Publications by authors named "Meghan E McGrath"

Introduction: Literature demonstrates the detrimental impact of discrimination and microaggressions at personal and institutional levels in the health care workplace. Residents in our program requested curricula to help with addressing manifestations of bias. In response, we designed and implemented an adaptable and reproducible 4-hour virtual simulation session aimed at helping residents identify and constructively respond to microaggressions.

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  • The study analyzed the posttraumatic neuropsychiatric symptoms experienced by over 2,000 survivors of motor vehicle collisions, focusing on ten key symptom areas such as pain, depression, and anxiety.
  • Researchers utilized smartphone surveys over two months to track symptom trajectories and found that adverse symptoms were common immediately after the trauma, with many shared risk factors across different symptom domains.
  • The findings highlight the importance of screening for multiple symptoms in individuals with a single diagnosis and suggest that a multidimensional approach to understanding these symptoms is beneficial for recovery.
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  • The study aimed to create and validate a quick bedside tool that helps identify patients at high risk for long-term posttraumatic stress symptoms following a car accident.
  • Researchers collected data from over 1,500 adults who had been treated in emergency departments after such trauma, ultimately focusing on an 8-question tool that assesses various risk factors.
  • The tool showed good effectiveness in predicting significant posttraumatic stress symptoms, but further research and validation are needed to enhance its accuracy and usefulness in public health interventions.
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Anxiety sensitivity, or fear of anxious arousal, is cross-sectionally associated with a wide array of adverse posttraumatic neuropsychiatric sequelae, including symptoms of posttraumatic stress disorder, depression, anxiety, sleep disturbance, pain, and somatization. The current study utilizes a large-scale, multi-site, prospective study of trauma survivors presenting to emergency departments. Hypotheses tested whether elevated anxiety sensitivity in the immediate posttrauma period is associated with more severe and persistent trajectories of common adverse posttraumatic neuropsychiatric sequelae in the eight weeks posttrauma.

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  • The study aimed to determine if short-term opioid prescriptions for acute pain in emergency departments (ED) lead to future at-risk opioid use, particularly after traumatic events.
  • Researchers analyzed data from a cohort of adult patients in 29 urban EDs, excluding those with prior non-medical opioid use or incomplete data.
  • Results showed that patients who received opioids in the ED were more likely to engage in at-risk opioid use within three months, suggesting a link between ED opioid exposure and potential misuse.
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Hippo campal impairments are reliably associated with post-traumatic stress disorder (PTSD); however, little research has characterized how increased threat sensitivity may interact with arousal responses to alter hippocampal reactivity, and further how these interactions relate to the sequelae of trauma-related symptoms. In a sample of individuals recently exposed to trauma ( = 116, 76 female), we found that PTSD symptoms at 2 weeks were associated with decreased hippocampal responses to threat as assessed with fMRI. Further, the relationship between hippocampal threat sensitivity and PTSD symptomology only emerged in individuals who showed transient, high threat-related arousal, as assayed by an independently collected measure of fear potentiated startle.

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  • The study explores the link between dissociation, specifically derealization, and adverse psychiatric outcomes following trauma, aiming to understand if it can help identify at-risk individuals.
  • It uses self-reported data and brain imaging from participants two weeks post-trauma to assess the predictive power of derealization on later symptoms like PTSD, depression, and anxiety.
  • The results indicate that persistent derealization is a significant early marker, both psychologically and biologically, for predicting worse mental health outcomes, highlighting the need for assessing dissociation after trauma.
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Background: Previous work has indicated that differences in neurocognitive functioning may predict the development of adverse post-traumatic neuropsychiatric sequelae (APNS). Such differences may be vulnerability factors or simply correlates of APNS-related symptoms. Longitudinal studies that measure neurocognitive functioning at the time of trauma are needed to determine whether such differences precede the development of APNS.

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  • The study analyzes how past experiences of posttraumatic stress disorder (PTSD) and major depressive episodes (MDE) can predict emotional reactions after a motor vehicle collision (MVC).
  • Data was collected from 1,306 patients in U.S. emergency departments, measuring their psychological states before and after the trauma.
  • Results showed that those with previous PTSD or MDE had significantly higher chances (2.6 to 7.4 times) of experiencing ongoing psychological issues three months later, suggesting that early assessments could improve targeted interventions for these patients.
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Objective: Major negative life events, such as trauma exposure, can play a key role in igniting or exacerbating psychopathology. However, few disorders are diagnosed with respect to precipitating events, and the role of these events in the unfolding of new psychopathology is not well understood. The authors conducted a multisite transdiagnostic longitudinal study of trauma exposure and related mental health outcomes to identify neurobiological predictors of risk, resilience, and different symptom presentations.

