bluuebunny/crossref_metadata_2025 huggingface dataset:
The Behaviour of Shallow-Buried Corrugated Steel Plate Bridge with RC Slab and EPS Geofoam Under Static Live Loads
Authors: Beben Damian , Maleska Tomasz , Janda Adriana , Nowacka Joanna
Published: December 2023

The increasing use of buried corrugated steel plate (CSP) bridges and culverts in transportation infrastructure contributes to looking for the most optimal solutions regarding durability and cost. The paper presents a finite element analysis and experimental testing under static live loads of a shallow-buried CSP bridge with a span of 10.00 m and a height of 4.02 m. The depth of the soil cover (0.65 m) did not meet the minimum requirements in this respect. Therefore, a reinforced concrete (RC) relieving slab was placed above the shell crown. In the parametric analysis, it was decided to use various types of expanded polystyrene (EPS) geofoam as an alternative to RC slab. Undoubtedly, using EPS is cheaper and faster than using an RC slab. Nevertheless, it is essential whether it gives a similar (or better) effect as the RC slab. Five models of the bridge were used in the analysis, i.e. without RC slab (model I), with RC slab (model II) and with various types of EPS (models III–V). The numerical analysis results were compared with experimental tests for the buried bridge with the RC slab. The obtained results can help design buried CSP bridges and culverts with a small depth of soil cover.
Bimolecular photoinduced symmetry-breaking charge separation of perylene in solution
Authors: Wega Johannes , Vauthey Eric
Published: December 2023

Photoinduced symmetry-breaking charge separation (SB-CS) results in the generation of charge carriers through electron transfer between two identical molecules, after photoexcitation of one of them. It is usually studied in systems where the two reacting moieties are covalently linked. Examples of photoinduced bimolecular SB-CS with organic molecules yielding free ions remain scarce due to solubility or aggregation issues at the high concentrations needed to study this diffusion-assisted process. Here we investigate the excited-state dynamics of perylene (Pe) at high concentrations in solvents of varying polarity. Transient absorption spectroscopy on the subnanosecond to microsecond timescales reveal that self-quenching of Pe in the lowest singlet excited state leads to excimer formation in all solvents used. Additionally, bimolecular SB-CS, resulting in the generation of free ions, occurs concurrently to excimer formation in polar media, with a relative efficiency that increases with the polarity of the solvent. Moreover, we show that SB-CS is most efficient in room-temperature ionic liquids due to a charge-shielding effect leading to a larger escape of ions and due to the high viscosity that disfavours excimer formation.

Graphical abstract
In Defence of Philanthropy
Authors: Breeze Beth
Published: December 2023

Running down 'do-gooders' has become a popular pastime in recent years. Journalists and academics alike have lampooned and criticized philanthropists and big donors for their charitable activities, which are often characterized as a means of self-aggrandisement or tax evasion.

Yet, it is widely acknowledged that philanthropy - from the establishment of Carnegie libraries in the nineteenth century to the recent global health interventions of the Gates Foundation - has played a critical role in both developed and developing societies.

In an impassioned defence of the role of philanthropy in society, Beth Breeze tackles the main critiques levelled at philanthropy and questions the rationale for undermining and disparaging philanthropic acts. She contends that although it might be flawed, philanthropy is a sector that ought to be celebrated and championed so that an abundance of causes and interests can flourish.
Antibiotic treatment duration for culture-negative sepsis in the pediatric intensive care unit
Authors: Wehrenberg Kelsey , Mitchell Michelle , Zembles Tracy , Yan Ke , Zhang Liyun , Thompson Nathan
Published: December 2023

Objective:

Sepsis remains a leading cause of morbidity and mortality in children. There is very limited guidance for sepsis treatment when cultures remain negative. This study sought to determine the effectiveness of short versus long course of antibiotics when treating culture-negative sepsis and assess for subsequent multidrug-resistant organism (MDRO) acquisition.

Design:

Retrospective cohort study.

Setting:

Quaternary academic children’s hospital.

Patients:

Pediatric intensive care unit (ICU) patients with culture-negative sepsis receiving a minimum of 72 hours of antibiotics.

Methods:

Patients found to have culture-negative sepsis from January 2017 to May 2020 were divided into two groups: short and long course of antibiotics. Various demographic and laboratory results were collected for each subject as available. Primary outcomes included mortality and lengths of stay. The secondary outcome was subsequent acquisition of a new MDRO.

Results:

Eighty-six patients were treated for culture-negative sepsis with 43 patients in both the short- (< or = 7 days) and long-course (>7 days) treatment cohorts. Patients who received a short course of antibiotics had a lower overall mortality than those who received a long course (9.3% vs 25.6% p = 0.047), but there was no difference in 30-day mortality (p > 0.99). Patients in the short-course group had a shorter hospital length of stay (22 vs 30 days p = 0.018). New MDROs were found in 10% of all patients.

