bluuebunny/crossref_metadata_2025_split huggingface dataset:
A machine learning‐based quality control tool for functional MRI images
Authors: Peraza Luis R , Weatheritt Jack , Wolz Robin 
Published: June 2023

AbstractBackgroundChanges in functional MRI (fMRI) have been associated with Alzheimer’s disease and other neurological disorders. Quality control (QC) of images prior to their computational analysis is a key step in a clinical trial analysis workflow, and it is traditionally implemented visually by image analysts. However, the number of images acquired from large clinical studies makes neuroimaging QC a difficult task that diverts skilled resources and introduces inter‐rater variability. This problem is accentuated in fMRI, where image analysts need to visually inspect 4D sequences, and although image processing reports can be used as aid, the problem of having to inspect each report remains.MethodWe implemented an automated fMRI QC process using a stacking classifier (STC), random forest + support vector machine, with imaging quality metrics (IQM) as inputs. The IQMs were estimated with MRIQC. We also added a designed IQM that measures how centred the participant’s brain is within the image. As train/test dataset we used the ABIDE multisite database. For our experiments, only adult brains from the ABIDE database were used, leaving 14 sites available for a leave‐one‐site‐out (LOSO) cross‐validation experiment. All images included in the experiment were visually QC’d using validated protocols at IXICO.ResultThe LOSO validation procedure resulted in a mean pass‐vs‐fail accuracy of 92% (with 5.7% standard deviation, SD). Pass/fail sensitivity and specificity resulted in 97% (6.7% SD) and 69% (29% SD) respectively. We tested a fully trained STC model on an independent dataset of healthy ageing participants from OpenNeuro (ds002872), which resulted in 87% accuracy, 94% sensitivity and 50% specificity, which validates our modelling procedure.ConclusionIt is possible to design and deploy an automatic QC model for fMRI. Although sensitivity was high in all models from the LOSO experiments, specificity was on average low, highlighting the difficulty of detecting fails in a QC pipeline. However, the STC model can be deployed to detect clear passes that will not need visual QC, reliably reducing the number of cases that require visual inspection. Our future work will focus on testing our developed model on additional datasets (e.g. ADNI) to validate its performance before roll‐out to clinical trial applications.aging after age 90.
A case study of urban design for wellbeing and mental health in Lagos, Nigeria
Authors: Akindejoye Funmi 
Published: June 2023

AbstractBackgroundThere are increasing interests in the impact and contribution of urban planning and design on mental health disorders. However, studies are scarce around such concepts within the densely populated urban city of Lagos State, Nigeria. This study explores the literature and expands on experts' opinions on mental health within Lagos’s urban design and planning.MethodThe reviewed literature presents mental health in the context of Lagos’s past, present and future urban planning and design; and identified those factors in the government policies on urban planning and design towards improving mental health. Next, a qualitative analysis of opinions extracted following a semi‐structured interview with experts was presented.ResultOur findings show that improving mental health in Lagos requires awareness, a safe and aesthetic environment, access to public spaces, reliable transportation, affordable housing and wetland protection.ConclusionAlthough this study suggests that political and socioeconomic factors limit Lagos state’s urban planning and design towards improved mental health, these factors provide opportunities for the state to be a model in Nigeria.
Remote clinical cognitive assessment: Validation of mobile interactive cognitive self‐assessment scale
Authors: Xie Kexin , Cui Yue , Chu Min , Liu Li , Chen Zhongyun , Xia Tianxinyu , Wu Liyong 
Published: June 2023

