Faculty Bibliography

Diffusion tensor imaging has become an important modality in the field of neuroimaging to capture changes in micro-organization and to assess white matter integrity or development. While there exists a number of tractography toolsets, these usually lack tools for preprocessing or to analyze diffusion properties along the fiber tracts. Currently, the field is in critical need of a coherent end-to-end toolset for performing an along-fiber tract analysis, accessible to non-technical neuroimaging researchers. The UNC-Utah NA-MIC DTI framework represents a coherent, open source, end-to-end toolset for atlas fiber tract based DTI analysis encompassing DICOM data conversion, quality control, atlas building, fiber tractography, fiber parameterization, and statistical analysis of diffusion properties. Most steps utilize graphical user interfaces (GUI) to simplify interaction and provide an extensive DTI analysis framework for non-technical researchers/investigators. We illustrate the use of our framework on a small sample, cross sectional neuroimaging study of eight healthy 1-year-old children from the Infant Brain Imaging Study (IBIS) Network. In this limited test study, we illustrate the power of our method by quantifying the diffusion properties at 1 year of age on the genu and splenium fiber tracts.

Since 2005, an extensive literature documents individuals from several families afflicted with "Uner Tan Syndrome (UTS)," a condition that in its most extreme form is characterized by cerebellar hypoplasia, loss of balance and coordination, impaired cognitive abilities, and habitual quadrupedal gait on hands and feet. Some researchers have interpreted habitual use of quadrupedalism by these individuals from an evolutionary perspective, suggesting that it represents an atavistic expression of our quadrupedal primate ancestry or "devolution." In support of this idea, individuals with "UTS" are said to use diagonal sequence quadrupedalism, a type of quadrupedal gait that distinguishes primates from most other mammals. Although the use of primate-like quadrupedal gait in humans would not be sufficient to support the conclusion of evolutionary "reversal," no quantitative gait analyses were presented to support this claim. Using standard gait analysis of 518 quadrupedal strides from video sequences of individuals with "UTS", we found that these humans almost exclusively used lateral sequence-not diagonal sequence-quadrupedal gaits. The quadrupedal gait of these individuals has therefore been erroneously described as primate-like, further weakening the "devolution" hypothesis. In fact, the quadrupedalism exhibited by individuals with UTS resembles that of healthy adult humans asked to walk quadrupedally in an experimental setting. We conclude that quadrupedalism in healthy adults or those with a physical disability can be explained using biomechanical principles rather than evolutionary assumptions.

Alzheimer's disease is a neurodegenerative disorder that is the most common cause of dementia in the elderly today. One of the earliest reported signs of Alzheimer's disease is olfactory dysfunction, which may manifest in a variety of ways. The present study sought to address this issue by investigating odor coding in the anterior piriform cortex, the primary cortical region involved in higher order olfactory function, and how it relates to performance on olfactory behavioral tasks. An olfactory habituation task was performed on cohorts of transgenic and age-matched wild-type mice at 3, 6 and 12 months of age. These animals were then anesthetized and acute, single-unit electrophysiology was performed in the anterior piriform cortex. In addition, in a separate group of animals, a longitudinal odor discrimination task was conducted from 3-12 months of age. Results showed that while odor habituation was impaired at all ages, Tg2576 performed comparably to age-matched wild-type mice on the olfactory discrimination task. The behavioral data mirrored intact anterior piriform cortex single-unit odor responses and receptive fields in Tg2576, which were comparable to wild-type at all age groups. The present results suggest that odor processing in the olfactory cortex and basic odor discrimination is especially robust in the face of amyloid beta precursor protein (AbetaPP) over-expression and advancing amyloid beta (Abeta) pathology. Odor identification deficits known to emerge early in Alzheimer's disease progression, therefore, may reflect impairments in linking the odor percept to associated labels in cortical regions upstream of the primary olfactory pathway, rather than in the basic odor processing itself.

Reviews the book, Reading Anna Freud by Nick Midgley (see record 2012-32286-000). Reading Anna Freud is less a work of criticism than a work of orientation, and doubly valuable as such. First, because of the Freud family fame, one sometimes presumes one knows more about them than one really does (indeed, a misplaced presumption of familiarity is at the core of so much of the popular contempt hurled Sigmund's way). Second, orienting yourself to Anna Freud is a way of orienting yourself to child mental health: from how we speak to children and the role of schools in a child's psychological health to developmental psychopathology and the consultation-liaison service. What comes through in Reading Anna Freud is that the core of Freud's success was not just patient, compassionate intellectualism, genes, or an ability to get published, but advocacy. Moreover, you do not need a degree or an internal review board to be an advocate. In fact, it is in this regard that she is most inspiring. Although the book provides a historical and personal orientation, it is intended as an orientation to Freud's intellectual contributions, and Midgely does an excellent job translating her work, some of it nearly a century old, into a language that is still alive, relevant, and enriching.

