Individual Person Level Research Articles

Comparison of plasma biomarkers and amyloid PET for predicting memory decline in cognitively unimpaired individuals.

We compared the ability of several plasma biomarkers versus amyloid positron emission tomography (PET) to predict rates of memory decline among cognitively unimpaired individuals. We studied 645 Mayo Clinic Study of Aging participants. Predictor variables were age, sex, education, apolipoprotein E (APOE) ε4 genotype, amyloid PET, and plasma amyloid beta (Aβ)42/40, phosphorylated tau (p-tau)181, neurofilament light (NfL), glial fibrillary acidic protein (GFAP), and p-tau217. The outcome was a change in a memory composite measure. All plasma biomarkers, except NfL, were associated with mean memory decline in models with individual biomarkers. However, amyloid PET and plasma p-tau217, along with age, were key variables independently associated with mean memory decline in models combining all predictors. Confidence intervals were narrow for estimates of population mean prediction, but person-level prediction intervals were wide. Plasma p-tau217 and amyloid PET provide useful information about predicting rates of future cognitive decline in cognitively unimpaired individuals at the population mean level, but not at the individual person level.

A digital humanism view on e-tourism

Informatics, its artefacts and methods, change our society and world, from the individual personal level up to the current geo-political powerplay. Today, Information Technology (IT) serves as the operating system of our society. From an ontological point of view Informatics influences also how we perceive the world and how we think about it. This change has happened during the short span of last half century. At the same time, despite of this enormous success, this development has serious shortcomings. I discuss some of them, and describe a positive “answer”: Digital Humanism. I will use this human centered approach to IT to critically review developments in e-tourism; and, one of the main lessons is: do not get lost in small things, have a look at the big picture, also aim for a better future and society. Two disclaimers: (a) This contribution is an opinion piece, not a scientific paper in the strict sense. I hope it provokes a lively, and probably also controversial discussion; and, (b) Some arguments regarding Digital Humanism are already partly expressed in other publications such as (Werthner, Electron Mark 32:145–151, 2022a) and (Werthner et al. Hoepken (eds) Handbook of e-tourism, Springer, Berlin, 2022b).

PCR28 The OPUF Tool: A New Type of Online Survey for Creating Value Sets for the EQ-5D-5L on the Societal-, Group-, and Individual Person Level

We recently reported on the development of a new method, called OPUF, for deriving value sets (=QALY-weights) for the EQ-5D-5L instrument. In contrast to established methods, such as time trade-off or discrete choice experiments, the OPUF approach does not require hundreds of respondents, but allows estimating utility functions for small groups and even on the individual person level. The objective of this study was to apply the OPUF approach in a large, representative sample of the UK population.

Association of Performance on the Financial Capacity Instrument-Short Form With Brain Amyloid Load and Cortical Thickness in Older Adults.

To investigate the association of the Financial Capacity Instrument-Short Form (FCI-SF) performance and timing total scores with brain β-amyloid and cortical thickness in cognitively unimpaired (CU) (at baseline) older adults. A total of 309 participants (aged 70 years or older) of the Mayo Clinic Study of Aging underwent 11C-Pittsburgh compound B PET amyloid imaging and MRI, and completed the FCI-SF. Abnormal amyloid PET was defined as standardized uptake value ratio ≥1.48 in an Alzheimer disease (AD)-related region of interest and reduced AD signature cortical thickness as ≤2.68 mm (neurodegeneration). A cohort of 218 (of the 309) participants had follow-up visits (every 15 months) with FCI-SF data for longitudinal analysis (number of visits including baseline, median [range]: 2 [2-4]). In the analysis, we used linear regression and mixed-effects models adjusted for age, sex, education, apolipoprotein E ε4 allele status, global cognitive z score, and previous FCI-SF testing. Participants' mean age (SD) was 80.2 (4.8) years (56.3% male individuals). In cross-sectional analysis, abnormal amyloid PET (vs normal) was associated with a lower FCI-SF total score and slower total composite time. In longitudinal analysis, FCI-SF total score declined faster (difference in annualized rate of change, beta coefficient [β] [95% confidence interval (CI)] = -1.123 [-2.086 to -0.161]) and FCI-SF total composite time increased faster (difference in annualized rate of change, β [95% CI] = 16.274 [5.951 to 26.597]) for participants with neurodegeneration at baseline (vs those without). Participants who exhibited both abnormal amyloid PET and neurodegeneration at baseline had a greater increase in total composite time when compared with the group without abnormal amyloid and without neurodegeneration (difference in annualized rate of change, β [95% CI] = 16.750 [3.193 to 30.307]). Performance and processing speed on the FCI-SF were associated with imaging biomarkers of AD pathophysiology in CU (at baseline) older adults. Higher burdens of imaging biomarkers were associated with longitudinal worsening on FCI-SF performance. Additional research is needed to delineate further these associations and their predictive utility at the individual person level.

