Measures Of Function Research Articles

Fermatean fuzzy score function and distance measure based group decision making framework for household waste recycling plant location selection.

The household waste (HW) disposal and recycling have become a significant challenge due to increasing quantities of generated household wastes and increased levels of urbanization. Selecting locations/sites for building new HW recycling plant comprises numerous sustainability dimensions, thus, this work aims to develop new decision-making model for evaluating and prioritizing the HW recycling plant locations. This paper is categorized into three phases. First, we propose new improved score function to compare the Fermatean fuzzy numbers. Moreover, an example is presented to validate the effectiveness of proposed score function over the extant ones. Second, we introduce new distance measure to estimate the discrimination degree between Fermatean fuzzy sets (FFSs) and further discuss its advantages over the prior developed Fermatean fuzzy distance measures. Third, we introduce an integrated methodology by combining the method with the removal effects of criteria (MEREC), the stepwise weight assessment ratio analysis (SWARA) and the measurement alternatives and the ranking according to compromise solution (MARCOS) approaches with Fermatean fuzzy (FF) information, and named as the "FF-MEREC-SWARA-MARCOS" framework. In this method, the FF-distance measure is used to find the weights of involved decision-making experts. Moreover, an integrated criteria weighting method is presented with the combination of MEREC and SWARA models under the context of FFSs, while the combined FF-MEREC-SWARA-MARCOS model is applied to evaluate and prioritize the locations for HW recycling plant development, which illustrates its feasibility of the developed framework. Comparative study and sensitivity assessment are conducted to validate the obtained outcomes. This work provides a hybrid decision analysis approach, which marks a significant impact to the HW recycling plant location selection process with uncertain information.

Patient-Reported Outcomes in RLBP1 Retinal Dystrophy: Longitudinal Assessment in a Prospective Natural History Study.

To evaluate the performance of two non-disease-specific patient-reported outcome (PRO) instruments, the National Eye Institute Visual Function Questionnaire-25 (VFQ-25) and the Low Luminance Questionnaire (LLQ), in patients with retinaldehyde-binding protein 1 retinal dystrophy (RLBP1 RD). PROs were assessed using the VFQ-25 and LLQ. Rasch analysis was conducted to estimate person and item measures of the VFQ-25 and LLQ questionnaires to determine the association between the two PROs. In addition, the association between these two instruments and their correlations to weighted measures of visual function and disease progression were analyzed in this three-year PRO-focused sub-study of a five-year prospective natural history study. Forty-two patients participated, with most of them having completed at least two PRO follow-up visits at least one year apart. The mean VFQ-25 scores were lowest for distance activities (39.2-49.0) and peripheral vision (37.5-52.4), with mean LLQ subscale scores generally low (<41), except for the emotional distress subscale. Using Rasch analysis, calibrated item and person measures along with their standard errors were estimated for both ePROs. This indicated that the distribution of the VFQ-25 and LLQ item measures well covered the distribution of person function in this group. This suggests that the item difficulties well cover the person-level performance in this population. As well, the two PROs showed a strong and significant correlation at all assessed time points as assessed with Pearson correlation coefficient (0.81, 0.91, 0.81 and 0.87 at baseline, 1/1.5, 2/2.5 (P < 0.001) and 3/3.5 years (P = 0.002)). The composite scores of both PRO questionnaires strongly correlated with clinical measures of visual function. At 2 to 2.5 years of follow-up, meaningful statistically significant declines in peripheral vision (both VFQ-25 and LLQ), distance vision (VFQ-25), and extreme lighting in dark and bright light (LLQ) subscales were noted. This study demonstrated a strong association between VFQ-25 and LLQ scores and their association with clinical measures of visual function. PRO instruments can provide insights into the specific disabilities of this unique patient population and help to guide appropriate outcome measures for future clinical trials.

Evaluation of a six-minute walk test in the DE50-MD canine model of Duchenne muscular dystrophy and its effect on blood-borne biomarkers

