Change Index Research Articles

Neuropsychological Outcomes After Stereo-EEG Radiofrequency Thermocoagulation.

Stereo-EEG-guided radiofrequency thermocoagulation (RFTHC) has been proposed as relatively safe from a cognitive perspective; however, there is a lack of evidence based on neuropsychological assessments supporting this. This study is the first prospective evaluation of neuropsychological outcomes associated with stereo-EEG-guided RFTHC in patients with focal drug-resistant epilepsy. This cohort study involved prospective recruitment of consecutive patients undergoing stereo-EEG from 2 Australian centers. A comprehensive neuropsychological assessment was administered before implantation and 3 months after RFTHC (M = 104.51 days, SD = 29.25). Outcomes across cognitive domains were assessed at a group level with repeated measures t tests. Factorial repeated measures analyses of variance compared memory and language outcomes according to whether dominant mesial temporal lobe (mTL) structures were coagulated. Reliable change indices (RCIs) were computed to explore psychometrically reliable changes at an individual level. The sample comprised 39 patients who underwent stereo-EEG (M = 37.08 ± 9.67 years, range = 17-56 years, 54% female). Nineteen (49%) had a language dominant epileptogenic zone (EZ), 16 (41%) a nondominant EZ, and 4 (10%) a bilateral EZ. All patients underwent RFTHC with a mean of 11.87 (SD = 6.82, range = 2-29) coagulation sites. Ten patients (26%) had RFTHC within the dominant mTL. At a group level, RFTHC was not associated with a significant decline on any neuropsychological measures (all comparisons p > 0.05). Subgroup analyses revealed a decline in delayed verbal recall after RFTHC of dominant mTL structures (F(1,37) = 4.46, p = 0.04, ηp2 = 0.11, 95% CI [0-0.30]; medium to large effect), although it did not remain statistically significant after correction for false discovery rate. No statistically significant group differences were observed on visual memory or language measures post-RFTHC (all comparisons p > 0.05). RCI revealed that after RFTHC within the dominant mTL, 20% of patients experienced a decline in verbal memory and 10% in visual memory. By contrast, 7% declined in verbal memory and 10% in visual memory post-RFTHC outside the dominant mTL. While these findings support the current view that RFTHC is cognitively benign for most cases, the results raise the question of a verbal memory decline after coagulation of the dominant mTL. Individualized neuropsychological counseling before stereo-EEG is essential to avoid unanticipated deficits.

Electrically controlled flexible and varifocal microlens array using liquid crystals on polymer

Abstract The microlens array (MLA) on the flexible substrates has a wide range of applications in advancing curved integral imaging and three-dimensional (3D) display systems with a large field of view. We developed an electrically controlled varifocal microlens array on flexible Polyethylene Terephthalate (PET) substrates by infiltrating the liquid crystals (LC) in polymeric concave lenses. The focusing and imaging characteristics of the flexible LC-MLA are studied experimentally. When voltage is applied across the LC layer, the refractive index of the LC changes, which causes a change in the effective focal length of MLA. The electrically tunable focal length and tunable focusing of the MLA are experimentally demonstrated. The mathematical analysis of the LC MLA is performed using the MATLAB platform. The presented flexible LC-MLA is developed using simple and cost-effective fabrication methods, which can potentially be used in future 3D displays and imaging solutions.

Neuroanatomical heterogeneity drives divergent cognitive and motor trajectories in Parkinson's disease subtypes

