bluuebunny/crossref_metadata_2025 huggingface dataset:
Diffusionsgewichtete MRT des Abdomens
Authors: Holzapfel Konstantin , Schreyer Andreas G.
Published: August 2020

Die diffusionsgewichtete MRT ist heute eine wichtige, ergänzende Sequenz bei einer MRT des Abdomens, insbesondere bei onkologischen Fragestellungen, jedoch auch bei entzündlichen Erkrankungen. Die folgende Arbeit befasst sich mit den technischen Grundlagen und zeigt typische Indikationen und Befunde sowie die Wertigkeit der Methode in der Diagnostik der parenchymatösen Oberbauchorgane und des Gastrointestinaltrakts.
Different Faces: Different Facelift Techniques
Authors: Sedgh Jacob , Fedok Fred G.
Published: August 2020

The introduction and evolution of different rhytidectomy techniques has spawned an exciting era of facial rejuvenation in modern times. To provide patients with the best customized approach to surgery the facial aesthetic surgeon must have familiarity and understanding of the fundamental differences between these techniques. Here we set forth to provide some historical and anatomical perspective, followed by reviewing and comparing some of the key aspects of the most commonly utilized facelift techniques.
Researchers create contact lens that stays moister and cleaner than other lenses
Authors: McConnon Aili
Published: August 2020

Silicone hydrogel contact lens with novel phosphorylcholine-based polymer surface increases wettability of lenses and decreases protein depositions.
Thermal properties of BaCu2SnQ4 (Q = S, Se) quaternary chalcogenides
Authors: Gunatilleke Wilarachchige D. C. B. , May Andrew F. , Wang Hsin , Nolas George S.
Published: August 2020

Quaternary chalcogenides form in different structure types and compositions and are of scientific interest, while their diversity of physical properties exemplifies why they continue to be investigated for potential technological applications. We investigate the thermal properties of BaCu2SnQ4 with trigonal (Q = S) and orthorhombic (Q = Se) crystal structures. BaCu2SnS2Se2 was also synthesized and characterized in order to investigate the effect of alloying on the thermal properties of these quaternary chalcogenides. The low thermal conductivity these materials possess originates from complex phonon spectra and local dynamics of distorted CuQ4 tetrahedra. Our results and analyses are presented in light of the ongoing fundamental interest in these materials as well as their continued interest for energy-related and opto-electronic applications.
Current-in-plane spin-valve magnetoresistance in ferromagnetic semiconductor (Ga,Fe)Sb heterostructures with high Curie temperature
Authors: Takase Kengo , Anh Le Duc , Takiguchi Kosuke , Tanaka Masaaki
Published: August 2020

We demonstrate spin-valve magnetoresistance (MR) with a current-in-plane (CIP) configuration in (Ga,Fe)Sb/InAs (thickness tInAs nm)/(Ga,Fe)Sb trilayer heterostructures, where (Ga,Fe)Sb is a ferromagnetic semiconductor (FMS) with high Curie temperature (TC). An MR curve with an open minor loop is clearly observed at 3.7 K in a sample with tInAs = 3 nm, which originates from the parallel-antiparallel magnetization switching of the (Ga,Fe)Sb layers and spin-dependent scattering at the (Ga,Fe)Sb/InAs interfaces. The MR ratio increases (from 0.03 to 1.6%) with decreasing tInAs (from 9 to 3 nm) due to the enhancement of the interface scattering. This demonstration of the spin-valve effect in Fe-doped FMS heterostructures paves the way for device applications of the high-TC FMS.
Analytical solutions to validate 3D numerical methods for solving direct ultraviolet photoionization and charge recombination of aerosol nanoparticles with laminar flow in circular ducts
Authors: Fernández-Díaz Julio M. , Palacios Sergio L. , Menéndez-Blanco Alberto
Published: August 2020

This work analyzes UV photocharging of aerosol particles in a cylindrical duct and develops analytical solutions to particular cases. A three-dimensional (3D) numerical method is also developed in order to be used as an example of validation. These methods consider diffusion, photoionization, recombination, and advection by both a fluid and an electric field in a three-dimensional space. In the first place, governing equations are developed to clarify misleading equations found in a previous literature. These equations are then used in analytical methods to find solutions for these particular cases: diffusion only, electric field only, electric field plus photoionization, and, finally, electric field plus recombination. An analysis of these solutions shows the existence of shock/rarefaction waves in the evolution of charged particles’ concentration inside the duct, a very interesting phenomenon that cannot be captured using zero-dimensional (0D) numerical models or a dimensional analysis. The numerical method of lines is applied to generate an axisymmetrical 3D numerical model that is validated using the analytical solutions. A good agreement between the numerical and analytical solutions was obtained despite the simplicity of the numerical method. The paper also comments on the advantages of using the presented methods for the prediction of concentration values against the use of non-dimensional parameters in 0D models.
Quotation, meta-data and transparency of sources in mediated political discourse
Authors: Fetzer Anita
Published: August 2020

