The effect of COVID-19 isolation measures on the cognition and mental health of people living with dementia: A rapid systematic review of one year of quantitative evidence

BACKGROUND: COVID-19 prevention and control policies have entailed lockdowns and confinement. This study aimed to summarize the global research evidence describing the effect of COVID-19 isolation measures on the health of people living with dementia. METHODS: We searched Pubmed, PsycINFO and CINAHL up to 27th of February 2021 for peer-reviewed quantitative studies about the effects of isolation during COVID-19 on the cognitive, psychological and functional symptoms of people with dementia or mild cognitive impairment. The Joanna Briggs Institute critical appraisal tool was used to conduct the quality assessment. PROSPERO registration: CRD42021229259. FINDINGS: 15 eligible papers were identified, examining a total of 6442 people with dementia. 13/15 studies investigated people living in the community and 2 in care homes. Out of 15 studies, 9 (60%) reported changes in cognition and 14 (93%) worsening or new onset of behavioral and psychological symptoms. Six studies (46%) reported a functional decline in daily activities in a variable proportion of the population analyzed. INTERPRETATION: COVID-19 isolation measures have damaged the cognitive and mental health of people with dementia across the world. It is urgent to issue guidance that balances infection control measures against the principles of non-maleficence to guarantee fair and appropriate care during pandemic times for this population

Performance of spiral-wound membrane modules in organic solvent nanofiltration – Fluid dynamics and mass transfer characteristics

AbstractDuring the past few decades organic solvent nanofiltration has received a great deal of attention and a growing number of studies has been reported on development and optimisation of solvent resistant membranes and their transport mechanism. However, most of these studies have used flat sheet membranes. On the other hand, many researchers studied fluid dynamics and mass transfer in spiral-wound membrane modules, almost exclusively in aqueous solutions. This paper reports the performance of four spiral-wound membrane modules tested in 0–20wt% solutions of sucrose octaacetate in ethyl acetate under various pressures and retentate flowrates. These modules were made of two different types of membranes (a commercial membrane, PuraMem® S600, and a development product, Lab-1, from Evonik Membrane Extraction Technology Limited) and covered three module sizes (1.8″×12″, 2.5″×40″ and 4.0″×40″). All modules had the same feed and permeate spacers. The classical solution diffusion model was applied to describe the transport of solute and solvent through the membrane and regress the unknown model parameters from flat sheet data. Correlations for characterising the fluid dynamics and mass transfer in the spiral-wound membrane modules, as well as the parameters describing the feed and permeate channels, were determined by performing the regression of experimental data of a 1.8″×12″ PuraMem® S600 membrane module. The classical solution–diffusion model, combined with the film theory, was then successfully applied to predict the performance of other modules of larger size (such as the 2.5″×40″ and 4.0″×40″ module sizes) and/or made of a different membrane material (such as Lab-1). The procedure proposed in this paper predicts the performance of a specific module by obtaining a limited number of experimental data for flat sheets and a 1.8″×12″ spiral-wound membrane module only (necessary to obtain the fitting parameters characteristic of the membrane and the module). Furthermore, with this procedure, it is not necessary to know a priori the spacer geometry, because the necessary information about the spacer geometry will be also obtained by regression of few experimental data

Culturally tailored therapeutic interventions for people affected by dementia: a systematic review and new conceptual model

Most people with dementia live in low and middle-income countries (LMICs) and there is an increased dementia prevalence in some minority ethnic groups in high-income countries. However, most interventions are devised for majority populations in high-income countries. We systematically searched 11 electronic databases for culturally tailored interventions for people with dementia and their family carers in LMICs and minority ethnic groups, without limit on language or date. 23 of 22 221 studies fulfilled inclusion criteria. Interventions adapted peripheral intervention components by, for example, translation and reducing the stigma of psychological therapy by emphasising physical illness and learning. Core therapeutic components were not changed. We found evidence-based, multicomponent interventions adapted for Latinx carers were acceptable, feasible, and effective in the USA and Columbia. Interventions developed for carers in India were effective there but not in other LMICs. Culturally adapted cognitive stimulation therapy was acceptable and effective for people with dementia in sub-Saharan Africa. We propose a new conceptual model from our findings to aid implementation of culturally appropriate treatments for people affected by dementia in LMICs and minority ethnic groups. Evidence-based interventions need cultural adaptation for different settings with therapeutic components retained. If they are acceptable, feasible, and remain effective then full effectiveness trials are unnecessary

