Mary Cazzell

Comparison of neural correlates of risk decision making between genders: an exploratory fNIRS study of the Balloon Analogue Risk Task (BART).

Functional magnetic resonance imaging (fMRI) research rarely reports gender differences in the neural correlates of risk decision making due to small sample sizes. In this functional near-infrared spectroscopy (fNIRS)-based imaging study of active and passive risk decision making, gender differences in oxygenated hemoglobin (HbO) concentration changes were investigated in the prefrontal cortex (PFC) of healthy adults. Forty adult participants (25-44 years; males=23) completed two sets of 15 balloon trials in active and passive decision making modes of the Balloon Analogue Risk Task (BART). In active mode, participants chose the number of balloon inflations, decided when to collect money, or risked accrued money if balloons exploded. BART is psychometrically well established and has predictive validity to real-world risk taking. The blocked experimental design and modification of BART for fNIRS were guided by a previous fMRI study that examined the neural correlates of risk decision making in young adults [Rao, H., Korczykowski, M., Pluta, J., Hoang, A., Detre, J.A., 2008. Neural correlates of voluntary and involuntary risk taking in the human brain: An fMRI study of the Balloon Analog Risk Task (BART). NeuroImage 42, 902-910]. Our findings were consistent with the previous fMRI study: no or little PFC activation during passive mode but strong PFC activation during active wins and losses among total sample. Active losses in females were associated with more significant bilateral activation in dorsal lateral prefrontal cortex (DLPFC) than males; no significant gender differences were found in DLPFC activation during active wins. Gender differences existed in direction and strength of correlations between BART behavioral and hemodynamic data. This study shows that use of fNIRS is a feasible, accessible, and less costly way to achieve adequate study power and investigate gender differences in neural correlates of risk decision making.

Innovations in basic life support education for healthcare providers: improving competence in cardiopulmonary resuscitation through self-directed learning.

Providing cardiopulmonary resuscitation is an essential competency for nurses. Nurse educators involved in staff development and continuing education spend numerous hours offering basic life support courses and conducting performance improvement activities such as mock codes. This study provides evidence that cardiopulmonary resuscitation performance skills using self-directed learning methods are as good as or, on a number of parameters, better than those achieved with a more resource- and time-intensive traditional approach.

Atlas-guided volumetric diffuse optical tomography enhanced by generalized linear model analysis to image risk decision-making responses in young adults

Diffuse optical tomography (DOT) is a variant of functional near infrared spectroscopy and has the capability of mapping or reconstructing three dimensional (3D) hemodynamic changes due to brain activity. Common methods used in DOT image analysis to define brain activation have limitations because the selection of activation period is relatively subjective. General linear model (GLM)‐based analysis can overcome this limitation. In this study, we combine the atlas‐guided 3D DOT image reconstruction with GLM‐based analysis (i.e., voxel‐wise GLM analysis) to investigate the brain activity that is associated with risk decision‐making processes. Risk decision‐making is an important cognitive process and thus is an essential topic in the field of neuroscience. The Balloon Analog Risk Task (BART) is a valid experimental model and has been commonly used to assess human risk‐taking actions and tendencies while facing risks. We have used the BART paradigm with a blocked design to investigate brain activations in the prefrontal and frontal cortical areas during decision‐making from 37 human participants (22 males and 15 females). Voxel‐wise GLM analysis was performed after a human brain atlas template and a depth compensation algorithm were combined to form atlas‐guided DOT images. In this work, we wish to demonstrate the excellence of using voxel‐wise GLM analysis with DOT to image and study cognitive functions in response to risk decision‐making. Results have shown significant hemodynamic changes in the dorsal lateral prefrontal cortex (DLPFC) during the active‐choice mode and a different activation pattern between genders; these findings correlate well with published literature in functional magnetic resonance imaging (fMRI) and fNIRS studies. Hum Brain Mapp 35:4249–4266, 2014.