Background Duchenne muscular dystrophy (DMD) is a fatal muscle wasting disease caused by mutations in the dystrophin gene resulting in cycles of muscle degeneration, inflammation and regeneration. The 6-minute walk test (6MWT) is a key functional outcome measure for DMD patient clinical trials and has been adapted for use in animal models of the disease. The DE50-MD dog model of DMD closely reflects the DMD patient phenotype prior to loss of ambulation. For pre-clinical trials using this model, functional outcome measures must be established. Methods This longitudinal study compared distance walked in a 6MWT by DE50-MD and WT control dogs and assessed the utility of the 6MWT as a functional biomarker. Dogs underwent two 6MWTs conducted approximately 48-hours apart, at 3, 6, 9, 12, 15 and 18 months of age. In addition, we evaluated the stability of selected blood-borne biomarkers in 12-month old DE50-MD and WT dogs 0, 3, 6, 24 and 48 hours following a 6MWT. Results DE50-MD dogs exhibited significantly shorter 6-minute walk distance (6MWD) than WT dogs at all timepoints (P&lt;0.05), with no difference in 6MWD between the first and second 6MWT. C-C motif chemokine ligand 2 (CCL2), myomesin-3 (MYOM3) and myostatin (MSTN) were biomarkers of the DE50-MD phenotype that remained unchanged in DE50-MD dogs following the 6MWT, while creatine kinase (CK) activity significantly increased 3-hours following the test in DE50-MD dogs but remained unchanged in WT dogs. Conclusions The 6MWT effectively discriminates DE50-MD from WT dogs aged 3-18 months and a single 6MWT is sufficient for future studies. Serum MYOM3, CCL2 and MSTN are good biomarkers of the DE50-MD phenotype that are unaffected by this relatively low level exertion.

The effect of topical medications on olfactory function: Barrier therapy

Introduction. Sensory organs help humans exist in the surrounding world, but the evaluation of olfaction remained “in the shadows” practically until the COVID-19 pandemic, although many questions are still insufficiently studied, such as the effect of intranasal medications on olfactory function.Aim. To assess the olfactory function in healthy volunteers before and after a course of using an ectoine nasal solution.Materials and methods. Under our observation were healthy volunteers (medical university students and healthcare workers aged 16 to 35 years) who, in addition to routine ENT examinations, underwent an assessment of their olfactory status using a professional set of odorants for olfactometry and subjectively using a self-assessment scale for olfaction before and after a course of ectoine nasal solution, as well as a self-assessment of its preventive effect. The collected data were recorded in Excel spreadsheets (Microsoft Office 365) for further statistical analysis.Results and discussion. The results showed an average increase of 1 point in the self-assessment of olfaction in the observation group, as well as an increase in the number of “correct” responses when using the set of odorants. However, discrepancies were noted between self-assessment and the objective evaluation of olfaction. The extent of the preventive effect (based on the self-assessment by participants using a 10-point visual analog scale) was rated at 5 points.Conclusions. 1. A one-month course of barrier therapy (ectoine nasal solution) does not cause any impairment in olfactory function, as evidenced by olfactometric testing (an average increase of 10% in correct responses across the group, with 80% of participants showing improvement) and olfaction self-assessment (an average increase of 1 point across the group, with 55% of participants showing improvement). 2. Self-assessment of olfaction cannot be considered a reliable measure of the actual olfactory function. 3. The use of barrier therapy (ectoine nasal solution) has a moderate preventive effect (5 points).

Worry about online fraud and older adults: Avoidant and protective responses

Given that cyber-enabled fraud makes up the vast majority of digital crime suffered by older adults, the impact of victimisation on this demographic group is of academic and practical relevance. This article examines the relationship between cyber fraud victimisation, worry about cyber fraud, and online avoidant behaviours and protective responses in older adults. The data come from the 2019 Special Eurobarometer 499, and the sample is made up of 6,257 Internet users aged 60 years and above. In addition to suffering cyber-enabled fraud, we also analyse various factors, such as the respondent's sex and knowledge of risks, which have been found to be associated with fear or worry about crime in other contexts. Our findings show that the respondent's sex and having experienced prior victimisation of oneself or family and friends is related to greater worry about online fraud. Moreover, we find that fraud victimisation of friends and family, knowledge of risks, and perceived self-efficacy are associated with dysfunctional avoidant behaviours and the adoption of functional security measures. We discuss the results in relation to gendered fear of crime socialisation and in terms of interventions with older adults that aim to respond to victimisation and to combat the digital divide.

Equine assisted services - an intervention in the motor disorders of a child with cytomegalovirus sequelae

Cytomegalovirus infection (CMV) represents the most prevalent infection correlated with congenital neurological impairment. After infection occurs several factors contribute for the child to have motor development deficits and possibly present several neurological manifestations. Equine assisted services- therapeutic and educational method that uses the horse within an interdisciplinary approach has shown positive results in the intervention of neurological dysfunctions. The objective to analyze the effect of equine assisted services on the gross motor function of a participant with sequelae caused by CMV infection. A quantitative and descriptive case study. It consisted of assessments pre- and post-equine assisted services interventions using the Gross Motor Function Measure (GMFM). The child participating in the study is classified as level III according to the Gross Motor Function Classification System (GMFCS). The results indicate a percentage increase in the total average between the pre- and post-intervention assessments, with results of 31.9 and 50.3%, respectively, and evolution in three of the five dimensions assessed through the GMFM, which are: lying and rolling, sitting, crawling and kneeling. It is concluded that equine assisted services are an effective tool for improving gross motor function of a participant with sequelae caused by cytomegalovirus infection.

