Digital Commons Network^™

Interventions To Improve Delivery Of Isoniazid Preventive Therapy: An Overview Of Systematic Reviews, Lisa V. Adams, Elizabeth A. Talbot, Karen Odato, Heather Blunt, Karen R. Steingart

Dartmouth Scholarship

Background:

Uptake of isoniazid preventive therapy (IPT) to prevent tuberculosis has been poor, particularly in the highest risk populations. Interventions to improve IPT delivery could promote implementation. The large number of existing systematic reviews on treatment adherence has made drawing conclusions a challenge. To provide decision makers with the evidence they need, we performed an overview of systematic reviews to compare different organizational interventions to improve IPT delivery as measured by treatment completion among those at highest risk for the development of TB disease, namely child contacts or HIV-infected individuals.

Methods:

We searched the Cochrane Database of Systematic Reviews, the …

A Written Self-Help Intervention For Depressed Adults Comparing Behavioural Activation Combined With Physical Activity Promotion With A Self-Help Intervention Based Upon Behavioural Activation Alone: Study Protocol For A Parallel Group Pilot Randomised Controlled Trial (Bacpac)., Paul Farrand, Claire Pentecost, Colin Greaves, Rs Taylor, Fiona Warren, Colin Green, Melvyn Hillsdon, Phil Evans, Jo Welsman, Ah Taylor

Peninsula Medical School

BACKGROUND: Challenges remain to find ways to support patients with depression who have low levels of physical activity (PA) to overcome perceived barriers and enhance the perceived value of PA for preventing future relapse. There is an evidence-base for behavioural activation (BA) for depression, which focuses on supporting patients to restore activities that have been avoided, but practitioners have no specific training in promoting PA. We aimed to design and evaluate an integrated BA and PA (BAcPAc) practitioner-led, written, self-help intervention to enhance both physical and mental health. METHODS/DESIGN: This study is informed by the Medical Research Council Complex Intervention …

Clinically Relevant Interactions Between Newer Antidepressants And Second-Generation Antipsychotics, Edoardo Spina, Jose De Leon

Psychiatry Faculty Publications

INTRODUCTION: Combinations of newer antidepressants and second-generation antipsychotics (SGAs) are frequently used by clinicians. Pharmacokinetic drug interaction (PK DI) and poorly understood pharmacodynamic (PD) drug interaction (PD DI) can occur between them.

AREAS COVERED: This paper comprehensively reviews PD DI and PK DI studies.

EXPERT OPINION: More PK DI studies are needed to better establish dose correction factors after adding fluoxetine and paroxetine to aripiprazole, iloperidone and risperidone. Further PK DI studies and case reports are also needed to better establish the need for dose correction factors after adding i) fluoxetine to clozapine, lurasidone, quetiapine and olanzapine; ii) paroxetine to …

A Refresher On Tourette Syndrome., James R. Batterson, Shayla Sullivant, Jean-Baptist Lepichon, Christy Kleinsorge, Sandy Price, Stephanie Andrews

Manuscripts, Articles, Book Chapters and Other Papers

Tourette Syndrome (TS) is recognized as a more common neurodevelopmental disorder than once thought. In this article we present an update on TS including the DSM-5 revised criteria, new findings in the genetics of TS, treatment advances such as new medications for tics and the use of new tools including Cognitive Behavioral Intervention for Tics (CBIT). We also explore supportive services for the ongoing care of patients using nursing education and family therapy.

Why 'Down Under' Is A Cut Above: A Comparison Of Rates Of And Reasons For Caesarean Section In England And Australia, Samantha J. Prosser, Yvette D. Miller, Rachel Thompson, Maggie Redshaw

Dartmouth Scholarship

Background: Most studies examining determinants of rising rates of caesarean section have examined patterns in documented reasons for caesarean over time in a single location. Further insights could be gleaned from cross-cultural research that examines practice patterns in locations with disparate rates of caesarean section at a single time point.