From absolute nonsense to the world’s operating system

Informatics, its artefacts and methods, have fundamentally changed our society and world, from the individual personal level up to the current geo-political powerplay between the US, China and Europe. Information Technology serves as the operating system of our society. This change has happened over the last 30 – 40 years, and the result should be compared with our historic views and expectations. At the same time, despite the enormous success of our discipline, it has serious shortcomings. I discuss some of them, especially the issue of online platforms, and describe a positive “answer”: Digital Humanism. This approach does not only describe and analyze the man – machine relationship, but also underlines the importance of humans in this development: we have to interfere – technology is not god given. This fundamental idea is already supported by a growing number of academics and practitioners from different disciplines and fields.

BCG vaccination at birth and COVID-19: a case-control study among U.S. military Veterans

ABSTRACT In the early stages of the COVID-19 global pandemic, caused by the SARS-CoV-2 virus, low- and middle-income countries (LMICs) appeared to be experiencing lower morbidity and mortality rates than high-income countries, particularly the United States. Various suggestions put forward to account for this included the possibility that LMICs might be experiencing off-target benefits of infant vaccination with BCG, intended primarily to protect against tuberculosis. A number of ecologic epidemiological studies that considered COVID-19 morbidity and mortality rates across countries appeared to support this suggestion. Ecologic studies, however, are primarily hypothesis-generating, given their well-known limitations in extrapolating to the individual-person level. The present study, which employed anonymized records of U.S. Military Veterans treated by the Department of Veterans Affairs was principally a case-control study of COVID-19 infections with a retrospective cohort study of mortality nested within the infections. Controls were a random sample of Veterans not recorded as having had COVID-19. There were 263,039 controls and 167,664 COVID-19 cases, of whom 5,016 died. The combination of country and year of birth was used as a surrogate for infant BCG vaccination. The study did not support the hypothesis that BCG in infancy was protective against COVID-19. The odds ratio for infection was 1.07 (95% confidence interval [CI]: 1.03, 1.11) and the risk ratio for mortality among the COVID-19 cases was 0.86 (95% CI: 0.63, 1.18). The potential for non-differential exposure misclassification was a concern, possibly biasing measures of association toward the null value.

Mental health literacy at the public health level in low and middle income countries: An exploratory mixed methods study in Vietnam.

PurposeMental health literacy (MHL) is key for mental health development, particularly in low-and-middle-income countries (LMIC) where mental health resources are limited. MHL development can be thought of as occurring at two levels: the individual person level (via direct contact, with specifically-targeted individuals), and the public health level (via indirect contact through public media, targeting the general public). Each approach has advantages and disadvantages.MethodsThe present mixed methods study assessed the status of and best approaches for development of mental health literacy in the Southeast Asian LMIC Vietnam. Because there has been relatively little discussion of MHL development at the public health level, this assessment focused on the public health level, although not exclusively. Because mental health professionals generally have the most in-depth understanding of their mental health system, study participants were 82 Vietnamese mental health professionals who completed a quantitative survey, with 48 participating in focus groups.ResultsMost of the professionals viewed MHL in Vietnam as low or very low, and that it was difficult or very difficult for the general public to find effective mental health services. Main barriers underlying these problems and more generally for developing MHL in Vietnam identified in the focus groups were: (a) misinformation in the media regarding mental health and mental illness; (b) lack of licensure for non-medical mental health professionals (e.g., psychologists; social workers); (c) lack of interest in mental health from upper-level leadership.ConclusionsTo the best of our knowledge, this is the first study assessing professionals’ perceptions regarding mental health literacy at both the public health and individual-person levels. Although sampling was restricted to Vietnamese professionals, results may provide initial preliminary guidance for other LMIC considering mental health literacy development at multiple levels.

