1
|
Khorammakan R, Omid A, Mirmohammadsadeghi M, Ghadami A. Puzzle game-based learning: a new approach to promote learning of principles of coronary artery bypass graft surgery. BMC MEDICAL EDUCATION 2023; 23:241. [PMID: 37055824 PMCID: PMC10100633 DOI: 10.1186/s12909-023-04156-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Since learning with high educational quality requires an advanced intervention. This study seeks to answer how many puzzles game-based training can improve knowledge and cognitive function of surgical technology students in CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation. MATERIALS AND METHODS This study was carried out as a quasi-experimental single-group pre-test-post-test, during which, after designing a puzzle game including various stages of surgery (from the preparation of the patient for surgical sutures and the necessary equipment to perform each stage), 18 people from third-year surgical technology students who met the inclusion criteria were entered in the study by convenience sampling method and based on the sample size determined using a similar study and they participated in the test of knowledge and cognitive function, that the validity and reliability were measured, before the intervention and 14 days after the intervention (using a puzzle game). Data were analyzed using descriptive and Wilcoxon statistical tests. RESULTS After the withdrawal of 2 people, 15 person (93.80 per cent) of the students were female, the average age of students was 21.87 ± 0.71 years, and 50% (8 people) of them were 22 years old. Also, the average score of the end-of-semester exam of the heart surgery technology course was 15.19 ± 2.30 (the lowest score was 11.25, and the highest score was 18.63), and the score of 43.80% (7 people) of them were in the range of 15.01-17.70, and their average of grade point average was 17.31 ± 1.10 (the lowest grade point average is 15 and the highest grade point average is 19.36) and grade point average 75% (11 people) of students were 16-18. The average scores of knowledge(5.75 ± 1.65 vs. 2.68 ± 0.79) and cognitive performance(6.31 ± 2.57 vs. 2.00 ± 1.09) of students in the post-intervention phase were significantly higher than the pre-intervention phase (P < 0.0001). CONCLUSION The results of the present study showed that the use of puzzle games in CABG surgery training led to a significant improvement in the knowledge and cognitive performance of surgical technology students regarding the stages of CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.
Collapse
Affiliation(s)
- Reza Khorammakan
- Student research committee, School of nursing and midwifery, Isfahan university of medical sciences, Isfahan, Iran
| | - Athar Omid
- Associate professor, Medical Education Research Center, Department of Medical Education, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ahmad Ghadami
- Department of operating room, Nursing and midwifery research center, School of nursing and midwifery, Isfahan university of medical sciences, Isfahan, Iran.
| |
Collapse
|
2
|
Aarsland D, Khalifa K, Bergland AK, Soennesyn H, Oppedal K, Holteng LBA, Oesterhus R, Nakling A, Jarholm JA, de Lucia C, Fladby T, Brooker H, Dalen I, Ballard C. A Randomised Placebo-Controlled Study of Purified Anthocyanins on Cognition in Individuals at Increased Risk for Dementia. Am J Geriatr Psychiatry 2023; 31:141-151. [PMID: 36372613 DOI: 10.1016/j.jagp.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/07/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022]
Abstract
IMPORTANCE Identifying nutritional compounds which can reduce cognitive decline in older people is a hugely important topic. OBJECTIVE To study the safety and effect of anthocyanins in maintaining cognitive functioning in people at increased risk for dementia. DESIGN, SETTING, AND PARTICIPANTS Participants (206 individuals, aged 60-80 years) diagnosed with either mild cognitive impairment (MCI) or two or more cardiometabolic disorders (i.e., diabetes, hypertension, obesity) were enrolled at three different centres in Norway. INTERVENTION Participants were randomly assigned to four capsules with a total of 320 mg/d of naturally purified anthocyanins or placebo 1:1 for 24 weeks. MAIN OUTCOMES AND MEASURES The primary outcome was the Quality of Episodic Memory composite measure (0-100) from an online cognitive test battery CogTrack, which was administered at baseline and monthly for the next 24 weeks. Secondary outcomes included other cognitive scores from the CogTrack battery. We applied mixed effects models with a baseline test score, group, time and their interaction as fixed effects, as well as other predefined baseline covariates. The primary comparison was the group difference at week 24 based on a modified intention-to-treat principle. RESULTS The primary analysis did not show a significant group difference at 24 weeks (78.2 versus 76.8; adjusted mean difference 1.4 (95% confidence interval -0.9-3.7); effect size 0.15; p = 0.23). However, there was a significant difference in slopes during weeks 8-24 (p = 0.007); the anthocyanin group improved while the placebo group worsened. No differences were found for the secondary cognitive outcomes. Anthocyanin capsules were well-tolerated and safe to use. CONCLUSION Anthocyanin supplementation for 24 weeks was safe and well tolerated in people with MCI or cardiometabolic disorders. We found no significant group difference in episodic memory at the end of the study but statistically significant differences in slopes. Further studies are warranted to explore whether anthocyanins supplementation can reduce cognitive decline in people at increased risk of dementia. TRIAL REGISTRATION ClinicalTrials.gov, (Identifier NCT03419039). http://www. CLINICALTRIALS gov/, NCT03419039.