Tutorial on use of intraclass correlation coefficients for assessing intertest reliability and its application in functional near-infrared spectroscopy–based brain imaging

Abstract. Test-retest reliability of neuroimaging measurements is an important concern in the investigation of cognitive functions in the human brain. To date, intraclass correlation coefficients (ICCs), originally used in inter-rater reliability studies in behavioral sciences, have become commonly used metrics in reliability studies on neuroimaging and functional near-infrared spectroscopy (fNIRS). However, as there are six popular forms of ICC, the adequateness of the comprehensive understanding of ICCs will affect how one may appropriately select, use, and interpret ICCs toward a reliability study. We first offer a brief review and tutorial on the statistical rationale of ICCs, including their underlying analysis of variance models and technical definitions, in the context of assessment on intertest reliability. Second, we provide general guidelines on the selection and interpretation of ICCs. Third, we illustrate the proposed approach by using an actual research study to assess intertest reliability of fNIRS-based, volumetric diffuse optical tomography of brain activities stimulated by a risk decision-making protocol. Last, special issues that may arise in reliability assessment using ICCs are discussed and solutions are suggested.

Linking Theory, Evidence, and Practice in Assessment of Adolescent Inhalant Use

&NA; Inhalants are often one of the first substances used by young children. Inhalant use is the purposeful inhaling, bagging, sniffing, or huffing of common easily accessible solvents, aerosols, or gases producing mind‐altering effects. Long term use leads to neurocognitive changes such as disorientation, inattentiveness, or short‐term memory loss. Detoxification for inhalant abuse requires longer treatment time due to the slow excretion of volatile substances. Recovery is complicated by immaturity, potentially permanent cognitive impairment, and prior disruptive family, school, and peer structures. The purpose of this paper is to discuss how the middle range theory of Adolescent Vulnerability to Risk Behaviors can be utilized to direct evidence‐based assessments of adolescents for risk behaviors such as inhalant use. Adapted from the Neuman Systems Model, this adolescent‐specific theory describes the layers of defense and resistance that surround and protect the five inner core variables of the adolescent from external stressors. When the layers fail to protect the adolescent, high risk behaviors can result. To better assess and intervene with adolescents who use inhalants, the clinician can use this theory to understand an adolescents inner core and the impact of external stressors, developmental assets, role models, peer influence, and parent functioning upon this specific high risk behavior.

Automated voxel classification used with atlas-guided diffuse optical tomography for assessment of functional brain networks in young and older adults.

Abstract. Atlas-guided diffuse optical tomography (atlas-DOT) is a computational means to image changes in cortical hemodynamic signals during human brain activities. Graph theory analysis (GTA) is a network analysis tool commonly used in functional neuroimaging to study brain networks. Atlas-DOT has not been analyzed with GTA to derive large-scale brain connectivity/networks based on near-infrared spectroscopy (NIRS) measurements. We introduced an automated voxel classification (AVC) method that facilitated the use of GTA with atlas-DOT images by grouping unequal-sized finite element voxels into anatomically meaningful regions of interest within the human brain. The overall approach included volume segmentation, AVC, and cross-correlation. To demonstrate the usefulness of AVC, we applied reproducibility analysis to resting-state functional connectivity measurements conducted from 15 young adults in a two-week period. We also quantified and compared changes in several brain network metrics between young and older adults, which were in agreement with those reported by a previous positron emission tomography study. Overall, this study demonstrated that AVC is a useful means for facilitating integration or combination of atlas-DOT with GTA and thus for quantifying NIRS-based, voxel-wise resting-state functional brain networks.

Author, reviewer, decision, oh my!