Conclusions:

Treatment of culture-negative sepsis with short-course antibiotics was not associated with worse outcomes in ICU patients. These findings warrant further investigation with a larger, prospective, multi-center study.
The paradox of disclosure: shifting policies from revealing to resolving conflicts of interest
Authors: Sah Sunita
Published: December 2023

This paper explores the complexities and unintended consequences of conflict of interest (COI) disclosures in various professional settings. It highlights key psychological processes encountered by recipients of such disclosures. Notably, it describes the burden of disclosure effect, which paradoxically reduces trust while increasing compliance due to social pressures, and disclosure's expertise cue, where disclosures inadvertently increase trust and persuasiveness by signalling expertise. The paper also outlines best practices for improving COI disclosures, emphasising the need for external third-party involvement and encouraging deliberation. It concludes that effective disclosure depends not only on how recipients process information but also critically on how the disclosure influences the behaviour of advisors, underscoring the need for a holistic approach to managing COIs that goes beyond mere transparency. A version of this paper was presented as a keynote at the Second Annual International Behavioural Public Policy Conference at the University of North Carolina in September 2023.
Experiences of Operating Room Professionals During the 2020 Izmir Earthquake: A Qualitative Approach
Authors: Yıldırım Gül Özlem , Sarı Bektaş
Published: December 2023

Objective:

In the aftermath of earthquakes, the availability of emergency units and operating rooms (OR) in hospitals can make a difference in the survival of those injured. OR professionals’ experience during earthquakes is vital for ensuring safe and effective surgical procedures. This study was conducted to explore perceptions and describe the experiences of OR professionals, aiming to improve OR processes during and after earthquakes.

Methods:

This phenomenological study employed semi-structured interviews to collect qualitative data from 16 OR professionals who experienced the earthquake. Purposeful sampling was utilized for face-to-face interviews, and MAXQDA20 was used for content analysis.

Results:

The primary themes included workplace perspectives, during-earthquake experiences, ethical considerations, and post-earthquake experiences. The workplace was described as unique, dynamic, stressful, and disciplined. Participants experienced fear and panic during the earthquake. Abandoning patients was deemed unethical, resulting in ethical quandaries for professionals when their safety was at risk.

Conclusion:

Participants displayed responsibility and ethical conduct while remaining with the patients during the tremor. Implementing practices is crucial in mitigating fear and chaos and improving information management. As such, it is highly recommended that hospital disaster plans incorporate the active participation of OR professionals.
Extensional flow of a compressible viscous fluid
Authors: McPhail M.A. , Oliver J.M. , Parker R. , Griffiths I.M.
Published: December 2023

We derive reduced models for extrusion problems where it is necessary to account for fluid compressibility. We consider the two-dimensional extensional flow of a compressible viscous fluid and discuss two specific applications: weakly compressible fluids and bubbly liquid–gas mixtures that behave as a single compressible fluid. The mathematical model we present consists of equations for conservation of mass, conservation of momentum and a closure relationship between the pressure and density. The most substantial differences between compressible extrusion problems is in the closure relationship. By integrating the conservation equations across the fluid cross-section and exploiting a slender aspect ratio, we derive reduced equations for conservation of mass and conservation of momentum in the direction of flow. The reduced system of equations relating cross-sectionally averaged quantities is closed by a relationship between the averaged pressure and density, which will differ substantially depending on the application. We demonstrate the utility of a reduced model for both the weakly compressible fluid and bubbly mixture applications; namely, in providing valuable quantitative insights without needing to solve a complicated free-boundary problem.
Smoothed particle hydrodynamics modelling of particle-size segregation in granular flows
Authors: Zhu Chengwei , Peng Chong , Wu Wei
Published: December 2023

In this work, smoothed particle hydrodynamics (SPH) is employed to investigate the segregation evolution in granular flows. We first provide the Lagrangian description-based governing equations, including the linear momentum conservation and the segregation–diffusion equation. Then the hybrid continuum surface reaction scheme is introduced to formulate the concentration-related inhomogeneous Neumann boundary condition on the free and wall surfaces. We follow a two-stage strategy to advance boundary particle searching and normal direction identification. Moreover,

$C^1$

consistency is considered based on the Taylor series to obtain accurate segregation flux gradient along the boundary. Our SPH model is validated with a shear box experiment. The model is then applied to investigate the segregation mechanism in bidisperse-sized granular flows in a rotating drum.
Review of Three Studies of Egyptian Cinema: Cinematic Cairo: Egyptian Modernity from Reel to Real; The National Imaginarium: A History of Egyptian Filmmaking; Making Film in Egypt: How Labor, Technology, and Mediation Shape the Industry
Authors: Alkassim Samirah
Published: December 2023

Nezar Alsayyad And Heba Safey Eldeen, eds., Cinematic Cairo: Egyptian Modernity from Reel to Real (Cairo: American University in Cairo Press, 2022). xxxiii + 288pp., £49.95 hardcover. ISBN 978-1-64903-133-4.
Flexible States in History: Rethinking Secularism, Violence, and Centralized Power in Modern Egypt
Authors: Friesen Isaac
Published: December 2023

