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We demonstrate a new tomographic imaging device for 2D cross-sectional and 3D volumetric images of the anterior eye segment. The optical system combines optical sectioning with a stereoscopic camera setup to determine the true spatial location of the ocular structures. Moreover, we propose a calibration procedure to estimate the triangulation function that links the stereo camera pixel indices with the eye-referenced 3D spatial coordinates. The proposed instrument will image the entire anterior chamber and contiguous structures, including the corneal limbus, sclera and eyelids. Furthermore, the system can obtain corneal topography. Finally, we studied the repeatability of the instrument and its agreement with a commercial Scheimpflug imaging tomographer in a group of healthy subjects.

Background Polypharmacy is common in older individuals with Alzheimer's disease and related dementia (ADRD) who present with neuropsychiatric symptoms (NPS). While it is associated with increased fall risk, specific impact of psychotropic and general medication use on fall risk in this population is not clear. We evaluated fall risk associated with psychotropic and general medication use in patients with ADRD and NPS while controlling for other clinical factors. Method We used the following data from participants with a clinical diagnosis of AD and clinically significant NPS in the Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) study (ClinicalTrials.gov/NCT03672201): number of psychotropic and general medications and scores on the Cohen Mansfield Agitation Inventory (CMAI) scores, Cumulative Illness Rating Scale‐Geriatric (CIRSG), Functional Assessment Staging Tool (FAST). and Morse Fall Scale (MFS). Linear regression analyses evaluated the associations between psychotropic or general medication use and fall risk (MFS) while adjusting for age, CIRS‐G, CMAI, and FAST scores. Result 185 participants (female: 96 (52.5%)) were included, with mean (SD) age of 80.5 (9.8) years, mean FAST score of 9.1 (SD: 0.65; median stage: 6e). Psychotropic or general medications and CMAI or CIRS‐G scores were not significantly associated with MFS, but FAST stage of dementia was. Conclusion Fall risk in AD may be influenced more by functional and cognitive impairment than by medication use. These findings should be considered in the context of unique characteristics of this cohort that include a severe stage of dementia and the presence of significant NPS, and may inform fall risk management strategies in this population. References Gallagher, E., Mehmood, M., Lavan, A., Kenny, R. A., & Briggs, R. (2023). Psychotropic medication use and future unexplained and injurious falls and fracture amongst community‐dwelling older people: Data from TILDA. European Geriatric Medicine, 14(4), 455–463. Zarei S, Choudhury S, Burhan AM, Chu L, Colman S, Derkach P, et al. Determinants of polypharmacy in patients with behavioral and psychological symptoms of dementia. Alzheimers Dement. 2021;17(S6).

Polypharmacy is common in older individuals with Alzheimer's disease and related dementia (ADRD) who present with neuropsychiatric symptoms (NPS). While it is associated with increased fall risk, specific impact of psychotropic and general medication use on fall risk in this population is not clear. We evaluated fall risk associated with psychotropic and general medication use in patients with ADRD and NPS while controlling for other clinical factors. We used the following data from participants with a clinical diagnosis of AD and clinically significant NPS in the Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) study (ClinicalTrials.gov/NCT03672201): number of psychotropic and general medications and scores on the Cohen Mansfield Agitation Inventory (CMAI) scores, Cumulative Illness Rating Scale-Geriatric (CIRSG), Functional Assessment Staging Tool (FAST). and Morse Fall Scale (MFS). Linear regression analyses evaluated the associations between psychotropic or general medication use and fall risk (MFS) while adjusting for age, CIRS-G, CMAI, and FAST scores. 185 participants (female: 96 (52.5%)) were included, with mean (SD) age of 80.5 (9.8) years, mean FAST score of 9.1 (SD: 0.65; median stage: 6e). Psychotropic or general medications and CMAI or CIRS-G scores were not significantly associated with MFS, but FAST stage of dementia was. Fall risk in AD may be influenced more by functional and cognitive impairment than by medication use. These findings should be considered in the context of unique characteristics of this cohort that include a severe stage of dementia and the presence of significant NPS, and may inform fall risk management strategies in this population. References Gallagher, E., Mehmood, M., Lavan, A., Kenny, R. A., & Briggs, R. (2023). Psychotropic medication use and future unexplained and injurious falls and fracture amongst community-dwelling older people: Data from TILDA. European Geriatric Medicine, 14(4), 455-463. Zarei S, Choudhury S, Burhan AM, Chu L, Colman S, Derkach P, et al. Determinants of polypharmacy in patients with behavioral and psychological symptoms of dementia. Alzheimers Dement. 2021;17(S6).

