bluuebunny/crossref_metadata_2025 huggingface dataset:
Thyroglossal Duct Cyst with Multiple Tracts- A Case Report
Authors: Prabakaran S , Swetha T , Navin RB Namasivaya , Rajasekaran S , Priya K
Published: February 2022

A thyroglossal duct cyst is an embryological remnant which persists due to failure in the closure of thyroglossal duct. Worldwide the prevalence of thyroglossal cysts is about 7%. There is no sexual predominance seen. Normally at about 10th week of gestation the thyroglossal duct involutes, if there is any persistent duct remnant then this can lead to thyroglossal duct cyst formation. There is 1% chance of malignant transformation (papillary carcinoma). A 21-year-old female presented to the Ear, Nose and Throat Department with the complaint of swelling in front of the neck for the past one month. A 2×1.5 cm2 swelling was observed in the anterior aspect of neck-infrahyoid region extending till thyroid notch. The swelling moved upwards with protrusion of the tongue and deglutition. Ultrasound neck revealed a complex cystic lesion in midline of neck of size 2×1×2.2 cm3 suggestive of thyroglossal cyst. Fine Needle Aspiration Cytology (FNAC) showed features suggestive of thyroglossal duct cyst. Patient was prepared for Sistrunk procedure. Intraoperatively multiple tracts of thyroglossal duct cyst were seen and the same were removed in toto. Patient was on regular follow-up postoperatively for a period of one year and no evidence of any recurrence was seen.
Awareness of Facemask and its Usage in the Rural Community of Western Maharashtra during COVID-19 Pandemic: A Cross-sectional Survey
Authors: Jat Urmila Hariram , Jaiswal Varoon Chandramohan , Rumani Ismaa Shakil Ahmed , Pargi Savni Mandar , Ghodey Snehal Avinash
Published: February 2022

Introduction: The Coronavirus Disease-19 (COVID-19) pandemic caused by 2019 novel coronavirus was first reported in Wuhan, China. It is a disease of the respiratory system with clinical presentation of fever, cough, breathlessness, headache, fatigue etc. Transmission route is through person to person contact and through direct contact with respiratory droplets generated when an infected person coughs or sneezes. In such cases usage of facemasks is very crucial. At the same time awareness regarding the same in the community is very important. Hence, through this survey authors have assessed and recorded the awareness about facemasks and its usage in the community in the Indian population along with the basic hygiene precautions taken by the people. Aim: To conduct a detailed survey regarding the awareness and usage of facemask in the rural population in Maharashtra. Materials and Methods: The study was a three month cross- sectional online survey conducted by Maharashtra Academy of Engineering Education and Research’s (MAEER’s) Talegaon Dabhade Physiotherapy College in the rural community of western Maharashtra, India, from October to December 2020. A self-administered online questionnaire consisting of 20 questions was prepared regarding the awareness about masks usage and proper methods to be considered with reference to the guidelines given by World Health Organisation (WHO), Indian Council of Medical Research (ICMR), Centers for Disease Control (CDC) and Prevention and literature reviews. The forms were shared on social media platforms such as WhatsApp, Facebook, and Instagram using Google forms. Statistical analysis was done by descriptive analysis using percentage. Results: Out of total 390 participants, 210 (53.84%) were males and 180 (46.15%) were females. Considering the knowledge about the types of masks available was 67.1%, self-education was 88%. A 44% of the population thinks that one can wear a facemask up to eight hours if worn properly. Similarly knowledge about disinfecting the mask before throwing was 86%. Active efforts to maintain good hygiene by washing hands was 90%. Also, 55% of the population avoids touching their mask frequently. In practice, 56.1% of the population avoids wearing a mask while walking or jogging. Varieties of masks are being used by the people depending on the cost and availability. Conclusion: The coronavirus pandemic has evoked a sense of awareness about self-care, hygienic habits and being updated about one’s health. Further work can be done on cost effectiveness and availability of the good quality masks.
Impact of Health Education on Knowledge, Attitude and Practices of COVID-19 among Slum Dwellers of Nashik, India
Authors: Palwe Supriya Dhakne , Bajaj Maanya Sumeet
Published: February 2022

Introduction: The spread of Coronavirus Disease 2019 (COVID- 19) pandemic can be effectively curtailed by COVID-19 appropriate practices. Identifying knowledge gaps and giving health education to address the weak areas will be key to breaking the chain of COVID-19. Aim: To assess the Knowledge, Attitude and Practices (KAP) of COVID-19 among slum dwellers and to assess the impact of health education on the same. Materials and Methods: The quasi-experimental was conducted among the slum dwellers from July 2021 to August 2021 at three slums (Sant Kabir Nagar, Anandwalli slum behind Wasan bungalow, Kamgar nagar) of Nashik city, Maharashtra, India. To assess KAP using a prevalidated questionnaire with 16 knowledge questions, six attitude questions and eight practice questions. A brief video was utilised for health education regarding COVID-19. Knowledge was reassessed after the intervention. A total of 164 participants from three slums completed the preintervention and postintervention questionnaire. Data was analysed using appropriate statistical tests like Chi-square test, Wilcoxon signed-rank test. Results: Satisfactory level of knowledge, attitude and practices was found in 72.56%, 82.32% and 51.83% of the study participants. Knowledge gap was found in social distancing (35.98%), possibility of re-infection (20.73%) and infection after vaccination (28.66%). Around 25.61% said that children need not follow COVID-19 appropriate practices. About 97.56% participants had taken at least 1st dose of COVID vaccine. There was high prevalence of inappropriate practices like not maintaining social distancing at workplace (21.95), using public transport (65.24%), etc. There was no association of socio- demographic characteristics and the COVID-19 KAP. There was significant increase in the knowledge level after the health education. Preintervention and postintervention knowledge scores was 10.82±2.39 and 12.91±1.79, respectively. Conclusion: In spite of satisfactory knowledge level and attitudes, around half the population was involved in incorrect practices. There was no association of socio-demographic factors on the KAP of COVID-19. Post health education, knowledge level improved significantly.
Evolutionary Sequence of Spacetime and Intrinsic Spacetime and Associated Sequence of Geometries in Metric Force Fields II
Authors: Joseph O. Akindele Adekugbe
Published: February 2022

