Faculty Bibliography

Unprecedented media coverage of concussion in sport has led to increased fears regarding the potential negative effects of participation in contact sports including North American football and ice hockey. Initial responses of professional sports leagues to implementation of acute concussion management practices and reports of a neurodegenerative condition known as chronic traumatic encephalopathy (CTE) developing in retired players caused an atmosphere of distrust whereby the leagues were accused of maintaining cover-ups analogous to what had been seen in association with studies of tobacco and smoking. This article reviews the important role that psychology has played in the study of sports concussion and in the establishment of methods currently used to diagnose and track concussion symptoms. Results of existing studies have shown that the neurobiological effects of concussion are rather short-lived with development of persisting symptoms in some individuals associated more with psychosocial factors than underlying physiological effects. With regard to CTE, the status of the science remains preliminary with little definitive information known about its epidemiology or cause. In the midst of the ongoing controversy, a polarized climate has developed in association with concussion and CTE, divided by believers in the dangers of long-term consequences and deniers who question the status of the existing science. The conclusion is that it is important for psychology to extend its scope of study to provide increased understanding of the social factors underlying the current polarized climate while continuing to provide the public with an accurate and reliable account of the existing science. (PsycInfo Database Record (c) 2020 APA, all rights reserved)Public Significance Statement"”Continued media reporting of the sports concussion and its potential long-term effects has been accompanied by public concerns about the safety of contact sports and potential development of chronic traumatic encephalopathy (CTE). Controversies have emerged about the status of the science, creating polarization on the topic. Psychology has provided significant contributions to our scientific knowledge on sports concussion and has the potential to provide a key to understanding the factors underlying division on these topics. (PsycInfo Database Record (c) 2020 APA, all rights reserved)Une couverture médiatique sans précédent des commotions cérébrales dans le sport a entraîné une augmentation des craintes quant aux effets négatifs potentiels de la participation aux sports de contact, notamment au football et au hockey sur glace en Amérique du Nord. Les premières réponses des ligues sportives professionnelles à la mise en Å“uvre de pratiques de gestion des commotions aiguës et les déclarations de maladie neurodégénérative connue sous le nom d"™encéphalopathie traumatique chronique (CTE) en développement chez les joueurs retraités ont provoqué une atmosphère de méfiance où les ligues ont été accusées de dissimulations de manière similaire à ce qui avait été observé avec les études sur le tabac et le tabagisme. Le présent article examine le rôle important que la psychologie a joué dans l"™Ã©tude des commotions liées au sport et dans l"™Ã©tablissement de méthodes actuellement utilisées pour diagnostiquer et surveiller les symptômes de commotion cérébrale. Les résultats des études existantes ont montré que les effets neurobiologiques de commotion cérébrale sont plutôt de courte durée avec l"™apparition de symptômes persistants, chez certaines personnes, plutôt associés à des facteurs psychosociaux qu"™aux effets physiologiques sous-jacents. En ce qui concerne la CTE, le statut de la science reste préliminaire, avec peu de renseignements définitifs connus sur son épidémiologie ou sa cause. Au cÅ“ur de la controverse actuelle, un climat polarisé s"™est développé en lien avec la commotion cérébrale et la CTE, divisé par les croyants aux dangers des conséquences à long terme et les négateurs qui remettent en question le statut de la science existante. En conclusion, il est important pour la psychologie d"™Ã©tendre sa portée d"™Ã©tude afin de mieux comprendre les facteurs sociaux sous-jacents au climat polarisé actuel tout en continuant à fournir au public un compte rendu exact et fiable de la science existante. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

This paper is a contribution to a theory of duration and subjective time in dream and waking consciousness. According to microgenetic theory, an act of thought begins, Wittgenstein wrote, and psychoanalysts would agree, as would I, with instinct as the animal inheritance traverses the evolutionary core of the brain, the drives arousing acquired experience and knowledge. These strands of the inherited and acquired constitute the core self, the "me," which is bound up with bodily function, immediacy and the largely innate determinants of behavior. This construct passes a liminal threshold leading to a conscious self in relation to desire for objects or conditions in the future. Thus, the self appears early in the mental state prior to thought and the endpoint of object-perception. A mental state enfolds a transition from instinct to thought to perception in a fraction of a second. The partial overlap of early segments in a series of mental states arouses preliminary phases out of which thoughts and perceptions actualize. Long-term or experiential memories, revised but not erased by the oncoming state, serve as a foundation for thought and perception, while segments at the surface or endpoint of the state that transition to an object, which are not enfolded in the overlap, are receptive to new perceptions. In dreaming, the specious or illusory present arises in the overlap of mental states and the incomplete revival of their predecessors. Incompleteness of revival is the key to recall as fading states lapse to successive planes of iconic, short- and long-term memory. The present arises in the forgetting of perceptions, or the passage of perceptual to memorial content, as the disparity between the floor of the mental state"“the endpoint of withdrawal beneath recall"“and conscious revival"“the ceiling of the mental state"“in the final actuality. This disparity is converted to a longitudinal epoch of duration. The degree to which each state is revived"“the forgetting of each state, in dream and waking"“accounts for the rapid decay in dream recall on waking, as well as the predominance of imagery.

