Publications by authors named "Lauren Thomas"

27 Publications

  • Page 1 of 1

Prenatal environmental tobacco smoke exposure alters children's cognitive control circuitry: A preliminary study.

Environ Int 2021 May 6;155:106516. Epub 2021 May 6.

The Division of Child and Adolescent Psychiatry in the Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA.

Background And Objectives: Prenatal exposure to environmental tobacco smoke (ETS) is associated with increased attention problems in children, however, the effects of such exposure on children's brain structure and function have not been studied. Herein, we probed effects of prenatal ETS on children's cognitive control circuitry and behavior.

Methods: Forty-one children (7-9 years) recruited from a prospective longitudinal birth cohort of non-smoking mothers completed structural and task-functional magnetic resonance imaging to evaluate effects of maternal ETS exposure, measured by maternal prenatal urinary cotinine. Attention problems and externalizing behaviors were measured by parent report on the Child Behavior Checklist.

Results: Compared to non-exposed children, exposed children had smaller left and right thalamic and inferior frontal gyrus (IFG) volumes, with large effect sizes (p-FDR < .05, Cohen's D range from 0.79 to 1.07), and increased activation in IFG during the resolution of cognitive conflict measured with the Simon Spatial Incompatibility Task (38 voxels; peak t(25) = 5.25, p-FWE = .005). Reduced thalamic volume was associated with increased IFG activation and attention problems, reflecting poor cognitive control. Mediation analyses showed a trend toward left thalamic volume mediating the association between exposure and attention problems (p = .05).

Conclusions: Our findings suggest that maternal ETS exposure during pregnancy has deleterious effects on the structure and function of cognitive control circuitry which in turn affects attentional capacity in school-age children. These findings are consistent with prior findings documenting the effects of active maternal smoking on chidlren's neurodevleoment, pointing to the neurotixicity of nicotine regardless of exposure pathway.
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http://dx.doi.org/10.1016/j.envint.2021.106516DOI Listing
May 2021

Contributions of Cerebellar White Matter Microstructure to Social Difficulty in Nonverbal Learning Disability.

Cerebellum 2021 Apr 15. Epub 2021 Apr 15.

New York State Psychiatric Institute and Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Box 74 / Room 2403, New York, NY, 10032, USA.

Emerging evidence suggests that the cerebellum may contribute to variety of cognitive capacities, including social cognition. Nonverbal learning disability (NVLD) is characterized by visual-spatial and social impairment. Recent functional neuroimaging studies have shown that children with NVLD have altered cerebellar resting-state functional connectivity, which is associated with various symptom domains. However, little is known about cerebellar white matter microstructure in NVLD and whether it contributes to social deficits. Twenty-seven children (12 with NVLD, 15 typically developing (TD)) contributed useable diffusion tensor imaging data. Tract-based spatial statistics (TBSS) were used to quantify fractional anisotropy (FA) in the cerebellar peduncles. Parents completed the Child Behavior Checklist, providing a measure of social difficulty. Children with NVLD had greater fractional anisotropy in the left and right inferior cerebellar peduncle. Furthermore, right inferior cerebellar peduncle FA was associated with social impairment as measured by the Child Behavior Checklist Social Problems subscale. Finally, the association between NVLD diagnosis and greater social impairment was mediated by right inferior cerebellar peduncle FA. These findings provide additional evidence that the cerebellum contributes both to social cognition and to the pathophysiology of NVLD.
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http://dx.doi.org/10.1007/s12311-021-01265-4DOI Listing
April 2021

Dermatological services; patient profiling in a rural tertiary hospital.

Australas J Dermatol 2021 May 17;62(2):195-198. Epub 2021 Mar 17.

Dermatology Department, Royal Darwin Hospital, Casuarina, Australia.

Background/objectives: There is a paucity of research available regarding the epidemiology of patients attending dermatology outpatient services in Australia. Our objective was to analyse who was attending public dermatology outpatient clinics in a Northern Territory tertiary hospital, with a particular focus on Indigenous and rural patients.

Methods: This is a retrospective cohort study of patients who attended dermatology outpatient clinics between 1 January 2016 and 31 December 2016. Outcome measures included patient demographics (age, gender, ethnicity and postcode) and referrer details.

Results: Over the 12 month study period, 923 appointments were scheduled for 500 patients. Of the appointments scheduled, 667 were attended. Twelve per cent of patients were Indigenous, and of the total appointment attendances, 10% were by Indigenous patients. Of the 923 appointments, 28% were not attended, with a higher non-attendance rate for Indigenous patients at 36%. The majority of patients seen were adults, for both groups, but a larger proportion of Indigenous children were seen. Nine per cent of patients with a recorded address were from a remote region.

Conclusion: Dermatology outpatient services are likely under-utilised by Indigenous, and remote patients. If we are to improve skin health in Australia, barriers such as limited access to dermatological services in remote regions must be addressed.
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http://dx.doi.org/10.1111/ajd.13548DOI Listing
May 2021

Survivors of Acute Lung Injury Have Greater Impairments in Strength and Exercise Capacity Than Survivors of Other Critical Illnesses as Measured Shortly After ICU Discharge.

J Intensive Care Med 2020 Dec 17:885066620981899. Epub 2020 Dec 17.