Collapse
Affiliation(s)
- Dag Aarsland
- Centre for Age-Related Medicine (DA, KK, AKB, HS, LBAH, RO, AN, CDL), Stavanger University Hospital, Stavanger, Norway; Department of Old Age Psychiatry (DA), King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Khadija Khalifa
- Centre for Age-Related Medicine (DA, KK, AKB, HS, LBAH, RO, AN, CDL), Stavanger University Hospital, Stavanger, Norway; Department of Old Age Psychiatry (DA), King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; The Faculty of Health Sciences (KK), University of Stavanger, Stavanger, Norway.
| | - Anne K Bergland
- Centre for Age-Related Medicine (DA, KK, AKB, HS, LBAH, RO, AN, CDL), Stavanger University Hospital, Stavanger, Norway
| | - Hogne Soennesyn
- Centre for Age-Related Medicine (DA, KK, AKB, HS, LBAH, RO, AN, CDL), Stavanger University Hospital, Stavanger, Norway
| | - Ketil Oppedal
- Department of Electrical Engineering and Computer Science (KO), University of Stavanger, Stavanger, Norway
| | - Lise B A Holteng
- Centre for Age-Related Medicine (DA, KK, AKB, HS, LBAH, RO, AN, CDL), Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine (LBAH, AN), University of Bergen, Bergen, Norway
| | - Ragnhild Oesterhus
- Centre for Age-Related Medicine (DA, KK, AKB, HS, LBAH, RO, AN, CDL), Stavanger University Hospital, Stavanger, Norway; The Hospital Pharmacy Enterprise of Western Norway (RO), Bergen, Norway
| | - Arne Nakling
- Centre for Age-Related Medicine (DA, KK, AKB, HS, LBAH, RO, AN, CDL), Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine (LBAH, AN), University of Bergen, Bergen, Norway
| | - Jonas A Jarholm
- Department of Neurology (AJ, TF), Akershus University Hospital, Lørenskog, Norway
| | - Chiara de Lucia
- Centre for Age-Related Medicine (DA, KK, AKB, HS, LBAH, RO, AN, CDL), Stavanger University Hospital, Stavanger, Norway; Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology & Neuroscience (CDL), King's College London, London, UK
| | - Tormod Fladby
- Department of Neurology (AJ, TF), Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine (HB, TF), University of Oslo, Oslo, Norway
| | - Helen Brooker
- Medical School (HB), University of Exeter, Exeter, UK; Ecog Pro Ltd. (HB, CB), Bristol, UK
| | - Ingvild Dalen
- Section of Biostatistics, Department of Research (ID), Stavanger University Hospital, Stavanger, Norway
| | - Clive Ballard
- Medical School (HB), University of Exeter, Exeter, UK
| |
Collapse
|
3
|
Belleville S, Cuesta M, Bieler-Aeschlimann M, Giacomino K, Widmer A, Mittaz Hager AG, Perez-Marcos D, Cardin S, Boller B, Bier N, Aubertin-Leheudre M, Bherer L, Berryman N, Agrigoroaei S, Demonet JF. Pre-frail older adults show improved cognition with StayFitLonger computerized home-based training: a randomized controlled trial. GeroScience 2022; 45:811-822. [PMID: 36266559 PMCID: PMC9589849 DOI: 10.1007/s11357-022-00674-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/12/2022] [Indexed: 02/02/2023] Open
Abstract
Multidomain interventions have shown tremendous potential for improving cognition in older adults. It is unclear if multidomain interventions can be delivered remotely and whether remote intervention is beneficial for older adults who are vulnerable or at risk of cognitive decline. In a 26-week multi-site, home-based, double-blind, randomized controlled trial, 120 cognitively healthy older adults (75 robust, 45 pre-frail; age range = 60-94) recruited from Switzerland, Canada, and Belgium were randomized to receive either the StayFitLonger (SFL) computerized multidomain training program or an active control intervention. Delivered on tablets, the SFL intervention combined adapted physical exercises (strength, balance, and mobility), cognitive training (divided attention, problem solving, and memory), opportunities for social and contributive interactions, and psychoeducation. The active control intervention provided basic mobilization exercises and access to video games. Cognitive outcomes were global cognition (Z-scores of attention, verbal fluency, and episodic memory for nondemented older adults; ZAVEN), memory, executive function, and processing speed. Linear mixed model analyses indicated improved performance on the ZAVEN global cognition score in the SFL group but not in the active control group. Stratified analyses by frailty status revealed improved ZAVEN global cognition and processing speed scores following SFL in the pre-frail group but not in the robust group. Overall, the study indicates that a computerized program providing a multidomain intervention at home can improve cognition in older adults. Importantly, pre-frail individuals, who are at higher risk of cognitive decline, seem to benefit more from the intervention. Trial registration: ClinicalTrials.gov, NCT037519 Registered on January 22, 2020-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04237519 .
