bluuebunny/crossref_metadata_2025 huggingface dataset:
Progress in the creation of long-lived atmospheric luminous formations in a pulsed electric discharge with an electrolytic electrode
Authors: YAO 姚 Jingfeng 静锋 , LI 李 Jianfei 健飞 , ZHAO 赵 Shixin 世鑫 , YUAN 袁 Chengxun 承勋 , MIAO 苗 Lin 琳 , CHEN 陈 Nie 聂 , ASTAFIEV A. M. , KUDRYAVTSEV A. A. , SHABANOV G. D.
Published: September 2024

This work presents an analysis of the research conducted in many countries in recent years on the so-called Gatchina discharge. The findings indicate that the Gatchina discharge exhibits the majority of the characteristics of natural ball lightning, making it the most effective method for reproducing and studying this phenomenon. To a large extent, our new results are based on experiments performed for the first time to visualize dust particles arising in an erosive emission, as well as the formation of vortex flows. These experiments make it possible to explain the ability of the Gatchina discharge to maintain its shape for a long time in the afterglow.
Contractual Interpretation
Authors: Yihan Goh
Published: September 2024

This chapter provides an overview of the law relating to contractual interpretation in India. It explains that contractual interpretation in India is also an exercise in statutory interpretation. This is because the Indian Evidence Act 1872 limits the range of admissible evidence that can be used to interpret contracts. Since the Evidence Act was adopted in many former British colonies, its influence extends far beyond India. The chapter examines the inherent tension between staying true to the Evidence Act and the modern rules developed by common law courts. It explains that the correct approach to contractual interpretation in India is not to apply the predominant English approach without paying attention to the statutory framework provided by the Evidence Act.
Stipulated Sums and Limitation Clauses
Authors: Arvind TT
Published: September 2024

This chapter discusses the law governing stipulated sum clauses and limitation clauses in India. The clauses trigger direct conflict between the principle of freedom of contract and the principle that the law provides full compensation for breach. Moreover, the clauses are used in a very wide range of transaction types, ranging from employment contracts to complex, cross-border commercial transactions. Thus, the law on stipulated sum and limitation clauses is characterised by a lack of clarity and over-interventionism that contains a surprisingly large number of different approaches. The chapter notes the reconsideration needed on the approach of the courts to section 74 of the Indian Contract Act 1872.
The Action for the Agreed Sum and Specific Performance in Indian Law
Authors: Venkatesan Niranjan
Published: September 2024

This chapter addresses the action for the agreed sum and specific performance in Indian law. As to the former, it demonstrates that the law took a wrong turn in the 1960s by reason of the adoption by the Indian courts of the civilian doctrine of the ‘fiction of fulfilment’ and a misinterpretation of section 53 of the Indian Contract Act, 1872 (hereinafter ‘the Contract Act’). As to the latter, it explains the law relating to specific performance as it stood prior to the 2018 amendment to the Specific Relief Act, 1963, drawing on the legislative history and choices made by those responsible for drafting the predecessor to the current legislation in 1877. The final section of the chapter addresses the 2018 amendments and concludes that they are, to put it at its lowest, something of a mixed bag, introducing as they do a number of oddities or anomalies which Parliament did not foresee but are the effect of the words it used.
Contracting with the State
Authors: Chandrachud Chintan
Published: September 2024

This chapter discusses contracts with governments and public authorities. State contracts retain direct participation in several sectors of the economy despite nearly three decades having elapsed since the reforms of 1991. The chapter examines state contracts from the perspective of the parties to the contract before elaborating on the contract from the perspective of third parties. The principal challenge with regulating contracts with the state is to strike an appropriate balance between two competing objectives of the parties’ sufficient liberty of contract and commercial autonomy and the parties’ transparency and fairness. The chapter explains that courts have consistently imposed a high threshold for intervention in the process of contracting.
Alethic nihilism against paradox
Authors: Liggins David
Published: September 2024

Chapter 2 introduces the Liar paradox, and explains how nihilism solves it. It then introduces a variety of other paradoxes concerning truth, such as Curry’s paradox and Yablo’s paradox. It also addresses the objection that, since the nihilist holds that nothing is true, they are committed to rejecting every claim. There is an Aristotelian argument that anyone who endorses the law of excluded middle is committed to bivalence. Nihilism endorses the former but rejects the latter, so the argument is an objection to nihilism; the chapter shows how rejecting propositions of the form <
 is true iff p> defuses the argument. The chapter also contains an extended discussion of the Truth-teller and related ‘paradoxes of underdetermination’. It first discusses in detail what problem these cases raise, before showing how nihilism resolves these paradoxes.
Truth in philosophy
Authors: Liggins David
Published: September 2024

Since truth-talk is often used in framing philosophical theories, nihilism threatens to trivialize worthwhile debates in philosophy. Two ways to respond this problem are discussed; different ones are appropriate in different cases. As a case study, the chapter examines the role of truth in norms of assertion and belief. It responds to an attack on deflationism made by Bar-On and Simmons. Beginning with the claim that to assert is to present as true, Bar-On and Simmons argue that deflationists cannot accept this analysis of assertion, but have no acceptable alternative analysis. The chapter shows how their argument threatens nihilism as well as deflationism; and it also shows how both nihilists and deflationists can respond to it. Finally, the chapter examines what the phenomena of ‘fake news’ and ‘post-truth’ have to do with nihilism. It shows that nihilism does not legitimize these tendencies—and that the nihilist can condemn these tendencies bitterly.
Conclusion
Authors: Liggins David
Published: September 2024

