Faculty Bibliography

While youth with autism spectrum disorder (ASD) are psychiatrically hospitalized at high rates, general psychiatric settings are not designed to meet their unique needs. Previous evaluations of an ASD-Care Pathway (ASD-CP) on a general psychiatric unit revealed sustained reductions in crisis interventions (intramuscular medication use, holds/restraints; Cervantes et al. in J Autism Dev Disord 49(8):3173-3180, https://doi.org/10.1007/s10803-019-04029-6, 2019; Kuriakose et al. in J Autism Dev Disord 48(12):4082-4089, https://doi.org/10.1007/s10803-018-3666-y, 2018). The current study investigated staff perceptions of the ASD-CP (N = 30), and examined rates of ASD-CP implementation fidelity in relation to patient outcomes (N = 28). Staff identified visual communication aids and reward strategies as most helpful. The number of days of reward identification early in the inpatient stay was associated with fewer crisis interventions later in a patient's stay.

Describe hospitalization rates in children with elevated symptoms of mania and determine predictors of psychiatric hospitalizations during the 96 month follow-up. Eligible 6-12.9 year olds and their parents visiting 9 outpatient mental health clinics were invited to be screened with the Parent General Behavior Inventory 10-item Mania Scale. Of 605 children with elevated symptoms of mania eligible for follow-up, 538 (88.9%) had ≥ 1 of 16 possible follow-up interviews and are examined herein. Multivariate Cox regression indicated only four factors predicted hospitalizations: parental mental health problems (HR 1.80; 95% CI 1.21, 2.69); hospitalization prior to study entry (HR 3.03; 95% CI 1.80, 4.43); continuous outpatient mental health service use (HR 3.73; 95% CI 2.40, 5.50); and low parental assessment of how well treatment matched child's needs (HR 3.97; 95% CI 2.50, 6.31). Parental perspectives on mental health services should be gathered routinely, as they can signal treatment failures.

Adeno-associated viruses (AAVs) are a commonly used tool in neuroscience to efficiently label, trace, and/or manipulate neuronal populations. Highly specific targeting can be achieved through recombinase-dependent AAVs in combination with transgenic rodent lines that express Cre-recombinase in specific cell types. Visualization of viral expression is typically achieved through fluorescent reporter proteins (e.g., GFP or mCherry) packaged within the AAV genome. Although nonamplified fluorescence is usually sufficient to observe viral expression, immunohistochemical amplification of the fluorescent reporter is routinely used to improve viral visualization. In the present study, Cre-dependent AAVs were injected into the neocortex of wild-type C57BL/6J mice. While we observed weak but consistent nonamplified off-target double inverted open reading frame (DIO) expression in C57BL/6J mice, antibody amplification of the GFP or mCherry reporter revealed notable Cre-independent viral expression. Off-target expression of DIO constructs in wild-type C57BL/6J mice occurred independent of vendor, AAV serotype, or promoter. We also evaluated whether Cre-independent expression had functional effects via designer receptors exclusively activated by designer drugs (DREADDs). The DREADD agonist C21 (compound 21) had no effect on contextual fear conditioning or c-Fos expression in DIO-hM3Dq-mCherry⁺ cells of C57BL/6J mice. Together, our results indicate that DIO constructs have off-target expression in wild-type subjects. Our findings are particularly important for the design of experiments featuring sensitive systems and/or quantitative measurements that could be negatively impacted by off-target expression.Significance StatementAdeno-associated viruses (AAVs) are widely used in neuroscience because of their safety and ease of use. Combined with specific promoters, Cre/loxP, and stereotaxic injections, highly specific targeting of cells and circuits within the brain can be achieved. In the present study, we injected Cre-dependent AAVs into wild-type C57BL/6J mice and found Cre-independent viral expression of AAVs encoding mCherry, GFP, or hM3Dq following immunohistochemical amplification of the fluorescent reporter protein. Importantly, we observed no functional effects of the Cre-independent expression in the hippocampus, as C21 (compound 21) had no detectable effect on double inverted open reading frame (DIO)-hM3Dq-mCherry-infected neurons in C57BL/6J mice. Given the widespread use of DIO recombinant AAVs by the neuroscience community, our data support careful consideration when using DIO constructs in control animals.