The geometry of curved ‘three-dimensional’ absolute intrinsic metric space (an absolute intrinsic Riemannian metric space) \(\varnothing\hat{\mathbb{M}}^3\), which is curved (as a curved hyper-surface) toward the absolute time/absolute intrinsic time ‘dimensions’ (along the vertical), and projects a flat three-dimensional absolute proper intrinsic metric space \(\varnothing\hat{\mathbb{E}}^\prime\)ab3 and its outward manifestation namely, the flat absolute proper 3-space \(\hat{\mathbb{E}}^\prime\)ab3, both as flat hyper-surfaces along the horizontal, isolated in the first part of this paper, is subjected to graphical analysis. Two absolute intrinsic metric tensor equations, one of which is of the form of Einstein free space field equations and the other which is a tensorial statement of absolute intrinsic local Euclidean invariance (A\(\varnothing\)LEI) on \(\varnothing\hat{\mathbb{M}}^3\), are derived. Simultaneous (algebraic) solution to the equations yields the absolute intrinsic metric tensor and the absolute intrinsic Ricci tensor of absolute intrinsic Riemann geometry on the curved \(\varnothing\hat{\mathbb{M}}^3\), in terms of a derived absolute intrinsic curvature parameter. A superposition procedure that yields the resultant absolute intrinsic metric tensor and the resultant absolute intrinsic Ricci tensor, when two or a larger number of absolute intrinsic Riemannian metric spaces co-exist (or are superposed) is developed.

The fact that a curved ‘three-dimensional’ absolute intrinsic metric space \(\varnothing\hat{\mathbb{M}}^3\) is perfectly isotropic and is consequently contracted to a ‘one-dimensional’ isotropic absolute intrinsic metric space, denoted by \(\varnothing\hatρ^3\), which is curved toward the absolute time/absolute intrinsic time ’dimensions’ (\(\hat{c}\)\(\hat{t}\)/\(\varnothing\)\(\hat{c}\)\(\varnothing\)\(\hat{t}\)) along the vertical is derived.
origins of the settlements at Kelso and Peebles, Scottish Borders
Authors: Perry David , Dixon Piers , Mackenzie James , Sharman Paul , Cox Adrian , Hall Derek , Smith Catherine , Spoerry Paul , Wickham-Jones Caroline , Gallagher Dennis , Ford Barbara , Henderson D , Tarling D , Crowdy Amanda , Moffatt Brian , Bateson Donald
Published: February 2022

This is a report on archaeological work in two of Scotland's less well-known medieval burghs of Kelso and Peebles (NGR: NT 7268 3402; NT 7261 3408; NT 2520 4053; NT 2057 4051).

The excavations at Wester Kelso/Floors Castle established that the original medieval burgh of Kelso or Wester Kelso was much further west than previously believed, being situated well inside the present Castle policies. That early settlement at Wester Kelso appears to have been abandoned in the 14th or 15th centuries, at the same time that the royal burgh of Roxburgh was deserted, probably as a result of the English occupation of Roxburgh Castle. The other settlement of Easter Kelso, near the abbey, survived and expanded northwards from the abbey along Roxburgh Street. The finding of a possible building terrace in Phase 1 at 13–19 Roxburgh Street indicates that settlement along the southern end of that street could date to as early as the 13th or 14th centuries. Combining the archaeological, cartographic and documentary evidence, it seems clear that 'Easter' Kelso, now Kelso, had expanded from the market area around the abbey northwards towards the Floors estate by the early 18th century. The excavations in Peebles have provided important information on the origins of the settlement of the peninsular ridge between the Tweed and Eddleston Water. The results obtained from the excavations at the two sites in Peebles indicate that settlement of the ridge began in the 12th century, soon after the establishment of the royal castle and burgh by David I (1124–53). At both sites, after initial dumping of rubbish, possibly to raise the ground level to counter flooding, occupation, in the form of stone structures, can be dated to the 14th century at the latest, with probable earlier dumping of domestic refuse in the 12th and 13th centuries. The street of Bridgegate was apparently laid out in the 13th or 14th centuries when the excavated site was divided into three properties aligned on that street, two of which had stone buildings erected on them. Alternatively, Bridgegate may have been the initial focus of settlement on the east side of the Eddleston, providing the access route from the east into Old Town, where a pilgrimage centre had been established at the Cross Kirk in 1261, and the location of the tolbooth (Bridgegate Building 4) in it suggests that this street was originally more important than High Street. It is noteworthy that all eight medieval buildings excavated at the two Peebles sites were of stone construction. Peebles tolbooth, the civic centre of the burgh, is the only medieval tolbooth site in Scotland to have been excavated.
Effect of Phenolic Substituent Position in Boron Complexes of Imidazo[1,5‐a]pyridine
Authors: Yagishita Fumitoshi , Hoshi Keita , Mukai Shoma , Kinouchi Takashi , Katayama Tetsuro , Yoshida Yasushi , Minagawa Keiji , Furube Akihiro , Imada Yasushi
Published: February 2022

