Tag: pubmed

Cochrane Database Syst Rev. 2022 Mar 7;3:CD012892. doi: 10.1002/14651858.CD012892.pub2.

ABSTRACT

BACKGROUND: The demand for residential aged care is increasing due to the ageing population. Optimising the design or adapting the physical environment of residential aged care facilities has the potential to influence quality of life, mood and function.

OBJECTIVES: To assess the effects of changes to the physical environment, which include alternative models of residential aged care such as a ‘home-like’ model of care (where residents live in small living units) on quality of life, behaviour, mood and depression and function in older people living in residential aged care.

SEARCH METHODS: CENTRAL, MEDLINE, Embase, six other databases and two trial registries were searched on 11 February 2021. Reference lists and grey literature sources were also searched.

SELECTION CRITERIA: Non-randomised trials, repeated measures or interrupted time series studies and controlled before-after studies with a comparison group were included. Interventions which had modified the physical design of a care home or built a care home with an alternative model of residential aged care (including design alterations) in order to enhance the environment to promote independence and well-being were included. Studies which examined quality of life or outcomes related to quality of life were included. Two reviewers independently assessed the abstracts identified in the search and the full texts of all retrieved studies.

DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data, assessed the risk of bias in each included study and evaluated the certainty of evidence according to GRADE criteria. Where possible, data were represented in forest plots and pooled.

MAIN RESULTS: Twenty studies were included with 77,265 participants, although one large study included the majority of participants (n = 74,449). The main comparison was home-like models of care incorporating changes to the scale of the building which limit the capacity of the living units to smaller numbers of residents and encourage the participation of residents with domestic activities and a person-centred care approach, compared to traditional designs which may include larger-scale buildings with a larger number of residents, hospital-like features such as nurses’ stations, traditional hierarchical organisational structures and design which prioritises safety. Six controlled before-after studies compared the home-like model and the traditional environment (75,074 participants), but one controlled before-after study included 74,449 of the participants (estimated on weighting). It is uncertain whether home-like models improve health-related quality of life, behaviour, mood and depression, function or serious adverse effects compared to traditional designs because the certainty of the evidence is very low. The certainty of the evidence was downgraded from low-certainty to very low-certainty for all outcomes due to very serious concerns due to risk of bias, and also serious concerns due to imprecision for outcomes with more than 400 participants. One controlled before-after study examined the effect of home-like models on quality of life. The author stated “No statistically significant differences were observed between the intervention and control groups.” Three studies reported on global behaviour (N = 257). One study found little or no difference in global behaviour change at six months using the Neuropsychiatric Inventory where lower scores indicate fewer behavioural symptoms (mean difference (MD) -0.04 (95% confidence interval (CI) -0.13 to 0.04, n = 164)), and two additional studies (N = 93) examined global behaviour, but these were unsuitable for determining a summary effect estimate. Two controlled before-after studies examined the effect of home-like models of care compared to traditional design on depression. After 18 months, one study (n = 242) reported an increase in the rate of depressive symptoms (rate ratio 1.15 (95% CI 1.02 to 1.29)), but the effect of home-like models of care on the probability of no depressive symptoms was uncertain (odds ratio 0.36 (95% CI 0.12 to 1.07)). One study (n = 164) reported little or no difference in depressive symptoms at six months using the Revised Memory and Behaviour Problems Checklist where lower scores indicate fewer depressive symptoms (MD 0.01 (95% CI -0.12 to 0.14)). Four controlled before-after studies examined function. One study (n = 242) reported little or no difference in function over 18 months using the Activities of Daily Living long-form scale where lower scores indicate better function (MD -0.09 (95% CI -0.46 to 0.28)), and one study (n = 164) reported better function scores at six months using the Interview for the Deterioration of Daily Living activities in Dementia where lower scores indicate better function (MD -4.37 (95% CI -7.06 to -1.69)). Two additional studies measured function but could not be included in the quantitative analysis. One study examined serious adverse effects (physical restraints), and reported a slight reduction in the important outcome of physical restraint use in a home-like model of care compared to a traditional design (MD between the home-like model of care and traditional design -0.3% (95% CI -0.5% to -0.1%), estimate weighted n = 74,449 participants at enrolment). The remaining studies examined smaller design interventions including refurbishment without changes to the scale of the building, special care units for people with dementia, group living corridors compared to a non-corridor design, lighting interventions, dining area redesign and a garden vignette.

AUTHORS’ CONCLUSIONS: There is currently insufficient evidence on which to draw conclusions about the impact of physical environment design changes for older people living in residential aged care. Outcomes directly associated with the design of the built environment in a supported setting are difficult to isolate from other influences such as health changes of the residents, changes to care practices over time or different staff providing care across shifts. Cluster-randomised trials may be feasible for studies of refurbishment or specific design components within residential aged care. Studies which use a non-randomised design or cluster-randomised trials should consider approaches to reduce risk of bias to improve the certainty of evidence.

