bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Heat Treatments on the Photocatalytic Activity of TiO2 Surfaces Produced by Direct Laser Interference Patterning
Authors: Fox Tobias , Bonner Fabian Kay , Pauly Christoph , Kickelbick Guido , Mücklich Frank
Published: January 2025

Direct laser interference patterning (DLIP) has in previous work shown to be an effective tool for producing photocatalytic surfaces in a single relatively simple processing step. These surfaces can be interesting candidates for antifouling or self‐cleaning surfaces, as well as substrates for photocatalytic water treatment. In this contribution, various heat treatments are performed both during and after the laser processing to create surfaces with even higher photocatalytic activities and to better understand the formation of various process oxides and their effect on the resulting activity. The photocatalytic activity of the samples is measured by methylene blue degradation and correlated to their chemical composition and morphology. Furthermore, a small prototype is built using low‐cost materials to prove the scalability of the approach.
Pump‐Probe Imaging of Ultrafast Laser Percussion Drilling of Glass in Single Pulse, MHz‐ and GHz‐Burst Regimes
Authors: Balage Pierre , Guilberteau Théo , Lafargue Manon , Bonamis Guillaume , Hönninger Clemens , Lopez John , Manek‐Hönninger Inka
Published: January 2025

A pump‐probe shadowgraphy study of femtosecond laser percussion drilling on glass samples is reported applying three different operating regimes, which are the standard repetitive single pulse, the MHz‐ and the GHz‐burst modes. The comparison of pump‐probe imaging in the MHz‐burst and the GHz‐burst regimes is demonstrated for the first time to the best of knowledge. Synchronizing a single pulse probe with a pump operating in a burst regime constitutes a real novelty in femtosecond laser micromachining studies. By this means, a better understanding of the drilling process dynamics of the two burst regimes is provided and reveals the differences between these regimes. Especially, the process of through via drillings of different hole depths in the GHz‐burst regime is investigated in sodalime glass. The results of the pump‐probe shadowgraphy show that the ablation plume in the GHz‐burst regime has an essential role in the drilling process as it stops as soon as the plume escapes from the through hole explaining the final hole morphology observed for deep through via drillings.
The Role of Post‐Sintering Heat Treatment on the Phase and Microstructural Development of Nano Cu‐Zno Modified Ceramic Surfaces
Authors: Calis Acikbas Nurcan , Acikbas Gokhan
Published: January 2025

The study examines the effect of heat treatment duration on microstructure and phase evolution concerning Cu content in nano ZnO‐Cu‐modified ceramic glazes. The thermal behavior of the nano Cu‐ZnO added glazes is investigated using heat microscopy and TG/DTA techniques to ascertain the appropriate firing and heat treatment temperature. Glazed tiles are sintered at 1210 °C for 10 min and heat treated at 965 °C for 2, 8, and 32 h. The surfaces are investigated with scanning electron microscopy and X‐ray diffractometer. The evolution of phase and microstructure exhibits variations between sintered and heat‐treated surfaces, dependent upon the concentration of Cu doping and heat treatment duration. The most important evidence is adding Cu into the ZnO‐modified glaze leads to a stacked micro‐nanostructure formation. The results show that while the willemite phase is dominant on the sintered surfaces, the size and quantity of fine plagioclase crystals increased with heat treatment and prolonged heat treatment time. The heat treatment period, depending on copper content, affects microstructure and phase development.
Droplet Microarrays for Miniaturized and High‐Throughput Experiments: Progress and Prospectives
Authors: Kartsev D.D. , Joaquin E Urrutia Gómez , Anna Popova A. , Levkin Pavel A.
Published: January 2025

Miniaturization in life sciences and chemical sciences offers substantial advantages to experimental workflows, such as increased throughput, reduced costs, and lower environmental impact. While microtiter plates are effective, further miniaturization is necessary to enhance efficiency and throughput. However, microtiter plates cannot be easily miniaturized to volumes below 5 µL, primarily because adhesive and capillary forces become stronger than the gravitational forces needed to confine the liquid within the wells. To overcome this, the droplet microarray (DMA) is developed, utilizing patterned adhesive regions on a liquid‐repellent background to immobilize and confine sub‐microliter droplets without physical barriers. This unique format enables novel applications such as droplet merging and parallel ultra‐high‐throughput manipulations. This review provides an overview of DMA's diverse applications and highlights the new experimental opportunities it offers, establishing it as a versatile tool for highly miniaturized, high‐throughput biological and chemical experiments. The evolving requirements and future applications of the DMA approach are also discussed.
Preparation of Mesoporous Cu2O Nanospheres for Green Synthesis in the Enantioselective Boron Conjugate Addition of α,β‐Unsaturated Chiral Compounds in Aqueous Phase
Authors: Zhao Xuhong , Ma Lian , Wang Meng , Li Weishuang , Zhang Yaoyao , Li Bojie , Fang Zhongpu , Xiong Bo , Zhu Lei
Published: January 2025