School of Physiotherapy and Exercise Science, Faculty of Health Sciences, 1649Curtin University, Perth, Australia.

Purpose: To compare the physical function on ICU discharge in adults who survived an ICU admission for acute lung injury (ALI) with those admitted for a critical illness other than ALI.

Materials And Methods: Two groups were recruited, (i) those who survived an ICU admission for ALI and, (ii) those who survived an ICU admission for a critical illness other than ALI. Within 7 days of discharge from ICU, in all participants, measures were collected of peripheral muscle strength, balance, walking speed and functional exercise capacity.

Results: Recruitment was challenging and ceased prior to achieving the desired sample size. Participants with ALI (n = 22) and critical illness (n = 33) were of similar median age (50 vs. 57 yr, = 0.09), sex proportion (males %, 45 vs. 58, = 0.59) and median APACHE II score (21.5 vs. 23.0, = 0.74). Compared with the participants with critical illness, those with ALI had lower hand grip (mean ± SD, 18 ± 9 vs. 13 ± 8 kg, = 0.018) and shoulder flexion strength (10 ± 4 vs. 7 ± 3 kg, = 0.047), slower 10-meter walk speed (median [IQR], 1.03 [0.78 to 1.14] vs. 0.78 [0.67 to 0.94] m/s, = 0.039) and shorter 6-minute walk distance (265 [71 to 328] vs. 165 [53 to 220] m, = 0.037). The Berg balance scores were similar in both groups.

Conclusions: Compared with survivors of a critical illness that is not ALI, those with ALI are likely to have greater physical impairment when measured shortly after discharge to the ward.
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http://dx.doi.org/10.1177/0885066620981899DOI Listing
December 2020

Which types of conditions should be included in reproductive genetic carrier screening? Views of parents of children with a genetic condition.

Eur J Med Genet 2020 Dec 30;63(12):104075. Epub 2020 Sep 30.

Department of Paediatrics, University of Melbourne, Australia; Victorian Clinical Genetics Services, Australia; Murdoch Children's Research Institute, Australia. Electronic address:

Reproductive genetic carrier screening identifies couples with an increased chance of having children with autosomal and X-linked recessive conditions. Initially only offered for single conditions to people with a high priori risk, carrier screening is becoming increasingly offered to individuals/couples in the general population for a wider range of genetic conditions. Despite advances in genomic testing technology and greater availability of carrier screening panels, there is no consensus around which types of conditions to include in carrier screening panels. This study sought to identify which types of conditions parents of children with a genetic condition believe should be included in carrier screening. Participants (n = 150) were recruited through Royal Children's Hospital (RCH) Melbourne outpatient clinics, the Genetic Support Network of Victoria (GSNV) and a databank of children with hearing loss (VicCHILD). This study found that the majority of participants support offering carrier screening for: neuromuscular conditions (n = 128/134, 95.5%), early fatal neurodegenerative conditions (n = 130/141, 92.2%), chronic multi-system disorders (n = 124/135, 91.9%), conditions which cause intellectual disability (n = 128/139, 92.1%) and treatable metabolic conditions (n = 120/138, 87.0%). Views towards the inclusion of non-syndromic hearing loss (n = 88/135, 65.2%) and preventable adult-onset conditions (n = 75/135, 55.6%) were more mixed. Most participants indicated that they would use reproductive options to avoid having a child with the more clinically severe conditions, but most would not do so for clinically milder conditions. A recurring association was observed between participants' views towards carrier screening and their lived experience of having a child with a genetic condition.
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http://dx.doi.org/10.1016/j.ejmg.2020.104075DOI Listing
December 2020

Management of Dyslipidemia for Cardiovascular Disease Risk Reduction: Synopsis of the 2020 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline.

Ann Intern Med 2020 11 22;173(10):822-829. Epub 2020 Sep 22.

South Texas Veterans Health Care System and University of Texas Health Science Center, San Antonio, Texas (L.S., J.R.D.).

Description: In June 2020, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) released a joint update of their clinical practice guideline for managing dyslipidemia to reduce cardiovascular disease risk in adults. This synopsis describes the major recommendations.

Methods: On 6 August to 9 August 2019, the VA/DoD Evidence-Based Practice Work Group (EBPWG) convened a joint VA/DoD guideline development effort that included clinical stakeholders and conformed to the Institute of Medicine's tenets for trustworthy clinical practice guidelines. The guideline panel developed key questions, systematically searched and evaluated the literature (English-language publications from 1 December 2013 to 16 May 2019), and developed 27 recommendations and a simple 1-page algorithm. The recommendations were graded by using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.

Recommendations: This synopsis summarizes key features of the guideline in 7 crucial areas: targeting of statin dose (not low-density lipoprotein cholesterol goals), additional tests for risk prediction, primary and secondary prevention, laboratory testing, physical activity, and nutrition.
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http://dx.doi.org/10.7326/M20-4648DOI Listing
November 2020

Altered structure and functional connectivity of the hippocampus are associated with social and mathematical difficulties in nonverbal learning disability.

Hippocampus 2021 Jan 19;31(1):79-88. Epub 2020 Sep 19.