Methods: We compared both rates of and main reason for pre-labour and intrapartum caesarean between England and Queensland, Australia, using data from retrospective cross-sectional surveys of women who had recently given birth in England (n = 5,250) and Queensland (n = 3,467).

Normal Acquisition Of Expertise With Greebles In Two Cases Of Acquired Prosopagnosia, Constantin Rezlescu, Jason J. S. Barton, David Pitcher, Bradley Duchaine

Dartmouth Scholarship

Face recognition is generally thought to rely on different neurocognitive mechanisms than most types of objects, but the specificity of these mechanisms is debated. One account suggests the mechanisms are specific to upright faces, whereas the expertise view proposes the mechanisms operate on objects of high within-class similarity with which an observer has become proficient at rapid individuation. Much of the evidence cited in support of the expertise view comes from laboratory-based training experiments involving computer-generated objects called greebles that are designed to place face-like demands on recognition mechanisms. A fundamental prediction of the expertise hypothesis is that recognition deficits …

Effector-Independent Motor Sequence Representations Exist In Extrinsic And Intrinsic Reference Frames., Tobias Wiestler, Sheena Waters-Metenier, Jörn Diedrichsen

Brain and Mind Institute Researchers' Publications

Many daily activities rely on the ability to produce meaningful sequences of movements. Motor sequences can be learned in an effector-specific fashion (such that benefits of training are restricted to the trained hand) or an effector-independent manner (meaning that learning also facilitates performance with the untrained hand). Effector-independent knowledge can be represented in extrinsic/world-centered or in intrinsic/body-centered coordinates. Here, we used functional magnetic resonance imaging (fMRI) and multivoxel pattern analysis to determine the distribution of intrinsic and extrinsic finger sequence representations across the human neocortex. Participants practiced four sequences with one hand for 4 d, and then performed these sequences …

Exploration And Confirmation Of The Latent Variable Structure Of The Jefferson Scale Of Empathy., Mohammadreza Hojat, Marianna Lanoue

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE: To reaffirm the underlying components of the JSE by using exploratory factor analysis (EFA), and to confirm its latent variable structure by using confirmatory factor analysis (CFA).

METHODS: Research participants included 2,612 medical students who entered Jefferson Medical College between 2002 and 2012. This sample was divided into two groups: Matriculants between 2002 and 2007 (n=1,380) and be-tween 2008 and 2012 (n=1,232). Data for 2002-2007 matriculants were subjected to EFA (principal component factor extraction), and data for matriculants of 2008-2012 were used for CFA (structural equation modeling, and root mean square error for approximation.

RESULTS: The EFA resulted in …

A Dedicated Binding Mechanism For The Visual Control Of Movement., Alexandra Reichenbach, David W Franklin, Peter Zatka-Haas, Jörn Diedrichsen

Brain and Mind Institute Researchers' Publications

The human motor system is remarkably proficient in the online control of visually guided movements, adjusting to changes in the visual scene within 100 ms [1-3]. This is achieved through a set of highly automatic processes [4] translating visual information into representations suitable for motor control [5, 6]. For this to be accomplished, visual information pertaining to target and hand need to be identified and linked to the appropriate internal representations during the movement. Meanwhile, other visual information must be filtered out, which is especially demanding in visually cluttered natural environments. If selection of relevant sensory information for online control …

The N400 As An Index Of Racial Stereotype Accessibility, Eric Hehman, Hannah I. Volpert, Robert F. Simons

Dartmouth Scholarship

The current research examined the viability of the N400, an event-related potential (ERP) related to the detection of semantic incongruity, as an index of both stereotype accessibility and interracial prejudice. Participants’ EEG was recorded while they completed a sequential priming task, in which negative or positive, stereotypically black (African American) or white (Caucasian American) traits followed the presentation of either a black or white face acting as a prime. ERP examination focused on the N400, but additionally examined N100 and P200 reactivity. Replicating and extending previous N400 stereotype research, results indicated that the N400 can indeed function as an index …