In recent decades, secularism has emerged as one of the most studied concepts in sociocultural anthropology, and Egypt a primary site of its analysis. This article considers trends in Egypt’s modern and contemporary history in order to complicate the great explanatory power some anthropological works have granted to secularism. Above all else, it interrogates the manner in which the state’s regulation of religion (which is the defining feature of Asadian conceptions of secularism) has unfolded in recent Egyptian history. First, I survey the different ways scholars have portrayed secularism in Egypt, focusing in particular on the insights and limitations of Asadian theories. A second section employs ethnographic data to uncover how ordinary Egyptians in the provincial capital of Beni Suef have experienced state power, religion, and secularism in their everyday lives. Contextualizing these ethnographic perspectives alongside several prominent instances of state violence between 2011 and 2013, I elucidate how, rather than typifying a secular state, Egyptian politics, above all else, have been driven by an opportunistic realpolitik. My final section brings historical and ethnographic perspectives into sustained conversation to argue that the state regulation anthropologists sometimes frame as secularism is better conceptualized as a form of state centralization. I conclude, in turn, that political developments in modern Egypt have most often been shaped by flexible national and imperial interests.
Advancing hospital-based health technology assessment: evaluating genomic panel contracting strategies for blood tumors through a multimethodology
Authors: Afonso Susana , Vieira Ana C.L. , Pereira Carla , Oliveira Mónica D.
Published: December 2023

Introduction

The adoption of genomic technologies in the context of hospital-based health technology assessment presents multiple practical and organizational challenges.

Objective

This study aimed to assist the Instituto Português de Oncologia de Lisboa Francisco Gentil (IPO Lisboa) decision makers in analyzing which acute myeloid leukemia (AML) genomic panel contracting strategies had the highest value-for-money.

Methods

A tailored, three-step approach was developed, which included: mapping clinical pathways of AML patients, building a multicriteria value model using the MACBETH approach to evaluate each genomic testing contracting strategy, and estimating the cost of each strategy through Monte Carlo simulation modeling. The value-for-money of three contracting strategies – “Standard of care (S1),” “FoundationOne Heme test (S2),” and “New diagnostic test infrastructure (S3)” – was then analyzed through strategy landscape and value-for-money graphs.

Results

Implementing a larger gene panel (S2) and investing in a new diagnostic test infrastructure (S3) were shown to generate extra value, but also to entail extra costs in comparison with the standard of care, with the extra value being explained by making available additional genetic information that enables more personalized treatment and patient monitoring (S2 and S3), access to a broader range of clinical trials (S2), and more complete databases to potentiate research (S3).

Conclusion

The proposed multimethodology provided IPO Lisboa decision makers with comprehensive and insightful information regarding each strategy’s value-for-money, enabling an informed discussion on whether to move from the current Strategy S1 to other competing strategies.
The value and impact of health technology assessment: discussions and recommendations from the 2023 Health Technology Assessment International Global Policy Forum
Authors: Trowman Rebecca , Migliore Antonio , Ollendorf Daniel A.
Published: December 2023

Health technology assessment (HTA) programs inform decision making about the value and reimbursement of new and existing health technologies; however, they are under increasing pressure to demonstrate that they are a cost-effective use of finite healthcare resources themselves. The 2023 HTAi Global Policy Forum (GPF) discussed the value and impact of HTA, including how it is assessed and communicated, and how it could be enhanced in the future. This article summarizes the discussions held at the 2023 HTAi GPF, where the challenges and opportunities related to the value and impact of HTA were debated. Core themes and recommendations identified that defining the purpose of value and impact assessment is an essential first step prior to undertaking it, and that it can be done through the use and expansion of existing tools. Further work around aligning HTA programs with underlying societal values is needed to ensure the long-term value and impact of HTA. HTA could also have a role in assessing the efficiency of the wider health system by applying HTA methods or concepts to broader budgetary allocations and organizational aspects of health care. Stakeholders (particularly patients, industry, and clinicians but also payers, wider society, and the media) should ideally be actively engaged when undertaking the value and impact assessment of HTA. More concerted efforts in communicating the role and remit of HTA bodies would also help stakeholders to better understand the value and impact of HTA, which in turn could improve the implementation of HTA recommendations and application to future actions in the lifecycle of technologies.
Les effets de la méditation de pleine conscience sur les symptômes cognitivo- émotionnels dans le trouble cognitif léger et la maladie d’Alzheimer : une revue de littérature narrative
Authors: Kalenzaga Sandrine , Clarys David
Published: December 2023

La maladie d’Alzheimer se manifeste par des troubles de la mémoire et un déclin cognitif plus général, le plus souvent associés à des troubles de l’humeur et du comportement. Les traitements médicamenteux ayant une efficacité assez modeste, il apparaît nécessaire de leur associer une prise en charge non pharmacologique. La méditation de pleine conscience, qui a des effets bénéfiques sur le fonctionnement cognitif et sur l’état émotionnel, semble être une piste intéressante. Cette revue de littérature narrative se propose de recenser les études ayant testé l’efficacité d’une intervention basée sur la pleine conscience auprès de personnes souffrant de la maladie d’Alzheimer ou à risque de développer cette maladie. Il apparaît que ces interventions présentent un intérêt pour réduire les symptômes cognitifs (troubles attentionnels et mnésiques notamment) et émotionnels (affects dépressifs et anxiété en particulier). Cependant, elles nécessitent un certain nombre de modifications pour être adaptées à ce public.
Evaluation of the use of visual storytelling as an educational intervention in the cardiac ICU: reaching parents before they are in crisis
Authors: Chlebowski Meghan M. , Stark Christiana , Khoury Philip R. , Zang Huaiyu , Baenziger Julia , Kasparian Nadine A.
Published: December 2023

Objective:

To evaluate the acceptability and safety of educational videos utilising visual storytelling to provide information about the cardiac ICU and post-operative care to parents. Videos were designed to educate, further encourage parents to engage in their child’s cardiac care, and address common sources of distress.