First, the implications of the arguments in this book are summarized: nihilism provides elegant solutions to a wide range of paradoxes involving truth; the nihilist solutions are superior to the other responses already in the literature; nihilism is epistemologically superior to theories that posit truths. The conclusion then explains how the book constitutes a challenge to deflationism, and why its arguments weaken the case for positing propositions. Some methodological morals are also drawn. Metaphysicians and philosophers of language sometimes treat semantic paradoxes as annoying technical complications. This work shows that semantic paradoxes are actually valuable pieces of evidence for ontologists and should not be dismissed. Conversely, those working on truth and paradox sometimes treat metaphysics as unimportant, for example, by treating as unimportant what sorts of entities they select as truthbearers. But that attitude is also mistaken: reflection on metaphysics can help us solve a range of paradoxes.
Adapting the Holocaust: Martin Amis’ and Jonathan Glazer’s The Zone of Interest
Authors: Sandberg Eric
Published: September 2024

Critics and reviewers have frequently dismissed the adaptive relationship between Martin Amis’ novel The Zone of Interest (2014) and Jonathan Glazer’s 2023 film of the same name. This essay argues that this is an inaccurate characterization of the connection between two works that respond to one of the main cultural challenges of the twentieth and twenty-first centuries: how best to represent the horrors of the Holocaust. Both, I argue, do so at least in part through strategies of adaptation, and should be seen not just as two parts of a source-text/adapted-text binary, but as part of a larger adaptive and intertextual network. This status has a direct impact on the overlapping ways they deal with the problematics of Holocaust representation. By addressing the challenges of Holocaust representation through strategies of adaptation, Amis’ novel and Glazer’s film reaffirm both the importance of the Holocaust to contemporary literary and cinematic culture and the importance of adaptation and adaptive processes to its representation.
Emulating target trials of postexposure vaccines using observational data
Authors: Boyer Christopher , Lipsitch Marc
Published: September 2024

Postexposure vaccination has the potential to prevent or modify the course of clinical disease among those exposed to a pathogen. However, due to logistical constraints, postexposure vaccine trials have been difficult to implement in practice. In place of trials, investigators have used observational data to estimate the effectiveness or optimal timing window for postexposure vaccines, but the relationship between these analyses and those that would be conducted in a trial is often unclear. Here, we define several possible target trials for postexposure vaccination and show how, under certain conditions, they can be emulated using observational data. We emphasize the importance of the incubation period and the timing of vaccination in trial design and emulation. As an example, we specify a protocol for postexposure vaccination against mpox and provide a step-by-step description of how to emulate it using data from a healthcare database or contact tracing program. We further illustrate some of the benefits of the target trial approach through simulation.
Biased Mediators in Conflict Resolution
Authors: Salamanca Andrés
Published: September 2024

One of the most important and disputed questions within the fields of international relations and conflict studies concerns the issue of mediator impartiality. Should mediators be biased—supportive of one but not both of the main disputants—or should mediators always be impartial? This paper contributes to this debate by studying the effectiveness of mediation with regard to the role of mediator bias in a game-theoretic model of cheap talk. This study shows that the institutional design of a mediation process is affected by two factors: the relative degree of conflict and the incentives to misrepresent private information. We find that a necessary (but not always sufficient) condition for the success of a mediation process is a sufficiently low likelihood of a misrepresentation problem. If in addition, the relative degree of conflict is low enough, mediation is effective, and the institutional design of a mediation process is the same regardless of the bias. Otherwise, the design will be quite different depending on the direction of the bias. (JEL D63, D74, D82)
AGR – 2 The Multi-Dimensional Role of Neuropsychology in Diagnostically Complex Epilepsy Patients: Refining the Surgical Plan and Post-Operative Expectations
Authors: Sacks-Zimmerman Amanda , Lokai Andrew , Bender Heidi A , McInnis Robert , Ginalis Christine
Published: September 2024

Objective

We present a case highlighting the importance of neuropsychological involvement at all phases of a pre-surgical epilepsy work-up, including clinical interview, neuropsychological evaluation, Wada testing, extra-operative electrical stimulation mapping (ESM), and psychoeducation.

Method

A 24-year-old, right-handed, Caucasian female presented with non-lesional, intractable left-hemisphere localization-related epilepsy characterized by frequent experiences of déjà vu and autonomic sensations.

Results

Neuropsychological evaluation revealed weaknesses in processing speed and verbal memory implicating left hippocampal involvement. Wada testing suggested minimal contralateral memory support, indicating poor candidacy for resective surgery. The patient underwent prolonged sEEG monitoring to refine a plan for device implantation (i.e., responsive neurostimulation; RNS). No typical events were captured during extended study. Episodic somatosensory changes were captured, which had no electrographic correlate and were presumed to be non-epileptic. ESM evoked the patient’s classic semiology, elucidating nuanced information about her seizure onset zone and network. Barriers to extended monitoring and consistent, reliable engagement during ESM included depression, anxiety, and trauma; considerable neuropsychologist-led emotional support was required. Typical seizure semiology was elicited during stimulation of entorhinal cortices, posterior and anterior hippocampi, amygdala, cingulate and insula. RNS placement included a depth electrode targeting the medial structures (via a posterior approach) with a sub-temporal strip.

