![]() ![]() To learn more about each of our physicians providing gastroenterology medical services, click on their name or photo below. the personal representative for the estate of Gary Wayne Sommers. DGC Digestive Health's medical staff consists of two experienced gastroenterologists. Gary Schwartz, MD, Gastroenterology Garden City. Sommers Schwartz attorney Matthew Turner filed a medical malpractice lawsuit alleging. He and his family attend Open Door Baptist Church. Gastroenterologists Near Me in Garden City, NY WebThe physicians and staff at. Gary J Schwartz M.D., Gastroenterologist Gastroenterology in Garden City, NY, 11530. He enjoys traveling and water sports with his family, as well as drawing and sculpture. He lives in North Raleigh with his wife and has four children. Schwarz has been involved with fundraising for the Crohns and Colitis Foundation, and the Cancer Hospital at Rex Healthcare. Schwartz, his performed two procedures on me in the past and he his bedside manner was always excellent. Some of his clinical interests include biliary and pancreatic diseases, therapeutic endoscopy, inflammatory bowel disease, and endoscopic ultrasound. Schwarz is board certified in internal medicine and gastroenterology. He is very thorough and methodical in his approach to medical practice. He has been practicing for over 26 years and is board certified by the American Board of Internal Medicine. Gary Schwartz, MD, specializes in family medicine and is board-certified in family medicine by the American Board of Family Medicine. Luke’s Medical Center in Chicago before relocating to the Southeast to do his fellowship in gastroenterology at the Medical College of Virginia. Schwartz is a caring and compassionate human being. Gary Schwartz, MD is a Gastroenterologist (Stomach & Bowel Specialist), who primarily practices in Uniondale, NY. He completed his internal medicine residency at Rush-Presbyterian St. He graduated from Wayne State University School of Medicine in Detroit with a medical degree, and completed graduate studies in Protein Biochemistry also earning a PhD. Christopher Schwarz is a Michigan native. He joined the faculty of the University of Arizona as a senior professor in 1988.Dr. Schwartz later became a tenured professor of psychology and psychiatry at Yale University, directed the Yale Psychophysiology Center, and co-directed the Yale Behavioral Medicine Clinic. He was an assistant professor at Harvard for five years. Schwartz also served as Chairman of Eternea, an organization whose mission is to foster the integration of science and spirituality for personal and global transformation.Īfter receiving his master’s degree from Harvard in clinical psychology, he earned a PhD there in psychophysiology. ![]() He collaborated with Canyon Ranch on biofield science and energy healing research and served as the Corporate Director of Development of Energy Healing. Schwarz is a gastroenterologist in Houston, Texas and is affiliated with multiple hospitals in the area, including Memorial Hermann Hospital and Houston Methodist Hospital. They specialize in Orthopedic Hand Surgery, has 42 years of experience. Schwartz was the founding president of the Academy for Advances in Postmaterial Sciences. Gary Schwartz, MD is an Orthopedic Hand Surgery Specialist in Hollywood, FL. This funding created the Center for Frontier Medicine in Biofield Science at the University of Arizona that he directed for four years. Schwartz received a two million-dollar award from the National Center on Complementary and Alternative Medicine of the National Institutes of Health. ![]()
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![]() ![]() oof I wish IF Beholder 3 will come out i wish that he was single on the 1st place so many choices, so many ladies :cleanseal: I’m not ready for a 3 yet I’m still trying to figure out good guy route on beholder 2. Using GameFAQs regularly with these browsers can cause temporary and even permanent IP blocks due to these additional requests. On the first floor it seems somebody always has to get screwed. Having to pick between screwing Marco or screwing Emma.Some unofficial phone apps appear to be using GameFAQs as a back-end, but they do not behave like a real web browser does.Emma hazer beholder 2 wiki Redgrave's LegacyGo go to bed to start the next day. This triggers our anti-spambot measures, which are designed to stop automated systems from flooding the site with traffic. Look around and chat with different characters. You have three business friends: Marco Legrand, Emma Hazer and Peter Dong. In the same room is Nicolas Page, a smuggler and doughnut salesman Serena Marwitz. Continued use