bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skill building blocks: Asynchronous online learning through interactive thematic instruction
Authors: Brown Nancy L , Rubin Vicki de Klerk 
Published: June 2023

AbstractBackgroundAmong non‐pharmacological strategies, research shows that the Validation method (VM) developed by Naomi Feil provides a theoretical framework enabling professionals and caregivers to better understand the reasons behind the behavior of the older person with dementia. Built upon the stage‐specific communication techniques of empathy, observation, listening, and verbal and non‐verbal skills, the relationship, emotions, lived experience, values, significant relationships, social roles, sensorial, physical, social and psychological losses of the older person are taken into account. With the increased need for online learning due to COVID‐19, Validation Training Institute (VTI) designed and implemented the Skill Building Blocks, an interactive thematic video‐based instruction, to provide an interactive online learning environment to facilitate user‐friendly self‐study and real‐time access to knowledge. Thematic instruction strategy relates to the learners’ life experience which more easily increases interest and engagement in the content, strengthens knowledge retention, and enables behavioral modelling for application to the real world.MethodTo boost learning and transfer of knowledge, cognitive load theory was applied wherein tasks are divided into smaller building blocks that are individual but included among a collection of related themes. The 6 ‘on‐demand’ videos deliver asynchronous learning followed by ‘exercises’ to reinforce learning and process information. This study, based on the cognitive theory of multimedia learning, investigated the participants’ reflection and learning performance through pre and post‐questionnaires using the Likert scale of 1 through 5, and the IMMS (Instructional Material Motivation Survey) which measures attention, relevance, confidence, and satisfaction. An online focus group of participants concluded the data collection process.ResultLearners express confidence and satisfaction with the user‐friendly, thematic design of each block that utilizes a variety of multimedia learning experiences including video, exercises, and quizzes that reinforces transfer of knowledge as well as cognitive learning. Techniques learned and practiced in each block were applicable to real life situations and could be applied immediately after each block.ConclusionTechniques taught through Skill Building Blocks proved to be relevant to the learners’ life experience, effective in retention and transfer of skills, and proved to be motivating for continued application in the real world.
Real‐time Neurofeedback Rewards Memory‐related Potentials in Older Brains
Authors: Liu Ziming , Jiang Yang , Zhao Xiaopeng 
Published: June 2023

AbstractBackgroundElectroencephalogram (EEG)‐based neurofeedback (NF) allows reward of desired brain activity in milliseconds. Compared to frequency power‐based approach during resting state EEG, event‐related potentials (ERPs) based NF during a task is technically challenging because of the cost of computation over a time window. We have previously established that left‐frontal memory‐related potentials discriminate normal cognitive aging from age‐ and education‐ matched older adults with risk of mild cognitive impairment (MCI). To modulate brainwaves during working memory retrieval towards healthier patterns, we develop an ERP‐based neurofeedback protocol to reward better memory‐related potentials.MethodThe training protocol is developed based on a modified delayed match‐to‐sample task also known as Bluegrass working memory paradigm. During each memory trial, a participant holds the sample target image in his/her working memory and responds whether each subsequent image is a Match or Nonmatch to the memory target by pressing the button. Real‐time classification of extracted ERP features is analyzed after stimulus onset, the dynamic machine‐learning program then modifies the stimulus by turning it into vivid color (reward) or leaving it with black‐and‐white (unrewarded). The processing pipeline has been developed using ERPs of older adults with and without MCI. The left frontal sites (F3 and F7) were preprocessed by re‐referencing and filtering with a 0.05 – 40 Hz band‐pass filter. For each participant, the EEG of 5 offline base trials in a 300‐600ms time window was used as a baseline. The ERP difference of the baseline versus the subsequent single trial is calculated to determine whether the image will be colored or left at black‐and‐white.ResultOur newly developed ERP‐neurofeedback protocol has succeeded in providing visual feedback based on fluctuation of single trial ERP in real time. The program was also designed to fit in each individual due to varied sensibility to NF. Currently we are to examine the feasibility and effectiveness of the proposed protocol by measuring memory indicators before and after NF training sessions.ConclusionWe have developed a new protocol using ERP‐based neurofeedback to improve personalized memory retrieval. The program is the first step to intervention trials for enhancing successful memory by rewarding desired memory‐related potentials in older brains.
A case study on AI and robot‐assisted psychoeducational support for Alzheimer’s caregivers
Authors: Yuan Fengpei , Proctor Lauren , Blackburn Jordis , Bray Robert , Mukherjee Namrata , Bowland Sharon , Lopez Ruth Palan , Li Shuai , Zhao Xiaopeng 
Published: June 2023