The Division of Child and Adolescent Psychiatry, Department of Psychiatry, The New York State Psychiatric Institute and the College of Physicians & Surgeons, Columbia University, New York, New York, USA.

The hippocampus is known to play a critical role in a variety of complex abilities, including visual-spatial reasoning, social functioning, and math. Nonverbal learning disability (NVLD) is a neurodevelopmental disorder characterized by deficits in visual-spatial reasoning that are accompanied by impairment in social function or mathematics, as well as motor or executive function skills. Despite the overlap between behaviors supported by the hippocampus and impairments in NVLD, the structure and function of the hippocampus in NVLD has not been studied. To address this gap in the literature, we first compared hippocampal volume and resting-state functional connectivity in children with NVLD (n = 24) and typically developing (TD) children (n = 20). We then explored associations between hippocampal structure, connectivity, and performance on measures of spatial, social, and mathematical ability. Relative to TD children, those with NVLD showed significant reductions in left hippocampal volume and greater hippocampal-cerebellar connectivity. In children with NVLD, reduced hippocampal volume associated with worse mathematical problem solving. Although children with NVLD exhibited more social problems (social responsiveness scale [SRS]) and higher hippocampal-cerebellar connectivity relative to TD children, greater connectivity was associated with fewer social problems among children with NVLD but not TD children. Such an effect may suggest a compensatory mechanism. These structural and functional alterations of the hippocampus may disrupt its putative role in organizing conceptual frameworks through cognitive mapping, thus contributing to the cross-domain difficulties that characterize NVLD.
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http://dx.doi.org/10.1002/hipo.23264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749072PMC
January 2021

Complicated skin and soft tissue infections in remote indigenous communities.

Intern Med J 2020 06;50(6):752-754

Menzies School of Health Research, Darwin, Northern Territory, Australia.

The burden and consequences of skin infections for remote living indigenous people are high. While skin infections are recognised as an antecedent to conditions such as acute rheumatic fever in children, data are limited concerning skin infection complications such as cellulitis, abscesses and osteomyelitis in older children and adults. In a 1-year retrospective audit of 439 patients presenting to two remote health clinics, 330/439 (75%) patients presented with a skin infection and 18 (4%) developed a complication.
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http://dx.doi.org/10.1111/imj.14858DOI Listing
June 2020

Mucormycosis in a 40-year-old woman with diabetic ketoacidosis.

CMAJ 2020 04;192(16):E431-E433

Departments of General Medicine (Thomas) and Infectious Diseases (Tay), Endocrinology (Howard), Royal Darwin Hospital, Darwin, Australia; Departments of Molecular Medicine and Surgery, and Endocrinology, Metabolism and Diabetes (Falhammar), Karolinska University Hospital, Stockholm, Sweden.

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http://dx.doi.org/10.1503/cmaj.191364DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7207186PMC
April 2020

Estimated Prevalence of Nonverbal Learning Disability Among North American Children and Adolescents.

JAMA Netw Open 2020 04 1;3(4):e202551. Epub 2020 Apr 1.

Center for the Developing Brain, Child Mind Institute, New York, New York.

Importance: Nonverbal learning disability (NVLD) is a neurodevelopmental disorder characterized by deficits in visual-spatial processing but not in reading or verbal ability; in addition, problems in math calculation, visual executive functioning, fine-motor skills, and social skills are often present. To our knowledge, there are no population-based estimates of the prevalence of NVLD in community samples.

Objective: To estimate the prevalence of the NVLD cognitive profile in 3 independent samples of children and adolescents from studies centered around brain imaging in the US and Canada.

Design, Setting, And Participants: This cross-sectional study used data from 2 samples recruited from the community and overselected for children with psychiatric disorders (Healthy Brain Network [HBN], January 1, 2015, to December 31, 2019, and Nathan Kline Institute-Rockland Sample [NKI], January 1, 2011, to December 31, 2018) and 1 community-ascertained population sample (Saguenay Youth Study [SYS], January 1, 2003, to December 31, 2012) overselected for active maternal smoking during pregnancy.

Main Outcomes And Measures: Prevalence of NVLD. Criteria for NVLD were based on clinical records of deficits in visual-spatial reasoning and impairment in 2 of 4 domains of function (fine-motor skills, math calculation, visual executive functioning, and social skills). Sample weighting procedures adjusted for demographic differences in sample frequencies compared with underlying target populations. Inflation factor weights accounted for overrepresentation of psychiatric disorders (HBN and NKI samples).

Results: Across 3 independent samples, the prevalence of NVLD was estimated among 2596 children and adolescents aged 6 to 19 years (mean [SD] age, 12.5 [3.4] years; 1449 male [55.8%]). After sample and inflation weights were applied, the prevalence of NVLD was 2.78% (95% CI, 2.03%-3.52%) in the HBN sample and 3.9% (95% CI, 1.96%-5.78%) in the NKI sample. In the SYS sample, the prevalence of NVLD was 3.10% (95% CI, 1.93%-4.27%) after applying the sample weight. Across samples and estimation strategies, the population prevalence of NVLD was estimated to range from 3% to 4%. When applied to the US population younger than 18 years, 2.2 million to 2.9 million children and adolescents were estimated to have NVLD.