S haring best practices and contributing to the body of knowledge in the field of addictions nursing is a professional responsibility by those who focus on the ‘‘prevention, intervention, treatment, and management of substance abuse, misuse, and addictive disorders’’ (International Nurses Society on Addictions, 2014). Professional conference presentations, although an important means of dissemination, reach a smaller audience than publications; less than 25% of conference presentations are ever published within 5 years (Grindstaff & Saliba, 2012; Smith, Bogenschutz, Bayliss, Altenburger, & Warden, 2011). Writing a manuscript for a peer-reviewed professional journal can be perceived as daunting and time-consuming series of steps toward publication. From the viewpoint of an experienced peer reviewer for the Journal of AddictionsNursing (JAN) and other professional journals, the goal of this editorial is to illuminate the roles of a peer reviewer while aligning these roles with strategies for authoring an accepted manuscript for publication. Peer reviewers are familiar with the scope and type of submissions solicited by the journal before reading a manuscript. JAN invites authors to submit ‘‘original articles on current research issues, practices and innovations as they related to the field of addictions’’ (International Nurses Society on Addictions, 2014). For authors, it is essential first to review author guidelines to become familiar with the journal of interest and formatting instructions, to decide if the article is suitable for the targeted audience, to read previous publications, and if necessary, to email the journal’s editor for feedback on interest of the topic (Holzmueller & Pronovost, 2013; Roederer, Marciniak, O’Connor, & Eckel, 2013; Saver, 2006; Smith, 2013). In the first two quarters of 2014, JAN published a wide variety of articles including two qualitative research studies, three quantitative research studies, and four descriptive articles of innovative interventional programs in clinical practice and educational settings. In addition, my first professional manuscript was published in JAN, a descriptive article linking a theory of adolescent risk behavior to clinical assessment in adolescent inhalant use (Cazzell, 2008). Peer reviewers volunteer their time and effort to review manuscript submissions for journals. The journal’s editor chooses reviewers based on their expertise in a particular area and also on their availability (Grindstaff & Saliba, 2012). Because of the significant time allotment to complete a serious manuscript review, the quality of the manuscript upon first submission is critical toward an ‘‘accept’’ decision. From a survey of 63 nursing journal editors, three main reasons for manuscript rejection were described: (a) poorly written manuscript, 35.8%; (b) irrelevant topic for journal, 32.8%; and (c) issues of methodology, 16.4% (Northam, Yarbrough, Haas, & Duke, 2010). Kalpakjian and Meade (2008) penned a whimsical yet practical article delineating 10 ‘‘tips to assure that you will not get published’’ (p. 230): 1. Reviewer annoyance from poor grammar, punctuation, and spelling 2. Avoidance of or ‘‘blowing off ’’ author guidelines 3. Overwhelming or underwhelming review of the literature 4. Inappropriate use of statistics (not related to research purpose or question) 5. Reviewer frustration from an unorganized manuscript 6. Results section not mirroring Methods section 7. Sloppy misinterpretation or overgeneralization of results 8. Figures, graphs, and tables with missing information and redundant narratives 9. Salami publications: same data and narratives across multiple articles 10. Dismissing reviewer-suggested revisions The next sections outline positive actions by authors that can definitely impress the peer reviewers toward outcomes such as revise and resubmit or accept. First, Smith (2013) asserts that most manuscripts could be trimmed by 20% without any loss to the author’s intent or story. Reviewers embrace clear, coherent, and concise manuscripts in plain English (minus frilly or fancy words) with active verbs used in mixed-length sentences. Roederer et al. (2013) suggested recruiting friends or peers, who are not familiar with the topic, to read the manuscript to assess for any comprehension issues. Colleagues can be excellent proofreaders before submissionVone way to show respect for the journal’s editor and peer reviewers (Kalpakjian & Meade, 2008). Usually written last, the Abstract is the first impression given to peer reviewers about the manuscript. The Abstract provides an informative snapshot of the manuscript to persuade the reviewer to volunteer and review the article. The author should avoid abbreviations, acronyms, and references as well as Guest Editorial

Test-retest assessment of functional near-infrared spectroscopy to measure risk decision making in young adults

Investigation of the reliability and reproducibility of the hemodynamic response is important for interpretation and understanding of the results of functional near-infrared spectroscopy (fNIRS). It measures optical signals absorbed by the brain tissue and reflects the neuronal activities indirectly. Here we described an fNIRS study measured in the prefrontal region (Brodman area 9, 10, part of 46)to examine the risk decision-making behavior in nine young adults. The Balloon Analog Risk Task (BART) is widely used to test the level of risk taking ability in the field of psychology. BART was a protocol utilized in this study to evoke a risk-taking environment with a gambling-like balloon game in each subject. Specifically, we recorded the brain oxygenated-hemoglobin (HbO) and deoxygenated-hemoglobin (HHb) changes during the two repeated measurements within a time interval of 3 weeks. The results demonstrate that the changes in HbO2 amplitudes have high reliability at the group level, and that the spatial patterns of the tomographic images have high reproducibility in size and a moderate degree of overlap. Overall, this study confirms that the hemodynamic response to risk decision-making (i.e., BART) seen by fNIRS is highly reliable and reproducible.

Assessment of resting-state brain networks in young and older adults by automatic voxel classification with atlas-guided diffuse optical tomography

We implemented an automatic voxel classification algorithm so that atlas-guided DOT and graph theory analysis can be jointly used to assess hemodynamic resting-state brain networks in young and older adults.

Investigation of age difference under risk decision-making using atlas-guided diffuse optical tomography

we aim to investigate the age difference in brain activities induced by risk-decision making tasks using atlas-guided diffuse optical tomography (atlas-DOT).