Study Design:

Two educational videos and survey were sent to 29 families of children previously admitted to the cardiac ICU (April 2020–March 2021). Views regarding information quality, quantity, format, and relevance were assessed, as were parents’ emotional responses. Quantitative thresholds for safety and acceptability were set a priori. An inductive approach to content analysis was applied to identify themes in qualitative data.

Results:

Sixteen parents participated (response rate: 55%). All acceptability and safety thresholds were met; 92% of parents rated the videos as helpful and 85% were “very” or “extremely likely” to recommend them to other families of children with CHD. No participants reported significant distress after viewing the videos. Expressions of parental engagement with their child’s care team were common (92%). In qualitative responses, parents perceived the videos as potentially helpful in reducing distress if viewed prior to cardiac ICU admission.

Conclusion:

Visual storytelling to orient parents to the cardiac ICU and address common stressors was found to be safe and acceptable when tested with parents of children previously admitted to the cardiac ICU. Further prospective studies are needed to test intervention effects when videos are viewed before or during cardiac ICU admission, especially for mitigating anxiety and traumatic stress associated with admission.
British Congenital Cardiac Association Fetal Cardiology Standards: impact of Patient and Public involvement exercise on the development of clinical standards
Authors: Bluebond-Langner Myra , Wakeling Sara , Vincent Katherine , Butler Ashleigh , Brown Kate , Jowett Victoria
Published: December 2023

Objective:

To examine the impact of a Patient and Public Involvement exercise on the development of British Congenital Cardiac Association Fetal Cardiology Standards 2021.

Design:

Open-ended, semi-structured interviews were undertaken to inform the design of a study to improve the quality of parents’ experiences during antenatal and perinatal care of their child with CHD. This Patient and Public Involvement exercise was used to inform the final version of the drafted ‘Standards’.

Setting:

One-on-one interviews with parents who responded to a request on the closed Facebook page of the user group “Little Hearts Matter”: “Would you be interested in helping us to design a study about parents’ experience on learning that their child had CHD”?

Patients:

Parents of children with single ventricle CHD.

Results:

Twenty-one parents (18 mothers, 3 fathers) participated. Parents responses were reported to have variably reinforced, augmented, and added specificity in the later stages of drafting to six of the seven subsections of Section C Information and Support for Parents including: “At the time of the Scan”; “Counselling following the identification of an abnormality”; “Written information/resources”; “Parent support”; “Communication with other teams and ongoing care”; and “Bereavement support”.

Conclusions:

This Patient and Public Involvement exercise successfully informed the development of Standards after the initial drafting. It contributed to the establishment of face validity of the ‘Standards’, especially when consistent with what is reported in the literature. Further research is needed to explore approaches to involving and standardising Patient and Public Involvement in the development of clinical standards.
23 Tamoxifen Effects on Cognition and Language in Women with Breast Cancer
Authors: Sharma Saryu , Wright Heather Harris
Published: December 2023

Objective:

Cognitive changes following adjuvant treatment for breast cancer (BC) are well documented particularly following chemotherapy. However, limited studies have examined cognitive and/or language functions in chemotherapy-naive women with BC taking tamoxifen (TAM). While there is some compelling evidence TAM affects cognitive and language domains, language has not been studied beyond semantics (i.e., content of language), which is just one aspect of language. Using ambulatory cognitive assessment, we investigated the trajectory of cognitive and language changes during early period of adjuvant endocrine treatment (tamoxifen) in women with BC at two time periods (pre-treatment and two months after treatment begins).

Participants and Methods:

Four women with BC (mean age = 62.25 years, SD = 8.38) and 18 cognitively healthy age-matched controls (mean age = 59.77, SD = 7.45) completed 3 cognitive tasks using smartphones, during a short time period (5 days) and repeated at two time periods. Symbol search, dot memory and color dots tasks were used to measure the cognitive constructs - processing speed and working memory. Response times were recorded in milliseconds. To determine language ability, language samples were collected at two time periods, where the participants described two stories from two wordless picture books and samples were assessed using core lexicon analyses.

Results:

Wilcoxon-signed rank test was computed to identify cognitive and linguistic changes during early period of TAM administration in women with BC at two time periods. No significant within group or between group differences were seen on the cognitive and language tasks at the two time periods, however, a trend for decline in performance was seen in some BC participants across different tasks.