Quotation has been defined as metarepresentation, metarepresenting not only the pragmatic force and content of a conversational contribution, but also its source and contextual coordinates. It thus displays a higher degree of explicitness than does the original contribution, as is reflected in explicit metadata which contribute to the contextualisation of the original participation format, the participants’ communicative intentions, communicative goals and intended perlocutionary effects, as well as physical, temporal and discursive setting. The chapter suggests that participants adapt the formatting of their quotations and the entextualisation of metadata to the contextual constraints and requirements of the quoting discourse. In mediated political discourse quotations and metadata are used strategically to (1) intensify the force of a contribution, (2) demonstrate argumentative (non)coherence and (non)credibility, (3) express (non)alignment, and (4) secure discourse common ground between multilayered and multifaceted audiences. On a more global level, quotations contribute to the construal of interdiscursitivity.
How LINE users struggle to come to terms with the adaptability-adaptivity dilemma
Authors: Intachakra Songthama
Published: August 2020

This article addresses the tension between the two contrasting forces of adaptation, introduced in Mey (1998, 2009). Many aspects of Thai people’s day-to-day interactions through/with LINE, a popular internet-based chat application, challenge the premises that humans should have control over technology (adaptability) rather than letting technology force limits on human’s affordances (adaptivity). My discussion will exhibit how Thai speakers operate LINE to achieve different purposes, both to the benefit and the detriment of themselves and one another, and despite unfavourable consequences from using or interacting with LINE, either known or unknown to them. These practices illustrate changes to various aspects of the Thai mindset and how relationships, identities and interactions among Thais in the modern world are constructed, negotiated and contested.
Loss of ZBTB24 impairs nonhomologous end-joining and class-switch recombination in patients with ICF syndrome
Authors: Helfricht Angela , Thijssen Peter E. , Rother Magdalena B. , Shah Rashmi G. , Du Likun , Takada Sanami , Rogier Mélanie , Moritz Jacques , IJspeert Hanna , Stoepker Chantal , van Ostaijen-ten Dam Monique M. , Heyer Vincent , Luijsterburg Martijn S. , de Groot Anton , Jak Rianca , Grootaers Gwendolynn , Wang Jun , Rao Pooja , Vertegaal Alfred C.O. , van Tol Maarten J.D. , Pan-Hammarström Qiang , Reina-San-Martin Bernardo , Shah Girish M. , van der Burg Mirjam , van der Maarel Silvère M. , van Attikum Haico
Published: August 2020

The autosomal recessive immunodeficiency, centromeric instability, and facial anomalies (ICF) syndrome is a genetically heterogeneous disorder. Despite the identification of the underlying gene defects, it is unclear how mutations in any of the four known ICF genes cause a primary immunodeficiency. Here we demonstrate that loss of ZBTB24 in B cells from mice and ICF2 patients affects nonhomologous end-joining (NHEJ) during immunoglobulin class-switch recombination and consequently impairs immunoglobulin production and isotype balance. Mechanistically, we found that ZBTB24 associates with poly(ADP-ribose) polymerase 1 (PARP1) and stimulates its auto-poly(ADP-ribosyl)ation. The zinc-finger in ZBTB24 binds PARP1-associated poly(ADP-ribose) chains and mediates the PARP1-dependent recruitment of ZBTB24 to DNA breaks. Moreover, through its association with poly(ADP-ribose) chains, ZBTB24 protects them from degradation by poly(ADP-ribose) glycohydrolase (PARG). This facilitates the poly(ADP-ribose)-dependent assembly of the LIG4/XRCC4 complex at DNA breaks, thereby promoting error-free NHEJ. Thus, we uncover ZBTB24 as a regulator of PARP1-dependent NHEJ and class-switch recombination, providing a molecular basis for the immunodeficiency in ICF2 syndrome.
How good are my data? Reference standards in superresolution microscopy
Authors: Mund Markus , Ries Jonas
Published: August 2020

Superresolution microscopy is becoming increasingly widespread in biological labs. While it holds enormous potential for biological discovery, it is a complex imaging technique that requires thorough optimization of various experimental parameters to yield data of the highest quality. Unfortunately, it remains challenging even for seasoned users to judge from the acquired images alone whether their superresolution microscopy pipeline is performing at its optimum, or if the image quality could be improved. Here, we describe how superresolution microscopists can objectively characterize their imaging pipeline using suitable reference standards, which are stereotypic so that the same structure can be imaged everywhere, every time, on every microscope. Quantitative analysis of reference standard images helps characterizing the performance of one’s own microscopes over time, allows objective benchmarking of newly developed microscopy and labeling techniques, and finally increases comparability of superresolution microscopy data between labs.
A-04 Signs of Injury, Preexisting Health Conditions, and Emergency Department Discharge Location among Older Adults with Mild Traumatic Brain Injuries
Authors: Karr J , Iverson G , Isokuortti H , Kataja A , Brander A , Öhman J , Luoto T
Published: August 2020

Objective

Preexisting health conditions are associated with worse outcome following mild traumatic brain injury (MTBI), which is especially important in MTBI management among older adults. This study focused on older adults who presented to an emergency department (ED) following uncomplicated MTBI, examining the relationship between clinical signs of MTBI, preexisting conditions, and the location of ED discharge.

Method

Participants included older adults (n = 616, men = 44.8%, ≥55 years-old) who presented to the Tampere University Hospital ED with uncomplicated MTBI (GCS = 15; ground-level falls = 72.4%). Data were collected retrospectively from hospital records, including clinical signs of injury, preexisting health conditions [including preinjury abnormalities on head computed tomography (CT)], and location of follow-up (i.e., home versus other health/rehabilitation facility). A higher odds ratio (OR) indicated a greater likelihood of continued care discharge to another health facility.