Chiral organoboron compounds are essential intermediates in various significant reactions. However, there are still few efficient catalysts for their synthesis. This paper reports a novel catalytic material for chiral asymmetric boron conjugate addition reactions: mesoporous Cu2O nanospheres (M−Cu2O). M−Cu2O is approximately 0.55 μm, exhibiting dense and uniformly distributed worm‐like pores. It features a specific surface area of 15.7 m2/g and an average pore size of 14.3 nm. Under the conditions of Toluene:H2O=9:1, with a chiral ligand amount of 3.6 mol% and no additional base, it achieves a high yield (98% yield) and impressive enantioselectivity (99% ee) for the template substrate chalcone using only 3.0 mol% of the catalyst. Notably, the catalyst can be easily recovered and maintains robust catalytic performance after seven cycles, yielding 92% and an ee value of 90%. This work presents a mild and effective method for synthesizing chiral boron compounds in an aqueous phase, significantly enhancing the application potential of mesoporous copper oxide nanospheres.
Nano‐Porous Melt‐Blown Poly(Lactic Acid) Fiber Mat Air Filters for High Efficiency Particulate Capture
Authors: Kalani Sahar , Jubinville Dylan , Mekonnen Tizazu H.
Published: January 2025

This study introduces a two‐step technique for developing nano‐porous, compostable melt‐blown nonwovens with high porosity, specifically engineered for high‐performance particulate capture in air filter applications. The first step entails creating a high melt flow index material by melt‐blending low‐viscosity polylactic acid (PLA) with a sacrificial additive, polyethylene glycol (PEG), of varying molecular weights. Rheological, compatibility, and thermal analyses are conducted on the sample blends. The MFI of the resulting blends ranges from 56 g/10 min (baseline PLA) to 238 g/10 min (PLA/PEG 400–10%), confirming their suitability for the melt‐blowing process. These blends are then formed into nonwoven mats using a twin‐screw extruder, producing microfibers with diameters between 1.05 and 2.64 µm. The second step involves boiling water etching to remove PEG, creating nanopores within the fibers. This etching process leaves a network of nanopores (50–200 nm in size), distributed throughout the microfiber structure. The PLA/PEG 2000 sample exhibits optimal properties, achieving ≈72% particulate capture efficiency for 0.3 µm NaCl particulates during air filtration testing. This study represents an innovative and eco‐friendly approach for creating nano‐porous nonwoven mats with potential applications in air filtration, water filtration, and battery separators, where high porosity is beneficial.
Directed Inward Migration of S‐Vacancy in Bi2S3 QDs for Selective Photocatalytic CO2 to CH3OH
Authors: Wang Jing , Wang Wenlei , Deng Yao , Zhang Zhen , Wang Hui , Wu Yiqiang
Published: January 2025

The directional migration of S‐vacancy is beneficial to the separation of photogenerated carriers and the transition of electrons in semiconductors. In this study, Bix/Bi2−xSy@carboxylic‐cellulose (CC) photocatalyst with bionic chloroplast structure is obtained by electron beam irradiation to induce S‐vacancy in Bi2S3@CC. The results of CO2 photoreduction experiments demonstrate that the reduction rate of CO2 to CH3OH by Bix/Bi2‒xS2.89@CC‐450 samples is 10.74 µmol·g−1·h−1, and the selectivity is 92.82%. The results show that the inward migration behavior of the borderline S‐vacancy (b‐Sv) induces the redistribution of electrons in Bix/Bi2−xSy@CC. The Bi° clusters in Bix/Bi2−xSy@CC is conducive to adsorb CO2, and the internal S‐vacancy (i‐Sv) is conducive to adsorb CH3OH, which accelerate the transfer of gas‐phase products to realize the controllable conversion of CO2 and photoreduction products at the gas–liquid–solid three‐phase interface. This study provides a new idea for the development and utilization of green photocatalysts in clean energy.
Primary Cilia Formation Mediated by Hsa_Circ_0005185/OTUB1/RAB8A Complex Inhibits Prostate Cancer Progression by Suppressing Hedgehog Signaling Pathway
Authors: Fan Aoyu , Zhang Yunyan , Li Yunpeng , Meng Wei , Wu Fan , Pan Wei , Ma Zhongliang , Chen Wei
Published: January 2025

Prostate cancer (PCa) is one of the most common malignancies for male individuals globally. Androgen deprivation therapy (ADT) initially demonstrated significant efficacy in treating PCa; however, most cases of PCa eventually progress to castration‐resistant prostate cancer (CRPC), which becomes increasingly challenging to manage. Notably, the loss or disruption of primary cilia in PCa cells may play a critical role in the progression of the disease, and there are no reports on the role of circular RNAs in ciliogenesis. Thus, this warrants further investigation.In this study, key circular RNAs linked to prostate cancer progression, and enzalutamide resistance is identified. Specifically, it is found that hsa_circ_0005185 interacts with OTUB1 and RAB8A, serving as a molecular scaffold. Hsa_circ_0005185 mediates the binding of the deubiquitinase OTUB1 to RAB8A, resulting in the deubiquitination of RAB8A. Consequently, the stable expression of RAB8A promotes the regeneration of primary cilia and enhances the production of GLI3R, an inhibitory factor in the Hedgehog signaling pathway, thereby suppressing AR activity and slowing the progression of CRPC.
Metal‐Catalyzed Abiotic Cleavage of C═C Bonds for Effective Fluorescence Imaging of Cu(II) and Fe(III) in Living Systems
Authors: Wang Chunfei , Chen Dandan , Wei Zixiang , Tan Jingyun , Wu Changfeng , Zhang Xuanjun
Published: January 2025

