A Novel Predictive Model Utilizing Retinal Microstructural Features for Estimating Survival Outcome in Patients with Glioblastoma.

Glioblastoma is a highly aggressive brain tumor with poor prognosis despite surgery and chemoradiation. The visual sequelae of glioblastoma have not been well characterized. This study assessed visual outcomes in glioblastoma patients through neuro-ophthalmic exams, imaging of the retinal microstructures/microvasculature, and perimetry. A total of 19 patients (9 male, 10 female, average age at diagnosis 69 years) were enrolled. Best-corrected visual acuity ranged from 20/20-20/50. Occipital tumors showed worse visual fields than frontal tumors (mean deviation - 14.9 and - 0.23, respectively, p < 0.0001). Those with overall survival (OS) < 15 months demonstrated thinner retinal nerve fiber layer and ganglion cell complex (p < 0.0001) and enlarged foveal avascular zone starting from 4 months post-diagnosis (p = 0.006). There was no significant difference between eyes ipsilateral and contralateral to radiation fields (average doses were 1370 cGy and 1180 cGy, respectively, p = 0.42). A machine learning algorithm using retinal microstructure and visual fields predicted patients with long (≥ 15 months) progression free and overall survival with 78% accuracy. Glioblastoma patients frequently present with visual field defects despite normal visual acuity. Patients with poor survival duration demonstrated significant retinal thinning and decreased microvascular density. A machine learning algorithm predicted survival; further validation is warranted.

Nutritional management of chyle leak after head and neck surgery: a systematic review and proposed protocol for management.

PURPOSE: Chyle leaks are a rare complication of neck surgery causing local damage, impairing healing and compromising free flaps. High output leaks can result in electrolyte imbalances and malnutrition. Nutritional management such as restricting the absorption of triglycerides is believed to reduce chyle, allowing spontaneous resolution of a leak. Dietary preparations and management can aid in reducing chyle production. There are no clear guidelines to aid nutritional decision-making in this complex scenario. METHODS: A systematic review of the literature was carried out to identify studies evaluating nutritional management of chyle leaks in patients after neck dissections. RESULTS: Ten studies were identified evaluating the role of nutritional therapy in the management of patients with chyle leaks after neck dissections. The level of evidence was low. Several studies identified that low volume leaks (defined as < 1000 mls per day) often resolved by dietary management and other conservative measures. High volume leaks rarely resolved with conservative measures alone. Parenteral nutrition had an established role in this context. CONCLUSIONS: There is limited evidence to guide dietary restriction and introduction of oral diet in patients with chyle leak after major head and neck surgery. Based on available evidence, local guidelines for the nutritional management of patients identified with a chyle leak were produced and adopted by the Trust and the head and neck MDT. A national database for voluntary contribution of prospective data would help to generate better quality management protocols.

Ways to Improve Workflow and Morale in an Ophthalmology Clinic: Survey Advice from Clinic Staff.

Objective: We aim to improve job workflow and satisfaction amongst clinic staff at an academic ophthalmology department. Methods: We analyzed survey data given over a 2-week period in July 2021. The participants were support staff (N = 18) from an academic ophthalmology department. Paper surveys were distributed to participants and returned anonymously for analysis. Results: The survey contained 9 Likert-style categorical questions, 2 of which were free response options. A total of 22 participants attempted the survey, 18 of these (82%) were complete and included in analysis. About half of the staff were satisfied with the current workflow 10/18 (56%). Staff who were clinical care coordinators had the lowest average satisfaction (2/5 on a 5-point scale) and the nursing team had the highest average (4.75/5). The most common staff suggestion for improving workflow efficiency was to train residents on forwarding and answering messages more effectively. Conclusion: This survey suggests that assigning patient message processing to the nursing staff can improve job satisfaction and workflow. Staff told us that the most exciting part of the job was appreciation from coworkers 9/30 (30%) and from physicians 8/30 (27%). The findings provide advice to physicians for optimizing communication, and staff experience, within their own ophthalmology clinics.

Examining the long-term cognitive effects of exposure to the Canterbury earthquakes in a resilient cohort.