Conclusions

Involvement of neocortical and mesial temporal structures, coupled with a clear neuropsychiatric component, were believed to be poly-etiological factors to the patient’s presentation. Neuropsychological input at all phases of pre-surgical assessment was instrumental in systematically identifying and addressing her complex needs. Psychotherapeutic intervention was suggested to be equally as important to clinical, long-term patient outcome.
Language Performance and Disruption of Brain Connectivity in Children with Epilepsy
Authors: Qi Wendy , Lee Katharine , Nix Kerry , Menchaca Miguel , Wu Wei , He Zihuai , Baumer Fiona
Published: September 2024

Objective

To explore the correlation between brain connectivity and language difficulties in children with epilepsy. We hypothesize that the epileptic cortex (where seizures arise) becomes hyperconnected to left frontal and temporal language regions thus suppressing connectivity between language regions. We expect that connectivity is associated with language performance.

Method

Right-handed children with Self-Limited Epilepsy with Centrotemporal Spikes (SeLECTS) recruited from a specialty clinic, and typically developing age and sex-matched controls (63 children, 9.3+/−2 years, 37% female) recruited from the community completed a language task (verb generation) and a resting task while undergoing an electroencephalogram. Phonological awareness was measured with the CTOPP-2. Connectivity between four regions – left frontal & temporal language regions and bilateral motor regions (epileptic cortices) – was measured using the weighted Phase Lag Index. We tested for group differences in connectivity in either task and for associations between connectivity and phonological awareness.

Results

SeLECTS had higher left frontal to left temporal connectivity than controls during verb generation (group difference = 0.07, 95% CI 0.02–0.11, p = 0.003) but not at rest. Right motor to left temporal connectivity was elevated in SeLECTS during verb generation (difference = 0.04, 95% CI 0.01–0.07, p = 0.008) and rest (difference = 0.03, 95% CI 0.01–0.05, p = 0.001). Higher right motor to left temporal (−55.8, 95% CI -81.5 to −30.1, p < 0.0001) connectivity during verb generation was associated with poorer phonological awareness in SeLECTS but not controls. Resting connectivity was not associated with phonological awareness in either group.

Conclusions

Hyperconnectivity may contribute to language difficulties and electroencephalogram may be a biomarker for phonological awareness in children with epilepsy.
The Relevance of Dual Language Experience in Interhemispheric Brain Connectivity in Older Adults
Authors: Rosselli Monica , Lang Merike , Baty Zachary M , Velez-Uribe Idaly , Velasquez Karen , Barker Warren W , Duara Ranjan , Newman David , Asken Breton M , Armstrong Melissa , Curiel Rosie , Loewenstein David A , Smith Glenn , Coombes Stephen A
Published: September 2024

Objectives

to analyze the volumes of sections of the corpus callosum (CC) and the integrity of the interhemispheric fibers that connect homotopic regions of the frontal and temporal lobes in bilinguals and monolinguals and to correlate neuroimaging data with cognitive measures and bilingual variables.

Method

107 bilinguals and 89 monolinguals from the 1Florida ADRC were clinically diagnosed as cognitively normal (CN), MCI, or dementia; mean age = 71.28 (10.94). CC volume was calculated from a T1-weighted scan using Freesurfer. Free water (FW) and free water-corrected fractional anisotropy (FAt) maps were calculated from a diffusion MRI scan within frontal and temporal transcallosal tracts (TCATT).

Results

Bilinguals had a larger proportion of the anterior CC volume compared to monolinguals independent of the diagnostic group. FAt values in the Supplementary Motor Area (SMA) and the inferior temporal lobe tracts (IT TCATTs) were higher in bilinguals compared to monolinguals indicating better white matter integrity. A significant interaction demonstrated that these values were higher in bilinguals for the dementia group. Correlations were significant between the SMA FW values and several cognitive tests particularly executive function tests in both language groups. In bilinguals, the IT TCATTs correlated with language test scores. FAt in the SMA TCATT correlated with the percentage of English exposure and FAt in the IT TCATTs positively correlated with English proficiency.

Conclusions

Bilingualism interacts with cognitive status in aging and is associated with CC volume and the integrity of white matter in the frontal and temporal lobes supporting its role in the increase of neural reserve.
A - 2 Risk Factors for Reduced Mobility and Falls in Older Adults: the Role of Medication Use and Cognitive Impairment
Authors: Nester Caroline O , Hinkle Caroline E , Davis Jennifer D , Goldstein Allyson , Murray Caroline , Daiello Lori A , Margolis Seth
Published: September 2024

Objective

Sedative and anticholinergic (AC) medication use and cognitive impairment impose risk of gait imbalance and falls in older adults, but their combined effects on mobility have not been assessed.

Method

This cross-sectional study of 392 outpatients (age = 72 ± 7.7; 60.5%women; 93%White; education = 14 ± 3 years) characterized AC use (Anticholinergic Cognitive Burden Scale [ACB]) and number of sedative medications. Balance confidence (Activities-specific Balance Confidence Scale), walking decline compared to 5 years prior (0–3 scale), and recurrent falls (dichotomized by ≥2) were self-reported. Neuropsychological performance was averaged into a norm-adjusted composite (COG). T-tests and Pearson correlations assessed bivariate relationships across medication use, COG, and mobility. Multivariate models regressed falls, balance confidence, and gait changes (in separate models) on COG and medication use (ACs and sedatives examined separately), controlling for covariates.

