AGR - 3 Socially Responsible Neuropsychology (SRN) in Action: Navigating Relevant Socio-Cultural and Educational Factors in Frontotemporal Dementia

Objective

Socio-cultural factors obscure diagnostic specificity for neurodegenerative disorders, particularly among minority or foreign-born patients with limited access to education. Our objective with the following case presentation is to illustrate the utility of a Socially Responsible Neuropsychology (SRN) model in guiding clinical practice through the comprehensive incorporation of significant, yet common, socio-cultural factors throughout the neuropsychological assessment.

Method

The present case involved a 79-year-old Spanish-speaking Mexican woman with two years of education, who underwent two serial neuropsychological assessments, as well as, structural/functional neuroimaging to monitor acute onset of telegraphic speech following the kidnapping of her husband. The SRN model guided clinical decision-making in understanding the onset and progression of symptoms within the context of medical-psychiatric comorbidities intertwined with socio-cultural and educational factors.

Results

Mild vascular neurocognitive disorder and complicated grief were the initial diagnostic impressions as supported by structural neuroimaging. Neuropsychological assessment over time, however, revealed progressive global cognitive decline whereas psychiatric symptomatology remained stable. In the presence of equivocal converging evidence from available neuroimaging studies (PET vs MRI), strong suspicion for the language variant of frontotemporal neurocognitive disorder was considered given the onset and progressive decline of expressive/receptive language, executive and memory abilities, and qualitative evidence for progressive behavioral disihibition.

Conclusion

Telegraphic speech in an elderly Latina woman that initially appeared most consistent with vascular neurocognitive disorder in the context of complex trauma with possible conversion disorder, was deemed most consistent with a neurodegenerative process after careful consideration of the time course and evolution of the neurocognitive profile over time within an SRN model.

C-14 Socially Responsible Neuropsychology (SRN) in Action: Assessment of a Highly Educated Bilingual Latina Older Adult

Objective

Early identification of cognitive symptoms pathognomonic of Alzheimer’s disease (AD) in highly educated bilingual adults remains challenging. We present a clinical case illustrating the application of an SRN model in a 70-year-old highly educated, balanced bilingual Latina eventually diagnosed with moderate-severe stages of AD following an event of severe confusion and disorientation.

Method

An SRN model was applied to promote equitable care through evidence-based consideration of cognitive aging-reserve and its putative manifestation in neurodegenerative disorders. The patient underwent a neuropsychological assessment and structural/functional neuroimaging. Her 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 clinical decision-making to determine the appropriate target language for bilingual assessment, and to identify reliable normative anchors of impairment relative to premorbid estimates, resulting in incorporation of validated Spanish measures/norms. Neuroimaging revealed bilateral parietal-temporal hypometabolism, which was generally consistent with neuropsychological findings, and the patient was diagnosed with major neurocognitive disorder due to AD.

Conclusions

Given the advanced nature of this patient’s cognitive decline by the time of assessment, it was hypothesized that the combination of bilingualism and high education further masked the precipitous decline atypically observed in AD individuals with high cognitive reserve. Cognitive reserve theories, nonetheless, continue to be anchored strictly within a monocultural-monolingual framework. This complex case, therefore, highlights the urgent need to incorporate bilingualism in current models of cognitive reserve to boost sensitivity in detecting early expression of bilingual AD.

Tilted-potential photonic crystal cavities for integrated quantum photonics

We propose and investigate a new type of photonic crystal (PhC) cavity for integrated quantum photonics, which provides tailored optical modes with both confined and extended spatial components. The structures consist of elongated PhC cavities in which the effective index of refraction is varied quasi-linearly along their axis, implemented by systematic lateral shifts of the PhC holes. The confined modes have approximately Airy-function envelopes, exhibiting single peaks and extended tails, which is useful for optimizing single photon extraction and transmission in integrated quantum photonic devices. The measured spectrally resolved near-field patterns of such devices show the expected spatial and resonance wavelength behavior, in agreement with numerical simulations of the Airy-Bloch modes. The effects of fabrication-induced disorder on the mode features are also analyzed and discussed. Selective excitation of specific Airy-Bloch modes using integrated, site-controlled quantum dots as localized light sources is demonstrated. Based on the tilted-potential cavity, multiple-QD single photon emitters exploiting wavelength division multiplexing are proposed.