BACKGROUND: Although most people do not develop mental health disorders after exposure to traumatic events, they may experience subtle changes in cognitive functioning. We previously reported that 2-3 years after the Canterbury earthquake sequence, a group of trauma-exposed people, who identified as resilient, performed less well on tests of spatial memory, had increased accuracy identifying facial emotions and misclassified neutral facial expressions to threat-related emotions, compared with non-exposed controls. AIMS: The current study aimed to examine the long-term cognitive effects of exposure to the earthquakes in this resilient group, compared with a matched non-exposed control group. METHOD: At 8-9 years after the Canterbury earthquake sequence, 57 earthquake-exposed resilient (69% female, mean age 56.8 years) and 60 non-exposed individuals (63% female, mean age 55.7 years) completed a cognitive testing battery that assessed verbal and visuospatial learning and memory, executive functioning, psychomotor speed, sustained attention and social cognition. RESULTS: With the exception of a measure of working memory (Digit Span Forward), no significant differences were found in performance between the earthquake-exposed resilient and non-exposed groups on the cognitive tasks. Examination of changes in cognitive functioning over time in a subset (55%) of the original earthquake-exposed resilient group found improvement in visuospatial performance and slowing of reaction times to negative emotions. CONCLUSIONS: These findings offer preliminary evidence to suggest that changes in cognitive functioning and emotion processing in earthquake-exposed resilient people may be state-dependent and related to exposure to continued threat in the environment, which improves when the threat resolves.

Development of Gelatin-Coated Hydrogel Microspheres for Novel Bioink Design: A Crosslinker Study.

The development of vascularized tissue is a substantial challenge within the field of tissue engineering and regenerative medicine. Studies have shown that positively-charged microspheres exhibit dual-functions: (1) facilitation of vascularization and (2) controlled release of bioactive compounds. In this study, gelatin-coated microspheres were produced and processed with either EDC or transglutaminase, two crosslinkers. The results indicated that the processing stages did not significantly impact the size of the microspheres. EDC and transglutaminase had different effects on surface morphology and microsphere stability in a simulated colonic environment. Incorporation of EGM and TGM into bioink did not negatively impact bioprintability (as indicated by density and kinematic viscosity), and the microspheres had a uniform distribution within the scaffold. These microspheres show great potential for tissue engineering applications.

Improving prospective memory with contextual cueing.

Prospective memory (PM) involves remembering to perform an intended action in the future. Researchers have demonstrated that, under certain conditions, contextual information about when PM performance opportunities are likely to occur can support PM performance while decreasing the cognitive demands of the PM task. The current study builds upon prior work to investigate whether warning participants that a PM-relevant context was approaching would improve the efficiency of PM control processes and benefit PM accuracy. Participants completed an ongoing lexical decision task with an embedded PM task of responding to a target syllable. For context conditions, targets only appeared on trials where letter strings were colored red (PM-relevant context), while PM-irrelevant trials were green. The warning in Experiment 1 was embedded in the ongoing task (trials preceding PM-relevant contexts were colored yellow). In Experiment 2 the warning was separate from the ongoing task (1-s pre-trial red fixation preceding PM-relevant contexts). Context improved PM control efficiency and PM accuracy in both experiments. Context always improved PM accuracy for targets in the second and third trial positions of PM-relevant contexts; however, only the Experiment 2 warning generated an accuracy benefit for targets in the first trial position. Experiment 3 replicated the findings of Experiments 1 and 2 and also confirmed that color change without associated context was not responsible for the current results.

When do pictures reduce false memory?

An important discovery in false-memory research is Israel and Schacter's (Psychonomic Bulletin & Review, 4, 577-581, 1997) finding that presenting pictures at study relative to words alone reduces false memory in the DRM paradigm, a result that has been replicated many times. The standard interpretation is that memory for visual processing of the pictures can be used to reject the critical distractors, which were not explicitly present at study. Beginning from the empirical observation that the pictures used by Israel and Schacter are not consistently labelled with the DRM word they are supposed to represent, we present a series of four studies designed to determine if it is the presentation of pictures or the mismatch between the pictures and the words that reduces false memory. The results across the four experiments demonstrate that picture presentation at study is neither necessary nor sufficient to reduce false memory in the DRM and the categorical associate paradigms. However, we discuss other studies in which picture processing clearly is responsible for reduction of false alarms and note that these studies use study materials and memory tests that are different from the DRM and categorical associate paradigms in that critical lures are externally provided rather than generated. We speculate that the effectiveness of memory for visual processing for reducing false memory may depend on the source of the false memory, but this remains for future research.

Earthquake brain: Impairment of spatial memory following long-term earthquake-related stress.