Imaging abnormal copper/iron with effective fluorescent tools is essential to comprehensively put insight into many pathological events. However, conventional coordination‐based detection is mired in the fluorescence quenching induced by paramagnetic Cu(II)/Fe(III). Moreover, the strong chelating property of the probe will consume dissociative metal ions and inevitably interfere with the physiological microenvironment. Here, a new strategy is developed by employing this aberrant Cu(II)/Fe(III) to catalyze bond cleavage for fluorescent imaging of them. A short series of near‐infrared fluorescent molecules (NIRB1−NIRB6) is devised as substrates, wherein the specific C═C bonds can be effectively cleaved to activate red fluorophore by Cu(II)/Fe(III) catalyzing. Representatively, NIRB1 is applied for fluorescent imaging of Cu(II)/Fe(III) in living cells, zebrafish, and Alzheimer's disease (AD)‐afflicted mouse brains which is of significance to monitor metal safety. The successful cleavage of C═C bonds catalyzed by Cu(II)/Fe(III) enriches the application of abiotic bond cleavage reactions in metal detection, and may also inspire the development of fluorescent tools for the future diagnosis and therapy of diseases.
Lattice Oxygen Redox Dynamics in Zeolite‐Encapsulated CsPbBr3 Perovskite OER Electrocatalysts
Authors: Ren Xiangrong , Zhai Yiyue , Yang Na , Wang Bolun , Liu Shengzhong (Frank)
Published: January 2025

Understanding the oxygen evolution reaction (OER) mechanism is pivotal for improving the overall efficiency of water electrolysis. Despite methylammonium lead halide perovskites (MAPbX3) have shown promising OER performance due to their soft‐lattice nature that allows lattice‐oxygen oxidation of active α‐PbO2 layer surface, the role of A‐site MA or X‐site elements in the electrochemical reconstruction and OER mechanisms has yet to be explored. Here, it is demonstrated that the OER mechanism of perovskite@zeolite composites is intrinsically dominated by the A‐site group of lead‐halide perovskites, while the type of X‐site halogen is crucial for the reconstruction kinetics of the composites. Using CsPbBrxI3‐x@AlPO‐5 (x = 0, 1, 2, 3) as a model OER catalyst, it is found that the CsPbBr3@AlPO‐5 behaves oxygen‐intercalation pseudocapacitance during surface restructuring due to absence of halogen‐ion migration and phase separation in the CsPbBr3, achieving a larger diffusion rate of OH− within the core‐shell structure. Moreover, distinct from the single‐metal‐site mechanism of MAPbBr3@AlPO‐5, experimental and theoretical investigations reveal that the soft lattice nature of CsPbBr3 triggers the oxygen‐vacancy‐site mechanism via the CsPbBr3/α‐PbO2 interface, resulting in excellent OER performance. Owing to the variety and easy tailoring of lead‐halide perovskite compositions, these findings pave a way for the development of novel perovskite@zeolite type catalysts for efficient oxygen electrocatalysis.
Optimized K+ Deposition Dynamics via Potassiphilic Porous Interconnected Mediators Coordinated by Single‐Atom Iron for Dendrite‐Free Potassium Metal Batteries
Authors: Lin Tzu‐Chi , Yang Yi‐Chun , Tuan Hsing‐Yu
Published: January 2025

Potassium metal batteries are emerging as a promising high‐energy density storage solution, valued for their cost‐effectiveness and low electrochemical potential. However, understanding the role of potassiphilic sites in nucleation and growth remains challenging. This study introduces a single‐atom iron, coordinated by nitrogen atoms in a 3D hierarchical porous carbon fiber (Fe─N‐PCF), which enhances ion and electron transport, improves nucleation and diffusion kinetics, and reduces energy barriers for potassium deposition. Molten potassium infusion experiments confirm the Fe─N‐PCF's strong potassiphilic properties, accelerating adsorption kinetics and improving potassium deposition performance. According to the Scharifker‐Hills model, traditional carbon fiber substrates without potassiphilic sites cause 3D instantaneous nucleation, leading to dendritic growth. In contrast, the integration of single‐atom and hierarchical porosity promotes uniform 3D progressive nucleation, leading to dense metal deposition, as confirmed by dimensionless i2/imax2 versus t/tmax plots and real‐time in situ optical microscopy. Consequently, in situ X‐ray diffraction demonstrated stable potassium cycling for over 1900 h, while the Fe─N‐PCF@K||PTCDA full cell retained 69.7% of its capacity after 2000 cycles (72 mAh g−1), with a low voltage hysteresis of 0.876 V, confirming its strong potential for high energy density and extended cycle life, paving the way for future advancements in energy storage technology.
Antiferroelectric Order in Nematic Liquids: Flexoelectricity Versus Electrostatics
Authors: Medle Rupnik Peter , Hanžel Ema , Lovšin Matija , Osterman Natan , Gibb Calum Jordan , Mandle Richard J. , Sebastián Nerea , Mertelj Alenka
Published: January 2025