Abstract 4126628: Worse Cardiac Structure and Function is Associated with Decline in Multiple Domains of Cognitive Function: the Atherosclerosis Risk in Communities (ARIC) Study

Background: Cognitive impairment is cross-sectionally associated with worse cardiac structure/function. However, limited data exist regarding cardiac structure/function and longitudinal changes in cognitive function. Objective: Determine the association of cardiac structure and function with longitudinal changes in cognitive performance in late life. Methods: Among HF- and dementia-free participants in the community-based ARIC study who attended the 5th study visit (V5; 2011-2013), underwent protocol echocardiography, and completed a neurocognitive test battery at both V5 and study Visit 6 (V6; 2015-17), we assessed associations of cardiac structure and function measures with changes in both domain-specific and global cognitive scores between V5 and V6 using multivariable linear regression. Models were initially adjusted for demographics and education level, with additional models further adjusting for cardiovascular risk factors and disease at both V5 and V6. The neuropsychological test battery consisted of 10 neuropsychological tests that covered 3 domains of cognitive function: memory, executive functioning, and language. Factor scores were constructed for each cognitive domain, and their average represented a global composite score. Results: Among 2,988 included participants, mean age was 74±5 years, 60% were female, 20% reported Black race, and mean LVEF was 66±6%. Over a mean of 4.9±0.6 years (the V5 to V6 interval), raw scores declined for all neuropsychological tests. In fully adjusted models, worse diastolic function (larger LAVi) and LV remodeling (greater LV mass index) were associated with decline in executive function. Lower LVEF was associated with decline in language function, while worse LV longitudinal strain – a more sensitive measure of systolic dysfunction – was associated with decline in executive function, language function, and global cognition performance (all p&lt;0.05; Table). Conclusion: Subclinical LV remodeling and dysfunction is associated with greater declines in cognitive function over 5 years in late life. Differential associations were observed by cognitive domains, with executive function decline most uniformly associated with impairments in cardiac structure/function.

Abstract 4132909: Hemodynamic Indices of Right Ventricular Function Differentially Predict Adverse Clinical Outcomes in Heart Failure with Preserved vs Reduced Ejection Fraction

Background: While the critical role of right ventricular dysfunction (RVD) in heart failure (HF) is increasingly recognized, the prevalence and prognostic impact of RVD across HF subtypes is poorly understood. Research Questions/Aims: We aimed to characterize differences in hemodynamic indices of RV function among patients with HF with preserved vs reduced ejection fraction (HFpEF, EF≥50% vs HFrEF, EF&lt;50%) and to examine associations of RVD with longitudinal clinical outcomes by HF subtype. Methods: We identified patients with prevalent HF undergoing clinically indicated right heart catheterization at Massachusetts General Hospital (2005-2016). We examined three RV hemodynamic indices: right atrial to wedge pressure ratio (RA/PCWP), RV stroke work index (RVSWI), and pulmonary artery pulsatility index (PAPi). We used multivariable linear regression to assess differences in RV indices in HFpEF vs HFrEF. We then used Cox models to examine the association of each index with HF hospitalizations (HFH), major adverse cardiac events (MACE), and death, stratified by HF subtype. Models were adjusted for age, sex, BMI, hypertension, diabetes, lung disease, sleep apnea, and prior MI. Results: Of 2,062 patients (age 66 years, 33% women), 1,242 (60%) had HFrEF and 820 (40%) had HFpEF. RVD (RVSWI &lt;450 mm Hg*ml/m 2 ) was present in 27% of HFrEF vs 21% of HFpEF patients. Those with HFpEF had higher RA/PCWP (β 0.12, SE 0.05, p=0.012) and RVSWI (β 0.22, SE 0.05, p&lt;0.001) relative to HFrEF. Over 4.1 median years follow-up, 915 HFH, 1,066 MACE, and 1,116 death events occurred. Among those with HFrEF, lower PAPi was associated with greater risk of HFH (HR 0.84 (0.77, 0.92); p&lt;0.001) and MACE (HR 0.88 (0.81, 0.96); p=0.003), and higher RVSWI was associated with greater risk of death (HR 1.17, (1.07, 1.27); p&lt;0.001, Figure ). In contrast, in those with HFpEF, only higher RA/PCWP was associated with greater risk of death (HR 1.11 (1.00, 1.23); p=0.042). Conclusion: RVD occurs frequently in both HFrEF and HFpEF, and hemodynamic measures of RV function are associated with greater risk of MACE, death, and HFH. Importantly, the prognostic value of RV indices varied by HF subtype, highlighting key differences in the role of RVD in HFrEF vs HFpEF.