Results

Among participants 55–69 years-old, preexisting neurological diseases (OR = 2.92), mental/behavioral health conditions (OR = 3.05), and CT abnormalities (OR = 3.02) were associated with greater odds of continued care. Among participants 70+ years-old, preexisting neurological diseases (OR = 2.60) and CT abnormalities (OR = 2.12) were associated with greater odds of continued care. Preexisting circulatory system diseases, loss of consciousness, and amnesia were not associated with greater odds of continued care for either age group.

Conclusions

Among older adults with uncomplicated MTBIs, preexisting health conditions were associated with greater odds of continued care than loss of consciousness or amnesia. These findings reveal the importance of preexisting health conditions in the acute clinical management of MTBI in older adults, in that preexisting conditions have greater associations with care planning than clinical signs of injury.
A-12 The Dimensionality of Symptoms Before and After Sport-Related Concussion
Authors: Karr J , Iverson G
Published: August 2020

Objective

Multiple factor analyses have examined the dimensionality of physical, emotional, and cognitive symptoms both before and after a sport-related concussion. The current study compared model fit and measurement invariance of five candidate factor models, including a one-factor model, original four-factor model (cognitive-sensory, vestibular-somatic, sleep-arousal, and affective), alternative four-factor model (cognitive, physical, sleep-arousal, and affective), five-factor model (cognitive-sensory separated), and bifactor model.

Method

Student athletes (N = 1,554; 56.7% boys; age: M = 16.1 ± 1.2) completed the Post-Concussion Symptoms Scale (PCSS) at preseason baseline and after a suspected concussion. Confirmatory factor analyses were conducted at both time points, with pre-injury to post-injury measurement invariance models (configural, weak, strong, and strict) also examined. Model results were assessed via fit indices (CFI ≥ .90/RMSEA≤.08) and change-in-fit indices (∆CFI ≤ -.01).

Results

All models other than the one-factor model showed excellent fit before and after concussion (CFIs>.95/RMSEAs < .06). Based on pre-injury to post-injury invariance analyses, full weak invariance was established for both four-factor and the bifactor models, and partial strict invariance was established for each of these models following modifications.

Conclusions

Support for partial strict invariance indicates that meaningful comparisons can be made between factor means before and after concussion for the four-factor and bifactor models, evidencing the validity of a total symptom score and specific symptom subscales before and after concussion. The alternative four-factor model may offer an improved conceptual framework compared to the original four-factor model, which included a non-intuitive cognitive-sensory factor. These findings could support the development of normative scores for PCSS subscales for use in research and clinical practice.
A-012 Meta-Analysis of Neuropsychological Intra-Individual Variability in Dementia and Mild-Cognitive Impairment
Authors: S Aita , C Demming , D Knapp , B Hill
Published: August 2020

Objective

Neuropsychological intra-individual variability (IIV) refers to within-person cognitive fluctuation. It is often measured within-task (i.e., consistency) and across-tasks (i.e., dispersion). This investigation meta-analyzed studies comparing cognitive IIV of dementia and mild cognitive impairment (MCI) participants to normal controls.

Method

Eight databases within the EBSCO network as well as ProQuest Dissertations & Theses were searched for original research comparing cognitive IIV between clinical and control samples. Studies were coded using a complex multi-comparison, outcome, and subgroup schema. All data were analyzed under random-effects modeling using Comprehensive Meta-Analysis. Main index of effect size was Hege’s g. The Q and I2 statistics were used to formally assess heterogeneity. Continuous and categorical moderator variables were tested using meta-regression and subgroup analysis, respectively.

Results

This study was a part of a broader meta-analysis looking at IIV across all clinical samples. The initial search strategy yielded 2,962 results, which were reduced to 87 studies for final inclusion. From which, the current meta-analysis included 28 consistency studies (dementia: k = 13, 88 effect sizes; MCI: k = 15, 110 effect sizes) and 16 dispersion studies (dementia: k = 10, 36 effect sizes; MCI: k = 6, 14 effect sizes). Meta-analysis revealed a greater combined effect size for dementia samples (consistency: g = 0.92; dispersion: g = 1.11) than MCI (consistency: g = 0.33; dispersion: g = 0.56). Significant between-study heterogeneity was noted across analyses. Age and education were the only notable moderators.

Conclusions

All clinical subgroups demonstrated significantly elevated IIV compared to controls. The extent of IIV was proportionate to neurologic burden. Dispersion-based IIV may be a more sensitive marker of neural integrity than consistency.
A-013 The Impact of Anxiety and Depressive Disorders on Late-Life Cognitive Functioning
Authors: M Delgadillo , A Boese , M Frank , T Schulte , J Fairchild
Published: August 2020

Objective

Research indicates that the presence of psychiatric disorders is predictive of cognitive performance and increases the risk of developing dementia. Some have found that psychiatric disorders decrease cognitive performance while others have found that they increase cognitive performance. The purpose of the present study is to further investigate the relationship between psychiatric disorders and cognitive performance in older Veterans.