of these apps may cause your IP to be blocked indefinitely. Using a script or add-on that scans GameFAQs for box and screen images (such as an emulator front-end), while overloading our search engine Found inside the food cart next to Serena Marwitz.There is no official GameFAQs app, and we do not support nor have any contact with the makers of these unofficial apps. Found within the cart of papers between Emma Hazer’s desk and the work phone. Using a badly configured (or badly written) browser add-on for blocking content So I need to get rid of Emma but I failed and I sent her kids to the foster home and now I can't do nothing.Running a "scraper" or "downloader" program that either does not identify itself or uses fake headers to elude detection.Given to you from Marco Legrand upon completing his 3 prank quests and asking for it OR stolen from his desk OR found within the Lost and Found if Marco Legrand is no longer in the Ministry. Overusing our search engine with a very large number of searches in a very short amount of time.I already put foreign money in dong's office so I can't put that in hers. If you promise to stop (by clicking the Agree button below), we'll unblock your connection for now, but we will immediately re-block it if we detect additional bad behavior. If you do not understand what is causing this behavior, please contact us here. Talk to her, and then tell Emma about the orphanage. 1 AAA 2 AAAS 3 Aachen 4 Aalborg 5 Aalesund 6 aardvark 7 aardvarks 8 aardvarks. If you wish to be unblocked, you must agree that you will take immediate steps to rectify this issue. ![]() Recommend Emma to use beauty, or do it yourself. In the second case, you will need to call the orphanage from home and convince them to take Emma’s children for 500 coins or credibility points. ![]() In the first case, Emma will sleep with the head of the orphanage. Please fill out the CAPTCHA below and then click the button to indicate that you agree to these terms. You are an intern at the central ministry of a totalitarian state with your whole career ahead of you. Continued abuse of our services will cause your IP address to be blocked indefinitely.The following is a complete list of Characters. On that foggy Sunday morning of September 8, the two women had breakfast together. ![]() Work your way up the ladder by scheming against employees, spying on your boss, and completing paperwork. The killer had raped her and forced her to perform oral sex before he. Or do you turn against the state and expose corruption. You can also check the list of characters in the core game Beholder or the list of characters in the DLC Blissful Sleep. ![]() ![]() Image by : Fill your cart with color today! Places to stay near fawn creek are 1486.77 ft² on average, with prices averaging $244 a. Glass LLC American Psycho Patrick Bateman Christian Bale Image by : Up to 3.2% cash back shop unique and stylish american psycho t shirts for everyone. Christian Bale American Psycho TShirt Men's Women's Etsy Up to 3.2% cash back shop unique and stylish american psycho t shirts for everyone. Image by : Map of fawn creek, ks, kansas. 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Unlike other brands, Noah dares to take a stand and speak out. Noah even closed its physical and online store last year on Black Friday to protest excessive consumerism. In the past, Noah has released clothing supporting Black Lives Matter, Robert Mueller, Smokey the Bear, relief efforts for Hurricane Harvey and Irma, Middle Eastern refugees, the Anti-Nazi League, the ACLU, and more, donating all the money raised to charities devoted to those causes in some cases. This disparity can be explained by Noah’s commitment to quality, refreshing transparency, and individuality to the point of losing money. Noah is most known for its signature core logo hoodies, but it also sells trench coats that cost $1,200. Noah’s founder, Brendon Babenzien, was previously the creative director of Supreme until 2015 when he left and established the brand. Ushering in a new age of politically-active, conscious branding, Noah is at the forefront of infusing stylish clothing with social commentary. Here are some of my favorite streetwear brands from NYC. Unsurprisingly, there are other more low-key brands with their own unique identities that also hail from the Big Apple. However, Supreme’s true roots lie in skateboarding and NYC and has never been shy of professing its love for both. In recent years, streetwear has been dominating fashion, thanks to Supreme being second-to-none in churning out season after season of sold out quality products. It would not be an understatement to say that Supreme