Influence Of The X-Chromosome On Neuroanatomy: Evidence From Turner And Klinefelter Syndromes., David S Hong, Fumiko Hoeft, Matthew J Marzelli, Jean-Francois Lepage, David Roeltgen, Judith L. Ross, Allan L Reiss

Department of Psychiatry and Human Behavior Faculty Papers

Studies of sex effects on neurodevelopment have traditionally focused on animal models investigating hormonal influences on brain anatomy. However, more recent evidence suggests that sex chromosomes may also have direct upstream effects that act independently of hormones. Sex chromosome aneuploidies provide ideal models to examine this framework in humans, including Turner syndrome (TS), where females are missing one X-chromosome (45X), and Klinefelter syndrome (KS), where males have an additional X-chromosome (47XXY). As these disorders essentially represent copy number variants of the sex chromosomes, investigation of brain structure across these disorders allows us to determine whether sex chromosome gene dosage effects …

Investigating The Relation Between Striatal Volume And Iq., Penny A Macdonald, Hooman Ganjavi, D Louis Collins, Alan C Evans, Sherif Karama

Brain and Mind Institute Researchers' Publications

The volume of the input region of the basal ganglia, the striatum, is reduced with aging and in a number of conditions associated with cognitive impairment. The aim of the current study was to investigate the relation between the volume of striatum and general cognitive ability in a sample of 303 healthy children that were sampled to be representative of the population of the United States. Correlations between the WASI-IQ and the left striatum, composed of the caudate nucleus and putamen, were significant. When these data were analyzed separately for male and female children, positive correlations were significant for the …

Headstrong Intervention For Pediatric Migraine Headache: A Randomized Clinical Trial., Michael A. Rapoff, Mark Connelly, Jennifer Bickel, Scott W. Powers, Andrew D. Hershey, Janelle R. Allen, Cynthia W. Karlson, Catrina C. Litzenburg, John M. Belmont

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The purpose of this study was to evaluate the efficacy of a self-guided CD-ROM program ("Headstrong") containing cognitive-behavioral self-management strategies versus an educational CD-ROM program for treating headaches, headache-related disability, and quality of life.

METHODS: Participants were 35 children ages 7-12 years with migraine recruited from one university medical center and two children's hospital headache clinics. Participants were randomly assigned to complete the Headstrong or educational control CD-ROM program over a 4-week period. Data on headache frequency, duration, and severity, migraine-related disability, and quality of life (QOL) were obtained at baseline, post-intervention, and 3-months post-intervention.

RESULTS: At post-intervention, Headstrong …

Attention, Predictive Learning, And The Inverse Base-Rate Effect: Evidence From Event-Related Potentials., Andy J. Wills, Aureliu Lavric, Yvonne Hemmings, Ed Surrey

School of Psychology

We report the first electrophysiological investigation of the inverse base-rate effect (IBRE), a robust non-rational bias in predictive learning. In the IBRE, participants learn that one pair of symptoms (AB) predicts a frequently occurring disease, whilst an overlapping pair of symptoms (AC) predicts a rarely occurring disease. Participants subsequently infer that BC predicts the rare disease, a non-rational decision made in opposition to the underlying base rates of the two diseases. Error-driven attention theories of learning state that the IBRE occurs because C attracts more attention than B. On the basis of this account we predicted and observed the occurrence …

Characteristics Of Acute Care Utilization Of A Delaware Adult Sickle Cell Disease Patient Population., Nina Anderson, Jennifer L. Bellot, Oluseyi Senu-Oke, Samir K. Ballas

Department of Nursing papers and presentations

Sickle cell disease (SCD) is an inherited blood disorder that is chronic in nature and manifests itself through many facets of the patient's life. Comprehensive specialty centers have the potential to reduce health care costs and improve the quality of care for patients who have chronic medical conditions such as heart failure and SCD. The purpose of this practice inquiry was to analyze de-identified data for acute care episodes involving SCD in order to create a detailed picture of acute care utilization for adult patients in Delaware with SCD from 2007 to 2009. Gaining a better understanding of acute care …