Method

The convenience sample included 216 older Veterans who were screened at the VA Palo Alto Health Care System (94% male, age = 71.8 ± 8.3). Psychiatric disorders (e.g., mood and anxiety disorders) were assessed using the Mini Neuropsychiatric Interview for DSM-IV. Domains of cognitive performance (e.g., Learning and Memory, Executive Function, Processing Speed, Attention, Visuospatial Ability, and Language) were measured using a comprehensive neuropsychological assessment battery.

Results

Results indicated that 25% of the sample had depression (n = 56) and 16% had anxiety (n = 34). Psychiatric diagnoses largely had no effect on executive function, processing speed, or language. Age was found to moderate the association between depression and learning and memory, though there were no main effects for depression on learning and memory. Anxiety was significantly associated with learning and memory performance, and age was found to further moderate that relationship. Age also moderated the association between depression and attention, though no main effects for depression were seen in the model. Anxiety had no effect on attention.

Conclusions

Age and psychiatric diagnoses interact to differentially impact cognitive functioning in late life. These findings support prior research on the complex relationship between psychiatric disorders and late-life cognitive impairment.
A-014 Positive, but not negative, self-perceptions of aging predict cognitive function in older adults
Authors: K Brown , A Mccarrey
Published: August 2020

Objective

Self-perceptions of aging (SPA) refer to expectations and attitudes about one’s aging process and are robustly linked to physical health and longevity outcomes. How SPA correlates with cognitive function in older adulthood is less well known. Thus, the present study sought to examine how a multidimensional measure of SPA correlated with older adult’s performance on a comprehensive neuropsychological battery.

Method

136 community-dwelling older adults (Mage = 70.18, SDage = 5.79 years) from Southeast Idaho were administered a multidimensional measure of SPA; The Brief Ageing Perceptions Questionnaire (B-APQ). This 17-item questionnaire requires participants to rate their agreement with positive and negative statements concerning their aging process. Participants were also administered a demographics form and a comprehensive neuropsychological battery that included measures of memory, attention and executive function.

Results

Both positive and negative subscales of the B-APQ were correlated with various aspects of cognitive function. After controlling for age, sex and education, regression analyses revealed that positive subscales of the B-APQ predicted mental status (β = .19, p < .05), short-delay memory (β = .16, p < .05), processing speed (β = −.21, p < .05) and two measures of executive function (β = −.21, p < .01; β = .18, p < .05). The negative subscales of the B-APQ were not predictive of any cognitive domain.

Conclusion

This is the first study to demonstrate that independent of selected sociodemographic factors, positive, but not negative dimensions of SPA relate to a wide range of cognitive abilities in older adulthood. We discuss our results in terms of positive psychology and the potential for interventions to improve cognitive function in older adults.
A-015 Posttraumatic Stress Disorder Symptoms are Associated with Reduced Performance on the MoCA among Vietnam Veterans
Authors: S Prieto , K Valerio , J Moody , S Hayes , J Hayes
Published: August 2020

Objective

To examine cross-sectional associations between posttraumatic stress disorder (PTSD) symptom severity, number of stressors experienced, and cognitive outcomes in Vietnam War veterans.

Methods

366 adults between the ages of 60–85 years old completed a Vietnam Veterans Alzheimer’s Disease Neuroimaging Initiative Project (ADNI-DoD) visit consisting of a clinical interview and neuropsychological assessment. Number of stressful experiences were measured with the Life Stressor Checklist-Revised (LSC-R). Severity scores were assessed via the current Clinician-Administered PTSD Scale (CAPS). Correlations were conducted between selected measures of stress and age, years of education, sex, ethnicity, and race. Demographic variables with significant associations with stress were included as covariates in the hierarchical regressions. Hierarchical linear regressions were conducted to examine the effect of CAPS and LSC-R on baseline Montreal Cognitive Assessment (MoCA) scores.

Results

Higher CAPS scores (indicating higher PTSD severity) were associated with worse cognitive outcomes on the MoCA [ΔF(1,269) = 15.058, p < 0.001, R2 = 0.116]. By contrast, number of stressful experiences was not associated with cognitive outcomes. Follow up analyses indicated that CAPS severity scores were significantly associated with the memory index and the attention index of the MoCA.

Conclusions

In a sample of older veterans, PTSD symptom severity was associated with worse performance on the MoCA. Moreover, further analyses indicated that results within the memory and attention domains are driving these results. As such, treating PTSD symptoms may be helpful in maintaining cognitive function as adults age.
A-017 Lifestyle activity engagement and cognition: Findings in healthy controls across the lifespan
Authors: J Randolph , J Randolph , P Arnett , L Strober , E Guty , C Roman , H Wishart
Published: August 2020

Objective

Engagement in physical and intellectual activity has been found to exert an impact on processing speed and executive functioning. One critical issue that remains unclear is at what point in the lifespan self-reported lifestyle factors impact cognition.

Method

A community sample of nondepressed adults aged 18–74 (N = 176) was administered measures assessing activity engagement (Cognitive Health Questionnaire), processing speed (SDMT), and executive functioning (PASAT, Oral Trails B). Very physically and intellectually active (over 3 instances/week of activity) participants were compared to those reporting less activity across three age ranges: young adults (YA; age 18–29), middle-aged adults (MA; age 30–55), and older adults (OA; age 56–74).