is the originator of streetwear and started the hype that is so prevalent today. Whenever you start a conversation about streetwear, Supreme is the obvious attention grabber. ![]() ![]() ![]() For instance, your mobile, television, tablet, as well as laptop, all emit such forces which might disrupt your lifestyle to a greater extent than you can imagine. These days, every electronic gadget that you use emits harmful electromagnetic forces which are very dangerous for your mental health. Electromagnetic Forces would not be that harmful You are advised to wear it in your left hand to make the most out of its powerful influence. ![]() This incredible bracelet is powerful when it comes to eradicating the effect of any negative forces. Some of the pixiu benefits and major advantages are described below in detail. This is because it carries so many different forces of energies which when worn, attract other certain energies. You must note that the Pixiu Bracelet meaning is unique and is believed to bring good luck to the owner. You must be aware of the advantages that this ornament might bring in your life, so check them out below.īenefits and Advantages of owning a Pixiu Bracelet: It is a popular belief that wearing this accessory can bring luck in several ways to the person. This famous accessory comes in other materials, too, so you can easily browse through the various options available to you and decide which one suits your personality the best! Moreover, there are benefits of wearing Pixiu, too. For instance, it can be made in Jade, Liu Li as well as Gold. This accessory comes in various materials. You might be amazed to know that Pixiu is a popular animal of Feng Shui. How do you exactly use a Pixiu Bracelet and what are the pixiu benefits? So, read on to know more about them and make sure you decide by the end! © Shanghai Museum photograph provided by Houston Museum of Natural ScienceĮver fancied a Pixiu Bracelet? How about collecting some really fascinating information about these beautiful accessories? Here, we will guide you through the most relevant information about these bracelets and also help you decide whether you should get one or not! Chinese tomb guardian statues were used during the Han Dynasty (206 B.C.-220 A.D.) to protect the soul of the deceased and the objects included in one’s burial from evil. ![]() Painted Pottery Tomb Guardian (Han Dynasty, 206 B.C.-220 A.D.). The fad reached its peak during the Southern Dynasties (AD420-589) when people worshipped pixiu to seek protection against a deadly epidemic that claimed thousands of lives in southern China. Commoners also adorned their houses with images of pixiu. The practice of using pixiu as a charm and house protector can be traced to the Shang Dynasty (1600-1046 BC) and became a custom in the Western Han Dynasty (206 BC-AD24) when the founding emperor Liu Bang placed many pixiu statues in his palace as the royal guardian and forbade his subjects to use the sacred beast for feng shui purposes.ĭespite this imperial decree, the popularity of pixiu prevailed across the country. They soon copied pixiu in paintings, sculptures and jade amulets in the hope it would bring them wealth. When ancient Chinese people found out that this animal (Pixiu/Piyao) could suck in anything valuable and store it within the body, they regarded it as a fortune god. However, this monster is said to have been punished by the God of Heaven for misbehaving and misconduct and was condemned to eating nothing but treasures and suffering from a blocked anus. It is said that pixiu helped the Huangdi (Yellow Emperor), a tribal leader who was later revered as the ancestor of the Chinese nation, defeat many enemy tribes in the middle and lower reaches of the Yellow River – the cradle of ancient Chinese civilization. Pixiu, also known as bixie, patrolled the universe and protected mankind from evil and pandemics from happening. PIXIU, also know as Piyao is a mythical animal with the head of a mighty dragon, the neck of a horse, the body of a lion and with wings on each side.