bluuebunny/crossref_metadata_2025 huggingface dataset:
H - 44 Relationship between Symptoms of Anxiety and Neurocognitive Functions of Attention and Working Memory in Trauma-Exposed Puerto Rican Adolescents: a Preliminary Data Analysis
Authors: Rodriguez Rosanna , Polanco-Frontera Norka , Cordero-Arroyo Giselle , Bermonti-Pérez Mario , Mercado-Nieves Fabiola C , Rodríguez-Beato Johanna N , Vélez-Báez Gina M , Méndez-González Geraldine M , Vega-Tirado Kiara M , Moreno Mary A
Published: October 2023

Objective

Examine the relationship between symptoms of anxiety [ANX] and neurocognitive functions of attention [ATT] and working memory [WM] in trauma-exposed Puerto Rican adolescents.

Method

Secondary data analysis was performed of the study’s sample, “Exploring the relationship between Traumatic Exposure on Neurocognitive Processes and Academic Achievement in a sample of Puerto Rican Youth”. This study’s design is a quantitative within-subjects, correlational-causal transactional non-experimental method. Spanish speaking adolescents who reside in Puerto Rico ages 12–17 were recruited. Without serious mental or motor disorders who self-reported exposure to more than one traumatic event. A non-probabilistic convenience sample (N = 21; M = 13; F = 8; Age: M = 15; SD = 1.6) was recruited from clinics (81%) and schools (19%) in different regions of Puerto Rico. To measure traumatic exposure, the Child and Adolescent Trauma Screen (CATS), which is a 15-item self-report trauma screening, was used. The Generalized Anxiety Disorder Scale-7 (GAD-7), a 7-item self-report assessment used to explore anxiety symptoms. Lastly, cognitive variables ATT and WM, were measured using subtests of the standardized neuropsychological battery, Cognitive Assessment System-2: Español (CAS2:ES).

Results

A Linear Regression analysis revealed that total ANX could explain 18% variability of ATT and 56% of WM and were not statistically significant (p = 0.534, IC 95%; 0.53–1.93; p = 0.245, IC 95%: −2.64-0.75) consecutively.

Conclusion

Preliminary data suggest some variability of WM can be explained by ANX experienced in trauma-exposed Puerto Rican adolescents. Confounding variables of complex trauma may exist. A larger clinical sample, including ANX severity and a control group, is recommended to explore cognitive, learning, and mental health consequences.
H - 47 Bilingual Auditory Naming Test Performance in an Epilepsy Sample
Authors: Wright Madison E , Schulte Tilman , Florentino Nicole L , Kopald Brandon E
Published: October 2023

Objective

The growing multilingual population in the United States calls for culturally adapted norms for neuropsychological tools. Language testing, for example, is paramount in pre-surgical assessment in patients with dominant temporal lobe epilepsy. The Boston Naming Test (BNT) and the Auditory Naming Test (ANT) are frequently used in pre-surgical epilepsy evaluations; yet, while bilingual norms exist for the BNT, these are lacking for the ANT. To parse out how much of a bilingual patient’s language performance is accounted for by bilingualism versus language deficits, we studied whether there is a significant difference in ANT performance between bilingual and monolingual English-speaking epilepsy patients.

Method

Our sample of patients with localized epilepsy from the UCSF Epilepsy Center included 22 bilingual (English-dominant; non-dominant languages included Spanish, Arabic, Dutch, Taiwanese, and Japanese) and 61 monolingual English-speakers (39% female, M age = 36.3). All patients took anti-seizure medication and completed the ANT and BNT as part of a pre-surgical neuropsychological assessment.

Results

Compared to monolingual English-speaking patients, bilingual patients had significantly lower scores on the ANT (Bilingual M = −4.03 [SD = 5.6], Monolingual M = −0.7 [SD = 1.9]; t(81) = 3.89, p < 0.001) and BNT (t(77) = 2.76, p = 0.007). This performance difference was significantly greater for the ANT than BNT (F(1,77) = 7.71, p = 0.007).

Conclusion

These results highlight the importance of considering multilingualism in neuropsychological assessments. This is especially needed for pre-surgical language mapping in epilepsy surgical candidates. Future research should establish bilingual normative standards for neuropsychological language-based tests such as the ANT.
H - 49 Neuropsychological Testing of a Bilingual Patient: Should you Test in the Native, Preferred, or Dominant Language?
Authors: Zambrana-Bonaparte Hjalmar M , Puente Antonio E
Published: October 2023

Objective

Testing of bilingual individuals still poses a challenge among neuropsychologists. Self-reported language proficiency and objective measures differ considerably. Consequently, we present a literature review on the neuropsychological testing of bilinguals and a case study to guide the discussion.

Data Selection

A narrative literature review approach to identify and describe variables that pose challenges in the neuropsychological testing of bilinguals. Interfaced search terms include (not limited to) biculturalism, acculturation, oppression, testing, bilingualism, types of bilingualism, and mastery of languages. The case study constitutes a bilingual/bicultural 68-year-old male native from Cuba who migrated to the United States at 14 years old and was referred secondary to memory concerns. The patient asked and insisted on being tested in English.

Data Synthesis

The following elements will be discussed: fairness in testing, the language of tester and testee, and optimal language for testing (i.e., native, preferred, or dominant) while considering the referral question. Challenging variables include age and method of languages acquisition, language of schooling, frequency and contexts of both languages, and personal/social/cultural attitudes toward each language.

