bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of the 2023 World Heart Federation guidelines for the echocardiographic diagnosis of rheumatic heart disease
Authors: Williamson Jacqueline , McLeod Amelia , Marangou James , Remenyi Bo , Morris Peter , Whalley Gillian 
Published: January 2025

AbstractRheumatic heart disease remains prevalent in some regions of Australia and New Zealand. Echocardiography is the gold standard for detection and diagnosis using the 2023 World Heart Federation guidelines. The guidelines describe specific features of mitral and aortic valve morphology and define pathological regurgitation associated with RHD. The aim of this education piece was to assist cardiac sonographers and reporting specialists in the accurate detection, diagnosis, and classification of RHD findings. We present the echocardiographic features of RHD as defined by the 2023 WHF guidelines, including a poster summarising the individual criteria for diagnosis.
Characterizing Challenges and Opportunities in Diagnostic Disclosure Communication in Dementia Care: A Qualitative Study of Clinicians
Authors: Paladino Joanna , Granados Heily Chavez , Blacker Deborah , Vranceanu Ana‐Maria , Jackson Vicki , Ritchie Christine S 
Published: January 2025

AbstractBackgroundDementia is a life‐changing condition for patients and caregivers. Response to a diagnosis often includes grief, shock, and despair. Unfortunately, evidence demonstrates inadequate use of person‐centered communication practices during diagnostic disclosure, which adds to psychological distress. Structured, person‐centered communication interventions are needed to improve the disclosure process. Our aim was to characterize communication challenges and opportunities in diagnostic disclosure.MethodSemi‐structured interviews of clinicians at 3 academic institutions, including one federally qualified health center. An interdisciplinary research team used rapid thematic analysis.Results18 clinicians participated (MDs/NPs/SWs/RNs) across neurology, geriatrics, geriatric psychiatry, primary care. Preliminary themes include: (1) An experience of trauma frequently accompanies dementia diagnostic disclosure. Participants described devastation or denial experienced by patients and caregivers after disclosure (especially an ‘abrupt’ disclosure’), which contributed to patient threats of suicide, clinicians getting fired, or reluctance to seek care. (2) Communicating a dementia diagnosis differs from other medical conditions due to the attribution of symptoms to other causes; perception that there is ‘no fighting back’ (which may change with anti‐amyloid therapies); and the importance of early involvement of caregivers due to variation in patient cognitive capacity. (3) An incremental team‐based communication process is perceived to improve patient and caregiver experience, including: establishing therapeutic alliance; assessing awareness of the cognitive condition and personal beliefs; managing expectations and acknowledging uncertainty; sharing a clear diagnosis with emotional support; creating partnership for anticipatory guidance and planning. (4) System barriers interfere with communication, including long wait times for specialists, lack of training, and unclear rolesConclusionsA structured, psychologically‐informed communication framework for inter‐professional teams may enhance the quality and reliability of the diagnostic disclosure communication process in dementia care. Future research to develop efficacious diagnostic disclosure communication interventions has the potential to improve patient, caregiver, and clinician experience.
Staff perspectives for maintaining staff morale in a nursing home setting
Authors: Como Dominique H. , Wong Carin M. , Shier Victoria , Lekovitch Cara A. , Chew Felicia M , Britton Julie , Leland Natalie E 
Published: January 2025

