Linda C. Mayes’s research while affiliated with Yale-New Haven Hospital and other places


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Publications (130)


How the cognitive load of simulated driving affects the brain dynamics underlying auditory attention
  • Article

November 2024

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9 Reads

Traffic Injury Prevention

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Federico E Vaca

Objective: Distracted driving is a primary contributor to for motor vehicle crashes, the leading cause for injuries and fatalities for youth. Although attention and working memory clearly underlie driving abilities, few studies explore these functions on the brain-level under the cognitive load of driving. To understand the load driving has on auditory attention processing, we examined the differences in dynamic brain response to auditory stimuli during LOAD (while driving in a high-fidelity driving simulator) and No-LOAD conditions (seated in simulator, parked on the side of the road). Methods: Twenty-seven young adult drivers (18-27 y/o; 15 = women) completed a Selective Auditory Attention Task during both a LOAD (driving) and No-LOAD condition in a ½ cab miniSim® high-fidelity driving simulator. During the task, participants responded by pressing the volume control button on the steering wheel when a target tone was presented to a target ear. Electroencephalography-recorded event-related brain responses to the target tones were evaluated through alpha and theta oscillations for two response windows (early: 150-330ms; late: 350-540ms). Results: During an early time window, we observed a significant interaction between attended/unattended and LOAD/No-LOAD theta power in the right frontal cortical region (F(1, 24)= 5.4, p=.03, partial η2=.18). During the later window, we observed a significant interaction between attended/unattended and LOAD/No-LOAD alpha response in the posterior cortical region (F(1, 24)=11.81, p=.002, partial η2=.15) and in the right temporal cortical region during the window (F(1, 24)=4.3, p=.05, partial η2=.33). Conclusions: Our data provide insight into the demand that driving has on cognitive faculties and how dual task engagement may draw resources away from driving. We suggest future research directly incorporate vehicle control abilities into study design to understand how brain-based measures relate to driving behaviors.



Figure 2. Reading grade level of output after running "Explain {} to a ____ grader" through each LLM. Legend: Each LLM was asked, "Explain {medical condition} to a __ grader." First-through twelfth-grade were tested by filling in the blank. A. The aRGL of outputs is depicted for each LLM. From top to bottom, GPT-3.5, GPT-4, Bing, and Bard are depicted. B. Grade-level outputs for each LLM from panel A are set side to side for comparison between LLMs.
Assessing the Efficacy of Large Language Models in Health Literacy: A Comprehensive Cross-Sectional Study
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  • Full-text available

March 2024

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18 Reads

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13 Citations

The Yale journal of biology and medicine

Enhanced health literacy in children has been empirically linked to better health outcomes over the long term; however, few interventions have been shown to improve health literacy. In this context, we investigate whether large language models (LLMs) can serve as a medium to improve health literacy in children. We tested pediatric conditions using 26 different prompts in ChatGPT-3.5, ChatGPT-4, Microsoft Bing, and Google Bard (now known as Google Gemini). The primary outcome measurement was the reading grade level (RGL) of output as assessed by Gunning Fog, Flesch-Kincaid Grade Level, Automated Readability Index, and Coleman-Liau indices. Word counts were also assessed. Across all models, output for basic prompts such as “Explain” and “What is (are),” were at, or exceeded, the tenth-grade RGL. When prompts were specified to explain conditions from the first- to twelfth-grade level, we found that LLMs had varying abilities to tailor responses based on grade level. ChatGPT-3.5 provided responses that ranged from the seventh-grade to college freshmen RGL while ChatGPT-4 outputted responses from the tenth-grade to the college senior RGL. Microsoft Bing provided responses from the ninth- to eleventh-grade RGL while Google Bard provided responses from the seventh- to tenth-grade RGL. LLMs face challenges in crafting outputs below a sixth-grade RGL. However, their capability to modify outputs above this threshold, provides a potential mechanism for adolescents to explore, understand, and engage with information regarding their health conditions, spanning from simple to complex terms. Future studies are needed to verify the accuracy and efficacy of these tools.

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Model illustrating research documenting parental tobacco smoking during the prenatal and postpartum periods and potential effects to the caregiving environment with respect to brain, cognition and emotion, and behavior
Parental Tobacco Smoking and Caregiving in the Perinatal and Early Infancy Periods

February 2024

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53 Reads

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1 Citation

Tobacco use continues to be a prevalent behavior among many mothers and fathers throughout pregnancy and the postpartum period. The current review provides a framework for understanding parental tobacco smoking during a critical period of child development and its potential impact on postpartum caregiving. It is well documented that maternal illicit substance use can compromise caregiving, increasing the risk of child neglect and maltreatment. However, to date, few studies have specifically investigated the impact of tobacco smoking among mothers and fathers during the prenatal and postpartum periods and how parental tobacco smoking may influence postpartum caregiving. We review current literature on parental tobacco smoking, with a predominant focus on mothers who use tobacco, and the potential impact on postpartum caregiving with a view to informing and tailoring tobacco-cessation programs for expectant and new parents who smoke tobacco.