Results

Most patients (70%–85%) used ≥1 sedative or AC medication. Few (12%) reported recurrent falls (range = 0–30), but balance confidence was reduced (M = 77.68 ± 21.31%) with mild walking declines reported (M = 1.34 ± 1.03). More sedative medication use and higher ACB scores were bivariately related to worse COG and mobility, and stronger COG was associated with better mobility (p’s ≤ 0.004). Worse COG (β = 0.196, p = 0.002) and more medication use, both sedatives (β = −0.246, p = 0.002) and ACB (β = −0.147, p = 0.047), independently predicted worse balance confidence. Higher ACB (β = 0.182, p = 0.022) and worse COG (β = −0.193, p = 0.007) uniquely predicted walking decline. Each sedative medication increased odds of falls by 27.4% (adjOR = 1.274, p = 0.034).

Conclusion

AC/sedative medication use and cognitive impairment pose complementary risks for compromised mobility. Clinicians should be alert to AC/sedative use and cognitive impairment in older patients at risk of falls.
A - 6 Effects of Inhibitory Control and Episodic Memory Deficits on Functioning in Probable Mild Cognitive Impairment and Individually Matched Healthy Controls
Authors: Fleischmann Holly H , Surprenant Britni G , Sweet Lawrence H
Published: September 2024

Objective

Episodic memory and inhibitory control deficits are prevalent among those with mild cognitive impairment (MCI). These deficits have been associated with worse functioning; however, the predictive utility of specific cognitive deficits vary. We investigated whether deficits of episodic memory and inhibitory control are associated with worse physical activity and life satisfaction among people with probable MCI (pMCI).

Method

The study included 79 pMCI and 79 individually matched controls (HC) who participated in the Human Connectome Project - Aging study. Groups were determined based on MoCA scores (pMCI ≤23; HC ≥ 26). Participants completed the Go/No-go (GNG) and Face Name (FNT) tasks during functional MRI. Associations between GNG False Alarms (GNG FA) and FNT Recognition Accuracy (GNG RA) scores and International Physical Activity Questionnaire (IPAQ) and the PROMIS General Life Satisfaction (GLS) self-reports were examined.

Results

The pMCI group exhibited deficits compared to the HC on GNG FA (t (152.17) = −1.26, p = 0.05) and FNT RA (t (85.78) = 13.72, p 0.05). However, hierarchical regressions revealed that the interaction of these cognitive tasks predicted IPAQ (∆R2 = 0.02, F(1, 78) = 3.74, p < 0.05).

Conclusions

Despite confirmation of cognitive deficits, their effects on function are complex. Therefore, MCI deficits may be detected on screening before they clearly impact functioning, underscoring the utility of screening to facilitate more effective earlier interventions.
A - 9 The Role of Ethnicity in Relationships among Depression, Chronic Stress, and Biomarkers of Alzheimer Disease
Authors: Chung Albert , Logue Erin
Published: September 2024

Objective

The purpose was to determine relationships among psychosocial risk factors, ethnicity, and blood biomarkers of Alzheimer Disease (ad) using data from the Health and Again Brain Study-Health Disparities. Hypotheses included significant three-way interactions between ethnicity, chronic stress, and depression in predicting ad biomarkers.

Method

Participants were 2200 adults (62.5% female; age M = 65.4 [SD = 8.7]; education M = 13.1 [SD = 4.5]) from a community cohort study. 49.8% identified as non-Mexican American white; 50.2% identified as Mexican American. Clinical Dementia Rating (CDR) scores: 0 (76%), 0.5 (20%), 1 (3%), 2 (1%). Hierarchical regression analyses were performed; age, gender, education, and CDR were covariates. The Geriatric Depression Scale and Chronic Burden Scale measured depression and chronic stress. Outcome variables were tau and the beta amyloid (Aβ) 42/40 ratio in plasma.

Results

Chronic stress predicted tau (β = 0.07 [CI = 0.02–0.12], p = 0.004). The three-way interaction between chronic stress, depression, and ethnicity predicting tau was significant (β = 0.09 [CI = 0.01–0.18], p = 0.047). Chronic stress and ethnicity interacted to predict Aβ 42/40 (β = 0.11 [CI = 0.02–0.20], p = 0.019). Mexican American individuals had higher Aβ 42/40 at higher levels of chronic stress; White individuals had higher Aβ 42/40 at lower levels of chronic stress.

Conclusions

Overall, findings indicated that chronic stress was more predictive of ad plasma biomarkers for Mexican American individuals versus non-Mexican American white individuals in this sample. Further investigation into the role of ethnicity in relationships among risk factors and biomarkers of ad is warranted.
A - 10 Selective Serotonin Reuptake Inhibitors Do Not Alter HD-tDCS Effects on Episodic Memory in Cognitively Impaired Older Adults
Authors: Driskill Tara M , Helphrey Jessica , Nguyen Trung , Khera Alka , Pandya Seema , Smernoff Eric , Logan Rebecca , Chiang Hsueh-Sheng , Hart John , Lobue Christian
Published: September 2024

Objective

High-Definition Transcranial Direct Current Stimulation (HD-tDCS) is a potential new intervention for mild cognitive impairment (MCI) and Alzheimer’s Dementia (ad) involving small doses of electrical stimulation. Prior studies suggest potential interactions with Selective Serotonin Reuptake Inhibitors (SSRIs) that could alter HD-tDCS’s effectiveness on cognitive outcomes. This study evaluated if SSRIs altered HD-tDCS response to episodic memory functioning in individuals with MCI and ad.