PMID:35253911 | DOI:10.1002/14651858.CD012892.pub2

Radiat Prot Dosimetry. 2022 Mar 7:ncac013. doi: 10.1093/rpd/ncac013. Online ahead of print.

ABSTRACT

Irradiated dose to the organs at risk surrounding the paranasal sinuses was compared in cone beam computed tomography (CBCT) and multi spiral computed tomography with respect to the organs’ relative positions to the imaging field. A head and neck Alderson-Rando phantom equipped with thermoluminescence dosemeters pellets was irradiated according to three routine CBCT protocols and one protocol in multi spiral computed tomography. Dose value of organs outside the imaging field as well as those measured dose of organs inside the field were assessed. The highest measured doses were obtained from CT scan for most of the organs investigated in this study, whereas the lowest one was associated with the low-resolution mode of CBCT. Also, statistical analysis showed no significant differences between the dose values of out-of-field organs in all CBCT modes, whereas significant differences were observed between the radiation doses of CT and CBCT modes for all organs at risk inside and outside of the imaging field. CBCT is recommended on the basis of having a lower dose; however, the image qualities were the same in the two employed modalities, so the approach of lower dose can be made.

PMID:35253875 | DOI:10.1093/rpd/ncac013

J Forensic Sci. 2022 Mar 7. doi: 10.1111/1556-4029.15012. Online ahead of print.

ABSTRACT

Silicone casts are widely used by practitioners in the comparative analysis of forensic items. Fractured surfaces carry unique details that can provide accurate quantitative comparisons of forensic fragments. In this study, a statistical analysis comparison protocol was applied to a set of 3D topological images of fractured surface pairs and their replicas to provide confidence in the quantitative statistical comparison between fractured items and their silicone cast replicas. A set of 10 fractured stainless steel samples were fractured from the same metal rod under controlled conditions and were replicated using a standard forensic casting technique. Six 3D topological maps with 50% overlap were acquired for each fractured pair. Spectral analyses were utilized to identify the correlation between topological surface features at different length scales of the surface topology. We selected two frequency bands over the critical wavelength (greater than two-grain diameters) for statistical comparison. Our statistical model utilized a matrix-variate t-distribution that accounts for overlap between images to model match and non-match population densities. A decision rule identified the probability of matched and unmatched pairs of surfaces. The proposed methodology correctly classified the fractured steel surfaces and their replicas with a posterior probability of match exceeding 99.96%. Moreover, the replication technique shows potential in accurately replicating fracture surface topological details with a wavelength greater than 20 μm, which far exceeds the feature comparison range on most metallic alloy surfaces. Our framework establishes the basis and limits for forensic comparison of fractured articles and their replicas while providing a reliable fracture mechanics-based quantitative statistical forensic comparison.

PMID:35253897 | DOI:10.1111/1556-4029.15012

Eur J Public Health. 2022 Mar 7:ckac018. doi: 10.1093/eurpub/ckac018. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to assess the association between multimorbidity and exit from paid employment, and which combinations of chronic health conditions (CHCs) have the strongest association with exit from paid employment.

METHODS: Data from 111 208 workers aged 18-64 years from Lifelines were enriched with monthly employment data from Statistics Netherlands. Exit from paid employment during follow-up was defined as a change from paid employment to unemployment, disability benefits, economic inactivity or early retirement. CHCs included cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), rheumatoid arthritis (RA), type 2 diabetes (T2DM) and depression. Cox-proportional hazards models were used to examine the impact of multimorbidity and combinations of CHCs on exit from paid employment.

RESULTS: Multimorbidity increased the risk of exiting paid employment compared with workers without CHCs (hazard ratio (HR): 1.52; 95% confidence interval (CI): 1.35-1.71) or one CHC (HR: 1.14; 95% CI: 1.01-1.28). The risk for exit from paid employment increased among workers with COPD if they additionally had CVD (HR: 1.39; 95% CI: 1.03-1.88), depression (HR: 1.46; 95% CI: 1.10-1.93) or RA (HR: 1.44; 95% CI: 1.08-1.91), for workers with T2DM if they additionally had CVD (HR: 1.43; 95% CI: 1.07-1.91) or depression (HR: 2.09; 95% CI: 1.51-2.91) and for workers with depression who also had T2DM (HR: 1.68; 95% CI: 1.21-2.32).

CONCLUSION: This study showed that workers with multimorbidity, especially having a combination of COPD and depression or T2DM and depression, have a higher risk for early exit from paid employment and, therefore, may need tailored support at the workplace.