The recent discovery of ferroelectric nematic liquid crystalline phases marks a major breakthrough in soft matter research. An intermediate phase, often observed between the nonpolar and the ferroelectric nematic phase, shows a distinct antiferroelectric response to electric fields. However, its structure and formation mechanisms remain debated, with flexoelectric and electrostatics effects proposed as competing mechanisms. By controlling the magnitude of electrostatic forces through ion addition in two representative ferroelectric nematic materials, it is shown that the primary mechanism for the emergence of antiferroelectric order is the flexoelectric coupling between electric polarization and splay deformation of the nematic director. The addition of ions significantly expands the temperature range over which the antiferroelectric phase is observed, with this range increasing with increasing ion concentration. Polarizing optical microscopy studies and second harmonic generation (SHG) microscopy reveal the splayed structure modulated in 2D, while SHG interferometry confirms its antiferroelectric character. The model previously used to describe pretransitional behavior is extended by incorporating the electrostatic contribution of ions. The model shows qualitative agreement with the experiments, accurately reproducing the phase diagram and temperature‐dependent evolution of the modulation period of the observed structure.
Photocatalytic Reforming Raw Plastic in Seawater by Atomically‐Engineered GeS/ZnIn2S4
Authors: Talebian‐Kiakalaieh Amin , Li Haobo , Guo Meijun , Hashem Elhussein M. , Xia Bingquan , Ran Jingrun , Qiao Shi‐Zhang
Published: January 2025

The escalating crisis of oceanic plastic pollution demands innovative and effective strategies for resolution. Photocatalysis offers a sustainable, green, and energy‐efficient approach for the upcycling of plastic waste into fuels and value‐added chemicals. In this study, an atomically engineered GeS NS/ZnIn₂S₄ photocatalyst is employed to directly transform raw polyethylene terephthalate (PET), a ubiquitous plastic, into a variety of organic chemicals (13 917 µmol g⁻¹) using Earth's most abundant resources: sunlight, seawater, and air. Advanced ex situ and in situ characterization analyses reveal that sulfur vacancies (Vs) and electrolyte‐assisted polarization effect of seawater play crucial roles in trapping photogenerated electrons and accelerating charge carrier separation, respectively. These effects significantly enhance photocatalytic plastic upcycling efficiency and improve oxidative organic reactions. This research introduces a methodology that accounts for real‐world conditions in photocatalytic plastic upcycling, utilizing abundant natural resources and paving the way for further exploration in this area.
Phenotypic Expansion: Fetus With Cole‐Carpenter Type 2 Presenting With Novel Neonatal Lethal Skeletal Dysplasia
Authors: Burrill Natalie , Teefey Christina Paidas , Wright Renee , Huynh Minh‐Huy , Schindewolf Erica , Pilchman Lisa , Crane Haley , Noyes Amanda G. , Roman Amanda , Gulersen Moti , Moldenhauer Julie S.
Published: January 2025

We report a 28‐year‐old G2P0 at 24 weeks 5 days who presented for evaluation secondary to suspected skeletal dysplasia in her fetus. Fetal ultrasound imaging demonstrated foreshortened long bones by 9–10 weeks, multiple bowing deformities and fractures, 11 foreshortened paired ribs with fractures, decreased skull mineralization, frontal bossing, enlarged cavum septum pellucidi, and severe fetal growth restriction (< 2%). Findings were concerning for life limiting condition with thoracic circumference < 2.5%, femur length/abdominal circumference ratio of 0.13, and the thoracic circumference/abdominal circumference ratio of 0.77 and a palliative care path was pursued. Exome sequencing through chorionic villus sampling revealed two variants SEC24D, a maternally inherited likely pathogenic variant at c.3031_3040delinsC, and a variant of uncertain significance (VUS) at c.2676 + 5del. These variants, along with the clinical overlap in the fetus were likely causative of a diagnosis of Cole‐carpenter syndrome type 2 (CLCRP2). Most publications of CLCRP2 report a fairly favorable prognosis. Concern for life limiting prenatal presentation has not been reported. We report a case of CLCRP2 that phenocopies perinatally lethal type OI and that resulted in early neonatal demise from respiratory compromise.
Manubriosternal Morphology of Anthropoid Primates
Authors: Middleton Emily R. , Alwell Morgan T. , Ward Carol V.
Published: January 2025

Objectives

The purpose of this paper is to examine the proportions of the manubrium and sternebrae across anthropoid primates to explore variation hypothesized to be related to thoracic shape and locomotor specialization, and to determine whether the sternoclavicular joint orientation in hominoids reflects hypothesized differences in shoulder joint positioning relative to the thorax.

Materials and Methods

Metric data and sternoclavicular joint orientation data were collected from calibrated photographs of manubria and sternebrae from a large sample (n = 244) of extant anthropoid primates, as well as a small sample of fossil taxa. Manubriosternal and rib cage metric data were also collected from CT scans of an additional 52 extant anthropoid torsos. The data were analyzed using descriptive statistics, regression analyses, and linear correlations.

Results

Manubriosternal morphology varies among anthropoids and appears to track thoracic shape and positional repertoire. Hominoids tend to have broader manubria and sterna than monkeys. Ekembo and Equatorius appear to most closely resemble colobines and Alouatta in sternebral shape, suggesting a thorax most similar to these taxa. Neandertals and early anatomically modern humans are most similar to humans, providing no evidence for a relatively broad rib cage. Sternoclavicular joint orientation also differs among hominoids, with all hominoids having more cranially inclined joint surfaces than humans. The human‐like value observed for Australopithecus sediba supports the hypothesis that the clavicle in this species was not inclined laterally in resting posture.