We have synthesized two boron complexes of 3‐(o‐hydroxyphenyl)imidazo[1,5‐a]pyridine exhibiting blue emission in solution. The transient absorption and theoretical studies of the complexes and their 1‐(o‐hydroxyphenyl) substituted isomers revealed that the phenolic substituent position in boron complex of imidazo[1,5‐a]pyridine affected the excites state dynamics involved in photoluminescence (PL). Although the introduction of phenolic substituent at 1‐position of the boron complex is effective to achieve the strong emission, the introduction of phenolic substituent at 3‐position results in the decreasing PL quantum yield due to intersystem crossing from the singlet excited state to the triplet excited state.
Cortical structure and episodic memory profiles in APOE ε4: Resilience and vulnerability for cognitive impairment
Authors: Coughlan Gillian , Zhukovsky Peter , Voineskos Aristotle N , Grady Cheryl
Published: February 2022

Background

The apolipoprotein E (APOE)‐ε4 allele represents the greatest genetic risk factor for late‐onset Alzheimer’s disease (AD). Identifying a resilience profile that might mitigate medial temporal lobe atrophy in enriched genetic risk may explain differences between individuals’ susceptibility to AD pathology.

Method

742 older adults from OASIS‐3 were stratified by APOE genotype status (423 ε3ε3 carriers; 271 ε3ε4 carriers and 48 ε4ε4 carriers) and classified as cognitively normal (74%) or with mild cognitive dysfunction (26%) using the clinical dementia rating scale (CDR) score. Neuropsychological screening measured general cognitive function, depression and psychiatric symptoms. Episodic memory, processing speed and naming ability were included as cognitive outcome measures. Cortical structure was measured using FreeSurfer. General linear models determined the main effects of APOE and cognitive status on relative regional volumes (regional volume divided by total intracranial volume) and cognition. APOE x cognitive status interactions were followed up with linear models to assess the effects of APOE in the cognitively normal and impaired groups separately.

Result

As expected main effects of APOE and cognitive status were observed on hippocampal, amygdala and entorhinal volumes. Greater effects of APOE were found on all regions in individuals with cognitive dysfunction, except on the entorhinal cortex. Significant interactions between APOE and cognitive status revealed that the left precuneus and superior frontal volumes were preserved in cognitively normal homozygote and heterozygote ε4 carriers with entorhinal atrophy, but were reduced in cognitively impaired ε4 carriers, controlling for age and sex. We found a similar interactive effect of APOE and cognitive status on episodic memory, with superior memory in cognitively normal e4ε4 carriers, and memory impairment in cognitively impaired e4ε4carriers, compared to their respective cognitive normal and impaired ε3ε3 counterparts.

Conclusion

Cortical and subcortical atrophic signatures were identified for cognitively normal and impaired ε4 carriers. Structural integrity of the precuneus and superior frontal cortices may protect against cognitive dysfunction, even if medial temporal atrophy is present. Thus, our results indicate that the structural integrity of frontal‐parietal lobes may provide resilience against cognitive impairment in the face of ε4‐related decline in medial temporal structures.
Methods and future directions for evaluation of Tau PET signal
Authors: Pontecorvo Michael J. , Devous Michael D. , Lu Ming , Fleisher Adam S. , Collins Emily C. , Mintun Mark A.
Published: February 2022

Background

Alzheimer’s disease (AD) is defined in vivo by evidence of amyloid and tau, usually accompanied by neurodegeneration, in accordance with the ATN criteria.

Method

Deposition of amyloid is thought to begin early in the disease process and, by the time symptoms become evident, can usually be detected as elevated PET signal in a stereotypical pattern across regions. In contrast tau deposition begins later in disease and the pattern and timing of evolution of tau deposition may vary across individuals. Thus, it is more difficult to assign a classification of tau positive that fits all purposes.

Result

Studies in autopsy confirmed patients indicate that tau PET visual interpretation methods may be effective in identifying subjects at the B3 (Braak V/VI) stage of deposition. B3 tau deposition is typically also associated with amyloid positivity, thus predicting a likely pathological diagnosis of high AD neuropathologic change at autopsy. However, a negative visual interpretation cannot rule out the presence of amyloid and tau levels sufficient to support a classification of intermediate AD neuropathological change. Quantitative methods focused on temporal lobe (particularly inferior and mesial temporal lobe) may be more sensitive to earlier stages of AD tau deposition, but confirmation of amyloid status may be required to rule out primary age‐related tauopathy.

Conclusion

Together visual and quantitative interpretation methods may identify patterns of tau distribution and density with implications for the expression of symptoms, and future progression of impairment, and may be of value in stratifying/selecting patients most likely to respond in clinical trials of AD therapeutics.
Hospital nurses' knowledge and confidence in caring for persons living with Alzheimer’s disease and other dementias
Authors: Shaw Clarissa
Published: February 2022

Background

Persons living with Alzheimer’s Disease and other dementias (PLWD) are twice as likely to be hospitalized compared to cognitively intact older adults and while hospitalized are significantly more likely to experience complications and increased length of stays. The purpose of this study is to determine if confidence in caring for PLWD is associated with knowledge of dementia in acute care nursing staff. We hypothesize that knowledge and confidence will be highly correlated. Additionally, we hypothesize that a higher knowledge of dementia will be associated with higher education and less elderspeak (i.e., infantilizing communication) use.