PMID:35253841 | DOI:10.1093/eurpub/ckac018

G3 (Bethesda). 2022 Mar 7:jkac054. doi: 10.1093/g3journal/jkac054. Online ahead of print.

ABSTRACT

Alu elements are one of the most successful groups of RNA retrotransposons and make up 11% of the human genome with over one million individual loci. They are linked to genetic defects, increases in sequence diversity, and influence transcriptional activity. Still, their RNA metabolism is poorly understood yet. It is even unclear whether Alu elements are mostly transcribed by RNA Polymerase II or III. We have conducted a transcription shutoff experiment by α-amanitin and metabolic RNA labeling by 4-thiouridine combined with RNA fragmentation (TT-seq) and RNA-seq to shed further light on the origin and life cycle of Alu transcripts. We find that Alu RNAs are more stable than previously thought and seem to originate in part from RNA Polymerase II activity, as previous reports suggest. Their expression however seems to be independent of the transcriptional activity of adjacent genes. Furthermore, we have developed a novel statistical test for detecting expression quantitative trait loci in Alu elements that relies on the de Bruijn graph representation of all Alu sequences. It controls for both statistical significance and biological relevance using a tuned k-mer representation, discovering influential sequence features missed by regular motif search. In addition, we discover several point mutations using a generalized linear model, and motifs of interest, which also match transcription factor binding motifs.

PMID:35253846 | DOI:10.1093/g3journal/jkac054

Bioinformatics. 2022 Mar 7:btac131. doi: 10.1093/bioinformatics/btac131. Online ahead of print.

ABSTRACT

MOTIVATION: The rapid development of scRNA-seq technologies enables us to explore the transcriptome at the cell level on a large scale. Recently, various computational methods have been developed to analyze the scRNAseq data, such as clustering and visualization. However, current visualization methods, including t-SNE and UMAP, are challenged by the limited accuracy of rendering the geometric relationship of populations with distinct functional states. Most visualization methods are unsupervised, leaving out information from the clustering results or given labels. This leads to the inaccurate depiction of the distances between the bona fide functional states. In particular, UMAP and t-SNE are not optimal to preserve the global geometric structure. They may result in a contradiction that clusters with near distance in the embedded dimensions are in fact further away in the original dimensions. Besides, UMAP and t-SNE cannot track the variance of clusters. Through the embedding of t-SNE and UMAP, the variance of a cluster is not only associated with the true variance but also is proportional to the sample size.

RESULTS: We present supCPM, a robust supervised visualization method, which separates different clusters, preserves the global structure and tracks the cluster variance. Compared with six visualization methods using synthetic and real datasets, supCPM shows improved performance than other methods in preserving the global geometric structure and data variance. Overall, supCPM provides an enhanced visualization pipeline to assist the interpretation of functional transition and accurately depict population segregation.

AVAILABILITY: The R package and source code are available at https://zenodo.org/record/5975977#.YgqR1PXMJjM.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:35253834 | DOI:10.1093/bioinformatics/btac131

J Alzheimers Dis. 2022 Feb 28. doi: 10.3233/JAD-215596. Online ahead of print.

ABSTRACT

BACKGROUND: Mounting evidence shows that the neuropathological burdens manifest preference in affecting brain regions during the dynamic progression of Alzheimer’s disease (AD). Since the distinct brain regions are physically wired by white matter fibers, it is reasonable to hypothesize the differential spreading pattern of neuropathological burdens may underlie the wiring topology, which can be characterized using neuroimaging and network science technologies.

OBJECTIVE: To study the dynamic spreading patterns of neuropathological events in AD.

METHODS: We first examine whether hub nodes with high connectivity in the brain network (assemble of white matter wirings) are susceptible to a higher level of pathological burdens than other regions that are less involved in the process of information exchange in the network. Moreover, we propose a novel linear mixed-effect model to characterize the multi-factorial spreading process of neuropathological burdens from hub nodes to non-hub nodes, where age, sex, and APOE4 indicators are considered as confounders. We apply our statistical model to the longitudinal neuroimaging data of amyloid-PET and tau-PET, respectively.

RESULTS: Our meta-data analysis results show that 1) AD differentially affects hub nodes with a significantly higher level of pathology, and 2) the longitudinal increase of neuropathological burdens on non-hub nodes is strongly correlated with the connectome distance to hub nodes rather than the spatial proximity.

CONCLUSION: The spreading pathway of AD neuropathological burdens might start from hub regions and propagate through the white matter fibers in a prion-like manner.

PMID:35253761 | DOI:10.3233/JAD-215596

J Alzheimers Dis. 2022 Mar 2. doi: 10.3233/JAD-215667. Online ahead of print.

ABSTRACT

BACKGROUND: The differentiation of behavioral variant frontotemporal dementia (bvFTD) from early-onset Alzheimer’s disease (EOAD) by clinical criteria can be inaccurate. The volumetric quantification of clinically available magnetic resonance (MR) brain scans may facilitate early diagnosis of these neurodegenerative dementias.

