Faculty Bibliography

Visual stimuli often dominate nonvisual stimuli during multisensory perception. Evidence suggests higher cognitive processes prioritize visual over nonvisual stimuli during divided attention. Visual stimuli should thus be disproportionally distracting when processing incongruent cross-sensory stimulus pairs. We tested this assumption by comparing visual processing with olfaction, a "primitive" sensory channel that detects potentially hazardous chemicals by alerting attention. Behavioral and event-related brain potentials (ERPs) were assessed in a bimodal object categorization task with congruent or incongruent odor-picture pairings and a delayed auditory target that indicated whether olfactory or visual cues should be categorized. For congruent pairings, accuracy was higher for visual compared to olfactory decisions. However, for incongruent pairings, reaction times (RTs) were faster for olfactory decisions. Behavioral results suggested that incongruent odors interfered more with visual decisions, thereby providing evidence for an "olfactory dominance" effect. Categorization of incongruent pairings engendered a late "slow wave" ERP effect. Importantly, this effect had a later amplitude peak and longer latency during visual decisions, likely reflecting additional categorization effort for visual stimuli in the presence of incongruent odors. In sum, contrary to what might be inferred from theories of "visual dominance," incongruent odors may in fact uniquely attract mental processing resources during perceptual incongruence.

BACKGROUND:Previous studies are inconclusive concerning the association between maternal pre-pregnancy overweight/obesity and risk of attention-deficit/hyperactivity disorder (ADHD) in offspring. We therefore conducted a systematic review and meta-analysis to clarify this association. To address the variation in confounding adjustment between studies, especially inadequate adjustment of unmeasured familial confounding in most studies, we further performed cousin and sibling comparisons in a nationwide population-based cohort in Sweden. METHODS:We searched PubMed, Embase and PsycINFO during 1975-2018. We used random-effects models to calculate pooled risk ratios (RRs) with 95% confidence interval. In the population-based study, Cox proportional hazard models were used to calculate the unadjusted hazard ratios (HRs) and HRs adjusted for all confounders identified in previous studies. Stratified Cox models were applied to data on full cousins and full siblings to further control for unmeasured familial confounding. RESULTS:Eight cohorts with a total of 784 804 mother-child pairs were included in the meta-analysis. Maternal overweight [RRoverweight = 1.31 (1.25-1.38), I2 = 6.80%] and obesity [RRobesity = 1.92 (1.84-2.00), I2 = 0.00%] were both associated with an increased risk of ADHD in offspring. In the population-based cohort of 971 501 individuals born between 1992 and 2004, unadjusted Cox models revealed similar associations [HRoverweight = 1.30 (1.28-1.34), HRobesity = 1.92 (1.87-1.98)]. These associations gradually attenuated towards the null when adjusted for measured confounders [HRoverweight = 1.21 (1.19-1.25), HRobesity = 1.60 (1.55-1.65)], unmeasured factors shared by cousins [HRoverweight = 1.10 (0.98-1.23), HRobesity = 1.44 (1.22-1.70)] and unmeasured factors shared by siblings [HRoverweight = 1.01 (0.92-1.11), HRobesity = 1.10 (0.94-1.27)]. CONCLUSION/CONCLUSIONS:Pre-pregnancy overweight/obesity is associated with an increased risk of ADHD in offspring. The observed association is largely due to unmeasured familial confounding.