Method

Eighteen individuals (M age = 70.5; 27.8% female; 8 stable on SSRIs), 9 with MCI and 9 with ad, underwent ten 20-minute HD-tDCS sessions of 1 milliampere over the medial frontal cortex. Neuropsychological testing assessed learning and delayed recall for visual (Brief Visuospatial Memory Test-Revised) and verbal (Rey Auditory Verbal Learning Test or Hopkins Verbal Learning Test-Revised) episodic memory at baseline and immediately post-treatment. Linear regressions evaluated SSRI use as a predictor of post-treatment episodic memory performance controlling for baseline scores.

Results

Ten participants demonstrated improvement on at least one measure by 0.5 standard deviation (SD; 5 T-score points), with 5 showing 1 SD improvement. Eleven showed a decline by 0.5 SD on at least one measure, with 7 showing 1 SD decline. SSRI use did not significantly predict better or worse verbal learning (β = −4.285, p = 0.194), verbal delayed recall (β-0.408, p = 0.883), visual learning (β = −2.788, p = 0.405), and visual delayed recall (β = −6.673, p = 0.150) performance post-HD-tDCS.

Conclusion

Preliminary findings suggest SSRIs may not impact HD-tDCS outcomes in cognitively impaired older adults, specifically for episodic memory. These results may not translate to other neuropsychological domains; however, larger samples are needed for further investigation.
A - 13 Cognitive Correlates of Technology-Based Instrumental Activities of Daily Living Performance in Older Adults Presenting for Cognitive Evaluations
Authors: Mis Rachel E , Gonzalez David A , Kiselica Andrew M , Scullin Michael K , Hilsabeck Robin C , Benge Jared F
Published: September 2024

Objective

Rapid advances in technology have altered how daily activities are performed. Accumulating evidence suggests technology-based instrumental activities of daily living (iADLs) are increasingly common in older adults’ lives, and assessing these skills may improve diagnostic identification of individuals with Alzheimer’s disease and related dementias (ADRD). While iADLs are complex tasks reliant on multiple cognitive processes, prior work suggests memory and executive functioning are the cognitive processes most strongly predictive of iADL performance in ADRD. However, whether similar associations exist with technology-based iADLs has not been established. The goal of the present study was to evaluate the cognitive correlates of technology-based compared to traditional iADL items.

Method

One hundred seventy-eight individuals (mean age: 75.35 ± 7.30) presenting for evaluation of cognitive status completed tests of memory, executive functioning, language, and processing speed. Care partners completed the Functional Activities Questionnaire (FAQ) and 11 technology-based iADL items. Associations between cognition and traditional and technology-based FAQ items were examined through Pearson’s correlations and multiple regression analyses.

Results

Cognition was significantly correlated with both traditional and technology-based iADLs (|r’s| > 0.30, p’s.44). In multiple regression models, executive functioning and processing speed but not memory were the strongest predictors of traditional iADL performance (p’s < 0.02), but for independence with technology-based iADLs, executive functioning alone (p < 0.001) emerged.

Conclusions

Relations between cognition and daily functioning are similar for both traditional and technology-based FAQ items, with executive functioning particularly relevant for both types of tasks. Implications for clinical practice and technology-based interventions are discussed.
A - 18 Complexities in Evaluating the “Oldest-Old”: a Case Study of a 101-Year-Old
Authors: Christopher Jennifer M , Christopher Theresa R
Published: September 2024

Objective

The population of the “oldest-old” (i.e., aged 80 and older) is projected to triple by 2050 (He, Goodkind, & Kowal, 2016). Major Neurocognitive Disorder (NCD), delirium, and depression are prevalent among older adults (Downing, Caprio, & Lyness, 2013). Having one of these conditions increases the likelihood of having another. These diagnoses have commonalities and can co-occur. This poses difficulty with differential diagnosis. This case elucidates the role of neuropsychologists in differential diagnosis.

Method

The present case involves a 101-year-old, right-handed, African American, female referred for a neuropsychological evaluation by a geriatric psychiatrist to aid in differential diagnosis. Onset of cognitive issues began after the Veteran sustained a cerebrovascular accident (CVA) documented on neuroimaging. There was a stepwise decline in functioning over the next few years. During that time, the Veteran experienced episodes of delirium and onset of psychiatric symptoms. Upon evaluation, the Veteran was medically stable in a subacute care setting. Clinical interviews were completed with the Veteran and an informant. Neuropsychological testing was completed beside. Demographically appropriate norms were utilized.

Results

Neuropsychological evaluation results revealed Major Vascular NCD, Delirium-Persistent, and Adjustment Disorder with Depressed Mood.

Conclusions

The clinical history delineating the onset after the CVA and stepwise course was essential in clarifying this diagnosis. Major NCD likely increased the Veteran’s risk of delirium. Delirium episodes and depression complicated the course and progression. Neuropsychologists’ ability to comprehensively integrate clinical history, neuroimaging, and standardized assessment results makes them well equipped to diagnose and offer treatment recommendations for the growing oldest-old population.
A - 20 Association between Smoking-Related DNA Methylation Marker and Brain MRI Volumes in Older Adults
Authors: Kaplan Burcu , O’Shea Deirdre
Published: September 2024

Objective

Smoking is a well-established risk factor for dementia. Studies have shown that a history of smoking is linked to higher rates of cortical volume loss in older adults. However, biological mechanisms of smoking, particularly through epigenetic changes, remain poorly understood. This study investigates the association between DNA methylation markers of smoking and patterns of brain atrophy.