Abstract 4134460: Application of Principal Component Analysis to Heterogenous Fontan Registry Data to Identify Independent Contributing Factors to Decline

Introduction: Single ventricle heart disease is a severe and life-threatening illness, and improvements in clinical outcomes of those with Fontan circulation have not yet yielded acceptable survival over the past two decades. Patients are at risk of developing a diverse variety of Fontan-associated comorbidities that may ultimately require heart transplant. Goal: Our study goal was to determine if principal component analysis (PCA), which determines unique directions of data variance, applied to data collected from a pediatric Fontan cohort can predict functional decline (N=140). Methods: Heterogeneous data broadly consisting of measures of cardiac and vascular function, exercise (VO 2max ), lymphatic biomarkers, and blood biomarkers were collected over 9 years at a single site as part of a prospectively applied clinical care pathway; in that time, 16 events occurred that are considered here in a composite adverse outcome measure. After standardization and PCA, principal components (PCs) representing &gt;5% of total variance were thematically labeled based on their constituents and tested for association with the composite outcome. Results: Our main findings suggest that the 6 th PC (PC6), representing 7.1% percent of the total variance in the set, is greatly influenced by albumin, alkaline phosphatase, total protein, BUN and BNP max and is a superior measure of proportional hazard compared to EF; it displayed the greatest accuracy for classifying Fontan patients as determined by AUC. In bivariate hazard analysis, we found that models combining systolic function (EF or PC5) and blood biomarkers (PC6) were most predictive, with the former having the greatest AIC, and the latter having the highest c-statistic. Conclusion: Our findings support the hypothesis that a broad, prospectively collected, multiorgan system model analyzed by way of unsupervised machine learning methods will improve prognosis of adverse outcomes in a Fontan cohort.

Abstract 4118178: Echocardiographic Measure of Right Ventricular-Pulmonary Arterial Coupling Predicts Survival in Lung Cancer

Background: Echocardiographic indicators of pulmonary hypertension have been reported to predict decreased survival in lung cancer. We sought to test the hypothesis that this may be associated with impaired right ventricular (RV)-systolic pulmonary arterial pressure (sPAP) coupling, further enhancing the prognostic strength of echocardiography in lung cancer. Methods: This prospective observational study included 220 patients with non-small cell lung cancer (NSCLC) examined by Doppler, strain and 3D echocardiography before starting therapy. Prediction of overall survival was assessed by univariable analysis followed by multivariate Cox regression, receiver operating characteristic (ROC) curves and Kaplan-Meier analyses. Results: Echocardiographic examination was on average within normal limits, even though 30% of the patients had sPAP ≥35 mm Hg. In univariable analysis, overall survival was associated with measures of RV systolic function and probability of pulmonary hypertension. In multivariate Cox regression, only RV global longitudinal strain (GLS)/sPAP (HR: 5.766 [95% CI: 1.025–32.443]) and Eastern Cooperative Oncology Group performance status &lt;2 (HR: 0.332 [95% CI: 0.171–0.644]) independently predicted survival. The optimal ROC curve-derived RV GLS/sPAP cut-off to predict survival was −0.54%/mm Hg. Among patients in Union for International Cancer Control (UICC) stage 4, those with impaired RV-arterial coupling (RV GLS/sPAP &gt;−0.54%/mm Hg) had worse survival than those with maintained RV-arterial coupling (HR: 2.8 [95% CI: 1.5–5.3]); the latter subgroup had similar survival compared with patients in UICC stage 3 (HR: 0.57 [95% CI: 0.28–1.14]). Conclusion: RV GLS/sPAP as an echocardiographic measure of RV-arterial coupling adds to prognostication by the UICC status in NSCLC.