Conclusions

Given the correlation between manubriosternal breadths and thoracic form across anthropoids, this study suggests that manubriosterna may provide useful information for interpreting skeletal form and positional repertoires in fossil anthropoids.
Psychosis in Alzheimer’s Disease
Authors: Ballard Clive G
Published: January 2025

Psychosis is a common and distressing disorder in people with Alzheimer disease, associated with a poor clinical prognosis, an increased risk of institutionalization and for which there are no approved treatments. New approaches to diagnosis and symptom assessment and treatment are beginning to move the field forward, including the emergence of psychosis at the pre‐clinical or even pre‐cognitive impairment stages of disease in some individuals. The Alzheimer’s Association International Society to Advance Alzheimer’s Research and Treatment (ISTAART) research criteria for psychosis in neurodegenerative disease, and the ISTAART criteria for mild behavioural impairment are examples of recent developments. New genomic, neuroimaging, post‐mortem and neurobiology studies are beginning to refine our mechanistic understanding and providing novel opportunities for drug discovery, drug repurposing and potentially for better approaches to precision medicine. Emerging potential therapies include the 5HT2A inverse agonist pimavanserin, which is already licensed in the US for the treatment of Parkinson’s disease, escitalopram, muscarinic agonists and cannabidiol. Emerging data also highlight opportunities to optimize and develop more targeted psychological therapies for people with Alzheimer’s disease psychosis. The treatment of psychosis also remains a major challenge in synuclein dementias where psychosis is more frequent and more persistent, and where many patients experience severe sensitivity reactions to antipsychotic medications. There is very little work examining the mechanisms or treatment of psychosis in people with vascular dementia, which remains a major unmet need. Although the assessment and management of psychosis in people with dementia remain challenging, improved diagnosis, evolving mechanistic understanding and an increased focus on new treatment studies are providing direction and new opportunities to the field and to people with Alzheimer’s disease.
Surrogate endpoints ‐ clinical and analytical considerations for maximal utility in trial design, drug development and regulatory decision making
Authors: Molenberghs Geert
Published: January 2025

An overview is given of surrogate marker evaluation, starting from the original definition of Prentice and his criteria, the estimation framework of Freedman, the meta‐analytic framework, and the evaluation of surrogate endpoints from a causal inference point of view.

Attention will be given, in particular, to evaluating tau‐PET as a reasonably likely surrogate in Alzheimer’s Disease. A meta‐analytic surrogate marker evaluation approach will be followed, for a continuous surrogate and a continuous true endpoint. Provisions are made to use both clinical trial data as well as natural history (real world) data. The statistical analysis consists of two steps: (1) a federated step where every site analyzes its own data, according to this protocol and the software provided; (2) a central step where the data hub processes the model outputs from the first step. The federated data analysis is a framework. As such, it can be applied based on a variety of choices made. Such choices pertain to patient population (e.g., early versus later stage), cognitive scale used (or, alternatively, sub‐scale or custom‐made item set), and particular tau PET measurement used (e.g., with variation over region of interest). A number of possible extensions are discussed too, as well as a single‐trial evaluation method to complement the federated meta‐analysis.
Empowering Patient Choice: The Essential Need for a Voluntary Advance Directive Framework in Healthcare
Authors: Frilling Stephanie
Published: January 2025

Background

A Medicare Voluntary Advance Directive Framework (Framework) would enable the creation, storage, and sharing of advance directive documents, ensuring end‐of‐life care appropriately honors the individual and their care wishes, while supporting healthcare teams and family members in making care decisions for their patients and loved ones.

With Medicare enrollment reaching over 65 million beneficiaries in 2023, and Alzheimer’s becoming one of the most expensive conditions ‐ CMS policy makers have a growing responsibility to improve care quality at end‐of‐life.

Method

The federal government will be called upon to assist providers in navigating documents and legal variations of approved forms of directives among the different states, and in ensuring privacy standards that keep an individual’s health data secure. Successful and secure data management at the federal level will be essential to achieving nationwide efficacy in furnishing advance care based upon an individual’s directive.

Result

The lack of a centralized registry for advance directives is particularly felt in underserved and marginalized communities, where access to reliable health care information management is often limited. Our Framework addresses this void by offering a dedicated data and document repository. It would serve as a beacon of health equity, meticulously recording and protecting individual health care directives and bridging the availability gap in regions plagued by health disparities. By assuring that advance directives are swiftly accessible and seamlessly incorporated into healthcare delivery, Medicare will improve quality of care and satisfaction for beneficiaries and uphold the dignity of personal health care decisions across all demographics. As a vital element of the health care system, a registry would ensure that all individual’s care preferences are known and honored, facilitating a more consistent and respectful patient experience.

Conclusion

Our poster/presentation identifies challenges associated with managing advanced directives for dementia and Alzheimer’s patients. Federal programs have a responsibility to ensure quality care and appropriate spending. Our work considers public policies and analyze spending for patient who have an advance directive and those that who do not across the health care continuum.
Understanding dementia aetiology in Uganda
Authors: Prynn Josephine E , Mugisha Joseph , Steves Claire J , Peto Tunde , Kimono Beatrice , Prince Martin J
Published: January 2025

Background

The prevalence of dementia in low‐ and middle‐income countries is increasing, yet epidemiological data from African populations remains scarce. Crucial risk factors differ in Africa from more intensively studied global areas, including a high burden of cerebrovascular disease (evidenced by high stroke incidence) and HIV, but lower rates of other risk factors such as physical inactivity. In the pre‐antiretroviral therapy era, dementia was a common consequence of HIV infection. However, it is not clear from existing literature what effect, if any, chronic and well‐controlled HIV has on cognition with ageing.