AbstractBackgroundThe COVID‐19 pandemic had a major impact on healthcare, contributing to a mass exodus of the workforce. This poses a concern for Alzheimer’s disease and related dementias (ADRD) care, which benefits from consistent care routine and staff that know the resident. Therefore, it is important to understand nursing home staff perspectives on maintaining high staff morale, which impacts recruitment, retention, and care quality.MethodEmbedded within a larger pragmatic clinical trial evaluating two approaches to dementia care, nursing home staff (n = 327) were interviewed about their perspectives of dementia care before and after the emergence of COVID‐19. Purposive sampling was used to gain insights across different job roles (e.g., administrators, direct care providers, ancillary support). Staff morale surfaced during the interviews in the context of the evolving COVID‐19 pandemic and the competing demands on staff. Thematic analysis was used to analyze this emergent topic.ResultNursing home staff identified several themes necessary to improve staff morale in light of the negative impact the pandemic had on the workforce striving to care for residents living with dementia. These themes reflected actions that are needed at the individual, interpersonal, and organizational level. The themes include (1) self‐care strategies, (2) peer‐to‐peer support, and (3) leadership approaches and policies. Self‐care strategies were described as being initiated by the staff member for the benefit of their own mental or physical wellbeing. Examples of self‐care included: stepping away from the situation, engaging in spiritual practices (e.g., prayer), and exercising to relieve stress. Descriptions of peer‐to‐peer support reflected instances where staff supported one‐another through teamwork, mentorship, and communication. Staff also highlighted how organizational leadership contributed to morale by ensuring staff felt appreciated and supported. Staff provided examples of leadership initiatives (e.g., scheduling, transparency, incentives) to convey support of staff.ConclusionThese findings highlight the actionable steps staff and administrators can take to foster staff morale among those who care for residents living with ADRD. Given the impact the pandemic had on the healthcare workforce and the challenge many staff who work on dementia units continue to face, staff morale may be a key factor in addressing staff retention and care quality.
Preliminary Results on the Effects of American Elderberry Juice for Improving Cognition and Inflammatory Markers in Mild Cognitive Impairment
Authors: Musich Madison , Curtis Ashley F. , Ferguson Bradley J. , Thomas Andrew L. , Greenlief C. Michael , Shenker Joel I. , Beversdorf David Q. 
Published: January 2025

AbstractBackgroundDespite data showing nutritional interventions high in antioxidant/anti‐inflammatory properties (anthocyanin‐rich foods such as blueberries/elderberries) may decrease risk of memory loss and cognitive decline, evidence for such effects in mild cognitive impairment (MCI) patients is limited. Therefore, we examined preliminary effects of American elderberry (Sambucus nigra canadensis) juice on cognition and inflammatory markers in MCI patients in a double‐blind placebo‐controlled trial.MethodMCI patients (N = 24, Mage = 76.33±6.95) received elderberry (n = 11) or placebo (n = 13) juice (5mL orally 3‐times‐a‐day) for 6 months. At baseline, 3‐month, and 6‐month follow‐ups, patients completed tasks assessing global cognition, verbal memory, language, cognitive flexibility, and visuospatial memory. A subsample (N = 12, 7 elderberry/5 placebo) provided blood samples at these timepoints to measure plasma inflammatory markers. Multilevel models examined effects of condition (elderberry/placebo), time (baseline/3‐months/6‐months) and condition by time interactions on cognition/inflammation outcomes. Interactions were evaluated via Kenward‐Roger pairwise tests.ResultFor cognition, the condition by time interaction trended towards significance for Visuospatial Problem Solving (VPS)‐mean latency correct (p = .08). Elderberry (not placebo) trended (p = .09) towards a decrease (faster performance in seconds) from baseline (M = 43.31, SD = 34.41) to 6‐months (M = 23.20, SD = 14.45). For inflammation, the condition by time interaction was significant for L‐lactate dehydrogenase A chain (LDHA; p = .03) and complement factor D (CFD; p = .03). In the placebo condition, LDHA significantly (p = .004) decreased from baseline (M = 4.78, SD = 1.41) to 6‐months (M = 2.07, SD = 0.89), while for elderberry LDHA remained stable (ps>.05). CFD significantly (p = .04) increased from 3‐months (M = 4.52, SD = 1.37) to 6‐months (M = 7.52, SD = 1.79) for placebo, while for elderberry, CFD trended (p = .051) towards decrease from baseline (M = 6.80, SD = 2.35) to 6‐months (M = 4.34, SD = 2.95). CFD was significantly higher for placebo vs. elderberry at 6‐months (p = .02). Exploratory correlation analyses (n = 12) showed a significant negative association (r = ‐0.93, p = .02) between change scores (6‐months–baseline) for LDHA and VPS‐mean latency correct in the elderberry condition.ConclusionElderberry (not placebo) juice consumption in MCI patients may provide some benefit to cognitive flexibility. Preliminary analyses reveal this benefit may be related to reduction of low‐grade inflammation. These promising findings provide support for larger, more definitive prospective studies with longer follow‐ups to better understand mechanisms of action and the clinical utility of elderberries for mitigating cognitive decline.
Plasma‐derived Extracellular Vesicle Surface Antigens related to Platelets as biomarker for Alzheimer’s Disease
Authors: Vacchi Elena , Cimiotti Carlotta Ginevra , Bolis Sara , Yadav Ankush , Pravatà Emanuele , Pinton Sandra , Rossi Stefania , Paganetti Paolo , Kaelin‐Lang Alain , Barile Lucio , Sacco Leonardo , Melli Giorgia 
Published: January 2025