AbstractBackgroundMore than 6.2 million older Americans live with Alzheimer’s disease and related dementias (AD/ADRD). Dementia care is mostly provided by family or friends. This long‐duration, time‐intensive care can negatively impact caregivers’ physical and mental health. Dementia caregivers often feel unprepared for their roles. Resources for Enhancing Alzheimer’s Caregiver Health: Offering Useful Treatments (REACH OUT) interventions have been shown to improve caregivers’ health. However, it is challenging and resource‐intensive to implement such interventions in real‐world settings. Artificial intelligence and robotics demonstrate the potential to assist delivering intervention and support caregivers.MethodWe developed a Friendly AI‐ and Robotics‐based REACH (FAIR‐REACH) program to deliver a modified version of REACH OUT using a friendly humanoid social robot, Pepper. FAIR‐REACH included five modules: introduction to AD/ADRD and caregiving, safety information, healthy lifestyle guide, stress and relaxation, and caregiving challenges. The robot delivered the program using multimodal presentation, including a touchscreen tablet, verbal and nonverbal communication. In each module, a list of topics were displayed on Pepper’s tablet for users to choose. Approaches were employed to enable Pepper to deliver interventions engagingly, interactively, and empathetically. After supplying information on the chosen topic, the robot asked users a question relevant to the content and provided a follow‐up comment. We tested FAIR‐REACH on 2 participants and used questionnaires to assess acceptance and user experience.ResultThe participants were 1 female and 1 male, both aged 65‐75. P1 previously worked as a paid in‐home caregiver. P2 currently acts as an informal caregiver. Both participants believed that FAIR‐REACH were useful for dementia caregivers. The program was perceived as easy to use. The robot’s appearance was pleasing to participants and the tablet designs (e.g., layout) were attractive to them. Participants provided suggestions on the robot’s functions, for example, speaking more slowly, talking with caregivers more interactively, and answering caregivers’ questions.ConclusionIn the case study, the FAIR‐REACH was perceived as easy to use and helpful. The future work includes refining FAIR‐REACH to improve user experience according to the feedback/suggestions collected from the case study and assessing the feasibility, Usability, and effectiveness with a large number of dementia caregivers.
PAS‐MCI: Design and rationale for a randomized controlled trial to enhance prefrontal cortical plasticity and working memory in individuals with amnestic mild cognitive impairment
Authors: Genadry François , Ledwos Nicole , Kumar Sanjeev , Bowie Christopher R. , Daskalakis Zafiris J. , Fischer Corinne E. , Herrmann Nathan , Mulsant Benoit H. , Pollock Bruce G. , Zomorrodi Reza , Blumberger Daniel M. , Rajji Tarek K. 
Published: June 2023