Single-Subject Research in Psychiatry: Facts and Fictions.

Scientific evidence in the field of psychiatry is mainly derived from group-based (“nomothetic”) studies that yield group-aggregated results, while often the need is to answer questions that apply to individuals. Particularly in the presence of great inter-individual differences and temporal complexities, information at the individual-person level may be valuable for personalized treatment decisions, individual predictions and diagnostics. The single-subject study design can be used to make inferences about individual persons. Yet, the single-subject study is not often used in the field of psychiatry. We believe that this is because of a lack of awareness of its value rather than a lack of usefulness or feasibility. In the present paper, we aimed to resolve some common misconceptions and beliefs about single-subject studies by discussing some commonly heard “facts and fictions.” We also discuss some situations in which the single-subject study is more or less appropriate, and the potential of combining single-subject and group-based study designs into one study. While not intending to plea for single-subject studies at the expense of group-based studies, we hope to increase awareness of the value of single-subject research by informing the reader about several aspects of this design, resolving misunderstanding, and providing references for further reading.

Our Self-Access Experience in Times of COVID

The coronavirus pandemic has without a doubt had an enormous impact on every possible way of our lives. We have felt its effects on an individual personal level and as family members, at work, as members of a community, and particularly as students and teachers. Even in institutions and departments such as ours where online education has been at the forefront of our work for years now, the challenge to survive a fully virtual new reality has left us with a lot of lessons learned and has opened doors to more opportunities for growth. For years now, the Language Department at ITESO has had its language courses in LMS platforms and has offered courses in blended and fully virtual options alongside face-to-face classes. In the English Certificate Programme, we have regular teletandem sessions with universities in other countries. The Language Hub, our self-access centre, offers writing support through an emailing writing desk service and we run virtual conversation clubs on Zoom alongside face-to-face sessions. We are certainly no strangers to online work, but up until now, that was just an option both students and teachers could consider. As of March, this year, our whole university had to move to online classes and the services of our self-access centre had to be adapted to virtual options as well. This report presents our answer to the questions posed by SISAL for this open call to the special issue on how we have lived the experience of self-access during the pandemic.

Interaction of Sleep and Cortical Structural Maintenance From an Individual Person Microlongitudinal Perspective and Implications for Precision Medicine Research.

Sleep and maintenance of brain structure are essential for the continuity of a person’s cognitive/mental health. Interestingly, whether normal structural maintenance of the brain and sleep continuously interact in some way over day–week–month times has never been assessed at an individual-person level. This study used unconventional microlongitudinal sampling, structural magnetic resonance imaging, and n-of-1 analyses to assess normal interactions between fluctuations in the structural maintenance of cerebral cortical thickness and sleep duration for day, week, and multi-week intervals over a 6-month period in a healthy adult man. Correlation and time series analyses provided indications of “if–then,” i.e., “if” this preceded “then” this followed, sleep-to-thickness maintenance and thickness maintenance-to-sleep bidirectional inverse interactions. Inverse interaction patterns were characterized by concepts of graded influences across nights, bilaterally positive relationships, continuity across successive weeks, and longer delayed/prolonged effects in the thickness maintenance-to-sleep than sleep-to-thickness maintenance direction. These interactions are proposed to involve normal circadian/allostatic/homeostatic mechanisms that continuously influence, and are influenced by, cortical substrate remodeling/turnover and sleep/wake cycle. Understanding interactions of individual person “-omics” is becoming a central interest in precision medicine research. The present n-of-1 findings contribute to this interest and have implications for precision medicine research use of a person’s cortical structural and sleep “-omics” to optimize the continuous maintenance of that individual’s cortical structure, sleep, and cognitive/mental health.

