Faculty Bibliography

INTRODUCTION/UNASSIGNED:Poor dental health is linked to poor physical and mental health. This study was aimed to examine the characteristics of U.S. adults that are associated with having seen a dentist in the past year. METHODS/UNASSIGNED:A cross-section of adults aged 18-64 years (N=19,975) from the 2023 National Health Interview Survey was examined. Bivariate analyses examined the associations of sociodemographic and financial variables with recent dental visits in the last 12 months. Multinomial modeling was used to assess these variables to predict 3 outcomes of time since the last dental visit: in the last 12 months; over a year but <10 years; and over 10 years or never, which was the reference category. RESULTS/UNASSIGNED:In young and middle-aged adults, 4.8% of Americans, representing over 9 million people, had either never seen a dentist or not seen a dentist in 10 years or more. The likelihood of a dental visit in the last 12 months increased with education level (no high-school degree versus a graduate or professional degree [AOR=0.21, 95% CI=0.09, 0.50]) and income (income below the federal poverty line versus income in the highest quartile [AOR=0.20, 95% CI=0.11, 0.35]). Having dental coverage in a private plan or Medicaid, compared with having no coverage, predicted having a dental visit within the last 12 months in both multinomial and bivariate analyses. CONCLUSIONS/UNASSIGNED:Access to dental care in young and middle-aged adults is determined by financial ability. Increasing access to dental care could happen once the financial barriers to dental care are reduced, including increasing the age at which a young adult can be covered by a parent's plan and making dental coverage comparable with physical health coverage. Given the current data about the links between dental, mental, and physical health, parity for all care is warranted.

The collection of electroencephalography (EEG) data in neonates typically occurs during sleep. EEG activity is highly sleep-state dependent, therefore differentiating between states during data processing can provide important insights into neurodevelopment. Despite this, there have been a paucity of studies directly comparing how infant EEG data, especially event-related potentials, differ between these sleep states. Here, we adapted the Maryland Analysis of Developmental EEG pipeline (MADE) to integrate sleep-state coding into its automated preprocessing pipeline. We recorded EEG in 102 sleeping one month old infants and evaluated their responses during a resting state and during a three-stimuli auditory oddball paradigm. Examination of resting-state power revealed significant differences between two sleep states, namely active (AS) and quiet (QS) sleep across all frequency bands in both absolute and relative power. For the auditory oddball paradigm, we computed responses to both standard and deviant tones and then created a difference score reflecting the Mismatch Response (MMR). For the novel tones we examined the evoked response (P300). Results revealed for the MMR, a significant electrode cluster by sleep-state interaction (F = 5.36, p = .01), indicating that the MMR was present at all three electrode clusters during AS (p-values <.05), but only at the frontal cluster during QS (t = 2.05, p = .04). There were no differences in the amplitude of the P300 to the novel sound as a function of sleep state.

Youth are presenting to Emergency Departments (EDs) following a suicide-related crisis at higher rates and younger ages. Clinicians lack tools to effectively discern suicide risk in younger patients. The present investigation examines how ED-based, suicidal pre-adolescents and adolescents conceptualize death. One hundred and sixty-seven suicidal pre-adolescents and adolescents (10-17 years; M = 12, SD = 1.4) presenting to a psychiatric ED with a suicide-related chief complaint completed assessments of suicidal ideation (SI; passive and active thoughts), suicide attempt (SA), depressive symptoms, and death conceptualizations (Death Avoidance, Escape Acceptance, Neutral Acceptance). Post-discharge SI and SA were assessed via survey emailed to participants 6 months later and via electronic medical record. At baseline, lower levels of Death Avoidance and higher levels of Escape Acceptance were most robustly associated with active SI. Pre-adolescents reported higher levels of Death Avoidance and lower levels of Escape Acceptance than adolescents at baseline. Death conceptualizations did not predict follow-up SI and SA. Youth who have recently experienced a suicide-related crisis are more likely to accept death as an escape from painand spend less time avoiding thoughts about death. This profile appears to be more representative of adolescents, relativeto pre-adolescents who display the opposite pattern.