Conclusion

This review presents 1) factors influencing bilingualism, 2) potential challenges in determining a neuropsychologically fair testing battery for bilinguals, and 3) highlights the importance of using a qualitative historic-sociocultural approach and quantitative measurements to inform this process. Hence, reducing the possibility of misdiagnosis. Lastly, based on the review, we will discuss the influence of various sociocultural variables that might have influenced the patient’s decision to be tested in English, such as, acculturation, cultural perception, and geographical location.
H - 51 Neuropsychological Evaluation of Non-Fluent English Speakers: a Case Study
Authors: Diaz Gisel , Ory Justin H
Published: October 2023

Objective

Sometimes patients are referred for neuropsychological evaluation who do not speak English as their first language. In many cases, we have declined evaluating patients who were not fluent in English, and when we have evaluated bilingual patients, have qualified the limitations of our interpretations. However, there are no neuropsychologists providing services in languages besides English in the state of Oklahoma, and most patients never received services.

Method

Patient is 83-year-old woman with five years of progressive decline in memory, unable to manage instrumental activities of daily living, presenting with family history of Alzheimer’s disease, and neuroimaging negative for atrophy or cerebrovascular disease. Patient was not fluent in English. Efforts to find a neuropsychologist able to evaluate in Spanish were unsuccessful, so testing was modified, and measures were administered by a bilingual psychometrist.

Results

Attention, orientation, and memory were impaired (MMSE = 14). Verbal fluency was intact in Spanish. Auditory memory was not assessed due to unavailability of Spanish measures. Visual memory was impaired, consistent with figure copy. WAIS-IV was administered in English, with instructions in Spanish.

Conclusions

Patient was diagnosed with possible Alzheimer’s disease. Recommended PET scan or spinal tap for Alzheimer’s disease biomarkers and reevaluation in Spanish in one year. Since neuropsychological evaluation is not available in every language, evaluation in English and highlighting the limitations of our findings may meet the ethical principle of beneficence, if we consider the impact of language and additional sources of data, such as collateral report of the patient’s caregivers, and medical tests.
H - 53 Performance Validity in a Mexican Population
Authors: Lopez Hernandez Daniel W , Sivaramakrishnan Krithika , Smith Krissy E , Munoz Isabel
Published: October 2023

Objective

The aim of the present study was to cross-validate recent research on three embedded performance validity tests (PVTs) in a Spanish-speaking Mexican sample.

Method

The sample consisted of 52 male and 77 female participants residing in Mexico with a mean age of 25.26 (SD = 10.45). Participants were neurologically and psychologically healthy and completed a neuropsychological battery in Spanish. The Reliable Digit Span, Phonemic Fluency Test (i.e., FAS), and Semantic Fluency Tests were used to evaluate failure rates in our sample. Daugherty and colleagues’ (2022) PVT cutoff scores were used. Chi-square analysis was used to evaluate failure rates between the groups.

Results

Chi-square analysis revealed no significant failure rate differences between gender groups on any PVTs. However, we found that 12% of the male group failed the Phonemic Fluency Test compared to 5% of the female group, X2 = 1.747, p = 0.186. Meanwhile, 2% of the male group failed the Semantic Fluency Test compared to 0% of the female group, X2 = 1.492, p = 0.222. Finally, 6% of the male group failed the Reliable Digit Span compared to 17% of the female group, X2 = 3.529, p = 0.060.

Conclusions

Our data shows that male participants demonstrate higher failure rates on verbal fluency tasks than females. Moreover, males had lower failure rates compared to females on Reliable Digit Span. Further exploration with bigger sample sizes is needed to explore what may be influencing validity test performance between gender groups. More studies in this area will help researchers and clinicians determine if persons completing cognitive tasks in Spanish are proving adequate effort.
H - 54 Effects of Acculturation in Neuropsychological Performance of Generation Z Mexicans
Authors: Lopez Hernandez Daniel W
Published: October 2023

Objective

We examined the influence of acculturation on Generation Z (i.e., persons born between 1997–2004) adults’ cognition.

Methods

The sample consisted of 15 low-acculturated, 47 moderately-acculturated, and 28 high-acculturated Mexican participants residing in Mexico with a mean age of 20.86 (SD = 1.63). All participants completed the Word Accentuation Test, all the subtests of the Stroop Color Word Test (SCWT), Boston Naming Test, Phonemic Fluency Test (i.e., FAS), Semantic Fluency Test, the copy and long-delayed Rey–Osterrieth Complex Figure (ROCF) tasks, all the subtests of the Digit Span, and the Abbreviated Multidimensional Acculturation Scale (AMAS) in Spanish. The AMAS was used to categorize acculturation groups. ANOVA’s were used to evaluate neuropsychological performance between our acculturation groups.

Results

We found the low-acculturation and moderately acculturation groups outperformed the high-acculturation group on the SCWT reading and color-word tasks, p’s < 0.05, np’s2 = 0.09–0.10. Results also revealed the high-acculturation group outperformed the low-acculturation and moderately acculturation groups on the Semantic Fluency Test, p = 0.002, np2 = 0.14. Finally, the low-acculturation group outperformed the high-acculturation group on the ROCF copy task, p = 0.042, np2 = 0.07.