IntroductionCognitive symptoms of Parkinson's disease (PD) may initially present subtly, often overshadowed by more noticeable motor symptoms. However, as PD progresses, predicting which individuals will experience significant cognitive decline becomes challenging due to variability, suggesting distinct PD subtypes with varying cognitive trajectories. This study aimed to identify early PD subtypes based on patterns of gray matter atrophy in brain regions associated with cognition and assess their distinct patterns of cognitive change over time. Recognizing PD primarily as a movement disorder, we also evaluated their motor symptoms. MethodsWe analyzed T1-weighted MRI data, cognitive, and motor scores from 114 de novo PD patients and 120 healthy controls. Multivariate gray matter volumetric distances (MGMV) across frontal, subcortical, parietal, temporal, and occipital regions were computed, and K-means clustering was used to identify PD subtypes. Subsequently, cognitive assessments were compared between subtypes at baseline and 48 months using linear mixed-effects models and reliable change indices. Motor-symptom changes were assessed using linear mixed-effects models. ResultsTwo PD subtypes were identified from baseline MRI. Subtype 1 showed significantly higher MGMV in frontal (p < 0.001) and subcortical (p < 0.001) regions, indicating atrophy. At 48 months, subtype 1 had poorer global cognitive performance than subtype 2 (p = 0.005) and faster progression of postural instability and gait disturbance (p = 0.04). ConclusionsPD subtypes identified early by distinct frontal and subcortical atrophy patterns exhibited divergent trajectories of cognitive decline and worsening motor symptoms over time, underscoring the neuroanatomical heterogeneity that drives clinical variability in PD.

Identification of climate change hotspots in the Mediterranean

The Mediterranean region has long been identified as a climate change hotspot. However, within the Mediterranean, there are smaller sub-areas that exhibit a higher risk of climate change and extremes. Previous research has often focused on indices based on mean climate values, yet extremes are typically more impactful on humans and ecosystems. This study aims to identify the most vulnerable sub-areas of the Mediterranean as climate change hotspots using two indices: the newly introduced Mediterranean Hotspot Index (MED-HOT) and the well-defined Regional Climate Change Index (RCCI). The MED-HOT focuses on extreme high maximum and minimum temperatures, rainfall, and drought, while RCCI assesses changes in mean climate conditions. By combining these indices, we provide an identification of Mediterranean hotspots, capturing both mean climate shifts and extremes. The spatiotemporal variation of both indices across the Mediterranean region is presented and the 20 subregions are categorized into distinct groups. The results reveal that the southeastern Mediterranean is at high risk according to both indices. Additionally, southern Italy is identified as high risk due to changes in mean climate (RCCI), while the northern part is at risk due to extreme events (MED-HOT). The Iberian Peninsula and Greece are also highlighted as vulnerable areas requiring extra attention.

Erodibility Prioritization and Mapping of a Mid Himalayan Watershed Using Technique of Order Preference by Similarity to Ideal Solution (TOPSIS)

The productivity of soils is drastically affected owing to soil erosion in human activities in the decline of the Western Nayar watershed situated in the Pauri district of Uttarakhand. Therefore, evaluation of these erodible areas is of utmost importance so that the preventive measures can be taken accordingly. It assessed the sub-basins in the basin using morphometric parameters and several multi- criteria decision-making models, such as Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), Utilizing Advanced Space Thermal Emission Radiometer (ASTER) data and a 30 m Digital Elevation Model (DEM), morphometric parameters were extracted and analyzed. To test the MCDM methods, percent and intensity of change indices were adopted. The ranking results were such that sub-watershed 2 was ranked at top as the most susceptible to erosion for TOPSIS model,In general, the morphometric parameters were effective for identifying erosion-prone areas.

The Relationship Between Neutrophil-to-Lymphocyte Ratio and Clinical Outcomes in Pediatric Patients After Cardiopulmonary Bypass Surgery: A Retrospective Study