Conclusions:

This is the first study to our knowledge to use ambulatory cognitive assessment method and study discourse-level language function during this early period (pre-treatment and 2 months post-TAM). Findings from the current study advance our understanding of trajectories of cognition and language changes during the initial course of adjuvant endocrine treatment for women with BC with ER+ tumors. Using a measurement-burst design and ambulatory cognitive assessment, we were able to apply better precision measurement to identify distinct cognitive constructs affected by adjuvant endocrine treatment. In addition, insight into changes in discourse ability are impactful for numerous reasons: (1) better understanding of how adjuvant endocrine therapy impacts communication and (2) discernment into language domains that may require early behavioral intervention.
36 Naming in Monolingual and Bilingual Children with Epilepsy
Authors: Silverman Melanie R. , Smith Mary Lou , MacAllister William S. , Heydari Nahal , Busch Robyn M. , Fee Robert , Hamberger Marla J.
Published: December 2023

Objective:

Word finding or “naming” difficulty is a symptom of multiple neurological disorders; therefore, naming assessment is an integral component of neuropsychological evaluation. Prior work has found weaker second-language naming in healthy proficient bilingual youth than monolingual youth, and similar findings have been shown in adults with epilepsy. Considering the potential influences of both early onset epilepsy and bilingualism on brain development, we compared naming in English second language (ESL) and monolingual youth with epilepsy. To assess the impact of bilingualism independent of the known effects of seizure laterality (i.e., poor naming in those with left, dominant-hemisphere seizures), we excluded patients with left language dominance and unilateral seizures. We hypothesized that like other groups, naming would be weaker in ESL than in monolingual youth with epilepsy.

Participants and Methods:

Participants included 84 children with seizures that could not be lateralized clinically (n=36), bilateral seizures (n=20), centrotemporal spikes (n=3), and those with unilateral seizures and atypical language dominance (n=25), ages 6-15 years old: 66 monolingual, English (mean age: 10.87 ± 2.70 years) and 18 ESL (mean age: 10.78 ± 2.88 years). Those with FSIQ < 70 and vocabulary SS < 6 were excluded to ensure English proficiency. Independent samples t-tests, multivariate ANOVA, and chi-square tests compared groups on demographic factors and test performance. All measures (FSIQ, WISC/WASI Vocabulary, letter and category fluency, Children’s Auditory (AN) and Visual Naming (VN) Tests) were administered in English.

Results:

Monolingual and ESL groups did not differ in: age, sex, SES, seizure type (i.e., non-lateralized, bilateral, centrotemporal spikes, or atypical language dominance), epilepsy onset age, or number of AEDs. Comparisons also showed no differences in FSIQ, vocabulary, letter fluency, or category fluency (all ps > 0.05). By contrast, auditory and visual naming performances were weaker among ESL patients than monolingual patients: AN accuracy, F(1,81) = 10.89, p = 0.001; AN tip-of-the-tongues (TOTs), F(1,81) = 6.35, p = 0.014; AN Summary Scores (SS), F(1,81) = 6.17, p = 0.015; VN accuracy, F(1,81) = 4.66, p = 0.034; VN SS, F(1,81) = 4.87, p = 0.030, with the exception of VN TOTs, which approached significance, F(1,81) = 3.55, p = 0.063.

Conclusions:

Consistent with findings in bilingual healthy youth and ESL adults with epilepsy, naming in ESL youth with epilepsy was weaker than in monolingual children. The groups did not differ on other aspects of language. Thus, unlike other expressive verbal functions, naming is adversely affected in the second language of bilingual people with epilepsy across the age span. These results suggest that poor naming in ESL patients cannot be used to infer a naming deficit, and/or left (dominant) temporal lobe dysfunction.
39 Neurodevelopmental Complexity of a Patient with Perinatal Right Middle Cerebral Artery Stroke and Infantile Spasms
Authors: Owens Ronnise D , Cernokova Ivana , Martinez Eva del Valle , Semaan Nicole , Bergeron Coralie , Bearden Donald J , Ono Kim E
Published: December 2023

Objective:

A rich literature exists on cognitive changes related to focal injury in the adult brain. In contrast, the developing brains of children are less understood. In contrast to adult cases, 20% to 25% of perinatal strokes result in language disorder regardless of lesion lateralization. Existing literature suggests children with perinatal stroke may present with a range of executive functioning and visuospatial processing difficulties. Gross and fine motor challenges are also likely to occur. Furthermore, these children have an increased prevalence of autism spectrum disorder (ASD) and carry the highest risk for epilepsy. Despite growing research on neurodevelopmental profiles in patients with perinatal stroke, published literature is limited.

Participants and Methods:

Our study examines neurodevelopment of a 2-year-old, right-handed male with a history of perinatal ischemic right middle cerebral artery (MCA) stroke, infantile spasms, and left hemiparesis following right hemispherectomy for seizure management who underwent two neurodevelopmental evaluations at our medical center over approximately 3 years.

Results:

Findings from the patient’s evaluation with the Mullen Scales of Early Learning revealed overall cognitive ability in the low average range (SS = 89, 23rd percentile); however, notable variability was seen in his performance. His receptive language was average (SS = 98, 45th %tile) and consistent with previous evaluation results, and he has made gains in visual reception (from SS = 75, 5th %tile to SS = 91, 27th %tile) and expressive language (from SS = 55, 0.1st %tile to SS = 70, 2nd %tile). In addition, his gross motor was exceptionally low (SS = 55, 0.1st %tile) and consistent with previous evaluation results. Fine motor was low average (SS = 84, 14th %tile).