Conclusions

Our data suggests that Generation Z Mexicans’ level of acculturation influences their cognition. A possible explanation can be time perspective, where perception of time is influencing cognition to select and pursue certain goals, cognition, and motivation. Future studies using larger sample sizes should investigate the intersection of time perspective and acculturation on Generation Z adults’ cognition. More research that evaluates how acculturation influences cognition will help researchers and clinicians understand Spanish speakers’ cognition from a generational cohort perspective.
H - 55 Socially Responsible Neuropsychology (SRN) in Action: the Role of Neuropsychology in Autism Spectrum Disorder (ASD) Care, a Case Study of a Bilingual Latino Patient
Authors: Carollo-DuPrey Giselle , Yañez Janet J , Fernandez Vindia G
Published: October 2023

Objective

Latinx children with ASD are diagnosed 1–3 years later than their White counterparts and typically present with more severe symptoms at the time of assessment. Systemic barriers include language barriers, limited literacy about ASD, mental health stigma, mistrust in healthcare. Latinx children are at greater risk of misdiagnosis, delayed access to special education, limiting early intervention. Within neuropsychology, there are limited bicultural/bilingual neuropsychologists trained in autism evaluations, few Spanish ASD diagnostic tools, no bilingual norms, and little understanding regarding neuropsychologists’ role in providing autism evaluations to culturally/linguistically diverse children. This social injustice results in unmet needs and inequities in ASD care for Latinx children. We aim to illustrate how the SRN model increases equitable ASD care amongst Latinx children.

Method

SRN model was utilized in 11-year-old bilingual Latinx male by applying culturally responsive interview to identify systemic barriers and language use, and a model of language proficiency testing. Testing was primarily in English after verbal fluency measures established language dominance. Clinical decision making identified the need for autism evaluation using Autism Diagnostic Observation Schedule (ADOS-2).

Results

His cognitive profile showed word reading and motor inefficiencies. ADOS-2 identified deficits in communication, reciprocal social interaction, restricted and repetitive behavior. Neuropsychological assessment confirmed ASD and Developmental Coordination Disorder diagnosis.

Conclusion

His unremarkable neurocognitive profile suggested compensatory strategies may have masked symptoms. This case highlights need for bicultural/bilingual neuropsychologists with experience providing comprehensive ASD evaluations to practice from equitable framework, using the SRN model to enhance early detection, treatment recommendations, and advocacy for access to culturally/linguistically appropriate resources.
H - 56 Culturally-Responsive Neuropsychological Evaluations: Two Case Studies Demonstrating the Application of the ECLECTIC Framework in Pediatric Medical Populations
Authors: Costello Rosalia , Jordan Lizabeth L , Papadakis Jackie L , MacDonald Beatriz
Published: October 2023

Objective

This case series aimed to demonstrate the application of Dr. Daryl Fujii’s ECLECTIC model to pediatric neuropsychological evaluations. The ECLECTIC model identifies a wide range of social and cultural factors (e.g., bilingual language development, economic factors, and social determinants) that are integrated to provide patient-centered, culturally responsive neuropsychological services.

Methods

The application of the ECLECTIC model to pediatric evaluations will be reviewed. Two cases of pediatric patients with different levels of bilingualism (English/Spanish) and diagnoses of Spina Bifida (SB) will be presented. These cases will illustrate a range of cultural and social factors (including ethnic, linguistic, and economic factors) that impact a pediatric neuropsychological evaluation. Clinical considerations and practical solutions will be provided.

Results

The ECLECTIC model provides a framework for understanding and integrating social-cultural factors and the intersection of such factors in a pediatric neuropsychological evaluation. This is the first case series to demonstrate the use of the ECLECTIC model in a pediatric medical population.

Conclusions

With the aim of reducing existing healthcare disparities, a social-cultural lens is critical to conducting a neuropsychological evaluation, formulating diagnoses and conceptualization, and offering relevant and patient/family-centered recommendations.
H - 57 Case Study: Chinese Older Adult with Parkinson Disease and Visual Impairment Presenting for Pre-Deep Brain Stimulation Evaluation
Authors: Eisenstein Alexander , Bosch Chelsea , Bruger Bryanna
Published: October 2023

Objective

We present a case in which intersecting linguistic and disability factors necessitated a flexible, qualitative approach to clinical decision making in the context of pre-deep brain stimulation (DBS) evaluation.

Method

LZ is a 70-year-old, right-handed, cisgender, Chinese male with history of Parkinson disease (PD) presenting for DBS evaluation. Symptoms included right extremity tremor with decreased effectiveness from dopamine therapy. Cognitive, behavioral, personality, or functional changes were denied. He had severe visual impairment due to macular degeneration and cataracts. LZ immigrated to the U.S. 30 years prior and obtained a Ph.D. in Law. His English was not at the level of native speaker, but he declined use of an interpreter. Nevertheless, English proficiency was adequate to conduct testing.

Results

LZ’s premorbid functioning was estimated as average. Scores on attention/working memory and verbal fluency were intact. Processing speed and auditory naming were below average. Memory performance was characterized by inefficient learning and intact recall. Executive functions were variable in verbal set switching and motor sequencing was intact.