Background/UNASSIGNED:F]PARPi, as a diagnostic tool to differentiate between brain cancers and treatment-related changes. Methods/UNASSIGNED:F]PARPi acquisition on a dedicated positron emission tomography/magnetic resonance (PET/MR) scanner. Lesion diagnosis was established by pathology when available or by Response Assessment in Neuro-Oncology (RANO) or RANO-BM response criteria. Resected tissue also underwent PARPi-FL staining and PARP1 immunohistochemistry. Results/UNASSIGNED:F]PARPi uptake on PET/MR in active brain cancers and low uptake in treatment-related changes independent of blood-brain barrier disruption. Immunohistochemistry results confirmed higher PARP1 expression in cancerous than in noncancerous tissue. Specificity was also corroborated by blocking fluorescent tracer uptake with an excess unlabeled PARP inhibitor in patient cancer biospecimen. Conclusions/UNASSIGNED:F]PARPi as a diagnostic tool to evaluate patients with brain cancers and possible treatment-related changes.

Background and Purpose/UNASSIGNED:The ideal dosing regimen of 4-factor prothrombin complex concentrate (4FPCC) after warfarin-induced intracranial hemorrhage (WICH) remains unclear. We sought to compare the safety and efficacy of the 4FPCC package insert dosing strategy (standard dose [SD]) with our institutional guideline for high-dose (HD) 4FPCC for patients with WICH. Methods/UNASSIGNED:We compared the percentage of SD and HD patients who achieved an international normalized ratio (INR) ≤1.3 at a single institution between January 2014 and July 2017. Additionally, we assessed hematoma expansion, recurrence of INR > 1.3, and occurrence of thrombotic events within 7 days of 4FPCC administration. Results/UNASSIGNED:= .243). Conclusions/UNASSIGNED:High-dose 4FPCC appears to be more effective at lowering INR and preventing bleed expansion in patients with WICH, while maintaining a similar safety profile.

Background/UNASSIGNED:Pediatric intracranial aneurysms tend to differ in etiology, size, and location from their adult counterparts, and they are often less amenable to microsurgical clip reconstruction techniques. Endovascular treatment with detachable coils is an accepted treatment technique for pediatric patients, though high recurrence rates have been reported with coil embolization of large and giant aneurysms in this population. While the Pipeline Embolization Device (PED) is FDA-approved for adult intracranial aneurysms, the use of PEDs in pediatric patients is considered off-label. Case Descriptions/UNASSIGNED:We present 3 cases of pediatric intracranial aneurysms in a 5-year-old male, a 12-year-old male, and a 12-year-old female who presented with symptoms including seizure, headache, and blurred vision. The 2 male patients were found to have intradural vertebral artery saccular aneurysms, while the female patient had a paraophthalmic right internal carotid complex aneurysm. After endovascular reconstruction of the aneurysms with PEDs, follow-up angiography showed complete occlusion of the previous aneurysms with no residual aneurysm filling in all 3 cases. Conclusion/UNASSIGNED:While further investigation is needed, the evidence presented here supports the conclusion that the PED can be an effective and viable treatment strategy in the pediatric population.