Maternal psychological risk and the neural correlates of infant face processing: A latent profile analysis

December 2023

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110 Reads

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3 Citations

Developmental Psychobiology

Maternal psychological factors, including anxiety, depression, and substance use, may negatively affect parenting. Previous works with mothers have often assessed each of these factors in isolation despite their frequent co‐occurrence. Psychological factors have also been associated with neural processing of facial stimuli, specifically the amplitude (i.e., size) and latency (i.e., timing) of the face‐specific N170 event‐related potential. In the current study, 106 mothers completed measures assessing maternal psychological factors—anxiety, depression, and substance use. A latent profile analysis was used to identify profiles of psychological factors and assess profile associations with the N170 elicited by infant faces and with parental reflective functioning (PRF) as a measure related to caregiving. Two profiles (termed high and low psychological risk) were identified, with the higher risk profile associated with delayed N170 latency responses to infant faces. An exploratory analysis evidenced an indirect effect between the higher psychological risk profile and lower PRF through delayed N170 latency responses to infant faces. Taken together, maternal psychological risk across multiple indicators may together shape neural processing of infant faces, which may have downstream consequences for caregiving.


Relationships Between Prenatal Cocaine Exposure, Cannabis-Use Onset and Emotional and Related Characteristics in Young/Emerging Adults

November 2023

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28 Reads

Background: Exposure to substances in utero may have significant early-life consequences. Less is known about the effects in emerging adulthood, particularly regarding patterns of substance use and related characteristics.Objectives: In this study, we recruited emerging adults, followed since birth, who had been prenatally exposed, or not, to cocaine. Individuals reported on their cannabis, alcohol, and tobacco use, and measures of impulsivity, anhedonia, emotional regulation, and mental health were obtained. Comparisons were made between emerging adults with prenatal cocaine exposure and those without. Correlations were performed between psychological measures and substance use, and regression analyses were conducted to determine potential pathways by which such measures may relate to prenatal exposure or substance use.Results: Individuals with prenatal cocaine exposure (vs. those without) used cannabis at younger ages, reported greater cannabis-use severity, and demonstrated higher impulsivity, state anxiety, and alexithymia. Earlier age of onset of cannabis use was associated with higher impulsivity, state anxiety, alexithymia, and social and physical anhedonia. Cannabis-use age-of-onset mediated the relationship between prenatal cocaine-exposure status and state anxiety and between prenatal cocaine-exposure status and cannabis-use severity in emerging adulthood but not relationships between prenatal cocaine-exposure status and impulsivity or alexithymia in emerging adulthood. Findings suggest that adults with prenatal cocaine exposure may use cannabis at younger ages, which may relate to increased anxiety and more severe use.Conclusions: These findings suggest both mechanisms and possible intervention targets to improve mental health in emerging adults with prenatal cocaine exposure.


"Morphologic Severity and Age at Surgery Are Associated with School Age Neurocognitive Outcomes in Metopic Craniosynostosis"

August 2023

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21 Reads

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2 Citations

Plastic & Reconstructive Surgery

Background: Radiographic severity of metopic synostosis has been suggested as a predictor of long-term neurocognitive outcomes, and artificial intelligence (AI) has recently been used to quantify severity. Age at surgery is predictive of long-term neurocognition in sagittal synostosis but has not been adequately explored in metopic synostosis. Methods: Children ages 6 to 18 years old with corrected metopic synostosis underwent testing of intelligence quotient (IQ), academic achievement, and visuomotor integration (VMI). Various manual measurements and AI-derived severity scores were determined. Scans were categorized as moderate or severe for head-to-head comparisons and multivariable linear regressions were used to assess the relationship of age at surgery and severity with neurocognitive outcomes. Results: 41 patients with average age at testing of 10.8 ± 3.4 years were included. 18 patients were in the severe group while 23 patients were in the moderate group with average ages at surgery 6.6 ± 2.7 and 10.6 ± 8.4 months, respectively (p = 0.062). Greater AI-derived severity was significantly associated with lower reading comprehension (p = 0.040 and 0.018) and reading composite scores (p = 0.024 and p = 0.008). Older age at surgery was significantly associated with lower VMI scores (p-values ranging from 0.017 to 0.045) and reading composite scores (p = 0.047 and 0.019). Conclusions: This study suggests an association between greater AI-derived radiographic severity and lower reading ability in corrected metopic synostosis. Older age at surgery was independently associated with lower reading ability and visuomotor integration. Surgical correction may mitigate neurodevelopmental differences based on severity that have been observed pre-operatively.