Conclusion

Typically, such a case with language/cultural differences would rely on more visuospatial than verbal tests; however, visual impairment necessitated reliance on verbal tests only. It was determined that variability of performances and low scores on naming were more likely attributable to language/cultural factors, and LZ was therefore deemed a good candidate for DBS surgery based on multiple intact cognitive abilities and strong social support. LZ received left subthalamic nucleus DBS. There was initial hemorrhagic complication during electrode placement resulting in language loss, which he recovered after five weeks.
H - 60 Navigating Cultural and Medical Factors in Pediatric Neuropsychological Assessment: a Case Study
Authors: Hammer Jasmine , Yund Brianna
Published: October 2023

Objective

The current case study focuses on a neurodevelopmental evaluation for a child with a complex medical history, suspected genetic disorder, and significant developmental delays within the context of cultural diversity, linguistic barriers, and interpretation services.

Methods

Patient is a 4-year-old male of Oromo decent who is exposed to both Oromo and English. Medical background is significant for congenital glaucoma and global developmental delay. He is nonverbal and uses few gestures to communicate. He presented with spastic motor movements and dysmorphic facial features. There is no history of genetic testing nor consults with neurology. Developmentally appropriate measure of neurocognitive functioning was administered with the use of an Oromo interpreter.

Results

Results revealed impaired performance within the areas of cognition, language, and motor functioning. Cognitive abilities measured similar to a 26-month-old. The patient’s social communication and emotional reciprocity varied; there was consideration of an autism spectrum disorder. Diagnostic challenges included medical complexity (i.e., vision differences with eye contact and visual referencing, motor functioning), unanswered diagnostic questions (i.e., underlying genetic or neurological condition), and cultural considerations. The evaluation yielded diagnoses of a global developmental delay and unspecified neurodevelopmental disorder. Recommendations included referrals to neurology, genetics, care coordination, and outpatient therapies.

Conclusion

Given the complexity of phenotypical behavioral manifestations of genetic disorders and cultural differences in terms of appropriate social behaviors convolute behaviors observed during the evaluation. The case study brings to light the consideration of cultural differences when interpreting behaviors as well as the value of a multidisciplinary approach to neuropsychological evaluation for diagnostic clarification.
H - 62 Current State of the Practice of Clinical Neuropsychology in Bolivia
Authors: Zarate Diego Jofre , Roth Eric , Calderón-Encinas Javier Fernando , Ramos-Usuga Daniela , Arango-Lasprilla Juan Carlos
Published: October 2023

Objective

The present study aimed to determine the current state of the practice of clinical neuropsychology in Bolivia.

Method

This is a descriptive and cross-sectional study. The sample consisted of 72 professionals working in the field of neuropsychology in Bolivia. The information was collected through an online questionnaire that included 70 questions about the participants’ professional training, professional practice, research, teaching, and perceived barriers to the profession’s development, among other factors.

Results

Approximately 76% of participants reported receiving postgraduate neuropsychology training. Their training was rated as very good (34.8%) and good (23.9%). Conversely, their clinical supervision was rated very good (24.3%) and good (33.3%). The participants indicated that their professional practice is conducted mainly in private settings (72.2%). Also, they mentioned that the most assessed disorders were learning disabilities (93.5%), intellectual disabilities (90%), and ADHD (87.5%). Similarly, the more frequent conditions rehabilitated were learning disabilities (23.6%), ADHD (20%), and depression (20.85%). Only 41.5% of the participants reported conducting research. A smaller proportion of professionals (31.5%) taught neuropsychology courses.

Conclusions

Neuropsychology is a relatively new field of work in Bolivia. For this reason, the participants considered that to enhance the quality of this specialty in Bolivia, new graduate programs in neuropsychology must be developed, more standardized tests validated, and more job positions created, especially in public institutions. Additionally, a professional organization that regulates the standards of this field needs to be established.
H - 64 When the Miranda Warning cannot be Understood: Implications of Utilizing an Unqualified Interpreter
Authors: Morales Sandra S , Cuellar Ruby , Renteria Laura
Published: October 2023

Introduction

Crenshaw (1989) identifies intersectionality as the interface between a person’s identities in relation to inequalities in social systems. She explicates how individuals receive distinct encounters with privilege and discrimination from society, depending on their unique amalgamation of personal, social, and political identities. An example of this is seen in a monolingual Spanish speaker of Mexican descent who underwent an independent neuropsychological evaluation to determine any cognitive impairment related to his legal charges.

Background

The defendant is a 39-year-old male with lifelong cognitive difficulties and one year of formal schooling. At the time of the arrest, he was interrogated with the assistance of an inexperienced, uncertified interpreter. Sight translation of the Miranda warning included 8 made-up words and multiple verb-tense errors, resulting in 15% + of the warning being nonsensical. The interview transcript indicated the defendant experienced frequent comprehension difficulties.

Test Results

The defendant is of extremely low intellectual abilities (FSIQ = 67, 1%ile). Cognitive deficits were observed across various domains including academic skills (reading, writing, math) and verbal comprehension. He is able to manage basic activities of daily living but needs assistance with more complex tasks (e.g., use of debit card, paying bills).