OBJECTIVES: The primary aim of this study was to investigate neuropsychological function in patients with earthquake-related posttraumatic stress disorder, compared with earthquake-exposed but resilient controls. We hypothesised that individuals with posttraumatic stress disorder would have poorer neuropsychological performance on tests of verbal and visuospatial learning and memory compared with the earthquake-exposed control group. The availability of groups of healthy patients from previous studies who had been tested on similar neuropsychological tasks prior to the earthquakes allowed a further non-exposed comparison. METHOD: In all, 28 individuals with posttraumatic stress disorder and 89 earthquake-exposed controls completed tests of verbal and visuospatial learning and memory and psychomotor speed. Further comparisons were made with non-exposed controls who had been tested before the earthquakes. RESULTS: No significant difference in performance on tests of verbal or visuospatial memory was found between the earthquake-exposed groups (with and without posttraumatic stress disorder), but the posttraumatic stress disorder group was significantly slowed on tests of psychomotor speed. Supplementary comparison with historical, non-exposed control groups showed that both earthquake-exposed groups had poorer performance on a test of visuospatial learning. CONCLUSION: The key finding from this study is that there were no differences in verbal or visuospatial learning and memory in individuals with posttraumatic stress disorder compared with similarly earthquake-exposed controls. Compared with non-exposed controls, both earthquake-exposed groups had poorer performance on a test of visuospatial (but not verbal) learning and memory. This offers preliminary evidence suggesting that it is earthquake (trauma) exposure itself, rather than the presence of posttraumatic stress disorder that affects aspects of neuropsychological functioning. If replicated, this may have important implications for how information is communicated in a post-disaster context.

Eye movements provide insights into the conscious use of context in prospective memory.

Prior research examining the impact of context on prospective memory (PM) has produced mixed results. Our study aimed to determine whether providing progressive context information could increase PM accuracy and reduce costs to ongoing tasks. Seventy-two participants made ongoing true/false judgements for simple sentences while maintaining a PM intention to respond differently to four memorised words. The context condition were informed of the trial numbers where PM targets could appear, and eye-tracking recorded trial number fixation frequency. The context condition showed reduced costs during irrelevant contexts, increased costs during relevant contexts, and had better PM accuracy compared to a standard condition that was not provided with context. The context condition also made an increasing number of trial number fixations leading up to relevant contexts, indicating the conscious use of context. Furthermore, this trial number checking was beneficial to PM, with participants who checked more frequently having better PM accuracy.

Earthquake Brain: Altered Recognition and Misclassification of Facial Expressions Are Related to Trauma Exposure but Not Posttraumatic Stress Disorder.

OBJECTIVES: The study investigated facial expression recognition (FER) in posttraumatic stress disorder (PTSD) caused by exposure to earthquakes, and in particular whether people with this condition showed a bias toward interpreting facial expressions as threat-related emotions (i.e., as anger, fear, or disgust). The study included a trauma-exposed control group who had been similarly exposed to the earthquakes but had not developed PTSD. We hypothesized that individuals with PTSD would have increased sensitivity to threat-related facial emotions compared with the trauma-exposed control group. This would be shown by increased accuracy in recognition of threat-related emotions and the misinterpretation of neutral expressions to these emotions (i.e., misidentifying them as anger, fear, or disgust). The availability of a group of healthy controls from a previous study who had been tested on a similar task before the earthquakes allowed a further non-exposed comparison. METHOD: Twenty-eight individuals with PTSD (71% female, mean age 42.8 years) and 89 earthquake-exposed controls (66% female, mean age 50.1 years) completed an FER task, which featured six basic emotions. Further comparisons were made with 50 non-exposed controls (64% female, mean age 38.5 years) who had been tested before the earthquakes. RESULTS: There was no difference in sensitivity to threat-related facial expressions (as measured by accuracy in recognition of threat-related facial expressions and the misinterpretation of neutral expressions as threatening) in individuals with PTSD compared with similarly earthquake-exposed controls. Supplementary comparison with an historical, non-exposed control group showed that both earthquake-exposed groups had increased accuracy for the identification of all facial emotions and showed a bias in the misclassification of neutral facial expressions to the threat-related emotions of anger and disgust. CONCLUSION: These findings suggest that it is exposure to earthquakes and repeated aftershocks, rather than the presence of PTSD that affects FER accuracy and misinterpretation. The importance of these biases in both PTSD and trauma-exposed controls needs further exploration and is an area for future research.

Prospective memory in context: Moving through a familiar space.