Participation in an Attachment-Based Home Visiting Program Is Associated with Lower Child Salivary C-Reactive Protein Levels at Follow-Up

May 2023

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43 Reads

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1 Citation

Journal of Developmental & Behavioral Pediatrics

Objective: Exposure to early childhood adversity is associated with an increased risk for physiological disruption, including increased inflammation. Early interventions that support the mother-child relationship have been shown to potentially buffer negative psychosocial outcomes related to early adversity, but it is unclear whether these interventions have long-term biological effects. We evaluated whether prior participation in Minding the Baby® (MTB), an attachment-based home visiting intervention for young mother-infant dyads living in underserved communities, is associated with lower child salivary inflammatory biomarkers compared with controls at follow-up. Methods: Ninety-seven maternal-child dyads (n = 43 intervention and n = 54 controls) enrolled in a follow-up study of the MTB randomized controlled trial, an average of 4.6 years after RCT completion. Children provided salivary specimens. We used adjusted linear regression to examine the relationship between MTB participation and child salivary inflammatory biomarkers (C-reactive protein [CRP], interleukin [IL]-1β, IL-6, IL-8, and TNF-α). Results: Children were on average 6.6 years old, 48% female, and identified as non-Hispanic/Latino Black/African American (34%) and Hispanic/Latino (63%). Participation in MTB was associated with lower salivary CRP levels (β = -0.31, SE = 0.28, p = 0.003) compared with controls. Participation in MTB was not associated with salivary cytokine levels. Discussion: Participation in an intensive two-generation home visiting intervention such as MTB may reduce salivary inflammatory biomarkers associated with early childhood adversity. Replication and further research are needed to improve the understanding of the potential for early childhood interventions to buffer the biological embedding of early adversity.


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Citations (79)


... Therefore, to examine young people's decision making comprehensively in the context of environmental threats such as cyanoHABs, the concept of risk avoidance has also been applied, as it provides insights into how young people evaluate and make decisions in risky situations. Risk avoidance, as a risk management strategy [42], is defined as the tendency of an individual to evade possible exposure to loss or harm [43]. Its goal is to eliminate hazards, activities, and exposures to risk that pose a potential loss [44] rather than to deal with their consequences [45]. ...

Reference:

Tourism and Career Development in the Face of Seawater Threats: Understanding the Perspectives of Tourism and Hospitality Students from Coastal Areas
Risk avoidance and social anxiety in adolescence: Examination of event-related potentials and theta-dynamics on the Balloon Risk Avoidance Task
  • Citing Article
  • August 2024

Brain and Cognition

... However, while multiple researchers have evaluated the effectiveness of Gemini Advanced, Google's latest AI, its use as an educational tool has yet to be thoroughly investigated. [16][17][18] The latest version of ChatGPT, ChatGPT 4o, has attracted considerable attention, prompting an evaluation of its capabilities. The primary aim of this study is to evaluate the accuracy of ChatGPT 4o's answers to multiple-choice questions (MCQs) from the Israeli national ophthalmology certification exam, translated into French, and to compare it with the accuracy of the answers provided by Israeli ophthalmology residents, ChatGPT 4, and Gemini Advanced. ...

Assessing the Efficacy of Large Language Models in Health Literacy: A Comprehensive Cross-Sectional Study

The Yale journal of biology and medicine

... The study findings emphasize the imperative for targeted educational interventions that acknowledge the varying perceptions of current, former, and never smokers to effectively modify parental behaviors and reduce children's secondhand smoke exposure [23]. An assessment of parental perceptions will inform the development of tailored clinical and psychoeducational interventions designed to promote smoking cessation during the early postnatal period [24]. Furthermore, identifying knowledge gaps and misconceptions regarding children's exposure to secondhand and thirdhand smoke can inform the development of more robust policy interventions. ...