Protein-DNA charge transport: Redox activation of a DNA repair protein by guanine radical

DNA charge transport (CT) chemistry provides a route to carry out oxidative DNA damage from a distance in a reaction that is sensitive to DNA mismatches and lesions. Here, DNA-mediated CT also leads to oxidation of a DNA-bound base excision repair enzyme, MutY. DNA-bound Ru(III), generated through a flash/quench technique, is found to promote oxidation of the [4Fe-4S](2+) cluster of MutY to [4Fe-4S](3+) and its decomposition product [3Fe-4S](1+). Flash/quench experiments monitored by EPR spectroscopy reveal spectra with g = 2.08, 2.06, and 2.02, characteristic of the oxidized clusters. Transient absorption spectra of poly(dGC) and [Ru(phen)(2)dppz](3+) (dppz = dipyridophenazine), generated in situ, show an absorption characteristic of the guanine radical that is depleted in the presence of MutY with formation instead of a long-lived species with an absorption at 405 nm; we attribute this absorption also to formation of the oxidized [4Fe-4S](3+) and [3Fe4S](1+) clusters. In ruthenium-tethered DNA assemblies, oxidative damage to the 5'-G of a 5'-GG-3' doublet is generated from a distance but this irreversible damage is inhibited by MutY and instead EPR experiments reveal cluster oxidation. With ruthenium-tethered assemblies containing duplex versus single-stranded regions, MutY oxidation is found to be mediated by the DNA duplex, with guanine radical as an intermediate oxidant; guanine radical formation facilitates MutY oxidation. A model is proposed for the redox activation of DNA repair proteins through DNA CT, with guanine radicals, the first product under oxidative stress, in oxidizing the DNA-bound repair proteins, providing the signal to stimulate DNA repair

Patterns in reduction or cessation of drinking in Australia (2001-2013) and motivation for change

Aims: This paper examines: 1) change over time (2001-2013) in recently reducing or ceasing drinking in the Australian population, and 2) the reasons given for reducing or ceasing drinking in the most recent survey (2013); stratified by sex and age group. Methods: Data are from five waves of the National Drug Strategy Household Survey (N=119,397). Logistic regression models with interaction terms were used to identify a shift in sex or age over time in predicting reduction or cessation of drinking, and to predict motivations for reducing or ceasing drinking by sex and age. Results: Reports of recently reducing the quantity or frequency of drinking increased from 2001 to 2007, and remained stable between 2007 and 2013. There was a steady increase in the number of Australians reporting recently ceasing drinking from 2001 to 2013, with a significant effect for age (younger groups more likely than older groups to cease drinking in the past two waves). Reasons for reducing or ceasing drinking varied by age, with older people more likely to report health reasons, and younger people more likely to report lifestyle reasons or enjoyment. Conclusion: Increases over time in reports of reduction or cessation of drinking due to health, lifestyle, social and enjoyment reasons, suggests that the social position of alcohol in Australia may be shifting, particularly among young people

Measuring the prevalence of sleep disturbances in people with dementia living in care homes: a systematic review and meta-analysis

STUDY OBJECTIVES: Sleep disturbances are a feature in people living with dementia, including getting up during the night, difficulty falling asleep, and excessive daytime sleepiness, and may precipitate a person with dementia moving into residential care. There are varying estimates of the frequency of sleep disturbances and it is unknown whether they are a problem for the individual. We conducted the first systematic review and meta-analysis on the prevalence and associated factors of sleep disturbances in the care home population with dementia. // METHODS: We searched Embase, MEDLINE, and PsycINFO (29/04/2019) for studies of the prevalence or associated factors of sleep disturbances in people with dementia living in care homes. We computed meta-analytical estimates of the prevalence of sleep disturbances and used meta-regression to investigate effects of method of measurement, demographics and study characteristics. // RESULTS: We included 55 studies of 22,780 participants. The pooled prevalence on validated questionnaires of clinically significant sleep disturbances was 20% (95% Confidence Interval, CI 16-24%) and of any symptom of sleep disturbance was 38% (95% CI 33%-44%). On actigraphy using a cut-off of sleep efficiency <85% prevalence was 70% (95% CI 55-85%). Staff distress, resident agitation and prescription of psychotropic medications were associated with sleep disturbances. Studies with a higher percentage of males had a higher prevalence of sleep disturbance. // CONCLUSION: Clinically significant sleep disturbances are less common than those measured on actigraphy, and are associated with residents and staff distress, and increased prescription of psychotropics. Actigraphy appears to offer no benefit over proxy reports in this population

