Faculty Bibliography

Infection with Zika virus is an emerging public health crisis. We observed prolonged detection of virus RNA in vaginal mucosal swab specimens and whole blood for a US traveler with acute Zika virus infection who had visited Honduras. These findings advance understanding of Zika virus infection and provide data for additional testing strategies.

Cat-scratch disease-associated vertebral osteomyelitis and epidural involvement are rare and may manifest with nonspecific chronic symptoms in children, such as fever or torticollis. We present only the fourth case in the literature describing epidural involvement in an immunocompetent boy presenting with fever, torticollis, and indiscriminate left upper back tenderness. Bartonella henselae serologies are important to consider because such atypical complications often are responsive to conservative management with antibiotics.

Mental illness and disability affect millions of individuals yearly in the U.S. The most important legislation protecting the mentally disabled in the workplace in the U.S. over the last half century has been the Americans with Disabilities Act (ADA) and its associated legislation and guidance. Although the employee should first request reasonable accommodation with the employer, evaluation by a mental health professional is one of the initial steps for individuals who report significant psychiatric symptoms that are impairing their functioning at work in the U.S.. Important regulations and laws in the United States that are essential knowledge to performing thorough mental disability evaluations include the ADA and Americans with Disabilities Act Amendments Act of 2008 (ADAAA), Social Security Disability, Workers' Compensation, and private disability insurance. These laws differ in applicability and in their definitions of disability. Social Security Disability is applicable to workers who have long-term impairments regardless of whether the disability arose on or off the job, while Worker's Compensation is specific to persons with work-related illness and injuries that occur on the job (Reno, Williams, & Sengupta, ). The Social Security definition of a disabled person is a person who is not "able to engage in any substantial gainful activity because of a medically-determinable physical or mental impairment(s): that is expected to result in death, or that has lasted or is expected to last for a continuous period of at least 12 months" (Social Security Red Book, ). However, the Workers' Compensation definition of what illnesses/injuries are compensated, the level of benefits and who provides the insurance are state-specific. Due to these differences in definition of disability, it is essential for the mental health professional performing a mental disability evaluation to clarify with the referral source or referring agency which legislation and laws they feel are directly relevant to the specific situation before starting the evaluation. While the ADA and ADA Amendments Act of 2008 have had the greatest impact on the improvement of conditions for mentally disabled individuals in employment over the last 25 years, they have also been the most challenging by far for mental health experts to understand and apply (Cook, ). Interestingly, the ADA has had a much quicker effect on improving access to services for the medically disabled as compared with the mentally disabled in the U.S. (Ullman, Johnsen, Moss, & Burris, ). This article reviews the history and status of current ADA- and ADAAA-related law and employment as well as Canadian disability law and global progress towards universal disability legislation as evidenced by the 2006 Convention on the Rights of Persons with Disabilities.

Three studies explored the sensitivity of aversive Pavlovian to instrumental transfer (PIT) to Pavlovian extinction in rodents. Rats underwent Pavlovian conditioning prior to avoidance training. The PIT test then involved assessment of the effects of the Pavlovian conditioned stimulus (CS) on the performance of the avoidance response (AR). Conducting extinction prior to avoidance training and transfer testing, allowed spontaneous recovery and shock reinstatement of extinguished motivation, whereas conducting extinction following avoidance training and just prior to PIT testing successfully reduced transfer effects. This was also the case in a design that compared responding to an extinguished CS against a non-extinguished CS rather than comparing extinguished and non-extinguished groups to one another. While extinction treatments in many appetitive PIT studies do not successfully reduce transfer, and can sometimes enhance the effect, the current findings show that an extinction treatment temporally close to transfer testing can reduce the motivational impact of the aversive Pavlovian CS on instrumental avoidance responding.

Despite growing numbers of homeless youth living in shelters with caregivers, little research has explored the impact of the shelter environment on emotional well-being. As such, this study assesses the relationship between shelter rules and two psychosocial outcomes among youth in New York City family shelters. Additionally, the direct effect of trauma and the moderating effect of difficulty following shelter rules on psychosocial outcomes was assessed. Youth with difficulty following shelter rules reported significantly more depressive symptoms, but less substance use. Trauma was found to be associated with increased depression and substance use. Difficulty following shelter rules was found to moderate the association between trauma and substance use. Recommendations for future interventions and the creation of shelter policies are discussed.