Īccording to Chinese history, this interesting monster (Pixiu/Piyao) was the ninth son of a dragon and was born with far greater power than his father. ![]() Whereas some Mansard roofs have flat tops, gambrels are pitched and meet along a central seam. On gambrels, the bottom portion of the roof has more of a pitch. ![]() Like Mansard roofs, gambrels have two slopes on each side. These roofs resemble many barns and have two sloped sides, with the other two sides meeting walls. Butterfly roofs maximize light and space, but can present drainage issues because the two sides meet in a valley instead of a peak. This creates a home with a dramatic, modern design. The butterfly roof has two vertical slopes that fold inward in an elongated V-shape. This style of roof easily sheds water and debris, and works well on smaller homes or adds-ons. Many builders use this style for additions and outbuildings. Shed roofs typically have one horizontal plane that’s slightly pitched. Flat roofs aren’t completely flat, but instead have a slight pitch to aid in water run-off. Flat Roofįlat roofs are commonly used to top commercial and industrial buildings, as well as some homes. Originally, the style was used to create grand chateaus and townhouses. This maximizes the space inside the home, and can allow for a usable third floor. This bottom section of the roof is steeper, with the pitch really beginning in the second slope on each side. This French design features two slopes on each side. The result offers easier access to the lower portion of the roof, with the added benefits of natural light and extra space. They consist of four sloping sides topped by a gable at each end. Dutchĭutch roofs are more complicated to build than hip or gable styles. It’s still a popular choice due to its stronger properties, which suit areas with high winds. This style is harder to build than a gable roof and has no open ends to allow for ventilation. It’s also flexible and easy to build, making it suitable for most home layouts. This is a popular type of roof that sheds water well and aids ventilation at the two open ends. Gable RoofĪ gable refers to a triangular area formed where two pitched sections meet. According to, the color and type of roofing material impact how well your roof absorbs and repels heat and cold. Each category has unique properties that may appeal to you. Knowing the different types of roofs gives you more than bragging rights during walks around the neighborhood. Learn more about the different types of roofs below. ![]() ![]() To choose the right roofing material, you should weigh the appearance, longevity, cost and structural issues among your top picks. With the many roofing materials available to choose from, it takes a bit of research to decide whether to go with your existing roof’s construction or select from the many types of roofs available. This guide to roof architecture and styles helps you identify the various types of roofs, so you can figure out the shape of your own house. However, if your roof starts leaking, it quickly takes on emergency status. Putting a new roof on your house may seem like the last priority when it comes to home improvement goals. Get A Free Estimate Frequently Asked Questions Financing and Warranties
![]() ![]() You start the Alfred workflow with ‘vpn’ followed by the letter of the VPN connection. Go to Applications > Utilities > Keychain Access Search for Shimo in the top right. I’ve chosen ‘c’ to close all connections, but of course simply closing Shimo would do the job as well. Alternative to Shimo 5 VPN Tracker supports many of the same V. I chose some letters here that are easy for me to remember for each of the VPN connections, but they can be chosen any way you want. Shimo is the prayerbook of the Syrian Orthodox Church for weekdays. ![]() And then ‘set acc to workVPN’ later on in the if statement block. set workVPN to “My VPN connection at work”. You can choose to either import a profile. To setup a new connection, just click on Profiles and then the '+' symbol to add a new connection. Once installed, it may ask you for your system password so that you can update Shimo's drivers to support as many VPN protocols as possible. The red bars are variable names that represent the strings, e.g. Shimo however, gives you much more control. In the image of the applescript in Alfred, the green bars are the names of the connections in Shimo. So I wrote an Applescript and added that to an Alfred Workflow. Today I decided to up the game and check if Shimo can be automated. Shimo is an awesome app that allows you to configure various VPN connections including passwords (stored in Keychain). Get ClearVPN, your shortcut to everything on the web.In my job I frequently need to switch VPN connections and it’s very cumbersome to use the Cisco client because it refuses to allow pasting a password in the password field or even keep a list of the most recent used configurations. If there was a word to describe the state of our digital lives in 2022, it would be “privacy.” We’re truly more concerned about exposing our personal information today than ever before. ![]() Even our ISPs (internet service providers) are selling information to marketers.