Method

Nursing staff (N=65) were recruited from one university hospital in the midwestern United States. A subset of nursing staff (n=32) were observed and audio‐recorded during care encounters with PLWD (n=16) and the nursing staff’s communication was coded for elderspeak using a reliable and evidence‐based coding scale. The nursing staff completed the 9‐item Confidence in Dementia (CODE) scale (9=not confident to 45=very confident) and 16‐item true or false Knowledge in Dementia (KIDE) scale (0=no items correct to 16=all items correct). The associations between nursing staff confidence, knowledge, and demographic characteristics were determined using Pearson’s correlation coefficient for continuous variables and ANOVA for categorical variables.

Result

Nursing staff were somewhat confident (mean=33.9, SD=4.9) in providing care to PLWD. More years working in healthcare was associated with higher confidence (r=.28, p=.03). Role, age, use of elderspeak, gender, education, and hospital unit were not associated with confidence. Nursing staff averaged 85% on the KIDE scale. More years working in healthcare was associated with lower knowledge (r=‐.26, p=.04) and staff nurses had higher knowledge compared to nursing assistants (p<.001). Age, use of elderspeak, gender, and hospital unit were not associated with knowledge. Confidence and knowledge were not associated (r=.02, p=.90).

Conclusion

Confidence in caring for a PLWD was not associated with knowledge of dementia itself. Acute care nursing staff—particularly experienced staff and nursing assistants—are in need of greater dementia education. Effective educational interventions for dementia care are warranted in order for education to enhance confidence in caring for PLWD.
The application of the Human Connectome Project in large scale brain network imaging: A potential biomarker for Alzheimer's disease and related dementias
Authors: Rosenbloom Michael H. , Hanson Leah R. , Kashyap Bhavani , Erickson Lauren O. , Sughrue Michael Edward
Published: February 2022

Background

Alzheimer’s disease and related dementias (ADRD) result in progressive dysfunction of large scale brain networks (LSBNs) including the default mode network (DMN). Resting state functional MRI (rs‐fMRI) is an imaging tool offering the potential for tracking LSBN degeneration, but been underutilized as an imaging biomarker. Potential reasons include complexity of imaging protocols and analyzing imaging data. If these steps were simplified and operationalized, further integration of rs‐fMRI into clinical trials as a surrogate endpoint may be feasible. We describe an automated connectome mapping program (Infinitome) that leverages rs‐fMRI scans with standardized protocols, Human Connectome Project (HCP) data, and machine learning to understand longitudinal LSBN degeneration in dementia (figure 1).

Method

The Infinitome program creates a subject specific version of the Human Connectome Project Multimodal Parcellation (HCP‐MMP1) atlas using diffusion tractography (figure 2). Analytics are performed on both diffusion tensor imaging and rs‐fMRI. Outlier detection using a tangent space connectivity matrix is performed by comparing results with a subset of 300 normal HCP subject fMRI samples to determine the range of normal correlations for each regions of interest in a LSBN. Abnormal connectivity is determined as a 3‐sigma outlier for that correlation (figure 3). The imaging protocol for rs‐fMRI is limited to 8 minutes, enabling each study to be readily added on to structural MRI sequences. The program also provides automated image processing and analysis, thus simplifying the process of accessing imaging data and incorporating rs‐fMRI into routine practice.

Result

Preliminary work has shown that connectomic analysis using this software in ADRD is feasible and can detect functional anomalies involving regions of interest described by the HCP.

Conclusion

By providing support for fMRI processing through a cloud‐based server and incorporating normal control data from the HCP, the Infinitome program addresses the challenges associated with the analysis and interpretation of rs‐fMRI data. Thus, it has the potential to simplify the incorporation of rs‐fMRI into clinical trials as a biomarker for progressive neurodegeneration of vulnerable networks in ADRD. Further studies are planned evaluating LSBNs in AD and dementia with Lewy bodies.
The location of PSEN1 pathogenic variants in transmembrane vs. cytoplasmic domains may alter neurodegenerative and cognitive trajectories: Findings from the DIAN study
Authors: Schultz Stephanie A. , Schultz Aaron P. , Joseph‐Mathurin Nelly , McDade Eric , Klunk William E. , Fox Nick C. , Levin Johannes , Hassenstab Jason , Goate Alison M. , Hanseeuw Bernard J , Lee Jae‐Hong , Fitzpatrick Colleen D. , Jucker Mathias , Allegri Ricardo Francisco , Benzinger Tammie L.S. , Berman Sarah , Chui Helena C. , Cruchaga Carlos , Fagan Anne M. , Gordon Brian A. , Farlow Martin R. , Graff‐Radford Neill R. , Martins Ralph N. , Mori Hiroshi , Noble James , Perrin Richard J. , Salloway Stephen P. , Sanchez‐Valle Raquel , Schofield Peter R. , Levey Allan I. , Karch Celeste M. , Xiong Chengjie , Johnson Keith A. , Bateman Randall J. , Sperling Reisa A. , Chhatwal Jasmeer P. ,   DIAN
Published: February 2022

Background

Though pathogenic variations in PSEN1 leading to Autosomal Dominant Alzheimer's disease (ADAD) are all highly penetrant, there is substantial inter‐individual variability in the rates of cognitive decline and biomarker change observed in ADAD. We hypothesized that this inter‐individual variability may be associated with the location of the pathogenic variant within PSEN1. We tested this hypothesis using biomarker and cognitive data from the Dominantly Inherited Alzheimer Network (DIAN) observational study.