Objectives: This study aimed to evaluate the prognostic utility of the neutrophil-to-lymphocyte ratio (NLR) and the perioperative change in NLR [Neutrophil Change Index (NCI)] in pediatric patients undergoing surgery with cardiopulmonary bypass (CPB) and to assess their correlations with clinical outcomes. Methods: A retrospective observational study was conducted with 416 patients from Children’s Medical Center in Tehran, Iran, spanning November 2021 to November 2022. Perioperative neutrophil and lymphocyte counts were collected, along with data on the presence or absence of complications. The prognostic value of NLR and NCI was evaluated concerning the length of ICU stay and mechanical ventilation among three groups: A no-complications survival group, a complications survival group, and a mortality group. Results: All patients showed an average rise in NLR postoperatively. The postoperative NLR magnitude did not significantly differ among the groups (P = 0.237) and was only correlated with mechanical ventilation duration (P = 0.0497), not with ICU stay length. However, the NCI was significantly lower in the mortality group compared to both the no-complication and surviving-complication groups (P &lt; 0.001 and P = 0.032). Neutrophil Change Index also showed a statistically significant correlation with ICU stay and mechanical ventilation duration (P = 0.004 and P = 0.002). ROC analysis indicated that NCI had some ability to discriminate mortality cases, with an AUC of 0.734. Conclusions: While NLR showed perioperative changes, its magnitude alone was not correlated with clinical outcomes. In contrast, the NCI demonstrated a significant relationship with outcomes, with surviving-complication patients having a higher perioperative NCI than those in the mortality group. A higher NCI was associated with shorter ICU stays, reduced mechanical ventilation time, and lower mortality risk in pediatric patients undergoing CPB surgery. Overall, NCI proved to be a more effective tool than NLR in predicting adverse outcomes in this patient population.

Changes in heart rate variability during an eHealth behavior change intervention program in patients with cardiovascular disease

BackgroundCardiovascular disease (CVD) risk is associated with health behaviors such as physical inactivity, dietary habits, and smoking. The autonomic nervous system plays a key role in this association. The present longitudinal study examines whether ECG-based indices of autonomic nervous system activity change during an eHealth-based behavior intervention program and assesses whether improvements in health behaviors are associated with increases in parasympathetic autonomic nervous system activity. MethodsData from the DoCHANGE-2 (https://clinicaltrials.gov/study/NCT03178305) eHealth-based behavior intervention study in patients with CVD were analyzed for participants with valid ECG recordings (N = 58, mean age = 58.9 [SD = 12.7] years, 21 % women). Heart rate variability (indexed as RMSSD) was calculated from home-recorded (40 s) ECGs over 5-day periods at baseline, 3, and 6 months. Health behaviors, clinical, and psychosocial information was obtained from questionnaires and medical records. Data were analyzed using linear mixed models and general linear models. ResultsOver the 6-month period, RMSSD decreased significantly, with the lowest values at six months (B = -19.336 [95 %CI −36.291; 2.381], p = 0.026). Health behaviors improved significantly during the active (0–3 months) intervention period (B = 13.360 [95 %CI 6.931 19.789], p < 0.001). Higher BMI (B = −0.369 [−0.739; 0.000]; p = 0.05) and older age (B = −0.404 [95 % CI −0.597; − 0.211]; p < 0.001) were associated with lower RMSSD across the three timepoints. No consistent associations were found between changes in health behaviors and changes in RMSSD. ConclusionThis study shows that changes in HRV during an eHealth-based behavioral intervention were not associated with the observed improvements in health behaviors. These findings require replication in larger well-controlled investigations.

Dust- versus cloud-radiation impacts on the diurnal temperature range for long-lasting dust weather over the Taklimakan Desert

The diurnal temperature range (DTR), determined by the difference between daily maximum and minimum air temperature, is an important index of global climate change. The dust direct radiative effect on DTR in cloudy conditions in the Taklimakan Desert (TD) area is still unclear. Based on springtime ground observation data from 2002 to 2013, the DTR variation in dust/cloudy days and the DTR-visibility relationship in dust days in TD were analyzed and summarized. The mean DTR was proportional to the mean visibility, with a slow DTR increase in the southwestern TD caused by cloud-induced radiation when visibility was 4–10 km; the DTR difference between cloudy and cloudless dust days was more significant (1.8–4.2 °C) when visibility was >6 km. The simulation of a long-lasting dust-cloud coexisting event (4 days) with the factor separation technique showed that both pure dust- and cloud-radiation impacts reduced DTR but their synergistic radiation impact mostly increased DTR in TD. Both simulated and observed results indicated that when the daily visibility of dust weather increased from 4-6 km to 6–10 km, the important pure dust impact on DTR weakened whereas the cloud impact became significant.