AbstractBackgroundThe diagnosis of Alzheimer’s disease relies on trained clinicians and specialized diagnostic tests. Under the circumstances of COVID‐19, the clinical interview is restricted, which caused an additional delay in diagnosis. Emerging demand for remote interactive cognitive assessment aroused for diagnosis and mass screening. We aimed to develop a mobile interactive cognitive self‐ assessment scale (ICSAS)MethodThe ICSAS was created by an expert group applying nominal group techniques and focus groups. Initial examination and iterative rounds were conducted in participants from the community and hospital to optimize the scale. The final version of ICSAS included 4 tasks, covering executive function, logic memory, visual memory, and logic memory recall. Validation was conducted in 387 cognitively impaired participants and 297 participants with normal cognition from the institution. 2034 participants were enrolled from the community.ResultNo significant difference was found in age and sex between cognitively impaired participants and normal controls. Years of education, the score of MMSE and MoCA were higher in normal controls. The Cronbach’s alpha was 0.79 which indicated relative good reliability. The KMO value was 0.76, and the optimal cutoff point was 228.90, leading to the sensitivity of 0.90 and specificity of 0.71. The positive likelihood ratio was 3.10, and the negative likelihood ratio was 0.14, which suggested ICSAS as an ideal scale. 284 participants from the community were predicted to be cognitively impaired, accounting for approximately 15% of participants from the community, which corresponds to the prevalence research.ConclusionOur research developed a remote interactive cognitive self‐assessment scale (ICSAS) which has relatively good reliability and sensitivity. The ICSAS may ease the struggle of remote clinical cognitive assessment brought by the COVID‐19 pandemic. Also, from the long‐term perspective, the application of ICSAS may enhance the feasibility of cognitive assessment, and it may be ideal for mass screening and cognitively impaired patients’ monitoring.
Mediation effect of WMH on the associations of dementia risk with cognition and AD‐related brain changes
Authors: Wang Yan‐li , Sun Mengfan , Zhang Yuan , Jia Ziyan , Li Runzhi , Jiang Jiwei , Xu Jun 
Published: June 2023

AbstractBackgroundThe Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) score, a validated tool estimating dementia risk, has been suggested to be associated with accelerated brain atrophy but the imaging biomarkers and AD pathologies remains to be elucidated. We aimed to explore the relationships of CAIDE score with cognition and AD‐related brain changes, including beta‐amyloid (Aβ) deposition and glucose metabolism and the mediation effect of the WMH on these associations.MethodA sample of 1,285 participants underwent CAIDE dementia risk assessment, of these, 958 individuals had a CAIDE score of less than or equal to 8. Memory and executive function were used to measure cognitive performance. We analyzed data using linear mixed‐effects and mediation.ResultCAIDE score was significantly associated with WMH volume, and also had significant association with Aβ deposition, AD‐metabolism, and memory and executive function. WMH volume mediated 6.04%, 12.87%, 6.93% and 7.92% of the total association of CAIDE score with memory, executive function, FDG‐PET and AV45‐PET, respectively.ConclusionMemory, executive function, AD‐metabolism and Aβ deposition are strongly associated with dementia risk. Besides, the associations could be mediated by WMH volume and whether this represents a causal relationship remains to be determined.
The value of heart rate variability in autonomic nervous function evaluation and diagnosis of fatal familial insomnia
Authors: Wu Liyong , Cui Yue , Huang Zhaoyang 
Published: June 2023

AbstractBackgroundFatal familial insomnia (FFI) is a rare autosomal dominant inherited prion disease characterized by prominent organic sleep‐related impairment accompanied by a series of symptoms with strong clinical heterogeneity in a rapid progression. As the most significant clinical feature and the potential diagnostic marker of FFI, progressive sympathetic symptoms were lack of a objective noninvasive quantitative method to detect.MethodFrom May 2013 to August 2020, nine patients with FFI, eight patients with Creutzfeldt‐jakob disease (CJD) and nine normal control (NC) with matched sex and age were recruited in this study. All the participants underwent a nocturnal video‐polysomnography included a lead II electrocardiography (ECG). Heart rate variability analysis with successive 5 min (in time domain methods, frequency domain methods and non‐linear measurement) was performed during quiet wake before sleep and in the following N2, N3 and REM of the first sleep cycle.ResultIn FFI group, the continuous increased heart rate with the relatively decreased amplitude of the oscillations compared with NC and CJD group, revealed the axis of equilibrium shifts towards sympathetic activation. Furthermore, the RMSSD and HF during sleep stage in FFI were significantly lower than in NC group, which reflected the decreased activation of parasympathetic nervous system. The significant abnormal LF/HF ratio and SD1/SD2 ratio in combination with the lower values of correlation dimension D2 in FFI group supported its unbalanced autonomic nervous function.ConclusionDysfunctions of autonomic nerve system in patients with FFI may be affected by parasympathetic hypofunction partly except sympathetic activation, and HRV is expected to become a method in diagnosis for FFI.
Specific structuro‐metabolic pattern of thalamic subnuclei in fatal familial insomnia: A PET/MRI imaging study
Authors: Xie Kexin , Chen Yaojing , Chu Min , Cui Yue , Chen Zhongyun , Liu Li , Wu Liyong 
Published: June 2023