OBJECTIVES/OBJECTIVE:This study aims to investigate the role and mechanism of FGFR3 in macrophages and their biological effects on the pathology of arthritis. METHODS:Mice with conditional knockout of FGFR3 in myeloid cells (R3cKO) were generated. Gait behaviours of the mice were monitored at different ages. Spontaneous synovial joint destruction was evaluated by digital radiographic imaging and μCT analysis; changes of articular cartilage and synovitis were determined by histological analysis. The recruitment of macrophages in the synovium was examined by immunostaining and monocyte trafficking assay. RNA-seq analysis, Western blotting and chemotaxis experiment were performed on control and FGFR3-deficient macrophages. The peripheral blood from non-osteoarthritis (OA) donors and patients with OA were analysed. Mice were treated with neutralising antibody against CXCR7 to investigate the role of CXCR7 in arthritis. RESULTS:R3cKO mice but not control mice developed spontaneous cartilage destruction in multiple synovial joints at the age of 13 months. Moreover, the synovitis and macrophage accumulation were observed in the joints of 9-month-old R3cKO mice when the articular cartilage was not grossly destructed. FGFR3 deficiency in myeloid cells also aggravated joint destruction in DMM mouse model. Mechanically, FGFR3 deficiency promoted macrophage chemotaxis partly through activation of NF-κB/CXCR7 pathway. Inhibition of CXCR7 could significantly reverse FGFR3-deficiency-enhanced macrophage chemotaxis and the arthritic phenotype in R3cKO mice. CONCLUSIONS:Our study identifies the role of FGFR3 in synovial macrophage recruitment and synovitis, which provides a new insight into the pathological mechanisms of inflammation-related arthritis.

Background and Purpose/UNASSIGNED:Many studies supporting the association between specific surgical procedure categories and postoperative stroke (POS) do not account for differences in patient-level characteristics between and within surgical categories. The risk of POS after high-risk procedure categories remains unknown after adjusting for such differences in patient-level characteristics. Methods/UNASSIGNED:Using inpatients in the American College of Surgeons National Surgical Quality Initiative Program database, we conducted a retrospective cohort study between January 1, 2000, and December 31, 2010. Our primary outcome was POS within 30 days of surgery. We characterized the relationship between surgical- and individual patient-level factors and POS by using multivariable, multilevel logistic regression that accounted for clustering of patient-level factors with surgical categories. Results/UNASSIGNED:We identified 729 886 patients, 2703 (0.3%) of whom developed POS. Dependent functional status (odds ratio [OR]: 4.11, 95% confidence interval [95% CI]: 3.60-4.69), history of stroke (OR: 2.35, 95%CI: 2.06-2.69) or transient ischemic attack (OR: 2.49 95%CI: 2.19-2.83), active smoking (OR: 1.20, 95%CI: 1.08-1.32), hypertension (OR: 2.11, 95%CI: 2.19-2.82), chronic obstructive pulmonary disease (OR: 1.39 95%CI: 1.21-1.59), and acute renal failure (OR: 2.35, 95%CI: 1.85-2.99) were significantly associated with POS. After adjusting for clustering, patients who underwent cardiac (OR: 11.25, 95%CI: 8.52-14.87), vascular (OR: 4.75, 95%CI: 3.88-5.82), neurological (OR: 4.60, 95%CI: 3.48-6.08), and general surgery (OR: 1.40, 95%CI: 1.15-1.70) had significantly greater odds of POS compared to patients undergoing other types of surgical procedures. Conclusions/UNASSIGNED:Vascular, cardiac, and neurological surgery remained strongly associated with POS in an analysis accounting for the association between patient-level factors and surgical categories.

We report 281 individuals carrying a pathogenic recurrent NF1 missense variants at p.Met1149, p.Arg1276 or p.Lys1423, representing three non-truncating NF1 hotspots in the University of Alabama at Birmingham (UAB) cohort, together identified in 1.8% of unrelated NF1 individuals. About 25% (95% CI, 20.5%-31.2%) of individuals heterozygous for a pathogenic NF1 p.Met1149, p.Arg1276 or p.Lys1423 missense variant had a Noonan-like phenotype, which is significantly more compared to the "classic" NF1-affected cohorts (all P<0.0001). Furthermore, p.Arg1276 and p.Lys1423 pathogenic missense variants were associated with a high prevalence of cardiovascular abnormalities, including pulmonic stenosis (all P<0.0001), while p.Arg1276 variants had a high prevalence of symptomatic spinal neurofibromas (P<0.0001) compared with "classic" NF1-affected cohorts. However, p.Met1149-positive individuals had a mild phenotype, characterized mainly by pigmentary manifestations without externally visible plexiform neurofibromas, symptomatic spinal neurofibromas or symptomatic optic pathway gliomas. As up to 0.4% of unrelated individuals in the UAB cohort carries a p.Met1149 missense variant, this finding will contribute to more accurate stratification of a significant number of NF1 individuals. Although clinically relevant genotype-phenotype correlations are rare in NF1, each affecting only a small percentage of individuals, together they impact counseling and management of a significant number of the NF1 population. This article is protected by copyright. All rights reserved.