Successful completion of delayed intentions is a common but important aspect of daily behavior. Such behavior requires not only memory for the intended action but also recognition of the opportunity to perform that action, known collectively as prospective memory. The fact that prospective memory tasks occur in the midst of other activities is captured in laboratory tasks by embedding the prospective memory task in an ongoing activity. In many cases the requirement to perform the prospective memory task results in a reduction in ongoing performance relative to when the ongoing task is performed alone. This is referred to as the cost to the ongoing task and reflects the allocation of attentional resources to the prospective memory task. The current study examined the pattern of cost across the ongoing task when the ongoing task provided contextual information that in turn allowed participants to anticipate when target events would occur within the ongoing task. The availability of contextual information reduced ongoing task response times overall, with an increase in response times closer to the target locations (Experiments 1-3). The fourth study, drawing on the Event Segmentation Theory, provided support for the proposal made by the Preparatory Attentional and Memory Processes theory of prospective memory that decisions about the allocation of attention to the prospective memory task are more likely to be made at points of transition. (PsycINFO Database Record

Reducing prospective memory error and costs in simulated air traffic control: External aids, extending practice, and removing perceived memory requirements.

In air traffic control (ATC), forgetting to perform deferred actions-prospective memory (PM) errors-can have severe consequences. PM demands can also interfere with ongoing tasks (costs). We examined the extent to which PM errors and costs were reduced in simulated ATC by providing extended practice, or by providing external aids combined with extended practice, or by providing external aids combined with instructions that removed perceived memory requirements. Participants accepted/handed-off aircraft and detected conflicts. For the PM task, participants were required to substitute alternative actions for routine actions when accepting aircraft. In Experiment 1, when no aids were provided, PM errors and costs were not reduced by practice. When aids were provided, costs observed early in practice were eliminated with practice, but residual PM errors remained. Experiment 2 provided more limited practice with aids, but instructions that did not frame the PM task as a "memory" task led to high PM accuracy without costs. Attention-allocation policies that participants set based on expected PM demands were modified as individuals were increasingly exposed to reliable aids, or were given instructions that removed perceived memory requirements. These findings have implications for the design of aids for individuals who monitor multi-item dynamic displays. (PsycINFO Database Record

Distinctive processing in young and older adults: Metacognitive judgments and the isolation paradigm.

The isolation paradigm is often used for studying the effects of distinctiveness on memory. Within this paradigm the isolated item can appear early or late in the list. Most prior studies using the isolation paradigm with older adults placed the isolated items late in the study list, however, Smith (2011) used an early isolation list and found that older adults showed an early isolation effect when the dimension of isolation was more readily detected (numbers vs. letters) but did not show an isolation effect when the dimension of difference was more subtle (category membership). The current experiments replicate these findings and demonstrate judgments of learning are elevated for the isolated item in the former case, but not in the latter case, for young and older adults.

Category cued recall evokes a generate-recognize retrieval process.

The experiments reported here were designed to replicate and extend McCabe, Roediger, and Karpicke's (2011) finding that retrieval in category cued recall involves both controlled and automatic processes. The extension entailed identifying whether distinctive encoding affected 1 or both of these 2 processes. The first experiment successfully replicated McCabe et al., but the second, which added a critical baseline condition, produced data inconsistent with a 2 independent process model of recall. The third experiment provided evidence that retrieval in category cued recall reflects a generate-recognize strategy, with the effect of distinctive processing being localized to recognition. Overall, the data suggest that category cued recall evokes a generate-recognize retrieval strategy and that the subprocesses underlying this strategy can be dissociated as a function of distinctive versus relational encoding processes.

An individual-based rurality measure and its health application: A case study of Latino immigrants in North Florida, USA.

Rurality has been frequently noted by researchers as pathways to understand human health in rural and remote areas. Current measures of rurality are mostly oriented to places, not individuals, and have not accounted for individual mobility, thus inappropriate for studying health and well-being at an individual level. This research proposed a new concept of individual-based rurality by integrating personal activity spaces. A feasible method was developed to quantify individuals' rural experience using household travel surveys and geographic information systems (GIS). For illustration, the proposed method was applied to understand the well-being and social isolation among rural Latino immigrants, who had participated in a community-based participatory research (CBPR) study in North Florida, USA. The resulting individuals' rurality indices were paired with their scores of well-being and social isolation to identify potential associations. The correlation analysis showed that the proposed rurality can be related to the social isolation, mental and physical well-being of individuals in different gender groups, and hence could be a suitable tool to investigate rural health issues.