Predicting The Risk Of Suicide By Analyzing The Text Of Clinical Notes, Chris Poulin, Brian Shiner, Paul Thompson, Linas Vepstas, Yinong Young-Xu, Benjamin Goertzel, Bradley Watts, Laura Flashman, Thomas Mcallister

Dartmouth Scholarship

We developed linguistics-driven prediction models to estimate the risk of suicide. These models were generated from unstructured clinical notes taken from a national sample of U.S. Veterans Administration (VA) medical records. We created three matched cohorts: veterans who committed suicide, veterans who used mental health services and did not commit suicide, and veterans who did not use mental health services and did not commit suicide during the observation period (n = 70 in each group). From the clinical notes, we generated datasets of single keywords and multi-word phrases, and constructed prediction models using a machine-learning algorithm based on a …

Primate Energy Eexpenditure And Life History, Herman Pontzer, David A. Raichlen, Adam D. Gordon, Kara K. Schroepfer-Walker, Brian Hare, Matthew C. O’Neill, Kathleen M. Muldoon

Dartmouth Scholarship

Humans and other primates are distinct among placental mammals in having exceptionally slow rates of growth, reproduction, and aging. Primates’ slow life history schedules are generally thought to reflect an evolved strategy of allocating energy away from growth and reproduction and toward somatic investment, particularly to the development and maintenance of large brains. Here we examine an alternative explanation: that primates’ slow life histories reflect low total energy expenditure (TEE) (kilocalories per day) relative to other placental mammals. We compared doubly labeled water measurements of TEE among 17 primate species with similar measures for other placental mammals. We found that …

Backward Position Shift In Apparent Motion, Hsin-Hung Li, Won Mok Shim, Patrick Cavanagh

Dartmouth Scholarship

We investigated the perceived position of visual targets in apparent motion. A disc moved horizontally through three positions from -10° to +10° in the far periphery (20° above fixation), generating a compelling impression of apparent motion. In the first experiment, observers compared the position of the middle of the three discs to a subsequently presented reference. Unexpectedly, observers judged its position to be shifted backward, in the direction opposite that of the motion. We then tested the middle disc in sequences of 3, 5, and 7 discs, each covering the same spatial and temporal extents (similar speeds). The backwards shift …

Investigating The Early Stages Of Person Perception: The Asymmetry Of Social Categorization By Sex Vs. Age, Jasmin Cloutier, Jonathan B. Freeman, Nalini Ambady

Dartmouth Scholarship

The wealth of information provided by facial cues presents challenges to our understanding of these early stages of person perception. The current study aimed to uncover the dynamics of processing multiply categorizable faces, notably as a function of their gender and age. Using a modified four-choice version of a mouse-tracking paradigm (which assesses the relative dominance of two categorical dimensions), the relative influence that sex and age have on each other during categorization of infant, younger adult, and older adult faces was investigated. Results of these experiments demonstrate that when sex and age dimensions are simultaneously categorized, only for infant …

Bihemispheric Transcranial Direct Current Stimulation Enhances Effector-Independent Representations Of Motor Synergy And Sequence Learning., Sheena Waters-Metenier, Masud Husain, Tobias Wiestler, Jörn Diedrichsen

Brain and Mind Institute Researchers' Publications

Complex manual tasks-everything from buttoning up a shirt to playing the piano-fundamentally involve two components: (1) generating specific patterns of muscle activity (here, termed "synergies"); and (2) stringing these into purposeful sequences. Although transcranial direct current stimulation (tDCS) of the primary motor cortex (M1) has been found to increase the learning of motor sequences, it is unknown whether it can similarly facilitate motor synergy learning. Here, we determined the effects of tDCS on the learning of motor synergies using a novel hand configuration task that required the production of difficult muscular activation patterns. Bihemispheric tDCS was applied to M1 of …