Understanding dementia aetiology in African settings has been limited by the expensive and invasive nature of biomarker testing. This study leverages developments in biomarker technology to examine the drivers of dementia in older Ugandans. This includes using blood‐based biomarkers for Alzheimer’s disease and retinal imaging with automated analysis of vascular morphology as a proxy for cerebrovascular disease.

Among older adults in a Ugandan population, this study will evaluate the prevalence of dementia, establish the pathological processes underlying dementia to inform risk reduction strategies, and examine the impact of dementia on individuals and their caregivers.

Methods

The study is nested within the existing General Population Cohort (GPC) run by the Medical Research Council /Uganda Virus Research Institute (MRC/UVRI) & London School of Hygiene and Tropical Medicine (LSHTM) Research Unit and includes all adults over 60.

In Step 1, cohort participants will undergo cognitive screening. Based on screening scores, a subgroup will undergo cognitive assessments using tools developed by the 10/66 Dementia Research Group to determine dementia diagnoses.

Step 2 is a case control study of people with and without dementia using antecedent data, questionnaires, physical assessment, retinal imaging, and Alzheimer’s blood‐based biomarkers. We will also compare disability, frailty, quality of life, and social engagement in people with and without dementia.

Results

We will identify the prevalence of dementia, odds ratios, and population attributable fractions for both modifiable risk factors for dementia and the pathological processes of Alzheimer’s pathology and cerebrovascular disease.

Conclusions

This will be first study in Africa to examine pathological processes leading to dementia including markers of Alzheimer’s and cerebrovascular disease.
Nursing home staff experiences with providing dementia care
Authors: Wong Carin M. , Como Dominique H. , Lekovitch Cara A. , Chew Felicia M , Kuziak Cindy , Leland Natalie E
Published: January 2025

Background

Caring for nursing home residents with dementia can be challenging. Staff who work in nursing homes tend to have high staff turnover. In order to help with staff retention, there needs to be an understanding of the job role. There is limited research examining staff experiences providing nursing home dementia care. Prior research has largely focused on the negative experiences of staff, such as difficulty managing residents’ behaviors, staff burnout, and staff stress, instead of positive experiences. It is important to understand the collective staff experience (i.e., both positive and negative experiences) in delivering dementia care, which can inform the development of job descriptions and hiring of nursing home staff who are a good fit.

Methods

This qualitative study was embedded within a pragmatic clinical trial. Participants were interviewed to gather staff perspectives on two approaches to dementia care training (team‐ and problem‐based). Interviews were conducted with 327 staff members representing a range of job roles. A rapid qualitative analysis approach was used to analyze the interviews. During the analysis, staff experiences in providing dementia care were consistently described. A thematic analysis approach was used to further analyze the data describing positive and negative experiences providing dementia care.

Results

Staff described experiencing both positives and negatives caring for residents with dementia. Positive experiences included three themes: the inter‐personal relationship with residents (e.g., learning about residents’ likes, dislikes, history), the emotional experiences from providing care (e.g., having a sense of purpose), and the cognitive demands of the job (e.g., using different strategies to distract residents). Challenges included two themes: the physical and cognitive demands of the job (e.g., not being able to manage residents’ behaviors) and the emotional impact on staff (e.g., affecting staff mental health).

Conclusions

Nursing home staff report positive and negative experiences while providing care to people with dementia. In order to ensure appropriate staff are being hired, nursing home administrators and hiring personnel should highlight the positives and describe the potential negative experiences that staff may have in caring for residents with dementia.
Development of Patient Resource for Lecanemab APOE Genetic Testing
Authors: Klee Victoria , Dratch Laynie , Fong Jamie C , Freeman Abigail A , Rumbaugh Malia C.
Published: January 2025

Current joint practice guidelines (PG) on genetic counseling and testing for Alzheimer’s disease (AD), published in 2011 by the National Society of Genetic Counselors (NSGC) and American College of Medical Genetics), recommend against clinical APOE genetic testing. These recommendations were largely followed, as seen in a survey of AD Research Centers in 2019 where only 7% of centers reported disclosure of APOE to research participants.

However, because the risk of amyloid related imaging abnormalities (ARIA) associated with anti‐amyloid therapy is increased for those with one or two copies of APOE e4, the FDA now endorses APOE testing for those considering this treatment. The current PG states that APOE testing should only occur within the context of genetic counseling. Because AD is a common disease, it is not feasible for genetic counselors to see every patient with MCI or early‐stage AD considering anti‐amyloid therapy. APOE testing is complex, with implications not only for the patient, but for their family members. This has created a need for patient‐facing educational materials and revised clinical guidelines, including when to refer for genetic counseling.

The NSGC Dementia Workgroup has received approval to formally update the current PG. Meanwhile, we recognize the urgent need for patient‐facing materials. We therefore developed a factsheet on APOE testing for lecanemab to be used by any provider prescribing the therapy. It has been reviewed by stakeholder and professional groups to optimize utility. Additional multimedia resources are in development.