Seasonal macro‐demography of North American bird populations revealed through participatory science

Avian population sizes fluctuate and change over vast spatial scales, but the mechanistic underpinnings remain poorly understood. A key question is whether spatial and annual variation in avian population dynamics is driven primarily by variation in breeding season recruitment or by variation in overwinter survival. We present a method using large‐scale volunteer‐collected data from project eBird to develop species‐specific indices of net population change as proxies for survival and recruitment, based on twice‐annual, rangewide snapshots of relative abundance in spring and fall. We demonstrate the use of these indices by examining spatially explicit annual variation in survival and recruitment in two well‐surveyed nonmigratory North American species, Carolina wren Thryothorus ludovicianus and northern cardinal Cardinalis cardinalis. We show that, while interannual variation in both survival and recruitment is slight for northern cardinal, eBird abundance data reveal strong and geographically coherent signals of interannual variation in the overwinter survival of Carolina wren. As predicted, variation in wintertime survival dominates overall interannual population fluctuations of wrens and is correlated with winter temperature and snowfall in the northeastern United States, but not the southern United States. This study demonstrates the potential of participatory science (also known as citizen science) datasets like eBird for inferring variation in demographic rates and introduces a new complementary approach towards illuminating the macrodemography of North American birds at comprehensive continental extents.

Mindful With Your Baby/Toddler: A Single Case Design (SCD) Study.

Transitioning to motherhood comes with new and intensive tasks that may cause parental stress, low parental self-efficacy, and internalizing problems. This can in turn negatively affect the mother-child relationship. Mindful with your Baby/Toddler (MwyB/T) is a mindfulness-based intervention for parents of young children experiencing parental stress and internalizing problems. Previous evaluative studies showed promising results, but methodology of these studies was limited. The current study used a single case design, including a baseline, intervention, posttest, and follow-up phase, to evaluate the effectiveness of MwyB/T. Ten participants were included and completed daily administered personalized items and validated questionnaires measuring mindfulness, mindful parenting, parental self-efficacy, internalizing problems, and parental stress, for 10 participants. Personalized items were first coded into themes and then assessed using visual analysis and descriptive effect size measures. Reliable change indices were computed for the questionnaires. All mothers improved on personalized items, with most improving on most (or all) of their items. On the questionnaires the majority of mothers improved. Results indicate that MwyB/T could benefit mothers with various intervention goals. More research is needed on the role of personalized items, both as a research measure and an as a possible additional element of interventions.

Quantifying neurobehavioral profiles across neurodevelopmental genetic syndromes and idiopathic neurodevelopmental disorders.

To examine neurobehavioral findings in three genetic syndromes (PTEN hamartoma tumor syndrome, Malan syndrome [mutations in the NFIX gene], and SYNGAP1-related disorder), a mixed group of other neurodevelopmental genetic syndromes (NDGS), idiopathic neurodevelopmental disorder, and neurotypical control participants. Using a longitudinal case-control design, caregivers reported neurobehavioral information for 498 participants (PTEN hamartoma tumor syndrome n = 112, Malan syndrome n = 24, SYNGAP1-related disorder n = 47, other NDGS n = 72, idiopathic neurodevelopmental disorder n = 54, neurotypical siblings n = 74, and unrelated neurotypical control participants n = 115) at three timepoints (baseline, and 1-month and 4-month follow-ups) using the online-administered Neurobehavioral Evaluation Tool (NET). NET scales had good scale and test-retest reliability. Unique patterns of neurobehavioral findings emerged, with SYNGAP1-related disorder and Malan syndrome showing generally more severe symptom and skill patterns than for other groups of patients. Patterns could be partly accounted for by estimated cognitive level, speech level, and the presence of autism spectrum disorder. However, even when accounting for these factors, group differences remained. Reliable change indices are reported. Genetic syndromes associated with neurodevelopmental disorders present with unique neurobehavioral profiles that can inform selection of outcome measures in future clinical trials. The NET may be a useful screening and monitoring instrument in clinical practice, where frequent in-person clinic attendance is difficult for many patients.

Evaluation of the Pregnancy to Parenthood program: A dyadic intervention for mothers with perinatal mental disorders and their infants.

