Improving the delivery of care for patients with diabetes through understanding optimised team work and organisation in primary care

Peer reviewedPublisher PD

Carbon and nitrogen isotopic ratios of urine and faeces as novel nutritional biomarkers of meat and fish intake

Purpose Meat and fish consumption are associated with changes in the risk of chronic diseases. Intake is mainly assessed using self-reporting, as no true quantitative nutritional biomarker is available. The measurement of plasma fatty acids, often used as an alternative, is expensive and time-consuming. As meat and fish differ in their stable isotope ratios, δ13C and δ15N have been proposed as biomarkers. However, they have never been investigated in controlled human dietary intervention studies. Objective In a short-term feeding study, we investigated the suitability of δ13C and δ15N in blood, urine and faeces as biomarkers of meat and fish intake. Methods The dietary intervention study (n = 14) followed a randomised cross-over design with three eight-day dietary periods (meat, fish and half-meat–half-fish). In addition, 4 participants completed a vegetarian control period. At the end of each period, 24-h urine, fasting venous blood and faeces were collected and their δ13C and δ15N analysed. Results There was a significant difference between diets in isotope ratios in faeces and urine samples, but not in blood samples (Kruskal–Wallis test, p < 0.0001). In pairwise comparisons, δ13C and δ15N were significantly higher in urine and faecal samples following a fish diet when compared with all other diets, and significantly lower following a vegetarian diet. There was no significant difference in isotope ratio between meat and half-meat–half-fish diets for blood, urine or faecal samples. Conclusions The results of this study show that urinary and faecal δ13C and δ15N are suitable candidate biomarkers for short-term meat and fish intake

How Much Do Focal Infarcts Distort White Matter Lesions and Global Cerebral Atrophy Measures?

BACKGROUND: White matter lesions (WML) and brain atrophy are important biomarkers in stroke and dementia. Stroke lesions, either acute or old, symptomatic or silent, are common in older people. Such stroke lesions can have similar signals to WML and cerebrospinal fluid (CSF) on magnetic resonance (MR) images, and may be classified accidentally as WML or CSF by MR image processing algorithms, distorting WML and brain atrophy volume from the true volume. We evaluated the effect that acute or old stroke lesions at baseline, and new stroke lesions occurring during follow-up, could have on measurement of WML volume, cerebral atrophy and their longitudinal progression. METHODS: We used MR imaging data from patients who had originally presented with acute lacunar or minor cortical ischaemic stroke symptoms, recruited prospectively, who were scanned at baseline and about 3 years later. We measured WML and CSF volumes (ml) semi-automatically. We manually outlined the acute index stroke lesion (ISL), any old stroke lesions present at baseline, and new lesions appearing de novo during follow-up. We compared baseline and follow-up WML volume, cerebral atrophy and their longitudinal progression excluding and including the acute ISL, old and de novo stroke lesions. A non-parametric test (Wilcoxon's signed rank test) was used to compare the effects. RESULTS: Among 46 patients (mean age 72 years), 33 had an ISL visible on MR imaging (median volume 2.05 ml, IQR 0.88–8.88) and 7 of the 33 had old lacunes at baseline: WML volume was 8.54 ml (IQR 5.86–15.80) excluding versus 10.98 ml (IQR 6.91–24.86) including ISL (p < 0.001). At follow-up, median 39 months later (IQR 30–45), 3 patients had a de novo stroke lesion; total stroke lesion volume had decreased in 11 and increased in 22 patients: WML volume was 12.17 ml (IQR 8.54–19.86) excluding versus 14.79 ml (IQR 10.02–38.03) including total stroke lesions (p < 0.001). Including/excluding lacunes at baseline or follow-up also made small differences. Twenty-two of the 33 patients had tissue loss due to stroke lesions between baseline and follow-up, resulting in a net median brain tissue volume loss (i.e. atrophy) during follow-up of 24.49 ml (IQR 12.87–54.01) excluding versus 24.61 ml (IQR 15.54–54.04) including tissue loss due to stroke lesions (p < 0.001). Including stroke lesions in the WML volume added substantial noise, reduced statistical power, and thus increased sample size estimated for a clinical trial. CONCLUSIONS: Failure to exclude even small stroke lesions distorts WML volume, cerebral atrophy and their longitudinal progression measurements. This has important implications for design and sample size calculations for observational studies and randomised trials using WML volume, WML progression or brain atrophy as outcome measures. Improved methods of discriminating between stroke lesions and WML, and between tissue loss due to stroke lesions and true brain atrophy are required

The Influence of Direct and Indirect Speech on Mental Representations

Language can be viewed as a set of cues that modulate the comprehender's thought processes. It is a very subtle instrument. For example, the literature suggests that people perceive direct speech (e.g., Joanne said: 'I went out for dinner last night') as more vivid and perceptually engaging than indirect speech (e.g., Joanne said that she went out for dinner last night). But how is this alleged vividness evident in comprehenders' mental representations? We sought to address this question in a series of experiments. Our results do not support the idea that, compared to indirect speech, direct speech enhances the accessibility of information from the communicative or the referential situation during comprehension. Neither do our results support the idea that the hypothesized more vivid experience of direct speech is caused by a switch from the visual to the auditory modality. However, our results do show that direct speech leads to a stronger mental representation of the exact wording of a sentence than does indirect speech. These results show that language has a more subtle influence on memory representations than was previously suggested