Background Commonly used screening measures of cognitive function such as the Montreal Cognitive Assessment (MoCA) are not sensitive to assess cognitive function among individuals with severe cognitive impairment due to floor effect. The Severe Cognitive Impairment Rating Scale (SCIRS) was designed to assess cognitive function in those with severe cognitive impairment, however, psychometric properties of its English version have not been reported. Method Using the existing data from StaN and tTED studies, floor and ceiling effects (percentage of minimal or maximal scores) of SCIRS and MoCA were examined, and the association between SCIRS and MoCA was evaluated. Result Data from 141 participants (mean age = 78.7, 56% females) who completed either the SCIRS (n = 122) or MoCA (n = 80) were collected (n = 61 completed both). There was robust association between SCIRS and MoCA, supporting criterion validity of the SCIRS as a measure of cognitive function. SCIRS had a lower floor effect (13.1% minimal scores) as compared to the MoCA (27.5% minimal scores). Out of 22 participants with minimal scores on the MoCA, 16 participants completed the SCIRS with mean score of 9.8 (SD = 7.5). Conclusion SCIRS appears to be a valid measure of cognitive function, showing better variance among individuals with severe cognitive impairment, as compared to MoCA.

Background Adherence to treatment guidelines for agitation in dementia is suboptimal and inconsistent. We designed an Integrated Care Pathway (ICP) that standardized behavioral and pharmacological interventions for agitation in dementia, and evaluated it against treatment‐as‐usual (TAU). The two primary hypotheses were that, compared to TAU, the ICP would result in (1) lower agitation and (2) lower rates of polypharmacy at study end. Method The Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) trial (ClinicalTrials.gov # NCT03672201) was conducted at five academically affiliated inpatient units (Inpatient) and seven long‐term‐care homes (LTCHs). Participants with agitation related to Alzheimer’s dementia were randomized 1:1 to receive the ICP or TAU for 12 weeks. Primary outcomes were: (1) Cohen Mansfield Agitation Inventory (CMAI) completed at weeks 3, 8, and 12 (primary), and (2) polypharmacy defined as using more than one psychotropic medication assessed at weeks 1, 3, 4, 6, 8, 10, and 12 (primary) post‐randomization. Linear mixed effect models and generalized estimating equations were used to test our hypotheses controlling for age, gender, and stage of dementia. The study was powered for Inpatient and LTCH settings separately. Result 185 participants were randomized: 93 in Inpatient (46 ICP: 47 TAU; females = 32 (34.4%); mean (standard deviation [SD]) age = 75.0 (8.4) years), and 92 in LTCH (46 ICP: 46 TAU; women = 63 (68.5%); mean (SD) age = 85.9 (7.6) years). There were no significant time*group interactions for the CMAI scores for Inpatient (F4, 297.9 = 0.8, p = 0.53) or LTCH (F4, 297.3 = 1.1, p = 0.36) and no significant differences at week‐12 (Inpatient: ICP‐TAU adjusted difference = 0.025; 95% Confidence Interval (CI): ‐0.410, 0.460; LTCH: ICP‐TAU adjusted difference = ‐0.214; 95%CI: ‐0.699, 0.270). However, there were significant time*group interactions for polypharmacy for both Inpatient (χ27 = 18.6, p = 0.01) and LTCH (Χ27 = 22.9, p = 0.002). Differences were not significant at week‐12 (Inpatient: ICP‐TAU adjusted difference = 0.15; 95%CI: ‐0.11, 0.40; LTCH: ICP‐TAU adjusted difference = 0.33; 95%CI: ‐0.06, 0.72), the ICP group had lower rates of polypharmacy than TAU group at weeks 3, 4, and 6 on Inpatient, and week 3 in LTCH. Conclusion Standardizing care for agitation in dementia may result in less polypharmacy without affecting efficacy. Future studies should assess the ICP in broader community and outpatient settings.

ABSTRACTObjectivesThis study examined the effectiveness of an integrated care pathway (ICP), including a medication algorithm, to treat agitation associated with dementia. DesignAnalyses of data (both prospective and retrospective) collected during routine clinical care. SettingGeriatric Psychiatry Inpatient Unit. ParticipantsPatients with agitation associated with dementia (n = 28) who were treated as part of the implementation of the ICP and those who received treatment-as-usual (TAU) (n = 28) on the same inpatient unit before the implementation of the ICP. Two control groups of patients without dementia treated on the same unit contemporaneously to the TAU (n = 17) and ICP groups (n = 36) were included to account for any secular trends. InterventionICP. MeasurementsCohen Mansfield Agitation Inventory (CMAI), Neuropsychiatric Inventory Questionnaire (NPIQ), and assessment of motor symptoms were completed during the ICP implementation. Chart review was used to obtain length of inpatient stay and rates of psychotropic polypharmacy. ResultsPatients in the ICP group experienced a reduction in their scores on the CMAI and NPIQ and no changes in motor symptoms. Compared to the TAU group, the ICP group had a higher chance of an earlier discharge from hospital, a lower rate of psychotropic polypharmacy, and a lower chance of having a fall during hospital stay. In contrast, these outcomes did not differ between the two control groups. ConclusionsThese preliminary results suggest that an ICP can be used effectively to treat agitation associated with dementia in inpatients. A larger randomized study is needed to confirm these results.