Dyadic interventions targeting maternal mental health and the mother-infant relationship in the perinatal period are critical due to the potential consequences of perinatal mental illness and relational disturbance for the mother, the infant, and their family. This paper describes the Pregnancy to Parenthood (P2P) model of care, a dyadic mother-infant community-based program designed to support vulnerable families in Western Australia in the context of an identified need to build workforce capacity. A pragmatic service evaluation study was conducted by analyzing routine clinical data collected from 105 dyads who completed pre- and post-intervention measures, including the Edinburgh Postnatal Depression Scale (EPDS), Perinatal Anxiety Screening Scale (PASS), and the Mother Object Relations Scale-Short Form (MORS-SF). Reliable change index and cut-off analyses indicated a clinically reliable pre-post reduction in perinatal depressive and anxiety symptoms for 71% and 68% of the sample, respectively. Significant pre-post improvements with medium effect sizes (r=-.46, r=-.32) were found for caregiving representations on the MORS-SF, suggesting representations became more balanced. These results provide provisional evidence that the P2P model of care may be effective in improving maternal mental health and caregiving representations. Further research is required to evaluate the efficacy of P2P in relation to enhancing family well-being, and to inform policy and mental health service development.

Delineating anticipatory arousal from reward consumption: evaluating fixed-intervals in cocaine seeking-taking response chains.

Anticipation is a critical antecedent to drug use, in which the prospect of imminent drug availability can potently motivate instrumental actions directed to procure it. Models that capture the behavioral dynamics that precede drug access may allow for the dissociation of key neural mechanisms underlying appetitive or consummatory processes in drug self-administration. We aimed to isolate measurements attributed to the procurement and consumption of a reward by defining distinct actions for each using a chain-schedule of reinforcement. Male Long-Evans rats were trained to self-administer cocaine or saccharin under a chained schedule of reinforcement (FI-FR) in order to dissociate appetitive ('seeking') from consummatory ('taking') behaviors. Completion of a fixed-interval (5min) was followed by 5min of continuously reinforced responding (FR1) on another lever. The FI-FR chain procedure appears to provide sensitive and dissociable dimensions of cocaine self-administration within a single experimental session. Importantly, we demonstrate that responding during the FI (i.e., seeking) link tracks with the incentive value of anticipated reward access - whereby response rates corresponded to expected reward magnitude, degree of reward-specific satiety, and general motivational state. The FI component is a sensitive and reliable index of motivational changes induced by either the extrinsic incentive value of reinforcement (i.e., anticipated dose) or intrinsic motive states (i.e., satiety or deprivation). This procedure provides a valuable tool for interrogating the neural dynamics of drug-seeking and -taking behavior, in isolation.

Spatiotemporal Changes and Utilization Intensity of the Zhoushan Archipelago Coastline over Four Decades

Coastal changes in China, notably in the Zhoushan Islands, have primarily been driven by coastal reclamation since the establishment of New China. This study conducted a comprehensive analysis of the Zhoushan Archipelago shoreline spanning four decades, employing remote sensing, aerial photographs, and shoreline data since 1984, along with GIS (Geographic Information System) technology. We assessed shoreline changes using the shoreline change index and shoreline artificialization index, as well as examined the influence of the Yangtze River’s suspended sediment and impoldering activities on Zhoushan’s shoreline. Furthermore, the correlation between local economic development and shoreline development was explored. The results revealed the following key findings: (1) From 1984 to 2018, the Zhoushan Archipelago shoreline decreased by 7.05 km. Temporally, the shoreline change index was −0.08%, with the most significant reduction occurring between 2008 and 2018. Spatially, differences among island groups were not pronounced. (2) The shoreline diversity index consistently increased, indicating greater diversity and complexity in shoreline use over the four decades. (3) The shoreline artificiality index steadily rose, particularly after 2000. It was highest in the south, followed by the center, and lowest in the north. (4) The intensity index of coastal land use continuously increased, with the southern island group having a higher index compared to the Zhoushan Islands. (5) The Yangtze River contributed significantly to sand inflow, influencing shoreline changes and beach shaping in Zhejiang. However, reclamation projects were identified as the primary and direct factor. (6) A positive correlation existed between Zhoushan City’s economic development and the intensity of coastal land use. This study emphasized the need for improving the control over reclamation projects and the better management of coastal protection and use. These measures could optimize resource allocation and establish a more scientific and rational coastal zone pattern.