Collapse
Affiliation(s)
- Sylvie Belleville
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L'Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec, H3W 1W5, Canada. .,Université de Montréal, Montreal, Canada.
| | - M. Cuesta
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada
| | - M. Bieler-Aeschlimann
- Leenaards Memory Centre and Infections Disease Service, University Hospital of Lausanne, Lausanne, Switzerland ,MindMaze, SA, Lausanne, Switzerland
| | - K. Giacomino
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | - A. Widmer
- HES-SO Valais-Wallis, School of Management, Sierre, Switzerland
| | - A. G. Mittaz Hager
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | | | | | - B. Boller
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université du Québec à Trois-Rivières, Trois-Rivieres, Canada
| | - N. Bier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université de Montréal, Montreal, Canada
| | - M. Aubertin-Leheudre
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université du Québec à Montréal, Montreal, Canada
| | - L. Bherer
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université de Montréal, Montreal, Canada ,Montréal Heart Institute, Montreal, Canada
| | - N. Berryman
- Research Centre, Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, 4565, Queen-Mary Road, Montreal, Quebec H3W 1W5 Canada ,Université du Québec à Montréal, Montreal, Canada
| | - S. Agrigoroaei
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - J. F. Demonet
- Leenaards Memory Centre and Infections Disease Service, University Hospital of Lausanne, Lausanne, Switzerland
| |
Collapse
|
4
|
Khalifa K, Bergland AK, Soennesyn H, Oppedal K, Oesterhus R, Dalen I, Larsen AI, Fladby T, Brooker H, Wesnes KA, Ballard C, Aarsland D. Effects of Purified Anthocyanins in People at Risk for Dementia: Study Protocol for a Phase II Randomized Controlled Trial. Front Neurol 2020; 11:916. [PMID: 32982933 PMCID: PMC7492209 DOI: 10.3389/fneur.2020.00916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/16/2020] [Indexed: 12/11/2022] Open
Abstract
Background: The number of people with dementia is increasing, with huge challenges for society and health-care systems. There are no disease-modifying therapies available. There is, therefore, an urgent need to identify strategies to reduce the risk of developing dementia. Anthocyanins are a class of compounds found in dark berries and fruits with some effects that might reduce the risk for cognitive decline and the development of dementia in older people. Aim: This phase II three-center, randomized, 24-week, placebo-controlled study, ongoing in Norway, aims to evaluate the safety, and efficacy of anthocyanins in modifying key dementia-related mechanisms and maintain cognitive functioning in older people at risk for dementia. Methods: Participants (220 individuals aged 60–80 years) who meet the inclusion criteria (either mild cognitive impairment or two or more cardiometabolic disorders) are being enrolled in this study at three different centers in Norway. Participants are block randomized to identically appearing capsules containing 80 mg of naturally purified anthocyanins or placebo 1:1. Dosage is 2 + 2 capsules per day for 24 weeks. The primary outcome will be the quality of episodic memory score, a composite measure from the extensively validated online cognitive test battery CogTrack®, which is administered at baseline and monthly for the next 6 months. Secondary outcomes include other major scores from CogTrack, as well as a range of neuroimaging and other biomarkers. Anthocyanin metabolites will be measured in blood and cerebrospinal fluid. The change from baseline scores will be subject to a mixed model for repeated measures analysis of covariance. The primary comparison will be the contrast (difference in the least-square means) between active and placebo at the end of the study (week 24). The primary study population will be a modified intention-to-treat population (ClinicalTrials.gov, NCT03419039). Discussion: This study aims to demonstrate whether there are beneficial effects of purified anthocyanins on cognition and relevant biological functions in people at increased risk for dementia. Forthcoming results may contribute to further improvement of intervention strategies to prevent or delay the onset of dementia, including a potential decision to take anthocyanins toward phase III trials.