Parental Tobacco Smoking and Caregiving in the Perinatal and Early Infancy Periods

... In light of evidence linking specific risk factors implicated in detached (e.g., depression, neglect) and intrusive (e.g., CPS referral) parenting with altered neural responding to infant expressions (Bernard et al., 2015Rodrigo et al., 2011;Wall et al., 2024), this study moved beyond a focus on sensitivity to investigate the significance of mothers' ERP responding to infant emotional expressions for direct observations of mothers' detached and intrusive behaviors. Unlike the other caregiving behaviors examined, intrusiveness was directly associated with mothers' N170 responding to infant emotional expressions, and this association was not moderated by infant temperamental distress. ...

Maternal psychological risk and the neural correlates of infant face processing: A latent profile analysis

Developmental Psychobiology

... Our institutional experience with OCT, which noninvasively quantifies peripapillary retinal structure, has demonstrated its potential as an effective surrogate for invasive ICP measurement with high sensitivity and specificity, although specialized equipment and sedation are required [30,31,34]. Overall, the objective assessment of neurocognition in craniosynostosis is an ongoing challenge that requires continued investigation [38][39][40][41]. It is our hope that more standardized measures of intellectual impairment can be implemented to better evaluate the neuropsychiatric development of patients with pansynostosis. ...

"Morphologic Severity and Age at Surgery Are Associated with School Age Neurocognitive Outcomes in Metopic Craniosynostosis"
  • Citing Article
  • August 2023

Plastic & Reconstructive Surgery

... In the present study, dyads whose mothers presented higher cognitive resources seemed to benefit more from the treatment offered by the residential community. Anyway, the process of change appeared to be slow and results required a rather long time to become observable (Greenson, 2018;Knekt et al., 2011), suggesting the need to integrate the treatments provided with modules specifically focused on parent-child relationship which could be more rapid and effective in supporting quality of care (Lowell et al., 2023;Mayes, 2023;Suchman et al., 2004Suchman et al., , 2006. ...

Reframing caring for parents who struggle with substance-use disorders
  • Citing Article
  • March 2023

Infant Mental Health Journal

... Minimally invasive techniques like EC not only reduce blood loss and hospital stays but also lower overall healthcare costs due to fewer complications [70]. Long-term follow-up is crucial to assess cranial growth, cephalic index changes, and potential complications, as variability in skull development may influence outcomes [71]. ...

Long-term neurocognitive outcomes in 204 single-suture craniosynostosis patients

Child's Nervous System

... The N170 is a facespecific ERP that has been widely examined in mothers and has been linked to maternal behavior (Maupin et al., 2015). Prior maternal ERP research has also associated N170 amplitude and latency measures with depression (Chen et al., 2014;Noll et al., 2012) and SU (Lowell et al., 2020;Rutherford et al., 2017;Wall et al., 2022) in mothers, and with anxiety in nonparenting studies (Cui et al., 2021;Wieser & Moscovitch, 2015). However, most of these studies have assessed these psychological factors individually rather than evaluating how these symptoms may co-occur across mothers and whether different patterns of symptoms may vary in their impact on the neural processing of infant faces. ...

Current Substance Use and Maternal Neural Responses to Infant Faces and Cries

International Journal of Mental Health and Addiction

... It has been frequently reported that children with nonsyndromic craniosynostosis may experience neurodevelopmental challenges such as cognitive, language, motor, and behavioral difficulties with a heightened risk of learning difficulties as children enter formal schooling (Kapp-Simon et al., 2007;Naran et al., 2016;Osborn et al., 2021;Peck et al., 2022). However, fewer studies have sought to examine the incidence of autism within this population or evaluated the social sequelae of craniosynostosis, and in those that have, results have varied. ...

Longitudinal outpatient and school-based service utilization among children with nonsyndromic craniosynostosis
  • Citing Article
  • September 2022

Plastic & Reconstructive Surgery

... In contrast to the results above, Misund et al. and Elansary et al. have found PTSD symptoms to be associated with more optimal parent-infant interactions and increased maternal sensitivity in this population and hypothesized that reactions to the traumatic experience of having a preterm infant may lead to an increased maternal focus on the infant's healthy development in some mothers (Elansary et al., 2022;Misund et al., 2016). Similarly, Hall and colleagues performed an explorative study of 197 mothers and infants (ranging from full-term to very-preterm) to look into the association between maternal postnatal distress levels and the quality of parenting and found that high levels of emotional distress did not necessarily negatively affect the quality of parenting and lower emotional distress levels were not always associated with a higher quality of parenting in mothers of preterm infants (Hall et al., 2017). ...

Posttraumatic Stress Symptoms and the Quality of Maternal-Child Interactions in Mothers of Preterm Infants
  • Citing Article
  • August 2022

Journal of Developmental & Behavioral Pediatrics