AbstractAmnestic Mild Cognitive Impairment (aMCI) is a prodromal stage to Alzheimer’s disease dementia (AD). Improving prefrontal cortical function in individuals with MCI could prevent progression from aMCI to AD. A key mechanism that has been linked to memory formation is cortical plasticity. Paired Associative Stimulation (PAS) is an intervention that uses transcranial magnetic stimulation (TMS) to enhance cortical plasticity. When delivered to the prefrontal cortex in individuals with AD, it has shown promise to improve prefrontal cortical plasticity and working memory.PAS‐MCI is a randomized controlled trial (RCT) that aims to assess: (1) dorsolateral prefrontal cortex (DLPFC) plasticity in individuals with aMCI compared to cognitively unimpaired control (CU) participants, (2) the efficacy of PAS delivered for 10 days bilaterally to the DLPFC of individuals with aMCI in enhancing their DLPFC plasticity, working memory, and executive function, and (3) whether changes in DLPFC plasticity mediate changes in working memory and executive function.100 aMCI and 50 CU control participants will be assessed clinically and cognitively, and undergo PAS combined with electroencephalography (PAS‐EEG) to characterize left DLPFC plasticity. The aMCI participants are randomized (1:1) to receive 10 daily sessions of either active or sham PAS delivered to the bilateral DLPFC. On Day 0, 7, and 28 following the PAS course, participants undergo repeat cognitive testing and PAS‐EEG to assess changes in working memory, executive function, and left DLPFC plasticity.As of February 1st, 2022, 14 aMCI and 9 CU participants consented, of which 5 aMCI and 4 CU participants completed the study. 7 aMCI participants were excluded because of: a contraindication for TMS (n = 1), having dementia (n = 1), and having non‐amnestic MCI (n = 5); 1 withdrew due to fatigue; and 1 is pending enrollment. 3 CU participants were excluded because of low cognitive scores; 1 withdrew due to not tolerating TMS; and 1 is pending enrollment.If successful, this RCT will establish the short‐term efficacy of PAS, a new TMS approach to enhance prefrontal cortical function in individuals with aMCI. A follow‐up longer‐term trial will be then needed to assess whether PAS could prevent cognitive decline and progression to AD.
Novel digital biomarker identification in Alzheimer’s Disease and related dementias
Authors: Wu Chao‐Yi , Cesnakova Lucy , Goldsack Jennifer C , Stefko Danielle , Kaye Jeffrey A , Au Rhoda 
Published: June 2023

AbstractBackgroundThe gold standard method for assessing the efficacy of dementia treatments, the Alzheimer’s Disease (AD) Assessment Scale‐Cognitive Subscale (ADAS‐Cog), has limitations of use based on the level of cognitive decline of a patient, the need for an in‐person evaluation, and the sampling of a time point in the patient experience. However, measuring factors associated with patient disease progression is key to not only assessing treatment efficacy, but also to predicting patient trajectory. New measures are needed to fill the gaps associated with the ADAS‐Cog, and digital tools are poised to reveal novel biomarkers of AD and related dementias (ADRD) with the added benefit of continuous measurements in a real‐world setting that give voice to patients unable to directly communicate experiences.MethodA systematic literature review conducted globally of over two million publications is used to identify meaningful aspects of health and physiological characteristics of ADRD. In‐person interviews of patients, caregivers, clinicians, and scientists (n = 50) supplement the findings of the review and, taken together in a mixed methods approach, allow for the creation and dissemination of a survey of the larger ADRD population (n = 2500) regarding the clinical and patient‐centric value of potential measures.ResultPrevious efforts led to the creation of a database of over 300 digital endpoints used in previous and ongoing trials, including several related to ADRD and cognition (i.e., blink count, activity, acoustic/linguistic measures). The resulting list of candidate biomarkers from the mixed methods study is assessed for feasibility of digital measurement, cultural inclusivity, clinical relevance, and accuracy of representation of patient lived experience to produce an optimized set of digital biomarkers defining a meaningful aspect of health in ADRD.ConclusionDigital biomarker measurement, particularly in ADRD, allows for a richer, more comprehensive understanding of the patient’s lived experience, the patient’s disease progression, and the efficacy of treatments. Capturing novel digital biomarkers continuously and in a real‐world setting provides patients, caregivers, and clinicians with useful insights absent of the limitations associated with the ADAS‐Cog. This digital approach further lays the foundation for the development of patient‐centric measures acceptable to clinicians, regulators, and payers.
MAPS: Music and psychology & social connections – a protocol for a pilot dyadic intervention for caregivers and people living with younger‐onset dementia
Authors: Loi Samantha M , Cadwallader Claire , Flynn Libby , Stretton‐Smith Phoebe , Bryant Christina , Baker Felicity 
Published: June 2023

