Time Differences From Abnormal Cervical Cancer Screening to Colposcopy Between Insurance Statuses.

OBJECTIVE: Screening and diagnostic follow-up to prevent cervical cancer are influenced by socioeconomic and systemic factors. This study sought to characterize intervals from abnormal cervical cancer screening to colposcopy between practices differing by insurance status at a large, urban academic center. MATERIALS AND METHODS: This retrospective cohort study included patients aged 21-65 who presented for colposcopy between January 1, 2021, and January 1, 2022, at the resident and faculty gynecology practices of a single large urban academic medical center. Patient characteristics were compared using t tests or Wilcoxon rank sum tests for continuous measures and χ 2 or Fisher exact tests for categorical measures. Intervals from abnormal cervical cancer screening to colposcopy were compared using the Wilcoxon rank sum test and linear regression analysis with multivariable models adjusted for age, cervical cytology result, human papillomavirus result, and HIV status. RESULTS: Resident practice patients were publicly insured and more likely to be Black or Hispanic ( p < .0001); rates of high-risk human papillomavirus and smoking were similar. Resident practice patients had longer intervals from abnormal cervical cancer screening to colposcopy compared with faculty practice patients (median 79.5 vs 34 d, p < .0001). On adjusted analysis, resident practice patients faced a 95% longer interval ( p < .0001). CONCLUSIONS: Publicly insured patients of a resident-based practice faced significantly longer intervals from abnormal cervical cancer screening to colposcopy than faculty practice patients at a single urban academic center. Effort to address these differences may be an area of focus in improving health disparities.

Brain connectivity and academic skills in English learners.

English learners (ELs) are a rapidly growing population in schools in the United States with limited experience and proficiency in English. To better understand the path for EL's academic success in school, it is important to understand how EL's brain systems are used for academic learning in English. We studied, in a cohort of Hispanic middle-schoolers (n = 45, 22F) with limited English proficiency and a wide range of reading and math abilities, brain network properties related to academic abilities. We applied a method for localizing brain regions of interest (ROIs) that are group-constrained, yet individually specific, to test how resting state functional connectivity between regions that are important for academic learning (reading, math, and cognitive control regions) are related to academic abilities. ROIs were selected from task localizers probing reading and math skills in the same participants. We found that connectivity across all ROIs, as well as connectivity of just the cognitive control ROIs, were positively related to measures of reading skills but not math skills. This work suggests that cognitive control brain systems have a central role for reading in ELs. Our results also indicate that an individualized approach for localizing brain function may clarify brain-behavior relationships.

A longitudinal examination of executive function abilities, attention-deficit/hyperactivity disorder, and puberty in adolescence.

Executive function (EF) abilities have been linked to numerous important life outcomes. We longitudinally characterized EF and attention-deficit/hyperactivity disorder (ADHD) trajectories across adolescence (initial ages 8-19). Utilizing 3 years of annual data in 99 youth collected between years 2016 and 2020 (70.7% White, 40 females), we examined how age, puberty, and ADHD symptom burden related to EF across time. Age and puberty levels interacted to predict EF such that older youth with higher puberty had lower EF. While EF and ADHD significantly predicted each other, cross-lagged panel models revealed that earlier EF predicted later ADHD burden while controlling for baseline ADHD burden, but not vice versa. These findings inform our understanding of the dynamics between EF and mental health in adolescence.

Bidirectional longitudinal relations between executive function and social function across adolescence.

Executive function (EF) and social function are both critical skills that continue to develop through adolescence and are strongly predictive of many important life outcomes. Longstanding empirical and theoretical work has suggested that EF shapes social function. However, there is little empirical work on this topic in adolescence, despite both EF and social function continuing to mature into early adulthood (e.g., Bauer et al., 2017). Further, adolescence might be a phase of life where social interactions can shape EF. We tested the longitudinal relation between EF and social function across adolescence utilizing a sample of 99 individuals (8-19 years) from the greater Austin area tested annually for 3 consecutive years. Although EF showed significant improvement in that span, the social function was largely consistent over age. Cross-lagged panel models revealed a bidirectional relation, such that Year 1 EF predicted social function in Year 2, and social function at Years 1 and 2 predicted EF in Year 3. When examining different components of social function, social motivation in earlier adolescence seemed to most consistently predict future EF outcomes, relative to other social functions. Our findings advance the field's theoretical understanding of how these two critical skills might develop alongside one another over adolescent development with particular emphasis on the role of social motivation on EF maturation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Brain Engagement During a Cognitive Flexibility Task Relates to Academic Performance in English Learners.