Method

PSEN1 pathogenic variant carriers [grouped based on whether their ADAD genotype affected transmembrane (PSEN1 TM; N = 125) or cytoplasmic (PSEN1 CY; N = 62) domains] and non‐carriers [NC; N = 176] enrolled in DIAN underwent clinical evaluation, multimodal neuroimaging, and lumbar puncture for collection of cerebrospinal fluid (CSF). Linear mixed effects models with a restricted cubic spline were used to determine cross‐sectional differences in clinical and biomarker measures between NC, PSEN1 TM, and PSEN1 CY groups, across the disease course (estimated years to symptom onset; EYO).

Result

Background characteristics are reported in Table 1. PSEN1 CY and PSEN1 TM groups had elevated β‐amyloid (PiB‐PET) and phosphorylated‐tau levels (CSF pTauT181) compared to NC, but these biomarker measures were not different between PSEN1 TM and CY groups (Figure 1a‐b). Additionally, the PSEN1 TM group had decreased glucose metabolism compared to NC but was similar to the PSEN1 CY group (Figure 1c). However, we observed that PSEN1 TM carriers had significantly smaller hippocampal volume, greater lateral ventricle volume, and greater cognitive impairment (Figure 1d‐f) across EYO as compared to PSEN1 CY carriers.

Conclusion

Despite similar β‐amyloid PET and CSF pTauT181 levels across EYO, individuals with pathogenic variants affecting transmembrane domains in PSEN1 may have more rapid progression of disease as measured by cognitive function and neurodegeneration as compared to those with variants affecting cytoplasmic domains. These results have implications both for understanding the heterogeneity in ongoing ADAD clinical trials and for better understanding the pathobiology of ADAD.
Radial peripapillary capillary network microvascular changes in Alzheimer's disease, mild cognitive impairment, and cognitively healthy controls
Authors: Robbins Cason B. , Grewal Dilraj S. , Soundararajan Srinath , Stinnett Sandra , Liu Andy , Johnson Kim , Fekrat Sharon
Published: February 2022

Background

The retinal and optic nerve head microvasculature may represent a non‐invasive, inexpensive biomarker for Alzheimer’s disease (AD) and mild cognitive impairment (MCI). In this study, we characterize microvascular changes at the optic nerve head (radial peripapillary capillary network) using optical coherence tomography angiography (OCTA).

Method

Optic nerve head‐centered OCTA images were obtained from 66 eyes of 36 patients with AD, 119 eyes of 63 patients with MCI, and 513 eyes of 265 cognitively healthy controls in a cross‐sectional study (NCT03233646) using Zeiss Cirrus HD‐5000 OCTA. Exclusion criteria included diabetes, uncontrolled hypertension, glaucoma, non‐AD dementia, and other optic nerve pathology. Two metrics of vessel perfusion were calculated in a 2.5mm‐wide annulus centered on the optic nerve head using Zeiss AngioPlex (Version 11.0.0.29946) – capillary perfusion density (CPD) and capillary flux index (CFI). CPD represents the percentage of perfused capillaries in a unit scan area; CFI is a unitless ratio of perfused capillaries in a unit scan area weighted by intensity of flow signal. Retinal nerve fiber layer (RNFL) thickness was measured using a peripapillary optic disc cube scan. Groups were compared using multivariable generalized estimating equations, controlling for age and sex as covariates.

Result

Average CPD was significantly greater in AD vs controls (0.446 ± 0.015 vs 0.439 ± 0.017, p = 0.001) and in MCI vs controls (0.443 ± 0.020 vs 0.439 ± 0.017, p = 0.007) but not AD vs MCI (p = 0.69). CFI and average RNFL thickness did not significantly differ among groups (all p > 0.05). Among all groups, average CPD differed significantly (p = 0.001), as did CPD in the nasal and inferior peripapillary quadrants (p < 0.001 and p = 0.001, respectively).

Conclusion

Peripapillary CPD is increased in eyes of patients with AD or MCI compared to cognitively healthy controls, despite similar RNFL thickness between these groups. This finding represents a novel biomarker and contrasts with macular microvascular changes, which show decreased vessel and perfusion density in AD and MCI compared to controls. Integration of optic nerve head OCTA in models using retinal imaging to diagnose AD and MCI may improve specificity; further investigation is necessary.
Attitudes towards screening for cognitive dysfunction: Interviews with Latinx adults with type 2 diabetes
Authors: Cuevas Heather E , Zuñiga Julie , Morgan Stephanie E , Ganucheau Grace E
Published: February 2022

Background

One in nine Latinx adults over 45 years old experience subjective cognitive decline (SCD). Yet less than half of people with SCD discuss symptoms with their provider (BRFSS, 2015‐2018). Because current diagnostic criteria focus on dementia, a later stage pathology, the window of opportunity for effective interventions may be missed. Cognitive screening can help identify pathology, and it can also assist in identifying those at risk for higher health care utilization. In qualitative interviews, Latinx adults with T2DM frequently avoided asking about cognitive problems or cognitive health due to stigma or discrimination (Cuevas & Zuñiga, 2020). The purpose of this project was to understand relevant factors affecting cognitive screening, which is critical for designing effective and timely interventions.