Methods

In this cross-sectional analysis, 78 participants aged 47 years and older (68% female) from the ongoing Health Brain Initiative Study were included. DNA methylation markers of smoking were quantified using a validated algorithm applied to blood samples analyzed via the 850 k EPIC array (i.e., EpiSmoking). Brain MRI variables assessed included total cortical, hippocampal, entorhinal cortex, white matter hyperintensity volumes, and machine learning-derived atrophy scores for various cortical regions. Partial correlation analysis controlled for age, sex, education, and cognitive status (normal or mild cognitive impairment).

Results

Higher EpiSmoking scores significantly correlated with increased atrophy in the total cerebral cortex (r = 0.27, p < 0.05), frontal (r = 0.25, p < 0.05), parietal (r = 0.20, p < 0.05), and temporal lobes (r = 0.28, p < 0.01). No significant associations were found with other brain regions.

Conclusions

Our findings indicate that smoking-related DNA methylation changes are linked to specific patterns of brain atrophy. These results support the theory that environmental factors, such as smoking, may negatively impact the epigenome and potentially increase the risk of dementia. However, further research with larger cohorts is necessary to validate these associations and explore the underlying mechanisms.
A - 21 The Association between Tau Pathology and Cognitive Impairment in Alzheimer’s Disease in the Democratic Republic of Congo
Authors: Thomas Lexie , Schwinne Megan , Ikanga Jean N
Published: September 2024

Objective

Previous studies in Western countries have shown that tau accumulation is more closely connected with cognitive decline in Alzheimer’s disease (ad). This association has not yet been investigated in the Sub-Saharan African countries/Democratic Republic of Congo (DRC). We investigated the association between phosphorylated tau (p-Tau) level and cognitive performance of older adults from the DRC.

Method

Blood and neuropsychological tests were collected on 80 Congolese older adults with suspected ad. Participants were classified according to the biomarkers of their ATN profiles with positive “A” values based on β-amyloid <0.061 and “T” values based on p-Tau 181 < 4.50, as well as APOEε4 using Simoa assays. An analysis of covariance examined the differences in memory performance for each pathological group, controlling for age, education, gender, and APOEε4 status.

Results

A-T- (n = 36) consisted of age (M = 71.3, SD = 7.44), gender (48.6% female), education level (M = 9.80, SD = 5.44), and APOEε4 (38.2%). A + T- (n = 29) consisted of age (M = 73.1, SD = 7.75), gender (62.1% female), education level (M = 7.21, SD = 5.92), and APOEε4 (41.4%). A + T+ (n = 15) consisted of age (M = 78.1, SD = 4.62), gender (60.0% female), education level (M = 6.60, SD = 3.46), and APOEε4 (93.3%). Overall, there were significant effects of memory performances on A-T- participants: verbal memory immediate (p = 0.0089), delayed (p = 0.00096), and recognition (p = 0.0104); and visual memory delayed (p = 0.00058) and recognition (p = 0.00039).

Conclusion

Reduced memory performance and p-Tau levels were associated in Congolese adults with and without ad. This study suggests abnormal tau accumulation underlies cognitive deficits in ad and could be used as an early marker of ad pathology for various populations in Sub-Saharan African countries.
A - 26 Self-Efficacy and Meta-Prospective Memory in Older Adults
Authors: Liming Kathleen D , Schmidt Brianna M , Huber Becca N , Fulton Erika K
Published: September 2024

Objective

Bandura’s theory of self-efficacy (2012) highlights the role of self-appraisal in performance. Individuals with mild cognitive impairment (MCI) may inaccurately appraise their performance on memory-based tasks. The current study predicted that the MCI group would have lower self-efficacy predicting lower meta-prospective memory (meta-PM) accuracy compared to healthy controls. Researchers also predicted a negative relationship between self-efficacy and reported memory complaints regardless of group status.

Method

Participants were recruited through community flyers and a rural outpatient neuropsychology clinic. Participants (ages 60 to 90) were divided into MCI (n = 31) and healthy (n = 50) groups based on MMSE scores or prior neuropsychological diagnoses. Measures included generalized and task-specific appraisals of PM, objective PM performance, and a self-reported measure of generalized self-efficacy.

Results

MCI and healthy groups were equivalent in self-efficacy ratings t(79) = 1.43, p = 0.16, d = 0.33. There was no significant correlation between self-efficacy and meta-PM accuracy (r = −0.05, p = 0.64). The difference in correlations between self-efficacy and overall memory complaints between healthy and MCI groups was approaching significance (Fisher’s Z = -1.88, p = 0.06), mostly driven by the MCI group’s significant negative correlation (r = −0.50, p = 0.004*). There was also a significant difference between groups’ correlations in efficacy ratings and PM-only complaints (Fisher’s Z = -2.06, p = 0.04*), given the MCI group’s strong negative correlation (r = −0.57, p < 0.001**).

Conclusions

Self-efficacy was not significantly related to meta-PM accuracy; self-efficacy was significantly related to overall and prospective-only memory complaints, attributable to significant negative correlations within the MCI group. As such, the MCI group’s self-efficacy is significantly related to perceptions of PM functioning in their daily lives.
A - 28 Let’s Get the Conversation Going! Group Intervention with Brain Injury Survivors to Promote Communication with Family and Friends about their Recovery
Authors: Fedio Alison , Nastea Katerina , Swartz Allison , Okeke Chioma , Rafel Hannah , Atiyeh Grace , Sexton James
Published: September 2024

Objective

This study explored changes in the self-conscious emotions of shame, guilt, and pride in adults with brain injuries after experiencing an intervention encouraging them to communicate with their loved ones about their recovery experiences.