Conclusions:

Our patient showed cognitive gains in language and visual reception since his prior evaluation despite history of right MCA stroke and right hemispherectomy. Improvements are likely due to a combination of early brain plasticity and intensive therapies he has received. Consistent with published findings in this population, he experienced seizures associated with his stroke. Our results add to the limited literature on neurodevelopmental challenges associated with perinatal stroke and progress that can be made when appropriate supports are provided early and consistently.
62 Cognitive Functioning and Non-Cognitive Symptoms in Post-Acute COVID-19 Syndrome
Authors: Gardner Melissa M , Thompson Ryan C , Moncrief Grant G , Roth Robert M
Published: December 2023

Objective:

Patients with Post-Acute COVID Syndrome (PACS) are reported to commonly experience a variety of cognitive, physical, and neuropsychiatric symptoms well beyond the acute phase of the illness. Notably, concerns involving mood, fatigue, and physical symptoms (e.g., pain, headaches) following COVID-19 appears to be especially prevalent. It is unclear, however, the extent to which such symptoms are associated with cognitive problems in patients with PACS. In the present study, we examined the prevalence of cognitive impairment in a sample of patients with PACS, as well as the relationship between cognitive functioning and several non-cognitive symptoms.

Participants and Methods:

Participants were 38 patients with PACS [71.1% female; mean age = 48.03 years (SD = 11.60) and years of education = 15.26 years (SD = 2.60)] seen for a neuropsychological evaluation at a large Northeastern medical center at least three months from the time of COVID-19 diagnosis (per PCR test). As part of a larger battery, patients completed the Hopkins Verbal Learning Test- Revised (HVLT, learning and delayed recall), Trail Making Test (TMT; time to complete parts A and B), Controlled Oral Word Association Test (COWAT total correct), and Animals (total correct). They also were administered the Chalder Fatigue Scale-11 (CFS-11), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Patient Health Questionnaire (PHQ-15). The percentage of patients with scores in the impaired range (z < -1.5) on cognitive tests was determined. Correlations between cognitive and non-cognitive measures were also examined.

Results:

The most frequent impairment was seen for COWAT (21.2%), followed by TMT-A and TMT-B (both 13.9%), then category fluency (9.1%). No patients were impaired on HVLT-R Learning and only one (4%) for HVLT-R Delayed Recall. Overall, the sample endorsed considerable depression, anxiety, fatigue, as well as physical symptoms. Greater fatigue was associated with worse verbal learning, processing speed, cognitive flexibility, and verbal fluency (letter and category). Worse physical symptom severity was related to poorer verbal delayed recall and cognitive flexibility. Greater anxiety was also associated with worse cognitive flexibility, while more severe depression was related to poorer category fluency.

Conclusions:

In our sample of patients with PACS, seen for evaluation several months since contracting COVID-19, phonemic fluency was the most common cognitive impairment, though less than a quarter were impaired on any given cognitive test. Importantly, several associations were observed between cognitive test performance and non-cognitive symptoms commonly endorsed by patients with PACS. These findings highlight the importance of assessing multiple factors potentially contributing to cognitive impairment in these patients. Interventions designed to address such symptoms may be helpful in ameliorating cognitive functioning in those with PACS.
63 Select Dietary Components are Associated with Better Global Cognition in Adults with HIV
Authors: Fazeli Pariya L , Davey Christine Horvat , Webel Allison , Oliveira Vitor , Buford Thomas , Vance David E , Burkholder Greer , Crane Heidi , Fleming Julia , Willig Amanda
Published: December 2023

Objective:

People with HIV (PWH) are at an increased risk for cognitive impairment as they age compared to their HIV-negative counterparts. Lifestyle factors can have protective effects on cognitive outcomes among PWH. However, little work has examined diet quality and cognitive function in PWH. Examining the association between diet quality and cognitive function among PWH is particularly important given this population’s increased risk for both poor diet quality and cognitive impairment. The purpose of this study was to examine the relationship between diet and cognitive function in aging PWH.

Participants and Methods:

This cross-sectional study was conducted in Birmingham, Alabama and Cleveland, Ohio. Eighty-six PWH (mean age 56 years) completed standard triple-pass 24-hour diet recalls and a neurocognitive assessment. Partial Pearson’s correlations were conducted between diet variables and global neurocognitive function T scores, adjusting for total calories, sex, and education level.

Results:

Overall diet quality of the sample was poor. The overall sample presented with low Healthy Eating Index (HEI)-2015 scores, high glycemic index, twice the goal amount for saturated fatty acids (SFAs), and inadequate consumption of several nutrients typically associated with cognitive health including omega-3 fatty acids, dietary protein, fiber, Vitamin D, Zinc, and several B-vitamins. Greater total calories per day (r=0.28, p<0.05), greater percentage of total calories of SFAs (r=0.26, p<0.01), and lower glycemic index (r=-0.24, p<0.05) were associated with better cognition. Higher intake of several individual fatty acids, particularly SFAs, were associated with better cognition (correlations ranging from 0.23 to 0.31). Higher intakes of phosphorus (r=0.29, p<0.01), magnesium (r=0.25, p<0.05), and potassium (r=0.22, p<0.05) were associated with better cognition. Higher grams/day of several amino acids were associated with better cognition (correlations ranging from 0.22 to 0.27).