AbstractBackgroundAlzheimer’s disease (AD) is the most common irreversible neurodegenerative disorder of the elderly. Its clinical diagnosis can be confirmed with expensive and invasive laboratory exams. Thus, new biomarkers and diagnostic tools to facilitate the proper management of patients are required. With the aim to identify new biomarkers for AD, we characterized the expression of multiple plasmatic Extracellular Vesicles (EVs) surface markers, related to immune response and inflammation. Indeed, emerging evidence suggests a central role of inflammation in the development and pathogenesis of AD.MethodsThirty confirmed AD patients, among which 7 with mild cognitive impairment (MCI) and 23 with moderate‐severe dementia, and 20 healthy controls (HC) were enrolled. Patients underwent clinical evaluation, cerebrospinal fluid Aβ and Tau analysis, and magnetic resonance imaging (MRI). All subjects underwent blood collection. Plasma‐derived EVs were analyzed by flow cytometry to measure the expression of 37 EV surface markers.ResultsAD‐derived EVs showed higher CD62P and lower CD2 expression compared to those from HC. CD62P was associated with AD diagnosis, displaying good diagnostic performance, correlating with cognitive impairment, and showing higher expression in AD patients with pathological levels of Aβ42 in the CSF. These results were re‐confirmed considering the moderate‐severe patients only. In addition, CD41b was found increased in MCI subjects compared to both HC and severe AD showing reliable diagnostic performance for the MCI group.ConclusionsPlasmatic EV surface markers characterization reinforces the role of EVs as promising biomarkers for AD, opening the possibility of developing non‐invasive diagnostic tools.
Reliability and validity of the Health‐Related Quality of Life Instrument with 8 Items for measuring health‐related quality of life in family caregivers of people with dementia
Authors: Choi Yu Mi , Seo Hyun‐Ju , Kim Seong Min 
Published: January 2025

AbstractBackgroundCaring for people with dementia can be demanding and challenging, requiring constant support and attention. Family caregivers often experience high‐stress levels, depression, and overall strain. To enhance the quality of life of family caregivers, it is crucial to use accurate measurement tools to identify their needs.It is unclear whether the Health‐Related Quality of Life Instrument with 8 Items (HINT‐8) is suitable for measuring the HRQoL of Korean family caregivers of people with dementia, as no studies have been conducted to assess its applicability.This study aims to assess the reliability and validity of the HINT‐8 tool compared with EQ‐5D‐5L and WHOQOL‐BREF in measuring the HRQoL of family caregivers of people with dementia in Korea.MethodThis study is designed as a methodological study, using a cross‐sectional design to verify the reliability and validity of HINT‐8. The Three HRQoL measures ‐ HINT‐8, EuroQoL 5‐Dimension 5‐Level (EQ‐5D‐5L), and WHOQOL‐BREF were provided to 340 family caregivers with people with dementia in dementia relief centers and home‐visiting nursing centers in Korea. The HRQoL scores obtained using the HINT‐8 were evaluated for subgroups with known differences based on demographics and recipient‐related characteristics (known‐group validity). Convergent and divergent validity to assess the Correlation coefficients of the HINT‐8 with other instruments and the intra‐class correlation coefficient (ICC) for test‐retest reliability were evaluated.ResultThe study will calculate descriptive statistics (including median, first quartile, third quartile, minimum, maximum, mean, and standard deviation) for all responses. We will also compare weighted percentages to examine ceiling effects for each HRQoL instrument. We will present the results of the construct validity, test‐retest reliability, and known‐group validity of HINT‐8.ConclusionThis study will show the validity and reliability of HINT‐8 for measuring health‐related quality of life in family caregivers of people with dementia in a Korean context.
Alzheimer’s disease subtypes based on cerebrospinal fluid proteomics have distinct CSF lipid profiles
Authors: Tijms Betty M. 
Published: January 2025