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Equilibrative nucleoside transporters (ENTs) are present at the blood-testis barrier (BTB), where they can facilitate antiviral drug disposition to eliminate a sanctuary site for viruses detectable in semen. The purpose of this study was to investigate ENT-drug interactions with three nucleoside analogs, remdesivir, molnupiravir, and molnupiravir's active metabolite, -d-N-hydroxycytidine (EIDD-1931), and four non-nucleoside molecules repurposed as antivirals for coronavirus disease 2019 (COVID-19). The study used three-dimensional pharmacophores for ENT1 and ENT2 substrates and inhibitors and Bayesian machine learning models to identify potential interactions with these transporters.

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  • The study investigated sex differences in autonomic functioning among individuals with PTSD, noting that PTSD rates are higher in women.
  • It found that men had higher systolic blood pressure, while women showed higher heart rates and lower heart rate variability, especially those who developed PTSD.
  • The results suggest significant sex differences in autonomic responses to trauma, highlighting potential cardiovascular risks linked to PTSD, which should be further explored in future research.
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Importance: A substantial proportion of the 40 million people in the US who present to emergency departments (EDs) each year after traumatic events develop posttraumatic stress disorder (PTSD) or major depressive episode (MDE). Accurately identifying patients at high risk in the ED would facilitate the targeting of preventive interventions.

Objectives: To develop and validate a prediction tool based on ED reports after a motor vehicle collision to predict PTSD or MDE 3 months later.

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  • PTSD is linked to reduced gray matter volume in the brain areas important for learning to overcome fear, but how this affects PTSD symptoms is unclear.
  • A study involving 99 participants used MRI scans and self-assessments to explore the relationship between brain volume, fear responses, and PTSD symptoms after trauma exposure.
  • The findings reveal that interactions between thalamic gray matter volume and fear responses during extinction learning can predict PTSD symptoms, suggesting that these factors are critical for understanding who may be more vulnerable to adverse effects after trauma.
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Acute lymphoblastic leukemia (ALL) is the most common cancer in children and adolescents. Although the 5-year survival rate is high, some patients respond poorly to chemotherapy or have recurrence in locations such as the testis. The blood-testis barrier (BTB) can prevent complete eradication by limiting chemotherapeutic access and lead to testicular relapse unless a chemotherapeutic is a substrate of drug transporters present at this barrier.

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Unlabelled: Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition resulting from threatening or horrifying events. We hypothesized that circadian rhythm changes, measured by a wrist-worn research watch are predictive of post-trauma outcomes.

Approach: 1618 post-trauma patients were enrolled after admission to emergency departments (ED).

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Neurobiological markers of future susceptibility to posttraumatic stress disorder (PTSD) may facilitate identification of vulnerable individuals in the early aftermath of trauma. Variability in resting-state networks (RSNs), patterns of intrinsic functional connectivity across the brain, has previously been linked to PTSD, and may thus be informative of PTSD susceptibility. The present data are part of an initial analysis from the AURORA study, a longitudinal, multisite study of adverse neuropsychiatric sequalae.

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Background: This is the first report on the association between trauma exposure and depression from the dvancing nderstanding of ecvery afte traum(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.

Methods: We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.

Results: Eight-week depression prevalence was relatively high (27.

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This is the initial report of results from the AURORA multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience. We focus on n = 666 participants presenting to EDs following a motor vehicle collision (MVC) and examine associations of participant socio-demographic and participant-reported MVC characteristics with 8-week posttraumatic stress disorder (PTSD) adjusting for pre-MVC PTSD and mediated by peritraumatic symptoms and 2-week acute stress disorder (ASD). Peritraumatic Symptoms, ASD, and PTSD were assessed with self-report scales.

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Study Objectives: Many patients in Emergency Departments (EDs) after motor vehicle collisions (MVCs) develop post-traumatic stress disorder (PTSD) or major depressive episode (MDE). This report from the AURORA study focuses on associations of pre-MVC sleep problems with these outcomes 8 weeks after MVC mediated through peritraumatic distress and dissociation and 2-week outcomes.

Methods: A total of 666 AURORA patients completed self-report assessments in the ED and at 2 and 8 weeks after MVC.

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Adverse posttraumatic neuropsychiatric sequelae (APNS) are common among civilian trauma survivors and military veterans. These APNS, as traditionally classified, include posttraumatic stress, postconcussion syndrome, depression, and regional or widespread pain. Traditional classifications have come to hamper scientific progress because they artificially fragment APNS into siloed, syndromic diagnoses unmoored to discrete components of brain functioning and studied in isolation.

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Study Objective: Health care reform in Massachusetts improved access to health insurance, but the extent to which reform affected utilization of the emergency department (ED) for conditions potentially amenable to primary care is unclear. Our objective is to determine the relationship between health reform and ED use for low-severity conditions.

Methods: We studied ED visits, using a convenience sample of 11 Massachusetts hospitals for identical 9-month periods before and after health care reform legislation was implemented in 2006.

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Background: In Massachusetts, patients with chronic alcohol dependence can be committed to 30 days of mandatory inpatient alcohol detoxification (MAD).

Study Objectives: To examine the effects of MAD on the number of emergency department (ED) visits, hospital admissions, and emergency medical service (EMS) transports.

Methods: This retrospective study identified patients in our urban ED committed to MAD.

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