Assessments Of Empathy In Medical School Admissions: What Additional Evidence Is Needed?, Mohammadreza Hojat

Department of Psychiatry and Human Behavior Faculty Papers

The Association for the Study of Medical Education (ASME) sponsored a symposium on the theme of Examin-ing the Evidence with Regard to Character, Personality and Values in Medical School Selection which was held on October 14, 2013 at the University of Sheffield Medical School in the United Kingdom. I was invited to speak about credibility issues related to personality assessments in health profession educations. To my pleasant surprise, I found the European audience receptive (more than their counterparts in the United States) to the idea of using personality assess-ments in admission decisions. There seems to be a hesita-tion among leaders …

Revealing Variations In Perception Of Mental States From Dynamic Facial Expressions: A Cautionary Note, Elisa Back, Timothy R. Jordan

All Works

Although a great deal of research has been conducted on the recognition of basic facial emotions (e.g., anger, happiness, sadness), much less research has been carried out on the more subtle facial expressions of an individual's mental state (e.g., anxiety, disinterest, relief). Of particular concern is that these mental state expressions provide a crucial source of communication in everyday life but little is known about the accuracy with which natural dynamic facial expressions of mental states are identified and, in particular, the variability in mental state perception that is produced. Here we report the findings of two studies that investigated …

The Mammalian Neocortex New Pyramidal Neuron: A New Conception, Miguel Marín-Padilla

Dartmouth Scholarship

The new cerebral cortex (neocortex) and the new type of pyramidal neuron are mammalian innovations that have evolved for operating their increasing motor capabilities while essentially using analogous anatomical and neural makeups. The human neocortex starts to develop in 6-week-old embryos with the establishment of a primordial cortical organization, which resembles the primitive cortices of amphibian and reptiles. From the 8th to the 15th week of age, new pyramidal neurons, of ependymal origin, are progressively incorporated within this primordial cortex forming a cellular plate that divides its components into those above it (neocortex first layer) and those below it (neocortex …

Proposed Guidelines For The Diagnosis And Management Of Methylmalonic And Propionic Acidemia., Matthias R Baumgartner, Friederike Hörster, Carlo Dionisi-Vici, Goknur Haliloglu, Daniela Karall, Kimberly A. Chapman, +19 Additional Authors

Pediatrics Faculty Publications

Methylmalonic and propionic acidemia (MMA/PA) are inborn errors of metabolism characterized by accumulation of propionic acid and/or methylmalonic acid due to deficiency of methylmalonyl-CoA mutase (MUT) or propionyl-CoA carboxylase (PCC). MMA has an estimated incidence of ~ 1: 50,000 and PA of ~ 1:100'000 -150,000. Patients present either shortly after birth with acute deterioration, metabolic acidosis and hyperammonemia or later at any age with a more heterogeneous clinical picture, leading to early death or to severe neurological handicap in many survivors. Mental outcome tends to be worse in PA and late complications include chronic kidney disease almost exclusively in MMA …

The Impact Of Multisensory Integration Deficits On Speech Perception In Children With Autism Spectrum Disorders., Ryan A Stevenson, Magali Segers, Susanne Ferber, Morgan D Barense, Mark T Wallace

Brain and Mind Institute Researchers' Publications

Speech perception is an inherently multisensory process. When having a face-to-face conversation, a listener not only hears what a speaker is saying, but also sees the articulatory gestures that accompany those sounds. Speech signals in visual and auditory modalities provide complementary information to the listener (Kavanagh and Mattingly, 1974), and when both are perceived in unison, behavioral gains in in speech perception are observed (Sumby and Pollack, 1954). Notably, this benefit is accentuated when speech is perceived in a noisy environment (Sumby and Pollack, 1954). To achieve a behavioral gain from multisensory processing of speech, however, the auditory and visual …