OBJECTIVE: To determine if volumetric quantification of brain MR imaging can identify persons with bvFTD from EOAD.

METHODS: 3D T1 MR brain scans of 20 persons with bvFTD and 45 with EOAD were compared using Neuroreader to measure subcortical, and lobar volumes, and Volbrain for hippocampal subfields. Analyses included: 1) discriminant analysis with leave one out cross-validation; 2) input of predicted probabilities from this process into a receiver operator characteristics (ROC) analysis; and 3) Automated linear regression to identify predictive regions.

RESULTS: Both groups were comparable in age and sex with no statistically significant differences in symptom duration. bvFTD had lower volume percentiles in frontal lobes, thalamus, and putamen. EOAD had lower parietal lobe volumes. ROC analyses showed 99.3% accuracy with Neuroreader percentiles and 80.2% with subfields. The parietal lobe was the most predictive percentile. Although there were differences in hippocampal (particularly left CA2-CA3) subfields, it did not add to the discriminant analysis.

CONCLUSION: Percentiles from an MR based volumetric quantification can help differentiate between bvFTD from EOAD in routine clinical care. Use of hippocampal subfield volumes does not enhance the diagnostic separation of these two early-onset dementias.

PMID:35253765 | DOI:10.3233/JAD-215667

Clin Hemorheol Microcirc. 2022 Mar 3. doi: 10.3233/CH-211324. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to investigate the application value of three-dimensional arterial spin labeling (ASL) perfusion imaging in detecting cerebral hemodynamics of neonates with hypoxic-ischemic encephalopathy (HIE).

METHODS: Sixty normal full-term neonates and 60 HIE neonates were enrolled in this study and were respectively divided into three groups: the 1-3 days group, the 4-7 days group, and the 8-15 days group. The brains of these neonates were scanned with the 3D ASL sequence, and cerebral blood flow (CBF) images were obtained. The CBF values of the bilateral symmetrical brain regions and brain stem were measured on CBF images, and the values were averaged. The cerebral blood flow of HIE neonates in the 1-3 days group, the 4-7 days group, and the 8-15 days group was compared with normal neonates at matched ages, and the characteristics of cerebral hemodynamics in HIE neonates at different ages were summarized.

RESULTS: The CBF values of the basal ganglia, thalamus, and brainstem in the 1-3 days HIE group were higher than normal neonates at matched ages, and the CBF value of the frontal lobe was lower than the normal group, and the differences were statistically significant (P < 0.05). The CBF values of the basal ganglia, thalamus, corona radiata, and frontal lobe in the 4-7 days HIE group were lower than the normal group, and the differences were statistically significant (P < 0.05). There were no significant differences in CBF values of different brain regions between the 8-15 days HIE and normal groups (P > 0.05).

CONCLUSION: Early hyperperfusion of the basal ganglia and thalamus is helpful for early diagnosis and prognosis of HIE.

PMID:35253735 | DOI:10.3233/CH-211324

J Alzheimers Dis. 2022 Feb 28. doi: 10.3233/JAD-215568. Online ahead of print.

ABSTRACT

BACKGROUND: Mild cognitive impairment (MCI), which is generally regarded as the prodromal stage of Alzheimer’s disease (AD), is associated with morphological changes in brain structures, particularly the hippocampus. However, the indicators for characterizing the deformation of hippocampus in conventional methods are not precise enough and ignore the evolution information with the course of disease.

OBJECTIVE: The purpose of this study was to investigate the temporal evolution pattern of MCI and predict the conversion of MCI to AD by using the multivariate morphometry statistics (MMS) as fine features.

METHODS: First, we extracted MMS features from MRI scans of 64 MCI converters (MCIc), 81 MCI patients who remained stable (MCIs), and 90 healthy controls (HC). To make full use of the time information, the dynamic MMS (DMMS) features were defined. Then, the areas with significant differences between pairs of the three groups were analyzed using statistical methods and the atrophy/expansion were identified by comparing the metrics. In parallel, patch selection, sparse coding, dictionary learning and maximum pooling were used for the dimensionality reduction and the ensemble classifier GentleBoost was used to classify MCIc and MCIs.

RESULTS: The longitudinal analysis revealed that the atrophy of both MCIc and MCIs mainly distributed in dorsal CA1, then spread to subiculum and other regions gradually, while the atrophy area of MCIc was larger and more significant. And the introduction of longitudinal information promoted the accuracy to 91.76% for conversion prediction.

CONCLUSION: The dynamic information of hippocampus holds a huge potential for understanding the pathology of MCI.

PMID:35253759 | DOI:10.3233/JAD-215568