Conclusions

The evaluation suggests the defendant likely did not understand the Miranda warning and was swayed to confess during the interrogation. To combat institutional bias, law enforcement should be educated on individuals with lower cognitive capacities and the importance of accurate Spanish translation. Ignoring intersectionality and institutional bias perpetuates inequities in culturally appropriate care but can also contribute to wrongful convictions.
H - 66 A Systematic Review of Available Normative Data of Neuropsychological Tests for Latinx and Hispanic Samples
Authors: Perez-Lao Ambar , Arias Franchesca , Levy Shellie-Anne , Smith Glenn , Ying Gelan
Published: October 2023

Objective

This review aimed to examine and compare norm stratification of available normative data of neuropsychological tests for Spanish-speakers in the United States, Latin America, the Caribbean, and Spain.

Data Selection

English and Spanish studies focused on acquiring normative data for Latinx/Hispanics in Latin America, the Caribbean, the United States, and Spain, were searched from Embase, PubMed, PsycINFO APA, ClinicalTrials.gov, Science Direct, and ProQuest with the date before August 31st, 2022. We used the terms “Neuropsychological testing”, “Cognitive assessment”, “Hispanic”, “Latinx” and “Latinos”. Studies were imported to COVIDENCE, and reviewed by two Spanish-English bilingual reviewers, and one proficient English-only reviewer. Out of 345 records identified, 55 met inclusion and exclusion criteria and were not two standard deviations below the quality criteria index.

Data Synthesis

Age, education, and sex were the most common variables included in the stratification of normative data. Age was a predictor of lower performance in adults, and higher education was a predictor of better performance. With children and adolescents, increased age was related to better cognitive performance. Most of the studies were written in English and included a cognitively intact sample that was assessed either with the Mini-Mental State Examination, health history, or other clinical interviews or exams.

Conclusion

There is an evident improvement in the availability of measures for Spanish speakers. However, there is a need for better-developed tests for this population. Future studies in this area should consider adding variables such as acculturation and bilingualism into research, as well as developing novel measures for Spanish speakers.
H - 67 Socially Responsible Neuropsychology (SRN) in Action: Considering Culture, Brain Structure, and Function Longitudinally in an Atypical Pituitary Adenoma Case
Authors: Rivera Jesus M , Díaz-Santos Mirella , Suarez Paola A
Published: October 2023

Objective

Research on the neuropsychological profile associated with pituitary adenoma (PA) in diverse populations is limited. Clinically, PAs are categorized by size (micro-vs-macro) and hormone secretion levels (functional/secreting-vs-nonfunctional/non-secreting [NFPA]). Macro-NFPA are associated with visual–spatial, memory, and executive functioning declines, likely due to mass effects. No previous reports of cognitive declines in micro-NFPA were found in the literature. We present a clinical case illustrating the application of an SRN model in a 75-year-old, Spanish-English bilingual male, with cognitive declines, diagnosed with micro-NFPA.

Method

An SRN model was applied to promote equitable care through evidence-based consideration of neuropsychological syndromes in bilinguals, neurodiagnostics, and complex psychosocial factors. The patient underwent longitudinal language-congruent neuropsychological assessment and structural/functional neuroimaging. Educational background, linguistic proficiencies, acculturation level, social/behavioral comportment, and limitations in available neuropsychological tools/norms were integrated to reflect the complexity in conducting a reliable bilingual assessment and formulating differential diagnoses.

Results

The SRN model guided complex clinical decision-making. Neuropsychological profile (frontal-subcortical-vs-cortical-involvement) varied across language and time-point. Within/between variable performances in memory, executive functioning, processing speed, and verbal fluency were inconsistent with structural neuroimaging at assessment points, increasing diagnostic ambiguity. Advocated-for functional neuroimaging revealed pituitary hypometabolism.

Conclusions

To our knowledge, this is the first reported case of neurocognitive impairment in micro-NFPA, and the first reported neuropsychological profile of a bilingual individual with PA. The findings suggest the need for further research on neurocognitive declines in NFPA in diverse populations. It also highlights the importance of assessing in all relevant languages when conducting longitudinal assessments to boost sensitivity and specificity in differential diagnoses.
H - 70 Self-Administration of the Language Acculturation Metertm in a Clinical Older Adult Population: a Pilot Study
Authors: Viruet- Sánchez Esteban , Gonzalez Marela Firpi , Stimmel Marnina , McGinley John , Bronshteyn Diana , Facchini Ronda , Weiss Erica F
Published: October 2023

Introduction

Language acculturation is the process by which a bilingual individual obtains proficiency and comfort in speaking a new language while maintaining fluency in their native language. Considering the degree of language acculturation in bilingual patients is essential to choosing appropriate tests and interpreting neuropsychological assessment. The Language Acculturation Meter™ (LAM) was created for native Spanish speakers who are bilingual in English to aid in selecting and interpreting verbally-administered assessments. While the LAM was created to be completed as an interview, a Spanish version of the form exists and can be given to patients to complete independently. We sought to evaluate the feasibility and utility of self-administered LAM in a clinical older adult population in NY State.

Methods

The LAM was given to Spanish-speaking older adults and their caregivers as part of their clinical neuropsychological evaluation at Montefiore’s Memory Disorders Centers. 16 patient and caregiver dyads completed the LAM in either English or Spanish.

Results

Patient ages ranged from 67 to 83; 75% of the patients were female, and 56% self-identified as bilingual. 18% of patients completed the LAM without caregiver assistance. Dyads did not comment on the form, but early qualitative feedback suggests that some had difficulty understanding how to complete aspects of the LAM, and others found that some items on the LAM did not apply to them.