AbstractBackgroundDysfunction of the thalamus has been proposed as a core mechanism of fatal familial insomnia. However, detailed metabolic and structural alterations in thalamic subnuclei are not well documented. We aimed to address the multimodal structuro‐metabolic pattern at the level of the thalamic nuclei in fatal familial insomnia patients, and investigated the clinical presentation of primary thalamic alterations.MethodFive fatal familial insomnia patients and 10 healthy controls were enrolled in this study. All participants underwent neuropsychological assessments, polysomnography, electroencephalogram, and cerebrospinal fluid tests. MRI and fluorodeoxyglucose PET were acquired on a hybrid PET/MRI system. Structural and metabolic changes were compared using voxel‐based morphometry analyses and standardized uptake value ratio analyses, focusing on thalamic subnuclei region of interest analyses. Correlation analysis was conducted between gray matter volume and metabolic decrease ratios, and clinical features.ResultThe whole‐brain analysis showed that gray matter volume decline was confined to the bilateral thalamus and right middle temporal pole in fatal familial insomnia patients, whereas hypometabolism was observed in the bilateral thalamus, basal ganglia, and widespread cortices, mainly in the forebrain. In the regions of interest analysis, gray matter volume and metabolism decreases were prominent in bilateral medial dorsal nuclei, anterior nuclei, and the pulvinar, which is consistent with neuropathological and clinical findings. A positive correlation was found between gray matter volume and metabolic decrease ratios.ConclusionOur study revealed specific structuro‐metabolic pattern of fatal familial insomnia that demonstrated the essential roles of medial dorsal nuclei, anterior nuclei, and pulvinar, which may be a potential biomarker in diagnosis. Also, primary thalamic subnuclei alterations may be correlated with insomnia, neuropsychiatric, and autonomic symptoms sparing primary cortical involvement.
Amyloid PET in patients with carotid occlusive disease: Preliminary results of the AMYCODE study
Authors: Starmans Naomi LP , Tolboom Nelleke , Leeuwis Anna E , Viol Sebastiaan L Meyer , Golla Sandeep S.V. , Boellaard Ronald , Biessels Geert Jan , Kappelle Jaap , van der Flier Wiesje M. , Connection Heart‐Brain 
Published: June 2023

AbstractBackgroundCarotid occlusive disease (COD) is a risk factor for cognitive decline. One of the proposed underlying mechanisms is that cerebral hypoperfusion may result in accelerated accumulation of amyloid‐β in the brain. We hypothesized that patients with longstanding, unilateral COD have an asymmetrical burden of cerebral amyloid‐β, with more amyloid‐β in the hemisphere ipsilateral to the COD than in the contralateral hemisphere.MethodThe AMYCODE study is a cross‐sectional observational study. Inclusion criterion is a unilateral occlusion of the internal carotid artery. Exclusion criteria are: a contralateral stenosis of > 70% and a history of vascular reconstructive surgery. All patients underwent a neuropsychological assessment, MRI‐scan and dynamic 18F Florbetaben positron emission tomography scan (PET). Global relative perfusion (R1) and binding potential (BPND) were determined from the PET‐images using PMOD and a simplified reference tissue model with the cerebellar grey matter as reference region. Distribution Volume ratio (DVR) was calculated as BPND + 1. We performed Wilcoxon signed‐rank tests to examine differences between hemispheres within subjects.ResultTo date, we included eight participants (seven males, age 66.1±7.3 years, MMSE score 28.1±2.0; inclusion ongoing, target n = 20). Mean global DVR was 1.03±0.03 in the ipsilateral hemisphere (i.e. side of the occlusion) and 1.04±0.02 in the contralateral hemisphere (p = 0.064). Mean global R1 was 0.89±0.06 in the ipsilateral hemisphere and 0.91±0.05 in the contralateral hemisphere (p = 0.033).ConclusionPreliminary analyses suggest that patients with unilateral COD had similar amyloid‐β distribution, despite lower cerebral perfusion in the hemisphere ipsilateral to the COD than in the contralateral hemisphere.
MR Nano‐Radiomics for Detection of Amyloid Plaques in Alzheimer’s Disease
Authors: Starosolski Zbigniew , Badachhape Andrew A , Devkota Laxman , Srivastava Mayank , Tanifum Eric , Annapragada Ananth , Ghaghada Ketan 
Published: June 2023