Практики потребления кофе и образ жизни (на материалах опроса жителей Волгоградской области)

The research presents the results of quantitative (formalized interview) and qualitative (in-depth in-terview) studies of daily practices of coffee con-sumption by Russians. Considering beverages as a component of nutrition is an important source of information about the socio-cultural specifics of various countries, their regions and cities. The for-mation of traditions in the field of beverage con-sumption is associated with the lifestyle of the pop-ulation and its dynamics, with the processes of cre-ating social meanings of this consumption by re-spondents. The authors focused on the importance of coffee consumption in various spheres of life of the regional population of Russia. It is noted that, as a rule, people prefer to drink coffee at home in the morning and in the afternoon being at work in order to increase their energy levels and working capacity. The choice of type and brand of coffee depends on the price, as well as the simplicity and speed of preparation. It is proved that social significance of coffee manifests itself more at the individual-personal level. Therefore, people drink a fragrant drink in order to enjoy the sensation of its taste, although the importance of the coffee ceremony and the commitment to tradition cannot be denied. At the same time, the young generation’s addiction to coffee can be largely explained by the influence of family practices on the consumption of this drink and warm memories of a pleasant coffee smell from their childhood.

The Post-Modern Era Spirituality Crisis: Values of Ideals a Post-Pandemic Day

In the postmodern era, the fundamental foundations of the human soul swayed. In accordance with this, in scientific approaches, there is a complex and controversial process of reassessment of the axiological orientations of modern man. Despite the painful collisions of this process, in the conditions of postmodernity, a person of a creative warehouse gets an unprecedented freedom so far, based on the constructive basis of spirituality, thanks to which a person acquires the ability to distance himself from society and independently critically comprehend all aspects and spheres of his life. The intensification of the search for the meaning of life on an individual-personal level is a characteristic sign of the development of society not only in the West, but also in societies with the preservation of traditional specifics. The effectiveness of the search for the meaning of life in the real world is directly dependent on the development by people of the new islands of freedom, life forms and directions of creativity, corresponding to the realities of the break of millennia. The purpose of the article is to identify the main problems of modern society, such as: globalization challenges, problems of attitude to the world, the environmental perception of the world in particular, and the problems of educating spirituality as a spiritual attitude to the world and to a holistic personality.

Different Strategies to Execute Multi-Database Studies for Medicines Surveillance in Real-World Setting: A Reflection on the European Model.

Although postmarketing studies conducted in population‐based databases often contain information on patients in the order of millions, they can still be underpowered if outcomes or exposure of interest is rare, or the interest is in subgroup effects. Combining several databases might provide the statistical power needed. A multi‐database study (MDS) uses at least two healthcare databases, which are not linked with each other at an individual person level, with analyses carried out in parallel across each database applying a common study protocol. Although many MDSs have been performed in Europe in the past 10 years, there is a lack of clarity on the peculiarities and implications of the existing strategies to conduct them. In this review, we identify four strategies to execute MDSs, classified according to specific choices in the execution: (A) local analyses , where data are extracted and analyzed locally, with programs developed by each site; (B) sharing of raw data, where raw data are locally extracted and transferred without analysis to a central partner, where all the data are pooled and analyzed; (C) use of a common data model with study‐specific data, where study‐specific data are locally extracted, loaded into a common data model, and processed locally with centrally developed programs; and (D) use of general common data model, where all local data are extracted and loaded into a common data model, prior to and independent of any study protocol, and protocols are incorporated in centrally developed programs that run locally. We illustrate differences between strategies and analyze potential implications.

РЕФЛЕКСИВНА Й АВТОПСИХОЛОГІЧНА КОМПЕТЕНТНІСТЬ ФАХІВЦІВ СОЦІАЛЬНОЇ СФЕРИ: ОСОБЛИВОСТІ РОЗМЕЖУВАННЯ ПОНЯТЬ

The purpose of the article is to scientifically comprehend and differentiate the concepts of specialists’s of social sphere reflexive and autopsychological competence, to determine the means of their empirical research. Methods. Theoretical analysis and generalization of data from literature sources allowed to methodologically substantiate the use of psychodiagnostic methods aimed at studying the reflexive and autopsychological competence of social sphere’s specialists. In particular, the research methods of reflection, assessment methods of components of self-concept and self-image, self-consciousness and self-conception are considered. Reflective practices, used in vocational training, are discussed separately. Results. The key moments of understanding in the psychological science the specialists’ autopsychological and reflexive competence are analyzed. It is determined that reflexive competence is a professional personal quality, which is manifested in the implementation of reflexive processes, accelerates personal and professional development, enhances creativity. Autopsychological competence is the integrated ability to reflective processes at the individual-personal level of mental regulation of professional activity of socionomic’s professionals. An important tool for the professional development is self-reflection, as a process of self-analysis, self-esteem, self-control and self-observation of the individual. Conclusions. Detected, that the ability for professional reflection is an important factor in achieving a high level of skill and effectiveness. Reflective competence is a meta-competence in the structure of the specialists’ personality-professional competence, which provides the capacity for awareness and criticism of oneself as a subject of activity, the process of professional activity, the person in need, as the object of cognition and professional influence. Reflexive competence is a common concept for autopsychological competence and self-reflection of specialists. Reflective practices, that shape the qualities of self-reflection of professional behavior, attitude and motivation of social sphere’s specialists, are of great importance during vocational training.