Biological variation and analytical performance specification study of erythrocyte and related parameters

Objective: To study biological variation (BV) and analytical performance specifications (APS) of 15 erythrocyte and related parameters. Methods: Sixty healthy participants from Beijing Hospital were prospectively recruited for the study, from July to December, 2023, including 30 males [aged (41.3±11.9) years] and 30 females [aged (40.3±12.4) years]. The study was designed based on the Biological Variation Data Critical Appraisal Checklist and the characteristics of erythrocyte detection. Whole blood samples were collected 10 times at 2-week intervals during 20 weeks. All samples were tested in duplicate using Mindray BC-7500 hematology analyzer and its accompanying reagents. Within-subject biological variation (CVI) and between-subject biological variation (CVG) were estimated by the nested ANOVA method. The BV data in this study were compared with the BV data of the European Database of Biological Variation. APS, reference change value (RCV) and index of individuality (II) were calculated. Results: The CVI for 15 parameters ranged from 0.49% to 86.46%, and the CVI data for red cell distribution width (RDW)-CV, RDW-SD, reticulocyte (RET) percentage, RET count, reticulocyte hemoglobin content (RHE), medium fluorescence reticulocyte (MFR) and high fluorescence reticulocyte (HFR) were significantly higher in females than in males (all P<0.05). The CVG ranged from 1.27% to 100.79%, and the CVG data for HFR were significantly different between genders (P<0.05). The CVI data for red blood cell (RBC), hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and RHE in this study were lower than those recommended by the European database. The derived indicators of most parameters were influenced by gender. The II values for all parameters were<1.4, where the II values of MCHC and HFR were between 0.6 and 1.4; the II values for the remaining 13 parameters were<0.6. Conclusions: A BV study protocol for erythrocyte parameters is designed. When the reference intervals differ between genders, BV data should be calculated separately and the lower BV data are recommended for calculating APS; the RCV should be set separately for each gender.

Collaborative and side-by-side artmaking: reducing social isolation in refugee youth group art therapy

ABSTRACT Background Research on social isolation in refugee youth is important because it affects their sense of belonging, mental health and wellbeing; integration and acculturation into a new country; education; and future employment opportunities. There is limited art therapy research in Australia in this area, leaving a compelling gap in understanding the effectiveness of collaborative and side-by-side artmaking in group art therapy to connect refugee youth with their peers. Aims This study aimed to explore whether collaborative and side-by-side artmaking in group art therapy would connect youth more effectively; alleviate their social isolation from trauma, displacement and re-settlement experiences; provide a safe environment and platform to express themselves; and improve their mental health and wellbeing. Methods The triangular mixed-methods approach used standardised scales and semi-structured interviews to gather information from youth, teachers and art therapists. Mixed-method data analysis was applied using the Reliable Change Index, line graphs, descriptive statistics, and thematic analysis. Results Refugee youths’ self-esteem and confidence seemed to increase through collaborative and side-by-side artmaking. Results highlighted the importance of social connection, self-esteem, confidence and a sense of safety for making positive connections during artmaking. Conclusions Findings indicate potential benefits of pportunities for refugee youth to connect with their peers in the school environment and of group art therapy. Implications for practice and future research Opportunities could be achieved through collaborative and side-by-side artmaking in group art therapy. A larger study, longer programme and mixed populations in the school setting are recommended for future research. Plain-language summary The research aimed to examine if there was an effect of a six-week art therapy programme on social isolation for five 14–15-year-old female refugee youth. This research is important because social isolation affects youth’s mental health and wellbeing. Through creating art individually and next to each other (side-by-side artmaking), and creating artworks together (collaborative artmaking), the programme aimed to reduce social isolation and increase connections between youth during the sessions and in the school environment. The research was conducted in an early intervention creative therapies service onsite at a Queensland English-language transition secondary school. The service is provided by accredited art therapists and uses creative methods to support culturally diverse refugee youth in resettling, learning and recovering from trauma and stress. During the research, youth participants engaged in art activities, such as drawing and painting, while listening to music. Interventions were designed to establish group bonds, build self-esteem and resilience, and empower youth in a safe and supportive environment. Art therapists and teachers observed youth during the research period, completed standardised scales before and after the programme and participated in semi-structured interviews. The youth participants also completed standardised scales and were interviewed before and after the programme. The results showed that after the six-week programme, youths’ wellbeing and connections to each other increased. Three central themes were identified: (1) social connection is important within the school environment; (2) self-esteem and confidence are related to connecting to others and social isolation; and (3) there is a sense of safety in artmaking individually and collaboratively with peers. The study found that the art therapy programme positively affected youth mental health and wellbeing. This suggests the programme effectively reduced participants’ social isolation, potentially offering positive opportunities to connect other youth at risk of social isolation.