AbstractBackgroundYounger‐onset dementia (YOD) has its onset at <65 years old, represents 5% of all dementias and affects people and their families during significant productive years of life. People living with YOD and their caregivers face unique challenges, and can feel isolated, less supported and at higher risk of depressive and anxiety symptoms. There is a scarcity of interventions for both caregivers and people with YOD. Cognitive behaviour therapy (CBT) and music therapy (MT) have evidence‐based positive effects in older adults with dementia and their caregivers, but are yet to be trialled in younger people. MT may be perceived as less threatening and motivate engagement. Social networking may also be a useful forum for sharing content and has been previously utilised in caregiver support groups.MethodMAPS is a 7‐week manualised online group program for people living with YOD and caregiver dyads. Weekly sessions (80‐90 minutes with a break) will be co‐facilitated by a psychologist and music therapist, and will include joint sessions with both members of the dyad (sessions 1 and 6), and separate sessions for the caregivers and the people living with YOD (sessions 2 to 5). The two major themes are: 1) Dealing with the challenges and changes associated with being a caregiver/living with YOD; and 2) Finding ways to be positive and focusing on the things they value. MAPS will utilise a combination of CBT techniques and MT methods, with the production of two songs per group and “homework”. A closed, private Facebook group will be used for sharing content and resources. The major outcome measure will be improvement in Depression Anxiety and Stress Scores, using the DASS21. Focus groups for qualitative feedback will occur in the final session, 7.ResultPendingConclusionIf successful this pilot has the ability to be expanded for larger outreach.
Atrophy patterns in subjects at increased risk of Alzheimer’s Disease
Authors: Liu Hangfan , Li Karl , Grothe Michel J. , Rashid Tanweer , Seshadri Sudha , Toledo Jon B. , Habes Mohamad 
Published: June 2023

AbstractBackgroundCognitively impaired individuals have multiple contributing conditions leading to heterogeneous atrophy patterns. Unfortunately, neuroimaging data is usually contaminated by noise, which can lead to spurious non‐clinically relevant clusters. Identification of true disease specific clusters requires techniques robust against noise.MethodWe developed an unsupervised approach named COllaborative Clustering based on Adaptive Laplace modeling (CoCAL) to simultaneously cluster individuals and features while removing noise. We derived the distributions of the coefficients produced by non‐negative matrix tri‐factorization (Fig. 1). We applied CoCAL to the PREVENT‐AD dataset, a cohort of cognitively unimpaired participants with a family history of Alzheimer’s Disease (AD). The groups clustered by CoCAL were compared by student’s t‐test with FDR correction, and each cluster is evaluated by Alzheimer’s Progression Score (APS).ResultExperimental results on a synthetic dataset demonstrated superior clustering performance of CoCAL over several benchmark clustering methods including k‐means and conventional matrix factorization based clustering methods. On the PREVENT‐AD dataset, two clusters (G1 and G2) were identified by CoCAL (Table 1). The corresponding t‐test statistic values of regions with p‐values < 0.05 are plotted in Fig. 2. Cluster G1 showed higher APS compared to G2 (APS scores: 0.197 ± 0.0562 [G1] vs ‐0.080 ± 0.0539 [G2], p < 0.001). There were no significant differences in sex, age and APOE ε4 status between the groups.ConclusionWhen applying CoCAL to the PREVENT‐AD cohort, two distinctive atrophy patterns emerge: a parietotemporal cluster (G1) and a fronto‐occipital cluster (G2). G1 corresponds well with classic patterns of cortical atrophy in AD, and participants in this group demonstrate higher APS than G2 participants. In contrast, the greater atrophy in the frontal and occipital lobes in the G2 cluster may reflect either gray matter atrophy from vascular contributions, or the frontal variant of AD. Further investigations into the progression of these different clusters and sub‐networks within the cluster could yield insight for more targeted management of AD.
Emotional characteristics associate with fronto‐amygdala connectivity in older‐old adults: Results from I‐CONECT
Authors: Pruitt Patrick J , Yu Kexin , Lahna David , Schwartz Daniel , Peltier Scott J , Silbert Lisa C , Dodge Hiroko H 
Published: June 2023