Conclusions And Relevance: The findings suggest that the prevalence of NVLD in children and adolescents may be 3% to 4%. Given that few youths are diagnosed with NVLD and receive treatment, increased awareness, identification of the underlying neurobiological mechanisms, and development and testing interventions for the disorder are needed.
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http://dx.doi.org/10.1001/jamanetworkopen.2020.2551DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7148441PMC
April 2020

Comparison of Cutaneous Lupus Erythematosus in Indigenous and Non-Indigenous Patients at a Regional Centre in Australia.

Australas J Dermatol 2020 Aug 7;61(3):291-292. Epub 2020 Apr 7.

Department of Dermatology, Royal Darwin Hospital, Casuarina, Northern Territory, Australia.

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http://dx.doi.org/10.1111/ajd.13281DOI Listing
August 2020

Spatial Network Connectivity and Spatial Reasoning Ability in Children with Nonverbal Learning Disability.

Sci Rep 2020 01 17;10(1):561. Epub 2020 Jan 17.

The Division of Child and Adolescent Psychiatry in the Department of Psychiatry, the New York State Psychiatric Institute and the College of Physicians & Surgeons, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA.

Nonverbal Learning Disability (NVLD) is characterized by deficits in visual-spatial, but not verbal, reasoning. Nevertheless, the functioning of the neural circuits supporting spatial processing have yet to be assessed in children with NVLD. We compared the resting state functional connectivity of a spatial brain network among children with NVLD, children with reading disorder (RD), and typically developing (TD) children. Seventy-five participants (7-15 years old) were included in the study (20 TD, 24 NVLD, and 31 RD). Group differences in global efficiency and functional connectivity among 12 regions comprising a previously defined spatial network were evaluated. Associations with behavior were explored. Global efficiency of the spatial network associated positively with spatial ability and inversely with socioemotional problems. Within the spatial network, associations between left posterior cingulate (PCC) and right retrosplenial cortical activity were reduced in children with NVLD relative to those without spatial deficits (RD and TD). Connectivity between left PCC and right posterior cerebellum (Crus I and II) was reduced in both groups of children with learning disabilities (NVLD and RD) relative to TD children. Functional connectivity of the spatial network was atypically associated with cognitive and socioemotional performance in children with NVLD. Identifying a neurobiological substrate for NVLD provides evidence that it is a discrete clinical entity and suggests targets for treatment.
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http://dx.doi.org/10.1038/s41598-019-56003-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969178PMC
January 2020

Phonological memory problems are magnified in children from language minority homes when predicting reading disability.

J Child Lang 2020 05 5;47(3):680-694. Epub 2019 Nov 5.

The Division of Child and Adolescent Psychiatry in the Department of Psychiatry, the New York State Psychiatric Institute and the College of Physicians & Surgeons, Columbia University Irving Medical Center, USA.

Children from language minority (LM) environments speak a language at home that differs from that at school, are often from socioeconomically disadvantaged backgrounds, and are at risk for reading impairment. We evaluated the main effects and interaction of language status and phonological memory and awareness on reading disorder in 352 children from socioeconomically disadvantaged backgrounds. A significant phonological memory by language status interaction indicated that phonological memory problems were magnified in predicting reading impairment in children from LM versus English dominant (ED) homes. Among children without reading disorder, language minority status was unrelated to phonological processing.
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http://dx.doi.org/10.1017/S0305000919000576DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263306PMC
May 2020

Neural correlates of cognitive control deficits in children with reading disorder.

Brain Imaging Behav 2020 Oct;14(5):1531-1542

The Division of Child and Adolescent Psychiatry in the Department of Psychiatry, the New York State Psychiatric Institute and the College of Physicians & Surgeons, Columbia University, Unit 74. 10032, 1051 Riverside Drive, New York, NY, USA.

Reading disorder (RD) is characterized by deficient phonological processing, but children with RD also have cognitive control deficits, the neural correlates of which are not fully understood. We used fMRI to assess neural activity during the resolution of cognitive conflict on the Simon Spatial Incompatibility task and patterns of resting-state functional connectivity (RSFC) from task control (TC) regions in 7-12-year-old children with RD compared to their typically developing (TD) peers. Relative to TD children (n = 17), those with RD (n = 16) over-engaged a right superior/medial frontal cluster during the resolution of conflict (p = .05). Relative to TD children (n = 18), those with RD (n = 17) also showed reduced RSFC (voxel-wise p < .001; cluster-size p < .05, FDR corrected) from cingulo-opercular seeds to left hemisphere fronto-parietal and temporo-parietal reading-related regions, perhaps reflecting reduced organization of TC circuits and reduced integration with reading-related regions. Children with RD additionally showed reduced RSFC between fronto-parietal and default mode network regions. Follow-up analyses in a subset of children with both useable task and resting state data (RD = 13; TD = 17) revealed that greater conflict-related activation of the right frontal Simon task ROI associated with better word-reading, perhaps suggesting a compensatory role for this over-engagement. Connectivity from fronto-parietal seeds significantly associated with Simon task performance and word-reading accuracy in RD children. These findings suggest that altered functioning and connectivity of control circuits may contribute to cognitive control deficits in children with RD. Future studies should assess the utility of adding cognitive control training to reading remediation programs.
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http://dx.doi.org/10.1007/s11682-019-00083-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6765445PMC
October 2020

Burden of skin disease in two remote primary healthcare centres in northern and central Australia.