Results

MA participants who frequently engaged in moderate or vigorous physical activity showed better SDMT performance than less active participants (p < .05). YA participants frequently engaging in mild physical activity showed a nonsignificant trend toward better PASAT and SDMT performance than those who were less active. YA and MA participants who reported high use of daily cognitive strategies showed stronger Oral Trails B (p < .05) and SDMT (p = .06) performance, respectively. Very intellectually active YA participants showed better PASAT performance than less active participants (p = .06). While OA participant group comparisons were not significant, small sample sizes for some analyses may have impacted results.

Conclusions

We found that individuals with strong lifestyle activity engagement showed better processing speed and executive functioning than less active participants. These findings are consistent with previous research indicating that more robust activity engagement is associated with better cognition.
A-026 Older Adults’ Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Age, Geographic Location, and Income
Authors: M Splonskowski , D Binng , H Cooke , C Jacova
Published: August 2020

Objective

Recent implementations of teleneuropsychological services allow cognitive assessment to take place within the individual’s home. Geographic location and financial resources may influence older adults’ decision to access these services. Additionally, the likelihood of older adults’ participation in home-based cognitive assessment (HBCA) is unknown. We aimed to examine the relationship between age, geographic location, income, and likelihood of participation in HBCA.

Method

A nation-wide sample of 483 adults ages 50–79 completed an online survey via the crowdsourcing website Amazon Mechanical Turk. Respondents were asked about age, income and geographic location (e.g. rural, urban, suburban). Income was categorically measured in $20,000 increments. Likelihood of participation in HBCA was measured using 4 likert-scale items. Total likelihood was calculated by summing items.

Results

Perceived likelihood of participating in HBCA increased with greater household income, B = .087, p = .001 (0-20 K: M = 13.08 ± 4.19; 20-40 K: M = 14.76 ± 3.39; 40-60 K: M = 14.55 ± 3.49; 60–80 K: M = 14.55 ± 3.38; 80-100 K: M = 15.11 ± 2.83 and > 100 K: M = 15.48 ± 2.55). Likelihood decreased with age, B = −.061 p = .025 (50–59: M = 15.03 ± 3.56; 60–69: M = 14.31 ± 3.52, 70–79 M = 14.29 ± 3.27). Likelihood was not related to geographic location B = −.005, p = .933 (rural: M = 14.52 ± 3.84; suburban: M = 14.48 ± 3.31; urban: M = 14.48 ± 3.56).

Conclusion

Adults aged 50–59 with high income were the group most likely to participate in HBCA. Geographic location does not appear to play a role in acceptance of HBCA. However, this survey was conducted with online respondents. Different results may be obtained with in-person samples.
A-032 The Relative Contribution of Neuropsychological Assessment and Radiological Scans to Diagnostic Accuracy in Young Onset Dementia
Authors: A Macrae , A Dyson , D Mason
Published: August 2020

Objective

Younger-onset dementias (YOD) are relatively rare neurodegenerative disorders that often present unique diagnostic challenges to health professionals. These difficulties often result in significant delays to diagnosis and uncertainty in clarifying the aetiology of a client’s presenting problems. In this audit of routine clinical practice, we evaluate the utility of radiological scan reports (Magnetic Resonance Imaging (MRI), Single Photo Emission Computed Tomography (SPECT) and Computerised Tomography (CT) with neuropsychological assessment, and retrospectively evaluate the relative contribution of each approach to diagnostic accuracy.

Method

83 clinical records were reviewed from a regional specialist centre for assessment and diagnosis of YOD in the United Kingdom. Patients were assessed using clinical interview, neuropsychological assessment and neuroradiological diagnosis (MRI, SPECT or CT scan). The correlations between radiologist report, neuropsychological status and neuropsychiatric evaluation were compared to established diagnoses retrospectively.

Results

The diagnostic labels identified and highlighted in radiology reports were found to be congruent with the final agreed diagnosis, arrived as a consensus by a multidisciplinary team of clinicians, in 70% of cases. In contrast, neuropsychological opinion was congruent with the final agreed clinical diagnosis in 93% of cases. Substantial differences in congruency between scan report and clinical diagnosis were observed for the different neuroradiological techniques with SPECT showing high rates of false positive abnormality.

Conclusion

Overall, neuropsychological opinion concurred with final diagnostic outcomes significantly more frequently than diagnosis indicated by radiology scan report. Results are discussed in terms of both cost–benefit analysis and the clinical utility of both assessments in the diagnosis of YOD.
A-035 What Make Them Tick? The Clock Drawing Test and Correlations Between Cognitive and Functional Abilities
Authors: D Gold , K Boulos , N Coolbrith , I Piryatinsky
Published: August 2020

Objective

The Clock Drawing Test (CDT) is among the most researched cognitive measures and is frequently used to screen for neurocognitive disorders (NCDs). No study to date has investigated the relationship between qualitative errors on the CDT and independence in instrumental activities of daily living (IADLs) or discrete cognitive abilities. Therefore, this study sought to evaluate the correlations between qualitative errors on the CDT and IADL status as well as performance in individual cognitive domains.

Method

Data were retrospectively collected from patients seen at an outpatient clinic in eastern Massachusetts, including 16 healthy controls, 22 patients with mild NCD, and 35 patients with major NCD. Analyses were performed between qualitative errors on the CDT and patients’ scores on the Lawton IADL Scale, Mattis Dementia Rating Scale-2 (DRS-2), Digit Span Forward and Backward, Trail Making Test (TMT), and the Boston Naming Test (BNT).