Method

Adults with acquired brain injuries (mean age 49.5; 70% female; 3 yrs post) attended a presentation regarding the importance of communication during their recovery and were asked to discuss their experiences. Seven participants completed the State Shame & Guilt Scale pre- and post-intervention, and 8 participants completed ratings regarding comfort discussing their injuries and post-injury experiences with loved ones. Shame and guilt scores were aggregated (negativity variable) and subtracted from pride to produce a positivity variable. Paired samples t-tests and Pearson correlations (p < 0.05) results are reported.

Results

Negativity decreased (t[6] = 1.760) while positivity increased (t[6] = 2.411) from pre- to post-intervention. There was no pre/post change in participants’ rated comfort in speaking with loved ones. However, the lowest levels of comfort rated pre-intervention were associated with greatest declines in negativity (r = −0.777) and gains in positivity (r = 0.807) post-intervention. When asked about feedback they would like to share with loved ones, 2 participants mentioned cognitive challenges and 6 referred to existential struggles about which their loved ones were likely unaware.

Conclusion

Results suggest that the communication intervention particularly diminished levels of negative self-conscious emotions in adults with brain injury. Individuals experiencing discomfort speaking with their loved ones about their injury/recovery may benefit from psychoeducation about the importance of communication and should be encouraged to share their experiences with their family and friends.
A - 31 The Interaction of Cognitive Reserve and Multi-Modal Cognitive Training on the Cognitive Functioning of Older Adults at Risk for Dementia
Authors: Hogan Kassidy , Dandurand Jade , Renzi-Hammond Lisa , Correia Stephen , Beer Jenay , Sweet Lawrence
Published: September 2024

Objective

Multi-modal cognitive training improves cognition among those at risk for dementia. Although the mechanism is likely via improved cognitive flexibility, conceptually central cognitive reserve, it remains unclear whether cognitive reserve moderates cognitive training effects. The objective of this study was to determine whether baseline cognitive reserve moderates cognitive improvement following cognitive training.

Methods

Forty-one older adults (M = 72.7+/−4.9 years, 65.1% female, 17% non-white) with self-reported memory loss and baseline TICS score of 24–37 participated in a 6-month cognitive training intervention consisting of weekly computer-administered piano lesson and 30 minutes of daily homework. Cognition was assessed pre and post-intervention using CNS-Vital Signs. Specific domains tested were cognitive flexibility, psychomotor speed, and executive functioning. Cognitive reserve was operationalized as years of education.

Results

Significant post-training improvements occurred in all three cognitive domains (cognitive flexibility t = −6.34, p < 0.001; psychomotor speed t = −2.62, p = 0.01; executive functioning t = −6.49, p < 0.001). Years of education significantly moderated improvements in executive functioning (b = −0.06, SE(b) = 0.03, t(37) = −2.07, p = 0.045), but neither cognitive flexibility nor psychomotor speed. Specifically, participants with lower education improved most in executive functioning (b = 1.60, t = 2.78, p = 0.008).

Conclusions

Findings suggest that participants with lower cognitive reserve may benefit more from far-transfer effects of cognitive training on executive functioning. This was not observed in domains closely related (cognitive flexibility) and relatively unrelated (psychomotor speed) to cognitive reserve.
A - 33 Impact of Cognitive Stimulation Therapy on Neuropsychiatric Symptoms and Everyday Functioning in a Veteran Sample
Authors: Marceaux Janice C , Talamantes Melissa A
Published: September 2024

Objective

Cognitive stimulation therapy (CST) is a well-supported nonpharmacological intervention, found to improve or maintain global cognition, daily functioning, and quality of life with persons with dementia. There are fewer studies assessing the effect of CST on neuropsychiatric symptoms; however, pilot studies have identified improvement in depression and anxiety in studies of persons with Alzheimer’s disease. The purpose of this program evaluation was to evaluate the impact of CST on neuropsychiatric symptoms and everyday functioning is a veteran sample.

Method

Twenty-six male veterans diagnosed with cognitive disorder (84.6% dementia, 15.4% mild cognitive impairment) completed a 7-week CST program. The sample was diverse (46.2% White/Caucasian, 42.3% Hispanic/Latino, 7.7% Black/African American; 38.5% bilingual). Most frequent etiologies included mixed (26.8%), Alzheimer’s (23.1%), and vascular (19.2%). Ages ranged from 43–86 (M = 74.5; SD = 7.6). Pre-group/post-group assessment included Geriatric Depression Scale-Short Form (GDS-SF), Geriatric Anxiety Inventory (GAI), Neuropsychiatric Inventory (NPI-informant), Everyday Cognitive (ECOG), and Texas Functional Living Scale (TFLS). Analyses included paired-samples t-test and Wilcoxon signed-rank test.

Results

Post-group GAI scores were significantly lower (Median = 1) than pre-group scores (Median = 3), z = −2.574, p = 0.01, r = −0.515. There were no significant declines or improvements across other measures of neuropsychiatric symptoms. Measures of IADLs/everyday functioning also remained stable.