Observing Object Lifting Errors Modulates Cortico-Spinal Excitability And Improves Object Lifting Performance., Gavin Buckingham, Jeremy D Wong, Minnie Tang, Paul L Gribble, Melvyn A Goodale

Brain and Mind Institute Researchers' Publications

Observing the actions of others has been shown to modulate cortico-spinal excitability and affect behaviour. However, the sensorimotor consequences of observing errors are not well understood. Here, participants watched actors lift identically weighted large and small cubes which typically elicit expectation-based fingertip force errors. One group of participants observed the standard overestimation and underestimation-style errors that characterise early lifts with these cubes (Error video--EV). Another group watched the same actors performing the well-adapted error-free lifts that characterise later, well-practiced lifts with these cubes (No error video--NEV). We then examined actual object lifting performance in the subjects who watched the EV …

Sign Language Ability In Young Deaf Signers Predicts Comprehension Of Written Sentences In English., Kathy N Andrew, Jennifer Hoshooley, Marc F Joanisse

Brain and Mind Institute Researchers' Publications

We investigated the robust correlation between American Sign Language (ASL) and English reading ability in 51 young deaf signers ages 7;3 to 19;0. Signers were divided into 'skilled' and 'less-skilled' signer groups based on their performance on three measures of ASL. We next assessed reading comprehension of four English sentence structures (actives, passives, pronouns, reflexive pronouns) using a sentence-to-picture-matching task. Of interest was the extent to which ASL proficiency provided a foundation for lexical and syntactic processes of English. Skilled signers outperformed less-skilled signers overall. Error analyses further indicated greater single-word recognition difficulties in less-skilled signers marked by a higher …

Links Between White Matter Microstructure And Cortisol Reactivity To Stress In Early Childhood: Evidence For Moderation By Parenting., Haroon I Sheikh, Marc F Joanisse, Sarah M Mackrell, Katie R Kryski, Heather J Smith, Shiva M Singh, Elizabeth P Hayden

Brain and Mind Institute Researchers' Publications

Activity of the hypothalamic-pituitary-adrenal axis (measured via cortisol reactivity) may be a biological marker of risk for depression and anxiety, possibly even early in development. However, the structural neural correlates of early cortisol reactivity are not well known, although these would potentially inform broader models of mechanisms of risk, especially if the early environment further shapes these relationships. Therefore, we examined links between white matter architecture and young girls' cortisol reactivity and whether early caregiving moderated these links. We recruited 45 6-year-old girls based on whether they had previously shown high or low cortisol reactivity to a stress task at …

Rule-Based Category Learning In Children: The Role Of Age And Executive Functioning., Rahel Rabi, John Paul Minda

Brain and Mind Institute Researchers' Publications

Rule-based category learning was examined in 4-11 year-olds and adults. Participants were asked to learn a set of novel perceptual categories in a classification learning task. Categorization performance improved with age, with younger children showing the strongest rule-based deficit relative to older children and adults. Model-based analyses provided insight regarding the type of strategy being used to solve the categorization task, demonstrating that the use of the task appropriate strategy increased with age. When children and adults who identified the correct categorization rule were compared, the performance deficit was no longer evident. Executive functions were also measured. While both working …

There Are Laterality Effects In Memory Functioning In Children/Adolescents With Focal Epilepsy., Michelle Y Kibby, Morris J Cohen, Sylvia E Lee, Lisa Stanford, Yong D Park, Suzanne M Strickland

Publications

In a sample of individuals with childhood focal epilepsy, children/adolescents with left hemisphere foci outperformed those with right foci on both measures of nonverbal learning. Participants with left foci performed worse than controls on paired associate delayed recall and semantic memory, and they had greater laterality effects in IQ. Participants with right foci performed worse than controls on delayed facial recognition. Both groups displayed reduced focused attention and poor passage retention over time. Although participants with bilateral foci displayed poor learning and lower IQ than controls, they did not have worse impairment than those with a unilateral focus.