Intern Med J 2019 Mar;49(3):396-399

Menzies School of Health Research, Darwin, Northern Territory, Australia.

The burden of skin infections across all age groups in remote Australian Indigenous communities is currently unknown. In a retrospective audit of 439 residents from two remote communities presenting to health clinics, skin conditions were the most common reason for presentation (1603/7392, 22%) and 330/439 (75%) residents presented at least once with a skin infection. Skin infections are an under-appreciated and dominant reason for presentation to primary healthcare centres in these indigenous communities and public health campaigns to address this should incorporate all age groups.
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http://dx.doi.org/10.1111/imj.14222DOI Listing
March 2019

Salience network connectivity and social processing in children with nonverbal learning disability or autism spectrum disorder.

Neuropsychology 2019 Jan 8;33(1):135-143. Epub 2018 Nov 8.

Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University Irving Medical Center.

Objective: Nonverbal learning disability (NVLD) is a putative neurodevelopmental disorder characterized by spatial processing deficits as well as social deficits similar to those characteristic of autism spectrum disorder (ASD). Nonetheless, NVLD may be a distinct disorder that is differentially associated with the functioning and connectivity of the salience (SN) and default mode (DMN) networks that support social processing. Thus, we sought to assess and compare connectivity across these networks in children with NVLD, ASD, and typically developing children.

Method: Resting-state fMRI data were examined in 17 children with NVLD, 17 children with ASD selected from the Autism Brain Imaging Data Exchange (ABIDE), and 40 TD children (20 from ABIDE). Average DMN and SN functional connectivity and pairwise region-to-region connectivity were compared across groups. Associations with social impairment and IQ were assessed.

Results: Children with NVLD showed reduced connectivity between SN regions (anterior insula to anterior cingulate and to rostral prefrontal cortex [rPFC]), whereas children with ASD showed greater connectivity between SN regions (supramarginal gyrus to rPFC) relative to the other groups. Both clinical groups showed higher levels of parent-reported social problems, which related to altered SN connectivity in the NVLD group. No differences were detected in overall average connectivity within or between networks.

Conclusions: The social deficits common across children with NVLD and ASD may derive from distinct alterations in connectivity within the SN. Such findings represent the first step toward identifying a neurobiological signature of NVLD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/neu0000494DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322976PMC
January 2019

Amygdala sub-regional functional connectivity predicts anxiety in children with reading disorder.

Dev Sci 2018 09 15;21(5):e12631. Epub 2017 Nov 15.

The Division of Child and Adolescent Psychiatry in the Department of Psychiatry, the New York State Psychiatric Institute, New York.

Pediatric reading disorder (RD) is associated with an increased risk of anxiety symptoms, yet understudied are the neurobiological factors that might underlie anxiety in children with RD. Given the role of the amygdala in anxiety, we assessed resting state functional connectivity of amygdalar subregions in children with RD to identify functional correlates of anxiety and reading impairment. We collected resting state functional MRI data from 22 children with RD and 21 typically developing (TD) children, ages 7 to 13 years. We assessed group differences in resting state functional connectivity (RSFC) from amygdalar subregions. Associations of amygdalar RSFC and volume with reading impairment, reading fluency scores, and anxiety symptoms were explored. Relative to TD children, those with RD showed increased RSFC from amygdalar nuclei to medial prefrontal cortex. Across all subjects, RSFC from right centromedial amygdala to left medial prefrontal cortex positively predicted both reading impairment and self-reported anxiety, and anxiety mediated the relationship between RSFC and reading impairment. These findings are consistent with amygdalar functional abnormalities in pediatric anxiety disorders, suggesting a common neurobiological mechanism underlying anxiety and reading impairment in children. Thus, aberrant patterns of RSFC from amygdalar subregions may serve as potential targets for the treatment of anxiety symptoms that typically co-occur with RD. Our dimensional approach to studying anxiety in RD revealed how amygdalar connectivity underlies anxiety and reading impairment across a continuum from normal to abnormal.
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http://dx.doi.org/10.1111/desc.12631DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042207PMC
September 2018

The role of serious mental illness in motivation, participation and adoption of health behavior change among obese/sedentary Latino adults.

Ethn Health 2019 11 10;24(8):889-896. Epub 2017 Nov 10.

Dartmouth Centers for Health and Aging, Geisel School of Medicine at Dartmouth , Hanover , NH , USA.

Serious mental illness (SMI; e.g. schizophrenia, schizoaffective disorder, delusional disorder, bipolar disorder, severe major depressive disorder, and psychotic disorders) and Latino ethnicity can produce a compounded health disparity, placing individuals at particularly high risk for excess morbidity and premature mortality. In this study we sought to identify the role of SMI in motivation, participation, and adoption of health behavior change among overweight Latino adults. Qualitative, semi-structured interviews were conducted with 20 overweight Latinos with SMI who were enrolled in a randomized trial evaluating the effectiveness of a motivational health promotion intervention adapted for persons with SMI, In SHAPE. The interviews explored the complicated role having an SMI had in the lives of the Latino participants. SMI had both positive and negative impact on Latino participants' health behaviors. The nature of their mental illness along with medication side effects (e.g. lethargy, weight gain, etc.) negatively impacted their ability to making lasting health behavior change. However, the regular appointments with various specialists provided them with structure that they otherwise would have lacked and gave them a reason to get out of the house. This exploratory research provides insight into the experience of overweight Latinos with SMI and the ways in which SMI impacts their participation in health behavior change. An understanding of the positive and negative effects of SMI on health behavior change will inform the development of health promotion interventions targeted at Latinos with SMI.
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http://dx.doi.org/10.1080/13557858.2017.1390552DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6224308PMC
November 2019

Gender, status, and psychiatric labels.