ETHICAL PRINCIPLES UNDER THE PSYCHOLOGICAL CULTURE OF THE STUDENT AND THE TEACHER HIGHER EDUCATIONAL INSTITUTION

The ethically enriched environment in an educational institution involves following the moral and legal norms of behavior by students, scientific and pedagogical workers in interpersonal relationships, and in relations with the surrounding world, the normalization of the rules of conduct. In this context, the increase of psychological culture manifests itself both at the social level and at the individual personal level, and includes: understanding of oneself as a person, awareness of his place among people, the formation of reflection skills, taking into account the needs and interests of others, solving problems in a constructive way, following cultural norms. The subject of our study was the problem of the introduction of ethical principles in the educational process in a higher educational institution in order to increase the standards of psychological culture of students and teachers, psychologization of training in terms of studying the disciplines of the humanities cycle in various specialties. Such social aspirations were declared in the Code of Ethics of the student and teacher of the Odessa Institute of the Interregional Academy of Personnel Management. The purpose of this code is to establish in the educational activity of a student and a scientific and pedagogical worker of moral and ethical values and norms on the principles of humanity, tolerance, respect for the dignity of each person, academic integrity, confidentiality, trust, activity, cooperation, courtesy and responsibility. Subsequently, students and teachers of the institute passed a special training on the use of ethical behavior skills in educational activities. Teaching subjects of the humanitarian cycle, enriched with the ethical principles of the educational institution, showed an increase in the level of student activity in independent work on the subject, promotion of active employment of students in public life institute. To the psychological and pedagogical influences during training and social interaction of students and teachers, in turn, on the individual level of the student’s personality contributed to raising the level of their self-development, self-regulation, self-determination, self-actualization — the main components of psychological culture. Further research requires the question of psychological diagnosis and correction of the psychological culture of the individual, as well as the improvement of the skills of teachers in problem courses.

Charismatic mediumship and traditional priesthood: power relations in a religious field

ABSTRACTIn the Indian Himalayas, mediums who operate as channels through which deities can communicate with their devotees, function alongside priests who serve these deities. In this article, we examine the relationship between these two religious roles with regard to the deity Mahāsū. At the individual-personal level we examine how their roles are linked to different sources of authority – whereas the priests’ source of authority is traditional, the mediums rely on charisma. At the societal level, we maintain that their different caste backgrounds are essential for understanding their public role. While the priests are Brahmins, almost all the mediums of Mahāsū are Rajputs. Thus, the medium institution enables the Rajputs, who make up the vast majority of Mahāsū’s devotees, to retain in their hands all decisions pertaining to the public sphere. Hence, they carry more political–social clout than the priests, because they can change the social-religious order or sustain it.

A/T/N: An unbiased descriptive classification scheme for Alzheimer disease biomarkers.

Biomarkers have become an essential component of Alzheimer disease (AD) research and because of the pervasiveness of AD pathology in the elderly, the same biomarkers are used in cognitive aging research. A number of current issues suggest that an unbiased descriptive classification scheme for these biomarkers would be useful. We propose the “A/T/N” system in which 7 major AD biomarkers are divided into 3 binary categories based on the nature of the pathophysiology that each measures. “A” refers to the value of a β-amyloid biomarker (amyloid PET or CSF Aβ42); “T,” the value of a tau biomarker (CSF phospho tau, or tau PET); and “N,” biomarkers of neurodegeneration or neuronal injury ([18F]-fluorodeoxyglucose–PET, structural MRI, or CSF total tau). Each biomarker category is rated as positive or negative. An individual score might appear as A+/T+/N−, or A+/T−/N−, etc. The A/T/N system includes the new modality tau PET. It is agnostic to the temporal ordering of mechanisms underlying AD pathogenesis. It includes all individuals in any population regardless of the mix of biomarker findings and therefore is suited to population studies of cognitive aging. It does not specify disease labels and thus is not a diagnostic classification system. It is a descriptive system for categorizing multidomain biomarker findings at the individual person level in a format that is easy to understand and use. Given the present lack of consensus among AD specialists on terminology across the clinically normal to dementia spectrum, a biomarker classification scheme will have broadest acceptance if it is independent from any one clinically defined diagnostic scheme.