197 Effect of follicle-stimulating hormone administered during different time intervals in superovulation protocols in beef cattle

Multiple ovulation and embryo transfer (MOET) is a biotechnology widely used for genetic improvement in cattle; however, there is great variability in donor response. Differences between management, genotype, environmental conditions, among other factors, can affect MOET results. The traditional protocols consist of 8 twice-daily FSH applications in decreasing dosages over 4 days. Reducing donor handling during MOET is an alternative for embryo production. The aim of this research was to evaluate a simplified protocol, testing single daily administrations of FSH over 4 days, without modifying the total dose calculated for treatment. The study was conducted in northern Mexico. Beef cattle donors (n=30) were used, 15 with control treatment (CT) and 15 with simplified treatment (ST). All donors were examined beforehand, focusing on the reproductive tract and body score condition, i.e. 5 to 7 (scale of 1-9). Intravaginal devices (IVD) Dispocel Max (Von Franken, Buenos Aires, Argentina) with 1.2g of progesterone were inserted and 2.5mg of oestradiol benzoate (Internacional Prode, Mexico) IM was applied on Day 0; FSH (Folltropin-V, Vetoquinol, Lure, France), applications were started on day 4. For CT, the FSH administration was done twice daily (at a 12-h interval), in 8 decreasing doses, and 150µg of D-cloprostenol (D-CLO; Prostagenol-D, International Prode, Guadalajara, Mexico) was administered IM in the morning and afternoon of Day 6. In the ST, donors were treated with once-daily injections of decreasing doses of FSH over 4 days, and 150µg of D-CLO was administered IM on Days 6 and 7. The IVD were removed on Day 7 and oestrus was detected using heat detection patches. Artificial insemination was performed using conventional frozen semen at 12, 20, and, in case of persistent heat, 30h after oestrus detection. Embryo collection was performed 7 days after insemination. The ovarian response was assessed by counting the corpora lutea (CL) detected by ultrasound. Embryo collection was performed by closed method. Analysis of variance was used with the GLM procedure in SAS software (version 9.3; SAS Institute Inc., Cary, NC, USA), to evaluate the results of ST compared with CT (α-level=0.05). The cattle breed and ranch identification were considered in the analyses. The number of CL in ST and CT was 6.8±1.6 and 8.8±1.5, respectively. The number of oocytes/embryos recovered in ST and CT were 7.3±3.0 and 11.4±2.7, respectively. The number of viable embryos (transferred or frozen) in ST and CT were 2.6±1.7 and 4.7±1.6, respectively. The number of unfertilized oocytes were 2.8±1.5 in ST and 4.2±1.3 in CT. The number of degenerated embryos in the ST were 2.0±1.1 and 1.0±1.0 in the CT. There were no significant differences between groups (P>0.05) for all variables analysed. Although the number of transferable embryos was numerically higher in the CT group, differences were not significant. Nevertheless, ST can be an alternative superovulation protocol, because working once a day saves time and facilitates the implementation of the MOET technique.

Lithium effect on the electronic properties of porous silicon for energy storage applications: a DFT study

Theoretical studies on the effect of Li on the electronic properties of porous silicon are still scarce; these studies could help us in the development of Li-ion batteries of this material which overcomes some limitations that bulk silicon has. In this work, the effect of interstitial and surface Li on the electronic properties of porous Si is studied using the first-principles density functional theory approach and the generalised gradient approximation. The pores are modeled by removing columns of atoms of an otherwise perfect Si crystal, dangling bonds of all surfaces are passivated with H atoms, and then Li is inserted on interstitial positions on the pore wall and compared with the replacement of H atoms with Li. The results show that the interstitial Li creates effects similar to n-type doping where the Fermi level is shifted towards the conduction band with band crossings of the said level thus acquiring metallic characteristics. The surface Li introduces trap-like states in the electronic band structures which increase as the number of Li atom increases with a tendency to become metallic. These results could be important for the application of porous Si nanostructures in Li-ion batteries technology.

Carbon monoxide sensing properties of B-, Al- and Ga-doped Si nanowires

Silicon nanowires (SiNWs) are considered as potential chemical sensors due to their large surface-to-volume ratio and their possible integration into arrays for nanotechnological applications. Detection of harmful gases like CO has been experimentally demonstrated, however, the influence of doping on the sensing capacity of SiNWs has not yet been reported. For this work, we theoretically studied the surface adsorption of a CO molecule on hydrogen-passivated SiNWs grown along the [111] crystallographic direction and compared it with the adsorption of other molecules such as NO, and O₂. Three nanowire diameters and three dopant elements (B, Al and Ga) were considered, and calculations were done within the density functional theory framework. The results indicate that CO molecules are more strongly adsorbed on the doped SiNW than on the pristine SiNW. The following trend was observed for the CO adsorption energies: E _A[B-doped] > E _A[Al-doped] > E _A[Ga-doped] > E _A[undoped], for all diameters. The electronic charge transfers between the SiNWs and the adsorbed CO were estimated by using a Voronoi population analysis. The CO adsorbed onto the undoped SiNWs has an electron-acceptor character, while the CO adsorbed onto the B-, Al-, and Ga-doped SiNWs exhibits an electron-donor character. Comparing these results with the ones obtained for the NO and O₂ adsorption, the larger CO adsorption energy on B-doped SiNWs indicates their good selectivity towards CO. These results suggest that SiNW-based sensors of toxic gases could represent a clear and advantageous application of nanotechnology in the improvement of human quality of life.