AbstractBackgroundDisease mechanisms underlying Alzheimer’s disease (AD) are heterogenous amongst patients. We recently identified five distinct AD subtypes in cerebrospinal fluid (CSF) proteomic data with data‐driven techniques (Figure 1). Two of these subtypes were characterised by brain barrier dysfunction: one with choroid plexus dysfunction, and another with blood‐brain barrier dysfunction. Since most lipid transport takes place across these barriers, we compared these two subtypes on CSF lipid levels.MethodWe included 419 individuals with abnormal amyloid across the clinical spectrum (i.e., AD) and 196 controls with intact cognition and normal AD biomarkers from the Amsterdam Dementia Cohort and related studies with CSF proteomic subtyping available. Next, we performed untargeted complex lipidomics with CSH‐QTOF mass spectrometry. Of 3532 lipids detected, 270 could be mapped to known classes. We compared AD barrier subtypes to controls on CSF lipid levels, controlling for sex and age with general linear models.ResultOf the 3532 lipids compared to controls, blood‐brain barrier dysfunction AD subtype had mostly increased levels of 302 lipids (148 with a known class; Figure 2, all p<0.05), whereas the choroid plexus subtype had mostly decreased levels of 314 lipids (163 known class;, all p<0.05) with an overlap of 150 lipids. These lipids included mostly glycerophospholipids, ceramides, and sphingomyelins. The blood‐brain barrier AD subtype further had increased levels of 14 tryglicerides, which were unaltered in the choroid plexus subtype. No specific alterations in CSF levels of known lipid classes were observed for the choroid plexus subtype.ConclusionWe previously identified 5 AD subtypes with distinct underlying mechanisms, including two subtypes with involvement of either the blood‐brain barrier or the choroid plexus. The subtypes with different type of brain barrier dysfunction had opposite alterations in CSF levels of lipids from specific classes. This implies that these barriers have a distinct role in lipid metabolism and transport alterations in AD, which may require specific treatments.
Clinicoradiologic correlates of corticolimbic index (CLix) and glial activation differences among neuropathologic subtypes of Alzheimer’s disease
Authors: Murray Melissa E. , Dunlop Sara R 
Published: January 2025

AbstractBackgroundSelective corticolimbic vulnerability to tau pathology in Alzheimer’s disease (AD) underlies clinicopathologic heterogeneity. The goal of this presentation will be to examine spatial heterogeneity of tangle distribution on a continuum through the utility of the corticolimbic index (CLix).MethodWe will discuss the development of CLix in the Florida Autopsied Multi‐Ethnic (FLAME) cohort, which sought to collapse the spatial distribution of thioflavin‐S tangle counts in AD (n=1361) to assign a continuum: hippocampal sparing with cortical predominance (<10), representative/typical (≥10 to <30), and limbic predominant with cortical sparing (≥30). The relationship with atypical, non‐amnestic clinical presentations will be described. Relevant clinical measures, including age at symptomatic onset and longitudinal decline on mini‐mental state examination (MMSE) will be examined. Digital pathology measures of AD (tau [AT8, GT‐38], amyloid‐β [6F/3D]) and glial activation (astrogliosis: GFAP, activated microglia/macrophage: CD68) will be shown in hippocampus and association cortices (n=60). To further extend these findings to the antemortem space, CLix score will be examined in an independent, autopsied neuroimaging group (n=93).ResultsLower CLix score correlated with younger age at symptomatic onset (R=0.39, p<0.001), faster MMSE decline (R=0.27, p<0.001), and associated with non‐amnestic clinical presentations (median=13 vs. 21, p<0.001). Lower CLix score correlated with greater hippocampal volume on MRI (R=‐0.45, p<0.001) and higher flortaucipir‐PET uptake (e.g., posterior cingulate‐precuneus cortex: R=‐0.74, p<0.001). Advanced tangle maturity burden (GT‐38) differed across all regions (p<0.001). Hippocampal sparing AD exhibited higher cortical tau pathology and reduced cortical activated microglia/macrophage.ConclusionsCorticolimbic tangle distribution links with AD clinical features and neuroimaging changes. Reduced activated microglia/macrophage in association cortices of relative hippocampal sparing AD may contribute to higher tau burden. Corticolimbic vulnerability should be considered for personalized therapies targeting immune dysregulation.
Improved gray and white matter volume loss analysis in Alzheimer's Disease using high resolution 3D MRI
Authors: Salokhiddinov Marufjon , Singh Dharmesh , Ismailova Munojat , Kumar Dileep 
Published: January 2025

