Digital Commons Network^™

Real-World Dispensing Of Buprenorphine In California During Prepandemic And Pandemic Periods, Yun Wang, Alexandre Chan, Richard Beuttler, Marc L. Fleming, Todd Schneberk, Michael Nichol, Haibing Lu

Pharmacy Faculty Articles and Research

Introduction: The opioid overdose crisis in the United States has become a significant national emergency. Buprenorphine, a primary medication for individuals coping with opioid use disorder (OUD), presents promising pharmacokinetic properties for use in primary care settings, and is often delivered as a take-home therapy. The COVID-19 pandemic exacerbated the scarcity of access to buprenorphine, leading to dire consequences for those with OUD. Most existing studies, primarily focused on the immediate aftermath of the COVID-19 outbreak, highlight the challenges in accessing medications for opioid use disorder (MOUDs), particularly buprenorphine. However, these studies only cover a relatively short timeframe. Methods: To …

Acetylcholine Receptor Based Chemogenetics Engineered For Neuronal Inhibition And Seizure Control Assessed In Mice, Quynh-Anh Nguyen, Peter M Klein, Cheng Xie, Katelyn N Benthall, Jillian Iafrati, Jesslyn Homidan, Jacob T Bendor, Barna Dudok, Jordan S Farrell, Tilo Gschwind, Charlotte L Porter, Annahita Keravala, G Steven Dodson, Ivan Soltesz

Faculty, Staff and Students Publications

Epilepsy is a prevalent disorder involving neuronal network hyperexcitability, yet existing therapeutic strategies often fail to provide optimal patient outcomes. Chemogenetic approaches, where exogenous receptors are expressed in defined brain areas and specifically activated by selective agonists, are appealing methods to constrain overactive neuronal activity. We developed BARNI (Bradanicline- and Acetylcholine-activated Receptor for Neuronal Inhibition), an engineered channel comprised of the α7 nicotinic acetylcholine receptor ligand-binding domain coupled to an α1 glycine receptor anion pore domain. Here we demonstrate that BARNI activation by the clinical stage α7 nicotinic acetylcholine receptor-selective agonist bradanicline effectively suppressed targeted neuronal activity, and controlled both …

Short Peripheral Blood Leukocyte Telomere Length In Rheumatoid Arthritis-Interstitial Lung Disease, Tracy J Doyle, Pierre-Antoine Juge, Anna L Peljto, Seoyeon Lee, Avram D Walts, Anthony Joseph Esposito, Sergio Poli, Ritu Gill, Hiroto Hatabu, Mizuki Nishino, Paul F Dellaripa, Michael E Weinblatt, Nancy A Shadick, M Kristen Demoruelle, Jeffrey A Sparks, Ivan O Rosas, Benjamin Granger, Kevin D Deane, Bruno Crestani, Paul J Wolters, Philippe Dieudé, Joyce S Lee

Faculty, Staff and Students Publications

Shortened telomere lengths (TLs) can be caused by single nucleotide polymorphisms and loss-of-function mutations in telomere-related genes (TRG), as well as ageing and lifestyle factors such as smoking. Our objective was to determine if shortened TL is associated with interstitial lung disease (ILD) in individuals with rheumatoid arthritis (RA). This is the largest study to demonstrate and replicate that shortened peripheral blood leukocytes-TL is associated with ILD in patients with RA compared with RA without ILD in a multinational cohort, and short PBL-TL was associated with baseline disease severity in RA-ILD as measured by forced vital capacity percent predicted.

Obesity And Skeletal Fragility, Rui Chen, Reina Armamento-Villareal

Faculty, Staff and Students Publications

Skeletal fracture has recently emerged as a complication of obesity. Given the normal or better than normal bone mineral density (BMD), the skeletal fragility of these patients appears to be a problem of bone quality rather than quantity. Type 2 diabetes mellitus (T2DM), the incidence of which increases with increasing body mass index, is also associated with an increased risk for fractures despite a normal or high BMD. With the additional bone pathology from diabetes itself, patients with both obesity and T2DM could have a worse skeletal profile. Clinically, however, there are no available methods for identifying those who are …

Causes, Functions, And Therapeutic Possibilities Of Rna Secondary Structure Ensembles And Alternative States, Ritwika Bose, Irfana Saleem, Anthony M Mustoe