Soc Sci Res 2015 Nov 29;54:68-79. Epub 2015 Jun 29.

Cedar Park, TX, United States.

We examine a key modified labeling theory proposition-that a psychiatric label increases vulnerability to competence-based criticism and rejection-within task- and collectively oriented dyads comprised of same-sex individuals with equivalent education. Drawing on empirical work that approximates these conditions, we expect the proposition to hold only among men. We also expect education, operationalized with college class standing, to moderate the effects of gender by reducing men's and increasing women's criticism and rejection. But, we also expect the effect of education to weaken when men work with a psychiatric patient. As predicted, men reject suggestions from teammates with a psychiatric history more frequently than they reject suggestions from other teammates, while women's resistance to influence is unaffected by their teammate's psychiatric status. Men also rate psychiatric patient teammates as less powerful but no lower in status than other teammates, while women's teammate assessments are unaffected by their teammate's psychiatric status. Also as predicted, education reduces men's resistance to influence when their teammate has no psychiatric history. Education also increases men's ratings of their teammate's power, as predicted, but has no effect on women's resistance to influence or teammate ratings. We discuss the implications of these findings for the modified labeling theory of mental illness and status characteristics theory.
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http://dx.doi.org/10.1016/j.ssresearch.2015.06.021DOI Listing
November 2015

Assessment of Food Insecurity in Children's Hospital of Wisconsin's Emergency Department.

WMJ 2015 Aug;114(4):148-51

Importance: Food insecurity is associated with adverse health outcomes and the emergency department may be an ideal location to identify food insecure children and families.

Objective: To determine the prevalence of food insecurity in families with children that present to an urban pediatric emergency department (ED) in Milwaukee, Wisconsin.

Design: We conducted a cross-sectional survey of caregivers of children 0-18 years between June and August, 2013. The questionnaire included 2 validated statements about food insecurity and demographic and community resource questions. Participant rooms were approached during predefined shifts in an order determined by random number generation.

Outcomes: The primary outcome was the prevalence of caregivers who identified as food insecure. A secondary outcome was the percentage of food insecure caregivers who accessed community resources.

Results: We enrolled 309 caregivers; 141 (45.6%) reported food insecurity. Nearly 60% (56.8%) of nonwhite caregivers were food insecure compared to 27.4% of non-Hispanic white caregivers (P < 0.0001). Among caregivers who identified as food insecure, 82% reported using at least 1 community resource for food.

Conclusions: Almost half of caregivers presenting to the ED reported food insecurity. The ED is an excellent location for targeted intervention to identify and link food insecure families with community resources.
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August 2015

Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial.

J Neuroeng Rehabil 2015 Aug 20;12:69. Epub 2015 Aug 20.

Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Rehabilitation Institute of Chicago, 345 E. Superior St, Chicago, IL, 60611, USA.

Background: Robots offer an alternative, potentially advantageous method of providing repetitive, high-dosage, and high-intensity training to address the gait impairments caused by stroke. In this study, we compared the effects of the Stride Management Assist (SMA®) System, a new wearable robotic device developed by Honda R&D Corporation, Japan, with functional task specific training (FTST) on spatiotemporal gait parameters in stroke survivors.

Methods: A single blinded randomized control trial was performed to assess the effect of FTST and task-specific walking training with the SMA® device on spatiotemporal gait parameters. Participants (n=50) were randomly assigned to FTST or SMA. Subjects in both groups received training 3 times per week for 6-8 weeks for a maximum of 18 training sessions. The GAITRite® system was used to collect data on subjects' spatiotemporal gait characteristics before training (baseline), at mid-training, post-training, and at a 3-month follow-up.

Results: After training, significant improvements in gait parameters were observed in both training groups compared to baseline, including an increase in velocity and cadence, a decrease in swing time on the impaired side, a decrease in double support time, an increase in stride length on impaired and non-impaired sides, and an increase in step length on impaired and non-impaired sides. No significant differences were observed between training groups; except for SMA group, step length on the impaired side increased significantly during self-selected walking speed trials and spatial asymmetry decreased significantly during fast-velocity walking trials.

Conclusions: SMA and FTST interventions provided similar, significant improvements in spatiotemporal gait parameters; however, the SMA group showed additional improvements across more parameters at various time points. These results indicate that the SMA® device could be a useful therapeutic tool to improve spatiotemporal parameters and contribute to improved functional mobility in stroke survivors. Further research is needed to determine the feasibility of using this device in a home setting vs a clinic setting, and whether such home use provides continued benefits.