Method

Data was collected using semi‐structured interviews with Latinx adults with type 2 diabetes. General questions were asked regarding knowledge of cognitive screening, risks for cognitive dysfunction, and attitudes towards screening. Interviews were transcribed, entered into NVivo software, and analyzed using grounded theory techniques.

Result

Interviews ranged from 30 minutes to 1 hour. Participants (n= 30) were 53% Female; mean age: 66.4 years; Mean A1C: 9.7%; and 57% Mexican American. Participants who were younger and had higher levels of education were more likely to report comfort with cognitive screening. Inability to work related to a possible diagnosis of dementia was a concern related to screening for most participants. However, that was not a reason to decline screening. Participants (88%) wanted more information on how the results of screening tests would be used as well as information on how to maintain or improve “brain health.” Although not part of the interview guide 45% said they would prefer to see healthcare providers with similar ethnic backgrounds.

Conclusion

Overall, screening for cognitive dysfunction was well received by participants. Themes included some hesitancy to be screened but also a desire to know more about risks for dementia and how to maintain health. Given the encouraging results, a larger study further exploring these themes with Latinx adults and comparing them with provider and clinic factors affecting screening is being conducted.
Perceptions and attitudes of brain donation for Alzheimer’s disease research among older Latinos
Authors: Morlett Alejandra , Guareña‐Espinosa Lesley A , Gonzalez Hector M
Published: February 2022

Background

Alzheimer’s disease and related dementias (ADRD) continue to be highly debilitating, particularly among older Latinos. Latinos are 1.5x more likely to develop ADRD compared to Non‐Hispanic Whites. Even though Latinos comprise 18.5% of the US population, only 8% participate in ADRD research, which is a significant problem given the substantial public health burden of ADRD among this population. Specifically, there is a dearth of brain tissue currently available that is essential for confirming clinical ADRD diagnoses. The purpose of this abstract is to present preliminary findings on a study looking at the perceptions and attitudes related to brain donation (BD) among older Latinos.

Method

Semi‐structured phone interviews were conducted over the phone in English or Spanish. Questionnaires were administered to assess demographic characteristics, psychological acculturation, fatalism, and knowledge of aging‐related research relevant to AD. The interview was used to guide participants in the topic of BD and their willingness to BD. All interviews were audio‐recorded and transcribed.

Result

Participants included 40 community‐dwelling Latinos living in the US (Mean age: 59.4, SD=7.35). The majority of participants were female (67.5%) and had an average of 12.55 (SD=3.21) years of education. Most participants were born in Mexico (85%), 10% in the US, and 5% in another Latin American country. Preliminary findings from a subsample of transcripts and the interviewer’s notes indicate some initial but salient themes, including but not limited to 1) lack of information and awareness about BD; 2) key social and cultural factors influencing willingness to donate; and (3) Interviewees’ recommendations for engaging and increasing Latinos BD knowledge and study participation.

Conclusion

Better understanding attitudes and perceptions of BD for ADRD research can facilitate targeted culturally‐relevant approaches for increasing autopsy consent that will have a significant and enduring impact on eliminating critical barriers in ADRD for Latinos. Work generated from this study will be used to develop a survey instrument to assess dimensions of diverse Latino willingness to consent to BD research with the goal to increase Latino participation in BD studies that will help address the disparities that exist in this population.
Driving and dementia: An “emotionally‐charged” issue for people with dementia and their multidisciplinary healthcare providers
Authors: Naglie Gary , Stasiulis Elaine , Sandhu Harvir , Brookes Jahnel , Vrkljan Brenda , Mariano Claudia , Gelinas Isabelle , Byszewski Anna , Rapoport Mark ,   CCNA Driving Cessation Team Co‐Investigators and CCNA Study Group
Published: February 2022

Background

The decision to stop driving and the transition to non‐driving is emotional and challenging not only for people with dementia (PWD) and their family members, but also for healthcare providers (HCPs) of multiple disciplines. With the growing number of older drivers, including drivers with dementia, HCPs are being increasingly tasked with addressing driving cessation issues. However, research indicates that most HCPs lack the knowledge, skills and resources to support PWD and their families in this context, often resulting in their avoidance of this issue. Our objective was to explore HCPs’ perspectives on the content they deemed important to include in an e‐learning program being developed to educate HCPs about dementia and driving.

Method

In‐depth semi‐structured interviews were conducted with 22 HCPs, including six primary care physicians, three geriatricians, three geriatric psychiatrists, six nurse practitioners and four occupational therapists practicing in six Canadian provinces. Participants were asked to provide feedback on the proposed content outline of an e‐learning program. Data were examined using a qualitative thematic analysis approach.

Results

Participants emphasized the “emotionally‐charged” nature of driving cessation, which they identified as being extremely challenging for PWD, their families and for HCPs. The trauma and negative impact that driving cessation has on PWD also affects HCPs’ emotions and work stress, influencing how they navigate driving cessation with their patients/clients. Further contributing to some HCPs’ stress was a lack of knowledge and confidence about determining when drivers were unsafe to drive and how to support them through the transition to non‐driving. Protecting the therapeutic relationship was a primary concern for HCPs, which they managed by: 1) employing avoidance and referral practices; and 2) mitigating PWD’s and family members’ emotional responses via communication strategies (e.g. deep understanding, prepared scripts, early and on‐going discussions about driving).