Faculty, Staff and Students Publications

RNA secondary structure plays essential roles in encoding RNA regulatory fate and function. Most RNAs populate ensembles of alternatively paired states and are continually unfolded and refolded by cellular processes. Measuring these structural ensembles and their contributions to cellular function has traditionally posed major challenges, but new methods and conceptual frameworks are beginning to fill this void. In this review, we provide a mechanism- and function-centric compendium of the roles of RNA secondary structural ensembles and minority states in regulating the RNA life cycle, from transcription to degradation. We further explore how dysregulation of RNA structural ensembles contributes to human …

Effect Of Testosterone Replacement Therapy On Sexual Function And Hypogonadal Symptoms In Men With Hypogonadism, Karol M Pencina, Thomas G Travison, Glenn R Cunningham, A Michael Lincoff, Steven E Nissen, Mohit Khera, Michael G Miller, Panagiotis Flevaris, Xue Li, Kathleen Wannemuehler, Shalender Bhasin

Faculty, Staff and Students Publications

Context: Few long-term randomized trials have evaluated the efficacy of testosterone replacement therapy (TRT) in improving sexual function and hypogonadal symptoms in men with hypogonadism and whether effects are sustained beyond 12 months.

Objective: The Testosterone Replacement therapy for Assessment of long-term Vascular Events and efficacy ResponSE in hypogonadal men (TRAVERSE) study evaluated the effect of TRT on major adverse cardiovascular events in middle-aged and older men with hypogonadism. The Sexual Function Study, nested within the parent trial, determined testosterone's efficacy in improving sexual activity, hypogonadal symptoms, libido, and erectile function among men reporting low libido.

Methods: Among 5204 men, …

Identification Of Molecular Subphenotypes In Two Cohorts Of Paediatric Ards, Nadir Yehya, Matt S Zinter, Jill M Thompson, Michelle J Lim, Mark R Hanudel, Mustafa F Alkhouli, Hector Wong, Matthew N Alder, Daniel J Mckeone, E Scott Halstead, Pratik Sinha, Anil Sapru

2020-Current year OA Pubs

BACKGROUND: Two subphenotypes of acute respiratory distress syndrome (ARDS), hypoinflammatory and hyperinflammatory, have been reported in adults and in a single paediatric cohort. The relevance of these subphenotypes in paediatrics requires further investigation. We aimed to identify subphenotypes in two large observational cohorts of paediatric ARDS and assess their congruence with prior descriptions.

METHODS: We performed latent class analysis (LCA) separately on two cohorts using biomarkers as inputs. Subphenotypes were compared on clinical characteristics and outcomes. Finally, we assessed overlap with adult cohorts using parsimonious classifiers.

FINDINGS: In two cohorts from the Children's Hospital of Philadelphia (n=333) and from a …

Factors Affecting The Ability Of Patients With Complex Vascular Anomalies To Navigate The Healthcare System, Bryan Sisk, Sunny Lin, Anna M Kerr

2020-Current year OA Pubs

BACKGROUND: Vascular anomalies (VAs) are rare congenital disorders that can cause pain, disfigurement, coagulopathy, asymmetric growth, and disability. Patients with complex VAs experience multiple barriers to accessing expert care. It is imperative to understand which factors support these patients' ability to navigate the healthcare system.

RESULTS: We surveyed adult patients with VAs using previously validated measures, recruiting participants from five patient advocacy groups and multidisciplinary VA clinics. The primary outcome was self-reported ability to access needed medical care, using the "Navigating the Healthcare System" subscale of the Health Literacy Questionnaire. We evaluated factors associated with the ability to navigate the …

Beyond Teaching: The Self-Fulfillment Of Creating A Positive And Safe Learning Environment For Children Exposed To Aces, Tessa J. Davis

The Journal of Advancing Education Practice

Due to factors such as burnout, lack of support, heavy workload, and student behavior, teachers are exiting the field for other occupations. Retention has become an issue. However, teachers are finding a sense of value and self-fulfillment for the same reasons they are leaving, which restores their outlook. This opinion paper will focus on teachers finding value in creating a positive learning environment in the classroom and creating resilience for students exposed to adverse childhood experiences at home.