Īll because services we rely on every day, such as Google and Facebook, are always hungry for more of our behavioral data to feed into their advertising engines. Protect your private information online from snooping advertisers So what exactly are the benefits of using a VPN client for Mac? There are quite a few: So a lot of people said “enough” and turned to VPNs.Ī good VPN (virtual private network) is essentially a cluster of servers spread out worldwide and it solves the problem of unsecured connection by encrypting the signal between your Mac and one of its servers of your choosing before it hits your ISP or any other people. in a cafe)Īdd an extra layer of online security (in case someone would ever want to get access to your Mac) Prevent hackers from seeing your data while you’re using unsecured public networks (e.g. US-based Netflix) by directing your traffic to a server in that country See geographically restricted content (e.g. You might also wonder whether there’s a built-in VPN already on your Mac. And if you’re new to VPNs, the answer is not really. While you could manually start a VPN connection, you’d need your own server to funnel it through - some large organizations actually use that feature for their corporate networks, but it’s out of limits for most people.īut if you want to get all the benefits that VPNs provide, let’s then go over all the factors that are important in choosing the best VPN service for your Mac. Since privacy has become a popular issue, it’s no wonder that the proliferation of Mac VPN clients happened at the same time. There are, however, some aspects by which you can pick the best VPN app for you. Simply put, the more servers your setup VPN on Mac has the better. You get more choice of countries to pick and browse from, although a curated selection is sometimes better than the sheer number, since you’ll probably not use most of them, but some of them you’ll use a lot. Cheap VPNs often provide the same service for less money. ![]() So why not? However, beware of the best free VPN for Mac marketing calls - running VPN servers costs money, so if they are not taking it from you, they are more likely to actually be selling your data too. The closer the VPN server is to your location the faster your signal can reach it - resulting in faster internet speeds. So reaching a US-based server from Canada would take much less time than from, say, India. Some VPN clients are enterprise-grade and complex, some are simple and user-friendly. Pick the one that’s right for your goals.ĭevice support. It’s important to check that your VPN on Mac also works for iOS, Windows, Linux, Android, and anything else you or people you share the VPN with are using. ![]() ![]() Kami are believed to dwell in every aspect of our daily lives. Ōmonoushi-no-Kami at Ōmiwa Shrine is a famous example. There are also Kami who have been worshipped locally since ancient times, although they do not appear in mythology. The most common tools worshipped as Kami are swords, but there are also unique Shinto shrines where figures of cartoon characters and containers of lactobacillus drink are worshipped. In fact, it is known that in prehistoric shell middens, tools that were no longer usable were serviced in the same way as humans and animals. In Shintoism, it is believed that the soul resides in everything, so tools are sometimes regarded as Kami. Livestock and seafood also receive offerings as Kami. ![]() ![]() Originally, they are the messengers of the Kami, but as they have great spiritual power, many people believe that they themselves are Kami. The spirits of ancestors are also worshipped as Kami in each family.įictitious animals such as dragons and Tengu, as well as real animals such as rabbits, snakes, foxes, raccoons, and dogs, etc., are sometimes worshipped as Kami. There are many Shinto shrines throughout Japan dedicated to the successive Emperors, Imperial families, nobles, Samurai, soldiers, scholars, and other great figures of each age. Sahohime presides over spring, Natsutakahigami presides over summer, Tatsutahime and Akibime preside over autumn, and Ame-no-Fuyukinu-no-Kami presides over winter. Japan is a country with four beautiful seasons, and the changing of the seasons is also thought to be the works by Kami. Shintoism is the belief in animism by the ancients, so these are also regarded as Kami. Natural objects and natural phenomena such as mountains, rivers, oceans, soil, waterfalls, rocks, wind, and plants, etc. They probably best fit the stereotype of Kami. Kami appear in Japanese mythology, such as Kojiki and Nihonshoki, like Amaterasu-Ōmikami at the Grand Shrines in Ise. They can be roughly classified as follows: In fact, since ancient times, there