A multicenter study of the early detection of synaptic dysfunction in Mild Cognitive Impairment using Magnetoencephalography-derived functional connectivity.

Synaptic disruption is an early pathological sign of the neurodegeneration of Dementia of the Alzheimer's type (DAT). The changes in network synchronization are evident in patients with Mild Cognitive Impairment (MCI) at the group level, but there are very few Magnetoencephalography (MEG) studies regarding discrimination at the individual level. In an international multicenter study, we used MEG and functional connectivity metrics to discriminate MCI from normal aging at the individual person level. A labeled sample of features (links) that distinguished MCI patients from controls in a training dataset was used to classify MCI subjects in two testing datasets from four other MEG centers. We identified a pattern of neuronal hypersynchronization in MCI, in which the features that best discriminated MCI were fronto-parietal and interhemispheric links. The hypersynchronization pattern found in the MCI patients was stable across the five different centers, and may be considered an early sign of synaptic disruption and a possible preclinical biomarker for MCI/DAT.

Mining Mobile Datasets to Enable the Fine-grained Stochastic Simulation of Ebola Diffusion

The emergence of Ebola in West Africa is of worldwide public health concern. Successful miti- gation of epidemics requires coordinated, well-planned intervention strategies that are specific to the pathogen, transmission modality, population, and available resources. Modeling and sim- ulation in the field of computational epidemiology provides predictions of expected outcomes that are used by public policy planners in setting response strategies. Developing up to date models of population structures, daily activities, and movement has proven challenging for developing countries due to limited governmental resources. Recent collaborations (in 2012 and 2014) with telecom providers have given public health researchers access to Big Data needed to build high-fidelity models. Researchers now have access to billions of anonymized, detailed call data records (CDR) of mobile devices for several West African countries. In addition to official census records, these CDR datasets provide insights into the actual population locations, densities, movement, travel patterns, and migration in hard to reach areas. These datasets allow for the construction of population, activity, and movement models. For the first time, these models provide computational support of health related decision making in these developing areas (via simulation-based studies). New models, datasets, and simulation software were produced to assist in mitigating the continuing outbreak of Ebola. Existing models of disease characteristics, propagation, and progression were updated for the current circulating strain of Ebola. The simulation process required the interactions of multi-scale models, including viral loads (at the cellular level), disease progression (at the individual person level), disease propagation (at the workplace and family level), societal changes in migration and travel movements (at the population level), and mitigating interventions (at the abstract governmental policy level). The predictive results from this system were validated against results from the CDC's high-level predictions.

A prospective study of the responsiveness of the original and the short form Berg Balance Scale in people with stroke

Objective: The study aim was to examine the responsiveness of the Berg Balance Scale (BBS) and that of its short form (SFBBS) at both the individual person level and the group level. Design: A repeated-measurements design. Setting: Hospital and home setting. Participants: Patients with stroke. Results: Totals of 226, 202, and 168 patients with stroke were assessed with the BBS at 14, 30, and 90 days after stroke, respectively. The SFBBS data were extracted from the patients’ responses on the BBS. At the group level, the BBS and the SFBBS had sufficient and similar responsiveness. For the Rasch scores, the effect sizes of the three change scores for the BBS and the SFBBS, respectively, had similar ranges between 0.38 and 0.88 and between 0.39 and 0.85, respectively. The standardized response means of the three change scores for the BBS and the SFBBS ranged from 0.74 to 1.33 and from 0.72 to 1.13, respectively. At the individual person level, the BBS detected significant balance improvement in about twice as many patients as the SFBBS detected. Conclusion: The responsiveness of the BBS at the individual person level was better than that of the SFBBS in patients with stroke. The BBS is recommended as an outcome measure to better detect changes in individual patients.