Adherence to treatment guidelines for agitation in dementia is suboptimal and inconsistent. We designed an Integrated Care Pathway (ICP) that standardized behavioral and pharmacological interventions for agitation in dementia, and evaluated it against treatment-as-usual (TAU). The two primary hypotheses were that, compared to TAU, the ICP would result in (1) lower agitation and (2) lower rates of polypharmacy at study end. The Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) trial (ClinicalTrials.gov # NCT03672201) was conducted at five academically affiliated inpatient units (Inpatient) and seven long-term-care homes (LTCHs). Participants with agitation related to Alzheimer's dementia were randomized 1:1 to receive the ICP or TAU for 12 weeks. Primary outcomes were: (1) Cohen Mansfield Agitation Inventory (CMAI) completed at weeks 3, 8, and 12 (primary), and (2) polypharmacy defined as using more than one psychotropic medication assessed at weeks 1, 3, 4, 6, 8, 10, and 12 (primary) post-randomization. Linear mixed effect models and generalized estimating equations were used to test our hypotheses controlling for age, gender, and stage of dementia. The study was powered for Inpatient and LTCH settings separately. 185 participants were randomized: 93 in Inpatient (46 ICP: 47 TAU; females = 32 (34.4%); mean (standard deviation [SD]) age = 75.0 (8.4) years), and 92 in LTCH (46 ICP: 46 TAU; women = 63 (68.5%); mean (SD) age = 85.9 (7.6) years). There were no significant time*group interactions for the CMAI scores for Inpatient (F = 0.8, p = 0.53) or LTCH (F = 1.1, p = 0.36) and no significant differences at week-12 (Inpatient: ICP-TAU adjusted difference = 0.025; 95% Confidence Interval (CI): -0.410, 0.460; LTCH: ICP-TAU adjusted difference = -0.214; 95%CI: -0.699, 0.270). However, there were significant time*group interactions for polypharmacy for both Inpatient (χ = 18.6, p = 0.01) and LTCH (Χ = 22.9, p = 0.002). Differences were not significant at week-12 (Inpatient: ICP-TAU adjusted difference = 0.15; 95%CI: -0.11, 0.40; LTCH: ICP-TAU adjusted difference = 0.33; 95%CI: -0.06, 0.72), the ICP group had lower rates of polypharmacy than TAU group at weeks 3, 4, and 6 on Inpatient, and week 3 in LTCH. Standardizing care for agitation in dementia may result in less polypharmacy without affecting efficacy. Future studies should assess the ICP in broader community and outpatient settings.

As the luxury market continues to grow, luxury brands are quickly incorporating art into brand communication due to the decrease in scarcity, which is the intrinsic value of luxury brand. This study aims to analyze the effect of art-related content usage behavior on luxury brand purchase intention. This study verified the effect of consumers' usage of art content on the purchase intention of luxury brands in social media, a representative consumer communication channel of luxury brands. As a result of the analysis, consumers who accept and diffuse more art-related content on social media showed higher purchase intention for luxury brands. In addition, aesthetic, symbolic, and hedonic values, which are art and luxury purchasing motives, were analyzed to mediate art content usage and purchase intention in social media, and the moderating effect of FOMO(Fear-of-missing-out) was verified as a psychological mechanism inherent in consumers. This study provides academic and practical management implications by exploring the impact of art content on luxury consumers at this time when luxury brands are becoming more artistic.

[...]environmental problems arise, and therefore, there is a great demand for the use of renewable energy and a corresponding need for an energy storage device1,2. [...]it is not only well known in EDLC industry that as the voltage gets higher, there is more deterioration from the reaction between the electrolyte and the activated carbon13, also serious corrosion occurs in the Al current collector due to the reaction with the electrolyte at the voltage limit and higher. [...]studies on improving energy density by raising the typical EDLC operating voltage of 2.5-2.7V must be accompanied by studying the aluminum corrosion in EDLC. [...]it was confirmed that the physical polishing method has an effect of reducing the amount of the chemical component on the surface of the Al current collector changed by the deterioration with the electrolyte (Table 1). [...]of analyzing the effect of electrode active material removal methods on Al current collector, ultrasonic treatment within 60 seconds and heat treatment method which does not include water have little effect on the chemical composition or pit change of the Al current collector.