have been many kinds of Kami, as there are said to be eight million Kami in Japan (In this case, eight does not mean real number, but a large number). Not to mention human beings, birds, animals, plants, oceans, mountains, and whatever else is uncommonly great and rare are called Kami.” ![]() “Kami are the deities in heaven and earth in mythology, or spirits enshrined in Shinto shrines. The early modern Japanese Kokugaku (interdisciplinary studies on Japanese history and traditions) scholar, Norinaga Motori, defined Kami in the following way: Furthermore, some Kami are not only like people as deities of Greece Mythology or Roman Mythology, etc, but also other types of Kami as those which exercise the power of growth, of natural objects, and of real persons. It is fundamentally different from Christian God, Jewish YHVH, and Islamic Allah. There are so many Kami, and they are not omnipotent. However, these translations can lead to misunderstandings. Kami is often translated as “God”, “Gods”, or “Deities” in English. The objects of worship in Shintoism are “Kami (神)”. One of the reasons why Shintoism is so different from other religions is the wide range of objects of worship. ![]() ![]() Use it to make sure your blog images follow a constant image ratio. It provides a great resizing feature that allows you to lock in the aspect ratio or choose from preconfigured sizes. In Windows 11, the app may be installed for free from the Microsoft Store. Paint 3D is essentially an improved version of Paint with support for creating 3D objects and pictures. If you’re running on Windows 10, you’ll find that Paint 3D comes installed as part of provisioned programs. How to resize an image on Windows with Paint 3D Recommends appropriate sizes for different uses No support for next-gen formats such as WEBPįree and no need for third-party downloads Like MS Paint, the Photos app doesn’t allow you to resample the pixels of your photos. Step 5: You can edit the File name and Save as Type to export the image to different image formats. Step 4: Choose the location to save your new resized file. You can choose the default options, or set custom dimensions. Step 3: Photos recommends some resizing options, for instance, Best for Thumbnails. Step 2: Click on the more icon (three dots) and select Resize. Or, right-click on the image, and choose Open With Photos. ![]() If Photos is the default photo viewing app, just double-click to open the image. But it’s similarly possible to resize other images with these steps: When trying to open very large images, Photos may automatically resize them. The app has been made available since 2012 with the release of Windows 8. MS Photos is a raster graphics editor that comes with many other functions, including image viewing, organizing, and sharing. How to resize an image on Windows using the Photos app? Supports other functions, drawing shapes, flipping, etc. May not support as many formats as other image convertors The fact that Microsoft Paint doesn’t offer resampling means that if you decrease the size of a large image from 1000px to 500px, its file size won’t be reduced. In case you’re wondering, we explained what resampling is when we described how to resize images on Mac. One of the main drawbacks of this method is that it doesn’t offer any resampling. You’ll have the new file with different dimensions and file size. Go to File > Save As > Choose the file format (PNG, JPEG, BMP, GIF, or other formats). Step 4: Save a copy of the image with the new dimensions. Step 3: In Image Properties, you can change the Width and the Height, for instance, from 2400 x 1600 to 1152 x 648. Go to File > Open > Choose the file path. In case you also own Apple devices, you may check our articles about how to resize images on your iPhone or how to reduce an image size on MacOS. ![]() Let’s examine techniques for resizing images on Windows. You can catch up on the differences between SVG and PNG. What if resizing was without consequences and quality issues? That’s a reality when dealing with a vector-file format such as SVG, where the image is not made of tiny color pixels but constructed from vectors and lines. However, there is an irreparable loss of information as the pixels are shrunk.ĭuring resizing, there are consequences! So a tip to remember is to always retain the original image before resizing, particularly when going smaller. The perceivable quality will remain the same if the image occupies a smaller area on the screen. Reducing the image dimensions means that you end up with a small photo. But if it’s a pixel-based (also called raster-type) image like PNG or JPG, you may end up with a pixelated image that doesn’t look all that great.