Results

IADL scores were moderately correlated with CDT error types. DRS-2 scores were strongly correlated commission of qualitative errors. Strong to very strong correlations were observed between TMT parts A & B scores and all qualitative error types. BNT performance was strongly correlated with conceptual deficits and spatial/planning errors. Digit Span Forward and Backward scores showed low correlations with all CDT errors.

Conclusions

Functional status appears only moderately correlated with commission of various CDT errors; however, several cognitive measures showed high correlation with various CDT error types. These findings suggest that certain qualitative errors may be indicative of cognitive impairments warranting further workup. Clinical implications and future directions are discussed.
A-036 Deficit Accumulation Frailty Index as a Predictor of Cognitive Outcomes in HIV+ and HIV- Adults
Authors: K Tureson , A Gold , E Mclntosh , A Thames
Published: August 2020

Objective

Adults aging with HIV face elevated rates of frailty than the general aging population and are frail at younger ages, but associations between frailty and cognition in HIV are not well understood. The study aimed to examine: 1) relationships between frailty index and age, and whether relationships differed by HIV status; 2) relationships between frailty index and cognitive performance, and whether relationships differed by HIV-status. It was hypothesized that 1) the frailty index would significantly predict age in non-infected (HIV-) controls but not HIV-infected (HIV+) adults; 2) higher frailty index scores would significantly predict worse cognitive functioning regardless of HIV-status.

Method

Participants included 109 (39.4% HIV+) participants aged ≥45 from a community-based sample in Los Angeles. HIV-status groups did not differ by age, education, or race (p’s > .10). Frailty was assessed using a deficit accumulation frailty index (DAFI) composed of 32 age-related health variables. A comprehensive neurocognitive battery was used to examine motor, processing speed, executive functioning, verbal fluency, learning, memory, and global functioning. Multivariate linear regression was used to assess relationships between the DAFI and age and cognitive performance, and HIV-by-frailty interaction.

Results

DAFI scores were higher in HIV+ adults compared to HIV- controls. The DAFI significantly predicted global, motor, and memory performance (p’s < .05), but the effect was only observed in HIV- controls. The DAFI did not significantly predict age in either group.

Conclusions

Findings highlight that relationships between frailty and cognition may be complicated in patients with chronic health conditions. Frailty may not predict cognitive dysfunction in aging HIV+ adults.
A-040 Shift as Mediator Between ADHD Status and Internalizing Symptoms
Authors: Z Imre , M Kibby
Published: August 2020

Objective

Individuals with ADHD are at a higher risk for internalizing disorders such as anxiety (APA, 2013). Some internalizing symptoms are associated with problems in shift (Ajilchi & Nejati, 2017). Individuals with ADHD also often have poor shift (Martel et al., 2007; Shuai et al., 2011). Hence, this project hypothesized shift to be a statistical mediator in the relationship between ADHD status and internalizing symptoms.

Method

Participants included 257 children from a pre-existing, grant-funded database (R03HD048752, R15HD065627), which is from a community sample. The mean age of participants is 9.54 years, with this sample being 53.7% male and 87.9% Caucasian. Participants included children with ADHD (n = 89), Reading Disorder (RD; n = 47), comorbid RD/ADHD (n = 47), and controls (n = 74). Parents completed several questionnaires on their child, including the Behavior Rating Inventory of Executive Function (BRIEF) and the Behavior Assessment System for Children-Second Edition (BASC-2). The BRIEF Shift and BASC-2 Internalizing Problems subscales were used for this project.

Results

Mediation analysis was run in PROCESS using ADHD status as the predictor variable, BRIEF Shift as the statistical mediator, and BASC Internalizing Problems as the outcome variable. ADHD status was no longer significant when including Shift in the model (from p = .01 to p = .59). Bootstrap estimation with 5,000 samples indicated a significant indirect effect, as the 95% confidence interval did not contain zero [2.66, 6.61].

Conclusions

Problems with shift may be a mediator contributing to the higher risk for internalizing problems in children with ADHD. However, this needs to be verified in a longitudinal study.
A-041 Everyone is Worse than Average: Base Rates of ADHD Impairments Among College Students.
Authors: E Johnson , J Suhr
Published: August 2020

Objective

Individuals presenting with concerns of Attention Deficit Hyperactivity Disorder (ADHD) report non-specific symptoms and may seek academic or disability accommodations. However, simply having a diagnosis is not equivalent to having a disability that justifies accommodations. The legal definition of disability is poorly understood by clinicians. Guidance for determining the need for accommodations promotes self-report as the primary source of information in decision making and suggests using “most people in the general population” as a reference point when making decisions. Unfortunately, this benchmark is not well defined, and the population base rates of functional impairments commonly reported in ADHD evaluations have not been established. The present study sought to evaluate the base rates of commonly self-reported impairments among non-treatment seeking college students.

Method

Undergraduate students (N = 282; 72.3% female; 90.1% Caucasian) completed an online inventory of 32 education-related functional impairments commonly reported during ADHD evaluations. Students indicated how frequently they experienced symptoms on a 6-point scale (Never to Very Often).