Collapse
Affiliation(s)
- Khadija Khalifa
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Anne Katrine Bergland
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Hogne Soennesyn
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Ketil Oppedal
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.,Stavanger Medical Imaging Laboratory (SMIL), Department of Radiology, Stavanger University Hospital, Stavanger, Norway.,Department of Electrical Engineering and Computer Science, University of Stavanger, Stavanger, Norway
| | - Ragnhild Oesterhus
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Ingvild Dalen
- Section of Biostatistics, Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - Alf Inge Larsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Helen Brooker
- Medical School, University of Exeter, Exeter, United Kingdom.,Ecog Pro Ltd., Bristol, United Kingdom
| | - Keith A Wesnes
- Medical School, University of Exeter, Exeter, United Kingdom.,Wesnes Cognition Ltd., Streatley, United Kingdom.,Department of Psychology, Northumbria University, Newcastle, United Kingdom.,Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC, Australia
| | - Clive Ballard
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Dag Aarsland
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.,Department of Old Age Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| |
Collapse
|
5
|
Belleville S, Cuesta M, Bieler-Aeschlimann M, Giacomino K, Widmer A, Mittaz Hager AG, Perez-Marcos D, Cardin S, Boller B, Bier N, Aubertin-Leheudre M, Bherer L, Berryman N, Agrigoroaei S, Demonet JF. Rationale and protocol of the StayFitLonger study: a multicentre trial to measure efficacy and adherence of a home-based computerised multidomain intervention in healthy older adults. BMC Geriatr 2020; 20:315. [PMID: 32859156 PMCID: PMC7453698 DOI: 10.1186/s12877-020-01709-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/16/2020] [Indexed: 11/22/2022] Open
Abstract
Background In older adults, multidomain training that includes physical and cognitive activities has been associated with improvement of physical and cognitive health. The goal of the multisite StayFitLonger study is to assess a home-based computerised training programme, which combines physical exercises, stimulating cognitive activities and virtual coaching. Methods One hundred twenty-eight cognitively healthy older adults will be recruited from the community in Switzerland, Canada and Belgium. The study will comprise (1) a 26-week double-blind randomized controlled efficacy trial and (2) a 22-week pragmatic adherence sub-study. In the efficacy trial, participants will be randomly assigned to an experimental or an active control intervention. In the experimental intervention, participants will use the StayFitLonger programme, which is computerised on a tablet and provides content that combines physical activities with a focus on strength and balance, as well as divided attention, problem solving and memory training. Outcomes will be measured before and after 26 weeks of training. The primary efficacy outcome will be performance on the “Timed-Up & Go” test. Secondary outcomes will include measures of frailty, cognition, mood, fear of falling, quality of life, and activities of daily living. Age, sex, education, baseline cognition, expectation, and adherence will be used as moderators of efficacy. Following the 26-week efficacy trial, all participants will use the experimental programme meaning that participants in the control group will ‘cross over’ to receive the StayFitLonger programme for 22 weeks. Adherence will be measured in both groups based on dose, volume and frequency of use. In addition, participants’ perception of the programme and its functionalities will be characterised through usability, acceptability and user experience. Discussion This study will determine the efficacy, adherence and participants’ perception of a home-based multidomain intervention programme and its functionalities. This will allow for further development and possible commercialization of a scientifically validated training programme. Trial registration ClinicalTrials.gov, NCT04237519 Registered on January 22, 2020 - Retrospectively registered.
Collapse
Affiliation(s)
- S Belleville
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada. .,Université de Montréal, Montréal, Canada.
| | - M Cuesta
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada
| | - M Bieler-Aeschlimann
- Leenaards Memory Centre, University Hospital of Lausanne, Lausanne, Switzerland.,MindMaze SA, Lausanne, Switzerland
| | - K Giacomino
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | - A Widmer
- HES-SO Valais-Wallis, School of Managment, Sierre, Switzerland
| | - A G Mittaz Hager
- HES-SO Valais-Wallis, School of Health Sciences, Loèche-les-Bains, Switzerland
| | | | - S Cardin
- MindMaze SA, Lausanne, Switzerland
| | - B Boller
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - N Bier
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université de Montréal, Montréal, Canada
| | - M Aubertin-Leheudre
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université du Québec à Montréal, Montréal, Canada
| | - L Bherer
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université de Montréal, Montréal, Canada.,Montréal Heart Institute, Montréal, Canada
| | - N Berryman
- Research Centre, Institut universitaire de gériatrie de Montréal, CIUSSS du Centre-Sud-de-l'Île-de-Montréal, 4565, Chemin Queen-Mary, Montréal, Québec, H3W 1W5, Canada.,Université du Québec à Montréal, Montréal, Canada
| | - S Agrigoroaei
- Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - J F Demonet
- Leenaards Memory Centre, University Hospital of Lausanne, Lausanne, Switzerland
| |
Collapse
|