īut with a neat feature like resampling - on Windows, the feature is available in Adobe Photoshop and Bulk Image Resize (from the MS Store) - you can still end up with a good-quality image. Looking to enlarge your blog post image size from 500px to 1000px? It’s quite easy to pull off in MS Paint or Photos. Here’s a question for you: What are you planning to accomplish today? ![]() ![]() You can resize an image in two ways: By making it larger or by making it smaller. ![]() ![]() ![]() Their basic demographic information such as age, gender, and education level were collected. This study was conducted in accordance with the Declaration of Helsinki and ethical approval was obtained from the Kowloon Central/Kowloon East Cluster Clinical Research Ethics Committee of the Hong Kong Hospital Authority.Īll subjects were assessed using HK-MoCA and Cantonese version of Mini-Mental State Examination (CMMSE) at the first visit. Lastly, patients diagnosed with an advanced stage of dementia, accordingly with Global Deterioration Scale (GDS) of six or above, were not recruited. Besides, persons with inability to use a pen or with communication barriers such as deafness or significant language or speech problem were also excluded. Patients were excluded if they had a history, as documented in medical records, of significant head trauma, subdural hematoma, neurodegenerative disorders, central nervous system infection, epilepsy, brain tumor, significant psychiatric disorders (such as major depression or schizophrenia), alcoholism, or substance abuse. They were divided into three groups: subjects with dementia, subjects who met the criteria for MCI, and cognitively normal controls (NC). They were seen for suspected cognitive impairment and all of them had given informed consent. It recruited a total of 315 community-dwelling and Cantonese-speaking Chinese adults aged 60 years or above. This was a cross-sectional study conducted in a public hospital-based cognition clinic from August 2012 to June 2017. Therefore, this study aimed at examining whether such findings also apply to a more heterogenous group of subjects with cognitive impairment due to various causes among Chinese older adults. However, the applicability of these findings to other patients with non-vascular causes is not known. These results advised against the use of single cutoff scores of HK-MoCA on patients with cognitive impairment due to vascular cause. 6 The study reported that using norm-derived cutoff as reference, a single cutoff at 21/22 yielded a classification discrepancy of 55.8%, with the majority of the misclassifications being false positives and the highest rate among patients with the lowest education duration of zero to three years. However, another study raised the issue that the single cutoff score of HK-MoCA was associated with a substantially high misclassification rate especially in older and less-educated patients with stroke. 4, 5 A score of less than 22 is considered positive for screening and calls for further diagnostic assessment. In Hong Kong, a local version of MoCA, the Hong Kong version (HK-MoCA), was validated in Chinese older adults. 3 Demographically adjusted norms may help improve the diagnostic accuracy. Moreover, the one-point correction for education has been debated as insufficient to compensate for educational differences. 2 Some studies have revealed that the originally recommended cutoff score of 26 leads to a higher false positive misclassification especially on those with increasing age and/or low education. Systematic review highlighted the necessity for cross-cultural considerations when using the MoCA as a screening tool. 1 There is a one-point adjustment for individuals with formal education of 12 years or fewer. The Montreal Cognitive Assessment (MoCA) is a brief, useful and validated cognitive screening instrument with a cutoff score of 26 to differentiate mild cognitive impairment (MCI) or dementia from normal. A cognitive screening measure with high sensitivity and specificity is essential for them to decide who needs a more detailed evaluation or make a referral for comprehensive geriatric assessments, including neuropsychological evaluations. ![]() Individuals concerned about their memory loss are mostly seen by primary care physicians. ![]() Poor memory is one of the commonest presenting complaints and other features include disturbances of behaviour, language, mood, personality or perception. ![]() Dementia is a major neurodegenerative disorder and often begins with focal cognitive or behavioural disturbances. ![]() |
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