Why do pictures, but not visual words, reduce older adults' false memories?

Prior work shows that false memories resulting from the study of associatively related lists are reduced for both young and older adults when the auditory presentation of study list words is accompanied by related pictures relative to when auditory word presentation is combined with visual presentation of the word. In contrast, young adults, but not older adults, show a reduction in false memories when presented with the visual word along with the auditory word relative to hearing the word only. In both cases of pictures relative to visual words and visual words relative to auditory words alone, the benefit of picture and visual words in reducing false memories has been explained in terms of monitoring for perceptual information. In our first experiment, we provide the first simultaneous comparison of all 3 study presentation modalities (auditory only, auditory plus visual word, and auditory plus picture). Young and older adults show a reduction in false memories in the auditory plus picture condition, but only young adults show a reduction in the visual word condition relative to the auditory only condition. A second experiment investigates whether older adults fail to show a reduction in false memory in the visual word condition because they do not encode perceptual information in the visual word condition. In addition, the second experiment provides evidence that the failure of older adults to show the benefits of visual word presentation is related to reduced cognitive resources. (PsycINFO Database Record

Hierarchical Multinomial Modeling Approaches: An Application to Prospective Memory and Working Memory.

Hierarchical extensions of multinomial processing tree (MPT) models have been developed to deal with heterogeneity in participants or items. In this study, the beta-MPT model ( J. B. Smith & Batchelder, 2010 ) and the latent-trait approach ( Klauer, 2010 ) were used to estimate individual model parameters for prospective and retrospective components of prospective memory (PM), which requires remembering to perform an action in the future. The data from two experiments investigating the relationship between PM and working memory ( R. E. Smith & Bayen, 2005 , Experiment 1; R. E. Smith, Persyn, & Butler, 2011 ) were reanalyzed using the two hierarchical modeling approaches, both of which provide parameter estimates for individual participants. The results showed a positive correlation of the prospective component of PM with working-memory span and provide the first direct comparisons of the two hierarchical extensions of an MPT model.

Rural Latinos' mental wellbeing: a mixed-methods pilot study of family, environment and social isolation factors.

Upon immigration to the rural areas in the US, Latino families may experience cultural, geographic, linguistic and social isolation, which can detrimentally affect their wellbeing by acting as chronic stressors. Using a community engagement approach, this is a pilot mixed-method study with an embedded design using concurrent qualitative and quantitative data. The purpose of this study is to evaluate family and social environments in terms of protective factors and modifiable risks associated with mental well-being in Latino immigrants living in rural areas of Florida. Latino immigrant mother and adolescent dyads were interviewed by using in-depth ethnographic semistructured interviews and subsequent quantitative assessments, including a demographic questionnaire and three structured instruments: the Family Environment Scale Real Form, the SF-12v2™ Health Survey and the short version (eight items) of PROMIS Health Organization Social Isolation. This mixed-method pilot study highlighted how family, rural, and social environments can protect or impair wellbeing in rural Latino immigrant mother and adolescent dyads.

I Didn't Ask to Come to this Country I was a Child: The Mental Health Implications of Growing Up Undocumented.

Growing up as an undocumented immigrant and transitioning to "illegal" adulthood can expose the person to adverse social determinants, which can detrimentally affect mental health by acting as chronic stressors. Although there have been several attempts to reform immigration, none have been entirely successful. Recently, the Dream Act and the path toward citizenship may be important steps for reducing mental health disparities among the undocumented, immigrant population. This case report will describe the experiences of one Latino "dreamer", reveal the effects of an undocumented status on mental health, and posit future directions for mental health promotion in this vulnerable population.

Investigating how implementation intentions improve non-focal prospective memory tasks.

Implementation intentions are a self-regulatory strategy broadly studied in the area of social cognition that can improve realization of one's goals and improve performance on prospective memory tasks. Three experiments, using a non-focal task for which the prospective memory targets were specified at the time of intention formation, investigated whether (and how) implementation intentions can improve non-focal prospective memory performance. An improvement in prospective memory performance was accompanied by an increase in the allocation of conscious resources to the prospective memory task, but not by an increase in perceived importance of the prospective memory task. The third experiment also investigated the effects of implementation intentions on recall of the appropriate action and found that accurate action recall was improved by implementation intentions. Finally, the effect of implementation intention instructions on cognitive processes that underlie non-focal prospective memory performance was investigated using a multinomial model.