Conclusions

The LAM is a previously validated interview tool that requires further research to determine if it can be used as a self-report questionnaire in clinical populations, including older adults with cognitive complaints.
MsQuality: an interoperable open-source package for the calculation of standardized quality metrics of mass spectrometry data
Authors: Naake Thomas , Rainer Johannes , Huber Wolfgang
Published: October 2023

Motivation

Multiple factors can impact accuracy and reproducibility of mass spectrometry data. There is a need to integrate quality assessment and control into data analytic workflows.

Results

The MsQuality package calculates 43 low-level quality metrics based on the controlled mzQC vocabulary defined by the HUPO-PSI on a single mass spectrometry-based measurement of a sample. It helps to identify low-quality measurements and track data quality. Its use of community-standard quality metrics facilitates comparability of quality assessment and control (QA/QC) criteria across datasets.

Availability and implementation

The R package MsQuality is available through Bioconductor at https://bioconductor.org/packages/MsQuality.
Joint modeling in presence of informative censoring on the retrospective time scale with application to palliative care research
Authors: Wu Quran , Daniels Michael , El-Jawahri Areej , Bakitas Marie , Li Zhigang
Published: October 2023

Joint modeling of longitudinal data such as quality of life data and survival data is important for palliative care researchers to draw efficient inferences because it can account for the associations between those two types of data. Modeling quality of life on a retrospective from death time scale is useful for investigators to interpret the analysis results of palliative care studies which have relatively short life expectancies. However, informative censoring remains a complex challenge for modeling quality of life on the retrospective time scale although it has been addressed for joint models on the prospective time scale. To fill this gap, we develop a novel joint modeling approach that can address the challenge by allowing informative censoring events to be dependent on patients’ quality of life and survival through a random effect. There are two sub-models in our approach: a linear mixed effect model for the longitudinal quality of life and a competing-risk model for the death time and dropout time that share the same random effect as the longitudinal model. Our approach can provide unbiased estimates for parameters of interest by appropriately modeling the informative censoring time. Model performance is assessed with a simulation study and compared with existing approaches. A real-world study is presented to illustrate the application of the new approach.
Prospective multicentre study of indications for surgery in patients with idiopathic acute pancreatitis following endoscopic ultrasonography (PICUS)
Authors: Umans Devica S , Timmerhuis Hester C , Anten Marie-Paule G F , Bhalla Abha , Bijlsma Rina A , Boxhoorn Lotte , Brink Menno A , Bruno Marco J , Curvers Wouter L , van Eijck Brechje C , Erkelens G Willemien , van Geenen Erwin J M , Hazen Wouter L , Hoge Chantal V , Hol Lieke , Inderson Akin , Kager Liesbeth M , Kuiken Sjoerd D , Perk Lars E , Quispel Rutger , Römkens Tessa E H , Sperna Weiland Christina J , Thijssen Annemieke Y , Venneman Niels G , Verdonk Robert C , van Wanrooij Roy L J , Witteman Ben J , Besselink Marc G , van Hooft Jeanin E
Published: October 2023

Background

Cholecystectomy in patients with idiopathic acute pancreatitis (IAP) is controversial. A randomized trial found cholecystectomy to reduce the recurrence rate of IAP but did not include preoperative endoscopic ultrasonography (EUS). As EUS is effective in detecting gallstone disease, cholecystectomy may be indicated only in patients with gallstone disease. This study aimed to determine the diagnostic value of EUS in patients with IAP, and the rate of recurrent pancreatitis in patients in whom EUS could not determine the aetiology (EUS-negative IAP).

Methods

This prospective multicentre cohort study included patients with a first episode of IAP who underwent outpatient EUS. The primary outcome was detection of aetiology by EUS. Secondary outcomes included adverse events after EUS, recurrence of pancreatitis, and quality of life during 1-year follow-up.

Results

After screening 957 consecutive patients with acute pancreatitis from 24 centres, 105 patients with IAP were included and underwent EUS. In 34 patients (32 per cent), EUS detected an aetiology: (micro)lithiasis and biliary sludge (23.8 per cent), chronic pancreatitis (6.7 per cent), and neoplasms (2.9 per cent); 2 of the latter patients underwent pancreatoduodenectomy. During 1-year follow-up, the pancreatitis recurrence rate was 17 per cent (12 of 71) among patients with EUS-negative IAP versus 6 per cent (2 of 34) among those with positive EUS. Recurrent pancreatitis was associated with poorer quality of life.

Conclusion

EUS detected an aetiology in a one-third of patients with a first episode of IAP, requiring mostly cholecystectomy or pancreatoduodenectomy. The role of cholecystectomy in patients with EUS-negative IAP remains uncertain and warrants further study.
Radiomics preoperative-Fistula Risk Score (RAD-FRS) for pancreatoduodenectomy: development and external validation
Authors: Ingwersen Erik W , Bereska Jacqueline I , Balduzzi Alberto , Janssen Boris V , Besselink Marc G , Kazemier Geert , Marchegiani Giovanni , Malleo Giuseppe , Marquering Henk A , Nio C Yung , de Robertis Riccardo , Salvia Roberto , Steyerberg Ewout W , Stoker Jaap , Struik Femke , Verpalen Inez M , Daams Freek ,   for the Pancreatobiliary and Hepatic Artificial Intelligence Research (PHAIR) consortium
Published: October 2023

Background

Accurately predicting the risk of clinically relevant postoperative pancreatic fistula after pancreatoduodenectomy before surgery may assist surgeons in making more informed treatment decisions and improved patient counselling. The aim was to evaluate the predictive accuracy of a radiomics-based preoperative-Fistula Risk Score (RAD-FRS) for clinically relevant postoperative pancreatic fistula.