A long history of postmortem studies has provided significant insight into human brain structure and organization. Cadavers have also proven instrumental for the measurement of artifacts and nonneural effects in functional imaging, and more recently, the study of biophysical properties critical to brain stimulation. However, death produces significant changes in the biophysical properties of brain tissues, making an ex vivo to in vivo comparison complex, and even questionable. This study directly compares biophysical properties of electric fields arising from transcranial electric stimulation (TES) in a nonhuman primate brain pre- and postmortem. We show that pre- vs. postmortem, TES-induced intracranial electric fields differ significantly in both strength and frequency response dynamics, even while controlling for confounding factors such as body temperature. Our results clearly indicate that ex vivo cadaver and in vivo measurements are not easily equitable. In vivo examinations remain essential to establishing an adequate understanding of even basic biophysical phenomena in vivo.

OBJECTIVE:Conflicting reports exist about hospital arrival time after stroke onset in Hispanics compared with African Americans and Caucasians. Our current study investigates race-ethnic disparities in hospital arrival times after stroke onset. METHODS:We performed a retrospective analysis of hospital arrival times in Hispanic, African American, and Caucasian acute ischemic stroke patients (N=1790) presenting to a tertiary-care hospital in the Bronx, New York. A multivariable logistic regression model was used to identify the association between race-ethnicity and hospital arrival time adjusting for age, sex, socioeconomic status (SES), NIH stroke scale (NIHSS), history of stroke, preferred language and transportation mode to the hospital. RESULTS:There were 338 Caucasians, 662 Hispanics, and 790 African Americans in the cohort. Compared with Caucasians, African Americans and Hispanics were younger (P<.0001 respectively), had lower SES (P<.001 respectively) and were less likely to use EMS (P=.003 and P=.001, respectively). A greater proportion of Hispanic and African American women had delayed hospital arrival times (≥3 hours) after onset of stroke symptoms compared with Caucasian women (74% of Hispanic, 72% of African American, and 59% of Caucasian women), but this difference between race-ethnicities is no longer present after adjusting for socioeconomic status. Compared with Caucasian men, hospital arrival ≥3 hours after symptom onset was more likely for African American men (OR 1.72, 95% CI:1.05-2.79) but not Hispanic men (OR .80, 95% CI .49-1.30). CONCLUSIONS:African American men and socially disadvantaged women delay in presenting to the hospital after stroke onset. Future research should focus on identifying the factors contributing to pre-hospital delay among race-ethnic minorities.

Relationships between spatially remote brain regions in human have typically been estimated by moment-to-moment correlations of blood-oxygen-level dependent signals in resting-state using functional MRI (fMRI). Recently, studies using subject-to-subject covariance of anatomical volumes, cortical thickness, and metabolic activity are becoming increasingly popular. However, question remains on whether these measures reflect the same inter-region connectivity and brain network organizations. In the current study, we systematically analyzed inter-subject volumetric covariance from anatomical MRI images, metabolic covariance from fluorodeoxyglucose positron emission tomography images from 193 healthy subjects, and resting-state moment-to-moment correlations from fMRI images of a subset of 44 subjects. The correlation matrices calculated from the three methods were found to be minimally correlated, with higher correlation in the range of 0.31, as well as limited proportion of overlapping connections. The volumetric network showed the highest global efficiency and lowest mean clustering coefficient, leaning toward random-like network, while the metabolic and resting-state networks conveyed properties more resembling small-world networks. Community structures of the volumetric and metabolic networks did not reflect known functional organizations, which could be observed in resting-state network. The current results suggested that inter-subject volumetric and metabolic covariance do not necessarily reflect the inter-regional relationships and network organizations as resting-state correlations, thus calling for cautions on interpreting results of inter-subject covariance networks.

PURPOSE/OBJECTIVE:Our study aimed to examine psychometric properties and cross-cultural utility of the Behavior Assessment System for Children-2, Parent Rating Scale-Child (BASC-2 PRS-C) in Korean children. MATERIALS AND METHODS/METHODS:Two study populations were recruited: a general population sample (n=2115) of 1st to 6th graders from 16 elementary schools and a clinical population (n=219) of 6-12 years old from 5 child psychiatric clinics and an epidemiological sample of autism spectrum disorder. We assessed the validity and reliability of the Korean version of BASC-2 PRS-C (K-BASC-2 PRS-C) and compared subscales with those used for US populations. RESULTS:Our results indicate that the K-BASC-2 PRS-C is a valuable instrument with reliability and validity for measuring developmental psychopathology that is comparable to those in Western population. However, there were some differences noted in the mean scores of BASC-2 PRS-C between Korean and US populations. CONCLUSION/CONCLUSIONS:K-BASC-2 PRS-C is an effective and useful instrument with psychometric properties that permits measurement of general developmental psychopathology. Observed Korean-US differences in patterns of parental reports of children's behaviors indicate the importance of the validation, standardization and cultural adaptation for tools assessing psychopathology especially when used in populations different from those for which the instrument was originally created.