This article discusses empirical research findings that demonstrate psychobiological dysregulation among violently traumatized mothers of very young children and then describes what effects this dysregulation can have on the mother-infant relationship. Out of this research, the first author developed CAVES originally as an experimental evaluation technique and test-intervention. The theoretical premise, evidence-base, and signature features of the CAVES are described along with a case example showing how it quickly became the foundation for a new brief psychotherapeutic model for traumatized parents and their very young children ages 0 to 4, CAVEAT. The essentials of CAVEAT as a 16-session manualized treatment model are also presented with a case example as illustration. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Abstract (German) Dieser Artikel diskutiert empirische Forschungsergebnisse, die bei gewalt- sam traumatisierten Muttern von Kleinkindern eine psychobiologische Dysregulation nachweisen, und beschreibt deren Auswirkungen auf die Mutter-Kind-Beziehung. Aus dieser Forschung entwickelte der Erstautor die CAVES als experimentelle Evaluationstechnik und Test-Intervention. Die theoretischen Grundlagen, die Evidenzbasis und Hauptmerkmale der CAVES werden zusammen mit einem Fallbeispiel beschrieben, das zeigt, wie CAVES zu einem neuen Modell fur eine kurze Psychotherapie fur traumatisierte Eltern und ihre Kinder im Alter von 0 bis 4 wurde (CAVEAT). Das Behandlungsmodell der CAVEAT mit 16 Sitzungen, das auch als Manual besteht, wird anhand eines Fallbeispiels veranschaulicht (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Cannabis (marijuana) has been known to humans for thousands of years but its neurophysiological effects were sparsely understood until recently. Preclinical and clinical studies in the past two decades have indisputably supported the clinical proposition that the endocannabinoid system plays an important role in the etiopathogeneses of many neuropsychiatric disorders, including mood and addictive disorders. In this review, we discuss the existing knowledge of exo- and endo-cannabinoids, and role of the endocannabinoid system in depressive and suicidal behavior. A dysfunction in this system, located in brain regions such as prefrontal cortex and limbic structures is implicated in mood regulation, impulsivity and decision-making, may increase the risk of negative mood and cognition as well as suicidality. The literature discussed here also suggests that the endocannabinoid system may be a viable target for treatments of these neuropsychiatric conditions.

BACKGROUND: The spread of SARS-CoV-2 has caused mortality and long-lasting morbidity worldwide. Acutely, COVID-19 may elevate risk of blood clots, cardiomyopathy, and acute kidney injury. For many critically ill patients, dialysis has been essential in managing infection. Long-term, the impact of COVID-19 on renal function remains unknown. This longitudinal observational study examines basic renal function indexed by serum creatinine and estimated Glomerular Filtration Rate (eGFR) measured ~10-26 weeks after COVID-19 onset.
METHOD(S): We queried the NYU Langone COVID Deidentified Dataset for adults with a positive SARS-CoV-2 PCR test and excluded End-Stage Renal Disease (ESRD) patients (3%). The cohort had a creatinine test from a Basic or Comprehensive Metabolic Panel >2 weeks before and >2 weeks after infection (n=501; 54% female; 18%=18-42 years, 39%=43-67 years, 43%=68+ year old). Within- patient pre- vs. post-COVID creatinine change change was normalized by the patient's latest pre- COVID creatinine test. To gauge the putative clinical relevance of creatinine change in understanding risk for deterioration to ESRD, renal function stratified by eGFR (ml/min/1.73m2 ), available only for n=221 (44% of cohort), is illustrated in the figure below.
RESULT(S): Post-COVID creatinine levels were greater (1.327 mg/dL +/- 0.06, mean +/- SEM) than pre- COVID levels (1.248 mg/dL +/- 0.07) representing a post-COVID increase change =0.093 (Cohen's d effect size=0.15, t500=3.3, p<0.001). This creatinine change was captured at a pre-/post-interval=192.5 +/- 3.1 days (mean +/- SEM), corresponding to 129.5 +/- 3.1 days after a COVID-19 infection (min=2 weeks, IQR=10-26 weeks, max=38 weeks).
CONCLUSION(S): In an early COVID-19 epicenter, we show preliminary evidence of sustained creatinine increases in a cohort without ESRD around 3- 6 months following COVID-19 onset. Future work should isolate the role of pre-existing risk factors and link potentially new renal dysfunction more directly to COVID-19. Given the long-term follow-up data available in this study, we recommend that primary care providers track renal function in patients following COVID-19 infection to screen for emergent renal disease and adjust any renally dosed medications. LEARNING OBJECTIVE #1: Identify changes in renal function after recovery from COVID-19 infection LEARNING OBJECTIVE #2: Depict patterns of long-term renal function changes post-COVID