Results

College students reported education impairments at a startlingly high rate. Of the 32 impairments, 22 were endorsed as “often” or higher by over 25% of students, and 30 were endorsed as “sometimes” or higher by over 25% of students.

Conclusions

Results suggest that functional impairments reported in ADHD evaluations that may be used in accommodation decision making are very common among college students. Common impairments included difficulty focusing or concentrating, needing to study more than others, and difficulty sitting in class. Results shed light on the need for clearer guidelines for determining accommodations.
A-049 Cognitive Correlates of Childhood Lead Poisoning in a High Achieving Child
Authors: Z Repp , J Hertza , J Burton , K Jupp
Published: August 2020

Objective

Individuals exposed to lead often have persistent medical issues, changes in personality, and cognitive decline, with worsening symptoms following chronic exposure. Lead poisoning in children can have lasting effects as they age. This case study examines the correlation between cognitive ability and brain damage, with demyelination, following lead exposure in an academically well performing eight-year-old. Lead poisoning was verified by medical records and neuroimaging showing demyelination is included.

Method

The individual was an eight-year-old male who was exposed to lead multiple times in a home environment over the course of one year starting as a two-year-old. Cognitive ability, academic achievement, and emotional development were assessed with clinical interview of the child and his mother and comprehensive test battery including cognitive and emotional measures. Testing also included appropriate imbedded and free-standing validity measures.

Results

Cognitive testing showed relative weakness in certain measures of verbal and visuospatial processing speed as well as indications of deficit in sustained attention. These deficits did not reach objective impairment but suggest weakness in these areas in the context of superior overall cognitive ability and academic achievement. Observation showed hyperactivity and anxious behaviors, the individual’s mother reported elevated anxiety and unusually high somatic complaints.

Conclusion

This pattern of scores corresponded to what is typically seen in patients with lead poisoning, suggesting an impact of lead poisoning on the individual’s neural development, potentially causing both cognitive and psychiatric deficits. This case is unique because, despite his lead poisoning, the patient performs well academically, suggesting that the brain can compensate for this impairment given the correct environment.
A-052 Computer Game Addiction in Children is a Risk for Emerging Weakness in Visuospatial Functions
Authors: N Kiseleva , S Kiselev
Published: August 2020

Objective

There are evidences that game addiction can cause the delay in development of cognitive functions in children. However, we need further research for revealing this risk. The goal of this research was to examine the hypothesis that children at the age of 5 with computer game addiction have a risk for emerging weakness in visuospatial functions at the age of 6.

Methods

We used questionnaire for parents to reveal children with computer game addiction. Experimental group consisted of 16 5-year-old children with computer game addiction. Control group consisted of 16 children without computer game addiction. Children from experimental and control group were matched for age, gender and IQ. In the framework of longitudinal research children at the age of 6 from both groups were assessed by 4 subtests from NEPSY which are designed for assessing visuospatial functions (Arrows, Block Construction, Design Copying, Route Finding).

Results

One-way ANOVA has revealed the significant differences (p < .05) between groups for scores in 3 visuospatial subtests (Block Construction, Design Copying, Route Finding). Children from experimental group had low level of performance in these subtests.

Conclusion

The findings from this study suggest that computer game addiction can have negative effect on the development of visuospatial functions in children. We are going to do further research for revealing the long-term effect of computer game addiction on cognitive development of children in the framework of longitudinal research.
A-057 Deficits in Inhibitory Control Are Associated with Social and Emotional Difficulties Among Children with Congenital Heart Defects
Authors: D Badaly , J Wallace , V Lee , S Beers , A Panigrahy
Published: August 2020

Objective

Research has suggested that children with congenital heart defects (CHD) may experience socioemotional maladjustment because of their often-seen executive dysfunction. However, preliminary work has largely used behavioral ratings of executive functioning. Our study used cognitive assessments of inhibitory control, an executive function key for emotional regulation and social initiative.

Method

We prospectively recruited 46 6-to-16 year olds with CHD (M = 11.65 years, SD = 3.11; 74% male) and 95 healthy controls (M = 12.09 years, SD = 2.87; 54% male). Children completed face-to-face and computerized tests of inhibitory control (D-KEFS Color-Word Interference Test; NIH Toolbox Flanker Inhibitory Control and Attention Test). Children and their parents also filled out scales assessing emotional and social functioning (Pediatric Quality of Life Inventory [PedsQL]; Harter Self Perception Profile [SPP]).

Results

Using regression, controlled for age, children with CHD had greater parent-rated emotional distress than healthy peers (p < .001). Poorer inhibition was associated with greater distress for children with CHD but not (or less so) healthy peers (p < .05). Children across groups rated their emotional functioning similarly; a face-to-face test of inhibition (but not a computerized test) was related with greater emotional health for both groups (p < .05). Children with CHD had poorer parent-rated social functioning than healthy peers on the PedsQL (p < .005) but not the SPP; there were no significant differences for self-reports. Inhibition was associated with social skills only in select models (p < .05).