Reliable change indices for the Italian version of the Montreal Cognitive Assessment (MoCA) in non-demented Parkinson’s disease patients

Background. The present study aimed at deriving regression-based reliable change indices (RCIs) for the Montreal Cognitive Assessment (MoCA) in an Italian cohort of non-demented Parkinson’s disease (PD) patients.MethodsN = 33 consecutive, non-demented PD patients were followed-up at a 5-to-8-month interval (M = 6.6; SD = 0.6) with the MoCA. Practice effects and test-retest reliability were assessed via dependent-sample t-tests and intra-class correlation (ICC) coefficients, respectively. RCIs were derived separately for raw and demographically adjusted MoCA scores according to a standardized regression-based approach by accounting for both baseline confounders (i.e., demographics, disease duration and Unified Parkinson’s Disease Rating Scale scores) and retest interval.ResultsNo practice effects were found (t(32) = 0.29; p = .778), with acceptable test-retest reliability being detected (ICC = 0.67). MoCA scores at T0 proved to be the only significant predictor of T1 MoCA performances within both the model addressing raw scores and that addressing adjusted scores (ps < 0.001).ConclusionsThe present study provides Italian practitioners and researchers with regression-based RCIs for the MoCA in non-demented PD patients, which can be reliably adopted for retest interval ≥ 5 and ≤ 8 months without encountering any practice effect.

Italian Evaluation and Excellence in REMS (ITAL-EE-REMS): appropriate placement of forensic patients in REMS forensic facilities

BackgroundWe set out to assess the appropriateness of current placement of mentally disordered offenders allocated by the courts in Italy to REMS or to forensic community residences. We hypothesised that as in other countries, the match between a standardised assessment and the decision of the court would be imperfect.MethodsThe DUNDRUM Toolkit was translated into Italian. The translation had good psychometric properties. In order to compare the current level of therapeutic security with a calculated safest current placement, we compared the DUNDRUM-1 triage security assessment of need for therapeutic security prior to treatment, with evidence for progress made in treatment (DUNDRUM-3) and forensic recovery (DUNDRUM-4). The more conservative of these two would be taken as the safe current level of need for therapeutic security.ResultsThe Italian translation of the DUNDRUM Toolkit had good internal consistency and mean scores had a Reliable Change Index less than one unit. 3.7% of those in REMS (medium security) were assessed as needing high security and 38% were ready to move to a less secure place. In low secure places, 56% were assessed as needing a higher level of therapeutic security and 6% could have moved to open non-secure places.ConclusionsThe Italian translation of the DUNDRUM Toolkit allows an assessment of the current working of the model of care for forensic psychiatry following the reforms of 2015. Most patients are safely placed. A small but important proportion needed high secure places that are not currently available. (3.7% of 604 nationally, 95% Confidence Interval 1.2% to 8.4%, 7 to 50). A greater use of such measures would enable better health gains and safer outcomes.Trial registration ClinicalTrials.gov ID: NCT06018298 Unique Protocol ID: ITAL-EE-REMS.

Boston Naming Test as a Screening Tool for Early Postoperative Cognitive Dysfunction in Elderly Patients After Major Noncardiac Surgery.