The future of the textbook as we know it is in doubt. Knowledge is being shuttled into the virtual world, where it is collaborative, linked, multimedia, and transnational. The iterative nature of knowledge never fit comfortably with textbooks. They have always been notoriously out of date by the time they roll off the press. Nevertheless, there remains something comforting in the textbook's authoritative heft, which is lost not only in the vapor-thin flicker of Web pages but also in the suspicion with which we approach anything online, knowing full well that the provenance is dubious. Sock puppetry is not just a children's craft anymore; it's a modern form of authorship. Of course, textbooks have value as a corpus of knowledge that is not constantly changing; as a way of studying a topic without being distracted by the rabbit holes of the Internet; and as a backup: all knowledge will not be lost in a blackout. What the future of the textbook means for expert knowledge is unclear. How can hardcover and paperback textbooks carve out a place in tomorrow's society? One answer may be to look back.

The human brain undergoes dramatic maturational changes during late stages of fetal and early postnatal life. The importance of this period to the establishment of healthy neural connectivity is apparent in the high incidence of neural injury in preterm infants, in whom untimely exposure to ex-uterine factors interrupts neural connectivity. Though the relevance of this period to human neuroscience is apparent, little is known about functional neural networks in human fetal life. Here, we apply graph theoretical analysis to examine human fetal brain connectivity. Utilizing resting state functional magnetic resonance imaging (fMRI) data from 33 healthy human fetuses, 19 to 39 weeks gestational age (GA), our analyses reveal that the human fetal brain has modular organization and modules overlap functional systems observed postnatally. Age-related differences between younger (GA <31 weeks) and older (GA≥31 weeks) fetuses demonstrate that brain modularity decreases, and connectivity of the posterior cingulate to other brain networks becomes more negative, with advancing GA. By mimicking functional principles observed postnatally, these results support early emerging capacity for information processing in the human fetal brain. Current technical limitations, as well as the potential for fetal fMRI to one day produce major discoveries about fetal origins or antecedents of neural injury or disease are discussed.

The aim of this study was to examine the information acquisition strategies of expert and competent non-expert intensive care physicians during two simulated diagnostic scenarios involving respiratory distress in an infant. Specifically, the information acquisition performance of six experts and 12 competent non-experts was examined using an eye-tracker during the initial 90 s of the assessment of the patient. The results indicated that, in comparison to competent non-experts, experts recorded longer mean fixations, irrespective of the scenario. When the dwell times were examined against specific areas of interest, the results revealed that competent non-experts recorded greater overall dwell times on the nurse, where experts recorded relatively greater dwell times on the head and face of the manikin. In the context of the scenarios, experts recorded differential dwell times, spending relatively more time on the head and face during the seizure scenario than during the coughing scenario. The differences evident between experts and competent non-experts were interpreted as evidence of the relative availability of task-specific cues or heuristics in memory that might direct the process of information acquisition amongst expert physicians. The implications are discussed for the training and assessment of diagnostic skills.

In this qualitative study the authors examine factors associated with the successful implementation and plans for continued use of an evidence-informed intervention, the 4Rs and 2Ss Program for Strengthening Families, in a sample of 29 New York State, Office of Mental Health licensed child mental health clinics. A learning collaborative (LC) approach was used as a vehicle for supporting training and implementation of the program. The PRISM theoretical framework ( Feldstein & Glasgow, 2008 ) was used to guide the data analysis. Data were analyzed using a multi-phase iterative process, identifying influences on implementation at multiple levels: the program (intervention), the external environment, implementation and sustainability infrastructure, and recipient characteristics. Clinics that were more proactive evidenced staff with advanced organizational skills were able to take advantage of the trainings and supports offered by the LC and fared better in their ability to adopt the intervention. The ability to adapt the intervention to the specific constraints of the clinics was a strong influence on continued use following the end of the LC. These preliminary results suggest that the supports provided by the LC are useful in consolidating information about the process of implementing evidence-informed interventions in community mental health settings. The impact of these supports is also based on their interactions with specific clinic contextual factors.

This article reviews the progression of a research program designed to develop, implement, and study the implementation of "achievable" evidence-based practices (EBPs) in schools. We review challenges encountered and ideas to overcome them to enhance this avenue of research. The article presents two federally funded randomized controlled trials involving comparison of a four-component targeted intervention (Quality Assessment and Improvement, Family Engagement and Empowerment, Modular Evidence-Based Practice, Implementation Support) versus a comparison intervention focused on personal wellness. In both studies, primary aims focused on changes in clinician attitudes and behavior, including the delivery of high-quality EBPs and secondary aims focused on student-level impacts. A number of challenges, many not reported in the literature, are reviewed, and ideas for overcoming them are presented. Given the reality that the majority of youth mental health services are delivered in schools and the potential of school mental health services to provide a continuum of mental health care from promotion to intervention, it is critical that the field consider and address the logistical and methodological challenges associated with implementing and studying EBP implementation by clinicians.