Abstract 4113164: Central Arterial Stiffness in Young Adults with Perinatal HIV Exposure

Intro: Young adults with perinatally acquired HIV (YPHIV) have higher morbidity and mortality than uninfected persons. Antiretroviral therapy (ART) has extended life expectancy making adult CV disease a concern. Perinatal exposure to HIV increases inflammation which is associated with increased arterial stiffness which predicts CV disease. Aims: We compared arterial stiffness between YPHIV and young adults perinatally HIV exposed but uninfected (YPHEU), and evaluated the association of type and duration of ART regimens, HIV disease severity, and cardiac structure and function with arterial stiffness. Methods: In a substudy of the Pediatric HIV/AIDS Cohort Study, 150 participants (95 YPHIV, 55 YPHEU, mean 23.4 yrs, 60% female, 72% Black, 24% Hispanic) had echocardiography and pulse wave velocity (PWV) measured. We compared PWV between YPHIV and YPHEU, adjusting for covariates. Among YPHIV, we fit linear regression models to evaluate the association of current (within 1 year of PWV) and historical measures of HIV disease severity with PWV. We computed correlations between PWV and measures of left ventricular (LV) structure and function, overall and by HIV status. Results: Mean PWV and hemodynamic parameters did not differ between YPHIV and YPHEU (YPHIV 5.63 vs YPHEU 5.39 m/s; p=0.5). HIV control was good (82% with viral load &lt;400 copies/ml), 91% used combination ART: integrase strand inhibitors (INSTIs; median duration 4.6 years), protease inhibitors (PIs 15.1 years), or non-nucleoside reverse transcriptase inhibitors (NNRTIs 5.2 years). Most participants had normal PWV compared to healthy controls but all values above 11.8 m/sec ( Figure , level associated with CV events in adults) were only in YPHIV. Only weak correlations were observed between PWV and echocardiographic measures (&lt;0.20) in both YPHEU and YPHIV. Among YPHIV, HIV severity measures were not associated with PWV using either current or historical measures. Mean PWV was 1.68 (-0.36, 3.72) m/s higher among YPHIV with current PI use than those on INSTIs, and 1.58 (-0.94, 4.11) m/s higher than those on NNRTIs, although these differences were not significant. Conclusions: PWV was within normal ranges in most YPHIV and YPHEU although 5% YPHIV had elevated PWV. PWV may be higher with PI use due to cardiometabolic side effects. Successful HIV treatment and control of traditional CV risk factors may prevent premature vascular aging and subsequent cardiac compromise in YPHIV.

Abstract 4115027: Transcutaneous phototherapy improves left ventricular systolic function

Background: The emerging field of cardiac optogenetics uses pulses of light to stimulate optically-sensitive proteins in the heart, influencing cellular physiology with unprecedented spatiotemporal resolution. Potential benefits may include heart rhythm stabilization and relief from congestive heart failure (CHF). Transcutaneous phototherapy devices (LifeWave Inc, San Diego, USA) may provide similar benefit without the need for opsin expression in the heart or exogenous light sources. Objective: To investigate whether upregulation of carnosine activity using a wearable cutaneous phototherapy device may improve echocardiographic measures of left ventricular systolic function. Methods: The Carnosine ® adhesive skin patch (34 mm diameter) contain an organic crystalline material that reflects specific frequencies of infra-red light emitted through the skin, and known to activate carnosine dipeptides throughout the body. These function as a high-energy phosphate system known to enhance muscle function. Study participants (n=12 healthy volunteers, 40-66 years of age) underwent a focused baseline echocardiogram, which included atrial (A) and early (E) mitral valve inflow, peak tissue velocity (E’) at both the lateral and septal mitral annulus, and left ventricular ejection fraction (LVEF). 10-12 patches were then applied along the sternum and across the left thorax (3 rd -5 th interspace), incorporating the anterior axilla. The echocardiogram was repeated after 20-30 minutes. Results: LVEF was improved following application of the phototherapy device, increasing from 59.4±5.8% to 66.65±5.8% (Δ 6.3%, p&lt;0.05), predicting an improvement in overall cardiac function. In those with normal diastolic function at baseline, septal E’ increased 7.3±0.57 cm/s to 8.2±0.58 cm/s (Δ 0.87 cm/s, p&lt;0.05), indicating a direct effect on contractility. E and A wave velocities increased 2.46±0.14 cm/s and by 5.7±0.72 cm/s, indicating augmented hemodynamics trending towards significance. Conclusion: Cutaneous phototherapy devices may enhance left ventricular systolic function without the need for drug delivery, gene manipulation, or exogenous light sources.