AbstractBackgroundAmyloid plaques are a pathological hallmark of Alzheimer’s disease (AD). In a recent pre‐clinical study, we showed an amyloid‐targeted liposomal macrocyclic gadolinium (Gd) contrast agent, ADx‐001, for in vivo MRI‐based detection of amyloid plaques in mouse. Although ADx‐001 showed high sensitivity at a high dose (0.2 mmol Gd/kg), the performance was sub‐optimal (<70%) at lower doses (0.1 and 0.15 mmol Gd/kg). In this work, we investigated if nano‐radiomics (radiomic analysis of nanoparticle contrast‐enhanced images) would increase sensitivity of ADx‐001 at lower dose levels.MethodIn vivo studies were performed in the APP/PSEN1 mouse model of amyloid pathology. The efficacy of ADx‐001‐ enhanced MRI was studied at three dose‐levels: 0.10, 0.15, and 0.20 (mmol Gd/kg). Pre‐ and post‐contrast MRI was performed in transgenic (n = 6/dose) and wild‐type mice (n = 6/dose) using a T1‐weighted spin‐echo sequence. Semi‐automatic 3D segmentation of hippocampal and cortical regions was performed using a mouse brain MR atlas (Fig.1). Radiomic analysis was executed on the hippocampus and cortex regions of ADx‐001‐enhanced MR images 900 radiomic features (RFs). RF selection was completed using a non‐parametric neighborhood component method. 5‐fold cross‐validation was performed using a set of linear and non‐linear classifiers to confirm the accuracy of group separation.ResultSeven RFs (three RFs for cortex and four RFs for hippocampus) were identified that differentiated amyloid‐positive transgenic mice from amyloid‐negative wild‐type mice based on ADx‐001‐enhanced MRI. The best performing nearest‐neighbor classification model was trained simultaneously on all ADx‐001 dose groups. Nano‐radiomic analysis of ADx‐001‐enhanced MRI demonstrated 100% accuracy, specificity, and sensitivity for dose levels of 0.2 and 0.15 mmol Gd/kg. For low dose level (0.1 mmol Gd/kg), radiomics achieved accuracy of 91.6% and sensitivity of 83.3%, while maintaining specificity at 100%. The new results were superior when compared to previously reported results based on global signal enhancement analysis.ConclusionNano‐radiomic analysis of ADx‐001‐enhanced MRI improved sensitivity of ADx‐001 at lower dose levels for the detection of amyloid pathology and demonstrated excellent for intermediate and high dose. Our study demonstrates that radiomic analysis of contrast‐enhanced MR images could boost the performance of targeted molecular imaging agents for early detection of AD.
Community research liaison role in increasing participation of African Americans in cognitive research: A case study
Authors: Brangman Sharon A , Royal Kathy , Dillenbeck Colleen , McNamara Sarah , Smith Nancy , De Rosa Eve , Anderson Adam , Riley Elizabeth 
Published: June 2023

AbstractBackgroundRacial and ethnic underrepresentation in aging research and need for effective recruitment strategies is well documented. A Community Research Liaison (CRL) role created under a NIA award is demonstrating the value of embedding staff from underrepresented communities in the research infrastructure.MethodsThe role and qualifications for a CRL were developed with individuals from an African American community. The CRL hired from this community is engaging in outreach to understand barriers to and discuss the value of research with community members. Through the CRL, community input is being translated into changes in recruitment methods that reflect the concerns, interests and needs of potential African American participants. This case study reports on recruitment outcomes for a study on markers of cognitive decline in older adults requiring 2 hours in an MRI, 5 for testing, and 3 for travel. Recruitment data are compared 6 months before and 3 months after the CRL was engaged.ResultIn the 6 months prior to the CRL’s involvement, 309 individuals passed an initial screening and 156 were found potentially eligible after a second screening. Five (3.2%) of the 156 were African American. Of these, one was found ineligible, one was lost to follow‐up and the 3 participated in the study. In the first 3 months after the CRL was engaged, 35 were referred to the study after recruitment by the CRL. All were African American, 15 (43%) were eligible and enrolled, 9 (26%) were ineligible, and 9 (26%) are still in the screening process.ConclusionThe case study demonstrates the promise of a CRL who is a member of an African American community in increasing African American participation in research. The CRL dramatically increased the number of older African Americans recruited despite potential participation barriers. The increase was due in large part to the CRL’s understanding of and recognition as a trusted member of the community and to changes she recommended to promotional materials and logistics based on community feedback. Data on recruitment effectiveness are continuing to be evaluated across a range of aging research studies and clinical trials in which the CRL is engaged.
Integrating Serious Illness Care into Primary Care Delivery for persons with dementia: CARIÑOS En Su Casa – Care for you at home
Authors: Patel Neela K. , Liu Jia , de Erausquin Gabriel A. 
Published: June 2023