Lithium effects on the mechanical and electronic properties of germanium nanowires

Semiconductor nanowire arrays promise rapid development of a new generation of lithium (Li) batteries because they can store more Li atoms than conventional crystals due to their large surface areas. During the charge-discharge process, the electrodes experience internal stresses that fatigue the material and limit the useful life of the battery. The theoretical study of electronic and mechanical properties of lithiated nanowire arrays allows the designing of electrode materials that could improve battery performance. In this work, we present a density functional theory study of the electronic band structure, formation energy, binding energy, and Young's modulus (Y) of hydrogen passivated germanium nanowires (H-GeNWs) grown along the [111] and [001] crystallographic directions with surface and interstitial Li atoms. The results show that the germanium nanowires (GeNWs) with surface Li atoms maintain their semiconducting behavior but their energy gap size decreases when the Li concentration grows. In contrast, the GeNWs can have semiconductor or metallic behavior depending on the concentration of the interstitial Li atoms. On the other hand, Y is an indicator of the structural changes that GeNWs suffer due to the concentration of Li atoms. For surface Li atoms, Y stays almost constant, whereas for interstitial Li atoms, the Y values indicate important structural changes in the GeNWs.

Physiological and ultrastructural characterisation of a desiccation-tolerant filmy fern, Hymenophyllum caudiculatum: Influence of translational regulation and ABA on recovery

The filmy fern Hymenophyllum caudiculatum can lose 60% of its relative water content, remain dry for some time and recover 88% of photochemical efficiency after 30 min of rehydration. Little is known about the protective strategies and regulation of the cellular rehydration process in this filmy fern species. The aim of this study was to characterise the filmy fern ultrastructure during a desiccation-rehydration cycle, and measure the physiological effects of transcription/translation inhibitors and ABA during desiccation recovery. Confocal and transmission electron microscopy were used to compare changes in structure during fast or slow desiccation. Transcription (actinomycin D) and translation (cycloheximide) inhibitors and ABA were used to compare photochemical efficiency during desiccation recovery. Cell structure was conserved during slow desiccation and rehydration, constitutive properties of the cell wall, allowing invagination and folding of the membranes and an important change in chloroplast size. The use of a translational inhibitor impeded recovery of photochemical efficiency during the first 80 min of rehydration, but the transcriptional inhibitor had no effect. Exogenous ABA delayed photochemical inactivation, and endogenous ABA levels decreased during desiccation and rehydration. Frond curling and chloroplast movements are possible strategies to avoid photodamage. Constitutive membrane plasticity and rapid cellular repair can be adaptations evolved to tolerate a rapid recovery during rehydration. Further research is required to explore the importance of existing mRNAs during the first minutes of recovery, and ABA function during desiccation of H. caudiculatum.

Hemorrhagic cystitis in pregnancy: Case report and review of the literature

Hemorrhagic cystitis is generally a benign self-limited disorder, however there are some severe cases which are associated to a significant blood loss. The etiology may be either bacterial, viral or chemical in origin; though the cause is not identified in most of the cases. Immunocompromised patients or patients who have undergone chemotherapy or radiation constitute the highest risk group. There are only a few articles about hemorrhagic cystitis in pregnancy, frequently associated with preterm labor. We describe, for the first time in literature, one patient with a clinical status of hematuria in two consequent pregnancies, without any identified cause and a medical history negative for recurrent or hemorrhagic cystitis and we report an overview of literature concerning this topic.

Analysis and evaluation of the effectiveness of epidural analgesia and its relationship with eutocic or dystocic delivery

OBJECTIVE

Numerous studies have demonstrated the difference in the verbal rating scale with regard to obstructed labour and induced labour, so that obstructed labour and foetal macrosomia have been related to a greater sensation of pain during labour, particularly in the first stage. Even the epidural analgesia is linked to the need for instrumented or caesarean section due to foetal obstruction. The goal of the study is to analyze and evaluate the effectiveness of epidural analgesia in normal versus obstructed labour.

PATIENTS AND METHODS

One hundred and eighty pregnant women were included in an observational, analytical, longitudinal and prospective study, that was performed in the Obstetrics Department of the Hospital Universitario Dexeus. All the nulliparous or multiparous over 36 weeks of pregnancy, after 3cm of cervical dilatation in spontaneous or induced labor were included. All the patients were given epidural analgesia according to protocol.

RESULTS

The basic descriptive methods were used for the univariate statistical analysis of the sample and the Mann-Whitney U test was used for the comparison of means between both groups. The correlations between variables were studied by means of the Spearman coefficient of correlation. The differences regarded as statistically significant are those whose P<.05.

CONCLUSION

In our population there were no statistically significant differences in the effectiveness of epidural analgesia in normal versus obstructed labour. Patients who got epidural analgesia and had obstructed labors have the same degree of verbal rating scale as patients that do not had obstructed labors (P>.05).