AbstractBackgroundAlzheimer's disease is a common neurodegenerative disease that affects the lives of millions of people worldwide. In our study, we aim to evaluate the effectiveness and accuracy of the latest automated brain volume analysis method for GM and WM analysis in health control and patients with AD and to compare optimized cut‐off values for both regions between subjects.MethodThe original baseline scans from 37 HC (HC) and 39 mild AD patients downloaded from ADNI. High‐resolution T1‐weighted MRI scans were collected for each participant using a sagittal 3D MP‐RAGE sequence. Volumetric differences between groups were determined in this investigation utilizing a cascaded weakly supervised confidence integration network (CINet). Data were collected from two areas of interest (ROI): white matter volume and gray matter volume. Total CGM encompassed all the gray matter in the frontal, parietal, temporal, and occipital lobes and all gray matter that could be visually identified as being a part of the cerebral cortex. Volume was measured in cc.ResultResults showed that healthy subjects GM and WM brain volume values were significantly greater than mild AD subjects by ∼18%. The mean ± SD of GM volume for HC was 618.41 ± 50.54 cc and for mild AD patients was 542.40 ± 101.37 cc. The mean WM brain volume was 502 ± 59.60 cc for HC and 445 ± 60 cc for mild AD subjects. Both GM and WM volume values for HC showed significant (p < 0.05) higher (∼18% in both GM and WM volumes) than mild AD subjects. There was very low correlation (r = 0.15) for GM volume of HC and mild AD, and r = 0.02 for WM volume of HC and mild AD patients.ConclusionIn conclusion, the CINet combined V‐Net method has demonstrated encouraging results in quantifying GM and WM volume in MRI images of people with early‐stage AD. Compared to conventional human segmentation techniques, this automated approach has various advantages, including improved productivity, accuracy, and dependability.
Brainstem Atrophy across the AD Clinical Spectrum: An Automated Volumetric MRI study
Authors: Bhalla Deepali M , Bendlin Barbara B. , Antuono Piero G. , Granadillo Elias 
Published: January 2025

AbstractBackgroundStudies suggest that structural changes in the midbrain are linked to Alzheimer’s disease (AD) symptoms such as memory, sleep, and emotional disturbances. Brainstem atrophy, particularly in the locus coeruleus, has also been linked with poorer executive function. Studies showing brainstem as one of the first regions affected by AD largely employed novel imaging techniques such as neuromelanin‐sensitive MRI, which is limited to research environments. Prior studies have established the utility of hippocampal measures using automated volumetric software such as Neuroreader (NR) aiding in diagnosis of AD, and is emerging as an inexpensive and easily accessible tool. Here, we used NR to assess brainstem (BS) volumes of AD patients to examine the potential to capture an effect using conventional T1‐weighted MRI.MethodsWe conducted a retrospective chart review (N=300) of participants who underwent volumetric scan evaluated with NR after 2015 (Table 1). NR was used to generated BS and hippocampal volumes corrected for total intracranial volume (BS‐Vc and Hip‐Vc) among 3 groups (N=100 each): subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and AD Dementia. Categorization of participants was based on the current clinical diagnostic criteria for AD clinical syndrome. Multiple regression models were run to determine group‐wise differences in BS‐Vc and Hip‐Vc, correcting for age, gender, and education.ResultsPreliminary results showed no difference in BS‐Vc across groups. Hip‐Vc was significantly different between SCI and AD (β = ‐0.048, p <0.001) and MCI and AD (β = ‐0.033, p =0.001) groups. Interestingly, with correction for age, education level, and disease stage, male gender was associated with lower BS‐Vc (β = ‐0.053, p <0.001); consistent with AD literature suggesting a differential susceptibility to AD pathology based on gender.ConclusionWe found no differences in BS‐Vc across the AD clinical spectrum, possibly due to low power of this study, or limitations in NR to detect atrophy in brainstem sub‐structures such as the locus coeruleus. Differences in BS‐Vc across genders was independent of disease status, suggesting a role of gender susceptibility in AD that is specific to the brainstem. Further exploration of these findings in future studies with increased power is needed.