Conclusions:

In a sample with overall poor diet quality not meeting recommended guidelines, findings suggest that being nourished in itself is associated with better cognitive function. Associations with several individual nutrients may inform potential intervention targets to protect brain health in PWH. Further, targeting food insecurity in interventions may have downstream effects on cognition in PWH.
86 Memory Performance in Children with Duchenne and Becker Muscular Dystrophy
Authors: Park Sydney E , Owens Ronnise , Kiefel Jacqueline , Verma Sumit
Published: December 2023

Objective:

There is limited and mixed research describing the memory performance of boys with Duchenne muscular dystrophy (DMD), a progressive disorder that affects the muscle and the brain, presumably due to the absence of dystrophin; however, the literature indicates either the existence of a selective deficit in verbal working memory, or more generalized impairment in both verbal and visual memory. Far less is documented about the neurocognitive profile of boys with Becker muscular dystrophy (BMD), a closely related neuromuscular disorder which allows for at least some functional dystrophin protein to circulate. The Child and Adolescent Memory Profile (ChAMP) is a valid and widely used memory battery that has not been studied in either DMD or BMD. This study aimed to assess the verbal and visual memory performance in boys having either a DMD or a BMD diagnosis using the ChAMP. A working memory measure, the Digit Span subtest from the Wechsler Intelligence Scale for Children-Fifth Edition, was also included for comparison.

Participants and Methods:

Twenty-one patients (Age M = 12.19 ± 3.60; 100% male; 76% DMD, 24% Becker) were selected from retrospective data collection of neuropsychological performance in children with neuromuscular disorders. Patients were recruited and assessed as part of a larger scale IRB-approved research study designed to better understand the neurocognitive and behavioral trajectories of boys with DMD or BMD with a complete neuropsychological battery.

Results:

Independent samples f-tests revealed no significant differences between groups across verbal (DMD M = 88.71; BMD M = 100.80; p = .08), visual (DMD M =90.36; BMD M 93.60; p = .33), and working memory (DMD M = 84.69; BMD: M 82.60; p = .40) domains. In additional analyses, a one sample f-test comparing verbal and visual memory within DMD children revealed significantly worse verbal than visual memory scores (verbal memory M = 88.71; visual memory M = 90.36; p = <.001).

Conclusions:

There were no significant differences between groups in verbal, visual, and working memory performance, though sample size was a significant limitation. However, based on a comparison of means, children with BMD appear to have stronger verbal memory skills than children with DMD. Furthermore, significant differences between verbal and visual memory within DMD children were observed, such that verbal memory skills were weaker. These findings add to the absence of literature on verbal and visual memory outcomes in children with DMD and BMD.
Plenary A: Presidential Address: Anesthesia: A Wake-Up Call. Part 2. Developmental Risk or Resilience?
Authors: Baron Ida Sue
Published: December 2023

Abstract & Learning Objectives:

This presentation is a clarion call to neuropsychologists to contribute their specialized knowledge to help answer a critical question: Is there a Fetal Anesthesia Syndrome that results in subtle and persistent adverse effects over an individual’s lifespan? Neuropsychologists are uniquely positioned to make substantial contributions to conceptualization, methodology, and interpretation in studies of human exposure to general anesthesia (GA). Part 1, presented at the 2022 INS Barcelona meeting, reviewed preclinical data that documented effects on the central nervous system and long-term behavioral adversities of GA exposure during an animal’s critical growth spurt developmental period. Studies of human adult exposure were also summarized, and attention directed to the absence of prospective studies from childhood to adulthood. Part 2 extends the conversation to GA exposure during the highly vulnerable in utero and early childhood developmental periods. Human retrospective study results began to be published in the early 2000s, and prospective studies only within the last decade. Reports of associations between GA and attentional problems, learning disorder, neuropsychological deficit, and neuropsychiatric disorder are emerging. Yet, due to methodological weaknesses and multiple confounders, clear evidence of causality remains lacking in this nascent literature. A 'developmentalistic’ way forward for neuropsychologists will be suggested, one using neuropsychological expertise along with the application of innovative technologies that is informed by the extensive preclinical data showing cellular, synaptic, and neural circuitry disruption during critical growth periods and short- and long-termeuropsychological effects. Upon conclusion of this course, learners will be able to:

1.

Describe types of central nervous system disruption that result in animals following exposure to general anesthesia

2.

Identify neuropsychological domains at high potential risk following exposure to general anesthesia during the human critical growth spurt period

3.

Explain what is meant by 'vertical transfer'
2 A Randomized, Double-blinded, Placebo-controlled Trial of Liraglutide in Patients with Parkinson’s Disease: Neuropsychological Outcomes
Authors: Wertheimer Jeffrey C , Hogg Elliot , Wu Tina , Gottuso Ann , Gold Dov , Tagliati Michele
Published: December 2023

Objective:

Parkinson’s disease (PD) is associated with metabolic disorders such as insulin resistance. Pharmacological intervention used to treat insulin resistance, like GLP-1 agonists, may have auspicious results in the treatment for PD. The objective of this clinical trial was to assess the therapeutic effect of liraglutide on non-motor symptoms, such as, but not limited to, cognitive function and emotional well-being, and quality of life for individuals with PD.