Studying Adherence To Reporting Standards In Kinesiology: A Post-Publication Peer Review Brief Report, Nikki M. Watson, Jafra D. Thomas

International Journal of Exercise Science

International Journal of Exercise Science 17(7): 25-37, 2024. To demonstrate how post-publication peer reviews—using journal article reporting standards—could improve the design and write-up of kinesiology research, the authors performed a post-publication peer review on one systematic literature review published in 2020. Two raters (1^st & 2^nd authors) critically appraised the case article between April and May 2021. The latest Journal Article Reporting Standards by the American Psychological Association relevant to the review were used: i.e., Table 1 (quantitative research standards) and Table 9 (research synthesis standards). A standard fully met was deemed satisfactory. Per Krippendorff’s alpha-coefficient, inter-rater agreement …

The Relationship Between Athlete Perceptions Of Coaching Leadership Behaviors And Athlete Grit, Landon Braun, Lindsay Ross-Stewart, Barbara B. Meyer

International Journal of Exercise Science

International Journal of Exercise Science 17(5): 12-23, 2023. Coach leadership style has long been positively correlated with athlete experiences such as motivation, health (i.e., burnout), and performance outcomes (i.e., enhanced execution time to complete tasks) (24). More recently, grit (18) has been positively correlated with athlete experiences such as engagement (39) and decreased burnout (32). Given the impact coaches have on their athletes and the positive psychological benefits of grit, it is reasonable to explore the intersections of coaching behaviors and grit. As such, the purpose of the current study was to examine the relationship between athlete perceptions of coach …

Fat-Free Mass Index In A Large Sample Of Collegiate American Football Athletes, Jennifer B. Fields, Margaret T. Jones, Adam Feit, Meghan K. Magee, Nicholas M. Kuhlman, Andrew R. Jagim

International Journal of Exercise Science

International Journal of Exercise Science 17(4): 129-139, 2024. High levels of fat-free mass (FFM) are favorable for athletes and are related to sport performance. However, fat-free mass index (FFMI), which includes adjustments for height, may offer a better way to characterize FFM beyond raw values. As FFMI is understudied relative to sport, the purpose of the current study was to assess position and age group differences in FFMI among collegiate American football players. National Collegiate Athletic Association DIII (n=111) football players underwent body composition assessment via bioelectrical impedance analysis. FFMI was calculated by dividing FFM by height squared. One-way analyses …

Stance Time And Impact Loading Rates Are Significant Predictors Of Critical Speed During A 3-Minute All-Out Running Test, Trevor Short, Cris Stickley, Bret Freemyer, Andrew Takata, Paulette Yamada

International Journal of Exercise Science

International Journal of Exercise Science 17(4): 115-128, 2024. The addition of wearable technology during a 3-minute all-out overground running test (3MAOT) could provide additional insights to guide training and coaching strategies. The purpose of this study was to explore the relationships between critical speed (CS) and biomechanical parameters (cadence, stride length, vertical oscillation, stance time, form power, leg spring stiffness, and impact loading rate), and changes in biomechanical parameters throughout the 3MAOT. Sixty-three (male, n=37, female, n=26) recreationally active college-aged (23.4±3.9 years) subjects completed a 3MAOT while wearing a Stryd foot-pod. The correlations between CS and biomechanical parameters were evaluated …

Lower-Body Strength Relationships With Sprint, Jump, And Sport-Specific Skill Performance In High School Girls Softball Players, Robert G. Lockie, Jacob D. Patron, J. Jay Dawes, Erika Viramontes

International Journal of Exercise Science

International Journal of Exercise Science 17(4): 86-98, 2024. Softball athletes require multiple fitness traits (e.g., strength, speed, power) and sport-specific skills (e.g., hitting, throwing) for success. Lower-body strength could underpin these qualities; this has received little analysis among high school female athletes. This research investigated correlations between absolute and relative lower-body strength with age, linear speed, lower-body power, and throwing and hitting velocity in high school girls softball athletes. Archival data collected from 34 high school girls softball players (age=14.91±1.00 years; height=1.66±0.07 m; body mass=63.21±9.59 kg) from a private strength and conditioning facility was analyzed. The data included: age, height, …

Physical Fitness Responses After Sixteen Weeks Of Three Fitness Program Trainings In Untrained Subjects, Habil Hamdouni, Brian Kliszczewicz, Hassane Zouhal, Abderraouf Ben Abderrahman