Conclusion

Study results highlight the importance of addressing the inter‐related emotional aspects of driving cessation for both PWD and HCPs in educational programs directed to HCPs.
Neuroimaging and neuropathological findings in older adults with COVID‐19: A cognitive‐neuroscience systematic review to inform the long‐term impact of the virus on neurocognitive trajectories
Authors: Manca Riccardo , De Marco Matteo , Ince Paul , Venneri Annalena
Published: February 2022

Background

Infection due to Coronavirus Disease 2019 (COVID‐19) has been found to have detrimental effects on multiple body systems, especially in older adults. Acute neurological symptoms may be present and often associated with neural injuries. However, the long‐term consequences of COVID‐19 on neurocognitive functioning are still unknown. Therefore, this systematic review aims to summarise neuroimaging and neuropathological findings in patients with COVID‐19 aged ≥ 60 within a cognitive neuroscientific perspective, to clarify which brain areas may be more affected and the possible cognitive consequences.

Method

Two databases (PubMed and Web of Science) were searched to identify all relevant manuscripts published between 1st March 2020 and 14th September 2020. The papers were screened and selected for inclusion by two independent assessors. Additional relevant studies not detected by the literature search were added manually.

Result

A total of 74 studies were included. A wide variety of neural findings in older patients with COVID‐19 emerged from most studies, with a prominent role played by cerebrovascular damage. Structural and functional abnormalities were reported in all brain areas. The most consistent findings were observed in white matter, brainstem and fronto‐temporal areas. Moreover, viral DNA was also detected mainly in olfactory, orbitofrontal and brainstem areas.

Conclusion

The vast literature on the link between COVID‐19 and neural damage is currently limited to the description of hospitalised patients who either had a fatal outcome or severe symptoms. The damage observed in this population seems acute and largely irreversible, mainly in neural regions involved in major functional cognitive networks. It is currently unknown whether the long‐term impact of COVID‐19 will be limited to the chronic evolution of acute events or whether novel mechanisms will emerge. Future theoretical frameworks describing the long‐term impact of COVID‐19 infection on mental abilities will have to factor in major trends of aetiological and topographic heterogeneity.
Lessons learned on recruiting dyads for mild cognitive impairment clinical trials
Authors: Gibson Allison , Bardach Shoshana H , Pope Caitlin N , Rhodus Elizabeth K , Oaks Dawn C , Jicha Gregory A
Published: February 2022

Background

Previous research has shown that up to one‐third of patients diagnosed with mild cognitive impairment (MCI) demonstrate resistance to acceptance of the diagnosis, which may contribute to reduced engagement in clinical research activities including interventional trials.

Method

This study explored researchers’ experiences to recruit 18 dyads from a U.S. Alzheimer’s Research Center to participate in a nine‐month duration, pilot, platform trial of biopsychosocial interventions for persons with MCI and their study partner. Thirty‐nine individuals with MCI met the inclusion criteria for the study. The MCI‐study partner dyads were contacted by mail and phone solicitation for recruitment. Thematic analysis of recruitment case notes was used to track the number of telephone contacts, reasons for interest/disinterest in participation, and questions about the study.

Result

Whereas many participants with MCI were interested and willing to enroll (92.3%), frequently study partners were not willing to enroll (53.8%). Study partners primarily consisted of male spouses with a mean age of 67. Study partners reported reasons for disinterest including being unavailable to participate in research sessions (due to availability or geographical distance) and lack of knowledge on MCI or the benefit of research involvement. Further data on the characteristics of study partners in regards to their willingness to engage in research will be presented.

Conclusion

Recruiting persons with MCI and their study partners for clinical trials research may require specialized communication messaging and strategies for dyad engagement. Strategies should target study partners by promoting the opportunities and potential benefits of MCI clinical trials while considering challenges to involvement due to availability (e.g., weekend meetings, remote offerings, and attempting to lessen the burden of research engagement), rather than focusing recruitment efforts solely on the participant. Further studies exploring strategies to educate and engage study partners to enhance recruitment into MCI research is warranted.
Relationships between serum 25‐hydroxyvitamin D and homocysteine levels of patients with cognitive impairment in Parkinson’s disease under hypoxia environment
Authors: Zhu Aiqin , Liang YuHua
Published: February 2022

Background

Analyze relation between serum 25‐hydroxyvitamin D(25‐OH‐VitD), homocysteine(Hcy) , folic acid(FA)and Vitamin B12 levels of patients with cognitive impairment in Parkinson’s disease (PD) on the Qinghai‐Tibet Plateau.

Method

From July 2017 to December 2020, 200 PD patients (mean age 66.18±12.13years) of Han nationality in PD clinic of Qinghai Provincial People’s Hospital (mean altitude 2,261m) were collected. There were 88 PD with cognitive impairment (PD‐CI) and 112 PD with normal cognitive function (PD‐NC). All patients meet PD diagnostic criteria of British Brain Bank and cognitive diagnostic criteria of International Movement Disorder Association. Serum 25‐OH‐VitD, Hcy, FA and vitamin B12 were determined by chemiluminescence assay.