The Boston naming test (BNT), as a simple, fast, and easily administered neuropsychological test, was demonstrated to be useful in detecting language function. In this study, BNT was investigated whether it could be a screening tool for early postoperative cognitive dysfunction (POCD). This prospective observational cohort study included 132 major noncardiac surgery patients and 81 nonsurgical controls. All participants underwent a mini-mental state examination (MMSE) and BNT 1 day before and 7 days after surgery. Early POCD was assessed by reliable change index and control group results. Seven days after surgery, among 132 patients, POCD was detected in 30 (22.7%) patients (95% CI, 15.5%-30.0%) based on MMSE, and 45 (34.1%) patients (95% CI, 26.3%-41.9%) were found with postoperative language function decline based on BNT and MMSE. Agreement between the BNT spontaneous naming and MMSE total scoring was moderate (Kappa .523), and the sensitivity of BNT spontaneous naming for detecting early POCD was .767. Further analysis showed that areas under receiver operating characteristics curves (AUC) did not show statistically significant differences when BNT spontaneous naming (AUC .862) was compared with MMSE language functional subtests (AUC .889), or non-language functional subtests (AUC .933). This study indicates the feasibility of implementing the BNT spontaneous naming test to screen early POCD in elderly patients after major noncardiac surgery.

Estrous activity in nulliparous heifers with divergent genetic merit for fertility traits

This observational study determined the effect of genetic merit for fertility traits on estrous activity and duration and inter-estrous interval in nulliparous dairy heifers. We also compared estrous activity between estrous events with or without conception and determined the effect of genetic merit for fertility traits on age and body weight at time of first detected estrous activity event. Activity monitoring devices (Heatime, SCR Engineers) were fitted to 7-9-mo aged Holstein-Friesian heifers with positive or negative genetic merit for fertility traits (POS FertBV: average +5%, n = 275; NEG FertBV: average -5%, n = 249) and activity data was collected to the end of the first breeding period (15-17-mo). An estrous event was defined as when the activity change index exceeded 19.2 activity units (AU) for ≥6 consecutive h. In total, 2,434 estrous events were identified (POS FertBV: n = 1454; NEG FertBV: n = 980). Estrous event duration was defined as the period when the threshold was first exceeded and when activity dropped below threshold, without another event starting within 24 h of the end of the previous event. This definition included occurrences where activity crossed the threshold multiple times in a day; these were classified as a single estrous event. A second measure, high activity duration, was defined as the total time activity exceeded the threshold. To characterize estrous activity, baseline activity was determined from the previous 7 d of activity. Peak activity and total activity (area under the curve of activity above baseline) were calculated. A fifth variable, inter-estrous interval, was calculated as a proxy for estrous cycle length. Total activity and peak activity were greater in POS than NEG FertBV heifers (total activity: 548 vs 464 AU, SED = 19.6 AU; peak activity: 72 vs 65 AU, standard error of the difference (SED) = 1.5 AU). The POS FertBV group had a mean estrous event duration and high activity duration of 15.1 h and 15.0 h, compared with 14.1 and 14.1 h for the NEG FertBV group (SED = 0.30 and 0.29 h, respectively). Inter-estrous interval did not differ between POS and NEG FertBV heifers (19.5 vs 20.0 d, SED = 0.49). Estrous events associated with conception were shorter than those not associated with conception (mean ± standard error of the mean, high activity duration: 13.0 ± 0.25 h vs 13.9 ± 0.31 h, estrous event duration: 13.1 ± 0.25 h vs 14 ± 0.32 h) and had less total activity (408 ± 15.2 vs 487 ± 18.2 AU). The POS FertBV heifers were more likely to have their first estrous activity event than NEG FertBV heifers by a given age (HR = 1.26, 95% CI = 1.0 to 1.6) or body weight (HR = 1.35, 95% CI = 1.1 to 1.6). The outcomes of this study provide evidence that positive genetic merit for fertility traits is associated with more overt estrous expression. Therefore, estrous expression traits may have potential to be used as earlier-in-life predictors of genetic merit for fertility.