Although there is a spotlight on APOE given the advances in anti‐amyloid therapeutics, the genetic landscape of AD is much more complicated and evolving. The future of genetic testing for AD includes broader dementia panel testing, exome and genome sequencing, proteomic testing for APOE and polygenic risk scores. Furthermore, APOE testing will likely expand to asymptomatic individuals for risk stratification and research participation. These new directions will increase the need for patient education and additional updates to the PG, as well as appropriate triage to maximize benefits from limited genetic counseling resources.
Current evidence and prevalence of dementia care in East Africa‐Uganda a systematic review
Authors: Moses Waiswa , Simon Wandera , Melinda Namuli , Davidson Kalsonid
Published: January 2025

Background

Uganda has an increasing population of older persons who require special attention to reduce the burden of dementia. With the growing prevalence of dementia worldwide, two third of the people with dementia are projected to be from the de‐eloping countries by 2050. Few studies have been conducted on the prevalence of dementia and its association with central nervous system (CNS) infections among older persons in African settings, particularly in Uganda.

Methods

The study was conducted in March 2022 among 434 older persons aged 50 and above years who were selected by multistage sampling. Data were collected using an inter‐viewer administered questionnaire supplemented with information from participant’s medical records and a brief community screening instrument for dementia. The instrument classifies dementia into unlikely, probable or possible dementia. Data were entered in duplicate into EpiData version 3.0, then transferred to statistical package for social sciences (SPSS) version 23 for statistical analysis.

Results

Our study found almost one in four (23%) of the older persons in tororo district eastern part of Uganda were suffering from probable or possible dementia. Our study further found that older persons with a positive history of central nervous system infections (CNS) had nearly five times higher odds of having probable or possible dementia compared to their counterparts (cOR: 4,5: 2.76‐7.23; p< 0.001). Being in advanced age of 70+ years (aOR: 2.6; 5:4; 1.4 ‐20.5; p = 0.013), and chronic headache (aOR: 1.9; 1.1‐3.1:p = 0.019) were independent predictors of probable or possible dementia among participants in the study.

Conclusion

This study highlights dementia as a growing public health issue in the African settings, in Uganda with over 1243 individuals affected in 2021. The findings emphasize the urgent need for investment in research and specialized services for older adults, particularly those with dementia.
The impact of constipation management on the quality of life of Alzheimer’s patients
Authors: Sushko Viacheslav Viktorovich , Sushko Viktor Vasilievich
Published: January 2025

Background

Patients with Alzheimer’s disease due to the peculiarities of this disease do not report constipation.

Method

In a study of 11 women with Alzheimer’s disease, aged 70‐75 years, we found that all of them had a tendency towards constipation. We divided the patients into two groups: a control group of 6 women who received help when they complained of constipation symptoms and an experimental group of 5 female patients who were routinely assessed by caregivers on their fecal status using the Bristol Scale. Through a combination of diet, physical exercises, and medication, we were able to maintain the type of feces in the experimental group at a level of 3‐5 on the Bristol Scale. The Neuropsychiatric Inventory Questionnaire (NPI‐Q) was filled out by nursing staff under medical supervision every month, and both groups of patients completed a monthly Quality of Life Scale.

Result

After 3 months, we found that the patients in the control group did not seek help in a timely manner, despite receiving instructions. In contrast, the experimental group showed improvements in sleep, mood, and social communication. The NPI‐Q results showed that sleep normalized in the experimental group within 3‐4 weeks, with no early awakenings, difficulty falling asleep, or daytime sleep observed until the end of the study. Additionally, after 4‐5 weeks, the mood of these patients improved, and they showed less anxiety. They also became more cooperative and willing to help with their own care. In contrast, the control group experienced periodic anxiety, bad mood, dysphoria, sleep disorders, and resistance to nursing care. Furthermore, the experimental group subjectively assessed their quality of life higher than the control group.

Conclusion

In conclusion, patients with Alzheimer’s disease require additional methods of control for the prevention and early detection of constipation. The timely application of these methods can greatly improve their subjective assessment of their quality of life, as well as their sleep, mood, and social communication. One such method is the use of the Bristol Scale by medical staff.
Exploring virtual reality gaming‐related cybersickness in Alzheimer’s disease
Authors: Chatterjee Rashmita , Moussavi Zahra
Published: January 2025

Background

In the last decade, virtual reality has become a popular tool for rehabilitation. It is quite useful in spatial rehabilitation for Alzheimer’s disease (AD) as it allows safe navigation in a virtual environment which looks realistic. However, a drawback of virtual reality is cybersickness. The symptoms and severities of cybersickness can vary among users. Possible cybersickness symptoms include headache, nausea, disorientation.

Cybersickness can be distracting for participants and can affect their performance on the virtual reality task. Hence, in our rehabilitation game called Barn Ruins Navigation (BRN), we used software design mechanisms that would reduce cybersickness, including (1) keeping the field of view to 60 degrees, (2) lowering speed of rotation and translation, (3) using a joystick which causes less cybersickness, and (4) using a laptop screen instead of a head‐mounted display.

There have been contradicting results on the effects cybersickness has on people with AD. We wanted to test if cybersickness felt by the BRN game differed between people with AD and cognitively healthy adults.

Method

Cybersickness was measured using the Simulator Sickness Questionnaire (SSQ) after playing BRN. Thirty adults were recruited for the BRN validation study between the ages of 20‐88. This includes ten younger adults (five males, 26±3.39 years), ten cognitively healthy older adults (three males, 70.7±5.31 years), and ten people living with mild to moderate AD (seven males, 77.8±5.94 years). All participants played the game once.