Conclusions

Similar to past research, families reported more maladjustment than children. Regardless, poor inhibition emerged as one potential contributor to socioemotional maladjustment among children with CHD. Interventions targeting executive dysfunction may support socioemotional development.
A-073 Intra-Individual Variability in Stroke and Mixed Neurologic Conditions
Authors: J Davis , N Kurniadi , C Mullen , K Kitchen Andren , S Rolin
Published: August 2020

Objective

Intra-individual variability (IIV) has shown utility in characterizing cognitive dysfunction in conditions including traumatic brain injury and dementia, but has been less studied in stroke. This study examined IIV in physical medicine and rehabilitation patients with stroke and mixed neurologic conditions.

Method

Participants (N = 95) were 40% female and 83% white with average age and education of 46 (SD = 13) and 14 (SD = 2) years, respectively. Participants completed an outpatient evaluation using a flexible battery of up to 33 common neuropsychological measures. Participants were grouped by diagnosis: stroke and other cerebrovascular events (e.g., aneurysm; 58%), and mixed neurologic conditions (e.g., anoxia, dementia; 42%). Adequate performance validity was determined on the basis of embedded and freestanding validity measures. Test battery scores were converted to T scores. Cases with four or more scores below 36 T were identified as impaired. Measures of IIV were calculated including overall test battery mean (OTBM), test battery standard deviation (SD), kurtosis, skew, range, and unbiased coefficient of variation (UCV). Groups were compared on IIV measures and impairment.

Results

Diagnostic groups were not significantly different on IIV measures. Impairment rates were not different in stroke (78%) and mixed (68%) groups. Unimpaired cases showed significantly higher OTBM, and significantly lower SD, range, and UCV (all p’s < .01); kurtosis and skew were not significantly different.

Conclusions

IIV markers of cognitive dysfunction in stroke are similar to those observed in dementia and other neurologic conditions. Further study of the clinical application of IIV measures is needed.
A-079 Hand Preference in Men and Women with Parkinson’s Disease: A Preliminary Investigation
Authors: J Ryan , D Kreiner , S Gontkovsky , A Paolo
Published: August 2020

Objective

Research has identified common genetic influences on handedness and neurological/mental health phenotypes. It also has been shown there may be increased risk for development of neurological disorders/diseases among individuals naturally left-handed or demonstrating non-right-hand preference. This investigation examined prevalence of right-handed versus non-right-handed individuals with Parkinson’s disease (PD) compared to controls.

Method

Participants were 264 patients with PD (mean age = 69.83 years) and 256 control volunteers (mean age = 71.42 years). Mean Dementia Rating Scale composites for the groups were 123.68 and 136.00, respectively. Participants self-identified their dominant hand for writing and usage was confirmed during the session.

Results

Proportions of non-right- and right-handed controls (7.0% and 93.0%) versus individuals with PD (6.8% and 93.2%) did not differ. Changes in proportions of non-right- and right-handedness across age ranges were not significant for controls or patients. There was a trend for a larger proportion of women (55.9%) versus men among controls (44.1%), □ 2 (1) = 3.29, p < .10; whereas, the proportion of men (64.4%) with PD was larger than that of women. (35.6%), □ 2 (1) = 21.31, p < .001. For controls and patients, non-right and right handedness gender proportions were similar.

Conclusions

This study is the first to assess handedness prevalence rates in PD. Results suggest prevalence of non-right handedness is similar in PD and healthy individuals and does not appear to differ markedly by gender or with advancing age. The occurrence of a trend for a larger proportion of women than men among controls is consistent with census-based statistics.
A-084 Magnetic Resonance-Guided Focused Ultrasound for Parkinson’s Disease: A Systematic and Qualitative Review of Nonmotor Cognitive Outcomes Since FDA Approval of ExAblate, 2016–2019
Authors: J Lennon , I Hassan
Published: August 2020

Objective

ExAblate received FDA approval for treatment of a range of movement disorders, including tremor-dominant Parkinson’s disease (TDPD), dyskinetic PD, and essential tremor. This incisionless device permits magnetic resonance-guided focused ultrasound (MRgFUS) for ablation of regions of interest. This systematic review sought to 1) determine the extent of literature on nonmotor cognitive outcomes of MRgFUS, 2) investigate differences in postoperative outcomes, 3) suggest future research directions.

Data Selection

PubMed, CINAHL, PsycINFO, Cochrane Library databases were searched January 2016 to January 2020. Guidelines for Preferred Reporting Items for Systematic Review and Meta-Analyses were used to review clinical trials comprehensively assessing pre- and postoperative neurocognitive functioning in PD patients undergoing MRgFUS. Due to limited literature, TDPD was expanded to dyskinetic PD.

Data Synthesis

Twenty-two abstracts were initially reviewed. After full-text review of eight articles, two studies included comprehensive neuropsychological evaluations of PD patients undergoing MRgFUS thalamotomy/pallidotomy—these occurred in different countries with different normative data, prohibiting quantitative comparison. Most excluded studies used only brief cognitive screeners with unsubstantiated cutoffs.

Conclusions

Few studies to-date have administered comprehensive neuropsychological batteries to ascertain MRgFUS risks to neurocognitive functioning in PD and how it compares to deep brain stimulation. Cognitive declines appear to be minimal following MRgFUS, with exceptions being verbal fluency and inhibition. These results are limited by sample size and sample diversity. Studies must extend beyond brief screeners when assessing PD populations vulnerable to decline. Further, consensus on a comprehensive battery would better serve replicability and the ability to engage in useful meta-analyses.