International Journal of Exercise Science

International Journal of Exercise Science 17(4): 54 - 72, 2024. The remarkable popularity of fitness trends like high intensity functional training (HIFT), choreographed high intensity classes (CHIC) and resistance (RT) trainings raises the question on their effect on cardio-respiratory, lactate removal rate, endurance and body composition responses. The purpose of this study was to assess and compare these effects. Ninety-five participants were randomly assigned into 16 weeks of these trainings, five sessions/week. Anthropometric and fitness tests were carried out before training (PRE), after eight (8W) and sixteen weeks (16W). Body composition measures demonstrated significant decrease in body fat percentage ( …

More Than Body Composition: A Darwinian Theory Of Somatotype, Applied To A Dii Track And Field Outdoor Season, Whitley J. Stone, Matthew J. Garver, Amanda Wakeman, Danilo Tolusso, Hannah Nelson, Josie Hair, Eric Nehlsen

International Journal of Exercise Science

International Journal of Exercise Science 17(4): 1-12, 2024. This study presents somatotype data on a team sport with chronic and diverse sporting demands. The aims were to (1) characterize a somatotype profile for Division II (DII) track and field athletes (n=54) by sex, class, and events; (2) determine if somatotype changed across the season; (3) determine if changes differed based on class or sex; and, (4) assess potential differences in somatotype between sexes. Methods: Anthropometrics (height, weight, body composition, somatotype) were evaluated after a competitive indoor season and immediately before the outdoor conference championships (41 days). Body measurements were assessed …

Feasibility Of Blood Flow Restriction Exercise In Adults With A Non-Surgically Treated Achilles Tendon Rupture; A Case Series, Andreas Bentzen, Stian Langgård Jørgensen, Sara Birch, Louise Mortensen, Marianne Toft, Michael Godsvig Lindvig, Per Hviid Gundtoft, Inger Mechlenburg

International Journal of Exercise Science

International Journal of Exercise Science 17(3): 140-153, 2024. Blood flow restriction exercise (BFRE) appears to provide a unique opportunity to preserve lower limb muscle and function in patients with an Achilles tendon rupture. The purpose of this study was to investigate the feasibility of BFRE in patients with an Achilles tendon rupture. Additionally, to evaluate muscle volume and patient-reported ankle function, symptoms, complications, and physical activity following 12 weeks of BFRE. Feasibility was measured by adherence to training sessions, drop-out rate, intervention acceptability, ankle pain exacerbation (NRS), and adverse events. At baseline and 12-weeks follow-up, patients completed the Achilles Tendon …

Evaluation Of The Craniovertebral Angle In Standing Versus Sitting Positions In Young Adults With And Without Severe Forward Head Posture, David A. Titcomb, Bridget F. Melton, Helen W. Bland, Theresa Miyashita

International Journal of Exercise Science

International Journal of Exercise Science 17(1): 73-85, 2024. The purpose of this study was to examine the effects of standing versus sitting body position on the craniovertebral angle (CVA) in young adults without pathology; and to investigate whether mean differences between positional CVA measures in subjects with severe forward head posture (FHP) are distinct from age-matched controls with normal head posture. Ninety-eight young adults (68 women, 30 men) without pathology (OVERALL; n = 98) volunteered for the study; those with CVA > 53° were also included in a normal posture group (NORM; n = 14); those with CVA < 45° were also included in a severe FHP group (SEV; n = 15). …

Bench Press Range-Of-Motion And Velocity-Based Repetition Control: Effects On Ballistic Push-Up Performance In Males, Kyle Collins, Adam Bradley, Bryan Christensen, Roman Waldera, Lukus Klawitter, Liam Ogren, Robert Salatto

International Journal of Exercise Science

International Journal of Exercise Science 17(1): 38-53, 2024. The purpose of this study was to investigate whether the ballistic push-up (BPU) is responsive to post-activation performance enhancement (PAPE) after a bench press conditioning exercise using velocity-based repetition control. Additionally, we aimed to evaluate the effects of range of motion (ROM) conditions on subsequent BPU performance. In a randomized crossover design, 18 males performed two conditions (full ROM and self-selected partial ROM) of bench press at 80% of their 1RM until mean concentric velocity dropped 10%. Each participant performed two pre- and six post-test BPUs to assess the PAPE effect. Paired …

Sleep Duration As A Risk Factor For Suicide Ideation And Attempts In Minoritized Youth, Danielle Williams

Posters-at-the-Capitol

Sleep duration as a risk factor for suicide ideation and attempts in minoritized youth

Danielle L. Williams, Caitlin P. Gregory, B.S., Jenessa Canen, B.S., & Amy Brausch Ph.D.