BACKGROUND/UNASSIGNED:Pregnancy requires finely tuned immune changes that support implantation, placental development, maternal-fetal tolerance, and preparation for labor, yet the normative trajectories of circulating inflammatory proteins across gestation remain poorly defined. This cross-sectional study investigates how circulating inflammatory proteins vary with gestational age in pregnancy and examines the impacts of fundamental biological characteristics, such as gravidity and fetal sex. METHODS/UNASSIGNED:Data were drawn from 1154 pregnant individuals from six study sites of the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Cohort. We used Olink high-throughput proteomic profiling to map cross-sectional associations between protein expression levels and gestational age at blood draw using linear, spline-based, and generalized additive modeling approaches. RESULTS/UNASSIGNED:Generalized additive models provided the best fit, revealing that immune changes across pregnancy were predominantly nonlinear. Sixty-one proteins showed significant associations with gestational age, with many exhibiting shared inflection points that aligned with major physiological transitions. A small subset of proteins also showed evidence of modification by fetal and maternal characteristics. CD244 displayed different gestational patterns by fetal sex, while CST5 and SIRT2 showed varied gestational associations by maternal gravidity. CONCLUSION/UNASSIGNED:The findings highlight pregnancy as a sequence of coordinated immune transitions rather than a simple linear shift and provide one of the most detailed characterizations to date of circulating inflammatory protein dynamics across human gestation. Establishing these normative trajectories offers a crucial reference for detecting early deviations that may signal risk for pregnancy complications and for identifying biomarkers in maternal and fetal health research.

A large body of evidence supports the role of the prenatal environment in shaping childhood development. The relative contributions of prenatal alcohol use (PAE), maternal socioeconomic, and nutritional status on child development vary in high- versus low-income settings. We analyzed data from a prospective cohort study among mother-infant dyads from Cape Town (CT), South Africa and the Northern Plains (NP), USA. The Mullen Scales of Early Learning were administered by trained assessors to evaluate cognitive, motor, and language development of 1-year old children. We used multiple linear regression models to assess standardized mean differences in development scores by (1) maternal prenatal factors, (2) delivery factors and (3) child factors within each study site. 1,728 infants from CT and 1,140 infants from the NP were included in the analyses. In CT, infants with moderate-to-high PAE had 0.17 SD (95% CI -0.30, -0.04) lower cognitive and 0.15 SD (-0.29, -0.2) lower expressive language scores compared to infants without PAE. In the NP, maternal obesity (BMI > 30 kg/m2) was significantly associated with -0.21 SD (-0.36, -0.06), and -0.13 SD (-0.27, -0.02) reductions in cognitive, and expressive language scores, respectively. Household crowding, lower levels of maternal educational attainment, prenatal maternal depression, low birthweight, admission to neonatal intensive care unit, and male sex had significant negative associations with cognitive and language development in both sites with effects ranging from -0.32 to -0.11 SDs. These results highlight the importance of assessing risk factors by populations across diverse social and cultural environments and emphasize the imperative to formulate intervention packages tailored to the local context.

Exposure to trauma is common and frequently overlooked in behaviorally dysregulated youth. Common trauma-related symptoms, such as exaggerated startle responses, dissociative episodes, and irritability, may resemble behavioral dysregulation. These responses may not be recognized as being related to trauma. As a result, traumatized young people are often misdiagnosed and treated with antipsychotics. Trauma-informed care in health care settings, which includes systematic screening, staff training, trauma skills groups, and ongoing monitoring, is one way of addressing the effects of trauma and ensuring that young people receive access to the evidence-based care they deserve.

Currently, the identification of individuals experiencing suicidal thoughts and behaviours (STBs) rely predominantly on self-report. Previous research on children and young people highlighted an association between difficulties in arousal regulation (reflected, for example, in reduced heart rate variability and altered electrodermal activity patterns) and STBs, but this has not been meta-analytically explored in adults. This systematic review and meta-analysis aimed to quantify the association between STBs and markers of autonomic functioning/regulation in adults. Based on a pre-registered protocol (PROSPERO CRD42024596886), we searched PubMed/MEDLINE, Embase, PsycINFO and Web of Science until 2^nd August 2025 for empirical studies assessing the association between measures of autonomic functioning and/or regulation and STBs in adults. Quality of cross-sectional and cohort studies was assessed through the Newcastle-Ottawa Scale. Pooled effect sizes (Hedge's g) were estimated with random-effects meta-analytic models in R. Out of 2,726 articles screened, 40 studies were included in the systematic review, and 22 in the meta-analyses (6,290 individuals, 28% with STBs). We found reduced heart rate variability in adults with STBs (g = -0.2469, p = 0.0069) but no significant associations between electrodermal activity patterns and STBs (g = -0.2563, p = 0.3953). Our results highlight the connection between reduced cardiac regulation and STBs, providing a rationale for further exploration of cardiac regulation as a potential objective marker for assessing and monitoring STBs in adults. Further research is warranted to understand how these markers can be used in clinical practice to assess and support the management of suicide risk in adults.

Trauma exposure in children and adolescents is a significant public health concern due to its profound impact on mental health and development. This study explores the complexities of trauma in youth, including the differentiation between trauma exposure and posttraumatic stress disorder, and the long-term effects of adverse childhood experiences. The study discusses the risks and benefits of polypharmacy in treating complex trauma and comorbid conditions in youth. Given the current gaps in research, the study emphasizes the need for comprehensive, individualized treatment plans that integrate psychotherapy, pharmacologic interventions, and psychosocial support to foster resilience and improve outcomes for trauma-exposed youth.