Abstract 4135617: Large Scale Proteomics Identifies Circulating Biomarkers Relating Atrial Fibrillation to Heart Failure: the Atherosclerosis Risk in Communities Study

Introduction: There is a bidirectional relationship between atrial fibrillation (AF) and heart failure (HF) risk. Data regarding shared and unique pathways underlying each are limited. Aims: Identify plasma proteins associated with both incident AF and HF and determine the extent to which associations with one outcome are conditional on interval occurrence of the other outcome. Methods: Among participants in the community-based Atherosclerosis Risk in Communities study free of HF and AF at study visit 5 (2011-2013), we measured 4,955 plasma proteins (SomaScan aptamer-affinity assay). We performed parallel analyses of individual protein associations with incident HF and AF using multivariable Cox regression adjusted for demographic and clinical covariates at Bonferroni significance. We then repeated the analysis for each outcome in models censoring participants with interval occurrence of the other outcome (i.e. incident AF censoring for interval HF, and vice versa). We tested associations of AF-related proteins with echocardiographic and Zio patch measures at Visit 5. Results: Among 4,118 participants included, mean age was 75±5 years, 60% were female, and 18% reported Black race. We identified 83 proteins associated with incident HF (n=355 incident events at 7 [IQR 6-8] year follow-up) and 24 with incident AF (n=517 incident events at 8 [7-9] years), of which 10 were associated with both. In models of incident HF censoring for interval AF, 63 (76%) proteins remained significantly associated with HF. In contrast, in the analysis of incident AF censoring for interval HF, only 4 (17%) proteins remained associated with AF, of which 3 were also associated with HF risk (Figure). These 4 AF-related proteins were associated with measures of LV diastolic function (LA volume, E/e’. average), LV mass index, LA function (LA reservoir, LA contraction), and supraventricular ectopy density (all p&lt;0.05). Conclusion: Nearly half of proteins reflecting AF risk also associate with HF, greater than 80% of AF-associated proteins are HF-dependent, and even those that are not correlate with measures of LV remodeling and dysfunction. These findings suggest that AF-related mechanisms among older adults are part of a wider HF syndrome.

Widespread resilience of animal species, functional diversity, and predator–prey networks to an unprecedented gigafire

Abstract Climate change is altering fire regimes globally, leading to an increased incidence of large and severe wildfires, including gigafires (&gt;100,000 ha), that homogenise landscapes. Despite this, our understanding of how large, severe wildfires affect biodiversity at the landscape scale remains limited. We investigated the impact of a gigafire that occurred during the unprecedented 2019–20 Australian ‘Black Summer’ on terrestrial fauna. We selected 24 study landscapes, each 0.785 km2 in size, that represented a gradient in the extent of high severity fire, unburnt vegetation, and the diversity of fire severity classes (‘pyrodiversity’). We used wildlife cameras to survey biodiversity across each landscape and quantified species activity, community and functional diversity, and predator–prey network metrics. We used Bayesian mixed‐effects models to assess the influence of fire‐induced landscape properties on these measures. Most native species showed resilience to the 2019–20 wildfires, displaying few relationships with fire‐induced properties of landscapes, including the extent of high severity fire, unburnt vegetation, or pyrodiversity. Community and functional diversity and measures of predator–prey networks were also largely unaffected by fire‐induced landscape properties, although landscapes with a greater proportion of high severity fire had higher abundance and richness of introduced animal species. Synthesis and applications: Despite prevailing narratives of widespread ecological destruction following the 2019–20 wildfires, our findings suggest widespread resilience, potentially facilitated by evolutionary adaptations of animals to fire. Interventions aimed at helping such species recover may not be necessary and could instead focus on the subset of species that are vulnerable to severe fire. While mixed‐severity fires are often advocated to promote biodiversity through pyrodiversity, our results suggest that such management efforts might not be necessary in our study region. Given that severe fire favours introduced animal species, invasive species management could focus on large, severely burnt areas.

Abstract 4131409: Systemic Review and Meta-analysis of Global Longitudinal Strain Changes after Angiotensin Receptor Nephrilysin Inhibitor Initiation in Patients with Heart Failure