Background and Objective: Suicide is the second leading cause of death in the United States for adolescents and poor sleep is a significant risk factor for suicide ideation and attempts. However, research shows that suicide risk factors identified in predominantly white samples of youth do not have the same association for racial minority youth; sleep may be one such factor. The current study evaluated how the association of total sleep duration with …

Heavy Metals Contamination Alters Soil Microbes, Ali Cass

Posters-at-the-Capitol

Urban green spaces can improve food security, enhance biodiversity, and provide recreational and educational opportunities in cities. Converting abandoned or vacant lots to functional urban green spaces such as parks or gardens is a promising way to increase urban canopy cover, make use of available land, and mitigate food insecurity. However, research has shown that heavy metal soil contamination is a major concern in urban vacant lots, not just for human health, but also for the plants, wildlife, and soil organisms that play crucial roles in providing beneficial ecosystem services. In our study, we asked whether heavy metals impacted soil …

Avaren-Fc, A Novel Immunotherapeutic, Recruits Nk Cells In B16f10 Melanoma Tumor Tissue, Sreevatsa Vemuri, Katarina Mayer, Nobuyuki Matoba

Posters-at-the-Capitol

Melanoma is the fifth most common cancer in the US, with limited effective immunotherapeutic options available for patients. Avaren-Fc (AvFc) is a novel experimental immunotherapeutic agent with a unique “lectibody” property. It is capable of targeting cancer cells through the selective recognition of high mannose glycans, which are aberrantly overrepresented on the surface of malignant cells. AvFc can interact with circulating effector immune cells equipped with Fc receptors, such as natural killer (NK) cells to induce antibody-dependent cell-mediated cytotoxicity (ADCC) and kill cancer cells. Previous work has shown that AvFc effectively induces ADCC activity against B16F10 cancer cells in vitro …

Enhancing The Safety Of Medication Administration: The Synergistic Role Of Closed Loop Electronic Medication Management And Iv Medication Administration, Kelly Goetz, Angela Schoenung, Lauren Daugherty, Kaitlyn Hornsby

Posters-at-the-Capitol

The high acuity of patients in the ICU results in numerous medications being administered, increasing the risk of medication errors. The purpose of this project is to investigate the impact of integrating consistent closed loop electronic medication management (CLEMM) to decrease medication errors in the ICU for bedside nurses who use electronic health records (EHRs). The project type is a comprehensive literature review, with studies that included a single prospective cohort study, case report, single non-randomized trial, quasi experimental study, single cross-sectional studies, and systematic reviews. The importance of this project is to address the break in the loop of …

Using Network Analysis To Personalize Care For Binge Eating Disorder, Legacy S. Carter, Dr. Anna Marie Ortiz

Posters-at-the-Capitol

Legacy Carter, KCTCS; Dr. Anna Marie Ortiz, University of Louisville, Psychology and Brain Sciences Department

Title:Using network analysis to personalize care for Binge Eating Disorder

Binge Eating Disorder is the compulsive behavior to overeat food, usually within a brief time frame. Symptoms such as anxiety, fear of being fat and perfectionism could trigger a person to binge eat. Network analysis is a statistical approach in health psychology that uses graphical representations of relationships among variables, and could be useful in identifying the symptoms that cause Binge Eating Disorder. The information collected could come from surveys, interviews or clinical studies. Network …

Mountain (Grand) Mamas: Grandparents Raising Grandchildren During The Opioid Epidemic In Appalachian America And Their Portrayal In Media, Rosemary P. Kelley

Posters-at-the-Capitol

Deep within the hills of Appalachia grandparents are stepping into the familiar role of parenting as many have become the primary caregivers for their grandchildren. These grandparent-headed households (GHHs), a form of kinship care, have increased largely in response to the opioid epidemic that has ravaged the region; children are often left in the care of grandparents as parents experience substance use disorders and, in turn, incarceration. According to the US Census Bureau, over seven million grandparents live with their own grandchildren; over 32 percent of which serve as caregivers and are responsible for these children. The impact of kinship …

The Effects Of Liftng Belts On Power Output, Julio Aguilar, Benjamin Coldwell, Patrick Jackson, Cade Pippen, Zane Thornton

International Journal of Exercise Science: Conference Proceedings

JULIO AGUILAR, BENJAMIN COLDWELL, PATRICK JACKSON, CADE PIPPEN, ZANE THORTON.