AbstractBackgroundThe patient‐centered medical home (PCMH) as a model of primary care transformation has the potential to improve the quality, safety, and efficiency of care and reduce costs, particularly during the COVID‐19 pandemic for persons with dementia. However, the effects of adopting the PCMH are lack of clinical and economic support, let alone the challenge of applying it in ethnically and culturally diverse patient populations.MethodTo address the limitations of the traditional PCMH model, the CARIÑOS approach, a patient‐driven, comprehensive, coordinated, and multi‐site care model, was developed by the University of Texas (UT) Health San Antonio Geriatrics and Supportive Care Practice to meet the healthcare needs of patients in an underserved, primarily Hispanic community, who are often frail and have complex medical and care needs between various healthcare settings. Early outcomes on costs were collected to demonstrate its economic effects.ResultOverall, the implementation of the CARIÑOS approach reduced total costs per patient per year by comparing six practices affiliated to the UT Health San Antonio Accountable Care Organization (ACO) – Regional Physicians Network. They serve similar underserved areas in the first and second Quarters of 2021. After adopting the CARIÑOS approach ($45,705), the costs were lower than 4 out of the 6 ACOs practices. In comparison, the Hierarchical Condition Category (HCC) score of the patients seen at the Geriatrics and Supportive Care Practice (HCC = 1.45) was higher than those seen at the other six practices (average = 1.15) during the same period of 2021.ConclusionThe CARIÑOS approach provides an innovative and comprehensive perspective delivering culturally congruent care for persons with dementia and support for their families.The main learning objectives of the session will be1. To enlist the elements of the CARINOS Approach for person centered care.2. To describe strategies that can be used to implement this approach in dementia care of underserved and Hispanic families.3. List the ways to engage promotores or community health workers as a bridge between the healthcare team and patient and family to improve patient experience.Key words – person centered, dementia care
Assessing trust and relationship quality in families with cognitively impaired family member
Authors: Patel Neela K. , Liu Jia , de Erausquin Gabriel A. 
Published: June 2023

AbstractBackgroundRelational factors play a critical role in the experience and outcomes of persons with Alzheimer’s Disease and related dementias (AD+RD).Complex and bi‐directional association of relational factors and cognitive decline using the Postiive Affect Index‐ PAI in Spanish.MethodSemi‐structured interviews were conducted for 20 dyads – 20 persons with dementia and 20 caregivers for total of 40 interviews. Patients were asked, “How did [caregiver] come to be your caregiver?”, and “What is their role when you go to the doctor and why do they play that role?”. Caregivers were asked, “How did you come to be the caregiver for [patient]?”; and “What is your role when they go to the doctor and why do you play that role?” Responses were recorded, transcribed, and analyzed using thematic analysis to describe overarching themes in patient and caregiver responses.Patients were asked about the quality of their relationship with their caregiver, and caregivers were asked about the quality of their relationship with the patient. Items in the 5‐item questionnaire are evaluated using a 6‐point Likert scale (1 = not close to 6 = extremely close) examples are “How is communication between yourself and this person—how well can you exchange ideas or talk about things that really concern you?” and “Taking everything into consideration, how close do you feel in your relationship with this person?” The PAI was orally administered, with patients being asked about the quality of their relationship with their caregiver and caregivers being asked about the quality of their relationship with the patient. Relationship quality scores were compared between patient and caregiver and as they relate to trust.ResultsConventional content analysis techniques were also used to identify and classify the existence and prevalence of factors for caregiver selection and to examine perceived roles and reasons for roles in the medical encounter. The data is derived from both the patient and caregiver perspective, and comparisons are made to determine whether and how accounts differ between patient and caregiver.ConclusionThe findings help elucidate the role of patient‐caregiver‐physician relational factors in AD + RD care, experience, and trajectory specific to underserved Hispanic dyads