AbstractBackgroundResearch into the emotional health of older adults, as it relates to brain network function, lags research into cognitive health, despite the importance of emotional health to quality of life. Here, we examine associations between three summary scores of emotional health from the NIH Toolbox Emotion Battery (NIHTB‐EB) – negative affect, social satisfaction, and psychological well‐being – and their associations with intrinsic brain network functional connectivity within three systems implicated in emotional function – the default mode network (DMN), salience network (SAL), and amygdala‐based connectivity.MethodFifty participants completed resting‐state functional magnetic resonance imaging (rs‐fMRI; 33 women, 80.7±4.4 years). We used two analytic approaches:Seed‐to‐voxel (amygdala): We extracted timeseries from bilateral amygdalae for a voxelwise, whole‐brain analysis. Separate analyses were conducted for each NIHTB‐EB summary score.ROI‐to‐ROI (DMN/SAL): Pairwise correlations were averaged to provide a single measure of within‐network connectivity for each network. ROI‐to‐ROI analyses were calculated in separate regression models using each NIHTB‐EB summary score to predict connectivity within each brain network.NIHTB‐EB outcomes were generated with subscale scores weighted by factor loading. Both sets of analyses included age, sex, site, in‐scanner motion, and cognitive status (unimpaired cognition or mild cognitive impairment).ResultPsychological well‐being associated negatively with amygdala connectivity with ventromedial prefrontal cortex (vmPFC; Fig1; peak T = ‐4.28; MNI xyz: [‐6,24,‐24]; k = 63 voxels). Conversely, negative affect associated positively with amygdala connectivity with vmPFC (Fig2; T = 4.24; [8,22,‐22]; k = 27).NIHTB‐EB summary scores did not associate with DMN or SAL connectivity.ConclusionThese results highlight the relevance of fronto‐amygdala connectivity in understanding emotional aging in older‐old adults. Previous research suggests that the inhibition of amygdala activity by frontal regions plays a key role in emotion regulation. In this light, diminished amygdala‐vmPFC connectivity may reflect better emotion regulation, which here associates with higher levels of psychological well‐being and lower levels of negative affect.While research on younger adults has established the relevance of DMN and SAL connectivity to emotional health, this work suggests that these networks may not be as relevant to emotional health in the older‐old population. These results should be interpreted with caution, as they use an uncorrected voxelwise threshold (p<0.001).
Cannabidiol for neuropsychiatric symptoms in Alzheimer’s dementia
Authors: Velayudhan Latha , Dugonjic Marta , Pisani Sara , Chowdary Seemulamoodi Yellappa , Harborow Lucy , Aarsland Dag , Sagnik Bhattacharyya 
Published: June 2023

AbstractBackgroundBehavioural and Psychological Symptoms of Dementia (BPSD) in people with Alzheimer’s disease (AD) is particularly distressing to patients and carers. There are currently no licensed medications for BPSD, and the current available treatments have limited benefits and greater risk for side effects. There is therefore a considerable unmet clinical need for interventions that are safe, well‐tolerated and effective for treating BPSD in AD. Cannabidiol (CBD), a non‐addictive substance present in cannabis shows promise for treating psychotic and anxiety symptoms in people without dementia and is generally safe and well‐tolerated in elderly. However, its efficacy, safety and tolerability need to be systematically tested in elderly with dementia. We aimed to evaluate acceptability and tolerability of CBD as treatment for BPSD in patients with AD.MethodsWe are conducting a double‐blind, parallel group, placebo‐controlled pragmatic randomized controlled feasibility trial (EudraCT Number ‐ 2019‐002106‐52) and recruiting AD patients with BPSD within Mental Health for Older Adults services, South London and Maudsley NHS trust, United Kingdom. Half of the participants receive 600 mg of CBD orally once a day over 6 weeks and the other half receive a placebo, in addition to their usual treatment for 6 weeks. Clinical data collected includes measures of cognition, Clinical Dementia Rating for staging, behaviour symptoms on Neuropsychiatric Inventory (NPI), global functioning, Quality of Life for patients and carer’s burden. Tolerability is assessed by self‐report of side‐effects, and side‐effect rating scale.ResultsOf the participants recruited and randomised so far, there have been no withdrawals or serious adverse events. The study is ongoing and due for completion at the end of April 2022, following which we will have the data to analyse and present the findings at the July 2022 conference.ConclusionsCBD has been generally acceptable and safe for people with AD with BPSD. The final analysis and findings related to adverse events, and changes in clinical measures for the groups (CBD treatment versus placebo) including BPSD, cognition etc. will be presented at the conference.