Quiet Sun magnetic fields from simultaneous inversions of visible and infrared spectropolarimetric observations

We study the quiet Sun magnetic fields using spectropolarimetric observations of the infrared and visible Fe I lines at 6301.5, 6302.5, 15648 and 15653 A. Magnetic field strengths and filling factors are inferred by the simultaneous fit of the observed Stokes profiles under the MISMA hypothesis. The observations cover an intra-network region at the solar disk center. We analyze 2280 Stokes profiles whose polarization signals are above noise in the two spectral ranges, which correspond to 40% of the field of view. Most of these profiles can be reproduced only with a model atmosphere including 3 magnetic components with very different field strengths, which indicates the co-existence of kG and sub-kG fields in our 1.5" resolution elements. We measure an unsigned magnetic flux density of 9.6 G considering the full field of view. Half of the pixels present magnetic fields with mixed polarities in the resolution element. The fraction of mixed polarities increases as the polarization weakens. We compute the probability density function of finding each magnetic field strength. It has a significant contribution of kG field strengths, which concentrates most of the observed magnetic flux and energy. This kG contribution has a preferred magnetic polarity, while the polarity of the weak fields is balanced.Comment: 16 pages and 14 figure

MCNP Simulations of Measurement of Insulation Compaction in the Cryogenic Rocket Fuel Tanks at Kennedy Space Center by Fast/Thermal Neutron Techniques

MCNP simulations have been run to evaluate the feasibility of using a combination of fast and thermal neutrons as a nondestructive method to measure of the compaction of the perlite insulation in the liquid hydrogen and oxygen cryogenic storage tanks at John F. Kennedy Space Center (KSC). Perlite is a feldspathic volcanic rock made up of the major elements Si, AI, Na, K and 0 along with some water. When heated it expands from four to twenty times its original volume which makes it very useful for thermal insulation. The cryogenic tanks at Kennedy Space Center are spherical with outer diameters of 69-70 feet and lined with a layer of expanded perlite with thicknesses on the order of 120 cm. There is evidence that some of the perlite has compacted over time since the tanks were built 1965, affecting the thermal properties and possibly also the structural integrity of the tanks. With commercially available portable neutron generators it is possible to produce simultaneously fluxes of neutrons in two energy ranges: fast (14 Me V) and thermal (25 me V). The two energy ranges produce complementary information. Fast neutrons produce gamma rays by inelastic scattering, which is sensitive to Fe and O. Thermal neutrons produce gamma rays by prompt gamma neutron activation (PGNA) and this is sensitive to Si, Al, Na, K and H. The compaction of the perlite can be measured by the change in gamma ray signal strength which is proportional to the atomic number densities of the constituent elements. The MCNP simulations were made to determine the magnitude of this change. The tank wall was approximated by a I-dimensional slab geometry with an 11/16" outer carbon steel wall, an inner stainless wall and 120 cm thick perlite zone. Runs were made for cases with expanded perlite, compacted perlite or with various void fractions. Runs were also made to simulate the effect of adding a moderator. Tallies were made for decay-time analysis from t=0 to 10 ms; total detected gamma-rays; detected gamma-rays from thermal neutron reactions d. detected gamma-rays from non-thermal neutron reactions and total detected gamma-rays as a function of depth into the annulus volume. These indicated a number of possible independent metrics of perlite compaction. For example the count rate for perlite elements increased from 3600 to 8500 cps for an increase in perlite density from 6 lbs/lcf to 16.5 lbs/cf. Thus the MCNP simulations have confirmed the feasibility of using neutron methods to map the compaction of perlite in the walls of the cryogenic tanks