Trial Registration: This study is registered under the title "Development of walk assist device to improve community ambulation" and can be located in clinicaltrials.gov with the study identifier: NCT01994395 .
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http://dx.doi.org/10.1186/s12984-015-0062-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4545867PMC
August 2015

Identification of infants at risk for developing Fabry, Pompe, or mucopolysaccharidosis-I from newborn blood spots by tandem mass spectrometry.

J Pediatr 2013 Aug 1;163(2):498-503. Epub 2013 Mar 1.

Department of Pediatrics, University of Washington, Seattle, WA 98195-6320, USA.

Objective: To assess the performance of a tandem mass spectrometry (MS/MS) technology in a newborn screening laboratory to simultaneously measure α-galactosidase, acid-α-glucosidase, and α-L-iduronidase for the detection of infants at risk to develop Fabry, Pompe, or mucopolysaccharidosis (MPS)-I diseases.

Study Design: Enzyme activity was assayed from a 3.2-mm punch from 100,000+ anonymous newborn blood spots. Punches with low enzyme activity were further evaluated by nucleotide sequence analysis of the responsible gene. Confirmation of affected infants was dependent on identification of mutations compatible with diminished enzyme activity.

Results: The technology for simultaneously measuring multiple enzyme activities by MS/MS was successful. The confirmation of diagnosis for Fabry, Pompe, or MPS-I, by DNA sequencing estimated the prevalence of Fabry disease at 1/7800 males (95% CI 1/17,800-1/3600); Pompe disease at 1/27,800 newborns (95% CI 1/90,000-1/10,200); and MPS-I at 1/35,500 newborns (95% CI 1/143,000-1/11,100). These estimates of prevalence are 2 to 4 times greater than the prevalence estimated by clinical diagnosis. The combined prevalence for the 3 disorders was 1/7500 newborns (95% CI 1/13,500-1/4500).

Conclusions: MS/MS for the simultaneous assay of multiple lysosomal enzymes can be successfully introduced into a routine newborn screening laboratory. The technology has a positive predictive value equal to, or better, than methods currently used for the detection of nonlysosomal disorders. Using newborn blood spots, the combined prevalence of Fabry, Pompe, and MPS-I is estimated at 1/7500 newborns based on low-enzyme activity and confirmation by mutation analysis.
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http://dx.doi.org/10.1016/j.jpeds.2013.01.031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725184PMC
August 2013

Pragmatic abilities of children with williams syndrome: a longitudinal examination.

Front Psychol 2012 18;3:199. Epub 2012 Jun 18.

Department of Psychological and Brain Sciences, University of Louisville Louisville, KY, USA.

Prior research has indicated that pragmatics is an area of particular weakness for individuals with Williams syndrome (WS). To further address this aspect of the WS social phenotype, we used an individual differences approach to consider both cross-sectional and longitudinal relations among different pragmatic abilities for 14 children with WS, taking into account individual differences in non-verbal reasoning abilities. We also considered the relations between pragmatic abilities and expressive vocabulary ability. Participants were tested at two time points: as 4-year-olds during a 30-min play session with their mothers (Time 1) and an average of 5.87 years later during a one-on-one conversation with a familiar researcher (Time 2). Children's intellectual and expressive vocabulary abilities were assessed at both time points. Results indicated that the ability to verbally contribute information beyond what was required in response to a question (ExtendQ) was significantly related to the ability to verbally contribute new information in the absence of a question (ExtendS) both at age 4 years and during primary school. At age 4, both the ability to pair verbalizations with eye contact in triadic interactions (secondary intersubjectivity) and expressive vocabulary ability were related to both ExtendQ and ExtendS. Finally, both ExtendQ and the ability to pair verbalizations with eye contact (intersubjectivity) at age 4 years predicted ExtendQ at age 9-12 years. The theoretical implications of our findings and the importance of early pragmatic language intervention for children who have WS are discussed.
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http://dx.doi.org/10.3389/fpsyg.2012.00199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376418PMC
October 2012

Inhibition of protein kinase C attenuates Pseudomonas aeruginosa elastase-induced epithelial barrier disruption.

Am J Respir Cell Mol Biol 2011 Dec 14;45(6):1263-71. Epub 2011 Jul 14.

Department of Biology, The University of Texas at Tyler, 75799, USA.

Pseudomonas aeruginosa pulmonary infection compromises the human airway epithelium, and can be especially devastating to immunocompromised or debilitated individuals. We have reported earlier that P. aeruginosa elastase (PE) increases paracellular permeability in epithelial cell monolayers by mechanisms involving tight junction (TJ) disruption and cytoskeletal reorganization, leading to destruction of epithelial barrier function. The aim of this study was to investigate putative TJ targets and potential mechanisms by which PE induces barrier disruption. We found that PE decreased localization of TJ proteins, occludin and zonula occludens (ZO)-1, in membrane fractions, and induced reorganization of F-actin within 1 hour. Although inhibition of protein kinase (PK) C α/β signaling modestly altered the extent of cytoskeletal disruption and ZO-1 translocation, we found PKC signaling to play a significant role in decreased occludin functionality during PE exposure. Furthermore, elevated PKC levels correlated with decreased levels of TJ proteins in membrane fractions, and increased paracellular permeability in a time-dependent manner. Therefore, we conclude that PKC signaling is involved during PE-induced epithelial barrier disruption via TJ translocation and cytoskeletal reorganization. Specifically, occludin, as well as associated ZO-1 and F-actin, may be early targets of PE pathogenesis occurring via a PKC-dependent pathway.
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http://dx.doi.org/10.1165/rcmb.2010-0459OCDOI Listing
December 2011

Adult weight management: translating research and guidelines into practice.