Angiotensin Receptor Nephrilysin Inhibitors (ARNi) have been established as a beneficial medication in patients with heart failure (HF). This class of medications has been shown to decrease HF hospitalizations and has been included as one of the pillars in guideline directed medical therapy. Recently, left ventricular (LV) global longitudinal strain (GLS) measurements on echocardiograms have become more common and provide a more precise measurement of LV function than ejection fraction. GLS is now being used as a more intricate way of monitoring improvement in the function of the myocardium, especially in patients with heart failure. This meta-analysis was conducted to determine if treatment with ARNi in HF patients significantly improves myocardial functioning measured by LV GLS. A meta-analysis of 9 studies including observational studies and randomized controlled trials found in a Pubmed search was performed and included patients with heart failure who were initiated on an ARNi for guideline directed medical therapy and had LV GLS measurements taken on an echocardiogram before and after ARNi initiation. The study included patients with heart failure with reduced ejection fraction. Studies were excluded if the patient population did not have a diagnosis of HF and if LV GLS measurements were not available before and after treatment with ARNi. This analysis was performed to determine if initiation of ARNi in patients with HF led to a significant improvement in LV GLS on echocardiography and therefore a significant improvement in myocardial function. There were 9 studies included in the analysis and 879 patients with HF who were treated with ARNi or a control. The change in LV GLS at the conclusion of the study period was measured in both treatment and control groups and the mean difference between the two groups was -1.61 with a 95% confidence interval of (-2.23, -0.98) (p &lt;0.00001). This indicates that the ARNi treatment groups had a significant improvement in GLS compared to the control groups. ARNi initiation was found to significantly improve LV GLS and therefore myocardial function in patients with HF with reduced ejection fraction. LV GLS is a precise measurement of myocardial function. Using this form of measurement in echocardiograms can aid in determining the effect different treatments have directly on myocardial function.

Preliminary findings of expository discourse in older adults

Aims: The purpose of this study was to: 1) examine older adults' ability to deliver coherent discourse in expository discourse elicitation tasks; and 2) explore whether cognitive ability and social behavior activity predict coherent discourse production in healthy older adults, separately by gender. Methods: Study participants included 58 neurologically healthy older adults–male (n\,=\,19) and female (n\,=\,39). For the discourse elicitation task, participants provided their opinion in response to four controversial topics. They also completed executive function measures and social engagement questionnaires. Results: Years of education significantly differed between the two groups; thus, education was used as a covariate. A 2 × 4 mixed analysis of covariance (ANCOVA) was conducted. Main effect differences for gender and topic for discourse coherence were not found. In order to examine the contributions of executive function and social engagement on discourse coherence by gender, multiple regression analysis was conducted. For the male group, social activity and social network were significant predictors of the ability to convey coherent discourse on the healthcare topic. For the female group, only executive function was a significant predictor of the coherent discourse production on the marriage topic. Conclusions: The findings suggest that in the same type of discourse elicitation task, the nature of topic influences performance in elicited expository discourse. Moreover, results indicated that the influence of cognitive ability and social engagement on discourse coherence differed between the two gender groups.

Sex differences in the associations of accelerometer-determined physical activity with physical and cognitive function in older adults living in long-term care

Older adults residing in long-term care often experience declines in physical and cognitive functions despite the access to in-house physical activity (PA) programs. This study aimed to evaluate the associations of PA with physical function and global cognitive function in older adults living in long-term care, while examining potential sex differences. A cross-sectional analysis of baseline data from a two-arm cluster randomized controlled trial was conducted, involving 67 participants (34 men, 33 women). PA levels were assessed using tri-axial accelerometers. Physical function, including muscular strength, postural sway, and Short Physical Performance Battery (SPPB) and cognitive function were measured. Spearman correlation analysis revealed no significant associations between PA metrics and muscular strength, postural sway, or global cognitive function across the entire samples (p ≥ 0.091). Multiple linear regression models were developed for the entire sample, males, and females to examine the associations between PA and physical function measures and global cognitive function. After adjustments for confounders, light PA was significantly associated with higher SPPB sub-scores (gait: β = 0.600, p &amp;lt; 0.001; sit-to-stand: β = 0.574, p &amp;lt; 0.001), faster usual gait speed (β = 0.659, p = 0.012), and shorter sit-to-stand times (β = −0.305, p = 0.041) across the whole sample. Similar significant associations were observed in males between light PA and SPPB scores (total: β = 0.319, p = 0.040; gait: β = 0.532, p &amp;lt; 0.001; sit-to-stand: β = 0.417, p = 0.009), usual gait speed (β = 0.762, p = 0.017), and sit-to-stand times (β = −0.677, p &amp;lt; 0.001). In females, a significant association was found between light PA and global cognitive function (β = 0.319, p = 0.012) after adjusting for confounders. This study highlights sex differences in the association of accelerometer-determined PA with physical and cognitive function in older adults living in long-term care, with LPA showing beneficial effects, especially for physical function in males and for cognitive function in females.

