowa City and Clinical Psychology, Psychiatry and Pediatrics at the Illinois Masonic Medical Center in Chicago, and his fellowship in Neuropsychology at University of Iowa Hospitals in Iowa City.
Dr. Levin started his career in 1972 as Instructor with the Department of Psychology at the University of Iowa and transitioned to The University of Texas Medical Branch (UTMB) in Galveston, Texas, in 1974, where he began an internationally renowned career in clinical work, teaching, and, most of all, pioneering research on traumatic brain injury (TBI). He ultimately became the Chela and Jimmy Storm Distinguished Professor in Surgical Research, Division of Neurosurgery, Department of Surgery in 1987. After leaving Texas for two years to take a position with the University of Maryland Medical System and Shock Trauma Institute in Baltimore, he moved back to Houston Texas in 1995 and established the Cognitive Neuroscience Laboratory (CNL) within the Department of Physical Medicine & Rehabilitation at Baylor College of Medicine, which was supported by federal grants, including funding from the National Institutes of Health, Department of Defense, Department of Veterans Affairs, and Centers for Disease Control and Prevention, and numerous private foundations. The CNL integrated rehabilitation and neuroplasticity research with multimodality brain imaging, clinical and neuropsychological assessment, and fluid biomarkers. Dr. Levin was Professor with the Departments of Physical Medicine and Rehabilitation where he served as Director of Research (1995-2014), Pediatrics, and Neurosurgery at Baylor College of Medicine. He was also a Research Scientist and the Director of the Center of Excellence for Traumatic Brain Injury at the Michael E. DeBakey Veterans Affairs Medical Center (2008-2013), and Adjunct Professor with the Department of Psychology at Rice University in Houston, Texas.
Dr. Levin’s research focused on investigating both acute and long-term outcomes of mild to severe TBI in civilian and military populations, including cognitive and behavioral sequelae in relation to neuropathology using advanced brain imaging modalities. He began prospective, longitudinal studies of adults and children who had sustained TBI associated with closed head trauma upon joining UTMB and developed, in collaboration with Drs O’Donnell and Grossman, the Galveston Orientation and Amnesia Test (GOAT). The GOAT was the first measure to assess post-traumatic amnesia and orientation following moderate to severe TBI, is still most widely used by the clinicians and researchers, and it has been translated to 16 languages. The original publication, “Levin HS, O’Donnell VM, Grossman RG. The Galveston Orientation and Amnesia Test. A practical scale to assess cognition after head injury. J Nerv Ment Dis. 1979 Nov;167(11):675-84. doi: 10.1097/00005053-197911000-00004. PMID: 501342”, has over 1200 citations. This work continued with participation in the NINDS Traumatic Coma Data Bank and the organization of outcome assessments for NINDS-funded clinical trials of hypothermia to treat severe TBI. To monitor the quality of outcome data across performing sites, Dr. Levin and colleagues developed a code for the reliability of data collected and implemented the role of an outcome monitor who evaluated adherence to protocol across sites. Following establishment of the CNL, he pursued investigation of TBI outcomes across the lifespan using multimodality brain imaging and biomarkers, errorless learning, translational studies in collaboration with neuroscientists using animal models, and clinical trials of methylphenidate, progesterone, CDP-choline. Dr. Levin spent over 30 years researching neurobehavioral outcomes of head injury in children, starting with a small pilot study funded by the Shriners Hospital in 1991 and continuing with several cycles of a multicenter R01 grant funded by the National Institute of Health. In later years, he used his expertise as a member of several large consortiums, including the Long-term Impact of Military-Relevant Brain Injury Consortium \ Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) funded by the VA and DoD and the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) funded by the NINDS.
During his career, Dr. Levin authored and coauthored more than 400 articles in scientific journals and over 100 books, with one of them, “Levin, H. S., Benton, A. L., & Grossman, R. G. (1982). Neurobehavioral consequences of closed head injury. Oxford University Press, USA”, having over 1100 citation, as well as book chapters that advanced knowledge of TBI, epilepsy, neurodegenerative diseases, and other illnesses that affect brain functioning. He was also very active as a reviewer on federal grant panels and as an editor and reviewer for the Journal of Neurotrauma, Journal of Clinical and Experimental Neuropsychology, Archives of Physical Medicine & Rehabilitation, Neuropsychology, Journal of the International Neuropsychological Society, Lancet, JAMA, Pediatrics, and other top-cited journals. He served as president of the International Neuropsychological Society in 1989-1990. Dr. Levin was a recipient of numerous prestigious awards, including the Javits Neuroscience Investigator Award, the Jennett-Plum Award for Research on Traumatic Brain Injury, the Distinguished Career Award by the International Neuropsychological Society, the American Congress of Rehabilitation Gold Key Award, the Distinguished Lifetime Contribution to Neuropsychology Award from the National Academy of Neuropsychology, as well as awards from other head injury and psychological organizations, including the International Brain Injury Association, the National Head Injury Foundation, the North American Brain Injury Society, Texas Psychological Association, and the Defense and Veterans Brain Injury Center. In addition to his stellar scientific accomplishments, Dr. Levin trained, mentored, and provided supervision to interns, fellows, postdocs, residents, medical and psychology students. He was the Director of an NCMRR/NIH T32 Postdoctoral Research Program, and training supervisor in neuropsychology for Baylor College of Medicine and for the Memorial Hermann TIRR Neuropsychology Postdoctoral Fellowship Programs. A passionate educator, he taught classes at Baylor College of Medicine, the University of Houston, and the National and Kapodistrian University of Athens Medical School in Greece and served as an evaluator for the American Board of Clinical Neuropsychology/American Board of Professional Psychology. He was often invited as a lecturer at numerous scientific organizations.
The main objective of this symposium is to provide an overview of the current state of research in TBI while highlighting Dr. Levin’s contributions to this field. The symposium will start with a brief overview of Dr. Levin’s career (Dr. Randall S. Scheibel), followed by presentations focused on the assessment of adult TBI, including posttraumatic amnesia (Dr. Felicia C. Goldstein), the current state of pediatric TBI (Dr. L. Ewing-Cobbs), and novel imaging in TBI (Dr. Erin D. Bigler). There will be a brief discussion session at the end lead by Dr. Elisabeth A. Wilde.