Kinesiology & Health Science; Stephen F. Austin State University; Nacogdoches, TX

Category: Undergraduate

Advisor: Chelette, Amber, [email protected]

Lifting belts, when lifting heavy weights, are purportedly used to support, stabilize, and attenuate the load on the spine. With the additional support, potential questions arise about whether weightlifting belts affect the power performed when squatting. This study aimed to examine the power produced during a squat with a weightlifting belt compared to a squat performed without one. Ten subjects, five male and five female, performed squats of two sets of 3 repetitions, …

Managing Diffuse Alveolar Hemorrhage In A Critical Care Setting, Yong-Chan Kim, Jessica Marcela Daza, Juan C. Naranjo, Timothy Heath

Research Symposium

Background: Diffuse alveolar hemorrhage (DAH) is defined as disruption of the alveolar-capillary basement membrane, causing bleeding into the alveolar spaces. It is one of the rarest complications in systemic lupus erythematosus (SLE) and life-threatening conditions. Symptoms include shortness of breath, cough, fluctuating fever, and rarely hemoptysis. Complications include acute respiratory distress syndrome. The test of choice for diagnosis is bronchoalveolar lavage (BAL). The hallmark is that BAL aliquots are progressively more hemorrhagic. CT-chest shows ground glass or consolidative opacities that are usually diffuse and bilateral nonspecific. There is no cornerstone therapy for DAH due to SLE. Considering this a fatal …

Molecular Insights To The P53-Independent Anticancer Activity Of Mortaparibmild, Yang Shi, Huayue Zhang, Hyonchol Kim, Sunil Kaul, Renu Wadhwa

Research Symposium

Background: Mortalin, a member of the Hsp70 family of proteins, enriched in many types of cancers, has been shown to promote carcinogenesis and metastasis by multiple ways of which inactivation of p53 has been firmly established. Downregulation of mortalin by small RNAs and disruption of mortalin-p53 interactions by small molecules have earlier been shown to activate tumor suppressor activities of p53 yielding growth arrest/apoptosis in cancer cells. In this premise, screening of a chemical library to identify potential abrogators of mortalin-p53 interaction was performed using two-way imaging assay involving (i) shift of mortalin staining pattern from perinuclear (characteristics of cancer …

Endophthalmitis In An Elderly Patient - A Case Of Delayed Transfer And Successful Management, Vamsikalayan Borra, Roy Kondapavuluru, Sreejith Pillali, Sabhi Gull, Andres Suarez Parraga

Research Symposium

Introduction: Endophthalmitis is a severe and potentially sight-threatening condition that demands immediate attention and intervention. It is characterized by inflammation and infection within the eye, typically caused by bacterial or fungal organisms entering the eye, often following surgery or trauma. Usually present with sudden, severe eye pain, redness, decreased vision, and photophobia. As endophthalmitis can rapidly progress and cause irreversible damage to the eye, it is considered a true ocular emergency.

Case presentation: An 80-year-old woman, known to have Insulin-dependent Type 2 Diabetes mellitus and a history of breast cancer, arrived at the Emergency Department (ED) with persistent and worsening …

Effect Of Alcohol Consumption On Cognitive Decline Among Mexicans 50 Years And Older, Silvia Mejia-Arango, Ihsan Salloum, Gladys Maestre

Research Symposium

Background: Studies on the association between alcohol use and cognitive impairment have yielded controversial results suggesting a reduced risk of dementia in drinkers vs. nondrinkers. We aimed to examine the effect of alcohol use on cognitive trajectories among Mexican adults aged 50 and over.

Methods: Data are from 5,898 cognitively normal individuals (2,512 men and 3,386 women) from the Mexican Health and Aging Study (MHAS) with a mean age of 59 years (50-90 years) at baseline (2001) and followed-up after 11 years (2012). The Cross-Cultural Cognitive Examination was the cognitive battery measuring verbal memory, visual memory, attention, and constructional praxis. …