English Learners (ELs), students from non-English-speaking backgrounds, are a fast-growing, understudied, group of students in the U.S. with unique learning challenges. Cognitive flexibility-the ability to switch between task demands with ease-may be an important factor in learning for ELs as they have to manage learning in their non-dominant language and access knowledge in multiple languages. We used functional MRI to measure cognitive flexibility brain activity in a group of Hispanic middle school ELs (N = 63) and related it to their academic skills. We found that brain engagement during the cognitive flexibility task was related to both out-of-scanner reading and math measures. These relationships were observed across the brain, including in cognitive control, attention, and default mode networks. This work suggests the real-world importance of cognitive flexibility for adolescent ELs, where individual differences in brain engagement were associated with educational outcomes.

Examination of Pre-pandemic Measures on Youth Well-being During Early Stages of the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has affected our lives in numerous ways. How youth have been impacted by the pandemic and which preexisting factors best relate to COVID-19 responses are of high importance for effective identification and treatment of those most vulnerable. Youth with pre-pandemic mental health difficulties such as attention-deficit/hyperactivity disorder (ADHD) could be at risk for worse well-being during and after the pandemic. METHODS: The current study tested potential risk factors (i.e., pre-pandemic mental health, age, and parental education) and their relationship to family experiences during early months of the COVID-19 pandemic. Participants were previously enrolled in an ongoing, yearly longitudinal study examining the relationship between mental health and executive functions in youth. Families with 1-4 annual pre-pandemic lab visits filled out an online COVID-19 survey in May-July 2020 to assess how the pandemic impacted their well-being (n = 135 youth). RESULTS: Youth pre-pandemic mental health difficulties, especially ADHD symptoms, related to worse well-being during the early pandemic. Trajectories of recent ADHD symptoms over time also predicted cognitive difficulties during the pandemic. We found that youth age was a strong predictor of pandemic response, with younger youth showing fewer negative responses. Parental education level buffered family economic impact during early COVID-19. Families showed synchrony in their pandemic responses. CONCLUSIONS: Pre-pandemic ADHD severity and slope, youth age, and parental education (a proxy for socioeconomic status) were risk factors that influenced youth or family well-being early in the COVID-19 pandemic; this information can help identify those who may need more community and educational support.

Pediatric ADHD symptom burden relates to distinct neural activity across executive function domains.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent childhood disorder marked by inattention and/or hyperactivity symptoms. ADHD may also relate to impaired executive function (EF), but is often studied in a single EF task per sample. The current study addresses the question of unique vs. overlapping relations in brain activity across multiple EF tasks and ADHD symptom burden. Three in-scanner tasks drawn from distinct EF domains (cognitive flexibility, working memory, and inhibition) were collected from children with and without an ADHD diagnosis (N = 63). Whole-brain activity and 11 regions of interest were correlated with parent reports of inattention and hyperactivity symptoms. Across the three EF domains, brain activity related to ADHD symptom burden, but the direction and location of these associations differed across tasks. Overall, activity in sensory and default mode network regions related to ADHD, and these relations did not consistently overlap across EF domains. We observed both distinct and overlapping patterns for inattention and hyperactivity symptoms. By studying multiple EF tasks in the same sample, we identified a heterogenous neural profile related to attention symptom burden in children. Our results inform ADHD characterization and treatment and explain some of the variable brain results related to EF and ADHD reported in the literature.

Genomics Analysis of L-DOPA Exposure in Drosophila sechellia.

Drosophila sechellia is a dietary specialist fruit fly that evolved from a generalist ancestor to specialize on the toxic fruit of Morinda citrifolia This species pair has been the subject of numerous studies where the goal has largely been to determine the genetic basis of adaptations associated with host specialization. Because one of the most striking features of M. citrifolia fruit is the production of toxic volatile compounds that kill insects, most genomic studies in D. sechellia to date have focused on gene expression responses to the toxic compounds in its food. In this study, we aim to identify new genes important for host specialization by profiling gene expression response to 3,4-dihydroxyphenylalanine (L-DOPA). Recent work found it to be highly abundant in M. citrifolia, critical for reproductive success of D. sechellia, and supplementation of diet with the downstream pathway product dopamine can influence toxin resistance phenotypes in related species. Here we used a combination of functional genetics and genomics techniques to identify new genes that are important for D. sechellia ecological adaptation to this new niche. We show that L-DOPA exposure can affect toxin resistance phenotypes, identify genes with plastic responses to L-DOPA exposure, and functionally test an identified candidate gene. We found that knock-down of Esterase 6 (Est6) in a heterologous species alters toxin resistance suggesting Est6 may play an important role in D. sechellia host specialization.