Result

1. Prevalence of PD in PDCI group over 70 years old (59.1%) and illiterate group(21.6%)were significantly higher than that in PDNC group (31.3% and 5.4%). 2.Compared with PDNC group, PD duration, ability of daily living(ADL) score, UPDRS total score and serum Hcy significantly increased in PDCI group, serum 25‐OH‐VitD, FA and VitB12 levels significantly decreased in PDCI group. 3.Multivariate logistic regression analysis showed that older age (OR=14.492, P<0.01), low education level(OR=4.631, P<0.05), long course of PD (OR=1.169, P<0.05), ADL disability(OR=1.062, P<0.05), high Hcy, low 25‐OH‐VitD, FA and VitB12 levels(OR=1.065, 0.817, 0.995, 0.927, P<0.05) were independently associated with PDCI group.

Conclusion

Aging, low education level, long, course of PD, ADL disability, hyperhomocysteinemic and VitD deficiency appears to be risk factors for PDCI under hypoxia environment.
Role of white matter alteration in the relationship between regional microbleeds and cognitive impairment in cerebral amyloid angiopathy
Authors: Jo Sungyang , Kim Hyung‐Ji , Lee Sun Ju , Lee Jae‐Hong
Published: February 2022

Background

Pathophysiology of cognitive decline in CAA is multifactorial, because microbleeds, white matter hyperintensities, and combined concomitant parenchymal Alzheimer’s disease (AD) pathology have been suggested to cause cognitive impairment. The mechanism by which microbleeds affect cognitive impairment is still under investigation. We aimed to investigate the mechanism of how microbleeds contribute to cognitive impairment, in association with white matter tract abnormalities or cortical thickness in CAA with significant amyloid deposition.

Method

We retrospectively investigated 30 patients with probable CAA according to Boston criteria and 30 patients with Alzheimer’s disease (AD), all of whom showed severe amyloid deposition on amyloid PET (Aβ+). Age, sex, and clinical deteriorating scale were matched. Using MRI, cortical thickness and white matter tract abnormalities as fractional anisotropy (FA) were obtained. We compared cortical thickness, FA, and cognitive scores of five domains between Aβ+ CAA and Aβ+ AD. Using path analysis, we investigated the correlation between number of regional microbleeds, cortical thickness, FA, and cognitive impairments.

Result

Both CAA and AD group showed similar cortical amyloid deposition in AD related regions such as precuneus, and posterior cingulate cortex suggesting that CAA in this study might have AD pathology. Patients with Aβ+ CAA presented with significantly lower FA in clusters of posterior area than patients with Aβ+ AD (FWE‐corrected p value <0.05) Importantly, total number of microbleeds were associated with decreased FA in tapetum of corpus callosum (r=‐0.429, p<0.001), which were consequently associated with visuospatial function (r=0.466, p<0.001). Cortical thickness was not significantly different between CAA and AD, and it did not mediate the association between regional microbleeds and cognition.

Conclusion

This study suggests that lobar microbleeds may impact cognitive decline through the mediation of white matter tract abnormalities in CAA.
Utility of total tau as a biomarker for Alzheimer’s disease among adults with Down syndrome
Authors: Petersen Melissa , Rafii Michael S. , Zhang Fan , Schupf Nicole , Hall James R. , O'Bryant Sid
Published: February 2022

Background

Blood based biomarkers have been continuously proposed as a mechanism for detecting Alzheimer’s disease (AD). Adults with Down syndrome (DS) are at high risk for AD due to triplication and overexpression of APP, the gene for beta amyloid located on Chromosome 21. This study aimed to further examine the utility for total tau in detecting AD among those with Down Syndrome (DS‐AD) and distinguish this diagnostic group from those with mild cognitive impairment (MCI‐DS) and/or cognitively stable (CS).

Method

Plasma samples were analyzed on n=305 DS participants (n=225 CS; n=44 MCI‐DS; n=36 DS‐AD) enrolled in the Alzheimer’s Biomarker Consortium‐ Down Syndrome (ABC‐DS). Assays were analyzed on the Simoa HD‐1 analyzer. Support vector machines analyses were conducted to examine the ability for total tau to distinguish among diagnostic classifications alone and in combination with demographic characteristics of age and gender.

Result

In distinguishing MCI‐DS from CS, total tau alone produced an AUC of 56% with a sensitivity (SN) of 0.05 and specificity (SP) of 1.00 using an optimized cut‐off score (‐0.788). When demographics of age and gender were included along with total tau, AUC increased to 83% (SN= 0.13, SP=1.00) with an optimized cut‐off score (‐0.933). When distinguishing DS‐AD from CS, total tau reached an AUC of 74% with an SN of 0.47 and SP of 0.94 with an optimized cut‐off score (‐0.819). When demographics were included, it increased the AUC to 0.94 (SN=0.86; SP=0.89) with an optimized cut‐off score (‐0.986). When applied to distinguish MCI‐DS from DS‐AD, total tau alone reached an AUC of 76% with a SN of 0.69 and SP of 0.80 using and optimized cut‐off score (0.194). With demographics, detection improved to an AUC of 81% (SN=0.86; SP=0.68) with optimized cut‐off score (0.141).

Conclusion

Total tau combined with demographics of age and gender was accurate in distinguishing across diagnostic classifications. The best discrimination between cognitive status was shown when total tau was applied to distinguish CS from DS‐AD cases. These findings support the potential use of total tau as a screening tool for clinical trials focused on DS‐AD as an alternative to more invasive neurodiagnostic modalities.