Methods

Radiomic features were derived from preoperative CT scans from adult patients after pancreatoduodenectomy at a single centre in the Netherlands (Amsterdam, 2013–2018) to develop the radiomics-based preoperative-Fistula Risk Score. Extracted radiomic features were analysed with four machine learning classifiers. The model was externally validated in a single centre in Italy (Verona, 2020–2021). The radiomics-based preoperative-Fistula Risk Score was compared with the Fistula Risk Score and the updated alternative Fistula Risk Score.

Results

Overall, 359 patients underwent a pancreatoduodenectomy, of whom 89 (25 per cent) developed a clinically relevant postoperative pancreatic fistula. The radiomics-based preoperative-Fistula Risk Score model was developed using CT scans of 118 patients, of which three radiomic features were included in the random forest model, and externally validated in 57 patients. The model performed well with an area under the curve of 0.90 (95 per cent c.i. 0.71 to 0.99) and 0.81 (95 per cent c.i. 0.69 to 0.92) in the Amsterdam test set and Verona data set respectively. The radiomics-based preoperative-Fistula Risk Score performed similarly to the Fistula Risk Score (area under the curve 0.79) and updated alternative Fistula Risk Score (area under the curve 0.79).

Conclusion

The radiomics-based preoperative-Fistula Risk Score, which uses only preoperative CT features, is a new and promising radiomics-based score that has the potential to be integrated with hospital CT report systems and improve patient counselling before surgery. The model with underlying code is readily available via www.pancreascalculator.com and www.github.com/PHAIR-Consortium/POPF-predictor.
Identification of different MRI atrophy progression trajectories in epilepsy by subtype and stage inference
Authors: Xiao Fenglai , Caciagli Lorenzo , Wandschneider Britta , Sone Daichi , Young Alexandra L , Vos Sjoerd B , Winston Gavin P , Zhang Yingying , Liu Wenyu , An Dongmei , Kanber Baris , Zhou Dong , Sander Josemir W , Thom Maria , Duncan John S , Alexander Daniel C , Galovic Marian , Koepp Matthias J
Published: October 2023

Artificial intelligence (AI)-based tools are widely employed, but their use for diagnosis and prognosis of neurological disorders is still evolving. Here we analyse a cross-sectional multicentre structural MRI dataset of 696 people with epilepsy and 118 control subjects. We use an innovative machine-learning algorithm, Subtype and Stage Inference, to develop a novel data-driven disease taxonomy, whereby epilepsy subtypes correspond to distinct patterns of spatiotemporal progression of brain atrophy.In a discovery cohort of 814 individuals, we identify two subtypes common to focal and idiopathic generalized epilepsies, characterized by progression of grey matter atrophy driven by the cortex or the basal ganglia. A third subtype, only detected in focal epilepsies, was characterized by hippocampal atrophy. We corroborate external validity via an independent cohort of 254 people and confirm that the basal ganglia subtype is associated with the most severe epilepsy.Our findings suggest fundamental processes underlying the progression of epilepsy-related brain atrophy. We deliver a novel MRI- and AI-guided epilepsy taxonomy, which could be used for individualized prognostics and targeted therapeutics.
The association of body mass index and body composition with plasma amyloid beta levels
Authors: Hermesdorf Marco , Esselmann Hermann , Morgado Barbara , Jahn-Brodmann Anke , Herrera-Rivero Marisol , Wiltfang Jens , Berger Klaus
Published: October 2023

Blood-based analysis of amyloid-β is increasingly applied to incrementally establish diagnostic tests for Alzheimer’s disease. To this aim, it is necessary to determine factors that can alter blood-based concentrations of amyloid-β. We cross-sectionally analysed amyloid-β-40 and amyloid-β-42 concentrations and the 40/42 ratio in 440 community-dwelling adults and associations with body mass index, waist-to-height ratio and body composition assessed using bioelectrical impedance analysis. Body mass index and waist-to-height ratio were inversely associated with plasma amyloid-β-42 concentrations. Body fat mass, but not body cell mass and extracellular mass, was inversely associated with amyloid-β-42 levels. The results indicate that plasma concentrations of amyloid-β-42 are lower in those with increased body mass index and body fat, and associations with amyloid-β-40 did not reach significance after controlling for multiple testing. The findings support the use of body mass index as an easy-to-measure factor that should be accounted for in diagnostic models for plasma amyloid-β.
Anterior cingulate sulcation is associated with onset and survival in frontotemporal dementia
Authors: Harper Luke , de Boer Sterre , Lindberg Olof , Lätt Jimmy , Cullen Nicholas , Clark Lyles , Irwin David , Massimo Lauren , Grossman Murray , Hansson Oskar , Pijnenburg Yolande , McMillan Corey T , Santillo Alexander F
Published: October 2023