J Am Acad Nurse Pract 2009 Apr;21(4):197-206

Graduate School of Nursing, Uniformed Services University of Health Sciences, Bethesda, Maryland 20814, USA.

Purpose: To provide a practical approach to managing overweight and obese adult patients based on data from research and recommendations from established guidelines.

Data Sources: Comprehensive review articles and original research articles identified through Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL).

Conclusions: There is a great deal of research being conducted on new ways to treat obesity; however, despite all this new information, many primary care providers continue to report that they do not address weight or weight control strategies with their patients. Reasons include too little time, not enough training, lack of financial incentive, and failure to believe that patients can be successful.

Implications For Practice: Weight management essentially comes down to one key concept: negative energy balance (fewer calories in and/or more calories out). Patients can be taught how to achieve a negative energy balance by using a food/exercise diary to track their daily caloric goal to achieve a 1-2 pound weight loss per week. Nurse practitioners (NPs) can implement safe and effective weight management plans for their patients by teaching them how to self-monitor, eat healthy, and exercise. This method is similar to what NPs commonly use for patients with diabetes mellitus.
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http://dx.doi.org/10.1111/j.1745-7599.2008.00383.xDOI Listing
April 2009

Evolution of the vertebrate ABC gene family: analysis of gene birth and death.

Genomics 2006 Jul 2;88(1):1-11. Epub 2006 May 2.

Laboratory of Genomic Diversity, Building 560, Room 21-18, NCI-Frederick, Frederick, MD 21702, USA.

Vertebrate evolution has been largely driven by the duplication of genes that allow for the acquisition of new functions. The ATP-binding cassette (ABC) proteins constitute a large and functionally diverse family of membrane transporters. The members of this multigene family are found in all cellular organisms, most often engaged in the translocation of a wide variety of substrates across lipid membranes. Because of the diverse function of these genes, their large size, and the large number of orthologs, ABC genes represent an excellent tool to study gene family evolution. We have identified ABC proteins from the sea squirt (Ciona intestinalis), zebrafish (Danio rerio), and chicken (Gallus gallus) and, using phylogenetic analysis, identified those genes with a one-to-one orthologous relationship to human ABC proteins. All ABC protein subfamilies found in Ciona and zebrafish correspond to the human subfamilies, with the exception of a single ABCH subfamily gene found only in zebrafish. Multiple gene duplication and deletion events were identified in different lineages, indicating an ongoing process of gene evolution. As many ABC genes are involved in human genetic diseases, and important drug transport phenotypes, the understanding of ABC gene evolution is important to the development of animal models and functional studies.
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http://dx.doi.org/10.1016/j.ygeno.2006.03.001DOI Listing
July 2006

Membrane type 1-matrix metalloproteinase (MMP)-associated MMP-2 activation increases in the rat ovary in response to an ovulatory dose of human chorionic gonadotropin.

Biol Reprod 2004 Apr 10;70(4):1024-32. Epub 2003 Dec 10.

Department of Obstetrics and Gynecology, Chandler Medical Center, University of Kentucky, Lexington, Kentucky 40536-0298, USA.

Gonadotropins stimulate ovarian proteolytic enzyme activity that is believed to be important for the remodeling of the follicular extracellular matrix. Membrane type 1-matrix metalloproteinase (MT1-MMP) has been identified in vitro as an activator of pro-MMP-2 by forming a complex with tissue inhibitors of metalloproteinase-2 (TIMP-2). In the present study, the expression pattern of MT1-MMP mRNA and the role of MT1-MMP were examined in the ovary using the gonadotropin-treated immature rat model. Ovaries were collected at selected times after eCG or hCG. RNase protection assays revealed a transient increase in MT1-MMP mRNA beginning 4 h after hCG. High expression of MT1-MMP mRNA was localized to the theca-interstitial layer of developing and preovulatory follicles, while low expression was observed in the granulosa cell layer of developing follicles by in situ hybridization. The localization pattern of MT1-MMP mRNA was compared with TIMP-2 mRNA. Both MMP-2 and TIMP-2 mRNA were expressed in the theca layer of preovulatory follicles, showing a similarity to MT1-MMP mRNA expression. To further determine whether MT1-MMP activates pro-MMP-2 in the ovary, crude plasma membrane fractions from preovulatory ovaries were analyzed by gelatin zymography. In plasma membrane fractions, pro-MMP-2 increased around the time of ovulation. Upon incubation, pro-MMP-2 was activated with the highest levels of activation at 12 h post-hCG. The addition of MT1-MMP antibody or excess TIMP-2 to membrane fractions inhibited pro-MMP-2 activation. The increase in MT1-MMP mRNA may be an important part of the mechanism necessary for the efficient generation of active MMP-2 during the ovulatory process.
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http://dx.doi.org/10.1095/biolreprod.103.023499DOI Listing
April 2004