Result

Regression analysis on the data showed that males had significantly lower SSQ scores by about 17.47 points compared to females (p = 0.0106), while adjusting for participant groups. The AD group had the highest SSQ scores in comparison to cognitively healthy older adults and younger adults while adjusting for sex. Only the younger adults had a statistically lower SSQ score than the AD group by 18 points (p = 0.023).

Conclusion

We found males were less prone to cybersickness than females, matching the cybersickness literature. Our study found people with AD were more prone to cybersickness, however not to a statistically higher degree than cognitively healthy older adults. We would need a larger sample size to draw solid conclusions.
Bone marrow derived stem cells (BMSC) may improve memory in Alzheimer’s Disease
Authors: Weiss Jeffrey Neill , Levy Steven
Published: January 2025

Background

A 73‐year‐old female with a 3 year history of Alzheimer’s disease was treated within the protocol of The Alzheimer’s Autism and Cognitive Impairment Stem Cell Treatment Study (ACIST), an IRB approved clinical study registered with clinicaltrials.gov NCT 03724136.

Method

The procedure consists of bone marrow aspiration, cell separation using an FDA cleared class 2 device, and intravenous and intranasal administration of the stem cell fraction. The patient’s son, a physician, recorded a video on the day prior to surgery, and on the first postoperative day.

Result

1 Day Pre‐Surgery https://drive.google.com/file/d/1fTfceevWLpPSh4J4V6XGenx3bMwNzEBp/view?usp=drive_web 1 Day Post‐Surgery https://drive.google.com/file/d/14AhVTes2kQ50tWzj6eWE5fEamgEJWa_D/view?usp=drive_web

The improvements lasted several weeks before gradually regressing.

Conclusion

Potential mechanisms of action of bone marrow derived stem cells (BMSC) are varied. These may include: the release of neurotrophic factors (NTF) including ciliary neurotrophic factor which has been shown to alleviate excitotoxicity in neurons; the release NGF (nerve growth factor) which enhances neuronal survival and function; and, immune modulation in a setting where neuroinflammation may exacerbate damage. BMSC can transfer their own organelles, including mitochondria and lysosomes, to injured or stressed cells, as well as release exosomes (secretome) containing proteins, mRNA and miRNA, which have the ability to regenerate axons and address neuronal dysfunction.

Human mesenchymal cells (hMSC), a subpopulation of BMSC, have been reported to provide de novo neuron regeneration. BMSC, through fusion with Muller cells (a retinal specific glial cell) can lead to new ganglion cells. Potentially, there may be local activity of BMSC directly in the hippocampus to help clear exogenous amyloid deposits, reduce microglial immunologic activity and enhance axonal recovery, including dendritic recovery and activity.

The improvement of long‐term memory in this patient suggests that neuron connectivity remains in place, for long periods after diagnosis, and can potentially be recovered.

Future research should include isolating components responsible for the improvement with the hope of extending the duration of response.
The combined impact of midlife and late‐life vascular risk factors on 33‐year incident dementia: the Atherosclerosis Risk in Communities Study
Authors: Smith Jason R , Pike James R. , Selvin Elizabeth , Lutsey Pamela L. , Palta Priya , Knopman David S. , Windham B Gwen , Coresh Josef , Sharrett Richey , Gross Alden L. , Deal Jennifer A.
Published: January 2025

Background

Midlife vascular risk factors are associated with an increased risk of dementia. However, the overall contribution of modifiable vascular risk factors in midlife and late‐life to dementia remains unclear. In this study, we quantified population attributable fractions, which account for risk factor prevalence and strength of relative risks, of incident dementia from vascular risk factors measured in midlife and early late‐life.

Method

We used 33 years of prospective cohort data in the Atherosclerosis Risk in Communities Study. Incident dementia (community surveillance and algorithmic diagnosis with expert clinical adjudication) was ascertained from baseline (1987‐1989) through December 31, 2020. We quantified population attributable fractions of incident dementia by age 80 from the combination of hypertension (systolic blood pressure ≥130, diastolic blood pressure ≥80, or use of medication), diabetes (fasting glucose ≥126, non‐fasting glucose ≥200, self‐reported physician diagnosis of diabetes, or use of medication for diabetes/insulin), and self‐reported current cigarette smoking (at least one risk factor versus none) measured at different ages (45‐54 [n = 7,731], 55‐64 [n = 12,273]; 65‐74 [n = 6,660]). We also computed attributable fractions stratified by sex, apolipoprotein ε4 genotype, and self‐reported race.

Result

The prevalence of having one or more of the vascular risk factors was 61.6% (95% CI: 60.5, 62.7%) at age 45‐54 and increased to 77.5% (95% CI: 76.5, 78.5%) by age 65‐74. Population attributable fractions of dementia increased from 22.7% (95% CI: 15.3, 30.1%) for vascular risk factors measured at age 45‐54 to 45.4% (95% CI: 32.5, 58.3%) for vascular risk factors assessed at age 65‐74 (see Figure). Attributable fractions were larger in females, participants without apolipoprotein ε4 alleles, and Black participants (Figure).

Conclusion

Between 23% to 45% of incident dementia cases by age 80 were attributed to a combination of hypertension, diabetes, or current smoking up through age 74. Attributable fractions for the combined impact of vascular risk varied by key demographics. Public health strategies targeting modifiable vascular risk factors could reduce dementia risk and increase healthy lifespan.