Frontotemporal dementia is the second most common form of early onset dementia (<65 years). Despite this, there are few known disease-modifying factors. The anterior cingulate is a focal point of pathology in behavioural variant frontotemporal dementia. Sulcation of the anterior cingulate is denoted by the presence of a paracingulate sulcus, a tertiary sulcus developing, where present during the third gestational trimester and remaining stable throughout life. This study aims to examine the impact of right paracingulate sulcal presence on the expression and prognosis of behavioural variant frontotemporal dementia. This retrospective analysis drew its population from two clinical samples recruited from memory clinics at university hospitals in the USA and The Netherlands. Individuals with sporadic behavioural variant frontotemporal dementia were enrolled between 2000 and 2022 and followed up for an average of 7.71 years. T1-MRI data were evaluated for hemispheric paracingulate sulcal presence in accordance with an established protocol by two blinded raters. Outcome measures included age at onset, survival, cortical thickness and Frontotemporal Lobar Degeneration-modified Clinical Dementia Rating determined clinical disease progression. The study population consisted of 186 individuals with sporadic behavioural variant frontotemporal dementia (113 males and 73 females), mean age 63.28 years (SD 8.32). The mean age at onset was 2.44 years later in individuals possessing a right paracingulate sulcus [60.2 years (8.54)] versus individuals who did not [57.76 (8.05)], 95% confidence interval > 0.41, P = 0.02. Education was not associated with age at onset (β = −0.05, P = 0.75). The presence of a right paracingulate sulcus was associated with an 83% increased risk of death per year after age at onset (hazard ratio 1.83, confidence interval [1.09–3.07], P < 0.02), whilst the mean age at death was similar for individuals with a present and absent right paracingulate sulcus (P = 0.7). Right paracingulate sulcal presence was not associated with baseline cortical thickness. Right paracingulate sulcal presence is associated with disease expression and survival in sporadic behavioural variant frontotemporal dementia. Findings provide evidence of neurodevelopmental brain reserve in behavioural variant frontotemporal dementia that may be important in the design of trials for future therapeutic approaches.
Appropriate assessment using virtual reality simulation for a novel reshaped curve sheath during percutaneous left atrial appendage closure: a follow-up case report
Authors: Shimura Tetsuro , Higami Hirooki , Matsuo Hitoshi , Yamamoto Masanori
Published: October 2023

Background

We previously reported a case of successful percutaneous left atrial appendage closure (LAAC) for complex left atrial appendage (LAA) morphology using a handmade double-curve delivery sheath (DS) reshaped by a heat gun. However, whether the reshaped curve was appropriately adjusted as an optimal configuration for this patient’s anatomy remained uncertain.

Case summary

We established the LAAC procedural simulation model supported by virtual reality (VR) technology. With this VR simulator, the patient’s whole heart model with venous access route and atrial septal puncture point of foramen ovale (FO) could be replicated based on the pre-procedural computed tomography image. Multiple views of the VR image provided a deep understanding of the patient-specific anatomy. Additionally, the operators were enabled to perform the virtual LAAC procedure using VR-derived LAAC devices, including various DS types. In the VR simulator, the manually reshaped DS showed better co-axiality from the FO to the LAA orifice than the conventional double-curve DS, resulting in the successful deployment inside the LAA of the VR simulator. However, the perpendicularity of the device towards the LAA orifice of the handmade reshaped DS remained insufficient. The VR simulator suggested that the ideal curve of the DS needed to change relatively posteriorly and have a more aggressive inferior slide than the previously reshaped DS.

Discussion

The post-procedural review of the VR simulator confirmed that the sheath reshaping technique helped ensure successful LAAC. Pre-procedural VR simulation may be useful for procedural planning that includes DS reshaping for patients with challenging anatomy undergoing LAAC.
Exaggerated elastin turnover in young individuals with Marfan syndrome: new insights from the AIMS trial
Authors: Iskandar Zaid , Dodd Matthew , Huang Jeffrey , Chin Calvin W L , Stuart Graham , Caputo Massimo , Clayton Tim , Child Anne , Jin Xu Yu , Aragon-Martin José Antonio , Gibb Jack , Flather Marcus , Choy Anna-Maria
Published: October 2023

Aims

The fragmentation and loss of elastic fibre in the tunica media of the aorta are pathological hallmarks of Marfan syndrome (MFS) but the dynamics of elastin degradation and its relationship to aortic size and physiological growth remain poorly understood.

Methods and results

In this post hoc analysis of the AIMS randomized controlled trial, the association of plasma desmosine (pDES)—a specific biomarker of mature elastin degradation—with age and aortic size was analysed in 113 patients with MFS and compared to 109 healthy controls. There was a strong association between age and pDES in both groups, with higher pDES levels in the lower age groups compared to adults. During childhood, pDES increased and peaked during early adolescence, and thereafter decreased to lower adult levels. This trend was exaggerated in young individuals with MFS but in those above 25 years of age, pDES levels were comparable to controls despite the presence of aortic root dilation. In MFS children, increased aortic diameter relative to controls was seen at an early age and although the increase in diameter was less after adolescence, aortic root size continued to increase steadily with age. In MFS participants, there was an indication of a positive association between baseline pDES levels and aortic root dilatation during up to 5 years of follow-up.

Conclusion

This study has shown that developmental age has a significant effect on levels of elastin turnover as measured by pDES in MFS individuals as well as healthy controls. This effect is exaggerated in those with MFS with increased levels seen during the period of physiologic development that plateaus towards adulthood. This suggests an early onset of pathophysiology that may present an important opportunity for disease-modifying intervention.