Participants and Methods:

In a single-center, randomized, double-blind, placebo-controlled trial, PD patients self-administered liraglutide injections once-daily (1.2 or 1.8 mg, as tolerated) or placebo in a 2:1 study design for 52 weeks after titration. Primary outcomes included adjusted difference in the OFF-state Movement Disorders Society Unified PD Rating Scale (MDS-UPDRS) part III, non-motor symptom scale (NMSS) and Mattis Dementia Rating Scale (MDRS-2). Secondary outcomes included quality of life scores (Parkinson Disease Questionnaire, PDQ-39) and other neuropsychological tests, including Delis-Kaplan Executive Function System (DKEFS), Geriatric Depression Scale (GDS), and Parkinson’s Anxiety Scale (PAS) scores.

Results:

Sixty-three subjects were enrolled and randomized to liraglutide (n=42) or placebo (n=21). Mean age in years was 63.5 (9.8) and 64.2 (6.4) for liraglutide and placebo cohorts, respectively (p=0.78), and mean age at symptom onset was 58.9 (10.5) and 59.3 (7.5) for liraglutide and placebo cohorts, respectively (p=0.86). At 54 weeks, NMSS scores had improved by 6.6 points in the liraglutide group and worsened by 6.5 points in the placebo group, a 13.1 point adjusted mean difference (p<0.05). Further analysis showed all nine NMSS sub-domain changes favoring the liraglutide group, with one (attention/memory) reaching statistical significance (p<0.05). Secondary outcome analyses revealed a significant improvement of PDQ-39 (p<0.001) and Parkinson’s Anxiety Scale - Avoidance Behavior scores (p<0.05) in the treatment group. MDRS-2 sub-scores did not further differentiate study groups, while DKEFS letter fluency scores favored placebo group (p<0.05).

Conclusions:

Treatment with liraglutide improved self-reported non-motor symptoms of PD, activities of daily living, and quality of life. These results validate similar outcomes reported with other GLP-1 agonists implicating consideration for novel treatment opportunities for individuals with PD. Notably, the absence of significant performance-based cognitive changes over the duration of the trial for the participants in this study has several plausible explanations given participant-related baseline demographic and clinical factors. Implications for neuropsychologists will be discussed.
8 Incident TBI among a Nationwide Cohort of US Older Adults
Authors: Kornblith Erica , Yaffe Kristine , Boscardin W. John , Diaz-Ramirez L. Grisell , Gardner Raquel C.
Published: December 2023

Objective:

Traumatic brain injury (TBI), very common in the United States (US) and occurring at highest rates in older adulthood, is a documented risk factor for cognitive impairment and dementia. However, the full scope of the problem is unknown, as comparative incidence of TBI among older adults is poorly characterized. Moreover, the effect of demographics (race/ethnicity, sex) and cognitive and medical status, as well as education, socioeconomic status, and other social determinants of health (SDOH) on TBI risk is not well understood. We aimed to explore the impact of demographics, cognitive and medical status, and SDOH on vulnerability to new TBIs among older adults.

Participants and Methods:

Enrollees 65 and older in the nationally representative Health and Retirement Study (HRS) who consented to have their survey data linked to Medicare claims and had not experienced a head injury prior to HRS enrollment were studied. We used claims data 2000-2018 to obtain incident TBI diagnoses and harnessed the detailed demographic, cognitive, medical, and SDOH information available in the HRS. Incident TBI was defined using inpatient and outpatient International Classification of Disease (ICD 9 and 10) codes received the same day as an emergency room (ER) visit code and a computed tomography (CT) scan code, occurring after the enrollee’s baseline HRS interview. We calculated descriptive statistics and bivariate associations for TBI status with demographic and SDOH characteristics measured at baseline using sample weights to account for the complex survey design.

Results:

Of respondents meeting inclusion criteria (n=9273) during the study follow-up period of 18 years, 8.9% received emergency room treatment for a TBI. Older adults who experienced TBI during the study period were more likely to be female (p=0.0006), and white (p=0.0001), to have normal cognition (vs. cognitive impairment or dementia, p=0.0011), higher education (p<0.0001), and higher income (p=0.01). Having lung disease (p=0.0003) or functional impairment (p=0.03) at baseline were protective against experiencing a TBI.

Conclusions:

Our results suggest that almost 9% of US older adults received ER treatment for a new TBI during the 18-year study period, and that race, sex, and SDOH factors may increase risk for, or be protective against, TBI. This novel investigation into the impact of demographics and SDOH on incident TBI suggests access to care may impact who gets treatment for TBI. Further study is indicated and may lead to opportunities for both targeted intervention (e.g., primary TBI prevention) to groups most at risk as well as identification and mollification of the most relevant structural and contextual factors (e.g., access to care) to reduce risk of TBI among older adults.