The influence of nutrition on brain aging: A Comprehensive Review

Purpose: Aging is characterized by a progressive decline in physiological functions, including those of the brain. As individuals age, cognitive and emotional functionalities are subject to change, Consequently, it is essential to consider both cognitive abilities and emotional functioning when examining the effects of aging on the brain. Objectives: The objective is to synthesize current scientific evidence on the relationship between nutrition and brain aging, with a specific focus on cognitive abilities as a measure of brain function. Methodology: A systematic review was conducted on nine studies. The PRISMA statement standards were adhered to in this systematic review. Findings: The findings showed how important it is for people to change their diets to prevent the onset and progression of various comorbidities and to encourage healthy aging. The findings of the study included in this Comprehensive review indicate that good aging and a higher quality of life may be achieved by abstaining from bad behaviors, particularly those related to food. Conclusions: The current body of study indicates a relationship between nutrition and brain aging, but additional studies are necessary to expand our understanding of these complex interactions and to develop clear dietary recommendations to support cognitive health across the lifespan.

Sheffield Adaptive Patterned Electrical Stimulation (SHAPES) Therapy for Post Stroke Arm spasticity: study protocol for a 3-arm, a partially blinded, randomised controlled trial

IntroductionPost stroke elbow spasticity (PSES) affects over a third of individuals following stroke and negatively impacts on functional recovery, comfort and quality of life. Drug therapies have limited efficacy and unwanted side effects, botulinum toxin, although effective, is costly, and conventional electrical stimulation therapies are limited long term by habituation. We aim to investigate the efficacy of Sheffield Adaptive Patterned Electrical Stimulation (SHAPES), that delivers temporally and spatially varying pattern of electrical stimulation, against transcutaneous electrical stimulation (TENS) and standard care at reducing PSES.Methods and designOverall, 297 people with PSES will be randomised (1:1:1) to one of 3 arms: Standard care (no electrical stimulation), TENS (conventional patterned electrical stimulation) or SHAPES (adaptive patterned electrical stimulation). Both SHAPES and TENS are delivered using a specially designed electrical stimulation sleeve used for 60 min each day for 6-weeks. Outcome measures are completed at baseline, end of treatment (EOT 6 weeks) and then 6-weeks, 12-weeks and 24-weeks after the end of treatment. Efficacy will be determined based on the proportion of participants experiencing meaningful improvement (18%) in the 7-day Numerical Rating Scale (NRS-S) for PSES, compared between both intervention arms and standard care, and between the two intervention groups. Measures of arm motor function (Action Research Arm Test, MRC scale), and quality of life (SQoL-6D, EQ-5D) will also be measured along with a parallel health economic evaluation.DiscussionThe results of the SHAPES trial will inform management of elbow spasticity after stroke. The SHAPES intervention is a low cost, self-administered intervention for the management of spasticity that can be used repeatedly, and if found to be more effective than TENS or control has the potential to be widely implemented in the UK NHS healthcare setting. Furthermore, despite the wide use of TENS in the management of spasticity, this study will provide critically required evidence regarding its efficacy. The trial has been registered with the ISRCTN registry (ISRCTN26060261).

Structural Brain Characteristics of Chronic Schizophrenia Patients with Different Types of Functional Outcome

Background: studies allowing to explore the neurobiological characteristics of the long-term schizophrenic process are of high significance for both clinical practice and biological psychiatry. Objective: to examine morphometric brain characteristics in chronic schizophrenia patients with different types of functional outcomes. Patients and methods: morphometric MRI characteristics of the cerebral cortex and subcortical structures are analysed in 46 patients with schizophrenia with a long disease durations (20.5 ± 6.7 years), and in 35 mentally healthy subjects matched by sex and age. Results and discussion: the whole group of patients showed decreased gray matter thickness in some cerebral cortex regions. When outcome was assessed using clinical-psychopathologic, clinical-catamnestic, and clinical-epidemiologic methods, bilateral increases in pallidum and putamen volumes were found to be a presumptive marker of worse functional outcome and remission poor quality. At the same time, when outcome was assessed on the basis of the current psychometric measures of social functioning and clinical symptomatology, patients with an unfavorable outcome were characterized by decreased gray matter thickness in the two cingulate cortex regions compared to both healthy controls and patients with a good outcome. However, the absence of correlations with clinical scales and functioning doesn’t allow a conclusion on the specificity of this decrease as a marker of outcome. Conclusion: the results may only presume beforehand the existence of different neuroanatomical subtypes (biotypes) associated with different functional outcomes in patients with chronic schizophrenia.