The underlying theme throughout this series of studies authored by the Multicenter anterior cruciate ligament (ACL) Revision Study consortium has been to determine the modifiable predictors or risk factors of long-term outcomes of revision ACL reconstruction. The observational studies described and summarized in the manuscript are both clinically relevant and of great interest in finding out the long-term consequences of the intervention and its relationship to the original injury. The successful completion of these studies has important implications for both therapy and future clinical trials. The identification of modifiable risk factors will play an important role in secondary prevention, while the identification of nonmodifiable risk factors will aid us in counseling our patients and making surgical decisions. Thus, we expect a profound clinical impact on patients' care. More importantly, this project represents an important step forward in bringing evidence to bear in clinical decision making in orthopedic surgery.
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Background: Endoscopic Ultrasound guided biliary drainage (EUS-BD) has been demonstrated as a safe and effective alternative to Endoscopic Retrograde Cholangiopancreatography (ERCP) in malignant biliary obstruction. Various plastic and metal stents have previously been used for drainage, with recently increasing use of lumen apposing metal stents (LAMS). However there is limited data to guide patient selection, choice of stent, or method of placement. This study examines the rates of technical success, clinical success, and adverse events associated with the use of LAMS for EUS-BD.
Method(s): A retrospective study was conducted at 10 institutions. It included all cases of biliary obstruction that EUS-BD was performed using a LAMS. Collected data points were clinical and technical factors, adverse events and mortality. Main outcomes were technical success (defined as successful LAMS placement), clinical success (50% decline in bilirubin at 2 weeks), recurrence of biliary obstruction, and adverse events.
Result(s): 72 patients were included with median follow up of 56 days. Descriptive data is in Table 1 and Table 2. Most obstructions (89%) were at the distal common bile duct and the main etiology was pancreatic cancer (82%). Mean pre-procedure bilirubin was 19.2 mg/dl and common bile duct size was 22.7 mm. ERCP was attempted initially in 47% of patients. In patients where technical success (97%) was achieved, 100% clinical resolution was noted. Median time to clinical success was 1 day. Biliary obstruction recurred in 6% of cases, though no predicting factors were identified. A total of 9 (12.5%) (6 mild, 1 moderate, 2 severe) non-LAMS related adverse events were reported. There were 11 (15%) LAMS associated adverse events (6 food impaction, 4 bleeding, 1 migration). Elective LAMS removal without fistula closure was performed in 3 cases and was not associated with recurrent biliary obstruction or adverse events. 17% of patients died during follow up but no deaths were attributed to the procedure.
Conclusion(s): EUS-BD with LAMS is effective in relieving malignant biliary obstruction with low rates of recurrence. There was high technical success with this procedure and this resulted in clinical resolution in all successful cases. No other clinical or technical factors were associated with initial technical or clinical success, recurrent biliary obstruction or adverse events. Further prospective studies are needed to validate these findings and generate longer term data. [Formula presented] [Formula presented]
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Schizophrenia subjects have shown deficits of inhibition in conditions such as a stop signal task. The stop signal response time (SSRT) is consistently longer compared with healthy controls, and is accompanied by decreased brain activations in the right inferior frontal gyrus. However, as to how the response inhibition function is supported by distributed brain networks, and whether such networks are altered in schizophrenia are largely unknown. We analyzed functional MRI data of a stop signal task from 44 schizophrenia patients and 44 matched controls, and performed whole-brain psychophysiological interaction analysis to obtain task-modulated connectivity (TMC). Support vector classification was used to classify schizophrenia, and support vector regression was applied to explore the relationships between TMC and behavior indexes, such as SSRT. Schizophrenia group showed a decreased TMC pattern which mainly involved the fronto-parietal network, and increased TMC related to the sensorimotor network. Moreover, TMC could only successfully predict SSRT in the control group, further suggesting an abnormal task modulation in schizophrenia. Lastly, we compared the classification and prediction results from different types of measures, i.e., TMC, task-independent connectivity (TIC), task-functional connectivity (TFC), and resting-state functional connectivity (RSFC). TMC performed better in the behavior predictions, while TIC performed better in the classification. TFC and RSFC had similar classification and prediction performance as TIC. The current results provide new insights into the altered brain functional integration underlying response inhibition in schizophrenia, and suggest that different types of connectivity measures are complementary for a better understanding of brain networks and their alterations.

BACKGROUND:Interdisciplinary research among health care professionals has gained importance over the last 20 years, but little is known about its impact on career development. PURPOSE/OBJECTIVE:This study examined professional development outcomes associated with interdisciplinary research. METHODS:An integrative review was conducted using Whittmore and Knafl's framework. PubMed, Embase, PsycInfo, Web of Science, and CINAHL were searched to identify studies. FINDINGS/RESULTS:Thirteen studies were included. The majority used bibliometric analyses, finding that moderate level of interdisciplinary collaboration was associated with a greater amount and higher quality of publications. Interdisciplinary publications allocated more credit (i.e., had more authors). Interdisciplinary research proposals had less funding success than single discipline proposals. Important cultural and personal aspects of interdisciplinary research (e.g., work and communication styles, research goals) have not been assessed to date. DISCUSSION/CONCLUSIONS:Rigorous qualitative studies are needed to characterize benefits and challenges of interdisciplinary research to scholars and to institutions.

The COVID-19 pandemic has convulsed human communities across the globe like no previous event in history. Family therapists, paradoxically, given the core of their work is with systems, are also experiencing upheaval in professional and personal lives, trying to work amidst a society in chaos. This paper offers a collection of reflections by systemic and family therapists from diverse cultures and contexts penned in the midst of the pandemic. The main intention in distilling these narratives is to preserve the 'cultural diversity' and 'ecological position' of the contributors, guided by phenomenology, cultural ecology, and systemic worldviews of 'experiencing.' The second intention is to 'unite' promoting solidarity in this isolating situation by bringing each story together, creating its own metaphor of a family: united, connected, stronger. As a cross-cultural family practitioner, with a strong mission for collaboration, the lead author acknowledges the importance of Context - the nation and location of the experience; Culture - the manner in which culture impacts on experience; Collaboration - enhancing partnership, enriching knowledge, and mapping the journey's direction; and Connectedness - combating isolation while enhancing unity. Since the key transmission of culture is through language, raw reflections were sought initially in the practitioners' own language, which were translated for an English-speaking readership. These narratives are honest and rich descriptions of the authors' lived experiences, diverse and distinctive. The contributors trust colleagues will find these reflections helpful, validating and acknowledging the challenges of this unique period in history.