Scanpath analysis of expertise and culture in teacher gaze in real-world classrooms

Humans are born to learn by understanding where adults look. This is likely to extend into the classroom, making teacher gaze an important topic for study. Expert teacher gaze has mainly been investigated in the laboratory, and has focused mostly on one cognitive process: teacher attentional (i.e., information-seeking) gaze. No known research has made direct cultural comparisons of teacher gaze or successfully found expert–novice differences outside Western settings. Accordingly, we conducted a real-world study of expert teacher gaze across two cultural settings, exploring communicative (i.e., information-giving) as well as attentional gaze. Forty secondary school teachers wore eye-tracking glasses, with 20 teachers (10 expert; 10 novice) from the UK and 20 teachers (10 expert; 10 novice) from Hong Kong. We used a novel eye-tracking scanpath analysis to ascertain the importance of expertise and culture, individually and as a combination. Attentional teacher scanpaths were significantly more similar within than across expertise and expertise + culture sub-groups; communicative scanpaths were significantly more similar within than across expertise and culture. Detailed analysis suggests that (1) expert teachers refer back to students constantly through focused gaze during both attentional and communicative gaze and that (2) expert teachers in Hong Kong scan students more than experts do in the UK

Evaluating the Robustness of Parameter Estimates in Cognitive Models: A Meta-Analytic Review of Multinomial Processing Tree Models Across the Multiverse of Estimation Methods

Researchers have become increasingly aware that data-analysis decisions affect results. Here, we examine this issue systematically for multinomial processing tree (MPT) models, a popular class of cognitive models for categorical data. Specifically, we examine the robustness of MPT model parameter estimates that arise from two important decisions: the level of data aggregation (complete-pooling, no-pooling, or partial-pooling) and the statistical framework (frequentist or Bayesian). These decisions span a multiverse of estimation methods. We synthesized the data from 13,956 participants (164 published data sets) with a meta-analytic strategy and analyzed the magnitude of divergence between estimation methods for the parameters of nine popular MPT models in psychology (e.g., process-dissociation, source monitoring). We further examined moderators as potential sources of divergence. We found that the absolute divergence between estimation methods was small on average (<.04; with MPT parameters ranging between 0 and 1); in some cases, however, divergence amounted to nearly the maximum possible range (.97). Divergence was partly explained by few moderators (e.g., the specific MPT model parameter, uncertainty in parameter estimation), but not by other plausible candidate moderators (e.g., parameter trade-offs, parameter correlations) or their interactions. Partial-pooling methods showed the smallest divergence within and across levels of pooling and thus seem to be an appropriate default method. Using MPT models as an example, we show how transparency and robustness can be increased in the field of cognitive modeling

Evaluating the Robustness of Parameter Estimates in Cognitive Models: A Meta-Analytic Review of Multinomial Processing Tree Models Across the Multiverse of Estimation Methods

Researchers have become increasingly aware that data-analysis decisions affect results. Here, we examine this issue systematically for multinomial processing tree (MPT) models, a popular class of cognitive models for categorical data. Specifically, we examine the robustness of MPT model parameter estimates that arise from two important decisions: the level of data aggregation (complete-pooling, no-pooling, or partial-pooling) and the statistical framework (frequentist or Bayesian). These decisions span a multiverse of estimation methods. We synthesized the data from 13,956 participants (164 published data sets) with a meta-analytic strategy and analyzed the magnitude of divergence between estimation methods for the parameters of nine popular MPT models in psychology (e.g., process-dissociation, source monitoring). We further examined moderators as potential sources of divergence. We found that the absolute divergence between estimation methods was small on average (&lt;.04; with MPT parameters ranging between 0 and 1); in some cases, however, divergence amounted to nearly the maximum possible range (.97). Divergence was partly explained by few moderators (e.g., the specific MPT model parameter, uncertainty in parameter estimation), but not by other plausible candidate moderators (e.g., parameter trade-offs, parameter correlations) or their interactions. Partial-pooling methods showed the smallest divergence within and across levels of pooling and thus seem to be an appropriate default method. Using MPT models as an example, we show how transparency and robustness can be increased in the field of cognitive modeling. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Gender Separation Increases Somatic Growth in Females but Does Not Affect Lifespan in Nothobranchius furzeri

According to life history theory, physiological and ecological traits and parameters influence an individual's life history and thus, ultimately, its lifespan. Mating and reproduction are costly activities, and in a variety of model organisms, a negative correlation of longevity and reproductive effort has been demonstrated. We are employing the annual killifish Nothobranchius furzeri as a vertebrate model for ageing. N. furzeri is the vertebrate displaying the shortest known lifespan in captivity with particular strains living only three to four months under optimal laboratory conditions. The animals show explosive growth, early sexual maturation and age-dependent physiological and behavioural decline. Here, we have used N. furzeri to investigate a potential reproduction-longevity trade-off in both sexes by means of gender separation. Though female reproductive effort and offspring investment were significantly reduced after separation, as investigated by analysis of clutch size, eggs in the ovaries and ovary mass, the energetic surplus was not reallocated towards somatic maintenance. In fact, a significant extension of lifespan could not be observed in either sex. This is despite the fact that separated females, but not males, grew significantly larger and heavier than the respective controls. Therefore, it remains elusive whether lifespan of an annual species evolved in periodically vanishing habitats can be prolonged on the cost of reproduction at all