Conclusions

Consistent with prior studies, CST was effective in reducing anxiety symptoms of veterans with cognitive disorders. While measures of everyday functioning did not improve, performance and informant-report remained stable. CST presents a unique opportunity to impact both cognition and neuropsychiatric symptoms that may cause significant distress in veterans with dementia and their caregivers.
A - 34 CBT Improves Cognitive Functioning in ADHD, Mixed Type
Authors: Constantinou Marios
Published: September 2024

Objective

To further expand on previous smaller study (with 25 participants) that found that children with ADHD, Mixed Type, improved their cognitive functioning after 12 weeks of CBT.

Method

In the current study 68 children (20 girls) diagnosed with ADHD, mixed type, between the ages of 9 and 12 (M = 10.25, SD = 1.88) were assessed with the WISC-V, CBCL, TEA-Ch2, and CPT-2, clinical interview with parents and teachers before the beginning of CBT. The same assessment was repeated 14 weeks later, following 12, weeks of individualized CBT. CBT included thought restructuring, impulse control exercises, relaxation techniques, and mindfulness exercises.

Results

Average Based Change (ABC) was employed and significant improvements, with large Cohen’s d (>. 80) effect size, were detected for Working Memory, Hyperactivity, Externalizing Behavior, Impulsivity, Selective, Sustained, and Everyday Attention. Ratings, during interviews, by teachers, psychologists, and parents agreed also that there was a significant clinical improvement.

Conclusion

In agreement with the first study, and other literature, CBT seems to be an important tool in helping significantly children with ADHD, Mixed Type, improve in behavior and cognitive functioning. More studies with younger and older children are needed to cement the utility of CBT with children and teens.
A - 37 ADHD-Related Hyperactivity and Impulsivity: Distinct or Overlapping Dimensions?
Authors: Greenwood Nicole , Kibby Michelle Y
Published: September 2024

Objective

It is debated whether hyperactivity and impulsivity should remain combined within the (DSM) hyperactivity/impulsivity domain or be separated. To address this dispute, we sought to determine whether hyperactivity and impulsivity are differentially related to executive functioning (EF), a common deficit area in ADHD.

Method

Participants included 120 children (ages 8–11; 89.9% White; 51.6% girls) from a community sample tested in a laboratory setting. To be included, they must have ADHD (59.4%) or be typically developing (40.6%). Hyperactivity and impulsivity scales were created from symptoms from a parent-report Behavior Assessment System for Children and DSM-IV questionnaire, ADHD section. The Behavior Rating Inventory of Executive Functioning (BRIEF) Working Memory scale (WMsc) and the Children’s Memory Scale Picture Locations (visuospatial sketchpad), Numbers Forward (phonological loop), and Sequences (central executive) subtests were used to assess working memory (WM). Inhibition was assessed with the BRIEF Inhibition scale (Isc) and A Developmental Neuropsychological Assessment (NEPSY) Tower Rule Violations (RV). Emotional control (EC) was measured with the BRIEF’s EC scale.

Results

Confirmatory linear regressions (SPSS Enter method) with all EF measures as IVs revealed Isc and WMsc were significant predictors of impulsivity [F(7,120) = 24.85, p < 0.001]. For hyperactivity [F(7,120) = 21.40, p < 0.001], WMsc, Isc, and RV were significant predictors. Exploratory analyses revealed WMsc was related to hyperactivity in controls but impulsivity in ADHD.

Conclusions

Similarities and differences were found between hyperactivity and impulsivity in relation to EF. Whereas inhibition was similarly related to hyperactivity and impulsivity, WM’s relationships were dissociable between groups. Hence, further research is needed, including areas affected in ADHD besides EF.
A - 40 Food Insecurity Is Associated with Serious Cognitive Difficulties among Adolescents with Attention-Deficit/Hyperactivity Disorder and Learning Disabilities
Authors: Iverson Ila A , Nyberg Gisela
Published: September 2024

Objective

Youth with neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and learning disabilities (LD), experience cognitive difficulties in their daily lives. Food insecurity, a public health problem, disproportionately affects youth with neurodevelopmental disorders and is associated with mental health and academic functioning. We examined the association between parent-reported food insecurity and cognitive difficulty among youth after adjusting for factors associated with cognitive difficulty.

Methods

The 2022 National Survey of Children’s Health, conducted in the United States, is designed to provide parent-reported information on the health and well-being of children and adolescents. Associations between cognitive difficulty, food insecurity, adverse childhood experiences (ACEs), psychiatric conditions, flourishing, receiving federal assistance, and low socioeconomic status were analyzed using binary logistic regressions.

Results

There were 6422 youth (aged 6–17) with ADHD and/or LD (63.4% boys). Around half had parent-reported serious cognitive difficulties (50.5%). A third (31.9%) were reported to have mild food insecurity and 6.7% had moderate/severe food insecurity. In the multivariable model [χ2(6) = 1138.25, p < 0.001; Nagelkerke R2 = 0.22], food insecurity [Odds Ratio (OR) = 1.21; 95% confidence interval (CI) = 1.07–1.34)] was an independent predictor of serious cognitive difficulty, in addition to ACEs (OR = 1.121, 95%CI = 1.075–1.168), anxiety or depression (OR = 2.279, 95%CI = 2.041–2.545), flourishing (OR = 0.473, 95%CI = 0.442–0.505), and free or reduced school meals (OR = 1.244, 95%CI = 1.108–1.397).

Conclusion

Food insecurity was independently associated with parent-reported cognitive problems among youth with ADHD and LD. Better understanding the mechanisms that underlie the associations between food insecurity, other social determinants of health, and cognitive difficulties can facilitate the development of targeted, evidence-informed interventions to bolster functional and academic outcomes for youth with neurodevelopmental disorders.